Membrane permeabilization of colistin toward pan-drug resistant Gram-negative isolates

Abstract Pan-drug resistant Gram-negative bacteria, being resistant to most available antibiotics, represent a huge threat to the medical community. Colistin is considered the last therapeutic option for patients in hospital settings. Thus, we were concerned in this study to demonstrate the membrane permeabilizing activity of colistin focusing on investigating its efficiency toward those pan-drug resistant isolates which represent a critical situation. We determined the killing dynamics of colistin against pan-drug resistant isolates. The permeability alteration was confirmed by different techniques as: leakage, electron microscopy and construction of an artificial membrane model; liposomes. Moreover, selectivity of colistin against microbial cells was also elucidated. Colistin was proved to be rapid bactericidal against pan-drug resistant isolates. It interacts with the outer bacterial membrane leading to deformation of its outline, pore formation, leakage of internal contents, cell lysis and finally death. Furthermore, variations in membrane composition of eukaryotic and microbial cells provide a key for colistin selectivity toward bacterial cells. Colistin selectively alters membrane permeability of pan-drug resistant isolates which leads to cell lysis. Colistin was proved to be an efficient last line treatment for pan-drug resistant infections which are hard to treat.

Prevalence of HBV and HCV infection among multi-transfused Egyptian thalassemic patients

Though regular blood transfusion improves the overall survival of patients with p-thalassemia, it carries a definite risk of infection with blood-borne viruses. The present study was carried out to estimate the real frequency of hepatitis B virus [HBV] and hepatitis C virus [HCV] among Egyptian P-thalassemic patients, and determine the infection-associated risk factors in these patients. A prospective study conducted in a university hospital from January 2009 to January 2010. Two hundred patients with p-thalassemia major were enrolled in this study. Using enzyme-linked immunoabsorbent assay [EEISA], their sera were tested for hepatitis B surface antigen [HBsAg], antibody to hepatitis C core antigen [anti-HBc], and HCV antibody [HCV Ab]. The positive HCV Ab results were confirmed by second generation recombinant immunoblot assay [RIBA]. The study sample consisted of 111 males and 89 females, with a median age of 13 years. Eighty-one [40.5%] patients were HCV Ab positive by ELISA and 39 [19.5] were anti-HCV positive By RIBA; 58 [29.0%] were HBsAg positive and 13 [6.5%] were anti-HBc positive. Older age, an increased number of transfusion units, and HBsAg seropositivity were significantly associated with a higher prevalence of HCV and HBV. The prevalence of HCV and HBV infections are very high among Egyptian p-thalassemic patients, which calls for a critical look into the prevailing transfusion practices and adoption of stricter donor selection criteria to decrease the incidence rate of both HCV and HBV infections effectively. Furthermore, there is a compressing need for the use of more specific and sensitive methods for HCV testing in Mansoura University Hospitals

Índice de massa corporal e hipertensão arterial em indivíduos adultos no Centro-Oeste do Brasil / Body mass index and hypertension in adult subjects in Brazil's Midwest / Índice de masa corporal e hipertensión arterial en individuos adultos en el Centro Oeste del Brasil

FUNDAMENTO: O excesso de peso e a obesidade constituem importante problema de saúde pública na sociedade, devido ao crescimento em todas as faixas etárias e por sua associação a várias doenças crônicas, especialmente a hipertensão arterial. OBJETIVO: Investigar possíveis fatores associados às alterações no índice de massa corporal (IMC). MÉTODOS: Estudo desenvolvido em Nova Andradina - Mato Grosso do Sul, com 369 indivíduos cadastrados no programa Estratégia Saúde da Família no ano de 2007. Os dados foram coletados nos domicílios, por meio de entrevista semiestruturada e avaliação antropométrica. Na análise dos dados, foram utilizados os testes qui-quadrado e Mantel Haensel, para respostas categóricas, e ANOVA e Tukey, para as contínuas. RESULTADOS: As prevalências de sobrepeso e obesidade foram de 33,3 por cento e 23,0 por cento, respectivamente. Em sua maioria, os indivíduos apresentavam as seguintes características: sexo feminino (85,4 por cento), inativos (89,7 por cento), relação cintura-quadril (RCQ) inadequada (83,7 por cento) e portavam algum problema de saúde crônico (31,9 por cento), especialmente a hipertensão arterial. Os fatores de risco para sobrepeso e obesidade podem ser relacionados às variáveis estado civil viúvo, RCQ inadequada, renda mais baixa e problemas de saúde. Já a hipertensão arterial pode ser associada apenas à obesidade. CONCLUSÃO: O percentual de pessoas que se encontravam acima do peso e daquelas que não praticavam atividade física em Nova Andradina indica que essas questões constituem desafio importante para o setor saúde também nas pequenas cidades. Por isso, é premente a implantação de programas de intervenção multidisciplinares no âmbito da atenção básica.

BACKGROUND: Overweight and obesity are an important public health problem in society, due to the growth in all age groups and their association with various chronic diseases, especially hypertension OBJECTIVE: To investigate possible factors associated with changes in body mass index (BMI). METHODS: Study developed in the city of Nova Andradina, State of Mato Grosso do Sul, with 369 subjects registered in the Family Health Strategy Program in 2007. Data were collected at the subjects' homes, by using a semi-structured interview and by an anthropometric assessment. In the analysis of data, we used the Chi-square and Mantel Haenszel tests, for categorical responses, and ANOVA and Tukey tests, for continuous responses. RESULTS: The prevalence of overweight and obesity was 33.3 percent and 23.0 percent, respectively. Most of the individuals had the following characteristics: they were female (85.4 percent), physically inactive (89.7 percent), their waist-hip ratio (WHR) was inadequate (83.7 percent) and they had some chronic health problem (31.9 percent), especially hypertension. Risk factors for overweight and obesity may be linked to variables such as widowed status, inadequate WHR, lower income and health problems. On the other hand, high blood pressure may be linked only to obesity. CONCLUSION: The percentage of people that were overweight and those who did not do exercises in Nova Andradina indicates that these issues are also an important challenge for the health sector in smaller cities. Therefore, it is urgent that multidisciplinary intervention programs be implemented in primary health care.

FUNDAMENTO: El exceso de peso y la obesidad constituyen importante problema de salud pública en la sociedad, debido al crecimiento en todas las franjas etáreas y por su asociación a varias enfermedades crónicas, especialmente la hipertensión arterial. OBJETIVO: Investigar posibles factores asociados a las alteraciones en el índice de masa corporal (IMC). MÉTODOS: Estudio desarrollado en Nova Andradina - Mato Grosso do Sul, con 369 individuos registrados en el programa Estrategia Salud de la Familia en el año 2007. Los datos fueron colectados en los domicilios, por medio de entrevista semiestructurada y evaluación antropométrica. En el análisis de los datos, fueron utilizados los tests chi-cuadrado y Mantel Haensel, para respuestas categóricas, y ANOVA y Tukey, para las continuas. RESULTADOS: Las prevalencias de sobrepeso y obesidad fueron de 33,3 por ciento y 23,0 por ciento, respectivamente. En su mayoría, los individuos presentaban las siguientes características: sexo femenino (85,4 por ciento), inactivos (89,7 por ciento), relación cintura-cadera (RCC) inadecuada (83,7 por ciento) y portaban algún problema de salud crónico (31,9 por ciento), especialmente la hipertensión arterial. Los factores de riesgo para sobrepeso y obesidad pueden ser relacionados a las variables estado civil viudo, RCC inadecuada, renta más baja y problemas de salud. Ya la hipertensión arterial puede ser asociada apenas a la obesidad. CONCLUSIÓN: El porcentual de personas que se encontraban encima del peso y de aquellas que no practicaban actividad física en Nova Andradina indica que esas cuestiones constituyen desafío importante para el sector salud también en las pequeñas ciudades. Por eso, es urgente la implantación de programas de intervención multidisciplinares en el ámbito de la atención básica.

Studies on organophosphorus compounds. XII[asterisk]: synthesis of bioactive heterocycles and hydrazones by using tris-dimethylaminophos-phoniodithioformate complex

Tris-dimethylaminophosphine reacted with carbon disulphide to produce the corresponding dithioformate complex 4, which was reacted in situe with hydrazonoyl halides 5a-c in the presence of potassium carbonate [K[2]CO[3]] forming the thiadiazaphosphinines 7a-c, respectively. Isolation of the complex 4 and its reaction with hydrazonoyl halides 8a-d in warm benzene led to the formation of the thiadiazoles 10a-d. Carrying out the reaction in chloroform with stirring produced the hydrazones 12a-d. The biological activity examination revealed that compounds 10b and 12a have significant antimicrobial activity against all tested microorganisms. Compounds 7b,c and 12b,c showed slight susceptibility for only the tested Gram positive organisms and they were incapable of inhibiting the growth of the examined Gram negative bacteria and fungi

Patient's rights as perceived by health care providers and patients

Patient's rights are a comprehensive statement that help patients to understand their rights and responsibilities in abroad area of medical and nursing practice. The aim of the study was to investigate perception of the patients versus health care providers regarding patients' bill of rights. The study was conducted in the medical, surgical, orthopedic, obstetric and urology departments at Zagazig University. The results reveled that the highest mean score of agreement about patientis rights between health care providers [nurses and physicians] and patients was related to patient's rights to considerate a respectful care of the patients while the lowest mean score was related to refuse prescribed treatment and there are statistical significant differences between total agreement of both health care providers and patients about patient's rights. It is recommended that the concept of patient's rights must be included in the undergraduate studies as well as postgraduate courses in nursing, medical faculties, and each health care organization must conduct continuing education programs for health care providers on the importance of patients' bill of rights

Evaluation of bone turnover in adolescent male patients with type 1 diabetes mellitus

A major consequence of metabolic derangement in diabetic patient is the defective bone mineralization. To evaluate the bone turnover in type 1 diabetic male adolescents, 20 male adolescents with type 1 diabetes and 10 age and sex matched healthy adolescents were subjected to a detailed history taking, thorough physical examination and serum investigations including fasting glucose, creatinine, albumin, total protein, fructosamine, total calcium, corrected calcium, ionized calcium, phosphorus, alkaline phosphatase, total testosterone, free testosterone, albumin-bound testosterone, parathyroid hormone [PTH], calcitonin, osteocalcin [OS], carboxy-terminals propeptide of type 1 procollagen [PICP], type 1 collagen cross-linked carboxy terminal telopeptide [ICTP] and beta 2 microglobulin [beta 2 M]. All values were expressed as mean +/- SD and significance was calculated according to unpaired students test. It was concluded that male adolescents with type-1 diabetes had a low bone turnover state due to decreased bone formation and increased bone resorption. The reduced bio-available testosterone in these patients plays as important role in this process and is negatively correlated with the duration of the disease. However, parathyroid hormone plays a nonsignificant role in this process

Serum and synovial neopterin, a marker for rheumatoid arthritis activity

Rheumatoid arthritis [RA] is a chronic inflammatory disease of unknown etiology characterized by an erosive proliferative synovitis. Since the etiology of RA remains obscure, rheumatoid disease activity can only be evaluated by indirect laboratory measures. Despite the intensive efforts to make the clinical assessment more objective by applying numerical grades and indices, a relevant, reliable and reproducible method to quantitate rheumatoid activity is still needed. The pathogenesis of RA is complex involving many cells and cytokines. Neopterin, a pyrazino-pyrimidine derivative from gua-nosine triphosphate, was found to be an excellent biochemical marker for the invivo activation state of cell-mediated immunity. The aim of the present work was to study the monocyte/macrophage activation in RA patients by measuring neopterin concentration in serum and synovial fluid to test the efficacy of this new biochemical parameter in reflecting rheumatoid disease activity. 47 RA patients and 25 controls were included in this study Neopterin as well as other routine laboratory investigations were performed on the serum and synovial fluid [when applicable]. The results of this work showed that serum neopterin is significantly higher in RA patients than normal controls. Both serum and synovial fluid neopterin correlated strongly with the activity of the disease. Serum levels increased significantly as the disease becomes more active. If has been concluded that neopterin measurement can be used as a parameter of rheumatoid disease activity

Clonidine versus diazepam as preanesthetic agents and their effects on cardiovascular and sympathoadrenal responses to laryngoscopy and intubation

Laryngoscopy and tracheal intubation frequently induce a cardiovascular stress response, characterized by hypertension, tachycardia and increased serum concentrations of catecholamines. Three qroups each contained 10 patients undergoing elective surgery under general anaesthesia were studied. Preanesthetic medications were nothing, oral diazepam 10 mg and oral clonidine 10 mg in each group. Heart rate, systolic arterial pressure, diastolic arterial pressure, HR, SAP, DAP and MAP were recorded. Estimation of plasma concentrations of catecholamines were performed. There were lack of significant changes in HR and MAP in the clonidine group in comparison to control group but diazepam group showed a significant reduction in HR. Plasma norepinephrine showed a significant decrease in both groups. It also showed a significant correlation between plasma norepinephrine concentration and MAP only in the clonidine group. Although clonidine has some side effects as sedation and dry mouth. It is preferable than diazepam as a premedicant agent as it causes analgesia, anxiolysis and sedation