Novel heterocyclic-fused pyridazinones as potent and selective phosphodiesterase IV inhibitors

A series of 6-aryl-4,5-heterocyclic-fused pyridazinones were designed and synthesized as selective phosphodiesterase (PDE) IV inhibitors. Biological evaluation of these compounds demonstrated a good selectivity profile toward the PDE IV family and greatly attenuated affinity for the Rolipram high-affinity binding site that seems to be responsible for undesiderable side effects. Structure-activity relationships (SARs) studies showed that the presence of an ethyl group at pyridazine N-2 is associated with the best potency and selectivity profile.

Morphology of the cervical vertebrae in the fetal-neonatal human skeleton

The gross anatomical features of human cervical vertebrae during the fetal-neonatal period were investigated in order to develop morphological standards for the individual ossification centres for use in forensic and anthropological osteology. It was found that the morphology of the cervical vertebral arches and the centra cannot be used for the determination of fetal age although the dens of the axis displays some developmental differences which may be useful for the determination of fetal maturity.

Estimation of fetal age from dimensions of atlas and axis ossification centers

The atlas and axis ossification centers of 106 human fetal and neonate skeletons were measured. The skeletons belong to the collection in the Department of Forensic Medicine of the Albert Szent-Györgyi Medical University, Szeged, Hungary. The age of the skeletons ranged from 4 to 10 lunar months. Nine linear measurements on the atlas, seven on the axis neural arches ossification centers and three on each one of the axis centra ossification centers were taken. We did simple and multiple linear regression analysis to estimate the age of fetuses. The results show that it is possible to use regression equations to estimate the fetal body length and age from atlas and axis ossification centers measurements during the whole period of development studied. The study of size and shape of the ossification centers using factorial analysis (principal component analysis) shows that the shape of the dens of the axis might be useful to estimate fetal viability.

Enzymatic characterization of E.U.E. (embryonal human explants) cells adapted to hypertonic media

E.U.E. cells (general population) were submitted to biochemical and cytoenzymatic tests to compare the enzymatic profile of E.U.E. cells (controls) with that of E.U.E. adapted to hypertonic medium. The adapted cells are characterized by very high oxoreductase activity (LDH, HBDH, G-6-P DH) and very high alkaline-phosphatase activity. Clones derived from general population were also submitted to biochemical tests to characterize those more strictly related to the enzymatic profile of adapted cells. The profile of clone N. 13 resembles on this respect that of the adapted cells. The high redox activity is a prerequisite supporting energy supply for osmotic work. The increased activity of plasma membrane enzymes of the adapted cells is also demonstrable in cells exposed for short time to salinity.

New forensic anthropological approachment for the age determination of human fetal skeletons on the base of morphometry of vertebral column

The anthropometrical study was carried out on 107 human fetal/newborn skeletons (54 male, 43 female, and 9 of unknown sex). The age of the individuals ranged from 4 to 10 lunar months. Each fetal or newborn vertebral region (cervical, thoracal and lumbar) has its own distinguishing features that are easily identifiable even in fragmentary bones. With our large sample size and extension of the age range studied, we are able to determine the fetal age with a considerable degree of accuracy from measurements defined in the vertebral ossification centers using regression equations. A simple rapid method for the identification and classification of fetal vertebral column bones has been contributed. The identification and classifications were carried out using discriminant functions. Knowledge of changes in vertebral column bones during fetal development is important in applied contexts of forensic and anthropology researches.

Side effects of long-term use of proton pump inhibitors: practical considerations

Proton pump inhibitors (PPIs) are among the most commonly prescribed drugs due to the increasing incidence of acid‑related disorders, but a large number of prescriptions are issued with inappropriate indications. Despite PPIs being effective and well tolerated, there have been growing concerns about potential adverse effects associated with long‑term use of these drugs. Indeed, pharmacovigilance agencies have issued broad-based product warnings on the association between treatment with PPIs and long‑term complications, including increased risk of fractures and impaired magnesium absorption. On the contrary, despite plausible underlying biological mechanisms, the available clinical evidence for most side effects is weak or contradictory, and the benefits of PPI treatment seem to outweigh the potential adverse effects. This review aims to discuss the most important and established side effects of long-term use of PPIs and provide practical considerations for their clinical management.

Endoscopic Management of Dysplastic Barrett's Oesophagus and Early Oesophageal Adenocarcinoma

Barrett's oesophagus is a pathological condition whereby the normal oesophageal squamous mucosa is replaced by specialised, intestinal-type metaplasia, which is strongly linked to chronic gastro-oesophageal reflux. A correct endoscopic and histological diagnosis is pivotal in the management of Barrett's oesophagus to identify patients who are at high risk of progression to neoplasia. The presence and grade of dysplasia and the characteristics of visible lesions within the mucosa of Barrett's oesophagus are both important to guide the most appropriate endoscopic therapy. In this review, we provide an overview on the management of Barrett's oesophagus, with a particular focus on recent advances in the diagnosis and recommendations for endoscopic therapy to reduce the risk of developing oesophageal adenocarcinoma.

Autoimmune Atrophic Gastritis: A Clinical Review

Autoimmune atrophic gastritis (AAG) is a chronic condition characterized by the presence of atrophy in the oxyntic mucosa due to anti-parietal cell antibodies. This review provides a comprehensive and up-to-date overview of autoimmune atrophic gastritis, reporting recent evidence on epidemiology, pathogenesis, diagnosis, clinical presentation, risk of malignancies, and management. The prevalence of AAG has been estimated at between 0.3% and 2.7% in the general population. The diagnosis of AAG is based on a combination of the serologic profile and the histological examination of gastric biopsies. Patients with AAG are often asymptomatic but can also have dyspeptic or reflux symptoms. The atrophy of the oxyntic mucosa leads to iron and vitamin B12 malabsorption, which may result in anemia and neurological affections. Autoimmune atrophic gastritis is associated with an increased risk of type I neuroendocrine tumors (NETs) and gastric cancer, with an incidence rate of 2.8% and 0.5% per person/year, respectively. Management is directed to reinstate vitamins and iron and to prevent malignancies with endoscopic surveillance. In conclusion, atrophic autoimmune gastritis is an infrequent condition, often asymptomatic and misdiagnosed, that requires an early diagnosis for appropriate vitamin supplementation and endoscopic follow-up for the early diagnosis of NETs and gastric cancer.

Epidemiological, diagnostic, therapeutic and prognostic impact of hepatitis B and D virus infection on hepatocellular carcinoma: A review of the literature

BACKGROUND

Hepatocellular carcinoma (HCC) accounts for >90% of primary liver cancer cases, and chronic infections with hepatitis B virus (HBV) and hepatitis D virus (HDV) are major contributors.

METHODS

A comprehensive literature review was conducted using the MEDLINE (PubMed) database, focusing on studies related to HBV, HDV, and HCC.

RESULTS

HBV contributes to HCC through mechanisms like viral integration into the host genome, chronic inflammation, and immune modulation, leading to genomic instability and altered cell signaling. HDV exacerbates HBV-induced liver damage, accelerating fibrosis and cirrhosis, and significantly increasing HCC risk. Antiviral therapies and vaccinations have majorly reduced the burden of HBV-related HCC, but HDV remains challenging to treat due to limited therapeutic options. Emerging treatments like Bulevirtide showed promising results.

CONCLUSION

This review highlights the critical impact of HBV and HDV co-infections on HCC development, emphasizing the need for more effective therapeutic strategies. While advances in antiviral therapies have reduced the incidence of HBV-related HCC, the high burden of HDV-related complications persists. Future research should focus on improving treatments for HDV and understanding its unique contribution to HCC pathogenesis.

[Atherosclerosis: a childhood problem]

The project "Precursors of Atherosclerosis (ATS) in Children" following the protocol of WHO started in Modena in 1981/82. A total of 527 schoolchildren of 6, 9, 12 and 15, living in the area around Modena, Emilia Romagna Region, were examined, sampled from whole schools or classes. Each group exceeds the minimum of 100 children with the exception of the group including subjects of 15. The population sampled is fairly homogeneous. There are no immigrants to the area and the intra-population differences due to social-classes are minimal. The standard of life is very high: the rate of income is one of the highest in Italy and the incidence of ATS manifestations is very high. The children will be reexamined each year for three years at the same season and the study will be over in 1984. A questionnaire with family story has been filled by the parents and the parents were directly examined about: height, blood pressure, cholesterolemia, triglyceridemia, smoking habit. Following the protocol in each child are determined: height, weight, Quetelet's index (kg/m2), skinfold thickness, blood pressure, cholesterolemia, triglyceridemia, sexual maturity and smoking habit. The statistical elaboration methods of data are chosen in cooperation with the "Centro di Calcolo" of the University of Modena, and elaborated with the Statistical Package for the Social Science (SPSS) method.

A multivariate method for classifying third to seventh cervical newborn vertebrae using bone measurements

This research provides a method to classify human newborn (9 to 10 lm) third to seventh cervical ossification centers. Nine linear measurements on the cervical neural arch were defined from 35 human neonates. Four discriminant functions were performed using the stepwise method. The model classifies 82.8% of grouped cases and 77.9% of cross-validated cases correctly. The model is useful in cases with isolated or commingled remains during anthropological or forensic investigations.