1,720,990 research outputs found
Gut microbiome and bone health: update on mechanisms, clinical correlations, and possible treatment strategies
No full textThe intestinal microbiome is increasingly regarded as a relevant modulator of the pathophysiology of several age-related conditions, including frailty, sarcopenia, and cognitive decline. Aging is in fact associated with alteration of the equilibrium between symbiotic bacteria and opportunistic pathogens, leading to dysbiosis. The microbiome is able to regulate intestinal permeability and systemic inflammation, has a central role in intestinal amino acid metabolism, and produces a large number of metabolites and byproducts, with either beneficial or detrimental consequences for the host physiology. Recent evidence, from both preclinical animal models and clinical studies, suggests that these microbiome-centered pathways could contribute to bone homeostasis, regulating the balance between osteoblast and osteoclast function. In this systematic review, we provide an overview of the mechanisms involved in the gut–bone axis, with a particular focus on microbiome function and microbiome-derived mediators including short-chain fatty acids. We also review the current evidence linking gut microbiota dysbiosis with osteopenia and osteoporosis, and the results of the intervention studies on pre-, pro-, or post-biotics targeting bone mineral density loss in both animal models and human beings, indicating knowledge gaps and highlighting possible avenues for future research
History-taking still the best diagnostic modality? the case of a threatening mass in the right ventricle
No full textHeart failure and acute pulmonary edema linked to sepsis: a case report and a short review of literature
No full textHeart failure is a most dangerous and insidious complication of the septic state. We describe the case of a patient admitted to our department for weakness of all four limbs and fever. During hospitalization the patient developed a septic state that has manifested itself through the development of heart failure with acute pulmonary edema
Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients
No full textDiaphragm muscle dysfunction is increasingly recognized as a fundamental marker of several age-related diseases and conditions including chronic obstructive pulmonary disease, heart failure and critical illness with respiratory failure. In older individuals with physical frailty and sarcopenia, the loss of muscle mass and function may also involve the diaphragm, contributing to respiratory dysfunction. Ultrasound has recently emerged as a feasible and reliable strategy to visualize diaphragm structure and function. In particular, it can help to predict the timing of extubation in patients undergoing mechanical ventilation in intensive care units (ICUs). Ultrasonographic evaluation of diaphragmatic function is relatively cheap, safe and quick and can provide useful information for real-time monitoring of respiratory function. In this review, we aim to present the current state of scientific evidence on the usefulness of ultrasound in the assessment of diaphragm dysfunction in different clinical settings, with a particular focus on older patients. We highlight the importance of the qualitative information gathered by ultrasound to assess the integrity, excursion, thickness and thickening of the diaphragm. The implementation of bedside diaphragm ultrasound could be useful for improving the quality and appropriateness of care, especially in older subjects with sarcopenia who experience acute respiratory failure, not only in the ICU setting
Hypoglicemia related to big Haemangiopericitoma: a difficult diagnostic definition
No full textWe describe the case of a 91 years old woman admitted to our department for dyspnea associated with drowsiness. At the admission to the Emergency Room the patient stay in a comatose state and blood tests performed showing severe hypoglycemia (38 mg/dl at admission in non diabetic patient). Anamnestic history: multifactorial anemia; frequent hospitalizations for heart failure; AMI treated with stenting; in 1986 Haemangiopericytoma resection in the right iliac region; in 2006 palliative surgery for recurrence with residual mass. Blood tests showed lower levels of insulin and normal C- peptide serum concentration in correspondence of low glucose concentration (in relation to continuous and adequate parenteral nutrition), IGF 1 and GH level was respectively suppressed (IGF1=47 ng/ml whit normal range 97-331 ng/ml) and normal/low (GH 0.43 uUI/mL whit normal range 0.06-14.00 uUI/mL).Therefore hypoglycemia appeared related to paraneoplastic production of IGF -2
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
The prognostic value of Clinical Frailty Scale in COVID-19 pneumonia across different pandemic phases: a comparison between the first and the fourth wave
No full textIntroduction: The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 may be influenced by the local characteristics of each pandemic wave. We aimed to establish the prevalence of frailty in older patients with COVID-19 who were admitted to hospital and investigate its association with mortality comparing non-vaccinated patients of the first wave versus vaccinated patients in the fourth wave.
Materials and methods: This was an observational study conducted at one single hospital center in Italy. All older adults (≥70 years) admitted with confirmed COVID-19 (positive molecular testing) were included. Data of 658 patients (493 non-vaccinated COVID-19 patients admitted during the first wave and 165 patients vaccinated against COVID-19 during the fourth wave), were collected from clinical records including symptom type, extension of lung abnormalities on chest computed tomography (CT), laboratory parameters. Frailty was assessed by Clinical Frailty Scale (CFS) and patients were grouped according to their score (≤4: fit or pre-frail; 5–6 = initial signs of frailty but with some degree of independence; >7 = severe or very severe frailty). The primary outcome was in-hospital mortality.
Results: In comparison with vaccinated patients from the fourth wave, unvaccinated patients from the first wave had reduced prevalence of heart disease (35% vs. 56%), renal failure (9% vs. 15%), but higher prevalence of fever at time of diagnosis (84% vs. 59%), malignancy (16% vs. 6%), higher computed tomography (CT) severity visual score, higher CRP (C-reactive protein) serum levels (median value 105 mg/L vs. 75 mg/L), but lower burden of frailty. In a stepwise multivariable logistic regression model, unvaccinated patients from the first wave had a higher risk of death regardless of CFS [Odds Ratio (OR) 2.241, 95% confidence interval (CI) 1.492–3.336, p < = 0.001], while in the fourth wave, CFS was significantly associated with hospital mortality.
Conclusion: Our study suggests that in non-vaccinated older patients from the first pandemic wave CFS was unable to stratify the risk of death
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