Antibacterial effect of novel biodegradable and bioresorbable PLDA/Mg composites.

Polylactic acid/Mg composites have been recently proposed for biodegradable osteosynthesis devices because, with regards to the neat polymer, they combine an enhanced biocompatibility and bioactivity with better mechanical properties, particularly creep strength. A question still arises about their bacterial behavior. For this purpose, composites of poly-L-D-lactic acid (PLDA) loaded with 1 and 10 wt.% of Mg microparticles were evaluated using Staphylococcus epidermidis, with special emphasis on the study of bacterial adhesion and biofilm formation. During biofilm formation the bacteria viability of the composites decreased up to 65.3% with respect to PLDA. These antibacterial properties do not compromise the cytocompatibility of the material as the composites enhanced the viability of mesenchymal stem cells and their osteogenic commitment. These findings provide an important added value to the biodegradable and biocompatible PLDA/Mg composites for the manufacture of osteosynthesis devices.

Determination of biofilm production by Candida tropicalis isolated from hospitalized patients and its relation to cellular surface hydrophobicity, plastic adherence and filamentation ability.

Candida tropicalis is an emerging virulent species. The aim of this study is to determine the biofilm-forming ability of 29 strains of C. tropicalis isolated from inpatients, and to examine its relation with other virulence factors such as cellular surface hydrophobicity (CSH), immediate (15 min, IA) and late (24 h, LA) plastic adherence and filamentation ability. The study was performed in parallel using two incubation temperatures - 37 and 22 °C - to determine the effect of growth temperature variations on these pathogenic attributes of C. tropicalis. Biofilm formation (BF) was measured by optical density (OD) and by XTT reduction (XTT); Slime index (SI), which includes growth as a correction factor in BF, was calculated in both methods. All strains were hydrophobic and adherent - at 15 min and 24 h - at both temperatures, with higher values for 22 °C; the adhered basal yeast layer appears to be necessary to achieve subsequent development of biofilm. Filamentation ability varied from 76.2% of strains at 37 °C to 26.6% at 22 °C. All C. tropicalis strains were biofilm producers, with similar results obtained using OD determination and XTT measurement to evaluation methods; SI is useful when good growth is not presented. BF at 37 °C was similar at 24 h and 96 h incubation; conversely, at 22 °C, the highest number of biofilm-producing strains was detected at 96 h. CSH is an important pathogenic factor which is involved in adherence, is influenced by the filamentation of yeast, and plays a critical role in BF.

A Case of Human Oral Myiasis by Lucilia sericata in a Hospitalized Patient in Extremadura, Spain.

Myiasis is the term used to describe infestations, both obligatory and accidental, in vertebrate animals and humans by dipteral larvae. The oral cavity is rarely affected by this infestation and the circumstances which can lead to oral myiasis include persistent mouth opening together with poor hygiene, or facial traumatism. We present a case of oral myiasis by larvae of Lucilia sericata, a species present in the Iberian Peninsula, in a hospitalized patient with surgical problems.

Reducción amigdalar por radiofrecuencia en pediatría / No disponible

Introducción: Se ha realizado un estudio preliminar donde se evalúa la radiofrecuencia como nueva técnica disponible para tratar casos seleccionados de hipertrofia amigdalar. Objetivos: El objetivo principal es determinar los beneficios y seguridad de la reducción amigdalar por radiofrecuencia mediante punción en pacientes pediátricos. Como objetivos secundarios se expondrán las implicaciones quirúrgicas y anestésicas de la técnica. Material y métodos: Estudio retrospectivo y descriptivo de todos los pacientes pediátricos intervenidos de hipertrofia amigdalar mediante radiofrecuencia por punción durante el periodo junio2010-febrero 2011 en nuestra Unidad. Los pacientes seleccionados se incluyeron dentro de un protocolo de actuación. Se ha estudiado: edad, sexo, sintomatología previa, dispositivo mantenimiento vía aérea, tiempo quirúrgico, asociación de adenoidectomía,complicaciones, estancia hospitalaria, dolor postoperatorio, recuperación actividad normal y resultado final. Resultados: Durante el periodo señalado 15 pacientes han sido sometidos a dicha técnica, nueve niñas (60%) y seis niños(40%), con edad media de 3,9 años. Los síntomas de indicación quirúrgica más frecuentes fueron mala respiración, ronquido y alteraciones de deglución. En todos los casos se utilizó mascarilla laríngea reforzada como único dispositivo de mantenimiento de la vía aérea. Se asoció adenoidectomía en el 80% de los pacientes. El tiempo medio de la intervención fue de 14 minutos. No se constataron complicaciones intraoperatorias ni postoperatorias. Como tratamiento del dolor postoperatorio inmediato se emplearon antiinflamatorios no esteroideos y paracetamol y tras el alta hospitalaria sólo requirieron paracetamol. La (..) (AU)

Introduction: We performed a preliminary study where puncture radiofrequency was evaluated as a new technique, available to treat selected cases of tonsillar hypertrophy. Objectives: The main objective is to determine the benefits and safety of puncture radiofrequency tonsil reduction in pediatric patients. Secondary we evaluated the implications of surgical and anesthetic techniques. Material and methods: Retrospective and descriptive study of all pediatric patients who underwent radiofrequency tonsil hypertrophypuncture during June 2010-February 2011 in our unit. The selected patients were included in a protocol including: age, sex, previous symptoms, airway maintenance device, surgical time, adenoidectomy association, complications, hospital stay, postoperative pain, recovery and outcome. Results: During the reported period 15 children have undergone this technique, nine girls (60%) and six boys (40%), with a mean age of 3.9 years. The most frequent symptoms for surgery were breathing difficulties, snoring and swallowing disorders. In allcases reinforced laryngeal mask was used as the sole device for airway maintenance. Adenoidectomy was associated in 80% of patients. The average time for surgery was 14 minutes. There were neither intraoperative nor postoperative complications. NSAIDs and acetaminophen were used as postoperative analgesia. At home, patients only used acetaminophen for pain control. Hospital stay was less than 24 hours, with 48-72 hours of recovery time. No patient came back to our emergency units. After two months, there was tonsillar reduction demonstrated in 14 of the 15 cases (93%).Conclusions: Puncture Radio frequency tonsils reduction, inpediatric selected cases can be a safe, effective and a low morbidity technique (AU)

Aspartyl proteinase, phospholipase, hemolytic activities and biofilm production of Candida albicans isolated from bronchial aspirates of ICU patients.

A correlation between mucosal colonization by Candida albicans and the subsequent development of invasive respiratory infection has been previously described. The aim of this study was to evaluate different enzymatic activities in vitro and to determine the capacity to form biofilms by 17 C. albicans isolates from bronchial aspirates of mechanically ventilated patients hospitalized in intensive care units. All the C. albicans clinical isolates tested were biofilm producers and displayed detectable levels of proteinase and hemolytic activities, although phospholipase activity was not detected in one strain. The correlation noted among the virulence factors studied suggests that the presence of more than one concurrent factor could facilitate the spread of infection.

Enzymatic activities of Candida tropicalis isolated from hospitalized patients.

Secretion of hydrolytic enzymes is considered a virulence factor in Candida spp. Extracellular enzymatic activities in 29 clinical isolates of Candida tropicalis were analyzed by plate assays. C. tropicalis, similar to Candida albicans, showed elevated hemolytic and esterase activities. However, unlike C. albicans, low aspartyl protease and very low phospholipase activities were detected in C. tropicalis isolates.

Actividad in vitro de posaconazol,fluconazol, itraconazol, ketoconazoly voriconazol frente a Candida glabrata / In vitro activities of posaconazole, fluconazole, itraconazole, ketoconazole and voriconazole against Candida glabrata

El prop¨®sito del presente trabajo ha sido determinar la actividadin vitro del nuevo antif¨²ngico triazol posaconazol frentea 123 aislamientos de levaduras de inter¨¦s cl¨ªnico. La susceptibilidadfue testada mediante el m¨¦todo comercial de microdiluci¨®nSensititre YeastOne. Las concentraciones m¨ªnimasinhibitorias (CMI) fueron establecidas de acuerdo con los criteriosrecomendados. Los resultados de la actividad de posaconazolfrente a Candida glabrata fueron comparados con losde fluconazol, itraconazol, ketoconazol y voriconazol. Las especiesm¨¢s sensibles a posaconazol fueron C. albicans, C. parapsilosis,C. tropicalis y C. dubliniensis. La especie menos sensiblefue C. glabrata. El porcentaje de cepas con CMI ¡Ý 1 mg/lpara posaconazol fue del 9%, todas ellas C. glabrata. Las especiescon CMI ¡Ý 0,5 mg/l para itraconazol supusieron un 36%(41 C. glabrata, 1 C. krusei, 1 C. guilliermondii, 1 C. ciferrii). Lascepas de C. glabrata resistentes a fluconazol, ketoconazol y voriconazolfueron el 8%, 4%y 4%, respectivamente. Posaconazolmuestra una buena activitad frente a la mayor¨ªa de las especiesde Candida; sin embargo, frente a C. glabrata es similar aitraconazol y menos activo que ketoconazol y voriconazol (AU)

This study has been conducted to asses the in vitro activityof the novel triazole antifungal agent posaconazoleagainst 123 clinically important isolates of yeasts. Susceptibilitywas tested using the Sensititre YeastOne microdilutioncommercial method. Minimun inhibitory concentrations(MICs) were determined at the recommendedendpoints and time intervals. The activity of posaconazole against Candida glabrata was compared with those offluconazole, itraconazole, ketoconazole and voriconazole.The most susceptible species to posaconazole were C. albicans,C. parapsilosis, C. tropicalis and C. dubliniensis. Candidaglabrata was the least susceptible. The percentage ofstrains with MIC for posaconazole ¡Ý 1 mg/L was 9%, allof them were C. glabrata. The species with MIC for itraconazole¡Ý 0.5 mg/L were 36% (41 C. glabrata, 1 C. krusei,1 C. guilliermondii, 1 C. ciferrii). Candida glabrata strainsresistant to fluconazole, ketoconazole and voriconazole were8%, 4% and 4%, respectively. Posaconazole exhibited goodactivity to the majority of Candida species. However, it wassimilar to itraconazole and less active than ketoconazoleand voriconazole against C. glabrata (AU)

[In vitro activities of posaconazole, fluconazole, itraconazole, ketoconazole and voriconazole against Candida glabrata]. / Actividad in vitro de posaconazol, fluconazol, itraconazol, ketoconazol y voriconazol frente a Candida glabrata.

This study has been conducted to asses the in vitro activity of the novel triazole antifungal agent posaconazole against 123 clinically important isolates of yeasts. Susceptibility was tested using the Sensititre YeastOne microdilution commercial method. Minimum inhibitory concentrations (MICs) were determined at the recommended endpoints and time intervals. The activity of posaconazole against Candida glabrata was compared with those of fluconazole, itraconazole, ketoconazole and voriconazole. The most susceptible species to posaconazole were C. albicans, C. parapsilosis, C. tropicalis and C. dubliniensis. Candida glabrata was the least susceptible. The percentage of strains with MIC for posaconazole >or= 1 mg/L was 9%, all of them were C. glabrata. The species with MIC for itraconazole >or= 0.5 mg/L were 36% (41 C. glabrata, 1 C. krusei, 1 C. guilliermondii, 1 C. ciferrii). Candida glabrata strains resistant to fluconazole, ketoconazole and voriconazole were 8%, 4% and 4%, respectively. Posaconazole exhibited good activity to the majority of Candida species. However, it was similar to itraconazole and less active than ketoconazole and voriconazole against C. glabrata.

[My clinical experience with efalizumab in the Hospital of Conxo]. / Mi experiencia clínica con efalizumab en el Hospital de Conxo.

Psoriasis in plaques is a chronic disease that requires systemic treatment in its moderate and severe forms. Because the need for treatment is generally prolonged, many medications indicated for its treatment cannot be used continuously and have to be replaced by other different drugs, but also with a limited use, both due to their possible side effects, their teratogenicity, the time of use and accumulated dose, among other reasons. The biological drugs have been designed for middle and long term control of the disease. Efalizumab is a drug that has been shown to be effective and safe in patients who have moderate-to-severe psoriasis. We present our results in a group of 50 patients, our special cases, the form in which we have treated the side effects due to Efalizumab and those due to the disease.

Modification of adherence to plastic and to human buccal cells of Candida albicans and Candida dubliniensis by a subinhibitory concentration of itraconazole.

Exposure to subinhibitory concentrations of antifungal agents can influence the adherence of Candida spp. to the host cell. In this study the adherence of Candida albicans ATCC 10231 and Candida dubliniensis CECT 11455 to plastic and to human buccal epithelial cells was evaluated following pre-exposure to 0.5 x minimum inhibitory capacity (MIC) of itraconazole and compared with the corresponding cellular surface hydrophobicity. The yeasts were grown in Sabouraud broth or RPMI-1640 with itraconazole (0.5 x MIC) for 24-26 h at 37 degrees C and the drug was then removed. The adhesion capacity to plastic was studied by turbidimetry in a polystyrene microtiter plate. The adhesion of the yeast to buccal epithelial cells was determined using microscopy techniques. The cellular surface hydrophobicity levels were determined by the microbial adhesion hydrocarbons test. Pre-exposure to itraconazole decreased plastic adherence and cellular surface hydrophobicity in both species when grown in RPMI. When C. albicans was grown in Sabouraud broth, it was nonhydrophobic and did not adhere and therefore no change was detected with the antibiotic. Itraconazole increased adherence to buccal epithelial cells in both species and media studied, as compared to controls without antifungal agents. To study the effects of these antifungal agents on pathogenicity mechanisms, it will be necessary to standardize the methodology for evaluation to determine their in vivo therapeutic efficacy.

Exposure to therapeutic concentrations of ritonavir, but not saquinavir, reduces secreted aspartyl proteinase of Candida parapsilosis.

The effect of ritonavir and saquinavir, HIV proteinase inhibitors, on the secreted aspartyl proteinase (Sap) activity of Candida parapsilosis was studied. In a proteinase-inducing medium (yeast carbon base-bovine serum albumin), Sap activity in all clinical isolates of C. parapsilosis (n = 20) was observed at 37 degrees C but not at 22 degrees C. The presence of ritonavir at a concentration of 8 microg/ml produced an inhibition close to 50% albumin consumption and also delayed yeast growth; however, saquinavir did not have any effect on growth or on Sap activity. In Sabouraud broth, which does not induce Sap production, no effect was shown on yeast growth by either of the two HIV proteinase inhibitors studied.

Moxifloxacin and biofilm production by coagulase-negative staphylococci.

The in vitro activity of moxifloxacin against 41 strains of coagulase-negative staphylococci was determined. A relationship between the activity of moxifloxacin and biofilm formation was detected. Biofilm-producing strains were more resistant to moxifloxacin than biofilm-negative strains. Our global results obtained with six strains of Staphylococcus epidermidis showed that subinhibitory concentrations of moxifloxacin did not significantly modify biofilm formation. On the other hand, moxifloxacin concentrations of 2, 10, 50 and 100 x MIC produced a log decrease in viable count (included in a biofilm) of 0.20, 0.37, 1.10 and 1.69, respectively.

In vitro activity of allicin against Staphylococcus epidermidis and influence of subinhibitory concentrations on biofilm formation.

AIMS: The aim of this study is to determine the in vitro activity of allicin against Staphylococcus epidermidis and to evaluate the influence of allicin on biofilm formation. METHODS AND RESULTS: In vitro activity of allicin (diallyl thiosulphinate) against 38 strains of S. epidermidis was investigated. The activity of allicin was similar against S. epidermidis methicillin susceptible and methicillin resistant strains [minimum inhibitory concentration (MIC)90=8 mg l(-1)]. In general, subinhibitory concentrations (sub-MIC) of allicin diminished biofilm formation in the five strains analysed. CONCLUSION: The results confirm the antibacterial effect of allicin. Sub-MICs of allicin also diminished the biofilm formations by S. epidermidis. SIGNIFICANCE AND IMPACT OF THE STUDY: The present study shows that allicin is active in vitro against S. epidermidis and that sub-MICs of allicin may play a role in the prevention of adherence of this bacteria to medical devices.

Effect of ritonavir and saquinavir on Candida albicans growth rate and in vitro activity of aspartyl proteinases.

An in vitro study to evaluate the antifungal effect and activity of aspartyl proteinases of the HIV-proteinase inhibitors ritonavir and saquinavir was conducted. Ritonavir diminished the growth rate of Candida albicans as well as the activity of its secreted aspartyl proteinases (Saps) in a nitrogen-limited medium, yeast carbon base and bovine serum albumin (YCB-BSA). This inhibition occurred in a dose-dependent fashion; with 8 mg l(-1) of ritonavir a partial growth inhibition (44%) was produced. The growth rate of C. albicans in medium with saquinavir was similar to that seen in the control, and Sap activity was inhibited only at high concentrations. In conventional medium (RPMI-1640), which does not induce the production of yeast proteases, no inhibitory effect was detected with either HIV-protease inhibitor.

National prevalence of larval echinococcosis in sheep in slaughtering plants Ovis aries as an indicator in control programmes in Uruguay.

Diagnostic surveys carried out on ovine larval echinococcosis in slaughtering plants at a national level in 1998 made it possible to meet several objectives, i.e. to estimate the existing levels of prevalence, to evaluate the effectiveness of the control actions applied by the Programme against Hydatidosis and to contribute to the improvement of the health information systems for epidemiological surveillance. The work included sheep (Ovis aries), both lambs (2-4 teeth) and adults (6-8 teeth). A random sample was performed among sheep from the plants that slaughter the majority of animals in the country. The sample included 22 animals per herd, and it involved removing their offal (liver, lungs and heart) and processing serial sections at the laboratory. The histopathological studies were performed on the lesions that could not be adequately identified at gross examination, and those that were so small that had to be submitted for confirmation of the diagnosis. Of the 2035 animals that were examined, 1019 were lambs (2-4 teeth) and 1016 were adults (6-8 teeth). The prevalence of larval echinococcosis was 7.7% in lambs and 18.0% in adults. The overall prevalence in the liver was 8.5 and 8.0% in the lungs. As to the characteristics of the morphologic structures of the larvae, in younger animals 29% of the lesions were calcified, and 71.0% were hyaline, while in older animals the proportions were 34.4% calcified versus 65.6% hyaline. Other conditions found in the liver parenchyma included: white stain (0.8%), caseous lymphadenitis (3.0%), abscess (0.4%), larvae of Taenia hydatigena (5.1%), Fasciola hepatica (3.9%). And 1.7% of the animals presented larvae of Taenia ovis in the cardiac muscle. Previous surveys carried out in 1994 using the same methodology showed a prevalence of 15.2% in 2-4 teethed animals and 33.9% in 6-8 teethed animals, thus confirming that rates have decreased by 49.6 and 47.0%, respectively. The data obtained reflect the reduction of areas contaminated with eggs of Echinococcus granulosus, which would cause a loss in immunity against this parasite after a certain time. Prevalence of larvae T. hydatigena and T. ovis could change if more sites were considered, a fact that was confirmed in studies carried out in our country. The species O. aries must be used as an indicator in the control programmes, especially in the category of 2-4 teethed lambs. The fact they are not as frequent in our market must be considered; in 1998 they accounted for only 3.0% of the total numbers of animals.

Resistance to vancomycin, LY333328, ciprofloxacin and trovafloxacin of community-acquired and nosocomial strains of Enterococcus faecalis isolated in Badajoz (Spain) with and without high-level resistance to streptomycin and gentamicin.

In vitro resistance of community-acquired and nosocomial strains of Enterococcus faecalis isolated in Badajoz (Spain) were determined by a microdilution method. The isolates were identified with conventional MicroScan Pos Combo 4 I dehydrated panels. No resistance to glycopeptides was found, but LY333328 was 2-4 times more active than vancomycin. In the nosocomial strains, high-level resistance to streptomycin (HLRS) was 54.7%, and high-level resistance to gentamicin (HLRG) was 38.1%. Resistance to ciprofloxacin and trovafloxacin was 45.3 and 38.9%, respectively. In the community-acquired isolates, HLRS, HLRG, resistance to ciprofloxacin and resistance to trovafloxacin were 44.2, 17.3, 15.4 and 13.5%, respectively. Trovafloxacin was 2-4 times more active than ciprofloxacin against both groups of strains. An association between high-level resistance to aminoglycosides and resistance to fluoroquinolones was noted. The resistance to aminoglycosides did not influence the activity of vancomycin and LY333328.

[Pattern of the distribution of total cholesterol and cHDL cholesterol Spanish children and adolescents: RICARDIN Study]. / Patrón de la distribución de colesterol total y cHDL en niños y adolescentes españoles: estudio RICARDIN.

BACKGROUND: The RICARDIN Study multicenter study of cardiovascular risk factors in children and adolescents has described the standards of normality of blood cholesterol levels in the Spanish school population. The objective of the present study was to compare mean values of cholesterol between different regions of Spain, and to compare the global mean with a pool international study. Also, the pattern of total cholesterol and cHDL by age and sex using mathematical model is described, and comparison with two international studies carried out in USA and Japan is performed. SUBJECTS AND METHODS: 10,683 children aged 6 to 18 were selected from 7 different Spanish provinces (Madrid, Vizcaya, Lugo, Badajoz, Murcia, Asturias and Barcelona). Blood samples were obtained by capilar puncture (Reflotron). RESULTS: Mean values of total cholesterol was different among provinces, and globally, were lower than the international pooled population, although the pattern observed in each population was very similar. Total cholesterol curve for Spanish boys showed a curvilinear trend that can be estimated through a cubic function that explains 89% of observed data, while for girls the best estimate was obtained through an inverse function (R2 = 0.40). cHDL for boys showed a cubic function as the best estimate (R2 = 0.90), while for girls the best estimate was obtained through a quadratic function (R2 = 0.59). CONCLUSIONS: There are important physiological variations of total cholesterol level by age and sex in children and adolescents. The pattern of cholesterol does not follow a linear model but a curvilinear one, that need to be considered in clinically assessing individual determinations of cholesterol, since highest percentiles can vary by age and sex.

Phagocytosis and killing of slime-producing Staphylococcus epidermidis bypolymorphonuclear leukocytes. Effects of sparfloxacin.

The interaction of slime-producing Staphylococcus epidermidis (S+ strain) with human polymorphonuclear leukocytes (PMNs) was analyzed. The phagocytosis index (PI) and the killing index (KI) were evaluated, and the effect of subinhibitory concentrations (sub-MICs) of sparfloxacin in this interaction was determined. The study was carried out in parallel with a non-slime-producing strain (S- strain). The MIC values of sparfloxacin against both strains was 0. 06 mg/ml. In the S- strain the mean values of PI and KI were 82% and 31%, respectively, whereas in the S+ strain these values diminished to 49% and 8%, respectively (p <0.05) when the inocula were prepared in aerobiosis. In a constant flow atmosphere of 5% CO2, the results were similar to the previous ones in the S- strain (PI = 79% and KI = 27%), whereas in the S+ strain a increase in the PI (59%) and a similar value to the KI (9%) were observed. Significant increases (p <0.05) in the PI were noted when PMNs were preincubated with 1/4 and 1/16 MIC of sparfloxacin, and S. epidermidis S+ grown in aerobiosis were used. In the other assays the variations in PI and KI were not statistically significant (p >0.05). Our results confirm that slime protects against phagocytosis and killing by PMNs, although they also suggest that the S+ strains possess additional properties which make them resistant to the action of the PMNs.

Influence of N-acetylcysteine on the formation of biofilm by Staphylococcus epidermidis.

The influence of various concentrations (0.003-8 mg/mL) of N-acetylcysteine on the formation of biofilms by 15 strains of Staphylococcus epidermidis has been studied. A dose-related decrease in biofilm formation was observed, except with the lowest concentrations. The 'slime' index relative to the control was 63%, 55%, 46%, 34%, 26% and 26% in the presence of 0.25, 0.5, 1, 2, 4, and 8 mg/mL of N-acetylcysteine, respectively. These data are statistically significant. The inhibitory effect of 2 mg/mL of N-acetylcysteine on slime formation was also verified by electron microscopy.

Incubation temperatures affect adherence to plastic of Candida albicans by changing the cellular surface hydrophobicity.

The influence of cellular surface hydrophobicity on the adherence capacity to plastic of Candida albicans was investigated at two culture temperatures (37 and 22 degrees C). The majority of the 42 strains studied were hydrophobic at 22 degrees C and hydrophilic at 36 degrees C. The hydrophobic cells showed a consistent adherence capacity which was absent from the hydrophilic strains. The culture temperatures affect adherence to plastic of C. albicans by changing the cellular surface hydrophobicity.