Genetic structure of Barbus spp. populations in the Marches Region of central Italy and its relevance to conservation actions.

A genetic survey of Barbus spp. populations in the Marches Region (Adriatic River basins), central Italy, was carried out using mitochondrial and nuclear markers (partial D-loop, cyt b sequences and microsatellite loci) in order to ascertain their systematic position and to address their genetic structure which is key to conservation action planning. Analyses were conducted on sequences obtained from 91 individuals collected from eight sampling sites in five different rivers, from two specimens provided by the Ichthyological Centre of Rome and mitochondrial sequences of Barbus spp. retrieved from GenBank. Presumptive classification based on external morphological characters was not confirmed by genetic analysis, by means of which all specimens collected in the Marches Region were ascribed to Barbus plebejus. Genetic diversity values (h and π) of sampling groups were all different from 0 except the one sample collected from the upper reaches of the River Tenna, above a hydroelectric dam. Population connectivity and colonization patterns of the studied area were inferred from an analysis of molecular variance distribution and evolutionary relationships among haplotypes. The results point to different levels of isolation among sampling groups due to ecological and anthropogenic factors and the effect of an artificial barrier on genetic variability and conservation status of the population. Finally, this study confirms the uncertainty associated with systematic classification of Barbus spp. based on morphological characters due to the phenotypic plasticity of the species.

Evaluation of long-term effects in patients treated with Fränkel-2 appliance.

AIM: To evaluate the dentoskeletal effects produced by Fränkel-2 (FR-2) appliance during the treatment of patients with Class II malocclusion by mandibular retrusion and to verify the long-term stability of these changes. MATERIALS AND METHODS: Pre-treatment, post-treatment and long-term serial cephalograms (at least 10 years after the end of treatment) of patients treated with FR-2 were compared with data obtained from untreated controls. To be included in the study, patients and controls had to exhibit Class II malocclusion caused by short mandibular body. Lateral cephalograms were analysed with a specific tracing regimen in both groups. Summary measures for the initial cephalometric values and increments of changes between visits were calculated. RESULTS: Compared to controls, the FR-2 treatment produced a significant decrease in the ANB angle that improved the skeletal intermaxillary and occlusal relationship. At long-term follow- up, the FR-2 group showed further improvements of skeletal intermaxillary and occlusal relationship, therefore the changes observed during treatment showed no compensatory decline or rebound. CONCLUSION: FR-2 treatment, in conjunction with a period of post-functional fixed appliance therapy designed to perfect the occlusion, can produce a long-lasting improvement of the skeletal Class II malocclusions with little skeletal correction and significant incisor compensation.

Clinical difficulties in diagnosis: a rare case of lipoma of the floor of the mouth.

Lipomas are soft tissue mesenchymal neoplasms that rarely occur in the oral and maxillofacial region. Their incidence in the floor of the mouth is very low. The authors present the case of a lipoma of the floor of the mouth, the diagnosis of this lesion was challenging as many clinical signs mimicked the appearance of a common ranula. Also the ultrasound imaging findings were not decisive and only during the operation the yellowish, solid and lobulated aspect of the lesion directed the surgeon to the correct treatment: a block resection of the mass was performed under local anesthesia with no complications. The patient remained asymptomatic with no evidence of recurrences in the postoperative follow-up period of 24 months. Histopathologically, the lesion was classified as a lipoma, a diagnosis based on the presence of mature adipose tissue with no cytologic atypia, subdivided by rare and thin septa of fibrous tissue with the presence of few blood vessels. The case reported highlights the difficulties in diagnosing lesions in the floor of the mouth and the necessity of including rare conditions like lipoma in the differential diagnosis.

Association between reduced pulmonary diffusing capacity and cardiac autonomic dysfunction in Type 1 diabetes.

BACKGROUND: In Type 1 diabetes mellitus (DM), it has been suggested that autonomic nervous system dysfunction (NAD) impairs lung diffusion capacity. Heart rate variability (HRV), a measure of cardiac autonomic function, is a sensitive method of detecting NAD. To our knowledge, no previous study has assessed whether cardiac sympatho-vagal balance is associated with lung diffusion capacity in diabetes. METHODS: Twenty Type 1 DM patients without pulmonary abnormalities and systemic NAD underwent measurement of lung diffusion capacity for carbon monoxide (DLCO) by single-breath method and assessment of cardiac autonomic function by HRV analysis on 24-h electrocardiographic Holter recordings. RESULTS: Standard respiratory function tests and peripheral autonomic tests were normal in all patients. DLCO was lower than normal reference values in six patients (30%). DLCO correlated significantly with most HRV variables, independent of the clinical and laboratory variables. The strongest correlation was found with standard deviation of all RR intervals (SDNN; r = 0.62, P = 0.003) in the time domain and low frequency (LF) power (r = 0.73, P < 0.001) in the frequency domain. CONCLUSIONS: In Type 1 diabetes, a significant association exists between cardiac NAD and reduced DLCO in the absence of clinical respiratory and autonomic abnormalities. Thus, NAD may be involved in the early reduction of DLCO in these patients, possibly through abnormalities in the regulation of pulmonary blood flow at the microvascular level.

Autofluorescence bronchoscopy to identify pre-cancerous bronchial lesions.

BACKGROUND: This study aimed to assess the diagnostic yield of autofluorescence bronchoscopy (AFB) in the detection of pre-cancerous bronchial lesions in a non-selected sample of patients. METHODS: Both fiberoptic white-light bronchoscopy (WLB) and AFB using the Storz D-light system were performed on 166 consecutive patients. Biopsy specimens were taken in areas of the tracheobronchial tree judged as abnormal or suspicious at WLB and/or AFB. The bronchoscopic procedures were randomly performed by two operators. RESULTS: A total of 93 patients had a positive biopsy specimen: 80 for cancer and 13 for dysplasia. AFB was abnormal or suspicious in 85 of the 93 patients with a sensitivity of 91.4%. Specificity was 50.7%. In 16 patients with normal WLB examination, AFB identified abnormal or suspicious areas which had a positive biopsy. Thus AFB significantly improved sensitivity of WLB (100% vs 82.8%, respectively, p<0.001) in the entire sample of patients studied. Data was further analysed separately for patients with dysplasia and those with cancer. Indeed, 13 of 16 patients recognized only by AFB had a histological diagnosis of dysplasia. The remaining three patients had a diagnosis of cancer (small intraepithelial neoplastic lesions). Since no other patient with dysplasia was found, AFB had a sensitivity of 100% in diagnosing dysplasia. On the other hand, excluding the 13 patients with dysplasia, WLB had a high sensitivity in diagnosing cancer (93.7%). CONCLUSIONS: The AFB Storz system showed a high sensitivity. The increase in diagnostic yield of AFB in comparison with WLB was related to the power of AFB to identify pre-cancerous bronchial lesions so showing its usefulness in the early diagnosis of lung cancer.

[Drug adverse effects in the elderly hospitalized with acute pathologies]. / Effetti collaterali da farmaci in anziani ospedalizzati per patologie acute.

OBJECTIVES: Data of Literature suggest that age is not an independent risk factor for adverse drug reactions (ADR), while there is evidence of a positive correlation between ADR and the number of drug taken. To investigate if that is true, we have examined the occurrence of ADR in elderly patients admitted to our Geriatric Department in the first nine months of 1999 for acute illness. MATERIALS AND METHODS: We have evaluated the occurrence of ADR in 510 patients more than 65 years of age (80 +/- 7.35 years). The adverse drug effect was worth considering when symptomatical or caused a change in the management of the patient (suspension or change of therapy, prolongation of staying in hospital). We used the algorithm of Naranjo (19) to estimate the probability that a drug caused an ADR. RESULTS AND CONCLUSIONS: In our study the frequency of ADR was 12.5%. Furosemide was responsible for 50% and digoxin for 8% of ADR. Among the patients taking furosemide, 12.5% had an ADR (generally low potassium). The frequency of ADR was correlated neither with the age of the subjects nor with the number of drug taken. It can be possible that the main cause of ADR is the type of drugs assumed by elderly.

[Conscious ketamine neuroleptanalgesia in oral surgery]. / La neuro-lepto-ketamina-analgesia vigile in chirurgia odontoiatrica.

The AA. describe an intravenous out-patient anaesthesia, utilized in oral surgery; it is called "conscious ketamina-neuroleptanalgesia". This original technique produces a heavy sedation of the patients without losing their consciousness and their capacity to collaborate; infact the verbal contact with the patient is maintained through the period of sedation. In this technique the use of local anesthetics is not suitable because analgesia is enough.

Effects of auricular transcutaneous electrical nerve stimulation on distal extremity pain: a pilot study.

The purpose of this pilot study was to determine the effectiveness of auricular acupuncture-like transcutaneous electrical nerve stimulation on pain. Fifteen subjects (6 men, 9 women) experiencing distal extremity pain received either one placebo pill or a 10-minute treatment of acupuncture-like TENS bilaterally to five acupuncture points on the auricle. Pain levels were measured before treatment and at 0, 10, and 30 minutes posttreatment using the visual analogue scale (VAS) and the pain rating index (PRI) of the McGill Pain Questionnaire. The VAS showed no statistically significant differences between Experimental Group (n = 8) and Control Group (n = 7) means at pretreatment or posttreatment; however, both groups showed a reduction in VAS means over time. The Experimental and Control Group means on the PRI were significantly different (p less than .05) at all three posttreatment measurements, but not at pretreatment baseline measurement. These results suggest that auricular acupuncture-like TENS could be an alternative for relief of distal extremity pain. Additional clinical studies are necessary to validate the results of this study.