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BACKGROUND: Studies of the gender-related differences in the clinical presentation of Alzheimer's disease (AD) have focused on specific aspects of the disease (eg, circulating metabolites, cognitive capacity, or epidemiologic trends). OBJECTIVE: This study accounts for several descriptors of the disease simultaneously, providing a multidimensional analysis of a cohort of patients with AD. METHODS: Our analysis was conducted using self-organizing maps (SOMs). The high number (60) of independent variables (clinical, demographic, biochemical, and neuropsychological) observed in the study patients defines a complex and high-dimensional input space that can be processed by SOMs. Without supervision, SOMs examine nonlinear relations among the variables and cluster observations so that topologic relationships between variables correspond to the similarity of their distribution. Through such nonlinear autoclustering, subsets of observations (ie, clusters of subjects) can be identified in which essential information is concentrated. Each subject is identified by particular values of the variables (the record), and a specific set of variable values (the codebook) defines a distinct class. RESULTS: The study sample included 211 patients with mild to moderate AD (143 women, 68 men; mean [SD] age, 71.9 [7.2] years). All patients were assigned to 3 macroclasses-called A, B, and C-on the basis of matrix codebook neighborhoods. In terms of vectorial distance between codebooks, class A and B were quite similar, whereas the separation between class C and classes A and B was evident. The SOM distribution of values of variables across the output matrix did not show any specific pattern for most of the considered characteristics. However, we found only male patients in class C. This class distinction was not substantially changed when sex was removed from the database. Male and female patients were comparable with respect to dementia severity, demographic characteristics, psychiatric and behavioral symptoms, indicators of physical disability, and general health status. CONCLUSIONS: SOMs indicate nonlinear multifactorial interactions among the descriptors of the features of AD that seem to be linked to sex and would have been missed by traditional statistical analysis. This finding may offer a novel epidemiologic rationale for research into different pathogenic mechanisms in men and women with AD. [ABSTRACT FROM AUTHOR]

Summary Surgical treatment with open reduction and internal fixation is advocated for Sanders’ type II and III intra-articular fractures of the calcaneus. Some clinical and technical problems in this type of operation are due to the thickness and the stiffness of the plates. The authors report their experience in the open reduction and internal fixation (ORIF) of type II and type III fracture using the multihole GECO® plate with 22 fractures treated in 19 patients during the period November 1994–May 1996. Fourteen patients (17 fractures) were followed-up at a mean of 18 months for both clinical and radiographic tests. According to the American Orthopaedic Foot and Ankle Society (AOFAS) score and to the Maryland Foot Score (MFS) the clinical results were ‘excellent’ and ‘good’ in 12 cases and 13 cases, respectively. There were more necroses of the surgical wound margins than in the literature; this was due to the learning curve and the initial prolonged surgical times. Peroneal tendonitis occurred less frequently (12%) than in the literature (20–30%). [ABSTRACT FROM AUTHOR]

This paper presents a novel technique to increase hydrogen production from dark fermentation of cheese whey, conducted using open mixed cultures. Hydrogen (H 2)-producing microbial pools were selected and enriched using an innovative biostimulation technique, performed by sequential re-inocula of the interstitial microbial community using porous supports in sequential batch reactors. The supports offered a spatial refuge to the microbial community, facilitated re-inoculum procedures and reduce operational disturbance. Two different re-inoculum times (i.e. 24 h and 96 h) were tested to verify the influence of timing on the selection/enrichment. Results showed that the H 2 production rate was up to 80 times higher using a 24 h re-inoculum time than using a 96 h re-inoculum time. Under a 24 h re-inoculum time, a stable H 2 production rate was reached after two sequential re-inocula, with values ranging between 4 and 6.1 mLH 2 h−1. The cumulative production, detected after the last re-inoculum (8 days), was 2.2 LH 2 L-1 reactor , corresponding to 42.5 mL gCOD-1. A very low methane (CH 4) production was observed and only in the first two re-inocula, as short re-inoculum intervals favoured H 2 -producing bacteria. Microbiological analyses confirmed that subsequent re-inocula contributed to an increase in total microbial abundance. The proposed approach provides a concentrated inoculum in liquid medium (which is easy to use) exploiting an enrichment technique that is conceptually new and more economical/environmentally friendly than conventional thermal, acid or alkaline enrichment techniques. [ABSTRACT FROM AUTHOR]

Background: Levels of cell-free circulating DNA have been correlated to clinical characteristics and prognosis in patients with cancers of epithelial origin, while there are no data on patients with B-lymphoproliferative diseases. Patients and methods: Cell-free DNA levels in the plasma samples of 142 patients with lymphomas [45 with Hodgkins lymphoma (HL), 63 with diffuse large B-cell non-Hodgkins lymphoma (DLBCL), 24 with follicular, and 10 with mantle cell non-Hodgkins lymphoma (NHL)] at diagnosis and of 41 healthy individuals were determined using a quantitative PCR for the β-globin gene. Results: Levels of circulating DNA in patients with HL, DLBCL, and mantle cell NHL were significantly higher than in controls (P 60 years (P = 0.009; P = 0.01) and DLBCL (P = 0.03). Conclusion: Quantification of circulating DNA by real-time PCR at diagnosis can identify patients with elevated levels that are associated with disease characteristics indicating aggressive disease and poor prognosis. [ABSTRACT FROM AUTHOR]