Outdoor exposure to formaldehyde (CH2O) is associated with an increased risk of hospitalization for respiratory diseases in children

Background and aims: Children living near wood industries have an increased risk of developing respiratory diseases. We aimed at assessing if residential outdoor exposure to NO2 and CH2O was associated with the risk of hospitalization for respiratory diseases in children. Methods: In 2006, all the children (3-14 years) living in the Viadana district (the largest wood manufacturing areas in Northern Italy) were surveyed through a parental questionnaire (n=3854) and their home addresses were geocoded. Their history of hospitalization for respiratory diseases (ICD-IX: 460-519) was assessed from January 2007 to December 2009, using discharge records obtained from the local Health Unit. To assess the outdoor exposure to NO2 and CH2O, 63 passive samplers were installed in the area using a Partitioning Around Medoids (PAM) algorithm. Pollutants were monitored twice, both in winter and in summer 2010. Kriging interpolation was used to attribute the average annual concentration of pollutants to each child. Poisson regression models were used to assess the association between the hospitalization rates (HR) and the average concentration of pollutants. Results: By December 2010, 3798 (98.5%) children had been traced. During the 3 years of follow-up, 121 hospital admissions, caused by respiratory diseases, occurred (annual HR = 10.8/1000/year). The HR for respiratory diseases slightly increased with increasing outdoor exposure to NO2 (µg/m3 ) (RR:1.02; 95%CI: 0.95-1.10), while they were strongly associated to CH2O outdoor concentration (µg/m3 ) (RR:2.41; 95%CI: 1.07-5.43). Conclusions: Emissions from wood industries apparently have a serious impact on children's healt

O-072: Outdoor Exposure to NO2 and Formaldehyde is Associated with Increased Genotoxic Damage in Children

Background: Industrial air pollution may be a health hazard for exposed people. Objectives: Residential outdoor exposure to NO2 and formaldehyde was evaluated and associated with early genotoxic damage, in buccal mucosa cells of children who lived in the largest chipboard manufacturing area in Northern Italy (Viadana). Methods: In 2010, randomly selected children (6-12 years) living in the Viadana district were surveyed through a parental questionnaire. DNA strand breaks and nuclear abnormalities were evaluated by the comet and micronucleus assays respectively. During the same year and in the same area, 63 passive samplers were installed, and NO2 and formaldehyde levels were monitored both in winter and summer. Kriging interpolation was used to attribute the average annual concentration of pollutants to each child’s residential address. Results: 417 out of 656 eligible children (64%) took part in the study. Children who lived near (<2km) the chipboard industries had a higher mean exposure to outdoor NO2 and formaldehyde (p<0.001). A 1- standard deviation (SD) increase in formaldehyde (+0.16 µg/m3) was associated with an increase of 10% (95%CI: 5-20%) in the comet tail intensity and of 10% (95%CI: 1-19%) in the frequency of nuclear buds. A 1-SD increase in NO2 (+1.50 µg/m3) was associated with a 12% (95%CI: 6-18%) increase in binucleated cells and with a 12% (95%CI: 4-21%) increase in nuclear buds. Conclusions: Exposure to pollutants emitted by chipboard industries statistically significantly increased DNA damage and nuclear abnormalities in children’s buccal mucosa cells

Outdoor exposure to formaldehyde is associated with increased DNA damage and respiratory symptoms in children

Background: Exposure to air pollutants emitted by industrial sources may be a health hazard for children living nearby. Objectives: to evaluate whether residential outdoor exposure to formaldehyde was associated with DNA damage and with respiratory symptoms in children who lived in the largest chipboard manufacturing area in Northern Italy (Viadana). Methods: In 2010, randomly selected children (6-12 years) living in the Viadana district were surveyed through a parental questionnaire on respiratory symptoms. A score was devised to evaluate the presence/intensity of asthma-like symptoms. DNA strand breaks and nuclear abnormalities of the oral mucosa cells were analyzed by the comet and micronucleus assays respectively. Passive samplers (n=63) were installed in the area to monitor formaldehyde both in winter and summer 2010. Kriging interpolation was used to estimate the concentration of formaldehyde of each child. Appropriate regression models were fitted to the data. Results: 417 out of 656 eligible children (64%) took part in the study. Children living near (<2km) the chipboard factories had the highest (p<0.001) formaldehyde exposure. A 1-standard deviation increase in formaldehyde (+0.16 µg/m³) was associated with an increase of 10% (95%CI: 5-20%) in the comet tail intensity and of 10% (95%CI: 1-19%) in the frequency of nuclear buds. Children exposed to the highest level of formaldehyde (>85th centile) had an increased risk of asthma like symptoms (OR=2.1; 1.1-4.2). Conclusions: Exposure to pollutants emitted by chipboard industries statistically significantly increased DNA damage and asthma-like symptoms in childre

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

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

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

Of cytochrome P450 isoenzymes in drug metabolism. Clinical aspects

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Kinetics of platinum in cancer patients treated with cisplatin at different doses

In this study were analyzed the kinetics of cisplatin in patients affected by different type of cance