Miotomia laparoscopica secondo Heller per acalasia esofagea. C’è bisogno di una fundoplicatio?

The last decade has witnessed radical changes in the treatment of esophageal achalasia due to the development of minimally invasive techniques. Because of the high success rate of the laparoscopic Heller myotomy, a radical shift in the treatment algorithm of these patients has occurred, and today this is the preferred treatment modality for achalasia. This remarkable change is due to the recognition by gastroenterologists and patients that a laparoscopic Heller myotomy outperforms pneumatic dilatation and intra-sphincteric injection of botulinum toxin injection. While there is agreement about the technique of the myotomy per se, some questions still linger about the need for a fundoplication after the myotomy. The following review describes the data present in the literature in order to identify the best procedure that can achieve relief of dysphagia while avoiding development of gastroesophageal reflux

Riparazione laparoscopica delle ernie paraesofagee: un approccio “evidence-based”

The approach to paraesophageal hernias has drastically changed over the last decade. The goal of this paper is to describe in detail our surgical technique of laparoscopic repair of paraesophageal hernias and to provide an evidence-based approach to the most controversial aspects of this type of repair

Phenotypic and genotypic study on antibiotic resistance and pathogenic factors of staphylococcus aureus isolates from small ruminant mastitis milk in south of italy (Sicily)

Staphyloccoccus aureus is the major cause of mastitis in small ruminants in the Mediterranean farms causing severe losses to dairy industry. Antibiotic treatment has been the most common approach to control these infections. Aim of this study was to investigate antimicrobial resistance (AMR), virulence factors and biofilm-related genes of 84 Sicilian strains of S. aureus isolated from sheep and goats milk during two different periods δT1 (2006-2009) and δT2 (2013-2015). Kirby Bauer method and Polymerase Chain Reaction (PCR) were utilized to monitor AMR and related genes (mecA, tetK, tetM, ermA, ermC). Moreover, toxin genes (tsst-1, sea-see, seg-sej, and sep) and biofilm genes (bap, ica, sasC) were studied. Twenty-six isolates (30.9%) showed multidrug resistance. The two groups showed similar results with exception for higher values of resistance for tilmicosin and lower for sulfamethoxazole and vancomycin of the second group. MecA gene was detected in one isolate. Tetracycline resistance was higher than 20%, with an increase in δT2 group. Toxin genes were found in 5 isolates (5.9%), belonging of δT2 group, while 57 of isolates (67.8%) showed biofilm related genes. The high presence of multi-resistant isolates suggests the need of more responsible use of antibiotic therapy for the control of these infections

MOLECULAR IDENTIFICATION AND GENOTYPING OF CIAUSCOLO AUTOCHTHONOUS MICROFLORA: PRELIMINARY STUDY

The present study reports the results of a preliminary characterization of the bacterial population of Ciauscolo, a typical Italian fermented sausage, traditionally manufactured in Marche region. The bacterial community involved in Ciauscolo fermentation was investigated using both molecular and culturebased methods. The estimation of genotypic intra-species variation of the autochthonous bacteria isolated was also evaluated by using randomly amplified polymorphic DNA (RAPD) analysis and unweighted pairgroup method with arithmetic averages (UPGMA) cluster analysis. Our findings revealed an high diversity of the autochthonous bacterial population investigated, both at species and strain level

Multimodal approach of advanced gastric cancer: Based therapeutic algorithm

Gastric cancer (GC) is the third leading cause of cancer death in both sexes worldwide, with the highest estimated mortality rates in Eastern Asia and the lowest in Northern America. However, the availability of modern treatment has improved the survival and the prognosis is often poor due to biological characteristics of the disease. In oncology, we are living in the "Era" of target treatment and, to know biological aspects, prognostic factors and predictive response informations to therapy in GC is mandatory to apply the best strategy of treatment. The purpose of this review, according to the recently published English literature, is to summarize existing data on prognostic aspects and predictive factors to response to therapy in GC and to analyze also others therapeutic approaches (surgery and radiotherapy) in locally, locally advanced and advanced GC. Moreover, the multidisciplinary approach (chemotherapy, surgery and radiotherapy) can improve the prognosis of GC

The Intersection of GERD, Aspiration, and Lung Transplantation

Lung transplantation is a radical but life-saving treatment option for patients with end-stage lung diseases, such as idiopathic pulmonary fibrosis (IPF) and scleroderma. In light of the proposed association and controversy linking gastroesophageal reflux disease (GERD) to IPF and lung transplant outcome, the American Gastroenterological Association convened during the DDW in Washington in May 2015 a multidisciplinary group of experts in the field of GERD and lung transplantation to make considerations about the care of these patients based on available data and subsequent expert panel discussion at this symposium. The following topics were discussed: (1) pathophysiology of GERD-induced pulmonary symptoms, (2) GERD evaluation before and after lung transplantation, (3) outcome of lung transplantation for IPF and scleroderma, and (4) role of laparoscopic fundoplication before or after lung transplantation

Use of complementary and alternative medicine (CAM) in cancer patients. An italian multicenter survey

INTRODUCTION: Complementary and Alternative Medicine (CAM) include a wide range of products (herbs, vitamins, minerals, and probiotics) and medical practices, developed outside of the mainstream Western medicine. Patients with cancer are more likely to resort to CAM first or then in their disease history; the potential side effects as well as the costs of such practices are largely underestimated. PATIENTS AND METHOD: We conducted a descriptive survey in five Italian hospitals involving 468 patients with different malignancies. The survey consisted of a forty-two question questionnaire, patients were eligible if they were Italian-speaking and receiving an anticancer treatment at the time of the survey or had received an anticancer treatment no more than three years before participating in the survey. RESULTS: Of our patients, 48.9% said they use or have recently used CAM. The univariate analysis showed that female gender, high education, receiving treatment in a highly specialized institute and receiving chemotherapy are associated with CAM use; at the multivariate analysis high education (Odds Ratio, (OR): 1.96 95% Confidence Interval, CI, 1.27-3.05) and receiving treatment in a specialized cancer center (OR: 2.75 95% CI, 1.53-4.94) were confirmed as risk factors for CAM use. CONCLUSION: Roughly half of our patients receiving treatment for cancer use CAM. It is necessary that health professional explore the use of CAM with their cancer patients, educate them about potentially beneficial therapies in light of the limited available evidence of effectiveness, and work towards an integrated model of health-care provision

Bdellovibrio bacteriovorus to control Escherichia coli on meat matrices

Bdellovibrio bacteriovorus is a predator micro-organism towards other Gram-negative bacteria. We tested B. bacteriovorus to control Escherichia coli growth on chicken slices and canned beef. Moreover, we analysed B. bacteriovorus's lytic ability on eight toxigenic or multidrug-resistant E. coli strains. In chicken slices, the predator induced the highest prey reduction (4.3 log) respect to control at 6 h. In canned beef, the predator induced the highest prey reduction (2.1 log) respect to control at 6 h. Moreover, B. bacteriovorus showed lytic ability towards all tested E. coli strains. B. bacteriovorus could control E. coli and other pathogenic and spoilage bacteria in those meat-based foods that have a shelf life <10 days. It could integrate modified atmosphere packaging (MAP) to prolong the shelf life and improve the safety of pre-packed fresh meat, meat preparations and meat products. In future applications on meat-based foods, B. bacteriovorus could also minimise the use of additives

Halo effects on fusion cross section in 4,6He+64Zn collision around and below the Coulomb barrier

The structure of the halo nuclei is expected to influence the fusion mechanism at energies around and below the Coulomb barrier. Here new data of 4He+64Zn at sub-barrier energies are presented which cover the same energy region of previous measurements of 6He+64Zn. The fusion cross section was measured by using an activation technique where the radioactive evaporation residues produced in the reaction were identified by the X-ray emission which follows their electron capture decay. By comparing the two system, we observe an enhancement on the fusion cross section in the reaction induced by 6He, at energy below the Coulomb barrier. It is shown that this enhancement seems to be due to static properties of halo 2n 6He nucleus

Quasielastic backscattering and barrier distributions for the 6, 7Li + 64Zn systems

Excitation functions of quasielastic scattering at backward angles were measured for the weakly bound 6Li and 7Li projectiles on a 64Zn target at energies around the Coulomb barrier. The corresponding barrier distributions were derived from the experimental cross sections. The experimental data were analyzed within the coupled-channel model using a double-folding potential as the bare potential. Inelastic excitations of the target, the 7Li first excited state, and 6Li, 7Li resonant state(s), corresponding to sequential breakup, were included in the calculations. The comparison between the data and coupled-channel predictions shows that the effects of channels not included in the calculations, such as direct breakup and transfers, are much larger for 6Li than for 7Li