Combined thrombolytic therapy for atrial thrombus in a preterm infant.

Intracardiac thrombosis is a rare event in newborn (5.1 per 100000 live births). It is associated with an high morbidity and mortality. Most of intracardiac thrombi are related to intravascular catheterism. The use of thrombolytic therapy in neonates has rapidly improved in the last few years, particularly with the introduction of more clot-selective second-generation agents like urokinase and tissue plasminogen activator. In literature there is no therapeutic trial concerning the pharmacological approach of atrial thrombosis in newborns; different approaches are described in the case reports present in literature. In all of them, tissue plasminogen activator or urokinase are alternatively administered. In no case report urokinase and tissue plasminogen activator are administered in a combined thrombolytic therapy. Combined thrombolytic therapy with urokinase and tissue plasminogen activator, in association with low-dose heparin, allows the use of lower drug doses, less therapy's duration and a rapid resolution of thrombus. Thormbolytic therapy is sometimes complicated with hemorrhagic complications. This article describes the case of a preterm infant (25 weeks of gestational age) with peduncolate thrombus in the right atrium, treated with combined thrombolytic therapy. The authors noticed a rapid decrease in thrombus dimension, no thrombus replacement and no organ bleeding.

Selective clean-up applicable to aqueous acetone extracts for the determination of carbendazim and thiabendazole in fruits and vegetables by high-performance liquid chromatography with UV detection.

Fungicide residues in vegetables (benomyl, carbendazim, thiabendazole) are analyzed through a clean-up procedure that uses a portion of the aqueous acetone extract prepared for multiresidue methodology. A portion of the aqueous acetone extract (equivalent to 5 g of vegetables) is loaded onto an Extrelut-20 cartridge (the cartridge is filled with a coarse, large-pore diatomaceous material). Then, acetone is partially removed by an upward stream of nitrogen at 2l/min for 30 min. Benzimidazolic fungicides are recovered by percolating the cartridge with 100 ml of 0.1 M phosphoric acid solution, which also serves to convert benomyl to carbendazim. The percolating acid solution is drained on-line through a strong cation-exchange (SCX) solid-phase extraction cartridge with the aid of a slight vacuum. Benzimidazolic fungicides are retained on the SCX cartridge. The phosphoric acid solution is discarded together with the washings of the SCX cartridge, i.e., water followed by methanol-water (75:25), that remove unwanted coextractives. Finally, benzimidazolic fungicides are recovered by eluting the SCX cartridge with methanol-ammonium formate buffer (75:25). The final extract is then analyzed by reversed-phase HPLC with UV detection. Recoveries from crops such as apples, lettuce, strawberries and citrus fruits are generally greater than 80% and no interferences were observed. The clean-up is simple and straightforward, requires only disposable items, water solutions and a few milliliters of solvent and a minimum number of manipulations, and does not require concentration steps or electrical equipment.