Trichinella spiralis larvae infective for laboratory mice were collected from muscle biopsies performed at different times (from 1 day to 16 months) following the end of treatment, indicating the failure of mebendazole to kill Trichinella parasites when they are encapsulating in muscles.

Cell-mediated immunity during the muscular phase of Trichinella infection in humans was studied. Cell proliferation, the phenotypic changes in the T-cell population, and expression and production of cytokines were examined by using peripheral blood mononuclear cells (PBMC) collected at different times postinfection from 10 individuals who had acquired Trichinella spiralis and five individuals who had acquired Trichinella britovi in two distinct outbreaks. T. spiralis and T. britovi crude worm extracts induced proliferation of PBMC from T. spiralis-and T. britovi-infected donors. Cytokine gene expression showed a predominant type 2 pattern for the entire period of infection studied, although gamma interferon (IFN-␥) was expressed. Interleukin-2 (IL-2), IL-5, IL-10, and IFN-␥ production was found in PBMC of all donors. There was a good correspondence between the cytokine expression and production patterns. Changes in PBMC composition, with a trend toward an increase in CD8 ؉ lymphocyte counts, were observed.The genus Trichinella is a group of nematodes which have a worldwide distribution and which cause trichinellosis in humans (15). Humans are infected by eating raw or undercooked meat or meat products (sausages, salami, etc.) from swine, horses, or game animals that are infected with larvae of these worms. In Italy, the main etiological agent of human trichinellosis is Trichinella britovi; however, some human infections have been attributed to consumption of products from imported animals infected with Trichinella spiralis (17).From 4 to 5 days after ingestion of infected meat, the larvae develop to the adult stage in a row of columnar epithelial cells in the small intestine. Six days after ingestion, the adult worms begin to reproduce, and the newborn larvae migrate across the lamina propria of the villus into the lymph and bloodstream. However, only the newborn larvae that reach striated muscles develop to the infective stage. In laboratory mice, the intestinal phase is longer for T. spiralis than for T. britovi and the female fecundity of T. spiralis is at least twice than that of T. britovi. These differences explain the different clinical pictures obtained for humans infected with these two species (20). Intestinal symptomatology (diarrhea, abdominal pain, and vomiting) occurs more frequently and lasts longer in human T. spiralis infections than in human T. britovi infections (20).When a larva penetrates a muscle cell, it causes the cell to become what is known as a nurse cell, and it becomes infective 15 to 16 days later (i.e., 21 to 22 days after ingestion of infected meat) (6).After ingestion of larvae, a host develops an immunity-mediated inflammatory response at the intestinal level, and this is followed by rapid expulsion of some of the larvae from the intestine (3). Studies conducted with mouse and rat models have suggested that antibodies play the most important role in this response, which depends on type Th2 cytokines derived from CD4 ϩ cells, and that mucosal mast cells also play an important rol...

Background. Infertility is both a clinical and a public problem, affecting the life of the couple, the healthcare services, and social environment. Standard semen analysis is the surrogate measure of male fertility in clinical practice. Objective. To provide information about the relationship between semen parameters and spontaneous conception. Methods. We evaluated retrospectively 453 pregnancies that occurred among 2935 infertile couples evaluated at an infertility clinic of a tertiary-care university hospital, between 2004 and 2009. Results. Normal semen analysis was present only in 158 patients; 295 subfertile patients showed alterations in at least one seminal parameter. A reduction in all seminal parameters was observed in 41 patients. Etiological causes of male infertility were identified in 314 patients. Conclusion. Our data highlights the possibility of a spontaneous conception with semen parameters below WHO reference values. Therefore, we support the importance of defining reference values on a population of fertile men. Finally, we analyzed the related ethical issues.

Plasma and cerebrospinal fluid amino acid levels wee measured in 12 cirrhotic patients in grade 0 hepatic encephalopathy and 17 in grade 3-4 hepatic encephalopathy. In 5 of these patients amino acid determinations were performed during the evolution of the encephalopathy. No correlation was found between the degree of hepatic encephalopathy and the plasma amino acid imbalance. In the CSF of cirrhotic patients without encephalopathy, a significant increase was found in nearly all amino acids, including those known to not easily cross the blood-brain barrier; this suggests the presence of a nonspecific modification of the blood-brain barrier permeability. In patients with severe hepatic encephalopathy, the further increase only in cerebrospinal fluid aromatic amino acids and methionine levels suggests the presence of a selective stimulation of the neutral amino acid transport system across the blood-brain barrier. Finally, the good correlation between glutamine and the sum of neutral amino acids found in the cerebrospinal fluid only in the presence of encephalopathy supports the hypothesis that brain glutamine may stimulate neutral amino acid transport across the blood-brain barrier.