Evaluation of genetic diversity between toxic and non toxic Jatropha curcas L. accessions using a set of simple sequence repeat (SSR) markers

Scepticism about Jatropha as a competitive biofuel feedstock especially on marginal soils has been growing; in fact, the jatropha-biofuel chain is risky economically and often financially unfeasible without significant government subsidies under these conditions. A valorization of the by-products and in particular of the extruded seed cake (about 70% (w/w) of the processed seed), as animal feed, currently prevented by the presence of phorbol esters (PE) toxins, could contribute to a significant improvement in the economic sustainability of the crop. Strategies for breeding improved varieties could be accelerated by DNA-based molecular marker technology. Wild Mexican accessions and accessions from other parts of the world (South America and Africa) were analyzed by 40 simple sequence repeat (SSR) markers. SSR primers were chosen on the grounds of their Tm, length, degree of polymorphism and specificity for toxic trait. The genetic study pointed out a high degree of similarity both within and among the non Mexican accessions. The Mexican accessions proved to be non toxic and genetically differentiated forming a well separated cluster from out of Mexico accessions. Some polymorphic loci were close correlated with the character toxicity and useful, once validated their association in segregating populations for Marker Assisted Selection (MAS). Keywords : Jatropha curcas , genetic variability, molecular markers, non-toxic accession, phorbol esters, simple sequence repeat (SSR) genotyping African Journal of Biotechnology Vol. 12(3), pp. 265-27

Molecular study on Senecio fontanicola (S. doria group, Asteraceae) and its conservation status

Senecio fontanicola is endemic to black-bog-rush fens of southern Austria, north-western Slovenia and north-eastern Italy. It is characterized by oblanceolate leaves, a low number of supplementary bracts and glabrous achenes and it grows in marshy spring areas, fens and reed beds, between elevations from 20 to 850 m . The species was never described with molecular traits and during the last decades, S. fontanicola showed a dramatic decline due to land reclamation for agriculture. Therefore, the present study aims to characterize S. fontanicola using the molecular barcoding technique and to updated its distribution to propose a global risk category for the species, based on IUCN criteria. The three molecular markers  used in this study (trnH-psbA, rbcL, and ITS) clearly distinguished S. fontanicola from S. doria. s.s.and the revised distribution allowed the definition of the conservation status of the species, that is Endangered-EN B2ab(i,ii,iii,iv) following the B criterion of the IUCN guidelines

Molecular study on Senecio fontanicola (S. doria group, Asteraceae) and its conservation status

Senecio fontanicola is endemic to black-bog-rush fens of southern Austria, north-western Slovenia and north-eastern Italy. It is characterized by oblanceolate leaves, a low number of supplementary bracts and glabrous achenes and it grows in marshy spring areas, fens and reed beds, between elevations from 20 to 850 m . The species was never described with molecular traits and during the last decades, S. fontanicola showed a dramatic decline due to land reclamation for agriculture. Therefore, the present study aims to characterize S. fontanicola using the molecular barcoding technique and to updated its distribution to propose a global risk category for the species, based on IUCN criteria. The three molecular markers  used in this study (trnH-psbA, rbcL, and ITS) clearly distinguished S. fontanicola from S. doria. s.s.and the revised distribution allowed the definition of the conservation status of the species, that is Endangered-EN B2ab(i,ii,iii,iv) following the B criterion of the IUCN guidelines

Valve Migration Into the Left Ventricular Outflow Tract Managed by Coaxial Double-Valve Alignment

The efficacy and overall safety of transcatheter aortic valve implantation (TAVI) in patients with severe aortic stenosis at high risk for conventional surgery is validated. Nevertheless, infrequent, but severe, intraprocedural complications, often necessitating intraoperative bailout maneuvers, are reported. Among these, valve migration into the left ventricle is particularly dismal and requires conversion to an emergent surgical procedure with a reported disproportionally high mortality rate. We report herein a case in which valve migration into the left ventricular outflow tract (LVOT) was successfully managed by repositioning a second prosthesis, thus avoiding emergent surgery

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population