Reducing Intrathecal Baclofen Related Infections: Service Evaluation and Best Practice Guidelines

Objectives: Intrathecal baclofen (ITB) pumps are an effective treatment for spasticity; however infection rates have been reported in 3–26% of patients in the literature. The multidisciplinary ITB service has been established at The National Hospital for Neurology and Neurosurgery, UCLH, Queen Square, London for over 20 years. Our study was designed to clarify the rate of infection in our ITB patient cohort and secondly, to formulate and implement best practice guidelines and to determine prospectively, whether they effectively reduced infection rates. / Methods: Clinical record review of all patients receiving ITB pre‐intervention; January 2013–May 2015, and following practice changes; June 2016–June 2018. / Results: Four of 118 patients receiving ITB during the first time period (3.4%, annual incidence rate of infection 1.4%) developed an ITB‐related infection (three following ITB pump replacement surgery, one after initial implant). Infections were associated with 4.2% of ITB‐related surgical procedures. Three of four pumps required explantation. Following change in practice (pre‐operative chlorhexidine skin wash and intraoperative vancomycin wash of the fibrous pocket of the replacement site), only one of 160 ITB patients developed infection (pump not explanted) in the second time period (0.6%, annual incidence rate 0.3%). The infection rate related to ITB surgical procedures was 1.1%. In cases of ITB pump replacement, the infection rate was reduced to 3.3% from 17.6%. / Conclusions: This study suggests that a straightforward change in clinical practice may lower infection rates in patients undergoing ITB therapy

Comparative antibacterial potential of selected aldehyde-based biocides and surfactants against planktonic Pseudomonas fluorescens

The antimicrobial efficacy of two aldehydebased biocides (glutaraldehyde, GTA, and orthophthalaldehyde, OPA) and two surfactants (cetyltrimethyl ammonium bromide, CTAB, and sodium dodecyl sulphate, SDS) was tested against planktonic Pseudomonas fluorescens. The antimicrobial effects were evaluated by respiratory activity as a measure of the oxygen uptake rate, adenosine triphosphate (ATP) release, outer membrane proteins (OMP) expression and cellular colour changes. The results were compared with the bacterial characteristics without chemical treatment. Tests in the presence of bovine serum albumin (BSA), in order to mimic a disinfection process in the real situation under dirty conditions, were performed according to the European Standard EN-1276. P. fluorescens was completely inactivated with OPA (minimum bactericidal concentration, MBC = 0.5 mM) and CTAB (MBC = 5 mM) and was resistant to GTA and SDS. Only CTAB promoted cellular disruption and consequent ATP release. The antimicrobial action of the chemicals tested was significantly reduced when BSA was introduced into the bacterial cultures, increasing markedly the MBC values. Additionally, the presence of BSA acted as a disruption protective agent when CTAB was applied and stimulated the bacterial respiratory activity when lower concentrations of SDS were tested. The OMP of the bacterial cells was affected by the application of both surfactants. OMP expression remained unaltered after biocide treatment. Bacterial colour change was noticed after treatment with biocides and surfactants. In summary, P. fluorescens was extremely resistant to GTA and SDS, with antimicrobial action being quenched markedly by the reaction with BSA.Instituto de Biotecnologia e Química Fina (IBQF).Fundação para a Ciência e a Tecnologia (FCT) - (Project CHEMBIO - POCI/BIO/61872/2004

Domain wall fermions for planar physics

In 2+1 dimensions, Dirac fermions in reducible, i.e. four-component representations of the spinor algebra form the basis of many interesting model field theories and effective descriptions of condensed matter phenomena. This paper explores lattice formulations which preserve the global U(2N) symmetry present in the massless limit, and its breakdown to U(N)xU(N) implemented by three independent and parity-invariant fermion mass terms. I set out generalisations of the Ginsparg-Wilson relation, leading to a formulation of an overlap operator, and explore the remnants of the global symmetries which depart from the continuum form by terms of order of the lattice spacing. I also define a domain wall formulation in 2+1+1d, and present numerical evidence, in the form of bilinear condensate and meson correlator calculations in quenched non-compact QED using reformulations of all three mass terms, to show that U(2N) symmetry is recovered in the limit that the domain-wall separation L tends to infinity. The possibility that overlap and domain wall formulations of reducible fermions may coincide only in the continuum limit is discussed

Optimization for the Production of Surfactin with a New Synergistic Antifungal Activity

-surfactin and the optimization of its production by the response surface method.O. A production of 134.2 mg/L, which were in agreement with the prediction, was observed in a verification experiment. In comparison to the production of original level (88.6 mg/L), a 1.52-fold increase had been obtained.-surfactin

New Nanostructured Carbon Coating Inhibits Bacterial Growth, but Does Not Influence on Animal Cells

An electrospark technology has been developed for obtaining a colloidal solution containing nanosized amorphous carbon. The advantages of the technology are its low cost and high performance. The colloidal solution of nanosized carbon is highly stable. The coatings on its basis are nanostructured. They are characterized by high adhesion and hydrophobicity. It was found that the propagation of microorganisms on nanosized carbon coatings is significantly hindered. At the same time, eukaryotic animal cells grow and develop on nanosized carbon coatings, as well as on the nitinol medical alloy. The use of a colloidal solution as available, cheap and non-toxic nanomaterial for the creation of antibacterial coatings to prevent biofilm formation seems to be very promising for modern medicine, pharmaceutical and food industries