Osme Bond: Geometric and Energetic Features in the Adducts between OsO4 and Lewis Bases.

Adducts between OsO4 and Lewis bases exert a role in important oxidation processes such as epoxidation and dihydroxylation. It has been shown that the attractive interaction driving the formation of these adducts is a σ-hole bond involving the metal as the electrophilic species; the term Osme Bond (OmB) was proposed for designating it. Here some new adducts between OsO4 and various bases have been characterized through single crystal x-ray diffraction (XRD) and computational studies (density functional theory, DFT), confirming the existence of a robust correlation between σ-hole interaction energy and deformation of the tetrahedral geometry of OsO4. Also, some adducts formed by RuO4 with nucleophiles were investigated computationally.

Tetrel Bond Affects the Self-Assembly of Acetylcholine and its Analogues and is an Ancillary Interaction in Protein Binding.

The -N+(CH3)3 residue is present in acetylcholine (ACh) and in many of its analogues which are used as selective ACh agonist or antagonists for human therapy. The X-ray structures of four ACh derivatives show the presence of short and linear contacts between the C atoms of -N+(CH3)3 groups and lone pair possessing atoms. These contacts can be rationalized as tetrel bonds (TtBs) thanks to their geometric features. Interrogation of the Protein Data Bank suggests that similar -N+-C⋅⋅⋅nucleophile contacts affect the details of the binding of ACh and its derivatives to proteins. Quantum theory of atoms in molecules, noncovalent interaction plot, and natural bond orbital analyses consistently confirm that the -N+-C⋅⋅⋅nucleophile contacts observed in small molecule crystals and in substrate/protein complexes are attractive in nature and can be rationalized as TtBs. TtBs involving methyl groups of the -N+(CH3)3 moiety can be proposed as a new item in the palette of interactions allowing the compounds containing this pharmacophoric unit to bind to their target protein and/or to express their biological/pharmacological properties.

[Cardiac arrythmias in the elderly]. / Aritmie cardiache in età geriatrica.

The prescription of antiarrhythmic therapy in the elderly depends on the characteristics of clinical symptoms and on the potential morbidity and mortality. Some cardiac arrhythmias may cause bothersome symptoms but do not affect the long-term prognosis. However, other dysrhythmias with mild or no symptoms may be associated with a poor prognosis.

Quality of Life and Excessive Daytime Sleepiness in Adults with Obstructive Sleep Apnea Who Are Treated with Multilevel Surgery or Adherent to Continuous Positive Airway Pressure.

Obstructive Sleep Apnea (OSA) syndrome is a respiratory sleep disorder characterized by a reduction (hypopnea) in or a complete cessation (apnea) of airflow in the upper airways at night, in the presence of breathing effort. The gold standard treatment for OSA is ventilation through continuous positive airway pressure (CPAP), although this often shows poor patient compliance. In recent years, transoral robotic surgery (TORS) has been proposed as a valid surgical treatment for patients suffering from OSA in a multilevel surgical setting. The aim of this study is to analyze the effects on QoL and daytime sleepiness of multilevel surgery for OSA (barbed pharyngoplasty + transoral robotic surgery). Furthermore, we compared the impact on QoL and daytime sleepiness of two different treatments for patients with moderate to severe OSA, such as CPAP and TORS. Sixty-seven OSA patients who underwent multilevel robotic surgery and sixty-seven OSA patients treated with CPAP were enrolled, defined as Group 1 and Group 2, respectively. The Glasgow Benefit Inventory (GBI) questionnaire was administrated to evaluate the changes in the QoL. Respiratory outcomes were evaluated and compared. Group 1 showed a GBI total average value of +30.4, whereas Group 2, a value of +33.2 (p = 0.4). General benefit score showed no difference between groups (p = 0.1). Better values of social status benefit (p = 0.0006) emerged in the CPAP Group, whereas greater physical status benefit (p = 0.04) was shown in the TORS Group. Delta-AHI (-23.7 ± 14.3 vs. -31.7 ± 15.6; p = 0.001) and Delta-ODI (-24.5 ± 9.5 vs. -29.4 ± 10.5; p = 0.001) showed better values in the CPAP group. Therapeutic success rate of the Multilevel TORS Group was 73.1% and 91% in the CPAP group (p = 0.01), respectively. Multilevel TORS and CPAP have a positive effect on the quality of life of OSA patients. Greater social support has been reported in the CPAP group and better physical health status in the TORS group. No statistical difference emerged in the reduction in daytime sleepiness between both groups.

[Non-invasive ventilation in acute respiratory failure. A case report]. / Insufficienza respiratoria acuta trattata con ventilazione meccanica non invasiva.

This is a case of 89 years old patient suffering by chronic obstructive pulmonary disease and affected by acute respiratory failure characterized by hypoxemia and hipercapnia. It is interesting because, comparing oxygen therapy and non invasive ventilation, the best results were reached with the last technique, in an elder patient.

[Prevalence of depression in a geriatric population with metabolic syndrome]. / Prevalenza della depressione in una popolazione geriatrica con sindrome metabolica.

Metabolic Syndrome (Metabolic Syndrome, MS) is associated with many other diseases in the elderly. We have studied a possible correlation between this disorder and depression in a Geriatric Centre. The study was conducted on a random sample of 30 geriatric patients, then divided into 2 groups according to clinical and instrumental diagnostic investigations: 15 patients affected MS according to the criteria of NCEP ATP III, and 15 controls without MS. Then it's administered the Geriatric Depression Scale (GDS). Elaboration of the results it appears statistically significant correlation (t=2.05, p=0.0495) between MS and depression in the elderly.

Positional Obstructive Sleep Apnea Syndrome in Elderly Patients.

Background The purpose of this study was to evaluate the prevalence of position-dependent obstructive sleep apnea (POSA) in elderly patients (≥65 years old). Adult (range 19-65 years old) and elderly patients were also compared in order to show differences in the incidence of POSA between these two groups of patients. Methods A prospective bi-center study was performed between January 2018 and May 2019. A total of 434 participants underwent polysomnography (PSG) study at home (Embletta MPR). Body position during the PSG recordings was determined. Patients were subdivided in two groups: those aged between 19 and 65 years old (adult patients) and ≥65 years old (elderly patients). POSA patients were defined using Cartwright's system, Bignold classification, and the new Amsterdam Positional OSA Classification (APOC). Results The prevalence of POSA in elderly patients differed according to the classification system used: 49.3% using Cartwright's classification system, 20.5% with the Bignold classification, and 22.6%, 38.9%, and 5.4% of APOC 1, APOC 2, and APOC3 sub-classes were respectively identified for the APOC classification system. No difference between adult and elderly patients regarding the prevalence of POSA was observed. No statistical differences emerged between the two groups of patients in terms of supine (p = 0.9) and non-supine AHI (p = 0.4). Conclusions A significant number of elderly patients could be considered treatable with positional therapy according to the APOC classification. However, the efficacy and applicability of positional therapy in elderly patients must be confirmed by further research.

Laryngopharyngeal Reflux Diagnosis in Obstructive Sleep Apnea Patients Using the Pepsin Salivary Test.

BACKGROUND: To investigate the presence of laryngopharyngeal reflux in patients with obstructive sleep apnea (OSA) employing the salivary pepsin concentration method. To compare the results of pepsin concentration with the severity of the pathology. METHODS: Seventy-five OSA patients (44 males, 31 females) were enrolled in the study. For each patient, the AHI (apnea-hypopnea index) and the BMI (body mass index) were initially evaluated. All the patients enrolled were assessed using the reflux symptom index (RSI) and the reflux finding score (RFS) in order to perform a clinical diagnosis of laryngopharyngeal reflux. In all patients a salivary sample was taken to estimate the presence of pepsin and its concentration. RESULTS: The incidence of LPR (laryngopharyngeal reflux) in OSA patients, evaluated using the salivary pepsin concentration test (PEP-test), was found to be 32% of cases. Linear regression testing did not show any correlation between AHI and pepsin concentration in salivary samples (p = 0.1). CONCLUSION: A high number of patients with OSA seem to show positivity for salivary pepsin, correlated to an LPR. There does not appear to be a correlation between the severity of apnea and the grade of salivary pepsin reflux. On the other hand, direct correlation between BMI and the value of pepsin in salivary specimens was observed.