In dental applications, the contact between the metal implant and the receiving living tissue is made through the oxide layer on the implant surface, which allows the osseointegration process. In dentistry, the passive film formed on titanium seems to be more stable and protective than that formed on the Ti alloys, customarily used in other medical applications. Corrosion of titanium alloys in the mouth can result from the presence of a number of corrosive species, such as the hydrogen ion (H(+)), sulfide compounds (S(2-)), dissolved oxygen (O(2)) and Cl(-) and can result in the release of Ti(4+) ions that, in turn, brings about the reduction of alkaline phosphatase activity of osteoblastic cells. The present study reports a time-dependent electrochemical corrosion study of titanium in contact with the following biologically relevant solutions: (i) SBF (simulating the inorganic part of human plasma), (ii) SBF with added ovalbumin (a protein simulating the post-implant environment) and (iii) human plasma. To the best of the authors' knowledge, this is the first report on the corrosion of Ti in human plasma. The electrochemical measurements are based on electrochemical impedance spectrometry. Impedance spectra were interpreted on the basis of the equivalent-circuit approach and estimates of the time-variation of oxide film thickness and resistance were computed. Surface Raman spectroscopy was used to characterise the structure of as-anodised and corroded TiO(2) films: the effects of phosphate and organic incorporation were highlighted. EIS and surface Raman measurements have demonstrated that the corrosion resistance of the oxide films formed on Ti is strongly affected by the presence of biomolecules in the chloride- and phosphate-based aqueous solution. In particular, ovalbumin increases corrosion performance and human plasma is found to be remarkably more aggressive in comparison to SBF. These results suggest some caution in extrapolating corrosion results obtained in simulated biological fluids to the actual behaviour in vivo.
This is one of the first report on adiponectin in benign and malignant gynecological diseases. Future studies are needed to address the clinical potential role of adiponectin in cancer.
Background and Aims
The High-Flux (HF) dialyzer in standard hemodialysis (HD) allow the removal of a wider spectrum of uremic toxin. However, the HD can remove mostly low molecular weight solutes while the HDF can remove solutes around 15kDa, so-called Middle Molecules (MM), improving morbidity and mortality by exchange volumes >23L per session. The new medium cut-off (MCO) filter Theranova® is designed to expand the removal of toxins up to 45kDa in HD compared to HF membranes (HemoDialysis eXpanded, HDx) even with conventional blood flows and without exchange fluid infusion. The aim of this study is to evaluate the performance of HDx and its impact on anemia and quality of life (QoL) in haemodialysis patients.
Method
11 stable HDs patients were enrolled (M/F 8/3, age 70.8±9) with Qb ≤300 ml/min in a 12 months observational case-control study. Each patient was evaluated first with HF filter (T0) and then in HDx for 12 months (T12). At T0-T6-T12 were evaluated: urea, phosphate (P), beta2-microglobulin (B2m), myoglobin (Myo), free light-chains k and λ (FLC- K and FLC- λ), C-Reactive Protein (CRP), hemoglobin (Hb) and albumin as well. Furthermore Kt/V, dose of EPO, ERI and SF-36 questionnaire were evaluated at the beginning and end of observation. We treat HD patients accordingly to the KDIGO Guideline for Anemia in CKD. The values have been reported as mean ±SD.
Results
HDx (Qb = 275 ± 41 ml/min, TT 215 ± 21 m) shows a significant increase in KT/V (T0 1,33 ± 0,19; T12 1,57 ± 0,16; p = 0.001) with relevant RR of: Urea 73.5%; P 58.4%; B2m 66,1 % (p< 0.05); Myo 55,1% (p< 0.05); FLC-k 64.1 % (p< 0.05); FLC-λ 59.9% (p< 0.05). There is a significant reduction at 12months for PCR (Tab.1). HDx reduced ERI [T0 10.1 ± 11.2; T6 4.1 ± 5.3 (p <0.05); T12 6±9.8] and EPO dose [T0 8182 ± 9141; T6 3545 ± 4547 (p <0.05); T12 5273±8912], keeping the Hb unchanged. QoL is significantly improved (ISF: T0 27.3 ± 10.1; T12 40.2 ± 8.4 p = 0.0001) (ISM: T0 43.8 ± 14.2; T12 51.1 ± 9.8 p = 0.001).
Conclusion
HDx effectively removes uremic toxins up to 45kDa, even with Qb <300 ml/min, without reducing serum albumin and with interesting results on inflammation. Reduction of ERI and improvement of QoL are encouraging and suggest the use of HDx even in patients who cannot benefit from convective techniques because of vascular access or intolerance to high volumes of exchange.
CONCISE COMMUNICATIONS preciated; as much as a 30% suppression of immunoglobulin production has been reported (5,6). Beyond that, experiences with high-dose MTX used in malignant disorders have revealed marked immunosuppressive properties, including decreased antibody production (7).Discontinuation of MTX is most important in managing interstitial pneumonia due to CMV following low-dose weekly MTX in patients with RA. Our patient showed a good and satisfactory response after discontinuation of MTX, despite the commencement of steroid therapy, indicating stronger immunosuppressive properties of MTX than prednisolone. However, in other patients, respiratory CMV involvement may be more severe and therapy with ganciclovir should then be considered (8).
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