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The main aim of the study was to propose a useful methodological approach to define easily understandable indicators to use in communication campaigns organized to improve the efficacy of municipal solid waste collection. For this purpose, six economic-environmental indicators were defined, combining life cycle thinking and environmental communication. The indicators make it possible to obtain several combinations that can follow a variety of communication channels. Three indicators (quantity of recyclable materials recoverable from unsorted residual waste; total potential economic saving; number of jobs for young people as communicators) are expressed in absolute value and therefore refer to the whole community even if they are also good for single-targeted messages. The other three indicators (potential economic saving for each citizen; per capita saving of carbon dioxide equivalent; per capita saving of Disability Adjusted Life Years) are normalized with respect to the number of inhabitants and therefore refer to the individual citizen, but can also be used for global messages. As a case example, the methodology was applied to the collection of paper and cardboard in twelve Southern Italy cities obtaining very promising results. For example, the maximum quantity of paper and cardboard recoverable from unsorted waste would allow Naples and Palermo to recover more than €15 million. The maximum potential economic saving for each citizen was 25 €/capita. The economic saving obtained for Naples and Palermo could be translated in more than one thousand positions as young environmental communicators. Catania was the city with both the highest per capita potential saving of carbon dioxide (>60 kg CO2eq./capita) and maximum hypothetical per capita ‘life-time recovery’ (almost an hour). The innovative communication method used (‘Greenopoli’) assumed that school is the starting point to obtain a change of mindset because speaking with students (all potential communicators) means indirectly communicating with all other targets.

Study question Evaluation of the effect of varicocele correction on conventional and microscopic seminal parameters and evaluation of which factors might predict sperm improvement after surgical treatment. Summary answer The detailed morphologic sperm evaluation has been identified as a novel parameter expressing the post-surgical semen amelioration after varicocelectomy. What is known already Generally, varicocele develops during puberty and occurs more often on the left side for anatomic reasons. However, its diagnosis is commonly delayed, especially in asymptomatic cases, until the man consults an andrologist for couple infertility. A causative relationship between varicocele and impairment of semen quality has been largely investigated in the context of male infertility. Despite the florid literature available on this topic, the clinical benefit in terms of semen quality improvement after varicocele surgical repair remains controversial. Study design, size, duration An observational, retrospective clinical trial was carried out including patients undergoing surgical treatment for varicocele at the Day Surgery of the Urology Operative Unit of the Santa Maria Nuova Hospital-IRCCS of Reggio Emilia from September 2011 to March 2020. Primary outcome was the detailed morphologic microscopic sperm evaluation. Secondary outcomes were conventional semen analyses. Each patient was considered two times (before and after the surgery) and evaluated by both physical examination and ultrasonography. Participants/materials, setting, methods The inclusion criteria considered the patients with diagnosis of varicocele at ultrasound examination, attending surgical resolution and with at semen analyses before and after the surgery, were excluded patients with diagnosis of varicocele without surgical indication, and/or semen analyses performed only before or only after the surgery. In the statistical analysis a logistic multivariate regression analysis was performed in order to evaluate the change before and after surgery. Main results and the role of chance The post-surgical semen analysis was performed after a mean of 183.7 + 112.5 days since the surgery for a total of 121 males (mean age 24.6 + 4.1 years) enrolled. The surgical treatment leads to a significant increase in sperm concentration (p = 0.015) and percentage of progressive and total motility (p = 0.022 and p = 0.039, respectively), with a significant decrease in the percentage of immobile sperms (p = 0.013). In particular, semen concentration improved in 71.7% of patients (p = 0.010). Considering the detailed morphologic microscopic evaluation, a significant improvement was detected: head abnormalities showed a significant reduction, considering microcephaly (3.3 + 3.6 versus 2.2 + 2.9%, p = 0.015), macrocephaly (1.4 + 0.6 versus 1.2 + 0.9%, p = 0.043) and cytoplasmic appendix (1.4 + 0.8 versus 0.9 + 1.2%, p = 0.041). Moreover, surgery led to a significant reduction of tails abnormalities, considering absence (0.6 +2.3 versus 0.1 + 0.7, p = 0.048) and coiled tail (5.2 + 1.5 versus 6.6 + 2.0, p = 0.037). Thus, surgical varicocele resolution leads to a significant improvement in specific morphological semen parameters. The multivariate logistic analysis identified the ultrasound varicocele degree before surgery as a main predictor of the sperm concentration improvement (p = 0.016). The semen parameters improvement was higher for varicocele of I and II degree (p = 0.008). Limitations, reasons for caution The retrospective study design precluded from carrying out a case-control study to compare the surgical techniques. Moreover, the study design limited the availability of patients’ clinical data in order to performed a more comprehensive predictive analysis. Wider implications of the findings Using a complex statistical approach, it emerged that the greatest improvement in semen quality was obtained in case of mild varicocele, increasing the knowledge on the therapeutic potential of surgery. This result has clinical implications, since it could help to select those patients ‘to treat or not to treat’. Trial registration number none

The main aim of this study was to evaluate, in the design phase, the most environmentally sound alternative between two on-site small-scale wastewater treatment systems (designed for 15 inhabitants), namely an activated sludge compact system and a constructed wetland system (both in linear low-density polyethylene), using Life Cycle Assessment. The procedure considered three sensitive parameters with three values. All the 27 combinations were evaluated with three different impact assessment methods (generating 81 comparison cases): IPCC 2007 100 years, Ecological Footprint and ReCiPe 2008 H. The constructed wetland system was the best environmental choice in 93% of the cases. Realizing the two treatment systems in different European countries, the activated sludge system would be the best environmental choice in some cases. Considering the production of electricity with photovoltaic systems, the total impact of the activated sludge system, evaluated with the ReCiPe 2008 H method, would be smaller than that of the constructed wetland system. The variation of the operating lifetime parameter had a major influence on the constructed wetland system, where the greatest consumption of energy and resources occurs during the construction phase. There were significant differences among the results with ReCiPe 2008 H and those with Ecological Footprint and IPCC 2007 100 years. Therefore, in a Life Cycle Assessment study, it would be preferable to adopt several impact assessment methods in order to verify how the results can vary.

The overarching goals of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) are to enable European citizens to lead healthy, active and independent lives whilst ageing. The EIP on AHA includes 74 Reference Sites. The aim of this study was to transfer innovation from an app developed by the MACVIA-France EIP on AHA reference site (Allergy Diary) to other reference sites. The phenotypic characteristics of rhinitis and asthma multimorbidity in adults and the elderly will be compared using validated information and communication technology (ICT) tools (i.e. the Allergy Diary and CARAT: Control of Allergic Rhinitis and Asthma Test) in 22 Reference Sites or regions across Europe. This will improve the understanding, assessment of burden, diagnosis and management of rhinitis in the elderly by comparison with an adult population. Specific objectives will be: (i) to assess the percentage of adults and elderly who are able to use the Allergy Diary, (ii) to study the phenotypic characteristics and treatment over a 1-year period of rhinitis and asthma multimorbidity at baseline (cross-sectional study) and (iii) to follow-up using visual analogue scale (VAS). This part of the study may provide some insight into the differences between the elderly and adults in terms of response to treatment and practice. Finally (iv) work productivity will be examined in adults.

At his own expense Augustus built his own aqueduct, known as Aqua Iulia, for Capua, located in today's Campania region of southern Italy, which was in Roman times, one of the most important civitas of the empire. The course of this aqueduct and of its likely branches, destined for two small towns, Saticula and Calatia, is hypothesized, in part based on the re-use in the seventeenth century of about 8 miles (i.e. 11.8 km) of the ancient aqueduct for another water supply that served Naples, namely the Carmignano aqueduct. The subsequent transformation in the eighteenth century in a new water supply along a new route at a higher altitude is described. This third water supply served the Bourbon royal palace of Caserta, a magnificent construction built in the same period. In summary, the historical evolution of the Augustan aqueduct of Capua is discussed in the context of the communities served and in the context of the organization and history of the territory supplied, demonstrating the richness of information that may be obtained by an integrated study of the transformation, over time, of this important water infrastructure.

CAPS is the acronym for chemically assisted primary sedimentation, which consists of adding chemicals to raw urban wastewater to increase the efficacy of coagulation, flocculation and sedimentation. The principal benefits of CAPS are: upgrading of urban wastewater treatment plants; increasing efficacy of primary sedimentation; and the major production of energy from the anaerobic digestion of primary sludge. Metal coagulants are usually used because they are both effective and cheap, but they can cause damage to the biological processes of anaerobic digestion. Generally, biodegradable compounds do not have these drawbacks, but they are comparatively more expensive. Both metal coagulants and biodegradable compounds have preferential and penalizing properties in terms of CAPS application. The problem can be solved by means of a multi-criteria analysis. For this purpose, a series of tests was performed in order to compare the efficacy of several organic and mixed-organic polymers with that of polyaluminium chloride (PACl) under specific conditions. The multi-criteria analysis was carried out coupling the simple additive weighting method with the paired comparison technique as a tool to evaluate the criteria priorities. Five criteria with the following priorities were used: chemical oxygen demand (COD) removalturbidity, SV60coagulant dose, and coagulant cost. The PACl was the best alternative in 70% of the cases. The CAPS process using PACl made it possible to obtain an average COD removal of 68% compared with 38% obtained, on average, with natural sedimentation and 61% obtained, on average, with the best PACl alternatives (cationic polyacrylamide, natural cationic polymer, dicyandiamide resin).

The aim of this paper is to study the treatment process of a Roman fullery (fullonica) with particular attention to the water and wastewater management system. Remains of several fullonicae have been documented at Pompeii and Herculaneum (Campania, Southern Italy), Ostia and Rome (Latium region, Central Italy), Florence (Tuscany, Central Italy), etc. The common academic perception of Roman fullonicae is significantly influenced by the fullonica of Stephanus (I 6, 7) in Pompeii, which is assumed to be a paradigmatic case study in this paper. The use of urine as an alkaline chemical agent in the soaping phase of the filling treatment process was overstated, with there also being no evidence of the fact that fullers collected their urine by means of vessels in front of their workshops, as usually reported. Thus, it is not clear how the Roman fullers collected and transported the urine they used in the fulleries. Finally, the rinsing phase can be considered a clear example of water reuse.

This paper investigates the total and per capita environmental impacts of municipal wastewater treatment in the function of the population equivalent (PE) with a Life Cycle Assessment (LCA) approach using the processes of the Ecoinvent 2.2 database available in the software tool SimaPro v.7.3. Besides the wastewater treatment plant (WWTP), the study also considers the sewerage system. The obtained results confirm that there is a 'scale factor' for the wastewater collection and treatment even in environmental terms, in addition to the well-known scale factor in terms of management costs. Thus, the more the treatment plant size is, the less the per capita environmental impacts are. However, the Ecoinvent 2.2 database does not contain information about treatment systems with a capacity lower than 30 PE. Nevertheless, worldwide there are many sparsely populated areas, where it is not convenient to realize a unique centralized WWTP. Therefore, it would be very important to conduct an LCA study in order to compare alternative on-site small-scale systems with treatment capacity of few PE.

Many new photovoltaic (PV) applications, such as the concentrating PV (CPV) systems, are appearing on the market. The main characteristic of CPV systems is to concentrate sunlight on a receiver by means of optical devices and to decrease the solar cells area required. A low CPV (LCPV) system allows optimizing the PV effect with high increase of generated electric power as well as decrease of active surface area. In this paper, an economic analysis and a life cycle assessment (LCA) study of a particular LCPV scheme is presented and its environmental impacts are compared with those of a PV traditional system. The LCA study was performed with the software tool SimaPro 8.0.2, using the Econinvent 3.1 database. A functional unit of 1 kWh of electricity produced was chosen. Carbon Footprint, Ecological Footprint and ReCiPe 2008 were the methods used to assess the environmental impacts of the LCPV plant compared with a corresponding traditional system. All the methods demonstrated the environmental convenience of the LCPV system. The innovative system allowed saving 16.9% of CO2 equivalent in comparison with the traditional PV plant. The environmental impacts saving was 17% in terms of Ecological Footprint, and, finally, 15.8% with the ReCiPe method.

The main aim of this study was to evaluate the costs and environmental impacts induced by a fixed model of MSW kerbside separate collection system for communities up to 10,000 inhabitants, in order to evaluate the convenience for the smaller municipalities to unite and form more economically and environmentally sound systems. This topic is important not only due to the large number of small municipalities (e.g. in Italy 72% of the municipalities has less than 5000 inhabitants) but also to the fact that separate collection systems are typically designed to take into account only the technical and economic aspects, which is a practice but not acceptable in the light of the sustainable development paradigm. In economic terms, between 1000 and 4000 inhabitants, the annual per capita cost for vehicles and personnel decreased, with a maximum at approximately 180 €/inhabitants/year; while, from 5000 up to 10,000 inhabitants, the annual per capita cost was practically constant and equal to about 80 €/inhabitants/year. For the municipalities of less than 5000 inhabitants, from an economic point of view the aggregation is always advantageous. The environmental impacts were calculated by means of the Life Cycle Assessment tool SimaPro 7.1, while the economic-environmental convenience was evaluated by combining in a simple multicriteria analysis, the annual total per capita cost (€/inhabitants/year) and the annual total per capita environmental impact (kEco-indicator point/inhabitants/year), giving the same importance to each criteria. The analysis was performed by means of the Paired Comparison Technique using the Simple Additive Weighting method. The economic and environmental convenience of the aggregation diminishes with the size of the municipalities: for less than 4000 inhabitants, the aggregation was almost always advantageous (91.7%); while, for more than or equal to 5000 inhabitants, the aggregation was convenient only in 33.3% of the cases. On the whole, out of 45 cases examined, for the municipalities from 1000 to 9000 inhabitants, the aggregation was both economically and environmentally convenient in 60.0% of the cases.

A qanat is an underground channel consisting of verticals shafts connected at their bottom with a sub-horizontal tunnel bringing water from an aquiferous stratum, with a slight downward slope useful for the water tapped to run down it and into the open air by gravity. Qanats were first developed in Kurdistan as a side result of mining activity by the early millennium B.C. at the latest. Qanats exist in more than 34 countries all over the world, but most are concentrated in present day Iran. In Italy, Sicily is usually cited for its “Ingruttati”, but also in the Campania Region, there are some qanats (“Qanate”). As a matter of fact, this paper describes the historical, biological and morphological aspects of the Roccarainola qanat located in the district of Naples, in Southern Italy. It dates back to the Roman Ages, but currently the hypogean environmental condition misrepresents its ancient state. The animal species discovered forty years ago in the Roccarainola qanat were substantially small sized arthropods, a planaria and some species of bats. The Roccarainola qanat is composed of three branches for a total length of 786 m, with a drop of 9 m. The tunnel slope varies from around 1.70 cm/m to 5.20 cm/m. However, original slopes have been modified due to accumulation of debris and waste. Seventeen vertical shafts (not internally covered) with a circular section were found along the hypogeum. On the average, the shafts are spaced 36.5 m apart.

The aim of the present study was to investigate the greatest water reservoirs in the ancient Roman world and, in particular, the “Piscina Mirabilis” in Misenum, in Southern Italy. In our study, we considered the reservoirs with a volume in the order of thousands of cubic metres, storing flowing water, set low in the ground or actually underground, and roofed over. In general, a Roman aqueduct was not built to provide drinking water, nor to promote hygiene, but either to supply the baths or for military aims. As a matter of fact, the population of Rome at the end of the 1st century AD had an average water supply of 1,550 L/d per capita especially used for baths. This circumstance required reservoirs of huge capacity. The reservoir of the Baths of Caracalla in Rome could contain over 80,000 m3 of water. The use of columns in a Roman reservoir was introduced in the ancient Constantinopolis and the Yerebatan Saray with a maximum capacity of almost 85,000 cubic metres can be considered the biggest Roman reservoir. While for military aims, the Piscina Mirabilis in Misenum can be considered the biggest Roman resevoirs used for military aims ever known until now (provide the Classis Praetoria Misenensis) with a volumetric capacity of 12,600 m3 of water.

The aim of this paper is to propose a journey through the history of water and wastewater management technologies in the ancient civilizations, a sort of Appian Way (“Via Appia”, the “regina longarum viarum”) through the Centuries. Moreover, this paper is a sort of short summary of papers presented in the first two IWA Specialty Conferences on Water and Wastewater Technologies in Ancient Civilizations with particular emphasis on the later one. The main topics considered are: aqueducts and tunnels, cisterns and reservoirs, water distributions systems, fountains, toilets and other purgatory structures, drainage and sewerage systems, irrigation systems and, finally, qanats and other similar systems. Upon completing the journey, we have arrived at the conclusion that the meaning of sustainability in modern times should be revaluated in light of ancient hydraulic water and wastewater works and management practices.

Purpose. The aim of this work was to investigate peroxidase activity in human tears during the various phases of the menstrual cycle. For comparative purposes saliva was also examined. Methods. Tear fluids and saliva from 10 healthy volunteers 23–41 years of age (mean: 28.2 years), with regular menstrual cycles were sampled for the duration of at least two complete cycles. Menstrual cycles and ovulation periods were evaluated by measuring morning body temperature and hormone levels in plasma and urine. Unstimulated tears and unstimulated saliva were collected in the morning every two days. Peroxidase activity was monitored according to the 5,5'-dithiobis,2-nitrobenzoic acid thiocyanate (Nbs-SCN) method and the protein content was determined by the Bradford method. Results. Peroxidase activity in tears, expressed as U/mL, was significantly (p

We compared the following stretchers to identify the better and safer to immobilize a fallen rider on the track. The stretchers were: Northwall's Innovation Skidboard, Ferno's Scoop EXL65 and anonymous aluminium scoop stretcher. We performed tests on track with several repetitions on a 25 meters path including asphalt, curb, natural and synthetic grass, and gravel. The Dainese Company supplied a suit and a helmet with sensors equipped to receive data. Dainese engineers processed data too. We timed the performance made by teams of three operators, men and women in different roles. The Skidboard turned out to be the most innovative and secure spine board, because generates less energy than other stretchers and reduces, almost cancels, the harmful consequences of the patient's fall on the ground. Exl65 generates more spin and longitudinal stresses than Skidboard, especially the cervical spine. Skidboard is faster than other stretchers to complete the fallen rider's rescue on the track. It is the only spineboard that allows to tie the patient to the stretchers from head to toe, which does not happen with the aluminum scoop and only partially with the Exl65. Skidboard is better than others to rescue fallen and traumatized riders on the tracks quickly and safely.

This chapter presents an overview of water and wastewater management practices in the ancient Minoan, Greek, and Roman civilizations. The main topics considered are: aqueducts; cisterns and reservoirs; water distribution systems and fountains; and drainage, sewerage systems, and toilets. The ancient technologies were surprisingly modern. The Minoan civilization gave an extraordinary contribution to the development of water and wastewater management practices. Also, most Greek houses had a cistern supplied by rainwater for several purposes (bathing, cleaning, houseplants, domestic animals, etc.) according to the sustainable development paradigm. The construction of an ancient Roman aqueduct was similar in principle to the present day.

The aim of this paper was to evaluate the groundwater pollution in an endoreic basin in southern Italy. The aquifer circulation was carried out on two different levels: a shallow groundwater, with a water table of about 10 m, and a deep groundwater in a karst aquifer, with a water table of 140–190 m. Reclaimed municipal wastewater and superficial water collected in the catchment area were both drained in a swallow hole linked with the deep groundwater. The agricultural practice conducted in the endoreic basin produced an excess of nitrate in the soil. Nitrate was subsequently washed out and displaced in the groundwater. With regard to the EU Drinking Water Directive (98/83/EC), the research activity conducted during 2003 showed the absence of pollution in the deep groundwater used for drinking water supply. The shallow groundwater, instead, was strongly influenced by agricultural and pasture activities, with detectable levels of nitrates and bacteria. In order to reduce the load of pollution entering the swallow hole and then in the deep groundwater, the realisation of a constructed wetland plant was proposed to improve the quality of reclaimed wastewater, as well as to pursue the wastewater reuse in agriculture.

The aim of the present study was to investigate the historical development of the Augustan Aqueduct Serino-Naples-Miseno in the Campania Region, in Southern Italy. The Serino aqueduct is not well known because there are no remains of spectacular bridges, but it was a masterpiece of engineering and one of the largest aqueduct systems in the whole Roman Empire. The Serino aqueduct was constructed during the Augustus period of the Roman Empire, probably between 33 and 12 BC when Marcus Vipsanius Agrippa was curator aquarum in Rome, principally in order to refurnish the Roman fleet of Misenum and secondarily to supply water for the increasing demand of the important commercial harbour of Puteoli as well as drinking water for big cities such as Cumae and Neapolis. The main channel of the Serino aqueduct was approximately 96 km long, and had 7 main branches to towns along its trace such as Nola, Pompeii, Acerra, Herculaneum, Atella, Pausillipon, Nisida, Puteoli, Cumae and Baiae. Since the total length of all the branches was approximately 49 km, the Serino aqueduct complex had a length of around 145 km and therefore it should be considered the largest aqueduct system in the Roman world.

The aim of the present study was to evaluate the behaviour of vertical flow constructed wetlands to treat high strength wastewater. Influents were obtained mixing tap water with different percentages of MSW landfill leachate (5%, 10% and 20%). Phragmites australis seedlings were used as macrophytes. The reeds were nurtured during three spring months, before the start of the experimental period. Three and four days of detention time were adopted. Influent concentrations of 510-2,050 mg L(-1), 180-740 mg L(-1) and 65-260 mg L(-1) were obtained for COD, N-NH4(+) and N-NO3(-), respectively. The environmental temperature averaged around 31.0 +/- 1.4 degrees C. During the experimental period, all parameters showed an increasing removal efficiency trend. Best results in terms of COD removal were obtained for mixtures at lowest rate of landfill leachate; while, denitrification process showed an opposite behaviour; finally, the removal of ammonia nitrogen appeared to be independent upon influent concentrations. Analysis carried out on the reed tissues showed a theoretic maximum storage of TKN in the leaves of about 55 mg/g dry weight. A leachate percentage of about 35% was derived to be able to fully inhibit the growth of macrophytes.

Gasification technology is by no means new: in the 1850s, most of the city of London was illuminated by "town gas" produced from the gasification of coal. Nowadays, gasification is the main technology for biomass conversion to energy and an attractive alternative for the thermal treatment of solid waste. The number of different uses of gas shows the flexibility of gasification and therefore allows it to be integrated with several industrial processes, as well as power generation systems. The use of a waste-biomass energy production system in a rural community is very interesting too. This paper describes the current state of gasification technology, energy recovery systems, pre-treatments and prospective in syngas use with particular attention to the different process cycles and environmental impacts of solid wastes gasification.

Lacrimal fluid peroxidase has been supposed to be involved in the protection against oxidative damage to the ocular surface. Our recent findings showed the existence of significant cyclic variations in lacrimal fluid peroxidase activity that were positively correlated with those of 17β-estradiol plasma levels throughout the menstrual cycle of fertile women. In the present study lacrimal fluid peroxidase activity of 8 healthy normocyclic women using low-dose oral contraceptives during the monthly cycle was determined. Data showed that low-dose oral contraceptives caused a decrease in lacrimal fluid peroxidase activity and a lack of its cyclic pattern with respect to the enzyme activity of 8 untreated age-matched women. Moreover, this result suggests that lacrimal fluid peroxidase activity could be regulated by estrogen.

The disease caused by Actinomyces spp. is often of difficult diagnosis. Actinomyces spp. are anaerobic or microaerophilic non-spore-forming gram-positive rods that may reach, occasionally, the normal female genital tract. IUD and pessaries facilitate the access of the microorganisms to the pelvis. We report an unusual case of ovarian infection by Actinomyces sp. in a 41 year-old female without IUD, admitted at the Institute in November 1998, with persistent fever. She had had an early menopause 3 years before, and had received hormonal replacement therapy. Usual and unusual infections were discarded by microbiological and serologic studies. Abdominal ultrasonography showed a slight left pyelocalycial dilatation and a simple cyst in the left ovary; heart ultrasonography was normal. Gynecological examination showed an enlarged uterus, similar to an 8 week pregnancy, painless, and fixed anexial masses. The transvaginal ultrasonography showed uterine myomas, one of them of 42 mm in the isthmus region, large ovaries, cystic, with acoustic shadows, and the left one with a septum. The preoperative diagnosis was infected bilateral cystic teratoma. The procedure was an exploratory laparotomy, followed by a bilateral salpingo-oophorectomy. The specimen studies showed an endometrioma with calcium deposits in the wall of the right ovary, and an abscess in the left ovary, also with calcification of the wall. The sample from the left abscess developed Actinomyces sp. After surgery, and treatment with penicillin, the fever disappeared. It is important to remark that the ovarian infection by Actinomyces sp. can also occur in patients without an IUD or a pessary; it might cause anexial images that can be interpreted as a tumour, inducing to erroneous diagnosis and treatment.

The aim of this work was to investigate peroxidase activity in human tears during the various phases of the menstrual cycle. For comparative purposes saliva was also examined.Tear fluids and saliva from 10 healthy volunteers 23-41 years of age (mean: 28.2 years), with regular menstrual cycles were sampled for the duration of at least two complete cycles. Menstrual cycles and ovulation periods were evaluated by measuring morning body temperature and hormone levels in plasma and urine. Unstimulated tears and unstimulated saliva were collected in the morning every two days. Peroxidase activity was monitored according to the 5,5'-dithiobis, 2-nitrobenzoic acid thiocyanate (Nbs-SCN) method and the protein content was determined by the Bradford method.Peroxidase activity in tears, expressed as U/mL, was significantly (p.05) higher during the preovulatory and luteal phases with respect to the menses, whilst total protein content remained almost unchanged throughout all phases. A positive correlation was found between lacrimal fluid peroxidase activity and 17beta-estradiol plasma levels (p.001). Salivary peroxidase activity did not show such estrogen-related changes.Our findings report cyclic variations in peroxidase activity in human tears during the menstrual cycle. Such cycling seems to reflect variations of 17 beta-estradiol plasma levels. These results suggest that a regulation of lacrimal fluid peroxidase by 17 beta-estradiol could be one possible cause for the female gender predilection in some ocular diseases, such as keratoconjunctivitis sicca.

Although the atypical antipsychotic agent clozapine has little propensity to induce hyperprolactinemia in humans it increases serum prolactin levels in the rat. In this study, the effects of clozapine and of some typical antipsychotic drugs on basal and dopamine-mediated prolactin secretion from cultured rat pituitary cells were compared. Despite being less potent than the other antipsychotic agents tested, clozapine reverted the effect of dopamine on prolactin secretion in vitro. This finding suggests that clozapine interferes with dopamine receptors in the pituitary gland.

In order to clarify pathogenesis of Obstructive Sleep Apnea Syndrome (OSAS) in patients with anatomic abnormalities of upper airways, we studied soft palate and uvula of OSAS patients by means of histological and ultrastructural techniques. 38 OSAS patients, severe and moderately severe form, underwent modified Palatopharingoplasty. We evaluated only 16 OSAS patients' soft palate and uvula and observed histological changes in all of them: submucosal edema and minor salivary glandes ipertrophy and iperplasy are present. On the contrary, ultramicroscope showed normal muscle fibers. Strie Z alterations and sarcomeres disorganization, although present, have no statistical value. Very probably, ronflement and apneas determined the observed alterations through trauma on pharingeal wall. Therefore, they are not OSAS primary cause.

e20009 Background: Dacarbazine (DTIC) is the standard treatment for metastatic melanoma. Temozolomide (TMZ) is a potentially attractive chemotherapeutic agent for this disease because of the oral route of administration and efficacy similar to that of dacarbazine. Cisplatin is active against melanoma and might counteract mechanisms of resistance to TMZ. Metronomic administration of TMZ might be another way to overcome resistance. Patients and Methods: We reviewed data of metastatic melanoma patients treated at our Institutions with cisplatin (75 mg/m2 every 28 days) plus TMZ (75 mg/m2/die from day 2 for 21 days). Our practice included such scheme for patients younger than 75 years, with a performance status not worse than 2, and adequate bone marrow, liver and renal function. Assessment of response was done every 3 cycles. Toxicity was graded according to NCI-CTC. Results: From August 2007 to September 2008, 33 patients were treated with a median age of 44 years (18–74); primary melanoma was ulcerated in 19 cases (58%); most frequent sites of metastases were lung (18 cases), brain and lymph nodes (11 cases each); 29 patients were treated as first-line and 4 as second-line. The median number of delivered cycles was 4 (range 2- 8). Toxicity was mild, with no grade 4 event reported. Nausea and vomiting were the most frequent and severe toxic effects: grade 3 in 2 cases each and grade 2 in 16 and 9 cases, respectively. Other toxicities included thrombocytopenia (2 case grade 3 and 3 cases grade 2), anemia (1 grade 3 and 4 grade 2), neutropenia, and fatigue (1 grade 3 each). Overall, 6 patients had a partial response (18.2%; 95% exact CI: 7.0–35.5) and 8 (24%) had a disease stabilization. With a median follow-up of 20 weeks (95% CI: 19–57), there were 19 progressions and a median progression-free survival of 24 weeks (95% CI:16-nr); 9 patients died with a median survival of 50 weeks (95% CI 43-nr). Conclusions: Results obtained in clinical practice with metronomic temozolomide plus cisplatin in the treatment of patients with metastatic melanoma are encouraging, in light of the negative prognostic features of treated patients. We are now planning a formal phase II study. [Table: see text]

CTRC-AACR San Antonio Breast Cancer Symposium: 2008 Abstracts Abstract #1150 Purpose. We compared the endocrine effects of 6 and 12 months of adjuvant letrozole versus tamoxifen in postmenopausal patients with hormone responsive early breast cancer, within an ongoing phase 3 trial (HOrmonal adjuvant treatment BOne Effects – HOBOE, ClinicalTrial.gov id: [NCT00412022][1]). Patients and M ethods . Patients were randomised to receive tamoxifen or letrozole ± zoledronate. Serum values of 17-b-estradiol, FSH, LH, testosterone, dehydroepiandrosterone-solphate, progesterone, and cortisol were measured at baseline, after 6 and 12 months of treatment. For each hormone, baseline, 6 and 12-month values were compared between treatment groups, by the exact Wilcoxon-Mann-Whitney test. Results. At December 31, 2006, 157 postmenopausal patients had been enrolled into the study; baseline data were available for 139 patients (88.5%), 43 assigned to tamoxifen and 96 assigned to letrozole. Median age was 61 and 62 years in the two groups, respectively. Baseline values were similar between the two groups for all hormones. At 6 and 12 months, levels of 17-b-estradiol were significantly lower with letrozole as compared with tamoxifen (p=0.0003 and p

We described an experimental condition, in which the i.p. administration of rats of irritants produces a misleading increase of the anticoagulant effect of warfarin. Group of 10 adult Wistar rats were treated i.p. or i.v. with HCl 0.1N plus warfarin p.o.; 24 hr after warfarin administration, prothrombin time was determined on citrate blood specimens and the animals were submitted to autopsy. When HCl is given i.p., a significant increase of prothrombin time is observed. On the contrary following i.v. administration no interference with the anticoagulant effect of warfarin is observed. Abdomen exploration of rats shows the presence of serum exudate following i.p. but not i.v. administration of HCl. The synergistic effect of i.p. administration of HCl on anticoagulant effect of warfarin appears an experimental artifact, probably attributable to a non-specific local irritating effect. This result stresses the need of caution in interpreting animal data indicating a synergism with oral anticoagulant.

In this paper we have studied the rat under chronic treatment with dapiprazole ip. (a drug with alpha-adrenergic blocking properties). For a 4 week period we have recorded, once a week, weight, rectal temperature, tail-flick, general activity and explorative behaviour on rotarod and one-arm radial maze. Surface (SEEG) and deep (DEEG) EEGrams were also recorded at the end of the experiments (4th week). SEEG and DEEG underwent the Fourier analysis (Fast Fourier Transform--see text). The findings were: 1) No change was observed in weight, rectal temperature and tail-flick time, glycemia and haematocrit. 2) Motor coordination on rotaroad dropped in 1st and 3rd week of treatment. 3) The treated rats, when in a one arm radial maze, showed signs of sedation (no grooming) from 2nd week of treatment. 4) SEEG and DEEG recordings showed a slowing activity; Fourier analysis confirmed these results. The slowing of activity (4) well agrees with the signs of sedation and behaviour (2, 3). It seems thus confirmed that alpha-adrenergic blockade is a feature of the drug together with the psychotropic effects previously described.

Summary The effects of acute experimental ocular hypertension on retinal cells have been studied. IOP levels and degree of cell damage have been evaluated by cytochemical and DNA analysis, by which the degeneration, necrotic and apoptotic modalities were observed. Possible pharmacological approaches, e.g. neuroprotection with troxol, have been determined for the prevention of the degenerative events that may be ascribed, at least in part, to oxidizing processes.

Bendazac has anti-inflammatory effects which are different from or complementary to those of corticosteroids; therefore, it has been associated with hydrocortisone or dexamethasone, in the attempt to obtain a dermatological preparation with a wide range of therapeutic applications. Results in laboratory animals were discouraging, in that a diminished activity was observed. On the other hand, bend-acort or (pregn-4ene 3, 20 dione 11β, 17α, 21 trihydroxy, 21 ester with acetic acid [(1-phenylmethyl-1H-indazol-3-yl)-oxy], inhibited both types of inflammatory responses which are sensitive either to bendazac or corticosteroids. Moreover, in acetic acid-induced erythema, which is sensitive to both types of drugs, AF 2071 had stronger effects than those produced by bendazac or corticosteroids. Therapeutic and theoretical implications of these results are discussed.

Summary The effects of amphetamine, scopolamine, phenoxybenzamine, haloperidol and clozapine on biting compulsion induced by large doses of clonidine were studied in mice. Clonidine-induced biting compulsion was potentiated by amphetamine and scopolamine, and inhibited by phenoxybenzamine, haloperidol and clozapine. It appears that biting compulsion elicited by clonidine is mediated by the stimulation of both noradrenaline and dopamine in the brain. Since clorapine, an atypical neuroleptic agent, inhibits this response, the possibility is discussed to use clonidine-induced biting compulsion to detect neuroleptic agents devoid of extrapyramidal side effects.

The synthesis of 5H-imidazo [2,1-c] [1,4] benzodiazepine derivatives is described. Hydroxymethylation of 1-(2-nitrobenzyl)imidazoles by reaction with formaldehyde in a sealed tube and subsequent oxidation of hydroxymethylimidazoles with activated manganese dioxide afforded 1-(2-nitrobenzyl)imidazole-2-carboxaldehydes. The latter compounds were treated with iron(II) sulphate to yield directly the expected tricyclic imidazobenzodiazepines by intramolecular cyclization of the intermediates aminoaldehydes. The tricyclic derivatives were subjected to pharmacological screening to evaluate the effects on the behavior of the animals and the interaction with some biogenic amines. Some of the tested compounds were comparable to chlordiazepoxide in sedative and muscle-relaxant activities. None of them showed antiserotonin, anticholinergic or adrenolytic activities.