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1.
Cell ; 185(20): 3705-3719.e14, 2022 09 29.
Artículo en Inglés | MEDLINE | ID: mdl-36179667

RESUMEN

The intestinal microbiota is an important modulator of graft-versus-host disease (GVHD), which often complicates allogeneic hematopoietic stem cell transplantation (allo-HSCT). Broad-spectrum antibiotics such as carbapenems increase the risk for intestinal GVHD, but mechanisms are not well understood. In this study, we found that treatment with meropenem, a commonly used carbapenem, aggravates colonic GVHD in mice via the expansion of Bacteroides thetaiotaomicron (BT). BT has a broad ability to degrade dietary polysaccharides and host mucin glycans. BT in meropenem-treated allogeneic mice demonstrated upregulated expression of enzymes involved in the degradation of mucin glycans. These mice also had thinning of the colonic mucus layer and decreased levels of xylose in colonic luminal contents. Interestingly, oral xylose supplementation significantly prevented thinning of the colonic mucus layer in meropenem-treated mice. Specific nutritional supplementation strategies, including xylose supplementation, may combat antibiotic-mediated microbiome injury to reduce the risk for intestinal GVHD in allo-HSCT patients.


Asunto(s)
Enfermedad Injerto contra Huésped , Trasplante de Células Madre Hematopoyéticas , Animales , Antibacterianos/farmacología , Antibacterianos/uso terapéutico , Bacteroides , Carbapenémicos/farmacología , Carbapenémicos/uso terapéutico , Enfermedad Injerto contra Huésped/tratamiento farmacológico , Enfermedad Injerto contra Huésped/etiología , Meropenem , Ratones , Mucinas/metabolismo , Moco/metabolismo , Polisacáridos/metabolismo , Xilosa
2.
Crit Rev Toxicol ; 53(1): 1-14, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-37051806

RESUMEN

Electronic cigarette (EC) usage or vaping has seen a significant rise in recent years across various parts of the world. They have been publicized as a safe alternative to smoking; however, this is not supported strongly by robust research evidence. Toxicological analysis of EC liquid and aerosol has revealed presence of several toxicants with known carcinogenicity. Oral cavity is the primary site of exposure of both cigarette smoke and EC aerosol. Role of EC in oral cancer is not as well-researched as that of traditional smoking. However, several recent studies have shown that it can lead to a wide range of potentially carcinogenic molecular events in oral cells. This review delineates the oral carcinogenesis potential of ECs at the molecular level, providing a summary of the effects of EC usage on cancer therapy resistance, cancer stem cells (CSCs), immune evasion, and microbiome dysbiosis, all of which may lead to increased tumor malignancy and poorer patient prognosis. This review of literature indicates that ECs may not be as safe as they are perceived to be, however further research is needed to definitively determine their oncogenic potential.


Asunto(s)
Sistemas Electrónicos de Liberación de Nicotina , Vapeo , Humanos , Aerosoles , Carcinogénesis
3.
AIDS Care ; 35(12): 1928-1937, 2023 12.
Artículo en Inglés | MEDLINE | ID: mdl-36794343

RESUMEN

Disclosure of HIV status is an important part of pediatric care. We studied disclosure and clinical outcomes in a multi-country Asian cohort of children and adolescents with HIV. Those 6-19 years of age who initiated combination antiretroviral therapy (cART) between 2008 and 2018, and who had at least one follow-up clinic visit were included. Data up to December 2019 were analyzed. Cox and competing risk regression analyses were used to assess the effect of disclosure on disease progression (WHO clinical stage 3 or 4), loss to follow-up (LTFU; > 12 months), and death. Of 1913 children and adolescents (48% female; median [IQR] age 11.5 [9.2-14.7] years at last clinic visit), 795 (42%) were disclosed to about their HIV status at a median age of 12.9 years (IQR: 11.8-14.1). During follow-up, 207 (11%) experienced disease progression, 75 (3.9%) were LTFU, and 59 (3.1%) died. There were lower hazards of disease progression (adjusted hazard ratio [aHR] 0.43 [0.28-0.66]) and death (aHR 0.36 [0.17-0.79]) for those disclosed to compared with those who were not. Disclosure and its appropriate implementation should be promoted in pediatric HIV clinics in resource-limited settings.


Asunto(s)
Revelación , Infecciones por VIH , Humanos , Niño , Femenino , Adolescente , Masculino , Infecciones por VIH/tratamiento farmacológico , Estudios Retrospectivos , Asia/epidemiología , Perdida de Seguimiento , Progresión de la Enfermedad
4.
Oral Dis ; 27 Suppl 3: 655-664, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32428372

RESUMEN

On 11 March 2020, the World Health Organization (WHO) declared the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) as a pandemic. Until an effective treatment or a vaccine is developed, the current recommendations are to contain the disease, and control its transmission. It is now clear that the primary mode of SARS-CoV-2 transmission is aerosol/droplet spread, and by contacting virus-contaminated surfaces acting as fomites (inanimate vectors). Furthermore, recent data indicate that the live virus particles are present in saliva, and, more alarmingly, asymptomatic individuals may transmit the infection. By virtue of the nature of the practice of dentistry where intrinsically, a high volume of aerosols is produced, as well as the close proximity of dentists and patients during treatment, dentists and allied health staff are considered the highest risk health professional group for acquiring SARS-CoV-2 during patient management. Therefore, several organizations and specialty associations have proposed guidelines and recommendations for limiting the transmission of SARS-COV-2 from carriers to dentists and vice versa. This paper aims to provide a review of these guidelines, and concludes with a brief look at how the practice of dentistry may be impacted by COVID-19, in the post-pandemic era.


Asunto(s)
COVID-19 , Infecciones por Coronavirus , Coronavirus , Atención Odontológica , Humanos , SARS-CoV-2
5.
Int J Mol Sci ; 22(14)2021 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-34299287

RESUMEN

Organoids represent one of the most important advancements in the field of stem cells during the past decade. They are three-dimensional in vitro culturing models that originate from self-organizing stem cells and can mimic the in vivo structural and functional specificities of body organs. Organoids have been established from multiple adult tissues as well as pluripotent stem cells and have recently become a powerful tool for studying development and diseases in vitro, drug screening, and host-microbe interaction. The use of stem cells-that have self-renewal capacity to proliferate and differentiate into specialized cell types-for organoids culturing represents a major advancement in biomedical research. Indeed, this new technology has a great potential to be used in a multitude of fields, including cancer research, hereditary and infectious diseases. Nevertheless, organoid culturing is still rife with many challenges, not limited to being costly and time consuming, having variable rates of efficiency in generation and maintenance, genetic stability, and clinical applications. In this review, we aim to provide a synopsis of pluripotent stem cell-derived organoids and their use for disease modeling and other clinical applications.


Asunto(s)
Evaluación Preclínica de Medicamentos/métodos , Técnicas de Cultivo de Órganos/métodos , Organoides/citología , Células Madre Pluripotentes/citología , Animales , Humanos , Modelos Biológicos , Organoides/efectos de los fármacos , Organoides/metabolismo , Células Madre Pluripotentes/efectos de los fármacos , Células Madre Pluripotentes/metabolismo
6.
BMC Oral Health ; 20(1): 274, 2020 10 07.
Artículo en Inglés | MEDLINE | ID: mdl-33028327

RESUMEN

BACKGROUND: The aim of this study was to analyze the root and canal morphology of the maxillary permanent first molars in an Emirati population using cone-beam computed tomography (CBCT). METHODS: Two hundred and sixty-one CBCT scans were acquired. The data were extracted and anonymized to remove all patient identifiers. Two observers (an endodontic resident and an endodontist) evaluated all scans on diagnostic quality monitors. RESULTS: The prevalence of a second mesiobuccal canal (MB2) was 80.1% in all examined samples. Type II Vertucci classification, was the most common canal configuration (59%) in the mesiobuccal root, followed by Types I (19.9%) and IV (15.3%), while Type III was the least common (5.7%). Types I, II, and IV were significantly more common in the 21-40-year age group (P < 0.001), while Type III was observed significantly more often in the < 20-year age group (P < 0.001). No significant effect of gender on the prevalence of Vertucci classification in the mesiobuccal root of maxillary first molars (P = 0.74) was found. Analysis of bilateral symmetry showed that 80% teeth had perfect bilateral symmetry, whereas 20% were asymmetrical. Type II canal configuration showed the highest prevalence of bilateral symmetry (48.7%), followed by Type I (15%) and Type IV (10%), while Type III showed the least prevalence of symmetry (3%). CONCLUSIONS: This was the first study to analyze the prevalence of MB2 canal in an Emirati population. Our results indicate high prevalence of MB2 (80.1%) and emphasize the importance of using advanced techniques to locate the MB2 canal.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Diente Molar , Cavidad Pulpar/diagnóstico por imagen , Humanos , Maxilar/diagnóstico por imagen , Diente Molar/diagnóstico por imagen , Raíz del Diente/diagnóstico por imagen
7.
Adv Exp Med Biol ; 1077: 31-40, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30357682

RESUMEN

Biodegradable scaffolds are useful tools in the field of tissue engineering and regenerative medicine. The aim of this study was to test the potential of the human stem cells of apical papilla (SCAP) to attach, proliferate and differentiate on a polycaprolactone (PCL)-based scaffolds. SCAP were extracted from the root apical papillae of freshly extracted immature premolar teeth by using enzymatic digestion. Porous PCL scaffolds were fabricated using particle leaching method and NaCl or mannitol as porogens. SCAP of passage 3 were seeded on non-porous and porous PCL scaffolds for up to 14 days. For control, cells were cultured on glass coverslips. Picogreen DNA quantification was used to assay for cell proliferation. Cell differentiation and development of calcification nodules were examined using scanning electron microscopy and alizarin red staining. SCAP showed a comparable attachment, growth and proliferation patterns on PCL scaffolds and coverslips. Cell proliferation was enhanced on mannitol scaffolds at all time points. Calcification nodules were detected in all PCL scaffolds while it was not present on glass coverslips. These nodules were detected on NaCl-scaffolds by day 7 and on mannitol and non-porous scaffolds by day 14. In conclusion, SCAP were able to attach, proliferate and differentiate on PCL scaffolds without using any inductive media, indicating their potential application for dental tissue regeneration.


Asunto(s)
Diferenciación Celular , Papila Dental/citología , Células Madre/citología , Andamios del Tejido , Proliferación Celular , Células Cultivadas , Humanos , Poliésteres , Ingeniería de Tejidos
8.
Fetal Pediatr Pathol ; 37(1): 49-68, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29336636

RESUMEN

BACKGROUND: This retrospective study assesses the contribution of genetic disorders in fetuses undergoing postmortem evaluation and the performance of a clinical dysmorphology based systematic approach toward genetic diagnosis. MATERIALS AND METHODS: Ninety fetuses, including spontaneous losses and terminated pregnancies, underwent a postmortem evaluation including dysmorphological examination, radiological studies, and histopathological examination. Genetic testing including karyotyping, biochemical testing, Sanger sequencing, and exome sequencing were performed selectively. RESULTS: A genetic etiology was concluded in 48 fetuses (55%). As a standalone test, dysmorphological examination was able to ascertain a definite genetic diagnosis in sixteen cases, histopathology in six; and karyotyping, biochemical testing and exome sequencing in two cases each (Total 28). Additionally, dysmorphology findings indicated possible genetic disorder in 20 cases. CONCLUSION: Genetic etiologies contribute significantly to fetuses undergoing autopsy in this series. A systematic approach to postmortem fetal evaluation guided by dysmorphological examination provides high diagnostic yield toward perinatal genetic diagnosis.


Asunto(s)
Anomalías Congénitas/diagnóstico , Anomalías Congénitas/genética , Autopsia , Feto , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Cariotipificación , Estudios Retrospectivos , Ultrasonografía Prenatal
9.
Artículo en Inglés | MEDLINE | ID: mdl-28320713

RESUMEN

Percutaneous nephrostomy (PCN) catheters are the primary method for draining ureters obstructed by malignancy and preventing a decline of renal function. However, PCN catheter-related infections, such as pyelonephritis and urosepsis, remain a significant concern. Currently, no antimicrobial PCN catheters are available for preventing infection complications. Vascular catheters impregnated with minocycline-rifampin (M/R) and M/R with chlorhexidine coating (M/R plus CHD) have previously demonstrated antimicrobial activity. Therefore, in this study, we examined whether these combinations could be applied to PCN catheters and effectively inhibit biofilm formation by common uropathogens. An in vitro biofilm colonization model was used to assess the antimicrobial efficacy of M/R and M/R-plus-CHD PCN catheters against nine common multidrug-resistant Gram-positive and Gram-negative uropathogens as well as Candida glabrata and Candida albicans Experimental catheters were also assessed for durability of antimicrobial activity for up 3 weeks. PCN catheters coated with M/R plus CHD completely inhibited biofilm formation for up to 3 weeks for all the organisms tested. The reduction in colonization compared to uncoated PCN catheters was significant for all Gram-positive, Gram-negative, and fungal organisms (P < 0.05). M/R-plus-CHD PCN catheters also produced significant reductions in biofilm colonization relative to M/R PCN catheters for Enterobacter spp., Escherichia coli, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, C. glabrata, and C. albicans (P < 0.05). M/R-plus-CHD PCN catheters proved to be highly efficacious in preventing biofilm colonization when exposed to multidrug-resistant pathogens common in PCN catheter-associated pyelonephritis. M/R-plus-CHD PCN catheters warrant evaluation in a clinical setting to assess their ability to prevent clinically relevant nephrostomy infections.


Asunto(s)
Antibacterianos/uso terapéutico , Enfermedades Renales/tratamiento farmacológico , Enfermedades Renales/microbiología , Antiinfecciosos/uso terapéutico , Biopelículas/efectos de los fármacos , Candida albicans/efectos de los fármacos , Candida albicans/patogenicidad , Candida glabrata/efectos de los fármacos , Candida glabrata/patogenicidad , Enterobacter/efectos de los fármacos , Enterobacter/patogenicidad , Escherichia coli/efectos de los fármacos , Escherichia coli/patogenicidad , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Staphylococcus aureus Resistente a Meticilina/patogenicidad , Nefrotomía , Enterococos Resistentes a la Vancomicina/efectos de los fármacos , Enterococos Resistentes a la Vancomicina/patogenicidad
10.
Antimicrob Agents Chemother ; 59(8): 4397-402, 2015 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-25941227

RESUMEN

Continuous subcutaneous insulin infusion (CSII) using pumps is a widely used method for insulin therapy in patients with diabetes mellitus. Among the major factors that usually lead to the discontinuation of CSII are CSII set-related issues, including infection at the infusion site. The American Diabetic Association currently recommends rotating sites every 2 to 3 days. This recommendation adds cost and creates inconvenience. Therefore, in order to prevent infections and extend the duration between insertion site changes, we developed a Teflon cannula coated with a combination of gentian violet and chlorhexidine (gendine) and tested its antimicrobial efficacy against different pathogens. The cannulas were coated with gendine on the exterior surface and dried. The efficacy and durability of gendine-coated cannulas were determined against methicillin-resistant Staphylococcus aureus, Staphylococcus epidermidis, methicillin-susceptible S. aureus, Streptococcus pyogenes, vancomycin-resistant enterococci, Escherichia coli, Pseudomonas aeruginosa, Candida albicans, and Candida glabrata using a biofilm colonization method. The cytotoxicity of gendine was assessed against mouse fibroblast cell lines. The gendine-coated cannulas showed complete prevention of biofilm colonization of all organisms tested for up to 2 weeks (P < 0.0001) compared to that with the uncoated control. A gendine-coated catheter against mouse fibroblast cells was shown to be noncytotoxic. Our in vitro results show that a novel gendine cannula is highly effective in completely inhibiting the biofilm of multidrug-resistant pathogens for up to 2 weeks and may have potential clinical applications, such as prolonged use, cost reduction, and lower infection rate.


Asunto(s)
Antiinfecciosos/administración & dosificación , Clorhexidina/administración & dosificación , Violeta de Genciana/administración & dosificación , Insulinas/administración & dosificación , Animales , Bacterias/efectos de los fármacos , Biopelículas/efectos de los fármacos , Candida/efectos de los fármacos , Catéteres , Línea Celular , Resistencia a Múltiples Medicamentos/efectos de los fármacos , Infusiones Subcutáneas/métodos , Ratones
11.
Antimicrob Agents Chemother ; 59(9): 5611-8, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26124171

RESUMEN

Antimicrobial peripherally inserted central catheters (PICCs) might reduce the incidence of central line-associated bloodstream infections (CLABSI). We tested the biocompatibility of a novel gendine-coated (combination of chlorhexidine [CHX] and gentian violet [GV]) PICC in a rabbit intravascular model and tested antimicrobial efficacy in comparison with commercially available minocycline/rifampin (M/R)- and CHX-treated PICCs in an in vitro biofilm colonization model. Gendine-coated and uncoated control PICCs were inserted in the jugular veins of rabbits for 4 days. Histopathological analysis was performed at the end of the 4-day period, and circulating levels of CHX and GV in the blood were measured at different time points using liquid chromatography-mass spectrometry. The antimicrobial efficacy of the PICCs was tested following simulated intravascular indwells of 24 h and 1 week against clinical isolates of methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, Pseudomonas aeruginosa, Escherichia coli, Acinetobacter baumannii, Enterobacter cloacae, Candida albicans, and Candida glabrata. Rabbits implanted with gendine-coated PICCs exhibited reduced levels of thrombosis and inflammation compared to those of the rabbits with uncoated controls. No GV was detected in blood samples over the entire study period, and trace concentrations of CHX were detected. The gendine-coated PICCs completely prevented the adherence of all pathogens from 24 h to 1 week (P ≤ 0.001), while M/R-treated, CHX-treated, and control PICCs did not. Gendine-coated PICCs were highly effective in preventing biofilm formation of multidrug-resistant pathogenic bacteria and fungi. Gendine-coated PICCs were biocompatible in an intravascular setting. Further, the pharmacokinetic testing established that acute systemic exposures of CHX and GV from the gendine-coated catheters were well within safe levels.


Asunto(s)
Antiinfecciosos/farmacología , Catéteres de Permanencia/microbiología , Acinetobacter baumannii/efectos de los fármacos , Animales , Antiinfecciosos/efectos adversos , Biopelículas/efectos de los fármacos , Candida albicans/efectos de los fármacos , Candida glabrata/efectos de los fármacos , Enterobacter cloacae/efectos de los fármacos , Femenino , Staphylococcus aureus Resistente a Meticilina/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , Minociclina/efectos adversos , Minociclina/farmacología , Pseudomonas aeruginosa/efectos de los fármacos , Conejos , Rifampin/efectos adversos , Rifampin/farmacología , Enterococos Resistentes a la Vancomicina/efectos de los fármacos
12.
Adv Exp Med Biol ; 830: 157-79, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25366227

RESUMEN

Different types of central venous catheters (CVCs) have been used in clinical practice to improve the quality of life of chronically and critically ill patients. Unfortunately, indwelling devices are usually associated with microbial biofilms and eventually lead to catheter-related bloodstream infections (CLABSIs).An estimated 250,000-400,000 CLABSIs occur every year in the United States, at a rate of 1.5 per 1,000 CVC days and a mortality rate of 12-25 %. The annual cost of caring for patients with CLABSIs ranges from 296 million to 2.3 billion dollars.Biofilm formation occurs on biotic and abiotic surfaces in the clinical setting. Extensive studies have been conducted to understand biofilm formation, including different biofilm developmental stages, biofilm matrix compositions, quorum-sensing regulated biofilm formation, biofilm dispersal (and its clinical implications), and multi-species biofilms that are relevant to polymicrobial infections.When microbes form a matured biofilm within human hosts through medical devices such as CVCs, the infection becomes resistant to antibiotic treatment and can develop into a chronic condition. For that reason, many techniques have been used to prevent the formation of biofilm by targeting different stages of biofilm maturation. Other methods have been used to diagnose and treat established cases of CLABSI.Catheter removal is the conventional management of catheter associated bacteremia; however, the procedure itself carries a relatively high risk of mechanical complications. Salvaging the catheter can help to minimize these complications.In this article, we provide an overview of microbial biofilm formation; describe the involvement of various genetic determinants, adhesion proteins, organelles, mechanism(s) of biofilm formation, polymicrobial infections, and biofilm-associated infections on indwelling intravascular catheters; and describe the diagnosis, management, and prevention of catheter-related bloodstream infections.


Asunto(s)
Biopelículas/crecimiento & desarrollo , Infecciones Relacionadas con Catéteres/sangre , Infecciones Relacionadas con Catéteres/microbiología , Cateterismo Venoso Central/métodos , Consorcios Microbianos/fisiología , Bacterias/clasificación , Bacterias/ultraestructura , Candida/clasificación , Candida/ultraestructura , Infecciones Relacionadas con Catéteres/etiología , Cateterismo Venoso Central/efectos adversos , Catéteres de Permanencia/efectos adversos , Humanos , Microscopía Electrónica
13.
Antimicrob Agents Chemother ; 58(9): 5291-6, 2014 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24957841

RESUMEN

Exchanging a central venous catheter (CVC) over a guide wire for a fresh uncoated CVC in the presence of bacteremia can result in cross-infection of the newly exchanged CVC. A recent retrospective clinical study showed that exchanging a catheter over a guide wire in the presence of bacteremia using an antimicrobial minocycline-rifampin (M/R) catheter may improve outcomes. To expand on this, we developed an in vitro cross-contamination model of exchange to evaluate the efficacy of different antimicrobial CVCs in preventing cross-contamination of multidrug-resistant organisms during exchange. Uncoated CVCs were allowed to form biofilm by methicillin-resistant Staphylococcus aureus (MRSA), Staphylococcus epidermidis, Escherichia coli, Pseudomonas aeruginosa, and Candida albicans. After 24 h, the biofilm-colonized CVCs were placed in a glass tube containing bovine calf serum plus Mueller-Hinton broth, and each catheter was exchanged over a guide wire for a fresh uncoated or an M/R-, chlorhexidine-silver sulfadiazine (CHX/SS)-, or chlorhexidine-M/R (CHX-M/R)-coated CVC. Cross-contamination of exchanged catheters was enumerated by sonication and quantitative plating methods. The exchange of M/R CVCs completely prevented cross-contamination by MRSA biofilms compared to control exchanged CVCs (P<0.0001). Exchange with CHX/SS CVCs reduced but did not completely prevent cross-contamination by MRSA (P=0.005). Exchange with CHX-M/R CVCs completely prevented cross-contamination by MRSA, P. aeruginosa, and C. albicans biofilms (P<0.0001). Furthermore, CHX-M/R CVCs were superior to M/R CVCs against P. aeruginosa and C. albicans (P=0.003) and were superior to CHX/SS CVCs against MRSA and P. aeruginosa (P=0.01). In conclusion, exchange with the novel CHX-M/R CVC was the only exchange effective in completely and concurrently preventing cross-contamination from bacteria and Candida.


Asunto(s)
Infecciones Relacionadas con Catéteres/prevención & control , Catéteres Venosos Centrales/microbiología , Antibacterianos/administración & dosificación , Antibacterianos/uso terapéutico , Biopelículas/efectos de los fármacos , Infecciones Relacionadas con Catéteres/microbiología , Infecciones Relacionadas con Catéteres/transmisión , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/métodos , Catéteres Venosos Centrales/efectos adversos , Clorhexidina/administración & dosificación , Clorhexidina/uso terapéutico , Desinfectantes/administración & dosificación , Desinfectantes/uso terapéutico , Farmacorresistencia Bacteriana Múltiple , Quimioterapia Combinada , Humanos , Minociclina/administración & dosificación , Minociclina/uso terapéutico , Rifampin/administración & dosificación , Rifampin/uso terapéutico
14.
Antimicrob Agents Chemother ; 58(2): 1179-82, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24165191

RESUMEN

Resistant Gram-negative bacteria are increasing central-line-associated bloodstream infection threats. To better combat this, chlorhexidine (CHX) was added to minocycline-rifampin (M/R) catheters. The in vitro antimicrobial activity of CHX-M/R catheters against multidrug resistant, Gram-negative Acinetobacter baumannii, Enterobacter cloacae, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Stenotrophomonas maltophilia was tested. M/R and CHX-silver sulfadiazine (CHX/SS) catheters were used as comparators. The novel CHX-M/R catheters were significantly more effective (P < 0.0001) than CHX/SS or M/R catheters in preventing biofilm colonization and showed better antimicrobial durability.


Asunto(s)
Antibacterianos/farmacología , Biopelículas/efectos de los fármacos , Catéteres/microbiología , Clorhexidina/farmacología , Minociclina/farmacología , Rifampin/farmacología , Acinetobacter baumannii/efectos de los fármacos , Acinetobacter baumannii/crecimiento & desarrollo , Biopelículas/crecimiento & desarrollo , Recuento de Colonia Microbiana , Medios de Cultivo , Combinación de Medicamentos , Enterobacter cloacae/efectos de los fármacos , Enterobacter cloacae/crecimiento & desarrollo , Escherichia coli/efectos de los fármacos , Escherichia coli/crecimiento & desarrollo , Klebsiella pneumoniae/efectos de los fármacos , Klebsiella pneumoniae/crecimiento & desarrollo , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/crecimiento & desarrollo , Stenotrophomonas maltophilia/efectos de los fármacos , Stenotrophomonas maltophilia/crecimiento & desarrollo
15.
BMC Infect Dis ; 14: 518, 2014 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-25253042

RESUMEN

BACKGROUND: Central venous catheters (CVC) removal and reinsertion of a new CVC in the setting of central line associated bloodstream infections (CLABSI) is not always possible in septic patients. The purpose of this study was to evaluate the outcome of patients with Staphylococcus aureus-CLABSI (SA-CLABSI) who had their CVCs exchanged over guidewire for minocycline/rifampin-coated (M/R)-CVC within seven days of bacteremia. METHODS: Each case was matched with two control patients who had SA-CLABSI and had their CVC removed within seven days and two control patients who had their CVC retained beyond seven days. In addition, an in vitro model was developed for exchange of catheters. RESULTS: We identified 40 patients with SA-CLABSI. Eight patients had their CVC exchanged over guidewire with M/R-CVC and were compared to 16 patients who had their CVC removed and 16 other patients who had their CVC retained. Patients who had their CVC exchanged over guidewire had a similar clinical response and relapse rates compared to patients whose CVC was removed or retained. However the rate of overall mortality was higher in patients who retained their CVC compared to those whose CVC was exchanged or removed (p = 0.034). The in vitro catheter exchange model showed that catheter exchange over guidewire using M/R-CVC completely prevented biofilm colonization compared to exchange using uncoated CVC (p < 0.0001). CONCLUSIONS: In the setting of SA-CLABSI, exchanging the CVC over guidewire with M/R-CVC could be an alternative to removing the CVC and reinserting another CVC at a different site and may be associated with a lower rate of overall mortality. Further large prospective randomized clinical trials are warranted.


Asunto(s)
Antibacterianos/administración & dosificación , Bacteriemia/prevención & control , Infecciones Relacionadas con Catéteres/prevención & control , Cateterismo Venoso Central/efectos adversos , Minociclina/administración & dosificación , Rifampin/administración & dosificación , Infecciones Estafilocócicas/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Bacteriemia/etiología , Bacteriemia/mortalidad , Infecciones Relacionadas con Catéteres/etiología , Infecciones Relacionadas con Catéteres/mortalidad , Catéteres Venosos Centrales/microbiología , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Infecciones Estafilocócicas/etiología , Infecciones Estafilocócicas/mortalidad , Adulto Joven
16.
Eur J Dent ; 18(1): 368-377, 2024 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-37591285

RESUMEN

OBJECTIVE: Periodontal disease is one of the most common infectious diseases. Several factors are associated with increased susceptibility of periodontal disease such as hormonal changes during pregnancy. Although pregnancy does not directly cause gingivitis, it can aggravate preexisting periodontal disease. This study aimed to evaluate knowledge of the association between periodontal disease and pregnancy in pregnant females. MATERIALS AND METHODS: A convenience sample of pregnant females attending two United Arab Emirates government hospitals was recruited for this study. A 23-item questionnaire was developed with four sections, covering sociodemographic details, oral hygiene, oral symptoms during pregnancy, and knowledge of periodontal health during pregnancy. The study was conducted between April and October 2017. All participants consented to the survey. RESULTS: A total of 100 participants with a mean age of 31 years (± 5.9) completed the survey. Most respondents brushed their teeth 2 to 3 times a day (65%), used a manual toothbrush (93%) but only visited the dentist when in pain (62%). Few respondents self-reported any gingival signs and symptoms during pregnancy; 38% had bleeding gums, 27% had no gum swelling, and 34% had bad odor/taste/smell. Only 21% of pregnant females lost a tooth/teeth during pregnancy, 15% believed that pregnancy increased the likelihood of gum disease, and 66% of gynecologists did not advise a visit to the dentist.Housewives were significantly less knowledgeable about periodontal health than students/employed respondents (p = 0.01). Quality of knowledge was not associated with educational attainment (< 0.06). Respondents > 30 years of age were more likely to believe in "a tooth for a baby" than younger participants aged < 30 years (p < 0.05). A logistic regression model showed that educational attainment was not a predictor for the belief in "a tooth for a baby" but age was a significant predictor (odds ratio = 2.0). CONCLUSION: Protocols should be developed in antenatal clinics in order to improve periodontal health in pregnant females and to prevent complications that can result in adverse pregnancy outcomes.

17.
Int Dent J ; 74(5): 1142-1150, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-38851929

RESUMEN

INTRODUCTION AND AIMS: Violations of the mandibular canal (MC) and mental foramen (MF) and subsequent injuries to their neurovascular bundle have been reported after surgical and nonsurgical dental procedures. Besides using advanced technologies such as cone-beam computed tomography (CBCT), clinicians should be aware of the anatomy and location of MC and MF in different populations. This study aims to describe the morphologic characteristics of the MF, MC, and its intrabony location in relation to the apices of mandibular posterior teeth in an Emirati subpopulation using CBCT. METHODS: A total of 3700 CBCT scans were screened, and 154 scans that met the inclusion and exclusion criteria were randomly selected. The scans were assessed using 3-dimensional multiplanar imaging for the following structures: the location of MF and the MC course, its intrabony location, and its relationship to the apices of the mandibular posterior teeth. The data were analysed statistically using SPSS software. RESULTS: The MC ran lingually and inferiorly at the posterior region and became more buccal and superior towards the MF. The distal root of the mandibular second molar was found to be the closest root to the MC (2.06 ± 1.83 mm). Moreover, the most common location of the MF was distal to the contact area between the 2 premolars (0.83 ± 1.84 mm) with a significant negative correlation to age (with and increase in age, the MF moves distally). The distance between the root apices and the MC was statistically significantly affected by age (positive correlation) and gender (male patients had a greater distance). CONCLUSIONS: The common course of the MC is lingual and inferior posteriorly and becomes more buccal and superior towards the MF, which is located mostly between the mandibular first and second premolars. Furthermore, the distal root of the mandibular second molar is the closest to the MC and has a positive relationship with age.


Asunto(s)
Tomografía Computarizada de Haz Cónico , Mandíbula , Foramen Mental , Humanos , Masculino , Femenino , Mandíbula/anatomía & histología , Mandíbula/diagnóstico por imagen , Emiratos Árabes Unidos , Adulto , Foramen Mental/diagnóstico por imagen , Foramen Mental/anatomía & histología , Adulto Joven , Adolescente , Nervio Mandibular/anatomía & histología , Nervio Mandibular/diagnóstico por imagen , Persona de Mediana Edad , Imagenología Tridimensional , Diente Molar/anatomía & histología , Diente Molar/diagnóstico por imagen , Ápice del Diente/diagnóstico por imagen , Ápice del Diente/anatomía & histología
18.
Cureus ; 16(4): e57497, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38707175

RESUMEN

Background Lung metastasis in head and neck cancer (HNC) patients is a critical concern, often indicating an advanced disease stage and a poor prognosis. This study explores the molecular complexities of such metastases, identifying specific genes and pathways that may serve as valuable targets for diagnosis and treatment. The findings underscore the potential for significantly improved patient outcomes through targeted therapeutic strategies. Methodology In this research, we systematically collected raw gene expression data from head and neck squamous cell carcinoma (HNSCC) and lung squamous cell carcinoma (LSCC). By comparing tumorous and normal gene expression profiles from paired patient samples, we identified differentially expressed genes (DEGs). Network analysis helped visualize protein interactions and pinpoint crucial hub genes. Through validation and comparison across several datasets, we identified common DEGs. Additionally, we employed Kaplan-Meier analysis and log-rank testing to examine the relationship between gene expression patterns and patient survival. Result The study identified 145 overlapping DEGs in both HNSCC and LSCC, which are crucial for cancer progression and linked to lung metastasis, offering vital targets for personalized therapy by identifying key genes affecting disease development and patient survival. Pathway analyses linked these to lung metastasis, while protein-protein interaction network construction and hub gene identification highlighted genes crucial for development and patient survival, offering targets for personalized therapy. Conclusion Identifying key genes and pathways in lung metastasis from HNC, this study highlights potential targets for enhanced diagnosis and therapy. It underscores the crucial role of molecular insights in driving forward personalized treatment approaches and improving patient outcomes.

19.
Gut Microbes ; 16(1): 2399260, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39239875

RESUMEN

The gut microbiota drives progression to liver fibrosis, the main determinant of mortality in metabolic dysfunction-associated steatohepatitis (MASH). In this study, we aimed to identify bacterial species associated with protection against liver fibrosis in a high-risk population, and test their potential to protect against liver fibrosis in vivo. Based on stool shotgun metagenomic sequencing of 340 subjects from a population cohort disproportionally affected by MASH, we identified bacterial species from the Bacteroidales and Clostridiales orders associated with reduced risk of liver fibrosis. A bacterial consortium was subsequently tested in a mouse model of MASH, which demonstrated protective effects against liver fibrosis. Six of the eight inoculated bacteria were detected in mouse stool and liver. Intrahepatic presence of bacteria was further confirmed by bacterial culture of mouse liver tissue. Changes in liver histological parameters, gut functional profiles, and amino acid profiles were additionally assessed. Comparison between fibrosis-associated human metagenome and bacteria-induced metagenome changes in mice identified microbial functions likely to mediate the protective effect against liver fibrosis. Amino acid profiling confirmed an increase in cysteine synthase activity, associated with reduced fibrosis. Other microbiota-induced changes in amino acids associated with reduced fibrosis included increased gut asparaginase activity and decreased hepatic tryptophan-to-kynurenine conversion. This human-to-mouse study identified bacterial species and their effects on amino acid metabolism as innovative strategies to protect against liver fibrosis in MASH.


Asunto(s)
Aminoácidos , Bacterias , Microbioma Gastrointestinal , Cirrosis Hepática , Hígado , Animales , Humanos , Cirrosis Hepática/microbiología , Cirrosis Hepática/metabolismo , Ratones , Aminoácidos/metabolismo , Bacterias/clasificación , Bacterias/metabolismo , Bacterias/genética , Bacterias/aislamiento & purificación , Masculino , Hígado/metabolismo , Hígado/patología , Hígado/microbiología , Femenino , Heces/microbiología , Ratones Endogámicos C57BL , Persona de Mediana Edad , Hígado Graso/metabolismo , Hígado Graso/microbiología , Modelos Animales de Enfermedad , Metagenoma , Adulto
20.
Cancer Immunol Res ; 2024 Sep 13.
Artículo en Inglés | MEDLINE | ID: mdl-39269772

RESUMEN

Accumulating evidence indicates that the gut microbiome influences cancer progression and therapy. We recently showed that progressive changes in gut microbial diversity and composition are closely associated with tobacco-associated lung adenocarcinoma (LUAD) in a human-relevant mouse model. Furthermore, we demonstrated that the loss of the antimicrobial protein Lcn2 in these mice, exacerbates pro-tumor inflammatory phenotypes while further reducing microbial diversity. Yet, how gut microbiome alterations impinge on LUAD development remains poorly understood. Here, we investigated the role of gut microbiome changes in LUAD development using fecal microbiota transfer and delineated a pathway by which gut microbiome alterations incurred by loss of Lcn2 fostered the proliferation of pro-inflammatory bacteria of the genus Alistipes, triggering gut inflammation. This inflammation propagated systemically, exerting immunosuppression within the tumor microenvironment, augmenting tumor growth through an IL-6-dependent mechanism and dampening response to immunotherapy. Corroborating our preclinical findings, we found that patients with LUAD with a higher relative abundance of Alistipes species in the gut showed diminished response to neoadjuvant immunotherapy. These insights reveal the role of microbiome-induced inflammation in LUAD and present new potential targets for interception and therapy.

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