Antimicrobial treatment of Corynebacterium striatum invasive infections: a systematic review

The aim of this study was to establish an evidence-based guideline for the antibiotic treatment of Corynebacterium striatum infections. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with systemic inflammatory response syndrome, harboring C. striatum isolated from body fluids or tissues in which it is not normally present. C. striatum had to be identified as the only causative agent of the invasive infection, and its isolation from blood, body fluids or tissues had to be confirmed by one of the more advanced diagnostic methods (biochemical methods, mass spectrometry and/or gene sequencing). This systematic review included 42 studies that analyzed 85 individual cases with various invasive infections caused by C. striatum. More than one isolate of C. striatum exhibited 100% susceptibility to vancomycin, linezolid, teicoplanin, piperacillin-tazobactam, amoxicillin-clavulanate and cefuroxime. On the other hand, some strains of this bacterium showed a high degree of resistance to fluoroquinolones, to the majority majority of β-lactams, aminoglycosides, macrolides, lincosamides and cotrimoxazole. Despite the antibiotic treatment, fatal outcomes were reported in almost 20% of the patients included in this study. Gene sequencing methods should be the gold standard for the identification of C. striatum, while MALDI-TOF and the Vitek system can be used as alternative methods. Vancomycin should be used as the antibiotic of choice for the treatment of C. striatum infections, in monotherapy or in combination with piperacillin-tazobactam. Alternatively, linezolid, teicoplanin or daptomycin may be used in severe infections, while amoxicillin-clavulanate may be used to treat mild infections caused by C. striatum

An Increasing Stellar Baryon Fraction in Bright Galaxies at High Redshift

Recent observations have shown that the characteristic luminosity of the rest-frame ultraviolet (UV) luminosity function does not significantly evolve at 4 < z < 7 and is approximately M*_UV ~ -21. We investigate this apparent non-evolution by examining a sample of 178 bright, M_UV < -21 galaxies at z=4 to 7, analyzing their stellar populations and host halo masses. Including deep Spitzer/IRAC imaging to constrain the rest-frame optical light, we find that M*_UV galaxies at z=4-7 have similar stellar masses of log(M/Msol)=9.6-9.9 and are thus relatively massive for these high redshifts. However, bright galaxies at z=4-7 are less massive and have younger inferred ages than similarly bright galaxies at z=2-3, even though the two populations have similar star formation rates and levels of dust attenuation. We match the abundances of these bright z=4-7 galaxies to halo mass functions from the Bolshoi Lambda-CDM simulation to estimate the halo masses. We find that the typical halo masses in ~M*_UV galaxies decrease from log(M_h/Msol)=11.9 at z=4 to log(M_h/Msol)=11.4 at z=7. Thus, although we are studying galaxies at a similar mass across multiple redshifts, these galaxies live in lower mass halos at higher redshift. The stellar baryon fraction in units of the cosmic mean Omega_b/Omega_m rises from 5.1% at z=4 to 11.7% at z=7; this evolution is significant at the ~3-sigma level. This rise does not agree with simple expectations of how galaxies grow, and implies that some effect, perhaps a diminishing efficiency of feedback, is allowing a higher fraction of available baryons to be converted into stars at high redshifts.Comment: Accepted to ApJ. 15 pages, 5 figures, 6 table

Kounis Syndrome Associated With the Use of Diclofenac

BACKGROUND: Diclofenac is a widely used analgesic, anti-inflammatory, antipyretic drug. In several case reports, its use was associated with the occurrence of Kounis syndrome. The aim of this review was to investigate and summarize published cases of Kounis syndrome suspected to be associated with the use of diclofenac. METHODS: Electronic searches were conducted in PubMed/MEDLINE, Scopus, Web of Science, Google Scholar, and the Serbian Citation Index. RESULTS: Twenty publications describing the 20 patients who met inclusion criteria were included in the systematic review. Specified patient ages ranged from 34 to 81 years. Eighteen (90.0%) patients were male. Five patients (25.0%) reported a previous reaction to diclofenac. Reported time from the used dose of diclofenac to onset of the first reaction symptoms ranged from immediately to 5 hours. Diclofenac caused both type I and type II Kounis syndrome, with the presence of various cardiovascular, gastrointestinal, dermatologic, and respiratory signs and symptoms. Most patients experienced hypotension (n = 15 [75.0%]) and chest pain (n = 12 [60.0%]). The most frequently reported finding on electrocardiogram was ST-segment elevations (n = 17 [85.0%]). Coronary angiogram showed normal coronary vessels in 9 patients (45.0%), with some pathologic findings in 8 patients (40.0%). CONCLUSION: Clinicians should be aware that Kounis syndrome may be an adverse effect of diclofenac. Prompt recognition and withdrawal of the drug, with treatment of both allergic and cardiac symptoms simultaneously, is important

Meta‐analysis of peripheral insulin‐like growth factor 1 levels in schizophrenia

Abstract Objective We aimed to investigate if there is a significant difference in peripheral insulin‐like growth factor 1 (IGF‐1) levels between schizophrenia patients and healthy controls and to determine whether a difference exists before and after initiation of antipsychotics. Methods PubMed/MEDLINE, Scopus, and Web of Science were searched up to March 27, 2022. Original clinical studies of any type that reported peripheral blood, serum or plasma IGF‐1 levels measured after fasting in schizophrenia patients and/or healthy control group were selected based on inclusion and exclusion criteria. Data were analyzed using Meta‐Essentials: Workbooks for meta‐analysis and pooled through random‐effects meta‐analyses. Results Twelve publications met eligibility criteria. Schizophrenia patients under antipsychotic treatment had significantly lower peripheral IGF‐1 levels compared to healthy controls (n = 632, Hedges’ g –0.42, 95% CI from –0.79 to –0.04, p = .006, I2 = 70.38%), while no significant difference was found between schizophrenia patients regardless of the antipsychotic treatment status and healthy controls, as well as between antipsychotic naïve or free schizophrenia patients and healthy controls, and before and after initiation of antipsychotic treatment. However, high heterogeneity was observed and its potential sources in some of the subgroup analyses included sample type and region. Conclusions Schizophrenia patients under antipsychotic treatment seem to have lower peripheral IGF‐1 levels compared to healthy controls. Additional studies with larger and more homogenous samples are needed to confirm these findings

Antimicrobial treatment of Erysipelatoclostridium ramosum invasive infections: a systematic review

The aim of this systematic review was to determine the causal role of Erysipelatoclostridium ramosum in specific invasive infections in humans, and to assess the clinical outcome of antibiotic therapy used to treat them. Several electronic databases were systematically searched for clinical trials, observational studies or individual cases on patients of any age and gender with a systemic inflammatory response syndrome (SIRS) due to E. ramosum isolated from body fluids or tissues in which it is not normally present. Only reports identifying E. ramosum as the only microorganism isolated from a patient with SIRS were included. This systematic review included 15 studies reporting 19 individual cases in which E. ramosum caused invasive infections in various tissues, mainly in immunocompromised patients. E. ramosum was most often isolated by blood cultures and identified by specific biochemical tests. Severe infections caused by E. ramosum were in most cases effectively treated with antibiotics, except in two patients, one of whom died. More than one isolate of E. ramosum exhibited 100% susceptibility to metronidazole, amoxicillin/clavulanate and piperacillin/tazobactam. On the other hand, individual resistance of this bacterium to penicillin, ciprofloxacin, clindamycin, imipenem and ertapenem was reported. This systematic review confirmed the clinical relevance of E. ramosum as a cause of a number of severe infections mainly in immunocompromised inpatients. Metronidazole and meropenem appear to be the antibiotics of choice that should be used in combination or as monotherapy to treat E. ramosum infections, depending on the type and severity of the infection

Epidemiology of suicidal behaviour in Shumadia district, Serbia: A fifteen-year retrospective study

© 2017, Czech National Institute of Public Health. All rights reserved. Objectives: The purpose of this study is to analyze epidemiological characteristics of suicide, as well as to emphasize possible risk factors. Methods: This is a retrospective study, covering the period of fifteen years (1996-2010), which aims at discovering the relevant factors which have an influence on suicidal behaviour. This research uses the data from the documentation of the Ministry of Internal Affairs of Serbia and Police Department in Kragujevac, hospitalization reports of patients treated at Psychiatric Clinic of the Clinical Centre Kragujevac, as well as the medical records of patients treated at the Health Centre Kragujevac. χ2 test was applied to examine the influence of all selected factors on incidence of suicide and for this purpose SPSS statistical software package was used. Results: The analysis has shown that during the given period average suicide rate reached 11.8 per population of 100,000. The male to female suicide ratio of 3.6:1 obtained through this study suggests that men (78.4%) are more prone to suicide than women (21.6%). The highest number of suicides has been found within the age group of 65-year-olds (31.2%), while for the youngest age group (15-24 years) the lowest prevalence of 8.8% has been determined. In other words, the youngest subjects are 3.5 times less likely to commit suicide than the participants of the oldest age group. During the given period suicide was most often committed by married males and females with primary school education than by employed and retired people. The research has also revealed that most suicides came from urban areas (52.0%) and that the most common method of suicide is hanging (60.8%), followed by suicide by firearms, jumping from height, poisoning, and drowning. Conclusion: In order to prevent suicide, it is essential to collect and analyze all information concerning suicide victims

Epidemiology of Suicidal Behaviour in Shumadia District, Serbia: a Fifteen-year Retrospective Study

© 2017, Czech National Institute of Public Health. All rights reserved. Objectives: The purpose of this study is to analyze epidemiological characteristics of suicide, as well as to emphasize possible risk factors. Methods: This is a retrospective study, covering the period of fifteen years (1996-2010), which aims at discovering the relevant factors which have an influence on suicidal behaviour. This research uses the data from the documentation of the Ministry of Internal Affairs of Serbia and Police Department in Kragujevac, hospitalization reports of patients treated at Psychiatric Clinic of the Clinical Centre Kragujevac, as well as the medical records of patients treated at the Health Centre Kragujevac. χ2 test was applied to examine the influence of all selected factors on incidence of suicide and for this purpose SPSS statistical software package was used. Results: The analysis has shown that during the given period average suicide rate reached 11.8 per population of 100,000. The male to female suicide ratio of 3.6:1 obtained through this study suggests that men (78.4%) are more prone to suicide than women (21.6%). The highest number of suicides has been found within the age group of 65-year-olds (31.2%), while for the youngest age group (15-24 years) the lowest prevalence of 8.8% has been determined. In other words, the youngest subjects are 3.5 times less likely to commit suicide than the participants of the oldest age group. During the given period suicide was most often committed by married males and females with primary school education than by employed and retired people. The research has also revealed that most suicides came from urban areas (52.0%) and that the most common method of suicide is hanging (60.8%), followed by suicide by firearms, jumping from height, poisoning, and drowning. Conclusion: In order to prevent suicide, it is essential to collect and analyze all information concerning suicide victims

Inappropriate prescribing of antibiotics to the patients with acute bronchitis

© 2019 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved. Background/Aim: Inappropriate prescribing of antibiotics to the patients with acute bronchitis is frequent event in clinical practice with potentially serious consequences, although majority of treatment guidelines do not recommend it. The aim of this study was to reveal risk factors associated with inappropriate prescribing of antibiotics to the patients with acute bronchitis in primary healthcare. Methods: This case/control study included the adult patients with acute bronchitis during the initial encounter with a general practitioner. Prescription of an antibiotic was an event that defined the case, and patients without prescribed antibiotic served as controls. Results: Antibiotics (mostly macrolides and beta-lactams) were prescribed to the majority of patients with diagnosis of acute bronchitis (78.5%). A significant association was found between antibiotic prescription rates and patient age, whether an attending physician is a specialist or not and the average number of patients a physician sees per day [ORadjustedwas 1.029 (1.007-1.052), 0.347 (0.147-0.818) and 0.957 (0.923-0.992), respectively]. Conclusion: When there is primary care encounter with patients suffering from acute bronchitis, older patients are more likely to receive inappropriate antibiotic prescription, especially if their physician is without specialist training and has less patient encounters in his/her office daily

Breast Cancer and p16: Role in Proliferation, Malignant Transformation and Progression

The definition of new molecular biomarkers could provide a more reliable approach in predicting the prognosis of invasive breast cancers (IBC). The aim of this study is to analyze the expression of p16 protein in IBC, as well as its participation in malignant transformation. The study included 147 patients diagnosed with IBC. The presence of non-invasive lesions (NIL) was noted in each IBC and surrounding tissue. p16 expression was determined by reading the percentage of nuclear and/or cytoplasmic expression in epithelial cells of IBC and NIL, but also in stromal fibroblasts. Results showed that expression of p16 increases with the progression of cytological changes in the epithelium; it is significantly higher in IBC compared to NIL (p &lt; 0.0005). Cytoplasmic p16 expression is more prevalent in IBC (76.6%), as opposed to nuclear staining, which is characteristic of most NIL (21.1%). There is a difference in p16 expression between different molecular subtypes of IBC (p = 0.025). In the group of p16 positive tumors, pronounced mononuclear infiltrates (p = 0.047) and increased expression of p16 in stromal fibroblasts (p = 0.044) were noted. In conclusion, p16 protein plays an important role in proliferation, malignant transformation, as well as in progression from NIL to IBC