Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Continuous flow single-atom catalysis: a viable organic process technology?

Heterogeneous catalysis under continuous flow conditions is increasingly used by the chemical industry to synthesize fine chemicals. Is single-atom catalysis a technically and economically viable organic process technology? Early results suggest valuable insight en route to the industrial uptake of SAC in the production of fine and specialty chemicals

Graphene oxide in palladium nanoparticle (GrafeoPlad): a new class of catalytic materials for heterogeneous catalysis

By encapsulating graphene oxide in palladium metal nanoparticles and reporting the first application of the resulting metal-organic alloys to nitrobenzene hydrogenation with hydrazine at room temperature, we introduce a completely new class of catalytic materials dubbed herein “GrafeoPlad” for designing platinum-group metals doped with 3D entrapped graphene oxide. This new class of hybrid materials opens practically relevant new perspectives in many areas of today’s catalysis science and technology

Practical aspects concerning catalysis with molecularly doped metals

Ranging from silver-entrapped dyes and gold-entrapped enzymes through palladium-entrapped graphene oxide, molecularly doped metals (or metal organic alloys, MORALs) are active, stable and uniquely versatile catalysts in a number of reactions of relevance to the chemical industry. Reactions successfully catalyzed by MORALs concern both industry’s main sectors, producing bulk and fine chemicals. Though first reported in 2005, and clearly holding a great applicative potential, their use in catalysis is still surprisingly limited. This study investigates a number of practical aspects concerning molecularly doped metals as heterogeneous catalysts

Catalytic performance of gold catalysts in the total oxidation of VOCs

Catalysts for the oxidation of volatile organic compounds (VOCs) were prepared by supporting 1% gold on cerium and zirconium oxides (CeO2, Ce0.5Zr0.5O2, ZrO2) using a simple impregnation method followed by reduction of gold in the presence or absence of ammonia (N). The catalysts were tested in model reactions, namely the total oxidation of benzene, hexane and chlorobenzene, using a micro flow reactor at atmospheric pressure in the temperature range 100–500°C and their activity was compared to that of Au/TiO2 and Au/Fe2O3 reference catalysts supplied by the World Gold Council (WGC). Benefits on the light-off temperatures were observed by adding gold to cerium-containing oxides: 100% conversion of hexane was obtained with Au/Ce0.5Zr0.5O2 at the lowest temperature (300°C). Full conversion of benzene was reached at only 250°C with Au/CeO2 (N), at 290°C with Au/Fe2O3 (WGC) and at 300°C with Au/Ce0.5Zr0.5O2. In the case of chlorobenzene oxidation, the addition of gold was of even greater relevance because of a drop in the light-off temperature of over 100°C for Au/Ce0.5Zr0.5O2 and Au/CeO2, with respect to the gold-free oxide supports; but in this case rapid deactivation took place