Seizures of illicit substances for personal use in two Italian provinces: analysis of trends by type and purity from 2008 to 2017

Background: The use of illicit substances represents one of the most difficult problems to confront in the health system. Drug use is a global problem but is not uniform throughout the world, within the same country and changes over time. Therefore, knowing the illicit substances that are used in a territory is essential to better organize health services in that specific geographical area. To this aim, we analysed 4200 samples confiscated from individuals who held them for personal use by police forces in the Italian provinces of Modena and Reggio Emilia from 2008 to 2017. Methods: The suspected samples were screened by gas-chromatography-mass spectrometry (GC-MS) and by liquid chromatography-tandem mass spectrometry (LC-MS/MS); all samples were subsequently analysed by gas chromatography-flame ionization detector (GC-FID) for quantitative analyses. Results: Cannabis was the most seized illicit substance (70.7%). Over the study period, the number of seizures of herb with a high content of \u3949-THC increased. The number of cocaine seizures remained stable (total 16.1%), but the median purity of seized cocaine increased to 75% in 2017. Heroin seizures decreased over time, but the median purity of seized heroin reached 16.8% in 2017. In almost all the years, heroin samples with a purity exceeding the 97.5 percentile were found. Especially from 2014, the range of seized substances increased and started to include synthetic cathinones, phenylethylamines, UR-144, LSD, psilocybe, prescription opioid and hypnotics. In two cases, tramadol together with tropicamide was seized. Most of the seizures involved male subjects and 82% of the seizures were from individuals younger than 35 years of age. Conclusions: The persistence of old illicit drugs and the rapid emergence of new psychoactive substances represented a serious challenge for public health in the studied Italian area. Some useful interventions might be: informing mainly young people about the possible complications of cannabis use; implementing standardized procedures to diagnose and treat cocaine-related emergencies in hospitals; increasing the distribution of naloxone to antagonize possible heroin overdoses; equipping laboratories to be able to identify the new psychoactive substances

Mapping pathological phenotypes in a mouse model of CDKL5 disorder.

open14sihe research was supported by EMBL (E.A. and C.T.G.), the Italian Telethon Foundation (grant GGP09196, T.P. and M.G.; grant GGP10162, E.C., T.P., and M.G.), Epigenomics Flagship Project EPIGEN, MIUR-CNR to T.P., AIRETT onlus (T.P. and M.G.), the International Rett Syndrome Foundation (ISRF, M.G.), and a fellowship from the International Foundation for CDKL5 Research (IFCR) in collaboration with ISRF (E.A.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Mutations in cyclin-dependent kinase-like 5 (CDKL5) cause early-onset epileptic encephalopathy, a neurodevelopmental disorder with similarities to Rett Syndrome. Here we describe the physiological, molecular, and behavioral phenotyping of a Cdkl5 conditional knockout mouse model of CDKL5 disorder. Behavioral analysis of constitutive Cdkl5 knockout mice revealed key features of the human disorder, including limb clasping, hypoactivity, and abnormal eye tracking. Anatomical, physiological, and molecular analysis of the knockout uncovered potential pathological substrates of the disorder, including reduced dendritic arborization of cortical neurons, abnormal electroencephalograph (EEG) responses to convulsant treatment, decreased visual evoked responses (VEPs), and alterations in the Akt/rpS6 signaling pathway. Selective knockout of Cdkl5 in excitatory and inhibitory forebrain neurons allowed us to map the behavioral features of the disorder to separable cell-types. These findings identify physiological and molecular deficits in specific forebrain neuron populations as possible pathological substrates in CDKL5 disorder.openAmendola E;Zhan Y;Mattucci C;Castroflorio E;Calcagno E;Fuchs C;Lonetti G;Silingardi D;Vyssotski AL;Farley D;Ciani E;Pizzorusso T;Giustetto M;Gross CTAmendola E;Zhan Y;Mattucci C;Castroflorio E;Calcagno E;Fuchs C;Lonetti G;Silingardi D;Vyssotski AL;Farley D;Ciani E;Pizzorusso T;Giustetto M;Gross C

Monitoring of adherence to headache treatments by means of hair analysis

The aim of this study was to evaluate the potential of hair analysis to monitor medication adherence in headache patients undergoing chronic therapy. For this purpose, the following parameters were analyzed: the detection rate of 23 therapeutic drugs in headache patients' hair, the degree of agreement between the self-reported drug and the drug found in hair, and whether the levels found in hair reflected the drug intake reported by the patients

Hair analysis for detection of triptans occasionally used or overused by migraine patients-a pilot study

Purpose The aim of this study is to evaluate the detection rate of almotriptan, eletriptan, frovatriptan, sumatriptan, rizatriptan, and zolmitriptan in the hair of migraineurs taking these drugs; the degree of agreement between type of self-reported triptan and triptan found in hair; if the concentrations in hair were related to the reported cumulative doses of triptans; and whether hair analysis was able to distinguish occasional use from the overuse of these drugs. Methods Out of 300 headache patients consecutively enrolled, we included 147 migraine patients who reported to have taken at least one dose of one triptan in the previous 3 months; 51 % of the patients overused triptans. A detailed pharmacological history and a sample of hair were collected for each patient. Hair samples were analyzed by liquid chromatography-electrospray tandem mass spectrometry (LC-MS/MS) by a method that we developed. Results All the triptans could be detected in the hair of the patients. The agreement between type of self-reported triptan and type of triptan found in hair was from fair to good for frovatriptan and zolmitriptan and excellent for almotriptan, eletriptan, sumatriptan, and rizatriptan (P < 0.01, Cohen’s kappa). The correlation between the reported quantities of triptan and hair concentrations was statistically significant for almotriptan, eletriptan, rizatriptan, and sumatriptan (P < 0.01, Spearman’ s rank correlation coefficient). The accuracy of hair analysis in distinguishing occasionally users from overusers was high for almotriptan (ROC AUC = 0.9092), eletriptan (ROC AUC = 0.8721), rizatriptan (ROC AUC = 0.9724), and sumatriptan (ROC AUC = 0.9583). Conclusions Hair analysis can be a valuable system to discriminate occasional use from triptan overuse

Guidelines on the diagnosis, treatment and management of visceral and renal arteries aneurysms: a joint assessment by the Italian Societies of Vascular and Endovascular Surgery (SICVE) and Medical and Interventional Radiology (SIRM)

: The objective of these Guidelines is to provide recommendations for the classification, indication, treatment and management of patients suffering from aneurysmal pathology of the visceral and renal arteries. The methodology applied was the GRADE-SIGN version, and followed the instructions of the AGREE quality of reporting checklist. Clinical questions, structured according to the PICO (Population, Intervention, Comparator, Outcome) model, were formulated, and systematic literature reviews were carried out according to them. Selected articles were evaluated through specific methodological checklists. Considered Judgments were compiled for each clinical question in which the characteristics of the body of available evidence were evaluated in order to establish recommendations. Overall, 79 clinical practice recommendations were proposed. Indications for treatment and therapeutic options were discussed for each arterial district, as well as follow-up and medical management, in both candidate patients for conservative therapy and patients who underwent treatment. The recommendations provided by these guidelines simplify and improve decision-making processes and diagnostic-therapeutic pathways of patients with visceral and renal arteries aneurysms. Their widespread use is recommended

Programmazione nazionale e regionale: la storia dei piani sanitari.

L'autore ricostruisce la vicenda dei piani sanitari nazionali e regionali con particolare riguardo al settore dell'Endoscopia Digestiva, rilevandone profili e limit

un caso di suicidio combinato da plastic bag ed inalazione di sostanze tossiche

L'autore presenta un caso di suicidio combinato mediante applicazione di un sacchetto di plastica intorno al collo ed inalazione di gas propano emesso da una piccola bombola inserita all'interno del sacchett

Il certificato necroscopico. Contenuti e problemi.

La certificazione necroscopica rappresenta uno strumento fondamentale non soltanto per l'accertamento della realtà morte ai fini delle funzioni proprie dello stato civile. L'autore ne individua i profili ed i limiti, connessi soprattutto alla variabilità della modulistica in uso nelle diverse sedi amministrative

Programmazione sanitaria nazionale, Endoscopia Digestiva e VRQ.

L'autore presenta i risultati di una ricerca sui piani sanitari, e discute i criteri adottatti nella distribuzione territoriale della Unità operative di Endoscopia Digestiva, criteri che pongono problemi e presentano ricadute rilevanti sul piano medico-legale, con particolare riguardo ai profili di responsabilità professional