5-Year control and treatment of edema and increased capillary filtration in venous hypertension and diabetic microangiopathy using O-(beta-hydroxyethyl)-rutosides: a prospective comparative clinical registry

This independent prospective controlled trial evaluates the efficacy of O-(beta-hydroxyethyl)-rutosides (HR) during 5 years of administration against signs and symptoms and further degeneration of microcirculatory disturbances. The protective effect of HR in preventing end-point complications such as venous ulceration is evaluated. This study is based on evaluation of edema and the capillary filtration rate (CFR) in association with a clinical score scale. Patients having a severe degree of chronic venous insufficiency (CVI) and venous microangiopathy and completing at least 5 years of treatment are included. The following 4 groups are considered: group A (patients with CVI but without diabetes mellitus, receiving 1500 mg/d of HR), group B (patients with CVI and diabetes mellitus, receiving 2 g/d of HR), group C (control subjects receiving no pharmacologic or compression treatment), and group D (patients using elastic compression stockings only). All patients received the "best" available treatment. No adverse effects or intolerance is noted, with good compliance (>85%). In group A, there is a statistically significant decrease in the CFR during 5 years of follow-up. In group B, the decrease in the CFR is greater than that in group A. Reductions in edema, swelling, and the CFR during 5 years are notable, and values approach normal levels. During 5 years, HR is effective in treating venous edema and hypertension and in preventing deterioration of the distal venous system. The prevention of ulcerations with HR is another important observation. The effects of HR seem to be partially dose related, and tolerability and compliance are good.     

AMIL survey (anemia in Internal Medicine in Liguria)

The aim of the present study was to evaluate the epidemiology of anemias in Internal Medicine Departments. The study involved all patients discharged between May 1 and June 15, 2001 who, at the time of admission, had presented with hemoglobin levels < 12 g%. One thousand and nineteen data collection forms were deemed suitable for analysis and were divided according to the etiology and severity of the anemia. We discovered that simple diagnostic tests (reticulocyte count) were underused, that the majority of anemias were not corrected during hospitalization and that most inpatients of Internal Medicine wards in our Region are elderly (mean age 75 years) and suffer from polypathologies. We believe that further observational studies should be carried out in order to evaluate the progress of patients with anemia and to establish guidelines for the diagnosis and treatment.     

Acute small bowel obstruction caused by endometriosis：A case report and review of the literature

Gastrointestinal involvement of endometriosis has been found in 3%-37% of menstruating women and exclusive localization on the ileum is very rare（1%-7%）.Endometriosis of the distal ileum is an infrequent cause of intestinal obstruction,ranging from 7% to 23% of all cases with intestinal involvement.We report a case in which endometrial infiltration of the small bowel caused acute obstruction requiring emergency surgery,in a woman whose symptoms were not related to menses.Histology of the resected specimen showed that endometriosis was mainly prevalent in the muscularis propria and submucosa and that the mucosa was not ulcerated but had inflammation and glandular alteration.Endometrial lymph node involvement,with a cystic glandular pattern was also detected.     

Neonatal Monosodium Glutamate Abolishes Corticotropin-Releasing Factor-Induced Epileptogenic Activity in Rats

Intracerebroventricular (i.c.v.) injection of rat corticotropin-releasing factor (rCRF) at doses of 5-20 micrograms in rats induces epileptogenic activity characterized by pacemaker-like spikes localized in the hippocampal leads. Such an effect was still present in rats neonatally treated with saline but was absent in those neonatally treated with monosodium glutamate (MSG), a treatment that caused marked changes in the concentration of several brain neurotransmitters and neuropeptides in hypothalamic nuclei where CRF is highly concentrated and is believed to induce endocrinologic and behavioral effects. The present results suggest the rCRF-induced spiking activity is mediated by activation of neuronal pathways sensitive to MSG neurotoxic effect.     

Bleeding renal angiomyolipomas. CT findings

PURPOSE: To describe our experience in three cases of abdominal haemorrhage caused by bleeding renal angiomyolipomas, which were studied with Computed Tomography (CT). MATERIALS AND METHODS: A retrospective study carried out at our archives identified 3 patients (aged 58.6 on average) with renal angiomyolipomas clinically manifested with acute abdomen and haemorrhage. The patients underwent an emergency CT scan of the abdomen. One patient also under-went a subsequent renal angiography. All patients had surgery and histological characterizations of the renal lesions. RESULTS: The CT study on all three patients allowed detection of a lesion in the kidneys with inhomogeneous density due to haemorrhage. Areas with fat-density values (-60 -80 UH) were always observable within the lesions. The lesions, measuring 5-9 cm, were located in the right kidney in two patients and in the left kidney in one. CONCLUSIONS: In 40% of patients, renal angiomyolipoma may account for a picture of hypovolemic shock, so a correct diagnostic approach is important to guide the surgical approach. CT allows detection of the angiomyolipoma as the cause of the haemorrhage in most cases. The diagnosis is relatively simple when the lesion has typical features such as adipose content, whereas it may be difficult with non-typical aspects. Furthermore the fat content may also be detected in varying quantities in other renal lesions responsible for bleeding.     

The presence of melatonin in grapevine (Vitis vinifera L.) berry tissues

Melatonin has been reported in a variety of food plants and, consequently, in a number of plant-derived foodstuffs. In grapevine (Vitis vinifera L.) products, it was found in berry exocarp (skin) of different cultivars and monovarietal wines. Herein, we assessed, by means of mass spectrometry, the occurrence of melatonin in all berry tissues (skin, flesh, and seed) at two different phenological stages, pre-véraison and véraison. We detected the highest melatonin content in skin, at pre-véraison, whereas, at véraison, the highest levels were reported in the seed. Furthermore, during ripening, melatonin decreased in skin, while increasing in both seed and flesh. The relative concentrations of melatonin in diverse berry tissues were somewhat different from those of total polyphenols (TP), the latter measured by the Folin-Ciocalteau assay, and more abundant in seed at pre-véraison and in exocarp at véraison. The highest antiradical activity, determined by both DPPH (2,2-diphenyl-1-pycryl hydrazyl) and ABTS [(2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid)] radical-scavenging assay, was reported at pre-veráison in seed. To the best of our knowledge, we reported, for the first time, the occurrence of melatonin in grape seeds.