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Hospital de Órbigo, Spain

Bourreille A.,French Institute of Health and Medical Research | Cadiot G.,Robert Debre University Hospital | Le Dreau G.,Hospital | Laharie D.,Bordeaux University Hospital Center | And 6 more authors.
Clinical Gastroenterology and Hepatology | Year: 2013

BACKGROUND & AIMS: Saccharomyces boulardii is a probiotic yeast that has been shown to have beneficial effects on the intestinal epithelial barrier and digestive immune system. There is preliminary evidence that S boulardii could be used to treat patients with Crohn's disease (CD). We performed a randomized, placebo-controlled trial to evaluate the effects of S boulardii in patients with CD who underwent remission during therapy with steroids or aminosalicylates. METHODS: We performed a prospective study of 165 patients who achieved remission after treatment with steroids or salicylates; they were randomly assigned to groups given S boulardii (1 g/day) or placebo for 52 weeks. The primary end point was the percentage of patients in remission at week 52. Time to relapse, Crohn's disease activity index scores, and changes in parameters of inflammation were secondary end points. RESULTS: CD relapsed in 80 patients, 38 in the S boulardii group (47.5%) and 42 in the placebo group (53.2%, a nonsignificant difference). The median time to relapse did not differ significantly between patients given S boulardii (40.7 weeks) vs placebo (39.0 weeks). There were no significant differences between groups in mean Crohn's disease activity index scores or erythrocyte sedimentation rates or in median levels of C-reactive protein. In a post hoc analysis, nonsmokers given S boulardii were less likely to experience a relapse of CD than nonsmokers given placebo, but this finding requires confirmation. CONCLUSIONS: Although the probiotic yeast S boulardii is safe and well tolerated, it does not appear to have any beneficial effects for patients with CD in remission after steroid or salicylate therapies. © 2013 AGA Institute. Source

Hajjar I.,Hospital | Rodgers K.,University of Southern California
Current Opinion in Cardiology | Year: 2013

PURPOSE OF REVIEW: The recent advances in our understanding of Alzheimer's disease pathophysiology and the renin angiotensin system pathways suggest that angiotensin receptor blockers (ARBs) are ideal drugs to explore for Alzheimer's disease therapy. RECENT FINDINGS: New evidence suggests that the brain renin angiotensin system has two opposing pathways: a damaging pathway and a neuro-protective pathway. Both pathways are involved in the amyloid hypothesis (Aβ cascades) and vascular mechanisms of Alzheimer's disease. Studies in animal models suggest that ARBs have cognitive protective effects that are related to their ability to decrease production and oligomerization and increase degradation of Aβ and their vascular effects (improve blood-brain barrier, restore endothelial function, decrease inflammation, and increase cerebral blood flow). Human observational studies have further suggested that ARB use is associated with decreased risk of Alzheimer's disease and protection against future cognitive decline. Our work has suggested that ARB use is associated with decreased amyloid deposition in the brain in Alzheimer's disease and can provide cognitive protection in those with mild cognitive impairment, a prodromal state for Alzheimer's disease, and dementia. SUMMARY: To date, no robust clinical trial of ARBs in Alzheimer's disease has been performed. All things being equal, it is reasonable to consider ARBs in those with cognitive risks. © 2013 Wolters Kluwer Health | Lippincott Williams &Wilkins. Source

Bialecki J.T.,Medical Center | Wieloch M.M.,Hospital | Kolomecki K.,University of Lodz
Wideochirurgia I Inne Techniki Maloinwazyjne | Year: 2014

Introduction: Nowadays the vast majority of inguinal hernia repairs are laparoscopically assisted. Single incision laparoscopy aims to accelerate recovery and provide a better cosmetic outcome after the operation. Aim: To present our own modification of the totally extraperitoneal (TEP) procedure with a single incision and without a multiport, and compare the results with those obtained in the classic three-trocar TEP method. Material and methods: The study group comprised 61 males. The first group consisted of 35 males who underwent single incision videoscopic alloplasty TEP. The second group comprised 26 males who underwent videoscopic alloplasty using the classic approach. The study assessed the time of operation, complications and postoperative pain based on the VAPS scale. Results: The operation time in the first group was statistically longer compared with the time in the second group. The assessment of differences in postoperative pain in both the examined groups on the first and seventh day after the operation was considered statistically insignificant. In both the studied groups there was no recurrence of hernia established on the first and seventh day after the operation. Conclusions: The reduced number of incisions in the TEP method with a single incision approach without a multiport involves a decrease in the number of postoperative scars, and thus offers a better cosmetic outcome compared with the classic TEP procedure. The time of TEP operation performed with a single incision approach without a multiport is statistically longer than the duration of the classic laparoscopic TEP procedure. Source

We report a 62-year-old caucasian woman with bilateral choroidal metastases as only clinical presenting sign of advanced metastatic tumour disease. She presented with decreased vision in the left eye since 5 days. She was treated for breast cancer 31 years before. Fundoscopy and ultrasound analysis showed a large choroidal metastasis in the left eye and one asymptomatic lesion in the right eye. Systemic screening revealed multiple lung and bone metastases. Health practitioners should be aware that choroidal metastasis from breast carcinoma can present throughout life. Small asymptomatic lesions may be detected that still can be treated effectively. Source

Bechi N.,University of Siena | Ietta F.,University of Siena | Romagnoli R.,University of Siena | Jantra S.,University of Siena | And 6 more authors.
Environmental Health Perspectives | Year: 2010

Background: para-Nonylphenol (p-NP) is a metabolite of alkylphenols widely used in the chemical industry and manufacturing. It accumulates in the environment, where it acts with estrogen-like activity. We previously showed that p-NP acts on human placenta by inducing trophoblast differentiation and apoptosis. oBjective: The aim of the present study was to investigate the effect of p-NP on cytokine secretion in human placenta. Methods: In vitro cultures of chorionic villous explants from human placenta in the first trimester of pregnancy were treated with p-NP (10 -13, 10 -11, and 10 -9 M) in 0.1% ethanol as vehicle. Culture medium was collected after 24 hr and assayed by specific immunoassays for the cytokines granulocyte-macrophage colony-stimulating factor (GM-CSF), interferon-γ (IFN-γ), interleukin (IL)-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and tumor necrosis factor-α (TNF-α). results: p-NP modulated cytokine secretion by inducing the release of GM-CSF, IFN-γ, IL-1β, IL-4, and IL-10, with a maximum effect at 10-11 M. It reduced the release of TNF-á at 10-13 M, whereas levels of IL-2 and IL-5 remained below the detection limit. IL-6 and IL-8 levels were 100-1,000 times higher than those of other cytokines, and they were not affected by p-NP. We observed significant differences from controls (ethanol alone) only for GM-CSF and IL-10. conclusion: An unbalanced cytokine network at the maternal - fetal interface may result in implantation failure, pregnancy loss, or other complications. The effects of extremely low doses of p-NP on the placental release of cytokines raise considerable concerns about maternal exposure to this endocrine disruptor during pregnancy. Source

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