[Cytochrome bd as Antioxidant Redox Enzyme].

One of the main functions of enzyme complexes that constitute electron transport (respiratory) chains of organisms is to maintain cellular redox homeostasis by oxidizing reducing equivalents, NADH and quinol. Cytochrome bd is a unique terminal oxidase of the chains of many bacteria including pathogenic species. This redox enzyme couples the oxidation of ubiquinol or menaquinol by molecular oxygen to the generation of proton motive force, a universal energy currency. The latter is used by the organism to produce ATP, another cellular energy currency, via oxidative phosphorylation. Escherichia coli contains two bd-type oxidases, bd-I and bd-II, encoded by the cydAB and appCB operons, respectively. Surprisingly, both bd enzymes make a further contribution to molecular mechanisms of maintaining the appropriate redox balance in the bacterial cell by means of elimination of reactive oxygen species, such as hydrogen peroxide. This review summarizes recent data on the redox-modulated H2O2-scavenging activities of cytochromes bd-I and bd-II from E. coli. The possibility of such antioxidant properties in cytochromes bd from other bacteria is also discussed.

Cytochrome bd Protects Bacteria against Oxidative and Nitrosative Stress: A Potential Target for Next-Generation Antimicrobial Agents.

Cytochrome bd is a terminal quinol oxidase of the bacterial respiratory chain. This tri-heme integral membrane protein generates a proton motive force at lower efficiency than heme-copper oxidases. This notwithstanding, under unfavorable growth conditions bacteria often use cytochrome bd in place of heme-copper enzymes as the main terminal oxidase. This is the case for several pathogenic and opportunistic bacteria during host colonization. This review summarizes recent data on the contribution of cytochrome bd to bacterial resistance to hydrogen peroxide, nitric oxide, and peroxynitrite, harmful species produced by the host as part of the immune response to microbial infections. Growing evidence supports the hypothesis that bd-type oxidases contribute to bacterial virulence by promoting microbial survival under oxidative and nitrosative stress conditions. For these reasons, cytochrome bd represents a protein target for the development of next-generation antimicrobials.

High frequency Lunar Penetrating Radar quality control, editing and processing of Chang'E-4 lunar mission.

Chinese lunar landing mission Chang'E-4 reached the far side of the Moon in January 2019 and has been providing unprecedented Lunar Penetrating Radar data able to explore the lunar subsurface down to more than 40 m (with its more resolutive high frequency band). Data are periodically released to the scientific community in raw PDS4 format. Here we provide different versions of the radar dataset after editing (i.e. pre-processing), partial, and full processing in order to provide a complete ready-to-use dataset to end-users (data collected since 4th January 2019 until 27th March 2023) which can be directly exploited for analysis, interpretation, inversion, as well as integration with imagery or other information. In particular, we implemented an efficient and objective way to remove duplicated traces representing more than 90% of original data, as well as a processing flow able to retain all the original data information, while avoiding redundancies. The provided datasets can be implemented with future data releases and straightforwardly exploited for any future analysis.

The use of anti-spasmodics in the treatment of irritable bowel syndrome: focus on otilonium bromide.

OBJECTIVE: Aim of this review is to summarize the studies carried out, with particular interest in those who dealt with otilonium bromide in treatment of IBS. Irritable bowel syndrome (IBS). DISCUSSION: IBS is a frequent gastrointestinal disease, characterized by a combination of several symptoms including abdominal pain or discomfort, flatulence and problems related to bowel habits (constipation and/or diarrhea). It affects about 15% of the western population, with a negative impact on the quality of life and also on health care costs. Face to such important complexity and negative impact, therapeutic options are still very limited and most of the pharmacological compounds mostly validated for short term use, are only partially controlling symptoms. Among those, anti-spasmodics are commonly used in clinical settings. Despite a discrete literature in support of these drugs, systematic collections of clinical evidence to support the use of anti-spasmodics and in particular the use of otilonium bromide in course of IBS are scarce. RESULTS AND CONCLUSION: Otilonium bromide is a systemically poorly absorbed antispasmodic, which has shown clear efficacy compared to placebo, in controlling symptoms related to IBS. Otilonium bromide was effective also in comparison to other drugs, such as pinaverium bromide and mebeverine, with a favorable tolerability profile. Further studies are necessary to better define duration of treatment and maximum therapeutic dose.

How social intimidation interferred with the increasing number of improper accesses at the E.R.: a first-month COVID19 outbreak evaluation.

ABSTRACT: SARS Cov 2 pandemic outbreak caused countless changes in the daily habits among people in the entire World. National Health Systems were highly stressed and at severe risk of collapse. In the first months of 2020, it was expected a worsening of the typical overcrowding working flow. Quite the opposite, we found out an unexpected decrease throughout the daily ED visits. We evaluated the ER visits of a University Metropolitan Hospital in Rome in March 2020, comparing them with the same month in 2019. We highlight the sharp decline in ED visits for deferrable urgencies, considered among the leading causes of ED overcrowding. On the contrary, the rate of visits for "time-dependent" pathologies is superimposable for those pathologies mainly centralized through the Out-of-Hospital Emergency System. In a historical period where significant outpatient activity restrictions took place, we expected an increase in ED visits for deferred emergencies. On the contrary, it was undergoing a considerable decrease. The critical decrease in accesses recorded in March 2020 can be considered an indicator of ED's improper use. Probably, the fear of a possible coronavirus-related infection might have to lead the population to refer to the ED just in case of real emergency condition or severe medical issues, as it should "normally" be. The critical decrease in accesses recorded in March 2020 can be considered an indicator of ED's improper use. We would highlight the need to sensitize people to proper use of Emergency Medical Services, avoiding overcrowding and overuse. This unexpected event, lead by a global pandemic, could help reorganize the whole Health System.

Aesthetic appreciation of musical intervals enhances behavioural and neurophysiological indexes of attentional engagement and motor inhibition.

From Kant to current perspectives in neuroaesthetics, the experience of beauty has been described as disinterested, i.e. focusing on the stimulus perceptual features while neglecting self-referred concerns. At a neurophysiological level, some indirect evidence suggests that disinterested aesthetic appreciation might be associated with attentional enhancement and inhibition of motor behaviour. To test this hypothesis, we performed three auditory-evoked potential experiments, employing consonant and dissonant two-note musical intervals. Twenty-two volunteers judged the beauty of intervals (Aesthetic Judgement task) or responded to them as fast as possible (Detection task). In a third Go-NoGo task, a different group of twenty-two participants had to refrain from responding when hearing intervals. Individual aesthetic judgements positively correlated with response times in the Detection task, with slower motor responses for more appreciated intervals. Electrophysiological indexes of attentional engagement (N1/P2) and motor inhibition (N2/P3) were enhanced for more appreciated intervals. These findings represent the first experimental evidence confirming the disinterested interest hypothesis and may have important applications in research areas studying the effects of stimulus features on learning and motor behaviour.

Anaphylactic reactions during cesarean section.

Sensitization to latex seems to occur more frequently in women than in men. Obstetric and gynecological surgical procedures have recently been shown to be a common setting for latex anaphylaxis. We analyzed all the cases of anaphylactic reactions during 1240 cesarean sections in 2004; the patients were questioned for risk factors and underwent allergy testing for drugs and latex. Four patients had anaphylaxis under spinal anesthesia and in all cases it was due to latex allergy. Reported symptoms included facial edema, profuse sweating, itching, generalized erythematous rash and hypotension. Only one patient manifested a severe reaction which included bronchospasm, dyspnea, tachypnea and anaphylactic shock, requiring orotracheal intubation and epinephrine. Our data showed a high incidence (1:310) of intraoperative latex anaphylactic reactions in the one-year study period. This may be related to the very specific population (all women) in a very specific setting (obstetrics). To prevent anaphylactic reactions during obstetric surgery it is important to identify potential risk factors to include, for example atopy, adverse reactions to foods and latex items. If latex allergy is confirmed or strongly suspected, patients should be managed in a latex-safe environment. Premedication with antihistamines and steroids might be useful to further reduce the risk. After the delivery, specific desensitization may represent a good therapeutic option.

Hybrid Core-Shell (HyCoS) Nanoparticles produced by Complex Coacervation for Multimodal Applications.

Multimodal imaging probes can provide diagnostic information combining different imaging modalities. Nanoparticles (NPs) can contain two or more imaging tracers that allow several diagnostic techniques to be used simultaneously. In this work, a complex coacervation process to produce core-shell completely biocompatible polymeric nanoparticles (HyCoS) for multimodal imaging applications is described. Innovations on the traditional coacervation process are found in the control of the reaction temperature, allowing a speeding up of the reaction itself, and the production of a double-crosslinked system to improve the stability of the nanostructures in the presence of a clinically relevant contrast agent for MRI (Gd-DTPA). Through the control of the crosslinking behavior, an increase up to 6 times of the relaxometric properties of the Gd-DTPA is achieved. Furthermore, HyCoS can be loaded with a high amount of dye such as ATTO 633 or conjugated with a model dye such as FITC for in vivo optical imaging. The results show stable core-shell polymeric nanoparticles that can be used both for MRI and for optical applications allowing detection free from harmful radiation. Additionally, preliminary results about the possibility to trigger the release of a drug through a pH effect are reported.

Wake-up test during major spinal surgery under remifentanil balanced anaesthesia.

Damage to spinal cord and subsequent neurological deficit is a recognised complication of major spinal surgery. It may be produced by a number of causes, not last excessive stretching when surgical instrumentation is positioned; it is easy to understand that early intraoperative warning of potential damage is highly desiderable. Wake-up test is a simple, safe and reliable method of recognition of such a complication, allowing rapid neurological recovery by reduction of spinal distraction. Remifentanil belongs to a new pharmacokinetic class of opioids (EMO: Esterase Metabolised Opioid) undergoing rapid biotransformation to minimally active metabolites, showing a short and predictable duration of action with no effect of accumulation. Authors describe a first 10 patient series subjected to wake-up-test during spinal surgery under remifentanil balanced anaesthesia. The protocol the authors set up allowed a very rapid intraoperative neurological examination (in average less than 5 min), without pain and/or disagreement for the patient and no complication related to the test was observed. Authors conclude that the use of Remifentanil for intraoperative awakening during major spinal surgery seems to be a safe, reliable and pratictical method to detect very quickly any potential neurological damage during the operation.

Anaesthesia for shock wave therapy in musculoskeletal disorders: a preliminary report.

The potential for using external applied energy to rectify or ameliorate musculoskeletal disorders has been explored for decades. A shock wave is a pressure disturbance: tissue effect is cavitation, producing microtrauma or microfracture and haematoma formation, inducing, as to date is thought, increase in vascularization, increased soft callus and faster enchondral ossification. Anaesthesiological interest in this field is focused in non-union or delayed osseous union, joint stiffness or osteochondrosis and femoral head necrosis in adults. Actually, because of the pain associated with high energy extracorporeal shock wave therapy on bones, anaesthesia is necessary, but, since almost all patients have no complaint after treatment, there is no need of postoperative analgesia. Therefore, short duration anaesthetic techniques and agents should be preferred. Loco-regional anaesthesia or general anaesthesia are both suitable to the purpose. Fifty patients have been treated nowadays in our Institution with shock wave therapy needing anaesthesia. 18 patients (36%) received general anaesthesia. Since patient's stay in hospital was expected to be short, short duration agents have been used, avoiding those causing unpleasent side effects, first emesis. We used Propofol or Remifentanil by continuous infusion, titrated to maintain stable haemodynamics and an appropriate level of anaesthesia. The short duration of action of Propofol depends on its rapid elimination, whereas Remifentanil undergoes rapid biotransformation to minimally active metabolites. 32 patients (64%) received regional anaesthesia. We avoided long acting agents or high concentration drugs. Spinal blocks have been performed with 0.5% hyperbaric bupivacaine; brachial plexus blocks, sciatic-femoral blocks and an epidural block have been performed with 0.5-1% xylocaine or 1% mepivacaine. Shock Wave Therapy has been done during a 3-day hospital stay. With suitable anaesthesiological treatment and preparation, almost all patients could be treated as outpatients or with an overnight hospital stay.

Detection and interpretation of lysergic acid diethylamide results by immunoassay screening of urine in various testing groups.

A total of 2259 urine samples were assayed for lysergic acid diethylamide (LSD) using radioimmunoassay (RIA, Coat-a-Count, Diagnostics Products) and a premarket cloned enzyme donor immunoassay (CEDIA, Boehringer Mannheim). Urine samples were obtained from patients admitted to the emergency room, patients in drug rehabilitation programs, and adults and juveniles in criminal probation programs. An overall incidence of positive results was 0.80% for CEDIA (500-pg/mL cutoff) and 0.89% and 0.18% for RIA at cutoffs of 250 and 500 pg/mL, respectively. Of the CEDIA-positive samples, only 17 and 11% were positive by RIA at 250 and 500 pg/mL, respectively, whereas among RIA-positive samples, only 10% of those > 250 pg/mL and only 25% of those > 500 pg/mL were positive by CEDIA. Moreover, only 2 of 25 of samples positive by one of these screening assays were confirmed by gas chromatography-mass spectrometry (GC-MS). It is likely that discrepancies in results between immunoassays are due to differences in antibody specificities used to detect LSD metabolites. In addition, immunoassays may be more sensitive than GC-MS for detecting LSD use as current confirmation assays are targeted towards detection of the parent drug only. The interpretation of results for LSD analysis must be made with knowledge of the limitations for each assay.

Inhibitory activity of spices and essential oils on psychrotrophic bacteria.

This study was designed to evaluate "in vitro" the inhibitory effects of spices and essential oils on the growth of psycrotrophic food-borne bacteria: Aeromonas hydrophila, Listeria monocytogenes and Yersinia enterocolitica. The sensitivity to nine spices and their oils (chilli, cinnamon, cloves, ginger, nutmeg, oregano, rosemary, sage, thyme) was studied. Antibacterial activity was evaluated on liquid and solid medium. Spices: 1% concentration of each spice was added separately to Triptic Soy Broth and then inoculated to contain 10(8)/ml organism and held to 4 degrees C for 7 days. Populations of test organism were determined on Triptic Soy Agar. Oils: Inhibition of growth was tested by using the paper disc agar diffusion method (at 35, 20 and 4 degrees C) and measuring their inhibition zone. MIC was determined by the broth microdilution method. Some culinary spices produce antibacterial activity: inhibition of growth ranged from complete (cinnamon and cloves against A. hydrophila) to no inhibition. Antibacterial inhibition zone ranged from 8 mm to 45 mm: thyme essential oil showed the greatest inhibition against A. hydrophila.

Definitive identification of an exceptionally high methanol concentration in an intoxication of a surviving infant: methanol metabolism by first-order elimination kinetics.

Intoxication by methanol was identified in a five-week-old infant suffering from moderate metabolic acidosis. The initial serum methanol at admission was 1148 mg/dL as measured by gas chromatography. The osmolal gap and formic acid concentrations were consistent with methanol intoxication. The child was treated with folic acid and a continuous ethanol infusion and survived without any apparent permanent problems. Because expected toxic symptoms did not develop in this case, and the methanol concentrations were at levels that might be deemed to be incompatible with life, blood and urine samples were assayed by a specific enzymatic assay, and by gas chromatography/mass spectrometry (GC/MS). Positive results definitively confirmed the presence of methanol. In contrast to previous reports, the elimination of methanol in this case appeared to following first-order kinetics. If hepatic ADH activity is low in neonates and young infants, another enzyme system such as catalase may be involved to explain this data. The lack of formic acid accumulation may have been due to folic acid therapy.

CEDIA for screening drugs of abuse in urine and the effect of adulterants.

The performance of the Microgenics CEDIA DAU assays for screening amphetamines, barbiturates, benzodiazepines, cocaine, opiates, phencylidine (PCP), and tetrahydrocannabinol (THC) was evaluated on the Boehringer Mannheim/Hitachi 717 in urine. Limits of detection ranged from 0.6 ng/mL for PCP, to 34.1 ng/mL for benzodiazepines. The average within run and total precision for these assays ranged from 1.3 to 7.3% for controls at cutoff concentrations, and control values at -25% and +25% of cutoffs. The rate separations by CEDIA between the negative and cutoff calibrators for all drugs were greater than corresponding EMIT II (Syva Co.) assays. The relative sensitivity and specificity of CEDIA as compared to EMIT II were 95.6 and 98.8%, respectively, on 13,535 urine samples. All positive samples, and those samples producing discordant results between the assays were confirmed by quantitative gas chromatography/mass spectrometry (GC/MS). Using SAMHSA cutoff limits (and including barbiturates and benzodiazepines at 300 ng/mL), the relative sensitivity and specificity of CEDIA vs. EMIT II were 96.7 and 98.8%, respectively. The overall sensitivity of CEDIA vs. GC/MS was 98.9% with 179 false positives, as compared to 96.2% with 189 false positives for EMIT II vs. GC/MS. The effect of adulterants added to urine to potentially invalidate screening results was also tested. CEDIA produced strong interferences for most drug assays in the presence of glutaraldehyde, detergent, and high concentrations of bleach and Drano. Minimal or selective interferences were seen with golden seal tea lemon juice, Visine, and low concentrations of bleach and Drano. Essentially no interference was observed with bicarbonate, sodium chloride, and vinegar.

Mental health home visits for the elderly.

TOPIC: The nurse's role in providing mental health services to the elderly. SOURCE: The Mental Health Interventions Program. GOAL: To provide a viable model for providing these services. CONCLUSION: Nurses have the skills necessary to ensure that the elderly are recipients of quality mental health care.

Management of acute dyarrhea: current and future trends.

Acute diarrhea is a very common symptom, which may recognize different causes and is basically the expression of an altered homeostasis of the bowel, which overcame current classifications. When approaching patients with acute diarrhea, we should firstly check body temperature and vital parameters and secondly provide a general medical examination mainly focused on the abdomen, in order to exclude surgical causes of diarrhea, such as acute appendicitis, diverticulitis, intestinal occlusion and others. Another important aspect is the assessment of the level of hydration in order to provide the right amount of fluids. There is no current indication for the administration of loperamide in infectious diarrhea, but there is a strong rationale for new class of drugs, which may be defined as "mucous regenerators", such as gelatin tannate. Further studies are needed on this matter in order to test the effect of gelatin tannate in adult patients with acute diarrhea.

New perspectives to repair a broken heart.

The aim of cardiac cell therapy is to restore at least in part the functionality of the diseased or injured myocardium by the use of stem/progenitor cells. Recent clinical trials have shown the safety of cardiac cell therapy and encouraging efficacy results. A surprisingly wide range of non-myogenic cell types improves ventricular function, suggesting that benefits may result in part from mechanisms that are distinct from true myocardial regeneration. While clinical trials explore cells derived from skeletal muscle and bone marrow, basic researchers are investigating sources of new cardiomyogenic cells, such as resident myocardial progenitors and embryonic stem cells. In this commentary we briefly review the evolution of cell-based cardiac repair, some progress that has been made toward this goal, and future perspectives in the regeneration of cardiac tissue.

Perioperative management of face-to-face craniopagus twins separation.

Craniopagus conjoining represents a complex and challenging issue for neurosurgeons as well as for anesthesiologists. A rare face-to-face case of conjoined twins underwent surgical separation and presented peculiar differences compared with those already reported in the literature. Even in cases lacking large cerebrovascular sinus connections, the impending risk of large blood loss and hemorrhagic shock in the infant requires a high level of surveillance and the institution of invasive monitoring.

[Anesthesia for neurosurgery in children: techniques and monitoring]. / Anestesia in neurochirurgia pediatrica: tecniche e monitoraggio.

Pediatric neuroanesthesia can be seen as a specific branch of anesthesia half way in between pediatric anesthesia and neuroanesthesia. As a matter of fact, we must keep well in mind the peculiarities of the pediatric patient and the different pharmadynamic and pharmacochinetic properties of the anesthetic drugs, particularly in neonates and infants. Other relevant problems are: 1) high complexity of surgical procedures implying a difficult anesthesiological management; 2) complex blood loss management either if we want to apply a blood sparing technique strategy or if we consider the problems related to diagnosis and treatment of coagulative disorders caused by intraoperative massive blood loss; 3) management of patients with latex allergy for the high incidence, in pediatric neuroanesthesia, of patients belonging to high risk groups; 4) need of repeated radiological examinations implying several anesthesiological procedures. In this article aspects related to the anesthesiological techniques and to the hemodynamic and neurophysiological monitoring of pediatric neurosurgical patients were also discussed.

Characterization of drug interferences caused by coelution of substances in gas chromatography/mass spectrometry confirmation of targeted drugs in full-scan and selected-ion monitoring modes.

Interference by substances coeluting with targeted drugs is a general problem for gas chromatographic/mass spectrometric analysis of urine. To characterize these interferences, we examined human urine samples containing benzoylecgonine and fluconazole, and other drug combinations including deuterated internal standards that coelute (ISd,c) with target drugs, by selected-ion monitoring (SIM) and full-scan mass spectrometry. We show that, by SIM analysis, detecting the presence of an interferent is dependent on the specific IS used for the assay. When an ISd,c is used, the presence of another coeluting substance (interferent) suggests that the intensity of IS ions is substantially diminished, because the interferent affects both the ISd,c and target drug. When a noncoeluting IS (ISnc) is used, the interferent cannot be discerned unless it coincidently contains one or more of the ions monitored for either the target drug or ISnc. Under full-scan analysis, a coeluting interferent is directly discernable by examining the total ion gas chromatogram.