Effectiveness of oral probiotics supplementation in the treatment of adult small chalazion

AIM: To define the possible beneficial impact of probiotics oral supplementation on patients affected by chalazion. METHODS: Prospective comparative pilot study on 20 adults suffering from chalazion randomly divided into two groups. The first group (n=10) received conservative treatment with lid hygiene, warm compression, and dexamethasone/tobramycin ointment for at least 20d. The second group (n=10), in addition to the conservative treatment, received a mixture of probiotic microorganisms of Streptococcus thermophilus ST10 (DSM 25246), Lactococcus lactis LLC02 (DSM 29536) and Lactobacillus delbrueckii (DSM 16606) once a day up to 3mo. Chalazia were classified according to their size into three groups: small (<2 mm), medium (≥2 to <4 mm), or large (≥4 mm). When conservative treatment with and without probiotics supplementation failed to resolve the lesion, invasive methods were used, intralesional steroid injection in medium size chalazion and surgical incision and curettage for the largest ones. RESULTS: Medical treatment with or without probiotics supplementation was effective only on the small size chalazia. There was a significant difference in the time taken for complete resolution of small size chalazia between the two groups in favor of the patients receiving probiotics (38.50±9.04d vs 21.00±7.00d, P=0.039). Medium and large size chalazia did not respond to medical treatment with or without probiotics supplementation over the follow-up period (3mo). The treatment did not induce any complications in both groups and no recurrence of chalaziosis was recorded in both groups. CONCLUSION: The considerable difference in time taken for complete resolution of small chalazia between the two groups in favor of the experimental one confirms the presence of a gut-eye axis.

Brucellosis relapse causing thoracic aortic ulcers and aneurysm formation: a case report

Background Brucellosis is an infectious disease caused by Brucella spp, which can involve the cardiovascular, digestive, and respiratory systems. Cardiovascular involvement is a rare occurrence, it has an extremely high mortality rate. Case presentation A 67-year-old Chinese man presented with thoracic aortic multiple ulcers and partial aneurysm formation that caused symptoms of left waist and left buttock pain. The man was admitted to our hospital due to abdominal aorta pseudoaneurysms 5 years ago. The diagnosis was made by thoracic computed tomography angiography (CTA), previous history, and positive culture of Brucella, and the patient was successfully treated by thoracic aortic covered stent-graft implantation and specific medical treatment. Conclusions People who have a history of contact with cattle and sheep, should beware of the possibility of Brucella infection. If chest and abdominal pain occur, timely medical treatment is recommended, aortic aneurysm, the disease with a high risk of death, can be identified or excluded by CTA. Early treatment and prevention of disease progression are more beneficial to patients.

Influencing Factors of Intention and Behavior of Patient Delay in Elderly Benign Prostatic Hyperplasia: a Descriptive Qualitative Study

Background: Most elderly patients with BPH have experienced patient delay. Based on the TPB, the aim of this study was to describe the influencing factors of BPH patients' intention and behavior of patient delay and to provide a reference for the development of a patient delay intention scale and personalized intervention.Methods: This descriptive qualitative study was carried out 4 months in 2021 in China. The participants were 20 patients with BPH ages 60 to 82 years old who experienced patient delay and were selected through purposive sampling method. The study was performed in a large general hospital and a community hospital. The data were collected via face-to-face semi-structured interviews.Results: The following themes were relevant to BPH patients with intention and behavior of patient delay: “Insufficient cognition of symptoms (low symptom alertness, symptom benign attribution)”, “Experience coping instead of going to a doctor”, “Negative attitude toward seeking medical care (Underestimation of the consequences of delayed medical treatment, Negative evaluation of early medical treatment)”, “The influence of others on decision-making for seeking medical care(People who approve or disapprove of going to a doctor, Do or do not follow the opinions of others)”, “Obstacles to seeking medical care(Factors from the patient, Factors from medical institutions)”Conclusion: The delay was longer in rural areas than in urban areas. BPH patients' intention and behavior of patient delay are the result of a combination of many factors. Therefore, it is recommended to develop a scale to evaluate the patient delay intention for BPH, and provide personalized interventions based on the scale to improve patient delay in elderly BPH patients

The criminal liability of the medical team considering the recent orientation of the Italian Court of Cassation

This article aims to analyze the thematic of medical team liability considering the recent Italian Supreme Court case-law, highlighting the various problems linked to the identification of the responsibility of each member of the team. The participation of several subjects in the execution of medical treatment makes the question of criminal liability very complex, especially when it comes to inauspicious events, such as injuries or death, occurring during medical treatment. The question concerns the exact identification of the duty of care and vigilance of the medical team and whether this duty is in line with the principle of individual criminal responsibility guaranteed by Article 27 of the Italian Constitution. In this regard, the case-law has elaborated the so-called “principle of reasonable confidence”, according to which the division of labour that belongs to each member should involve a delimitation of his responsibility, limited only to what is within his competence, except in case of the person who organizes, directs, and controls the team. Precisely, based on this principle, the Italian Supreme Court in 2018 reasserted that in the medical team is necessary to identify the role played by each member, thus avoiding resorting to objective responsibility.

Non-Inflammatory Pathologies of Conjunctiva

Non-inflammatory pathologies of conjunctiva refer to conjunctival diseases or conditions that do not have infectious or immune inflammatory origin. This chapter includes disorders such as conjunctivochalasis, conjunctival cysts, conjunctival lymphangiectasias, conjunctival lymphoma, dermoids, papilloma, intraepithelial neoplasia, nevi and other rarely seen tumors, conjunctival degenerations and changes related to aging, xerosis, as well as interesting cases of fastidious conjunctivitis. Some cases of neoplasia have before and after treatment illustration to highlight the possibility of medical treatment against surgical interventions. At the end of this chapter, some observations are added to show the anatomical changes of conjunctiva without any underlying disease or inflammation.