Climate change impacts on eutrophication in the Po River (Italy): Temperature-mediated reduction in nitrogen export but no effect on phosphorus.

Rivers worldwide are under stress from eutrophication and nitrate pollution, but the ecological consequences overlap with climate change, and the resulting interactions may be unexpected and still unexplored. The Po River basin (northern Italy) is one of the most agriculturally productive and densely populated areas in Europe. It remains unclear whether the climate change impacts on the thermal and hydrological regimes are already affecting nutrient dynamics and transport to coastal areas. The present work addresses the long-term trends (1992-2020) of nitrogen and phosphorus export by investigating both the annual magnitude and the seasonal patterns and their relationship with water temperature and discharge trajectories. Despite the constant diffuse and point sources in the basin, a marked decrease (-20%) in nitrogen export, mostly as nitrate, was recorded in the last decade compared to the 1990s, while no significant downward trend was observed for phosphorus. The water temperature of the Po River has warmed, with the most pronounced signals in summer (+0.13°C/year) and autumn (+0.16°C/year), together with the strongest increase in the number of warm days (+70%-80%). An extended seasonal window of warm temperatures and the persistence of low flow periods are likely to create favorable conditions for permanent nitrate removal via denitrification, resulting in a lower delivery of reactive nitrogen to the sea. The present results show that climate change-driven warming may enhance nitrogen processing by increasing respiratory river metabolism, thereby reducing export from spring to early autumn, when the risk of eutrophication in coastal zones is higher.

Ten new cases of Balanced Reciprocal Translocation Mosaicism (BRTM): Reproductive implications, frequency and mechanism.

Chromosomal anomalies are well known to be an important cause of infertility, sterility and pregnancy loss. Balanced Reciprocal Translocation Mosaicism (BRTM) is an extremely rare phenomenon, mainly observed in subjects with a normal phenotype accompanied by reproductive failure. To date the mechanism of origin and the incidence of BRTM are poorly defined. Here we describe 10 new cases of BRTM. In 9 cases chromosome analysis revealed the presence of two different cell lines, one with a normal karyotype and the second with an apparently balanced reciprocal translocation. In the remaining case, both cell lines showed two different, but apparently balanced, reciprocal translocations. We document the clinical implications of BRTM, discuss its frequency in our referred population and suggest that carrier individuals might be more frequent than expected.

[Polypharmacy and psychotropic drugs as risk factors for falls in long-term care setting for elderly patients in Lombardy]. / Psicofarmaci e polifarmacoterapia come fattori di rischio per le cadute negli anziani istituzionalizzati. Uno studio trasversale in una Residenza socio assistenziale lombarda.

Aim of the study was to investigate polypharmacy and psychotropic drugs as risk factors for falls in a Long-term Care Setting for elderly patients. In a cross-sectional study we investigated the characteristics of 414 subjects: 207 fallen patients 44 (21.3%) male e 163 (78.7%) female mean age 84.16 +/- 8.3 y.o. First generation neuroleptics (OR 1.739 CI 95% 1.047-2.889), benzodiazepines (OR 2.357 CI 95% 1.5-3.702) and mood stabilizers (OR 1.889 CI 95% 1.091-3.270) were associated to falls when adjusted for age, sex and comorbidities. Polypharmacotherapy (> or = 4 drugs) was a risk factor for falls when associated to a risk medication in the daily regimen only (OR 2.157 CI 95% 1.447-3.217). What raised has to be taken into account in the prescriptive activities in a Long term Care Setting for elderly patients.

Gender differences in chronic obstructive pulmonary diseases: a narrative review.

Chronic obstructive pulmonary disease (COPD) is generally considered to be prevalent in males. However, smoking is rising in women in developing and developed countries, while exposure to biomass fuel for domestic purposes is a recognized risk factor among females. Females developing more severe COPD patterns due to tobacco exposure than men may be due to a genetic predisposition, a greater dose-dependent effect of smoke related to smaller airways caliber and an increased oxidative stress with augmented TGF-beta1 signaling. Gender hormones also seem to be involved in tobacco-smoke metabolism and in lung and pulmonary development. while menopause is associated with accelerated alveolar loss and decline of lung function pulmonary function. The time to diagnosis differs between the sexes since a lower rate of spirometry is performed in women. Also, comorbidities vary between genders: osteoporosis, inflammatory bowel diseases, reflux, hypertension, rheumatoid arthritis, and mental diseases are more common in women. Women pay more attention to breathlessness, maybe due to higher emotional response and anxiety. These elements could lead to higher hospitalization rates in women. The aim of this review is to provide the available evidence with the aim of inviting healthcare professionals to evaluate gender differences in patients with COPD, key point for optimizing the care plan.

Fluorescence in situ hybridization dissection of a chronic myeloid leukemia case bearing the apparently balanced translocations (9;22)(q34;q11.2) and (11;11)(p15;q13).

We report on a patient with chronic myeloid leukemia (CML), which was detected by conventional cytogenetic analysis, to carry two different acquired and apparently balanced translocations, (9;22)(q34;q11.2) and (11;11)(p15;q13). By fluorescence in situ hybridization characterization, we were able to finely map the genomic regions involved in the translocation breakpoints and to disclose concomitant deletions adjacent to the breakpoints on the two derivative chromosomes 11 and the derivative chromosome 22, and the insertion of a segment from chromosome band 11q12.2 into the derivative chromosome 9. We discuss the putative mechanism that could have led to the formation of this complex rearrangement and speculate on the role in leukemogenesis played by the genes mapping at the breakpoints and within the deleted regions.

De novo balanced chromosome rearrangements in prenatal diagnosis.

OBJECTIVE: We surveyed the datasheets of 29 laboratories concerning prenatal diagnosis of de novo apparently balanced chromosome rearrangements to assess the involvement of specific chromosomes, the breakpoints distribution and the impact on the pregnancy outcome. METHOD: By means of a questionnaire, data on 269.371 analyses performed from 1983 to 2006 on amniotic fluid, chorionic villus and fetal blood samples were collected. RESULTS: A total of 246 balanced anomalies were detected at frequencies of 72% for reciprocal translocations, 18% for Robertsonian translocations, 7% for inversions and 3% for complex chromosome rearrangements. The total frequencies of balanced rearrangements were 0.09%, 0.08% and 0.05% on amniotic fluid, chorionic villus and fetal blood samples. CONCLUSION: A preferential involvement of chromosomes 22, 7, 21, 3, 9 and 11 and a less involvement of chromosomes X, 19, 12, 6 and 1 was observed. A nonrandom distribution of the breakpoints across chromosomes was noticed. Association in the location of recurrent breakpoints and fragile sites was observed for chromosomes 11, 7, 10 and 22, while it was not recorded for chromosome 3. The rate of pregnancy termination was about 20%, with frequencies decreasing from complex chromosomal rearrangements (33%), reciprocal translocations (24%) to inversions (11%) and Robertsonian translocations (3%).

Padrão de prescrição de medicamentos as Unidades de Programa de Saúde da Família de Blumenau / Prescribed drugs in Attendance Sampling at Basic Health Service in Blumenau

Os medicamentos constituem parte importante dos recursos terapêuticos disponíveis e muitas vezes são a opção com melhor perfil custo-benefício. O conhecimento do padrão de prescrição de um determinado local possibilita melhor gerenciamento da assitência farmacêutica. O objetivo do presente trabalho foi descrever os medicamentos prescritos em uma amostragem do Programa de Saúde da Família (PSF) de Blumenau, SC. Foram entrevistados 186 pacientes durante um dia de atendimento, classificando-se dados de acordo com os indicadores de prescrição da OMS. Foram prescritos 336 medicamentos, sendo que o número médio de medicamentos por prescrição foi 1,8...