Rivista europea per le scienze mediche e farmacologiche = European review for medical and pharmacological sciences = Revue europeenne pour les sciences medicales et pharmacologiques最新文献

A new oral dosage form of diclofenac sodium, enabling the single administration of the daily dose of 150 mg, has been tested for treatment of 20 patients suffering from osteoarthritis of the spine. A control group of 20 patients with the same diagnosis instead received 3 enteric-coated tablets/day, each containing 50 mg of the drug. Treatments lasted in both groups one month. Clinical efficacy was monitored by evaluating the changes in the disease's symptoms and signs (pain, cramps, alterations of function capacity, morning stiffness) and in some laboratory parameters (ESR, C-reactive protein, Rheuma test). Treatment tolerability was evaluated through the routine laboratory blood and urine tests, and by registering any complaint at the gastrointestinal level, as well as any adverse event. The two posology schemes were equally effective in favourably reducing the disease's clinical and laboratory manifestations. Also systemic and local tolerability were superimposable and on the whole good: only a few episodes of mild epigastralgia were reported (3 cases in each group), as expected during a treatment course with NSAIDs.

Objective: The aim of this study was to evaluate the distribution of the concentrations of lipoprotein(a) [Lp(a)] in a free-living population, that of Brisighella, and to study the degree of association with cardiovascular disease (CVD) and other associated risk factors. The Brisighella study is included in the framework of observational and interventional longitudinal studies; it began in 1972 to monitor the spontaneous trend of the risk factors for atherosclerosis and to evaluate the incidence of CVD in a rural population.

Methods: The studies were carried out on 1319 subjects, 627 males and 692 females, aged over 14 years, of which 134 men and 113 women were geriatric (age > 64 years); the data are relative to the control of the population in 1988. The following were evaluated for each subject: (a) weight and height; (b) hematological parameters; (c) clinical events; (d) presence of other concomitant diseases. For the dosage of the hematological parameters, enzymatic-colorimetric parameters were used (total and HDL cholesterol, triglycerides, glycemia and uremia), radial immunodiffusion and immunoturbidimetry (apoAI and B), ELISA-sandwich immunoenzymatic method (Lp(a)). All the methods used are standardized and internal and external laboratory quality control was carried out. The data collected were analyzed with the program STATGRAPHIC VERSION 6.0; the mean, the standard deviation and the median were calculated for all the variables. The frequency tables, distribution curves (approximation estimates with the chi 2 test), and single and multiple regression were also calculated. A value of p < 0.01 was taken as the level of significance.

Results: The distribution of Lp(a) in the control population and in subjects with CVD was substantially the same for both sexes; the differences between the mean levels of Lp(a) were not statistically significant (18.5 mg/dl vs 20.09 mg/dl for men and 19.98 mg/dl vs 22.78 mg/dl for women). The same also applies to the elderly population (18.81 mg/dl vs 23.31 in the men and 21.13 mg/dl vs 21.47 mg/dl in the women). No significant variations were observed in the mean values of Lp(a) even when other risk factors were taken into consideration, such as hypertension, obesity and diabetes. Finally, multiple regression analysis did not show any correlation between Lp(a) levels and those of the other hematological parameters.

Conclusions: In this transversal study, we found no evidence to suggest that Lp(a) can be considered and independent and predictive risk factor for CVD. It would therefore seem that in the population of Brisighella the levels of Lp(a) are "causally" distributed, without any correlation with the presence of cardiovascular events or with hypertension, diabetes or obesity in both sexes.

The authors report five cases of dermatomyositis in which positivity for hepatitis C virus was ascertained. A virus-related (ECHO virus, Coxsackie) dermatomyositis is known, but a hepatitis virus C-related dermatomyositis was reported only in one case in a Letter to the Editor of Journal of Rheumatology (1994).

The authors report a case of acute pancreatitis (AP) occurring in a patient under treatment with carbamazepine (CBZ) for post-traumatic petit mal epilepsy, and review the current literature of drug-induced AP. The evidence of high plasmatic levels of CBZ and the absence of other aetiologic factors lead the authors to conclude that the overdose of CBZ could have represented the precipitating of the episode of acute pancreatitis.

In order to confirm the mouth-stomach crossing of Helicobacter pylori (H. pylori) we performed a study to isolate the bacterium both from dental plaque and gastric mucosa of 83 subjects. Out of the 83 subjects, 62 were affected by gastroduodenal pathologies usually related to H. pylori whereas, the other 21 subjects were healthy. Each patient underwent one plaque sampling and three gastric samplings. The samples were cultured and an analytical technique, isoelectrofocusing (IEF), was used to show if dental and gastric strains isolated from the same subject had the same proteic profile. The H. pylori was isolated from the dental plaque of five subjects. Out of these, four subjects were suffering from gastric pathologies and the H. pylori was besides isolated from their gastric mucosa. The dental and gastric strains isolated from the same patient showed the same proteic profile. The hypothesis of H. pylori crossing from mouth to stomach seems to be confirmed.

The authors report the data concerning 2295 women tested for toxoplasmosis immunodiagnosis, in the Department of Infectious and Tropical Diseases of "La Sapienza" University of Rome in the years 1993-1994. Four hundred eleven cases (17.9%) were positive for IgG only; 2 cases (0.1%) for IgM only; 15 cases (0.6%) for both IgG and IgM while 1867 cases (81.4%) were negative. 1668 women were pregnant. In this group 260 (15.6%) were positive for IgG only, 2 (0.1%) for IgM only, and 10 (10.6%) for both IgG and IgM; in one case there was a spontaneous absorption in the 10th week of pregnancy, in another case a still-birth in the 20th week with brain lesions; a child was born with phocomelia of the right arm and one with a clubfoot. While it is possible to explain the absorption and the still-birth with the toxoplasma infection, it is difficult to understand the causes of the abnormality of the limbs.

Percutaneous emptying of benign renal cysts represents the adopted treatment for this kind of pathology. The introduction of pure ethilic alcohol (95 degrees) is usually associated with emptying because it determines the necrosis of the secreting epithelious with recurrences and little significant complications. This treatment is the less bloody solution that can be executed in surgery and for this reason it is proposed in the time as an alternative to surgery treatment of removal.

Transcranial Doppler (TCD) can be useful in the diagnosis and validation of surgical treatment of vertebrobasilar insufficiency (VBI). A case is reported in which TCD confirmed the diagnosis of vertebrobasilar insufficiency and validated the indication of surgery by detecting a bidirectional flow in a stenotic and compressed vertebral artery. In the postoperative period and at late follow-up TCD demonstrated a restored antegrade flow, as a consequence of a well functioning revascularization. Surgical indication of VBI is rare and TCD can be proposed as part of routine patients' study before a surgical decision is taken.

A case of low molecular weight heparin induced thrombocytopenia is reported. Mechanisms and treatment of this condition are discussed.

The authors point out the possible relationship between the biochemical and immunological components of nasal mucus in subjects affected by allergic rhinitis and/or olfactory disorders. Fifty seven subjects (33 F, 24 M) aged between 19 and 73 years, (median age 65 SD 14.60) were studied. Twenty seven of them were normosmic affected by allergic rhinitis and taken as control group, (14 were positive to allergometric tests and/or RAST, while the other 13 were negative), 30 were dysosmic, and subdivided into parosmic (n = 6), anosmic (n = 15) and hyposmic (n = 9) (only one was negative both to allergometric tests and to RAST). In all patients we assessed: nasal mucus (it was analysed for: mucus quantity, pH, protein concentration, K+ concentration and the SIgA antibodies, tested both by radian immunodiffusion and by ELISA), allergometric tests, PRIST, RAST, anterior rhinomanometry, evoked olfactory potential. As regard to allergometric tests, we have no observed statistically significant differences between the control and the dysosmic group, although all the dysosmic patients (except one) were positive both to allergometric tests and to RAST. Total (PRIST) and specific (RAST) IgE values (except for the anosmic subjects who had IgE values moderately higher) were similar to the results obtained by allergometric tests. As regards to nasal secretion quantity, it was reduced (p: n.s.), like the pH (p: n.s.), in the parosmic subjects. On the other hand, proteins concentration of nasal secretion was lowered in hyposmic (p: n.s.) and anosmic (p = 0.05) subjects, while there were no differences between parosmic subjects and control group. The values of SIgA in controls and hyposmic subjects were not too different and similar to those observed by other authors; however they were slightly increased in controls affected by allergic rhinitis with positivity both to RAST and/or allergometric tests (p: n.s.), while they were reduced in the parosmic and significantly in the anosmic patients (p < 0.01). On the basis of that data, the authors conclude that, (though related to a limited case reports) being the secretory IgA values inversely proportional to the gravity of olfactory pathology, a their protective role (if the anatomic-functional substratum is efficient), in the pathologies examined, can be easily hypothesized. Besides, that data highlight that their concentration is slightly decreased in those patients affected by allergic rhinitis, without olfactory disorders (p: n.s.).