Surviving adversity: Exploring the presence of Lunularia cruciata (L.) Dum. on metal-polluted mining waste.

The tailings dump of Barraxiutta (Sardinia, Italy) contains considerable concentrations of heavy metals and, consequently, is scarcely colonized by plants. However, wild populations of the liverwort Lunularia cruciata (L.) Dum. form dense and healthy-looking carpets on this tailing dump. L. cruciata colonizing the tailing dump was compared with a control population growing in a pristine environment in terms of: (i) pollutant content, (ii) photochemical efficiency, and (iii) volatile secondary metabolites in thalli extracts. L. cruciata maintained optimal photosynthesis despite containing considerable amounts of soil pollutants in its thalli and had higher sesquiterpene content compared to control plants. Sesquiterpenes have a role in plant stress resistance and adaptation to adverse environments. In the present study, we propose enhanced sesquiterpenes featuring Contaminated L. cruciata as a defence strategy implemented in the post-mining environment.

Spa therapy induces clinical improvement and protein changes in patients with chronic back pain.

This study is primarily aimed at assessing serum changes on a large panel of proteins in patients with chronic back pain following spa therapy, as well as evaluating different spa therapy regimens as a preliminary exploratory clinical study. Sixty-six patients with chronic back pain secondary to osteoarthritis were randomly enrolled and treated with daily mud packs and bicarbonate-alkaline mineral water baths, or a thermal hydrotherapy rehabilitation scheme, the combination of the two regimens or usual medication only (control group), for two weeks. Clinical variables were evaluated at baseline, after 2 and 12 weeks. One thousand serum proteins were tested before and after a two-week mud bath therapy. All spa treatment groups showed clinical benefit as determined by improvements in VAS pain, Roland Morris disability questionnaire and neck disability index at both time points. The following serum proteins were found greatly increased (≥2.5 fold) after spa treatment: inhibin beta A subunit (INHBA), activin A receptor type 2B (ACVR2B), angiopoietin-1 (ANGPT1), beta-2-microglobulin (B2M), growth differentiation factor 10 (GDF10), C-X-C motif chemokine ligand 5 (CXCL5), fibroblast growth factor 2 (FGF2), fibroblast growth factor 12 (FGF12), oxidized low density lipoprotein receptor 1 (OLR1), matrix metallopeptidase 13 (MMP13). Three proteins were found greatly decreased (≤0.65 fold): apolipoprotein C-III (Apoc3), interleukin 23 alpha subunit p19 (IL23A) and syndecan-1 (SDC1). Spa therapy was confirmed as beneficial for chronic back pain and proved to induce changes in proteins involved in functions such as gene expression modulation, differentiation, angiogenesis, tissue repair, acute and chronic inflammatory response.

Growth of Listeria monocytogenes in ready to eat salads at different storage temperatures and valuation of virulence genes expression.

BACKGROUND: Vegetables are major components of a healthy and balanced diet. However, 25% of foodborne diseases are linked to the consumption of vegetables. STUDY DESIGN: The aim of this work was to assess the microbiological risks associated with consumption of ready to eat salads (RTE). METHODS: Microbiological challenge tests were carried out for the evaluation of the L. monocytogenes growth potential in RTE salads stored at different temperatures. RESULTS: The results indicate that L.monocytogenes was able to grow (δ ≥ 0.5) in all storage conditions considered at the end of shelf life. In order to evaluate the virulence role of L. monocytogenes, the temperature-dependent transcription of major virulence genes was also investigated by RT-PCR. CONCLUSIONS: The microbiological challenge test allowed us to confirm, as also demonstrated by other authors, that RTE salads are able to support the growth of L. monocytogenes strains (d δ≥ 0.5) stored under different temperatures.

Microbiological Quality of the Water used in Agriculture in Sardinia.

BACKGROUND: The microbiological quality of the water used in irrigation is crucial for the safety of products, such as fruit and vegetables, especially when destined to be consumed raw. However, the microbiological quality of this water is not defined at a community regulatory level or at a national level. METHODS: With our present work, we wanted to investigate the microbiological quality of the water used for crop irrigation in various Sardinian provinces. Since in most fields the irrigation water is filtered to remove any impurities, the sample was processed twice - both before and after the filtering process. Furthermore, with the purpose of hypothesising the potential health risks attributable to the consumption of crops from the tested fields, samples of horticultural product were collect. Any eventual seasonal differences in the values of microbial concentration were assessed. Microorganism faecal contamination indicators (Escherichia coli, total coliform and faecal streptococci), but even the presence of the opportunistic pathogen such as Pseudomonas aeruginosa were researched in irrigation water. Total mesophilic counts (TMC) were assessed at 36°C and 22°C. On horticultural products we researched both the indicators of process parameters, such as Escherichia coli, Total mesophilic counts at 30°C, Enterobacteriaceae, Total Psychrophilic counts and Pseudomonas aeruginosa, and pathogens, such as Salmonella spp, Listeria monocytogenes and Yersinia enterocolitica. RESULTS: The number of target microorganisms, when present in irrigation water, was very limited: Escherichia coli, total coliform and faecal streptococci, were detected respectively in 48% and 67% of the water samples tested with average concentration values of 0.9, 1.2 and 1.4 log respectively. In fresh vegetable products, the total mesophilic counts (TMC) were found to have average values of 6.6x107 CFU/g. The average values of Enterobacteriaceae totalled 6.1x105 CFU/g; Escherichia coli was detected in only one sample (curly endive) with a value of 180 CFU/g. CONCLUSION: The data highlights the high quality of the water and how this contributed to achieving satisfactory quality on prime material. However the use of filters, to eliminate impurities, and reservoirs, may represent a crucial issue, if not managed correctly.

Hygiene and health risks associated with the consumption of edible lamellibranch molluscs.

Edible lamellibranch molluscs are frequently the cause of very serious outbreaks of food poisoning. Microbiological suitability for human consumption, according to EC Reg. n. 1441/2007, is only based on two faecal bacteriological contamination parameters (Escherichia coli and Salmonella) and does not consider other microorganisms which are naturally present within the marine environment and are potentially pathogenic such as those belonging to the genus Vibrio. In this study, a total of 540 samples of edible lamellibranch molluscs (mussels, clams and oysters) bred in Sardinia were analyzed for E. coli and Salmonella, according to EC Reg n. 1441/2005, and for the presence of Vibrios of major public health interest. Environmental parameters (seawater temperature and salinity) were also recorded. The 40% (n=216) of samples were positive for Vibrio while the levels of E. coli were above the legal European limit only in 6.4% of samples. A correlation between the presence of micro-organisms of faecal origin and potentially harmful Vibrios to human health was not observed. Vibrio alginolyticus was the most common in 68% of isolated species, followed by Vibrio parahaemolyticus in 22.6%, Vibrio cholerae in 6% and Vibrio vulnificus in 1.1%. Virulence gene (trh sequence) was present in 1.6% of the V. parahaemolyticus-positive samples. The V. cholerae, V. vulnificus and V. alginolyticus strains detected were non toxigenic. The absence of genes encoding major virulence factors in the studied strains does not exclude the possibility of exposure to pathogenic strains. This study indicates the potential health risk associated with the presence of pathogenic Vibrios in edible lamellibranch molluscs bred in Sardinia, where shellfish production is very important to the local economy.

Evaluation of the level of domestic hygiene in household kitchens.

BACKGROUND: Each year in industrialized countries, 30-40% or more cases of food poisoning occur in the household. The aims of this study are to describe the aspects related to food safety in households by carrying out a microbiological characterization of the kitchens in residential dwellings and to increase consumers' awareness concerning the importance of good hygienic practices, which are required for preventing foodborne diseases at household level. METHODS: The collection of data involved taking 760 analytical samples of kitchen-counter tops and food from 80 kitchens of private dwellings; the manner in which food was treated was evaluated from the moment of purchase to its transformation and storage by means of a checklist; the questionnaire enabled us to determine the extent of consumers' knowledge concerning the food sector. RESULTS: Overall, the results showed a good level of hygiene concerning both food and kitchen-counter top food surfaces. The respondents of the questionnaire did not appear to be aware of various health risks especially concerning the management of the temperature and compartments of refrigerators as well as food storage times and the cooking or heating of food. CONCLUSIONS: The data indicate that final consumers should take more care when cleaning kitchen-counter tops and washing salad; special training programmes should be included in school curricular in order to increase citizens' awareness and knowledge concerning food risks within the household.

The host model Galleria mellonella is resistant to taylorellae infection.

The genus Taylorella is composed of two species: (i) Taylorella equigenitalis, the causative agent of CEM, a venereally transmitted infection of Equidae and (ii) Taylorella asinigenitalis, a closely related species considered to be nonpathogenic, although experimental infection of mares with this bacterium resulted in clinical signs of vaginitis, cervicitis or endometritis. Currently, there is a need for an alternative host model to further study the taylorellae species. In this context, we explored Galleria mellonella larvae as potential alternative model hosts for taylorellae. Our results showed that infection of G. mellonella larvae with a high concentration of taylorellae did not induce overt G. mellonella mortality and that taylorellae were not able to proliferate within G. mellonella. In conclusion, G. mellonella larvae are resistant to taylorellae infection and therefore do not constitute a relevant alternative system for studying the virulence of taylorellae species. Significance and impact of the study: To date, the pathogenicity and host colonization capacity of Taylorella equigenitalis, the causative agent of contagious equine metritis (CEM) and T. asinigenitalis, the second species within the Taylorella genus, remain largely unknown. In this study, we evaluated the relevance of Galleria mellonella as an infection model for taylorellae; we showed that G. mellonella are resistant to taylorellae infection and therefore do not constitute a suitable host model for taylorellae.

Polar and antioxidant fraction of Plumbago europaea L., a spontaneous plant of Sardinia.

Secondary metabolite isolation and analysis of Plumbago europaea L. (Plumbaginaceae) is the aim of this work, which is included in a project of our groups on spontaneous and endemic Sardinian species. Plumbago europaea is the only specie of the genera that grows wild in Italy. Metabolites from leaves and roots of this specie were compared. Moreover, at present, literature on the phytochemical characterisation of P. europaea is poor. Plumbagin was isolated in both of the samples analysed, confirming its nature in the Plumbaginaceae family as chemotaxonomic marker of the Plumbaginae tribe. In this work, hydroplumbagin-4-O-glucoside and myricetin-3-O-rhamnoside are isolated for the first time in the genus.

External biliary fistula in orthotopic liver transplantation.

During orthotopic liver transplantation (OLT), various situations may occur in which biliary reconstruction is neither technically feasible nor recommended. One bridge to a delayed anastomosis can be an external biliary fistula (EBF). This procedure allows the surgeon to execute hemostatic maneuvers, such as abdominal packing; therefore, biliary reconstruction can be subsequently performed in a bloodless operative field without edematous tissues. EBF can be made by placing in the donor biliary tract a cannula that is fixed to the bile duct using 2-0 silk ties and secured outside the abdominal wall. The biliary anastomosis will be performed within 2 days after the OLT. The aim of this study was to examine the safety of EBF in terms of the incidence of biliary complications compared with a direct anastomosis. Among 1,634 adult OLTs performed in 17 years in our center, 1,322 were carried out with termino-terminal hepaticocholedochostomy (HC-TT); two with side-to-side hepaticocholedochostomy; 208 with hepaticojejunostomy (HJ); 31 with EBF and delayed HC-TT, and 71 with EBF and delayed HJ. Biliary complication rates in the EBF group were 24.5%, including 23.9% in the delayed HJ and 25.8% in the delayed HC-TT. Biliary complication incidence among all OLTs was 24.6% (P = NS). No complications related to the procedure were observed. Therefore, EBF is a safe technique without a higher biliary complication rate. It may be useful when a direct biliary anastomosis is dangerous.

Endoscopic retrograde cholangiopancreatography in patients with biliary complications after orthotopic liver transplantation: outcomes and complications.

Biliary complications after orthotopic liver transplantation (OLT) still remain a major cause of morbidity and mortality. The most frequent complications are strictures and leakages in OLT cases with duct-to-duct biliary reconstruction (D-D), which can be treated with dilatation or stent placement during endoscopic retrograde cholangiopancreatography (ERCP), although this procedure is burdened with potentially severe complications, such as retroperitoneal perforation, acute pancreatitis, septic cholangitis, bleeding, recurrence of stones, strictures due to healing process. The aim of the study was to analyze the outcome of this treatment and the complications related to the procedure. Among 1634 adult OLTs, we compared postprocedural complications and mortality rates with a group of 5852 nontransplanted patients (n-OLTs) who underwent ERCP. Of 472 (28,8%) post-OLT biliary complications, 319 (67.6%) occurred in D-D biliary anstomosis cases and 94 (29.5%) patients underwent 150 ERCP sessions. Among 49/80 patients (61.2%) who completed the procedure, ERCP treatment was successful. Overall complication rate was 10.7% in OLT and 12.8% in n-OLT (P = NS). Compared with the n-OLT group, post-ERCP bleeding was more frequent in OLT (5.3% vs 1.3%, P = .0001), while the incidence of pancreatitis was lower (4.7% vs 9.6%, P = .04). Procedure-related mortality rate was 0% in OLT and 0.1% in n-OLT (P = NS). ERCP is a safe procedure for post-OLT biliary complications in the presence of a D-D anastomosis. Morbidity and mortality related with this procedure are acceptable and similar to those among nontransplanted population.

Serum lipoprotein pattern as modified in G6PD-deficient children during haemolytic anaemia induced by fava bean ingestion.

In the present study, plasma lipid concentrations were determined at different times after admission in sera from G6PD-deficient children during haemolytic crisis induced by fava bean ingestion. Reductions in total, LDL and HDL cholesterol were found in association with the maximum of bone marrow hyperplasia. A return towards normal values occurred with regression of the disease. No changes in other lipid parameters were observed. These data suggest that alterations of lipoprotein pattern, other than in experimental animals, are also present in humans with non-malignant proliferative processes. These changes appear to be a consequence of the disease, probably due to an increased utilization of cholesterol by proliferating cells.

Human salmonellosis transmitted by a domestic turtle.

Salmonella typhimurium was isolated in the culture test of a small child admitted to hospital suffering from febrile gastroenteritis with stools containing traces of mucus and blood. Her mother also resulted positive for this microorganism. The family had recently bought a small turtle, imported from Florida, at the city fair. Further tests revealed Salmonella typhimurium in both the turtle's feces and the water in its tank.

[Empyema due to an anaerobic Streptococcus in childhood]. / Empiema da streptococco anaerobio in età infantile.

Anaerobic infections are quite rare in pediatric age, being that, they affect only neonates and immunodepressed patients. We think to be somewhat interesting to describe the case of our patient, a 9 year old boy, unaffected by any predisposing factor, came under our observation because of a severe respiratory distress. He showed evident clinical and radiological signs of pleural effusion in the right lung, together with a gas coil in the upper field and a left mediastinal shifting. A thoracentesis was then performed, giving rise to 600 ml of foul smelling purulent material; this procedure promptly improved his respiratory function. A permanent drainage trough the chest wall was set and an antibiotic therapy, based on the clinical picture and the character of the exudate, begun. In effect, the typical smell of the purulent material led us to suspect an anaerobic infection, and for this reason we employed the teicoplanin iv, a rarely used in the pediatric age drug. While blood cultures were negative for any organism, exudate cultures yielded Peptostreptococcus anaerobius; the last one resulted highly sensible following antibiogram to the previously chosen drug. The x-ray pattern and the rapid disappearing of the gas coil induced us to exclude further either congenital or acquired lung diseases. We conclude that, in absence of other proved sources of entry, the air presence in the pleural space was secondary to gas formation by the anaerobic micro-organism. The clinical course was very satisfactory allowing the patient to be dismissed on the 28th hospital day, with no need of further surgical therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Hyperplastic polyp of the stomach simulating hypertrophic pyloric stenosis.

We describe a rare case of hyperplastic polyp of the stomach having its clinical origin in the neonatal period and initially stimulating hypertrophic stenosis of the pylorus. After this neoformation, which almost completely obstructed the pylorus, was endoscopically removed, vomiting ceased and a rapid weight gain was observed. It is known that tumors are a rare cause of gastric outlet obstruction if compared with hypertrophic stenosis of the pylorus. However, our experience suggests that in the case of atypical symptoms, the investigations should be extended, especially to endoscopic examination of the upper digestive tract.

[Radiodiagnostic evaluation in osseointegrated dental implants]. / Iter radiodiagnostico negli imianti dentari osteointegrati.

The Authors examine the various radiological techniques indispensable to pre- and postsurgical evaluation in endosseous dental implantology. Of each technique the choice criteria and diagnostic potentialities are suggested.

[Duodenal ulcer in 2 dizygotic twins]. / Ulcera duodenale in due gemelli dizigoti.

We report two cases of duodenal ulcer (DU) identified at endoscopy in a pair of dizygotic twins; their outstanding clinically recognizable features were a very early onset, a great familiar occurrence, a lack of triggering conditions (drugs, burns, stress, sepsis, respiratory distress), normal serum levels of gastrin and pepsinogen I, inadequate response to medical treatment with H2-receptor antagonists, but satisfactory response to associated therapy with H2-receptor antagonists and sucralfate. Results of this study show that examined twins were affected by a form of early-onset primary DU, probably inherited like an autosomal dominant disorder with high degree of penetrance, associated with normal serum pepsinogen I and gastrin; in this form of Du a decreased tissue resistance of duodenal mucosa is likely more important, pathogenically, than an increased peptic secretion. At present long-term prognosis of our patients is unknown.