Hypothyroidism and nephrotic syndrome: why, when and how to treat

Hypothyroidism, characterised by low/normal free thyroxine (FT4) and free tri-iodothyronine (FT3) with elevated thyroid-stimulating hormone (TSH), is a well-known complication of nephrotic syndrome (NS). This is a common feature of primary and secondary glomerular diseases and comprises loss of protein in the urine and increased urinary excretion of thyroid hormones and thyroxine-binding globulin. With a normal thyroid reserve, this scenario is associated with the development of subclinical hypothyroidism, with a slight increase in TSH and normal free fractions. However, with a low thyroid reserve the transition toward overt hypothyroidism is almost inevitable, affecting morbidity and mortality. As T4 replacement is a cheap and well-established treatment to achieve a stable hormone status in different types of thyroid deficiency, it is essential to recognise and appropriately treat this condition. In this article we summarise the evidence on this nephro-endocrine disorder in humans and focus on diagnostic and therapeutic strategies

Evaluación de la capacidad antifúngica de pinturas de base acuosa formuladas con aditivos biocidas basados en cationes metálicos estabilizados en matrices zeolíticas

En este trabajo se formularon pinturas de base acuosa para mampostería incorporando como aditivo biocida una zeolita tipo A intercambiada con Ag+1 y/o Zn+2. La eficiencia biocida de los recubrimientos se evaluó frente a A. niger. En primera instancia, se realizó la síntesis de zeolita sódica tipo A (estructura LTA), la cual fue caracterizada a través de difracción de rayos X (XRD) y microscopía electrónica de barrido (SEM). Los cationes biocidas Ag+1 y/o Zn+2 se incorporaron de manera controlada en las cavidades de la matriz aluminosilícea por intercambio catiónico, obteniéndose muestras zeolíticas con contenido variable de estos cationes biocidas. Se determinó la concentración mínima inhibitoria de las zeolitas intercambiadas frente a A. niger con el fin de hallar los valores de intercambio que provean actividad antifúngica eficiente a las pinturas de base acuosa diseñadas. Finalmente se realizó un ensayo de inhibición del crecimiento microbiológico sobre sustratos pintados. Los resultados indican que los cationes biocidas Ag+1 y Zn+2 incorporados en las cajas zeolíticas del tipo LTA podrían ser una herramienta beneficiosa para el desarrollo de recubrimientos de base acuosa ya que proporcionan una protección eficiente contra el ataque microbiológico en comparación con biocidas orgánicos tradicionales cuyos efectos contaminantes han sido altamente investigados y reconocidos.Tópico 4: Materiales. Evaluación de propiedades, caracterización tecnológica y patologías. Mamposterías (de ladrillos o piedras) y Morteros (materiales cálcicos y cementícios)

Myringotomy and ventilation tube insertion with endoscopic or microscopic technique in adults: a pilot study

The purpose of this study is to assess the feasibility of endoscopic-assisted myringotomy and ventilation tube insertion in adults affected by chronic otitis media with effusion, comparing the outcomes of this approach with those obtained with the traditional microscopic technique. Twenty-four patients were enrolled in this trial and alternately assigned to 2 groups of 12 subjects each. In group A, patients underwent myringotomy and ventilation tube insertion under endoscopic view, whereas in group B, the same procedure was performed traditionally using a microscope. All cases were evaluated 1 week after surgery and then monthly until tube extrusion. Type A tympanogram was achieved in 10 of 13 ears in both groups (76.92%). No significant difference in operative times or complication rates was observed (P > .05). Endoscopic technique could be a viable alternative to the microscopic approach for myringotomy and ventilation tube positioning in adults affected by chronic otitis media with effusion

A Grid-enabled web portal for NMR structure refinement with AMBER

Abstract Motivation: The typical workflow for NMR structure determination involves collecting thousands of conformational restraints, calculating a bundle of 20–40 conformers in agreement with them and refining the energetics of these conformers. The structure calculation step employs simulated annealing based on molecular dynamics (MD) simulations with very simplified force fields. The value of refining the calculated conformers using restrained MD (rMD) simulations with state-of-art force fields is documented. This refinement however presents various subtleties, from the proper formatting of conformational restraints to the definition of suitable protocols. Results: We describe a web interface to set up and run calculations with the AMBER package, which we called AMPS-NMR (AMBER-based Portal Server for NMR structures). The interface allows the refinement of NMR structures through rMD. Some predefined protocols are provided for this purpose, which can be personalized; it is also possible to create an entirely new protocol. AMPS-NMR can handle various restraint types. Standard rMD refinement in explicit water of the structures of three different proteins are shown as examples. AMPS-NMR additionally includes a workspace for the user to store different calculations. As an ancillary service, a web interface to AnteChamber is available, enabling the calculation of force field parameters for organic molecules such as ligands in protein–ligand adducts. Availability and Implementation: AMPS-NMR is embedded within the NMR services of the WeNMR project and is available at http://py-enmr.cerm.unifi.it/access/index/amps-nmr; its use requires registration with a digital certificate. Contact: [email protected] Supplementary information: Supplementary data are available at Bioinformatics online

Parkinson's disease: autoimmunity and neuroinflammation

Parkinson's disease is a neurodegenerative disease that causes the death of dopaminergic neurons in the substantia nigra. The resulting dopamine deficiency in the basal ganglia leads to a movement disorder that is characterized by classical parkinsonian motor symptoms. Parkinson's disease is recognized as the most common neurodegenerative disorder after Alzheimer's disease. PD ethiopathogenesis remains to be elucidated and has been connected to genetic, environmental and immunologic conditions. The past decade has provided evidence for a significant role of the immune system in PD pathogenesis, either through inflammation or an autoimmune response. Several autoantibodies directed at antigens associated with PD pathogenesis have been identified in PD patients. This immune activation may be the cause of, rather than a response to, the observed neuronal loss. Parkinsonian motor symptoms include bradykinesia, muscular rigidity and resting tremor. The non-motor features include olfactory dysfunction, cognitive impairment, psychiatric symptoms and autonomic dysfunction. Microscopically, the specific degeneration of dopaminergic neurons in the substantia nigra and the presence of Lewy bodies, which are brain deposits containing a substantial amount of α-synuclein, have been recognized. The progression of Parkinson's disease is characterized by a worsening of motor features; however, as the disease progresses, there is an emergence of complications related to long-term symptomatic treatment. The available therapies for Parkinson's disease only treat the symptoms of the disease. A major goal of Parkinson's disease research is the development of disease-modifying drugs that slow or stop the neurodegenerative process. Drugs that enhance the intracerebral dopamine concentrations or stimulate dopamine receptors remain the mainstay treatment for motor symptoms. Immunomodulatory therapeutic strategies aiming to attenuate PD neurodegeneration have become an attractive option and warrant further investigation

Renal parenchymal thickness is both related to vascular endothelial growth factor and intrarenal stiffness in systemic sclerosis

Questa Letter con dati originali dimostra che nei pazienti sclerodermia lo spessore parenchima, valutato ecograficamente, dipende sia dalla stiffess intrarenale , valutata mediante Doppler delle arterie renali, che dall'angiogenesi, valutata mediante il dosaggio sferico del vascular endothelial growth factor (VEGF). Lo spessore parenchima renale nella sclerosi sistemica mostra una correlazione lineare negativa sia con l'indice di resistenza renale che con l dosaggio sferico del VEGF. E' ipotizzabile che la ridotta neoangiogenesi e l'aumento degli indici di resistenza renale siano la causa di una riduzione dello spessore parenchima renale

A very rare case of duodenal hemolymphangioma presenting with iron deficiency anemia

AbstractINTRODUCTIONIntraabdominal lymphangiomas account for less than 5% of all lymphangiomas and small intestinal hemolymphangioma is a very rare benign tumor.PRESENTATION OF CASEHere we describe the first case of primary ulcerated duodenal hemolymphangioma in a 24-year-old woman, causing occult bleeding from gastrointestinal tract. She presented with an unexplained refractory iron-deficiency anemia and gastroduodenoscopy revealed an ulcerated and polypoid lesion of the second portion of the duodenum. Partial resection of the duodenum was thus performed and the final pathological diagnosis was hemolymphangioma.DISCUSSIONThere were only two reports, one of a hemolymphangioma of the pancreas invading to the duodenum and another of a small intestinal hemolymphangioma, presenting with gastrointestinal bleeding until May 2012.CONCLUSIONThe aim of this case report is to highlight the difficulty in making an accurate preoperative diagnosis and describe the surgical management of an unusual location for a very rare tumor. To arrive at a definitive diagnosis and exclude malignancy, partial resection of the duodenum was considered to be the required treatment