Uncovering the psychoactivity of a cannabinoid from liverworts associated with a legal high.

Phytochemical studies on the liverwort Radula genus have previously identified the bibenzyl (-)-cis-perrottetinene (cis-PET), which structurally resembles (-)-Δ9-trans-tetrahydrocannabinol (Δ9-trans-THC) from Cannabis sativa L. Radula preparations are sold as cannabinoid-like legal high on the internet, even though pharmacological data are lacking. Herein, we describe a versatile total synthesis of (-)-cis-PET and its (-)-trans diastereoisomer and demonstrate that both molecules readily penetrate the brain and induce hypothermia, catalepsy, hypolocomotion, and analgesia in a CB1 receptor-dependent manner in mice. The natural product (-)-cis-PET was profiled on major brain receptors, showing a selective cannabinoid pharmacology. This study also uncovers pharmacological differences between Δ9-THC and PET diastereoisomers. Most notably, (-)-cis-PET and (-)-trans-PET significantly reduced basal brain prostaglandin levels associated with Δ9-trans-THC side effects in a CB1 receptor-dependent manner, thus mimicking the action of the endocannabinoid 2-arachidonoyl glycerol. Therefore, the natural product (-)-cis-PET is a psychoactive cannabinoid from bryophytes, illustrating the existence of convergent evolution of bioactive cannabinoids in the plant kingdom. Our findings may have implications for bioprospecting and drug discovery and provide a molecular rationale for the reported effects upon consumption of certain Radula preparations as moderately active legal highs.

Insertion of distal locking screws of tibial intramedullary nails: a comparison between the free-hand technique and the SURESHOT™ Distal Targeting System.

INTRODUCTION: Positioning of the distal locking screws of an intramedullary nail is often challenging and time consuming because of difficult localisation of the distal locking holes, potential screw malalignment and nail deformation during insertion. The standard free-hand technique under fluoroscopic control involves considerable radiation exposure of both the patient and the surgical team. In this study, we aimed to compare the free-hand technique with a new system that utilises electromagnetic (EM) tracking data (SURESHOT™ Distal Targeting System) to localise distal locking holes. MATERIAL AND METHODS: Patients admitted from March 2010 to January 2013 for tibial fracture that required intramedullary nailing were analysed retrospectively. We compared intraoperative radiation exposure time and distal locking time in patients treated with the standard free-hand technique and distal locking using the EM field-generating device. Intraoperative radiation exposure time and distal locking time were used for comparison. RESULTS: Data from a total of 50 patients were analysed. The standard free-hand technique and the EM field-generating device were used in 25 (group 1) and 25 (group 2) patients, respectively. Mean distal locking time was 1258.6 (450-2289) s in group 1 and 603.5 (360-1140)s in group 2. Mean radiation exposure time was 19.4 (6-33) s in group 1 and 4.6 (1-10) s in group 2. CONCLUSION: The EM field-generating device significantly reduces distal locking time and, more importantly, significantly decreases duration of exposure to ionising radiation.

Improving grape quality using microwave vacuum drying associated with temperature control.

Microwave (MW) vacuum dehydration using temperature to control the level of MW power demonstrated potential in improving the performance of the process. Product surface temperature measured by an infrared temperature sensor was used to control MW power at any level between 0 and 3 kW. Multiple linear regression analysis indicated an r2 = 0.942 for prediction of final moisture content and r2 = 0.985 for prediction of puffed character of grapes based on product temperature, time, specific energy, fresh fruit sugar, and fresh fruit moisture content. Temperature was found to be the most significant predictor. The elemental and compound contents of grapes dried using MW vacuum was compared to sun-dried raisins. The grapes dried using MW vacuum exhibited better preservation. Vitamin A was found in the MW-vacuum-dried grapes but none was detected in the raisins, and Vitamin C, thiamine, and riboflavin were also higher in the MW-vacuum-dried grapes than in the raisins.

[Bilateral femoro-popliteal acute recurrent arterial thrombosis in the course of heparin-induced thrombocytopenia (white thrombus syndrome)]. / Trombosi arteriosa acuta recidivante femoropoplitea bilaterale in corso di trombocitopenia indotta da eparina (sindrome da trombo bianco).

Heparin induced thrombocytopenia with thrombosis, or the "white clot syndrome" is a rare but very important complication of heparin therapy. The syndrome is idiosyncrasic, immune-mediated and not dose dependent and therefore is equally likely to occur with prophylactic and therapeutic heparin dosage regimens. We report a typical case of HIT that occurs with prophylactic heparin therapy and results in bilateral amputation of the lower limbs. We discuss this important condition and some guidelines on its prevention and treatment.

Biofiltration with buffer-free dialysate.

The presence of acetate in the dialysate appears to be superfluous in the new depurative technique indicated as biofiltration, which consists in a standard hemodialysis with high ultrafiltration combined with the reinfusion of 3-4 1/2 liters of solution containing bicarbonate. The presence of acetate could in fact be contraindicated by a number of potential side effects, metabolic, cardiovascular and biological. Hence, starting from the consideration that in standard biofiltration a buffer is already infused directly as bicarbonate, we tried to overcome the potential hazards of the acetate-containing bath simply by using a dialysate without acetate and by increasing the concentration of bicarbonate in the reinfusate. A cumulative clinical experience of 20 months in 4 patients proved the feasibility and safety of the technique and suggests further advantages over standard biofiltration (better control of acid-base equilibrium, better cardiovascular stability.