249 research outputs found
National guidelines and evidence based medicine
No full textIn the international scenario of evidenced based medicine oncologic treatments are crucially involved, since clinical trials are of utmost importance in oncology and levels of recommendations are their direct consequence. As for the majority of cancers, the result of evidence based medicine in gastric cancer field is very often a guide-lines document. Such a consensus file is mostly reached within national associations of specialists dedicated to the treatment of gastric cancer. The aim of our web round table is to try to compare many of these national guide-lines, contacting their own Authors and to have a feed-back for all the users of them on how much these guide-lines are useful and followed in every single country. Our objective would like to be not a scientific discussion on the single topics expressed in the guide-lines, but how such guide-lines were defined, how much evidence based medicine was crucial in this definition and if it could be possible to extend this way of take steps from a national setting to an international scale
Energy and Economic Comparison between natural gas fired and biomass fired Combined Heat and Power (CHP) plants for tissue paper production in remote areas
No full textIn remote areas, such as India, Africa and Southeast Asia, typically not connected to the natural gas distribution grid, tissue paper drying process is currently carried out using a Yankee cylinder, heated with saturated steam, and hot air hoods warmed with saturated steam or diathermic oil. In this way the drying impingement air is heated, at maximum, at around 250 °C, with consequent low levels of dried paper production in comparison to modern hoods heated with natural gas.
In this context, the present study intends to evaluate the technical and economic feasibility of using a CHP plant fully powered by biomass, for the production of steam and electricity in order to satisfy all the electrical needs of the paper mill and the steam for the Yankee cylinder, while a wood biomass fixed bed downdraft gasification plant is utilised for the production of syngas to be used as fuel in the gas hoods, in order to reach high drying temperatures (around 500 °C), comparable with those of the current natural gas powered hoods. Using previously developed calculation codes, an evaluation of the overall energy performances of the paper drying system and of the gasification plant has been performed.
Results show that, for a paper mill with a production of about 80 t/day of paper, two gasification reactors with a thermal output of about 1.95 MWt, and a consumption of dry biomass of 0.86 t/h, are required. For the steam system, the net electric power needed to meet the needs of the paper mill is about 3100 kW with a consumption of 4.72 t/h of moist biomass and a net efficiency of 23.9 %.
The performances of this innovative biomass fueled CHP plant are finally compared with those of a traditional natural gas fueled CHP plant
Insulin glargine 300 U/ml for the treatment of feline diabetes mellitus
No full textObjectives: The study aimed to evaluate the efficacy and safety of insulin glargine 300 U/ml (IGla-U300) in cats with variable duration of diabetes mellitus (DM). Methods: Thirteen client-owned cats with DM completed a prospective clinical trial. Four cats were highly suspected of hypersomatotropism and excluded from the insulin efficacy evaluation. All cats were treated with IGla-U300 SC at a starting dosage of 0.5 U/kg q12h and fed with a low carbohydrate diet. Cats were monitored for 8 weeks with a once-weekly at-home 16 h blood glucose curve (BGC) and a questionnaire evaluating the presence of DM-related clinical signs. In-clinic evaluations, including serum fructosamine measurement, were scheduled within 3 days of the first, third, sixth and eighth BGC. Glycemic variability was assessed by calculating the SD of each BGC. Results: Excluding four cats suspected of hypersomatotropism, at the time of the eighth BGC, improved or absent polyuria, polydipsia, polyphagia, weight loss, lethargy and improved or normal general demeanor were reported in 8/9 (88%), 8/9 (88%), 7/9 (77%), 7/9 (77%), 7/9 (77%) and 8/9 (88%) cats, respectively. Two cats achieved remission after 29 and 53 days. Another two cats went into remission after the end of the study (days 82 and 96). All cats that achieved remission were newly diagnosed diabetics. Median (range) serum fructosamine concentration significantly decreased when comparing the time of enrollment (604 [457–683] μmol/l) with the eighth week of treatment (366 [220–738] μmol/l) (P = 0.02). In all 13 cats, biochemical hypoglycemia (blood glucose <60 mg/dl; <3.3 mmol/l) was detected in 13/104 (12.5%) BGCs, while clinical signs suggesting hypoglycemic episodes were not reported. Glycemic variability was significantly lower at the fifth BGC when comparing cats that achieved remission with cats that did not achieve remission (P = 0.02). Conclusions and relevance: IGla-U300 seems effective and safe for the treatment of feline diabetes, but more long- term and comparative clinical trials are needed
Un ambiente computazionale integrato per l’analisi interazionale fluido struttura di sistemi non-lineari di interesse aeronautico
No full textNel contesto di una progettazione aeronautica multidisciplinare sempre più accurata dal punto di vista della modellizzazione ed efficiente dal punto di vista computazionale, nasce l’esigenza di sviluppare strumenti specifici per l’analisi di problemi interazionali fluido-struttura che tengano conto degli effetti non-lineari sia di natura fluidodinamica che strutturale. In occasione della recente release del codice MD Nastran, con MD Nastran 2010, e della distribuzione dell’ultima versione del programma MpCCI, versione 4.0, (Mesh-based parallel Code Coupling Interface, distribuito dalla Frahunofer), programma in grado di svolgere un ruolo di interfaccia tra diversi solutori commerciali con una modalità indipendente dai singoli ambienti di calcolo, si è voluto sperimentare le potenzialità offerte da questi nuovi strumenti nell’ambito dell’analisi interazionale fluido-struttura di interesse aeronautico
Feasibility study of a CHP plant with steam turbine and biomass gasification for tissue paper production
No full textIn remote areas, such as India, Africa and Southeast Asia, typically not connected to the natural gas distribution network, tissue paper production is currently carried out using a Yankee cylinder and two hot air hoods heated with saturated steam produced in conventional boilers. In this way the drying air is heated at medium temperature, around 160-180°C, with consequent low levels of dried paper production. In this context, the present study intends to evaluate the technical and economic feasibility of using a wood biomass fixed bed downdraft gasification plant for the production of syngas to be used as fuel in gas hoods, in order to reach high drying temperatures (around 500°C), comparable with those of the current modern hoods powered with natural gas. Using previously developed calculation codes, an evaluation of energy performance of the paper drying system and of the gasification plant has been performed. The present study also evaluates the possibility of applying a CHP plant, powered by biomass, for the production of steam and electric, this last obtained adopting a steam turbine, thus covering all the electrical and thermal needs of the paper mill. Results show that, for a paper mill with a production of about 80 t/day of paper, two gasification reactors with a thermal output of about 1.95 MWt, and a consumption of dry biomass of 0.86 t/h, are required. For the steam system, the net electric power needed to meet the needs of the paper mill is about 3100 kW with a consumption of 4.72 t/h of moist biomass and a net efficiency of 23.9 %
Cadmium inhibits stimulated amylase secretion from isolated pancreatic lobules of the guinea-pig
No full textThe effect of cadmium chloride on pancreatic exocrine secretion 'in vitro' was examined using guinea-pig isolated lobules, Cadmium (10(-3) M) stimulated amylase release when added alone to the incubation medium and the increase of amylase was unaffected by atropine. Cadmium (10(-4) M) did not significantly modify the basal amylase release. Depolarization of pancreatic nerves with potassium stimulated amylase secretion; the stimulant effect of KCl was completely inhibited by atropine. Cadmium (10(-4) M) inhibited, but did not abolish, the stimulant effect of KCl, indicating a direct effect of the metal on the acinar cell. Cadmium (10(-4) M) also inhibited the amylase release evoked by the secretagogues carbachol and caerulein, which are known to act directly on the acinar cell. Taken together with previous data reporting a large increase of pancreatic cadmium concentration following cadmium ingestion, the strong inhibition of pancreatic secretion observed in our experiments suggests that the exocrine pancreas may be regarded as a possible target organ of cadmium toxicity. (C) 2001 Academic Press
The mechanism of the force response to stretch in human skinned muscle fibres with different myosin isoforms
No full textForce enhancement during lengthening of an active muscle, a condition that normally occurs during locomotion in vivo, is attributed to recruitment of myosin heads that exhibit fast attachment to and detachment from actin in a cycle that does not imply ATP splitting. We investigated the kinetic and mechanical features of this cycle in Ca(2+) activated single skinned fibres from human skeletal muscles containing different myosin heavy chain (MHC) isoforms, identified with single-fibre gel electrophoresis. Fibres were activated by using a new set-up that allows development of most of the tension following a temperature jump from 0-1 degrees C to the test temperature ( approximately 12 degrees C). In this way we could prevent the development of sarcomere non-uniformity and record sarcomere length changes with a striation follower in any phase of the mechanical protocol. We found that: (i) fibres with fast MHC isoforms develop 40-70% larger isometric forces than those with slow isoforms, as a result of both a larger fraction of force-generating myosin heads and a higher force per head; (ii) in both slow and fast fibres, force enhancement by stretch is due to recruitment of myosin head attachments, without increase in strain per head above the value generated by the isometric heads; and (iii) the extent of recruitment is larger in slow fibres than in fast fibres, so that the steady force and power output elicited by lengthening become similar, indicating that mechanical and kinetic properties of the actin-myosin interactions under stretch become independent of the MHC isoform
The effects of [Arg(14), Lys(15)] nociceptin/orphanin FQ, a highly potent agonist of the NOP receptor, on in vitro and in vivo gastrointestinal functions
No full textNociceptin/orphanin FQ (N/OFQ) administered into the lateral left cerebral ventricle of rats has been reported to inhibit in vivo gut motor
and secretory functions. Recently, a novel N/OFQ analog, [Arg14, Lys15] N/OFQ, was synthesized and demonstrated to behave as a highly
potent agonist at the human recombinant N/OFQ peptide (NOP) receptors and to produce long-lasting effects in vivo in mice compared with
the natural ligand N/OFQ. In the present study, the pharmacological profile of [Arg14, Lys 15] N/OFQ was further evaluated and compared
with that of N/OFQ in vitro on guinea pig exocrine pancreas and in vivo on gastric emptying, colonic propulsion and gastric acid secretion
in rats. [Arg14, Lys15] N/OFQ and N/OFQ significantly decreased the KCl-evoked amylase secretion from isolated pancreatic lobules of the
guinea pig. In in vivo experiments, [Arg14, Lys15] N/OFQ mimicked the effects of N/OFQ, inducing, after intracerebroventricular injection,
a delay (up to 70%) in the gastric emptying of a phenol red meal, an increase (about 40 times) of the mean bead colonic expulsion time and
a decrease (up to 90%) of gastric acid secretion in water loaded rats after 90 min pylorus ligature. In all these assays, [Arg14, Lys15] N/OFQ
was more effective than N/OFQ, and its effective doses were at least 10-fold lower than N/OFQ effective doses. The highly selective NOP
receptor antagonist, UFP-101, decreased the efficacy of [Arg14, Lys15] N/OFQ in in vitro and in vivo assays above reported. These findings:
(a) show that pancreatic NOP receptors mediate an in vitro inhibitory effect on stimulated guinea pig amylase secretion; (b) confirm that the
stimulation of central NOP receptors exerts an inhibitory control on gastric emptying, colonic motility and gastric secretion in rats and (c)
put in evidence that [Arg14, Lys15] N/OFQ, being more potent and effective than the natural ligand N/OFQ, represents a new pharmacological
tool for the study of the physiological and pharmacological roles mediated by the N/OFQ-NOP receptor system
High efficacy of combined therapy with pegylated interferon plus ribavirin in patients with hemophilia and chronic hepatitis C
No full textBACKGROUND AND OBJECTIVES: Eradication of hepatitis C virus (HCV) is particularly difficult in patients with hemophilia. In this open, prospective, multicenter trial, the efficacy and tolerability of the combination therapy with pegylated interferon alpha2b (Peg-IFNalpha2b) plus ribavirin was evaluated in 64 human immunodeficiency virus (HIV) seronegative adult hemophiliacs with chronic hepatitis C naive to previous antiviral therapy. DESIGN AND METHODS: Peg-IFNalpha2b was administered at a dose of 1.5 microg/kg subcutaneously once weekly plus oral ribavirin 800-1200 mg/day, for 24 weeks to patients with HCV genotypes 2 and 3 (n=22, 34%) or for 48 weeks to those with genotypes 1 and 4 (n=42, 66%). RESULTS: Nine patients (14%) did not complete the study because of non-compliance (n=6) or side-effects such as decompensated diabetes, alanine aminotransferase flares and severe vomiting (n=3). Twenty-eight patients (44%) required dose reduction of either drug. Six months after stopping treatment a sustained virological response was achieved in 40 patients (63%), 19 with genotype 2 or 3 (86%) and 21 with genotype 1 or 4 (50%). A sustained virological response was significantly associated with an early virological response (p<0.0001), HCV genotypes 2 or 3 (p=0.008), no clinical evidence of cirrhosis (p=0.02) and higher pre-treatment serum alanine aminotransferase (p=0.016). INTERPRETATION AND CONCLUSIONS: These results show that combination therapy with Peg-IFNalpha2b plus ribavirin is highly efficacious in hemophiliacs with chronic hepatitis C
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