Characterization of the main steps in first shell formation in Mytilus galloprovincialis: possible role of tyrosinase

Bivalve biomineralization is a highly complex and organized process, involving several molecular components identified in adults and larval stages. However, information is still scarce on the ontogeny of the organic matrix before calcification occurs. In this work, first shell formation was investigated in the mussel Mytilus galloprovincialis. The time course of organic matrix and CaCO3 deposition were followed at close times post fertilization (24, 26, 29, 32, 48 h) by calcofluor and calcein staining, respectively. Both components showed an exponential trend in growth, with a delay between organic matrix and CaCO3 deposition. mRNA levels of genes involved in matrix deposition (chitin synthase; tyrosinase- TYR) and calcification (carbonic anhydrase; extrapallial protein) were quantified by qPCR at 24 and 48 hours post fertilization (hpf) with respect to eggs. All transcripts were upregulated across early development, with TYR showing highest mRNA levels from 24 hpf. TYR transcripts were closely associated with matrix deposition as shown by in situ hybridization. The involvement of tyrosinase activity was supported by data obtained with the enzyme inhibitor N-phenylthiourea. Our results underline the pivotal role of shell matrix in driving first CaCO3 deposition and the importance of tyrosinase in the formation of the first shell in M. galloprovincialis

Influence of lifestyle habits, nutritional status and insulin resistance in NAFLD

Non alcoholic fatty liver disease (NAFLD) is associated with obesity, diabetes and insulin resistance (IR). The aim of our study was to assess the relationship between IR, anthropometry, lifestyle habits, resting energy expenditure (REE) and degree of fatty liver at ultrasound in 48 overweight patients with NAFLD as compared to 24 controls without fatty liver, matched for age. Nutritional status, alcohol intake and physical activity were assessed by skinfold thickness measurements, a 7-day diary, and SenseWear armband (SWA). REE was assessed by both SWA (REE-SWA) and a Vmax metabolic cart (REE-Vmax). Fatty liver was measured by US and the Doppler Power Index was calculated. IR was assessed using the HOMA index. There was significant correlation between waist circumference, HOMA, Doppler power index and fatty liver grade at US. Multivariate analysis showed that alteration of waist circumference, Doppler power index, and HOMA were the major significant predictors of fatty liver. Our data demonstrated a significant association between NAFLD and central adiposity and IR

Renal Stone Formation in Patients with Inflammatory Bowel Disease

Kidney stones are more common in patients with inflammatory bowel disease (IBD) than in the general population. The main lithogenetic risk factors were evaluated in patients affected by Crohn\u27s disease and ulcerative colitis. Our results show the presence of several factors, besides hyperoxaluria, in patients with IBD although their behaviour appears different in Crohn\u27s disease and ulcerative colitis at pre- and post-operative stages. Before surgery in patients with Crohn\u27s disease we found a decreased citrate (p \u3c 0.001) and magnesium (p \u3c 0.005) excretion together with a low urinary volume (p \u3c 0.001) and pH (p \u3c 0.005). After surgery patients with Crohn\u27s disease showed a further reduction of magnesium and citrate. Patients with ulcerative colitis before surgery showed a reduced citrate excretion (p \u3c 0.05) and a more acidic pH (p \u3c 0.05) than healthy subjects. Surgical treatment of proctocolectomy with ileal pouch-anal anastomosis seems to increase the risk of stone formation; in fact, after surgery we observed a relevant decrease of urinary volume (p \u3c 0.001), pH (p \u3c 0.0001) and urinary excretion of citrate (p \u3c0.0001) as well as magnesium (p \u3c 0.005). Patients with IBD seem to be at greater risk of stone formation than patients with idiopathic calcium lithiasis; in fact, they show a lower excretion of citrate (p \u3c 0.001) and magnesium (p \u3c 0.001) together with a low urinary pH (p \u3c 0.001) and volume (p \u3c 0.001). Urinary volume reduction is probably one of the major risk factors together with the decrease of small molecular weight inhibitors that is a constant finding in all patients with IBD

5-ASA Suppositories in Hemorrhoidal Disease

Forty patients with active hemorrhoidal disease were entered into this double-blind trial, 20 of whom were randomized to treatment with 5-aminosalicylic acid (5-ASA) (500 mg) suppositories. Clinical and sigmoidoscopic assessment was carried out before the start of the trial and after two weeks of treatment. At the end of the study, 5-ASA suppositories showed results superior to those of placebo for all parameters evaluated (P<0.01). There were no adverse events reported related to the use of suppositories. 5-ASA suppositories are a valid therapeutic approach for hemorrhoidal disease as it reduces the intensity of all symptoms and significantly decreases congestion of the hemorrhoidal plexus

[acute Dapsone Exposure And Methemoglobinemia In Children: Treatment With Multiple Doses Of Activated Charcoal With Or Without The Administration Of Methylene Blue]

OBJECTIVE: To study the changes in methemoglobinemia of 17 children admitted with acute exposure to dapsone complicated by a methemoglobin concentration greater than 20% of the total hemoglobin. The children were treated with multiple doses of activated charcoal with or without the administration of methylene blue.PATIENTS AND METHODS: Seventeen patients (ages 1-13 y, median 3 y), were admitted 1-72 h after the ingestion of 100-1200 mg (median 350 mg, 10 patients) or an unknown amount of dapsone (7 patients). The methemoglobin blood concentrations upon admission ranged from 23.5%-49.7% (median 37.8%), and the main clinical features were cyanosis (17), tachycardia (17), vomiting (11) and tachypnea (8). All of the children received multiple doses of activated charcoal orally or via nasogastric tube (1g/kg, 10% solution, 4-6 times/day, 3-16 doses with a median of 8 doses). Twelve of the 14 patients with methemoglobin levels greater than 30% were also treated with a single dose of methylene blue (1-2% solution, 1-2 mg/kg) infused IV over 5 min.RESULTS: There was a progressive decrease in the methemoglobin levels after the beginning of both treatments (multiple doses of activated charcoal alone or associated with methylene blue), and only one dose of methylene blue was necessary. There were no significant statistical differences between the results of the two treatments according to the time-course decrease in methemoglobinemia (p=0.49 Wilcoxon test).CONCLUSIONS: Multiple doses of activated charcoal given when methemoglobin levels were greater than 20% can be considered as a possible treatment for pediatric patients, with or without the administration of methylene blue, after acute dapsone exposure.76290-

Purchasing management in a tertiary teaching hospital: a case study

Modelo do Estudo: Estudo de Caso. Objetivo do Estudo: O presente trabalho visou estudar o processo de compras e programação de materiais de um hospital público de ensino de nível terciário e analisar os perfis de itens de materiais de consumo faltantes em determinado período, com a finalidade de identificar como ferramentas de gestão de materiais podem ajudar na definição de políticas de compras e estoque. Metodologia: O estudo foi elaborado com base em análises qualitativas e quantitativas. As primeiras foram feitas por meio de coleta de dados relativos ao entendimento dos processos e estrutura interna da Divisão de Materiais do Hospital através de observação e entrevistas semiestruturadas entre o período de setembro a novembro de 2013. A relação dos itens faltantes em 2012 e 2013 foi obtida através do sistema de informação da instituição e a partir destes dados foram feitas as análises quantitativas dos perfis destes itens segundo as classificações ABC e VEN (ou XYZ). Resultado: Os resultados apontam que dos 8.595 itens de materiais de consumo do Hospital apenas 5% em quantidade são classificados como A na curva ABC, no entanto tais itens correspondem a 42% em valores. Já os itens vitais representam 49% do valor e 46% em termos de quantidade. Quando analisadas em conjunto, as duas curvas apontam que a maioria das quantidades de materiais de consumo do Hospital são classificados como vitais da curva C (36,35%) e os itens não essenciais da curva A representam tanto em valor como em quantidade a menor parcela de materiais. O perfil dos itens faltantes em 2012 e 2013 são semelhantes, o maior índice de faltas está nos itens vitais da curva C e a menor nos itens não essenciais da curva A. Conclusão: Por meio do estudo foi possível concluir que a definição de políticas de compras e estoques que analisem não somente recursos econômicos, mas também a criticidade dos itens para o funcionamento dos processos é fundamental, principalmente levando em consideração o atual contexto das organizações de saúde públicas, a fim de melhor otimizar recursos e minimizar faltas.Model Study: Case Study. Purpose of the Study: This study aims to explore the purchasing materials process in a tertiary teaching hospital and analyze the missing items profiles in a given period in order to identify how materials management tools can help optimizing purchasing and inventory policies. Methodology: The study was based on qualitative and quantitative analyses. The first was made by means of collecting data to understand both processes and internal structure of the Materials Division through observation and semi-structured interviews between September-November 2013. A list of missing items in 2012 and 2013 was obtained from system information in order to analyze the profiles of these items according to the ABC and VEN (or XYZ) ratings. Results: The results show that out of 8,595 items of consumable materials, only 5 % in volume are classified as A in ABC curve, however such items correspond to 42 % in value. On the other hand, vital items represent 49 % on value and 46 % in terms of quantity. When analyzed together, the two curves show that most quantities of consumables materials are classified as vital from the C curve (36.35%) whereas non-essential items from the A curve represent both in value and in volume the smallest amount portion of materials. The missing items profile in 2012 and 2013 were similar, the highest rate of faults is from vital and C curve materials and the smaller, of nonessentials of the A curve. Conclusion: Through the study, it can be concluded that the definition of procurement policies inventories from the analyses of not only economic resources, but also item’s criticality to processes is essential, especially considering the current context of public health organizations, in order to optimize resources and minimize materials faults