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Background: Vaginal infections caused by non-albicans species have become common in women of all age groups. The resistance of species such as Candida parapsilosis to the various antifungal agents is a risk factor attributed to these types of infections, which instigates the search for new sources of active compounds in vulvovaginal candidiasis (VCC) therapy. Objective: This study evaluated the antifungal activity of Syngonanthus nitens Bong. (Ruhland) derivatives and employed a lipid nanoemulsion as a delivery system.' Methods: In this study, a lipid nanoemulsion was employed as a delivery system composed of Cholesterol (10%), soybean phosphatidylcholine: Brij 58 (1: 2) and PBS (pH 7.4) with the addition of 0.5% of a chitosan dispersion (80%), and evaluated the antifungal activity of S. nitens Bong. (Ruhland) derivatives against planktonic cells and biofilms of Candida parapsilosis. By a biomonitoring fractionation, the crude extract (EXT) and one fraction (F2) were selected and incorporated into a lipid nanoemulsion (NL) composed of cholesterol (10%), a 1:2 mixture of soybean phosphatidylcholine:polyoxyethylene -20- cetyl ether (10%), and phosphate buffer solution (pH 7.4) with a 0.5% chitosan dispersion (80%). The NL presented a diameter size between 50-200 nm, pseudoplastic behavior, and positive charge. The EXT and five fractions were active against planktonic cells. Results and Discussion: The incorporation of EXT and F2 into the NL increased antifungal activity and enhanced the anti-biofilm potential. This study classified the use of an NL as an important tool for the administration of S. nitens derivatives in cases of infections caused by this C. parapsisilosis. Conclusion: This work concluded that S. nitens derivatives were important sources of active molecules against C. parapsilosis and the use of a lipid nanoemulsion was an important tool to promote more effective F2 release and to improve the antifungal activity aiming the control of C. parapsilosis infections.

Several renal function modifications can be related to sports activity, as pre-existing renal dysfunction can influence the assessment of sports practice capability. The multiplicity of aetiologies requires an accurate diagnosis to correctly define the treatment approach and feasible activities. Previous nephrectomy or chronic renal failure are conditions that complicate the sport exercise fitness assessment and every patient should be assessed individually by a multidisciplinary medical team.

A novel hydrogel based on 2-hydroxyethyl- methacrilate and SiO2nanoparticles was prepared. The filler was added at a concentration of 30% w/w of silica nanoparticles to the mass of polymer. The composite material was characterised as far as concerns swelling behaviour in comparison to pHEMA. Swelling ratio of modified pHEMA was higher. Bioactivity of both SiO2nanoparticles and the modified hydrogel was evaluated by soaking samples into a simulated body fluid (SBF). FT-IR spectroscopy, scanning electron microscopy (SEM) and energy dispersive system (EDS) results suggest silica nanoparticles keep bioactive in the polymer. SiO2filler in a p(HEMA) matrix makes the composite bioactive. Therefore, these composites can be used to make bioactive scaffold for bone engineering.A novel hydrogel based on 2-hydroxyethyl- methacrilate and SiO2nanoparticles was prepared. The filler was added at a concentration of 30% w/w of silica nanoparticles to the mass of polymer. The composite material was characterised as far as concerns swelling behaviour in comparison to pHEMA. Swelling ratio of modified pHEMA was higher. Bioactivity of both SiO2nanoparticles and the modified hydrogel was evaluated by soaking samples into a simulated body fluid (SBF). FT-IR spectroscopy, scanning electron microscopy (SEM) and energy dispersive system (EDS) results suggest silica nanoparticles keep bioactive in the polymer. SiO2filler in a p(HEMA) matrix makes the composite bioactive. Therefore, these composites can be used to make bioactive scaffold for bone engineering.

Bone implants must simultaneously satisfy many requirements, even though the surface properties remain a crucial aspect in osseointegration success. Since a single material with a uniform structure cannot satisfy all of these requirements, composite materials specifically designed for orthopedic or dental implant application should be envisaged. Two poly(methyl-methacrylate)/hydroxyapatite composites reinforced by E-glass fibres, uncoated (PMMA/HA/Glass) and poly(2-hydroxyethyl methacrylate) (PMMA/HA/Glass+pHEMA) coated by the biomimetic method, were mechanically (push-out test) and histomorphometrically (Affinity Index, AI) investigated in an in vivo rabbit model. Cylindrical implants (ø 2 mm × 5 mm length) were inserted into rabbit femoral cortical (mid-diaphysis) and cancellous (distal epiphysis) bone, under general anesthesia. The highest values of push-out force and ultimate shear strength were observed for the PMMA/HA/Glass at 12 weeks, which significantly (p < 0.001) differed from those of PMMA/HA/Glass+pHEMA at the same experimental time and from those of PMMA/HA/Glass at 4 weeks. At both experimental times, significantly (p < 0.0005) lower values of AI were observed in the PMMA/HA/Glass+pHEMA versus PMMA/HA/Glass (distal femoral epiphysis: 4 weeks = 33%; 12 weeks = 19%; femoral diaphysis: 4 weeks = 15%; 12 weeks = 11%). The good mechanical and histomorphometric results obtained with PMMA/HA/Glass should be followed by further evaluation of bone remodeling processes and mechanical strength around loaded PMMA/HA/Glass implants at longer experimental times. Finally, the biomimetic method applied to pHEMA needs to be further investigated in order to improve the positive effect of SBF on pHEMA and to enhance the coating adhesion.

AbstractBackground and Aims: Hyperleptinemia is a common feature in hemodialysis (HD) patients. However, the role of increased serum leptin levels in the pathogenesis of HD-related anorexia is still controversial. The purpose of the present prospective study was to ascertain whether hyperleptinemia is causally implicated in the pathogenesis of HD-related anorexia. Methods: We measured the serum leptin levels and the serum leptin/body mass index (BMI) ratio in 24 healthy subjects and in 49 end-stage renal disease patients on maintenance HD. HD patients were subdivided into anorexic (14/49, 28.5%) and non-anorexic (35/49, 71.5%) according to a questionnaire discriminating for the presence of anorexia-related symptoms. Results: Calorie (kcal/kg/day) and protein (g/ kg/day) intakes were significantly lower in anorexic than in non-anorexic patients (20.1 ± 1.1 vs. 27.9 ± 1.3, p = 0.004, and 0.82 ± 0.05 vs. 1.19 ± 0.05, p = 0.001, respectively). Accordingly, serum albumin, total lymphocyte count, mid-arm muscle circumference, and the protein equivalence of nitrogen appearance (PNA) were significantly lower in anorexic patients. The serum leptin concentration (ng/ml) was significantly higher in HD patients than in controls, in males (15.33 ± 3.4 vs. 3.7 ± 0.3, p = 0.003) and in females (42.3 ± 7.2 vs. 10.5 ± 1.3, p = 0.03). Similarly, serum leptin/BMI ratio was significantly higher in HD patients than in controls, in males (0.56 ± 0.1 vs. 0.16 ± 0.02, p = 0.0028) and in females (1.8 ± 0.2 vs. 0.4 ± 0.04, p &lt; 0.0001). However, serum leptin levels were similar in anorexic and in non-anorexic patients, in males (15.3 ± 5.6 vs. 16.9 ± 4.2, p = 0.85) and in females (46.6 ± 12.9 vs. 47.4 ± 9.4, p = 0.96). No differences were observed between the 2 groups in the serum leptin/BMI ratio, in males (0.59 ± 0.2 vs. 0.58 ± 0.14, p = 0.92) and in females (1.5 ± 0.4 vs. 1.8 ± 0.3, p = 0.94). Similarly, no statistically significant differences in terms of serum leptin levels and leptin/BMI ratio were observed between patients with dietary energy intake of &lt;30 or ≥30 kcal/kg/day and between those with a dietary protein intake of &lt;1.2 or ≥1.2 g/kg/day. No significant correlations were found between serum leptin levels and PNA, albumin, cholesterol, total lymphocytes number, weight change, C-reactive protein, fibrinogen, ferritin, and complement. Conclusion: The present results indicate that mechanisms other than increases in serum leptin levels might be involved in the pathogenesis of HD-related anorexia. Copyright © 2004 S. Karger AG, Basel

The biomimetic method was used in order to deposit, on titanium substrates, an hydroxyapatite (HA) coating. The bioactive HA layer was obtained by using, in the first stage of the process, a glass having the composition 2.5CaOċ2SiO2different from the one proposed for the application of the biomimetic method. This glass can be obtained via sol–gel, a method that allows one to obtain, easily, very pure products. The growth of HA crystals was confirmed by Fourier transform infrared, SEM, EDS and X-ray photoelectron spectroscopy (XPS) results. The experimental results suggest that, as reported in the literature for other supports, the silicate ions released from the glass in the first stage bind themselves to the titanium support. In particular, from XPS analysis it is evident that the titanium substrate is well covered by a calcium phosphate layer of the type of HA.

Poly2hydroxyethyl methacrylates PHEMAs structurally modified by means of polymer blends and random copolymers are intensively studied in order to improve mechanical properties. It was recently shown that a hydroxyapatite coating, which should improve the bonding of this biomaterial to the bone, can be obtained by means of the biomimetic method. When PHEMA is submitted to the biomimetic method, its swelling ratio is improved. This can be ascribed to the deposition of a silicatic layer, which improves the hydrophilicity, on the surface of the internal pores during the first stage of the method. This appears to be a valuable result for producing modified PHEMAs with improved mechanical properties and good swelling. The experimental results indicate the following: stronger interactions with the water molecules are set up, an induction period is observed that is linked to the rate of the reactions occurring at the surface of the glass and the establishment of a convenient concentration of the silicate ions at the external surface of the polymer, and the diffusion of simulated body fluid into the pores is the limiting stage of the process. © 2001 John Wiley & Sons, Inc. J Biomed Mater Res, 57: 79–83, 2001.

In this paper Tgvalues of calcium (sodium) silicate glasses containing added with oxides of trivalent elements are reported. The plots of Tgas a function of composition or vs. the ionic field strength prove to be useful in discussing the role of the oxides in the glass structure. It is found that, at least in the studied composition range, Sc2O3, Y2O3, La2O3, and In2O3, behave as network modifier oxides. In the compositional ranges studied, the hypothesis based on them well agree with the expectations based on the known criteria reported in literature and on FTIR spectra.

In this paper a DSC study is reported of the behavior of Fe40Ni40P14B6alloy produced by rapid quenching. The experimental results show that relaxation phenomena can be studied directly from the DSC curves. From these experiments, the spread of the Ecvalues in the literature is attributed to differences in the quenching rates and the presence of variable number of quenched-in nuclei. It is also shown that the microstructure (number and size of crystals) of the non-isothermally devitrified metallic alloy changes with the heating rate; this is a consequence of the shift of crystallization temperatures and, therefore, of the change of the ratio of nucleation and crystal growth rates.

Reoperations on the ascending aorta after prior aortic procedures are formidable challenges. In order to identify factors predictive of clinical outcome using a uniform surgical approach, results of a 15-year experience were reviewed.

1. The effects of phosphate and protons on the mechanics and energetics of muscle contraction have been investigated using glycerinated rabbit psoas muscle. 2. Fibres were fully activated by addition of Ca2+ (pCa 4‐5) at 10 degrees C. The velocities of contraction were measured in isotonic load clamps, and the velocities of unloaded fibres were measured by applying a series of step changes in fibre length. Fibre ATPase activity was monitored using an enzyme system to couple ADP production to reduced nicotinamide‐adenine dinucleotide (NADH) and measuring the depletion of NADH by optical density. 3. At pH 7.0 and 3 mM‐phosphate, isometric tension (P0) was 13.2 +/‐ 0.9 N/cm (mean +/‐ S.E.M., n = 10 observations), the maximum contraction velocity (Vmax) was 1.63 +/‐ 0.05 lengths/s (n = 5) and the ATPase activity was 1.27 +/‐ 0.12 s‐1 myosin head‐1 (n = 35). Increasing phosphate from 3 to 20 mM at pH 7.0 does not affect Vmax, causes a small decrease in the ATPase activity (15‐20%) and decreases P0 by approximately 20%. Changing pH from 7 to 6 at 3 mM‐phosphate decreases P0 by 45% and both Vmax and ATPase activity by 25‐30%. The effects of changing both pH and phosphate were approximately additive for all parameters measured. The inhibition of these parameters by low pH and high concentration of phosphate was reversible. 4. The force‐velocity relation was fitted by the Hill equation using a non‐linear least‐squares method. The value of the parameter which describes the curvature, a/P0, was 0.20. The curvature of the force‐velocity relation was not changed by addition of phosphate or by changes in pH. 5. These data provide information on both the kinetics of the actomyosin interaction and on the process of muscle fatigue. The data are consistent with models of cross‐bridge kinetics in which phosphate is released within the powerstroke in a step involving a rapid equilibrium between states. The inhibition by protons is more complex, and may involve less specific effects on protein structure. 6. During moderate fatigue of living skeletal muscle, MgATP concentration is known to remain approximately constant at 4 mM, phosphate to increase from 3 to 20 mM, and protons from 0.1 to 1 microM. The data suggest that much of the inhibition of P0 observed during moderate fatigue can be explained by the increased levels of phosphate and protons, and that much of the inhibition of fibre Vmax and ATPase activity can be explained by the increase in protons.

To evaluate the incidence and risk factors for reoperations on the pre-isthmic aorta after repair of type A acute aortic dissection.

Pheochromocytoma (Pheo) is an uncommon neoplasm producing blood pressure troubles and it may be undiagnosed in chronic dialyzed patients in whom hypertension is a common finding. The symptoms in Pheo syndrome depends on the prevalent catecholamine released, the most common being epinephrine (E) and norepinephrine (NE). Recently, a particular clinical picture has been described for dopamine (DA)-producing Pheos, in whom a normo-hypotensive status is more often observed. The authors report a case of mainly dopamine-producing Pheo in a long-term dialyzed patient, successfully treated with adrenalectomy. The main steps in diagnosis and preoperative management are described and debated also in view of the particular background produced by the end-stage renal failure. The common imaging techniques adopted for adrenal medullary neoplasms (US, CT, MIBG scintiscan) confirmed to be decisive for diagnosis; HPLC assay of plasma catecholamines is the only biochemical test available in these patients although its significance is questionable due to the poor knowledge of catecholamine metabolism in chronic renal failure. The clinical findings observed in this case seem in disagreement with those already reported in DA producing Pheos. Pheo in hemodialyzed patients is a rare event and it may be hidden by other more common causes of hypertension. However, more awareness from the medical staff allows to diagnose the neoplasm correctly by the currently available methods and to plan a safe surgical therapy also in high-risk patients.

The surgical approach to children with complex cardiovascular and pulmonary anomalies is still controversial. Staged operations through multiple incisions are often performed in this setting.