Irreversible Condition Research Articles

Membrane backwash cleaning using CO2 nucleation

Low pressure membranes, such as ultrafiltration (UF), are widely used in water treatment applications, including the pretreatment of reverse osmosis desalination. UF membranes produce a water of superior quality, in addition to reducing the footprint and the use of chemicals, compared to conventional methods. However, membrane fouling remains a major drawback, and frequent membrane cleanings are required to maintain the flux of water and its quality. Typically, after a series of backwashes using an UF permeate, a chemical cleaning process is applied to fully recover the membrane's permeability. However, frequent chemical cleanings negatively affect the lifetime of the membrane, the environment, and increase operational costs. Here, we introduce a novel cleaning method that uses a solution saturated with CO2 to clean the membranes through the backwash step. As the pressure drops, the CO2 solution becomes supersaturated, and bubbles start to nucleate within the membrane pores and on its surface, resulting in the effective removal of the deposited fouling material. These foulants are further helping the nucleation process as they are considered as imperfection sites with high creation and growth of bubbles. Investigations performed for different synthetic feed solutions of organic compounds (sodium alginate), colloidal matter (silica) and sea salts, at different concentrations, show that our new physical cleaning process using CO2 is more performant than the regular backwash using Milli-Q water. We obtain a 100% flux recovery, in a short time, even under severe irreversible fouling conditions. Based on these results, we conclude that replacing water by a solution saturated with CO2 for the backwash cleaning of filtration membranes provides significant benefits to existing cleaning processes, and represent a promising alternative for improving and lowering the frequency of conventional chemical cleaning methods.

Prevalencia de edentulismo parcial según Kennedy y Applegate en pacientes de la clínica odontológica de una universidad de Lambayeque-Perú

Introduction: Edentulism is an irreversible chronic condition that seriously affects the stomatognathic system. Consequently, determining its prevalence may contribute to prioritize preventive and rehabilitative oral health interventions. Objective: To determine the prevalence of partial edentulism according to the Kennedy and Applegate classification in patients attending the Dental Clinic at Universidad San Martín de Porres - Lambayeque Campus, Peru, in the years 2016 and 2017. Materials and methods: A descriptive, retrospective and cross-sectional study was designed. The study comprised 321 clinical records that previously underwent a quality control stage, which included a calibration process (k=0.86). The criteria and rules proposed by Kennedy and Applegate were applied to estimate the prevalence of edentulism in each jaw according to sex; tables of frequency distribution containing percentage results were used. Results: The highest prevalence of partial edentulism in the upper jaw corresponded to Class III (42.4%), followed by Class I (34.6%), and Class II (16.5%). In the lower jaw, the most prevalent were Class I (42.4%), Class III (36.4%), and Class II (15.6%). According to sex, Class III and Class I were the most prevalent in both females and males. Conclusion: Class III and I were the most prevalent in the upper jaw in both females and males; while in the lower jaw, Classes I and III were the most prevalent for both sexes.

Conhecimento e a sua socialização na educação escolar para a pedagogia da autonomia de Paulo Freire

Este artigo visa compreender a visão de Paulo Freire acerca do conhecimento sistematizado e sua socialização na escola, na obra Pedagogia da autonomia: saberes necessários à prática educativa. (FREIRE, 2016a). O fio condutor da análise será a ontologia, pois é a partir da compreensão do nascedouro do homem enquanto ser social e a serviço do processo de humanização por ele idealizado, que Freire explicita sua visão sobre o conhecimento e desenvolve sua teoria pedagógica, sustentando-se em uma base teórica de inspiração existencialista cristã e na filosofia humanista moderna da educação, conforme esclarece Saviani (2008). Neste prisma, tomando por referência a Pedagogia histórico-crítica, sistematizada a partir obras de Saviani (2013) Duarte, (2016) e Martins (2013), entre outros teóricos caberá neste artigo uma comparação entre o sentido do conhecimento para pedagogia da autonomia e para a Pedagogia histórico-crítica. Nossa tentativa aqui é de capturar a essência do pensamento de Freire (2016a) sobre conhecimento, para compreender até que ponto a sua teoria poderá contribuir para criar uma condição irreversível, superior e revolucionária de humanização.

Devices for mechanical circulatory support and strategies for their management in cardiogenic shock.

Cardiogenic shock (CS) is a low cardiac-output state resulting in end-organ hypoperfusion and hypoxia that if untreated leads to an irreversible condition of multi-organ failure. Acute coronary syndrome (ACS) is the most common cause of CS, with a high prevalence of patients with multi vessels disease. Cardiogenic shock management remains a challenge since mortality rates are still high and have not declined over the last 20 years. The treatment strategy of CS in patients with ACS needs to take into account both the presence of myocardial ischemia and tissue hypoperfusion. The first part of the review will focus on the characteristics, the hemodynamic profile and the evidence available of the mechanical circulatory support devices for an optimal patient-device matching. The second part will focus on the management strategy of CS in terms of myocardial revascularization and hemodynamic support in light of the most recent available evidence.

Nanocarriers in effective pulmonary delivery of siRNA: current approaches and challenges.

Research on siRNA is increasing due to its wide applicability as a therapeutic agent in irreversible medical conditions. siRNA inhibits expression of the specific gene after its delivery from formulation to cytosol region of a cell. RNAi (RNA interference) is a mechanism by which siRNA is silencing gene expression for a particular disease. Numerous studies revealed that naked siRNA delivery is not preferred due to instability and poor pharmacokinetic performance. Nanocarriers based delivery of siRNA has the advantage to overcome physiological barriers and protect the integrity of siRNA from degradation by RNAase. Various diseases like lung cancer, cystic fibrosis, asthma, etc can be treated effectively by local lung delivery. The selective targeted therapeutic action in diseased organ and least off targeted cytotoxicity are the key benefits of pulmonary delivery. The current review highlights recent developments in pulmonary delivery of siRNA with novel nanosized formulation approach with the proven in vitro/in vivo applications.

Silibinin efficacy in a rat model of pulmonary arterial hypertension using monocrotaline and chronic hypoxia

BackgroundC-X-C chemokine receptor type 4 (CXCR4) may be involved in the development of pulmonary arterial hypertension (PAH). CXCR4 inhibitor AMD3100 was described to have a positive effect on the prevention of pulmonary arterial muscularization in PAH models. Silibinin is a traditional medicine that has an antagonistic effect on CXCR4. We investigated the effect of silibinin using rat models of PAH.MethodsPAH was induced by a single subcutaneous injection of monocrotaline. The rats were maintained in a chronic hypoxic condition (10% O2) with or without silibinin. To evaluate the efficacy of silibinin on PAH, right ventricular systolic pressure (RVSP), Fulton index (weight ratio of right ventricle to the left ventricle and septum), percent medial wall thickness (% MT), and vascular occlusion score (VOS) were measured and calculated. Immunohistochemical analysis was performed targeting CXCR4 and c-Kit. Reverse transcription-quantitative polymerase chain reaction was performed for the stem cell markers CXCR4, stromal cell derived factor-1 (SDF-1), c-Kit, and stem cell factor (SCF), and the inflammatory markers monocyte chemoattractant protein 1 (MCP1), interleukin-6 (IL-6), and tumor necrosis factor alpha (TNFα). Statistical analyses were performed using t-test and one-way analysis of variance with Bonferroni’s post hoc test.ResultsSilibinin treatment for 1 week reduced RVSP and Fulton index. Treatment for 2 weeks reduced RVSP, Fulton index, % MT, and VOS, as well as downregulating the expression of CXCR4, SDF-1, and TNFα in pulmonary arteries. In contrast, treatment for 3 weeks failed to ameliorate PAH. The time-course study demonstrated that RVSP, Fulton index, % MT, and VOS gradually increased over time, with a decrease in the expression of CXCR4 and TNFα occurring after 2 weeks of PAH development. After 3 weeks, SDF-1, c-Kit, and SCF began to decrease and, after 5 weeks, MCP1 and IL-6 gradually accumulated.ConclusionsThe CXCR4 inhibitor silibinin can ameliorate PAH, possibly through the suppression of the CXCR4/SDF-1 axis, until the point where PAH becomes a severe and irreversible condition. Silibinin results in reduced pulmonary arterial pressure and delays pulmonary arteriolar occlusion and pulmonary vascular remodeling.

Structural and functional changes in human aquaporin (AQP4) and its role in the symptoms of glaucoma

As the human body grows older, the eyes become susceptible to an array of conditions that are detrimental to their ability to perceive the world around them, the most severe being a complete loss of vision. Glaucoma is a disease that involves the gradual build‐up of fluid in the eye, an irreversible condition that puts pressure on the optic nerve and eventually renders the victim blind. The focus of this project is to investigate possible treatments on a molecular level for primary open‐angle glaucoma in its later stages. Human aquaporin‐4 (hAQP4), a protein that serves as a water channel in the cell membrane, was identified as a potential treatment for advanced primary open‐angle glaucoma due to its involvement in the production of the aqueous humor (jelly‐like fluid which gives the eye its shape) and its presence in the optic nerve. The Mahtomedi MSOE Center for BioMolecular Modeling MAPS Team used 3D modeling and printing technology to examine structure‐function relationships of hAQP4 in the optic nerve. hAQP4 is found in the eye along with hAQP1, but hAQP4 stands out for its high water permeability, a characteristic that has been attributed to the function of the side chains of asparagines 213 and 97. In hAQP4, these side chains hydrogen bond with a single water molecule at a time as opposed to several, as occurs within other hAQPs. In this poster, we investigate possible structural changes of hAQP4 that cause a buildup of fluid in the eye and how to reverse the effects. We are also exploring the medical implications of potential inhibitors of hAQP4. Being able to activate and deactivate hAQP4 has the potential to allow doctors to drain the fluid buildup in the eye and reverse the effects of glaucoma. Currently, several potential inhibitors of hAQP4 are being investigated, but none have been confirmed.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Surgical growth guidance with non-fused anchoring segments in early-onset scoliosis.

Surgical treatment of early-onset scoliosis (EOS) requires a balance between maintained curve correction and the capacity for spinal and thoracic growth. Spinal fusion creates irreversible conditions that prevent the implementation of further treatment methods. Our hypothesis was that non-fused anchors in growth guidance show a comparable outcome as the technique described in the literature, which involves spondylodesis of the anchoring segments. This retrospective study analysed 148 surgeries in 22 EOS patients (11 female, 11 male) over a 15-year period. Patients underwent surgery with non-fused anchors and growth guidance techniques. Scoliosis, kyphosis, growth and anchoring segments were measured. For the latter, a new measuring technique was developed. Complications were recorded and classified. The mean Cobb angle reduced from 73.5 ± 24.4° to 28.4 ± 16.2° (60.2 ± 22.9%, p < 0.001) at the last follow-up. Spinal growth T1-S1 and T1-T12 were 41.1 ± 23.3mm and 24.9 ± 16.6mm (p < 0.001), respectively. Growth at the cranial and caudal anchoring segment was 1.5mm/segment/year and 1.9mm/segment/year, respectively. A total of 63 complications were documented in 20 patients, with 40 requiring unplanned revision surgery. Definitive spondylodesis was performed in three patients. Patients demonstrated a significant spinal growth including the anchoring segments. A comparable correction in Cobb angle and the type of complications was noted, although the rate of device-related complications was higher. No permanent impairment was reported. The rate of device-related complications is acceptable and outweighed by the significant degree of growth preservation and more flexible and individualised treatment strategy for patients with EOS. These slides can be retrieved under Electronic Supplementary Material.

Synthesis of Ceramic and Glass Ceramic Matrices with Immobilized Cesium Radionuclides for Active Zones of Ionizing Radiation Sources

The present study was devoted to the development of alternative solutions related to replacement of highly dispersed powder of cesium chloride (137CsCl) used as a filler of active zones of g-radiation IRSs (ionizing radiation sources of the closed type) by safer and more efficient in operation highly compacted ceramic or glass ceramic material. An advanced method of fabrication of highly compacted (density of ~99.8 % of the theoretical one) aluminosilicate (artificial NaA zeolites) ceramic and glass ceramic matrices characterized with high construction strength (compression strength ~149 MPa) applicable for reliable immobilization of cesium radionuclides (leaching rate &lt;10-5–10-6g/cm2×day) has been suggested. Unique matrices properties are ensured by advanced features of the technology of Spark Plasma Sintering (SPS) based on high-rate electro-pulse consolidation of the radioactive charge (adsorbed cesium content ~22.16 mass %) into thermodynamically stable ceramics or glass ceramics. The earlier unstudied features of the SPS consolidation of natural zeolite powders sorption-saturated with a radioactive cesium simulant are presented, including the dynamics of their compaction and specifics of phase and structural transformations under effect of irreversible spark plasma conditions.

Reversal of bleomycin-induced rat pulmonary fibrosis by a xenograft of human umbilical mesenchymal stem cells from Wharton's jelly.

Pulmonary fibrosis (PF) is a progressive and irreversible condition with various causes, and no effective treatment has been found to rescue fibrotic lungs. Successful recovery from PF requires inhibiting inflammation, promoting collagen degradation and stimulating alveolar regeneration. Human umbilical mesenchymal stem cells (HUMSCs) not only regulate immune responses but also synthesize and release hyaluronan to improve lung regeneration. This study investigated the feasibility of HUMSC engraftment into rats with bleomycin (BLM)-induced PF to explore HUMSC therapeutic effects/outcomes.Methods: A unique BLM-induced left-lung-dominated PF animal model was established. Rats were transplanted with low-dose (5×106) or high-dose (2.5×107) HUMSCs on Day 21 after BLM injection. Combinations in co-culture of pulmonary macrophages, fibroblasts, HUMSCs treated with BLM and the same conditions on alveolar epithelia versus HUMSCs were evaluated.Results: Rats with high-dose HUMSC engraftment displayed significant recovery, including improved blood oxygen saturation levels and respiratory rates. High-dose HUMSC transplantation reversed alveolar injury, reduced cell infiltration and ameliorated collagen deposition. One month posttransplantation, HUMSCs in the rats' lungs remained viable and secreted cytokines without differentiating into alveolar or vascular epithelial cells. Moreover, HUMSCs decreased epithelial-mesenchymal transition in pulmonary inflammation, enhanced macrophage matrix-metallopeptidase-9 (MMP-9) expression for collagen degradation, and promoted toll-like receptor-4 (TLR-4) expression in the lung for alveolar regeneration. In coculture studies, HUMSCs elevated the MMP-9 level in pulmonary macrophages, released hyaluronan into the medium and stimulated the TLR-4 quantity in the alveolar epithelium.Principal Conclusions: Transplanted HUMSCs exhibit long-term viability in rat lungs and can effectively reverse rat PF.

SU102 - GENOME-WIDE ASSOCIATION OF TARDIVE DYSKINESIA

Background Tardive Dyskinesia (TD) is a persistent and potentially irreversible condition associated with long term exposure to antipsychotics. Commonly observed in schizophrenia, TD is a movement disorder characterised by involuntary movements of orofacial muscles, trunk and limbs. TD appears to represent a genetically complex phenotype, with candidate gene and genome-wide studies identifying a collection of genes. The pathophysiology of TD is still unclear and the genetic factors predisposing TD across ancestries remain relatively unexplored. Here, we performed a GWAS of TD in a sample of East Asians, European and African-American ancestries. Methods Two available datasets were used: 780 schizophrenia patients of Chinese ethnicity from Singapore and 626 schizophrenia patients of European and African ancestry from the CATIE cohort. Dyskinesia was rated on the Abnormal Involuntary Movement Scale (AIMS) and TD case ascertainment followed the Schooler and Kane criteria. Standard GWAS QC procedures were carried out. Imputation was carried out on the Sanger imputation server; markers were phased via SHAPEIT and imputed via Minimac3 (MACH) to the 1000 Genomes Project Phase 3 reference panel (GRch37). To address complex ancestry effects, linear mixed model association was carried out via GEMMA. Fixed-effects meta-analysis was conducted via GWAMA. Results Meta-analysis revealed one locus on chr16 (rs11639774), which met the GWAS significant threshold (Z=5.551, p=3.09e-8). Three other loci of interests were at subthreshold significance; these were found on chromosomes 1 (rs499646, p=8.48e-8), 6 (rs6926250, p=2.59e-7) and 12 (rs4237808, p=1.1e-7) respectively. Further investigation revealed that these four loci harboured i) downstream gene variant (rs11639774) ii) intronic variants (rs499646, rs6926250) and iii) intergenic variant (rs4237808). Though MAGMA gene-set analysis did not reveal significant gene-based results, one of the top gene-sets appeared to implicate immunoglobulin production. Further gene prioritization of the top 200 associated genes revealed unique brain expression profiles. Notably, several pathways emerged that point to DNA damage and immune responses. Discussion Here we report the largest TD GWAS study to date and evidence for a significant GWAS locus for TD and three other candidate loci of interest. This suggests an inherent vulnerability to TD, which might be brought about by long term antipsychotic exposure. Of interest, the role of immune system in the aetiopathogenesis of TD warrants further research.

Role of SOD3 in silica-related lung fibrosis and pulmonary vascular remodeling

BackgroundWork-place exposure to silica dust may lead to progressive lung inflammation culminating in the development of silicosis, an irreversible condition that can be complicated by onset of pulmonary hypertension (PH). The molecular mechanisms leading to the development of PH and lung fibrosis in response to silica are not well understood. Oxidant/antioxidant imbalance in the lung may promote fibroproliferation and vascular smooth muscle proliferation, ultimately leading to the development of PH. Herein, we analyze the development of PH and lung fibrosis in mice deficient in extracellular superoxide dismutase (SOD3), an enzyme with anti-oxidant activity.MethodsPH and silicosis were induced in wild-type and Sod3−/− mice through intratracheal injection of crystalline silica at dose 0.4 g/kg. Pulmonary hypertension and lung fibrosis were characterized by changes in right ventricular systolic pressure (RVSP) and collagen deposition 28 days following silica injections. Vascular remodeling was analyzed using immunohistochemistry and morphometric analysis. The expression of genes were analyzed using qRT-PCR and Western blot.ResultsC57BL6 mice exposed to silica showed attenuated expression of Sod3 in the lung suggesting a protective role for Sod3. Consistent with this, Sod3−/− mice developed more severe fibrotic inflammatory nodules with increased collagen deposition. Furthermore, the expression of genes involved in tissue remodeling (Timp1), fibrotic lesion formation (Fsp1) and inflammatory response (Mcp1) were significantly elevated in Sod3−/− mice compared to Sod3+/+ mice treated with silica. Infiltration of neutrophils and activated macrophages into affected lung was significantly higher in Sod3 deficient mice. In addition, silica produced more profound effects on elevation of RVSP in Sod3−/− compared to wild-type littermate. Increase in RVSP was concomitant with hypertrophy of pulmonary arteries located in silicotic nodules of both mouse strains, however, vascular remodeling in unaffected areas of lung was detected only in Sod3−/− mice.ConclusionsOur data suggest that Sod3 and extracellular oxidative stress may play an important role in the development of pneumoconiosis and pulmonary vascular remodeling following exposure to environmental and occupational silica.

Efficiency at Maximum Power of Dissipative Thermoelectric Generators: A Finite-time Thermodynamic Analysis

In this paper we analyze the thermodynamic efficiency expected for a fully dissipative thermoelectric generator (TEG) operating under stationary conditions at a finite rate. Although a finite-time thermodynamic analysis of TEGs has been aimed at since long time, no complete theory is available yet. The state of the art of theory is reviewed, and a simple expression for the maximum achievable efficiency of TEGs operating under fully irreversible conditions is obtained. This also sets a reference efficiency for forthcoming studies of nonstationary operation of TEGs.

Significance of molecular biomarkers in idiopathic pulmonary fibrosis: A mini review.

Idiopathic pulmonary fibrosis (IPF) is a chronic, irreversible condition with poor prognosis that is characterized by a variable clinical course in each patient, which renders it a complex disease with unknown causes. Despite the proven efficacy of novel antifibrotic therapies, including pirfenidone and nintedanib, the diagnosis and follow-up of IPF remain challenging. Hence, the identification of molecular biomarkers for early detection of IPF and to predict biologically determined individual clinical courses, has recently piqued the interest of researchers. Previous studies have demonstrated the diagnostic and prognostic efficacy of blood proteins such as KL-6, Surfactant protein (SP)-A, and SP-D, in patients with IPF. Due to their use in clinical practice in Japan, for approximately twenty years, a significant amount of data about these biomarkers has been accumulated. This paper reviews the recent literature on molecular biomarkers for IPF that have been developed in Japan as well as other potential molecular biomarkers.

Partial Edentulism in Patients Visiting the Dental Out-Patient Department at the Tertiary Care Centre in the Eastern Part of Nepal

Introduction: Partial edentulism is an irreversible condition resulting from various dental diseases like dental caries and periodontal lesions. Loss of teeth produces deleterious effects on masticatory function, phonetics, facial appearance and comfort of the patients. If not restored on time, it can lead to pathological changes in vertical dimension, occlusion and temporomandibular joint.&#x0D; Methods: This study was conducted in the department of Prosthodontics, CODS, BPKIHS from September 2015 to March 2016. All patients above the age of 14 years presenting with partial loss of dentition and willing to give informed consent were included in the study. Data regarding age, gender, missing teeth, cause of permanent tooth loss and age of first permanent tooth loss were collected from 750 patients.&#x0D; Results: Dental caries was the major cause of tooth loss accounting for 60.5% of the study population followed by periodontal disease (14.0%) and trauma (11.9%). First permanent tooth loss was highest in the age group of 35-44 years (22.9%). The most common type of partial edentulism was found to be Kennedy’s class III followed by class IV, class I and class II in both the arches.&#x0D; Conclusions: The most common cause of permanent tooth loss was dental caries in the study population. The first permanent tooth loss was found to be highest in age group 35-44 years. The most common type of partial edentulism was the Kennedy's class III in both the arches.

Optimalisasi Stand-Alone Photovoltaic System dengan Implementasi Algoritma P&amp;O-Fuzzy MPPT

The need for electrical energy continues to increase every time. Concerns about the depletion of fossil energy reserves encourage the acceleration of the development of renewable energy use. One of renewable energy is the solar energy. Due to the irreversible irradiation conditions, it takes controls to keep the solar panel's maximum power. The most widely in Maximum Power Point Tracking (MMPT) is Perturb Algorithm and Observe (P&amp;O) but P&amp;O Algorithm has deficiency of oscillations when steady state and MPP trace errors when irradiation changes rapidly. In this paper proposed P &amp; O-Fuzzy algorithm is a modification of conventional P &amp; O to improve the efficiency of solar panels. This research uses Matlab for simulation and hardware implementation using microcontroller Arduino Uno and buck converter topology. The result of simulation and hardware implementation, conventional P &amp; O has an average efficiency of 85.03% while MPPT modification with P &amp; O-Fuzzy algorithm can improve MPP tracking efficiency with 89.67%.

Elementos fisiológicos y fisiopatológicos en la Fluorosis dental

La Fluorosis dental es una enfermedad grave que implica además un problema estético, caracterizada por una anomalía de las piezas dentales, que es el primer signo de que la persona ha estado expuesta a niveles elevados de flúor, en el Ecuador su prevalencia es mayor en la región andina. Objetivo: Realizar una revisión sistemática y crítica de la literatura sobre la Fluorosis dental. Material y Métodos: Se efectuó una revisión sistemática y crítica de la literatura, usando motores de búsqueda de artículos indexados en Scopus, Latindex, Scielo sobre el tema Fluorosis Dental. Resultados: La revisión sistemática de la Literatura permitió analizar 20 artículos publicados en revistas indexadas sobre el tema Fluorosis Dental, evidenciándose que es una condición irreversible causada por la ingestión excesiva de fluoruros presentes en el medio ambiente, alimentos, pastas dentales, agua, enjuagues, que afecta no solo a la estética sino fundamentalmente a la formación y maduración normal de las estructuras del esmalte en dentición temporal y definitiva en grupos etarios comprendidos entre 1 - 18 años. Se analizó la documentación y se evidenció que entre los factores determinantes de la salud para esta patología tenían mayor relevancia los biológicos, sociales, medio ambientales y la asistencia sanitaria estableciendo que el patrón común de la patología era el suministro de agua y de ahí su posibilidad de prevención. Por ser el agua la fuente principal de fluoruros y su fluorización, hace varios años, se constituyó en estrategia, asumida por varios países como medio de prevención de caries, hoy por el contrario se prohíbe, al considerar que el consumo de alimentos y bebidas embotelladas, los efectos aditivos de los dentífricos y suplementos fluorados son suficientes y están dentro del límite establecido de aporte al organismo. Conclusiones: La Fluorosis dental puede ser evitable regulando la fluorización del agua de consumo en las comunidades andinas.

Thiamine and Alcohol for Brain Pathology: Super-imposing or Different Causative Factors for Brain Damage?

Drinking more than the recommended limits is a worldwide emerging problem, difficult to circumscribe, and alcohol-related brain damages are an under-recognized health problem. Alcohol-cognitive disruption can be considered as transient and recoverable if the alcohol consumption is limited and occasional; if not, it can progress to the so-called Alcohol-Related Dementia (ARD), or to the Wernicke encephalopathy, or it can even induce the Korsakoff syndrome, an irreversible and long-lasting medical condition. ARD still remains poorly diagnosed and addressed, despite having increased research interest being a frustrating condition, a relatively non-progressive, or even partially reversible condition in abstinent ex-drinkers. On the contrary, Wernicke encephalopathy, with its neurological symptoms (ocular coordination imbalance and gait ataxia), is a dramatic medical condition, potentially lethal which can lead towards Korsakoff dementia. The alcohol consumption is a strong reinforcing condition of the thiamine deficit, the main biochemical determinant factor that starts the cascade of the brain irreversible damaging events. Our review focuses on the possible common neural pathways of this three condition, on the biochemical basis of the damages, and tries to underline the strong need of better understanding the pathogenesis of the brain lesions, including epigenetics and the nutritional aspects of the problem.

Serious somatic disease as a limit-experience: clinical aspect of end-stage renal disease

Terminal kidney failure is a serious and irreversible somatic condition. The ordeal of the disease can undermine the internal identity markers of patients, prey to unbearable anxieties, exposing them to formlessness and a vacillating identity.

Chinese Herbal Medicine as a Potential Treatment of Abdominal Aortic Aneurysm.

Abdominal aortic aneurysm (AAA) is an irreversible condition where the abdominal aorta is dilated leading to potentially fatal consequence of aortic rupture. Multiple mechanisms are involved in the development and progression of AAA, including chronic inflammation, oxidative stress, vascular smooth muscle (VSMC) apoptosis, immune cell infiltration and extracellular matrix (ECM) degradation. Currently surgical therapies, including minimally invasive endovascular aneurysm repair (EVAR), are the only viable interventions for AAAs. However, these treatments are not appropriate for the majority of AAAs, which measure <50 mm. Substantial effort has been invested to identify and develop pharmaceutical treatments such as statins and doxycycline for this potentially lethal condition but these interventions failed to offer a cure or to retard the progression of AAA. Chinese herbal medicine (CHM) has been used for the management of cardiovascular diseases for thousands of years in China and other Asian countries. The unique multi-component and multi-target property of CHMs makes it a potentially ideal therapy for multifactorial diseases such as AAA. In this review, we review the current scientific evidence to support the use of CHMs for the treatment of AAA. Mechanisms of action underlying the effects of CHMs on AAA are also discussed.