Acute chest syndrome in children with sickle cell disease: Data from a national AIEOP cohort identify priority areas of intervention in a hub-and-spoke system

Acute chest syndrome (ACS) is a frequent cause of hospitalization in sickle cell disease (SCD). Despite advances in acute care, many settings still lack knowledge about ACS best practices. After the AIEOP Guidelines were published in 2012, suggesting standardized management in Italy, a retrospective study was performed to assess the diagnostic and therapeutic pathways of ACS in children. From 2013 to 2018, 208 ACS episodes were presented by 122/583 kids in 11 centres. 73 were male, mean age 10.9 years, 85% African, 92% HbSS or Sβ°. In our hub-and-spoke system, a good adherence to Guidelines was documented, but discrepancies between reference centres and general hospitals were noted. Improvement is needed for timely transfer to reference centres, use of incentive spirometry, oxygen therapy and pain management.

Secondary hemophagocytic lymphohystiocytosis in a Rubinstein Taybi syndrome patient

Rubinstein-Taybi syndrome (RSTS) is an autosomal dominant disorder, caused by variants in CREBBP or EP300. Affected individuals present with distinctive craniofacial features, broad thumbs and/or halluces, intellectual disability and immunodeficiency. Here we report on one RSTS patient who experienced hemophagocytic lymphohystiocytosis (HLH) and disseminated herpes virus 1 ( HSV-1) disease. The clinical picture of RSTS is expanding to include autoinflammatory, autoimmune, and infectious complications. Prompt treatment of HLH and disseminated HSV-1 can lower the mortality rate of these life-threatening conditions.

Reconciling livestock production and wild herbivore conservation: challenges and opportunities

Increasing food security and preventing further loss of biodiversity are two of humanity's most pressing challenges. Yet, efforts to address these challenges often lead to situations of conflict between the interests of agricultural production and those of biodiversity conservation. Here, we focus on conflicts between livestock production and the conservation of wild herbivores, which have received little attention in the scientific literature. We identify four key socio-ecological challenges underlying such conflicts, which we illustrate using a range of case studies. We argue that addressing these challenges will require the implementation of co-management approaches that promote the participation of relevant stakeholders in processes of ecological monitoring, impact assessment, decision-making, and active knowledge sharing.

Two siblings presenting with novel ADA2 variants, lymphoproliferation, persistence of large granular lymphocytes, and T-cell perturbations

The presence of large granular lymphocytes has been reported in patients with ADA2 deficiency and T-LGL leukemia. Here we describe two siblings with novel ADA2 variants, expanding the mutational spectrum of ADA2 deficiency. We show that lymphoproliferation, persistence of large granular lymphocytes, T-cell perturbations, and activation of PI3K pathway, measured by means of phosphorylation levels of S6, are detectable in DADA2 patients without T-LGL leukemia.

Enhancing discovery in spatial data infrastructures using a search engine

A spatial data infrastructure (SDI) is a framework of geospatial data, metadata, users and tools intended to provide an efficient and flexible way to use spatial information. One of the key software components of an SDI is the catalogue service which is needed to discover, query and manage the metadata. Catalogue services in an SDI are typically based on the Open Geospatial Consortium (OGC) Catalogue Service for the Web (CSW) standard which defines common interfaces for accessing the metadata information. A search engine is a software system capable of supporting fast and reliable search, which may use 'any means necessary' to get users to the resources they need quickly and efficiently. These techniques may include full text search, natural language processing, weighted results, fuzzy tolerance results, faceting, hit highlighting, recommendations and many others. In this paper we present an example of a search engine being added to an SDI to improve search against large collections of geospatial datasets. The Centre for Geographic Analysis (CGA) at Harvard University re-engineered the search component of its public domain SDI (Harvard WorldMap) which is based on the GeoNode platform. A search engine was added to the SDI stack to enhance the CSW catalogue discovery abilities. It is now possible to discover spatial datasets from metadata by using the standard search operations of the catalogue and to take advantage of the new abilities of the search engine, to return relevant and reliable content to SDI users.

[Health surveillance in a steel making industry with electric arc furnace: 15 years of experience]

This paper analyzes the results of health surveillance carried out in an electric steel mill for 15 years. We have analyzed the trend of audiometry, spirometry and main indicators of exposure to chemical risk: serum lead, urinary OH-pyrene, erythrocyte ZPP, and the results of risk assessment of stress work related. The analyses of the trend of audiometry, spirometry and biological monitoring shows an important improving in the working environment due to the progressive automation of production steps in the course of several years, consistent and correct use of DPI, information and training.

Polyomavirus JC-targeted T-cell therapy for progressive multiple leukoencephalopathy in a hematopoietic cell transplantation recipient

Progressive multifocal leukoencephalopathy (PML) associated with polyomavirus JC (JCV) infection has been reported to be usually fatal in allogeneic hematopoietic SCT (HSCT) recipients. We present the case of a 19-year-old HSCT patient diagnosed with JCV-associated PML after prolonged immunosuppression for severe GVHD. No short-term neurological improvement was observed after antiviral treatment and discontinuation of immunosuppressive therapy. Donor-derived JCV Ag-specific CTLs were generated in vitro after stimulation with 15-mer peptides derived from VP1 and large T viral proteins. After adoptive CTL infusion, virus-specific cytotoxic cells were shown in the peripheral blood, JCV-DNA was cleared in the cerebrospinal fluid and the patient showed remarkable improvement. Adoptive T-lymphocyte therapy with JCV-specific CTLs was feasible and had no side effects. This case suggests that adoptive transfer of JCV-targeted CTLs may contribute to restore JCV-specific immune competence and control PML in transplanted patients.

Impact of cumulative anthracycline dose, preparative regimen and chronic graft-versus-host disease on pulmonary and cardiac function in children 5 years after allogeneic hematopoietic stem cell transplantation: a prospective evaluation on behalf of the EBMT Pediatric Diseases and Late Effects Working Parties

This prospective study focused on risk factors and clinical outcome of pulmonary and cardiac late effects after allogeneic hematopoietic stem cell transplantation (allo-HSCT). We prospectively evaluated 162 children by pulmonary function tests (PFTs) and cardiac shortening fraction (SF) before allo-HSCT and yearly up to the 5th year of follow-up. The 5-year cumulative incidence of lung and cardiac impairment was 35 (hazard rate=0.03) and 26% (hazard rate=0.06), respectively. Patients presenting abnormal PFTs and SF at last follow-up were 19 and 13%, respectively, with a median Lansky performance status of 90% (70-100). Chronic graft-versus-host disease (c-GVHD) was the major risk factor for reduced lung function in univariate (P=0.02) and multivariate analysis (P=0.02). Total body irradiation (TBI) alone and TBI together with pre-transplant anthracycline administration were significant risk factors for reduced cardiac function in univariate analysis, only (P=0.04 and 0.004, respectively). In conclusion, our prospective study demonstrates an asymptomatic post-allo-HSCT deterioration of pulmonary and cardiac function in some long-term survivors, who had been transplanted in childhood, and thus emphasizes the need for lifelong cardiopulmonary monitoring and the development of new strategies both to reduce pre-transplant cardiotoxic regimens and to treat more efficiently c-GVHD.

Growth and mitogenic effects of arylphorin in vivo and in vitro

In insects, developmental responses are organ- and tissue-specific. In previous studies of insect midgut cells in primary tissue cultures, growth-promoting and differentiation factors were identified from the growth media, hemolymph, and fat body. Recently, it was determined that the mitogenic effect of a Manduca sexta fat body extract on midgut stem cells of Heliothis virescens was due to the presence of monomeric alpha-arylphorin. Here we report that in primary midgut cell cultures, this same arylphorin stimulates stem cell proliferation in the lepidopterans M. sexta and Spodoptera littoralis, and in the beetle Leptinotarsa decemlineata. Studies using S. littoralis cells confirm that the mitogenic effect is due to free alpha-arylphorin subunits. In addition, feeding artificial diets containing arylphorin increased the growth rates of several insect species. When tested against continuous cell lines, including some with midgut and fat body origins, arylphorin had no effect; however, a cell line derived from Lymantria dispar fat body grew more rapidly in medium containing a chymotryptic digest of arylphorin.

Allogeneic bone marrow stem cell transplantation following CD34+ immunomagnetic enrichment in patients with inherited metabolic storage diseases

T-cell depletion is an essential step in reducing the risk of graft-versus-host disease (GVHD) in patients with inherited metabolic storage diseases (IMSD) undergoing hematopoietic stem cell transplantation. This goal can be achieved either by selective removal of T cells or by positive selection of CD34+ cells. Large-scale preparations of purified CD34+ cells from bone marrow products have not been extensively described. We report our results with bone marrow CD34+ cell enrichment using the CliniMACS system in eight children with IMSD. The median recovery of positively selected CD34+ cells was 46.2% with a purity of 97.5%, and a residual T cell content of 0.04 x 10(6). A median of 5.5 x 10(6)/kg of CD34+ cells was infused. All patients engrafted at a median time of 12 days and none of the patients developed GVHD. This method is technically feasible and can be successfully used to transplant children with IMSD.

Ureteral obstruction following allogeneic bone marrow transplantation in children

Two patients with Ph + CML underwent URD-BMT after conditioning with Bu-Cy-LPAM. They developed hemorrhagic cystitis with an extremely complicated and painful course, caused by ureteral obstruction, requiring prolonged hospitalization. No virus other than cytomegalovirus was found and in both cases was attributed to Cy use. Treatment is usually conservative, but in the case of severe obstruction, a surgical approach should be considered and performed as early as possible to preserve renal function.

Rituximab for immune hemolytic anemia following T- and B-Cell-depleted hematopoietic stem cell transplantation

The treatment of immune-mediated hemolytic anemia (IHA) complicating hematopoietic stem cell transplantation (HSCT) is often unsatisfactory. We report a case of IHA which occurred after T- and B-cell depleted unrelated donor HSCT carried out for mucopolysaccharidosis type I-H (Hurler syndrome) which was successfully treated with anti-CD20+ monoclonal antibody

[Italian emigration: historiography, anthropology, and comparative research]

"This brief paper identifies the most important moments and the most significant studies of Italian historiography on emigration. These range from the first formulation of economic and national models of the Italian exodus to their subsequent fragmentation into a mosaic of regional and local historical and anthropological studies. Ultimately, this will allow a much needed conceptual synthesis, aiming at new comparative research objectives, and a less specialized and sectorial analysis of emigration. Such an approach would also help us to tackle the migrational phenomena in contemporary society with a greater historical awareness and with more adequate cultural comprehension." (SUMMARY IN ENG AND ITA AND SPA)

Determination of levamisole in animal tissues using liquid chromatography with ultraviolet detection

An efficient and sensitive liquid chromatographic method is described for the determination of the anthelminthic drug levamisole, in muscle, liver, kidney and fat of sheep, pigs and poultry, using thiabendazole as internal standard. Samples were extracted by homogenizing with chloroform, and were applied to Supelco Si solid-phase extraction columns and eluted with methanol. Chromatographic analysis was performed on a LiChrospher 60 RP-Select B column using methanol/ammonium acetate buffer 0.05 M (55/65, v/v) as mobile phase and reading at 220 nm. The quantification limit for the assay was 4 ng/g. Mean recoveries were about 84% for liver, 85% for kidney, 89% for muscle and 84% for fat. The assay has been used for statutory testing purposes.

Secondary thyroid carcinoma after allogeneic bone marrow transplantation during childhood

The aim of this study was to evaluate the incidence and risk factors related to secondary thyroid carcinoma (STC) in patients who have undergone allogeneic BMT during childhood. Data related to the primary hematological disorder and BMT procedure were obtained from the records of 113 patients (42 F; 71 M) who underwent BMT before the age of 18 (median 10.0 years; range 1.7-18.0) and survived more than 3 years after transplant with a median follow-up of 10.1 years (range 3.0-19.0). Sixteen received cranial radiation (CRT) during first-line treatment. Pre-transplant conditioning included TBI in 85 patients, TAI in two, while 26 children did not receive irradiation. The standardized incidence ratio of STC after BMT was significantly higher (P < 0.001) than that of the general population. STC was found in eight patients, 3.1 to 15.7 years after transplant. All received TBI and three also CRT. The Cox's regression analysis, although not statistically significant due to the small study population, showed an increased risk in those who had received a cumulative radiation dose higher than 10 Gy and in those who developed chronic GVHD. Careful follow-up of thyroid status including annual ultrasound examination is recommended for early detection of tumor.

High-performance liquid chromatographic assay of erythromycin from biological matrix using electrochemical or ultraviolet detection

Two chromatographic methods were developed for the determination of erythromycin A (EA) residues in animal tissues (muscle, liver, kidney and fat of cattle, pigs and poultry) and cow's milk. In addition to a more traditional method using electrochemical detection, we developed an original alternative method based on UV detection at 236 nm, by pretreating to create a chromophore in the molecule. An internal standard was used with both methods to check the variability of the analytical system. Analysis times and performance were compared. The recovery of EA from various matrices was greater than 95%. For both methods the quantification limit for EA was 0.25 microgram ml-1 for plasma, 0.025 microgram g-1 for milk and 0.125 microgram g-1 for the other biological matrices. The methods can be used to check for EA residues in these matrices; in fact, the statutory maximum residue limits (MRLs) of EA are 0.4 microgram g-1 in muscle, kidney, liver and fat of beef cattle, sheep, pigs and poultry, and 0.04 microgram g-1 in cow's and sheep's milk.

Evaluation of transcutol as a clonazepam transdermal permeation enhancer from hydrophilic gel formulations

The influence of diethyleneglycol monoethyl ether (transcutol), alone or in combination with propylene glycol, on clonazepam permeation through an artificial membrane and excised rabbit ear skin from Carbopol hydrogels was investigated. Drug kinetic permeation parameters were determined for both series of experiments and compared. Rheological characteristics, drug solubility and membrane/vehicle partition coefficient for each gel formulation were also determined, and their role in the formulation performance was investigated. Both series of experiments showed an increase of drug permeation as a function of transcutol content in the formulation. The combination of transcutol and propylene glycol resulted in a synergistic enhancement of clonazepam flux. A different trend was found in experiments with gels containing mixtures of the two enhancers, where an increase (in the case of artificial membrane) or a decrease (in the case of rabbit ear skin) of drug permeation was found by increasing the transcutol/propylene glycol ratio in the mixture. Such a result is explained on the basis of the particular mechanism of action demonstrated for transcutol which associates the increase of drug solubility to the potent effect of a depot in the skin.

Near infrared transmittance analysis for the assay of solid pharmaceutical dosage forms

The recent commercial availability of near infrared spectrometric instruments for the transmittance analysis of solids makes it possible to analyse solid drugs in their finished form. Application of the method to the control of the assay of the active ingredient in diphenhydramine tablets gave results comparable to those obtained in reflectance mode with whole and milled tablets.

Near infrared reflectance spectroscopy in the study of atopy. Part 3. Interactions between the skin and fomblins

The near infrared reflectance spectra of the skin of atopic and normal subjects were compared after topical application of perfluorinated polyethers (fomblins) of different molecular weight and viscosity. It was possible to distinguish the two classes of subjects and the different fomblins applied, by principal components analysis.

Evaluation of release of antioxidant from high density polyethylene by planar chromatography

Irganox 1330 (1,3,5-trimethyl-2,4,5-tris(3',5'-ditert-butyl)-4'-hydroxybenzyl)- benzene) (I), an alkylphenol compound used as antioxdiant in the production of high density polyethylene (HDPE), was the subject of this study. The quantity of I given up by polyethylene samples of different thickness to aqueous and lipophilic media simulating food was studied by planar chromatography (PC). The manner of antioxidant release was also investigated. The chromatographic method developed was found satisfactory for the quantification of I in the migration studies undertaken, and had quantification limits (12 ng/deposit) suitable for quality control of HDPE.

In vitro studies of simulated percutaneous absorption: influence of various enhancers in the release of clonazepam from 2-hydroxyethyl acetate patches

A diffusion cell with an artificial membrane and the single-pass perfused rabbit ear were used to evaluate the percutaneous absorption of clonazepam from various 2-hydroxyethyl acetate (HEA) patches. The influence on drug permeation of the various type of enhancers (isopropylmyristate, lauryl alcohol, propylene glycol and water) in the patches was tested. A comparison between the two types of systems of percutaneous absorption of clonazepam has been done. The results showed that HEA patches produce controlled uniform drug release, modulated by the addition of enhancers.

Application of near-infrared reflectance spectrometry in the study of atopy. Part 1. Investigation of skin spectra

An investigation into the existence of spectral differences and differences in response in terms of water and lipid content between normal and atopic skin is described. Since NIR radiation penetrates complex structured matrices down to a depth of 0.15-0.20 mm, it is evident that the method lends itself to spectral detection of skin components down to the deepest level. First the reproducibility of readings made with the instrument was tested and it was also checked whether the use of the probe caused changes in skin equilibrium due to occlusion. Analysis of the NIR spectra did not enable normal and atopic subjects to be distinguished unequivocally but provided important information on the use of NIR spectrometry in these subjects and insights into the stratum corneum. Although the responses of water and lipid structures could not be read directly from the spectra, it was possible to decompose the global spectral information into components by principal components analysis. It was possible to observe a fraction of variance associated in different ways with water.

Near-infrared reflectance spectrometry in the study of atopy. Part 2. Interactions between the skin and polyethylene glycol 400, isopropyl myristate and hydrogel

An investigation into the existence of spectral differences and differences in response in terms of water and lipid content between normal and atopic skin after interaction with chemical agents is described. Three compounds were taken as models: a prevalently hydrophilic solvent (polyethylene glycol, PEG 400), a prevalently lipophilic solvent (isopropyl myristate) and a hydrophilic pharmaceutical (gel) used to promote contact in electrocardiography. Using principal component analysis it was possible to distinguish atopic and normal subjects by simple contact of the skin with chemical agents.

Planar chromatographic and liquid chromatographic analysis of thiamphenicol in bovine and human plasma

A planar chromatographic (PC) method was developed to determine thiamphenicol in human and bovine plasma with florphenicol as internal standard. The performance of the method was compared with that of a liquid chromatographic method. Recovery of extraction method developed for plasma was 81.51 +/- 2.85%. Reproducibilities of the PC assay performed with various PC plates were also good.

Microspectrophotometric evaluation of digestibility of pollen grains

Digestibility of pollen grains of poppy (Papaver rhoeas) and hazelnut (Corylus avellana) subjected to a human-like in vitro digestion with pancreatic enzymes was evaluated. Pollens showed different types of walls. Digestibility was determined for total protein and insoluble carbohydrate contents by means of a new application of microspectrophotometry. Results demonstrated that pollen grains of both species were only partly digested; after 24 h treatment, only 26% of carbohydrates and 48% of proteins were digested in poppy and only 3% and 59% in hazelnut. This is probably due to the difficulty of enzymes to penetrate the intine of pollen grains. The degree of digestion of insoluble carbohydrates varied in the studied species according to their chemical nature and their storage sites.

Influence of vehicle composition variations on the in vitro and ex vivo clonazepam diffusion from hydrophilic ointment bases

A systematic study of formulation factors influencing the release of clonazepam from hydrophilic ointment bases was performed. Diffusion experiments were carried out using both artificial membranes (cellulose nitrate membrane impregnated with lauryl alcohol or isopropylmiristate or vaseline oil) and natural ones (rabbit ear skin). The formulation variables were the percentage of polyethylene glycol 400, polyethylene glycol 6000 and water, and the type of lipophilic component (lauryl alcohol, isopropylmyristate or vaseline oil) added to the vehicle. In vitro and ex vivo results were compared and the best formulation was found, even if it was not possible to establish a precise correlation between the in vitro and ex vivo flux values.

Application of near-infrared reflectance spectrometry to the analytical control of pharmaceuticals: ranitidine hydrochloride tablet production

The possibility of applying near-infrared reflectance spectrometry to the control of the production cycle of ranitidine hydrochloride tablets was investigated. The results were good for the identification of ranitidine hydrochloride drug substance, mixtures for tablets, cores and coated tablets. The determination of the compound and of its water content also gave satisfactory results.

Heteroduplex mobility assay and phylogenetic analysis of V3 region sequences of human immunodeficiency virus type 1 isolates from Gulu, northern Uganda. The Italian-Ugandan Cooperation AIDS Program

We analyzed peripheral blood mononuclear cells from 19 asymptomatic seropositive pregnant women from the district of Gulu in northern Uganda. A 700-bp fragment of the human immunodeficiency virus type 1 (HIV-1) env gene, including the V3-V5 region, was successfully amplified by PCR from 10 samples (52.6%) and was subsequently subjected to both a heteroduplex mobility assay for genetic screening and subtyping and DNA sequence analysis (approximately 300 bp) for nucleotide comparison and phylogenetic studies. The results show the presence of HIV-1 A and D subtypes (or clades) in this rural area, with the prevalence of the A subtype (8 of 10) being greater than that of the D (2 of 10) subtype, which is unlike what was previously reported for Uganda. By pairwise comparison analysis, the percentage of sequence divergence among samples within each subtype is low (the average intrasubtype divergence is 15.8%), but it is significantly higher between the two subtypes (the average intersubtype divergence is 23%). At the amino acid level, the two HIV-1 subtypes show distinct tetramers at the apex of the V3 loop and, in particular, GPGQ in clade A and GPGR in clade D. In addition, 10 of the 19 viral samples (52.6%) have been isolated in vitro. Nine of the samples have been classified as rapid/high, which reflects a high in vitro replication capacity for the HIV-1 field isolates from this country, even for those obtained from seropositive asymptomatic individuals. These observations, despite being made on the basis of a limited sample size, show a modest degree of genetic divergence among samples isolated in the last 4 years in this country by comparison with those based on the 1990 data on HIV-1 isolates from Kampala. The results reported here are, therefore, extremely relevant for Uganda, which is one of the selected World Health Organization field sites for future HIV-1 vaccine evaluation programs.

New 1-[quinolyl(4)]-1,2,3-triazoles: synthesis and evaluation of antiinflammatory and analgesic properties. I

The synthesis of new 1-[quinolyl(4)]-1,2,3-triazoles is reported. These have been obtained by reacting 4-azidoquinolines with ethyl p-nitrobenzoylacetate. The synthesized compounds, tested for antiinflammatory and analgesic activities, results moderately active as antiinflammatories, but with a very interesting analgesic activity, sometimes higher than that of indomethacin, used as reference drug.

Pyrazolo[4,3-c]quinolines, synthesis and specific inhibition of benzodiazepine receptor binding. Note II

Two new series of 2-arylpyrazolo[4,3-c]quinolin-3-ones (6,8-difluoro- and 7,9-dichloro-derivatives) have been synthesized and tested for their ability to displace [3H]flunitrazepam from rat brain membranes. Several compounds possess comparable and sometimes higher affinity for central benzodiazepine receptors than that of diazepam. Some selected compounds were also tested in vivo in the anti-pentylenetetrazol test; some anticonvulsant activity resulted for the 6,8-difluoroderivatives only.

The single-pass perfused rabbit ear as a model for studying percutaneous absorption of clonazepam. II. Influence of hydrogel-borne propylene glycol and skin pretreatment with lauryl alcohol

Enhancers of the percutaneous diffusion of clonazepam in the isolated single-pass perfused rabbit ear were evaluated and included propylene glycol (PG), polyethylene glycols (PEGs) of different molecular weight, as well as skin pretreatment with lauryl alcohol (LA). PG caused a concentration-dependent increase in the diffusion of clonazepam, due partly to the increased solubility of the active principle in the hydrogel. PEGs of molecular weight up to 3,000 Daltons added to the PG hydrogel showed a simple additive effect on percutaneous diffusion enhancement induced by PG. Transdermal delivery of clonazepam also increased as a function of exposure time following pretreatment with LA.

Near infrared reflectance analysis: features and applications in pharmaceutical and biomedical analysis

Growing interest has recently been expressed for the qualitative and quantitative analytical capabilities of Near Infrared Reflectance Spectroscopy (NIRS) in the measurement of physical and chemical parameters. The authors described the details of the method and its applications in the pharmaceutical and biomedical sectors.

[Societies without men and the integration of women abroad: migration and female roles. The case of Italy]

"The role of women during the 'grande emigrazione' from Italy at the end of the century needs to be studied from two different angles. First it is necessary to identify what was preserved and what evolved in the societies that were left behind after the departure of the menfolk....Second, it is necessary to describe the role played by the women who emigrated abroad, and therefore to look at the conditions they met with in the foreign countries where they arrived alone, or as wives, daughters and mothers. These two aspects of the relationship between gender and migration are dealt with in this article, which reflects the current debate in Italy on the subject." (SUMMARY IN ENG AND SPA AND ITA)

The single-pass perfused rabbit ear as a model for studying percutaneous absorption of clonazepam. I. General characteristics

A single-pass perfused rabbit ear was employed as the model for studying percutaneous absorption of clonazepam in an open perfusion system. Clonazepam at 1.5% concentration (w/w) was suspended in a gel containing 1% (w/w) neutralized Carbopol 934 vehicled by a 50% water solution of propylene glycol and applied to the skin, in a thermostatically controlled chamber, after 10 min pretreatment with a lauryl alcohol enhancer. At 32 degrees C, the amount of clonazepam which diffused into the effluent after a 3 h lag phase was constant for 3 h and the flux averaged 0.486 mcg/h/cm2, whereas at 25 degrees C, the flux averaged 0.424 mcg/h/cm2. The amount of drug diffusing into the effluent was a function of the contact surface area and was independent of the rate of perfusion up to values of 1 ml/min. The apparent diffusion coefficient, Ds, and the partition coefficient, KM, were 2.75/10(6)/cm/h and 5.21, respectively.

Dehalogenation and N-dealkylation of chlorpromazine as revealed by plasma concentrations of metabolites in a population of chronically medicated schizophrenics

Dehalogenaton and N-demethylation of chlorpromazine (CPZ) were studied in twelve psychotic inpatients orally treated for four weeks with a daily CPZ dose of 6.4 +/- 1.1 (S.E.) mg/kg body weight (1.5-14.1, range). Weekly drug and metabolite plasma concentrations were measured by a gas liquid chromatography-nitrogen/phosphorus detector method (GLC/NPD). Plasma concentrations of the parent compound CPZ, of the dehalogenated metabolite promazine (PZ) and of the N-dealkylated metabolites N-monodemethylated chlorpromazine (CPZ-nor1) and N-didemethylated chlorpromazine (CPZ-nor2) had already reached a steady state by the end of the first week of treatment. During the entire treatment period the major plasma component was found to be PZ. Patients (N = 6) on a low dose regimen (3.7 +/- 0.2 mg/kg body weight) showed significantly lower mean plasma concentrations of CPZ and nor metabolites than patients (N = 6) on a higher dose regimen (8.6 +/- 0.7 mg/kg body weight). PZ mean plasma concentrations, however, were not significantly different in the two groups of patients, indicating that the yield of the CPZ dechlorination pathway, as opposed to that of the N-demethylation pathway, was already maximal at the CPZ concentrations attained under the low dose regimen. Male patients (N = 5) exhibited significantly higher mean PZ plasma concentrations over the 4 week period of the study than female patients (N = 7).

Comparison of HPTLC and HPLC procedures for the determination of certain xenobiotic residues in apples and pears

HPTLC was used to check for residues of benomyl, carbendazim, ethoxyquin and thiabendazole in apples and pears. The method used showed good precision with a percentage coefficient of variation of less than 5%; recoveries were always greater than 90%. The limits of determination using HPTLC were always at least four times lower than Italian statutory limits. Selectivity with respect to other matrix components was excellent for all fruit varieties tested. Comparison with HPLC confirmed the validity of the results.

[Cholelithiasis in childhood: description of 2 cases]

Two cases of cholelithiasis in children are reported. The first patient was a 10-year-old girl with hyperinsulinism and hypoglycemia as associated medical conditions. The second one was a 3-year-old boy who had no definable cause for cholelithiasis. Both patients were symptomatic. Recurrent abdominal pain was the main symptom. A specific and accurate diagnosis was readily made by ultrasound in both children.

Comparison of an HPTLC and an HPLC procedure for the determination of chlorpropham, propham and thiabendazole residues in potatoes

HPTLC was used to check for residues of chlorpropham, propham (sprout inhibitors) and thiabendazole (fungicide) applied to potatoes. The method used gave good precision and analytical sensitivity. The sample preparation method developed by the authors was simple and gave good recovery and selectivity as far as other components of the matrix were concerned. Comparison with liquid chromatography confirmed the validity of the results.

[Synpolydactyly: unusual features and variable expression in 5 generations of an Italian family]

The Authors report a family with synpolydactyly (or syndactyly type II) present in eleven out of thirty four members in five generations. Affected members do not show any other anomalies so that chromosomal or other genetic syndromes may be excluded. The possible mode of inheritance, the variability in expression, the penetrance in five generations are discussed. The peculiar bone deformities of hands and feet already reported by Cross et Al. are confirmed. The Authors presume that the present report is the first observation of synpolydactyly in an Italian family.

[Cutis marmorata telangiectasica congenita. Description of 2 further cases]

We report two cases of C.M.T.C., a rare cutaneous vascular anomaly, which is manifested at birth. It is a rare birth defect of unknown etiology; usually occurs sporadically. There is an association of C.M.T.C. with other congenital anomalies in at least 50% of the patients. On the basis of two cases, the clinical features of cutis marmorata telangiectasica congenita are described and the differential diagnosis discussed.

Thin-layer chromatography and densitometry in drug assay: comparison of methods for monitoring valproic acid in plasma

A thin-layer chromatographic (TLC) method is described for the assay of the anti-epileptic drug, valproic acid, in plasma. The use of high-performance (HPTLC) plates gave sensitive detection limits (4.87 micrograms ml-1) for derivatives of valproic acid and the reproducibility on the same or different plates was good. Comparison with high-performance liquid chromatography showed a similar performance of plate and column.

Formulation factors influencing the release of clonazepam from a carbopol hydrogel

A study of formulation factors influencing the release of clonazepam from a Carbopol hydrogel through a cellulose nitrate membrane impregnated with lauryl alcohol was performed using two diffusion cell assemblies. The formulation variables were the cosolvent effects of propylene glycol and polyethylene glycol of different molecular weights in aqueous solutions of various composition. The gel formulation phenomenologically behaves as a zero-order release system, although the diffusion controlled mechanism may also be operative. The results showed that both methods were practically equivalent in terms of drug release profile and total drug released allowing the best formulation to be found.