The heart in uremia: role of hypertension, hypotension, and sleep apnea.

Cardiovascular disease is the leading cause of morbidity and mortality in end-stage renal disease. Causes include those usually found in the general population, those related to the uremic status, and those related to dialytic treatment. Hypertension, hypotension, anemia, hypoalbuminemia, malnutrition, dyslipidemia, reactive C protein, calcium-phosphate product, dialysis modalities, and hyperhomocysteinemia are discussed extensively. Special emphasis is put on hyperparathyroidism as a traditional toxin. The emergent role of sleep apnea has been confirmed in animal models as well as in humans studied using polysomnography. There are difficulties in diagnosing coronary disease, because angiography is not risk-free, is expensive, and should be reserved for patients having symptoms of heart failure and/or patients having diabetes mellitus, and/or patients entering a transplantation list. This allows patients with coronary disease to undergo coronary artery bypass (preferably) or percutaneous transluminal angioplasty. Patients for whom surgery is not appropriate should be treated using more traditional medical procedures.

[New possibility of genetic characterization of human papillomavirus in pathology of male and female genitalia]. / Nuova possibilitá di caratterizzazione genetica dell'Human Papillomavirus nella patologia dell'apparato genitale maschile e femminile.

Several epidemiologic studies point to the role of different sublines of Human Papillomavirus (HPV) in the development of neoplasias of the genito-rectal tract. The spread of the virus in the population makes it necessary to constantly investigate this pathogen in order to adopt a correct therapeutic approach and follow the evolution of associated disease. This paper gives an epidemiologic outline of HPV infection in the adult population--males and females--based on a correlated study of the relationship between the lesion and the presence of the virus and its sublines. The methods used both traditional examinations (colposcopy, cytology, histology) and innovative chemiluminescence molecular biology techniques. Chemiluminescence molecular hybridization includes the use of RNA probes which, on the basis the identification of different viral strains, allow a subdivision of infections into low and high/medium risk. The test resulted positive in 60.7% of the cases in which there was clinical and cyto-histopathological evidence of HPV infection. Notwithstanding the high percentage of negative results in the cases of condylomatous disease, the method used has proved to be easily applicable and more sensitive than other molecular biology techniques (comparison by in situ hybridization and Southern blot analysis). Moreover, from the clinical point of view, it seems to provide useful data for a correct diagnosis and monitoring of patients.

[A clinical study of cyclopyroxolamine versus clotrimazole in the treatment of mycotic vulvovaginitis]. / Studio clinico sulla ciclopiroxolamina versus clotrimazolo nel trattamento delle vulvovaginiti micotiche.

The therapeutic efficacy and tolerability of the antifungal agent ciclopiroxolamine have been verified with a double-blind study versus clotrimazole in 46 patients affected by vulvovaginal candidiasis. The patients of the first group (23) have been treated with ciclopiroxolamine globules, one 100 mg globule nightly for six days; the second group (23 patients) received clotrimazole vaginal tablets, one 200 mg tablet nightly for six days. Ciclopiroxolamine treatment showed an equivalent effectiveness to that of clotrimazole both on signs and symptoms and on vaginal smear culture. No local or systemic adverse reaction was observed.

[Experience with preoperative preventive care in obstetrics and gynecology]. / Nostra esperienza sulla profilassi pre-operatoria in ostetricia e ginecologia.

The clinical behaviour and post-operative course of 60 patients who had undergone obstetrics or gynaecological surgery is compared. In 30 cases (20 obstetric and 10 gynaecological), antibiotic prophylaxis took the form of a single i.m. injection of 600 mg of lincomycin and 80 mg of gentamycin, 30 minutes before the operation. In the remaining 30 cases (20 obstetric, 10 gynacological), the antibiotic cover was administered postoperatively by i.v. injection of doxicyclin (100 mg every 12 hours for 3 days and 100 mg every 12 hours per os for a further 2 days). From a comparison of the 2 groups, and keeping obstetric and gynaecological cases separate, it is concluded that preoperative antibiotic prophylaxis is comparable in its results to post-operative antibiotic cover. Postoperative haematochemical tests were also done and, as has been reported, showed no significant alterations from the tests administered preoperatively, thus confirming the high tolerance of the drugs in question in the above-stated doses. No cochleovestibular disturbances were encountered nor were drug-resistant bacteriological strains. The efficacy of this prophylactic treatment is confirmed and though comparable in results to the alternative postoperative types is indubitably advantageous both in the lower cost to the community and the short duration of the treatment itself.

[Experience acquired in application of Law No. 194 for a period of 18 months]. / Nostre considerazioni sulla esperienza maturata dopo circa un anno e mezzo di applicazione della legge n. 194.

PIP: After the promulgation of law 194, legalizing abortion in Italy, 455 pregnancy terminations were done at the Hospital of Saluzzo. In 98% of cases the technique used was dilatation and curettage under general anesthesia; most patients were hospitalized for 2 days; there was 1 case of uterine perforation, 2 cases of hemorrhage, and 4 cases of fever. Almost half of the patients came from other provinces, over 50% were in the age group 26-36, 78.72% were married, 53.19% were housewives, and 33.68% had 2 children. About 53.19% had elementary school education only, and about 28.01% were in the 8th week of gestation. Most requests for abortion were for economic reasons; 21.03% were because of contraceptive failure. The most important and striking information from this study is the lack of contraceptive information on the part of most patients; information on family planning is an absolute necessity to safeguard a woman's health, and should be made available to all women.^ieng