Autoxidation of packed almonds as affected by maillard reaction volatile compounds derived from roasting.

Shelled almonds of two Italian varieties, Romana and Pizzuta, peeled and unpeeled, were roasted and packed under different conditions: air (control), vacuum, and Maillard reaction volatile compounds (MRVc) derived from the roasting process. Samples were stored for approximately 8 months at room temperature, without light, and, at regular intervals, were collected and analyzed to evaluate the progress of lipid oxidation. Peroxide values, triglyceride oligopolymers, and oxidized triglycerides were evaluated during the storage time. Results showed that, although the MRVc atmosphere did not protect the lipid fraction of almonds as well as the vacuum condition; nevertheless, it was more protective than the control atmosphere, showing an antioxidant effect. The effect of the natural coating was a strong protection against lipid oxidation; in fact, only the unpeeled samples showed peroxide values lower than the threshold of acceptability (25 milliequiv of O(2)/kg of oil). Moreover, at the end of the storage period, Pizzuta almonds showed a greater deterioration than those of the Romana variety.

Is interferon a useful treatment for virus C cirrhosis?

The authors have reviewed the recent literature on the usage of interferon alpha and beta with patients affected by liver cirrhosis caused by HCV. Broad wide surveys, consisting of ten trials, met the criteria for inclusion in the study. The following points were considered: the degree of complete response (transaminase normalization); complete follow-up response; viremia clearance. Interferon alpha was used in 9 cases out of 10, while interferon beta was used in one case only, with variable dosage and different time of administration, according to the different studies. A total of 539 patients affected by chronic hepatitis or cirrhosis were examined. 245 of them were affected by chronic cirrhosis: the response was complete in 65 patients out of 245 examined (26%), while 17 of 245 (7%) had a limited response. The clearance of viremia, in those studies where this value was reported, was noted in no more than 75% of the responders. The best results were achieved in those cases where it had been possible to use higher dosages of IFN (up to 6 MU x 3) and for a period of more than 12 months, without causing noteworthy side effects. The low percentage of patients with a limited response (7%) should not dissuade from using IFN. In accordance with significant recent reports, in several cases this therapy would lead to a slowing down of the histological progression of the disease and even to a decrease in the percentage of hepato-carcinoma developments, consequently resulting in a longer life for the patient and in less need of hospitalization. These results could justify the use of interferon even though it is a very expensive treatment.

Subclinical peripheral nerve involvement in patients with rheumatoid arthritis.

OBJECTIVE: Clinical involvement of the peripheral nervous system is uncommon in rheumatoid arthritis (RA); the most common disorders are multiple mononeuritis, sensorimotor neuropathy, and entrapment neuropathy. This study was undertaken to investigate the occurrence of electrophysiologically evident peripheral nerve involvement in RA patients without a clinical history of peripheral nerve involvement. METHODS: Forty RA patients were examined neurologically and electrophysiologically, and sural nerve biopsies were performed in 4. RESULTS: No patient reported symptoms or signs of peripheral nerve involvement. Twenty-six patients (65%) exhibited electrophysiologic findings consistent with a sensorimotor neuropathy (in 2 of them a carpal tunnel syndrome was also present), while 3 patients showed isolated carpal tunnel syndrome. There was a moderate loss of myelinated fibers in 3 of the 4 nerve biopsy samples, and all showed an increased number of endo- and perineurial vessels and some signs of axonal degeneration. CONCLUSION: Patients with RA may have electrophysiologic and histologic findings of peripheral nerve damage, even in the absence of clinical evidence of peripheral nerve involvement.

[Disseminated tuberculosis with cutaneous manifestations in AIDS patients. Presentation of 4 cases]. / Tuberculosis diseminada con manifestaciones cutáneas en pacientes con SIDA. A propósito de 4 observaciones.

BACKGROUND: Acute cutaneous miliary tuberculosis is a rare form of Mycobacterium tuberculosis infection which has been described in only 25 published cases in the last 15 years. The appearance of serious disseminated forms of tuberculosis is enhanced by the severe immunodeficiency which characterizes AIDS. METHODS: Four cases are described of disseminated tuberculosis with cutaneous localization clinically described as the acute miliary form. Patients had AIDS and CD4 lymphocyte levels of < 100 cells/mm3. Diagnosis was established in all cases by scraping of cutaneous lesions and direct examination with Ziehl-Neelsen coloration. RESULTS: The 4 patients presented signs and symptoms of disseminated tuberculosis with cutaneous manifestations, without a definite pattern and with localization predominantly on the thorax. Three had BAAR-positive sputum. Multiresistant strains of Mycobacterium tuberculosis were confirmed by antibiogram. One patient infected by a strain sensitive to first-line drugs responded favorably to conventional treatment for disseminated tuberculosis. In the remaining three with multiresistant strains, the evolution of the disease was rapid and unfavorable. CONCLUSIONS: Abrupt appearance of cutaneous lesions in a patient with disseminated tuberculosis and advanced HIV-disease should raise the suspicion of its etiology. Scraping and direct examination using Ziehl-Neelsen coloration is practical, economical and non-invasive diagnostic method.

Infección por Enterocytozoon bieneusi en un paciente con SIDA y diarrea crónica / Enerocytozoon bieneusi in a patient with AIDS and chronic diarrhea

Expone el caso clínico de un paciente de 37 años, de sexo masculino, con serología positiva para el VIH-1 y diarrea crónica, en el cual se identificó el Enterocytozoon bieneusi a través de las técnicas recomendadas para su diagnóstico. Enumera las especies identificadas de microsporidias asociadas a patologías en humanos, tanto intestinales como extraintestinales. El caso presentado constituiría la primera identificación fidedigna de una microsporidia en la Argentina por lo que se recomienda buscar estos patógenos a través de las técnicas de diagnóstico recomendadas en pacientes con SIDA y diarrea crónica o compromiso de la vía biliar en forma de colangitis

Infección por Enterocytozoon bieneusi en un paciente con SIDA y diarrea crónica / Enerocytozoon bieneusi in a patient with AIDS and chronic diarrhea

Expone el caso clínico de un paciente de 37 años, de sexo masculino, con serología positiva para el VIH-1 y diarrea crónica, en el cual se identificó el Enterocytozoon bieneusi a través de las técnicas recomendadas para su diagnóstico. Enumera las especies identificadas de microsporidias asociadas a patologías en humanos, tanto intestinales como extraintestinales. El caso presentado constituiría la primera identificación fidedigna de una microsporidia en la Argentina por lo que se recomienda buscar estos patógenos a través de las técnicas de diagnóstico recomendadas en pacientes con SIDA y diarrea crónica o compromiso de la vía biliar en forma de colangitis

Median nerve sensory responses evoked by tactile stimulation of the finger proximal and distal phalanx in normal subjects.

We compared the characteristics of near-nerve recorded sensory potentials elicited in response to electrical stimulation of digital nerves versus tactile stimulation of the digital skin in 17 healthy subjects with a mean age of 26 years. We also calculated the density of Meissner's corpuscles in the distal and proximal phalanx of digit III of 6 males who had suffered a violent death, but were free from diseases of the peripheral nerve system. Responses to tactile stimulation had a longer latency and lower amplitude than responses to electrical stimulation. Unlike electrically elicited responses, responses to tactile stimulation, which consisted of six or seven main spike components plus several minor components, were similar in recordings from the wrist and elbow. However, with proximal stimulation the electrically evoked responses were more compact and had a higher amplitude and area, whereas the tactile evoked potential became significantly reduced in maximum amplitude and cumulative area. The differences in sensory conduction between distal and proximal could reflect activation of a larger number of nerve fibers when electrical stimuli are used and a smaller amount of mechanoreceptors when tactile stimuli are used.

Sensory nerve findings by tactile stimulation of median and ulnar nerves in healthy subjects of different ages.

We studied orthodromic sensory conduction velocity along the distal and proximal segments of the median and ulnar nerves by tactile stimulation of the distal phalanx of the 3rd and 5th digits in 44 healthy subjects divided into 2 age groups: from 16 to 35 years and from 63 to 81 years. In the same nerves, we used selective electrical stimulation of the corresponding digital nerves to obtain sensory potentials. In both groups, responses to tactile stimuli had a longer latency and smaller amplitude than those to electrical stimulation, and they were distributed in a series of 6-7 main deflections, apparently regardless of whether the recording site was distal or proximal. Moreover, irrespective of the nerve and of subject age, conduction velocity along both the digit-wrist and the wrist-elbow nerve segments was significantly slower with tactile stimuli than with electrical stimuli. However, independently of the stimulus used, conduction velocity along the proximal nerve segment was significantly faster than that measured along the digit-wrist nerve segment. In both the median and ulnar nerves, maximum potential amplitude, cumulative area and conduction velocity were significantly reduced in the older age group. This finding could reflect the smaller number of Meissner's corpuscles in older subjects, and the loss of large nerve fibres in individuals over 60.

The relationship between electrophysiological findings, upper limb growth and histological features of median and ulnar nerves in man.

In 19 median and 10 ulnar nerves of 28 healthy young volunteers, the maximum orthodromic sensory conduction velocity was studied along one or two fingers (the third and/or the fifth), the palm, and the forearm. In five 20 to 32-yr-old males and in a newborn male, post-mortem samples of either the median or the ulnar nerve were obtained from the finger (either the third or the fifth), the palm, the wrist and the forearm in order to study the size distribution of external fibre and axon diameters, and the fibre internodal length. In 2374 infants, children and adolescents, the height, length of both the third and the fifth finger, length of the palm, and length of the forearm were measured. The results showed (i) a significantly slower conduction velocity along the fingers; (ii) a significantly shorter internodal length without remarkable fibre diameter changes in the same nerve segments; (iii) a significantly smaller elongation of these body parts; (iv) a significant correlation between these data. In conclusion, internodal length seems to play an important role in governing conduction velocity of myelinated peripheral nerve fibres.

Electrophysiological and histological follow-up study in 15 Friedreich's ataxia patients.

A clinical and electrophysiological follow-up was carried out for 3 to 7 years on 15 patients with Friedreich's ataxia (FA). Sural nerve biopsy was performed once in all patients, and a second time 6-7 years later in three of them. Clinical worsening and progression of disturbance were evaluated according to IAP and IACR scales. Sensory orthodromic conduction along median and tibial nerves was typical of FA and did not change between first and last examinations, nor were there morphological changes between the first and the second sural nerve biopsies. Peripheral nerve involvement is thought to be a result of defective development of the largest neurons and to remain stable from a very early stage of the disease; the clinical worsening may then be due to a progressive involvement of the pyramidal tracts and the cerebellar pathways.

[Influenza vaccination and polyradiculoneuritis of the Guillain-Barré type]. / Vaccinazione antinfluenzale e poliradicoloneurite a tipo sindrome di Guillan-Barré.

The Authors present a Guillain-Barré like case of polyradiculoneuritis occurring two weeks after the 1988-89 influenza vaccination. The existence of similar cases recently reported in the literature and their frequent association with swine influenza vaccination suggest the opportunity of a better epidemiological survey of similar cases.

Pernicious anemia, vitiligo and positive antiglobulin test: an unusual association.

The authors present the case of a patient with concomitant pernicious anemia and positive antiglobulin test. After discussing previous cases in the literature and pointing out the probably simultaneous occurrence of the two, the authors comment on the persistence of a positive antiglobulin test after remission of the pernicious anemia and the association with vitiligo, which has been sometimes described as associated with autoimmune hemolytic anemia and more often with pernicious anemia, but not with both. The patient also had diabetes mellitus and a persistently false positive test for syphilis.

Friedreich's ataxia: electrophysiologic and histologic findings in patients and relatives.

Peripheral nerve conduction velocity and cortical evoked potentials were investigated in 48 patients with Friedreich's disease and in 35 relatives. There were 14 patients and 2 relatives who underwent sural nerve biopsy. In the patients sensory conduction velocity was moderately slowed, whereas sensory responses were markedly reduced. Nerve biopsy showed a severe loss of large myelinated fibers and no demyelination. On teased nerve fiber preparations, most fibers presented uniformly short internodes. No correlation was seen between sensory conduction findings or histologic abnormalities and clinical disability. In patients SSEP changes, which were constant, and VEPs, which were frequently involved, were unrelated to the severity or duration of clinical disability. There were 14 relatives who showed clinical signs of Friedreich's disease. Slightly decreased distal conduction velocity along sensory fibers was observed in more than half of the relatives. Nerve biopsy was noncontributory. In conclusion, we could not determine whether the abnormalities observed in the siblings were an expression of a heterozygotic condition, or whether they were early signs of the disease.

Is the sensory neuropathy in ataxia-telangiectasia distinguishable from that in Friedreich's ataxia? Morphometric and ultrastructural study of the sural nerve in a case of Louis Bar syndrome.

The bioptical morphometric and ultrastructural study of sural nerve in a 17-year-old boy with ataxia-telangiectasia (AT) is reported. Our findings include a loss of fibers, particularly of large ones, axonal degenerative changes, Schwann cell inclusions of various type, and rare signs of primary demyelination. Teased-fiber study showed paranodal myelin enlargements, segmental demyelination, shortening, and/or variability of internodal length. This picture is similar to that in Friedreich's ataxia (FA), although they differ in degree and time of onset. A correct neuropathologic diagnosis of AT cannot be made on the basis of sural nerve biopsy alone.