B cells compartment in centenarian offspring and old people.

Immunosenescence is considered a major contributory factor to the increased frequency of morbidity and mortality among elderly. On the other hand centenarians are considered the best example of successful ageing. To gain insight into mechanisms of immunosenescence and its clinical relevance, a possible model is represented by centenarians and/or their offspring. Nowadays centenarians are not more a curiosity, but in Europe are 1/8000 inhabitants and it has been demonstrated that the centenarian offspring, who are typically in their 70s and 80s, have a survival advantage when compared with age-matched controls whose parents died at an average life expectancy. Then again, studies on immunosenescence focus mainly on T cell impairment, although B cells are also affected. So, in the present preliminary report, we have studied B cell compartment in two classes of individuals, old people and centenarian offspring. B cell compartment was analysed using IgD and CD27 antibodies which characterize naïve B cells (IgD(+) CD27(-)), memory unswitched B cells (IgD(+)CD27(+)), memory switched B cells(IgD(-)CD27(+)) and double negative B cells (DN) (IgD(-)CD27(-)), i.e. exhausted memory cells. As expected, in both cohorts we observed a decreased B cell count. However, in centenarian offspring, naïve B cells are more abundant whereas exhausted memory cells (DN B cells, IgD(-)CD27(-)) do not show the increase that we have previously demonstrated in healthy elderly donors. These data are similar to that found in previously experiments on young subjects. So, our preliminary results show that centenarian offspring do not have the typical trend of memory/naive B cell subsets observed in elderly people and this is in agreement with the higher levels of IgM in the serum of centenarian offspring in comparison with data obtained in age-matched controls. This reservoir of naive B cell might be one of the causes that make centenarian offspring able to keep fighting off new infections, hence prolonging their life. So, B cell subset changes could represent a hallmark of successful or unsuccessful ageing and could be used as a biomarker of human life span, potentially useful for the evaluation of anti-ageing treatment.

Torsades de pointes induced by erythromycin.

We describe two patients who develop torsades de pointes in a temporal relationship to the intravenous administration of erythromycin lactobionate in the absence of other drugs or metabolic abnormalities known to cause the arrhythmia. We also review the current literature regarding this topic, including other case histories and the evidence for erythromycin's effect on cardiac tissue. Due to the increasing use of erythromycin in clinical practice, we believe it is important that all physicians be made aware of this potential complication, which was not recognized at our institutions until these patients were seen by one of us (B.G.).

Aspiration pneumonia. A threat when deglutition is compromised.

Aspiration results from abnormal structure or from dysfunction during the oral, pharyngeal, or esophageal stage of deglutition. Chemically induced inflammation of the lungs and obstruction of the airways may ensue. Feeding and swallowing problems may occur at any age, but they are particularly prevalent in the elderly, and the morbidity and mortality that result from impaired oral intake are now recognized as a major geriatric problem. Aspiration pneumonitis and/or pneumonia has a high morbidity and mortality rate. Medical management is mainly aimed at supportive care with the hope of resolution over time. Complications demand aggressive measures. Prevention of aspiration is apt to be more rewarding than treatment of consequences. All predisposing factors should be carefully assessed by the physician and modified whenever possible.

[Caloric intake and bone mineral content in obese and normal weight subjects]. / Apporto calorico e contenuto minerale osseo nei soggetti obesi e nei normopeso.

Bearing in mind the reports which clearly document the constant dissociation between daily calorie intake from diet, obesity and the positive effects of the mechanical load on bone trophism, the possible correlation between total daily calorie intake of some nutrients (Ca, P and vitamin D) on the one hand, and bone mineral density (BMD) on the other was evaluated in 61 obese women. The results appear to indicate that the higher BMD in obese compared to normal weight subjects may largely depend on the presence of notoriously high estrogen levels which allow a better efficacy and use of dietary calcium.