Modulation of opportunistic species Corynebacterium diphtheriae, Haemophilus parainfluenzae, Moraxella catarrhalis, Prevotella denticola, Prevotella melaninogenica, Rothia dentocariosa, Staphylococcus aureus and Streptococcus pseudopneumoniae by intranasal administration of Streptococcus salivarius 24SMBc and Streptococcus oralis 89a combination in healthy subjects.

OBJECTIVE: Probiotics S. salivarius 24SMBc and S. oralis 89a comprised in the nasal spray Rinogermina are known to exert inhibition of harmful pathogens and ameliorate the outcome of patients with chronic upper airways infections. In this study, for the first time, the effect of this formulation on the modulation of the microflora of healthy subjects was evaluated, with particular interest on pathobionts and pathogens present. PATIENTS AND METHODS: Metagenomic identification and quantification of bacterial abundances in healthy subjects were carried out by means of Ion Torrent Personal Machine. In particular, nasal swabs were sampled one, two and four weeks after seven days of treatment with Rinogermina. RESULTS: The modulation of the abundance of pathobionts and pathogenic species (i.e., Corynebacterium diphtheriae, Haemophilus parainfluenzae, Moraxella catarrhalis, Prevotella denticola, Prevotella melaninogenica, Rothia dentocariosa, Staphylococcus aureus and Streptococcus pseudopneumoniae) was characterized and a significant temporary decrease in their presence was identified. CONCLUSIONS: The beneficial effects of S. salivarius 24SMBc and S. oralis 89a nasal intake was assessed but seemed to be restricted in specific temporal windows. Thus it would be interesting to evaluate also this positive impact of longer administration of this probiotic formulation.

Gastric chief cell mass in chronic gastritis. Count and relationships to parietal cell mass and functional indices.

The chief cell mass, expressed as the Zymogenous Index (number of cells per mm2 multiplied by the thickness of the glandular layer) was calculated in 42 subjects with chronic gastritis, and in 40 subjects with normal gastric mucosa, and was compared with the serum concentration of Pepsinogen I (PG I), with the parietal cell mass (expressed as Parietal Index: number of cells per mm2 multiplied by the thickness of the glandular layer), and with the acid output. The results showed that there are no significant variations in the chief cells in comparison with healthy controls in the case of superficial gastritis and follicular gastritis. Conversely, in the case of pre-atrophic and atrophic gastritis there is a significant reduction in the chief cell mass. The serum PG I increases significantly in the case of superficial gastritis as compared with healthy controls, while it is equivalent in the case of follicular gastritis, decreases non-significantly in pre-atrophic gastritis and is significantly reduced in the case of atrophic gastritis. The parietal cell mass shows a behavior equivalent to that of the chief cell mass, and the acid output decreases significantly in the case of pre-atrophic and atrophic gastritis, with no significant variations in the case of superficial and follicular gastritis. On comparing the behavior of the chief cell mass with that of the parietal cell mass, it was noticed that in the most severe stages of chronic gastritis there is a more pronounced reduction of the former than of the latter.

Chief cell mass in normal gastric mucosa: relationship with serum pepsinogen I.

In the present study, a counting method for the evaluation of chief cell mass was proposed, based on the assessment of a zymogenous index (ZI) obtained by multiplying the number of cells/mm2 by the thickness of the glandular layer. Results obtained in 40 subjects with normal gastric mucosa did not show significant ZI differences between sexes. A statistically significant decrease in ZI was observed in patients above age 50, thus being directly related to the significant decrease in the thickness of the glandular parenchyma and in the number of chief cells/mm2 observed in this age group. The data obtained were in agreement with the pattern of change observed for serum pepsinogen I (PG I) whose values were related to the chief cell mass in connection with sex and age of the subjects.

[Tumor markers. II. Their significance in the follow-up of patients after radical resection of lung neoplasms]. / Marcatori tumorali. II. Loro significato nel follow-up dei pazienti sottoposti a resezione radicale di neoplasie polmonari.

The clinical field in which tumor markers proved to be most useful is the monitoring of cancer patients. The present study was carried out in order to evaluate the role of tumor markers in the prognostic assessment, and pre-clinical identification of disease recurrence in patients with completely resectable non-small cell bronchial carcinoma. Tumor markers have been measured: a) pre-operatively, in 109 patients with resectable lung cancer and b) post-operatively, in 61 patients who underwent complete resections and were followed for at least one year after surgery. The carcinoembryonic antigen (CEA), the neuron specific enolase (NSE), the tissue polypeptide antigen (TPA), the carbohydrate antigen 19-9 (CA 19-9) and the carbohydrate antigen 50 (CA 50) have been determined in each patient. Long-term survival was significantly correlated with serum levels of the CEA, CA 50 and CA 19-9, while not with those of TPA and NSE. For pre-clinical detection of cancer recurrence, TPA and NSE were the most suitable indicators.

[Tumor markers. I. Their significance in the preoperative assessment of lung neoplasms]. / Marcatori tumorali. I. Loro significato nella valutazione pre-chirurgica delle neoplasie polmonari.

The present study has been carried out in order to evaluate the role of tumor markers in the presurgical assessment of patients with bronchial carcinoma. The carcinoembryonic antigen (CEA), the neuron specific enolase (NSE), the tissue polypeptide antigen (TPA), the carbohydrate antigen 19-9 (CA 19-9) and the carbohydrate antigen 50 (CA 50) have been preoperatively measured in 133 subjects with potentially resectable lung cancers, and in 75 healthy smokers. Sixty-one patients had squamous cell carcinoma, 55 adenocarcinoma and 17 small cell carcinoma. Lobectomy (or bilobectomy) was performed in 74 cases, pneumonectomy in 36 cases, exploratory thoracotomy in 15 cases and a palliative resection in 8 cases. When individual markers were considered, TPA showed the highest sensitivity (85%) and CA 19-9 the lowest sensitivity (11%). Specificity was uniformly superior to 90%. When marker associations were considered, the combined measurement of TPA and NSE gave the best results: both the sensitivity and specificity rates approached 90%. The application of the TPA-NSE association allowed detection of 94% of small cell carcinomas, 89% of adenocarcinomas and 85% of squamous cell carcinomas. A positive correlation was found between the complete resectability of lung cancer and serum levels of CEA, CA 50 and CA 19-9. By using the discriminant analysis, a statistical model yielding identification of about 74% of patients with tumors which were judged potentially resectable according to the pre-operative non-invasive diagnostic procedures and were found to be unresectable at thoracotomy, has been get available.

[The clinical evaluation of the hypocholesterolemic effects of an inhibitor of cholesterol synthesis: mevalonic acid]. / Valutazione clinica degli effetti ipocolesterolemizzanti di un inibitore della sintesi del colesterolo: l'acido mevalonico.

Twenty eight patients with heterozygous familial hypercholesterolemia were treated with mevalonic acid (an inhibitor of cholesterol synthesis) for 45 days. Patients received a daily dose of 750 to 1500 mg mevalonic acid depending on plasma cholesterol levels. Results showed a significant reduction in cholesterol values whereas no significant difference was observed in HDL cholesterol and triglyceride levels.

[Study of the beta cell function in type I diabetes by the determination of peptide C after glucagon challenge]. / Studio della funzionalità beta-cellulare nel diabete tipo I mediante dosaggio del peptide C dopo carico con glucagone.

In 35 patients (13F/22M; age range 2-15 years), affected by insulin dependent diabetes mellitus (IDDM), basal and glucagon stimulated C peptide was determined and correlated with the daily insulin requirement (U/Kg/die), the glycosylated hemoglobin (HbA1c), the age of onset (months) and the length of the illness (months). The results of C peptide determinations are illustrated in tab. 1: in 20 patients (group I) the basal value of C peptide is higher than 1 ng/ml and increases after glucagon load; in 15 patients (group II) the basal value of C peptide is lower than 1 ng/ml; in 9 ones (group IIA) of these 15 a glucagon load does not elicit a residual insulin secretion; in the other 6 ones (group IIB) a significative C peptide increase is observed after glucagon load. A better metabolic control (p less than 0.01); Student t test) and a shorter length of the illness (p less than 0.05; Mann-Withney U test) was noticed in the group I in comparison with the group IIA, in which no insulin reserve, even after glucagon load, was demonstrated (tab. 2). However, no difference in the metabolic control, insulin requirement, age of onset or length of the illness resulted between group IIA and group IIB (in which an insulin reserve had been demonstrated only after glucagon load). The basal C peptide evaluation and follow up is useful in the assessment of the individual case of IDDM: a glucagon load may demonstrate a residual insulin reserve in some patients with a low basal C peptide.

[Significance of the evaluation of C-peptide in children with type 1 diabetes mellitus]. / Interesse della valutazione del peptide C nel bambino affetto da diabete mellito tipo 1.

In type I diabetes mellitus (DM) the presence of C peptide (Cp), whose determination is unaffected by exogenous insulin, is considered expression of a residual beta-cell activity, which allows a better metabolic control. In 35 children affected by type I DM the fasting Cp was measured: in 18 cases (1st group) a value greater than or equal to 1 ng/ml was observed, while in the remaining 17 (2nd group) the Cp value was less than 1 ng/ml. A statistical comparison between the two groups demonstrated that in the first one a better metabolic control was achieved with a daily lower insulin dosage. Moreover in the 1st group the onset of the disease was more recent, while there was no difference between the two groups with regard to the age at diagnosis. The Cp evaluation and follow-up is useful in the assessment of the individual case; furthermore, on the basis of these studies, an immunosuppressive treatment may be considered during the early phase of the disease, when a residual beta-cell activity is demonstrated.

Relationships of serum leptin to body composition and resting energy expenditure.

Body weight (BW), body mass index (BMI), body fat, serum leptin concentration and resting energy expenditure (REE) were fitted in a multiple linear regression model in a group of individuals with stable body weight. While serum leptin concentration was well related to BW, to BMI and to body fat, no correlations with the REE values were found. This suggests that serum leptin concentration would represent an index of adiposity and poorly reflects energy metabolism.

[Variations of vasoactive intestinal peptide (VIP) concentration in the lung of asthmatic patients]. / Variazioni del peptide intestinale vasoattivo (VIP) nel passaggio attraverso il polmone nella malattia asmatica.

The vasoactive intestinal peptide (VIP) concentrations in the pulmonary and systemic arterial blood were evaluated in 11 asthmatic patients in symptom-free period and during methacholin induced broncospasm. The basal venous and arterial mean values do not significantly differ. A significant difference was observed after bronchial challenge. This could be caused by an increased VIP pulmonary production as a defensive mechanism. No correlation was found between bronchial reactivity (as PD20-FEV1 Methacholin) and VIP concentrations.

[Evaluation of a new immunoturbidimetry technique for measuring microalbuminuria]. / Valutazione di una nuova tecnica immunoturbidimetrica per il dosaggio della microalbuminuria.

Subclinical elevation of urinary albumin excretion is a good predictor of later clinical proteinuria. A simple, sensitive and rapid immunoturbidimetric method was developed to quantify urinary albumin excretion (URIN-PAK ImmunoMICRO LAB, Miles Italia Spa). In the presence of polyethylene glycol 6000, immunocomplex between human albumin and its specific antibody are rapidly formed (5-50 min, at room temperature). Absorbance reading are mode U 340 nm (Automatic Analyzer RA 1000, Technicon). The test is specific for albumin failing to cross react with other plasma proteins present in urine, as well as with glibenclamide, chlorpropamide, phenformin, hemoglobin, glucose, urea and thymol. The present method correlates with SCLAVO H-ALBUMIN RIA Kit (r = 0.9917). The test is suitable for clinical use.

Influence of the colonic environment on duodenal G-cell activity and proliferation.

To investigate the effects of the colonic environment on duodenal G-cell activity and proliferation, thirty white rats underwent antrectomy with gastroduodenostomy (control group) or antrectomy with interposition of a 15 mm segment of transverse colon between the gastric fundus and the first duodenal portion (experimental group). Three to four months after surgery, serum gastrin determinations were carried out by radioimmunoassay either in fasted or freely fed rats. The duodenum was then removed and its proximal third was used for G-cell count (immuno-peroxidase method) and for assessment of G-cell cytoplasmic granule content (electron microscopy examination). The interposition of a colonic segment between the gastric fundus and the first duodenal portion did not affect either serum gastrin levels or the cytoplasmic granule content of duodenal G-cells, while significantly increasing duodenal G-cell density. These results indicate that the colonic environment enhances duodenal G-cell proliferation, but gastrin release from the enlarged duodenal G-cell mass is not stimulated by the interposition of a colonic segment to replace the antrum, either under fasting or feeding conditions.

[Changes in immune status due to anesthesia and surgical intervention. The role of thymopentin and interleukins]. / Modificazioni dello stato immunitario indotte dall'anestesia e dall'intervento chirurgico. Il ruolo della timopentina e delle interleuchine.

OBJECTIVE: Purpose of the study was clinical evaluation of thymopentin and interleukins in the changes of immunity due to anesthesia and surgical operation. DESIGN: After randomization the patients were divided into four groups according to starter type (thiopental or propofol) and immunological pre-treatment (tymopentin or saline of control group) administered for three days before and two days after operation. SETTING AND PATIENTS: The study was effected on 40 patients undergoing venous vascular surgery in operating rooms of Medical School of University of Genoa. MEASUREMENT: At pre-established times (basal, before and after induction, recovery and 72 postoperative hours) were measured some immunological data (plasmatic concentrations of red blood cells, white blood cells, lymphocyte cells, antibodies, complement analysis, interleukins 1 and 2). RESULTS: The results show a depression of immunity with hypoleucocistosis and hyperlymphocytosis due to surgical trauma or to anesthesia drugs. CONCLUSIONS: Pre-treatment with thymopentin no change perioperative immunity and the role of interleukins isn't clear; the immunological depression is the same in thiopental of propofol groups.

[Clinical evaluation of pre-surgical anxiety: changes in plasma levels of the anxiety peptide (diazepam binding inhibitor)]. / Valutazione clinica dell'ansia pre-intervento chirurgico: modificazioni dei livelli plasmatici del peptide dell'ansia (DBI).

The score scale of anxiety (STAI, Y, 1-2) and haematic levels of DBI (diazepam binding inhibitor) were used in 48 surgical patients for clinical evaluation of preoperative anxiety, before and after drugs for preoperative medication. After randomization, were clinically and statistically compared 6 groups according to premedicant drugs (diazepam 0.3 mg/kg; flunitrazepam 0.03 mg/kg; saline; prometazine 0.7 mg/kg); before and after preoperative medication were evaluated the anxiety relief with the score scale, haematic levels of DBI and haemodynamics (systolic and diastolic AP and HR). The results show that DBI can objectively measure the anxiety relief, that not are correlate haematic levels of DBI and score scale, that the best benzodiazepines are diazepam (0.3) and flunitrazepam (0.015) and that the prometazine might give anxiety relief for 5-HT antagonist action. Even if there are limits to study (scanty cases, are missing the range and the brain values of DBI and blood test of DBI is slow method) may be useful the use of score scale and haematic levels of DBI in clinical evaluation of preoperative anxiety relief.

Evidence of healing of secondary hyperparathyroidism in chronically hemodialyzed uremic patients treated with long-term intravenous calcitriol.

The aim of this study was to assess the effect of a long-term course of high-dose i.v. pulses of calcitriol (CLT) on hyperparathyroid bone disease (HBD) and functional mass of parathyroid glands of chronically hemodialyzed uremic (CHU) patients. We prospectively studied nine CHU patients treated with CLT, 30 ng/kg/body wt, i.v., thrice weekly over a period of eight months. Plasma concentrations of intact parathyroid hormone (iPTH), bone GLA protein (bGLA) and bone isoenzyme of alkaline phosphatase (biALP) were sampled throughout. Transiliac bone biopsies were made before and after the start of CLT therapy. Double scanning scintigraphy of the neck with 201Tl-99Tc was made before, during and eight months after the start of the treatment. All patients but one, who later responded to higher than planned CLT doses, had significant decreases of plasma iPTH (F = 76; P < 0.0001; ANOVA). The mean pretreatment value of PTH was 966 +/- 160 (mean +/- SE) pg/ml and it had decreased significantly by the first week (T = 2.4, P < 0.04), and had fallen an average of 80% by the 35th week. Ionized plasma calcium concentration was 1.19 +/- .01 mmol/liter which rose significantly (F = 13.5; P < 0.0001) by the 14th week to maximal peak levels, averaging 1.34 +/- .02 mmol/liter. Changes in biALP were parallel to those of iPTH, while bGLA tended to increase immediately after the start of the therapy and to significantly decrease thereafter (T = 3.2; P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)