Bile analysis in heroin overdose.

Following its metabolism in the liver, morphine and its metabolites can be directly eliminated in bile. Then, they undergo the enterohepatic cycle (EHC) and mostly reappear in the circulation. We report a case showing the presence of morphine in bile (21.3 lg \u2044 mL) and hair (4.8 ng \u2044mg) but not in blood, urine or the liver of an addict who survived in hospital for about 144 h (6 days). These data would indicate that the EHC does not play any role about 144 h after the last injection, and directly confirms that gall bladder is a storage depot for morphine. They constitute the first report of a demonstration of the effect of the EHC on morphine bioavailability in an addict, and could be considered as indication, without supporting circumstantial evidence, that the morphine level in bile is related to chronic opiate use

Origanum vulgare essential oil vs. A commercial mixture of essential oils: In vitro effectiveness on salmonella spp. from poultry and swine intensive livestock

open11noSalmonella spp. represent a public health concern for humans and animals due to the increase of antibiotic resistances. In this scenario, the use of essential oils (EOs) could be a valid tool against Salmonella contamination of meat. This work compares the in vitro effectiveness of an Italian mixture of feed additives based on EOs (GR-OLI) with EO of Origanum vulgare L., recently admitted by European Food Safety Authority (EFSA) for animal use. Twenty-nine Salmonella serotypes isolated from poultry and pig farms were used to assess GR-OLI and O. vulgare EO antimicrobial propeties. O. vulgare EO was active on the disaggregation of mature biofilm, while GR-OLI was capable of inhibiting biofilm formation and disaggregating preformed biofilm. Furthermore, GR-OLI inhibited bacterial adhesion to Caco-2 cells in a dose-dependent manner. Both products showed inhibition of bacterial growth at all time points tested. Finally, the synergistic action of GR-OLI with commonly used antibiotics against resistant strains was investigated. In conclusion, the mixture could be used both to reduce the meat contamination of Salmonella spp. before slaughter, and in synergy with low doses of ciprofloxacin against resistant strains. Although EOs as feed additives are already used in animal husbandry, no scientific study has ever highlighted their real antimicrobial potential.openDi Vito M.; Cacaci M.; Barbanti L.; Martini C.; Sanguinetti M.; Benvenuti S.; Tosi G.; Fiorentini L.; Scozzoli M.; Bugli F.; Mattarelli P.Di Vito M.; Cacaci M.; Barbanti L.; Martini C.; Sanguinetti M.; Benvenuti S.; Tosi G.; Fiorentini L.; Scozzoli M.; Bugli F.; Mattarelli P

A case of suicide by ingestion of sodium nitroprusside.

The aim of this paper is to present a general semantic structure of the notions of the “freedom of conscience and religion” and “freedom of conscience and religious denomination.” The text refers to the concept of Ch. L. Stevenson, by means of a differentiation between the descriptive and emotive levels of the notions. The descriptive and emotive senses of both notions are presented vis- à-vis the evolution of the notions of “dignity” and “tolerance”. The persuasive and manipulative potential contained in the notions of the “freedom of conscience and religion” and “freedom of conscience and religious denomination” is also emphasized

Post-natal ultrasound morpho-dynamic evaluation of mild fetal hydronephrosis: a new management

BACKGROUND: Fetal hydronephrosis is the most common anomaly detected on antenatal ultrasound examination, affecting 1-5% pregnancies. AIM: A new management in mild antenatal renal pelvis dilatation (ARPD), using a technique based on both morphological and dynamical evaluation. MATERIALS AND METHODS: Prospective study conducted during a 36-months period in 180 consecutive newborns referred as having mild ARPD. Examinations consisted in a morphological ultra-sound (US) scan evaluating antero-posterior diameter, renal parenchyma, ureteral evidence and pelvis morphology and, subsequently, a dynamic evaluation to analyze any change of the urinary tract during bladder voiding. All children were evaluated both at 3rd day and 1 month after birth. They were divided among those with negative examinations and those with at least one positive scan, trying to discriminate within the latter, children suspected for transient pyelectasis from those suspected for organic pathology. RESULTS: 108 patients had normal US findings both at birth and at 1 month. The remaining 72 babies had at least one abnormal US examination: 54 were suspected for transient pyelectasis, while 18 suspected for organic pathology. At the end of the study, 61 babies (33.9%) had final diagnosis of transient pyelectasis and 11 cases (6.1%) of organic pathology. At one month the dynamic pattern of US findings had the highest negative predictive value, while renal parenchyma evaluation has the highest accuracy. CONCLUSIONS: a dynamic US approach allowed to better select among infants suspected for transient pyelectasis from those suspected for organic pathology, avoiding unnecessary and invasive examinations in healthy babies

Origanum vulgare essential oil vs. A commercial mixture of essential oils: In vitro effectiveness on salmonella spp. from poultry and swine intensive livestock

Salmonella spp. represent a public health concern for humans and animals due to the increase of antibiotic resistances. In this scenario, the use of essential oils (EOs) could be a valid tool against Salmonella contamination of meat. This work compares the in vitro effectiveness of an Italian mixture of feed additives based on EOs (GR-OLI) with EO of Origanum vulgare L., recently admitted by European Food Safety Authority (EFSA) for animal use. Twenty-nine Salmonella serotypes isolated from poultry and pig farms were used to assess GR-OLI and O. vulgare EO antimicrobial propeties. O. vulgare EO was active on the disaggregation of mature biofilm, while GR-OLI was capable of inhibiting biofilm formation and disaggregating preformed biofilm. Furthermore, GR-OLI inhibited bacterial adhesion to Caco-2 cells in a dose-dependent manner. Both products showed inhibition of bacterial growth at all time points tested. Finally, the synergistic action of GR-OLI with commonly used antibiotics against resistant strains was investigated. In conclusion, the mixture could be used both to reduce the meat contamination of Salmonella spp. before slaughter, and in synergy with low doses of ciprofloxacin against resistant strains. Although EOs as feed additives are already used in animal husbandry, no scientific study has ever highlighted their real antimicrobial potential

Curcumin-loaded graphene oxide flakes as an effective antibacterial system against methicillin-resistant staphylococcus aureus

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for serious hospital infections worldwide and represents a global public health problem. Curcumin, the major constituent of turmeric, is effective against MRSA but only at cytotoxic concentrations or in combination with antibiotics. The major issue in curcumin-based therapies is the poor solubility of this hydrophobic compound and the cytotoxicity at high doses. In this paper, we describe the efficacy of a composite nanoparticle made of curcumin (CU) and graphene oxide (GO), hereafter GOCU, in MRSA infection treatment. GO is a nanomaterial with a large surface area and high drug-loading capacity. GO has also antibacterial properties due mainly to a mechanical cutting of the bacterial membranes. For this physical mechanism of action, microorganisms are unlikely to develop resistance against this nanomaterial. In this work, we report the capacity of GO to support and stabilize curcumin molecules in a water environment and we demonstrate the efficacy of GOCU against MRSA at a concentration below 2 mg ml21. Further, GOCU displays low toxicity on fibroblasts cells and avoids haemolysis of red blood cells. Our results indicate that GOCU is a promising nanomaterial against antibiotic-resistant MRSA

Efficacia in vitro e in vivo dell’olio essenziale di Cinnamomum zeylanicum in nanoformulati e in sinergia con fluconazolo verso isolati di C. auris

Introduzione. C. auris è un patogeno emergente particolarmente attenzionato a livello mondiale in quanto resistente ai principali antifungini, viene spesso identificato dalle analisi di routine in maniera erronea, genera focolai tra pazienti ospedalizzati ed è resistente a disinfettanti di utilizzo comune (1). Tra le poche alternative ad oggi disponibili, l’olio essenziale di Cinnamomum zeylanicum (OE-CZ) potrebbe essere un ottimo strumento da impiegare nella lotta contro C. auris, grazie alle sue proprietà antifungine (2). Materiali e metodi. I ceppi clinici di C. auris sono stati ottenuti da emocolture positive e sottoposti a test di sensibilità agli antifungini e a 15 oli essenziali mediante tecnica della micro-diluizione. Per individuare la frazione attiva e migliorare il delivery, l’OE-CZ è stato sia frazionato con cromatografia liquida su colonna a bassa pressione che nano-incapsulato in particelle di policaprolattone (PCL). Di OE-CZ e dei prodotti della sua lavorazione è stata valutata sia la qualità chimica (GC-MS accoppiato allo spazio di testa) che l’efficacia antifungina unitamente alle principali componenti delle frazioni. La tossicità e l’efficacia di OE-CZ libero (L-OE-CZ) e nano-incapsulato (N-OE-CZ) sono state testate in vivo su G. mellonella. Il metodo di titolazione a scacchiera è stato usato per valutare la sinergia tra l’L-OE-CZ o N-OE-CZ e gli antimicotici (fluconazolo e micafungina). Il meccanismo d’azione è stato indagato valutando l’attività ATPasica in cellule di C.auris mediante kit ELISA, e la quantità di fluconazolo intracellulare con UPLC-MS/MS. Risultati. Tra i diversi OEs testati, l’OE-CZ era il più attivo (MIC90=0,06% v/v; MFC90=0,06% v/v). Tutti i ceppi di C. auris mostravano resistenza al fluconazolo (MIC>1024 μg/ml). La cinnamaldeide è il maggior costituente di L-OE-CZ (66,1 %). L’analisi dello spazio di testa indica che la quantità di quest’ultima aumentava da L-OE-CZ (24.2%) a di N-OE-CZ (80,1%) con una conseguente migliore efficacia (MIC90 ed MFC90=0.02 % v/v). Solo L-OE-CZ mostrava sinergia con il fluconazolo (FIC = 0,26 ± 0,14) e con la micafungina (FIC= 0,23 ± 0,13 e FIC=0,32 ± 0,13). In vivo, nessuna concentrazione di L-OE-CZ testata è risultata tossica e l’efficacia migliore era data dalla sinergia individuata in vitro (fluconazolo 2,5 μg/mL + OE 0,002% v/v) con parallela diminuzione dell’attività ATPasica (p<0,0001) e aumento della quantità di fluconazolo (p<0,002) intracellulare rispetto al controlli non trattati. Conclusioni e discussione. L’analisi di qualità dell’OE di C. zeylanicum individua la cinnamaldeide (66.1%) e il cinnamil-acetato (5.5%) come principali componenti. La nanoincapsulazione dell’OE comporta l’incorporazione selettiva di specifici principi attivi, come cinnamaldeide ed eugenolo, con il conseguente incremento delle proprietà antifungine del formulato. Dai test di sinergia emerge che solo L-OE-CZ va in sinergia con il fluconazolo e con la micafungina, mentre N-OE-CZ perde questa proprietà: ciò è probabilmente dovuto alla mancanza di componenti importanti minoritari del fitocomplesso che vengono persi nel processo di incapsulazione. I dati in vivo indicano sia la sicurezza d’uso delle concentrazioni testate che l’efficacia della sinergia tra OE e fluconazolo. Sebbene non sia ancora noto il meccanismo con cui L-OE-CZ agisca sul meccanismo di resistenza della cellula è possibile presupporre che questo coinvolga l’inibizione delle pompe di efflusso attivo ATP dipendenti permettendo al farmaco di permanere nella cellula e agire come farebbe in cellule di Candida spp. sensibil