An epidemiological study was carried out on 114 beta-thalassaemics in order to select those subjects susceptible to hepatitis B virus (HBV) infection for hepatitis B vaccination. The results confirmed the high risk of HBV infection in these patients: 9.6% were HBsAg positive, 29.8% were anti-HBs positive/anti-HBc positive, and 9% were anti-HBc positive. In 60 HBV-negative patients, 20 micrograms doses of hepatitis B vaccine were administered on a schedule of 0, 1 and 6 months. Sera were collected for six years to determine the seroconversion rate and the anti-HBs titre. Seroconversion reached a maximum rate of 93% 12 months after the first vaccination dose and was 80% at the final control (72 months). Highly protective anti-HBs titres were observed until the last control in a high percentage of subjects. The HBVax hepatitis B vaccine has been shown to be safe, immunogenic and effective in beta-thalassaemics.

Adolescent↗

PubMedDate not supplied

Hepatitis C virus serotypes and sources of infection in patients with HCV-related chronic liver disease from one geographical area in southeast Italy.

Hepatitis C virus serotypes and sources of infection in HCV-positive patients from a restricted geographical area were evaluated. HCV serotypes were determined by Murex serotyping assay. Of 192 samples, serotypes were detected in 189 (98.5%): type 1 proved to be the most common (53.1%), followed by types 2 (15.2%), 3 (6.2%), 6 (5.3%), 4 (3.6%) and 5 (1.6%). Intravenous drug users were significantly younger than the rest of the patients and infected mainly with HCV type 3. Transmission of HCV 3 has only been observed over the past 20 years; other types have been transmitted for up to 40 years. These results support the view that the prevalence of the infection by different HCV types in one restricted geographical area may be associated with the source and duration of infection.

Adult↗

PubMedDate not supplied

Dermorphin decreases plasma LH levels in human: evidence for a modulatory role of gonadal steroids.

The purpose of this study was to evaluate the effects of dermorphin, a new synthetic powerful opiate-like heptapeptide, on plasma luteinizing hormone (LH) and follicle stimulating hormone (FSH) levels in fertile and postmenopausal women. In fertile subjects, dermorphin (5.5 micrograms/kg min for 30 min) decreases plasma LH (p less than 0.01 vs. baseline and placebo values), but not plasma FSH. The area under the curve during dermorphin infusion was significantly lower than during placebo infusion (p less than 0.01). Pretreatment with the opioid receptor antagonist naloxone, blocked the decrease of plasma LH levels. In postmenopausal women not subjected to any treatment, dermorphin infusion did not significantly modify plasma LH and FSH levels. On the contrary, its administration to postmenopausal subjects treated with conjugated estrogens and medroxyprogesterone acetate significantly decreased plasma LH levels (p less than 0.01, vs. baseline, placebo and area under the curve). Considering the modulatory role exerted by ovarian steroids on the activity of such receptors, these data also indicate that opioid systems play a very important part in the hypothalamus-pituitary-ovarian axis.

Adult↗

PubMedDate not supplied

Expression of proopiomelanocortin-related peptides in human follicular fluid.

In order to evaluate the expression of the opioid precursor proopiomelanocortin (POMC) in the ovarian follicle, we measured 6 of its main end-products in 23 follicular fluids. We coupled high performance liquid chromatography (HPLC) to specific radioimmunoassays. Seven follicles were immature (diameter less than 9 mm), 10 were obtained from superovulated patients during an in vitro fertilization-embryo transfer program (greater than 22 mm) and six were persistent follicles, collected during the luteal phase [15-31 mm, luteinized unruptured follicles (LUF)]. Follicular fluids were extracted by mean of Sep-pak cartridges and then purified by HPLC with a reverse-phase C-18 column eluted in a linear gradient with acetonitrile/0.01 M hydrochloric acid (from 18:82 to 40:60). Fractions were tested with specific antisera for ACTH (1-39), alpha-MSH, beta-lipotropin (beta-LPH), beta-endorphin (beta-EP) and gamma-endorphin (gamma-EP) immunoreactivities. No presence of beta-LPH, beta-EP and ACTH was confirmed, while gamma-EP, alpha-MSH and des-alpha-MSH were detected for the first time in follicular fluid. In every class of follicles shorter chain peptides predominate over their longer chain precursor. Immature follicles are characterized by the highest amounts of gamma-EP, ACTH, alpha-MSH and des-alpha-MSH if compared to superovulated and LUF. On the contrary, beta-EP amount was highest after superovulation. Apart from this finding, peptide levels in superovulated patients and LUF are similar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗

PubMedDate not supplied

Serum nitrites predict the response to prostaglandin-induced delivery at term.

OBJECTIVE: To evaluate whether the clinical response to prostaglandin-induced labor is modulated by nitric oxide (NO) activity. METHODS: Fifty-two cases of nulliparous women at term who delivered vaginally after prostaglandin E (PGE) induction of labor were enrolled. The induction was required mainly for amniotic fluid reduction or late-onset gestational hypertension. Either intracervical (0.5 mg) or vaginal (2.0 mg) PGE was administered every 12 hours, according to the Bishop score. After the third PGE application, in absence of labor onset, intravenous oxytocin was used. Nitrites/nitrates (NOx) serum levels were used as a marker of NO activity. They were measured just before the start of induction by using an enzymatic reduction and then a colorimetric evaluation. Time to delivery from the first PGE application was the main outcome variable. RESULTS: Time to delivery ranged from 4 to 62 hours (median: 15.5). Nitrites/nitrates levels were unaffected by both gestational age, Bishop score at entry, indication allowing labor-induction, fetal position, and birth weight. In a multiple regression analysis including the previous factors, NOx levels significantly explained 33.9% of the variance of the time to delivery. Indeed, patients delivering within 15 hours (26.4 +/- 6.9) showed NOx levels significantly lower than in patients delivering after more than 15 hours (39.5 +/- 16.4) from the first PGE application. CONCLUSIONS: A reduced level of NOx is associated with a prompt clinical response to PGE-induced labor. Provided we do not know the origin of NOx in the general circulation, these data indicate NOx levels as predictors of the response to PGE-induced delivery at term and support the hypothesis that labor onset is modulated by the endogenous NO activity.

Adult↗

PubMedDate not supplied

The L-arginine-nitric oxide system regulates platelet aggregation in pregnancy.

OBJECTIVE: To investigate the ex vivo platelet aggregation in response to a substrate (L-arginine [L-Arg]) and a donor (sodium nitroprusside [SN]) of nitric oxide (NO) in nonpregnant women and in normotensive pregnancies. METHODS: Platelet aggregation was studied with a dual-channel aggregometer and expressed as a percentage of light transmission. Measurements were done at baseline and after preincubation with scalar doses of L-Arg and SN. The intraplatelet L-citrulline (L-Cit) levels were measured by high-performance liquid chromatography (HPLC). RESULTS: In both groups, the baseline aggregation values were similar for adenosine diphosphate (ADP) and collagen stimuli. Wilcoxon rank-sum testing demonstrated that in both groups the addition of L-Arg had a significant effect on aggregation: Doses of 50 to 5000 mumol decreased ADP-induced aggregation. Conversely, collagen-induced aggregation was affected only by the highest dose of L-Arg. Sodium nitroprusside administered in doses of 2.5 to 250.0 nmol decreased ADP- and collagen-induced platelet aggregation equally. ADP-induced aggregation values obtained after (SN) incubation were positively correlated with gestational age. Intraplatelet L-Cit levels showed a significant rise after the incubation with L-Arg, and this effect was negatively correlated with gestational age. CONCLUSION: The L-Arg-NO system regulates platelet aggregation during pregnancy. Moreover, a physiologic reduction of platelet sensitivity to the antithrombotic effect of NO occurs.

Adenosine Diphosphate↗

PubMedDate not supplied

L-arginine infusion reduces blood pressure in preeclamptic women through nitric oxide release.

OBJECTIVE: This study investigates the biochemical and cardiovascular effects of L-arginine administration in normotensive pregnant women and women with preeclampsia. METHODS: The study groups consisted of 12 women with uncomplicated pregnancies and 17 preeclamptic patients, four of whom were on antihypertensive treatment. In both groups, saline infusion was started, followed by 30 g L-arginine administration, and finally more saline. Blood pressure was recorded every 5 minutes and blood samples were collected for measurement of serum citrulline, arginine, and nitrite levels. Amino acid assays were done by using high-performance liquid chromatography with fluorometric detection. RESULTS: L-Arginine infusion was associated with a significant reduction of blood pressure in both groups, the decrease being greater in the women with preeclampsia. Baseline serum citrulline and arginine levels were not significantly different between the two groups. L-Citrulline levels were significantly increased during infusion of L-arginine, and the increase was significantly lower in the women with preeclampsia. Serum nitrite levels were increased only in controls and not in preeclampsia patients. The total citrulline production stimulated by L-arginine was related inversely to baseline blood pressure values and was unrelated to clinical parameters such as gestational age at delivery, birth weight, and Apgar score. CONCLUSIONS: L-Arginine load in pregnant women is associated with increased nitric oxide (NO) production and hypotension. Despite a reduced ability to produce NO, patients with preeclampsia may benefit from L-arginine supplementation. Overall, these findings partially support the hypothesis that preeclampsia is characterized by a dysfunction of the L-arginine-NO pathway.

Adult↗

PubMedDate not supplied

Psychological group support attenuates distress of waiting in couples scheduled for assisted reproduction.

The aim of the study is to determine whether a cognitive-behavioral group treatment could lead to a decrease of psychological distress in couples waiting for assisted reproduction. Fifty consecutive couples included in the waiting list for IVF-ET or ICSI were randomly allocated either to receive Cognitive-Behavioral Treatment (CBT Group) or just waiting (Observation Group). The group is formed by 8-10 couples; 12 meetings are provided for a period of 4 months. Two psychometric test have been administered (Symptom Rating Test and Westbrook Coping Scales) at baseline and after 4 months. At baseline, females showed a higher level of SRT than males (F= 16.6+/-14.1; M = 10.2+/-9.0; p=0.01). This became evident for anxiety (F= 5.6+/-4.9; M =3.3+/-3.0, p = 0.004), somatization (F= 3.0+/-2.5; M = 1.8+/-2.1, p = 0.01) and feelings of inadequacy (F = 3.9+/-3.7; M = 2.3+/-2.7, p = 0.01). After 4 months in the males of Observation Group (from 2.3+/-2.0 to 4.0+/-2.8, p=0.01) there was an increase of the level of anxiety. No other meaningful differences in other variables were found. In females of CBT Group a trend towards a significant decrease in the total value of psychological uneasiness (the SRT) (from 17.7+/-13.7 to 14.1+/-14.0, p = 0.07) was found. A long wait before the scheduled intervention of assisted reproduction increased anxiety levels, namely in male partners. CBT avoids such a 'waiting stress' and could be useful for stimulating discussion and awareness inside the couple. Shortening the waiting list and psychological support would be provided by infertility centres

Adaptation, Psychological↗