Tularemia in the Southeastern Swiss Alps at 1,700 m above sea level.

A 37-year-old man presented with a 4-day history of nonbloody diarrhea, fever, chills, productive cough, vomiting, and more recent sore throat. He worked for the municipality in a village in the Swiss Alps near St. Moritz. Examination showed fever (40 °C), hypotension, tachycardia, tachypnea, decreased oxygen saturation (90 % at room air), and bibasilar crackles and wheezing. Chest radiography and computed tomography scan showed an infiltrate in the left upper lung lobe. He responded to empiric therapy with imipenem for 5 days. After the imipenem was stopped, the bacteriology laboratory reported that 2/2 blood cultures showed growth of Francisella tularensis. He had recurrence of fever and diarrhea. He was treated with ciprofloxacin (500 mg twice daily, oral, for 14 days) and symptoms resolved. Further testing confirmed that the isolate was F. tularensis (subspecies holarctica) belonging to the subclade B.FTNF002-00 (Western European cluster). This case may alert physicians that tularemia may occur in high-altitude regions such as the Swiss Alps

A new case manager for diabetic patients: a pilot observational study of the role of community pharmacists and pharmacy services in the case management of diabetic patients

The adherence of type 2 diabetes mellitus (DM2) patients with an individual care plan (ICP) is often not satisfactory, nor does it allow for a significant improvement in outcome, because of poor accessibility to services, poor integration of pathway articulations, poor reconciliation with the patient's life, or the lack of a constant reference person. The purpose of this study was to evaluate the contribution of community pharmacists and pharmacy services in improving adherence with periodic controls in DM2. The study was conducted at a rural pharmacy. A sample of 40 patients was calculated with respect to a historical cohort and subsequently enrolled. Clinical and personal data were collected in an electronic case report form. Pharmacists acting as a case manager followed patients carrying out their ICP developed by an attending physician. Some of the activities foreseen by the ICP, such as electrocardiogram, fundus examination, and self-analysis of blood and urine, were carried out directly in the pharmacy by the pharmacist through the use of telemedicine services and point of care units. Activities that could not be performed in the pharmacy were booked by the pharmacist at the accredited units. Examination results were electronically reported by the pharmacist to the attending physician. The primary endpoint was the variation in patient adherence with the ICP compared to a historical cohort. Secondary endpoints were variation in waiting time for the examinations, mean percentage change in glycated hemoglobin (HbA1c) and low-density lipoprotein (LDL) cholesterol levels and blood pressure, impact on healthcare-related costs, and perceived quality of care. Adherence to the ICP significantly increased. Waiting times were reduced and clinical outcomes improved with conceivable effects on costs. Patients appreciated the easier access to services. Community pharmacists and pharmacy services represent ideal actors and context that, integrated in the care network, can really favor ICP adherence and obtain daily morbidity reduction and cost savings through proper disease control and an early diagnosis of complications

A pilot study of nurse-led, home monitoring for patients with chronic respiratory failure and with mechanical ventilation assistance.

We assessed the feasibility of telemedicine for home monitoring of 45 patients with chronic respiratory failure (CRF) discharged from hospital. The patients transmitted pulsed arterial saturation (pSat) data via a telephone modem to a receiving station where a nurse was available for a teleconsultation. A respiratory physician was also available. Scheduled and ad hoc appointments were conducted. Thirty-five patients were on home mechanical ventilation, 13 with invasive and 22 with non-invasive devices. The main diagnosis was chronic obstructive pulmonary disease (COPD). The follow-up period was 176 days (SD 69). In all, 376 calls for scheduled consultations were received and 83 ad hoc consultations were requested by the patients. The actions taken were: 55 therapy modifications, 19 hospitalizations in a respiratory department for decompensated CRF, three hospitalizations in an intensive care unit (ICU), 22 requests for further investigations, 25 contacts with the general practitioner (GP), 66 demands for respiratory consultations and 10 calls for the emergency department. The mean time recorded for the 459 calls was 16 min/patient/week. In 82% of calls, a pSat recording was received successfully. The nurse time required to train the users in the operation of the pSat instrument was high (mean time 30 min). However, the results showed that home monitoring was feasible, and useful for titration of oxygen, mechanical ventilation setting and stabilization of relapse

Novel correlations between spectroscopic and morphological properties of activated carbons from waste coffee grounds

Massive quantities of spent coffee grounds (SCGs) are generated by users around the world. Different processes have been proposed for SCG valorization, including pyrolytic processes to achieve carbonaceous materials. Here, we report the preparation of activated carbons through pyrolytic processes carried out under different experimental conditions and in the presence of various porosity activators. Textural and chemical characterization of the obtained carbons have been achieved through Brunauer–Emmett–Teller (BET), ESEM,13C solid state NMR, XPS, XRD, thermogravimetric and spectroscopic determinations. The aim of the paper is to relate these data to the preparation method, evaluating the correlation between the spectroscopic data and the physical and textural properties, also in comparison with the corresponding data obtained for three commercial activated carbons used in industrial adsorption processes. Some correlations have been observed between the Raman and XPS data

Synthesis and Characterization of Rutile TiO2Nanopowders Doped with Iron Ions

Titanium dioxide nanopowders doped with different amounts of Fe ions were prepared by coprecipitation method. Obtained materials were characterized by structural (XRD), morphological (TEM and SEM), optical (UV/vis reflection and photoluminescence, and Raman), and analytical techniques (XPS and ICP-OES). XRD analysis revealed rutile crystalline phase for doped and undoped titanium dioxide obtained in the same manner. Diameter of the particles was 5–7 nm. The presence of iron ions was confirmed by XPS and ICP-OES. Doping process moved absorption threshold of TiO2into visible spectrum range. Photocatalytic activity was also checked. Doped nanopowders showed normal and up-converted photoluminescence

Nanoscale Magnesium Oxide

Synthesis of magnesium oxide nanoparticles by precipitation from oxalate solutions is investigate

XPS study of MgO nanopowders obtained by different preparation procedures

Nanosized magnesium oxide powders have been prepared by different preparation procedures (surfactant method with different surfactants, precipitation, ...) and their surfaces have been compared by means of XPS

Low temperature oxidation of carbon monoxide: the influence of water and oxygen on the reactivity of a Co3O4 powder surface

In this paper, the effect of the presence of humidity and molecular oxygen on the low temperature oxidation of carbon monoxide on a Co3O4 powder surface was studied. The interaction between the probe molecules and the Co3O4 surface was investigated by means of diffuse reflectance infrared Fourier transform (DRIFT) spectroscopy and quadrupolar mass spectrometry (QMS). Carbon monoxide interacts with the Co3O4 surface and is converted to carbon dioxide at rather low temperature (T 65 323 K); the formation of carbonate species is also evident. The reactivity of Co3O4 is strongly depressed by humidity: as a matter of fact, in steam conditions carbon monoxide oxidation is significant at temperatures higher than 523 K. Moreover, the formation of carbonate species is more evident than in dry conditions. The Co3O4 powder surface interacts with oxygen molecules at T 65 323K to originate several activated surface oxygen species. The activation with oxygen does not appear to facilitate significantly the formation of carbon dioxide

WO3/CeO2 nanocomposite powders: Synthesis, characterization, and reactivity

WO3/CeO2 nanocomposite powders, characterized by increasing W/Ce atomic ratio, were prepared by depositing, by wet impregnation, different amounts of WO3 on the CeO2 surface. The powders were characterized by means of X-ray photoelectron and diffuse reflectance infrared Fourier transform spectroscopic techniques as well as thermal analysis. The WO3/CeO2 samples are slightly reduced with respect to the pure oxides: the presence of W(V) and Ce(III), in addition to W(VI) and Ce(IV), is evident at the interface supported/supporting oxides. Interesting information concerning particle dimensions and growth mode derive by X-ray diffraction and transmission electron microscopy. New acidic/basic and redox sites are evident on the surface of the WO3/CeO2 nanocomposites. The interaction with methanol was also investigated. Methanol interacts both molecularly and dissociatively with the WO3/CeO2 surface; the dissociation is prevalent on the sample characterized by a lower content of WO3, whereas a mainly molecular interaction is observed with increasing amount of tungsten oxide. Oxidation of methanol is evident from 423 K on the sample with [W/Ce]nominal ) 0.025 and from 473 K on the one richer in WO3. The reactivity toward methanol oxidation is higher in the sample with a lower content of WO3, but the sample richer in WO3 shows a higher selectivity with respect to formation of carbon dioxide