Panminerva medica
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Herein, we review evidence that systemic insulin-resistance diseases linked to obesity, type 2 diabetes, and non-alcoholic steatohepatitis promote neurodegeneration. Insulin-resistance dysregulates lipid metabolism, which promotes ceramide accumulation with attendant inflammation and endoplasmic reticulum (ER) stress. ⋯ These abnormalities establish or help propagate a cascade of neurodegeneration associated with increased ER stress and ceramide generation, which exacerbate brain insulin-resistance, cell death, myelin degeneration, and neuro-inflammation. The data suggest that a mal-signaling network mediated by toxic ceramides, ER stress, and insulin-resistance should be targeted to disrupt positive feedback loops that drive the AD neurodegeneration cascade.
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Hyaluronic acid (HA), an endogenous substance whose concentration increases during the process of wound repair, can be manufactured in order to use it as an exogenous intervention able to reduce the time to wound repair and improve the quality of the scar. The role of HA as a key component of the extracellular matrix structure has been recognized for many decades, while its actions on cells involved in the process of tissue repair has been partly clarified only in the last few years. ⋯ The molecular patterns leading to cell activation have been substantially clarified and it is now widely accepted that cellular actions of hyaluronic acid are mediated by specific surface receptors, including CD44, RHAMM and toll like receptors. Elucidation of the mechanisms of cellular activation will allow an optimal use of exogenous hyaluronan and its derivatives in the wound care setting.
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Review
Microvasculopathy in ischemic acute kidney injury: consequences and therapeutic implications.
Ischemic acute kidney injury (iAKI) is the most frequent type of hospital-aquired acute renal failure (ARF). Mortality of ARF still ranges between 30% and 50%. Although acute renal ischemia significantly affects function and structure of the tubular epithelium, postischemic interstitial inflammation and microvasculopathy both contribute to ongoing renal dysfunction. ⋯ Although heterogenous in nature, EPCs can be employed for anti-ischemic treatment in different situations. Meanwhile the cells have been shown to protect mice from iAKI and several strategies have been established in order to increase the renoprotective capacity of EPCs. Further investigations will help to clarify whether EPCs not only protect the kidney in the short- but also in the long-term.
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Invasive monitoring with intracranial electrodes continues to play a critical role in the presurgical evaluation of patients with medically intractable epilepsy. Intracranial monitoring helps in localizing the epileptogenic zone and can be used to delineate eloquent cortical areas adjacent to this zone. In this review we analyzed surgical successes and failures of invasive video-electroencephalography (EEG) monitoring. ⋯ Intraparenchymal hematomas are even less frequent and are typically associated with the placement of depth electrodes. In 47-98% of cases, invasive video-EEG monitoring results into resective surgery. Invasive video-EEG monitoring is a reasonably safe and effective method to help delineate the epileptogenic zone and its relation to eloquent cortex.
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Randomized Controlled Trial
Gore external valve support for superficial saphenous vein incompetence: a 10-year, follow-up registry.
This long-term (10-year) study evaluated the safety and efficacy of expanded polytetrafluoroethylene (ePTFE) external valve support (EVS) implants used for external valvuloplasty in the treatment of incompetence of the proximal long saphenous veins. ⋯ EVS implants used to correct superficial venous incompetence at 10 years were well tolerated and produced good results on incompetence and on the evolution of varicose veins.