Polyphenols and organic acids as alternatives to antimicrobials in poultry rearing: a review.

For decades antibiotics have been used in poultry rearing to support high levels of production. Nevertheless, several problems have arisen because of the misuse of antibiotics (i.e., antibiotic resistance, residues in animal products, environmental pollution). Thus, the European Union (EU) as well as the European Food Safety Authority (EFSA) promote action plans to diminish the use of antibiotics in animal production. Alternatives to antibiotics have been studied. Polyphenols (PPs) or organic acids (OAs) seem to be two accredited solutions. Phenolic compounds, such as phenols, flavonoids, and tannins exert their antimicrobial effect with specific mechanisms. In contrast, short chain fatty acids (SCFAs) and medium chain fatty acids (MCFAs), the OAs mainly used as antibiotics alternative, act on the pathogens depending on the pKa value. This review aims to collect the literature reporting the effects of these substances applied as antimicrobial molecules or growth promoter in poultry feeding (both for broilers and laying hens). Organic acids and PPs can be used individually or in blends, exploiting the properties of each component. Collected data highlighted that further research needs to focus on OAs in laying hens’ feeding and also determine the right combination in blends with PPs

The adipokines in cancer cachexia

Cachexia is a devastating pathology induced by several kinds of diseases, including cancer. The hallmark of cancer cachexia is an extended weight loss mainly due to skeletal muscle wasting and fat storage depletion from adipose tissue. The latter exerts key functions for the health of the whole organism, also through the secretion of several adipokines. These hormones induce a plethora of effects in target tissues, ranging from metabolic to differentiating ones. Conversely, the decrease of the circulating level of several adipokines positively correlates with insulin resistance, metabolic syndrome, diabetes, and cardiovascular disease. A lot of findings suggest that cancer cachexia is associated with changed secretion of adipokines by adipose tissue. In agreement, cachectic patients show often altered circulating levels of adipokines. This review reported the findings of adipokines (leptin, adiponectin, resistin, apelin, and visfatin) in cancer cachexia, highlighting that to study in-depth the involvement of these hormones in this pathology could lead to the development of new therapeutic strategies

Milk and conjugated linoleic acid a review of the effects on human health

Dairy products and milk play an important role in a healthy diet as they contribute to the intake of essential nutrients, high-quality proteins, and fats. Despite the large number of existing studies on the possible association between dairy products and chronic degenerative diseases, studies examining the effects of dairy products and milk on the risk of common causes of mortality such as cardiovascular and neoplastic diseases are scarce and conflicting. Some studies have reported an increased risk of cardiovascular diseases for individuals who consume large amounts of cheese, whereas others have shown no relationship between these products and atherosclerotic biomarkers

Subtotal supracricoid laryngectomy: changing in indications, surgical techniques and use of new surgical devices.

The aim of this study is to evaluate the evolution of supracricoid partial laryngectomy (SCPL) in indications, surgical techniques and outcomes through last decades.A retrospective analysis of 146 patients affected by laryngeal cancer treated with SCPL was carried on. We defined: (1) group A, 100 patients treated by cold instruments between 1995 and 2004; (2) group B, 46 patients treated by harmonic scalpel between 2005 and 2010. Complications rate, and functional and oncological results were documented and a comparison between the two groups was made; histopathological analysis of surgical margins was evaluated and correlated with local incidence of recurrence.Significant differences in age mean-value (p=0.02), T classification (p=0.007), and in indication for more advanced-staged patients were found in group B (p=0.001). Surgical procedure was shorter in group B (p<0.001), with shorter swallowing recovery (p=0.003). Oncological outcomes did not report any significant differences. Group B showed a higher incidence of post- operative arytenoid edema (p=0.03) associated with a lower rate of pneumonia (p=0.038). Despite a higher rate of close or positive-margins found in group B no higher incidence of local-recurrence was reported (p=0.02) compared to group A.We documented changing in indications and surgical technique for SCPL because of the development of modern diagnostic techniques and the introduction of low-thermal injury device allowing a more challenging tumor excision as well as with a shorter swallowing recovery in our series

Tobacco exposure and complications in conservative laryngeal surgery.

Smoking is an important risk factor in the development of head and neck cancer. However, little is known about its effects on postoperative complications in head and neck cancer surgery. We performed a retrospective analysis on 535 consecutive laryngeal cancer patients submitted to open partial laryngectomy at the Otolaryngology-Head and Neck Surgery Department of Florence University to evaluate a possible correlation between smoking and surgical complications. Patients were grouped in non smokers and smokers and evaluated for airway, swallowing, local and fistula complications by multivariate analysis: 507 (95\%) patients were smokers, 69\% presented supraglottic, 30\% glottic and 1\% transglottic cancer. The most common operation was supraglottic horizontal laryngectomy in 58\%, followed by supracricoid partial laryngectomy in 27\% and frontolateral hemilaryngectomy in 15\% of cases. The incidence of overall complications was 30\%, airway complications representing the most frequent (14\%), followed by swallowing (7\%), local (6\%) and fistula complications (3\%). Smokers developed more local complications (p = 0.05, univariate, p = 0.04, multivariate analysis) and pharyngocutaneous fistula (p = 0.01, univariate, p = 0.03, multivariate analysis)

Is open tracheotomy performed by residents in otorhinolaryngology a safe procedure? a retrospective cohort study.

Surgical or percutaneous tracheotomy is one of the commonest operations in the ENT practice and one of the first procedures to be taught to residents. No study exists that demonstrates the safety of this surgical procedure performed by unexperienced surgeons. The purpose was to compare outcomes of tracheotomies performed by supervised residents and surgeons in terms of postoperative complications and mortality, and identify risk factors for the onset of complications. Retrospective cohort study. Otolaryngology-Head and Neck Surgery Department, University of Florence, Italy. We included all patients undergoing tracheotomy from July 2008 to January 2013 and compared tracheotomies performed by supervised residents or surgeons. During the study period, 304 patients were submitted to tracheotomy. Patients operated by surgeons had a significantly higher number of tracheal rings fracture (p = 0.05), subcutaneous emphysema (p = 0.003) and tracheostomy tube displacement (p = 0.003), while supervised residents had a higher number of tracheitis/pneumonia (p = 0.04) as early complications. Patients operated by supervised residents had a significantly higher number of tube obstructions as late complication (p = 0.04). Using multivariate model, risk factors for early postoperative complications were male sex (p = 0.04) and delayed time to substitution with cuffless tube (p = 0.01), while only a trend to statistical significance was observed for urgent tracheotomies concerning the risk for late postoperative complications (p = 0.08). The current practice where residents perform tracheotomies supervised by a surgeon should not be disheartened. Our study demonstrates that it is safe and does not lead to higher risk of complications nor negatively affects the quality of care