The phlebologist confronted with the neurologic foot. Phlebologic aspects of the neurologic foot

Vascular complications are frequent in paralyzing neurologic disorders, particularly in peripheral neurologic diseases: edema of the declive, cold feet, acrocyanosis, increased sudation. An enlarged leg in a paralyzed subject presenting frequently reduced sensitivity may indicate phlebitis, but also hematoma of an undetected fracture, or osteoarthropathy. Trophic disorders, such as edema, ulcerative hyperkeratosis and subcutaneous hematoma, are sometimes indicative of an unrecognized peripheral neuropathy, notably diabetic. Sclerous complications of venous impairment, or trophic disorders in algesic dystrophy, may result in incorrect diagnosis of a neurologic disorder. In practical therapeutic terms, it is necessary to emphasize the value of elastic retention, attentive pedicure and flexible and shock-absorbing footwear.     

Heparin-interacting sites of bovine lactoferrin are involved in anti-adenovirus activity

Lactoferrin, a member of the transferrin family of approximately 80 kDa, consists of a single polypeptide chain folded in two symmetric, globular lobes (N- and C-lobes), each able to bind one ferric ion. This glycoprotein, found in physiological fluids of mammals, plays an important role in immune regulation and in defense mechanisms against bacteria, fungi, parasites, and viruses. Although the antiviral activity of lactoferrin is one of the major biological functions of such protein, the mechanism of action is still under debate. We have investigated both the role of tryptic fragments of bovine lactoferrin and the mechanism of lactoferrin antiviral effect toward adenovirus infection in HEp-2 cells. The results obtained demonstrated that the anti-adenovirus activity of lactoferrin is mediated by the N-terminal half of the protein as the N-lobe was able to inhibit adenovirus infection, even if at lower extent than undigested lactoferrin, whereas C-lobe was ineffective. The results also showed that the anti-adenovirus action of lactoferrin and of its N-terminal peptide lactoferricin took place on virus attachment to cell membrane, mainly through competition for common glycosaminoglycan receptors. The data provide evidence that the anti-adenovirus activity of lactoferrin is mediated mainly by the cluster of positive charges at the N-terminus of whole molecule and that the N-terminal peptide lactoferricin alone is sufficient to prevent infection.     

Image Guided Neuroendoscopy for Third Ventriculostomy

Summary  Third ventriculostomy has become an increasing popular procedure for the treatment of hydrocephalus of different aetiologies. Between october 1997 and october 1998, 17 patients (12 females, 5 males; 12–82 year-old; mean age 43) underwent image-assisted endoscopic third ventriculostomy for hydrocephalus at the Istituto Nazionale Neurologico “C.Besta” of Milano. There was no mortality and no long term morbidity. Neuronavigation has been found useful in selecting the safest trajectory to the target avoiding any traction on the foramen of Monro related structures and allowing the necessary mobility for fine adjustments under visual and “tactile” control when choosing the safest point to perform the stoma.  According to our experience neuro-endoscopy and neuronavigation seems to be complementary in reaching easy, safe and successful results in the treatment of hydrocephalus of different origins.