In search of the best method to detect carriage of carbapenem-resistant Pseudomonas aeruginosa in humans: a systematic review.

BACKGROUND: Detection of carbapenem-resistant Pseudomonas aeruginosa (CR-PA) in humans is important to prevent transmission. However, the most optimal culture method to detect CR-PA is unknown. This systematic review aims to determine which culture method is most sensitive and which culture methods are used to detect CR-PA in humans. Second, to establish the most feasible culture method taking into account the turnaround time (TAT), and third, to provide an overview of the sampling sites used to detect carriage. METHODS: We systematically searched the electronic databases Embase, Medline Ovid, Cochrane, Scopus, CINAHL, and Web of Science until January 27, 2023. All diagnostic accuracy studies comparing two or more culture methods to detect CR-PA and recent outbreak or surveillance reports on CR-PA carriage or infection in humans, which describe culture methods and their results, were eligible for inclusion. We used QUADAS-2 guideline for diagnostic accuracy studies and the STROBE or ORION guideline for outbreak-surveillance studies to assess the risk of bias. RESULTS: Six diagnostic accuracy studies were included. An enrichment broth was found to increase the detection of CR-PA. Using an enrichment broth extended the TAT by 18-24 h, yet selective media could reduce the TAT by 24 h compared to routine media. In total, 124 outbreak-surveillance studies were included, of which 17 studies with surveillance samples and 116 studies with clinical samples. In outbreak-surveillance studies with surveillance samples, perianal, rectal swabs or stools were the most common sampling site/specimen (13/17, 76%). A large variety was observed in whether and which kind of enrichment broth and selective media were used. CONCLUSIONS: We found a benefit of using an enrichment step prior to inoculation of the material onto selective media for the detection of CR-PA. More research is needed to determine the most sensitive sampling site and culture method. TRAIL REGISTRATION: This study was registered in the PROSPERO International prospective register of systematic reviews (registration number: CRD42020207390, http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42020207390 ).

Outbreak investigations after identifying carbapenem-resistant Pseudomonas aeruginosa: a systematic review.

BACKGROUND: Carbapenem-resistant Pseudomonas aeruginosa (CRPA) are a serious cause of healthcare-associated infections. Part of the infection prevention and control measures are outbreak investigations (OI) of patients, healthcare workers (HCW), and the environment after identifying a CRPA in order to identify carriers and environmental reservoirs, so that targeted actions can be taken to prevent further transmission. However, little is known on when and how to perform such OI. Therefore, this systematic review aims to summarize OI performed after detection of CRPA in the endemic and epidemic hospital setting. MAIN TEXT: Articles related to our research question were identified through a literature research in multiple databases (Embase, Medline Ovid, Cochrane, Scopus, Cinahl, Web of Science, and Google Scholar) until January 12, 2022 (Prospero registration number CRD42020194165). Hundred-twenty-six studies were included. In both the endemic and the epidemic setting, a median number of two out of seven predefined components of OI were identified. In the endemic setting, the most frequent component of OI was screening of the environment (28 studies, 62.2%). In the epidemic setting, screening of the environment (72 studies, 88.9%), and screening of patients during hospitalization (30 studies, 37%) were most frequently performed. Only 19 out of 126 studies (15.1%) reported screening of contact patients, and 37 studies reported screening of healthcare workers (HCW, 29.4%). CONCLUSION: Due to probable underreporting of OI in the literature, the available evidence for the usefulness of the individual components of OI is scarce. This could lead to inhomogeneous performance of OI after detection of CRPA in the healthcare setting, and with this, potential under- or overscreening. While we could show evidence for the usefulness for environmental screening in order to identify the mode of transmission, evidence for HCW screening is scarce and might not lead to the identification of modes of transmission. Further studies are needed to better understand CI in different settings and, finally, develop guidance on when and how to best perform OI.

Go Micro Aesthetics: A Cross-Sectional Study to Assess Anterior Hard and Soft Tissue Parameters in Young Adults of Bhopal City.

Background In the maxillary aesthetic zone, the symmetry and proportions of hard and soft dental tissue play a crucial role. A dental practitioner should have a thorough knowledge of parameters such as crown length (CL), crown width (CW), zenith point, and gingival angle (GA) to perform teeth restorations. This study aims to assess the anterior hard and soft tissue parameters and determine the crown shape and its correlation with the gingival parameters of young adults' anterior teeth. Methods In the study, 110 patients were assessed and divided into two groups: Group I with 55 females and Group II with 55 males. Using a calibrated vernier caliper, the following parameters were calculated: crown width (CW)/crown length (CL) ratio, gingival angle (GA), distance from the lateral incisor (LI) to the gingival aesthetic line (GAL), interdental papilla height (PH) between the two central incisors (CI), distance between the central incisor (CI) and the lateral incisor (LI), and distance between LI and canine. Results Statistical analysis of data was performed using the independent samples t-test (P<0.05). The mean value of CW, CL, CW/CL ratio, and GA, along with the distance from LIs to GALs and PHs of the anterior teeth, were lower in females than in males. The correlation between the GA and the CW/CL ratio indicated that higher GAs and CW/CL ratios give teeth a square appearance. Moreover, a lower GA and CW/CL ratio will make teeth appear round or narrow. Conclusion The present study concluded that the mean values of hard and soft dental tissue parameters are higher in males than in females. These values can be used to restore functional aesthetics in accordance with the results of a local population and could help form restorative, aesthetic, and cosmetic procedures while maintaining focus on the size and shape of teeth and the level of gingiva at various significant treatment stages.

Efficacy of Turmeric as Adjuvant Therapy in Type 2 Diabetic Patients.

It is known that there is a significant interplay of insulin resistance, oxidative stress, dyslipidemia, and inflammation in type 2 diabetes mellitus (T2DM). The study was undertaken to investigate the effect of turmeric as an adjuvant to anti-diabetic therapy. Sixty diabetic subjects on metformin therapy were recruited and randomized into two groups (30 each). Group I received standard metformin treatment while group II was on standard metformin therapy with turmeric (2 g) supplements for 4 weeks. The biochemical parameters were assessed at the time of recruitment for study and after 4 weeks of treatment. Turmeric supplementation in metformin treated type 2 diabetic patient significantly decreased fasting glucose (95 ± 11.4 mg/dl, P < 0.001) and HbA1c levels (7.4 ± 0.9 %, P < 0.05). Turmeric administered group showed reduction in lipid peroxidation, MDA (0.51 ± 0.11 µmol/l, P < 0.05) and enhanced total antioxidant status (511 ± 70 µmol/l, P < 0.05). Turmeric also exhibited beneficial effects on dyslipidemia LDL cholesterol (113.2 ± 15.3 mg/dl, P < 0.01), non HDL cholesterol (138.3 ± 12.1 mg/dl, P < 0.05) and LDL/HDL ratio (3.01 ± 0.61, P < 0.01) and reduced inflammatory marker, hsCRP (3.4 ± 2.0 mg/dl, P < 0.05). Turmeric supplementation as an adjuvant to T2DM on metformin treatment had a beneficial effect on blood glucose, oxidative stress and inflammation.

Evaluation of effective regurgitant orifice area of mitral valvular regurgitation by multislice cardiac computed tomography.

OBJECTIVE: The purpose of our study was to assess the diagnostic accuracy of multislice computed tomography (MSCT) for the identification and quantification of mitral valve regurgitation in comparison with transthoracic echocardiography (TTE). METHODS: Twenty-six patients (15 females, 11 males with a mean age of 44.6±14.1 years) who were in follow-up with the diagnosis of mitral regurgitation and those who were referred for MSCT were enrolled. MSCT results were compared with TTE measurements. RESULTS: The mean effective mitral regurgitant orifice area at MSCT was 23.1±13.0 mm² and at echocardiography was 24.4±16.0 mm². Bland-Altman analysis showed good agreement between the two imaging methods. CONCLUSION: MSCT provides reliable and good results for the evaluation of mitral regurgitation.

The relationship of the peroxisome proliferator-activated receptor-gamma 2 exon 2 and exon 6 gene polymorphism in Turkish type 2 diabetic patients with and without nephropathy.

BACKGROUND: Peroxisome proliferator-activated receptor gamma (PPAR gamma) has recently been shown to be associated with type 2 diabetes. We aim to investigate Turkish type 2 diabetic patients with/without diabetic nephropathy and healthy group and examined the contribution of the G/C exon 2 and T/C exon 6 of the PPAR gamma gene polymorphism to the development of diabetic nephropathy. METHODS: The PPAR gamma genotypes were determined retrospectively in 43 patients with nephropathy and 48 without nephropathy and a control group of 50 healthy individuals. Genotyping of the G/C exon 2 and T/C exon 6 of the PPAR-gamma gene polymorphism for all individuals was performed by melting curve analysis of the generated amplicons after real-time online PCR. RESULTS: This genotype (exon 2 and exon 6) distribution did not differ between control subjects and type 2 diabetic patients. The genotype frequencies and allele exon 2 were CC, 100%; GC, 0%; GG, 0% and C, 100%; G, 0% in diabetic patients with nephropathy versus CC, 97.9%; GC, 2.1%; GG, 0% and C 98.9%, G 1.1% in those without nephropathy. Genotype exon 6 frequencies in diabetic patients with nephropathy were (T/T) 0%, (T/C) 14%; (C/C) 86% versus (G/G) 0%; (G/C) 2.1%; (C/C) 97.9% in those without nephropathy. The PPAR gamma exon 2 and exon 6 genotype and allele frequencies were not different between diabetic patients with and without nephropathy. CONCLUSIONS: PPAR gamma exon 2 and exon 6 gene polymorphism is not associated with the development of diabetic nephropathy in Turkish type 2 diabetic patients.

Gravity-free hydraulic jumps and metal femtoliter cups.

Hydraulic jumps created by gravity are seen everyday in the kitchen sink. We show that at small scales a circular hydraulic jump can be created in the absence of gravity by surface tension. The theory is motivated by our experimental finding of a height discontinuity in spreading submicron molten metal droplets created by pulsed-laser ablation. By careful control of initial conditions, this leads to solid femtoliter cups of gold, silver, copper, niobium, and tin.

A facile method of producing femtoliter metal cups by pulsed laser ablation.

Cuplike structures of Au, Ag, Cu, Zn, Nb, Cd, Al, In, and Sn in the size range of 300 nm to a few micrometers with an internal volume of a few femtoliters have been produced by the laser ablation of metal targets in a vacuum, by optimizing, in each case, the laser fluence and the substrate temperature. The metal droplets impinging on the substrate seem to undergo a hydraulic jump driven by the surface tension forces before solidifying into cups. The cups are robust and can be functionalized with biomarkers, filled with nanoparticle sols, oxidized to crucibles, or detached from the substrate without causing any deformation. We envisage their potential applications as femtoliter metal containers.

Chemotherapy influences inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) activity on 3D breast cancer cell line.

Multicellular tumor spheroids (MTS) are three-dimensional structural forms of tumors grown in vitro in the laboratory. In this study, the aim was to determine the regulation of inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) expressions on MTS in response to treatment with the commonly used anti-cancer drugs Doxorubicin and Docetaxel. The spheroids were generated using the "liquid overlay" technique. The distribution of both iNOS and eNOS was detected using indirect immunohistochemistry, while the expression of both iNOS and eNOS was measured using Western blots. Additionally, S-phase analysis using 5-bromo-2'-deoxyuridine (BrdU) was done on the MTS after treatment with doxorubicin, docetaxel, and a combination of the two. The Griess method was used to measure nitric oxide (NO) production in the cells. An increase in iNOS immunoreactivity and a decrease in eNOS immunoreactivity were observed after doxorubicin treatment, when compared with the other groups. Furthermore, upregulation of iNOS and downregulation of eNOS were detected in doxorubicin-treated cells using Western blotting. Insignificant iNOS expression was observed in all of the groups, and it was particularly low in the control and drug combination groups. NO production was also found to be significantly high after docetaxel treatment, and cell proliferation decreased after doxorubicin treatment. In conclusion, chemotherapy influences NOS activity differently with the presence of different drugs. The results with iNOS show that doxorubicin is a more effective drug than docetaxel, and a drug combination may play a helpful role in the suppression of tumorigenicity and cancer metastasis. Interestingly, eNOS expression increased after the addition of both docetaxel and the drug combination, and it was found to negatively correlate with the histological grade of the tumor. Therefore, analyzing the expression of both iNOS and eNOS might be very useful for targeting the treatment of breast carcinoma and obtaining better information on prognosis.

Arsenic trioxide exposure to ovarian carcinoma cells leads to decreased level of topoisomerase II and cytotoxicity.

The objective of this study was to investigate the effect of arsenic trioxide (As(2)O(3)) on topoisomerase II levels using western blotting method on MDAH 2774 ovarian carcinoma cell culture. Experimental designs were established to determine the cytotoxic effects of As(2)O(3) on MDAH 2774 cells and the IC50 (fatal dose for the 50% of cells) value. Cytotoxicity experiments were carried out using various concentrations of As(2)O(3). The 2,3-bis[2-methyloxy-4-nitro-5-sulfophenyl]-2H-tetrazolium-5-carboxanilide (XTT) and trypan blue dye-exclusion tests were used to evaluate cytotoxicity. Topoisomerase II expressions were investigated using western blotting method with various concentrations of As(2)O(3). Densitometric analysis of topoisomerase 2 bands was carried out using Quantity One 1-D analysis software (Bio-Rad USA, Life Science Research, Hercules, CA). IC50 value of As(2)O(3) was found to be 5 x 10(-6) M for MDAH 2774 cells. When the bands were evaluated, it was observed that there was a decrease in topoisomerase II levels in MDAH 2774 cells with increasing concentrations of As(2)O(3). It was also observed by the densitometric analysis that topoisomerase II expression ratios of MDAH 2774 cells were decreased by approximately 50% at this concentration. Topoisomerase II levels were significantly decreased with the increasing concentrations of As(2)O(3). Inhibition of topoisomerase II enzyme was one of the antiproliferative influence mechanisms of As(2)O(3).

Arsenic trioxide-loaded, microemulsion-enhanced cytotoxicity on MDAH 2774 ovarian carcinoma cell line.

The antiproliferative effect of As(2)O(3)-loaded microemulsion (As(2)O(3)-M) on human MDAH 2774 ovarian cancer cells was compared with a regular solution of the As(2)O(3). We used MDAH 2774 as model cell lines for ovarian cancer. The (2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide) (XTT) and trypane blue dye exclusion tests were used to evaluate cytotoxicity. Apoptotic effect of solutions was evaluated using cell death detection kit. Standard microemulsion formulation used in this experiment contains 5 x 10(-6) M As(2)O(3). It was clearly demonstrated that As(2)O(3)-M had a significant cytotoxic effect on MDAH 2774 cell line, and the cytotoxic effect of As(2)O(3)-M was significantly higher than that of regular As(2)O(3) solutions. Even approximately 6000 times diluted microemulsion formulation loaded with 5 x 10(-6) M As(2)O(3) showed a cytotoxic effect. As a result, this diluted concentration (approximately 8 x 10(-10) M) was found to be approximately 6000 times more effective than regular As(2)O(3) solutions (5 x 10(-6) M). Moreover, this diluted concentration resulted in 1.5-fold enhancement of apoptosis. According to the in vitro cytotoxicity studies, we concluded that by incorporating As(2)O(3) into the microemulsion (As(2)O(3)-M), which is a new drug carrier system, it is possible to increase antiproliferative effect of regular As(2)O(3) on MDAH 2774 cells. Translating these results to in vivo conditions would open new windows in the treatment of ovarian cancer.

Generation of onions and nanotubes of GaS and GaSe through laser and thermally induced exfoliation.

Although theoretical calculations have predicted that layered GaS and GaSe should form nanotube and related structures, they have not been prepared experimentally to date. We have carried out laser irradiation as well as thermal treatment of GaS and GaSe to cause exfoliation, which yielded onionlike structures and nanotubes by the rolling of the exfoliated sheets.

Up-regulation of serine/threonine protein phosphatase type 2A regulatory subunits during methylprednisolone-induced differentiation of leukaemic HL-60 cells.

Serine/threonine protein phosphatase 2A (PP2A) may play a role in leukaemic cell differentiation of the HL-60 myeloid leukaemic cell-line after methylprednisolone induction. We have investigated the specific enzyme activity and expression of catalytic and regulatory subunits of PP2A. The resulting specific enzyme activity and immunoblots showed an increase in enzyme activity and the expression of regulatory subunits after methylprednisolone treatment. There was no change in the expression of PP2A catalytic subunits. It is suggested that the effect of methylprednisolone on leukaemic differentiation may be the result of PP2A upregulation.