Cocoa by-product inclusion in dairy sheep diet: effect on sensory, volatile and antioxidant properties of cheese

The possibility of inclusion of agro-industrial by-products in the diet of small ruminants represents both an economical and an environmental strategy for reducing waste management by industries and the cost of feeding as well as the impact of livestock farming. Large amounts of wastes from the cocoa industry are annually produced with a considerable part represented by cocoa bean shells, considered a suitable ingredient to be included in the diet of ruminants within the limits established by European legislation. The aim of this study was to assess the effect of including cocoa bean shells in the diet of dairy sheep on the sensory, volatile, and antioxidant properties of cheese. To this purpose, 20 Comisana lactating ewes were randomly assigned to 2 experimental groups: control (CTRL) and cocoa bean shells (CBS), and received alfalfa hay ad libitum and 800g of conventional (CTRL) or experimental (CBS) concentrate containing 11.7% CBS to partially replace corn and barley of the CTRL concentrate. Bulk milk collected from each group was used to produce a total of 15 cheeses per group, obtained in 5 different days of cheese-making (3 cheeses a day per group). After 60 d of aging, each cheese of each experimental group was sampled for the analyses. The results on chemical composition revealed a greater monounsaturated fatty acids content and an increase in the nutritional indices suggesting a favorable role of cocoa bean shells dietary inclusion on the nutritive value of the cheese. The cheese sensory profile was affected by the cocoa bean shells inclusion, with more pronounced appearance, odor, aroma, and taste attributes in the product. The volatile profile showed only a few significant differences, mainly related to the cheese ripening process, and no differences were found in α-tocopherol contents in cheese fat between the 2 groups. Therefore, the coca bean shells inclusion in the diet of dairy sheep allowed to obtain a good quality cheese, without altering the characteristics associated with the typical profiles of sheep cheese. Furthermore, the use of this by-product could contribute to decrease feed costs and waste management, representing a good practice for increasing the sustainability of dairy products.

Feeding tannins to dairy cows in different seasons improves the oxidative status of blood plasma and the antioxidant capacity of cheese

The aim of the present study was to assess the dietary supplementation of tannins to grazing dairy cows in 2 seasons characterized by a good quality pasture (spring) or a poor-quality pasture (summer). The effects of dietary tannins were assessed on plasma antioxidant status and cytokines profile and on the antioxidant properties of cheese and cheese in vitro digestates. Fourteen lactating dairy cows were divided into 2 homogeneous groups (n = 7): a control group (CON), and an experimental group (TAN) receiving 150 g/head per day of tannins supplementation. The experiment was performed twice, in spring and in summer. The animals were free to graze on spontaneous pasture (spring) or on dry stubble (summer). Blood was sampled at the beginning (d 0), at the midpoint (d 11), and at the end (d 22) of the trial. Individual cheese was produced before the beginning (d -1) and at the end (d 22) of the trial from the milk collected from each cow. On blood plasma, the reactive oxygen metabolites (ROM), biological antioxidant potential (BAP), nonesterified fatty acids quantification, and cytokines profile in terms of IL-10, IL-8, IL-1β, and IFN-γ were determined. Data on ROM demonstrated that tannins supplementation lowered oxidative stress both in spring and in summer. Accordingly, TAN diet increased BAP levels compared with the CON during summer trial. Thus, feeding tannins resulted in lower ratio between ROM and BAP (oxidative stress index) in both spring and summer. Cytokines' profile showed lower IL-1β values in TAN group at d 22 during spring season, with a concomitant higher IL-10 level, during summer season. Moreover, TAN group had a lower level of IFN-γ in plasma than CON group, both in spring and in summer. On cheese samples, the in vitro digestion was performed and on cheese and cheese digestates (gastric and intestinal digestate) the free radical scavenging antioxidant activity was evaluated. The intestinal digestate fraction registered the highest antioxidant activity compared with cheese and gastric digestate, in both spring and summer seasons. Furthermore, an improvement of the antioxidant property of cheese and cheese digestates was found. Present data demonstrated that tannins supplementation contributed to reduce the oxidative stress of lactating dairy cows and showed an increase of anti-inflammatory cytokines ratio.

Cheese quality from cows given a tannin extract in 2 different grazing seasons

The aim of the present study was to compare the effect of dietary tannins on cow cheese quality in 2 different grazing seasons in the Mediterranean. Two experiments were performed on 14 dairy cows reared in an extensive system. The first experiment took place in the wet season (WS), and the second experiment took place in the dry season (DS). In the WS and DS experiments, cows freely grazed green pasture or dry stubbles, respectively, and the diet was supplemented with pelleted concentrate and hay. In both experiments, the cows were divided into 2 balanced groups: a control group and a group (TAN) receiving 150 g of tannin extract/head per day. After 23 d of dietary treatment, individual milk was collected, processed into individual cheeses, and aged 25 d. Milk was analyzed for chemical composition, color parameters, and cheesemaking aptitude (laboratory cheese yield and milk coagulation properties). Cheese was analyzed for chemical composition, proteolysis, color parameters, rheological parameters, fatty acid profile, and odor-active volatile compounds. Data from the WS and DS experiments were statistically analyzed separately with an analysis of covariance model. In the WS experiment, dietary tannin supplementation had no effect on milk and cheese parameters except for a reduced concentration of 2-heptanone in cheese. In the DS experiment, TAN milk showed lower urea N, and TAN cheese had lower C18:1 trans-10 concentration and n-6:n-3 polyunsaturated fatty acid ratio compared with the control group. These differences are likely due to the effect of tannins on rumen N metabolism and fatty acid biohydrogenation. Dietary tannins may differently affect the quality of cheese from Mediterranean grazing cows according to the grazing season. Indeed, tannin bioactivity on rumen metabolism seems to be enhanced during the dry season, when diet is low in protein and rich in acid detergent fiber and lignin. The supplementation dose used in this study (1% of estimated dry matter intake) had no detrimental effects on cheese yield or cheesemaking parameters. Also, it is unlikely that sensorial characteristics would be affected by this kind of dietary tannin supplementation.

Inclusion of cocoa by-product in the diet of dairy sheep: Effect on the fatty acid profile of ruminal content and on the composition of milk and cheese

In this study, we hypothesized that dietary cocoa bean shell (CBS) as a partial replacer of human edible cereal grains in the diet of lactating ewes may affect performance and milk and cheese composition. Twenty Comisana lactating ewes allotted into control (CTRL; n = 10) or cocoa (CBS; n = 10) group received alfalfa hay ad libitum and 800 g of conventional (CTRL) or experimental (CBS) concentrate containing 11.7% CBS to partially replace corn and barley of the CTRL concentrate. Milk yield and composition did not differ between groups, and only urea concentration was lower in CBS milk. Dietary CBS increased cheese fat and reduced protein percentage in CBS group. Fatty acid composition of rumen content partially reflected that of the ingested diet, with total saturated fatty acids (SFA), total monounsaturated fatty acids (MUFA), 16:0, 18:0 and 18:1c9 greater in the CBS group. Moreover, all the identified trans- and cis-18:1 isomers were greater in CBS rumen content. Milk and cheese showed a similar fatty acid composition. Total MUFAs were greater in milk and cheese of CBS, mainly due to the proportion of 18:1c9, and conversely, total polyunsaturated fatty acids (PUFA), PUFAn-6 and PUFAn-6-to-PUFAn-3 ratio was greater in CTRL group. Concluding, the inclusion of CBS in the diet of lactating ewes within the limit imposed by the current legislation did not cause detrimental effects on animal performance and milk composition. Interestingly, dietary CBS reduced milk urea concentration probably due to the phenols contained in CBS concentrate. However, our results support that biohydrogenation was weakly impaired by dietary CBS. Finally, CBS negatively affected cheese nutritional characteristics due to lower protein and greater fat content, but improved fat health indexes in milk and cheese.

Successful pregnancy after uterine artery embolization for uterine arterovenous malformation: a rare case report

Objective

This paper reports on a rare case of pregnancy after uterine artery embolization (UAE) for uterine arteriovenous malformation (AVM). Debate exists about persistence of fertility in women after UAE. Adverse effects of this technique can modify both uterine echostructure, inducing necrosis and infarction, endometrial atrophy and uterine artery rupture, and ovarian reserve, causing persistent amenorrhea. Ovarian reserve appears to be affected by UAE in pre-menopausal women. However, younger ovaries (according to biological ovarian age) exhibit a greater capacity for recovery after ovarian damage. Therefore, larger studies are needed for more conclusive results.

Case report

A 28-year-old woman was admitted to our department due to life-threatening uterine bleeding, resulting in tachycardia, pallor, and sweating. The patient came with a history of two spontaneous miscarriages. After sonography and computed tomography, AVMs were identified at uterine fundus and anterior wall.

Conclusion

The pathogenesis of infertility after UAE is not yet known. The peculiarity of this case was that, only few months later, the patient became pregnant and gave birth to a live fetus at 37 weeks with cesarean delivery.

Histoplasmose Cutânea Disseminada em Doente com SIDA: Relato de um Caso Clínico

Descreve-se o caso clínico duma mulher de 30 anos, raça negra, natural e residente em Moçambique, internada no serviço de dermatologia do Hospital Central de Maputo por múltiplas pápulas de aparecimento progressivo e aditivo disseminadas por todo o tegumento cutâneo. O teste para VIH 2 foi positivo, com CD4 de 1 cel/mm3. O exame histológico de uma das lesões foi compatível com infecção por Histoplasma capsulatum. Foi medicada com anfotericina B durante 21 dias com melhoria clínica. Teve alta medicada com fluconazol 400 mg/dia e tratamento anti-retroviral mas viria a falecer 13 meses depois após gastrenterite aguda.

Fatty acid composition of ruminal digesta and longissimus muscle from lambs fed silage mixtures including red clover, sainfoin, and timothy

This work investigated the effects of feeding silage mixtures of a plant containing polyphenol oxidase (PPO; red clover [; RC]), a plant containing tannins (sainfoin [; SF]), and a grass species not containing these compounds (timothy [; T]) on ruminal and intramuscular (i.m.) fatty acids of lambs. Forty 4-mo-old castrated male Romane lambs, divided into 5 groups, received 1 of the following silages: 1) T (100%), 2) a binary mixture of timothy and tannin-containing sainfoin ( cv. Perly; 50:50 [T-SF]), 3) a binary mixture of timothy and PPO-containing red clover ( cv. Mervius; 50:50 [T-RC]), 4) a ternary mixture of timothy, sainfoin, and red clover containing both tannins and PPO (50:25:25, respectively [T-SF-RC]), and 5) a binary mixture of tannin-containing sainfoin and PPO-containing red clover (50:50 [SF-RC]). In the rumen digesta, the partial or total replacement of T with forage legumes was associated with greater concentrations of PUFA ( < 0.001) and 1esser concentrations of MUFA ( < 0.001). The inclusion of forage legumes in the silage favored the accumulation of 18:3 -3 ( < 0.001), with the greatest concentrations being observed in SF-RC. This latter diet also led to the greatest percentage of 18:2 -6 ( < 0.001). Forage legumes decreased the -11 18:1 to 30% of T in rumen digesta ( < 0.001). Forage legumes decreased the total concentration of branched-chain fatty acids in the rumen digesta (on average, -28%; < 0.001), this effect being less marked (-17%; = 0.014) in T-RC in comparison with T. The dietary treatment tended to affect the proportion of MUFA ( = 0.081) and of PUFA ( = 0.079) in the i.m. fat of the LM, respectively, at the highest and lowest numerical value in the T group. The sum of -3 fatty acids was less in the T and T-SF groups compared with the mixture of legumes without T (SF-RC; < 0.001 and < 0.008, respectively). The latter group had also a lesser -6-to--3 ratio than the T-SF group ( = 0.01). -11 18:1 was greater ( < 0.03) in lambs given T as the sole silage in comparison with lambs given T-RC, T-SF-RC, and SF-RC. Rumenic acid (-9 -11 CLA) was detected at a greater percentage in the LM from the animals fed the T silage compared with animals fed the T-SF-RC treatment ( = 0.004). Contrarily, -9 -12 -15 18:3 was found at a greater concentration in the muscle from lambs in the SF-RC treatment compared with lambs in the other treatments ( < 0.001). Furthermore, the T-RC group showed a greater proportion of α-linolenic acid than the T group ( = 0.03). In conclusion, the effects of the 2 active compounds (PPO and tannins) appear to be similar and additive. Moreover, a silage composed of a mixture of RC and SF is an excellent forage for growing lambs in terms of i.m. fatty acid composition.

The effects of barley replacement by dehydrated citrus pulp on feed intake, performance, feeding behaviour and serum metabolic indicators in lambs

The citrus industry produces a wide amount of citrus pulp which can represent an alternative feed resource for feeding ruminants. However, citrus pulp also contains chemicals such as polyphenols, which can cause toxicity, limiting its use. We investigated the potential of replacing barley by dehydrated citrus pulp (DCP), at two levels of inclusion (24% and 35% on an as-fed basis), in a lamb fattening diet and monitored the performance, feeding pattern and serum parameters of the experimental lambs. The consumption of a diet containing up to 35% of DCP resulted in equivalent performance, feed efficiency and carcass weight and yield as compared with animals ingesting a cereal-based diet (control). The daily feed consumption pattern was slightly affected by the inclusion of citrus pulp in the diet. In terms of serum haematochemical profile, DCP ingesting animals had similar levels to control lambs. Pertaining to the serum protein profile, DCP addition had minor effects. A significant increase in the albumin content and in the albumin to globulin ratio was observed in the animals ingesting 35% DCP compared with the control-fed ones; but the values were not at a level to cause metabolic distress. The use of high levels of DCP in small ruminant fattening can ensure equivalent animal performances and metabolic welfare while providing a value addition to a local by-product.

Fatty acid metabolism in lambs fed citrus pulp

In the present study, we have hypothesized that replacing barley with high proportions of dried citrus pulp in a concentrate-based diet for lambs could increase the intake of unsaturated fatty acids and could reduce the rate of the ruminal biohydrogenation of PUFA, with a consequent improvement of the intramuscular fatty acid composition. To test this hypothesis, 26 Comisana lambs were divided into 3 groups and for 56 d were fed a barley-based concentrate diet (CON; 8 lambs) or 2 diets in which barley was replaced with 24% (CIT24; 9 lambs) or 35% (CIT35; 9 lambs) dried citrus pulp. An overall improvement of the fatty acid composition of LM from lambs fed citrus pulp-containing diets was found. The PUFA/SFA ratio was lower (P < 0.05) in the LM from lambs in the CON group compared with both the CIT24 and CIT35 groups. The thrombogenic index was lower (P < 0.05) in meat from lambs fed the CIT35 diet compared with those fed the CON diet. The CIT35 diet increased the proportion of C20:5 n-3 in the LM (P < 0.05), whereas the CIT24 diet enhanced that of C22:6 -3 (P < 0.05) compared with the CON diet. Some of these results might be explained considering that feeding the CIT24 and CIT35 diets increased the intake of total fatty acids (P < 0.05) and of C18:3 n-3 (P < 0.01) compared with feeding the CON treatment. On the other hand, phenolic compounds present in citrus pulp could have inhibited the ruminal biohydrogenation of PUFA. This is supported by the fact that regardless of the level of inclusion in the diet, citrus pulp increased the proportion of rumenic acid (P < 0.001) in LM compared with the CON diet. The plasma from lambs fed both CIT24 and CIT35 diets had a greater percentage of vaccenic acid (VA; < 0.001) compared with that from lambs fed the CON diet, and the CIT35 diet increased the proportion of rumenic acid in plasma compared with the CON treatment (P < 0.05). In the ruminal fluid, stearic acid (SA) tended to decrease, and the sum of CLA tended to increase (P = 0.09) with increasing level of citrus pulp in the diets. Furthermore, the SA/(SA + VA) ratio tended to be lower (P = 0.10) in the ruminal fluid from lambs fed the CIT35 diet compared with that of the CON group. In conclusion, our results support the hypothesis that replacing barley with citrus pulp in the diet of growing lambs improves intramuscular fatty acid composition and underline the need for specific studies to clarify the mechanisms by which feeding citrus pulp affects the fatty acid metabolism in ruminants.

Variations in stable isotope ratios in lamb blood fractions following dietary changes: a preliminary study

RATIONALE

In meat production it is common practice to use finishing diets based on concentrates, even for those animals previously raised on pasture. No studies have investigated the variations of stable isotope ratios in lamb plasma and erythrocytes, following a switch from pasture to a concentrate-based diet during the last days before slaughter. For meat traceability it is important to verify how and whether these parameters are affected in blood fractions.

METHODS

Blood of ten male Italian Merino lambs, whose diet was switched from pasture to concentrate, was sampled 8 times (days 1, 2, 3, 4, 5, 6, 7 and 14) in the last 14 days before slaughter. The variations in the δ(13)C, δ(15)N, δ(18)O and δ(34)S values of blood plasma and erythrocytes were investigated. The stable isotope ratios of the samples were measured using a stable isotope mass spectrometer coupled with an elemental analyser (C, N, S) and a CO2/H2O equilibration system (O(plasma)).

RESULTS

The δ(13) C(plasma), δ(18)O(plasma) and δ(34)S(plasma) values were shown to be different 7 days after the abrupt variation in the diet. The comparison between erythrocytes and plasma stable isotope ratios could be suitable for verifying whether the animal was actually pasture-raised and could merit a higher price. The erythrocytes isotopic signature was not affected by very short finishing periods in previously grazed animals and maintained the pasture-raised fingerprint, while the analysis of plasma could detect very short finishing periods with concentrate and hay.

CONCLUSIONS

The present study has demonstrated that the combination of blood plasma and erythrocytes stable isotope ratios of carbon, nitrogen, oxygen and sulphur can be used to infer the dietary background of lambs and thus offers a tool for the authentication of the animal production system.

Carob pulp inclusion in lamb diets: effect on intake, performance, feeding behaviour and blood metabolites

Carob (Ceratonia siliqua) is commonly found in the Mediterranean region and may be used as an alternative feed resource in livestock production. However, carob contains plant secondary compounds, such as polyphenols, which limit its use due to potential toxicity problems. This study aimed to investigate whether the substitution of barley by carob pulp at a relatively high level of up to 35% causes production-level reduction and has detrimental effects on animal welfare. Lamb performance parameters such as feed intake, liveweight and carcass weight were recorded and feeding behaviour was monitored. Blood metabolites and protein profiles were determined to detect signs of metabolic distress. The inclusion of carob pulp resulted in similar level of performance by animals in all the experimental diets. However, the feeding pattern was different with feed intake being significantly lower during the first 90 min post feed supply in the carob-fed lambs compared with the Control animals, although total daily intake was similar. In terms of welfare indicators, the inclusion of carob pulp in the lambs’ diet reduced blood cholesterol while increasing both non-esterified fatty acid and urea levels. These indicate that the animals were probably under some form of metabolic stress but not at a level to cause concerns, as confirmed by the similar serum protein profile especially in terms of albumin to globulins ratio.

The quality of meat from sheep treated with tannin- and saponin-based remedies as a natural strategy for parasite control

Lambs were assigned to four groups of seven and treated as follows for 12 days: control group (BP) was fed beet pulp; group T (tannin remedy) received the BP diet including 80 g/kg of quebracho extract; group S (saponin remedy) received the BP diet including 15 g/kg of quillaja extract; and group C had a free choice between T and S remedies. Lipid oxidation was lower in meat from S lambs compared to T lambs (P<0.05). Among the volatile compounds, lactate was lower in meat from S lambs compared to T animals (P=0.05). Metabolomic analysis showed that the T treatment increased ribose, fructose, glucose and sorbitol concentration in meat (P<0.05), while cholesterol was decreased by S and C treatments. The T treatment increased the concentration of C14:1 cis-9 (P<0.05). These findings indicate that treatments for parasite control containing tannins and saponins do not detrimentally affect sheep meat quality.

The effect of the change from a herbage- to a concentrate-based diet on the oxidative stability of raw and cooked lamb meat

Over 89 days, 10 lambs (S) were fed concentrates and hay in stall, while 9 lambs (P) grazed at pasture. Two groups of 9 animals grazed at pasture until switching to a concentrate-based diet for 14 or 37 days before slaughter (P-S14 and P-S37). The fat content of longissimus dorsi muscle (LM) increased with increasing duration of concentrate feeding (P=0.05). As a consequence, the concentration of polyunsaturated fatty acids (PUFA) and of the highly peroxidisable (HP) PUFA in the polar lipids was similar between treatments. Lipid oxidation in fresh LM over 8 days of storage was affected by the diet (P<0.0005) with the P-S37 and P treatments producing, respectively, the highest and the lowest TBARS values. The P treatment reduced TBARS in cooked minced LM over 2 days of storage and no difference was found between the P-S14, P-S37 and S treatments. Colour stability of fresh LM was not noticeably affected by the dietary treatment.

Dietary olive cake reduces the oxidation of lipids, including cholesterol, in lamb meat enriched in polyunsaturated fatty acids

Over 40 days, lambs were fed: concentrate (C), concentrate containing 20% linseed (L), concentrate containing 35% olive cake (OC), or concentrate containing 10% linseed and 17% olive cake (OCL). The polyunsaturated fatty acids (PUFA) and peroxidation index (PI) in phospholipids were increased by the L and OCL treatments (P=0.007 and P=0.003, respectively). The OC and OCL diets increased the concentration of tocopherol in muscle (P<0.001). Compared to the OC and OCL diet, the L diet increased fatty acid oxidation, measured as conjugated dienes (CD; P=0.003), peroxides (PV; P<0.001) and TBARS (P=0.002) in minced muscle over 11 days of storage in high-oxygen atmosphere. Also, the L diet increased (P<0.001) the levels cholesterol oxidation products (COPs). In conclusion, feeding olive cake improved the oxidative stability of lamb meat and the combination of olive cake and linseed improved the fatty acid composition of meat without compromising its oxidative stability.

Optimization of a glucose biosensor setup based on a Ni/Al HT matrix

An amperometric glucose biosensor was developed using an anionic clay matrix of hydrotalcitic nature (Ni/Al-NO3 HT) as enzyme support, which was electrochemically synthesized at -0.90 V versus SCE, using a rotating disk Pt electrode to assure homogeneity of the electrodeposition suspension. The biorecognition element was glucose oxidase (GOx) immobilized on HT during the electrosynthesis, which was followed by cross-linking with glutaraldehyde vapours to avoid the enzyme release. The performances of the biosensor, in terms of sensitivity to glucose calculated from the slope of the calibration curve, are dependent on parameters related to the electrodeposition. An experimental design was applied to detect the optimal conditions of electrosynthesis in order to optimize the glucose biosensor performance. The factors taken into account were enzyme concentration and Ni/Al molar ratio. A full factorial design was performed to study linear interactions between factors and their quadratic effects and the optimal setup was evaluated by the isoresponse curves. The significant factors were enzyme concentration (linear and quadratic terms) and the interaction between enzyme concentration and Ni/Al molar ratio. Under the optimized electrodeposition conditions, the reproducibility of the biosensor fabrication was very good, being the RSD of the sensitivity about 5%.

Ejaculation Disorders: Our Experience

Over a 12-year period the authors have studied 132 patients with premature primitive ejaculation treated with metoclopramide, fluoxetine and/or sexual techniques and kinesitherapy. Best and lasting results were achieved with an association of serotonergic drug (fluoxetine) with sexual and kinesitherapy (84.62%). Fifty-two patients with hemospermia were studied and 63.5% were found to have an infection of the urogenital tract, idiopathic in 15%. The proportion and persistence of hemospermia in some cases would not suggest that this be considered a minor andrological symptom. The authors have also studied 82 painful ejaculations, 6 retrograde ejaculations and 8 anejaculations.

The value of andrology in managing oncological patients

The authors discuss the psychological reactions to surgical procedures that mutilate sexuality. They show the importance of andrology in oncological patients to improve their life quality and the andrological procedures in surgery for prostate and testis cancer. An Andrological Center is useful and profitable because, strictly under sanitary management, it fulfills the aim of improving the QALYs.

Hemospermia: Minor andrological disorder?

18 patients with hemospermia were studied and 50% were found to have an infection of the urogenital tract. Other pathologies which came to light were: urethral polyps (11%), BPH (11%), K. prostate (5.6%), urethral varices (5.6%), and interesting prostatovesicular cysts (5.6%); idiopathic in 11% of cases. The proportion and persistence of the hemospermia in some cases would not suggest that this be considered a minor andrological symptom.

Andrologic Pathology and Chronic Prostatitis

The following andrologic diseases were found in 54 patients with genital tract infection, diagnosed by a modified Meares-Stamey test and sperm analysis: haemospermia (9.2%), dyspermia (51.8%), premature ejaculation (57.4%), erectile dysfunction (45.4%), partly due to anxiety for premature ejaculation, but in some cases due to inexplicable venous occlusive disease.

Premature Ejaculation: Our Experience

Over a 10-year period the Authors have studied 103 patients with premature primitive ejaculation treated with Metoclopramide, Fluoxetine and/or sexual techniques (squeeze, stop and start, positional techniques). Best results were achievied with an association of Fluoxetine and sexual therapy (77.33%). Fluoxetine (serotonergic) seems to be more effective than Metoclopramide (antidopaminergic).

Pyrazinoic acid esters with broad spectrum in vitro antimycobacterial activity

A series of substituted pyrazinoic acid esters has been prepared and examined for their in vitro activity against Mycobacterium avium and Mycobacterium kansasii as well as Mycobacterium tuberculosis. Modification of both the pyrazine nucleus and the ester functionality have been very successful in expanding the activity of pyrazinamide to include M. avium and M. kansasii, organisms normally not susceptible to pyrazinamide. Several of these compounds have activities 100-1000-fold greater than that of pyrazinamide against M. tuberculosis.

Chemioterapia sistemica MVEC: 5 anni di esperienza: MVEC systemic chemotherapy: 5 years’ experience

The Authors describe their experience in treating 81 patients, suffering from urothelial cell carcinoma, with neo-adjuvant, adjuvant or final MVEC chemotherapy according to stage and localisation. The prospective results would seem to indicate conservative surgery and adjuvant chemotherapy for pT3N0M0G1-2 bladder tumours, prognostic improvement, at least with regard to disease-free period, in pT3N0M0 cancer, the possibility of downstaging in T4N + M + cancer and more clinical remissions in transitional cell carcinoma in the upper urinary tract. Furthermore, the therapy proved to be relatively easy for the “non-oncologist” urologists. Side effects are mentioned.

Coping in panic and major depressive disorder. Relative effects of symptom severity and diagnostic comorbidity

This study used the Ways of Coping Checklist to examine coping style in patients with panic and major depressive disorders. The relative contribution of distress (symptom severity) and diagnostic comorbidity was determined in three sets of diagnostic subgroups: patients suffering from both panic and major depressive disorders (compared with either disorder alone); panic patients with and without agoraphobia (regardless of concurrent depression); and patients with versus without a concurrent axis II personality disorder. Use of less problem-focused and more emotion-focused coping was strongly correlated with level of distress and was associated with all three examples of diagnostic comorbidity when level of distress was used as a covariate. Regression analyses showed that, except for the presence of a personality disorder, distress was a much stronger predictor of coping than diagnostic subtype.