Studies on the clinical significance of nonesterified and total cholesterol in urine

Gas-liquid chromatographic determinations of nonesterified and total urinary cholesterol were performed in 137 normals, 264 patients with various internal diseases without evidence of neoplasias or diseases of the kidney or urinary tract, 497 patients with malignancies and 236 patients with diseases of the kidney, urinary tract infections or prostatic adenoma with residual urine. A normal range (mean±2 SD) of 0.2–2.2 mg/24 hours nonesterified cholesterol (NEC) and of 0.3–3.0 mg/24 hours total cholesterol (TC) was calculated. Values of urinary cholesterol excretion were independent of age and sex and did not correlate with cholesterol levels in plasma. Patients with various internal diseases, without evidence of neoplasias nor diseases of the kidney or obstruction of the urinary tract, showed normal urinary cholesterol excretions, as did patients with infections of the urinary tract. However, elevated urinary cholesterol was found in patients with diseases of the kidney or urinary tract obstruction (prostatic adenoma with residual urine), malignant diseases of the urogenital tract and metastasing carcinoma of the breast. In patients with other malignant diseases urinary cholesterol was usually normal. Lesions of the urothelial cell membranes are considered to be the most likely cause of urinary cholesterol hyperexcretion. The clinical value of urinary cholesterol determinations as a possible screening test for urogenital carcinomas in unselected populations is limited by lacking specificity, expensive methodology and low prevalence of the mentioned carcinomas, although elevated urinary cholesterol excretions have been observed in early clinical stages of urogenital cancers

Photodegradation of the iodinated X-ray contract medium iopromide using combined oxidants of S₂O₈²⁻ and H₂O₂ promoted by UV irradiation promoted by UV irradiation

Author name used in this publication: W. ChuVersion of RecordPublishe

Recurrent acute heart failure caused by sliding hiatus hernia

The case is reported of a 75 year old woman who presented with recurrent nocturnal episodes of acute pulmonary oedema. The cause was uncertain as she had normal cardiothoracic ratio on chest radiography and normal left ventricular systolic and diastolic function by transthoracic echocardiogram. Another transthoracic echocardiogram was repeated when she was recumbent for an hour and had a full stomach. It showed a striking finding of severe left atrial compression by an external structure. Computed tomography of the thorax showed an intrathoracic mass behind the left atrium causing external compression of the left atrium suggestive of a sliding hiatus hernia. Cardiac catheterisation confirmed the diagnosis by showing a pronounced rise of pulmonary capillary wedge pressure in the recumbent position compared with the sitting up position.published_or_final_versio

Clinical and Pathological Findings in Women with Fabry Disease

Introduction. Fabry disease is a rare metabolic disorder caused by the genetic deficiency of the lysosomal hydrolase alpha-galactosidase A, located on chromosome X. Females with the defective gene are more than carriers and can develop a wide range of symptoms. Nevertheless, disease symptoms generally occur later and are less severe in women than in men. The enzyme deficiency manifests as a glycosphingolipidosis with progressive accumulation of glycosphingolipids and deposit of inclusion bodies in lysosomes giving a myelinlike appearance. Patients and Methods. Records of renal biopsies performed on adults from 1st January 2008 to 31st August 2011, were retrospectively examined at the Renal Pathology Laboratory. We retrieved biopsies diagnosed with Fabry disease and reviewed clinical and laboratory data and pathology findings. Results. Four female patients with a mean age of 49.3±4.5 (44-55) years were identified. The mean proteinuria was 0.75±0.3 g/24h (0.4-1.2) and estimated glomerular filtration rate (CKD EPI equation) was 71±15.7 ml/min/1.73m2 (48-83). Three patients experienced extra-renal organ involvement (cerebrovascular, cardiac, dermatologic, ophthalmologic and thyroid) with distinct severity degrees. Leukocyte α-GAL A activity was below normal range in the four cases but plasma and urinary enzymatic activity was normal. Light microscopy showed predominant vacuolisation of the podocyte cytoplasm and darkly staining granular inclusions on paraffin and plastic-embedded semi-thin sections. Electron microscopy showed in three patients the characteristic myelin-like inclusions in the podocyte cytoplasm and also focal podocyte foot process effacement. In one case the inclusions were also present in parietal glomerular cells, endothelial cells of peritubular capillary and arterioles. Conclusion. Clinical signs and symptoms are varied and can be severe among heterozygous females with Fabry disease. Intracellular accumulation of glycosphingolipids is a characteristic histologic finding of Fabry nephropathy. Since this disease is a potentially treatable condition, its early identification is imperative. We should consider it in the differential diagnosis of any patient presenting with proteinuria and/or chronic kidney disease, especially if there is a family history of kidney disease

2016 Consensus statement on prevention of atherosclerotic cardiovascular disease in the Hong Kong population

published_or_final_versio

Normal-State Spin Dynamics and Temperature-Dependent Spin Resonance Energy in an Optimally Doped Iron Arsenide Superconductor

The proximity of superconductivity and antiferromagnetism in the phase diagram of iron arsenides, the apparently weak electron-phonon coupling and the "resonance peak" in the superconducting spin excitation spectrum have fostered the hypothesis of magnetically mediated Cooper pairing. However, since most theories of superconductivity are based on a pairing boson of sufficient spectral weight in the normal state, detailed knowledge of the spin excitation spectrum above the superconducting transition temperature Tc is required to assess the viability of this hypothesis. Using inelastic neutron scattering we have studied the spin excitations in optimally doped BaFe1.85Co0.15As2 (Tc = 25 K) over a wide range of temperatures and energies. We present the results in absolute units and find that the normal state spectrum carries a weight comparable to underdoped cuprates. In contrast to cuprates, however, the spectrum agrees well with predictions of the theory of nearly antiferromagnetic metals, without complications arising from a pseudogap or competing incommensurate spin-modulated phases. We also show that the temperature evolution of the resonance energy follows the superconducting energy gap, as expected from conventional Fermi-liquid approaches. Our observations point to a surprisingly simple theoretical description of the spin dynamics in the iron arsenides and provide a solid foundation for models of magnetically mediated superconductivity.Comment: 8 pages, 4 figures, and an animatio

Estudo de caso: Gestão do risco operacional ligado às reclamações dos clientes na indústria hoteleira

Cada vez é mais difícil fidelizar os clientes, o desafio para os hotéis continua a ser a diminuição do número de reclamações e a melhoria da satisfação dos hóspedes. A indústria hoteleira já implementou processos para ter uma regularidade na qualidade do serviço. Contudo, no dia a dia os clientes continuam a reclamar quando existe uma falha no serviço. É aqui que entra o conceito do risco operacional, um conceito mais conhecido no setor da banca e pouco estudado na literatura para a indústria do Turismo e da Hotelaria. O relatório de estágio inclui um estudo de caso, criado de maneira a simular as estadias de um casal que vem com regularidade ao Hotel cinco estrelas Penha Longa Ritz-Carlton. Cada reclamação foi resolvida da melhor maneira para satisfazer novamente os hóspedes e o custo associado foi simulado com o objetivo de medir o impacto do risco operacional na rendibilidade. Em conclusão, o risco operacional tem de ser medido com cuidado, mesmo que não seja suposto gerir perdas financeiras significativas, o seu custo tem um impacto na rendibilidade. Existem várias formas de gerir o risco operacional, antecipando processos bem definidos no papel até à gestão das reclamações.As it becomes more complicated to build up customer loyalty, the challenge for hotels continues to be the reduction of customer complaints and the improvement of customer satisfaction. The Hotel industry already implemented processes to assure a regularity in the service quality. However, customers are still complaining on a daily basis when they are victim of a service failure. The operational risk is a concept known in the bank sector and few studies exist for tourism and Hotel industry. The internship report includes a case study, created in a way to simulate various stays of a couple that comes regularly in the five stars Hotel Penha Longa Ritz-Carlton. Each complaint was solved in the best way to satisfy the client and the cost was simulated in order to measure the impact of operational risk on profitability. To conclude, operational risk has to be considered carefully, even if it is not supposed to generate important loss, the cost has impact on profitability. It exists various ways to manage the operational risk, from the anticipation with well-defined processes until the complaints management

Annual outpatient hysteroscopy and endometrial sampling (OHES) in HNPCC/Lynch syndrome (LS)

Background: LS women have a 40-60 % lifetime risk of endometrial cancer (EC). Most international guidelines recommend screening. However, data on efficacy are limited. Purpose: To assess the performance of OHES for EC screening in LS and compare it with transvaginal ultrasound (TVS) alone. Methods: A prospective observational cohort study of LS women attending a tertiary high-risk familial gynaecological cancer clinic was conducted. LS women opting for EC screening underwent annual OHES and TVS. Histopathological specimens were processed using a strict protocol. Data of women screened between October 2007 and March 2010 were analysed from a bespoke database. Histology was used as the gold standard. Diagnostic accuracy of OHES was compared with TVS using specificity, and positive (PLR) and negative (NLR) likelihood ratios. Results: Forty-one LS women underwent 69 screens (41 prevalent, 28 incident). Four (three prevalent, one incident) women were detected to have EC/atypical endometrial hyperplasia (AEH), five had endometrial polyps and two had endometrial hyperplasia (EH) on OHES. TVS detected two of four EC/AEH. OHES had similar specificity of 89.8 % (CI 79.2, 96.2 %), but higher PLR 9.8 (CI 4.6, 21) and lower NLR (zero) compared to TVS: specificity 84.75 %(CI 73, 92.8 %), PLR 3.28 (CI 1.04, 10.35) and NLR 0.59 (CI 0.22, 1.58). No interval cancers occurred over a median follow-up of 22 months. The annual incidence was 3.57 % (CI 0.09, 18.35) for EC, 10.71 % (CI 2.27, 28.23) for polyps and 21.4 % (CI 8.3, 40.1) for any endometrial pathology. Conclusions: Our findings suggest that in LS, annual OHES is acceptable and has high diagnostic accuracy for EC/AEH screening. Larger international studies are needed for confirmation, given the relatively small numbers of LS women at individual centres. It reinforces the current recommendation that endometrial sampling is crucial when screening these women. © 2012 Springer-Verlag

Multiple-mode excitation in spin-transfer nanocontacts with dynamic polarizer

Author name used in this publication: A. RuotoloAuthor name used in this publication: Kwok, D. T. K.2010-2011 > Academic research: refereed > Publication in refereed journalVersion of RecordPublishe