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

Background: The diurnal rhythm in the circulating serum levels of erythropoietin (EPO) was investigated in healthy subjects.

Methods: Venous blood samples were drawn during the span of a whole day every four hours, starting from midnight, for the determination of serum Epo levels by RIA in 40 clinically healthy normocytemic subjects, 27 males and 13 females, aged 30-75 years. Statistical analysis was carried out by means of the "cosinor" method.

Results: Serum EPO presents a significant (p < 0.05) circadian rhythm with higher levels in the afternoon and lower levels in the nightime.

Conclusions: These data confirm the presence of a circadian rhythm in serum EPO levels. The mechanisms behind the circadian rhythmicity are still unknown. For clinical evaluation of the serum EPO values, the time of day for collection of blood samples has to be taken into consideration.

The serum concentrations of circulating ICAM-1 (cICAM-1) and soluble receptors for interleukin-2 (sIL-2R) were evaluated on 48 patients with B-cell chronic lymphocytic leukaemia (B-CLL) and on 15 healthy control subjects. The mean +/- SD concentration of cICAM-1 was significantly higher (p < 0.002) in B-CLL patients (407.7 +/- 164.3 ng/ml) than in healthy controls (245.4 +/- 76.7 ng/ml). Patients with progressive disease had higher cICAM-1 levels than patients with "indolent" disease (440.38 +/- 32.3 ng/ml versus 321.36 +/- 14.45 ng/ml; p < 0.0001). Serum levels of cICAM-1 were also significantly higher (p < 0.0002) in patients with advanced stage (III-IV) than in those with early stage (I-II). The increase of cICAM-1 levels was positively correlated to increases of soluble receptors for interleukin-2 (r = 0.9; p < 0.0001). These results seem to show that the measurement of serum levels of cICAM-1 may be an useful tool for monitoring disease activity and tumoral mass in patients with B-CLL. However, further studies are needed to define the functional role of high cICAM-1 levels in the immunological dysregulation of patients with malignancy.

Background: Abnormalities in proteinase metabolisms have been found in psoriasis and higher concentrations of neutral proteinases in psoriatic skin lesions than in unaffected skin of psoriatic patients have been observed.

Aim: The aim of the study was to determine whether repeated whole body UV-(UVB and PUVA) irradiation is associated with changes in proteinase inhibitor alpha 2-macroglobulin (alpha 2-M) in patients with active plaque psoriasis.

Patients and methods: In this study, the sera alpha 2-M levels were evaluated in cases of active plaque psoriasis before UV-, four weeks UVB (15 patients) and PUVA (11 patients) irradiation, and two weeks after completed treatment.

Results: Both UVB and PUVA treatment had no significant influence on alpha 2-M levels in psoriatic sera, it was, however, sufficient to treat most of the skin lesions.

Discussion: The beneficial effect of phototherapy in psoriasis seems not to be mediated through increased binding of proteinases by proteinases inhibitor alpha 2-M from serum.

To investigate the prevalence of asymptomatic hypothyroidism and hyperthyroidism in hospitalized people, we performed thyroid function tests on a group of 2545 elderly patients consecutively observed in a General Hospital in Rome, during a six year period. The rate of asymptomatic hypothyroidism was as high as 0.71% in female patients and only 0.20% in male patients. In asymptomatic hyperthyroid subjects the prevalence rate was 0.58% in females and 0.20% in males. On the whole, prevalence rate of asymptomatic thyropathies resulted 0.94%, showing a clear difference in sex (women 1.29% and men 0.40%). The asymptomatic thyropathies screening of hospitalized elderly women may result in a very low cost diagnosis of many new cases of hypothyroidism and hyperthyroidism.

In epidemiology of osteoporosis, obesity is to be considered one of its protecting factors. However there are in the literature discordant opinions: some authors describe a protective effect of obesity on the trabecular bone, others on the cortical one, others no effects at all and others finally a positive influence on both the trabecular and the cortical bone. However, only few studies on obesity's impact on bone metabolism are available. Bone mineral density at forearm and serum osteocalcin levels, a specific and sensitive marker of bone turn-over, in a group of postmenopausal obese women with those of a nonobese control group were compared. Obese women showed higher densitometric measurements than nonobese, but only the values of the third distal site of forearm resulted higher in a significant way. Serum osteocalcin values were similar between the two groups but the obese women showed a greater dispersion of the values (8.15 +/- 4.96 ng/ml) compared to nonobese (8.35 +/- 1.63 ng/ml). This high variability suggests an heterogeneity of bone turn-over in obese subjects and could explain the discordant results of the literature.

Variations of the origin of the medullary artery. The purpose of this study was to define the origin of the medullary artery through medullary angiography in order to prevent paraplegia during surgery of the thoraco-abdominal aorta. Twenty-eight patients, candidate to thoracoabdominal aorta operations, have been studied for the study of the origin of the medullary artery and its eventual reimplantation during surgery. The artery has been localized in 24 of the 28 patients. In 22 cases (78.6%) it originated from an intercostal artery between D8 and D12, while in 6 cases (21.4%) it originated from a lumbar artery between L1 and L2. In 23 (82.1%) cases it originated from the left side, while only in 5 (17.9) from the right side. Although medullary artery originates more frequently at the thoracic level, particularly from the left D9 and D10, its variability is important, and its localization before thoraco-abdominal aortic surgery is often desirable.

Purpose: To evaluate patterns and evolution of treatment of infectious arterial aneurysms in a 15 year period.

Material and method: Eight patients bearing 8 arterial aneurysms: 4 aorto-iliac, 1 of the internal carotid, 1 of the posterior tibial, 1 of the cubital, 1 of the internal carotid artery. For the aorto-iliac aneurysms treatment consisted in resection extra-anatomic by-pass in 2, "in situ" prosthetic grafting in the other 2. Extra-abdominal aneurysms were treated by excision/"in situ" vein grafting in two cases and simple resection in other two cases.

Results: One post-operative death occurred, due to rupture of a ligated aortic stump. No death or major complication occurred after "in situ" treatment of aorto-iliac aneurysms and, overall, in extra-aortic aneurysms.

Conclusions: Staphylococcus and miceti have become the most frequently encountered causative agents. "In situ" grafting together with aggressive antibiotic therapy became the preferred method in the recent years and yielded good results.

In this study the authors report the case of HIV patients with visceral leishmaniasis. He presented a pancreatitis with evident clinical signs and high increase of amilasis (9876 U/L) the twelfth day of treatment with meglumine antimoniate. The interruption of therapy was followed by a rapid disappearance of signs and symptoms and a normalization of amilasis. In accordance with the most recent studies, it is expedient, for every patients treated with antimonial drugs, to undergo an accurate amilasis monitoring.

Twenty eight patients (15 F, 13 M mean age 37.7 SD +/- 9.93 range 22-55) affected by Helicobacter Pylori infection associated gastritis were studied. HSP 70 Antibodies were found in 21.4% of patients and their mean values were significantly higher in the patients than in the subjects affected by gastritis HP negative used as controls (p = 0.05). This datum was confirmed by Western blotting. The presence of HSP 70 antibodies in the sera of those patients may support the link between the protein and the development and persistence of chronic inflammation in the gastric mucosa.

The aim of this study was evaluate the usefulness of intravescical administration of Bacillus of Calmette Guerin (BCG) in patients with superficial bladder cancer. The BCG, an immunostimulating agent, has been introduced in routine clinical use; according to the international literature, it is reported to offer better result than the above-mentioned drugs. A retrospective analysis was made of 210 patients who had undergone a complete TUR for superficial bladder tumor. The irritative symptoms and systemic effects are acceptables considering the benefit of the BCG. The results are of great interest and encourage us to continue this study to confirm therapeutic strength.