Modulating the skin mycobiome-bacteriome and treating seborrheic dermatitis with a probiotic-enriched oily suspension

Seborrheic dermatitis (SD) affects 2-5% of the global population, with imbalances in the skin microbiome implicated in its development. This study assessed the impact of an oily suspension containing Lactobacillus crispatus P17631 and Lacticaseibacillus paracasei I1688 (termed EUTOPLAC) on SD symptoms and the skin mycobiome-bacteriome modulation. 25 SD patients were treated with EUTOPLAC for a week. Symptom severity and skin mycobiome-bacteriome changes were measured at the start of the treatment (T0), after seven days (T8), and three weeks post-treatment (T28). Results indicated symptom improvement post-EUTOPLAC, with notable reductions in the Malassezia genus. Concurrently, bacterial shifts were observed, including a decrease in Staphylococcus and an increase in Lactobacillus and Lacticaseibacillus. Network analysis highlighted post-EUTOPLAC instability in fungal and bacterial interactions, with increased negative correlations between Malassezia and Lactobacillus and Lacticaseibacillus genera. The study suggests EUTOPLAC's potential as a targeted SD treatment, reducing symptoms and modulating the mycobiome-bacteriome composition.

Acinetobacter baumannii in the critically ill: complex infections get complicated

Acinetobacter baumannii is increasingly associated with various epidemics, representing a serious concern due to the broad level of antimicrobial resistance and clinical manifestations. During the last decades, A. baumannii has emerged as a major pathogen in vulnerable and critically ill patients. Bacteremia, pneumonia, urinary tract, and skin and soft tissue infections are the most common presentations of A. baumannii, with attributable mortality rates approaching 35%. Carbapenems have been considered the first choice to treat A. baumannii infections. However, due to the widespread prevalence of carbapenem-resistant A. baumannii (CRAB), colistin represents the main therapeutic option, while the role of the new siderophore cephalosporin cefiderocol still needs to be ascertained. Furthermore, high clinical failure rates have been reported for colistin monotherapy when used to treat CRAB infections. Thus, the most effective antibiotic combination remains disputed. In addition to its ability to develop antibiotic resistance, A. baumannii is also known to form biofilm on medical devices, including central venous catheters or endotracheal tubes. Thus, the worrisome spread of biofilm-producing strains in multidrug-resistant populations of A. baumannii poses a significant treatment challenge. This review provides an updated account of antimicrobial resistance patterns and biofilm-mediated tolerance in A. baumannii infections with a special focus on fragile and critically ill patients.

[Multinodular goiter as an organ disease: study of continual nodulogenesis. Biological bases indicating total thyroidectomy]

Multinodular goitre is a very common pathology among people especially female adult and represents more than 90% of the thyroid surgery. We analyzed 37 patients, demonstrating that the whole gland is progressively affected by an incessant nodulogenesis and we confirm the necessity of total thyroidectomy in order to eliminate any persistent pathology.

CD44v6 and Nm23-H1 protein expression related to clinico pathological parameters in colorectal cancer

OBJECTIVE

Nm23-H1 and CD44v6 expression has been shown to be correlated with the metastatic potential of colorectal cancer (CRC) in some studies but not in others. The present study was undertaken to evaluate immunohistochemically the expression of these markers and to correlate them with clinicopathological variables.

MATERIALS AND METHODS

Archival tissues of 41 non metastatic colorectal cancers were histopathologically evaluated and stained with monoclonal antibodies versus Nm23-H1 and CD44v6.

RESULTS

Expression of Nm23-H1 was detected in 73% (n = 30) of all CRC, and CD44v6 in 37% (n = 15) of all CRC. CD44v6 was found to be statistically associated with tumour grading differentiation (p < 0.03), but no correlation emerged between Nm23-H1 and CD44v6 and Dukes stage, site, peritumoral lymphocytic infiltration, venous infiltrating, perineural infiltrating, tumour budding, pushing and infiltrating tumour growth.

CONCLUSION

Even if the results are not statistically significant, the authors noticed that the expression of Nm23-H1 was correlated with those histopathological parameters that indicate local disease progression and metastases.

[Breast carcinoma with neuroendocrine differentiation. Clinical case and review of the literature]

Female breast carcinoma with neuroendocrine differentiation is a lesion which can enhance of conventional therapy added with tamoxifene-octreotide association. The Authors report a case completely responsive after two years therapy, which grading was: pT4, N1biii, Mx, G2 staging III.

[Study of the facial nerve in parotid surgery]

The Authors, basing on cadaveric dissections and 40 parotidectomies performed, accurately describe relations between facial nerve and surrounding tissues in its extracranial tract, with particular reference to parotid surgery. They underline Schwalbe's apophysis as the sole safe and constant anatomic landmark in the dissection of the facial nerve trunk.

[Chronic periaortitis]

The authors, o the basis of a retrospective analysis of a series of 13 cases of chronic periaortitis, after a review of the literature about the subject, discuss about the most recent theories about pathogenesis, pathological anatomy, diagnosis and treatment of this condition. At first the authors stress the importance of adopting the term chronic periaortitis to describe any idiopathic fibrotic retroperitoneal process, as a consequence of the well established relationship between the atherosclerotic abdominal aorta an the development of this condition. Histological, immunohistochemical and immunological studies, consented to clarify the pathogenesis o the lesion. CT or MRI currently makes the diagnosis but histological confirmation is desiderable. Surgical therapy plays still a fundamental role in the management of chronic periaortitis, but the use of immunosuppressive drugs is to be considered extremely promising.

Preservation and peeling of the inferior mesenteric artery in the anterior resection for complicated diverticular disease

The authors, on the basis of 3 cases of complicated diverticular disease, discuss the indications to surgery, considering the advantages and disadvantages of the various surgical techniques and examining in particular the rules for a correct operation with resection and primary or secondary anastomosis. As they performed a rectosigmoidectomy with primary high colorectal anastomosis, they report the reasons why they adopted the preservation and peeling of the inferior mesenteric artery (IMA).

[Ambulatory surgery of varices: our experience]

The Authors, on the basis of their experience with 196 patients aged from 18 to 45, affected by relapsing varicose veins, stress the advantages of the outpatient treatment according to Muller's technique. For these lesions excellent aesthetic and functional results, easy surgical technique, low incidence of complications, prompt resumption to work were registered.

[Role of total thyroidectomy in benign multinodular benign goiter]

The Authors report a review of the Literature and their personal series to evaluate the role of total thyroidectomy in the surgical management of non-toxic multinodular goiter. On the basis of the data obtained, the Authors consider total thyroidectomy the therapy of choice for this pathology.

[Gardner syndrome: diagnostic, clinical and genetic questions in the light of 2 case reports]

The authors on the base of two cases of Gardner's syndrome recently observed, proceed to a wide review of literature on this subject so as to stress the peculiar aspects of this syndrome, so complex and uncommon. The greatest emphasis is given to the role of genetics as regarding to diagnosis and screening programs, as well as to the more recent acquisitions about diagnosis, therapy and follow up of risk lesions, such as colorectal and duodenal adenomas, as well as of intrabdominal desmoid tumours, which, although not histologically malignant, may often influence prognosis negatively, because of their remarkable local invasiveness and tendency to recurrence.

[Subtotal colectomy with ceco-rectal anastomosis]

A case of subtotal colectomy cecoproctostomy for multiple lesions of the colon is introduced. This procedure has advantages over ileoproctostomy because it spares the terminal ileum, ileocecal junction and cecum. Due to the high incidence of bowel movements after the ileoproctostomy operation, the authors recommend cecoproctostomy as a valid choice in a selectioned group of patients with multiple or extended lesions that spares cecum and rectum.

[A case of ileocecocolic intussusception from cecal carcinoma]

The authors present a case of ileocecocolic intussusception by carcinoma of the caecum. They stress the most peculiar aspects of this condition: rare etiology; complete invagination of caecum appendix and ileum; typical clinical presentation characterized by variable dimensions of the mass and symptoms not ascribing to occlusion, no lesions at endoscopy; evidence of a typical "target mass" visualized at T.C.

[Squamous carcinoma of the anal canal and its variations. Personal experience and review of the literature]

Six cases of anal canal squamous carcinoma are presented. The authors precise the present view about pathological, epidemiological, clinical and therapeutical aspects of these lesions. They stress, also, the primary role of embryology and anatomy in the oncogenesis of such tumours; the importance to single out specific population at risk, absolutely different from the typical one for rectal adenocarcinoma and the role of chemoradiation therapy as treatment of choice of these neoplasms. Particular importance is given to modern histologic and histogenetic classification of these tumours, stressing the difficulties to distinguish the various histologic types.

[Perianal Paget's disease: clinical observation and review of the literature]

The authors present a case of PPD, stressing the importance to distinguish "true" PPD from pagetoid spread, for correct diagnosis and appropriate treatment. This distinction is possible by using immunohistochemical stains, with particular regarding Ab-GCDFP-15, considered specific marker for Paget's cell.

[Anorectal neuroendocrine carcinoma: observations on a case and review of the literature]

Carcinoid tumours of the anorectum are rare (0.7% of malignant rectal tumours). Because of this rarity several aspects of the management of these tumours remain controversial. Diagnosis may be delayed because of failure to recognize their morphological characteristics and histological appearance may not reflect their biological behaviour. Immunocytochemistry for neuroendocrine-cells are essential to identify different types of carcinoid tumours and to do differential diagnosis from other malignant tumours. All that allow an exact therapeutic approach to these tumours. The tumours less than cm 1 in diameter can be safely treated by local excision; the tumours more than cm 1 in diameter are treated by radical surgery (AAP).

[Ovarian endometriosis involving the intestine with "ab ++estrinseco" stenosis of the sigmoid]

The Authors report a case of ovarian endometriosis causing an "Ab extrinseco" sigmoid stenosis. The histogenesis as well as different possibilities of treatment, i.e. medical and surgical, are discussed.

[The colorectal adenoma-carcinoma sequence: the limits between polypectomy and intestinal resection]

According to a clinic case, the authors pointed out the role of histological diagnosis in the therapeutic approach of large intestinal adenomas. In order to identify those lesions which can metastasize, having exceeded the muscularis mucosae and having invaded the submucosa, rigorous histological standards must be performed. Intestinal resection versus polypectomy is determined only according to the involvement or not of the muscularis mucosae.

[Posttraumatic pseudoaneurysms of the anterior tibial artery: a review of the literature and a clinical case report]

The authors after a review of the literature report a case of anterior tibial artery false aneurysm in a seventeen year old male, due to traumatic sprained ankle during a basketball match. Surgical techniques used in repairing the lesion as well as microsurgical technique for the direct suture of the artery, which allowed to resolve the problem, are discussed.

[Juvenile vascular pathology due to homocystinuria. A clinical case report]

The authors report a case of juvenile vasculopathy in a homocystinuria patient. They point out that thromboembolism may be the only symptomatic expression of this genetically determined metabolic disease. Diagnostic approach and surgical therapy of the vascular lesions as well as medical therapy to prevent further complications are analysed. The opportunity to perform clinical tests for the diagnosis of homocystinuria in all those young patients presenting vascular lesions without other risk factors is finally stressed.

[Intermuscular and intramuscular lipomas of the neck]

Two cases of deep lipomas of the neck developed between the skeletal muscles were presented: one intermuscular and the other intramuscular. Taking into consideration the rarity of the case, the authors examined the clinical surgical aspect, paying special attention to the relationship between sonographic and computerized tomographic characteristics and the histological aspects in order to define whether the lipomatous tumors were benign or malignant. They also studied the localization of cervical lipomas, of lipoblastomas of hibernomas and of liposarcomas and defined an anatomo-clinical classification of both superficial and deep cervical lipomas.

[Ultrasonography and the kidney: a screening method?]

The Authors retrospectively analyzed 733 hepatic U.S. involving non symptomatic urologic patients. The study detected 23 renal cysts, 3 lithiasis (with associated hydronephrosis in two) and 3 kidney neoplasms. It is concluded that U.S. represents a reliable and useful screening method for renal carcinoma, therefore it should be routinely adopted.