The quantitative distribution of the two main T lymphocyte subsets, recognizable by the 'high' and "low-affinity' E rosette-forming cell technique of West, was studied in both the bone marrow and peripheral blood from ten untreated multiple myeloma (MM) patients. A reduced total T lymphocyte count, with a relative predominance of 'low-affinity' T lymphocytes (putative suppressor T cells), was found in the peripheral blood. Within a normal total T lymphoid cell count, a predominance of the T lymphocyte subset with 'low-affinity' characteristics was also observed in the bone marrow. An inverse correlation, that was statistically significant, was seen between the monoclonal malignant cellular B component and the 'low-affinity' T cell percentage in all cases. It is concluded, therefore, that such an imbalance between the 'high' and "low-affinity' T subsets, with the latter predominating, could be of importance in the regulation of the growth rate of the monoclonal cellular B component.

Aged↗

PubMedDate not supplied

Heavy smoking is an important risk factor for erectile dysfunction in young men.

Clinical and basic science studies provide strong indirect evidence that smoking may affect penile erection. The objective of this retrospective research was to investigate the role of smoking for erectile dysfunction (ED) in order to obtain some insight into the prevention of ED. We reviewed the data from 860 male patients aged between 18 and 44 visited during the period January 1999 to December 2002. The patients were divided into three groups: smokers, never smokers and former smokers. All patients were submitted of medical history, such as, IIEF 5 Questionnaire, physical examination, serum levels of glucose, cholesterol, prolactin and free testosterone. Our data were compared with ISTAT (Italian Institute of Statistics) and data on the Italian population of smokers. We have stratified the data by age and area of residence. The 860 patients, mean age 32.4 y old (range 18-44), are distributed into three groups: smokers 460 (53.5%), never smokers 320 (37.2%) and former smokers 80 (9.3%). Current smokers in our series are 460 (53.5%) in comparison to 34.7% of male current smokers in Italy, in the same range (18-44). Out of 860, 337 are patients who smoked more than 20 cigarettes per/day (39.2%) and these data are extremely interesting; while comparing the same aged men through ISTAT, it is found that only 4% are heavy smokers. On analysing the incidence of heavy smoking in middle-aged patients affected by ED with the whole Italian population by means of ISTAT, taking into account males with the same age range and area of residence, it was shown that the data of our population (sample) compared all Italian middle-aged patients are 39.2 vs 4%; this explains the need for education within a comprehensive smoking cessation programme, and should be reserved especially for young smokers, in order to be aware and informed of the effect of tobacco on erectile function.

Adolescent↗

PubMedDate not supplied

Chemohyperthermia for advanced abdominal malignancies: a new procedure with closed abdomen and previously performed anastomosis.

ChemoHyperthermic Peritoneal Perfusion (CHPP) after cytoreductive surgery is a relatively new procedure in the treatment of abdominal carcinomatosis or sarcomatosis. An assessment of the CHPP technique performed on 20 patients suffering from abdominal malignancies was carried out. After surgical debulking and gastrointestinal anastomosis, two Tenckhoff catheters were positioned for the immediate performance of CHPP, which was carried out at 42-43 degrees C for 1 h, after closing the abdomen. In 19 assessable patients, 47.3% and 36.8% complete responses (CR) were recorded at 1 and 6 months, respectively, with responses of 37.5% in patients affected with gastrointestinal cancer and 50% in patients affected with ovarian cancer. CR were obtained only in patients who had undergone accurate peritoneal debulking. Survival rate for gastrointestinal and ovarian cancer was 68% at 12 months. Patients who underwent radical cytoreductive surgery are all alive at a follow-up median time of 17 months. Two anastomotic leakages with spontaneous recovery were observed, along with one hydrothorax, which was immediately drained during the procedure, three cases of chemotherapic gastrointestinal toxicity, one sepsis, one renal failure that required a transient dialysis, and one cholecystitis that required cholecystectomy. One patient died 30 days after CHPP of a cardiac ischaemia not strictly related to the surgical procedure. In the authors' experience, CHPP with closed abdomen after reconstructive gastrointestinal surgery is a safe and feasible treatment with acceptable side effects.

Abdominal Neoplasms↗

PubMedDate not supplied

Adult-onset Hallervorden-Spatz syndrome presenting as cortical dementia.

The authors examined behavioral and pathophysiologic substrates in a patient with adult-onset Hallervorden-Spatz syndrome who presented with insidious cognitive decline but no motor impairment. The authors combined longitudinal case history and serial neuropsychologic testing with functional neuroimaging (positron emission tomography), structural neuroimaging (magnetic resonance imaging), and brain tissue analyses. Serial assessments of a 29-year-old woman showed progressive dementia. Marked cognitive and behavioral deficits were seen on neuropsychologic testing, corresponding to striking cortical abnormalities on positron emission tomography, magnetic resonance imaging, and histopathologic studies. Typical motor manifestations of the disorder did not emerge until the patient was 34 years old, 5 years after the onset of cognitive symptoms. Hallervorden-Spatz syndrome should be considered in the differential diagnosis of progressive cortical dementia in a young adult, even in the absence of motor dysfunction.

Adult↗

PubMedDate not supplied

Simulated car crashes at intersections in drivers with Alzheimer disease.

Current evidence suggests that car crashes in cognitively impaired older drivers often occur because of failure to notice other drivers at intersections. We tested whether licensed drivers with mild to moderate cognitive impairment due to Alzheimer disease (AD) are at greater risk for intersection crashes. In this experiment, 30 participants drove on a virtual highway in a simulator scenario where the approach to within 3.6 seconds of an intersection triggered an illegal incursion by another vehicle. To avoid collision with the incurring vehicle, the driver had to perceive, attend to, and interpret the roadway situation; formulate an evasive plan; and then exert appropriate action on the accelerator, brake, or steering controls, all under pressure of time. The results showed that 6 of 18 drivers with AD (33%) experienced crashes versus none of 12 nondemented drivers of similar age. Use of a visual tool that plots control over steering wheel position, brake and accelerator pedals, vehicle speed, and vehicle position during the 5 seconds preceding a crash event showed inattention and control responses that were either inappropriate or too slow. The findings were combined with those in another recent study of collision avoidance in drivers with AD that focused on potential rear end collisions. Predictors of crashes in the combined studies included visuospatial impairment, disordered attention, reduced processing of visual motion cues, and overall cognitive decline. The results help to specify the linkage between decline in certain cognitive domains and increased crash risk in AD and also support the use of high-fidelity simulation and neuropsychologic assessment in an effort to standardize the assessment of fitness to drive in persons with medical impairments.

Accidents, Traffic↗

PubMedDate not supplied

A multicentre trial to evaluate the efficacy and tolerability of alpha-glycerylphosphorylcholine versus cytosine diphosphocholine in patients with vascular dementia.

An open clinical trial was carried out to compare the efficacy and the tolerability of 1 g/day alpha-glycerylphosphorylcholine (alpha-GPC) with 1 g/day cytosine diphosphocholine (CDP) both given intramuscularly for 90 days in 120 patients with mild to moderate vascular dementia. The clinical evaluation, carried out at the start as well as halfway through (45 days) and at the end of treatment (90 days), was expressed by psychometric tests (modified Parkside behaviour rating scale, Sandoz clinical assessment geriatric scale, word fluency test, Hamilton's rating scale of depression, narration subtest of Wechsler memory scale). Both treatments produced a definite symptomatic improvement and showed a very good tolerability. The results suggest that in most tests alpha-GPC possessed a statistical higher efficacy and an overall more satisfactory activity assessed by both patients and investigators compared with CDP.

Aged↗

PubMedDate not supplied

[Emergency treatment of traumatic lesions of the male urethra].

Explore the source record for details and available documents.

Emergencies↗

PubMedDate not supplied

Lipid profile variations in a group of healthy elderly and centenarians.

Epidemiological and clinical studies have clearly shown a close relationship between plasma cholesterol concentrations and vascular risk. We focused our attention on the phenotypic-biohumoral conditions capable of influencing longevity in relation to different age classes. We evaluated the lipid profile in an elderly institutionalized population of 80 subjects (20 males and 60 females divided into age classes) in the town of Catania. Our results revealed a statistically significant reduction in total cholesterol, triglycerides and LDL-cholesterol concentrations as well as Apolipoprotein B100/Apolipoprotein A1, total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios, and a significant increase in HDL-cholesterol, Apolipoprotein A1, Apolipoprotein B100 and Lipoprotein (a) values. This changes are progressive with age. We believe that low total cholesterol, LDL-cholesterol and triglyceride concentrations, elevated HDL-cholesterol values, and low ratios protect subjects from ischemic and thrombotic events, thus favouring longevity. These changes are most evident and statistically significant in the most advanced decades of life, especially in centenarians, and may depend on diverse determinants, such as body composition, environmental factors, physical activity, diet and drugs.

Activities of Daily Living↗

PubMedDate not supplied

Diagnosis and survey of abnormal/atypical squamous cells of undetermined significance and low-grade squamous intraepithelial lesions: a retrospective study.

The new Bethesda System (BS) terminology has opened a series of problems about the Abnormal/Atypical Squamous Cells of Undetermined Significance (ASCUS) and Low-Grade Squamous Intraepithelial Lesion (L-SIL) categories, particularly on their treatment and follow-up. Moreover in these field a non negligible portion of lesions progress to High-Grade Lesion (H-SIL). With the aim of comparing the data, we examined samples observed in our Ambulatories with 6-12 months follow-up. We observed retrospectively 11.197 Pap test from January 1995 to June 1997, mostly first visits. All received a Pap test, colposcopy and gynaecological examination. Biopsy and histological standard examinations were performed when necessary. Alterations classified as mild epithelial abnormalities, of both ASCUS and L-SIL categories, were observed in 146 cases: 78 ASCUS and 68 L-SIL. Of these 48 were CIN 1/mild dysplasia (25 HPV associated) and 20 were HPV lesions, according to BS. All the cases with persistent ASCUS and L-SIL underwent a second control. In these 45 cases we observed 2 new cases of H-SIL and one of L-SIL; so 82.3% and 30.7% of ASCUS and L-SIL regressed to negatives. In the stable group 11.8% and 60.4% were ASCUS and L-SIL. Moreover 5.9% of ASCUS and 4.8% of L-SIL progressed to H-SIL. No cases of invasive cancer were observed. Our data show that ASCUS and L-SIL diagnosis can identify 6% and 4.8% of H-SIL respectively. In addition 17-18% of ASCUS were stable or progressed. These two categories, as already demonstrated in other studies, are mostly at risk.

Cervix Uteri↗