The effects of a fibre-enriched bakery product on glucose, insulin values and appetite. A pilot randomised cross-over trial

Brewers spent grain (BSG) is a valuable source of arabinoxylans with potential beneficial effects on glucose values. This pilot randomised crossover double-blind trial compared the effects of panettone, a sweet baked-product, enriched with BSG-fibre (p-rich) to unenriched panettone (p-standard) on glucose and insulin blood values and appetite scores. Ten healthy volunteers consumed each food in a random order. Blood variables and appetite scores were assessed at fasting and at different intervals after each food consumption. Glucose values were significantly higher after p-standard intake at 90-min (89.9 ± 16.1 vs 74.6 ± 19.4 mg/dL) and 120-min (81.1 ± 9.85 vs 72.1 ± 14.0 mg/dL). The areas-under-the-curve (AUCs) were lower for both glucose (p = .043) and insulin values (p = .036) with p-rich. At 240-min, satiety was higher (p = .006), and desire-to-eat lower (p = .008) with p-rich; desire-to-eat AUC was lower with p-rich too (p = .029). The integration of a small amount of BSG-derived fibre into a sweet food led to improved glycaemic control and appetite regulation.

Meeting Report: WHO Workshop on modelling global mortality and aetiology estimates of enteric pathogens in children under five. Cape Town, 28-29th November 2018

Investment in vaccine product development should be guided by up-to-date and transparent global burden of disease estimates, which are also fundamental to policy recommendation and vaccine introduction decisions. For low- and middle-income countries (LMICs), vaccine prioritization is primarily driven by the number of deaths caused by different pathogens. Enteric diseases are known to be a major cause of death in LMICs. The two main modelling groups providing mortality estimates for enteric diseases are the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, Seattle and the Maternal Child Epidemiology Estimation (MCEE) group, led by Johns Hopkins Bloomberg School of Public Health. Whilst previous global diarrhoea mortality estimates for under five-year-olds from these two groups were closely aligned, more recent estimates for 2016 have diverged, particularly with respect to numbers of deaths attributable to different enteric pathogens. This has impacted prioritization and investment decisions for vaccines in the development pipeline.

The mission of the Product Development for Vaccines Advisory Committee (PDVAC) at the World Health Organisation (WHO) is to accelerate product development of vaccines and technologies that are urgently needed and ensure they are appropriately targeted for use in LMICs. At their 2018 meeting, PDVAC recommended the formation of an independent working group of subject matter experts to explore the reasons for the difference between the IHME and MCEE estimates, and to assess the respective strengths and limitations of the estimation approaches adopted, including a review of the data on which the estimates are based.

Here, we report on the proceedings and recommendations from a consultation with the working group of experts, the IHME and MCEE modelling groups, and other key stakeholders. We briefly review the methodological approaches of both groups and provide a series of proposals for investigating the drivers for the differences in enteric disease burden estimates.

Drivers of the reduction in childhood diarrhea mortality 1980-2015 and interventions to eliminate preventable diarrhea deaths by 2030

BACKGROUND

Childhood diarrhea deaths have declined more than 80% from 1980 to 2015, in spite of an increase in the number of children in low- and middle-income countries (LMIC). Possible drivers of this remarkable accomplishment can guide the further reduction of the half million annual child deaths from diarrhea that still occur.

METHODS

We used the Lives Saved Tool, which models effects on mortality due to changes in coverage of preventive or therapeutic interventions or risk factors, for 50 LMIC to determine the proximal drivers of the diarrhea mortality reduction.

RESULTS

Diarrhea treatment (oral rehydration solution [ORS], zinc, antibiotics for dysentery and management of persistent diarrhea) and use of rotavirus vaccine accounted for 49.7% of the diarrhea mortality reduction from 1980 to 2015. Improvements in nutrition (stunting, wasting, breastfeeding practices, vitamin A) accounted for 38.8% and improvements in water, sanitation and handwashing for 11.5%. The contribution of ORS was greater from 1980 to 2000 (58.0% of the reduction) than from 2000 to 2015 (30.7%); coverage of ORS increased from zero in 1980 to 29.5% in 2000 and more slowly to 44.1% by 2015. To eliminate the remaining childhood diarrhea deaths globally, all these interventions will be needed. Scaling up diarrhea treatment and rotavirus vaccine, to 90% coverage could reduce global child diarrhea mortality by 74.1% from 2015 levels by 2030. Adding improved nutrition could increase that to 89.1%. Finally, adding increased use of improved water sources, sanitation and handwashing could result in a 92.8% reduction from the 2015 level.

CONCLUSIONS

Employing the interventions that have resulted in such a large reduction in diarrhea mortality in the last 35 years can virtually eliminate remaining childhood diarrhea deaths by 2030.

The biomechanics of the umbilical cord Wharton Jelly: Roles in hemodynamic proficiency and resistance to compression

The umbilical cord is a complex structure containing three vessels, one straight vein and two coiled arteries, encased by the Wharton Jelly (WJ) a spongy structure made of collagen and hydrated macromolecules. Fetal blood reaches the placenta through the arteries and flows back to the fetus through the vein. The role of the WJ in maintaining cord circulation proficiency and the ultimate reason for arterial coiling still lack of reasonable mechanistic interpretations. We performed biaxial tension tests and evidenced significant differences in the mechanical properties of the core and peripheral WJ. The core region, located between the arteries and the vein, resulted rather stiffer close to the fetus. Finite element modelling and optimization based inverse method were used to create 2D and 3D models of the cord and to simulate stress distribution in different hemodynamic conditions, compressive loads and arterial coiling. We recorded a facilitated stress transmission from the arteries to the vein through the soft core of periplacental WJ. This condition generates a pressure gradient that boosts the venous backflow circulation towards the fetus. Peripheral WJ allows arteries to act as pressure buffering chambers during the cardiac diastole and helps to dissipate compressive forces away from vessels. Altered WJ biomechanics may represent the structural basis of cord vulnerability in many high-risk clinical conditions.

Exploration of Web-Sites Affects Autonomic Responses Related to Unconscious Emotions

In this work we are interested in analyzing any correlations between physiological parameters, extracted from signals such as Electrocardiogram, respiratory signal and Skin Conductance, and self-reported indices related to emotional or cognitive stimulations. For this purpose, an experiment involving twenty participants with a mean age of 25±5 years of both sexes (13 males and 7 females) was carried out. The protocol included the navigation in simulated web-sites and the vision of two different commercial products (utilitarian and hedonistic). At the end of the navigation, a questionnaire was submitted to the subject in order to measure his/her feelings and emotions in a qualitative and subjective way. Quantitative features were extracted from the physiological signals recorded during the execution of the protocol. We performed a correlation analysis between self-reported and physiological responses related to Arousal, Pleasure, Expectancy and Situational Involvement. Findings showed that when a consumer is exposed to a utilitarian product, the physiological emotional responses are disassociated from the self-reported ones. For the hedonistic product, instead, self-reported measures significantly correlate with physiological arousal features like the combined effect of cardiac and respiratory activity and the Heart Rate.

The project to understand and research preterm pregnancy outcomes and stillbirths in South Asia (PURPOSe): a protocol of a prospective, cohort study of causes of mortality among preterm births and stillbirths

Background

In South Asia, where most stillbirths and neonatal deaths occur, much remains unknown about the causes of these deaths. About one-third of neonatal deaths are attributed to prematurity, yet the specific conditions which cause these deaths are often unclear as is the etiology of stillbirths. In low-resource settings, most women are not routinely tested for infections and autopsy is rare.

Methods

This prospective, cohort study will be conducted in hospitals in Davengere, India and Karachi, Pakistan. All women who deliver either a stillbirth or a preterm birth at one of the hospitals will be eligible for enrollment. With consent, the participant and, when applicable, her offspring, will be followed to 28-days post-delivery. A series of research tests will be conducted to determine infection and presence of other conditions which may contribute to the death. In addition, all routine clinical investigations will be documented. For both stillbirths and preterm neonates who die ≤ 28 days, with consent, a standard autopsy as well as minimally invasive tissue sampling will be conducted. Finally, an expert panel will review all available data for stillbirths and neonatal deaths to determine the primary and contributing causes of death using pre-specified guidance.

Conclusion

This will be among the first studies to prospectively obtain detailed information on causes of stillbirth and preterm neonatal death in low-resource settings in Asia. Determining the primary causes of death will be important to inform strategies most likely to reduce the high mortality rates in South Asia.

Trial registration

Clinicaltrials.gov (NCT03438110) Clinical Trial Registry of India (CTRI/2018/03/012281).

Radiolabeled Localization of the Sentinel Lymph Node: Dosimetric Evaluation in Personnel Involved in the Procedure

Aims and Background

Peritumoral injection of 99mTc-labeled colloids for lymphoscintigraphy and radioguided surgery does not entail any relevant radiation burden to the patients. The real issue about radiation protection concerns the personnel involved in the procedure besides the nuclear medicine personnel. The aim of our study was to evaluate the cumulative doses to personnel involved during the injection of radiolabeled compounds under ultrasound or stereotactic guidance and the radiation burden to the personnel involved in the surgical incision of the tumor 24 hours after the administration of 99mTc-labeled colloids.

Methods and Study Design

We performed environmental contamination tests (SMEAR TEST) and exposure evaluation in the operating room.

Results

In the operating room the removed activity in the analyzed samples was less than 0.5Bq/g and exposure to the personnel was less than 6μSv/h. The evaluations made during ultrasound guidance demonstrated an equivalent and effective dose less than 20μSv.

Conclusions

Our results show that during ultrasound or stereotactic administration of radiolabeled compounds the radiation burden to the personnel involved in the procedure is virtually negligible. The surgeons too are exposed to a negligible radiation dose.

Comparison of Chromosome Aberration Frequency before and after Administration of 131I in Two Groups of Thyroid Cancer Patients

The chromosome aberration frequencies of 10 thyroid cancer patients, before and after their first radioiodine treatment (group A), were compared to the frequencies found in another 10 subjects previously treated with two or more radioiodine administrations (group B). Our data show that the relative increase in chromosome-type aberrations was similar in the two groups: from 2.0% to 3.7% (group A) and from 4.7% to 9.0% (group B). However, the increase in the number of cells with aberrations was greater in group A. Moreover, the higher frequency of aberrations in group B, even before the radioiodine treatment, points out the effect of previous treatments and demonstrates the persistence of this type of lesion. The sister chromatid exchange frequency in the two groups was also analysed, but no effect bound to the radioiodine treatment could be demonstrated.

Estimating global, regional and national rotavirus deaths in children aged <5 years: Current approaches, new analyses and proposed improvements

BACKGROUND

Rotavirus is a leading cause of diarrhoeal mortality in children but there is considerable disagreement about how many deaths occur each year.

METHODS AND FINDINGS

We compared CHERG, GBD and WHO/CDC estimates of age under 5 years (U5) rotavirus deaths at the global, regional and national level using a standard year (2013) and standard list of 186 countries. The global estimates were 157,398 (CHERG), 122,322 (GBD) and 215,757 (WHO/CDC). The three groups used different methods: (i) to select data points for rotavirus-positive proportions; (ii) to extrapolate data points to individual countries; (iii) to account for rotavirus vaccine coverage; (iv) to convert rotavirus-positive proportions to rotavirus attributable fractions; and (v) to calculate uncertainty ranges. We conducted new analyses to inform future estimates. We found that acute watery diarrhoea was associated with 87% (95% CI 83-90%) of U5 diarrhoea hospitalisations based on data from 84 hospital sites in 9 countries, and 65% (95% CI 57-74%) of U5 diarrhoea deaths based on verbal autopsy reports from 9 country sites. We reanalysed data from the Global Enteric Multicenter Study (GEMS) and found 44% (55% in Asia, and 32% in Africa) rotavirus-positivity among U5 acute watery diarrhoea hospitalisations, and 28% rotavirus-positivity among U5 acute watery diarrhoea deaths. 97% (95% CI 95-98%) of the U5 diarrhoea hospitalisations that tested positive for rotavirus were entirely attributable to rotavirus. For all clinical syndromes combined the rotavirus attributable fraction was 34% (95% CI 31-36%). This increased by a factor of 1.08 (95% CI 1.02-1.14) when the GEMS results were reanalysed using a more sensitive molecular test.

CONCLUSIONS

We developed consensus on seven proposals for improving the quality and transparency of future rotavirus mortality estimates.

MAGnesium-oral supplementation to reduce PAin in patients with severe PERipheral arterial occlusive disease: the MAG-PAPER randomised clinical trial protocol

INTRODUCTION

Magnesium exerts analgaesic effects in several animal pain models, as well as in patients affected by acute postoperative pain and neuropathic chronic pain. There is no evidence that magnesium can modulate pain in patients with peripheral arterial occlusive disease (PAOD). We describe the protocol of a single-centre randomised double-blind clinical trial aimed at assessing the efficacy of oral magnesium supplementation in controlling severe pain in patients with advanced PAOD.

METHODS AND ANALYSIS

Adult patients affected by PAOD at stages III and IV of Lèriche-Fontaine classification, who are opioid-naïve, and who have been admitted to our Acute Pain Service for intractable pain, will be eligible. Patients will be randomised to the control group, treated with standard therapy (oxycodone and pregabalin) plus placebo for 2 weeks, or to the experimental group (standard therapy plus magnesium oxide). Patients will be evaluated on days 0, 2, 4, 6, 8, 12 and 14; the following information will being collected: daily oxycodone dose; average and maximum pain (Numerical Rating Scale); pain relief (Pain Relief Scale); characteristics of the pain (Neuropathic Pain Scale); impact of pain on the patient's daily activities (Brief Pain Inventory). The primary outcome will be oxycodone dosage needed to achieve satisfactory analgaesia on day 14. Secondary outcomes will be pain relief on day 2, time needed to achieve satisfactory analgaesia and time needed to achieve a pain reduction of 50%. A sample size calculation was performed for the primary outcome, which estimated a required sample size of 150 patients (75 per group).

ETHICS AND DISSEMINATION

Ethical approval of the study protocol has been obtained from Comitato Etico Provinciale di Brescia, Brescia, Italy. Trial results will be disseminated through scientific journal manuscripts and scientific conference presentations.

TRIAL REGISTRATION NUMBER

NCT02455726.

A hybrid characterization framework to determine the visco-hyperelastic properties of a porcine zona pellucida

The zona pellucida (ZP) is a specialized extracellular matrix surrounding the developing oocyte. This thick matrix consists of various types of glycoprotein that play different roles in the fertilization process. Nowadays, several techniques are available for assessing ZP's mechanical response. The basic assumption behind these methods is that the ZP behaves like an elastic body: hence, dissipative forces are neglected and Young's modulus remains unaffected by probe dynamics. However, dissipative forces are strongly regulated by the slippage of ZP chains past one another while reaction forces related to elastic deformations (driven by the ability of each chain to stretch) depend on the ZP structure (i.e. number of cross-links and distances between knots). Although viscous reaction forces generated by the ZP are one of the main factors regulating sperm transit, their peculiar behaviour along the ZP structure remains poorly understood and rarely investigated. In order to overcome this limitation, a novel visco-hyperelastic model describing the porcine ZP reaction forces generated by nanoindentations at different probe rates is developed and verified in this study. Visco-hyperelastic parameters of porcine ZP membranes are determined by means of a hybrid characterization framework combining atomic force microscopy nanoindentation measurements, nonlinear finite-element analysis and nonlinear optimization. Remarkably, it is possible to separate the contributions of hyperelastic and viscous terms to ZP mechanical response and evaluate the error made in the determination of ZP mechanical properties if viscous effects were not considered.

Does childhood diarrhea influence cognition beyond the diarrhea-stunting pathway?

Background

Diarrhea is a leading cause of morbidity among children under 5 years of age in low- and middle-income countries yet the additional effects and sequelae, such as cognitive impairment associated with diarrhea, have not been quantified.

Methods

We quantified the association between diarrhea prevalence and cognitive outcomes while controlling for linear growth in 4 study populations. Cognition was assessed using different methods across sites and was expressed in standardized units. We built linear regression models for each study with standardized cognitive score as the outcome and diarrhea prevalence as the main predictor variable. We then conducted meta-analyses of the regression coefficients to generate pooled estimates of the association between diarrhea prevalence and cognition whilst controlling for anthropometric status and other covariates.

Results

Diarrhea was not a significant predictor of cognitive score in any site in the regression models or in the meta-analyses (Coefficient = 0.07; 95% CI: −0.1, 0.2). The length for age Z- score was negatively related to cognition in all sites (0.18; 95% CI: 0.14, 0.21), with coefficients remarkably similar across sites (Coefficient Range: 0.168–0.186).

Conclusions

We did not demonstrate an association between diarrhea and cognition with stunting included in the model. The links between diarrhea, stunting, and cognition provide additional rationale for accelerating interventions to reduce diarrhea.

Mechanical behavior of an osteotomized mandible with distraction orthodontic devices

This work analyzes the mechanical behavior of a human mandible when distraction orthodontic devices are used for correcting problems of dental overcrowding and/or arch shrinkage. The mandible 3D model is reconstructed from CT scan data and meshed into finite elements. The distractor is also modeled. FEM analysis included geometric non-linearity. Displacement field of healthy and osteotomized mandibles are compared. Progressive expansion of the distractor and effects of mastication are also analyzed. Finally, we compare two distraction protocols PROT1 and PROT2 where device is, respectively, expanded by 0.6 or 1.2mm/day. The global displacement is 6mm according to clinical recommendations. It came out that mastication forces generate displacements compatible with bone remodeling. However, parasitic rotations of the mandible arms due to mastication may counteract arch expansion induced by the device. Stress concentrations occurred where the device is fixed: stress peaks stay however below yield limit. Finally, PROT2 reduced by about 10% stresses in mandible and reproduces better than PROT1 the displacement field imposed by the device.

Structural behaviour of endodontically treated teeth under thermomechanical loading

Choosing the optimal combination of post construction and restorative materials to minimize thermomechanical stresses in endodontically post-restored teeth is a very challenging task. In fact, while thermal properties of metallic alloys used for endodontic posts are rather similar to those of natural dental tissues, composite restorative materials used for constructing post and postcore usually possess better mechanical properties than metallic alloys. This may make it very difficult to evaluate directly thermomechanical stresses in the restored tooth. Therefore, this paper presents a detailed analysis of the structural behaviour of several post-endodontic restorations submitted to different combinations of thermomechanical load. The aim of the study is to compare the relative merits of different restoration concepts. Three-dimensional finite element method (FE) analysis is carried out for an upper incisor restored with composite as well as metallic post systems. Furthermore, customized and standard post constructions are compared. Two loading cases are considered: (a) exposure to cold irritants in absence of mastication; (b) mastication of cold or hot foods. Effects of thermal field inhomogeneity and occlusal force magnitude are also included in the analysis. Because of the transient nature of thermal loads, relative performance of different restorations is investigated as the thermal perturbation spreads through the restored tooth. Results indicate that composite post systems are globally more efficient than restorations including a metallic alloy post when thermal cycles and mastication act together. However, relative performance of different restoration concepts in the absence of mastication may depend strongly on the time of exposure to thermal irritants.

Biomechanical effects of prosthesis neck geometries to contrast limb lengthening after hip replacement

Hip prostheses should meet the anatomical and physiological characteristics of patients; this is the rationale for designing modular implants of different sizes. To optimize implant geometry, it is necessary to consider, not only the prosthesis component design, but also the final configuration of the implanted leg. This means the necessity to consider the specific morphological and functional condition of ""that"" patient and not only of ""that"" hip to restore, at best, limb functions. Variations in the length of the implanted limb are frequent; therefore, the variations in the three geometrical features of the hip prosthesis neck, which can affect the restoration of the anatomical symmetry of the limbs, were investigated: (i) neck lengths (Ln ), between 50.5 and 64.5 mm; (ii) cervico-diaphyseal (CD) angle ( ã ), between 135 and 125 degrees and; (iii) anteversion (AV) angle ( â ), between 0 and 15 degrees . Adopting a three-dimensional (3D) simplified biomechanical model, the resultant load acting on the hip was estimated for each different design solution; corresponding stress distributions and contact pressures at the interface between the prosthesis head and the ultra high molecular weight polyethylene (UHMWPE) layer were evaluated by 3D finite element (FE) analyses and using the Strozzi approach. The following values have been assumed as physiological values: ã = ã p = 125 degrees , â = â p = 15 degrees and Ln = 57 mm; it was found that to contrast limb lengthening, if the CD angle varies from 135-125 degrees (with neck length Ln = 64.5 mm and AV = 0 degrees ), the joint resultant load decreases by 8.8% (7.2% if AV = 15 degrees ); the contact pressure de-creases by 5.8%, (5% if AV = 15 degrees ); the bending moment in the stem neck increases by 10.9% (13.8% if AV = 15 degrees ) and the torque increases by 1% (12.8% if AV = 15 degrees ).

Finite element analysis of a new customized composite post system for endodontically treated teeth

This paper investigated the mechanical behavior of a new customized post system built up with a composite framework presently utilized for crowns, bridges, veneers and inlay/onlay dental restorations. The material has been shaped so to follow perfectly the profile of the root canal in order to take advantage of the better mechanical properties of composites with respect to metallic alloys commonly used for cast posts. The analysis has been carried out with 3D finite element models previously validated on the basis of experimental work. The new post system has been compared to a variety of restorations using either prefabricated or cast posts. The structural efficiency of the new restoration has been evaluated for an upper incisor under different loading conditions (mastication, bruxism, impact). Results prove that maximum stress values in restored teeth are rather insensitive to post types and materials. However, the new customized composite restoration allows to reduce significantly the stresses inside the dentinal regions where conservative clinical interventions are not possible.

Chromosomal aberrations, sister chromatid exchanges and high frequency cells in young patients with neurofibromatosis 1 (NF1)

Chromosomal aberrations (CAs), sister chromatid exchanges (SCEs) and high frequency cells (HFCs) have been assessed in peripheral blood lymphocytes of 10 neurofibromatosis (NF1) patients and 10 healthy controls. In both groups, the spontaneous rates and the induced (bleomycin for CA and MMC for SCE) frequencies were analyzed. No differences between cells from NF1 patients and controls were observed with respect to spontaneous or bleomycin induced CA. Spontaneous or MMC induced SCE frequencies were also similar in NF1 patients and controls. HFCs, on the contrary, were statistically lower in NF1 patients.

MFASAT: a new alphoid DNA sequence isolated from Macaca fascicularis (Cercopithecidae, Primates)

A new highly repeated DNA fragment isolated from Macaca fascicularis (MFASAT) is described. Our findings obtained by sequencing, Southern blot analysis, and fluorescent in situ hybridization (FISH) on metaphasic chromosomes strongly suggest that MFASAT can be considered as a member of the alphoid DNA family characteristic of Old World monkeys. The chromosomal localization of MFASAT, obtained by FISH, showed that this alphoid DNA is present in the peri-centromeric area of all the chromosomes. MFASAT showed a high degree of conservation when compared, by sequence alignment, to other Macaca species and Papio papio as expected for species with considerable genome conservation. A low degree of homology has been found comparing M. fascicularis alphoid DNA with a more distantly related Cercopithecidae species such as Cercopithecus aethiops.

In vivo cytogenetic studies of the genotoxic effects of polymethyl methacrylate employed in orthopaedics

Polymethyl methacrylate (PMMA) is a material employed as a cement in prosthesis that has been found to induce cytogenetic damage in human lymphocytes in vitro. This effect is particularly achieved before the 5th day of the exposition, while after this period no significant variations appeared. In the present study, results of cytogenetic tests in humans are reported. Sister chromatid exchange analysis and micronucleus tests have been performed on lymphocytes of patients who had undergone prosthesization with cemented prosthesis (group A) or with biological anchorage prosthesis, as control (group B). DNA damage was investigated before implantation and 5 d after surgery in both groups. Cytogenetic tests did not show any significant increase in the number of micronuclei and sister chromatid exchanges with respect to control values in patients with PMMA cemented prosthesis.

Age-related increase of baseline frequencies of sister chromatid exchanges, chromosome aberrations, and micronuclei in human lymphocytes

Intra- and interindividual variations of baseline frequencies of cytogenetic end points in lymphocytes of human populations have been reported by various authors. Personal characteristics seem to account for a significant proportion of this variability. Several studies investigating the role of age as a confounding factor in cytogenetic biomonitoring found an age-related increase of micronucleus (MN) frequency, whereas contradictory results were reported for chromosomal aberrations (CAs) and sister chromatid exchanges (SCEs). We have quantitatively evaluated the effect of age on SCE, CA, and MN through the analysis of a population sample that included data from several biomonitoring studies performed over the last few decades in 12 Italian laboratories. The large size of the data set, i.e., more than 2000 tests for each end point, allowed us to estimate the independent effect of age, taking into account other covariates, such as sex, smoking habits, occupational exposure, and inter- and intralaboratory variability. A greater frequency of the mean standardized values by increasing of age was observed for all of the end points. A leveling off was evident in the last age classes in the trend of MN frequencies. Frequency ratios (FRs), which express the increase of the cytogenetic damage with respect to the first age classes, i.e., 1-19 years, were estimated using Poisson regression analysis after adjustment for the potential confounding factors and confirmed the increasing trend by age class for all three end points. The most dramatic increase was observed for MN, with a FR that approaches the value of 2 at the age class 50-59 (FR, 1.97; 95% confidence interval, 1.43-2.71) and remains substantially unchanged thereafter. The trend of FRs for CA is more homogeneous, with a constant rise even in the older classes, whereas the frequency of SCE increases with age to a lesser extent, reaching a plateau in the age class 40-49 and the maximum value of FR in the age class over 70 (FR, 1.14; 95% confidence interval, 1.07-1.23). In conclusion, our results point to an age-related increase of the chromosome damage in lymphocytes and emphasize the need to take into account the potential confounding effect of this variable in the design of biomonitoring studies based on chromosome damage.

Increased frequencies of sister chromatid exchanges and micronuclei in "in vitro" lymphocyte cultures treated with the fungicides thiram and ziram

The two fungicides analysed in this paper, Thiram (TH) and Ziram (ZI) are among the most common residues found in fruit and vegetables sold in Italy. These compounds were tested in "in vitro" lymphocyte cultures, from 16 individuals, at different concentrations (Thiram 5 x 10(-8) M; 5 x 10(-7) M; 5 x 10(-6) M and Ziram 1 x 10(-7) M; 1 x 10(-6) M; 1 x 10(-5) M) in order to ascertain if they are able to modify sister chromatid exchange and/or micronuclei frequencies. Both fungicides produced a significant increase in SCE and Micronuclei frequencies. The two highest doses of TH and ZI were found to be cytotoxic for most of the individuals and were not included in the statistical analysis. With regard to the Proliferation Rate Index (i.e. the number of first, second, third or more mitoses), no difference was found between controls and treated cultures.

Study of C-polymorphisms of chromosomes 1, 9 and 16 in lymphocytes of patients with laryngeal carcinoma

A case-control study of the C-bands of #1, 9 and 16 was performed on PHA-stimulated lymphocytes in 29 individuals, 16 of whom with laryngeal carcinoma. C-bands were revealed using Sumner's CBG staining technique. The assay for chromosomic markers was performed using traditional measuring methods and an image analysis system. The calculation of the heterochromatic index (HI) using Neeley's method was chosen to evaluate size heteromorphisms and was used for each homologue of chromosome pairs examined. No significant difference was found between patients and controls with regard to size polymorphisms. The comparison between patients and controls was significant when size polymorphisms at the level of #9 were taken into account. In fact, 9 out of 16 patients (56%) versus 2 out of 13 controls (15%) presented a partial pericentric inversion on one of the two homologues of chromosome pair 9 (chi 2 = 5.325; 0.05 > p > 0.01). The two measuring techniques produced broadly similar results. However, in our opinion, the classic method is preferable owing to its simplicity of use. In conclusion, we affirm that pericentric inversion of #9 may be regarded as a predisposing factor for the onset of laryngeal carcinoma whose manifestation is triggered by tobacco and alcohol consumption.

Cytogenetic effect of thiabendazole and diphenylammine on cultured human lymphocytes: sister chromatid exchanges and cell cycle delay

The two fungicides analysed in this paper, Thiabendazole (TBZ) and Diphenylammine (DPA), are among the pesticides found in higher concentration in fruits and vegetables sold in Tuscany. These compounds were tested in "in vitro" lymphocyte cultures at different concentrations and using 3 protocols; protocol 1: the cultures were treated with the fungicides for 48 h; protocols 2 and 3: the cultures were treated with fungicides for 4 h in the presence or absence of the metabolic activator S9 mix. Both fungicides produced a slight increase in the SCE frequency in the 48 h treatment, at the higher non-toxic concentrations tested, but not when exposed for only 4 h, with or without S9 mix. As far as concerns the Proliferation Rate Index (i.e. the number of first, second and third mitoses), Thiabendazole also produced a significant decrease in the replication rate of the treated cultures, while Diphenylammine did not produce any effect.

Retrospective study of couples with a history of recurrent spontaneous abortion

Clinical treatment of recurrent spontaneous abortion (RSA) is still a matter of debate due to the absence of an univocal definition of the term. As a consequence of the reproductive history of the couple, there is still uncertainty regarding the moment when the problem of recurrent abortion arises and this prevents the start of diagnostic evaluation and therapy. In addition to a critical review of the literature, the aim of this study was to evaluate whether two successive abortions with the same partner are sufficient to suggest that the couple should undergo diagnostic test, or if it would be more sensible to wait for other reproductive failures. The study was performed in 50 couples suffering from recurrent abortion who attended the Laboratory of Cytogenetics in the Department of Animal Biology at Turin University for caryotyping in order to exclude the presence of chromosomal aberrations. Interviewed by telephone, out of 50 couples 41 presented the necessary requisites for being included in the study. Follow-up ranged between a maximum of 8.5 years and a minimum of 1 year (mean of 4.7 years). From the data collected it emerged that the probable cause of RSA was identified in 21 out of 41 couples enrolled in the study group (51.2 per cent). In the remaining 20 couples tests were within normal ranges. In all diagnosed cases the reproductive problem was identified with one or more alterations present in women. Among the hypothesized cause of RSA, uterine abnormalities were the most frequent (19.5 per cent), followed by immunological problems (17.1 per cent), etiologic factors of hormonal origin (12.2 per cent), one single case of genital infection (2.4 per cent), one balanced chromosomal translocation (2.4 per cent) and at last only one case of cervical incompetence of (2.4 per cent). The diagnosis was determined effectively in 85.7 per cent of couples. Of 20 couples who had not shown any abnormalities, 80 per cent had had a healthy child without any abortions and with the same partner. In conclusion, diagnostic tests performed finally identified the cause of RSA in 43.9 per cent of the couples who completed the procedure; vice versa, 39.0 per cent of couples solved the problem without the need for diagnostic tests; finally, the remaining 18.1 per cent were unable to carry pregnancy to term. By comparing our results to those reported by other authors, we believe that the probability of identifying the cause of RSA and curing it is sufficiently high to justify the start of the diagnostic evaluation of the problem as early as the second abortion in view of the stress on the couple produced by repeated reproductive failures.

Are chromosome aberrations in circulating lymphocytes predictive of future cancer onset in humans? Preliminary results of an Italian cohort study

To investigate the existence of an association between the frequency of chromosome aberrations (CA) in non-target tissues and cancer risk, a historical cohort study was carried out in a group of 1455 subjects screened for CA over the last 20 years in Italy. Statistically significant increases in standardized mortality ratio (SMR) for all cancers were found in subjects with medium and high levels of CA in peripheral blood lymphocytes (SMR = 178.5 and SMR = 182.0, respectively) and in subjects with high levels of CA for respiratory tract cancers (SMR = 250.8) and lymphatic and hematopoietic tissue neoplasms (SMR = 548.8). Significant trends in the SMRs were observed for these latter causes of death.

In vitro micronucleus induction by polymethyl methacrylate bone cement in cultured human lymphocytes

Human lymphocytes cultured in vitro were used to assess the ability of polymethyl methacrylate (PMMA), currently used in orthopaedic surgery as bone cement, to induce micronuclei in binucleated cells. The results of the study show a significant increase in the micronucleus frequency in treated cultures and therefore the genotoxic effect of PMMA bone cement or its ingredients (methyl methacrylate, dimethyl para-toluidine and hydroquinone) usually present in self-curing methacrylate bone cement and released in small quantities after polymerisation. This effect is evident during the stage immediately after the polymerisation process, and after a certain period of time (5 days in our experimental model).

Nucleolar organizer regions activity in lymphocytes of patients with laryngeal carcinoma

The activity of nucleolar organizer regions (Ag-NORs) and the frequency of NOR associations in chromosomes of phytohemagglutinin-stimulated lymphocytes from 12 patients with laryngeal carcinoma and 12 healthy subjects were studied using the gelatine silver staining technique. This study was undertaken to examine whether any disease associated changes occur in NOR activity. A lower mean number of Ag-NORs per metaphase (t test, 0.05 > p > 0.02) was found in patients compared to controls. This difference was not due to any specific group of acrocentric chromosomes (D or G). The mean number of NOR associations per metaphase was also found to be markedly lower (t test, 0.01 > p > 0.001) in patients than in controls. This difference was principally due to the significant decrease in the associations between 2 chromosomes (t test, 0.02 > p > 0.01), and in particular to the decrease in the D-G type associations (t test, 0.05 > p > 0.02). These findings are discussed in relation to existing data on the nucleolar activity of lymphocytes in a variety of solid tumours and leukemias.

Asymmetry in melanocytic lesions: a morphometric analysis

The purpose of this study was to establish a morphometric technique that would approximate the subjective histological criteria of asymmetry in the diagnosis of malignant melanoma. The dermal and epidermal outlines of 52 consecutive malignant melanomas and 56 consecutive melanocytic nevi were digitized and analyzed for morphometric parameters of size, coordinates, and shape. The two parameters that showed the most significant discriminatory functions were the differences in the center of masses of the epidermal and dermal components in the horizontal dimension and the length of the longest segment in the lesion.

Sister-chromatid exchange rates in XX and XY cells of ten chimeric Callithrix jacchus individuals

In order to ascertain whether or not sister-chromatid exchange (SCE) differs in relation to sex, SCE rates in XX and XY cells from 10 specimens of marmoset (Callithrix jacchus) were examined. The choice of this primate is particularly suitable for three reasons: most individuals have a chimeric constitution, the X chromosome is quite large and the Y chromosome is particularly small. Therefore, the influence of possible differences in their exposure to the external environment can be eliminated. The results obtained did not reveal any significant difference between SCE rates in male and female cells in any of the examined individuals.

Lack of sister-chromatid exchange induction by polymethyl methacrylate bone cement in human lymphocytes cultured in vitro

Human lymphocytes cultured in vitro were used to assess the ability of polymethyl methacrylate (PMMA), currently used in orthopedic surgery as bone cement, to induce sister-chromatid exchanges (SCE). Under the conditions used in this study, PMMA bone cement did not produce any significant increase in SCEs in phytohemagglutinin-stimulated human lymphocytes. However, a significant decline (p less than 0.05) in the proliferation rate index was observed, which might be an indicator of the cytotoxic effect of PMMA.

Chromosome analysis in operating room personnel

Cytogenetic tests were performed on operating room personnel working in a Turin hospital. The aim of our study was to determine if any chromosome damage was caused by the use of anaesthetic gases. Blood samples were collected from 45 hospital workers: 15 exposed to anaesthetic gases, 15 exposed to both anaesthetic gases and ionizing radiations and 15 controls. An examination of sister-chromatid exchanges did not highlight significant differences when exposed subjects were compared to controls. Chromosomal aberrations were significantly higher (P = 0.029) in all the exposed personnel, while no statistically significant increase was observed in staff exclusively in contact with anaesthetic gases. Moreover there was a positive correlation for chromosome aberrations with the years of employment, when the entire exposed population was considered and when personnel from the different operating rooms were considered separately. Both sister-chromatid exchange and chromosomal aberrations were higher among smokers though differences were not statistically significant.

Cytogenetic monitoring of hospital workers exposed to low-level ionizing radiation

In the present study the cytogenetic effects in hospital workers exposed to low-level radiation were evaluated. Samples of peripheral blood were collected from 63 subjects working in radiodiagnostics and from 30 subjects, working in the same hospitals, who were used as controls. A higher number of cells with chromosome-type aberrations (CA) was observed in the exposed workers vs. the controls and the difference was statistically significant (p less than 0.05). No correlation was, on the contrary, found between CA and years of exposure. A significant difference was observed in the incidence of cells with CA between smokers and non-smokers, but in the control group only. In contrast, in the workers exposed to ionizing radiation, the frequency of cells with CA was very similar in smokers and non-smokers.

[Protein-sparing peripheral parenteral nutrition in urologic surgery]

The use of parenteral nutrition in patients operated on for cystectomy is a basic post-operative therapeutic aid used for maintaining an adequate state of nutrition. In the present paper, the authors report the results of a study conducted for the purposes of comparing the efficacy of protein-sparing parenteral nutrition versus TPN.

Paracentric inversion in a female with multiple miscarriages (7inv)(q2.13;q3.13)

A phenotypically normal woman with a history of multiple miscarriages was found to have a paracentric inversion in the long arm of chromosome, which may be the reason for the miscarriages.

Influence of a constant magnetic field on human lymphocyte cultures

The growing exposure to magnetic fields of a certain intensity could represent a serious hazard for our health. In the present note we analyze the effect of a 740 Gauss magnetic field on human lymphocyte cell cultures. From the analysis of our data it is possible to point out that this field produces an inhibition of the cell growth, while does not affect at all the sister chromatid exchange frequency of the chromosomes. Conversely we found a significant increase of chromosome aberrations in the exposed cells. The chromosome aberrations found were mostly gaps and breaks.

[Pancreatic fistulas: evaluation of medical treatment in 50 observed cases]

The authors, on the basis of their experience concerning the observation and treatment of 50 patients sucering from "pure" pancreatic fistula, appraise the results of the therapy adopted. From their experience it results the Total Parenteral Nutrition (TPN) is the choice protection in such patients. They report some encouraging preliminary results through the use of Somatostatin.

Cell kinetics and sister-chromatid-exchange frequency in human lymphocytes

Repeated cultures from 5 healthy donors were set up in 3 tissue-culture media: TC109, TC199 and TC1640. For each donor, 3 blood samples were taken at 1-week intervals, making a total of 5 x 3 x 3 = 45 cultures. Our results show a large variability in the individual SCE base-line frequency. This variability can be partly attributed to the different tissue-culture media or to the donors themselves. Our results, however, stress the importance of the proliferating rate of the culture in determining the SCE frequency.

The banded karyotypes of Macaca fuscata compared with Cercocebus aterrimus

The karyotypes of Macaca fuscata and Cercocebus aterrimus are compared after G, C and AgNOR banding. Although it is often assumed that the 42-chromosome monkeys (species of the genera Macaca, Papio, and Cercocebus) are identical at the chromosomal level, a number of clear and consistent differences between the karyotypes of these two taxa are described. These differences include one pericentric inversion and differences in staining intensity, particularly in centromeric and pericentromeric areas. It is probable that high resolution chromosome techniques could reveal more differences between taxa in the 42-chromosome group than are now believed to exist. It is therefore probable that karyological data could provide insight into the phylogenetic relationships in this group of Old World monkeys.

Analysis of cell kinetics, chromosome aberration frequency and sister chromatid exchanges in lymphocyte "in vitro" cultures of patients irradiated by 131I. Preliminary note

In the present note we analyse the possible effect of 131I administration on lymphocyte cultures or patients previously subjected to thyroidectomy because of carcinoma. Three parameters were taken into consideration: cell kinetics, SCE frequency and chromosome aberrations frequency before and after treatment. It is possible to point out only an increase of chromosome aberrations. Our data stress the importance of considering several variables at the same time when we are faced with the problem of evaluating possible DNA damage.

The effect of cell kinetics and harvest time on SCE and NOR associations in Macaca fuscata lymphocytes

The relationship between cell kinetics and cell harvest time on sister chromatid exchange (SCE) and NOR (marker chromosome) association was investigated in cultured Macaca fuscata lymphocytes. The average number of SCE's in individuals ranged from 3.77 to 9.07 per cell. The highest SCE rate was found in cultures harvested at 60 h. The data suggest a decrease in SCE frequency between 60 h and subsequent cell harvest at 72, 84, and 96 h. NOR association frequency was also affected by cell kinetics, as well as by cell harvest time. The highest association frequencies were at 48 h, when the number of first mitoses was greatest.