Are seizures associated with neuroschistosomiasis mansoni? An exploratory survey in an endemic area of Brazil.

BACKGROUND: Deposition of Schistosoma mansoni eggs in the brain of patients with hepatosplenic schistosomiasis (HS-SM) is frequent and usually asymptomatic. However, it is questioned whether it could cause seizures. Thus, we investigated the occurrence of seizures in these patients and also searched for parameters associated with this disorder. METHODS: In a cross-sectional survey, we compared 128 patients with HS-SM with 102 patients with portal hypertension due to compensated chronic hepatic disease of other etiologies. A standardized questionnaire, emphasizing epilepsy-related parameters, was applied to all participants. RESULTS: Eight (6.3%) patients with HS-SM had a history of seizures, whereas this condition was reported by three (2.9%) individuals from the comparison group (p=0.354). None of the variables were associated with the occurrence of seizures, either in univariate or in multivariate analysis. CONCLUSIONS: The frequency of seizures was similar in both study groups. However, it was higher than that described in population-based studies. Thus, we hypothesize that HS-SM individuals may have a higher frequency of seizure. The lack of difference between the two study groups may be explained by the inclusion of cases of HS-MS overlapping other chronic liver diseases in the comparison group, because this finding is relatively common in schistosome-endemic areas.

Macrozoobenthos in the Adriatic Sea ports: Soft-bottom communities with an overview of non-indigenous species.

The present paper is a contribution to the first initiative of the Port Baseline Survey (PBS) for Non-indigenous species (NIS) in the Mediterranean Sea. It presents a report on the soft-bottom macrobenthos from the five Adriatic ports: Bari, Ancona (Italy), Koper (Slovenia), Pula, Rijeka (Croatia), with a focus on the presence and contribution of NIS to native assemblages. Out of 451 species identified, only four were common to all ports. A total of eight NIS were recorded, five in surveyed ports and three in the lagoon connected to the Port of Koper. The highest number of NIS was recorded in Bari, and the highest abundance in Ancona and Bari. Generally, the number, abundance and contribution of NIS seems too low to cause a substantial impact on native communities in surveyed ports. The suitability of methods adopted for PBS for soft-bottom NIS was discussed and suggestion for methodological improvement is provided.

Non-indigenous macrozoobenthic species on hard substrata of selected harbours in the Adriatic Sea.

The intense shipping traffic characterising the Adriatic Sea favours the spread of marine organisms. Yet, a study of 12 Adriatic ports (4 on the western side and 8 on the eastern side of the basin) found that non-indigenous species (NIS) accounted for only 4% of the benthic communities settled on hard substrates. The cirripeds Amphibalanus amphitrite and Balanus trigonus, found in 8 harbours, were the most common invaders followed by Amphibalanus eburneus, the ascidian Styela plicata, and the bivalve Magallana gigas. The highest percentage of NIS was recorded in Venice and Ploce, the harbours with the least rich native communities; the lowest percentage was retrieved in Trieste, Koper, Pula, and Rijeka, the harbours hosting the highest species diversity. In contrast, the ports of Bari and Ancona showed both high NIS percentages and highly diversified communities.

Effect of the 5-HT3 receptor antagonist, ondansetron, on gastric size in dyspeptic patients with impaired gastric accommodation.

BACKGROUND: A reduction of gastric accommodation after a meal has been documented in patients with idiopathic dyspepsia. In these patients the administration of a 5-HT3 receptor antagonist may reduce some of the dyspeptic symptoms; it is not clear however, whether these drugs influence gastric adaptation to distension as well. AIM: To evaluate the effects of the 5-HT3 receptor antagonist, ondansetron, on gastric distension after a liquid meal in dyspeptic patients with reduced gastric accommodation. METHODS: Before and after a 500 ml water load, gastric accommodation (area of the proximal and distal stomach) was evaluated using real-time ultrasonography in 21 idiopathic dyspepsia patients and 26 healthy controls. In dyspeptic patients, the test was repeated twice: after the administration of placebo and after ondansetron 8 mg i.v. (in both cases, 15 min prior to the water load). Secondary outcomes were epigastric pain, fullness and nausea as assessed by a visual analogue scale at basal and after ondansetron. RESULTS: Fasting gastric size was similar in dyspeptic and controls. Compared with controls, dyspeptic patients showed a statistically significant smaller area of the proximal stomach (14.7+/-1.2 cm(2) vs. 18.6+/-1.4 cm(2), respectively; p=0.0247). In dyspeptic patients, gastric proximal and distal size did not change significantly following placebo, whereas after the administration of ondansetron the mean area of the proximal and distal stomach significantly increased (proximal stomach: 14.6+/-1.6 cm(2) placebo, 20.4+/-1.9 cm(2) ondansetron, p=0.0095; distal stomach: 8.9+/-0.9 placebo, 11.4+/-1.2cm(2) ondansetron, p=0.0409). Of the symptoms, only nausea was significantly reduced after ondansetron. CONCLUSION: In dyspeptic patients with impaired gastric accommodation, ondansetron reverts gastric accommodation to within the range of controls.

Peppermint oil (Mintoil) in the treatment of irritable bowel syndrome: a prospective double blind placebo-controlled randomized trial.

INTRODUCTION: The use of peppermint oil in treating the irritable bowel syndrome has been studied with variable results probably due to the presence of patients affected by small intestinal bacterial overgrowth, lactose intolerance or celiac disease that may have symptoms similar to irritable bowel syndrome. AIM: The aim of the study was to test the effectiveness of enteric-coated peppermint oil in patients with irritable bowel syndrome in whom small intestinal bacterial overgrowth, lactose intolerance and celiac disease were excluded. METHODS: Fifty-seven patients with irritable bowel syndrome according to the Rome II criteria, with normal lactose and lactulose breath tests and negative antibody screening for celiac disease, were treated with peppermint oil (two enteric-coated capsules twice per day or placebo) for 4 weeks in a double blind study. The symptoms were assessed before therapy (T(0)), after the first 4 weeks of therapy (T(4)) and 4 weeks after the end of therapy (T(8)). The symptoms evaluated were: abdominal bloating, abdominal pain or discomfort, diarrhoea, constipation, feeling of incomplete evacuation, pain at defecation, passage of gas or mucus and urgency at defecation. For each symptom intensity and frequency from 0 to 4 were scored. The total irritable bowel syndrome symptoms score was also calculated as the mean value of the sum of the average of the intensity and frequency scores of each symptom. RESULTS: At T(4), 75% of the patients in the peppermint oil group showed a >50% reduction of basal (T(0)) total irritable bowel syndrome symptoms score compared with 38% in the placebo group (P<0.009). With peppermint oil at T(4) and at T(8) compared with T(0) a statistically significant reduction of the total irritable bowel syndrome symptoms score was found (T(0): 2.19+/-0.13, T(4): 1.07+/-0.10*, T(8): 1.60+/-0.10*, *P<0.01 compared with T(0), mean+/-S.E.M.), while no change was found with the placebo. CONCLUSION: A 4 weeks treatment with peppermint oil improves abdominal symptoms in patients with irritable bowel syndrome.

Sexual reoffense trajectories with youths in the child welfare system.

The present study sought to determine whether the persistence of problematic sexualized behaviors (PSBs) committed by boys in the Massachusetts child welfare system would lend support to previous taxonomies categorizing offenders as early-onset/life course-persistent, adolescence-onset/adolescence-limited, or childhood-limited in their offending behavior. We examined the persistence of PSBs in a male sample (N=638; age range: two to 17), using a retrospective longitudinal archival design. Procedures involved a comprehensive archival review of records from the Department of Children and Families. Subsamples were established by trifurcating the sample based on age at the time of the boys' first documented PSB, resulting in age cohorts reflecting early childhood (age two to seven), middle childhood (age eight to 11), and preadolescence/adolescence (age 12-17). Results supported the hypothesis that youths who first exhibited PSBs in early childhood would produce higher sexual reoffense rates during each of three follow-up windows (i.e., three years, five years, and seven years) than youths who first exhibited such behaviors in middle childhood, or preadolescence/adolescence (p<0.01 for all group contrasts). Findings supported the distinctions of several taxonomies classifying youthful offenders in the juvenile justice system. Abuse reactivity, coping ability, and vulnerability to iatrogenic intervention effects are considered as some of many possible contributing factors.

Effect of an acute intraluminal administration of capsaicin on oesophageal motor pattern in GORD patients with ineffective oesophageal motility.

Ineffective oesophageal motility (IOM) is a functional disorder affecting about 50% of gastro-oesophageal reflux disease (GORD) patients. This disease in a severe form limits the clearing ability of the oesophagus and is considered one of the predictive factors for poorer GORD resolution. Capsaicin, the active compound of red pepper, exerts a prokinetic effect on oesophageal motility in healthy subjects by increasing the amplitude of body waves, even if no evidence exists on its possible role in situations of reduced motility. The aim of the study was to evaluate the effect of an acute administration of capsaicin on the oesophageal motor pattern in a group of GORD patients affected by severe IOM. Twelve GORD patients with severe IOM received an intra-oesophageal administration of 2 mL of a red pepper-olive oil mixture and 2 mL of olive oil alone serving as a control during a stationary manometry. The motor patterns of the oesophageal body and lower oesophageal sphincter (LOS) were analysed at baseline and after the infusion of the two stimuli. The administration of capsaicin induced a significant improvement in oesophageal body contractility when compared with baseline. The velocity of propagation of waves and the LOS basal tone remained unchanged. The motor pattern was unaltered by the administration of olive oil alone. An acute administration of capsaicin seems to improve the motor performance of the oesophageal body in patients with ineffective motility. Whether this could represent the basis for further therapeutic approaches of GORD patients needs further study.

Effects of Costa Concordia shipwreck on epiphytic assemblages and biotic features of Posidonia oceanica canopy.

This research provides first information about Posidonia oceanica canopy in the area affected by Costa Concordia wreck. Percentage cover of algal and animal taxa on the leaves was estimated and biotic features of the meadow were measured in the period just after the shipwreck until its removal from the impacted site. Changes in epiphytic assemblages and some biotic features were detected in the Disturbed site compared with Control ones, highlighting effects due to the wreck presence and activities related to its removal. A temporary decrease of encrusting macroalgae and an increase of erected macroalgae and foraminifers, as well as a temporary increase of tip erosion of the canopy were detected in the Disturbed site. The obtained results were discussed and hypotheses about possible synergic effects occurred near the wreck were commented.

The effects of nickel, calcium and magnesium on the acid phosphatase activity of two Alyssum species.

Root Surface acid phosphatase activity was assessed in seedlings of two species of Alyssum, one endemic to Tuscan serpentines (Alyssum bertolonii Desv.) and the other of wide occurrence (Alyssum saxatile L.), cultivated in solutions to which various concentrations of Ni2+ , Ca2+ and Mg2+ were added. Treatments were applied in two factorial experiments of type 2n . A concentration of 0.01 mM Ni2+ markedly stimulated phosphatase activity in A. bertolonii, but slightly decreased it in A. saxatile. Increased Ca2+ concentration stimulated enzyme activity in both species, hut in A. bertolonii the highest activity was obtained with low Ca2+ concentrations, whilst the opposite occured in A. saxatile. A. bertolonii instead required high Mg2+ concentrations to increase phosphatase activity significantly. The same concentrations were toxic to A. saxatile. In the serpentine species, favourable conditions for the increase of phosphatase activity were induced by a high Mg2+ /Ca2+ ratio, which also favoured dry mass production. Therefore it is possible that the increase of phosphatase activity might be an aspect of plant adaptation to serpentines.

Role of antimicrobial susceptibility testing on efficacy of triple therapy in Helicobacter pylori eradication.

BACKGROUND: Helicobacter pylori treatment failure may be due to resistance to macrolides and 5-nitroimidazoles. AIM: To test whether a preliminary in vitro susceptibility test of H. pylori to tinidazole and clarithromycin and a consequent specific regimen could improve the eradication rate. METHODS: A total of 109 consecutive H. pylori-positive patients with dyspeptic symptoms were included. At endoscopy, biopsy from the antrum was obtained for H. pylori culture and antimicrobial susceptibility testing. Fifty-six patients were treated with omeprazole, tinidazole and clarithromycin for 10 days (group OTC) and 53 patients received therapy on the basis of the susceptibility test (group SUSC). Treatment success was evaluated by the 13C-urea breath test 1 month after the end of therapy. RESULTS: Eight patients dropped out. Overall primary resistance to clarithromycin, tinidazole and both antibiotics was 13%, 33% and 4%, respectively. In group OTC, H. pylori was eradicated in 81% and 75% of patients by per protocol and intention-to-treat analysis, respectively. Per protocol and intention-to-treat eradication rates for group SUSC were 98% and 91% (P < 0.05 vs. group OTC). CONCLUSIONS: These data show that in H. pylori infection, antibiotic therapy based on the results of culture and susceptibility testing gives, in comparison to standard therapy, a significant improvement in eradication rate.

Evidence for an oral-faecal transmission of Helicobacter pylori infection in an experimental murine model.

An experimental murine model was used to evaluate the possible animal-to-animal transmission of Helicobacter pylori and the mechanism involved. Twenty-four Balb/C mice were infected with H. pylori type I strain culture and kept with 24 noninoculated mice to evaluate the possible transmission of the microorganism. Twelve inoculated mice were housed with 12 noninoculated mice in a grated cage (supporting an oral-oral transmission); the remaining inoculated and noninoculated mice were housed in another cage without grating on the floor (supporting a faecal-oral transmission). The bacterial colonization was assessed by culture and immunohistochemistry. The systemic antibody response to H. pylori and the histopathological changes were evaluated; controls were examined at 2, 4, 8, 12 weeks after the start of the experiment. Faecal samples were also collected from each mouse on the day before sacrifice, to assess the presence of H. pylori by culture and by immunohistochemistry. In the gastric mucosa of inoculated mice, histopathological changes were recorded at each control time and H. pylori was detected both by immunohistochemistry and by a systemic antibody response; the microorganism was also cultured at 2, 4, 8 weeks postinoculation. H. pylori was detected in noninoculated mice, housed in the cage without grating, using an immunoperoxidase technique at 2, 4, 8 weeks after starting the experiment, and these positive values were supported by histopathological changes, and, in one case, at 8 weeks, also by the serum immune response. No colonies of H. pylori were detected by culturing faecal samples from either noninoculated or inoculated mice. The results obtained in this study seem to support an oral-faecal route as the mode of transmission of H. pylori infection in this animal model.

Migrating motor complex recorded spontaneously and induced by motilin and erythromycin in an ex vivo rabbit intestinal preparation.

We investigated basal motility and the motor effects of motilin, erythromycin, and prostigmine on segments of rabbit gastrointestinal tract removed from extrinsic neural and vascular pathway and immersed in an oxygenated organ bath. Motility was recorded by means of four strain gauges sutured on the serosal surface of the segment. During basal recording, clusters of duodenal contractions that propagated distally, resembling phase III activity of migrating motor complex, were seen. Motilin (10(-6) M) and erythromycin (10(-6) M) induced a propagated cluster of contractions similar to the phase III recorded during the basal period. Prostigmine (10(-6) M) induced a simultaneous increase in gastric and small intestinal motility. Atropine (10(-5) M) prevented the motor effect of motilin, erythromycin, and prostigmine. Thus, MMCs do not appear to require central input for initiation and propagation. Motilin and erythromycin stimulate MMCs through an enteric cholinergic mechanism; therefore, the previously reported smooth muscle receptors for both substances were not apparent in the ex vivo preparation.

Enhanced clearing of Helicobacter pylori after omeprazole plus roxithromycin treatment.

The in vitro antibacterial activity of omeprazole against eight strains of Helicobacter pylori was evaluated. Minimum inhibitory concentration (MIC) values were 32 micrograms/ml and 64 micrograms/ml (MIC50 and MIC90 respectively). We performed a randomized single blind study comparing the efficacy of omeprazole alone (for 4 weeks) or combined with roxithromycin (for 2 weeks) in the treatment of duodenal ulcer and chronic active gastritis associated with H. pylori infection, H. pylori was eradicated in 75% of patients treated with omeprazole alone whereas the patients treated with the combination of these drugs were completely free from H. pylori at the end of the therapy.

Effect of the 5-HT1 agonist sumatriptan on oesophageal motor pattern in patients with ineffective oesophageal motility.

The 5-HT1 agonist sumatriptan (SUM) elicits an increase in amplitude of oesophageal motor waves and of lower oesophageal sphincter (LOS) tone in healthy subjects. The aim of the study was to evaluate whether such an effect occurs also in patients with ineffective oesophageal motility (IOM). 16 patients (nine males and seven females, age range 34-55 years) with chest pain and mild to moderate dysphagia were studied; all had undergone previous cardiologic, radiologic and upper gastrointestinal endoscopic exams that were normal. An oesophageal manometry was performed using an electronic probe to record swallows, oesophageal, LOS and gastric motility. The patients whose motor pattern were compatible with IOM (>30% of motor waves with amplitude <30 mmHg and/or non-transmitted) received SUM or placebo 6 mg s.c., injected in the morning and in the afternoon in a random order. The data analysis was limited to 1 h before and 1 h after the drug injections. Ten out of the 16 patients showed an IOM motor pattern. The administration of SUM caused a significant increase in the number of swallows (SUM 99.5 +/- 15.4 vs 78.6 +/- 16.1 basal, P = 0.03) and of primary oesophageal motor waves (SUM 89.6 +/- 13.4 vs 67.2 +/- 12.9 basal, P = 0.04) with no significant changes in the percentage of swallows associated with propagation. Placebo was not associated with increase in the number of swallows (80.3 +/- 14.6, P = 0.9) or of primary oesophageal motor waves (70.1 +/- 12.3, P = 0.7). The amplitude and the percentage of propagated oesophageal motor waves as well as the mean basal LOS tone were unaltered by SUM. There was no change in the symptoms reported after SUM. Although effective in healthy subjects, SUM 6 mg s.c. improves only the numbers but not the amplitude or propagation of oesophageal motility of patients with IOM. The 5-HT1 pathway and its acute stimulation seem to play only a minor role in the pathogenesis of such a disease.

Effect of nitric oxide on propagated clusters of spontaneous motor waves in an ex vivo rabbit intestinal preparation.

The aim of this study was to determine whether nitric oxide can play a role in regulating the propagation of spontaneous motor activity in a rabbit intestinal preparation completely excluded from any central and vascular connection. Experiments were done on nine rabbits of either sex, weighing 2.5 +/- 0.5 kg (mean +/- SD). After one week of semiliquid diet the animals were sacrificed and a segment including the stomach, duodenum and part of the jejunum was removed and placed into a single chamber organ bath containing 1 L of oxygenated Krebs' solution. Four strain gauges connected to a Dynograph Recorder were sutured on the serosal surface 10 cm apart starting from the gastric antrum to the distal duodenum. Once the motor activity was stabilized, N-nitro-L-arginine methyl-ester (L-NAME) was added to the bath at increasing concentration from 10(-7) to 10(-4) M. Spontaneous motor activity was recorded, characterized by the cycling occurrence of bursts of waves, starting from the stomach and propagating to the descending duodenum. L-NAME at higher concentrations reduced the time interval between the bursts of waves with a concomitant increase in the propagation velocity of the motor activity. No change in the frequency of waves was detected. The effect of L-NAME was prevented by the administration of L-Arginine. This study suggests an important role for the nitric oxide pathway in the distal propagation of the spontaneous motor activity of the alimentary tract.

Transient lower oesophageal sphincter relaxations play an insignificant role in gastro-oesophageal reflux to the proximal oesophagus.

Gastro-oesophageal reflux to the proximal oesophagus may cause atypical symptoms of gastro-oesophageal reflux disease (GORD). The motor abnormalities underlying reflux into the proximal oesophagus are still unclear. The aim of this study was to analyse the oesophageal motility during reflux into the proximal oesophagus in a group of healthy subjects and in patients with atypical symptoms of GORD. We concentrated particularly on lower oesophageal sphincter (LOS) activity and transient lower oesophageal sphincter relaxations (TLOSRs). Ten patients (7M, 3F, age 25-51 years) with mild oesophagitis (Savary-Miller grade I-II) and 10 healthy subjects (6M, 4F, age 23-54 years) underwent a 24-h dual pH-metric and manometric recording, using an electronic portable device. This recorded distal and proximal oesophageal pH values, oesophageal body and LOS motility. GORD patients had more distal and proximal reflux (DR and PR) compared with healthy controls (DR P < 0.001; PR P < 0.05). TLOSRs were the most frequent event during reflux into the distal oesophagus, whereas TLOSR frequency was much lower during reflux to the proximal oesophagus in GORD patients and in healthy controls (P < 0.05 and P < 0.01 vs. distal reflux, respectively). A significant relationship between TLOSRs and distal refluxes was present but no relationship with proximal reflux was detected. We conclude that TLOSRs are much less frequent during reflux to the proximal oesophagus than distal oesophageal reflux in patients with mild GORD suffering from atypical manifestations. The mechanism of acid reflux to the proximal oesophagus is unclear.

Swallows, oesophageal and gastric motility in normal subjects and in patients with gastro-oesophageal reflux disease: a 24-h pH-manometric study.

BACKGROUND: the motor aspects underlying gastro-oesophageal reflux disease (GORD) are still not completely clear. AIM: to evaluate the relationship between oesophageal and gastric motility in GORD patients. PATIENTS: twelve patients with grade I-II oesophagitis, mean age 45 yr, and 10 healthy subjects, mean age 42 yr, were studied. METHODS: a pH-manometry was performed to analyse oesophageal and gastric motility, swallows and oesophageal pH values for the whole 24-h period, and for the 2-min period before and after each reflux episode. RESULTS: as compared to controls, GORD patients showed in the 24-h period, a greater number of swallows (P < 0.01) and a lower percentage of post deglutitive propagated oesophageal body waves (P < 0.05). The number of migrating motor complexes (MMC) was similar in the two groups, with a lower amplitude of phase III gastric waves in GORD. During MMC reflux episodes were seen only in GORD patients. After refluxes an increase in swallows, simultaneous and secondary oesophageal waves were detected in GORD patients, with a reduction of primary peristalsis. Isolated gastric contractions preceded reflux episodes more frequently in GORD patients than in controls. CONCLUSIONS: GORD patients showed an increase in swallows with altered post-deglutitive oesophageal motility and a reduced amplitude of gastric MMC. Moreover small contractions of gastric antrum are present before acid refluxes, suggesting a multifactorial pathogenesis of the disease.

Characterization, via ESR spectroscopy, of radical intermediates in the photooxidation of arylcarbinols by ceric ammonium nitrate

The photooxidation by ceric ammonium nitrate (CAN) of several aryl and naphthylcarbinols has been studied by means of ESR spectroscopy. For all the investigated arylcarbinols, but not for the naphthyl derivatives, it has been possible to detect radical intermediates deriving from the parent alkoxyl radicals. In particular, in the photooxidation of 1,1-diphenylethanol, a bridged-radical intermediate has been detected. The assignment has been validated through experiments with two different labeled compounds: the 1,1-[2', 3', 4', 5', 6', 2", 3", 4", 5", 6"-2H10]diphenylethanol and the 1,1-diphenyl[2, 2, 2-2H3]ethanol. A similar bridged radical has been found to be formed in the photooxidation of triphenylmethanol, while, for the 1,1-diphenylpropanol, the only detectable species has been the ethyl radical deriving from a competitive beta-scission process. Finally, for the 2-phenylpropan-2-ol (cumyl alcohol), two radical species have been identified: the methyl, deriving from the beta-scission process, and the cyanomethylene, deriving from H-abstraction of the cumyloxyl radical from the solvent. A kinetic study on the competition of the two processes has also been conducted and the parameters of the Arrhenius equation for the latter process have been estimated.