The effects of regular intensive exercise training on immune system homeostasis and the potential value of treatment with an immunostimulating agent were assessed in this randomized, double-blind, placebo-controlled, parallel-group study. A total of 60 athletes were studied over a 3-month period of regular intensive physical activity. After 1 and 3 months there were significant decreases in the immunoglobulin levels in the whole athlete population compared with baseline values. Specifically there were significant decreases in immunoglobulin M and immunoglobulin G (G1 and G2 subclasses). There was also a significant decrease in natural killer cells and a slight but significant increase in B and T lymphocytes. In the thymomodulin-treated group, unlike the placebo group, there was no significant decrease in the immunoglobulin G2 subclass and there was a significant increase in the T-helper cell subpopulation. The clinical relevance of these immunological findings should be evaluated in larger clinical and epidemiological studies.

Adolescent↗

PubMedDate not supplied

[Present position of non-shunt surgery for bleeding oesophageal varices (author's transl)].

This is a critical retrospective study of a homogeneous group of 24 patients with hepatic cirrhosis and portal hypertension who underwent emergency surgery for bleeding oesophageal varices. The adopted procedure was the porta-azygos disconnection, according to Torres-Degni, with or without splenectomy. The criterion derived from the need to stop bleeding, from contraindications to a portal-systemic shunt, or from other situations which are illustrated. The difficulty of selecting in these cases the appropriate surgery and the high operative death rate (46%) is commented. In survivors, the long-term outcome depends on the progress of the underlying liver disease.

Adult↗

PubMedDate not supplied

[Further comments on changes in hepatic function after interposition meso-caval shunt (author's transl)].

Further to a previous paper, the Authors followed up ten cirrhotic patients who had all undergone meso-caval shunt with Dacron prosthesis, for ascites or haemorrhage, Functional and anzymatic investigations were carried on over periods up to 10 months. No constant changes in hepatic function parameters were found during the post-operative period, compared to those before surgery. This observation suggests that these investigations might be more useful in defining liver disease than in practical assessment of transient, post-operative liver failure.

Adult↗

PubMedDate not supplied

[Neuroleptic malignant syndrome and related conditions].

Neuroleptic malignant syndrome is characterised by muscular rigidity, fever and signs of severe vegetative nervous system involvement. Its etiopathogenesis is still unclear and the disease is potentially fatal. Its clinical aspects, which are often only partially manifested, make it difficult to formulate a correct diagnosis in time, not least due to the problem of differential diagnosis with other syndromes with similar symptoms but a different pathogenesis, psychopathology and therapy: acute lethal catatonia, fatal acute delirium, heat-stroke, malignant hyperthermia. The speed of the diagnosis is vital for effective therapy, but this is made even more difficult by the need approach. The paper presents eleven case studies; after an analysis of the numerous clinical aspects of the syndrome and the definition of its diagnostic parameters, an appropriate therapeutic protocol is outlined. Lastly, the problem of retreatment using a neuroleptic of the same or a different class is discussed once the acute phase has been overcome.

Amantadine↗

PubMedDate not supplied

[Exposure to water disinfection by-products and adverse pregnancy outcomes: results of a case-control study carried out in Modena (Italy)].

Chlorination By Products (CBPs) in drinking water have been associated with an increased risk of adverse pregnancy outcomes, such as small term birth (STB) and preterm delivery. Up to date epidemiological evidence is weakened by a generally inaccurate exposure assessment, often at an ecological level: in this study the exposure is evaluated at the individual level. A case control study with incident cases was performed in Modena between October 1999-September 2000. 332 subjects were enrolled: 93 preterm births (26th-37th week of pregnancy), 73 STB (from 38th week, and weight less than the lowest 10th percentile) and 166 controls. Exposure was assessed both by applying a questionnaire on personal habits and by personal water sampling directly at subjects' home. THMs were analysed in all samples, chlorite and chlorate in water samples treated with chlorine dioxide. Subjects usually drinking tap water were few (5.2%): most of them were living in areas supplied by water treated with chlorine dioxide (87%). Levels of THMs were low (mean: 0.73 microgram/l), while chlorite and chlorate concentrations were relatively high (mean: 217.8 microgram/l for chlorites and 95.2 microgram/l for chlorates). Preterm birth did not show any significant association with CBPs, while STB appeared significantly associated, after adjusting for many potential confounders, with CBPs induced by chlorine dioxide treatment, especially with levels of chlorate higher than 200 microgram/l (OR: 4.7; 95%CI: 1.15-19.72). The association between STB and chlorate must be investigated further as the number of water utilities applying chlorine dioxide as disinfection treatment is increasing.

Adult↗

PubMedDate not supplied

[Dynamic psychopathology for a unified approach to psychogenic eating disorders].

The paper focuses on psychopathological problems relating to psychogenic dietary disorders. Using a psychodynamic approach, the Authors hypothesise the existence of a structural "continuum" which links these diseases to the contexts of either exaggerated food consumption or reduced or insufficient food intake. The discussion in centered on the dynamic-genetic aspect, also taking into account intermediate psychopathological morphologies, which underlies this branch of clinical psychiatry. The failure to overcome "infantile dependence" is identified as the most important genetic factor. The type and efficacy of strategy used to neutralise the persistent anxiety caused by this unresolved "separation/identification" of the Ego shape the individual symptomatology of each dietary disorder described in the study.

Anxiety, Separation↗

PubMedDate not supplied

[Dynamic psychopathology of anorexia nervosa. Clinical hypothesis].

In this paper the Authors discuss the psychopathological problem of nervous anorexia. Moving from a psychodynamic point of view, they examine the anorexic defensive strategy and the psycho-pathogenetic aspects which are probably involved in its expression.

Anorexia Nervosa↗

PubMedDate not supplied

[Zidovudine in the treatment of HIV-related thrombocytopenia. A study of 11 cases].

HIV-related thrombocytopenia sometimes requires a therapeutic choice: current therapies are similar to those applied in idiopathic thrombocytopenic purpura. Some Authors described a positive effect on platelets with Zidovudine (AZT) administration. We evaluated the efficacy of this drug in a group of 11 HIV-seropositive patients. Our results were not encouraging: increase in platelet count was obtained in a few patients only and it generally was of little importance.

Adult↗

PubMedDate not supplied

[Treatment of hemorrhagic syndrome caused by peritoneovenous shunt with a flow regulation device].

A case of severe coagulopathy after peritoneovenous shunting for intractable ascites and hepatorenal syndrome in a cirrhotic patient is reported. It was controlled and solved without removal of the shunt, using a vascular tourniquet which allowed a regulation of the ascitic flow. The method seems susceptible of improvement and could be routinely used in risk patients.

Ascites↗

PubMedDate not supplied

[Symbolic function and dysfunction].

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Humans↗