ABSTRACT
Microbial resistance to antibiotics, antifungals, and virucides is one of today's most significant public health problems. Antimicrobial Photodynamic Therapy (aPDT) is a prominent therapeutic strategy for infection control that does not cause microbial resistance to treatment. Its microbial eradication potential is significantly increased when aPDT is associated with nanotechnology. aPDT causes cell death due to photophysical and photochemical events derived from the interaction between a photosensitive agent (PS), a light at an appropriate wavelength, and the oxygen in the medium. Its main product, reactive oxygen species (ROS), leads to the death of microorganisms in and around the irradiated PS. However, the low water solubility, instability, and low microbial internalization of PSs with high quantum yield diminish the effectiveness of the aPDT. Nanoparticles emerge to overcome these limitations. They have been shown to increase the photodynamic activity of PSs and potentially target their delivery to infected sites, increasing the selectivity of the therapy. This review addresses the main constraints of bacteria, fungi, and viruses to the effectiveness of aPDT and discusses how nanotechnology can overcome these difficulties. Current studies that used polymeric, lipid, and metallic nanoparticles associated with aPDT were raised, and the significant advances impacted by them were critically discussed. Among the microorganisms eliminated by nanoparticles-associated aPDT, Methicillin-Resistant Staphylococcus aureus (MRSA) bacteria in planktonic culture and the form of biofilms, and fungi such as Candida albicans, stand out. The nanoparticle-associated aPDT increases the chances of success of oral cavity treatments, such as those that affect the root canal, and cutaneous, such as dermatophytosis. The use of aPDT against viruses such as HSV-1 and HIV, including Sars-CoV-2, has also shown promising results. The selectivity and effectiveness of aPDT are strictly related to the characteristics of the PS-loaded nanoparticle. It is essential to know the microorganism and the place it is installed to select the nanocarrier properly.
ABSTRACT
BACKGROUND: In recent years, there has been increasing interest in implementing digital technologies to diagnose, monitor, and intervene in substance use disorders. Smartphones are now a vehicle for facilitating telepsychiatry visits, measuring health metrics, and communicating with health care professionals. In light of the COVID-19 pandemic and the movement toward web-based and hybrid clinic visits and meetings, it has become especially salient to assess phone ownership among individuals with substance use disorders and their comfort in navigating phone functionality and using phones for mental health purposes. OBJECTIVE: The aims of this study were to summarize the current literature around smartphone ownership, smartphone utilization, and the acceptability of using smartphones for mental health purposes and assess these variables across two disparate substance use treatment sites. METHODS: We performed a focused literature review via a search of two academic databases (PubMed and Google Scholar) for publications since 2007 on the topics of smartphone ownership, smartphone utilization, and the acceptability of using mobile apps for mental health purposes among the substance use population. Additionally, we conducted a cross-sectional survey study that included 51 participants across two sites in New England-an inpatient detoxification unit that predominantly treats patients with alcohol use disorder and an outpatient methadone maintenance treatment clinic. RESULTS: Prior studies indicated that mobile phone ownership among the substance use population between 2013 and 2019 ranged from 83% to 94%, while smartphone ownership ranged from 57% to 94%. The results from our study across the two sites indicated 96% (49/51) mobile phone ownership and 92% (47/51) smartphone ownership among the substance use population. Although most (43/49, 88%) patients across both sites reported currently using apps on their phone, a minority (19/48, 40%) reported previously using any apps for mental health purposes. More than half of the participants reported feeling at least neutrally comfortable with a mental health app gathering information regarding appointment reminders (32/48, 67%), medication reminders (33/48, 69%), and symptom surveys (26/45, 58%). Most patients were concerned about privacy (34/51, 67%) and felt uncomfortable with an app gathering location (29/47, 62%) and social (27/47, 57%) information for health care purposes. CONCLUSIONS: The majority of respondents reported owning a mobile phone (49/51, 96%) and smartphone (47/51, 92%), consistent with prior studies. Many respondents felt comfortable with mental health apps gathering most forms of personal information and with communicating with their clinician about their mental health. The differential results from the two sites, namely greater concerns about the cost of mental health apps among the methadone maintenance treatment cohort and less experience with downloading apps among the older inpatient detoxification cohort, may indicate that clinicians should tailor technological interventions based on local demographics and practice sites and that there is likely not a one-size-fits-all digital psychiatry solution.