Individual dosage of digoxin in patients with heart failure

Backgroud: After the publication of DIG trial, the therapeutic target of serum digoxin concentration (SDC) for the treatment of heart failure (HF) has been lowered (0.40-1.00 ng/ml). However, the majority of equations to calculate digoxin dosages were developed for higher SDCs. Recently, a new equation was validated in Asian population for low SDCs by Konishi et al., but results in Caucasians are unknown. Aim: This study was aimed to test the Konishi equation in Caucasians specifically targeting low SDCs. Furthermore, the Konishi equation was compared with other frequently used equations. Design: This was a prospective, multicenter study. Methods: Clinically indicated digoxin was given in 40 HF patients. The dosage was calculated with the Konishi equation. The SDC was measured at 1 and 6 months after starting digoxin. Adherence to digoxin was monitored with a specific questionnaire. Results: After exclusion of patients admitting poor adherence, we found a reasonable correlation between predicted and measured SDC (r = 0.48; P < 0.01) by the Konishi equation. Excluding patients with poor adherence and relevant worsening of renal function, the measured SDC (n = 54 measurements) was within the pre-defined therapeutic range in 95% of the cases. The mean, maximal and minimal measured SDC were 0.69 ± 0.19, 1.00 and 0.32 ng/ml, respectively. The correlation was weaker for the Jelliffe, the Koup and Jusko, and the Bauman equations. Conclusions: This study supports the clinical validity of the Konishi equation for calculating individual digoxin dosage in Caucasians, targeting SDCs according to current HF guideline

Anatomical factors associated with gender recognizability: A study on intraoral standardized photographs

AIM: The aim of this research was to evaluate the possibility of identifying the sex of 1 subject through visual assessment of a frontal photograph of dentition, and to investigate if some morphological characteristics are related to sex determination. METHODS: 5 expert dentists, 5 non-expert dentists and 5 laypeople were made to watch 100 intraoral photographs for 5&nbsp;seconds each and to establish their sex. The responses of the participants and the baseline characteristics of photographed dentitions were analyzed. RESULTS: The proportion of right answers was 56.0%&nbsp;\ub1&nbsp;8.2% in the group of expert dentists, 65.0%&nbsp;\ub1&nbsp;6.0% in the group of non-expert dentists and 58.6%&nbsp;\ub1&nbsp;4.5% in the group of non-expert people. The round shape of maxillary central incisors was related to the female gender (P&nbsp;=&nbsp;.006). The male condition was correlated with poor oral hygiene for 4 observers. Female sex perception was correlated with round morphology of upper central incisors for 3 observers. CONCLUSION: No difference in the ability to determine the sex was registered among groups, suggesting that sex perception is not strongly influenced by the characteristics of dentition

Influence of teeth anatomical characteristics on the efficacy of manual toothbrushing manoeuvres

Purpose: The aim of the study was to investigate the efficacy of two toothbrushing techniques on the amount of plaque accumulation and to evaluate how the changes were correlated to the anatomical characteristics of the anterior maxillary arch. Methods: Thirty subjects of both genders were included, they were asked not to brush for 12 h. Afterwards, they were asked to manually brush the left side of their maxillary arch with the modified Bass technique and the right side adopting the roll technique. The comparison of photographs taken before and after the manoeuvres, using a plaque disclosing agent, allowed the researchers to measure the changes in plaque accumulation measured using the Quigley and Hein plaque scoring classification. Linear regression analysis was used to evaluate the correlation between such changes and the teeth and arch anatomical characteristics. Results: A mean reduction of 9.6 ± 5.2% considering both arches after brushing was observed. The changes in plaque accumulation were not different between the two techniques. The length of the line obtained joining the contact point between the central incisors and the contact point between the second premolar and the first molar on the left side and the distance between that line and the lateral incisor on the same side positively correlated to the decrease in the plaque scores (P = 0.046 and P = 0.044, respectively). Conclusion: Both tested techniques were effective in plaque removal in the anterior maxillary arches. However, the research for the anatomical factors influencing the amount of efficacy of the toothbrushing manoeuvres was inconclusive. We can hypothesise that the adoption of one adequate technique could be more important than the teeth characteristics

Fabrication and characterization of Eri silk fibers-based sponges for biomedical application

Cocoon-derived semi-domesticated Eri silk fibers still lack exploitation for tissue engineering applications due to their poor solubility using conventional methods. The present work explores the ability to process cocoon fibers of non-mulberry Eri silk (Samia/Philosamia ricini) into sponges through a green approach using ionic liquid (IL) â 1-buthyl-imidazolium acetate as a solvent. The formation of β-sheet structures during Eri silk/IL gelation was acquired by exposing the Eri silk/IL gels to a saturated atmosphere composed of two different solvents: (i) isopropanol/ethanol (physical stabilization) and (ii) genipin, a natural crosslinker, dissolved in ethanol (chemical crosslinking). The sponges were then obtained by freeze-drying. This approach promotes the formation of both stable and ordered non-crosslinked Eri silk fibroin matrices. Moreover, genipin-crosslinked silk fibroin sponges presenting high height recovery capacity after compression, high swelling degree and suitable mechanical properties for tissue engineering applications were produced. The incorporation of a model drug â ibuprofen â and the corresponding release study from the loaded sponges demonstrated the potential of using these matrices as effective drug delivery systems. The assessment of the biological performance of ATDC5 chondrocyte-like cells in contact with the developed sponges showed the promotion of cell adhesion and proliferation, as well as extracellular matrix production within two weeks of culture. Spongesâ intrinsic properties and biological findings open up their potential use for biomedical applications.The authors SSS, DSC, MBO, NMO acknowledge financial support from Portuguese Foundation for Science and Technology – FCT (Grants SFRH/BPD/45307/2008, SFRH/BPD/85790/2012, SFRH/BD/71396/2010 and SFRH/BD/73172/2010, respectively), ‘‘Fundo Social Europeu” – FSE, and ‘‘Programa Diferencial de Potencial Humano POPH”. This work is also financially supported by the European Union Seventh Framework Programme (FP7/2007-2013) under grant agreement n REGPOT-CT2012-316331-POLARIS and from Fundação para a Ciência e Tecnologia (FCT) through the project ENIGMA – PTDC/EQU-EPR/121491/2010. The laboratory work of SCK is supported by Department of Biotechnology and Indian Council of Medical Research, Govt of India. SCK and RLR acknowledge their short visits either Institutes. SCK is also grateful to 3B´ s Research Group- Biomaterials, Biodegradables and Biomimetics, University of Minho, Portugal for providing facilities during his short visit

Rapporto di dettaglio sulla progettazione e realizzazione del sistema di purificazione dell'impianto LiFus6

This document deals with the solutions employed for the purification system of Lifus 6, a plant devoted to corrosion tests in flowing liquid Lithium, whose operations are going to start the next year. Reducing significantly the concentration of non metals (C, O, H and N) solved in Lithium, which highly enhance its corrosive behavior, is the purpose of the purification. The purification is performed through a Cold Trap, where the precipitation of the various binary non metals-Lithium compounds is promoted thanks to the reduction of the Temperature (200°C), and an Hot Trap, filled with a Titanium sponge getter, where Nitrogen concentration in Lithium is further reduced, thanks to the formation of a stable Titanium Nitride at 600°C. The residual concentration of Nitrogen in Lithium is online monitored by the Resistivity Meter, thanks to the existence of a linear relation linking it to Lithium resistivity, and by an offline Lithium analysis procedure, based on the transformation of small amounts of Lithium taken from the plant at defined time spans into Ammonia: this procedure, even if more time and work consuming, has the advantage of an higher sensitivity and may be useful also for the calibration of the Resistivity Meter. Both the Cold Trap and the Resistivity Meter are inserted into a secondary (purification) loop, which is characterized by a Lithium flow rate reduced to about 1% of Lifus 6 main loop, so to guarantee a sufficiently large residence time of Lithium through them and their best operative conditions. The purification system so defined will permit to reduce C, O and N content below 10 wppm, while H content will be reduced to about 60 wppm; on the other hand, no existing device could permit to precisely quantify a so small H concentration, so the efficiency of a more pronounced purification could in no case be verified

Toward osteogenic differentiation of marrow stromal cells and in vitro production of mineralized extracellular matrix onto natural scaffolds

Uncorrected proofTissue engineering has emerged as a new interdisciplinary field for the repair of various tissues, restoring their functions by using scaffolds, cells, and/or bioactive factors. A temporary scaffold acts as an extracellular matrix analog to culture cells and guide the development of new tissue. In this chapter, we discuss the preparation of naturally derived scaffolds of polysaccharide origin, the osteogenic differentiation of mesenchymal stem cells cultured on biomimetic calcium phosphate coatings, and the delivery of biomolecules associated with extracellular matrix mineralization

The carotid wallstent for the endovascular treatment of carotid artery stenosis

Aim: To report a retrospective, 15-years single-center experience about Carotid Artery Stenting (CAS) using the Carotid Wallstent in high surgical risk patients. Methods: Primary outcomes were procedural success, 30-day mortality and cerebrovascular complications, and long-term survival, neurological complication and restenosis. P values< 0.05 were considered significant. Results: From January 2000 to June 2015, 560 patients underwent CAS using the Carotid Wallstent for either a symptomatic (22.6%) or an asymptomatic significant carotid stenosis. Primary success was achieved in 99.1% as 4 acute stent thrombosis occurred and in 1 case selective catheterization of the supra-aortic trunks was not possible due to extreme tortuosity. At 30 days, 7 TIAs and 9 strokes accounted for a 2.8% of neurological complication rate. There were 2 deaths unrelated to the procedure. At 10 years, survival was 71.2% +/- 2.5%. Freedom from cerebrovascular events (TIA/stroke) at 10 years was 91.2% +/- 1.9% for asymptomatic patients and 81.7% +/- 5% for symptomatic patients (P = 0.008). Freedom from a restenosis >30% was estimated to be of 93.9% +/- 1.3% at 10 years, being significantly affected by age (P = 0.01). Conclusion: In our experience the Carotid Wallstent was a safe and effective device for the treatment of both asymptomatic and symptomatic carotid stenosis in high surgical risk patients. Freedom from cerebrovascular events in the long term was worse in symptomatic patients

Rapporto di dettaglio sulla progettazione e realizzazione dell'impianto LiFus6 per le prove di corrosione da litio

This document describes the engineering design of the LiFus6 experimental loop under construction in ENEA Brasimone. It deals with the following topics: Background of the ENEA in corrosion experiments in lithium; Design description of the LiFus6 loop; Hydraulic thermal and mechanical analysis of the loop

Biodegradable Chitosan-Based Ambroxol Hydrochloride Microspheres: Effect of Cross-Linking Agents

The objective of this study was to investigate the influence of type of cross-linking method used on the properties of ambroxol hydrochloride microspheres such as encapsulation efficiency, particle size, and drug release. Microspheres were prepared by solvent evaporation technique using chitosan as a matrix-forming agent and cross-linked using formaldehyde and heat treatment. Morphological and physicochemical properties of microspheres were then investigated by scanning electron microscopy (SEM), X-ray diffractometry (XRD), differential scanning calorimetry (DSC), and Fourier-transform infrared spectroscopy (FTIR) spectroscopy. The cross-linking of chitosan takes place at the free amino group because of formation of imine bond as evidenced by FTIR. The DSC, XRD, and FTIR analysis showed that chitosan microspheres cross linked by heating were superior in properties and performance as compared to the microspheres cross-linked using formaldehyde. SEM results revealed that heat-treated microspheres were spherical, discrete having smooth, and porous structure. The particle size and encapsulation efficiencies of the prepared chitosan microspheres ranged between 10.83–24.11 μm and 39.73μ80.56%, respectively. The drug release was extended up to 12 h, and the kinetics of the drug release was obeying Higuchi kinetic proving diffusion-controlled drug release