Morphology and properties of neutralized chitosan-cellulose nanocrystals biocomposite films.

Chitosan/cellulose nanocrystals (CH-CN) films were obtained by casting of dispersions, and treated with NaOH for neutralization proposes. The composition of films was varied from 1 to 10wt.% of CN. Changes in the morphology of the systems were correlated with the different properties studied. FTIR revealed the presence of a weak interaction between the polymer matrix and nanofiller, confirmed by a slightly increase in thermal stability. SEM images suggested that incorporating CN amounts higher than 3wt.% generates phase-segregated systems, and SAXS showed that CH avoid the typical organization of CN at concentrations below 5wt.%. Improved performance against water was obtained in composite materials comparing to the pure polymer matrix, as well as CH and CH-CN films did not show antibacterial activity demonstrating that remnant acetic acid, when no neutralization step is done, plays an important role in this property.

Lactobacillus plantarum CIDCA 8327: An α-glucan producing-strain isolated from kefir grains.

Lactobacillus plantarum CIDCA 8327 is an exopolysaccharide (EPS)-producer strain isolated from kefir with promising properties for the development of functional foods. The aim of the present study was to characterize the structure of the EPS synthesized by this strain grown in skim milk or semidefined medium (SDM). Additionally, genes involved in EPS synthesis were detected by PCR. L. plantarum produces an EPS with a molecular weight of 104Da in both media. When grown in SDM produce an heteropolysaccharide composed mainly of glucose, glucosamine and rhamnose meanwhile the EPS produced in milk was composed exclusively of glucose indicating the influence of the sugar source. FTIR spectra of this EPS showed signals attributable to an α-glucan. Both by 1H NMR and methylation analysis it was possible to determine that this polysaccharide is a branched α-(1→4)-d-glucan composed of 80% linear α-(1→4)-d-glucopyranosyl units and 19% (1→4)-d-glucopyranosyl units substituted at O-3 by single α-d-glucopyranosil residues.

Causes of death and clinical diagnostic errors in extreme aged hospitalized people: a retrospective clinical-necropsy survey.

BACKGROUND: There are little data on causes of death in extreme aged. We compared, using autopsy findings, main cause of death, overall disease status, and accuracy rate of clinical diagnoses in extreme aged and persons dying at younger ages. METHODS: We reviewed the complete clinical and autopsy records of 114 consecutive inpatients (97 women, 17 men, age range 97-106, mean 99, median 98) who died in Trieste, Italy, and represented 99% of all extreme-aged person deaths in the hospital and 70% in the area. The control group included 151 patients (66 women, 85 men, age range 65-74, mean 70, median 70) who died during the same period in that hospital. RESULTS: Vascular and respiratory diseases together caused 84% of deaths in extreme aged. The main causes of death were pneumonia (n = 40, 35%), pulmonary embolism (n = 16, 14%), stroke (n = 12, 11%), and myocardial infarction (n = 8, 7%). Cancer was responsible for 6% (7/114) of deaths in extreme aged and 42% (64/151) in the control group. In 5% of extreme aged, autopsy findings did not explain death. The premortem diagnostic accuracy rate for clinical diagnoses was good in 44% of extreme aged, sufficient in 18%, poor in 28%, and not evaluable in 10%, and was significantly different from controls. Pneumonia, pulmonary embolism, and myocardial infarction were markedly underestimated by clinicians in both groups. CONCLUSIONS: Extreme aged die mainly of cardiovascular and respiratory diseases and, in most cases, of acute events. Senescence is a rare cause of death. Death from cancer is substantially lower than in persons dying at younger ages. In contrast to no autopsy studies, most extreme aged in our study were found to have specific diseases that explained their deaths.

[Lung cancer in the province of Trieste]. / Cancro polmonare nella Provincia di Trieste.

In our study we analyzed a file of 756 males with lung cancer and an equal number of controls matched by sex, age and year of death. All the subjects were resident in the Trieste area, died between 1979-81 and 1985-86 and underwent autopsy at the Istitute of Pathological Anatomy of the University of Trieste. The aim of the research was to analyze and quantify the risk to develop lung cancer in those exposed to asbestos, and well-recognized carcinogens (list A of I.A.R.C.) or suspected (list B). We have also analyzed the relative risk (R.R.) for lung cancer among those subjects with environmental exposure to air pollution in industrial and urban areas. The study was set up in the Trieste province, a geographic area which is particularly suitable for epidemiological studies. We have demonstrated on excess of risk for males exposed to asbestos (R.R. = 1.99) and to other well known carcinogens (R.R. = 2.28). The capability in differentiating the relative risk of smoking and professional exposure to oncogenetic substances allowed us to detect an excess of risk for people living in industrial and urban areas, when compared to those living in rural and peripheral areas.

[Occupation and lung cancer risk in the province of Trieste: a case-control study]. / Occupazione e rischio di tumore polmonare nella provincia di Trieste: uno studio caso-controllo.

To investigate the relationship between occupation and lung cancer, a case-control study was performed in the province of Trieste, Italy, where metallurgical and mechanical industries, dock activities and shipbuilding and ship repairing are predominant. Through the local Cancer Registry, pathology records of 938 men who died of primary lung cancer (ICD 162) in a five-year period were examined. Residential, smoking and occupational histories were obtained from interviews of next of kin of 756 cases and 756 age-matched male controls (+/- 2 years). Occupational exposures to lung carcinogens were assessed according to a job-title based approach, identifying industries/occupations with well-recognized lung carcinogen exposures (list A) and industries/occupations with suspected lung carcinogen exposures (list B). Exposure to asbestos was classified as absent, possible or definite. After adjustment for cigarette smoking (four levels) and residence (three levels), a significant association was found between lung cancer and occupations in list A (RR = 2.28, 95% CI = 1.70-3.07) and in list B (RR = 1.33, 95% CI = 1.04-1.71). A significant excess risk was found for workers with definite exposure to asbestos when compared to those with no exposure to lung carcinogens (RR = 1.99, 95% CI = 1.43-2.76). A very high relative risk was observed among heavy smokers with definite exposure to asbestos (RR = 42.8). A stratified analysis showed that the combined effect of asbestos and smoking was compatible with that expected under a multiplicative model. The overall attributable risk in the population (ARp) for cigarette smoking was found to be 87.6%. The ARp fraction for occupations with well-established exposures to lung carcinogens (list A) was 16.2%. The ARp fraction increased to 25.5% (85% CI = 1.4-34.6) when occupations with suspected exposure to lung carcinogens (list B) were included. The ARp fraction for possible or definite exposure to asbestos was 20.1% (95% CI = 11.6-28.6).

[Cancer of the liver (analysis of autopsy data)]. / Rak pecheni (analiz sektsionnykh dannykh).

The findings at 26.879 autopsies, that is 70% of all the deaths registered in the Province of Trieste, obtained at the Institute of Pathologic Anatomy and Histology of Trieste from 1976 to 1985 were studied. Liver cancer showed in the Province the World Standardized Incidence Rate (WR) of 1.87 (females) and 12.78 (males), one of the highest ever observed in nonendemic areas. In view of close association between cancer of the liver and cirrhosis (88%), the authors studied the most important etiological factors of cirrhosis in the region, i.e. hepatitis B and alcohol abuse. Some effective measures are suggested to decrease the incidence of cirrhosis and eventually cancer of the liver.

Occurrence of liver cirrhosis among autopsies in Trieste.

The reports of 26,879 autopsies performed at the Institute of Pathological Anatomy at the University of Trieste during 1876-85 (70% of all deaths that occurred in the Province) were examined, and 2563 cases of liver cirrhosis were found. Analysis of the sample allowed us to make the following conclusions: (i) The prevalence of cirrhosis at autopsy is high in Trieste and shows no tendency to decrease, as has been inferred by some clinical studies. (ii) The increasing average age at death over the decade studied appears to be unrelated to the new, early treatments adopted for hepatopathic patients, since a similar yearly increase in mean age at death was seen for the whole population of the Province. The combination of a high incidence of cirrhosis and increasing average age of patients will probably result in an increasing occurrence of hepatocellular carcinoma. (iii) The observed male:female ratio (2.3) is analogous to that of alcohol drinkers in the Province and thus suggests a role of alcohol abuse in the development of cirrhosis. The distribution of markers of hepatitis B virus in the population of Trieste, which is very similar in the two sexes, supports this hypothesis.

Occupational exposure and lung cancer risk in a coastal area of northeastern Italy.

A case-control study of lung cancer and occupational exposure was conducted in a coastal area of Northeastern Italy where metallurgical and mechanical industries, docks and shipyards are located. Cases comprised 756 men who died of primary lung cancer in a 5-year period. Controls comprised 756 male subjects dying from other causes during the same period. Occupational exposures to lung carcinogens were assessed according to a job title-based approach, using two separate lists of industries/occupations recognized as being causally associated (list A) or suspected of being causally associated (list B) with lung cancer in humans. Exposure to asbestos was classified as absent, possible, or definite. After adjustment for cigarette smoking and place of residence, a significant association was found between lung cancer and occupations in both list A [relative risk (RR) = 2.25, 95% confidence interval (CI) = 1.68-3.03] and list B (RR = 1.33, 95% CI = 1.03-1.71). A significant excess risk was found for workers with definite exposure to asbestos as compared to those with no exposure to lung carcinogens (RR = 1.98, 95% CI = 1.42-2.75). Among occupations with recognized exposure to lung carcinogens other than asbestos, a significant excess risk for lung cancer was observed in iron and metalware workers. In occupational groups with definite exposure to asbestos, elevated risk estimates were found for shipyard workers, dockworkers, carpenters, and electricians. The combined effect of smoking and asbestos was found to be compatible with that expected under a multiplicative model. The overall population-attributable risk (ARp) for cigarette smoking was found to be 87.5%.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison between diagnoses on death certificates and autopsy reports in Trieste: gynaecological cancers.

We have compared autopsy results with the diagnosis reported on 759 death certificates for gynaecological cancers. High levels of discrepancies were noted for all sites. Surprisingly, complete agreement between death certificates and autopsy reports was found for only 30% of cervical and corpus tumours and for 50% of ovarian tumours. This low level of agreement was due partly to the poor quality of death certificates of older women. No difference in accuracy was found over the 15-year period considered. The most obvious causes of the discrepancies were of two types. The first was erroneous interpretation of codes; confusion between 180 (cervix) and 182 (corpus) was very frequent. The second type was associated with clinical factors, such as confusion of anatomical site, adjacent organs or metastases being diagnosed as primary tumours. A relatively frequent cause of inaccuracy on death certificates was consideration of patients who had been cured of a cancer as having died of the disease.