Pinealectomy reduces hepatic and muscular glycogen content and attenuates aerobic power adaptability in trained rats

The current study emphasizes the crucial role of the pineal gland on the effects of chronic training in different tissues focusing on carbohydrate metabolism. We investigated the maximal oxygen uptake (aerobic power), muscle and liver glycogen content, and also the enzymes involved in the carbohydrate metabolism of rat adipose tissue. Pinealectomized and sham-operated adult male Wistar rats were distributed into four groups: pinealectomized (PINX) untrained, pinealectomized trained, control untrained and control trained. The maximal oxygen uptake capability was assayed before and after the training protocol by indirect open circuit calorimetry. The rats were killed after 8 wk of training. Blood samples were collected for glucose and insulin determinations. The glycogen content was assayed in the liver and muscle. Maximal activities of epididymal adipose tissue enzymes (hexokinase, pyruvate kinase, lactate dehydrogenase, citrate synthase and malic enzyme) as well as adipocyte size were determined. The exercise training in control animals promoted an increase in the aerobic power and in liver glycogen content but caused a reduction in the malic enzyme activity in adipose tissue. However, PINX trained animals, in contrast to trained controls, showed a decrease in the aerobic power and in liver and muscle glycogen content, as well as an increase in the activity of the adipocyte enzymes involved in carbohydrate metabolism. In conclusion, these data show that the pineal gland integrity is necessary for the homeostatic control of energy metabolism among adipose, muscle and hepatic tissues. The pinealectomized animals showed alterations in adaptive responses of the maximal oxygen uptake to training. Therefore, the pineal gland must be considered an influential participant in the complex adaptation to exercise and is involved in the improvement of endurance capacity.     

Key points in the management of gastroesophageal reflux disease

Gastroesophageal reflux disease (GERD) is a relatively common condition with a prevalence ranging from 10% to 20% in Western countries and 5% to 10% in Asian populations [1]. In a recent evidence-based consensus [2], GERD was defined as a condition that develops when the reflux of stomach contents causes troublesome symptoms or complications. This global definition emphasizes the syndromic nature of the disease and subdivides the patients in different groups depending on the presence of mucosal complications (ie, esophagitis, metaplasia, stenosis) and on the prevalent clinical manifestations (ie, typical reflux symptoms or extraesophageal/supraesophageal syndromes). General practitioners, gastroenterologists, and specialists from different branches of medicine generally share the management of GERD patients, and basically they need to address the following four issues.     

Residential facilities for older people in Italy: a five-region survey

BACKGROUND AND AIMS: To survey all Residential Facilities (RFs) for older people (more than 50% residents over 65 years of age) in five Italian regions (Calabria, Sardinia, Sicily, Umbria, Veneto), and to evaluate their logistic and organizational characteristics and staff and resident features. METHODS: Structured interviews with RF managers; selected RFs operating in five regions. RESULTS: A total of 853 RFs were operating in the five regions, with an average of 198.0 beds per 10,000 older people - a rate showing marked regional variability. The number of RFs actually surveyed was 754 (88.4% of sample pool). The mean number of RF beds was 59.8 (+/-65.0; median: 34), and the great majority (96%) had 24-hour staff cover. A large proportion (29%) were managed by local municipal authorities, religious non-profit associations (approx. 24%) and other non-profit organizations (approx. 21%). In the RFs 24,456 workers were employed; the number of staff per facility also showed great variability. The mean number of workers directly involved in resident care was 27.8 (+/-39.0; range: 1-331); the median number of staff members was 14, and the resident/staff ratio was 2.1. These 754 RFs hosted 42,687 residents, with an average of 53.5 (+/-58.5) older people in each facility, and 3.2 residents below the age of 65. The mean age of the entire resident sample was 79.3 years (+/-5.2) and there was a high proportion of residents with neurological (including dementia), psychiatric and medical disorders. CONCLUSIONS: The five regions varied considerably in residential bed provision; many other RF characteristics, including staff/resident ratios, showed similar variability. Most RFs hosted older people with a variety of neurological, psychiatric and medical disorders. Future phases of the project will aim at shedding light on many other features in these institutions, which care for 2.1% of the older population in Italy and may serve even greater proportions of older people in the future.     

Two entrances, one exit--an atypical shotgun injury: a case report

Firearm-related injuries are a major problem worldwide and one of the central issues in forensic pathology. An atypical appearance of a gunshot wound can create surgical or medico-legal diagnostic problems. We report a case of a homicidal shotgun fatality with an unusual trajectory of pellets in the body. Two large pellets perforated the anterior chest wall near to each other but made their exit through a common wound in the back. Our report describes the results of the medico-legal investigation and discusses problems related to examination of firearm wounds.     

Normal values and prospective validation of transient ischaemic dilation index in 82Rb PET myocardial perfusion imaging

BACKGROUND: The use of Rb positron emission tomography (PET) for the diagnosis of coronary artery disease (CAD) has increased in recent years but the role of some of the traditional parameters used in SPECT for the diagnosis of CAD, such as transient ischaemic dilation index (TID) of the left ventricle, have not been validated in PET studies. METHODS AND RESULTS: We studied 95 patients who had undergone rest/pharmacological stress Rb PET scans. Thirty of these patients (18 female and 12 male) who had less than 5% likelihood of CAD (LLK) based on sequential Bayesian analysis, were used to determine the normal limits of TID index in this protocol. The remaining 65 patients (33 female and 32 male) underwent coronary angiography within 15 days of the cardiac PET scan. This second group of patients was used to validate the TID normal limits determined in the first group. In LLK patients mean TID index was 1.01+/-0.07 and there were no significant differences between genders. The TID index upper normal limit was 1.15 and was calculated as mean+2 SD. Using this cut-off point, TID index had high specificity and PPV in the diagnosis of single vessel CAD (100% and 100% respectively) and multiple vessel CAD (93% and 85%, respectively). CONCLUSION: Our results indicate that elevated TID index is a specific, although not sensitive marker of single and multiple vessel CAD in pharmacologically stressed Rb PET myocardial perfusion studies.     

Error count of radiopaque markers in colonic segmental transit time study

OBJECTIVE: The objective of our study was to evaluate the feasibility and efficacy of a radiologic technique in increasing colon visibility in colonic transit time studies. Three radiologists counted segmental colonic radiopaque markers in two patient groups, based on classic criteria in the first group and also on a colonic barium trace in the second. Agreement between marker counts was assessed using method comparison analysis. CONCLUSION: With the barium trace technique, the anatomic conspicuity of colonic segments is improved, a correct segmental marker count can be obtained, and colonic inertia can be more easily distinguished from distal constipation.     

Gallium-68-labeled DOTA-rhenium-cyclized alpha-melanocyte-stimulating hormone analog for imaging of malignant melanoma

INTRODUCTION: Diagnosis of malignant melanoma is critical, since a patient's prognosis is poor. Previous studies have shown that 64Cu- and 86Y-DOTA-ReCCMSH(Arg11) have the potential for early detection of malignant melanoma by exploiting the sensitivity and high resolution of positron emission tomography (PET). This encouraged us to investigate DOTA-ReCCMSH(Arg11) labeled with another beta+-emitting radionuclide, 68Ga. METHODS: DOTA-ReCCMSH(Arg11) was successfully labeled with 68Ga at pH 3.8-4 at 85 degrees C. Acute biodistribution and small-animal PET imaging studies were performed in mice bearing B16/F1 melanoma tumor. RESULTS: Biodistribution studies showed moderate receptor-mediated tumor uptake, fast nontarget organ clearance and high tumor to nontarget tissue ratios. Preadministration of d-lysine significantly reduced kidney uptake without affecting the uptake of the agent in the tumor. Small-animal PET images showed that the tumor could be clearly visualized at all time points examined (0.5-2 h) with the standardized uptake value analysis following a similar trend as the biodistribution data. CONCLUSIONS: The preliminary data obtained suggest that 68Ga-DOTA-ReCCMSH(Arg11) is a promising PET imaging agent for early detection of malignant melanoma.     

A rare case of intestinal carcinoid tumour. Clinical considerations and therapeutic approach

The AA report on a case of intestinal carcinoid tumour. The characters of these tumours to permit a specific clinical and therapeutic approach.