Antithrombotic treatment in elderly patients with atrial fibrillation: a practical approach

Background: Atrial fibrillation (AF) in the elderly is a complex condition. It has a direct impact on the underuse of antithrombotic therapy reported in this population. Discussion: All patients aged >= 75 years with AF have an individual yearly risk of stroke > 4 %. However, the risk of hemorrhage is also increased. Moreover, in this population it is common the presence of other comorbidities, cognitive disorders, risk of falls and polymedication. This may lead to an underuse of anticoagulant therapy. Direct oral anticoagulants (DOACs) are at least as effective as conventional therapy, but with lesser risk of intracranial hemorrhage. The simplification of treatment with these drugs may be an advantage in patients with cognitive impairment. The great majority of elderly patients with AF should receive anticoagulant therapy, unless an unequivocal contraindication. DOACs may be the drugs of choice in many elderly patients with AF. Summary: In this manuscript, the available evidence about the management of anticoagulation in elderly patients with AF is reviewed. In addition, specific practical recommendations about different controversial issues (i.e. patients with anemia, thrombocytopenia, risk of gastrointestinal bleeding, renal dysfunction, cognitive impairment, risk of falls, polymedication, frailty, etc.) are provided

CALOCUBE: An approach to high-granularity and homogenous calorimetry for space based detectors

Future space experiments dedicated to the observation of high-energy gamma and cosmic rays will increasingly rely on a highly performing calorimetry apparatus, and their physics performance will be primarily determined by the geometrical dimensions and the energy resolution of the calorimeter deployed. Thus it is extremely important to optimize its geometrical acceptance, the granularity, and its absorption depth for the measurement of the particle energy with respect to the total mass of the apparatus which is the most important constraint for a space launch. The proposed design tries to satisfy these criteria while staying within a total mass budget of about 1.6 tons. Calocube is a homogeneous calorimeter instrumented with Cesium iodide (CsI) crystals, whose geometry is cubic and isotropic, so as to detect particles arriving from every direction in space, thus maximizing the acceptance; granularity is obtained by filling the cubic volume with small cubic CsI crystals. The total radiation length in any direction is more than adequate for optimal electromagnetic particle identification and energy measurement, whilst the interaction length is at least sufficient to allow a precise reconstruction of hadronic showers. Optimal values for the size of the crystals and spacing among them have been studied. The design forms the basis of a three-year R&D activity which has been approved and financed by INFN. An overall description of the system, as well as results from preliminary tests on particle beams will be described

Tuberculosis extrapulmonar

A pesar de que el pulmón es el órgano diana por excelencia de la tuberculosis, cualquier otro órgano y sistema puede verse afectado. En este trabajo se revisan las formas de tuberculosis extrapulmonar a excepción de la pleural que requieren del facultativo, en ocasiones, su más valiosa pericia diagnóstica. Desde la temida meningitis tuberculosa, pasando por la afectación insidiosa de la espondilodiscitis, la llamativa afectación ganglionar, la afectación genitourinaria, la pericarditis, para terminar las formas menos frecuentes como la ocular o la cutánea. En cada apartado indicaremos lo más característico con la finalidad de que pueda servir de orientación diagnóstica y terapéutica

Lipomatosis simétrica múltiple: a propósito de un caso

Se presenta el caso de un varón de 46 años con lipomatosis simétrica múltiple (LSM), enfermedad poco frecuente y de etiología desconocida. La LSM se caracteriza por múltiples depósitos de tejido adiposo y se asocia con alcoholismo, trastornos metabólicos y neuropatía. Se describen las características clínico-morfológicas de las lesiones que presenta, los hallazgos exploratorios, TAC cervical, los resultados analíticos y de biopsia subcutánea. Se diagnostica al paciente de LSM tipo I, aplicándose el tratamiento de elección, la lipectomía que le permite obtener una importante mejoría de la enfermedad, tanto física como estéticamente

Editorial: Current trends in environmental psychology, volume I

This Research Topic on “Current trends in environmental psychology, volume I”, which is linked to the 3rd International Conference of Environmental Psychology (ICEP 2021), held in Siracusa, Italy, 4–9 October 2021, constituted an enormous challenge. Our proposal was aimed to promote an interdisciplinary turnaround in environmental psychological thinking, at a time when major existential challenges posed by the raise of new technologies in everyday life settings (homes, workplaces, hospitals, schools, green areas, urban open spaces), and by the worsening of the global emergency at the planetary level, seem to be at their peak. The still ongoing transformations of human social life induced by the COVID-19 pandemic, and in general different ways of interacting and communicating are bringing about significant changes in terms of models and methodologies in different areas of psychological science, including environmental psychology

Current trends in environmental psychology, volume I, 2nd Edition

This Research Topic on “Current trends in environmental psychology, volume I”, which is linked to the 3rd International Conference of Environmental Psychology (ICEP 2021), held in Siracusa, Italy, 4–9 October 2021, constituted an enormous challenge. Our proposal was aimed to promote an interdisciplinary turnaround in environmental psychological thinking, at a time when major existential challenges posed by the raise of new technologies in everyday life settings (homes, workplaces, hospitals, schools, green areas, urban open spaces), and by the worsening of the global emergency at the planetary level, seem to be at their peak. The still ongoing transformations of human social life induced by the COVID-19 pandemic, and in general different ways of interacting and communicating are bringing about significant changes in terms of models and methodologies in different areas of psychological science, including environmental psychology