Effect of probiotic strains of lacto- and bifidobacteria on the activity of macrophages and other parameters of immunity in cases of staphylococcosis.

The immunomodulatory properties of Lactobacillus delbrueckii subsp. bulgaricus IMVB-7281, Lactobacillus casei IMV B-7280, Lactobacillus acidophilus IMV B-7279, Bifidobacterium animales VKL and B. animales VKB strains on the models of experimental staphylococcosis infection in mice were determined. It was found that after the mice, infected with staphylococcus, were treated by some probiotic strains of lacto- and bifidobacteria, a normalization of functional activity of phagoctic cells system and increase of the endogenous interferon production were observed. L. delbrueckii subsp. bulgaricus IMVB-7281, L. casei IMVB-7280, L. acidophilus IMV B-7279, B. animales VKB and B. animales VKL are promising for the development of probiotics, effective against staphylococci and for the immunity correction.

Probiotic strains of lactobacilli and bifidobacteria alter pro- and anti-inflammatory cytokines production in rats with monosodium glutamate-induced obesity.

The aim of this study was to investigate the effect of probiotic strains of Lactobacillus casei IMV B-7280, Bifidobacterium animalis VKL, B. animalis VKB on the pro- and anti-inflammatory cytokines production in Wistar male rats with monosodium glutamate (MSG)-induced obesity. It was established that neonatal administration of MSG to rats leads to increasing levels of the interleukin (IL)-1ß and IL-12, and to decreasing ofthe IL-4, IL-10 and tumor growthfactor (TGF)-ß levels in the bloodserum. After administration of the B. animalis VKL - B. animalis VKB - L. casei IMV B-7280 composition to obese rats the level of the IL-lP in blood serum wasn't differ from that in the obese rats, that didn't receive of the probiotic bacteria. But there was no statistically signifcant difference comparing with intact rats. The level of the IL-12B p4O in blood serum was decreased under influence of the B. animalis VKL - B. animalis VKB - L. casei IMV B-7280 composition (18.9%, p < 0.05) and B. animalis VKL (10.5%, p < 0.05) compared with obese rats, not receiving probiotic bacteria, but remained higher than in intact animals. After administration to obese rats ofthe B. animalis VKL - B. animalis VKB - L. casei IMV B-7280 composition the levels ofthe IL-4, IL- 10 and TGF-ß increased in blood serum comparing with obese rats, not receiving probiotic bacteria. The level of the IL-10 also increased under influence of the B. animalis VKB, and IL-4 - under influence of the L. casei IMVB-7280. Our results suggest that these probiotic bacteria and probiotic composition are able to down-regulation the inflammation in rats with MSG-induced obesity but the strongest anti-inflammatory effects have probiotic composition. The ability of lactobacilli and bifdobacteria to alter the pro- and anti-inflammatory cytokines production, opens perspectives to create new treatments for obesity and metabolic syndrome based on probiotics.

Acute thrombosis of the infrarenal aorta. Therapeutic problems.

Acute thrombosis of the infrarenal aorta is a rare event, usually complicating aortic atherosclerotic lesions or aortic aneurysms. During the last twelve years, we treated 10 acute aortic thromboses out of 353 acute ischemias of the lower limbs (2.8%). The high mortality of our series (60%) is related to advanced age (71 years on average), severe underlying cardiopathy, and the frequent involvement of the renal and mesenteric vessels. In our experience Fogarty catheter thrombectomy is usually ineffective, and the surgical approach in high risk patients should be confined to axillobifemoral bypass graft.

Long term results of extra anatomical bypasses.

The authors discuss their own experience with extra anatomical bypasses. It is composed by 214 patients who underwent 224 extra anatomical bypasses: 167 axillofemoral bypasses, 50 femorofemoral bypasses and 7 trans-obturator bypasses. The indications included the presence of infections, or a previously thrombosed aortic prosthesis, or infected aneurysm, in 12.1% of the cases; in 6.2% of the cases the extra anatomical bypass was due to acute ischaemia of limb. In 81.7% it was chosen because of the presence of some general or local contraindication to direct aortoiliac reconstruction. The results are comparable to those reported in the literature. The only unusually high datum is the rate of early infections in femorofemoral bypasses (12%). On the ground of these results, the Authors stress the value of extra-anatomical bypasses as an alternative to direct aortoiliac reconstructions.

[Complications of vascular prosthesis]. / Complicanze delle protesi vascolari.

The main complications deriving from the use of vascular prostheses in the surgical reconstruction of the arteries are thrombosis, infection and the appearance of pseudoaneurysms. Among 233 aorto-femoral b.p., prosthetic thrombosis occurred in 45 patients creating the need for 66 reoperations, 19 early and 47 tardive. In 387 aorto-iliac reconstructions, infection arose early in 11 cases, tardively in 6. Out of 1118 vascular reconstructions there were also 28 pseudoaneurysms (2.5%). After remarks on the aetiopathogenesis of such complications, methods that can be used to prevent them are discussed and personal results of treatment are presented.

[Axillofemoral bypass: a potential solution of acute ischemia of the lower limb]. / Il bypass axillofemorale: una possibile soluzione dell'ischemia acuta dell'arto inferiore.

When deobstruction by Fogarty catheter fails, the axillofemoral bypass can be considered as a therapeutic solution of the acute ischaemia of the limb. The authors discuss a case occurred in their experience and focus their attention on the therapeutic potentiality of this kind of revascularization. As a matter of fact it is important to consider that the operation should not only eliminate the acute ischaemia, but also correct the atherosclerotic lesions that led to it. Therefore, if deobstruction by Fogarty catheter does not restore a good inflow, in high risk patients with acute arterial thrombosis of the limb, there is a well indication for extra-anatomic revascularization.

[Critical ischemia of the diabetic patient]. / L'ischemia critica nel paziente diabetico.

BACKGROUND: Critical ischemia of the lower limbs is the final result of diabetic arteriopathy. The surgeon is more and more forced to choose between amputation d emblée and the attempt to revascularization in very old patients and in deficient general conditions. Shall we point out some principle to address our strategy? METHODS: To answer this question we reviewed retrospectively our surgical choices and the results obtained during two years, from January 1997 to December 1998 (medium follow-up 11.3 months), at the Emergency Division of the Cannizzaro Hospital of Catania. In this period 143 diabetic patients were selected by our ambulatory. Of these, nineteen had a critical lower limb ischemia and therefore were submitted to a revascularization and/or amputation. All the revascularized patients were controlled by Doppler-sonography immediately after operation and then daily, till their discharge. Controls were done at the first, third, sixth month and after one year, except for patients who complained a new objective or subjective ischemic symptomatology. RESULTS: The primary patency rate was 84.2% and the secondary patency rate was 89.4%. The amputation rate due to the procedure failure was 5%. The complications were three: two graft infections (10.5%) and one early thrombosis of a femoro-popliteal bypass graft, due to technical defect (5.2%). Perioperative mortality rate was 15.7%. CONCLUSIONS: These results, if related with those reported in the letterature about amputations, are in favour of the attempt to revascularization.

[Klippel-Trenaunay syndrome]. / La sindrome di Klippel e Trenaunay.

The Klippel-Trenaunay syndrome is a rare congenital pathology which includes varices, hemangiomas and hypertrophy of limbs. The Authors report two cases and pay particular attention to the diagnostic and therapeutical protocols. Although these aspects are still open questions, the Authors conclude that conservative therapy is often sufficient while surgery is requested only in the severe forms.

New York City syndromic surveillance systems.

New York City's first syndromic surveillance systems were established in 1995 to detect outbreaks of waterborne illness. In 1998, daily monitoring of ambulance dispatch calls for influenza-like illness began. After the 2001 World Trade Center attacks, concern about biologic terrorism led to the development of surveillance systems to track chief complaints of patients reporting to emergency departments, over-the-counter and prescription pharmacy sales, and worker absenteeism. These systems have proved useful for detecting substantial citywide increases in common viral illnesses (e.g., influenza, norovirus, and rotavirus). However, the systems have not detected more contained outbreaks earlier than traditional surveillance. Future plans include monitoring school health and outpatient clinic visits, augmenting laboratory testing to confirm syndromic signals, and conducting evaluation studies to identify which of these systems will be continued for the long term.