Development of a first-contact protocol to guide assessment of adult patients in rehabilitation services networks

OBJECTIVE: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). DEVELOPMENT OF THE PROTOCOL: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. CONCLUSIONS: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time

Monoclonal antibodies production in wave and stirred tank bioreactors

The rapid increase in the number of monoclonal antibodies (mAbs) which are being regularly approved for therapeutic use results in the need of their large scale production. However, this requires the development of bioreactors and processes simple to operate and easily scaledup, that allow cultivation of mammalian cells. The Stirred Tank bioreactor is the traditional and most widely used reactor type, mainly due to the know-how acquired with microbial fermentation, its flexibility and suitability for different cell types, operation modes, products and working volumes.[1] However, recently, disposable bioreactors, such as the new Wave reactor, are becoming increasingly popular due to their low initial and lifetime costs, simplified scale-up, reduced turn-around time between runs and low risk of crosscontamination.[2] Due to the current lack of comparative studies about these different technologies, we are optimizing and comparing mAb production in both Stirred Tank and Wave bioreactors. Different modes of operation are being tested (batch and fed-batch), and the use of microcarrier technology for culture of anchorage-dependent cells will also be assayed. Furthermore, it is important to evaluate the product in terms of biological activity, assuring that it maintains full functionality, by assessing how the glycosylation pattern is affected during the process of production in both reactors

Antimicrobial potential of Eucalyptus globulus against biofilms of Staphylococcus aureus isolated from bovine mastitis

Staphylococcus aureus are among the most common species isolated from bovine mastitis. The pathogenesis of this bacterium is facilitated by a number of virulence factors, including the ability to adhere to abiotic surfaces and/or host tissues often leading to biofilms formation. From the clinical perspective, the most important feature of Staphylococcus species biofilms is their high tolerance to the conventional antimicrobial therapy. So, the increasing number of bovine mastitis and the higher levels of Staphylococcus species resistance to traditional antimicrobial agents are considered an important alert for the necessity to focus the future research on identification and development of new strategies to combat S. aureus mastitis. Recently, the interest in natural alternatives based on plant extracts has been rising. In addition to their health benefits, their antimicrobial potential has been increasingly reported. Taking this into consideration, the evaluation of hydromethanolic extracts of E. globulus against S. aureus biofilms was tested and compared with penicillin, one of the antibiotics most often used in the treatment of cattle infections. All mastitis isolates tested were good-biofilm producers. As expected penicillin has demonstrated poor activity against S. aureus biofilms (<1 log reduction). However, E. globulus Labill was bactericidal, promoting a biofilm cell reduction of 2-3 log. Therefore, the present work showed the potential antimicrobial activity of E. globulus against S. aureus from bovine mastitis, namely in biofilm mode of growth and drew attention to its promising use as an alternative to penicillin

Economic analysis and environmental impact assessment of three different fermentation processes for fructooligosaccharides production

Three different fermentation processes for the production of fructooligosaccharides (FOS) were evaluated and compared in terms of economic aspects and environmental impact. The processes included: submerged fermentation of sucrose solution by Aspergillus japonicus using free cells or using the cells immobilized in corn cobs, and solid-state fermentation (SSF) using coffee silverskin as support material and nutrient source. The scale-up was designed using data obtained at laboratory scale and considering an annual productivity goal of 200 t. SSF was the most attractive process in both economic and environmental aspects since it is able to generate FOS with higher annual productivity (232.6 t) and purity (98.6%) than the other processes; reaches the highest annual profit (6.55 M€); presents the lowest payback time (2.27 years); and is more favourable environmentally causing a lower carbon footprint (0.728 kg/kg, expressed in mass of CO2 equivalent per mass of FOS) and the lowest wastewater generation

Vulvovaginal candidiasis: Epidemiology, microbiology and risk factors

Vulvovaginal candidiasis (VVC) is an infection caused by Candida species that affects millions of women every year. Although Candida albicans is the main cause of VVC, the identification of non-Candida albicans Candida (NCAC) species, especially Candida glabrata, as the cause of this infection, appears to be increasing. The development of VVC is usually attributed to the disturbance of the balance between Candida vaginal colonization and host environment by physiological or nonphysiological changes. Several host-related and behavioral risk factors have been proposed as predisposing factors for VVC. Host-related factors include pregnancy, hormone replacement, uncontrolled diabetes, immunosuppression, antibiotics, glucocorticoids use and genetic predispositions. Behavioral risk factors include use of oral contraceptives, intrauterine device, spermicides and condoms and some habits of hygiene, clothing and sexual practices. Despite a growing list of recognized risk factors, much remains to be elucidated as the role of host versus microorganisms, in inducing VVC and its recurrence. Thus, this review provides information about the current state of knowledge on the risk factors that predispose to VVC, also including a revision of the epidemiology and microbiology of VVC, as well as of Candida virulence factors associated with vaginal pathogenicity.The authors report no declarations of interest. This study was supported by the Programa Operacional, Fatores de competitividade – COMPETE and by national funds through FCT – Fundac¸a ˜o para a Cie ˆncia e a Tecnologia on the scope of the projects FCT PTDC/EBB-EBI/120495/2010, RECI/EBBEBI/0179/2012 and PEst-OE/EQB/LA0023/2013. The authors thank the Project ‘‘BioHealth – Biotechnology and Bioengineering approaches to improve health quality,’’ Ref. NORTE-07-0124-FEDER-000027, co-funded by the Programa Operacional Regional do Norte (ON.2 – O Novo Norte), QREN, FEDER

In vitro study of the antifungal potential of Glycyrrhiza glabra L. against Candida species

In the last two decades, an increasing incidence of opportunistic fungal infections has been observed, not only at hospital level but also in the community. Candida albicans was identified as the main responsible agent for those infections, but other non-Candida albicans Candida (NCAC) species have also been associated with this complicated medical condition [1]. Furthermore, higher rates of fungal resistance to the current drugs have been observed and are still growing, making the discovery of new active antifungal substances very urgent. Medicinal plants can be explored for that purpose. Glycyrrhiza glabra L. is commonly used in folk medicine due to its antimicrobial and antiviral activities, as well as for a wide variety of dermal affections [2]. Some reports have described the antimicrobial potential of licorice (G. glabra roots), namely aqueous extracts [e.g., 3]. Herein, the antifungal potential of the hydroalcoholic extract prepared from rhizomes and roots of G. glabra, was evaluated against 19 Candida strains, using the disc diffusion halo assay. The licorice extract was effective against all the tested C. albicans, C. glabrata, C. parapsilosis and C. tropicalis strains. It is very interesting to highlight the broad spectrum of activity of this extract, for which were observed similar results into different strains of the same species and even between different species. The results for the inhibitory zones, at the tested concentration (50 mg/mL), after 24h, were 1.0-1.2 cm for C. albicans and C. parapsilosis, 1.0-1.3 cm for C. tropicalis and 1.2 cm for C. glabrata, maintaining the potential at 48h and even at 72h. This study demonstrates that G. glabra hydroalcoholic extract probably exerts mainly fungicidal and not so much fungistatic effects, and it could find applications in antifungal therapy. Nevertheless, further studies will be performed in order to characterize the extract, namely on phenolic composition, and to elucidate its mechanism of action

Glycyrrhiza glabra L. as a promisor candidacidal in biofilms and planktonic cells: comparison between phenolic extract and isolated compounds

Opportunistic fungal infections, particularly involving Candida species (candidiasis) have become a serious prob- lem of public health. Current antifungal agents have been loosing the effectiveness, in part due to their overuse, and appearance of resistant Candida species. Plants have been used over years and recommended by natural physicians for multitude of health conditions. The aim of the present study was to evaluate the anti-Candida potential of a hydrometh- anolic extract of rhizomes and roots of Glycyrrhiza glabra L. (licorice), in planktonic cells and biofilms, as well as to compare its effect with individual phenolic compounds identified in the extract. Licorice extract evidenced an antifungal activity against all of the nineteen tested Candida strains, including C. al- bicans, C. glabrata, C. parapsilosis and C. tropicalis species. The inhibition zones varied between 10-13 mm; MIC and MFC values varied, between 0.375-1.5 and 0.75-3 mg/mL for planktonic cells and biofilms, respectively. Considering the pronounced antifungal activity, a chemical characterization of the extract was conducted, and the main phenolic compounds identified were tested. Flavones (mainly apigenin derivatives), flavanones (mainly liquiritin derivatives), an isoflavone and a chalcone, were the most abundant compounds. However, these compounds were not active neither individually nor combined. Thus, probably synergistic effects among all components in the phenolic pool and/or other compounds present in the extract should be responsible for the observed antifungal activity. Detailed in vivo studies should be performed, not only to evaluate the actual effects in a complete organism, but also the safety of the preparation and bioavailability in systemic infection models

In vivo anti-Candida activity of phenolic extracts and compounds: future perspectives focusing effective clinical interventions

Candida species have increasingly deserved a special attention among the medical community. In spite of its presence as a human commensal, alarming rates of local and systemic infections have been observed, varying from moderate to severe impact. Currently available antifungal drugs have progressively lost its effectiveness, pointing urgently the problem of the microorganisms with acquired-resistance. Natural matrices are secularly used for numerous purposes, being inclusive highly effective as antimicrobials. Increasing evidences give a particular emphasis to the contribution of phenolic extracts and related individual compounds. In vitro studies clearly confirms its prominent effects, but the confirmation through in vivo studies, including the involved mechanisms of action are not so much deepen. Therefore, the present reports aims to provide an extensive knowledge about all these aspects, highlighting the most efficient phytochemical formulations, including therapeutic doses. Further studies need to be incited to deepen knowledge on this area, namely focused on clinical trials to provide safer and more effective antimicrobials than the current ones.The authors are grateful to Foundation for Science and Technology (FCT, Portugal) for N. Martins Grant (SFRH/BD/87658/2012), L. Barros researcher contract under "Programa Compromisso com Ciencia-2008," and financial support to the research centre CIMO (strategic project PEst-OE/AGR/UI0690/2014). This work was also supported by the Programa Operacional, Fatores de competitividade-COMPETE and by national funds through FCT (Fundacao para a Ciencia e a Tecnologia) on the scope of the Projects FCT PTDC/SAU-MIC/119069/2010, RECI/EBB-EBI/0179/2012, and PEst-OE/EQB/LA0023/2013. The authors thank the Project "BioHealth-Biotechnology and Bioengineering approaches to improve health quality," Ref. NORTE-07-0124-FEDER-000027, cofunded by the Programa Operacional Regional do Norte (ON. 2-O Novo Norte), QREN, and FEDER

In vitro study of the antifungal potential of Apiaceae hydroalcoholic extracts against Candida species

The use of medicinal plants is an ancient practice, but recently there is an increasing interest towards the evaluation of their bioactive properties. Opportunistic fungal infections, linked with higher rates of fungal resistance to the current antifungal drugs, have deserved special relevance in the last decades. Candida albicans was identified as the main responsible agent for those infections, but other non-Candida albicans Candida (NCAC) species have been also found [1]. Thus, it is urgent to discover new alternatives against those pathogens with high resistance. In the present work, the antifungal potential of hydroalcoholic extracts obtained from two Apiaceae plants (Coriandrum sativum L. and Pimpinella anisum L.), commonly used in folk medicine, were evaluated against a total of 19 Candida strains (from the species: C. albicans, C. glabrata, C. parapsilosis and C. tropicalis). The fruits of Coriandrum sativum L. (coriander) and Pimpinella anisum L. (anise) showed similar antifungal potential considering the studied strains, being effective against three of the nineteen strains. However, regarding the tested Candida species, the extracts presented considerable variations. Whereas coriander was effective against C. parapsilosis (ATCC22019 and 513143) and C. tropicalis (ATCC750), anise was effective against C. parapsilosis (513143 and 491861) and C. albicans (558234). Furthermore, the inhibitory zones were different at 24 and 48h. Further studies are being carried out in order to characterize the mechanism of action and the compounds responsible for the bioactivity, but the use of these extracts seems to have potential in antifungal therapy. REFERENCES [1] Martins N, Ferreira ICFR, Barros L, Silva S, Henriques M. (2014). Mycopathol. 177, 223–240.Instituto Nacional de Saúde Dr. Ricardo Jorg