Probiotics and their role in gastrointestinal cancers prevention and treatment; an overview

Cancers of the gastrointestinal [GI] track are a serious global health problem. The human GI tract is home to trillions of microorganisms that known as gut microbiota and have established a symbiotic relationship with the host. The human intestinal microbiota plays an important role in the development of the gut immune system, metabolism, nutrition absorption, production of short-chain fatty acids and essential vitamins, resistance to pathogenic microorganisms, and modulates a normal immunological response. Microbiota imbalance has been involved in many disorders including inflammatory bowel disease, obesity, asthma, psychiatric illnesses, and cancers. Oral administration of probiotics seems to play a protective role against cancer development as a kind of functional foods. Moreover, clinical application of probiotics has shown that some probiotic strains can reduce the incidence of post-operative inflammation in cancer patients. In the present narrative review, we carried out update knowledge on probiotic effects and underlying mechanism to GI cancers. Currently, it is accept that most commercial probiotic products are generally safe and can used as a supplement for cancer prevention and treatment. Nevertheless, well-designed, randomized, double blind, placebocontrolled human studies are required to gain the acceptance of the potential probiotics as an alternative therapy for cancer control.

Effects of intraperitoneal administration of simvastatin in prevention of postoperative intra-abdominal adhesion formation in animal model of rat

Objective: To determine the preventive effects of local administration of simvastatin for postoperative intra-abdominal adhesion formation in animal model of rat

Methods: In this experimental study, 32 Wistar albino rats as the animal model of intra-abdominal adhesion formation were included. Adhesions were induced in all the animals via abrasion of the peritoneal and intestinal surface during laparotomy. Afterwards, the rats were randomly assigned to receive simvastatin [30 mg/kg body weight] as a single intraperitoneal dose at the time of laparotomy [n=16] or normal saline in same volume at the same time [n=16]. At the day 21, animals were euthanized and the adhesions were quantified clinically [via repeated laparotomy] and pathologically and compared between the two groups

Results: The baseline characteristics of the animals were comparable between two study groups. Clinically, in simvastatin group, 10 rats [62.5%] did not develop any adhesion and 6 [37.5%] had first-grade adhesion; whereas in the control group, 11 [68.8%] rats had first- and 5 [31.2%] had second-grade adhesions [p<0.001]. Pathologically, in simvastatin group, 6 rats [37.5%] had first-grade adhesion, while in control group, 11 rats [68.8%] had first- and 5 [31.2%] had second-grade adhesions [p<0.001]

Conclusion: Our findings suggest that intraperitoneal administration of simvastatin is an effective method for prevention of postoperative intra-abdominal adhesion formation in animal model of rat

Outcome of penetrating cardiac injuries in southern Iran, Shiraz / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>Cardiac injuries are one of the most challenging injuries in the field of trauma surgery. Their management often requires immediate surgical intervention, excellent surgical technique and the ability to provide excellent postoperative critical care to patients. The aim of this study was to evaluate the outcome and survival rate of patients with penetrating cardiac injury in southern Iran, Shiraz.</p><p><b>METHODS</b>From January 2001 to June 2007, medical records of all patients suffering from penetrating cardiac injuries were reviewed and their outcomes were investigated. The inclusion criterion was the presence of a confirmed penetrating cardiac injury intraoperatively or by autopsy. Patients with blunt cardiac injuries were excluded from the study.</p><p><b>RESULTS</b>The study consisted of 37 patients, including 1 gunshot wound (2.7%), 35 stab wounds (94.6%) and 1 (2.7%) shotgun wound. The overall survival rate was 76% (28 in 37) and that in stab wound patients was 80%. The collected data of 9 expired patients revealed 11% death on arrival, 67% hypotensive, and 22% normotensive considering physiologic presentation. Paired sample test showed significant correlation between mortality and electrocardiographic changes, amount of retained blood in pericardium, clinical stage and physiologic condition at presentation, as well as associated injury type (gunshot more than stab wound).</p><p><b>CONCLUSION</b>Our results show that injury mechanism and initial cardiac rhythm are significant predictors of outcomes in patients with penetrating cardiac injuries. Besides, gunshot injury and exsanguination are the most important predictive variables of mortality.</p>

Role of physical examination in decision making for selective exploration in patients with penetrating zone ii neck injury

Objective: To evaluate the role of physical examination in decision making for exploring patients with penetrating zone II neck injury

Methods: This was a cross-sectional study being performed in a level I trauma center between 2006 and 2010. The present study reviewed the records of 150 patients with penetrating neck injuries. Of 46 cases with zone II deep platysma neck injuries, 3 patients died before taking any significant medical measure

Results: Thirty of 43 patients [70%] presented with hard sings while 13 [30%] did not show these sings. All patients underwent neck exploration. Two patients [4.6%] without hard sings exhibited positive findings, whereas 29 cases [67%] with hard sings reported positive on exploration

Conclusion: Briefly, we hold the view that it seems reasonable to follow an algorithmic approach by using physical examination of the patients with zone II penetrating neck injuries. This prevents unnecessary exploration for management of such patients

application of a new cyanoacrylate glue in pediatric surgery for fistula closure

Surgical glues have been used in pediatric surgery because of the fragility of tissue, and to prevent major surgeries. The present report describes our experience with using a new cyanoacrylate Glubran 2 [Viareggio, Italy] in the treatment of five cases of tracheoesophageal atresia with fistula [one fistula protection, three recurrent fistula, and one unstable patients], two cases of hypospadias, one case of vesicutanouse fistula after bladder extrophy, and one case of cloacal extrophy from January-December 2008. Three cases of recurrent tracheoesophageal atresia with fistula were treated by bronchoscpic glue injection. The other two cases benefited from glue through its ability to plug the fistula and to act as a protecting layer on anastomosis. In two cases with hypospadias excessive use of the glue caused skin necrosis, which was repaired. The wounds of cloacal extrophy were protected from nearby colostomy contamination and infection, and the vesicocutanouse fistula was closed by deepithelialization and sealing with glue. Based on the outcomes of the cases, it may be possible to suggest that Glubran 2 may be used safely in Pediatric Surgery as a sealant for the prevention and treatment of fistulas

Human amniotic membrane dressing: an excellent method for outpatient management of burn wounds

Burns are among the most common traumas in developing countries, which consume large amounts of medical resources. It is important to find an appropriate material for dressing of burn wounds that improves healing and is readily available, easily applicable, and economical. In a single-blind randomized controlled clinical trial from March to October 2006, 211 patients with less than 20% burn were enrolled into two groups. The first group contained 104 patients with average burn of 11.90 +/- 3.80% of total body surface area [TBSA] for whom amnion dressing was used. The second group composed of 107 patients with average burn of 12.30 +/- 4.14% of TBSA treated with routine silver sulfadiazine dressing. Amniotic membrane usage was accompanied by acceleration in wound healing, less need for skin graft, and less pain. The mean healing time in superficial parts of burn wounds in the amnion group was significantly shorter than the control group [9.50 +/- 2.13 v 14.30 +/- 2.60 days; P value < 0.01]. The extent of the wound with granulation tissue which needed skin graft was less in the amnion group [2.10 +/- 2.21% v 4.2 0 +/- 1.44%; P value < 0.01]. Widespread use of amniotic membrane dressing is recommended for limited burn wound management

effect of season and Ramadan fasting on the onset of acute cholecystitis

To investigate whether Ramadan fasting and seasonal variation has any effect on the onset of acute cholecystitis. A cross-sectional study was conducted in Faghihi and Namazee Hospitals between September 1999 to August 2004. All files of patients with definite diagnosis of gallstone induced acute cholecystitis were reviewed for age, gender, date and method of treatment in relation to seasons and Ramadan fasting month. For comparison, we used Shaaban months [prior months] and Shavval months [following months]. Eight hundred and sixty-four files [32.7% male and 62.8% were female] with definite diagnosis of acute cholecystitis were reviewed. Mean age was 56.3 +/- 16.18 years. The frequency of acute cholecystitis was higher in summer in comparison with other seasons. The difference in the frequency of acute cholecystitis in Ramadan in comparison with Shaaban and Shavval months was not considerable. Acute cholecystitis displays seasonal characteristics; however, this seasonal variability would be influenced by other unknown environmental and genetic factors. Ramadan fasting may not precipitate the onset of acute cholecystitis

Evaluation of autoantibody against modified LDL levels in patients with cardioovascular diseases

Atherosclrosis is a process that initiated with hypercholestrolemia and fatty streak formation. Previous studies showed oxidative modification of LDL render immunogenic and autoantibodies to epitopes of oxidized LDL. Oxidized LDL [OX-LDL], has antigenic properties. Antibodies against oxidized LDL have been proposed to be independent predictors of atherosclerosis development. The main aims of the current study were to compare antibody titers to different types of oxidized LDL [Cu+2-LDL, Malondialdehyde-LDL] and Native-LDL between angiographically documented coronary patients, non-documented patients and healthy subjects. Correlation between autoantibodies against oxidized LDL and increased risks of cardiovascular diseases has been shown. As a case-control study, we evaluated angiographically documented coronary patients, non-documented patients and healthy subjects to measure anti-OX-LDL autoantibody levels. Enzyme-linked immunosorbent assay was used to measure anti-OX-LDL autoantibodies. ANOVA test used for statistical analysis. Titers of anti-Malondialdehydo-LDL autoantibodies were 3.55 +/- 0.415, 0.361 +/- 0.20, 0.093 +/- 0.078 respectively in each group [P<0.005]. There was not statistically meaningful difference, between native-LDL and Cu+2-LDL antibodies. It seems the titre of autoantibodies against OX-LDL considered as a predictor of progression of atherosclerosis. Our data provide further support for a role of oxidatively modified LDL in atherogenesis