Simultaneous vs staged bilateral hip arthroplasty: monocentric analysis of satisfaction rate and complications.

PURPOSE: Interest in bilateral total hip arthroplasty (THA) has been increasing over the past decade. This study aims to compare postoperative local and systemic complications, hospital readmissions, and satisfaction assessment in patients undergoing simultaneous versus staged bilateral THA. METHODS: A retrospective observational study was conducted among patients who underwent simultaneous or staged bilateral THA between 2017 and 2020. Data on perioperative parameters, local and systemic complications, and 30-day hospital readmissions were collected. Patient satisfaction was assessed using Forgotten Joint Score (FJS). The comparison of continuous variables with normal distribution of variance was performed by ANOVA; for variables with abnormal distribution, the nonparametric test Mann-Whitney U was adopted. The distribution of dichotomous variables was analyzed by chi-square test, and statistical significance was calculated by Fisher exact test. RESULTS: The study included 199 patients, of whom 156 underwent staged and 43 simultaneous bilateral THA. A total of 44 patients developed complications (21 systemics, 12 locals, and 20 postoperative anemia). There were no significant differences regarding local (simultaneous 5% vs. staged 6%; p = 0.999) or systemic complications (simultaneous 14% vs. staged 10%; p = 0.408). Only the incidence of postoperative anemia was significantly higher in simultaneous group compared with staged group (p = 0.003). There were no significant differences in FJS between the two groups (p = 0.258). CONCLUSION: No differences in local or systemic complications nor readmission rates were observed following simultaneous or staged bilateral THA. Simultaneous bilateral THA is non-inferior to staged implants in terms of safety and patient satisfaction.

Longer resistance of some DNA traits from BT176 maize to gastric juice from gastrointestinal affected patients.

The presence of antibiotic resistance marker genes in genetically engineered plants is one of the most controversial issues related to Genetically Modified Organism (GMO)-containing food, raising concern about the possibility that these markers could increase the pool of antibiotic resistance genes. This study investigates the in vitro survival of genes bla and cryIA(b) of maize Bt176 in human gastric juice samples. Five samples of gastric juice were collected from patients affected by gastro-esophageal reflux or celiac disease and three additional samples were obtained by pH modification with NaHCO3. DNA was extracted from maize Bt176 and incubated with samples of gastric juices at different times. The survival of the target traits (bla gene, whole 1914 bp gene cry1A(b), and its 211 bp fragment) was determined using PCR. The stability of the target genes was an inverse function of their lengths in all the samples. Survival in samples from untreated subjects was below the normal physiological time of gastric digestion. On the contrary, survival time in samples from patients under anti-acid drug treatment or in samples whose pH was modified, resulted strongly increased. Our data indicate the possibility that in particular cases the survival time could be so delayed that, as a consequence, some traits of DNA could reach the intestine. In general, this aspect must be considered for vulnerable consumers (people suffering from gastrointestinal diseases related to altered digestive functionality, physiological problems or drug side-effects) in the risk analysis usually referred to healthy subjects.

Melaleuca alternifolia essential oil possesses potent anti-staphylococcal activity extended to strains resistant to antibiotics.

Melaleuca alternifolia Cheel essential oil (TTO) and its major component terpinen-4-ol were examined against a large number of clinical isolates of Staphylococcus aureus to establish their anti-staphylococcal activities. Classic and established procedures were used to study M.I.C., time-kill curves, synergism and mutational frequency. The anti-staphylococcal activity of terpinen-4-ol and TTO were superior to those of antibiotics belonging to the major families (all the tested drugs are for topical use or included in ointments, eye drops or used during surgery); terpinen 4-ol and TTO were active against strains resistant to mupirocin, fusidic acid, vancomycin, methicillin and linezolid. TTO and terpinen-4-ol were bactericidal as revealed by time-kill curves; the frequency of mutational frequency to TTO was < 2.9 x 10 9. The study demonstrates good anti-staphylococcal activity of TTO and terpinen-4-ol against a large number of S.aureus isolates and suggests the possible application of these agents for topical treatment of staphylococcal infections. This is the first extensive study on the anti-staphylococcal activity of TTO. The results suggest that this compound may have application as a topical agent for the control of superficial staphylococcal infections, including activity against organisms resistant to antibiotics which can be used, or are specific, for topical use.

Combined Plate Microbial Assay (CPMA): a 6-plate-method for simultaneous first and second level screening of antibacterial residues in meat.

This paper proposes an improved high throughput microbial method for the simultaneous performance of first and second level screening for antibacterial residues in meat. It is based on growth inhibition of B. subtilis on agar medium pH 6, 7.2 and 8, of B. cereus on agar medium pH 5.9, of M. luteus on agar medium pH 8 and of E. coli on agar medium pH 7.2 (research or first level screening) and on the use of confirmatory solutions (Pase, Paba, MgSO4) for the identification or second level screening. In kidney control samples, dialysis membranes were interposed between samples and the agar surface to both prevent the action of lysozyme and reduce false positive results. The proposed method detects beta-lactams, sulfonamides, tetracyclines, aminoglycosides, macrolides and quinolones at MRL concentrations and reliably indicates the inhibitor family. Results are obtained in 18-24 h.

Genetic variability among Blastoschizomyces capitatus isolates from different clinical sources.

Sixteen clinical isolates and nine ATCC reference strains of Blastoschizomyces capitatus were analysed genetically, examined for the cellobiose, arbutin and salicin assimilation and tested for the aspartyl-proteinase secretion. The restriction endonuclease analysis (REA) with HpaII and HinfI enzymes and the electrophoretic karyotype (EK) were investigated. Both the restriction enzymes revealed two groups (I, II) constituted by the same isolates: 17 isolates (68%) in group I and 8 (32%) in group II. The EK analysis revealed sixteen groups. These data prompts for a genetic variability of the isolates of Blastoschizomyces capitatus and their account in two distinct genetic groups as suggested by REA. This grouping was confirmed by examining the utilisation of cellobiose, arbutin and salicin. The tests for secretory aspartyl proteinase (Sap) were positive only for three isolates, suggesting a marginal role of this specific enzyme in pathogenesis for these isolates.

Use of IgG Avidity test in case definitions of toxoplasmosis in pregnancy.

A survey network for congenital toxoplasmosis (TOXO-NET) was set up in December 1996 in Piedmont (Italy). Participants were asked to classify the infections in pregnant mothers and newborns by the criteria of the European Network on Congenital Toxoplasmosis published by Lebech in 1996. Because the IgG Avidity test is largely employed as a 2nd level test in toxoplasmosis diagnosis and it could be helpful to date infection, the co-ordinators of TOXO-NET suggested including it in the "case definition" of "probable" infection and "unlikely" infection. 117 cases of toxoplasmosis in pregnancy divided into the risk categories under Lebech's criteria were re-examined using the "new" case definitions. 77 out of 117 (65.8%) Toxoplasma gondii infections during pregnancy could be defined with only one serum sample using the IgG Avidity test. The IgG Avidity test proved a useful method to classify the Toxoplasma gondii infections in pregnancy, especially when we had only one serum sample.

Antimycotic activity of Melaleuca alternifolia essential oil and its major components.

AIMS: The aim of this study was to analyse the antimycotic properties of Melaleuca alternifolia essential oil (tea tree oil, TTO) and its principal components and to compare them with the activity of 5-fluorocytosine and amphotericin B. METHODS AND RESULTS: The screening for the antimycotic activity was performed by serial twofold dilutions in Roswell Park Memorial Institute medium with the inclusion of Tween-80 (0.5%). TTO and terpinen-4-olo were the most active compounds. CONCLUSIONS: The majority of the organisms were sensitive to the essential oil, with TTO and terpinen-4-olo being the most active oils showing antifungal activity at minimum inhibitory concentration values lower than other drugs. SIGNIFICANCE AND IMPACT OF THE STUDY: This study provides a sample large enough to determine the antifungal properties of TTO and terpinen-4-olo and suggests further studies for a possible therapeutic use.

Clostridium botulinum spores and toxin in mascarpone cheese and other milk products.

A total of 1,017 mascarpone cheese samples, collected at retail, were analyzed for Clostridium botulinum spores and toxin, aerobic mesophilic spore counts, as well as pH, a(w) (water activity), and Eh (oxidation-reduction potential). In addition 260 samples from other dairy products were also analyzed for spores and botulinum toxin. Experiments were carried out on naturally and artificially contaminated mascarpone to investigate the influence of different temperature conditions on toxin production by C. botulinum. Three hundred and thirty-one samples (32.5%) of mascarpone were positive for botulinal spores, and 7 (0.8%) of the 878 samples produced at the plant involved in an outbreak of foodborne botulism also contained toxin type A. The chemical-physical parameters (pH, a(w), Eh) of all samples were compatible with C. botulinum growth and toxinogenesis. Of the other milk products, 2.7% were positive for C. botulinum spores. Growth and toxin formation occurred in naturally and experimentally contaminated mascarpone samples after 3 and 4 days of incubation at 28 degrees C, respectively.

A case of infant botulism associated with honey feeding in Italy.

A case of infant botulism in a 9 week-old female is described. A strain of C. botulinum type B was isolated from the feces of the baby. The epidemiologic study detected in a sample of home canned honey Clostridium botulinum spores of the same serotype that was isolated from the patient. The honey had been used only to sweeten the pacifier of the baby. This is the first case of infant botulism in Europe linked conclusively to honey.

Presence of tobramycin in kidneys and placentae of Sprague-Dawley rat fetuses and newborns following in utero exposure.

The maternal-fetal transfer of tobramycin (TBM) was investigated in the rat by means of a microbiological assay, to assess the presence and amount in the kidneys and placentae of fetuses at gestational day (GD) 20, in the kidneys of newborns 6 and 11 days after the end of treatment and in the kidneys of the dams. In the qualitative assay, pregnant rats were injected i.p. with 0, 30, 60 mg/kg b.w. of TBM on GD 10-19. A group of dams treated in parallel with 30 mg/kg b.w. was utilized for a microbiological semiquantitative assay. All litters contained some fetuses showing no detectable TBM accumulation in either kidney or in placentae: at 30 mg/kg/b.w. accumulation appeared more prevalent in placenta than in the kidneys of the corresponding fetuses, as confirmed also by the semiquantitative assay. Some newborns (about 6%) of both groups showed detectable renal TBM residues on the 6th and on the 11th day after the end of treatment. The frequency of newborns showing residues was not obviously related to the dose or the day of sampling, and the concentrations of TBM found were comparable to those observed in fetuses. It is possible that they represent a particularly sensitive subgroup.

Wound botulism: clinical and microbiological findings of an Italian case.

A case of wound botulism in a 41-year old man is reported. The patient had accidently been wounded when he fell on an iron bar. Some days later he developed typical clinical manifestations of botulism. Wound botulism was confirmed by detection and quantification of type B botulinal toxin in the serum. Ventilatory supportive care was necessary and botulinal antitoxin was not given. The patient was hospitalized for 30 days and recovery was complete.

Kinetics of excretion in milk of some antimastitis drugs.

A study on the kinetics of excretion in milk of some antimastitis drugs is described. The five antibiotic molecules used were detected by confronting two methods: the Galesloot-Hassing method which, even though specific for the detection of penicillin in milk, is officially used for the detection of antibiotic residues in general; and the M. luteus paper disk assay, which uses M. luteus ATCC 9341 as test microorganism. The obtained results show that withdrawal times for the assayed molecules are longer than those declared and that M. luteus is more efficient for the detection of kanamycin residues.

[Primary lymphoma of the breast]. / Il linfoma primitivo della mammella.

Analysis of 5 cases of primary breast lymphoma highlights the marked rarity of the lesion and the extreme difficulty of pre-operative diagnosis. It is also shown that the disease generally runs a rapid course and that prognosis is usually unfavourable. The most effective treatment appears to be a combination of surgery and radiation therapy, while chemotherapy--although widely used--still requires further confirmation.

[Food poisoning caused by Clostridium botulinum type E]. / Intossicazione alimentare da Clostridium botulinum tipo E.

The results of a microbiological investigation carried out into a home-canned tuna fish are reported in relation to a suspected botulism case. Toxin of Cl. botulinum type E was detected by mouse toxicity and neutralization tests. The food specimen were also cultured for Cl. botulinum. The isolates was identified as Cl. botulinum type E by biochemical, gas chromatographic and immunological tests. The outbreak in which for the first time in Italy, the Cl. botulinum type E is involved, concerns one person who showed typical signs and symptoms consistent with botulism (abdominal cramps, dilatated pupils, diplopia, dysphagia, paralysis of lower upper limbs). The laboratory results are discussed with relation to environmental characteristics of the micro-organism and their resistance to same chemical and physical factors with are involved in the canning practice.

Riboflavin status among rural children in Southern Italy.

A sample of 107 boys aged 7-10 in a rural area of Southern Italy was studied for riboflavin deficiency and its association with milk consumption. The boys represented 74 per cent of the total male population of that age group in the study area. The nutritional status was assessed by means of anthropometric indicators, dietary intakes by a 24-h recall method and the riboflavin status was evaluated by the assay of erythrocyte glutathione reductase activity. The nutritional status was found to be generally satisfactory with about one tenth of the children presenting stunting, wasting, or obesity. This picture is comparable to that recorded at the national level. The overall incidence of biochemical riboflavin deficiency was 13 per cent. No clinical sign of riboflavin deficiency was observed. None of the anthropometric indicators of malnutrition appeared to be related to biochemical evidence of riboflavin malnutrition. Dietary data showed that the children consumed a relatively small amount of milk and dairy products (mean 224 +/- 109 g/d). Thirteen out of 14 children with biochemical evidence of riboflavin deficiency belonged to the group who consumed less than 300 g/d of milk. However, only 15 per cent of the children consuming less than 300 g/d of milk and dairy products had biochemical evidence of riboflavin deficiency. It appears that the dietary pattern in rural areas with traditionally low milk consumption is compatible with a relatively satisfactory riboflavin nutriture. This finding suggests that milk and dairy products may occupy, under different dietary practices, a role less critical than usually attributed.