CHOLESTEROL CRYSTAL EMBOLISM: A RECOGNIZABLE CAUSE OF RENAL DISEASE

7openopenFrancesco Scolari; Regina Tardanico; Roberta Zani; Alessandra Pola; Battista Fabio Viola; Ezio Movilli; Rosario MaiorcaScolari, Francesco; Regina, Tardanico; Roberta, Zani; Alessandra, Pola; Battista Fabio, Viola; Ezio, Movilli; Rosario, Maiorc

Enhanced Oil Spill Remediation by Adsorption with Interlinked Multilayered Graphene

The performances of an innovative material based on graphene multilayers in a 3D structure similar to expanded graphite, Grafysorber\uae G+ (Directa Plus), have been tested via in field applications on a real contaminated site. Several experimental tests were performed using Grafysorber\uae inside adsorbent devices (booms and pillows) to treat waters polluted by oil. The experimental campaign was carried out with the aim of comparing the performances of Grafysorber\uae with those of polypropylene (PP), which is the material used worldwide in case of water oil spill clean-up activities. The results achieved have confirmed a considerably higher selective adsorption capacity of Grafysorber\uae compared to PP, and configure the new material as a promising alternative to standard materials in enhancing oil spill remediation by selective adsorption

CHRONIC INFLAMMATION AND END-DIALYSIS OVERWEIGHT. A 36 MONTH PROSPECTIVE OBSERVATIONAL STUDY

Introduction and Aims: Attaining dry body weight is paramount in dialysis practice, but this goal is not always reached.We hypothesized that the amount of end-dialysis overweight (edOW), could be associated to increased chronic inflammation and mortality. Aim of the study: to evaluate the effect of edOWon serum C-reattive protein (hsCRP) concentrations and on survival in a cohort of 182 prevalent HD patients ( pts) followed for 36 months. Methods: In 182 pts (117 men, age 65±12 years, vintage 48 months; range 6-336), edOWwas present in 98/182 (54%) pts. Mean value was 0.4±0.2 Kg (range: 0.1-1.4). In the 98 pts with edOW(Group 1) and in the other 84 (Group 2) we evaluated: Ultrafiltration rate(UFR), hsCRPdry body weight (dBW), Kt/V, protein catabolic rate (PCRn), interdialytic weight gain (IDWG), mean arterial pressure (MAP). Unpaired Student’s t test was employed to compare groups, linear regression analysis to test correlations, log-rank test and Kaplan-Meier curves to evaluate survival. Results: Mean UFR was 11.7±2.8 ml/Kg/hour, dBW 64±12 Kg, hsCRP 6.6 (0.2-36) mg/L, Kt/V 1.27±0.09, PCRn 1.06±0.10 g/Kg/day, IDWG 2.8±0.4 Kg, MAP 97±6.5 mmHg. edOWand hsCRP were directly and significantly correlated (r= 0.67; p<0.0001). Comparison between pts with (Group 1) and without (Group 2) edOW showed significant differences in: UFR (12.7±2.6 vs 10.9±2.6 ml/Kg/hour; p< 0.0001), hsCRP (13.0±8.1 vs 5.2±5.3 mg/L; p< 0.0001), and PCRn (1.03±0.09 vs 1.08±0.10 g/Kg/day; p<0.004). 98 pts (54%) died during follow-up for cardiovascular complications in 69% of cases. Survival curves showed significantly greater mortality in Group 1 vs Group 2 in relation to the amount of edOW, and hsCRP (p<0.0001). Conclusions: edOWand chronic inflammation are directly correlated in HD pts, and both are associated to a greater long-term risk of mortality

Oral health care regulation in Brasil: regulations acts on public and private services

Introdução - Para o Ministério da Saúde, sistemas de saúde são complexas estruturas sociais compostas por elementos que se inter-relacionam para produzir respostas em saúde. No Brasil, tais respostas ainda se mostram insuficientes e ineficazes no campo da Saúde Bucal, no que se refere à integralidade da atenção, ao acesso à assistência e aos índices epidemiológicos da população. A regulação estatal sobre a atenção à Saúde Bucal atua na produção de bens e serviços, através de regulamentações e ações específicas. Tais instrumentos, aliados aos projetos de grupos sociais, conformam o modelo de atenção, em determinado período. Objetivo - Identificar os instrumentos criados pelos poderes de Estado para fazer a regulação sobre a atenção à Saúde Bucal e analisar o seu emprego pelos órgãos e instituições competentes. Método - Pesquisa documental da produção Legislativa Federal publicada entre 1824 e julho de 2007, dos atos normativos ministeriais do setor Saúde publicados entre 1946 e julho de 2007 e dos documentos aprovados pelo Conselho Nacional de Saúde - CNS entre 1988 e julho de 2007. Foram identificadas em base de dados (SICON, SAUDE LEGIS e página da internet do CNS) regulamentações relacionadas ao objeto, empregando-se termos de busca como \"bucal\", \"odontologia\", \"cárie\", \"dente\", e derivações dos radicais \"fluor\", \"dent\", entre outros relacionados à odontologia. Os documentos foram submetidos à análise de conteúdo. Resultados - Localizaram-se 591 atos normativos ministeriais, 495 atos da produção Legislativa e 109 documentos do CNS. A temática emergente da análise demonstra que, até a Constituição Federal de 1988, as regulamentações relativas ao Ensino Superior da Odontologia, à Gestão de Pessoal na Administração Pública Civil e Militar e ao Exercício Profissional da Odontologia tiveram prioridade no processo de implementação das ações e serviços de Saúde Bucal no Brasil. A partir de 1989, com a regulamentação do Sistema Único de Saúde, ganharam destaque os temas como Transferências de Recursos, Tabelas e Procedimentos Odontológicos e Regulamentação sobre as Operadoras e Planos Odontológicos, a partir da criação de mecanismos financeiros para a indução da política nos estados e municípios e a partir da Regulamentação da Saúde Suplementar. Somente a partir de 2002, os Programas e as Ações de Saúde Bucal começaram a se inserir de forma mais consistente nos documentos selecionados, principalmente no CNS. Entre as instituições analisadas, constataram-se diferenças nas prioridades temáticas. Conclusões - As prioridades estabelecidas nas normas e nas regulamentações demonstram que o modelo de atenção à Saúde Bucal no Brasil foi conformado a partir de propostas técnicas e políticas de cada gestão de governo e por demandas de grupos corporativos, profissionais e de mercado, a cada período. A aplicação desses instrumentos de regulação deve ser reavaliada para a construção de uma Política Nacional de Saúde Bucal consistente e de longo prazo.Introduction - In the Health Department\'s view health systems consist of complex social structures made up of elements that interact to find the answers to health issues. In Brasil, such answers are still immature and inefficient in the Oral Health field, regarding the completeness of the care, the access to assistance and to epidemiological indexes of the population. The official regulation on the Oral Health Care implies the production of goods and services according to specific regulations and acts. Such instruments, together with projects of social groups, conform to the care model in a definite period. Objective - Identify the instruments created by the Official Entities to create a regulation on the care with the Oral Health and analyse its employment by the proper institutions. Method - Documental research of the legislative production approved between 1824 and July 2007, of the normative production published by the Health Ministry (Executive Power) between 1946 and July 2007 and of the documents approved by the Health National Council - HNC between 1988 and July 2007. Regulations related to the object were identified in the database (SICON, SAUDELEGIS and CNS homepage) by means of searching terms like \"bucal\", \"odontologia\", \"cárie\", \"dente\", and derivatives of the radicals \"fluor\", \"dent\", and other dentistry terms. The documents were submitted to a content analysis. Results - Five hundred and ninety one Normative Acts of the Health Ministry were found, 495 of the Legislative Power and 109 HNC documents. The emerging matter of the analysis demonstrates that until the Federal Constitution back in 1988, the regulations related to Dentistry College Education, Human Resources issues in Military and non-military Administration and the Dentistry Professional Practice had priority in the implementation process of Oral Health actions and services in Brasil. Effective from 1989, with the regulation of the Health Central System, themes like Funds Transference, Tables and Dental Procedures and regulations on Service Centers and Dental Plans were highlighted after the creation of financial mechanisms for political induction in the states and cities and after the Supplementary Health regulation. Nevertheless, from 2002 on, the Programs and the Oral Health Actions started being introduced in a more consistent way in the selected documents, mainly at the HNC. Amongst the institutions under analysis, differences in thematic priority were seen. Conclusions - The priorities established in the norms and regulations have demonstrated that the model of care to Oral Health in Brasil was conformed as per technical and political proposals of each government administration and by requirement from corporative, professional and market groups in each period. The application of these regulation instruments must be reassessed for the construction of a solid, long-termed Oral Health National Policy

"Finalmente è stato chiesto a noi stranieri che cosa ne pensiamo!”. Prendere parola come esercizio di cittadinanza attiva

While the current debate highlights an increasing deficit of civic engagement, new - and often less visible - forms of “participation” are beginning to be detected, such as those implemented by citizens with migratory background living at the physical and symbolic margins of Western towns. Our study, part of the project “Abitare insieme” (Living together) in Milan’s multicultural suburbs, was developed with a dual purpose: to analyze the relationship between citizens with a migratory background, active citizenship, and their place representations/belongings; to experiment the co-construction of innovative spaces of speech for citizens, through their dialogical involvement in the research. In a framework of participatory research to enhance reflexivity and transformative practices, a survey was designed and administered. In this paper we will discuss the survey results, along with some methodological implication. The aim is to contribute to reinvent the “active citizenship” construct from a transformative, pedagogical, and intercultural perspective.Se da una parte il dibattito evidenzia un crescente deficit civico nelle società contemporanee, dall’altra si iniziano a rilevare nuove forme di “partecipazione” spesso meno visibili, come quelle messe in campo da cittadini con background migratorio, ai margini fisici e simbolici delle città occidentali. Il nostro studio, all’interno del progetto “Abitare insieme”, nella periferia multiculturale milanese, in Italia, ha avuto il duplice scopo di analizzare pratiche e significati di cittadinanza attiva nell’intreccio con rappresentazioni/sensi di appartenenza connessi ai luoghi da parte di cittadini con background migratorio e di sperimentare la co-costruzione di innovativi spazi di parola per i cittadini a partire dal loro coinvolgimento dialogico nella ricerca. Metodologicamente, un questionario è stato ideato e somministrato all’interno di una prospettiva di ricerca di tipo partecipativo con la finalità di stimolare la riflessività e pratiche trasformative. In questo articolo, discuteremo i risultati del questionario, insieme ad alcune indicazioni di metodo emerse dalla ricerca, con l’obiettivo di contribuire a una rilettura del costrutto di “cittadinanza attiva” in chiave trasformativa, pedagogica e interculturale

Magnitude of End-Dialysis Overweight is Associated with All-Cause and Cardiovascular Mortality: A 3-Year Prospective Study.

9Background: We hypothesized that the difference between the prescribed end-dialysis body weight, defined end-dialysis over-weight (edOW; kg), and the body weight which is actually attained could impact survival in hemodialysis (HD) patients. The aim of this prospective observational study was to evaluate if edOW could influence survival in a cohort of prevalent HD patients, controlled for multiple dialysis and clinical risk factors and followed for 3 years. Methods: One hundred and eighty-two patients (117 men, age 65 ± 13 years) on regular HD treatment for at least 6 months [median 48 months (range: 6-366)] were followed from January 1, 2008 to December 31, 2010. Eighty-four patients (46%) did not achieve their prescribed dry body weight (dBW); their median edOW was 0.4 kg (range: 0.1-1.4). Ninety-eight died during observation, mainly from cardiovascular reasons (69%). Multivariate Cox regression analysis was utilized to evaluate the effect edOW, ultrafiltration rate (UFR), interdialytic weight gain (IDWG), age, sex, dialytic vintage, cardiovascular disease, antihypertensive therapy, diabetes, duration of HD, dBW, BMI, mean arterial blood pressure, Kt/V, and protein catabolic rate (PCRn) had on mortality. Results: Age (HR: 1.04; CI: 1.03-1.05; p <0.0001), IDWG (HR: 2.62; CI: 2.06-3.34; p < 0.01), UFR (HR: 1.13; CI: 1.09-1.16; p< 0.01), PCRn (HR: 0.02; CI: 0.01-0.04; p <0.001), and edOW (HR: 2.71; CI: 1.95-3.75; p < 0.02) were independently correlated to survival. The relative receiver operating characteristic curve identified a cutoff value of 0.3 kg for edOW in predicting death. Conclusions: High edOW is independently associated with an increased long-term risk of all-cause and cardiovascular mortality in HD patients. Better survival was observed in patients with edOW <0.3 kg. For patients with higher edOW, longer or more frequent dialysis sessions should be considered in order to prevent the deleterious consequences of excessive body fluid expansionreservedmixedMovilli, E.; Camerini, C.; Gaggia, P.; Zubani, R.; Feller, P.; Poiatti, P.; Pola, A.; Carli, O.; Cancarini, G.Movilli, Ezio; Camerini, Corrado; Gaggia, Paola; Zubani, Roberto; Feller, P.; Poiatti, P.; Pola, A.; Carli, O.; Cancarini, Giovann