Cross-sectional study of 168 patients with hepatorenal tyrosinaemia and implications for clinical practice

Background: Hepatorenal tyrosinaemia (Tyr 1) is a rare inborn error of tyrosine metabolism. Without treatment, patients are at high risk of developing acute liver failure, renal dysfunction and in the long run hepatocellular carcinoma. The aim of our study was to collect cross-sectional data. Methods. Via questionnaires we collected retrospective data of 168 patients with Tyr 1 from 21 centres (Europe, Turkey and Israel) about diagnosis, treatment, monitoring and outcome. In a subsequent consensus workshop, we discussed data and clinical implications. Results: Early treatment by NTBC accompanied by diet is essential to prevent serious complications such as liver failure, hepatocellular carcinoma and renal disease. As patients may remain initially asymptomatic or develop uncharacteristic clinical symptoms in the first months of life newborn mass screening using succinylacetone (SA) as a screening parameter in dried blood is mandatory for early diagnosis. NTBC-treatment has to be combined with natural protein restriction supplemented with essential amino acids. NTBC dosage should be reduced to the minimal dose allowing metabolic control, once daily dosing may be an option in older children and adults in order to increase compliance. Metabolic control is judged by SA (below detection limit) in dried blood or urine, plasma tyrosine (<400 μM) and NTBC-levels in the therapeutic range (20-40 μM). Side effects of NTBC are mild and often transient. Indications for liver transplantation are hepatocellular carcinoma or failure to respond to NTBC. Follow-up procedures should include liver and kidney function tests, tumor markers and imaging, ophthalmological examination, blood count, psychomotor and intelligence testing as well as therapeutic monitoring (SA, tyrosine, NTBC in blood). Conclusion: Based on the data from 21 centres treating 168 patients we were able to characterize current practice and clinical experience in Tyr 1. This information could form the basis for clinical practice recommendations, however further prospective data are required to underpin some of the recommendations.

Resolución N° 168 del 20 de septiembre de 2010 ¿A la cámara de comercio le es dable controlar el requisito de las mayorías para la inscripción de un acta de nombramiento de administradores de una sociedad limitada?

Servicios registrales

HG 168.50-168.60

Brown sediment with three main domains; two different fine grained domains and one coarse grained domain. The fine grained domains can be distinguished based on the abundance of organic material (darker). Both domains contain lineations. The coarse grained domain contains clasts ranging from small to medium in size and angular to rounded in shape. Rotation structures, lineations and comet structures can be seen in this domain. It also contains some fractured grains.

Postcard - H.K. Woodruff's Residence at 168 Ontario Street, St. Catharines

A black and white postcard of H.K. Woodruff's residence at 168 Ontario Street, St. Catharines, Ontario. It is described on the reverse by R. Band in 1977.

Correlation of temperature induced conformation change with optimum catalytic activity in the recombinant G/11 xylanase A from Bacillus subtilis strain 168 (1A1)

The 1.7 angstrom resolution crystal structure of recombinant family G/11 beta-1,4-xylanase (rXynA) from Bacillus subtilis 1A1 shows a jellyroll fold in which two curved P-sheets form the active-site and substrate-binding cleft. The onset of thermal denaturation of rXynA occurs at 328 K, in excellent agreement with the optimum catalytic temperature. Molecular dynamics simulations at temperatures of 298-328 K demonstrate that below the optimum temperature the thumb loop and palm domain adopt a closed conformation. However, at 328 K these two domains separate facilitating substrate access to the active-site pocket, thereby accounting for the optimum catalytic temperature of the rXynA. (c) 2005 Federation of European Biochemical Societies. Published by Elsevier B.V. All rights reserved.

Caracterização estrutural e biofísica de duas proteínas relacionadas: β-1,3-1,4-glicanase de Bacillus subtilis 168 e α-L-arabinofuranosidase termoestável de Thermotoga petrophila RKU-1

Pós-graduação em Biofísica Molecular - IBILCE

Da apropriação indébita previdenciária (Art. 168-A, parágrafo 1, Inciso I do Código Penal) e sua efetiva materialização no plano da tipicidade

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)