A Prospective Randomized Controlled Trial to Study the Impact of a Nutrition-Sensitive Intervention on Adult Women With Cancer Cachexia Undergoing Palliative Care in India

Purpose. Advanced cancer patients with disease progression develop cachexia. Nevertheless, cancer patients at nutritional risk have shown improved body weight and quality of life with oral nutritional supplements. Method. This was a randomized controlled trial in adult female cancer patients (n = 63) attending palliative clinics, with symptoms of cachexia. Eligible patients were randomly distributed into control (n = 33) and intervention (n = 30) groups. Both groups were provided with nutritional and physical activity counseling, but the intervention group received an additional 100 g of Improved Atta (IAtta) for 6 months daily consumption. This study was designed to assess the efficacy of IAtta (with counseling) in enhancing the health status of cachexic patients. Anthropometric measurements, dietary intake, physical activity level and quality of life parameters were assessed at baseline, after 3 months, and at the end of 6 months. Results. Patients in the control group (n = 15) had significantly decreased body weight (P = .003), mid–upper-arm circumference (P = .002), and body fat (P = .002) by the end of intervention. A trend of body weight gain in the intervention group (n = 17; P = .08) and significant increase of body fat (P = .002) was observed; moreover, patients reported a significant improvement in fatigue (P = .002) and appetite scores (P = .006) under quality-of-life domains at the end of intervention. Conclusions. Embedding a nutrition-sensitive intervention ( IAtta ) within Indian palliative care therapy may improve quality of life and stabilize body weight in cancer cachexia patients

Prediction and Verification of the Conditions Governing the Synthesis of Tailored Zeolite a for Heavy Metals Removal

Numerous experimental trials, exhaustive analytical and testing procedures are usually undertaken, to reach the appropriate conditions for synthesis of “Zeolite A”. However, it is possible to come-up with a semi quantitative approach, through modeling and optimization techniques, to define the approximate range of initial conditions governing the preparation of a tailored zeolite with specific characteristics including silica to alumina ratio, particle size, and cation exchange capacity to be used for the removal of heavy metals. This paper is an attempt to adopt an engineering approach essentially comprising the formulation of a mathematical model relating the characteristics of zeolite A to the synthesis conditions based on numerous experimental published results, optimization to define the synthesis conditions required to produce specific zeolite A , verification of this proposed approach with experimental results for preparation of tailored zeolite A conducted at our laboratories and the assessment of its efficiency for separation of chromium (III). The composition of the synthesized zeolite A has been as anticipated and the removal of chromium (III) has been in agreement with the developed model. These results indicate that is possible to adopt this approach in a generic manner to select the optimum synthesis conditions for the preparation of zeolites having specific performance characteristics

Management of free flap failure in head and neck surgery

Lutilizzo dei lembi liberi è oggi considerata lopzione di prima scelta nella ricostruzione dei difetti testa-collo, con una percentuale di successo di circa il 95%. La gestione del fallimento di un lembo libero e quale soluzione, tra un secondo lembo libero e un lembo peduncolato, sia più sicura è ancora controversa. Lobiettivo del presente lavoro è descrivere le opzioni adottate dagli Autori e confrontare le scelte e i risultati ottenuti con quelli riportati in letteratura. Dal Gennaio 2012 al Gennaio 2016, presso lUO di Chirurgia Maxillo-Facciale dellOspedale Casa Sollievo della Sofferenza, sono stati allestiti 149 lembi liberi per la ricostruzione di difetti interessanti il distretto testacollo. Di questi, 6 lembi sono stati persi a causa della comparsa di una necrosi totale nel post-operatorio. In 5 casi si è scelto di allestire un secondo lembo libero, nel restante paziente invece è stato utilizzato un lembo di muscolo temporale. Tutti i lembi liberi di salvataggio allestiti hanno avuto successo, senza complicanze e con un buon recupero estetico e funzionale dei pazienti. Analizzando i dati ottenuti e confrontandoli con quanto riportato in letteratura, è possibile concludere come lallestimento di un secondo lembo libero costituisca una procedura sicura e ideale come salvataggio dopo necrosi totale di un precedente lembo

Role of Innate Immunity in the Pathogenesis of Chronic Rhinosinusitis: Progress and New Avenues

Chronic rhinosinusitis is a heterogeneous and multifactorial disease with unknown etiology. Aberrant responses to microorganisms have been suggested to play a role in the pathophysiology of the disease. Research has focused on the presence, detection, response to, and eradication of these potential threats. Main topics seem to center on the contribution of structural cells such as epithelium and fibroblasts, on the consequences of activation of pattern-recognition receptors, and on the role of antimicrobial agents. This research should be viewed not only in the light of a comparison between healthy and diseased individuals, but also in a comparison between patients who do or do not respond to treatment. New players that could play a role in the pathophysiology seem to surface at regular intervals, adding to our understanding (and the complexity) of the disease and opening new avenues that may help fight this incapacitating disease

Deficient LRRC8A-dependent volume-regulated anion channel activity is associated with male infertility in mice

Ion channel-controlled cell volume regulation is of fundamental significance to the physiological function of sperm. In addition to volume regulation, LRRC8A-dependent volume-regulated anion channel (VRAC) activity is involved in cell cycle progression, insulin signaling, and cisplatin resistance. Nevertheless, the contribution of LRRC8A and its dependent VRAC activity in the germ cell lineage remain unknown. By utilizing a spontaneous Lrrc8a mouse mutation (c.1325delTG, p.F443*) and genetically engineered mouse models, we demonstrate that LRRC8A-dependent VRAC activity is essential for male germ cell development and fertility. Lrrc8a-null male germ cells undergo progressive degeneration independent of the apoptotic pathway during postnatal testicular development. Lrrc8a-deficient mouse sperm exhibit multiple morphological abnormalities of the flagella (MMAF), a feature commonly observed in the sperm of infertile human patients. Importantly, we identified a human patient with a rare LRRC8A hypomorphic mutation (c.1634G>A, p.Arg545His) possibly linked to Sertoli cell-only syndrome (SCOS), a male sterility disorder characterized by the loss of germ cells. Thus, LRRC8A is a critical factor required for germ cell development and volume regulation in the mouse, and it might serve as a novel diagnostic and therapeutic target for SCOS patients

Association Pattern of Interleukin-1 Receptor-Associated Kinase-4 Gene Polymorphisms with Allergic Rhinitis in a Han Chinese Population

Interleukin-1 receptor-associated kinase-4 (IRAK-4) encodes a kinase that is essential for NF-kB activation in Toll-like receptor and T-cell receptor signaling pathways, indicating a possible crosstalk between innate and acquired immunities. We attempted to determine whether the polymorphisms in the Interleukin-1 receptor-associated kinase-4 (IRAK-4) gene are associated with allergic rhinitis (AR) in the Han Chinese population.A population of 379 patients with AR and 333 healthy controls was studied. Blood was drawn for DNA extraction and total serum immunoglobulin E (IgE). A total of 11 single nucleotide polymorphisms (SNPs) in IRAK-4 were selected and individually genotyped.Significant allelic differences between cases and controls were obtained for the SNP of rs3794262 in the IRAK-4 gene. In the stratified analysis for gender, two SNPs (rs4251431 and rs6582484) in males appeared as significant associations. Subgroup analysis for the presence of different allergen sensitivities displayed associations only in the house dust mite-allergic cohorts (rs3794262, rs4251481). None of the selected SNPs in IRAK-4 was associated with total IgE level. The haplotype analysis indicated GCCTGCGA was significantly associated with AR. The SNP-SNP interaction information analysis indicated that the selected sets of polymorphisms had no synergistic effect.Our findings did not support the potential contribution of the IRAK-4 gene to serum IgE levels. However, the results demonstrated a gender- and allergen-dependant association pattern between polymorphisms in IRAK-4 and AR in Chinese population