Search

Purpose of Review Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder in women of reproductive age worldwide. This disease causes menstrual, metabolic, and biochemical abnormalities such as hyperandrogenism, oligo-anovulatory menstrual cycles, polycystic ovary, hyperleptinemia, insulin resistance (IR), and cardiometabolic disorders, often associated with overweight or obesity and visceral adiposity. Recent Findings The etiology and pathophysiology of PCOS are not yet fully understood, but insulin seems to play a key role in this disease. PCOS shares an inflammatory state with other chronic diseases such as obesity, type II diabetes, and cardiovascular diseases; however, recent studies have shown that a healthy nutritional approach can improve IR and metabolic and reproductive functions, representing a valid therapeutic strategy to ameliorate PCOS symptomatology. Summary This review aimed to summarize and collect evidence about different nutritional approaches such as the Mediterranean diet (MedDiet) and the ketogenic diet (KD), as well as bariatric surgery and nutraceutical supplementation as probiotics, prebiotics, and synbiotics, among the others, used in patients with PCOS.

na

Compact urbanization is the main strategy for sustainable urban development. However, it is yet unclear whether compact urban forms are ecologically more favourable than dispersed ones. In this paper, we studied the effects of urban sprawl on the riparian vegetation condition in one of the most degraded watersheds in the Buenos Aires metropolitan area, Argentina. We conducted random sampling of the riparian vegetation at sites along streams in the basin and assessed urban indicators at the reach and sub‐watershed scales for each of those sites in a geographic information system: urban area, impervious surface, population density and two landscape metrics of dispersion. The indicators assessed explained a high proportion of the variability of the vegetation response variables, thereby confirming the importance of urban sprawl pressure in shaping riparian communities in fluvial ecosystems. Dispersed urbanization had more positive than negative effects on the vegetation in the study area. Riverbanks associated with dispersed urbanization had more plant species, including exotics, when urban sprawl was assessed at the local scale. At the sub‐watershed scale, dispersed urbanized areas were richer in native plants and most of the functional groups, and poorer in exotic species. The model of the compact city, including bio‐corridors along watercourses, has been proposed for the Buenos Aires conurbation process for the next decades. Our results showed that the quality of existing river corridors across the compact matrix was not desirable and best practices for redesigning a more sustainable landscape structure are necessary, including the restoration of habitats for wetland species. Copyright © 2017 John Wiley & Sons, Ltd.

Tropical cyclones represent one of the most catastrophic examples of Natural Hazard. The effect of such events on the environment and human activities is a foregone conclusion. Metocean design criteria are usually defined using databases of historical tropical cyclone tracks characterized by wind and central pressure values. From these historical databases wind and wave maxima are subjected to extrapolation in logarithmic space. In order to correctly evaluate the required return period (up to 1 on 10,000 years) extrapolating the tail of the distribution from historical database provides highly uncertain estimates, therefore, a synthetic tropical cyclone database is needed. The present work describes step-by-step the setup of a synthetic tropical cyclone database valid for the Mozambique Channel area and finalized at the definition of metocean design criteria in area characterized by such events. The synthetic tropical cyclone database, statistically consistent, has been build-up using an autoregressive model for increments in track speed, direction and maxima cyclone winds. Moreover the used methodology involves application of a physically based wave model in order to catch a correct representation of the main processes: wave shoaling/refraction, trapped fetch effects, wave breaking, correct representation of offshore islands, etc. In order to reduce the computational time without reducing the benefit of the wave modeling phase, the proposed methodology considers a track pre-selection step allowing wave simulation only for tropical cyclone tracks characterized by the higher waves at point of interest. In such way the tail of the distribution, obtained from the synthetic database and characterized by higher return periods (i.e. 1,000, 5,000 and 10,000 years), is effectively simulated by the wave numerical model allowing a correct definition of the corresponding metocean design criteria. Furthermore, fitting modeling results with an extreme distribution function (e.g. Weibull, Pareto, etc.) allows definition of extreme values at lower return periods (i.e. 100, 200 and 500 years).

Management success of urban water bodies depends on public perceptions among other factors, because opinions and attitudes can be used to identify problems and also to evaluate the implementation of rehabilitation programs. The aim of this study was to explore the environmental perception of residents living along streams of one of the most polluted watersheds in Buenos Aires (Argentina) in view of future rehabilitation programs. During 2012 and 2013, 276 door-to-door surveys were carried out randomly and were analyzed regarding two perspectives: differences in perception with respect to (1) their position in the watershed, and (2) the distance from the watercourses where they reside. In general, residents' perceptions were highly influenced by what they saw or smelled. Although they did not value the watercourses for their wildlife or scenery and did not use them for recreation, they would like them to be improved. Three main topics were relevant: (1) the type of experience they had with the streams near their homes, (2) the recognition that riverbanks have a potential for recreation, and (3) the desire and individual commitment to improve the critical environmental condition. These results have implications for environmental management and, particularly, for the implementation of riparian rehabilitation projects. Fil: Guida Johnson, Bárbara. Universidad Nacional de Lomas de Zamora. Facultad de Ingeniería; Argentina. Universidad Maimónides; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Faggi, Ana Maria. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Museo Argentino de Ciencias Naturales “Bernardino Rivadavia”; Argentina Fil: Voigt, Annette. Universitat Salzburg; Austria Fil: Schnellinger, Johanna. Universitat Salzburg; Austria Fil: Breuste, Jürgen. Universitat Salzburg; Austria

A 688-bp region of the mitochondrial cytochrome oxidase I gene was sequenced from larvae of 18 species of Oestridae causing obligate myiasis. Larvae belonged to the four Oestridae subfamilies (Cuterebrinae, Gasterophilinae, Hypodermatinae and Oestrinae), which are commonly found throughout the world. Analysis of both nucleotide and amino acid data was performed. Nucleotide sequences included 385 conserved sites and 303 variable sites; mean nucleotide variation between all species was 18.1% and variation within each subfamily ranged from 5.3% to 13.34%. Intraspecific pairwise divergences ranged from 0.14% to 1.59%, and interspecific variation ranged from 0.7% to 27%. Of the 229 amino acids, 76 were variable (60 of which were phylogenetically informative), with some highly conserved residues identified within each subfamily. Phylogenetic analysis showed a strong divergence among the four subfamilies, concordant with classical taxonomy based on morphological and biological features. This study provides the first molecular data set for myiasis-causing Oestridae species, providing an essential database for the molecular identification of these parasites and the assessment of phylogenetic relationships within family Oestridae.

Department of Immunology, University ‘Federico II’, Naples, ItalyObjective: The aim of this study was to evaluate the effects of an oligoantigenic and histamine-free diet onpatients affected with chronic idiopathic urticaria (CIU).Design: Ten patients with chronic idiopathic urticaria were prescribed an oligoantigenic and histamine-free dietfor 21 days, followed by serial and controlled reintroduction of foods during a further 70 days. Modification inclinical illness as well as histamine plasma levels, post-heparin plasma diamine oxidase (DAO) and intestinalpermeability were evaluated.Results: The oligoantigenic and histamine-free diet induced a significant improvement of symptoms (P

Apart from waist circumference, other adiposity measures, such as subscapular skin fold (SST), arouse growing interest due to their relationship to metabolic complications and cardiovascular risk. The IGF-I system is deregulated in obese subjects in proportion to their degree of visceral adiposity.To examine the association among IGF-I, IGF-binding protein (BP)-1 and -3 levels and different measures of adiposity in a sample of adult male population in Southern Italy.A complete database for this analysis was available for 229 (age range 50-82 yr) participating at 2002-2004 Olivetti Heart Study follow-up.After adjustment for age, IGF-I was inversely associated with body mass index (BMI) and waist circumference (p0.05). IGFBP-1 was inversely associated with BMI, waist circumference, SST, homeostasis model assessment (HOMA) index, fat mass. HOMA index, age, and SST significantly predicted the IGFBP-1 plasma levels, with 24% of IGFBP-1 variability explained at a linear regression analysis.IGFBP-1 inversely correlated to adiposity and HOMA index. Among adiposity indexes, SST was the best predictor of IGFBP-1 levels. The evaluation of some components of the IGF system, and simple measures of body adiposity, such as SST, may represent a further tool to better evidence phenotype profiles associated to the pathogenetic mechanism of cardiovascular risk factor clustering in male adults.

We report on the occurrence of an uncommon pathogen, Rhodococcus equi (R.e.) in HIV infection. In the period february 1990-July 1991 we performed the diagnosis of R.e. infection (lung, lung-central nervous system) in two infected patients, aged 27 and 31 years, both males, drug addicts, classified as CDC IV. In the first of them an cavitating right bronchopneumonia (bpm) was diagnosed as of tuberculous origin, on the ground of the microscopic demonstration of an acid-fast, gram-positive strain in b.a.l.. A standard antituberculous regimen was uneffective and R.e. was eventually isolated in three blood culture taken shortly before the exitus and at post-mortem examination of the lungs. In the second patient a subclavian right bpm developed without microbiological evidence of any common pathogen. A third-generation cephalosporin course was only partially successful (clinical amelioration, incomplete clearing of radiological findings). After 3 months the patient relapsed and an aseptic meningitis developed. Cultures of blood and csf yielded a R.e. strain; post-mortem examination revealed a diffuse, cavitating bpm. Our personal experience underlines the difficulty in recognizing R.e. infections in compromised host, because of similarity to other entities (i.e. tuberculosis) and the absence of pathognomonic hints.

A man 55 years old reached of chronic bronchopneumopathy was underwent a subumbilical surgery under an epidural anesthesia. The puncture has been realized at the level of the space L3-L4, with the location of an epidural catheter after negative aspiration test. The local anesthetic with lidocaine 2% (12 ml) Ten minutes later, the patient presented cardiac arrest that evaluated favourably under the cardiocirculatory intensive care. Blood and LCR analysis exclude the eventuality of a toxic accident, an anaphylaxia or spinal anesthesia.

Isolate esophageal ulcer caused by Geotrichum candidum in a case of AIDS. We report the case of a 29-year-old white man, AIDS affected, presented with odynophagia, dysphagia and chest pain. X-ray and endoscopic study revealed an isolated esophageal ulcer whose culture demonstrated to be caused by Geotrichum candidum. This etiologic agent was not previously described in this kind of lesion.

Indomethacin, a potent prostaglandin synthesis inhibitor, has been proven to be effective in a number of tubular defects characterized by enhanced prostaglandin (namely, prostaglandin E2 (PGE2) production, but its mechanism of action is poorly understood. To elucidate further the mechanism(s) by which indomethacin reverses the abnormal tubular functions, five children with different tubular defects (nephrogenic diabetes insipidus, three cases; Fanconi syndrome, one case; and pseudohypoaldosteronism, one case) were treated with indomethacin. Indomethacin, 1 mg/kg every eight hours, was given for 1 week to all children and then was given chronically to four of the children who responded to the drug. Its use was suspended in a 10 year-old-boy with nephrogenic diabetes insipidus because it proved ineffective. To assess the site along the nephron where indomethacin affects the solute and water excretion, an acute water load study was performed in three responsive children before and during the treatment. Indomethacin did not significantly alter the glomerular filtration rate but was effective in reducing diuresis and levels of urinary sodium and potassium excretion. In the child with Fanconi syndrome, indomethacin was also effective in controlling the urinary loss of phosphate, urate, glucose, and bicarbonate. Results of the water load studies show that indomethacin decreases the delivery of solute from the proximal tubule, reduces the fractional free water clearance, and increases the urine-plasma osmolar ratio. The rate of urinary excretion of prostaglandin E2 was high in all five children; it decreased below normal values in four of them after 1 week of treatment. In the child with nephrogenic diabetes insipidus who did not respond to indomethacin therapy, prostaglandin E2 excretion decreased but the rate remained higher than normal. These results suggest that indomethacin induces retention of solute and water mainly through an enhanced proximal tubular reabsorption.

A case of scrotoperineal gas gangrene is presented. This condition is discussed as an expression of anaerobic infection and both old and new views as to its aetiopathogenesis are described. Treatment has been potentiated by the introduction of clindamycin and other particularly active drugs. It is felt that cultures should be directed to the detection of both anaerobic and aerobic germs, since the former have shown a recent tendency to reappear as causes of infection.

The Authors using new immunochemical method studied the increases of CSF fluid immunoglobulin fractions during bacterial, viral and tuberculous meningitis. IgG, IgM and IgA levels are increases in all forms of acute meningitis, therefore the rise result most marked in bacterial. It presents further increase in the later stages of viral meningitis. The Authors valued, by mathematical proceeding, IgG, IgA and IgM variations to offer further physiopathologic, diagnostic, therapeutic and prognostic aknowledgements.

Lupus nephritis is the most important cause of death in patients with systemic lupus erythematous (1–4). For this reason, an early biologic and clinic evaluation could be of great prognostic rilevance.

The present review will supply an simple notice over the characters of every one viral infection interesting the materne-faetal conditions, and also propose the most convenient intervention for each observed type. A not small lot of these problems are not resolved in the field of the antiviral immunity regarding the mother and newborn.

From January 1974 to December 1976 122 exploratory laparotomies were performed in patients with primary lung cancer. With this method detection of asymptomatic abdominal metastases was achieved in 23.8% of the cases. The more frequent sites of metastases were the abdominal lymph nodes and the liver. The most common histological findings were oat-cell carcinoma (50%) and adenocarcinoma (35.7%). The detection of asymptomatic abdominal metastases using this procedure permitted the modification of the clinical staging (adopted by the UICC) in 9.8% of the cases, with emphasis on clinical stage I and II. This diagnostic procedure is harmless: no patient died during the period of the study. The authors recommended inclusion of exploratory laparotomy as an adequate routine means both for the detection of abdominal metastases and for the surgical and clinical staging of primary lung cancer, with emphasis on female patients and clinical stages I and II.

A case of Lyell's syndrome in a patient of paediatric age is presented complete with iconography organized according to the chronological sequence of skin manifestations. The aetiopathogentic aspects are discussed, from the importance of pharmacotoxic factors to that of bacterial or viral agents and unknown factors. The possible immunological or genetic mechanism that may play a part are also examined. The histological picture is described and the personal therapeutic approach is commented on. This is suitable for everyday clinical practice and consists of local dermato-oculo-protective treatment, rehydration and antishock treatment, and anti-infective and nutritional measures.

Cyclosporine A (CyA) is probably the most important advance in the immunosuppressive management of transplants, reducing the incidence of acute rejections without relevant incidence of haematologic and infective complications as observed with “traditional” therapy. This encouraged to evaluate the effectiveness of Cy in the treatment of several immunological diseases. In Nephrology, Cy has been mostly experimented -besides in renal tranplants- in the treatment of nephrotic syndrome secondary to different forms of glomerular diseases, with conflicting results. However, in the last few years many authors have pointed out that Cy can acutely impair renal function by inducing renal vasoconscriction or by reducing Kf (1–4) or both. Since systemic and renal haemodynamics is often impaired in nephrotic patients (NP), the detrimental effect of Cy on GFR could be magnificated in these patients, with dangerous clinical consequences (5).