Liver involvement in pediatric celiac disease

Celiac disease (CD) is an intestinal inflammatory disease that manifests in genetically susceptible individuals when exposed to dietary gluten. It is a common chronic disorder, with a prevalence of 1% in Europe and North America. Although the disease primarily affects the gut, the clinical spectrum of CD is remarkably varied, and the disease can affect many extraintestinal organs and systems, including the liver. The hepatic dysfunction presenting in CD ranges from asymptomatic liver enzyme elevations or nonspecific reactive hepatitis (cryptogenic liver disorders), to chronic liver disease. In this article, we review the clinical presentations and possible mechanisms of CD-related liver injury to identify strategies for the diagnosis and treatment of these disorders in childhood

The impact of nonalcoholic fatty liver disease on renal function in children with overweight/obesity

The association between nonalcoholic fatty liver disease (NAFLD) and chronic kidney disease has attracted interest and attention over recent years. However, no data are available in children. We determined whether children with NAFLD show signs of renal functional alterations, as determined by estimated glomerular filtration rate (eGFR) and urinary albumin excretion. We studied 596 children with overweight/obesity, 268 with NAFLD (hepatic fat fraction >= 5% on magnetic resonance imaging) and 328 without NAFLD, and 130 healthy normal-weight controls. Decreased GFR was defined as eGFR < 90 mL/min/1.73 m(2). Abnormal albuminuria was defined as urinary excretion of >= 30 mg/24 h of albumin. A greater prevalence of eGFR < 90 mL/min/1.73 m2 was observed in patients with NAFLD compared to those without liver involvement and healthy subjects (17.5% vs. 6.7% vs. 0.77%; p < 0.0001). The proportion of children with abnormal albuminuria was also higher in the NAFLD group compared to those without NAFLD, and controls (9.3% vs. 4.0% vs. 0; p < 0.0001). Multivariate logistic regression analysis revealed that NAFLD was associated with decreased eGFR and/or microalbuminuria (odds ratio, 2.54 (confidence interval, 1.16-5.57); p < 0.05) independently of anthropometric and clinical variables. Children with NAFLD are at risk for early renal dysfunction. Recognition of this abnormality in the young may help to prevent the ongoing development of the disease

Novel Antimicrobial Strategies to Prevent Biofilm Infections in Catheters after Radical Cystectomy: A Pilot Study

Catheter-associated infections in bladder cancer patients, following radical cystectomy or ureterocutaneostomy, are very frequent, and the development of antibiotic resistance poses great challenges for treating biofilm-based infections. Here, we characterized bacterial communities from catheters of patients who had undergone radical cystectomy for muscle-invasive bladder cancer. We evaluated the efficacy of conventional antibiotics, alone or combined with the human ApoB-derived antimicrobial peptide r(P)ApoBLAla, to treat ureteral catheter-colonizing bacterial communities on clinically isolated bacteria. Microbial communities adhering to indwelling catheters were collected during the patients' regular catheter change schedules (28 days) and extracted within 48 h. Living bacteria were characterized using selective media and biochemical assays. Biofilm growth and novel antimicrobial strategies were analyzed using confocal laser scanning microscopy. Statistical analyses confirmed the relevance of the biofilm reduction induced by conventional antibiotics (fosfomycin, ceftriaxone, ciprofloxacin, gentamicin, and tetracycline) and a well-characterized human antimicrobial peptide r(P)ApoBLAla (1:20 ratio, respectively). Catheters showed polymicrobial communities, with Enterobactericiae and Proteus isolates predominating. In all samples, we recorded a meaningful reduction in biofilms, in both biomass and thickness, upon treatment with the antimicrobial peptide r(P)ApoBLAla in combination with low concentrations of conventional antibiotics. The results suggest that combinations of conventional antibiotics and human antimicrobial peptides might synergistically counteract biofilm growth on ureteral catheters, suggesting novel avenues for preventing catheter-associated infections in patients who have undergone radical cystectomy and ureterocutaneostomy

The Need for a Specific Risk Prediction System in Native Valve Infective Endocarditis Surgery

The need for a specific risk score system for infective endocarditis (IE) surgery has been previously claimed. In a single-center pilot study, preliminary to future multicentric development and validation, bivariate and multivariate (logistic regression) analysis of early postoperative mortality predictors in 440 native valve IE patients were performed. Mathematical procedures assigned scores to the independent predictors emerged (AUC of the ROC curve: 0.88). Overall mortality was 9.1%. Six predictors were identified and assigned scores, including age (5–13 points), renal failure (5), NYHA class IV (9), critical preoperative state (11), lack of preoperative attainment of blood culture negativity (5), perivalvular involvement (5). Four risk classes were drawn ranging from “very low risk” (≤5 points, mean predicted mortality 1%), and to “very high risk” (≥20 points, 43% mortality). IE-specific risk stratification models are both needed, as disease-specific factors (e.g., cultures, abscess), beside the generic ones (e.g., age, renal impairment) affect mortality, and feasible

Validation of a low-cost Electromyography (EMG) system via a commercial and accurate EMG device : pilot study

Electromyography (EMG) devices are well-suited for measuring the behaviour of muscles during an exercise or a task, and are widely used in many different research areas. Their disadvantage is that commercial systems are expensive. We designed a low-cost EMG system with enough accuracy and reliability to be used in a wide range of possible ways. The present article focuses on the validation of the low-cost system we designed, which is compared with a commercially available, accurate device. The evaluation was done by means of a set of experiments, in which volunteers performed isometric and dynamic exercises while EMG signals from the rectus femoris muscle were registered by both the proposed low-cost system and a commercial system simultaneously. Analysis and assessment of three indicators to estimate the similarity between both signals were developed. These indicated a very good result, with spearman’s correlation averaging above 0.60, the energy ratio close to the 80% and the linear correlation coefficient approximating 100%. The agreement between both systems (custom and commercial) is excellent, although there are also some limitations, such as the delay of the signal (1 s) and noise due to the hardware and assembly in the proposed system

Hybrid constructed wetlands for the treatment of wastewater from a fertilizer manufacturing plant: Microcosms and field scale experiments

Wastewater from a fertilizer manufacturing plant requires improvement prior to its environmental disposal. Ammonium is the critical contaminant to be removed. The aim of this study was to evaluate the feasibility of using free water surface wetlands (FWSWs), horizontal subsurface flow wetlands (HSSFWs), and their combination in hybrid wetlands (HWs) for the final treatment of wastewater with high ammonium concentration from a fertilizer manufacturing plant. Substrates and macrophytes were evaluated in microcosm experiments during three months. There were no significant differences in contaminant removal among HSSFWs with LECA or FWSWs planted with Typha domingensis or Canna indica. In a second stage, two configurations of pilot-scale HWs were constructed at the manufacturing facilities. Configuration A: HSSFW(A1)-FWSW(A2) and Configuration B: FWSW(B1)-HSSFW(B2) were evaluated during 12 months. There were no significant differences in contaminant removal (%) between the two configurations of HWs for COD (A: 74.5 ± 12.2/B: 81.5 ± 9.4), ammonium (A: 59.5 ± 17.5/B: 57.9 ± 21.4), nitrite (A: 79.8 ± 24.2/B: 80.6 ± 16.8) and dissolved inorganic nitrogen (DIN) (A: 59.4 ± 17.3/B: 50.3 ± 24.4). However, nitrate concentration (9.83 ± 3.11 mg N L−1) was significantly lower after Configuration A than after Configuration B (18.8 ± 5.2 mg N L−1). Comparing FWSWs and HSSFWs, they did not present significant differences in ammonium removal, while FWSWs presented the highest DIN removal. T. domingensis and C. indica in HSSFWs and T. domingensis in FWSWs tolerated wastewater conditions. T. domingensis presented the highest productivity. In further research, FWSWs in series planted with T. domingensis should be studied.Fil: Maine, Maria Alejandra. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; ArgentinaFil: Sanchez, Gabriela Cristina. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; ArgentinaFil: Hadad, Hernán Ricardo. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; ArgentinaFil: Caffaratti, Sandra Ester. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; ArgentinaFil: Pedro, María del Carmen. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; ArgentinaFil: Mufarrege, María de Las Mercedes. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; ArgentinaFil: Di Luca, Gisela Alfonsina. Universidad Nacional del Litoral. Instituto de Química Aplicada del Litoral. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Santa Fe. Instituto de Química Aplicada del Litoral.; Argentin

Guidance on Noncorticosteroid Systemic Immunomodulatory Therapy in Noninfectious Uveitis : Fundamentals Of Care for UveitiS (FOCUS) Initiative

Supplemental material available at www.aaojournal.org. Supported by AbbVie, Inc., and the Fundamentals of Care for Uveitis Initiative National Faculty. This manuscript was developed subsequent to an AbbVie-sponsored literature review of noninfectious, nonanterior uveitis. The meeting was conducted to understand the available literature regarding the management of patients with noninfectious, nonanterior uveitis. The program involved a total of 139 experts from 28 countries, who were selected for participation by AbbVie. However, AbbVie was not involved in the development of the manuscript. The authors maintained complete control over the content and this manuscript reflects the opinions of the authors. AbbVie selected the discussion participants and reviewed the final manuscript draft for scientific accuracy, but the authors determined the final content. All authors made substantial contributions to the article or critically revised it for important intellectual content and approved the final manuscript. AbbVie provided funding to invited participants, including honoraria for their attendance at the meetings. Travel to and from the meetings was reimbursed. No payments were made to the authors for the development of this manuscript. Dhinakaran Sambandan, PhD, and Shula Sarner, PhD, of Lucid Partners, Burleighfield House, Buckinghamshire, United Kingdom, provided medical writing and editorial support to the authors in the development of this manuscript; financial support for these services was provided by AbbVie. AbbVie reviewed the manuscript, but was not involved in the methodology, data collection and analysis, or completion of this manuscript.Peer reviewedPublisher PD

Primordial black holes and their gravitational-wave signatures

In the recent years, primordial black holes (PBHs) have emerged as one of the most interesting and hotly debated topics in cosmology. Among other possibilities, PBHs could explain both some of the signals from binary black hole mergers observed in gravitational wave detectors and an important component of the dark matter in the Universe. Significant progress has been achieved both on the theory side and from the point of view of observations, including new models and more accurate calculations of PBH formation, evolution, clustering, merger rates, as well as new astrophysical and cosmological probes. In this work, we review, analyse and combine the latest developments in order to perform end-to-end calculations of the various gravitational wave signatures of PBHs. Different ways to distinguish PBHs from stellar black holes are emphasized. Finally, we discuss their detectability with LISA, the first planned gravitational-wave observatory in space.Comment: 161 pages, 47 figures, comments welcom

Humedales constr uidos para tratamiento de ef luentes de industrias metalúrgicas en Santa Fe, Argentina

En Argentina, el uso de humedales construidos para tratamiento de efluentes es aún limitado, a pesar de que las condiciones para su implementación son ideales (gran disponibilidad de terrenos marginales de bajo costo, clima templado con inviernos poco rigurosos y gran disponibilidad de macrófitas adaptadas al clima). El objetivo de este trabajo fue evaluar la eficiencia de dos humedales construidos (HC1 y HC2) para el tratamiento de efluentes de industrias metalúrgicas y determinar si los contaminantes son retenidos por el sedimento o por la plantas, conocimientos clave para llevar a cabo un correcto manejo del humedal. En ambos humedales se trata el efluente cloacal junto con el industrial que contiene metales. Como los volúmenes a tratar y la composición química de los efluentes es diferente, los humedales construidos presentan distintas características de diseño. HC1 está en operación desde hace 12 años y HC2 desde hace cinco años. Ambos humedales funcionaron de manera eficiente, mostrando eficiencias de remoción satisfactorias para PRS, P total, especies nitrogenadas, DQO, DBO, sulfato, y metales. Typha domingensis (totora), especie dominante en ambos casos, presentó alta capacidad de retención de metales, en especial en su zona radicular, lo que demuestra su capacidad de fitoestabilización. Las concentraciones de metales y P aumentaron en el sedimento de la zona de entrada en fracciones químicamente estables, que no los liberarán al agua si se mantienen las condiciones ambientales. Los detritos de Typha domingensis acumularon altas concentraciones de metales. Estos detritos pueden ser removidos con facilidad para su disposición final

La inclusió és cosa de tothom : 10 idees pel professorat

Aquest decàleg és fruït del treball del grup d'interès d'inclusió de la Facultat de Ciències de l'Educació amb l'objectiu de compartir estratègies d'inclusió a les nostres aules universitàries. Aquest document parteix de la intenció de compartir algunes idees claus que hem trobat útils i valuoses per millorar el procés d'inclusió seguint marcs com els del DUA (Disseny Universal per l'Aprenentatge)