Ciprofloxacin-Loaded Gold Nanoparticles against Antimicrobial Resistance: An In Vivo Assessment.

Metallic nanoparticles, such as gold nanoparticles (AuNPs), have been extensively studied as drug delivery systems for various therapeutic applications. However, drug-loaded-AuNPs have been rarely explored in vivo for their effect on bacteria residing inside tissues. Ciprofloxacin (CIP) is a second-generation fluoroquinolone with a broad-spectrum of antibiotic properties devoid of developing bacteria resistance. This research is focused on the synthesis and physical characterization of Ciprofloxacin-loaded gold nanoparticles (CIP-AuNPs) and their effect on the colonization of Enterococcus faecalis in the liver and kidneys of mice. The successfully prepared CIP-AuNPs were stable and exerted enhanced in vitro antibacterial activity against E. faecalis compared with free CIP. The optimized CIP-AuNPs were administered (500 µg/Kg) once a day via tail vein to infected mice for eight days and were found to be effective in eradicating E. faecalis from the host tissues. Moreover, unlike CIP, CIP-AuNPs were non-hemolytic. In summary, this study demonstrated that CIP-AuNPs are promising and biocompatible alternative therapeutics for E.-faecalis-induced infections resistant to conventional drugs (e.g., beta-lactams and vancomycin) and should be further investigated.

Effect of Flavonoid-Coated Gold Nanoparticles on Bacterial Colonization in Mice Organs.

Multidrug resistance (MDR) has been a potentiator for the exploration of antibiotics. Nano drug delivery systems have opened new avenues to overcome this challenge. Although antibacterial nanocarriers are extensively realized, their effect on the bacteria residing inside the tissues and their toxicity is rarely explored. This study investigated the effects of flavonoid coated gold nanoparticles (FAuNPs) on the colonization of Enterococcus faecalis in the mouse liver and kidneys. Flavonoids were extracted from the leaves of Berberis lycium Royle and used to stabilize gold following a green synthesis approach. FAuNPs were characterized by ultraviolet-visible (UV-Vis) spectroscopy, Fourier-transform infrared spectroscopy (FTIR), scanning transmission electron microscopy (STEM), X-ray powder diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDS). FAuNPs showed significantly higher reduction in bacterial counts in in-vitro and in-vivo in mice organs as compared to the free flavonoids owing to their biocompatibility and effectiveness.

Cannabinoids and Terpenes as an Antibacterial and Antibiofouling Promotor for PES Water Filtration Membranes.

Plant phytochemicals have potential decontaminating properties, however, their role in the amelioration of hydrophobic water filtration membranes have not been elucidated yet. In this work, phytochemicals (i.e., cannabinoids (C) and terpenes (T) from C. sativa) were revealed for their antibacterial activity against different Gram-positive and Gram-negative bacteria. As such, a synergistic relationship was observed between the two against all strains. These phytochemicals individually and in combination were used to prepare polyethersulfone (PES) hybrid membranes. Membrane characterizations were carried out using scanning electron microscopy, Fourier transform infrared spectroscopy, energy-dispersive X-ray spectroscopy. Moreover, contact angle, water retention, surface roughness, mechanical testing, and X-ray florescence analysis were also carried out. According to results, the CT-PES hybrid membrane exhibited the lowest contact angle (40°), the highest water retention (70%), and smallest average pore size (0.04 µm). The hybrid membrane also exhibited improved water flux with no surface leaching. Quantitative bacterial decline analysis of the CT-PES hybrid membranes confirmed an effective antibacterial performance against Gram-positive and Gram-negative bacteria. The results of this study established cannabinoids and terpenes as an inexpensive solution for PES membrane surface modification. These hybrid membranes can be easily deployed at an industrial scale for water filtration purposes.

Traumatic Double-Level Unilateral Achilles Tendon Rupture: A Case Report.

BACKGROUND Unilateral double-level Achilles tendon tear is a rare presentation that has not been previously reported in the English literature. Diagnosis and management of these cases are challenging, and outcomes are not well described in the literature. CASE REPORT A 46-year-old man presented to us with ankle pain following a football sports injury. Clinical examination and ultrasound scan showed unilateral Achilles tendon double-level partial tears that were managed conservatively. The patient presented again with another trauma and progression to full-thickness tear, managed operatively with open Achilles tendon repair technique. CONCLUSIONS Management of these cases is complex and challenging. In the literature, both operative and non-operative management have been described. However, the recent literature shows no major difference between these 2 methods of treatment. Our case was quite unique, so we decided to use the open repair technique. Awareness about this rare presentation and the need for further research is necessary for proper management of such cases.

Interactive implementations of thermodynamics-based RNA structure and RNA-RNA interaction prediction approaches for example-driven teaching.

The investigation of RNA-based regulation of cellular processes is becoming an increasingly important part of biological or medical research. For the analysis of this type of data, RNA-related prediction tools are integrated into many pipelines and workflows. In order to correctly apply and tune these programs, the user has to have a precise understanding of their limitations and concepts. Within this manuscript, we provide the mathematical foundations and extract the algorithmic ideas that are core to state-of-the-art RNA structure and RNA-RNA interaction prediction algorithms. To allow the reader to change and adapt the algorithms or to play with different inputs, we provide an open-source web interface to JavaScript implementations and visualizations of each algorithm. The conceptual, teaching-focused presentation enables a high-level survey of the approaches, while providing sufficient details for understanding important concepts. This is boosted by the simple generation and study of examples using the web interface available at http://rna.informatik.uni-freiburg.de/Teaching/. In combination, we provide a valuable resource for teaching, learning, and understanding the discussed prediction tools and thus enable a more informed analysis of RNA-related effects.

A Prospective Study of Endoscopic Injection Sclerotherapy and Endoscopic Variceal Ligation in the Treatment of Esophageal Varices.

INTRODUCTION: The aim of this study was to compare the effectiveness and safety of endoscopic injection sclerotherapy (EIS) with endoscopic variceal ligation (EVL) in the management of esophageal variceal bleeding (EVB). PATIENTS AND METHODS: In this prospective study, we compared the EIS and EVL in 124 patients who had endoscopically proved bleeding from esophageal varices. According to different treatment methods, they were randomly divided into the EIS and the EVL groups. Sixty-four patients were treated with sclerotherapy and 60 with ligation. The patients were followed for a mean of 2 years, during which we determined the incidence of complications and recurrences of bleeding and the number of treatment sessions needed to eradicate varices, mortality, and survival. RESULTS: Active bleeding at the first treatment was controlled by EIS in 19 of 19 patients and by EVL in 16 of 16 patients. The likelihood of early rebleeding was slightly smaller in the patients treated with EIS (7.8% versus 11.7%, P = .47). However, late rebleeding rate was slightly more in EIS patients (28.1% versus 23.3%, P = .54) without statistical significance. The rate of eradication of varices in the EIS group was slightly lower than in the EVL group (79.7% versus 86.7%, P = .30). There were also no statistically significant differences in mortality (1.6% versus 3.3%, P = .61) or survival rate (71.9% versus 78.3%, P = .41) (all P > .05) after EIS and EVL. However, fever in the EIS group was significantly higher compared to that of in the EVL group (n = 17, 26.6% versus n = 6, 10.0%, P = .02). CONCLUSIONS: Both EIS and EVL produce excellent results, are safe, effective, feasible, and acceptable for EVB with minimum complications and obviate need for subsequent procedures in the short term. To make better choice, we should consider the hospital conditions, operator experience, and the characteristics of esophageal varices.

Kudo's pit pattern classification for colorectal neoplasms: a meta-analysis.

AIM: To analyze the current available evidence of Kudo's pit pattern classification for diagnosing colorectal neoplasms. METHODS: A search was performed on Pubmed/Embase to identify studies reporting the outcomes of the pit pattern classification in colorectal polyps. Retrieved records were evaluated and selected by two independent investigators. The number of patients, polyps and diagnostic performance of Kudo's pit pattern classification were retrieved from suitable studies. Pooled sensitivities and specificities were calculated using fixed or random effect models according to their heterogeneity. Publication bias was evaluated using funnel plot, Egger's test, and Begg's test. Sensitivity analysis was performed by omitting one study at a time and selecting a subgroup consisting of 11 magnifying chromoendoscopy studies. RESULTS: 20 eligible studies were included in which a total of 5111 colorectal lesions in 3418 patients were identified for the differentiation of neoplastic and non-neoplastic polyps. Pit pattern classification in all the studies of mucosal patterns with magnification resulted in a pooled sensitivity of 89.0% (95%CI: 85.2-91.9) and pooled specificity of 85.7% (95%CI: 81.3-89.2) and the area under the SROC curve was 0.9354. There was significant publication bias (P = 0.038 and 0.006 for sensitivity and specificity using Egger's test, P = 0.035 and 0.139 for sensitivity and specificity using Begg's test, respectively). No single study significantly affected the pooled result, and the magnifying chromoendoscopy subgroup yielded a sensitivity of 92.7% (95%CI: 89.2-95.2) and specificity of 87.3% (95%CI: 81.6-91.4). CONCLUSION: Kudo's pit pattern classification is an accurate diagnostic method for the differentiation of neoplastic colorectal lesions. Publication bias is significant in the current available literature.

Bilateral double osteotomy in severe torsional malalignment syndrome: 16 years follow-up.

BACKGROUND: Torsional malalignment syndrome (TMS) is a well defined condition consisting of a combination of femoral antetorsion and tibial lateral torsion. The axis of knee motion is medially rotated. This may lead to patellofemoral malalignment with an increased Q angle and chondromalacia, patellar subluxation and dislocation. Conservative management is recommended in all but the most rare and severest cases. In these cases deformity correction requires osteotomies at two levels per limb. MATERIALS AND METHODS: From 1987 to 2002 in our institution three patients underwent double femoral and tibial osteotomy for TMS bilateral correction (12 osteotomies). All patients were reviewed at mean follow-up of 16 years. RESULTS: At final follow-up no patients reported persistence of knee or hip pain. At clinical examination both lower limbs showed a normal axis and a normal patella anterior position. Pre-operative femoral version measurement showed an average hip internal rotation of 81.5° (range 80°-85°) and average hip external rotation of 27.2° (10°-40°). Thigh-foot angle measurement showed an average value of 38.6° (32°-45°). At final follow-up femoral version measurement showed an average hip internal rotation of 49° (range 45°-55°) and average hip internal rotation of 44.3° (20°-48°) (Figs. 1, 2, 3, 4, 5, 6). Thigh-foot angles measurement showed an average value of 21.6° (18°-24°) outward. CONCLUSION: We recommend a clinical, radiographical and CT scan evaluation of all torsional deformity. In cases of significant deformity, internally rotating the tibia alone is not sufficient. Ipsilateral outward femoral and inward tibial osteotomies are our current recommendation for TMS, both performed at the same surgical setting.