Effects of coffee on serum cholesterol and lipoproteins: The Italian brewing method

In order to evaluate the effects of Italian brewed coffee (moka) on cholesterol and serum lipoproteins, a randomized double-blind 14-week clinical trial was performed. After a coffee-free period of four weeks, 49 subjects drank coffee, caffeinated and decaffeinated, for ten weeks. There was no evidence that the Italian method of brewing coffee affects serum lipoproteins since no statistically significant differences were found.     

Atypical bronchial carcinoids. Review of 46 patients

BACKGROUND: The purpose of this study was to assess the behaviour of atypical carcinoids operated at our Department in the period 1977-1998 and to review the last 19 cases according to Capella's classification (1994), indicating the most adequate surgical approach. METHODS: On the basis of anatomo-pathological characteristics, we have reviewed surgical treatment and outcome in 46 patients, submitted in the last 22 years to surgical resection for neuroendocrine neoplasms. RESULTS: 5-year survival is 77.2%; 10-year survival is 53.2%. Lymph node metastases are also important for survival, but less than the histotype. The review of our last six years' series, according to Capella's classification, of 19 patients affected by so-called atypical carcinoids revealed that: 5 were well differentiated neuroendocrine tumors (WDNT), 12 were well differentiated neuroendocrine carcinomas (WDNC), 2 were small cell neuroendocrine carcinomas (SCLC). The 5-year overall survival of our cases is 78%, for the WDNT 100%, for WDNC 81.2%. Of the 2 patients with SCLC, one survived 2 months; the other is still alive 5 months after surgery. CONCLUSIONS: The authors conclude that 5-year and 10-year survival are strongly related to the histological type of neuroendocrine neoplasm and to the presence of lymph node metastases. Capella's anatomo-pathological classification helps to give a more accurate prognosis for survival in so-called "atypical carcinoids". If the neoplasm is malignant, the authors recommend radical resection, if possible.     

Surgical applications of the greater omentum. A critical review of the literature.

The paper presents and discusses a review of the literature on the use of the greater omentum, focusing in particular on chest surgery. Following an introduction on the anatomy and surgical techniques of mobilisation based on the vascular anatomy of the organ, the author examines the applications of the greater omentum in general surgery. Among these, it is particularly interesting to note the possibility of covering anastomoses, above all extraperitoneal; the interposition of the omentum in the prevention of endoabdominal adhesive syndromes, the covering of pathological perforations of hollow viscera. Lastly, the Author illustrates the applications of the omentum in chest surgery, both preventive and due to endothoracic pathological processes. The Author mentions the covering of bronchial and tracheal anastomoses following resection or lung transplant; the covering of defects in the thoracic wall in patients with osteoradionecrosis or previous irradiation; its therapeutic use in broncho-pleural fistulae and in post-sternotomy mediastinitis.     

The Castroviejo square graft: a retrospective study

We examined 19 eyes of 12 patients who had undergone penetrating keratoplasty utilizing the Castroviejo square graft technique. The visual acuities at the time of examination for inclusion in the study ranged from 20/30 to counting fingers. Of the 19 original square grafts, eight were judged clear centrally with varying degrees of peripheral stromal haze, and one was hazy. The remaining eight failed with varying degrees of irreversible corneal edema. The eight corneas obtained following repeat penetrating keratoplasty were studied with light and electron microscopy. The donor/recipient corneal stromal lamellae were continuous at the graft-host junction, particularly in the mid-stromal area. Disruptions in Descemet's membrane were present at the wound; transmission electron microscopy revealed differences in the composition of Descemet's membrane between the graft and the host. Two additional square grafts had failed, and the patients were awaiting keratoplasty. Nine of the 19 grafts were judged functionally clear, with six of the nine requiring contact lens correction.     

Recovery of treatment doses of surfactants from the lungs and vascular compartments of mechanically ventilated premature rabbits

Premature rabbits delivered by cesarean section at 28 d of gestation were each given intratracheally 75 mg/kg of radiolabeled preparation of either natural rabbit surfactant, natural calf surfactant, or surfactant-TA. Each newborn rabbit was ventilated for up to 6 h in a ventilator-plethysmograph with individual adjustments of peak inspiratory pressures to attain tidal vol of 12-15 mL/kg body wt. Dynamic compliances were about 0.7-0.9 mL/cm H2O. kg after treatment with the three surfactants and did not deteriorate during the 6-h study. Rabbits were randomly studied at 0.5, 1.5, 3, 4.5, and 6 h of age for the recovery of the labeled surfactant phosphatidylcholine in the total lungs (alveolar wash plus postlavage lung tissue). The labeled phosphatidylcholine was cleared from the total lungs of rabbits treated with natural rabbit or calf surfactants at comparable rates of about 25%/6 h. In contrast, the clearance rate of surfactant-TA phosphatidylcholine from the total lungs was not significantly different from 0. Lipids from rabbit surfactant that had been administered intratracheally were only minimally present in the blood and liver. In other similarly treated rabbits, the lipids from radiolabeled rabbit surfactant and liposomes of dipalmitoylphosphatidylcholine that had been injected intravenously were recovered in blood and liver in substantial quantities. These studies documented significant losses of rabbit and calf surfactant phosphatidylcholine but not surfactant-TA phosphatidylcholine from the lungs of preterm ventilated rabbits. The losses were not explained by surfactant losses to the vascular compartment.     

Lung donors selection criteria: a review

Lung transplantation has had increasing success worldwide and it became an acceptable treatment modality in end-stage pulmonary diseases. The insufficient supply of donor lungs, resulting in prolonged waiting time, and the significant rise of patients on the waiting list, have forced the most experienced transplantation centers to redefine the acceptable lung donor criteria including marginal allografts. Existing standard lung donor criteria have been established in the first period of lung transplantation activity, based mainly on opinions and individual experiences rather than on existing evidences: the paucity of donors may be also explained by the rigid application of these criteria. The quality of donor organs has a significant impact on early and long-term recipient outcome. Recent studies have demonstrated that the use of marginal donors did not affect early and late recipient outcome, and significantly increased the number of transplants performed. The aim of this paper is to review how the main lung donor selection criteria have been changed and how they influence the recipient outcome.     

Targeting CXCR1/2 in the first multicenter,double-blinded,randomized trial in autologous islet transplant recipients

Several cytokines and chemokines are elevated after islet infusion in patients undergoing total pancreatectomy with islet autotransplantation (TPIAT), including CXCL8 (also known as interleukin-8), leading to islet loss. We investigated whether use of reparixin for blockade of the CXCL8 pathway would improve islet engraftment and insulin independence after TPIAT. Adults without diabetes scheduled for TPIAT at nine academic centers were randomized to a continuous infusion of reparixin or placebo (double-blinded) for 7 days in the peri-transplant period. Efficacy measures included insulin independence (primary), insulin dose, hemoglobin A_1c (HbA_1c), and mixed meal tolerance testing. The intent-to-treat population included 102 participants (age 39.5 ± 12.2 years, 69% female), n = 50 reparixin-treated, n = 52 placebo-treated. The proportion insulin-independent at Day 365 was similar in reparixin and placebo: 20% vs. 21% (p = .542). Twenty-seven of 42 (64.3%) in the reparixin group and 28/45 (62.2%) in the placebo group maintained HbA_1c ≤6.5% (p = .842, Day 365). Area under the curve C-peptide from mixed meal testing was similar between groups, as were adverse events. In conclusion, reparixin infusion did not improve diabetes outcomes. CXCL8 inhibition alone may be insufficient to prevent islet damage from innate inflammation in islet autotransplantation. This first multicenter clinical trial in TPIAT highlights the potential for future multicenter collaborations.