Hydrolyzable tannins from Poincianella (Caesalpinia) microphylla fruits: Metabolite profiling and anti-Trichomonas vaginalis activity.

Poincianella (Caesalpinia) microphylla fractions were analyzed by LC-DAD-MS and by statistical tools to determine the possible bioactive compounds against T. vaginalis. Tannins enriched-fractions toxicity (M5 and M10) were analyzed in in vitro against human red cells and in in vivo model of Galleria mellonella. Twenty-six compounds were detected from the P. microphylla fractions. The main compounds identified were hydrolyzable tannins (gallotanins and ellagitannis), such as O-digalloyl hexoside, O-digalloyl HHDP -hexoside, tri-O-galloyl HHDP-hexoside, O-galloyl HHDP-DHHDP-hexoside and their isomers. In addition, procyanidin dimer, epicatechin, ellagic acid and O-(digalloyl) quinic acid were also identified. Based on univariate statistical analyses, stronger correlations with the anti-T. vaginalis properties were observed for the compounds 7 (O-galloyl HHDP-DHHDP-hexoside - Geraniin isomer), 3 (O-digalloyl HHDP -hexoside - mallotinic acid), 2 (O-digalloyl) quinic acid), 1 (O-digalloyl hexoside) and 9 (unknown). Tannins enriched-fractions (M5 and M10) presented anti-Trichomonas activity (IC50 70.41 µg/mL and 142.1 µg/mL, respectively) and no toxicity in the in vivo model of G. mellonella. This innovative approach allowed us to identify likely bioactive compounds in the extracts, although the mechanism(s) underlying anti-trichomonal activity encompass a complex trait.

Risk of inflammatory bowel disease attributable to smoking, oral contraception and breastfeeding in Italy: a nationwide case-control study. Cooperative Investigators of the Italian Group for the Study of the Colon and the Rectum (GISC).

BACKGROUND: Using data from a case-control study carried out in Italy 1989-1992, we estimated the odds ratios (OR) and the population attributable risks (AR) for inflammatory bowel diseases (IBD) in relation to smoking, oral contraception and breastfeeding in infancy. METHODS: The study focused on 819 cases of IBD (594 ulcerative colitis: UC; 225 Crohn's disease: CD) originating from populations resident in 10 Italian areas, and age-sex matched paired controls. RESULTS: Compared with non-smokers, former smokers were at increased risk of UC (OR = 3.0; 95% confidence interval [CI]: 2.1-4.3), whereas current smokers were at increased risk of CD (OR = 1.7; 95% CI: 1.1-2.6). Females who reported use of oral contraceptives for at least one month before onset of symptoms had a higher risk of CD (OR = 3.4; 95% CI: 1.0-11.9), whereas no significant risk was observed for UC. Lack of breastfeeding was associated with an increased risk of UC (OR = 1.5; 95% CI: 1.1-2.1) and CD (OR = 1.9; 95% CI: 1.1-3.3). Being a 'former smoker' was the factor with the highest attributable risk of UC both in males (AR = 28%; 95% CI: 20-35 %) and in females (AR = 12%; 95% CI: 5-18%). Smoking was the factor with the highest attributable risk for CD in males (AR = 31%; 95% CI: 11-50%). Lack of breastfeeding accounted for the highest proportion of CD in females (AR = 11%; 95% CI: 1-22%). Oral contraceptive use accounted for 7% of cases of UC and for 11% of cases of CD. CONCLUSIONS: Taken together, the considered factors were responsible for a proportion of IBD ranging from 26% (CD females) to 36% (CD males). It is concluded that other environmental and genetic factors may be involved in the aetiology of IBD.

Effects of amphetamine on the plus-maze discriminative avoidance task in mice.

RATIONALE: The contradictory amphetamine effects on memory could be due to different protocols of amphetamine administration or the well-known anxiogenic effect of the drug. OBJECTIVE: The effects of different protocols of administration of amphetamine were investigated on mice tested in the plus-maze discriminative avoidance task (DAT), which provides simultaneous information about memory and anxiety. METHODS: Acutely pre- or post-training, 0.3, 1.0, or 3.0 mg/kg amphetamine-treated, 10-day chronically 3.0 mg/kg amphetamine-treated, 0.3 mg/kg amphetamine plus 0.25 mg/kg scopolamine and 3.0 mg/kg amphetamine plus 3.0 mg/kg tacrine-treated mice were conditioned to choose between two enclosed arms (one of which was aversive) while avoiding two open arms. Learning/memory was evaluated by the percentage time in the aversive enclosed arm (PTAV), and anxiety by the percentage time in the open arms (PTO). RESULTS: Given acutely before conditioning, amphetamine significantly decreased PTO in training, suggesting an anxiogenic effect, and significantly increased PTAV in the test, suggesting an amnestic action. Given acutely after the conditioning, no action of this drug on memory was found. After repeated treatment, the anxiogenic effect disappeared, while the amnestic effect remained. While no effects of subeffective doses of amphetamine and scopolamine co-administration were detected, tacrine attenuated the amnestic effect of amphetamine. CONCLUSIONS: Amphetamine has different effects on DAT when given pre- or post-training. While acute pre-training amnestic action is temporally correlated with an anxiogenic effect, there is tolerance to the anxiogenic but not to the amnestic effect after repeated administration. Because this acute amnestic effect of amphetamine is attenuated by tacrine, a possible relationship with cholinergic system cannot be discarded as a mechanism to amphetamine-induced amnesia in DAT.

Comparison of three different risk scoring systems in non-variceal upper gastrointestinal bleeding.

BACKGROUND AND AIMS: To prospectively validate in patients with non-variceal upper gastrointestinal bleeding three risk scoring systems (the Baylor College scoring system, the Rockall's risk scoring system and the Cedars-Sinai Medical Centre predictive index) previously proposed to be predictive of rebleeding/death after upper gastrointestinal bleeding. PATIENTS AND METHODS: We calculated values of the scores for 343 patients, who underwent endoscopy after non-variceal upper gastrointestinal haemorrhage during the years 1997-1999. We compared the observed outcomes with the ones expected upon the original series contributed by the authors. Discriminative ability was evaluated by calculating the area under the receiver operating characteristic curve. RESULTS AND CONCLUSIONS: Rockall's score accurately predicted rebleeding in low- and intermediate-risk categories (< 6), but not in high-risk patients. The rates of rebleeding were significantly higher than the ones predicted by the low-risk categories of either Cedars-Sinai index (< or = 2) or Baylor score (< or = 6). The predicted and the observed mortality was not significantly different throughout all the categories of Rockall's score, except for patients with a score of 4. All the scores had better discriminative ability for mortality than for rebleeding. The Rockall's score identifies a low-risk group of patients (Rockall's score < or = 2) for rebleeding and mortality.

Baseline sero-epidemiology of hepatitis B virus infection in children and teenagers in Italy. A survey before mass hepatitis B vaccination.

During the period May 1987 to November 1989, the prevalence of hepatitis B virus (HBV) markers was determined by ELISA in serum samples of 7405 (55% male, 45% female) apparently healthy persons 3-19 years of age in Italy. Earlier studies of adults there had shown an intermediate degree of HBV endemicity (hepatitis B surface antigen carrier rate greater than 2%). Persons were selected by systematic cluster sampling in five different geographical areas of Italy. The overall prevalence of hepatitis B surface antigen (HBsAg) was 0.6%. The overall prevalence of at least one marker of HBV was 2.8%; it increased from 1.7% among children 3-5 years of age to 4.5% in teenagers 17-19 years of age (P less than 0.001). The prevalence of any HBV marker was higher in southern then in northern areas (3.5% vs. 1.8%, P less than 0.001). A significant association was found with sociodemographic features. Persons whose fathers had less than 6 years of schooling had a 2.3-fold risk (C.I. 95% = 1.5-3.4) while those belonging to a household of six or more under one roof had a 1.7-fold risk (C.I. 95% = 1.2-2.4) of previous exposure to HBV infection. These findings indicate that, today in Italy, exposure to HBV infection at a young age is very low and suggest a shift towards a low degree of endemicity following improvements in socio-economic conditions, decreased family size and increasing use of disposable syringes during recent years.(ABSTRACT TRUNCATED AT 250 WORDS)

Somatostatin and cimetidine in the control of acute upper gastrointestinal bleeding. A controlled multicenter study.

Acute upper gastrointestinal bleeding remains a difficult emergency problem, and, despite recent pharmacological advances, the choice and results of medical treatment are the subject of debate. To determine the effectiveness of two potent inhibitors of gastric acid secretion, somatostatin and cimetidine, in the control of upper gastrointestinal bleeding of non-variceal origin, we initiated a multicentric, randomized, prospective therapeutic trial in 56 patients presenting with acute hemorrhage due to gastric and duodenal ulcers and erosions defined by uniform and precise criteria. The two drugs were administered i.v. for 48 hours at a dose of 250 mcg/h (somatostatin) and 1,600 mg/24 h (cimetidine). Vital signs, laboratory values, and gastric aspirate were checked frequently in accordance with a strict schedule; the number of blood transfusions was also noted. Endoscopy for the assessment of bleeding before admission to the trial and the end of treatment was performed in every patient. Bleeding stopped in 28 of the 30 (93.3%) patients treated with somatostatin, and in 16 of the 26 (61.5%) of those receiving cimetidine (p less than 0.01). The blood requirement of the patients treated with somatostatin and cimetidine was, on average, 1.10 +/- 1.16 and 2.46 +/- 4.03 units per patient, respectively (p less than 0.05). Somatostatin was also significantly superior - in the patients in whom the treatments were successful - with respect to the time taken to achieve this result. In conclusion, our results, together with those already published, point to a definite therapeutic effectiveness of somatostatin in upper gastrointestinal bleeding as here defined, and would appear to justify a more extensive clinical use under controlled conditions.

Primary gastric lymphoplasmacytoid malignant lymphoma (gastric plasmacytoma): an endoscopic cytologic diagnosis.

A case of primary gastric plasmacytoma in which diagnosis was made preoperatively by an endoscopic technique is presented. Exfoliative cytology using a brush under direct visual control enabled the case to be classified as lymphoplasmacytoid malignant lymphoma. Data which favor the diagnosis of plasmacytoma are: 1) plasma cells in various stages of maturation, 2) abnormal plasma cells often in mitotic division, 3) the presence of atypical immunoblasts.

[The activity of misoprostol on the gastric and duodenal mucosal damage in patients with liver cirrhosis]. / Attività del misoprostol sul danno mucoso gastrico e duodenale in pazienti con cirrosi epatica.

Twenty-five liver cirrhosis patients with endoscopically demonstrated gastro-duodenal mucosal damage (microhemorrhages, erosions, ulcers) were treated with misoprostol (prostaglandin E1) 400 mg/die. Eleven patients (44%) had abdominal pain and diarrhea and stopped treatment. Three months later, a new endoscopy was performed in the 11 patients that completed the study (3 patients were lost at follow up). Mucosal damage was stable in 5 patients (45%) and improved in 6 patients (55%), with complete absence of mucosal lesions in 2 patients (P = 0.027, Wilcoxon Ranks test). No case of worsening was observed and no patient had digestive bleeding during treatment. Digestive bleeding is a common complication of liver cirrhosis, originating in about 50% of cases from gastro-duodenal mucosal damage. Misoprostol suggests itself as a possible alternative therapy to the drugs usually utilized in these lesions (beta-blockers, H2-inhibitors), but individual intolerance is frequent and must be preliminary excluded.

[Roxatidine in the treatment of gastroduodenal mucosal lesions in hepatic cirrhosis]. / La roxatidina nel trattamento del danno mucoso gastroduodenale in corso di cirrosi epatica.

In about 50% of patients with liver cirrhosis, upper digestive bleeding is not due to oesaphageal varices rupture, but to a group of peculiar mucosal lesions usually referred as "congestive gastropathy" and "hepatogenic ulcer". The pathogenesis of such mucosal damage is still unclear: an important causative role is commonly thought to be played by portal hypertension, but the role of peptical pathway and of the mucosal barrier impairment must not be underscored as well. Aim of this study was to evaluate the effect of roxatidine in the long-term treatment of mucosal damage in 19 patients with liver cirrhosis. Patients showed a good tolerance and no side effects. The improvement of endoscopic pattern after a three months period of roxatidine therapy was statistically significant; moreover there was no occurrence of digestive bleeding. In conclusion, H2 antagonist may be considered as the drug of choice for the treatment of mucosal damage in patients with liver cirrhosis, for both its safety and effectiveness.

[Retrograde cholangiopancreatography in the diagnosis of Alagille's syndrome]. / La colangiopancreatografia retrograda nella diagnosi della sindrome di Alagille.

The present report deals with an 11-year-old boy affected by Alagille's Syndrome. He presented hepatic ductular hypoplasia without any other associated malformation and with forward evolution to cirrhosis. The diagnosis was made by hepatobiliary scanning with Tc99 HIDA and by Endoscopic Retrograde Cholangiopancreatography (ERCP), because it was impossible to execute liver biopsy.

Quantitative changes of the C-cell population in the rat thyroid during postnatal ontogenesis.

The number and distribution of C-cells in the rat thyroid gland, have been investigated during postnatal ontogenesis from birth to 120 days of age. The argyrophilic and metachromatic properties of these cells were used to identify them. In the thyroid of newborn rats the C-cells do not exhibit argyrophilia and metachromasia. These reactions appear at 10 days and can be seen at all subsequent ages. The number of C-cells shows a parallel increase with age as demonstrated by the change in the proportion of C-cells: F-cells: colloid: stroma during development. A marked increase in C-cells was found at 50 days of age when the proportion of C-cells rose to 27.67% from the value of 16.78% at 30 days. At 70 days a decrease was noted (20.50%) which hardly changed until 120 days of age (22.20%). The numerical increase in C-cells occurs at the expense of the follicular epithelium and stroma. The C-cells occupy elongated islet-like region in the central part of the lells are present. The long axis of the C-cells area is parallel with the longitudinal axis of the lobe. The area of C-cells is largest at the centre of the lobe, corresponding to the territory of the peak of the Gaussian curve for the numerical distribution of C-cells.

Prevalence of hepatitis B markers among teen-agers in Friuli.

In 1989, the prevalence of hepatitis B virus (HBV) markers was studied by Elisa in 421 healthy teen-agers, 17-19 year old, in Udine, Friuli. The prevalence of any HBV marker was 2.4%, with a male predominance (3.8% vs. 0.5%). The prevalence of hepatitis B surface antigen (HBsAg) was 0.5% (2/421); both subjects were anti-Hbc IgM negative, with AST/ALT values in the normal levels, and males. The prevalence of any HBV marker was not associated with largest family size, nor with lowest father's years of schooling. These findings suggest a very low exposure to HBV infection in such area.

[Gastrooesophageal cytology obtained through needle aspiration (author's transl)]. / La citologia gastroesofagea ottenuta mediante agoaspirazione profonda.

The AA. present a new endoscopic method of gastrooesophageal cytology sampling through needle aspiration and results obtained in 90 cases. The AA. believe that this method offers undoubted advantages with regard to brushing in cases of ulcerate and necrotizing neoplasia and in those with submucous beginnings.

[Regenerative gastritis of the peptic ulcer: cytological diagnosis and cytohistological correlation (author's transl)]. / La gastrite rigenerativa dell'ulcera peptica: diagnosi citologica e correlazione citoistologica.

The AA., having already illustrate the cytohistological characteristics of regenerative gastritis of the peptic ulcer, propose some differential cytological criteria with regard serious chronic atrophic gastritis and differentiated adenocarcinoma. The AA. conclude, also as result of reviewing their survey (621 cases) that the perfect knowledge of such criteria that any dubious cytological diagnosis and mistaken positives can be reduced to accettable terms.

Hemodynamic changes after ruthenium irradiation of Hippel's angiomatosis.

The authors report a case of Hippel's angiomatosis successfully treated with contact beta irradiation. The area of the multiplex retinal angioma and the accompanying retinal detachment was irradiated with a 106Ru/106Rh radioactive applicator. Hemodynamic changes due to irradiation were followed up in the ipsilateral ophthalmic artery with transcranial Doppler sonography. Scarring was also demonstrated by fluorescein angiography and A- and B-scan ultrasonography. Irradiation caused the narrowing and later the occlusion of the precapillaries and capillaries (i.e. the resistance vessels) and that of the shunts inside the angioma; consequently, vascular resistance increased. Transcranial Doppler sonographic recordings showed a decrease in blood flow velocity as compared to pathologically increased blood flow velocity in angiomas, and a gradual increase in vascular resistance which was lower before treatment.