Functionalization of polycaprolactone/hydroxyapatite scaffolds with Usnea lethariiformis extract by using supercritical CO2.

Investigation of an integrated supercritical fluid extraction and supercritical solvent impregnation process for fabrication of microporous polycaprolactone-hydroxyapatite (PCL-HA) scaffolds with antibacterial activity is presented. The HA content and particle size as well as the operating conditions of the integrated process is optimized regarding the amount of impregnated antibacterial agent (Usnea lethariiformis extract) in the PCL-HA matrix, scaffold morphology and antibacterial activity against methicillin resistant Staphylococcus aureus (MRSA) strains. High pressure differential scanning calorimetry (HP-DSC) assay reveals that an increasing amount of HA results in decreasing melting temperature as well as crystallinity at an operating pressure of 17 MPa. The PCL-HA composites with micrometric sizes of the HA particles are convenient for being processed by the integrated process due to the simple preparation, a good interaction between the PCL matrix and filler and the advantageous impact on sorption. The scaffold obtained from PCL-HA with 20% of the HA shows the highest impregnation yield at 17 MPa and 35 °C (5.9%) and subsequently also the best bactericidal effect on the tested MRSA strains at an initial bacterial inoculum of 2 × 10(-4)CFU/mL.

Esophagectomy in esophageal perforations: an analysis.

This study aimed to study the factors that are associated with urgent esophagectomy for the treatment of esophageal perforations and the impact of this therapy. A retrospective review of all esophageal perforations treated at a tertiary care hospital from January 1984 to January 2012 was performed. Compiling demographics, cause and site of perforations, time to presentation, comorbidities, radiological tests, the length of perforation, the hemodynamic status of the patient, type of treatment required, and outcomes were performed. Univariate, multivariate, and Cox regression analyses were conducted. Of 127 cases of esophageal perforation, it was spontaneous in 44 (35%), iatrogenic in 53 (44%), foreign body ingestion in 22 (17%), and traumatic perforation in 7 (6%) cases. Overall, 85 of the 127 (67%) patients were managed operatively, 35 (27.6%) patients were treated conservatively, and 7 (6.3%) patients were treated by endoscopic stent placement. Of the 85 patients who were managed operatively, 21 (16.5%) required esophagectomies, 13 (15.3%) had esophagectomy with immediate reconstruction, 5 (5.9%) patients had esophagectomy followed by delayed reconstruction, and 3 (3.5%) patients failed primary repair and required an esophagectomy as a secondary definitive procedure. Multivariate analysis revealed that esophagectomy in esophageal perforations was associated with the presence of benign or malignant esophageal stricture (P = 0.001) and a perforation >5 cm (P = 0.001). Mortality was mainly associated with the presence of a benign or malignant esophageal stricture (P = 0.04). The presence of pre-existing benign or malignant stricture or large perforation (>5 cm) is associated with the need for an urgent esophagectomy with or without immediate reconstruction. Performing esophagectomy was not found to be a significant prognosticator for mortality.

Response inhibition and elevated parietal-cerebellar correlations in chronic adolescent cannabis users.

The ability to successfully inhibit an inappropriate behaviour is a crucial component of executive functioning and its impairment has been linked to substance dependence. Cannabis is the most widely used illicit drug in adolescence and, given the accelerated neuromaturation during adolescence, it is important to determine the effects of cannabis use on neurocognitive functioning during this developmental period. In this study, a cohort of adolescent heavy cannabis users and age-matched non-cannabis-using controls completed a Go/No-Go paradigm. Users were impaired in performance on the task but voxelwise and region-of-interest comparisons revealed no activation differences between groups. Instead, an analysis of correlation patterns between task-activated areas revealed heightened correlation scores in the users between bilateral inferior parietal lobules and the left cerebellum. The increased correlation activity between these regions was replicated with resting state fMRI data and was positively correlated with self-reported, recent cannabis usage. The results suggests that the poorer inhibitory control of adolescent cannabis users might be related to aberrant connectivity between nodes of the response inhibition circuit and that this effect is observable in both task-induced and intrinsic correlation patterns. This article is part of the Special Issue Section entitled 'Neuroimaging in Neuropharmacology'.

Cost of surgical intervention for reconstructive therapy of HIV-associated facial lipoatrophy.

This study aims to assess direct cost of reconstructive interventions with facial fillers for treatment of HIV (human immunodeficiency virus)-associated facial lipoatrophy (FLA). Evaluation was performed on data from patients enrolled in one arm of a comparative study of immediate versus delayed reconstructive treatment of facial lipoatrophy. Median costs were standardized for efficacy, estimated using data reported by physicians and patient reported outcomes. The variations of the results were evaluated with a sensitivity analysis. Evaluation was performed on 66 patients characterized by significant differences in terms of severity of FLA. Total cost resulted of €140,416.15, with a median cost per patient of €2126.04 (interquartile range [IQR]: 1599-2822). Taking into consideration severity of disease, median costs were €1641.67 (IQR: 1326.67-2126.04) and 2557.12 (IQR: 1939.34-2872.04) (P = 0.0) respectively for patients with low and high severity scores at baseline. Significant differences in term of cost-effectiveness ratios were also found between patients with different severity of FLA, and sensitivity analysis showed that these ratios increase with higher severity scores at baseline and vary widely depending on the costs of filler. Although these results cannot be considered representative because of important limitations, the present study suggests the severity of disease as an important determinant of costs.

A factor analytic study of the Italian National Institute of Health Quality of Life - Core Evaluation Form (ISSQoL-CEF).

OBJECTIVES: The Italian National Institute of Health Quality of Life - Core Evaluation Form (ISSQoL-CEF) is a specific questionnaire measuring health-related quality of life for human immunodeficiency virus-infected people in the era of highly active antiretroviral therapy. The main goal of this study was to examine the construct validity of this questionnaire by confirmation of its hypothesized dimensional structure. METHODS: Baseline quality of life data from four clinical studies were collected and a confirmatory factor analysis of the ISSQoL-CEF items was carried out. Both first-order and second-order factor models were tested: Model 1 with nine correlated first-order factors; Model 2 with three correlated second-order factors (Physical, Mental, and Social Health); Model 3 with two correlated second-order factors (Physical and Mental/Social Health); Model 4 with only one second-order factor (General Health). RESULTS: A total of 261 patients were surveyed. Model 1 had a good fit to the data. Model 2 had an acceptable fit to the data and it was the best of all hierarchical models. However, Model 2 fitted the data worse than Model 1. CONCLUSIONS: The findings of in this study, consistent with the results of previous study, pointed out the construct validity of the ISSQoL-CEF.

[Hospital hygiene and disinfectants: experience in a teaching hospital]. / Igiene ospedialiera e disinfettanti: esperienza in un policlinico universitario.

A survey was conducted during March-July 1999 to assess and identify the disinfectants and chemical sterilants employed in a teaching hospital of Roma. The purposes were studying the problems of safety in the use also, and the treatment like waste of disinfectants and chemical sterilants. Were collected the data from 61% of 39 Department/Institutes of the whole hospital. A total of 635 records were examined, and 40 different active ingredients of 110 commercial forms were identified. This study was conducted by a survey chart. Data collected outline that to minimize the risk for nursing staff, workers and the patients a modern hospital staff should prepare a handbook that can explain the concentrations and correct use for various disinfectants and chemical sterilants that was choose and employed.

Effect of the Host Plant on the Antioxidative Defence in the Midgut of Lymantria dispar L. Caterpillars of Different Population Origins.

THE RESPONSES OF GYPSY MOTH LARVAE ORIGINATING FROM TWO POPULATIONS (OAK FOREST, LOCUST FOREST) TO FAVORABLE (OAK) AND UNFAVORABLE (LOCUST) HOST PLANTS WERE MONITORED AT THE LEVEL OF MIDGUT ANTIOXIDATIVE DEFENCE: the activities of superoxide dismutase (SOD), catalase (CAT), glutathione-S-transferase (GST), glutathione reductase (GR), glutathione peroxidase like ('GSH-Px like') and glutathione content (GSH). Short-term change of the diet (3 days) to locust leaves of the 5th instar larvae (oak population) provoked an increase in GST and 'GSH-Px like' activities as well as in the amount of GSH. On the contrary, transferring the gypsy moth larvae (locust population) to oak leaves was followed by a decrease in GST, 'GSH-Px like' activities, and in the amount of GSH. Feeding gypsy moth larvae from hatching on an unfavorable host plant such as locust, led to increases in GST and SOD activities and GSH content, as well as to a decrease in CAT activity in all instars studied (4th, 5th, 6th). The locust leaf diet caused changes in other components of antioxidative defence dependent on larval instar and population origin, a feature which could be ascribed to trophic adaptation of the gypsy moth to an unfavorable host plant.