What do men and women ask a helpline on sexual concerns? Results of an Italian telephone counselling service.

INTRODUCTION: In Europe, helplines have become a common counselling service for men and women who are seeking advice for sexual problems. Despite this, relatively few peer-reviewed reports on this subject have been published in the last decade. AIM: To investigate the range of sexual concerns reported by users of an Italian helpline and to describe the differences, if any, between male and female callers; to identify the overlap among sexual difficulties and the associations between the variables of the study. METHODS: The study included selected records of the calls received during the 3-year period between 2006 and 2008 (n = 944). Data were analysed using descriptive statistics and bivariate analysis. RESULTS: Users were more often male (62.2%), aged between 26 and 35 years, who had not sought any previous help. The most frequently reported male sexual difficulties were erectile dysfunction (ED) and premature ejaculation, while the majority of female callers reported vaginismus and orgasmic disorder (OD). We found an association between desire disorder (DD) and ED in men (41.7%), and between OD and DD in women (36.8%). CONCLUSIONS: Telephone counselling is an important and effective resource to elicit requests that otherwise might remain hidden; therefore, it can be a useful link between the health-care system and callers. This is true mainly for men. The next step could be to establish a quality management instrument to investigate whether users find the service helpful.

Comorbidity in specific language disorders and early feeding disorders: mother-child interactive patterns.

OBJECTIVE: This empirical study has its main object in highlighting the role of mother-child interactive experiences in the development of affective and communicative exchanges in infancy. METHODS: The study analyzed four groups of mother-child couples with children who presented a Specific Language Disorder (SLD) the first, a Feeding Disorder (FD) the second, the third an association of SLD and FD, and a fourth non clinical group. Diagnostic assessments were done through: a specific linguistic protocol, the Italian version of the Feeding Scale-Observational Scale for Mother-Infant Interactions during Feeding, specific psychodiagnostic questionnaires for mothers and children. CONCLUSION: A distortion in the communication area can significantly weigh upon the quality of infant-caregiver relationship: our data on mothers of children with a SLD/FD comorbidity confirm this finding by describing their children as prone to isolation and withdrawal, thus directing their efforts and worries to a specifically communicative and relational factor.

Actinosporean stages of Myxozoan parasites of oligochaetes from Nera River basin, Central Italy.

The aim of this study was to check the occurrence of actinosporean stages of Myxozoan parasites of oligochaetes in the Nera River basin (Central Italy). The investigation was conducted near twelve trout farms (rainbow and brown trout) along the Nera River and in the littoral of the Piediluco Lake. Four actinosporean types, belonging to the collective groups aurantiactinomyxon, triactinomyxon, raabeia and echinactinomyxon, were detected in some of the biotopes investigated (Piediluco Lake and Sordo River). Differential diagnosis, carried out on a sub-sample of spores, showed a complete fitting with forms previously described in literature, with the exception of the triactinomyxon type.

Surgical intradiscal decompression without annulotomy in lumbar disc herniation using a coblation device: preliminary results.

Annulotomy is a mandatory step to perform intradiscal decompression to resolve a disco radicular conflict. However, this manoeuvre can lead to post surgical complications such as vertebral instability and back pain. Coblation assisted microdiscectomy (CAM procedure) allows a quoted removal of disc without anulus damage.

AMPA receptor activation regulates the glutamate metabotropic receptor stimulated phosphatidylinositol turnover in human cerebral cortex slices.

The effect of excitatory amino acids (EAA) on phosphatidylinositol (PI) turnover in human cerebral cortical slices was investigated. Trans-1-aminocyclopentane-1,3-dicarboxylic acid (ACPD) increased inositol phosphate (IP) formation in the 1-1000 microM range. Quisqualic acid (QA) was maximally effective at 10-100 microM, showing an inverse correlation between concentration and effect in the 100-1000 microM range. The glutamate metabotropic receptor antagonist 2-amino-3-phosphonopropionic acid (AP3), the ionotropic non-NMDA receptor antagonist 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX) and the NMDA channel blocker dizolcipine (MK-801) failed to prevent the PI response to ACPD (1000 microM). However, CNQX (100 microM) modified the concentration-response curve of QA reducing the effect of QA 10 microM by approx. 50% and enhancing that of QA 1000 microM by 2-fold. In addition, CNQX (100 microM) together with MK-801 (100 microM) unmasked the ability of L-glutamate (L-GLU) 3000 microM to stimulate PI turnover. The effect of alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) on the EAA-induced PI turnover was also studied. AMPA (0.1-1 microM) potentiated the response to submaximal (30 microM) ACPD and (1 microM) QA concentrations. However, higher AMPA concentrations (10 microM) failed to synergize with ACPD 30 microM and, in addition, inhibited the PI turnover maximally stimulated by QA 10 microM. These results further support the presence of the glutamate metabotropic receptor in the human neocortex. In addition, they show the occurrence of a concentration-related dual interaction between AMPA and glutamate metabotropic receptor activation in the IP formation in this brain area.

Inhibitory effect of NMDA receptor activation on quisqualate-stimulated phosphatidylinositol turnover in the human cerebral cortex.

The effect of excitatory amino acids (EAA) on the phosphatidylinositol (PI) turnover in human cerebral cortical slices was investigated. Quisqualic acid (QA) and, to lesser extent, ibotenic acid (IBO) at 10(-5)-10(-3) M increased inositol phosphate (IP) accumulation. L-Glutamic acid (L-glu), kainic acid (KA), alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid and N-methyl-D-aspartic acid (NMDA) were ineffective. NMDA dose-dependently antagonized the QA facilitatory effect. Such inhibition was prevented by the NMDA receptor complex antagonists (+)-5-methyl-10,11-dihydro-5H-dibenzo[a, d]cyclohepten-5,10-imine (MK-801) and by 3[+/-)-2-carboxypiperazin-4-yl)propyl-1-phosphonic acid. The effect of IBO (but not that of QA) was greatly potentiated by MK-801. These data suggest that the EAA metabotropic receptor described in the rodent brain is also present in human cerebral cortex and is negatively modulated by the NMDA receptor.

Noradrenergic modulation of gamma-aminobutyric acid outflow from the human cerebral cortex.

The noradrenergic modulation of endogenous gamma-aminobutyric acid (GABA) outflow from slices and synaptosomes prepared from human cerebral cortex biopsies has been studied. GABA outflow was responsive to depolarizing stimuli such as ouabain and high potassium. Basal GABA outflow in slices, but not in synaptosomes, appeared to be largely dependent upon neuronal activity, being prevented by tetrodotoxin (TTX). 10 mM K(+)-evoked outflow in synaptosomes also proved to be TTX sensitive. Norepinephrine (NE) concentration dependently increased basal GABA outflow both in slices and synaptosomes. This effect was alpha 1-adrenoreceptor-mediated because it was prevented by a selective antagonist of the alpha 1-adrenoreceptor class (prazosin) but not by the alpha 2 antagonist idazoxan. However, an alpha 2-mediated inhibitory modulation was also present in the preparations used, since (1) in slices, NE significantly inhibited GABA outflow in the presence of prazosin; (2) in synaptosomes, NE significantly inhibited 10 mM K(+)-evoked outflow in the presence of prazosin. Both of these effects were prevented by idazoxan. No beta-adrenoreceptor modulation could be demonstrated. A comparison between species was also conducted. The response to ouabain and to TTX proved similar in human, rat and guinea-pig cerebral cortex. In the most simple tissue preparation used (synaptosomes), a close similarity between the three species could be observed. In all species, NE stimulated basal GABA outflow, an effect prevented by prazosin. This suggests a predominant alpha 1-adrenoreceptor-mediated stimulatory effect. In a more complex preparation (slices), differences between species could be demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

Functional role of inducible nitric oxide synthase on mouse colonic motility.

A possible functional role of inducible isoform of nitric oxide synthase (iNOS) was explored in vitro on the motility of mouse distal colon. Using an isotonic - non-isovolumic technique, peristaltic activity and video images of the external wall of colonic segments were recorded before and after addition to the medium of Aminoguanidine (AG) and N-(3-(aminomethyl)benzyl) acetamidine (W1400) [10(-7) M-10(-4) M], two iNOS inhibitors. AG and W1400 induced an hyperexcitability of visceral smooth muscle characterised by an increase of basal tone and spontaneous phasic activity. As a consequence of these effects, the peristaltic activity declined and disappeared at the highest concentrations. These findings indicated a removal of inhibitory action performed by NO synthesised by iNOS in the colonic segment. The implications of results are discussed in term of tonic relaxation of intestinal smooth muscle to allow intraluminal content accommodation.

Primary intrasellar germinoma: case report.

Intracranial germinomas arising primarily within the sella turcica are extremely rare. Preoperative diagnosis is difficult to establish even with sophisticated procedures. Diabetes insipidus is the main clinical manifestation. The authors report a case of an apparently primary intrasellar germinoma causing subclinical pituitary apoplexy in a 12-year-old boy. The transsphenoidal approach and appropriate radiotherapeutic management were employed with a good outcome.

Neuropathy caused by spontaneous intraneural hemorrhage: case report.

A case of ulnar neuropathy at the elbow produced by spontaneous intraneural hemorrhage in a patient with acquired immunodeficiency syndrome and thrombocytopenia is reported. Intraneural hemorrhage in patients with bleeding disorders occurs infrequently. It consists of acute intrafascicular bleeding, presumably producing very high elevations of endoneurial fluid pressure. The clinical features and treatment of this condition are considered, the pertinent literature is reviewed, and the involved pathophysiological mechanisms are discussed.

Perioperative lumbar injection of Ringer's lactate solution in chronic subdural hematomas: a series of 100 cases.

A series of 100 patients underwent surgical treatment for chronic subdural hematomas between 1979 and 1987. The procedure consisted of craniectomy with a 30-mm trephine, irrigation and drainage of the hematoma, laceration of the outer and inner membranes, and lumbar intrathecal injection of Ringer's lactate solution for immediate cerebral reexpansion (average injection, 130 ml). This technique gave the following results: 2% mortality, 2% moderate morbidity, and 96% recovery. The recovery of the patients was rapid, and good outcome was achieved in Grade 3 and Grade 4 cases (Markwalder's classification).

Anterior discectomy without fusion for treatment of cervical lateral soft disc extrusion: a follow-up of 120 cases.

One hundred and twenty patients with soft lateral disc herniation underwent surgery by anterior microsurgical discectomy and routine ablation of the posterior longitudinal ligament between 1976 and 1986. The study excluded patients with hard discs and soft disc extrusion with medullary symptoms. In our series 76.6% of patients were men. In 64% of the patients no causative factor was found. All of the patients presented with cervicobrachialgia; 53% also had a motor deficit. In 91.7% a single disc was involved. The last 40 cases were evaluated by computed tomography alone. In 51.5% an extruded disc was found. No permanent postoperative complication was encountered. All patients returned to their previous activities. Fifty patients underwent follow-up radiological evaluation at 1 and 5 years after the intervention and vertebral fusion was observed in 70% of these.

Benign arterial dissections of the posterior circulation.

Four young adults with spontaneous dissection of the vertebrobasilar system are reported. Clinically, two patients presented with subarachnoid hemorrhage and two with brain-stem ischemia. In two cases of ruptured arterial dissection of the posterior cerebral artery, angiography demonstrated fusiform and "sausage-like" dilatation of the involved vessel. In two cases of occlusive dissection of the basilar artery, angiography revealed the typical "string sign." All four patients were treated conservatively: three survive in good clinical condition and one remains disabled. Follow-up angiograms showed spontaneous healing of the lesion with return to an almost normal arterial configuration in two cases; residual narrowing corresponding to the dissection was the most notable finding in the other two. It is recommended that, in a subset of neurologically stable patients, angiographic monitoring is undertaken to assess the tendency for spontaneous repair before surgical intervention is planned.

Inhibition of peristaltic activity by cannabinoids in the isolated distal colon of mouse.

The effects of the cannabinoid receptor agonist Win 55,212-2 and of the competitive cannabinoid receptor antagonist SR 141716A on the electrically-evoked peristalsis of isolated distal colon of mouse were studied. Intraluminal pressure, longitudinal displacement, ejected fluid volume and changes in morphology of external intestinal wall were simultaneously recorded in the pre-drug period and in presence of Win 55,212-2 alone or in combination with SR 141716A. In the pre-drug period (control), peristaltic activity was characterised by regular, monophasic waves and the intraluminal content propelled towards anterograde (oro-aboral) direction with a propulsion velocity of 1.25 +/- 0.1 mm x s(-1). Pressure and shortening waves showed a peak amplitude of 2.44 +/- 0.32 kPa and 1.8 +/- 0.72 mm, respectively. The mean amount of fluid volume ejected during each contraction was 80 +/- 12.6 microl. The addition of Win 55,212-2 [10(-7)-10(-4) M] to the organ bath determined a dose-related attenuation of peristaltic activity consequent to the decrease of circular and longitudinal muscle strength. The decrease of contractile activity was followed by dose-dependent decrease of the amount of fluid ejected during peristalsis. The effects of Win 55,212-2 [10(-7)-10(-5) M] were prevented by SR 141716A, indicating the presence of cannabinoid CB1 receptors in the mouse distal colon. SR 141716A alone enhanced both tonic and phasic motor activities in the colonic longitudinal smooth muscle, suggesting that CB1 receptor antagonists could act either through antagonising the effect of endogenous CB1 receptor agonist or by an agonist effect on these receptors. The present results further support the hypothesis that cannabinoids perform a neuromodulatory role in various tracts of gastrointestinal system and first demonstrate their action also in the distal colon of rodents.

Benign solitary nerve sheath tumors of the spinal accessory nerve in the posterior triangle of the neck. Report of two cases.

A case of solitary schwannoma and one of solitary neurofibroma originating from the spinal accessory nerve in the posterior triangle of the neck are described. Location of such neoplasms in this region is exceptional. The authors emphasize the importance of accurately enucleating the mass; when it is impossible to preserve the continuity of the neural pathway, nerve repair should be considered.

Stereotactic radioisotope implantations in the treatment of inoperable low malignancy neoplasms.

The authors report their experience of 53 patients with low grade malignancy cerebral neoplasms treated by means of stereotactic 125-I permanent interstitial radiotherapy. The method has been employed from 1981 to date. The authors confirm the validity of the technique in this brief report, and stress the greater efficacy of this treatment in young patients (less than 40 y/o) than in adults.

[Microcompression of Gasser's ganglion. A treatment of essential facial neuralgia. Apropos of 70 cases]. / La micro-compression du ganglion de Gasser. Un traitement de la névralgie faciale essentielle. A propos de 70 observations.

Percutaneous micro-compression of the trigeminal ganglion for trigeminal neuralgia, using the technique of Mullan and Lichtor (1983), with some modifications, was performed during the last five years, in our institution in 70 patients. 97.5% of the patients were initially relieved of their pain. There were 14 recurrences (20.5%). 9 of these patients underwent a second micro-compression with 8 excellent results. The follow up examination 6 to 60 months (average: 16.5 months) showed that 88.5% of the patients were free of pain (54 times after one micro-compression and 8 times after two). Sequellae are: --hypoesthesia: 14.3%, --loss of the corneal reflex without keratitis: 11.4%, --dysesthesias without anesthesia dolorosa: 11.4%. We think that this technique should be the first operation considered for trigeminal neuralgia, in the aged and poor cooperative patients, especially when V1 or V1-V2 pain is present, for symptomatic neuralgia (especially multiple sclerosis), or after recurrences after other procedures.

[Stereotaxic guidance in open surgery of the brain]. / Guidage stéréotaxique de certaines interventions à crâne ouvert.

The authors describe the technique used to precisely locate, before surgical ablation, small superficial or deep seated intracerebral lesions. When they are superficial, a burrhole is placed above the lesional site, that is reconstructed by superimposing the CT image onto a plain film radiogram taken during stereotaxy. Deep seated lesions are localized by inserting a guide under stereotaxy, prior to open surgery, which will lead the neurosurgeon without error from the cortex to the lesion. 37 observations are reported where this technique lead to a greatly simplified intervention with minimal cortical damage.

[Results of percutaneous selective thermocoagulation of Gasser's ganglion in essential facial neuralgia. Synthesis of results obtained in 939 treated patients]. / Résultats de la thermo-coagulation percutanée sélective du ganglion de Gasser dans la névralgie faciale essentielle. Synthèse des résultats obtenus chez 939 patients traités.

The authors report the late results of thermocoagulation of the gasserian ganglion in 939 patients operated by 3 different neurosurgical teams, (Bologna, Bordeaux, Marseille). It has been assessed that the results are comparable among the 3 teams and that percutaneous selective thermocoagulation represents a simple and low-risk technique with a high rate of efficacity.