Lifestyle changes associated with a new antioxidant formulation in non-alcoholic fatty liver disease: a case series.

Non-alcoholic fatty liver disease (NAFLD) is a relevant issue in public health owing to its epidemiological burden. It represents the most common chronic liver disease in the general population and is expected to increase in future as a result of an ageing population. The only currently recommended treatment for NAFLD is lifestyle modification. However, literature reports pre-clinical and clinical studies on the use of antioxidant supplementation in NAFLD. A new antioxidant complex, called Bilirel (BIL) (Pharmaluce, Republic of San Marino), have recently introduced in the Italian market. However no data are reported on his effects on liver steatosis. Here we report on a cases series of seven overweight patients with NAFLD, in which the association of an Italian Mediterranean diet, increased physical activity, and daily administration of two pills of BIL for 6 weeks, have induced the rapid improvement of fatty liver accumulation, glucose and lipid metabolism, and weight reduction.

Severe hepatitis induced by cyproterone acetate: role of corticosteroids. A case report.

Cyproterone acetate (CPA) is an oral anti-androgen commonly used to treat advanced prostate cancer. A variety of hepatotoxic reactions has been reported with CPA. Here we describe a case of a male patient who developed severe drug-induced hepatotoxicity during the treatment with CPA. The case, presenting sub-acute hepatitis, was characterized by a rapid evolution of cirrhosis and a protracted activity during the period of a few months despite the treatment withdrawal and an apparent benefits of corticosteroids, suggesting their indication in life threatening cases.

A proposal of a diagnostic protocol for isolation of Corynebacterium ulcerans from cow's milk

Background: Literature about presence Corynebacterium ulcerans in milk samples from cows with mastitis is rare and in the literature there are only a few reports. In this study the isolation and identification of Corynebacterium ulcerans from mastitis in dairy cows were done. Also, optimization of diagnostic protocols to identify Corynebacterium ulcerans was performed. Materials, Methods & Results: The investigation was performed at the cattle farm that is characterized by closed housing system diary Holstein-Friesian cows during an outbreak of acute mastitis. Milk samples from 298 lactating cows were collected in sterile sampling tubes. Before the collection of quarter milk samples, the udder was thoroughly cleaned with soap and water and rubbed to dry. All collected milk samples were examined for mastitis using California mastitis test, which was carried out by the method first described by Schalm and Noorlander. Equal volumes (5 mL) of commercial CMT reagent and quarter milk were mixed and the changes in milk fluidity and viscosity were observed. Sample portions (0.1 mL each) were inoculated on 10% sheep blood agar, Endo agar and Sabouraud agar as well as on thioglycolate medium and nutrient broth. Primary plates were incubated for 3 days at 37ºC in aerobic conditions. Cultural, morphological and conventional biochemical testing was done. The survey was complemented by double CAMP and plasma coagulation tube test. All 14 isolates developed a synergistic haemolysis with Rhodococcus equi (ATCC 6939) and inverse CAMP phenomenon with Staphylococcus aureus and coagulated rabbit plasma. Final diagnosis was confirmed using API Coryne V 2.0 and software program by BioMerieux1, revealing an identity rate of 99.9%, accuracy rate T = 1, test count = 0. Discussion: The first fourteen isolates of Corynebacterium ulcerans have been identified in our country, on the basis of a diagnostic protocol that is proposed in this paper. In our experience double CAMP test, rabbit plasma coagulation, catalase, oxidase tests and selected biochemical parameters, are sufficient as a diagnostic minimum. In the diagnostics of bacterial agents in cow mastitis, the attention of a bacteriologist is mostly limited to most widespread agents of mastitis, the isolation of which is mandatory pursuant to national legislation (Staphylococcus aureus and Streptococcus agalactiae). A more important reason for "missing" Corynebacterium ulcerans in the diagnosis is its colonial morphology that could resemble organisms of the genus Staphylococcus. Complex and expensive diagnostic procedure that is not available to most laboratories is also responsible for the small number of reports of isolation C. ulcerans. Furthermore, in routine work C. ulcerans could be misidentified with Staphylococcus intermedius, because of cultural similarity, positive plasma coagulation tube test and absence of manitol fermentation of both species. This paper is a report on isolation and identification of Corynebacterium ulcerans from milk of cows with mastitis, as well as a suggestion of a diagnostic protocol available for routine work in most veterinary microbiology laboratory. Therefore we suggest as the diagnostic protocol double CAMP test to be used as a complementary method to rabbit plasma coagulation tube test.

A proposal of a diagnostic protocol for isolation of Corynebacterium ulcerans from cows milk / A proposal of a diagnostic protocol for isolation of Corynebacterium ulcerans from cows milk

Background: Literature about presence Corynebacterium ulcerans in milk samples from cows with mastitis is rare and in the literature there are only a few reports. In this study the isolation and identification of Corynebacterium ulcerans from mastitis in dairy cows were done. Also, optimization of diagnostic protocols to identify Corynebacterium ulcerans was performed.Materials, Methods & Results: The investigation was performed at the cattle farm that is characterized by closed housing system diary Holstein-Friesian cows during an outbreak of acute mastitis. Milk samples from 298 lactating cows were collected in sterile sampling tubes. Before the collection of quarter milk samples, the udder was thoroughly cleaned with soap and water and rubbed to dry. All collected milk samples were examined for mastitis using California mastitis test, which was carried out by the method first described by Schalm and Noorlander. Equal volumes (5 mL) of commercial CMT reagent and quarter milk were mixed and the changes in milk fluidity and viscosity were observed. Sample portions (0.1 mL each) were inoculated on 10% sheep blood agar, Endo agar and Sabouraud agar as well as on thioglycolate medium and nutrient broth. Primary plates were incubated for 3 days at 37o C in aerobic conditions. Cultural, morphological and conventional biochemical testing was done. The survey was complemented by d

Background: Literature about presence Corynebacterium ulcerans in milk samples from cows with mastitis is rare and in the literature there are only a few reports. In this study the isolation and identification of Corynebacterium ulcerans from mastitis in dairy cows were done. Also, optimization of diagnostic protocols to identify Corynebacterium ulcerans was performed.Materials, Methods & Results: The investigation was performed at the cattle farm that is characterized by closed housing system diary Holstein-Friesian cows during an outbreak of acute mastitis. Milk samples from 298 lactating cows were collected in sterile sampling tubes. Before the collection of quarter milk samples, the udder was thoroughly cleaned with soap and water and rubbed to dry. All collected milk samples were examined for mastitis using California mastitis test, which was carried out by the method first described by Schalm and Noorlander. Equal volumes (5 mL) of commercial CMT reagent and quarter milk were mixed and the changes in milk fluidity and viscosity were observed. Sample portions (0.1 mL each) were inoculated on 10% sheep blood agar, Endo agar and Sabouraud agar as well as on thioglycolate medium and nutrient broth. Primary plates were incubated for 3 days at 37o C in aerobic conditions. Cultural, morphological and conventional biochemical testing was done. The survey was complemented by d

A proposal of a diagnostic protocol for isolation of Corynebacterium ulcerans from cows milk / A proposal of a diagnostic protocol for isolation of Corynebacterium ulcerans from cows milk

Background: Literature about presence Corynebacterium ulcerans in milk samples from cows with mastitis is rare and in the literature there are only a few reports. In this study the isolation and identification of Corynebacterium ulcerans from mastitis in dairy cows were done. Also, optimization of diagnostic protocols to identify Corynebacterium ulcerans was performed.Materials, Methods & Results: The investigation was performed at the cattle farm that is characterized by closed housing system diary Holstein-Friesian cows during an outbreak of acute mastitis. Milk samples from 298 lactating cows were collected in sterile sampling tubes. Before the collection of quarter milk samples, the udder was thoroughly cleaned with soap and water and rubbed to dry. All collected milk samples were examined for mastitis using California mastitis test, which was carried out by the method first described by Schalm and Noorlander. Equal volumes (5 mL) of commercial CMT reagent and quarter milk were mixed and the changes in milk fluidity and viscosity were observed. Sample portions (0.1 mL each) were inoculated on 10% sheep blood agar, Endo agar and Sabouraud agar as well as on thioglycolate medium and nutrient broth. Primary plates were incubated for 3 days at 37o C in aerobic conditions. Cultural, morphological and conventional biochemical testing was done. The survey was complemented by d

Background: Literature about presence Corynebacterium ulcerans in milk samples from cows with mastitis is rare and in the literature there are only a few reports. In this study the isolation and identification of Corynebacterium ulcerans from mastitis in dairy cows were done. Also, optimization of diagnostic protocols to identify Corynebacterium ulcerans was performed.Materials, Methods & Results: The investigation was performed at the cattle farm that is characterized by closed housing system diary Holstein-Friesian cows during an outbreak of acute mastitis. Milk samples from 298 lactating cows were collected in sterile sampling tubes. Before the collection of quarter milk samples, the udder was thoroughly cleaned with soap and water and rubbed to dry. All collected milk samples were examined for mastitis using California mastitis test, which was carried out by the method first described by Schalm and Noorlander. Equal volumes (5 mL) of commercial CMT reagent and quarter milk were mixed and the changes in milk fluidity and viscosity were observed. Sample portions (0.1 mL each) were inoculated on 10% sheep blood agar, Endo agar and Sabouraud agar as well as on thioglycolate medium and nutrient broth. Primary plates were incubated for 3 days at 37o C in aerobic conditions. Cultural, morphological and conventional biochemical testing was done. The survey was complemented by d

[Rene Favaloro--a surgeon who has changed the history of coronary disease].

Rene Favaloro was one of the most distinguished surgeons of the 20th century. He was the first to introduce the original technique of aortocoronary bypass grafting, entering the new era of coronary artery disease treatment. Working at the Cleveland Clinic, together with Mason Sones and Effler, he became a member of the medical team which performered the first aortocoronary bypass grafting and showed the functional competence of the new graft. Although today percutaneous coronary interventions and coronary artery stents have a very important role in coronary artery disease treatment, five years after his death aortocoronary bypass grafting is the method of choice in selected groups of patients. Nowadays, when urgent percutaneous coronary interventions are an important treatment option in our country, it is good to remember that this also was the idea of Rene Favaloro and Mason Sones, who discussed agressive treatment in the first hours of myocardial infarction, and to remember his tremendous contributions and life dedicated to cardiosurgery.