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Background/Objectives: Urinary tract infections (UTIs) are infections that involve the urethra, bladder, and, in much more severe cases, even kidneys. These infections represent one of the most common diseases worldwide. Various pathogens are responsible for this condition, the most common being Escherichia coli (E. coli). Bromelain is a proteolytic complex obtained from the stem and stalk of Ananas comosus (L.) Merr. showing several beneficial activities. In addition to bromelain, N-acetylcysteine (NAC) has also been used. Methods: The purpose of this experiment was to evaluate the antibacterial, anti-motility, and anti-biofilm effects of a new polyenzymatic complex (DIF17BRO®) in combination with NAC (the Formulation) on various strains of E. coli isolated from patients with UTIs. Subsequently, the anti-inflammatory and antioxidant effects of the Formulation were studied in an ex vivo model of cystitis, using bladder samples from mice exposed to E. coli lipopolysaccharide (LPS). Results: Our results showed that the Formulation significantly affects the capability of bacteria to form biofilm and reduces the bacteria amount in the mature biofilm. Moreover, it combines the interesting properties of NAC and a polyenzyme plant complex based on bromelain in a right dose to affect the E. coli adhesion capability. Finally, the Formulation exhibited protective effects, as confirmed by the inhibitory activities on multiple inflammatory and oxidative stress-related pathways on bladder specimens exposed to LPS. Conclusions: This blend of active compounds could represent a promising and versatile approach to use to overcome the limitations associated with conventional therapies. [ABSTRACT FROM AUTHOR]

The repair of lower leg defects, not amenable toprimary closure, may be challenging, since the skinat this level is scarcely elastic and difficult to mobilize.Local skin flaps are generally utilized only to restoremoderately sized losses, whereas grafting becomesa realistic choice in presence of larger wounds.We present the case of a 70-year-old man with awide defect on his right leg following the surgicalexcision of a squamous cell carcinoma. The woundwas successfully closed with a combination of threehatchet flaps. The various steps of the procedure andthe subsequent outcome are illustrated. Our choiceproved to be an easy, time-sparing, but effectivereconstructive solution for a large skin defectinvolving the leg.

Chronic inflammation is a recognized risk factor for various cancers, including prostate cancer (PCa). We aim to explore the potential protective effects of aged black garlic extract (ABGE) against inflammation-induced prostate damage and its impact on prostate cancer cell lines. We used an ex vivo model of inflammation induced by Escherichia coli lipopolysaccharide (LPS) on C57BL/6 male mouse prostate specimens to investigate the anti-inflammatory properties of ABGE. The gene expression levels of pro-inflammatory biomarkers (COX-2, NF-κB, and TNF-α, IL-6) were measured. Additionally, we evaluated ABGE's therapeutic effects on the prostate cancer cell lines through in vitro functional assays, including colony formation, tumorsphere formation, migration assays, and phosphorylation arrays to assess the signaling pathways (MAPK, AKT, JAK/STAT, and TGF-β). ABGE demonstrated significant anti-inflammatory and antioxidant effects in preclinical models, partly attributed to its polyphenolic content, notably catechin and gallic acid. In the ex vivo model, ABGE reduced the gene expression levels of COX-2, NF-κB, TNF-α, and IL-6. The in vitro studies showed that ABGE inhibited cell proliferation, colony and tumorsphere formation, and cell migration in the prostate cancer cells, suggesting its potential as a therapeutic agent. ABGE exhibits promising anti-inflammatory and anti-cancer properties, supporting further investigation into ABGE as a potential agent for managing inflammation and prostate cancer. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is a morbid condition characterized by relapsing–remitting inflammation of the colon, accompanied by persistent gut dysmotility and abdominal pain. Different reports demonstrated biological activities of aged black garlic (ABG), including anti‐inflammatory and antioxidant effects. We aimed to investigate beneficial effects exerted by ABGE on colon inflammation by using ex vivo and in vivo experimental models. We investigated the anti‐inflammatory effects of an ABG water extract (ABGE) on rat colon specimens exposed to E. coli lipopolysaccharide (LPS), a known ex vivo experimental model of ulcerative colitis. We determined gene expression of various biomarkers involved in inflammation, including interleukin (IL)‐1β, IL‐6, nuclear factor‐kB (NF‐kB), tumor necrosis factor (TNF)‐α. Moreover, we studied the acute effects of ABGE on visceral pain associated with colitis induced by 2,4‐di‐nitrobenzene sulfonic acid (DNBS) injection in rats. ABGE suppressed LPS‐induced gene expression of IL‐1β, IL‐6, NF‐kB, and TNF‐α. In addition, the acute administration of ABGE (0.03–1 g kg−1) dose‐dependently relieved post‐inflammatory visceral pain, with the higher dose (1 g kg−1) able to significantly reduce both the behavioral nociceptive response and the entity of abdominal contraction (assessed by electromyography) in response to colorectal distension after the acute administration in DNBS‐treated rats. Present findings showed that ABGE could represent a potential strategy for treatment of colitis‐associated inflammatory process and visceral pain. The beneficial effects induced by the extract could be related to the pattern of polyphenolic composition, with particular regard to gallic acid and catechin. [ABSTRACT FROM AUTHOR]

Background: There are many reported pharmacist‐led transitions of care (TOC) programs to address medication‐related problems (MRP) at discharge from the acute care setting. Most have identified time and labor resources as significant limitations. This study aims to assess the effectiveness of a medication risk score (MRS)‐driven clinical decision support system (CDSS) in identifying actionable MRPs and improving medication safety in the acute care discharge TOC setting. Methods: A cross‐sectional analysis was conducted in a cohort of 481 subjects discharged from the acute care setting. The MRS‐CDSS was utilized to identify MRPs and provide recommendations for risk reduction. The distribution of MRPs, recommendations, and their associations with MRS severity were analyzed. Additionally, the potential reduction in MRS per subject and its correlation with MRS severity were examined. Results: The median MRS reduction per subject was 2 points, while high/severe‐risk patients showed a median potential reduction of 7 points. Among the identified MRPs (n = 691), drug interaction, drug use without indication, and adverse drug reaction accounted for 89.7% of all MRPs. The top three recommendations, discontinue medication, change the time of administration, and start alternative therapy, represented 94.1% of all recommendations. Stratified analysis by MRS category revealed a significant increase in adverse drug reaction MRPs and recommendations to discontinue medications with higher MRS severity. The results were consistent with previous outpatient studies, supporting the MRS‐CDSS's ability to enhance medication safety. Conclusion: This study demonstrates that the MRS‐CDSS effectively identifies actionable MRPs and has the potential to substantially reduce overall pharmacotherapy regimen risk when applied during acute care discharge TOC. The findings support implementable recommendations directed at patient safety and the allocation of health care resources to high‐risk patients for maximum benefit. [ABSTRACT FROM AUTHOR]