Phytocannabinoids: Pharmacological effects, biomedical applications, and worldwide prospection

Scientific evidence exists about the association between neurological diseases (i.e., Parkinson's disease, Alzheimer's disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis, depression, and memory loss) and oxidative damage. The increasing worldwide incidence of such diseases is attracting the attention of researchers to find palliative medications to reduce the symptoms and promote quality of life, in particular, in developing countries, e.g., South America and Africa. Among potential alternatives, extracts of Cannabis Sativa L. are suitable for people who have neurological disorders, spasticity, and pain, nausea, resulting from diseases such as cancer and arthritis. In this review, we discuss the latest developments in the use of Cannabis, its subtypes and constituents, extraction methods, and relevant pharmacological effects. Biomedical applications, marketed products, and prospects for the worldwide use of Cannabis Sativa L. extracts are also discussed, providing the bibliometric maps of scientific literature published in representative countries from South America (i.e., Brazil) and Africa (i.e., South Africa). A lack of evidence on the effectiveness and safety of Cannabis, besides the concerns about addiction and other adverse events, has led many countries to act with caution before changing Cannabis-related regulations. Recent findings are expected to increase the social acceptance of Cannabis, while new technologies seem to boost the global cannabis market because the benefits of (-)-trans-delta-9-tetrahydrocannabinol (Δ9-THC) and cannabidiol (CBD) use have been proven in several studies in addition to the potential to general new employment.

Case Report: A child with NFKB1 haploinsufficiency explaining the linkage between immunodeficiency and short stature

We report the case of a patient with common variable immunodeficiency (CVID) presenting with short stature and treated with recombinant human growth hormone (rhGH). Whole exome sequencing revealed a novel single-nucleotide duplication in the NFKB1 gene (c.904dup, p.Ser302fs), leading to a frameshift and thus causing NFKB1 haploinsufficiency. The variant was considered pathogenic and was later found in the patient's mother, also affected by CVID. This is the first reported case of a patient with CVID due to NFKB1 mutation presenting with short stature. We analyzed the interconnection between NFKB1 and GH - IGF-1 pathways and we hypothesized a common ground for both CVID and short stature in our patient.

Case Report: Zellweger Syndrome and Humoral Immunodeficiency: The Relevance of Newborn Screening for Primary Immunodeficiency

BACKGROUND

Zellweger syndrome (ZS) is a congenital autosomal recessive disease within the spectrum of peroxisome biogenesis disorders, characterized by the impairment of peroxisome assembly. The presence of peroxisome enzyme deficiencies leads to complex developmental sequelae, progressive disabilities, and multiorgan damage, due to intracellular accumulation of very-long-chain fatty acids (VLCFAs).

CASE PRESENTATION

We report the case of an infant affected by ZS in which agammaglobulinemia, detected through neonatal screening of congenital immunodeficiencies, appeared as a peculiar trait standing out among all the other classical characteristics of the syndrome. The exome analysis through next-generation sequencing (NGS), which had previously confirmed the diagnostic suspicion of ZS, was repeated, but no mutations causative of inborn error of immunity (humoral defect) were detected.

CONCLUSION

In this case, no genetic variants accountable for the abovementioned agammaglobulinemia were detected. Given that the scientific literature reports the involvement of peroxisomes in the activation of Nuclear Factor κ-light-chain-enhancer of activated B cells (NF-κB) pathway, which is crucial for B-cell survival, with this work, we hypothesize the existence of a link between ZS and humoral immunodeficiencies. Further studies are required to confirm this hypothesis.

Hippocampal cholineacetyltransferase activity, agonistic behaviour and social stress in male rabbits

Agonistic behaviour was observed in pairs of unfamiliar male rabbits living in an outdoor enclosure. Attack, Chase, Follow and Cross-over were scored. On the basis of their frequencies the subjects in the pair were assigned a first or second rank-position. Hippocampal cholineacetyltransferase (ChAT) and plasma levels of corticosterone were considered in relation to rank. ChAT levels in the dorsal hippocampus varied in relation to agonistic behaviour. Second-ranking subjects had significantly higher levels of ChAT than the first-ranking animals and had levels of corticosterone which were markedly higher at the end of the experimental period than at the beginning. A negative correlation was found between Attack and ChAT levels in the dorsal hippocampus. These results suggest the presence of social stress in the second-ranking animals and indicate a state of activation of the hippocampus in relation to agonistic behaviour.

Congenital dacryocystocele: diagnosis and treatment

Five children were diagnosed with congenital dacryocystocele; in all cases, the cystic lesion was unilateral; age ranged from 7 to 60 days (mean 29 days). The mean ultrasonography diameter of the cyst, at the time of the diagnosis, was 11.51 mm. Topical and systemic antibiotics and massage were prescribed. One patient had no recurrence of the dacryocystocele but 4 showed no improvement with medical treatment; they were submitted to successful probing in the first months of life under general anaesthesia. Nasal endoscopy revealed a nasolacrimal cyst in one patient. True dacryocystocele is relatively rare: ultrasound is a simple, non-invasive method that can reliably distinguish dacryocystocele from other pathological conditions. Several reports have described a variable natural course of these lesions but there are controversial opinions regarding their management. Initially, we treated this congenital anomaly with digital massage, and topical and systemic antibiotics. Probing under general anaesthesia was performed in the event of dacryocystitis or lack of resolution after a short trial period with digital massage. Particular attention was paid to nasal bilateral endoscopy to exclude a nasal obstruction caused by cystic swelling of the nasolacrimal duct. When performed, the probing procedure was successful in all patients.

[Instruments and accessories for interventional endoscopic ultrasonography]

Endoscopic ultrasound-guided (EUS) biopsy is now an established method for acquisition of cytohistological specimens. Some other procedures can be performed successfully in most instances (e.g., celiac plexus block, pseudocystic drainage), and some are being performed but need further refinement or validation (e.g., pancreatic and biliary drainage, ablation of pancreatic cyst neoplasm). The present review describes the interventional endoscopes, the needle systems and the specific devices for other interventional procedures available on the market.

Cognitive and physiological effects of Omega-3 polyunsaturated fatty acid supplementation in healthy subjects

BACKGROUND

It has been reported that Omega-3 fatty acids may play a role in nervous system activity and that they improve cognitive development and reference memory-related learning, increase neuroplasticity of nerve membranes, contribute to synaptogenesis and are involved in synaptic transmission. The aim of this study was to examine the effects of Omega-3 supplementation on some cognitive and physiological parameters in healthy subjects.

MATERIALS AND METHODS

Subjects were tested at the beginning of the experiment and after 35 days. In this period they were supplemented with Omega-3 polyunsaturated fatty acids. A group was supplemented with olive oil (placebo). Tests involving different types of attention were used, i.e. Alert, Go/No-Go, Choice and Sustained Attention. For each test, the reaction time, the event-related potentials by electroencephalogram (EEG) and the electromyography (EMG) of the forefinger flexor muscle were recorded. The Profile of Mood States test (POMS) was also administered.

RESULTS

Blood analyses showed that after Omega-3 supplementation the arachidonic acid/eicosapentaenoic acid ratio (AA/EPA) was strongly reduced. The mood profile was improved after Omega-3 with increased vigour and reduced anger, anxiety and depression states. This was associated with an effect on reactivity with a reduction of reaction time in the Go/No-Go and Sustained Attention tests. The latency of EMG activation was concomitantly reduced in the same tests plus Choice. An EEG frequency shift towards the theta and alpha band were recorded in all the tests after Omega-3.

CONCLUSIONS

Omega-3 supplementation is associated with an improvement of attentional and physiological functions, particularly those involving complex cortical processing. These findings are discussed in terms of the influence of Omega-3 on the central nervous system.

Glucocorticoid receptors in human peripheral blood mononuclear cells in relation to explosive performance in elite handball players

Ten handball players, members of the Italian National Team (aged 20-25 years), were studied in two sessions corresponding to different performance levels. The first session occurred one week after the end of the regular season of the Italian Handball Federation: it corresponded to the beginning of the training cycle for the European Handball Championship. The second session occurred ten weeks after the first session. During this period, training consisted of 3 weeks of active recovery and 7 weeks of increasing workload. For each session, jumping performances (maximal height in a single jump, average mechanical power for a 15-s set of consecutive jumps) were evaluated. Venous blood samples were collected in resting conditions immediately before jumping performances to assess cortisol and testosterone plasma concentrations and glucocorticoid receptors (GcR) binding capacity and affinity in peripheral blood mononuclear cells (PBMCs). All the parameters, except GcR binding affinity, increased in the second session. The trends of variation in jumping performances, steroid hormone levels and GcR binding capacity were similar. For testosterone, this agrees with the hypothesis that an adequate level of this hormone is a prerequisite for improvement in explosive performances. For cortisol, higher GcR binding capacity after 10 weeks of training (with respect to initial values) indicated an up-regulation of GcR concomitant with the increase in hormone levels and performances. These findings suggest that the adaptation to training, confirmed by the improvement in performance, is characterized by a high value of GcR binding capacity and that it is mediated, among other factors, by the hormone levels and up-regulation of the receptors.

Policosanol, reaction time and event-related potentials

The aim of the present study was to compare the results of a 1-week, double-blind placebo-controlled trial investigating the effects of isopolicosanol and octacosanol on reactivity and related brain activity. In particular, reaction time (RT) and event-related potentials such as contingent negative variations (CNV) and P300 (P3) have been studied. Thirty sedentary healthy students were tested before and after treatment (3.6 mg/die for 7 days) with orally administered tablets of placebo (group A), isopolicosanol (B) and octacosanol (C). RT were studied according to three procedures: simple RT (SRT), go/no-go RT (GRT) and choice RT (CRT). Results show that before treatment, there were no significant differences between groups A, B and C. After treatment, the RT of group A was unchanged, while the RT of groups B and C were reduced. In group B, in the SRT test, the reduction of RT was accompanied by electrical data exhibiting increased amplitudes of CNV and shorter latencies of P3. These results show that the main effect on reactivity and event-related potentials can be ascribed to policosanol and is mainly evident in the SRT test.

Emotional behavior in female rabbits: hippocampal EEG and neuroendocrine aspects

Behavior, hippocampal electrical activity, plasma hormones and hippocampal choline acetyltransferase (ChAT) were considered in two groups of female rabbits, different in age and condition of breeding, both in the presence and absence of emotional stimuli. In the two groups of female rabbits (4 and 18 months old), permanent electrodes were implanted bilaterally in the two dorsal hippocampi and, one week later, the animals were exposed for three consecutive days to the following tests: Day 1, novel environment (NE); Day 2, object with odor (O); Day 3, sparrow hawk (SP). Behavior: in comparison with Day 1, exploration was decreased by the object and by the sparrow hawk in the older females and increased in the younger ones. Quiet and alert immobility was higher during the SP test, while freezing and pointing were lower in the older females than in the young ones. Electrical activity: peak frequency was lower in younger females than in the older ones. The frequency band distribution corresponding to exploration and immobility showed that in the older females the % of high frequency band increased from the first to the third day of testing, while an opposite trend was present in the younger females. In the case of freezing the hippocampal electric activity showed a more rhythmical component in younger females than in the older ones. Hormones: increased corticosterone levels after the SP test were directly correlated with exploration and inversely correlated with freezing. Dorsal hippocampal ChAT was directly correlated with quiet immobility. These data indicate a relationship between the responses to the anxious/fearful stimuli and the age and/or breeding experience of the female rabbits; this is shown by both the hippocampal electrical activity and the behavioral differences between the two groups.

Close relation between cirrhosis and gallstones: cross-sectional and longitudinal survey

BACKGROUND

Increased gallstone prevalence and incidence in cirrhosis have already been reported in different series, including a limited number of patients with cirrhosis.

OBJECTIVE

To evaluate the frequency of gallstones and related risk factors in a large series of patients with cirrhosis.

PATIENTS AND METHODS

The cross-sectional study involved 1010 patients with cirrhosis related to alcohol abuse, chronic viral infection, or miscellaneous causes (42%, 48%, and 10%, respectively) in Child class A, B, or C (48%, 36%, and 16%, respectively). In the longitudinal study gallstone development was monitored ultrasonographically in 618 patients free of gallstones at enrollment.

RESULTS

The overall prevalence of gallstone(s) was 29.5% and increased significantly with age without differences according to sex or cause of cirrhosis. Multiple logistic regression analysis showed that only Child classes B and C were significantly related to a higher risk of gallstone (odds ratio, 1.63 for class C vs class A and 1.91 for class B vs class A; P = .001). During a mean+/-SD follow-up of 50 months+/-9 months, 141 (22.8%) of 618 patients developed gallstone(s), with an estimated cumulative probability of 6.5%, 18.6%, 28.2%, and 40.9% at 2, 4, 6, and 8 years, respectively. Multivariate analysis showed that Child class (hazard ratio, 2.8 for class C vs class A and 1.8 for class B vs class A; P = .002 and P = .001, respectively) and high-body mass index (hazard ratio, 1.31; P = .04) carried a significantly greater risk of gallstone formation.

CONCLUSION

Cirrhosis per se represents a major risk factor for gallstones whose prevalence and incidence were far higher than those reported in a general population from the same area.

Glucocorticoid receptors in human peripheral blood mononuclear cells in relation to age and to sport activity

Glucocorticoid receptors (GR) are ubiquitous molecules and are present also in the hippocampus and in several other nervous and immune tissues. Peripheral blood mononuclear cells (PBMCs) are a good model for studies of GR in humans. Glucocorticoids are important for maintaining cellular and humoral homeostasis and are key mediators of neuroendocrine-immune regulatory interactions. The increase of cortisol is immunosuppressive and reduces GR concentration both in nervous and immune systems. Variation of glucocorticoids in healthy aged subjects and athletes has been shown. Prompted by these results, we have investigated in man a possible relationship between GR binding capacity in the PBMCs and age, in relation also to plasma testosterone and cortisol. The same parameters have been examined in a group of soccer players for comparison with the sedentary group. GR binding capacity was higher in younger subjects than in older ones, and lower in the group of athletes than in the younger and older sedentary subjects. In the sedentary group a negative correlation was present between GR binding capacity and age. Plasma cortisol was higher and testosterone lower in the athletes; they were negatively correlated in athletes and positively correlated in the sedentary subjects. The results for athletes agree with their lower anabolic/catabolic balance. The mechanism of reduced GR levels in relation to age and sport activity could involve a loss or an involution of receptor synthesis. However other possibilities, such as altered distribution of lymphocyte subpopulations with different receptor concentrations and with different cytokine production, cannot be excluded. Several neuroendocrine-immune interactions could be responsible for reduced GR levels with age and sport activity in man.

[Hepatitis C and dentistry. Review of the literature]

In 1988 the RNA virus responsible for the majority of cases of parenteral non A, non B hepatitis (NANBH) was isolated and designated Hepatitis C Virus (HCV). Since then, the sequence of the genome of the virus has been defined and at least 10 different types identified. Clinical studies indicate that the majority of patients who acquire HCV develop chronic hepatic disease, in particular chronic active hepatitis or cirrhosis and some of them will develop hepatocellular carcinoma. Currently, there is no effective anti-HCV therapy and no passive or active immunization protocol for HCV. Epidemiological studies indicate that HCV infection is relatively well confined to specific patient populations, in particular injecting drug users and recipients of blood and blood products. Nevertheless as HCV infection is transmitted mainly parenterally it must be regarded as a potential hazard for dental health care staff. This article reviews current knowledge concerning HCV infection with particular attention to those issues relevant to the dentists in Italy including the dental management of the HCV infected patient and the risk of HCV cross-infection in the dental environment.

Influence of training on the response of androgen plasma concentrations to exercise in swimmers

In eight top-level male endurance swimmers the aerobic performance and the response to exercise of total testosterone (T), free testosterone (fT), sex hormone binding globulin (SHBG), non-SHBG-bound testosterone (NST) and cortisol (C) were evaluated during a training season. The swimmers participated in three test sessions which occurred 6, 12 and 24 weeks after the beginning of the season. During each session, after a standard warm-up, the swimmers performed a set of 15 x 200-m freestyle, with a 20-s rest between repititions, at a predetermined individual speed. Three blood samples were collected: before warm-up, at the end of the set, and after 1 h of recovery. A few days before each session, the individual swimming velocity associated with a 4 mmol.l-1 blood lactate concentration (v4) was assessed as a standard of aerobic performance. The values of v4 were lower in the second session than in the third one. The concentrations of C. which increased after the exercise, showed the highest values in the second session. The values of T and the T:SHBG ratio increased after the exercise but returned to their initial concentrations during the recovery period. The values of fT and NST increased after the exercise in the first and third sessions. In the initial two sessions, when the aerobic performance was still low, the concentrations of NST decreased to below the initial values after recovery. In session III, when the adaptation to the training workload was complete, NST returned to resting concentrations after recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Responses of atrial natriuretic peptide and other fluid regulating hormones to long distance swimming in the sea

The plasma hormonal response following a swimming competition in the sea (18 km) was evaluated in 12 top level male endurance swimmers. At the end of the effort, while plasma renin activity (PRA) and aldosterone concentration (ALDO) were unchanged, a significant increase in plasma atrial natriuretic peptide (ANP) and antidiuretic hormone (ADH) concentrations were recorded. These changes were associated with a decrease in haematocrit and an increase in Na+ and Cl- plasma concentrations. The individual variations of ANP (difference between the final and initial concentrations) were inversely correlated with the corresponding individual variations of PRA and ADH. The results suggest that, during prolonged swimming, ANP may exert an inhibitory effect on the PRA-ALDO axis and have a modulatory role with regard to ADH secretion.

Decrease of hippocampal choline acetyltransferase activity induced by formalin pain

The involvement of the hippocampal choline acetyltransferase (ChAT) activity in the response to tonic pain was investigated in rats injected with formalin, either 50 microliters 10% or 50 microliters 0.1%. Hippocampal ChAT activity was found to be reduced both 30 and 60 min after injection of the higher concentration of formalin but only 30 min after the lower one. Results indicate that the decrease in ChAT activity depends upon the presence of the nociceptive input rather than its magnitude. The hippocampal formation is involved in the specific behavioural response to pain, namely licking.

Immune and neuroendocrine response to restraint in male and female rats

A parallel study of the modification in the opioid and immunological systems induced by acute restraint (RT) was carried out in male and female rats 24 hr after the treatment. beta-Endorphin-like immunoreactivity (beta-ELI) was measured in two brain areas (ventral hypothalamus [HYP] and periaqueductal gray matter [PAG]) and in the pituitary (anterior and neurointermediate lobes), together with plasma corticosterone (C) and ACTH. Immune function was measured as mitogen-induced Interferon-gamma (IFN-gamma) production by splenocytes. RT reduced beta-ELI levels in the PAG in males and females. Plasma levels of C and ACTH did not differ from the basal levels in restrained animals. RT reduced IFN-gamma production in both sexes, but this effect was more marked in females than in males. The possible relationship between the immune and opioid system is discussed.

Immunologic effects in patients with psoriatic arthritis treated with cyclosporine A

Twelve patients with psoriatic arthritis (PsA) and very active articular disease resistant to conventional second line therapy entered into a 6-month open study of cyclosporine A (CsA) at a starting dosage of 3 mg/kg/day. Comparisons of phenotypic characteristics of lymphocytes and response to mitogens of peripheral blood mononuclear cells (PBMC) were made between these patients with PsA before CsA therapy, 7 patients without prior 2nd line therapy, 14 untreated patients with psoriasis alone, and 61 healthy controls. We confirmed a significant reduction of the basal percentage of CD8+ cells and an increase in the CD4/CD8 ratio in patients with PsA before CsA therapy compared to controls. These abnormalities were not present in patients with PsA without prior 2nd line therapy and in patients with psoriasis alone. Peripheral blood activated T cells (CD3+, HLA-DR+), natural killer (NK) (CD3-, CD16+ and/or CD56+), total B and CD5+ B cells were decreased only in patients with PsA before CsA therapy. The reduction of non-MHC restricted cytotoxicity T (CD3+, CD16+ and/or CD56+) was observed in all the 3 groups of patients compared to controls. After the 6 months of CsA therapy we observed a significant increase of CD3+, HLA-DR+, CD3+, CD16+ and/or CD56+, total B, and CD20+, CD5+ cells in the 11 patients with PsA compared to pretreatment values. Contrary to azathioprine, CsA does not impair the NK cell population which has a protective role against cancer and viral infections.

Soluble interleukin 2 receptors in polymyalgia rheumatica/giant cell arteritis. Clinical and laboratory correlations

Serum levels of soluble interleukin 2 receptors (sIL-2R) were measured in 21 patients with polymyalgia rheumatica (PMR)/giant cell arteritis (GCA) prior to steroid treatment. These levels were significantly elevated in patients with PMR/GCA compared with healthy controls (p = 0.002). A significantly longer duration of morning stiffness (p = 0.005) was observed in patients with a high concentration of sIL-2R. A significant correlation was observed at diagnosis between sIL-2R and erythrocyte sedimentation rate (ESR) (p = 0.01) and between ESR and C-reactive protein (CRP) (p = 0.005). We investigated prospectively a group of 10 patients over a period of 6 months of prednisone therapy. At the end of the study sIL-2R levels fell significantly compared to pretreatment values (p = 0.02), but remained significantly higher compared to controls (p = 0.02). ESR and CRP values also fell significantly compared to pretreatment levels (p = 0.0001 in both cases). We observed a significant correlation between the decrease in ESR values and the decrease in sIL-2R and CRP levels after 6 weeks (p = 0.01 in both cases) and after 6 months of therapy (p = 0.002 and p = 0.05). sIL-2R may be considered a useful serologic marker for monitoring response to steroid therapy in patients with PMR/GCA. This laboratory variable correlated more closely with ESR than with CRP. The presence of elevated levels of sIL-2R is likely to reflect T cell activation occurring in PMR/GCA. T lymphocyte activation persisted after 6 months of steroid therapy, despite rapid and continuous control of disease manifestations.

Extraarticular manifestations of rheumatoid arthritis and HLA antigens in northern Italy

We performed retrospective analysis of 141 Northern Italian patients with rheumatoid arthritis (RA). This series represents all the patients seen as in and/or outpatients at the rheumatologic unit of Reggio Emilia Hospital during a 2 year period (1987-88). We observed a low frequency of nodules (16%) and vasculitis (2.1%). Thus, RA seems to be milder in our population compared to Caucasian patients with RA originating from North America or England. We observed a weak association with DR4 (RR = 2.4) in the total group of patients with RA. A low frequency of DR4 was observed in patients and controls (29 vs 14.5%, p = 0.001). When compared with controls the frequency of DR4 was significantly higher in seropositive (p = 0.001), but not in seronegative patients. We found that DR4 was significantly associated with nodules (RR = 6.4), with extraarticular features (EAF) (RR = 4) and with erosions (RR = 3) compared with controls. The subgroups with nodules and EAF had a DR4 frequency (respectively, of 52 and 40%) which was significantly higher than that observed in remaining patients (respectively, 25 and 24%). No significant difference was observed in the DR4 frequency between the patients with erosions and those without (34 vs 18%). Thus, DR4 in our population seems to be predominantly associated with a subgroup of patients characterized by seropositivity and EAF.

Changes in the exercise-induced hormone response to branched chain amino acid administration

It was the aim of the present experiment to detect possible effects of branched-chain amino acids (BCAA) on the endocrine response to 1 h of continuous running. Blood samples were collected from 14 long-distance runners (age 24-42 years) in two different trials performed at 1-week intervals. In both trials (E and P) blood samples were collected at the following times: 9 a.m. (basal values sample), 10.30 a.m. (sample 90), 11.30 a.m. (sample 150), 12.30 p.m. (sample 210); the athletes performed 1 h of running at a constant predetermined speed between samples 90 and 150. Following the basal sample a mixture containing BCAA (E trial), or not containing BCAA (P trial) was ingested. In both trials no hormone basal concentrations, except insulin, were changed before exercise. In P trial, following exercise (sample 150), human growth hormone (HGH), prolactin (PRL), adrenocorticotropic hormone (ACTH) and cortisol (C) increased, while testosterone (T) decreased. In sample 210, after 1 h of rest, while ACTH, PRL and HGH had recovered to basal concentrations, C remained elevated and T displayed a further decrease. In the E trial a similar pattern of change was observed in sample 150 for HGH, PRL, ACTH and C; in sample 210 HGH and PRL displayed significantly lower values than in the corresponding P trial samples. The T was not modified by the running exercise and increased during the recovery period. It is, therefore, suggested that BCAA administration before exercise affects the response of some anabolic hormones, mainly HGH and T.

Increased uptake of radio labelled white blood cells into abdomen of uremics on peritoneal dialysis

Peritonitis and exit-site tunnel infection are frequent causes of CAPD drop out. We studied 9 patients, 8 treated by CAPD and 1 by IPD. These patients underwent sonographic and scintigraphic study of the abdomen. All scintigraphic examinations showed a visceral uptake. In two cases, sub-clinical bowel inflammation, demonstrated by scintigraphic study, preceded a gram negative peritonitis. The scintigraphic study with radiolabelled white blood cells may be useful in identifying chronic aseptic inflammations and some bowel and exit-site conditions which are possible risk factors in some cases of peritonitis.

Low dose cyclosporine A in psoriatic arthritis: relation between soluble interleukin 2 receptors and response to therapy

Twelve patients with psoriatic arthritis (PsA) were treated with low doses of cyclosporine A (CsA) (the initial dose was 3 mg/kg daily) and were entered into an open 6-month study. At the end of the study arthritis was improved in 7 patients (number of patients achieving a 50% or more reduction in the number of swollen or tender joints) and unchanged in 4 patients. Cutaneous psoriasis also improved significantly as shown by psoriasis area and severity index score. Only one patient withdrew from the study after one month because of severe nephrotoxicity. Serum creatinine fell to baseline value 6 weeks after the discontinuation of CsA. Three patients had minor side effects. CsA maintained articular improvement also in the 9 patients who are still taking this drug (mean duration of therapy of 12 +/- 0.8 months). There was no significant reduction of erythrocyte sedimentation rate during the study period. We assayed levels of soluble interleukin 2 receptors (sIL-2R) in serial serum samples obtained from 10 patients during the study period. Concentrations of sIL-2R were significantly increased in patients with PsA compared to controls. In 6 responder patients we observed a parallel decrease in joint pain/tenderness score and serum sIL-2R values. This finding was not observed in 4 nonresponders. Our results suggest that low dose CsA is a short term effective and safe therapy in patients with PsA and that serial sIL-2R levels are a useful means of measuring changes in disease activity.

[Isthmic coarctation of the aorta. Description of an anomalous case]

An anomalous (because of the advanced age of its onset) case of isthmic coarctation of the aorta in preductal site observed at the persistence of hypertensive symptomatology associated with cephalgic and lipothymic attacks is reported. Instrumental examinations confirmed the clinical suspicion and resective-reconstructive surgical treatment led to complete resolution of both cause and effect.

Hormonal changes after supine posture, immersion, and swimming

This study was undertaken to evaluate the effects of the supine posture, immersion, and swimming on hormones involved in the regulation of hydrosaline equilibrium. Plasma levels of atrial natriuretic peptide (ANP), arginine vasopressin (AVP), plasma renin activity (PRA), and aldosterone (ALDO) were measured by radioimmunoassay in eight untrained young subjects (five males and three females). Blood samples were collected on different days: control morning samples in a relaxed standing posture before each test; after 20 min in a supine position; after 20 min of horizontal immersion in water at 28 degrees C; after 20 min of backstroke swimming (speed about 1 m/s). No changes occurred in AVP levels after each test. ALDO and PRA increased significantly only after swimming and were directly correlated. ANP increased significantly after immersion, but no further increase was observed after swimming. The hematocrit, which increased after swimming, was inversely correlated with ANP levels in the post-exercise samples. These data show that while ALDO and PRA increase only in response to swimming, even at moderate intensity, ANP probably requires more prolonged and intense exercise to reach a significantly higher level than in immersion.

Interaction of tonic immobility and dexamethasone in the modulation of hippocampal 5-HT activity in rabbits

The immobility reaction (animal hypnosis) in the rabbit is related to basal levels of corticosterone and to modifications in 5-HT activity in the brain. In order to investigate the relationship between adrenocortical function, brain 5-HT activity and immobility response in rabbits, the susceptibility to the reaction and 5-HT and 5-HIAA levels in the hippocampus were studied in animals whose pituitary-adrenal function was altered by chronic DEX treatment. It was still possible to induce immobility in animals treated with DEX. The reduction in duration observed under the present testing schedule (two sessions of immobility separated by a one week interval) did not occur in the treated animals. There was a reduction in 5-HT turnover as a consequence of the immobility response and this confirms previous findings in other brain areas of the same species. In animals pretreated with DEX, so as to drastically reduce ACTH and corticosterone, not only was a reduction in 5-HT turnover prevented, but there was also an increase in 5-HT and 5-HIAA levels when immobility was induced. These results are discussed in terms of the influence of the pituitary-adrenal system in the neuroendocrine and behavioural aspects of the immobility reaction.

Testosterone metabolism in the olfactory epithelium of intact and castrated male rats

To study the ability of the olfactory epithelium (OE) to transform testosterone (T) into its active metabolites estradiol (E2) and dihydrotestosterone (DHT), and the influence of castration on this ability, 24 adult male rats were either castrated, and subsequently treated with oil or T, or sham operated. In all groups the in vitro conversion of T by the OE into E2 and DHT is relevant, demonstrating for the first time the presence of aromatase and of 5 alpha-reductase in this tissue. In particular conversion of T into E2 is lowered by castration and restored by T replacement, suggesting that aromatization in this tissue is androgen dependent. The ability of circulating T to influence morphological and physiological features of the OE suggests the hypothesis that androgens may vary the functioning of the olfactory apparatus and modulate the efficiency by which olfactory information is conveyed to the brain.

Hormonal and metabolic effects following a football match

Hormonal and metabolic parameters were studied for two teams after a football match. Blood samples were collected before the start, at half-time, at the end, and 45 and 90 min after the end of the game. In the first team, ACTH, cortisol, and lactate levels increased significantly during the whole match to resume basal levels in the fourth sample (45 min after the end of play). HGH, prolactin, and blood glucose were found to be increased only at half-time. The second team had an intense and long warm-up period before the match and the lactate concentrations were already elevated in the first sample. All the other parameters, except ACTH and glucose, displayed a pattern similar to that of the first team. The differences in the time courses of the hormonal and metabolic values are discussed.

Androgen levels following a football match

In 18 trained football players, blood samples were collected before a football match, at half-time, at the end, and 45 and 90 min after the end of the match. The testosterone (T) level showed a decrease in the rest period. Dihydrotestosterone (DHT) increased during the match, but returned to initial levels in the last samples. The T/DHT ratio decreased, reached the minimal value at the end of the exercise, and returned to basal levels in the rest period. Cortisol and androstenedione levels increased during the match, but returned to control levels 45 and 90 min after the end of the match, respectively. It is suggested that during this type of exercise anabolic and catabolic hormones may be simultaneously activated.