Haematology and Plasma Biochemistry of Stamboek Pre‐pubertal Gilts in Italy: Reference Values

Blood samples were taken between February and April from 105 healthy Stamboek pre‐pubertal gilts, aged 1–3 months, which were housed at a modern pig farm in northern Italy. The blood was analysed for nine haematological and nine selected haematochemical variables by means of automated and semi‐automated blood analysis apparatus. After detection and rejection of outliers, the data were submitted to reference limits evaluation, also taking into account the limits for the red blood cell volume histogram as the anisocytosis index. Some haematological reference values deal with previously published data; in the haematochemical parameters, several discrepancies between evaluated limits and existing reference limits were noted, mainly for aspartate aminotransferase, alanine aminotransferase and lactate dehydrogenase levels and total protein concentration. The results confirm the relevance of age in determining blood reference intervals and that ‘normal’ values should be determined by each laboratory, taking into account the age of subjects, the sample size and methods of analysis.     

Circadian rhythm of plasma testosterone in men with idiopathic hypogonadotrophic hypogonadism before and during pulsatile administration of gonadotrophin-releasing hormone

OBJECTIVE: The aim was to investigate whether a pulsatile discharge of LH from the pituitary is necessary to achieve the circadian secretion of testosterone. DESIGN: The daily rhythm of the androgen has been studied in patients with idiopathic hypogonadotrophic hypogonadism (IHH) both in the absence of therapy and during pulsatile administration of gonadotrophin releasing hormone (GnRH). PATIENTS: Six patients with IHH and ten normal subjects were analysed. Blood sampling was performed at 2-hourly intervals, for 24 hours. The IHH patients then received synthetic GnRH i.v. at the rate of one pulse every 2 hours (10 micrograms/pulse). On day 11 of treatment, blood samples were taken for the rhythm analysis every 2 hours, for 24 hours. MEASUREMENTS: Plasma testosterone and LH were measured in the individual samples by radioimmunoassay. Evaluation of the rhythm was performed by cosinor analysis. RESULTS: A significant circadian rhythm of plasma testosterone was statistically validated in the normal subjects, whereas no rhythm was detected in the IHH patients in the absence of therapy. On day 11 of GnRH pulsatile administration the IHH patients showed normal testosterone levels and a statistically significant circadian rhythm of the androgen was evident, with acrophase between 0700 and 0800 h. Moreover, the amplitude, acrophase and mesor of testosterone rhythm in IHH patients in the course of treatment were statistically indistinguishable from the corresponding values in the normal subjects. Plasma LH did not show statistically significant circadian variations, either in the control group or in the IHH patients before or during therapy. CONCLUSIONS: We conclude that a physiological circadian rhythm of plasma testosterone can be obtained, in IHH men, by treatment with GnRH. Since the pulsatile administration of exogenous GnRH at constant doses induced a circadian rhythm in testosterone and no daily variations in LH were evident, we suggest that, although a pulsatile secretion of LH is probably necessary for the synchronization of the circadian rhythm with acrophase in the morning, the testosterone variations might be the results of a local testicular modulation of LH action.     

Correction to: Resolution of Persistent COVID-19 After Convalescent Plasma in a Patient with B Cell Aplasia

Journal of Clinical Immunology - A Correction to this paper has been published: https://doi.org/10.1007/s10875-021-01029-z     

Antibody responses after first and second Covid-19 vaccination in patients with chronic lymphocytic leukaemia

B-cell chronic lymphocytic leukaemia (CLL) is associated with immunosuppression and patients are at increased clinical risk following SARS-CoV-2 infection. Covid-19 vaccines offer the potential for protection against severe infection but relatively little is known regarding the profile of the antibody response following first or second vaccination. We studied spike-specific antibody responses following first and/or second Covid-19 vaccination in 299 patients with CLL compared with healthy donors. 286 patients underwent extended interval (10–12 week) vaccination. 154 patients received the BNT162b2 mRNA vaccine and 145 patients received ChAdOx1. Blood samples were taken either by venepuncture or as dried blood spots on filter paper. Spike-specific antibody responses were detectable in 34% of patients with CLL after one vaccine (n = 267) compared to 94% in healthy donors with antibody titres 104-fold lower in the patient group. Antibody responses increased to 75% after second vaccine (n = 55), compared to 100% in healthy donors, although titres remained lower. Multivariate analysis showed that current treatment with BTK inhibitors or IgA deficiency were independently associated with failure to generate an antibody response after the second vaccine. This work supports the need for optimisation of vaccination strategy in patients with CLL including the potential utility of booster vaccines.Subject terms: Translational research, Adaptive immunity, Chronic lymphocytic leukaemia     

The endoscopic versus the traditional approach in pituitary surgery

The transsphenoidal route is the most widely used technique for pituitary adenoma surgery due to its rapidity, good tolerance, effectiveness and low complication rate. These are the parameters we utilized in comparing endoscopic with microscopic transsphenoidal surgery. We reviewed the medical records of 418 patients affected by pituitary adenomas who underwent endoscopic transsphenoidal surgery between May 1998 and December 2004, and in this paper, we present the results of 381 patients who fulfilled the follow-up criteria after a minimum period of 15 months. Our experience confirms the previous data on the rapidity and satisfactory tolerance of the endoscopic procedure. We also confirm the low complication rate, specifying that complications characteristic of the approaching phase were certainly reduced; instead, complications characteristic of tumor removal still remained similar to those reported in the microsurgical literature. The results were comparable with those of the best microsurgical series regarding endosellar lesions, but tumor removal was notably superior when dealing with tumors having an extrasellar extension. The improvement may be explained by the excellent vision of the deep surgical fields due to the endoscope and by the extreme flexibility of the surgical trajectory, mainly due to the absence of the divaricator, giving access to the ramifications of the tumor, otherwise difficult to reach.     

Oxytocin‐induced PGF2α Release in Mares With and Without Post‐breeding Delayed Uterine Clearance

The aim of the present study was to evaluate within 24 h post‐ovulation oxytocin‐induced PGF_2α release in mares with and without post‐breeding delayed uterine clearance (DUC). Twenty‐one of 34 mares with a variable amount of intrauterine fluids accumulation were considered to be affected by delayed uterine clearance (DUC group), while the other 13 mares did not show any uterine fluid accumulation, and were considered as controls (WDUC group). Both DUC and WDUC mares were administered with 20 IU oxytocin i.m. 90 min after the ultrasound examination performed 24 h after breeding. Immediately before, 5 and 10 min after oxytocin administration, blood samples were collected for 15‐ketodihydro‐PGF_2α (PG‐metabolite), 17β‐estradiol, and progesterone analysis. Ultrasonography performed 24 h after oxytocin treatment showed a complete uterine clearance in all DUC mares. The oxytocin‐induced PG‐metabolite increase was detected in 71.4% DUC mares compared with 38.5% in WDUC group, with a positive trend of release, as evidenced from 5 min after oxytocin administration. In WDUC mares, no significant differences in oxytocin‐induced PG‐metabolite trend of release were observed. In conclusion, the results of the present study showed the importance of PGF_2α involvement in the pathogenesis of post‐breeding DUC in the mare.     

The burden of hospitalised pneumonia in Lazio, Italy, 1997-1999.

OBJECTIVE: To evaluate the burden of hospitalised pneumonia in adults in the Lazio region (1997-1999); to describe community-acquired pneumonia (CAP), suspected nosocomial infection (NI) and AIDS-related pneumonia. METHODS: Using data from the Hospital Information System, we traced the hospitalisation history of patients and classified CAP, NI and AIDS-related pneumonia. RESULTS: During the study period, 30517 incident events of pneumonia occurred: 20497 CAP, 9760 NI, and 964 AIDS-related pneumonia; 704 of these were also NI (annual incidence rate 158, 75 and 7.4 per 100 000 population, respectively). The mean ages were 65, 69 and 38 years for CAP, NI, and AIDS-related pneumonia, respectively. Higher hospitalisation rates were observed in Rome than in the rest of the region for NI and AIDS-related cases, but not for CAP. Lower socioeconomic groups showed a higher incidence of CAP and AIDS-related pneumonia. Peaks of incidence were observed in winter for CAP and NI. Only 20% of pneumonias have an aetiological diagnosis. In-hospital fatality rates were 9.4%, 29.3% and 11.2% for CAP, NI and AIDS-related pneumonia, respectively. CONCLUSION: The high incidence and fatality of CAP and NI, especially among the elderly, makes these diseases a problem that is re-emerging in industrialised countries with an ageing population.