DILATION TREATMENT OF BENIGN STRICTURED OF COLOCOLONIC ANASTOMOSES

SCOPO DI QUESTO ARTICOLO E' DI METTERE IN LUCE LA COMPLIANCE, I BENEFICI ED IL MIGLIORAMENTO DELLA QUALITA' DELLA VITA, NEI SOGGETTI AFFETTI DA STENOSI BENIGNA POST-ANASTOMOTICA COLO-COLICA E COLO-RETTALE E TRATTATI CON DILATAZIONE ENDOSCOPICA DEL TRATTO STENOTICO. LA DILATAZION PER VIA ENDOSCOPICA RISULTA ESSERE SICURA E DI SEMPLICE ESECUZIONE E PERMETTE DI OTTENERE RISULTATI SODDISFACENTI ANCHE PER PERIODI PROLUNGATI. I CRITERI STANDARD PER UNA EFFICACE DILATAZIONE VARIANO TRA 1 10 E 13 MM

The growing importance of ultrasonography in cosmetic dermatology: An update after the 23rd IMCAS Annual World Congress (2022).

BACKGROUND Ultrasound (US) has been used for many years in the field of medicine. Many specialties have embraced US as a quick, painless, and relatively inexpensive tool to assist the clinician in determining anatomy, pathology, and aid in diagnostic or therapeutic procedures. US allows for precise mapping of cutaneous and subcutaneous structures in the face, in particular vascular structures. The use of US leads to reduced chances of complications and clinical failures, rendering more safety and high quality. METHODS US is considered the first-imaging technique for dealing with fillers and managing their potential complications. US can be deployed for vascular mapping, safe placement of fillers, and directed low-dose hyaluronidase reversal of vascular adverse events. It is a noninvasive imaging modality that provides a good definition for studying the skin, deeper layers, and blood flow in real time. In other words, we go from static to dynamic anatomy. In addition, US can guide with the application of botulinum toxin, in order to define the muscular planes. US may contribute to a more personalized procedure, better cosmetic results, and help to avoid complications. In general, physicians tend to use it for prevention. Last, for research purposes, US examination provides valuable information on the behavior, longevity, and interaction of the filler within the tissues. CONCLUSION This new approach for US-guided treatments is a very practical and an effective method in cosmetic dermatology. As doctors, we owe it to our patients to do our best to prevent any harm. We feel that in near future, US will be an essential diagnostic tool in any dermatology or cosmetic doctor's office to both ensure safety and provide legal protection for the professional

Simple and fast orotracheal intubation procedure in rat

Introduction: Endotracheal intubation in the rat is difficult because of extremely small size of anatomical structures (oral cavity, epiglottis and vocal cords), small inlet for an endotracheal tube and the lack of proper techniacal instruments. Matherial and Methods: In this study we used seventy rats weighthing 400-500 g. The equipment needed for intubation was an operating table, a longish of cotton, a cotton tip, orotracheal tube, neonatal laryngoscope KTR4, small animal ventilator, and isoflurane for inhalation anaesthesia. Premedication was carried out by medetomidine hydrochloride 1 mg/mL; then, thanks to a closed glass chamber, a mixture of oxygen and isoflurane was administered. By means of neonatal laryngoscope the orotracheal tube was advanced into the oral cavity untile the wire guide was visualized trough the vocal cords; then it was passed through them. The tube was introduced directly into into the larynx over the wire guide; successively, the guide was removed and the tube placed into the trachea. Breathing was confirmed using a glove, cut at the end of a finger, simulating a small ballon. Conclusions: We believe that our procedure is easier and faster than those previously reported in scientific literature. (www.actabiomedica.it

Argentum-quarz solution in the treatment of anorectal fistulas: Is it possible a conservative approach?

Patients suffering from chronic intestinal diseases (Crohn's disease, Ulcerative Colitis, Indeterminate Colitis) are prone to the development of pyogenic complications. These complications are most commonly in the form of perianal or intraabdominal abscesses and/or fistulas. The treatment of these complications are managed differently but, after an initial treatment based on medical or minimally invasive management, the solution of the pathological condition is always achieved by a surgical procedure. In the last few years prospective studies have proposed an alternative conservative therapeutic approach based on application of fibrin glue in the healing of patients with fistulas-in-ano. In this paper we suggest and discuss the therapeutic potential of silver and quarz in the conservative treatment of anorectal fistulas pointing out their role in modulating particular steps of the pathogenetic process which characterizes this pathological condition

Potential protective effects of melatonin against UV-A irradiation on fibroblast cell line

The sun’s radiation that reaches Earth contains ultraviolet (UV) wavelights made up of a combination of UV-A (95%) and UV-B (5%) radiations. Chronic sun exposure is responsible for long term clinical skin changes such as photoaging, photodamage and photocancers. Moreover, inflammation is mostly due to UV-A which stimulates the production of reactive oxygen species (ROS) inducing also photoaging (Mouchet et al., 2010; Marionnet et al., 2010). In order to protect themselves against oxidative stress, skin cells developed several defense systems, including ROS and metal ions scavengers and a battery of detoxifying and repair enzymes (Bickers and Athar, 2006). In addition, UV-A can also directly influence the structure of nucleic acids, breaking the chain or changing the nucleotide sequence. Altogether these perturbations of cells homeostasis advantages a significant up-regulation of oxidative and inflammatory responsive genes. In this study, we focused our attention on prevention of photodamage, choosing melatonin as antioxidant agent. Melatonin is a neuroendocrine mediator with pleiotropic bioactivities such as hormonal, neurotransmitter, immunomodulator and biological modifier actions. Its antioxidant activity is the result of two different but synergic actions: a direct, due to its ability to act as a free radical scavenger and an indirect due to the up-regulation of antioxidant enzymes (Fischer et al., 2008). The aim of the present study was to analyze the impact of pre-treatment of murine fibroblasts cells (NIH-3T3) with melatonin (10-3 M- kindly provided by Chronolife S.r.l., Roma, Italy) later irradiated by UV-A irradiation (15 J/ cm2) evaluating the changes of fibroblast microenvironment conditions. We observed that UV-A irradiation caused matrix restructuration and alteration, oxidative stress and inflammation; while melatonin pre-treatment suppresses UV-A induced photodamage. Collectively, these results suggest that melatonin provides relevant protective effects against UV-A irradiation. A new chapter of melatonin in dermato-endocrine research could be open

VALIDATION OF A MODIFIED MODEL OF TNBS-INDUCED COLITIS IN RATS. HOW TO INDUCE A CHEMICAL COLITIS IN RATS.

Background: there are no standard practice in the induction of colitis by 2,4,6-trinitrobenzene sulfonic (TNBS) acid. Usually, the repeated administration of TNBS is preferred, because it will result in a local Th1 response that has the characteristics of Crohn's disease. material and Methods: A total of 30 rats were randomized into two groups, consisting of a saline control group of ten rats and a TNBS groups of 20 rats. After the animals were anesthesized, 0,5 ml of either 0,9 % saline 8controls) or TNBS 50 mg/Kg dissolved in 50% ethanol were instilled into the colon through a rubber catheter. The experiment was repeated weekly for four weeks, then, the rats were killed at day 40, and the distal colon removed. results: At day 40, the bowel wall basically normal in the control group. In the TNBS group, the bowel lumen became narrow with tickened wall, and the mucosal surface presented adherent membrane with brown black, linear ulcers, proliferous lymphocites tissue, inflammatory granulomas and submucosal neutrophil infiltration. The median score of the severity of the colonic damage was 0 in the control group, and 4,75 (range 4-5) in the TNBS group; the mean weight of the rats was 180+35 g in the TNBS group, while it was 215+25 in the control group. Conclusions: The presented experiment is a cost-effective and safe method to induce Crohn-like colonic damage using a lower dose of TNBS, thus avoiding the risk of a massive loss of rats. This model is rather suitable for the assessment of the effects of potential therapeutic agent

Enteral nutrition: our experience with percutaneous endoscopic gastrostomy (PEG) and revision of literature

Enteral nutrition (EN), as parenteral nutrition (PN), can be used in cases of patients whose medical conditions prevent the intake of food by mouth; unlike PN, EN keeps the functionality of the digestive tract and it makes home management of patients easier. However, the experience and literature have documented a number of serious complications, fortunately rare, which depend on the methods used in EN realization. We report in this paper our experience in 44 cases of percutaneous endoscopic gastrostomy (PEG), concluding that it is a safe and complications-free procedure. We believe that a nutritional intervention is indicated when, improving nutritional status, patients can obtain a better quality of life and have an average life expectancy

HEAT SHOCK PROTEINS AND AUTOIMMUNE SYSTEM ACTIVATION IN IBD: ARTICULAR MANIFESTATIONS AND THE EPIDEMIOLOGICAL FREQUENCY IN ORTHPEDICS

clinical evidence suggest that arthritis is one of the complications of inflammatori bowel disease (IBD) of which the etiological causes are still not completely understood. Among the possible explanations the most probable theory is poor regulation of the intestinal immune system, which causes a cross-like immune reactivity against the resident micro flora. Arthritis is these subjects involves different joints and is asymmetric, with greater involvement of the large joints of the lower limbs. Joints may also be involved with the spinal forms of sacroileitis and ankilosing spondylitis. This clinical evidence explains the existence of Lesnioski-Crohn's disease, a variant of IBD in which patients have bone joint problems that may also be the primary manifestations of the disease

NUTRITION IN IBD PATIENT'S: WHAT ARE THE PROSPECTS?

Summary: Inflammatory Bowel Disease (IBD) is a chronic disorder characterized by a relapsing-remitting course, which alternates between active and quiescent states, ultimately impairing a patients quality of life. The two main types of IBD are Crohn's disease (CD) and Ulcerative Colitis (UC). In physiological conditions the gut is costantly exposed to various antigens, commensal microflora and pathogens and the inflammatory response is finely balanced. It is thought that a vast number of environmental risk factors may be implicated in the development of IBD, including smoking factors, dietary factors, psycological stress, use of non-steroidal anti-inflammatory drugs and oral contraceptives, appendicectomy, breastfeeding, as well as infections. Nutritional support, as a primary therapy, has a crucial role in the management of patients with IBD. The gut microbiota is clearly manipulated by dietary components such as n-3 polyunsatured fatty acids (n-3 PUFA) and coniugated linoleic acid (CLA) which favorably reduce endotoxin load via shifts in the composition and metabolic activity of the microbial community. in particular, the beneficial effect of n-3 PUFAs and fermentable fiber, during the remission/quiescent phase of both CD and UC is Highlighted. In fact, PUFAs are associated with a less grade of inflammation since they are metabolized to 3-series prostagliandins and thromboxanes and 5-series leukotrienes and, in addition, exert antiinflammatory effects when compared with their n-6 PUFA counterparts. In similar action to dietary n-3 PUFA, coniugated linoleic acid (CLA) have been reported to ameliorate intestinal inflammation in animal models of IBD. Currently, is still unclear the role of the fibers in helping the remission of the disease. Data about the consumption of fiber are controversial. On one hand, dietary fibers can act as effective prebiotics by altering the intestinal microbial composition and promoting the growth of beneficial bacterial communities within the large intestine. On the other hand, fibers can promote diarrhea, pain and gas aggravating the clinical sate. Cocnclusion: We suggest that the consumption of fermentable fibers may have a good impact on patient's health