Sine Materia Research Articles

Laser-evoked potential abnormalities in central pain patients: the influence of spontaneous and provoked pain.

We recorded laser-evoked cortical potentials (LEPs) in 54 consecutive patients presenting with unilateral neuropathic central pain (n = 42) or with lateralized pain of non-organic origin (n = 12). A number of cases in each group had superimposed hyperalgesia or allodynia. In patients with central pain, LEPs were significantly attenuated after stimulation over the painful territory, relative to stimulation of the homologous normal territory. LEP attenuation concerned not only patients with decreased pain/heat sensation, but also those with allodynia or hyperalgesia to laser pulses. In contrast, LEPs were never attenuated in patients with non-organic forms of pain, in whom LEPs could even be enhanced to stimulation of the painful territory. Increased responses in non-organic pain were a reminder of the cognitive modulation observed in normal subjects who direct attention to a laser stimulus. Enhanced LEPs never accompanied truly neuropathic hyperalgesia or allodynia. In central pain patients with exclusively spontaneous pain, LEP attenuation was more pronounced than that observed in those with allodynia and hyperalgesia. Patients with allodynia also presented occasionally ultra-late responses (>700 ms) to stimulation of the painful side. The hypothesis that such responses may reflect activation of a slow conducting 'medial' pain system is discussed. We conclude that, as currently recorded, LEPs essentially reflect the activity of a 'lateral' pain system subserved at the periphery by rapidly conducting A-delta fibres. They are useful to document the sensorial deficits (deafferentation) leading to neuropathic pain syndromes. Conversely, in the case of deafferentation, they fail to index adequately the affective aspects of pain sensation. On practical grounds, chronic pain coupled with reduced LEPs substantiates the diagnosis of neuropathic pain, whereas the finding of normal or enhanced LEPs to stimulation of a painful territory suggests the integrity of pain pathways, and does not support a neuropathic pathophysiology. In neuropathic cases, partial LEP preservation might increase the probability of developing provoked pain (allodynia/hyperalgesia). The possible predictive value of this phenomenon, when observed before the development of pain, remains to be demonstrated. In selected contexts (pain sine materia, non-organic anaesthesia), normal or enhanced LEPs may support a psychogenic participation in the syndrome.

Biliary symptoms and complications more than 8 years after endoscopic sphincterotomy for choledocholithiasis

BACKGROUND & AIMS: Although long-term results of endoscopic sphincterotomy (ES) have been poorly estimated, extended indications of ES have been proposed, especially in young patients. The aim of this study was to assess late biliary complications of ES. METHODS: Between 1981 and 1986, 169 patients younger than age 70 (55+/-11.8 years; range, 24-70 years; male-female sex ration, 0.55) underwent ES for choledocholithiasis. One hundred fifteen patients (68%) underwent cholecystectomy. Long-term data were obtained retrospectively from the patients and general practitioners. RESULTS: Information was obtained for 156 patients, 2 of whom died within 1 month (one ES-related death). The mean follow-up for 154 patients was 9.6+/-3.3 years (range 8-13 years); 138 patients had no biliary symptoms. During follow-up, 16 patients experienced biliary symptoms; 2 of these patients underwent elective cholecystectomy, 3 had malignant strictures, 1 had a complicated cirrhosis, and 1 had a benign stricture related to the previous cholecystectomy. Nine patients developed potentially ES- related biliary symptoms. Second endoscopic exploration showed papillary stenosis in 3 patients (with stones in 2 patients) and recurrent bile duct stones in 3 others. Two patients had sine materia cholangitis, and 1 patient developed liver abscesses. CONCLUSIONS: Long- term ES-related complications seem to be rare, ES could reasonably be included in management strategies of choledocholithiasis, even in young patients. (Gastroenterology 1996 Mar;110(3):894-9)

Occupational dermatitis in shoemakers.

In an epidemiological study of occupational dermatitis in 5 different shoe factories, 246 workers were interviewed, examined and patch tested using standard and occupational patch test series. The prevalence of occupational contact dermatitis was 14.6% (36/246): 8.1% (20/246) irritant contact dermatitis (OICD) and 6.5% (16/246) allergic contact dermatitis (OACD). Among the latter, the most common occupational allergens were p-tert-butylphenol-formaldehyde resin and mercaptobenzothiazole. 6% (15/246) presented with hyperkeratosis of the fingertips, while 3.2% (8/246) reported pruritus sine materia (PSM) present only during working hours. 2 workers presented with vitiligo-like leukodermic patches on the backs of their hands and on their forearms. Some jobs were more frequently associated with skin complaints. In the assembly department, OACD was most frequent (11.4%), attributed to contact with adhesives and, to a lesser degree, with rubber and leather. OICD caused by contact with the solvents contained in adhesives and varnishes was most frequent in the assembly and trimming departments (17.1% and 15.6%, respectively). PSM, probably caused by the dust present in the working environment was reported by 33.3% of the workers in the sole-cutting and scraping departments. Hyperkeratosis of the fingertips, as a reaction to the continuous trauma of leather on the skin, was observed most frequently (41.6%) in the sole-cutting department.

Early interstitial cystitis

Interstitial cystitis can often be the cause of persistent sine materia irritative voiding synptoms. The Authors report their experience in diagnosis and therapy of this rare and invalidating pathology, showing typical endoscopic and histopathological features. Cystoscopic features, although defined non-typical, are very characteristic because of quick appearance of glomerulus, multiple petechial hemorrhages of the mucosa during bladder distension at also mild hydrostatic pressure. Histopathological features in interstitial cystitis, also if nonspecific, are very important, both to exclude neoplastic or specific inflammatory lesions, and for the exact inflammatory definition of the bladder wall. Mastocytosis in the bladder muscular layer (> 28/mmq) is typical of IC, but to consider lower concentrations is also important, together with remaining histological findings, in order to give exact therapy and follow-up to this disease that affects the quality of life.

Occupational dermatitis in animal feed mill workers

In an epidemiological study of occupational dermatitis in 15 different northern Italian animal feed mills, 204 workers were interviewed, examined and patch tested to 34 allergens, selected from the additives most commonly used in the animal feed mills under consideration. The prevalence of occupational contact dermatitis was 13.7% (28/204): 7.8% (16/204) irritant contact dermatitis and 5.8% (12/204) allergic contact dermatitis from animal feed additives. Among the latter, there were sensitizations, to our knowledge hitherto unreported in the literature: to indigo carmine (2 cases), monensin sodium (1 case), thiabendazole (1 case), methylchlorpindol (1 case) and amprolium hydrochloride (1 case). 3.9% (8/204) of the workers complained only of pruritus sine materia on exposed areas of the body. Contact dermatitis increased with respect to duration of employment: the difference in the rate of contact dermatitis between workers employed in animal feed mill for greater than 10 years and those employed for less than 10 years was statistically significant (p less than 0.05). 6.8% (14/204) had latent sensitivity, which was more frequent in workers with less than 1 year of employment with respect to more experienced colleagues.

Notes on human behavioural pharmacotoxicology

De Maio, Domenico: Notes on Human Behavioural Pharmacotoxicology. Prog. Neuro-Psychopharmacol. & Biol. Psychiat. 1988, 12 : 33–40. 1. 1. After 30 years of psychopharmacological therapy we are able to identify some aspects which can be referred to a “collateral behavioural effect”. The apparent rarity of this depends on the facility of confusing behavioural modifications (often sine materia ), with patological ones (normaly of a physical nature). 2. 2. Memory, learning, the ability of evoking, problems regarding reality, paradoxical reactions, “makefobic” behaviour, passivity and social and behavioural withdrawal, form part of the Human Behavioural Pharmacotoxicology. 3. 3. This ought to deserve greater attention on the part both of research workers and health authorities.

Aspetti genetici dell'omosessualità

SUMMARYThe Autor gives a genetic interpretation of homosexuality. A first division may be done between homosexuality cum materia and sine materia. For instance we speak of homosexuality cum materia in the case of such adrenogenital syndromes in which an augmented secretion of androgens may orientate the females towards the male direction, including psychological inversion. As for homosexuality sine materia, the Author reports the twin data by Kallman demonstrating, by means of a new statistical analysis, the presence of hereditary factors. According to the Author such cases could be microforms of inherited endocrine diseases originated by an enzyme affection, or equivalents of inherited psychiatric diseases.

Reflexion on the Question of God’s Existence in Contemporary Thomistic Metaphysics: Part Two

REFLEXION ON THE QUESTION OF GOD'S EXISTENCE IN CONTEl\1PORARY THOMISTIC METAPHYSICS PART TWO (Continued from previou8 number) INTRODUCTION T HE survey of the status of the question of God's existence in Thomistic metaphysics imposes the need for the formal reflective element that is now to be undertaken . The positions indicated are advanced as metaphysics' discovery, as its direct knowledge of the truth concerning God's existence. Metaphysics as wisdom has the right of reflexion upon its own inventive process; and given the divergency of positions advanced, the Thomistic metaphysician must assume the obligation of exercising this reflective function concerning the question of God's existence. It is well to restate the conditions of the reflexion in this instance, namely, that the matter at hand is the question of God's existence in its scientific pertinence to Thomistic metaphysics ' process of discovery. The reflexion itself entails a judgment concerning metaphysics' proportion to the discovery of this truth. The varied presentations of authors regarding God's existence result, like their origins, from positions affirmed, or at least assumed, relative to the nature of metaphysics itself. A true judgment, perfective of the reflexion upon the point at hand, must similarly proceed as from its principles, from the clear position of St. Thomas regarding metaphysics' nature and proportion to the truth concerning God. 211 212 THOMAS C. o'BRIEN As has been indicated, St. Thomas' position is clearly presented in his commentary on the De Trinitate of Boetius. The principles regulative of the present reflexion are to be found in the fourth article of the fifth question. At the outset, it is necessary, with this· text at hand, to analyze its argument. The point raised in the article is this: whether divine science is concerned with those things which are without matter and movement? 1 In the development of the response to this question, there are two main steps. First of all, the possibility of some sort of scientific consideration of divine realities is established; then the actual character of the philosophic consideration of these is determined. As to the possibility, speculative science in general, to explain its subject, must concern itself with the principles of that subject. Among principles, some are principles only, and not complete natures in themselves; others are both principles and complete natures. The first .type are not apt matter for any separate consideration but are attained solely in the science of the subject whose principles they are. The other sort are attainable not only in this way, but also as complete natures in themselves they are apt to be the subject of a distinct science. In the science concerning being in common, metaphysics , this twofold class of principles is to be discerned. Furthermore , the principles common to all beings by way of causality are complete natures in themselves. In fact, as beings which are most actual, immobile, most complete, they are divine. For if the divine exists anywhere it ought to exist in this manner.2 Thus in establishing that among the principles attained by metaphysics, there are divine realities, complete natures in themselves, St. Thomas leaves open the possibility of a science which is divine insofar as it considers such realities. As to the character of the philosophic consideration of the divine, however, the power of natural reason is restricted. The 1 The question proposed by this article: Utrum divina scientia sit de his quae sunt sine materia et motu? Ed. Wyser, 43. • Cf. ibid., 46-48. REFLEXION ON THE QUESTION OF GOD'S EXISTENCE 213 only philosophic consideration that is divine science is metaphysics insofar as and exclusively as it attains to the divine as principles of its subject. Any separate consideration of the divine as subject must presuppose a divine manifestation of the divine nature. The final precision resulting from the argument of the article, thus~ is that philosophic theology, otherwise called metaphysics, is divine science solely inasmuch as it considers divine things not as its subject, but as principles of its subject. This is the theology pursued by the philosophers. The theology which is such because it considers divine things as its subject, is that which is presented in Sacred Scripture.8...