Synergistic ROS-Associated antimicrobial activity of silver nanoparticles and gentamicin against "Staphylococcus epidermidis"

Introduction: Increasing bacteria resistance to antibiotics is a major problem of healthcare system. There is a need for solutions that broaden the spectrum of bactericidal agents improving the efficacy of commonly used antibiotics. One of the promising directions of search are silver nanoparticles (obtained by different methods and displaying diversified physical and chemical properties), and their combination with antibiotics. Purpose: In this study, we tested the role of reactive oxygen species in the mechanism of synergistic antibacterial activity of gentamicin and Tween-stabilized silver nanoparticles against gentamicin-resistant clinical strains of Staphylococcus epidermidis. Methods: Synergistic bactericidal activity of gentamicin and silver nanoparticles stabilized with non-ionic detergent (Tween 80) was tested by the checkerboard titration method on microtiter plates. Detection of reactive oxygen species was based on the chemiluminescence of luminol. Results: Hydrophilic non-ionic surface functionalization of silver nanoparticles enabled the existence of non-aggregated active nanoparticles in a complex bacterial culture medium. Tween-stabilized silver nanoparticles in combination with gentamicin exhibited bactericidal activity against multidrug-resistant biofilm forming clinical strains of Staphylococcus epidermidis. A synergistic effect significantly decreased the minimal inhibitory concentration of gentamicin (the antibiotic with numerous undesirable effects). Gentamicin significantly enhanced the generation of reactive oxygen species by silver nanoparticles. Conclusion: Generation of reactive oxygen species by Tween-coated metallic silver nanoparticles was significantly enhanced by gentamicin, confirming the hypothesis of oxidative-associated mechanism of the synergistic antibacterial effect of the gentamicin-silver nanoparticles complex

Evaluation of "in vitro" tigecycline activity against multidrug resistant "Acinetobacter Baumannii" clinical isolates from Poland

Acinetobacter baumannii is a major cause of nosocomial infections worldwide. Therapeutic optionsin management of this bacteria are limited. Tigecycline is considered as an alternative treatment of infections caused by multidrug-resistant A. baumannii strains, however this resistance has emerged recently. Another growing problem is a lack of international consensus between U.S. FDA and EUCAST recommendations, regarding tigecycline breakpoints for Acinetobacter spp., and frequently off-label use. The aim of the present study was to assess the in vitro susceptibility to tigecycline and other antimicrobials, routinely used in the treatment of infections, among 155 A. baumannii isolates, collected between 2008-2013 from a hospital in Poland. The most active agent against the tested MDR strains was colistin (99.3% susceptible isolates). Our study has shown a low efficiency of tigecycline, with 74.2% of non-susceptible strains (according to the U.S. FDA guidelines). Tigecycline MIC values ranged from 0.125 to 48 mg/L. The MIC50 and MIC90 were 3 and 8 mg/L, respectively, and 25.8% (40) of the isolates displayed MIC = 2 mg/L. The highest percentage of tigecyclineresistant strains were noted in 2010 (56.3%). Our study revealed remarkably high tigecycline non-susceptibility rates among MDR A. baumannii isolates, therefore this antimicrobial should be administered with caution

Activity of thyme oil ("Oleum Thymi") against multidrug-resistant "Acinetobacter baumannii" and "Pseudomonas aeruginosa"

Almost as soon as antibiotics were introduced to treat infectious diseases, it could be observed that bacteria were able to develop resistance against them. Currently, multidrug-resistant strains are being isolated mainly in the hospital environment. These are primarily non-fermenting Gram-negative bacilli, which exhibit both natural and acquired resistance to multiple antibiotics and disinfectants rendering them difficult to eradicate. The development of new, effective and safe substances that prevent troublesome infections is greatly needed to provide alternative therapeutic options for patients. There is increasing interest in drugs of natural origin, including essential oils. It is of particular interest that, although active against many bacterial strains, they do not contribute to antibacterial resistance against their components. The aim of our study was to evaluate the in vitro antibacterial activity of thyme oil against multidrug-resistant strains of A. baumannii and P. aeruginosa using the disc diffusion and macrodilution methods. The strains were isolated from patients hospitalized in the years 2013-2014. The in vitro antibacterial activity of thyme oil was assessed by the disc diffusion method and the inhibition zones for the oil at different concentrations, produced against A. baumannii, ranged from 7 to 44 mm. Low level of activity of thyme oil was observed against P. aeruginosa strains. The results of serial dilution tests confirmed the high activity of thyme oil against A. baumannii isolates, expressed as MIC values ranging from 0.25 to 2 μL/mL. These results suggest the need for further studies of antibacterial activity of essential oils, especially against multidrug-resistant bacterial isolates

Early depression independently of other neuropsychiatric conditions, influences disability and mortality after stroke (research study-part of PROPOLIS study)

Post-stroke depression (PSD) is the most frequent neuropsychiatric consequence of stroke. The nature of the relationship between PSD and mortality still remains unknown. One hypothesis is that PSD could be more frequent in those patients who are more vulnerable to physical disability, a mediator variable for higher level of physical damage related to higher risk of mortality. Therefore, the authors’ objective was to explore the assumption that PSD increases disability after stroke, and secondly, that mortality is higher among patients with PSD regardless of stroke severity and other neuropsychiatric conditions. We included 524 consecutive patients with acute stroke or transient ischemic attack, who were screened for depression between 7–10 days after stroke onset. Physical impairment and death were the outcomes measures at evaluation check points three and 12 months post-stroke. PSD independently increased the level of disability three (OR = 1.94, 95% CI 1.31–2.87, p = 0.001), and 12 months post-stroke (OR = 1.61, 95% CI 1.14–2.48, p = 0.009). PSD was also an independent risk factor for death three (OR = 5.68, 95% CI 1.58–20.37, p = 0.008) and 12 months after stroke (OR = 4.53, 95% CI 2.06–9.94, p = 0.001). Our study shows the negative impact of early PSD on the level of disability and survival rates during first year after stroke and supports the assumption that depression may act as an independent mediator for disability leading to death in patients who are more vulnerable for brain injury

Pre-stroke apathy symptoms are associated with an increased risk of delirium in stroke patients

Neuropsychiatric symptoms can be interrelated to delirium. We aimed to investigate an association between pre-stroke neuropsychiatric symptoms and the risk of delirium in stroke patients. We included 606 patients (median age: 73, 53% female) with stroke or transient ischemic attack admitted within 48 hours from symptoms onset. We assessed delirium on a daily basis during the first 7 days of hospitalization. To make diagnosis of delirium we used DSM-5 criteria. We used Neuropsychiatric Inventory to assess neuropsychiatric symptoms occurring within 4 weeks prior to stroke. We diagnosed delirium in 28.2% of patients. On univariate analysis, higher score of pre-stroke depression (OR: 1.58, 95% CI: 1.04–2.40, P = 0.03), apathy (OR: 2.23, 95% CI: 1.44–3.45, P < 0.01), delusions (OR: 2.00, 95% CI: 1.09–3.68, P = 0.03), hallucinations (OR: 2.39, 95% CI: 1.19–4.81, P = 0.01) and disinhibition (OR: 2.10, 95% CI: 1.04–4.25, P = 0.04) was associated with the increased risk of delirium. On multivariate analysis adjusted for age, atrial fibrillation, diabetes mellitus, stroke severity, right hemisphere lesion, pre-stroke cognitive decline, pre-stroke disability and infections, higher apathy score (OR: 2.03, 95% CI: 1.17–3.50, P = 0.01), but no other neuropsychiatric symptoms, remained independent predictor of delirium. We conclude that pre-stroke apathy symptoms are associated with increased risk of delirium in stroke patients

PRospective Observational POLIsh Study on post-stroke delirium (PROPOLIS) : methodology of hospital-based cohort study on delirium prevalence, predictors and diagnostic tools

BACKGROUND: Between 10 % to 48 % of patients develop delirium in acute phase of stroke. Delirium determinants and its association with other neuropsychiatric disturbances in stroke are poorly understood. The wildly accepted predictive model of post-stroke delirium is still lacking. METHODS/DESIGN: This is a prospective, observational, single-center study in patients with acute phase of stroke. We aim to include 750 patients ≥18 years with acute stroke or transient ischemic attack admitted to the stroke unit within 48 hours after stroke onset. The goals of the study are: 1) to determine frequency of delirium and subsyndromal delirium in Polish stroke patients within 7 days after admission to the hospital; 2) to determine factors associated with incidence, severity and duration of delirium and subsyndromal delirium and to create a predictive model for post-stroke delirium; 3) to determine the association between delirium and its cognitive, psychiatric, behavioral and functional short and long-term consequences; 4) to validate scales used for delirium diagnosis in stroke population. Patients will be screened for delirium on daily basis. The diagnosis of delirium will be based on DSM-V criteria. Abbreviated version of Confusion Assessment Method and Confusion Assessment Method for the Intensive Care Unit will be used for delirium and sub-delirium screening. Severity of delirium symptoms will be assessed by Delirium Rating Scale Revised 98 and Cognitive Test for Delirium. Patients who survive will undergo extensive neuropsychological, neuropsychiatric and functional assessment 3 and 12 months after the stroke. DISCUSSION: This study is designed to provide information on clinical manifestation, diagnostic methods and determinants of delirium spectrum disorders in acute stroke phase and their short and long-term consequences. Collected information allow us to create a predictive model for post-stroke delirium

Plan De Intervención Sobre La Puntualidad escolar Para Fortalecer La Identidad Cultural en Los Alumnos De La Institución Educativa N°16213. Tomocho, Bagua Grande, Utcubamba.

La investigación titulada: “Plan de intervención sobre la puntualidad escolar para fortalecer la identidad cultural en los alumnos de la institución educativa N°16213. Tomocho, Bagua Grande, Utcubamba”, tiene como objetivo: “Determinarla influencia del plan de intervención sobre la puntualidad escolar se fortalece la identidad cultural en los alumnos de la institución educativa N° 16213. Tomocho,Bagua Grande, Utcubamba” El estudio se abordó en el marco de una investigación cuantitativa a través del desarrollo del tipo de investigación aplicativa–explicativa, se aplicó un plan de intervención sobre la puntualidad escolar y se explica a través de las teorías científicas, a través de un diseño pre experimental con un solo grupo, en una muestra de 26 estudiantes de la institución educativa en mención. La variable identidad cultural se ejecutó con las dimensiones: gastronomía, música y danzas tradicionales y artesanías; del mismo modo la variable plan de intervención sobre la puntualidad escolar se ejecutó con el desarrollo de las dimensiones: aumento de eficacia, incremento de confianza, adquisición de respeto y conquista del empleo En los resultados alcanzados se observa que de los 26 alumnos entrevistados antes de aplicar el programa en las tres dimensiones se ubicaron en el nivel bajo gastronomía 53.8%, Música y danza 46.2% y artesanías 50%.Mientras que después de aplicar el programa alcanzaron un nivel muy bueno gastronomía 46.2%, Música y danzas 38.5% y artesanía 23.1%. Demostrando de esa manera la eficacia del plan de intervención sobre puntualidad escolar