The uraemic hypertensive patient. a therapeutic challenge-right you are (if you think so)

High blood pressure (BP) is a leading cause of chronic kidney disease (CKD) and at the same time represents its most frequent complication. High BP is an independent risk factor for advanced CKD; on the other hand, at least 40% of patients with normal glomerular filtration rate (GFR) and virtually all patients with GFR <30 mL/min are hypertensive. CKD and microalbuminuria are powerful risk factors for cardiovascular morbidity and mortality. Consequently, in uraemic hypertension, it is of utmost importance to carefully manage both high BP and microalbuminuria, in order to slow down the progression of kidney damage and to reduce the incidence of cardiovascular events. The first purpose of the medical treatment in hypertensive patients is to normalize BP, regardless of the drug used. Nevertheless, some drugs have an 'additional' nephroprotective effect at the same BP target achieved. In this regard, first-line drugs are definitely renin-angiotensin-aldosterone inhibitors, mainly for their proved efficacy in reducing hypertension-related kidney damage and proteinuria. Anyway, a combined approach (two or more drugs) is usually needed to achieve the optimal BP target and reduce the worsening of CKD

Flexible Refrigeration systems for the food industry with natural fluids, with particular reference to CO2

UE Directives tend to equate the benefits associated with the use of natural refrigerants and low environmental impact with those relating to the employment of traditional fluids. The actual Acts provide for obligations and penalties that may weigh on business and management, as well as influence the technical decisions at plant level. In this perspective, the aim of this paper was to realize a CO2 refrigeration system characterized by low environmental impact. The employment of this refrigerant fluid is partly consolidated and its use is increasing throughout Europe but it has not been adequately tested on agricultural products and foodstuffs. However, the possibility to realize a variable geometrical system is deepened, in order to meet a wide range of environmental and process conditions. A flexible prototype plant was designed and realized which is able to perform both subcritical and transcritical cycles, only varying the geometry of the circuit, according to both environmental conditions and product conservation needs. Having such a versatile refrigerating machine which could function as a laboratory test, it is possible firstly to determine, for a very specific application, the most suitable values of the parameters characterizing the process. In particular, to verify the feasibility of a possible solution only in foodstuffs applications where more stages of processing of the product at different values of temperature and humidity which currently require a device for each stage are requested, for example in the production of sausages

Effects of biostimulants on annurca fruit quality and potential nutraceutical compounds at harvest and during storage

The cultivar Annurca is an apple that is cultivated in southern Italy that undergoes a typical redding treatment and it is appreciated for organoleptic characteristics, high pulp firmness, and nutritional profile. In this study, the effects of three different biostimulants (Micro-algae (MA), Protein hydrolysate (PEP), and Macro-algae mixed with zinc and potassium (LG)), with foliar application, on the quality parameters of Annurca apple fruits at the harvest, after redding, and at +60 and +120 days of cold storage were analyzed: total soluble solids (TSS) content, total acidity (TA), pH, firmness flesh, and red coloration of epicarp. Additionally, the polyphenolic quali-quantitative profile of pulp and peel was analyzed by UHPLC-Q-Orbitrap HRMS and Folin-Ciocalteu and the antioxidant capacity with the methods 1,1-diphenyl-2-picrylhydrazyl (DPPH) and ferric-reducing antioxidant capacity (FRAP). The results obtained suggest that biostimulants are involved in the regulation of the secondary metabolism of the treated plants, acting positively on the quality of the Annurca fruits and their nutritional value. Fruits treated with PEP have shown, during cold storage, a significantly higher content of total polyphenols in flesh and a higher concentration of phloretin xylo-glucoside and phloridzin (350.53 and 43.58 mg/kg dw respectively). MA treatment caused, at the same time, an enhancement of flavonols between 0.6–28% and showed the highest total polyphenol content in the peel after 60 and 120 days of cold storage, with 2696.048 and 2570.457 mg/kg dw, respectively. The long-term cold storage (120 days) satisfactorily maintained phenolic content of fruits deriving from MA and PEP application, in accordance with data that were obtained for peel, showed an increase of 7.8 and 5.8%, respectively, when compared to the fruits cold stored for 60 days. This study represents the first detailed research on the use of different types of biostimulants on the quality of the Annurca apple from harvest to storage

Infectious endocarditis in dentistry practice: recent controversies and modes of the use of antibiotic prophylaxis

A survey by questionnaire to assess the daily practice of the antibiotic prophylaxis of infective endocarditis by physicians attending post-graduate schools of the Institutes of Oral Surgery and Stomatology (Group A n = 83) and Cardiology (Group B n = 46) of the Second University of Naples has been conducted. They were asked about dental procedure and cardiopathies that require prophylaxis for infective endocarditis, the relationship between infective endocarditis and rheumatic disease and the provision of antibiotic. Extraction of tooth and dental and oral surgery have been reported as the most risky procedures. Moreover provision of antibiotic prophylaxis was suggested to patients not at risk (pacemaker or coronary artery bypass), and was not suggested in high risk conditions (mitral valve prolapse with regurgitation and hypertrophic cardiomyopathy). Most of the 50-60% practitioners usually start the prophylaxis 24-48 hours before the procedure and prolong it for 48-72 hours. These results underline the need for improvement of the knowledge for the antibiotic prophylaxis of infective endocarditis