Low levels of natural killer cells in pregnant women transmitting Toxoplasma gondii.

The role of cell-mediated immunity in the maternal-fetal transmission of Toxoplasma gondii was investigated in 17 pregnant women with primary T. gondii infection, in 7 of whom fetal infection occurred. 18 healthy pregnant women were followed-up as controls. Fetal outcome was uneventful in six women who were treated early in pregnancy with spiramycin, while stillbirth due to T. gondii encephalitis occurred in the offspring of one patient who started with therapy at 34 weeks' gestation. All patients who transmitted T. gondii showed significant changes in the mean levels of immune cells. The most prominent finding was a significantly lower level of natural killer (NK) cells in the mothers transmitting T. gondii to the fetus compared with non-transmitters and controls both in the number (99.7 (71.8-107.5)/microl versus 320.9 (307.9-356.4)/microl and 172.1 (122.4-213.3)/microl: median (25 degrees-75 degrees). p<0.001) and the percentage of NK cells (4.0+/-1.5 per cent versus 13.2+/-2.3 per cent and 10.2+/-3.4 per cent; mean+/-SD, p<0.001). Although limited by the small number of patients, our data suggest that the assessment of NK cells may be considered as a prognostic marker of primary T. gondii infection in pregnancy.

Bone mass density in post-menopausal women.

OBJECTIVES: To evaluate the effect of age, years since menopause and body weight on bone mass density (BMD) in 283 patients. METHODS: Bone mass density was assessed by bone computerized mineralometry at two sites of the forearm. RESULTS: The mean distal BMD and ultra BMD in the postmenopausal group were negatively correlated with age (P < 0.001, r = -0.48 and P < 0.001, r = -0.50, respectively) and years since menopause (P < 0.001, r = -0.32 and P < 0.001, r = -0.33, respectively). When body-mass index was regressed against distal and ultra distal BMD, positive correlations were found (P = 0.008 and P = 0.007). CONCLUSIONS: From our data, forearm computerized mineralometry seems to be a reliable method for the evaluation of the effects of age and body-mass index on bone mass.

Differences in erythrocyte membrane cholesterol to phospholipids ratio in postmenopausal women with and without hormone replacement.

OBJECTIVES: To investigate the changes in the cholesterol:phospholipids (C/PL) ratio of erythrocyte membrane in post-menopausal women with and without hormone replacement therapy (HRT). STUDY DESIGN: A cross-sectional study including 83 patients divided into three groups according to HRT (group 1, no HRT (n = 52); group 2, combined HRT (n = 16); and group 3, estrogen-only therapy (n = 15)). RESULTS: The C/PL ratio was lower in group 2 with respect to group 1 and group 3 (P = 0.03). No difference was found in erythrocyte membrane cholesterol between the three groups; however, the phospholipid concentration was higher in group 2 with respect to the other groups (P < 0.05). In the control group, C/PL values correlated positively with plasma LDL levels (P < 0.005) and negatively with HDL levels (P < 0.005). CONCLUSIONS: From our data the addition of progestogens in HRT appears to decrease the C/PL of the erythrocyte membrane possibly resulting in a beneficial effect on rheological properties of erythrocyte membrane. The results of our study thus suggest additional benefits from supplementation of progestogens in HRT, in addition to prevention of estrogen dependent endometrial hyperplasia and adenocarcinoma.

[Treatment of chronic inflammation of the upper respiratory airways by inhalation thermal therapy with sulfur-sulfate-bicarbonate- carbonate-alkaline earth mineral water: a study of nasal cytology]. / Trattamento delle flogosi croniche delle vie aeree superiori con crenoterapia inalatoria solfureo-solfato-bicarbonato-carbonica-alcalinoterrosa: studio della citologia nasale.

The purpose of the paper is to better characterise changes occurred in nose cytology in a group of 50 subjects affected by chronic inflammation of upper respiratory airway. The patients were random shared in two groups: group A 40 subjects treated using sulphurous thermal water and a group B (control), 10 cases, treated using placebo saline solution. The post-therapy evaluation of nasal cytology showed an improvement of the chronic inflammation in 65% of group A patients (diminution of bacterial dust 65%, diminution of PMN cells in 60% of cases and disappearance of metaplasy notes in all the cases of group A. No statistical modifications were observed in control group. Moreover were observed a increase of plasma-cell number much more in group A. The author conclusion is that a period of thermal therapy using sulphur-sulphate-alkaline-earth metals water in chronic inflammation of the nose, throw pharmacological and physical actions, cause an improvement of the chronic inflammation and a normalisation of nose cytology.

An obstetric and neonatal study on unplanned deliveries before arrival at hospital.

OBJECTIVE: To establish the prevalence of unplanned deliveries before arrival at a big metropolitan hospital and to determine the demographic characteristics of the group of women at risk of delivering before arrival. DESIGN: A random case control study. Each baby born before arrival and its mother were compared to the next baby born in the same Department. SUBJECTS: All babies born before arrival at the Department of Obstetrics and Gynecology, University "La Sapienza" in a 10 yr. period (Jan 1983-Dec 1993). RESULTS: Of 27,274 consecutive deliveries in the study period, 22 (0.8%) babies were born before arrival at hospital. Of the 22 women who delivered before arrival, 16 were Italian, 5 were considered nomad (no fixed address) and one was a Polish tourist. No statistical difference was found between groups regarding maternal age, parity, gestational age, birth weight and immediate delivery complications. No mortality cases were observed in the study or control group. Neonatal stay in the neonatal ward was longer in the study group (6.5 vs 3.5 days, P < 0.001). Hypothermia was the highest morbidity (P < 0.001) and neonatal complications were more prevalent in babies delivered before arrival than in-born babies (P < 0.001). CONCLUSIONS: Delivery before arrival to hospital does not seem to carry a higher neonatal mortality risk. However, the prevalence of complications was higher in such babies, with hypothermia being the highest morbidity.

[Early signs of occupational ototoxicity caused by inhalation of benzene derivative industrial solvents]. / Studio dei segni precoci di ototossicità professionale da inalazione di solventi industriali derivati dal benzene.

People exposed to industrial solvents may suffer from disturbances of different psycho-physiological and vestibulo-oculomotor function. Therefore an investigation was performed testing vestibular and oculomotor reactions in workers exposed to solvents. It also seemed to be of interest to study if the auditory pathways were affected in these workers. 53 men aged 27-54 (Md = 37.7) were studied. They had been exposed to aromatic solvents in their work as colour mixers, painters, printers and petrol truck drives. Time of working was between 4-25 (Md = 15.2) years. At the time of this investigation none of the men had been exposed to solvents for at least the last four years. The clinical investigation included cerebellar tests and a general ENT investigation. Electronystagmography was performed and comprised the following functions: 1) spontaneous and caloric vestibular tests; 2) a sinusoidal swing test in darkness, the patient sitting in a rotatory chair; 3) visual suppression test; 4) a saccade test; a slow pursuit eye movement test. In addition all the patients were subjected to an audiological test battery including pure tone threshold, conventional vocal audiometry, speech discrimination used interrupted speech 10 interruptions per second, acoustic reflex thresholds and reflex decay. The clinical investigation showed in 19 patients balance problems in the balance test. The sinusoidal test was normal in all cases. The caloric test showed 8 cases of asymmetry in vestibular reactions. 10 of the patients had pathological spontaneous nystagmus. 17 of the patients had a pathologically decreased ability for visual suppression. The saccades were abnormal in 25 patients. The patients who were subjected to audiological testing all had pure tone thresholds and conventional vocal thresholds as expected with regard to age. 31 patients showed decreased discrimination scores at the interrupted speech. The acoustic reflex thresholds were normal and there was not pathological reflex decay. Results show the prevalently pathologic concern for C.N.S. Authors, last, give prominence to the significant relationship between the exposure time to solvents' vapour and changing of several parameters, connection conditioned by constitution and life habits in predisposing workers to a greater susceptibility at damages caused by organic solvents.

[Otomycosis: a microbiological study of 147 cases of otitis externa]. / Otomicosis: estudio microbiologico sobre 147 casos de otitis externa.

An accurate and systematic myco- and bacteriological appraisal of each case, should comport the lowering of wrong diagnosis and also therapeutic failures in those patients. The target of the AA. is to verify the frequency and the identification as well, of bacteria and/or fungi, unique or in association, responsible for the otitis. And the objective is to start with the most appropriate treatment in spite of the laboratory answer and also to schedule a laboratory protocol to follow in suspected cases of otomycosis.

[Secretory otitis media: current aspects and therapeutic role of adenoidectomy]. / Otite media secretoria: aspetti attuali e ruolo terapeutico della adenoidectomia.

The prognostic influence of adenoidectomy on the clinical course of secretory otitis media (S.O.M.) was evaluated in 46 children with abnormal tympanometry, i.e. a flat curve (type B tympanogram) or a middle ear pressure less than 100 mm H2O (type C tympanogram). The children were divided by randomized, blind allocation into one group of 22 subjected to myringotomy with adenoidectomy and another group of 24 subjected to myringotomy without adenoidectomy. All 46 children were followed up by impedance audiometry, pure tone audiometry and otomicroscopy 1, 3, 6 and 15 months after surgery. No significant differences were found between the two groups. Possible pathogenetic mechanisms leading to the development of S.O.M. in the presence of large adenoids are discussed.