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

Effects of acute or subchronic administration of human placental extract (HPE), a worldwide clinically used agent, on hepatic drug metabolizing enzyme activities were evaluated in rats. Hepatic microsomal cytochrome P-450 (Cyt. P450) and cytochrome b5 (Cyt. b5) contents and cytosolic glutathione S-transferase (GST) activities were maximally induced after various periods of time following a single intraperitoneal injection of HPE (4 ml/kg) whereas microsomal UDP-glucuronyltransferase (UDPGT) activities were inhibited significantly. All these altered effects were returned almost to the basal levels after 96 h of treatment. Subchronic treatment (30 days) with HPE (1,2 or 4 ml/kg) afforded a significant induction of Cyt. P-450 and Cyt. b5 levels and that of GST activities with a concurrent suppression of the activities of UDPGT and these results were found to be dose-dependent. However, microsomal NADPH cytochrome c reductase activity was not affected either by acute or subchronic treatment. The observed variations in the levels and activities of above house-keeping enzymes were discussed in relation to the possible carcinogenic risk of long-term treatment with this pharmaceutical agent.

The AA have conducted a controlled trial to determine the efficacy of two verbal techniques for muscular relaxation on 53 patients with fibromyalgia. The subjects were assigned at random to a autogenous training group (27 patients) or a analogic Erickson's techniques group (26 patients). The autogenous training showed the presence of various limits: (1) application limits (in which notable difficulties had to be faced to train the patients with fibromyalgia to practice the Autogenous training due to the revelation of "intrusive thoughts" or "abreactions", or because of the incapacity of the patients to practice the exercises at home without hearing the instructions of a therapist); (2) limits of efficacy (the state of optimum training needed many therapeutic sittings in order to be achieved and the improvements regarded nighttime sleep and morning rigidity, however, these improvements were less than those obtained with the analogic Erickson's techniques). The Erickson's techniques have showed, instead, many advantages: numerous patients continued the treatment until it was finished; only a small number of therapeutic sittings were necessary. There was an improvement of all the parameters examined, superior compared to the results obtained in the group of patients treated with autogenous training.

Respiratory allergy and bronchial asthma in particular can be serious afflictions in younger as well as in older children. Therefore interest has been focused on methods for the prevention of atopy. The role and allergenic importance of Dermatophagoides pteronyssinus (Dpt) in house and other environments have been identified. This mite provokes asthma in children at an earlier age than pollens. However the most under-valued area of asthma prevention is environmental control. The steps may seem difficult at first, but the results will be well worth the efforts and the sacrifices. We report on the high effectiveness of the guanine detection test (Acarex) based on the colorimetric quantification of allergen sources in house dust (mattresses, pillows, upholstered furniture, carpets, moquettes, etc), which can be treated with house dust mite extermination products such as benzyl benzoate. The eradication measures will allow the parents to reduce the allergen exposure, to be monitored at 3-6 month intervals. The guanine detection test performed in our Division on house dust samples assembled by the patents of children with house dust mite induced asthma (study group) or pollen asthma (control group) yielded highly significant statistical differences.

Approximately 5% of all lymphomas are located in the gastrointestinal tract. These lesions may be secondary manifestations of systemic lymphomatous disease, but there are also primary lesions that are not associated with superficial lymph node enlargement mediastinal adenopathy, liver and spleen involvement or hematologic alterations. Primary lymphomas may arise in the stomach or intestine. Small intestinal lesions may or may not be preceded by other types of intestinal pathology, such as celiac or inflammatory disease. The former cases are characterized by persistent diarrhea, malabsorption and weight loss. Abdominal pain and later nausea and/or vomiting are the most common presenting symptoms of lesions that arise in an already diseased bowel, palpable abdominal masses are present in approximately one third of these cases. Gastric lymphomas often presents with non-specific symptoms: cramp-like epigastric pain, anorexia and weight loss.

The clinical consequences of intestinal malabsorption are extremely variable and a dissociation between malabsorption, malabsorption syndrome and enteropathy is often noted. Enteropathy does not always results in malabsorption and in an alteration of the tests exploring the absorptive function. The following have particular relevance in clinical practice: coeliac disease, malabsorption induced by microbiologic agent (including Whipple's disease), post-surgical malabsorption and selective carbohydrate malabsorption. In particular, coeliac disease has been analyzed in its various aspects, from studies with organ cultures to immunological hypotheses, from the classical variety to subclinical forms and to serious complications, such as enteropathy-associated T cell lymphoma. Malabsorption syndromes are dramatically underdiagnosed: in the typical case of coeliac disease, enteropathy represents a clinical iceberg, and the discovery of the submerged portion, represented by the polymorphous subclinical varieties, has just started. As far as intestinal malabsorption is concerned, the main clinical problem regards diagnosis.

Primary gastric lymphoma is the most frequent non-Hodgkin's lymphoma (NHL) of extranodal origin (25%). It accounts for 5% of all NHL and 4% of primary gastric malignancies. Recent studies suggest its origin from B-cell immune system. The majority of these tumors are high-grade centroblastic and immunoblastic subtype. The extent of disease is by far the most important guide to prognosis. Patients with gastric lymphoma usually recur in the gastrointestinal tract, but one-half of those recurring in abdomen also have tumor spread to extra-abdominal sites. Gastrectomy as a single treatment modality cures about one-third of patients with gastric lymphoma. The role of adjuvant therapy both in terms of radiotherapy and chemotherapy is not sufficiently known. In advanced stage when chemotherapy is indicated, CHOP combination seems to be appropriate in favorable prognostic situation, whereas aggressive third-generation combinations should be used for unfavorable cases.

Ultrasonography (US) plays an important role in the diagnosis, staging and follow-up of gastrointestinal lymphomas particularly when associated with complementary techniques such as echo-guided biopsy and endoscopic ultrasonography. Besides the well-known ultrasonographic "pseudo-kidney" image as sign of gastrointestinal pathology, the "spoke wheel" image is suggestive of gastroenteric lymphoma. This lesion is due to the lymphomatous infiltration of intestinal wall that looks ipoechoic compared to the iperechoic lumen. An early abdominal US study performed after clinical suspicion, should allow a presumptive identification of the enteric tract involved on the basis of the relationship between the "pseudokidney" image and the other abdominal organs. US study of the abdomen may be useful also to demonstrate enlarged retroperitoneal or visceral lymph nodes both in primary gastroenteric or systemic lymphomas. Fine needle biopsy (FNB) of deep lymph nodes is mandatory when superficial enlarged lymph nodes are not found showing a specificity and sensitivity of 100% and 66% respectively. The typical image of gastric wall on endoscopic US is constituted of five layers; the second one represents the lamina propria with the lymphatic tissue. The thickness increase of this layer suggest the diagnosis of gastric lymphoma. Therefore the endoscopic US examination is particularly important when the endoscopic features and the endoscopic biopsies are negative. Finally endoscopic US may be used to guide FNB of gastrointestinal tract lesions.

The alterations of the normal biological oxidoreductive balance can be due both to an increase of the plasmatic concentration of the free radical and the loss of the protective mechanisms. These conditions lead to the damages of cellular structure by the mechanism of lipoperoxidation. We have studied the lipoperoxidative effects of anesthetic drugs and the possible protective effect of the taurine. Two groups of 30 patients subjected to general anesthesia for a time of about 160 minutes, have been studied. The taurine has been administered in the second group, intravenously, before and during anesthesia. Blood samples were drawed in all patients in order to determinate plasmatic Malondialdehyde (MDA) and Glutathione peroxidase activities both in erythrocyte lysate and plasma. Our results revealed an increase of values of MDA and Glutathione peroxidase activities in the first group (without taurine). We think that this increase has been caused by the anesthetic drugs administration and that a protective cellular effect is developed by the taurine administration.

Non-Hodgkin lymphomas affecting extranodal tissues can be primitive or secondary. The area most frequently involved is the gastrointestinal tract. MALT-type lymphomas are B-cell lymphomas characterized by small cells originating from the lymphoid tissue of the mucosa. The criteria for a correct diagnosis of extranodal lymphomas are morphological, but include immunophenotypic and immunogenotypic analysis. Gastrointestinal lymphomas consist of B-cell and T-cell lymphomas. B cell-lymphomas include: small cell B-lymphomas, large cell B-lymphomas, immunoproliferative small intestinal disease; multiple lymphomatous polyposis, follicular lymphomas, B-cell lymphomas centrocytic type. T-cell lymphomas include enteropathy-associated and non enteropathy-associated lymphomas.