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1.
Health Care Women Int ; 40(1): 33-46, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-29494785

RESUMO

Researchers' aim was to investigate if patients/physicians characteristics could differently affect males/females health care expenditure. In 2009/2010, a health-related-quality-of-life (HRQL) measure was distributed to 887 general practitioners' (GP) patients in Siena's province-Italy. Severity of diseases was calculated through Cumulative Illness Rating Scale Severity Index (CIRS-SI). Information about GPs' gender and age and patients' gender, age, and socio-economic variables were recorded. 2012 data about pharmaceutical, outpatient and hospital expenditure were obtained. Multivariate regression was carried out. In males, hospital expenditure increased with higher CIRS-SI and female GP whilst in females it was not influenced by any of the variables. Outpatient and pharmaceutical expenditure increased with aging, higher CIRS-SI, and lower HRQL and education, both in males and females. Gender differences in health expenditure determinants emerged for hospital expenditure.


Assuntos
Custos de Medicamentos/estatística & dados numéricos , Prescrições de Medicamentos/economia , Gastos em Saúde/estatística & dados numéricos , Tempo de Internação/economia , Qualidade de Vida , Adulto , Fatores Etários , Idoso , Envelhecimento , Prescrições de Medicamentos/estatística & dados numéricos , Tratamento Farmacológico/economia , Feminino , Medicina Geral , Clínicos Gerais , Pesquisas sobre Atenção à Saúde , Nível de Saúde , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Fatores Socioeconômicos
2.
PLoS One ; 18(11): e0293619, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37910515

RESUMO

BACKGROUND: The geothermal power plants for electricity production currently active in Italy are all located in Mt. Amiata area in the Tuscany region. A cross-sectional survey was conducted in the framework of the regional project "InVETTA-Biomonitoring Survey and Epidemiological Evaluations for the Protection of Health in the Amiata Territories", using objective measures of lung function to investigate the role of hydrogen sulphide (H2S) in affecting the respiratory health of the population living in this area. METHODS: 2018 adults aged 18-70 were enrolled during 2017-2019. Home and workplace addresses of participants were geocoded. Dispersion modelling was used to evaluate the spatial variability of exposure to H2S from the geothermal power plants' emissions. We estimated average long-term historical exposure to H2S and more recent exposure indicators. Chronic Obstructive Pulmonary Disease (COPD) was defined according to the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Multivariable logistic regressions were performed to investigate associations between outcome and exposure. RESULTS: Our findings did not showed any evidence of an association between increasing H2S exposure and lung function impairments. Some risk reductions were observed: a -32.8% (p = 0.003) for FEV1<80% and a -51.7% (p = 0.001) risk decrease for FVC<80% were associated with interquartile increase (13.8 µg/m3) of H2S levels. CONCLUSION: Our study provides no evidence that chronic exposure to low levels of H2S is associated with decrements in pulmonary function, suggesting that ambient H2S exposure may benefit lung function.


Assuntos
Sulfeto de Hidrogênio , Doença Pulmonar Obstrutiva Crônica , Adulto , Humanos , Sulfeto de Hidrogênio/análise , Estudos Transversais , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Pulmão/química , Itália/epidemiologia
3.
J Pathol ; 225(1): 118-28, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21630272

RESUMO

Nephrin is an immunoglobulin-like adhesion molecule first discovered as a major component of the podocyte slit diaphragm, where its integrity is essential to the function of the glomerular filtration barrier. Outside the kidney, nephrin has been shown in other restricted locations, most notably in the central nervous system (CNS) of embryonic and newborn rodents. With the aim of better characterizing nephrin expression and its role in the CNS of adult rodents, we studied its expression pattern and possible binding partners in CNS tissues and cultured neuronal cells and compared these data to those obtained in control renal tissues and podocyte cell cultures. Our results show that, besides a number of locations already found in embryos and newborns, endogenous nephrin in adult rodent CNS extends to the pons and corpus callosum and is expressed by granule cells and Purkinje cells of the cerebellum, with a characteristic alternating expression pattern. In primary neuronal cells we find nephrin expression close to synaptic proteins and demonstrate that nephrin co-immunoprecipitates with Fyn kinase, glutamate receptors and the scaffolding molecule PSD95, an assembly that is reminiscent of those made by synaptic adhesion molecules. This role seems to be confirmed by our findings of impaired maturation and reduced glutamate exocytosis occurring in Neuro2A cells upon nephrin silencing. Of note, we disclose that the very same nephrin interactions occur in renal glomeruli and cultured podocytes, supporting our hypothesis that podocytes organize and use similar molecular intercellular signalling modules to those used by neuronal cells.


Assuntos
Encéfalo/metabolismo , Proteínas de Membrana/biossíntese , Receptores de Glutamato/metabolismo , Animais , Células Cultivadas , Córtex Cerebral/metabolismo , Glomérulos Renais/metabolismo , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Proteínas de Neoplasias , Neurônios/metabolismo , Podócitos/metabolismo , Proteínas Tirosina Quinases , Células de Purkinje/metabolismo , RNA Mensageiro/genética , Ratos , Ratos Sprague-Dawley , Quinases da Família src/metabolismo
4.
J Gerontol A Biol Sci Med Sci ; 68(9): 1122-8, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23459207

RESUMO

BACKGROUND: Although extensively investigated, the prognostic role of thyroid hormone abnormalities in older participants remains uncertain. We investigated the relationship between thyroid hormones and mortality during hospitalization and in a prolonged follow-up in frail older patients. METHODS: A nonconcurrent cohort study was conducted by enrolling 450 participants hospitalized for an acute disease, who were classified into four groups (euthyroidism, hypothyroidism, hyperthyroidism, and low triiodothyronine [T3] syndrome), according to clinical and laboratory data. Multidimensional geriatric assessment variables were considered in order to identify short- and long-term predictors of death. RESULTS: Participants were very old (mean age: 84 years) and frail, as indicated by severely impaired functional status, extensive comorbidity, high prevalence of dementia, and hospital mortality (8%). Prevalence of any thyroid dysfunction was 40.7%; 32% of participants had low T3 syndrome, which was associated with an excess hospital mortality risk (odds ratio: 2.7, 95% confidence interval [CI]: 1.1-6.5; p = .025), adjusted for demographic, clinical, functional, and laboratory data. Conversely, long-term mortality was unrelated to low T3 syndrome. In euthyroid participants, increasing levels of free thyroxine (FT4) were associated with a slightly greater mortality (hazard ratio, CI: 2.12, 0.99-4.54; p = .053) in adjusted Cox regression models. CONCLUSIONS: This observational study on a cohort of very old, frail hospitalized patients gives support to the independent prognostic short-term, but not long-term, role of low T3 syndrome. Moreover, in older euthyroid participants, increasing levels of FT4 are a weak marker of poorer long-term survival. Thyroid hormones may help monitor changes in general health status and predict short- and long-term clinical outcomes in very old, frail patients.


Assuntos
Envelhecimento/sangue , Idoso Fragilizado , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/mortalidade , Hormônios Tireóideos/sangue , Idoso , Idoso de 80 Anos ou mais , Estudos de Coortes , Comorbidade , Síndromes do Eutireóideo Doente/sangue , Síndromes do Eutireóideo Doente/mortalidade , Feminino , Seguimentos , Idoso Fragilizado/estatística & dados numéricos , Hospitalização , Humanos , Hipertireoidismo/sangue , Hipertireoidismo/mortalidade , Hipotireoidismo/sangue , Hipotireoidismo/mortalidade , Itália/epidemiologia , Masculino , Prognóstico , Fatores de Risco
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