Adverse reactions of amiodarone

Adverse drug reaction is defined by the World Health Organization as any response to a drug that is noxious and unintended and occurs at a dose normally used in man. Older people are at elevated risk of adverse drug reactions-because of changes in pharmacodynamics, concurrent use of multiple medications and the related drug interactions. However, adverse drug reactions are significantly underestimated in the elderly population that is also exposed to inappropriate drugs. Amiodarone is an antiarrhythmic drug used commonly for the treatment of atrial fibrillation and is increasingly prescribed in older people. While amiodarone is an efficient drug for rhythm control, it's a carrier of different adverse reactions, and pro and cons must be carefully evaluated before its use especially in older people

Cellule somatiche in latte ovino: analisi e applicazione delle curve ROC

Negli ovini da latte le mastiti costituiscono una delle principali cause di perdite economiche per la ridotta produzione e soprattutto per la scarsa qualità tecnologica del latte. Diversi studi hanno dimostrato che il contenuto in cellule somatiche (SCC) del latte può essere impiegato sia come metodo diagnostico sia come criterio di selezione nei programmi di miglioramento genetico per la resistenza alle mastiti. Obiettivo di questo lavoro è stato applicare la metodologia delle Receiver Operating Characteristics curves (ROC) per valutare la capacità diagnostica del SCC nel discriminare le mammelle infette da quelle sane e per individuare un valore soglia discriminante in ovini da latte. In totale sono stati analizzati 14.072 campioni di latte individuale da 720 pecore di razza Valle del Belice in 5 allevamenti. L’isolamento e l’identificazione batterica sono stati effettuati tramite semina di 10 μl di latte su Agar Sangue incubato a 37°C per 24 - 48h in aerofilia e, se necessario, in microaerofilia e la determinazione delle SCC mediante citometria di flusso. In base al risultato dell’esame batteriologico sono stati identificati 9 gruppi. La media aritmetica del SCS per i test negativi e positivi è risultata rispettivamente di 5.17 ± 0.008 e 5.80 ± 0.010, la media geometrica del SCC per i test negativi e positivi è risultata rispettivamente di 146.96 x 103 e 630.85 x 103 cells/ml. Complessivamente sono risultati positivi all’esame batteriologico 6207 campioni con una prevalenza pari al 44,1%. L’AUC è risultata pari a 0.73 ± 0.004 (P 0.0001). Il POO è risultato essere >427x103 cells/ml, in corrispondenza di tale punto la sensibilità è pari al 59,2% mentre la specificità si attesta all’80,9%. In corrispondenza di tale valore il 71% dei soggetti positivi ed il 72% dei soggetti negativi sono classificati correttamente. L’approccio di tipo non parametrico per la stima delle ROC ha dimostrato che il SCC può essere validamente utilizzato per discriminare gli animali infetti da quelli sani. Tuttavia ulteriori studi si ritengono necessari per una più precisa valutazione economica dei costi delle mastiti in considerazione del fatto che il POO sulle ROC tende a spostarsi verso valori con più alta Se e più bassa Sp man mano che i costi dei falsi positivi si riducono rispetto a quelli dei falsi negativi o quando aumenta il valore della prevalenza

Cellule somatiche ed isolamento di agenti mastidogeni in ovini di razza Valle del Belice

Il conteggio delle cellule somatiche nel latte ovino si è dimostrato un valido strumento per la determinazione dello stato sanitario della mammella. Oggetto del presente studio è stato valutare eventuali relazioni fra il contenuto in cellule somatiche (SCC) e le infezioni mammarie (IMI) negli ovini. L’indagine è stata condotta nel periodo 2006-2012 su n.14072 campioni di latte individuale. In base al tenore i campioni sono state inseriti in 4 classi: 300.000; da 301.000 a 500.000; da 501.000 a 1.000.000 e ≥1.001.000 cellule/ml. Per l’isolamento colturale sono stati seminati 10 μl di latte su piastre di Agar Sangue incubate per 24-48 h a 37 °C in aerofilia e, se necessario, in microaerofilia. Sono stati distinti 10 gruppi: nessun isolamento, isolamento di stafilococchi coagulasi positivi (S. aureus, S. intermedius e S. hyicus), stafilococchi coagulasi negativi (CNS), streptococchi patogeni (S. agalactiae, S. dysgalactiae e S. uberis), altri streptococchi o enterococchi (S. acidominimus,S. canis, S. viridans, S. mitis, S. mitior ed E. faecalis), Corynebacterium, Mannheimia haemolithyca, Bacillus spp, altri germi (Proteus spp., E.coli e Pseudomonas spp.) ed associazione di CNS ed altri streptococchi. Per ogni gruppo è stata calcolata la media geometrica del SCC. Il 44% dei campioni analizzati mostrava positività all’esame microbiologico con percentuali crescenti in funzione della classe di SCC d’appartenenza. Si riportano i microrganismi isolati e le relative prevalenze: CNS 80%, stafilococchi coagulasi positivi 11,76% di cui 677 S. aureus (10,9%), 43 S. intermedius (0,69%) e 10 S. hyicus (0,16%), Streptococcus spp. 3,09%, streptococchi patogeni 2,64%, M. haemolytica 0.63%, Corynebacterium 0,18%, Pseudomonas 0,10%, Bacillus 0,68%, E. coli 0,06% e Proteus 0,34%. La media geometrica del SCC mostra differenze statisticamente significative fra i vari gruppi di batteri. Nell’allevamento ovino gli CNS si confermano i principali agenti di mastite subclinica con tendenza alla cronicizzazione pertanto ulteriori approfondimenti sono necessari per indagare il loro ruolo patogenetic

On bulk singularities in the random normal matrix model

We extend the method of rescaled Ward identities of Ameur-Kang-Makarov to study the distribution of eigenvalues close to a bulk singularity, i.e. a point in the interior of the droplet where the density of the classical equilibrium measure vanishes. We prove results to the effect that a certain "dominant part" of the Taylor expansion determines the microscopic properties near a bulk singularity. A description of the distribution is given in terms of a special entire function, which depends on the nature of the singularity (a Mittag-Leffler function in the case of a rotationally symmetric singularity).Comment: This version clarifies on the proof of Theorem

Influence of a knot on the strength of a polymer strand

Many experiments have been done to determine the relative strength of different knots, and these show that the break in a knotted rope almost invariably occurs at a point just outside the `entrance' to the knot. The influence of knots on the properties of polymers has become of great interest, in part because of their effect on mechanical properties. Knot theory applied to the topology of macromolecules indicates that the simple trefoil or `overhand' knot is likely to be present with high probability in any long polymer strand. Fragments of DNA have been observed to contain such knots in experiments and computer simulations. Here we use {\it ab initio} computational methods to investigate the effect of a trefoil knot on the breaking strength of a polymer strand. We find that the knot weakens the strand significantly, and that, like a knotted rope, it breaks under tension at the entrance to the knot.Comment: 3 pages, 4 figure

Miglioramento delle abilità linguistiche e dell'assertività nei disturbi del comportamento alimentare: studio randomizzato controllato di un'attività di laboratorio letterario [Improving linguistic skills and assertiveness in eating disorders: A randomized controlled trial on a literary workshop activity]

Objectives: To assess the effectiveness of a literary workshop activity for increasing linguistic skills and assertiveness in patients with eating disorders (ED). Methods: Twenty-four patients consequently admitted to the ED in-patient unit at the private clinic "Villa Maria Luigia" (Parma, Northern Italy) were enrolled in the study. Of these, 8 were randomly assigned to treatment and 16 to care as usual (the only difference between treatment and care as usual was the literary workshop activity). The literary workshop consisted in 15 weekly 60-minute group sessions. Linguistic and expressive skills were provided and tested during the sessions. The Rathus Assertiveness Schedule and the Verbal Fluency Test (phonemic and semantic) were administered to all patients at the beginning and end of hospitalization. Results: A significant improvement of semantic skills, phonetic skills and assertiveness (p < 0.01) was registered in the treatment group. A positive correlation was also found between variations of linguistic skills and assertiveness in the treatment group, but not in the control group. Conclusions: The results of this study suggest that a literary workshop activity within a rehabilitation program for patients suffering from ED can aid in improving communication and language skills that might have a positive and significant impact on levels of assertiveness

Sporormiella as a tool for detecting the presence of large herbivores in the Neotropics

The reliability of using the abundance of Sporormiella spores as a proxy for the presence and abundance of megaherbivores was tested in southern Brazil. Mud-water interface samples from nine lakes, in which cattle-use was categorized as high, medium, or low, were assayed for Sporormiella representation. The sampling design allowed an analysis of both the influence of the number of animals using the shoreline and the distance of the sampling site from the nearest shoreline. Sporormiella was found to be a reliable proxy for the presence of large livestock. The concentration and abundance of spores declined from the edge of the lake toward the center, with the strongest response being in sites with high livestock use. Consistent with prior studies in temperate regions, we find that Sporormiella spores are a useful proxy to study the extinction of Pleistocene megafauna or the arrival of European livestock in Neotropical landscapes

High prevalence of hepatitis C virus infection in patients with B-cell lymphoproliferative disorders in Italy.

Starting from the observation that a number of consecutive patients with non-Hodgkin's lymphoma (NHL) resulted positive for hepatitis C virus (HCV) antibodies on routine testing, we set up a survey for HCV contact prevalence in all patients with lymphoproliferative disorders (LPD) followed in our institution. We searched for HCV antibodies by a thirdgeneration ELISA technique, followed by a confirmation test (RIBA III); serum viral RNA and HCV genotype were investigated by a RT-PCR technique. We screened a total of 315 patients suffering from B-NHL (91), multiple myeloma (56), MGUS (48), chronic lymphocytic leukemia (57), Waldentrom's macroglobulinemia (13), Hodgkin's disease (HD)(43), and T-NHL (9). While only I of 52 patients with a non-B-LPD (HD or T-NHL) had signs of HCV contact (i.e., 1.9%, which is in the range of the normal population in the South of Italy), 59 of 263 patients with a B-LPD (22.4%) had HCV antibodies or RNA, or both, with no major differences among the various types of disorders, except for WM, in which the rate was higher (61.5%). The same prevalence was found for patients tested at diagnosis or during the follow-up, and in transfused or never-transfused patients. Only a few patients were aware of having a liver disease; one-half of HCV-positive patients never had transaminase increase. A review of data from Central and Northern Italy is included, showing similar findings; a report from Japan has confirmed such an association, while limited surveys in England have not revealed any correlation. These findings may have important biological and clinical implications

Acute febrile illness is associated with Rickettsia spp infection in dogs

BACKGROUND: Rickettsia conorii is transmitted by Rhipicephalus sanguineus ticks and causes Mediterranean Spotted Fever (MSF) in humans. Although dogs are considered the natural host of the vector, the clinical and epidemiological significance of R. conorii infection in dogs remains unclear. The aim of this prospective study was to investigate whether Rickettsia infection causes febrile illness in dogs living in areas endemic for human MSF. METHODS: Dogs from southern Italy with acute fever (n = 99) were compared with case–control dogs with normal body temperatures (n = 72). Serology and real-time PCR were performed for Rickettsia spp., Ehrlichia canis, Anaplasma phagocytophilum/A. platys and Leishmania infantum. Conventional PCR was performed for Babesia spp. and Hepatozoon spp. Acute and convalescent antibodies to R. conorii, E. canis and A. phagocytophilum were determined. RESULTS: The seroprevalence rates at first visit for R. conorii, E. canis, A. phagocytophilum and L. infantum were 44.8%, 48.5%, 37.8% and 17.6%, respectively. The seroconversion rates for R. conorii, E. canis and A. phagocytophilum were 20.7%, 14.3% and 8.8%, respectively. The molecular positive rates at first visit for Rickettsia spp., E. canis, A. phagocytophilum, A. platys, L. infantum, Babesia spp. and Hepatozoon spp. were 1.8%, 4.1%, 0%, 2.3%, 11.1%, 2.3% and 0.6%, respectively. Positive PCR for E. canis (7%), Rickettsia spp. (3%), Babesia spp. (4.0%) and Hepatozoon spp. (1.0%) were found only in febrile dogs. The DNA sequences obtained from Rickettsia and Babesia PCRs positive samples were 100% identical to the R. conorii and Babesia vogeli sequences in GenBank®, respectively. Febrile illness was statistically associated with acute and convalescent positive R. conorii antibodies, seroconversion to R. conorii, E. canis positive PCR, and positivity to any tick pathogen PCRs. Fourteen febrile dogs (31.8%) were diagnosed with Rickettsia spp. infection based on seroconversion and/or PCR while only six afebrile dogs (12.5%) seroconverted (P = 0.0248). The most common clinical findings of dogs with Rickettsia infection diagnosed by seroconversion and/or PCR were fever, myalgia, lameness, elevation of C-reactive protein, thrombocytopenia and hypoalbuminemia. CONCLUSIONS: This study demonstrates acute febrile illness associated with Rickettsia infection in dogs living in endemic areas of human MSF based on seroconversion alone or in combination with PCR

Cognitive reserve in granulin-related frontotemporal dementia: from preclinical to clinical stages

OBJECTIVE Consistent with the cognitive reserve hypothesis, higher education and occupation attainments may help persons with neurodegenerative dementias to better withstand neuropathology before developing cognitive impairment. We tested here the cognitive reserve hypothesis in patients with frontotemporal dementia (FTD), with or without pathogenetic granulin mutations (GRN+ and GRN-), and in presymptomatic GRN mutation carriers (aGRN+). METHODS Education and occupation attainments were assessed and combined to define Reserve Index (RI) in 32 FTD patients, i.e. 12 GRN+ and 20 GRN-, and in 17 aGRN+. Changes in functional connectivity were estimated by resting state fMRI, focusing on the salience network (SN), executive network (EN) and bilateral frontoparietal networks (FPNs). Cognitive status was measured by FTD-modified Clinical Dementia Rating Scale. RESULTS In FTD patients higher level of premorbid cognitive reserve was associated with reduced connectivity within the SN and the EN. EN was more involved in FTD patients without GRN mutations, while SN was more affected in GRN pathology. In aGRN+, cognitive reserve was associated with reduced SN. CONCLUSIONS This study suggests that cognitive reserve modulates functional connectivity in patients with FTD, even in monogenic disease. In GRN inherited FTD, cognitive reserve mechanisms operate even in presymptomatic to clinical stages