Reference values of urinary 3,5,6-trichloro-2-pyridinol in the Italian population--validation of analytical method and preliminary results (multicentric study).

The interlaboratory validation of analytical procedures for the assay of urinary 3,5,6-trichloro-2-pyridinol (TCP) in the general Italian population is reported. The determinations were performed by high-resolution gas chromatography (HRGS) with electron capture detection and HRGS with mass spectrometry (MS) in 2 laboratories. The urine samples were from 42 participants from 3 regions of Italy. The results were evaluated by interlaboratory quality control. Urinary TCP concentrations were above the detection limit (1.2 micrograms/L) in 88% of the population, with a mean detectable concentration [GM (GSD)] of 2.8 (1.9) micrograms/g creatinine (creat). (GM, geometric mean; GSD, geometric standard deviation.) The Mann-Whitney U test showed that wine consumption was a statistically significant variable (p < 0.05) for urinary concentrations of TCP. Analysis of variance of the logarithm of urinary TCP versus wine consumption and diet showed a statistically significant fit. The model used explained 30% of the total variance: wine consumption and diet accounted for 37 and 17% respectively of the explained variance.

Urinary excretion of ethylenethiourea in five volunteers on a controlled diet (multicentric study).

Urinary excretion of ethylenethiourea (ETU) was monitored for 8 days in a group of five male non-smoker volunteers on a diet, the items of which were assayed for ETU and carbon sulphide. Urinary excretion of ETU reflected the consumption of wine, fruit and vegetables. Urinary ETU concentrations ranged from 0.6 to 6.7 micrograms/g creatinine. ETU concentrations in the food eaten by the volunteers were generally below the detection limit whereas in wine 8.8 micrograms/l ETU was detected. Evolution of carbon sulphide by food samples ranged from 0.03 to 0.17 mg/kg. Mean (+/- S.D.) daily intake of ETU in wine was 3.5 +/- 0.2% of the acceptable daily intake (ADI): 0.070 +/- 0.004 micrograms/kg body wt. During the 8 days of the study, an average of 48.3% of the ETU ingested in wine was excreted unmodified by the kidneys. Twenty-four hour urinary excretion of ETU was significantly correlated with daily intake of ETU (r = 0.768) and CS2 evolved by the daily food items (r = 0.414).

Reference values of urinary ethylenethiourea in four regions of Italy (multicentric study).

The results of a study in which urinary ethylenethiourea (ETU) was assayed in the general population (167 subjects) of four Regions of Italy (Veneto, Lombardy, Piedmont and Trentino Alto Adige) are reported. The results are compared with those in a population of 97 subjects from Rovescala, a hillside wine-producing town a few kilometers from Pavia, where ethylenebisdithiocarbamates are sprayed by helicopter. It was found that an average of 24% of the populations of the four regions, taken together, had urinary ETU levels above detection limits (1.0 microgram 1(-1)) as compared to 37% of the population of Rovescala. The ranges of concentration were 0.8-8.3 micrograms 1(-1) for the four regions and 0.9-61.4 micrograms 1(-1) for Rovescala. Statistically significant variables for urinary ETU levels were smoking and wine drinking.

[Intravenous anesthesia with perfused propofol combined with loco-regional spinal anesthesia]. / Anestesia endovenosa con propofol in perfusione associato ad anestesia locoregionale rachidea.

The authors review the advantages and disadvantages of general and regional anesthesia in bad clinical conditions. The purpose of this study was to evaluate the efficacy of Blended Anesthesia (association of general anesthesia with a regional technique) in 25 patients belonging to ASA classes II-III-IV, undergoing surgery for various disease. General anesthesia was provided by perfusion of propofol, after a peridural or subarachnoid continuous anesthesia was started. Patients were either in spontaneous or controlled ventilation. There were no cases of hypotension or other important side effects and the majority of patients judged good the anesthetic technique in regard to lack of pain, exhaustion and recall of operation.

[Nutritional support in patients with relapsing chronic respiratory failure]. / Il supporto nutrizionale nel paziente affetto da insufficienza respiratoria cronica riacutizzata.

The authors review the scientific data on nutritional problems in patients with acute decompensation of COPD and present their own experience in the nutritional management of such condition. Artificial nutrition (enteral and parenteral) allowed a reduction in the duration of hospitalization, a lower incidence of infections, and a shorter weaning time from mechanical ventilation in comparison to a homogeneous group of patients treated in the same unit in an earlier period, when less attention was paid to nutritional problems. The importance of artificial nutrition in patients with acute decompensation of COPD is highlighted.

[Acute pulmonary edema after intravenous naloxone]. / Edema polmonare acuto dopo una dose di naloxone endovena.

We present one case of pulmonary edema following intravenous naloxone administration for antagonism of residual narcotic drugs. The patient was a young man without cardiopulmonary or neurologic disease. Pathogenesis results from a massive sympathetic discharge which leads to neurogenic pulmonary edema.

[The Ehlers-Danlos syndrome and its surgical implications]. / La sindrome di Ehlers-Danlos e sue implicazioni chirurgiche.

The Ehlers-Danlos syndrome, type IV, i.e. the arterial and ecchymotic variety, has a severe prognosis and may represent a threat to life in that it predisposes to spontaneous rupture of the intestine and large vessels. The authors report a case in which spontaneous rupture of the colon and thoracic aorta occurred in short succession. Description of the syndrome and its many variants is preceded by a brief explanatory note on the formation and composition of collagen and its different types. The authors stress the important surgical implications of the syndrome the special risks deriving from elective surgery. Serious consequences may also derive from pregnancy trauma and from acts such as arteriography, endotracheal intubation, endoscopy and other invasive procedures. After examining the cases reported in literature (Sacks, Barabas, Beighton Sykes), they point out that, contrary to what is generally believed, the syndrome is not rare and cases, sporadic or familial, of recurrent episodes of spontaneous rupture of the intestine and large vessels or peripheral arteries are frequent. The authors come to the following conclusions: rupture of the aorta may occur spontaneously or after minimal trauma in subjects with EDS type IV and the cases complicated by spontaneous colon perforation would take advantage from definitive colostomy, considering the high incidence of recurrent perforations when intestinal continuity is restored.