['Writer of the soul' - Virginia Woolf's bipolar disorder in light of her life story and traumatization].

Virginia Woolf was one of the most talented and innovative writers of the 20th century. In our study, we review the family background of Virginia Woolf, affective spectrum disorders occuring in her family, as well as the genetic and psychosocial factors, such as the writer's childhood traumatization and coping strategies, which influenced the course and symptoms of her bipolar disorder. We summarize the data which are related to the supposed neuroprogressive processes and suicidal behaviour.

Giant and multiple cardiac papillary fibroelastomas masquerading as acute cerebrovascular events.

Cardiac papillary fibroelastomas are rare benign cardiac tumors. Their clinical significance results from their very high propensity for embolization. We present two such cases, which are rare regarding the size and multiplicity of these tumors.

Phenolic composition, antioxidant and antinociceptive activities of Syringa vulgaris L. bark and leaf extracts.

Metabolite profile, antioxidant and antinociceptive activities of Syringa vulgaris bark and leaf methanolic extracts were investigated. By means of HPLC-DAD-ESI-TOF and HPLC-DAD-ESI-MS/MS, a total of 33 phenolics were identified, including 15 secoiridoids, 6 phenylpropanoids, 3 flavonoids, 3 lignans and 6 low molecular weight phenols. Validated quantitative analysis show that syringin (2.52%) and rutin (1.13%) are the main phenolic compounds in bark and leaf, respectively. Notable radical scavenging and antinociceptive activities of the bark and leaf extracts were confirmed by in vitro DPPH● and ABTS●+ assays and by in vivo hot-plate method in mice, respectively. Our results could lay the scientific basic of future clinical perspectives of lilac bark and leaf.

Three newly identified lipophilic flavonoids in Tanacetum parthenium supercritical fluid extract penetrating the Blood-Brain Barrier.

Feverfew (Tanacetum parthenium L.) as a perennial herb has been known for centuries due to its medicinal properties. The main sesquiterpene lactone, parthenolide is considered to be responsible for the migraine prophylactic effect, however the pharmacological benefits of the lipophilic flavonoid components can not be neglected. Supercritical fluid extraction (7% ethanol, 22MPa, 64°C) was carried out on the leaves of Tanacetum parthenium L. from which the presence of methylated flavonoids beside parthenolide and other sesquiterpene lactones were indicated by preliminary LC-MS analyses. Specific Parallel Artificial Membrane Permeability Assay (PAMPA) was applied to identify the components capable to cross the Blood-Brain Barrier (BBB). Three lipophilic flavonoids were detected on the acceptor side, that were isolated (Prep-HPLC) and identified as sudachitin, aceronin and nevadensin (LC-MS/MS, NMR). These flavonoids were also characterized individually by PAMPA-BBB model. The presence of sudachitin and nevadensin was proven in the Asteraceae family, but neither of the three flavonoids were reported in Tanacetum parthenium L.

Contribution of individual flavonoids in Lysimachia species to the antioxidant capacity based on HPLC-DPPH assay.

Quantitative phytochemical characterisation of the chief flavonoid aglycones in the hydrolysed Lysimachia extracts revealed the dominance of kaempferol, quercetin and myricetin in L. vulgaris, L. nummularia, L. punctata, L. christinae, L. ciliata and L. clethroides, respectively. Due to the significant radical scavenging capacity of the samples, the contribution of the individual aglycones to the total antioxidant activity became of interest. Therefore, a HPLC method coupled to pre-column DPPH scavenging assay was developed. Differences in the six Lysimachia species' phenolic composition regarding their participation to the antioxidant activity were revealed. The participation of the three investigated flavonoids to the radical quenching activity was the highest (91.2%) in the L. vulgaris sample, the lowest in L. christinae sample with 29.6%. In L. vulgaris sample, the 76.3% contribution of quercetin to the scavenger capacity was the highest peak area decrement ratio among the investigated samples.

Convergence chromatographic determination of camphor in the essential oil of Tanacetum parthenium L.

Feverfew (Tanacetum parthenium L., Asteraceae) is a perennial medicinal plant which has been used to alleviate the symptoms of migraine, headache and rheumatoid arthritis and possesses numerous pharmacological activities. An ultra-high-performance supercritical fluid chromatographic method (UHPSFC) was developed and validated in accordance with the International Conference on Harmonization guidelines in order to determine the camphor content of the volatile oil, which was accurate, precise, robust and selective. The method was validated for specificity, accuracy (100.2%), repeatability and intermediate precision, linearity (r2 > 0.999), limit of detection (2.055 µg/mL), limit of quantification (6.228 µg/mL) and robustness. The common range of accuracy and linearity was between 0.125 and 1.000 mg/mL. Steam distillation was carried out in order to study the essential oil yield of three different T. parthenium L. samples originating from Hungarian medicinal herb collections. The camphor content of the essential oils from the aerial parts of feverfew samples from different origin was compared. Although the composition of the essential oil is well reported, a validated quantitative UHPSFC method for the determination of the constituents is presented herein for the first time.

A new ultra-high pressure liquid chromatography method for the determination of antioxidant flavonol aglycones in six Lysimachia species.

UPLC-DAD method was developed and validated for the quantitative determination of free flavonol aglycones (kaempferol, quercetin and myricetin) after acidic hydrolysis in six Lysimachia species. Quantitative analyses showed that the amounts of various flavonol aglycones were significantly different in Lysimachia vulgaris, Lysimachia nummularia, Lysimachia punctata, Lysimachia christinae, Lysimachia ciliata and Lysimachia clethroides. The L. clethroides sample was found to be the richest in kaempferol (25.77 ± 1.29 µg/mg extract) and quercetin (97.67 ± 4.61 µg/mg extract), while the L. nummularia sample contained the highest amount of myricetin (20.79 ± 1.00 µg/mg extract). The antioxidant capacity of hydrolysed extracts was evaluated using in vitro DPPH(•) (2,2-diphenyl-1-picrylhydrazyl) and ABTS(•+) [2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulphonic acid)] decolourisation tests. The observed radical scavenging capacities of the extracts showed a relationship with the measured flavonol aglycone content and composition. The acidic treatment resulted in an increased free radical scavenging activity compared to the untreated methanol extract.

Characterization of antioxidant phenolics in Syringa vulgaris L. flowers and fruits by HPLC-DAD-ESI-MS.

In this study the polyphenolic composition of lilac flowers and fruits was determined for the first time. For the identification of compounds, accurate molecular masses and formulas, acquired by LC and ESI-TOF-MS and fragmentation pattern given by LC-ESI/MS/MS analyses, were used. Our chromatographic system in conjunction with tandem MS was found to be valuable in the rapid separation and determination of the multiple constituents in methanolic extracts of lilac flowers and fruits. Altogether 34 phenolics, comprising 18 secoiridoids, seven phenylpropanoids, four flavonoids and five low-molecular-weight phenols, were identified. As marker compounds two secoiridoids (oleuropein and nuzhenide), two phenylpropanoids (acteoside and echinacoside) and rutin were quantified by validated methods. As a result of quantitative analysis, it was confirmed that flowers contain significant amounts of phenylpropanoids (acteoside, 2.48%; echinacoside, 0.75%) and oleuropein (0.95%), while in fruits secoiridoid oleuropein (1.09%) and nuzhenide (0.42%) are the major secondary metabolites. The radical scavenging activities of the extracts and the constituents were investigated by DPPH (2,2-diphenyl-1-picrylhydrazyl) and ABTS [2,2'-azino-bis-(3-ethylbenzothiazoline-6-sulfonic acid)] assays. Both extracts show remarkable antioxidant activities. Our results clearly show that lilac flowers and fruits are inexpensive, readily available natural sources of phenolic compounds with pharmacological and cosmetic applications. Copyright © 2015 John Wiley & Sons, Ltd.

Polyphenol composition and antioxidant capacity of three Lysimachia species.

The polyphenol composition and antioxidant properties of three Lysimachia species (L. nummularia L., L. vulgaris L. and L. punctata L.) and their column chromatographic fractions were investigated. The antioxidant activity of herb extracts and 54 different column chromatographic fractions was evaluated using in vitro DPPH and ABTS+ decolorization tests. The total polyphenol content was determined by spectrophotometric methods. The phenolic compounds of extracts of different Lysimachia species and their bioactive fractions were characterized by online chromatographic methods. For identification of the compounds, UV spectral data, accurate molecular mass and formula, as well as MS and fragmentation patterns given by LC-DAD-ESI/MS/MS and LC-ESI- TOF analyses were used. Quantification of the compounds was performed by LC-DAD using an external standard method. In the extracts, caffeic acid derivatives, chlorogenic acid, free flavonoid aglycones, and 11 various flavonoid glycosides were identified. Flavonoid composition of Lysimachia extracts showed significant differences. L. punctata extracts had the strongest DPPH and ABTS+ radical scavenger activity (IC50=43.3 µg/mL and 21.3 µg/mL), due to their high myricitrin and quercetin-hexoside content. Correlation between polyphenol content and radical scavenging activity of each column chromatographic fractions is also included.

The frequency of alcohol, illicit and licit drug consumption in the general driving population in South-East Hungary.

In the framework of the DRUID (Driving under the Influence of Drugs, Alcohol, and Medicines) EU-6 project, a roadside survey was performed in South-East Hungary to determine the incidence of alcohol and the most frequent illicit and licit drug consumption (amphetamines, THC, illicit and medical opiates, cocaine, ketamine, benzodiazepines, zopiclone and zolpidem) in the general driving population. All 3110 drivers stopped between 01 January 2008 and 31 December 2009 were checked for alcohol, and among them 2738 persons (87.7%) participated in the further examinations, on a voluntary basis. Licit and illicit drugs were determined from their oral fluid samples by GC-MS analysis. Illicit drugs were detected in 27 cases (0.99%), licit drugs in 85 cases (3.14%), and alcohol (cut off: 0.1g/l) was found in 4 (0.13%) cases. Illicit drug consumption was the highest among men of the ages 18-34, during the spring, and on the week-end nights. With respect to licit drugs, the highest incidence was found among women over the age of 50, during the summer, and on the week-days. All alcohol positive cases were men over the age of 35. In comparison to international European averages, the alcohol and illicit drug consumption was low, but the licit drug consumption was over the European average.

[A new designer drug: methylone related death]. / Új dizájner drog: metilonfogyasztással összefüggo haláleset.

This report presents a fatal case related to the consumption of methylone, a relatively new cathinone type designer drug. A 16-year-old boy suddenly lost his consciousness in a party. Resuscitation had been continued for about 1.5 hours at the intensive care unit, but it was unsuccessful. His previous history included cardiac malformation detected at infancy and bronchial asthma had been diagnosed one year before his death. Signs of sudden cardiac death were observed during autopsy. Methylone intake was proved in blood and liver extract using gas chromatography/mass spectrometry; its concentration was 272 ng/ml in the blood, and 387 ng/g in the liver. Pathohistology revealed microvascular steatosis in the liver, which raised the possibility of chronic use of toxic substances. In addition, striated heart muscle damage was observed, which could be due to the use of an amphetamine-like substance. The authors presume that steatosis of the heart muscle, congenital heart disease and bronchial asthma could be predisposing factors for sudden cardiac death that occurred in the presence of relatively low levels of methylone. Access to various designer drugs is easy, fast and broad. Consequently, the potential abuse or overdose should be taken into consideration in the emergency practice. The use of "non-illicit" drugs does not require formal intervention by the authorities, but the medical service must alarm the stakeholders.

[Mephedrone -- an old-new drug of abuse]. / Egy régi-új kábítószer - a mefedron.

UNLABELLED: New natural and synthetic compounds are continuously introduced into the illicit drug market. Their origin, composition, main and side-effects are often not exactly known by the users themselves. Thus, the control of these substances is extremely difficult. AIMS: In year 2008, a new synthetic drug called mephedrone (2-metilamino-1-(4-metilfenil) propan-1-on) appeared in Hungary. This work summarizes its frequency in biological samples investigated for illicit drugs, and experiences of the medical examination of mephedrone-users. METHODS: Toxicological analyses of biological samples (urine and/or blood) were carried by GC-MS at the Institute of National Toxicology and at Department of Forensic Medicine, University Szeged. RESULTS: Altogether 5386 samples were analyzed in 2010 (4922 in Budapest and 464 in Szeged), and mephedrone was identified in 363 cases (7%). CONCLUSIONS: Mephedrone is banned in Hungary since January 1st, 2011, but it still available in the illegal drug market. At present we do not have sufficient experience with its long-term effects, tolerance, addiction, withdrawal symptoms or toxic dose. Thus, it is difficult to establish whether addiction and/or mental disorder occurred.

Myocardium and striated muscle damage caused by licit or illicit drugs.

Illicit and central nervous system active licit drug consumption related deaths are mainly the consequences of either unintentional or intentional overdose. According to the data in the relevant literature occurrences of different organ damages are also observable and this can play a role in death, as well. Organ damages may appear simultaneously with overdosing or can be extended in time, which may lead to proving the cause of death and establishing the relationships with previous medication difficult. The most frequent damage observed is rhabdomyolysis syndrome, which has been mainly described after cocaine or opium consumption. Authors present four cases from the autopsy documentation of the period between 2003 and 2008 at the Institute of Forensic Medicine, University of Szeged, Hungary in which illicit drug consumption or neuroleptic licit drug medication resulted in development of myocardium and striated muscle damage. The dominant clinical symptoms were hyperthermia, renal and circulatory failure. The laboratory tests showed renal and liver insufficiency; in addition the CK and CK-MB level increase suggested damage in striated muscles. The focal myocardium and striated muscle damage could be assessed as the cause of death in one case, but microscopic investigation proved the presence of damage in each.

The role of licit and illicit drugs in traffic (Hungary 2000-2007).

The authors analyzed the biological samples available in suspected DWI cases between 2000 and 2007. The result of the on-the-spot clinical test is not informative, especially at the simultaneous presence of alcohol. The average age (males 26.92 years, females 27.6 years) of the apprehended drivers is higher than in case of illicit drug users, and male dominance (1652 males--94% and 88 females--6%) is also more expressed. This male-female ratio corresponds to the epidemiological figures of drunken-driving, which may indicate identical driving attitude. Licit or illicit drugs in the urine could be detected in 1293 people out of 1740 (74.31%) whereas in 319 (18.33%) cases there was some substance present in the blood. The occurrence of multiple drug use was high. The use of THC, amphetamine and methamphetamine derivates are the most frequent. An increase in cocaine consumption has been observed for the last few years. The joint use of alcohol and drugs has increased, but the observed blood-alcohol concentrations are much lower than in simple drunken-driving cases. The evaluation of clinical symptoms on its own is not enough to evaluate the effects of drugs, especially when the effect of alcohol is to be considered at the same time.

Tuberculosis prevention and treatment.

Tuberculosis (TB) is one of the oldest known diseases and has claimed more lives than any other Today, about one-third of the world's population is infected with TB. In 2003, 1,379 cases of new, active and relapsed TB were reported in Canada. TB is caused by Mycobacterium tuberculosis. Only 10 per cent of infected individuals will develop active TB. Pulmonary TB can be spread by an infectious person through the aerosolization of droplets when coughing, talking, spitting, sneezing or singing. Symptoms of pulmonary TB are a cough with or without sputum production lasting at least three weeks, chest pain, hemoptysis, fever, night sweats, weight loss, lack of appetite, chills and weakness. Extrapulmonary TB is generally not associated with person-to-person spread. Common sites include the throat, lymph nodes, abdomen, intestines, long bones of the legs, spine, kidneys, bladder, skin, eyes and meninges. The risk factors for TB infection and disease include close contact with an active pulmonary TB case, HIV infection or AIDS, inactive disease not adequately treated, low income, underlying medical condition, homelessness, alcoholism, injection drug use, aboriginal background or occupation in health care. Risk settings include travel or residence in an endemic area or work or residence in a correctional facility, shelter, rooming house, residential facility, hospital or long-term care facility. Nurses need to advocate for the prompt diagnosis and isolation of suspected and confirmed TB cases. Knowing when to institute such measures as isolation in a negative pressure room, using respirator masks and limiting interpersonal contacts is vital to the nursing care of TB patients. In addition, the role of the public health department needs to be understood; for example, all jurisdictions have legislated requirements for reporting new positive TB skin tests to public health.