Introduzione: II procurement ė fondamentale per aumentare ¡I numero di donazioni di organi e tessuti, In letteratura, sia nazionale che internazionale, ė difficile comprendere le modalita con cui le ...aziende sanitarie si sono organizzare per mettere ¡n atto ¡I processo di procurement.Obiettivo: L'obiettivo generale di questo lavoro e stato quello di effettuare una revisione della letteratura per reperire, catalogare e studiare le metodologie di procurement adottati dai vari centri di riferimento.Materiali e Metodi: La ricerca, condotta attraverso il metodo PRISMA, e stata condotta nelle banche dati PUBMED, COCHRANE LIBRARY, CINAHL. Sono stati presi in considerazione studi pubblicati negli ultimi tre anni riguardanti l'essere umano e pubblicati in qualsiasi lingua.Risultati: Dalla revisione sono emerse 233 pubblicazioni, di queste 186 in PUBMED, 46 COCHRANE LIBRARY, e 1 solo articolo in CINAHL. 15 articoli sono stati analizzati full text.Discussione: E stato possibile verificare tre approcci metodologici diversi: il metodo "spagnolo", il metodo "anglosassone" e l'esperienza di alcuni distretti sanitari del Brasile, dove si e tentato di integrare i due sistemi.Conclusioni: Lo studio dimostra che l'introduzione di personale dedicato e una adeguata formazione al procurement di organi, aumenta il numero di donatori. Maggiori ricerche sono necessarie, ma l'aumento dei potenziali donatori di organi e possibile.
Lethal varicella in immunocompetent hosts is rare and its pathogenesis is largely unknown. The discovery of glycoprotein E (gE) mutants showing attributes consistent with increased virulence in vitro ...and in animal models, provided a possible molecular mechanism underlying a more aggressive virus infection. However, these mutants have never been associated with unusually severe clinical cases.
To varicella-zoster virus (VZV) mutations that correlate with increased virulence.
We report a case of fatal hepatitis caused by a VZV bearing a novel mutation on the 3B3 monoclonal antibody epitope of gE in an immunocompetent host.
This report describes a mutant VZV responsible for an aggressive clinical course in an immunocompetent host. Linking these severe clinical presentations of VZV infection to virus mutations might provide insights into the underlying pathogenic mechanisms.
Background:
Musculoskeletal pathologies are among the most frequent causes of long-term non-oncological severe pain and consequent physical impairment. Aims of pharmacological and physical therapy ...are to reduce pain, promote functional recovery and improve overall quality of life. Pharmacological therapy may include the use of opioids.
Objective:
To evaluate the efficacy and tolerability of transdermal buprenorphine (TDS) in the long-term management of non-oncological, chronic, moderate-to-severe musculoskeletal pain.
Study Design:
An open-label, prospective, single-centre, 6-month study.
Setting:
A ‘real world’ outpatient setting.
Patients:
Adult patients with chronic moderate-to-severe musculoskeletal pain were enrolled consecutively.
Intervention:
Patients initially received buprenorphine TDS 11.7 µg/h (onethird of 35 µg/h patch) every 72 hours. If required, patients could be uptitrated to 17.5 µg/h (one-half of 35µg/h patch), 23.4 µg/h (two-thirds of 35 µg/h patch) or 35 µg/h. Concomitant antiemetics were allowed.
Main Outcome Measures:
The primary endpoint was percentage mean reduction in static and dynamic pain visual analogue scale (VAS) scores at study end (10 being worst pain, 0 being no pain). Quality of life and tolerability were also assessed.
Results:
We enrolled 146 patients aged 41–94 years; their baseline mean± SD static and dynamic pain VAS scores were 6.87±1.89 and 7.70 ± 1.74, respectively. Buprenorphine TDS initial dosages were 11.7 µg/h (n=139), 17.5 µg/h (n = 4), 23.4 µg/h (n= 1) and 35 µg/h (n = 2). At 6 months, 89 patients were under treatment; 11% (n=10) were receiving 11.7µg/h, 30% (n = 27) 17.5 µg/h, 6% (n = 5) 23.4 µg/h and 53% (n = 47) 35µg/h. Patients achieved a nonsignificant reduction in pain at rest and in movement; mean ± SD static and dynamic pain VAS scores decreased to 1.56 ± 2.05 and 3.54 ± 2.02, respectively. The quality of life improved as shown by significant (p< 0.01) increases from baseline in all items relating to physical and mental health on the Short-Form 36 health survey. Patients experienced recovery of daily and social activities according to the significant (p<0.01) increase in Karnofsky Performance Status sub-item scores. Twenty-three patients discontinued treatment because of adverse events, which were mainly gastrointestinal or CNS-related.
Conclusions:
Low-dose buprenorphine TDS had good analgesic efficacy, and quality of life improved as early as 1 month after treatment initiation. Our results suggest that buprenorphine TDS is a well tolerated long-term analgesic for patients experiencing chronic musculoskeletal pain of moderateto-severe intensity.
Phosphate may promote the onset and progression of chronic nephropathies. Here we evaluated the relationships between baseline serum phosphate levels, disease progression, and response to ACE ...inhibition in 331 patients with proteinuric nephropathies in the prospective Ramipril Efficacy In Nephropathy (REIN) trial. Independent of treatment, patients with phosphate levels in the highest two quartiles progressed significantly faster either to ESRD or to a composite endpoint of doubling of serum creatinine or ESRD compared with patients with phosphate levels below the median (P < 0.001). Results were similar when we analyzed phosphate as a continuous variable (P ≤ 0.004). The renoprotective effect of ramipril decreased as serum phosphate increased (P ≤ 0.008 for interaction); this modification of the treatment effect by phosphate persisted despite adjusting for potential confounders such as GFR and urinary protein. In summary, these data suggest that phosphate is an independent risk factor for progression of renal disease among patients with proteinuric CKD, and high levels of phosphate may even attenuate the renoprotective effect of ACE inhibitors. Future trials should test whether reducing serum phosphate improves renal outcomes and optimizes the renoprotective effect of ACE inhibition.
•Broccoli were exposed to different light emitting diodes (LED) during cold storage.•Phytonutrients content was evaluated and analyzed by a global statistical analysis.•Green LED increased ...chlorophyll, ascorbic acid, proteins and overall appearance.•Red and yellow LEDs increased phenols and overall appearance.•Globally, green LED prolonged the shelf life of broccoli during cold storage.
Broccoli (Brassica oleracea L. var. italica) is largely cultivated in southern Italy. It is an important source of phytonutrients, which are partially lost during postharvest storage. The aim of this work was to evaluate the overall effect of five different low-intensity light-emitting diodes (LEDs) on the quality parameters of broccoli florets over 20 d of cold storage. The level of ascorbic acid, chlorophylls, carotenoids, phenolic compounds and soluble proteins, as well as colour analysis, were evaluated. Green LED increased the chlorophyll and ascorbic acid content; white, red and yellow LEDs had a positive effect on the redox status of broccoli. Globally, only green LED had a statistically significant positive effect when considering all analysed parameters and could be proposed to prolong the shelf life of broccoli during cold storage.
Insufficient intake of beneficial food components into the human body is a major issue for many people. Among the strategies proposed to overcome this complication, colloid systems have been proven ...to offer successful solutions in many cases. The scientific community agrees that the production of colloid delivery systems is a good way to adequately protect and deliver nutritional components. In this review, we present the recent advances on bioactive phenolic compounds delivery mediated by colloid systems. As we are aware that this field is constantly evolving, we have focused our attention on the progress made in recent years in this specific field. To achieve this goal, structural and dynamic aspects of different colloid delivery systems, and the various interactions with two bioactive constituents, are presented and discussed. The choice of the appropriate delivery system for a given molecule depends on whether the drug is incorporated in an aqueous or hydrophobic environment. With this in mind, the aim of this evaluation was focused on two case studies, one representative of hydrophobic phenolic compounds and the other of hydrophilic ones. In particular, hydroxytyrosol was selected as a bioactive phenol with a hydrophilic character, while curcumin was selected as typical representative hydrophobic molecules.
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