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A kidney-transplanted patient, unvaccinated against yellow fever (YF), developed high fever, progressed rapidly to hepatic insufficiency and coma, and died 8 days later. Real-time polymarase chain reaction for YF virus collected on the seventh day of symptoms was positive. Autopsy showed disseminated infection and midzonal hepatitis with apoptotic hepatocytes and minimal inflammatory reaction. [ABSTRACT FROM AUTHOR]

A derivative UV-vis spectrophotometric procedure for the simultaneous determination of Zofenopril, a new angiotensin-converting enzyme inhibitor and Hydrochlorothiazide, a thiazide diuretic, in tablets is developed and applied. The procedure is based on the use of the fourth-derivative ultraviolet spectra, by utilizing the derivative peak amplitude. The calibration graph is found to be linear in the range of 5.0-40 μg mL-1 for Zofenopril and 1.0-20 μg mL-1 for Hydrochlorothiazide. The proposed method is simple, rapid and gives accurate and precise results. [ABSTRACT FROM AUTHOR]

Introduction - Rhamnus alpinus L. (Rhamnaceae), a traditional plants in the flora of the Abruzzo region, is known to contain active anthraquinone secondary metabolites. However, the content of anthraquinones varies among R. alpinus samples depending on collection season and site. Thus, using simple, reliable and accurate analytical methods for the determination of anthraquinones in R. alpinus extracts allows comparative study of different methods of extraction. Objective - After a partial validation of an HPLC method for the simultaneous determination of five anthraquinones, aloe-emodine, rheine, emodine, chrysophanol and physcione, in the bark of R. alpinus, we compared three different methods of extraction. Methodology - Anthraquinones were extracted from the bark of R. alpinus using different techniques (methanol maceration, ultrasonic and supercritical CO2 extraction). Separation and quantification of anthraquinones were accomplished using a reversed-phase C18 column with the mobile phase of H2O-methanol (40 : 60, v/v, 1% formic acid) at a wavelength of 254 nm. The qualitative analyses were also achieved at wavelength of 435 nm. Results - All calibration curves were linear over the concentration range tested (10-200 mM) with the determination coefficients ≥0.991. The detection limits (S/N = 3) were 5 mM for each analytes. All five anthraquinones were found in the samples tested at concentrations reported in experimental data. Conclusion - The described HPLC method and optimised extraction procedure are simple, accurate and selective for separation and quantification of anthraquinones in the bark of R. alpinus and allow evaluation of the best extraction procedure between the tested assays. Copyright © 2009 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Previous research has indicated that corpus callosum atrophy is associated with global cognitive decline in neurodegenerative diseases, but few studies have investigated specific cognitive functions.Objective: To investigate the role of regional corpus callosum atrophy in mental speed, attention and executive functions in subjects with age-related white matter hyperintensities (WMH).Methods: In the Leukoaraiosis and Disability Study, 567 subjects with age-related WMH were examined with a detailed neuropsychological assessment and quantitative magnetic resonance imaging. The relationships of the total corpus callosum area and its subregions with cognitive performance were analysed using multiple linear regression, controlling for volume of WMH and other confounding factors.Results: Atrophy of the total corpus callosum area was associated with poor performance in tests assessing speed of mental processing--namely, trail making A and Stroop test parts I and II. Anterior, but not posterior, corpus callosum atrophy was associated with deficits of attention and executive functions as reflected by the symbol digit modalities and digit cancellation tests, as well as by the subtraction scores in the trail making and Stroop tests. Furthermore, semantic verbal fluency was related to the total corpus callosum area and the isthmus subregion.Conclusions: Corpus callosum atrophy seems to contribute to cognitive decline independently of age, education, coexisting WMH and stroke. Anterior corpus callosum atrophy is related to the frontal-lobe-mediated executive functions and attention, whereas overall corpus callosum atrophy is associated with the slowing of processing speed. [ABSTRACT FROM AUTHOR]

Cognitive impairment and gait disturbances are the most frequent clinical findings in patients with leukoaraiosis (LA). Corpus callosum (CC) atrophy has been associated with dementia in patients with LA, as well as with gait disturbances in patients with normal pressure hydrocephalus. We investigated, in patients with LA, the possible association between gait impairment and CC atrophy, taking into account cognitive deficits and the other brain lesions commonly present in these patients. Thirty patients (M:F=21:9; mean age 72.5±6.3 years) with gait disturbances and brain CT images consistent with LA underwent an assessment of gait and a cognitive assessment of global and selective functions. Magnetic resonance imaging (MRI) was used to measure thickness and area of the CC, total LA volume, lacunar infarcts and size of lateral ventricles. We examined the effect of every MRI change on each performance measure. Reduction of CC thickness, particularly that of the anterior segment, had a significant effect on severity of gait impairment, as measured using the gait scale’s score. It was independent of any other brain changes revealed by MRI, including LA. An independent, significant association was also found between CC area and the Left Hand Praxis test results. In patients with LA, CC atrophy is associated with gait impairment independently of LA and other brain abnormalities usually present in these patients. [ABSTRACT FROM AUTHOR]

The performance of particle-loaded disks and traditional, packed extraction columns is compared. In this study, solid-phase extraction and liquid chromatographic analysis of the anticancer drug mitomycin C are duplicated using two devices that contain chemically similar C18 bonded silica. The following parameters are used to assess performance: linearity, recovery, precision, and lowest limit of detection. The extraction of mitomycin C from plasma and ultrafiltrate using particle-loaded membranes achieves better precision, improved concentration ability, lower detection limits, and greater efficiency. In addiction, elution of drug from the membrane adsorbent is efficiently accomplished using a small volume of mobile phase, eliminating analyte instability problems and the need for additional time-consuming evaporation. [ABSTRACT FROM AUTHOR]

Evidence-based medicine’s aims are to retrieve, screen and compound the best external evidence with the experience of the physician, and to best respond to the specific medical need of each individual patient. Clinical questions are better answered when good systematic reviews of randomised trials or good randomised clinical trials are available. On the other hand, in a clinical scenario, difficulties in applying the evidence may be amplified due to variability of disease conditions, feasibility of intervention and patient’s preferences. Guidelines are recommendations, based as much as possible on evidence, aimed at supporting clinical judgement/diagnostic skills/treatment decisions in everyday practice. Guidelines may improve the quality of care received by the patient and may contribute towards better consistency of care in a definite geographical area. However, guidelines risk reducing physician skills to critically appraising the evidence. In a clinical scenario, guidelines do not always provide substantial help, especially when no conclusive evidence supports them. The Italian Stroke Guidelines (SPREAD) have contributed towards more evidence-based and better harmonised stroke care in Italy. However, the number of high grade recommendations in SPREAD is still limited. Professionals should not forget that clinical decisions often reflect several issues, not only scientific ones, including personal experience, applicability of intervention and patient’s preferences. [ABSTRACT FROM AUTHOR]

Diaper dermatitis, which is the most common form of contact dermatitis in the newborn and in baby, is a consequence of prolonged contact with urine and feces, mainly affecting the diapered area. A clinical trial was carried out in order to verify whether the distribution of the hydrogel superabsorbents (HS) in the structure of the diaper is able to affect the incidence of dermatitis. The trial was carried out on 200 babies, age range from 1 to 24 months. It was divided into 2 groups. It was concluded that group A babies showed lower incidence of dermatitis in which diapers were containing HS on the cellulose mat surface than group B in which diapers were containing HS blended with the cellulose fluff.