Development and validation of analytical method for identification of new psychoactive substances using linear retention indexes and gas chromatography-mass spectrometry.

New Psychoactive Substances (NPS) are quickly developing to evade legislation, posing unprecedented challenges to public health and law enforcement authorities around the world. The aim of this work was to develop and validate a simple and reliable non-target gas chromatography/mass spectrometry (GC/MS) analytical method based on linear retention indexes for the expeditious identification of NPS without the need of analytical standards. The method was optimized and validated for 22 different drugs covering ten categories: phenethylamines (amphetamine, MDMA, methamphetamine, 25CNBOMe, 2-FA, 5-MAPB), "classic" drugs (cocaine, ephedrine, THC, heroine), synthetic cannabinoids (JWH-081, AM-2201, JWH-210, MAM-2201), piperazines (o-CPP, p-CPP), tryptamines (5-MeO-MiPT), synthetic cathinones (N-ethylpentylone), synthetic opioids (U-47700), aminoindanes (5-IAI), plant-based substances (Salvinorin-A) and "other" (methiopropamine).

How to distinguish an active air leak from a pleural space effect.

Aim: We aimed to distinguish a pleural space effect from an active air leak, using a digital chest drain system that provided continuous air flow and pleural pressure checks.

Methods: between March 2010 and October 2011, we employed 144 digital drains for 138 thoracic surgical procedures.

Results: We observed 18 (12.

Use of a sealant to prevent prolonged air leaks after lung resection: a prospective randomized study.

Background: Pulmonary air leaks are common complications of lung resection and result in prolonged hospital stays and increased costs. The purpose of this study was to investigate whether, compared with standard care, the use of a synthetic polyethylene glycol matrix (CoSeal®) could reduce air leaks detected by means of a digital chest drain system (DigiVent™), in patients undergoing lung resection (sutures and/or staples alone).

Methods: Patients who intraoperatively showed moderate or severe air leaks (evaluated by water submersion tests) were intraoperatively randomized to receive just sutures/staples (control group) or sutures/staples plus CoSeal® (sealant group).

[Solitary metachronous metastasis of the sternum from pancreatic adenocarcinoma].

Sternal metastases from adenocarcinoma of the pancreas are extremely rare, and even more so when solitary. Two years earlier, the patient reported on here, a 67-year-old man with a solitary osteolytic lesion of the sternal manubrium, had undergone a duodeno-cephalopancreatectomy for adenocarcinoma of the pancreas (G2, pY3, pN1) followed by adjuvant radio-chemotherapy. PET/CT scans, in response to the onset of burning pain in the sternal region, revealed a hypermetabolic area only at the level of the manubrium, while MRI showed a bulging manubrium due to the presence of extensive solid pathological tissue towards the right articulations of the ribs.

[Iatrogenic hemothorax and unknown spontaneous rupture of the oesophagus, double dramatic disease].

Iatrogenic haemothorax is a dramatic event and generally lethal if not treated appropriately and rapidly. Any thoracic co-morbidity increases the risk of death. Spontaneous rupture of the oesophagus is an equally lethal illness if not treated.

Gold standard for sternectomies and plastic reconstructions after resections for primary or secondary sternal neoplasms.

Background: Between January 1980 and December 1999, 88 patients underwent the surgical resection of sternal tumors: 30 primary malignant tumors, 28 local relapses or metastases from breast carcinomas, 16 other types of tumor, and 14 radionecroses.

Methods: The sternectomies were total in 8 cases, subtotal in 32, and partial in 48. Prosthetic materials covered by flaps of myocutaneous or muscle tissue were used in 55 patients, prosthetic material alone in 13, myocutaneous or muscle flaps alone in 5, and other techniques in the remaining 15.