An uncommon cause of well-known symptoms: acute abdomen in a 2-year-old boy with intestinal malrotation. Case report and literature review

Midgut malrotation is the most frequent congenital defect of the small intestine. The clinical manifestationcan vary from being asymptomatic to presenting acutely as volvulus with bilious vomiting.Presented here is a case of a 32-months-old boy with abdominal pain and several emetic episodes beforeadmission. The patient was diagnosed with ileus and needed emergency surgery which showed thepresence of volvulus due to malrotation of the midgut. Extensive partial resections of the jejunum, ileumand colon beginning in the upper part of the rectum up to ascending colon were performed.Intestinal malrotation is rarely a symptomatic abnormality, however, when it occurs severely it can resultin life-threatening complications. Ultrasonography may be a helpful screening tool for early diagnosis,but it needs the experience of the doctor. Treating significant malrotation almost always requires surgery.The timing and urgency depend on the child’s condition

Alcoholic Cardiomyopathy: a summary of current knowledge and possible future directions

Introduction and purpose:  Ethanol is still one of the most frequently consumed drugs worldwide and is a strong risk factor for more than 60 illnesses including alcoholic cardiomyopathy which is a specific heart muscle disease caused by long-term excessive alcohol consumption. The review aims to gather available data and summarize it to give better understanding of the disease, to help select patients with the condition to implement proper treatment, and to present possible future directions as the incidence of the disease is projected to persist in the future.  Brief description of the state of knowledge:  Alcoholic cardiomyopathy (ACM) is characterized by dilation, increased mass of the left ventricle, and reduced ejection fraction leading to end-stage heart failure. It is caused by ethanol’s direct toxicity on myocytes disturbing many different metabolic pathways. The result is a decrease in both systolic and diastolic function of the heart. The ACM development depends on factors such as genetics, gender, dietary factors and the dosage of ethanol consumption. The goal of the treatment is total alcohol abstinence, but  the reduction of ethanol intake may also be beneficial. Patients  should obtain a complete pharmacological treatment for heart failure. Summary: Ethanol overconsumption remains an unresolved problem, with the incidence of ACM projected to persist in the future, especially among patients with alcohol use disorder (AUD). Efforts for prevention, early detection, and effective treatment of ACM need to be established. A primary focus should be on treating AUD because it is the most effective way to halt the progression of the disease. Further research should focus on both asymptomatic and symptomatic patients with AUD to better define clinical manifestations, diagnostic approaches, and the most effective treatments for ACM

Cystatin C peptidomimetic derivative with antimicrobial properties as a potential compound against wound infections

A peptidomimetic called A20 (Cystapep 1) structurally based upon the N-terminal fragment of human cystatin C is known to have strong antibacterial properties. A20 is characterized by high activity against several bacterial strains often isolated from infected wounds, including methicillin-resistant S. aureus (MRSA). In this work we wanted to explore the therapeutic potential of A20 in the treatment of wound infections. We examined, cytotoxicity, allergenicity and impact of A20 on the proliferation and viability of human keratinocytes. Furthermore, the previously described antimicrobial action of A20. has been confirmed here with reference strains of bacteria and extended by several other species. The A20 was highly active against Gram-positive bacteria with minimal inhibitory (MIC) and minimal bactericidal concentrations (MBC) between 8 and 128. μg/mL. A20 did not affect proliferation of primary human keratinocytes in concentrations up to 50. μg/mL. At the same time, it did not activate Peripheral Blood Mononuclear Cells (PBMCs), including basophils or neutrophils in vitro. Interestingly A20 was found to display immunomodulatory functions as it influences the production of Th2 cytokines (IL-4 and IL-13) by activated PBMCs. It was also resistant to degradation for at least 48. h in human plasma. The results indicate that A20 is effective against the multiantibiotic-resistant bacteria and has a high safety profile, which makes it a promising antimicrobial drug candidate