Ultrasound to improve both synthesis and pollutants degradation based on metal nanoparticles supported on TiO2.

Sonochemistry is based on acoustic cavitation, which consist in the formation, growth, and implosive collapse of bubbles within a liquid. Collapsing bubbles generate localized hot spots, characterized by temperatures up to 5000 K and pressures up to 1800 atm. These extreme conditions allow producing a variety of nanostructured and amorphous materials, as well as they are advantageous for chemical processes. Ultrasound requires inexpensive equipment and fewer steps than conventional methods. Combining ultrasound and photocatalysis enhances the performance of the processes, reduces reaction time, avoids the use of extreme physical conditions and improves the photocatalytic materials properties increasing their activity. Here, we reported the positive effect of US in synthesizing Me-modified TiO2 (Me = Ag, Cu, Mn) for pollutants degradation in gas-phase; also, we proved the advantageous application of ultrasound for the photocatalytic removal of organic compounds in water. Ultrasound produced more efficient Me-doped TiO2, which showed higher activity in visible light. When combined with photocatalytic water treatment, the organic compounds degradation and mineralization increases.

Micro-TiO2 coated glass surfaces safely abate drugs in surface water.

The ingredients of Pharmaceuticals and Personal Care Products (PPCPs) persist in water and conventional treatment plants are not able to remove them efficiently. Sonochemical treatment is insufficient to mineralize organics such as ibuprofen into CO2 and H2O. TiO2 degrades ibuprofen (IBP) under UV light; however, it does not reach a high grade of conversion. Here, we investigated the mineralization of ibuprofen to CO2 by TiO2 UV-C photocatalysis. We replaced nano-sized P25 (the standard catalyst) with a micro-sized commercial sample of TiO2 to preclude the use of nanoparticles which are dangerous for human health and because typical filtration systems are expensive and inefficient. We deposited micro-TiO2 on glass Raschig rings to ensure an easy recovery and reuse of the photocatalyst and we studied its performance both with a batch and a continuous reactor. Micro-TiO2 mineralized 100% of IBP in 24 h. TiO2-coated glass Raschig rings degraded 87% of IBP in 6 h of UV-C irradiation in a continuous reactor, with a mineralization of 25%. Electronspray ionization mass spectrometer (ESI-MS, positive mode) analyses identified 13 different byproducts and we hypothised a degradration pathway for IBP degradation.

Ultrasound assisted synthesis of Ag-decorated TiO2 active in visible light.

Titanium dioxide is the most popular photocatalyst to degrade organic pollutants in air, as well as in water. The principal drawback preventing its commercial application lies in its limited absorption of the visible light (400-700nm), while it is active under UV irradiation (≤387nm). Supporting noble metals in the form of nanoparticles on TiO2 increases its activity in the visible range. However, both the synthesis of noble metal nanoparticles and their deposition on TiO2 are multi-step processes that often require organic solvents. Here, we deposit Ag nanoparticles from AgNO3 on the surface of micrometric TiO2 with H2O as a solvent and under ultrasound irradiation at 30Wcm-2. Ultrasound increases the surface amount of Ag on TiO2 with heterogeneous size distribution of Ag nanoparticles, which are bigger and overlaid (1-20nm vs. 0.5-3nm) compared to the sample obtained in traditional conditions (TEM images). While this change in morphology had no effect on acetone photodegradation under UV light, the 5%, 10%, and 20% Ag-TiO2 degraded 17%, 20% and 24% acetone under visible light, respectively. The 10% by weight Ag-TiO2 sample obtained in absence of ultrasound only degraded 14% acetone in 6h, while the bare TiO2 was not active.

New guidelines for lupus anticoagulant: sensitivity and specificity of cut-off values calculated with plasmas from healthy controls in mixing and confirmatory tests.

INTRODUCTION: The updated guidelines for lupus anticoagulant (LA) diagnosis indicate locally calculate the cut-off values of the index of circulating anticoagulant (ICA) and the clotting time in seconds (s) for mixing studies and % of correction (%C) for confirmatory tests. We assess sensitivity (SEN) and specificity (SPC) of the cut-off values obtained as the 99th percentile from 60 plasmas of healthy individuals. METHODS: We analysed 647 plasmas from patients studied in the last 3 years, and results were revaluated according to the new criteria and cut-off values. Four hundred and three had LA, and 75 of them were under oral anticoagulants (OA). We performed three screening tests: activated partial thromboplastin time (APTT), diluted Russell viper venom time (dRVVT) and dilute prothrombin time (dPT), and previous diagnosis was carried out using our home-made cut-off calculated by receiver operating characteristics curves. We reanalysed the mixing and confirmatory data of APTT/dRVVT, the tests selected in the new guidelines. To evaluate SPC, 244 plasmas (160 OA and 84 congenital deficient patients) were studied. RESULTS: Considering mixing studies, the cut-off values demonstrate that SEN of ICA-APTT was 94% and of clotting time in second (s) 83%, with an SPC of 77% and 84%, respectively. For ICA-dRVVT, SEN was 72% and for clotting time in second (s) 77%, with SPC of 98% and 84%, respectively. The cut-off values for %C for confirmatory APTT show good SEN 82% and high SPC 96%; for confirmatory dRVVT lower SEN 77%, but a SPC of 100%. CONCLUSION: The combination of mixing and confirmatory tests interpreted according to the new guidelines can clearly differentiate LA from other coagulopathies.

Gas-phase phenol methylation over Mg/Me/O (Me = Al, Cr, Fe) catalysts: mechanistic implications due to different acid-base and dehydrogenating properties.

This contribution reports about an in situ FT-IR investigation and the catalytic reactivity of Mg/Me(3+) mixed oxides (Me = Cr, Fe, or Al; Mg/Me = 2, atomic ratio) in the gas-phase methylation of phenol with methanol. It is the second of two papers concerning the mentioned systems, and its purpose is twofold: to confute the classic and not accurate theory concerning the reaction mechanism, and to propose a novel interpretation based on the combined use of catalytic tests and in situ molecular spectroscopy. Results here reported highlight that: (i) the reaction mechanism in phenol methylation, when catalysed by basic systems, is not a classical electrophylic substitution, as generally reported in the literature, but proceeds through the formation of formaldehyde as an intermediate, and (ii) the catalytic behaviour in respect to both methanol and phenol reactants is strictly dependent on catalyst features. Although all investigated systems exhibit a basic-type behaviour with regard to phenol, which dissociates to yield an adsorbed phenolate species, the distribution of phenolic compounds obtained with the Mg/Al/O catalyst was that typically observed with acid catalysts, with prevailing formation of anisole when the reaction was carried out below 350 degrees C and of mono and poly-C-alkylated compounds when the reaction temperature was above 350 degrees C. On the contrary, the reactivity shown by both Mg/Fe/O and Mg/Cr/O systems was that reported in the literature as typical of mixed oxides possessing basic features. The extent of methanol decomposition into light compounds was maximum in the case of Mg/Fe/O catalysts, because of the pronounced redox behaviour typical of Fe(3+) species, whereas neither methanol dehydrogenation nor decomposition were ever observed with Mg/Al/O up to 400 degrees C. Reactivity tests and spectroscopic experiments hinted for methanol dehydrogenation to formaldehyde as the first step in the ring-methylation of phenol with Mg/Cr/O and Mg/Fe/O: in that case, o-cresol and 2,6-xylenol were the only reaction products. But, with Mg/Al/O systems, for which no methanol dehydrogenation occurred, the formation of anisole was due to the synergistic effect of stronger basic features and the presence of Lewis acidic sites, that facilitate the reaction between phenol and methanol after activation over the two different types of catalytic sites.

Link between anti-CD36 antibodies and thrombosis in the antiphospholipid syndrome.

OBJECTIVE: Some studies have previously suggested the involvement of antibodies directed against CD36 (anti-CD36) in the pathogenesis of thrombosis. The aim of this study was to evaluate the prevalence of anti-CD36 in patients with antiphospholipid antibodies (aPL) and its relationship with thrombosis. METHODS: Anti-CD36 were tested using an indirect MAIPA assay in 62 patients with autoimmune aPL but without SLE; there were 38 with and 24 without thrombosis. Nineteen patients with thrombosis served as an aPL(-) control group and 58 healthy subjects as the normal control group. RESULTS: 15 of 62 aPL patients (24.2%) but only 1 of 58 (1.7%) normal controls had anti-CD36 (p < 0.0005). As compared to normal controls, the prevalence of anti-CD36 was significantly higher in aPL patients with (26.3%, p < 0.0005) or without thrombosis (20.8%, p < 0.01). Anti-CD36 were significantly more frequent in aPL patients with thrombosis than in thrombosis aPL(-) subjects (26.3% vs 0%, p = 0.02). The presence of anti-CD36 seems to be more frequent in aPL patients with recurrent thrombosis than in those with a single episode (36.8% vs 15.8%). CONCLUSION: The presence of anti-CD36 is highly prevalent in patients with autoimmune aPL with a trend to being more frequent in patients with recurrent episodes of thrombosis.

Central retinal vein occlusion and thrombophilia risk factors.

The purpose of the present study was to investigate the role of risk factors predisposing to thrombosis in patients with central retinal vein occlusion (CRVO). We prospectively examined 37 consecutive patients with CRVO, and 144 healthy controls, for major and potential inherited and acquired thrombophilic risk factors. Among them, only the prevalence of hyperhomocysteinaemia (10/37, 27.0%) and antiphospholipid antibodies positivity (5/37, 13.5%) were significantly higher in patients with respect to controls (5.5%, P < 0.001 and 2.1%, P < 0.01, respectively). Both hyperhomocysteinaemia and antiphospholipid antibodies seem to be associated with CRVO. A search for acquired thrombophilia is advisable in patients with CRVO.

Major and potential prothrombotic genotypes in a cohort of patients with venous thromboembolism.

Factor V Leiden (FVL) and the prothrombin 20210A (PT-20210A) variant are well-known risk factors for venous thromboembolism (VT). The thermolabile variant (TT) of the methylenetetrahydrofolate reductase (MTHFR) gene, and homozygosity for the 4G allele of the promoter region of the plasminogen activator inhibitor-1 (PAI-1) are potential genetic polymorphisms that have not been consistently associated with increased risk of VT. A case-control study was performed on 192 consecutive unrelated patients referred for evaluation of thrombophilia because of VT and 200 healthy controls. FVL was found in 10.4% of patients compared to 3.0% of controls, while 6.3% of patients were carriers of the PT-20210A allele compared to 2.0% of controls. The adjusted odds ratios (OR) were 5.92 and 4.03 for FVL (P=.001) and the PT-20210A (P=.033), respectively. The prevalence of homozygotes for MTHFR (TT) and PAI-1 (4G/4G) among patients and controls were 13.7% versus 13.0% and 21.6% versus 23.5%, respectively (P=ns). A total of 121 patients underwent a complete screening for FVL, the PT-20210A, protein C (PC), protein S (PS), antithrombin III (ATIII), levels of factor VIII, and antiphospholipid antibodies (aPL). In 59 patients (48.8%) at least one defect was found, being a single defect in 55 and combined defects in 4 patients. Plasma levels of homocysteine (Hcy) were measured in 138 patients and 144 controls. Subjects from both groups carrying the MTHFR-TT variant had higher Hcy levels than those with the normal genotype. Hyperhomocysteinemia (HHcy) by itself is a risk factor for VT (OR 4.92, P<.0001). We conclude that FVL and the PT-20210A are risk factors for VT as well as Hcy levels, but the MTHFR and PAI-1 polymorphisms do not appear to be associated with VT in our country.

Lupus anticoagulant, high levels of anticardiolipin, and anti-beta2-glycoprotein I antibodies are associated with chronic thromboembolic pulmonary hypertension.

OBJECTIVE: To evaluate the prevalence of lupus anticoagulant (LAC) and anticardiolipin antibodies (aCL), and that of anti-beta2- glycoprotein I (anti-beta2-GPI) and prothrombin antibodies in patients with pulmonary hypertension (PH). METHODS: Fifty-four consecutive patients with PH were studied: 23 with primary, 20 secondary, and 11 chronic thromboembolic PH. LAC was diagnosed by screening and confirmatory coagulation tests, while aCL, anti-beta2-GPI, and prothrombin antibodies were measured by ELISA. RESULTS: Prevalence of aPL was higher in patients with chronic thromboembolic PH compared to the other 2 groups. The prevalence in chronic thromboembolic PH vs primary and secondary PH was: LAC 63.6 vs 13.0 and 10.0%, p < 0.001; aCL-IgG 54.5 vs 17.4 and 15.0%, p < 0.02; anti-beta2-GPI-IgG 36.4 vs 0 and 0%, p < 0.001; and prothrombin antibodies-IgG 36.4 vs 8.7 and 5.0%, p < 0.05. No differences between groups were found for any antibody of IgM isotype. Antibodies detected in patients with primary and secondary PH were of low titer, so considering only moderate or high titers these differences were greater for aCL-IgG (odds ratio, OR 24.6, confidence interval, CI 3.0-282, p = 0.0004) and IgM (OR 35.0, CI 2.9-1692, p = 0.0007) and remained significant for anti-beta2-GPI-IgG (OR = undefined, p = 0.006). Multivariate analysis showed that only LAC and aCL-IgG at moderate or high levels were independent variables associated with chronic thromboembolic PH. CONCLUSION: The presence of LAC, moderate or high levels of aCL-IgG, or anti-beta2-GPI-IgG was strongly associated with that of chronic thromboembolic PH. These data are in agreement with the close relationship observed among these 3 variables and thromboembolism in patients with aPL.

Relationship of anti beta2-glycoprotein I and anti prothrombin antibodies to thrombosis and pregnancy loss in patients with antiphospholipid antibodies.

The lupus anticoagulant (LA) and anticardiolipin antibodies (aCL) are clinically relevant because of their association with thrombosis and pregnancy loss. The group of antiphospholipid antibodies (aPL) includes antibodies primarily directed against various phospholipid-binding proteins, mainly beta2-glycoprotein I (beta2GPI) and prothrombin. Some studies suggest that there is an association between the presence of anti beta2GPI antibodies (alphabeta2GPI) of IgG isotype and thrombosis. Therefore, aPL defined according to the plasma protein to which they are directed appear to be more appropriate for the evaluation of their clinical importance. Using home-made ELISAs we evaluated the presence of alphabeta2GPI and antiprothrombin antibodies (anti-II) of both isotypes (IgG and IgM) in a group of 233 patients with LA and/or aCL. Forty-four women had a history of pregnancy loss, 45 patients had a history of venous thrombosis (VT) and 32 of arterial thrombosis (AT). Patients from the autoimmune group (systemic lupus erythematosus and antiphospholipid syndrome) had a higher prevalence of alphabeta2GPI and/or anti-II than those from the miscellaneous group. In the univariate analysis, a significant association was shown between the presence of alphabeta2GPI-IgG (OR 3.2; 95% CI 1.5-6.6) and previous VT, but not AT. Anti-II were related to VT but the multivariate analysis showed that alphabeta2GPI-IgG are the only independent risk factor for VT (OR 3.0; 95% CI 1.3-6.2). The presence of alphabeta2GPI-IgM correlates well with a history of pregnancy loss (OR 2.6; 95% CI 1.1-6.1). The coagulation tests profile showed that the clotting assays were more prolonged in patients having aCL, alphabeta2GPI or anti-II. But a higher prevalence of abnormal results was only found for the dilute Russell viper venom time in patients with VT, as compared to those without thrombosis (94.4% vs. 58.7%, p <0.02). The measurement of alphabeta2GPI of both isotypes could help to identify aPL-positive patients with a higher risk for thrombosis and pregnancy loss, although this association should be confirmed by prospective studies.

Pregnancy loss and autoantibodies against phospholipid-binding proteins.

OBJECTIVE: To evaluate the relationship between antibodies against beta 2-glycoprotein I or prothrombin and pregnancy losses in women with antiphospholipid antibodies. METHODS: Women with antiphospholipid antibodies, (lupus anticoagulant and/or anticardiolipin antibodies), with (n = 41) and without (n = 61) a history of pregnancy loss were evaluated. Thirty-one out of the forty-one patients with pregnancy loss had early miscarriages (at less than 13 weeks) and ten patients had late miscarriages. Immunoglobulin (Ig)-G and IgM anti-beta 2-glycoprotein I and anti-prothrombin antibodies were measured by an enzyme-linked immunosorbent assay method. RESULTS: A significant association between pregnancy loss and positive IgM anti-beta 2-glycoprotein I antibodies was found (odds ratio 2.6; 95% confidence interval 1.03, 6.6; P = .043). Women with late pregnancy loss had higher levels of both IgG and IgM anti-beta 2-glycoprotein I antibodies compared with controls (P < .05). There was a good correlation between anticardiolipin and anti-beta 2-glycoprotein I antibodies levels (IgG: r = 0.75; IgM: r = 0.73). In contrast, there was no correlation between the levels of anticardiolipin or anti-beta2-glycoprotein I antibodies and the levels of anti-prothrombin antibodies. Furthermore, the presence of anti-prothrombin antibodies was not associated with a history of pregnancy loss. CONCLUSION: The result of our study shows that there is a relationship between the presence of IgM anti-beta 2-glycoprotein I and previous miscarriages in women with anti-phospholipid antibodies.

Activated protein C resistance in patients with anti-beta 2 glycoprotein I antibodies.

To evaluate if the presence of anti-beta 2GPI antibodies (a beta 2GPI) is associated with activated protein C resistance (APC-R) phenotype, we performed the APC-R APTT-based assay in 74 plasma samples from patients with antiphospholipid antibodies (aPL). Samples were diluted 1:5 in factor V-deficient plasma. Lupus anticoagulant (LA), anticardiolipin antibodies (aCL) and a beta 2GPI (IgG and IgM) were also performed. A control group of 22 healthy volunteers was used. The prevalence of reduced APC-R ratio in patients with aPL was significantly higher than in normal controls (31.1 vs 4.5%, P < 0.05) and the mean APC-R ratio was lower (mean +/- SD; 2.32 +/- 0.40 vs 2.55 +/- 0.21, P < 0.02). There were no differences in the prevalence of APC-R and the ratio values between LA(+) and LA(-). Among the LA(+), the aCL(+) had a higher prevalence of APC-R than the aCL(-) (P < 0.01) and lower APC-R ratios (P < 0.01). The latter group was no different to normal controls. Anti-beta 2GPI antibodies were associated with a higher prevalence of APC-R (50.0 vs 19.6%, P < 0.001), and lower APC-R ratios (2.15 +/- 0.41 vs 2.42 +/- 0.35, P < 0.005), compared with a beta 2GPI(-). In conclusion, the acquired APC-R in patients with aPL seems to be associated with aCL and a beta 2GPI rather than an in vitro interference by LA.

Evaluation of recently described tests for detection of the lupus anticoagulant.

It is known that lupus anticoagulants (LA) are antibodies which interfere with phospholipid-dependent coagulation tests, but due to the heterogeneity of LA and the differences in sensitivity of reagents and tests, the diagnosis of LA remains difficult. Recently, Triplett et al. (26) have proposed a new test based on two venoms, Textarin (T) and Ecarin (E), that activate prothrombin but differ in their phospholipid requirements. By testing this new assay we have evaluated 36 patient plasmas containing LA according to standard tests (activated partial thromboplastin time, dilute Russell viper venom time and platelet neutralization procedure) and our results confirm a high sensitivity for LA of the T/E test. In addition, we observed a greater sensitivity of the tissue thromboplastin inhibition test using a recombinant thromboplastin instead of a human placenta thromboplastin. Our study also showed that the T/E test seems to be a useful assay in confirming the diagnosis of LA in patients with an unexplained prolonged APTT.

[Endocervical and vaginal changes in women wearing IUD's]. / Modificazioni a livello endocervicale e vaginale in donne portatrici di IUD.

The authors have studied the endocervical and vaginal changes in common vaginal smears from IUD supplied women. 521 smears from IUD supplied women have been comparized with 500 "normal" smears and 210 from women affected by lesions of the cervix uteri. The results point out that the IUD seems to be the cause of two different alterations: 1) bacteriological changes; 2) cytological changes. 1) There is a noticeable increase in mixed bacterial population and trichomonas; this picture corresponds to the one in women with cervical ectopia. 2) Cytologically there is an increase in parabasal-like cells as those from areas of squamous metaplasia. The Aa. assume that probable hormonal or mechanical changes may cause a squamous metaplasia of the cervix uteri in IUD supplied women. These stimuli themselves are the probable cause of the microbial morbid variations.

[Lobular neoplasia of the breast (author's transl)]. / Il carcinoma lobulare "in situ".

Lobular Neoplasia of the breast, a term which we prefer to that of Lobular Carcinoma in Situ, is a multifocal microscopic entity of uncertain and controversial clinical significance. Lobular Neoplasia is a incidental histological finding among otherwise benign breast biopsies (0.5%-3.5%) depending mainly upon the diagnostic intensity. Its extent is rarely so massive that it makes up a palpable tumor. Although this lesion may be demonstrated at all ages after puberty it occurs most often in premenopausal women. The multicentricity is not below 70% and bilateral occurrence not below 30-35%. Demonstration of Lobular Carcinoma in situ means a 7-12 times greater risk of later developing invasive breast carcinoma as compared with an age corrected general population. Both breast are at risk and about one half of these subsequent carcinomas will develop in the controlateral breast. Attempts at correlating the histological appearances in Lobular Neoplasia with the subsequent occurrence of invasive breast carcinoma have generally be negative. From this data it appears that ipsilateral mastectomy will protect only one half of women with lobular neoplasia who will eventually develop carcinoma and the only surgical approach would perform a bilateral mastectomy. As an alternative to mastectomy, a careful program of frequent follow-up examinations, when possible is preferable.