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Cardiovascular diseases are still the main cause of death among women despite the improvements in treatment and prognosis achieved in the last 30 years of research. The determinant factors and causes have not been completely identified but the role of "gender" is now recognized. It is well known that women tend to develop cardiovascular disease at an older age than men, and have a high probability of manifesting atypical symptoms not often recognized. Other factors may also co-exist in women, which may favor the onset of specific cardiac diseases such as those with a sex-specific etiology (differential effects of estrogens, pregnancy pathologies, etc.) and those with a different gender expression of specific and prevalent risk factors, inflammatory and autoimmune diseases and cancer. Whether the gender differences observed in cardiovascular outcomes are influenced by real biological differences remains a matter of debate.This ANMCO position paper aims at providing the state of the research on this topic, with particular attention to the diagnostic aspects and to care organization.

It has been recently suggested by many epidemiological studies, and emphasized by a nonspecialistic press, that a moderate alcohol intake may exert a protective role in coronary heart diseases. In our study, by means of a questionnaire, the consumption of alcohol in 100 male patients, less than 70 years old, affected by myocardial infarction and/ or angina pectoris, has been evaluated during a period before and after the admission to our Coronary Care Unit. On the basis of their alcohol intake, patients were divided into five categories: abstainers (8%), daily intake lower than one drink (7%), between one and two drinks (8%) between three and four drinks (46%) and equal or higher than five drinks (31%). In the light of these results, we suggested that, in our region (a country area in the north-east of Italy), there are higher levels of ethanol intake compared to those reported by other authors, that these parameters are only slightly modified by the occurrence of coronary heart diseases and that alcohol consumption, although low and moderate, must be therefore emphasized with extreme caution.

Treatment of recurrence, which is one of the major complications of pericarditis, is often difficult. After three recurrences of idiopathic acute pericarditis, over a period of four months, despite therapy with acetylsalicylic acid, indomethacin and methilprednisolone, a patient, 37 years old, responded favorably to colchine treatment. No recurrences, no side effects were observed, after a prolonged low dose treatment. Our report suggests, therefore, that colchinine may be beneficial in acute attacks of idiopathic pericarditis and may be useful in avoiding recurrent episodes of pericarditis.

Neuro-muscular blocking agents are currently administered to the fetus during intrauterine procedures, in order to freeze fetal movements and to avoid traumatic effects. The authors have evaluated three drug regimens (Pancuronium, Vecuronium, Atracurium), both via the intramuscular and the intravascular route of administration to the fetus. The time lapse between injection and disappearance of movements and the duration of paralysis have shown no significant differences for each group. The duration of fetal immobilization, on the other hand, has resulted excessively long for the necessity of the procedure. The authors speculate that immaturity of fetal metabolism can be responsible for the prolonged action of the drug. No side effect related to paralysis have been recorded at birth and after two years follow-up.

The results of some clinical trials performed with levamisole on 12 HBsAg-positive subjects, including 5 patients with aggressive chronic hepatitis, (ACH) 2 patients with persistent chronic hepatitis (PCH) and 5 healthy carriers are reported. Levamisole was administered in 2.5 mg/Kg/day doses for three consecutive days. During treatment prothrombin activity normalized in ACH and PCH as well as transaminases, the latter starting from the 4th week, even though a two-fourfold increase of the starting values was observed in the first weeks of disease. HBsAg, anti-HBs titres and immunocomplexes values did not show any significant variations, but for 1 case, while some immunological parameters (E, EA rosettes) normalized in those cases showing base- values lower than the norm.

Anti-HBV core IgM antibodies (anti-HBc IgM) were tested by RIA in the sera from 269 patients with acute viral hepatitis (AVH), from 39 patients with chronic HBSAg+ hepatitis (CH) at various stage of evolution, in 41 asymptomatic HBsAg carriers and in 30 healthy volunteers. Anti-HBc IgM were found in 100/108 HBsAg+ AVH, in 6/161 HBsAg--AVH, in 9/39 with CH and only 1 asymptomatic HBsAg carrier. Among the chronic patients with anti-HBc IgM, 3 were HBeAg+ and 6 were anti-HBe+. The test of anti-HBc IgM results useful in the early aetiological diagnosis of acute hepatitis since it is always positive in HBV acute hepatitis even in the subjects who early seroconvert to anti-HBs; the absence of anti-HBc IgM in the HBsAg+ acute hepatitis suggests other overinfecting agents. The presence of anti-HBc IgM in CH seems not to be related to an active viral replication.

The authors describe 3 cases of the extracranial Vertebral artery fenestration. This anomaly is a rare case seen in autopsy and angiographically, and in literature too the cases described are few and prevalently by Japanese authors. This anomaly is important because frequently is associated with others congenital intra and extracranial vascular abnormalities.

The prevalence of the anti-HBc antibodies was studied in 54 patients with chronic liver disease and in a group of controls pair-matches. The meaning of the anti-HBc antibodies titer in the patients HBsAg negative is discussed. From our data, obtained by Radioimmunoassay, anti-HBc titers I:I000 seem to indicate an ongoing or recent viral replication, being probative, even in the absence of the HBsAg marker, for the viral etiology.

Little is known from the literature about the epidemiology of non A - non B hepatitis (NANB/H) in childhood. Aim of this study was to assess the prevalence of NANB/H in a consecutive series of children with acute viral hepatitis hospitalized over an one year's period. Thirty children, 9 females, aged 3-12 years, were studied. Serial blood samples were tested for HBsAg, anti-HBs, anti-HBc, anti-HAV (Abbott RIA), anti-HAV-IgM (Absorption Staph. aureus protein A), anti-EBV (Immunofluorescence), anti-CMV, anti-Herpes s. virus (complement fixation). The diagnosis of NANB/H was based on the absence of these markers. Nineteen patients (63,3%) had type A, and 5 (16,6%), had type B hepatitis. One child showed antibodies anti-Herpes with rising titer and 5 (16.6%), 2 females, were considered suffering from NANB/H. None of these patients had been injected or haemotransfuded; all but one came from rural ambient and two from the same family. Two children had an anicteric course. The illness lasted less than 30 days in all but one, who showed three peaks of transaminases and recovered after 70 days. These data show a prevalence of NANB/H in childhood greater than that elsewhere reported, while the absence of injections suggests a way of infection other than parenteral.

HBeAg and anti-HBe were tested by RIA (Abbott Kits) in 53 patients (38 HBsAg +) with acute viral hepatitis (AVH), in 27 patients (5 HBsAg +) with chronic active hepatitis (CAH), in 54 (8 HBsAg +) with cirrhosis, in 32 (17 HBsAg +) undergoing haemodialysis, in 6 HBsAg carriers and in 45 controls. Most of the patients with HBsAg + AVH were HBeAg + in the first week and showed seroconversion to anti-HBe within the fourth week of the illness. Two from the four patients still HBeAg + in the fourth week seroconverted later on and clinically recovered, one is still HBsAg +/HBeAg + in the seventh week and one developed CAH HBsAg +/HBeAg +. High prevalence of HBeAg was found in the haemodialysed (94%) and in the patients with CAH (80%) while anti-HBe was more frequent in the HBsAg carriers (100%) and in the cirrhotics (62,5%). Among the patients HBsAg-, none was HBeAg + while 18% with CAH, 21,7% with cirrhosis, 26,6% of the haemodialysed and 4% of the controls were anti-HBe +. Our data, relating to AVH, are similar to those referred in the literature, but show conversely high prevalence of anti-HBe in CAH and in cirrhosis.

As high levels of Prostaglandins E2 were observed in several gastric diseases, the Authors determined the PGE2 levels in gastric cancer patients without recurrences, in pre and post-operative period. PGE levels were correlated with cancer progression and their significance as tumoral markers was also assessed.

The parameters in antibody-positive with LAS/ARC and antibody negative drug-users have been studied. The results show that in the first group the lymphocyte profile and in vitro immunoglobulin production are greatly affected. In the second group only modifications about activation markers and PWM induced B lymphocyte differentiation are present.