Preliminary results of a program for the implementation of laparoscopic colorectal surgery in an Italian comprehensive cancer center during the COVID-19 pandemic.

Despite operative benefit and oncological non-inferiority, videolaparoscopic (VLS) colorectal surgery is still relatively underutilized. This study analyzes the results of a program for the implementation of VLS colorectal surgery started in an Italian comprehensive cancer center shortly before COVID-19 outbreak. A prospective database was reviewed. The study period was divided in four phases: Phase-1 (Open surgery), Phase-2 (Discretional phase), Phase-3 (VLS implementation phase), and Phase-4 (VLS consolidation phase). Formal surgical and perioperative protocols were adopted from Phase-3. Postoperative complications were scored by the Clavien-Dindo classification. 414 surgical procedures were performed during Phase-1, 348 during Phase-2, 360 during Phase-3, and 325 during Phase-4. In the four phases, VLS primary colorectal resections increased from 11/214 (5.1%), to 55/163 (33.7%), 85/151 (57.0%), and 109/147 (74.1%), respectively. The difference was statistically significant (P < 0.001). All-type VLS procedures were 16 (3.5%), 61 (16.2%), 103 (27.0%), and 126 (38.6%) (P < 0.001). Conversions to open surgery of attempted laparoscopic colorectal resections were 17/278 in the overall series (6.1%), and 12/207 during Phase-3 and Phase-4 (4.3%). Severe (grades IIIb-to-V) postoperative complications of VLS colorectal resections were 9.1% in Phase-1, 12.7% in Phase-2, 12.8% in Phase-3, and 5.3% in Phase-4 (P = 0.677), with no significant differences with open resections in each of the four phases: 9.4% (P = 0.976), 11.1% (P = 0.799), 13.8% (P = 1.000), and 8.3% (P = 0.729). Despite the difficulties deriving from the COVID-19 outbreak, our experience suggests that volume of laparoscopic colorectal surgery can be significantly and safely increased in a specialized surgical unit by means of strict operative protocols.

Safety of ethanolic kava extract: Results of a study of chronic toxicity in rats.

BACKGROUND: Recently, potential liver toxicity was discussed with the intake of kava extract preparations (Piper methysticum) as anxiolytic drugs. The aim of this study was to test chronic toxicity in rats by oral application of an ethanolic kava full extract. METHODS: Wistar rats of both sexes were fed 7.3 or 73 mg/kg body weight of ethanolic kava extract for 3 and 6 months. The animals were examined for changes in body weight, hematological and liver parameters, and macroscopical and microscopical histological changes in the major organs. RESULTS: No signs of toxicity could be found. CONCLUSIONS: The results are in accordance with the medical experience regarding the use of kava preparations and the long tradition of kava drinking in the South Pacific island states. Specifically, the results do not back the suspicion of potential liver toxicity.

Pharmacological studies on the sedative and hypnotic effect of Kava kava and Passiflora extracts combination.

Kava kava extract, Passiflora extract and a combination of both extracts, administered to mice, caused a significant decrease of the amphetamine-induced hypermotility and significant prolongation of sleeping phase induced by subcutaneous injection of barbiturates. Due to a synergism of both extracts, simultaneously administered the pharmacologically registered effect in both in vivo experiments was found to be superior over the sum of the single separately administered extracts.

Phytochemical and pharmacological studies of Guettarda acreana.

The present study examines the effects of the extracts [petroleum ether, CHCl3, CHCl3/MeOH (9:1) and MeOH], partially purified fractions and pure compounds from Guettarda acreana on the electrically induced contractions (E.C.I.) of the isolated guinea-pig ileum. The results of the experiments indicate that CHCl3/MeOH (9:1), MeOH extract, and the MeOH soluble part from CHCl3/MeOH extract tested at concentrations of 1.2, 2.5, and 5 micrograms/ml, dose-dependently reduced the guinea-pig ileum contractions. Furthermore, some partially purified fractions I-IV from the MeOH extract, each tested at the same concentrations of the extracts, and some pure compounds (6 x 10(-6), 3 x 10(-6), 1 x 10(-6) M) isolated from the above fractions significantly reduced, in a dose-dependent manner, the electrical contractions of the ileum. The active compounds were identified as the known indole alkaloids strictosidic acid, lyalosidic acid, 5 alpha-carboxystrictosidine, strictosidine, and sickingine, as well as the known quinic acid derivatives 5-caffeoylquinic acid, 4,5-dicaffeoylquinic acid, and shikimic acid by spectral data. Two known quinovic acid glycosides and a new triterpenic glycoside, quinovic acid 3 beta-O-alpha-rhamnopyranosyl-(1-->3)-(beta-glucopyranosyl-(1-->6)-beta- glucopyranoside, were also isolated and their structures established by NMR and M5 data.

New protopine and benzyltetrahydroprotoberberine alkaloids from Aristolochia constricta and their activity on isolated guinea-pig ileum.

Five new protopine-type alkaloids, 3,5-di-O-methylconstrictosine (1), 5,6-dihydro-3,5-di-O-methylconstrictosine (2), 5,6-dihydroconstrictosine (3), constrictosine (4), 3-O-methylconstrictosine (5), and a novel 8-benzylberberine-type alkaloid, (-)-8 beta-(4'-hydroxybenzyl)-2,3-dimethoxyberbin-10-ol (6) were isolated from the aerial parts of Aristolochia constricta. Their structures were elucidated by physical and spectroscopic data. The results of our pharmacological experiments indicated that MeOH extract, its partially purified fraction VI and the protopine derivatives constrictosine 1-5, significantly reduced, in a dose dependent manner, the electrical, acetylcholine, and histamine contractions of the isolated guinea-pig ileum.

Isoquinoline alkaloids from Argemone mexicana reduce morphine withdrawal in guinea pig isolated ileum.

The present study examined the effect of the MeOH extract, partially purified fraction (IV), and pure compounds from Argemone mexicana L. (Papaveraceae) on the morphine withdrawal in guinea pig isolated ileum. The MeOH extract, the partially purified fraction (IV), and the pure compounds isolated from A. mexicana significantly and in a concentration-dependent manner reduced the morphine withdrawal. Since the pure compounds were identified as protopine and allocryptopine, the observed effects could be related to these compounds. The results of the present study suggest that isoquinoline alkaloids may be potential agents in the treatment of drug abuse.

Experimental animal studies on the hypoglycemic effects of a Copalchi extract.

The hypoglycemic effect of a Copalchi extract (Sucontral) was tested in 60 adult-male and female-Wistar rats in the present randomized, placebo-controlled, parallel-comparative animal study. A control group receiving only an Altromin standard chow was compared to treatment groups which received an Altromin chow enriched with Copalchi dry substance at 0.028% m/m or at 0.28% m/m. The study period was 30 days. The distinctly significant blood glucose lowering effect of the Copalchi extract could be demonstrated in both treatment groups. No significant difference in the antidiabetic effect was seen between the two concentrations. The onset of action of the Copalchi extract was observed between treatment day 1 and 3. A 20-25% decrease in the blood glucose concentration was achieved between the 7th and 15th day of treatment and remained at this level thereafter. This plateau was reached in the female rats already between treatment day 3 and 5. The parallel observed increase in the mean body weight was not striking and generally was the same between the test animals and the control animals.

Neuropharmacological effects of extracts from Sickingia williamsii.

Sickingia williamsii Standl. (Rubiaceae) is used in Peruvian folk medicine for its analgesic and anti-inflammatory activity. In this study we have examined the pharmacological profiles of petroleum ether, chloroform, chloroform-methanol (9:1) and methanol extracts of the tree. Both chloroform-methanol (250, 500 or 750 mg kg-1, p.o.) and methanol (125, 250 or 500 mg kg-1, p.o.) extracts significantly reduced both the locomotor activity and motor co-ordination of mice; they also prolonged sleep induced by pentobarbital, although no significant cataleptic response was observed. These extracts did not have a significant impact on the nociceptive threshold in the hot-plate and tail-flick tests. Petroleum ether and chloroform extracts did not, furthermore, induce any significant pharmacological effects. The results of the study suggest that these extracts possess neurosedative-like properties.

[Cefotetan treatment of suppurative bronchopulmonary syndromes sustained by anaerobic germs]. / Trattamento con cefotetan delle sindromi suppurative bronco-polmonari sostenute da germi anaerobi.

The Authors have analyzed the effect of Cefotetan in 20 patients affected by bronchopulmonary pathologies supported by anaerobic bacterium. During 7 days doses of 50 mg. pro Kg/pro die were given. From beginning to end of the treatment clinical, hematochemical and radiological data were evaluated. Bacteriological analysis was made on samples drawn with BFS according to a traditional method and with microbiology specimen brush. Almost all the patients (95%) realized improvements in clinical symptomatology and in radiological picture.

Anti-inflammatory activity of Eryngium maritimum L. rhizome extracts in intact rats.

The administration of rough hydrophilic extract of Eryngium maritimum L. to intact rats inhibits carrageenin induced paw oedema, but it is inactive against cotton pellet granuloma; moreover, the extract does not reduce the weight of thymus, adrenals and spleen. These data show that the anti-inflammatory effect of E. maritimum extract is unlikely to be produced by a steroid-like compound or to be a consequence of adrenal stimulation. Further fractionation of total hydrophilic extract showed that the anti-inflammatory activity is retained by a sub-alkaline fraction.