P594Contrast transthoracic echocardiography as a gatekeeper for patent foramen ovale closure.

BACKGROUND.: The presence of patent foramen ovale (PFO) has been linked to many illness, including cryptogenic stroke, transient ischemic attack, migraine, platypnea-orthodeoxia syndrome and decompression sickness in scuba divers. Transesophageal echocardiography is the gold standard technique for the visualization of atrial septal anatomy, but it is a secondary level exam, not always available, with additional associated costs and not completely free from procedural risks. Standard transthoracic echocardiography (TTE) has a too low sensitivity for PFO screening. PURPOSE.: The aim of the study was to assess the role of TTE associated with agitated saline contrast injection (contrast-TTE) as a gatekeeper for the identification of PFO in a large cohort of patients undergoing selection for percutaneous closure. METHODS.: A total of 200 patients undergoing a diagnostic work-up for the identification of PFO was imaged by contrast-TTE at rest and after provocative maneuvers (PM: Valsalva in all cases). Contrast TTE was graded from 0 to 4 on the bases of bubbles counting (0: no bubbles; 1: < 10 bubbles; 2: 10-30 bubbles; 3: >30 bubbles; 4: complete LV opacification). PFO closure was performed after a consensual clinical decision by the cardiologist and the neurologist taking into account comprehensive imaging, clinical evaluation and thrombophilia screening. PFO closure was always monitored by intracardiac echocardiography. RESULTS.: At baseline contrast TTE was positive (≥2) in 34 patients (17%) while contrast TTE with PM was positive in 94 cases (47%). 27 out of 200 patients (14%) had an interatrial septal aneurysms. PFO closure was performed in 34 cases (17%). All of these had severe right-to-left shunting (≥3) at contrast TTE and 9 cases had also an interatrial septal aneurysms. The procedure was aborted in only 1 patient due to a complex defect anatomy. CONCLUSION.: Contrast TTE with PM may be not only considered an accurate tool for the detection of PFO but may be also inserted in the diagnostic work- up as a primary gatekeeper for percutaneous closure. Severe shunting at contrast TTE influences final decision making in a large cohort of cases undergoing screening for PFO closure.

Interactions of water stress and solar irradiance on the physiology and biochemistry of Ligustrum vulgare.

We studied the interactive effects of water stress and solar irradiance on physiological and biochemical traits in Ligustrum vulgare L., with special emphasis on antioxidant enzymes and flavonoids. Water relations, photosynthetic performance, plant growth, activities of antioxidant enzymes and of phenylalanine-ammonia-lyase, and concentrations of nonstructural carbohydrates and phenylpropanoids were measured in plants growing in 12% (shade) or 100% (sun) sunlight and supplied with 100 or 40% of daily evapotranspiration-demand over a 4-week period. The mild water stress treatment caused leaf water potential and relative water content to decline on average by -0.22 MPa and 4.5%, respectively. In response to the water stress treatment, photosynthetic rates decreased more in sun plants than in shade plants, likely because of declines in photosystem II photochemistry, apparent maximum rate of carboxylation and apparent maximum electron transport rate coupled with significant reductions in stomatal conductance. Antioxidant enzymatic activities, which were much greater in sun leaves than in shade leaves under well-watered conditions, increased (particularly the enzymatic activities associated with hydrogen peroxide removal) in response to water stress only in shade leaves. Antioxidant phenylpropanoids, particularly quercetin and luteolin derivatives, markedly increased in response to full sunlight irrespective of water treatment; however, antioxidant phenylpropanoid concentrations increased in response to water stress only in shade leaves. We suggest that: (1) assimilated carbon in sun plants was used largely to support an effective antioxidant system capable of countering water-stress-induced oxidative damage--an example of cross tolerance; and (2) in shade plants, carbon was also diverted from growth to counter oxidative damage driven by the mild water-stress treatment. Both findings are consistent with the nearly exclusive distribution of L. vulgare in well-watered, partially shaded Mediterranean areas.

Effect of rootstocks and harvesting time on the nutritional quality of peel and flesh of peach fruits.

The influence was evaluated of four rootstocks (Ishtara, Mr. S 2/5, GF 677 and Barrier 1) and of harvesting time (early, middle, late) on the quality characteristics and nutritional value (vitamin C, phenols, carotenoids, total antioxidant capacity) of 'Flavorcrest' peach. The better rootstocks were Mr. S 2/5 (low-vigour) and Barrier 1 (high-vigour). In particular, Flavorcrest fruit on Mr. S 2/5 and on Barrier 1 rootstocks had higher antioxidant capacities and also higher phytochemical content, although fruits on Mr. S 2/5 were less firm. Flesh firmness was best for fruits at mid-harvest (H2, 7 July 2006), whereas phytochemical contents were best at late harvest (H3, 13 July 2006), when, for all rootstocks, the best nutritional characteristics were also recorded. Total antioxidant capacity and phytochemical content were determined for the peel and flesh. The results show that removal of peel from peach results in a significant loss of total antioxidant capacity.

Biochemical study of leaf browning in minimally processed leaves of lettuce (Lactuca sativa L. var. acephala).

A series of biochemical parameters, including the concentration of total ascorbic acid (ASA(tot)) and the activities of phenylalanine ammonia lyase (PAL), polyphenol oxidase (PPO), and peroxidases (PODs), was investigated during cold storage (72 h at 4 degrees C in the dark) in fresh-cut (minimally processed) leaves of two lettuce (Lactuca sativa L. var. acephala) cultivars differing in the susceptibility to tissue browning: Green Salade Bowl (GSB), susceptible, and Red Salade Bowl (RSB), resistant. The two cultivars showed differences also at the biochemical level. The content in ASA(tot) increased in RSB, as a consequence of increased DHA concentration; conversely, ASA(tot) diminished in GSB, in which ASA was not detectable after 72 h of storage, thus suggesting a disappearance of ascorbate (both ASA and DHA) into nonactive forms. The antioxidant capacity (as determined by using FRAP analysis) decreased significantly during storage in RSB, while a strong increase was observed in GSB. PAL activity increased soon after processing reaching a maximum by 3 h, then it declined to a relatively constant value in RSB, while in GSB it showed a tendency to decrease in the first few hours from harvest and processing. POD activity, at least for chlorogenic acid, increased significantly during storage only in GSB.

Selective absorption processes as the origin of puzzling spectral line polarization from the Sun.

Magnetic fields play a key role in most astrophysical systems, from the Sun to active galactic nuclei. They can be studied through their effects on atomic energy levels, which produce polarized spectral lines. In particular, anisotropic radiation 'pumping' processes (which send electrons to higher atomic levels) induce population imbalances that are modified by weak magnetic fields. Here we report peculiarly polarized light in the He I 10,830-A multiplet observed in a coronal filament located at the centre of the solar disk. We show that the polarized light arises from selective absorption from the ground level of the triplet system of helium, and that it implies the presence of magnetic fields of the order of a few gauss that are highly inclined with respect to the solar radius vector. This disproves the common belief that population imbalances in long-lived atomic levels are insignificant in the presence of inclined fields of the order of a few gauss, and opens up a new diagnostic window for the investigation of solar magnetic fields.

Assimilation of CO2 , enzyme activation and photosynthetic electron transport in bean leaves, as affected by high light and ozone.

• Bean seedlings (Phaseolus vulgaris cv. Pinto) were grown in the greenhouse at a light intensity of 400 µmol m-2  s-1 . When the primary leaf was fully expanded, plants were divided into four groups and subjected to one of the following treatments: light intensity of 400 µmol m-2  s-1 and filtered air (control); light intensity of 400 µmol m-2  s-1 and ozone (O3 ) (150 nl l-1 for 5 h) (ozonated); light intensity of 1000 µmol m-2  s-1 for 5 h and filtered air (HL); and light intensity of 1000 µmol m-2  s-1 and O3 (150 nl l-1 ) for 5 h (HL + O3 ). • At the end of the treatments (HL and/or O3 ) a strong decrease in CO2 assimilation rate as well a decrease in stomatal conductance were observed, while no changes in intercellular CO2 concentration were recorded. In addition the Fv  : Fm ratio (maximal quantum yield for PSII photochemistry) decreased in the stressed leaves (HL and/or O3 ), indicating photoinhibition, and they showed a corresponding increase in minimal fluorescence (F0 ), indicating a higher number of deactivating photosystem II (PSII) centres. • The maximum catalytic activity of the Benson-Calvin cycle enzymes, fructose-1,6-bisphosphate phosphatase (FBPase) and Rubisco, decreased following HL + O3 stress but activation was enhanced. A linear relation was found between activation state of NADP-malate dehydrogenase (MDH) and the flux of electrons through PSII and in HL + O3 -treated plants NADP-MDH activity decreased at high irradiance levels, indicating a limitation in linear electron flux.

Developing a general practice medical workstation: the integration aspect.

ISAAC (Integrated System Architecture for Advanced Primary Care) is a project aiming at developing information technology and telematic support in the specific field of General Practice--and more broadly in the Primary Health Care sector--within the health care systems of different European Countries. The project aims at improving the work of the General Practitioners through the development of a useful and usable medical workstation for day-to-day patient care. Moreover ISAAC has the goal of prototyping an integration architecture for the improvement of the communications between the ISAAC workstation and heterogeneous application environments, namely other components of the health care system. This paper deals with a general description of the design along with a discussion of the adopted approach to fulfill the integration requirements.

Natural contraceptive methods.

PIP: This is a brief review of the available natural family planning methods, the rhythm, basal body temperature, cervical mucus, and symptothermal methods, for use by Italian adolescents and young women who choose to avoid artificial contraception. Data from the last AIED Report show that 50% of Italian adolescent girls aged 16-18 have had coitus, while only 3-7.3% are using contraception, and a high proportion of women having abortions are under 20. The majority of adolescents using natural family planning state that they use the rhythm method, which has a Pearl Index ranging from 14.4-47%. Consistent use of the basal body temperature method can be improved with electronic or digital thermometers which take seconds rather than minutes to use. The cervical mucus method is notoriously unreliable in the post-menarchic period, when anovulatory cycles are common. An electronic instrument is also available to facilitate its use. The symptothermal method, combining cervical mucus, basal body temperature, and other clinical signs, is more difficult to integrate for new users, and no data are available in the literature on its use by adolescents. When the wide variation in menstrual cycle lengths, ovulatory and anovulatory cycles, and the myriad psychosocial barriers to regulated sexuality, a 3-6 month training period, and a committed relationship rarely found in adolescents are considered, it is highly unlikely that any natural family planning method can be recommended to this group of women.^ieng

[Prevention and public structure: biennial evaluation of the response of Bersaglio population to therapeutic indications]. / Prevenzione e struttura pubblica: valutazione biennale della risposta alle indicazioni terapeutiche da parte di una popolazione Bersaglio.

A Community Dental Prevention Program is carrying out by Department of Dentistry Ussl n. 19 del Mediobrenta (Regione Veneto). All children attending the first class of primary school were visited during two years. The affluence for care at the Public Service became greater in the second year of activity.