Cost-effectiveness of buffered soluble alendronate 70 mg effervescent tablet for the treatment of postmenopausal women with osteoporosis in Italy.

The use of buffered soluble alendronate 70 mg effervescent tablet, a convenient dosing regimen for bisphosphonate therapy, seems a cost-effective strategy compared with relevant alternative treatments for postmenopausal women with osteoporosis aged 60 years and over in Italy. INTRODUCTION: To assess the cost-effectiveness of buffered soluble alendronate (ALN) 70 mg effervescent tablet compared with relevant alternative treatments for postmenopausal osteoporotic women in Italy. METHODS: A previously validated Markov microsimulation model was adjusted to the Italian healthcare setting to estimate the lifetime costs (expressed in €2019) per quality-adjusted life-years (QALY) of buffered soluble ALN compared with generic ALN, denosumab, zoledronic acid and no treatment. Pooled efficacy data derived from the NICE network meta-analysis were used for bisphosphonate treatments. Two treatment duration scenarios were assessed: 1 year using persistence data derived from an Italian prospective observational study including 144 and 216 postmenopausal osteoporotic women on buffered soluble ALN and oral ALN, respectively, and 3 years. Analyses were conducted for women 60-80 years of age with a bone mineral density T-score ≤ - 3.0 or with existing vertebral fractures. RESULTS: In all simulated populations, buffered soluble ALN was dominant (more QALYs, lower costs) compared to denosumab. The cost per QALY gained of buffered soluble ALN compared to generic ALN and no treatment always falls below €20,000 per QALY gained. In the 1-year treatment scenario, zoledronic acid was associated with more QALY than buffered soluble ALN but the cost per QALY gained of zoledronic acid compared with buffered soluble ALN was always higher than €70,000, while buffered soluble ALN was dominant in the 3-year treatment scenario. CONCLUSION: This study suggests that buffered soluble ALN represents a cost-effective strategy compared with relevant alternative treatments for postmenopausal osteoporosis women in Italy aged 60 years and over.

Identifying N fertilizer management strategies to reduce ammonia volatilization: Towards a site-specific approach.

Concerns about ammonia (NH3) losses from nitrogen (N) mineral fertilizers have forced policymakers to set emission reduction commitments across Europe. Although best available techniques (BATs) have been recommended, large uncertainties still exist due to poorly targeted site-specific approaches that might compromise their effectiveness. Here we proposed and tested a conceptual framework designed to identify most effective BATs that reduce NH3 at the site-specific level. The study was conducted in the Veneto region, northeast Italy. After the mapping of NH3 emission potential areas, BATs and business-as-usual N fertilization scenarios were assessed using a modified version of the DNDC agroecosystem model and compared with urea broadcast distribution under different pedo-climatic conditions. The most promising practices were further tested in a field experiment using a wind tunnel combined with a FTIR gas analyzer. Results showed that closed-slot injection reduced NH3 emissions with any type of mineral or organic fertilizers. Injected application, with ammonium nitrate or organic fertilizers, reduced NH3 loss in maize by 75% and 96%, respectively, and in winter wheat by 87% and 98%, compared to surface broadcast. Injection was the most promising technology to support, being already available to farmers. However, some increase in nitrate leaching was observed, mostly in case of winter wheat (+24% for AN injection; +89% for organic fertilizers). By contrast, urea incorporation with hoeing, the most common technique used by farmers in spring crops, did not show satisfactory results, because the partial burial of urea caused strong NH3 emissions that were even higher compared to surface broadcast. Recommended NH3 reduction techniques should be tailored to local pedo-climatic and management conditions, and evaluated, in a holistic approach, considering all N fluxes in the environment.

Vitamin D status and non-alcoholic fatty liver disease in patients with type 1 diabetes.

PURPOSE: In patients with type 1 diabetes (T1D), the prevalence of non-alcoholic fatty liver disease (NAFLD) ranges from 10 to 53% and contrasting evidence suggests that vitamin D deficiency may favor liver fat accumulation. Here, we investigated the association between vitamin D status and NAFLD in adults with T1D. METHODS: 220 consecutive adult T1D patients on multiple daily injections or continuous subcutaneous insulin infusion and not taking calcium or vitamin D supplements were included. Patient characteristics, 25(OH)D serum levels, and metabolic parameters were analyzed. Vitamin D status was defined as sufficiency ( ≥ 75 nmol/L; 30 ng/ml), insufficiency (50-75 nmol/L; 20-30 ng/ml), or deficiency ( < 50 nmol/L; 20 ng/ml). NAFLD was diagnosed at ultrasound examination and graded 0-3. RESULTS: NAFLD was present in 57 patients (29.5%): 51 grade 1, 5 grade 2, and 1 grade 3. Median 25(OH)D levels were 53 nmol/L (IQR 38-70) in patients with NAFLD and 50 nmol/L (34-69) in patients without (p = 0.46). At multivariable analysis, NAFLD was not associated with 25(OH)D levels (p = 0.42) or vitamin D deficiency (p = 0.55), while BMI (OR 1.16, 95% CI 1.07-1.27) and serum triglycerides (OR 1.02, 95% CI 1.01-1.03) were independently associated with NAFLD. CONCLUSIONS: Vitamin D status appears to have no link with low-grade NAFLD in patients with type 1 diabetes.

High serum uric acid levels increase the risk of metabolic syndrome in elderly women: The PRO.V.A study.

BACKGROUND AND AIMS: Serum uric acid (SUA) is the end-product of purine metabolism in humans, and its levels often increase in subjects with metabolic syndrome (MetS). Despite several studies demonstrating a relationship between increased SUA levels and the prevalence of MetS, prospective data on SUA as a predictor of the incidence of MetS in the elderly are limited. Our aim was to conduct a prospective study on the association between SUA concentrations and the onset of MetS in an elderly Italian cohort. METHODS AND RESULTS: This is a cohort study (Progetto Veneto Anziani; Pro.V.A.) involving community-dwelling subjects aged ≥65 years and followed up for a mean 4.4 years. We included 1128 participants (aged 74.7 ± 7.1 years) without MetS at the baseline. Gender-specific SUA groups according to the standard deviation (SD) from the mean were considered, taking the incidence of MetS as the main outcome. The mean SUA level was significantly higher in men than in women (5.4 ± 1.2 vs. 4.5 ± 1.2 mg/dl; p < 0.0001). Over the 4.4-year follow-up, 496 individuals developed MetS. After adjusting for potential confounders, Cox's regression analysis revealed no relationship between higher baseline SUA concentrations and the incidence of MetS in men or in the sample as whole, while women with SUA levels more than 1 SD above the mean (≥5.7 mg/dl) carried a 58% higher risk (95%CI: 1.03-2.40; p = 0.03) of being newly diagnosed with MetS during the follow-up. CONCLUSION: High SUA levels significantly and independently predicted MetS in older women, but not in men, over a 4.4-year follow-up.

Ultrasonic shears and bipolar vessel-sealing system for three-port laparoscopic ovariohysterectomy in dogs / Bisturi ultrassônico e sistema de selamento de vasos sanguíneos para ovário-histerectomia laparoscópica com três portais em cães

In the current experimental study, two different instruments were compared for prophylactic hemostasis during a 3-port technique of laparoscopic ovariohysterectomy (OVH) in bitches. Moreover, the need for port enlargement for specimen retrieval using 5mm or 10mm trocartes, technical difficulties and complications were assessed. Ultrasonic energy and a vascular sealing system were tested. Duration of surgery, patient weight and diameter of the uterine arteries and veins were compared among the groups. Fifteen dogs randomly divided into three groups (GI, GII, GIII) were submitted to ovariohysterectomy with hemostasis from the use of ultrasonic scalpel or vascular sealing equipment. In GI and GII the LigaSure(tm) impedance-controlled bipolar vessel-sealing device was used, differing in the size of trocartes used between groups, and in GIII Autosonix(tm) was used. Patients' weight, duration of surgery, technical difficulties and complications were compared among the groups. Statistical analysis showed no difference between the data analyzed among the groups. In conclusion, both methods of hemostasis were effective for 3-port total laparoscopic ovariohysterectomy in bitches. However, 5mm trocartes were not adequate for retrieval of the uterus and ovaries without need for enlargement of the port incision.

No presente experimento, foram comparados dois diferentes equipamentos, um com emprego de energia ultrassônica, e outro utilizando sistema de selamento vascular, como única forma de hemostasia em ovário-histerectomias laparoscópicas com três portais em cadelas. Ademais, a necessidade de ampliação da incisão do portal de 5mm ou de 10mm para a remoção dos espécimes ressecados, dificuldades técnicas e complicações foram avaliadas. Quinze cadelas aleatoriamente distribuídas em três grupos (GI, GII, GIII) foram submetidas à ovário-histerectomia com hemostasia a partir da utilização de bisturi ultrassônico ou equipamento de selamento vascular. Nos GI e GII foi utilizado um sistema de selamento vascular eletrotérmico bipolar (LigaSure(r)), diferindo-se no tamanho dos portais utilizados; em GIII foi utilizado bisturi ultrassônico (Autosonix(r)). A análise estatística não demonstrou diferença significativa entre os dados analisados nos três grupos. Conclui-se que ambos os métodos de hemostasia utilizados mostraram-se adequados e viabilizaram a realização de ovário-histerectomia laparoscópica em cadelas. Todavia, o trocarte de 5mm não foi adequado para remoção do útero e ovários sem necessidade de ampliação da incisão de acesso.

[Candidemia epidemiology in Córdoba Argentina. Surveillance study of five institutions]. / Epidemiologia de candidemia en Córdoba Republica Argentina. Estudio de vigilancia de cinco instituciones.

UNLABELLED: The incidence rate of invasive infections due to Candida species has increased drastically in the last 20 years, causing a 40% mortality rate in hospitalized patients. In order to comprehend the epidemiology of Candida bloodstream infection, the study was carried out. MATERIALS AND METHODS: A retrospective study was done based on microbiology laboratory reports from five terciary care hospitals from the city of Cordoba between January 2010 and August 2012. RESULTS: 158 patients had candidemia, the average age was 55,8 years, and 54% of patients were in the intensive care unit. Candida albicans (44%), Candida parapsilosis (22%) and Candida tropicalis (12%) were the main fungi isolated. Candida parapsilosis was commonly associated with catether infections. CONCLUSIONS: The data from the city of Cordoba showed that C. albicans, C. parapsilosis y C. tropicalis were the more frequent species isolated from blood cultures. This is similar to what is seen in other series published from Argentina and Latinamerica. This study may have implications when it comes to deciding which empiric antifugal agent is best for the treatment of candidemia.

La incidencia de infecciones invasivas por Candida ha aumentado en forma dramática en los últimos 20 años, siendo causa importante de mortalidad en torno al 40% en los pacientes hospitalizados. Material y métodos: Se realizó un estudio retrospectivo, basado en reportes de laboratorio de cinco hospitales de tercer nivel de la ciudad de Córdoba entre enero de 2010 y agosto de 2012, con el objetivo de conocer la epidemiología regional. Resultados: 158 pacientes con candidemia, edad promedio de 55.8 años, el 60% internados en unidades de cuidados intensivos. Candida albicans 44%, Candida parapsilosis 22% y Candida tropicalis 12% fueron las principales especies aisladas. Candida parapsilosis estuvo comúnmente asociada a infecciones relacionadas a catéteres. Conclusiones: Esta serie local de la ciudad de Córdoba muestra que C. albicans, C. parapsilosis y C. tropicalis son las especies mas frecuentes coincidente con el perfil de las series publicadas en Argentina y Latinoamérica. Esto puede tener implicancias para decidir que agente antifúngico usar empíricamente para tratar las candidemias.

Identification of Candida species isolated from cows suffering mastitis in four Brazilian states / Identificação de espécies de Candida isoladas de vacas com mastite em quatro estados Brasileiros

A mastite representa um dos problemas mais sérios que afetam as fazendas de gado leiteiro. As mastites clínica e subclínica em bovinos, devido a leveduras, são causadas principalmente por espécies do gênero Candida. O objetivo deste trabalho foi identificar quais espécies dessa levedura estavam presentes em amostras de leite obtidas da glândula mamária de vacas apresentando mastite. Um total de 428 amostras de leite foi coletado nos estados de São Paulo, Paraná, Santa Catarina e Rio Grande do Sul. A identificação foi realizada por meio de critérios fenotípicos e fisiológicos. Foi possível isolar seis espécies de Candida em 55 (12,8%) das amostras. As espécies mais frequentes foram C. krusei (34,6%), C. parapsilosis (25,4%), C. tropicalis (18,2%) e C. albicans (12,8%). Esses resultados sugerem que outras espécies de Candida, além da C. albicans, possuem um papel importante em mastites micóticas em vacas.(AU)

Avaliação macroscópica e microscópica de implante de Biomembrana em estômago de coelhos (Oryctolagus cuniculus) / Macroscopic and microscopic evaluation biomembrane implant in the stomach of rabbits (Oryctolagus cuniculus)

Neste estudo foi implantado um retalho de biomembrana de látex natural em substituição a um fragmento da parede de estômago de coelhos albinos, raça Nova Zelândia, adultos, machos não castrados (n=12), com o intuito de avaliar o processo de reparação tecidual no que se refere à biocompatibilidade, à capacidade de reparação tecidual e a possíveis complicações. Aos 15, 30 e 60 dias de pós-operatório, os animais foram sacrificados, mediante o emprego de tiopental sódico (200mg kg-1), para posterior avaliação macroscópica e análise histopatológica da interface do implante com o tecido nativo. Macroscopicamente, aos 15, 30 e 60 dias de pós-operatório observou-se presença de aderências na face serosa. Aos 60 dias de pós-operatório, em todos os animais avaliados, a biomembrana não foi encontrada. Sob microscopia de luz, aos 15 e 30 dias, verificaram-se descontinuidade das camadas muscular e mucosa, presença de infiltrado inflamatório polimorfonuclear. Foram visualizados vasos sanguíneos e fibras musculares. Aos 60 dias, as camadas mucosa, muscular estavam completamente reconstituídas. O implante foi biocompatível e forneceu arcabouço para orientação e desenvolvimento das camadas teciduais do estômago, mediante processos de reparação, restabelecendo a estrutura do órgão.

In this study, biomembrane of natural latex was utilized to replace a section of the stomach wall of New Zealand rabbits, adult and non-castrated males (n=12), in order to evaluate the tissue repair process in regards to its biocompatility, scar formation ability and possible complications. The animals were euthanized at fifteen, 30 and 60 days post operation, by use of sodium thiopental (200mg kg-1), followed by macroscopic and histopathological analysis of the implant interface with the native tissue. Macroscopically, at fifteen, 30, and 60 days post operation adherence was observed in the serosal wall. At 60 days post operation, the biomembrane is not in the stomach. Under light microscopy, at fifteen and 30 days, discontinuity of muscle layer and mucosa layer, and presence of polimorfonuclear population of inflammatory cells was observed. New vessels and muscle fibers were observed. At 60 days, the mucosa and muscle layers were complete reconstituted. The implants were biocompatible and had provided the mainframe for orientation and development of the tissue layers through repairing processes, thus reestablishing the organ structure.

Epidemiologia de candidemia en Córdoba Republica Argentina. Estudio de vigilancia de cinco instituciones / [Candidemia epidemiology in Córdoba Argentina. Surveillance study of five institutions].

UNLABELLED: The incidence rate of invasive infections due to Candida species has increased drastically in the last 20 years, causing a 40

mortality rate in hospitalized patients. In order to comprehend the epidemiology of Candida bloodstream infection, the study was carried out. MATERIALS AND METHODS: A retrospective study was done based on microbiology laboratory reports from five terciary care hospitals from the city of Cordoba between January 2010 and August 2012. RESULTS: 158 patients had candidemia, the average age was 55,8 years, and 54

of patients were in the intensive care unit. Candida albicans (44

) and Candida tropicalis (12

) were the main fungi isolated. Candida parapsilosis was commonly associated with catether infections. CONCLUSIONS: The data from the city of Cordoba showed that C. albicans, C. parapsilosis y C. tropicalis were the more frequent species isolated from blood cultures. This is similar to what is seen in other series published from Argentina and Latinamerica. This study may have implications when it comes to deciding which empiric antifugal agent is best for the treatment of candidemia.

Epidemiologia de candidemia en Córdoba Republica Argentina. Estudio de vigilancia de cinco instituciones. / [Candidemia epidemiology in Córdoba Argentina. Surveillance study of five institutions].

UNLABELLED: The incidence rate of invasive infections due to Candida species has increased drastically in the last 20 years, causing a 40

mortality rate in hospitalized patients. In order to comprehend the epidemiology of Candida bloodstream infection, the study was carried out. MATERIALS AND METHODS: A retrospective study was done based on microbiology laboratory reports from five terciary care hospitals from the city of Cordoba between January 2010 and August 2012. RESULTS: 158 patients had candidemia, the average age was 55,8 years, and 54

of patients were in the intensive care unit. Candida albicans (44

), Candida parapsilosis (22

) and Candida tropicalis (12

) were the main fungi isolated. Candida parapsilosis was commonly associated with catether infections. CONCLUSIONS: The data from the city of Cordoba showed that C. albicans, C. parapsilosis y C. tropicalis were the more frequent species isolated from blood cultures. This is similar to what is seen in other series published from Argentina and Latinamerica. This study may have implications when it comes to deciding which empiric antifugal agent is best for the treatment of candidemia.

Eicosapentaenoic acid modulates CyA-induced proinflammatory cytokine over-expression in osteoblastic cells in vitro.

Several adverse outcomes are reported in subjects undergoing long term Cyclosporin A (CyA) treatment. Severe osteopenia has been described in clinical and experimental reports, while beneficial effects of n-3 polyunsaturated fatty acids (PUFAs) on bone metabolism are recognized. In the present study we investigated the effects of n-3 versus n-6 PUFAs on osteoblastic cells treated with CyA, evaluating the expression of interleukin (IL)-1ß, interleukin-6 (IL-6), inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) in two different experimental protocols and the production of IL-6, IL-1ß, and tumor necrosis factor alpha (TNFalpha) in cells challenged simultaneously with CyA and eicosapentaenoic acid (EPA) for 48h. IL-1ß and IL-6 up-regulation, induced by CyA, was counteracted by the addition of EPA in both protocols; on the contrary, arachidonic acid (AA) magnified CyA the effects. COX-2 and iNOS levels were not modified by CyA treatment. These in vitro results, that substantiate clinical reports of CyA-induced osteopenia, demonstrate a beneficial effect of EPA on CyA-altered cytokine profile, opening new perspectives in the non-pharmacological management of adverse outcomes in CyA-treated patients.

Zooplankton fluctuations in Jurumirim Reservoir (São Paulo, Brazil): a three-year study.

During three consecutive years, monthly samples of zooplankton were taken in the lacustrine (dam) zone of Jurumirim (São Paulo, Brazil). The seasonal effect on basic limnological features (thermal regime, oxygen distribution, phytoplankton biomass, etc.) was also examined. The influence of the seasonality on the fluctuation of the zooplankton composition and abundance was not clearly detected (low degree of recurrent patterns). Rotifers (32 taxa) were the most abundant organisms during almost the entire study period with some seasonal alternations in the maximum abundance peaks of the main taxa (Conochilus unicornis, Keratella americana, K. cochlearis and Hexarthra spp.), except for Polyarthra (mainly P. vulgaris). Only occasionally copepods were numerically dominant. Higher copepod abundance was positively associated to periods of increase in the water retention time. Among the Copepoda (10 taxa) the calanoids (mainly Notodiaptomus iheringi) were more abundant, especially in warmer periods. Conversely, cyclopoids had higher abundance in autumn and winter. The species Thermocyclops minutus and T. decipiens co-occurred, but the first attained higher abundance. Some evidence of co-existence strategies between both species are considered. Cladocera (17 taxa) was never numerically dominant and the main taxa (Bosmina spp., Ceriodaphnia spp. and Diaphanosoma spp.) occurred almost the whole study period and did not present a seasonal pattern of fluctuation. Diaphanosoma (mainly D. birgei) attained the highest abundance among cladocerans. Most organisms were always found at the surface, but they also occupy the whole water column, even in periods of stratified conditions and low oxygen concentration in the bottom layers. Among the main zooplanktonic taxa, only Hexarthra avoids deep layers. An exceptionally high concentration of Copepoda nauplii on the surface was influenced by low transparency, high concentration of phytoplankton at this layer and low oxygen concentration at the bottom. In periods of higher retention timevariability there was a more heterogeneous distribution of the zooplankton in the water column. The increase in the retention time seems also to favor the copepod development. Finally, some inter-decade changes are considered on the basis of zooplankton assemblage structure observations.

Zooplankton fluctuations in Jurumirim Reservoir (São Paulo, Brazil): a three-year study / Flutuações do zooplâncton na represa de Jurumirim (São Paulo, Brasil): um estudo de três anos

During three consecutive years, monthly samples of zooplankton were taken in the lacustrine (dam) zone of Jurumirim (São Paulo, Brazil). The seasonal effect on basic limnological features (thermal regime, oxygen distribution, phytoplankton biomass, etc.) was also examined. The influence of the seasonality on the fluctuation of the zooplankton composition and abundance was not clearly detected (low degree of recurrent patterns). Rotifers (32 taxa) were the most abundant organisms during almost the entire study period with some seasonal alternations in the maximum abundance peaks of the main taxa (Conochilus unicornis, Keratella americana, K. cochlearis and Hexarthra spp.), except for Polyarthra (mainly P. vulgaris). Only occasionally copepods were numerically dominant. Higher copepod abundance was positively associated to periods of increase in the water retention time. Among the Copepoda (10 taxa) the calanoids (mainly Notodiaptomus iheringi) were more abundant, especially in warmer periods. Conversely, cyclopoids had higher abundance in autumn and winter. The species Thermocyclops minutus and T. decipiens co-occurred, but the first attained higher abundance. Some evidence of co-existence strategies between both species are considered. Cladocera (17 taxa) was never numerically dominant and the main taxa (Bosmina spp., Ceriodaphnia spp. and Diaphanosoma spp.) occurred almost the whole study period and did not present a seasonal pattern of fluctuation. Diaphanosoma (mainly D. birgei) attained the highest abundance among cladocerans. Most organisms were always found at the surface, but they also occupy the whole water column, even in periods of stratified conditions and low oxygen concentration in the bottom layers. Among the main zooplanktonic taxa, only Hexarthra avoids deep layers. An exceptionally high concentration of Copepoda nauplii on the surface was influenced by low transparency, high concentration of phytoplankton at this layer ...

Durante três anos consecutivos, foram feitas amostragens mensais do zooplâncton na zona lacustre (barragem) do reservatório de Jurumirim. Os efeitos da sazonalidade nas características limnológicas básicas (regime térmico, distribuição do oxigênio, biomassa fitoplanctônica, etc.) também foram examinados. Um padrão de flutuação da composição zooplanctônica e da sua abundância não foi claramente detectado (baixo grau de recorrência interanual). Os rotíferos foram os organismos mais abundantes durante a maior parte do tempo, com alterações nos picos de abundância dos principais táxons (Conochilus unicornis, Keratella americana, K. cochlearis e Hexarthra spp.), exceto para Polyarthra (principalmente P. vulgaris). Apenas ocasionalmente, os copépodes foram numericamente dominantes, estando esse fato relacionado a períodos de aumento no tempo de residência da água. Entre os Copepoda (10 táxons), os calanóides (principalmente Notodiaptomus iheringi) foram mais abundantes, especialmente em períodos mais quentes. Por outro lado, os ciclopóides foram mais abundantes no outono e no inverno. As espécies Thermocyclops minutus e T. decipiens coocorreram, mas a primeira alcançou maior abundância. Algumas estratégias de coexistência entre ambas as espécies são consideradas. Cladocera (17 táxons) nunca foi dominante numericamente e os principais gêneros (Bosmina, Ceriodaphnia e Diaphanosoma) ocorreram durante quase todo o período de estudo e não apresentaram um padrão sazonal de flutuação. Diaphanosoma birgei foi o táxon mais abundante entre os cladóceros. Embora a maioria dos organismos ocupasse toda a coluna d'água, mesmo em períodos de estratificação térmica e baixas concentrações de oxigênio no fundo, foram sempre mais abundantes na superfície. Entre os principais táxons zooplanctônicos, apenas Hexarthra evitou camadas profundas. A alta concentração de náuplios de Copepoda na superfície foi influenciada pela baixa transparência, alta concentração do ...

Prevalence of chondrocalcinosis in Italian subjects from northeastern Italy. The Pro.V.A. (PROgetto Veneto Anziani) study.

OBJECTIVES: To undertake an epidemiological survey of the prevalence of radiological chondrocalcinosis (CC) of the lower limbs in the elderly Italian population of the Pro.V.A. study. METHODS: Knee and pelvic basin radiographs were performed on 3099 subjects aged 65 and older, residing in the Veneto Region of Italy (Rovigo and Camposampiero areas). Two readers independently analysed the knee, coxofemoral and pubic symphysis x-rays of a consecutive sample of 1629 subjects according to Altman. Some laboratory indexes, such as serum parathyroid hormone (PTH), vitamin D (vit D), bone alkaline phosphatase (bALP), deyidroepiandrosterone (DHEA), urinary CrossLaps (XL), and inflammatory biomarkers were evaluated. Quantitative variables were summarised as mean + or - standard deviation and qualitative ones as distributions. Unpaired t-test was used to compare mean values among groups for normally distributed variables, and non-parametric Mann-Whitney test for non normal variables. RESULTS: CC was found in 169 (mean age 78.2 + or - 8.0 yrs) out of the 1629 subjects studied (10.4%). After adjusting for the sex and age structure of the target population, the prevalence was 10.0%. CC was more often observed in women than in men (M: 7.0%; F: 12.8%, p=0.0002), and increased in occurrence with age, rising from 7.8% in subjects aged 65-74 yrs, to 9.4% in those aged 75-84 yrs, and to 21.1% in subjects older than 85 yrs. The knee was the most prevalent location since it was affected in 94.1% of all the subjects with CC, in particular the right limb. Knee CC was bilateral in 71.7% of the affected patients. The occurrence of rheumatic disorders did not differ significantly between the subjects with CC and those without (rheumatoid arthritis 0.59% vs. 0.48%, p=ns). CONCLUSIONS: Although the detection of CC was limited to few joints with the knee being the most affected location, our study confirms the frequent presence of CC at different sites, in keeping with the possible role of systemic factors. Articular CC is an age-related disorder, which could partly explain the prevalence discrepancies reported by various studies. The prevalence of CC found in our survey based on standardised x-ray reading was high, suggesting that CC could be an underdiagnosed disease in the absence of radiographic investigation.

[New questionnaire to evaluate psychological treatment effects]. / Proposta di un nuovo strumento per la verifica dell'efficacia nella pratica dei trattomenti psicologici e psicoteropeutici.

A new questionnaire named CBA-VE (Cognitive Behavioral Assessment for outcome evaluation) was developed to evaluate psychological treatment intervention--especially for counseling and psychotherapy. The questionnaire has 80 items and a 5 point Likert-like scale ranging from 1 = nothing to 5 = a lot. The aim of this study was to evaluate the validity and the reliability of the five constructs of the questionnaire both in normal and clinical subjects. Participants. Two samples were analyzed: a "Normal" group composed of 250 normal adults plus 51 university students; and a "Clinical" group including 261 adults undergoing psychotherapy and psychological counseling provided by the public health service. The questionnaire includes five scales: three of them are related to important psychological aspects (anxiety, depression, and psychological distress); the remaining two are measurements of psychological wellbeing and self-perception of a positive change. The questionnaire has excellent psychometric characteristics, both for normal and clinical subjects. We observed a good reliability, good internal consistency, and an excellent structural validity for the five interrelated dimensions. The normalized factorial loadings are consistent, significant (from around 0.6 up), and similar in both the groups. The so-called Clinical group showed higher scores in anxiety, depression, and psychological distress and smaller scores in wellbeing and change perception. This is coherent with what the authors assumed a priori.

Evaluating energy efficiency of site-specific tillage in maize in NE Italy.

This paper examine the efficiency of energy use of three conservation tillage practices (SST - sub-soil tillage; MT - minimum tillage; and NT - no tillage) performed within two management zones, previously identified in a field according to the stability of yield variability. Experiments were carried out in 2003 in NE Italy, on a farm near Rovigo, on a 8-ha field with clay soil, in maize (Zea mays, L.). The purpose of the paper is (i) to investigate the energy variability due to these tillage practices performed spatially within two management zones and (ii) to analyze the long-term energetic efficiency for each tillage practice. The energy balance was highest for SST with respect to MT and NT, due to labor and fuel consumption rates. The energy balance was influenced by the spatial pattern of yield, with appreciable differences between practices in terms of both the conversion index of energy for tillage (9.0, 12.6 and 22.8GJha(-1) for SST, MT and NT, respectively) and the energy use efficiency for tillage (8.0, 11.6, 21.8GJha(-1) for SST, MT and NT, respectively). Based on the simulated data and the calibration results, SALUS model proved to be a good tool for analyzing long-term effects of tillage practices on yield. The NT treatment showed the best efficiency over years, due to the low inputs in comparison with the output level.

Heart rate differences between targets and non targets in intuition tasks.

This study reports the results of one experiment and a replication, aimed at investigating heart rate changes related to a pure intuition task. In each experiment, twelve subjects were required to guess which of the four pictures presented in sequence for about 10 seconds, was the target. Each subject performed 20 trials. In each trial the target was automatically selected using a pseudo-random algorithm. Heart rate was recorded (see Method section for details) during the pictures presentation. In the first experiment, a statistical significant increment of heart rate associated to targets with respect non targets was observed. The replication experiment with new twelve subjects confirmed the data obtained in the main experiment. These findings support the hypothesis that heart rate is related not only to overt but also to covert cognitive activity such as that involved in intuition tasks, giving convergent evidence to the models describing our intuitive cognitive activity as a double, partial independent information processing system.

Definition of a population-specific DXA reference standard in Italian women: the Densitometric Italian Normative Study (DINS).

Osteoporosis is currently defined on the basis of the T-score by dual-energy X-ray absorptiometry (DXA). Despite its limitations, this definition is applied worldwide. However, the normal values provided by manufacturers may not be fully representative of specific local populations. So far, there are no normative data in the Italian population using Hologic densitometers. The Densitometric Italian Normative Study (DINS) is an ongoing multi-center study that aims to establish reference values for bone densitometry with dual-energy X-ray absorptiometry (DXA) in the male and female Italian population. In this paper we report the results of the lumbar vertebrae (L2-L4) and proximal femur in 1,622 women aged 20-79 years. Bone mineral density (BMD) was determined using dual-energy X-ray absorptiometry (DXA) on Hologic bone densitometers (Hologic, Waltham, Mass.). Most of the subjects were examined with a QDR 4500. The BMD of the lumbar vertebrae was virtually constant between 20 and 49 years (test for trend: P=0.66); the BMD values between 20-45 in premenopausal women (mean 1.036; SD 0.109 g/cm(2)) were thus defined as the peak bone mass values, significantly lower compared to the Hologic reference curve (mean 1.079, SD 0.11 g/cm(2)). The mean BMD values of the femoral neck were virtually identical to those of the NHANES study in the first 3 decades; after the age of 50 the BMD values were slightly greater than those of the NHANES subject. The subject classification according to the WHO criteria was similar using the DINS and NHANES reference values for the femur; for the spine, the Hologic reference values classified a larger proportion of women as osteoporotic (21 vs. 16%) or osteopenic (42 vs. 38%) compared to DINS.

Atividade antiinflamatória do granulado de Calendula officinalis L. e Matricaria recutita L.

Este trabalho descreve os resultados da atividade antiinflamatória de um granulado composto pelos extratos secos de Calendula officinalis L. e Matricaria recutita L. (GECOMR® - granulado encapsulado de Calendula officinalis e Matricaria recutita). Estas espécies são utilizadas na medicina popular devido às suas atividades antiinflamatória, antiúlcera gástrica e antiespasmódica. A redução do processo edematogênico nos grupos de animais tratados com o GECOMR foi observada para todos agentes inflamatórios testados (Carragenina, dextrana e histamina). Esta associação mostrou-se eficaz sobre os modelos de edema de pata induzidos pelas diferentes substâncias inflamatórias, com as doses de 100 e 250 mg.kg-1. A associação dos extratos hidroalcoólicos destas espécies medicinais não modificou a indicação isolada de cada uma.

This study shows the results of the anti-inflammatory activity of a phytocomplex composed by dry extracts of Calendula officinalis L. and Matricaria recutita L. (GECOMR®). These plants have been used by folk medicine for its anti-inflammatory, antiulcerogenic and antispasmodic activities. The reduction of the edematogenic process in the treated animals with GECOMR was observed for all inflammatory agents tested, (Carrageenan, Dextran and Hystamine). Its association has been efficient in rat paw edema induced by inflammatory substances in 100 and 250 mg.kg-1 doses. This association of the ethanolic extracts did not modify the indication of each plant isolated.