Studio di alcuni oli essenziali nella pratica clinica

During the Ph.D. period, mastery of several traditional microbiology techniques, such as bacteriology and cytology, and molecular techniques was acquired, with application on randomized clinical trials. The research activity has focused mainly on in vitro antibacterial, antioxidant and cytotoxic activity with subsequent application of some essential oils in vivo on animals and on humans. Considering the results obtained, it is clear that Thymus vulgaris - red thyme geraniol sel and L. grosso oils have shown good antimicrobial activity, compared to L. angustifolia and L. sumian on multi-drug clinical strains of P. aeruginosa. While L. angustifolia Miller presented a cytotoxic action on CaCo-2 cells (Colon-carcinoma Carcinoma Cells) probably due to the action of terpenes. The oleolites of Helichrysum microphyllum Cambess. subsp. tyrrhenicum Bacch., Brullo & Giusso and Hypericum perforatum subsp. Angustifolium were tested against 30 strains of Candida spp.: the oleolite of H. microphyllum showed greater antifungal activity compared to H. perforatum. Finally, the antifungal action of Mirtus communis was studied against 86 strains of Malassezia spp.: the obtained data showed a remarkable activity against M. furfur and M. sympodialis. Furthermore, an in vivo study was performed and we present here the preliminary data. The topic developed is part of a research area aimed at the use of essential oils with antibacterial activity in the problem of drug resistance

Insights on carbapenem-resistant Pseudomonas aeruginosa : phenotypic characterization of relevant isolates

Pseudomonas aeruginosa (P. aeruginosa) is ubiquitous in nature, and may be a causative agent in severe, life-threatening infections. In >60% of cases, β-lactam antibiotics are used in the therapy of P. aeruginosa infections, therefore the emergence of carbapenem-resistant P. aeruginosa (CRPA) is a significant clinical concern. In this study, phenotypic methods were used to characterize fifty-four (n = 54) P. aeruginosa isolates, which were included based on their suspected non-susceptibility to meropenem. Minimum inhibitory concentrations (MICs) of meropenem, ceftazidime, cefepime, ciprofloxacin, gentamicin, were determined using E-tests, while colistin MICs were determined using broth microdilution. The isolates were subjected to the modified Hodge test (MHT), the modified carbapenem-inactivation method (mCIM) and the imipenem/EDTA combined disk test (CDT). AmpC and efflux pump overexpression was studied using agar plates containing cloxacillin and phenylalanine-arginine β-naphthylamide (PAβN), respectively. Assessment of biofilm-formation was carried out using the crystal violet tube-adherence method. 38.9% of the strains showed meropenem MICs in the resistant range (>8 mg/L). Efflux-pump overexpression and AmpC-hyperproduction was seen in 44.4% and 35.2% of isolates, respectively. 88.8% of the isolates were characterized as strong biofilm-producers. On the other hand, the presence of carbapenemases was suspected in a minority (16.7%) of tested isolates. As safe and effective therapeutic options in carbapenem-resistant Gram-negative infections are severely limited, characterization of these isolates using phenotypic and molecular-based methods is important to provide insights into the epidemiological features of these pathogens

Insights on carbapenem-resistant Acinetobacter baumannii : phenotypic characterization of relevant isolates

Acinetobacter baumannii (A. baumannii) is an important nosocomial pathogen, which may be a causative agent in a wide-range of human pathologies. Carbapenems are usually considered the last safe and effective choice of drugs for the treatment of Gram-negative infections. The emergence of carbapenem-resistant A. baumannii (CRAB) is a critical public health issue as they leave clinicians with limited therapeutic options. In this study, phenotypic methods were used to characterize sixty-two (n = 62) A. baumannii isolates, which were included based on their suspected non-susceptibility to meropenem. Minimum inhibitory concentrations (MICs) of meropenem, levofloxacin, gentamicin, sulfamethoxazole/trimethoprim, tigecycline were determined using E-tests, while colistin MICs were determined using broth microdilution. The isolates were subjected to the modified Hodge test (MHT), the modified carbapenem-inactivation method (mCIM) and the imipenem/EDTA combined disk test (CDT). Efflux pump overexpression was studied using agar plates containing phenylalanine-arginine β-naphthylamide (PAβN). Assessment of biofilm-formation was carried out using the crystal violet tube-adherence method. 64.5% of the strains showed meropenem MICs in the resistant range (>8 mg/L), resistance rates were similarly high to the other tested antibiotics. The MHT and mCIM assay were positive in 79.0% and 67.7% of cases, respectively; the presence of an MBL was suggested for 29.0% of isolates. Efflux-pump overexpression was seen in 12.9% of isolates. 54.8% of the isolates were characterized as strong biofilm-producers. Microbiology laboratories have an important role in differentiating the distinct mechanisms by which these pathogens develop the CRAB phenotype, as plasmid-borne carbapenemases are significant from the standpoint of public health microbiology

The Treatment of Acute Diaphyseal Long-bones Fractures with Orthobiologics and Pharmacological Interventions for Bone Healing Enhancement: A Systematic Review of Clinical Evidence

The healing of long bones diaphyseal fractures can be often impaired and eventually end into delayed union and non-union. A number of therapeutic strategies have been proposed in combination with surgical treatment in order to enhance the healing process, such as scaffolds, growth factors, cell therapies and systemic pharmacological treatments. Our aim was to investigate the current evidence of bone healing enhancement of acute long bone diaphyseal fractures

Essential oils in ocular pathology: an experimental study

Introduction: The antimicrobial activity of essential oils (EOs) has been known for ages; in particular, the EOs of Melaleuca alternifolia, Thymus vulgaris, Mentha piperita, and Rosmarinus officinalis have been used for the treatment of fungal and bacterial infections. Methodology: This study focused on the in vitro cytotoxicity to normal human conjunctiva cells and antimicrobial activity of 20 EOs. Results: The oils tested showed no cytotoxic effect at very low concentrations. Rosmarinus officinalis, Melaleuca alternifolia, and Thymus vulgaris L. red thyme geraniol sel oils had good antimicrobial activity against Gram-positive and Gram-negative strains. Conclusions: The results of this study are of great interest and may have a major impact on public health, providing useful tips to optimize the therapeutic use of some natural drugs

Clinical outcome and drug expenses of intravitreal therapy for diabetic macular edema: A retrospective study in Sardinia, Italy

Background: Diabetic macular edema (DME) is a leading cause of visual loss in working-age adults. The purpose of this retrospective study was to perform an epidemiological analysis on DME patients treated with intravitreal drugs in a tertiary hospital. The clinical outcome, adverse drug reactions (ADRs), and intravitreal drug expenses were assessed. Methods: All DME patients treated with Ranibizumab, Aflibercept, Dexamethasone implant, and Fluocinolone Acetonide implant at the Sassari University Hospital, Italy, between January 2017 and June 2020 were included. Central macular thickness (CMT) and best corrected visual acuity (BCVA) were measured. ADRs and drug expenses were analyzed. Results: Two-hundred thirty-one DME patients (mean age: 65 years) received intravitreal agents. Mean CMT and BCVA were 380 μm and 0.5 LogMAR at baseline, 298 μm and 0.44 logMAR after one year (p = 0.04), and 295 μm and 0.4 logMAR at the end of the follow-up period. A total of 1501 intravitreal injections were given; no major ADRs were reported. Treatment cost was €915,000 (€261,429/year). Twenty non-responders to Ranibizumab or Afliber-cept were switched to a Dexamethasone implant. In these patients, mean CMT and BCVA were 468 µm and 0.5 LogMar at the time of switching and 362 µm and 0.3 LogMar at the end of the follow-up (p = 0.00014 and p = 0.08, respectively). Conclusion: Results confirm that Ranibizumab, Afliber-cept, and Dexamethasone implant are effective and safe in DME treatment. A switch to Dexame-thasone implant for patients receiving Aflibercept or Ranibizumab with minimal/no clinical benefit should be considered