Non cross-linked equine collagen (Salvecoll-E gel) for treatment of complex ano-rectal fistula

Summary: Background: Fistula-in-ano is one of the most commonly presenting anorectal diseases. Sphincter sparing treatment options should be considered in patients with complex fistulas. Salvecoll-E gel is a native collagen deantigenated and purified, non-cross-linked equine dermal extract, with an amino acid composition identical to human collagen. Methods: The multicentric trial study was a prospective, single-arm observational clinical study with the objective to assess the efficacy of Salvecoll-E gel for anal fistula repair in 70 patients. All patients had undergone preliminary surgical treatment consisting of positioning of a draining loosing seton that was maintained for a period of 4–6 weeks. After seton removal, a gentle debridement and washing of the fistula track was performed. The scar tissue was removed from the internal orifice. Internal opening was covered by a side-to side mucosal suture. Salvecoll-E was injected through the external opening into the fistula track, the external opening it has been opened. Results: Twelve months after surgery, 55 patients demonstrated a clinically healed fistula (78,5%), 15 patients have a recurrence (21,5%). Most of the recurrences were observed in the first 6 months of treatment (13/15, 86.6%). We don't observe any worsening in CCF score. The results obtained at 1 year certainly seem satisfactory and in line with the best results published in literature using mini-invasive techniques. Conclusion: Salvecoll-E gel is a promising non-invasive technique for conservative treatment of anal fistulas, it's well tolerated by the patients and, in case of recurrence, reinjection or all other known techniques are feasible. Keywords: Complex ano-rectal fistula, Non cutting technique, Mini-invasive treatmen

Postoperative complications after procedure for prolapsed hemorrhoids (PPH) and stapled transanal rectal resection (STARR) procedures

Procedure for prolapsing hemorrhoids (PPH) and stapled transanal rectal resection for obstructed defecation (STARR) carry low postoperative pain, but may be followed by unusual and severe postoperative complications. This review deals with the pathogenesis, prevention and treatment of adverse events that may occasionally be life threatening. PPH and STARR carry the expected morbidity following anorectal surgery, such as bleeding, strictures and fecal incontinence. Complications that are particular to these stapled procedures are rectovaginal fistula, chronic proctalgia, total rectal obliteration, rectal wall hematoma and perforation with pelvic sepsis often requiring a diverting stoma. A higher complication rate and worse results are expected after PPH for fourth-degree piles. Enterocele and anismus are contraindications to PPH and STARR and both operations should be used with caution in patients with weak sphincters. In conclusion, complications after PPH and STARR are not infrequent and may be difficult to manage. However, if performed in selected cases by skilled specialists aware of the risks and associated diseases, some complications may be prevented

STRATEGIES FOR THE EXTENSION OF THE SHELF LIFE OF READY-TO-EAT PRICKLY PEAR FRUITS.

The prickly pear fruit (Opuntia ficus indica L. Miller) belongs to the Cactaceae family. The fruit is a berry, composed by an epicarp and the pulp, which represents the edible portion. At maturation, the epicarp turns yellow, red or white, depending on the cultivar. In Italy, the prickly pear is mainly cultivated in Sicily (90% of the national production). The fruit is very sensitive to low storage temperatures (< 5\ub0C) which cause chilling injuries. The fruits can be successfully commercialized as a ready-to-eat product, peeled and suitably packaged. The main limit to its production is the formation of off-flavours due to different factors, such as the growth of microorganism and the action of endogenous enzymes (lipid oxidation). In fact, the oxidoreductases are directly responsible for the lipid oxidation, which has influence on the production of off-flavours, on the structure and on the shelf-life of the fruit. The lipoxygenase (LOX) is a dioxygenase which catalyzes the oxidation of polyunsaturated fatty acids to hydroperoxides. The aim of this work was to compare different packaging technologies to extend the shelf life of ready-to-eat prickly pear fruits. The LOX activity, microbial counts and gas composition were evaluated for non-treated samples packed in ordinary atmosphere and in two modified atmospheres having different O2 and CO2 composition (MA1 5% O2, 2% CO2, 93%N2; MA2 2% O2, 5% CO2, 93% N2) and for samples treated either with a blanching or with a blanching followed by a dipping in a citric acid solution. The pretreatment conditions are essential for the LOX activity, in particular the blanching reduced its activity by at least 30% especially in combination with fruit acidification and limited the microbial proliferation. As a result of suitable pretreatment and packaging operations the shelf life of ready-to-eat prickly pears can be successfully extended

Milligan-Morgan hemorroidectomy vs. Longo rectal mucosa prolapsectomy: comparisno of two surgical techniques

Copia digital. Madrid : Ministerio de Cultura. Subdirección General de Coordinación Bibliotecaria, 200

Recurrence after stapled haemorrhoidopexy

The surgical procedure of stapled haemorrhoidopexy is now considered safe, and its reliability is improving with experience and technical upgrading. Compared to conventional procedures, the short-term advantages of stapled haemorrhoidopexy include less postoperative pain, faster recovery and healing, whereas the disadvantages of the procedure in the long term include an increased possibility of recurrent prolapse. The percentage of symptomatic prolapse after stapled procedures widely varies in the several clinical trials described in the literature, ranging between 2 and 53.3 %. Many short- and long-term complications of the different treatments for haemorrhoids (conventional, stapled or realized with different new devices) have been reported in the literature. Less evidence is available about how to minimize these undesirable effects of stapling procedures, and there are no studies that describe and classify recurrences and the strategies to deal with them

Studio dell&#8217;analisi computerizzata dell&#8217;occlusione mediante T-Scan III nella valutazione audiologica del paziente con acufene

Scopo dello studio \ue8 stato quello di studiare il pattern dei contatti occlusali in pazienti affetti da acufene monolaterale. Metodi: 13 soggetti normoudenti con acufene idiopatico (55.6\ub117.6 anni; 8 femmine e 5 maschi) e 15 soggetti affetti da sindrome di M\ue9ni\ue8re disease (MD) (56.2\ub114.8 anni; 9 femmine e 6 maschi) di controllo. Risultati: Il centro di forza \ue8 risultato significativamente spostato verso il lato opposto a quello dell\u2019acufene nei soggeti con acufene idiopatico. (p=0.045) Conclusioni: I nostri dati suggeriscono che la valutazione della stabilit\ue0 occlusale potrebbe essere uno strumento clinicamente utili da inserire nella valutazione audiologica