The smokeless tobacco: a survey in a cohort of young Italians through a social-media questionnaire.

This observational survey aimed to demonstrate the use of the Snus kind of smokeless tobacco, among young Italian adults from alpine areas. A customized anonymous questionnaire was purposely created using the Google Forms platform and made it available for 4 weeks through social media supports to a cohort of young adults living in a mountain area in Italy. Out of four hundred recipients, 332 interviewees returned the survey. Participants had a mean age of 22.8, range 17-40 years. One hundred fifty regular consumers used Snus for more than 5 years. Gingival changes were reported in 92 subjects, associated with gingival bleeding in 14 subjects. 79 subjects reported discoloration of the mucosa. The 50% of the habitual users developed an addiction to Snus and 90% didn't smoke conventional cigarettes. In Italian young adults the use of Snus tobacco could be an adjunctive risk factor for the oral mucosa. It is essential to extend and spread the awareness about this addictive habit among dental professionals, to give to the patients a reliable and effective oral and systemic education.

Further discussion on dermatological radiotherapy.

Dermatological radiotherapy has used for decades in the treatment of skin diseases with very good results. The Florentine school has always played a fundamental role in the development of this technique, this is where a phototherapy institute, which was going, in the future, to be 1st one in Italy to perform contact radiotherapy regularly, started. As time went by and with the development to new therapeutical modalities, the roentgentherapy met with a decreasing consent. So far, it is still proposed as an effective therapeutically modality in dermatological oncology, if even in selected cases. Basal cell carcinomas can reach big dimensions mainly for recurrence or because the tumor was overlooked for a long time. We bring to attention the case of a 65-year-old man presenting an ulcerated, sharp-bordered, infiltrating and bleeding lesion, occupying most of the left wing of the nose, with a diameter of about 3 cm. The man hadn't received any previous treatment. The lesion was subjected to a biopsy and the istopathological analysis diagnosed an ulcus rodens. The man refused the complete surgical removal, and was thus treated with roentgentherapy, with satisfying results and without any complications in the irradiated area. The patient didn't show any relapse after one year of follow-up. Radiotherapy can still be considered as an effective therapeutical alternative both for lesion requiring a surgical approach and for those developing in patients that couldn't be subjected to any other therapies.

Long-term regeneration of fast and slow murine skeletal muscles after induced injury by ACL myotoxin isolated from Agkistrodon contortrix laticinctus (broad-banded copperhead) venom.

The aim of the present work was to analyze the regenerated muscle types I and II fibers of the soleus and gastrocnemius muscles of mice, 8 months after damage induced by ACL myotoxin (ACLMT). Animals received 5 mg/kg of ACLMT into the subcutaneous lateral region of the right hind limb, near the Achilles tendon; contralateral muscles received saline. Longitudinal and cross sections (10 microm) of frozen muscle tissue were evaluated. Eight months after ACLMT injection, both muscle types I and II fibers of soleus and gastrocnemius muscles still showed centralized nuclei and small regenerated fibers. Compared with the left muscle, the incidence of type I fibers increased in the right muscle (21% +/- 03% versus 12% +/- 06%, P = 0.009), whereas type II fibers decreased (78% +/- 02% versus 88% +/- 06%, P = 0.01). The incidence of type IIC fibers was normal. These results confirm that ACLMT induced muscle type fiber transformation from type II to type I, through type IIC. The area analysis of types I and II fibers of the gastrocnemius revealed that injured right muscles have a higher percentage of small fibers in both types I and II fibers (0-1,500 microm2) than left muscles, which have larger normal type I and II fibers (1,500-3,500 microm2). These results indicate that ACLMT can be used as an excellent model to study the rearrangement of motor units and the transformation of muscle fiber types during regeneration.

Injury and recovery of fast and slow skeletal muscle fibers affected by ACL myotoxin isolated from Agkistrodon contortrix laticinctus (Broad-Banded copperhead) venom.

The response of different types of skeletal muscle fibers to a snake venom PLA2 myotoxin was tested in vivo by injecting ACL myotoxin (ACLMT) into mice. Both the soleus (slow-twitch) and gastrocnemius (fast-twitch) were examined at different time periods (3 h, 3 and 21 d) after the injection. All animals received 5 mg/kg myotoxin into the subcutaneous lateral region of the right hind limb, near the Achilles tendon; contralateral muscles were used as controls. Cross-sections (10 microm) of frozen muscle tissue were cut from the medial region of the muscle. Alternate serial sections were stained either with toluidine blue or for acid phosphatase, myofibrillar ATPase activity after alkali (pH 10.3) or acid preincubation (pH 4.3), succinate dehydrogenase or acetylcholinesterase. Several stages of necrosis were observed 3 h after ACLMT injection, in both superficial and deep regions of both muscles. In these same regions 3 d after injection, clusters of regenerated muscle fibers were present, and some of them presented AChE activity. Twenty-one days after ACLMT injection the muscle fibers of soleus and gastrocnemius presented only chronic signs of damage such as split fibers and centralized nuclei. Using m-ATPase reactions it was possible to determine that both muscle fiber types I and II were injured in both muscles. The number of type IIC fibers was significantly increased, and the number of type II fibers significantly decreased in the gastrocnemius 21 d after ACLMT injection, suggesting a change in muscle fiber type from type II to type I, through type IIC. The increased number of type IIC fibers and the presence of AChE activity in clusters of regenerating fibers and split fibers indicate that injury by ACLMT produces axonal remodeling and muscle fiber type change.

Pharmacological profiles of fentanyl analogs at mu, delta and kappa opiate receptors.

Receptor binding assays using [3H]DAGO ([D-Ala2,MePhe4-Gly5-ol]enkephalin) (mu), [3H]DPDPE ([D-Pen2,D-Pen5]enkephalin) (delta) and [3H]U-69593 (kappa) were done in guinea pig whole brain membranes. Agonist activity was determined in norbinaltorphimine or beta-funaltrexamine (beta-FNA) treated guinea pig ileum (mu and kappa, respectively) and beta-FNA-treated mouse vas deferens (delta). The compounds with highest affinity were the most potent at the mu-receptor. The selectivity observed in the binding affinities was also found in in vitro activity. No correlation was found between mu-affinity and selectivity; the highest affinity analog, lofentanil, was found to be among the least selective, while another high affinity analog, R30490, was the most mu-selective. The results show that not all fentanyls are highly mu-selective, and could produce actions through delta- and kappa-opiate receptors.

Molecular determinants of mu receptor recognition for the fentanyl class of compounds.

We report here a theoretical study of a series of fentanyl analogs with a wide range of affinities and selectivities at the mu receptor, designed to identify and characterize the molecular determinants of mu receptor recognition. In this work, a complete conformational search combining nested rotations and molecular dynamic simulations has been made, leading to identification of accessible conformers for all analogs and to the selection of a candidate bioactive form. In addition, electronic properties have been calculated and examined as possible modulators of recognition at the mu receptor. The results of these studies have led to a distinct pharmacophore for interaction at the mu receptor for this class of compounds, with the piperidine ring in a chair conformation and the N-phenethyl and 4-phenylpropanamide substituents both equatorial. Moreover, four key moieties necessary for optimum receptor recognition and a postulated role for each of them in this recognition have been identified. These are (i) a protonated amine nitrogen, assumed to be involved in an initial electrostatic interaction with a negatively charged site on the receptor; (ii) a polar function capable of hydrogen-bonding with an electrophilic site; (iii) an aromatic ring involved in lipophilic interaction with a similar moiety; and (iv) a second aromatic ring, most probably involved in electron transfer interaction with the receptor. These requirements, taken together, form the basis of our proposed mechanism for mu receptor recognition. Not only is the presence of these components required for recognition, but specific steric relationships between them have been determined, implying the appropriate arrangement for interaction with complementary receptor sites. These steric parameters are pseudobond angles and one torsion angle that determine the relative spatial arrangement of these four moieties. They are the angles theta 1 and theta 3, defining the relative position of the protonated nitrogen and the polar function with each of the two aromatic rings, and the torsion angle eta 1, defining the orientation of the lone pair(s) on the polar proton-accepting function with respect to the lone pair on the piperidine nitrogen. This postulated mechanism of recognition provides a conceptual framework to understand why some compounds do and some do not recognize the mu receptor.

Development of a conformational search strategy for flexible ligands: a study of the potent mu-selective opioid analgesic fentanyl.

An extensive conformational search of the potent opioid analgesic, fentanyl, was performed using the semiempirical quantum mechanical method AM1 and the CHARMm potential energy function. A combination of two procedures was used to search the conformational space for fentanyl, which included nested dihedral scans, geometry optimization and molecular dynamics simulation at different temperatures. In addition, the effect of a continuum solvent environment was taken into account by use of appropriate values for the dielectric constant in the CHARMm computations. The results of the conformational search allowed the determination of the probable conformation of fentanyl in polar and nonpolar solvents and of three candidate conformers for its bioactive form.

[Anti-tetanus protection in a homogeneous group of vaccinated subjects from the city of Reggio Emilia]. / Protezione antitetanica in un gruppo omogeneo di vaccinati della città di Reggio Emilia.

The AA. have determined the antibodies against tetanus toxin of 739 young people that in 1968 underwent the first vaccination (passive haemagglutination test). 570 subjects (77.13%) entirely immunized and other 129 partially immunized turned out. Whereas the antibodies level of many examined subjects after fifteen years from vaccination was protective, the AA. suggest as correct a vaccination schedule with a dose every ten years to preserve the immunity.

[Considerations on and personal experience with postoperative acute pancreatitis after biliary tract surgery]. / Considerazioni ed esperienze personali sulla pancreatite acuta post-operatoria dopo interventi sulle vie biliari

Blood amylase was evaluated as a sign of pancreas damage in 120 patients subjected to bile duct surgery. Increases justifying the description "acute pancreatitis" were noted only in cases involving the papilla and were small in other circumstances. Emphasis is placed on the value of this routine examination in the immediate postoperative period as a defence against acute pancreatitis.