Endoscopic treatment of vesicoureteral reflux with polyacrylate polyalcohol copolymer and dextranomer/hyaluronic acid in adults

Purpose Aim of this study is to examine the effectiveness of dextranomer/hyaluronic acid copolymer and polyacrylate polyalcohol copolymer in endoscopic treatment of vesicoureteral reflux disease in adult patients with and without chronic renal failure. Materials and Methods Thirty two patients (12 female, 20 male) with a total of 50 renal units were treated for vesicoureteral reflux. There were 26 (81%) chronic renal failure patients. The success of treatment was evaluated by voiding cystouretrography at 3rd and 12th months after subureteric injection. The persistence of reflux was considered as failure. Patients were divided into two groups according to injected material. Age, sex, grade of reflux and treatment results were recorded and evaluated. Results Reflux was scored as grade 1 in seven (14%), grade 2 in 16 (32%), grade 3 in 21 (42%) and grade 4 in six (12%) renal units. There was not patient with grade 5 reflux. Fourteen renal units (28%) were treated with dextranomer/hyaluronic acid copolymer (group 1) and 36 renal units (72%) were treated with polyacrylate polyalcohol copolymer (group 2). The overall treatment success was achieved at 40 renal units (80%). The treatment was successful at 11 renal units (79%) in group 1 and 29 renal units (81%) in group 2 (p = 0.71). There was not statistically significant difference between two groups with patients with chronic renal failure in terms of treatment success (p = 1.00). Conclusions The effectiveness of two bulking agents was similar in treatment of vesicoureteral reflux disease in adult patients and patients with chronic renal failure

Generation and characterization of a defective HIV-1 Virus as an immunogen for a therapeutic vaccine

BACKGROUND: The generation of new immunogens able to elicit strong specific immune responses remains a major challenge in the attempts to obtain a prophylactic or therapeutic vaccine against HIV/AIDS. We designed and constructed a defective recombinant virus based on the HIV-1 genome generating infective but non-replicative virions able to elicit broad and strong cellular immune responses in HIV-1 seropositive individuals. RESULTS: Viral particles were generated through transient transfection in producer cells (293-T) of a full length HIV-1 DNA carrying a deletion of 892 base pairs (bp) in the pol gene encompassing the sequence that codes for the reverse transcriptase (NL4-3/ΔRT clone). The viral particles generated were able to enter target cells, but due to the absence of reverse transcriptase no replication was detected. The immunogenic capacity of these particles was assessed by ELISPOT to determine γ-interferon production in a cohort of 69 chronic asymptomatic HIV-1 seropositive individuals. Surprisingly, defective particles produced from NL4-3/ΔRT triggered stronger cellular responses than wild-type HIV-1 viruses inactivated with Aldrithiol-2 (AT-2) and in a larger proportion of individuals (55% versus 23% seropositive individuals tested). Electron microscopy showed that NL4-3/ΔRT virions display immature morphology. Interestingly, wild-type viruses treated with Amprenavir (APV) to induce defective core maturation also induced stronger responses than the same viral particles generated in the absence of protease inhibitors. CONCLUSIONS: We propose that immature HIV-1 virions generated from NL4-3/ΔRT viral clones may represent new prototypes of immunogens with a safer profile and stronger capacity to induce cellular immune responses than wild-type inactivated viral particles.This study was supported by grants FIS PI050265, FIS PI040503, FIS PI070291, FIS Intrasalud 080752, FIS PS09/01297, FIS PI10/02984, SAF2006-26667-E, FIT 09-010-205-9, FIPSE 36780/08, Fundación Mútua Madrileña, TRA-094, EC10-153, ISCIII-RETIC RD06/0006, HIVACAT–HIV Development Program in Catalonia, FIPSE 36630/07, UE Program Health 2009 CHAARM. Spanish Health Institute Carlos III (ISCIII) and the Health Department of the Catalan Government (Generalitat de Catalunya). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.S

Imitators of exercise-induced bronchoconstriction

Exercise-induced bronchoconstriction (EIB) is described by transient narrowing of the airways after exercise. It occurs in approximately 10% of the general population, while athletes may show a higher prevalence, especially in cold weather and ice rink athletes. Diagnosis of EIB is often made on the basis of self-reported symptoms without objective lung function tests, however, the presence of EIB can not be accurately determined on the basis of symptoms and may be under-, over-, or misdiagnosed. The goal of this review is to describe other clinical entities that mimic asthma or EIB symptoms and can be confused with EIB

‘‘Beet-ing’’ the Mountain: A Review of the Physiological and Performance Effects of Dietary Nitrate Supplementation at Simulated and Terrestrial Altitude

Exposure to altitude results in multiple physiological consequences. These include, but are not limited to, a reduced maximal oxygen consumption, drop in arterial oxygen saturation, and increase in muscle metabolic perturbations at a fixed sub-maximal work rate. Exercise capacity during fixed work rate or incremental exercise and time-trial performance are also impaired at altitude relative to sea-level. Recently, dietary nitrate (NO3-) supplementation has attracted considerable interest as a nutritional aid during altitude exposure. In this review, we summarise and critically evaluate the physiological and performance effects of dietary NO3- supplementation during exposure to simulated and terrestrial altitude. Previous investigations at simulated altitude indicate that NO3- supplementation may reduce the oxygen cost of exercise, elevate arterial and tissue oxygen saturation, improve muscle metabolic function, and enhance exercise capacity/ performance. Conversely, current evidence suggests that NO3- supplementation does not augment the training response at simulated altitude. Few studies have evaluated the effects of NO3- at terrestrial altitude. Current evidence indicates potential improvements in endothelial function at terrestrial altitude following NO3- supplementation. No effects of NO3- supplementation have been observed on oxygen consumption or arterial oxygen saturation at terrestrial altitude, although further research is warranted. Limitations of the present body of literature are discussed, and directions for future research are provided

Semi-empirical relationships to assess the seismic performance of slopes from an updated version of the Italian seismic database

Funder: Dipartimento della Protezione Civile, Presidenza del Consiglio dei Ministri; doi: http://dx.doi.org/10.13039/100012783; Grant(s): ReLUIS research project - Working Pachage 16: Geotechnical Engineering - Task Group 2: Slope stabilityAbstractSeismic performance of slopes can be assessed through displacement-based procedures where earthquake-induced displacements are usually computed following Newmark-type calculations. These can be adopted to perform a parametric integration of earthquake records to evaluate permanent displacements for different slope characteristics and seismic input properties. Several semi-empirical relationships can be obtained for different purposes: obtaining site-specific displacement hazard curves following a fully-probabilistic approach, to assess the seismic risk associated with the slope; providing semi-empirical models within a deterministic framework, where the seismic-induced permanent displacement is compared with threshold values related to different levels of seismic performance; calibrating the seismic coefficient to be used in pseudo-static calculations, where a safety factor against limit conditions is computed. In this paper, semi-empirical relationships are obtained as a result of a parametric integration of an updated version of the Italian strong-motion database, that, in turn, is described and compared to older versions of the database and to well-known ground motion prediction equations. Permanent displacement is expressed as a function of either ground motion parameters, for a given yield seismic coefficient of the slope, or of both ground motion parameters and the seismic coefficient. The first are meant to be used as a tool to develop site-specific displacement hazard curves, while the last can be used to evaluate earthquake-induced slope displacements, as well as to calibrate the seismic coefficient to be used in a pseudo-static analysis. Influence of the vertical component of seismic motion on these semi-empirical relationships is also assessed.</jats:p

Endurance performance is influenced by perceptions of pain and temperature: Theory, applications and safety considerations.

Models of endurance performance now recognise input from the brain, including an athlete’s ability to cope with various non-pleasurable perceptions during exercise, such as pain and temperature. Exercise training can reduce perceptions of both pain and temperature over time, partly explaining why athletes generally have a higher pain tolerance, despite a similar pain threshold, compared with active controls. Several strategies with varying efficacy may ameliorate the perceptions of pain (e.g. acetaminophen, transcranial direct current stimulation and transcutaneous electrical stimulation) and temperature (e.g. menthol beverages, topical menthol products and other cooling strategies, especially those targeting the head) during exercise to improve athletic performance. This review describes both the theory and practical applications of these interventions in the endurance sport setting, as well as the potentially harmful health consequences of their use

Specific and redundant functions of Gli2 and Gli3 zinc finger genes in skeletal patterning and development

The correct patterning of vertebrate skeletal elements is controlled by inductive interactions. Two vertebrate hedgehog proteins, Sonic hedgehog and Indian hedgehog, have been implicated in skeletal development. During somite differentiation and limb development, Sonic hedgehog functions as an inductive signal from the notochord, floor plate and zone of polarizing activity. Later in skeletogenesis, Indian hedgehog functions as a regulator of chondrogenesis during endochondral ossification. The vertebrate Gli zinc finger proteins are putative transcription factors that respond to Hedgehog signaling. In Drosophila, the Gli homolog cubitus interruptus is required for the activation of hedgehog targets and also functions as a repressor of hedgehog expression. We show here that Gli2 mutant mice exhibit severe skeletal abnormalities including cleft palate, tooth defects, absence of vertebral body and intervertebral discs, and shortened limbs and sternum. Interestingly, Gli2 and Gli3 mutant mice exhibit different subsets of skeletal defects indicating that they implement specific functions in the development of the neural crest, somite and lateral plate mesoderm derivatives. Although Gli2 and Gli3 are not functionally equivalent, double mutant analysis indicates that, in addition to their specific roles, they also serve redundant functions during skeletal development. The role of Gli2 and Gli3 in Hedgehog signaling during skeletal development is discussed.link_to_OA_fulltex

Conclusions: Multiple dimensions of human engagement with the Antarctic environment

The future scenarios developed by the contributors to this volume communicate a strong message. They concur that existing environmental management practices and the current system of governance are insufficient to meet the obligations set out under the Madrid Protocol to protect the Antarctic environment, let alone to address the challenges facing a warmer and busier Antarctic in the twenty-first century and beyond. However, not all is doom and gloom. A variety of environmental protection provisions have already been agreed. Reassertion and full compliance to their objectives, as well as wider use of existing environmental management tools (e.g. monitoring, information sharing, systematic designation of protected areas) can significantly increase the protection of the Antarctic environment. Notwithstanding, contentious and strategic issues need to be addressed urgently and proactively. Long-term and large-scale considerations need to permeate throughout all the steps of planning, decision making, implementation, enforcement, monitoring and compliance. Decisions should be guided by long-term visions and goals that are supported by genuine commitment from all actors. Multiple dimensions and perspectives of human engagement with the Antarctic environment (e.g. time, space, individual and collective values, ecosystems) need to be taken into consideration. Effective Antarctic environmental governance can only exist within the context of a stable and supportive governance regime that is invested with genuine political will and necessary resources. This ultimately depends on how much Antarctic Treaty Parties or, in fact, humankind in general, want to protect the Antarctic environment. The future of human engagement with the Antarctic environment draws on basic human values that underlie all decision making. We strongly recommend continued and coordinated studies into the values that different publics and Antarctic Treaty Party members actually associate with Antarctica and into how these values manifest themselves in human behaviour in Antarctica as well as in its governance. Finally, the Antarctic exists within a global context, and its environment cannot be protected through efforts within the Antarctic only. The sustainability of the Antarctic environment also depends on the preservation and broadening of agreed provisions within the Antarctic Treaty System (ATS), links between the ATS and other relevant global environmental agreements and global environmental initiatives