Alcohol and drug abuse is a major contributory factor of all road deaths in Europe. The aim of this study is to investigate the prevalence of alcohol and licit/illicit drug intake among victims of ...road accidents in Campania region (Italy). A retrospective analysis of road traffic deaths from 2013 to 2022 in Campania was performed. The toxicological results from fluid samples collected at autopsy were reviewed. In total, 228 road deaths occurred, mostly during nights and weekends. A total of 106 victims tested positive for alcohol and/or drugs, among which 39 (36.8%) tested positive for alcohol only, 27 (25.5%) for alcohol and drugs in association; and 40 (37.7%) for licit/illicit drugs only, either individually or in combination. Polydrug intake has been found in 21 victims, and nine in combination with alcohol. The most detected drugs were cocaine and Δ9THC, followed by benzodiazepines. Blood alcohol concentration (BAC) > 1.5 g/L was found in most alcohol positives, both alone and in association with drugs. Despite the penalties for driving under the influence of alcohol (DUI) and drugs (DUID), no decrease in the number of alcohol and/or drugs related fatal road accidents has been observed. DUI and/or DUID cases were approximately one third of the entire sample study.
In complex suicides, more than one suicide method is applied at the same time or one after the other. The most common complex suicide includes the ingestion of drugs combined with drowning. A case of ...acute intoxication by Bisoprolol and drowning is reported. The dead body of a 40-year-old woman was discovered on a river side, soon after her husband found a suicide note at home. In the woman’s vehicle four empty boxes of Bisoprolol, a widely used beta blocker, were also found. Main autopsy findings were consistent with drowning and represented by plume of froth at the mouth and nostrils with frothy fluid also in the airways, water into the stomach, and a remarkable pulmonary edema as a result of fluid aspiration. Toxicological analyses were performed on peripheral blood, urine and gastric content samples using liquid and gas chromatography, coupled with mass spectrometry. Toxicological results were negative for ethanol and other common drugs of abuse. High levels of bisoprolol were found in blood (7.54 mg/L), far exceeding the therapeutic range, in the urine (1.14 mg/L), and gastric content (13.12 mg/L). Bisoprolol intoxication was assessed as a relevant contributing condition to the immediate cause of death represented by drowning. Although Bisoprolol would certainly have a heart-depressing effect, it is not possible to determine if the victim fell unconscious or if she simply collapsed into the water with a secondary drowning.
The COVID-19 pandemic has consistently raised the number of drug seizures, in United States as in Europe. The COVID-19 pandemic has also changed the typology of seizures from “more traditional” drugs ...to New Psychoactive Substances (NPSs), depending on geographical area. In Europe, the most frequent NPSs are synthetic cannabinoids (SCs) and cathinones, nonetheless synthetic opioids and phenethylamines are widely used. The aim of the study is the detection of NPS and other substances of abuse available in the black market, by quali/quantitative methods in LC-MS/MS and GC-MS. From 2018 to 2021, 268 seizures occurred in total and were analyzed by the Forensic Toxicology Laboratory (FTL) of Naples (Italy). The distribution of analyzed seizures over the years is the following: 53 in 2018, 61 in 2019, 89 in 2020 and 65 during the first semester of 2021. Cannabis was the most detected drug both in hashish and marijuana seizures, followed by cocaine > heroine > prescribed drugs > ketamine−amphetamine MDMA. No NPSs were seized until June 2021, when NPSs were found in two different seizures: Case #1 showed a bar of Cannabis resin containing a low level of Δ9THC = 0.57% associated to SC AB-FUBINACA in 4.5%; Case #2 showed a vegetal resinous substance (Δ9THC = 0.27%) with SC 5F-APINACA (4.1%) associated with methadone (1.0%). The detection of NPSs is alarming evidence that can lead to an increase in the risk of overdose or other negative and unpredictable consequences, such as violent or self-harming behavior in unaware users of cannabis derivatives considered of “natural” origin.
Few data are available on the role of emotional distress as a possible mediator of the relationship between coping strategies and the Patient Global Assessment (PGA). This study aims to investigate, ...in a large cohort of patients affected by RA, the relationship between specific copying strategies and PGA, and the role of emotional distress as a mediator.
A total of 490 patients with RA completed a set of standardized assessments including the self-reported PGA, the Coping Orientation to the Problems Experienced (COPE-NVI) and the Hospital Anxiety and Depression Scale (HADS). A mediation analysis was conducted to investigate the role of emotional distress.
The effect of coping strategies on the PGA score was significantly mediated by the emotional distress for religious (total effect mediated 42.0%), planning (total effect mediated 17.5%), behavioural disengagement (total effect mediated 10.5%), and focus on and venting of emotions (total effect mediated 9.8%). Seven coping strategies (acceptance, positive reinterpretation and growth, active coping, denial, humour, substance use-mental disengagement) resulted directly associated to PGA total score, but no mediation effect was found. The remaining four coping strategies were not associated to the PGA score.
This study suggests that coping strategies could be an important factor in the perceived disease severity. Consequently, in order to reduce PGA in patients with RA, a useful tool could be represented by the implementation of psychological interventions aiming to modify the specific coping styles. Moreover, to prevent or treat emotional distress seems to further reduce PGA.
Depression is a quite common comorbidity in patients with rheumatoid arthritis (RA) and is thought to influence its severity. This study aims to estimate, in a large cohort of Italian patients with ...RA, the prevalence of depression and to investigate the clinical correlates of depression in terms of disease activity and disability.
This is a cross-sectional study enrolling 490 outpatients with RA (80% female, mean age 59.5). The Hospital Anxiety and Depression Scale (HADS) was used to assess the presence of depression with a cut-off of 11. We collected data about disease activity and disability with DAS28, TJC-68, PhGA, PGA, VAS, DAS28, SDAI, CDAI and HAQ.
Prevalence of depression was 14.3% (95% CI: 11-17%). Depressed patients, when compared with not depressed ones, were found to have higher scores for TJC-68 (p = 0.011), PhGA (p = 0.001), PGA (p = 0.001), VAS (p = 0.001), DAS28 (p = 0.007), SDAI (p = 0.001), CDAI (p = 0.001) and HAQ (p = 0.001). Out of the 70 depressed patients, 30 subjects, already known to be depressed in the past, were still depressed at the time of the assessment, with only 11 (15.7%) under antidepressants. A multivariate analysis showed that male sex, higher PGA score, use of antidepressants and higher HAQ score were significantly associated with an increased risk of depression.
Our study shows that depression is common in RA and may affect its activity mainly via an alteration in the perception of the disease. Although its important implications, depression is still under-diagnosed and its management is inadequate.
We report on the aerosol-assisted atmospheric-pressure plasma deposition onto a stainless-steel woven mesh of a thin nanocomposite coating based on TiO2 nanoparticles hosted in a hybrid ...organic–inorganic matrix, starting from nanoparticles dispersed in a mixture of hexamethyldisiloxane and isopropyl alcohol. The stainless-steel mesh was selected as an effective support for the possible future technological application of the coating for photocatalytically assisted water depollution. The prepared coatings were thoroughly investigated from the chemical and morphological points of view and were demonstrated to be photocatalytically active in the degradation of an organic molecule, used as a pollutant model, in water upon UV light irradiation. In order to optimize the photocatalytic performance, different approaches were investigated for the coating’s realization, namely (i) the control of the deposition time and (ii) the application of a postdeposition O2 plasma treatment on the pristine coatings. Both strategies were found to be able to increase the photocatalytic activity, and, remarkably, their combination resulted in a further enhancement of the photoactivity. Indeed, the proposed combined approach allowed a three-fold increase in the kinetic constant of the degradation reaction of the model dye methylene blue with respect to the pristine coating. Interestingly, the chemical and morphological characterizations of all the prepared coatings were able to account for the enhancement of the photocatalytic performance. Indeed, the presence of the TiO2 nanoparticles on the outmost surface of the film confirmed the accessibility of the photocatalytic sites in the nanocomposite and reasonably explained the enhanced photocatalytic performance. In addition, the sustained photoactivity (>5 cycles of use) of the nanocomposites was demonstrated.
The role of retroperitoneal staging in endometrial cancer is still unclear. Although the prognostic value of lymphadenectomy has been demonstrated no data support the therapeutic value of nodal ...dissection. Sentinel node mapping represents an evolution of lymphadenectomy. Sentinel node mapping allows a more accurate identification of low-volume diseases (i.e., micrometastasis and isolated tumor cells) that are not always detectable via conventional histopathological evaluation. Adjuvant therapy might play a role in patients with low-volume disease. However, the presence of isolated tumor cells alone seems to not impact outcomes of endometrioid endometrial cancer patients. Hence, the choice to deliver adjuvant therapies has to be tailored based on uterine factors only. The introduction of molecular and genomic profiling would be useful in selecting appropriate surgical and adjuvant treatments. The molecular-integrated risk profile should be integrated in clinical practice to overcome the need of retroperitoneal staging (in case of non-bulky nodes) in patients at low risk.
We report on the aerosol-assisted atmospheric-pressure plasma deposition onto a stainless-steel woven mesh of a thin nanocomposite coating based on TiO2 nanoparticles hosted in a hybrid ...organic−inorganic matrix, starting from nanoparticles dispersed in a mixture of hexamethyldisiloxane and isopropyl alcohol. The stainless-steel mesh was selected as an effective support for the possible future technological application of the coating for photocatalytically assisted water depollution. The prepared coatings were thoroughly investigated from the chemical and morphological points of view and were demonstrated to be photocatalytically active in the degradation of an organic molecule, used as a pollutant model, in water upon UV light irradiation. In order to optimize the photocatalytic performance, different approaches were investigated for the coating’s realization, namely (i) the control of the deposition time and (ii) the application of a postdeposition O2 plasma treatment on the pristine coatings. Both strategies were found to be able to increase the photocatalytic activity, and, remarkably, their combination resulted in a further enhancement of the photoactivity. Indeed, the proposed combined approach allowed a three-fold increase in the kinetic constant of the degradation reaction of the model dye methylene blue with respect to the pristine coating. Interestingly, the chemical and morphological characterizations of all the prepared coatings were able to account for the enhancement of the photocatalytic performance. Indeed, the presence of the TiO2 nanoparticles on the outmost surface of the film confirmed the accessibility of the photocatalytic sites in the nanocomposite and reasonably explained the enhanced photocatalytic performance. In addition, the sustained photoactivity (>5 cycles of use) of the nanocomposites was demonstrated.
We report on the aerosol-assisted atmospheric-pressure plasma deposition onto a stainless-steel woven mesh of a thin nanocomposite coating based on TiOsub.2 nanoparticles hosted in a hybrid ...organic-inorganic matrix, starting from nanoparticles dispersed in a mixture of hexamethyldisiloxane and isopropyl alcohol. The stainless-steel mesh was selected as an effective support for the possible future technological application of the coating for photocatalytically assisted water depollution. The prepared coatings were thoroughly investigated from the chemical and morphological points of view and were demonstrated to be photocatalytically active in the degradation of an organic molecule, used as a pollutant model, in water upon UV light irradiation. In order to optimize the photocatalytic performance, different approaches were investigated for the coating's realization, namely (i) the control of the deposition time and (ii) the application of a postdeposition Osub.2 plasma treatment on the pristine coatings. Both strategies were found to be able to increase the photocatalytic activity, and, remarkably, their combination resulted in a further enhancement of the photoactivity. Indeed, the proposed combined approach allowed a three-fold increase in the kinetic constant of the degradation reaction of the model dye methylene blue with respect to the pristine coating. Interestingly, the chemical and morphological characterizations of all the prepared coatings were able to account for the enhancement of the photocatalytic performance. Indeed, the presence of the TiOsub.2 nanoparticles on the outmost surface of the film confirmed the accessibility of the photocatalytic sites in the nanocomposite and reasonably explained the enhanced photocatalytic performance. In addition, the sustained photoactivity (>5 cycles of use) of the nanocomposites was demonstrated.
Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in ...9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI.
We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI. The Rs1333040 polymorphism was evaluated by polymerase chain reaction-restriction fragment length polymorphism using restriction endonucleases (Bsml). Two expert operators unaware of the patients' identity performed the angiographic analysis; collaterals were assessed applying Rentrop's classification. Angiographic MVO was defined as a post-pPCI Thrombolysis In Myocardial Infarction (TIMI)<3 or TIMI 3 with myocardial blush grade 0 or 1, whereas electrocardiographic MVO was defined as ST segment resolution <70% one hour after pPCI.
Among our 133 STEMI patients (mean age 63 ± 11 years, men 72%), 35 (26%) and 53 (40%) respectively experienced angiographic or electrocardiographic MVO. Angiographic and electrocardiographic MVO were different among the three variants (
= 0.03 and
=0.02 respectively). In particular, T/T genotype was associated with a higher incidence of both angiographic and electrocardiographic MVO compared with C/C genotype (
=0.04 and
=0.03 respectively). Moreover, Rentrop score <2 detection rate differed among the three genotypes (
=0.03). In particular T/T genotype was associated with a higher incidence of a Rentrop score <2 as compared with C/C genotype (
= 0.02).
Rs1333040 polymorphism genetic variants portend different MVO incidence. In particular, T/T genotype is related to angiographic and electrocardiographic MVO and to worse collaterals towards the culprit artery.
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