Exploring the Effect of the Composition of Three Different Oregano Essential Oils on the Growth of Multidrug-Resistant Cystic Fibrosis Pseudomonas aeruginosa Strains

Oregano essential oils (EOs) could represent interesting therapeutic strategies to treat multidrug-resistant (MDR) pathogens as Pseudomonas aeruginosa, responsible for respiratory infections in cystic fibrosis (CF) patients. There could be a great variability in EOs composition when extracted from different plant species. The aim of this study was to chemically characterize and to test EOs, extracted from Origanum compactum, Origanum vulgare and Origanum vulgare var. hirtum, for in vitro antimicrobial activity against a panel of twenty MDR P. aeruginosa strains isolated from CF patients. EOs main components were carvacrol (71.8-73.8-47.1%), thymol (1.6-2.3-21.5%), p-cymene (11.6-7.4-10.8%) and γ-terpinene (1.7-3.1-8.4%). In general, the EOs showed inhibitory activity even at low concentration: 0.5% (v/v) OvEO and OhEO were able to inhibit the 80% of P. aeruginosa strains. Furthermore, the three EOs killed at least 75% of the strains at concentrations lower than 1% (v/v). Average MIC and MBC values were not significantly different. Similar levels of OEOs antimicrobial activities might be related to the fact that the main chemical class (i.e. carvacrol/thymol) is represented in quite similar percentages. Hence, the results of the present study shed light on a carvacrol/thymol-rich EO with a well-represented monoterpene hydrocarbons class as promising standardized antimicrobial herbal product.

Realization of a high voltage generator by series connection of floating modules

A high voltage generator built by a series connection of 100 kV modules was produced. The series connection feasibility is ensured by the inherent floating character of each module which is wireless powered by high efficiency photovoltaic cells illuminated by a laser system. Each module is equipped with a control and monitoring board allowing excellent stabilization of the high voltage output. The performance of the system in terms of reliability, stability, and efficiency was evaluated. In particular using a three module setup, we achieved a maximum voltage of 234 kV with stability better than 0.1%.

Essential Oil from Origanum vulgare Completely Inhibits the Growth of Multidrug-Resistant Cystic Fibrosis Pathogens

Essential oils (EOs) are known to inhibit the growth of a wide range of microorganisms. Particularly interesting is the possible use of EOs to treat multidrug-resistant cystic fibrosis (CF) pathogens. We tested the essential oil (EO) from Origanum vulgare for in vitro antimicrobial activity, against three of the major human opportunistic pathogens responsible for respiratory infections in CF patients; these are methicillin-resistant Staphylococcus aureus, Stenotrophomonas maltophilia and Achromobacter xylosoxidans. Antibiotic susceptibility of each strain was previously tested by the standard disk diffusion method. Most strains were resistant to multiple antibiotics and could be defined as multi-drug-resistant (MDR). The antibacterial activity of O. vulgare EO (OEO) against a panel of 59 bacterial strains was evaluated, with MIC and MBC determined at 24, 48 and 72 hours by a microdilution method. The OEO was effective against all tested strains, although to a different extent. The MBC and MIC of OEO for S. aureus strains were either lower or equal to 0.50%, v/v, for A. xylosoxidans strains were lower or equal to 1% and 0.50%, v/v, respectively; and for S. maltophilia strains were lower or equal to 0.25%, v/v. The results from this study suggest that OEO might exert a role as an antimicrobial in the treatment of CF infections.

Essential Oil from Origanum vulgare Completely Inhibits the Growth of Multidrug-Resistant Cystic Fibrosis Pathogens

Essential oils (EOs) are known to inhibit the growth of a wide range of microorganisms. Particularly interesting is the possible use of EOs to treat multidrug-resistant cystic fibrosis (CF) pathogens. We tested the essential oil (EO) from Origanum vulgare for in vitro antimicrobial activity, against three of the major human opportunistic pathogens responsible for respiratory infections in CF patients; these are methicillin-resistant Staphylococcus aureus, Stenotrophomonas maltophilia and Achromobacter xylosoxidans. Antibiotic susceptibility of each strain was previously tested by the standard disk diffusion method. Most strains were resistant to multiple antibiotics and could be defined as multi-drug-resistant (MDR). The antibacterial activity of O. vulgare EO (OEO) against a panel of 59 bacterial strains was evaluated, with MIC and MBC determined at 24, 48 and 72 hours by a microdilution method. The OEO was effective against all tested strains, although to a different extent. The MBC and MIC of OEO for S. aureus strains were either lower or equal to 0.50%, v/v, for A. xylosoxidans strains were lower or equal to 1% and 0.50%, v/v, respectively; and for S. maltophilia strains were lower or equal to 0.25%, v/v. The results from this study suggest that OEO might exert a role as an antimicrobial in the treatment of CF infections.

Mycotic and aflatoxin contamination in Myristica fragrans seeds (nutmeg) and Capsicum annum (chilli), packaged in Italy and commercialized worldwide

Aflatoxins are secondary metabolites of moulds known to be carcinogenic for humans, and therefore should not be ingested in high doses. This study aimed to determine the level of mould and aflatoxin contamination in dehydrated chilli and nutmeg imported from India and Indonesia, respectively, packaged in Italy, and commercialized worldwide. We tested 63 samples of chilli (22 sanitized through heat treatment and 41 not heat-treated) and 52 samples of nutmeg (22 heat-treated and 30 not heat-treated) for aflatoxin, moulds and moisture content. Heat-treated samples were less contaminated than untreated samples. Spices in powder form (both chilli and nutmeg) were more contaminated than whole ones. In untreated spices, we observed a positive correlation between mould and moisture content. Of the powdered nutmeg and chilli samples, 72.5% and 50% tested positive for aflatoxin contamination, with a range of 0-17.2 μg kg(-1) and 0-10.3 μg kg(-1), respectively. The steam treatment of spices would be useful in reducing the initial amount of moulds. Although the risk from the consumption of spices contaminated with aflatoxins is minimal, owing to the small amount used in food, preventive screening of the whole food chain is very important, especially because the most frequently identified toxin was B1, which is the most dangerous of the four toxins (B1, B2, G1, G2).

Occurrence of Acrylamide in breakfast cereals and biscuits available in Italy

INTRODUCTION

Acrylamide, produced during thermal processing of carbohydrate-rich foods, is classified as "probably carcinogenic to humans" by the International Agency for Research on Cancer.

OBJECTIVE

The aim of this study was to determine acrylamide levels in biscuits and breakfast cereals considering the widespread use of these products for all ages.

METHOD

Acrylamide determination was carried out in 56 samples by HPLC-UV technique.

RESULTS AND DISCUSSION

The results showed a considerable variability in the contents of acrylamide in the samples analysed, most likely due to differences in industrial processing and ingredients. The percentages of contaminated samples tested were very high (95.5% of the biscuits and 75% of the breakfast cereals) with a wide range of contamination: from 30 μg/kg to 940 μg/kg. Our results showed that 22.7% of biscuits and 33% of breakfast cereals exceeded the indicative values recommended by EC 2013/647 set at 500 μg/kg and 200-400 μg/kg (according to the composition) respectively.

CONCLUSIONS

Our findings suggest concern about the risk for human health.

Sero-epidemiology of hepatitis B markers in the population of Tuscany, Central Italy, 20 years after the implementation of universal vaccination

Italy was one of the first industrialized countries to introduce a program of universal vaccination against hepatitis B in 1991. Twenty years later we verified the impact of universal immunisation on the epidemiology of hepatitis B infection by analyzing the prevalence of specific viral markers (anti-HBs, anti-HBc and HBsAg). The ELISA tests were performed on residual blood samples collected by 0.05% of the resident population aged 1-50 years in Tuscany (Italy). About 63% of subjects aged < 30 years were anti-HBs positive compared to about 25% in older subjects, without differences between genders. About 22% of subjects over 40 years were anti-HBc-positive compared to 5% in the younger age groups. The number of HBsAg-positive subjects was almost 10 fold higher in the unvaccinated age groups than in the cohorts involved in the universal vaccination program. The results of our study show the persisting high anti-HBs reactivity in vaccinated cohorts, while HBV markers related to natural exposure or persistent infection remain remarkably higher in older age groups. This sero-epidemiological study supports with prevalence data the downward incidence trend of acute hepatitis B highlighted by epidemiological surveillance systems, and corroborates the forecast for elimination of hepatitis B in Italy in a few decades.

Progress towards measles and rubella elimination in Tuscany, Italy: the role of population seroepidemiological profile

BACKGROUND

As a part of the National Plan for Measles and Congenital Rubella Elimination, a catch-up campaign targeting children aged 7-14 years with Measles-Mumps-Rubella (MMR) vaccine was conducted during 2004-05 in Tuscany, Central Italy.

METHODS

To assess the profile of measles and rubella susceptibility, immunoglobulin G antibodies against measles (945 subjects) and rubella (1110 subjects) were detected using two commercial enzyme-linked immunosorbent assay tests in sera from a population aged 1-49 years.

RESULTS

Overall immunity towards measles increased in the last years, but the WHO-Euro recommended threshold of susceptibility for elimination was attained only in 2- to 4-year-olds. All fertile women up to 29 years had rates of susceptibility clearly higher than those required by WHO-Euro (5%) to eliminate congenital rubella. Despite the reduction of susceptibility among subjects targeted by the catch-up campaign, continuous efforts to increase immunization coverage are needed to eliminate measles and rubella circulation. Our results are predictive of a high chance of measles and rubella outbreaks because of the accumulation of susceptible individuals.

CONCLUSION

Additional catch-up vaccination strategies targeting the adult population (particularly fertile women) are strongly needed to eliminate the risk of measles and congenital rubella syndrome for future generations.

Hofmeister effects in supramolecular and biological systems

Specific ion effects, representative of near-universal Hofmeister phenomena, are illustrated in three different systems. These are the formation of supramolecular assemblies from cyclodextrins, the optical rotation of L-serine, and the growth rate of two kinds of microorganisms (Staphylococcus aureus and Pseudomonas aeruginosa). The strong specific ion effects can be correlated with the anion polarizabilities and related physico-chemical parameters. The results show the relevance of dispersion (non-electrostatic) forces in these phenomena.

Primary Hepatitis A vaccination failure is a rare although possible event: results of a retrospective study

A case of Hepatitis A occurred in a traveller in spite of a complete course of immunization with a combined HAV and HBV vaccine [Taliani G, Sbaragli S, Bartoloni A, Santini MG, Tozzi A, Paradisi F. Hepatitis A vaccine failure: how to treat the threat. Vaccine 2003;21(31):4505-6]. A retrospective study was performed to evaluate whether the failure was primary or could be attributed to a specific lot of vaccine or to its inadequate handling and/or storage. Two distinct populations of vaccinees were selected in a 1:2 proportion. The case group (N=31) included subjects who were vaccinated in the same period and with the same lot and batch of vaccine as the case. The control group (N=62) included subjects who received different lot and batch of the same vaccine as the case group. A persisting antibody response to HAV vaccine was found among all subjects (anti-HAV >20mIU/ml). The overall anti-HBs seropositivity rate (anti-HBs >10mIU/ml) was 74%, without significant difference between the case (77%) and the control group (73%; P>0.05). The reported Hepatitis A case can be attributed to a rare primary vaccine failure rather than to inefficacy of a specific lot of vaccine or to inappropriate vaccine handling or storage. Our study supports the indications for use of combined Hepatitis A+B immunization in travellers at risk for both infections, but stresses the need for information on correct hygienic behaviours while abroad.

Specific ion effects on the growth rates ofStaphylococcus aureusandPseudomonas aeruginosa

Motivated by recent advances in the physical and chemical basis of the Hofmeister effect, we measured the rate cell growth of S. aureus--a halophilic pathogenic bacterium--and of P. aeruginosa, an opportunistic pathogen, in the presence of different aqueous salt solutions at different concentrations (0.2, 0.6 and 0.9 M). Microorganism growth rates depend strongly on the kind of anion in the growth medium. In the case of S. aureus, chloride provides a favorable growth medium, while both kosmotropes (water structure makers) and chaotropes (water structure breakers) reduce the microorganism growth. In the case of P. aeruginosa, all ions affect adversely the bacterial survival. In both cases, the trends parallel the specific ion, or Hofmeister, sequences observed in a wide range of physico-chemical systems. The correspondence with specific ion effect obtained in other studies, on the activities of a DNA restriction enzyme, of horseradish peroxidase, and of Lipase A (Aspergillus niger) is particularly striking. This work provides compelling evidence for Hofmeister effects, physical chemistry in action, in these organisms.

Impact of universal vaccination programmes on the epidemiology of hepatitis B: 10 years of experience in Italy

Ten years have elapsed since routine vaccination of infants and of 12-year-old adolescent was implemented in Italy. In this period, evidence has accumulated on the epidemiological impact of universal immunisation. Coverage is on average >90% and is >or=95% in many areas of the country. Incidence of acute hepatitis B, that was already declining before 1991, was further decreased by routine vaccination programmes. This is particularly evident in adolescents and young adults (cohorts involved by mandatory vaccination), while incidence shows little changes in older subjects according to data of the last years. Prevalence of hepatitis B virus (HBV) markers detected by sero-epidemiological studies on anonymous sera confirms both the very high coverage with hepatitis B vaccination and the virtual absence of chronic HBsAg carriers in cohorts involved by routine vaccination programmes. The system of passive surveillance on adverse events following hepatitis B vaccination supports the excellent safety record of hepatitis B vaccines. In a hyperendemic area of Southern Italy, where a pilot programme was firstly implemented, it was also possible to document the decline of the involvement of hepatitis B in chronic liver pathologies (from 48% in 1982 to 18% in 1997). If coverage rates are maintained at the present levels, elimination of HBV transmission in Italy may be envisaged in few decades.

Human polyomavirus BK (BKV) load and haemorrhagic cystitis in bone marrow transplantation patients

Several observations suggest an association between long-lasting haemorrhagic cystitis (HC) in bone marrow transplantation (BMT) recipients and human polyomavirus BK (BKV) reactivation, but no conclusive evidence has been obtained so far. The amount of BKV measured in the urine of BMT patients during an episode of HC was compared with that detected in the urine of BMT patients without HC and of immunocompetent individuals in order to better assess the association of BKV reactivation with HC. For this purpose a quantitative competitive PCR was developed. The application of this assay to clinical samples allowed us to distinguish asymptomatic reactivation both in healthy individuals and in immunocompromised patients from reactivation associated with HC, in almost all cases. Low levels, below the sensitivity of the quantitative assay, were shown in asymptomatic healthy individuals and in about 50% of immunocompromised patients. A significantly higher viral load than in the urine of asymptomatic immunocompromised patients was detected in the urine of patients with HC. These data strengthen the hypothesis that BKV reactivation can cause, together with other factors, the majority of late HC in BMT recipients as well as in patients treated for acute refractory lymphoblastic leukemia.

Italian experience of voice restoration after laryngectomy with tracheoesophageal puncture

This report concerns 102 cases of tracheoesophageal puncture performed as a means of secondary voice restoration after total laryngectomy, in 70 patients proving unable to learn esophageal speech and as a treatment of choice in a further 32 cases. Complications arose in 21 cases but were generally minor and could be overcome. Results were favorable in 45 of 70 and 29 of 32 cases, respectively. The method was considered effective, particularly when supported by the patient's determination to learn a verbal communication method.

Implantation of parotid pleomorphic adenoma in the upper neck

This paper presents a case of pleomorphic adenoma from an abnormal site in the right upper neck in a patient surgically treated 4 years previously for pleomorphic adenoma of the right parotid gland. The lack of normal salivary tissue in the neck growth oriented us towards a diagnosis of implantation tumor, resulting from surgery of the parotid mass, rather than towards one of heterotopic tumor. The literature concerning salivary heterotopias and salivary tumors arising from heterotopic foci is also reviewed.

Metastasis to the larynx revealing a renal cell carcinoma

A rare case of laryngeal metastasis as the first sign of an unrecognized renal cell carcinoma, occurring in a 73-year-old man, is reported. The clinical picture, pathology, diagnosis, differential diagnosis and prognosis are discussed.

Recurrent life-threatening epistaxis in a child with Bernard-Soulier syndrome controlled by bilateral ligation of external carotids and ethmoidal arteries

Bilateral ligation of external carotids and ethmoidal arteries proved successful in controlling severe recurring epistaxis in a 13-year-old patient with Bernard-Soulier syndrome. In this child, epistaxis was the major bleeding symptom. Despite massive substitutive therapy, the patient suffered several life-threatening episodes of hypovolaemic shock. Although epistaxis is not reported as a cause of death in patients with haemostasis defect, our case might suggest that in selected cases with inherited platelet defect and intractable epistaxis so severe as to make normal or near-normal life impossible, surgical treatment could be considered.

Leishmaniasis donovani presenting as an isolated lesion in the larynx

A case of leishmaniasis of the larynx caused by Leishmania donovani occurring in a 42-year-old man is reported. The oral cavity and the upper respiratory tract are commonly involved in mucocutaneous American leishmaniasis, but are less frequently reported in the 'Old World'. The primary and isolated location in the larynx is exceptional. The immunoperoxidase technique using antisera to anti-L. donovani is a useful method to identify the parasite.

Long-term survival in response to combined chemotherapy and radiotherapy in laryngeal small cell carcinoma

Fourteen patients with small cell carcinoma of the larynx are studied. This represents the largest series, from a single institution, reported in the literature. This neoplasm is usually highly aggressive and the prognosis very poor, but, in our experience, combined chemo- and radiotherapy can significantly improve the clinical course of the disease. Three of six patients who received this combined modality treatment are still clinically disease-free more than six years after the initial diagnosis.

Radical excision of a craniobasal tumor involving the middle cranial fossa. Technical note

Craniobasal tumors affecting the middle cranial fossa are rarely treated radically; the main problem to solve is the presence of important nervous and vascular structures in this region. The Authors report a case of complete removal of a malignant tumor involving the temporal bone and the middle cranial fossa. Surgery was performed by the cooperation of the neurosurgical and the ENT teams.

Assessment and treatment of neurogenic and non-neurogenic tumors of the parapharyngeal space

The clinical and pathologic findings in eleven cases of parapharyngeal space tumors are described. The anatomy of this area and diagnostic procedures are discussed. Investigations should include a few basic examinations such as sialogram-computed tomographic (CT) scan, carotid angiogram, and echography. Several surgical approaches are considered in relation to the site and the size of the neoplasm. Prognosis depends on the histologic type of the tumor.

Primary clear cell carcinoma of the larynx

The clinical and pathological findings in three patients with clear cell carcinoma of the larynx are described. This type of neoplasm in the larynx is extremely rare. The aggressiveness of the tumour and its high biological malignancy are stressed.

Benign solitary schwannoma of the cervical vagus nerve. A case report with a review of the literature

A case of benign solitary schwannoma of the cervical vagus nerve occurring in a 12-year-old girl is reported. Clinical and pathological problems connected with the neoplasm are discussed. From a review of the literature, the lesion seems to be less rare than is commonly believed. Treatment is also discussed, including the possibility of a surgical procedure which allows the restoration of function in the vagus nerve.

Benign mixed tumour of heterotopic salivary gland tissue in upper neck. Report of a case with a review of the literature on heterotopic salivary gland tissue

A case of benign mixed tumour arising in ectopic salivary gland tissue of the mucous type is described. The tumour was located at the angle of the right mandible, in the upper middle third of the neck, along the anterior border of the sternomastoid muscle. This observation is substantiated by a pathomorphological study. A comprehensive review of the world literature on heteroptic salivary gland tissue has also been carried out, together with a search of the possible pathogenesis which seems to be connected with an anomalous embryonic development within the branchial apparatus.