The Evaluation of the Detection of Cr(VI) in Leather

The topic of hexavalent chromium (Cr(VI)) in leather has been debated throughout the whole supply chain for years. However, its significance has recently increased due to proposed changes in European legislation concerned with skin-sensitising substances suggesting that acceptable Cr(VI) concentrations in leather goods should be lowered from 3 mg kg 121 to 1 mg kg 121. The proposition of a stricter limit and current analytical difficulties created the need for a review of current standard test methods. The research presented in this paper investigates both the colorimetric (Part 1) and chromatographic (Part 2) methods under BS EN ISO 17075. The focus of the study was to identify possible sources of interference leading to large statistical variance in results and to define the limit of quantification with respect to the proposed new compliance limit. This study into the colorimetric method has shown that the presence of Cr(III), dyes, and proteins can be significant interferences, becoming critical at low Cr(VI) concentrations. Dilution factors worsen the problem of detecting low concentrations: a reliable quantitative detection of 0.01 mg kg 121 and 0.003 mg kg 121 Cr(VI) in solution are required at the 3 mg kg 121 and 1 mg kg 121 compliance limits in leather, respectively. BS EN ISO 17075 part 1 was shown to be incapable of reliably resolving to 3 mg kg 121 or below in leather. Part 2 shows a marked improvement in detection limits and reliability; however, data suggest that 1 mg kg 121 Cr(VI) is not reliably detectable in leather. Suggested improvements to the established test methods and a possible alternative are discussed

The Evaluation of the Detection of Cr(VI) in Leather

The topic of hexavalent chromium (Cr(VI)) in leather has been debated throughout the whole supply chain for years. However, its significance has recently increased due to proposed changes in European legislation concerned with skin-sensitising substances suggesting that acceptable Cr(VI) concentrations in leather goods should be lowered from 3 mg kg−1 to 1 mg kg−1. The proposition of a stricter limit and current analytical difficulties created the need for a review of current standard test methods. The research presented in this paper investigates both the colorimetric (Part 1) and chromatographic (Part 2) methods under BS EN ISO 17075. The focus of the study was to identify possible sources of interference leading to large statistical variance in results and to define the limit of quantification with respect to the proposed new compliance limit. This study into the colorimetric method has shown that the presence of Cr(III), dyes, and proteins can be significant interferences, becoming critical at low Cr(VI) concentrations. Dilution factors worsen the problem of detecting low concentrations: a reliable quantitative detection of 0.01 mg kg−1 and 0.003 mg kg−1 Cr(VI) in solution are required at the 3 mg kg−1 and 1 mg kg−1 compliance limits in leather, respectively. BS EN ISO 17075 part 1 was shown to be incapable of reliably resolving to 3 mg kg−1 or below in leather. Part 2 shows a marked improvement in detection limits and reliability; however, data suggest that 1 mg kg−1 Cr(VI) is not reliably detectable in leather. Suggested improvements to the established test methods and a possible alternative are discussed

Central-line associated bloodstream infections in a tertiary care children's University hospital: a prospective study

BACKGROUND: The central-line associated bloodstream infections (CLABSI) are the most common healthcare-associated infections in childhood. Despite the international data available on healthcare-associated infections in selected groups of patients, there is a lack of large and good quality studies. The present survey is the first prospective study monitoring for 6 months the occurrence of central-line associated bloodstream infections in all departments of an Italian tertiary care children’s university hospital. METHODS: The study involved all children aged less than 18 years admitted to Meyer Children’s University Hospital, Florence, Italy who had a central line access between the October 15(th), 2014 and the April 14(th), 2015. CLABSI were defined according to the Center for Disease Control and Prevention criteria. CLABSI incidence rates with 95% confidence limits were calculated and stratified for the study variables. For each factor the relative risk and 95% confidence intervals were evaluated. Statistical analysis was performed using the statistical software SPSS for Windows, version 22.0 (SPSS Inc., Chicago, IL), p < 0.05 was considered statistically significant. RESULTS: CLABSI rate was 3.73/1000 (95% CI: 2.54–5.28) central line-days. A higher CLABSI incidence was seen with female gender (p = 0.045) and underlying medical conditions (excepting prematurity, surgical diseases and malignancy) (p = 0.06). In our study 5 infections, were caused by extended-spectrum β-lactamase producing organisms and in one case by carbapenem-resistant Klebsiella pneumoniae. CONCLUSIONS: Our study confirms the spreading of multi-resistant pathogens as causes of healthcare associated infections in children. An increased incidence rate of CLABSI in our study was related to underlying medical conditions. Pediatric studies focusing on healthcare infections in this type of patients should be done in order to deepen our understanding on associated risk factors and possible intervention areas

Efficacy of 1998 <i>vs</i> 2006 first-line antiretroviral regimens for HIV infection: an ordinary clinics retrospective investigation

Purpose: The evidence suggesting increased HAART efficacy over time comes from randomized trials or cohort studies. This retrospective multicenter survey aimed to assess the variation over time in the efficacy and tolerability of first-line HAART regimens in unselected patients treated in ordinary clinical settings. Methods: Retrospective analysis of data of all patients starting first-line HAART regimens in 1998 and 2006 at adhering centers in the Italian CISAI group. Results: For the 543 patients included, mean age was 39.1 ± 9.8y in 1998 and 41.0 ± 10.7y in 2006 (p=0.03), with a similar proportion of males. Baseline mean log10 HIV-RNA was 4.56 ± 0.97 copies/mL in 1998 vs 4.91 ± 0.96 copies/mL in 2006 (p&lt;0.001); baseline mean CD4 T-cell counts were 343 ± 314/mm3 in 1998 vs 244 ± 174/mm3 in 2006 (p&lt;0.001). The following outcomes were significantly improved at 48w in 2006: proportion with undetectable HIV-RNA (86.3% vs 58.0%; p&lt;0.001); mean increase in CD4 T-cells count (252 ± 225 vs 173 ± 246; p&lt;0.001); HAART modification (20.1% vs 29.2%; p=0.02); HAART interruption (7.3% vs 14.6%; p=0.01); proportion reporting optimal adherence (92.2% vs 82.7%, p=0.03). No differences were observed in the prevalence of grade 3-4 WHO toxicities (26.4% vs 26.6%; p=0.9). Multivariate logistic regression showed that being treated in 1998 remained an independent predictor of virological failure after several adjustments, including adherence. Conclusions: Our data from patients not included in clinical trials or cohort studies provide an additional line of evidence that the effectiveness of HAART significantly improved in 2006. Treated patients, however, were significantly older and more frequently late HIV presenters in 2006 than in 1998.</br

Lurasidone in adolescents and adults with schizophrenia: from clinical trials to real-world clinical practice

Introduction: Lurasidone is an atypical antipsychotic agent approved in the European Union for the treatment of schizophrenia in adults and adolescents (13-17 years). Clinical trials have shown a generally favorable balance between efficacy and tolerability. Areas covered: This paper provides a review and commentary regarding the use of lurasidone in adults and adolescents with schizophrenia. The available information about efficacy, tolerability, dosing, and switching is analyzed, highlighting the strategies that may be most useful in real-world clinical practice. Virtual case studies, designed based on the authors' clinical experience with real-world patients, are provided. Expert opinion: Lurasidone is efficacious in adolescents and adults in a wide range of symptoms of schizophrenia. Choosing the right dose for each patient and combining lurasidone with other medications is key to treatment success. Lurasidone has proven effective both in adolescents and adults in treating the acute phase of schizophrenia and reducing the risk of relapse. It has shown a relatively favorable tolerability profile, with minimal effects on metabolic parameters and prolactin levels

Characterization and Degradation Behavior of Agar–Carbomer Based Hydrogels for Drug Delivery Applications: Solute Effect

In this study hydrogels synthesized from agarose and carbomer 974P macromers were selected for their potential application in spinal cord injury (SCI) repair strategies following their ability to carry cells and drugs. Indeed, in drug delivery applications, one of the most important issues to be addressed concerns hydrogel ability to provide a finely controlled delivery of loaded drugs, together with a coherent degradation kinetic. Nevertheless, solute effects on drug delivery system are often neglected in the large body of literature, focusing only on the characterization of unloaded matrices. For this reason, in this work, hydrogels were loaded with a chromophoric salt able to mimic, in terms of steric hindrance, many steroids commonly used in SCI repair, and its effects were investigated both from a structural and a rheological point of view, considering the pH-sensitivity of the material. Additionally, degradation chemistry was assessed by means of infrared bond response (FT-IR) and mass loss