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Amplitude/frequency characteristics of postural hand tremor in 59 patients with bilateral essential tremor of various degrees of severity were assessed using accelerometric recordings and spectral analysis. Intra-subject comparisons of tremor characteristics between the more and less affected hands were used to control for variability of tremor due to age factors and intersubject differences in amplitude and frequency. Statistical analysis distinguished three different patient groups. Some patients had low amplitude (less than 0.1-0.015 cm) tremor in the less affected limb (which tended to be 7 Hz or more in frequency in the young) and a larger amplitude tremor in the more affected hand which was 1 Hz or more lower in frequency. Other subjects had either bilaterally small or bilaterally large amplitude tremors of similar frequencies. These findings imply that there is a downwards step in frequency between symptomatic tremors of small and large amplitude. The amplitude and frequency of the small amplitude tremors were unrelated but frequency declined with age. The frequency of the large amplitude tremor was generally determined by amplitude but a wide range of amplitudes were compatible with similar frequencies. The frequency of large amplitude tremor also declined with age. It was concluded that there are two types of essential tremor, the smaller amplitude tremor probably derives from an exaggeration of some or all of the mechanisms of normal physiological tremor whereas the larger amplitude tremor probably arises from a separate "pathological" central nervous mechanism. It is not known if or how one may transform into, or be replaced by, the other during progression of the disease. [ABSTRACT FROM AUTHOR]

The supine and erect arterial blood pressure and pulse rate were measured in 13 patients with Parkinson's disease, chronically treated with levodopa and peripheral decarboxilase inhibitors presenting with or without On-Off phenomenon (end-of-dose akinesia). In the patients with dose-related response fluctuations the mean systo-diastolic blood pressure, both supine and erect, was found significantly higher during the Off phase as compared to the On phase and to that of the control group (patients with stable clinical response). The mean diurnal "excursion" of systo-diastolic supine and erect blood pressure in patients with On-Off phenomenon was significantly larger than in the control group. Although the clinical implications of such findings remain to be established, the results of this study indicate that arterial blood pressure fluctuations are a definite autonomic component of end-of-dose akinesia. [ABSTRACT FROM AUTHOR]

Although ex situ conservation programs are increasingly valuable support tools for in situ conservation measures, success depends on these captive individuals to be genetically representative of the recipient population. The Eurasian stone-curlew ( Burhinus oedicnemus ) inhabit steppes that represent some of the most degraded and exploited habitats worldwide. A captive breeding program was implemented in Morocco as a pre-emptive effort for the conservation of the North African subspecies Burhinus oedicnemus saharae . However, the genetic origins of the founders of the captive flock were unknown. We applied a multi-locus approach to characterize the genetic ancestry of the current captive breeding flock by comparing it to wild populations from both Western and Eastern Morocco. Mitochondrial DNA and microsatellite markers were employed to assess levels of genetic diversity and relatedness within each sample, as well as potential genetic differentiation between wild and captive samples through PCA and admixture analyses. We recovered similar genetic diversity estimates, low levels of relatedness, and little differentiation between captive and wild samples. These results confirmed the Moroccan origin of the founders. We provide recommendations for the optimization of the Eurasian Stone Curlew conservation breeding program but also for future conservation breeding programs to ensure the effective conservation of genetic diversity and wild populations.

CD44 is a cell receptor glycoprotein overexpressed in circulating tumor cells (CTCs), with levels linked to an increase in metastatic capacity of several tumors. Hyaluronic acid (HA), the natural ligand of CD44, has primarily been investigated for tumor cell interaction in self-assembled polyelectrolyte multilayer films, with little attention given to the complementary polycation. In this study, we screened sixteen different polyelectrolyte multilayer assemblies of HA and chitosan (CHI) to identify key assembly parameters and surface properties that control and govern CTCs adhesion. Statistics analysis revealed a major role of CHI molecular weight in the adhesion, followed by its combinatorial response either with HA ionization degree or ionic strength. PM-IRRAS analysis demonstrated a correlation between the orientation of HA carboxyl groups on the film surface and CTCs adhesion, directly impacted by CHI molecular weight. Overall, although CTCs binding onto the surface of multilayer films is primarily driven by HA-CD44 interaction, both chitosan properties and film assembly conditions modulate this interaction. These findings illustrate an alternative to modifying the performance of biomaterials with minimal changes in the composition of multilayer films., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier B.V.)

The study aimed to investigate the in vitro effects of the fluoroquinolone antibiotics (FQs) Ciprofloxacin (CIP), Enrofloxacin (ENR) and Danofloxacin (DAN) on the mussel Mytilus galloprovincialis exposed to environmentally relevant concentrations. In vitro exposure was performed on subcellular fractions of the digestive gland and gills through a multi-biomarker approach, which included the assessment of cellular damage, antioxidant and biotransformation enzyme activities, neurotoxicity, and DNA single-strand breaks (DNAssb). Results showed a decrease in protein carbonyl content in the gills when exposed to all concentrations of ENR. A significant overall decrease in the enzymatic activity of antioxidant defences was observed in the digestive gland exposed to the highest concentration of DAN and CIP, with a similar trend observed in the gills. Neurotoxicity was observed in the digestive gland at all tested concentrations of all FQs, but no effects were detected in the gills. DNAssb was evident in both tissues at all higher FQ concentrations., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

The establishment of marine protected areas is considered the main global strategy to halt the loss of marine biodiversity. Since most of marine areas are open systems, this form of habitat protection cannot prevent their contamination due to human activities performed outside of their borders. Innovative approaches to assess the health status of protected marine habitats are therefore needed. Here we developed a multidisciplinary approach that combines ecological characteristics, bioaccumulation of inorganic and organic pollutants, cell damage (micronuclei frequency, nuclear alterations and LPO) and enzymatic (AChE, CAT, IDH, LDH, GST and CAT) markers focused on an intertidal brachyuran crab, Pachygrapsus marmoratus, to assess the impacts of contaminant exposure on Mediterranean coastal habitats. As study sites we selected two protected areas and two sites within industrial ports of the Ligurian Sea. Our results showed that the selected crab species is an excellent bioindicator. Individuals collected in sites with the highest levels of heavy metal pollution showed the highest signals of stress responses at both cellular and enzymatic levels, coupled with a high incidence of the parasite Sacculina carcini, a signal of impairment of their standard development and reproduction cycle. We could also prove that one of the selected marine protected areas showed the same intensity of impact as its adjacent port site. Our multidisciplinary approach proved to be a valuable tool to assess the environmental quality and health of protected and disturbed Mediterranean coastal environments and to inform efficient management and protection schemes for such habitats., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Contaminants of emerging concern (CECs) are a class of chemicals that can spread throughout the environment and may cause adverse biological and ecological effects. While there are many different classes of CECs, one of the most well documented in the aquatic environment are pharmaceutical drugs, such as natural and synthetic estrogens. In particular, the widespread presence of the synthetic estrogen 17 α-Ethinylestradiol (EE2) in water may lead to bioaccumulation in sediment and biota. EE2 is the primary component in contraceptive pills, and is a derivative of the natural hormone estradiol (E2). In this study, the mussel Mytilus galloprovincialis was exposed to EE2 in a semi-static and time-dependent experiment, for a total exposure period of 28 days. Biochemical and transcriptomics analyses were performed on mussel digestive glands after exposure for 14 (T14) and 28 (T28) days. Metabolic and DNA impairments, as well as activation of antioxidant and biotransformation enzymes activation, were detected in T28 exposed mussels. RNA-Seq analysis showed significant differential expression of 160 (T14 compared to controls), 33 (T28 compared to controls) and 79 (T14 compared to T28) genes. Signs of stress after EE2 treatment included up-regulation of gene/proteins involved with immune function, lipid transport, and metabolic and antibacterial properties. This study elucidates the underlying mechanisms of EE2 in a filter feeding organisms to elucidate the effects of this human pharmaceutical on aquatic biota., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The ocellated skink ( Chalcides ocellatus ) is a widespread lizard, naturally distributed between the Maghreb and coastal Pakistan, with few insular populations in the Mediterranean coastal area. Some populations of this species have also been recorded in peninsular Italy, Campania and Southern Tuscany due to accidental introductions via touristic and commercial routes. In this work, we conducted genetic analyses on mitochondrial DNA COXI, cytb and 16S mtDNA genes on a sample of Italian insular and peninsular populations. Differently from what previously suggested, the nucleus in Portici (Southern Italy) may have originated from Sardinia. The intense trade and touristic traffic between Sardinia and Southern Tuscany may have been responsible for the introduction of this lizard also to Central Italy.

The acquisition of data to safeguard marine protected areas located close to ports is important in order to develop plans that allow effective protection from pollution as well as sustainable development of the port. The area Secche della Meloria is a Marine Protected Area (MPA-MEL) three miles from Livorno Harbour (LH), which is characterized by a long history of pollution. Here we studied the bioaccumulation and transcriptomic patterns of the marbled crab, Pachygrapsus marmoratus (Fabricius, 1787) (Crustacea; Brachyura, Grapsidae), inhabiting the two selected sites. Results showed that the two crab populations are significantly different in their chemical composition of trace elements and Polyciclic Aromatic Hydrocarbons (PAHs), and gene expression patterns (1280 DEGs). Enrichment analysis indicated that crabs at LH had the highest stress response genes, and they were associated with higher levels of bioaccumulation detected in body tissues. We are confident that the significant differential gene expression profiles observed between crabs, characterized by significant chemical differences, is associated with responses to contaminant exposure., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

The marble crab Pachygrapsus marmoratus inhabits the rocky shores of the Mediterranean Sea, Black Sea and East Atlantic Ocean. As other intertidal species, it is considered a model species to study the effects of environmental stressors on natural populations. In this study, we performed Illumina next-generation sequencing on eleven P. marmoratus specimens with the aims to (i) reconstruct their whole transcriptome, (ii) perform a functional annotation of the assembled transcriptome and (iii) develop gene-based markers for future genetic and genomic studies on this as well as other brachyuran species. We obtained a transcriptome assembly constituted by 56,308 unigenes and covering about 60.3 Mbp. We detected 43,915 Simple Sequence Repeats (SSRs) and 192,631 high-quality Single Nucleotide Polymorphisms (SNPs). Due to the scarcity of genomic resources in decapods, and crabs in particular, our results constitute a valuable resource for future studies on brachyuran crabs. The present data also represent a sound resource to investigate biological responses to pollution in intertidal and marine populations., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Previous studies suggested the suitability of the brackish-water serpulid (Ficopomatus enigmaticus) to be used as model organism for both marine and brackish waters monitoring, by the performance of sperm toxicity and larval development assays. The present study focused on larval development after the exposure of two F. enigmaticus populations (Mediterranean and Atlantic, collected in Italy and Portugal, respectively) to different trace elements (copper, mercury, arsenic, cadmium, and lead) at different concentrations. Results of larval development assays were presented as the percentage of abnormal developed larvae. The effect, measured in terms of EC 50 for all toxicants tested, showed that mercury was the most toxic metal for larvae of both populations. Specifically, the tested trace elements may be racked in the following order from the highest to the lowest toxicity: Mediterranean: mercury > copper > lead > arsenic > cadmium; Atlantic: mercury > copper > cadmium > arsenic > lead. Responses of both populations were similar for arsenic. Lead was the least toxic element for the Atlantic population, while cadmium showed the least toxicity for the Mediterranean population. These preliminary results demonstrate the sensitivity and suitability of the organisms to be used in ecotoxicological bioassays and monitoring protocols. Moreover, chemical analyses on soft tissues and calcareous tubes of collected test organisms and their sampling site water were performed, to identify and quantify the concentration of the tested trace elements in these 3 matrices. Populations exhibited less sensitivity to a certain element together with a relevantly higher concentration of the same element in soft tissues. This may indicate a certain resistance to particular contaminant toxic effects by organisms that tend to accumulate the same toxicant. This highlights the potential correlation between wild-caught test organisms' responses and a deep characterization of the sampling site to identify putative abnormalities or differences in model organism response during bioassay execution., (Copyright © 2020 Elsevier Inc. All rights reserved.)

This paper explores different film assembly conditions of the polyelectrolyte solutions of hyaluronan (HA) and chitosan (CHI), as well as both substrate and cell surface modifications, to investigate PC3 cells adhesion properties. UV-Visible, AFM-IR and Zeta potential techniques indicate that the solution ionic strength is a relevant parameter to modulate the free carboxylic groups of HA on the film surface. In addition, capacitive coupling measurements suggest that assembly conditions that favor surface charge mobility inhibit cell adhesion due to polymer rearrangements that support non-specific electrostatic interactions of positively charged CHI residues and the negatively charged cell moieties, rather than specific CD44-hyaluronan interactions. Moreover, the PC3 cells treatment with hyaluronidase and anti-CD44 antibody also highlighted the importance of CD44 binding site availability on the tumor cell adhesion properties. Finally, the conjugation of wheat germ agglutinin on the film surface proved to be a suitable strategy to boost the PC3 cell adhesion properties. Our results reveal the remarkable capacity of HA/CHI films to modulate cell-substrate properties, which pave the road for the development of surfaces suitable for several applications based on biosensing., (Copyright © 2020. Published by Elsevier B.V.)

Background and Purpose: Public campaigns to increase stroke preparedness have been tested in different contexts, showing contradictory results. We evaluated the effectiveness of a stroke campaign, designed specifically for the Italian population in reducing prehospital delay., Methods: According to an SW-RCT (Stepped-Wedge Cluster Randomized Controlled Trial) design, the campaign was launched in 4 provinces in the northern part of the region Emilia Romagna at 3-month intervals in randomized sequence. The units of analysis were the patients admitted to hospital, with stroke and transient ischemic attack, over a time period of 15 months, beginning 3 months before the intervention was launched in the first province to allow for baseline data collection. The proportion of early arrivals (within 2 hours of symptom onset) was the primary outcome. Thrombolysis rate and some behavioral end points were the secondary outcomes. Data were analyzed using a fixed-effect model, adjusting for cluster and time trends., Results: We enrolled 1622 patients, 912 exposed and 710 nonexposed to the campaign. The proportion of early access was nonsignificantly lower in exposed patients (354 [38.8%] versus 315 [44.4%]; adjusted odds ratio, 0.81; 95% confidence interval, 0.60-1.08; P =0.15). As for secondary end points, an increase was found for stroke recognition, which approximated but did not reach statistical significance ( P =0.07)., Conclusions: Our campaign was not effective in reducing prehospital delay. Even if some limitations of the intervention, mainly in terms of duration, are taken into account, our study demonstrates that new communication strategies should be tested before large-scale implementation., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01881152., (© 2017 American Heart Association, Inc.)

Background: Systematic reviews call for well-designed trials with clearly described intervention components to support the effectiveness of educational campaigns to reduce patient delay in stroke presentation. We herein describe the systematic development process of a campaign aimed to increase stroke awareness and preparedness., Methods: Campaign development followed Intervention Mapping (IM), a theory- and evidence-based tool, and was articulated in two phases: needs assessment and intervention development. In phase 1, two cross-sectional surveys were performed, one aiming to measure stroke awareness in the target population and the other to analyze the behavioral determinants of prehospital delay. In phase 2, a matrix of proximal program objectives was developed, theory-based intervention methods and practical strategies were selected and program components and materials produced., Results: In phase 1, the survey on 202 citizens highlighted underestimation of symptom severity, as in only 44% of stroke situations respondents would choose to call the emergency service (EMS). In the survey on 393 consecutive patients, 55% presented over 2 hours after symptom onset; major determinants were deciding to call the general practitioner first and the reaction of the first person the patient called. In phase 2, adult individuals were identified as the target of the intervention, both as potential "patients" and witnesses of stroke. The low educational level found in the patient survey called for a narrative approach in cartoon form. The family setting was chosen for the message because 42% of patients who presented within 2 hours had been advised by a family member to call EMS. To act on people's tendency to view stroke as an untreatable disease, it was decided to avoid fear-arousal appeals and use a positive message providing instructions and hope. Focus groups were used to test educational products and identify the most suitable sites for message dissemination., Conclusions: The IM approach allowed to develop a stroke campaign integrating theories, scientific evidence and information collected from the target population, and enabled to provide clear explanations for the reasons behind key decisions during the intervention development process., Trial Registration: NCT01881152 . Retrospectively registered June 7 2013.

Ammonia pollution is a critical issue in Europe, since more than half of the European freshwater bodies actually fail to meet EU quality standards for this chemical. In this study, the response of stress-related genes to a sublethal ammonia concentration has been investigated in the adults of the freshwater cyclopoid Eucyclops serrulatus. Two short-term exposures (12h and 24h) at 12mg/L NH 4 + have been tested. Results indicate that 12mg/L NH 4 + causes a significant increase in the expression of some proteins, namely CAT, HSP90 and HSP40, suggesting an activation of the protecting antioxidant system after both 12h and 24h., (Copyright © 2017. Published by Elsevier B.V.)

This article documents the public availability of (i) RAD sequencing data and validated SNPs for the American mink Neovison vison and (ii) Transcriptome resources for two nonmodel freshwater crustacean species, the copepod Eucyclops serrulatus and the amphipod Echinogammarus veneris., (© 2015 John Wiley & Sons Ltd.)

Non-motor symptoms are gaining relevance in Parkinson's disease (PD) management but little is known about their progression and contribution to deterioration of quality of life. We followed prospectively 707 PD patients (62 % males) for 2 years. We assessed non-motor symptoms referred to 12 different domains, each including 1-10 specific symptoms, as well as motor state (UPDRS), general cognition, and life quality. Hoehn & Yahr (H&Y) stage was used to categorize patient status (I-II mild; III moderate; IV-V severe). We found that individual non-motor symptoms had variable evolution over the 2-year follow-up with sleep, gastrointestinal, attention/memory and skin disturbances (hyperhidrosis and seborrhea) becoming more prevalent and psychiatric, cardiovascular, and respiratory disorders becoming less prevalent. Development of symptoms in the cardiovascular, apathy, urinary, psychiatric, and fatigue domains was associated with significant life-quality worsening (p < 0.0045, alpha with Bonferroni correction). During the observation period, 123 patients (17 %) worsened clinically while 584 were rated as stable. There was a fivefold greater increase in UPDRS motor score in worse compared with stable patients over 24 months (p < 0.0001 vs. baseline both in stable and worse group). The total number of reported non-motor symptoms increased over 24 months in patients with motor worsening compared to stable ones (p < 0.001). Thirty-nine patients died (3.4 % of patients evaluable at baseline) with mean age at death of 74 years. Deceased patients were older, had significantly higher H&Y stage and motor score, and reported a greater number of non-motor symptoms at baseline. In conclusion, overall non-motor symptom progression does not follow motor deterioration, is symptom-specific, and only development of specific domains negatively impacts quality of life. These results have consequences for drug studies targeting non-motor features.

In sexually dimorphic species, partners can assess heritable mate quality by analyzing costly sexual ornaments in terms of their dimension and possibly of their symmetry. In vertebrates an important aspect of genetic quality is the efficiency of the immune system, and in particular the Major Histocompatibility Complex (MHC). If ornaments are honest advertisements of pathogen resistance (good genes), in line with the Hamilton-Zuk hypothesis, a correlation between ornament expression and MHC profiles should exist. We tested this hypothesis in the common pheasant Phasianus colchicus by comparing male ornament characteristics (wattle and spur size, and wattle fluctuating asymmetry) with a portion of exon 2 of the class IIB MHC genes containing 19 putative antigen recognition sites. A total of 8 new alleles was observed in the MHCPhco exon IIB. We found significant differences in the occurrence of MHC genotypes between males carrying large or small wattles. Homozygous genotypes predicted large wattle males more correctly than small wattle males. The association between the dimension of the spur and the occurrence of MHC genotypes was marginally significant, however, we did not find any significant association between MHC genotypes and asymmetry. Our results suggest that female pheasants may use the ornament size as a cue to evaluate male quality and thus choose males carrying particular MHC profiles.

Dopaminergic medications could increase the occurrence of a set of dysregulated behaviours in Parkinson's disease (PD), including reward-seeking behaviours (pathological gambling, hypersexuality, compulsive shopping, binge eating, reckless driving), punding and compulsive medication use. We report a preliminary evaluation of a questionnaire to assess the presence of these impulsive-compulsive behaviours associated to dopamine replacement therapy in PD. We screened 38 patients and their caregivers, comparing dopamine dysregulation syndrome (DDS) patients and non-DDS patients. The questionnaire was well accepted and demonstrated a preliminary good discriminant validity (p = 0.000). In addition, clinically relevant dysregulated condition is associated with a younger age (p = 0.006), younger age at disease onset (p = 0.001), levodopa-equivalent daily dose (p = 0.029), UPDRS III (p = 0.021), increased global psychopathology (interpersonal sensitivity and psychoticism), and differences in our inventory (p = 0.000). These preliminary results suggest that the DDS-PC inventory could help to identify patients experiencing impulsive-compulsive behaviours associated to DDS.

Nine polymorphic microsatellites were characterized in the marine isopod Sphaeroma terebrans (Isopoda, Sphaeromatidae) for phylogeographic and parentage analyses. The number of alleles ranged from 3 to 10. Observed heterozygosity ranged from 0.428 to 0.950, while expected heterozygosity ranged from 0.532 to 0.889. Heterozygote deficiency was detected for one locus, possibly the result of null alleles., (© 2009 Blackwell Publishing Ltd.)

We report two male patients with Parkinson's disease who developed compulsive risk-seeking driving behaviour as a result of self-administering high doses of L-dopa despite an adequate therapeutic response at lower doses. When L-dopa reduction was feasible, it resulted in cessation of unsafe driving. We believe that this impairment in driving performance, due to deliberate overuse of dopaminergic medication, should be included as a new behavioural phenomenon in dopamine dysregulation syndrome.

Pathological gambling (PG) is a psychiatric disorder characterized by loss of control of gambling, which has repercussions on family, personal, and professional life. Several recent studies have reported the relationship between PG and the treatment of Parkinson's disease (PD), but no prevalence study has yet been conducted to investigate this correlation. The purpose of this study was to evaluate the prevalence of PG in Italian patients with PD on dopamine replacement therapy. The prevalence of PG in a PD sample (n = 98) and in an age- and sex-matched control group (n = 392) was obtained. The prevalence of PG results significantly higher (P = 0.00001) in PD patients than in control subjects (6.1% vs. 0.25%). Our results emphasize that PG in patients with idiopathic PD on dopamine replacement therapy is an emergent comorbidity, but probably at present the condition is not properly diagnosed because it is mostly unknown., (Copyright 2006 Movement Disorder Society.)

To verify an eventual disfunction of the palmar sympathetic skin activity in Duchenne Muscular Dystrophy, we studied the sympathetic skin response (SSR) with endogenous, Deep Breathing (DB-SSR), exogenous Startle (SE-SSR) and Electric type stimuli (EE-SSR) in a group of patients and a control group. At the same time as the SSR, the heart rate (HR) and the basic R-R interval variation (RRIV) as well as the EMG diaphragmatic activity were checked. In this way, significant differences in the latency (p = 0.02) and amplitude (p = 0.009) values of the EE-SSR and in the amplitude values of the SE-SSR (p = 0.001) and of the DB-SSR (p = 0.02) were noted in the DMD group compared to the control group. In the group of patients the rise in latency of the EE-SSR correlates with the age (p = 0.0001) and with the reduction of its amplitude (p = 0.03). This last parameter correlates with the stage of the illness (p = 0.02). In the control group the mean amplitude of the EE-SSR is approximately 30% greater than that of startle and 50% of deep breathing. Although with amplitudes homogeneously reduced, these ratios are also conserved in the DMD group. Moreover the HR is greater (p = 0.0001) whilst the RRIV is reduced (p = 0.02) in the group of the patients. However these parameters do not correlated either to the cardiac involvement or to the stage of the illness. The presence of the SSR for all the modalities of stimulation indicates the substantial integrity of the afferent and the efferent paths of the ANS. The alterations in latency and amplitude of the SSR in the patients could be the consequence of a lack of dystrophin at the level of the sudoriparous myopithelium in analogy to what has been demonstrated in the mdx mouse.

Lyme borreliosis is a systemic disease. The etiologic agent is a tick-bite borne spirochete (Borrelia burgdorferi) of which men are casual hosts. Although the illness is reported worldwide, it is more frequent in the northern parts of Countries. Some isolated clinical pictures are reported in the past, but only in 1975 the illness was well described at Old Lyme (Connecticut, Usa) and then well defined in its pathogenesis and clinical course in three stages. Lyme disease, involving skin, heart, nervous system and joints, is frequently protean and misdiagnosed, so that it was called "the new great imitator". In Italy the first case is reported in 1985. The authors report three (3) new cases, mostly with neuro-articular signs and symptoms. Literature is partially reviewed, for a better definition and outline of some epidemiological, etiopathogenetic, historical and clinico-therapeutic aspects of Lyme disease.

The effect of the beta-adrenoceptor antagonist propranolol has been investigated in nine patients suffering from isolated (six patients) or prominent (three patients) essential tremor of the head. In a double-blind, placebo-controlled study the tremorolytic efficacy of propranolol has been assessed by a quantitative accelerometric method after a single oral dose (120 mg) and following 2 weeks of sustained treatment with two different dosage regimens of the drug (120 and 240 mg daily). As compared with placebo, a significant reduction in tremor magnitude was found following a single oral dose but not on sustained administration of the beta-blocker at either dosage. The results suggest that the efficacy of sustained propranolol on isolated or prominent essential head tremor is less predictable and satisfactory than expected on the basis of the single-dose response, as compared with hand tremor.

The authors report a 69-year-old man affected by polycythaemia rubra vera since the age of sixty, who presented persistent left hemichorea of acute onset, occurring ten months before the exacerbation of the haematologic abnormalities. Previously he had been suffering from a transient episode of chorea concomitant with relapsing of polycythaemia. CT scan of the brain showed diffuse cortico-subcortical atrophy, whereas Doppler velocimetry of carotid arteries demonstrated a rise in cerebral blood flow resistance and a stenosis of the right carotid artery in its first tract. Pathogenetic mechanisms of chorea complicating polycythaemia vera are discussed and a multifactorial origin of the syndrome is suggested.