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In conformity with an integrated clinico-telethermographic protocol, the therapeutic efficacy of cinnoxam cream was evaluated in 20 patients presenting minor rheumatic pathologies or post-traumatic syndromes. The product under examination induced favourable and precocius changes in the clinical and symptomatologic-functional parameters considered.

Different methods available for investigating patients for pancreatic disease are discussed. They first include measurement of pancreatic enzymes in biological fluids. Basal amylase and/or lipase in blood are truly diagnostic in acute pancreatitis but their utility is low in chronic pancreatic diseases. Evocative tests have been performed to increase the sensitivity of blood enzyme measurement. The procedure is based on enzyme determination following administration of pancreozymin and secretin, and offers a valuable aid in diagnosis of chronic pancreatitis and cancer of the pancreas. They are capable of discerning pancreatic lesions but are not really discriminatory because similar changes are observed in both diseases. The measurement of urinary enzyme levels in patients with acute pancreatitis is a sensitive indicator of disease. The urinary amylase excretion rises to abnormal levels and persists at significant values for a longer period of time than the serum amylase in acute pancreatitis. The fractional urinary amylase escretion seems to be more sensitive than daily urinary measurement. The pancreatic exocrin function can be assessed by examining the duodenal contents after intravenous administration of pancreozymin and secretin. Different abnormal secretory patterns can be determinated. Total secretory deficiency is observed in patients with obstruction of excretory ducts by tumors of the head of the pancreas and in the end stage of chronic pancreatitis. Low volume with normal bicarbonate and enzyme concentration is another typical pattern seen in neoplastic obstruction of escretory ducts. In chronic pancreatitis the chief defect is the inability of the gland to secrete a juice with a high bicarbonate concentration; but in the advanced stage diminution of enzyme and volume is also evident. Diagnostic procedures for pancreatic diseases include digestion and absorption tests. The microscopic examination and chemical estimation of the fats in stool specimens in different conditions of intake are still important screening tests. Isotopic estimates of steatorrhea and distinction between labeled triolein and oleic acid absorption do not provide greater diagnostic discrimination than traditional procedures. 131I labeled proteins permit a good evaluation of a negative nitrogen balance. Sophisticated procedures to estimate exocrine pancreatic insufficiency are based on the study of endoluminal digestive processes at several times and different level of the small intestine. They permite esclusion of extrapancreatic factors interfering in digestion and absorption functions. The endocrin pancreatic function is evaluated by mean of oral tolerance test an radioimmunoassay of blood insulin. It is generally agreed that "diabetes" caused by insulin deficiency and digestion and absorption defects are the result of diffuse pancreatic destruction. Many methods are now available investigating patients with pancreatic disease but the single use of one of them is never satisfactory...

The enhanced sorbitol synthesis in diabetic red blood cells can lead to a depletion of NADPH and, by limiting the amount of GSH produced in the glutathione-reductase step, can make the cell more susceptible to oxidant injury. Diabetic red blood cells have a shortened life span, as shown by the increase of creatine level. The osmotic resistance of diabetic erythrocytes was measured and the erythrocyte flexibility was studied using a filtration method in which the cells were forced, at a constant flow rate, through a polycarbonate membrane with 5-mu pores. The increased osmotic resistance and the impaired flexibility shown by diabetic red blood cells can be induced in normal cells by a treatment with SH-reagents (diamide). This points to a redox state-mediated decrease in deformability and survival of diabetic erythrocytes.

The hypothesis that diabetes mellitus is a syndrome has been confirmed by recent physiopathological studies. In idiopathic diabetes differences in the genetic status and in the alternations of the beta cells allow to identify two completely different diseases: type 1 (or juvenile) diabetes and type II (or adult) diabetes. On the basis of the differences in the physiopathology of the different types of diabetes, the usefulness of vitamin supplementation for prophylaxis and therapy is discussed. The nutritional intake of thiamine is, for instance, recommended for patients suffering from the type II disease. Riboflavin deficiency has recently been observed in rat experimental diabetes as well as in human type II diabetes; the vitamin deficiency seems to be relevant in connection with functional alterations of pancreatic beta-cells. Other water-soluble vitamins are known to be involved in the pathogenesis and evolution of diabetes mellitus. Among the fat-soluble vitamins, retinol ought to be mentioned because of its importance in the mechanism of synthesis of pre-collagen and in view of the alterations in collagen and glycoprotein synthesis which accompany diabetes. Moreover, a diminished secretion of insulin has been described together with vitamins deficiences. The critical analysis of these data enables the diabetologist to define a reliable program for the prophylaxis and treatment of different kinds of diabetes.

In epidemiological terms the frequency of infectious endocarditis is constant. In contrast acute forms in males and old people are on the increase. Atypical cases are more frequent than in the past so that prompt diagnosis is often difficult. Aetiologically, mycete and gram-negative cases are increasingly common.