The prognostic importance of chronic end-stage diseases in geriatric patients admitted to 163 Italian ICUs

BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in five years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analyzed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours. RESULTS: 44,551 elderly patients (19.2%) underwent emergency (47.3%) or elective surgery (52.7%). At least one severe comorbidity was present in 14.6% of them, yielding a higher hospital mortality (32.4%, vs. 21.1% without severe comorbidity). In the models for patients staying in the ICU 24 hours or more, cirrhosis, NYHA class IV, and severe COPD were constant independent predictors of death (adjusted odds ratios [ORs] range 1.67-1.97, 1.54-1.91, and 1.34-1.50, respectively), while dementia was statistically significant in four out of five models (adjusted ORs 1.23-1.28). End-stage renal disease, instead, never resulted to be an independent prognostic factor. For patients staying in the ICU less than 24 hours, chronic comorbidities were only occasionally independent predictors of death. CONCLUSIONS: Our study confirms that elderly surgical patients represent a relevant part of all ICUs admissions. About one of seven bear at least one severe chronic comorbidity, that, excluding end-stage renal disease, are all strong independent predictors of hospital death

Methane Emission Estimated from Different Cattle Intake Data in Heifers Grazing a Tropical Pasture

The quantification of methane (CH4) from enteric fermentation related to cattle diet is a useful tool to identify strategies to mitigate greenhouse gas emissions. This is even important in tropical and subtropical regions due to the lack of CH4 estimations in beef cattle, particularly from Bos Indicus breeds grazing tropical grasses (Kurihara et al., 1999). Several modelling approaches have been developed in order to predict CH4 emission. However, the use of these models has limitations associated with uncertainty information required such as feed intake (FI), composition of the selected diet and animal responses (Gonzalez et al., 2014). FI is the main factor influencing CH4 emission. Individual FI measurements are not easy to achieve accurately in grazing animals rather than those located in pens, particularly under deferred tropical pastures at the end of the dry season, due to the large proportion of death forage. In this case, cattle supplementation with energetic and proteins concentrates, is a viable practice in order to improve animal FI and reduce CH4 emissions. The main objectives of this study was estimate and compare CH4 emission using data collected from experimental trials and predicted by a model (UNFCCC, 2014) in supplemented heifers grazing low quality Chloris gayana pasture in northwestern Argentina (Semiarid Chaco Region)

Effect of Supplementation Frequency on Forage Utilization by Heifers Grazing a Tropical Pasture during the Dry Season

In tropical pasture, low quality and availability forage during the dry season can limit the cattle intake. Energetic and protein supplementation is a viable practice to improve feed intake and animal performance. Previous studies have shown that infrequent protein supplementation decreases feeding cost achieving similar performance compared with every day supplementation (Farmer et al., 2004). Even though infrequent protein supplementation has been widely studied, little research has been carried out on infrequent energetic supplementation, especially its effect on pasture utilization. Some evidence indicates that negative effects on forage use at low levels of infrequent supplementation (Beaty et al., 1994). However, high levels of energetic supplementation can result in a substitution effect of forage for concentrate, reducing pasture utilization, even more when forage quality decreases as dry season progresses. Thus, the aim of this study was to evaluate the effect of supplementation frequency (continuous or discontinuous, based on energetic concentrate) on forage utilization by heifers grazing a Chloris gayana pasture during the dry season in the Semiarid Chaco Region (Northwestern Argentine)

Mosaicism of alpha-synuclein gene rearrangements: Report of two unrelated cases of early-onset parkinsonism

Dear Sir, In genetics, the term ‘mosaicism’ describes the situation in which groups of cells have a different genetic composition to other cells in an organism. Somatic gene rearrangements due to multiplication or deletion of genes (copy number variation) and/or sections of chromosomes can lead to mosaicism. The presence of multiple copies of the alpha-synuclein gene (SNCA) is known to be associated with Parkinson’s disease (PD) and the severity of symptoms increases with the number of copies of the gene [1]. While the features of PD associated with duplication of SNCA are usually (but not always) typical of the condition [2–3], patients with triplicate copies have atypical features, including rapidly evolving symptoms, severe cognitive impairment, limited response to levodopa, more severe symptoms of dementia and more..

Hypothesis: Somatic Mosaicism and Parkinson Disease

Letter to the EditorFil: Perandones, Carlos Edgardo. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Pellene, L. A. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Giugni, J. C.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Calvo, D. S.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Raina, G. B.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Cuevas, S. M.. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Mata, I. F.. University of Washington; Estados UnidosFil: Zabetian, C. P.. University of Washington; Estados UnidosFil: Caputo, Mariela. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Servicio de Huellas Digitales Genéticas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; ArgentinaFil: Corach, Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentina. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Servicio de Huellas Digitales Genéticas; ArgentinaFil: Micheli, Federico. Universidad de Buenos Aires. Facultad de Farmacia y Bioquímica. Servicio de Huellas Digitales Genéticas; ArgentinaFil: Radrizzani Helguera, Martin. Universidad Nacional de San Martín. Escuela de Ciencia y Tecnología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay; Argentin

Different Conformations of Phosphatase and Tensin Homolog, Deleted on Chromosome 10 (PTEN) Protein within the Nucleus and Cytoplasm of Neurons

PTEN is a critical gene involved in the regulation of many cellular processes. The product of this gene has dual phosphatase activity and is able to dephosphorylate the 5′ end of the phosphatidylinositol (3,4,5)-trisphosphate. Within the cellular nucleus, this protein has been associated with regulation of the expression of many genes, although the mechanism of this regulation remains unclear. In this paper, two specific oligonucleotide aptamers were developed and selected, using the SELEX procedure, according to their ability to detect the PTEN protein in different subcellular compartments of neurons. While one aptamer was able to detect PTEN in the nucleus, the other recognized PTEN in the cytoplasm. The recognition pattern of PTEN by both aptamers was confirmed using antibodies in western blots of the proteins purified from mouse cerebellar homogenates and subcellular fractions. Additionally, we demonstrated that the two aptamers recognized different epitopes of the target peptide. The results presented here could not be fully explained by the canonical phosphatase structure of PTEN, suggesting the existence of different conformations of phosphatase in the nucleus and the cytoplasm

Letter to the Editor: Hypothesis: Somatic Mosaicism and Parkinson Disease

Fil: Perandones, Claudia. ANLIS Dr.C.G.Malbrán. Dirección Científico Técnica; Argentina.Fil: Pellene, Luis A. Universidad Nacional de Buenos Aires. Hospital de Clínicas. Programa de Parkinson y Movimientos Anormales; Argentina.Fil: Giugni, J. C. Universidad Nacional de Buenos Aires. Hospital de Clínicas. Programa de Parkinson y Movimientos Anormales; Argentina.Fil: Calvo, D. S. Universidad Nacional de Buenos Aires. Hospital de Clínicas. Programa de Parkinson y Movimientos Anormales; Argentina.Fil: Raina, G. B. Universidad Nacional de Buenos Aires. Hospital de Clínicas. Programa de Parkinson y Movimientos Anormales; Argentina.Fil: Cuevas, S. M. Universidad Nacional de Buenos Aires. Hospital de Clínicas. Programa de Parkinson y Movimientos Anormales; Argentina.Fil: Mata, Ignacio F. University of Washington and VA Puget Sound Health Care System, Seattle, Washington; Estados Unidos.Fil: Zabetian, Cyrus P. University of Washington and VA Puget Sound Health Care System, Seattle, Washington; Estados Unidos.Fil: Caputo, Mariela. Universidad de Buenos Aires. Escuela de Farmacia y Bioquímica. Servicio de Huellas Digitales Genéticas; Argentina.Fil: Corach, Daniel. Universidad de Buenos Aires. Escuela de Farmacia y Bioquímica. Servicio de Huellas Digitales Genéticas; Argentina.Fil: Micheli, Federico E. Universidad Nacional de Buenos Aires. Hospital de Clínicas. Programa de Parkinson y Movimientos Anormales; Argentina.Fil: Radrizzani, Martin. Universidad Nacional de San Martín. Escuela de Ciencia y Tecnología. Centro de Estudios en Salud y Medio Ambiente. Laboratorio de Citogenética Neuro y Molecular; Argentina