Role of Nutrition in the Management of Hepatic Encephalopathy in End-Stage Liver Failure

Malnutrition is common in patients with end-stage liver failure and hepatic encephalopathy, and is considered a significant prognostic factor affecting quality of life, outcome, and survival. The liver plays a crucial role in the regulation of nutrition by trafficking the metabolism of nutrients, their distribution and appropriate use by the body. Nutritional consequences with the potential to cause nervous system dysfunction occur in liver failure, and many factors contribute to malnutrition in hepatic failure. Among them are inadequate dietary intake, malabsorption, increased protein losses, hypermetabolism, insulin resistance, gastrointestinal bleeding, ascites, inflammation/infection, and hyponatremia. Patients at risk of malnutrition are relatively difficult to identify since liver disease may interfere with biomarkers of malnutrition. The supplementation of the diet with amino acids, antioxidants, vitamins as well as probiotics in addition to meeting energy and protein requirements may improve nutritional status, liver function, and hepatic encephalopathy in patients with end-stage liver failure

Mild hypothermia prevents brain edema and attenuates up-regulation of the astrocytic benzodiazepine receptor in experimental acute liver failure

BACKGROUND/AIMS: Mild hypothermia has proven useful in the clinical management of patients with acute liver failure. Acute liver failure in experimental animals results in alterations in the expression of genes coding for astrocytic proteins including the "peripheral-type" (astrocytic) benzodiazepine receptor (PTBR), a mitochondrial complex associated with neurosteroid synthesis. To gain further insight into the mechanisms whereby hypothermia attenuates the neurological complications of acute liver failure, we investigated PTBR expression in the brains of hepatic devascularized rats under normothermic (37 degrees C) and hypothermic (35 degrees C) conditions. METHODS: PTBR mRNA was measured using semi-quantitative RT-PCR in cerebral cortical extracts and densities of PTBR sites were measured by quantitative receptor autoradiagraphy. Brain pregnenolone content was measured by radioimmunoassay. RESULTS: At coma stages of encephalopathy, animals with acute liver failure manifested a significant increase of PTBR mRNA levels. Brain pregnenolone content and [(3)H]PK 11195 binding site densities were concomitantly increased. Mild hypothermia prevented brain edema and significantly attenuated the increased receptor expression and pregnenolone content. CONCLUSIONS: These findings suggest that an attenuation of PTBR up-regulation resulting in the prevention of increased brain neurosteroid content represents one of the mechanisms by which mild hypothermia exerts its protective effects in ALF.CIH

Научные подходы к диагностике социо-эколого-экономической устойчивости приморских регионов

На основе научных подходов предложена методика, позволяющая опреде-лить уровень социо-эколого-экономической устойчивости приморских ре-гионов. На основе использования системы показателей, характеризующих уровень социо-эколого-экономической устойчивости региона, сформули-рованы и предложены основные направления реализации методики опре-деления интегрального показателя уровня устойчивости приморской территории в социальном, экономическом и экологическом развитии.Based on the scientific approaches proposed technique allows to deter-mine the level of social, ecological and economic sustainability of coastal re-gions. On the basis of a system of indicators characterizing the level of social, ecological and economic sustainability of the region, formulate and propose guidelines implementation methodology for determining the integral indicator of the sustainability of the coastal territory in the social, economic and envi-ronmental development

Петрологічні дослідження в Україні: досягнення останніх десятиліть та нагальні проблеми

Викладено основні досягнення за останні 30–35 років українських геологів, в першу чергу — наукових працівників ІГМР ім. М. П. Семененка НАН України в області петрології. Висвітлені такі проблеми: 1 — метаморфізм, співвідношення грануліто-гнейсових і граніт-зеленокам’яних терейнів; 2 — чарнокіти; 3 — гранітоутворення та гранітоїдні формації; 4 — анортозит-рапаківігранітна формація; 5 — лужні породи; 6 — коматиїти; 7 — санукітоїди; 8 — метасоматоз; 9 — породоутворювальні та акцесорні мінерали; 10 — формаційний аналіз, петрологія та стратиграфія докембрію; 11 — фанерозойський магматизм; 12 — магматизм морського та океанічного дна; 13 — деякі нагальні проблеми.Изложены основные достижения за последние 30–35 лет украинских геологов, в первую очередь — научных сотрудников ИГМР им. Н. П. Семененко НАН Украины в области петрологии. Освещены такие проблемы: 1 — метаморфизм, соотношение гранулито-гнейсовых и гранит-зеленокаменных террейнов; 2 — чарнокиты; 3 — гранитообразование и гранитоидные формации; 4 — анортозит-рапакивигранитная формация; 5 — щелочные породы; 6 — коматииты; 7 — санукитоиды; 8 — метасоматоз; 9 — породообразующие и акцессорные минералы; 10 — формационный анализ, петрология и стратиграфия докембрия; 11 — фанерозойский магматизм; 12 — магматизм морского и океанического дна; 13 — некоторые насущные проблемы.Main achievements of Ukrainian geologists for the recent 30–35 years have been stated. In the first place the scientific results of petrologists of M. P. Semenenko Institute of Geochemistry, Mineralogy and Ore Formation of NAS of Ukraine. The following problems have been elucidated: 1 — metamorphism; interrelation of granulite-gneissic and granite-greenstone terrains; 2 — charnokites; 3 — granite formation and granitoid formations; 4 — anorthosite-rapakivi-granite formation; 5 — alkaline rocks; 6 — komatiites; 7 — sanukitoids; 8 — metasomatosis; 9 — rock-forming and accessory minerals; 10 — formation analysis, petrology and Precambrian stratigraphy; 11 — Phanerozoic magmatism; 12 — magmatism of the sea and ocean bottom; 13 — some current problems

Fabrication of an Array of Eccentric Sources for Freehand Optical Ultrasound Imaging

Free-hand optical ultrasound (OpUS) imaging is an emerging ultrasound imaging paradigm that utilises an array of fiber-optic sources and a fiber-optic detector to achieve video-rate, real-time imaging, with a flexible probe. Previous designs used multimode fibers to achieve circular OpUS sources that emitted divergent fields propagating away from the imaging plane, resulting in image artefacts and reduced penetration depths. The directivity of the emitted ultrasound field can be optimised by changing the trasnducer shape, moving to eccentric transducers can improve elevational confinement and associated aretefacts. In this work, methods for fabricating suitably eccentric waveguides that can be placed distally to a fiber-bundle array probe are presented. In addition, the scalability of one of these methods is demonstrated by fabricating a ten-element array of waveguides

LA FAMILIA, LA ESCUELA Y LA AUTORIDAD

DESJARDINS: (..) Pero una de las causas que hacen necesaria la creación de escuelas nuevas, es la incapacidad de la familia francesa actual de educar a sus hijos. DURKHEIM: ¿No habrá exageración al hablar así de la familia de hoy en día? Estoy de acuerdo, y soy el primero en deplorar, que la noción de autoridad ha decaído en la familia y en la escuela. Pero no debemos olvidar que en nuestros años era ruda en exceso. Nuestros inmediatos predecesores lucharon por suavizarla. Convengo en que ellos sobrepasaron la medida, pero no hay que olvidar lo que hicieron y lo que les debemos. En suma, ello no demuestra que la familia esté sensiblemente por debajo de lo que ella ha sido: es sólo diferente

DEBATE SOBRE LOS INTERNADOS Y LA ESCUELA NUEVA

DESJARDINS: Yo veo claramente donde está la ventaja para el niño mismo, ¿pero donde está el interés general de la sociedad? ¿Me concederéis aquel principio que requiere (que el interés de la sociedad demanda), que la obra de la educación sea, si es posible, sustraída a aquello que deshace la educación, es decir, en este caso al bullicio de las ciudades? ¿Me concederéis el principio de que el educador debe tomar deliberadamente su punto de apoyo fuera de la realidad social inestable a fin de que sea capaz de resistirla? Sobre este asunto he tomado ya partido y sé bien lo que haría. Pero surgen los problemas prácticos.DURKHEIM: La pregunta planteada por mi amigo Desjardins parece tener un interés platónico. Es evidente que en Francia no podemos librarnos de los internados. Los jesuitas quisieron evitarlos, pero se vieron obligados a ceder ante las quejas de las familias y de las municipalidades. Las Escuelas Centrales de la Revolución no tenían internados, y esta fue una de las causas de su fracaso

Effect of portacaval anastomosis on glutamine synthetase protein and gene expression in brain, liver and skeletal muscle

The effects of chronic liver insufficiency resulting from end-to-side portacaval anastomosis (PCA) on glutamine synthetase (GS) activities, protein and gene expression were studied in brain, liver and skeletal muscle of male adult rats. Four weeks following PCA, activities of GS in cerebral cortex and cerebellum were reduced by 32\% and 37\% (p<0.05) respectively whereas GS activities in muscle were increased by 52\% (p<0.05). GS activities in liver were decreased by up to 90\% (p<0.01), a finding which undoubtedly reflects the loss of GS-rich perivenous hepatocytes following portal-systemic shunting. Immunoblotting techniques revealed no change in GS protein content of brain regions or muscle but a significant loss in liver of PCA rats. GS mRNA determined by semi-quantitative RT-PCR was also significantly decreased in the livers of PCA rats compared to sham-operated controls. These findings demonstrate that PCA results in a loss of GS gene expression in the liver and that brain does not show a compensatory induction of enzyme activity, rendering it particularly sensitive to increases in ammonia in chronic liver failure. The finding of a post-translational increase of GS in muscle following portacaval shunting suggests that, in chronic liver failure, muscle becomes the major organ responsible for the removal of excess blood-borne ammonia