Roles of platelets and proteinase-activated receptors in gastric ulcer healing

Proteinase-activated receptors (PARs) are expressed on the surface of many cells, but those on the platelet have been among the most thoroughly characterized. PARs act as key receptors mediating the proaggregatory and pro-secretory effects of thrombin. In addition to contributing to hemostasis, platelets are increasingly being viewed as important contributors to healing and to tumor growth. This is attributable to the many pro- and anti-angiogenic factors that are stored within platelets, which can be released at the sites of injury and new vessel growth. In this paper, we review the importance of the platelet in gastric ulcer healing, the contribution of platelet-contained angiogenic factors to the healing of gastric ulcers, and the role of PARs in regulating the release of angiogenic factors from platelets. Taken together, our results suggest that PARs, including those expressed on platelets, are a rational therapeutic target for modulating healing processes and tumor growth.     

Epidemiologic Study of Mortality during summer 2003 in Italy

Following the unusually hot summer this year and the dramatic news from neighboring countries such as France, the Italian Minister of Health requested an epidemiologic mortality study during summer 2003, to investigate whether there had been an excess of deaths in Italy, particularly for the elderly population. Communal offices, which provide vital statistics, were asked for the number of deaths among resident people, occurred from June 1 to August 31, for 2003 and 2002, for the 21 Italian regions capitals. A mortality increase of 3,134 deaths was observed for 2003; most of them (92%) were people aged 75 years and older. The highest increases were observed in the North Western cities (Turin, Milan, Genoa). The relationship between mortality and climatic indexes (T. max, Humidex) was investigated and a clear correlation was observed.     

Exposure to Saccharopolyspora rectivirgula among cattle breeders in the province of Reggio Emilia and the risk of extrinsic allergic alveolitis (farmer's lung)

INTRODUCTION: Nearly 2.350 dairy farms (and 137.000 milk cows) are located in the province of Reggio Emilia, Italy, to produce the famous Parmigiano-Reggiano" cheese. Feeding is hay-based both in the cold season and (together with grazing) in the warm season. This requires a large production of hay and frequent handling by the farmers. Hay is packed in large cylindrical bales, "round bales" (nearly 2.41 m3), or, rarely, in traditional small prisms-shaped bales (about 0.15 m3), only used on small farms. We estimated there were 6.000-9.000 the workers exposed to hay dust. The risks for the farmer's health due to the hay dust exposure are well known; in particular Farmer's Lung disease (FL) is rather frequent in this Region (1.5%-3.0% among people exposed). We studied hay and air pollution by Saccharopolyspora Rectivirgula (SR) in relation to these two different hay-packing techniques (hay dried in the open air) both in flat and in hilly areas. METHODS: On 56 cattle-farms, hay and air samples were collected and analyzed using a six-stage Andersen sampler and a sedimentation chamber (SC) for hay samples with plastic Petri dishes containing culture medium. RESULTS: Round bales were richer in SR spores than the small prism-shaped bales (n = 37, mean = 6.20 logn ufc/m3 in SC, ds: 3.87 vs n = 15, mean = 2.40 logn ufc/m3 in SC; ds: 4.16) and they seem to produce higher air pollution (n = 30, mean = 5.30 logn ufc/m3; ds: 3.71 vs n = 15, mean = 2.32 logn ufc/m3; ds: 2.99). In hilly areas the pollution produced by round bales (in hay and air) was higher than in flat areas. On the contrary hay from small bales produced in hilly areas was poorest in SR spores. CONCLUSIONS: An heavy exposure to actinomycetes spores, therefore, comes from "round bales" hay handling, especially when the bales are produced in mountain areas. New drying systems, probably, can reduce this risk and raise hay quality.     

Leigh disease: clinical, neuroradiologic, and biochemical study of three new cases with cytochrome c oxidase deficiency

Three cases of Leigh disease are described. In all three, symptoms began in the first months of life, with muscle hypotonia, lactic acidosis, and psychomotor delay. The diagnosis was made on the basis of the clinical characteristics, biochemical abnormalities, and typical brain magnetic resonance imaging with symmetric lesions suggesting bilateral necrosis at the level of the basal ganglia and of the midbrain. Cytochrome c oxidase (complex IV of the mitochondrial respiratory chain) deficiency was demonstrated in muscle tissue in all patients and confirmed in skin fibroblasts in patient 3. A genetic heterogeneity was present in these patients since only one had a SURF-1 gene mutation. The clinical, biochemical, and neuroradiologic aspects are discussed. Finally, the finding of facial dysmorphisms in the cytochrome c oxidase deficiency observed in one of the described cases is of extreme interest; to our knowledge, this association has never been reported in the literature.     

Quality of life in systemic lupus erythematosus

The SF-20 and the SF-36 are the most frequently used questionnaires for assessing the quality of life in SLE patients. The SF-36 is actually considered the most suitable for this disease, due to the inclusion of fatigue, a manifestation frequently observed in SLE patients. Using these instruments, it has been clearly demonstrated that patients with SLE have a worse quality of life than healthy people of the same age. Some aspects of daily life, like physical activity, job, social relationship and vitality, are particularly affected. In the majority of studies, an inverse relation between quality of life and disease activity has been observed. The influence the damage has on the quality of life is more complex, since a greater number of variables are involved. In fact, the amount of damage largely depends on the organ involved and on functional impairment resulting from it. To explain the variability in the quality of life among different patients, it is important to consider, besides the clinical complaints, the psycho-social dimension of each person. In fact, some SLE patients, unlike others, cope well with the disease. People behave differently when faced with critical situations, i.e. after being diagnosed with a chronic disease; their reaction depends on the degree of support they receive from family, friends and colleagues, and from the different strategies of coping, that they use.     

The self selected speed of running in recreational long distance runners.

The aim of this study was to test the hypothesis that the self selected speed in running (vss) is dependent upon the same factors that determine maximal speed in endurance events (e. g. the anaerobic threshold). Experiments were carried out on 8 recreational long distance runners (42.1 +/- 8.6 years of age, 70.1 +/- 10.6 kg of body mass, 1.74 +/- 0.06 m of body height) while they were participating in a 14 day relay race. During the "race" the subjects were not requested to perform maximally but only to cover their running turn (1 hour per day) at their preferred pace. The relationships between heart rate (HR), perceived exertion (RPE), blood lactate concentration ([La]b) and speed (v) were determined in each subject, before the race, during an incremental running test. From these relationships the speed corresponding to a 4 mM concentration of lactate in blood (v4mM) was calculated and found to be 14.3 +/- 1.8 km x h(-1) (n = 8). At this speed the RPE and HR values were 13.6 +/- 1.4 and 156.4 +/- 12.8 bpm, respectively. The average values of speed (vss, 13.4 +/- 0.6 km x h(-1)), RPE (13.5 +/- 1.4) and HR (154.4 +/- 7.6 bpm) measured during the race (n = 47) were not significantly different from those measured at the lactate threshold (v4mM, RPE4mM and v4mM). However, vss and the average HR during the race showed significantly lower variances than v4mM and HR4mM suggesting that, besides the need of avoiding lactate accumulation in blood, other factors must be involved in the choice of speed in running.     

Cyclophosphamide as second-line therapy in multiple sclerosis: benefits and risks

Aim of this study was to determine the predictors of caregiver burden among spouse caregivers of patients with Parkinson’s disease (PD). Forty consecutive PD patients and their spouse caregivers were included. Patients were assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS), the Hoehn and Yahr scale (HY), the Mini-Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), and the Geriatric Depression Scale (GDS). Stress and depressive symptoms among caregivers were evaluated using the Caregiver Burden Inventory (CBI) scale and the GDS. Only PD severity (HY) and mental symptoms (NPI) were significantly associated to caregiver distress. A major attention must be given to the early identification of factors generating stress in caregivers in order to improve caregiver quality of life and patient’s care. M. D’Amelio and V. Terruso equally contributed to the study.     

High prevalence of stress hyperglycaemia in children with febrile seizures and traumatic injuries

Although hyperglycaemia is relatively frequent in the course of severe illnesses and may be looked upon as the possible result of an uncoordinated insulin response to the increased glucose that the body may need during periods of stress, it is generally agreed that it does not constitute a prediabetic condition. Numerous studies have aimed to explain the pathophysiology of this occurrence but none has looked at which conditions are more prone to develop stress hyperglycaemia (SH). Therefore, the aim of this study was to evaluate the main clinical conditions that may be associated with SH in children. A total of 1199 children was studied: 833 children (439 M, 394 F, mean age 5.2 +/- 4.5 y) admitted for an acute illness or injury constituted the stress-exposed group, while 366 children (222 M, 144 F, mean age 6.2 +/- 4.6 y) admitted for elective minor surgery represented the stress-unexposed group and were considered as the control group. SH was defined as plasma glucose concentrations > or = 8.3 mmol l(-1) during an acute illness. Stress-exposed patients had significantly higher glycaemic levels than controls (5.6 +/- 1.4 vs 4.7 +/- 0.7 mmol l(-1); p < 0.0001). SH was found in 41 (4.9%) stress-exposed patients and in none of the controls. SH was significantly more prevalent in children affected by febrile seizures (12.9%) or traumatic injuries (11.7%; p < 0.008 and p < 0.02, respectively, vs other diagnoses). A significant correlation was found between glycaemia and systolic pressure (r = 0.1; p < 0.01), white cell count (r = 0.12; p < 0.0003) and body temperature (r = 0.16; p < 0.0001). SH was more frequent in patients with body temperature > 39 degrees C (14%) than in those with a temperature < or = 39 degrees C (4%; p < 0.0008). SH was more prevalent in clinical conditions of fever associated with seizures or pain (12.9% and 12.5%, respectively) than fever alone (4.4%). After a mean period of 3.5 +/- 0.6 y of follow-up none of the hyperglycaemic patients had developed diabetes mellitus. Conclusion: Traumatic injuries, febrile seizures or conditions in which an elevated body temperature may be found are frequently associated with SH in children. In the presence of these conditions specific studies directed towards unmasking a prediabetic state may be unnecessary.     

Perceptions of adolescents and young people regarding endemic dental fluorosis in a rural area of Brazil: psychosocial suffering

Severe dental fluorosis is endemic in some rural areas of Brazil. This paper describes the psychosocial consequences of this condition and how it has affected the self-esteem of adolescents and young people in a rural area in Brazil. Semi-structured, face-to-face interviews were carried out with 23 adolescents and young people affected by severe dental fluorosis and 14 of their teachers. The study revealed the affected individuals were embarrassed to smile at strangers due to a presumed association between fluorosis and a lack of dental hygiene. Further findings include conflicts between affected and non-affected students at school, problems in pursuing a romantic relationship and uncertainties regarding a professional future. Disbelief and scepticism were observed regarding the ethical position that science can offer a solution to the problems stemming from the disease. Lesions from severe dental fluorosis appear to be a stigmatising factor and have contributed toward suffering and self-exclusion among an entire generation of adolescents and young people.