Advanced Nanobiomaterials: Vaccines, Diagnosis and Treatment of Infectious Diseases

The use of nanoparticles has contributed to many advances due to their important properties such as, size, shape or biocompatibility. The use of nanotechnology in medicine has great potential, especially in medical microbiology. Promising data show the possibility of shaping immune responses and fighting severe infections using synthetic materials. Different studies have suggested that the addition of synthetic nanoparticles in vaccines and immunotherapy will have a great impact on public health. On the other hand, antibiotic resistance is one of the major concerns worldwide; a recent report of the World Health Organization (WHO) states that antibiotic resistance could cause 300 million deaths by 2050. Nanomedicine offers an innovative tool for combating the high rates of resistance that we are fighting nowadays, by the development of both alternative therapeutic and prophylaxis approaches and also novel diagnosis methods. Early detection of infectious diseases is the key to a successful treatment and the new developed applications based on nanotechnology offer an increased sensibility and efficiency of the diagnosis. The aim of this review is to reveal and discuss the main advances made on the science of nanomaterials for the prevention, diagnosis and treatment of infectious diseases. Highlighting innovative approaches utilized to: (i) increasing the efficiency of vaccines; (ii) obtaining shuttle systems that require lower antibiotic concentrations; (iii) developing coating devices that inhibit microbial colonization and biofilm formationThis work has benefited by the financial support of a grant of the Romanian National Authority for Scientific Research and Innovation, CNCS–UEFISCDI, project number PN-II-RU-TE-2014-4-2269S

Impact of Dental Plaque Biofilms in Periodontal Disease: Management and Future Therapy

Oral cavity represents an ideal environment for the microbial cell growth, persistence, and dental plaque establishment. The presence of different microniches leads to the occurrence of different biofilm communities, formed on teeth surface, above gingival crevice or at subgingival level, on tongue, mucosa and dental prosthetics too. The healthy state is regulated by host immune system and interactions between microbial community members, maintaining the predominance of “good” microorganisms. When the complexity and volume of biofilms from the gingival crevice increase, chronic pathological conditions such as gingivitis and periodontitis can occur, predisposing to a wide range of complications. Bacteria growing in biofilms exhibit a different behavior compared with their counterpart, respectively planktonic or free cells. There have been described numerous mechanisms of differences in antibiotic susceptibility of biofilm embedded cells. Resistance to antibiotics, mediated by genetic factors or, phenotypical, due to biofilm formation, called also tolerance, is the most important cause of therapy failure of biofilm-associated infections, including periodontitis; the mechanisms of tolerance are different, the metabolic low rate and cell’s dormancy being the major ones. The recent progress in science and technology has made possible a wide range of novel approaches and advanced therapies, aiming the efficient management of periodontal disease

Наследственная тромбофилия и репродуктивная патология

Centrul Medical „Repromed”Inherited thrombophilia is a genetic disorder of haemostasis that appears to predispose to blood clotting. Thrombosis have a negative impact (directly or indirectly) to any person’s life. Genetic mutations in genes such as factor V, factor II and PAI-1 can shift haemostatic balance between pro- and anticoagulant forces in favor of coagulation. There is an evidence that inherited thrombophilia may increase the risk of fetal loss, vascular complications of pregnancy (like intrauterine growth restriction or preeclampsia) and consequently it can be a cause of female infertility. Women affected by infertility or pregnancy loss are advised to undergo genetic testing for mutations involved in thrombophilia in order to estimate the risk of thrombosis and decide whether patients need treatment and intervention on risk factors.Наследственная тромбофилия является генетическим заболеванием, которое может произойти у любого человека, наследуется от родителей и происходит из-за мутаций на уровне ДНК. Она характеризуется тем, что повышает риск тромбоза в кровеносных сосудах, которые могут оказать негативное воздействие (прямое или косвенное) на жизнь любого человека. Генетические мутации, участвующие в наследственной тромбофилии, такие как фактор V, фактор II или PAI-1, могут быть причиной женского бесплодия, или могут увеличить риск потери плода. Женщинам, страдающим от бесплодия, рекомендуется проведение молекулярно-генетического тестирования для выявления мутаций ДНК, которые могут привести к тромбофилии, чтобы оценить риск тромбоза и решить, нужно ли им лечение или же вмешательство в отношении факторов с обратимым риском

Гипергомоцистеинемия и репродуктивная патология

Centrul Medical „Repromed”Hyperhomocysteinemia defines the state in which concentrations of the non-protein forming amino acid homocysteine exceeds normal level. Mutations in the genes of folic acid cycle (MTHFR, MTR, MTRR) togheter with decreased intake of vitamins of B group involved in homocysteine metabolism have a great contribution to hyperhomocysteinemia. Elevated concentration of homocysteine is toxic for the blood vessels and can initiate a cascade of vascular complications, including thrombosis. At the moment, hyperhomocysteinemia may be associated with adverse events during pregnancy: placental abruption, preeclampsia, neural tube defects, intrauterine growth retardation. Genetic testing for patients allows to predict the risk of hyperhomocysteinemia and thrombotic events, indicate an appropriate treatment and monitor evolution of pregnancy.Гипергомоцистеинемия характеризуется повышением концентрации небелковой аминокислоты - гомоцистеина. Мутации в генах цикла фолиевой кислоты (MTHFR, MTR, MTRR) при дефиците витаминов особенно группы Б, воздействуют на уровень гомоцистеина в крови. Повышенные концентрации гомоцистеина оказывают токсическое действие на кровеносные сосуды и могут инициировать каскад воспалительных реакций, и даже образование тромбов. Во время беременности повышенные уровни гомоцистеина могут быть причиной невынашивания беременности и таких осложнений как: отслойка плаценты, преэклампсия, дефекты нервной трубки, синдром задержки внутриутробного развития плода. Генетическое тестирование пациентов позволит предсказать риск гипергомоцистеинемии и образования тромбов, назначения соответствующего лечения и мониторинг беременности

Antibiotic Drug Delivery Systems for the Intracellular Targeting of Bacterial Pathogens

Intracellular bacterial pathogens are hard to treat because of the inability of conventional antimicrobial agents belonging to widely used classes, like aminoglycosides and β-lactams, fluoroquinolones, or macrolides to penetrate, accumulate, or be retained in the mammalian cells. The increasing problem of antibiotic resistance complicates more the treatment of the diseases caused by these agents. In many cases, the increase in therapeutic doses and treatment duration is accompanied by the occurrence of severe side effects. Taking into account the huge financial investment associated with bringing a new antibiotic to the market and the limited lifetime of antibiotics, the design of drug delivery systems to enable the targeting of antibiotics inside the cells, to improve their activity in different intracellular niches at different pH and oxygen concentrations, and to achieve a reduced dosage and frequency of administration could represent a prudent choice. An ideal drug delivery system should possess several properties, such as antimicrobial activity, biodegradability, and biocompatibility, making it suitable for use in biomedical and pharmaceutical formulations. This approach will allow reviving old antibiotics rendered useless by resistance or toxicity, rescuing the last line therapy antibiotics by increasing the therapeutic index, widening the antimicrobial spectrum of antibiotics scaffolds that failed due to membrane permeability problems, and thus reducing the gap between increasingly drug-resistant pathogens and the development of new antibiotics. Different improved drug carriers have been developed for treating intracellular pathogens, including antibiotics loaded into liposomes, microspheres, polymeric carriers, and nanoplexes. The purpose of this chapter is to present the limitations of each class of antibiotics in targeting intracellular pathogens and the main research directions for the development of drug delivery systems for the intracellular release of antibiotics

Alimentația naturală: protocol clinic naţional PCN-369

Acest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii, Muncii și Protecției Sociale al Republicii Moldova (MSMPS RM), constituit din specialiştii Departamentului Pediatrie USMF „Nicolae Testemiţanu”, IMSP Institutul Mamei și Copilului, Consultanții în alăprare „Mămica alăptează”. Protocolul clinic naţional este elaborat în conformitate cu Recomandările OMS și ghidurile internaţionale actuale privind alimentația naturală. Acest protocol va servi drept bază pentru elaborarea protocoalelor instituţionale. La recomandarea MSMPS, pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional

Gripa la adult: protocol clinic naţional PCN-370

Acest protocol a fost elaborat de grupul de lucru al Ministerului Sănătăţii, Muncii și Protecției Sociale al Republicii Moldova (MSMPS RM), constituit din specialiştii Catedrei de boli infecţioase, tropicale şi parazitologie medicală şi Catedrei de boli infecţioase, Catedra de medicină de familie, Agenția Națională pentru Sănătate Publică. Protocolul naţional este elaborat în conformitate cu ghidurile internaţionale actuale privind gripa la adulţi şi va servi drept bază pentru elaborarea protocoalelor instituţionale, în baza posibilităţilor reale ale fiecărei instituţii în anul curent. La recomandarea MSMPS pentru monitorizarea protocoalelor instituţionale pot fi folosite formulare suplimentare, care nu sunt incluse în protocolul clinic naţional