143 research outputs found
New methods to assess the correlation between reward system and chronic fatigue in patients on chronic hemodialysis
No full textBackground: One of the most frequently observed clinical manifestation in patients with kidney disease on chronic hemodialysis (HD) treatment is fatigue, a complex symptom that deeply affects their quality of life [1]. Research suggested that fatigue is associated to chronic inflammation and disfunction of the basal ganglia, leading to an alteration of reward processes, in chronic patients [2]. Recently, there is a growing interest in finding new methods and perspectives to assess these dimensions in chronic populations. For this reason, this study aimed to examine the correlation between fatigue and motivational systems in HD patients.
Materials and methods: To assess the effect of fatigue on motivational and physical aspects, the Fatigue Severity Scale (FSS) was applied to a total of ninety-four hemodialysis patients. While the Behavioural Activation System (BAS) and Behavioural Inhibition System (BIS) Scale was administered to measure their mechanisms of reward, that predispose to activation or inhibition of action. Finally, State-Trait Anxiety Inventory (STAI-Y) and Beck Depression Inventory (BDI-II) were used to detect the presence of anxiety and depression.
Results: FSS score was significantly higher in patients with high BIS Z-score than in patients with low and medium BIS Z-score. Conversely, all BIS Z-score groups of patients showed similar BDI and STAI-Y1/Y2 scores. Finally, the correlation between BIS and FSS score was found to be significant.
Conclusions: Globally, these findings suggest a correlation between fatigue symptoms and the behavioral inhibition system that, within the motivational mechanisms, is related to the inhibition of action with possible consequences on patients’ engagement.
References
1. Bossola M, Di Stasio E, Antocicco M, Panico L, Pepe G, Tazza L. Fatigue is associated with increased risk of mortality in patients on chronic hemodialysis. Nephron. 2015; 130:113–118.
2. Bossola M, Di Stasio E, Giungi S, Rosa F, Tazza L. Fatigue Is Associated With Serum Interleukin-6 Levels and Symptoms of Depression in Patients on Chronic Hemodialysis. J Pain Symptom Manage. 2015;49:578–85
Malnutrition and postoperative complications in abdominal surgery
No full textWe read with great interest the article by Hennessey et al 1 who studied retrospectively the relationship between preoperative serum albumin and surgical site infection(SSI) in a heterogeneous population of 524 patients undergoing gastrointestinal surgery.A total of 105 patients developed SSI and among them hypoalbuminemia (>30 mg/dL) was significantly associated, both at univariate and multivariate analysis, with the development of SSI, deeper SSI and prolonged inpatient stay. It is well known that malnutrition is a significant risk factor of postoperative complications in major abdominal surgery. Disclosure: The authors declare that they have nothing to disclose. DOI: 10.1097/SLA.0b013e3182306457
However, in the last 3 decades we have assisted to an impressive improvement of anaesthetic and surgical techniques and in an amelioration of postoperative patient management that have led to a reduction of postoperative morbidity and mortality.
At the same time, some recent evidence suggests that being overweight and obesity, rather than malnutrition, are significant risk factors of postoperative complications in major abdominal surgery.
Indeed, in 2008 we published the results of a prospective study that evaluated the incidence of mortality and major and minor postoperative complications in patients who underwent surgery for gastric cancer between 2000 and 2006. In this study, we stratified patients according to the preoperative percentage weight loss (0%–5%, 5.1%–10%, >10%) and serumalbumin levels < 3.0 g/dL; 3.0–3.4 g/dL; ≥ 3.5 g/dL). Interestingly, the rate of major infectious, major non-infectious and minor infectious (as SSI) postoperative complications was similar in patients with serum albumin 8.1%, respectively); between 3.0 and 3.4 (8.8%, 13.3%, 17.7%, respectively) or ≥ 3.5 g/dL (10.5%, 7.9%, 8.7%, respectively). It is difficult to explain the difference between our study and that of Hennessey et al Indeed, the study of Hennessey et al was retrospective and it is unknown if the surgeons or the attending doctors who made the diagnosis of SSI in each case were blinded to the status of serum albumin. In addition, the population studied by Hennessey et al was extremely heterogeneous, including patients who underwent elective or urgent operations on the gastrointestinal tract including stomach, duodenum, gallbladder, small intestine and colon and rectum, whereas we studied only patients undergoing gastric surgery. It has been shown that malnutrition does not re-enter in the risk factors predictive of postoperative morbidity in surgery for malignant gastric tumors.
It seems that role of hypoalbuminemia in the development of SSI varies according to the type of disease, to the type of surgery and to the characteristics of patients
Skeletal muscle of gastric cancer patients expresses genes involved in muscle regeneration
No full textExperimental studies have suggested that defective skeletal muscle regeneration could contribute to muscle wasting in cancer patients. However, data in humans are still lacking. In this study we aimed to assess the expression of the genes involved in muscle regeneration in gastric cancer patients. The RNA expression of the genes involved in muscle regeneration was assessed in the rectus abdominis muscle of patients with gastric cancer (n=30) and in age-matched control subjects (n=8). The Pax7 expression was significantly increased in the muscle of gastric cancer patients, either in the first stages of the disease or in stages IIIA and B. The increased expression was present both in stages IA and B and in stages II and III. The MyoD espression was also higher in the cancer patients than in the controls. However, the increased MyoD expression was present only in stages IA and B and not in the more advanced stages of the disease. The Myf5 expression, as well as that of the neonatal isoform of Myosin Heavy Chain (nMHC) did not differ significantly between the cancer patients and the controls. The necdin expression was negligible in healthy adult muscles and was significantly up-regulated in the muscle of gastric cancer patients. Its expression was highly increased in stages IA and B while it was similar to the control in stages II and III. The results of the present study show that in the skeletal muscle of gastric cancer patients, the expression of the genes involved in muscle regeneration is increased with respect to the controls
Cooperative action of Bronsted and Lewis acid sites of niobium phosphate catalysts for cellobiose conversion in water
No full textThe lively acidic properties in water of niobium phosphate (NBP) catalyst and NBP modified samples by acidic treatments in HCl solutions at 0.1, 1.0, and 10 M concentration (NBP01, NBP1, and NBP10, respectively) have been exploited for the direct conversion reaction of cellobiose to hydroxymethylfurfural (HMF) at temperature of 80-130 °C. Acidity of the samples was determined by liquid-solid titrations working in a modified HPLC line with basic solutions of phenylethylamine (PEA), used as a base probe. As solvents, an apolar-aprotic one, cyclohexane, was used for determining the intrinsic acidity and water for the effective acidity. In addition, pyridine/water co-adsorption FT-IR experiments complemented the acidity study, and the results obtained confirmed the presence of both water-tolerant Lewis acid sites (LAS) and some residual Brønsted acid sites (BAS) on all the NBP samples. On NBP, the LAS to BAS ratio was 1.69, measured in cyclohexane, and only slightly decreased to 1.30, when measured in water. Catalytic activity was studied in a liquid-solid reaction line with fixed bed flow reactor working in complete recirculation. The reaction of HMF formation from cellobiose consists of three distinct catalytic actions: hydrolysis of the β-1,4-glycosidic bonds of cellobiose, isomerization of the formed glucose monomers to fructose, and cyclo-dehydration of fructose to HMF. Comparative catalytic results obtained with a sulfonic acid resin (Amberlite IR 120) showed that it was not able to form any HMF from cellobiose in the range of temperature studied, only cellobiose hydrolysis to glucose can be successfully achieved on the protonic acid resin
Skeletal muscle regeneration in cancer cachexia
No full textMuscle wasting is the most important phenotypic and clinical feature of cancer cachexia, and the principal cause of impaired physical function, fatigue, and respiratory complications. Muscle loss has been attributed to a variable combination of reduced nutritional intake and an imbalance between anabolic and catabolic processes. It has been suggested that defective skeletal muscle regeneration may also contribute to muscle wasting in cancer patients. However, there is little invitro or invivo data available, in either animals or in humans, regarding skeletal muscle regeneration in cancer wasting. The aim of the present review is to define the role of skeletal muscle regeneration in the muscle wasting of cancer patients and to determine possible therapeutic implications
Catalytic systems for the selective transformation of levulinic acid to pentanediols
No full textCarbon dioxide emission can be reduced using renewable resources such as plant biomass as a carbon-neutral feedstock for commodity chemicals [1]. Levulinic acid (LA) is a useful C5 resource from lignocellulose. Its catalytic transformations into highly valuable chemicals such as γ-valerolactone (GVL) is quite easily obtained; however, there are few catalytic systems for its further transformation to pentanediols, even when drastic reaction conditions are used [2]. Mo and Pt already showed promising results in this reaction [3]. This work wants to investigate the role of the Mo precursor (Na2MoO4 or (NH4)6Mo7O24) and the influence of thermal treatments of Pt-Mo catalytic systems for LA hydrogenation to pentanediols. Na2PtCl4 have been impregnated on fresh or calcined (in N2) Mo/C previously prepared by wet impregnation. Pt was then reduced by NaBH4. LA hydrogenation was carried out at 150 °C and 20 bar H2 in autoclave (Parr Instrument).
XPS analyses, TEM spectroscopy and acidity characterization allowed to correlate the catalytic results with specific morphological properties of the materials
Lymphadenectomy for gastric cancer: Still a matter of debate?
No full textBackground: For more than a century the extent of surgical treatment of gastric cancer is a matter of debate. Through experience, evaluation and research, the outcome of gastric cancer has improved. Many aspects are of influence of outcome, but only a radical resection can offer long-term outcomes. In this review, we will discuss the history and current status of the extent of lymph node dissection. Materials aqnd Methods: Some issues about the extent of gastric resection seem to have been settled. For survival it is not necessary to perform a total gastrectomy if free resection margins can be obtained with a subtotal gastrectomy. In the context of postoperative morbidity and mortality a subtotal gastrectomy is to be preferred. Microscopic resection line involvement has shown to be of great influence on prognosis. Discussion: At this moment the main discussion centres around the extent of lymph node dissection, locoregional recurrence and to the influence of additional treatment. For many years it has been debated whether an extended lymph node dissection for gastric cancer is beneficial. Theoretically, removal of a wider range of lymph nodes by extended lymph node dissection increases the chances for cure. Such resection, however, may be irrelevant if there are no lymph nodes affected or if the cancer has developed into a systemic disease, or if it increases morbidity and mortality substantially. Conclusion: Relapse after curative surgery because of local recurrence or regional lymph node metastasis have been shown in up to 87.5% of patients. The extent of surgery, however, may be of influence on the locoregional recurrence rate
The Dielectric Behavior of Protected HKUST-1
No full textWe investigated the adsorption properties and the dielectric behavior of a very well-known metal-organic framework (MOF), namely Cu3(BTC)2 (known as HKUST-1; BTC = 1,3,5-benzenetricarboxylate), before and after protection with some amines. This treatment has the purpose of reducing the inherent hygroscopic nature of HKUST-1, which is a serious drawback in its ap-plication of as low-dielectric-constant (low-κ) material. Moreover, we investigated the structure of HKUST-1 under a strong electric field, confirming the robustness of the framework. Even under dielectric perturbation, the water molecules adsorbed by the MOF remained almost invisible to X-ray diffraction, apart from those directly bound to the metal ions. However, the replacement of H2O with a more visible guest molecule such as CH2Br2 made the cavity that traps the guest more visible. Finally, in this work we demonstrate that impedance spectroscopy is a valuable tool for identifying water sorption in porous materials, providing information that is complementary to that of adsorption isotherms
Surgery in the Multimodal Management of Gastric Cancer
No full textCancer cachexia is a multifactorial paraneoplastic syndrome characterized by anorexia, decreased body weight, and loss of adipose tissue and skeletal muscle. It accounts for at least 20% of deaths in neoplastic patients. Cancer cachexia significantly impairs the quality of life and the response to anti-neoplastic therapies, thereby increasing morbidity and mortality of cancer patients. Muscle wasting is the most important phenotypic feature of cancer cachexia and the principal cause of function impairment, fatigue, and respiratory complications, mainly related to the hyperactivation of muscle proteolytic pathways. Most therapeutic strategies aimed at preventing cancer cachexia have proven to be only partially effective. The inhibition of catabolic processes in muscle has been attempted pharmacologically, with encouraging results in animal models. However, data in the clinical setting are scant and contradictory. Stimulation of muscle anabolism could represent a promising and valid therapeutic alternative for cancer-related muscle wasting
Parenteral nutrition does not stimulate tumor proliferation in malnourished gastric cancer patients
No full textThe present study evaluated the effects of preoperative parenteral nutrition (PN) on tumor cell proliferation in malnourished gastric cancer patients
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