Towards a network around civic agriculture in the Province of Pisa

This paper aims at exploring the pathway towards the creation of a network around the principles of civic agriculture in the Province of Pisa (Tuscany, Italy). The research is part of the process towards a local Food Plan, aimed at coordinating public policies, civil society and private initiatives, to foster the access to a healthy and sustainable diet. In this context, the experiences of civic agriculture have played an important role, highlighting the centrality of agriculture in the animation of rural areas and in the rural-urban relationship and becoming a point of intersection amongst several vital areas for local communities. The research methods consisted in a first monitoring of civic agriculture experiences, a second round of in-depth interviews and in a more targeted focus group. The research has confirmed the presence of an expressed willingness to create a network of farms engaged on issues of sustainable food and sustainable local development. However, some critical points emerged with respect to the process of network building. Brokerage activities appear crucial to reinforce the relationships amongst the farmers and civil and institutional actors engaged in food related issues

Fertility after "only B-Lynch" suture: A case report and literature review

Abstract Objective A new fertility assessment after a B-Lynch suture without a concomitant uterine devascularization is proposed. Case Report The case of a 37-year-old woman who experienced postpartum hemorrhage due to uterine atony during cesarean delivery of the previous pregnancy is reported. A B-Lynch brace suturing technique, not associated to any other hemostatic surgical procedure, was carried out. One year later and after an uncomplicated pregnancy of 39 weeks, the patient delivered a healthy infant by an elective cesarean section. Only omental adhesions were found on the anterior surface of the uterus as a consequence of the previous B-Lynch suture. Conclusion The B-Lynch hemostatic surgical procedure, alone, does not seem to have a negative impact on fertility. Additional clinical evidences in a greater case-series of patients are needed to assess the value of the method for fertility preservation

The influence of air pollution on the phyllosphere microflora composition of Tillandsia leaves (Bromeliaceae).

The effect of air pollution on total phyllospheric microflora from two species of the epiphytic neo tropical genus Tillandsia (Bromeliaceae) was studied by comparing unpolluted plants living in a forest (Escazú, San José) with polluted ones from an urban site of Costa Rica (San José city). Dilutions of homogenized leaf samples were plated on media suitable for each microbial group. For each microorganism group, total counts were performed and purified strains of randomly chosen colonies were identified. There was a global reduction in the number of living microorganisms due to pollution effects, especially yeasts and bacteria, while nitro gen-fixing microorganisms and fungi were les s affected. Our results showed that the phyllosphere microflora of Tillandsia plants living in a tropical urban environment changes in terms of number and species composition of yeasts and bacteria with respect to plants living in unpolluted environment

Two-Dimensional Aortic Size Normalcy: A Novelty Detection Approach

Background: To develop a tool for assessing normalcy of the thoracic aorta (TA) by echocardiography, based on either a linear regression model (Z-score), or a machine learning technique, namely one-class support vector machine (OC-SVM) (Q-score). Methods: TA diameters were measured in 1112 prospectively enrolled healthy subjects, aging 5 to 89 years. Considering sex, age and body surface area we developed two calculators based on the traditional Z-score and the novel Q-score. The calculators were compared in 198 adults with TA > 40 mm, and in 466 patients affected by either Marfan syndrome or bicuspid aortic valve (BAV). Results: Q-score attained a better Area Under the Curve (0.989; 95% CI 0.984–0.993, sensitivity = 97.5%, specificity = 95.4%) than Z-score (0.955; 95% CI 0.942–0.967, sensitivity = 81.3%, specificity = 93.3%; p 40 mm. The prevalence of TA dilatation in Marfan and BAV patients was higher as Z-score > 2 than as Q-score p Conclusions: Q-score is a novel tool for assessing TA normalcy based on a model requiring less assumptions about the distribution of the relevant variables. Notably, diameters do not need to depend linearly on anthropometric measurements. Additionally, Q-score can capture the joint distribution of these variables with all four diameters simultaneously, thus accounting for the overall aortic shape. This approach results in a lower rate of predicted TA abnormalcy in patients at risk of TA aneurysm. Further prognostic studies will be necessary for assessing the relative effectiveness of Q-score versus Z-score

Resilience and response of the congenital cardiac network in Italy during the COVID-19 pandemic

: The worldwide response to the current COVID-19 pandemic has been focused on how to prevent the disease and to protect the high-risk patient from a potentially lethal infection. Several consensus and guidelines articles have been published dealing with the cardiac patient with systemic hypertension, heart transplant or heart failure. Very little is known about the patients, both in the pediatric as well as in the adult age, with congenital heart disease. The peculiar physiology of the heart with a native, repaired or palliated congenital heart defect deserves a specialized care. Hereby we describe the early recommendations issued by the Italian Society of Pediatric Cardiology and Congenital Heart Disease and how the network of the congenital cardiac institutions in Italy reacted to the threat of potential wide spread of the infection among this fragile kind of patient

Genetic Testing and Counselling in Hypertrophic Cardiomyopathy: Frequently Asked Questions

Genetic counselling and genetic testing in hypertrophic cardiomyopathy (HCM) represent an integral part of the diagnostic algorithm to confirm the diagnosis, distinguish it from phenocopies, and suggest tailored therapeutic intervention strategies. Additionally, they enable cascade genetic testing in the family. With the implementation of Next Generation Sequencing technologies (NGS), the interpretation of genetic data has become more complex. In this regard, cardiologists play a central role, aiding geneticists to correctly evaluate the pathogenicity of the identified genetic alterations. In the ideal setting, geneticists and cardiologists must work side by side to diagnose HCM as well as convey the correct information to patients in response to their many questions and concerns. After a brief overview of the role of genetics in the diagnosis of HCM, we present and discuss the frequently asked questions by HCM patients throughout our 20-year genetic counselling experience. Appropriate communication between the team and the families is key to the goal of delivering the full potential of genetic testing to our patients

Wpływ lewosimendanu podawanego bez dawki nasycającej na skurczową i rozkurczową funkcję serca u pacjentów ze schyłkową niewydolnością serca

Wstęp: Lewosimendan (L) jest lekiem stosowanym w terapii ciężkiej niewydolności serca (HF). Działa inotropowo dodatnio oraz wazodylatacyjnie, nie zwiększając zapotrzebowania serca na tlen. W ostrej HF lewosimendan poprawia parametry hemodynamiczne. W dostępnych publikacjach wykazano, że pozytywnie wpływa na funkcję rozkurczową lewej komory (LV). Celem niniejszego badania była ocena wpływu lewosimendanu na zmiany długiej osi LV, która jest wczesnym markerem dysfunkcji rozkurczowej. Metody: Do badania włączono 41 pacjentów w średnim wieku 62 &#177; 12 lat przyjętych do kliniki autorów niniejszej pracy z powodu ostrej HF w klasie IV według NYHA z istotną dysfunkcją LV. Dwudziestu sześciu pacjentom podano lewosimendan w dawce 0,1 &#956;g/kg/min w ciągu 24 godzin bez dawki nasycającej (grupa L), zaś 15 chorych poddano standardowej terapii (grupa C). Wyniki: Grupy nie różniły się między sobą pod względem podstawowych danych demograficznych, klinicznych i wyników badań biochemicznych. Po tygodniu od leczenia lewosimendanem obserwowano istotną poprawę wydolności w klasie NYHA oraz obniżenie stężenia N-końcowego propeptydu natriuretycznego typu B (pro-BNP). W badaniu echokardiograficznym obserwowano poprawę funkcji skurczowej (p < 0,05) i frakcji wyrzutowej LV (p < 0,05) przy redukcji wskaźnika E/E&#8217; (p < 0,05) w grupie L. Grupę L podzielono na podgrupę z aktywnym niedokrwieniem i bez niedokrwienia oraz wykazano istotną poprawę funkcji skurczowej w pierwszej podgrupie. Nie wykazano różnic między podgrupami w odniesieniu do funkcji rozkurczowej LV. Wnioski: Stosowanie lewosimendanu bez dawki nasycającej poprawia funkcję LV i klasę NYHA u pacjentów z ostrą HF. Wydaje się, że przedłużony wpływ na parametry hemodynamiczne jest związany z działaniem aktywnych metabolitów leku. (Folia Cardiologica Excerpta 2012; 7, 2: 71-77

Takotsubo cardiomyopathy in a Caucasian Italian woman: Case report

BACKGROUND: Takotsubo cardiomyopathy is an acute cardiac syndrome characterized by transient LV regional wall motion abnormalities (with peculiar apical ballooning appearance), chest pain or dyspnea, ST-segment elevation and minor elevations of cardiac enzyme levels CASE PRESENTATION: A 68-year-old woman was admitted to the Emergency Department because of sudden onset chest pain occurred while transferring her daughter, who had earlier suffered a major seizure, to the hospital. The EKG showed sinus tachycardia with ST-segment elevation in leads V2–V3 and ST-segment depression in leads V5–V6, she was, thus, referred for emergency coronary angiography. A pre-procedural transthoracic echocardiogram revealed regional systolic dysfunction of the LV walls with hypokinesis of the mid-apical segments and hyperkinesis of the basal segments. Coronary angiography showed patent epicardial coronary arteries; LV angiography demonstrated the characteristic morphology of apical ballooning with hyperkinesis of the basal segments and hypokinesis of the mid-apical segments. The post-procedural course was uneventful; on day 5 after admission the echocardiogram revealed full recovery of apical and mid-ventricular regional wall-motion abnormalities. CONCLUSION: Takotsubo cardiomyopathy is a relatively rare, unique entity that has only recently been widely appreciated. Acute stress has been indicated as a common trigger for the transient LV apical ballooning syndrome, especially in postmenopausal women. The present report is a typical example of stress-induced takotsubo cardiomyopathy in a Caucasian Italian postmenopausal woman