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2.
Medicine (Baltimore) ; 99(6): e18854, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-32028395

RESUMEN

BACKGROUND: The elimination of the pathogenic microorganisms of the periodontal pocket is one of the main points for success in periodontal treatment. The objective of this study is to investigate the clinical and antimicrobial effect of papain-mediated photodynamic therapy in the clinical treatment of periodontal disease. METHODS: Twenty patients with chronic periodontitis will be selected. Patients will be randomly divided into 2 groups (n = 10). Group 1 will receive conventional periodontal treatment and group 2 will receive conventional treatment and antimicrobial photodynamic therapy (PACT). Conventional treatment will consist of oral hygiene guidance, with brushing technique instructions and recommendation of daily flossing. The calculus deposits on the teeth will be removed with ultrasound equipment and curettes for scraping and root planning. The PACT will be performed at the end of each periodontal treatment session, at sites with bags ≥4 mm. PapaMblue photosensitizer will be deposited in the periodontal pockets with a syringe and a pre-irradiation time of 1 minute will be adopted. Then, the laser emitting wavelength of 660 nm, with power of 100 mW, for 2 minutes, radiant exposure of 30 J/cm and power density of 250 mW/cm will be applied. Patients will undergo clinical evaluations before treatment (day 1) at 30, 60, and 90 days after the end of treatment; and microbiological evaluations before and immediately after treatment. The distribution of the data within each group and the homogeneity of the variances will be verified. With this information, the most appropriate statistical test in each evaluation will be used. The sample calculation is based on the literature and the significance level of 5% will be adopted. DISCUSSION: The combination of PACT with methylene blue in a papain gel and the conventional treatment may increase the reduction of bacteria in periodontal pockets.


Asunto(s)
Antiinfecciosos/uso terapéutico , Periodontitis Crónica/terapia , Azul de Metileno/uso terapéutico , Fármacos Fotosensibilizantes/uso terapéutico , Adulto , Antiinfecciosos/administración & dosificación , Terapia Combinada , Método Doble Ciego , Femenino , Humanos , Masculino , Azul de Metileno/administración & dosificación , Fotoquimioterapia , Fármacos Fotosensibilizantes/administración & dosificación , Resultado del Tratamiento
3.
Global Health ; 16(1): 8, 2020 01 14.
Artículo en Inglés | MEDLINE | ID: mdl-31937338

RESUMEN

BACKGROUND: In the Mekong Delta region of Vietnam, high quantities of products containing antimicrobial are used as prophylactic and curative treatments in small-scale chicken flocks. A large number of these contain antimicrobial active ingredients (AAIs) considered of 'critical importance' for human medicine according to the World Health Organization (WHO). However, little is known about the retail prices of these products and variables associated with the expense on antimicrobials at farm level. Therefore, the aims of the study were: (1) to investigate the retail price of antimicrobials with regards to WHO importance criteria; and (2) to quantify the antimicrobial expense incurred in raising chicken flocks. We investigated 102 randomly-selected small-scale farms raising meat chickens (100-2000 per flock cycle) in two districts in Dong Thap (Mekong Delta) over 203 flock production cycles raised in these farms. Farmers were asked to record the retail prices and amounts of antimicrobial used. RESULTS: A total of 214 different antimicrobial-containing products were identified. These contained 37 different AAIs belonging to 13 classes. Over half (60.3%) products contained 1 highest priority, critically important AAI, and 38.8% 1 high priority, critically important AAI. The average (farm-adjusted) retail price of a daily dose administered to a 1 kg bird across products was 0.40 cents of 1 US$ (₵) (SE ± 0.05). The most expensive products were those that included at least one high priority, critically important AAI, as well as those purchased in one of the two study districts. Farmers spent on average of ₵3.91 (SE ± 0.01) on antimicrobials per bird over the production cycle. The expense on antimicrobials in weeks with disease and low mortality was greater than on weeks with disease and high mortality, suggesting that antimicrobial use had a beneficial impact on disease outcomes (χ2 = 3.8; p = 0.052). Farmers generally used more expensive antimicrobials on older flocks. CONCLUSIONS AND RECOMMENDATION: The retail prices of antimicrobial products used in chicken production in Mekong Delta small-scale chicken farms are very low, and not related to their relevance for human medicine. Farmers, however, demonstrated a degree of sensitivity to prices of antimicrobial products. Therefore, revising pricing policies of antimicrobial products remains a potential option to curb the use of antimicrobials of critical importance in animal production.


Asunto(s)
Antiinfecciosos/economía , Pollos , Comercio/estadística & datos numéricos , Granjas , Animales , Antiinfecciosos/uso terapéutico , Humanos , Encuestas y Cuestionarios , Vietnam
4.
BMC Infect Dis ; 20(1): 75, 2020 Jan 23.
Artículo en Inglés | MEDLINE | ID: mdl-31973704

RESUMEN

BACKGROUND: Healthcare-Associated Infections (HAIs) represent one of the leading issues to patient safety as well as a significant economic burden. Similarly, Antimicrobial Use (AMU) and Resistance (AMR) represent a growing threat to global public health and the sustainability of healthcare services. METHODS: A Point Prevalence Survey (PPS) following the 2016 ECDC protocol for HAI prevalence and AMU was conducted at Ferrara University Hospital (FUH). Data were collected by a team of trained independent surveyors in 2016 and 2018. Risk factors independently associated with HAI were assessed by a multivariate logistic regression model. RESULTS: Of the 1102 patients surveyed, 115 (10.4%) had an active HAI and 487 (44.2%) were on at least 1 systemic antimicrobial agent. Factors independently associated with increased HAI risk were a "Rapidly Fatal" McCabe score (expected fatal outcome within 1 year), presence of medical devices (PVC, CVC, indwelling urinary catheter or mechanically assisted ventilation) and a length of hospital stay of at least 1 week. The most frequent types of HAI were pneumonia, bloodstream infections, and urinary tract infections. Antimicrobial resistance to third-generation cephalosporins was observed in about 60% of Enterobacteriaceae. CONCLUSIONS: The survey reports a high prevalence of HAI and AMU in FUH. Repeated PPSs are useful to control HAIs and AMU in large acute-care hospitals, highlighting the main problematic factors and allowing planning for improvement actions.


Asunto(s)
Antiinfecciosos/uso terapéutico , Bacteriemia/epidemiología , Infección Hospitalaria/epidemiología , Enterobacteriaceae/aislamiento & purificación , Neumonía/epidemiología , Infecciones Urinarias/epidemiología , Adolescente , Adulto , Anciano , Bacteriemia/tratamiento farmacológico , Infección Hospitalaria/tratamiento farmacológico , Femenino , Hospitales Universitarios , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Neumonía/tratamiento farmacológico , Prevalencia , Factores de Riesgo , Encuestas y Cuestionarios , Catéteres Urinarios/microbiología , Infecciones Urinarias/tratamiento farmacológico , Adulto Joven
7.
Mini Rev Med Chem ; 20(1): 3-11, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31518221

RESUMEN

Benzocaine is well-known for its role as an anesthetic agent and largely used in oral ulcers, ear pain and dental complications. Along with lidocaine and other local anesthetics, benzocaine has marked it as an anesthetic agent in surgical procedures and as Na+ channels blocker, as well. Analogues of benzocaine have been found to possess biological potentials including antibacterial, antifungal and anti-cancer. Some derivatives were found to have conspicuous action against tuberculosis. The current review focuses to explore the century-long potential of the molecule and its analogs that have appeared in the literature. Furthermore, highlighting the biological potential of benzocaine and its analogues shall open-up new dimensions of future research to design more potent analogues.


Asunto(s)
Anestésicos Locales/química , Anestésicos Locales/farmacología , Benzocaína/análogos & derivados , Benzocaína/farmacología , Desarrollo de Medicamentos , Anestésicos Locales/uso terapéutico , Animales , Antiinfecciosos/química , Antiinfecciosos/farmacología , Antiinfecciosos/uso terapéutico , Antineoplásicos/química , Antineoplásicos/farmacología , Antineoplásicos/uso terapéutico , Benzocaína/uso terapéutico , Desarrollo de Medicamentos/métodos , Descubrimiento de Drogas/métodos , Humanos
8.
N Z Vet J ; 68(2): 126-133, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31608795

RESUMEN

Case history: Gradual onset of ocular opacity was observed in three gold-striped geckos (Woodworthia chrysosiretica), and five Pacific geckos (Dactylocnemis pacificus) held in two adjacent terrariums in a zoological institution located in the North Island of New Zealand. Ultraviolet light and heat had been provided for the previous 3-4 years by a fluorescent bulb, but in the last 4 weeks of winter a ceramic heat bulb had been added, situated 10 cm above the upper mesh of the cageClinical findings: All eight geckos presented with mostly bilateral lesions of varying severity confined to the central or upper quadrant of the spectacles. These lesions ranged from variable areas of opacity within the stroma of the spectacle to similarly distributed ulcers of the surface epithelium of both spectacles. The spectacle lesions in the Pacific geckos responded well to treatment with topical combined antimicrobial therapy, within 18-29 days. The gold-striped geckos suffered complications including dysecdysis, severe spectacle ulceration and perforation, mycotic spectaculitis, and widespread mycotic dermatitis resulting in death or leading to euthanasia.Pathological findings: In the three gold-striped geckos, there were extensive areas of deep ulceration and replacement of the spectacle with a thick serocellular crust containing large numbers of fungal elements. The affected areas of the stroma were expanded by large deposits of proteinaceous and mucinous material, pyknotic cellular debris and moderate numbers of heterophils and macrophages as well as infiltrating fungal hyphae.Diagnosis: Mycotic spectaculitis with ulceration and perforation, and disseminated mycotic dermatitis likely secondary to thermal burns.Clinical relevance: This is the first report of thermal burns of the spectacle in any reptile. There was species variation in the burn severity with gold-striped geckos showing more severe lesions, possibly due to a mix of behavioural and anatomical factors. The thermal burns to the spectacles in three cases were complicated by delayed healing, perforation, dysecdysis and severe mycotic infection.


Asunto(s)
Quemaduras/veterinaria , Oftalmopatías/veterinaria , Calefacción/instrumentación , Vivienda para Animales , Lagartos , Animales , Animales de Zoológico , Antiinfecciosos/administración & dosificación , Antiinfecciosos/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Bacitracina/administración & dosificación , Bacitracina/uso terapéutico , Quemaduras/etiología , Combinación de Medicamentos , Oftalmopatías/etiología , Oftalmopatías/patología , Meloxicam/uso terapéutico , Neomicina/administración & dosificación , Neomicina/uso terapéutico , Polimixina B/administración & dosificación , Polimixina B/uso terapéutico , Rayos Ultravioleta
9.
J Ethnopharmacol ; 246: 112184, 2020 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-31465817

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: In the pre-antibiotic era, a broad spectrum of medicinal plants was used to treat livestock. This knowledge was neglected in European veterinary medicine for decades but kept alive by farmers. Emergence of multidrug resistant bacterial strains requires a severely restricted use of antibiotics in veterinary medicine. We conducted a survey on the ethnoveterinary knowledge of farmers in the bilingual (French and German speaking) Western region of Switzerland, namely the cantons of Fribourg, Neuchâtel and Jura, and in the French speaking part of the canton of Bern. AIM OF THE STUDY: To find out whether differences exist in plants used by farmers in French speaking and bilingual regions of Switzerland as compared to our earlier studies conducted in Switzerland. Additional focus was on plants that are used in diseases which commonly are treated with antimicrobials, on plants used in skin afflictions, and on plants used in animal species such as horses, for which the range of veterinary medicinal products is limited. MATERIAL AND METHODS: We conducted in 2015 semistructured interviews with 62 dialog partners, mainly cattle keeping farmers but also 18 horse keeping farmers. Of these, 41 were native French (FNS) and 21 native German speakers (GNS). Detailed information about homemade herbal remedies (plant species, plant part, manufacturing process) and the corresponding use reports (target animal species, category of use, route of administration, dosage, source of knowledge, frequency of use, last time of use and farmers satisfaction) were collected. RESULTS: A total of 345 homemade remedies were reported, of which 240 contained only one plant species (Homemade Single Species Herbal Remedy Reports; HSHR). A total of 289 use reports (UR) were mentioned for the 240 HSHR, and they comprised 77 plant species belonging to 41 botanical families. Of these, 35 plant species were solely reported from FNS, 20 from GNS, and 22 from both. Taking into account earlier ethnoveterinary studies conducted in Switzerland only 10 (FNS) and 6 (GNS) plant species connected with 7% of FNS and GNS UR respectively were "unique" to the respective language group. The majority of the UR (219) was for treatment of cattle, while 38 UR were intended to treat horses. The most UR were for treatment of gastrointestinal and skin diseases. The most frequently mentioned plants were Linum usitatissimum L., Coffea L., Matricaria chamomilla L., Camellia sinensis (L.) Kuntze, and Quercus robur L. for gastrointestinal diseases, and Calendula officinalis L., Hypericum perforatum L. and Sanicula europaea L. for skin afflictions. CONCLUSION: No clear differences were found between the medicinal plants used by French native speakers and German native speakers. Several of the reported plants seem to be justified to widen the spectrum of veterinary therapeutic options in gastrointestinal and dermatological disorders in cattle and horses, and to reduce, at least to a certain degree, the need for antibiotic treatments. Our findings may help to strengthen the role of medicinal plants in veterinary research and practice, and to consider them as a further measure in official strategies for lowering the use of antibiotics.


Asunto(s)
Antiinfecciosos/uso terapéutico , Enfermedades de los Bovinos/tratamiento farmacológico , Enfermedades Gastrointestinales/tratamiento farmacológico , Conocimientos, Actitudes y Práctica en Salud , Enfermedades de los Caballos/tratamiento farmacológico , Medicina Tradicional , Fitoterapia/veterinaria , Enfermedades de la Piel/tratamiento farmacológico , Adulto , Anciano , Anciano de 80 o más Años , Animales , Bovinos , Etnobotánica , Agricultores , Femenino , Enfermedades Gastrointestinales/veterinaria , Caballos , Humanos , Lenguaje , Masculino , Persona de Mediana Edad , Plantas Medicinales , Enfermedades de la Piel/veterinaria , Suiza
10.
Vet Clin North Am Small Anim Pract ; 50(2): 311-329, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31879130

RESUMEN

The etiology of feline chronic rhinitis is incompletely understood and often is a diagnosis of exclusion. History, clinical signs, and investigations performed to reach this diagnosis are discussed. Several treatment options are provided, although cure of this frustrating disease is rarely achieved.


Asunto(s)
Enfermedades de los Gatos , Rinitis/veterinaria , Animales , Antiinfecciosos/uso terapéutico , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/tratamiento farmacológico , Enfermedades de los Gatos/etiología , Enfermedades de los Gatos/cirugía , Gatos , Pronóstico , Rinitis/diagnóstico , Rinitis/etiología , Rinitis/terapia
11.
Mini Rev Med Chem ; 19(19): 1560-1563, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31833463

RESUMEN

This work discusses the idea that drug discovery, instead of being performed through a series of filtering-based stages, should be viewed as a multi-scale optimization problem. Here, the most promising multi-scale models are analyzed in terms of their applications, advantages, and limitations in the search for more potent and safer chemicals against infectious diseases. Multi-scale de novo drug design is highlighted as an emerging paradigm, able to accelerate the discovery of more effective antimicrobial agents.


Asunto(s)
Antiinfecciosos/química , Enfermedades Transmisibles/tratamiento farmacológico , Diseño de Drogas , Modelos Biológicos , Antiinfecciosos/uso terapéutico , Enfermedades Transmisibles/patología , Humanos , Relación Estructura-Actividad Cuantitativa
12.
J Photochem Photobiol B ; 201: 111633, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31726378

RESUMEN

In the present study, we assessed the oral mucosal irritation potential of antimicrobial chemotherapy involving hydrogen peroxide (H2O2) photolysis with a 405-nm laser device at an output power of ≥100 mW in hamsters. Twenty-four cheek pouches from 12 male Syrian hamsters received 7-min treatment with pure water (PW), 3% H2O2, laser irradiation of PW at 100 mW, laser irradiation of 3% H2O2 at 100 mW, laser irradiation of PW at 200 mW, or laser irradiation of 3% H2O2 at 200 mW (n = 4 each). The diameter of the irradiation area was set at 3 mm; accordingly, the calculated irradiances (optical power densities) of the 100- and 200-mW laser lights were approximately 1400 and 2800 mW/cm2, respectively. In addition, 12 cheek pouches from six animals received laser irradiation of 3% H2O2 at 100 mW for 1, 3, or 5 min (n = 4 each). Each treatment was repeated three times at 1-h intervals. Macroscopic and histological changes were evaluated 24 h after the last treatment. In addition, in vitro bactericidal activity of the treatment against periodontal pathogens was evaluated. We found that 405-nm laser irradiation of 3% H2O2 caused moderate to severe oral mucosal irritation when performed at powers of 100 and 200 mW for ≥3 min, while the same treatment performed at 100 mW for 1 min resulted in mild irritation. Moreover, 1-min H2O2 photolysis at 100 mW caused a >4-log decrease in viable bacterial counts. These findings suggest that 1-min H2O2 photolysis, which can effectively kill periodontal pathogens, may be acceptable when a 405-nm laser device is used at 100 mW. However, use of the laser at a lower power would be preferable for the prevention of unnecessary oral mucosal irritation.


Asunto(s)
Antiinfecciosos/farmacología , Peróxido de Hidrógeno/farmacología , Rayos Láser , Mucosa Bucal/efectos de los fármacos , Fotólisis/efectos de los fármacos , Células 3T3-L1 , Animales , Antiinfecciosos/química , Antiinfecciosos/uso terapéutico , Supervivencia Celular/efectos de los fármacos , Supervivencia Celular/efectos de la radiación , Cricetinae , Espectroscopía de Resonancia por Spin del Electrón , Masculino , Ratones , Mucosa Bucal/metabolismo , Mucosa Bucal/efectos de la radiación , Periodontitis/tratamiento farmacológico , Fotólisis/efectos de la radiación , Porphyromonas gingivalis/efectos de los fármacos , Especies Reactivas de Oxígeno/química , Especies Reactivas de Oxígeno/metabolismo , Streptococcus mutans/efectos de los fármacos
14.
Medicine (Baltimore) ; 98(48): e17830, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31770199

RESUMEN

RATIONALE: Neonatal scalp mass is common in clinical practice. After birth canal compression and traction force, a cephalohematoma is usually found. However, cephalohematoma with abscess is extremely rare and dangerous. So far, there have been no reported cases of multidrug-resistant Escherichia coli infections in giant neonatal scalp hematoma. PATIENT CONCERNS: We present a 9-day-old with a scalp abscess and a large scalp defect that remained after surgical drainage. DIAGNOSIS: Physical examination showed a giant mass suggestive in the parietal region. B-mode ultrasound indicated the scalp mass was liquid. The early diagnosis was massive scalp hematoma. During conservative treatment, purulent fluid flowed from the mass region through a rupture in the scalp. MR examination showed the scalp had burst and no abnormalities were found in the medial side of the skull and skull. INTERVENTIONS: The surgeon opened up the mass and removed necrotic tissue. The scalp was severely damaged; the aseptic auxiliary materials that we made in-house were used to gradually reduce the defect. OUTCOMES: The scalp was healed by anti-infection treatment and frequent changing of the dressings. The patient was successfully treated without two-stage surgery. There were no complications. LESSONS: A scalp hematoma is a potential site of infection. Anti-infection treatment and surgery are necessary to correct infected scalp hematoma. This work offers a new way of treating other large scalp defects.


Asunto(s)
Absceso/microbiología , Infecciones por Escherichia coli/microbiología , Escherichia coli , Hematoma/microbiología , Dermatosis del Cuero Cabelludo/microbiología , Absceso/terapia , Antiinfecciosos/uso terapéutico , Terapia Combinada , Drenaje/métodos , Infecciones por Escherichia coli/terapia , Femenino , Hematoma/terapia , Humanos , Recién Nacido , Cuero Cabelludo/microbiología , Dermatosis del Cuero Cabelludo/terapia
15.
PLoS Negl Trop Dis ; 13(11): e0007847, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-31751336

RESUMEN

INTRODUCTION: Individuals and communities affected by NTDs are often the poorest and most marginalised; ensuring a gender and equity lens is centre stage will be critical for the NTD community to reach elimination goals and inform Universal Health Coverage (UHC). NTDs amenable to preventive chemotherapy have been described as a 'litmus test' for UHC due to the high mass drug administration (MDA) coverage rates needed to be effective and their model of community engagement. However, until now highly aggregated coverage data may have masked inequities in availability, accessibility and acceptability of medicines, slowing down the equitable achievement of elimination goals. METHODS: We conducted qualitative programmatic analysis across different country contexts through the novel application of the Tanahashi Coverage Framework enhanced by gendered intersectional theory to interrogate different components of programme coverage: availability, accessibility, acceptability, contact and effective. Drawing on communities and health implementers perspectives (using focus groups, interviews, and participatory methods) from varying levels of the health system, across four African country contexts (Cameroon, Ghana, Liberia and Nigeria), we show who is left behind and provide recommendations for programmes to respond. FINDINGS: We have unmasked inequities in programme delivery that repeatedly leave vulnerable populations underserved in relation to the prevention and treatment of PC NTDs across all components of coverage explored within the Tanahashi framework. Inequities are influenced by health systems challenges and limitations, due to lack of consideration of gender, power and equity issues. Effective treatment for individuals and communities is shaped by individual identities and the intersecting axes of inequity that converge to shape these positions including gender, age, disability, and geography. Health systems are inherently social and gendered thus they become mediators in managing the impact that social and structural processes have on individual health outcomes. SIGNIFICANCE: To our knowledge this is the only paper which has combined a comprehensive equity framework with intersectional feminist theory, to establish a fuller understanding of who is left behind and why in MDA across countries and contexts. Ensuring the most vulnerable have continued access to future treatment options will contribute to the progressive realisation of UHC, allowing the NTD community to continue to support their vision of being a true 'litmus test'.


Asunto(s)
Antiinfecciosos/uso terapéutico , Enfermedades Transmisibles/tratamiento farmacológico , Enfermedades Transmisibles/epidemiología , Disparidades en Atención de Salud/estadística & datos numéricos , Administración Masiva de Medicamentos/métodos , Enfermedades Desatendidas/tratamiento farmacológico , Enfermedades Desatendidas/epidemiología , África , Femenino , Humanos , Masculino
16.
Chem Commun (Camb) ; 55(100): 15020-15032, 2019 Dec 28.
Artículo en Inglés | MEDLINE | ID: mdl-31782426

RESUMEN

With the rapid spread of resistance among parasites and bacterial pathogens, antibiotic-resistant infections have drawn much attention worldwide. Consequently, there is an urgent need to develop new strategies to treat neglected diseases and drug-resistant infections. Here, we outline several new strategies that have been developed to counter pathogenic microorganisms by designing and constructing antimicrobial peptides (AMPs). In addition to traditional discovery and design mechanisms guided by chemical biology, synthetic biology and computationally-based approaches offer useful tools for the discovery and generation of bioactive peptides. We believe that the convergence of such fields, coupled with systematic experimentation in animal models, will help translate biological peptides into the clinic. The future of anti-infective therapeutics is headed towards specifically designed molecules whose form is driven by computer-based frameworks. These molecules are selective, stable, and active at therapeutic doses.


Asunto(s)
Antiinfecciosos/uso terapéutico , Péptidos Catiónicos Antimicrobianos/química , Enfermedades Transmisibles/tratamiento farmacológico , Algoritmos , Antiinfecciosos/química , Antiinfecciosos/farmacología , Péptidos Catiónicos Antimicrobianos/genética , Péptidos Catiónicos Antimicrobianos/uso terapéutico , Biopelículas/efectos de los fármacos , Enfermedades Transmisibles/patología , Diseño de Drogas , Humanos , Inmunidad Innata/efectos de los fármacos , Factores Inmunológicos/química , Factores Inmunológicos/farmacología , Factores Inmunológicos/uso terapéutico , Ingeniería de Proteínas , Pseudomonas/fisiología
17.
Vestn Oftalmol ; 135(5. Vyp. 2): 160-170, 2019.
Artículo en Ruso | MEDLINE | ID: mdl-31691655

RESUMEN

PURPOSE: To investigate the toxic effects of frequent instillations of anti-infective solutions (antibiotic eye drops - 0.3 and 1.4% tobramycin, 0.5% levofloxacin and 0.5% moxifloxacin; antiseptic eye drops - 0.05% pyloxidine and 0.025% chlorhexidine; antifungal drug - 2 mg/ml fluconazole solution) on ocular tissues. MATERIAL AND METHODS: The study was conducted on 21 Wistar rats (42 eyes) using method of semi-fine sections. RESULTS: The majority of antibiotics and antifungal agents do not cause toxic reactions in rats` eyes when instilled with frequent regimen with the exception of 'fortified' 1.4% tobramycin and pyloxidine solutions, which caused a decrease in corneal endothelial cells density and formation of fibrovascular tissue in the anterior chamber. CONCLUSION: Frequent instillations of antimicrobial drug solutions is a safe method for the treatment of purulent corneal ulcers and purulent keratitis. The exceptions were solutions of 'fortified' 1.4% tobramycin and piloxidine (vitabact).


Asunto(s)
Antiinfecciosos/uso terapéutico , Infecciones Bacterianas del Ojo , Animales , Antibacterianos , Cefazolina , Células Endoteliales , Soluciones Oftálmicas , Ratas , Ratas Wistar
19.
Nephrol Nurs J ; 46(5): 511-518, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31566346

RESUMEN

Antimicrobial resistance is a major growing problem fueled by inappropriate use of antimicrobials. Patients requiring maintenance hemodialysis are at especially high risk for infections caused by antimicrobial-resistant bacteria. The Centers for Disease Control and Prevention has recommended development and implementation of antimicrobial stewardship programs to combat the spread of resistant pathogens. This article describes in detail a multifaceted antimicrobial stewardship intervention that featured staff education and a behavioral change process, Positive Deviance, and its implementation in six outpatient hemodialysis units. Results of the intervention demonstrated a 6% month-to-month reduction in antimicrobial doses/100 patient months over the course of the 12 months intervention, with a decrease in mean antimicrobial doses from 22.6/100 to 10.5/100 patient months from the beginning to the end of the intervention period. These results demonstrate the effectiveness of this multifaceted intervention in engaging staff and improving antimicrobial prescribing patterns.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Antiinfecciosos/uso terapéutico , Programas de Optimización del Uso de los Antimicrobianos/organización & administración , Diálisis Renal/enfermería , Humanos
20.
Molecules ; 24(19)2019 Oct 06.
Artículo en Inglés | MEDLINE | ID: mdl-31590459

RESUMEN

There is robust epidemiological evidence for the beneficial effects of broccoli consumption on health, many of them clearly mediated by the isothiocyanate sulforaphane. Present in the plant as its precursor, glucoraphanin, sulforaphane is formed through the actions of myrosinase, a ß-thioglucosidase present in either the plant tissue or the mammalian microbiome. Since first isolated from broccoli and demonstrated to have cancer chemoprotective properties in rats in the early 1990s, over 3000 publications have described its efficacy in rodent disease models, underlying mechanisms of action or, to date, over 50 clinical trials examining pharmacokinetics, pharmacodynamics and disease mitigation. This review evaluates the current state of knowledge regarding the relationships between formulation (e.g., plants, sprouts, beverages, supplements), bioavailability and efficacy, and the doses of glucoraphanin and/or sulforaphane that have been used in pre-clinical and clinical studies. We pay special attention to the challenges for better integration of animal model and clinical studies, particularly with regard to selection of dose and route of administration. More effort is required to elucidate underlying mechanisms of action and to develop and validate biomarkers of pharmacodynamic action in humans. A sobering lesson is that changes in approach will be required to implement a public health paradigm for dispensing benefit across all spectrums of the global population.


Asunto(s)
Brassica/química , Isotiocianatos/química , Isotiocianatos/uso terapéutico , Animales , Antiinfecciosos/química , Antiinfecciosos/farmacocinética , Antiinfecciosos/uso terapéutico , Antineoplásicos Fitogénicos/química , Antineoplásicos Fitogénicos/farmacocinética , Antineoplásicos Fitogénicos/uso terapéutico , Biomarcadores de Tumor/metabolismo , Ensayos Clínicos como Asunto , Humanos , Isotiocianatos/farmacocinética , Estructura Molecular , Extractos Vegetales/química
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