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Treating diabetes mellitus in older and oldest old patients
No full textThere is a rapidly growing number of persons reaching extreme age limits. Indeed, the fastest growth is found in those over the age of 80 years or octogenarians. Along with this continuous rise, there is a significant increase in type 2 diabetes in this population. Unfortunately, individuals living past 80 years of age are often accompanied by numerous comorbidities and geriatric conditions, all which render anti-diabetic treatment options challenging. Indeed the principles of managing type 2 diabetes are similar to younger patients. Special considerations in this delicate group are essential due to the increased prevalence of comorbidities and relative inability to tolerate adverse effects of medication and severe hypoglycemia. It is important to recall that octogenarians have shown to have a greater prevalence for cognitive impairment, physical disability, ren al and hepatic dysfunction, and syndromes, such as frailty compared to younger elders. The frailty syndrome is considered one of the most important limitations when treating octogenarians with type 2 diabetes in polypharmacy. Due to the lack of evidence for specific targets of glucose and glycated hemoglobin (A1C) levels in the elderly, available treatment guidelines are based on data extrapolation from younger adults and expert opinion citing reliable evidence. Overall, the most important conclusion emerging from these groups is to accomplish a moderate glycemic control (A1C levels between 7 -8%) in complex elderly patients. However, the risk of hypoglycemia from some treatments may present the greatest significant barrier to optimal glycemic control for the very old. The present review discusses the highlights from the latest guidelines for treating older persons and underlines the need for specific considerations when treating the very old in order to maintain a balance between treating comorbidities and maintaining quality of life
Observations on the fungi associated with esca and on spatial distribution of esca-symptomatic plants in Apulian (South Italy) vineyards
No full textDrag effect of steam flow on droplet removal during dropwise condensation at different surface inclinations
Full text linkDropwise condensation is a quasi-cyclic process characterized by the nucleation, growth, and removal of discrete liquid droplets on a subcooled surface. The removal of condensate is a critical aspect, usually achieved by exploiting the gravity force, the drag force of vapor or the surface wettability gradient. This paper presents an experimental study of the vapor drag action on condensate removal, with focus on droplet's departing radius (rmax). Specifically, for the experimental campaign, vapor velocity was varied from 3 to 14 m s−1 considering three different surface inclinations: vertical, 45° inclined, and horizontal. The results showed that, as the velocity increases, the difference in departing radii among the three different configurations decreases and, consequently, the difference in heat transfer coefficients decreases too. In fact, at the highest vapor velocity (~14 m s−1), rmax was almost equal for all the inclinations leading to similar heat transfer coefficients (~120 kW m−2 K−1). Interestingly, on a horizontal surface considering vapor velocity equal to 3 m s−1, despite the lack of gravity's contribution to droplet removal, no transition to filmwise condensation was observed
Usage of molecular markers (PCR-RAPD) for studying variability in Phellinus (Phomitiporia) sp
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