Asthma and gender: The female lung.

Asthma is a common chronic disease that affects over 300 million people worldwide, resulting in a considerable socio-economic burden. Literature data suggest that asthma has a higher incidence in females, particularly at certain stages of pubertal development. Moreover, women seem to experience more asthma symptoms than men and to use more rescue medications, resulting in a reduced quality of life. Although several mechanisms have been proposed to explain these differences, there are not yet final data available in the literature on the role of gender in the pathogenesis of asthma and different behavior in females. Some study suggested a more prevalent hyper-responsiveness in women than in men. Nevertheless, in the literature definitive data on a possible different response to drugs used for asthma between males and females are not described. Understanding the mechanisms that underlie these gender differences in clinical history of asthma patients could give inspiration to new areas of research to obtain a more specific diagnostic and therapeutic approach gender-oriented.

Expression of p16 and cervical infection with high-risk human papillomavirus are not related to p53 activity in cervical intraepithelial neoplasia.

The objective of the study was to investigate the expression of p53 and p16(INK4a) in cervical intraepithelial neoplasia (CIN) and their relation with disease severity and high-risk human papillomavirus (HR-HPV) status. A series of 125 women with previous positive Pap smear were selected for this cross-sectional study. All patients underwent gynecological examination, including colposcopy. Specimens for Pap smears, Hybrid Capture 2 (HC2) test, and pathologic analysis were obtained. After evaluation of CIN grade, immunohistochemical detection of proteins p53 and p16(INK4a) was performed on paraffin-embedded sections. The extent of immunoexpression of both proteins was analyzed in relation to CIN grade and HR-HPV status. CIN was graded as 1 in 21, 2 in 17, and 3 in 87 specimens. p16(INK4a) positivity (at least 5% of epithelial cells stained) was found in 99 of 125 cases (79.2%) and was significantly higher in high-grade lesions as compared to low-grade CIN (P < 0.001). The expression of p53 did not differ across histologic strata. Protein expression neither of p16(INK4a) nor of p53 correlated with HR-HPV status. Expression of p16(INK4a) was not related with that of p53. Our study gives further support to previous findings of strong association of p16(INK4a) immunostaining with severity of epithelial atypia, but this protein may not be considered a predictor of HR-HPV status determined with HC2. By contrast, immunoexpression of p53 was related neither to CIN grade nor to HR-HPV status.

Kidney disease and venous thromboembolism: Does being woman make the difference?

The risk of venous thromboembolism (VTE) is increased across the spectrum of chronic kidney disease (CKD), from mild to more advanced CKD, and typically characterizes nephrotic syndrome (NS). VTE risk in patients with kidney disease may be due to underlying hemostatic abnormalities, including activation of pro-thrombotic factors, inhibition of endogenous anticoagulation systems, enhanced platelet activation and aggregation, and decreased fibrinolytic activity. The mechanisms involved differ depending on the cause of the kidney impairment (i.e. presence of NS or CKD stage). Sex and gender differences, as well as, environmental factors or comorbidities may play a modulating role; however, specific sex and gender data on this topic are still rare. The aim of the present review is to discuss the VTE risk associated with impairment of kidney function, the potential mechanism accounting for it and the impact of sex differences in this clinical setting.

The IL33/ST2 axis in Sjogren syndrome in relation to disease activity.

OBJECTIVE: Primary Sjogren's Syndrome (pSS) is a systemic autoimmune disorder characterized by infiltration of the exocrine glands leading to secretory insufficiency. Despite the progress made in understanding the pathogenesis of the SS, many aspects remain to be clarified. Interleukin-33 (IL33) is a recently discovered cytokine, belonging to IL-1 superfamily. IL33 and its soluble receptor ST2 were implied in a number of immune and in autoimmune diseases pathogenesis. In this work ,we analyzed expression of IL33 and ST2 in Sjogren's syndrome. PATIENTS AND METHODS: Serum IL-33 and soluble ST2 were analyzed using commercial ELISA kit in 15 pSS, 9 patients with Systemic Lupus Erythematosus and 9 controls. RESULTS: We found significant hyperexpression of sST2 in sera of SS patients and SLE patients compared to healthy subjects (p = 0.04 and p = 0.07, respectively). In pSS, sST2 levels in pSS positively correlated with activity index SSDAI (r = 0.662, p = 0.007). In SLE, we found positive correlation between ST2 and SLEDAI 2K (r = 0.685, p = 0.04). Circulating levels of IL-33 were detectable in 2 of 15 SS patients, in 2 SLE patients and in 1 of control subjects. CONCLUSIONS: We found an hyperexpression of sST2 in pSS and SLE patients with a possible immune modulatory role, because of a substantial suppression of circulating IL33. In our pSS and SLE cohort, sST2 levels were in correlation with disease activity indices.

Relationship between leptin and regulatory T cells in systemic lupus erythematosus: preliminary results.

OBJECTIVE: Crescent literature data demonstrated a role of adipokines in immune responses, particularly leptin is involved in wide spectrum of pro-inflammatory functions. Several evidences suggested that leptin is able to inhibit T regulatory cells proliferation and function in vitro models. In the present study, we investigate the relationship between leptin and circulating T regulatory cells (Tregs) in patients affected by systemic lupus erythematosus (SLE). PATIENTS AND METHODS: 13 SLE patients and 11 healthy controls were enrolled. Metabolic syndrome and cardiovascular parameters were evaluated. Serum leptin levels were detected by commercial ELISA kit and circulating regulatory T cells were determined by FACS analysis as CD4+CD25highFOP3+ lymphocytes. RESULTS: Metabolic syndrome, defined by ATPIII criteria, was more prevalent in SLE compared to controls (38.4% vs. 0%, p = 0.04), as well as arterial hypertension (38.4% vs. 0%, p = 0.04). We did not find significant differences in mean leptin levels among SLE and controls (13.13 ± 1.51 ng/ml vs. 9.48 ± 8.67 ng/ml, p = 0.6). Mean Tregs percentage of total CD4 were 1.27 ± 0.9 in SLE vs. 2.8 ± 1.2 in healthy controls (p = 0.001). We found a negative correlation between leptin levels and Tregs percentage of total CD4 in SLE patients (r = 0.4, p = 0.01). CONCLUSIONS: Our results suggest a role of leptin in the regulation of circulating T regulatory cells amount in human SLE.

[Sulpiride and extrahepatic bile ducts. Radioisotope study]. / Sulpiride e vie biliari extraepatiche. Ricerca con radioisotopi.

An original radioisotopic method was employed in an investigation of the effect of sulpiride on extrahepatic bile duct motility. Stress is laid on the primarily hyposthenic effect of the drug, and the influence of various factors on the functional status of the gallbladder.

[Surgery of inguinal hernia: our experience]. / Chirurgia dell'ernia inguinale: nostra esperienza.

The study is based on 848 patients that had surgery for inguinal hernia from January 1990 to May 1996. It compares the results obtained using the traditional plastic, called "direct suture", with the results of plastics with prosthesis. A special attention is given to tension-free techniques carried in local anesthesia, undoubtedly considered advantageous because of the technical simplicity in association with the total absence of postoperative complications and relapses, when correctly executed.

Cell proliferation activity unrelated to COX-2 expression in ovarian tumors.

The objective of this study was to assess the expression of Cyclooxygenase-2 (COX-2) and cell proliferation activity (Ki67 expression) in benign, borderline, and malignant serous and mucinous ovarian tumors. Expression of COX-2 and Ki67 proteins were evaluated by immunohistochemistry, in paraffin-embedded sections of ovarian epithelial tumors. The study included 113 serous (67 benign, 15 borderline, and 31 malignant) and 85 mucinous (48 benign, 28 borderline, and 9 malignant) tumors, removed from women who underwent laparotomy between January 1997 and December 2003. From benign to malignant tumors, there was a progressive positive trend in COX-2 expression in both serous and mucinous tumors, more evident in mucinous ones (P < 0.001). Comparing histologic types, COX-2 expression was more prominent in serous than in mucinous benign tumors (P < 0.01), but this difference was not significant in the borderline (P= 0.11) or malignant categories (P= 0.71). There was a progressive Ki67 positivity in line with the tumor histologic gradient for both serous (P < 0.01) and mucinous lesions (P < 0.01), but this increasing expression did not correlate with COX-2 expression in the present series (P= 0.78). There was a higher COX-2 expression in serous ovarian adenomas than in mucinous ones. COX-2 positivity increases in line with the morphologic gradient, from benign to malignant in both histologic types, but it was more prominent in mucinous lesions, pointing to different oncogenic pathways related to different histologic types. A correlation between the expression of COX-2 and Ki67 was not found, suggesting that COX-2 may be required for carcinogenesis, but this pathway is not responsible for cell proliferation in ovarian tumors.

[Malate dehydrogenase and glutamate dehydrogenase activity modification in livers of rats exposed to a double stress (dry heat - fasting). I]. / Modificazioni dell'attivita' della malico-deidrogenase e della glutammato-deidrogenasi nel fegato di ratti sottoposti a duplice stress (caldo secco - digiuno). Nota I.

We have studied MDH and GLDH behaviour in liver homogenized of rats exposed to double stress (dry heat and starvation) for 24 hours respectively. Both enzyme showed a statistically significant activity increase, either after 24 and 72 hours. Such an increase is affected mainly by starvation. This behaviour reflects the metabolic needs of organism, related to increased energetic requirements.

[Modification of malate dehydrogenase and glutamate dehydrogenase in kidneys of rats exposed to a double stress (dry heat - fasting). II]. / Modificazioni dell'attivita' della malico-deidrogenasi e della glutammato-deidrogenasi nel rene di ratti sottoposti a duplice stress (caldo secco - digiuno). Nota II.

MDH and GLDH activity changes have been studied in kidney homogenized of rats exposed to double stress (dry heat and starvation) for 24 and 72 hours respectively. MDH behaviour activity decrease after 24 hours and increase to basic values after 72 hours leads to suspect the primer of a defence mechanism that precedes to face up increased metabolic needs. GLDH activity shows a constant decrease after 24 hours and after 72 hours; this was explained as a premature acclimatization reaction.

[The role of ultrasonography in the diagnosis and staging of gastroenteric lymphoma]. / Ruolo della ultrasonografia nella diagnosi e nella stadiazione dei linfomi gastroenterici.

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.

Doppler ultrasound evaluation of acute effects of cigarette smoking on portal blood flow in man.

The acute systemic haemodynamic effects of cigarette smoking are well known, but there are no studies dealing with the possible smoke-related acute changes of splanchnic circulation in man. In the present study we evaluated the acute effects of cigarette smoking on portal blood flow (PBF) in normal subjects by the use of Doppler ultrasound. Twenty-three normal volunteers were asked to smoke two cigarettes with a known total nicotine content (1.1 mg each) in a supine position. Each cigarette was smoked during a 5 min period and a 5 min interval between the two cigarettes was allowed. Both mean PBF velocity and volume were evaluated at time 0 (basal values) and 8, 15, 30, 45 and 60 min after the first inhalation of the first cigarette. The basal mean PBF velocity (22 cm/s; 95% CI 20.9-24.2) was significantly decreased at 8 min (19 cm/s; 95% CI 17.9-20.8; P < 0.0007) and 15 min (20 cm/s; 95% CI 17.8-21.3; P < 0.005). Similarly, the PBF volumes at 8 min (710 mL/min; 95% CI 660-876; P < 0.002) and 15 min (750 mL/min; 95% CI 650-862; P < 0.005) were significantly lower than those measured at time 0 (850 mL/min; 95% CI 766-987). Both mean PBF velocity and volume measured at successive times did not differ significantly from basal values. The present study shows that cigarette smoking causes acute and transient reduction of PBF velocity and volume in normal subjects.