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Several rare genetic variations of humanXDHhave been shown to alter xanthine oxidoreductase (XOR) activity leading to impaired purine catabolism. However, XOR is a multi-functional enzyme that depending upon the environmental conditions also expresses oxidase activity leading to both O·-and H O and nitrite (·NO-) reductase activity leading to NO. Since these products express important, and often diametrically opposite, biological activity consideration of the impact of XOR mutations in the context of each aspect of the biochemical activity of the enzyme is needed to determine the potential full impact of these variants. Herein, we show that known naturally occurringhXDHmutations do not have a uniform impact upon the biochemical activity of the enzyme in terms of uric acid (UA), reactive oxygen species (ROS) and nitric oxide (·NO) formation. We show that the His1221Arg mutant, in the presence of xanthine, increases UA, O2·-and NO generation compared to the WT, whilst the Ile703Val increases UA and ·NO formation, but not O2·-. We speculate that this change in the balance of activity of the enzyme is likely to endow those carrying these mutations with a harmful or protective influence over health that may explain the current equipoise underlying the perceived importance ofXDHmutations. We also suggest that targeting enzyme activity to enhance the NO2--reductase profile in those carrying such mutations may provide novel therapeutic options, particularly in cardiovascular disease.HighlightsMutations of xanthine oxidoreductase modulate both its expression and activityThe His1221Arg natural mutation increases xanthine oxidoreductase activityRaised xanthine oxidoreductase activity coupled with increased availability of nitrite substrate leads to increased NO provision

To evaluate the long-term effect of simultaneous treatment of hypertension and hypercholesterolemia with angiotensin-converting enzyme (ACE) inhibitors and statins on the incidence of major cardiovascular events (MACE) and other clinical outcomes.We considered data from a subset of Brisighella Heart Study (BHS) participants who were consecutively evaluated in three epidemiological surveys between 2012 and 2020. We excluded normotensive subjects and individuals with a low calculated 10-year CVD risk, hypertensive patients treated with antihypertensive drugs different from ACE inhibitors and patients who changed antihypertensive medications during follow-up. The remaining participants were divided into four groups depending on whether they were treated with (I) perindopril ± amlodipine without statin treatment (N. 132), (II) perindopril ± amlodipine and atorvastatin (N. 132), (III) an ACE inhibitor other than perindopril ± a calcium-channel blocker without statin therapy (N. 133), (IV) an ACE inhibitor other than perindopril ± a calcium-channel blocker and statin therapy (N. 145). The long-term (8 years) effects of the different combined treatment were compared among the pre-defined groups. Over the follow-up period of 8 years, the proportion of subjects who developed MACE, type 2 diabetes mellitus and hyperuricemia, and the proportion of subjects needing for the intensification of antihypertensive treatment to improve blood pressure control were statistically different among the predefined groups (P 0.05).Combined treatment with ACE inhibitors and statins (especially atorvastatin) in hypertensive patients seems to significantly reduce the risk of developing CVD in comparison with treatment with ACE inhibitors alone.

Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): University of Bologna Background Coenzyme Q10 (CoQ10) is a natural antioxidant compound that prevents the vascular damage induced by free radicals and the activation of inflammatory signaling pathways. Supplementation with CoQ10 is safe though its bioavailability is generally low, as far as variable depending on the pharmaceutical form of preparation. Recently, the development of phytosome technology has improved the bioavailability of CoQ10 and definitely facilitated its effective use in clinical. Purpose and Methods The present double-blind, randomized, placebo-controlled, cross-over clinical study aimed to investigate the effect on endothelial reactivity and total antioxidant capacity (TAC) of either acute and chronic supplementation with CoQ10 phytosome in a sample of 20 healthy young not smoking subjects. Results The immediate acute effect of dietary supplementation with CoQ10 phytosome on pulse volume (PV) was sustained in the actively treated group in comparison with placebo and the baseline (p< 0.05). Chronic supplementation of the tested pharmaceutical formulation of CoQ10 significantly improved mean arterial pressure and TAC compared to placebo and baseline values (p< 0.05 for both comparisons). In the actively treated group, the effect on dietary supplementation with CoQ10 phytosome on PV was also sustained when compared to the baseline (P

The study aimed to evaluate the healthcare direct costs for Italian National Health System of patients treated with lipid–lowering drugs that do not achieve the low–density lipoprotein (LDL)–cholesterol target compared to those reaching their targets, and to analyze costs according to the distance from LDL target by using real–world data. An observational analysis was performed on administrative and laboratory data from selected Italian Healthcare Departments. Patients were included if they presented at least one laboratory LDL test between 2012 and 2019 and if they were prescribed lipid–lowering drugs during 6 months prior the last LDL detection (index date). Mean annual direct costs were evaluated in the 12 months before index date in terms of all drugs prescribed, all–cause hospitalizations and all outpatient services. Distance to LDL target was calculated as difference between the index LDL level and LDL target. Total mean annual healthcare direct cost for patients that did not reach LDL target was higher compared to total cost of patients achieving LDL target (€3,678 vs €2,906). Costs were mainly driven by hospitalization (€1,330) followed by drugs expenditure (€1,012) and outpatient services (€563). Mean total annual healthcare costs increased with the distance from LDL target, specifically from €3,004 for patients with 10% distance from LDL target up to €4,823 for those 50% or more distance from LDL target. This trend was particularly evident for the cost item related to hospitalization, that went from €1,486 to €2,819 moving from 10% to ≥ 50 distance from LDL target. Results from this real–world study highlighted the higher economic burden for patients that do not reach the therapeutic LDL target, that tend to rise along with increasing distance from the LDL target. Overall, our findings could suggest that reducing the distance from LDL target could have a positive impact also on the economic outcomes for these patients.

The objective of the present real–world analysis was to evaluate the impact of adherence to lipid–lowering drugs in reaching the lipid target in settings of clinical practice in Italy. The analysis was based on administrative and laboratory database of selected Healthcare Units in Italy covering approximately 10% of Italian population. Adult patients prescribed with statin and with at least a low–density lipoprotein (LDL) determination were included between 2012 and 2019. The index date was defined as the first prescription for statin within the inclusion period. Patients fell into 4 clusters collectively exhaustive and mutually exclusive based on their characteristics assessed during the year prior index date. Patients were considered as adherent if they had a proportion of days covered (PDC)≥80%. Among overall patients prescribed statin and with a LDL determination, 1% was with familial hypercholesterolemia, 28% with previous cardiovascular events, 21% with diabetes and 50% in primary prevention. Regardless their risk profile, the increasing of adherence was related to a higher achievement of LDL–target, with an increment of + 53.2% among familial hypercholesterolemia, +43.1% in diabetes and +30% in previous cardiovascular events and primary prevention clusters while progressing from low (PDC The analysis showed adherence to be a key factor for cholesterol control. However, our findings underline a therapeutic need for patients that, although adherent, fail to achieve the lipid target, especially among patients with previous cardiovascular events (that have low level of LDL to achieve) and with familial hypercholesterolemia (that have high LDL basal level), suggesting therapeutic intensification should be applied.

Objective: Sensory deficits are important risk factors for delirium but have been investigated in single-center studies and single clinical settings. This multicenter study aims to evaluate the association between hearing and visual impairment or bi-sensory impairment (visual and hearing impairment) and delirium. Design: Cross-sectional study nested in the 2017 "Delirium Day" project. Setting and participants: Patients 65 years and older admitted to acute hospital medical wards, emergency departments, rehabilitation wards, nursing homes, and hospices in Italy. Methods: Delirium was assessed with the 4AT (a short tool for delirium assessment) and sensory deficits with a clinical evaluation. We assessed the association between delirium, hearing and visual impairment in multivariable logistic regression models, adjusting for: Model 1, we included predisposing factors for delirium (ie, dementia, weight loss and autonomy in the activities of daily living); Model 2, we added to Model 1 variables, which could be considered precipitating factors for delirium (ie, psychoactive drugs and urinary catheters). Results: A total of 3038 patients were included; delirium prevalence was 25%. Patients with delirium had a higher prevalence of hearing impairment (30.5% vs 18%; P < .001), visual impairment (24.2% vs 15.7%; P < .01) and bi-sensory impairment (16.2% vs 7.5%) compared with those without delirium. In the multivariable logistic regression analysis, the presence of bi-sensory impairment was associated with delirium in Model 1 [odds ratio (OR) 1.5, confidence interval (CI) 1.2-2.1; P = .00] and in Model 2 (OR 1.4; CI 1.1-1.9; P = .02), whereas the presence of visual and hearing impairment alone was not associated with delirium either in Model 1 (OR 0.8; CI 0.6-1.2, P = .36; OR 1.1; CI 0.8-1.4; P = .42) or in Model 2 (OR 0.8, CI 0.6-1.2, P = .27; OR 1.1, CI 0.8-1.4, P = .63). Conclusions and implications: Our findings support the importance of routine screening and specific interventions by a multidisciplinary team to implement optimal management of sensory impairments and hence prevention and the management of the patients with delirium.

BACKGROUND Children with cerebral palsy (CP) often present a loss of effectiveness of the plantarflexors/knee-extensors couple that leads to crouch gait. When treating a child with crouch gait by means of ankle foot orthoses, preserving or restoring push off power is a key issue. AIM To compare carbon-fiber spring (Carbon Ankle Seven® [CAFO], Ottobock® HealthCare, Duderstadt, Germany) and hinged ankle-foot orthoses (HAFO) effectiveness in improving functionality and walking ability in children with diplegic CP and crouch gait. DESIGN Randomized crossover trial. SETTING Hospital center. POPULATION Ten children with diplegic CP and crouch gait, 5 males and 5 females, aged 11 (4) years. METHODS The gait of each child was evaluated by means of instrumental gait analysis with both CAFO and HAFO, in a randomized order and after a 4-week adaptation period. The primary outcome measure was the change in ankle power generation. As secondary outcome measures, knee joint kinematics, stride length, walking speed, Observational Gait Scale, and preferred orthosis were considered. RESULTS The median of the energy produced in stance was superior with CAFO (+2.2 J/kg, IQR 4.7, P=0.006), and the energy absorbed inferior (-3.3 J/kg, IQR 4.3, P=0.011). No statistically significant difference was found for any other parameter. Preference of the children was equally distributed between the two orthoses. CONCLUSIONS No evident superiority of CAFO with respect to HAFO was found in improving gait performance of children with CP and crouch gait. Nevertheless, the results suggest the possibility that CAFO permits an energy saving and reduction of the more compromising deficits. CLINICAL REHABILITATION IMPACT The final choice of the participants indicates that CAFOs are preferred by older and heavier children, but the preference does not correlate with the performance of the orthoses during gait.

Every year 0.5-2% of women undergo non-obstetric surgery in pregnancy. Hypoxic events with short-term and long-term consequences are one of the most frequent complications in surgery. There is only limited data available regarding the impact of these events. This review aims to analyze the current literature on hypoxic events occurring in non-obstetric abdominal surgery in pregnant women, focused on maternal and fetal outcomes.We performed a non-systematic review of the literature, through a PubMed search using the key words "hypoxemia", "non-obstetric surgery", "surgical procedures", "pregnancy", "pregnant women" and "outcome".There is little data available regarding maternal and fetal outcomes after hypoxic episodes during non-obstetric surgery in pregnancy. In these cases, conservative intrauterine resuscitation maneuvers or immediate delivery should be taken into account. Perimortem cesarean section can be lifesaving for both mother and fetus when maternal collapse is non responsive to resuscitation procedures. Inaccurate information regarding maternal and fetal outcomes is due to the lack of robust data and the heterogeneity of the causes underlying maternal respiratory complications during surgery.Non-obstetric surgery during pregnancy must be performed when indicated. An expert multidisciplinary team, composed of obstetricians, surgeons, and anesthesiologists need to be included, giving appropriate attention to the physiological changes of respiratory, cardiovascular, and gastrointestinal system that occur during pregnancy. The shortest operative time and peri-operative assistance should be ensured. Complications, such as hypoxic events in pregnant patients need adequate assistance. Multidisciplinary cooperation, continuous training and simulation for anesthesiology and resuscitative procedures can guarantee this.

Hypertensive disorders are the most common medical complications in the peripartum period associated with a substantial increase in morbidity and mortality. Hypertension in the peripartum period may be due to the continuation of pre-existing or gestational hypertension, de novo development of pre-eclampsia or it may be also induced by some drugs used for analgesia or suppression of postpartum haemorrhage. Women with severe hypertension and hypertensive emergencies are at high risk of life-threatening complications, therefore, despite the lack of evidence-based data, based on expert opinion, antihypertensive treatment is recommended. Labetalol intravenously and methyldopa orally are then the two most frequently used drugs. Short-acting oral nifedipine is suggested to be used only if other drugs or iv access are not available. Induction of labour is associated with improved maternal outcome and should be advised for women with gestational hypertension or mild pre-eclampsia at 37 weeks' gestation. This position paper provides the first interdisciplinary approach to the management of hypertension in the peripartum period based on the best available evidence and expert consensus. © The Author(s) 2019.

Summary Background Increased blood pressure is the biggest contributor to the global burden of disease and mortality. Data suggest that less than half of the population with hypertension is aware of it. May Measurement Month was initiated to raise awareness of the importance of blood pressure and as a pragmatic interim solution to the shortfall in screening programmes. Methods This cross-sectional survey included volunteer adults (≥18 years) who ideally had not had their blood pressures measured in the past year. Each participant had their blood pressure measured three times and received a a questionnaire about demographic, lifestyle, and environmental factors. The primary objective was to raise awareness of blood pressure, measured by number of countries involved, number of people screened, and number of people who have untreated or inadequately treated hypertension (defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg, or both, or on the basis of receiving antihypertensive medication). Multiple imputation was used to estimate the mean of the second and third blood pressure readings if these were not recorded. Measures of association were analysed using linear mixed models. Findings Data were collected from 1 201 570 individuals in 80 countries. After imputation, of the 1 128 635 individuals for whom a mean of the second and third readings was available, 393 924 (34·9%) individuals had hypertension. 153 905 (17·3%) of 888 616 individuals who were not receiving antihypertensive treatment were hypertensive, and 105 456 (46·3%) of the 227 721 individuals receiving treatment did not have controlled blood pressure. Significant differences in adjusted blood pressures and hypertension prevalence were apparent between regions. Adjusted blood pressure was higher in association with antihypertensive medication, diabetes, cerebrovascular disease, smoking, and alcohol consumption. Blood pressure was higher when measured on the right arm than on the left arm, and blood pressure was highest on Saturdays. Interpretation Inexpensive global screening of blood pressure is achievable using volunteers and convenience sampling. Pending the set-up of systematic surveillance systems worldwide, MMM will be repeated annually to raise awareness of blood pressure. Funding International Society of Hypertension, Centers for Disease Control and Prevention, Servier Pharmaceutical Co.

Diplegia is a specific subcategory of the wide spectrum of motion disorders gathered under the name of cerebral palsy. Recent works proposed to use gait analysis for diplegia classification paving the way for automated analysis. A clinically established gait-based classification system divides diplegic patients into 4 main forms, each one associated with a peculiar walking pattern. In this work, we apply two different deep learning techniques, namely, multilayer perceptron and recurrent neural networks, to automatically classify children into the 4 clinical forms. For the analysis, we used a dataset comprising gait data of 174 patients collected by means of an optoelectronic system. The measurements describing walking patterns have been processed to extract 27 angular parameters and then used to train both kinds of neural networks. Classification results are comparable with those provided by experts in 3 out of 4 forms.

Endometrial cancer (EC) is a complex gynecological neoplasm with several clinical, histopathological and genetic features. Different hormonal, metabolic and biochemical axes are involved in pathogenesis. Obesity is a well-known risk factor for this disease and the role of local and systemic effects of adipose tissue, especially in the promotion of subclinical chronic inflammation, is an important issue. Indeed, inflammation is related to the pathogenesis of different tumors, including EC. This review aims to remark the role of obesity and inflammation in the pathogenesis of EC cancer through an exploration of the current literature.We performed a comprehensive review of the literature through a PubMed search using key words and including English language papers looking at this topic.Only few authors analyzed the role of inflammatory cytokines released by adipose tissue in visceral abdominal fat depots. Tumor Necrosis Factor-α, Interleukin-6, Interleukin-1 Receptor Antagonist, Nuclear Factor-kB, Leptin, Adiponectin and C Reactive Protein were studied for cancer risk prediction models, risk stratification or targeted therapies. Furthermore, genetic studies evaluated the effect of inflammatory cytokines secreted by visceral adipocytes in the modulation of angiogenesis and signaling pathways such as PI3K/AKT/mTOR, that result altered in the pathogenesis of EC.The identification of inflammatory biomarkers released by adipose tissue, in the pathogenesis of EC, could be useful in improving diagnostic accuracy, identifying targets of therapy, suggesting useful lifestyle behaviors. A deeper knowledge of the genetic background of alterations in inflammatory pathway genes could better define the population exposed to a higher susceptibility to EC due to genetic polymorphisms. Future studies are needed to better understand this field.

The buttercup (Ranunculus asiaticus L.) belongs to the family Ranunculaceae and is a popular ornamental plant cultivated for the sale of cut flowers and for the production of potted or border plants. This species is native to the eastern Mediterranean basin and has become widespread in Western Europe, South Africa, California, Israel and Japan. The hybrids of Ranunculus asiaticus are susceptible to infection by several viruses, very often present in mixed infection, and all associated with economically important diseases. The main viral species that infect the buttercup are: Tomato spotted wilt virus (TSWV, genus Tospovirus), Impatiens necrotic spot virus (INSV, Tospovirus), Ranunculus white mottle virus (RWMV, Ophiovirus), Cucumber mosaic virus (CMV, Cucumovirus), Tobacco mosaic virus (TMV, Tobamovirus), Tobacco rattle virus (TRV, Tobravirus), Tobacco necrosis virus (TNV, Tombusvirus); moreover, several viral species listed in Potyvirus genus were detected: Potato virus Y -Ranunculus strain (PVY-R), Turnip mosaic virus (TuMV), Ranunculus leaf distortion virus (RLDV), Ranunculus mild mosaic virus (RMMV), Ranunculus mosaic virus (RMV) and Ranunculus latent virus (RLV, Potyviridae, Macluravirus). Although the serological diagnosis (ELISA) is in many ways sufficient for the identification of viruses and for the diagnosis of viral diseases, it may find serious limitations in the case of viruses with low titer in the natural host. For this reason molecular analysis has been widely used as a highly sensitive and specific detection method. In the present study, the main viruses infecting Ranunculus hybrids, grown in greenhouse in the Liguria region (Imperia province), will be evaluated by double step RT-PCR assays and specific primers, in comparison with ELISA, using leaf tissues as starting material. Preliminary results show the presence of some viral species (TSWV, RLDV, RMV) in the samples analyzed, either in single or in mixed infection, and confirm that the molecular evaluation, due to versatility of use and reliability of results, can be easily used as a tool for viruses detection on large scale propagation materials in order to prevent the spread of the principal viruses and assure the production of virusfree Ranunculus plants.

Background: The prevalence of senile dementia is increasing worldwide, especially in the developed countries. Nevertheless, drug therapy isn’t often enough to treat this condition. Researchers are evaluating the possible impact of a preventive approach, based on an improvement of lifestyle and the intake of micronutrients. Moreover, there is an increasing interest for combined nutraceuticals that can act as memory and learning enhancers, with a significant and beneficial potential on the cognitive disorders. Objective: To evaluate the effects of a rational assemblage of nutraceuticals on cognitive functions in a sample of 30 elderly subjects. Design: Double bind, cross-over designed trial versus placebo Setting: outpatient clinical practice Participants: 30 elderly subjects with basal Mini-Mental State Examination score between 20 and 27 and self-perceived cognitive decline. Intervention: Treatment with a combination of nutraceuticals based on Bacopa monnieri, L-theanine, Crocus sativus, copper, folate and vitamins of B and D group. After2 months of treatment or placebo. Measurements: Patients were evaluated with Mini-Mental State Examination (MMSE), Perceived Stress Questionnaire (PSQ) and Index and Self-Rating Depression Scale (SRDS). Results: MMSE and PSQ Index significantly improved in the active treatment arm, both versus baseline and versus the parallel arm. Both groups experienced a significant improving in the SRDS scores. Conclusions: We obtained a good and significant improvement of the cognitive functions tested with the MMSE, PSQ-Index and SRDS score, after 2 months of combined therapy of nutraceuticals. Further confirmation will be needed to verify these observations on the middle and long term in a larger number of subjects.

Vivipary, referred here as the formation of novel complete plantlets on mature organs, has been reported in many families as an asexual propagation strategy. In K. × houghtonii (Crassulaceae), viviparous plantlets are formed on leaf margin notches in response to a long day photoperiod and their appearance follow a basipetal fashion. To identify genes involved in this process, suppression subtractive hybridisation libraries (SSH) were prepared. Two hundred c-DNA clones were classified and grouped into 14 functional categories according to Goldberg database (http://estdb.biology.ucla.edu/PcEST). Six hundred thirty sequences (200 SSH library, 48 database Kalanchoe genus, 382 other species database genes) were used as probes for microarray analysis according to the CombiMatrix technology and a 4x2K Custom Array ™ was synthesized. RNA was extracted from margin of leaves at 7 stages of development before buds emission (5 to 50 mm) during long-day photoperiod (permissive conditions). Three replications for each sample were prepared. From double strand cDNAs antisense RNAs (a RNA) were synthesized and amino-allil-UTP incorporated and coupled with Alexa Fluor ® 647. Microarray was hybridized according to CombiMatrix protocol. Data were extracted with CombiMatrix Microarray Imager software and exported into Microsoft Excel for computing of mean, median and standard deviation. Person's correlation was computed and data normalized. After background removal, probes were reduced to 484. "Fold change" method (FC=2) was used to compare different levels of gene expression of samples. Significance Analysis of Microarrays Statistic (SAM method) generated 263 significant modulated genes with a False Discovery Rate (FDR) of 5%.

OBJECTIVE: Serum uric acid (SUA) has been associated to incident hypertension and increased risk of cardiovascular diseases. Our aims were to compare the haemodynamic characteristics of normotensives, undiagnosed hypertensives, controlled and uncontrolled hypertensive subjects, and to evaluate if SUA level could also been associated to a different control of blood pressure in pharmacologically treated patients. DESIGN AND METHOD: During the last population survey of the Brisighella Heart Study we identified 146 new cases of arterial hypertension and 394 treated but uncontrolled hypertensive patients. Thus we compared their haemodynamic characteristics with those of age- (58 ± 14 years old) and sex-matched normotensive (N. 324) and controlled hypertensive (N. 470) subjects. Then, by logistic regression analysis, we evaluated which factors were associated to a worse blood pressure control under pharmacological treatment. RESULTS: Pulse Wave Velocity (PWV) was significantly higher (p

Objective: In this study anxiety and depressive disorders were evaluated in patients admitted to an emergency department (ED) or to a medical department (MD). Methods: The General Health Questionnaire-30 (GHQ-30) was administered to screen all patients (n = 719) consecutively admitted to an ED (n = 556) and to MD (n = 163) in a 120 day period. All GHQ-30 positive (score>4) underwent the Mini International Neuropsychiatric Interview, a structured interview to diagnose mental disorders according to DSM-IV criteria. Results: Subjects positive to GHQ-30 were 264 (47%) in ED and 88 (54%) in MD. A mental disorder was diagnosed in 233 ED patients (42%) and in 77 MD patients (47%) (p = 0.70). The most frequent disorders were anxiety disorders in ED patients (18.1%) and depressive disorders in MD patients (21%) (p = 0.04). Conclusions: Anxious patients more frequently seek attention at ED, whereas patients with depressive disorders are more often observed in medical units. The improvement of quality of care, the waste of healthcare resources through unnecessary medical care, and the well known efficacy of appropriate treatments in patients with anxiety and depressive disorders make the diagnosis of these patients particularly important.

Essential hypertension (EH) has been associated with abnormal sympathetic outflow particularly during mental stress. However data were unclear because of associated pharmacological drugs often taken by patients. The aim of this study is to ascertain abnormalities of sympathetic during mental stress in patients with untreated EH. We studied 7 untreated patients with established criteria for EH, and 10 sex and age matched healthy subjects. Patients with EH underwent an extensive laboratory screening excluding secondary causes of hypertension. Subjects underwent sitting microneurographic recording of muscle sympathetic activity (MSNA) from peroneal nerve, heart rate (HR) and blood pressure (BP) during resting state and mental stress (3-min of paced auditory serial arithmetic test -PASAT) and a cold test (two minutes immersion of a hand in ice water). The pharmacological treatment for EH was usually started after the microneurographby evaluation. As expected EH patients showed increased resting BP compared to controls but MSNA was not significantly increased although showed a tendency toward the increase. During mental stress BP was increased compared to controls but HR and MSNA did not show a significant difference. Sympathetic and cardiovascular parameters did not differ during cold test. Our data confirmed the higher BP reactivity in EH patients but this was not due to increased MSNA. However these data are preliminary and a larger cohort of patients must be recruited before drawing a definite conclusion.

The sensitivity of the IRMA method is limited by the specific activity (SA) of the conventionally employed radioisotropic label and high sensitivity radioimmunoassay should theoretically be attained by the use of short-lived radiometallic nuclides. Our group have achieved radiolabeling of high SA IgG by using the radiometal, gallium-67 (67Ga) with a short half-life (T1/2 = 78 h) and deferoxamine (DF), a bifunctional chelating agent bound through a multispacer (dialdehyde starch, DAS) as the linker (J Nucl Med 32:825, 1991). In the present work, the application of the approach is attempted by employing a two-site IRMA for human growth hormone (hGH); the monoclonal antibody to hGH (MAB2) is bound to DF via DAS and the coupled DF-DAS-MAB2 is radiolabeled with 67Ga. The 67Ga-DF-DAS-MAB2 of high SA (4,884 MBq/mg versus 370-518 MBq/mg calculated for radioiodinated MAB2) was thus used for the two site 'sandwich' 67Ga-IRMA. Excellent correlation with the 125I-IRMA was registered, and higher detection capability obtained by using 67Ga over the 125I in the hGH IRMA offered a good basis for the exploitation of short-lived radio-nuclides in the IRMA system.

This work reports the radioiodination of human thyrotropin (hTSH) in our laboratory (IPEN) and evaluates its quality in comparison with a commercial product. The radioiodination yield obtained in 20 experiments ranged from 18.5 to 56.3%, while the purification recovery ranged from 75.5 to 124.0% and the specific activity ranged from 1.01 to 3.10 MBq μg−1. The values for the distribution coefficient revealed in the purification of radioiodinated hTSH ranged from 0.232 to 0.371. When tested concomitantly in the same radioimmunoassay system, the IPEN and the commercial tracer presented parallel standard curves. A highly significant correlation ion was observed between the quality control samples estimated through both curves (p

alking. Healthy young subject were asked to mimic voluntarily nterior pelvic tilt during gait analysis sessions. Materials andmethods: Six healthy young adults (29±3 years ld) performed a gait analysis along a 12 meters walkway bareoot. After that, they were asked to mimic anterior pelvic tilt, Fig . Data were collected with Vicon Mx system with 8 cameras, two MTIOR6-5 forceplatformsandWave surfaceEMGsystem. Spatioemporal parameters, kinematic, kinetic and surface EMG of four ait cycles were analyzed, comparing self placed barefoot gait with oluntary anterior pelvic tilt one. Digital video acquisitions were lso performed. Results: Videoobservation:duringvoluntary anteriorpelvic tilt, he trunk tilted forward, the upper limbs tilted backward, the foot ontact was flat or on toe, Fig. 1. Kinematic: in comparison with barefoot gait the main diferences were the ankle plantar-flexion at foot contact, the nticipation of ankle plantar-flexion during late stance, a reduced aximum of knee flexion during swing, an increased hip flexion nd, of course, the requested increased anterior pelvic tilt. Kinetic: double bump and reduction of ankle dorsal-flexion oment, increased ankle power absorption and generation during arly stance, and reduced ankle power generation in late stance as observed, Fig. 2. Spatio-temporal parameters: the cadence increased from 24±5.11 steps/min to 145±14.4 steps/min; the stride time ecreased from 0.96±0.040 s to 0.84±0.078 s and consequently alking speed increased from 1.34±0.11 m/s to 1.57±0.26 m/s. he other spatio-temporal variables did not differ. EMG: triceps enveloped surface EMG diagram showed anticipaion of triceps activation during voluntary tilt, Fig. 3. Discussion: Voluntary anterior pelvic tilt facilitated the forward rojection of the upper bodywith the association of a not requested oewalking like behaviour. The kinematic, kinetic, spatio-temporal nd EMG parameters showed a pattern similar with the gait of toealkers. From the results of this work it is possible to hypothesize hat anterior pelvic tilt could be considered one of the elements acilitating toe walking. The whole body biomechanical configuation contributes to the aetiology of gait strategies. The selected daptive solution for balancing thepelvis could constrain alsodistal egments configurations.

Background: Sex hormones and adipokines seem to differently interact in both genders at different ages. Aim: To comparatively evaluate the serum level of adipokines and sex hormones in healthy non-pharmacologically treated premenopausal women, post-menopausal women, and elderly women, and in age-matched men. Subjects: From the historical cohort of the Brisighella Heart Study we selected 199 adult healthy subjects (males: 89; females: 110), aged 62.5 +/- 12.4 yr. Men and women included in the age-class subgroups were matched for body mass index (BMI), waist circumference, blood pressure, heart rate, fasting plasma glucose, plasma lipids. Results: Leptin did not differ among various age classes in men, while pre-menopausal women displayed significantly lower serum leptin than post-menopausal women (-6.7 +/- 2.2 pg/ml, p=0.036). Post-menopausal women had significantly greater serum leptin when compared with age-matched men (+13.1 +/- 2.0 pg/ml, p

The lack of a correct diagnostic and therapeutic planning of vestibular diseases is still often observed, and some difficulties are still to deal with in clinical practice, even when treating acute hearing problems, although the needed competence is more easily identified as otologic. A review of the international literature confirms the existence of such a problem, and permits to underline the scarcity of connections between otology and neurotology, on one hand, and principles of basic sciences and general and internal medicine, on the other hand: this can explain some therapeutic contradictions in treating inner ear disorders, their frequent labelling as idiopathic and the persisting uncertainties concerning a correct diagnostic and therapeutic management. In order to overcome the difficulties deriving to insufficient interdisciplinary cooperation, the institution of hospital audiovestibular services with a strictly linked net of cooperation with internal medicine units could represent a progress. This could help prevent clinically and economically inadequate management, contributing to minimize the possibility of expensive and/or health-threatening mistakes; moreover, it could represent an example to easily improve the practical aspects of both pre graduate and postgraduate curricula, and to form more open-minded clinicians, starting both from an ear. Nose and throat (ENT)/audiological and from an Internal Medicine extraction.

34 79 False detection rate (FDR) 80% sion criteria: concomitant medullar lesion, akinesia or iperkinesia, hydrocephalus, cerebellar syndrome. Patients with elicitable ankle clonus were also excluded. A single experienced rater assessed the MAS score for all patients, at their bed, for gastrocnemius medialis (GM) and lateralis (GL), and soleus (SOL) muscles. The presence of reflex muscular activity was measured by surface EMG, used as the criterion standard to assess the presence of spasticity. Bi-polar surface electrodes (ARBO H124 SG, diameter 15 mm, interelectrode distance 20 mm) were placed on the minimum crosstalk points recommended in [5]. EMG data were collected at 1000 Hz (PocketEMG, BTS, Italy). During the MAS assessment sEMG data were acquired but not displayed to ensure the assessor’s blindness to the presence of EMG. The presence in sEMG traces of muscular activity consequent to the stretching manoeuvres was assessed separately by visual inspection by an experienced operator. This assessor was blind to any information on patients and, mainly, to all MAS scores. A score “Yes” was given to trials with EMG reflex activity, and a score “No” was given otherwise. Results Results are presented in Table 1.

This work is aimed at comparing mucinous colorectal adenocarcinomas (MUC) and non-mucinous colorectal adenocarcinomas (non-MUC), and at verifying the existence of two different subgroups of MUC, in terms of clinicopathological features, chromosomal alterations, and outcome, in a geographical area where mucinous colorectal cancer resulted as being very frequent. One hundred and fifty-six unselected patients who underwent curative colorectal resection for sporadic colorectal cancer over a 4-year period were evaluated for histological classification as to MUC and non-MUC subtype, for microsatellite instability (MSI) using six microsatellite markers, and for the presence of p27, Fhit, and cyclooxygenase-2 (Cox-2). Molecular data, immunohistochemical results, recurrence frequency, and patient survival were analyzed statistically in relation to histological subtypes. MUC accounted for 38.5% of all colorectal carcinomas. Compared to non-MUCs, MUCs were more frequently located in the proximal colon (p