Solubility study and intensification of extraction of phenolic and anthocyanin compounds from Oryza sativa L. 'Violet Nori'.

Oryza sativa L. 'Violet Nori' is an Italian cultivar of spontaneous growing aromatic purple rice which is particularly rich in polyphenolic compounds, especially anthocyanins, conferring it an excellent antioxidant capacity. The present study aimed at increasing the extraction yields of its antioxidant compounds with green strategies and it is divided into two steps. The first step concerned a solubility study of the targeted polyphenols in different ethanol:water mixtures by means of a theoretical prediction method, using the simulation program COSMO-RS, and the subsequently confirmation of the computational results by practical experiments. Once the best extraction mixture was identified, the second step of the work was performed, with the purpose of intensifying the extraction yield. Therefore, various innovative green extraction techniques, including ultrasound, using both the probe system and the ultrasonic bath, bead milling, microwave and accelerated solvent extractions were tested and compared to conventional maceration. Results, expressed in terms of total phenolic and total monomeric anthocyanin contents, showed that the best extracting solvent for 'Violet Nori' rice was the mixture ethanol:water (60:40 v/v), being COSMO-RS computational predictions in good correlation with the experimental results. Moreover, the most efficient techniques to extract the antioxidant compounds resulted to be both ultrasound-assisted extraction probe and bead milling, that in only 5 min got the same extractive efficiency obtained after 3 h of conventional maceration.

Home care for chronic respiratory failure in children: 15 years experience.

BACKGROUND: Advances in paediatric intensive care have reduced mortality but, unfortunately, one of the consequences is an increase in the number of patients with chronic diseases. It is generally agreed that home care of children requiring ventilatory support improves their outcomes and results in cost saving for the National Health Service. METHODS: Since 1985, the Children's Hospital Bambino Gesù of Rome has developed a program of paediatric home care. The program is performed by a committed Home Health Care Team (HHCT) which selects the eligible patients for home care and trains the families to treat their child. During the period January 1985 to January 2001, 53 children with chronic respiratory failure were included in the home care program. Of these, seven patients were successively excluded and six died in our intensive care unit (ICU), while one still lives in our ICU since 1997. The results obtained in the remaining 46 children are reported. RESULTS: The pathologies consisted of disorders of respiratory control related to brain damage (26%), upper airways obstructive disease (26%), spinal muscular atrophy (22%), myopathies and muscular dystrophies (6.5%), bronchopulmonary dysplasia (6.5%), tracheomalacia (6.5%), central hypoventilation syndrome (4.3%) and progressive congenital scoliosis (2.2%). Of these 46 patients, 34 children are mechanically ventilated and the median of their ICU stay was 109.5 days (range 54-214 days), while the remaining 12 children were breathing spontaneously and the median of their ICU stay was 90.5 days (range 61-134 days). We temporarily readmitted six patients to our ICU to perform scheduled otolaryngological surgery, eight patients for acute respiratory infections and two patients for deterioration of their neurological status due to high pressure hydrocephalus for placement of a ventriculoperitoneal shunt; these 16 patients were discharged back home again. Two other patients were readmitted for deterioration of their chronic disease and died in our ICU, while seven patients died at home. CONCLUSIONS: Thirty-seven children are still alive at home and four of them improved their respiratory condition so that it was possible to remove the tracheostomy tube. Our oldest patient has now achieved 15 years of mechanical ventilation at home.

[Determination of brain death in Intensive Pediatric Therapy]. / L'accertamento della morte cerebrale in Terapia Intensiva Pediatrica.

The subject of this paper is to report our experience in the determination of brain death in infants and children. We have retrospectively examined the incidence of brain death occurred in 504 consecutive children admitted to multidisciplinary pediatric ICU at "Bambino Gesù" Hospital of Rome during the years 1994 to 1997. According to current Italian Law, brain death was declared in 8 children (1.6%), whose primary diagnoses were: Meningitis (3 cases); nontraumatic intracerebral hemorrhage (2 cases); medulloblastoma (1 case); brain metastasis of neuroblastoma (1 case); SIDS (1 case). All brain death diagnoses were made using clinical criteria and confirmatory tests. A difficult problem was met in achieving the required Pa-CO2 values higher than 60 mmHg without unduly lowering O2 saturation. In order to obtain easily this objective we have recently switched the ventilator to intermittent mandatory volume ventilation at a rate of five stroke per minute using a FiO2 of 1 before starting the apnea test. In infants younger than one year the required cerebral circulatory arrest was documented in the pericallosal artery by doppler ultrasonography performed through the fonticuli cranii. The absence of cerebral blood flow was recorded for one to five days after clinical and electroencephalographic diagnosis of brain death, causing an unnecessary prolonged rianimative support. This also confirms that in young infants brain death may occur without a marked increase of intracranial pressure. Last, but not least, we believe that particular attention must be paid to psycho-emotional conditions of parents as well as of intensivists and nurses especially when brain death must be assessed in children.

[Severe pulmonary gas embolism caused by intraoperative administration of hydrogen peroxide]. / Grave embolia polmonare gassosa da somministrazione intraoperatoria di acqua ossigenata.

We report the case of a 3 year old boy who developed cardiac arrest during general anesthesia, immediately after the subcutaneous administration of hydrogen peroxide solution. Massive pulmonary embolization was hypothesized as the postoperative ECG showed an acute heart strain. However the occurrence of transient anisocoria, associated with a paresis affecting the left arm, remained unexplained. Since brain MR did not reveal any pathological data, a direct toxicity of hydrogen peroxide on a limited area of the CNS could be assumed.