Mental disorders and request for psychiatric intervention in an Italian local jail.

The issue of the prevalence of psychiatric illnesses in Italian prison samples has not received the same attention paid at an international level. The aims of the present study were to evaluate the prevalence of psychiatric disorders diagnosed according to DSM-III-R criteria among an Italian prisoner population, and to examine prisoners' requests for psychiatric intervention in relationship to the presence or absence of different psychiatric disorders. One hundred forty-two Italian male subjects from the Casa Circondariale of Messina, Italy, were evaluated using the Structured Clinical Interview for DSM-III-R Non-Patient Version - SCID I and SCID II. A very high rate of disorders was found among inmates: 85.2% (n=121) of the sample were affected by a psychiatric disorder. Of the total sample, 51.4% (n=73) had requested psychiatric treatment during detention. The detection, diagnosis and treatment of the mentally ill prisoners is a primary goal for a better organization of services and prison settings; screening procedures for evaluating the presence of psychiatric disorders, with the aim to promote differential strategies for the care and rehabilitation of inmates, are needed.

Bovine lactoferrin for Helicobacter pylori eradication: an open, randomized, multicentre study.

BACKGROUND: Cure rates for eradication of Helicobacter pylori appear to be decreasing, thus more effective therapies must be identified. AIM: To evaluate the efficacy of bovine lactoferrin in the treatment of H. pylori infection. METHODS: In a multicentered prospective study, 402 (mean age 52.4, range 19-84 years) H. pylori-positive patients were assigned to one of three regimens: group A - esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. for 7 days; group B - lactoferrin 200 mg b.d. for 7 days followed by the same schedule of group A; group C - esomeprazole 20 mg b.d., clarithromycin 500 mg b.d. and tinidazole 500 mg b.d. plus lactoferrin 200 mg b.d. for 7 days. RESULTS: Of the 402 patients, 389 completed the study. Six patients were discontinued due to side effects, one patient in group B died and six patients were lost to follow up. The eradication rate (intention-to-treat analysis) was 77% in group A (105/136), 73% in group B (97/132) and 90% in group C (120/134) (chi(2)-test P < 0.01). The incidence of side effects was 9.5% in group A, 9% in group B and 8.2% in group C (chi(2)-test P = 0.1). CONCLUSION: This study demonstrates that bovine lactoferrin is an effective adjuvant to 7-day triple therapy for eradication of H. pylori infection.

Clinical usefulness of serum pepsinogens I and II, gastrin-17 and anti-Helicobacterpylori antibodies in the management of dyspeptic patients in primary care.

BACKGROUND: Several tests have been proposed for evaluating dyspeptic symptoms and their relationship to the underlying gastric disease. Serum pepsinogens and gastrin-17 are known to be useful biomarkers for the detection of gastric pathologies. AIM: To evaluate the capability of screening dyspeptic patients in the primary care by analyses of serum pepsinogens I (sPGI) and II (sPGII), gastrin-17 (sG-17) and the IgG anti-Helicobacter pylori antibodies (IgG-Hp). PATIENTS AND METHODS: Three hundred and sixty-two consecutive patients with dyspeptic symptoms (208 females, mean age 50.6 +/- 16 years, range 18-88 years) referred by general practitioners for upper gastrointestinal endoscopy were enrolled. A blood sample was taken from each subject for IgG-Hp, sPGI, sPGII and sG-17 analyses. RESULTS: Two hundred and eighty-seven patients had a complete screening; of these, 132 resulted positive for Hp infection. Patients with atrophic chronic gastritis showed significantly lower serum pepsinogen I levels and sPGI/sPGII ratio than patients with non-atrophic chronic gastritis. Moreover, by calculating the values of sPGI by sG-17 and sG-17 by sPGII/sPGI, subjects with atrophic chronic gastritis could be distinguished from those with non-atrophic chronic gastritis and from those with normal mucosa, respectively. sG-17 levels were found to be a useful biomarker for the detection of antral atrophic gastritis, while the combination of sPGI, the sPGI/sPGII ratio and sG-17 was found effective in identifying corpus atrophy. CONCLUSION: A panel composed of PGI, PGII, G-17 and IgG-Hp could be used as a first approach in the 'test and scope' and/or 'test and treat' strategy in the primary care management of dyspeptic patients.

Use of bovine lactoferrin for Helicobacter pylori eradication.

BACKGROUND: One-week triple therapy is the most frequently recommended treatment for Helicobacter pylori infection. Eradication rate is satisfactory, nevertheless is advisable to look for more effective therapies. AIM: To test the efficacy of a standard triple therapy plus bovine lactoferrin in the eradication of H. pylori infection. PATIENTS AND METHODS: One hundred and fifty consecutive H. pylori positive patients, suffering from dyspeptic symptoms were recruited in a 7-day triple therapy open randomised single centre study with rabeprazole, clarithromycin, tinidazole, bovine lactoferrin (group A) or rabeprazole, clarithromycin, tinidazole (group B), or a 10-day therapy with rabeprazole, clarithromycin, tinidazole (group C). H. pylori status was assessed 8 weeks after the end of the treatment by means of a 13C-urea breath test or a H. pylori stool antigen-test. RESULTS: Eradication rates (intention to treat/per protocol) were: group A (92.2/95.9%), group B (71.2/72.5%) and group C (70.2/75%). The efficacy of triple therapy added with lactoferrin was significantly higher than other two regimens (p=0.01, intention to treat analysis; p=0.005, per protocol analysis). CONCLUSION: These results suggest that lactoferrin tested in the present study was effective in curing H. pylori and could be a new agent to assist the antimicrobials in the eradication of the bacterium.

Cytotoxic effect of Argentine medicinal plant extracts on human hepatocellular carcinoma cell line.

Methanolic extracts from Achyrocline satureioides (Dc.) Lam, Aristolochia macroura Gomez, Lithraea molleoides (Vell.) Engl., Schinus molle L., unlike those from Celtis spinosa Spreng, Chenopodium ambrosioides L., Petiveria alliacea L., and Plantago major L. showed cytotoxic activity against a human hepatocellular carcinoma cell line, Hep G2. Schinus molle L. was the most active (IC50=50+/-7 microg/ml). These results call for further studies of these extracts.

Antiviral activity in Argentine medicinal plants.

In an ethnopharmacological screening of selected medicinal plants used in Argentina for the treatment of infectious diseases, aqueous extracts of five species were assayed in vitro to detect antiviral activity against herpes simplex virus type 1 (HSV-1), respiratory syncytial virus (RSV) and adenovirus serotype 7 (ADV-7). Polygonum punctatum, Lithraea molleoides, Sebastiania brasiliensis and Sebastiania klotzschiana but not Myrcianthes cisplatensis showed in vitro antiherpetic activity with 50% effective dose (ED50) ranging from 39 to 169 microg/ml. P. punctatum, L. molleoides and M. cisplatensis showed antiviral activity against RSV with ED50 ranging from 78 to 120 microg/ml. None of the extracts had antiviral activity against ADV-7. The differences between their maximal non cytotoxic concentration and their antiviral activity values were high enough to justify further analysis.

Accurate encoding and decoding of emotional facial expressions in schizophrenia.

This is a study of the encoding and decoding of emotional facial expressions by people diagnosed as schizophrenic. The results of most previous investigations have shown that schizophrenics are worse than other psychiatric and normal comparison groups at adopting and recognizing facial expressions of emotion. This study is the first in which both abilities were tested within the same group of outpatient subjects. In contrast to earlier findings, the results of this study indicate that this group of schizophrenics was equally proficient, as compared with unipolar depressive and normal medical control subjects, in the encoding and decoding of facial expressions of anger, sadness, fear, happiness, disgust, and surprise. Encoding and decoding responses in all three groups were largely unrelated. Some of the potential explanatory factors for these unusual findings include the older age of this sample and the use of a rating procedure in the decoding task that is more similar to the nature of decoding decisions made in social situations than those typically used by other investigators. The general conclusion that schizophrenics are deficient relative to comparison groups in the encoding and decoding of emotional facial expressions is not supported by these results.

[A comparison between propafenone and hydroquinidine perorally in the treatment of recent-onset atrial fibrillation]. / Confronto tra propafenone e idrochinidina per via orale nel trattamento della fibrillazione atriale di recente insorgenza.

The aim of this study was to assess the effectiveness of propafenone and quinidine to restore sinus rhythm in patients with paroxysmal atrial fibrillation. Eighty consecutive patients with recent onset atrial fibrillation were randomized to one of the following oral treatments: a) propafenone 450 mg as single dose followed by 300 mg t.i.d.; b) hydroquinidine 900 mg/24 hours + digoxin if necessary. Drugs were given for a maximum of three days and withdrawn at the restoration of sinus rhythm. If atrial fibrillation was persistent, the other drug was administered after two days wash out. The two groups did not differ from each other with respect to left atrial size, age and presence of organic heart disease, and kind of cardiopathies between the two groups. Sinus rhythm was restored in 39 patients of group 1 (93%) and 36 of group 2 (95%). In conclusion, oral propafenone is as effective as quinidine in the treatment of paroxysmal atrial fibrillation.

[Arrhythmia in thalassemia major: evaluation of iron chelating therapy by dynamic ECG]. / Aritmie nella talassemia major: valutazione della terapia ferrochelante mediante ECG dinamico.

Arrhythmias and sudden death represent striking features in the natural history of thalassemia major. Antiarrhythmic treatment, however, does not appear to change the clinical course. During recent years the disease's therapeutics approach has undergone a substantial evolution, being more adequate the transfusional regimens as well as more effective the iron chelation therapy through subcutaneous infusion of deferoxamine. The aim of the present study was to determine possible influences exerted by the current treatment upon disease's arrhythmic disorders. Thirty patients of both sexes were enrolled in the study. The age ranged from 9 to 24 years. No congenital or acquired heart diseases were present. Each patient underwent concentrated red cell transfusions (in order to obtain pretransfusional hemoglobin levels of 10-11 g%), and iron-binding therapy through continuous subcutaneous microinjection of deferoxamine 40-50 mg/kg/day (6-8 hours/day, 6 days/week). Patients were divided in 2 groups: the first group (group A) comprising the 16 patients with good therapeutic compliance and regular pharmacological regimen; the second group (Group B) including the remaining poorly compliant 14 patients. The following parameters were analyzed: age, average hemoglobin levels during the last year, total amount of red cell transfusions, ferritin levels, starting age of iron-binding therapy. Moreover, each patient underwent 24-hour ECG Holter monitoring. Age (Group A: 18 +/- 4.6; Group B: 14 +/- 2.7; p < 0.02), total amount of transfusions (Group A: 272 +/- 73; Group B: 211 +/- 44; p < 0.03), and ferritin levels (Group A: 1697 +/- 860; Group B: 2908 +/- 730; p < 0.002) proved to be significantly different in the two groups.(ABSTRACT TRUNCATED AT 250 WORDS)

What is known about the antiviral agents active against bovine viral diarrhea virus (BVDV)?

Viruses belonging to the Flaviviridae family cause clinically significant diseases in humans and animals. This family includes three genera: Pestivirus [including bovine viral diarrhea virus (BVDV)], Flavivirus [including yellow fever virus (YFV), dengue virus, and West Nile virus (WNV)], and Hepacivirus [including hepatitis C virus (HCV)]. BVDV is responsible for major losses in cattle, causing a range of clinical manifestations, and is also a problematic contaminant in the laboratory. Noncytopathic BVDV infection can remain unnoticed and infect laboratory cell lines through its presence in contaminated bovine serum used in cell culture. BVDV is considered to be a valuable surrogate virus model for identifying and characterizing antiviral agents to be used against HCV. In some aspects of viral replication, BVDV is more advantageous than the currently used HCV replicon systems. In this review, we report the design, synthesis, and activity against BVDV of a series of compounds assayed until now.

Non-invasive tests in gastric diseases.

Although the gastric cancer incidence is decreasing, this neoplasia remains one of the major causes of oncological mortality. Because of an insidious development, gastric cancer is often diagnosed in an advanced stage and consequently with a poor prognosis. Accurate non-invasive tests should be extremely useful in order to detect gastric neoplasm in an early phase. In clinical practice, there is no reliable bio-marker for detecting this malignant disease. However, intestinal as well as diffuse types of gastric cancer are preceded by gastric mucosa inflammation. Furthermore, the intestinal type of the neoplasia is, generally, related to chronic atrophic gastritis, especially if associated with intestinal metaplasia. In particular, the risk of the neoplasm is linked to both extension and severity of gastric atrophy. Serological parameters such as serum pepsinogens I (PGI) and II (PGII), gastrin-17 (G-17) cytokines (e.g. IL-8), antiparietal cells, IgG anti-Hp and CagA antibodies and lastly ghrelin supply information about either atrophic or inflammatory conditions characterising gastric mucosa. Low PGI and PGI/PGII ratio levels, especially if combined with high G-17 levels, are recognised bio-markers of corpus atrophic gastritis. Low G-17 levels could be, also, suggestive of antral atrophic gastritis. Furthermore, plasmatic ghrelin levels seem to be also a bio-marker of corpus atrophy. Anti-Hp IgG and CagA antibodies as well as PGII levels are able to detect gastric inflammation. Serological parameters could select subjects at risk for gastric mucosa alterations such as inflammation or atrophy, rather than gastric cancer itself. This review analyses the information derived from serological bio-markers as well as the involved clinical studies.

1,3-dihydroxy-5-(tridec-4',7'-dienyl)benzene: a new cytotoxic compound from Lithraea molleoides.

A dichloromethane extract from the leaves of Lithraea molleoides (Anacardiaceae), an argentine medicinal plant, showed cytotoxicity on human hepatocellular carcinoma cell line. Bioassay guided fractionation of this extract led to the isolation of a new active 5-alkyl resorcinol: 1,3-dihydroxy-5-(tridec-4',7'-dienyl)benzene. Chemical structure was established based on spectroscopic data (UV, IR, MS, 1H-NMR, 13C-NMR, COSY). This compound presented cytotoxic activity on 3 human tumoral cell lines: hepatocellular carcinoma cell line-Hep G2 (IC50 +/- SD of 68 +/- 2 microM), mucoepidermoid pulmonary carcinoma cell line-H292 (IC50 +/- SD of 63 +/- 5 microM) and mammary gland adenocarcinoma cell line -MCF7 (IC50 +/- SD of 147 +/- 5).

Intermittent sinus bigeminy as an expression of sinus parasystole: a case report.

A case of sinus parasystole is reported. The diagnosis of sinus parasystole is relatively difficult because there is no difference between the basic sinus P wave and the parasystolic wave. Sinus parasystole is diagnosed according to the following electrocardiographic criteria: (1) premature P waves having contour identical to P waves of basic beats; (2) intervals between premature P waves mathematically related. In the case reported, the coupling intervals during long phases of intermittent sinus bigeminy were nearly fixed, because there was little variability in the returning cycles, making the diagnosis of sinus parasystole difficult.

[The many faces of parasystolic rhythm]. / Le molte facce del ritmo parasistolico.

BACKGROUND: Parasystole is the expression of a pacemaker that is protected from, and thus independent of, the dominant rhythm. The arrhythmia is not always associated with the 3 classic signs: variable coupling, mathematically related interectopic intervals, and fusion beats. A large amount of experimental and clinical data have pointed out several atypical phenomena that make the recognition of parasystole difficult. This especially occurs in the presence of influence exerted from sinus impulses upon the parasystolic rhythm. METHODS: A pattern of ventricular parasystole was evident throughout a 24-hour Holter recording obtained from a 55-year-old female. The following data were analyzed: a) distribution of ectopic complexes; b) parasystolic cycle duration; c) regularity of parasystole, as assessed by means of the variation index. In some sections of the tracing in which an electrotonic influence (modulation) exerted by the sinus rhythm on the parasystolic rhythm appeared as very likely, phase-response curves were constructed in order to express the time-dependent modulation effected by sinus impulses. RESULTS: Parasystole occurred in two separate periods, lasting 4 hours and 90 minutes, respectively. On both occasions, the arrhythmia was apparently precipitated by a brief episode of atrial tachycardia. Phases of regular parasystole, as well as periods of irregular modulated parasystole, were observed. The distribution of ectopic complexes was at times typical for concealed bigeminy (intervening beats always in odd numbers), but on other occasions reflected the even variant of concealed bigeminy where the intervening beats conform to the formula 1 + n (n being zero or an odd number). Some couplets of identical ectopic complexes were also observed. CONCLUSIONS: The study shows that several different expressions of parasystolic rhythm may be present within the same tracing. A minimal or absent modulation results in the classical picture of parasystole; when a mild modulating influence is present, the typical pattern of modulated parasystole ensues, whereas a strong modulation leads to disappearance of the typical features of parasystole and manifestation of concealed bigeminy. Finally, supernormal modulation is responsible for the occurrence of couplets.

Irregular sinus parasystole due to intermittency and modulation of parasystolic activity.

A case of intermittent sinus parasystole in which the parasystolic focus is protected from the dominant sinus rhythm only during the second half of its intrinsic cycle is reported. In addition, a modulating (i.e., electronic) effect is often clearly exerted from the dominant rhythm upon the focus during the protected period. Coexistence of both modulation and intermittency in sinus parasystole, as well as a modulating effect limited to the second part of the parasystolic cycle, have not been previously reported.

Emotional expression and feeling in schizophrenia: effects of specific expressive behaviors on emotional experiences.

The purpose of this study was to investigate the relationship between emotional expression and experience in schizophrenia by manipulating expressive behaviors directly and then assessing subsequent emotional feelings. In Study 1, facial expressions and bodily postures were manipulated in a sample of normals, the results of which replicate findings from previous studies of peripheral feedback effects on emotions. In Study 2, the same procedures were used with matched groups of outpatient schizophrenic men, patients with depression, and nonpsychiatric controls. Schizophrenia patients showed the usual effects from their facial expressions of sadness, fear, happiness, and surprise, but only from their postures of anger, whereas patients with depression showed the same effects only from their expressions and postures of sadness, and normal controls only from their expressions and postures of anger. These patterns may reflect those aspects of the emotional response system that are functional and dysfunctional in schizophrenia and depression.

Accuracy of low load exercise-induced T wave normalization in predicting the presence of contractile reserve after an anterior myocardial infarction.

BACKGROUND AND METHODS. Exercise-induced T wave normalization occurring at a low (less-than-or-equal50 watt) workload in infarct-related electrocardiographic leads was studied in 30 consecutive patients with a recent transmural anterior acute myocardial infarction. Patients underwent both ergometric stress testing (within 30 days after the infarction) and low dose dobutamine echocardiography. The T wave normalization was considered significant when it occurred in at least two infarct-related leads. A significant contractile reserve was considered present in an infarcted region when 50% or more of the dyskinetic segments functionally improved on exercise during dobutamine infusion. RESULTS. Eighteen patients showed exercise-induced T wave normalization (group 1), and 12 patients did not (group 2). Myocardial contractile reserve in the infarct area was detected in 16 patients of group 1 (88%) and in 3 patients (25%) of group 2 (p=0.004). The overall sensitivity, specificity, and diagnostic accuracy of T wave normalization, as it reflects contractile reserve in the infarct area, were 84%, 82%, and 83%, respectively. CONCLUSION. Low load exercise-induced T wave normalization in infarct-related leads appears to be an accurate marker of residual contractile reserve in the infarct area in patients with recent transmural acute anterior myocardial infarction. (c) 2000 by CHF, Inc.

Modification of foot-and-mouth disease virus after serial passages in the presence of antiviral polyclonal sera.

Foot-and-mouth disease virus (FMDV) shows a remarkable antigenic variability. Like other RNA viruses, this virus has a high rate of mutation. It has been proposed that selection exerted by the host's antibodies could play a major role in the rapid evolution of FMDV. The present work reports the selection of FMDV antibody-resistant populations (Nr), after serial passages of cloned FMDV A24 Cruzeiro strain on secondary monolayers of bovine fetal kidney cells in the presence of subneutralizing antiviral polyclonal sera (APS). After a limited number of passages under selective pressure, the virus population showed the following characteristics: (1) increased resistance to neutralization by APS; (2) altered electrophoretic mobility of structural viral proteins (VP1); (3) remarkable plaque size reduction, (4) a pronounced thermosensitivity (ts); and (5) decreased pathogenicity for mice, in both uncloned and cloned small plaque size populations. This indicates that FMDV populations under antibody pressure in vitro, have acquired, in addition to expected characteristics of natural FMDV variants (resistance to neutralization and altered viral structural proteins), phenotypic markers which correspond to attenuated, less virulent variants.

[The allorhythmic distribution of ectopic ventricular beats. Observations on the electrogenesis and dynamics of concealed ventricular extrasystole]. / Distribuzione alloritmica dei battiti ectopici ventricolari. Osservazioni sull'elettrogenesi e sulla dinamicità dell'extrasistolia ventricolare occulta.

BACKGROUND: A regular distribution of ventricular ectopic beats is thought to be a relatively uncommon phenomenon, known as "concealed extrasystole". Several experimental studies suggest that the phenomenon originates from a "protected" ventricular focus. The aim of the present study was to evaluate the 24-hour ECG monitoring incidence of ventricular concealed extrasystole in patients with highly frequent ventricular ectopic beats, looking for signs useful in postulating the electrogenesis of the arrhythmia. METHODS: The 24-hour ECGs of 10 patients (pts) with highly frequent ventricular extrasystoles were analysed, searching for significant sequences in the distribution of ectopic beats (i.e., ectopic beats separated by a number of interectopic sinus beats fulfilling one of the formulas of concealed extrasystole). RESULTS: Five cases (50%) showed an allorhythmic distribution resulting in a prevalent pattern of concealed bigeminy (2n-1) in 3 cases, and concealed trigeminy (3n-1) in 2 cases. The phenomenon, however, showed a dynamic behaviour, alternating the distributions from patterns of concealed bigeminy to concealed trigeminy or less common patterns, and vice versa. The evidence of the pure ectopic cycle and mathematically related interectopic intervals in 2 cases, the variability of coupling intervals, and the presence of fusion beats in the remaining 3 cases, strongly suggests a parasystolic origin of the phenomenon. CONCLUSIONS: The results suggest the following: Concealed extrasystole is a relatively common phenomenon, at least in patients with highly frequent ventricular extrasystoles; the phenomenon, however, is somewhat underestimated due to prevalent quantitative, instead of qualitative, Holter monitoring analyses. Among patients with allorhythmically distributed ventricular extrasystoles, none showed only one pattern of distribution. In fact, each single patient showed two or more patterns throughout the 24-hour recordings. Changes from one pattern to another is governed by several factors, such as sinus heart rate and/or the influence of electrotonic "modulation" upon the ectopic focus. Ventricular extrasystoles with regular allorhythmic distribution show a significantly higher variability of coupling intervals than the others (p = 0.005).