Problematiche relative al controllo della popolazione di gatti sinantropi ed alla gestione di strutture rifugio ad essi dedicate.

Il problema della sovrappopolazione felina è presente su scala mondiale, in ogni luogo abitato dall’uomo. L’unica strategia di controllo che si è dimostrata vincente è la sterilizzazione sistematica tramite programmi “high volume surgery” di TNR (trap-neuter-return), associata all’adozione dei cuccioli ed a campagne di informazione volte a incentivare la sterilizzazione dei gatti di casa e a prevenirne l’abbandono. Negli USA il problema è particolarmente sentito, e negli ultimi anni la branca della Shelter Medicine ha avuto un notevole sviluppo: nel 1999 è sorta la prima scuola di specializzazione in Shelter Medicine alla Cornell University, e attualmente diversi atenei statunitensi collaborano con strutture rifugio. In Italia la situazione è arretrata rispetto al modello USA e, sebbene la legge 281/91 sancendo una politica no-kill abbia rafforzato l’importanza di una sterilizzazione sistematica per il controllo della sovrappopolazione, non sono ancora in atto protocolli “high surgery” in grado di gestire grandi numeri (eccezione fatta per il Roman Cat Sanctuary di Torre Argentina, sorto su un modello USA) e la normativa è scarna e poco chiara. Assodato che programmi sistematici di TNR sono necessari ed al momento non sostituibili, dovrebbero essere previste strutture per la stabulazione dei gatti di strada, qualora bisognosi di cure, adottabili, “domestici” o almeno per la degenza post-operatoria. In Italia la situazione è piuttosto nebulosa, e, da un punto di vista giuridico, i gattili per alcune regioni sono inesistenti mentre altre hanno stabilito i requisiti strutturali minimi. Le strutture rifugio dovrebbero sempre attenersi a dei requisiti strutturali e gestionali minimi, anche se non previsti dalla normativa vigente, poiché l’elevata promiscuità e gli alti numeri favoriscono la diffusione delle malattie infettive: divengono così necessari reparti di quarantena, isolamento, pavimenti e pareti in materiali facilmente lavabili e disinfettabili, l’uso di attrezzatura usa e getta (…) e sistematiche operazioni di pulizia, affiancate ad un corretto management per il benessere degli animali. Un’indagine preliminare sulle strutture rifugio per gatti in Italia è stata condotta con l’ausilio di un questionario, strumento che ha mostrato seri limiti. Ciò nonostante è emersa una situazione estremamente eterogenea, che va da strutture sanitarie attrezzate e funzionali a soluzioni “di fortuna”, entrambe comprese sotto il denominatore comune di “gattile”, dal momento che non ve ne è una definizione giuridica.openVET-51

Quantifying ENSO impacts at the basin scale using the Iterative Input variable Selection algorithm

Medium-to-long range streamflow predictions provide a key assistance in anticipating hydro- climatic adverse events and prompting effective adaptation measures. In this context, recent modelling efforts have been dedicated to seasonal and inter-annual predictions based on the teleconnection between at-site hydrological processes and large-scale, low-frequency climate fluctuations, such as El Nino Southern Oscillation (ENSO). This work proposes a novel procedure for first detecting the impact of ENSO on hydro-meteorological processes at the basin scale, and then quantitatively assessing the potential of ENSO indexes for building medium-to-long range streamflow prediction models. Core of this procedure is the adoption of the Iterative Input variable Selection (IIS) algorithm, which is employed to find the most relevant determinants of streamflow variability and derive predictive models based on the selected inputs. The procedure is tested on two different case studies, the Columbia River (US) and the Williams River (Australia), whose sensitivity to ENSO fluctuations has been documented in previous studies. Results show that IIS outcomes for both case studies are consistent with the results of previous analyses conducted with state-of-the-art detection methods, and that ENSO indexes can effectively be used in both regions to enhance the accuracy of streamflow prediction models

Use of angiotensin-converting enzyme inhibitors and variations in cognitive performance among patients with heart failure

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Crystal structure of non-metamict minerals of chevkinite group

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Identifying older diabetic patients at risk of poor glycemic control

BACKGROUND: Optimal glycemic control prevents the onset of diabetes complications. Identifying diabetic patients at risk of poor glycemic control could help promoting dedicated interventions. The purpose of this study was to identify predictors of poor short-term and long-term glycemic control in older diabetic in-patients. METHODS: A total of 1354 older diabetic in-patients consecutively enrolled in a multicenter study formed the training population (retrospective arm); 264 patients consecutively admitted to a ward of general medicine formed the testing population (prospective arm). Glycated hemoglobin (HbA1c) was measured on admission and one year after the discharge in the testing population. Independent correlates of a discharge glycemia ≥ 140 mg/dl in the training population were assessed by logistic regression analysis and a clinical prediction rule was developed. The ability of the prediction rule and that of admission HbA1c to predict discharge glycemia ≥ 140 mg/dl and HbA1c > 7% one year after discharge was assessed in the testing population. RESULTS: Selected admission variables (diastolic arterial pressure < 80 mmHg, glycemia = 143–218 mg/dl, glycemia > 218 mg/dl, history of insulinic or combined hypoglycemic therapy, Charlson's index > 2) were combined to obtain a score predicting a discharge fasting glycemia ≥ 140 mg/dl in the training population. A modified score was obtained by adding 1 if admission HbA1c exceeded 7.8%. The modified score was the best predictor of both discharge glycemia ≥ 140 mg/dl (sensitivity = 79%, specificity = 63%) and 1 year HbA1c > 7% (sensitivity = 72%, specificity = 71%) in the testing population. CONCLUSION: A simple clinical prediction rule might help identify older diabetic in-patients at risk of both short and long term poor glycemic control

Study on COgnition and Prognosis in the Elderly (SCOPE)

Blood Press. 1999;8(3):177-83. Study on COgnition and Prognosis in the Elderly (SCOPE). Hansson L, Lithell H, Skoog I, Baro F, Bánki CM, Breteler M, Carbonin PU, Castaigne A, Correia M, Degaute JP, Elmfeldt D, Engedal K, Farsang C, Ferro J, Hachinski V, Hofman A, James OF, Krisin E, Leeman M, de Leeuw PW, Leys D, Lobo A, Nordby G, Olofsson B, Zanchetti A, et al. University of Uppsala, Department of Public Health, Sweden. Abstract The Study on COgnition and Prognosis in the Elderly (SCOPE) is a multicentre, prospective, randomized, double-blind, parallel-group study designed to compare the effects of candesartan cilexetil and placebo in elderly patients with mild hypertension. The primary objective of the study is to assess the effect of candesartan cilexetil on major cardiovascular events. The secondary objectives of the study are to assess the effect of candesartan cilexetil on cognitive function and on total mortality, cardiovascular mortality, myocardial infarction, stroke, renal function, hospitalization, quality of life and health economics. Male and female patients aged between 70 and 89 years, with a sitting systolic blood pressure (SBP) of 160-179 mmHg and/or diastolic blood pressure (DBP) of 90-99 mmHg, and a Mini-Mental State Examination (MMSE) score of 24 or above, are eligible for the study. The overall target study population is 4000 patients, at least 1000 of whom are also to be assessed for quality of life and health economics data. After an open run-in period lasting 1-3 months, during which patients are assessed for eligibility and those who are already on antihypertensive therapy at enrolment are switched to hydrochlorothiazide 12.5 mg o.d., patients are randomized to receive either candesartan cilexetil 8 mg once daily (o.d.) or matching placebo o.d. At subsequent study visits, if SBP remains >160 mmHg, or has decreased by 85 mmHg, study treatment is doubled to candesartan cilexetil 16 mg o.d. or two placebo tablets o.d. Recruitment was completed in January 1999. At that time 4964 patients had been randomized. All randomized patients will be followed for an additional 2 years. If the event rate is lower than anticipated, the follow-up will be prolonged. PMID: 10595696 [PubMed - indexed for MEDLINE

Associations between cardiac arrhythmia, incident disability in activities of daily living and physical performance: the ILSA study

Background: Cardiac arrhythmias are common conditions in older people. Unfortunately, there is limited literature on associations between cardiac arrhythmias and physical performance or disability. We therefore aimed to prospectively investigate associations between cardiac arrhythmias and changes in disability and physical performance during 8 years of follow-up, using data from the Italian Longitudinal Study on Aging (ILSA). Methods: Cardiac arrhythmias diagnosis was posed through a screening phase, confirmed by a physician. The onset of disability in activities of daily living (ADL) and the changes in several physical performance tests during follow-up were considered as outcomes. Fully-adjusted and propensity-score Cox Proportional Hazard models and mixed models were used for exploring associations between cardiac arrhythmia and the outcomes of interest. Results: The prevalence of cardiac arrhythmia at baseline was 23.3%. People reporting cardiac arrhythmia at the baseline were significantly older, more frequently male, smokers and reported a higher presence of all medical conditions investigated (hypertension, heart failure, angina, myocardial infarction, diabetes, stroke), but no difference in dementia, Parkinsonism, cognitive or mood disorder. Cardiac arrhythmia at baseline was significantly associated with the incidence of disability in ADL (HR = 1.23; 95%: CI: 1.01–1.50; P = 0.0478 in propensity score analyses; HR = 1.28; 95% CI: 1.01–1.61; P = 0.0401 in fully adjusted models). Cardiac arrhythmia at baseline was also associated with a significant worsening in balance test (P = 0.0436). Conclusions: The presence of cardiac arrhythmia at baseline was associated with a significant higher risk of disability and of worsening in some physical performance tests, particularly those relating to balance. Screening and frequently assessing physical performance in older people affected by cardiac arrhythmia can be important to prevent a loss of physical performance, with further, potential, complications of medical management

Adverse Drug Reactions in Hospital In-Patients: A Prospective Analysis of 3695 Patient-Episodes

Adverse drug reactions (ADRs) are a major cause of hospital admissions, but recent data on the incidence and clinical characteristics of ADRs which occur following hospital admission, are lacking. Patients admitted to twelve wards over a six-month period in 2005 were assessed for ADRs throughout their admission. Suspected ADRs were recorded and analysed for causality, severity and avoidability and whether they increased the length of stay. Multivariable analysis was undertaken to identify the risk factors for ADRs. The 5% significance level was used when assessing factors for inclusion in multivariable models. Out of the 3695 patient episodes assessed for ADRs, 545 (14.7%, 95% CI 13.6–15.9%) experienced one or more ADRs. Half of ADRs were definitely or possibly avoidable. The patients experiencing ADRs were more likely to be older, female, taking a larger number of medicines, and had a longer length of stay than those without ADRs. However, the only significant predictor of ADRs, from the multivariable analysis of a representative sample of patients, was the number of medicines taken by the patient with each additional medication multiplying the hazard of an ADR episode by 1.14 (95% CI 1.09, 1.20). ADRs directly increased length of stay in 147 (26.8%) patients. The drugs most frequently associated with ADRs were diuretics, opioid analgesics, and anticoagulants. In conclusion, approximately one in seven hospital in-patients experience an ADR, which is a significant cause of morbidity, increasing the length of stay of patients by an average of 0.25 days/patient admission episode. The overall burden of ADRs on hospitals is high, and effective intervention strategies are urgently needed to reduce this burden

Effects of temperature on the crystal structure of epidote: a neutron single-crystal diffraction study at 293 and 1070K

The effects of temperature on the crystal structure of a natural epidote [Ca1.925 Fe0.745Al2.265Ti0.004Si3.037O12(OH), a = 8.890(6), b = 5.630(4), c = 10. 50(6) \uc5 and \u3b2 = 115.36(5)\ub0, Sp.Gr. P21/m] have been investigated by means of neutron single-crystal diffraction at 293 and 1,070 K. At room conditions, the structural refinement confirms the presence of Fe3+ at the M3 site [%Fe(M3) = 73.1(8)%] and all attempts to refine the amount of Fe at the M(1) site were unsuccessful. Only one independent proton site was located. Two possible hydrogen bonds, with O(2) and O(4) as acceptors [i.e. O(10)-H(1)\ub7\ub7\ub7O(2) and O(10)-H(1)\ub7\ub7\ub7O(4)], occur. However, the topological configuration of the bonds suggests that the O(10)-H(1)\ub7\ub7\ub7O(4) is energetically more favourable, as H(1)\ub7\ub7\ub7O(4) = 1.9731(28) \uc5, O(10)\ub7\ub7\ub7O(4) = 2.9318(22) \uc5 and O(10)-H(1)\ub7\ub7\ub7O4 = 166.7(2)\ub0, whereas H(1)\ub7\ub7\ub7O(2) = 2.5921(23) \uc5, O(10)\ub7\ub7\ub7O(2) = 2.8221(17)\uc5 and O(10)-H(1)\ub7\ub7\ub7O2 = 93.3(1)\ub0. The O(10)-H(1) bond distance corrected for "riding motion" is 0.9943 \uc5. The diffraction data at 1,070 K show that epidote is stable within the T-range investigated, and that its crystallinity is maintained. A positive thermal expansion is observed along all the three crystallographic axes. At 1,070 K the structural refinement again shows that Fe3+ share the M(3) site along with Al3+ [%Fe(M3)1,070K = 74(2)%]. The refined amount of Fe3+ at the M(1) is not significant [%Fe(M1)1,070K = 1(2)%]. The tetrahedral and octahedral bond distances and angles show a slight distortion of the polyhedra at high-T, but a significant increase of the bond distances compared to those at room temperature is observed, especially for bond distances corrected for "rigid body motions". The high-T conditions also affect the inter-polyhedral configurations: the bridging angle Si(2)-O(9)-Si(1) of the Si2O7 group increases significantly with T. The high-T structure refinement shows that no dehydration effect occurs at least within the T-range investigated. The configuration of the H-bonding is basically maintained with temperature. However, the hydrogen bond strength changes at 1,070 K, as the O(10)\ub7\ub7\ub7O(4) and H(1)\ub7\ub7\ub7O(4) distances are slightly longer than those at 293 K. The anisotropic displacement parameters of the proton site are significantly larger than those at room condition. Reasons for the thermal stability of epidote up to 1,070 K observed in this study, the absence of dehydration and/or non-convergent ordering of Al and Fe3+ between different octahedral sites and/or convergent ordering on M(3) are discussed