Gastrointestinal Manifestations of IgA Vasculitis-Henoch-Schönlein Purpura

Immunoglobulin A vasculitis, formerly called Henoch-Schönlein purpura (HSP), is the most common systemic vasculitis in childhood. It is a small-vessel vasculitis mediated by type III hypersensitivity, manifested as rash accompanied by gastrointestinal (GI) symptoms, arthritis, and nephritis. The etiology of this disease (a leukocytoclastic vasculitis) is still uncertain, but immune complexes of IgA and unidentified antigens seem to have a central pathogenic role. Most often the diagnosis is established after the clinical examination; it is easy at first glance when the clinical presentation includes the classic tetrad of rash (nonthrombocytopenic palpable purpura), arthralgia/arthritis, abdominal pain, and renal manifestations but may be difficult when the gastrointestinal manifestations precede the skin purpuric rash. Gastrointestinal involvement is frequently seen and varies from mild symptoms to severe complications; sometimes the gastrointestinal symptoms (colicky abdominal pain, nausea, vomiting, diarrhea, gastrointestinal bleeding) are the first manifestations of the disease. Immunoglobulin A vasculitis is usually a self-limited disease with a benign course, and the treatment is often symptomatic; in severe cases corticosteroids are necessary

Exploitation of Business Models for Deep Renovation

In this workshop, we discussed the exploitation experiences gathered in some relevant H2020 projects on deep renovation: TripleA-reno, ProGETonE, P2Endure, 4rinEU, STUNNING, and TURNkey Retrofit. Directives and practical insights that support the experimentation with exploitation strategies in EU-funded projects will be elaborated as outcome of the workshop. The ability to envision user needs and integrate them into a project value proposition is a vehicle towards more effective and sustainable business models for deep renovation practices. However, many projects still struggle to involve the user in their business model design method. In spite of the clarified potential for business models underpinning energy efficiency measures to generate profit in the clean energy market, the uptake of deep renovation practices is not flourishing to its full potential. Several barriers have been highlighted that still distress the market uptake of energy efficiency measures, among which the need for long-term capital for often comparatively small investments, the strain of measuring and distributing the energy savings due to deep renovation practices, as well as general lack of familiarity among consumers with renovation concepts. The dispute here, with even the economically sound business models, is that, for the user, there is an apparent lack of attractiveness for deep renovations, that goes beyond the mere financial savings or economical profitability offered by the investment. A conceivable resolution to upsurge the market uptake of renovation practices, is therefore the design of business models, which focus on the multiple environmental, social and financial benefits deep renovation practices might deliver for the different stakeholders involved in the process. Benefits, that are sometimes hard to monetise and generalize among the involved user groups, as they do not always resonate to the provider/receiver of these values equally, but on the contrary can develop contrasting interests. Therefore, in this report, we are summarizing the contributions of several H2020 projects on deep renovation, including: TripleA-reno [1], ProGETonE [2], P2Endure [3], 4rinEU [4], STUNNING [5], and TURNkey Retrofit [6]. This, in a way to explore what type of deep renovation business models exist in practice, and how they actually are impacting the EU market uptake of deep renovation practices

Limits of postnatal management of congenital diaphragmatic hernia

Universitatea de Medicina si Farmacie “Grigore T. Popa” Iasi, Disciplina de Chirurgie Pediatrică, Spitalul Clinic de Urgenţe pentru Copii “Sf. Maria” Iaşi, Clinica de Chirurgie şi Ortopedie Pediatrică, Spitalul Clinic de Urgenţe pentru Copii “Sf. Maria” Iaşi, Secţia Clinica de Anestezie şi Terapie Intensivă, Universitatea de Medicină si Farmacie “Grigore T. Popa” Iaşi, Disciplina de Neonatologie 5 Spitalul Clinic de Obstetrică-Ginceologie ”Cuza-Vodă”, Iaşi, Centrul Regional de Terapie Intensivă NeonatalăIntroducere: Managementul postnatal al herniei diafragmatice congenitale (CDH) implică abordarea multidisciplinară şi este nonstandardizat în majoritatea centrelor de chirurgie pediatrică. Obiectiv: Evaluarea statusului managementului cazurilor cu hernie diafragmatică congenitală tratate într-un centru terţiar de chirurgie pediatrică, respectiv de terapie intensivă pediatrică. Material si Metode: Am revizuit rezultatele tuturor cazurilor de hernie diafragmatică congenitală din ultimele 30 de luni, tratate în departamentul de chirurgie pediatrică al Spitalului Clinic de Urgenţe pentru Copii “Sf. Maria” din Iaşi, România. Rezultate: A fost inclus un număr total de 14 cazuri. Dintre acestea, 64% (9 cazuri) au fost diagnosticate antenatal. Un număr de 12 cazuri au fost tratate chirurgical, 8 prin abord deschis prin laparotomie şi 4 prin abord minim invaziv toracoscopic cu o mortalitate generală de 78%. Factorii de risc postnatali, cum ar fi localizarea herniei, prematuritatea, greutatea mică la naştere şi mărimea defectului, au fost confirmaţi în lotul de studiu ca fiind corelaţi cu mortalitatea inregistrată. Durata medie de spitalizare a fost de 43 de zile. Pentru cele 3 cazuri de supravieţuitori durata medie de urmărire a fost de 1 an. Concluzii: Chiar în condiţiile managementului nostru actualizat mortalitatea pe care am înregistrat-o a fost foarte ridicată şi s-a corelat cu prezenţa factorilor de risc postnatali. Hipertensiunea pulmonară persistentă a fost dificil de evaluat şi a reprezentat o continuă provocare de management, mai ales din cauza lipsei, în secţia de Terapie Intensivă Pediatrică, a posibilităţilor terapeutice postoperatorii, de tip ventilaţie cu frecvenţă înaltă, ventilaţie cu oxid nitric sau ECMO.Introduction: Postnatal management of congenital diaphragmatic hernia involves a multidisciplinary approach and is non-standardized in most pediatric surgery departments. Objective: To evaluate the status of congenital diaphragmatic hernia (CDH) management in a tertiary department of pediatric surgery and neonatal intensive care unit. Study design: We reviewed the last 30 months' outcomes of all cases of CDH treated in NICU and the department of pediatric surgery of “Sf. Maria” Emergency Children Hospital Iasi, Romania. Results: A total of 14 cases were included. Of these, 64% (9 cases) were prenatally diagnosed. A number of 12 cases were surgically treated, 8 by abdominal open approach and 4 by thoracoscopic minimally invasive approach with an overall mortality rate of 78%. Postnatal risk factors of mortality such as side of hernia, prematurity, low birth weight, and size of the defect were confirmed in our study group. The median time of hospital stay was 43 days. For the 3 survivors, the mean period of follow-up was 1 year. Conclusions: Despite our updated management of CDH, mortality was still very high and was associated with postnatal risk factors. Persistent pulmonary hypertension was difficult to evaluate and presented persistent challenges in management

Nuovi strumenti di gestione della qualit\ue0 nel tempo per gli edifici storici e monumentali

Nonostante la comunit\ue0 internazionale abbia da tempo preso atto dei gravi rischi ai quali \ue8 esposto il patrimonio culturale, l\u2019efficacia delle strategie di salvaguardia, conservazione e manutenzione dei preziosissimi assets dell\u2019ingente patrimonio concentrato in Europa rappresenta ancora una sfida che molti paesi affrontano con mezzi insufficienti o inadeguati. Le caratteristiche del contesto nel quale si opera richiedono l\u2019acquisizione di dati e conoscenze che vanno ben oltre le caratteristiche tecniche e costruttive degli edifici. L\u2019articolo illustra un sistema innovativo di gestione degli interventi finalizzati al monitoraggio e alla manutenzione degli edifici storici e monumentali, sviluppato nell\u2019ambito del progetto di ricerca europeo Horizon 2020 INCEPTION (Inclusive Cultural Heritage in Europe through 3D semantic modelling).The success of the strategies for safeguarding, preserving and maintaining the precious assets of the huge European Cultural Heritage still represents a challenge that many countries tackle with limited or inadequate actions or systems, despite the fact that the international community is now aware of the serious risks endangering its heritage. The nature of this fragile context requires the knowledge of data and information other than the technical and construction characteristics of buildings. The paper describes an innovative management tool for inspection and maintenance of historical and monumental buildings, developed within the Horizon 2020 European research project INCEPTION (Inclusive Cultural Heritage in Europe through 3D semantic modelling)

EFFECTS OF BOILING ON PHYSICO-CHEMICAL PROPERTIES, TEXTURE AND QUALITY OF POTATOES

The objective of this study was to investigate the thermal processing of potatoes in water, by determining the physico-chemical, sensory and textural characteristics of potatoes. The study took into account losses determined by the heat treatment of fresh and frozen potatoes in clear water, salt water (2% salt) and water with rosemary (0.5% rosemary). The boiling process was done for 12 samples at 150oC and 180°C. Sensory analysis was performed on a target group of 30 panelists. Instrumental analysis aimed to characterize the samples in terms of texture, taking into account five parameters: hardness, cohesiveness, fracturability, springiness and chewiness

Role of PNPLA3 in the Assessment and Monitoring of Hepatic Steatosis and Fibrosis in Patients with Chronic Hepatitis C Infection Who Achieved a Sustained Virologic Response

Background and Objectives: Hepatic diseases are an important public health problem. All patients with chronic hepatitis C virus (HCV) infection receive treatment, regardless of hepatic fibrosis severity. However, evaluation of hepatic fibrosis and steatosis is still useful in assessing evolution, prognosis and monitoring of hepatic disease, especially after treatment with direct-acting antivirals (DAAs). The aim of this study was to assess the link between patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism and the degree of hepatic steatosis and fibrosis in patients with chronic HCV infection, as well as changes in steatosis and fibrosis three monthsafter obtaining a sustained viral response (SVR). Materials and Methods:Ourstudy included 100 patients with chronic hepatitis C (CHC) infection and compensated cirrhosis who received DAA treatment and who were evaluated using Fibromax prior to and 3 months after SVR. The influence of PNPLA3 (CC, CG, GG) genotype among these patients on the degree of post-treatment regression of steatosis and fibrosis was assessed. Results: Regression was noticed in the degree of both hepatic steatosis and hepatic fibrosis post-DAA treatment (three months after SVR). Analysis of the correlation between PNPLA3 genotype and fibrosis indicated that the average level of fibrosis (F) before DAA treatment was higher in patients with the GG genotype than in patients with the CC or CG genotype. Three months after SVR, the average level of fibrosis decreased; however, it remained significantly increased in GG subjects compared to that in CC or CG patients. The degree of hepatic steatosis before treatment was not significantly different among patients with different PNPLA3 genotypes, and no significant correlations were observed three months after SVR. Conclusions: The genetic variants of PNPLA3 influence the evolution of hepatic fibrosis. The GG subtype plays an important role in the degree of hepatic fibrosis both before and after treatment (three months after SVR)and could be a prognostic marker for assessment of post-SVR evolution

Role of PNPLA3 in the Assessment and Monitoring of Hepatic Steatosis and Fibrosis in Patients with Chronic Hepatitis C Infection Who Achieved a Sustained Virologic Response

Background and Objectives: Hepatic diseases are an important public health problem. All patients with chronic hepatitis C virus (HCV) infection receive treatment, regardless of hepatic fibrosis severity. However, evaluation of hepatic fibrosis and steatosis is still useful in assessing evolution, prognosis and monitoring of hepatic disease, especially after treatment with direct-acting antivirals (DAAs). The aim of this study was to assess the link between patatin-like phospholipase domain-containing 3 (PNPLA3) polymorphism and the degree of hepatic steatosis and fibrosis in patients with chronic HCV infection, as well as changes in steatosis and fibrosis three monthsafter obtaining a sustained viral response (SVR). Materials and Methods:Ourstudy included 100 patients with chronic hepatitis C (CHC) infection and compensated cirrhosis who received DAA treatment and who were evaluated using Fibromax prior to and 3 months after SVR. The influence of PNPLA3 (CC, CG, GG) genotype among these patients on the degree of post-treatment regression of steatosis and fibrosis was assessed. Results: Regression was noticed in the degree of both hepatic steatosis and hepatic fibrosis post-DAA treatment (three months after SVR). Analysis of the correlation between PNPLA3 genotype and fibrosis indicated that the average level of fibrosis (F) before DAA treatment was higher in patients with the GG genotype than in patients with the CC or CG genotype. Three months after SVR, the average level of fibrosis decreased; however, it remained significantly increased in GG subjects compared to that in CC or CG patients. The degree of hepatic steatosis before treatment was not significantly different among patients with different PNPLA3 genotypes, and no significant correlations were observed three months after SVR. Conclusions: The genetic variants of PNPLA3 influence the evolution of hepatic fibrosis. The GG subtype plays an important role in the degree of hepatic fibrosis both before and after treatment (three months after SVR)and could be a prognostic marker for assessment of post-SVR evolution

Chemical composition and antibacterial activity of essential oil of Tetraclinis articulata (Vahl) Masters branches of eastern Morocco

Abstract Background Some pathogenic microbial species are becoming less sensitive to antibiotics and developing resistance multiples. The use of essential oils is a serious substitute for treatment with antibiotics in infectious diseases. The present study aims to investigate the chemical composition and to evaluate the antibacterial activity of the essential oil of branches of Tetraclinis articulata (Vahl) Masters (Cupressaceae). Methods The extraction of the essential oil was realized by hydrodistillation, and the analysis was carried out by gas chromatography coupled with mass spectroscopy (GC–MS/FID). The antibacterial test was carried out using two different methods: the disc diffusion method and the macrodilution method which aims to determine the minimum inhibitory concentration (MIC). Results The yield of essential oil was 0.84%. Chromatographic analysis revealed that the major constituents were α-pinene (38.75%), limonene (13.24%), bornyl acetate (8.78%) and camphor (7.68%). The results of the antibacterial activity show that the essential oil exerts a powerful effect to inhibit some strains tested. Conclusions The antibacterial activity demonstrated in this study could justify the traditional uses of this plant and could contribute to value its potential in order to develop new bioactive compounds

Systemic Oxidative Stress Markers in Cirrhotic Patients with Hepatic Encephalopathy: Possible Connections with Systemic Ammoniemia

Background and objectives: Oxidative stress shows evidence of dysregulation in cirrhotic patients with hepatic encephalopathy (HE), although there are still controversies regarding the connections between oxidative stress and ammonia in these patients. The aim of this study was to evaluate the oxidative stress implication in overt HE pathogenesis of cirrhotic patients. Materials and Methods: We performed a prospective case-control study, which included 40 patients divided into two groups: group A consisted of 20 cirrhotic patients with HE and increased systemic ammoniemia, and group B consisted of 20 cirrhotic patients with HE and normal systemic ammoniemia. The control group consisted of 21 healthy subjects matched by age and sex. The activity of superoxide dismutase (SOD), glutathione peroxidase (GPx), malondialdehyde (MDA) levels (lipid peroxidation marker), and ammoniemia were evaluated. Results: We found a significant decrease in SOD and GPx activity and also a significant increase of MDA levels in cirrhotic patients with HE as compared to the healthy age-matched control group (1.35 ± 0.08 vs. 0.90 ± 0.08 U/mL, p = 0.002; 0.093 ± 0.06 vs. 0.006 ± 0.008 U/mL, p = 0.001; and 35.94 ± 1.37 vs. 68.90 ± 5.68 nmols/mL, p = 0.0001, respectively). Additionally, we found significant correlations between the main oxidative stress markers and the levels of systemic ammonia (r = 0.452, p = 0.005). Patients from group A had a significant increase of MDA as compared with those from group B (76.93 ± 5.48 vs. 50.06 ± 5.60 nmols/mL, p = 0.019). Also, there was a compensatory increase in the activity of both antioxidant enzymes (SOD and GPx) in patients with increased systemic ammoniemia (group A), as compared to HE patients from group B. Conclusions: Our results demonstrated a significant decrease in antioxidants enzymes activities (SOD and GPx), as well as a significant increase in MDA concentrations, adding new data regarding the influence of oxidative stress in HE pathogenesis in cirrhotic patients