Effect of Perioperative Somatostatin Administration of Sphincteroplasty-Induced Increase of Amylase

Twenty patients undergoing sphincteroplasty for cholelithiasis were randomly divided into two groups of 10. The former (T) were treated with a 4-h somatostatin intravenous drip (250 micrograms/h), started at the beginning of operation, while the latter (C) made up the control group. Serum and urine amylase, amylase creatinine clearance ratio, and liver function tests were assessed for 2 days before surgery, after the operation and for a period of 5 postoperative days. Homogeneity between the two series was verified in experimental conditions. Statistical differences occurred postoperatively in amylase creatinine clearance ratio, which proved higher in C group, and gamma-GT, which was higher in T group. Short-term somatostatin administration proved effective in reducing the postoperative amylase creatinine clearance ratio, although more evident results are reported after long-term administration. Cholestasis or any serious impairment in liver function did not occur, suggesting the suitability of somatostatin use even in patients with jaundice. Since a relationship between postoperative amylase levels and risk of pancreatitis has not yet been proved, the value of somatostatin in the prevention of postoperative pancreatitis after sphincteroplasty needs to be further verified.     

Effect of glucantime on field and patient isolates of New World Leishmania : use of growth parameters of promastigotes to assess antimony susceptibility

The effect of pentavalent meglumine antimoniate (glucantime) on the growth kinetics of promastigotes of 13 South American Leishmania strains isolated from patients, sylvatic reservoirs, and vectors was studied. Four of five L. (Viannia) braziliensis human isolates were obtained from drug-responsive patients and one was isolated from an unresponsive mucocutaneous-type infection. Studies involved the cell yield at the late log phase, the growth rate, and the growth-curve patterns of promastigotes in vitro. Restriction-fragment-length polymorphism, pulsed-field gel electrophoresis, and hybridization with the gene coding for a P-glycoprotein from L. (V.) guyanensis were used in an attempt to correlate the resistance phenotype with gene amplification. Consistent differences observed in both cell yield and growth rate among the isolates in the presence of glucantime indicated these parameters to be good criteria for the estimation of susceptibility to glucantime. Drug susceptibility varied widely between strains, indicating a great genetic heterogeneity of the isolates. Five L. (V.) braziliensis strains and three L. (V.) guyanensis strains were shown to be susceptible to glucantime. Five isolates were resistant, four of which were obtained from sylvatic vectors and one, from a patient with an unresponsive mucocutaneous infection. Molecular analyses of total DNA indicated the presence of a pgpA-related gene in all strains tested. No amplified sequence could be detected, suggesting that pgpA amplification is not involved in glucantime resistance in these wild Leishmania strains. Received: 13 March 1998 / Accepted: 24 April 1998     

Prevalence of medication discrepancies in pediatric patients transferred between hospital wards

International Journal of Clinical Pharmacy - Background Children are more susceptible to harm from medication errors and adverse drug reactions when compared to adults. Such events may occur from...     

Macro and trace elements in two populations of brown crab Cancer pagurus: Ecological and human health implications

Cancer pagurus is a widely appreciated crustacean in Southern European countries, where they have different market prices depending on the catching area and animal sex. Yet, the mineral composition of this species is still poorly understood. Therefore, the aim of this study was to quantify the content of essential elements in edible tissues of specimens from the Scottish Coast and English Channel and to compare such values with the Dietary Reference Intakes. Crabs caught off Scottish Coast had higher Na, Cl, K, Cu, Zn and Se content, while specimens harvested in the English Channel showed higher Mn concentrations. Females were better sources of Cu, Zn and Se, whereas males had higher concentrations of Na, Cl, K, Ca and Mn. Hepatopancreas showed higher contents of most elements, except Mn, Zn and Se than muscle and gonads. These results are certainly related to the crabs’ physiological needs and the bioavailability of the elements in water and diet. In general, C. pagurus is an excellent source of macro (Na, Cl and Ca) and trace elements (Fe, Cu, Zn and Se) for human consumption. The present study highlights the importance to take into consideration all edible tissues of crustaceans to evaluate their nutritional quality given consumers’ habits.     

Heterogeneity of hepatitis C virus genotypes in hemophilia: relationship with chronic liver disease

In this study we have determined the hepatitis C virus (HCV) serotype and genotype in a cohort of 96 HCV-infected hemophiliacs and have examined the relationship between HCV genotype and severity of chronic liver disease as determined by liver biopsy. HCV serotype was determined by specific enzyme-linked immunosorbent assays (ELISAs) and genotype by restriction fragment length polymorphism (RFLP) and HCV viral sequencing. The pattern of genotype distribution was quite unlike that of HCV-infected United Kingdom (UK) blood donors in that five of the six known HCV genotypes were represented, 50% were type 1, 13% type 2, and 18% type 3. An unexpected observation was the presence of HCV genotype 4 in four patients and type 5 in two patients. An additional feature was the presence of mixed infection, detected in 14% and 7% by serotype and genotype analysis, respectively. Liver biopsies were available from 51 patients. Cirrhosis was present in five of 27 (19%) of individuals with type 1, in 2 of 9 (22%) with type 2, and 5 of 8 (63%) of those with type 3. The heterogeneous pattern of HCV genotype distribution in this cohort of patients and the observed relationship between the severity of the related liver disease and specific HCV genotype may have important implications with respect to the natural history and treatment of HCV-related chronic liver disease in infected hemophiliacs worldwide.     

Proposal of an ultrasonographic classification for hepatic alveolar echinococcosis: Echinococcosis multilocularis Ulm classification-ultrasound

AIM: To establish an ultrasonographic classification based on a large sample of patients with confirmed hepatic alveolar echinococcosis(AE).METHODS: Clinical data and ultrasonography(US) findings of 185 patients(100 males; 85 females; mean age at diagnosis: 51.4 ± 17.6 years; mean age at time of US examination: 58.7 ± 18.2 years) were retrospectively reviewed with respect to the US morphology of hepatic AE lesions. The sonomorphological findings were grouped according to a five-part classification scheme.RESULTS: Application of the new classification resulted in the following distribution of sonomorphological patterns among the patients examined: hailstorm(54.1%); pseudocystic(13.5%); ossification(13.0%); hemangioma-like(8.1%); and metastasis-like(6.5%). Only 4.9% of lesions could not be assigned to a sonomorphological pattern.CONCLUSION: The sonomorphological classification proposed in the present study facilitates the diagnosis,interpretation and comparison of hepatic alveolar echinococcosis in routine practice and in the context of scientific studies.     

DJ‐1 is a Parkinson's disease susceptibility gene in southern Italy

De Marco EV, Annesi G, Tarantino P, Nicoletti G, Civitelli D, Messina D, Annesi F, Arabia G, Salsone M, Condino F, Novellino F, Provenzano G, Rocca FE, Colica C, Morelli M, Scornaienchi V, Greco V, Giofrè L, Quattrone A. DJ‐1 is a Parkinson's disease susceptibility gene in southern Italy. Mutations in the gene DJ‐1 have been shown to be a rare cause of early‐onset Parkinson's disease (EOPD). Since DJ‐1 mutations have been found in patients with Parkinson's disease (PD) from southern Italy, we aimed to investigate whether polymorphisms within the DJ‐1 gene could represent a risk factor for sporadic PD. First, we genotyped 294 patients with PD and 298 controls coming from southern Italy to assess the distribution of the insertion/deletion (Ins/Del) polymorphism. In a second phase, we identified five single‐nucleotide polymorphisms (SNPs) useful to delimit a region potentially involved and genotyped all patients and controls for these markers. All the markers analyzed were significantly associated with PD at both allelic and genotypic level. The most significant association with the disease was found at the Ins/Del polymorphism (p = 0.0001; adjusted odds ratio (OR ) = 2.05; confidence interval (CI ) = 1.36–3.08). When we considered a three‐marker sliding window, we found a highly significant association between the disease and the haplotypes including markers rs17523802, Ins/Del, and rs3766606 (p = 0.0007) and markers Ins/Del, rs3766606 and rs7517357 (p = 0.0054). Our results indicate that polymorphisms located in a region spanning 3535 bp from the promoter to the intron 2 of the DJ‐1 gene confer risk to sporadic PD in southern Italy.     

Bedside diagnosis of outpatient childhood urinary tract infection using three-media dipslide culture test

To determine the accuracy of a three-media dipslide test, the Uricult Trio, for the diagnosis of childhood urinary tract infections (UTIs), we collected urine specimens from children at the outpatient department. Two hundred consecutive patients presenting with symptoms of UTI were examined. Randomly voided, midstream, clean-catch and catheterized samples were used. Each was tested by routine laboratory culture and the dipslide test. The subjects’ ages ranged from 4 months to 7 years, with a median age of 5 years. There were 112 (56%) boys and 86 (43%) girls. Of the subjects, 98 (49%) showed urine culture results indicating significant bacteriuria. There was complete agreement in 70 cases (35%). The sensitivity and specificity of the dipslide were 68% and 82%, respectively. The positive and negative predictive values were 81% and 71%, respectively. The likelihood ratio for a positive test was 3.7, while for a negative test it was 0.39. The specificity, using Escherichia coli special agar, increased to 85% and the negative predictive value to 93%. The Uricult Trio dipslide method was technically simple and could be applied in the outpatient setting. Further studies are required, however, before it can be recommended as a routine diagnostic tool.