Plasma Exchange in Clinical Practice

Plasma exchange (PEX) is a treatment method with increasing range of indications. However, due to the small number of randomized trials, its effectiveness is still under debate in certain conditions. The aim of our chapter is to present the major principles of PEX, discuss safety issues and reveal current data for treatment effectiveness of the method. Novel indications for PEX will also be discussed

Vitamin D and Renal Disease

The metabolism of vitamin D (VD) is severely impaired in chronic kidney disease (CKD). Uremia is not only associated with the reduction of its active form 1,25-dihydroxyvitamin D but also in the reduction of all VD metabolites. CKD-associated abnormalities in VD are part of the CKD-related mineral-bone disease. However, VD has beneficial effect on the kidneys due to its pleiotropic effects, namely, antiproteinuric effect and renin-angiotensin-aldosterone system suppression, thus making the relationship between VD and the kidney even more complicated. The aim of our chapter is to reveal the changes in vitamin D axis in CKD, to outline the possible beneficial effects of vitamin D in renal patients, including end-stage renal patients and kidney transplant recipients, and to address the current opinions concerning treatment with cholecalciferol, calcitriol, and vitamin D analogs

Effects of the combined action of a desensitizing gel and toothpaste on dentin hypersensitivity due to dental bleaching

Objectives: The present study is aimed at evaluating the effectiveness of a fluoride- and potassium nitrate-containing gel and toothpaste in reducing dentinal hypersensitivity due to dental bleaching. Materials and methods: Specific inclusion and exclusion criteria were used to recruit patients for the study. They were randomly allocated to a test or a placebo control group. Patients underwent a treatment of home dental bleaching with 10% carbamide peroxide. Dental shades were evaluated in a standardized environment and dentinal hypersensitivity was valuated by means of evaporation stimuli. A nominal scale was used to score the painful reaction. The patients were recalled 8, 15 and 28 days after the baseline for both shade and sensitivity assessment. Statistical analysis was performed using the Student’s T-test. Results: The patients recall rate was 96.9%. The statistical analysis demonstrated a significant reduction of the painful symptoms in the experimental group (p=0.031) while no statistically significant differences were evidenced in the control group at any follow-up recall (p>0.05). Discussion: The tested agents proved to be safe and effective in the short term. Neither pigmentations nor interferences with the bleaching action of peroxides due to the desensitizing agents were observed. The compliance of the patients to the proposed protocol as well as the motivation to maintain good oral hygiene were paramount in the achievement of the reported results. Conclusions: The use of a desensitizing gel and toothpaste containing fluoride and potassium nitrate was effective in reducing dentinal hypersensitivity due to dental bleaching and did not interfere with the bleaching action of peroxides. Clinical significance: Desensitizing gels and toothpastes containing fluoride and potassium nitrate can be considered safe and effective in the control of tooth sensitivity after dental bleaching

Perturbative renormalization of bilinear quark and gluon operators

The renormalisation constants for local bilinear quark operators are calculated using the Sheikholeslami-Wohlert improved action. In addition we compute the renormalisation constant of the leading gluon operator for different group representations and discuss the mixing of the operators E^2 and B^2.Comment: 3 pages, poster contributed at Lattice96, St. Loui

Ozone in Lombardy: Years 1998-1999

Photochemical pollutants, especially ozone, have reached very high levels in Lombardy in recent years, with peaks of up to 150 ppb in late spring and summer. Lombardy, lying on the Po Plain, supports a large number of cities and industries and these, along with heavy traffic, produce copious amounts of primary pollutants such as nitrogen oxides and numerous volatile organic compounds. Furthermore, the peculiar orography of this region fosters the stagnation of air masses on a basin-scale and the presence of diurnal breezes towards northern areas, along with the evolution of the Mixing Layer, spread the polluted air masses over a large territory. Numerous stations in Lombardy give the concentrations of ozone and of nitrogen oxides. In this paper, ozone measurements carried out at the plain area around Milan and at pre-alpine sites in the spring and summer 1998 and 1999 will be shown and discussed, focusing on the months of May and July. The study of temporal and spatial behaviour of ozone goes hand in hand with the analysis of the Boundary Layer’s evolution. A number of radon stations were operating in Milan and in other sites in Lombardy. Measurements of atmospheric concentrations of radon yield an index of atmospheric stability, of the formation of thermal inversion, of convective turbulence, and of the movement of air masses, and hence they are very relevant to the understanding of the conditions of atmospheric pollutants

Determinants of aggression against all health care workers in a large-sized university hospital

Background: The paper aims to describe the 3-year incidence (2015/17) of aggressive acts against all healthcare workers to identify risk factors associated to violence among a variety of demographic and professional determinants of assaulted, and risk factors related to the circumstances surrounding these events. Methods: A retrospective observational study of all 10,970 health workers in a large-sized Italian university hospital was performed. The data, obtained from the "Aggression Reporting Form", which must be completed by assaulted workers within 72 h of aggression, were collected for the following domains: Worker assaulted (sex, age class, years worked); profession (nurses, medical doctors, non-medical support staff, administrative staff, midwives); aggressive acts (activity type during aggressive acts, season, time and location of aggressive acts); and type of aggressive acts (verbal, non-verbal, consequences, aggressors). Results: Three hundred sixty-four (3.3%) workers experienced almost one aggression. The majority of the assaulted workers were female (77.5%), had worked for 6/15 years and were Nurses (64.3%). The majority of aggressive acts occurred during assistance and patient care (38.2%), in the spring and during the afternoon/morning shifts and took place in locations where patients were present (47.3%). The most prevalent aggression type was verbal (76.9%). The patient was the most common aggressor (46.7%). 56% of those assaulted experienced interruptions in their work. Being female, being < 50 years of age, having worked for 6-15 years were significant risk factors for aggression. Midwives suffered the highest risk of experiencing aggression (RR = 12.95). The risk analysis showed that non-verbally aggressive acts were related to assistance and patient care with respect to activity type, to the presence of patients and during the spring and afternoon/evening. Conclusions: The findings suggest the parallel use of future qualitative studies to clarify the motivation behind aggression. These suggestions are needed for the implementation of additional adequate prevention strategies on either an organizational or a personal level

Asbestos Fibers Enhance the TMEM16A Channel Activity in Xenopus Oocytes

Background: The interaction of asbestos fibers with target cell membranes is still poorly investigated. Here, we detected and characterized an enhancement of chloride conductance in Xenopus oocyte cell membranes induced by exposure to crocidolite (Croc) asbestos fibers. Methods: A two-microelectrode voltage clamp technique was used to test the effect of Croc fiber suspensions on outward chloride currents evoked by step membrane depolarization. Calcium imaging experiments were also performed to investigate the variation of 'resting' oocyte [Ca2+]i following asbestos exposure. Results: The increase in chloride current after asbestos treatment, was sensitive to [Ca2+]e, and to specific blockers of TMEM16A Ca2+-activated chloride channels, MONNA and Ani9. Furthermore, asbestos treatment elevated the 'resting' [Ca2+]i likelihood by increasing the cell membrane permeability to Ca2 in favor of a tonic activation of TMEME16A channels. Western blot analysis confirmed that TMEME16A protein was endogenously present in the oocyte cell membrane and absorbed by Croc. Conclusion: the TMEM16A channels endogenously expressed by Xenopus oocytes are targets for asbestos fibers and represent a powerful tool for asbestos-membrane interaction studies. Interestingly, TMEM16A channels are highly expressed in many types of tumors, including some asbestos-related cancers, suggesting them, for the first time, as a possible early target of crocidolite-mediated tumorigenic effects on target cell membranes

Remark on lattice BRST invariance

A recently claimed resolution to the lattice Gribov problem in the context of chiral lattice gauge theories is examined. Unfortunately, I find that the old problem remains.Comment: 4 pages, plain TeX, presentation improved (see acknowledgments

Conceptual analysis: A Social neuroscience approach to interpersonal interaction in the context of disruption and disorganization of attachment (NAMDA)

Humans are strongly dependent upon social resources for allostasis and emotion regulation. This applies especially to early childhood because humans-as an altricial species-have a prolonged period of dependency on support and input from caregivers who typically act as sources of co-regulation. Accordingly, attachment theory proposes that the history and quality of early interactions with primary caregivers shape children's internal working models of attachment. In turn, these attachment models guide behavior, initially with the set goal of maintaining proximity to caregivers but eventually paving the way to more generalized mental representations of self and others. Mounting evidence in non-clinical populations suggests that these mental representations coincide with differential patterns of neural structure, function, and connectivity in a range of brain regions previously associated with emotional and cognitive capacities. What is currently lacking, however, is an evidence-based account of how early adverse attachment-related experiences and/or the emergence of attachment disorganization impact the developing brain. While work on early childhood adversities offers important insights, we propose that how these events become biologically embedded crucially hinges on the context of the child-caregiver attachment relationships in which the events take place. Our selective review distinguishes between direct social neuroscience research on disorganized attachment and indirect maltreatment-related research, converging on aberrant functioning in neurobiological systems subserving aversion, approach, emotion regulation, and mental state processing in the wake of severe attachment disruption. To account for heterogeneity of findings, we propose two distinct neurobiological phenotypes characterized by hyper- and hypo-arousal primarily deriving from the caregiver serving either as a threatening or as an insufficient source of co-regulation, respectively

The Ferroxidase Hephaestin in Lung Cancer: Pathological Significance and Prognostic Value

Hephaestin (HEPH) belongs to a group of exocytoplasmic ferroxidases which contribute to cellular iron homeostasis by favouring its export. Down-regulation of HEPH expression, possibly by stimulating cell proliferation due to an increase in iron availability, has shown to correlate with poor survival in breast cancer. The lung is particularly sensitive to iron-induced oxidative stress, given the high oxygen tension present, however, HEPH distribution in lung cancer and its influence on prognosis have not been investigated yet. In this study we explored the prognostic value of HEPH and its expression pattern in the most prevalent histotypes of lung cancers, namely lung adenocarcinoma and lung squamous cell carcinoma. In silico analyses, based on UALCAN, Gene Expression Profiling Interactive Analysis (GEPIA) and Kaplan–Meier plotter bioinformatics, revealed a significant correlation between higher levels of HEPH expression and favorable prognosis, in both cancer histotypes. Moreover, TIMER web platform showed a statistically significant association between HEPH expression and cell elements belonging to the tumor microenvironment identified as endothelial cells and a subpopulation of cancer-associated fibroblasts, further confirmed by double immunohistochemical labeling with cell type specific markers. Taken together, these data shed a light on the complex mechanisms of local iron handling lung cancer can exploit to support tumorigenesis