Anti-laminin antibodies in inner ear diseases: a potential marker for infectious and post-infectious processes

Summary Natural antibodies against laminin (ALA) have been detected recently in some acute and chronic infectious disorders. In our present study sera of a large number of patients with inner ear disorders of unknown etiology (n=413) were tested for ALA. Control sera were taken from patients with diseases of known infectious etiology and patients with diseases of unknown etiology in which an infectious etiology was suggested. Patients with classical autoimmune diseases as well as healthy blood donors were also included in this study. The highest frequency of ALA was found in patients with sensorineural hearing loss (SNHL) (68%), whereas the incidence of ALA was comparatively uncommon in patients with Meniére's disease (14%). In patients with chronic infectious diseases ALA were detected with almost the same frequency as in patients with SNHL. The elevation of the erythrocyte sedimentation rate and the association of ALA-positive SNHL with other chronic inflammatory disorders suggest that ALA might be stimulated by a persisting infectious process. These findings suggest that certain forms of inner ear disorders might have a chronic infectious etiology.     

Renal transplantation and osteoporosis

A cross sectional study assessed the bone mineral density (BMD) of 20 young adult patients who received a renal transplantation in childhood. The BMD of the lumbar spine, mainly trabecular bone, and of the total body, mainly cortical bone, were measured and expressed as an SD score. Fourteen patients (70%) had a BMD SD score of the lumbar spine below -1, of whom six patients were below -2. Fifteen patients (75%) had a BMD SD score of the total body below -1, of whom seven patients were below -2, Both trabecular and cortical bone appeared to be involved in the osteopenic process. The cumulative dose of prednisone was inversely correlated to both lumbar spine and total body BMD SD score. In a multiple regression analysis the cumulative dose of prednisone appeared to be the only factor with a significant effect on BMD SD score. Most young adult patients who had received a renal transplantation in childhood had moderate to severe osteopenia. Corticosteroid treatment played a major part in the development of osteopenia in these patients.     

Women caring for women: a study at the "Viva Maria" shelter, Porto Alegre, Rio Grande do Sul, Brazil

This research was conducted in Porto Alegre, Rio Grande do Sul, with a sample of battered women selected from a government shelter called the "Casa Viva Maria". We analyzed data on 110 women staying at the shelter during the previous two years (January 1996-June 1998). The profile of the women was as follows: abused women were young (mean age 29 years), all had low socioeconomic status, 12% were illiterate, 21% were black, 80% reported frequent abuse by their partners, and 18% had returned to violent homes. The researchers visited 34 former lodgers from the shelter and invited them to participate in a series of evaluation workshops. A total of 118 persons, including mothers and children, attended three evaluation meetings. During this process, researchers encouraged participants to express opinions, perceptions, and feelings about their past experience in the shelter and their own concept of violence. Finally, a focal group was organized with the "Viva Maria" staff members. Female workers reported how their job had been helpful for their personal development and had helped change their own lives.     

Nursing care theory and practice: teaching and the labor market

This study identifies how faculty nurses and clinical nurses experience the relationship between teaching and the labor market in Nursing. Data were collected by means of interviews and documentary analysis. Methodological and content categories were utilized for analysis. It became evident that teaching is far from the clinical practice and that it is based on contents which do not have correspondents; there is a phase displacement between what is taught in undergraduation and the incorporation of new technologies, practices and knowledge. Action towards reflections about nursing teaching in order to approach it to clinical work areas is pointed out.     

Will epidemiology succeed in saving the tumor registries?

The present paper focuses on the Italian registries: their actual achievements, future developments and the possible critical states. The present setting is analysed in perspective with the international and European framework of cancer registries. Given the recent development of new cancer registries in Italy, and their participation to traditional and new international publication of their data, there is an increasing delay in publication time, both in Italy and abroad International and national institutions played an important role in helping and supporting registries' development, but delays in publications and some uncertainty in coordinating incidence and survival analyses in a unique framework is posing an unavoidable challenge.     

Tobacco consumption and sports participation: a survey among university students in northern Italy

Social-demographic information of a total of 1249 students attending the University of Bologna was analyzed by means of an anonymous questionnaire containing 33 questions with particular reference to tobacco smoking and sports activity. Results revealed that 31.6% of the students practise some form of sports regularly (6 hours a week or more), 40.5% occasionally (at least an hour a week for 8 months in a year) and 27.9% do not take part in any kind of sport. Significant differences were seen between those that practise sports (60.4% are non-smokers and 33.5% are habitual smokers) and those that do not (52.9% are non-smokers and 40.1% smoke habitually). The smokers who are active in sports smoke a lower mean number of cigarettes a day than the inactive group and thus belong to the category of light smokers. They also smoke fewer cigarettes on days when they take part in sports activity. As far as knowledge of health risks is concerned, 21.1% of those who practise sports obtained a score between good and excellent compared to 15.9% of those who do not. Although on the whole the results appear to show a certain influence of sports on smoking habits, the kind of study we led and the differences in the number of smokers are not sufficient to consider sports practitioners as a group not at risk for behaviour harmful to the health. Further studies are necessary to verify the cause-effect relationship between sports activity and smoking habits.     

Regional brain atrophy in patients with mild Alzheimer's disease and delusions

BACKGROUND AND OBJECTIVE: The pathophysiology and the neurobiology of the behavioral disturbances in Alzheimer's disease (AD) are far from understood. The aim of the study was to assess whether delusional AD patients have a specific pattern of regional brain atrophy. METHODS: The setting of the study was the outpatient facility of a memory clinic. Subjects were 41 AD patients with mild dementia severity (Mini-Mental State Exam score of 22 +/- 3, range 18 to 27). Delusions were assessed with the pertinent subscale of the UCLA Neuropsychiatric Inventory (NPI). Nondelusional (n = 22) AD and delusional (n = 19) AD were defined on the basis of absence (NPI delusions subscale = 0) or presence (NPI delusions subscale = 1 or higher) of delusions. Thirteen (68%) of the delusional patients had isolated theft delusions, and 6 (32%) had theft associated with another paranoid delusion (of jealousy or persecution). None of the patients had misidentifications or other delusions of nonparanoid content. Temporal lobe and frontal lobe atrophy were assessed with linear measures (radial width of the temporal horn, rWTH, and frontal index, FI) taken from computed tomographic films. Temporal and frontal asymmetries were computed as right/left ratio of the rWTH and FI. RESULTS: AD patients without delusions had symmetrical enlargement of both temporal (8.1 +/- 3.9 vs. 8.5 +/- 4.5) and frontal horns (35.8 +/- 4.8 vs. 35.9 +/- 4.6). On the contrary, AD with delusions showed temporal horns larger to the right (9.1 +/- 3.3 vs. 7.7 +/- 3.1, p = .06) and the frontal horn to the left (35.7 +/- 4.3 vs. 37.5 +/- 4.2, p = .02). This different pattern was confirmed with a gender-adjusted repeated measures analysis of variance model interaction term between asymmetry and group: F1,38 = 5.5, p = .03). DISCUSSION: AD patients with delusions are characterized by a specific pattern of frontal and temporal asymmetry of brain atrophy, whereas nondelusional patients are symmetric. Because the asymmetry pattern of the delusional patients is similar to the physiological pattern of asymmetry of individuals without dementia, the data indicate that the absence of theft delusions in the mild stage of AD rather than their presence is associated with an abnormal asymmetry pattern.     

Femoral trochlear dysplasia: MR findings

PURPOSE: To establish quantitative and qualitative magnetic resonance (MR) criteria for the diagnosis of trochlear dysplasia. MATERIALS AND METHODS: MR images were analyzed in 16 consecutive patients with and 23 without trochlear dysplasia. The standard of reference was a true lateral radiograph of the knee. Quantitative and qualitative MR criteria were assessed. RESULTS: In patients with trochlear dysplasia, the trochlear groove was significantly less deep than that in control subjects. The most accurate measurement was 3 cm above the femorotibial joint space (P: <.001), where a trochlear depth of 3 mm or less had a sensitivity of 100% and a specificity of 96%. The ventral trochlear prominence between the supratrochlear femoral cortex and the most ventral point of the trochlear floor (midsagittal section) was always larger than 6.9 mm in dysplastic trochleae. A facet ratio of less than 2:5 (medial to lateral) 3 cm above joint space level had a sensitivity of 100% and a specificity of 96%. A nipplelike anterior prominence at the superior end of the femoral trochlea on midsagittal images was a specific (91%) qualitative criterion. CONCLUSION: Dysplasia of the femoral trochlea can be diagnosed reliably by using quantitative or qualitative criteria on midsagittal or transverse MR images obtained 3 cm above the femorotibial joint space.     

Type 2 diabetes,polycystic ovary syndrome and the insulin resistance syndrome in adolescents: Are they one big iceberg?

Obesity in children may cause overt clinical disease in childhood. The complex endocrine and metabolic changes of obesity and insulin resistance in adolescents result in hyperinsulinemia, dyslipidemia, hypertension, steatohepatitis, glucose intolerance, type 2 diabetes, acanthosis nigricans and ovarian hyperandrogenemia, commonly known as polycystic ovarian syndrome (PCOS). Type 2 diabetes and PCOS in adolescents are new endocrine diseases in this age group that require unique approaches to diagnosis and treatment. The direct correlation between duration of disease and control of the disease, and subsequent long term complications of these two diseases, predict serious morbidity in young adult life for the affected adolescents. Pediatricians have an important role in the prevention, diagnosis and treatment of obesity, insulin resistance syndrome, type 2 diabetes and PCOS.