Trace Element Estimation – Methods & Clinical Context

Understanding the effects of trace metals on human health is as complex as it is fascinating. As mentioned earlier, the high concentrations may prove toxic, as also, depletion in the concentration of the essential trace elements may cause various metabolic instabilities due to enzyme dysfunction. In the era of rapid industrialization and technological advances, it is imperative to watch keenly for contamination of the environment and its vital composition from heavy metal wastes emanating out of industries. Many metabolic disorders in man are accompanied by alterations in the concentration of one or more trace elements in some body fluid, especially blood serum or plasma It is thus important to update ourselves with various techniques available for such determinations, their operational aspects, advantages / disadvantages etc. More recently, element analysis from hair and nail has been stated as the best indices of such contamination and has also been discussed in this article

Haematalogical investigations in children

The haematology laboratory is able to perform a number of tests to help establish the cause of illness in children. The full blood count (FBC, also known as a complete blood count, CBC) is one of the most basic blood tests performed on children attending hospital or a primary care clinic. All doctors should therefore have an understanding of how the test is performed, possible pitfalls, be able to interpret results and know when more specialised testing or advice is required. Other haematological investigations in routine use include coagulation screens, blood film examination, reticulocyte counts and methods for estimation of iron stores and detection of abnormal haemoglobins. This section will focus on these basic tests and simple algorithms for the subsequent investigation and differential diagnosis of the commonest haemato-logical abnormalities encountered in general paediatric practice. The reader is referred to Chapter 15 for an account of the clinical presentation and management of primary haematological disorders in children

Specific issues concerning the management of patients on the waiting list and after liver transplantation

The present document is a second contribution collecting the recommendations of an expert panel of transplant hepatologists appointed by the Italian Association for the Study of the Liver (AISF) concerning the management of certain aspects of liver transplantation, including: the issue of prompt referral; the management of difficult candidates; malnutrition; living related liver transplants; hepatocellular carcinoma; and the role of direct acting antiviral agents before and after transplantation. The statements on each topic were approved by participants at the AISF Transplant Hepatology Expert Meeting organized by the Permanent Liver Transplant Commission in Mondello on 12-13 May 2017. They are graded according to the GRADE grading system

Mucocutaneous manifestations and nail changes in patients with end-stage renal disease on hemodialysis.

Mucocutaneous manifestations are common among patients on hemodialysis (HD). This study was undertaken to determine the prevalence of mucocutaneous manifestations in patients with end-stage renal disease (ESRD) who are on HD. In this cross-sectional, descriptive and analytic study conducted in 2009, 100 patients on HD at the Five Azar Hospital in Gorgan city were randomly selected. All the patients underwent detailed examination by a dermatologist to look for lesions in the skin, hair, nail and mucous membranes; if felt necessary, biopsy was obtained from the lesions. The findings were statistically analyzed using SPSS-13 software. For evaluation of normality of distribution, Kolmogorov-Smirnov was used, for quantitative variables Mann-Whitney and T-test (abnormal distribution) were used and for qualitative variables, Chi-2 and Fisher were used. In this study, P-value less than 0.05 was considered significant. Fifty-one males and 49 females were enrolled. The mean age was 49 ± 12 years. Diabetes was the most common cause of ESRD. In 95% of the patients, at least one mucocutaneous manifestation was present. Xerosis (78.3%) was the most common lesion, followed by pruritus (39.1%), lentigo (34.8%), skin discoloration (32.6%), leukonychia (32%) and thinning of the nail bed (24%). Xerosis, scaling, lentigo, folliculitis, idiopathic guttate hypopigmentation, leukonychia and half and half nail were associated with age. A significant relationship was seen between duration on dialysis and skin discoloration and leukonychia. Clubbing had a significant association with calcium-phosphorus product (Ca � P). There was a significant association between serum ferritin level and pruritus and tinea versicolor lesions. Our study shows that mucocutaneous manifestations are common among patients with ESRD. Identification of these manifestations and their association with causative factors are useful for preventing the lesions

Structural Neuroimaging of Anorexia Nervosa: Future Directions in the Quest for Mechanisms Underlying Dynamic Alterations.

Anorexia nervosa (AN) is a serious eating disorder characterized by self-starvation and extreme weight loss. Pseudoatrophic brain changes are often readily visible in individual brain scans, and AN may be a valuable model disorder to study structural neuroplasticity. Structural magnetic resonance imaging studies have found reduced gray matter volume and cortical thinning in acutely underweight patients to normalize following successful treatment. However, some well-controlled studies have found regionally greater gray matter and persistence of structural alterations following long-term recovery. Findings from diffusion tensor imaging studies of white matter integrity and connectivity are also inconsistent. Furthermore, despite the severity of AN, the number of existing structural neuroimaging studies is still relatively low, and our knowledge of the underlying cellular and molecular mechanisms for macrostructural brain changes is rudimentary. We critically review the current state of structural neuroimaging in AN and discuss the potential neurobiological basis of structural brain alterations in the disorder, highlighting impediments to progress, recent developments, and promising future directions. In particular, we argue for the utility of more standardized data collection, adopting a connectomics approach to understanding brain network architecture, employing advanced magnetic resonance imaging methods that quantify biomarkers of brain tissue microstructure, integrating data from multiple imaging modalities, strategic longitudinal observation during weight restoration, and large-scale data pooling. Our overarching objective is to motivate carefully controlled research of brain structure in eating disorders, which will ultimately help predict therapeutic response and improve treatment

Investigating alcohol consumption during pregnancy for the prevention of Fetal Alcohol Spectrum Disorders (FASD)

The term FASD (Fetal Alcohol Spectrum Disorders) is used to describe the entire spectrum of pathologies and disorders caused by alcohol exposure in uterus. Alcohol assumed in pregnancy passes directly through the placental barrier causing a broad range of symptoms whose severity can greatly vary in degree. The alcohol teratogenic effect may result in physical damage and specific facial anomalies, growth delays, neurological defects along with intellectual disabilities and behavioral problems. Children affected show difficulties in verbal learning, memory, visual-spatial abilities, attention, logic and math abilities, information processing, executive functions as well as in many other domains and in general coping with daily life. Total abstention from alcohol during pregnancy is strongly recommended, as a safe threshold of consumption has not been established yet. Hence, the early identification of alcohol consumption in pregnancy is crucial. Specific methodologies to overcome difficulties related to the identification of alcohol behavior in pregnant women are needed and intervention protocols should be implemented to prevent damage in offsprings. This paper gives an overview on this pathology, from clinical delineation to epidemiology and risk factors with a special focus to promote alcohol-free pregnanc

Impact of Sleep and Circadian Disruption on Energy Balance and Diabetes: A Summary of Workshop Discussions

A workshop was held at the National Institute for Diabetes and Digestive and Kidney Diseases with a focus on the impact of sleep and circadian disruption on energy balance and diabetes. The workshop identified a number of key principles for research in this area and a number of specific opportunities. Studies in this area would be facilitated by active collaboration between investigators in sleep/circadian research and investigators in metabolism/diabetes. There is a need to translate the elegant findings from basic research into improving the metabolic health of the American public. There is also a need for investigators studying the impact of sleep/circadian disruption in humans to move beyond measurements of insulin and glucose and conduct more in-depth phenotyping. There is also a need for the assessments of sleep and circadian rhythms as well as assessments for sleep-disordered breathing to be incorporated into all ongoing cohort studies related to diabetes risk. Studies in humans need to complement the elegant short-term laboratory-based human studies of simulated short sleep and shift work etc. with studies in subjects in the general population with these disorders. It is conceivable that chronic adaptations occur, and if so, the mechanisms by which they occur needs to be identified and understood. Particular areas of opportunity that are ready for translation are studies to address whether CPAP treatment of patients with pre-diabetes and obstructive sleep apnea (OSA) prevents or delays the onset of diabetes and whether temporal restricted feeding has the same impact on obesity rates in humans as it does in mice

The Economic Cost of Domestic Hunger: Estimated Annual Burden to the United States

Examines the extent of domestic hunger and estimates the cost burden of food insecurity to the nation, including the costs of charity to help feed families, mental health and physical illnesses, and impaired educational outcomes and economic productivity

Chemical and Biological Characterization from Condalia microphylla Fruits, a Native Species of Patagonia Argentina

Condalia microphylla Cav. (Rhamnaceae), popularly known as “piquillin”, is widely distributed in Patagonia. The drupes are consumed as fresh fruits by Argentine communities. The aim of this work was to quantify the nutritional value of C. microphylla fruit and the phenolic compounds present and to determine the functional antioxidant properties in vitro and in vivo. The nutritional value was determined according to the Association of Official Analytical Chemists (AOAC) methodology, and phenolic compounds were quantified by diode-array detection (HPLC-DAD). Antioxidant activity in vitro and in vivo was analyzed through the use of the radical species 2,2-diphenyl-1-picrylhydrazyl (DPPH) and zebrafish model, respectively. Quercetin-3-O-rutinoside (rutin) was the single principal phenolic compound. The extracts contained in vitro antioxidant activities and total phenolic contents (TPCs) between 1,143 ± 112 µg and 4,633 ± 174 µg gallic-acid equivalents (GAEs) per 100 g dry weight (DW), though no relationship was found between the latter parameter and the antioxidant activity of the extracts. When zebrafish larvae were exposed to oxidative stress (2.4% v/v H2O2), a concentration as low as 1.44 µg of GAEs/mL of piquillin-derived polyphenols inhibited lipid oxidation by up to 40%. Thus, in view of these advantageous functional food properties and the opportunity to exploit this Patagonian natural resource, piquillin consumption should be promoted worldwide.Fil: Boeri, Patricia. Universidad Nacional de Río Negro. Sede Atlántica; ArgentinaFil: Piñuel, Maria Lucrecia. Universidad Nacional de Rio Negro. Centro de Investigaciones y Transferencia de Rio Negro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Transferencia de Rio Negro; Argentina. Universidad Nacional de Río Negro. Sede Atlántica; ArgentinaFil: Sharry, Sandra Elizabeth. Universidad Nacional de Río Negro. Sede Atlántica; Argentina. Universidad Nacional de la Plata. Facultad de Cs.agrarias y Forestales. Departamento de Tecnología Agropecuaria y Forestal. Centro Exptal.de Propagación Vegetativa; ArgentinaFil: Tombari, Andrea Diana. Universidad Nacional de Río Negro. Sede Atlántica; ArgentinaFil: Barrio, Daniel Alejandro. Universidad Nacional de Río Negro. Sede Atlántica; Argentina. Universidad Nacional de Rio Negro. Centro de Investigaciones y Transferencia de Rio Negro. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro de Investigaciones y Transferencia de Rio Negro; Argentin

Multidisciplinary studies on a sick-leader syndrome-associated mass stranding of sperm whales (Physeter macrocephalus) along the Adriatic coast of Italy

Mass strandings of sperm whales (Physeter macrocephalus) are rare in the Mediterranean Sea. Nevertheless, in 2014 a pod of 7 specimens stranded alive along the Italian coast of the Central Adriatic Sea: 3 individuals died on the beach after a few hours due to internal damages induced by prolonged recumbency; the remaining 4 whales were refloated after great efforts. All the dead animals were genetically related females; one was pregnant. All the animals were infected by dolphin morbillivirus (DMV) and the pregnant whale was also affected by a severe nephropathy due to a large kidney stone. Other analyses ruled out other possible relevant factors related to weather conditions or human activities. The results of multidisciplinary post-mortem analyses revealed that the 7 sperm whales entered the Adriatic Sea encountering adverse weather conditions and then kept heading northward following the pregnant but sick leader of the pod, thereby reaching the stranding site. DMV infection most likely played a crucial role in impairing the health condition and orientation abilities of the whales. They did not steer back towards deeper waters, but eventually stranded along the Central Adriatic Sea coastline, a real trap for sperm whales