Stress echocardiography in Italian echocardiographic laboratories: A survey of the Italian society of echocardiography and cardiovascular imaging

Background: The Italian Society of Echography and Cardiovascular Imaging (SIECVI) conducted a national survey to understand the volumes of activity, modalities and stressors used during stress echocardiography (SE) in Italy. Methods: We analyzed echocardiography laboratory activities over a month (November 2022). Data were retrieved through an electronic survey based on a structured questionnaire, uploaded on the SIECVI website. Results: Data were obtained from 228 echocardiographic laboratories, and SE examinations were performed in 179 centers (80.6%): 87 centers (47.5%) were in the northern regions of Italy, 33 centers (18.4%) were in the central regions, and 61 (34.1%) in the southern regions. We annotated a total of 4057 SE. We divided the SE centers into three groups, according to the numbers of SE performed: <10 SE (low-volume activity, 40 centers), between 10 and 39 SE (moderate volume activity, 102 centers) and >= 40 SE (high volume activity, 37 centers). Dipyridamole was used in 139 centers (77.6%); exercise in 120 centers (67.0%); dobutamine in 153 centers (85.4%); pacing in 37 centers (21.1%); and adenosine in 7 centers (4.0%). We found a significant difference between the stressors used and volume of activity of the centers, with a progressive increase in the prevalence of number of stressors from low to high volume activity (P = 0.033). The traditional evaluation of regional wall motion of the left ventricle was performed in all centers, with combined assessment of coronary flow velocity reserve (CFVR) in 90 centers (50.3%): there was a significant difference in the centers with different volume of SE activity: the incidence of analysis of CFVR was significantly higher in high volume centers compared to low - moderate - volume (32.5%, 41.0% and 73.0%, respectively, P < 0.001). The lung ultrasound (LUS) was assessed in 67 centers (37.4%). Furthermore for LUS, we found a significant difference in the centers with different volume of SE activity: significantly higher in high volume centers compared to low - moderate - volume (25.0%, 35.3% and 56.8%, respectively, P < 0.001). Conclusions: This nationwide survey demonstrated that SE was significantly widespread and practiced throughout Italy. In addition to the traditional indication to coronary artery disease based on regional wall motion analysis, other indications are emerging with an increase in the use of LUS and CFVR, especially in high-volume centers

Global changes in pampean lowland streams (Argentina): Implications for biodiversity and functioning

The rivers and streams in the pampean plains are characterized by a low flow rate due to the low slope of the surrounding terrain, high levels of suspended solids, silty sediment in the benthos, and reduced rithron; the riparian forest of this region has been replaced by low-altitude grasslands. Many of these environments contain a wide coverage of aquatic reeds, both submerged and floating, making the pampas limologically extraordinary. These terrains have undergone a gradual transformation in response to the progress of urbanization and agricultural activity in recent years with a resulting loss of biodiversity, leaving only few sites that continue to reflect the original characteristics of the region. Because of human activities in combination with the global climate change, variations have occurred in biological communities that are reflected in the structure and function of populations and assemblages of algae, macrophytes, and invertebrate fauna or in the eutrophication of affected ecosystems. The objective of this article is to describe the principal limnologic characteristics of the streams that traverse the Buenos Aires Province and relate these features with the predicted future global changes for the area under study. Considering the future climate-change scenarios proposed for the pampean region, the projected increment in rainfall will affect the biological communities. Higher rainfall may enhance the erosion and generate floodings; increasing the transport of sediments, nutrients, and contaminants to the ocean and affecting the degree of water mineralization. Changes in discharge and turbidity may affect light penetration in the water column as well as its residence time. The modifications in the use of the soil will probably favor the input of nutrients. This latter effect will favor autotrophy, particularly by those species capable of generating strategies for surviving in more turbid and enriched environments. An accelerated eutrophication will change the composition of the consumers in preference to herbivores and detritivores. The increase in global population projected for the next years will demand more food, and this situation coupled with the new scenarios of climate change will lead to profound socioeconomic changes in the pampean area, implying an increase in demand for water resources and land uses.Fil: Rodrigues Capitulo, Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Limnología ; ArgentinaFil: Gomez, Nora. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Instituto de Limnología ; ArgentinaFil: Giorgi, Adonis David Nazareno. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Luján. Departamento de Ciencias Básicas. Programa Ecología de Protistas; ArgentinaFil: Feijoó, Claudia Silvina. Universidad Nacional de Luján; Argentin