Milk protein intake in the term infant. II. Effects on plasma amino acid concentrations

The response of plasma amino acids to two bovine protein formulas with different protein content (1.6 and 1.2 g/100 ml containing 60% whey proteins and 40% caseins) was measured in term infants. These two groups of infants were compared with a group of infants that were breast-fed; all infants were fed ad libitum. Concentrations of threonine, valine and total branched chain amino acids reflected the amount of protein provided. Thus, the concentrations were higher in the higher protein formula infants from the second week of the study. In the low protein formula infants these amino acids were lower but differed from the infants on breast milk at eight and twelve weeks. Concentration of taurine was lower in the formula fed infants than they were in breast-fed infants at the end of the study. The valine/glycine ratio in the low protein formula group was lower than in the breast-fed group for the first four weeks of the study. After this time it was equal to that of the breast-fed group. These differences in plasma amino acid concentrations give further evidence that formulas now in common use for term infants provide a protein intake in excess of protein requirements after the first months of life.     

Milk protein intake in the term infant. I. Metabolic responses and effects on growth

Thirty healthy term infants were studied during the three first months of life. The infants were divided into three feeding groups consisting of 10 infants in each. The feeding regimens were: human milk by breast feeding, a formula (F-I) containing 1.2 g/100 ml of protein and a control formula (F-II) containing 1.6 g protein/100 ml. Both formulas were whey predominant and isocaloric. Protein intake was significantly higher with formula F-II when compared to the human milk group and to formula F-I. No significant differences with respect to weight, length and head circumference were found among the groups, but the rate of growth between 2 to 12 weeks was higher in the control formula (F-II) group. Serum albumin concentrations were normal and similar in all feeding groups. Blood urea nitrogen and urine total nitrogen concentration was significantly lower in the low protein formula I group when compared to the control formula II. After the fourth week of life the low protein formula infants had similar blood urea nitrogen and urine nitrogen concentrations as those of the breast-fed infants. The results indicate that current formulas in use provide excessive protein intakes after the first months of life.     

Choroidal tubercles in miliary tuberculosis

OBJECTIVE/METHOD: We present 2 cases of miliary tuberculosis with choroidal tubercles. RESULTS/CONCLUSIONS: Miliary tuberculosis is a severe disease that may cause death in case of misdiagnosis, but might be resolved with an adequate mycobacterial therapy. The diagnosis was based on a combínation of findings and the presence of choroidal tubercles may play an important role in the final diagnosis and correct treatment.     

Antibiotic microbial resistance surveillance in invasive infections caused by Streptococcus pneumoniae and Staphylococcus aureus: the EARSS (European Antimicrobial Resistance Surveillance System) project in Italy (April 1999-April 2000)

This paper presents the results of an Italian multicentric study conducted in the period April 1999-April 2000 in 64 clinical microbiology laboratories, aimed at collecting antimicrobial resistance data using a standard European protocol (EARSS Project, European Antimicrobial Surveillance System). A total of 1701 strains of Staphylococcus aureus were isolated from blood and 367 strains of Streptococcus pneumoniae were isolated from blood (72.7%) or from CSF (27.3%). Methicillin resistance in S. aureus was found to be 42.1%; it was significantly higher in adults (RR = 6.6, CI 95% 2.5-17.0), in hospitals of Centre and North of Italy (respectively RR = 1.45, CI 95% 1.1-2.0; RR = 1.6, CI 95% 1.1-2.2), and in intensive care and surgery units (respectively RR = 1.8, IC 95% 1.6-2.0 and RR = 1.7, CI 95% 1.4-1.9). Penicillin resistance in S. pneumoniae was found to be 12.1%; it was higher in South Italy (RR = 3.5, CI 95% 1.9-6.6, in meningitis compared to sepsis (RR = 2.5, CI 95% 1.4-2.5) and in intensive care units compared to other departments (RR = 2.2, CI 95% 1.0-4.8). The level of erythromycin resistance in S. pneumoniae was of 28.2%, reaching 56.4% in penicillin resistant strains. These results suggest that a continued surveillance and effective control measures are required.     

Molecular modeling as a tool to investigate molecular recognition in P2Y receptors

Nucleotides are emerging as an ubiquitous family of extracellular signaling molecules. These effects are mediated through a specific class of plasma membrane receptors called P2 receptors that, according to the molecular structure, are further subdivided into two subfamilies: P2Y and P2X. Specifically, P2X-receptors are ligand-gated ion channels, whereas P2Y-receptors belong to the superfamily of G-protein-coupled receptors. In this review, we focus our attention to GPCRs molecular architecture, with the special emphasis on our work on the human P2Y(1) receptor. In fact, despite an enormous amount of research on the structure and function of these receptors, fundamental understanding of the molecular details of ligand/GPCR interactions remains very rudimentary. How agonist binding transforms a resting GPCR into its active form and the microscopic basis of binding site blockade by an antagonist are generally still unclear. In the absence of high-resolution structural knowledge of GPCRs, such questions only can be addressed by building models, which are tested through pharmacological and biochemical studies. In this review, we underline how different molecular modeling approaches can help the investigation of both receptor architecture and ligand/receptor molecular recognition.     

Diaphragmatic blunt injuries: analysis of cases

Blunt injuries of diaphragm are frequently encountered in polytrauma and thoraco-abdominal injuries. Between 1992/2001, 12 cases were analyzed, representing 19.64% of of a total of 52 cases with diaphragmatic injuries (12 blunt and 40 penetrating). 11 were victims of traffic accidents (91.66%) and one of precipitation (8.3%). There were six men and five women. When they were admitted all patients presented with signs of trauma and hemorrhagic shock. 11 cases were operated. On the first 3 hours and in 3 cases, the patients were directly transported in operator theatre. Death rate was quite high--27.27%. Hospital stay was 15.54 days in average (13-38 days). Complication rate was 27.3%. Diaphragmatic injury are life threatening injuries, always challenging, associated with a high rate of mortality.     

Primary pituitary abscess: case report

Pituitary abscesses are potentially life-threatening lesions if not appropriately diagnosed and treated. The authors have operated on more than five hundred cases of pituitary tumors and only one represented a case of pituitary abscess. A 35-year-old woman was investigated for chronic frontal headache. CT scan showed a cystic sellar lesion with ring enhancement after contrast injection leading to an initial diagnosis of pituitary adenoma. She underwent a sublabial transsphenoidal approach to the pituitary gland. After dural opening, purulent material was obtained and no tumor or other associated lesion was detected. There was no evidence of current or previous septicemic illness, meningitis, cavernous sinus thrombosis or sinus infection. Cultures were negative. She was put on antibiotics and discharged after 4 weeks. Nowadays, 10 years after treatment, she is doing well, with no anterior pituitary hormone deficit. MRI shows a partially empty sella without residual lesion and the pituitary stalck is in the midline. The early diagnosis and adequate treatment of this life-threatening lesion may result in excellent prognosis.     

Fat intake and metabolism in Swedish and Italian infants

The purpose of the study was to compare fat intake and metabolism between two infant populations from Sweden and Italy given breast milk or similar infant formulas, but different weaning foods. Nutrient intake and fat metabolism were studied prospectively from 3-12 mo in 68 Swedish and 46 Italian healthy infants, breastfed or given similar infant formulas in combination with Swedish or Mediterranean weaning foods. Although nutrient intake and fat metabolism were similar at 6 mo, fat intake was lower at 12 mo in the Italian than in the Swedish formula group (p < 0.001). At 6 and 12 mo, higher dietary ratios of monounsaturated to saturated fatty acids (p < 0.01 and p < 0.001, respectively), and monounsaturated to polyunsaturated fatty acids (p < 0.05, p < 0.001) were found in the Italian than in the Swedish formula group. Total cholesterol and apolipoprotein B were lower at 6 mo (p < 0.01) in Italian breastfed infants than in Swedish ones. Lower concentrations at 6 and 12 mo of total cholesterol (p < 0.05, p < 0.05, respectively), apolipoprotein B (p < 0.05, p < 0.01) and triglycerides (p < 0.001, p < 0.01), and of apolipoprotein A1 (p < 0.01) at 12 mo, were found in the Italian formula group than in the Swedish one. In conclusion, plasma total cholesterol, apolipoprotein B and triglycerides were found to be lower in Italian infants than in Swedish infants during the second half of infancy. These findings may partly result from differences in fat compositions between Swedish and Mediterranean weaning diets and in total fat intake in late infancy. Differences in duration of breastfeeding and possibly in breast milk composition may also have influenced our results.