Several Faces of Multiple Myeloma

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Dysproteinemia-Associated Kidney Diseases: Clinicopathological Correlations

Introduction: Dysproteinemia-associated kidney diseases can have diverse clinical and histological presentation but not all patients with monoclonal gammopathy have Monoclonal Gammopathy of Renal Significance (MGRS) and some have other causes for kidney lesions. Therefore, kidney biopsy is essential to make this diagnosis. We made a retrospective study, which aimed to: 1. Identify dysproteinemiaassociated kidney lesions; 2. Establish clinicopathological correlations of patients with those lesions and 3. Identify kidney and patient survival predictors. Methods: A retrospective, observational chart review of kidney biopsies performed, between January 2015 and February 2020, in three Portuguese Hospitals, to a total of 39 patients, with kidney lesions associated with monoclonal gammopathy, was undertaken. Results: The three main dysproteinemic kidney diseases identified were cast nephropathy, AL amyloidosis and Monoclonal Immunoglobulin Deposition Disease (MIDD), with different features among them. Only three patients fulfilled the criteria to Monoclonal Gammopathy of Renal Significance (MGRS). In regard to treatment, we verified that most of our patients were treated with chemotherapy. Unfortunately, only four recovered, either partially or completely. The mean kidney survival since kidney biopsy was 29,23 months and the mean patient survival since diagnosis was 24,46 months. Some clinical and pathologic features correlated to lowerkidney survival: acute tubular necrosis, cast nephropathy, Thrombotic Microangiopathy (TMA), haemoglobin and estimated Glomerular Filtration Rate (eGFR). Previous Nephrology follow-up correlated with higher kidney survival. Only eGFR was associated with lowerpatient survival.info:eu-repo/semantics/publishedVersio

Estudio de la composición química de las semillas y aceites seminales de Ligustrum lucidum Ait y Ligustrum sinense Lour

The fruits of Ligustrum lucidum Ait and Ligustrum sinense Lour were harvested in Olavarria (Province of Buenos Aires, Argentine). The seeds and extracted oils were analysed for characteristics and composition. The seed contained 8,7-10 and 10,7 % (dry basis), respectively. The physicochemical characteristics of the crude oils were: refractive index 1,4647 and 1,4640 (at 25ºC), iodine value 93,7 and 88,8, saponification index 167 and 154, unsaponifiable matter 11 and 18 %, and free fatty acid content of 4,8 and 9,2 (mg KOH/g), respectively. Gas chromatographic analysis of the oils revealed high levels of oleic acid (57,8 and 51,10%), about 25,1 and 29,6 % of saturated acids, respectively, most of them consisting of palmitic acid, but they have a significant content of acid of more than 18 atoms of carbon. The residual seed meals contained low level of crude protein and of available lysine (2.45, 3.65, g/16g N, respectively). Total and phytic acid phosphorous, calcium, ash, crude fiber, and polysaccharides (non presence of starch) contents are reported.Frutos de Ligustrum lucidum Ait y Ligustrum sinense Lour fueron cosechados en Olavarría (provincia de Buenos Aires, Argentina) y sus semillas separadas en forma manual. Las semillas se agotaron con n-hexano, obteniendo los aceites crudos con rendimientos del 8,7-10% y 10,7 % (base seca), respectivamente. Los aceites crudos se examinaron en sus características fisicoquímicas (Índice de refracción: 1,4647 y 1,4640 (a 25ºC), Indice de iodo: 93,7 y 88,8, Indice de saponificación: 167 y 154, insaponificable: 11 y 18 %, Indice de acidez: 4,8 y 9,2 (mgKOH/g) respectivamente. El análisis por cromatografía gaseosa de los ésteres metílicos reveló alto porcentaje de ácido oleico (57,8 y 51,1%), alrededor de un 25,1 y 29,6 % de ácidos saturados, respectivamente, predominando el ácido palmítico, pero con un significativo contenido de ácidos de más de 18 átomos de carbono. Las harinas residuales de extracción contenían baja proporción de proteína cruda y de lisina disponible. Se informan valores de fósforo total y de ácido fítico, cenizas, calcio, fibra cruda, hidratos de carbono

Influencia del Estado Metabólico Preoperatorio sobre los Cambios en el Gasto Energético en Reposo después del Transplante Hepático en Adultos

Introduction: The resting energy expenditure (REE) evolution after liver transplantation is not fully understood. Objective: To assess longitudinally the REE evolution in adults undergoing liver transplantation, in association with other nutritional measurements that characterize the metabolic profile. Methods: A single-center cohort of consecutive end-stage liver disease patients with indication for liver transplantation was recruited. REE, subjective global assessment (SGA), handgrip strength and body composition measurements were assessed before transplantation (T0) and at median nine (T1) and 36 (T2) days after transplantation. Mixed effects regression models were used for analysis. Results: Fifty-six patients with a mean age of 53.7 (8.5) years were included; 87.5% were males. In T0, 41% of patients were normometabolic, 37.5% were hypometabolic and 21.4% were hypermetabolic. After transplantation, the mean REE decreased progressively in patients initially hypermetabolic and the opposite occurred in those initially hypometabolic. The REE evolution was positively associated with body weight (β = 9.6, p < 0.001) and energy intake (β= 13.6, p = 0.005) in the whole sample; it was positively associated with body weight (β= 7.1, p = 0.018) and percentage of energy intake from lipids (β= 18.9, p = 0.003) in initially hypometabolic patients, and positively associated with body weight (β= 14.1, p < 0.001) and negatively associated with SGA-undernourishment (β = -171, p = 0.007) in initially normometabolic patients. Conclusion: Different REE evolutions after liver transplantation are associated with the preoperative metabolic status. In patients initially hypometabolic, the REE evolution is positively associated with body weight and percentage of energy intake from lipids, and in those initially normometabolic, it is positively associated with body weight and negatively associated with SGA-undernourishment.info:eu-repo/semantics/publishedVersio

Estudio de la composición química de la semilla, harina y aceite seminal de Pyracantha crenulata Roem

Seeds from Pyracantha crenulata Roem, harvested in Olavarría (Buenos Aires, Argentine) were defatted with hexane, obtaining raw oil with a yield of 5.5 % dry basis. The physicochemical characteristics of crude oil were: refractive index: 1.4770 (at 25ºC), iodine value: 121; saponification index: 203, unsaponifiable matter: 7.4 %, peroxide value: 8.7. The fatty acid composition of seed oil was studied by gas-liquid chromatography. Major fatty acids of seed oil were: linoleic (61.1 %), oleic (17.3 %) and palmitic acid (17.4 %). The residual seed meal contained low level of crude protein (13%, dry basis), considerable content of crude fiber and a relativity high value of neutral detergent fiber, that matching with the low digestibility observed. Metals, ash, sugar and polysaccharides contents are reported.Semillas de Pyracantha crenulata Roem, provenientes de frutos cosechados en Olavarría (provincia de Buenos Aires, Argentina) se trataron con hexano (soxhlet) obteniéndose el aceite crudo (rendimiento: 5,5 %) y la harina residual de extracción. Las características fisicoquímicas del aceite crudo fueron: índice de refracción: 1,4770 (a 25ºC); índice de iodo: 121; índice de saponificación: 203; insaponificable: 7,4%, índice de peróxidos (mEq/kg) 8,7. Se determinó la composición acídica del aceite por cromatografía gas-líquido. Los ácidos grasos mayoritarios fueron: ácido linoleico (61,1%), ácido oleico (17,3%) y ácido palmítico (17,4%). La harina residual de extracción contenía baja proporción de proteína cruda (13% b.s), considerable contenido de fibra cruda; y un valor de fibra detergente neutra relativamente alto, lo que concuerda con la muy baja digestibilidad observada. Se informan valores de cenizas, minerales e hidratos de carbono

Caracterización química del aceite y harina residual de Solanum sisymbriifolium lam

Seeds from Solanum sisymbriifolium Lam harvested at Olavarría (Buenos Aires, Argentine) were defatted with hexane and the raw oil obtained with a yield of 20,6 % dry basis. The physicochemical characteristics of crude oil were: refractive index: 1,4610 (at 25ºC), iodine value: 112,8; saponification index: 170,0; unsaponifiable matter: 14,0 % and free fatty acid content: 2,4 (mg KOH/g). The fatty acid composition of seed oil was studied by gas-liquid chromatography. Major fatty acids of seed oil were: linoleic (52,3%), oleic (23,4 %) and palmitic acid (16,4 %). The residual seed meal contained moderate level of crude protein (14,75%, dry basis), low level of available lysine (2,25 g/16gN) and high content of crude fiber (51,5%, dry basis). Total and phytic acid phosphorous, calcium, ash, sugar and polysaccharides contents are reported.Semillas de Solanum sisymbriifolium Lam cosechadas en Olavarría (prov. de Buenos Aires, Argentina) se trataron con hexano (soxhlet) obteniéndose el aceite crudo (rendimiento:20,6%) y la harina residual de extracción. Las características fisicoquímicas del aceite crudo fueron: Índice de refracción: 1.4610 (a 25ºC); Índice de iodo: 112,8; Índice de saponificación: 170,0; Insaponificable: 14,0%, Índice de acidez: 2,4 (mgKOH/g). Se determinó la composición acídica del aceite por cromatografía gas-líquido. Los ácidos grasos mayoritarios fueron: ácido linoleico (52,3%), ácido oleico (23,4%) y ácido palmítico (16,4%). La harina residual de extracción contenía una moderada proporción de proteína cruda (14,75% b.s), baja proporción de lisina disponible (2,25 g/16gN) y un alto contenido de fibra cruda (51,5 %b.s). Se informan valores de fósforo total y de ácido fítico, cenizas, calcio e hidratos de carbono

Multiple solutions to a magnetic nonlinear Choquard equation

We consider the stationary nonlinear magnetic Choquard equation [(-\mathrm{i}\nabla+A(x))^{2}u+V(x)u=(\frac{1}{|x|^{\alpha}}\ast |u|^{p}) |u|^{p-2}u,\quad x\in\mathbb{R}^{N}%] where $A\$is a real valued vector potential, $V$ is a real valued scalar potential$,$ $N\geq3$, $\alpha\in(0,N)$ and $2-(\alpha/N) <p<(2N-\alpha)/(N-2)$. \ We assume that both $A$ and $V$ are compatible with the action of some group $G$ of linear isometries of $\mathbb{R}^{N}$. We establish the existence of multiple complex valued solutions to this equation which satisfy the symmetry condition $$u(gx)=\tau(g)u(x)\text{\ \ \ for all}g\in G,\text{}x\in\mathbb{R}^{N},$$ where $\tau:G\rightarrow\mathbb{S}^{1}$ is a given group homomorphism into the unit complex numbers.Comment: To appear on ZAM

Triple Regimen with Rituximab, Plasmapheresis and Intravenous Immunoglobulin in the Treatment of Dialysis Dependent Acute Humoral-Mediated Rejection in Kidney Grafts

Introduction: The clinical importance of humoral-mediated acute rejection has been progressively recognised. Early recognition and treatment with plasmapheresis and intravenous immunoglobulin have recently improved short term prognosis. Case report: In this report we describe the clinical features of three 2nd transplant patients developing severe acute humoral rejection during the first week post-transplant while on anti-thymocyte globulin therapy. Treatment with plasmapheresis/ intravenous immunoglobulin/rituximab resulted in rapid reversal of oliguria,and recovery of renal function within the 1st week of treatment in 2/3 patients. Diagnosis was confirmed by graft biopsies revealing peritubular neutrophiles and C4d deposits. Sequential graft biopsies in all three patients revealed complete histological recovery within two weeks. One patient never recovered renal function, and one patient lost his graft at three months following hemorrhagic shock. After 2 years follow up, the remaining patient maintains a serum creatinine of 1.1mg/dl. Conclusion: The regimen using plasmapheresis plus intravenous immunoglobulin and rituximab was effective in rapidly reversing severe acute humoral rejection

Human and ecotoxicological impacts assessment from the Mexican oil industry in the Coatzacoalcos region, as revealed by the USEtox™ model

Human and ecotoxicological impacts were analyzed in the lower basin of the Coatzacoalcos River (Veracruz, State in Mexico). High pollution levels of contaminants from the oil industry have been reported in natural streams and the Coatzacoalcos River and in their sediments. USEtox™ model was employed to evaluate environmental fate, exposure, and effect of nine organic compounds (polycyclic aromatic hydrocarbons and one of which was in the group of polychlorinated biphenyls), a heavy metal (lead), and the effect of the industrial wastewater emitted into the river, on the Coatzacoalcos region. Most of these compounds are highly toxic; they bioaccumulate in human and animal tissue, mainly in the fatty tissues and can damage different organs and systemic targets such as the liver, kidney, hormonal system, nervous system, etc., of both humans and wildlife. The model estimates that 96 % (3,247 kg/day) of organic compounds is transferred from the water into air, whereas only 4 % (151 kg/day) remains in the water. In addition, it predicts that humans are mainly exposed to polychlorinated biphenyls (PCBs) congeners (28 and 153) by eating contaminated fish, due to PCBs accumulating in the fish fat tissue. The number of cases of cancer and noncancer (1 in 862 habitants per additional kilogram) is expected to have an increment due to the higher PCBs exposure of human population. Genetic damages in fishes, earthworms, and toads have been observed and related to higher exposure to organic compounds. The relationship between the field reported data and those one predicted by the USEtox™ model have been confirmed empirically by using the nonparametric correlation analysis (Spearman's rho). Based on the USEtox model, the environmental stress in the Coatzacoalcos industrial zone is between 2 and 6 orders of magnitude over geometric mean of acute aquatic EC50s. We think that USEtox model can be used to expand the number of substances that have the current water quality guidelines to improve the watermanagement inMexico

A negative mass theorem for surfaces of positive genus

We define the "sum of squares of the wavelengths" of a Riemannian surface (M,g) to be the regularized trace of the inverse of the Laplacian. We normalize by scaling and adding a constant, to obtain a "mass", which is scale invariant and vanishes at the round sphere. This is an anlaog for closed surfaces of the ADM mass from general relativity. We show that if M has positive genus then on each conformal class, the mass attains a negative minimum. For the minimizing metric, there is a sharp logarithmic Hardy-Littlewood-Sobolev inequality and a Moser-Trudinger-Onofri type inequality.Comment: 8 page