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Traditional economic theory recognizes that the company's sole purpose is to produce a profit to be distributed to shareholders in the form of a dividend. Since the last quarter of the last century, corporate strategies have been oriented towards satisfying not only the shareholders, but all the stakeholders in the company: shareholders, employees, customers, suppliers, lenders but also the community and the natural environment with a view to corporate social responsibility. The article presents the difficulties of satisfying all stakeholders jointly due to the inevitable trade-offs arising and to this end suggests some win-win strategies. [ABSTRACT FROM AUTHOR]

Purpose: Childhood obesity is on the rise worldwide increasing the risk for metabolic, cardiovascular and liver diseases in children. Eating habits and lifestyle changes are currently the standard of care for treating pediatric obesity. Our study aimed to determine the impact of a dietary intervention based on the Mediterranean Diet (MD) and the Health Eating Plate, on anthropometric and metabolic parameters in obese and overweight boys. Methods: We studied 126 overweight/obese boys with anthropometric measurements, blood biochemistry and nutrient intakes evaluation by means of Food Frequency Questionnaire (FFQ) at baseline, at 6 and 12 months after a nutritional–behavioral intervention. Results: We observed a significant reduction in energy, macronutrients and micronutrients intakes. BMI-SDS significantly decreased after 1 year with the proportion of obese boys decreasing by 33% and of overweight boys by 41%, while also all fat mass measures decreased both in obese and overweight individuals. In obese boys, ALT decreased significantly after 1-year nutritional intervention and these changes correlated with BMI-SDS reduction. Insulin-resistance and secretion indexes correlated with fat mass and BMI-SDS. In obese boys, significant changes were observed at 6 months for insulin concentrations, 1/HOMA-IR and QUICKI. With regard to the lipid profile, significant decreases were observed for total and LDL cholesterol in obese boys. Conclusion: Metabolic and anthropometric risk factors in overweight and obese boys can be improved by a nutritional–behavioral intervention of 1-year duration.

Abstract The relationship of low prepregnant body mass index with breastfeeding was investigated in 1272 women who delivered a term infant with birth weight ≥ 2500 g at the San [...]

Abstract Determinants of exclusive versus predominant breastfeeding in the maternity ward and the relationship with later feeding practices were investigated in 1656 mothers who breastfed exclusively or predominantly in the [...]

AbstractThe most recent scientific evidence supports the consumption of cow’s milk and dairy products as part of a balanced diet. However, these days, the public and practicing physicans are exposed to a stream of inconsistent (and often misleading) information regarding the relationship between cow’s milk intake and health in the lay press and in the media. The purpose of this article, in this context, is to facilitate doctor–patient communication on this topic, providing physicians with a series of structured answers to frequently asked patient questions. The answers range from milk and milk-derived products’ nutritional function across the life span, to their relationship with diseases such as osteoporosis and cancer, to lactose intolerance and milk allergy, and have been prepared by a panel of experts from the Italian medical and nutritional scientific community.When consumed according to appropriate national guidelines, milk and its derivatives contribute essential micro- and macronutrients to the diet, especially in infancy and childhood where bone mass growth is in a critical phase. Furthermore, preliminary evidence suggests potentially protective effects of milk against overweight, obesity, diabetes, and cardiovascular disease, while no clear data suggest a significant association between milk intake and cancer. Overall, current scientific literature suggests that an appropriate consumption of milk and its derivatives, according to available nutritional guidelines, may be beneficial across all age groups, with the exception of specific medical conditions such as lactose intolerance or milk protein allergy.Key teaching points:Milk and its derivatives contribute essential micro and macronutrients to the diet, when consumed according to appropriate national guidelines, especially in infancy and childhood where bone mass growth is in a critical phase.Preliminary evidence suggests potentially protective effects of milk against overweight, obesity, diabetes and cardiovascular diseaseNo clear data are available about the association between milk intake and cancer.Current scientific literature suggests that an appropriate consumption of milk and its derivatives may be beneficial at all ages, with the exception of specific medical conditions such as lactose intolerance or milk protein allergy.

Wheezing is the most common symptom associated with asthma in young children. There is a lack of well-designed prospective studies on the relationship of exclusive breastfeeding with wheezing in infants. This prospective cohort study investigated whether a relationship exists of exclusive breastfeeding with wheezing at 12 months of age.

Hyperphenylalaninemias (HPA) are due to several gene mutations, of which the PAHgene is the most frequently involved. Prevalence and incidence of disease vary between populations, with genotype/phenotype correlations not always capable to correctly predict disease severity. The aim of this study was to give an overview of PAHmutations among one of the largest cohort of patients among Europe, born in Lombardy (Italy) starting from late 1970 s and including over a 60 years of activity; furthermore, to evaluate and discuss identified genotype/phenotype correlations and related reliability. Eight hundred and twenty‐six HPA patients in current follow‐up at the San Paolo Hospital in Milan (Italy) were retrospectively reviewed, including molecular results and allelic phenotype and genotype values (attributed on the basis of the APV/GPV system) to verify genotype–phenotype correlations. A total of 166 different PAHvariants were reviewed; of those, seven variants were identified as not previously described in literature. Most frequently reported variant was p.Ala403Val, followed by p.Arg261Gln, p.Val245Ala, IVS10‐11 g>a, p.Tyr414Cys and p.Leu48Ser. Phenotype prediction, based on APV/GPV, matched the actual phenotype in most cases, but not always. The cohort of patients included in this study constitute a representative sample of the HPA population worldwide. Studies on this sample may allow to improve clinical and genetic evaluation performances for affected patients, consequently to develop personalized medicine interventions and provide more precise indications on the correct treatment approach based on the accumulated evidence, also in light of a prognostically reliable but not always conclusive APV/GPV system. An overview of PAH mutations among one of the largest cohort of patients among Europe to evaluate and discuss identified genotype/phenotype correlations and related reliability. APV/GPV system is a prognostically reliable but not always conclusive system.

ABSTRACTOsteoarthritis (OA) is a chronic disease affecting the cartilage of over 15% of Canadians. Synovial fluid mesenchymal progenitor cells (sfMPCs) are present in joints and are thought to contribute to healing. OA sfMPCs have a greater proliferative ability but decreased chondrogenic potential. However, little is known about the factors influencing/regulating the differences between normal and OA sfMPCs. Recently, our lab has shown that sfMPC chondrogenic differentiation in vitrois favorably biased toward a similar osmotic environment as they experience in vivo. The current study now examines the expression and functionality of a variety of ion channels in sfMPCs derived from normal individuals and early OA patients. Results indicated that there is differential ion channel regulation at the functional level and expression level in early OA sfMPCs. All ion channels were upregulated in early OA compared to normal sfMPCs with the exception of KCNMA1 at the mRNA level. At the protein level, TRPV4 was over expressed in early OA sfMPCs, while KCNJ12 and KCNMA1 were unchanged between normal and early OA sfMPCs. At the functional level, the inward rectifying potassium channel was under expressed in early OA sfMPCs, however the membrane potential was unchanged between normal and early OA sfMPCs. In the synovial environment itself, a number of differences in ion concentration between normal and early OA synovial fluid were observed. These findings suggest that normal and OA progenitor cells demonstrate functional differences in how they interact with the synovial ion environment.

Lung ultrasonography (LUS) has emerged as a noninvasive tool for the differential diagnosis of pulmonary diseases. However, its use for the diagnosis of acute decompensated heart failure (ADHF) still raises some concerns. We tested the hypothesis that an integrated approach implementing LUS with clinical assessment would have higher diagnostic accuracy than a standard workup in differentiating ADHF from noncardiogenic dyspnea in the ED.

The resting membrane potential, Em, of mammalian cells is a fundamental physiological parameter. Even small changes in Em can modulate excitability, contractility and rates of cell migration. At present accurate, reproducible measurements of Em and determination of its ionic basis remain significant challenges when patch clamp methods are applied to small cells. In this study, a mathematical model has been developed which incorporates many of the main biophysical principles which govern recordings of the resting potential of 'small cells'. Such a prototypical cell (approx. capacitance, 6pF; input resistance 5 GΩ) is representative of neonatal cardiac myocytes, and other cells in the cardiovascular system (endothelium, fibroblasts) and small cells in other tissues, e.g. bone (osteoclasts) articular joints (chondrocytes) and the pancreas (β cells). Two common experimental conditions have been examined: (1) when the background K+ conductance is linear; and (2) when this K+ conductance is highly nonlinear and shows pronounced inward rectification. In the case of a linear K+ conductance, the presence of a "leakage" current through the seal resistance between the cell membrane and the patch pipette always depolarizes Em. Our calculations confirm that accurate characterization of Em is possible when the seal resistance is at least 5 times larger than the input resistance of the targeted cell. Measurement of Em under conditions in which the main background current includes a markedly nonlinear K+ conductance (due to inward rectification) yields complex and somewhat counter-intuitive findings. In fact, there are at least two possible stable values of resting membrane potential for a cell when the nonlinear, inwardly rectifying K+ conductance interacts with the seal current. This type of bistable behavior has been reported in a variety of small mammalian cells, including those from the heart, endothelium, smooth muscle and bone. Our theoretical treatment of these two common experimental situations provides useful mechanistic insights, and suggests practical methods by which these significant limitations, and their impact, can be minimized.

R1623Q and R1626P, slowly inactivating mutants of sodium channel, Nav1.5, associate with sporadic Long-QT3 (LQT3), a syndrome involving ventricular tachyarrhythmias and lethal cardio/respiratory disturbances. Cardiac mechanoelectric feedback is considered a factor in sporadic arrhythmias, and since stretch and shear forces modulate hNav1.5 gating, gating mechanics of LQT-Nav1.5 channels might provide insights. We compared recombinant R1623Q and WT currents in quiescent and stretched membrane of cell-attached patches of Xenopus oocytes. Macroscopic current was monitored before, during and after stretch induced by pipette suction. In either channel peak current at small depolarizations could be more than doubled by stretch. As in WT, R1623Q showed reversible stretch intensity dependent stretch-acceleration of current onset and decay at all voltages, with kinetic coupling between the two processes retained during stretch. The channels differed in the absolute extent of kinetic acceleration for a given stretch intensity; over a range of intensities, R1623Q inactivation speed increased significantly less than did WT. The LQT3 mutant R1626P also retained its kinetic coupling during stretch. Whereas stretch-difference currents in WT were mostly inhibitory, they were substantially (R1623Q) or entirely (R1626P) excitatory for the LQT3 mutants. If stretch-modulated Nav1.5 current (i.e. brief excitation followed by accelerated current decay) routinely contributes to cardiac mechanoelectric feedback, then during hemodynamic load variations, the abnormal stretch-modulated components of R1623Q and R1626P current could be perilously pro-arrhythmic.

AbstractIn this paper, we evaluate the factorial validity of the Spanish short version of the Utrecht Work Engagement Scale (UWES–9) and assess its predictive validity with respect to self-assessed work performance. A total of 229 employees from educational institutions in Ecuador participated. Using a model comparison analysis, the unidimensional model exhibited an excellent goodness of fit, χ2= 26.176 (24), p= .344; CFI =1.000; TLI = 1.000; RMSEA = .020; SRMR = .034; it was not improved by more complex models, Three-factor model: χ2= 22.148 (21), p= .391; CFI =1.000; TLI = 1.000; RMSEA = .016; SRMR = .033. Two-factor model: χ2= 26.080 (23), p= .297; CFI = 1.000; TLI = 1.000; RMSEA = .025; SRMR = .034). Therefore, it is justified as a unidimensional instrument of work engagement. However, upon analyzing the correlation patterns of the overall score and the work engagement dimensions in relation to the task performance, contextual performance, and counterproductive behaviors, we conclude that, while the unidimensional model exhibits a good fit, the three-factor theoretical approach is substantively superior in that it maintains differential predictive validity for each theoretical dimension.

This study examined the effectiveness of the manual for obesity Perdere peso senza perdere la testa (Losing weight without losing your mind) used in form of guided self-help on 161 patients. Three levels of treatments were compared: (a) guided self-help treatment (GSH); (b) minimal guided self-help treatment (M-GSH); (c) control condition (CC). At the end of the treatment, a significant reduction in body weight was observed in GSH and MGSH, but not in the CC. At six-month follow-up 32.7% of GSH subjects and 15.1% of M-GSH subjects were able to maintain at least a 5% weight loss. The findings show that GSH is more effective than M-GSH in determining a significant short-term reduction of body weight.

Abstract. We describe a case of inferior glenohumeral subluxation or drooping shoulder secondary to acute calcific tendinitis of the rotator cuff. The various etiologies of drooping shoulder and the specific causes determining glenohumeral widening in our report are discussed. The importance in recognizing this uncommon complication of a common abnormal finding and correction by aspiration is stressed.

1The effect of extracellular nucleotides applied on the apical side of polarised A6 cells grown on permeant filters was investigated by measuring the changes in (i) the 36Cl efflux through the apical membranes, (ii) the intracellular chloride concentrations (aCli, measured with N‐(6‐methoxyquinolyl) acetoethyl ester, MQAE), (iii) ICl, the short‐circuit current in the absence of Na+transport and (iv) the characteristics of the apical chloride channels using a patch‐clamp approach.2ATP or UTP (0.1‐500 μm) transiently stimulated ICl. The sequence of purinergic agonist potencies was UTP = ATP > ADP >> the P2X‐selective agonist β,γ‐methylene ATP = the P2Y‐selective agonist 2‐methylthioATP. Suramin (100 μm) as the P2Y antagonist Reactive Blue 2 (10 μm) had no effect on the UTP (or ATP)‐stimulated current. These findings are consistent with the presence of P2Y2‐like receptors located on the apical membranes of A6 cells. Apical application of adenosine also transiently increased ICl. This effect was blocked by theophylline while the UTP‐stimulated IClwas not. The existence of a second receptor, of the P1 type is proposed.3ATP (or UTP)‐stimulated IClwas blocked by apical application of 200 μmN‐phenylanthranilic acid (DPC) or 100 μmniflumic acid while 100 μmglibenclamide was ineffective.4Ionomycin and thapsigargin both transiently stimulated ICl; the nucleotide stimulation of IClwas not suppressed by pre‐treatment with these agents. Chlorpromazin (50 μm), a Ca2+‐calmodulin inhibitor strongly inhibited the stimulation of IClinduced either by apical UTP or by ionomycin application. BAPTA‐AM pre‐treatment of A6 cells blocked the UTP‐stimulated ICl. Niflumic acid also blocked the ionomycin stimulated ICl.5A fourfold increase in 36Cl effluxes through the apical membranes was observed after ATP or UTP application. These increases of the apical chloride permeability could also be observed when following aClichanges. Apical application of DPC (1 mM) or 5‐nitro‐2(3‐phenylpropylamino)benzoic acid (NPPB; 500 μm) produced an incomplete inhibition of 36Cl effluxes through the apical membranes in ATP‐stimulated and in untreated monolayers.6In single channel patch‐clamp experiments, an apical chloride channel with a unitary single channel conductance of 7.3 ± 0.6 pS (n= 12) was usually observed. ATP application induced the activation of one or more of these channels within a few minutes.7These results indicate that multiple purinergic receptor subtypes are present in the apical membranes of A6 cells and that nucleotides can act as modulators of Cl−secretion in renal cells.

Three children with acquired immunodeficiency syndrome (AIDS) and chronic anaemia and leucopenia were treated with 5 μg/kg recombinant granulocyte colony-stimulating factor subcutaneously three times a week and 50 IU/kg erythropoietin subcutaneously twice a week. The therapy was not interrupted during the follow-up period. All children showed an increase of leukocyte count and haemoglobin levels. No transfusion was necessary and the number of admissions into hospital fell. These results suggest that combined therapy with granulocyte colony-stimulating factor and erythropoietin may improve leukopenia and anaemia, which is not zidovudine-related, in children who have AIDS.

Single-channel patch-clamp experiments were performed on MDCK cells in order to characterize the ionic channels participating in regulatory volume decrease (RVD). Subconfluent layers of cultured cells were exposed to a hypotonic medium (150 mOsm), and the membrane currents at the single-channel level were measured in cell-attached experiments. The results indicate that MDCK cells respond to a hypotonic swelling by activating several different ionic conductances. In particular, a potassium and a chloride channel appeared in the recordings more frequently than other channels, and this allowed a more detailed study of their properties in the inside-out configuration of the patch-clamp technique. The potassium channel had a linear I/V curve with a unitary conductance of 24±4 pS in symmetrical K+ concentrations (145 mm). It was highly selective for K+ ions vs. Na- ions: PNa/PK<0.04. The time course of its open probability (P0)showed that the cells responded to the hypotonic shock with a rapid activation of this channel. This state of high activity was maintained during the first minute of hypotonicity. The chloride channel participating in RVD was an outward-rectifying channel: outward slope conductance of 63.3+ 4.7 pS and inward slope conductance of 26.1±4.9 pS. It was permeable to both Cl- and NO3-and its maximal activation after the hypotonic shock was reached after several seconds (between 30 and 100 sec). The activity of this anionic channel did not depend on cytoplasmic calcium concentration. Quinine acted as a rapid blocker of both channels when applied to the cytoplasmic side of the membrane. In both cases, 1 mm quinine reversibly reduced single-channel current amplitudes by 20 to 30%. These results indicate that MDCK cells responded to a hypotonic swelling by an early activation of highly selective potassium conductances and a delayed activation of anionic conductances. These data are in good agreement with the changes of membrane potential measured during RVD.

The antitussive efficacy and tolerability of dropropizine and of its enantiomer levodropropizine were evaluated in children with non-productive cough; 258 were evaluable for tolerability and 254 for efficacy. Patients randomly received either 1 mg/kg dropropizine or 2 mg/kg levodropropizine orally, three times daily for 3 days. There were statistically significant decreases in the frequency of coughing spells and nocturnal awakenings after both levodropropizine and dropropizine treatments (P< 0.001). Gastrointestinal symptoms were mild in the two groups; somnolence was twice as frequent in the dropropizine group (10.3% vs 5.3%) and the difference is clinically relevant, though not statistically significant. Levodropropizine is as effective as an antitussive as dropropizine, but appears to carry a lower risk of daytime somnolence.

The calcium intakes of 35 072 Italian schoolchildren aged 7 – 10 years were investigated as part of a nation-wide survey of nutritional patterns. The Friuli, Piedmont, Latium and Sicily regions of Italy were selected as representative of the nation's north–south and east–west socio-economic divisions. A food-frequency questionnaire was used to assess the nutritional intakes of the whole sample. The validity of the food-frequency questionnaire method was assessed in a sub-sample of children by traditional methods: 24-h dietary recall and a weighted food diary. The data indicate that the mean calcium intakes of girls were below the recommended daily intake of 800 mg in all of the regions except Sicily, and that the calcium intakes of boys were above the recommended daily intake in all of the regions except Friuli. These results suggest that there may be deficiencies in the calcium intakes of this age-group in the wider population, particularly in girls. Food-frequency questionnaires are potentially valuable as part of a multi-method approach in large-scale nutritional monitoring.

The efficacy and safety of γ-linolenic acid in the treatment of atopic dermatitis was evaluated. The children (mean age, 11.4 months) with atopic dermatitis (mean duration, 8.56 months) were openly treated with 3 g/day γ-linolenic acid, for 28 days. Clinical evaluations were carried out every 7 days, and parents were asked to keep a diary, recording details of symptoms of eczema every day. Blood chemistry and immunological tests were done before and after treatment. None of the children showed complete recovery of symptoms. A gradual improvement in erythema, excoriations and lichenification was seen; significant differences were shown for itching (P< 0.01), and the use of antihistamines (P< 0.01). A significant rise in the percentage of circulating CD8 was found. No side-effects were recorded. Dietetic and pharmacological approaches are the basis of the treatment of atopic dermatitis and γ-linolenic acid appears to be a safe and efficient additional therapy for infants and young children.

Abstract.: A new technique allowing single-channel patch-clamp recordings from basolateral membranes of A6 renal epithelial cells in culture was developed. Using this technique we studied the chloride channels activated in these basolateral membranes during hypo-osmotic stress. Four different types of channel were identified and classified according to their current/voltage (I/V) relationships as observed in the on-cell configuration of the patch-clamp technique. Three of these channels had linear I/V relationships with unitary conductances of 12, 30 and 42 pS. The fourth type had an outwardly rectifying I/V curve with inward and outward conductances of 16 and 57 pS respectively. The kinetic properties of each class of channel were studied and kinetic models developed for two of them: the 42 pS channel and the outward rectifier. These models permitted the study of the evolution of the kinetic parameters during hypo-osmotic shock and revealed two different kinetic schemes of channel activation. The results of experiments made on the basolateral membranes were also compared with those of a set of analogous patch-clamp experiments carried out on isolated A6 cells. In these latter, the frequency of successful observations of active channels in a patch was 13%, whereas it was 31% for basolateral membranes. Also, of the four types of channel observed in basolateral membranes, two were never found in isolated cells, only the 12 pS channel and the outward rectifier were present in these isolated cells.

The effect of diet on the development of immunoallergic signs and symptoms in children with phenylketonuria (PKU) was evaluated. Immunological indices of 58 children with PKU treated with diets were compared to the immunological indices of 58 healthy (non-PKU) children. In the PKU group, 39 children had been placed on diet therapy within the first month of life; 19 children had been placed on diet therapy after 6 months of age. Total circulating lymphocytes; CD3+, CD4+, CD8+ circulating lymphocytes; and serum IgA, IgM, IgG and total IgE levels were measured for each child. Skin prick tests were performed for common inhalant and food allergens. Every 3 months over the 2-year period of this study, the signs and symptoms of eczema, allergic rhinitis and asthma were recorded.

To determine whether granulocyte-colony stimulating factor and erythropoietin are effective in the therapy of neutropenia and anaemia related to human immunodeficiency virus (HIV) infection and to anti-retroviral agents, we recruited 11 HIV-infected children (mean age 4 years 10 months). All the children were given granulocyte-colony stimulating factor at a dosage of 5 μ-g/kg twice or three times a week while erythropoietin was administered additionally to three patients at a dosage of 50 U/kg twice a week. Both agents were administered subcutaneously for at least 4 months. Leukocyte and neutrophil counts significantly increased during the treatment (after 1 month, P= 0.003 and P= 0.009, respectively). Erythropoietin prevented blood transfusions and increased haemoglobin levels in the three children treated. No side-effects were recorded during the administration of either agent. Granulocyte-colony stimulating factor and erythropoietin appear to be safe and useful agents in the management of HIV-infected children.

The permeability to Cl- of the basolateral membrane (blm) was investigated in renal (A6) epithelial cells, assessing their role in transepithelial ion transport under steady-state conditions (isoosmotic) and following a hypoosmotic shock (i.e. in a regulatory volume decrease, RVD). Three different complementary studies were made by measuring: (1) the Cl- transport rates (?F/Fo · s-1 (× 10-3)), where F is the fluorescence of N-(6-methoxyquinoyl) acetoethyl ester, MQAE, and Fo the maximal fluorescence (×10-3) of both membranes by following the intracellular Cl-3 activities (aiCl-, measured with MQAE) after extracellular Cl- substitution (2) the blm 86Rb and 36Cl uptakes and (3) the cellular potential and Cl- current using the wholecell patch-clamp technique to differentiate between the different Cl- transport mechanisms. The permeability of the blm to Cl- was found to be much greater than that of the apical membranes under resting conditions: aiCl- changes were 5.3±0.7 mM and 25.5±1.05 mM (n=79) when Cl- was substituted by NO3- in the media bathing apical and basolateral membranes. The Cl- transport rate of the blm was blocked by bumetanide (100 µM) and 5-nitro-2-(3-phenylpropylamino)benzoic acid (NPPB, 50 µM) but not by N-phenylanthranilic acid (DPC, 100 µM). 86Rb and 36C1 uptake experiments confirmed the presence of a bumetanide- and a NPPB-sensitive Cl- pathway, the latter being approximately three times more important than the former (Na/K/2Cl cotransporter). Application of a hypoosmotic medium to the serosal side of the cell increased ?F/Fo · s-1 (×10-3) after extracellular Cl-3 substitution (1.03±0.10 and 2.45±0.17 arbitrary fluorescent units·s-1 for isoosmotic and hypoosmotic conditions respectively, n=11); this ?F/Fo·s-1 (×10-3) increase was totally blocked by serosal NPPB application; on the other hand, cotransporter activity was decreased by the hypoosmotic shock. Cellular Ca2+ depletion had no effect on ?F/Fo·s-1 (×10-3) under isoosmotic conditions, but blocked the ?F/Fo·s-1 (×10-3) increase induced by a hypoosmotic stress. Under isotonic conditions the measured cellular potential at rest was -37.2±4.0 mV but reached a maximal and transient depolarization of -25.1±3.7 mV (n=9) under hypoosmotic conditions. The cellular current at a patch-clamping cellular potential of -85 mV (close to the Nernst equilibrium potential for K+) was blocked by NPPB and transiently increased by hypoosmotic shock (˜ 50% maximum increase). This study demonstrates that the major component of Cl- transport through the blm of the A6 monolayer is a conductive pathway (NPPB-sensitive Cl- channels) and not a Na/K/2Cl cotransporter. These channels could play a role in transepithelial Cl- absorption and cell volume regulation. The increase in the blm Cl- conductance, inducing a depolarization of these membranes, is proposed as one of the early events responsible for the stimulation of the 86Rb efflux involved in cell volume regulation.

1We recently cloned a putative chloride channel (xClC‐5) from the renal cell line A6, which induced the appearance of a Cl−conductance not found in control oocytes after homologous expression in Xenopusoocytes. With the aim of increasing the Xenopusoocyte xClC‐5 expression, we constructed a new plasmid in which the native 5′ and 3′ non‐coding regions of xClC‐5 were replaced by the non‐coding regions of the Xenopusβ‐globin sequence and in which a Kozak consensus site was introduced before the initiator ATG.2We then compared the induced currents Inative(induced by injection of cRNA presenting the native non‐coding regions of xClC‐5) and Iβ‐globin(induced by injection of cRNA presenting the non‐coding regions of the Xenopusβ‐globin sequence) investigating anion selectivity and anion blocker sensitivity. Several differences were found: (1) expression yield and oocyte surviving rate were largely increased by injecting (β) xClC‐5 cRNA, (2) the Iβ‐globinoutward rectification score was 2.6 times that of Inative, (3) the anion conductivity sequence was nitrate > bromide > chloride > iodide >> gluconate for Iβ‐globinand iodide > bromide > nitrate > chloride >> gluconate for Inative, (4) 5‐nitro‐2‐(3‐phenylpropylamino)‐benzoic acid (NPPB), anthracene‐9‐carboxylic acid (9‐AC), DIDS, lanthanum ions, cAMP and ionomycin‐induced [Ca2+]iincrease inhibited Inativebut had no effect on Iβ‐globin, and (5) Inativeshowed considerable similarity to the previously reported endogenous current appearing after ClC‐6 or pICln cRNA injection.3Comparison of Inativewith the endogenous chloride current ICl,swellwhich develops under hyposmotic conditions demonstrated several similarities in their electrophysiological and pharmacological characteristics but were nevertheless distinguishable.4In vitrotranslation assays demonstrated that protein synthesis was much greater using the (β) xClC‐5 construct than that of xClC‐5. Furthermore, immunoreactivity of membrane preparations of Xenopusoocytes was only observed with the (β) xClC‐5 construct, its intensity being positively correlated with Iβ‐globinlevels.5In addition, the current induced in (β) xClC‐5 cRNA‐injected oocytes presented a very marked pH dependence (inhibition by acid external media) with a pKavalue (negative log of the acid dissociation constant) of 5.67.6In conclusion, Iβ‐globinmay be due to the presence of xClC‐5 in the oocyte plasma membrane playing a role as an anion channel whereas Inativemay represent an endogenous current induced by xClC‐5 cRNA injection. The use of antibodies will facilitate the tissue and subcellular localization of xClC‐5 and the identification of its physiological role.

Large losses of amino acids by diffusion were previously observed in Madin-Darby canine kidney (MDCK) cells during volume regulation. Also, an outward rectifying anion channel was activated. Because this channel was not selective among anions, it was suggested that it could be permeable to amino acids. Its permeability to aspartate, glutamate, and taurine was studied using the patch-clamp technique in the inside-out configuration. Solutions containing 500 mM aspartate or glutamate were used on the cytoplasmic side of excised patches to detect single-channel currents carried by these anions. Permeability ratios were estimated in two different ways: 1) from the shift in reversal potential of current-voltage curves after anion replacement in the bath solution and 2) from comparisons of amplitudes of single-channel currents carried by tested anions and chloride, respectively. The values of aspartate-to-chloride and glutamate-to-chloride permeability ratios obtained with both methods were quite consistent and were of the order of 0.2 for both amino acids. Taurine in solutions at physiological pH 7.3 is a zwitterionic molecule and bears no net charge. To detect single-channel currents carried by taurine, solutions containing 500 mM taurine at pH 8.2 were used in inside-out experiments. Under these conditions 120 mM of negatively charged taurine was present in the solutions bathing the cytoplasmic side of excised patches. The permeability ratio estimated from the shift in reversal potential was 0.75. These results showed that some of the organic compounds released by cells during regulatory volume decrease could diffuse through this outwardly rectifying anionic channel.

The ultrasound and CT findings in two patients with hemangioma of the adrenal gland are presented. Ultrasound showed large masses with heterogeneous nonspecific structural pattern. Unenhanced CT demonstrated lesions with hypodense centers and thick irregular peripheries with higher density. A few small peripheral calcifications were noted in one patient. Following contrast medium injection, patchy enhancement of the peripheral zone of the tumor was seen in both cases.

Retinol palmitate oral administration is convenient, but it is difficult to assess/monitor its nutritional status in preterm infants and literature is controversial about the administration route and the effectiveness of vitamin A supplementation. We primarily evaluated retinol plasma levels to assess the vitamin A nutritional status in preterm infants (<1500 g; 32 weeks) after 28 days of oral supplementation (3000 IU/kg/day, retinol palmitate drops), in addition to vitamin A standard amount as suggested by European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines. We then observed the rate of typical preterm pathologies in the supplemented group (31 newborns) and in 10 matching preterm infants, hospitalized in neonatal intensive care unit (NICU) in the same period, who received neither vitamin A supplementation nor parents allowed plasma sampling. Oral integration resulted in constant retinol plasma concentration around the desired level of 200 ng/mL, but without statistical increase during the study period. Due to the complexity of vitamin A metabolism and the immaturity of preterm infant’s organs, retinol supplementation may had first saturated other needy tissues; therefore, plasmatic measures may not be consistent with improved global vitamin A body distribution. Therefore, achieving a constant retinol concentration is a valuable result and supportive for oral administration: decreasing levels, even after parenteral/enteral supplementation, were reported in the literature. In spite of favourable trend and no adverse events, we did not report statistical difference in co-morbidities. This investigation confirms the necessity to perform further trials in preterm newborns, to find an index reflecting the complex nutritional retinol status after oral administration of vitamin A, highlighting its effectiveness/tolerability in correlated preterm infant’s pathologies.

Aim: To assess whether an association may exist of PPAR-?2 Pro12Ala variant with longitudinal variation in metabolic outcomes and plasma polyunsaturated fatty acids (PUFA) in obese children one-year after nutritional intervention.Methods: One hundred and nine consecutive normolipidemic obese children (42 girls and 67 boys, age 8-13 yrs,) were analyzed. Body mass index (BMI) z-scores were calculated. Fasting blood samples were evaluated for insulin, glucose, lipid profile and fatty acid (FA) levels at baseline and one-year after nutritional-behaviour intervention, based on normocaloric balanced diet and physical activity. Insulin resistance was estimated by homeostatic model assessment method (HOMA) and quantitative insulin sensitivity check index (QUICK1). Genomic DNA was obtained from peripheral blood using standard methods, and the Pro12Ala PPAR-g2 variant was detected by DNA sequencing.Results: The frequency of Ala allele was 8% (Pro/Pro 83.5%, Pro/Ala 16.5%). At the end of the intervention children showed decreased BMI z-score (median 0.16; IQR, 0.00-0.3; P< 0.0001) and HOMA (0,75;0.10-1,73; P< 0.0001) and increased QUICK1 (0,015;0.005-0,024; P< 0.0001), but no significant difference was observed between carriers and non-carriers of PPAR-?2 Pro12Ala variant (minimum P=0.653). Compared to non-carriers of PPAR-?2 Pro12Ala variant, plasma saturated FA decreased (P=0.006) while PUFA (P=0.014), n-6 PUFA (P=0.002) and n-3 PUFA (P=0.047) increased more in carriers.Conclusions: Different response of plasma PUFA to nutritional interventions in obese children may be associated with Pro12Ala variant of the PPAR- ?2 gene.

Aim: To assess whether an association may exist between maternal pre-pregnancy Body Mass Index (BMI) and infant's growth throughout the first year of life.Methods: Prospective observational cohort study including 1246 at term, singleton, healthy newborns. Mothers were interviewed before discharge about pre-pregnancy weight, sociodemographic data, lifestyle and were given a diary to record the type of feeding during the study period. Maternal pre-pregnacy BMI was categorized according to the World Health Organization criteria as: underweight (BMI < 18.5 kg/m2), normal-weight (18.5 kg/m2< BMI< 25 kg/m2) and overweight (BMI = 25 kg/m2). Infant's growth (weight, length, BMI) data were collected during visits scheduled at 1, 3, 6, 9, 12 months of life, and z-scores were calculated.Results: Birth weight was lower in infants born to underweight (mean 3289 g, SD 384) than normal-weight (mean 3416 g, SD 408) and overweight mothers (mean 3426 g, SD 431) (P< 0.05). Throughout the first year of life, the infant's BMI z-score ranged between 0.37 and 0.77 in the whole sample but was significantly higher in infants born to overweight than underweight and normal-weight mothers from 6 months onwards (maximum P=0.024). Significance of difference decreased (P=0.072) after adjusting for confounders (breastfeeding, solid foods introduction and type, mother age,educational level. No overall significant difference occurred among underweight, normal-weight and overweight mothers for length z-score.Conclusions: The infant's BMI z-score pattern throughout the first year of life may be associated with maternal pre-pregnancy BMI.

Objective: To evaluate whether an one-year nutritional-behaviour intervention based on normocaloric balanced diet and physical exercise may reduce the liver fat in obese children.Methods: Twenty-six obese children (11 males and 15 females), aged 6-14 years, underwent anthropometic, nutritional, metabolic and liver magnetic resonance imaging (MRI) examinations at baseline and after an one-year nutritionalbehaviour intervention. Anthropometry included weight, height, waist and hip circumference and total upper arm area. Body mass index (BMI) z-scores were calculated. Biochemistry included serum aminotransferases, lipid profile, glucose and insulin. Liver steatosis was judged as hepatic fat fraction (FF) by MRI was = 9%.Results: Prevalence of steatosis was 34.6 % at baseline and declined to 7.7 % after intervention (P< 0.0001). Mean (95% CI) reduction of liver FF was 8.0 (4.0-12.0) %. In 77.8% of children with liver steatosis at baseline the FF declined lower than 9% at the end of intervention, going from a mean [SD] of 18.7 [9.1] % to 1.3 [4.1] %, (P< 0.0001). At the end of the intervention children showed a mean reduction in BMI z-score of 0.26 (0.11- 0.41), and waist circumference of 1.46 (0.34-2.60) cm. Triglycerides, total cholesterol, ApoA1, ApoB, ApoA1/ApoB ratio and gamma-GT plasma values in plasma decreased at the end of intervention (P< 0.05).Conclusions: The results suggest that in obese children nutritional-behaviour interventions may reduce the liver fat.

Objective. To evaluate and compare the rates of initiation and duration of breastfeeding across geographical areas of Italy.Methods. A total of 2450 mothers, who delivered a healthy full term infant in Italy, were interviewed through the first 12 months after delivery about feeding practices. Breastfeeding was classified in accordance with the World Health Organization (WHO). Adherence to the WHO ten steps to successful breastfeeding was further assessed. Chi-square and log-rank tests, logistic and Cox regressions were used for the statistical analysis.Results. Breastfeeding started in 91% of mothers, ranging from 85% (Sicilia) to 93% (North-east, South). At discharge the rate of exclusive breastfeeding was 77%, ranging from 57% (Sicilia) to 81% (North-east, Sardinia). Mean duration of breastfeeding ranged from 3.1 (Sicilia) to 6.0 months (Sardinia). Mean duration of exclusive breastfeeding ranged from 1.8 (Sicilia) to 2.6 months (North-east and Sardinia). Lower adherence to the WHO steps and less favorable socio-demographic characteristics, especially maternal lower education level, smoking habits and overweight, influenced negatively both breastfeeding and exclusive breastfeeding.Conclusion. Differences in duration of breastfeeding and exclusive breastfeeding across geographical areas of Italy require planning of strategies for improvement, possibly taking into account for the WHO steps and socio-demographic characteristics.

Aim of this study was to compare sexual activity and serum steroid hormones levels of hypertensive (Hypertens) males with those of healthy normotensive (Normotens) males. We investigated 110 consecutive newly diagnosed never treated hypertensive (DBP = 95 mmHg) males and 110 healthy normotensive (DBP < 90 mmHg) males. All of them were aged 40-49 years, married, without any previous sexual dysfunction, non diabetic, non obese (BMI < 28 Kg/m2) and not taking any drug. Patients and controls were interviewed by a questionnaire about their sexual activity and a venous blood sample was obtained in the morning to evaluate total testosterone (Testost.) and androstenedione (Androst.) levels. The main results are as follows: (See Table) SBPDBPTestost.Androst.Intercourse(mmHg)(mmHg)(nmol/L)(nmol/L)/month (n)Normotens127±979±425.2±9.17.3±3.18.3±3.8Hypertens159±11**100±6**18.8±7.6**6.2±2.5*6.5±2.9** p < 0,05, ** p < 0,01 vs normotensive. In hypertensive patients testosterone levels were strongly and inversely correlated with BP (SBP r = -0,50, p< 0,01, DBP r = -0.48, p< 0,01) and directly correlated with sexual activity (r = 0,30, p < 0,05). Essential hypertensive men have a 25% reduction in serum total testosterone, a 15 % reduction in androstenedione, the immediate precursor of testosterone, and a 22 % reduction in sexual activity when compared with age-matched normotensive men. These data suggest a relationship between hypertension and impaired sex steroid hormone metabolism in males and allow to better understand why hypertensive males are so prone to develop sexual dysfunctions with many antihypertensive drugs.

Aim of this study was to compare sexual activity and serum testosterone levels of hypertensive males with those of healthy normotensive males. We investigated 98 consecutive newly diagnosed uncomplicated never treated hypertensive (DBP = 95 mmHg) males and 101 healthy normotensive (DBP < 90 mmHg) males. All of them were aged 40–49 years, married, without any previous sexual dysfunction, non diabetic, non obese (BMI < 30 Kg/m2) and not taking any drug. Patients and controls were interviewed by a questionnaire about their sexual activity and a venous blood sample was obtained in the morning between 0800 and 0900 to evaluate total testosterone levels. The main results are as follows: (See Table) SBP (mmHg)DBP (mmHg)Testosterone (nmol/L)Intercourse /month (n)Normotensive127 ± 979 ± 426,2 ± 9,18,1 ± 3,8Hypertensive159 ± 11***100 ± 5***17,3 ± 7,6**6,3 ± 2,9** p < 0,05, ** p < 0,01, *** p < 0,001 vs normotensive. In hypertensive men testosterone levels were significantly correlated with sexual activity (r = 0,37, p = 0,038) and weakly and inversely correlated with DBP (r = -0,31, p = 0,048). Essential hypertensive men have a 22% reduction in sexual activity and a 33% reduction in serum testosterone levels when compared with age-matched normotensive men. These data suggest a relationship between hypertension and impaired sex steroid hormone metabolism in males and allow to better understand why hypertensive males are so prone to develop sexual dysfunctions with many antihypertensive drugs.