186 research outputs found

    Changing the approach to anticoagulant therapy in older patients with multimorbidity using a precision medicine approach

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    The ageing of the world population has resulted in an increase in the number of older patients with multimorbid conditions receiving multiple therapies. This emerging clinical scenario poses new challenges, which are mostly related to the increased incidence of adverse effects. This translates into poor clinical care, reduced cost-effectiveness of drug therapies, and social isolation of multimorbid patients due to reduced autonomy. A strategy to address these emerging challenges could involve the personalization of therapies based on the clinical, molecular, and genetic characterization of multimorbid patients. Anticoagulation therapy is a feasible model to implement personalized medicine since it generally involves older multimorbid patients receiving multiple drugs. In this study, in patients with atrial fibrillation, the use of the new generation of anticoagulation therapy, i.e., direct oral anti-coagulants (DOACs), is based on a preliminary assessment of the molecular targets of DOACS and any possible drug–drug interactions. Then, the genetic polymorphism of enzymes metabolizing DOACs is studied. After DOAC prescription, its circulating levels are measured. Clinical data are being collected to assess whether this personalized approach improves the safety and efficacy profiles of anticoagulation therapy using DOACs, thereby reducing the costs of healthcare for ageing multimorbid patients

    Efficiency and costs of the health management in an organic dairy farm where we use unconventional medicines

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    The EU organic regulation explicitly promote the use of unconventional therapies, like homoeopathy and phytotherapy. The aim of the present study was to investigate the efficiency and the costs of these treatment methods. From December 2006 to September 2008, we analyzed the data recorded in an organic dairy farm where the animals are normally treated by classical unicistic homeopathy and phytotherapy, and only when indispensable, by allophaty, antiparasitic drugs, surgery and vaccines. The use of homeopathy resulted to be predominant in comparison with the others treatments. Besides, our trial showed that homeopathy and phytotherapy could be used to treat, with good outcomes, the majority of diseases that occur in a dairy cattle farm, even if, sometimes, conventional medicines have to be used. The costs for unconventional treatments are very low in comparison with conventional ones. This will allow the spreading of unconventional medicines in the Italian organic farms

    Mobile crowdsensing for road sustainability: exploitability of publicly-sourced data

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    ABSTRACTThis paper examines the opportunities and the economic benefits of exploiting publicly-sourced datasets of road surface quality. Crowdsourcing and crowdsensing initiatives channel the parti..

    Electrocardiographic ST-Segment Depression and Exposure to Traffic‐Related Aerosols in Elderly Subjects with Coronary Artery Disease

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    BackgroundAir pollutants have not been associated with ambulatory electrocardiographic evidence of ST-segment depression ≥ 1 mm (probable cardiac ischemia). We previously found that markers of primary (combustion-related) organic aerosols and gases were positively associated with circulating biomarkers of inflammation and ambulatory blood pressure in the present cohort panel study of elderly subjects with coronary artery disease.ObjectivesWe specifically aimed to evaluate whether exposure markers of primary organic aerosols and ultrafine particles were more strongly associated with ST-segment depression of ≥ 1 mm than were secondary organic aerosols or PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 µm) mass.MethodsWe evaluated relations of air pollutants to ambulatory electrocardiographic evidence of cardiac ischemia over 10 days in 38 subjects without ST depression on baseline electrocardiographs. Exposures were measured outdoors in retirement communities in the Los Angeles basin, including daily size-fractionated particle mass and hourly markers of primary and secondary organic aerosols and gases. Generalized estimating equations were used to estimate odds of hourly ST-segment depression (≥ 1 mm) from hourly air pollution exposures and to estimate relative rates of daily counts of ST-segment depression from daily average exposures, controlling for potential confounders.ResultsWe found significant positive associations of hourly ST-segment depression with markers of combustion-related aerosols and gases averaged 1-hr through 3-4 days, but not secondary (photochemically aged) organic aerosols or ozone. The odds ratio per interquartile increase in 2-day average primary organic carbon (5.2 µg/m3) was 15.4 (95% confidence interval, 3.5-68.2). Daily counts of ST-segment depression were consistently associated with primary combustion markers and 2-day average quasi-ultrafine particles < 0.25 µm.ConclusionsResults suggest that exposure to quasi-ultrafine particles and combustion-related pollutants (predominantly from traffic) increase the risk of myocardial ischemia, coherent with our previous findings for systemic inflammation and blood pressure

    Consumo de produtos lácteos de origem não bovina no sul do Brasil

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    As cadeias de produção de leites de origem não bovina estão em crescimento no Brasil. O objetivo deste estudo foi identificar os tipos de produtos lácteos não bovinos mais consumidos e sua origem (se caprina, ovina ou bubalina), bem como avaliar as características do consumidor que adquire esses produtos. Verificou-se, ainda, a frequência de consumo de leite bovino e derivados. Realizou-se uma pesquisa tipo survey, pela internet, com 636 respondentes. O produto derivado de leite não bovino mais citado é o queijo, seguido do leite e do iogurte. A espécie mais citada é a cabra, seguida pela búfala e a ovelha. Os consumidores que mais tendem a já ter consumido esses tipos de produtos são pessoas com mais de 45 anos, renda superior a três salários mínimos e formação superior. Os consumidores diários de queijo bovino demonstram já ter consumido produtos de leite de outra espécie. Os resultados obtidos poderão subsidiar decisões de marketing das cadeias de produção de leite não bovino.The production chains of non-cow’s milk are growing in Brazil. The aim of this study was to identify the most consumed types of non-bovine dairy products and their origin (goat, sheep or buffalo), as well as to assess the characteristics of the consumer who purchase such products. The frequency of cow’s milk and dairy products consumption was also verified. A survey-type research was carried out through the internet with 636 respondents. The most mentioned dairy product of non-bovine origin is cheese, followed by milk and yoghurt. The most mentioned species is goat, followed by buffalo and sheep. Consumers who are most likely to have already consumed these kinds of products are persons over 45 years of age, whose income is above three minimum wages and with an academic background. Daily consumers of cow’s cheese seem to have already consumed dairy products from other species. The results obtained by this study may subsidize market decisions of non-cow’s milk production chains
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