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The use of the Pap test is a method of the prevention of cervical cancer in our local division of the Sanitary Unit and has been studied with the help of a questionnaire which was completed by women who had adopted this test. The socioeconomic characteristics, level of education, occupation and general attitudes regarding the Pap test as well as how the women had acquired knowledge of the test, have all been examined. From an analysis of the answers, we have been able to trace a precise social, economic and cultural profile of the type of women who take advantage of this test. Principally, we are dealing with women aged 40-49 years, often with children, with a medium to low level of education, who are mainly housewives and white-collar workers. Very few elderly women present themselves for the Pap test. We have noticed that there is a direct decrease in the use of preventive methods, proportional to the increase in age. These results demonstrate that an erratic use of this preventive method, in the absence of an organized screening programme, seems only to involve women who are among those at less risk from cervical cancer.

Some Local Sanitary Units (USL) of the Emilia-Romagna region were contacted to define cervical screening variables, such as adequacy of smear technique, data collection and evaluation, laboratory quality control modalities of invitations to screening. Our data show there are a lot of deficiencies in the present management of the cervical program in Romagna. The most serious inadequacies concern data evaluation, follow-up, cytologic quality control, modalities of active invitations of women to screening. The survey has confirmed the need for launching organized programs of cervical screening to promote their efficacy of diagnosis and therapy.

To determine the influence of the metal coordination sphere on the permeability of the blood-brain barrier (BBB), rats were injected intraperitoneally with aluminum lactate (Al(lact)3), aluminum acetylacetonate (Al(acac)3), aluminum maltolate (Al(malt)3) at pH 7.5, or with physiological saline. Two h after each treatment, [14C]sucrose physiological saline solution was injected in animals, and the radioactivity was measured in 5 brain regions (cerebral cortex, mesencephalon, diencephalon, medulla-pons, cerebellum). Radioactivity was significantly elevated in brains from animals treated with Al(malt)3 (hydrolytically stable and hydrophilic), and with Al(acac)3 (hydrolytically stable and lipophilic) but not with Al(lact)3. Time-course study carried out at 2, 4 and 24 h with different aluminum compounds showed a persistent radioactivity 24 h after treatment only in the brain from animals treated with Al(acac)3. Morin stain localized AlIII only in neurons from animals treated with Al(acac)3. These findings indicate that AlIII alters the BBB function in the rat either permanently or transiently depending on the physiochemical properties of the metal coordination sphere. Implications of these results, in terms of AlIII as a potential toxic factor in humans, are considered and discussed.

Controversy over the relevance of aluminium to certain human encephalopathies has emphasized the importance of in vivo and in vitro models as tools for shedding light on the biological and molecular aspects of the aluminium toxicity. The search for an experimental model in animals or in cultured cells able to reproduce specific pathological human conditions may prove to be an unattainable aim; nevertheless, in vivo and in vitro models should be actively sought and the pathological changes induced in experimental animals should always be evaluated at the cellular level, just as for changes produced directly in cultured cells. These toxicological aspects are outlined with particular emphasis on the role played by the molecular form of aluminium (metal speciation) in determining the quality and intensity of the metal's biological effects.

Recently much interest has been focused on the phenomena produced by the interaction between blood and dialytic membranes. The aim of this study was to evaluate beta 2-M, Il-2 and TNF changes in relation to the long-term use of different membranes (CU, PAN-AN69, PMMA, PS) and different dialytic treatments (HD, HDF, AFB). Plasma beta 2-M was significantly increased in patients dialysed with CU compared to synthetic membranes, and decreased in AFB compared to HD and HDF. Intradialytic changes of beta 2-M, corrected for haemoconcentration, resulted in a significant increase with CU and PMMA, while a decrease was found with PAN-AN69 and PS and during convective treatments, more evident during haemofiltration performed with sterile dialysate without acetate. I1-2R was increased in all patients compared to normal subjects, without any intradialytic change, regardless of the type of membrane used. TNF was in the normal range. The different decrease of beta 2-M observed with synthetic membranes, the stable intradialysis I1-2 R values during HD performed with membranes non-permeable to endotoxins and during AFB, and the absence of detectable TNF support the hypothesis that dialysate plays an important role in activating beta 2-M and cytokines, together with other factors.

From March 1977 to December 1982, 142 patients with varicocele of various sizes underwent preoperative antegrade or retrograde phlebography of the left spermatic vein. In 8 of them both procedures were carried out. A retrospective analysis of 68 preoperative antegrade venographies in supine (0 degree) and upright (30 degrees, 45 degrees and 90 degrees) positions was made and compared with 66 retrograde venograms. The preoperative 'dynamic' antegrade phlebography has been performed in order to study the hemodynamic conditions of the varicocele, avoiding any pressure interference on the valvular function of the venous renospermatic area. This technique has allowed us to get useful anatomoradiological and physiopathological information about the spontaneous reflux into the internal spermatic vein by its positional filling and emptying. It has also permitted a good visualization of collateral channels, particularly in the pelvic, femorosaphenous and scrotal areas. We could, at the same time, simultaneously sample blood from the cubital and intrascrotal spermatic veins to determine the testosterone, cortisol and serotonin levels, in different positions; the evaluation of these biochemical data is being pursued. In our opinion, this diagnostic procedure is easy to perform and inexpensive. The procedure and the results are discussed in detail.

The importance of the urine volume and the residual functional capacity of the kidneys has been emphasized by several authors in connection with preservation of the quality of life of patients having to undergo chronic dialysis therapy. Since it has been found that muzolimine can increase diuresis even in patients with extremely high uraemia (GFR values less than 5 ml/min), a group of 16 patients (10 haemodialysis patients, HD, and 6 peritoneal dialysis patients, CAPD) was treated daily with 90 mg for a period of one year, commencing with the start of dialysis therapy. The aim of the study was to monitor the diuresis and to evaluate any changes in the quality of life. The latter were assessed on the basis of clinical criteria by the scheme of Ravid et al. The results were compared with the results obtained from another group of 16 patients (10 HD and 6 CAPD) who had likewise been on dialysis for a year but without receiving diuretic therapy. The two groups were homogeneous in age, sex, aetiology of the kidney disease, and renal function. Even though diuresis, like the residual renal function, normally deteriorates in the course of time owing to the underlying kidney disease, the administration of muzolimine showed that the compound is able to induce statistically significantly higher diuresis in the treated patients in the first year of dialysis compared with the untreated patients. In addition it was possible to preserve the residual kidney function established at the start of the dialysis therapy, which corresponds to a significantly improved quality of life.