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Chiavari, Italy

Nicolini A.,Respiratory Diseases Unit | Ferraioli G.,Emergency Medicine Unit | Ferrari-Bravo M.,Public Health Unit | Barlascini C.,Forensic Medicine | And 2 more authors.
Clinical Respiratory Journal | Year: 2016

Background and Aims: Severe community-acquired pneumonia (sCAP) have been as defined pneumonia requiring admission to the intensive care unit or carrying a high risk of death. Currently, the treatment of sCAP consists of antibiotic therapy and ventilator support. The use of invasive ventilation causes several complications as does admission to ICU. For this reason, non-invasive ventilation (NIV) has been used for acute respiratory failure to avoid endotracheal intubation. However, few studies have currently assessed the usefulness of NIV in sCAP. Methods: We prospectively assessed 127 patients with sCAP and severe acute respiratory failure [oxygen arterial pressure/oxygen inspiratory fraction ratio (PaO2/FiO2) <250]. We defined successful NIV as avoidance of intubation and the achievement of PaO2/FiO2 >250 with spontaneous breathing. We assessed predictors of NIV failure and hospital mortality using univariate and multivariate analyses. Results: NIV failed in 32 patients (25.1%). Higher chest X-ray score at admission, chest X-ray worsening, and a lower PaO2/FiO2 and higher alveolar-arteriolar gradient (A-aDO2) after 1h of NIV all independently predicted NIV failure. Higher lactate dehydrogenase and confusion, elevated blood urea, respiratory rate, blood pressure plus age ≥65 years at admission, higher A-aDO2, respiratory rate and lower PaO2/FiO2 after 1h of NIV and intubation rate were directly related to hospital mortality. Conclusions: Successful treatment is strongly related to less severe illness as well as to a good initial and sustained response to medical therapy and NIV treatment. Constant monitoring of these patients is mandatory. © 2016 John Wiley & Sons Ltd. Source

El-Gammal O.A.,Mansoura University | Abu El-Reash G.M.,Mansoura University | El-Gamil M.M.,Forensic Medicine
Spectrochimica Acta - Part A: Molecular and Biomolecular Spectroscopy | Year: 2014

Hg(II), Cd(II) and binuclear Zn(II) complexes derived from the tetradentate N1-ethyl-N2-(pyridine-2-yl) hydrazine-1, 2-bis (carbothioamide) ligand (H2PET) have been prepared and characterized by conventional techniques. The isolated complexes acquired the formulas, [Hg(HPET)(H2O)2Cl]×H2O, [Cd(HPET)Cl] and [Zn2(HPET)(PET)(OAc)]×H2O, respectively. IR data revealed that the ligand behaves as monobasic tridentate through (CN) py, (C-S) and new (NC)azomethineâ̂ - groups in both Hg(II) and Cd(II) complexes. In the binuclear Zn(II) complex, the behavior of ligand contains two types, where H2PET acts as dibasic tetradentate via (CN)py, both deprotonated (C-SH) and the new (NC) azomethineâ̂ - towards two Zn atoms and also it acts as monobasic tridentate via (CS), deprotonated (C-SH) and (CN)py towards the same Zn atoms. An octahedral geometry for Hg(II) complex and tetrahedral geometry for both Cd(II) and Zn(II) complexes were proposed. The bond lengths, bond angles, HOMO, LUMO and dipole moment have been calculated by DFT using materials studio program to confirm the geometry of ligand and its metal complexes. The association constant of the ligand and the stability constants of its complexes as well as the thermodynamic parameters were calculated by pH metric measurements at 298, 308 and 318 K in 50% dioxane-water mixture, respectively. Also, the kinetic and thermodynamic parameters for the different thermal degradation steps of the complexes were determined by Coats-Redfern and Horowitz-Metzger methods. Moreover, the anti-oxidant (using ABTS and DPPH methods), anti-hemolytic, and cytotoxic activities of the compounds have been tested. © 2013 Published by Elsevier B.V. Source

Singh P.,Forensic Medicine | Harish D.,Government Medical College Hospital
Journal of Indian Academy of Forensic Medicine | Year: 2011

A severe burn injury is a life threatening incident to the patients in many ways and infection is one of the most common complications of burns. This prospective study was conducted to assess the incidence, magnitude and profile of post burn septicemia in burn cases coming to Government Medical College Hospital, Chandigarh.During the one year study period, a total of 89 cases of burns were admitted, with an overall male to female ratio of 1: 1.14. Septicemia was seen in 60% cases of which 28% were males and 72% were females; incidence of septicemia was 40% in males and 73% in females, respectively. Fifty-two percent of the septicemic patients werefrom rural areas, with 71% incidence of septicemia. Flame burns were seen in 96% cases studied, of which 66% suffered septicemia. Eighty-eight percent had sufferedaccidental burns and they had 58% incidence of septicemia. The mean age of the septicemic patients who survived was 26.8 years and it was 30.2 years in the fatal cases. Mean TBSA was 37% in the septicemic patients who survived and it was 68% in the fatal cases. Source

Nicolini A.,Respiratory Diseases Unit | Merliak F.,Respiratory Diseases Unit | Barlascini C.,Forensic Medicine
Multidisciplinary Respiratory Medicine | Year: 2013

Background: The six-minute walk test (6MWT) is widely used because it is both simple and reliable as a measure of exercise capacity. Individuals with chronic obstructive pulmonary disease (COPD) usually show a limited capacity to perform exercise. Methods: Our study is a prospective, randomized controlled trial which uses the 6MWT in one hundred consecutive in and out- patients with moderate to severe COPD to assess the benefit of a simple positive expiratory pressure (PEP) device. PEP device consisted of a PEP valve 5 cmH2O connected to 1-meter tube and a mouthpiece. All the enrolled patients performed a 6MWT before randomization. The following day PEP group patients performed the 6MWT using PEP device. Control group patients performed the 6MWT without this device. The primary outcome was the difference in distance (meters) walked. Results: Functional capacity assessed by the distance covered during 6MWT improved in the PEP group more than in the control group. The difference was statistically significant (p < 0.001).Oxygen saturation improved to a statistically significant level during 6MWT (p < 0.01). Heart rate was also reduced (p < 0.03). Conclusions: There are few studies demonstrating that PEP devices enhance exercise capacity in COPD patients. Our results has been obtained using only a low positive expiratory pressure (5 cmH2O). In our opinion the strength of this study is the simplicity and the lower cost when compared to other devices and approaches. The study was registered as Chi CTR-ORC-12002173 at www.chictr.org. © 2013 Nicolini et al.; licensee BioMed Central Ltd. Source

Yousef T.A.,Forensic Medicine | Yousef T.A.,Mansoura University | El-Gammal O.A.,Mansoura University | Ahmed S.F.,Mansoura University | Abu El-Reash G.M.,Mansoura University
Spectrochimica Acta - Part A: Molecular and Biomolecular Spectroscopy | Year: 2015

Three new NOS donor ligands have been prepared by addition ethanolic suspension of 2-hydrazino-2-oxo-N-phenyl-acetamide to phenyl isocyanate (H 2PAPS), phenyl isothiocyanate (H2PAPT) and benzoyl isothiocyanate (H2PABT). The Ni(II) complexes prepared from the chloride salt and characterized by conventional techniques. The isolated complexes were assigned the formulaes, [Ni2(PAPS)(H 2O)2](H2O)2, [Ni(H 2PAPT)Cl2(H2O)](H2O)2 and [(Ni)2(HPABT)2Cl2(H2O) 2], respectively. The IR spectra of complexes shows that H 2PAPS behaves as a binegative pentadentate via both CO of hydrazide moiety in keto and enol form, enolized CO of cyanate moiety and the CN (azomethine) groups of enolization. H2PAPT behaves as neutral tridentate via both CO of hydrazide moiety and CN (azomethine) group due to SH formation and finally H2PABT behaves as mononegative tetradentate via CO and enolized CO of hydrazide moiety, CO of benzoyl moiety and CS groups. The experimental IR spectra of ligands are compared with those obtained theoretically from DFT calculations. Also, the bond lengths, bond angles, HOMO (Highest Occupied Molecular Orbitals), LUMO (Lowest Unoccupied Molecular Orbital) and dipole moments have been calculated. The calculated HOMO-LUMO energy gap reveals that charge transfer occurs within the molecule. The theoretical values of binding energies indicate the higher stability of complexes than of ligands. Also, the kinetic and thermodynamic parameters for the different thermal degradation steps of the complexes were determined by Coats-Redfern and Horowitz-Metzger methods. The antibacterial activities were also tested against B. Subtilis and E. coli bacteria. The free ligands showed a higher antibacterial effect than their Ni(II) complexes. The antitumor activities of the Ligands and their Ni(II) complexes have been evaluated against liver (HePG2) and breast (MCF-7) cancer cells. All ligands were found to display cytotoxicity that are better than that of Fluorouracil (5-FU), while Ni(II) complexes show low activity. © 2014 Elsevier B.V. All rights reserved. Source

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