Contact allergy: another occupational risk to Tetranychus urticae

BACKGROUND

Tetranychus urticae is a phytophagous, macroscopic mite ubiquitous to warm climates, which causes occupational allergic symptoms in farm workers.

OBJECTIVE

This study was designed to investigate the cause and mechanisms of an otherwise "undetermined" recurrent and occupational dermatitis on the hands of farm workers and to obtain a better diagnostic profile of the urticaria that many farm workers who are allergic to T. urticae experience.

METHODS

Fifty-six farm workers with occupational cutaneous and/or respiratory symptoms and 10 healthy farm workers underwent in vivo and in vitro diagnostic trials by skin prick testing, serum-specific IgE determination, and three different types of epicutaneous tests.

RESULTS

Four of the 10 patients with recurrent dermatitis had a positive IgE reaction to T. urticae, and five of the 10 had a positive patch test response. The percentage of positive patch test responses between subjects with positive T. urticae IgE and those with negative T. urticae IgE was similar. The diagnostic trial allowed the diagnosis of immune-mediated contact dermatitis in seven of the 10 patients with recurrent occupational dermatitis on the hands. The result of the epicutaneous open test on healthy skin with no history of eczema was positive in almost all patients with IgE to T. urticae and episodes of occupational urticaria.

CONCLUSIONS

Urticaria frequently occurring in farm workers allergic to T. urticae is an allergic contact urticaria. T. urticae is also directly responsible for recurrent dermatitis, caused by a different immune-mediated mechanism, in farm workers.

Effects of enzyme-potentiated desensitization in the treatment of pollinosis: a double-blind placebo-controlled trial

Several controlled clinical trials have shown that specific immunotherapy (SIT) using incremental injections of allergens can be effective in the treatment of allergic rhinitis and asthma. Nevertheless, the risk of side effects have led to some recommended limitations of SIT. Enzyme-potentiated desensitization (EPD) is a proposed method for immunotherapy with very low doses of mixed allergens plus beta-glucuronidase enzyme, for which irrelevant or no side effects have been claimed. The aim of this study was to determine the clinical efficacy of EPD in the treatment of pollinosis. A double-blind placebo-controlled trial of EPD among 20 patients sensitive to Parietaria and grass pollen was performed. All patients recorded daily symptom scores for nine months following a single intradermal injection of EPD or buffered saline received in February. Symptoms recorded were nasal itching and obstruction, sneezing, rhinorrhea, itchy eyes and excessive tear production. Moreover, total and specific lgE were measured and CD3+, CD4+ and CD8+ peripheral blood lymphocytes were counted at different times. In the same period, ten additional subjects, with an allergic clinical profile similar to the subjects admitted to the double-blind trial, were studied in an open clinical trial in order to evaluate the effects of EPD without enzyme using a mixture of allergens. Symptom scores were higher in the placebo group (p < 0.001), with a similar level of significance for both global symptom score and for each individual symptom. Active-treated patients had a significant post-treatment increase in the mean percentage of T-CD8+ peripheral blood cells and a significant post-seasonal decrease in the mean percentage of Parietaria specific lgE. On the contrary, placebo-treated patients had a borderline significant post-seasonal decrease in the mean percentage of CD8+ circulating cells and a significant seasonal increase in the mean percentage of Parietaria specific lgE with no significant post-seasonal decrease. Finally, clinical results of the mixture of allergens injection were similar to those of the placebo in the double-blind trial. EPD injection caused only an asymptomatic, local wheal and flare lasting about two hours. Two patients (20%) in the active-treated group experienced a delayed, mild, unusual headache lasting about two days. In conclusion, EPD is clinically effective in the treatment of pollinosis. Some immunological modifications observed in the EPD-treated patients suggest an EPD-induced enhancement of tolerogenic mechanisms like "immune deviation."

[Variable expression of non insulin dependent diabetes mellitus in childhood]

Non Insulin Dependent Diabetes Mellitus (NIDDM) in pediatric age remains not well defined as a nosological entity. The so-called Maturity Onset Diabetes of the Young (MODY), for example, recognizes three different etiologies. Three cases are presented as an example of different possibilities of onset and evolution in pediatric age: a 12.5 year old girl presents a positive familial history of NIDDM, a slow onset of the disease and goes on well with administration of an oral hypoglycemic drug; a 12.5 year old girl too, with a positive familial history of NIDDM, with acute onset of the disease, needed an oral hypoglycemic drug when she was overweight. Having lost the ponderal excess, she goes on very well with the diet alone; a 13 year old girl without any familial history of NIDDM, who presented a dramatic onset in occasion of an intercurrent illness; she required insulin therapy only during a steroidal therapy period, administered for ovaric polycystosis. The authors argue over the age of onset, the familial history and the therapeutic approach to NIDDM in pediatric age.

High prevalence of overweight in a children population living in Naples (Italy)

OBJECTIVE

The present study estimates the prevalence of obesity among ten-year old children living in Southern Italy and compares it with the prevalence of obesity among children living in other western countries.

METHODS

110 children attending the 4th grade of a randomly selected primary school in Naples were studies in the 1992. Eighty-eight per cent of the total school population was examined: 52 girls, 58 boys: mean age = 9.6 years (SEM = +/- 0.10). Each child underwent medical examination and anthropometric assessment. The percentile values for Body Mass Index (BMI = weight/height 2) and triceps skinfolds thickness (mm) were calculated and compared to that of children of the same age and sex living in other countries, chosen from comparable studies available in the literature.

RESULTS

Percentile values for triceps skinfolds thickness in Neapolitan children are similar to those reported in the other populations considered for comparison, however BMI values were different. Children in Naples have the highest BMI values at the 50th, 75th, 90th and 95th percentile. The prevalence of obesity among Neapolitan children was estimated using as a cut-off, the BMI value at the 90th percentile of each population considered for the comparison and calculating the rate ratio with 95% confidence interval (95% CI). The prevalence of obesity in Naples among girls, was 5.2 times (3.8-6.6 95% CI) as high as in France, 3.3 times (2.2-4.4) as high as in Holland, 1.7 times (0.9-2.5) as high as in USA, 2.5 times (1.7-3.4) as high as in Milan (Northern Italy); among boys it was 4.3 times (3.0-5.6) as high as in France, 4.0 times (2.7-5.2) as high as in Holland, 2.1 times (1.2-3.0) as high as in the USA, 2.5 times (1.7-3.4) as high as in Milan.

Diabetes mellitus in Kearns-Sayre syndrome: a case with a 10-year follow-up

An 11-year-old girl with Kearns-Sayre Syndrome developed diabetes mellitus with ketoacidosis at onset and immediate insulin-requirement. In a 10-year follow-up, while neuromuscular disease was progressively increasing, diabetes was well controlled by once-a-day insulin therapy. Insulin secretion appears low, but without impairment during the years. This case points out the diabetes' features in Kearns-Sayre syndrome.

Familial and environmental influences on body composition and body fat distribution in childhood in southern Italy

The aim of this paper was to evaluate the factors affecting body fat excess and distribution in prepubertal age. A cross-sectional survey was carried out on children attending the 4th grade of a primary school in Naples. Eighty-eight per cent of the total sample was examined: 52 girls, 58 boys; mean age = 9.6 yrs (s.e. +/- 0.10). Each child underwent a medical examination, anthropometric measurements and bio-impedance analysis of body composition. The parents were asked to fill in a questionnaire that included demographic data, family history, parent's weight and height, child's perinatal history and his or her involvement in sports activities. Data were analyzed by multiple linear regression. The results showed a direct correlation between parental BMI and children's anthropometric measurements: the children's BMI correlated with the fathers' (P = 0.02) and mothers' BMI (P = 0.027); the children's waist/hip ratio correlated with the fathers' BMI (P = 0.07); the children's subscapular skinfolds correlated with the father's (P = 0.07) and mothers' BMI (P = 0.02); the children's triceps skinfolds correlated with the fathers' BMI (P = 0.004). Among congenital factors, sex was shown to be correlated with the children's waist/hip ratio (P = 0.05) with a lower ratio in the female, indicating a sex influence on body fat distribution even in prepubertal age. The children's BMI correlated with their waist/hip ratio (P = 0.001). Children's systolic blood pressure showed a positive correlation with triceps (P = 0.04) and subscapular (P = 0.05) skinfolds thickness % FAT-PLI (P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

[Turner syndrome and insulin-dependent diabetes mellitus]

BACKGROUND

Cases of diabetes mellitus associated with Turner syndrome are noninsulin-dependent. We report a case of insulin-dependent diabetes mellitus (IDDM) with Turner syndrome.

CASE REPORT

An 11 year-old girl with Turner syndrome was investigated for glucose tolerance that was normal with glycosylated hemoglobin at 5.1%. The patient was then given growth hormone plus oxandrolone until the age of 15 yr 3 mo; estrogen replacement was initiated at 15 yr 9 mo and progesterone 6 months later. At the age of 16.5 yrs, the patient developed manifestations of diabetes mellitus with polyuria, polydipsia, weight loss. Blood glucose concentration was 415 mg/dl with ketoacidosis. She was given insulin; at that time, blood insulin level was 7 mU/ml, C-peptide 0.8 ng/ml and glycosylated hemoglobin Alc 8.2%. Islet cell auto-antibodies were positive (1/80) and histocompatibility antigens were A1, A2, B14, B18, CW7, DR7, DR11, DQ7. After 6 months of treatment, blood insulin and C-peptide after IV glucagon were nil. There was no familial case of IDDM.

CONCLUSIONS

This case of IDDM seems to be the first reported in Turner syndrome. This IDDM could be a manifestation of autoimmunity.

Farm workers' occupational allergy to Tetranychus urticae: clinical and immunologic aspects

A group of 46 farm workers (32 men), affected by a recurrent "occupational disease of undetermined origin", underwent an immunologic investigation with a Tetranychus urticae (TU) whole-body extract (TU-WBE) prepared in our laboratory. The patients suffered from seasonal attacks of rhinitis, during the summer and autumn periods, when working in open fields (30 subjects) or in greenhouse flower cultivation (16 subjects). In most patients, rhinitis was associated with bronchial asthma (16 subjects), urticaria (14 subjects), or both (three subjects). Allergic alveolitis or other common allergic diseases had been excluded, and a diagnosis of "occupational disease of undetermined origin" had been made before by other medical centers. Ten healthy farm workers and 10 atopic townsmen were chosen as control groups. An in vivo and in vitro diagnostic trial by skin prick testing (SPT) and serum specific IgE dosage with TU-WBE were done in all subjects. Thirty-six patients (78%) were found to be positive to both SPT and the IgE enzyme allergosorbent test (EAST), with a good correlation between IgE serum levels and cutaneous wheal size. Control groups did not show any reaction. The IgE-EAST homologous inhibition test was positive. The IgE-EAST cross-inhibition test excluded cross-reactivity between TU and Dermatophagoides pteronyssinus. The TU-exposure test was positive for the 36 patients with TU-WBE-specific IgE. Three patients who were negative for TU-WBE-specific IgE reacted to the TU-exposure test; in these patients, the scratch-chamber test (Finn chamber) with eggs and droppings from TU was positive.(ABSTRACT TRUNCATED AT 250 WORDS)

Two interesting cases of transient neonatal diabetes mellitus

Two cases of transient neonatal diabetes mellitus associated with anemia, macroglossia and umbilical hernia were studied in relation to the possible etiologies that have been postulated to be responsible for this syndrome. Both patients required insulin therapy for the control of their hyperglycemia but case number two needed to be treated for 14 months before glucose normalization occurred. This patient developed classical insulin dependent diabetes mellitus during our follow-up; the HLA typing showed DR4 allele.

[L-T4 malabsorption determined by intolerance to cow's milk proteins and celiac disease in a patient with congenital hypothyroidism. A clinical case]

An infant with congenital hypothyroidism (CH) is described who in the course of thyroxin replacement therapy developed cow's milk protein intolerance (CMPI) and subsequently coeliac disease (CD). The presence of these two pathologies interfered with the intestinal absorption of L-thyroxin (L-T4) and made the appropriate management of CH difficult. A male patient, formula fed from birth, was screened for CH at 5 days of age. CH was confirmed and L-T4 treatment (6.8 micrograms/kg/day per os) begun at 35 days of age. Seen after 3 weeks because of feeding problems and impaired growth and with a serum T4 concentration of 4.7 micrograms/dl and a TSH of 56 mU/ml, his replacement dose was increased to 12 micrograms/kg/day. One week later, the child was hospitalized because of vomiting, acidosis and shock. CMPI was diagnosed and the child began a diet with a hydrolyzed milk protein food. After 7 weeks the serum T4 improved to 11 micrograms/dl, the TSH decreased to 10 mU/ml, while maintaining the 12 micrograms/kg dose. After 2 months an oral challenge with cow's milk confirmed the diagnosis of CMPI with a concomitant decrease in serum T4 to 6.4 micrograms/dl, while TSH rose to 64 mU/ml. Weight and T4 levels normalised with CMPI diet. At 12 months of age the patient presented anorexia and impaired growth.(ABSTRACT TRUNCATED AT 250 WORDS)

[The epidemiology of adverse reactions to nonsteroidal anti-inflammatory drugs. Nimesulide is tolerated by patients with adverse reactions to NSAIDs and modulates in man the skin response to histamine and codeine]

We evaluated the tolerance to NIM in patients with adverse reactions to NSAIDs, expressed by urticaria-angioedema, bronchial asthma or erythema polymorphous on 92 patients among which 32 atopics affected by asthma, rhinitis or contact dermatitis. Challenge test has been performed with increasing amounts of NIM per os every 2 hrs to a maximum of 100 mg/dose. The last dosage was repeated every 12 hrs for 4 times more. No reactions were observed in 86 patients (93.4%). Moreover we evaluated the efficacy of NIM in modulating pomphoid cutaneous reaction to histamine (HIS) and codeine (COD). Three subjects were prick tested with HIS and COD solutions at different concentrations (0.1 to 10 mg/ml), before and after a 5 days therapy with NIM at different dosages/kg/die. At NIM dosages of 3.7 and 2.7 mg/kg/die we observed a strong reduction of pomphoid activity of both HIS and COD. No clear effects were detected at 2.2 mg/kg/die dosage. We assume a dose-related in vivo inhibitory effect of NIM on cutaneous mast cells releasability or a direct anti-histaminic effect. We point out the possible therapeutic role of NIM in the treatment of allergic flogosis at steroid and cromon's side.

Tension type headache: a neuropsychological and neurophysiological study

Characteristic personality profiles of patients suffering from either migraine headache (MH) or tension type headache (TTH) have been described in the light of Minnesota Multiphasic Personality Inventory (MMPI). In the present study we evaluated personality profile changes following modifications of the painful symptoms after treatment, through the administration of the MMPI to MH and TTH patients. In TTH patients with no clinical improvement the depression scale scores were higher after 6 months of treatment, whereas in MH patients similar scores were observed before and after therapy, thus suggesting a primary role of depression in the onset of pain in the latter patients. Computerized EMG recording of the neck muscle activity showed different patterns of muscle contraction in resting condition and during stress or maximal muscular activity in patients suffering from TTH as compared to MH patients and normal subjects.

[Visceral leishmaniasis complicated by herpes zoster. An unusual case in the pediatric age]

The Authors describe a case report of a girl of 7 years affected by visceral leishmaniasis (VL) complicated by herpes zoster (Hz). Hz infection is unusual in paediatric age, but it may complicate immunodeficiency states. VL causes, as well known, T cell immunity depression: Hz infection could be facilitated by this situation.

Intellectual functions and personality in subjects with noncongenital myotonic muscular dystrophy

Mental retardation and personality disorders are commonly described among the symptoms of myotonic dystrophy. Nevertheless, this tendency is not supported by systematic studies performed on large samples, whose results are controversial. We studied the cognitive functions and personalities of a group of 28 patients, in whom myotonic dystrophy had commenced in juvenile or adult life. The severity of the disease was variable, but all subjects were self-sufficient. Only 7.1% of subjects showed low intelligence with deterioration of perceptual-motor functions. This was not correlated with the severity of their disease. Women had a substantially lower mean Wechsler-Bellevue score than men. The personality function study of the entire group showed no change of psychiatric relevance but did present a depressive attitude with marked somatic concern and difficulties in establishing relationships in social life.

Prognostic signs in the evolution of premature thelarche by discriminant analysis

Since premature thelarche (PT) can be a first sign of precocious puberty (PP), the aim of our study was to identify simple items in the course of the first 6 months of follow-up that could help predict if PT would evolve to PP. Thirty-two girls with PT were studied. First evaluation included bone age (BA), basal estradiol, FSH, LH and prolactin. GnRH was performed in 15 subjects and BA was checked at 6 month intervals in 30. Based on clinical outcome after a mean follow-up of 33.4 +/- 16.5 (SD) months, patients were divided into 2 groups: Group I (G-I) included subjects whose breast development either remained unchanged, increased or regressed; Group II (G-II) included subjects who progressed to PP. The multivariate combination of the items which was able to best discriminate between the two groups was chosen in predicting the evolution of PT. The items considered included four variables available at the time of diagnosis [chronological (CA) at onset less than 3 years, basal FSH, basal LH and BA/CA ratio] and two additional variables after a 6-month follow-up (delta BA/delta CA and growth velocity); 88% of G-I and 14% of G-II had CA less than 3 yr. Basal FSH levels were elevated in both G-I (7.6 +/- 3.0 mIU/ml) and G-II (12.1 +/- 4.1) with respect to controls (2.6 +/- 1.2); however, approximately 20% of G-I had low FSH levels. Basal LH levels were consistently higher in G-II (8.0 +/- 1.3 mIU/ml) than in G-I (2.9 +/- 1.5) or controls (2.8 +/- 1.2). Although initial BA was advanced (greater than 2SD) in 21% of G-I and in all of G-II, an acceleration of BA was seen only in G-II. The mean growth velocity of G-I (44.1 +/- 31.5%) was significantly less than G-II (92 +/- 32%; p less than 0.0025). With the help of the discriminant equations derived from data obtained at diagnosis and during the first 6 months of follow-up, all subjects with isolated premature thelarche could be sharply distinguished from those who subsequently progressed to precocious puberty.(ABSTRACT TRUNCATED AT 250 WORDS)

Relations between on-off phenomena and cognitive functions in Parkinson disease

10 patients with Parkinson disease on long term levodopa therapy and with fluctuations in motor performance unrelated to drug administration (on-off phenomena) were assessed on the following neuropsychological tests during the on and off phases: tests of attention (Toulouse-Pieron), memory (Digit Span, Rey forms 1 and 2), psychomotor capacity (maze test, single and multiple choice reaction times) and mood (Maudley Adjective Check List). The extrapyramidal symptoms were assessed on the Webster Rating Scale. We found no significant differences in attention, cognitive performance or mood between the on and off phases despite large fluctuations in motor performance.

Endorphins in male impotence: evidence for naltrexone stimulation of erectile activity in patient therapy

In the present study we evaluated whether naltrexone administration could stimulate sexual function in 30 male patients, ages 25 to 50 years, with idiopathic impotence of at least one year's duration and not of organic etiology. The patients received naltrexone (50 mg/day) or placebo, on a random basis for two weeks. Sexual performance, expressed as the number of full coitus/week, was assessed before (time 0) and during (on days 7 and 15) each treatment. The naltrexone therapy significantly increased the number of successful coitus compared to placebo after 7 and 15 days of treatment: improvement of sexual performance was evident in 11 out of the 15 treated patients. All the patients experienced a significant increase in morning and spontaneous full penile erections/week. No significant side effects were reported. Endocrine studies revealed no significant modification of plasma LH, FSH or testosterone by naltrexone, suggesting that the positive effect of the drug on sexual behavior was exerted at a central level. A two-month follow-up, at which time patients were off treatment, erectile capacity had returned to baseline in 10 patients, while five reported complete recovery of their sexual ability. We hypothesize that an alteration in central opioid tone is present in idiopathic impotence and is involved in the impairment of sexual behavior.

Psychologic evolution of patients with Menière's disease in relation to therapy

The state of anxiety experienced by menieric patients indicates the importance of the psychologic component in this disease. Uncertainties as to the type of treatment that is actually curative for this disease have put doubts on the favorable outcome for patients referred for endolymphatic shunt procedures; some clinicians claim that in such cases surgery simply had a psychologic support function. To evaluate the effectiveness of such a statement, the authors have studied three groups of patients: patients who underwent surgery; patients who underwent medical treatment; and nonmenieric, otosclerotic subjects prior to surgery as a control group. The first group was further divided into subjects with and without improvement after surgery. The following personality tests were used: Minnesota Multiphase Personality Inventory, reduced version; Adjective Check List; State-Trait Anxiety Inventory; and Symptom Check List. The results relative to the whole menieric group show a tendency toward a state of dysphoria and more striking somatizations than in the otosclerotic group. In regard to the distinction between operated and nonoperated patients, the former group showed a personality with a strong neurotic trait associated with dysphoria and a state of free anxiety tending toward hypochondria. The outcome of the operation (improvement of the vertigo) does not seem to influence the personality of the subjects, even though there are signs of higher anxiety levels than in subjects without improvement.

An epidemiological study of atopy in children

A sample of 930 children, between 9 years and 15 years old from six Italian towns, were studied. Their family history of allergy, personal allergy and medical history, current allergy symptoms, exposure to environmental allergens, feeding as infants, and their parents' occupations were recorded. They were skin-prick tested (SPT) with a range of common allergens. A subject was defined as atopic if at least one SPT caused a weal greater than 3 mm diameter. The association between the recorded information and atopy was investigated by logistic multiple regression. Atopy was positively associated with: high density housing; medium or high exposure to environmental allergens; a history of rhinitis, asthma or atopic eczema; male gender; and a history of breastfeeding. It was independent of infectious diseases, vaccinations and operations, social class and family history. Thus, there was no evidence of a genetic factor in atopy, other than sex.

Hypertension, non-insulin-dependent diabetes, and intracellular sodium metabolism

The present study was designed to investigate whether non-insulin-dependent diabetic hypertensive patients exhibit abnormalities in intracellular sodium metabolism similar to those described for essential hypertensive patients. Both normotensive and hypertensive non-insulin-dependent diabetic patients had similar average values of both Na+-Li+ countertransport and Na+-K+ cotransport compared with nondiabetic controls. Within the group of diabetic patients, hypertensive patients did not exhibit any abnormalities in either of the sodium transport pathways studied. The possible implications of these findings are addressed.

Red blood cell Na content, Na, Li-countertransport, family history of hypertension and blood pressure in school children

This study focuses on the relationship between some aspects of intra-erythrocytic sodium metabolism (intra-erythrocytic Na content, Na,Li-countertransport), blood pressure, and family history of hypertension, in a group of 84 randomly selected school children (45 males, 39 females). Na,Li-countertransport was significantly related to both systolic blood pressure (SBP) and diastolic blood pressure (DBP) only in boys at the univariate level, but both of these associations lost statistical significance after the possible confounding role of weight and height were taken into consideration. In both sexes, participants with a family history of hypertension had similar values of both intra-erythrocytic Na content and Na,Li-countertransport to participants with no family history. We conclude that family history of hypertension does not seem to play an important role in the determination of either intra-erythrocytic Na content or Na,Li-countertransport at this age. Although the positive association between Na,Li-countertransport and blood pressure observed in adult males is already present in childhood, this probably is still, at least in part, dependent upon body size.

Intraerythrocytic cation metabolism in children with uremia undergoing hemodialysis

Erythrocytes from children with uremia who are undergoing hemodialysis show normal maximal velocity of NA+-Li+ countertransport and Na+/K+/Cl- cotransport and normal intracellular sodium content. These aspects of intracellular sodium metabolism are not affected by dialysis. The normality of intraerythrocytic cation metabolism in children with uremia is associated with anemia, increased systolic and diastolic blood pressure, reduced body mass index, retention of solutes (urea, creatinine, potassium), a low triiodothyronine and thyroxine syndrome, and high parathormone levels.

Evidence of polyglandular involvement in Niemann-Pick disease type B

We report a girl with Niemann-Pick disease type B in whom short stature was recorded over a long period. Association of short stature with the presence of a polyglandular involvement in this patient is discussed.

Outward Na-K-Cl cotransport in human red blood cells: a methodological evaluation of method for epidemiologic investigations

The present report evaluates a method for the determination of the maximal velocity of the outward sodium, potassium, chlorine (Na-K-Cl) cotransport in erythrocytes. The loading procedure was carried out using the ionophore nystatin. The technical error for this assay, based on concurrent analysis of randomized blind duplicate samples, was 8.04% of the sample mean and 27.5% of the sample standard deviation. The assay was stable over time and reproducible. Fasting was not necessary. The ratio of intra- to interindividual variances was small. The cells can be safely preserved in an appropriate preservation solution without modification of the ion transport assay. The assay appears to be adequate for use in large-scale field trials.

Intracellular ion metabolism in erythrocytes and uraemia: the effect of different dialysis treatments

The present report focuses on some aspects of the intra-erythrocytic cation metabolism (e.g. the maximal velocity of the Na+-Li+ countertransport and Na+/K+/Cl- cotransport) in uraemic patients on different dialysis treatments. Patients undergoing dialysis treatment [continuous ambulatory peritoneal dialysis (CAPD) or haemodialysis (HD)] overall showed higher Na+-Li+ countertransport than controls. With regard to Na+/K+/Cl- cotransport, CAPD patients and controls did not differ and both showed, on average, higher values than HD patients. A subgroup of HD patients was studied before and after dialysis. No significant overall changes were detected as a result of the dialysis process with regard to Na+/K+/Cl- cotransport. Na+-Li+ countertransport was significantly reduced by dialysis and a distinctly different response to dialysis was evident according to predialysis values. Patients with high values of Na+-Li+ countertransport showed a significant reduction in this parameter while patients with normal values showed no effect. No distinct association was detected between alteration in either Na+-Li+ countertransport or Na+/K+/Cl- cotransport and the clinical characteristics of the patients. It is concluded that uraemia and/or dialysis influences the maximal velocity of the parameters under investigation. The effect on Na+-Li+ countertransport seems to be similar for both CAPD and HD, while Na+/K+/Cl- cotransport is not altered in CAPD patients.

Mental impairment in Parkinson's disease. The role of anticholinergic drugs

The trial has been carried out on 33 treated Parkinsonian patients and 14 healthy controls. A series of psychometric tests were employed in order to show a possible intellectual deterioration in Parkinsonian patients. Bender's test showed greater motor-perceptive deterioration in Parkinsonian patients respect to control, the Wechsler-Bellevue Intelligence Scale evidenced in patients significant deterioration of mnesic and psychomotor capacity. When considering drug treatments patients undergoing combined treatment or anti-cholinergics alone obtained worse results in all tests made whilst patients on L-Dopa alone obtained the best results.