Management of severe head injury with brain exposure in three loggerhead sea turtles Caretta caretta

The loggerhead Caretta caretta is the most common sea turtle in the Mediterranean. Currently, sea turtles are considered endangered, mainly due to the impact of human activities. Among traumatic lesions, those involving the skull, if complicated by brain exposure, are often life-threatening. In these cases, death could be the outcome of direct trauma of the cerebral tissue or of secondary meningoencephalitis. This uncontrolled study aims to evaluate the use of a plant-derived dressing (1 Primary Wound Dressing®) in 3 sea turtles with severe lesions of the skull exposing the brain. Following surgical curettage, the treatment protocol involved exclusive use of the plant-derived dressing applied on the wound surface as the primary dressing, daily for the first month and then every other day until the end of treatment. The wound and peri-wound skin were covered with a simple secondary dressing without any active compound (non-woven gauze with petroleum jelly). Data presented herein show an excellent healing process in all 3 cases and no side effects due to contact of the medication with the cerebral tissue.

Periodontal disease associated with red complex bacteria in dogs

OBJECTIVE

Red complex bacteria (Treponema denticola, Tannerella forsythia and Porphyromonas gingivalis) play a major role in the aetiology of periodontal disease in humans. This study was designed to evaluate the association of such bacteria with periodontal disease in dogs.

METHODS

Seventy-three subgingival samples taken from dogs ranging from 2 months to 12 years (median age 4 years) were tested for red complex bacteria using a polymerase chain reaction assay.

RESULTS

Thirty-six of 73 (49 · 3%) dogs were found to be positive for T. forsythia and P. gingivalis. Dogs with gingivitis or periodontitis were more likely to be infected with T. forsythia and P. gingivalis [odds ratio (OR) 5 · 4 (confidence interval (CI) 1 · 9-15 · 6), P = 0 · 002] than healthy animals. Only 3 (4 · 1%) of 73 samples were positive for red complex bacteria, but the association with periodontal disease was not significant.

CONCLUSION AND CLINICAL RELEVANCE

The results indicate that involvement of red complex bacteria in periodontal disease in dogs is similar to that observed in humans. Only the concurrent presence of T. forsythia and P. gingivalis were correlated to periodontal disease in dogs in this study.

Volume effect and exertional dyspnoea after bronchodilator in patients with COPD with and without expiratory flow limitation at rest

BACKGROUND

A study was undertaken to investigate whether bronchodilators are associated with less breathlessness at rest and during light exercise in patients with moderate to severe chronic obstructive pulmonary disease (COPD) with resting tidal expiratory flow limitation (EFL; flow limited (FL)) compared with those without EFL (non-flow limited (NFL)).

METHODS

Twenty subjects (13 men) of mean (SD) age 65 (8) years (range 43-77) suffering from COPD with forced expiratory volume in 1 second (FEV(1)) 47 (18)% predicted were studied before and after inhalation of salbutamol (400 microg). Routine pulmonary function tests were performed in the seated position at rest. EFL was assessed by the negative expiratory pressure (NEP) method and changes in end expiratory lung volume (EELV) were inferred from variations in inspiratory capacity (IC). Dyspnoea was measured using the Borg scale at rest and at the end of a 6 minute steady state exercise test at 33% of the maximal predicted workload.

RESULTS

EFL occurred in 11 patients. Following salbutamol IC did not change in NFL patients but increased by 24% (95% CI 15 to 33) in FL patients (p<0.001). Maximal inspiratory pressure (PImax) improved at EELV from 45 (95% CI 26 to 63) to 55 (95% CI 31 to 79) cm H(2)O (p<0.05) in FL patients after salbutamol but remained unchanged in NFL patients. The workload performed during exercise amounted to 34 (95% CI 27 to 41) and 31 (95% CI 21 to 40) watts (NS) for patients without and with EFL, respectively. After salbutamol, dyspnoea did not change either at rest or during exercise in the NFL patients, but decreased from 0.3 (95% CI -0.1 to 0.8) to 0.1 (95% CI -0.1 to 0.4) at rest (NS) and from 3.7 (95% CI 1.7 to 5.7) to 2.6 (95% CI 1.1 to 4.0) at the end of exercise (p<0.01) in FL patients.

CONCLUSIONS

Patients with COPD with EFL may experience less breathlessness after a bronchodilator, at least during light exercise, than those without EFL. This beneficial effect, which is closely related to an increase in IC at rest, occurs even in the absence of a significant improvement in FEV(1) and is associated with a greater PImax.

[Alpha 1-antitrypsin deficiency: the Brescia clinical study]

In a longitudinal clinical study, two hundred subjects have been evaluated in order to identify alpha 1-antitrypsin deficiency patients. According to their serum alpha 1-antitrypsin levels, they have been divided into three groups: 25 patients with severe deficiency (with both pathological alleles--ZZ, SZ or Z and rare deficiency allele--and, if clinically suggested, to be treated with augmentation therapy), 92 patients with intermediate deficiency (with one pathological allele, to be followed up in order to evaluate the risk to develop deficiency related disease) and 63 healthy subjects (normal alleles MM). They performed lung function test (including cardiopulmonary exercise test and methacholine bronchial challenge) chest X-ray and high resolution computed tomography, blood tests. Severe deficiency patients also performed perfusional lung scan to detect early disorders of blood flow, evaluation of arterial blood gases and liver echotomography. Expiratory flow limitation, the prevalence of vascular disease, the amount of urine elastin products and correlations between the amount of nitric oxide exhaled and bronchial hyperresponsiveness have been also investigated. The study showed that in Brescia county the deficiency is more common than expected and that evaluation of liver and vessels might be as useful as lung function tests. In addition, beneficial effect on local system has been observed. The longitudinal study might permit to detect early organ damage and to eliminate additive risk factors.

Neuroendocrine responses of healthy volunteers to 'techno-music': relationships with personality traits and emotional state

A variety of studies reported psychological and physiological effects of music. Different types of music have been found to induce different neuroendocrine changes. The aim of the present experiment was to investigate the possible combination of emotional and endocrine changes in response to techno-music and to define personality variables as predictors of respective changes. Sixteen psychosomatically healthy subjects (18- to 19-year-olds, eight males and eight females) were exposed, in random order, to techno-music or to classical music (30 min each). Plasma norepinephrine (NE), epinephrine (EPI), growth hormone (GH), prolactin (PRL), adrenocorticotropic hormone (ACTH) cortisol (CORT), beta-endorphin (beta-EP) concentrations and changes of emotional state were measured in basal conditions and after the experimental trials with two different types of music. Techno-music was associated with a significant increase in heart rate, systolic blood pressure and significant changes in self-rated emotional states. A significant increase was observed in beta-EP, ACTH, NE, GH and CORT after listening to techno-music. Classical music induced an improvement in emotional state, but no significant changes in hormonal concentrations. No differences between male and female subjects' responses to music have been found. Plasma levels of PRL and EPI were unaffected by techno- and classical music. Changes in emotional state and NE, beta-EP and GH responses to techno-music correlated negatively with harm avoidance scores and positively with the novelty-seeking temperament score on the Cloninger scale. Listening to techno-music induces changes in neurotransmitters, peptides and hormonal reactions, related to mental state and emotional involvement: personality traits and temperament may influence the wide inter-individual variability in response to music.

Mast cells in bronchiolitis obliterans organizing pneumonia. Mast cell hyperplasia and evidence for extracellular release of tryptase

Idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) is characterized by air space inflammation and fibrosis of unknown origin. The pathogenesis of the inflammatory reaction and fibrosis in fibrotic lung disorders remains unclear; however, recent attention has focused on the potential role of the mast cell in the genesis of fibrosis. To determine whether mast cells are implicated in the pathogenesis of BOOP, mast cells were identified in BAL fluid and in transbronchial lung biopsy specimens from 11 patients affected by BOOP and 17 control subjects. Mast cells and tryptase were significantly increased in BAL fluid of patients with BOOP (p = 0.001 and p = 0.03, respectively). In lung tissue of patients with BOOP, there was an increased number of mast cells per square millimeter of lung tissue with respect to control group (p = 0.001). Seventy-three percent of mast cells were found in the alveolar septa, 18% within alveoli often plunged in organizing pneumonia, 4% among alveolar lining cells, and 6% along blood vessels. No mast cells were located within alveoli in control subjects. Mast cell degranulation was evident in lung tissue specimens of patients with BOOP but not in those of control subjects (p = 0.01). This study shows the importance of mast cells and mast cell activation in the pathogenesis of BOOP.

Naloxone and metergoline effects on growth hormone response to gamma-hydroxybutyric acid

Gamma-hydroxybutyric acid (GHB) has been recently used in alcohol detoxification, but conflicting data are available concerning the central mechanism of action of this GABA catabolite. GHB ability to stimulate growth hormone (GH) secretion has been reported. Our previous studies revealed the ability of flumazenil (a benzodiazepine antagonist) to counteract GHB effects on GH secretion. Other hypotheses, including an opioid or serotonergic role of GHB, have been considered. In the present study we investigated GH responses to GHB with or without naloxone (an opiate receptor antagonist) or metergoline (a serotonin receptor antagonist) pretreatment. This study included 10 male healthy volunteers (aged 24.3 +/- 2.9 years) who were submitted to four tests in random order: (A) oral GHB administration; (B) oral GHB and i.v. naloxone administration; (C) oral GHB and oral metergoline administration; and (D) oral placebo and i.v. saline administration. Blood samples for GH assay were collected during the three tests at -15, 0, 15, 30, 45, 60 and 90 min. GHB induced a significant increase in GH plasma levels; naloxone pretreatment did not antagonize GHB action on GH secretion; metergoline significantly decreased GH response to GHB (p < 0.05). No changes were obtained with placebo and saline administration. The opioid system does not seem to be involved in GHB effects on GH-secreting pituitary cells; GHB effects on the serotonergic system influencing GH secretion, on the other hand, cannot be excluded.

[Prevention in dentistry: evaluation after one year]

The Authors planned an after one year revision of a sample of no. 138 children of a ULSS 8 (VI) District, involved in a odontoiatric prevention program.

[Epidemiological study of the prevalence of caries, periodontal diseases and malocclusion in a school population]

A randomized stratified sample of children 3 to 12 years of age has been examined, DMFT, CPITN, soft deposits and malocclusion have been analyzed. The prevalence of caries, periodontal involvement and malocclusion has been observed to be rather high, thus requiring the organizing of detailed preventive programs to reach the W H O target set for the year 2000.

[Progression of DMF index--DMF from 3 to 12 years: need for preventive intervention]

To evaluate the prevalence of soft deposits and the trend of dmf/DMF index, a group of children between 3 and 12 years of age has been examined. A DMF Index of 5.74 at 12 proves the need to promote educational and prevention programmes in the Ulss 34 area since the WHO program "Health for all in the year 2000" sets a target of a DMF Index below 3 at 12.

Relationship between procollagen III peptide serum levels, synovitis of weight bearing joints and disability in rheumatoid arthritis

We studied P-III-P levels along with several acute phase reactants, Beta-2-microglobulin and autoantibody synthesis in 52 rheumatoid patients. No relationship arose between P-III-P levels and immunological parameters nor with acute phase reactants. We observed a highly significant difference between P-III-P levels in patients with knee and/or hip involvement with respect to those with only polyarthritis of small joints (86.1 +/- 21.5 vs 61.2 +/- 19.1 ng/ml; p less than 0.001). In 24 consecutive patients we also observed a significant correlation (p less than 0.02) between P-III-P levels and AIMS score. We conclude that P-III-P levels are mainly related to the synovial inflammation of major joints and as such P-III-P might represent the biochemical marker of the synovial mass in rheumatoid arthritis.

[Epidemiological study of the prevalence of malocclusion in a Bersaglio group]

The Authors planned an epidemiological survey to evaluate the prevalence of malocclusion in a target group of children living in the Ussl 8-Vicenza. The results confirm the data in the literature. The Authors think necessary to carry on more precise longitudinal epidemiological studies, orthodontic prevention of malocclusion during childhood and interceptive therapy.

[Epidemiology of dental caries in a Vicenza school group]

The Authors have made a stratified randomized enquiry about scholastic population of the Ulss no 8. The results obtained have shown a high prevalence of the decayed phenomenon in all bands of age.

[Plasma beta-endorphin levels in silent or symptomatic myocardial ischemia]

The role of increased beta-endorphin activity in patients with silent myocardial ischemia has been postulated. To further investigate this hypothesis, 13 patients with silent myocardial ischemia (A) and 10 patients with exercise-induced angina (B) were studied. To be entered in groups A and B patients had to fulfill the following criteria: occurrence or not of anginal pain, according to history and clinical data, during a positive exercise ECG and associated imaging of reversible perfusion defect at thallium-201 scintigraphy. Basal plasma beta-endorphin levels showed significantly (p less than 0.05) higher values in group A as compared to group B. At the end of an exercise stress test, plasma beta-endorphin levels were measured in 9 patients from group A and in 7 from group B. Post-exercise beta-endorphin levels showed a mild increase in group A, but increased significantly in group B (p less than 0.02). The patients with silent or symptomatic myocardial ischemia were quite well-matched with regard to age, sex, number and localization of obstructed coronary vessels, positive exercise ECG and imaging of reversible perfusion defect at thallium-201 scintigraphy. The higher basal plasma beta-endorphin levels in patients with painless ischemia, compared to symptomatic patients, suggested that endogenous opioid peptides play a role in the perception of anginal pain during myocardial ischemia. The fact that post-exercise plasma beta-endorphin levels increased in symptomatic patients but remained unchanged in patients with silent myocardial ischemia does not lead to conclusive considerations.

[Immunoscintigraphy in the diagnosis of choroid melanoma]

This study was aimed at evaluating the role of 99mTc-labelled anti-melanoma antibodies as in vivo tumor markers in the diagnosis of uveal melanomas. Usually, neither conventional semeiological techniques nor more recent diagnostic imaging methods allow a differential diagnosis to be made of benign and malignant intra-ocular tumors. Immunoscintigraphy was employed to examine 9 patients with monolateral reduction of sight, and photopsy. All patients were previously submitted to funduscopy, fluorescein angiography, and US. Four hours after iv injection of 370 MBq of 99mTc F(ab1)2, we obtained 500,000-count images of skull, abdomen, and thorax, with a computerized gamma camera equipped with a general-purpose collimator. A SPET of the head followed the conventional examination. Our first results seem promising enough for further study to be carried out to assess immunoscintigraphy specificity in the diagnosis of uveal melanoma.

Isotope retention for assessment of bone turnover in involutional osteoporosis

A continuous bone remodelling takes place throughout life at different turnover speed according to age, physiological and pathological conditions. The evaluation of bone turnover may be of value for a prognostic and therapeutical assessment. Calcium bone exchange may be considered a suitable marker of bone turnover; for this reason 47Ca or 45Ca kinetics may be used; these methods have been employed in the past. Labelled diphosphonates, and in particular 99Technetium-methylene-diphosphonate (99TcmDP) are simpler and safer, because these substances are strongly and almost completely stored in bone and not absorbed by the soft tissue; for this reason they are used at the present time. The evaluation of blood levels and 24 hrs urinary elimination of 99TcmDP is used to measure whole bone diphosphonate retention (WBR). This parameter is positively correlated with other markers of bone turnover such as alkaline phosphatase (AP), osteocalcin (OC), urinary hydroxyproline (HOP). A bicompartmental analysis schedule of 99TcmDP distribution has been proposed some years ago and therefore applied by our group, based on the mathematical evaluation of serum concentration at different times and urinary elimination of the label given intravenously. This method provides the possibility to calculate not only WBR but also total body retention (TBR) and a constant (Kbh) which reflects the influx speed of the tracer in the bone. Kbh probably represents a more sensitive index of bone turnover than WBR. It presents a better correlation with AP and OC values and also shows some (statistically less significant correlations with some indices of bone remodelling obtained by histomorphometry on bone biopsies.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of boxing on some metabolic indices of muscular contraction

Muscular contraction, especially if it is protracted or particularly intense, causes notable changes in the substrate and enzymes involved. Marked changes have been found in the serum levels of myoglobin and CK in individuals subjected to very stressful physical work. This phenomenon has usually been attributed to the repeated and intense muscular traumas inherent in certain sporting activities. In the light of these facts, the authors decided to perform a study on amateur boxers aimed at measuring the difference between simple muscular work (shadow boxing) and traumatic activity (real boxing) in terms of their effect on a number of humoral parameters, especially myoglobin and CK. The serum levels of these two latter substances were found to increase more after real boxing than after shadow boxing.