1-Aryl-6,7-methylenedioxy-3H-quinazolin-4-ones as anticonvulsant agents

A set of novel 1-aryl-6,7-methylenedioxy-3 H-quinazolin-4-(thi)ones (3a\u2013f) has been designed and screened as anticonvulsant agents in DBA/2 mice. The new compounds are provided with anticonvulsant properties comparable to those of GYKI 52466. To clarify the mode of action, their affinity for the quinazolinone/2,3-benzodiazepine site of the AMPA receptor complex has been assayed

Clinical effects of Helicobacter pylori outside the stomach

The discovery of Helicobacter pylori infection in the stomach could be considered as one of the most important events of modern gastroenterology. Understanding of the natural history of many disorders of the upper gastrointestinal tract, including chronic gastritis, peptic ulcer disease, gastric cancer and MALT lymphoma, was altered by this discovery. Interestingly, epidemiological studies have also revealed a correlation between H. pylori infection and some diseases localized outside the stomach, especially those characterized by persistent and low-grade systemic inflammation. Of note, H. pylori has an important role in iron deficiency anaemia, idiopathic thrombocytopenic purpura and vitamin B12 deficiency. Moreover, the association of this bacterial pathogen with many other diseases, including hepatobiliary, pancreatic, cardiovascular and neurodegenerative disorders is currently under investigation. In this Review, we summarize the results of the most important studies performed to date surrounding the association of H. pylori infection with extragastric diseases, as well as the strength of the evidence. We also provide information concerning bacterial-host interactions and the mechanisms implicated in the pathogenesis of each of these extragastric diseases

Health care for older persons, a country profile: Italy

Special articl

Postsurgical complications in older patients. The role of pharmacological intervention

The number of elderly patients undergoing surgery has been rapidly increasing during the last few years. Following surgical interventions, high rates of mortality and morbidity have been reported in the most advanced age groups. Nevertheless, perioperative evaluation and postoperative care are the major determinants of the overall outcome. Postsurgical complications are common in advanced age, since multiple pathology is often present in geriatric patients. Furthermore, the decreased efficiency of homeostatic mechanisms may facilitate the development of multiple organ failure (MOF), even as a consequence of apparently slight alterations in immune, cardiac or respiratory systems. Thus, prompt recognition and treatment of any complication often prevents the development of irreversible conditions. While cardiac and pulmonary complications account for 50% of early postoperative adverse events, infections, thromboembolism, renal failure, stress ulcers and coagulation disorders may occur well after surgical procedures. An important part of postoperative geriatric care is the diagnosis and correction of fluid, electrolyte and acid-base disturbances. These disturbances may manifest as mild, atypical signs, such as slight neuromuscular depression or delirium. Yet, they often constitute life-threatening conditions that should be rapidly and properly corrected. Finally, it should be remembered that, due to the frequent use of multiple drugs, elderly patients are at high risk of developing adverse drug reactions. Thus, the treatment of postoperative complications requires a strong rational effort to disentangle the combined effects of aging, drugs and pathology

Safety and efficacy of the combination acetaminophen-codeine in the treatment of pain of different origin

Pain is the most common reason people see doctors in developed Countries and a very common cause of access in Emergency Department (ED). The combination acetaminophen/codeine represents the standard medication in the second step of the WHO analgesic scale and codeine is one of the most commonly used opioid analgesic for a variety of pain conditions. However, many aspects related to safety and efficacy are still undefined

13C-Urea breath test for the diagnosis of Helicobacter pylori infection.

Helicobacter pylori (H. pylori) is a Gram-negative bacterium able to colonize the gastric mucosa as well as gastric metaplastic areas of the duodenum, producing inflammation. The clinical outcome depends on sophisticated interactions between bacterial factors, such as the expression of determinants of virulence and pathogenicity, and host characteristics. The severity of inflammation, may then vary among different subjects, leading to the occurrence of different gastroduodenal diseases, ranging from chronic gastritis to gastric cancer and MALTlymphoma, to some defined extragastric manifestations. Many diagnostic tests are available for the detection of H. pylori infection including noninvasive methods, such as serology, 13Curea breath test (UBT), and fecal antigen tests and invasive techniques, including a combined use of endoscopic biopsy-based methods, such as rapid urease testing, histology, culture, and molecular methods. UBT is a highly sensitive and specific and allows to diagnose the presence or absence of infection of H. pylori, through the oral administration of a solution containing urea labelled with the non-radioactive natural carbon 13. This review article analyzes microbiological and clinical features of H. pylori as well as the different diagnostic tests able to detect this bacterium with a special focus on UBT

Recurrent use of the Emergency Department in patients with anxiety disorder

Panic disorder is characterized by the spontaneous and unexpected occurrence of panic attacks. During panic attacks, patients (pts) refer to the Emergency Department (ED). The diagnostic work-up for any panic attack is expensive since symptoms at presentation mimic other diseases such acute coronary syndrome or neurological emergencies. The aim of the present study was to describe a 10 years cohort of pts diagnosed with panic disorder in the ED in terms of ED visit recurrence

Body mass index and mortality among older people living in the community

To determine if body mass index (BMI = weight/height2), predictive of mortality in seriously ill hospitalized and institutionalized patients, is also predictive of mortality in a longitudinal epidemiologic study