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

MODIFICATION OF CELLULOSE BY UV-GRAFTING OF AN ORGANO-POLYSILAZANE OLIGOMER

AbstractThe modification of cellulose fibers by grafting specific functions could improve their quality and allow their use for the development of new products. In this work we report about the functionalization of a cellulose fiber network (filters) with organo-polysilazane oligomers by UV-irradiation. Photo-induced grafting, as assessed by contact angle and TGA measurements, was successful: an interesting enhancement of thermal resistance and mechanical properties was obtained. Water repellency was also achieved.</jats:p

Polyurethane based biomaterials for shape adjustable cardiovascular devices

A series of biostable polyurethane (PUR) formulations, including a composite containing a clay as filler, were prepared as new biomaterials for cardiovascular applications. Poly(dimethyl siloxane) and poly(tetramethylene oxide) were selected as macrodiols because of their mechanical properties and the high hydrolysis resistance they confer to PURs. 1,6-Diisocyanatohexane and 1,4-cyclohexane dimethanol were used as a diisocyariate and chain extender, respectively. The polymeric products were chemically, thermally, and mechanically characterized. Thermomechanical characterizations highlighted that some of the obtained formulations are promising materials for applications in the cardiovascular field, in particular, for the realization of annuloplastic rings in mitral valve repair