Defective spleen function in autoimmune gastrointestinal disorders

Defective spleen function increases susceptibility to bacterial infections which can be prevented by vaccine prophylaxis. Splenic hypofunction can be found in a number of autoimmune disorders; however, no data are available regarding autoimmune atrophic gastritis (AAG), autoimmune enteropathy (AIE) and autoimmune liver disease (AILD). Peripheral blood samples from patients with AAG (n = 40), AIE (n = 3) and AILD (n = 40) were collected. Patients affected by autoimmune disorders already known to be associated with splenic hypofunction, i.e. coeliac disease (CD) and ulcerative colitis (UC), were included as disease controls, while splenectomised patients and healthy subjects were evaluated as positive and negative controls, respectively. Counting of erythrocytes with membrane abnormalities, i.e. pitted red cells, was used as an indicator of spleen function (normal upper limit 4%). Defective splenic function was observed in 22 of the 40 patients with AAG (55.0%), in two of the three patients with AIE (66.6%) and in 35 of the 40 patients with AILD (87.5%). As expected, in untreated CD, refractory CD and UC there was a high prevalence of hyposplenism (43.7%, 88.2% and 54.4%, respectively). Due to the high prevalence of splenic hypofunction, patients with AAG, AILD and AIE should undergo pitted red cell evaluation and, if hyposplenic, they should be candidate to vaccine prophylaxis against encapsulated bacteria

Cell Blood Count Alterations and Patterns of Anaemia in Autoimmune Atrophic Gastritis at Diagnosis: A Multicentre Study

Background: Autoimmune atrophic gastritis (AAG) leads to iron and/or vitamin B12 malabsorption, with subsequent haematological alterations which could represent the sole clinical manifestation. We aimed to assess patterns of anaemia and micronutrient deficiencies in patients with AAG at the time of diagnosis. Methods: Observational, multicentre, cross-sectional study including consecutive adult patients diagnosed with AAG within the last ten years. Cell blood count, red cell distribution width, serum vitamin B12, and ferritin were collected. Multivariate analysis for predictive factors of anaemia was computed. Results: 654 AAG patients (mean age 59.2 ± 13.8 years, female (F): male (M) ratio = 2.3:1) were included. Anaemia was present in 316 patients (48.3%; mean age 60.1 ± 15.8 years, F:M ratio=2.3:1). Pernicious anaemia (132/316 cases, 41.7%) wasmore common inmales (27.1% versus 12.4%; p = 0.001) and in older patients (63.0 ± 14.6 versus 58.9 ± 14.9 years; p = 0.014), while iron deficiency anaemia (112/316 cases, 35.4%) was more common in females (16.9% versus 10.0%; p = 0.039) and in younger patients (56.8 ± 16.6 versus 60.2 ± 14.6 years; p = 0.043). The prevalence of iron deficiency was equally distributed between anaemic and non-anaemic patients (p = 0.9). Anisocytosis (odds ratio: 10.65, 95% confidence interval: 6.13–18.50, p < 0.0001) was independently associated with anaemia. Conclusions: Anaemia is a common manifestation in AAG patients, mostly due to micronutrient deficiencies. Scant haematologic alterations and micronutrient deficiencies may precede overt anaemia

Comparative indoor and outdoor stability measurements of polymer based solar cells

We report comparative indoor and outdoor stability testing of organic solar cells based on a blend between a donor-acceptor polyfluorene copolymer and a fullerene derivative. The outdoor testing was conducted for a period over 12,000 hours in Sheffield, England, with a Ts80 lifetime determined in excess of 10,000 hours (420 days). Indoor lifetime testing was performed on solar cells using a solar simulator under a constant irradiance of 1000 W/m(2) for more than 650 hours. We show that under the conditions explored here, device degradation under the two sets of conditions is approximately dependent on the absorbed optical energy dose

Sex-Differences in the Pattern of Comorbidities, Functional Independence, and Mortality in Elderly Inpatients: Evidence from the RePoSI Register

Background: The RePoSi study has provided data on comorbidities, polypharmacy, and sex dimorphism in hospitalised elderly patients. Methods: We retrospectively analysed data collected from the 2010, 2012, 2014, and 2016 data sets of the RePoSi register. The aim of this study was to explore the sex-differences and to validate the multivariate model in the entire dataset with an expanded follow-up at 1 year. Results: Among 4714 patients, 51% were women and 49% were men. The disease distribution showed that diabetes, coronary artery disease, chronic obstructive pulmonary disease, chronic kidney disease, and malignancy were more frequent in men but that hypertension, anaemia, osteoarthritis, depression, and diverticulitis disease were more common in women. Severity and comorbidity indexes according to the Cumulative Illness Rating Scale (CIRS-s and CIRS-c) were higher in men, while cognitive impairment, mood disorders, and disability in daily life measured by the Barthel Index (BI) were worse in women. In the multivariate analysis, BI, CIRS, and malignancy significantly increased the risk of death in men at the 1-year follow-up, while age was independently associated with mortality in women. Conclusions: Our study highlighted the relevance and the validity of our previous predictive model in the identification of sex dimorphism in hospitalised elderly patients underscoring the need of sex-personalised health-care

Emissions estimation for obsolescing bus fleets. Problems and advances

When it comes to simulate traffic emissions, problems arise: which is the best model to use, which data are needed and whether they are all available, whether the process is time-consuming and/or calls for expert, etc. It is not surprising, then, that public transport operators might be hesitant in estimating the emission package of the bus fleets they manage. Moreover, the underestimation of the local fleet potential in producing pollution (in case of small fleets) on the one hand, and the reluctance to estimate it when the fleet is composed by a good amount of old-generation vehicles on the other, are further elements of uncertainty. However, transit operators’ obligation to manage and maintain clean bus fleets is becoming more and more imperative and in Italy recent regulations subsidize transit companies to purchase buses with cleaner performance. The assessment of how much pollutant is the fleet to renovate becomes, then, crucial. To this end, an emission-estimation model for bus fleets is developed and described in the paper, with the research goal to facilitate the emissions calculation among transit operators. The procedure is embedded in an already successfully-implemented software for the management and maintenance of bus fleets. The model moves from well-known assessment methods (namely COPERT and IVE) but addresses issues like long-protracted mileage and age of vehicles which make it especially useful when “old” fleets emissions are to be assessed. A case study, in a middle-size city in Italy, is also described to highlight the model developmen

Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy

Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome

Análise do tempo de reação e do estado cognitivo em idosas praticantes de atividades físicas

Este estudo tem por objetivo verificar a correlação entre o tempo de reação e o estado cognitivo de idosas praticantes de atividades físicas. Foram avaliadas 77 idosas (68,6 ± 3,9 anos), participantes de um programa estruturado de atividade física. Os testes de Tempo de Reação Simples e Tempo de Reação de Escolha foram avaliados por meio de um software e para avaliação cognitiva utilizou-se o Mini-Exame do Estado Mental. Os dados foram analisados no Pacote Estatístico SPSS, versão 16.0, com nível de significância de pThe objective of this study was to investigate the correlation between reaction time and cognitive state of elderly women that are engaged in physical activities. We evaluated 77 elderly women (68.6 ± 3.9 years) that were participating in a structured program of physical activity. The Simple Reaction Time and Choice Reaction Time tests were evaluated by software tool and to the cognitive estimation; we used the Mini-Mental State Examination. The results were analyzed with the SPSS package, version 16.0, with a significance level of p <0.05 and before the non-normality of the data, Spearman correlation was chosen. The results observed in the tests represented a satisfactory score on the Mini-Mental State Examination, while for the reaction time the results were unsatisfactory. The correlation between the simple reaction time and cognitive state were considered significant and weak, it was hoped that with good results in cognitive state and by participating in physical activity, the women could show a shorter reaction time. Based on the information observed and considering the evidence that physical exercise helps in the efficiency of information processing by the central nervous system, it suggests, besides the practice of regular physical activity, motor and cognitive interventions that stimulate the plasticity of nervous system central should be promoted, with the purpose of contributing to the improved functionality of the elderly population