IL-1-dependent electrophysiological changes and cardiac neural remodeling in a mouse model of Kawasaki disease vasculitis.

Kawasaki disease (KD) is the leading cause of acquired heart disease in children. In addition to coronary artery abnormalities, aneurysms and myocarditis, acute KD is also associated with echocardiogram (ECG) abnormalities in 40-80% of patients. Here, we show that these ECG changes are recapitulated in the Lactobacillus casei cell wall extract (LCWE)-induced KD vasculitis mouse model. LCWE-injected mice developed elevated heart rate and decreased R wave amplitude, with significant differences in prolonged ventricular repolarization. LCWE-injected mice developed cardiac ganglion inflammation, that may affect the impulse-conducting system in the myocardium. Furthermore, serum nerve growth factor (NGF) was significantly elevated in LCWE-injected mice, similar to children with KD vasculitis, associated with increased neural remodeling of the myocardium. ECG abnormalities were prevented by blocking interleukin (IL)-1 signaling with anakinra, and the increase in serum NGF and cardiac neural remodeling were similarly blocked in Il1r1-/- mice and in wild-type mice treated with anakinra. Thus, similar to clinical KD, the LCWE-induced KD vasculitis mouse model also exhibits electrophysiological abnormalities and cardiac neuronal remodeling, and these changes can be prevented by blocking IL-1 signaling. These data support the acceleration of anti-IL-1 therapy trials to benefit KD patients.

[Phenomenology and phenomenological method: their usefulness for nursing knowledge and practice]. / Fenomenologia e metodo fenomenologico: loro utilita' per la conoscenza e la pratica infermieristica.

Phenomenology is a thought movement the main aim of which is to study human fenomena as they are experienced and lived. Key concepts of phenomenology are: the study of lived experience and subjectivity of human beings, the intentionality of consciousness, perception and interpretation. Phenomenological research method has nine steps: definition of the research topic; superficial literature searching; sample selection; gathering of lived experiences; analysis of lived experiences; written synthesis of lived experiences; validation of written synthesis; deep literature searching; writing of the scientific document. Phenomenology and phenomenological method are useful for nursing either to develop knowledge or to guide practice. Qualitative-phenomenological and quantitative-positivistic research are complementary: the first one guides clinicians towards a person-centered approach, the second one allows the manipulation of phenomena which can damage health, worsen illness or decrease the quality of life of people who rely on nursing care.

[Fetal urinoma caused by pyelo-ureteral obstruction; spontaneous remission]. / Urinoma fetale da stenosi del giunto pielo-ureterale: evoluzione naturale.

With advances in obstetric ultrasound, prenatal observation of the pathogenesis and natural history of obstructive uropathy is possible. The Authors describe the ultrasonographic appearance of a fetal monolateral urinoma associated with a severe hydronephrosis and the progressive reduction of the urinoma during the last weeks of the pregnancy until complete disappearance in the first month of life. Urinoma detected antenatally, with onset very early in gestation, usually is associated with severe urinary tract obstruction, like posterior urethral valves or ureteropelvic junction obstruction and is always associated with a severe impairment of ipsilateral renal function.

Vitamin D-binding protein in the perinatal period.

The molecular polymorphism and quantitative levels of serum vitamin D-binding protein (DBP) were ascertained in a group of preterm, full-term and hypocalcaemic full-term newborn infants. The serum concentration of DBP is not influenced by phenotype and increases with fetal age from the 32nd-33rd week of gestation until the 35th week of gestation. Neither different DBP allele distribution nor abnormal quantitative levels found among 29 hypocalcaemic full-term newborn infants.

Transferrin subtypes in cystic fibrosis.

The molecular polymorphism and quantitative data of serum transferrin (Tf) were ascertained in a group of fibrocystic patients, their parents and controls. Quantitative rates of pre-albumin, retinol binding globulin (RBG) and alpha-1-glycoprotein were also investigated as a reference for the evaluation of Tf quantitative data. Neither different allele distributions nor abnormal electrophoretic patterns were observed among CF patients. A slight lowering of Tf, pre-albumin and RBG, probably due to malnutritional condition in CF subjects was found.

Evaluation of plasma iodothyronines in various stages of pregnancy.

Evaluation of thyroid status during the whole normal pregnancy was carried out by measuring serum total thyroxine (TT4), total 3,5,3' triiodothyronine (TT3), T3 resin uptake (T3(U)), 3,3',5' triiodothyronine (rT3), free thyroxine index (FTI), free thyroxine (FT4) and thyrotrophin (TSH) in 70 serum samples from 42 pregnant women being in a variable period from the 6th to the 40th week of pregnancy and in 14 serum samples from 14 non pregnant healthy women. The serum samples were divided in 7 groups, according to the gestational age of the subjects. Every group was formed by 10 samples collected within the same five weeks period. The levels of TT4, TT3, T3 (U) and rT3 were found significantly elevated during pregnancy, above the levels of the control group (p less than 0.01); the increase is very early. FTI remained in the range of normal non pregnant subjects without any significant change in all groups studied. FT4 concentration showed a progressive downward trend with gestational age. This fall became significant in the second group (11th to 15th weeks), when compared to the levels of non pregnant women (p less than 0.01) TSH mean values remained in the normal range within the three trimesters, though they showed some fluctuations.