Limosilactobacillus reuteri Strains as Adjuvants in the Management of Helicobacter pylori Infection

Helicobacter pylori (HP) is a Gram-negative bacterium which finds its suitable habitat in the stomach. The infection affects about half of the global population with high variability in prevalence among regions and for age. HP is the main causative agent of chronic active gastritis, peptic and duodenal ulcers, and may be the primary cause of gastric cancer or MALT lymphoma. Due to the high rate of failure of eradication therapy in various countries and the increase in antibiotic resistance reported in the literature, there is an ever wider need to seek alternative therapeutic treatments. Probiotics seem to be a promising solution. In particular, the Limosilactobacillus reuteri (L. reuteri) species is a Gram-positive bacterium and is commonly found in the microbiota of mammals. L. reuteri is able to survive the gastric acid environment and bile and to colonize the gastric mucosa. This species is able to inhibit the growth of several pathogenic bacteria through different mechanisms, keeping the homeostasis of the microbiota. In particular, it is able to secrete reuterin and reutericycline, substances that exhibit antimicrobial properties, among other molecules. Through the secretion of these and the formation of the biofilm, it has been found to strongly inhibit the growth of HP and, at higher concentrations, to kill it. Moreover, it reduces the expression of HP virulence factors. In clinical trials, L. reuteri has been shown to decrease HP load when used as a single treatment, but has not achieved statistical significance in curing infected patients. As an adjuvant of standard regimens with antibiotics and pump inhibitors, L. reuteri can be used not only to improve cure rates, but especially to decrease gastrointestinal symptoms, which are a common cause of lack of compliance and interruption of therapy, leading to new antibiotic resistance

A severe infective endocarditis successfully treated with linezolid

Despite significant improvements in surgical and medical therapy, prosthetic valve endocarditis (PVE) is a diagnostic and therapeutic challenge and is often associated with a severe prognosis. We report a case of a 59-year-old woman, with  PVE and bacterial endocarditis (Streptococcus bovis) successfully treated with linezolid. Linezolid is a bacteriostatic oxazolidinone antibiotic that has been proven to be effective for the treatment of patients with pneumonia, skin and soft tissue infections, and infections due to Gram-positive cocci. Linezolid is not yet recognised as a standard therapy for infective endocarditis, but its use becomes a necessity when infection is due to multidrug-resistant microorganisms

Choosing a medical specialty course in Italy: explorative analysis of factors related to the choice

Background: In order to be able to access a course of medical or surgical specialization, in addition to the degree and the qualification to the profession it is necessary to perform an entrance test. In this study we wanted to analyze the possible factors that determined the choice of a given graduate school and the place where to attend it in the year 2021.Study design: Cross-sectional study to evaluate the association between the type of graduate school, the score class obtained at the admission test, the location of the graduate school and the location of the degree. Methods: The evaluation of the association between site of specialty admission and degree, score at degree and score at admission test was performed by multiple correspondences analysis (MCA). Then, through a logistic regression model, the Odds Ratios (OR) and the respective confidence interval with 95% (95%CI) confidence level of the covariates on the probability of remaining in the same degree site, or in the same region or in the same geographical area, were estimated.Results The highest admission score and the highest age are significantly and independently associated with the probability of choosing, as a graduate school location, the same location where the degree was obtained.Conclusion: In conclusion, the choice of the course and the location of the specialty course is made in most cases, taking into account the score made in the exam, based on the location where you attended the course of study in medicine and surgery

Is acidemia at birth a risk factor for functional gastrointestinal disorders?

Functional gastrointestinal disorders (FGIDs) are common in early childhood. It has been demonstrated that neonatal acidemia at delivery can lead to significant neonatal morbidity. The primary aim of this study was to evaluate the relationship between acidemia at birth and the development of FGIDs, as regurgitation, colic, and constipation, in term infants. Term newborns born at the Foggia University Hospital, Italy during the year 2020 were included in the study. As per routine clinical practice, a cord blood gas analysis on a blood sample drawn from the umbilical artery (UA) of each infant immediately after birth was performed, and Apgar score was recorded. One year after birth, each infant's parents were interviewed through a phone call to investigate development of FGIDs, feeding practices, and morbidities. During the study period, 1574 term newborns met the inclusion criteria. The prevalence of infantile colic, regurgitation, and constipation was higher in infants with low UA pH (colic 51.5% vs. 25.4%, p < 0.001; regurgitation 30.6% vs. 15.2%, p < 0.001; constipation 24.6% vs. 16.0%, p = 0.015), with infants having moderate-severe acidemia facing the highest risk for all the examined FGIDs. In binary logistic regression analyses, UA pH and perinatal antibiotic exposure proved to be independently associated with the later diagnosis of each FGID. Conclusion: Newborns with acidemia at birth appear to face a higher risk of FGIDs in infancy. Avoiding low cord blood pH should continue to be the goal for obstetricians, while enhanced long-term surveillance for infants who experienced birth acidemia should be required

The Importance of Strengthening Mother and Child Health Services during the First 1000 Days of Life: The Foundation of Optimum Health, Growth and Development

The first 1000 days of a child's life, spanning from the time of conception until 2 years of age, are a unique period of laying down the foundations of optimum health, growth, and development across the lifespan. However, the first 1000 days are also a period of enormous vulnerability. How mothers and children are cared for during this crucial time has a profound influence on a child's ability to grow, learn, and thrive.1 The role of the first 1000 days of life is well-described. However, investments in this key period are scarce and the provision of adequate health care services id insufficient. The aim of this report is to further raise the attention of decision-makers and health care officers and professionals, including pediatricians, pediatric surgeons, obstetricians, nurses, midwives, dieticians, and lactation consultants, on the importance of investing in health care services to support and empower parents and families during a most critical period of their children's life. In particular, we encourage the adoption of integrated strategies to establish adequate preventive efforts and a perspective shift to strengthen or develop where lacking, efficient health care services dedicated to the first 1000 days of life as the first line of prevention

Esophageal Eosinophilia and Eosinophilic Esophagitis in Celiac Children: A Ten Year Prospective Observational Study

The association between eosinophilic esophagitis and celiac disease is still controversial and its prevalence is highly variable. We aimed to investigate the prevalence of esophageal eosinophilia and eosinophilic esophagitis in a large group of children with celiac disease, prospectively followed over 11 years. Methods: Prospective observational study performed between 2008 and 2019. Celiac disease diagnosis was based on ESPGHAN criteria. At least four esophageal biopsies were sampled in patients who underwent endoscopy. The presence of at least 15 eosinophils/HPF on esophageal biopsies was considered suggestive of esophageal eosinophilia; at the same time, eosinophilic esophagitis was diagnosed according to the International Consensus Diagnostic Criteria for Eosinophilic Esophagitis. Results: A total of 465 children (M 42% mean age 7.1 years (range: 1–16)) were diagnosed with celiac disease. Three hundred and seventy patients underwent endoscopy, and esophageal biopsies were available in 313. The prevalence of esophageal eosinophilia in children with celiac disease was 1.6% (95% CI: 0.54–2.9). Only one child was diagnosed as eosinophilic esophagitis; we calculated a prevalence of 0.3% (95% CI: 0.2–0.5%). The odds ratio for an association between eosinophilic esophagitis and celiac disease was at least 6.5 times higher (95% CI: 0.89–47.7; p = 0.06) than in the general population. Conclusion: The finding of an increased number of eosinophils (>15/HPF) in celiac patients does not have a clinical implication or warrant intervention, and therefore we do not recommend routine esophageal biopsies unless clinically indicated

Marca-país: identidad nacional argentina

En el presente trabajo se abordará la temática sobre la marca, más puntualmente la “marca-país”, haciendo foco en el caso de Argentina. La marca país es el signo más preponderante, lo que se dice marca paraguas. Funciona como respaldo, rubrica, marca, sella, legitima y prestigia todo lo que por debajo de ella se ubica. La marca país es un símbolo unívoco de la nacionalidad, y para que así sea debe ser socialmente transversal, debe representar a todos. La experiencia en el proceso de creación y gestión de la estrategia de marca país en Argentina tuvo su origen en el contexto marcado por la grave crisis económica, social y política en la que se vio inmersa entre 2001 y 2002; y fue realizada con el fin de respaldar la imagen del país. La creación de la marca país en Latinoamérica tiene una relevancia aún mayor que en el resto del mundo, ya que se presenta como una herramienta de reposicionamiento a nivel global, y en los países que conforman Hispanoamérica existen constantes pujas entre los grupos mediáticos existentes y limitaciones político-económicas más notorias y particularmente fuertes. Este hecho hace que la vigencia de la marca país, la cual debe ser atemporal, se torne temporaria, y por consecuencia, se obtenga una indiferencia social, dejando en perspectiva la falta de identificación por parte de sus habitantes.Mesa F.Facultad de Bellas Arte

Infections in patients with lymphoproliferative diseases treated with targeted agents: SEIFEM multicentric retrospective study

We describe the opportunistic infections occurring in 362 patients with lymphoproliferative disorders treated with ibrutinib and idelalisib in clinical practice. Overall, 108 of 362 patients (29·8%) developed infections, for a total of 152 events. Clinically defined infections (CDI) were 49·3% (75/152) and microbiologically defined infections (MDI) were 50·7% (77/152). Among 250 patients treated with ibrutinib, 28·8% (72/250) experienced one or more infections, for a total of 104 episodes. MDI were 49% (51/104). Bacterial infections were 66·7% (34/51), viral 19·6% (10/51) and invasive fungal diseases (IFD) 13·7% (7/51). Among the 112 patients treated with idelalisib, 32·1% (36/112) experienced one or more infections, for a total of 48 episodes. MDI were 54·2% (26/48). Bacterial infections were 34·6% (9/26), viral 61·5% (16/26) and IFD 3·8% (1/26). With ibrutinib, the rate of bacterial infections was significantly higher compared to idelalisib (66·7% vs. 34·6%; P = 0·007), while viral infections were most frequent in idelalisib (61·5% vs. 19·6%; P < 0·001). Although a higher rate of IFD was observed in patients treated with ibrutinib, the difference was not statistically significant (13·7% vs. 3·8% respectively; P = 0·18). Bacteria are the most frequent infections with ibrutinib, while viruses are most frequently involved with idelalisib

Marca-país: identidad nacional argentina

En el presente trabajo se abordará la temática sobre la marca, más puntualmente la “marca-país”, haciendo foco en el caso de Argentina. La marca país es el signo más preponderante, lo que se dice marca paraguas. Funciona como respaldo, rubrica, marca, sella, legitima y prestigia todo lo que por debajo de ella se ubica. La marca país es un símbolo unívoco de la nacionalidad, y para que así sea debe ser socialmente transversal, debe representar a todos. La experiencia en el proceso de creación y gestión de la estrategia de marca país en Argentina tuvo su origen en el contexto marcado por la grave crisis económica, social y política en la que se vio inmersa entre 2001 y 2002; y fue realizada con el fin de respaldar la imagen del país. La creación de la marca país en Latinoamérica tiene una relevancia aún mayor que en el resto del mundo, ya que se presenta como una herramienta de reposicionamiento a nivel global, y en los países que conforman Hispanoamérica existen constantes pujas entre los grupos mediáticos existentes y limitaciones político-económicas más notorias y particularmente fuertes. Este hecho hace que la vigencia de la marca país, la cual debe ser atemporal, se torne temporaria, y por consecuencia, se obtenga una indiferencia social, dejando en perspectiva la falta de identificación por parte de sus habitantes.Mesa F.Facultad de Bellas Arte