Vitamin D status of inmates: the experience of penitentiaries prisons in the province of Salerno in Southern Italy.

Introduction: Prisoners are at risk of developing vitamin D deficiency due to their lacking exposure to sunlight. So far, there are no published studies evaluating blood levels of vitamin D in relation to the health status of inmates and the quality of the Italian prison system. Aim: To investigate vitamin D status and its determinants in a cohort of prisoners. Subject and Methods: One hundred and seventy-two (172) pri-son inmates (males, n=159, age 47± 11.3 years; females, n=13, age 43.91±12.18 years) of three penitentiaries in the province of Salerno. Vitamin D deficiency, insufficiency and sufficiency were respectively defined as a 25(OH)D level <20 ng/mL; from 20 to 30 ng/mL, >30 ng/mL. Results: In our group, Vitamin D deficiency occurs in 77.32% of the prisoners with 32.55% of the cases having severe insufficiency. Prisoners with higher BMI show lower circulating vitamin D levels (p<0.001). No significant relationship was found with the duration of detention (Pearson R: 0.01). Conclusion: In this cohort of inmates the vitamin D status is determined by BMI, but not by the duration of the detention.

Microbial community composition and reactor performance during hydrogen production in a UASB reactor fed with raw cheese whey inoculated with compost.

This study investigated the microbial community developed in a UASB reactor for hydrogen production and correlated it to reactor performance. The reactor was inoculated with kitchen waste compost and fed with raw cheese whey at two organic loading rates, 20 gCOD/Ld and 30 gCOD/Ld. Hydrogen production was very variable, using an OLR of 30 gCOD/Ld averaged 1.0 LH(2)/Ld with no methane produced under these conditions. The hydrogen yield was also very variable and far from the theoretical. This low yield could be explained by selection of a mixed fermentative population with presence of hydrogen producing organisms (Clostridium, Ruminococcus and Enterobacter) and other non-hydrogen producing fermenters (Lactobacillus, Dialister and Prevotella). The molecular analysis of the raw cheese whey used for feeding revealed the presence of three predominant organisms that are affiliated with the genera Buttiauxella (a low-yield hydrogen producer) and Streptococcus (a lactic acid-producing fermenter). Although these organisms did not persist in the reactor, the continuous addition of these fermenters could decrease the reactor's hydrogen yield.

Anatomical redistribution of sweating after T2-T3 thoracoscopic sympathicolysis: a study of 210 patients.

BACKGROUND: The cutaneous influence areas of the different sympathetic ganglia have not been fully established to date. The aim of this study was to define the cutaneous influence area of sympathetic ganglia T2-T3. METHODS: A total of 210 patients with primary hyperhidrosis (PH) underwent 420 thoracoscopic sympathicolysis procedures of ganglia T2-T3 in a prospective study. All completed a preoperative questionnaire and a second questionnaire 12 months after the operation. The questionnaires evaluated perspiration in the different body areas. Only the zones of anhidrosis were considered in delimiting the cutaneous expression of sympathetic ganglia T2-T3. RESULTS: Redistribution of perspiration as reported by the patients comprised significant reduction in the palms, axillas, and soles, and an increase in the abdomen, back, and gluteal and popliteal regions. Regarding the incidence of anhidrosis by anatomical location, statistically significant changes were recorded in the head, hands, axillas, and soles (p < 0.001). CONCLUSIONS: Bilateral upper thoracic sympathicolysis is followed by redistribution of body perspiration, with a clear decrease in the zones regulated by mental or emotional stimuli, and an increase in the areas regulated by environmental stimuli, though we are unable to establish the etiology of this redistribution.

[Results of high bilateral endoscopic thoracic sympathectomy and sympatholysis in the treatment of primary hyperhidrosis: a study of 1016 procedures]. / Resultados de la simpaticólisis y la simpatectomía torácica superior bilateral endoscópica en el tratamiento de la hiperhidrosis primaria. Estudio de 1.016 procedimientos.

OBJECTIVE: Thoracic sympatholysis and sympathectomy are the current standard treatments for primary hyperhidrosis. In this study, we evaluated the incidence of peri- and postoperative complications associated with these procedures. PATIENTS AND METHODS: From 1996 to 2004, 520 consecutive patients (364 women), with a mean age of 26.8 years, were treated for primary hyperhidrosis at our hospital. The procedure was bilateral in all but 24 cases. The 484 patients in the sympatholysis group underwent a single intervention while the 36 patients in the sympathectomy group underwent 2 separate interventions. RESULTS: No deaths occurred. Anhidrosis of the target area was achieved in 97.6% of patients while 2.2% experienced hypohidrosis. In 0.2% of the cases, the procedure was initially unsuccessful and a second intervention was required. The mean duration of hospital stay was 72 hours for patients in the sympathectomy group and 17 hours for the sympatholysis group. Serious intraoperative complications requiring conversion to thoracotomy were recorded in 0.2% of patients. Postoperative complications--of which pneumothorax was the most common--occurred in 5.2% of the cases (in 22.5% of the sympathectomy group and 3.55% of the sympatholysis group). Compensatory hyperhidrosis occurred in 48.4% of the patients, excessive dryness of the hands and palpebral ptosis in 0.38%, and gustatory sweating in 0.9%. The degree of patient satisfaction was quite high (88.5%) and only 2.3% were very unsatisfied. CONCLUSIONS: Given the results obtained, we can conclude that both sympatholysis and sympathectomy are appropriate treatments for hyperhidrosis. Nonetheless, because sympatholysis is both easier to perform and less aggressive, we consider it the treatment of choice for primary hyperhidrosis.

Resultados de la simpaticólisis y la simpatectomía torácica superior bilateral endoscópica en el tratamiento de la hiperhidrosis primaria. Estudio de 1.016 procedimientos / Results of high bilateral endoscopic thoracic sympathectomy and sympatholysis in the treatment of primary hyperhidrosis: a study of 1016 procedures

Objetivo: La simpaticolisis y la simpatectomía torácica son actualmente los tratamientos habituales de la hiperhidrosis primaria. En este estudio evaluamos la incidencia cuantitativa y cualitativa de las complicaciones peri y postoperatorias. Pacientes y métodos: Desde 1996 a 2004 se intervino consecutivamente a 520 pacientes (364 mujeres) con hiperhidrosis primaria, con una edad media de 26,8 años. En todos, excepto en 24 casos, el procedimiento fue bilateral. La intervención se realizó en un tiempo en 484 pacientes (simpaticólisis) y en 2 tiempos en 36 (simpatectomía). Resultados: No hubo mortalidad. La anhidrosis del territorio deseado fue del 97,6%, se apreció hipohidrosis en el 2,2% y hubo un 0,2% de fallos que requirieron reintervención. La estancia media fue de 72 h en el grupo de simpatectomía y de 17 h en el de simpaticólisis. Se registró un 0,2% de complicaciones intraoperatorias mayores con reconversión a toracotomía. Se produjo un 5,2% de complicaciones postoperatorias (un 22,5% en las simpatectomías y un 3,55% en la simpaticólisis), de las cuales el neumotórax fue la más frecuente. Se observó hiperhidrosis compensadora en un 48,4% de los casos, sequedad excesiva de manos y ptosis palpebral en el 0,38%, e hiperhidrosis gustativa en un 0,9% de casos. El grado de satisfacción fue muy elevado (88,5%) y sólo un 2,3% de los pacientes se manifestaron muy insatisfechos. Conclusiones: De los resultados obtenidos se deduce que tanto la simpaticolisis como la simpatectomía son tratamientos adecuados de la hiperhidrosis, si bien la mayor sencillez y menor agresividad de la primera nos llevan a considerarla el tratamiento de elección en la hiperhidrosis primaria

Objective: Thoracic sympatholysis and sympathectomy are the current standard treatments for primary hyperhidrosis. In this study, we evaluated the incidence of peri- and postoperative complications associated with these procedures. Patients and methods: From 1996 to 2004, 520 consecutive patients (364 women), with a mean age of 26.8 years, were treated for primary hyperhidrosis at our hospital. The procedure was bilateral in all but 24 cases. The 484 patients in the sympatholysis group underwent a single intervention while the 36 patients in the sympathectomy group underwent 2 separate interventions. Results: No deaths occurred. Anhidrosis of the target area was achieved in 97.6% of patients while 2.2% experienced hypohidrosis. In 0.2% of the cases, the procedure was initially unsuccessful and a second intervention was required. The mean duration of hospital stay was 72 hours for patients in the sympathectomy group and 17 hours for the sympatholysis group. Serious intraoperative complications requiring conversion to thoracotomy were recorded in 0.2% of patients. Postoperative complications--of which pneumothorax was the most common--occurred in 5.2% of the cases (in 22.5% of the sympathectomy group and 3.55% of the sympatholysis group). Compensatory hyperhidrosis occurred in 48.4% of the patients, excessive dryness of the hands and palpebral ptosis in 0.38%, and gustatory sweating in 0.9%. The degree of patient satisfaction was quite high (88.5%) and only 2.3% were very unsatisfied. Conclusions: Given the results obtained, we can conclude that both sympatholysis and sympathectomy are appropriate treatments for hyperhidrosis. Nonetheless, because sympatholysis is both easier to perform and less aggressive, we consider it the treatment of choice for primary hyperhidrosis

Thoracic sympathicolysis for primary hyperhidrosis: a review of 918 procedures.

BACKGROUND: Bilateral upper thoracic sympathectomy or sympathicolysis, currently the standard treatment for palmar or axillary hyperhidrosis, is regarded as a safe procedure. This study evaluates the quantitative and qualitative incidence of intraoperative and postoperative complications resulting from bilateral thoracic sympathicolysis. METHODS: From 1996 to 2004, 458 consecutive patients with primary hyperhidrosis underwent surgery. These patients comprised 143 men (31.2%) and 315 women (68.7%) with a mean age of 26 years (range, 14-52 years). In all but seven cases, the procedure was bilaterally synchronous. RESULTS: No mortality was recorded. The anhydrosis rate was 97.4%, with a hypohidrosis rate of 2.4% and a failure rate of 0.2%. The latter was resolved with reintervention. The mean hospital stay was 17 h. The rate of major perioperative complications with conversion to thoracotomy was 0.4%. The overall rate of postoperative complications was 3.6%. The complications and rates observed were as follows: pneumothorax (2.06%), subcutaneous emphysema (1.08%), pleural bleeding (0.2%), hemothorax (0.1%), and atelectasis (0.1%). Compensatory hyperhidrosis was observed in 48.4% of the patients, but the sensation of compensatory hyperhidrosis was reported in 85.6% of the cases. Excessive dryness of the hands was reported in 0.38%, Horner's syndrome in 0.32%, and gustatory hyperhidrosis in 1.1% of the cases. The overall satisfaction rate was 88.5%. CONCLUSIONS: The results suggest that endoscopic bilateral thoracic sympathicolysis is an effective method for managing primary hyperhidrosis, especially severe palmar hyperhidrosis, but it is necessary to inform patients fully concerning the undesirable effects.

[Primary hyperhidrosis and anxiety: a prospective preoperative survey of 158 patients]. / Hiperhidrosis primaria y ansiedad: estudio prospectivo preoperatorio de 158 pacientes.

OBJECTIVE: To determine the location of hyperhidrosis, the accompanying signs and symptoms, and patient anxiety assessed on 2 scales and standardized psychometric instruments. PATIENTS AND METHODS: A prospective study of patients with hyperhidrosis was carried out between September 1, 2001 and June 30, 2003 with a self-administered preoperative questionnaire. The variables studied included the location of hyperhidrosis, the accompanying signs and symptoms, and the self-reported degree of anxiety and perception of its effect on daily life assessed by the State-Trait Anxiety Inventory (STAI) and a questionnaire designed in our department. RESULTS: Palmar hyperhidrosis was reported by 93.6% of patients, plantar by 70.2%, axillary by 66.4%, facial by 12.1%, groin by 8.2%, chest by 5%, and abdominal by 2%. While more than 50% of the patients reported facial blushing and palpitations as accompanying signs and symptoms, approximately 30% experienced epigastric pain, trembling, and headaches. Over half of the patients reported that their anxiety was incapacitating, and a mere 1.2% experienced none at all. STAI scores were similar to those of the general population whereas scores on our department's questionnaire reflected those of the self-reported anxiety ratings. CONCLUSIONS: Primary hyperhidrosis is a disorder in which excessive sweating occurs mainly, but not exclusively, on the palms. The condition is accompanied by signs and symptoms typical of autonomic nervous system hyperactivity and by a degree of anxiety that has an incapacitating effect on normal life, although that anxiety is not detected by the STAI questionnaire alone.

Hiperhidrosis primaria y ansiedad: estudio prospectivo preoperatorio de 158 pacientes / Primary hyperhidrosis and anxiety: a prospective preoperative survey of 158 patients

OBJETIVO: Determinar la localización de la hiperhidrosis, la clínica acompañante y la ansiedad que refieren los pacientes tanto subjetivamente como mediante instrumentos psicométricos estandarizados. PACIENTES Y MÉTODOS: Estudio prospectivo realizado entre el 1 de septiembre de 2001 y el 30 de junio de 2003 mediante una encuesta autoadministrada preoperatoria a los pacientes con hiperhidrosis. Las variables de estudio fueron: localización de la hiperhidrosis, clínica acompañante, ansiedad subjetiva y percepción de ésta en la vida diaria mediante el cuestionario Escala de Ansiedad Estado-Rasgo (STAI) y un cuestionario elaborado por nuestro servicio. RESULTADOS: La localización de la hiperhidrosis fue palmar en el 93,6% de los pacientes, plantar en el 70,2%, axilar en el 66,4%, facial en el 12,1%, inguinal en el 8,2%, pectoral en un 5% y abdominal en un 2%. En cuanto a la clínica acompañante, el enrojecimiento facial y las palpitaciones superaban el 50%, mientras que alrededor de un 30% presentaba epigastralgia, temblor y cefalalgia. En cuanto a la ansiedad subjetiva, más de la mitad de los pacientes presentaban ansiedad incapacitante y sólo el 1,2% no la experimentaban en ningún grado. Según el STAI, los valores obtenidos reflejaban un paralelismo con la población general, mientras que nuestro cuestionario reflejó la ansiedad autorreferida. CONCLUSIONES: La hiperhidrosis primaria es un trastorno que cursa principalmente con hipersudación palmar, aunque no de forma exclusiva. Se acompaña de clínica típica de hiperactividad del sistema vegetativo y un grado de ansiedad que incapacita para llevar una vida normal y que, sin embargo, no se detecta mediante el cuestionario STAI

OBJECTIVE: To determine the location of hyperhidrosis, the accompanying signs and symptoms, and patient anxiety assessed on 2 scales and standardized psychometric instruments. PATIENTS AND METHODS: A prospective study of patients with hyperhidrosis was carried out between September 1, 2001 and June 30, 2003 with a self-administered preoperative questionnaire. The variables studied included the location of hyperhidrosis, the accompanying signs and symptoms, and the self-reported degree of anxiety and perception of its effect on daily life assessed by the State- Trait Anxiety Inventory (STAI) and a questionnaire designed in our department. RESULTS: Palmar hyperhidrosis was reported by 93.6% of patients, plantar by 70.2%, axillary by 66.4%, facial by 12.1%, groin by 8.2%, chest by 5%, and abdominal by 2%. While more than 50% of the patients reported facial blushing and palpitations as accompanying signs and symptoms, approximately 30% experienced epigastric pain, trembling, and headaches. Over half of the patients reported that their anxiety was incapacitating, and a mere 1.2% experienced none at all. STAI scores were similar to those of the general population whereas scores on our department’s questionnaire reflected those of the self-reported anxiety ratings. CONCLUSIONS: Primary hyperhidrosis is a disorder in which excessive sweating occurs mainly, but not exclusively, on the palms. The condition is accompanied by signs and symptoms typical of autonomic nervous system hyperactivity and by a degree of anxiety that has an incapacitating effect on normal life, although that anxiety is not detected by the STAI questionnaire alone

[Compensatory sweating after upper thoracic sympathectomy. Prospective study of 123 cases]. / Sudación compensatoria secundaria a la simpaticólisis torácica superior. Estudio prospectivo de 123 casos.

OBJECTIVE: The most unpleasant consequence of upper thoracic sympathectomy is compensatory sweating (CS). De-pending on the series, the incidence of CS ranges from 24% to 85%. The aim of this study was to determine the relation between CS and the following factors: distribution of hyperhidrosis, procedure performed (unilateral, synchronic bilateral, or sequential bilateral), and number of sympathetic ganglia eliminated. In addition, the degree of patient satisfaction was recorded as objectively as possible. PATIENTS AND METHODS: Prospective study of 123 patients who underwent upper thoracic sympathectomy for palmar and/or axillary hyperhidrosis between 1 January, 1996 and 1 June, 2002 at our unit. All patients completed a questionnaire on symptoms 8 weeks before and after surgery to deter-mine postoperative changes in distribution of the hyperhidrosis and the overall degree of satisfaction on a scale of 0 to 4. RESULTS: The sensation of CS was reported by 86.1% of the patients. When asked to relate this sensation to changes in sweating intensity in specific parts of the body, 46.54% reported CS and 48.37% no change. The trunk was the only region where statistically significant increases in CS occurred; in the feet, a decrease in sweating was noted. No differences in CS were observed with respect to the type of surgery or the number of sympathetic ganglia eliminated. The overall results were considered very satisfactory or quite satisfactory by 84.55% of the patients, while 4.88% were very dissatisfied. CONCLUSIONS: Although CS is a side effect of upper thoracic sympathectomy, not all patients are affected by it. Significant CS occurs mainly in the back, chest, and abdomen. Neither the type of intervention nor the number of ganglia eliminated has an effect on CS. This side effect notwithstanding, overall satisfaction with the treatment is very satisfactory given that the palmar hyperhidrosis is eliminated.

In search of a biological pattern for human longevity: impact of apo A-IV genetic polymorphisms on lipoproteins and the hyper-Lp(a) in centenarians.

We studied centenarians to investigate the biological basis of human longevity focusing on the apolipoprotein A-IV and lipoprotein(a), potentially involved in the susceptibility to atherogenic mechanisms. We analyzed two restriction polymorphisms, HinfI347 (alleles +, -) and Fnu4HI360 (alleles 1, 2), and a VNTR (alleles 3, 4) at the 3' region of the apo A-IV gene. The allele frequencies, the lipoprotein concentrations and their association in centenarians and adults have been compared. In centenarians, the HinfI genotype distribution is different (P < 0.05) and the (+13) haplotype is prevalent (0.54 vs. 0.39), with a greater association of (+3), indicating the selection of a favourable allele. The lipoprotein modulation by the apo A-IV polymorphisms is suggested by significant associations in adults ((+/+) homozygotes have lower LDL-cholesterol and apo B than heterozygotes; (1/1) homozygotes have higher TG and apo B than heterozygotes), that in centenarians still exists as a trend. Centenarians show peculiar lipoprotein features: lower LDL-cholesterol (mean 103 vs. 115 mg/dl; P < 0.02), and higher lipoprotein(a) (median 17.5 vs. 4.5; P < 0.002). Large part of them (47%), especially the Hinf(+/+) and the (+13) homozygotes, have a lipoprotein(a) > 20 mg/dl, value considered as the threshold for atherogenic risk, surprisingly compatible with healthy longevity.

A new Italian case of lipoprotein lipase deficiency: a Leu365- > Val change resulting in loss of enzyme activity.

We describe a second Italian family with primary Lipoprotein Lipase deficiency. A new mutation in exon 8 causes a Leu365- > Val change resulting in severe mass reduction and loss of enzyme activity. We suggest that this change interferes with the correct folding and stability of the protein and impairs the assembly of the active homodimer. The procedures applied are useful to screen a large sample of population for genetic variants and allow the clear identification of asymptomatic heterozygous subjects at risk from atherosclerosis disease.

[AIDS and the community. Preliminary data of an epidemiological study]. / A.I.D.S. e comunità. Dati preliminari di uno studio epidemiologico.

An epidemiological study into the prevalence and incidence of anti-H.I.V. antibody seropositivity in closed communities produced preliminary data on 746 subjects, the majority of whom admitted potentially dangerous behaviour. These results demonstrated that residence in a closed community in which one can limit the use of drugs and sexual contacts reduces the risk of infection.