In vivo antimicrobial activity of silver nanoparticles produced via a green chemistry synthesis using Acacia rigidula as a reducing and capping agent.

INTRODUCTION: One of the main issues in the medical field and clinical practice is the development of novel and effective treatments against infections caused by antibiotic-resistant bacteria. One avenue that has been approached to develop effective antimicrobials is the use of silver nanoparticles (Ag-NPs), since they have been found to exhibit an efficient and wide spectrum of antimicrobial properties. Among the main drawbacks of using Ag-NPs are their potential cytotoxicity against eukaryotic cells and the latent environmental toxicity of their synthesis methods. Therefore, diverse green synthesis methods, which involve the use of environmentally friendly plant extracts as reductive and capping agents, have become attractive to synthesize Ag-NPs that exhibit antimicrobial effects against resistant bacteria at concentrations below toxicity thresholds for eukaryotic cells. PURPOSE: In this study, we report a green one-pot synthesis method that uses Acacia rigidula extract as a reducing and capping agent, to produce Ag-NPs with applications as therapeutic agents to treat infections in vivo. MATERIALS AND METHODS: The Ag-NPs were characterized using transmission electron microscopy (TEM), high-resolution TEM, selected area electron diffraction, energy-dispersive spectroscopy, ultraviolet-visible, and Fourier transform infrared. RESULTS: We show that Ag-NPs are spherical with a narrow size distribution. The Ag-NPs show antimicrobial activities in vitro against Gram-negative (Escherichia coli, Pseudomonas aeruginosa, and a clinical multidrug-resistant strain of P. aeruginosa) and Gram-positive (Bacillus subtilis) bacteria. Moreover, antimicrobial effects of the Ag-NPs, against a resistant P. aeruginosa clinical strain, were tested in a murine skin infection model. The results demonstrate that the Ag-NPs reported in this work are capable of eradicating pathogenic resistant bacteria in an infection in vivo. In addition, skin, liver, and kidney damage profiles were monitored in the murine infection model, and the results demonstrate that Ag-NPs can be used safely as therapeutic agents in animal models. CONCLUSION: Together, these results suggest the potential use of Ag-NPs, synthesized by green chemistry methods, as therapeutic agents against infections caused by resistant and nonresistant strains.

[Safety and tolerance of transrectal ultrasound-guided (TRUS) biopsy in the diagnosis of prostate cancer]. / Seguridad y tolerancia de la punción-biopsia transrectal guiada por ultrasonidos (TRUS), en el diagnóstico del carcinoma de próstata.

OBJECTIVE: To identify the complications and possible associated factors observed in patients with suspected prostate cancer undergoing transrectal ultrasound-guided (TRUS) biopsy. PATIENTS AND METHODS: A prospective analysis of the TRUS biopsy procedures performed between 1995-2005. Descriptive statistics: mean, standard deviation, percentage, and 95% confidence intervals. Inferential statistics: t-test, chi-square analysis, 95% confidence intervals, and odds ratio (OR). EPI-Info Program 3.2.2-2005 of the WHO. RESULTS: A total of 1067 patients underwent the procedure; 913 (85%; CI: 83.3; 87.6) reported no pain or only slight pain. Clinical complications were detected in 284 cases (26.6%; CI: 24.2; 27.4). Self-limiting hematuria and rectorrhagia accounted for 82% of all complications. Observation and/or hospital admission was required in 7 cases (0.6%; CI: 0.3; 0.8). Immediate US follow-up after puncture registered complications in 302 cases (28.3%; CI: 26.6; 29.3). Periprostatic and/or submucosal hematoma in 264 cases accounted for 87% of these complications. The complications observed during US were related to: a history of prior urological pathology (OR = 1.52; CI: 1.31; 1.73; p = 0.005) and increased pain (OR = 5.63; CI: 5.60; 5.66 p < 0.001). The clinical complications were associated with: altered coagulation (OR = 1.67; CI: 1.64; 1.70 ;p = 0.045) and increased pain (OR = 0.37; CI: 0.32; 0.42 p < 0.001). The complications detected during US were not translated to clinical complications (OR = 0.16; CI: 0.13; 0,20 p < 0.001). CONCLUSIONS: TRUS biopsy is well tolerated by patients in our environment. Clinical complications are minimal and generally self limiting and rarely require hospital care. The role of the radiologist can be important for improving patients' tolerance of the test and reducing complications.

Seguridad y tolerancia de la punción-biopsia transrectal guiada por ultrasonidos (TRUS), en el diagnóstico del carcinoma de próstata / Safety and tolerance of transrectal ultrasound-guided (TRUS) biopsy in the diagnosis of prostate cancer

Objetivo. Identificar las complicaciones y los posibles factores asociados observados en pacientes con sospecha de carcinoma de próstata, sometidos a punción para una biopsia TRansrectal guiada por UltraSonografía (TRUS). Pacientes y métodos. Análisis prospectivo de los protocolos TRUS realizados entre los años 1995-2005. Estadística descriptiva: media, desviación estándar, porcentaje e intervalos de confianza al 95%. Estadística inferencial: pruebas de la "t" de Student y ji al cuadrado, intervalos confianza al 95% y odds ratio (OR). Programa EPI-Info 3.2.2-2005 de la Organización Mundial de la salud (OMS). Resultados. Se analizan 1.067 pacientes, de los cuales 913 (85% intervalo de confianza [IC]: 83,3; 87,6) refieren la sensación dolorosa como ausente o leve. Se detectan complicaciones clínicas en 284 casos (26,6% IC: 24,2; 27,4). La hematuria y la rectorragia autolimitadas suponen el 82% del total de los pacientes. En 7 casos (0,6% IC: 0,3; 0,8) se requirió observación y/o ingreso hospitalario. El control ecográfico inmediato postpunción registra complicaciones en 302 casos (28,3% IC: 26,6; 29,3). Hay hematoma periprostático, hematoma submucoso o combinados en 264 casos que suponen el 87% de las complicaciones. Las complicaciones observadas en la ecografía guardan relación con: antecedente de patología urológica previa (OR =1,52; IC: 1,31; 1,73; p = 0,005), sensación dolorosa aumentada (OR = 5,63; IC: 5,60; 5,66; p < 0,001). Las complicaciones clínicas se asocian con: coagulación alterada (OR = 1,67; IC: 1,64; 1,70; p = 0,045) y aumento de la sensación dolorosa (OR = 0,37; IC: 0,32; 0,42; p < 0,001). Las complicaciones detectadas en la ecografía no se traducen en complicaciones clínicas (OR = 0,16; IC: 0,13; 0,20; p < 0,001). Conclusiones. La punción biopsia transrectal en nuestro medio es una técnica bien tolerada por el paciente, con escasa repercusión clínica, generalmente autolimitada y que excepcionalmente precisa de atención hospitalaria. El papel del radiólogo puede ser determinante para mejorar la tolerancia del paciente a la prueba y disminuir las complicaciones (AU)

Objective. To identify the complications and possible associated factors observed in patients with suspected prostate cancer undergoing transrectal ultrasound-guided (TRUS) biopsy. Patients and methods. A prospective analysis of the TRUS biopsy procedures performed between 1995-2005. Descriptive statistics: mean, standard deviation, percentage, and 95% confidence intervals. Inferential statistics: t-test, chi-square analysis, 95% confidence intervals, and odds ratio (OR). EPI-Info Program 3.2.2-2005 of the WHO. Results. A total of 1067 patients underwent the procedure; 913 (85%; CI: 83.3; 87.6) reported no pain or only slight pain. Clinical complications were detected in 284 cases (26.6%; CI: 24.2; 27.4). Self-limiting hematuria and rectorrhagia accounted for 82% of all complications. Observation and/or hospital admission was required in 7 cases (0.6%; CI: 0.3; 0.8). Immediate US follow-up after puncture registered complications in 302 cases (28.3%; CI: 26.6; 29.3). Periprostatic and/or submucosal hematoma in 264 cases accounted for 87% of these complications. The complications observed during US were related to: a history of prior urological pathology (OR = 1.52; CI: 1.31; 1.73; p = 0.005) and increased pain (OR = 5.63; CI: 5.60; 5.66 p < 0.001). The clinical complications were associated with: altered coagulation (OR = 1.67; CI: 1.64; 1.70 ;p = 0.045) and increased pain (OR = 0.37; CI: 0.32; 0.42 p < 0.001). The complications detected during US were not translated to clinical complications (OR = 0.16; CI: 0.13; 0,20 p < 0.001). Conclusions. TRUS biopsy is well tolerated by patients in our environment. Clinical complications are minimal and generally self limiting and rarely require hospital care. The role of the radiologist can be important for improving patients' tolerance of the test and reducing complications (AU)

[The costs of hospital infections in a group of patients in a tertiary-care hospital]. / Costos de infecciones intrahospitalarias de un grupo de pacientes en un hospital de tercer nivel de atención.

OBJECTIVE: To know the cost generated by nosocomial infections, to establish the proportion of the total hospital budget used in extra-days of stay, drugs, laboratory and others items used for the treatment. METHODS: We studied 131 nosocomial infections in 82 patients attended in hospital's departments from June to August 1995. We evaluated days of stay, type of infection, episodes per patient, drugs, laboratory, and others items used in the treatment of nosocomial infections. We took percentage of cost of every point and the mean of the total cost generated by year cause nosocomial infections and a cost per infection in every department. RESULTS: The total overtime of stay was 970 days, mean per infection was 7.4. Totals days of antimicrobials was 974, mean was 11.9 days per infection. The hospital processed 410 laboratory studies, 191 cabinet studies. The total cost generated by overtime stay was $3,415,860.00, and considering also drugs, laboratory and cabinet studies $3,516,421.00. CONCLUSIONS: The cost of the nosocomial infections depends on the overtime stay, drugs, laboratory and cabinet studies needed for their treatment. Neonatology generated presented more than one infection generating higher cost. Total cost in 3 months was $3'516,421.00, nosocomial infections would take $14'065,684.00 in a year, involving 12.1% of the hospital total budget. Preventive measures must be taken trying to diminish these costs.

[Spontaneous hematoma of the sheath of the rectus muscles of the abdomen. Experience in primary care]. / Hematoma espontáneo de la vaina de los músculos rectos del abdomen. Experiencia en atención primaria.

AIM: Presentation of 3 cases of spontaneous hamatoma of the sheath of the rectus muscles in the abdomen. DESIGN: Retrospective clinical observations. LOCATION: Primary Care. PATIENTS: Two males (23 and 28 years old) and a woman (64 years old) who were clinically examined because the reported an acute abdominal pain. RESULTS: Clinical observations. CONCLUSIONS: We should consider the diagnosis of spontaneous hematoma of the sheath of the rectus muscles in the abdomen, differentiating it from a diagnosis of the acute abdomen.

Comparison of methods for the prediction of phenytoin concentrations.

A comparison was made of different methods for the prediction of the serum concentrations of phenytoin (PHT) at steady-state with a view to determining which of them had the best predictive performance. The methods employed calculated the predicted concentrations based on a dose steady-state concentration pair. Two of the methods used involved solving the Michaelis-Menten equation, determination of a single parameter in each individual and maintaining the Km (Method A) or Vmax (Method B) values at a constant. Methods C and D were Bayesian techniques that used population parameters determined in a population studied by us (Method C) and parameters drawn from the literature (Method D). Calculation of bias and precision suggests that Method C is the most suitable of those studied, with a mean prediction error (ME) of 0.56 +/- 2.16 mg/litre, a mean absolute error (MAE) of 1.76 +/- 1.31 mg/litre and a root mean squared prediction error (RMSE) of 2.17 mg/litre. Method C was also the method that showed the lowest percentage of underestimation (5.26%) and overestimation (10.53%).

Clomipramine test: serum level determination in three groups of psychiatric patients.

Concentrations of clomipramine, a specific and potent serotonin uptake inhibitor, are measured in 67 psychiatric patients and 12 normal volunteers. The psychiatric patients are grouped according to the DSM III R criteria namely; pathological gamblers, obsessive compulsives and sufferers of panic disorders. Before and 30, 60, 90 and 120 min after an intravenous infusion of the drug (12.5 mg in 10 min), serum samples are collected to evaluate the concentrations of cortisol, prolactine and growth hormone. Simultaneously the clomipramine concentration of these samples is determined and these results only are reported in this communication. Very different drug concentrations are observed in individual patients receiving the same amount of drug, indicating a substantial inter-individual variability of drug metabolism. No statistical differences (Newman-Keules test) between the clomipramine concentrations from the patients of the three psychiatric groups and the normal group are observed. Neither are statistical correlations observed when clomipramine concentrations from all individuals (n = 79) are related with the age, sex or consumer behaviour (cigarette smoking, alcohol and coffee intakes) of the patients.