Independent Functioning in Nonagenarians Living in a Rural Italian Community: The Mugello Study.

Nonagenarians are a fast-growing population deserving specific research. We explored the prevalence and characteristics of functionally independent nonagenarians from a rural community-dwelling Italian population. Data were collected in the Mugello Study; 475 persons aged ≥90 years (median age, 92) underwent a home-based clinical and functional assessment, including psychosocial, clinical, functional, and lifestyle history and status and physical and instrumental examinations. Sixty-eight (15%) persons reported no need for help in basic and instrumental daily living activities. Among variables significantly associated with independent functionality after age- and gender-adjusted cross-sectional analysis, lower body mass index (BMI; p = .034) and depressive symptoms (p = .028), higher current physical activity (p < .001), better cognitive status (p = .033), and lower medication intake (p = .048) were associated with reporting no disability in the logistic regression analysis. Disability was mainly associated with current lifestyle-related potentially modifiable factors. Thus, lifestyle-oriented multidimensional interventions, should be developed and evaluated for their potential effects on functionality, even in the oldest old.

Low-risk cigarettes: a prescription.

Antismoking education campaigns in out society have met with only partial success: today 55 to 60 million Americans smoke, and the habit is increasing among teenagers and women. It is important to protect individuals who continue to smoke despite all warnings. There is evidence that this can be accomplished in at least two ways. First, it may be possible to remove toxic smoke components and thus reduce specific hazards. Second, the doseresponse evidence suggests that, if the total intake of smoke can be reduced, after an appropriate time a reduction in disease incidence should occur. The technology to achieve these results has been developed and can be applied to the manufacture of commercial cigarettes. These cigarettes will not conform to traditional flavour patterns, but consumer perception can be made to change and compensating flavours and fragrances can be added. The feasibility of less hazardous cigarettes raises the question of whether there are limits of cigarette and smoke composition that may approach relative safety. These limits can be defined as the smoke intake doses at which the risk of disease in smokers approaches that in nonsmokers. Such values can be extimated by dose-response analysis of several epidemiological studies and by extrapolation of blood concentrations at different rates of intake for certain smoke components, such as carbon monoxide. Critical values determined by these methods should not be interpreted as indicators of safe smoking levels; they do imply, however, that a rapid shift in cigarette consumption habits toward the proposed range of values will make possible a substantial reduction in the current epidemic proportions of smoking-related diseases.

Genetic polymorphisms of thiopurine S-methyltransferase in a cohort of patients with systemic autoimmune diseases.

OBJECTIVES: Azathioprine (AZA) is a purine antimetabolite, prodrug widely used as a disease modifying drug in several rheumatic conditions. The aim of the present study was to evaluate the prevalence of TPMT genetic polymorphisms in a cohort of Italian Caucasian patients affected by rheumatic diseases and treated with AZA, and to establish correlations with the tolerability of AZA treatment. RESULTS: Seventy-eight Caucasian patients, 16 males and 62 females, median age 41 years (min-max: 24-76) were enrolled. At the time of evaluation, the median duration of treatment with AZA was 8 months (min-max: 2-150 months); the median dose of AZA per kg of body weight was 1.42 mg (min-max: 0.5-2). Among the 78 patients evaluated, 76 presented a wild type genotype (TPMT *1), while polymorphic alleles were identified in 2 patients (2.6%). Twenty-five patients (32%) experienced different types of adverse events (AE) under AZA treatment. Eighteen patients (23.1%) discontinued AZA because of AE. No correlation was observed between polymorphic TPMT alleles and the development of AE. CONCLUSIONS: Our analysis supports the view that TPMT genotyping alone is not sufficient to adequately personalize the AZA dosage in rheumatic patients. Further studies based on phenotypic analysis of TPMT enzyme and assay of AZA metabolite appear to be required.

Effects of a bicarbonate-alkaline mineral water on digestive motility in experimental models of functional and inflammatory gastrointestinal disorders.

This study investigates the effects of Uliveto, a bicarbonate-alkaline mineral water, in experimental models of diarrhea, constipation and colitis. Rats were allowed to drink Uliveto or oligomineral water (control) for 30 days. Diarrhea and constipation were evoked by 16,16-dimethyl-prostaglandin E(2) (dmPGE(2)) or loperamide, respectively. Colitis was induced by 2,4-dinitrobenzenesulfonic acid (DNBS) or acetic acid. Gastric emptying, small-intestinal and colonic transit were evaluated. dmPGE(2)-induced diarrhea reduced gastric emptying and increased small-intestinal and colonic transit. In this setting, Uliveto water enhanced gastric emptying, and this effect was prevented by L-365,260 (gastrin receptor antagonist). Loperamide-induced constipation reduced gastric emptying, small-intestinal and colonic transit, and these effects were prevented by Uliveto water. L-365,260 counteracted the effects of Uliveto on gastric emptying, while alosetron (serotonin 5-HT(3) receptor antagonist) blunted the effect of Uliveto on colonic transit. Gastric emptying, small-intestinal and colonic transit were reduced in DNBS-induced colitis, and Uliveto water enhanced gastric emptying and normalized small-intestinal and colonic transit. Gastric emptying, small-intestinal and colonic transit were also reduced in acetic acid-induced colitis, and Uliveto increased both gastric emptying and small-intestinal transit. In conclusion, Uliveto water exerts beneficial effects on gastrointestinal motility in the presence of bowel motor dysfunctions. The effects of Uliveto water on gastric emptying depend on gastrin-mediated mechanisms, whereas the activation of serotonergic pathways accounts for the modulation of colonic functions.

One-dimensional long-range percolation: A numerical study.

In this paper we study bond percolation on a one-dimensional chain with power-law bond probability C/r^{d+σ}, where r is the distance length between distinct sites and d=1. We introduce and test an order-N Monte Carlo algorithm and we determine as a function of σ the critical value C_{c} at which percolation occurs. The critical exponents in the range 0<σ<1 are reported. Our analysis is in agreement, up to a numerical precision ≈10^{-3}, with the mean-field result for the anomalous dimension η=2-σ, showing that there is no correction to η due to correlation effects. The obtained values for C_{c} are compared with a known exact bound, while the critical exponent ν is compared with results from mean-field theory, from an expansion around the point σ=1 and from the ɛ-expansion used with the introduction of a suitably defined effective dimension d_{eff} relating the long-range model with a short-range one in dimension d_{eff}. We finally present a formulation of our algorithm for bond percolation on general graphs, with order N efficiency on a large class of graphs including short-range percolation and translationally invariant long-range models in any spatial dimension d with σ>0.

The diet, nutrition, and cancer program of the NCI National Cancer Program.

In November 1974, in response to a mandate in the revised National Cancer Act of 1974, a plan was introduced for the formation of a Diet, Nutrition, and Cancer Program. Dr. Frank J. Rauscher, Director of the National Cancer Institute, selected a group of scientists who defined the goals of the program and recommended the appointment of a program director and of an advisory committee. These recommendations were accepted, and an Advisory Committee, reflecting a cross-section of scientific expertise, has been selected. To recommend a well-balanced program, it will be necessary for the Advisory Committee to assess the current state of the art of nutrition in cancer etiology and therapy and to be apprised of current opportunities, needs, and resources. Toward this end, a literature survey project has been initiated and two specialized workshops have been held.

[Tannin and gallic acid as marker of exposure to hardwood dust]. / I tannini e l'acido gallico come indicatori di esposizione a polveri di legno duro.

The total tannin concentration was determined, using two different SPF methods, in 35 dust powdered wood species, both hard and softwood. Using direct reading-method (280 nm) the concentration varied from 2485 mg/g for Swedish pine to 35,843 mg/g for European oak (quercus robur, hardwood). The data obtained with the second method (Folin-Chocalteau) were well correlated (y = 0.9885x + 4.3373; r = 0.84; n=35) with the data obtained with the first method. The measured concentrations are usually higher in hardwood than softwood tested. Finally, a simple HPLC-DAD method was tested for gallic acid (GA), recently proposed as a marker for oak dust.

[Validation of PM10 and PM2.5 personal samplers: comparison between PEM and CEN-ARPAV selectors]. / Studio di validazione dei selettori per il campionamento personale di PM10 e PM2.5: confronto fra selettori PEM e teste di prelievo CEN-ARPAV.

In order to validate specific personal selectors for the collection of fine particles, 65 double measurements of PM10 and PM2.5 were carried out at the same collection site; thus allowing a comparison between two different methods of sampling. The first method was that normally used by ARPAV in order to sample the above-mentioned granulometric fractions in outdoor environment. The second method was chosen by us for personal sampling (PEM working at 2 l/min and at 4 l/min). In both cases the filters gravimetric analysis conformed to the expectations of D.M. 60 of 2/4/2002. The comparison between the two methods showed a good correlation in both the granulometric fractions: correlation coefficients r for the PM2.5 are equal to 0.96 and 0.99 for the PEM working at 2 l/min and at 4 l/min respectively; r for the PM10 are equal to 0.98 and 0.99 for the PEM working at 2 l/min and at 4 l/min respectively. The analysis of results in terms of fine particles concentration and difference between methods against their mean, shows a slight overestimate of the particles concentration with PEM working at 2 l/min, compared to those working at 4 l/min. Nevertheless, considering the good results obtained even with a flow of 2 l/min, we believe that using PEM working at 2 l/min to monitoring 24 hours-personal exposure assures an improved capacity in the battery-operated pumps.

Automatic and voluntary orienting of attention in patients with visual neglect: horizontal and vertical dimensions.

The present study was aimed at testing internally and externally-controlled mechanisms of covert orienting in patients with visuo-spatial neglect. Internally-controlled orienting was tested by presenting central informative cues. Externally-controlled orienting was tested by presenting peripheral non-informative cues. We also tested for the presence of vertical neglect in patients with horizontal neglect, and tried to assess whether altitudinal neglect is an attentional deficit. Finally we examined whether altitudinal neglect manifests itself only in the visual field contralateral to the lesion or, as has been shown for horizontal neglect, whether it is also present in the ipsilesional visual field. The results showed that patients with neglect have a deficit of externally-controlled covert orienting in the visual field opposite to that of the lesion. Further, the impairment appeared to be more pronounced in the lower than in the upper visual field and to be mainly evident in the visual field contralateral to the lesion. The deficit could, however, be partially compensated for by the use of internally-controlled covert orienting. These findings seems to support the dual-mechanisms hypothesis which maintains that automatic and voluntary orienting are subserved by separate mechanisms possibly located in different parts of the brain.

Science, policy, and ethics: the case of environmental tobacco smoke.

The successful campaign against smoking will long be celebrated as a landmark achievement of public health. Recently, a prominent component of this campaign has been the portrayal of environmental tobacco smoke as a major health risk. To this day, however, the scientific basis for this later contention remains speculative. The elevation of heuristic hypotheses into official precepts raises an intriguing ethical question: Should a claim of best intentions justify representing conjecture as scientific knowledge in public policy formulation?

Presentation: Epidemiology and public health: is a new paradigm needed or a new ethic?

Public health militancy has been increasingly frustrated by what many perceive as the marginally fertile studies of risk factors operating at the individual level, whose causal underpinnings are often and inevitably weakened in multifactorial situations. As a remedy, leading advocates propose a refocusing of epidemiology and public health on socioeconomic, cultural, and political studies, and on broad interventions at population level. This new "paradigm" would be aided by a relaxation of evidentiary standards of causality, away from scientific criteria and more toward dialectic (rhetorical) precepts derived in a humanistic and sociologic tradition. It is countered here that such proposals would further reduce the objectivity and thus likely weaken rather than strengthen epidemiology and the justification of public health action. Instead, a realistic appraisal finds that multifactorial epidemiology raises warning signals of varying influence, and that the usefulness of epidemiology and public health could be enhanced by conceiving of methods to score the relative strength and priority of such warnings.