Low levels of endogenous estradiol protect bone mineral density in young postmenopausal women.

OBJECTIVE: Low levels of endogenous estrogens may play a role in the protection of bone mineral density (BMD) in healthy postmenopausal women. The aim of this study was to evaluate the effect of endogenous estradiol and testosterone on bone mass in young and older healthy postmenopausal women. METHODS: The study involved 99 postmenopausal women aged 55-75 years. The BMDs of the lumbar spine, proximal femur and total skeleton were determined. Measurements were taken of serum calcium, bone alkaline phosphatase, Crosslaps, estradiol, estrone, sex hormone binding globulin, testosterone, bioavailable testosterone and urine calcium. Estradiol was measured using a sensitive assay with a lower detection limit at 5 pg/ml. RESULTS: A multivariate analysis showed that the BMD of the lumbar spine was significantly predicted by estradiol (p < 0.05), and testosterone (p < 0.0001). Likewise, testosterone was found to be an independent predictor of the BMD of the total femur (p < 0.001) and the total skeleton (p < 0.001). The population was divided into two groups: < or = 65 (Group 1) and > 65 years (Group 2) of age and also stratified according to estradiol levels: > 10 and < or = 10 pg/ml. Significant differences in BMD were found in women in Group 1 in whom estradiol levels higher than 10 pg/ml were associated with a higher BMD of the lumbar spine (+ 14%, p < 0.01), proximal femur (+ 6%, p < 0.05) and total skeleton (+ 7%, p < 0.05) compared with women with estradiol levels below 10 pg/ml. Bone alkaline phosphatase levels (p < 0.05) and serum Crosslaps (not significant) were lower in women in Group 1 with a level of estradiol more than 10 pg/ ml. CONCLUSION: Endogenous estradiol levels higher than 10 pg/ml and testosterone protected bone mass in healthy postmenopausal women under 65 years of age. These results were not observed in the group of older women.

Working memory interference control deficit in children referred by teachers for ADHD symptoms.

It has been hypothesised that children with Attention Deficit/Hyperactivity Disorder (ADHD) present memory problems, including working memory deficits. This research is aimed at finding clearer evidence of a working memory deficit in these children. In the first study 22 children that had been referred by teachers as having ADHD symptoms were compared with a control group. Their performance on a listening span test, drawn up by De Beni, Palladino, Pazzaglia, and Cornoldi (1998), was investigated. In this task the subjects were asked to select the names of animals in word strings and to remember the last word in each string. In a second study, 34 children with ADHD symptoms and 50 control children were presented with a visuospatial working memory task mirroring the verbal task used in Study 1. In both studies, the children with ADHD symptoms had difficulty in remembering the last item in the string and had a higher number of intrusions when memorising items that were not in the final position. The results were interpreted that children with ADHD symptoms have working memory problems because they are not capable of suppressing information that initially has to be processed, and subsequently excluded from memory. This particular difficulty can be interpreted as an inhibitory processing deficit. The implications of the results in understanding learning difficulties in children with ADHD are discussed.

Modulation of spatial alternation and anxiety by septal scopolamine systemic diazepam in mice.

To investigate the behavioral consequences of benzodiazepines in subjects whose septo-hippocampal cholinergic (ACh) activity was impaired, C57BL/6 mice received an injection of 2.5 microg/0.2 microl of scopolamine into the medial septal area with an i.p. injection of 0.5 mg/kg of diazepam. The consequences of these treatments administered in combination or alone were evaluated on anxiety measured in an elevated plus-maze and on spontaneous alternation carried out in a T-maze, using two different intertrial intervals (ITI: 5s or 30s). In these conditions, only the combined treatment provoked a decrease of the anxiety level, which was associated with an impairment of spontaneous alternation restricted to the 5s ITI. Because mice were not impaired during the sequential 30s ITI, this seems to rule out the possibility that this alternation deficit resulted from a working memory loss. These results suggest an involvement of a septal ACh-GABA-A/BDZ interaction in the exaggeration of cognitive deficits produced by benzodiazepines in patients characterized by a cholinergic hypofunction.

Consequences of selective blockade of septal noradrenergic afferents on anxiety and spatial working memory performance in mice.

This experiment was designed to investigate the role of septal noradrenergic (NA) afferents in the control of anxiety and spatial working memory. To this end, C57Bl/6 mice were infused bilaterally into the lateral septal nuclei with 500 ng/0.2 microliter of BE 2254, a selective alpha 1 postsynaptic adrenoceptor antagonist. The consequences of this reversible treatment were evaluated 20 min later on the anxiety level measured in an elevated plus-maze and on spatial working memory, evaluated under four different conditions via the learning of a delayed nonmatching to place (DNMTP) rule achieved in an eight-arm radial maze. In these conditions, the BE 2254, as well as the saline-injected control group, showed an elevation of the anxiety level that may be the indirect expression of a nonspecific septal dysfunction induced by the vehicle injection rather than the normal behavioral response produced by the decrease of septal NA activity. This septal dysfunction also impaired spatial working memory but only when mnesic difficulty of the task is increased, suggesting that this impairment expresses a general memory deficit rather than a working memory deficit per se. A lack of spatial working memory deficits in BE 2254 or saline-injected animals was also observed in two other conditions of the behavioral protocol. However, when treatments were applied before the first exposure of animals to the radial maze (exploration session), only the group which received BE 2254 was impaired during the acquisition session for the rule performed 24 h later. This delayed perturbation seems to be linked, at this stage of the learning procedure, to the lack of NA-dependent processes taking place during the exploration session. Taken together, these data suggest that septal NA mechanisms are more essential at initial stage of this learning, when animals process new features of the situation, than during the expression of spatial working memory per se.

[Effects of bicarbonated-alkaline water (Uliveto) on gastric and gallbladder emptying in normal subjects. Ultrasonic evaluation]. / Effetti di un'acqua bicarbonato-alcalina (Uliveto) sullo svuotamento gastrico e colecistico nel soggetto normale. Valutazione ecotomografica (ETG).

In 10 healthy patients gastric and gallbladder emptying after a standard meal (800 cal, 60% glucides, 20% protides, 20 lipids) associated with 400 ml alkaline bicarbonated water or tap water were evaluated by ultrasonography. An increase of gastric emptying was noted after alkaline bicarbonated water versus tap water with significant differences at 30' (p less than 0.05), 60' (p less than 0.01) and 120' (p less than 0.05). No significant differences exist in final gastric emptying time. Alkaline bicarbonated water induced less intensive gallbladder emptying with statistical difference versus tap water at 60' and 120' from the standard meal (p less than 0.01).

[Experience with regard to the use of plasmapheresis in pathologies of resuscitative importance]. / Esperienza riguardo all'uso della plasmaferesi in patologie di interesse rianimatorio.

After a report on the basic techniques and clinical significance of plasmapheresis, personal experience of the application of the technique on 6 patients with various pathologies is described. The overall results were satisfactory.

Is tubal rupture a discriminating factor in the surgical conservative treatment of ectopic pregnancy?

217 women have been submitted to a surgical intervention for ectopic pregnancy in the years 83 - 84 - 85 in five hospitals in Piedmont. The rupture has been observed in 147 cases (67%). The percentage of women who presented a rupture was higher among those who underwent annexiectomy (75%), average among those who underwent salpingectomy (69%) and lower in case of conservative intervention (52%). Owing to these rather high percentages, we cannot state that the rupture is a discriminating factor as far as it concerns the choice of intervention, even if a fairly more conservative orientation is evident in case of unruptured tube.

Ectopic pregnancy: which treatment? Analysis of 217 cases.

The Authors describe the various types of treatment performed on 217 cases of ectopic pregnancy examined, which took place in the years 1983 - 84 - 85 in five among the main Hospital in Piedmont. 136 salpingectomies (62%), 41 annexiectomies (18%), 40 conservative interventions (20%) were performed. In most cases the destructive intervention was performed in the presence of a tubal rupture; no meaningful relations between the location and the type of surgical treatment have been found in the ectopic pregnancy. Conservative interventions have been more frequent on young women (under 35: 97%) and desiring children either because nullipara (65%) or because uniparous (27%). The highest number of conservative interventions was performed in the largest of the five Hospitals examined (23 cases: 57%). There is therefore a remarkable relation between diagnostic and therapeutic means and the possibility of performing the surgery most appropriate to the specific requirements of each case.

Comparative evaluation of ectopic pregnancy surgical treatment between a specialized hospital and a general hospital.

The surgical approaches followed in cases of ectopic pregnancy by the operators in two centres in Piedmont, one specialized in ostetrics and gynecology, the other a general county hospital are taken into consideration and compared. 131 cases have been registered in Turin and 30 in Biella. The salpingectomy has been performed on most cases in both centres with 56.5% and 66% respectively in the specialized Hospital and in the General one. The annexiectomy has been chosen for 25%. The intervention aiming at preserving the tube has been chosen for 17.5% in Turin and 34% in Biella. The most discriminating factor in choosing the type of intervention is mainly based on the patient's amnestic history, and therefore on her age, parity, any preceeding tube intervention and also on her desire for children.

[Between safety and risk: the propensities and resistance to prevention in the daily behavior of adolescents]. / Fra sicurezza e rischio: propensioni e resistenze alla prevenzione nel comportamento quotidiano degli adolescenti.

Various levels of awareness and attitudes in 2500 High School students regarding prevention of daily risk were examined before and after a special training program on prevention (promoted by the Clinica del Lavoro della Università di Pavia). The concept of prevention was examined in four analytical realms, through questionnaire and projective tests: actual notion, cognitive organization of knowledge, emotional level, social approval. The data collected showed that the tendency towards prevention of risk is limited in adolescents: from a cognitive point of view, since the conceptual probability of risk is comprehended with difficulty; emotionally, since risk-producing behavior usually provides gratification at various levels; socially, since adolescent usually views risk-producing behavior as associated with a positive social image. The informative training session proved to effectively orient the students towards a more rationally controlled behavior, therefore favoring a more positive attitude towards prevention.

Almohadillas articulares (knuckle pads). / Articular knuckle (knuckle pads)

Se presenta un caso de almohadillas articulares primarias con asiento en manos y pies en un paciente de 22 anos de edad. Es tratado con infiltraciones con corticoides sin resultados positivos. Se realizan comentarios con respecto a su clinica e histopatologia

Almohadillas articulares (knuckle pads). / Articular knuckle (knuckle pads)

Se presenta un caso de almohadillas articulares primarias con asiento en manos y pies en un paciente de 22 anos de edad. Es tratado con infiltraciones con corticoides sin resultados positivos. Se realizan comentarios con respecto a su clinica e histopatologia