Search

Background: Possible therapeutic failure of pediatric obesity is influenced by the high dropout rate. The aim of this study was to evaluate the rate of dropout and the rate of weight loss over the 24 months of follow-up., Methods: The retrospective, single-center study, involved 489 patients followed for obesity in the period 2016-2020. Patients' auxological data and blood samples were collected during the first (V1) and last visit (V2). Dropout was defined as a follow-up of less than 12 months and/or including less than one visit every 6 months. Patients were divided into two groups and compared: Group A of dropout (297 patients) and Group B of non-dropout (192 patients)., Results: In the follow-up period, which had a mean duration of 24 months, the dropout rate was 60.7%. In Group A, the percentage of patients with BMI ≥ 3 SD at V2 was significantly higher than that in Group B. In Group B, the percentage of patients with pathological HOMA-IR and with fasting glucose >100 mg/dL was higher than group A. The probability of dropout was positively associated with pubertal stage and negatively with impaired fasting glycemia and pathological insulinemia at V1., Conclusion: The study demonstrated a high dropout rate during follow-up, mainly among adolescents and patients with no glucometabolic alterations.

Phalaris brachystachys (short-spiked canary grass) is considered to be among the most troublesome cereal weeds in Mediterranean areas. A bioeconomic model, based on population dynamics, competition and economic sub-models, was developed to simulate the long-term economic consequence of using herbicide-based strategies: no herbicide application, full herbicide dose (standard rate) and two reduced dose rates (75 and 50% of the standard rate) to control P. brachystachys in a biennial wheat-sunflower rotation. Simulation results indicated that only herbicide application at a full dose (90% control) and 3/4 dose (80% control) produced positive economic results, with the full dose being the best strategy (EUR 98.65 ha -1 year -1 ). A sensitivity analysis showed that the economic outcome, in terms of annualized net return, was strongly influenced by changes in yield, price, and fixed costs. In addition, the annualized net return was more sensitive to parameter changes at reduced herbicide doses than at full rate. In the wheat-sunflower rotation system, the application of the full dose of herbicide was the most economical and stable strategy in the long-term. Reduced doses are not a recommended option from an economic point of view. Bioeconomic models provide practical insight into different management approaches for effective weed control.

Background : The difficulty of frail, non-self-sufficient or non-ambulatory collaborating elderly residents in nursing homes to eat due to a lack of teeth or the absence of a dental prosthesis leads to an increasingly evident increase in the patients' systemic pathological state, particularly in older patients who take a lot of medications. Total or partial edentulousness that is not filled with dental prostheses or that is filled with inadequate prostheses, associated with socioeconomic factors, depression, impaired motor functions, heart disease and a large number of chronic diseases including excessive use of drugs, often affects elderlies' feeding. Aim : In this study, prosthetic rehabilitation was performed on some frail elderly residents in 10 nursing homes in the Lombardy district, and, subsequently, meal behavior and social activity were examined in two information questionnaires through compilation. Methods : The research was conducted on only 67 patients, 26 men and 41 women, aged between 75 and 99, who were guests in 10 health facilities (nursing homes) in the Lombard district; only 8 residents did not undergo prosthetic rehabilitation, as they did not cooperate. All the patients who were visited underwent oral prosthetic rehabilitation, and, subsequently, some aspects such as nutrition and socialization were assessed with other residents through the aid of two information dossiers. Results : the results showed that all the residents, despite difficulties in chewing with the new prosthesis, were fed and did not refuse more consistent foods; in addition, there was an improvement in social activity among the residents. Only 19.3% of men and 22% of women continued to eat little; there was an improvement in the participation in social activities among the residents, with a percentage of 73% of men and 88% of women; in particular, during meals 35 residents conversed with the other residents. Discussion : The dental problems of elderly people residing in social welfare homes are increasingly evident when other systemic pathologies are present. It would be desirable to introduce telemedicine in residences for the elderly for the monitoring of dental problems. Conclusions : From the information obtained and from the evaluation of the change in the elderly, it can be concluded that it would be desirable to include specific dental protocols to create a network, including a telematic one, to monitor and perform more dental checks in nursing homes.

Cardiorenal syndrome (CRS) is defined as a disorder resulting from the abnormal interaction between the heart and kidney, in which acute or chronic dysfunction of one organ may lead to acute and/or chronic dysfunction of the other. The functional interplay between the heart and kidney is characterized by a complex bidirectional symbiotic interaction, regulated by a wide array of both genetic and environmental mechanisms. There are at least five known subtypes of CRS, based on the severity of clinical features and the degree of heart/renal failure. The fourth subtype (cardiorenal syndrome type 4 (CRS4)) is characterized by a primary chronic kidney disease (CKD), which in turn leads to a decreased cardiac function. Impairment of renal function is among the most important pathophysiological factors contributing to heart failure (HF) in the pediatric age group, and cardiovascular complications could be one of the most important causes of mortality in pediatric patients with advanced CKD. In this context, a loss of glomerular filtration rate directly correlates with both the progression of cardiovascular complications in CRS and the risk of HF. This review describes the interaction pathways between the heart and kidney and the recently identified pathophysiological mechanisms underlying pediatric CRS, with a special focus on CRS4, which encompasses both primary CKD and cardiovascular disease (CVD).