Seriousness, preventability, and burden impact of reported adverse drug reactions in Lombardy emergency departments : a retrospective 2-year characterization

OBJECTIVE: The purpose of this study was to determine the prevalence of adverse drug reactions (ADRs) reported in emergency departments (EDs) and carry out a thorough characterization of these to assess preventability, seriousness that required hospitalization, subsequent 30-day mortality, and economic burden. METHODS: This was a retrospective cohort study of data from an active pharmacovigilance project at 32 EDs in the Lombardy region collected between January 1, 2010 and December 31, 2011. Demographic, clinical, and pharmacological data on patients admitted to EDs were collected by trained and qualified monitors, and deterministic record linkage was performed to estimate hospitalizations. Pharmacoeconomic analyses were based on Diagnosis-Related Group reimbursement. RESULTS: 8,862 ADRs collected with an overall prevalence rate of 3.5 per 1,000 visits. Of all ADRs, 42% were probably/definitely preventable and 46.4% were serious, 15% required hospitalization, and 1.5% resulted in death. The System Organ Classes most frequently associated with ADRs were: skin and subcutaneous tissue, gastrointestinal, respiratory thoracic and mediastinal, and nervous system disorders. The most common Anatomical Therapeutic Chemical classes involved in admissions were J (anti-infectives and immunomodulating agents), B (blood and blood-forming organs), and N (nervous system). Older age, yellow and red triage, higher number of concomitantly taken drugs, and previous attendance in ED for the same ADR were significantly associated with an increased risk of hospitalization. The total cost associated with ADR management was 5,184,270, with a mean cost per patient of 585. Fifty-eight percent of the economic burden was defined as probably/definitely preventable. CONCLUSION: ADRs are a serious health/economic issue in EDs. This assessment provides a thorough estimation of their seriousness, preventability, and burden impact in a large population from a representative European region

MANEJO DE Amaranthus hybridus EM ÁREA DE INTEGRAÇÃO LAVOURA-PECUÁRIA NA REGIÃO SUL DO RIO GRANDE DO SUL.

A área cultivada com soja aumentou no Brasil nos últimos anos, assim como sua produção total. No Rio Grande do Sul (RS) o cultivo da leguminosa também mostra crescimento, sendo utilizado na sucessão à pecuária de corte no período frio, modelo de produção que contribui para melhor utilização das áreas durante os 12 meses do ano, contribuindo assim para o incremento da renda do produtor, bem como, quando bem manejado, colaborar no manejo integrado de plantas daninhas. Apesar disso, a presença de plantas daninhas dicotiledôneas de difícil controle como Amaranthus hybridus em lavouras de soja do RS vêm aumentando. Assim, o objetivo deste estudo foi avaliar a eficiência de herbicidas pré- e pós-emergentes, e de diferentes programas de manejo para controle de populações de Amaranthus hybridus. O estudo foi composto por quatro experimentos, dois sob condições controladas em casa de vegetação e dois a campo, em uma propriedade rural no município de Cerrito, RS, que integra a produção de soja com pecuária de corte. Os experimentos evidenciaram que alguns biótipos são tolerantes ao glyphosate e aos herbicidas inibidores de ALS (imazethapyr e chlorimuron-ethyl), e que a utilização dos herbicidas pré-emergentes imazethapyr + flumioxazin, metribuzin, s-metolachlor e sulfentrazone + diuron contribui para o manejo destes biótipos. Verificou-se também que a dessecação do azevém e sua complementação com herbicidas de contato e o uso de pré-emergentes são fatores determinantes para o controle de A. hybridus. Ainda, os resultados apontam que em condições de déficit hídrico, a presença de palha prejudica a eficiência de alguns herbicidas pré-emergentes

Toward sustainable environmental quality : priority research questions for Europe

The United Nations' Sustainable Development Goals have been established to end poverty, protect the planet, and ensure prosperity for all. Delivery of the Sustainable Development Goals will require a healthy and productive environment. An understanding of the impacts of chemicals which can negatively impact environmental health is therefore essential to the delivery of the Sustainable Development Goals. However, current research on and regulation of chemicals in the environment tend to take a simplistic view and do not account for the complexity of the real world, which inhibits the way we manage chemicals. There is therefore an urgent need for a step change in the way we study and communicate the impacts and control of chemicals in the natural environment. To do this requires the major research questions to be identified so that resources are focused on questions that really matter. We present the findings of a horizon-scanning exercise to identify research priorities of the European environmental science community around chemicals in the environment. Using the key questions approach, we identified 22 questions of priority. These questions covered overarching questions about which chemicals we should be most concerned about and where, impacts of global megatrends, protection goals, and sustainability of chemicals; the development and parameterization of assessment and management frameworks; and mechanisms to maximize the impact of the research. The research questions identified provide a first-step in the path forward for the research, regulatory, and business communities to better assess and manage chemicals in the natural environment. Environ Toxicol Chem 2018;9999:1-15

Prenatal Hyperandrogenization Induces Metabolic and Endocrine Alterations Which Depend on the Levels of Testosterone Exposure

Prenatal hyperandrogenism is able to induce polycystic ovary syndrome (PCOS) in rats. The aim of the present study was to establish if the levels of prenatal testosterone may determine the extent of metabolic and endocrine alterations during the adult life. Pregnant Sprague Dawley rats were prenatally injected with either 2 or 5 mg free testosterone (groups T2 and T5 respectively) from day 16 to day 19 day of gestation. Female offspring from T2 and T5 displayed different phenotype of PCOS during adult life. Offspring from T2 showed hyperandrogenism, ovarian cysts and ovulatory cycles whereas those from T5 displayed hyperandrogenism, ovarian cysts and anovulatory cycles. Both group showed increased circulating glucose levels after the intraperitoneal glucose tolerance test (IPGTT; an evaluation of insulin resistance). IPGTT was higher in T5 rats and directly correlated with body weight at prepubertal age. However, the decrease in the body weight at prepubertal age was compensated during adult life. Although both groups showed enhanced ovarian steroidogenesis, it appears that the molecular mechanisms involved were different. The higher dose of testosterone enhanced the expression of both the protein that regulates cholesterol availability (the steroidogenic acute regulatory protein (StAR)) and the protein expression of the transcriptional factor: peroxisome proliferator-activated receptor gamma (PPAR gamma). Prenatal hyperandrogenization induced an anti-oxidant response that prevented a possible pro-oxidant status. The higher dose of testosterone induced a pro-inflammatory state in ovarian tissue mediated by increased levels of prostaglandin E (PG) and the protein expression of cyclooxygenase 2 (COX2, the limiting enzyme of PGs synthesis). In summary, our data show that the levels of testosterone prenatally injected modulate the uterine environment and that this, in turn, would be responsible for the endocrine and metabolic abnormalities and the phenotype of PCOS during the adult life

Toxicity of wine effluents and assessment of a depuration system for their control: assay with tadpoles of Rhinella arenarum (BUFONIDAE)

We evaluated the toxicity of the winery effluent and the efficiency of a symbiotic depuration system by means an experiment with Rhinella arenarum tadpoles. The studied effluent was taken from warehouses during the cleaning season. These effluents subsequently subjected to the purification treatment under evaluation. The effluent samples differentiated into two treatment levels: “raw” where the effluent was evaluated with field conditions and “treated” where the effluent was previously filtered with the symbiotic depuration system. The results of the bioassays compared with the physicochemical parameters determined in the effluent samples. The lethal response had a clear-cut correspondence with the effluent quality assessed utilizing physicochemical parameters. In all cases, dilution of the samples resulted in a significant reduction of their toxicity. It concluded that (a) winery effluents could be harmful to tadpoles of R. arenarum, (b) the symbiotic purification system used to treat wine effluents it would produce a significant reduction in the contaminant levels of the effluent. However, this reduction in contaminant levels does not provide sufficient safety for the release of the effluents into the environment.Fil: Navas Romero, Ana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Herrera Moratta, Mario Andres. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Provincia de Mendoza. Instituto Argentino de Investigaciones de las Zonas Áridas. Universidad Nacional de Cuyo. Instituto Argentino de Investigaciones de las Zonas Áridas; ArgentinaFil: Rodríguez, María Rosa. Universidad Nacional de San Juan. Facultad de Ingeniería; ArgentinaFil: Quiroga, Lorena Beatriz. Universidad Nacional de San Juan. Facultad de Filosofía, Humanidades y Artes. Instituto de Ciencias Básicas; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Echegaray, Marcelo Eduardo. Universidad Nacional de San Juan. Facultad de Ingeniería; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; ArgentinaFil: Sanabria, Eduardo Alfredo. Universidad Nacional de San Juan. Facultad de Filosofía, Humanidades y Artes. Instituto de Ciencias Básicas; Argentina. Universidad Nacional de Cuyo. Facultad de Ciencias Exactas y Naturales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - San Juan; Argentin

A bicategorical approach to information flow and security

In [D. Sutherland, in Proceedings of the 9th National Computer Security Conference (Gaithersburg, MD, 1986), 175\u2013183, National Bureau of Standards, Gaithersburg, MD, 1986] a model of information flow and security was established and investigated. The model consists of sets S, A, B and mappings f: S 12!A and g: S 12!B; an element s 2 S is a complete description of the state of a system, f(s) [or g(s)] is the information about s available to the first [or second] user. The measure of security is based on what facts we can deduce about s from knowledge of f(s) [or g(s)]. The paper generalizes this model to the language of category theory. First generalizations of the model to languages of the category of all sets and the category of all relations or to languages of the category of all posets and the category of all ideals are presented and discussed. From this, a generalization to general locally-ordered bicategories is suggeste

Application of SoilFug Model for Estimating Pesticide Runoff in Orchards

Concentrations of 3 pesticides, azinphos methyl, parathion [parathion-methyl] and penconazole in soil, runoff and rain, were measured in 2 experimental areas in Italy, to assess the behaviour of these chemicals and to provide an experimental validation of a predictive model for surface water contamination. Soil loads of azinphos methyl just after the treatment resulted in 23-26% of the applied dose. Significant concentrations were measured in runoff water, related to loads and physiochemical properties of the chemicals. High values were observed in rain water. Runoff water concentrations and treatment loads validated the SoilFug model showing good correspondence between measured and predicted values