The EPICOVID19-BS study: a web-based epidemiological survey in bariatric patients.

PURPOSE: To assess the occurrence and severity of SARS-CoV-2 infection/COVID-19, frequency of symptoms, clinical manifestations and behaviours in a sample of patients undergoing bariatric surgery (BS). METHODS: The EPICOVID19-BS is an observational cross-sectional study conducted in Italy during the second wave of the COVID-19 pandemic (September 2021-February 2022). Patients with severe/extreme obesity undergoing BS were asked to complete an online multiple-choice questionnaire and to provide additional clinical information and blood biochemistry. Positive COVID-19 cases were defined by the combination of positive nasopharyngeal swab test results and/or positive serological test results. Sociodemographic, clinical and behavioural characteristics were compared between positive and negative COVID-19 cases. RESULTS: A total of 745 participants were enrolled (mean age 44.5 ± 10.5 years SD, 78% female). The proportion of positive COVID-19 cases was 20.4%. They were more likely to be health care workers, to have close contacts with confirmed cases, to use anti-inflammatory drugs, to have immune system disorders, to have previous CMV infection, to have lower cholesterol levels and to have less metabolic syndrome than negative cases. Infected participants significantly increased their use of national health resources for minor health problems. The majority of participants experienced flu-like symptoms and taste and smell disturbances. Only 9.6% were hospitalised and none required intubation. CONCLUSIONS: Our results seem to support the evidence that patients undergoing BS have a low rate of severe SARS-CoV2. Further longitudinal studies in multiple obesity treatment centres are needed to more effectively monitor and control obesity in this specific population.

The molluscicidal activity of the latex of Euphorbia splendens var. hislopii on Melanoides tuberculata (Thiaridae), a snail associated with habitats of Biomphalaria glabrata (Planorbidae).

The use of the latex of Euphorbia splendens var. hislopii was considered as an effective control method for Biomphalaria glabrata in Sumidouro, Rio de Janeiro. However, the appearance and expansion of the snail Melanoides tuberculata since August 1997, with the concomitant reduction of the population of B. glabrata suggest that competitive exclusion might be taking place. Depending on the susceptibility of the thiarid to the E. splendens toxin, the natural control that is occurring could be interrupted by the employment of the latex if the planorbid were less susceptible to the toxin. The aim of this study is to investigate the molluscicidal activity of the latex on M. tuberculata. We used 420 M. tuberculata, from Sumidouro. Fourteen different latex concentrations were tested using World Health Organization general methodology. Probit analysis was used for LD90 and LD50 determination. The LD50 was 3.57 mg/l and LD90 was 6.22 mg/l. At the highest concentration (10 mg/l) there was no survival. No significant differences among replicas (chi2 = 8.31; gl = 13; p > 0.05) were found. The LD90 dose for M. tuberculata was 13.8 times greater than that for B. glabrata, so that the molluscicide in the presence of the thiarid may have a synergic effect on reduction of Biomphalaria populations.

[Abundance and infection of Biomphalaria glabrata with Schistosoma glabrata in the state of Rio de Janeiro, Brazil]. / Abundância e infecção do molusco Biomphalaria glabrata pelo Schistosoma mansoni no Estado do Rio de Janeiro, Brasil.

OBJECTIVES: To investigate the spatial distribution, abundance and natural schistosomiasis infection levels in the snail Biomphalaria glabrata, the intermediate host of Schistosoma mansoni in an area of the State of Rio de Janeiro, Brazil. METHODS: In the Pamparrão area, Sumidouro county, RJ, Brazil, snail captures were carried out every other month from June 1991 to November 1995. There were 23 collecting sites along the Pamparrão stream and its three tributaries (A, B and C). Captured snails were examined in the laboratory for infection. Data analyses were performed using Spearman coefficient (0.5% significance level) and Qui-square test. RESULTS: The abundance of B. glabrata was variable in both time and space. Most of the collection sites showed a negative correlation with rainfall. The tributary B had the highest and most steady infection rates (more than 25% in some sites). There were found significantly more infected snail in the dry season (chi2 = 20.08; p=0.001). CONCLUSIONS: B. glabrata population in the Pamparrão valley was negatively influenced by rainfall, especially at the Pamparrão stream. The dry season seems to promote the infection probably due to the lower water volume, increasing the chance of interaction between the intermediate host and the parasite.

[Multifocal carcinoid of the stomach]. / Il carcinoide multifocale dello stomaco.

Carcinoid tumors are among the most frequently reported neuroendocrine neoplasms of the gastroenteropancreatic system. They occur more commonly as benign diseases but malignant ones can also be found. Gastric carcinoid is an uncommon pathology which accusin 2% of the carcinoid tumors of various districts and 0.5% of the gastric carcinomas. The authors report a case of gastric malignant multifocal carcinoid, diagnosed in a 63 year-old female patient. Diagnosis was confirmed at histologic analysis of the operating piece. The aim of this paper has been to review the frequency, prognosis and treatment of this neoplasm in the literature.

Spontaneous and evoked oscillations of cytosolic calcium in the freshly prepared ciliary epithelial bilayer of the rabbit eye.

Under confocal microscopy, calcium imaging of the isolated secretory ciliary epithelium, especially the inner layer, non-pigmented epithelium (NPE), revealed spontaneous calcium oscillations in multiple patterns. Oscillations induced by stimulation of the muscarinic receptor have an onset that coincides with synthesis and release of InsP3. Caffeine (5 mM) induced a calcium transient and blocked spontaneous and (0.1 mM) muscarine induced oscillations. Thapsigargin (1 microM) prevented a muscarinic response. Muscarine and caffeine induced transients have significantly greater amplitude in NPE than in PE (outer layer, pigmented epithelium). Calcium transients and frequencies of spontaneous oscillations are greater in NPE than PE. In NPE muscarine induced oscillations are observed with higher frequencies than the spontaneous ones: gamma-0.24 +/- 0.05Hz (8) versus 0.08 +/- 0.01Hz (18). These repetitive responses, spontaneous and receptor coupled, reflect intracellular coding of information. A calcium signal may contribute to the regulation of aqueous humor formation.

[Epidemiological behavior of perforated peptic ulcer before and after the introduction of the antisecretory drug therapy. Our experience]. / Il comportamento epidemiologico dell'ulcera peptica perforata prima e dopo l'introduzione della terapia medica antisecretiva.

The diagnostic iter and treatment of peptic ulcer have evolved considerably over the past 20 years. The capillary spread of endoscopy has permitted secure and precise diagnoses to be made, in terms of both the site and size of the anatomic lesion, on the one hand, and on the other, the introduction of antisecretory drugs has led to the resolution of the majority of ulcers, so much so that the ulcer is no longer managed using strictly surgical methods but is now treated medically and only emergency cases, such as perforations, undergo surgery. Complications, such as digestive hemorrhage, penetration and stenosis, may lead to the need for surgery. In particular, perforation seems to be the only complication which has not been significantly influenced by the introduction of antisecretory therapy, the point that its status as a "complication" has been questioned leading to the suspicion of its nosological autonomy. The authors review the series of ulcer patients admitted to hospital during the period 1968 to 1991, paying special attention to the correlation with the use of antisecretory drugs which were introduced during the period 1978-1981, the trend of ulcer complications over the entire period, the duration of symptoms and the epidemiology of peptic and perforated ulcers.

[Diagnostic findings and the surgical treatment of liver metastases: our experience]. / Orientamenti diagnostici e trattamento chirurgico delle metastasi epatiche: nostra esperienza.

The authors report their 10 year experience of 32 consecutive hepatic resections for metastases. All patients were preoperatively evaluated with US and CT, however, in 9 cases the diagnosis was obtained at laparotomy. In the first years there were no codified criteria for indications to surgery, while recently these were restricted, because of more favourable prognostic evaluations, to the metastases from colorectal carcinoma, endocrine or carcinoid tumours, digestive system neoplasms invading adjacent liver (in this case usually with palliative goal). The low mortality and morbidity registered explain the safety and efficacy of this procedure, also taking into account the fact that currently surgery is the only effective procedure with curative purpose. Criteria for patients selection, particularly in case of colorectal cancer, are referred and discussed and consequently prognostic factors are proposed: hepatic involvement extent, stage of primary tumour, absence of extrahepatic metastases, disease free interval between resection of primary tumour and hepatic resection for metachronous metastases.

[Digestive hemorrhage secondary to fistula between hepatic artery and jejunal stump following duodenocephalopancreasectomy. A clinical case]. / Emorragia digestiva secondaria a fistola tra arteria epatica e moncone digiunale in esiti di duodenocefalopancreasectomia. Caso clinico.

The authors describe a case of one patient who underwent duodenocephalopancreasectomy for CBD cancer 6 years ago and developed gastrointestinal bleeding caused by a fistula between the hepatic artery and the jejunal stump. They discuss the differential diagnosis problem in the gastrointestinal bleeding syndrome caused by this rare pathology.

[Choledocholithotomy and papillosphincterotomy in surgery of the bile ducts]. / Coledocolitotomia e papillosfinterotomia nella chirurgia delle vie biliari.

The Authors argue about the different surgical choices feasible in case of CBD stones. They consider a case-record of 74 patients that underwent, from January 1988 to June 1990, choledocholithotomy or transduodenal sphincterotomy for non-neoplastic pathology of the CBD in the I Divisione di Chirurgia Generale OO.RR. Bergamo. Analysis of the data shows a significant pre-operative alteration of the gamma-GT plasmatic levels. That represent a risk-index useful to suspect a silent CBD lithiasis. The good results attained with the choledocholithotomy and with the transduodenal sphincterotomy show the efficacy of both methods, that keep up different indications. The Authors point out the efficacy of the antibiotic prophylaxis in the prevention of the operative infections.

Acetylcholine induces voltage-independent increase of cytosolic calcium in mouse myotubes.

Electrophysiological, biochemical, and Ca2+ imaging studies of cultured mouse myotubes were used to investigate whether the neurotransmitter acetylcholine causes an increase in intracellular Ca2+ concentration ([Ca2+]i) through activation of a second messenger system. Bath applications of acetylcholine to myotubes (i) elicited a significant membrane current even in a Na(+)-free Ca2+ medium, when the current was carried mainly by calcium ions; (ii) caused a rapid and transient cytosolic accumulation of inositol 1,4,5-trisphosphate; (iii) evoked a conspicuous alpha-bungarotoxin-sensitive long-lasting [Ca2+]i enhancement even in the presence of Cd2+; and (iv) transiently increased [Ca2+]i when cells were equilibrated in a Ca(2+)-free atropine-containing medium. We propose that, in addition to opening ion channels, the nicotinic action of acetylcholine on the muscle cell membrane increases [Ca2+]i through activation of the inositol 1,4,5-trisphosphate second messenger system and mobilization of Ca2+ from intracellular stores.

[Use of somatostatin in acute pancreatitis of biliary origin]. / L'uso della somatostatina nelle pancreatiti acute di origine biliare.

The aetiology of acute pancreatitis may be alcoholic, dyslipidaemic, post-operative, traumatic, cryptogenic or biliary and only the biliary form is considered here. Fifteen patients with biliary pancreatitis and blood amylase above 250 mg (n.v. less than 100) were encountered in 1984-85. Six patients were given traditional medical treatment and 9 somatostatin alone. Despite the limited number treated the results obtained in the second group appear to confirm the validity and efficacy of somatostatin. In fact given the rapid disappearance of pain and the normalisation of the altered blood parameters it was never necessary to administer somatostatin for more than 24-36 hours.

[Transduodenal papillosphincteroplasty]. / La papillo-sfintero-plastica transduodenale.

On the basis of a thourough anatomosurgical study of Vater's ampulla and after a critical survey of all surgical techniques for the sphincter of Oddi, the indications for and technique of total papillosphincteroplasty are presented. The results obtained in 544 total papillosphincteroplasties, their possible complications and failure supported by long-term (from 6 months to 7 years) follow-up are discussed. The conclusion is drawn that papillosphincteroplasty is to be considered the surgical technique of choice in the treatment of benign pathology of the main bile way.

Lymphoid cell surface markers in acute lymphocytic leukaemia.

Peripheral blood lymphoid cells of 29 patients with acute lymphocytic leukaemia (ALL) at onset were studied for characterization of B and T membrane markers and phytohaemagglutinin responsiveness. 24 cases (83%) were classified as "null" cell ALL and 5 (17%) as T-cell ALL. No relationship could be found between cytological presentation and immunological classification. Moreover, no correlation has been demonstrated between clinical-immunological parameters and prognosis, indicating that in our series of patients, assessment of cell size and surface markers were not a reliable predictor of prognosis.