COVID-19 lockdown, personal protective equipment, hyper-hygiene and allergy.

Summary: At the beginning of SARS-CoV 2 pandemic, in the absence of "targeted" therapies, the national health authorities have introduced some measures aimed at reducing the spread of infection in the community (lockdown, social distancing, personal protective equipment (PPE), personal hygiene and disinfection of living environments). All the containment measures have led to both positive and negative effects in patients with allergic diseases. We believe that further studies should be undertaken to investigate the possible correlations between SARS-CoV-2 infection and allergy, from a broader perspective. In particular, the risk factors for the development of undesirable effects should be investigated, especially in healthcare professionals forced to use PPE and sanitizing agents for a long time. However, since the COVID-19 pandemic probably will not be short-lived, the use of such protective aids will necessarily be widespread even in the general population. Therefore, further studies on the materials used for the production of PPE and sanitizing agents would be necessary to reduce their sensitizing and, in some cases, toxic potential.

Lessons from peculiar cases of anaphylaxis: why allergists should be prepared for the unexpected.

Summary: Anaphylaxis is the most severe systemic hypersensitivity reaction, it can be caused by a number of well identified triggers such as foods, drugs, stinging insects and facilitated by predisposing clinical conditions. However, sometimes anaphylaxis shows up with uncommon or peculiar characteristics which could delay diagnosis and therapeutic treatment. In this report we aimed to describe less accounted / difficult-to-approach shapes of anaphylaxis to facilitate clinicians to suspect these severe reactions even in uncommon conditions. We choose to present data on anaphylaxis regarding simulation, mode of exposure to sensitizing agents, pregnancy, exposure to animals, intimate behaviour, psychological stress and other situations.

Mutagenic and toxic effects of 4-hydroperoxycyclophosphamide and of 2,4-tetrahydrocyclohexylamine (ASTA-Z-7557) on human lymphocytes cultured in vitro.

Certain biological effects exerted by 4-hydroperoxycyclophosphamide and by 2,4-tetrahydrocyclohexylamine (ASTA-Z-7557), utilized in vitro in the therapy of leukemias and lymphomas to eliminate the occult tumor cells in autologous marrow transplantations, were studied in human lymphocytes cultured in vitro. The data show that these drugs exert mutagenic activity eliciting unscheduled DNA synthesis (reparative synthesis) after DNA damage and cause about tenfold higher frequency of sister chromatid exchanges than controls. Furthermore, they exert strong toxic effects, measured as tritiated thymidine uptake inhibition, on mitogen-stimulated dividing cells even if pretreated during the nonproliferative phase of the cell cycle in which the toxic activity of the drugs is not detectable. Data obtained with doses of the drugs similar to those used in the therapy are discussed in terms of the therapeutic use of these chemicals.

Increase of sister chromatid exchange and unscheduled synthesis of deoxyribonucleic acid by acrylonitrile in human lymphocytes in vitro.

The investigation has been carried out on cultures grown in the presence of 5 x 10(-1) - 5 x 10(-5) M acrylonitrile with or without a rat liver metabolizing system (S-9 mix). The results obtained showed that acrylonitrile was toxic starting from the 5 x 10(-3) M concentration, caused a significant increase in the sister chromatid exchange (SCE) frequency in comparison with the controls (p less than or equal to 0.001) when the concentration was 5 x 10(-4) M, and elicited reparative deoxyribonucleic acid (DNA) synthesis, determined by tritiated thymidine uptake, particularly when the concentration was 5 x 10(-1) M. These effects were observed in lymphocytes of different donors and after drug activation by the S-9 mix metabolizing system.

Studies of pyrimidine metabolism during chick development: two enzymes involved in UMP breakdown.

The pattern of uridylate phosphatase and uridine phosphorylase has been studied in the liver, brain, heart and thigh muscles of the chick during development. The study of enzymes involved in pyrimidine metabolism confirms that differences in utilisation of the metabolic pathways exist during ontogenesis. In the liver, starting from the 12th day, an active metabolic pathway, leading to UMP via cytosine should be added to the catabolic ones. In the brain, the second period of embryogenesis should be characterized by a lower utilisation of the catabolic pathways and by an increase of the anabolic ones. In the heart, pyrimidine metabolism during development regards especially UMP. In skeletal muscle, pyrimidine metabolism shows low activity.

Glucose.

Disorders of glucose metabolism are commonly seen by practicing emergency physicians. Reagent strips such as Visidex and Chemstrip are useful as a quick and accurate method of glucose estimation provided the procedure is followed correctly. These reagent strips are particularly useful for rapid screening in the unresponsive patient. The accuracy of glucose analysis obtained from the clinical laboratory is improved when methods to prevent glycolysis are used and when enzymatic methods of glucose analysis are used. The common and important indications for routine glucose analysis include evaluation of symptomatically ill patients with known diabetes or patients with altered mental status or coma of unknown etiology; patients on insulin or sulfonylureas; sick neonates; patients with a variety of drug intoxications; and patients suffering from significant systemic illness or injury likely to manifest with physiologic stress expressed as glucose intolerance.

Electrical interventions in cardiopulmonary resuscitation: pacing.

The techniques of cardiac pacing, the types of pacing electrodes, technologic advances and new devices, and the future of pacing in CPR are discussed.

The Cincinnati DC-9 experience: lessons in aircraft and airport safety.

Twenty-three passengers died on June 2, 1983, when a McDonnell Douglas DC-9 experienced an inflight rear lavatory fire near Cincinnati, OH. Evidence of toxic fume inhalation was developed by investigators, demonstrating lethal levels of carbon monoxide and cyanide in the victims' blood. An analysis of the inflight progression of fire and smoke, and the subsequent extension of this following the emergency landing at Greater Cincinnati Airport has been accomplished. This data is augmented by other data from previous accidents of this type. Data from interviews with survivors was collected, including inflight experiences, emergency escape processes and airport disaster management during the emergency. Several practical means of respiratory protection both inflight and during emergency evacuation are documented. Onboard preventive measures in regard to this type of emergency have been identified. Emergency evacuation and modern airport disaster management techniques are codified and described. This recent accident provides information for future adoption by the responsible authorities so that inflight and postflight fires do not continue to cause significant numbers of fatalities. Modified lightweight passenger breathing apparatus, upgraded flight attendant and aircrew portable breathing apparatus, floor level guidance to exits, less flammable and toxic interior materials, improved passenger evacuation information, tailored airport emergency response procedures, and upgraded toilet smoke detector equipment are examples.

Enzymes of pyrimidine metabolism in the musculus complexus of the chick during development.

The pattern of cytidylate and uridylate phosphatase, uridine phosphorylase, cytidine and cytosine deaminase activities has been studied in M. complexus during chick development. The comparison of these enzyme activities with thigh muscles ones has shown that quantitative and temporal changes occur, in parallel with the unusual pre-natal and early post-natal development of M. complexus. The results suggest that during the first period of incubation, UMP might follow the anabolic pathway UMP-UTP, which leads to cytidine nucleotides, while approaching the hatching, the catabolic pathway should prevail. In addition, immediately after hatching, pyrimidine metabolism is especially supported by cytidine nucleotides.

An overview of managed care in state Medicaid programs.

The National Governor's Association predicts that Medicaid will account for 28 percent of total state spending in 1995, double the 1991 level. During 1992, total Medicaid enrollment reached 31.6 million beneficiaries, up 4.7 million (17.5 percent) from 1991. The total expenditure of $118.2 billion in 1992 was up 25 percent from the 1991 level of 94.5 billion. A recent General Accounting Office (GAO) report, revealed that, in 1990, 43 percent of 99 million emergency department visits were for minor ailments. From 1985 to 1990, Medicaid emergency department visits increased 34 percent, compared to 19 percent growth in all emergency department visits. A Department of Health and Human Services Inspector General Report on Medicaid recipient emergency department usage recommended that states develop a comprehensive initiative to reduce nonemergency usage of the emergency department, including increased implementation of managed care options. During 1992, 42 states used some type of Medicaid cost containment measure, with managed care being the most frequent choice.

[Quantitative and qualitative variations in the glycoproteins in the chick embryo brain]. / Variazioni quantitative e qualitative delle glicoproteine del cervello embrionale di pollo.

Sugar content was examined in soluble and insoluble glycoproteins extracted from the chick embryo brain at different developmental stages. The content of hexosamines and uronic acids in the soluble fraction is higher during the whole period examined. The difference between the two fractions reaches a maximum at the 15th day. The insoluble fraction shows the highest content of sialic acid and fucose in comparison with the soluble one, especially toward hatching. The sialic acid/fucose ratio shows a different pattern in the two fractions examined, particularly in the soluble glycoproteins. The patterns of sialic acid and fucose indicate that quantitative and qualitative developmental changes occur in the soluble and insoluble glycoproteins. All sugars examined show significant changes on the 15th day, suggesting that this stage may represent a critical period in the development of the chick embryo brain.

[Electrophoretic characterization of glycosaminoglycans during development of the chick embryo skin]. / Caratterizzazione elettroforetica dei glicosaminoglicani durante lo sviluppo della cute embrionale di pollo.

Glycosaminoglycans extracted by CPC precipitation from chick embryo skin at 9, 12, 15, 18, 21 days of incubation were separated by three different electrophoretic methods on acetate cellulose strips. We observed the presence of Hyaluronic acid, Dermatan Sulfate and Chondroitin-4-Sulfate during the whole period considered and of Heparan Sulfate only after the 9th day. Dermatan Sulfate increases until the 15th day then decreases progressively; on the contrary Hyaluronic acid and Chondroitin-4-Sulfate decrease during days 9 to 15 then increase until hatching. Heparan Sulfate appear the 9th day then increases progressively until hatching.

Developmental change in the glycosaminoglycan composition of the chick embryo brain.

GAGs content was examined in chick embryo brain starting from the 9th day of incubation to the 4th post-hatching day. Chondroitin 6-sulfate, hyaluronate and heparan sulfate were recovered at any developmental stage examined. C6-S was the main GAG (except on the 15th day), while HS was the least represented. The highest differences in the relative amounts of GAGs are observed on the 9th day. C6-S shows high developmental relative changes, while HA and HS exhibit a similar pattern.

Changes of glycosaminoglycan composition in aging chicken brain. A preliminary investigation.

The qualitative and quantitative pattern of GAGs was examined by electrophoresis in aging chicken brain in four different stages starting from day 1 to 30 months. GAG content referred to defatted dry tissue exhibits constant decrease. Four main GAGs have been identified with a mobility corresponding to hyaluronate, condroitin sulfate, heparan sulfate and dermatan sulfate controls. Hyaluronate appears the main GAG represented while dermatan sulfate the minor one. Our data show that in chicken brain GAG percentage undergoes age-related changes.