In vitro activity of Aloe vera inner gel against microorganisms grown in planktonic and sessile phases.

The failure of traditional antimicrobial treatments is becoming a worldwide problem. The use of Aloe vera is of particular interest for its role as curative agent and its efficacy in complementary therapies for a variety of illnesses. This study evaluated the antimicrobial activity of A. vera inner gel against a panel of microorganisms, Gram-positive and -negative bacteria, and Candida albicans. In addition to A. vera inner gel being used in the treatment of peptic ulcers, in dermatological treatments, and wound healing, it was also tested on the sessile phase of clinical Helicobacter pylori strains (including multi-drug-resistant strains) and on planktonic and sessile phase of Staphylococcus aureus/Pseudomonas aeruginosa clinical isolates from venous leg ulcers.A. vera inner gel expresses its prevalent activity against Gram-negative bacteria and C. albicans in respect to Gram-positive bacteria. The results of the A. vera antibiofilm activity showed a decrease of the produced biomass in a concentration-dependent-way, in each analyzed microorganism. The data obtained show that A. vera inner gel has both an antimicrobial and antibiofilm activity suggesting its potential use for the treatment of microbial infections, in particular for H. pylori gastric infection, especially in case of multi-drug-resistance, as well as for an effective wound dressing.

BRAVISSIMO: 12-month results from a large scale prospective trial.

The BRAVISSIMO study is a prospective, non-randomized, multi-center, multi-national, monitored trial, conducted at 12 hospitals in Belgium and 11 hospitals in Italy. This manuscript reports the findings up to the 12-month follow-up time point for both the TASC A&B cohort and the TASC C&D cohort. The primary endpoint of the study is primary patency at 12 months, defined as a target lesion without a hemodynamically significant stenosis on Duplex ultrasound (>50%, systolic velocity ratio no greater than 2.0) and without target lesion revascularization (TLR) within 12 months. Between July 2009 and September 2010, 190 patients with TASC A or TASC B aortoiliac lesions and 135 patients with TASC C or TASC D aortoiliac lesions were included. The demographic data were comparable for the TASC A/B cohort and the TASC C/D cohort. The number of claudicants was significantly higher in the TASC A/B cohort, The TASC C/D cohort contains more CLI patients. The primary patency rate for the total patient population was 93.1%. The primary patency rates at 12 months for the TASC A, B, C and D lesions were 94.0%, 96.5%, 91.3% and 90.2% respectively. No statistical significant difference was shown when comparing these groups. Our findings confirm that endovascular therapy, and more specifically primary stenting, is the preferred treatment for patients with TASC A, B, C and D aortoiliac lesions. We notice similar endovascular results compared to surgery, however without the invasive character of surgery.

Mechanical thrombectomy in in-stent restenosis: preliminary experience at the iliac and femoropopliteal arteries with the Rotarex System.

AIM: Iliac and femoropopliteal arterial stenting remains controversial due to frequent restenosis. This study aims to evaluate the efficacy of a mechanical rotational thrombectomy procedure with the Rotarex Mechanical Thrombectomy System (Straub Medical, Wangs, CH) and percutaneous transluminal angioplasty (PTA) in terms of technical success, patency rates and limb salvage. METHODS: From May 2006 to March 2010, 32 selected patients with sub-acute or chronic in-stent restenosis at the iliac or femoropopliteal arteries were treated with a Rotarex and then PTA procedure. RESULTS: Technical success was 100%. Intra-procedural complications included a superficial femoral artery (SFA) dissection (1), SFA (1) and external iliac (1) perforations and a groin hematoma (1). There was no incidence of embolization in this series. One patient required reintervention (3.1%); an attempted surgical bypass and amputation. Secondary reinterventions were required in 17 patients (53.1%). Limb salvage rate at 12 months was 90.6%. Primary patency at 30 days was 96.8%. Primary, primary assisted and secondary patency rates at 6 months were 75%, 75% and 89.6% and at 12 months were 58.1%, 58.1% and 75.5%, respectively. Late mortality was 18.75% at an average follow-up of 13.1 months (3-45) due to the severe disease state of these patients.. CONCLUSION: This treatment seems promising in terms of technical success and embolization risk. Reinterventions are frequently required but mid-term limb salvage rates are encouraging. Larger, randomised studies are needed to determine the cost/benefit advantage and long-term results.

Detection of incidental vertebral fractures on routine lateral chest radiographs.

PURPOSE: This study sought to assess the usefulness of routine lateral chest radiographs for detecting unrecognised vertebral compression fractures. MATERIALS AND METHODS: We prospectively selected outpatients without symptoms or risk factors for osteoporosis who underwent chest radiography for different clinical indications. Two independent reviewers with different levels of experience assessed the radiographs for vertebral deformities and graded them as mild, moderate and severe according to the semiquantitative Genant Index. The kappa statistic was used to evaluate interobserver agreement and verify the reproducibility of this method. The prevalence of vertebral fractures observed was compared with that recorded in the official radiology reports. RESULTS: Our study involved 145 patients (73 men, 72 women; age range 50-86 years, mean age 67.5). Clinically relevant vertebral fractures were seen in 18/145 patients (12.4%). These were moderate in 13 patients and severe in five, and single in 12 patients and multiple in six. Interobserver agreement was very high (kappa=0.9). Only 11% of these fractures were recorded in the official reports. CONCLUSIONS: Lateral chest radiographs could be effective for assessing previously unknown vertebral compression fractures in individuals without clinical evidence or risk factors for osteoporosis.

Advantages of multidetector-row CT with multiplanar reformation in guiding percutaneous lung biopsies.

PURPOSE: This study aimed to assess the usefulness of multiplanar reformations (MPR) during multidetector-row computed tomography (MDCT)-guided percutaneous needle biopsy of lung lesions difficult to access with the guidance of the native axial images alone owing to overlying bony structures, large vessels or pleural fissures. MATERIALS AND METHODS: MDCT-guided transthoracic needle biopsy (TNB) was performed on 84 patients (55 men and 29 women; mean age 65 years) with suspected lung neoplasm by using a spiral MDCT scanner with the simultaneous acquisition of six slices per rotation. We determined the site of entry of the 22-gauge Chiba needle on native axial images and coronal or sagittal MPR images. We took care to ensure the shortest needle path without overlying large vessels, main bronchi, pleural fissures or bony structures; access to the lung parenchyma as perpendicular as possible to the pleural plane; and sampling of highly attenuating areas of noncalcified tissue within the lesion. RESULTS: Diagnostic samples were obtained in 96% of cases. In 73 patients, lesions appeared as a solid noncalcified nodule <2 cm; 11 lesions were mass-like. In 22, the biopsy required MPR guidance owing to overlying ribs (18), fissures (2) or hilar-mediastinal location (2). CONCLUSIONS: MDCT MPR images allowed sampling of pulmonary lesions until now considered unreachable with axial MDCT guidance because of overlying bony structures (ribs, sternum and scapulae) or critical location (hilar-mediastinal, proximity to the heart or large vessels). Compared with the conventional procedure, the use of MPR images does not increase the rate of pneumothorax or the procedure time.

Relationship of blood trace elements to liver damage, nutritional status, and oxidative stress in chronic nonalcoholic liver disease.

Trace elements are involved in chronic liver diseases because these elements may have a direct hepatic toxicity or may be decreased as a consequence of the impaired liver function, particularly in patients with alcoholic cirrhosis and/or malnutrition. In this study, we determined plasma and erythrocytes trace elements in 50 inpatients with nonalcoholic chronic liver disease (11 with biopsy-proven chronic hepatitis, 39 with cirrhosis [16 in stage A according to Child-Pugh criteria, 23 Child B+C]), and in a control group of 10 healthy subjects by the proton induced x-ray emission method. The relationship between trace element concentration and the extent of liver damage, the nutritional status (by anthropometric evaluations), and various blood markers of oxidative stress--reduced glutathione, total lipoperoxides and malonyldialdehyde--was investigated. We found that cirrhotics had a significant decrease of Fe, Zn, Se, and GSH levels in the plasma and of GSH and Se in the erythrocytes with respect to the control and chronic hepatitis groups. GSH levels were related to the degree of liver damage; a significant direct correlation was observed among Se, Zn, and GSH plasma values and between GSH and Se in the erythrocytes. The trace element decrease was, on the contrary, independent of the degree of liver function impairment and only partially affected by the nutritional status. Data indicate that liver cirrhosis, even if not alcohol related, induces a decrease of Se and Zn and that, in these patients, an oxidative stress is present, as documented by the significant correlation between Se and GSH. The plasma Br level was higher in cirrhotics with respect to the control and chronic hepatitis groups.

Trace elements and chronic liver diseases.

The relationships between chronic liver diseases and trace element (TE) contents are debated. Particularly, no defined data are available about the TE levels in viral liver disease patients with or without malnutrition. In this study we evaluated blood and plasma levels of various trace elements in patients with HCV-related chronic liver disease, at different stages of liver damage (8 patients with chronic hepatitis and 32 with liver cirrhosis) with or without malnutrition. We also studied 10 healthy volunteers as control group. We found that cirrhotic subjects had a significant decrease of blood levels of Zn and Se, independently on the nutritional status, whereas plasma levels of Fe were significantly reduced only in malnourished cirrhotic patients. Our data indicate that liver impairment is the main cause of the blood decrease of Se and Zn levels in patients with non alcoholic liver disease, whereas the malnutrition affects Fe levels only.

[Anti-ENA antibody determination in various connective tissue diseases: comparison of 2 detection techniques]. / Determinazione di anticorpi anti-ENA in alcune connettiviti: confronto di due tecniche di rilevazione.

The authors compared two different techniques for the detection of anti-ENA antibodies (anti-Sm, anti-RNP, anti-SSA, anti-SSB) in several different connective tissue diseases, using double immunodiffusion (ID) and a new membrane-based enzyme immunoassay. The aim of the work was to research the assay sensibility and specificity of the results obtained with the two different methods. Notwithstanding the fact that the two techniques are equivalent in their performance, the recombinant DNA appears to have greater sensibility and less specificity compared to ID. The former requires less time of execution although it presents difficulty in interpreting low scale positive results. Although the number of sera examined was low, the authors assert that the recombinant DNA technique will require further development.

[Ketoprofen efficacy and tolerance in simple painful shoulder]. / Efficacia e tollerabilità del ketoprofene nella spalla dolorosa semplice.

Thirty patients presenting with painful shoulder syndrome were treated with i.m. ketoprofen 100 mg b.d. for 8 days to assess the efficacy and tolerance of the above treatment regime. The patients' condition was monitored by clinical, instrumental and laboratory examinations. Ketoprofen was found to be significantly effective in all cases of non calcific rotator cuff tendinitis while no improvement was noted in calcific tendinitis. The above data confirm the efficacy and tolerance of ketoprofen in the treatment of painful shoulder syndrome as an alternative to local steroid therapy.

[Efficacy of sucralfate in the prevention of stomach diseases induced by non-steroidal anti-inflammatory drugs]. / Efficacia del sucralfato nella profilassi delle gastropatie indotte dai farmaci antiinfiammatori non steroidei.

In 20 patients suffering from osteoarthritis and treated with non steroidal anti-inflammatory drugs (NSAIDs) for one month sucralfate has been added for further two months. Endoscopic examination before/after this treatment confirmed the cytoprotective property of sucralfate, with normalization of the gastric mucosa and subsidence of subjective symptomatology.

[Variations of functional parameters in chronic aggressive HBAg positive and negative hepatitis by means of radioimmunologic method (preliminary note)]. / Variazioni dei parametri funzionali nelle epatiti croniche aggressive HBAg positive e negative con metodo radioimmunologico (nota preliminare)

43 subjects, affected by chronic aggressive hepatitis (CAH) have been divided into two groups according to the presence of HBAg. No statistically significant differences between the two groups have been provided. The two classes of subjects (HBAg + and -) were also divided into the already treated (with immunosuppressive drugs) and untreated to investigate the eventual differences existing between the two classes. The results of this division was that previously treated subjects present a lower total bilirubin (P less than 0.05) in respect to those that were not treated previously. The results of all the other comparisons carried out and the tested correlations were negligible. In conclusion, bearing in mind the inadequate methods used up to now to research the HBAg, the transversal studies show that CAH patients are both affected by the same syndrome, whether the HBAg is positive or negative. However, it is probable that it is not the carrier state of HBAg which enables the liver disease evolution but the liver disease itself enables the cellular immunity disorders that often appear in the course of CAH.