Stocking density and its influence on the productivity of red cusk eel, Genypterus chilensis (Guichenot, 1848), in shallow raceways

We compared the growth properties of red cusk eel Genypterus chilensis with initial mean weight ± standard error, 106.2 ± 6.1 g reared in shallow raceways at three different stocking densities (28.5, 46.1, and 60.7 kg m-3) in a 226-day long growth trial at a constant temperature of 17°C. There was a trend towards higher specific growth rates at the highest density. Final mean weights were 333 ± 12, 352 ± 12, and 354 ± 15 g, at the 30, 45, and 60 kg m-3 density, respectively. Overall, the growth rates were higher in the 60 kg m-3 density group than the two other density groups. The daily feeding intake (%) was higher in the medium (0.51), and high (0.55) density groups compared the low-density group (0.45). Feed conversion efficiency (FCE) did not differ between the density groups. A significant size rank correlation was maintained in all density groups throughout the study. Calculated productivity increased almost linearly with increasing stocking density and was found to be 32, 34, and 39 g m-2 d-1 at 30, 45, and 60 kg m-3, respectively. The results show that the optimum density conditions for farming juvenile red cusk eel, both concerning growth rate, feed conversion, and productivity is at densities equal to or higher than 60 kg m-3.publishedVersio

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Stocking density and its influence on the productivity of red cusk eel, Genypterus chilensis (Guichenot, 1848), in shallow raceways

We compared the growth properties of red cusk eel Genypterus chilensis with initial mean weight ± standard error, 106.2 ± 6.1 g reared in shallow raceways at three different stocking densities (28.5, 46.1, and 60.7 kg m-3) in a 226-day long growth trial at a constant temperature of 17°C. There was a trend towards higher specific growth rates at the highest density. Final mean weights were 333 ± 12, 352 ± 12, and 354 ± 15 g, at the 30, 45, and 60 kg m-3 density, respectively. Overall, the growth rates were higher in the 60 kg m-3 density group than the two other density groups. The daily feeding intake (%) was higher in the medium (0.51), and high (0.55) density groups compared the low-density group (0.45). Feed conversion efficiency (FCE) did not differ between the density groups. A significant size rank correlation was maintained in all density groups throughout the study. Calculated productivity increased almost linearly with increasing stocking density and was found to be 32, 34, and 39 g m-2 d-1 at 30, 45, and 60 kg m-3, respectively. The results show that the optimum density conditions for farming juvenile red cusk eel, both concerning growth rate, feed conversion, and productivity is at densities equal to or higher than 60 kg m-3

Verapamil and norverapamil plasma levels in infants and children during chronic oral treatment

The Drug Monit I.F. = 1.553

Long-Term Outcomes with Pharmacological Ovarian Suppression during Chemotherapy in Premenopausal Early Breast Cancer Patients

Background: Although use of gonadotropin-releasing hormone agonist (GnRHa) during chemotherapy is an established strategy to protect ovarian function in premenopausal breast cancer patients, no long-term safety data are available raising some concerns in women with hormone receptor-positive disease. There are controversial data on its fertility preservation potential. Methods: The PROMISE-GIM6 is a multicenter, randomized, open-label, phase III superiority trial conducted at 16 Italian centers from October 2003 to January 2008. Eligible patients were randomized to (neo)adjuvant chemotherapy alone (control arm) or combined with the GnRHa triptorelin (GnRHa arm). Primary planned endpoint was incidence of chemotherapy-induced premature ovarian insufficiency (POI). Post-hoc endpoints were disease-free survival (DFS), overall survival (OS), and post-treatment pregnancies. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. Results: Of 281 randomized patients, 80.4% had hormone receptor-positive breast cancer. Median follow-up was 12.4\u2009years (interquartile range = 11.3-13.2\u2009years). No differences in 12-year DFS (65.7% [95% CI\u2009=\u200957.0% to 73.1%] in GnRHa arm vs. 69.2% [95% CI\u2009=\u200960.3% to 76.5%] in control arm; HR\u2009=\u20091.16, 95% CI\u2009=\u20090.76 to 1.77) nor in 12-year OS (81.2% [95% CI\u2009=\u200973.6% to 86.8%] in GnRHa arm vs. 81.3% [95% CI\u2009=\u200973.1% to 87.2%] in control arm; HR\u2009=\u20091.17, 95% CI\u2009=\u20090.67 to 2.03) were observed. In patients with hormone receptor-positive disease, the HR was 1.02 (95% CI\u2009=\u20090.63 to 1.63) for DFS and 1.12 (95% CI\u2009=\u20090.59 to 2.11) for OS. In the GnRHa and control arms, 9 and 4 patients had a post-treatment pregnancy, respectively (HR\u2009=\u20092.14, 95% CI\u2009=\u20090.66 to 6.92). Conclusions: Final analysis of the PROMISE-GIM6 trial provides reassuring results on the safety of GnRHa use during chemotherapy as a strategy to preserve ovarian function in premenopausal patients with early breast cancer, including those with hormone receptor-positive disease

What changed in the Italian internal medicine and geriatric wards during the lockdown

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White Paper of Italian Gastroenterology: Delivery of services for digestive diseases in Italy: Weaknesses and strengths

In 2011 the three major Italian gastroenterological scientific societies (AIGO, the Italian Society of Hospital Gastroenterologists and Endoscopists; SIED, the Italian Society of Endoscopy; SIGE, the Italian Society of Gastroenterology) prepared their official document aimed at analysing medical care for digestive diseases in Italy, on the basis of national and regional data (Health Ministry and Lombardia, Veneto, Emilia-Romagna databases) and to make proposals for planning of care. Digestive diseases were the first or second cause of hospitalizations in Italy in 1999-2009, with more than 1,500,000 admissions/year; however only 5-9% of these admissions was in specialized Gastroenterology units. Reported data show a better outcome in Gastroenterology Units than in non-specialized units: shorter average length of stay, in particular for admissions with ICD-9-CM codes proxying for emergency conditions (6.7 days versus 8.4 days); better case mix (higher average diagnosis-related groups weight in Gastroenterology Units: 1 vs 0.97 in Internal Medicine units and 0.76 in Surgery units); lower inappropriateness of admissions (16-25% versus 29-87%); lower in-hospital mortality in urgent admissions (2.2% versus 5.1%); for patients with urgent admissions due to gastrointestinnal haemorrhage, in-hospital mortality was 2.3% in Gastroenterology units versus 4.0% in others. The present document summarizes the scientific societies' official report, which constitutes the "White paper of Italian Gastroenterology". © 2014 Editrice Gastroenterologica Italiana S.r.l

Comparison between drug therapy-based comorbidity indices and the Charlson Comorbidity Index for the detection of severe multimorbidity in older subjects.

Background: To know burden disease of a patient is a key point for clinical practice and research, especially in the elderly. Charlson's Comorbidity Index (CCI) is the most widely used rating system, but when diagnoses are not available therapy-based comorbidity indices (TBCI) are an alternative. However, their performance is debated. This study compares the relations between Drug Derived Complexity Index (DDCI), Medicines Comorbidity Index (MCI), Chronic Disease Score (CDS), and severe multimorbidity, according to the CCI classification, in the elderly. Methods: Logistic regression and Receiver Operating Characteristic (ROC) analysis were conducted on two samples from Italy: 2579 nursing home residents (Korian sample) and 7505 older adults admitted acutely to geriatric or internal medicine wards (REPOSI sample). Results: The proportion of subjects with severe comorbidity rose with TBCI score increment, but the Area Under the Curve (AUC) for the CDS (Korian: 0.70, REPOSI: 0.79) and MCI (Korian: 0.69, REPOSI: 0.81) were definitely better than the DDCI (Korian: 0.66, REPOSI: 0.74). All TBCIs showed low Positive Predictive Values (maximum: 0.066 in REPOSI and 0.317 in Korian) for the detection of severe multimorbidity. Conclusion: CDS and MCI were better predictors of severe multimorbidity in older adults than DDCI, according to the CCI classification. A high CCI score was related to a high TBCI. However, the opposite is not necessarily true probably because of non-evidence-based prescriptions or physicians' prescribing attitudes. TBCIs did not appear selective for detecting of severe multimorbidity, though they could be used as a measure of disease burden, in the absence of other solutions

Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register)

To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry)

Impact of Diabetes Mellitus and Its Comorbidities on Elderly Patients Hospitalized in Internal Medicine Wards: Data from the RePoSi Registry.

Background: Currently, diabetes represents the seventh leading cause of death worldwide, with a significant economic burden. The number and severity of comorbidities increase with age, and are identified as important determinants that influence the prognosis. We aimed to investigate comorbidities and outcomes in a cohort of hospitalized elderly patients affected by diabetes. Methods: In this observational study, we retrospectively analyzed data collected from the REgistro dei pazienti per lo studio delle POlipatologie e politerapie in reparti della rete Simi (RePoSi) registry. Socio-demographic, clinical characteristics, and laboratory findings were considered. The association between variables and in-hospital and 1-year follow-up were analyzed. Results: Among 4708 in-patients, 1378 (29.3%) had a diagnosis of diabetes. Patients with diabetes had more previous hospitalization, a clinically significant disability, and more need for a urinary catheter in comparison with subjects without diabetes. Patients affected by diabetes took more drugs, both at admission, at in-hospital stay, at discharge, and at 1-year follow-up. Thirty-five comorbidities were more frequent in patients with diabetes, and the first five were hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and chronic obstructive pulmonary disease (22.7%). Heart rate was an independent predictor of in-hospital mortality. At 1-year follow-up, cancer and male sex were strongly independently associated with mortality. Conclusions: Our findings showed the severity of the impact of diabetes and its comorbidities in the real life of internal medicine and geriatric wards, and provide data to be used for a better tailored management of elderly in-patients with diabetes