A model study for tethering of (bio)active molecules to biomaterial surfaces through arginine.

A new approach for tethering of bioactive molecules via arginine is proposed and validated on collagen 2D matrices. The method involves the introduction of a methyl ketone on arginine side-chains, followed by reaction with model alkoxyamino derivatives.

Clostridium ramosum rapidly identified by MALDI-TOF MS. A rare gram-variable agent of bacteraemia.

Clostridium ramosum is an enteric anaerobic, endospore-forming, gram-positive rod with a low GC content that is rarely associated with disease in humans. We present a case of C. ramosum bacteraemia. To the best of our knowledge, this is the second case of C. ramosum bacteraemia in an elderly patient presenting with fever, abdominal pain and bilious emesis. We highlight the Gram stain variability, the lack of visualization of spores and the atypical morphology of the colonies that showed C. ramosum in a polymicrobial presentation that initially appeared to show monomicrobial bacteraemia. The microorganism was rapidly identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). We present a comprehensive literature review of 32 cases of clinical infections by C. ramosum in which we describe, if available, sex, age, clinical symptoms, predisposing conditions, other organisms present in the blood culture, other samples with C. ramosum , identification methodology, treatment and outcome.

Synthesis and biological activity of Akt/PI3K inhibitors.

Phosphatidylinositol 3-kinase (PI3K) and serine/threonine protein kinase B (PKB or Akt) pathways regulate important cellular processes and are related to a number of human pathologies, such as cancer. The development of kinase inhibitors, with particular attention to small molecule analogues of natural phosphoinositides for pathway interruption and therapeutic applications will be reviewed.

Pulmonary complications after tricyclic antidepressant overdose.

We studied 82 consecutive patients admitted to the ICU with predominant tricyclic antidepressant overdose (mean plasma tricyclic level, 1,025 ng/ml) to determine the nature and incidence of respiratory complications. The majority of patients (80.4 percent) had a decreased arterial to alveolar oxygen tension ratio (PaO2/PAO2) on initial emergency room arterial blood gas analysis (mean, 0.56). Mechanical ventilation was required in 76.8 percent of the patients for a mean duration of 46.2 h. Chest radiograph abnormalities developed during the first 48 h in 32/82 patients (39 percent). The group with radiographic abnormalities had higher mean drug levels than the group without (p less than 0.05). Of 82 patients, nine (11 percent) developed radiographic evidence of bilateral alveolar infiltrates suggestive of acute lung injury. This group had significantly higher mean drug levels than the groups with other types of radiographic abnormalities (p less than 0.001). Charcoal was recovered from the airway of 18/72 patients who received activated charcoal slurry by nasogastric tube in the emergency room after endotracheal intubation. The group who aspirated did not show statistically significant difference in the incidence of chest radiograph abnormalities, gas exchange, or survival compared with the group that did not aspirate.

Growth factors and corneal endothelial cells: III. Stimulation of adult human corneal endothelial cell mitosis in vitro by defined mitogenic agents.

Human corneal endothelial cells (HCEC) do not mitose extensively in vivo after damage to the endothelial layer. However, HCEC will divide in vitro if cultured under appropriate conditions. We measured the ability of various sera, plasma, growth factors, and nutritional substances to stimulate mitosis of HCEC during 5 days of organ culture after a central freeze injury to the endothelium. Supplementation of a chemically defined medium (CDM) with 20% fetal human serum (FHS) induced significantly higher numbers of mitotic figures or labeled nuclei of human or cat corneas compared with paired corneas cultured in CDM alone. Furthermore, addition of 20% FHS produced more labeled nuclei than did addition of 20% fetal bovine serum or 20% adult human serum. Dialyzed fetal human serum failed to stimulate mitosis, indicating that one or more components of fetal human serum with molecular weight less than 12,000 are essential for mitosis. Human plasma also failed to stimulate mitosis, but an extract of human platelets significantly stimulated high levels of nuclear labeling, suggesting that growth factors contained in platelet granules were responsible for serum-stimulated mitosis of HCEC. Addition of 100 nM epidermal growth factor (EGF) or 10 microM insulin to CDM supplemented with low levels of adult human serum (0.5%) stimulated significantly higher numbers of labeled nuclei compared with paired corneas cultured with 0.5% adult human serum. Supplementation of corneal storage media (K-Sol and CSM) with a mixture of chemically defined agents consisting of EGF, insulin, transferrin, selenium, linoleic acid, and albumin stimulated significantly higher numbers of labeled nuclei compared with paired corneas cultured in the unsupplemented corneal storage media.(ABSTRACT TRUNCATED AT 250 WORDS)

Cesarean section using the Misgav Ladach method.

OBJECTIVE: To stress the advantages of the Misgav Ladach method for cesarean section. STUDY DESIGN: In this study operative details and the postoperative course of 139 patients who underwent cesarean section according to the Misgav Ladach method in 1995-96 are presented. RESULTS: The Misgav Ladach method reduces operation time, time of child delivery, and time of recovery. The rates of febrile morbidity, wound infection and wound dehiscence are not affected by the new technique. CONCLUSION: Our study highlights the efficiency and safety of the Misgav Ladach method, and points out the speeded recovery, with early ambulation and resumption of drinking and eating, that makes the cesarean section delivery closer and closer to natural childbirth.

[Clinico-statistical and social considerations on 1,040 cases of voluntary abortion interventions at the Gorgonzola-Melzo Provincial General Hospital]. / Considerazioni clinico-statistiche e sociali su 1.040 casi di I.V.G. all'Ospedale Generale Provinciale Gorgonzola-Melzo.

PIP: 3 years after the introduction of Law 194/1978, a report is presented on the organization of the abortion service and the available data are analyzed according to certain clinical, statistical, and socially significant parameters. (author's modified)^ieng

[Use of sulprostone in nulliparous patients in voluntary interruption of pregnancy during the first trimester]. / Uso del sulprostone in pazienti nullipare nel corso di I.V.G. del primo trimestre.

A new PGE2 derivate, sulprostone, is described in detail. The drug was used to induce abortion in 68 patients in the first three months of pregnancy. It was administered intramuscularly, in a single dose of 500 mcg. The results obtained clearly reveal sulprostone to be an effective drug, easily handled and well tolerated.

[Fluconazole in the treatment of vaginitis caused by Candida albicans]. / II Fluconazolo nel trattamento delle vaginiti sostenute da Candida albicans.

The authors verified the local activity and tolerance of the antimycotic drug Fluconazole in 125 cases of women suffering from clinical diagnosed vulvovaginitis caused by Candida albicans. Results were positive with regard to the efficacy and safety of the treatment.

[New pharmacological approach to therapy of perimenopausal meno-metrorrhagia. Vaginal use of progesterone]. / Nuovo approccio farmacologico alla terapia delle meno-metrorragie peri-menopausali. Utilizzo del progesterone per via vaginale.

The authors evaluate the effectiveness of a therapy based on natural progesterone to be employed as a vaginal cream in the treatment of meno-metrorrhagia in peri-menopause in 40 patients who were not prepared to consider surgery as a solution for their problems. In the polycentric out-patient study this new preparation has proved to be efficacious and to induce a regression of the endometrial hyperplasia in more than 90% of patients subject to five months' treatment.

[Treatment with GnRH analogs in polycystic ovarian disease. A collaborative multicenter study. The preliminary results]. / Il trattamento con analoghi del GnRH della malattia policistica dell'ovaio. Studio policentrico collaborativo. Risultati preliminari.

The study evaluates the efficacy of tryptorelin treatment in cases of acne and hirsutism associated with polycystic ovarian (PCO) disease. This non-comparative open study in a sample population of 20 young patients who wished to have children demonstrates the reduction of the hirsutism and acne score after six months' treatment. Tryptorelin was even capable of normalizing the hematic hormonal levels examined and ovarian function following six months of treatment, as well as at an initial follow-up after three months. The authors state their intention of performing a larger trial in order to observe the real efficacy of tryptorelin in a study which includes a 12-month follow-up to assess the pregnancy rate.

[The effect of two contraceptive methods (EP vs. IUD) in relation to inflammatory changes and CIN]. / L'influenza di due metodiche contraccettive (EP versus IUD) nei confronti di alterazioni infiammatorie e CIN.

The authors examine Smear Test phlogistic picture repair processes, endometrial cells and preneoplastic lesions in women who used IUD and EP. The research has pointed out that infection due to Actinomyces is only (present) in IUD carriers. CIN affects for 4.2% of IUD carriers.

[The medical treatment of condylomatosis of the lower genital tract. A multicenter outpatient study]. / Trattamento medico della condilomatosi del basso tratto genitale. Studio policentrico ambulatoriale.

Beta-interferone (Frone, Serono) has been used to treat 56 patients with clinical diagnosis of genital condylomatosis in quantity of 3 million UI/die. Controls have been effected at 3 months since the end of therapy. 30 patients were cured after 3 months of therapy, while at 6 months follow-up we have reported a complete regression in 78.6% of cases.

[Therapy of simple endometrial hyperplasia with GnRH analogs. Evaluation of a multicentric ambulatory study. Preliminary results]. / Trattamento con GnRH analoghi della iperplasia endometriale semplice. Valutazione di uno studio policentrico ambulatoriale. Risultati preliminari.

Endometrial hyperplasia is a frequent pathology during menopause and involves the risk of malignant transformation of the lesions. In an attempt to avoid radical surgery, this study proposes the use of triptorelin which was used to treat 56 patients with histologically confirmed symptoms of endometrial hyperplasia without atypia. GnRH-analog was administered using the intramuscular route every 28 days for 6 months. Histological controls were carried out 30 days after the last injection and showed the resolution of histological symptoms, confirmed after three months.

The management of depression: the implications for managed care--roundtable discussion: Part 2.

One of the most commonly utilized drug classes today is antidepressant therapy, which accounts for billions of dollars in spending. Pharmacoeconomic tools may play an influential role in formulary decision making, particularly in this drug class. In part 2 of the roundtable discussion, a pharmacoeconomic model is presented that may clarify the health economic effects of placing serotonin-norepinephrine reuptake inhibitors on the drug formulary, particularly in the context of other antidepressant medications.

The management of depression: the implications for managed care--roundtable discussion: Part 3.

From the standpoint of managed care, the rising cost of depression can be addressed in multiple ways. In the final portion of the roundtable discussion, the faculty discuss not only disease management programs for depression, but other initiatives health plans (including at the pharmacy level) are undertaking to address the rising costs associated with depression. They also discuss the effect of mental health coverage "parity" laws, which can be expected to drive costs even higher.

[Etiopathogenesis and classification or recurrent varices]. / Eziopatogenesi e classificazione delle varici recidive.

The AA examine the most frequent causes of relapsing varices: they remember that the exact anatomic knowledge of sapheno-femoral and and sapheno-popliteal crosses in essential for the execution of an exact operation; rapidly they inspect the casuistry of S. Giuseppe Hospital, classifying the relapses on the base of a topographic standard and seeing that the technical mistake is essential for the relapses.

[Surgical treatment of recurrent varices]. / La terapia chirurgica delle varici recidive.

The AA describe the different kinds of operation, on the base of the different kinds of relapsing varices. They outline the importance of a through isolation of internal saphena vein at sapheno-femoral "cross" and of external saphena at sapheno popliteal "cross" for avoiding "high" relapses. They they insist on the subfascial ligature of incontinent perforating veins and on the closing of open muscular breach though a "zed" stitch.

[Prevention of pulmonary embolism in surgery: analysis of 2 clinical cases]. / La prevenzione dell'embolia polmonare in chirurgia: analisi di due casi clinici.

After some short notices on the physiopathology of thrombosis, the AA. consider clinic, symptomatology and surgical therapy for prevention of pulmonary embolism. They outline that only a precocious operation and an exact diagnosis can help the patient who had had an embolism; in the end they report two cases, describing the operation and its indications.

[Urinary incontinence: clinco-diagnostic and therapeutic problems]. / L'incontinenza urinaria: problemi clinico-diagnostici e terapeutici.

Consideration is given to the problem of urinary incontinence within the framework of the wider syndrome defined as "perimenopausal cystopathy". The physiopathological factors are analysed and the clinicodiagnostic and therapeutic problems defined. The Authors then report data of their own cases.