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1.
Front Chem ; 11: 1128255, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36874068

RESUMO

Photodynamic therapy (PDT) is widely used for the treatment of hypertrophic scars in clinical practice. However, the low transdermal delivery of photosensitizers in scar tissue and protective autophagy induced by Photodynamic therapy greatly reduces the therapeutic efficiency. Therefore, it is necessary to deal with these difficulties for overcoming obstacles in Photodynamic therapy treatment. In this study, a photosensitizer with photocatalytic performance was designed and synthesized using innovative MOFs (metal-organic frameworks). Additionally, the MOFs, together with an autophagy inhibitor chloroquine (CQ), was loaded in a high mechanical strength microneedle patch (MNP) for transdermal delivery. With these functionalized MNP, photosensitizers and chloroquine were delivered deep inside hypertrophic scars. Inhibition of autophagy increases the levels of reactive oxygen species (ROS) under high-intensity visible-light irradiation. Multiprong approaches have been used to remove obstacles in Photodynamic therapy and successfully enhance its anti-scarring effect. In vitro experiments indicated that the combined treatment increased the toxicity of hypertrophic scar fibroblasts (HSFs), downregulated the level of collagen type I expression as well as transforming growth factor-ß1 (TGF-ß1)expression, decreased the autophagy marker protein LC3II/I ratio, increased the expression of P62. In vivo experiments showed that the MNP had good puncture performance, and significant therapeutic effects were observed in the rabbit ear scar model. These results indicate that functionalized MNP has high potential clinical value.

3.
Microb Drug Resist ; 27(1): 36-43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32522093

RESUMO

In recent years, nosocomial infections due to multidrug resistant Klebsiella pneumoniae strains have been increasing, associated with growing trend of resistance to beta-lactams and fluoroquinolones (FQs) worldwide. In this study, prevalence of beta-lactamase genes and resistance mechanisms to FQ were analyzed in 191 clinical K. pneumoniae isolates derived from respiratory tract infections in a teaching hospital in Yangon, Myanmar. The major extended-spectrum beta-lactamase gene was blaCTX-M, which was detected in 33% of isolates, with CTX-M-15 being dominant. Fourteen isolates (7.3%) harbored carbapenemase genes that were genotyped as blaNDM-1, blaNDM-5, or blaNDM-7. The most common plasmid-mediated quinolone resistance (PMQR) gene was aac6'-Ib-cr (51.8%), followed by qnrB (41.9%), oqxAB (23%), and qnrS (15.2%). In quinolone-resistance determining region of GyrA, eight different types of mutation were identified for FQ-resistant isolates, with double mutations at two positions (S83F, D87A) being most common (54.6%). Isolates with double mutations (three patterns) showed higher minimal inhibitory concentration to levofloxacin (LVX) (≥64 µg/mL) than those with a single mutation. PMQR gene profiles, including aac6'-Ib-cr and any other gene(s), were generally related to higher resistance level to LVX. K. pneumoniae isolates with different profiles of beta-lactamase genes and FQ-resistance determinants were mostly classified into ST15 or its single-locus variant (SLV). The most common NDM gene, blaNDM-5, was detected in ST975 (ST15-SLV) isolates and an ST4000 isolate. The present study revealed the wide spread of FQ-resistant K. pneumoniae clinical isolates acquiring various FQ-resistance determinants and beta-lactamases that were presumably derived from a single clonal lineage in a hospital in Myanmar.


Assuntos
Fluoroquinolonas/farmacologia , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/genética , Klebsiella pneumoniae/efeitos dos fármacos , beta-Lactamases/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/genética , Relação Dose-Resposta a Droga , Feminino , Hospitais de Ensino , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Mianmar , Plasmídeos , Prevalência , Adulto Jovem
4.
J Med Internet Res ; 22(10): e19762, 2020 10 02.
Artigo em Inglês | MEDLINE | ID: mdl-33006570

RESUMO

BACKGROUND: Reporting cumulative antimicrobial susceptibility testing data on a regular basis is crucial to inform antimicrobial resistance (AMR) action plans at local, national, and global levels. However, analyzing data and generating a report are time consuming and often require trained personnel. OBJECTIVE: This study aimed to develop and test an application that can support a local hospital to analyze routinely collected electronic data independently and generate AMR surveillance reports rapidly. METHODS: An offline application to generate standardized AMR surveillance reports from routinely available microbiology and hospital data files was written in the R programming language (R Project for Statistical Computing). The application can be run by double clicking on the application file without any further user input. The data analysis procedure and report content were developed based on the recommendations of the World Health Organization Global Antimicrobial Resistance Surveillance System (WHO GLASS). The application was tested on Microsoft Windows 10 and 7 using open access example data sets. We then independently tested the application in seven hospitals in Cambodia, Lao People's Democratic Republic, Myanmar, Nepal, Thailand, the United Kingdom, and Vietnam. RESULTS: We developed the AutoMated tool for Antimicrobial resistance Surveillance System (AMASS), which can support clinical microbiology laboratories to analyze their microbiology and hospital data files (in CSV or Excel format) onsite and promptly generate AMR surveillance reports (in PDF and CSV formats). The data files could be those exported from WHONET or other laboratory information systems. The automatically generated reports contain only summary data without patient identifiers. The AMASS application is downloadable from https://www.amass.website/. The participating hospitals tested the application and deposited their AMR surveillance reports in an open access data repository. CONCLUSIONS: The AMASS is a useful tool to support the generation and sharing of AMR surveillance reports.


Assuntos
Farmacorresistência Bacteriana/efeitos dos fármacos , Hospitais/estatística & dados numéricos , Monitoramento Epidemiológico , Humanos , Estudo de Prova de Conceito
5.
Trop Med Health ; 48: 24, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32346355

RESUMO

BACKGROUND: Globally, cardiovascular diseases, chronic respiratory diseases, cancers, and diabetes are the four major non-communicable diseases (NCDs) contributing to more than 80% of mortality and morbidity due to NCDs. In Myanmar, the proportional mortality rate due to NCDs increased from 46.9% in 2000 to 68% in 2017. However, the trends and patterns of four major NCDs or their hospital admissions are not known. In this regard, we aimed to assess the trends and profile of admissions with four major NCDs using final diagnosis coded in International Classification of Diseases-2010 version (ICD-10) from medical record data of the large tertiary hospitals in different regions of Myanmar. RESULTS: Of the 774,970 total admissions in the study hospitals, the median and interquartile range (IQR) age was 39 (25-55) years and 51.6% were males. Over a 6-year period, there was not only 2.2-fold increase in the number of admissions due to any of four major NCDs but also their proportion increased significantly from 18.8% in 2012 to 25.4% in 2017 (chi-square for trend, p value < 0.001). The number of admissions due to cancers, cardiovascular diseases, and chronic respiratory diseases also showed linear increasing trends at the rate of 1741 (95% CI 766 to 2715), 1797 (95% CI 345 to 3249), and 597 (95% CI 530 to 612) per year, respectively. Though the admissions with diabetes increased over the years, the rate of increase of 284 (95% CI - 60 to 628) per year was not statistically significant. Among cancer admissions, colorectal (13.1%), breast (13.0%), and lung (11.0%) cancers were the commonest. Stroke (30.6%) and ischemic heart disease (21.9%) admissions were the highest among the cardiovascular diseases. Chronic obstructive pulmonary disease (35.5%) and type 2 diabetes (53.9%) were commonest among chronic respiratory diseases and diabetes, respectively. CONCLUSION: There was a disproportionate increase in NCD admissions which requires tertiary health facilities to increase their infrastructure and trained workforce to cater to such admissions. The primary health care facilities have to be strengthened for prevention, early detection, and efficient management of NCDs to prevent life-threatening complications requiring hospitalization.

6.
Trop Med Infect Dis ; 3(1)2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-30274425

RESUMO

Sporadic cases of melioidosis have been diagnosed in Myanmar since the disease was first described in Yangon in 1911. Published and unpublished cases are summarized here, along with results from environmental and serosurveys. A total of 298 cases have been reported from seven states or regions between 1911 and 2018, with the majority of these occurring before 1949. Findings from soil surveys confirm the presence of Burkholderia pseudomallei in the environment in all three regions examined. The true epidemiology of the disease in Myanmar is unknown. Important factors contributing to the current gaps in knowledge are lack of awareness among clinicians and insufficient laboratory diagnostic capacity in many parts of the country. This is likely to have led to substantial under-reporting.

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