Malignant Tumors of the Central Nervous System

Malignant tumors of the central nervous system in adults comprise a heterogeneous group of malignancies, the largest subgroups comprising astrocytomas, ependymomas, and oligodendrogliomas. Glioblastomas are the most common tumor type, and they have dismal prognosis. Due to differences in cell type of origin, as well as pathogenesis, it is plausible that their etiology also differs between tumor types. The etiology of malignant CNS tumors is largely unknown and no occupational risk factors have been definitively identified. High doses of ionizing radiation increase the risk, but in occupational settings the dose levels appear too small to result in discernible excesses. Several studies have assessed possible effect of extremely low frequency and radiofrequency electromagnetic fields, but the results are inconsistent. Increased brain tumor risk has been reported in agricultural workers, but no specific exposure has been linked to them. Pesticides have been analyzed in several studies without showing a clear increase in risk.acceptedVersionPeer reviewe

Intertidal mussel beds from the South-western Atlantic show simple structure and uniform appearance: does environmental harshness explain the community?

Communities of the rocky mid-intertidal zone of the South-western Atlantic are uniform in appearance, dominated by dense monocultures of small-size mussels (Brachidontes rodriguezii and Perumytilus purpuratus). To explain this, two hypotheses have been advanced in the literature: environmental harshness due to high potential evaporation and historical contingency after the Last Glacial Maximum. In this study of Uruguayan and Argentine shores, we address the implications and predictions of these two hypotheses from a biogeographic perspective by studying the regional distribution and composition of mid-intertidal mussels. We conducted an extensive latitudinal sampling survey (21 locations, 34–54°S), along with a compilation of available information on mussel bed composition and mussel predators present along the coastline. Then we constructed latitudinal profiles of ecologically significant environmental variables with specific emphasis on potential evaporation, a proxy for desiccation stress. The results show that mussel beds are composed of two species of small mussels, which coexist over a biogeographic transition zone (40–42°S) related to sea surface water temperature. The distribution of mussels along the coastline studied is not consistent with the environmental harshness hypothesis. In addition, in the Central Patagonian zone (44–50°S), two invertebrate predators also inhabit the intertidal rocky shores. However, these localities showed higher environmental harshness (potential evaporation rate) than non-Patagonian localities. We suggest that further attention should be given to historical contingency in order to advance towards a hypothesis consistent with current knowledge on the post-glacial biogeographic history of the South-western Atlantic.Fil: Adami, Mariana Laura. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de la Plata. Facultad de Ciencias Naturales y Museo. División Zoología Invertebrados; ArgentinaFil: Schwindt, Evangelina. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Centro Nacional Patagónico. Instituto de Biología de Organismos Marinos; ArgentinaFil: Tablado, Alejandro. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; ArgentinaFil: Calcagno, Javier Ángel. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Maimónides. Área de Investigaciones Biomédicas y Biotecnológicas. Centro de Estudios Biomédicos, Biotecnológicos, Ambientales y de Diagnóstico; ArgentinaFil: Labraga, Juan Carlos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; ArgentinaFil: Orensanz, Jose Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Nacional Patagónico; Argentin

Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study

It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an overt stroke (CI). Our aim was to investigate, assuming an underlying role of atrial microembolism, the impact of CI and CKD in elderly hospitalized patients with AF

The stigma of low opioid prescription in the hospitalized multimorbid elderly in Italy

The primary aim of this study was to evaluate the prevalence of opioid prescriptions in hospitalized geriatric patients. Other aims were to evaluate factors associated with opioid prescription, and whether or not there was consistency between the presence of pain and prescription. Opioid prescriptions were gathered from the REgistro POliterapie Societa` Italiana di Medicina Interna (REPOSI) data for the years 2008, 2010 and 2012. 1,380 in-patients, 65+ years old, were enrolled in the first registry run, 1,332 in the second and 1,340 in the third. The prevalence of opioid prescription was calculated at hospital admission and discharge. In the third run of the registry, the degree of pain was assessed by means of a numerical scale. The prevalence of patients prescribed with opioids at admission was 3.8\ua0% in the first run, 3.6\ua0% in the second and 4.1\ua0% in the third, whereas at discharge rates were slightly higher (5.8, 5.3, and 6.6\ua0%). The most frequently prescribed agents were mild opioids such as codeine and tramadol. The number of total prescribed drugs was positively associated with opioid prescription in the three runs; in the third, dementia and a better functional status were inversely associated with opioid prescription. Finally, as many as 58\ua0% of patients with significant pain at discharge were prescribed no analgesic at all. The conservative attitude of Italian physicians to prescribe opioids in elderly patients changed very little between hospital admission and discharge through a period of 5\ua0years. Reasons for such a low opioid prescription should be sought in physicians\u2019 and patients\u2019 concerns and prejudices

Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in hospital and during the 3-month post-discharge follow-up were explored by logistic regression and propensity score analysis. Among the 1,380 patients enrolled, 171 (15.2 %) were on TP during the hospital stay (162 on low molecular weight heparins, 9 on fondaparinux). The disability Barthel index was the main independent predictor of TP prescription. Rate of fatal and non-fatal VTE and bleeding during and after hospitalization did not differ between TP and non-TP patients. In-hospital and post-discharge mortality was significantly higher in patients on TP, that however was not an independent predictor of mortality. Among elderly medical patients there was a relatively low rate of TP, that was more frequently prescribed to patients with a higher degree of disability and who had an overall higher mortality