Grafts and Graft Materials as Vascular Substitutes for Haemodialysis Access Construction

AbstractApart from long-term central venous catheterisation, the insertion of an arteriovenous graft (AVG) remains the only option to allow continued haemodialysis when the patient's superficial veins have been exhausted. Although, expanded PTFE has become the graft of choice for haemodialysis access throughout the world, many other organic or semi-organic materials are currently available for AVG construction. These are less prone to steal syndrome, easier to handle, more resistant to infection and may have similar, if not better, long term patencies

Physical-Mechanical Modifications of Eggs for Food-Processing During Storage

Abstract Physical-mechanical properties of egg constituents and their modifications during storage and poststorage greatly influence the efficiency of food processing, such as the separation of white and yolk by mechanical shelling. Thick albumen height, Haugh unit, yolk index and vitelline membrane-yolk system strength of eggs from Hy-Line White and Lohmann Brown hens were analyzed during 7 mo of storage at 0°C performing 3 poststorage treatments: i) immediately after refrigeration, T1; ii) after a further 6 h at 18°C after refrigeration, T2; and iii) after a week at 18°C after refrigeration, T3. For all qualitative parameters considered, this last poststorage treatment appeared to be the factor that produced the highest decrements; with respect to the first poststorage treatment, a further week at 18°C after refrigeration can involve mean decreases of about 19, 14, 14, and 16% in thick albumen height, Haugh unit, yolk index, and vitelline membrane-yolk system strength (in terms of maximum force), respectively. During about 7 mo of storage at 0°C, the latter parameter decreases, on average, by 10%. Increasing the storage time, physical-mechanical behavior was sometimes divergent from the observed trends

Nondestructive rainbow trout (Oncorhynchus mykiss) freshness estimation by using an affordable open-ended coaxial technique

In the present work, a nondestructive device set up for a rapid and reliable freshness assessment of rainbow trout during 10 days of storage in ice was evaluated. The device was characterized by a vector network analyzer interfaced with an open coaxial probe to be placed in contact with the fish eye. The acquisition of the reflected scattering parameter (S11), which is the ratio between the amplitude of the reflected and the incident signal, was assessed in the 50 kHz-3 GHz spectral range. S11 is composed of a real part and an imaginary part, and both parts were used to predict quality index method for freshness evaluations. Partial least squares regression predictive models of the demerit scores related to fish eye attributes (eye pupil and eye shape) and the day of storage were set up. The main results showed that both the real and imaginary parts of the S11 decrease as a function of storage time. The combination with multivariate analysis allowed to set up predictive models of the storage time and the demerit scores with R-2 values up to 0.946 (root mean square error [RMSE] = 0.88 days) and 0.942 (RMSE = 3.17 demerit scores related to the fish eyes attributes), respectively (external validation). According to our results, the proposed cheap solution appears a useful tool for the freshness assessment of rainbow trout

The use of a Polymeric Sealant for Prevention of Posttransplantation Lymphocele

The aim of this study was to investigate the effectiveness of a synthetic polyethy lenglycol (PEG) sealant to prevent lymphocele formation after kidney transplantation. The examined group consisted of 719 recipients including 294 female and 425 male who were immunosuppressed with a calcineurin inhibitor, plus basiliximab since 1999, and with mycophenolate mofetil in addition since 2000. We retrospectively analyzed the incidence of lymphoceles among 545 recipients operated between November 1999 and November 2007 (group I), 93 recipients at standard risk for lymphocele transplanted between December 2007 and December 2009 (group II) in whom we performed only routine ligation of the lymphatic vessels during preparation of the graft, and 31 patients also transplanted between December 2007 and December 2009 who were at higher risk for lymphocele (group III) and underwent an off-label application of the PEG sealant. There was no significant difference in patient demographic features among the groups. In total, 21 group I, patients (3.5%) developed symptoms of a lymphocele that required _1 corrective procedures, whereas only 1 group II patient (1.07%) developed a lymphocele and no group III patient evidenced a symptomatic lymphocele. No adverse events were observed among group III patients after PEG sealant application. although the preliminary results are interesting, a prospective randomized study is required to assess the cost-effectiveness of PEG sealant to prevent lymphocele formatio

Muscle Fiber Conduction Velocity Correlates With the Age at Onset in Mild FSHD Cases

A majority of patients with facioscapulohumeral muscular dystrophy (FSHD) report severe fatigue. The aim of this study was to explore whether fatigability during a performance task is related to the main clinical features of the disease in mildly affected patients. A total of 19 individuals with a molecular genetic-based diagnosis of FSHD (median D4Z4 deletion length of 27 kb) performed two isometric flexions of the dominant biceps brachii at 20% of their maximal voluntary contraction (MVC) for 2 min, and then at 60% MVC until exhaustion. Fatigability indices (average rectified value, mean frequency, conduction velocity, and fractal dimension) were extracted from the surface electromyogram (sEMG) signal, and their correlations with age, age at onset, disease duration, D4Z4 contraction length, perceived fatigability, and clinical disability score were analyzed. The conduction velocity during the low level contraction showed a significant negative correlation with the age at onset (p < 0.05). This finding suggest the assessment of conduction velocity at low isometric contraction intensities, as a potential useful tool to highlight differences in muscle involvement in FSHD patients

Molecular profiling, including TERT promoter mutations, of acral lentiginous melanomas

Acral lentiginous melanoma (ALM) is the less common subtype with singular characterization. TERT (human telomerase reverse transcriptase) promoter mutations have being described as recurrent in melanomas and infrequent in ALM, but their real incidence and clinical relevance is unclear. The objectives of this study were to describe the prevalence of TERT promoter mutations in ALM, and correlate with the molecular profile of other drive genes and clinical features. Sixty-one samples from 48 patients with ALM were analyzed. After DNA isolation, the mutation profiles of the hotspot region of BRAF, NRAS, KIT, PDGFRA, and TERT genes were determined by PCR amplification followed by direct Sanger sequencing. KIT, PDGFRA, and VEGFR2 gene amplification was performed by quantitative PCR. Clinical information such as survival, clinical stage, and Breslow tumor classification were obtained from medical records. TERT promoter mutations were found in 9.3% of the cases, BRAF in 10.3%, NRAS in 7.5%, KIT in 20.7%, and PDGFRA in 14.8% of ALM. None of the cases showed KIT, PDGFRA, or VEGFR2 gene amplification. We found an association between KIT mutations and advanced Clark level (IV and V, P=0.043) and TERT promoter mutations with low mitotic index. No other significant associations were observed between mutation profile and patients' clinical features nor survival rates. Oncogenic TERT promoter mutations are present in a fraction of ALMs. No relevant associations were found between TERT mutation status and clinical/molecular features nor survival. Mutations of KIT and PDGFRA are the most common genetic alterations, and they can be therapeutic targets for these patients.This project was supported by FAPESP - Brazil (2012/4194-1) to Vinicius de Lima Vazquez.info:eu-repo/semantics/publishedVersio

Health-related quality of life and functional changes in DMD:A 12-month longitudinal cohort study

Family caregivers of people with amyotrophic lateral sclerosis (ALS) live stressful lives in which they spend most of their time caring for their loved ones and managing difficult situations, thereby reducing the time spent in taking care of themselves. This situation may last several years. Previous literature has widely highlighted that this situation reduces caregivers' quality of life and increases their psychological distress and risk of health problems, but there is a lack of studies that focus on psychological interventions for these situations. This qualitative study examined a pilot experience of two mutual support groups for family caregivers of people with ALS. The aim was to identify caregivers' needs, the prominent aspects of their experience, and to understand whether and how this intervention strategy might help them. Six partners (four men and two women) and six adult children (five women and one man) participated in the groups, which were conducted in northern Italy. After the support groups finished, participants underwent semi-structured interviews. The authors conducted a content analysis of the transcripts of the interviews and the 20 group sessions. The thematic areas identified were "caregiving," "being the son/daughter of a person with ALS," "being the partner of a person with ALS," "group experience" and "group evaluation." The caregiving experience was profoundly different depending on whether the caregiver was a son/daughter or a partner of a patient with ALS. Moreover, comparison with peers and mutual support helped participants to better cope with ALS and its consequences, to improve their care for their relatives and to overcome typical caregiver isolation. These results suggest the usefulness of involving communities in caregiver support in order to create new networks and activate personal and social resources for well-being