Oxygen reduction in alkaline medium at thin MnxCo3−xO4 (0≤x≤1) spinel films prepared by spray pyrolysis. Effect of oxide cation composition on the reaction kinetics

We have studied the relationships between the cation distributions in bulk and on the surface and the electrocatalytical reactivity towards the oxygen reduction reaction (orr) on thin film electrodes of cobalt and manganese spinel type oxides Mn_xCo_3?xO₄ (0≤x≤1). The cationic distributions were computed from XRD, XPS, magnetism and oxidation power measurements showing the presence of the Co³⁺/Co²⁺ and Mn⁴⁺/Mn³⁺ solid state redox couples and also vacancies in octahedral sites. The electrocatalytic activity and kinetic parameters for the orr were determined using the RRDE technique in 1 M KOH solution at 25 °C. Two Tafel zones of slopes b_c1 and b_c2 around ?60 and ?120 mV dec^?1 were observed. The disk current/ring current ratio, (I_D/I_R), increases with x and decreases with the applied overpotential. At constant overpotential η the real electrocatalytical current densities j increase when x increases. The orr can be characterized by an intrinsic kinetic parameter J′ obtained from this current ratio at various electrode rotational frequencies. This J′ increases with the redox couple Co²⁺/Co³⁺ ratio, increasing more in the bulk than at the surface of the electrode.     

Podocytes are new cellular targets of haemoglobin‐mediated renal damage

Recurrent and massive intravascular haemolysis induces proteinuria, glomerulosclerosis, and progressive impairment of renal function, suggesting podocyte injury. However, the effects of haemoglobin (Hb) on podocytes remain unexplored. Our results show that cultured human podocytes or podocytes isolated from murine glomeruli bound and endocytosed Hb through the megalin–cubilin receptor system, thus resulting in increased intracellular Hb catabolism, oxidative stress, activation of the intrinsic apoptosis pathway, and altered podocyte morphology, with decreased expression of the slit diaphragm proteins nephrin and synaptopodin. Hb uptake activated nuclear factor erythroid‐2‐related factor 2 (Nrf2) and induced expression of the Nrf2‐related antioxidant proteins haem oxygenase‐1 (HO‐1) and ferritin. Nrf2 activation and Hb staining was observed in podocytes of mice with intravascular haemolysis. These mice developed proteinuria and showed podocyte injury, characterized by foot process effacement, decreased synaptopodin and nephrin expression, and podocyte apoptosis. These pathological effects were enhanced in Nrf2‐deficient mice, whereas Nrf2 activation with sulphoraphane protected podocytes against Hb toxicity both in vivo and in vitro. Supporting the translational significance of our findings, we observed podocyte damage and podocytes stained for Hb, HO‐1, ferritin and phosphorylated Nrf2 in renal sections and urinary sediments of patients with massive intravascular haemolysis, such as atypical haemolytic uraemic syndrome and paroxysmal nocturnal haemoglobinuria. In conclusion, podocytes take up Hb both in vitro and during intravascular haemolysis, promoting oxidative stress, podocyte dysfunction, and apoptosis. Nrf2 may be a potential therapeutic target to prevent loss of renal function in patients with intravascular haemolysis. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Intracranial Aneurysm: Diagnostic Monitoring,Current Interventional Practices,and Advances

Purpose of review

Cerebral aneurysms are commonly diagnosed incidentally with non-invasive neuro-imaging modalities (i.e., brain MRA and/or head CTA). The first decision to be made in the management of patients with unruptured cerebral aneurysms is to determine if the aneurysm should undergo treatment as any intervention carries a risk of morbidity and mortality.

Recent findings

The multiple risk factors that are associated with increased risk of aneurysm rupture should be evaluated (size, shape, and location of aneurysm; history of hypertension and cigarette smoking and family history of cerebral aneurysms). With the advent and rapid evolution of less traumatic neuro-endovascular surgery techniques in the past two decades, many more patients are undergoing treatment of cerebral aneurysms. The neuro-endovascular surgeon has multiple options for the treatment of aneurysms including coiling, with or without balloon/stent assistance, and flow diversion. A number of intrasaccular devices for the neuro-endovascular treatment of cerebral aneurysms are being evaluated. The percentage of patients with cerebral aneurysms treated with craniotomy and clip ligation is decreasing. This is controversial as it has direct impact in neurosurgical training and the aneurysms that are usually recommended for microsurgical clipping are the ones with challenging anatomy that cannot be treated safely with endovascular approaches.

Summary

The best outcomes are achieved with management by experienced, high-volume practitioners at specialized cerebrovascular treatment centers that consist of individuals with dedicated training in neuro-endovascular surgery as well as individuals trained in open cerebrovascular neurosurgery.