COVID-19 MORTALITY IN LOMBARDY: THE VULNERABILITY OF THE OLDEST OLD AND THE RESILIENCE OF MALE CENTENARIANS

Italy was the first European nation to be affected by COVID-19. The biggest cluster of cases occurred in Lombardy, the most populous Italian region, and elderly men were the population hit in the hardest way. Besides its high infectivity, COVID-19 causes a severe cytokine storm and old people, especially those with comorbidities, appear to be the most vulnerable, presumably in connection to inflammaging. In centenarians inflammaging is much lower than predicted by their chronological age and females, presenting survival advantage in almost all centenarian populations, outnumber males, a phenomenon particularly evident in Northern Italy. Within this scenario, we wondered if: a) the COVID-19 mortality in centenarians was lower than that in people aged between 50 and 80 and b) the mortality from COVID-19 in nonagenarians and centenarians highlighted gender differences. We checked COVID-19-related vulnerability/mortality at the peak of infection (March 2020), using data on total deaths (i.e. not only confirmed COVID-19 cases). Our conclusion is that excess mortality increases steadily up to very old ages and at the same time men older than 90 years become relatively more resilient than age-matched females

STEAM GRANULATION VERSUS WET GRANULATION: IMPACT ON GRANULE AND TABLETS PROPERTIES

Steam granulation (SG) involves the use of steam as the granulating medium instead of traditional liquid water [1]. Steam provides a higher diffusion rate into the powder bed and a more favourable thermal balance during the drying step. Due to the ability of the steam to diffuse, a reduction of up to 50% of the amount of water necessary for granulation is possible. Furthermore, the literature reports that the granules produced by SG have a larger surface area than those obtained with wet granulation (WG) [2]. However, no articles have been published on the effect of steam on the compressibility characteristics of the granules. The purpose of this study was to compare the technological properties of granules and their relative tablets obtained with SG and WG. To evaluate the effect of the solubility and thickening power of the diluents on process performance, different formulations were used containing 20% (w/w) caffeine as a model drug, 50% (w/w) microcrystalline cellulose as granulating aid and 30% (w/w) diluent (maltodextrin, sorbitol, lactose or corn starch) were used. The preliminary rheological characterizations performed on the four formulations highlighted that SG requires a lower amount of liquid binder than conventional WG; moreover, SG generally allows better control of granule growth because it occurs more slowly than WG. Granulation experiments were performed using a standardized experimental procedure, and the granules, after drying in a ventilated oven, were characterized by sieve analysis to evaluate the particle size distribution and by measuring the tensile strength and uniformity of the content. A compression study was also performed to identify the compression mechanism. The granules obtained with SG are generally smaller, with a narrow particle size distribution and lower crushing strength. The granules were then compressed in a single punch tablet machine using different compression forces, and the tablets that had a tensile strength of 1-2 MPa were characterized by mass and content uniformity tests, disintegration and dissolution tests. The results demonstrate that the granules manufactured through SG have better compression properties and the tablets present shorter disintegration time and a faster caffeine release than those achieved through WG. [1] S. Shanmugam, Granulation techniques and technologies: recent progress. BioImpacts (2015) 5 (1) 55-63. [2] M. Vialpaldo, B. Albertini, N. Passerini, D. Bergers, P. Rombaut, J.A. Martens, G. Van Den Mooter, Agglomeration of mesoporous silica by melt and steam granulation. Part I: A comparison between disordered and ordered mesoporous silica. Journal of Pharmaceutical Sciences, 102 (2013) 3966-3977

OCT Biomarkers in Neovascular Age-Related Macular Degeneration: A Narrative Review

Age-related macular degeneration (AMD) is the leading cause of legal blindness in elderly people. Neovascular AMD (nAMD) is responsible for the majority of cases of severe visual loss in eyes with AMD. Optical coherence tomography (OCT) is the most widely used technology for the diagnosis and follow-up of nAMD patients, which is widely used to study and guide the clinical approach, as well as to predict and evaluate treatment response. &e aim of this review is to describe and analyze various structural OCT-based biomarkers, which have practical value during both initial assessment and treatment follow-up of nAMD patients. While central retinal thickness has been the most common and one of the first OCTidentified biomarkers, today, other qualitative and quantitative biomarkers provide novel insight into disease activity and offer superior prognostic value and better guidance for tailored therapeutic management. &e key importance of retinal fluid compartmentalization (intraretinal fluid, subretinal fluid, and subretinal pigment epithelium (RPE) fluid) will be discussed firstly. In the second part, the structural alterations of different retinal layers in various stages of the disease (photoreceptors layer integrity, hyperreflective dots, outer retinal tubulations, subretinal hyperreflective material, and retinal pigment epithelial tears) will be analyzed in detail. &e last part of the review will focus on how alterations of the vitreoretinal interface (vitreomacular adhesion and traction) and of the choroid (sub-RPE hyperreflective columns, prechoroidal clefts, choroidal caverns, choroidal thickness and choroidal volume, and choroidal vascular index) interact with nAMD progression. OCT technology is evolving very quickly, and new retinal biomarkers are continuously described. &is up-to-date review article provides a comprehensive description on how structural OCT-based biomarkers provide a valuable tool to monitor the progression of the disease and the treatment response in nAMD patients. &us, in this perspective, clinicians will be able to allocate hospital resources in the best possible way and tailor treatment to the individual patient\u2019s needs

What do we learn from the clinical and biological evaluation of the oral cavity in centenarians?

The number of centenarians is rapidly increasing worldwide and so are the studies on this segment of the population. A general consensus in the literature is that healthy longevity is an outcome of multiple factors, but the interrelationship between good oral health and healthy aging remains not fully understood. As part of the \u201cCaT: Centenari a Trieste\u201d study, a population-based cohort study set in Trieste, Italy, we report here the results of subjective self-reported oral health parameters and objective clinical and biological oral variables and their association with cognitive impairment in 25 centenarians enrolled in the study from September 2017 to May 2019. Oral health-related variables were recorded by means of a self-evaluation questionnaire and a compre- hensive oral examination of teeth, prostheses and mucosae conducted by a trained dentist. In addition, 6-n- propylthiouracil (PROP) taste perception and salivary oxidative stress markers, specifically the Total Oxidative Status and Ferric Reducing Ability of Saliva, were measured. Finally, the oral data obtained were compared with the presence or absence of dementia in the enrolled subjects. The centenarians included in our study were generally satisfied with their oral health. Among the causes of discomfort, the most prevalent were difficulties in chewing and biting, with few subjects describing a correlation between their oral health and psycho-social issues. We evaluated possible relations of clinical and biological variables to the likelihood of being demented and did not find significant associations. We found a higher though not statistically significant mean salivary flow and antioxidant capacity of saliva in non-demented subjects. When evaluating the PROP taste perception profile, we found a higher proportion of supertasters compared with previous studies and different taste perception profiles according to dementia. Despite the relatively small number of participants, we believe that our study contributes to a better understanding of the clinical and biological profile of the oral cavity in subjects aged over 100 years, encouraging the inclusion of a comprehensive evaluation of the oral cavity in centenarian studies performed worldwide

Genres littéraires et gender dans les Amériques

Genres littéraires et gender dans les Amériques présente une série de dix-huit articles qui explorent l’inscription des rapports de genre dans le champ littéraire dans la lignée des travaux de Christine Planté. Au-delà de l’idée qui associe les genres littéraires à une classification et à une hiérarchisation dans le champ littéraire, c’est à l’aune de la généricité que nous avons souhaité approcher la littérature contemporaine écrite par les femmes des Amériques. Il s’agit de savoir comment les écrivaines négocient les paradigmes patriarcaux autour du pouvoir et du savoir (dont le système des genres et le gender sont des supports structurels) pour donner à lire des œuvres littéraires plurielles, dynamiques, dégagées des carcans de la classification au profit de l’intergénéricité comme force structurante de l’écriture