Antimicrobial, antibiofilm, and antiviral investigations using egyptian phoenix dactylifera L. pits extract.

Phoenix dactylifera L. and its wastes are known to be high in nutrients that are beneficial to human health. The study aimed to evaluate the antimicrobial, antibiofilm, and antiviral properties of Phoenix dactylifera L. pits extract (PDPE) in vitro. Gas chromatography-mass spectrometry (GC-MS) analysis indicated phenol, 2,5-bis(1,1-dimethyl ethyl), tetradecanoic acid, octaethylene glycol monododecyl ether, á-D-glucopyranosiduronic acid, and heptaethylene glycol monododecyl ether existence. The PDPE influenced pathogenic microorganisms, with inhibition zone diameters (IZDs) ranging from 10.0 to 35.0 mm. Staphylococcus aureus ATCC 5638 had the highest IZD, while Salmonella typhi DSM 17058 and Shigella sonnei DSM 5570 had the lowest. The antifungal effect observed only in spore failure or conidia formation. PDPE showed a 100% antibacterial spectrum against bacteria, with MIC values between 250 and 1000 µg/ml. MIC was only indicated with S. aureus of 500 µg/ml. MBC values ranged from 500 to 1000 g/ml, with MBC values of 500 g/ml for B. cereus, E. faecalis, S. typhi, and S. sonnei. The activity was 66.7% at 500 µg/ml, further concentrations of 125-250 g/ml had no antibacterial effect. PDPE biofilm inhibition % had the highest percentage of inhibition (98.59%) with S. aureus, B. cereus (94.12%), and E. coli (74.46%). With 50% (CC50) viral activity, the highest non-toxic PDPE dose was found to be at 123.0 µg/ml.

Adherence to stewardship recommendations for antibiotic discontinuation reduces antibiotic-associated adverse drug events.

Inappropriate antibiotic use may lead to increased adverse drug events (ADEs). This study assessed whether an antimicrobial stewardship recommendation to discontinue antibiotics in patients with low likelihood for bacterial infection reduced antibiotic duration and antibiotic-associated ADEs. At a 4-hospital system, hospitalized adult patients receiving empiric antibiotics for suspected infection were identified between May 2, 2016 and June 30, 2018. For those patients who were deemed unlikely to have a bacterial infection, a note was left by an infectious diseases physician recommending antibiotic discontinuation. Patient cases were considered "adherent" to recommendations if antibiotics were discontinued within 48 hours of the note and "non-adherent" to recommendations if antibiotics were continued beyond this. Duration of antibiotics and potential antibiotic-associated ADEs were collected retrospectively. Attribution of the adverse event to the antibiotic was decided upon by the investigators. The incidence of ADEs and duration of antibiotics between the adherent and non-adherent groups were compared. Of 253 patients deemed unlikely to have a bacterial infection, 114 (45%) treatment teams stopped antibiotics within 48 hours of the recommendation, and 139 (55%) continued antibiotics. The total number of ADEs was significantly higher in the non-adherent group compared to the adherent group (34 ADEs vs 9 ADEs, P = .001). The median number of total prescribed antibiotic days was higher in the non-adherent group than in the adherent group (5 days vs 1 day, P < .001). This study demonstrates that stewardship programs may prevent ADEs by recommending antibiotic discontinuation in patients with low suspicion for bacterial infection.

Peritoneal Dialysis-Related Peritonitis With Acinetobacter Pittii: A Case Report.

We demonstrate the first reported case of peritoneal dialysis (PD)-related peritonitis with Acinetobacter pittii. Although previous reports have reported the uncommon similar infection in the larger Acinetobacter calcoaceticus-baumannii complex group of organisms, none have particularly focused on A pittii. Furthermore, we present a case of a young man with end-stage renal disease on PD who had a severe infection with A pittii. Although the organism was sensitive to ceftazidime, and despite a 4-week extended course of intraperitoneal antibiotics, the patient had a worsening infection leading to the removal of the PD catheter. Furthermore, the case illustrates the importance of proper sterile technique and hand hygiene, as this may have been the nidus of infection for this case.

Hair Follicle-Related MicroRNA-34a Serum Expression and rs2666433A/G Variant in Patients with Alopecia: A Cross-Sectional Analysis.

Alopecia areata (AA) is a type of immune-mediated alopecia. Recent studies have suggested microRNAs' (miRNAs) implication in several cellular processes, including epidermal and hair follicle biology. Single nucleotide polymorphisms (SNPs) can modify gene expression levels, which may induce an autoimmune response. This case−control study included 480 participants (240 for each case/control group). MicroRNA-34a gene (MIR-34A) rs2666433A/G variant was genotyped using real-time allelic discrimination polymerase chain reaction (PCR). Additionally, circulatory miR-34a levels were quantified by quantitative reverse transcription PCR (qRT-PCR). On comparing between alopecia and non-alopecia cohorts, a higher frequency of A variant was noted among patients when compared to controls­A allele: 28 versus 18% (p < 0.001); A/A genotype: 9 versus 2%; A/G genotype: 39 versus 32% (p < 0.001). A/A and A/G carriers were more likely to develop alopecia under heterozygote comparison (OR = 1.83, 95% CI = 1.14−2.93), homozygote comparison (OR = 4.19, 95% CI = 1.33−13.1), dominant (OR = 2.0, 95% CI = 1.27−3.15), recessive (OR = 3.36, 95% CI = 1.08−10.48), over-dominant (OR = 1.65, 95% CI = 1.04−32.63), and log additive (OR = 1.91, 95% CI = 1.3−2.82) models. Serum miR-34a expression levels were upregulated in alopecia patients with a median and quartile fold change of 27.3 (1.42−2430). Significantly higher levels were more pronounced in A/A genotype patients (p < 0.01). Patients carrying the heterozygote genotype (rs2666433 * A/G) were two times more likely to develop more severe disease grades. Stratified analysis by sex revealed the same results. A high expression level was associated with concomitant autoimmune comorbidities (p = 0.001), in particular SLE (p = 0.007) and vitiligo (p = 0.049). In conclusion, the MIR34A rs2666433 (A/G) variant is associated with AA risk and severity in the studied population. Furthermore, high miR-34a circulatory levels could play a role in disease pathogenesis.

Association of Rs231775 Genetic Variant of Cytotoxic T-lymphocyte Associated Protein 4 with Alopecia Areata Disease in Males: A Case-Control Study.

BACKGROUND: Alopecia Areata (AA) is a common inflammatory immune-mediated non-scarring hair loss; however, the exact genetic susceptibility remains to be clarified. Cytotoxic T-lymphocyte Associated Protein 4 (CTLA4) has emerged as a central and critically important modulator of immune responses and is believed to play a crucial rule in AA pathogenesis. OBJECTIVES: To investigate the association of CTLA4 variant (rs231775) within codon 17 with AA risk and outcomes. METHODS: Genetic analyses of the rs231775 SNP of CTLA4 gene were performed in 186 males (93 AA patients and 93 controls). RESULTS: The rs231775 CTLA4 variant was significantly higher in AA patients in comparison with control subjects especially among heterozygous and dominant model. This association varied significantly with disease severity. CONCLUSIONS: Individuals with homozygosity of rs231775 CTLA4 variant represented AA disease risk and increased severity than their counterparts.Abbreviations: AA: Alopecia areata; CTLA4: Cytotoxic T-lymphocyte Associated Protein 4; SNP: Single nucleotide polymorphism; LADA: Latent autoimmune diabetes in adults; SLE: Systemic lupus erythematosus; SCU: Suez Canal University; SALT: Severity of Alopecia Tool; DNA: Deoxyribonucleic acid; RT-PCR: Real-time polymerase chain reaction, HWE: Hardy-Weinberg equation; RA: rheumatoid arthritis.

Therapeutic implications and role of serum sphingolipids on psoriasis severity after narrow band ultraviolet B treatment: A cross sectional controlled study.

Sphingolipids (SLs), are structural components of the skin that contribute to the regulation of the proliferation and differentiation of keratinocytes as well as regulation of the skin epidermal barrier. A prospective cross sectional comparative controlled study was designed to evaluate the serum level of sphingosine 1 phosphate (S1P) and ceramide (CER) before and after narrow band ultraviolet B (NBUVB) in psoriatic patients. The study included 32 patients presented with psoriasis and 32 healthy age and sex matched control volunteers. (S1P and CER) levels were measured before and after NBUVB sessions for psoriatic patients and their levels were correlated to psoriasis area and severity index (PASI) improvements. PASI scores and serum values of the studied sphingolipids demonstrated a significant difference between the baseline and at the end of the 12 weeks NBUVB treatment. A statistically significant positive correlation was established between psoriasis severity and S1P serum levels before and after treatment while no correlation was observed between psoriasis severity and CER serum levels. Decreased total CER and increased S1P serum levels reflect altered sphingolipid metabolism in psoriasis and can be predictors of disease severity.

Randomized clinical trial of CO2 LASER pinpoint irradiation technique versus chemical reconstruction of skin scars (CROSS) in treating ice pick acne scars.

BACKGROUND: Pinpoint irradiation technique CO2 LASER and Chemical Reconstruction Of Skin Scars (CROSS) are effective treatments for atrophic acne scars as fractional photothermolysis. OBJECTIVE: This study was designed to prospectively compare the use of a pinpoint irradiation technique versus TCA CROSS in treating ice pick acne scars. METHODS: Thirty-two patients with ice pick acne scars were included in this open, label pilot study. Pinpoint irradiation technique by CO2 LASER and TCA CROSS were applied for the study and control group, respectively. Twenty-eight patients with ice pick acne scars were included in this open, label pilot study. They were randomly assigned to two groups: the first group (14 patients) received pinpoint irradiation by CO2 LASER as a study group, and the second group (14 patients) received TCA CROSS as a control group. In both treatments, there were four sessions at 3-week interval, and 3 months of follow up. RESULTS: There were statistically significant difference in acne scar severity index and qualitative scarring grading system in the improvement results between the study and control groups (p < 0.05). CONCLUSION: Pinpoint irradiation technique by CO2 LASER is safe and more effective than TCA CROSS technique. Clinical improvement was achieved in all 14 patients without dramatic adverse effects.