Zearalenone screening of human breast milk from the Naples area

The mycotoxin zearalenone exhibits estrogenic and anabolic properties in several animal species, humans included. Food contamination by zearalenone is caused either by direct contamination of grains, fruits, and their based-products or by “carry-over” of mycotoxins in animal tissues, milk, and eggs after intake of contaminated feedstuff. Now, a survey on zearalenone contamination in breast milk of healthy primiparous women living in the Naples countryside was conducted. From 47 healthy primiparous women, breast milk samples were collected within the first six weeks after delivery as well as clinical data of mother newborn pairs. Breast milk analyses were performed with both competitive indirect enzyme-linked immunosorbent assay and high- performance liquid chromatography with fluorescence detection. At 36.9 § 2.6 days after vaginal delivery, the mean zearalenone contents of the breast milk samples were 1.13 § 0.34 mg/L. The zearalenone levels correlated with both mother weights before pregnancy (r D ¡0.506; P < 0.001) and at delivery (r D ¡0.351; P < 0.05). The present results indicate that breast milk may be contaminated with zearalenone

Incidence and costs of hip fractures in elderly Italian population: first regional-based assessment

We analyzed for the first-time hospitalizations and costs for hip fractures in the elderly Italian population at the regional level from 2007 to 2014. The number of fractures and the overall costs increased, mainly due to people aged > 85 in all the Italian regions, although at different rates

Multiparametric identification of subclinical atrial fibrillation after an embolic stroke of undetermined source

Subclinical atrial fibrillation (SCAF) may represent a cause of embolic stroke of undetermined source (ESUS) and its detection has important implications for secondary prevention with anticoagulation. Indications to implantable cardiac monitors (ICM) include SCAF detection. The aims of this study were to (1) evaluate the frequency of ICM-detected SCAF; (2) determine predictors of SCAF; and (3) identify patients who would benefit most from ICM implantation

Evaluation of mexiletine effect on conduction delay and bradyarrhythmic complications in patients with myotonic dystrophy type 1 over long-term follow-up

Myotonic dystrophy type 1 (DM1) is a multisystemic disorder characterized by progressive cardiac conduction impairment, arrhythmias and sudden death. Mexiletine is a sodium-channel blocker drug used in such patients for the treatment of myotonia, even if definitive proof of its safety over long-term follow-up is lacking OBJECTIVE: To assess the impact of mexiletine for treatment of neurological symptoms on the composite endpoint of significant ECG modification (new onset or worsening of atrioventricular or intraventricular conduction delay) and bradyarrhythmic complications requiring pacemaker implantation (advanced atrioventricular block, symptomatic sinus pause >3 s) METHODS: This retrospective longitudinal study included a series of consecutive patients with genetically confirmed DM1 evaluated in our Neurology and Cardiology Clinic from January 1st 2011 to January 1st 2020, who received a 200 mg twice daily (BID) dose of mexiletine. Patients with pacemaker, implantable cardioverter defibrillation, or severe conduction abnormality (PQ interval 65230ms, complete bundle branch block or atrial fibrillation) at enrollment were excluded RESULTS: we included 18 mexiletine-treated patients and 68 mexiletine-free controls. Over a median follow-up of 53 months, the endpoint was reached by 4 (22%) mexiletine-treated patients and 23 (33%) non mexiletine-treated patients (logrank p=0.45). In 3 non mexiletine-treated patients, bradyarrhythmic complications requiring pacemaker implantation were observed. At multivariable univariable analysis, only the presence of mild conduction delay (first-degree AV block with PQ<230 ms or left anterior fascicular block) at baseline predicted the endpoint (HR=2.22, CI=1.04-4.76) CONCLUSION: Mexiletine, at dosage of 200 mg BID, is safe in patients with DM1 and no severe conduction abnormality

Characteristics and hospital course of patients admitted for acute cardiovascular diseases during the coronavirus disease-19 outbreak

INTRODUCTION: During the coronavirus disease-19 (COVID-19) outbreak in spring 2020, people may have been reluctant to seek medical care fearing infection. We aimed to assess the number, characteristics and in-hospital course of patients admitted for acute cardiovascular diseases during the COVID-19 outbreak.METHODS: We enrolled all consecutive patients admitted urgently for acute myocardial infarction, heart failure or arrhythmias from 1 March to 31 May 2020 (outbreak period) and 2019 (control period). We evaluated the time from symptoms onset to presentation, clinical conditions at admission, length of hospitalization, in-hospital medical procedures and outcome. The combined primary end point included in-hospital death for cardiovascular causes, urgent heart transplant or discharge with a ventricular assist device.RESULTS: A similar number of admissions were observed in 2020 (N\u200a=\u200a210) compared with 2019 (N\u200a=\u200a207). Baseline characteristics of patients were also similar. In 2020, a significantly higher number of patients presented more than 6\u200ah after symptoms onset (57 versus 38%, P\u200a<\u200a0.001) and with signs of heart failure (33 versus 20%, P\u200a=\u200a0.018), required urgent surgery (13 versus 5%, P\u200a=\u200a0.004) and ventilatory support (26 versus 13%, P\u200a<\u200a0.001). Hospitalization duration was longer in 2020 (median 10 versus 8 days, P\u200a=\u200a0.03). The primary end point was met by 19 (9.0%) patients in 2020 versus 10 (4.8%) in 2019 (P\u200a=\u200a0.09).CONCLUSION: Despite the similar number and types of unplanned admissions for acute cardiac conditions during the 2020 COVID-19 outbreak compared with the same period in 2019, we observed a higher number of patients presenting late after symptoms onset as well as longer and more complicated clinical courses