Characteristics and outcomes of heart failure hospitalization before implementation of a heart failure clinic: The PRECIC study

Objective: This study aims to characterize patients hospitalized for acute heart failure (HF) in an internal medicine department and their one-year mortality and rate of rehospitalization for decompensated HF. Methods: This retrospective observational study enrolled all patients discharged in 2012 after hospitalization for acute HF. Discharge summaries, clinical records and telephone interviews were analysed. The data reports to the year before implementation of a heart failure clinic. Results: Four hundred and twenty-nine patients were enrolled, with a mean age of 79 years, 62.5% female. The most prevalent comorbidity and etiology was hypertension (86.7%) and the most frequent decompensation trigger was infection. HF with preserved ejection fraction (HFpEF) was present in 70.5%. In-hospital mortality was 7.9%. At discharge more than half of the patients were prescribed beta-blockers (52.8%) and angiotensin-converting enzyme inhibitors (52%). Women presented a significantly higher proportion of HFpEF than men (75.3% vs. 62.7%, p=0.01). Patients with diabetes and those with ischemic etiology had significantly higher pro-portions of HF with reduced ejection fraction (HFrEF) (34.8% vs. 24.3% in non-diabetic patients,p=0.027, and 56.2% vs. 15.6% for other etiologies, p<0.001). The HFrEF group were more fre-quently discharged under beta-blockers and spironolactone (75.2% vs. 46.4% in the HFpEF group,p<0.001 and 31.2% vs. 12.6% in the HFpEF group, p<0.001, respectively). Mortality was 34.3%and rehospitalization for HF was 30.5% in one-year follow-up.Conclusions: The population characterized is an elderly one, mainly female and with HFpEF.Nearly a third of patients died and/or were rehospitalized in the year following discharge

Discolouring the Amazon Rainforest: how deforestation is affecting butterfly coloration

This is the author accepted manuscript. The final version is available from Springer via the DOI in this record .Butterflies are among the most colourful organisms in the world and colour plays a central role in many of their life-history strategies. However, the efficacy of coloration strategies in these and other animals could be affected by sudden environmental changes, including anthropogenic disturbances such as habitat loss and fragmentation. Here we investigate the effect of forest disturbance gradients on the colours of fruit-feeding butterflies in the Amazon Rainforest. The disturbance gradients tested represented habitat-size (continuous primary forests versus forest fragments of 1, 10 and 100 ha) and succession gradients (continuous primary forests, 30 year old secondary forests, and three year old early successional forests). Using digital image analysis, we obtained intrinsic measures of butterfly colour patches corresponding to hue, saturation, brightness, in addition to measures of the contrast among patches and of the overall wing-colour diversity corresponding to 220 individuals, belonging to 60 species. Our results showed that butterflies in the secondary forest and continuous primary forest are more colourful than those found in early succession and fragments of forests. Individuals occurring in forests of early succession showed higher average values of hue and saturation, but lower brightness. Accompanying changes in colour composition, wing-colour diversity among species was lower in human-disturbed habitats, such as those of early forest succession and secondary forest. Forest fragments have smaller effects on butterfly colour composition, indicating that well-structured forest habitats can house butterfly assemblages with more diverse phenotypic features and colours. We show how high deforestation rates in recent years is linked with negative changes in functional coloration strategies (e.g. camouflage, warning colours), something that has to date been poorly explored or demonstrated for butterflies. Specifically, human interference has apparently placed butterflies under strong selection for lower diversity in their colours and range of defensive strategies. Those species that are most colourful are the first to be locally extinguished, likely due to removal of native vegetation and increased exposure to predators, and more broadly owing to inhospitable environmental conditions. This illustrates an accelerated loss of local fauna and a “discolouration” of the Amazonian butterflies due to anthropogenic impacts.Thomas Lovejoy research fellowshi

Factors affecting milk cortisol in mid lactating dairy cows

Background: Whether the measurement of cortisol in dairy cows can be used as a biomarker of adverse environmental or pathophysiological conditions is still under of scientific debate. In these situations, several systems mainly the hypothalamic-pituitary-adrenal axis, the autonomic nervous system, and the immune system are recruited to reestablish homeostasis. A first aim of the present study was to compare milk and blood cortisol concentrations and to consider its variability in milk in relation to farm, milk yield and days in milk. A second study investigates the effects of breed, class of somatic cell count (SCC) and farm on milk cortisol levels in a larger number of cows and farms, with the aim to validate the results obtained in the pilot study. Methods: For study 1, 135 cows were sampled from 2 Italian Simmental and 2 Italian Holstein commercial farms, whilst in the second study, 542 cows were sampled from 6 commercial farms of Italian Simmental and 499 cows from 4 commercial farms of Italian Holstein. Results: In study 1, the values of cortisol content in milk were significantly higher in Holstein than Simmental cows. Significant differences between farms were observed for milk and plasma cortisol concentrations. Cortisol content in milk was not correlated to plasma content in study 1 and the mean milk to plasma cortisol ratio was about 1:30. In study 2, for Holstein cows, significantly higher values of milk cortisol in comparison to Simmental cows was reported. A significant effect of class of SCC was observed, cows belonging to class 3 (SCC higher than 400.000/ml) showed the highest mean values of milk cortisol. The farm effect was significant also in the study 2, confirming the results obtained in the first study. Conclusions: Milk can be considered a preferential site of sampling in dairy cows to point out short term stimulation of the hypothalamic-pituitary-adrenal axis. Further studies are needed to investigate the physiological basis of the relationship between milk cortisol content and bree

Genome of the Avirulent Human-Infective Trypanosome—Trypanosoma rangeli

Background: Trypanosoma rangeli is a hemoflagellate protozoan parasite infecting humans and other wild and domestic mammals across Central and South America. It does not cause human disease, but it can be mistaken for the etiologic agent of Chagas disease, Trypanosoma cruzi. We have sequenced the T. rangeli genome to provide new tools for elucidating the distinct and intriguing biology of this species and the key pathways related to interaction with its arthropod and mammalian hosts.  Methodology/Principal Findings: The T. rangeli haploid genome is ,24 Mb in length, and is the smallest and least repetitive trypanosomatid genome sequenced thus far. This parasite genome has shorter subtelomeric sequences compared to those of T. cruzi and T. brucei; displays intraspecific karyotype variability and lacks minichromosomes. Of the predicted 7,613 protein coding sequences, functional annotations could be determined for 2,415, while 5,043 are hypothetical proteins, some with evidence of protein expression. 7,101 genes (93%) are shared with other trypanosomatids that infect humans. An ortholog of the dcl2 gene involved in the T. brucei RNAi pathway was found in T. rangeli, but the RNAi machinery is non-functional since the other genes in this pathway are pseudogenized. T. rangeli is highly susceptible to oxidative stress, a phenotype that may be explained by a smaller number of anti-oxidant defense enzymes and heatshock proteins.  Conclusions/Significance: Phylogenetic comparison of nuclear and mitochondrial genes indicates that T. rangeli and T. cruzi are equidistant from T. brucei. In addition to revealing new aspects of trypanosome co-evolution within the vertebrate and invertebrate hosts, comparative genomic analysis with pathogenic trypanosomatids provides valuable new information that can be further explored with the aim of developing better diagnostic tools and/or therapeutic targets