Diffuse abdominal hydatidosis: role of magnetic resonance imaging

Hydatid cyst disease still is a serious public-health problem in endemic areas. It is a tissue infestation caused by the larval stage of a parasite, Echinococcus granulosus. Although liver and lung are the most commonly involved organs, hydatid disease can occur in all viscera and soft tissues. In 10% of cases, hydatid disease arises in the viscera: mainly in the spleen (0.9-8%), but also in kidney, bone, heart and peritoneal cavity (0.5-5%). Other rare locations such as muscles have been described in less than 1% of cases of hydatid disease. We report magnetic resonance imaging findings of a case of diffuse abdominal hydatidosis.

[A new reality in the field of penitentiary medicine: the Complex Protected Medicine Structure of the ASL Rome B. Initial report of our working sanitary care]

BACKGROUND

The continuous demand for sanitary care from the imprisoned patients to the general public hospitals has carried to the creation of dedicated structures like the Complex Protected Medicine Structure (SCMP) at the Hospital Sandro Pertini of Rome. Aim of this study was to present the preliminary epidemiologic-clinical data gathered from July 26th 2006 to March 1st, 2006 in our SCMP.

MATERIAL AND METHODS

This study is based on an observational retrospective protocol. Patients characteristics included sex, age, alcohol, smoke and drug abuse, serology for viral hepatitis and AIDS, and treatment with benzodiazepine.

RESULTS

The records of 200 consecutive patients (18 F, 182 M; median age 46 years; range: 20-84 years), attending our Unit were analyzed retrospectively. Out of these patients, 40 (20%) were foreigners, 43 (21.5%) alcohol abusers, and 141 (70.5%) smokers. Forty-eight patients (24%) had a recent or last history of drug addiction (heroin and/or cocaine). The HIV antibodies have been assayed only on 28 patients, turning out positive in 10 (35.71%). Twenty-five patients were positive for HBsAg (12.5%) and 57 (28.5%) for HCV. A consumption of benzodiazepine (BZD) was present in 71 (35.5%) of the patients.

CONCLUSIONS

The essential elements of medical attendance of our structure are described in the article. We present the initial report of our working experience. The present data are in keeping with previous studies of the literature. We hope that our experience coul be extended to all italian Countries.

Static and dynamic heterogeneities in a model for irreversible gelation

We study the structure and the dynamics in the formation of irreversible gels by means of molecular dynamics simulation of a model system where the gelation transition is due to the random percolation of permanent bonds between neighboring particles. We analyze the heterogeneities of the dynamics in terms of the fluctuations of the self-intermediate scattering functions: in the sol phase close to the percolation threshold, we find that this dynamic susceptibility increases with the time until it reaches a plateau. At the gelation threshold this plateau scales as a function of the wave vector k as k(eta-2), with eta being related to the decay of the percolation pair connectedness function. At the lowest wave vector, approaching the gelation threshold it diverges with the same exponent gamma as the mean cluster size. These findings suggest an alternative way of measuring critical exponents in a system undergoing chemical gelation.

Columnar and lamellar phases in attractive colloidal systems

In colloidal suspensions, at low volume fraction and temperature, dynamical arrest occurs via the growth of elongated structures that aggregate to form a connected network at gelation. Here we show that, in the region of parameter space where gelation occurs, the stable thermodynamical phase is a crystalline columnar one. Near and above the gelation threshold, the disordered spanning network slowly evolves and finally orders to form the crystalline structure. At higher volume fractions the stable phase is a lamellar one, which seems to have a still longer ordering time.

Complex viscosity behavior and cluster formation in attractive colloidal systems

The increase in viscosity that is observed in attractive colloidal systems by varying the temperature or the volume fraction can be related to the formation of structures due to particle aggregation. In particular we have studied the nontrivial dependence of the viscosity from the temperature and the volume fraction in the copolymer-micellar system L64. The comparison of the experimental data with the results of numerical simulations in a simple model for gelation phenomena suggests that this intriguing behavior can be explained in terms of cluster formation and that this picture can be quite generally extended to other attractive colloidal systems.

Size segregation in granular media induced by phase transition

In order to study analytically the nature of the size segregation in granular mixtures, we introduce a mean field theory in the framework of a statistical mechanics approach, based on Edwards' original ideas. For simplicity we apply the theory to a lattice model for a hard sphere binary mixture under gravity, and we find a new purely thermodynamic mechanism that gives rise to the size segregation phenomenon. By varying the number of small grains and the mass ratio, we find a crossover from the Brazil nut to the reverse Brazil nut effect, which becomes a true phase transition when the number of small grains is larger then a critical value. We suggest that this transition is induced by the effective attraction between large grains due to the presence of small ones (depletion force). Finally the theoretical results are confirmed by numerical simulations of the 3d system under taps.

Jamming transition in granular media: a mean-field approximation and numerical simulations

In order to study analytically the nature of the jamming transition in granular material, we have considered a cavity method mean-field theory, in the framework of a statistical mechanics approach, based on Edwards' original idea. For simplicity, we have applied the theory to a lattice model, and a transition with exactly the same nature of the glass transition in mean-field models for usual glass formers is found. The model is also simulated in three dimensions under tap dynamics, and a jamming transition with glassy features is observed. In particular, two-step decays appear in the relaxation functions and dynamic heterogeneities resembling ones usually observed in glassy systems. These results confirm early speculations about the connection between the jamming transition in granular media and the glass transition in usual glass formers, giving moreover a precise interpretation of its nature.

Cyclosporine preconditions dendritic cells during differentiation and reduces IL-2 and IL-12 production following activation: a potential tolerogenic effect

The mode of action of cyclosporine (CsA) has been ascribed to its capacity to inhibit IL-2 and IFNgamma production by T cells, two cytokines implicated in allograft rejection. Recently, it has been reported that upon activation, dendritic cells (DCs) exhibit transient production of IL-2, a property that appears to be related to their capacity to initiate immune responses. On the other hand, DCs can generate signals determining Th1/Th2 polarizing effects, an effect that can drastically influence the outcome of organ transplant. The purpose of the present study was to investigate the effect of CsA on cytokine production by immature and mature DCs. DC precursors from mouse bone marrow were induced to differentiate by incubation with GM-CSF for 5 days followed by activation with LPS for 4 hours. CsA was added at different times during this process. Our results show that when CsA is added during the differentiation period following activation with LPS, IL-2 and IL-12 secretion are significantly reduced without affecting the evolution of the DC. Conversely, CsA had no effect when added during the LPS activation period. These results show that CsA affects DCs before they receive the final activation stimulus, preconditioning them to antigen stimulation. This preconditioning of DCs by calcineurin-inhibiting drugs conceptually integrates the mode of action of CsA with the tolerogenic and T-cell polarization function ascribed to DCs. These results may be especially meaningful for the future design of immunosuppressive protocols.

Interleukin-4 Selectively Inhibits Interleukin-2 Secretion by Lipopolysaccharide-Activated Dendritic Cells

Dendritic cells (DCs) generated in vitro from bone marrow precursors using granulocyte-macrophage colony-stimulating factor (GM-CSF) secrete interleukin-2 (IL-2) upon activation, an event probably associated to the initiation of adaptive immune responses. Additionally, they produce IL-12, a cytokine related to T-cell polarization. To analyse the effect of IL-4 on DC differentiation and function, we assessed the capacity of murine bone marrow dendritic cells (BMDCs) differentiated with GM-CSF in the presence or absence of IL-4 to produce IL-2 and IL-12 upon lipopolysaccharide (LPS) activation. We found that although IL-4 enhanced DC IL-12p70 production, it strongly impaired IL-2 secretion by BMDCs. This inhibition, which depends on the presence of IL-4 during LPS activation, is DC specific, as IL-4 did not affect IL-2 secretion by T cells. Interestingly, inhibition of DC IL-2 production did not prevent DC priming of T lymphocytes. These results illustrate a new putative role for IL-4 on the regulation of the immune response and should help clarify the controversial reports on the effect of IL-4 on DCs.

Probability distribution of inherent states in models of granular media and glasses

The present paper develops a Statistical Mechanics approach to the inherent states of glassy systems and granular materials by following the original ideas proposed by Edwards for granular media. We consider three lattice models (a diluted spin glass, a system of hard spheres under gravity and a hard-spheres binary mixture under gravity) introduced to describe glassy and granular systems. They are evolved using a "tap dynamics" analogous to that of experiments on granular media. We show that the asymptotic states reached in such a dynamics are not dependent on the particular sample history and are characterized by a few thermodynamical parameters. We assume that under stationarity these systems are distributed in their inherent states satisfying the principle of maximum entropy. This leads to a generalized Gibbs distribution characterized by new "thermodynamical" parameters, called "configurational temperatures" (related to Edwards compactivity for granular materials). Finally, we show by Monte Carlo calculations that the average of macroscopic quantities over the tap dynamics and over such distribution indeed coincide. In particular, in the diluted spin glass and in the system of hard spheres under gravity, the asymptotic states reached by the system are found to be described by a single "configurational temperature". Whereas in the hard-spheres binary mixture under gravity the asymptotic states reached by the system are found to be described by two thermodynamic parameters, coinciding with the two configurational temperatures which characterize the distribution among the inherent states when the principle of maximum entropy is satisfied under the constraint that the energies of the two species are independently fixed.

Glass transition in the quenched and annealed version of the frustrated lattice gas model

In this paper we study the three-dimensional frustrated lattice gas model in the annealed version, where the disorder is allowed to evolve in time with a suitable kinetic constraint. Although the model does not exhibit any thermodynamic transition it shows a diverging peak at some characteristic time in the dynamical nonlinear susceptibility, similar to the results on the p-spin model in mean field and the Lennard-Jones mixture recently found by Donati et al. (e-print cond-mat/9905433). Comparing these results to those obtained in the model with quenched interactions, we conclude that the critical behavior of the dynamical susceptibility is reminiscent of the thermodynamic transition present in the quenched model, and signaled by the divergence of the static nonlinear susceptibility, suggesting therefore a similar mechanism also in supercooled glass-forming liquids.

Surgical treatment of multinodular goiter: incidence of lesions of the recurrent nerves after total thyroidectomy

The problems concerning surgical goiter treatment are discussed, particularly the morbidity of total thyroidectomy and possible injury to recurrent nerves in comparison to the partial resection of the gland. We discuss our case material and review the literature. We conclude that total thyroidectomy seems to be the most effective surgical procedure with lower morbidity than subtotal thyroidectomy.

Shortened head-up tilt testing potentiated with sublingual nitroglycerin in patients with unexplained syncope

BACKGROUND

Head-up tilt testing is extensively used to determine the vasovagal origin of syncope in patients with otherwise unexplained loss of consciousness, although issues remain regarding the method of the test. The diagnostic value of a shortened head-up tilt test potentiated with sublingual nitroglycerin was assessed in patients with unexplained syncope.

METHODS

Two hundred two patients (mean age 49+/-19 years) with syncope of unknown origin and 34 subjects in a control group (mean age 45+/-17 years) were studied. The patients and the subjects in the control group were tilted upright to 60 degrees for 20 minutes. If syncope did not occur, sublingual nitroglycerin (400 microg) was administered, and observation was continued for 25 more minutes.

RESULTS

During the unmedicated phase syncope occurred in 22 (11%) patients and in one member of the control group. After nitroglycerin was administered, syncope occurred in 119 (59%) patients and in 1 (3%) member of the control group. False-positive response (exaggerated response) was observed in eight (4%) patients and in four (12%) subjects in the control group. The total positivity rate of the test was 70% with a specificity rate of 94%.

CONCLUSIONS

Short-duration head-up tilt test potentiated with sublingual nitroglycerin provides an adequate specificity and positivity rate in patients with unexplained syncope.

[Experience at an ambulatory surgical service for thyroid diseases]

Based of a personal series of 206 patients, the authors evaluate their personal experience of an outpatient surgery ward for thyroid pathologies. The paper reports the diagnostic and therapeutic approaches both in patients undergoing surgery and those who do not. Attention is focused on the importance of the multidisciplinary team and the quality of the results of a homogeneous follow-up.

[Surgical treatment of non-toxic multinodular goitre. Retrospective evaluation of a personal case series]

The authors base their study on a retrospective evaluation of a personal series of patients and on a review of the literature on this topic. They focus their attention on surgical problems relating to the type of treatment of non-toxic multinodular goitre. On the basis of the data obtained, they underline that in this pathology total thyroidectomy is the most appropriate form of surgery and does not entail a higher morbidity in relation to more conservative resection.

ACTH 1-17 and short-term memory, anxiety, heart rate, blood pressure

The research investigated the effects of acute ACTH 1-17 administration on plasma cortisol, short-term memory, anxiety state, blood pressure and heart rate. In a double blind crossover design, healthy volunteers were serially evaluated at 5 min, 20 min, 40 min, 60 min after injection of ACTH 1-17 or placebo in separate sessions. Results show that ACTH 1-17 produced, in addition to an increase in plasma cortisol (5 min - 60 min), significant improvements in short-term memory (5 min), a reduction in anxiety (20 min and 40 min), and an increase in systolic (5 min and 20 min) and diastolic blood pressure (5 min). If confirmed by other studies, the short-term memory effect of ACTH 1-17 at 5 min after i.v. could suggest a central action of the peptide, and confirm the role of HPA axis as a modulator of performance and emotional arousal during acute environmental changes.

Diclofenac sodium in ureteral colic: a double-blind comparison trial with placebo

A randomized prospective double blind study of the analgesic effect of 75 mg intramuscular diclofenac sodium (Voltaren), a potent prostaglandin synthetase inhibitor, versus placebo (saline solution) was carried out in 131 consecutive patients with acute ureteral colic. Diclofenac provided complete relief of pain 25 minutes after the injection in 59% of the cases, while placebo provided relief in 29% (p less than 0.01). Forty patients in the placebo group and seventeen patients in the diclofenac group needed an open injection of 75 mg diclofenac intramuscularly after 25 minutes due to persistent pain. Fifty-four of the fifty-seven patients treated with an open injection of diclofenac achieved complete relief of pain after 30 minutes. There were no side-effects of the treatment.

[Behavior of basal values and circadian rhythm of ACTH, cortisol, PRL and GH in a high-protein diet]

Basal values and circadian rhythm of cortisol, ACTH, GH and PRL were studied in 8 normal subjects during a normal balanced caloric diet and during a high protein diet ( + 12% proteins ). GH, ACTH and cortisol levels were considerably higher following the protein rich diet probably on account of the metabolic processes directly related to the higher protein load.

[Influence of haloperidol on blood cortisol response to lysine-8-vasopressin in normal subjects]

The investigations were done on ten normal subjects. The LVP test was performed before and after intravenous-infusion of Haloperidol (Img). The results show that haloperidol eliminates the cortisolemic response during stimulation with LVP; that is most likely, in relation to the specific blocking effect of this drug on dopaminergic receptors in the hypothalamus and on the hypothalamo-diencephalic pathways.