Effects of side group functionality and molecular weight on the activity of synthetic antimicrobial polypeptides.

The rapid emergence of antibiotic-resistant bacteria along with increasing difficulty in biofilm treatment has caused an immediate need for the development of new classes of antimicrobial therapeutics. We have developed a library of antimicrobial polypeptides, prepared by the ring-opening polymerization of γ-propargyl-L-glutamate N-carboxyanhydride and the alkyne-azide cycloaddition click reaction, which mimic the favorable characteristics of naturally occurring antimicrobial peptides (AmPs). AmPs are known not to cause drug resistance as well as prevent bacteria attachment on surfaces. The ease and scale of synthesis of the antimicrobial polypeptides developed here are significantly improved over the traditional Merrifield synthetic peptide approaches needed for naturally occurring antimicrobial peptides and avoids the unique challenges of biosynthetic pathways. The polypeptides range in length from 30 to 140 repeat units and can have varied side group functionality, including primary, secondary, tertiary, and quaternary amines with hydrocarbon side chains ranging from 1 to 12 carbons long. Overall, we find these polypeptides to exhibit broad-spectrum activity against both Gram positive and Gram negative bacteria, namely, S. aureus and E. coli , while having very low hemolytic activity. Many of the polypeptides can also be used as surface coatings to prevent bacterial attachment. The polypeptide library developed in this work addresses the need for effective biocompatible therapeutics for drug delivery and medical device coatings.

Health Care Needs of Incarcerated Patients: A Case Study at a Large Urban Hospital.

This study examined a sample of incarcerated patients who received health care at an urban safety-net hospital in Massachusetts. Sociodemographic, clinical, and utilization data were obtained from patients' charts and administrative data. Our sample was 87% male and 36% Black and included a large proportion of patients with substance-related use. Incarcerated patients receiving outside care had a wide range of acute and chronic medical and surgical conditions, necessitating both emergent and scheduled care. The most frequent outpatient encounters included surgery (neurosurgery and oral/maxillofacial surgery), ophthalmology, medicine, and radiation oncology. Our findings provide a better understanding of the health care services that incarcerated patients may require outside their facilities and the kinds of interventions and policies that are needed to increase access to more timely care.