A variety of effective methods for treatment of hemorrhoids has been proposed. In recent years, there has been an increasing number of studies comparing transanal hemorrhoidal dearterilization (THD) and conventional hemorrhoidectomy (CH), but the focus of most studies has been about the early postoperative results. The data about long-term outcomes is still limited. We aimed to compare Doppler-guided THD and CH with regard to early and long-term postoperative results. The conducted prospective research included 287 patients who underwent CH (167 cases) or Doppler-guided THD with mycopexy (120 patients) between November 2010 and December 2015. Information on hemorrhoidal stage, demographic data, presenting symptoms, complications, duration of hospital stay, postoperative pain, patients’ satisfaction and follow-up were obtained. Statistical tests were performed by SPSS 19.0. There was no significant difference between the studied groups according to gender, mean age, preoperative prolapse, pain and pruritus, hemorrhoidal stage and postoperative complications. Preoperative bleeding was more frequent in THD group (p = 0,002). The mean visual analog scale (VAS) pain scores in CH and THD groups on days 1, 2 and 7 were 7.01 vs 5.03, 5.07 vs 2.98, 2.39 vs 0,57 (p = 0,000). Practically, there was no difference in VAS on day 30 and patients’ satisfaction at the 18th month. Mean hospital stay was 5,13 (CH) and 3,38 days (THD), p = 0,000. The postoperative follow-up was between 18 and 78 months (mean 46 ± 16 months). During this stage, 5 patients (2,99%) in CH group required surgery for recurrence. In THD group, 3 patients (2,5%), all with 4th-degree hemorrhoids underwent additional procedures (p 0,802). Doppler-guided THD seems to be an efficient and safe option for treatment of hemorrhoids, related to lower postoperative pain and excellent, similar long-term outcomes compared to CH. For advanced grades of hemorrhoids, Doppler-guided THD could be a valuable alternative, but there is a need for patients’ selection. (retrospectively registered) researchregistry 3090 .

The aim of the study was to evaluate the activity of three cranberry (Vaccinium macrocarpon) ethanol solutions on Helicobacter pylori growth and urease activity. We included numerous clinical Helicobacter pylori isolates and three methods: agar well diffusion method (AWDM), disk diffusion method (DDM) and urease inhibition test (UIT). The results were expressed as differences in inhibitory zone diameters (AWDM and DDM) or urease inhibition duration (UIT) by cranberry solutions compared to the ethanol control. AWDM showed that 400, 40 and 4 mg/l cranberry extracts inhibited the growth of 82.1, 57.1 and 42.8% of the isolates, respectively, while DDM at the highest cranberry concentration suppressed only 39.3% of the isolates. At 400, 40 and 4 mg/l, cranberry extracts also inhibited urease activity of 63.6, 54.5 and 40.9% isolates within 10 min, but of fewer isolates (18.2, 13.6 and 9.1%, respectively) at the 45th min. Although cranberry activity was dose- and strain-dependent, it affected more than half of the isolates at the two highest concentrations. DDM was less effective in detecting this activity. The cranberry extracts also inhibited the urease activity of H. pylori; however, in most cases, the inhibition was only temporary. Briefly, the high cranberry activity against H. pylori, together with its anti-adhesive, antioxidant, anti-biofilm and anti-cancer properties, justifies its use for prophylaxis or adjunctive treatment of chronic H. pylori infection. Importantly, UIT results suggest the benefit of regular cranberry intake over random intake.

Background: Antibiotic resistance in Helicobacter pylori is steadily increasing, rendering the treatment of related gastroduodenal diseases increasingly difficult. Lefamulin is a new broad-spectrum antibacterial in the pleuromutilin class, acting by suppressing bacterial protein synthesis. It has the advantages of its unique “induced-fit” mechanism, a low frequency of spontaneous mutations, stepwise development of resistance, stability in acidic environments, and potential for additive or synergistic activity when combined with certain other antibiotics against various facultative anaerobes, including multidrug-resistant isolates. Methods: We investigated, for the first time to the best of our knowledge, the activity of lefamulin against 91 clinical H. pylori isolates from symptomatic adult patients using MIC test strips. Results: Overall, lefamulin MICs₅₀ and MICs₉₀ were 0.25 and 2 mg/L versus 4 and ≥256 mg/L for clarithromycin, and 0.75 and ≥32 mg/L, respectively, for levofloxacin. Lefamulin MICs₅₀ and MICs₉₀ were 0.5 mg/L and 4 mg/L against the 61 clarithromycin-resistant (MICs, >0.25 mg/L) isolates, 0.25 and 0.75 mg/L against the 40 levofloxacin-resistant (MICs, >1 mg/L) isolates, and 0.38 mg/L and 0.75 mg/L, respectively, against the 28 isolates resistant to both agents. Conclusions: Briefly, the new pleuromutilin antibiotic outperformed in vitro both clarithromycin and levofloxacin against H. pylori isolates. Its potential usefulness in treating H. pylori infections resistant to macrolides and fluoroquinolones, and especially those with dual resistance, justifies further investigation. However, some precautions should also be considered. The use of the novel antibiotic lefamulin may offer benefits for H. pylori eradication if our results are confirmed in subsequent studies, including clinical trials.