ABSTRACT
The review is devoted to the secondary prevention of ischemic events after ischemic stroke. Recommendations for antithrombotic therapy and prolonged indirect anticoagulant therapy with INR monitoring based on evidence-based medicine of the secondary prevention of ischemic stroke and TIA are presented. Patients who do not need anticoagulants should receive antiplatelet therapy. Due to the increasing number of patients resistant to antiaggregant therapy, the rapid and adequate evaluation of platelet function is needed. Current laboratory diagnostic methods have some shortcomings and do not meet criteria of evidence-based medicine. It is necessary to improve the laboratory diagnosis with the elaboration of reliable standardized methods.
Subject(s)
Anticoagulants/therapeutic use , Fibrinolytic Agents/therapeutic use , Ischemic Attack, Transient/prevention & control , Secondary Prevention , Stroke/prevention & control , HumansABSTRACT
Antibacterial effect of chitosan on the morphofunctional organization of clinical strains of Klebsiella pneumoniae and Staphylococcus aureus was studied by transmission electron microscopy. Chitosan promoted aggregation of bacterial cells and disorganization of bacterial cell wall and cytoplasmic membrane, which leads to the release of bacterial contents into the environment. These structural changes result in bacterial death.
Subject(s)
Cell Membrane/drug effects , Chitosan/pharmacology , Klebsiella pneumoniae/drug effects , Klebsiella pneumoniae/ultrastructure , Staphylococcus aureus/drug effects , Bacterial Capsules/drug effects , Bacterial Capsules/ultrastructure , Cell Wall/drug effects , Microscopy, Electron, Transmission , Staphylococcus aureus/ultrastructureABSTRACT
Low-molecular-weight chitosans with a viscosity-average molecular weight (Mv) of 5 to 27 kDa and equal degree of deacetylation (DD, 85%) were highly active against Pseudomonas aureofaciens, Enterobacter agglomerans, Bacillus subtilis, and Bifidobacterium bifidum 791, causing death of 80 to 100% of cells. An exception to this tendency was Escherichia coli, for which the rate of cell death, induced by the 5-kDa chitosan, was 38%. The antibacterial effect was manifested as early as 10 min after incubation of 12-kDa chitosan with B. subtilis or E. coli cells. Candida krusei was almost insensitive to the above crab chitosans. However, Candida krusei was highly sensitive to chitosans with Mv 5, 6, 12, 15.7, and 27 kDa: the minimum inhibitory concentration (MIC) varied from 0.06 to 0.005%. Chitosans with M, 5, 12, and 15.7 kDa exerted an antibacterial effect on Staphylococcus aureus. Chitosans with Mv 5, 15.7, and 27 kDa had no effect on Bifidobacterium bifidum ATCC 14893. The antibacterial effect of the 4-kDa chitosan on E. coli and B. bifidum 791 increased with DD in the range 55-85%.
