Sepsis outside intensive care unit: the other side of the coin.

INTRODUCTION: A growing body of evidence points out that a large amount of patients with sepsis are admitted and treated in medical ward (MW). With most of the sepsis studies conducted in intensive care unit (ICU), these patients, older and with more comorbidities have received poor attention. Provided the differences between the two groups of patients, results of diagnostic and therapeutic trials from ICU should not be routinely transferred to MW, where sepsis seems to be at least as common as in ICU. METHODS: We analyzed clinical trials on novel tools for an early diagnosis of sepsis published in the last two year adopting strict research criteria. Moreover we conducted a target review of the literature on non-invasive monitoring of severe sepsis and septic shock. RESULTS AND CONCLUSIONS: The combination of innovative and non-invasive tools for sepsis rule in/out, as quick alternatives to blood cultures (gold standard) with bedside integrated ultrasonography could impact triage, diagnosis and prognosis of septic patients managed in MW, preventing ICU admissions, poor outcomes and costly complications, especially in elderly that are usually highly vulnerable to invasive procedures.

Activation of protease-activated receptor-2 reduces airways inflammation in experimental allergic asthma.

BACKGROUND: Proteinase-activated receptors (PAR)-2 are members of the family of G-protein-coupled receptors activated by proteases. These receptors are widely expressed in several tissues and in virtually all cells involved in rhinitis and asthma. In particular, proteinases activating PAR-2 may affect airway functions and play a role in human diseases. OBJECTIVE: Assessment of the role of PAR-2 in bronchoconstriction, airway responsiveness and immune response after allergic challenge, in rabbits sensitized to Par j 1, the major allergen of Parietaria judaica pollen. METHODS: Evaluation of antigen challenge in rabbits treated with PAR-2-activating peptide (PAR-2AP) (SLIGRL) or the scrambled peptide LSIGRL or vehicle immediately before allergen exposure measuring airway responsiveness. Characterization of bronchoalveolar lavage (BAL) following histamine challenge and phenotype analysis of cells by flow cytometry and analysis of cytokine production by quantitative PCR. RESULTS: PAR-2AP pre-treatment, but not the scrambled peptide, was able to significantly inhibit bronchoconstriction, airway hyper-responsiveness and to modulate the immune response induced by allergic challenge in sensitized rabbits. The phenotype analysis of the cells recovered from BAL showed an increase in RLA-DR-positive cells while RTLA-positive cells were unchanged. IFN-gamma and IL-2 production were inhibited, with a concomitant increase in IL-10 of about 10-fold over the control values. CONCLUSIONS: In this experimental model, PAR-2 modulates bronchoconstriction interfering with antigen challenge-induced immune response in rabbits sensitized and challenged to Par j 1.

Synthesis and antitumor activity of aminoacid derivatives of the antimetastatic agent DM-COOK.

Esters and amides of N-(3,3-dimethyl-1-triazeno)benzoylamino acids have been synthesized as inhibitors of cell surface neutral proteases. Preliminary data on activity against P-388 lymphocytic leukemia are also reported.

[Relation between chemical constitution and sweet taste. XV. Sulfamic acids and sulfur chlorides]. / Rapporti fra costituzione chimica e sapore dolce. Nota XV. Acidi sulfamici e solfocloruri.

In studies concerning the relation between structure and sweetness in sulfamic acid derivatives, two new sweeteners (VI) and (VIII) were found. Their corresponding sulfochlorides are also unexpectedly sweet-tasting.

[Relationship between chemical structure and sweetness. XIV. Analogs of aspartame]. / Rapporti fra costituzione chimica e sapore dolce. Nota XIV - Analoghi dell'aspartame.

Several analogs structurally related to aspartame were prepared in order to establish if chemical modifications of the molecule might improve sweetness. None of these analogs exhibited any sweet taste; on the contrary in most cases they were bitter.

[Relationship between chemical structure and sweet taste. XIII. Derivatives of L-acylamidosuccinanilic acids]. / Rapporti fra costituzione chimica e sapore dolce. Nota XIII. Derivati L-acilamidosuccinanillci

Several derivatives of L-acylamidosuccinanilic acids have been prepared inorder to study the relationship between the chemical structure and the sweetening activity by modifying the amino or the acylamido portions of the molecule. Some synthesized compounds possess a pronounced sweet taste, the L-4'-nitro-(2,2,2-trichloroacetamido)succinanilic acid is the most outstanding compound, being approximately 3000-4500 times as sweet as sucrose.

Synthesis and anticancer activity of 5-diethylaminomethyl derivatives and nitrogen mustards of uracil and 2-thiouracils.

Several 5-diethylaminomethyl derivatives and nitrogen mustards of uracil and 2-thiouracil have been synthesized and tested for their potential anticancer activity in vitro on KB cells and in vivo on Ehrlich carcinoma. Among the alkylating derivatives tested several showed cytotoxic activity in vitro and compound V [5-[bis(2-chloroethyl) amino] methyl-6-propyluracil hydrochloride] showed both in vitro and in vivo anticancer activity.

[Antiviral chemotherapeutic agents. XVIII. Adamantane derivatives of amphetamine. Their potential interest as autonomic and antiparkinson agents]. / Chemioterapici antivirali. Nota XVIII - Amfetamina adamantilica e derivati. Loro potenziale interesse anche come farmaci autonomici ed antiparkinsoniani

Adamantane isologs of amphetamine, methamphetamine and pheniprazine and several derivatives were synthesized in order to study the influence of their more pronounced lipophilic characteristics on their biological properties. A preliminary examination of their toxicity, antiviral, CNS stimulant and antiparkinson activity is described. The adamantyl amphetamine, which proved active, will be further studied.