Headache in cerebral venous thrombosis associated with extracranial tumors: a clinical series.

Cerebral venous thrombosis (CVT) may represent the clinical onset of malignancies or complicate their course, also in phase of quiescence. In literature, there are several case reports on the association between CVT and tumors, but there are few articles on its clinical characteristics in cancer patients (Pts). Our aim was to analyze the clinical characteristics of CVT associated with extracranial tumors. We identified nine cases of CVT in adults affected by extracranial tumors in 6 years from six hospitals. The median age was 40 years; eight Pts were female. Associated tumors were: lymphoma (4/9); breast (2/9), rhinopharynges (1/9) and gastric (1/9) carcinomas. One patient presented a kidney tumor and a melanoma at the same time. Multiple sinuses were affected in seven Pts. MRI showed parenchymal lesions in most cases (7/9). Clinical manifestations were: focal deficits (7/9), headache (6/9), early seizures (4/9) and consciousness disorders (3/9). Headache was the onset symptom in six Pts. In four of these Pts, headache preceded the onset of the focal deficit and/or seizures than 2-15 days. The characteristics of the headache were variable in intensity, location and type but all the Pts agreed in saying that it was an unusual headache, unresponsive to common pain medications. Five of the six Pts complaining of headache in the course of CVT presented focal deficits and parenchymal lesions at admission to the emergency room. All nine Pts were anticoagulated without further haemorrhagic complications. At discharge, the Pts presented a complete recovery in four cases, mild sequelae in four and moderate sequelae in one. In conclusion, we would like to underline the importance of particular care to cancer Pts complaining of headache, since the early diagnosis and the appropriate anticoagulant treatment could prevent the appearance of parenchymal lesions and the consequent neurological deficits. Also in the cases of normal brain CT, a brain MRI/MR venography should be performed in emergency setting if CVT is suspected.

Polycyclic aromatic hydrocarbons and metals in transplanted lichen (Pseudovernia furfuracea) at sites adjacent to a solid-waste landfill in central Italy.

The aim of the study was to evaluate the airborne contamination by polycyclic aromatic hydrocarbons (PAHs) and some heavy metals (arsenic [As], cadmium [Cd], chromium [Cr], copper [Cu], nickel [Ni], lead [Pb], and zinc [Zn]) of different pollution scenarios around a solid-waste landfill in central Italy using the lichen Pseudovernia furfuracea as a monitoring tool. For this purpose, eight stations around a landfill characterized by different air pollution sources (industrial, agricultural, residential areas, and roads with different traffic intensities), together with three stations far from the landfill (control areas), were monitored using a set of 22 lichen samples (11 samples analysed for PAHs and metals after 4 months, and 11 samples analysed for metals after 8 months). After 4 months of exposure, the lichen content of all of the analysed elements was greater than that in the pre-exposed lichens. In addition, the Cu and Pb concentration after 8 months was greater than the level after 4 months. The order of metal concentration was Zn > Pb > Cu (or Cu > Pb) > Cr > Ni > As > Cd in all cases. The range of ∑11PAHs concentration was 634-1,371 ng/g dw (three to seven times greater than the amount in the pre-exposed lichens). The ∑11PAHs were dominated (>70 %) by compounds with three aromatic rings. The comparison of the levels of air pollutants among the monitored stations shows nonrelevant spatial patterns between the landfill stations and the control areas; the levels of PAHs and metals found in the lichen samples around the landfill seemed to be more related to the general diffusion of these pollutants in that area.

Surfactant therapy for acute respiratory distress in children.

In children with acute lung injury the endogenous surfactant system is altered via a variety of different mechanisms, including inflammation, vascular dysfunction, oxidant injury, cellular injury and oedema. This article examines the pathophysiology of acute lung injury and surfactant use for treatment of acute respiratory failure in infants and children.

Air pollution positively correlates with daily stroke admission and in hospital mortality: a study in the urban area of Como, Italy.

Some current evidences suggest that stroke incidence and mortality may be higher in elevated air pollution areas. Our study examined the hypothesis of a correlation between air pollution level and ischemic stroke admission and in Hospital mortality in an urban population. Data on a total of 759 stroke admissions and 180 deaths have been obtained over a 4-year period (2000-2003). Five air ambient particles have been studied. A general additive model estimating Poisson distribution has been used, adding meteorological variables as covariates. NO(2) and PM(10) were significantly associated with admission and mortality (P value < 0.05) and with estimated RR of 1.039 (95% CI 1.066-1.013) and 1.078 (95% CI 1.104-1.052) for hospital admission at 2- and 4-day lags, respectively. In conclusion, this study suggests an association between short-term outdoor air pollution exposure and ischemic stroke admission and mortality.

Iron-montmorillonite clays as active sorbents for the decontamination of hazardous chemical warfare agents.

A class of heterogeneous catalysts based on commercial bentonite from natural origin, containing at least 80 wt% of montmorillonite clay, was designed to transform selectively and under mild conditions toxic organosulfur and organophosphorus chemical warfare agents into non-noxious products with a reduced impact on health and environment. The bentonite from the natural origin was modified by introducing iron species and acid sites in the interlayer space, aiming to obtain a sorbent with strong catalytic oxidising and hydrolytic properties. The catalytic performance of these materials was evaluated in the oxidative abatement of (2-chloroethyl)ethyl sulfide (CEES), a simulant of sulfur mustard, in the presence of aqueous hydrogen peroxide as an oxidant. A new decontamination formulation was, moreover, proposed and obtained by mixing sodium perborate, as a solid oxidant, to iron-bentonite catalysts. Solid-phase decontamination tests, performed on a cotton textile support contaminated with organosulfide and organophosphonate simulant agents revealed the good activity of the solid formulation, especially in the in situ detoxification of blistering agents. Tests carried out on the real blistering warfare agent, sulfur mustard (HD agent), showed that, thanks to the co-presence of the iron-based clay together with the solid oxidant component, a good decontamination of the test surface from the real warfare agent could be achieved (80% contaminant degradation, under ambient conditions, in 24 h).

A multi-biomarker analysis of DNA damage in automobile painters.

The genotoxic effects associated with automobile painting were analyzed using a panel of biomarkers. Chromosomal aberrations (CAs), sister chromatid exchange (SCE), and micronuclei were evaluated in 25 car painters (12 smokers, 13 nonsmokers) working in different automobile paint-shops in Italy and in 37 control subjects. The controls were healthy blood donors (14 smokers, 23 non-smokers) that were matched with the experimental population for gender and age. Air samples were analyzed regularly at the work places, and elevated concentrations of benzene and toluene were detected consistently. The exposed group had higher frequencies of CAs (both chromosome- and chromatid-type), micronuclei, and SCE (P < 0.5 - P < 0.001). Furthermore, exposed and control subjects were also genotyped for GSTM1 and GSTT1 polymorphism. No significant associations were detected between the biomarker responses and either the GSTM1 or GSTT1 genotype of the subjects, but the small sample size does not allow definite conclusions on the relationship between the genetic polymorphism and the biomarkers. The results indicate that automobile painters have increased levels of clastogenic and possible aneugenic damage and that smoking may be a confounding factor for the responses.

Reversible ischemic attacks with normal angiogram: risk factors, clinical findings, and prognosis.

One hundred seventeen patients with reversible ischemic attacks were divided into two groups according to the presence of atheromatous lesions on angiography. Female sex, vertebrobasilar territory involvement, and younger age were related to normal angiograms. Among risk factors, only hypertension was associated with atheroma. However, the number of risk factors in each patient was related linearly to angiographic abnormality. Later stroke and myocardial infarction were significantly more common in patients with atheromatous lesions.

Development of orally active oxytocin antagonists: studies on 1-(1-[4-[1-(2-methyl-1-oxidopyridin-3-ylmethyl)piperidin-4-yloxy]-2- methoxybenzoyl]piperidin-4-yl)-1,4-dihydrobenz[d][1,3]oxazin-2-one (L-372,662) and related pyridines.

The previously reported oxytocin antagonist L-371,257 (2) has been modified at its acetylpiperidine terminus to incorporate various pyridine N-oxide groups. This modification has led to the identification of compounds with improved pharmacokinetics and excellent oral bioavailability. The pyridine N-oxide series is exemplified by L-372,662 (30), which possessed good potency in vitro (Ki = 4.1 nM, cloned human oxytocin receptor) and in vivo (intravenous AD50 = 0.71 mg/kg in the rat), excellent oral bioavailability (90% in the rat, 96% in the dog), good aqueous solubility (>8.5 mg/mL at pH 5.2) which should facilitate formulation for iv administration, and excellent selectivity against the human arginine vasopressin receptors. Incorporation of a 5-fluoro substituent on the central benzoyl ring of this class of oxytocin antagonists enhanced in vitro and in vivo potency but was detrimental to the pharmacokinetic profiles of these compounds. Although lipophilic substitution around the pyridine ring of compound 30 gave higher affinity in vitro, such substituents were a metabolic liability and caused shortfalls in vivo. Two approaches to prevent this metabolism, addition of a cyclic constraint and incorporation of trifluoromethyl groups, were examined. The former approach was ineffective because of metabolic hydroxylation on the constrained ring system, whereas the latter showed improvement in plasma pharmacokinetics in some cases.

Subcortical aphasia: two clinical-CT scan correlation studies.

Two clinical-CT scan studies were undertaken in order to investigate the frequency and the characteristics of aphasia following strictly subcortical left hemisphere lesions. In Study 1, all patients whose CT scan, carried out within a given period, showed subcortical lesions in both hemispheres, were evaluated for presence and type of aphasia; conversely, in Study 2 the records of all patients referred to our Aphasia Unit for language evaluation within a given period, were examined for presence of subcortical lesions on the CT scan. In Study 1 aphasia was found in two out of six patients. In Study 2 stabilized, strictly subcortical lesions of the left hemisphere were found in six out of 250 patients referred to the Aphasia Unit; 4 out of 6 were aphasics. Closer scrutiny of the type of language disorder in the aphasics from both studies (N = 6) suggests the possibility of differentiating two types of defect: an atypical non fluent aphasia, sometimes associated with anterior capsular-putaminal lesions, and a mild fluent aphasia, sometimes associated with posterior capsular-putaminal lesions.

Lichens as polycyclic aromatic hydrocarbon bioaccumulators used in atmospheric pollution studies.

The aim of this work has been to determine the possibility of using lichens as polycyclic aromatic hydrocarbon (PAH) bioaccumulators for the evaluation of atmospheric pollution in the city of Rieti. A lichen sample collected in a remote unpolluted area was divided into 18 sub-samples. These were collocated in nine different stations in the city of Rieti and every 5 months the PAH concentrations were determined. Only phenanthrene, anthracene, fluoranthene, pyrene and chrysene were found at concentrations over the limit of quantification. In the meantime a continuous increase of their concentrations was observed.

Inter-laboratory validation of solid-phase microextraction for the determination of triazine herbicides and their degradation products at ng/l level in water samples.

The accuracy and precision of solid-phase microextraction (SPME) were validated in an inter-laboratory study including ten laboratories for the analysis of triazine herbicides and their metabolites at ng/l level in aqueous samples. The SPME conditions were optimised in order to obtain maximum sensitivity. Especially, salt addition and choice of the SPME fibre coated with Carbowax-divinylbenzene increased the sensitivity. The average detection limits were in the range from 4 to 24 ng/l for the triazine herbicides, and 20 and 40 ng/l for desisopropylatrazine and desethylatrazine, respectively. The average r2 values of the calibration curves were above 0.99 for all of the analytes. The statistical data treatment was performed in accordance with the International Standardisation Organisation (ISO) standard 5725. Relative repeatability standard deviations between 6 and 14% and relative reproducibility standard deviations between 10 and 17% were found. The determined concentrations of the reference sample compared well to the "true" values, thus proving the good accuracy of the method. It is concluded that SPME is a reliable technique for the quantitative analysis of water samples containing triazine herbicides in concentrations around the European limit of 100 ng/l for individual pesticides in drinking water.

An outbreak of skin rash by echovirus 25 in an infant home.

In September 1980 an outbreak of a skin eruption occurring in an infant home in Milan involved 15 children (aged five to 22 months) out of a total of 25. All of them showed a pink maculopapular rash, three had slight fever and eight mild gastroenteric symptoms (diarrhoea). The exanthem lasted three to four days and was distributed over the trunk and the face and only affected the limbs partially. Mild gastroenteric symptoms (abdominal pain or diarrhoea) were reported also by five subjects out of 13 of the staff. Specimens of stools from the 15 affected children and from the five nurses were submitted for virological examination. A strain of echovirus 25 was isolated on primary monkey kidney cells from the stools of eight children and from one adult.

Determination of organic micropollutants in rain water for laboratory screening of air quality in urban environment.

Rain water may collect organic air pollutants, such as polycyclic aromatic hydrocarbons (PAHs), phthalate ester (PEs), pesticides, and polychrorinated biphenyls (PCBs), that could be present in air in consequence of different factors. The determination of these compounds in rain water samples consequently may be interesting for a first screening of air quality in urban and/or industrial areas. For this purpose, 3 areas of the city of Rieti (central Italy) were selected for rain water sampling: a) the city center, densely populated and with high road traffic; b) a suburban residential area; c) the industrial area, about 3 km out of the city center and along the state road. Wet-only precipitation collectors were used for sampling; solid-phase microextraction or liquid-liquid microextraction techniques followed by GC/MS determinations were applied for sample analysis. PCBs and pesticides were never found in the samples collected. On the contrary, some polycyclic aromatic hydrocarbons and phthalates were always found. Significant and seasonal differences in PAH levels were observed in the 3 different sampling areas, with higher values always found in the city center and during the winter period; on the contrary, PEs levels remained unchanged.

Determination of the binding of a beta 2-blocker drug, frusemide and ceftriaxone to serum proteins by capillary zone electrophoresis.

A modified Hummel-Dreyer method was used to study the binding of drugs with serum proteins by high performance capillary electrophoresis. The study was carried out to check the possible interaction between serum proteins and a highly selective beta 2-blocker, ICI 118551 (ICI). To prove the suitability of the method the protein binding of frusemide and ceftriaxone, drugs previously investigated, was also studied. The analyses were carried out by injecting a solution of s alpha(1)-acidic glycoprotein (alpha(1)-AGP) or human serum albumin in 70 mM NaH2PO4/Na2HPO4(pH 7.4) buffer into an uncoated fused silica capillary filled with the same buffer. In the capillary, maintained at a working temperature of 35 degrees C, a known amount of the ICI, frusemide or ceftriaxone was added. The method allows the bound drug to be determined directly.

Progress in the development of oxytocin antagonists for use in preterm labor.

From a targeted screening effort and medicinal chemistry program, L-368,899 was selected as the first orally-active oxytocin (OT) antagonist to enter clinical trials. In animal studies, L-368,899 was shown to be a potent and selective OT antagonist and was orally bioavailable in rats, dogs and chimpanzees. L-368,899 was further shown to be a potent OT antagonist in pregnant rhesus and to inhibit spontaneous nocturnal uterine contractions. In Phase I human studies, L-368,899 was generally well-tolerated given intravenously and showed significant plasma levels after oral administration. In addition, L-368,899 blocked OT-stimulated uterine activity in postpartum women with a potency similar to that in the pregnant rhesus monkey. More recently, another structural series has been pursued, represented by L-371,257 [1-(1-(4-(N-acetyl-4-piperidinyloxy)-2-methoxybenzoyl)pip eridin-4-yl)- 1,2-dihydro-4(H)-3,1-benzoxazin-2-one]. L-371,257 exhibits high affinity (Ki, 4.6 nM) for human uterine OT receptors with high selectivity vs. human vasopressin receptors. In rat tissues in vitro, L-371,257 is a potent and competitive OT antagonist (pA2, 8.4) and, in vivo, blocks OT-stimulated uterine activity given both i.v. and intraduodenally. L-371,257 highlights the promise of this novel structural class.

Determination of Se4+ in drinkable water by solid-phase microextraction and gas chromatography/mass spectrometry.

A method was developed for the selective determination of Se4+ in drinkable water by solid-phase microextraction (SPME) and gas chromatography/mass spectrometry (GC/MS). Se4+ was selectively derivatized to ethane, 1,1'-selenobis by reaction with sodium tetraethylborate, extracted by the SPME fiber, and determined by GC/MS. Both headspace (HS)-SPME and direct SPME were studied. The method requires only a few milliliters of sample and 20 min for completion. At 2.0 microg/L concentration, the relative standard deviation was 10.1% for HS-SPME and 9.1% for direct SPME. For HS-SPME, the theoretical detection limit was 81 ng/L and 166 ng/L for direct SPME. The recovery rate was 95%. The method was used to determine Se4+ in 10 tap water samples.

Pirprofen in the treatment of migraine and episodic headache attacks: a placebo-controlled crossover clinical trial.

A double-blind, within patient, randomized study to compare the efficacy and tolerability of acute rectal administration of 600 mg pirprofen capsules with matched placebo was carried out in 40 out-patients. They were divided into two groups of 20 patients each according to diagnosis of episodic headache or common or classic migraine. Treatment was given once during each of two consecutive attacks according to a crossover design. None of the patients was withdrawn after randomization. There was a statistically significant difference in favour of pirprofen as regards the preferences expressed by patients at the end of the trial: 34 patients preferred pirprofen, two preferred placebo and four patients had no preference. Pirprofen significantly reduced the duration of headache attack and associated symptoms, but not the peak of pain intensity. Tolerability of the drug was good.

[Current interpretation of aphasia and medico-social problems of recovery and rehabilitation of the aphasic patient]. / Attuale interpretazione dell'afasia e problemi medico-sociali del recupero e del reinserimento del malato afasico.

The Authors review the present theories about cortical areas of language and describe the different aphasic syndromes. At last they confront the rehabilitation problem of aphasic patient and his reinstatement in the social and family life.

Silent cerebral ischemia in patients with chronic atrial fibrillation--a case-control study.

The cerebral CT-scan results of 72 patients with chronic atrial fibrillation (AF) were compared to those of an age- and sex-matched control group, affected by muscle-tensive headache. None of the patients in the study had any neurologic symptoms. All were normal on neurologic examination. Mean age was 68 years in both groups. Patients with atrial fibrillation had a higher prevalence of hypertension, diabetes and hyperlipidemia, although the differences were not significant. Thirty-two patients (44.4%) with AF showed hypodense lesions on cerebral CT-scan, suggestive of small infarcts, whereas this finding was present only in eight control subjects (11.1%) (p less than 0.05). These results confirm in part the observations reported in literature and suggest a more thorough examination of the problem regarding the prophylaxis of thrombo-embolic risk in patients affected by chronic AF.

[Laboratory diagnosis: correlated health and environmental risks]. / La diagnostica di laboratorio: rischi sanitari e ambientali correlati.

Method description and initial results of a study to assess risks to health sector workers and environment due to chemical agents used and waste products generated in diagnostic clinical chemical laboratories, and image diagnostic testing. A survey was conducted of the methods and agents used and their toxicological classification, the number of workers exposed and an analytical profile of the waste produced. The assessment of risk to workers was based on cytogenetic tests (chromosome aberrations and micronuclei); the assessment of environmental risk from waste disposal was based on tests on plant systems.