Analytical Investigation of Iron-Based Stains on Carbonate Stones: Rust Formation, Diffusion Mechanisms, and Speciation.

In cultural heritage, unaesthetic stains on carbonate stones due to their close contacts with metals are of concern for the preservation of sculptures, monumental facades and archeological finds of various origin and antiquities. Rust stains made up of various oxidized iron compounds are the most frequent forms of alteration. The presence of ferric iron on rust-stained marble surfaces was confirmed in previous studies and oriented the choice of the best cleaning method (based on complexing agents specific for ferric ions). However, the composition of rust stains may vary along their extension. As the corrosion of the metallic iron proceeds, if the oxygen levels in the surroundings are low and there are no conditions to favor the oxidation, ferrous ions can also diffuse within the carbonate structure and form a variety of intermediate compounds. In this study, the iron stains on archeological marbles were compared with those artificially produced on Carrara marbles and Travertine samples. The use of integrated techniques (optical and scanning electron microscopy as well as Mössbauer and XPS spectroscopy) with complementary analytical depths, has provided the overall information. Rust formation and diffusion mechanisms in carbonates were revealed together with the evolution of iron speciation and identification of phases such as ferrihydrite, goethite, maghemite, nanomagnetite, and hematite.

Follow-up to Age 4 Years of Treatment of Type 1 Retinopathy of Prematurity Intravitreal Bevacizumab Injection versus Laser: Fluorescein Angiographic Findings.

PURPOSE: To compare structural outcome at age 4 years of eyes treated with intravitreal injection of bevacizumab with fellow eyes treated with conventional laser photoablation in type 1 retinopathy of prematurity (ROP). DESIGN: Single, randomized, controlled trial. PARTICIPANTS: All inborn babies with type 1 zone 1 ROP at the Neonatal Intensive Care Unit of the Catholic University, Rome, from September 1, 2009, to March 31, 2012. METHODS: In 21 infants (42 eyes), 1 eye was randomized to receive an intravitreal injection of 0.5 mg bevacizumab; the fellow eye underwent conventional laser photoablation. Digital retinal imaging and fluorescein angiography (FA) were performed at an average of 4 years after treatment in follow-up after these studies performed at treatment and 9 months. MAIN OUTCOME MEASURES: Fluorescein angiograms were examined by 2 experts to document retinal and choroidal findings. RESULTS: Among the 20 bevacizumab-treated eyes available at 4 years of age, all showed abnormalities at the periphery (avascular area, vessel leakage, shunts, abnormal vessel branching, and tangles) or the posterior pole (hyperfluorescent lesions, absence of foveal avascular zone). These lesions were not observed in the majority of the lasered eyes. Among the 19 laser-treated eyes, leakage was noted in 1 eye, shunts and tangles were noted in 3 eyes, and macular abnormalities were noted in 3 eyes. CONCLUSIONS: Fluorescein angiography has shown potentially serious and long-term ocular effects that are present more commonly after treatment with bevacizumab for acute-phase ROP than after laser.

Direct Methanol (or Ethanol) Fuel Cell as Enzymatic or Non-Enzymatic Device, Used to Check Ethanol in Several Pharmaceutical and Forensic Samples.

It was already demonstrated by our research group that a direct catalytic methanol (or ethanol) fuel cell (DMFC) device can be used also for analytical purposes, such as the determination of ethanol content in beverages. In the present research we extended the application to the analysis of several ethanol-based pharmaceutical products, i.e., pharmaceutical tinctures (dyes) and disinfectants. In recent work we have also shown that the use of alcohol dehydrogenase enzyme as a component of the anodic section of a direct catalytic methanol (or ethanol) fuel cell significantly improves the performance of a simple DMFC device, making it more suitable to measure ethanol (or methanol) in real samples by this cell. At the same time, we have also shown that DMFC can respond to certain organic compounds that are more complex than methanol and ethanol and having R(R')CH-OH group in the molecule. Firstly, pharmaceutical dyes were analyzed for their ethanol content using the simple catalytic DMFC device, with good accuracy and precision. The results are illustrated in the present paper. Additionally, a detailed investigation carried out on commercial denatured alcoholic samples evidenced several interferences due to the contained additives. Secondly, we hypothesized that by using the enzymatic fuel cell it would be possible to improve the determination, for instance, of certain antibiotics, such as imipenem, or else carry out determinations of ethanol content in saliva and serum (simulating forensic tests, correlated to drivers "breath test"); even if this has already been hypothesized in previous papers, the present study is the first to perform them experimentally, obtaining satisfactory results. In practice, all of the goals which we proposed were reached, confirming the remarkable opportunities of the enzymatic (or non-enzymatic) DMFC device.

Intravitreal bevacizumab versus laser treatment in type 1 retinopathy of prematurity: report on fluorescein angiographic findings.

PURPOSE: To compare the structural outcome at 9 months of eyes treated with intravitreal injection of bevacizumab with fellow eyes treated with conventional laser photoablation in zone I type 1 retinopathy of prematurity (ROP). DESIGN: Single randomized controlled trial. PARTICIPANTS: All inborn babies with type 1 zone I ROP at a single institution were included in the study. One eye was randomized to receive an intravitreal injection of 0.5 mg bevacizumab; the fellow eye received conventional laser photoablation. METHODS: Digital fundus photographs and fluorescein angiography (FA) using the RetCam (Clarity Medical Systems Inc., Pleasanton, CA) were performed before treatment and 9 months after treatment. MAIN OUTCOME MEASURES: Presence of retinal and choroidal abnormalities on FA at 9 months. RESULTS: Thirteen infants were enrolled; 1 died 3 months after birth. One laser-treated eye progressed to stage 5 retinal detachment. The remaining 23 eyes had favorable structural results at the 9-month follow-up and provided FA results. At 9 months of age, all eyes treated with a bevacizumab injection were noted to have abnormalities at the periphery (large avascular area, abnormal branching, shunt) or the posterior pole (hyperfluorescent lesion, absence of foveal avascular zone). These posterior and peripheral lesions were not observed in the majority of the lasered eyes. CONCLUSIONS: This study documents significant vascular and macular abnormalities of eyes in the bevacizumab group. Long-lasting implications of these abnormalities for visual function of the child need to be studied.

Phenylephrine eye drops in pediatric patients undergoing ophthalmic surgery: incidence, presentation, and management of complications during general anesthesia.

BACKGROUND: Phenylephrine eye drops are widely used as mydriatic agent to reach the posterior segment of the eye. In literature, many reports suggest a systemic absorption of this agent as a source of severe adverse drug reactions. Hence, we reviewed our experience with topical phenylephrine in ophthalmic surgery. METHODS: In May 2006, following US guidelines publication, a standard operating procedure was issued in our operating rooms to standardize the use of phenylephrine eye drops in our practice. Two years later, after the occurrence of a cluster of serious adverse drug reactions in infants undergoing surgery, a review of phenylephrine safety and systemic complications incidence was performed. RESULTS: We observed 451 pediatric patients, and 187 met the inclusions criteria: Among them, 4 experienced hemodynamic complications due to phenylephrine eye drops. The incidence of major complications was 2.1%. CONCLUSIONS: Two different patterns of side effects occurred. The first one was a cardiovascular derangement with severe hypertension and heart rate alterations; the other one involved exclusively pulmonary circuit causing early edema. These clinical manifestations, their duration, and treatment responses are all explainable by alfa1-adrenergic action of phenylephrine. This hypothetic pathogenesis has been confirmed also by the usefulness of direct vasodilators (anesthetic agents) and by the negative outcome occurred in the past with the use of beta-blockers.

Microplastic contamination in commercial salt: An issue for their sampling and quantification.

Sea salt can be considered as a vector of microplastics in the human body. In this work, the sea salts collected from three Italian salterns has been solubilized in MilliQ water and filtered to extract microplastics. The visual quantification of microplastics with a stereomicroscope was carried out on the bases of their size, followed by a classification taking into account their physical characteristics. ATR-FTIR and Raman spectroscopy were used to identify the polymeric type of microplastics. Their significant presence has been revealed: 1653 ± 29 microplastics/kg of sea salt. In total, 80.6 % of microplastics have a fiber shape, 18.9 % a fragmented shape and 2.7 % are sphere. The size of microplastics has been analysed, indicating that the most frequent is between 0 and 500 µm. Polypropylene, polyamide and polyethylene were identified as the most frequent types of polymers. This research could be of global relevance given the significant export of Italian salt to foreign countries.

Characteristics of Commercial and Raw Pellets Available on the Italian Market: Study of Organic and Inorganic Fraction and Related Chemometric Approach.

Air pollution and the increasing production of greenhouse gases has prompted greater use of renewable energy sources; the EU has set a target that the use of green energy should be at 32 percent by 2030. With this in mind, in the last 10 years, the demand for pellets in Italy has more than doubled, making Italy the second largest consumer in Europe. The quality of the pellets burned in stoves is crucial to indoor and outdoor pollution. Among other parameters, moisture and ash are used to classify pellets according to EN ISO 17225:2014. This work involved the analysis of the organic and inorganic fraction of both some finished products on the Italian market and some raw materials (e.g., wood chips) sampled according to the technical standard EN 14778:2011. The analytical results showed the presence of some substances potentially harmful to human health such as formaldehyde, acetone, toluene and styrene for the organic fraction and nickel, lead and vanadium for the inorganic fraction. The chemometric approach showed that it is the inorganic fraction which is most responsible for the diversification of the samples under study. The detection of some substances may be a warning bell about the impact of such materials, both for the environment and for human health.

Atlas of fluorescein angiographic findings in eyes undergoing laser for retinopathy of prematurity.

PURPOSE: We sought to examine the clinical features of severe retinopathy of prematurity (ROP) using fluorescein angiography (FA). DESIGN: Retrospective case series of eyes with severe acute-phase ROP that underwent FA at the time of laser photocoagulation. PARTICIPANTS: We included 22 eyes of 11 infants that developed ROP stage 3 in zone 1 with plus disease, 8 eyes of 4 infants classified as ROP stage 3 in zone 1 without plus disease, and 21 eyes of 11 infants that developed ROP stage 3 in zone 2 with plus disease. All eyes underwent laser photocoagulation. A total of 51 sets of digital images including FA were obtained immediately before treatment. METHODS: RetCam (Clarity, Pleasanton, CA) fundus images and video digital FAs were performed under general anesthesia right before laser treatment. A 10% solution of fluorescein was intravenously administered as a bolus at a dose of 0.1 ml/kg, followed by an isotonic saline flush. MAIN OUTCOMES MEASURES: Fluorescein angiograms were examined retrospectively to catalog different retinal and choroidal findings RESULTS: In eyes with severe ROP, FA clearly shows extreme variability in both retinal circulation and choroidal filling pattern. Different patterns of vessels branching at the junction between vascular and avascular retina (V-Av junction) are noted. Posterior to the V-Av junction, hypoperfused retinal areas with or without hyperfluorescent "cotton-wool-like" or "popcorn-like" lesions due to dye leakage are documented by FA. Focal dilatation of capillaries, capillary tufts formations, and rosary-bead-like hyperfluorescent lesions inside the vessels were seen; sometimes all 3 are noted. Various macular abnormalities are noted including absence of foveal avascular area and significant exudative component. CONCLUSIONS: Fluorescein angiography was useful to distinguish the deceptively featureless zone 1 junction between the vascularized and nonvascularized retina. Further studies are needed to understand the role of vascular abnormalities observed in zone 1 vascularized retina.

Release of Heavy Metals from Plastic Statuettes Used as Souvenirs and/or Toys Handled by Children.

Different plastic toys are on sale in the Italian market: they are sold as souvenirs and/or as toys. Such statuettes, called Gongoli, represent a famous character (a soccer player, a politician, the Pope, etc.). In particular, these products are widely sold, but the material composition is not sufficiently defined. Further, the effect of the release of dangerous compounds on human health is not sufficiently documented. Following this hypothesis, a study on eight different statuettes was carried out both for evaluating the possible presence of heavy metals and for evidencing their release from these objects. Preliminary analysis by means of EDS spectroscopy highlighted the percentage chemical composition of different products, especially the presence of total Cr and Ni. Release tests evidenced the release of Cr, Cu, Ni, and Pb: Pb reached 74 mg kg-1, which is an interesting value even if it is lower than reported in the legislation. This study should be considered preliminary due to its limitations, such as the number of items investigated and the large variability found for some elements, but it highlights a serious problem related to the classification of these products which are marketed as souvenirs but manipulated by children.

Simple Yeast-Direct Catalytic Fuel Cell Bio-Device: Analytical Results and Energetic Properties.

This paper reports the analytical detection and energetic properties of a glucose-fed Direct Catalytic Fuel Cell (DCFC) operated in association with yeast cells (Saccharomyces Cerevisiae). The cell was tested in a potentiostatic mode, and the operating conditions were optimized to maximize the current produced by a given concentration of glucose. Results indicate that the DCFC is characterized by a glucose detection limit of the order to 21 mmol L-1. The cell was used to estimate the "pool" of carbohydrate content in commercial soft drinks. Furthermore, the use of different carbohydrates, such as fructose and sucrose, has been shown to result in a good current yield.

Remifentanil in neonatal intensive care and anaesthesia practice.

UNLABELLED: Remifentanil is a relatively new ultrashort action synthetic opioid. Studies on the use of remifentanil in neonatology have emerged demonstrating its effectiveness and safety in neonates. The present study describes the use of remifentanil in both full-term and premature newborns, highlighting the theoretical benefits for this population in terms of both neonatal intensive care and anaesthesia. A Medline search was undertaken of all reviews and reports about the use of remifentanil in neonates published between 1996 and 2009 using MeSH search terms 'remifentanil', 'analgesia', 'anaesthesia', 'newborn' and 'neonate'. The review points that remifentanil has been used with advantages in newborns including preterm neonates and even for foetal anaesthesia. It proved to be a good option to attenuate the hemodynamic/endocrine markers of stress related to surgery. Owing to its unique pharmacokinetic profile, shorter extubation times can be achieved what makes the drug also a good option for short duration invasive procedures in NICUs (InSurE). A concern on its use is that the hemodynamic response (hypotension) may become significant when the drug is associated to other drugs like sevoflurane. CONCLUSION: Remifentanil seems to be an effective and safely used opioid for neonatal intensive care and anaesthesia practice.

Remifentanil in children.

Remifentanil has gained the confidence of anesthesiologists and has given a real opportunity to change the way anesthesia is given. It can be considered the ideal opioid despite many obstacles to pediatric use: the condition of 'off-label', the lack of wide randomized clinical trials, and the fear of adverse events because of its high potency. Experiences in the field with this opioid over the years encouraged its use. Use has been associated with N(2)0 and volatile agents for general anesthesia and with propofol for total intravenous anesthesia (TIVA). It seems very useful for sedation inside and outside the operating room and in intensive care for both short painful procedures and synchronization with mechanical ventilation. However, its unique pharmacokinetic characteristics causing rapid onset and offset of effect appear unchanged in small children and even in premature neonates and need to be really confirmed by further pharmacokinetic studies. Moreover, the real risks of tolerance and hyperalgesia should be evaluated in the pediatric population. In this review, we go through the newer aspects of this versatile drug that has been proposed as 'the pediatric anesthetist's opiate'.

Remifentanil analgosedation in preterm newborns during mechanical ventilation.

AIM: To assess efficacy of remifentanil in preterm newborns during mechanical ventilation. METHODS: Remifentanil was administered by continuous intravenous infusion to provide analgesia and sedation in 48 preterm infants who developed respiratory distress and required mechanical ventilation. We examined the doses needed to provide adequate analgesia, extubation time after the discontinuation of opioid infusion, the presence of side effects and safety of the use. RESULTS: Remifentanil provided adequate analgesia, with a significant reduction of NIPS and COMFORT score since 1 h after starting the infusion of remifentanil. The drug was initially administered at a dose of 0.075 microg/kg/min, but in 73% of newborns the latter had to be increased; at a dose of 0.094 +/- 0.03 (mean +/- standard deviation) microg/kg/min, 97% of the newborns received adequate analgesia and sedation. The time elapsed between the discontinuation of remifentanil infusion and extubation was 36 +/- 12 min. Treatment was started between the 1st and the 17th day of life. The mean duration of therapy was 5.9 +/- 5.7 days. No side effects on the respiratory or cardiovascular system were observed. CONCLUSION: Remifentanil is a manageable and effective opioid in the newborn undergoing mechanical ventilation, though randomized controlled trials and information about long-term outcomes are necessary.

Iron stains on paper. Can electrophoretic removal become an effective alternative to chemical cleaning?

Research in restoration and conservation is directed vs. more sustainable working materials, methods and technologies. Electrophoretic removal, from porous material, of undesired stains due to charged species is theoretically an interesting alternative to chemical cleaning methods, but the lack of specific and comprehensive research work leads to controversial opinions about the efficiency and the needed harmfulness for the treated objects. In this work paper, samples with artificial rust stains were subjected to electrophoretic cleaning treatments in mineral water as electrolyte. Treatments were carried out either in a bath by complete sample immersion between the distanced electrodes or by sample wetting and sandwiching between the electrodes. Evaluation of cleaning efficiency and treatment effects was based on colour change measurements (image analysis of scanned paper samples before and after the treatment and by colorimetric data via spectrophotometric measurements), investigation of morphological changes by SEM observations and folding endurance measurements.

Guidelines on pediatric day surgery of the Italian Societies of Pediatric Surgery (SICP) and Pediatric Anesthesiology (SARNePI).

The Italian Society of Pediatric Surgery (SICP) together with The Italian Society of Pediatric Anesthesia (SARNePI) through a systematic analysis of the scientific literature, followed by a consensus conference held in Perugia on 2015, have produced some evidence based guidelines on the feasibility of day surgery in relation to different pediatric surgical procedures. The main aspects of the pre-operative assessment, appropriacy of operations and discharge are reported.

Does caffeine improve respiratory rate during remifentanil target controlled infusion sedation? A case report in endoscopic sedation.

Sedation for endoscopic procedures may be challenging when facing patients with high risk. Traditional techniques, as propofol or meperidine/midazolam administration, cannot ensure an adequate level of safety and efficacy for these patients. Remifentanil infusion is a common alternative, but the incidence of apneic events does not allow achieving safely a good level of analgesia. To overcome with this issue, the authors borrowed suggestions from other medical fields. The clinical practice has recognized a wide utility of methylxanthines (caffeine, theophylline, etc). The positive effect of caffeine on the airways function is known and in the treatment of neonatal apnea, it works as direct stimulant of central respiratory center. Furthermore, preclinical studies suggest that methylxanthines could have a protective role on the opioids inhibition of the bulbar-pontine respiratory center. As described in this report, the authors observed that, also when apnea has been induced by remifentanil, caffeine is able to restore the respiratory rate. The authors present the management of a respiratory impaired patient scheduled for a therapeutic colonoscopy. Our sedation was focused on the match between remifentanil in target controlled infusion and intravenous caffeine, like an "expresso to wake-up" the respiratory drive.