Efficacy and safety of vaginal formulations with tyndallized ferments in subjects with nonspecific vulvovaginitis: A randomized study in Italy

AIM

In this study, we tested the efficacy, safety, and tolerability of vaginal ovules and a vaginal douche containing tyndallized ferments in women affected by nonspecific vulvovaginitis, with or without the human papillomavirus (HPV).

METHODS

The study included 91 female patients and had a randomized, controlled sequential design, with parallel groups. Ovules and douche were tested and compared to a control group treated with sterile physiological solution. Total symptom score (TSS), individual signs and symptoms, therapeutic success were evaluated, as well as safety and tolerability.

RESULTS

The tyndallized ferments formulations (ovules and douche) had a safe and tolerable profile, and resulted in a significant decrease in TSS in patients affected by nonspecific vulvovaginitis, both at 5 and 10 days of treatment, when compared to a control group. The treatment was more effective than the control in reducing symptoms such as vulvar erythema, vulvar edema, itching, and burning. Patients affected by vulvovaginitis and HPV-positive received a 30 days treatment either with ovules or ovules + douche, and we observed an improvement at Day 30 compared to Day 0, for both regimens.

CONCLUSIONS

Our study suggests that topical treatment with tyndallized ferments is a safe and effective strategy to reduce symptoms of nonspecific vulvovaginitis.

Genetic characterization of an almond germplasm collection and volatilome profiling of raw and roasted kernels

Almond is appreciated for its nutraceutical value and for the aromatic profile of the kernels. In this work, an almond collection composed of 96 Sicilian accessions complemented with 10 widely cultivated cultivars was phenotyped for the production of volatile organic compounds using a proton-transfer time-of-flight mass spectrometer and genotyped using the Illumina Infinium^®18 K Peach SNP array. The profiling of the aroma was carried out on fresh and roasted kernels enabling the detection of 150 mass peaks. Sixty eight, for the most related with sulfur compounds, furan containing compounds, and aldehydes formed by Strecker degradation, significantly increased during roasting, while the concentration of fifty-four mass peaks, for the most belonging to alcohols and terpenes, significantly decreased. Four hundred and seventy-one robust SNPs were selected and employed for population genetic studies. Structure analysis detected three subpopulations with the Sicilian accessions characterized by a different genetic stratification compared to those collected in Apulia (South Italy) and the International cultivars. The linkage-disequilibrium (LD) decay across the genome was equal to r² = 0.083. Furthermore, a high level of collinearity (r² = 0.96) between almond and peach was registered confirming the high synteny between the two genomes. A preliminary application of a genome-wide association analysis allowed the detection of significant marker-trait associations for 31 fresh and 33 roasted almond mass peaks respectively. An accurate genetic and phenotypic characterization of novel germplasm can represent a valuable tool for the set-up of marker-assisted selection of novel cultivars with an enhanced aromatic profile.

HaploSNP affinities and linkage map positions illuminate subgenome composition in the octoploid, cultivated strawberry (Fragaria×ananassa)

The cultivated strawberry, Fragaria×ananassa possesses a genetically complex allo-octoploid genome. Advances in genomics research in Fragaria, including the release of a genome sequence for F. vesca, have permitted the development of a high throughput whole genome genotyping array for strawberry, which promises to facilitate genetics and genomics research. In this investigation, we used the Axiom® IStraw90®)array for linkage map development, and produced a linkage map containing 8,407 SNP markers spanning 1,820cM. Whilst the linkage map provides good coverage of the genome of both parental genotypes, the map of 'Monterey' contained significantly fewer mapped markers than did that of 'Darselect'. The array contains a novel marker class known as haploSNPs, which exploit homoeologous sequence variants as probe destabilization sites to effectively reduce marker ploidy. We examined these sites as potential indicators of subgenomic identities by using comparisons to allele states in two ancestral diploids. On this basis, haploSNP loci could be inferred to be derived from F. vesca, F. iinumae, or from an unknown source. When the identity classifications of haploSNPs were considered in conjunction with their respective linkage map positions, it was possible to define two discrete subgenomes, while the remaining homoeologues of each chromosome could not be partitioned into two discrete subgenomic groupings. These findings suggested a novel hypothesis regarding octoploid strawberry subgenome structure and evolutionary origins.

[Prospective observational study of pneumonia in an Italian hospital]

A prospective observational study was conducted during a two-year period to evaluate the prevalence of hospitalized pneumonia in six hospital units of the Bologna S.Orsola-Malpighi hospital (Italy). The selected units were: general surgery, general medicine, internal medicine, geriatrics, respiratory physiopathology and pneumology, with a total of 205 beds and around 4,800 admissions per year. Data were collected from the clinical cards and cases of pneumonia were distinguished by origin (community-acquired or hospital-acquired according to CDC definition), individual and clinical characteristics, and aetiology. The study involved 486 cases of pneumonia: 75 hospital-acquired and 411 community-acquired (84.6%). Patients affected by hospital-acquired pneumonia were older (average age 77 years) compared to community-acquired cases (74 years) and show a more homogeneous gender distribution (males: 48.0% vs 59.4%). Hospital stays (42 vs 21 days) and mortality rates (24.0% vs 11.7%) were significantly higher in hospital-acquired pneumonia. The incidence rate of nosocomial pneumonia was 7.4 per 1000 hospitalized patients and increased to 17-23 per 1000 in the pneumology and respiratory physiopathology units. Only 16.9% of cases had an aetiological diagnosis (14.1% community-acquired; 31.8% hospital-acquired); the most common isolates were S. aureus and P. aeruginosa. The hospital-acquired cases were caused by Gram-negative bacilli more often than the community-acquired cases, and infections were more frequently polymicrobial (37.5% vs 3.4%). In order to reduce morbidity and mortality due to pneumonia it is important to implement prevention measures in the community (i.e. specific vaccination campaigns), improve clinical protocols for aetiological diagnosis in hospitalised patients and increase epidemiological surveillance of hospital-acquired infections.

[Survey on sports practice and physical activity of primary school children living in the area of Bologna Local Health Unit in relation with some individual and environmental variables]

A randomized stratified sample of 522 children attending the third class of primary schools within the area of Bologna Local Health Unit was analysed for physical activity and sports practice. Information about the children's habits and availability of facilities for physical and sports activities were collected by means of structured questionnaires completed by children (507 respondents), parents (491), reference teachers for physical education (26) and class teachers (46) during the school year 2006-07. At the same time, the children's heights and weights were measured in order to calculate BMI values. Regular sports activity is practised by 80.1% of children (males: 82.4%, females: 77.6%), with significant diferences between genders only in children with at least one non-Italian parent (M>F, p < 0.05); the practice of sports is influenced by the area of residence (metropolitan > plain and hills, p < 0.05) and nationality (Italians > non-Italians, p < 0.01). Children with at least one actively sports practising parent are involved more frequently in sports activities (p < 0.001). In free time, sedentary activities are prevalent for both sports-practising children and not. However children not involved in regular sports activities tend to practise outdoor physical activities with a frequency significantly higher than children involved in sports (17.3% vs 10.4% of respondents). The percentage of completely sedentary children, who stated that they practise neither sports nor physical activity in their free time, is 7.3% (metropolitan area: 4.5%, hills: 8.7%, plain: 10.6%). The prevalence of overweight is 24.4%, of obesity 9.7%, with a better distribution of BMI values in the metropolitan area where there is the highest occurrence of positive conditions and behaviours: availability of sports facilities, the highest prevalence of sports practice, and the lowest prevalence of completely sedentary children.

[Breakfast habits in moderately obese adults and its effect on daily energy and nutrient intake, on alcohol consumption and on various clinical and anthropometric parameters]

It is widely held that obesity may be due to alterations in the total caloric intake, the distribution of nutrient intake and the number of meals; widely spaced out meals of large proportions may be associated with metabolic dysfunctions. An observational study was performed in a random sample (80 males and 183 females) of moderately obese adults (IMC > 30 and < 40) attending the dietary unit of our hospital to evaluate spontaneous breakfast eating habits (understood as caloric contribution > 10% of daily caloric intake) in relation to: working activity, region of origin, possible influence on daily intake of energy and nutrients and on common clinical and anthropometric variables (arterial pressure, glycemia, cholesterolemia, triglyceridemia, IMC, WHR). Following the subdivision of patients into breakfast eaters (SC = 26 males, 52 females) and non-breakfast eaters (NC = 54 males and 131 females), no significant differences emerged between sexes with regard to region of origin, working activity, IMC, WHR, total kcal, distribution of nutrients, glycemia, cholesterolemia, triglyceridemia, arterial pressure. The only significant difference between SC and NC concerns alcohol consumption which was inversely correlated to breakfast eating in both males and females (males: r = -0.225, p < 0.05; females: r = -0.157, p < 0.05). No significant differences appear between wine consumers (SE = 29) and abstemious males (NE = 51), except for daily caloric consumption (kcal/die), triglycerides and arterial pressure, which were higher in SE (p < 0.05, p < 0.01, p < 0.05 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

[Lung interstitial disease in systemic sclerosis: semiologic characteristics with high-resolution computerized tomography and comparison with other methods]

In 28 patients with systemic sclerosis interstitial lung involvement was investigated with high-resolution Computed Tomography (HRCT) in comparison with other diagnostic methods (respiratory function tests, lung scintigraphy and conventional radiography of the chest). The most frequent CT signs were: interlobular septal thickening, intralobular interstitial thickening, and ground-glass density. Their distribution was generally basal and posterior and high correlation was observed between the extent of lung disease and the cutaneous pattern of scleroderma. Pathological findings were present in 93% of cases: HRCT can must be considered more effective than the other methods in the evaluation of systemic sclerosis and should therefore be a fundamental diagnostic tool in the study and follow-up of interstitial diseases in the patients with systemic sclerosis.

Pharmacological activity and safety of trandolapril (RU 44570) in healthy volunteers

The pharmacological activity and safety of the new angiotensin converting enzyme (ACE) inhibitor trandolapril (RU 44570) has been evaluated in ten healthy male volunteers given 2 mg once daily for seven days. Assessment criteria included evaluation of plasma ACE and renin activity and aldosterone levels in the supine and standing positions, monitoring of blood pressure, heart rate and electrocardiogram, routine blood and urine laboratory tests, and evaluation of adverse effects. Plasma ACE activity (both in the supine and standing positions) was significantly lower after the first dose and was almost completely suppressed after 7 days of treatment. Plasma renin activity with the subjects in both positions was significantly increased at the end of treatment. Plasma aldosterone did not vary significantly, except for an increase in the standing position after 7 days of wash-out. No significant changes occurred in blood pressure, heart rate, electrocardiogram, blood or urine laboratory tests. No adverse effects were reported, in particular, no orthostatic hypotension, cough or episodes of bronchospasm occurred. It is concluded that oral trandolapril 2 mg o.d. is an effective and long-lasting ACE inhibitor with a good safety profile on repeated dosing. Further studies are warranted to investigate its therapeutic application as well as its safety profile after long-term administration.

1,2-Dichloropropane hepatotoxicity in rats after inhalation exposure

The hepatic effects of 1,2-dichloropropane (DCP) were investigated in male Wistar rats exposed to 15, 50, 100, 250, 450, 1000, 1300, 1800 or 4900 mg DCP m-3. At the end of a 4-h period of exposure, average blood DCP levels were 0.025 and 5.38 micrograms ml-1 in animals treated with 15 and 1300 mg m-3, respectively. Blood DCP concentrations were correlated with the air DCP concentrations in the inhalation chamber. At DCP concentrations of 100 mg m-3 or higher, the liver non-protein thiol (NPT) content was significantly reduced. Assays performed 20 h after 4-h DCP exposure showed that exposure to 100-1000 mg DCP m-3 had no effect on hepatic NPT levels. The NPT content increased only in the liver of rats exposed to higher (1300-4900 mg m-3) DCP concentrations. Treatment with DCP did not cause hepatic lipid peroxidation and did not modify total protein content. The observed changes in liver cell thiol homeostasis are likely to reflect the action of reactive intermediates formed during DCP metabolism. These changes can occur in rats following exposure to considerably low levels of DCP vapour.

[Insulin response to food in obese women]

The effects of two standard meals (meal A: 20 g proteins, 20 g lipids, 80 g maltodextrin; meal B: meal A plus 52 g lipids) on insulin and C-peptide secretion and on plasma levels of glucose and free fatty acids (FFA) was studied in 12 obese women separated into two groups according to the onset of obesity. One group (n = 6) developed into obesity after puberty (OP), the other (n = 6) became obese after pregnancy (OG). Meals A.--In OP women, the maximum insulin response was reached at 30 min after meal (141.8 +/- 14.2 microU/ml) and insulinaemia fell to the basal values at 180 min; in OG women the insulin response was linear in the interval 30-150 min after meal. The maximum secretion of C-peptide occurred between 30 min and 90 min in OP and between 60 min and 120 min in OG; the secretion rate was similar in the two groups. Blood glucose levels returned to the basal values at 120 min after meal in OP and at 180 min in OG. FFA levels significantly decreased after meal in both groups (p less than 0.01 vs basal values). Meal B.--Insulin secretion was decreased at 30 min after meal in OP and at 150 min in OG and the levels of C-peptide was not modified in both groups. The glycaemic response was unchanged in OP, but was lower in OG women (p less than 0.02). These results show that OP women present stronger and more rapid insulin response to meals than the OG women; this conclusion is supported by the analysis of the secretion of C-peptide. Blood glucose levels return to basal values faster in OP than in OG women. The blood level of FFA after the standard meals A and B are normal both in OP and OG women.

Malnutrition and malabsorption after total gastrectomy. A pathophysiologic approach

We investigated the nutritional state and pathophysiologic mechanisms involved in the malabsorption of 27 patients with total gastrectomy and esophagojejunostomy reconstruction without reservoir; they were first evaluated after a median period of 9 months after surgery and were not receiving either nutritional or pharmacologic support. Mean postoperative weight loss was -13.7 +/- 1.59%; mean daily caloric intake was 31.7 +/- 2.41 kcal/kg/day, with 70% of subjects ingesting less than 30 kcal/kg; P/kg was 1.2 +/- 0.09, with 21% of patients ingesting less than 1 g P/kg/day; mean ratio of nonprotein energy to 1 g nitrogen intake was 142 +/- 8.74:1, with only 24% of patients attaining a ratio greater than 150:1; and mean fat malabsorption was 37.4 +/- 4.6%. Hemoglobin (Hb), serum albumin, prealbumin iron, and folate were more often abnormal in the early postoperative period, whereas transferrin and vitamin B12 concentrations deteriorated later. alpha 1-Antitrypsin clearance was abnormal in almost all patients (indicating an intestinal protein loss), and the pancreolauryl test was abnormal in 60%. Neither morphological nor absorptive alterations of the small bowel nor an abnormal transit time or bacterial overgrowth was found. We conclude that inadequate caloric intake appears to be the main cause for malnutrition after total gastrectomy, but that caloric losses caused by steatorrhea and enteric protein leakage must be subtracted from intake, thus decreasing the amount of available calories.

Treatment of heart failure following chronic cor pulmonale with ibopamine

A group of 36 patients with cor pulmonale chronicum were treated for 12 months with ibopamine, a dopamine-related drug, orally active, suitable for the long-term therapy of congestive heart failure. In heart failure due to chronic pulmonary disease other drugs such as digitalis are hardly effective. The results obtained indicate that ibopamine, given alone or associated to other drugs, is clinically efficient in the treatment of cor pulmonale chronicum while very few side effects definitely related to ibopamine were reported. In particular no increase in arrhythmias or significant augmentation of anginal episodes was noted.

Hearing loss and desferrioxamine in homozygous beta-thalassemia

The authors present the results obtained during an audiometric screening of 153 children aged 5-18 years, affected by beta-thalassemia and treated with regular blood transfusions and iron overload chelation by means of desferrioxamine. Thirty-eight percent of the patients showed a significant sensorineural hearing loss at high frequencies with recruitment. Younger patients had a greater hearing loss, indicating that cochlear damage was not due to the disease itself. Furthermore, hearing loss appeared to be correlated with the mean and peak desferrioxamine doses administered and was higher in subjects with lower iron load. Thus, the ototoxic effect seems to have been higher when a good iron chelation had been obtained. Among our patients, conductive hearing loss was not more frequent than in patients without beta thalassemia.

[The role of vitamin E in the therapy of thalassemia]

Serum vitamin E values are depressed in thalassaemia owing to increased consumption because of the oxidative stress imposed both to red cells and other tissues by haemochromatosis. A study of vitamin E deficiency was carried over a period of about 2 years in 161 transfusion dependent thalassaemic patients aged 4 months to 18 years (including 74 splenectomized subjects) all following the same transfusion and chelation protocol (pretransfusion Hb = 11 gr/dl and daily chelation with subcutaneous infusion of desferrioxamine 12 hr a day). Serum vitamin E levels were determined by Martinek's method. The mean value for the entire series was 0.45 +/- 0.21 mg/dl (normal value 0.76 +/- 0.22), with no differences between splenectomized (0.43 +/- 0.19) and not--splenectomized (0.45 +/- 0.21) subjects. Values of less than 0.32 mg/dl (mean-2SD) were found in 50 patients (31,1%). Below--normal values were noted in 5/11 patients at the time of diagnosis. 124 subjects with less than 0.54 mg/dl received 5-10 mg/Kg/day vitamin E per os. In 38 cases it has been possible to control vitamin E level after one year of therapy. Mean values before treatment were 0.36 +/- 0.13 mg/dl and 1.19 +/- 0.35 mg/dl after therapy. No patient failed to respond and no adverse effect was recorded. These results show that by no means all thalassaemic patients are vitamin E deficient to the point where replacement therapy is necessary, and oral administration can easily correct low serum levels, contrary to what has been found by other workers.

Skin Cancer in Professional and Amateur Female Golfers

In brief: Fifty-one female professional golfers and 142 female amateur golfers were evaluated for skin cancer and skin cancer risk. The professionals were considerably younger than the amateurs (average of 28.4 vs 54.5 years) and received five times as much sun exposure as the amateurs. Four of the professionals had already developed basal cell carcinoma (BCC). Their average age was 25.5 years. Eleven amateurs also developed BCC, but their average age was 51.4 years. This study suggests that skin cancer can develop at earlier ages when sun exposure has been heavy. The likelihood of developing a skin I cancer also was related to eye and hair color.

Acute haemodynamic effects of ibopamine in patients with severe congestive heart failure

Ten patients with congestive heart failure (CHF), in III and IV NYHA Class, were treated orally with a single dose of ibopamine ranging from 1.2-3.3 mg/kg, and were studied using the Swan-Ganz catheter and thermodilution technique. Cardiac index (CI) and stroke volume index (SVI) were increased, and mean pulmonary pressure (PAP), systemic vascular resistances (SVR) were lowered. Ibopamine increased CI (+33%) and SVI (+26%), and decreased PAP (-17%) and SVR (-24%). All changes were statistically significant. The maximum haemodynamic effect occurred 180 min after ibopamine administration. Blood pressure and heart rate were unaffected. Tolerability was good. This study shows that ibopamine when orally administered to human subjects improves cardiac performance and further investigations on its use as a therapeutic agent in the long term treatment of CHF are recommended.

[Preliminary evaluation of the effect of ibopamine on the secretion of prolactin]

Ibopamine, diisobutyric ester of N-methyl dopamine, is an orally active dopaminergic agonist. The prolactin-lowering activity of Ibopamine was studied in 8 subjects with normal prolactine levels given the drug in a single dose of 100 mg. Prolactin levels measured by radioimmuno assay were evaluated before and within 2, 4 and 8 h of administration. Afterwards prolactin levels were evaluated after 4 and 8 days of treatment with Ibopamine administered at a dose of 50 mg three times daily. Ibopamine was shown to decrease prolactin to a statistically significant extent at the 2nd h after administration. At the 4th h prolactin returned to baseline values. After 4 and 8 treatment days prolactin levels did not differ significantly from baseline values. These results provide further evidence for the dopaminergic activity of Ibopamine and suggest a more through investigation in hyperprolactinemic subjects.

Effect of ibopamine on peripheral haemodynamics

Peripheral haemodynamics was studied in healthy volunteers by strain gauge plethysmography after administration of ibopamine (IB), diisobutyric ester of N-methyl-dopamine, an orally active dopaminergic agonist. Seven subjects received a single oral dose of ibopamine of 150 mg and 6 received a daily dose of 150 mg (50 mg t.i.d.) for 5 consecutive days. Arterial resting blood flow and venous capacity increased and peripheral resistance decreased significantly. Six further subjects were then studied; 3 h after an oral dose of ibopamine 150 mg, the parenteral administration of Sulpiride 50 mg, a specific vascular dopaminergic antagonist, was found significantly to counteract its peripheral activity. Heart rate and arterial blood pressure were never affected and tolerability was good.

Birth control in China: local data and their reliability

In 1979, at about the same time that the birth control campaign received renewed impetus, China released impressive data on demographic trends. If these and other more recent data are reliable, the decline of the natural increase rate has been both belated and spectacular. Contrary to what has been assumed the birth rate would seem to have reached its peak during the 1960s (43·6 per 1,000 in 1963). After a secondary peak in the late 1960s, it then declined precipitously during the 1970s, declining by almost half (46·7 per cent) over nine years (33·59 per 1,000 in 1970; 17·9 per 1,000 in 1979). The natural increase rate was, for its part, more than halved during the same period (25·95 per 1,000 in 1970; 11·7 per 1,000 in 1979).

[Preoperative renutrition in patients with esophageal stenosis]

50 patients suffering from dysphagia and oesophageal stenosis were treated in the period 1975-77. Of these 31 had renutrition of longer than two weeks and are the subject of the present study. Three nutrition systems were employed: 1) total parenteral feeding (7 patients), 2) feeding by naso-gastric tube or gastric fistula (15 patients), 3) feeding per os with semiliquid foods (9 patients). The patients were suffering from benign cicatricial stenosis (5), tumours of the cardia (7), tumours of the oesophagus (19). Short-term survival, weight behaviour and the course of certain blood parameters (Hb, GR, cholesterol, albumin, total proteins) are reported.

CONCLUSIONS

--in benign cicatricial stenosis and tumours of the cardia, a normal protein-caloric amount (2000-3500 KCal., 80-120 g/24 h of proteins) is sufficient to obtain weight increase and stabilization of blood examinations. The administration route is unimportant; --in malignant stenosis, 4000-6000 KCal. and 100-130 g of protein/24 h must be provided to obtain the same result. In patients treated with total parenteral nutrition the weight loss persists. The reason for this behaviour is not known; it is likely that enzymatic blocks exist in substrate utilization; --further study is needed to improve results obtained and to clarify the reasons for such behaviour.