Frailty assessment in an unselected population admitted to an intensive cardiac care unit

Abstract Background Although interest in frailty has expanded among cardiology experts over the past 2 decades, its integration, as part of cardiovascular disease management, is still lacking, above all in the acute cardiac care setting. The Clinical Frailty Scale (CFS) is a brief guided tool to assess frailty in hospital settings without specialist equipment. Purpose Our objective was to test the performance of the CFS in an older, unselected population, admitted to an Intensive Cardiac Care Unit (ICCU) during the year 2019. Methods The study sample included 431 patients ≥65 years old, admitted to an ICCU of a tertiary cardiac center in Italy. The CFS ranged from "very fit: 1" to "terminally ill: 9", but it was considered present at a score ≥5. Our primary endpoint was defined by a combination of severe complications requiring critical care and in-hospital death. The data were collected from the hospital discharge summary and the electronic chart records. Results 158 patients (36.7%) were frail. These individuals had greater comorbidity and higher in-hospital mortality (Table 1). After a multivariable logistic regression analysis, 4 predictors were identified: signs of congestive heart failure (OR: 8.51, 95% Confidence Interval-CI: 4.63–14.6; p<0,001), systolic blood pressure (OR per 1 mmHg increasing: 0.98, 95% CI: 0.97–0.99; p<0,001), smoking habit (OR: 0.49, 95% CI: 0.22–1.11; p=0.09) and the CFS ≥5 (OR: 1.86, 95% CI: 1.08–3.23: p=0,026). Conclusions The CFS is a simple guided frailty tool that may enhance outcome prediction in the acute cardiac care setting. These findings merit evaluation in larger cohorts of unselected patients. Funding Acknowledgement Type of funding sources: None

Parent–child interactions and obesity prevention : a systematic review of the literature

Child obesity research has generally not examined multiple layers of parent&ndash;child relationships during weight-related activities such as feeding, eating and play. A literature review was conducted to locate empirical studies that measured parent&ndash; child interactions and child eating and child weight variables; five papers met the inclusion criteria and were included in the review. The findings of the review revealed that parent&ndash;child relationships are an important element in explaining the unhealthy trend of childhood obesity. We argue that prevention/intervention strategies must extend on the current models of parenting by targeting the family from a bi-directional perspective, and focusing, specifically, on the mutually responsive orientation that exists in the parent&ndash;child relationship.<br /

Using Online Role-playing Games for Entrepreneurship Training

This edited collection of chapters explores the application, potential and challenges of game-based learning and gamification across multiple disciplines and sectors, including psychology, education, business, history, languages and the ..

Resident lactic acid bacteria in raw milk Canestrato Pugliese cheese

Aims: Investigation of the autochthonous lactic acid bacteria (LAB) population of the raw milk Protected Designation of Origin Canestrato Pugliese cheese using phenotypic and genotypic methodologies. Methods and Results: Thirty phenotypic assays and three molecular techniques (restriction fragment length polymorphism, partial sequencing of the 16S rRNA gene and recA multiplex PCR assay) were applied to the identification of 304 isolates from raw milk Canestrato Pugliese cheese. As a result, 168 of 207 isolates identified were ascribed to genus Enterococcus, 25 to Lactobacillus, 13 to Lactococcus and one to Leuconostoc. More in details, among the lactobacilli, the species Lactobacillus brevis and Lactobacillus plantarum were predominant, including 13 and 10 isolates respectively, whereas among the lactococci, Lactococcus cremoris subsp. cremoris was the species more frequently detected (seven isolates). Conclusions: Except for the enterococci, phenotypic tests were not reliable enough for the identification of the isolates, if not combined to the genotype-based molecular techniques. The polyphasic approach utilized allowed 10 different LAB species to be detected; thus suggesting the appreciable LAB diversity of the autochthonous microbial population of the Canestrato Pugliese cheese. Significance and Impact of the Study: A comprehensive study of the resident raw milk Canestrato Pugliese cheese microbial population has been undertaken

Cianosis después del cierre quirúrgico de una comunicación interauricular

El cierre en el momento oportuno de las comunicaciones interauriculares (CIA) del tipo defecto de fosa oval, ostium secundum en la nomenclatura anglosajona, garantiza una vida normal y el riesgo quirúrgico tiende a cero. Pero existe una variedad de estas malformaciones congénitas que induce a errores quirúrgicos que, aunque raros, se siguen repitiendo desde el inicio de la cirugía cardíaca. Se trata de las CIA con limbo incompleto situadas en la parte inferior del septo, que se extienden hasta la desembocadura de la vena cava inferior y coinciden con una válvula de Eustaquio grande. En estos casos se puede producir una desviación inadvertida de la vena cava inferior hacia la aurícula izquierda al suturar erróneamente los bordes del limbo a la válvula de Eustaquio. Informamos de un niño de 7 años, operado 2 años antes de una CIA, que presentaba cianosis y disnea de esfuerzo, y del tratamiento quirúrgico seguido para su corrección. Para prevenir esta complicación es importante prestar atención a la anatomía y comenzar el cierre de las CIA por su extremo inferior