Toe web intertrigo in Kaposi's sarcoma patients: a microbiological study in a large cohort of patients.

Kaposi 's sarcoma (KS) is a rare multifocal angioproliferative disease associated with human herpes virus 8 (HHV-8) infection, characterized by cutaneous nodules or plaques especially on the lower limbs. Some skin modifications, such as chronic lymphedema, plantar hyperkeratosis and interdigital desquamation, may be associated with consequent impairment of the local immunosurveillance and increased risk of some bacterial or mycotic infections. With the objective of evaluating if bacterial or mycotic infections in KS patients are supported by different microorganisms compared to control patients, we performed an observational retrospective study, comparing positive cultural swabs of interdigital intertrigo of KS patients with positive cultural swabs of interdigital intertrigo of patients admitted to our dermatologic unit during the last 10 years. One hundred KS patients and 84 control patients were admitted to this study. Some of the skin swabs from interdigital spaces were positive for more than one microorganism, and therefore we found 187 microorganisms among the KS group and 182 microorganisms in the control group. The most common microrganisms among KS patients were T. mentagrophytes (16%), S. aureus (14.9%), P. aeruginosa (13.9%), S. marcescens (5,9%), while among non-KS patients were S. aureus (26,9%), C. albicans (22%), S. agalactiae (7.7%) and E. coli (9.9%). These differences are statistically significant (p < 0.01). KS patients may be more affected by toe web intertrigo due to other bacteria and dermatophytes than the general population. During clinical examination, a careful inspection is necessary for an early diagnosis of toe web intertrigo, in order to prevent serious complications, such as cellulitis and sepsis. Consequently, a cultural examination with antibiogram is required to identify the causative agent of intertrigo and guide antimicrobial therapy.

Programmable system on chip for controlling an atomic physics experiment.

Most atomic physics experiments are controlled by a digital pattern generator used to synchronize all equipment by providing triggers and clocks. Recently, the availability of well-documented open-source development tools has lifted the barriers to using programmable systems on chip (PSoCs), making them a convenient and versatile tool for synthesizing digital patterns. Here, we take advantage of these advancements in the design of a versatile clock and pattern generator using a PSoC. We present our design with the intent of highlighting the new possibilities that PSoCs have to offer in terms of flexibility. We provide a robust hardware carrier and basic firmware implementation that can be expanded and modified for other uses.

Eradication of Chlamydia trachomatis parallels symptom regression in chronic bacterial prostatitis patients treated with a fluoroquinolone-macrolide combination.

To investigate the association between eradication of Chlamydia trachomatis (CT) and symptom regression in chronic prostatitis, 55 symptomatic patients were subjected to segmented tests to localise CT in first voided urine (VB1), prostatic secretions (EPS), post-massage voided (VB3) or semen specimens. Patients were divided in three treatment groups: the 'urethral involvement' group ('U': VB1 positive, EPS/VB3/Semen negative) was treated with 500 mg day(-1) azithromycin for 3 days. The 'prostatitis' group ('P': VB1 negative, EPS/VB3/semen positive) with 4-week levofloxacin-azithromycin combination. A third group, 'U+P' (VB1, EPS/VB3/semen positive) received both treatments in sequence. In P patients, eradication of CT was paralleled by marked, sustained symptom improvement and by significant decrease of serum prostate-specific antigen (PSA) levels. Compared with U patients, undergoing rapid regression of symptoms related to painful micturition after short-term azithromycin, U+P patients showed symptom and pathogen persistence in VB3/EPS/semen and required additional treatment with 4-week levofloxacin-azithromycin to achieve pathogen eradication, symptom regression, and decrease of PSA. Our results support a causative role of CT in chronic bacterial prostatitis. In the presence of a positive urethral localisation of the pathogen, thorough microbiological investigation together with focused symptom analysis may reveal an underlying chlamydial prostatitis and direct effective therapy with appropriate antibacterial agents.

A radiofrequency voltage-controlled current source for quantum spin manipulation.

We present a wide-bandwidth, voltage-controlled current source that is easily integrated with radiofrequency magnetic field coils. Our design uses current feedback to compensate for the frequency-dependent impedance of a radiofrequency antenna. We are able to deliver peak currents greater than 100 mA over a 300 kHz to 54 MHz frequency span. The radiofrequency current source fits onto a printed circuit board smaller than 4 cm2 and consumes less than 1.3 W of power. It is suitable for use in deployable quantum sensors and nuclear magnetic resonance systems.

Microcontroller based scanning transfer cavity lock for long-term laser frequency stabilization.

We present a compact all-digital implementation of a scanning transfer cavity lock (STCL) for long-term laser frequency stabilization. An interrupt-driven state machine is employed to realize the STCL with the capability to correct for frequency drifts in the slave laser frequency due to measured changes in the lab environmental conditions. We demonstrate an accuracy of 0.9 MHz for master laser and slave laser wavelengths of 556 nm and 798 nm as an example. The slave laser is also demonstrated to dynamically scan over a wide frequency range while retaining its lock, allowing us to accurately interrogate atomic transitions.

A low-steering piezo-driven mirror.

We present a piezo-driven translatable mirror with excellent pointing stability, capable of driving at frequencies up to tens of kilohertz. Our system uses a tripod of piezo actuators with independently controllable drive voltages, where the ratios of the individual drive voltages are tuned to minimize residual tilting. Attached to a standard ∅ = 12.7 mm mirror, the system has a resonance-free mechanical bandwidth up to 51 kHz, with displacements up to 2 µm at 8 kHz. The maximum static steering error is 5.5 µrad/µm displaced, and the dynamic steering error is lower than 0.6 µrad µm-1. This simple design should be useful for a large set of optical applications where tilt-free displacements are required, and we demonstrate its application in an ensemble of cold atoms trapped in periodically driven optical lattices.

An ultra-low noise, high-voltage piezo-driver.

We present an ultra-low noise, high-voltage driver suited for use with piezoelectric actuators and other low-current applications. The architecture uses a flyback switching regulator to generate up to 250 V in our current design, with an output of 1 kV or more possible with small modifications. A high slew-rate op-amp suppresses the residual switching noise, yielding a total root-mean-square noise of ≈100 µV (1 Hz-100 kHz). A low-voltage (±10 V), high bandwidth signal can be summed with unity gain directly onto the output, making the driver well-suited for closed-loop feedback applications. Digital control enables both repeatable setpoints and sophisticated control logic, and the circuit consumes less than 150 mA at ±15 V.

Active stabilization of ion trap radiofrequency potentials.

We actively stabilize the harmonic oscillation frequency of a laser-cooled atomic ion confined in a radiofrequency (rf) Paul trap by sampling and rectifying the high voltage rf applied to the trap electrodes. We are able to stabilize the 1 MHz atomic oscillation frequency to be better than 10 Hz or 10 ppm. This represents a suppression of ambient noise on the rf circuit by 34 dB. This technique could impact the sensitivity of ion trap mass spectrometry and the fidelity of quantum operations in ion trap quantum information applications.

[Chronic use of glucomannan in the dietary treatment of severe obesity]. / Impiego cronico del glucomannano nel trattamento dietetico delle obesità severe.

Two groups of 25 severely obese patients underwent 3 months of hypocaloric diet therapy either alone or associated with a glucomannan-based fibrous diet supplement (approx. 4 g/die in 3 doses). The comparative analysis of the results obtained in both groups showed that the diet + glucomannan group had a more significant weight loss in relation to the fatty mass alone, an overall improvement in lipid status and carbohydrate tolerance, and a greater adherence to the diet in the absence of any relevant side effects. Due to the marked ability to satiate patients and the positive metabolic effects, glucomannan diet supplements have been found to be particularly efficacious and well tolerated even in the long-term treatment of severe obesity.

Tolerability profile of the antiinflammatory compound imidazole salicylate: a metanalysis of safety data in 1408 patients.

In order to evaluate the incidence of side-effects (S.E.), the withdrawal rate and the type of S.E. of the new antiinflammatory agent imidazole salicylate, we performed an analysis of 33 clinical trials involving 1408 patients treated with 750 mg t.i.d. (tablets or solution) or 1000 mg b.i.d. (granulated powder), taking into account all the factors (treatment duration, pharmaceutical form, indications, etc.) that could influence the type and incidence of S.E. Slight and transient episodes of pyrosis or epigastric pain represented the great majority of S.E. The overall rate of withdrawal was 1.8%. According to the duration of therapy, the incidence of S.E. was: 2-3 days, 3.3%; 5-7 days, 5.6%; 10-14 days, 8.8%; 30 days, 10.2%. The pharmaceutical forms, the treated pathologies and the various experimental designs adopted (double-blind, open, etc.) did not influence the S.E. rate. With imidazole salicylate the overall incidence of S.E. was always lower than other NSAID's ranging from 10% to 64% of that observed with the reference drugs (other salicylates, ibuprofen, naproxen, flurbiprofen, piroxicam, diclofenac). In conclusion, this analysis showed a linear relationship between S.E. and exposure time up to 10-12 days, followed by a clear trend toward a plateau of 10% of S.E. with treatments up to 30 days. Therefore the risk-benefit ratio, particularly when compared with that of the reference drugs, seems to be very favourable.

[Current world experience in the surgical treatment of gross obesity]. / L'esperienza mondiale attuale nel trattamento chirurgico della grande obesità.

Since 1954 the aim of surgical treatment of severe obesity has been to perfect a specific treatment capable of obtaining a massive, long-lasting and well tolerated loss of weight in severely obese subjects in which different and repeated attempts using conservative medicine have proved inefficacious or non-resolutive. During the course of almost 40 years, bariatric surgery has gradually evolved in the search for the "ideal" surgical treatment: for this purpose, operative methodologies and techniques have been proposed and experimented using differing physiopathological concepts and means of application. After a brief analysis of the history of bariatric surgery, there is a short summary of the most internationally widespread surgical methods and the most recent techniques now used for the surgical treatment of severe obesity based on the Authors' ten year experience of 321 intestinal bypasses (jejuno-ileal and biliointestinal), 110 horizontal gastroplasties and 23 vertical gastroplasties with a silastic ring. Intestinal bypass almost always allows sufficient weight loss to be achieved (85% of operated patients lose 80% of excess body weight) and the various postoperative problems of differing degrees of severity can be prevented by adequate replacement therapy and regular outpatient monitoring. Gastroplasties lead to a slightly smaller loss of weight (73% of excess body weight) within a shorter period of time, with fewer postoperative problems, but at the expense of a drastic and continual reduction in food intake. All patients operated require intense and long-term postoperative follow-up carried out by experts in order to achieve the desired results.

[Horizontal gastroplasty in surgery for morbid obesity: an unjustified condemnation?]. / Gastroplastie horizontale dans la chirurgie de l'obésité morbide: une condamnation injustifiée?

Horizontal gastroplasty has been performed on 100 pathologically obese patients over the last nine years. In our series, the mean age was 39.3 +/- 8.2 years and the mean body weight was 120.8 +/- 19.6 kg. One year after surgery the average weight loss was 29.7 kg which corresponds to a reduction of 24.6% of the preoperative weight (BMI:-24%). After three years, the body weight stabilised, reaching a total weight reduction of 30.5% (BMI:-28.7%), corresponding to 36.8 kg. The incidence of complications directly related to surgery was generally acceptable. The absence of specific malabsorption problems, the low incidence of severe complications and the satisfactory weight loss induced and maintained make, in our opinion, horizontal gastroplasty one of the most suitable and effective interventions in the long-term management of morbid obesity.

[Does jejunoileal bypass still have a place in the surgical treatment of morbid obesity?]. / Y a-t-il encore une place pour le court-circuit jéjuno-iléal dans le traitement chirurgical de l'obésité morbide?

Jejuno-ileal bypass has been widely used for the surgical treatment of morbid obesity since 1954, but from 1978 onwards the operation has met with increasing disfavor, especially in the USA as a result of its unacceptably high complication rate. From 1982 onwards, 235 morbidly obese patients had a side-to-side jejuno-ileal bypass in our Department. Our data concerning weight loss and the overall incidence of complications show that jejuno-ileal bypass can still play a role in the surgical treatment of morbid obesity.

Impact of adrenalectomy and dexamethasone treatment on testicular morphology and sperm parameters in rats: insights into the adrenal control of male reproduction.

Here we investigated the hypothesis that normal levels of glucocorticoids, a class of adrenal steroid hormones, are required for normal testicular and epididymal functions. We examined the effects of the manipulation of glucocorticoid plasma levels by bilateral adrenalectomy (1, 2, 7 and 15 days) alone or in combination with daily treatment with the synthetic glucocorticoid dexamethasone (DEX; 5 µg/kg, i.p., 6 days) on the morphology of the testis and sperm parameters in rats. We showed that adrenalectomy led to a reduction in testicular sperm count and daily sperm production starting 2 days after surgery and a differential decrease in sperm count in the epididymis, according to the region and time post-adrenalectomy analysed. In parallel, testes from 7-day adrenalectomized (ADX) rats displayed a higher frequency of damaged seminiferous tubules and the presence of elongated spermatids retained in the basal epithelial compartment in stages IX-XVII, which is indicative of defective spermiation. The alkaline comet assay revealed a late effect of adrenalectomy on epididymal sperm DNA fragmentation, which was increased only 15 days after surgery. DEX treatment prevented the changes in testicular and epididymal sperm count observed in 7-day ADX rats, but failed to protect the testis from ADX-induced morphological abnormalities. Thus, our results indicated that glucocorticoids may be involved in events related to the maintenance of spermatogenesis and sperm maturation during adulthood. These findings provide new insights into the importance of adrenal steroids to male fertility.