scholarly journals Trends of antimicrobial resistance in Escherichia coli isolates from urine cultures of women in Jordan: A 10-year retrospective study

10.3823/849 ◽  
2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Mustafa Abdulkarim Alrabayah ◽  
Nisreen Abdel-kareem Nadi ◽  
Aiman Mohammad Suleiman ◽  
Ala' Mohammad Abbad ◽  
Hadil Simon Ghanem ◽  
...  

Background: Urinary tract infection (UTI) is a common medical condition among women. E.coli is the most common causative organism. Appropriate understanding of the development of antimicrobial resistance over the past helps to establish efficient treatment strategies in the future. The study aims to discover antimicrobial resistance trends exhibited by E.coli strains isolated from women urine cultures over the past 10 years. Methods: A total of 1874 affected urine samples over the years 2009 to 2018 were collectively reviewed and classified according to the response they showed to 24 different antimicrobial disks in the laboratory. Relations between time and resistance evolutionary profiles were calculated. Results: Gentamicin (p value =0.039), Augmentin (p value =0.017), Cefoxitin (p value =0.001), Cefixime (p value =0.026) fulfilled satisfactory figures in terms of average resistance, regression of resistance, speed of resistance evolution, steadiness of performance, side effects, spectrum range and cost with high significance. Conclusion: Drugs that showed satisfactory figures are recommended for future treatment protocols in Jordan.  


2020 ◽  
Vol 3 (2) ◽  
pp. 01-06
Author(s):  
Fathy Abdolmejed ◽  
Khalid Almajri ◽  
Ghamela Ali

Retrospective statistical study a collection of all patients with post intra vitreal injection (IVI) endophthalmitis in last 10 year period between 2010–2019 in eye department of Tobruk medical center -Tobruk and eye department of Alwahda hospital - Derna. We aim in this study to review the microbiology, clinical characteristics, diagnosis, and management strategies of post-intra vitreal injection endophthalmitis, by comparing our results with the different studies designs and treatment protocols. There were 9 patients of the after intra vitreal injections endophthalmitis cases. The age average is 70 years, 6 cases are females and 3 casees are male, all of them were practice post intravitreal Avastin injection endophthalmitis. There were 8 patients had Diabetes mellitus (DM), 2 patients had cardiovascular disease and 1 patient had hepatitis C as a systemic disease. The most common causative organism after intra vitreous injection endophthalmitis is Coagulase-negative staphylococci (CNS) 100% from the 56% positive causative organisms and 44% are no detected microorganisms, the outcome of cases which managed with pars-plana-vitrectomy (PPV) improved significantly about 60 Letters (> 3 Lines) and cases managed without PPV > 15 Letters (> 3 Lines). The cases of post intraocular endophthalmitis which diagnosed and treated early with PPV give a good result and can save the vision. The cases of acute POE in the first 3 day had significant better function (P value = 0.02).



Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 871-871 ◽  
Author(s):  
Carmelo Rizzari ◽  
Maria Grazia Valsecchi ◽  
Paola De Lorenzo ◽  
Maurizio Aricò ◽  
Giuseppe Basso ◽  
...  

Abstract Introduction: Cure rates of ALL in children aged less than one year (i.e. infants) at diagnosis are in the range of 35–40%. Encouraging results have been recently reported in infants by using intensified treatment, including high dose chemotherapy, with or without allogeneic hematopoietic stem cell transplantation (HSCT) in first complete remission (CR). Aim: To evaluate the impact of the two treatment strategies adopted in the AIEOP ALL 91 and 95 studies on the outcome of ALL in infants. Patients and Methods: Fifty-two infants with ALL were enrolled between 1991 and 1999 in two consecutive studies, named AIEOP ALL 91 and ALL 95. Infants with an identified t(4;11) translocation had to be included in the high risk (HR) groups whilst those without this genetic abnormality could be treated in the intermediate (IR) or HR groups according to presenting features and treatment response. Patients belonging to the IR groups received a traditional BFM back-bone based treatment (protocols I, M and II), while those classified in the HR groups underwent an tensified treatment including induction (BFM protocol IA only, in study AIEOP ALL 91, and IA+IB in study ALL 95), consolidation with either 9 blocks of non-cross-resistant drugs (ALL 91) or 3 blocks followed by the 8-drug reinduction regimen - BFM protocol II - repeated twice (ALL 95). All patients were given a continuation phase (reinforced in HR patients of study ALL 95 by vincristine/prednisone pulses). Overall treatment duration was 2 years in both studies. Results: Infants in studies ALL 91 (n=21) and ALL 95 (n=31) had similar biological and clinical characteristics. The overall event-free survival (EFS) at 5 years was 45.0% (SE 7.0%). The EFS, after censoring for HSCT in 1st CR, was 38.1% (SE 11.4%) in ALL 91 and 51.6% (SE 9.9%) in ALL 95 (p-value=0.29). Patients treated in the IR arm of the two studies had a similar outcome. Better results were obtained in patients treated in the HR arm of ALL 95 study, where 9/17 chemotherapy-only patients and 3/4 HSCT patients are alive in CCR as compared to 1/7 and 0/2, respectively, in patients treated in the ALL 91 study. Discussion: These data show that full traditional BFM therapy intensified by 3 post-induction chemotherapy blocks and double protocol II (adopted in study ALL 95), is associated with a better outcome in infants with HR ALL.



Author(s):  
Fatemeh Nayeri ◽  
Fariba Asghari ◽  
Ali Baser ◽  
Leila Janani ◽  
Mamak Shariat ◽  
...  

Attitudes of physicians toward neonates with poor prognosis greatly influence their decisions regarding the course of treatment and care. The present study aimed to investigate factors contributing to attitudes of medical practitioners toward poor prognosis neonates. This was a cross-sectional, descriptive-analytic study. Questionnaires for assessing subjects’ attitudes toward care of very poor prognosis neonates were administered to all neonatologists, pediatricians, neonatology assistants, and pediatric residents (a total of 88 individuals) working in the NICUs of Imam Khomeini Hospital. Participants’ attitudes were determined through analysis of responses to seven questions on a 5-point Likert scale ranging from “strongly agree” to “strongly disagree”. Presence of anomalies incompatible with an acceptable quality of life, birth weight, gestational age, responses to neonatal diagnostic tests, certain types of diseases, parental marital status and practitioner predictions about patient prognosis were the factors contributing to practitioners’ attitude (P-value < 0.005). However, no significant relationship was found in connection with religious beliefs, socioeconomic status, opinions of consulting physicians, hospital treatment protocols, standards of the Association of Neonatal Physicians, and ethics committee expectations (P-value > 0.005). It can be concluded that the attitudes of practitioners toward intensive care of poor prognosis neonates is determined by the medical condition of the neonate rather than socio-demographic characteristics.



Author(s):  
Jolien Onsea ◽  
Virginia Post ◽  
Tim Buchholz ◽  
Hella Schwegler ◽  
Stephan Zeiter ◽  
...  

Because of the growing spread of antimicrobial resistance, the use of alternative prevention and treatment strategies is gaining interest. Although the therapeutic potential of bacteriophages has been demonstrated in a number of case reports and series over the past decade, many unanswered questions remain regarding the optimal application protocol.



2019 ◽  
Vol 19 (4) ◽  
pp. 232-241 ◽  
Author(s):  
Xuegong Chen ◽  
Wanwan Shi ◽  
Lei Deng

Background: Accumulating experimental studies have indicated that disease comorbidity causes additional pain to patients and leads to the failure of standard treatments compared to patients who have a single disease. Therefore, accurate prediction of potential comorbidity is essential to design more efficient treatment strategies. However, only a few disease comorbidities have been discovered in the clinic. Objective: In this work, we propose PCHS, an effective computational method for predicting disease comorbidity. Materials and Methods: We utilized the HeteSim measure to calculate the relatedness score for different disease pairs in the global heterogeneous network, which integrates six networks based on biological information, including disease-disease associations, drug-drug interactions, protein-protein interactions and associations among them. We built the prediction model using the Support Vector Machine (SVM) based on the HeteSim scores. Results and Conclusion: The results showed that PCHS performed significantly better than previous state-of-the-art approaches and achieved an AUC score of 0.90 in 10-fold cross-validation. Furthermore, some of our predictions have been verified in literatures, indicating the effectiveness of our method.



2020 ◽  
Vol 13 ◽  
Author(s):  
Rohit Bhatia ◽  
Amit Sharma ◽  
Raj Kumar Narang ◽  
Ravindra K. Rawal

: Cancer is one of the most serious health concerns in 21st century whose prevalence is beyond boundaries and can affect any organ of human beings. The conventional chemotherapeutic treatment strategies lack specificity to tumours and are associated with toxic effects on immune system and other organ systems. In the past decades, there has been a continuous progress in the development of smart nanocarrier systems for target specific delivery of drugs against variety of tumours including intracellular gene-specific targeting. These nanocarriers are able to recognize the tumour cells and deliver the therapeutic agent in fixed proportions causing no or very less harm to healthy cells. Nanosystems have modified physicochemical properties, improved bioavailability and long retention in blood which enhances their potency. A huge number of nanocarrier based formulations have been developed and are in clinical trials. Nanocarrier systems include polymeric micelles, liposomes, dendrimers, carbon nanotubes, gold nanoparticles, etc. Recent advancements in nanocarrier systems include mesoporous silica nanoparticles (MSNs), metal organic frame works and quantum dots. In the present review, various nanocarrier based drug delivery systems along with their applications in the management of cancer have been described with special emphasis on MSNs.



2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i28-i28
Author(s):  
N Hassan ◽  
R Slight ◽  
S P Slight

Abstract Introduction Antimicrobial resistance is a global health problem, especially in developing countries. Antimicrobial Stewardship Programmes (AMS) have been shown to be effective at reducing antimicrobial resistance and hospital patient stays. Health information technology (HIT) can support Outpatient Parenteral Antimicrobial Therapy (OPAT) through more accurate diagnosis and management of infectious diseases. Aim To evaluate the knowledge and attitude of Egyptian healthcare professionals towards the application of HIT to optimize OPAT. Methods Healthcare professionals who worked in either private or public sectors of Egyptian healthcare system were emailed and asked if they would be willing to complete an electronic questionnaire (using google forms). One reminder was sent by email each week for two weeks (two in total) from the first invitation. The survey was laid out in four sections. The first section included specific details about the healthcare professional’s current employment and role, the second related to HIT services available in their organisations, the third covered their training in HIT and antimicrobial stewardship programmes, and the fourth included their use of HIT to optimize OPAT. Ethical approval was obtained from National Heart Institute, Egypt. Descriptive analysis was carried out for all the variables. One-way ANOVA testing at level of significance P-value &lt;0.05, was used to compare numerical variables. SPSS version 26 was used for statistical analysis. Results Three hundred and eighty-five healthcare professionals were invited to respond to the questionnaire. (The response rate was 75.34% (290)). Of these, 152 (52.6%) were pharmacists, 134 (46.4%) physicians, and 3 (1%) nurses, and many participants (30.8%) had between 6 to 10 years of experience working in either outpatient or in-patient units. Only 15.2% of respondents mentioned that they have access to OPAT in their organizations, 51.2% did not have the service, while 33.6% responded that they did not know if the service was available. However, 27.3% had a training on ASP and 18.3% had a training on HIT. Mean scores for both knowledge (14.31±5.49) and attitude (14.67±2.53) were significantly higher in professionals who had received training in HIT (p = 0.003 & 0.006 respectively). However, scores for attitude were better than scores for knowledge. Conclusions In developing countries, HIT applications in OPAT are still in their infancy with only a few organisations adopting them. Egyptian healthcare professionals showed positive attitudes towards HIT use, especially when their knowledge was improved through training. Two strengths of this study include our high response rate and the wide breadth of different healthcare professionals who responded from both private and public healthcare settings. However, being a questionnaire, some questions were left unanswered and some respondents may not have been aware of their reasons for a particular answer. That said, this study has important implications for practice, with more awareness amongst healthcare professionals required on the availability of HIT services in their hospitals and how further training may be needed on the applications of HIT in optimizing OPAT.



CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 151-151
Author(s):  
Jonathan M. Meyer ◽  
Ericha Franey ◽  
Leslie Lundt ◽  
Betsy Benning ◽  
Edward Goldberg ◽  
...  

AbstractObjectiveVesicular monoamine transporter 2 (VMAT2) inhibitors including valbenazine are first-line therapies for tardive dyskinesia (TD), a persistent movement disorder associated with antipsychotic exposure. This real-world study was performed to assess the association between patient awareness of TD symptoms and clinician-assessed symptom severity.MethodsClinicians who treated antipsychotic-induced TD with a VMAT2 inhibitor within the past 24 months were asked to extract demographic/clinical data from patients charts and complete a survey for additional data, including patient awareness of TD (yes/no) and TD symptom severity (mild/moderate/severe).ResultsData for 601 patients were provided by 163 clinicians (113 psychiatrists; 46 neurologists; 4 primary care physicians). Patient demographics: 50% male; mean age 50.6 years; 55% schizophrenia/schizoaffective disorder; 29% bipolar disorder; 16% other psychiatric diagnoses. Positive relationships were seen between patient awareness and clinician-assessed symptom severity. Awareness was highest in patients with severe symptoms in specific body regions: face (88% vs 78%/69% [awareness by severe vs moderate/mild symptoms]); jaw (90% vs 80%/67%); wrists (90% vs 69%/63%). In other regions, awareness was similar in patients with severe or moderate symptoms: lips (85%/86% vs 68% [severe/moderate vs mild]); tongue (81%/80% vs 73%); neck (80%/78% vs 68%); arms (67%/66% vs 62%); knees (67%/67% vs 53%).ConclusionsIn patients prescribed a VMAT2 inhibitor for TD, patient awareness was generally higher in those determined to have moderate-to-severe symptom severity as assessed by the clinician. More research is needed to understand how awareness and severity contribute to TD burden, and whether different treatment strategies are needed based on these factors.FundingNeurocrine Biosciences, Inc.



Children ◽  
2021 ◽  
Vol 8 (6) ◽  
pp. 482
Author(s):  
Irene Paraboschi ◽  
Laura Privitera ◽  
Gabriela Kramer-Marek ◽  
John Anderson ◽  
Stefano Giuliani

Neuroblastoma (NB) is the most common extracranial solid tumour in childhood, accounting for approximately 15% of all cancer-related deaths in the paediatric population1. It is characterised by heterogeneous clinical behaviour in neonates and often adverse outcomes in toddlers. The overall survival of children with high-risk disease is around 40–50% despite the aggressive treatment protocols consisting of intensive chemotherapy, surgery, radiation therapy and hematopoietic stem cell transplantation2,3. There is an ongoing research effort to increase NB’s cellular and molecular biology knowledge to translate essential findings into novel treatment strategies. This review aims to address new therapeutic modalities emerging from preclinical studies offering a unique translational opportunity for NB treatment.



AMB Express ◽  
2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Zhaohui Li ◽  
Han Wang ◽  
Jun Wei ◽  
Liang Han ◽  
Zhigang Guo

Abstract Glioma causes significant mortality across the world and the most aggressive type of brain cancer. The incidence of glioma is believed to increase in the next few decades and hence more efficient treatment strategies need to be developed for management of glioma. Herein, we examined the anticancer effects of Indirubin against a panel of human glioma cells and attempted to explore the underlying mechanisms. The results of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay showed that Indirubin could inhibit the growth of all the glioma cells but the lowest IC50 of 12.5 µM was observed against the U87 and U118 glioma cells. Additionally, the cytotoxic effects of Indirubin were comparatively negligible against the normal astrocytes with an IC50 of > 100 µM. Investigation of mechanism of action, revealed that Indirubin exerts growth inhibitory effects on the U87 and U118 glioma cells by autophagic and apoptotic cell death. Annexin V/PI staining assay showed that apoptotic cell percentage increased dose dependently. Apoptosis was associated with increase in Bax decrease in Bcl-2 expressions. Additionally, the expression of autophagic proteins such as LC3II, ATG12, ATG15 and Beclin 1 was also increased. Wound heal assay showed that Indirubin caused remarkable decrease in the migration of the U87 and U118 cells indicative of anti-metastatic potential of Indirubin. Taken together, these results suggest that Indirubin exerts potent anticancer effects on glioma cells and may prove essential in the management of glioma.



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