JLB: a flexible and effective device in critical patients. Review of clinical cases

JLB catheter (Deltamed Inc) is an alternative way to manage difficult venous access; it is placed under US-guidance in large bore veins, with an easy-sterile approach. Internal jugular vein (IJV) is the first choice for cannulation, followed by subclavian or deep upper-arm veins. The catheter is available in different lengths and gauges, it allows high flow rates and can be left in place up to 30 days. From June 2015 to March 2017, JLB has been positioned in 409 patients: in 354 as primary access in IJV, brachial or subclavian vein; in 55 cases JLB became an introducing line for the Seldinger guidewire and further CVC positioning. All clinical cases were reviewed selecting those with greater clinical relevance. We report 8 cases in which JLB resulted determinant for the patient treatment: a 16 years old obese girl born with perinatal distress, a 78 years old obese woman with hemorrhagic shock caused by gastrointestinal bleeding, a 40 years old man with severe hypokalemia, a 30 years old man with severe sepsis, a 40 years old man with Becker’s muscular dystrophy and severe sepsis, a 40 years old man with multiple myeloma who had to carry out cycles of chemotherapy, a 76 years old man with CMV pancolitis and myelofibrosis who needed parenteral nutrition, antiviral therapy and frequent blood and platelets transfusion. Moreover, it has been useful in elderly patients who needed to carry out palliative care for seniority or cancer lasting up to 30 days . In our experience the JLB catheter is safe, easy to place, quick and cost –effective. It is a valid solution either in unstable patients requiring an immediate access in emergency and stable patients with difficult venous access, in which invasive devices can be considered an over-treatment

Preparation, characterization, and antibacterial activity of photocured thymol-doped acrylic resins

This article describes the preparation of thymol-doped acrylic resins by photopolymerization of solutions of thymol in tripropylenglycoldiacrylic monomer. This provides an easy, energy-saving, and environmental friendly process to prepare antibacterial plastics (fulfilling most of the "green chemistry" requirements). The results demonstrate that thymol can be included in the resin even at high concentration (up to 28.6%) without affecting the photocuring reaction and losing transparency. The glass transition temperature of the doped resin decreases when the thymol content increases, as it behaves like a plasticizer with respect to the acrylic resin. As indicated by HPLC analysis, thymol can be released in liquid media at a rate that depends on the chemical nature of the liquid. Evaluation by agar diffusion assays showed an antibacterial activity on both Gram-negative and Gram-positive bacteria (Staphylococcus aureus, Listeria monocytogenes, and Escherichia coli). The antibacterial activity can occur just on the plastic surface when the thymol-doped resins is applied as thin coating, while it is evident also in the surrounding agar medium for doped plastic discs, 1.2 mm thick with a concentration of thymol in the resin higher than 16.7%

Silver-doped organic-inorganic hybrid coatings with antibacterial activity.

Organic\u2013inorganic hybrid coatings containing Silver-ions were prepared by sol-gel processes and applied as thin layers onto PE and PVC films. The antibacterial activity of the coated films was tested against Gram-negative and Gram-positive bacteria The effects of several factors (O/I ratio, catalyst, Ag+ conc., etc.) were investigated. A high antibacterial activity (more than 6 log reduction within 6 hours) was observed for coatings with an O/I weight ratio of 80:20 and 5 wt% of Silver salt. A good durability of the antibacterial activity in contact with aqueous solution was also observed and confirmed by measurements of Ag+ ion release over the long period

Antibacterial Activity of Plastics Coated with Silver-Doped Organic-Inorganic Hybrid Coatings Prepared by Sol-Gel Processes.

Silver-doped organic–inorganic hybrid coatings were prepared starting from tetraethoxysilane and α-triethoxysilane terminated poly(ethylene)–block–poly(ethyleneglycole) using the sol–gel process. They were applied as a thin layer (600-1000 nm) to PE and PVC films and the antibacterial activity of the coated films was tested against Gram-negative (Escherichia coli ATCC 25922) and Gram-positive (Staphylococcus aureus ATCC 6538) bacteria. The effect of several parameters (such as organic-inorganic ratio, type of catalyst, time of post-curing, Silver-ion concentration, etc.) was investigated. Measurements at different contact times showed a rapid decrease of the viable count for both the tested strains. The highest antibacterial activity (more than 6 log reduction within 6 hours starting from 106 CFU ml-1) was obtained for samples with an organic-inorganic ratio of 80:20 and a percentage of Silver salt of 5 wt% with respect to the coating. For the coatings prepared by an acid catalyzed process, a good antibacterial activity of the coated films was demonstrated through repeated washings in warm water or in physiological saline solution at room temperature

Antibiotics and heavy metals resistance and other biological characters in enterococci isolated from surface water of Monte Cotugno Lake (Italy)

Considering the limited knowledge about the biological characters in enterococci isolated from surface waters, we investigated antibiotic and heavy-metal resistance, bacteriocin production, and some important virulence traits of 165 enterococci collected in water samples from Monte Cotugno Lake, the largest artificial basin built with earth in Europe. The species distribution of isolates was as follows: Enterococcus faecium (80%), Enterococcus faecalis (12.7%), Enterococcus casseliflavus (3%), Enterococcus mundtii (1.8%), Enterococcus hirae (1.8%), Enterococcus durans (0.6%). All enterococci showed heavy metal resistance toward Cu, Ni, Pb and Zn, were susceptible to Ag and Hg, and at the same time exhibited in large percentage (83.7%) resistance to one or more of the antibiotics tested. Relatively to virulence factor genes, 50.9% enterococci were positive for gelatinase (gelE), 10.9% for aggregation substance (agg), 12.7% and 66.6% for the cell wall adhesins (efaAfs and efaAfm), respectively. No amplicons were detected after PCR for cytolysin production (cylA, cylB and cylM) and enterococcal surface protein (esp) genes. Bacteriocin production was found in most of the isolates. Given that the waters of the Monte Cotugno Lake are used for different purposes, among which farming and recreational activities, they can contribute to spread enterococci endowed with virulence factors, and antibiotics and heavy metals resistance to humans