Cilostazol reduces dry eye symptoms and improve walking distance in patients with peripheral artery disease

AIM OF THE STUDY

Cilostazol is a phosphodiesterase III inhibitor that has anti-inflammatory and immunomodulatory effects and can act with beneficial effect in Dry Eye Syndrome (DES). This clinical trial evaluates the effects of cilostazol on the tear film.

MATERIALS AND METHODS

Following the run-in period, subjects were randomly into two groups: 40 subjects treated with cilostazol and 40 no-treated subjects. The Walking Impairment Questionnaire (WIQ) has been administered to all patients.

RESULT

The data obtained from comparison of the two study groups A and B were, respectively, the following: Schirmer I: 10.2±0.2 Vs 13.8±0.4 (p< 0.001); Schirmer II: 3.8±0.1 Vs 4.6±0.2 (p<0.001); Break-up time (BUT) 4.2±0.3 Vs 6.5±0.2 (p<0.001) with disappearing of symptoms. The WIQ showed a significant difference in the walking distance (p<0.05) and calf pain severity (p<0.005) of treated patients. In comparison with the placebo group, treated patients showed an improvement (p<0.03) in calf pain severity.

CONCLUSION

The administration of cilostazol was effective, in reducing DES and improve walking distance questionnaire.

Microbiological Etiology of Chronic Skin Lesions in Type 2 Diabetic Subjects

INTRODUCTION

Skin lesions represent lesions that result in loss of tissues and their joints and often this cutaneous process is a primary or secondary consequence of structural changes in the same skin surface. Type 2 diabetic subjects developing chronic skin lesions in the lower limbs in the western world are steadily increasing. We conducted a study on the etiologic incidence of chronic skin lesions in type II diabetic subjects in the lower limbs compared to subjects with chronic skin lesions (controls).

MATERIALS AND METHODS

Thirty subjects (group "A") with Chronic Skin Lesions (CSL controls) (19 F-11M, mean age 67.5±7.2) in the lower limbs were admitted to our study according to a randomization scheme and compared a thirty (group "B") type II diabetic patients (18F-12M, mean age 73.5±4.9) with chronic skin lesions (CSL). These two groups "A" and "B" have been studied and compared on the basis of infectious etiology responsible for the infectious skin process.

RESULT

In the subjects of the "A" group we found a positive bacteriological colony test of 9 examinations corresponding to the total 30.0%. In the group called "B" we obtained a colony test positive of 12 subjects over 30 corresponding to 40.0% of the examinations. For the number of bacterial species identified in the "A" group we obtained 7 monomicrobial and 2 poly microbial bacteriological tests, while in the "B" group we observed 3 mono microbial and 9 poly microbial tests. All bacteriological isolates showed "in vitro" sensitivity to satisfactory aminoglycosides with MICs range of 0.78- 1.56mg/L.

CONCLUSIONS

Data from this study show a different etiology among diabetic subjects than nondiabetic subjects. In fact, in the "B" group, more poly microbial bacteriological findings are found in positive culture studies with subjects in group "A". This phenomenon confirms an alteration of the skin microbiome of diabetic subjects with modification of the "opportunistic role" of some species of the skin bacterial flora.

Etiology of chronic skin lesions in subjects with peripheral arterial disease

INTRODUCTION

Skin lesions can be defined as lesions that result in loss of tissues and their joints, and often this cutaneous skin process is a primary or secondary consequence of the structural changes in the skin itself. Subjects with peripheral arteripathies that develop chronic skin lesions in the lower extremities of the Western world are constantly increasing. We conducted a study on the etiologic incidence of chronic skin lesions in peripheral arterial disease CSLpa subjects in the lower limbs compared to subjects with chronic skin lesions CSL (controls).

MATERIALS AND METHODS

30 subjects with peripheral atheropathies PA (22 F - 8 M mean age 74,5 ± 4,9) and with chronic skin lesions (CSLpa) in the lower limbs "A" group were admitted to our study according to a randomized and compared to 30 no peripheral atheropathies subjects (19 F-11 M, mean age 81,5 ± 7,3 - controls) group B with chronic skin lesions (CSL). These two groups "A" and "B" have been studied and compared on the basis of infectious etiology responsible for the infectious skin process.

RESULTS

In the subjects of the "A" group we found a 12 positive assay of 40.0% of the examinations, while in the group "B" we achieved a total cultured positivity of 9 cases corresponding to 30.0% of the examinations . For the number of bacterial species identified for "A" group we obtained 3 mono microbial and 6 poly microbial bacteriological tests and for group "B" we observed 7 mono microbial and 2 poly microbial tests. All bacteriological isolates showed "in vitro" sensitivity to satisfactory ciprofloxacin with MICs range of 0.78-1.56mg/L. The data observed after 4 weeks after the amniotic membrane (MA) in the two study groups A and B were respectively the following: and for group A 50% scarring, 46.6% partial resolution and in one case worsening for the B-healing group in 63.3%, the partial resolution in the remaining 36.6.

CONCLUSIONS

The data from this study show a different etiology between subjects with CSLpa than subjects with CSL. This phenomenon confirms an alteration of the skin microbioma of subjects with peripheral arteriopathy and chronic skin lesions with modification of the opportunistic role of some species of cutaneous bacterial flora.

The mixture of bifidobacterium associated with fructo-oligosaccharides reduces the damage of the ocular surface

BACKGROUND

Despite its high prevalence Dry Eye Syndrome (DES) in frequently under-recognized owing to its negative influence on patients visual function.

METHODS

This clinical trial was a pilot study to evaluate the effects of supplementation with mixture (Bifidobacterium lactis and Bifidobacterium bifido) on the tear film. Following the run-in period subjects were randomized in two groups: group A (N°20 subjects) and group B (N°20 subjects). Group A (control) treated only with substitute tear and group B treated with substitute tear + mixture (symbiotic).

RESULTS

The data obtained in the two study groups A and B were, respectively the following: Schirmer 9.1±0.2 vs 12.7±0.4 (p< 0.001); Schirmer II 3.5±0.1 VS 4.7±0.2 (p<0.001); BUT 3.9±0.3 vs 6.3±0.2 (p<0.001). Culture test showed initial bacterial growth in group "A" (placebo) 18 out of 40 samples tested, corresponding to 45.0% and "B" after treatment ((symbiotic) was found positive culture whit growth of bacteria in 12 tests equal to 30.0%. The total numbers of isolations of aerobic and anaerobic bacteria found group A and B after treatment. A reduction of 15 to 11 strains of aerobic and anaerobic isolates from 9 to 5 has been found.

CONCLUSIONS

The present study shows that the administration of bifidobacterium may represent a success full treatment in ameliorating dry eye syndrome (DES). The effect of imbalanced microbiota are not restricted by gastrointestinal abnormalities but could have systemic impact on immunity. Commensal bacteria or probiotics interact with the endogenous enteric microbiota and gut cells therein confereing health benefit to the host.

Silybin supplementation during HCV therapy with pegylated interferon-α plus ribavirin reduces depression and anxiety and increases work ability

BACKGROUND

Hepatitis C virus infection and interferon treatment are often associated with anxiety, depressive symptoms and poor health-related quality of life. To evaluate the Silybin-vitamin E-phospholipids complex effect on work ability and whether health related factors (anxiety and depression) were associated with work ability in subjects with chronic hepatitis C treated with Pegylated-Interferon-α2b (Peg-IFN) and Ribavirin (RBV).

METHODS

Thirty-one patients (Group A) with chronic hepatitis and other 31 subjects in Group B were recruited in a randomized, prospective, placebo controlled, double blind clinical trial. Group A received 1.5 mg/kg per week of Peg-IFN plus RBV and placebo, while Group B received the same dosage of Peg-IFN plus RBV plus association of Silybin 94 mg + vitamin E 30 mg + phospholipids 194 mg in pills for 12 months. All subjects underwent to laboratory exams and questionnaires to evaluate depression (Beck Depression Inventory - BDI), anxiety (State-trait anxiety inventory - STAI) and work ability (Work ability Index - WAI).

RESULTS

The comparison between group A and group B showed significant differences after 6 months in ALT (P < 0.001), and viremia (P < 0.05), after 12 months in ALT (P < 0.001), and AST (P < 0.001), at follow up in AST (P < 0.05), and ALT (P < 0.001). Significant difference were observed after 1 month in WAI (p < 0.001) and BDI (P < 0.05), after 6 months in WAI (P < 0.05) and STAI (P < 0.05), after 12 months and at follow up in WAI, STAI and BDI (p < 0.01).

CONCLUSIONS

The supplementation with Silybin-vitamin E -phospholipids complex increased work ability and reduced depression and anxiety in patients treated with Peg-IFN and RBV.

TRIAL REGISTRATION

NCT01957319 , First received: September 25, 2013. Last updated: September 30, 2013 (retrospectively registered).

Silybin-vitamin E-phospholipids complex reduces liver fibrosis in patients with chronic hepatitis C treated with pegylated interferon α and ribavirin

Chronic hepatitis C is both a virologic and a fibrotic disease, with mortality resulting mainly from the complications of cirrhosis and HCC. The aim was to evaluate the impact on of supplementation with a new pharmaceutical complex of silybinvitamin E-phospholipids in patients with chronic hepatitis C treated with Pegylated-Interferon-α2b plus Ribavirin. In this prospective, randomized, placebo controlled, double blind clinical trial, 32 subjects with chronic hepatitis, received Pegylated-Interferon-α2b (1.5 mg/kg per week) plus Ribavirin and placebo, while 32 subjects received the same dosage of Pegylated-Interferon-α2b plus Ribavirin plus association of Silybin 47 mg + vitamin E 15 mg + phospholipids 97 mg in two pill for 12 months. Serum levels of the following markers of liver fibrosis were evaluated: transforming growth factor beta, hyaluronic acid, metalloproteinase 2, amino-terminal pro-peptide of type III procollagen, tissue inhibitor of matrix metalloproteinase type I. The comparison between group A and group B showed a significant difference in ALT (P<0.001), and viremia (P<0.05) after 12 months; in TGF beta levels after 12 months and at follow up (P<0.05); in MMP-2 after 6 months (P<0.05); in PIIINP after 6, 12 months and at follow up (P<0.05); in TIMP-1 after 6, 12 months and at follow up (P<0.001). In conclusion, the supplementation with silybin-vitamin E-phosholipids complex ameliorated the response to Peg-IFN plus RBV treatment and reduced serum levels of markers of liver fibrosis. The ameliorative effect of the complex maybe related to a direct effect on the activation of hepatic stellate cells, or mediated via antioxidants.

Ciprofloxacin as Treatment for Conjunctivitis

The authors studied the bactericidal action and therapeutic effectiveness of ciprofloxacin in treating external ocular infections (bacterial conjunctivitis and bacterial blepharoconjunctivitis). 108 ambulatory patients with clinical signs of conjunctivitis and blepharoconjunctivitis were enrolled in the study. All subjects underwent a conjunctival swab before starting therapy and at 10 days, to identify the causative bacteria and their susceptibility to ciprofloxacin, following routine microbiological methods. The reported therapeutic success rate (95%) and bacteriological analysis confirmed the effectiveness of ciprofloxacin in subjects with bacterial conjunctivitis and bacterial blepharoconjunctivitis. In vitro tests conducted 10 days after treatment confirmed the in vivo therapeutic effectiveness, even for those infections characterized by a difficult etiological identification which interferes with specific antibiotic therapy.

Toxic hepatitis in occupational exposure to solvents

The liver is the main organ responsible for the metabolism of drugs and toxic chemicals, and so is the primary target organ for many organic solvents. Work activities with hepatotoxins exposures are numerous and, moreover, organic solvents are used in various industrial processes. Organic solvents used in different industrial processes may be associated with hepatotoxicity. Several factors contribute to liver toxicity; among these are: species differences, nutritional condition, genetic factors, interaction with medications in use, alcohol abuse and interaction, and age. This review addresses the mechanisms of hepatotoxicity. The main pathogenic mechanisms responsible for functional and organic damage caused by solvents are: inflammation, dysfunction of cytochrome P450, mitochondrial dysfunction and oxidative stress. The health impact of exposure to solvents in the workplace remains an interesting and worrying question for professional health work.

The supplementation of acetyl-L-carnitine decreases fatigue and increases quality of life in patients with hepatitis C treated with pegylated interferon-α 2b plus ribavirin

The aim of this study was to evaluate whether supplementation of acetyl-L-carnitine (ALC) to pegylated-interferon-α 2b (Peg-IFN-α 2b) and ribavirin (RBV) improves the health-related quality of life during the treatment for chronic hepatitis C, thereby decreasing the risk of treatment discontinuation. Sixty patients with chronic hepatitis C underwent treatment with Peg-IFN-α 2b + RBV (group A; n = 29) or Peg-IFN-α 2b + RBV + ALC (group B; n = 31) for 12 months. At the end of the study, the comparison between group A and group B showed significant differences in aspartate aminotransferase (AST) (-80.9 versus -110.3; P < 0.001), alanine aminotransferase (-111.6 versus -134.7; P < 0.001), Viremia (-3.26 versus -3.82; P < 0.05), mental health (0 versus 11; P < 0.001), physical functioning (-1 versus 8; P < 0.001), role-physical (1 versus 13; P < 0.001), bodily pain (1 versus 12; P < 0.001), general health (3 versus 12; P < 0.001), vitality (3 versus 13; P < 0.001), social functioning (3 versus 10; P < 0.001), physical fatigue (2.1 versus -5.4; P < 0.001), mental fatigue (-0.7 versus -2.7; P < 0.001), and fatigue severity scale (-3.4 versus -12; P < 0.001). ALC supplementation reduced both mental and physical fatigue, improved health-related quality of life, and, therefore, has the potential to increase patient adherence to the combination regimen. This, in turn, may increase the percentage of patients achieving a sustained virological response.

Endophthalmitis: gram positive ethiological agents and susceptibility to glycopeptides

Endophthalmitis is a serious sight-threatening condition, with a postoperative incidence of 0.13 -0.7%. This study aimed to investigate the spectrum of Gram-positive bacteria causing culture-proven endophthalmitis and their susceptibility to teicoplanin and vancomycin. At this purpose, minimum inhibitory concentrations of teicoplanin and vancomycin of Gram-positive bacteria isolated in the period 2001--2007 from vitreous cultures were determined. Staphylococcus epidermidis was the most common organisms identified (31,8 %), followed by Staphylococcus aureus, Peptococcus spp. e Bacillus spp. All bacteria were susceptible to teicoplanin and vancomycin. The two drugs showed a comparable activity against staphylococci and bacilli, while teicoplanin was more potent against streptococci and anaerobes. In conclusion, teicoplanin showed a spectrum of activity similar or even better that of vancomycin against the most common ethiological agents of postoperative endophthalmitis.

Visual outcome after excimer laser refractive surgery in adult patients with amblyopia

PURPOSE

To evaluate the visual and refractive outcome in adult patients wi th refractive and anisometropic amblyopia treated with photorefractive keratectomy.

METHODS

An interventional non-comparative study was performed on 50 consecutive patients with amblyopia treated with photorefractive keratectomy. Sixty-eight eyes of 18 participants with bilateral refractive amblyopia and 32 participants with unilateral anisometropic amblyopia were studied. The photorefractive keratectomy was performed with MEL 70 G-Scan excimer laser. Follow-up was 1, 3, 6, and 12 months after the treatment. The mean outcome measures were uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BCVA), refraction, and corneal transparency.

RESULTS

In 64.7% of eyes, the UCVA at 12 months after the treatment was better than or equal to their preoperative BCVA. A total of 82.4% of eyes improved their BCVA one or more lines. No eye lost lines of BCVA, 17.6% remained unvaried, 50% gained one line, 20.6 % gained two lines, and 11.8% gained three lines of BCVA. The number of lines gained correlated strongly with diopters of anisometropia between eyes (p<0.01). The mean sphere changed from -5.62+/-3.37 D to -0.47+/-1 D, mean cylinder varied from -2.36+/-1.57 to -0.18+/-0.41 D, and the spherical equivalent varied from -6.82+/-3.1 to -0.45+/-1.08 D. No clinically significant haze was observed.

CONCLUSIONS

Excimer laser refractive surgery appears to be a safe and efficient procedure in the treatment of ametropic and anisometropic amblyopia in adults. Adult patients with anisometropic and refractive amblyopia could benefit from the refractive treatment with significant improvement of the visual acuity.

Presurgical antimicrobial prophylaxis: effect on ocular flora in healthy patients

OBJECTIVE

Evaluation of presurgical antimicrobial prophylaxis for reduction of ocular flora.

SETTING

Ophthalmology Section, Department of Medicine and Surgery, University of Catania, Italy.

METHODS

Three days before photorefractive keratectomy (PRK), conjunctiva of 70 healthy patients (100 eyes) were swabbed. After 3 days of instillation of ofloxacin 0.3% (3 times daily), conjunctival swabs were taken again. Bacteria were isolated and identified from each swab.

RESULTS

A total of 191 independent isolates were obtained prior to antimicrobial treatment. Bacteria were isolated from all 100 eyes sampled. Gram-positive species predominated, with Staphylococcus epidermidis and Staphylococcus aureus cultured from 69% and 25% of eyes sampled, respectively. Species of the anaerobic genera Peptococcus and Peptostreptococcus were found in 22% and 14% of eyes, respectively. After prophylaxis with ofloxacin, bacteria could be cultured from only 7% of eyes (10 independent isolates). All isolates were sensitive to ofloxacin except 5 strains of S. epidermidis, which displayed intermediate sensitivity. No infections occurred after PRK.

CONCLUSION

Prophylaxis by instillation of ofloxacin 0.3% 3 times daily for 3 days substantially reduced the ocular flora of 100 healthy eyes prior to refractive surgery.

[Treatment of bacterial conjuntivitis with topical ciprofloxacin and norfloxacin: a comparative study]

The authors studied the epidemiology of external ocular infections and the therapeutic efficacy of topical ciprofloxacin and norfloxacin in the treatment of conjunctivitis and blepharitis. Signs and symptoms in two study-group (ciprofloxacin group A = 95 patients and norfloxacin group B = 95 patients) as well as the microbiological data obtained from the conjunctival swab before and after treatment were considered. The clinical and bacteriological success rate in the two study-groups was respectively 91% (group A) and 83% (group B). The results of the present study confirm the therapeutic efficacy of topical fluoroquinolones in the treatment of bacterial conjunctivitis and blepharitis.

Effect of aminoglycosides (sub-MICs) on adherence of coagulase-negative Staphylococci to intraocular lens surface

The authors evaluated the in vitro effects of subinhibitory concentrations (sub-MICs) of aminoglycosides (gentamicin, netilmicin and tobramycin) on the adherence of coagulase-negative staphylococcus to intraocular lens (PMMA, acrylic and heparin) surface. The five strains of coagulase-negative Staphylococcus epidermidis used (S. epidermidis IMe7, IMe11, IMe27, IMe29 and IMe31) were tested for their ability to produce slime. The minimum inhibitory concentrations (MIC) indicated high susceptibility in vitro to the antibiotics and homogeneous values. The adhesion tests without antibiotics (K1, K2 and K3) for every time considered (30 min, 60 min and 180 min) and for all examined strains showed more constant adhesive activity on the surface of acrylic intraocular lens (IOLs) than on the surface of heparin IOLs. The aminoglycosides tested were able to reduce adhesivity by coagulase-negative S. epidermidis slime to the IOL surfaces, even at sub-MICs. The documentation obtained by scanning electron microscope shows the growth of a strain of S. epidermidis IMe11 after 180 minutes of contact which remains adherent to the surface of the acrylic IOLs.

Sub-MIC ciprofloxacin effect on fimbrial production by uropathogenic Escherichia coli strains

The urine from 210 patients with acute urinary tract infection (UTI) was examined to study the in vitro effect of ciprofloxacin on fimbriae production by uropathogenic Escherichia coli isolates. Forty-nine bacterial samples of density 10(5) CFU/ml were not considered. From the resulting 161 samples, E. coli was the major strain found, present in 54 samples. Other microoganisms found were: Enterococcus sp. (34 samples), Staphylococcus epidermis (22), yeasts (11), Proteus sp. (11), Pseudomonas sp. (11), Klebsiella sp. (8), Enterobacter sp. (6), Citrobacter sp. (3), and Acinetobacter sp. (1). The uropathogenic E. coli strains found were P-fimbriated, as demonstrated by hemoagglutination activity against human erythrocytes with and without mannose, SDS-PAGE of fimbrial proteins and transmission electron microscopy (TEM). All E. coli strains found were exposed in vitro to sub-inhibitory concentrations of ciprofloxacin (1/8 MIC). Our results showed that: 1) P-fimbriated E. coli is the most prevalent microorganism in acute UTI (34%); 2) exposure to sub-MICs of ciprofloxacin inhibits fimbrial production in 79% of E. coli strains; 3) the pattern of SDS-PAGE fimbrial proteins is modified after exposure; in particular, the most affected synthesis involves the protein at 18 kD known as P-fimbriae.

The in vitro activity of trospectomycin against anaerobic bacteria

The authors evaluated the activity of trospectomycin, a new aminocyclitol which is characterized by good antibacterial and broad spectrum activity, in comparison with clindamycin and ampicillin on a sample of recent isolates: Bacteroides fragilis (15 strains), Bacteroides urealyticus (5 strains), Bacteroides vulgatus (5 strains), Bacteroides spp. (15 strains), Prevotella melaninogenica (6 strains), Porphyromonas asaccharolytica (7 strains), Mobiluncus spp. (3 strains), Peptococcus niger (3 strains), Peptococcus variabilis (9 strains), Peptococcus spp (30 strains), Peptostreptococcus anaerobius (5 strains), Peptostreptococcus asaccharolyticus (3 strains), Peptostreptococcus spp. (25 strains) and Propionibacterium spp. (7 strains). The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were determined for all strains by microtiter serial dilutions in Wilkins-Chalgren broth in an anaerobic chamber in an atmosphere of 10% H2, 10% CO2, 80% N2. All the drugs tested exert their activity against Gram-positive and Gram-negative anaerobic isolates. In particular, trospectomycin is quite active against Gram-positive cocci (MIC 90 = 4 - 8 mg/l), Gram-negative rods (MIC 90 = 8 - 16 mg/l), Gram-positive rods (MIC 90 = 4 mg/l) and Mobiluncus spp. (MIC 90 = 0.5 mg/l).

[A microbiological evaluation of the use of roxithromycin in oral odontogenic infections]

Odontogenic infections are the primary infections caused by indigenous oral bacteria, when a factor changes their perfect equilibrium. We studied 30 samples from patients with odontogenic infections that were submitted to therapy with roxithromycin. Our results showed that 79% of aerobic and 71% of anaerobic bacteria, responsible for odontogenic infections, were sensitive to roxithromycin.

Efficacy of azithromycin compared with spiramycin in the treatment of odontogenic infections

Sixty patients with acute odontogenic infections were randomly allocated to oral treatment with azithromycin 500 mg/day once-daily for three days (n = 30) or spiramycin 3,000,000 units three-times daily for seven days (n = 30). Baseline and post-treatment oral specimens were collected from patients to test for pathogenic bacteria. Aerobic bacteria were tested using the Kirby-Bauer disc diffusion method, and anaerobic bacteria with a broth microdilution method, for their susceptibility to azithromycin and spiramycin. A greater incidence of resistance was found in the spiramycin group than in the azithromycin group. The bacteriological assessment showed that the normal balance of microflora was re-established in 67% of patients treated with azithromycin vs 53% in the group treated with spiramycin. Clinical cure was higher in the azithromycin treatment group (97%) compared with the spiramycin group (73%). These results indicate that three-day azithromycin, possibly because of its unusual pharmacokinetics, is more effective than seven-day spiramycin in the treatment of odontogenic infections.

[The effect of Lactobacillus acidophilus and Bifidobacterium bifidum on the intestinal ecosystem of the elderly patient]

The authors have tested the therapeutic efficacy of a multibacterial combination consisting of Lactobacillus acidophilus (10(9)) and Bifidobacterium bifidum (10(9)) in elderly patients with bowel disorders. Bacteriological and histopathologic investigation showed this combination to yield excellent biologic results with restoration of duodenal bacterial flora and subsidence of clinical symptoms. The function of the muciparous glands was restored and the duodenal mucosa was normalized.

[Adhesion capacity of Enterococcus faecium (SF 68) and Enterococcus faecalis to various substrates]

The author's studied the adherence ability of Enterococcus faecium SF 68 compared to that of Enterococcus faecalis IM 11f, on various substrates: vascular catheters and cardiac valves of rabbit, immunodepressed rats and diabetic rats. The bacterial adherence test was calculated by the number of bacteria adhered for microscopic field enlarged to 2000. The data obtained by scanning electron microscope SEM (Cambridge Stereoscan 150 MK2) revealed a different adherence action of the two germs on the various substrates. All the adherence tests showed a higher and uniform adherence activity of E. faecalis compared to that of E. faecium.

Increased rate of survival in Streptococcus pneumoniae-infected rats treated with the new immunomodulator Pidotimod

Wistar rats infected with Streptococcus pneumoniae (type III ATCC) rapidly develop an acute form of experimental lobar pneumonia (ELP) with death of 80-90% of the animals by 6 days after the infection. Prophylactic treatment of these animals with the novel immunomodulator Pidotimod, at the dose of 25 mg/kg bw, significantly increased their rate of survival as compared to the control group (50 vs. 90% respectively). Recovery from the infection appeared definitive since all the Pidotimod-treated survivors were alive and in good condition at the end of the observation period (45 days post infection). Prophylactic treatment with higher or lower doses of the drug was ineffective. Therapy with Pidotimod was not effective. This preliminary study suggests that Pidotimod may have contributed to activation of specific and non-specific immune effectors involved in the host response to S. pneumoniae infection.

[Study on the activity of a therapeutic bacterial combination in intestinal motility disorders in the aged]

The possible beneficial effects and changes in the histology of the duodenojejunal and colonic mucosa brought about by oral bacterial therapy were studied in 60 elderly patients (mean age +/- SD: 76.6 +/- 5.3 years) with bowel disorders mainly represented by diarrhea accompanied by abdominal pain and meteorism. All patients were submitted to a 7-day washout followed by treatment with 6 capsules daily, each capsule containing live, lyophilized Lactobacillus acidophilus (10(9) CFU/ml). The clinical course was observed in 50 patients while the remaining 10 were hospitalized and submitted to esophago-gastro-duodenoscopy and colonoscopy both before and after treatment for withdrawal of duodenal secretion and fragments of duodenojejunal and colonic mucosa biopsies. Duodenal secretion was examined bacteriologically, and after treatment an increase of the anaerobic flora at the expense of the aerobic one was found together with improved quality of the former. Histologic examination showed reduction of the inflammatory infiltration by lymphocytes and plasma cells and increased muciparous activity of the glands. Clinically, a marked improvement of the symptoms was observed in all 60 patients.

[The interference of miocamycin on the adhesiveness and coaggregation of the bacteria responsible for periodontopathies]

The authors studied the effect miocamycin has on the adherence and coaggregation of pathogenic bacteria in periodontopathy. The data obtained by optic microscopy, after treatment of the strains with doses of miocamycin equal to 1/4 and 1/8 of the MIC after 3 and 6 hours, shows the interference effect on the coaggregation and adhesivity of the antibiotic. These results have been confirmed by the observations obtained by scanning electron microscope (SEM).

[Effect of spiramycin on the interbacterial aggregation process in dental plaque formation]

The Authors valued on 18 periodontal patients the bleeding, probing depth, plaque indexes before and after antibiotic therapy with spiramycin. After bacteriological test and coaggregation test the Authors concluded spiramycin all day long is endowed with a good activity in periodontal diseases.

Microbiological study of Enterococcus faecium SF68: post-antibiotic effect and growth curves

We studied the microbiological characteristics of Enterococcus faecium SF 68 (an oral vaccine) assessing post-antibiotic effect of ampicillin and growth curves in different media. Results showed a good resistance of the microorganism tested which has important implications in clinical practice. The growth ability of Enterococcus faecium SF 68 was similar on all media tested.

[Competitive activity of a bacterial preparation on colonization and pathogenicity of C. pylori. A clinical study]

The authors studied the ability of a live polymicrobial formulation containing Lactobacillus acidophilus 10(9) and Bifidobacterium bifidum 10(9) to act as an "ecological" therapy for gastritis and duodenitis. The study was carried out in volunteers suffering from these disorders which nowadays are attributed to C. pylori. The results obtained confirm previous findings in experimental animals. The polymicrobial formulation was found to be able to compete effectively with the microorganism responsible for the disorders and to improve the results obtained by traditional therapy.

[Interference of clindamycin in skin infection in rabbits caused by suture threads infected with slime-producing S. epidermidis]

The authors have carried out an experimental study to evaluate the interference of sub-inhibitory concentrations of clindamycin on the adherence of slime producing S. epidermidis to surgical nets and its ability to infect rabbits. 80 rabbits divided into 4 groups, (A, B, C, and D), underwent sham operation of the abdominal zone and were sewn up with sterile nets, infected nets and sub MIC of clindamycin equal to 1/8 MIC, respectively. The results obtained stressed a different survival rate 12 days after operation: 95% in group A, 35% in group B; 100% in group C and 95% in group D. This data were confirmed by the results obtained using MES (Cambridge Stereosecan 150 KM2). From our research an excellent clindamycin inhibitory activity on the pathogenicity of slime producing staphylococci emerged.

Effect of clindamycin on adherence of coagulase-negative Staphylococcus to surgical nets

The authors studied the effect that a subinhibitory concentration of Clindamycin has on adherence of coagulase negative S. epidermidis to surgical nets. Clindamycin, as expected, interferes with the adhesivity to the nets of coagulase-negative S. epidermidis slime producing when sub-MICs are used. The documentation obtained by scanning electron microscope, after treatment of the strains with doses of Clindamycin equal to 1/6 of the MIC after 3 and 6 hours, confirms the anti-adherent effect of the antibiotic.

[Immunogenic activity of a polyvalent oral vaccine]

The AA. studied the effects of a polyvalent oral vaccine on the cellular immunity, and on IgA level in animal. They also studied its ability to reactivate the response to the Clostridium tetani toxin in human volunteers. The results show a very good ability of the vaccine as specific and aspecific stimulator.

[Mixed culture of Enterococcus faecium SF 68 with pathogenic intestinal bacterial strains]

An antagonistic activity of Enterococcus faecium SF 68 towards Plesiomonas shigelloides, Aeromonas sp., enteropathogenic Escherichia coli and Yersinia enterocolitica has been studied and demonstrated.

[Protection of an oral vaccine against experimental infection of mice and its role combined with the administration of penicillin]

The AA. studied the immunologic profile of an oral vaccine to prevent the experimental infection in mice and its effect when it was administered with antibiotic. The mice were infected with Staphylococcus aureus and protected by the vaccine administration. Our results confirmed the higher survival in the group that used this combination. The observed mortality was lower in group of mice treated with vaccine and penicillin combination, than in the untreated group.

[Role of Enterococcus faecium SF 68 in experimental infection in mice]

The normal intestinal flora is an important defence against various infectious agents. It also allows important metabolic stages in the host. The Authors studied the ability of Enterococcus faecium SF 68 to protect the mice (Swiss strain) from infection by Salmonella typhi and its role when used with penicillin in infection by Staphylococcus aureus. Our results showed that SF 68, determined a good protection against infection. Moreover the association E. faecium SF 68-antibiotic lowers the mortality rate in the infected mice compared with the control group.

[Immunologic characteristics of a polyvalent vaccine]

A lot of bacterial vaccines show a very interesting immunostimulating profile. The AA. studied the effects of a polyvalent vaccine on the phagocytosis, on the cellular immunity and on the IgA production. They also investigated its capacity to reactivate the response to the C tetani toxin (Booster effect), both "in vitro" and in human volunteers. The results show a significant improvement in the immunity response to specific and aspecific stimuli.

[The intestinal ecosystem of mice after administration of a polyvalent oral vaccine]

Bacterial antigens orally administered, have been showed by many Authors capable to stimulate immunity system, hinding thus the pathogen flora from gut-colonization. Founding on these findings, AA. of the present paper intend to point out by collected microbial data and M.E.S. photos, the activity of an oral polyvalent vaccine made by lysates strains of E.coli, enterococci, staphylococci and P.vulgaris, on normal intestinal flora of mice contemporaneously administered with a pathogenic strain of Salmonella enteritidis. Vaccine showed himself to be able enough to limit alterations of intestinal flora due to infection by the pathogens.

Microbiological basis for the use of fosfomycin trometamol as single-dose therapy for simple cystitis

Fosfomycin trometamol (FOT), a new soluble salt of fosfomycin, was developed especially for single-dose treatment in uncomplicated urinary tract infections. In this study, the minimum inhibitory concentrations (MICs) of FOT were measured both in nutrient broth and human urine and compared with calcium fosfomycin, pipemidic acid and cotrimoxazole. A total of 300 bacterial strains of different species from recent urinary infections were studied. Staphylococcus aureus showed the lowest MIC (0.38 micrograms/ml) and Pseudomonas spp. the highest (50 micrograms/ml) with fosfomycin salts in nutrient broth. The MIC of fosfomycin resulted in being higher than those for pipemidic acid and cotrimoxazole against Escherichia coli and Proteus rettgeri and lower for all the other species considered. The MIC values increased about ten times when urine was used as medium. No differences were observed between the two fosfomycin salts. The fosfomycin concentrations of 137-1500 micrograms/ml, easily obtained in urine of healthy adult subjects after a single dose of FOT (3g of fosfomycin), were able to kill all the strains, with the exception of Streptococcus faecalis. The bacterial adhesion of a resistant microorganism (P. aeruginosa) to the cells of the urinary tract, showed a 50% reduction after FOT treatment.

Coaggregation between Actinomyces viscosus with Streptococcus pyogenes and Streptococcus agalactiae

Interbacterial coaggregation between Actinomyces viscosus indigenous to the human mouth and Streptococcus pyogenes and Streptococcus agalactiae was studied. Fifteen of twenty-six strains of Streptococcus pyogenes and thirteen of thirty-one Streptococcus agalactiae showed a coaggregation with Actinomyces viscosus strain. The results show that the coaggregation mechanism required calcium and was dependent on pH. Some coaggregations were inhibited by 0.06 M. lactose and by 1 M. NaCl.

[Bactericidal and potent antiadhesive activity of sulbenicillin]

Sulbenicillin, a wide broad spectrum penicillin, is active against a lot of gram positive and gram negative bacteria. The AA. studied the activity of this molecule against urinary infections causing germs, by evaluating two parameters: his antiadhesive capability and the Killing curves, in comparison with mezlocillin and piperacillin. An inhibition in adhesive capability of test-germs, due to sulbenicillin was obtained. Furthermore, resulting Killing curves showed more rapidity in action for sulbenicillin than for the two others molecules, versus resistant germs, like P. aeruginosa and S. faecalis.

In vitro comparative study of RU 28965 against organisms from oral and vaginal flora

The Authors studied the activity of RU 28965, a new macrolide antibiotic, in comparison whith erytromycin, josamycin, miocamycin, ampicillin and rifampicin against oral streptococci (45 strains), coryneform bacteria (23 strains) and G. vaginalis (15 strains). Minimum inhibitory concentrations (MIC), minimum bactericidal concentrations (MBC) and the effect of inoculum size on MICs were determined. RU 28965 showed better activity than the other macrolides. The MICs of RU 28965 were eightfold higher than the corresponding MICs. The MICs of RU 28965 showed up to 10 fold increase by increasing the inoculum density from 10(3) to 10(7) CFU/ml.