Which Are the Best Regimens of Broad-Spectrum Beta-Lactam Antibiotics in Burn Patients? A Systematic Review of Evidence from Pharmacology Studies

Background: Burn injury causes profound pathophysiological changes in the pharmacokinetic/pharmacodynamic (PK/PD) properties of antibiotics. Infections are among the principal complications after burn injuries, and broad-spectrum beta-lactams are the cornerstone of treatment. The aim of this study was to review the evidence for the best regimens of these antibiotics in the burn patient population. Methods: We performed a systematic review of evidence available on MEDLINE (from its inception to 2023) of pharmacology studies that focused on the use of 13 broad-spectrum beta-lactams in burn patients. We extracted and synthetized data on drug regimens and their ability to attain adequate PK/PD targets. Results: We selected 35 studies for analysis. Overall, studies showed that both high doses and the continuous infusion (CI) of broad-spectrum beta-lactams were needed to achieve internationally-recognized PK/PD targets, ideally with therapeutic drug monitoring guidance. The most extensive evidence concerned meropenem, but similar conclusions could be drawn about piperacillin-tazobactam, ceftazidime, cefepime, imipenem-clinastatin and aztreonam. Insufficient data were available about new beta-lactam-beta-lactamase inhibitor combinations, ceftaroline, ceftobiprole and cefiderocol. Conclusions: Both high doses and CI of broad-spectrum beta-lactams are needed when treating burn patients due to the peculiar changes in the PK/PD of antibiotics in this population. Further studies are needed, particularly about newer antibiotics

Smart Bandaid Integrated with Fully Textile OECT for Uric Acid Real-Time Monitoring in Wound Exudate

: Hard-to-heal wounds (i.e., severe and/or chronic) are typically associated with particular pathologies or afflictions such as diabetes, immunodeficiencies, compression traumas in bedridden people, skin grafts, or third-degree burns. In this situation, it is critical to constantly monitor the healing stages and the overall wound conditions to allow for better-targeted therapies and faster patient recovery. At the moment, this operation is performed by removing the bandages and visually inspecting the wound, putting the patient at risk of infection and disturbing the healing stages. Recently, new devices have been developed to address these issues by monitoring important biomarkers related to the wound health status, such as pH, moisture, etc. In this contribution, we present a novel textile chemical sensor exploiting an organic electrochemical transistor (OECT) configuration based on poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) for uric acid (UA)-selective monitoring in wound exudate. The combination of special medical-grade textile materials provides a passive sampling system that enables the real-time and non-invasive analysis of wound fluid: UA was detected as a benchmark analyte to monitor the health status of wounds since it represents a relevant biomarker associated with infections or necrotization processes in human tissues. The sensors proved to reliably and reversibly detect UA concentration in synthetic wound exudate in the biologically relevant range of 220-750 μM, operating in flow conditions for better mimicking the real wound bed. This forerunner device paves the way for smart bandages integrated with real-time monitoring OECT-based sensors for wound-healing evaluation

ContrattiPubblici.org, a Semantic Knowledge Graph on Public Procurement Information

The Italian anti-corruption Act (law n. 190/2012) requires all public administrations to spread procurement information as open data. Each body is therefore obliged to yearly release standardized XML files, on its public website, containing data that describe all issued public contracts. Though this information is currently available on a machine- readable format, the data is fragmented and published in different files on different websites, without a unified and human-readable view of the information. The ContrattiPubblici.org project aims at developing a se- mantic knowledge graph based on linked open data principles in order to overcome the fragmentation of existent datasets and to allow easy anal- ysis and the reuse of information. The objectives are to increase public awareness about public spending, to improve transparency on the public procurement chain and to help companies to retrieve useful knowledge for their business activities

Removing Barriers to Transparency: a Case Study on the Use of Semantic Technologies to Tackle Procurement Data Inconsistency

Public Procurement (PP) information, made available as Open Government Data (OGD), leads to tangible benefits to identify government spending for goods and services. Nevertheless, making data freely available is a necessary, but not sufficient condition for improving transparency. Fragmentation of OGD due to diverse processes adopted by different administrations and inconsistency within data affect opportunities to obtain valuable information. In this article, we propose a solution based on linked data to integrate existing datasets and to enhance information coherence. We present an application of such principles through a semantic layer built on Italian PP information available as OGD. As result, we overcame the fragmentation of datasources and increased the consistency of information, enabling new opportunities for analyzing data to fight corruption and for raising competition between companies in the market

Novel Textile Wearable Sensor for Uric Acid Monitoring in Wound Exudate

A major cause for the development of severe and/or chronic wounds is to be found in certain pathologies such as immunodeficiencies, diabetes, compression traumas in bedridden people and diabetes. Nowadays, wound health assessment is performed by removing the bandages and visually inspecting the injury, i.e. an operation that presents an intrinsic risk of infection and disturbance of the healing processes. Instead, for these afflictions it would be crucial to have a continuous and real-time insight regarding the wound health status, which provides the medical personnel with the ability to deliver targeted therapies, leading to a better and faster patient recovery. To address these issues, our research group has recently developed new devices to non-invasively monitor pH and moisture in wound exudate, as these two biomarkers are strongly correlated with wound health status. In this work we showcase a novel textile sensor base on an organic electrochemical transistor (OECT) architecture based on poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) for uric acid (UA) monitoring in wound exudate, as UA levels can be correlated to infective and necrotic processes during the wound healing phases. This sensor is produced using special medical grade textile materials that provide a passive sampling system, enabling the continuous, real-time and non-invasive analysis of wound exudate to monitor wound health status. The devices are made by screen-printing a PEDOT:PSS-based conductive ink on medical gauzes, while the electrical connections are assembled by sewing conductive textile threads. UA was quantified by means of potentiostatic electrochemical techniques both in phosphate buffer solutions (PBS) and synthetic wound exudate (SWE) while operating in flow conditions using a HPLC pump at a flow rate of 0.05 mL/min to simulate the natural wound fluid emission. The sensors here developed proved to be capable to reversibly respond to variations in UA concentration within the biological range of interest for wound exudate (220 - 750 μM), displaying a normalized current response equal to a 47% signal variation per 10-fold increase in UA concentration (R2 = 0.98). The values obtained in PBS and SWE were found to be statistically comparable, as confirmed by a t-test (P = 0.95)

A Novel Textile Wearable OECT-Integrated Smart Bandaid for Real-Time Uric Acid Monitoring in Wound Exudate

Wound care is a constantly expanding field, as in the medical world new solutions are required to treat chronic and/or severe wounds, which derive from pathologies or conditions such as diabetes, third-degree burns, or skin grafts. Today, a preventive type of approach is usually followed for treatment, using materials such as antibacterial fibers or nanoparticles- loaded hydrogels, along with the visual inspection of the wound site upon bandage removal, e.g., an operation which carries an intrinsic risk of infection and disturbance of the wound bed healing process. To address these issues, we developed a novel smart bandaid1 featuring a fully textile Organic Electrochemical Transistor (OECT) based on the conductive polymer poly(3,4-ethylenedioxythiophene):polystyrene sulfonate (PEDOT:PSS) to monitor wound exudate uric acid levels (UA) in real-time, a crucial biomarker correlated with wound health status. The wearable devices were produced by screen-printing a PEDOT:PSS-based ink formulation on medical-grade gauzes, obtaining a smart medication with a passive sampling system, allowing for continuous, flow-conditions operativity. UA was quantified by means of potentiostatic determination, upon imposition of drain-source and gate-source voltage biases equal to -0.3 and +0.6 V, respectively. Different UA solution in Phosphate Buffer (PBS) or Synthetic Wound Exudate (SWE) were supplied using a HPLC pump at a flow-rate equal to 0.05 mL/min mimicking the natural emission of wound exudate. The devices reported a sensitivity equal to a 47% change in drain current for a 10-fold variation in UA concentration (R2 = 0.98) in both media, as statistically proven by performing a t-test (P = 0.95)

La corruzione nelle politiche sociali. Il caso Roma

L'ordine della corruzione nelle politiche sociali a Roma

Memorias IX Congreso Geológico Venezolano (2)

IX Congreso Geológico Venezolano (2

Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey

Over 80% (365/454) of the nation's centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment