Pathogenicity of Phytopythium chamaehyphon: A New Player in Kiwifruit Vine Decline Syndrome of Actinidia chinensis var. deliciosa 'Hayward' in Italy.

Kiwifruit vine decline syndrome (KVDS) is a serious soil-borne disease that degrades the fine roots of both Actinidia chinensis var. deliciosa and var. chinensis. The disease seems to be the result of an interaction between several soil-borne pathogens, mostly oomycetes, and waterlogging. This work investigates the pathogenicity of the oomycete Phytopythium chamaehyphon recently isolated from roots of diseased plants. Pathogenicity was tested in 6-month-old and 1-year-old plants that, after inoculation, were flooded up to three times to induce symptom appearance. Leaf wilting and root rot typical of KVDS was observed in all the plants inoculated with P. chamaehyphon strain KD-15 (PCHA) and in all the positive controls potted in a mix of peat and soils collected in KVDS-affected orchards, while negative controls remained symptomless. Disease development on 6-month-old plants was characterized by unusual degradation of the not-lignified collar, occurring even in absence of flooding. Conversely, on 1-year-old plants, symptoms faithfully reproduced KVDS dynamics observed in orchard. This work confirmed the pathogenicity of P. chamaehyphon and raised new questions about the actual role of waterlogging in KVDS etiology.

Evolution of fungal populations in corn silage conserved under polyethylene or biodegradable films.

AIMS: To identify cultivable filamentous fungi before ensiling, after silage conservation, in farm-silos covered with two different plastic films (polyethylene (PE) vs biodegradable (MB)), as well as after aerobic exposure of whole-crop corn silage. METHODS AND RESULTS: Molecular techniques coupled with traditional microbial counting were utilized to identify the predominant fungal species. The cultivable fungal population changed remarkably from harvesting to silo opening. Anaerobiosis and low pH reduced mould count and the presence of Fusarium species both under PE and MB film. However, in the peripheral areas of the silo, where air penetration could not be completely prevented, the fungal population did not decrease. The predominant fungal species after aerobic exposure of silage was Aspergillus fumigatus, without differences between the two plastic films. CONCLUSIONS: Maintenance of anaerobiosis and a low pH also in the upper layer of the silo reduce the risk of mould growth during corn silage feed-out. SIGNIFICANCE AND IMPACT OF THE STUDY: Even if the new MB plastic film did not completely maintain the anaerobiosis in the upper layer of silage, the overall silage quality was not compromised and was similar to that observed under PE, indicating that the development and use of MB film to cover silage is promising, but needs some improvement.

Potential of two Metschnikowia pulcherrima (yeast) strains for in vitro biodegradation of patulin.

Patulin contamination of apple and other fruit-based foods and beverages is an important food safety issue, as consumption of these commodities throughout the world is great. Studies are therefore necessary to reduce patulin levels to acceptable limits or undetectable levels to minimize toxicity. This study was undertaken to investigate the efficacy of two Metschnikowia pulcherrima strains (MACH1 and GS9) on biodegradation of patulin under in vitro conditions. These yeast strains were tested for their abilities to degrade patulin in liquid medium amended with 5, 7.5, 10, and 15 µg/ml patulin and a yeast cell concentration of 1 × 10(8) cells per ml at 25°C. Of the two strains tested, MACH1 completely (100%) reduced patulin levels within 48 h, and GS9 within 72 h, at all concentrations of patulin. MACH1 effectively degraded the patulin within 24 h by 83 to 87.4%, and GS9 by 73 to 75.6% at 48 h, regardless of concentration. Patulin was not detected in yeast cell walls. This indicates that yeast cell walls did not absorb patulin, and that they completely degraded the toxin. Patulin had no influence on yeast cell concentration during growth. Therefore, these yeast strains could potentially be used for the reduction of patulin in naturally contaminated fruit juices. To our knowledge, this is the first report regarding the potential of M. pulcherrima strains for patulin biodegradation.

First Report of Penicillium griseofulvum Causing Blue Mold on Stored Apples in Italy (Piedmont).

In northern Italy, blue mold can occur generally on apples after 3 months of storage under controlled atmospheres. The mold can be caused by Penicillium griseofulvum Dierckx (synonym P. urticae Bainier). During 2008, several postharvest fruit rots were observed on apples (cv. Golden Delicious) after 180 to 240 days of storage at 1°C. Approximately 8% of the fruits showed blue mold. Apples had been cultivated in Aosta (Aosta Valley Region) and Lagnasco (Piedmont Region). Infected fruits showed soft, watery, brown spots enlarging rapidly at 20°C. There was a distinct margin between soft rotted flesh and firm healthy tissues. Under high humidity, masses of blue-green spores formed on the surface of the lesion. Apple fruit excisions from the margin between the healthy and diseased tissues were plated on potato dextrose agar (PDA), pH 5.6. The recovered fungus produced abundant mycelium and conidia, with the colonies attaining a diameter of 2.0 to 2.4 cm after 7 days at 20 ± 2°C on PDA. Colonies were mostly yellow-green, with a yellowish-to-orange brown underside. Conidiophores were mononematous or loosely synnematous, hyaline, with branches strongly divergent. Phialides were cylindrical with a very short neck. Conidia were ellipsoidal, sometimes subglobose, 2.5 to 3.5 × 2.2 to 2.5 µm, hyaline to greenish. Preliminary morphological identification of the fungus (2) was confirmed by PCR using genomic DNA extracted from mycelia of pure cultures. Two sequences, obtained through the amplification of ribosomal region ITS1-5.8S-ITS2 (1), were blast searched in GenBank and showed 99% sequence coverage and 99% similarity to ribosomal sequences of P. griseofulvum. Two sequences were deposited in GenBank with Accession Nos. HQ012498 (a strain from Aosta Valley) and HQ012499 (a strain from the Piedmont Region). Pathogenicity was tested on 20 ripe fruits each of four apple cultivars (Golden Delicious, Red Chief, Granny Smith, and Royal Gala). Fruits were surface sterilized with 1% sodium hypochlorite. Conidial suspensions (30 µl of 105 conidia/ml) of the fungus were placed on artificial wounds generated on the apple surface. Control fruits were treated with sterile water. Seven days after inoculation, the symptoms were reproduced on the four cultivars and P. griseofulvum was reisolated on PDA from the inoculated fruits of all four cultivars. Control fruits were symptomless. An analysis using high-performance liquid chromatography with diode array of the rotting tissues associated with inoculated fruits of all four cultivars (4) confirmed, as in the case of other strains of P. griseofulvum, the production of the mycotoxin patulin (12.1 to 44.4 mg kg-1). Previously, P. griseofulvum was reported on apple in other countries such as the United States (3), Japan, Egypt, and Brazil. To our knowledge, this is the first report of P. griseofulvum on apples during storage in Italy. References: (1) R. Nilsson et al. FEMS Microbiol. Lett. 296:97, 2009. (2) R. A. Samson and J. L. Pitt. Integration of Modern Taxonomic Methods for Penicillium and Aspergillus Classification. Harwood Academic Publishers, Singapore, 2001. (3) P. G. Sanderson and R. A. Spotts. Phytopathology 85:103, 1995. (4) D. Spadaro et al. Food Addit. Contam. B 1:134, 2008.

Effect of culture media and pH on the biomass production and biocontrol efficacy of a Metschnikowia pulcherrima strain to be used as a biofungicide for postharvest disease control.

Few strains of Metschnikowia pulcherrima (Pitt) M.W. Miller are under development for control of postharvest pathogens on fruit. A substrate was developed to optimize the biomass production of M. pulcherrima strain BIO126. Different complex nutrient sources, with or without pH control, were tested. Growth in yeast extract provided at concentrations > or =30 g*L-1 yielded the highest biomass. The addition of two carbon sources, D-mannitol and L-sorbose, at 5 g*L-1 each, significantly improved yeast growth. The greatest amount of yeast growth occurred when pH values of the medium ranged from 5.0 to 7.5. A combination of yeast extract, D-mannitol, and L-sorbose (YEMS), probably with diauxic utilization, showed a synergistic effect, widening the exponential phase (maximum specific growth rate of 0.45 h-1) and increasing the final cell number (1.5 x 109 cells*mL-1) and dry biomass (6.0 g*L-1) in well-controlled batch fermentation. In efficacy trials on 'Golden Delicious' apples, M. pulcherrima grown in YEMS effectively reduced incidence and severity of Botrytis cinerea (51.1% and 70.8%, respectively) and Penicillium expansum (41.7% and 14.0%, respectively). Also on 'Gala' apples, the best reduction of grey and blue mould incidence was obtained with cells grown in YEMS (58.1% and 50.5%, respectively).

First Report of Penicillium glabrum Causing a Postharvest Fruit Rot of Pomegranate (Punica granatum) in the Piedmont Region of Italy.

Pomegranates (Punica granatum L.) are widely grown in many tropical and subtropical countries, especially in the moderate climate of the Mediterranean Region. In Italy, pomegranates are harvested from September to November. During October and November 2009 in Orbassano (Piedmont Region), postharvest fruit rots were observed on pomegranates (cv. Dente di Cavallo) after 30 days of storage at 5°C. Infected fruits showed soft, brown tissues that later were covered with masses of green mycelium, conidiophores, and hyphae of a fungus. Tissues were excised from the margin between the healthy and diseased tissues on pomegranates and plated on potato dextrose agar amended with 25 µg of streptomycin per liter. The fungus recovered from the tissue produced abundant mycelium and conidia on PDA after 7 days at 20 ± 2°C. Colonies consisting of dense erect conidiophores appeared velvety, gray-green, and the reverse of PDA culture was usually yellow to yellow-orange. Conidiophores were monoverticilliate, consisting of an unbranched stipe, smooth to finely roughened, and germinating in a whorl of 10 to 12 phialides. Phialides were flask shaped and 8 to 12 × 3 to 3.5 µm. Conidia were produced in typical long columns, globose to subglobose, smooth to finely roughened, with walls somewhat echinulate, and ranging from 3 to 3.5 µm in diameter (3). Preliminary morphological identification of the fungus was confirmed by PCR using genomic DNA extracted from the mycelia of pure cultures. One sequence, obtained through the amplification of ribosomal region ITS1-5.8S-ITS2 (4), was blasted in GenBank and showed 100% sequence coverage and 99% similarity to ribosomal sequences of Penicillium glabrum. The sequence was deposited in GenBank (Accession No. GU734815). Pathogenicity was tested on 10 ripe fruits (cv. Dente di Cavallo) surface sterilized with 1% sodium hypochlorite. To make inoculum, 7-day-old PDA cultures of the fungus were flooded with sterile water and scraped with a sterile spatula. Resulting suspensions were filtered through two layers of sterile cotton lint and brought to a final concentration of 105 conidia/ml with sterile distilled water. Conidial suspensions (30 µl) were placed on artificial wounds generated on the fruit surface. Control fruits were treated with sterile water. Ten days after inoculation, P. glabrum was reisolated on PDA from the inoculated fruit. Control fruits were symptomless. Previously, P. glabrum was reported on pomegranate in Greece (1). Other species of Penicillium, including P. expansum, P. implicatum, and P. purpurogenum, also were reported on pomegranate in the United States (2), Slovakia, and India, respectively. To our knowledge, this is the first report of P. glabrum causing a postharvest fruit rot of pomegranate in Italy. References: (1) G. A. Bardas et al. Plant Dis. 93:1347, 2009. (2) A. M. French. California Plant Disease Host Index. Calif. Dep. Food Agric., Sacramento, 1989. (3) R. A. Samson et al. Introduction to Food-Borne Fungi. Centraalbureau voor Schimmelcultures, Baarn, the Netherlands, 1995. (4) T. J. White et al. Page 315: in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, 1990.

First Report of Brown Rot of Stone Fruit Caused by Monilinia fructicola in Italy.

Monilinia fructicola, causal agent of brown rot, is one of the most important fungal pathogens of stone fruit. M. fructicola is a quarantined pathogen in Europe. During the summer of 2008 in 15 orchards located in Piedmont (northern Italy), 12,500 stone fruits (cherries, apricots, peaches, nectarines, and plums) were stored in cold chambers at 4 and 6°C and monitored for 8 weeks for the presence of Monilinia spp. M. fructicola was detected on 0.5% of nectarines (cvs. Sweet Red and Orion) that originated from two orchards in Lagnasco. Symptoms appeared on the fruit during storage, starting 3 weeks after harvest. Fruit rot lesions were brown, sunken, and covered with grayish tufts. The majority of infected fruit became dry and mummified. Brown rot symptoms were similar to those caused by endemic M. fructigena and M. laxa. Symptoms began with a small, circular, brown spot, and the rot spread rapidly. At the same time, numerous, small, grayish stromata developed. Finally, the whole surface of the fruit was covered by conidial tufts. Tissues were excised from diseased stone fruits and cultured on potato dextrose agar (PDA) amended with 25 µg of streptomycin per liter. The isolates produced abundant mycelium on PDA at 20 ± 2°C. Colonies were initially gray, but after sporulation, they became hazel, showing concentric rings (sporulation is sparse in M. laxa or M. fructigena). Conidia were one-celled, ellipsoid, hyaline, 15.2 × 10.1 µm, and produced in branched monilioid chains (2). Preliminary morphological identification of fungi resembling M. fructicola was confirmed by PCR using genomic DNA extracted from the mycelia of pure cultures. The DNA was amplified with a common reverse primer and three species-specific forward primers (3) obtained from a sequence characterized amplified region and a product of 535 bp, diagnostic for the species M. fructicola, was obtained. BLAST analysis of the amplified sequence (GenBank Accession No. FI569728) showed 96% similarity to the sequence of a M. fructicola isolated from Canada (GenBank Accession No. AF506700), 15% similarity to M. laxa ATCC11790 (GenBank Accession No. AF506702), and 35% similarity to a M. fructigena sequence isolated in Italy (GenBank Accession No. AF506701). Moreover, two sequences obtained through the amplification of ribosomal region ITS1-5.8S-ITS2, showing 100% similarity to the same ribosomal sequence of M. fructicola, were deposited in GenBank (Accession Nos. FJ411109 and FJ411110). The pathogen was detected on some mummified fruit from the same orchards in November of 2008. Pathogenicity was tested by spraying 103 conidia/ml on 10 surface-sterilized artificially wounded nectarines per strain of M. fructicola. After 5 days of incubation at 20 ± 2°C, typical, brown, rot symptoms developed on inoculated fruit. M. fructicola was reisolated from the inoculated fruit on PDA. Symptoms did not appear on control fruit. To our knowledge, this is the first report of M. fructicola in Italy. Its occurrence in Europe has been reported sporadically in Austria and France, and in 2006, it was detected in Hungary and Switzerland on peaches and nectarines imported from Italy and Spain (1,4). References: (1) E. Bosshard et al. Plant Dis. 90:1554, 2006. (2) R. J. W. Byrde and H. J. Willetts. The Brown Rot Fungi of Fruit: Their Biology and Control. Pergamon Press, Oxford, 1977. (3) M. J. Coté et al. Plant Dis. 88:1219, 2004. (4) M. Petròczy and L. Palkovics. Plant Dis. 90:375, 2006.

Insulin resistance in postmenopausal women: concurrent effects of hormone replacement therapy and coffee.

BACKGROUND: In postmenopausal women, an increase in insulin resistance is associated with an increased risk of diabetes, cardiovascular disease and breast cancer. Hormone replacement therapy (HRT) can reduce insulin resistance and coffee use is reported to decrease the incidence of diabetes. The aim of our study was to assess possible concurrent effects of HRT and espresso coffee intake on insulin resistance and on interdependent nutritional and clinical features. METHODS: A total of 478 healthy postmenopausal, non-diabetic women (aged 54.5 +/- 4.2 years) were studied: 360 had been on HRT for at least 2 years and 118 were not treated. Insulin resistance was assessed by a conventional homeostasis model (HOMA-IR). RESULTS: Insulin resistance is directly related to body mass index (p < 0.0001), and not with age and blood pressure; hypertensive menopausal women have a slightly higher body mass index but the same degree of insulin resistance as normotensive women. Women on HRT show lower insulin resistance, but not lower prevalence of arterial hypertension. Coffee use is associated with a decrease in insulin resistance in non-obese women receiving HRT, but not in other subsets. CONCLUSIONS: The combination of coffee consumption and HRT could lower insulin resistance in postmenopausal women. In overweight women, greater insulin sensitivity is associated with intake of espresso coffee and not with HRT; in normal weight women, only HRT is associated with lower insulin resistance.

Effect of nutrition on toxicity of contaminants to the epibenthic amphipod Melita plumulosa.

The amphipod Melita plumulosa is commonly used to assess the toxicity of contaminated sediments. Seven-day-old M. plumulosa are <1 mm in size, and during 10-day tests in sandy sediments with low nutritional value, starvation can cause >50% mortality. In sediment toxicity tests, therefore, it can be difficult to determine if toxicity is due to contaminants or starvation, particularly in contaminated sandy sediments. This study investigated the influence of amphipod age and food addition on amphipod survival in toxicity tests. The 4-day LC(50) increased linearly from 120 to 470 microg/L when M. plumulosa age at the beginning of the test increased from 5 to 30 days. The addition of food as algae or fish food did not significantly affect the sensitivity of 11-day-old M. plumulosa (11-d Mp) to dissolved copper over 4 days in water-only tests. The survival of 11-d Mp in water-only tests over 10 days was poor without feeding, but when fed fish food, the 10-day LC(50) was 76 +/- 15 microg/L. In sediment tests, feeding 0.063 mg fish food/amphipod on days 3 and 7 of 10-day tests consistently resulted in greater than 80% survival of 11-d Mp for a range of clean, sandy sediments, which had low amphipod survival without added food. Algae were not always suitable as a food source, as their growth can be stimulated by nutrients released from sediment and was inhibited by contaminants. The toxicity of most contaminated sediments was not ameliorated by the addition of food, suggesting that food addition was suitable for inclusion in routine testing protocols for this amphipod.

Use of AFLP for differentiation of Metschnikowia pulcherrima strains for postharvest disease biological control.

Metschnikowia pulcherrima occurs naturally on fruits, buds and floral parts of apple trees. Some strains are effective as biocontrol agents against postharvest decay of apples and other fruits. The usefulness of the amplified fragment length polymorphism (AFLP) technique was evaluated for the genetic analysis of 26 strains of M. pulcherrima, isolated from different sources in different geographical regions. With six AFLP primer pairs, 729 polymorphic bands were scored. The technique showed a high discriminatory power. Genetic relationships between strains were also estimated using AFLP. All the isolates from the carposphere of apple, previously tested as biocontrol agents, were grouped in a single cluster with a high bootstrap value (97), indicating robustness and reproducibility. AFLP patterns could clearly distinguish the different strains and research is in progress to use some putative specific bands for single tag sequence (STS) conversion to develop isolate-specific markers.

Occurrence of patulin and its dietary intake through pear, peach, and apricot juices in Italy.

Pear, peach, apricot, and mixed juices (125 samples) were purchased in Italian supermarkets and organic food shops and analysed for patulin content. An overall incidence of 34.4% was observed in the fruit juices, with a mean contamination level of 3.6 µg kg(-1). No one sample exceeded 50 µg kg(-1), the maximum permitted limit according to European legislation. However, 19 positive samples contained more than 10 µg kg(-1) of patulin, which is the maximum level permitted for baby food. The incidence of patulin contamination was significantly higher in pear juices (64.1%) than in apricot, peach, or mixed juices. Statistical analysis (p = 0.002; Kruskal-Wallis test) showed a significantly higher level of patulin in pear (5.1 µg kg(-1)) and mixed juices (4.9 µg kg(-1)) than in the other juices. A slightly higher incidence of positive samples was found in conventional juices (35.7%) compared with the organic ones (29.6%). The magnitude between the mean contamination levels was similar in conventional (3.6 µg kg(-1)) and organic (3.3 µg kg(-1)) juices (p = 0.474; Mann-Whitney U-test). Samples were further divided based on the fruit content in fruit juices, fruit nectars, and fruit drinks. In fruit nectars the incidence of positive samples (37.8%) was slightly higher than in fruit drinks (27.2%), but the mean patulin contamination was higher in fruit drinks (5.2 µg kg(-1)) than in fruit nectars (3.4 µg kg(-1)). However, the magnitude between the two means was not statistically different (p = 0.734; Mann-Whitney U-test). Italian juices had a higher incidence of patulin (35.3%), with a lower mean content (3.5 µg kg(-1)), compared with the incidence (22.2%) and level (4.1 µg kg(-1)) foreign juices commercially available in Italy. The magnitude of the means between Italian and foreign juices was not statistically different, according to the Mann-Whitney U-test (p = 0.616). The estimated intake of patulin ranged from 0.1 to 1.5 ng kg(-1) body weight for the whole population and from 0.3 to 5.1 ng kg(-1) body weight for the consumers only. The highest patulin intake was estimated for consumers of pear juices, followed by consumers of mixed juices. The daily intake of patulin derived from the consumption of pear juice suggests that also pear juices, though a minor patulin source, could be monitored for their patulin content in order to control the mycotoxin contamination, especially in countries, such as Italy, where pear nectars are preferred as fruit drinks.

Psychological stress measure in type 2 diabetes.

Psychological stress has been implicated as a cause of several psychosomatic disorders, but also as a factor that can unfavourably influence many diseases including diabetes mellitus. Measure of psychological stress in diabetes was performed by Psychological Stress Measure (PSM), a validated instrument, designed using 49 items drawn from descriptors generated by focus groups on stress. Clinical and psychological framework was assessed in a cohort of 100 type 2 diabetic patients (30 m, 70 f), aged 66.99 +/- 13.68 years considering disease grade, complications and level of instruction. Three other questionnaires were administered concurrently to all patients: Sickness Impact Profile (SIP), Functional Living Index (FLI) and SF-36 QOL. ANOVA statistical testing and Spearman correlation matrix were used also vs socio-cultural and clinical profile. Gender, obesity, diet compliance, smoking do not affect PSM response. Hypertensive patients and those with family history of diabetes show lower PSM scores, according to a sort of moderator effect on stress of concurrent and/or previous experience with chronic disease. Neuromuscular ailments are more prevalent in women; men vs women experience severe limitations of their working capacities and relational possibilities, with severe discomfort. In the whole, higher scores of PSM (greater stress p < 0.01) and lower scores of FLI (fair well-being perception; p < 0.01) are reciprocally related inside any school instruction level. Despite the great reciprocal association of the PSM vs FLI and SIP, no significant correlation is found between PSM vs SF-36 QOL. Socio-cultural elements interfere, and particularly instruction level quantified as school grades achieved, with the manner of living their disease. Interventions on psychological distress of type 2 diabetes mellitus patients is warranted, specially in the groups with lower levels of instruction which may need an attentive strategy for achieving a satisfactory coping with this disease.

Patient valuation of pharmacist services for self care with OTC medications.

BACKGROUND AND OBJECTIVES: The objectives of this study were to determine whether patients would be willing to pay for pharmacist self-care services on proper use of over-the-counter medications. In addition, we examined whether patients' willingness to pay was associated with community pharmacy setting and patients' socio-economic factors. METHODS: A self-administered questionnaire was handed out to patrons of community pharmacies in Arkansas, USA. The questionnaire contained question items related to patients' willingness to pay, community pharmacy setting, prescription drug insurance and socio-economic information. Patients' willingness to pay was measured using the checklist method. RESULTS AND DISCUSSION: A total of 262 questionnaires were completed. More than twice as many patients (51%) are now willing to pay for pharmacist services for patient self care than a decade ago. They were willing to pay about US5 dollars for a 5-min consultation. Willingness to pay was significantly associated with community pharmacy setting (chi-square, P = 0.030). Grocery/chain pharmacy patrons were more willing to pay than independent pharmacy patrons. CONCLUSION: This increased patient willingness to pay, along with growing self-care markets, provides pharmacists with opportunities to develop self-care clinics or services.

[Quality of life in diabetes]. / Qualità della vita nel paziente diabetico.

Different clinical features of diabetic patients and type of complications are certainly a critical components of the global individual perception of quality of life (qol); but also personal socio-cultural characteristics interfere concurrently. Qol in diabetes was assessed considering disease grade, complications and level of instruction in a population of 100 diabetic patients (30 m, 70 f), aged 66.99 +/- 13.68 years. Two questionnaires were administered to all patients; Sickness Impact Profile (SIP) and Functional Living Index (FLI). SIP is an index of psycho-social, physical and motor functionality; FLI derives from a scale devised for cancer patients and adapted to diabetic patients. Both were analysed by Spearman correlation test, and assayed vs. sociocultural profile and clinical symptoms. Neuro-muscular ailments were more prevalent in women; men experience severe limitations of working capacities an relational possibilities, with severe discomfort. In the whole, higher scores of SIP (greater disability p: ns) and lower score for FLI (scant well-being perception r = 0.29: p<0.01) are related with lower school instruction level. Global QOL score is related as well with degree of instruction (r = 0.22: p<0.03). So QOL is altered during chronic diseases: however, in diabetes, qol impairment does not seem related with severity, treatment features and complications of diabetes. Socio-cultural elements, and particularly instruction level quantified as school grades achieved, interfere with the manner of living diabetic disease.

[Portal flow, nutritional status, and circulation effects of parathormone]. / Flusso portale, stato nutrizionale ed effetti circolatori del paratormone.

Circulatory effects of parathyroid hormone (PTH) were reported in experimental animal models, also in liver portal system. We devised to study non invasively relationship between plasmatic iPTH and portal blood flow rate in humans. The study was done in a group of healthy post-menopausal women aged 52.0 +/- 5.2 years (range 47-65), not treated with hormone therapy, with different body mass index. Women were studied by echocolor-doppler and by clinical and biochemical assays of common laboratory test and of iPTH, insulin and prolactin (RIA). A positive correlation between iPTH and mean portal flow rate was observed in the overall group. Women with BMI < 25 showed a more marked correlation between these two parameters, not observed in women with BMI > 25, with slight-moderate overweight. In this last group an inverse correlation between blood pressure and iPTH was observed. From these preliminary results, as previously observed in chronic disease, relationship among iPTH, regional flows and nutritional state can be operating also in physiological conditions.

[Erythropoietin and cisplatin-induced neuropathies in cancer patients]. / Eritropoietina e neuropatie da cisplatino nei pazienti oncologici.

Anaemia commonly occurs in cancer patients on chemotherapy, often necessitating blood transfusion, and, in most recent years, treatment with human recombinant cythropoietin (rHuEPO). However, several extra-hematological effects were reported for EPO, and multi-organ physiological effects on development and repair of tissues are described both on nerves and muscles. Moreover, EPO is presently used in oncological patients with the goal of preventing or limiting anemia secondary to chemotherapy. Ten patients with advanced lung cancer and without neurological impairment assessed by Siegal score and without severe anemia, were studied. Patients (age 56.2 +/- 8.3 years) were random assigned to two groups of 5 patients each: the control group and the EPO treated group. In both groups, at the end of the study, hemoglobin concentration was not different (above 9 mg/dl). In EPO treated group neurological score was 4.00 +/- 1.87, significantly lower (p < 0.004) in comparison with untreated group (score 9.20 +/- 4.32). From these preliminary data we suggest that EPO treatment in cancer patients can exert also a limiting effect on cisplatin peripheral neurotoxicity.

Optical performances of the Ultraviolet Coronagraph Spectrometer of the Solar Heliospheric Observatory.

The optical performances of the spectrometer assembly for the Ultraviolet Coronagraph Spectrometer of the Solar and Heliospheric Observatory mission have been tested. The flight unit of the spectrometer assembly, consisting of the structure equipped with the entrance slits assembly, the grating drive mechanisms mounting two toroidal gratings, and the photon-counting detectors, has been integrated and aligned; also the flight unit of the White Light Channel has been integrated and aligned in the spectrometer assembly. Tests with both visible and UV radiation have been performed. Aberration and stray-light measurements have shown that the instrument performs satisfactorily, almost in compliance with the scientific requirements; also some measurements of the polarimeter modulation curve and the relative error have shown performances within the specified requirements.

Evaluation of the growth-hormone-releasing hormone test in short normal and growth-hormone-deficient children.

Growth-hormone-releasing hormone (GHRH) tests were performed once [GHRH(1-29)NH2, 1 microgram/kg] or on 2 consecutive days [GHRH(1-44)NH2, 1 and 2 microgram/kg administered in random order] in 27 children with idiopathic, isolated growth hormone (GH)-deficiency and in 49 short normal children, all clinically prepubertal. No differences in GH release were found between the tests performed on the 1st and 2nd day or according to GHRH dose or sex, both in GH-deficient and control children. 80% of GH-deficient and 87% of control children responded (GH peak greater than 10 ng/ml) to GHRH(1-29)NH2, and 65% of GH-deficient and all control children to GHRH(1-44)NH2. No differences in GH release were found between GH-deficient GHRH responders and control children. 17% of GH-deficient and 10% of control children responded only to one of the two tests performed on 2 consecutive days; the lack of responsiveness was unrelated to GHRH dose and sequence of GHRH administration (1st or 2nd day). The GHRH test does not seem to be a reproducible test for the evaluation of GH release, nor is it useful to differentiate GH-deficient GHRH responders from short normal children.

Pharmacy teaching for family practice residents.

Because undergraduate training in pharmacology is insufficient preparation for prescribing drugs appropriately, comprehensive systematic education in clinical pharmacy is essential for family practice residents. A pharmacy curriculum could contribute to improved treatment of disease, decreased health care costs, decreased iatrogenicity and morbidity, lower risk of litigation, and better communication among physicians, pharmacists, and patients. The pharmacy curriculum which has been developed at the family practice residency program in Little Rock, Ark. focuses on problem-solving activities in the clinical setting, primarily utilizing problems from the residents' patient caseloads. A long-term plan of the department is to follow residents into practice in order to examine utilization of what they learned from the pharmacy curriculum.