The preclinical and clinical progress of bacteriophages and their lytic enzymes : the parts are easier than the whole

The therapeutic potential of phages has been considered since their first identification more than a century ago. The evident concept of using a natural predator to treat bacterial infections has, however, since then been challenged considerably. Initially, the vast success of antibiotics almost eliminated the study of phages for therapy. Upon the renaissance of phage therapy research, the most provocative and unique properties of phages such as high specificity, self-replication and co-evolution prohibited a rapid preclinical and clinical development. On the one hand, the typical trajectory followed by small molecule antibiotics could not be simply translated into the preclinical analysis of phages, exemplified by the need for complex broad spectrum or personalized phage cocktails of high purity and the more complex pharmacokinetics. On the other hand, there was no fitting regulatory framework to deal with flexible and sustainable phage therapy approaches, including the setup and approval of adequate clinical trials. While significant advances are incrementally made to eliminate these hurdles, phage-inspired antibacterials have progressed in the slipstream of phage therapy, benefiting from the lack of hurdles that are typically associated with phage therapy. Most advanced are phage lytic enzymes that kill bacteria through peptidoglycan degradation and osmotic lysis. Both phages and their lytic enzymes are now widely considered as safe and have now progressed to clinical phase II to show clinical efficacy as pharmaceutical. Yet, more initiatives are needed to fill the clinical pipeline to beat the typical attrition rates of clinical evaluation and to come to a true evaluation of phages and phage lytic enzymes in the clinic

Colonic adenocarcinoma revealing Crohn's disease: a case report

<p>Abstract</p> <p>Introduction</p> <p>There is growing evidence from epidemiological studies and clinicopathological data obtained from case reports that Crohn's disease is associated with an increased risk of carcinoma of the large bowel.</p> <p>Case presentation</p> <p>A 70-year-old Arabic African man with undiagnosed Crohn's disease presented with acute abdominal obstruction due to an occlusive carcinoma of the sigmoid. At laparotomy, the colonic tumor was excised with continuity restored by end-to-end anastomosis.</p> <p>Conclusion</p> <p>The risk of colonic carcinoma in Crohn's disease is increasing. Several case reports actually support the possibility that a genuine association between these two conditions exists.</p

Non-Hodgkin’s lymphoma revealed by an ilio-colic intussusception in a Moroccan patient: a case report

Intussusceptions are rare but well-known causes of the small bowel obstruction in adults and an underlying cause is present in the majority of cases. Lymphoma’s involvement of the ileum is one of the rare causes of intussusception. CT is a sensitive examination that diagnoses intussusceptions and provides an excellent pre-operative evaluation including possible extension and dissemination especially in intestinal lymphomas. The treatment is almost always surgical and the pathological study is needed for diagnostic confirmation. Authors present an unusual case of intestinal intussusception due to lymphoma of the terminal part of the ileum in a 49-year-old man. Computed tomography confirmed the diagnosis of intussusception and non-Hodgkin’s lymphoma of B-cell was diagnosed by histological examination after surgical treatment. Primary intestinal lymphomas differ from gastric lymphomas in clinical features, treatment, and prognosis. They are not well characterized and the standardized concepts for their clinical diagnosis and management are absent. The aim of this rare observation is to shed light on NHL of the small bowel, its clinical and radiological diagnosis and its treatment especially in forms revealed by intussusceptions in adults

Association of iron deficiency with or without anaemia and cognitive functions among primary school children in Malaysia

Iron deficiency and anaemia affect millions of children worldwide. This study aimed to investigate the effect of iron deficiency with or without anaemia on cognitive functions, specifically with short-term memory, attention and visualmotor coordination in children. A total of 173 primary school children was enrolled. Cognitive functions were assessed using the Wechsler Intelligence Scale for Children. Three sub-tests were selected to assess processing speed (coding test), immediate auditory memory (digit span test) and visual processing and problem solving ability (maze test). The results showed significant correlation between age and coding test (r =0.38, p<0.001), digit span test (r =0.16, p = 0.028), and maze test scores (r =0.28, p<0.001), and the total sub-test scores (r=0.43, p <.001). After age adjustment of the cognitive function tests, iron deficientchildren without anaemia scored significantly lower than the healthy children (p<0.001) on coding test, while iron deficient children with anaemia and iron deficient children without anaemia scored significantly lower (p<0.001) than the healthy counterparts on maze test. No significant differences were observed on digit-span score among the groups. This study confirms the negative effect of both iron deficiency and iron deficiency anaemia on processing speed and visualmotor coordination in children

A pilot study for sustainable ecotourism at Gunong Stong State Park, Kelantan using Visitor Experience and Resource Protection (VERP) management framework

Ecotourism plays a vital role in tourism industries and has become one of the effective practices towards conservation effort in the natural environment activity. Thus, it is important to know the concept of carrying capacity issues applied to the area pertaining to the visitors’ experiences, to ensure the benefits it brings to the socio-cultural, economic, and environmental sustainability of the area. The objective of this study was to identify the relationship of visitors’ experience and the protection of the natural resources at Gunung Stong State Park (GSSP) using the management framework of Visitor Experience and Resource Protection (VERP). This approach provided a set of management framework in order to manage the sustainable ecotourism in GSSP without abandoning the good manner of visitor experiences. A total of 35 respondents have participated in this pilot study and our result showed that the tourists’ satisfaction towards the GSSP was at moderate level. Therefore, the GSSP was suitable for nature tourism attraction. However, a proper management of the park is required whilst the biodiversity there is still intact. The management of GSSP can be further improved by instilling awareness among visitors in order to sustain the ecotourism activity, and attract more tourists besides improving their experience throughout their visit

Screening of suitable ionic liquids as green solvents for extraction of eicosapentaenoic acid (EPA) from microalgae biomass using COSMO-RS model

Omega-3 poly unsaturated fatty acids (PUFA) particularly eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA), have many health benefits including reducing the risk of cancer and cardiovascular disease. Recently, the use of ionic liquids (ILs) in lipid extraction from microalgae provides the potential to overcome common drawbacks, offers several other benefits. To date, very limited researches are available to focus on extracting microalgae lipid and PUFA in particular by using ILs. The objective of current work is to screen the potential ILs that can be applied in EPA extraction. In this study, fast ILs screening was performed with the help of a conductor like screening model for real solvents (COSMO-RS) and the ILs with higher capacity values for use in extraction of EPA were compared. According to the results, the highest capacity for EPA extraction among 352 screened cation/anion combinations belongs to [TMAm][SO4]. It is expected to achieve a higher yield of EPA once applying this combination as the solvent in the process of extraction. ILs with small anions were observed to have higher capacities, as well possessing higher charge density compared to larger ones, and therefore, they are more preferable for extraction purposes. Moreover, shorter alkyl chain cations are preferred when using imidazolium-based IL, which agrees with experimental data

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Seroprevalence of antibodies to SARS-CoV-2 among blood donors in the early month of the pandemic in Saudi Arabia

Background: Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. Objective: To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. Methods: Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. Results: The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12-1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31-2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04-2.89) and these were not statistically different from seroprevalence in the Makkah region. Conclusions: At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling

An interventional study on the levels of knowledge, attitude and practice on hand washing among the residents of Kampung Stapang I, Sibu from 11th June to 17th August 2012

/ Hand washing practice is one of preventive measures for some common infectious diseases. Thus to promote hand washing among community, level of knowledge and awareness amoog the population should be assessed so that appropriate interventions can be carried out. The objective of this study was to study the knowledge, attitude and practice 00 hand washing among residents of Stapang I aged 18 and above from 11th of June to 17th of August 201iJ The results obtained were then using as the baseline data to conduct an intervention programme beneficial to the community to enhance their level of knowledge, attitude and practice towards hand washing. Data collection was done by face to face interview using interview-based questionnaire. Data analysis was done using SPSS software version 20.0. Results showed that 50% of the respondents had good knowledge and good attitude while 63.3% had good practice towards hand washing. Post-intervention study showed significant improvement in the total score for knowledge and attitude towards hand washing (pO.05). In conclusion, there is a great need for intensive intervention in order to enhance the practice of hand washing among the respondents