Role of nutritional therapy on dietary habits and glycemic control in insulin-treated kidney transplant patients with diabetes.

AIMS: To evaluate the effect of nutritional therapy on glycemic compensation and key cardio-renal risk markers in patients with diabetes and kidney transplant, on insulin treatment by Multiple Daily Injection (MDI) or Continuous Subcutaneous Insulin Infusion (CSII). METHODS: 34 patients with diabetes on insulin treatment and kidney transplant recipients were enrolled;12 participated in the structured nutritional program (intervention group), 22 patients (control group) did not receive nutritional protocol. Both groups were then divided into subgroups according to the method of insulin administration (MDI and CSII). RESULTS: Statistically significant reduction in fasting blood glucose values, glycosylated hemoglobin (HbA1c) and glycosuria were observed in both groups at the end of the study. The intervention group, significantly reduced total cholesterolemia and the glycemic index, together with reduced dietary intake of lipids, cholesterol, soluble carbohydrates and increased consumption of carbohydrates and fiber. These improvements were even more pronounced in patients treated with CSII. CONCLUSIONS: A proper nutritional approach optimize glycometabolic outcomes and contribute significantly to the reduction of the major cardiovascular risk factors in renal transplant patients.

Electrochemical Deposition of Polypyrrole in the Presence of Silanes as Adhesion Promoters.

Polypyrrole adhesion to indium-tin oxide electrodes was improved by adding pre-hydrolyzed alkoxysilanes to the electrodeposition media. The pyrrole oxidation and film growth rates were studied by potentiostatic polymerization in acidic media. The morphology and thickness of the films were studied by contact profilometry and surface-scanning electron microscopy. The bulk and surface semiquantitative chemical composition was studied by Fourier-transform infrared spectroscopy and X-ray photoelectron spectroscopy. Finally, the adhesion was studied by scotch-tape adhesion test, where both alkoxysilanes showed a significant improvement in adhesion. We proposed a hypothesis for the improvement in adhesion, that involves the formation of siloxane material as well as in situ surface modification of the transparent metal oxide electrode.

The Use of Recycled PET for the Synthesis of New Mechanically Improved PVP Composite Nanofibers.

Polyethylene terephthalate (PET) waste has become a major challenge for the conservation of the environment due to difficult degradation. For this reason, it is important to develop new recycling strategies for reusing this waste. In this work, the electrospinning technique was used to synthesize composite nanofibers of polyvinylpyrrolidone (PVP), recycling PET (RPET) that was obtained from the chemical recycling of postconsumer PET with glycolysis and styrene (ST) as a crosslinking agent. The polymer solutions were analyzed by viscosity and frequency sweeping, while the composite nanofibers were characterized by scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), thermogravimetric analysis/differential scanning calorimetry (TGA/DSC), and nanoindentation to compare their properties. The PVP nanofibers presented an average diameter of 257 nm; the RPET/PVP and RPET/PVP/ST composite nanofibers had average diameters of 361 nm and 394 nm, respectively; and the modulus of elasticity and hardness of the RPET/PVP/ST composite nanofibers were 29 and 20 times larger, respectively, than those of the PVP nanofibers. With the synthesis of these composite nanofibers, a new approach to PET recycling is presented.

Mechanochemical Preparation of Magnetically Separable Fe and Cu-Based Bimetallic Nanocatalysts for Vanillin Production.

A highly sustainable method for the preparation of supported iron oxide and copper nanoparticles (NPs) on a biomass-derived carbon by solvent-free mechanochemical process is reported. In-situ mechanochemically obtained extracts from orange peel could behave as a green reducing agent, allowing the formation of Cu metal nanoparticles as well as generating a magnetic phase (magnetite) in the systems via partial Fe3+ reduction. At the same time, orange peel residues also served as template and carbon source, adding oxygen functionalities, which were found to benefit the catalytic performance of mechanochemically synthesized nanomaterials. The series of magnetic Cu-Fe@OP were tested in the oxidation of trans-ferulic acid towards vanillin, remarkably revealing a maximum vanillin yield of 82% for the sample treated at 200 °C.

Mechanochemically Synthetized PAN-Based Co-N-Doped Carbon Materials as Electrocatalyst for Oxygen Evolution Reaction.

We report a new class of polyacrylonitrile (PAN)-based Co-N-doped carbon materials that can act as suitable catalyst for oxygen evolution reactions (OER). Different Co loadings were mechanochemically added into post-consumed PAN fibers. Subsequently, the samples were treated at 300 °C under air (PAN-A) or nitrogen (PAN-N) atmosphere to promote simultaneously the Co3O4 species and PAN cyclization. The resulting electrocatalysts were fully characterized and analyzed by X-ray diffraction (XRD) and photoelectron spectroscopy (XPS), transmission (TEM) and scanning electron (SEM) microscopies, as well as nitrogen porosimetry. The catalytic performance of the Co-N-doped carbon nanomaterials were tested for OER in alkaline environments. Cobalt-doped PAN-A samples showed worse OER electrocatalytic performance than their homologous PAN-N ones. The PAN-N/3% Co catalyst exhibited the lowest OER overpotential (460 mV) among all the Co-N-doped carbon nanocomposites, reaching 10 mA/cm2. This work provides in-depth insights on the electrocatalytic performance of metal-doped carbon nanomaterials for OER.

One-Pot Cu/TiO2 Nanoparticles Synthesis for Trans-Ferulic Acid Conversion into Vanillin.

In this study, the co-synthesis of TiO2 and Cu metallic nanoparticles obtained via one-pot cost-efficient hydrothermal process has been addressed. Different nanocatalysts with Cu contents were characterized by X-ray diffraction, nitrogen porosimetry, scanning electron microscopy, and transmission electron microscopy. The TiO2 and Cu metallic nanoparticles were synthesized with copper loading up to one (Cu/Ti atomic ratio). Synthesized catalysts exhibited pore sizes in the mesoporous range and high surface areas above 150 m2/g. The particle size for TiO2 presented a homogeneous distribution of approximately 8 nm, moreover, Cu nanoparticles varied from 12 to >100 nm depending on the metal loading. The nanostructured materials were successfully tested in the conversion of trans-ferulic acid into vanillin under sustainable conditions, achieving the best performance for 0.3 Cu/Ti atomic ratio (70% vanillin yield).

Modalities for assessing the nutritional status in patients with diabetes and cancer.

Epidemiological data have shown that an increased body mass index (BMI) is associated with a higher risk of various cancers, especially in obese diabetic patients. However, oncologic patients often present nutritional alterations that can worsen their prognosis. The aim of this review is to propose the use of cheaper and easy to use tools to assess the nutritional status of patients with cancer with altered glucose metabolism. Based on a literature review, we propose anthropometric measures to classify the degree of malnutrition. Moreover, the Karnofsky Performance Status (KPS) and the Eastern Cooperative Oncology Group's performance index (ECOG) are useful to assess the functional status of the body; the achievement of nutritional needs can be analysed with the PG-SGA questionnaire, while the quality of life can be investigated using the DTSQ, SF36, EQ-5D questionnaires and the Edmonton Symptom Assessment System. Pre-albumin dosage and lymphocyte count are proposed as nutritional parameters. The degree of hydration can be evaluated through the Bio-Impedance Test (BIA), and energy intake through the dairy food diary, which considers the type of nutrition and the consistency of the meals. It is possible to use a score for each tool used, which is useful to plan an adequate nutritional intervention.

Sol-Gel PMMA-ZrO2 Hybrid Layers as Gate Dielectric for Low-Temperature ZnO-Based Thin-Film Transistors.

We report a simple sol-gel process for the deposition of poly(methyl methacrylate) (PMMA)-ZrO2 organic-inorganic hybrid films at low temperature and studied their properties as a function of the molar ratios of the precursors in the hybrid sol-gel solution, which included zirconium propoxide as the inorganic (zirconia) source, methyl methacrylate as the organic source, and 3-trimethoxy-silyl-propyl-methacrylate (TMSPM) as the coupling agent to enhance the compatibility between the organic and inorganic phases. The hybrid thin-film deposition was done on glass slide substrates by the dip-coating method. After deposition, the films were heat-treated at 100 °C for 24 h. The analysis of the hybrid films included Fourier transform infrared spectroscopy to identify their chemical groups and thermogravimetric analysis to determine the content of their organic and inorganic components. In addition, capacitance-voltage (C-V) and current-voltage (I-V) curves in metal-insulator-metal structures, using gold as metal contacts, were measured to find the dielectric constant and leakage current of the PMMA-ZrO2 hybrid films. Finally, because of their adequate dielectric characteristics, single hybrid layers were deposited on indium tin oxide-coated glass substrates and were tested as gate dielectric in thin-film transistors (TFTs), using sputtered ZnO layers as the semiconductor active channel. We measured the output electrical response and transfer characteristics of these hybrid dielectric gate-based devices and determined their main electrical parameters as a function of the TMSPM content in the hybrid dielectric gate layer. The better TFT electrical behavior presents field effect mobility of 0.48 cm2/V s, low threshold voltage of 3.3 V, and on/off current ratio of 105, and it was obtained by using PMMA-ZrO2 with 0.3 TMSPM content as the gate dielectric layer. The values obtained for the electrical parameters show that PMMA-ZrO2 hybrid films are quite suitable for dielectric gate applications in TFTs.

Sex differences in food choices, adherence to dietary recommendations and plasma lipid profile in type 2 diabetes - The TOSCA.IT study.

BACKGROUND AND AIMS: Diabetic women have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes. METHODS AND RESULTS: We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women. CONCLUSIONS: Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake.

Influence of dietary fat and carbohydrates proportions on plasma lipids, glucose control and low-grade inflammation in patients with type 2 diabetes-The TOSCA.IT Study.

PURPOSE: The optimal macronutrient composition of the diet for the management of type 2 diabetes is debated, particularly with regard to the ideal proportion of fat and carbohydrates. The aim of the study was to explore the association of different proportions of fat and carbohydrates of the diet-within the ranges recommended by different guidelines-with metabolic risk factors. METHODS: We studied 1785 people with type 2 diabetes, aged 50-75, enrolled in the TOSCA.IT Study. Dietary habits were assessed using a validated food-frequency questionnaire (EPIC). Anthropometry, fasting lipids, HbA1c and C-reactive protein (CRP) were measured. RESULTS: Increasing fat intake from <25 to ≥35 % is associated with a significant increase in LDL-cholesterol, triglycerides, HbA1c and CRP (p < 0.05). Increasing carbohydrates intake from <45 to ≥60 % is associated with significantly lower triglycerides, HbA1c and CRP (p < 0.05). A fiber intake ≥15 g/1000 kcal is associated with a better plasma lipids profile and lower HbA1c and CRP than lower fiber consumption. A consumption of added sugars of ≥10 % of the energy intake is associated with a more adverse plasma lipids profile and higher CRP than lower intake. CONCLUSIONS: In people with type 2 diabetes, variations in the proportion of fat and carbohydrates of the diet, within the relatively narrow ranges recommended by different nutritional guidelines, significantly impact on the metabolic profile and markers of low-grade inflammation. The data support the potential for reducing the intake of fat and added sugars, preferring complex, slowly absorbable, carbohydrates.

A whole-grain cereal-based diet lowers postprandial plasma insulin and triglyceride levels in individuals with metabolic syndrome.

BACKGROUND AND AIM: Until recently, very few intervention studies have investigated the effects of whole-grain cereals on postprandial glucose, insulin and lipid metabolism, and the existing studies have provided mixed results. The objective of this study was to evaluate the effects of a 12-week intervention with either a whole-grain-based or a refined cereal-based diet on postprandial glucose, insulin and lipid metabolism in individuals with metabolic syndrome. METHODS AND RESULTS: Sixty-one men and women age range 40-65 years, with the metabolic syndrome were recruited to participate in this study using a parallel group design. After a 4-week run-in period, participants were randomly assigned to a 12-week diet based on whole-grain products (whole-grain group) or refined cereal products (control group). Blood samples were taken at the beginning and end of the intervention, both fasting and 3 h after a lunch, to measure biochemical parameters. Generalized linear model (GLM) was used for between-group comparisons. Overall, 26 participants in the control group and 28 in the whole-grain group completed the dietary intervention. Drop-outs (five in the control and two in the whole-grain group) did not affect randomization. After 12 weeks, postprandial insulin and triglyceride responses (evaluated as average change 2 and 3 h after the meal, respectively) decreased by 29% and 43%, respectively, in the whole-grain group compared to the run-in period. Postprandial insulin and triglyceride responses were significantly lower at the end of the intervention in the whole-grain group compared to the control group (p = 0.04 and p = 0.05; respectively) whereas there was no change in postprandial response of glucose and other parameters evaluated. CONCLUSIONS: A twelve week whole-grain cereal-based diet, compared to refined cereals, reduced postprandial insulin and triglycerides responses. This finding may have implications for type 2 diabetes risk and cardiovascular disease.

Modelling drying kinetics of thyme (Thymus vulgaris L.): theoretical and empirical models, and neural networks.

The drying kinetics of thyme was analyzed by considering different conditions: air temperature of between 40°C and 70°C , and air velocity of 1 m/s. A theoretical diffusion model and eight different empirical models were fitted to the experimental data. From the theoretical model application, the effective diffusivity per unit area of the thyme was estimated (between 3.68 × 10(-5) and 2.12 × 10 (-4) s(-1)). The temperature dependence of the effective diffusivity was described by the Arrhenius relationship with activation energy of 49.42 kJ/mol. Eight different empirical models were fitted to the experimental data. Additionally, the dependence of the parameters of each model on the drying temperature was determined, obtaining equations that allow estimating the evolution of the moisture content at any temperature in the established range. Furthermore, artificial neural networks were developed and compared with the theoretical and empirical models using the percentage of the relative errors and the explained variance. The artificial neural networks were found to be more accurate predictors of moisture evolution with VAR ≥ 99.3% and ER ≤ 8.7%.

Positron emitting tracers in pre-clinical drug development.

Molecular imaging tools such as Positron Emission Tomography (PET) are increasingly being used in the drug development process. The unrivaled sensitivity of PET coupled with a solid experience in developing highly targeted molecular probes makes this technique a very valuable tool at all stages from pre-clinical development to the clinical phases. Positron emitting tracers allow us to measure, quantitatively, molecular processes and interactions between a candidate drug and its molecular targets. This information can save time and money by directing development towards the most promising compounds and excluding molecules with unfavorable properties that would otherwise only be recognized as failures in latter stages of the process. In this paper we review the application of positron emitting tracers in the pre-clinical stages of the drug development process in the areas of oncology, cardiology, neurosciences and inflammatory diseases. PET tracers provide an important support for drug development in the areas of: discovery of new drug targets, clarification of pathophysiology, identification of potential drug candidates and validation of drug effectiveness, as well as the evaluation of pharmacokinetic and pharmacodynamic parameters in vivo.

Use of transient elastography (FibroScan®) for the noninvasive assessment of portal hypertension in HIV/HCV-coinfected patients.

The hepatic venous pressure gradient (HVPG) is the gold standard for assessing portal pressure and correlates with the occurrence of portal hypertension (PH)-related complications. Transient elastography (TE) is a new, highly accurate noninvasive technique, which enables us to evaluate hepatic fibrosis to detect advanced fibrosis and cirrhosis. We performed a hepatic haemodynamic study and TE in 38 HIV/HCV-coinfected patients. The association between HVPG and liver stiffness was assessed by linear regression. The diagnostic value of TE was assessed by receiver operating characteristic (ROC) curves. We considered clinically significant PH as an HVPG ≥ 10 mmHg and severe PH as an HVPG ≥ 12 mmHg. A total of 38 HIV/HCV-coinfected patients were included. Twenty-eight patients (73.7%) had clinically significant PH (HVPG ≥ 10 mmHg), and 23 (60.5%) of these had severe PH (HVPG ≥ 12 mmHg). We found a statistically significant association between liver stiffness (kPa) and HVPG (r(2) = 0.46, P < 0.001, straight line equation HVPG=7.4 + 0.204*TE). The areas under the ROC curves were 0.80 [95% confidence interval (CI), 0.64-0.97] and 0.80 (95% CI, 0.66-0.94) for the prediction of HVPG ≥ 10 and ≥ 12 mmHg, respectively. Our data suggest that TE can predict the presence of clinically significant and severe PH in HIV/HCV-coinfected patients.

Lymphoepithelial cyst of the pancreas: case report and review of the literature.

BACKGROUND AND STUDY AIMS: Lymphoepithelial cyst of the pancreas (LCP) is a rare, benign cyst mimicking pseudocyst or cystic neoplasm. Literature describing LCP is limited to case or brief series reports, and the natural history of this condition is largely unknown. A literature review was carried out in order to elucidate the clinical, pathological and biochemical features of LCP. The aim of this study was to define diagnostic criteria and treatment. METHODS: A Medline and Pubmed search was conducted by using the key-words "lymphoepithelial cyst" and "pancreas". The articles found were accurately examined and all details regarding clinical and pathological features were included in a data-base. Furthermore, a case recently observed in our unit was added to the review. RESULTS: Ninety-two cases of LCP were found in the worldwide literature, including the case that we observed. LCP occurs more frequently in males (M:F=5.5:1), its preferred site is the tail of the pancreas, and its size ranges between 2 and 10centimetres. Histologically, it is a true cyst delineated by a keratinizing squamous epithelium surrounded by lymphoid tissue. LCP is asymptomatic in the majority of cases and preoperative diagnosis is complicated by a lack of specific radiological features of the disease. An accurate preoperative diagnosis can only be made by obtaining cytological specimens and placing them in the hands of a pathologist who is familiar with the cytological appearances of the disease. CONCLUSIONS: LCP is a rare lesion worldwide, without any prevalence in different countries or in different ethnic groups. Understanding the features of LCP, making an accurate diagnosis and differentiating it from cystic neoplasm preoperatively is vital, as when it is diagnosed certainly, a conservative treatment is justified. Otherwise, radical surgery in the form of pancreatic resection is required to exclude the diagnosis of pancreatic cystic neoplasm.

Drying modelling of defrosted pork meat under forced convection conditions.

Drying is the lengthiest and the most energy consuming step during the production of dry-cured ham, affecting also the curing process and consequently product quality. In order to manage the drying process, it is quite interesting to establish the complexity of model needed. For that purpose, pork meat cylinders (Biceps femoris and Semimembranosus muscles) were dehydrated under forced convection conditions (25°C and air velocity 0.6±0.1, 2.0±0.1 and 2.8±0.1 m/s). Experimental drying kinetics were modelled by means of 4 diffusion models: model 1 (not considering shrinkage and no external resistance), model 2 (considering shrinkage and no external resistance), model 3 (not considering shrinkage and considering external resistance) and model 4 (considering both shrinkage and external resistance). From the effective diffusivity values identified, it was concluded that when external resistance was negligible (air velocity 2.0±0.1 and 2.8±0.1 m/s), the results obtained for D(e) with the four models were the same. Nevertheless, when external resistance was not negligible (0.6±0.1 m/s) the D(e) identified was influenced by the model due to the fact that models 1 and 2 neglect that resistance and for that reason they do not describe experimental conditions properly. The effect of shrinkage did not influence the identified D(e) values for the drying conditions considered. In order to model water losses in meat curing chambers, external resistance must be considered.

Liver resection for intrahepatic stones in congenital bile duct dilatation.

OBJECTIVE: This study reports our clinical experience with liver resection for congenital dilatation of the intrahepatic bile duct and intrahepatic gallstones to evaluate results and define indications for treatment. PATIENTS AND METHODS: We studied the clinical data of patients who underwent hepatic resection for intrahepatic lithiasis from January 1992 to December 2008 and assessed the immediate and long-term results of these interventions. RESULTS: Of 49 treated patients, 47 underwent liver resection. In the majority of cases, the disease was limited to the left lobe and left hepatectomy was the most commonly performed surgical procedure. The operative mortality was zero with morbidity in 24.5% of patients. Cholangiocarcinoma was diagnosed in six cases (12.2%). In 91.6% of cases the long-term results were good or satisfactory. CONCLUSION: Treatment goals in all cases should be the elimination of intrahepatic stones, the prevention of recurrent lithiasis, and prevention or cure of cholangiocarcinoma. Surgical excision is the best possible treatment for symptomatic patients with localized disease and atrophy of the affected liver.

Gas in portal circulation and pneumatosis cystoides intestinalis during chemotherapy for advanced rectal cancer.

OBJECTIVES: Acute abdominal symptoms with CT scan evidence of intramural gas in bowel walls (pneumatosis cystoides intestinalis, PCI) and of gas in the portal venous blood (PBG) in patients undergoing chemotherapy may represent a worrisome picture, suggestive of bowel necrosis. This picture remains a major clinical clue and the reporting of new cases may help to share awareness and experience on management. We describe a patient with acute abdominal symptoms and evidence of PCI with PBG under cetuximab, oxaliplatin, tegafur-uracil and folinic acid chemotherapy for metastatic adenocarcinoma of the rectosigmoid junction. METHODS: After admission for mucositis with diarrhea and profound dehydration, and subsequent emergency laparotomy for derotation of an intestinal volvulus, on the tenth postoperative day the patient developed fever and abdominal pain, with CT scan evidence of PCI with PBG. The exam of the abdomen did not suggest major problems requiring emergency surgery, and antibiotic treatment with close monitoring were performed, followed by rapid improvement. RESULTS: Twelve days later, after resumption of oral diet, the patient unexpectedly suffered a spontaneous jejunal microperforation, requiring emergency laparotomy and bowel resection. Pathology showed that the perforation was within an area of ulceration involving the inner superficial layer of the bowel. Subsequently recovery was normal and at present, after 15 months, the patient is well and continuing chemotherapy. CONCLUSIONS: This is probably the first report of PCI with PBG related to intestinal toxicity during cetuximab, oxaliplatin, tegafur-uracil and folinic acid chemotherapy in a patient with advanced rectal carcinoma, followed by delayed small bowel perforation. It provides an example of the challenges involved in the management of this type of patient.

Potato shrinkage during hot air drying.

Shrinkage is one of the most important physical changes that occur during the dehydration of foods. In this work, the effect of the temperature (35, 40, 50, 60 and 70 °C) and air velocity (7, 8, 9 and 10 m/s) on bulk volumetric shrinkage was investigated. Volume changes were evaluated by image analysis. It was found that neither temperature nor air velocity had any significant effects on bulk shrinkage in this system. The bulk shrinkage of the potato cubes was well correlated with the moisture content of the sample during drying (R(2) = 97.28). Volume varied linearly with the moisture content changes under the studied conditions. The volume of lost water and the decrease in volume of the samples during dehydration were similar.