Screening for Neglected Tropical Diseases and other infections in African refugees and asylum seekers in Rome and Lazio region, Italy.

BACKGROUND: Few reliable data are available on Neglected Tropical Diseases (NTDs) and other infections among African refugees and asylum seekers in Italy. We aimed to estimate the prevalence of NTDs and other infections in a large cohort of African refugees and asylum seekers living in reception centers in Lazio, Italy. MATERIAL AND METHODS: This is an observational, prospective prevalence study on infectious diseases in a large population of African refugees and asylum seekers (936 overall) consecutively enrolled for screening purpose at the Infectious and Tropical diseases outpatient clinic of the National Institute of Migrant and Poverty (INMP), Rome from August 2019 to December 2020. RESULTS: We found a prevalence of 8.8 % and 31 % for Strongyloides and schistosoma infection, respectively, while the prevalence of human immunodeficiency virus (HIV) infection was 0.7 %, HCV antibodies 2.5%, hepatitis B virus surface antigen 10.8 % and syphilis serological tests 2.9 %. CONCLUSION: Strongyloidiasis and schistosomiasis are highly prevalent among African refugees and asylum seekers in Italy, in contrast to communicable diseases (with the exception of hepatitis B). Raising awareness of NTDs among health professionals and implementing guidelines seems to be of paramount importance to prevent these diseases and their sufferers from becoming even more "neglected".

[Probable role of obesity on the adrenal response to acute stimulation with adrenocorticotrophic hormone in eumenorrheic and hirsute, non-eumenorrheic women]. / Ruolo eventuale dell'obesità nella risposta surrenalica allo stimolo acuto con ormone adrenocorticotropo in donne eumenorroiche e in irsute non eumenorroiche.

Obesity, the most frequent nutritional problem throughout the rich nations, can have a vast and significant influence on different aspects of endocrinology, in particular on ovulation disfunction, on hyperandrogenemia, on hormone-sensitive carcinomas. Our study proposes to value the response to adrenal cortex to stimulation with adrenocorticotropin (ACTH) hormone in obese patients, with particular attention to the behavior of adrenocortical androgens and their precursor. We recruited 30 female patients so divided: 12 obese, nonhirsute, eumenorrheic patients (group A); 10 normal weight, hirsute patients in situation of secondary amenorrhea (group B); 8 normal weight, nonhirsute, eumenorrheic patients (group C). Cortisol, progesterone, 17 OH progesterone, dehydroepiandrosterone sulfate, androstenedione, testosterone were measured at 60, 120, 180, 240, 300 min during continual infusion i.v., for 5 h, of ACTH 1-17 at 100 mcg dose, in physiological sodium chloride solution. All the women with monthly menstruation were studied between the IV and VIII day of their cycle. In the patients with secondary amenorrhea the value of basic progesterone was used to completely exclude an eventual luteal phase and the relationship LH/FSH was so as to logically exclude a diagnosis of polycystic ovary. This exclusion was also confirmed from the report of the ultrasonography. The basic concentration of hormone dosage is not significantly different between the patients of the three groups, except for T. This hormone is different because it is found to be significantly (p < 0.01) increase in the hirsute patients, in respect of the patients in group A and group C. Also P and 17OHP have been found to be higher, if only in insignificant measure, in hirsute patients.(ABSTRACT TRUNCATED AT 250 WORDS)

[Effect of 5-hydroxytryptophan on the secretion of PRL, GH, TSH and cortisol in obesity]. / Effetto del 5-idrossitriptofano sulla secrezione di PRL, GH, TSH e cortisolo nell'obesità.

The role of the neurotransmitter serotonin (SER) in regulating the hypothalamic-pituitary function is not completely clarified, although considerable evidence suggests a dominant stimulatory control of ACTH and PRL and a dominant inhibition of TSH, with more variable effects on GH secretion. Furthermore, SER has been implicated in the regulation of appetite, given the anorectic activity of SERergic drugs in animals and humans and experimental evidence suggesting that animal obesity can be a function of SER depletion. In order to study the hypothesized impairment of the SERergic system in human obesity, PRL, GH, TSH and cortisol levels before and after oral administration of the SER precursor 5-hydroxytryptophan (OH-TRY) (500 mg), were determined in 10 obese (BMI 41.5 +/- 1.68 kg/m2) but otherwise healthy women (mean age 50.9 +/- 1.43 yr) and in control group of 7 normal-weight (BMI 20.9 +/- 0.66 kg/m2) women (mean age 49.8 +/- 1.18 yf) after oral administration of the SER precursor 5-hydroxytryptophan (OH-TRY) (500 mg). The results were matched against placebo. In contrast with placebo, OH-TRY administration provoked a PRL and cortisol increase in all the subjects: PRL levels increased in controls at 120 min (p < 0.05) and at 180 min (p < 0.01) and in obese women at 120 and 180 min (p < 0.01); cortisol levels increased in both groups at 90, 120, 180 min (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

[Evaluation of central dopaminergic tone in diabetes mellitus]. / Valutazione del tono dopaminergico centrale nel diabete mellito.

The role of dopaminergic ways in human copulatory activity and the high frequency of impotence in diabetes mellitus are well known. In order to study the involvement of the central dopaminergic tone in diabetic impotence we have evaluated the PRL and TSH response to metoclopramide (MCP 10 mg ev) in 28 diabetic male patients (15 ID including 6 impotent and 13 NID including 5 impotent ) compared with 9 healthy controls. All subjects were investigated for the presence of neuropathy, retinopathy, macroangiopathy, gonadal and thyroid diseases. The PRL response to MCP was greater (p less than 0.05) in impotent patients than in controls at 60' and 90' in ID, and at 30' and 120' in NID. There was no significant difference in TSH increase and in PRL and TSH response areas between the groups considered. In conclusion, the dopaminergic tone is substantially normal in diabetic patients, while some PRL hyperresponsiveness to MCP exists in impotent diabetics.

[Transverse study of obesity: distribution of adipose tissue and correlated pathology]. / Studio trasversale di obesità: distribuzione del tessuto adiposo e patologie correlate.

The relationship between obesity and prevalence of dyslipidemia is well known. Recent studies affirm that differences in fat distribution can be predictive for differences in the prevalence of metabolic disturbances and cardiovascular disease independently of the BMI, presently the most common index of obesity. In order to verify whether body fat distribution can be associated with a higher risk of atherosclerosis, we have evaluated in a group of obese women the eventual presence of endocrine and metabolic diseases. Assessing regional fat distribution, the waist/hip ratio has been shown to be more closely correlated with these diseases than BMI. We have studied two groups of 10 women, comparable for age and BMI: group A aged 45.8 +/- 6.9 years with a BMI of 35.6 +/- 2.8 kg/m2; group B aged 48.3 +/- 3.6 years with a BMI of 38.5 +/- 2.8 kg/m2. The women were divided according to the waist-hip ratio, which was calculated by measuring the circumference of the waist, namely the smallest circumference between the xiphoid and the umbilicus, and the circumference of the hips at the point of the maximum protuberance of the buttocks. The cut-off value for the waist/hip ratio was considered as 0.80 for the reason that this variable is the most accurate cut-off value for abdominal obesity: for group A 0.76 +/- 0.02; for group B 0.89 +/- 0.02 (p < 0.01). All the women were healthy. None of them was in therapy with any kind of drugs, nor was there any restriction to diet. Nobody was a smoker, neither did anyone drink alcoholic beverages.(ABSTRACT TRUNCATED AT 250 WORDS)

[The prehypophyseal-gonadal system in the normal male and in some forms of testicular dyscrinism. Evaluation studies in basic conditions and after stimulation]. / Il sistema preipofiso-gonadico nel maschio normale e in alcune forme di discrinia testicolare. Studio della valutazione di base e dopo stimolo.

The secretion values of the two seric gonadotropins and of plasmatic testosterone have been estimated in a casuistry of normal males subdivided in groups of 8 to 95 years of age, and of primitive and secondary testicular dyschrinia. In one part of this casuistry, normal and primitive hypogonadics, we have estimated the response to the intravenous administration of Gn-RH. Among the results which have been obtained, it appears that physiologic hypogonadism of the elderly is a primary phenomenum, not hypophyso-dependent. In the hypophysiary stimulus test, the response of gonadotropins in those old men moves away from the response of hypogonadics considered, by a behaviour much more similar to that of normal adults, even if delayed and prolonged. In all the cases, normal and pathologic, the response of testosterone is variable, perhaps owing to the relation with the various factor which have been noted.

[Action of trazodone on the secretion of pituitary hormones. Behavior of prolactin and somatotropin]. / Studio dell'azione del trazodone sulla secrezione di ormoni ipofisari. Comportamento della prolattina e del somatotropo.

The effect of i.v. trazpdone on PRL and GH was studied in normal subjects and in patients with hypophyseal adenoma coupled with amenorrhoea and galactorrhoea or acromegaly. PRL levels were reduced, whereas the behaviour of GH was paradoxical. These results suggest that the dopaminergic and serotoninergic systems take part in regulating the secretion of these two hormones. An interesting comparison was made with their behaviour following the administration of bromoergocryptine in the adenoma series.

[Obstetric complications associated with DIC. Importance of D-dimer in the diagnosis and treatment. A clinical case]. / Complicanze ostetriche associate a DIC. Importanza del D-dimero nella diagnosi e nel trattamento. Caso clinico.

The case of a 32-year old woman with 36-week pregnancy presented at hospital because of spontaneous vaginal bleeding, anemia and mild hypotension is reported. Fetal mors in utero, abruptio placentae and diffuse intravascular coagulation were diagnosed. The patient subsequently underwent cesarean section and large retroplacental hematoma was removed and obviously fetum. The DIC was easily controlled by means of recently introduced method of determination of fibrin D-dimer.

Effects of fenfluramine and cyproheptadine on growth hormone secretion.

The behaviour of GH, its biological behaviour and response to insulin-induced hypoglycemia in obese and underweight patients, of ages varying from 10 to 39 years, was studied before and after treatment wie circadian course of the hormone following adminstration of either drug. Neither did pre-treatment with fenfluramine and cyproheptadine, No modification was noted in the circadian course of the hormaone following administration of either drug. Neither did pre-treatment with cyproheptadine modify the hormonal level in the stimulated test. It was, however, noted that pre-treatment with fenfluramine appears to influence the somatotropinic response to insulin-induced hypoglycemia, yet of different significance in children and adults.

Healthcare applications based on software agents.

Healthcare has been recognised as one of the most important areas for enterprise applications and services. Presently, information technologists and systems engineers all over the world are working towards achieving better efficiency and quality of service in various sectors of healthcare, such as telemedicine, hospital management, patient-care, and treatment. This paper addresses the issue of more effective and efficient handling of doctor-patient relationship. The idea is to use Software Agent technology to extend the patient-doctor relationship beyond the physical and logistical limitation of face-to-face consultations in patient management. Software agents can provide an extension of the doctor by interacting with the patient via a computer and the Internet. The agent is visualised as an anthropomorphic figure to further enhance the patient interaction.

[Combined therapy, oral hypoglycemic agent and low-dose insulin, in type 2 diabetes mellitus in secondary failure: a year's experience]. / Terapia combinata, ipoglicemizzante orale e insulina a basso dosaggio, nel diabete mellito tipo 2 in fallimento secondario: un anno di esperienza.

We have evaluated, for a period of 12 months, the response to the combined therapy with oral hypoglycaemic agents and insulin at low doses in a group of 21 patients with type 2 diabetes mellitus in secondary failure. A clear improvement of the parameters considered (fasting and postprandial glycaemia, glycated haemoglobin) was obtained, while maintaining the endogenous secretion of insulin. Important side effects were not observed and the increases of body weight and insulin dose registered in the course of one year were of minor importance.

Oral feeding competences of healthy preterm infants: a review.

Background. With increasing sophistication and technology, survival rates hugely improved among preterm infants admitted to the neonatal intensive care unit. Nutrition and feeding remain a challenge and preterm infants are at high risk of encountering oral feeding difficulties. Objective. To determine what facts may impact on oral feeding readiness and competence and which kind of interventions should enhance oral feeding performance in preterm infants. Search Strategy. MEDILINE database was explored and articles relevant to this topic were collected starting from 2009 up to 2011. Main Results. Increasingly robust alertness prior to and during feeding does positively impact the infant's feeding Skills. The review found that oral and non-oral sensorimotor interventions, provided singly or in combination, shortened the transition time to independent oral feeding in preterm infants and that preterm infants who received a combined oral and sensorimotor intervention demonstrated more advanced nutritive sucking, suck-swallow and swallow-respiration coordination than those who received an oral or sensorimotor intervention singly.