Preparation of Nano-Medicine to Eliminate Helicobacter pylori Infection.

Helicobacter pylori (H. pylori) is considered a challenging type of bacteria that is difficult to treat with the currently used antibiotics, such as amoxicillin, erythromycin, and metronidazole, which have proven ineffective against these bacteria. In this study, modern technology was used to treat these bacteria by converting the aforementioned antibiotics to their nano state using the lyophilization method and diagnosing them using scanning electron microscopy. A mixture of the three nano-antibiotics was prepared in the form of a nano-medicine, which was used to treat H. pylori bacteria in cultures and determine the effectiveness of nano-antibiotics and nano-medicine on these bacteria. The findings showed that nano-medicine was highly effective in inhibiting these bacteria at the lowest concentration (OD=0.042) and the highest concentration (OD=0.038), compared to the three micro-antibiotics individually. The OD values of amoxicillin, azithromycin, and metronidazole were 0.523, 0.521, and 0.453, respectively. The OD values of the three nano-antibiotics, including nano-amoxicillin, nano-azithromycin, and nano-metronidazole, were 0.386, 0.258, and 0.167, respectively. It was observed that the percentage of inhibition in each of the nano-antibiotics was higher than the inhibition in micro-antibiotics and that the nano-medicine had much higher inhibition than each of the three micro- and nano-antibiotics alike. The safety of using nano-antibiotics in the prepared medicine was confirmed using electrochemical technology and cyclic voltammetry to identify the electrochemical properties through oxidation and reduction in blood media. Based on the findings, only reduction peaks appeared, and there were no oxidation peaks in the prepared kit or for each of the three nano-antibiotics. It was found that they were all non-oxidants and could be used safely as good antioxidants in treatments. However, the same three micro treatments showed blood oxidation due to the appearance of oxidation peaks in all of them. The study proved that all H. pylori isolates are resistant to usable antibiotics. All of the antibiotics in the nano-medicine had an anti-bacterial effect, and the effect of the new form of antibiotic was proportional to the concentration of the antibiotic.

Consensus Report by the Pediatric Acute Lung Injury and Sepsis Investigators and Pediatric Blood and Marrow Transplant Consortium Joint Working Committees on Supportive Care Guidelines for Management of Veno-Occlusive Disease in Children and Adolescents: Part 2-Focus on Ascites, Fluid and Electrolytes, Renal, and Transfusion Issues

Even though hepatic veno-occlusive disease (VOD) is a potentially fatal complication of hematopoietic cell transplantation (HCT), there is paucity of research on the management of associated multiorgan dysfunction. To help provide standardized care for the management of these patients, the HCT Subgroup of the Pediatric Acute Lung Injury and Sepsis Investigators and the Supportive Care Committee of the Pediatric Blood and Marrow Transplant Consortium, collaborated to develop evidence-based consensus guidelines. After conducting an extensive literature search, in part 2 of this series we discuss the management of fluids and electrolytes, renal dysfunction; ascites, pleural effusion, and transfusion and coagulopathy issues in patients with VOD. We consider the available evidence using the GRADE criteria.

Tigecycline prevents LPS-induced release of pro-inflammatory and apoptotic mediators in neuronal cells.

Pro-inflammatory and pro-apoptotic mediators have been involved in the pathogenesis of neurodegenerative diseases. Tigecycline (Tig), a glycylcycline antibiotic and an analog of Minocycline, is shown to exert anti-inflammatory effects that are distinct from its anti-microbial activity. Its neuroprotective mechanism is unknown. In this study, we investigated the direct protective mechanisms of tigecycline against lipopolysaccharide (LPS)-induced Rat pheochromocytoma (PC12) cells. The results showed that tigecycline significantly attenuated the expression and the release of nuclear factor-kappa beta (NF-κB), tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1ß), as well as nitric oxide (NO) levels in LPS-induced PC12 cells. In addition, tigecycline dose-dependently decreased cytochrome c release and caspase-3 activity. This later finding corroborated the results of decreased pro-apoptotic Bad, and increased anti-apoptotic Bcl-2 protein expression thus, confirming a neuroprotective effect of the drug in differentiated PC12 cells induced with LPS. The findings of our study suggest new targets for tigecycline and support the potential for tigecycline to be investigated as a therapeutic agent for neurodegenerative disorders.

Successful unrelated umbilical cord blood transplantation in children with Shwachman-Diamond syndrome.

Shwachman-Diamond syndrome (SDS) is an autosomal recessive disorder characterized by pancreatic insufficiency and variable degrees of neutropenia. SDS patients are at risk of developing myelodysplasia, aplastic anemia, and leukemic transformation. The role and timing of allogeneic hematopoietic stem cell transplantation (HSCT) in SDS remain controversial. We report three SDS patients with severe aplasia transplanted using unrelated umbilical cord blood (UCB). Patients received melphalan (180 mg/m2), etoposide (1200 mg/m2), anti-thymocyte globulin (90 mg/kg), and total lymphoid irradiation (500 cGy); graft-versus-host disease (GVHD) prophylaxis consisted of cyclosporine and prednisone. Myeloid engraftment occurred promptly with absolute neutrophil count >500 cells/mm3 on day 15 +/- 5 and all patients displayed 100% donor chimerism by 2 months post transplant. The major complication of transplant was GVHD, with all patients developing grade II or III acute GVHD, one progressing to chronic extensive GVHD. Patients are alive 309, 623, and 2029 days post transplant. Factors important in HSCT outcome for SDS may include transplantation at a young age, avoidance of cyclophosphamide, and adequate GVHD prophylaxis. Importantly, these cases also suggest that unrelated UCB, in the absence of a matched family member, is an excellent alternative stem cell source for SDS patients undergoing HSCT.