Selenium and reproductive function. A systematic review.

Selenium (Se) is an essential element involved in normal gonadal development, gametogenesis, and fertilization. Molecular studies show that the gonads actively take up and store Se, most of which is incorporated in the glutathione peroxidase enzymes. We provide a systematic review of the original molecular studies, prospective observational data and randomized controlled trials on the role of Se in reproductive function conducted in the past 30 years. A critical appraisal of these findings suggests that Se supplementation produces a bell-shaped response curve, with negative effects observed for both low and high concentrations. The few available clinical trials support the use of Se supplementation (<200 µg/d) to improve male infertility, although their pre-treatment assessment of Se levels in enrolled subjects is inconsistent and their quality and size are insufficient to enable general recommendations. In females, a putative role in oocyte maturation and fertilization is suggested, but no large controlled trials have yet been performed. The role of Se supplementation on pregnancy outcomes is promising, and ongoing studies and meta-analysis should soon enable proper recommendations to be suggested. How best to assess Se in terms of cut-off value, sample type (serum, semen, other fluids) and the specific outcome of interest remains to be clarified. In the meantime, assessment of serum Se levels followed by low-dose replacement therapy when necessary is a reasonable approach to improve male idiopathic infertility and gestational outcome.

[Male to female transsexualism].

The transsexual is a person who suffers from a deep identity disturbance caused by physical characteristics which do not correspond to mental traits and tendencies. The persistent sense of contradiction between his or her deceptive sexual appearance and his or her inner perception, causes a strong desire to achieve harmonization of the two. This aspiration, even if modification of chromosomal sex is impossible, can be fulfilled by undergoing SRS (Sex Reassignment Surgery). SRS represents the last major step of a clinical, therapeutic and diagnostic program involving skilled professionals in the physical and psychological sciences. Their assistance and counseling helps the patient to calmly and consciously decide to undergo SRS. A surgeon has the obligation not only to validate the operation outcome, but to also to maintain a long-term follow-up. A transsexual is not just like any other person; he or she should therefore be treated with sympathy and understanding. The surgeon should try his best to establish a relationship of mutual trust, taking into account the causes of anxiety and stress felt by the patient, and keeping in mind the ultimate objective, which is an improvement in the quality of life. At present, the most widely used surgical techniques are the Simple Penile Skin Inversion, the Penile-scrotal flap Inversion and the enterovaginoplasty. Each surgical technique has its own advantages and disadvantages, and it is up to the surgeon, in discussion with the patient, to make the appropriate choice. The surgical technique performing the Simple Penile Skin Inversion seems to ensure a better cosmetic appearance and an adequate lubrication, but a lower rate of satisfaction, in relation to the neocavity depth. On the contrary, the Penile-Scrotal Flap Inversion guarantees an adequate vaginal depth and lubrication, even though the cosmetic appearance is not always completely satisfactory. In our experience, a significant number of patients were satisfied with the chosen surgery and felt comfortable with their new post-operative gender. Taking into account all the complications involved, none of the patients did regret; actually, they would recommend the same operation to others. The overall results of some studies carried out on patient satisfaction before and after SRS show a marked post-surgery improvement of sexual life.

Connexin-30 mRNA is up-regulated in astrocytes and expressed in apoptotic neuronal cells of rat brain following kainate-induced seizures.

Glial connexins (Cxs) make an extensively interconnected functional syncytium created by a network of gap junctions between astrocytes and oligodendrocytes. Among Cxs expressed in the brain, Cx30 is expressed in grey matter astrocytes, as shown at the protein level by immunoistochemistry. In the present study we aimed to perform a detailed study of the regional distribution of Cx30 mRNA in the adult and postnatal developing rat brain, analyzing its expression by in situ hybridization, and determining its cell type localization by double labeling. Recently, it has been suggested that neuronal activity may control the level of intercellular communication between astrocytes through gap junctions channels. Thus, a second aim of the present study was to investigate the short-term effects of kainate-induced seizures on Cx30 expression. The results showed that, in basal condition, Cx30 was expressed only in grey matter astrocytes with distinct regional patterns in developing and adult brain. Kainate treatment induced strong and region-specific changes of astroglial Cx30 mRNA levels and expression of Cx30 mRNA in neuronal cells undergoing cell death, suggesting a direct or indirect involvement of this connexin in the neuronal apoptotic process.

[Epidemiological research on dental caries incidence in a sample of the school-age population of Ragusa]. / Ricerche epidemiologiche sull'incidenza della carie dentale in un campione della popolazione scolastica di Ragusa.

The authors have conducted an epidemiologic research into a sample of 1500 schoolboys of Ragusa aged between a six and a twelve years old, to evaluate the incidence of dental caries. A small percentage of children practice correct oral cleanliness and know the importance of regular medical check-ups. The result is that, since childhood, a large incidence of dental caries is present whether in permanent teeth or in deciduous teeth, often precociously extracted and rarely treated with all the negative consequences that follow. Therefore it's necessary to intensify both information programs and dental prevention at a scholastic level in the intervention of a valid program of social and preventive medicine.

[Prevalence of dental caries in a Catania school group]. / Ricerche sulla prevalenza della carie dentale in un campione della popolazione scolastica di Catania.

In order to evaluate the importance of information on dental caries prevention and to study variations of dental caries incidence in the years we have studied a children populations studying in some Catania's schools. It was made a screening test on 528 children between from 10 to 14 years old 62.14% of the group.

[Epidemiological survey of dental caries in 937 middle school students in Gravina, Catania]. / Ricerche epidemiologiche sulla carie dentale su 937 alunni delle scuole medie del comune di Gravina di Catania.

The AA. have carried out a transversal epidemiologic investigation on 937 children attending the school of Gravina. The age of the subjects range from 10 to 14 years. In these young subjects dental decays percentage, DMF/dmf were evaluated and compared to age and oral hygiene. Oral hygiene has been expressed with values ranging from 1 to 3, the point 1 showed the best situation and 3 the worst. It has been evaluated also the number of subjects with dental decay that have been cured by the dentist. No correlation between dental decay and weight has been found infact X analysis was not significative.

Preliminary pharmacokinetic and clinical evaluation of ofloxacin in dental and oral cavity diseases.

In 14 healthy volunteers (8 M and 6 F), aged 19 to 33 years, serum and salivary concentrations of ofloxacin, administered in a single oral dose of 300 mg, were measured by high performance liquid chromatography (HPLC) and the microbiological agar diffusion method. The serum peak was observed at hour 1 (2.61 +/- 0.17 micrograms/ml), with a T1/2 of 4.14 h, a Kel of 0.167 h-1 and AUC of 15.07 micrograms/ml.h. The peak salivary concentration, obtained at hour 2, was 1.96 micrograms/ml, with a T1/2 of 4.40 h. Twenty dental patients (12 M and 8 F), aged 18 to 37 years, with various diseases, were treated orally with ofloxacin 600 mg/day for a period of four to six days. The clinical response proved excellent in one case, good in 16, fair in two and poor in one, with 85% efficacy rating. In five of these patients, ofloxacin concentrations in gingival tissue and alveolar bone were found to be 1.90 +/- 0.09 micrograms/g and 1.58 +/- 0.06 micrograms/g, respectively, while serum and salivary assays by HPLC confirmed the previous results. No changes of importance in haematochemical parameters were found in any of the patients. One patient only presented with diarrhoea and a skin rash which promptly cleared on discontinuing the therapy. Ofloxacin for its spectrum of action and good diffusion in the salivary and parodontal tissue compartment can be considered an useful tool in oral chemo-antibiotic therapy.