Clinical and ultrasonographic characteristics of pregnancy-related enhanced myometrial vascularity: prospective cohort study

OBJECTIVE

To assess the ultrasonographic, epidemiological, clinical and evolutive characteristics of enhanced myometrial vascularity (EMV) following a first-trimester termination of pregnancy (TOP) or management of non-viable pregnancy.

METHODS

This prospective study included women who underwent follow-up ultrasound examination 5-6 weeks after a first-trimester TOP or after management of a first-trimester non-viable pregnancy at the University Hospital Polyclinic San Martino of Genoa between March 2021 and March 2022. EMV was characterized using two- and three-dimensional ultrasound and Virtual Organ Computer-aided Analysis. Ultrasonographic diagnosis of EMV was made when an unusual, tortuous myometrial vessel structure, with high-velocity blood flow, protruding towards the endometrium was observed, while an abnormal junctional zone, absent endometrial midline and heterogeneous endometrium supported the diagnosis. Patients with EMV underwent expectant management with planned ultrasonographic follow-up every 2 weeks until resolution.

RESULTS

During the study period, 305 women underwent TOP, of whom 132 attended the initial follow-up 5-6 weeks later, at which 52 were diagnosed with EMV. Ninety-six women were managed for a non-viable pregnancy, of whom 32 presented for follow-up, at which six had a diagnosis of EMV. Thus, overall, 164 of 401 women were included in the study and EMV was identified in 58 (35%) of these. The prevalence of EMV 5-6 weeks after a TOP was therefore between 52/305 (17%) and 52/132 (39%), and that after management of a non-viable pregnancy was between 6/96 (6%) and 6/32 (19%). Bleeding/pelvic pain was present in half (29/58) of the women with EMV, and serum human chorionic gonadotropin was detectable in 29% (17/58) at the first follow-up examination. At ultrasound assessment, all cases with EMV presented abundant tortuous myometrial vessels with high-velocity flow projecting from the myometrium towards the endometrium, along with non-uniform heterogeneous endometrium in 97% of cases, which often (67% of these) contained cystic areas, absence of the endometrial midline in 98% of cases and an abnormal junctional zone in 97% of cases (64% interrupted, 33% irregular). Most (67%) women with EMV were parous and 90% of them had undergone TOP rather than management for a non-viable pregnancy. Medical management of the TOP or non-viable pregnancy was more frequent in women with than those without EMV (93% vs 77%, P = 0.023). Multiple regression analysis showed the risk of EMV to be increased following TOP vs non-viable pregnancy (odds ratio (OR), 3.67 (95% CI, 1.16-11.56), P = 0.026) and in parous compared with nulliparous women (OR, 2.95 (95% CI, 1.45-6.01), P = 0.002). All women with EMV underwent expectant management. Eleven women did not return for subsequent follow-up examinations and did not present to our outpatient or emergency facilities, so were lost to further follow-up. Spontaneous resolution of the lesion was observed within 7-16 weeks after the procedure in 96% (45/47) of the remaining cases. Two women chose to undergo surgery for pelvic discomfort, and histology showed the presence of neovessels mixed with retained chorionic villi.

CONCLUSIONS

EMV is a transient and common finding 5-6 weeks following first-trimester TOP or management of non-viable pregnancy. TOP and being parous are risk factors for EMV. Expectant management of EMV is appropriate, because, in almost all cases, this resolves spontaneously, without complications, within 2-4 months. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.

Posterior Circumflex Humeral Artery Perforator Flap: A Cadaveric Study and Case Series

BACKGROUND

Reconstruction of soft tissue defects of the acromioclavicular region represents a relatively uncommon but challenging event. Many muscular, fasciocutaneous, and perforator flaps have been described, including the posterior circumflex humeral artery perforator (PCHAP) flap based on the direct cutaneous perforator of the PCHA. This study aims to describe a variant of the PCHAP flap, based on a constant musculocutaneous perforator, by means of a cadaveric study and a case series.

METHODS

A cadaveric study was conducted using 11 upper limbs. The perforator vessels originating from the PCHA were dissected and the musculocutaneous ones were identified and measured in their length and distance from the deltoid tuberosity. Besides, we retrospectively analyzed the posterior shoulder reconstruction conducted among 2 plastic surgery department (San Gerardo Hospital, Monza and Hospital Papa Giovanni XXIII, Bergamo) using the musculocutaneous perforators of the PCHA.

RESULTS

The cadaver dissection showed the presence of a constant musculocutaneous perforator arising from the PCHA. The mean pedicle length is 6.10 ± 1.18 cm, and the musculocutaneous perforator pierces the fascia at a mean distance of 10.4 ± 2.06 cm from the deltoid tuberosity. In all the cadaver dissected, the perforator of interest divided into 2 terminal branches, anterior and posterior, nourishing the skin paddle.In our case series, the mean age of the patients was 66.7 years, the mean size of the defect was 46 cm 2 , the mean operating time was 79.3 minutes, the mean length of hospital stay was 2.7 days, and the complication rate was 28.6%.

CONCLUSIONS

According to this preliminary data, the PCHAP flap based on the musculocutaneous perforator seems to be a reliable alternative in posterior shoulder region reconstruction.

Does a decannulation protocol exist in COVID-19 patients? The importance of working in a multiprofessional team

As a Covid Hub in Emilia Romagna, we have experienced an increasing number of tracheostomized patients, prompting us to develop a standardized decannulation protocol for COVID-19 ARDS patients. Currently, there are no guidelines or protocols for decannulation in this population, and few studies have investigated the early outcomes of tracheostomy in COVID-19 patients, with no detailed analysis of the decannulation process. We recognized the importance of mutual reliance among our team members and the significant achievements we made compared to previous decannulation methods. Through the optimization of the decannulation process, we identified a clear, safe, and repeatable method based on clinical best practice and literature evidence. We decided to implement an existing standardized decannulation protocol, which was originally designed for severe brain-damaged patients, due to the growing number of COVID-19 patients with tracheostomy. This protocol was designed for daily practice and aimed to provide a uniform approach to using devices like fenestrated cannulas, speaking valves, and capping. The results of our implementation include:expanding the applicability of the protocol beyond severe brain-damaged patients to different populations and settings (in this case, patients subjected to a long period of sedation and invasive ventilation)early activation of speech therapy to facilitate weaning from the cannula and recovery of physiological swallowing and phonationearly activation of otolaryngologist evaluation to identify organic problems related to prolonged intubation, tracheostomy, and ventilation and address proper speech therapy treatmentactivation of more fluid and effective management paths for decannulation with a multiprofessional team.

Relation between adenomyosis and elastographic characteristics of the cervix

STUDY QUESTION

Is there a possible etiologic link between cervical stiffness and adenomyosis?

SUMMARY ANSWER

Women with adenomyosis have a stiffer internal cervical os than those without adenomyosis.

WHAT IS KNOWN ALREADY

An increased myometrial contractility during menses, leading to breaches in the endometrial basal lamina and subsequent infiltration of endometrial cells into the myometrium, has been proposed as a possible pathogenic mechanism for adenomyosis. Intense menstrual pain has already been shown to be associated with an increased stiffness, at elastography, of the internal cervical os.

STUDY DESIGN, SIZE, DURATION

A cross-sectional study on 275 women was performed between 1 February and 31 July 2022.

PARTICIPANTS/MATERIALS, SETTING, METHODS

Among the participants, 103 were and 172 women were not affected by adenomyosis as evaluated by ultrasonography. General and clinical characteristics of the patients were collected. Strain elastography was used to document tissue stiffness at different regions of interest of the cervix, i.e. the internal cervical os, the middle cervical canal, the anterior and the posterior cervical compartment. Tissue stiffness was expressed as a colour score from 0.1 = blue/violet (high stiffness) to 3.0 = red (low stiffness). Simple and multiple logistic regression analyses were used to evaluate the relation between the presence of adenomyosis, as the dependent variable, and independent factors.

MAIN RESULTS AND THE ROLE OF CHANCE

Women with adenomyosis had a higher prevalence (P = 0.0001) and intensity (P = 0.0001) of pain during menses, between menses and at intercourse compared to control. The internal cervical os colour score was lower (higher stiffness) in women with adenomyosis (0.55 ± 0.29 versus 0.67 ± 0.26; P = 0.001) and the middle cervical canal/internal cervical os colour score ratio was greater (3.32 ± 4.36 versus 2.59 ± 4.99; P = 0.008), compared to controls. Upon logistic regression modelling (R2 = 0.077), the internal cervical os stiffness was an independent factor related to adenomyosis (odds ratio (OR) 0.220, 95% CI 0.077, 0.627; P = 0.005) along with age (P = 0.005) and the use of gonadal steroid therapies (P = 0.002). We obtained the same results using a different logistic regression model (R2 = 0.069), by substituting the internal cervical os stiffness with the ratio of the middle cervical canal/internal cervical os stiffness (OR 1.157, 95% CI 1.024, 1.309; P = 0.019).

LIMITATIONS, REASONS FOR CAUTION

Women did not undergo surgery therefore we have no histological confirmation of the adenomyosis diagnosis. Strain elastography is a semiquantitative analysis and can be conditioned by the force applied by the operator during the analysis. The data were obtained mainly in White women in a single centre.

WIDER IMPLICATIONS OF THE FINDINGS

To the best of our knowledge, this is the first study indicating that women with adenomyosis have an increased stiffness of the internal cervical os. The results indicate that a stiff internal cervical os, as determined by elastography, is a possible contributor to the development of adenomyosis. These findings may have clinical significance and should prompt further investigation.

STUDY FUNDING/COMPETING INTEREST(S)

None.

TRIAL REGISTRATION NUMBER

N/A.

Sensory deficits after a radial nerve injury

BACKGROUND

The aim of our study was to objectively test sensibility on the dorsal side of the hand in patients with radial nerve injury, to document deficits and to detect if surgery for sensory reconstruction is needed.

METHODS

Nineteen patients of mean age 31 ± 10 years were examined at a mean of 26.4 ± 27.8 months post radial nerve injury. Sensory mechanical thresholds on the dorsal surface of the hand were evaluated using Semmes-Weinstein monofilaments. Sensation was considered significantly impaired when there was no perception of a 2.0 gr. Semmes-Weinstein filament. Nociception was evaluated using Adson forceps.

RESULTS

Five patients had normal 2.0 monofilament perception. Two of these five also had normal perception of the lighter 0.05 monofilament. In nine patients, zones of impaired sensibility were restricted to the first web space. In combined radial and musculocutaneous nerve lesions, the zone of impaired sensibility extended to the dorsum of the third metacarpus and occasionally to the dorsal aspect of the thumb. This zone averaged being five times the size as in isolated radial nerve injuries. On average, the zone of decreased 0.05 monofilament perception was six times the size detected for the 2.0 monofilament. No patient had complete anesthesia over the dorsum of the hand. No patient complained about pain or numbness. Only one patient among four with a combined radial and musculocutaneous nerve injury required sensory reconstruction.

CONCLUSIONS

Minimal sensory abnormalities should be expected after a radial nerve injury. Patients likely neither warrant nor request sensory reconstruction.

Energy levels in CaWO4:Tb(3+) at high pressure

The luminescence properties of Tb(3+) in CaWO4 crystals are investigated under a hydrostatic pressure of up to 200 kbar, i.e. across scheelite-to-fergusonite phase transition. It is shown that the typical blue ((5)D3) and green ((5)D4) emissions in this material are progressively quenched at room temperature as pressure is increased. This quenching is caused by a downshift of the charge transfer (or impurity trapped exciton) state that is formed between Tb(3+) and nearby W(6+) cations in conjunction with a pressure-induced increase of the lattice relaxation experienced by this excited state. An empirical model is introduced to calculate the evolution of the (Tb(3+)-W(6+)) charge transfer energy with pressure. Combined with the pressure dependence of the energy bandgap in CaWO4, the model allows locating the 4f levels of Tb(3+) relative to the fundamental host lattice for any pressure in the range 0-200 kbar.

Effects of pumping wavelength and pump density on the random laser performance of stoichiometric Nd crystal powders

Laser slope and threshold properties have been investigated in Nd stoichiometric crystal powders as a function of pump wavelength and pump beam size. Above a given pumped area, the laser slope and the threshold pump energy per unit area are invariant and the known theoretical expressions are well fulfilled. Likewise, the size of the stimulated emission zone as a function of the pump beam area has been measured, also showing a different behavior above or below a given pumped area value which coincides with the one mentioned above. In conclusion, two different operating regimes with different performances are clearly observed as a function of the pump beam area.

High pressure luminescence spectra of CaMoO4:Ln3+ (Ln = Pr, Tb)

Photoluminescence spectra and luminescence kinetics of pure CaMoO(4) and CaMoO(4) doped with Ln(3+) (Ln = Pr or Tb) are presented. The spectra were obtained at high hydrostatic pressure up to 240 kbar applied in a diamond anvil cell. At ambient pressure undoped and doped samples exhibit a broad band emission extending between 380 and 700 nm with a maximum at 520 nm attributed to the MoO(4)(2-) luminescence. CaMoO(4) doped with Pr(3+) or Tb(3+) additionally yields narrow emission lines related to f-f transitions. The undoped CaMoO(4) crystal was characterized by a strong MoO(4)(2-) emission up to 240 kbar. In the cases of CaMoO(4):Pr(3+) and CaMoO(4):Tb(3+), high hydrostatic pressure caused quenching of Pr(3+) and Tb(3+) emission, and this effect was accompanied by a strong shortening of the luminescence lifetime. In doped samples, CaMoO(4):Pr(3+) and CaMoO(4):Tb(3+), quenching of the emission band attributed to MoO(4)(2-) was also observed, and at pressure above 130 kbar this luminescence was totally quenched. The effects mentioned above were related to the influence of the praseodymium (terbium) trapped exciton PTE (ITE-impurity trapped exciton) on the efficiency of the Pr(3+) (Tb(3+)) and MoO(4)(2-) emissions.

Photon conversion in Bi(3+)/Pr(3+)-codoped CaTiO(3)

The luminescence properties of CaTiO(3) both singly and doubly doped with Bi(3+) and Pr(3+) have been measured in different experimental conditions in order to investigate the de-excitation processes active in these materials and in particular to understand the mechanism responsible for the significant increment of the red emission observed in the codoped system upon near-ultraviolet (NUV) excitation. The steady state spectra and the decay profiles have been analyzed in the light of the possible interactions between active ions and host lattice. The general model applied to the analysis of the temporal profiles of the emission allows us to assess which are the main mechanisms involved in the Bi(3+)  →  Pr(3+) sensitization process.

High pressure luminescence spectra of CaMoO4:Pr3+

Steady state and time resolved luminescence measurements of CaMoO(4) doped with Pr(3+) as a function of hydrostatic pressure in the 1-175 kbar range are presented. It has been observed that with increasing pressure the spectral features shift towards lower energies, the decay times of both (3)P(0) and (1)D(2) emitting levels become shorter and the intensity of the (3)P(0) emission decreases to complete quenching at about 110 kbar, whereas that of the (1)D(2) emission increases in the 0-100 kbar range and then rapidly decreases when the pressure exceeds 127 kbar. A variation of the structure of the spectral manifolds indicates that a pressure induced phase transition of the host lattice occurs in the 80-100 kbar range. The quenching of the luminescence and the shortening of the decay times have been accounted for by means of a model that takes into account the role played by a praseodymium trapped exciton in the excited state dynamics of the investigated material.

Luminescence properties of K1/2Bi1/2TiO3:Pr3+ and Na1/2Bi1/2TiO3:Pr3+

The luminescence properties of K(1/2)Bi(1/2)TiO(3):Pr(3+) and Na(1/2)Bi(1/2)TiO(3):Pr(3+) powders are investigated in the temperature range 10-600 K. The experimental data are interpreted on the basis of metal-to-metal charge transfer processes and by considering Bi(3+)-to-Pr(3+) sensitization effects.

A COMPARISON OF ENDOSCOPIC AND OPEN TRIGGER FINGER RELEASE

The main complaint of the patients after an open trigger finger release is a discomfort at the incision site. In this prospective study, we compared the two consecutive groups of patients with trigger fingers. One was treated by an open approach and the other by the endoscopic release of the A1 pulley. Pre- and post-operative evaluation at seven, 30 and 90 days showed a faster recovery from the discomfort with a faster return to daily and working activities, after the endoscopic procedure.

ARTHROSCOPIC ASSISTED BONE GRAFTING FOR EARLY STAGES OF KIENBÖCK'S DISEASE

Kienböck's disease is known for its difficulty in being diagnosed and treated at early stages; option treatments are few and most of them quite aggressive. The author describes his experience with arthroscopic assisted lunate bone grafting. Three patients with diagnosis of stage I avascular necrosis of the lunate (average age: 45 years), were treated. Before surgical procedure, the patients underwent to a conservative treatment. After harvesting the bone graft from the volar surface of the radius, arthroscopic bone grafting was performed.

At an average follow-up of 13.5 months (9–15), all the patients show a normal density of the lunate and no arthritic changes in radiographs. The MRI confirmed the lunate vascularity.

The number of patients is definitely small, due also to the rarity of the disease and the difficulty in diagnosis, but, despite the very high learning curve, could be the proper first choice of treatment.

Optical transition probabilities in Er3+- and Tm3+-doped LiLa9(SiO4)6O2 crystals

In this work, Er(3+) and Tm(3+)-doped LiLa(9)(SiO(4))(6)O(2) crystals have been grown from an Li(2)MoO(4) flux in the 1360-940 °C temperature range. Optical absorption spectra have been measured to obtain the experimental oscillator strengths of the transitions from the ground state to the excited levels. Judd-Ofelt calculations have been performed to estimate the Ω(2), Ω(4) and Ω(6) intensity parameters. The dynamics of selected Er(3+) and Tm(3+) manifolds have been investigated under selective pulsed excitation in order to determine the energy gap law by comparing the observed decay rates with the Judd-Ofelt predictions.

Energy levels and emission parameters of the Dy(3+) ion doped into the YPO(4) host lattice

Single crystals of Dy(3+)-doped YPO(4) have been grown from Pb(2)P(2)O(7) flux and investigated by optical spectroscopy techniques. The energy level scheme of the active ion has been deduced from the low temperature spectra and reproduced by means of a crystal-field calculation. The room temperature absorption spectra have been analysed in the framework of the Judd-Ofelt approach, and the results of this analysis have been applied in a discussion concerning the spectral composition of the visible luminescence.

High pressure evolution of YVO(4):Pr(3+) luminescence

Photoluminescence and time-resolved photoluminescence spectra of YVO(4) doped with Pr(3+) obtained at high hydrostatic pressure up to 76 kbar applied in a diamond anvil cell are presented. At pressures lower than 60 kbar the steady state emission spectra consist of sharp lines related to the [Formula: see text] transition in Pr(3+). At pressures above 68 kbar the Pr(3+) emission intensity decreases and the corresponding bands are replaced by a broad band peaking at 19 500 cm(-1) attributed to perturbed VO(4)(3-) host luminescence. The quenching of the [Formula: see text] emission has been attributed to nonradiative transition to the charge transfer exciton trapped at Pr(3+) ion. The recovering of the VO(4)(3-) host luminescence at high pressure has been attributed to energy transfer from a Pr(3+) trapped exciton (PTE) to the host YVO(4). The kinetics of such a process is analyzed using the model of PTE considered as a Pr(4+) + electron bound by the Coulomb potential at the delocalized Rydberg states.

Effects of neodymium incorporation on the structural and luminescence properties of the YAl(3)(BO(3))(4)-NdAl(3)(BO(3))(4) system

The luminescence of Nd(3+) ions in Nd(x)Y(1-x)Al(3)(BO(3))(4) (Nd:YAB) single crystals has been investigated as a function of the neodymium concentration in order to evidence the relation between the structural and spectroscopic properties in this nonlinear laser system. The analysis of the experimental data allowed us to individuate four different composition ranges. For moderate concentrations (x<0.2) the lattice parameters are nearly constant, and the emission spectra arise from Nd(3+) ions in unperturbed crystal sites. For concentrations in the 0.2<x<0.75 range the lattice parameters notably depend on the neodymium content, and a concomitant variation of the luminescence features is observed. In the 0.75<x<0.9 range a hexagonal to monoclinic phase transition takes place: the structural disorder is evidenced well by the broadening of the emission lines and by discontinuities in the concentration behaviour of other indicators such as the crystal-field strength, energy transfer parameters, etc. Finally, for x>0.9 the final formation of the NdAl(3)(BO(3))(4) (NAB) monoclinic phase is complete, and a new local ordering around Nd(3+) is very evident in the spectral features.

Triazinic herbicide determination by gas chromatography-mass spectrometry in breast milk

A solid-phase extraction procedure using a graphitized carbon black cartridge for extraction and cleaning of a series of five triazines (atrazine, deethylatrazine, deisopropylatrazine, ametryne and prometryne) from breast milk samples was developed. Using a chemometric methodology, the optimisation of both the analysis time and the triazinic herbicide separation by gas chromatography-mass spectrometry (GC-MS) was then carried out with only 18 experiments. Detection and quantification limits for 1ml breast milk sample were, respectively, 0.3 and 1 ppb for each studied compound. The variation coefficients were less than 5% over the concentration range from 1 to 100 ppb. The accuracy was between 98.63 and 104.62% for each triazinic herbicide. The recovery was between 58.64 and 63.22% for the concentration range from 1 to 100 ppb for each triazinic herbicide. The assay was successfully applied to the analysis of several breast milk samples.

[Actinomycosis infection presenting as malignant pelvic frostbite]

Actinomycosis is a chronic inflammatory disease rarely observed in the pelvic form but rather frequently in the cervicofacial tract. The pelviabdominal form is difficult to diagnose because of its various clinical presentations that can lead to misdiagnosis by imitating a neoblastic disease, a bowel inflammatory disease, an acute diverticulitis or gynecological disorders. The case is reported of a 43 year old woman with prolonged use of an intrauterine contraceptive device and with severe phlogosis secondary to extensive pelvic actinomycosis involving both ovaries, the urinary duct and the rectosigmoid, misdiagnosed as pelvic frostbite presentation of a malignant neoplasm. A bilateral hysterosalpingo-oophorectomy surgery was performed and a urethral stent was placed before the operation. Rarely, has the pelvis been so heavily involved by a chronic actinomycosis infection.

Growth, optical spectroscopy and crystal field investigation of YAl3(BO3)4 single crystals doped with tripositive praseodymium

Single crystals of YAl3(BO3)4 doped with 1 and 10% Pr3+ were grown by spontaneous nucleation from a K2Mo3O10 and B2O3 flux. Polarised absorption and luminescence spectra in the visible, near infrared and infrared ranges were recorded at room and low temperatures on ground and polished samples of about 1 mm thickness. The microsymmetry of the Pr3+ sites is D3. The observed transitions were assigned and analysed on the basis of the selection rules for the D3 point group. A set of free ion and crystal field parameters in reasonable agreement with the observed energy level structure is reported. The possible applications of the material in the field of optical devices are considered.

Optical spectroscopy and density functional calculations of chromium(V)-doped YVO4 and YPO4: influence of the second coordination sphere

Low temperature polarized single-crystal absorption and luminescence spectra of Cr(V)-doped YVO4 and the powder luminescence spectrum of Cr(V)-doped YPO4 are reported and discussed. A rich fine structure and strong polarization effects are observed in the near-infrared. Due to a strong interaction of the Cr(V) ion with two Y3+ ions in the second coordination sphere of the Cr(V) ion, the electronic ground state is different from the one expected on the basis of an angular overlap calculation in which only the four oxygen ligands are taken into account. This effect of the Y3+ ions on the ground state of Cr(V) is confirmed by a density functional calculation and by literature EPR data. CrO4(3-) bending modes are responsible for the fine structure in the d-d transition and the resulting distortion in the emitting excited state.

High-performance thin-layer chromatographic determination of 5-methoxypsoralen in serum from patients

A simple and rapid high-performance thin-layer chromatographic (HPTLC) determination of 5-methoxypsoralen in serum is necessary for the therapeutic survey of patients treated with Puvatherapy (psoralen+UVA). The assay for this biological fluid involves an extraction with heptane-dichloromethane (4:1, v/v). The analytical method is linear from 50 to 250 ng/ml. This assay range is adequate for analysing human serum, as it corresponds to psoralen concentrations measured in serum from patients treated with psoralen and UVA against psoriasis and vitiligo. The limit of detection is 15 ng/ml. The coefficient of variation was less than 7%.

Comparison of quantitative high performance thin layer chromatography and the high performance liquid chromatography of parabens

A method is described for the densitometric determination of the p-hydroxybenzoic esters and p-hydroxybenzoic acid in mixtures or in drugs. This method is compared with the one used in high performance liquid chromatography (HPLC). The calibration curves were linear in interval 0.250-3.60 mumol ml-1 per 200 nl per spot. The limit of detection and the relative standard deviation (RSD) are higher than in HPLC (RSD is 6% in HPTLC. 3% in HPLC; limit of detection about 40 pmol in HPTLC and 25 pmol in HPLC) but HPTLC quantitative determination of parabens in drugs is faster.

Novel lipid-lowering properties of Vaccinium myrtillus L. leaves, a traditional antidiabetic treatment, in several models of rat dyslipidaemia: a comparison with ciprofibrate

Vaccinium myrtillus L. (blueberry) leaf infusions are traditionally used as a folk medicine treatment of diabetes. To further define this therapeutical action, a dried hydroalcoholic extract of the leaf was administered orally to streptozotocin-diabetic rats for 4 days. Plasma glucose levels were consistently found to drop by about 26% at two different stages of diabetes. Unexpectedly, plasma triglyceride (TG) were also decreased by 39% following treatment. Subsequent to the latter observation, possible lipid-lowering properties of the extract were investigated on other models of hyperlipidaemia and ciprofibrate, a well-established hypolipidaemic drug, was used as a reference compound. Both drug reduced TG levels of rats on hyperlipidaemic diet in a dose-dependent fashion. When administered at single doses over the same experimental period, blueberry and ciprofibrate were effective in lowering TG concentrations in ethanol-treated normolipidaemic animals and in genetically hyperlipidaemic Yoshida rats. Unlike ciprofibrate, however, blueberry failed to prevent the rise in plasma TG elicited by fructose and did not affect free fatty acid levels in any of the above experimental conditions. In rats treated with Triton WR-1339, blueberry feeding induced an hypolipidaemic activity one hour after injection but proved to be ineffective at later time points, thus suggesting that its hypolipidaemic action may reflect improved TG-rich lipoprotein catabolism. In addition, ciprofibrate and the extract were tested for antithrombotic activity using a collagen-triggered model of venous thrombosis in diabetic and Yoshida rats. Only ciprofibrate, however, significantly reduced thrombus formation in diabetics, possibly because of its effects on free fatty acid metabolism, whereas no effect was observed in Yoshida rats. In conclusion, the present findings indicate that active consituent(s) of Vaccinium myrtillus L. leaves may prove potentially useful for treatment of dyslipidaemiae associated with impaired TG-rich lipoprotein clearance.

Oxatomide reduces inflammatory events induced by allergen-specific conjunctival challenge

BACKGROUND

Allergen-specific conjunctival challenge is a safe and reproducible experimental model to evaluate effectiveness and possible mechanism(s) of action of drugs employed in the treatment of allergic diseases.

OBJECTIVE

The protective effect of oxatomide on inflammatory changes that follow allergen-specific conjunctival challenge was assessed in 20 patients with rhinoconjunctivitis due to Parietaria judaica in a double-blind study.

METHODS

After a screening allergen-specific conjunctival challenge, patients were randomized into two treatment groups, each being given oxatomide (oral tablets) at 60 mg daily or matching placebo for seven days during off-pollen season. Clinical evaluation, cytologic assessment (number of inflammatory cells and ICAM-1 expression on epithelial cells) were assessed at baseline, 30 minutes, 6 hours, and 24 hours after allergen-specific conjunctival challenge, before and after treatment. In addition, electrocardiograms were obtained before and after treatment.

RESULTS

Early phase reaction clinical events as well as total numbers of inflammatory cells were significantly reduced by oxatomide compared with placebo. Late phase reaction clinical events as well as total numbers of inflammatory cells were significantly reduced by oxatomide compared with placebo. ICAM-1 expression was significantly reduced by oxatomide in early phase reactions and late phase reactions compared with placebo. No pathologic cardiac events were detected in any subject.

CONCLUSIONS

Oxatomide has a protective effect on clinical and cellular early phase reactions and late phase reactions (including ICAM-1 expression on epithelium) induced by allergen-specific conjunctival challenge and is safe and well tolerated.