Intestinal inflammation is a frequent feature of cystic fibrosis and is reduced by probiotic administration.

AIMS: To assess the incidence of intestinal inflammation in children with cystic fibrosis and to investigate whether probiotics decrease it. STUDY DESIGN: In this two-phase, controlled, prospective study, faecal calprotectin was measured by enzyme-linked immunosorbent assay in 30 children with cystic fibrosis, 30 healthy controls and 15 children with active inflammatory bowel disease. Ten children with cystic fibrosis received Lactobacillus GG, and faecal calprotectin was re-measured 4 weeks later. Rectal nitric oxide production was measured with the rectal dialysis bag technique in 20 children with cystic fibrosis, 20 healthy controls and 15 children with inflammatory bowel disease. Five children with cystic fibrosis received Lactobacillus GG and nitric oxide was re-measured 4 weeks later. RESULTS: Mean faecal calprotectin was significantly higher in the two groups of patients than in controls. Abnormal values were detected in 27 of 30 cystic fibrosis and in 15 of 15 inflammatory bowel disease children. Also mean nitric oxide production was increased in both group of patients, and abnormal values were detected in 19 of 20 cystic fibrosis and in 15 of 15 inflammatory bowel disease children. Calprotectin and nitric oxide concentrations were reduced after probiotics administration. CONCLUSIONS: Intestinal inflammation is a major feature of cystic fibrosis and is reduced by probiotics. The latter finding suggests that intestinal microflora play a major role in intestinal inflammation in cystic fibrosis children.

[Margagni-Larrey diaphragmatic hernia. Description of a clinical case]. / Ernia diaframmatica di Morgagni-Larrey. Descrizione di un caso clinico.

A clinical case report of a Morgagni-Larrey hernia is presented. The finding was made at the age of four months by means of x-ray of the thorax, performed because of recurrent respiratory symptoms regressed after surgical intervention. The rarity of this type of hernia, without a herniary sac and accompanied by the late appearance of respiratory symptomatology, is stressed. It is suggested that x-ray of the thorax should be performed when recurrent respiratory disease is the presenting complaint, even in the first few months of life.

X-linked hypophosphatemic rickets: a probable upper Paleolithic case.

The skeleton of a middle-aged adult male, found in the Late Epigravettian necropolis of Arene Candide cave (Italy) and dated to the XII millennium B.C., exhibits abnormal changes, including bowing deformities, stunted growth, enthesopathies, and increased bone density. The pattern of the observed changes is less consistent with diagnoses of metaphyseal chondrodysplasias, hypophosphatasia, dietary rickets, or diffuse idiopathic skeletal hyperostosis (DISH) than with X-linked hypophosphatemic rickets, which is the most likely etiological factor. This diagnosis may explain other abnormalities (exceptional elongation of the skull and bilateral absence of the lesser trochanter) displayed by other individuals from the same site.

Stature reconstruction from long bones in ancient population samples: an approach to the problem of its reliability.

Stature estimates provided by the application of the anatomical method of Fully and Pineau (1960) to well preserved Neolithic skeletons (39 males and 27 females) from seven different European countries are compared with those drawn from lower-extremity components by means of regression equations commonly used to predict stature of earlier European populations. The analysis of data, carried out with reference both to the sample of origin of the skeletons and to stature classes, suggests that the equations of Pearson (1899) and of Trotter and Gleser for Negroes (1952, 1977) yield very good estimates in female samples, leading to errors below 2 cm in most of the cases. These equations, and those of Olivier et al. (1978), prove useful for stature reconstruction in males too, with the exception of very low (below 154 cm) and very tall (over 179 cm) individuals. Formulae of Breitinger (1938) yield values consistent with those resulting from the anatomical method only within a range including medium-high statures, while the corresponding Bach (1965) formulae for females provide poor approximations. The Trotter and Gleser formulae for Whites (1952) yield very unsatisfactory evaluations, except in specimens taller than 180 cm, and usually overestimate stature both in male and in female skeletons. The results obtained from the long bones by means of alternative approaches to the least-squares regression formulae (Model II regression, and femur/stature ratio) and their efficacy in predicting stature of the samples under study is discussed in the final part of the paper.

Regression equations for estimating stature from long bones of early holocene European samples.

Regression equations for estimating living stature from long bone lengths have been calibrated on a sample of European Neolithic skeletons (33 males and 27 females) by using both least-squares (model I) and major axis (model II) regression techniques. Stature estimates of the skeletal sample have been made by means of Fully's anatomical method, a procedure based on the sum of all osseous components of height, providing the best approximations to the actual stature. The calculated equations have been tested, along with those generally used to predict stature of earlier European remains, on a small, well-preserved sample including Late Upper Paleolithic, Mesolithic, and Neolithic skeletons. The results indicate that the model II equations are particularly useful when very short or very tall individuals are involved and, at the same time, are among the best predictors of stature in less extreme conditions.

Evolutionary trends of stature in upper Paleolithic and Mesolithic Europe.

Long bone lengths of all available European Upper Paleolithic (41 males, 25 females) and Mesolithic (171 males, 118 females) remains have been transformed into stature estimates by means of new regression equations derived from Early Holocene skeletal samples using "Fully's anatomical stature" and the major axis regression technique (Formicola & Franceschi, 1996). Statistical analysis of the data, with reference both to time and space parameters, indicates that: (1) Early Upper Paleolithic samples (pre-Glacial Maximum) are very tall; (2) Late Upper Paleolithic groups (post-Glacial Maximum) from Western Europe, compared to their ancestors, show a marked decrease in height; (3) a further, although not significant, reduction of stature affects Western Mesolithics; (4) no regional differences have been observed during both phases of the Upper Paleolithic; (5) a high level of homogeneity has also been found in the Mesolithic, both in Western and Eastern Europe; (6) the internal homogeneity found during the Mesolithic in Western and Eastern Europe is associated with marked inter-regional variability, with populations of the latter region showing systematically significantly greater stature than their Western contemporaries. Evaluation of possible causes for the great stature of the Early Upper Paleolithic samples points to high nutritional standards as the most important factor. Results obtained on later groups clearly indicate that the Last Glacial Maximum, rather than the Mesolithic transition, is the critical phase in the negative trend affecting Western European populations. While changes in the quality of the diet, and in particular decreased protein intake, provide a likely explanation for that trend, variations in levels of gene flow probably also played a role. Reasons for the West-East Mesolithic dichotomy remain unclear and lack of information for the Late Upper Paleolithic of Eastern Europe prevents insight into the remote origins of this phenomenon. Analysis of regional differentiation of stature, particularly well supported by data from Mesolithic sites, points to the absence of today's latitudinal gradients and suggests a relative homogeneity in dietary, cultural and biodemographic patterns for the last hunter-gatherer populations of Western Europe.

Evidence of spinal tuberculosis at the beginning of the fourth millennium BC from Arene Candide cave (Liguria, Italy).

This paper describes tuberculosislike lesions affecting the spine of Neolithic skeleton found in Arene Candide cave (Liguria, Italy) and representing one of the earliest cases of this disease in Europe. The burial is attributed to middle Neolithic (square-mouthed pottery culture) whose layers date, by 14C, to the first half of the fourth millennium BC. The skeleton, well preserved in the postcranial portion, belongs to a male aged about 15 years having a very light body build. Resorptive lesions localized to the lower thoracic and upper lumbar vertebral bodies, collapse and angular kyphosis, resulting from complete destruction of T11 and T12 and partial destruction of T10 and L1, are the main pathologic features. The morphology of the lesions, sites involved, and age of the specimen are consistent with a diagnosis of tuberculous spondylitis (Pott's disease). The extreme gracility of the skeleton, along with other signs of stress (Harris lines, enamel hypoplasia) suffered during the last years of life, and the limited bony regeneration point to a disease process in its late phase having arisen at the beginning of adolescence. The funerary ritual suggests that the social integration of this adolescent was not prevented by the severe infirmity.

The Upper Paleolithic triple burial of Dolní Vestonice: pathology and funerary behavior.

This work focuses on paleopathological analysis of one of the skeletons from the Gravettian triple burial of Dolní Vestonice (Moravia) and addresses issues of Upper Paleolithic funerary behavior. The burial includes the well-preserved skeletons of three young individuals. The skeleton in the middle (DV 15) is pathological and very problematic to sex; the other two (DV 13 and DV 14) are males and lie in an unusual position. The young age, the possibility of a simultaneous interment, and the position of the three specimens have given rise to speculations about the symbolic significance of this spectacular and intriguing funerary pattern. The pathological condition of the skeleton in the middle further emphasizes its peculiarity. Main pathological changes of the DV 15 skeleton include: asymmetric shortening of the right femur and of left forearm bones, bowing of the right femur, right humerus, and left radius, elongation of fibulae, dysplasias of the vertebral column, and very marked enamel hypoplasias. Scrutiny of the medical literature suggests that the most likely etiology is chondrodysplasia calcificans punctata (CCP) complicated by trauma and early fractures of the upper limbs. CCP is a rare inherited disorder characterized by stippled ossification of the epiphyses. The cartilaginous stippling is a transient phenomenon that disappears during infancy, leaving permanent deformities on affected bones. Among the different forms of CCP, the X-linked dominant form is that resulting in asymmetric shortening and is lethal during early infancy in males. Thus, survival of DV 15 until young adult age would require the specimen to be a female. Clinical findings often associated with the disease (erythemas, ichthyosis, alopecia, cataracts, and joint contractures, among others) would emphasize the singular aspect of this individual, pointing to a condition that should be carefully taken into account when speculating on the significance of that peculiar burial.

Bilateral absence of the lesser trochanter in a late Epigravettian skeleton from Arene Candide (Italy).

A virtually complete skeleton recovered from excavations in a Late Upper Paleolithic context by Cardini between 1940 and 1942 at the Arene Candide cave (NW Italy) lacks the normal development of the left and right lesser trochanters. The specimen is a short-statured male about 25 years old and shows no other especially peculiar skeletal irregularities, except for high negative angles of femoral torsion. We discuss a number of possible etiologies for the anomalous absence of the lesser trochanters. The condition is most likely a result of an epigenetic effect or a traumatic avulsion of both lesser trochanters. If the absence of normal development of the lesser trochanters involves a congenital condition, it is an extremely rare, previously undescribed trait. If the condition results from bilateral traumatic avulsion, it is probably the result of excessive muscular stress on the proximal femur and provides further evidence of hardship of life in Paleolithic populations and of the ability of these people to survive debilitating trauma.

[Use of biological prostheses for cardiac valve replacement in children and adolescents]. / L' impiego di protesi biologiche nela sostituzione valvolare cardiaca in bambini ed adolescenti.

Between January 1976 and June 1980 a consecutive series of 13 patients aging from 9 to 18 years underwent cardiac valve replacement, out of 590 valve replacement operations. All had rheumatic heart disease and many had severe cardiac symptoms; all underwent cardiac catheterization and angiography before operation. Ten single valve replacements, 7 in the aortic, and 3 in the mitral position, and 3 double valve replacements were performed. All patients survived operation, except the one who died 2 months later for congestive heart failure. The others have been followed from 1 to 47 months, averaging 20,5 months. All are free of cardiac symptoms and are being treated with antirheumatic drugs. They are not anticoagulated after 6 months. The operative mortality is low in our bioprosthetic valve replacement, and we think that these operations are safely feasible.

[Suture of the diaphragm by polyglactin 910 (Vicryl): histological study in the rat]. / Sutura del diaframma con polyglactin 910 (Vicryl): studio isotologico nel ratto.

The Authors evaluated the histological aspects on 2nd, 7th, 21st day of diaphragma of rats sutured by polyglactin 910 (vicryl). In result they proved that the absorbment was complete on 21st day and the vicryl produced a greater inflammatory acute and chronic reaction.

[Suture of the diaphragm with collagen: histological study in the rat]. / Sutura del diaframma con collageno: studio isotologico nel ratto.

The Authors evaluated the histological aspects on 2nd, 7th, 21st day of diaphragma of rat sutured by collagen. In result they proved that collagen produced a small inflammatory acute and chronic reaction and the absorbment was complete on 7th day.