Liquid chromatography quadrupole time-of-flight mass spectrometry quantification and screening of organophosphate compounds in sludge.

For the first time, we assess the performance of liquid chromatography (LC) quadrupole time-of-flight (QTOF) mass spectrometry (MS) for the selective quantification of eight organophosphate compounds (OPs), used as plasticizers and flame retardants additives, in sludge from urban sewage treatment plants (STPs). Moreover, the usefulness of accurate, full scan MS and MS/MS spectra to screen and to confirm the presence of additional OPs, without using reference standards, in sludge samples is discussed. Matrix solid-phase dispersion (MSPD) was used as a sample preparation technique. Under optimized conditions, MSPD provided quantitative recoveries for the group of targeted analytes, requiring just 15 mL of solvent and integrating extraction and clean-up processes in the same step. For these species, the achieved limits of quantification (LOQs) varied between 2 and 50 ng g(-1) and the efficiency of electrospray ionization (ESI) did not change significantly between pure standards and sludge extracts. Among targeted OPs, tri(chloroisopropyl) phosphate (TCPP), tributoxyethyl phosphate (TBEP) and triphenyl phosphate (TPP) were ubiquitous in sludge. The average concentrations of TCPP and TBEP stayed above 700 ng g(-1), whereas the mean value for TPP was 67 ng g(-1). Full scan, accurate spectra provided relevant clues for the screening of additional OPs, using a database containing just their empirical formulae and exact molecular weights; however, the occurrence of in-source fragmentation processes hampered the detection and correct identification of those species which did not render the expected [M+H](+) molecular ion, as was the case of 2-ethylhexyl-diphenyl phosphate (EHDPP).

[Pediatric steatohepatitis: is it only obesity?]. / Steatoepatite in un bambino obeso: solo questione di peso?

We describe the case of an 11-year-old obese child with nonalcoholic steatohepatitis and Wilson's disease. Nonalcoholic steatohepatitis, although frequently found in patients with obesity, can also be caused by other etiologies, including Wilson's disease, which must therefore always be ruled out in the obese child.

[Acute appendicitis. Experimental model in rabbits]. / Apendicite aguda. Modelo experimental em coelhos.

The evolving phases of acute appendicitis were studied experimentally. Sixty female rabbits (Oryctogalus cuniculus) of New Zealand lineage weighing about 2510 to 3040 g were divided in two groups: a control group and experimental group. The experimental group was divided into three subgroups for observation after 12, 24 and 48 hours of the operation, that consisted on a 4-0 polypropylene circular suture at 8 cm from the distal part of the cecal appendix. The control group was sham operated. The macroscopic exam (increase of the appendix volume, necrosis, perfuration, adherence and secretion in the abdominal cavity) and the microscopic finding showed a progression in the anatomopathological alterations. There was a close relationship between the histopathological findings and time after the appendiceal obstruction. We conclude that the method causes acute appendicitis and that the anathomo pathological alterations depends on the time elapsed between the operation and the postoperation findings.

Diagnosing pediatric epilepsy: an update for the primary care clinician.

Epilepsy is a chronic disorder that first appears in childhood. Seizure types and presentation vary from dramatic and obvious to subtle and discrete. Accurate identification of the seizure type is imperative to ensure proper disease management. The International league Against Epilepsy has developed two classification systems--the classification of Epileptic Seizures and the classification of Epilepsies and Epileptic Syndromes--to assist in the provision of an International language of epilepsy, to improve the diagnosis and management of seizures, and to establish prognostic criteria. Knowledge of the classification systems of seizures, seizure types, and management of seizures is essential in the delivery of health promotion, disease prevention, and anticipatory guidance for the child with epilepsy. The primary care practitioner is often the first person consulted when medical questions or problems arise, and therefore is in a key position to detect seizures, monitor treatment, and educate the family. A comprehensive knowledge of pediatric epilepsy will allow the practitioner to provide the additional resources needed to coordinate the care of this special population.