A population-based study of familial clustering of inflammatory bowel disease in Florence

In the frame of a population-based epidemiological study inthe metropolitan area of Florence in a 15 year period (1978–1992)all prevalent patients affected with ulcerative colitis (UC)or Crohn's disease (CD) (alive and resident in the area at theend of the study) were investigated in order to identify familialclustering. Only 45 patients (5.2%) reported at least 1 relativewith a diagnosis of inflammatory bowel disease (IBD). Amongthese, 25 patients reported a first-degree relative affectedwith IBD (2.9%). All the 28 families were contacted and detailedpersonal interviews were carried out in order to collect familytrees. The affected relatives living outside the study areawere also identified and their IBD diagnoses were verified.Fifteen families included only affected members with a diagnosisof UC; 5 had only CD, while 8 families had members affectedwith both forms. Two large families had 4 affected members and2 other families had 3. Overall 9 parent-child affected pairswere identified (1 out of every 3 families). The high concordancewithin families for the type of disease (p=0.015) suggests thatthe disease susceptibility is specific. The authors discussthese findings and a possible interpretation of the low proportionof familial cases in this area.     

Ventricular Parasystole: A Chronobiologic Study

Previous works have reported circadian rhythms for several cardiovascular parameters. A chronobiologic rhythm is characterized by: mesor (a rhythm-determined average), amplitude (half difference between the highest and lowest values), and acrophase (timing of high point in degrees and/or in hours) along with 95% confidence limits. We performed 24-hour ECG Holler monitoring in seven patients (mean age, 50.6 years) with ventricular parasystole (VP) in order to determine whether the chronotropic activity of parasystolic foci has a circadian rhythm similar to that of the sinus node. For each Holter recording parasystolic rates (PRs) and heart rates (HRs) were calculated every hour. Furthermore, a mean hourly PR and a mean hourly HR were calculated from the hourly PRs and HRs of the patients. The statistic chronobiologic analysis was done by single and mean cosinor methods. Correlation between mean hourly PR and HR was evaluated by Pearson's V coefficient. A statistically significant rhythm (P < 0.05) was found for the single and mean rhythms both of HR and PR. In our patients, HR had acrophase at 1.27 P.M., mesor at 73.28 beats/min, and amplitude at 9.53 beats/min, whereas PR had acrophase at 1.42 P.M., mesor al 38.31 beats/min, and amplitude at 3.64 beats/ min. Chronobiological data and the high direct correlation between mean hourly HRs and mean hourly PRs (r = 0.96, P < 0.001) indicate a similar circadian variability of the chronotropic activity of sinus nodes and parasystolic foci. Although several hypotheses can be made, responsiveness of parasystolic foci to circadian variations of the autonomic nervous system tone (sympathetic and/or vagal) and/or circulating substances (particularly catecholamines) seems the more probable one for explaining our findings.     

Generation of reactive oxygen species in subgroups of infertile men

The capacity to generate reactive oxygen species (ROS), both basally and after stimulation with the calcium ionophore A23187, was examined in the motile fraction of sperm isolated after swim-up from the semen of 10 naturally fertile men and three groups of infertile patients. The latter included: (1) men with a non-bacterial inflammation of the genital tract (n = 10); (2) men unable to impregnate their partners during an intra-uterine insemination programme (IUI) (n = 8) and their matched controls (n = 6); and (3) men with hypogonadotrophic hypogonadism (HH) who remained infertile after induction of spermatogenesis with gonadotrophin or gonadotrophin-releasing hormone therapy (n = 3) and their matched controls (n = 3). The levels of ROS production were elevated in the sperm of some infertile men with inflammation of the genital tract compared to those found in 10 naturally fertile men. In addition, sperm from those patients who remained infertile after an IUI programme produced higher amounts of ROS compared to their control group who became fertile. Similarly, the production of ROS by sperm from three patients with HH who remained infertile was significantly higher than those of the three men who became fertile. These data suggest that an excessive production of ROS by sperm may explain some cases of idiopathic male infertility.     

B8, DR3 antigens and production of human leucocyte migration inhibitory factor (LIF) by mononuclear cells stimulated with concanavalin A (Con A)

LIF release by Con A stimulated mononuclear cells was evaluated in 67 randomly selected healthy Sicilians typed for HLA antigens. The results show that B8 and/or DR3 positive subjects release less LIF than negative ones, suggesting that this immunological response might be controlled by HLA-linked immune response (Ir) gene(s).     

The Practice and Process of Healthy Exercise: An Investigation of the Treatment of Exercise Abuse in Women with Eating Disorders

This study investigates the effectiveness of an exercise program designed to reduce exercise abuse in women who are in residential treatment for eating disorders. One hundred and twenty-seven women who participated in the exercise program were compared to 127 non-participants on weight gain and self-reported obligatory attitudes and beliefs about exercise. The exercise participants were women who were medically cleared and attended at least two exercise groups during treatment. The control group were women who were medically cleared, but did not attend any exercise groups during treatment. Significant group × diagnosis interactions revealed that women in the exercise group who were diagnosed with anorexia nervosa gained more than one-third as much weight as those in the control group. Also, women in the exercise group demonstrated significantly reduced obligatory attitudes toward exercise compared to the control group. These findings suggest that the use of an exercise program that targets exercise abuse in women with eating disorders is feasible during residential treatment and results in positive change without interfering with weight gain. Limitations that result from the lack of random assignment to the exercise and control group are discussed.     

ICD Implantation in Noncompaction of the Left Ventricular Myocardium: A Case Report

Isolated noncompaction of the ventricular myocardium (INVM) is an uncommon cardiomyopathy characterized by the persistence of fetal myocardium with prominent trabecular meshwork and deep intertrabecular recesses, often associated with systolic dysfunction and ventricular dilatation. A 23-year-old man from Burkina Faso was referred to our operative unit with a diagnosis of INVM, made with echocardiogram and magnetic resonance imaging and nonsustained ventricular tachycardia. The literature reports the incidence of malignant ventricular arrhythmias in as many as 47% of the patients and sudden cardiac death in almost 50% of them and this supported our decision to perform implantable cardioverter-defibrillators implantation.