Comparing Results of Five Glomerular Filtration Rate-Estimating Equations in the Korean General Population. MDRD Study, Revised Lund-Malmö, and Three CKD-EPI Equations

Estimated glomerular filtration rate (eGFR) is a widely used index of kidney function. Recently, new formulas such as the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations or the Lund-Malmö equation were introduced for assessing eGFR. We compared them with the Modification of Diet in Renal Disease (MDRD) Study equation in the Korean adult population. METHODS: The study population comprised 1,482 individuals (median age 51 [42-59] yr, 48.9% males) who received annual physical check-ups during the year 2014. Serum creatinine (Cr) and cystatin C (CysC) were measured. We conducted a retrospective analysis using five GFR estimating equations (MDRD Study, revised Lund-Malmö, and Cr and/or CysC-based CKD-EPI equations). Reduced GFR was defined as eGFR <60 mL/min/1.73 m². RESULTS: For the GFR category distribution, large discrepancies were observed depending on the equation used; category G1 (≥90 mL/min/1.73 m²) ranged from 7.4-81.8%. Compared with the MDRD Study equation, the other four equations overestimated GFR, and CysC-based equations showed a greater difference (-31.3 for CKD-EPI(CysC) and -20.5 for CKD-EPI(Cr-CysC)). CysC-based equations decreased the prevalence of reduced GFR by one third (9.4% in the MDRD Study and 2.4% in CKD-EPI(CysC)). CONCLUSIONS: Our data shows that there are remarkable differences in eGFR assessment in the Korean population depending on the equation used, especially in normal or mildly decreased categories. Further prospective studies are necessary in various clinical settings

Enhancements of G3-PLC technology for smart-home/building applications

To enable the smart grid concept, it is fundamental to consider the in-home/building context where, beside the conventional home networking services, home automation and smart energy management services have to be offered. In this paper, we consider the in-home/building scenario, for which we propose a convergent network architecture to enhance the performance of the narrowband power line communication (PLC) G3-PLC technology through its integration with an Ethernet-based network. To this end, we define the protocols characterizing the network modules, namely, switches and routers, which allow for integrating the G3-PLC with Ethernet devices. Since Ethernet represents a convergent standard for many communication devices, by adding this functionality to G3-PLC, interconnectivity with other heterogeneous nodes can be offered. Furthermore, since the G3-PLC medium access control layer is based on a carrier sense multiple access scheme, its performance decreases when the number of network nodes contending for the channel increases. Therefore, we evaluate the network performance when an optimized time division multiple access scheme is adopted. The proposed convergent network architecture has been implemented in the OMNeT++ network simulator

Troponina e infarto periprocedurale: filo di Arianna o folle volo di Icaro?

Percutaneous coronary interventions cause frequently an increase in myocardial necrosis markers. Is troponin elevation after percutaneous coronary intervention a predictor of events at follow-up or a consequence of the procedure with no cause-effect relationship with prognosis? The debate is still ope

Quantum phase excitations in Ginzburg-Landau superconductors

We give a straightforward generalization of the Ginzburg-Landau theory for superconductors where the scalar phase field is replaced by an antisymmetric Kalb-Ramond field. We predict that at very low temperatures, where quantum phase effects are expected to play a significant role, the presence of vortices destroys superconductivity.Comment: revtex, 4 pages, no figure

New Relation-Theoretic Fixed Point Theorems in Fuzzy Metric Spaces with an Application to Fractional Differential Equations

In this paper, we introduce the notion of fuzzy R − ψ−contractive mappings and prove some relevant results on the existence and uniqueness of fixed points for this type of mappings in the setting of non-Archimedean fuzzy metric spaces. Several illustrative examples are also given to support our newly proven results. Furthermore, we apply our main results to prove the existence and uniqueness of a solution for Caputo fractional differential equations

TAVI nel trattamento della stenosi aortica degenerativa: stato dell’arte e prospettive

Degenerative aortic stenosis is the most common form of heart valve disease in developed countries and predominantly affects the elderly. Aortic valve replacement (AVR) has been the gold standard, but recently, transcatheter aortic valve implantation has emerged as an effective therapeutic alternative to conventional AVR for high-risk patients. This review analyzed the literature about AVR, with the objective of evaluating the outcomes of transcatheter aortic valve implantation in patients who are not eligible for surgery showing an improvement in quality of life and middle-term outcomes. The crucial point is the lack of studies with long-term follow-up that could give therapeutic importance to percutaneous valve replacemen

Quantitative determination of casein genetic variants in goat milk: Application in Girgentana dairy goat breed

The study was conducted to develop a high-performance liquid chromatographic (HPLC) method to quantify casein genetic variants (s2-, β-, and κ-casein) in milk of homozygous individuals of Girgentana goat breed. For calibration experiments, pure genetic variants were extracted from individual milk samples of animals with known genotypes. The described HPLC approach was precise, accurate and highly suitable for quantification of goat casein genetic variants of homozygous individuals. The amount of each casein per allele was: s2-casein A=2.9 ± 0.8 g/L and F=1.8 ± 0.4 g/L; β-casein C=3.0 ± 0.8 g/L and C1=2.0 ± 0.7 g/L and κ-casein A=1.6 ± 0.3 g/L and B=1.1 ± 0.2 g/L. A good correlation was found between the quantities of s2-casein genetic variants A and F, and β-casein C and C1 with other previously described method. The main important result was obtained for κ-casein because, till now, no data were available on quantification of single genetic variants for this protein

Skeletal myocyte types and vascularity in the Black Sicilian Pig.

The objective of this study was to verify the presence of giant fibres in the Black Sicilian pig skeletal muscle and to evaluate the effect of sex on histochemical and morphometric characteristics of the myocytes (myofibres) as well as vascularity of the muscle. Twenty Black Sicilian pigs (10 males, 10 females) from a farm in Sicily (Italy) were slaughtered at two years of age. Muscle tissues were obtained from three muscles: psoas major, longissimus dorsi, and trapezius. Myofibres were stained for myosin ATPase, succinic dehydrogenase, and α-amylase-PAS. For all fibre types, area and perimeter were measured. Slow-twitch oxidative fibres, fast-twitch glycolytic fibres and fast-twitch oxidative-glycolytic fibres were histochemically differentiated; an image-analyzing system was used. The results showed no differences between males and females in percentage of the fibre types, but there were significant differences between sexes in size of all the three fibre types. Psoas major muscle had a high percentage of slow-twitch oxidative fibres and contained more capillaries per fibre and per mm2 than trapezius and longissimus dorsi, in which fast-twitch glycolytic fibres dominated. The cross-sectional area of all fibres types was larger in longissimus dorsi than in trapezius and psoas major muscles; the giant fibres were absent in all the muscles studied. Fibre type composition may contribute to the variation of meat quality

Postoperative infectious complications in head and neck cancer surgery

Aim: In our work we have considered the problems related to the post-operative hospitalization in patients admitted to our ENT's department in the last 4 years. Material of study: Our observations refer to a sample of 155 patients suffering from head and neck tumors. Results: Regarding therapy, some drugs have been less effective to prevent post-operative infection: the ceftriaxone at the level of the oral cavity/oropharynx and ceftriaxone/pefloxacin at the level of the hypopharynx/larynx. Discussion: Post-operative infections in cancer surgery can compromise not only the surgical outcome but also be responsible for delays for any adjuvant treatments. Post-operative infections risk in head-neck cancer surgery drops from 30- 80 % to 20 % with perioperative antibiotic prophylaxis. Despite the introduction of pre-operative prophylaxis , according to guidelines, the number of post-surgical infections still remains high (40/61% of cases). It is important to know the intrinsic risk factors (related to the patient) and extrinsic (related to the external environment and the same procedure) to better understand how to prevent infections. Prolonged hospitalization can expose patients to the risk of hospital pathogens. Conclusion: We tried to outline a profile of head-neck cancer patients more likely to contract post-operative infections. We also compared the effects of various antibiotics administered before and after the onset of complications to suggest a therapeutic protocol. Key words: Antibiotics therapy Post-operative infectious, Prophylaxis in head and neck surgery

Steatosis affects the performance of liver stiffness measurement for fibrosis assessment in patients with genotype 1 chronic hepatitis C

BACKGROUND & AIMS: In Chronic Hepatitis C (CHC), the influence of steatosis on liver stiffness measurement (LSM) is still debated. We assessed the impact of steatosis and its ultrasonographical sign - bright liver echo pattern (BLEP) - on LSM values and on transient elastography (TE) accuracy for the diagnosis of liver fibrosis, in a cohort of consecutive patients with Genotype 1 (G1) CHC. METHODS: Patients (n=618) were assessed by clinical, ultrasonographic and histological (Scheuer score) features. TE was performed using the M probe. RESULTS: Male gender (p=0.04), steatosis as continuous variable (p<0.001), severity of necroinflammation (p=0.02) and stage of fibrosis (p<0.001) were associated with LSM by multivariate linear regression analysis. Among patients within the same fibrosis stages (F0-F2 and F3-F4; F0-F3 and F4), mean LSM values, expressed in kPa, were significantly higher in subjects with moderate-severe steatosis (⩾20% at liver biopsy) compared with those without, as well as in patients with BLEP on US compared with their counterpart. In subjects without severe fibrosis (F0-F2) and without cirrhosis (F0-F3), a higher rate of false-positive LSM results was observed in patients with steatosis ⩾20% compared with those without (F0-F2: 35.3% vs. 17.9%; F0-F3: 38.9% vs. 16.6%), and in patients with BLEP on US (F0-F2: 28.0% vs. 18.3%; F0-F3: 29.7% vs. 17.8%) compared with their counterpart. CONCLUSIONS: In patients with G1 CHC, the presence of moderate-severe steatosis, detected by histology or by US, should always be taken into account in order to avoid overestimations of liver fibrosis assessed by TE