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Aim: The aim of this study was to assess if the probing pocket depth is a reliable clinical parameter in the evaluation of the depth of the peri-implant sulci. In case of chronic inflamed peri-implant tissues, this evaluation is useful for understanding the level of bone resorption., Methods: The study enrolled 22 patients. All of them were diagnosed for a peri-implantitis and were scheduled for a resective surgery with implantoplasty. During the surgery, a full thickness flap was raised and resective surgery was performed as well as an implantoplasty procedure. Peri-implant probing values before the surgery (PAL) were recorded, as were values of bone resorption after flap elevation (DIB), at all four sites around each implant (88 sites)., Results: The mean value of PAL calculated for all 88 sites was 5.67 mm (+/-1.46); the correspondent value of DIB was 6.37 mm (+/-1.81). In 52 sites out of 88 (59.1%) the values of PAL and DIB were exactly the same (maximum difference 0.5 mm). In only 10 cases (11.3%) the difference between PAL and DIB was >2 mm. The mean values for PAL and DIB were not statistically different., Conclusions: Authors have concluded that in case of chronic inflammation of peri-implant tissues, the probe reaches the bone pick, allowing the clinician to have reliable information on the actual bone resorption.

Background: To study the effect of second-line treatment with tetracycline (T) combination therapy in patients with Helicobacter pylori (H. pylori) infection after failure of triple one-week therapy with a proton pump inhibitor, omeprazole (O) with amoxycillin (A) and claritromycin (C) or metronidazole (M)., Methods: Three hundred twenty-five naive patients (146 males, 179 females, mean age 50, range 18-76), with H. pylori infection, were randomised to receive one-week triple therapy b.i.d. with O 20 mg; A 1 g; C 500 mg (OAC7 163 pts) or O 20 mg; A 1 g; M 500 mg (OAM7 162 pts). H. pylori status was determined before therapy by histology and 3 months after the end of treatment by C-13 urea breath test (UBT). When eradication did not occur, the patients were retreated with OTA7: O 20 mg b.i.d.; T 500 mg t.i.d. and A1 g b.i.d. for another week. H. pylori was assessed by C-13 UBT 3 months after the end of retreatment. Statistical analysis was done by c2 and Student t test., Results: Three hundred and ten patients have completed the study with compliance >95%: 15 patients complained of side effects (diarrhea, nausea, urticaria, abdominal pain): 9 group OAC7, 6 group OAM7. After the first treatment h. pylori eradication were obtained in 124/154 (80.5%) (PP) OAC7 group and 123/156 (78.8%) (PP) OAM7 group (ns). 49/63 patients (77.7%) were negative after second-line treatment with OTA7 regimen., Conclusions: In personal experience the drug compliance was excellent. The rate of eradication after one-week therapy-omeprazole combined with A+C or with A+M-was satisfactory. The retreatment with tetracycline combination regimen cured 77.7% of patients: that seems to be a promising options, in clinical practice, after an eradication failure.

Aims: The colonization of suspected periodontal pathogens during the healing of periodontal defects treated by guided tissue regeneration (GTR) with e-PTFE membranes and tetracycline fibers was investigated., Methods: Fifteen patients, each with one pair of angular periodontal bone defects of comparable size and morphology were recruited for the study. In a matched-pair study design, the test defects were treated with e-PTFE membranes in combination with tetracycline fibers, while control defects were treated with e-PTFE membranes alone. Microbiological specimens were taken from control as well as from test sites preoperatively (T0), intraoperatively (T1), two weeks after surgery (T2) and from membranes at time of removal (T3). Cultural methods were used to identify the following species: Porphyromonas gingivalis (Pg), Prevotella intermedia (Pi), Fusobacterium nucleatum (Fn) and Actinobacillus actinomicetemcomitans (Aa)., Results: At baseline and T1, none of the suspected periodontal pathogens were detected at test or control sites. Levels of P. intermedia and F. nucleatum, as mean percentages of total culturable microflora, were detected at levels significantly higher in control sites than test sites at times T2 and T3., Conclusions: Findings from this study suggest that e-PTFE membranes are frequently colonized by periodontal pathogens, and that bacterial colonization of healing sites after GTR procedures can be kept under control with a controlled delivery system releasing tetracycline.

Background: The aim of the present study was to analyze the composition of subgingival microflora in patients with refractory periodontitis and to evaluate the antimicrobial sensitivity of isolated periodontopathic microorganisms to different antibiotics., Methods: Eleven subjects with a mean age of 46.4 years were selected for the present study. All had been treated for periodontal disease in the past. After further disease progression patients were included in this study. Eight subgingival plaque samples per patients were collected for cultural analysis., Results: "Black pigmenting anaerobic bacilli" were the pathogenic microorganisms more frequently isolated. The findings from antibiotic susceptibility test showed that high number of bacteria associated with refractory periodontitis resulted resistant to erythromycin, metronidazole and tetracycline. The most effective antibiotics were ciprofloxacin, amoxicillin-metronidazole and amoxicillin-clavulanic acid., Conclusions: Microbiological analysis and antibiotic susceptibility test should be considered important tools in the management of patients with poor clinical response to conventional periodontal treatment.

In order to verify sclerotherapy efficiency in solitary thyroid cysts, needle aspiration of the cyst followed by instillation of tetracycline hydrochloride into the cyst cavity was performed in 110 patients; in thirty of these the aspirations was ultrasonically guided. A tight dressing on the neck was applied for 48 hours in order to maintain pressure on the cyst cavity. All patients were treated with L-T4 in TSH-suppressive doses. In a few patients (< 155), the tetracycline instillation caused local pain, lasting less than two hours. In no case, did cytological examination of the sediment of the aspirated fluid reveal any evidence of malignant cells. In 82 patients (84.54% of the 97 controlled patients), the last ultrasonic follow-up (performed at 3, 6, 9, 12 or 24 months) showed a decrease in lesion size. In particular, 16 patients (16.50%) had a complete cyst disappearance, 41 patients (42.17%) had a volume reduction of the cyst between 85 and 65%, and in 25 patients (25.77%) the reduction was more than 25%. In the remaining 15 patients (15.46%) a second treatment was performed, 3 of them also required a third treatment but in all these cases, the results seemed to be less satisfactory. The distinction in cyst size seemed to indicate that in the case of a large cyst (> 36 mm diameter), the treatment gives better results (92% success rate against 82% of the other patients). In conclusion, we are able to affirm that needle aspiration of the thyroid cyst with instillation of tetracycline hydrochloride is a simple, well tolerated and low cost technique.(ABSTRACT TRUNCATED AT 250 WORDS)

We have reexamined a series of 1119 patients consecutively submitted to fine needle aspiration of nodules of the neck. Among these in 166 cases ultrasonography combined with aspiration suggested the presence of cysts. 60 patients were submitted to cyst aspiration and 34 were aspirated and submitted to cyst injection with tetracycline hydrochloride. The patients were followed up clinically and ultrasonically 3 and 12 months after treatment. Cure was defined as the absence of any residual cystic lesion and an ultrasonic cyst volume less than 50% with respect to basal after 12 months from the start of treatment. 18 of the 60 (30%) patients only aspirated and 24 of the 34 patients (70%) in the tetracycline group were cured (statistically significant; p < 0.005). We conclude that tetracycline seems an effective sclerotherapy in treatment of thyroid cysts.

Chlamydia pneumoniae is the third strain of Chlamydia and transmission is presumed to be by droplet spread from symptomatic patients. The authors show a literature scientific review on subject-matter emphasizing several sporadic and epidemic case of illness in every age, first months excepted. The described cases are few and therefore clinical characteristics are shadowy. Certain clinical features are suggesting of severe pneumonia with fever and pharyngitis without exudate. In the childhood and in the adolescence the clinical evolution is favourable. Tetracyclines or erythromycin is recommended for therapy.

Twenty-eight patients with malignant pleural effusion observed in a two year period were treated with intrapleural instillation of different substances: Tetracycline, Corynebacterium parvum and Beta-Interferon. Different results were observed: complete responsiveness (no recurrence of pleural effusion within three months); partial responsiveness (recurrence of moderate pleural effusion within one month after drainage removal); insufficient responsiveness (recurrence of massive effusion within one month). Among patients treated with Tetracycline seven complete, five partial and one insufficient responses were observed. Instillation of Corynebacterium parvum allowed two complete, two partial and three insufficient responses. Finally, in the group treated with Beta-Interferon complete responsiveness was obtained in just one patient, partial responsiveness in three, while the treatment was insufficient in the last two. These results suggest pleural drainage is the best treatment in patients with malignant pleural effusion, however, the association of Tetracycline instillation allows better results.

The co-existence of pelvic tumor, hydrothorax and ascites has been known since the last century. The features of this disease were described by Meigs and Cass in 1937; in the same year Roads named it Meigs syndrome. According to the original description this syndrome only included, as pelvic involvement, an ovarian neoplasm; at present it is accepted that hydrothorax and the ascites can also be associated with a uterine tumor, like a fibroma. The existence of either an ovarian or a uterine neoplasm distinguishes the typical Meigs syndrome from a pseudo-Meigs syndrome. The most likely pathogenesis of Meigs syndrome ascribes the formation of the peritoneal and pleural effusion to the filtration of interstitial fluid in the peritoneum through the tumor capsule, and the diffusion to the pleural space, generally at the right side, through the diaphragm lymphatic vessels and the foramen of Bochdalek. Dockerty reported that at least 40% of ovarian tumors had a diameter of more than 6 cm when associated with hydrothorax and ascites. The entity of pleural and peritoneal effusion can be moderate or massive. The effusions generally derive from a transudative process, but they can occasionally contain blood cells. The connection between the pelvic tumor and the effusion is demonstrated by the regression of the latter when the neoplasm is excised. When the pelvic tumor has an ovarian location it derives from the connective tissue of the hilus, it appears during fertile age and has a slow growth, the clinical signs becoming evident in elder age.

The Authors report the case of a young man with urethritis, conjunctivitis and oligoarticular arthritis. These symptoms are characteristic of Reiter's syndrome. Our patient also presented an inversion of CD4/CD8 ratio but the number and the activity of natural killer cells were normal and the research for HIV was negative. On the contrary the research for Chlamydiae by fluorescein-binding antibodies in urethral fluid was positive while the human leukocyte antigen HLA B27 was absent. The patient has been successfully treated by tetracycline and steroids. The Authors discuss the diagnostic, etiopathogenetic and therapeutical problems of this case, matching their findings to the up-to-date knowledge of Reiter's syndrome.

A rapid and adequate intravenous infusions of saline and alkali in correcting hypovolemic shock, alectrolyte abnormalities, acidosis and renal failure, is the choice treatment in the majority of acute cholera patients. On the basis of the knowledge of chemical composition of the gastrointestinal fluids loss and the definition of exact mechanism of metabolic features observed in acute cholera patients, it has been possible, in the last ten years, to develop and utilize in a large numbers of patients, a more exact and adequate treatment consisting of replacement of water and electrolytes depletion with saline and alkali of the same ionic composition of fluids lost through the gastrointestinal tract. The isotonic saline and isotonic sodium lactare regimen in a 2:1 ratio has been employed in the treatment of our adult acute cholera patients. Hypotensive patients received a rapid fluids infusion of 2-4 liters within the first 4-6 hours immediately after admission. Later on the quantity of intravenous fluids replacement was regulated on the basis of blood electrolytes pattern, blood pressure, diuresis and patient's hydratation. With this regimen of treatment we observed electrolytes and acid-basic abnormalities in only 25% of our patients. The peritoneal dialysis was applied in three of these patients with irreversible renal failure. Antibiotic therapy, that assume a secondary role in the treatment of cholera patients, was carried out in each case: in 19 cases were given 1 gram every 12 hours i.m. of chloramphenicol succinate; 14 cases received mg 500 of tetracycline orally every six hours; 34 cases received two tablets of trimethoprim-sulphamethoxazole every 12 hours (mg 240 of TM and g 1,6 of SMZ total dose). Except one case of TM-SMZ group who had stool culture positive for Vibrio on 4th day of therapy, in each other patients the stool cultures were sterilized in a period of 24-72 hours of antibiotic treatment.

Two cases of Lyell's syndrome (toxic necrolysis of the epidermis) are reported on account of their rarity. The differential diagnosis of this form and its aetiopathogenesis and treatment are described.

Good therapeutic results free of unwanted side-effects were observed in the management of acute and chronic non-tubercular bronchopneumopathies with an association of tetracyclin hydrochloride, proteolytic enzymes (trypsin and chymotrypsin), vanillic acid diethylamide and pyridophyllin.

A case of Fitz-Hugh Curtis syndrome caused by chlamydia is described in which the perihepatic and abdominal swelling also extended to the right perirenal tissue. The case was diagnosed on the basis of the clinical picture, the behaviour of anti-chlamydia serum antibodies, abdominal echography and laparoscopy. The infection was quickly cured by the administration of tetracycline.