Aging affects the response of female rats to a hypercaloric diet.

Metabolic syndrome is a major risk factor for the development of cardiovascular diseases and diabetes, among other conditions. Studies have shown that aging and metabolic syndrome share several metabolic alterations, and that aged individuals, in particular females, are at an increased risk of developing metabolic disorders. Although several studies have investigated the effects of hypercaloric diets in the development of obesity and metabolic syndrome in young animals, few studies have investigated these parameters in aged animals, especially in females. Therefore, the aim of this study was to investigate the effects of a hypercaloric diet in metabolic parameters of young and aged female rats, including its effects on lipid and glycemic profile and on liver lipid content. When compared to young animals, the aged rats presented increased serum levels of triglycerides and decreased serum levels of HDL cholesterol and glycemia, as well as increased hepatic levels of triglycerides and total cholesterol. The hypercaloric diet increased food intake, body weight gain and adiposity index, leading both young and aged animals to a dyslipidemia, represented by increased serum levels of triglycerides. The hypercaloric diet increased the glycemia and the HOMA index only in the young animals. On the other hand, the diet increased the frequency of hepatocellular microvacuolar degeneration only in the aged animals. In summary, it was observed that the females from different ages respond differently to hypercaloric diet intake: while the aged animals were more resistant to the changes in the glycemic profile, they were more susceptible to the hepatic damage caused by this diet.

Diet-induced obesity alters memory consolidation in female rats.

Obesity is a multifactorial disease characterized by the abnormal or excessive fat accumulation, which is caused by an energy imbalance between consumed and expended calories. Obesity leads to an inflammatory response that may result in peripheral and central metabolic changes, including insulin and leptin resistance. Insulin and leptin resistance have been associated with metabolic and cognitive dysfunctions. Obesity and some neurodegenerative diseases that lead to dementia affect mainly women. However, the effects of diet-induced obesity on memory consolidation in female rats are poorly understood. Therefore, the aim of this study was to evaluate the effect of a hypercaloric diet on the object recognition memory of female rats and on possible related metabolic changes. The animals submitted to the hypercaloric diet presented a higher food intake in grams and in calories, resulting in increased weight gain and liposomatic index in comparison with the animals exposed to the control diet. These animals presented a memory deficit in the object recognition test and increased serum levels of glucose and leptin. However, no significant differences were found in the serum levels of insulin, TNF-α and IL-1ß, in the index of insulin resistance (HOMA), in the hippocampal levels of insulin, TNF-α and IL-1ß, as well as on Akt expression or activation in the hippocampus. Our findings indicate that adult female rats submitted to a hypercaloric diet present memory consolidation impairment, which could be associated with diet-induced weight gain and leptin resistance, even without the development of insulin resistance.

Effect of transdermal nitroglycerin or N-acetylcysteine, or both, in the long-term treatment of unstable angina pectoris.

OBJECTIVES: This study was designed to evaluate whether the addition of transdermal nitroglycerin or oral N-acetylcysteine, or both, to conventional medical therapy improves the natural history of unstable angina pectoris. BACKGROUND: Transdermal nitroglycerin is widely used to treat angina pectoris, but the development of tolerance is a major problem that may reduce its clinical efficacy. It has been suggested that the addition of N-acetylcysteine to nitroglycerin reverses the development of tolerance, potentiates the hemodynamic response to nitroglycerin and may improve in-hospital prognosis in unstable angina. METHODS: We assessed the efficacy of adding transdermal nitroglycerin or oral N-acetylcysteine, or both, to conventional medical therapy in a randomized, double-blind, placebo-controlled trial involving 200 patients with unstable angina who were followed up for 4 months. RESULTS: Outcome events--death, myocardial infarction or refractory angina requiring revascularization--occurred in 31% of patients receiving nitroglycerin, 42% of those receiving N-acetylcysteine, 13% of those receiving nitroglycerin plus N-acetylcysteine and 39% of those receiving placebo (p = 0.0052). Kaplan-Meier curves showed a higher probability (p < 0.01) of no failure of medical treatment in the group receiving both nitroglycerin and N-acetylcysteine than in those receiving placebo, N-acetylcysteine or nitroglycerin alone. The combination of nitroglycerin and N-acetylcysteine was associated with a high incidence of side effects (35%), mainly intolerable headache, which was almost twice as frequent as in patients receiving nitroglycerin alone. CONCLUSIONS: The combination of nitroglycerin and N-acetylcysteine, associated with conventional medical therapy in the long-term treatment of patients with unstable angina, reduces the occurrence of outcome events. However, the high incidence of side effects limits the clinical applicability of this therapeutic strategy at least at the dosage used in the present study.

[Biliary ileus: pros and cons of the most current diagnostic methods]. / Ancora sull'ileo biliare: luci e ombre delle metodiche diagnostiche più attuali.

The authors, on the basis of their recent experiences in treating biliary ileus, discuss diagnostic problems of serious side effects and talk about more recent diagnostic techniques. Above all ecography, CT, and Endoscopic Retrograde Cholangiography are able to offer, in a lot of cases, a correct preoperative diagnosis. Endoscopic Retrograde Cholangiography is a real progress even if it needs a more extensive use and, presents some doubts about its utility like all diagnostic techniques in biliary ileus.

[Benign giant ovarian cystadenoma. Description of a clinical case]. / Cistoadenoma benigno gigante dell'ovaio. Considerazione su di un caso clinico.

The authors describe a case of giant benign cystadenoma of the ovary in a 55 year old woman. The patient came to their observation complaining of severe abdominal pain which started right after she was treated with a paracentesis, because of the suspicion of cirrhosis with ascites. The authors briefly outline the two goals of the diagnostic strategy: the diagnosis of the disease and the diagnosis of the nature of the disease. They stress the utmost importance of ultrasound and computerized tomography scans in the diagnosis of disease. For the diagnosis of the nature of the disease the authors counted on Ca 125, CEA, LDH levels and on Ca 19.9 and ACE levels as well. The surgical management of abdominal mass, which is the only possible treatment, led to the removal of a 60 cm in diameter and 30 kg mucinous cystadenoma. After the viscera of the higher abdomen (liver and stomach) had been repositioned, a plastic closure of the enormously expanded anterior abdominal walls was performed.

[Gynecomastia in chronic renal insufficiency. Presentation of a clinical case]. / Ginecomastia in corso di insufficienca renale cronica. Presentazione di un caso clinico.

Gynecomastia may occur in men with chronic renal failure, developing in the course of complex endocrine abnormalities. It is often associated with aberration in the hypothalamo-pituitary-testicular axis even producing a severe hypogonadism. A case of monolateral gynecomastia in a hemodialyzed young man, without other clinical and endocrine signs, is described.

[Recurrence of Crohn disease, complicated by intestinal perforation, during pregnancy. Discussion of a clinical case]. / Morbo di Crohn riacutizzato nel corso della gravidanza e complicato da perforazione intestinale libera. Discussione di un caso clinico.

We describe a case of Crohn's disease which came up before pregnancy and which is responsible of an acute abdomen picture caused by intestinal reacutation and perforation to the 38th week of amenorrhea. The relations between the disease and the pregnancy state are analyzed from the clinical, diagnostic and therapeutical aspect.

Felodipine (once daily) versus nifedipine (four times daily) for Prinzmetal's angina pectoris.

In 30 consecutive patients with Prinzmetal's angina pectoris, the antiischemic effect of felodipine, a new long-acting vasoselective calcium antagonist, administered at doses of 10 and 20 mg once daily was compared with that of the well-established therapeutic regimen with nifedipine administered at a dose of 20 mg 4 times daily. Twenty-four-hour Holter monitoring was performed during a 2-day placebo run-in and at the end of each of 3 consecutive 6-day periods during which the 3 active treatments were administered in randomized sequence. Three patients withdrew, whereas 27 completed the study. The therapeutic regimens tested proved to be similarly effective; primary end points (ischemic episodes recorded by Holter monitoring, and anginal attacks reported on diary cards) occurred in 5 patients (19%) during nifedipine treatment, and in 7 (26%) and 3 (11%) during felodipine treatment with 10 and 20 mg, respectively (p = not significant). The distribution of residual ischemic episodes demonstrated that treatment with felodipine once daily provides 24-hour antiischemic protection. Twenty-six patients were followed up with 20 mg of felodipine once daily for a mean of 6 +/- 5 months, and 21 of them (81%) remained free of symptoms and Holter-recorded ischemic attacks. It is concluded that for Prinzmetal's angina pectoris, 24-hour antiischemic protection may be achieved with administration of felodipine once daily. The availability of a simplified therapeutic approach may constitute a real advantage in terms of patient compliance and improving the quality of life.

Ability of calcium-entry blockade by felodipine to disclose different pathogenetic mechanisms behind hyperventilation-induced myocardial ischemia in men.

To verify that myocardial ischemia occurring during either the overbreathing or recovery phase of the hyperventilation test is based on different pathogenetic mechanisms, 2 consecutive series of patients, selected on the basis of their response to a run-in hyperventilation test, were studied. Group I comprised 15 patients who developed ST-segment depression early during overbreathing, whereas group II consisted of 12 patients showing ST-segment depression late during the recovery phase. A single oral dose of felodipine 10 mg or of placebo was administered on 2 consecutive days according to a randomized, double-blind, crossover design, and the hyperventilation test was repeated, on both days of the study, 3 to 5 hours after drug intake. In group I, ST-segment depression occurred after placebo in all patients during overbreathing, with an increase in rate pressure product (from 112 +/- 31 at baseline to 168 +/- 55 mm Hg x beats/min/100 at the onset of ST-segment depression; p less than 0.01). After felodipine, 13 patients continued to show ST-segment depression during overbreathing, together with an increase in rate pressure product (from 107 +/- 24 at baseline to 158 +/- 46 mm Hg x beats/min/100 at the onset of electrocardiographic changes; p less than 0.01). In group II, all 12 patients showed ST-segment depression during recovery after placebo, with a rate pressure product comparable to baseline conditions (112 +/- 35 at baseline vs 102 +/- 27 mm Hg x beats/min/100 at the onset of ST-segment depression; difference not significant). After felodipine, no patient developed ST-segment depression or chest pain.(ABSTRACT TRUNCATED AT 250 WORDS)

Usefulness of the hyperventilation test in stable exertional angina pectoris in selecting medical therapy.

To assess the prevalence of abnormal coronary vasoconstriction in stable exertional angina and to evaluate whether the presence of increased coronary tone may have therapeutic implications, we studied 83 consecutive patients with typical exertional angina, positive response to exercise stress testing and documented coronary artery disease. Abnormal coronary vasoconstriction was induced by a hyperventilation test in 16 patients (group I) while the remaining 67 had a negative response (group II). No differences were observed between the 2 groups with regard to clinical, exercise and angiographic data. All group I patients and 16 patients in group II repeated hyperventilation and exercise tests after the administration of dihydropyridine-type calcium antagonists (7 patients nifedipine, 9 patients felodipine). After treatment 15 of 16 group I patients had a negative response to the hyperventilation test. The total exercise duration was significantly increased (278 +/- 183 vs 554 +/- 248 seconds; p less than 0.001) with higher values of rate pressure product at peak exercise (168 +/- 47 vs 235 +/- 67 mm Hg x beats/min/100; p less than 0.0025). In group II no significant differences were observed between pre- and posttreatment values for total exercise duration (244 +/- 210 vs 308 +/- 243 seconds) and rate pressure product at peak exercise (170 +/- 46 vs 188 +/- 56 mm Hg x beats/min/100). These data show that the hyperventilation test can be used to select a subset of patients with stable exertional angina and detectable abnormal coronary vasoconstriction who will improve their exercise tolerance with coronary vasodilator treatment.

[Coexistence of intra- and extra-uterine pregnancy: a clinical case]. / Coesistenza di gravidanza intra- ed extrauterina: caso clinico.

Simultaneous intrauterine and ectopic pregnancy is considered to be very rare. The Authors describe a case of intrauterine pregnancy which degenerated into vesicular mola and was associated with a tubal pregnancy. It is concluded that, in spite of the presently available advanced investigational techniques, the identification of such an event still a difficult diagnostic procedure.

[Extracorporeal circulation in homologous and heterologous isolated liver in the depurative treatment of prolonged limb ischemia. Experimental research]. / La circolazione extracorporea in fegato isolato omologo ed eterologo nel trattamento depurativo dell'ischemia protratta di arto. Ricerca sperimentale

Preliminary experiments in extracorporeal cleansing of long ischaemic limbs with isolated liver prior to re-establishment of normal circulation are described. The absence of cases of renal block and the survival of all the animals so treated offer encouragement for the prosecution of this line of investigation.

[Nephrographic study with 131 iodine hippuran in surgical diseases of the uropoietic apparatus]. / L'indagine nefrografica con ippuran marcato con iodio + 131 nelle affezioni chirurgiche dell'apparato uropoietico

Personal experience with 131I-Hippuran nephrography, particularly in surgical cases, is described. The examination is a useful aid to the diagnosis diagnosis of recent colic and in the investigation of cases where a negative finding has been obtained with other radiological means. Its pre- and post-operative employment in the evaluation of renal function is also discussed.