Institute of Chartered Accountants of Nigeria

About: Institute of Chartered Accountants of Nigeria is a based out in . It is known for research contribution in the topics: Population & Adipose tissue. The organization has 528 authors who have published 579 publications receiving 18688 citations.

The Adipose Tissue: Storage, Source, and Target of Pollutants

Abstract: The adipose tissue plays an important role in the toxicokinetics of Persistent Organic Pollutants. This tissue may have a protective function in case of acute or subacute exposure: it can take up these pollutants and thereby prevent their localization in other more sensitive tissues. In the long run, the adipose tissue constitutes an endogenous source of chronic low-grade exposure. This is revealed in case of weight loss. The adipose tissue is also a target of toxicants which alter signaling pathways, differentiation programs and induce inflammation.

Critical limits for urgent clinician notification at South African intensive care units.

Abstract: Summary Background Critical value policies are used by clinical laboratories to decide when to notify caregivers of life-threatening results. There, however, remains much debate regarding which tests should be included in critical value lists and clinically relevant limits. Method An electronic survey was designed to determine the critical value policies of specialists for haematology tests in South African intensive care units. Data collected included a demographic component, critical value policies and critical value reporting. Results There were 68 respondents who represented a range of specialists from different disciplines. Four key critical values were identified, namely white cell count (WCC), haemoglobin, platelet count and international normalised ratio (INR). Median low and high adult and paediatric critical limits for the most frequently listed tests were as follows: haemoglobin 20 g/dL, platelet count 1000 × 109/L, WCC 20 × 109/L and INR > 4. Specific critical limits for neonates were reported by 20 of the respondents. Of the respondents, 95.92% indicated that it was important to be contacted with first-time critical results and approximately half for repeat critical values. The majority preferred that the person notified of the critical value be the caregiver directly involved with the patient's care. Conclusion It is important for critical value policies to be reviewed by each discipline to ensure cut-offs are clinically relevant.

Genetic and Acquired Lipodystrophic Syndromes

Abstract: Lipodystrophic syndromes are rare conditions of genetic or acquired origin in which total or partial fat loss is associated with severe hypertriglyceridemia and insulin resistance leading to early diabetes, cardiovascular, and hepatic complications. Recent advances in genetics have shown that, although genetic lipodystrophies are heterogeneous, most of them result from primary alterations in genes involved in adipogenesis, triglyceride fat storage, and/or formation of the unique adipocyte lipid droplet. Acquired forms could be iatrogenic or linked to immune and/or endocrine factors. The most common are secondary to treatment with some human immunodeficiency virus (HIV)-antiretrovirals or to endogenous or exogenous excess of cortisol. Overall, the reduced adipose tissue amount and expandability alters its capacity to buffer excess caloric intake, leading to ectopic lipid accumulation responsible for insulin resistance and cellular dysfunctions. Increased lipolysis and production of inflammatory mediators also participate to this “lipotoxicity” phenotype with increased oxidative stress, insulin resistance, and fat remodeling. The treatment of lipodystrophic syndromes is difficult. Lifestyle modifications, insulin sensitizers, and lipid-lowering molecules are generally insufficient. Very high doses of insulin are frequently needed. New therapeutic options as recombinant human leptin substitution could be helpful in patients with severe metabolic complications.