Microbiological and physicochemical properties of smoked ricotta cheese during refrigeration and temperature abuse storage.

In the last years changes occurred in the production process of ricotta mustia, a traditional smoked, salted and sometimes ripened ricotta cheese, produced in Sardinia. Fresher, slightly smoked and with reduced salt content products, were introduced into the market to meet changes in consumer's preferences for milder products. The present study of durability was conducted on an innovative fresh and smoked industrial product, also characterized by the small size and the packaging in modified atmosphere. A durability test to assess the evolution of microbiological and physicochemical profile of the product stored at refrigeration (4°C) and mild abuse (7°C) temperatures was carried out. A total of 126 ricotta samples smoked for either 1, 2, or 3 h were analyzed at intervals during shelflife for the determination of aerobic mesophilic counts, Enterobacteriaceae, yeast, moulds, L. monocytogenes, Pseudomonas spp. and B. cereus. Intrinsic properties, physic-chemical and headspace gas composition were also analyzed. Average and standard deviation were respectively 6,06±0,22 for pH, 0,982±0,05 for aW, 74,67%±1,81% for moisture, 10,25%±1,35% for fat, 10,92%±0,46% for protein and 1,70%±0,42% for salt content. Total bacterial count ranged between 3.88±0.48 log cfu/g at T0 and 3.25±1.02 at T45. L. monocytogenes, Pseudomonas spp. and E. coli were always below the detection limit. Enterobacteriaceae prevalence (percentage) was 3.17% (2.62±0.42 lg10 cfu/g) and was limited to samples stored longer than 30 days while B. cereus was recovered in 5.55% (2.36±0.35 lg10 cfu/g) of the samples and was never observed in samples after 45 days of refrigerated storage. The durability study is preliminary to challenge test to assess the shelf-life of this product in compliance with the requirements of Regulation (EC) 2073/2005.

Prevalence of erectile dysfunction in a cohort of Italian hypertensive subjects.

The aim of this study was to evaluate the prevalence of erectile dysfunction (ED) in a cohort of Italian hypertensive men and the association with clinical and biochemical data. The study involved 270 consecutive hypertensive subjects aged 40-70 years evaluated in Italian Hypertension Centers of six hospitals from Liguria and Piedmont. ED was assessed through the self-administered questionnaire of the International Index of Erectile Function. Clinical history with ongoing drug treatment, various clinical parameters, biochemical data and evidence about the presence of subclinical target organ damage was collected. Twenty-seven subjects refused to answer the questionnaire (10%). Among the 243 remained subjects, 123 presented ED (50.6%). ED was highly related to age, systolic blood pressure, pulse pressure, smoking status, statin therapy and kidney function. The addition of a thiazide diuretic to an inhibitor of the renin-angiotensin system significantly increased the prevalence of ED. The prevalence of ED increased in relation with the number of hypotensive drug classes taken by the patients. ED was highly prevalent in this cohort of Italian hypertensive subjects and was associated with other cardiovascular risk factors, such as age, smoking status and kidney function. The role of ED as an early marker of cardiovascular disease is discussed.

Hospital admissions for hypertensive crisis in the emergency departments: a large multicenter Italian study.

Epidemiological data on the impact of hypertensive crises (emergencies and urgencies) on referral to the Emergency Departments (EDs) are lacking, in spite of the evidence that they may be life-threatening conditions. We performed a multicenter study to identify all patients aged 18 years and over who were admitted to 10 Italian EDs during 2009 for hypertensive crises (systolic blood pressure ≥220 mmHg and/or diastolic blood pressure ≥120 mmHg). We classified patients as affected by either hypertensive emergencies or hypertensive urgencies depending on the presence or the absence of progressive target organ damage, respectively. Logistic regression analysis was then performed to assess variables independently associated with hypertensive emergencies with respect to hypertensive urgencies. Of 333,407 patients admitted to the EDs over the one-year period, 1,546 had hypertensive crises (4.6/1,000, 95% CI 4.4-4.9), and 23% of them had unknown hypertension. Hypertensive emergencies (n = 391, 25.3% of hypertensive crises) were acute pulmonary edema (30.9%), stroke (22.0%,), myocardial infarction (17.9%), acute aortic dissection (7.9%), acute renal failure (5.9%) and hypertensive encephalopathy (4.9%). Men had higher frequency than women of unknown hypertension (27.9% vs 18.5%, p<0.001). Even among known hypertensive patients, a larger proportion of men than women reported not taking anti-hypertensive drug (12.6% among men and 9.4% among women (p<0.001). Compared to women of similar age, men had higher likelihood of having hypertensive emergencies than urgencies (OR = 1.34, 95% CI 1.06-1.70), independently of presenting symptoms, creatinine, smoking habit and known hypertension. This study shows that hypertensive crises involved almost 5 out of 1,000 patients-year admitted to EDs. Sex differences in frequencies of unknown hypertension, compliance to treatment and risk of hypertensive emergencies might have implications for public health programs.

Real-world management of atrial fibrillation in Internal Medicine units: the FADOI 'FALP' observational study.

BACKGROUND: Atrial fibrillation is the most frequent arrhythmia, but few data are available on patients' characteristics and management in the context of Internal Medicine wards. METHODS: Data were collected at the beginning of 2010 in 18 Internal Medicine units of the regions Liguria and Piemonte (Italy). Each centre reviewed the hospital charts of the last 50 patients discharged during the year 2009 in whom a diagnosis of atrial fibrillation had been made (patient's history or during the hospitalization). RESULTS: A total of 903 atrial fibrillation patients were evaluated. Prevalence of atrial fibrillation among patients hospitalized in Internal Medicine units was 18.2%. More than 85% of patients had at least two diseases other than atrial fibrillation, and 'lone' atrial fibrillation was rare (1.3%). During hospital stay, 80.5% of the patients received at least one treatment for atrial fibrillation: 55.5% received an antithrombotic and 61.8% a drug for arrhythmia, mostly aimed at rate control (47.2%). In-hospital all-cause mortality was 13.4%. At discharge, 70.2 and 68.9% of the patients received prescription of a drug for arrhythmia and for antithrombotic treatment, respectively. Prescription of oral anticoagulants was significantly associated with hypertension, while previous bleeding, age above 75 years, paroxysmal atrial fibrillation, male sex and a number of concomitant drugs of more than four were strong negative predictors. CONCLUSION: Data from our study confirm that atrial fibrillation is a common finding in patients hospitalized in Internal Medicine units, and this population is characterized by multiple comorbidities and severe prognosis. Discrepancies exist between recommendations by guidelines and real-world management, owing to the complexity of patients and limits of existing treatment strategies.