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The aerial parts of Inula aschersoniana Janka var. aschersoniana afforded parthenolide, diepoxycostunolide, inusoniolide, chrysosplenol C and four new pseudoguaiane-type sesquiterpenoids. Their structures were determined using spectral methods and relative stereochemistry by NOESY correlations.

Background: Recently, there has been an interest in the relative effectiveness of progressive muscle relaxation (PMR) within the multidisciplinary treatment of patients with schizophrenia.The present study is aimed at providing evidence on the efficacy of PMR as means of alleviating the state anxiety and psychological distress and a way to increase subjective well-being in chronic patients with schizophrenia., Subjects and Methods: Sixty four schizophrenia patients underwent 2 sessions of PMR. On the third session they were randomly allocated to either the PMR or the reading control condition. The State Anxiety Inventory (SAI) was used to assess state anxiety and the Subjective Exercise Experience Scale (SEES) to assess psychological distress and subjective well-being before and after the third session for both groups., Results: Our data show a significant time by group interaction for the SAI and SEES (Wilks λ=0.58, p<0.001). Effect sizes for PMR were -0.22 (95%CI=-0.73 to 0.19) for state anxiety, -0.96 (95%CI=-0.41 to -1.43) for psychological stress, and +1.01 (95%CI=0.45 to 1.54) for subjective well-being., Conclusion: The present study provides scientific evidence for the utility of PMR in the chronic psychiatric settings for patients with schizophrenia.

Objective: To identify which factors commonly associated with low back pain (LBP) and disability differ between college-aged persons with LBP and with no or minimal LBP., Design: Clinical measurement, observational study. Subjects were assessed for LBP with the visual analog scale (VAS) and for disability from LBP using the Oswestry Disability Index (ODI). Subjects were measured for variables commonly associated with LBP and were grouped by both VAS (minimum [min]/no pain, pain) and ODI (no disability, disability) scores., Setting: College campus at a university., Participants: A convenience sample (N=84) of English-speaking students (34 men, 50 women) between 18 and 30 years of age., Interventions: Not applicable., Main Outcome Measures: Sports activity (sports activity score of the Baecke Physical Activity Questionnaire), depression, hamstring and hip flexor range of motion, low back extensor endurance, abdominal strength and endurance., Results: A significant main effect of group was found for both pain (P=.019) and disability groups (P=.006). The min/no pain and pain groups differed in back endurance (114.2±38.8s vs 94.5±44.5s, respectively; P=.04). The no disability and disability groups differed in back endurance (116.3±35.9s vs 97.1±45.7s, respectively; P=.03) and the sports activity score of the Baecke Physical Activity Questionnaire (2.98±.95 vs 2.48±.85, respectively; P=.01). Subjects with hyperkyphotic postures compared with the normative thoracic group had higher depression scores (49 vs 38.5, respectively; P=.03) and less hamstring flexibility (30.5 vs 49.9, respectively; P<.001)., Conclusions: Back extensor endurance was consistently different between both the pain and disability groups. Addressing limited low back extensor endurance and low levels of physical activity in young adults may have clinical relevance for the prevention and treatment of LBP and disability., (Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Aim: Chronic cerebrospinal venous insufficiency (CCSVI) is a syndrome described in multiple sclerosis (MS) patients, characterized by stenosis of the main extracranial veins with hampered cerebral venous outflow. In the original description echo-colour Doppler demonstrated to be an ideal non invasive tool for screening CCSVI patients, but the reproducibility was not assessed. Aim of this study is to assess the variability coefficient between trained and in not trained echo-colour Doppler operators., Methods: Thirty-six (36) subjects, matched for age and gender, were subset in 3 groups (group A, 12 healthy controls, HC; group B, 12 multiple sclerosis patients, MS; group C, 12 patients with other neurological disease, OND) underwent echo-colour Doppler screening for CCSVI according to an original protocol previously described. The inter observer variability rate was assessed by comparing respectively trained vs not trained operators, and trained vs trained operators, by using the same echo-colour Doppler equipment. In addition, by scanning 15 subjects after one month from the first session, intra observer coefficient was also assessed in trained operator., Results: The inter observer variability rate between trained and not trained echo-colour Doppler operators, were not completely satisfactory (K coefficient 0.47 95% CI 0.27-0.68). To the contrary the inter observer agreement between trained operators was much more reliable (K coefficient 0.80 95% CI 0.59-1.01). Finally, the intra observer variability rate in trained operators was 0.93, (95% CI 0.80-1.06) confirming a highly satisfactory agreement., Conclusion: Echo-colour Doppler is a powerful, non-invasive and reproducible tool for screening CCSVI-MS but it needs special training.

The educational needs in a large hospital in the Venice region were analysed in order to plan continuing education programs for 2005-2006. The reference model was the analysis of the educational waiting lists in both operative and managerial professions. Two identical questionnaires were used: the first was distributed to all the professional staff of the hospital with university qualifications and asked them to give their opinion regarding educational priorities. The second was given to staff with managerial roles, asking them to indicate the educational priorities for the staff under their direction. Analysis of the data collected focused on : the priority given to the various areas and topics of education; differences of opinion identified between the various working environments between professional groups and between staff/managers; influence of social and personal factors on the opinions expressed. The fact that the fields of interest indicated varied according to the role and working activities of staff involved, indicate the need to offer educational procedures tailored to the requirements of each group.

The conversion of the prion protein (PrP) into a protease-resistant isoform (PrP(Res)) is considered the pathogenic event responsible for prion encephalopathies. Microglia activation accompanies PrP(Res) deposition representing an early event in the progression of these diseases. It is now believed that microglial cells play a worsening, if not causative, role in prion-induced neuronal death, through the release of proinflammatory and neurotoxic molecules. Indeed, in vitro observations have demonstrated that PrP(Res) and the synthetic prion fragment PrP106-126 induce neuronal death by activating microglial to migrate in the lesion area and secrete cytokines. Recently, we and others have demonstrated that the recombinant peptide, corresponding to the protease-resistant portion of PrP encompassing the amino acids 90-231 (PrP90-231), when beta-structured, is toxic for neuronal cells, in vitro. Here we report that PrP90-231 induces activation of N9 microglial cells, characterized by cell proliferation arrest and increased secretion of different cytokines (RANTES, GCSF, and IL-12). Moreover, the treatment of N9 cells with PrP90-231 elicited inducible nitric oxide synthase (i-NOS) expression, nitric oxide release, and a delayed (15 min to 1 h of treatment) extracellular signal-regulated kinases 1/2 (ERK1/2) phosphorylation/activation. Although ERK1/2 is known to regulate proliferative and differentiative events, we show that its blockade, using the specific MEK inhibitor PD98059, did not prevent PrP90-231-induced inhibition of N9 cell proliferation. To our knowledge, this is the first evidence that a recombinant PrP(Res)-like peptide elicits microglial activation in vitro, thus representing a potentially important tool to develop possible therapeutic strategies to target prion-induced brain inflammation.

The case of a 36-year-old female, who following a road accident, had a cervical whiplash, is discussed. A radiographic examination of the affected region was performed at the Emergency Department. It showed a transverse radiolucent line at the basal odontoid process of the axis. A definitive interpretation was not possible and fracture of the odontoid process of the axis was suggested as differential diagnosis. On coronal CT reconstruction the presence of this fracture was ruled out. The line seen on the film was actually the product of a psychophysiologic visual illusion known as "Mach band". The use of conventional radiography correlated with digital CT images shows that the practical application of Mach band theory allows a better differentiation between normal and pathologic anatomy.

Although the presence of multiple cases of melanoma on the same side of a family is the best predictor of germline CDKN2A mutation, other features (i.e. early age at onset) may be useful to identify carriers. We analysed the records of 682 hospital-based Ligurian melanoma patients. Of these, 238 cases (34 familial, 14 non-familial multiple primary and 190 non-familial single primary melanomas) were consecutively enrolled for screening of the CDKN2A and CDK4 genes. Screening of the 34 familial patients revealed that nine were carriers of the CDKN2A G101W founder mutation. Of the 14 non-familial multiple primary melanoma patients, three carried the G101W founder mutation and one the P48T mutation. For the non-familial patients with a single melanoma, 17 of 190 carried germline CDKN2A mutations, with most (16/17) carrying the G101W Ligurian founder mutation and one a novel single base pair substitution, D74Y. The effect of mutation on age at diagnosis was significant (P=0.012) after correcting for melanoma type (familial or non-familial), number of primaries (single or multiple), gender and disease occurrence (incident or prevalent). Early age at onset may be a good predictor of CDKN2A mutation in Liguria, where the G101W founder mutation is prevalent among melanoma patients, independent of family history.

To fill the knownledge gap on the extension and quality of physical restraints in acute care hospitals a survey aiming at evaluating knowledge, opinions and behaviours of nurses in this area of care was performed. A questionnaire administered to the nurses of a large Italian hospital obtained a response rate of 66.2% (227 nurses) and the situation of 77 patients (15.8% of admitted patients) hospitalised and constrained in the target wards was reported. The physical restraints were widely used in intensive care and medical specialty wards (bed rails and limbs constraints). The main reasons for restraining the patients were: disorientation, agitation, aggressiveness, and balance disturbances. The application of constraints is an autonomous of the nurses decision in 60.8% of cases and the information is seldom reported in clinical or nursing records. Fifty-two per cent of nurses feel uneasy in constraining patients because of the relational implications with relatives. Lack of knowledge on ethical and legal implications and on the possible negative effects of constraining patients, on the different forms of constriction and on alternative strategies warrant an educational intervention to control and improve the implementation of physical measures of containment.

The Nottingham Health Profile (NHP) was administered to 85 dialysis patients treated at Mestre Hospital, to assess their quality of life and compare any differences between haemodialysis (HD) and peritoneal dialysis (PD) patients. The two groups were similar for the main characteristics. Overall dialysis patients do not enjoy a good quality of life. Comparing baseline demographic and clinical scores, 72.9% patients have problems with energy and 69.4 with mobility, 47.1% refer pain and 54.1% sleep disorders. The main differences between HD and PD patients concern psychological reactions, where 42.9% of HD patients report "at risk/compromised" scores compared to 17.2% of PD patients. NHP showed to be an easy to administer and efficient instrument in identifying areas of concern for dialysis patients.

We describe protocols for the fabrication of microfluidic devices in plastics using a number of different embossing masters. Masters were fabricated by deep reactive ion etching (DRIE) of silicon (100), wet etching of silicon (100) and (110), and SU-8 processing. Structures embossed into a cyclo-olefin polymer were characterized in terms of the quality of pattern transfer as well as of the surface roughness. High quality pattern transfer was achieved with masters containing structures with angled sidewalls. Pattern distortions occurring during de-embossing were minimized by using masters consisting of SU-8 (which has a thermal expansion coefficient close to that of the substrates). Structures embossed with SU-8 masters also exhibited the lowest surface roughness. However, due to structural deformation, the reusability of the masters prepared for this study extended to only five embossing experiments. Masters fabricated on silicon, on the other hand, were more robust, but were subject to breakage during the de-embossing phase of the experiment. The results of this study will guide researchers in choosing master fabrication methods that will provide profile and surface characteristics of embossed microfluidic channels that are advantageous to their specific application.

Unlabelled: In the intensive care unit (ICU) of Mestre hospital (Italy) a research was carried out to analyse the possibility to improve nurses' lip-reading skills., Methods: A specialized speech therapist organized a 20 hour training course for 34 health workers in ICU., Results: The participants had a lip-reading test at the beginning and at the end of the course and six months later. The final test revealed that participants could recognize a greater number of typical words in ICU in comparison to the initial test. Yet, after 6 months the skill decreased to the level shown at the beginning of the course. On the other hand, the trend shows that some participants' skill did not decrease. Neither the starting level nor intermediate stage are conditioned by sex, age, profession, and experience. In order to measure clinic efficacy, the participants had another test to understand if improved lip-reading skill could influence the following variables: word comprehension, nurse attitude to communication toward non-speaking people, patient emotional status and nurse emotional status. The training course seems to have had good effects on nurses' attitudes towards their patients and on their communication. Yet, study results do not show if increased lip-reading skills have real positive effects on ICU communication and whether this method is better than usual communication methods (e.g. mimic or alphabetic board).

Foot reflexology is both a diagnostic technique and therapy. It is an alternative therapy which is considered useful in pain management. Its effectiveness as a therapy has been studied at the Mestre hospital where a clinical study has been undertaken to determine the effectiveness of reflexology in the reduction of pain. A group of 40 persons suffering almost exclusively from a lumbar-sacral disc hernia received three treatments of reflexology massage for a week. The results found that 25 persons (62.5%) reported a reduction in pain, (rating at 0.75 on a scale of 0-4). These results however did not take into consideration the relationship between the effectiveness of foot reflexology and variables such as the persons physicality (Body Mass Index), or their psychological or social status.

Cyclic ADP-ribose (cADPR) elicits calcium-induced calcium release (CICR) in a variety of cell types. We studied the effect of cADPR on Ca2+ release in muscle cells by incubating SR vesicles from scallop (Pecten jacobaeus) adductor muscle in the presence of the Ca2+ tracer fluo-3. Exposure of SR to cADPR (20 microM) produced Ca2+ release, which was a function of free [Ca2+] in a range between about 150 and 1000 nM, indicating an involvement of ryanodine-sensitive Ca2+ channels. This Ca2+ release was not significantly enhanced by calmodulin (7 micrograms/ml), but it was enhanced by equimolar addition of noncyclic ADPR. Also, the Ca2+ release elicited by cADPR/ADPR was a function of free [Ca2+] in a range between about 150 and 3000 nM, over which Ca2+ was inhibitory. cADPR self-inactivation was observed at low free [Ca2+] (about 150 nM), but it tended to disappear upon [Ca2+] elevation (about 250 nM). Caffeine or ryanodine induced a Ca2+ release which was ruthenium red (2.5 microM) sensitive at low [Ca2+]. However, the Ca2+ release induced by either ryanodine or cADPR was no longer ruthenium red sensitive when free [Ca2+] was increased. Based on these data, a model is proposed for Ca2+ signaling in muscle cells, where a steady-state cADPR level would trigger Ca2+ release when free [Ca2+] does reach a threshold slightly above its resting level, hence producing cascade RyR recruitment along SR cisternae from initial Ca2+ signaling sites., (Copyright 1999 Academic Press.)

The changes in the level of glycated proteins and some factors of coagulation were studied in 30 patients with diabetes mellitus--15 with and 15 without diabetic retinopathy. The mean level of glycoalbumin was elevated (2.9 +/- 0.8 mg) HMF (mg protein) without an authentic difference in the two subgroups. Glycohemoglobin was also increased (means--13.6 +/- 1%) in all studied subjects The activity of antithrombin III was high (means--222 +/- 53%) and the concentration--reduced--means--22.1 +/- 2.2 mg%, without authentic difference in the two subgroups. The concentration of alpha-2-macroglobulin, as well as its activity showed no significant deviations. Factor VIII (von Willebrand) was within reference limits (means--97.04 +/- 15.06%) with a tendency to lower values in the group without diabetic retinopathy. Fibrinogen level (means--4.3 +/- 1.2 g) was within the reference range, and FDP--increased in the majority of the examined. A syndrome of intensified latent coagulability, equivalent to chronic decompensated DIC, determined by the basic dismetabolism and non-enzymatic glycating of proteins has been outlined. The changes are more marked in the cases with diabetic retinopathy.

The thrombocytic beta-thromboglobulin (beta-TG) level--a specific globulin secreted by the alpha-granules--is an important criterion in the contemporary diagnosis of acquired thrombocytopathies. The beta-TG was determined by the radioimmunologic test of the firm "Amersham" in thrombocytic lysates and thrombocyte-poor plasma of 54 persons: 24 patients with acute leukemia, 14 patients with chronic myeloid leukemia and 15 healthy controls. The leukemic patients were with a preliminary proved thrombocytopathy type "empty thrombocytic pool disease" which had been proved via aggregation measurement by the ATP and ADP levels in the thrombocytes and by the thrombocytic factor 4 level. While the intraplatelet beta-TG concentration in acute leukemia and chronic myeloid leukemia was found unchanged, in the patients with acute leukemia its secretion in the plasma was decreased (154.71 + 16.77 ng/10(5) platelets). The data interpretation shows that in these malignant hemopathies the alpha-granules do not take part in the "empty pool disease". In acute leukemia the pathogenesis of the thrombocytopathy is determined by the so-called "thrombocytic secretion paresis" which is confirmed by the thrombocytic factor 4 low level.

Factor VIII/von Willebrand antigen (VA), part of the molecule of plasma factor VIII, realizes the interaction between platelets and vascular endothelium and the triggering of primary hemostasis. The modern diagnostics and treatment of the complicated acquired thrombocytopathies are impossible without the investigation on the concentration of factor VIII/von Willebrand antigen. The immune coagulation method used allows the objective, exact and fast determination of VA--referent values have been developed in healthy subjects. The patients with blastic leukosis studied--28 and with chronic myeloleukemia--18, all with severe endogenous complicated thrombocytopathy, functionally and biochemically confirmed, showed normal values of VA/von Willebrand antigen. On the contrary, a slightly elevated VA was established in patients with diabetes with no vascular-degenerative syndrome, corresponding to the activation of platelet functions and to enhanced adhesiveness in particular, contributing to thrombotic complications. The data obtained are discussed in connection with the etiopathogenesis of the separate kinds of thrombocytopathies and the necessity of substitutive therapy.

In 35 patients with decompensated diabetes mellitus the following hemostatic indices were studied: glycohemoglobin, prothrombin time, partial thromboplastin time, fibrin monomers (determined by protamine sulfate test), fibrinogen and platelet count. A statistically significant decrease of the prothrombin time (p less than 0.001) and of the partial thromboplastin time (p less than 0.001) was found. Glycohemoglobin was significantly increased in all patients. The remaining indices were in the normal ranges. A syndrome of increased latent coagulability emerges which explains the tendency to thromboembolism in diabetes.

The kinetics of 111In-oxine-labeled platelets was studied in 37 patients with idiopathic thrombocytopenic purpura and in 12 control subjects using gamma-chamber. A comparison was made of the parameters of the kinetics, survival and sequestration type of platelets, as well as their recovery and exchange. In less severe processes the splenic type, while in more severe disease--the hepatic type of sequestration prevailed.

In 28 diabetics, classified into two groups according to the presence or absence of diabetic retinopathy, the following indices were examined: glycohemoglobin, factor VIII/von Willebrand, alpha-I-antitrypsin and alpha-2-macroglobulin. Factor VIII/von Willebrand and alpha-2-macroglobulin showed no changes in diabetes mellitus. Alpha-I-antitrypsin was statistically significantly decreased (p less than 0.05). Glycohemoglobin was significantly increased. No statistically significant differences were found between the two groups of diabetic patients (with and without retinopathy) studied for all indices examined.

Investigation of the kinetics of blood platelets is of paramount importance in cases where it is necessary to differentiate the cause of thrombocytopenia in patients: reduction of the output, changes in organ distribution or increase of sequestration of blood platelets. Using the method of labeling own blood platelets and a gamma-chamber, the kinetics of blood platelets (organ distribution, recovery and survival) was studied and computed in 40 patients with hypoplastic anemia, hypersplenism and thrombocytopenic purpura. A complex of the parameters characterizing the given disease has been defined.