Campus Incivility and Free Speech: A Contemporary Dilemma

The issue of free speech on college campuses is as old as education itself and as current as today\u27s news. Institutions of higher education often find themselves torn between their desire to create environments where students and professors remain physically safe and their mission to protect academic freedom and the right of free speech. This interactive presentation will provide academic leaders with the skill set to increase the likelihood that constructive conflicts between ideas don\u27t escalate into destructive, violent acts

Oxaliplatin toxicity presenting as a liver nodule - case report

BACKGROUND: Oxaliplatin based chemotherapy is often used as adjuvant therapy in colon and rectal cancer. A reported side effect is Sinusoidal Obstruction Syndrome which is characterized by a spectrum of pathologic changes, from sinusoidal dilation, peri-sinusoidal haemorrhage, peliosis and nodular regenerative hyperplasia. Very rarely it can cause the development of liver nodules mimicking liver metastases. Herein, we report a case of Sinusoidal Obstruction Syndrome causing a liver nodule suspicious of liver metastasis on imaging. This is the third reported case of this complication of oxaliplatin toxicity, in which resection was performed and pathological diagnosis confirmed. CASE PRESENTATION: We report the case of a 59 year old man with stage III colon cancer who underwent sigmoidectomy followed by adjuvant chemotherapy with oxaliplatin. One year after surgery a liver nodule was detected and the patient underwent right hepatectomy. Pathology showed no liver nodule and diagnosed sinusoidal obstruction syndrome. CONCLUSION: We describe the third reported case of a liver lesion mimicking a liver metastasis after oxaliplatin-based chemotherapy for colon cancer. We suggest that in patients heavily treated with oxaliplatin with de novo liver nodules, this differential diagnosis should be considered. In particular, in this population of patients an intense imagiologic evaluation and even a preoperative biopsy should be pursued to confirm the diagnosis of malignancy and avoid overtreatment.info:eu-repo/semantics/publishedVersio

Custo de medicamentos produzidos pelo Hospital Universitário, papel da Farmácia Central

The hospital pharmacy in large and advanced institutions has evolved from a simple storage and distribution unit into a highly specialized manipulation and dispensation center, responsible for the handling of hundreds of clinical requests, many of them unique and not obtainable from commercial companies. It was therefore quite natural that in many environments, a manufacturing service was gradually established, to cater to both conventional and extraordinary demands of the medical staff. That was the case of Hospital das Clinicas, where multiple categories of drugs are routinely produced inside the pharmacy. However, cost-containment imperatives dictate that such activities be reassessed in the light of their efficiency and essentiality. METHODS: In a prospective study, the output of the Manufacturing Service of the Central Pharmacy during a 12-month period was documented and classified into three types. Group I comprised drugs similar to commercially distributed products, Group II included exclusive formulations for routine consumption, and Group III dealt with special demands related to clinical investigations. RESULTS: Findings for the three categories indicated that these groups represented 34.4%, 45.3%, and 20.3% of total manufacture orders, respectively. Costs of production were assessed and compared with market prices for Group 1 preparations, indicating savings of 63.5%. When applied to the other groups, for which direct equivalent in market value did not exist, these results would suggest total yearly savings of over 5 100 000 US dollars. Even considering that these calculations leave out many components of cost, notably those concerning marketing and distribution, it might still be concluded that at least part of the savings achieved were real. CONCLUSIONS: The observed savings, allied with the convenience and reliability with which the Central Pharmacy performed its obligations, support the contention that internal manufacture of pharmaceutical formulations was a cost-effective alternative in the described setting.A Farmácia Hospitalar em instituições avançadas e de grande porte evoluiu de uma simples unidade de armazenamento e distribuição, para um centro de manipulação altamente especializado, responsável pelo processamento de centenas de requisições clínicas, muitas delas únicas e não disponíveis de fontes comerciais. Foi perfeitamente natural portanto que em muitos ambientes, um Serviço Industrial fosse gradualmente estabelecido, visando responder a demandas tanto convencionais como extraordinárias da equipe médica. Tal foi o caso do Hospital das Clínicas, onde múltiplas categorias de fármacos são rotineiramente elaboradas nas dependências da Farmácia. Entretanto, imperativos de contenção de gastos determinam que tais atividades sejam reajuizadas sob o prisma de sua eficiência e essencialidade. MÉTODOS: Num estudo prospectivo, a produção do Serviço Industrial da Farmácia Central durante um período de 12 meses foi documentada, e classificada em três modalidades. O Grupo I abrangia medicamentos similares a outros fornecidos comercialmente, no Grupo II foram listadas formulações de composição exclusiva, e finalmente o Grupo III espelhava pedidos especiais voltados para investigações clínicas. RESULTADOS: Os achados das diversas categorias assinalaram que 34,4%, 45,3% e 20,3% dos medicamentos elaborados correspondiam a estes três grupos, respectivamente.Os custos industriais foram calculados para os fármacos do Grupo I e comparados com valores de mercado, chegando-se a uma economia de 63,5%.Quando extrapolada para os outros dois grupos, relativamente aos quais não se contava com preços comerciais diretamente equivalentes, atingiu-se uma estimativa superior a 5 100 000 dólares de economia durante um ano de operação. Mesmo levando-se em conta que tais contas deixaram de lado muitos custos, notavelmente aqueles subordinados à comercialização e distribuição, foi lícito concluir que pelo menos parte da economia citada era verdadeira. CONCLUSÕES: A economia observada, em combinação com a eficiência e confiabilidade com que a Farmácia desempenhou suas obrigações, vieram ao encontro do ponto de vista de que a manufatura interna de drogas foi uma alternativa vantajosa sob o prisma de custos, no contexto descrito

A role for atorvastatin and insulin combination in protecting from liver injury in a model of type 2 diabetes with hyperlipidemia

Non-alcoholic fatty liver disease (NAFLD) is a major complication linked with the metabolic syndrome associated with dyslipidemia, inflammation, and oxidative stress. Impact of type 2 diabetes with hyperlipidemia in NAFLD has to be established, as well as the utility of commonly prescribed anti-diabetic and lipid-lowering agents in improving liver injury markers. Genetic type 2 diabetic Goto-Kakizaki rats were fed with a high-fat diet to test hepatic effects of type 2 diabetes with hyperlipidemia and the effect of atorvastatin and insulin, individually and in combination, in systemic and hepatic inflammatory and oxidative stress markers. High-fat diet aggravated fasting glycemia, systemic and liver lipids, and inflammatory and oxidative stress markers. Individual treatments improved glycemic and lipid profiles, but failed to improve inflammatory markers, whereas insulin was able to reduce liver oxidative stress parameters. Combination of insulin and atorvastatin further improved glycemic and lipid profiles and decreased circulating C-reactive protein levels and liver inflammatory and oxidative stress markers. Insulin and atorvastatin combination leads to better glycaemic and lipid profiles and to better protection against liver inflammation and oxidative stress, giving a superior level of liver protection in type 2 diabetic with hyperlipidemia

Zinc-bound metallothioneins and immune plasticity: lessons from very old mice and humans

The capacity of the remodelling immune responses during stress (named immune plasticity) is fundamental to reach successful ageing. We herein report two pivotal experimental models in order to demonstrate the relevance of the immune plasticity in ageing and successful ageing. These two experimental models will be compared with the capacity in remodelling the immune response in human centenarians. With regard to experimental models, one model is represented by the circadian rhythms of immune responses, the other one is the immune responses during partial hepatectomy/liver regeneration (pHx). The latter is suggestive because it mimics the immunosenescence and chronic inflammation 48 h after partial hepatectomy in the young through the continuous production of IL-6, which is the main cause of immune plasticity lack in ageing. The constant production of IL-6 leads to abnormal increments of zinc-bound Metallothionein (MT), which is in turn unable in zinc release in ageing. As a consequence, low zinc ion bioavailability appears for thymic and extrathymic immune efficiency, in particular of liver NKT cells bearing TCR γδ. The remodelling during the circadian cycle and during pHx of zinc-bound MT confers the immune plasticity of liver NKT γδ cells and NK cells in young and very old mice, not in old mice. With regard to human centenarians and their capacity in remodelling the immune response with respect to elderly, these exceptional individuals display low zinc-bound MT associated with: a) satisfactory intracellular zinc ion availability, b) more capacity in zinc release by MT, c) less inflammation due to low gene expression of IL-6 receptor (gp130), d) increased levels of IFN-gamma and number of NKT cell bearing TCR γδ. Moreover, some polymorphisms for MT tested in PBMCs from human donors are related to successful ageing. In conclusion, zinc-bound MT homeostasis is fundamental to confer the immune plasticity that is a condition "sine qua non" to achieve healthy ageing and longevity

Análise sensorial e microbiológica da carne ovina submetida a diferentes formas de conservação no pós-abate.

Foram utilizados seis cordeiros machos da raça Santa Inês, castrados, com idade média de quatro meses, que foram abatidos com peso entre 30-35 kg com o objetivo de avaliar o e feito de três tipos de acondicionamento da carne ovina (natural, resfriada e congelada) na qualidade sensorial e microbiológica da carne. Para a análise sensorial foi separado e preparado o músculo Longissimus dorsi para um painel de provadores que avaliaram a carne quanto ao aroma, sabor, maciez, suculência, mastigabilidade e aparência geral. O mesmo músculo foi utilizado para a análise microbiológica onde se determinaram coliformes totais e fecais, bolores e leveduras. A carne in natura foi mais macia e de melhor mastigabilidade (p<0,05) em relação à resfriada e congelada. Observou-se também nas carcaças não resfriadas maior incidência de bolores e leveduras e presença de coliformes fecais. Apesar da carne in natura ter apresentado maior maciez, o crescimento microbiano foi maior neste tipo de conservação pós abate, o que pode comprometer a saúde humana

Abdominal Adiposity Is Associated With Elevated C-Reactive Protein Independent of BMI in Healthy Nonobese People

Objective: There is debate over the most appropriate adiposity markers of obesityassociated health risks. We evaluated the relationship between fat distribution and highsensitivity C-reactive protein (hs-CRP), independent of total adiposity. Research design and methods : We studied 350 people with abdominal adiposity (waist-to-hip ratio (WHR) ≥0.9 in male and ≥0.85 in female subjects) and 199 control subjects (WHR< 0.9 in male and <0.85 in female subjects) matched for BMI and age. We measured hs-CRP and major cardiovascular risk factors. Results Participants with abdominal adiposity had BMI similar to that in control subjects (24.8 ±2.5 vs. 24.7 ±2.2 kg/m2, respectively), but significantly higher waist circumference (96.4 6.±0 vs. 83.3 ±6.7 cm; p < 0.01) and WHR (1.07 ± 0.08 vs. 0.85 ±0.05; p<0.001). Compared with the control subjects, participants with abdominal adiposity had an adverse cardiovascular risk factor profile, significantly higher hs-CRP (1.96 ±2.60 vs. 1.53 ± 1.74 mg/dl; p< 0.01), and a twofold prevalence of elevated CRP values (≥3 mg/dl). Conclusions In non obese people, moderate abdominal adiposity is associated with markers of subclinical inflammation independent of BMI

Antiparasitic efficacy of essential oils for Neobenedenia melleni infecting farmed Lebranche mullet (Mugil liza).

The present study indicates that sanitary treatments with essential oils and freshwater baths for N. melleni infecting the Lebranche mullet M. liza are highly sustainable and pose a low risk to the environment