[Nutrition knowledge of Sardinian and Corsican university students]. / Conoscenze nutrizionali degli studenti universitari sardo-corsi.

The aim of this work was to evaluate the knowledge of Dietary Guidelines of university students in Sardinia and in Corsica. A nutrition knowledge questionnaire was administered to 566 university students, 141 from Corte University and 425 from Cagliari University. Sardinian students scored higher on the sections of the questionnaire about the recommended food intake, the sources of nutrients and the links between diet and disease, the best food choices to keep and to promote health. Corsican students were more trained to specify the best food choices to reduce the amount of fat, salt and sugar. In both countries females scored higher than males did, showing a greater nutrition knowledge. Obtained results from this work confirm the need of a wider and deeper diffusion of the Dietary Guidelines for a healthy diet, so that it is possible to reach more healthful dietary choices and to plan the aimed educative interventions to bridge the gaps.

Poor reliability of heart rate monitoring to assess oxygen uptake during field training.

The aim of this study was to quantify the error associated with the assessment of oxygen uptake (VO2) by heart rate (HR) monitoring in 15 athletes freely performing their training session. A laboratory-derived equation was used on the running track to calculate VO2 (VO2est) from HR. Oxygen uptake was also assessed by means of a portable gas analyzer (VO2real). Bland and Altman statistics were carried out in order to evaluate agreement between VO2real and VO2est. The excess in carbon dioxide production (CO2excess) was measured to test the hypothesis that the subject with the highest CO2excess had the highest VO2est - VO2real difference. VO 2real was on average 0.14 l x min (-1) below VO2est. The limits of agreement of this difference were between + 0.77 and - 0.48 l x min (-1). Thus, on average VO2real was overestimated by VO2est. Spearman non-parametric statistics found a significant correlation between CO2excess and VO2est - VO2real difference (R = 0.55, p = 0.031). This study demonstrates that the use of HR monitoring to assess VO2 during field training overestimates VO2real, especially when a substantial increase in CO2excess occurs. Therefore, this method should be used with care when an excessive amount of CO2 is produced as occurs in activities that involve the lactic acid anaerobic source of energy production.

[Prevalence of rheumatoid arthritis in North Sardinia: the Tempio Pausania's study]. / Prevalenza dell'artrite reumatoide nel Nord Sardegna: lo studio di Tempio Pausania.

OBJECTIVE: To estimate the prevalence of rheumatoid arthritis in an Italian general population. METHODS: The study was conducted in the years 2002-2003 in Tempio Pausania's health district located on the North Sardinia and involved 30264 subjects aged 18 years or more treated by 29 general practices (GP). The GP was contact first by phone and letter and secondly a Rheumatologist administered a structured interview that included a screening questionnaire for RA. Cases were defined by the 1987 American College of rheumatology criteria adapted to epidemiological surveys. Every cases were examined by Rheumatologist and General practices together. The age and sex distribution of the sample were similar to those of the Italian population from the 2001 census. RESULT: Of the 141 subjects who fulfilled the inclusion criteria, there were 113 women and 28 men, with a mean age at diagnosis of 45 years. The prevalence of RA was 0,46% in the general population, 0,73% in women and 0,19% in men. CONCLUSION: Our results suggest that the prevalence of RA is comparable to that reported in other Mediterranean countries. Women are more affected than men. Our prevalence is higher than that observed in Chiavari in 1992.

[Diagnostic and prognostic value of antibodies to cyclic citrullinated peptide (Anti-CCP) in rheumatoid arthritis]. / Il significato diagnostico e prognostico degli anticorpi anti-peptide citrullinato ciclico (Anti-CCP) nell'artrite reumatoide.

There is strong evidence that the determination of autoantibodies against filaggrine is a very useful tool for the diagnosis of rheumatoid arthritis (RA). Anti-cyclic citrullinated peptide antibodies (Anti-CCP)-ELISA appear to be the most efficient test among those available for the detection of antifilaggrine autoantibodies, as it has the best diagnostic accuracy for the diagnosis of RA. Furthermore, the anti-CCP-ELISA determination in early arthritis is a good predictor of disease persistence and radiographic joint damage. The positivity of Anti-CCP some years before the onset of the RA and the high concentration of autoantibodies in synovial fluid suggest a possible pathogenetic role of citrullination. However, at present, it is unclear whether anti-CCP antibodies have a better diagnostic performance than rheumatoid factor in recent onset synovitis and if they confer any additional value to the prognostic evaluation obtained with validated predictors of outcome (FR, joint count, duration of disease).

[Chronic polyarthritis in a patient affected by sarcoidosis and chronic HCV infection. Case report and review of the literature]. / Poliartrite cronica in un caso di sarcoidosi ed epatopatia HCV correlata. Descrizione di un caso clinico e revisione della letteratura.

Sarcoidosis is a systemic granulomatous disease of unknown etiology that has a wide variety of clinical manifestation. Lung involvement may slowly undergo pulmonary fibrosis. Chronic sarcoid arthritis is a rare, usually non destructive arthropathy; may be a mono, oligo or polyarthritis. Knees, ankles, shoulders, wrists and small joint of the hands and feet may be involved. It can involve skin, eyes, exocrine glands such as salivary and lacrimal glands, and many other tissues. We describe the case of a 77 years old woman with a history of rhinopharyngitis with epistaxis and chronic laryngitis since youth; a dry mouth and throat, a erythematous, infiltrative skin lesion in the forehead and in the nape of the neck, a purple lesion of the left ear and nose, skin dystrophy of the hands from 30 years before. She underwent an operation for a left femoral fracture with hemotransfusion 14 years ago. Then she developed a polyarthritis of the small joints of the hands (II, III and IV right DIP, I, III, e V left DIP; III and V bilateral PIP), knees, tarsi, toes and left elbow. An HCV chronic hepatitis was discovered 6 years before. She is affected by productive cough, dysphonia, dyspnoea at rest, fever, headache and asthenia for over 5 years. Laboratory examination revealed leukopenia, HCV hepatitis with anti HCV, HCV-RNA, transaminases elevated and cryoglobulinemia. HCV may be involved in the etiopathogenesis of rheumatic diseases, lung fibrosis and may moreover contribute to the onset or progression of sarcoidosis; the possible pathogenesis is discussed.

Kelley-Seegmiller syndrome in a patient with complete hypoxanthine-guanine phosphoribosyltransferase deficiency.

Different degrees of hypoxanthine guanine phosphoribosyltransferase (HPRT) deficiency are associated with hyperuricemia, uric acid nephrolithiasis and severe gout. Up to 25-30% of HPRT deficient patients, indicated as neurological variants or HPRT-related hyperuricemia with neurological dysfunction (HRND), may develop neurological manifestation, from mild to severe; the most serious ones manifesting in the devastating Lesch-Nyhan syndrome, characterized by choreoathetosis or self-mutilation. Here we present a 30 years old male patient suffering from gout and mild psycho-motor impairment without Lesch Nyhan disease despite severe HPRT deficiency residual activity 0.02% with hypoxanthine, no activity at all with guanine as a substrate. The Curto's theory that neurologic impairment is dependent on VGPRT/VHPRT ratio is not confirmed by our observations. The finding of such a severe HPRT deficiency in a non-Lesch-Nyhan patient needs further investigation. G6PD deficiency was also referred together with beta-thalassemic trait. We have studied purine and pyridine nucleotide metabolism in the erythrocytes and discussed the literature. The bone marrow sample shows a megaloblastyc aspect.

Urinary glycosaminoglycans in patients with systemic lupus erythematosus.

OBJECTIVE: Several investigations indicate that glycosaminoglycans (GAG) are important components of the glomerular basement membrane (GBM) and that they play a remarkable role in the control of charge-selectivity in the glomerular capillary wall. In order to evaluate the possible use of GAG as a marker of glomerular disease, we evaluated urinary GAG excretion in 37 patients with systemic lupus erythematosus (SLE) grouped by disease activity and kidney involvement and in 17 healthy controls. METHODS: GAG were isolated from urine by using ion-exchange chromatography on DEAE Sephacel. GAG composition was determined by cellulose acetate electrophoresis and expressed as relative percentages by densitometric scanning of Alcian Blue stained strips. RESULTS: Total GAG levels were significantly increased only in active extra-renal SLE patients. Qualitative analysis of urinary GAG revealed the presence of a low sulphated chondroitin sulphate-protein complex (LSC-PG), whose frequency was higher in patients compared to controls. Moreover, inactive SLE was characterized by an alteration of the chondroitin sulphate/heparan sulphate ratio. CONCLUSION: These variations suggest the presence of an abnormal permeability of the renal filter in patients without other appreciable signs of kidney alteration. Therefore, qualitative-quantitative urinary GAG analysis could represent an additional diagnostic approach.

Multicenter study of the safety/efficacy of misoprostol in the prevention and treatment of NSAID-induced gastroduodenal lesions.

Gastrointestinal symptoms and lesions are often associated with the clinical use of non-steroidal antiinflammatory drugs (NSAIDs). An open-label, single arm multicenter Italian study evaluated if misoprostol, a prostaglandin E1 analogue with gastroduodenal mucosal protective activity, was effective in the prevention and treatment of NSAID-induced gastroduodenal lesions. Patients affected by rheumatoid arthritis (RA) or osteoarthritis (OA), in treatment with NSAIDs and suffering from gastric symptoms or gastroduodenal lesions related to NSAID use, were admitted to the study. Gastrointestinal and arthritic symptoms were assessed before and after 4 weeks co-administration of an NSAID (the most frequent was diclofenac, used in 35% of the RA and in 22% of the OA patients, followed by piroxicam and tenoxicam respectively) + misoprostol (200 mcg two times daily in 58% of the cases, 200 mcg three times daily in 39%, 200 mcg four times daily in 3%). On admission and after 4 weeks of therapy a gastrointestinal endoscopy was performed to evaluate the condition of the gastroduodenal mucosa. Final results showed that: (i) NSAID-related gastric lesions were more frequent than duodenal lesions; (ii) when patients were given misoprostol and NSAIDs, 96% of them did not develop gastric lesions and 97% did not develop duodenal lesions; (iii) even when NSAID therapy was continued, gastric or duodenal lesions induced by NSAIDs healed or in any case did not worsen in 92% and 91% respectively of the cases; (iv) during the period of coadministration of NSAIDs+misoprostol, NSAID-related UGI symptoms disappeared or improved in 77% of the cases.(ABSTRACT TRUNCATED AT 250 WORDS)

[Gamma-glutamyltransferase and alcohol consumption in primary gout]. / Gamma-GT e consummo di alcool nella gotta primitiva.

The behaviour of gamma-GT, an enzyme whose activity is related with alcohol intake, was studied in three groups of patients with primary gout, divided on the basis of alcohol intake. Poor drinkers (A) and good drinkers (B) do not show significant differences in the serum levels of gamma-GT, uric acid and triglycerides. The above parameters are highest in the group of strong drinkers (C), in which the increase in serum gamma-GT activity is statistically significant and reaches values above the normal range.

Effects of long-lasting stimulation of extensor muscle nerves on pulmonary ventilation in cats.

Increments in pulmonary ventilation were shown to occur in anaesthetized cats during long-lasting stimulation of a peripherally cut extensor muscle nerve at maximal intensity for group I afferent fibers. However, these increments tended to gradually adapt to a lower value when stimuli were delivered at high frequency and constant rate whereas a tendency to potentiation, up to a steady state, occurred when stimulation was intermittent. End-tidal PCO2 initially decreased with a tendency to adaptation in the case of continuous stimulation, and decreased progressively in the case of intermittent stimulation. It is concluded that the nervous mechanisms producing hyperpnoea exhibit fatigue during their constant excitation while their effects sum up during intermittent stimulation.

Respiratory responses to stimulation of large fibers afferent from muscle receptors in cats.

Experiments were carried out on cats to re-examine the respiratory effects of the stimulation of the large afferent fibers originating in the receptors of the hindlimb muscles. During the contraction of the triceps surae induced by stimulating the ventral roots, pulmonary ventilation increased due to an increase in tidal volume and, usually, in respiratory frequency. An increase in ventilation occurred also during stimulation at group I strength of the central end of the previously cut nerves to the triceps surae (LGS + MG) and to the posterior biceps plus the semitendinosus (PBST) muscles. Appreciable increase in ventilation was seen for stimuli near threshold for group I (Ia + Ib) afferent fibers of the LGS + MG nerves, while stimuli at group Ib strength were needed to produce the same effects when using the PBST nerves. It is concluded that group Ib fibers afferent from muscle receptors play a role in the reflex control of respiration.

[Behavior of plasma and urinary cAMP after intravenous fructose load]. / Comportamento dell'AMPc plasmatico e urinario dopo carico endovenoso di fruttoso.

Increased excretion of uric acid and cAMP has been observed in many pathological conditions in man, but interrelation between behaviour of uric acid and cAMP is not well known. To investigate these aspects of purine metabolism the authors have studied behaviour of plasma and urinary cAMP in 8 subjects after intravenous rapid load of fructose (0.5 g/Kg b.w.) compared with the uric acid one. The results have shown that urinary excretion of cAMP after load of fructose is increased, but levels of plasma cAMP remain unchanged. These data confirm consensual relation between urinary uric acid and cAMP excretion, but the exact mechanism of this relation remains unexplained.

[Acute Candida arthritis. Isolation of Candida krusei in a heroin addict]. / Artrite acuta da Candida. Isolamento di Candida krusei in un eroinomane.

Candida arthritis in men is very rare. In most cases Candida albicans is isolated from joints (commonly the knee) of immature infants or of immunodeficient subjects without underlying joint disease; Candida non albicans is isolated from joints of immunodeficient patients with underlying joint disease. A case of Candida arthritis in a heroin addict is described. This is the second report of Candida arthritis in a heroin addict, but it is the first in which Candida krusei has been isolated.