Metal Nanoparticle-Based Biosensors for the Early Diagnosis of Infectious Diseases Caused by ESKAPE Pathogens in the Fight against the Antimicrobial-Resistance Crisis.

The species included in the ESKAPE group (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa and the genus Enterobacter) have a high capacity to develop antimicrobial resistance (AMR), a health problem that is already among the leading causes of death and could kill 10 million people a year by 2050. The generation of new potentially therapeutic molecules has been insufficient to combat the AMR "crisis", and the World Health Organization (WHO) has stated that it will seek to promote the development of rapid diagnostic strategies. The physicochemical properties of metallic nanoparticles (MNPs) have made it possible to design biosensors capable of identifying low concentrations of ESKAPE bacteria in the short term; other systems identify antimicrobial susceptibility, and some have been designed with dual activity in situ (bacterial detection and antimicrobial activity), which suggests that, in the near future, multifunctional biosensors could exist based on MNPs capable of quickly identifying bacterial pathogens in clinical niches might become commercially available. This review focuses on the use of MNP-based systems for the rapid and accurate identification of clinically important bacterial pathogens, exhibiting the necessity for exhaustive research to achieve these objectives. This review focuses on the use of metal nanoparticle-based systems for the rapid and accurate identification of clinically important bacterial pathogens.

Burkholderia cepacia complex in cystic fibrosis: critical gaps in diagnosis and therapy.

Burkholderia cepacia complex (Bcc) is a bacterial group with 'natural' multi-antimicrobial resistance. This complex has generated epidemic outbreaks across the world. In people with cystic fibrosis (CF), Bcc can cause severe lung infections that lead to accelerated lung damage, which can be complicated by necrotizing pneumonia accompanied by high fevers, leucocytosis, and bacteraemia, which commonly causes fatal outcomes. Specifically, infection by Burkholderia cenocepacia is considered an exclusion criterion for lung transplantation. The species of Bcc exhibit both genetic and phenotypic hypervariability that complicate their accurate microbiological identification. Automated methods such as MALDI-TOF can err in the determination of species. Their slow growth even in selective agars and the absence of international consensuses on the optimal conditions for their isolation make early diagnosis a difficult challenge to overcome. The absence of correlations between antibiograms and clinical results has resulted in the absence of standardized cut-off values of antimicrobial susceptibility, a fact that brings a latent risk since incorrect antibiotic therapy can induce the selection of more aggressive variants that worsen the clinical picture of the host, added to the absence of a clear therapeutic guide for the eradication of pulmonary infections by Bcc in patients with CF, resulting in frequently ineffective treatments. There is an urgent need to standardize methods and diagnostic tools that would allow an early and accurate diagnosis, as well as to perform clinical studies of the effectiveness of available antibiotics to eradicate Bcc infections, which would allow us to establish standardized therapeutic schemes for Bcc-infected patients.

Diagnosis and Therapeutic Strategies Based on Nucleic Acid Aptamers Selected against Pseudomonas aeruginosa: The Challenge of Cystic Fibrosis.

Antimicrobial resistance (AMR) is a rapidly spreading global health problem, and approximately five million deaths associated with AMR pathogens were identified prior to the COVID-19 pandemic. Pseudomonas aeruginosa has developed increasing AMR, and in patients with cystic fibrosis (CF) colonized by this bacterium, rare phenotypes have emerged that complicate the diagnosis and treatment of the hosts, in addition to multiple associated "epidemic strains" with high morbidities and mortalities. The conjugation of aptamers with fluorochromes or nanostructures has allowed the design of new identification strategies for Pseudomonas aeruginosa with detection limits of up to 1 cell ⋅ mL-1 , and the synergy of aptamers with antibiotics, antimicrobial peptides and nanostructures has exhibited promising therapeutic qualities. Some selected aptamers against this bacterium have shown intrinsic antimicrobial activity. However, these aptamers have been poorly evaluated in clinical isolates and have shown decreased interactions for CF isolates, demonstrating, in these cases, uncommon phenotypes resulting from the selective qualities of this disease as well as the great adaptive capacity of the pathogen. Therefore, finding an aptamer or set of aptamers that have the ability to recognize strange phenotypes of this bacillus is crucial in the battle against AMR.

A Combination of Caffeine, TeaCrine, and Dynamine Improves the Neurophysiological and Performance Measures of Electronic (E)-Gamers.

INTRODUCTION: Video games require precise motor skills, quick reaction times, and cognitive engagement. The tremendous growth of the electronic (e)-gaming industry has increased the demands for cognitive supplements (e.g., nootropics) to help e-athletes gain a competitive edge. The primary aim of this study was to evaluate the effects of combined caffeine + TeaCrine + Dynamine measures of neurophysiological and first-person shooter game performance in e-gamers. METHODS: Using a randomized double-blinded, crossover design, we assessed the effects of an acute, single-dose treatment of caffeine (200 mg) vs. caffeine (200 mg) + TeaCrine (10 mg) + Dynamine (50 mg) (CTD) vs. Ppacebo (maltodextrin). Each participant was tested under all three conditions one week apart. Baseline and post-dose measures were tested one hour apart. Participants [n = 49 male (24.4 ±, 4.5 yr)] were amateur e-gamers who play a first-person video game for at least 10 hours/week. Gaming performance was assessed through a series of first-person shooter training games through AIMLAB (State Space Labs, Inc., New York, USA). These included Reflex Shot (RS) standard, speed, and precision. The neurophysiological activity was captured while participants played three games through a single-channel EEG. RESULTS: In the standard game, the caffeine and the CTD conditions shot significantly more targets relative to the placebo, and both caffeine and the CTD condition had significantly greater targets post-dose compared to pre-dose. However, both the placebo and caffeine conditions had significantly slower reaction times post-dose compared to pre-dose. In the speed game, both the caffeine and placebo conditions shot a significantly greater number of targets, while the placebo and caffeine conditions had significantly more shots post-dose compared to pre-dose. Only the CTD condition had a significant increase in total kills post-dose compared to pre-dose. In the precision game, only the CTD condition significantly improved the number of kills per second post-dose, while only the caffeine condition had more shots post-dose. EEG data collected concomitantly with game playing showed that the CTD condition resulted in significantly lower alpha power compared to the placebo condition. The CTD group also showed increased theta activity post-dose during game playing compared to both the placebo caffeine conditions. CONCLUSION: CTD appears to improve overall shooting gaming performance and neurophysiological measures of cognitive activity compared to caffeine and placebo. Collectively, these findings suggest that CTD assists with speed-accuracy tradeoffs where caffeine-only can lead to erratic play; thus, CTD may be particularly beneficial for shooting precision. The EEG data support this notion since the CTD exhibited lower alpha power suggesting increased cognitive flexibility and arousal and higher theta power suggesting greater cognitive control and decision-making under pressure.

Correction: The Effects of a Pre-workout Supplement on Measures of Alertness, Mood, and Lower-Extremity Power.

[This corrects the article DOI: 10.7759/cureus.24877.].

The Effects of 5-HTP on Body Composition: An 8-Week Preliminary RCT.

The purpose of this investigation was to determine the effects of supplementing with 100 mg daily of 5-Hydroxytryptophan (5-HTP) on indices of body composition in exercise-trained men and women. Sixty-one subjects volunteered for this investigation. Forty-eight subjects were randomized into a treatment (n = 31, 12 male/19 female; 100 mg 5-HTP daily; CLEANMOOD™) or a placebo (n = 17, six male/11 female; maltodextrin). Body composition was assessed pre- and post-treatment after eight weeks via a multi-frequency bioelectrical impedance device (InBody® 270). Subjects were instructed to not change their training or eating habits; moreover, they were instructed to track their diet ∼2-3 days per week using a mobile app (MyFitnessPal). There were no changes in food intake (i.e. total energy intake or grams of macronutrients) between or within groups. Lean body mass, total body water, and % body fat did not change significantly in either group. Fat mass decreased significantly post versus pre in the 5-HTP group (p = 0.02) but did not change in the placebo group (p = 0.58). Moreover, changes in fat mass were significantly different between the 5-HTP and placebo group (p = 0.048). Based on the limited data from this investigation, daily supplementation with 100 mg of 5-HTP may affect body composition.

The Effects of a Pre-workout Supplement on Measures of Alertness, Mood, and Lower-Extremity Power.

Objective The purpose of this study was to investigate the effects of a multi-ingredient pre-workout supplement (MIPS) on mental and physical performance. Materials and methods Fourteen exercise-trained men (n=7) and women (n=7) completed this randomized, placebo-controlled, double-blind, counterbalanced, crossover trial. Participants consumed either a MIPS or a placebo in a randomized, counterbalanced order. Forty-five minutes after consumption, the following assessments were conducted: psychomotor vigilance test (PVT), Profile of Mood States (POMS), vertical jump test, and heart rate and blood pressure. There was a one-week washout period between assessments. Results Statistically significant differences were observed between the treatment and placebo groups for the PVT (reaction time: treatment: 286 ± 28 ms, placebo: 306 ± 46 ms, p=0.0371) and POMS (i.e., vigor: treatment: 15.2 ± 14.9, placebo: 9.7 ± 9.6, p=0.0403; fatigue: treatment: 1.0 ± 1.1, placebo: 3.3 ± 3.4, p=0.0100). There were no significant differences between groups for the other indices of mood, false starts from the PVT, and vertical jump. Conclusion Based on our findings, the acute consumption of a MIPS produced a significant improvement in a sustained-attention, reaction-timed task as well as measures of vigor and fatigue.

Aptámeros acoplados a nanopartículas para el diagnóstico y tratamiento de las infecciones microbianas / Aptamers coupled to nanoparticles in the diagnosis and treatment of microbial infections

Existen nanopartículas con características antibacterianas destacables y aptámeros capaces de reconocer con gran afinidad y especificidad a determinadas bacterias patógenas. La combinación de ambos sistemas se ha utilizado en el diseño de métodos rápidos de detección bacteriana con excelentes límites de detección. Asimismo, la sinergia entre aptámeros y nanopartículas ha permitido optimizar la actividad antimicrobiana de antibióticos y otras nanoestructuras dotándolos de actividad bacteria-específica, convirtiéndolas en herramientas atractivas y prometedoras frente a las bacterias resistentes a múltiples antimicrobianos

There are nanoparticles with remarkable antibacterial characteristics and aptamers able to recognize specific pathogenic bacteria with high affinity and specificity. The combination of both systems has been used to design rapid bacterial detection methods with excellent detection limits. Likewise, the synergism between aptamers and nanoparticles have allowed to optimize the antimicrobial activity of antibiotics and other nanostructures providing them with activity bacterium-specific, turning into attractive and promising tools to fight against bacteria resistant to multiple antimicrobials

Aptamers coupled to nanoparticles in the diagnosis and treatment of microbial infections. / Aptámeros acoplados a nanopartículas para el diagnóstico y tratamiento de las infecciones microbianas.

There are nanoparticles with remarkable antibacterial characteristics and aptamers able to recognize specific pathogenic bacteria with high affinity and specificity. The combination of both systems has been used to design rapid bacterial detection methods with excellent detection limits. Likewise, the synergism between aptamers and nanoparticles have allowed to optimize the antimicrobial activity of antibiotics and other nanostructures providing them with activity bacterium-specific, turning into attractive and promising tools to fight against bacteria resistant to multiple antimicrobials.

Effect of oral glycine on the clinical, spirometric and inflammatory status in subjects with cystic fibrosis: a pilot randomized trial.

BACKGROUND: Patients with cystic fibrosis (CF) have airway inflammation that contributes to symptoms and to pulmonary function derangement. Current drugs used to diminish airway inflammation improve the clinical and spirometric status of patients with CF, but their use is limited due to their undesired side effects, for example, glucose intolerance, growth retardation, and cataracts with corticosteroids, gastrointestinal toxicity with ibuprofen, and macrolide resistance with azythromycin. Glycine is known to decrease activation of inflammatory cells, including alveolar macrophages and neutrophils, and is relatively inexpensive, palatable, and virtually devoid of untoward effects. These features make glycine a good candidate for antiinflammatory treatment of CF. Thus, we aimed to explore whether glycine can exert a beneficial effect in a population of patients with CF. METHODS: This was a randomized, double blinded, cross-over pilot clinical trial. Subjects with CF received, in random order, oral glycine (0.5 g/kg/day, dissolved in any liquid) and placebo (glass sugar), each during 8 weeks with an intermediate 2-week wash-out period. RESULTS: Thirteen subjects aged 6-23 years, 8 females, completed the two arms of the study. As compared with placebo, after glycine intake patients had better symptom questionnaire scores (p = 0.02), mainly regarding sputum features and dyspnea. While spirometric variables tended to decline during placebo intake, they remained stable or even increased during glycine treatment (p = 0.04 to p = 0.003). In this context, FEV1 declined 8.6% after placebo and increased 9.7% at the end of the glycine period. Pulse oximetry improved after glycine intake (p = 0.04 vs. placebo). TNF-α in serum and IL-6 and G-CSF in sputum tended to decline at the end of the glycine period (p = 0.061, p = 0.068 and p = 0.04, respectively, vs placebo). Glycine was remarkably well tolerated. CONCLUSIONS: The clinical, spirometric and inflammatory status of subjects with CF improved after just 8 weeks of glycine intake, suggesting that this amino acid might constitute a novel therapeutic tool for these patients. Thus, further studies are warranted. TRIAL REGISTRATION: www.clinicaltrials.gov , registration number: NCT01417481 , date of registration: March 12, 2012.

A kinetic and electromyographic comparison of the standing cable press and bench press.

This study compared the standing cable press (SCP) and the traditional bench press (BP) to better understand the biomechanical limitations of pushing from a standing position together with the activation amplitudes of trunk and shoulder muscles. A static biomechanical model (4D Watbak) was used to assess the forces that can be pushed with 2 arms in a standing position. Then, 14 recreationally trained men performed 1 repetition maximum (1RM) BP and 1RM single-arm SP exercises while superficial electromyography (EMG) of various shoulder and torso muscles was measured. The 1RM BP performance resulted in an average load (74.2 +/- 17.6 kg) significantly higher than 1RM single-arm SP (26.0 +/- 4.4 kg). In addition, the model predicted that pushing forces from a standing position under ideal mechanical conditions are limited to 40.8% of the subject's body weight. For the 1RM BP, anterior deltoid and pectoralis major were more activated than most of the trunk muscles. In contrast, for the 1RM single-arm SP, the left internal oblique and left latissimus dorsi activities were similar to those of the anterior deltoid and pectoralis major. The EMG amplitudes of pectoralis major and the erector muscles were larger for 1RM BP. Conversely, the activation levels of left abdominal muscles and left latissimus dorsi were higher for 1RM right-arm SP. The BP emphasizes the activation of the shoulder and chest muscles and challenges the capability to develop great shoulder torques. The SCP performance also relies on the strength of shoulder and chest musculature; however, it is whole-body stability and equilibrium together with joint stability that present the major limitation in force generation. Our EMG findings show that SCP performance is limited by the activation and neuromuscular coordination of torso muscles, not maximal muscle activation of the chest and shoulder muscles. This has implications for the utility of these exercise approaches to achieve different training goals.

Risk factors for lead poisoning among Cuban refugee children.

OBJECTIVES: This study was designed to explore whether parental activities such as repairing cars, welding, and rebuilding car batteries are risk factors for lead poisoning among Cuban refugee children in Miami-Dade County. METHODS: The authors performed a cross-sectional study of 479 children aged 12-83 months who had lived in Cuba during the six months prior to immigrating to the U.S. Lead levels were obtained, and parents provided information on demographics, home/neighborhood environment in Cuba prior to immigration, family/occupational factors prior to immigration, and child behavior factors. RESULTS: Of 479 children, 30 (6.3%) had elevated blood lead levels (EBLLs), defined as > or = 10 microg/dL, based on the Centers for Disease Control and Prevention action level. In multivariate analysis, racial/ethnic identification other than white, living in a home built after 1979, car repair in the home or yard, eating paint chips, and male sex were independently associated with EBLL. CONCLUSIONS: Risk factors for lead poisoning among immigrant children may differ from those among U.S.-born children. Screening of immigrant children who may have been exposed in their country of origin and education of immigrant parents about lead exposure hazards associated with activities such as car repair should be considered in the design of lead poisoning prevention and control programs.

Neumonía por Chlamydia trachomatis, revisión de la literatura: a propósito de un caso / Pneumonia caused by chlamydia trachomatis: report of a case and review of the literature

Presentamos el caso de un lactante con neumopatía crónica cuya madre tuvo leucorrea en último trimestre del embarazo y posteriormente al parto. El ejemplo de pruebas rápidas y específicas para la detección del antígeno mediante técnicas de ELISA e inmunofluorescencia directa, tanto de las secreciones bronquiales de la paciente como en las cervicovaginales de la madre, permitió diagnosticar neumonía por Chlamydia trachomatis adquirida al momento del nacimiento. Se empleó claritromicina durante 14 días consecutivos, y se obtuvo mejoría clínica con erradicación de la bacteria de la vía aérea de la paciente. Es el primer caso informado en México de neumonía por Chlamydia trachomatis tratado con éxito con claritromicina. El seguimiento de la paciente permitió documentar cuadros leves de hiperreactividad bronquial