The effects of oral supplements with sambucus nigra, Zinc, Tyndallized Lactobacillus acidophilus (H122), Arabinogalactans, Vitamin D, vitamin E and Vitamin C in otitis media with effusion in children: a randomized controlled trial

– OBJECTIVE: To evaluate the ability of oral supplements with immune-stimulating molecules (Sambucus nigra, Zinc, Tyndallized Lactobacillus acidophilus (H122), Arabinogalactans, vitamin D, vitamin E and vitamin C) to reduce the inflammation of the upper airway tract and improve the outcome of otitis media with effusion (OME) in children. PATIENTS AND METHODS: Randomized controlled trial. One-hundred ninety-eight children (CI 95%: 12-96 months) were divided into four groups. Group 1 (48 subjects) received 10 ml of oral supplements (OS) with immune-stimulating molecules for three months (20 days consecutively, then 10 days of suspension – the therapeutic scheme was repeated three times); Group 2 (54 children) underwent treatment with 10 ml of OS for 90 consecutive days; Group 3 (48 subjects) received 15 ml of OS for 45 consecutive days; a control group (48 children) underwent the standard treatment for rhinitis and OME. Outcome measures included otoscopy, tympanometry, fibroendoscopy, and the pure tone audiometry (PTA) at T0 (before treatment), T1 (45 days after treatment), and T2 (90 days after treatment). RESULTS: All children treated with OS showed a reduction of Upper Airway Infection (UAI) episodes and OME compared to the control group independent of the administration method and posology. The three groups treated with OS showed statistically significant differences between T0 and T2 for otoscopy, tympanometry, fibroendoscopy, and PTA. In Group 2, the otoscopy and the tympanometry scores improved at T1. Group 2 and 3 had better PTA results than Group 1. CONCLUSIONS: OS with immune-stimulating molecules should be considered as a supporting therapy in children affected by recurrent episodes of UAI associated with OME due to their capacity to improve the immune response and reduce the inflammatory phenomena. OS can improve the fibroendoscopic findings by restoring middle ear ventilation, in addition to their ability to reduce inflammation in the middle ear

A night of sleep deprivation alters brain connectivity and affects specific executive functions

Sleep is a fundamental physiological process necessary for efficient cognitive functioning especially in relation to memory consolidation and executive functions, such as attentional and switching abilities. The lack of sleep strongly alters the connectivity of some resting-state networks, such as the default mode network and attentional network. In this study, by means of magnetoencephalography (MEG) and specifc cognitive tasks, we investigated how brain topology and cognitive functioning are affected by 24 h of sleep deprivation (SD). Thirty-two young men underwent resting-state MEG recording and evaluated in letter cancellation task (LCT) and task switching (TS) before and after SD. Results showed a worsening in the accuracy and speed of execution in the LCT and a reduction of reaction times in the TS, evidencing thus a worsening of attentional but not of switching abilities. Moreover, we observed that 24 h of SD induced large-scale rearrangements in the functional network. These findings evidence that 24 h of SD is able to alter brain connectivity and selectively affects cognitive domains which are under the control of different brain network

Role of oxidative stress in chronic otitis media with effusion in children

Chronic otitis media with effusion (OME) is a common pathologic condition characterized by nonpurulent fluid in the middle ear (ME) that leads to moderate conductive hearing loss and flat tympanogram. During OME inflammatory cells generate large amounts of superoxide radicals to improve bactericidal activity. Overproduction of oxygen-derived free radicals induces oxidative damage in humans. Glutathione (GSH) is one of the major components of the antioxidant system that protects cells from oxidative stress. The aim of the study was to evaluate oxidative stress in chronic OME by investigation of ME fluids collected during myringotomy.  During myringotomy, fluid was collected from the ME to evaluate lipid peroxide levels in the effusion. Immunohistochemical study was also performed to assess the anatomical features of tympanic membrane. Fifty-nine children with ME effusion without any resolution after repeated medical treatments were enrolled in the study.  No morphological significant changes were observed. Lipid peroxide levels in all samples were high (mean 11.5 nmole/million cells), similar to the values found in other chronic diseases. GSH might be employed during surgery while applying ventilation tubes and after surgery to prevent oxidative stress. The high oxidant levels in chronic OME observed in our research and the improvement seen in children after antioxidant treatment suggest that oxygen-derived free radicals play an important role in chronic OME.

Istituto tecnico a Conegliano

Casabella, Milan

Cell based therapeutic approach in vascular surgery: application and review

Multipotent stem cells - such as mesenchymal stem/stromal cells and stem cells derived from different sources like vascular wall are intensely studied to try to rapidly translate their discovered features from bench to bedside. Vascular wall resident stem cells recruitment, differentiation, survival, proliferation, growth factor production, and signaling pathways transduced were analyzed. We studied biological properties of vascular resident stem cells and explored the relationship from several factors as Matrix Metalloproteinases (MMPs) and regulations of biological, translational and clinical features of these cells. In this review we described a translational and clinical approach to Adult Vascular Wall Resident Multipotent Vascular Stem Cells (VW-SCs) and reported their involvement in alternative clinical approach as cells based therapy in vascular disease like arterial aneurysms or peripheral arterial obstructive disease

Hemophilia, how will end the story? [Emofilia, come si concluderà la storia?]

Hemophilia A (HA) and B (HB) are the most frequent inherited bleeding disorders caused by defects in the F8C and F9 genes that encode coagulation factor VIII and factor IX, respectively. Both HA and HB are X-linked recessive diseases and have an incidence of 1:5000 and 1:30,000 males, respectively. The diagnosis is based on normal prothrombin time, altered activated partial thromboplastin time and reduced activity of factor VIII or factor IX in plasma. Furthermore, laboratory contributes to identify the inhibitor (an immunoglobulin against the factor that some hemophilic patients develop during therapy) and to reveal acquired hemophilia. Carrier females of HA and HB are tipically asymptomatic and can be identified only by molecular analysis; their evaluation is important, as one third of cases of hemophilia is due to novel mutations and in these cases the mother (and consanguineous females) of the proband have no risk to be carrier. Both diseases are due to a myriad of different mutations (mostly private), so that the molecular diagnosis is based on scanning techniques or gene sequencing. Given the number of hemophilic patients that experience severe perinatal complications, high-risk couples usually require prenatal diagnosis. We revise here our experience on 50 prenatal diagnoses of hemophilia. The clinical heterogeneity of hemophilic patients prompted many groups to study prothrombotic gene variants in these subjects to investigate whether such variants modify the clinical expression of disease. Finally, therapy (using recombinant factors) and, in a near future, gene therapy will change the natural history of hemophilic patients