Postoperative pain surveys in Italy from 2006 and 2012. (POPSI and POPSI-2)

OBJECTIVE: Despite established standards, effective treatments, and evidence-based guidelines, postoperative pain control in Italy and other parts of the world remains suboptimal. Pain control has been recognized as a fundamental human right. Effective treatments exist to control postsurgical pain. Inadequate postoperative analgesia may prolong the length of hospital stays and may adversely impact outcomes. MATERIALS AND METHODS: The same multiple-choice survey administered at the SIAARTI National Congress in Perugia in 2006 (n=588) was given at the SIAARTI National Congress in Naples, Italy in 2012 (n=635). The 2012 survey was analysed and compared to the 2006 results. RESULTS: Postoperative pain control in Italy was less than optimal in 2006 and showed no substantial improvements in 2012. Geographical distinctions were evident with certain parts of Italy offering better postoperative pain control than other. Fewer than half of hospitals represented had an active Acute Pain Service (APS) and only about 10% of postsurgical patients were managed according to evidence-based guidelines. For example, elastomeric pumps for continuous IV infusion are commonly used in Italy, although patient-controlled analgesia systems are recommended in the guidelines. The biggest obstacles to optimal postoperative pain control reported by respondents could be categorized as organizational, cultural, and economic. CONCLUSIONS: There is considerable room for improvement in postoperative pain control in Italy, specifically in the areas of clinical education, evidence-based treatments, better equipment, and implementation of active APS departments in more hospitals. Two surveys taken six years apart in Italy reveal, with striking similarity, that there are many unmet needs in postoperative pain control and that Italy still falls below European standards for postoperative pain control

Protein adsorption onto Fe3O4 nanoparticles with opposite surface charge and its impact on cell uptake

Nanoparticles (NPs) engineered for biomedical applications are meant to be in contact with protein-rich physiological fluids. These proteins are usually adsorbed onto the NP surface, forming a swaddling layer called protein corona that influences cell internalization. We present a study on protein adsorption onto different magnetic NPs (MNPs) when immersed in cell culture medium, and how these changes affect the cellular uptake. Two colloids with magnetite cores of 25 nm, same hydrodynamic size and opposite surface charge were in situ coated with (a) positive polyethyleneimine (PEI-MNPs) and (b) negative poly(acrylic acid) (PAA-MNPs). After few minutes of incubation in cell culture medium the wrapping of the MNPs by protein adsorption resulted in a 5-fold size increase. After 24 h of incubation large MNP-protein aggregates with hydrodynamic sizes 1500 to 3000 nm (PAA-MNPs and PEI-MNPs respectively) were observed. Each cluster contained an estimated number of magnetic cores between 450 and 1000, indicating the formation of large aggregates with a "plum pudding" structure of MNPs embedded into a protein network of negative surface charge irrespective of the MNP_core charge. We demonstrated that PEI-MNPs are incorporated in much larger amounts than the PAA-MNPs units. Quantitative analysis showed that SH-SY5Y cells can incorporate 100 per cent of the added PEI-MNPs up to about 100 pg per cell, whereas for PAA-MNPs the uptake was less than 50 percent. The final cellular distribution showed also notable differences regarding partial attachment to the cell membrane. These results highlight the need to characterize the final properties of MNPs after protein adsorption in biological media, and demonstrate the impact of these properties on the internalization mechanisms in neural cells.Comment: 32 pages, 10 figure

PANIC DISORDER, ANXIETY, AND CARDIOVASCULAR DISEASES

Different data indicate that psychological and/or emotional disorders may play an important role in the natural history of heart diseases. Although the major evidence is that related to depression, epidemiological data would indicate that anxiety and panic disorders are highly represented in cardiac patient, thus influencing mortality and morbidity. The diagnosis of panic disorder in patients with chest pain is crucial to a correct therapeutic approach, as well as to reduce the risks and costs of inappropriate treatments. Anxiety and panic may accelerate different direct and indirect processes involved in the pathogenesis of cardiovascular diseases: lifestyle risk factors, arterial hypertension, myocardial perfusion, autonomic nervous system or hypothalamus-pituitary-adrenal axis, platelet activation, and inflammation processes. Panic disorder seems to correlate particularly with sudden death: this suggests that it may be considered one of the main inducers of life-threatening arrhythmias, rather than to be linked to the development and progression of coronary atherosclerosis. Beyond hard outcomes, panic disorders produce negative effects on both global adjustment and life quality that may impair the course of the cardiac diseases. Interestingly, specific antipanic and anxiolytic agents seem to be particularly effective upon life quality. In any case, adequate controlled clinical trials are necessary in order to confirm the possibility of cardiovascular risk reduction by means of anxiety and panic disorder treatment

1-(4-Methoxy­phen­yl)-3-phenyl-1H-pyrazol-5-amine

The synthesis of the title compound, C16H15N3O, is regiospecific and single-crystal X-ray diffraction provides the only means of unambiguous structural analysis, with the benzene ring bonded to the imine C atom. The phenyl ring and the essentially planar (r.m.s. deviation 0.0354 Å) methoxy­benzene group are rotated by 29.41 (5) and 37.01 (5)°, respectively, from the central pyrazole ring. An inter­molecular N—H⋯N hydrogen bond links symmetry-related mol­ecules into a C(5) chain, which runs parallel to the b axis

NUOVI DERIVATI 2-ACETAMMIDOBENZAMMIDICI: ATTIVITÀ ANTIPROLIFERATIVA E POSSIBILE MECCANISMO DI AZIONE

Le cinnammido benzammidi rappresentano una classe di sostanze biologicamente attive di grande interesse farmaceutico. Nonostante siano state descritte per svariate attività biologiche, nessun dato è stato riportato sulla loro attivita antitumorale. Inizialmente una serie di 2-cinammidobenzammidi variamente sostituite sono state sintetizzate e valutate per la loro attività antiproliferativa. Partendo dal derivato risultato più attivo, il 2-cinnammido-5-iodobenzammide, che ha mostrato una percentuale di inibizione della crescita sulle K562 del 74% a 10μM, sono stati sintetizzati una serie di derivati al fine di approfondirne la SAR.I composti così ottenuti sono risultati attivi nei confronti di numerose linee cellulari tumorali a concentrazioni micromolari e submicromololari inducendo un blocco del ciclo cellulare delle K562 in fase G2M. Inoltre i derivati sintetizzati sono in grado di indurre apoptosi nelle cellule HEP G2

A protective role for autophagy in vitiligo

A growing number of studies supports the existence of a dynamic interplay between energetic metabolism and autophagy, whose induction represents an adaptive response against several stress conditions. Autophagy is an evolutionarily conserved and a highly orchestrated catabolic recycling process that guarantees cellular homeostasis. To date, the exact role of autophagy in vitiligo pathogenesis is still not clear. Here, we provide the first evidence that autophagy occurs in melanocytes and fibroblasts from non-lesional skin of vitiligo patients, as a result of metabolic surveillance response. More precisely, this study is the first to reveal that induction of autophagy exerts a protective role against the intrinsic metabolic stress and attempts to antagonize degenerative processes in normal appearing vitiligo skin, where melanocytes and fibroblasts are already prone to premature senescence

Virtual inspection based on 3D survey supporting risks detachment analysis in Pietraforte stone built heritage

The paper presents the first results of a multidisciplinary research project launched to support the conservation and restoration of the stone façades of the Pitti Palace in Florence with innovative techniques from the fields of geomatics and diagnostic analysis. Monitoring campaigns are periodically conducted on the façades of the palace to identify stone elements in critical conditions; such surveys primarily require close and careful observation of the façade, for which a crane basket is required. The paper proposes first attempt to compare results obtained through a traditional workflow with those coming from a deeper use of the high-resolution 3D model to conduct a virtual inspection and to map elements of vulnerability on a GIS. On a test area, the analysis of the factors considered relevant to the risk of detachment was carried out on the digital model and compared with what the experts observed on-site by carrying out Non-Destructive diagnostic tests. Traditionally conducted monitoring and diagnostic surveys are assumed to validate the proposed method, which, following a simple data analysis, remotely identifies all blocks detected as vulnerable by the in-situ inspection, potentially drastically reducing fieldwork. It is therefore proposed as a preliminary screening useful to better address further analysis

Immigration Policy and the Health of Latina Mothers and Their Infants

Restrictive immigration policies may adversely affect the health of Latina mothers and their infants. We hypothesized that undocumented Latina mothers and their US born children would have worse birth outcomes and healthcare utilization following the November 2016 election. We used a controlled interrupted time series to estimate the impact of the 2016 presidential election on low birth weight (LBW), preterm birth, maternal depression, well child visit attendance, cancelled visits, and emergency department (ED) visits among infants born to Latina mothers on emergency Medicaid, a proxy for undocumented immigration status. There was a 5.8% (95% CI: −0.99%, 12.5%) increase in LBW and 4.6% (95% CI: −1.8%, 10.9%) increase in preterm births immediately after the 2016 election compared to controls. While these findings were not statistically significant at p < 0.05, the majority of our data suggest worsened birth outcomes among undocumented Latina mothers after the election, consistent with larger prior studies. There was no difference in well child or ED visits. While restrictive policies may have contributed to worse birth outcomes among undocumented Latina mothers, our findings suggest that Latino families still attend infants’ scheduled visits. © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature

Marked pseudoepitheliomatous hyperplasia secondary to a red-pigmented tattoo. a case report

Tattooing is gaining increasing popularity in developed countries in recent years. Adverse cutaneous reactions of many different types against coumponds in tattoo inks are being reported more and more often in medical literature,especially against red-pigmented tattoo. Delayed immune-mediated reactions can manifest in several ways and different histological patterns have been described This article is protected by copyright. All rights reserved