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We define as early seizure (ES) those occurring within 7 days after stroke and late seizures those developing beyond 1 week after stroke. Seizures are well known to occur at the onset of intracerebral hemorrhage and serve as a clinical marker. Onset seizures may be focal or generalized, are usually brief and are associated with loss of consciousness in the setting of hemorrhage. A similar concept of immediate seizure occurs in traumatic brain injury. Predictive factors of ES can be classified of general and neurologic origin. An important question is whether ES per se worsen prognosis and outcome. The viability of the penumbral region in animal models of focal ischemia is influenced by the peri-infarct depolarization waves. If this also is true in humans, seizures in the immediate poststroke period might worsen outcome. Recently, hypercholesterolemia has been associated with better functional outcome at 1 month after a first-ever stroke, and multivariate analysis studies have shown that mean cholesterol values were lower in patients with ES compared with controls.

We reviewed P300 and contingent negative variation (CNV) studies performed in migraine in order to identify their relevance in migraine and the role of neurophysiology in migraine. Publications available to us were completed by a Medline search. There is experimental and clinical evidence for loss of cognitive habituation in migraine which may serve as a specific diagnostic tool; therefore, we reviewed studies on migraine that analyzed habituation and lack of habituation by P300 and CNV, performing short-term habituation (STH) and long-term habituation (LTH). Finally, we described the two components of P300 (a and b) and of CNV (early and late wave) and the two abnormalities reported from the majority of studies on event-related potential in migraine: increased amplitude of average event-related potential and lack of habituation. These abnormalities are especially related to the early component characterizing orienting activity.

Anticardiolipin antibodies (ACA) have been de tected in a variety of infectious diseases, especially viral infec tions. ACA also have been described in human immunodefi ciency virus (HIV)-infected hemophiliacs. Recently the pres ence of ACA in hemophiliac and nonhemophiliac patients with chronic hepatitis C virus has been reported. We performed a case-controlled study to establish if ACA are present in hemo philia and if they are due to the hepatitis C infection; and to confirm the association between ACA and hepatitis C infec tions in nonhemophiliac patients. Anticardiolipin antibodies have been studied in the serum of 62 hemophiliacs with chronic hepatitis C virus and in the control group (70 hepatitis C- negative patients with hemophilia or other clotting disorders). ACA were positive in only three hepatitis C-positive hemo philiac patients and in three hepatitis C-negative patients with hemophilia or other coagulation defects (first control group). No significant statistical differences were found in the groups (OR = 1.1; 95% CI 0.2-7.4, p = .6). Sixteen of 111 nonhe mophiliacs with chronic hepatitis C were positive for ACA while in 100 matched hepatitis C-negative subjects (second control group) anticardiolipin antibodies were positive in 9 pa tients. ACA tended to be higher in hepatitis C-positive nonhe mophiliac patients than in the control group, but the difference between the two groups was not statistically significant (OR = 1.7, 95% CI 0.7-4.4, p = .3). ACA do not seem to be associ ated with the chronic hepatitis C virus.

The prevalence of lupus anticoagulant (LA) and antiphospholipid antibodies (APA) in young patients ( 0.5). An inherited coagulation defect was found in seven (7.5%) patients. Our data suggest that the presence of LA or APA is associated with an increased incidence of thrombotic manifestation in young patients. Moreover LA is more frequent in patients with idiopathic DVT. Because the incidence of recurrent thrombotic manifestations in patients with LA or APA is estimated to be ∼50% within 2 years from the first thrombotic episode, the tests should be performed in all patients with juvenile thrombosis.

Molti studi preclinici ed epidemiologici hanno evidenziato che i fitoestrogeni, sostanze naturali non steroidee contenute nelle piante, potrebbero svolgere un ruolo importante nella prevenzione di diverse malattie ormone-dipendenti come il cancro al seno, i disturbi della menopausa e l'osteoporosi. Negli ultimi anni, sono stati introdotti sul mercato integratori alimentari o formulazioni a base di estratti di soia, per il trattamento dei sintomi della menopausa , in quanto osservazioni epidemiologiche hanno evidenziato una minore incidenza dei disturbi climaterici, dei tumori mammari, uterini e intestinali nelle donne asiatiche, la cui dieta giornaliera è molto ricca in estratti della soia. Questa contiene fitoestrogeni, in particolare gli isoflavoni genisteina e daidzeina, che hanno una conformazione chimica simile a quella dell'estradiolo, il principale ormone sessuale femminile. Si ritiene che gli isoflavoni della soia agiscano attraverso un effetto di modulazione selettiva sui recettori estrogenici (azione ormone-simile), che riducano la produzione di radicali liberi (“radical scavenger”) e che inibiscano la proliferazione di cellule tumorali (azione non ormonale). L’abbondanza di prodotti commerciali a base di derivati della soia determina la necessità di procedere ad un loro accurato controllo di qualità al fine di evidenziare possibili adulterazioni o escludere la possibilità di sovradosaggi. Nel Laboratorio di Analisi Farmaco-Tossicologica sono stati sviluppati alcuni metodi analitici basati sia sulla cromatografia elettrocinetica micellare (MEKC) che sulla cromatografia liquida ad alta prestazione (HPLC) per il controllo di qualità di integratori commerciali contenenti estratti di soia. In particolare, l’analisi elettroforetica di genisteina, daidziena, gliciteina (e loro glicosidi) è stata effettuata, utilizzando un elettrolita supporto (BGE) a pH basico contenente sodio dodecil solfato . Si sta ora mettendo a punto un metodo più sensibile e selettivo basato sull’uso di un HPLC con detector coulombometrico. Inoltre, è in fase di sviluppo anche un metodo semplice e veloce che utilizza un HPLC con detector Diode Array che permette oltre alla quantificazione anche l’identificazione degli analiti attraverso gli spettri di assorbimento UV. I risultati preliminari sembrano essere soddisfacenti; si sta proseguendo con i test per la convalida dei metodi.

The pharmaco-toxicological profile of duloxetine, a novel SNRI antidepressant, is still not completely known; in particular, intoxication cases have been scarcely studied. Here a duloxetine overdose case, in combination with other antidepressants and benzodiazepines, is reported and the chemicalclinical correlations discussed; this is probably the first detailed report of such a case. The patient referred to have ingested nine tablets of Cymbalta† (more than 500 mg of duloxetine) and high amounts of four other drugs (venlafaxine, trazodone, sertraline and clonazepam). The patient was dozy and confused and some electrolyte imbalances were found. After gastrolavage, toxicological analyses revealed high plasma levels of duloxetine (384 ng/ml) and low levels of the other supposedly involved drugs. The overdose resulted to be not fatal and the outcome was relatively benign, also thanks to the fast emergency assistance. This case suggests that clinicians should be alerted to the possibility of toxic effects caused by simultaneous overdoses of duloxetine and other antidepressants and that caution should be used when prescribing more than one of these drugs to patients at risk of suicide.

Risk management in healthcare refers to the process of developing strategies aimed at preventing and controlling the risk of occurrence of errors and harmful events. The final objective is primarily that of increasing patient safety and secondarily, that of reducing the financial burden of adverse events. The implementation of a risk management system is therefore of vital strategic importance. Nevertheless, a fundamental question that needs to be answered in the operational phase is: should a proactive or reactive approach to risk management be taken? In our view, proactive risk management has many advantages over a reactive approach and is therefore preferable. The reactive approach should be taken exclusively to obtain information regarding risk and errors, in the preliminary, as well as monitoring and follow-up phases of the project.

Nella soia e nei suoi estratti sono presenti numerosi composti a struttura isoflavonica che possono esercitare un'azione ormono-simile ed in particolare estrogeno-simile. Pertanto, la soia viene spesso utilizzata come integratore alimentare allo scopo di eliminare o ridurre i sintomi spiacevoli della menopausa: vampate di calore, insonnia, affaticabilità, nervosismo, iperforesi e aumento di peso. Recentemente, è stata introdotta in commercio una nuova formulazione (Soymen GN) comprendente due tipi di capsule di gelatina molle: per la somministrazione diurna, contenenti estratto di soia e per la somministrazione serale, contenenti melatonina oltre all'estratto di soia. In questo modo si potrebbe migliorare il controllo dell'insonnia, che risulta essere uno dei sintomi più fastidiosi e più difficilmente gestibili. Sono attualmente in fase di sviluppo due metodi HPLC rispettivamente con rivelazione UV e con rivelazione ED (di tipo amperometrico), che permettono di dosare contemporaneamente la melatonina, i principali isoflavoni della soia (genisteina, daidzeina e gliciteina) e le loro forme glicosilate (genistina e daidzina) nel plasma di soggetti che assumono Soymen GN®. I metodi utilizzano una colonna C18 a fase inversa ed una fase mobile composta da tampone fosfato a pH acido ed acetonitrile. Il pre-trattamento dei campioni biologici è effettuato mediante estrazione in fase solida con cartucce a bilanciamento idrofilo-lipofilo e pochi µL di plasma sono sufficienti per un'analisi completa. I risultati preliminari sono soddisfacenti, sia in termini di rese d'estrazione, sia in termini di purificazione dei campioni.

Soymen GN is a new commercial preparation, containing soy extract and melatonin for the treatment of menopausal symptoms such as insomnia, hot flushes, tachycardia and osteoporosis. The commercial package contains two kinds of soft gelatin capsules: the “light” capsules for morning administration contain soybean extract (40 mg), while the “dark” capsules for evening administration contain soy extract (40 mg) and melatonin (5 mg). The main active compounds are the isoflavones, which are present both as aglycones and as glycosides: genistein, daidzein, glycitein, genistin and daidzin. These compounds are of particular interest for their possible estrogenic effects on the symptoms of menopause, in fact they have been used in therapy as a replacement to estrogen deficiency as a consequence of menopause. Melatonin is a hormone whose main function is the regulation of circadian rhythms. Thus, it can be helpful for the relief of insomnia and other sleep disturbances. The aim of this study is to develop a quality control system for the Soymen GN formulation. For this purpose, it is important to have access to reliable analytical methods for the determination of melatonin and of the main soy isoflavones, both aglycones and glycosides. Two original HPLC methods coupled to spectrophotometric and amperometric detection, respectively, have been developed for the quality control of Soymen GN capsules. UV detection is carried out at 260 nm, while amperometric detection is carried out at an oxidation potential of + 800 mV. The chromatographic separation is obtained using a reversed-phase C8 column as the stationary phase and a mixture of acetonitrile and an acidic phosphate buffer (30/70, v/v) as the mobile phase. A third analytical method based on micellar electrokinetic chromatography is currently undergoing validation. The BGE is composed of a 25 mM, pH 10.3 carbonate buffer, containing 55 mM SDS and 5% methanol. The analytes are quantitatively extracted from both “light” and “dark” capsules by agitation in a methanol/water mixture. From these preliminary results, all three methods seem to be promising for the quality control of the new formulation.

Antiphospholipid antibodies (APAs) are associated with venous thromboembolism in patients with systemic lupus erythematosus (SLE). In patients without SLE, but with deep vein thrombosis (DVT) this association is established only for patients with lupus anticoagulant (LA). In a case-controlled study APAs were determined in 171 consecutive outpatients who underwent phlebography at the first episode of clinically suspected DVT of lower limbs. Phlebography confirmed the presence of DVT in 54 (32%) patients and excluded it in 117. Antiphospholipid antibodies (exluding LA) were detected in 5 (9.2%) of the 54 patients with DVT and in 7 (5.9%) of the 117 subjects without DVT, The prevalence of APAs tended to be higher in patients with DVT than in patients without DVT, but the difference was not statistically significant (p = 0.3%). Antiphospholipid antibodies in the absence of LA are not associated with DVT in symptomatic patients. Therefore future studies should be performed before changing our clinical approach in APA-A positive but LA-negative patients. Key Words: Antiphospholipid antibodies-Deep vein thrombosis.

Introduction: Amphetamine (alpha-methylphenylethylamine) and its analogues such as methamphetamine (N,alpha-dimethylphenylethylamine) and MDMA (N,alpha-dimethyl-3,4-methylenedioxyphenylethylamine) are currently among the most well-known abuse drugs. They are used especially by young people as stimulants during the week-end (e.g. in discos), and are thus often referred to as "recreational drugs". Their mechanism of action is complex, but surely involves the release of catecholamines and serotonin from synaptic vesicles. Aim of this study is the development of a reliable analytical method for the simultaneous determination of amphetamine, methamphetamine and MDMA, and its application to the analysis of these compounds in human biological fluids, such as plasma and urine. Materials and Methods: Since the analytes show native fluorescence, liquid chromatography (HPLC) with fluorimetric detection was chosen for the purpose of separating and quantitating them. Separation was achieved on a C8 reversed-phase column using a phosphate buffer/acetonitrile (88:12) mixture (apparent pH = 2.8) as the mobile phase, flowing at 1 mL/min. Quinine was chosen as the Internal Standard (IS). Detection wavelengths were: lambda(exc) = 210 nm; lambda(em) = 300 nm for the analytes; lambda(exc) = 340 nm; lambda(em) = 420 nm for the IS. The sample pre-treatment procedure was carried out by means of solid-phase extraction (SPE) on hydrophilic-lipophilic balance cartridges. The cartridges were loaded with 250 µL of plasma or urine; the analytes were then eluted, dried and redissolved with 250 µL of mobile phase. Results: Under the described leading conditions, all analytes are baseline separated and detected within 13 minutes. Good linearity was obtained over different concentration ranges, according to the drug and the matrix. The sample pre-treatment procedure gave good extraction yields for all analytes, with mean recovery values ranging from 85 to 95% in plasma. Furthermore, the samples are devoid of interference from the biological matrices, thus good purification has been achieved. Conclusion: The method thus developed seems to be suitable for the determination of amphetamine, methamphetamine and MDMA in human plasma and urine.

Glycyrrhizin is the main active compound of Glycyrrhiza glabra root extracts; according to recent studies, glycyrrhizin and its aglycon, glycyrrhetic acid, have interesting therapeutic properties. A new capillary electrophoretic method has been developed for the separation and quantification of glycyrrhizin, beta-glycyrrhetic acid and its isomer alfa-glycyrrhetic acid. Separation of the analytes was achieved in less than 3 min on a fused silica capillary, by injecting the samples at the short end of the capillary (effective length: 8.5 cm). The background electrolyte was composed of pH 10.0 carbonate buffer, methanol and ethylene glycol (80/10/10) and contained 0.4% beta-cyclodextrin; indomethacin was used as the internal standard. Diode array detection was used, with quantitative assays carried out at 254 nm. Linearity was found over the 5–200 and 2.5–100 microg/mL concentration ranges for glycyrrhizin and glycyrrhetic acid, respectively. This method has been applied to the determination of the analytes in different matrices (liquorice roots and commercial confectionery products), and to the purity control of beta-glycyrrhetic acid obtained from the hydrolysis of glycyrrhizin. When analysing beta-glycyrrhetic acid and its epimer in roots, the samples were purified by means of a suitable solid-phase extraction (SPE) procedure with Oasis HLB cartridges, which granted good selectivity, eliminating matrix interference.

Summary Background. A definite evidence in favour of an association of deep-vein thrombosis (DVT) with lupus anticoagulant (LA) in patients free from systemic lupus erythematosus is still lacking. Methods. In a case-control study, LA was determined in 176 consecutive outpatients who underwent phlebography because of the first episode of clinically suspected DVT of lower limbs. The association between DVT and LA was described using odds ratios (OR). Results. Contrast venography confirmed the clinical suspicion in 59 patients (33.5%). LA was detected in 5 of the 59 patients with DVT (8.5%), and in none of the 117 subjects with normal venogram (P = 0.007). The OR for having an acute DVT in patients with LA was 10.7 (95% CI: 1.2-94.2). Conclusions. LA is significantly associated with DVT in symptomatic patients. Further studies are needed to establish the clinical implications of this association.

Growth of CdTe (111) layers on GaAs (100) and GaAs (111) substrates by metalorganic chemical vapor deposition (MOCVD) has been investigated using a commercial, vertical, high‐speed, rotating disk reactor. Dimethylcadmium (DMCd) and diisopropyltelluride (DIPTe) were used as the growth precursors. The growth rate was measured over the temperature range from 308 to 402 °C. DMCd molar growth efficiencies greater than 50% are obtained for growth temperatures greater than 368 °C. X‐ray rocking curves for the (422) and (333) reflection planes of CdTe (111)

The metalorganic chemical vapor deposition (MOCVD) growth of CdTe and HgTe on GaAs (111) and (100) substrates in a vertical, high-speed, rotating-disc reactor was investigated. A range of total reactor pressure, carrier gas flow rate, chemical concentrations, deposition temperature, and rotation rate have been investigated in an attempt to optimize growth conditions. Diisopropyltelluride (DIPTe) and Dimethylcadmium (DMCd) were used as growth precursors. Thickness uniformity varies less than +/- 1.5% over 50 mm diameter wafers. Films having FWHM X-ray rocking curves less than 90 arcsec were obtained on GaAs (111) substrates. The films have excellent surface morphology, exhibiting less than 5x104 cm-2 orange peel dents which are << 1 µm in size. An elemental mercury source was added to the growth system. Initial results for the growth of HgTe and HgCdTe will be discussed in this text.

La Valle dell’Idice, posta a S-W di Bologna, presenta una notevole continuità di frequentazione. L’insediamento etrusco-celtico di Monte Bibele unito alla relativa necropoli di Monte Tamburino confermano come a partire dal IV secolo a.C. tale territorio abbia assunto un ruolo primario all’interno dello schema dei commerci fra Pianura Padana e Toscana. L’abbondante materiale faunistico evidenzia come l’allevamento, soprattutto quello suino, costituisse a Monte Bibele la base della sussistenza, a cui si aggiungeva la caccia a cervi, caprioli e cinghiali. I dati provenienti invece dalle offerte animali dei contesti tombali di Monte Tamburino (Méniel, 2003) e della coeva necropoli di Monterenzio Vecchio, mostrano un’elevata standardizzazione nella deposizione dei resti che vedono nuovamente il maiale come elemento principale dei pasti per i defunti. Il confronto, dunque, fra i resti animali dal contesto utilitaristico di abitato e quello sacro delle tombe svela la credenza in una vita dopo la morte, in cui ai defunti si concedono le stesse abitudini alimentari dei vivi.

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