Medicine and science in the life of Luigi Galvani (1737-1798).

Together with its companion paper, dealing with the contribution of Luigi Galvani to the history of electrophysiology, this article provides a biographical sketch of the scientist of Bologna in the occasion of the bicentenary of his death. Studies on Galvani have focused mainly on his "discovery" of animal electricity, and on the controversy with Alessandro Volta. Much less is known about Galvani's life and activity as a teacher, physician, and researcher in the fields of comparative anatomy, physiology, and chemistry of life. Yet, a balanced assessment of the significance and the role of Galvani's research in the history of science will be possible only after a historical reconstruction of his entire activity. This should take into account aspects of Galvani's life that have been little studied up to now: Galvani's scientific background, the scientific context in which his interest for muscular physiology arose, the interplay between his activity as a researcher and as a physician, the origin and characteristics of his experimental approach to biological studies, and the development of his experimental research in the crucial period culminating in his electrophysiological explanation of muscular motion. The present article aims at offering a contribution in this direction.

[Comparative clinical study of a new imidazole molecule (fluconazole) and ketaconazole in the treatment of Candida albicans vulvovaginitis]. / Studio clinico comparato tra una nuova molecola imidazolica (fluconazolo) e il ketoconazolo nella terapia della vulvovaginite da Candida albicans.

A multicentre trial was carried out in Italy with the aim of comparing the efficacy, safety and tolerability of the oral administration of fluconazole with the oral administration of ketoconazole in the treatment of patients affected by Candida vulvovaginitis. A total of 174 patients with symptomatic Candida vulvovaginitis were identified both by objective examination and cell culture tests: of these 87 were treated using a single oral administration of fluconazole (150 mg) whereas the other 87 received 2 200 mg capsules of ketoconazole daily for 5 days. Tests to assess the efficacy, safety and tolerability of both treatments were carried out approximately 7 days and 5-6 weeks from the start of therapy. The results obtained showed a success rate of 92% for fluconazole-treated patients and 83% for those treated with ketoconazole. In addition to the rapid and safe efficacy of treatment, the most important findings which emerged from this study were the extreme simplicity of use, excellent patient compliance and the complete absence of collateral effects of variations in the hematochemical and urine parameters taken into consideration caused by fluconazole.

Preterm labour and neonatal parameters.

OBJECTIVES: Our objective was to identify those neonatal factors associated with survival in preterm infants. MATERIAL AND METHODS: We examined a population of 457 preterm newborns delivered between 1 January-31 December 1990, with birthweight between < 1000 gr and > 2000 gr, in respect to umbilical pH values, plasmatic glucose values, 5-minute Apgar score and gestational age. Data were abstracted from the maternal intrapartum records and the neonatal records, with specific attention to neonatal parameters. RESULTS: A positive correlation between birthweight and 5-minute Apgar score, between birthweight, pH and glucose values was noted. No such relationship existed between pH values and 5-minute Apgar score. Within birthweight groups the distribution of neonatal mortality rate was 85.18% in ELBW (Extremely Low Birth Weight) and only 5.26% in LBW (Low Birth Weight). CONCLUSION: The importance of the echographic estimate of the fetal weight must be emphasized, since a birthweight of 1500 gr represents the cut-off for the neonatal morbidity and mortality, and also an accurate clinical evaluation of the risk of preterm labour or pathologies in order to improve the estimate of childbirth timing.

Prognostic value of biophysical profile score in post-date pregnancy.

OBJECTIVES: This study was undertaken to assess the ability of each individual biophysical profile score variable and combination of variables, to predict fetal distress or imminent labor in the post data pregnancy. MATERIALS AND METHODS: From June 1992 to August 1993, Biophysical Profile Scoring (BPS) was performed on 182 pregnant women. Thirty one patients delivered between 42 and 43 weeks of gestation, while the other 151 pregnant women delivered between 38 and 41+6 days. Monitoring procedures were based on the evaluation of fetal heart rates by Non Stress Test and four ultrasound parameters: Fetal Tone; Gross Body Movements; Fetal breathing movements; Evaluation of amniotic fluid volume. RESULTS: In this analysis the BPS showed a high specificity (82.7%) with a negative predictive value of 100%. The mean value of the last BPS among the 151 term patients was significantly higher if compared with the 31 post term pregnant women (6.73 and 6.12 respectively with p < 0.05). The predictive value of Fetal Breathing Movements (FBM) for the onset of imminent labor was confirmed. CONCLUSION: BPS, as measured in this study, has proved to be a very accurate method of determination of fetal well-being. Although these results will be further verified by other studies, BPS should come into general use to help reach the correct diagnosis and treatment of post date pregnancy.

[Therapy and iron supplements with ferritin iron during pregnancy. Randomized prospective study of 458 cases]. / Terapia e supplemento marziale con ferro ferritinico durante la gravidanza. Studio prospettico randomizzato di 458 casi.

A randomized polycentric study was programmed to establish the effects of daily administration of ferritin iron from early pregnancy to puerperium. 254 women with normal iron balance at the beginning of their pregnancy were randomized receiving no supplements or 40 mg iron daily. At the end of pregnancy iron balance was still normal only in one third of the pregnant women of the first group versus two third of the second group. 204 women who were iron-deficient received daily 40 or 120 mg of iron; in this group anemia developed less frequently (13% versus 29%) and iron balance normalized in one subject on four; the great majority of these women remained iron-deficient. Unwanted effects of minimal or mild relevance, and almost always sporadic were observed in 6.5% of cases and with the reduction or withdraw of the treatment in only 1.4% of cases. These results showed that daily administration of ferritin iron during pregnancy is effective and well tolerated; furthermore they suggest that the treatment must be done with at least 60 mg daily in women with normal iron balance and protracted also after the puerperium in iron deficient subjects.

Cell-mediated immunity imbalance in pregnancy-induced hypertension.

Pregnancy is associated with modifications in the maternal immune system that may be involved in the absence of rejection of the fetoplacental graft characterized by the presence of paternal antigens. This active and specific tolerance towards the fetoplacental unit seems to be compromised in pregnancy-induced hypertension (PIH). To evaluate whether the immunological state in patients with PIH is altered with respect to normal pregnant women we studied 15 patients with PIH, 15 uncomplicated pregnant and 10 healthy nonpregnant women using monoclonal antibodies directed to specific lymphocyte antigen determinants, cytokines (TNF) and soluble molecules (sIL-2R, sCD8). The percentage of CD4 lymphocytes and of natural killer (NK) cells was significantly higher in PIH patients compared to controls (CD4: 42.9 +/- 10.5 vs. 32.7 +/- 12.5%; p < 0.05; NK: 14.7 +/- 6.3 vs. 8.3 +/- 3.4%; p < 0.01). However, these values did not differ when compared to normotensive nonpregnant controls (CD4: 53.1 +/- 5.9%; NK: 17.2 +/- 7.1%). In addition, the soluble IL-2 receptor (sIL-2R) was higher in PIH patients when compared to control patients (725.5 +/- 194.2 vs. 482.5 +/- 187.2 U/ml; p < 0.01). The immune response observed in normal pregnancies responsible for the tolerance towards the fetoplacental unit seems to be altered in PIH patients as suggested by higher levels of CD4 and NK cells, and sIL-2R. This may lead to a chronic rejection syndrome and be involved in the pathophysiology of PIH.

Amniotic fluid insulin and glucagon in normal pregnancy and pregnancy complicated by rhesus isoimmunization.

Immunoreactive insulin (IRI) and immunoreactive glucagon (IRG) were determined in the amniotic fluid from 28 rhesus isoimmunized pregnancies with moderately affected fetuses and from 15 normal pregnancies; in umbilical arterial plasma from nine newborn infants with rhesus haemolytic disease of moderate degree and from 19 normal infants; in plasma from their respective mothers at delivery; and in the urine of 13 normal infants at birth. Levels of IRI and IRG in amniotic fluid from rhesus cases were not different from those of normal pregnancies. IRG was detected in the first voided neonatal urine.

[Flunitrazepam anesthesia and voluntary abortion in the first trimester (author's transl)]. / L'impiego del flunitrazepam nell'anestesia per l'interruzione volontaria della gravidanza (IVG) nel primo trimestre.

PIP: Intravenous flunitrazepam was used for 300 patients undergoing voluntary abortion by vacuum aspiration. 3 hours after the operation, all patients were completely conscious and able to leave the ward. 96.6% (288 subjects) had no memory of the procedure. Side effects were minimal and mild. Thus, this type of anesthesia is considered suitable in this type of surgery. (author's modified)^ieng