Clinical and subclinical atherosclerosis in systemic sclerosis: consequences of previous corticosteroid treatment.

OBJECTIVE: To investigate the prevalence of clinical and subclinical atherosclerosis in systemic sclerosis (SSc) patients and its associated features. METHODS: Fifty unselected SSc patients and 41 controls, matched for sex and age, were investigated for previous cardiovascular events, cardiovascular risk factors, and ultrasonographic features of subclinical atherosclerosis in the carotid arteries, that is intima-media thickness (IMT) > 0.9 mm or plaques. SSc patients were also investigated for disease features and previous treatment. Finally, blood samples were randomly selected from 27 patients and 18 controls to evaluate concentrations of amino-terminal propeptide of type III procollagen (PIIINP), transforming growth factor (TGF)-ß, hepatocyte growth factor (HGF), soluble interleukin-2 receptor (sIL-2R), IL-13, E-selectin, intercellular adhesion molecule (ICAM)-1, plasminogen activator inhibitor (PAI)-1, tissue plasminogen activator (t-PA), D-dimer, and prothrombin fragments (F1+2). RESULTS: Previous cardiovascular events were recorded in three SSc patients and no controls (p > 0.05). Mean IMT (0.613 ± 0.240 vs. 0.654 ± 0.173 mm) did not differ between patients and controls (p > 0.05), but subclinical atherosclerosis was detected in 14/50 SSc patients and 4/41 controls (p = 0.036). At multiple logistic regression analysis, mean IMT was correlated with older age [p = 0.006; odds ratio (OR) 1.276, 95% confidence interval (CI) 1.043-1.516] and a higher cumulative corticosteroid intake (p = 0.017; OR 1.155, 95% CI 1.027-1.300). No correlation was found with any soluble marker of disease activity and of coagulation/fibrinolysis system activation. CONCLUSION: Our study confirms an increased prevalence of subclinical atherosclerosis in SSc patients and demonstrates a hitherto unknown association with corticosteroid cumulative dosage.

Scopolamine for uterine involution of dairy cows.

The objective of this study was to evaluate the effect of administration of scopolamine (a parasympatholytic drug) immediately after delivery, on uterine involution in dairy cows. The cows were divided into two groups: group T (treated with scopolamine butylbromide 40 mg/100 kg P.V., within 24 h of delivery) and group C (treated with 2 ml/q of saline solution). The cows were monitored at T0, within 24 h of delivery, T7, T14, T28 and T40 respectively 7th, 14th, 28th and 40th day postpartum, by measuring the levels of hydroxyproline (HYP), an important marker of uterine involution; by ultrasound examination for the measurement of the diameter of uterine horns and of blood flow in the middle uterine artery; and by evaluation of reproductive indices. HYP showed higher concentrations in the T group than in the C group at all times, but the difference was significant at T7 and T40. Uterine diameters were reduced from T7 to T40, with lower values in the T group, as compared to the C group; the pulsatility index (PI) of the middle uterine artery increased in the T group compared to the C group, with a statistically significant difference at T7. There was a better conception-delivery interval and higher pregnancy rate in the T group compared to the C group. It is likely that scopolamine blocked the uterine contractions in postpartum, for the duration of its half-life. After cessation of its pharmacological effect, the uterus may have started to contract more effectively. These results suggested that scopolamine could be useful as a pharmacological approach to postpartum management.

Restoring microvascular efficiency with mesoglycan in women affected by moderate chronic venous disease.

AIM: Chronic venous disorders (CVDs) subtend a spectrum of vascular abnormalities, including microcirculation and skin damages (as ulcers) in the lower limb. Mesoglycan has been established as an effective agent to improve microcirculation associated with CVDs. The aim of this study was to determine the beneficial function of mesoglycan on cutaneous blood flow measured by laser Doppler fluometry (LDF) before and after iontophoresis analysis using methacholine chloride (MCh) injection in a group of female patients in different stages of CVDs, according to the CEAP classification. METHODS: Female patients with chronic venous disorders (CVD) were referred from primary care practices and vascular clinics. The study selected 75 women aged 45.5 ± 9.6 years (range, 30 to 60 years). And grading in CEAP classification. Eligible patients were allocated consecutively, according to entrance order, in an active treatment group and in a control group for 90 days. The active group (N. = 37) received mesoglycan 50 mg twice daily in adjunct to standard care. The primary outcome variable for the study was the measurement of skin microcirculation blood flow by LDF. Data obtained was transferred to a database (Excel) and analysed using statistical software (SPSS version 12, SPSS, USA). RESULTS: After 90 days of treatment, mesoglycan obtained a significative increase in peak flow at LDF of about 13% respect of baseline and standard care in the entire group of CVD treated women. In upper CEAP classes there was a trend for a more intense vasodilating activity of mesoglycan. CONCLUSION: The study shows improving in microvascular function induced by a 3-month mesoglycan treatment in patients classified by CEAP stages C1 and C4.

Different binding to DNA of enantiomeric platinum complexes assessed by inhibition of restriction enzyme activity.

The ability of enantiomeric platinum complexes to block the action of selected restriction enzymes has been investigated. The complexes [PtCl2(DAC)], [PtCl2(DAB)] and [PtCl2(DAP)] (DAC = 1,2-diamminocyclohexane; DAB = 2,3-diamminobutane; DAP = 1,2-diamminopropane) exhibit a guanine-cytosine preference in accord with previous results on cis-[PtCl2(NH3)2] (cis-DDP). The extent of inhibition, however, is significantly different for the different isomers; the R,R form is more active than the others at short incubation time, as the time becomes longer, the differences among isomers level off. It also appears that cis-DDP is more active than [PtCl2(DAC)] in blocking the Cfo I enzyme, though it shows a preference for the G-X-G sequences.

Treatment strategies for postinfarction left ventricular free wall rupture: stabilization with peri-operative IABP and off-pump repair.

BACKGROUND: Perioperative management of post-infarction left ventricular free wall rupture (LVFWR) is not clearly standardized and surgical repair is the only therapeutic option. Role of off-pump surgery and stabilization with perioperative intraaortic balloon pumping (IABP) were here analysed. METHODS: Seven patients underwent surgery for LVFWR between 1990 and 2002. Clinical picture included electromechanical dissociation (3 patients) and sudden hypotension (4 patients). Except in one patient who was reanimated through femoro-femoral cardiopulmonary bypass, off-pump repair through on-lay patching technique was always performed. IABP was employed in the immediate postoperative period in five cases. RESULTS: A satisfactory hemodynamic state was restored in all cases and there were no reoperations for bleeding or rerupture. Hospital survival was 100%. One patient underwent successful surgical myocardial revascularization two months after LVFWR. Two patients died at follow-up. The survivors present with good NYHA and CCS functional classes. CONCLUSIONS: When the anatomy of the LVFWR is favourable, off-pump external patching repair proves a good choice. Postoperative IABP provides satisfactory hemodynamic support.

[Plasmapheresis combined with pharmacology in the treatment of lupus nephritis: a new therapeutic protocol]. / La plasmaferesi associata alla terapia farmacologica nel trattamento della nefrite lupica: nuovo protocollo terapeutico.

Systemic Lupus Erythematosus (SLE) is a pathology of unknown cause, characterized by tissue and cellular damage, secondary to production of autoantibodies and to deposition of immunocomplexes. Lupus nephritis is one of the most common complications of SLE. Our purpose is to propose a therapeutic protocol for patients suffering from Lupus nephritis. This consists of Plasmapheresis associated with pharmacological therapy so that dosage of immunosuppressors can be reduced and consequently also the side effects of the pharmacological therapy.

[Goldenhar's syndrome: a case report]. / La sindrome di Goldenhar: descrizione di un caso osservato.

The Authors describe one case of Goldenhar's syndrome. They concentrate on the etiopathogenetic hypothesis and they believe it helps the gradual healing in time.

[A case of persistent fever]. / Su di un caso di febbre persistente.

The Authors report a case of difficult diagnosis, clinically characterised by long-term persistent fever. Clinical and laboratory tests led to a first conclusion of a tubercular infection; later of a perisplenic hematoma and the persistence of high inflammatory indices directed to a different diagnosis.

[Cheilognathopalatoschisis: its embryology, epidemiology, etiology, clinical picture and therapy. The experience of a division of pediatrics]. / La cheilognatopalatoschisi: embriologia, epidemiologia, etiologia, clinica e terapia. Esperienza presso una divisione di pediatria.

The authors report their experience about cleft lip and palate.

Treatment of hypothermia by extracorporeal circulation and internal rewarming.

The treatment of accidental hypothermia by extracorporeal circulation and internal rewarming can be life saving in patients unconscious from drug overdose or victims of accidental exposure to severe cold. Advantages are the rapidity of treatment, the provision of circulatory support, and a lessened chance of rewarming collapse, since peripheral vasodilation is paralleled by an increase in cardiac output. A premature diagnosis of clinical death was averted in two patients with rectal temperatures of 25 degrees C or below, and their lives were saved by the use of this technique.

DNA interactions of antitumor cisplatin analogs containing enantiomeric amine ligands.

Modifications of natural DNA and synthetic oligodeoxyribonucleotide duplexes in a cell-free medium by analogs of antitumor cisplatin containing enantiomeric amine ligands, such as cis-[PtCl(2)(RR-DAB)] and cis-[PtCl(2)(SS-DAB)] (DAB = 2,3-diaminobutane), were studied by various methods of molecular biophysics and biophysical chemistry. These methods include DNA binding studies by pulse polarography and atomic absorption spectrophotometry, mapping of DNA adducts using transcription assay, interstrand cross-linking assay using gel electrophoresis under denaturing conditions, differential scanning calorimetry, chemical probing, and bending and unwinding studies of the duplexes containing single, site-specific cross-link. The major differences resulting from the modification of DNA by the two enantiomers are the thermodynamical destabilization and conformational distortions induced in DNA by the 1,2-d(GpG) intrastrand cross-link. It has been suggested that these differences are associated with a different biological activity of the two enantiomers observed previously. In addition, the results of the present work are also consistent with the view that formation of hydrogen bonds between the carbonyl oxygen of the guanine residues and the "quasi equatorial" hydrogen of the cis amine in the 1, 2-d(GpG) intrastrand cross-link plays an important role in determining the character of the distortion induced in DNA by this lesion.