"Falling down": a retroperitoneal catastropheC.

Hemoperitoneum due to ruptured retroperitoneal varices is an extremely rare condition and a poor prognostic sign with a catastrophic and life-threatening situation. Early recognition affords appropriate management and urgent surgical intervention in order to favor the survival rate. In this case report we accurately describe the complex clinical course of a 56-year old woman with retroperitoneal varices, who few months earlier had a chest trauma with multiple left lower rib fractures and 10 years earlier she underwent to ovarian hyperstimulation for an ovulation induction. She was taken to the emergency room for a fainting episode with signs of a clear hemodinamic shock without a present history of trauma. The intricacy of this case was mostly due to the choice of the correct management, where the damage control resuscitation turned out to have an important role.

[Nephrotic syndrome after treatment with d-penicillamine in a pediatric patient with Wilson's disease]. / Sindrome nefrosica da penicillamina in un caso pediatrico di Morbo di Wilson.

We describe a case of nephrotic syndrome (NS) after a 7 months treatment with D-penicillamine in a 14 years old girl with Wilson's disease, with a prompt regression at the discontinuation of the drug. Kidney function, proteinuria in particular, must be always monitored during the chelating therapy, and the drug must be discontinued as soon as signs of renal injury are detected.

[Pediatric steatohepatitis: is it only obesity?]. / Steatoepatite in un bambino obeso: solo questione di peso?

We describe the case of an 11-year-old obese child with nonalcoholic steatohepatitis and Wilson's disease. Nonalcoholic steatohepatitis, although frequently found in patients with obesity, can also be caused by other etiologies, including Wilson's disease, which must therefore always be ruled out in the obese child.

Migration and health service delivery.

Migration has positive and integrative effects on health service delivery. This paper presents initiatives promoting circular migration of diaspora health professionals to contribute to health service delivery and capacity development in their countries of origin. The paper will also highlight the contributions that foreign trained and foreign born health professionals can make to the delivery of migrant friendly health services for diverse multi-cultural populations.

Strain variability and the effects of organic compounds on the growth of the chemolithotrophic bacterium Thiobacillus ferrooxidans.

The effects of naturally-occurring organic compounds on ferrous iron oxidation by the bacterium Thiobacillus ferrooxidans were examined with a view to using these compounds to treat or prevent acid mine/rock drainage. The compounds glucose, cellobiose, galacturonic acid, and citric acid were added to the growth medium of five different strains of the bacterium and growth studies were done to determine whether or not strain differences existed with respect to organic compound sensitivity. The effects of these compounds were compared to the effects of sodium dodecyl sulfate (SDS) an anionic detergent. Each of the compounds tested had an inhibitory effect on the strains of the bacterium and sensitivity to these compounds was strain dependent. All strains appeared to be equally susceptible to SDS. Inhibitory concentrations ranged from 70 mM to >280 mM for glucose, 7.5 mM to 150 mM for cellobiose, 20 mM to 230 mM for galacturonic acid, and 50 mM to 130 mM for citric acid. SDS effectively inhibited iron oxidation for all strains at a concentration of 0.3 mM, the lowest concentration tested. Some naturally-occurring organic compounds, therefore, might be candidates for the growth control of T. ferrooxidans.

[Characteristics of a new controlled release formulation of ursodesoxycholic acid]. / Aspetti relativi alle caratteristiche di una nuova formulazione di acido ursodesossicolico a rilascio controllato.

Ursodeoxycholic acid, like all weak acids, has to be formulated so as his release and absorption depend as little as possible by the pH of gastrointestinal tract. To obtain this result a controlled release formulation of UDCA was developed, based on bioadhesive technique. This allowed a longer residence and absorption time of the active ingredient both at gastric (due to gastrosoluble rate) and duodenal-jejunum level (gastroresistant rate). Thus, all the absorption windows for bile acids are utilized, to ameliorate the total bioavailability of the drug.

[The follow-up in adulthood of subjects with progressive rheumatic disease in childhood. Considerations of secondary prevention]. / Controllo in età adulta di soggetti con pregressa malattia reumatica nell' infanzia. Considerazioni sulla profilassi secondaria.

We reviewed 57 patients who had previously suffered from rheumatic fever (RF) after an average period of 7.2 (+/- 2.8) years without penicillin prophylaxis. In 24 cases (42%) RF began with carditis and in 9 patients valvular damage remained after hospital discharge. Prophylaxis with retard penicillin every four week was carried out for 5.5 +/- 1.8 years. At present the patients are all asymptomatic. There was in 7 cases mild valvular damage without clinical and instrumental involvement. There was not recurrency after the end of prophylaxis, except for a doubtful case, analysed in the Discussion. Although our cases are not numerous, we believe that a regular prophylactic treatment over 5 or 6 years is sufficient to avoid any recurrency in patients with previous RF. After this period of treatment, only subjects with valvular damage should have further extensive treatment until their 20th year and always for a period not shorter than ten years.

[Evaluations of 169 cases of decompression sickness treated in Italian hyperbaric centers 1980-1981]. / Alcune valutazioni su 169 casi di malattia da decompressione trattati nei Centri Iperbarici Italiani nel biennio 1980-1981.

An assessment was made of 169 cases of decompression sickness occurring during the period 1980-81. Nearly all (95,6%) were attributable to superficial planning and execution of the immersion and reascent to the surface marker as the result of panic. Breakdown in the diving apparatus was only responsible in 4.4% of cases. Irrispective of the intermediate decompression stages, the rate of reascent was more than 10 metres a minute in 71.6% of cases. Full recovery as a result of hyperbaric management was obtained in 78,2% type I sickness and 61.9% type II, with improvements in 17.3% and 35.1% respectively. The interval between emersion and treatment ranged from 1 to 72 hr, though the results of treatment were not significantly related to the rapidity of intervention (p greater than 0.05). Good results were dependent on the type of treatment employed, with a significantly better outcome (p less than 0.01) from U.S. Navy tables 2-2A, 3-3A, 4, 5 and 6 and the 2 + 6 recompression protocol, than from tables 5A and 6A.

Constituents of the Essential Oil of Artemisia coerulescens.

By combination of liquid-solid chromatography, capillary GLC and mass spectrometry, the essential oil obtained by steam distillation from the leaves and flowers of ARTEMISIA COERULESCENS L., growing in Tuscany (Poggio di Monselvoli, Siena), was analysed, alpha-Thujone, beta-thujone and camphor accounted for about 69% of the oil which contained more than a hundred compounds, most of which were present only in traces; 36 components were identified.

Constituents of Essential Oil of Artemisia arborescens.

By combination of capillary GLC and mass spectrometry it was possible to analyze the composition of the essential oil obtained by steam distillation from leaves and flowers of ARTEMISIA ARBORESCENS L. growing in Sassari (Osilo) in Sardinia. This oil is coloured blue by the presence of relatively high amounts (11.32%) of chamazulene, a substance with anti-inflammatory properties. The oil, after separation in fractions on a silica gel column, was investigated by means of capillary GLC and capillary GLC-MS. Thujone, camphor and chamazulene account for about 75% of the oil. Almost a hundred minor components were found by capillary GLC and 44 were identified.

[Synthesis of analogues of acetohydroxam lacetic acid with phytotoxic activity]. / Sintesi di analoghi dell'acido acetidrossamoilacetico e loro attivitá fitotossica

Syntheses, spectroscopic data and phytotoxic activities of some N-acyl-O-alkylhydroxylamines, similar in structure to the natural compoud, methyl acetohydroxamyl acetate, are reported. Many of synthesized compounds show strong growth-inhibiting activity on both roots and coleoptiles of Triticum vulgare seedlings.