Incidentally discovered enteric duplication cyst: a case report

Enteric duplications are rare congenital diseases with heterogeneous clinical pictures ranging from an asymptomatic course to life-threatening consequences, most commonly arising at the ileal and ileocecal region. The antenatal discovery is possible when it concerns a voluminous cystic form enabling an early management. The radiologic examinations are nonspecific and no diagnostic tools can allow a certain diagnosis on its own. Sometimes, the diagnosis of intestinal duplication is only made during the surgical exploration and confirmed after a histopathological examination. We report a 4 years old girl with antenatal diagnosed ovarian cystic mass of about 4 mm. She was admitted to our unit for abdominal pain and constipation. Abdominal ultrasonography showed a cystic mass in the right iliac fossa. MRI revealed a well-defined cystic mass (6 x 4.2 x 5.4 cm) in the right mid abdomen displacing the bowel to the left, likely to be strongly adherent to the last part of the ileum. 99mtc pertechnetate scan was negative for ectopic gastric mucosa. A laparoscopic approach was eventually necessary and the diagnosis of duplication cyst was confirmed. Children with antenatal diagnosis of abdominal mass need a close follow up and enteric duplication should be considered as potential diagnosis. The laparoscopic approach has an important role in differential diagnosis between intestinal duplications and other mass

Beneficial Effects of Pomegranate Peel Extract and Probiotics on Pre-adipocyte Differentiation

The beneficial effects of pomegranate are due to the ellagitannins and anthocyanins content, which are protective toward a wide variety of diseases including inflammatory diseases. Many investigators have reported that pomegranate waste (peel and seeds) extracts, made from waste product of industrial processing, show free radical scavenger and a potent antioxidant capacity. Pomegranate extracts (PEs) were also reported to possess noteworty antibacterial, antiviral, hypolipidemic, and anti-inflammatory bioactivities thanks to the polyphenolic compounds content, which includes punicalagins, gallic acid, and ellagic acid derivatives. The focus of the present manuscript was to study the prebiotic potentiality of a PE, soluble in water, and characterized through HPLC–PDA–ESI/MSn for its phenolic content. Moreover, since it has been reported that pomegranate extracts decreased the level of lipids in the blood and that a number of probiotic strains have been shown to affect adipogenesis in cell culture, this study was also performed to test the in vitro effects of PE and probiotic L. rhamnosus GG ATCC 53103 strain (LGG) on 3T3-L1 cell line. PE and probiotics substantially reduced the triglyceride content and intracellular lipid increase, compared to the control group. However, the combination treatment of PE and LGG filtered spent broth (SB) was the most effective in reducing triglyceride content and intracellular lipid accumulation. The mRNA expression levels of the main transcriptional factors implicated in adipocyte differentiation were substantially lower in 3T3-L1 cells treated with PE and LGG filtered SB. These results evidenced that a synergistic effect of probiotics and polyphenols contained in PE may affect in vitro adipogenesis and may contribute in development of new nutraceutical/probiotic-based remedies to prevent and to treat obesity

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Characterization and Antimicrobial Activity of Alkaloid Extracts from Seeds of Different Genotypes of Lupinus spp.

Alkaloid profiles of 22 lupin genotypes belonging to three different cultivated species, Lupinus albus L., Lupinus luteus L., and Lupinus angustifolius L., collected from different Italian regions and grown in Sicily, were studied by gas chromatography mass spectrometry (GC-MS) to determine alkaloid composition. More than 30 alkaloids were identified. The lowest alkaloid concentration was observed in the L. albus Luxor, Aster, and Rosetta cultivars, and in all the varieties of L. luteus and L. angustifolius. The highest content was observed in all the landraces of L. albus. Surprisingly, the white lupin Lublanc variety and the commercial seeds of cv Multitalia had a high alkaloid content. The tested species and the different genotypes exhibited different alkaloid profiles: lupanine, 13α-hydroxylupanine, and albine were the main alkaloids in the analyzed L. albus seeds; angustifoline and 13α-tigloyloxylupanine were well-represented in L. albus landraces; sparteine and lupinine were typical of L. luteus; and lupanine, 13α-hydroxylupanine, and angustifoline were the main alkaloids in L. angustifolius seeds. The samples with the highest amounts of total alkaloids proved to be interesting from a pharmaceutical viewpoint. The alkaloid extracts showed significant activity on Klebsiella pneumoniae and Pseudomonas aeruginosa clinical isolates

Acetic acid bacteria in agro-wastes: from cheese whey and olive mill wastewater to cellulose

In this study, cheese whey and olive mill wastewater were investigated as potential feedstocks for producing bacterial cellulose by using acetic acid bacteria strains. Organic acids and phenolic compounds composition were assayed by high-pressure liquid chromatography. Fourier-transform infrared spectroscopy, scanning electron microscopy, and X-ray diffraction were used to investigate modifications in bacterial cellulose chemical and morphological structure. Cheese whey was the most efficient feedstock in terms of bacterial cellulose yield (0.300 g of bacterial cellulose/gram of carbon source consumed). Bacterial cellulose produced in olive mill wastewater presented a more well-defined network compared to pellicles produced in cheese whey, resulting in a smaller fiber diameter in most cases. The analysis of bacterial cellulose chemical structure highlighted the presence of different chemical bonds likely to be caused by the adsorption of olive mill wastewater and cheese whey components. The crystallinity ranged from 45.72 to 80.82%. The acetic acid bacteria strains used in this study were characterized by 16S rRNA gene sequencing, allowing to assign them to Komagataeibacter xylinus and Komagataeibacter rhaeticus species. This study proves the suitability to perform sustainable bioprocesses for producing bacterial cellulose, combining the valorisation of agro-wastes with microbial conversions carried out by acetic acid bacteria. The high versatility in terms of yield, morphology, and fiber diameters obtained in cheese whey and olive mill wastewater contribute to set up fundamental criteria for developing customized bioprocesses depending on the final use of the bacterial cellulose

Almond [<i>Prunus dulcis</i> (Mill.) DA Webb] Processing Residual Hull as a New Source of Bioactive Compounds: Phytochemical Composition, Radical Scavenging and Antimicrobial Activities of Extracts from Italian Cultivars (‘Tuono’, ‘Pizzuta’, ‘Romana’)

In this study we developed a new extract, by the use of conventional solid-solvent extraction and a food-grade hydroalcoholic solvent, rich in phenolic and triterpenoid components from almon hull to be employed as functional ingredient in food, pharma and cosmetic sectors. Two autochthonous Sicilian cultivars (‘Pizzuta’ and ‘Romana’) and an Apulian modern cultivar (‘Tuono’) have been tested for the production of the extract. Results showed that the two Sicilian varieties, and in particular the ‘Romana’ one, present the best characteristics to obtain extracts rich in triterpenoids and hydroxycinnamic acids, useful for the production of nutraceutical supplements. About triterpenoids, the performance of the hydroalcoholic extraction process allowed to never go below 46% of recovery for ‘Pizzuta’ samples, with significantly higher percentages of recovery for ‘Tuono’ and ‘Romana’ extracts (62.61% and 73.13%, respectively) while hydroxycinnamic acids were recovered at higher recovery rate (84%, 89% and 88% for ‘Pizzuta’, ‘Romana’ and ‘Tuono’ extracts, respectively). Invitro antioxidant and antimicrobial activities exerted by the extracts showed promising results with P. aeruginosa being the most affected strain, inhibited up to the 1/8 dilution with ‘Romana’ extract. All the three tested extracts exerted an antimicrobial action up to 1/4 dilutions but ‘Romana’ and ‘Pizzuta’ extracts always showed the greatest efficacy

Multi-Functional Potential of Lactic Acid Bacteria Strains and Antimicrobial Effects in Minimally Processed Pomegranate (<i>Punica granatum</i> L. cv Jolly Red) Arils

This study aimed to evaluate the antimicrobial activity of both cells, and cell-free supernatants (CFS) of 7 selected lactic acid bacteria (LAB) strains belonging to Limosilactobacillus fermentum (4 strains), Lacticaseibacillus paracasei (1 strain), Lacticaseibacillus rhamnosus (1 strain), and Enterococcus faecium (1 strain) species, against Listeria monocytogenes, Escherichia coli, Salmonella Typhimurium, Pseudomonas aeruginosa and Staphylococcus aureus, by both the agar-well diffusion and co-culture methods. In addition, probiotic and safety traits were also detected. Great variability was detected on antimicrobial effects, whereas all tested strains were found sensitive to most of the tested antibiotics, and without any DNase, gelatinase, or hemolytic activity. Moreover, strains showed excellent survival in acidic conditions and exhibited tolerance to pepsin and bile salts. Based on the in vitro results, the CFSs of two selected L. fermentum strains were applied, in a mixed solution, as bio-preservative into minimally processed pomegranate arils, inoculated with a cocktail of L. monocytogenes and E. coli. Samples, packaged in an ordinary atmosphere, were analyzed during refrigerated storage, for up to 12 days, for physicochemical (as weight loss, texture, color, pH, total soluble solids and organic acid content) and for microbiological traits. Results revealed the effectiveness of CFS, up to 12 days, in reducing weight loss and microbial growth, without any significant effect on texture, total soluble solid content and color, found comparable to the acid citric treatment, highlighting the multi-functional potential of selected probiotic strains

Risk of surgical site infections following hip and knee arthroplasty. Results of the ischia-gisio study

Introduzione. L'infezione del sito chirurgico (SSI) è una delle principali complicanze a seguito dell'inserimento della protesi dell'anca o del ginocchio. Lo scopo del presente studio era di descrivere i tassi di SSI e i fattori di rischio associati durante le procedure di protesi dell'anca e del ginocchio negli ospedali italiani. Metodi. Gli ospedali italiani sono stati invitati a unirsi al progetto ISChIA (Infezioni del sito chirurgico in chirurgia di artroplastica) e hanno partecipato allo studio su base volontaria. La sorveglianza SSI è stata eseguita in base al protocollo SSI di collegamento ospedaliero per il controllo delle infezioni attraverso la sorveglianza (HELICS). La popolazione dello studio era composta da tutti i pazienti che avevano avuto una protesi protesica del ginocchio o dell'anca tra marzo 2010 e febbraio 2011. Sono state incluse solo operazioni elettive. Risultati. Sono stati inclusi un totale di 14 ospedali e 1285 procedure chirurgiche. L'incidenza cumulativa di SSI è stata di 1,3 per 100 anca e 2,4 per 100 interventi chirurgici al ginocchio; una tendenza positiva significativa delle incidenze SSI è stata osservata con l'aumento dell'indice di rischio SSI. Nell'analisi multivariata, considerando le procedure dell'anca, il singolo fattore di rischio indipendente associato alla SSI era la lunghezza dell'operazione (RR: 4,54; IC al 95%: 1,06-19,48). Per le procedure al ginocchio, non è stato identificato alcun fattore di rischio significativo. Conclusioni. Nel presente studio, l'incidenza cumulativa SSI era nell'intervallo di dati europei. Tuttavia, è necessario un numero maggiore di operazioni per stimare meglio le tariffe SSI. È già stata condotta una seconda edizione del progetto ISChIA e i risultati dei due sondaggi forniranno nuove conoscenze per approfondire le nostre conoscenze per il controllo delle infezioni.Background. Surgical Site Infection (SSI) is one of the major complications following insertion of hip or knee prosthesis. The aim of the present study was to describe rates of SSIs and associated risk factors during hip and knee prosthesis procedures in Italian hospitals. Methods. Italian hospitals were invited to join the ISChIA (Surgical Site Infections in Arthroplasty Surgery) project and participated in the study on a voluntary basis. SSI surveillance was performed according to the Hospitals in Europe Link for Infection Control through Surveillance (HELICS)-SSI protocol. The study population consisted of all patients who had a prosthetic knee or hip joint replacement between March 2010 and February 2011. Only elective operations were included. Results. A total of 14 hospitals and 1285 surgical procedures were included. SSI cumulative incidence was 1.3 per 100 hip and 2.4 per 100 knee surgical procedures; a significant positive trend of SSI incidences was observed with increasing SSI risk index. In multivariate analysis, considering hip procedures, the single independent risk factor associated to SSI was operation length (RR: 4.54; 95%CI: 1.06-19.48). For knee procedures, no significant risk factor was identified. Conclusions. In the present study, SSI cumulative incidence was in the range of European data. However, a larger number of operations is needed to better estimate SSI rates. A second edition of the ISChIA project has been already conducted and results of the two surveys will provide new insight to further our knowledge for infection control