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Uremic toxins contribute to clinical manifestations of kidney dysfunction. These toxins include organic and inorganic elements or compounds. While the kidney typically clears uremic toxins, gut dysbiosis, and tissue inflammation could lead to increased production of substances that can further the clinical manifestations of uremia. The uremic toxins are quantitatively measurable in biological fluids and have an established relationship with azotemia signs and symptoms. Their elimination is associated with mitigated uremic manifestations, while their administration to the uremic levels leads to uremic signs in animal or human models or in vitro studies. Besides, the uremic toxins have an established and plausible pathophysiologic relationship with uremic manifestations. The previous classification of uremic toxins was mainly focused on the physicochemical characteristics of these substances to divide them into three categories, (1) free water-soluble low-molecular-weight (500 Da and 12,000 Da). Unfortunately, the classification named above was not centered around patient outcomes and quality of life among those with severe kidney failure. Therefore, a panel of experts convened virtually to provide additional insights into the current state and propose a new uremic toxin classification. This article describes the group’s consensus recommendations regarding the new classification of uremic toxins into more clinically oriented categories.

Opposed to whole wheat (WWP), traditional pizza (TP) is loved by patients with type 1 diabetes mellitus (T1DM) despite causing hyperglycemia. 50 well-trained T1DM patients had higher glucose levels after TP than after WWP or mixed flour pizza, which however was tasty, digestible and metabolically appropriate to break diet monotony.

In this work we pose attention to the nanotexture tuning (strictly linked to the chemical reactivity and, in turn, to the surface chemistry) of carbonaceous Palas GFG particles produced from graphite rods by acting on three parameters: gas carrier (nitrogen, argon), gas purity, discharge frequency (50, 300 Hz). The chemical reactivity and the surface chemistry of the particles have been evaluated by thermogravimetry (TG) and infrared spectroscopy (FTIR), respectively, as a function of the Palas operating parameters, crossing the findings with the morphology and internal structural characteristics inferred by transmission electron microscopy (HRTEM).

Lipohypertophy (LH) is the most common skin complication of incorrect injection technique which does not only represent an aesthetic defect but also severely disrupts insulin pharmacokinetics/pharmacodynamics. As a consequence of that, hormone release is delayed and unexplained/unpredictable hypoglycemia occurs, both deteriorating metabolic control while negatively affecting adherence to treatment and quality of life. The economic burden due to unwanted intra-LH injections is accounted for by inappropriately high insulin requirements, increased emergency-related hospitalizations, and loss of work days. Greater attention has to be paid by diabetes care teams to education programs with periodic refreshers to achieve better metabolic control and reduce the economic burden of diabetes.

The control of particle emissions from industrial plants is a crucial point in pollution control mainly because the commonly used abatement devices are inefficient in the dimensional range between 0.1 and 1 ?m. An innovative technique to control particle emissions exploits the water vapor condensation onto submicrometric particles acting as condensation nuclei. In this way, particle sizes increase from nanometric up to micrometric scale. The aim of this work is to analyze the 150 nm particle growth process, activated via a heterogeneous water condensation mechanism, as a function of the vapor concentration. Particle chemical-physical features are also taken into account. The evolution of the particle growth process has been followed at a lab scale along the axis of a laminar flow chamber by means of a spatially resolved measurement of the polarization ratio of the condensation nuclei and growing droplets. The main result reported here is the scheme of interpretation of the temporal profile of the polarization ratio related to the composite particle (particle embedded in the water layer) growth. The controlling mechanism of the overall condensation process has been identified with respect to the saturation conditions, evaluated on the basis of different theories available in the literature. The covering process has been found to be active also under conditions far from saturation of the vapor bulk phase. Moreover, it has been clearly shown that, irrespective of the particle nature, the nucleation activation and droplet growth occur almost simultaneously on all particles present in the control volume, with a capture efficiency close to unity. The water nucleation activation time also depends upon the particle chemical-physical characteristics. This paper also demonstrates that the experimentally determined characteristic times of nucleation and growth of the liquid layer are compatible with residence times of an industrial unity and can be used to condition its design.

Scrubbers are common and efficient systems for micrometer-sized particles removal from in-dustrial waste gas stream by means of the interaction with liquid jets or flows. Wet scrubbers use liquids (mainly water) to remove pollutants from gas streams incorporating them in liquid droplets through multiple interaction mechanisms (atomization of the liquid or gas stream bubbling through the liquid) whose selection is driven by the nature of the pollutant that has be removed. For particles diameter ranging between 0.1 and 1 ?m, the probability to impact on liquid droplets is extremely low resulting in a very low-efficient removal. In the case of submicronic particles the activation of heterogeneous water nucleation mechanism on a parti-cles surface (water nucleation on foreign particles) is of great interest for flue gases cleaning process. In order to optimize the process is important to understand the dependence of the nucleation efficiency on size, charge, morphology and surface characteristics of the particles and the temperature and the saturation of the environment. In the field of flue gas cleaning by heterogeneous nucleation process there is a continuous need to access to methods for production of aerosol of narrowly distributed nanoparticles, es-pecially methods assuring control, reproducibility and versatility with respect to the chemical-physical nature of the particulate, with the possibility to tune the particle size distribution and concentration in a wide range. The equipment that best meets these requirements is a spark discharge generator (Palas GmbH Aerosol Generator GFG 1000), which provides particles aerosol through the vaporization of two electrodes between which is applied a suitable poten-tial difference. The Palas system offers control, versatility and reproducibility of nanoparticle aerosols coupled with the absence of undesirable combustion by-products (tar-like species or PAH). It provides aerosol nanoparticles in a wide nanometer range (1-100 nm) and beyond [1]. Depending the typology of electrodes, carrier gases and operative condition (spark fre-quency, system dilution level) the nanoparticles can be completely contamination free or com-posed of one or more elements with different compositions. The Palas system is particularly suitable for producing particles with structure similar to carbonaceous particles typically formed in combustion systems (flames, engines). It also offers the possibility, by changing the typologies of electrodes, to obtain particles of different nature such as metal and metal oxides, of peculiar interest for the research typology for which the instrument will be applied for. This issue is of particularly interest since the factor influencing the submicronic particle wetting show a clear dependence on the surface chemical composition and microstructure: phenomena as capillary condensation, occurring in all confined geometries, divided media, cracks, or contact between surfaces [2] become relevant at nanoscale. The goal of this work is the analysis of the effect of particle nature on heterogeneous nuclea-tion activation process. To this aim, a multi-step experimental approach was applied. At first particles of different chemical nature were produced by using electrodes differing for density, melting temperatures, electrical and thermal conductivity which affect the production effi-ciency of aerosols. The particles were characterized as powders by means of different analyti-cal techniques to get structural and chemical insights. Condensation experiments were then performed in a lab-scale apparatus [4]. Finally, the condensation results then have been corre-lated to the chemical features of the nanoparticles.

The effectiveness of a condensational growth technique for particle abatement, activated via heterogeneous nucleation, was evaluated both theoretically and experimentally. Based upon information present in the literature, the heterogeneous nucleation rate and particle activation probability were estimated as a function of the environmental conditions. This work demonstrated that it is possible to capture the dispersed particles in the water droplets with high efficiency, depending on operating conditions. Increased final particle size, which improves removal from the gas stream, was found with relatively high inlet vapor concentrations and low working temperatures. It is also worth noting that extreme working conditions might be useful for the particle coverage. In fact, both nucleation and growth processes are active at very low vapor concentrations, although the maximum growth factor at these conditions is relatively low. Although it is not valid in predicting the induction time, a theoretical evaluation of the activation probability provides an indication of the process effectiveness at high vapor concentrations and low inlet temperatures. In contrast, at low vapor concentrations, this method fails to predict the occurrence of the vapor condensation on particles. At the experimentally evaluated conditions, the characteristic induction and growth times are compatible with practical applications.

The typical reactive structure stabilized in a diffusion layer in standard conditions can be significantly modified whether injected flows are diluted and/or preheated. The flow high initial enthalpy and the low fuel and/or oxygen concentration can drastically modify the structure of the oxidative and pyrolytic region due to change of the physical and chemical kinetics respect to conventional diffusion flame. Such operative conditions are typical of MILD (Moderate or Intense Low-oxygen Dilution)combustion processes. The effect of inlet conditions on the stabilized reactive structure has been studied by analyzing the behavior of a steady, one-dimensional diffusive layer. The change of the structures of the reactive region induced by a hot oxidant and diluted oxidant flow (HODO) fed towards a fuel jet at environmental temperature was numerically analyzed by means of temperature and heat release profiles, that are key parameters to understand the main features of the reactive region. In addition, the effect of diluent nature was studied by comparing the reactive structures also obtained with steam and carbon dioxide.

A novel technique for both industrial and domestic applications for submicronic particles removal from flue gasesrelies on increasing the diameter of fine and ultra- fine particles by condensing water vapor onto the particles themselves. This study experimentally evaluated the condensational growth activation via the heterogeneous nucleation of water vapor on particles for different temperature and vapor concentration as well as the characteristic time of the condensation process. It has been shown that it is possible to capture the dispersed particles in the water droplets with high efficiency in dependence on operative conditions. Higher inlet vapor concentration as well as lower working temperature increase the final size of the particles thus improving their removal from the gas stream. Furthermore the characteristic induction and growth times are experimentallyevaluated. They are compatible with practical applications and their identification and the estimation can be very useful in the design and dimensioning of a real abatement unit.

Reactive oxygen species (ROS) are hghly unstable molecular entities whose reactivity is responsible for a variety of damage on biological systems. Such effects include damage of DNA, RNA, protein, and lipid peroxidation. In the protection against the damaging effects of oxygen radicals, vitamin E is of paramount importance in terminating peroxidative chain reactions of unsaturated lipids and therefore protecting membranes from lipid peroxidation. It is well known that levels of ROS increase as the metabolic rate is enhanced. Therefore, the role played by antioxidants is of obvious importance in cells and tissues proliferating fastly like in growing organisms. The purpose of the present study was to assay, by HPLC, the vitamin E content in eggs and larvae at different stages of development of the sea bass Dicentrarchus labrax.

The typical reactive structure stabilized in a diffusion layer in standard conditions can be significantly modified whether injected flows are diluted and/or pre-heated. The increase of the fuel and/or oxidant flow dilution up to extreme conditions could lead to the formation of not ignitable mixtures so that the oxidation processes could be sustained just in case the pre-heating temperature of one of the two flows is high enough to promote the auto-ignition of the system. The flows high initial enthalpy and the low fuel and/or oxygen concentration can drastically modify the structure of the oxidative and pyrolytic region due to change of the physical and chemical kinetics respect to conventional diffusion flame. Such operative conditions are typical of Mild Combustion processes. More specifically a combination of both heating and dilution of oxidant and/or fuel can yields to a not premixed combustion process named Hot Diluted Diffusion Ignition (HDDI). The effect of inlet conditions on the stabilized reactive structure has been studied by analyzing the behavior of a steady, unidimensional diffusive layer. Numerical simulations have been carried out by means of OPPDIF application of ChemKin code and kinetic mechanisms available in literature, which simulates the behavior of two opposed jets. The change of the structures of the reactive region induced by a hot and diluted oxidant flow (HDDI-HODO) fed towards a fuel jet at environmental temperature has been numerically analyzed. Temperature and heat release profiles are considered as key parameters to understand the main features of the reactive region. The oxidant flow dilution causes a lower maximum temperature and more uniform temperature profiles with respect to un-diluted traditional diffusion flames even though oxidant flow is pre-heated. At the same time, higher oxidant flow dilution levels affect drastically heat release profiles and cause the disappearance of fuel pyrolitic reactions (negative heat release values). Further simulations were performed to understand the effect of water and carbon dioxide on flame structure.

The typical structure of un-premixed counter-diffusion flames in standard conditions can be significantly modified when injected flows are diluted and/or pre-heated. The increase of the fuel and/or oxidant flow dilution up to extreme conditions can lead to the formation of nonignitable mixtures. The oxidation processes can be sustained just in case the pre-heating temperature of one flow is high enough to promote self-ignition of the system. A high initial enthalpy of flows and a low fuel and/or oxygen concentration can drastically modify the structure of the oxidative region as well as the physical and chemical kinetics with respect to conventional diffusion flame. Such operating conditions are typical of mild combustion processes. More specifically a combination of both heating and dilution of oxidant and/or fuel yields an un-premixed combustion process named Hot Diluted Diffusion Ignition (HDDI). Numerical simulation was carried out by means of commercial codes and kinetic mechanisms available in the literature in order to analyze the change of the structures of the reactive region induced by pre-heating and dilution of flows in two different configurations.

Of the 53 cirrhotic patients with cholelithiasis observed at our Institution from 1978 to 1991, 31 were operated on. Twenty-eight Child-Pugh class A, two class B and one class C patients underwent elective cholecystectomy with (5 cases) or without (26 cases) common bile duct exploration. Among the symptomatic patients, nine (18.7%) were refused for surgery because the risk was estimated to be too high. Symptoms ranged from mild-moderate abdominal pain to typical biliary colic. Acute biliary inflammatory complications as cholecystitis or cholangitis could be detected in the clinical history of 5 patients (16%). Although a common clinical feature, jaundice was directly related to gallbladder or common bile duct stones only in one half of the cases. A total of 18 postoperative non-lethal complications occurred in ten patients (32.2%), with haemorrhage from the gallbladder bed being the most frequent event. Bleeding was associated with increased prothrombin time more than 1.5 seconds above the control (p0.01) but severe haemorrhage occurred only when the platelet count was less than 100.000/ml (p0.05). Common bile duct explorations increased the risk of bleeding. Two of the 3 class B or C patients developed ascites (p0.05). It is concluded that elective cholecystectomy can be performed without mortality in selected and symptomatic patients with adequate hepatic functional reserve.

Ultrasound appearance of intragallbladder haemorrhage in two patients with haemobilia is presented. Gallbladder lumina were occupied by non-shadowing, firm masses of mixed echogenicity representing blood clots. In both cases iatrogenic trauma following percutaneous transcholecystic cholangiography and blind hepatic biopsy caused bleeding in the biliary tree.

Three cases of secondary gastric lymphoma are presented in which diagnosis was suggested by ultrasound (US) and confirmed by endoscopy and microscopical examination. Three different US patterns are illustrated and compared with endoscopy. US findings paralleled endoscopy during follow-up under antiblastic treatment: both improvement and lack of change in the gastric lesions were reliably predicted by US.

The fatty acid composition of subcutaneous tissue has been determined in a population sample of apparently healthy middle aged men from Southern Italy. Dietary appraisal has been carried out by evaluating the usual pattern of food consumption during the year preceding the interview. The whole population sample was subdivided into three tertiles on the basis of the energy intake by the different individuals. The proportion of adipose tissue polyunsaturated fatty acids was relatively low in the high energy tertile III and high in the low energy tertile reflecting parallel differences in the intake of polyunsaturated fatty acids. The percentage of monounsaturated fatty acids (mainly oleic acid) was relatively high (p less than 0.01) and that of saturated fatty acids (mainly palmitic acid) relatively low (p less than 0.05) in the high energy tertile (III) as compared to the low energy tertile (I); these differences were independent of the amount and type of dietary fatty acids. Total energy was positively correlated (r = .87, p less than 0.01) to carbohydrate intake (g/day). Dietary carbohydrates (g/day) were inversely related to adipose tissue saturated fatty acids (r = -.40, p less than 0.001) and directly correlated to adipose tissue monounsaturated fatty acids (p = .40, p less than 0.001). Carbohydrate intake was related to adipose tissue monounsaturated and saturated fatty acids independently of daily energy intake. On the other hand when the influence of dietary carbohydrates was eliminated, no correlation was detectable any longer between energy intake and adipose tissue fatty acids.(ABSTRACT TRUNCATED AT 250 WORDS)

A series of clinical steps in the severity of chronic liver disease (CLD) has been arranged to represent the case history of chronic active hepatitis and cirrhosis retrospectively. The 'steps' in such series of clinical stages have been chosen on the basis of physiopathological considerations, the state of health of the patients, and their ability to work. For every 'step' the laboratory findings were studied in order to verify the hypothesis that a laboratory case history exists, which is parallel to the clinical history of CLD. With the exception of serum albumin and, to a lesser extent, sulfobromophthalein-ki, which seem to reflect the progressive deterioration in hepatocellular function, the results suggest that most conventional tests do not seem to be of any value in monitoring a CLD patient in cases where the diagnosis is already known, whereas a physical examination provides a physician with more, and cheaper, information than laboratory tests.

An epidemiological study has been carried out on a group of 622 students (10 to 13 years old) from a secondary school in Naples. Aims of the present work were: the evaluation of the prevalence of hypertension in an adolescent population; the association with familial hypertension and obesity; the persistence of high blood pressure values at follow-up. Blood pressure data obtained in these subjects by the use of a standard evaluation scale based on body surface percentiles were compared with those obtained by two major current methods used for the definition of "normal" blood pressure values in pediatric age. The method based on body surface percentiles has shown the highest specificity. The prevalence of hypertension, as detected by this method, has been of 3,5% as compared to 12,9% and to 9,5% of the other two methods. In a follow-up at one year, while the percentage of hypertensive students remained unchanged in the group detected by the method of body surface percentiles, it decreased from 12,9% to 9,3% and from 9,5% to 7,8% in the other two groups. The high prevalence of obesity and familial hypertension observed in these young hypertensive subjects suggest the possibility of selecting, by body surface percentiles, well defined group of subjects at risk, characterized by borderline hypertension, high grade of familial aggregation, high prevalence of obesity and by the persistence of hypertension at the follow-up.

Sensitivity and specificity of physical and laboratory findings have been evaluated for the purpose of establishing a differential diagnosis between cirrhosis and chronic active hepatitis on clinicolaboratory grounds. Data from 213 patients from southern Italy with biopsy-proven chronic active hepatitis or cirrhosis have been studied retrospectively. Splenomegaly, hypocholesterolemia, and decreased sulfobromophthalein-Ki were among the most sensitive individual findings in cirrhosis, whereas decreased platelet count, jaundice, and hypoprothrombinemia were the most specific ones. The presence in the same patient of both one of the former and one of the latter findings yields a correct diagnosis of cirrhosis with at least 90% likelihood. Advantages of the proposed diagnostic technique and comparison with data from an American series are discussed.

The behaviour of some urinary metabolites of tryptophan/nicotinic acid pathway was studied in 7 patients with Parkinson's disease during a 24-day period of levodopa treatment. Corresponding to the appearance of side-effects (agitation, anorexia, dysphagia, glossitis, abdominal pains) in 5 patients there was an increase in urinary Ky, AA, AAG, o-AHA, and 3-HK, while 3-HAA excretion fell. Since no other drugs were given, it was presumed that this effect was due to levodopa administration.