Acute onset of paraplegia due to melanocytic cervicodorsal lesion.

BACKGROUND: Melanocytomas are rare pigmented tumors of the central nervous system (CNS). They are more frequent in females in their fifties and are typically benign, but locally aggressive lesions that very are rarely found in the spine. They can occur in all the age groups. CASE DESCRIPTION: A 62-year-old male presented with acute paraplegia a attributed to a C7-T1 intradural extramedullary melanocytoma. Urgent surgery, consisting of subtotal removal of the lesion, resulted in subtotal recovery of motor function with full resolution of his sensory deficit. Histologically, the lesion proved to be a melanocytoma. CONCLUSION: Rarely, patients with intradural extramedullary melanocytomas of the spine may present with acute paralytic deficits warranting emergent surgical intervention.

Positive clinical outcomes derived from using a proprietary mixture of selected strains during pregnancy.

BACKGROUND: While the use of antibiotic prophylaxis is clearly advantageous to prevent streptococcal infection, it alters the composition of the gut microbiota in mothers and infants. Enterococcus faecium L3 is one of the best studied probiotic strains and shows strong antagonistic activity against Streptococcus agalactiae due to the production of bacteriocins able to inhibit common gut and vaginal pathogens. METHODS: We tested an L3-based probiotic formula (iNatal®) on 127 pregnant women attending our gynaecological unit in 2015. We compared the study subjects with 279 pregnant women enrolled in the same year and with 892 other pregnant women who attended our gynaecological unit in 2013 and 2014. RESULTS: The findings demonstrate: (a) the safety profile of the product; (b) its ability to reduce gut disorders; (c) a 6% decrease in the incidence of streptococcal colonization; (d) an approximately 30% decline in episodes of premature rupture of membranes; (e) fewer caesarean sections during labour; and (f) a reduction in pathological umbilical cord blood pH. CONCLUSIONS: Our results demonstrate that a probiotic treatment during pregnancy could have unexpected but favourable clinical results. Further randomized, double-blind, placebo controlled studies are now needed to confirm our preliminary findings.

Surgical wound infection by mannitol-nonfermenting Staphylococcus aureus after lumbar microdiscectomy.

Purulent infection of a surgical wound developed after discectomy, and a mannitol-nonfermenting Staphylococcus aureus isolate was cultivated as the etiologic agent. Nonfermenting S. aureus strains are exceedingly rare and may be erroneously mistaken and dismissed as contaminants. This report then emphasizes that pure and massive cultures must be carefully evaluated, even if preliminary examination does not suggest a pathogenic organism. Also, although mannitol-negative, the studied strain was correctly detected as S. aureus by both the-FISH test (AdvanDx, USA) and the Liofilchem 'Chromatic Staph aureus', highlighting that additional diagnostic methods may support recognition of uncommon, nonfermenting S. aureus strains in the daily practice.