A genome guided evaluation of the Lab4 probiotic consortium.

Draft genome sequences of the Lab4 probiotic consortium were deposited in Genbank: Bifidobacterium animalis subsp lactis CUL34 (PRJNA482550), Bifidobacterium bifidum CUL20 (PRJNA559984), Lactobacillus acidophilus CUL60 (PRJNA482335), Lactobacillus acidophilus CUL21 (PRJNA482434). Probiogenomic analyses confirmed existing taxonomies and identified putative gene sequences that were functionally related to the performance of each organism during in vitro assessments of bile and acid tolerability, adherence to enterocytes and susceptibility to antibiotics. Genomic stability predictions identified no significant risk of gene acquisition of both antibiotic resistance and virulence genes. These observations were supported by acute phase and repeat dose tolerability studies in Wistar rats. High doses of Lab4 did not result in mortalities, clinical/histopathological abnormalities nor systemic toxicity. Increased faecal numbers of Lab4 in supplemented rats implied survival through the gastrointestinal tract and/or impact the intestinal microbiota composition. In summary, this study provides multifaceted support for probiotic functionality and the safety of the Lab4 consortium.

Daily supplementation with the Lab4P probiotic consortium induces significant weight loss in overweight adults.

This 9-month randomised, parallel, double-blind, single-centre, placebo-controlled study (PROBE, ISRCTN18030882) assessed the impact of probiotic supplementation on bodyweight. Seventy overweight Bulgarian participants aged 45-65 years with BMI 25-29.9 kg/m2 received a daily dose of the Lab4P probiotic comprising lactobacilli and bifidobacteria (50 billion cfu/day). Participants maintained their normal diet and lifestyle over the duration of the study. The primary outcome was change from baseline in body weight and secondary outcomes included changes in waist circumference, hip circumference and blood pressure. A significant between group decrease in body weight (3.16 kg, 95% CI 3.94, 2.38, p < 0.0001) was detected favouring the probiotic group. Supplementation also resulted in significant between group decreases in waist circumference (2.58 cm, 95% CI 3.23, 1.94, p < 0.0001) and hip circumference (2.66 cm, 95% CI 3.28, 2.05, p < 0.0001) but no changes in blood pressure were observed. These findings support the outcomes of a previous shorter-term Lab4P intervention study in overweight and obese participants (PROMAGEN, ISRCTN12562026). We conclude that Lab4P has consistent weight modulation capability in free-living overweight adults.

A randomised controlled study shows supplementation of overweight and obese adults with lactobacilli and bifidobacteria reduces bodyweight and improves well-being.

In an exploratory, block-randomised, parallel, double-blind, single-centre, placebo-controlled superiority study (ISRCTN12562026, funded by Cultech Ltd), 220 Bulgarian participants (30 to 65 years old) with BMI 25-34.9 kg/m2 received Lab4P probiotic (50 billion/day) or a matched placebo for 6 months. Participants maintained their normal diet and lifestyle. Primary outcomes were changes in body weight, BMI, waist circumference (WC), waist-to-height ratio (WtHR), blood pressure and plasma lipids. Secondary outcomes were changes in plasma C-reactive protein (CRP), the diversity of the faecal microbiota, quality of life (QoL) assessments and the incidence of upper respiratory tract infection (URTI). Significant between group decreases in body weight (1.3 kg, p < 0.0001), BMI (0.045 kg/m2, p < 0.0001), WC (0.94 cm, p < 0.0001) and WtHR (0.006, p < 0.0001) were in favour of the probiotic. Stratification identified greater body weight reductions in overweight subjects (1.88%, p < 0.0001) and in females (1.62%, p = 0.0005). Greatest weight losses were among probiotic hypercholesterolaemic participants (-2.5%, p < 0.0001) alongside a significant between group reduction in small dense LDL-cholesterol (0.2 mmol/L, p = 0.0241). Improvements in QoL and the incidence rate ratio of URTI (0.60, p < 0.0001) were recorded for the probiotic group. No adverse events were recorded. Six months supplementation with Lab4P probiotic resulted in significant weight reduction and improved small dense low-density lipoprotein-cholesterol (sdLDL-C) profiles, QoL and URTI incidence outcomes in overweight/obese individuals.

Identifying Ferrara's elderly people with low influenza immunization rates: the contribution of a local socio-economic deprivation index.

Influenza immunization coverage rates remain far below the optimal value recommended by the World Health Organization, even in groups considered at high risk, such as the elderly. A possible explanation for this suboptimal vaccination uptake may be deprivation. A specifically developed local deprivation index was proposed for the classification of residents in the municipality of Ferrara in order to evaluate the characteristics of subjects over 65 years of age who accepted/refused influenza immunization (2010-2015). The variables building this deprivation index were primarily related to demographic aspects, such as age, widow/widower status, education, family composition and housing characteristics. Influenza immunization coverage rates were unsatisfactory in all categories of deprivation. A statistically significant decreasing trend in coverage rates was observed with decreasing deprivation in the general population and in males, but not in females. In addition to factors composing the local deprivation index, being separated, living in a family of three members and independent contractor were features that hindered immunization among very deprived elderly.

Prevalence of diabetes mellitus, hyperinsulinaemia and metabolic syndrome among 755 adult patients with HIV-1 infection.

Metabolic complications of antiretroviral therapy in HIV-infected patients include insulin resistance, diabetes mellitus, dyslipidaemia and lipodystrophy syndrome. Metabolic syndrome is an aggregation of central obesity with glucose and lipid metabolism alterations that confers an increased risk of cardiovascular disease, which reproduces the antiretroviral-associated metabolic and morphological abnormalities. In this study, we report the prevalence of diabetes mellitus, hyperinsulinaemia and metabolic syndrome among 755 adult patients with HIV-1 infection referred to our outpatients unit. The prevalence of diabetes mellitus and metabolic syndrome was 4.5% and 9.1%, respectively. A longer exposure to antiretroviral therapy and a diagnosis of lipodystrophy syndrome were significantly associated with both metabolic disturbances.

New composites of hydroxyapatite and bioresorbable macromolecular material.

Composite materials were prepared by mixing in different proportions of hydroxyapatite (HA) and poly(epsilon-caprolactone-oxyethylene-epsilon-caprolactone) block copolymer (PCL-POE-PCL) to produce a new resorbable material for biomedical applications. This material has proved to be very interesting for production of periodontal membranes. Mechanical properties are linearly proportional to the amount of HA introduced. Fourier transform infrared (FTIR) investigations have pointed out that HA is able to influence some close epsilon-caprolactone molecules to start its homopolymerization giving PCL with an end chain ionic bonding. HA grains are therefore surrounded by a film of PCL which grants close connection of HA grains within copolymeric matrix. This interface bond with PCL is, however, an interesting occurrence for preparations of HA/PCL composites.

Indications and limits of acetabular reimplantations using screwed prostheses.

The clinical and radiographic results of 95 acetabular reimplantations performed between 1984 and 1992 are presented. A screwed acetabular prosthesis was used in 56 patients, the acetabulum was cemented in 15, and a press-fit acetabulum stabilized by screws (1 case without screws) was used in 24. Mean clinical follow-up was 35.6 +/- 24 months, ranging from 7 to 94 months. Clinical results were good and excellent (> or = 5 points according to Merle D'Aubigné) in 77% of the cases for pain, in 70% for walking, and in 71% for joint movement. Forty months after surgery 48% of the screwed acetabula and 44% of the cemented ones were osteointegrated. The incidence of loosening for the screwed acetabula was 24%. The preliminary results 24 months after the press-fit acetabula with screws had been inserted showed 100% osteointegration. Radiographic results of the screwed acetabula were satisfactory (92% osteointegration) only in reimplantations performed in patients with minimum acetabular osteolytic injury (Paprosky types I and IIA). The use of homoplastic bone grafts did not improve the radiographic results of the screwed acetabula in the cases with severe osteolysis: 57% of the acetabula screwed on grafts distributed throughout the acetabulum were, in fact, loosened.

Considerations on ceramic prosthesis explants.

The authors report data obtained for 11 cases of explants of prostheses having ceramic joint surfaces. The wear phenomena observed in 9 prostheses, including 1 case with breakage of the ceramic head, was moderate: 20-22,000 debris per mu 2. In 2 cases the wear was massive, with a concentration of debris in the peri-implant tissues 5-10 times greater (100,000-218,000 debris per mu 2). An explanation for the trigger mechanism of wear phenomena is proposed: the cases of massive wear are related to loosening of the acetabulum. A histological examination of the bone tissue surrounding a stem covered with alumina (Al2O3) carried out in three cases allowed us to observe an area of demineralization measuring approximately 500 mu of tissue in contact with the ceramic coating. The osteomalacia could be caused by the diffusion of alumina ions.

Osteosynthesis in fractures of the femoral neck in the young adult.

The authors report 21 cases of fracture of the femoral neck in the young adult followed-up after a minimum of 2 years, which is a sufficient amount of time to be able to evaluate cephalic necrosis. The results obtained with the various methods of osteosynthesis were: excellent: 38%; good: 33.5%; fair: 9.5%; poor: 19%. Emphasis is made on the effectiveness of the Garden classification system for prognosis and treatment, and several aspects of the method used are discussed.

The Ilizarov method for the treatment of non-union in the humerus.

The authors report 7 cases of septic and aseptic pseudoarthrosis in the humerus, with or without tissue loss, treated with the Ilizarov apparatus. The method proved to be therapeutically effective, guaranteeing a short amount of time required for consolidation, with bone callus of the periosteal type which was abundant and mechanically effective, immediate functional recovery, and no important complications.

Interilioabdominal amputation.

Thirty two consecutive cases of interilioabdominal amputation are reported. They were performed for malignant tumours of the hip and the proximal end of the femur and thigh. This operation is rather more frequently indicated than disarticulation of the hip and involves less trauma.