'Palaeoshellomics' reveals the use of freshwater mother-of-pearl in prehistory.

The extensive use of mollusc shell as a versatile raw material is testament to its importance in prehistoric times. The consistent choice of certain species for different purposes, including the making of ornaments, is a direct representation of how humans viewed and exploited their environment. The necessary taxonomic information, however, is often impossible to obtain from objects that are small, heavily worked or degraded. Here we propose a novel biogeochemical approach to track the biological origin of prehistoric mollusc shell. We conducted an in-depth study of archaeological ornaments using microstructural, geochemical and biomolecular analyses, including 'palaeoshellomics', the first application of palaeoproteomics to mollusc shells (and indeed to any invertebrate calcified tissue). We reveal the consistent use of locally-sourced freshwater mother-of-pearl for the standardized manufacture of 'double-buttons'. This craft is found throughout Europe between 4200-3800 BCE, highlighting the ornament-makers' profound knowledge of the biogeosphere and the existence of cross-cultural traditions.

Cardiac risk stratification in patients undergoing endovascular aortic repair.

Endovascular aortic repair (EVAR) for abdominal aortic aneurysms (AAA) is the preferred first treatment option in case of patients with advanced age and/or fit anatomy owing to shorter length of in hospital staying, less complications or laparotomy-related re-interventions, and lower initial costs. Although it is a less-invasive intervention, EVAR entails a risk similar to that of open aortic procedures for medical comorbidities, and a perioperative clinical evaluation is mandatory to minimize the early and late cardiovascular risk. In this brief review the determinants of cardiac risk (functional capacity, cardiac evaluation, non-invasive tests, bio markers and "specialist" cardiac tests) as well the most widely used predictive risk scores were analyzed. Taking into account that a preoperative cardiovascular assessment is conditioned by the urgency of the repair, in everyday practice rarely the patient undergoes over a complete and exhaustive cardiac assessment with the exclusion of few selected cases that do not represent the rule. Moreover most of models focused on perioperative mortality, tailored for open repair and then adjusted to EVAR or specifically retailed for this procedure show both differences and remarkable similarities. None defines the patient's cardiac risk "alone" (angina, recent myocardial infarction, chronic heart failure, arrhythmias). Actually they measure a "global" medical risk for they take into account of various comorbidities, such as previous stroke, kidney failure, including dialysis, diabetes, COPD, etc. that contribute to intra and perioperative mortality/morbidity and that may be heavier for prognosis.

Heart failure with preserved systolic function: prevalence and clinical features in a cohort of patients admitted to internal medicine units. The study PRESYF-HF Tuscany.

BACKGROUND: There is uncertainty about the prevalence and clinical characteristics of heart failure (HF) patients with preserved systolic function (PRESYF). AIM: To analyze the prevalence and clinical characteristics of patients with PRESYF in an unselected cohort of subjects consecutively hospitalized for HF. METHODS: The study cohort included 338 patients consecutively admitted for HF at 24 Internal Medicine units homogeneously settled in Tuscany area (Italy). We did not have any criteria for exclusion. All patients had an echocardiographic measure of left ventricular ejection fraction (LVEF) within 72 hours from hospital admission. Patients with LVEF > or = 50% were considered to have PRESYF. RESULTS: The patients with PRESYF were 112 (33.1%), those with depressed systolic function (DESYF) 226 (66.9%). In the group PRESYF were prevalent female sex, hypertensive etiology, and elevated BMI. The distribution for classes of age shows a great frequency of PRESYF in the elderly. CONCLUSION: About one third of patients admitted for HF have a PRESYF. They are different compared to those with DESYF. A correct identification of this form of HF may be important in clinical practice for more targeted therapeutic options and for prognostic implications.

Heart failure, oxidative stress and allopurinol.

Oxidative stress is one of the new and most intriguing pathogenetic hypotheses of heart failure; it involves various mechanisms such as endothelial dysfunction, mechano-energetic uncoupling and apoptosis. Xanthine oxidase, a key enzyme in purine catabolism, is overexpressed in patients with heart failure, and it is also an important source of oxidizing activity molecules (free radicals, superoxide anion, oxygen peroxide, etc...). Allopurinol competitively inhibits the action of xanthine oxidase and effectively counters oxidative stress. It could thus prove useful in the treatment of heart failure: in fact it is the only drug that has been proven able to lower O2 consumption of dysfunctioning myocardium. The Authors briefly review the xanthine oxido-reductase enzyme system and in particular analyse the latest evidence reported in the literature on allopurinol in the treatment of heart failure.

Living-floors and structures from the Lower Paleolithic to the Bronze Age in Italy.

New researches have been performed on the analysis of some Italian dwelling structures dating from the Lower Paleolithic to Bronze Age. Different methods have been applied to each study according to the extensions of the areas explored. The following sites have been analyzed: Isernia La Pineta (Molise), Visogliano (Trieste) - Lower Paleolithic; Grotta del Cavallo (Lecce), Grotta Grande and Riparo del Molare (Salerno) - Middle Paleolithic; Grotta di Fumane (Verona), Riparo Tagliente (Verona), Grotta Continenza (Fucino L'Aquila), San Bartolomeo (Maiella Mountain, Abruzzo) - Upper Paleolithic; Mondeval de Sora (Belluno), Alpe Veglia (Verbania) and Grotta Edera (Aurisina, Trieste) -Mesolithic; Cala Giovanna Piano (Pianosa Island, Livorno), Contraguda (Perfugas, Sassari), Colle Santo Stefano (Fucino, L'Aquila), Catignano (Pescara), Settefonti (L'Aquila) - Neolithic; Castellaro Lagusello (Monzambano, Mantua) - Bronze Age.