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Giovanna TrainaDepartment of Economics and Food Sciences, University of Perugia, Perugia, ItalyAbstract: L-carnitine (LC) is part of the carnitine shuttle system at the mitochondrial inner membrane (MIM) and transports long chain fatty acids over the MIM route. Acetyl-L -carnitine (ALC), the acetyl ester of LC, plays an essential role in intermediary metabolism. To ALC are ascribed neurotrophic actions, antioxidant and antiapoptotic activity, positive effects on mitochondrial metabolism, and stabilization of intracellular membranes. Acylcarnitine and LC supplementation have shown beneficial effects in the treatment of aging, chronic degenerative pathologies and the slowing of the progression of mental deterioration in neurodegenerative diseases, and painful neuropathies. ALC is reported to affect brain energy and phospholipid metabolism and to interact with cell membranes, proteins, and enzymes. It also shows a neuromodulatory effect on synaptic morphology and neurotransmitter synaptic transmission, including that of acetylcholine and dopamine. All these data suggest that ALC can affect several targets in the central nervous system. The roles and effects of LC and ALC have led researchers to investigate carnitine's involvement in a variety of neuropathological states and treatments, including autism, Parkinson's disease, Alzheimer's disease, Down's syndrome, Huntington's disease, cerebellar ataxia, age-associated mental decline, hepatic encephalopathy, and ammonia neurotoxicity. This review summarizes evidence that carnitine analogs play many roles in serious neurological pathologies.Keywords: L-carnitine, acetyl-L-carnitine, brain, neural disorders

There is evidence showing that increasing the vertical dimension of occlusion, or interocclusal distance, reduces pain symptoms in patients with temporomandibular disorders (TMD) and bruxism. The mechanism underlying the analgesic effect is still under investigation. Some researchers propose either a gate mechanism or the activation of the trigemino-cardiac reflex. In this study, sensory and pain thresholds changes in the mandibular district have been evaluated in twenty healthy subjects immediately after 5 minutes of mandibular stretching at maximum opening of the jaw. Results showed a 60% increment in sensory threshold and a 70% increment in pain threshold (p<0.001) compared with the baseline values. The magnitude of the analgesic effect seems proportional to the extent of mandibular opening. These and similar results are discussed as for the implication in the treatment of TMD related symptoms. [ABSTRACT FROM AUTHOR]

Increasing occlusal vertical dimension (OVD) by means of oral splints is a practice widely used in the treatment of temporomandibular disorders (TMD), specifically myofascial pain, although the results are still uncertain. Oral splints with a vertical height that significantly exceeds the clinical rest position are considered by some researchers to be a better therapeutic solution in alleviating TMD symptoms than are "low" splints. In our observational study, 21 patients suffering from myofascial pain were examined for the effects of wearing a "high" oral splint while sleeping for 3 months. To ensure proper splint making, a mandibular stretching procedure was used to induce a relaxation of the patients' masticatory muscles and allow the correct alignment of the jaws. Results showed a marked increase of the interocclusal distance or "free space" (hence of OVD; from 0.64±0.53 mm to 1.42±0.76 mm, p<0.0001) measured by a kinesiograph, followed by a substantial reduction of the intensity of pain in oral and extraoral regions after using the splint. These results support the view that increasing OVD beyond the clinical rest position is not detrimental to patients' health. More importantly, high oral splints has been shown to be a promising therapeutic aid for the treatment of TMD and correlated pain syndromes. This clinical trial was registered on clinicaltrials.gov (Identifier: NCT02908568). [ABSTRACT FROM AUTHOR]

A method for detoxifying industrial wastes is presented, aiming at a safer management and reuse. Focusing, in particular, on bottom ashes from a municipal solid waste incinerator, the proposed “ElectroKinetic Stabilization” (EKS) technique requires a relatively short treatment time and improves the remediation of ashes by combining a fast extraction of chlorides by electromigration, together with a stabilization of metals through their reaction with phosphate anions, which migrate through the ash under the influence of the electric field. Heavy metals react with the phosphate anions, leading to the precipitation of metal hydroxy-apatite or chloro-apatite (for Pb and Ba), or to their trapping in a calcium-apatite mineral, that formed during the process. Along with precipitation, metal immobilization is allowed by the decrease of ash pH to 9–11 by means of H+ produced at the anode from the electrolysis of water. The migration of salts through the wet ashes is very fast and the treatment time could be decreased to 24h. After EKS, Ba, Pb and F− leaching was reduced by 97%, 92% and 92%, respectively, below the allowed limits. In contrast, the final leaching of Cu and chlorides was reduced by 90% and 80%, respectively, still above the allowed limits. [Copyright &y& Elsevier]

We have studied the pharmacokinetics of teicoplanin, a new glycopeptide antibiotic active against Gram-positive aerobic and anaerobic bacteria, in five patients with end-stage renal disease on continuous ambulatory peritoneal dialysis (CAPD). Although teicoplanin was eliminated in the peritoneal fluid, relatively little was recovered (6.8±1.2% of the given dose). The following values were obtained: elimination half-time 102-347 h; total body clearance 4.16-7.38 ml·h·kg, peritoneal clearance 0.31-0.37 ml·h·kg. Because the elimination of teicoplanin is about four times less in patients undergoing CAPD compared with subjects with normal renal function, the dose of teicoplanin should be reduced appropriately in such cases. [ABSTRACT FROM AUTHOR]

The pharmacokinctic profile of teicoplanin after single 3 mg/kg doses in adults with different degrees of renal failure was reviewed. The disposition of teicoplanin was adequately described by a three-compartment open pharmacokinetic model and it appears to be primarily related to the degree of renal function. Teicoplanin total body clearance was less and the terminal elimination half-life progressively prolonged in association with renal failure, but the. volume of distribution at steady-state did not change. Highly significant relationships between teicoplanin total body and renal clearance and creatinine clearance have been reported and serve as a basis for adjusting dosage in patients with renal failure. In patients on continuous ambulatory peritoneal dialysis teicoplanin, administered either intravenously or intraperitoneally, showed bidirectional exchange characteristics through the peritoneal membrane, although transfer from the systemic circulation to peritoneal fluid was consistently low. Haemodialysis made no significant contribution to total body clearance of teicoplanin. Guidelines for administration of teicoplanin in patients with renal failure are discussed. [ABSTRACT FROM PUBLISHER]