Potential Applications of Essential Oils for Environmental Sanitization and Antimicrobial Treatment of Intensive Livestock Infections

The extensive use of antibiotics has contributed to the current antibiotic resistance crisis. Livestock infections of Salmonella spp, Clostridium spp. and E. coli antimicrobial-resistant bacteria represent a public threat to human and animal health. To reduce the incidence of these zoonoses, essential oils (EOs) could be effective antibiotic alternatives. This study aims at identifying EOs safe for use, effective both in complementary therapy and in the environmental sanitization of intensive farming. Natural products were chemo-characterized by gas chromatography. Three S. Typhimurium, three C. perfringens and four E. coli strains isolated from poultry and swine farms were used to assess the antimicrobial properties of nine EOs and a modified GR-OLI (mGR-OLI). The toxicity of the most effective ones (Cinnamomum zeylanicum, Cz; Origanum vulgare, Ov) was also evaluated on porcine spermatozoa and Galleria mellonella larvae. Cz, Ov and mGR-OLI showed the strongest antimicrobial activity; their volatile components were also able to significantly inhibit the growth of tested strains. In vitro, Ov toxicity was slightly lower than Cz, while it showed no toxicity on G. mellonella larvae. In conclusion, the study confirms the importance of evaluating natural products to consolidate the idea of safe EO applications in reducing and preventing intensive livestock infections

The T.O.S.C.A. Project: Research, Education and Care

Despite recent and exponential improvements in diagnostic- therapeutic pathways, an existing “GAP” has been revealed between the “real world care” and the “optimal care” of patients with chronic heart failure (CHF). We present the T.O.S.CA. Project (Trattamento Ormonale dello Scompenso CArdiaco), an Italian multicenter initiative involving different health care professionals and services aiming to explore the CHF “metabolic pathophysiological model” and to improve the quality of care of HF patients through research and continuing medical education

Effetti della nifedipina nel trattamento dell'angina stabile da sforzo. Studio a doppio cieco. [Effects of nifedipine in the treatment of effort stable angina: a double blind study (author's transl)].

The effectiveness of chronic treatment with nifedipine in patients (pts) with a history of stable angina on effort has been evaluated in a double-blind study in 15 subjects of both sexes, aged 45 to 65 years. All pts underwent diagnostic cardiac catheterization and selective coronary angiography, which showed stenosis of one or two main coronary vessels between 50 and 70%. The pts, after 2 weeks of observation, underwent erect bicycle exercise test with increasing workloads. After 4 weeks of treatment with nifedipine or placebo the stress test was repeated. Nifedipine treatment reduced the weekly number of anginal attacks as well as the weekly number of nitroglycerin tablets consumed by the pts, increased maximum workload tolerated and reduced the S-T segment depression for the same workload, meanwhile heart rate and blood pressure did not change significantly either at rest or during exercise. The result of this study indicate that nifedipine is useful in the treatment of pts with stable angina on effort

Ottimizzazione di un protocollo per testare l'attività degli oli essenziali sul biofilm di agenti patogeni dei pesci

La formazione di un biofilm è un evento potenzialmente pericoloso, con possibili implicazioni nelle epidemie, poiché costituisce un serbatoio di microrganismi patogeni. Le cellule microbiche possono aderire tra loro, alle cellule ospiti e alle superfici abiotiche, come vetro, polistirene e conchiglie, favorendo così la colonizzazione e la formazione del biofilm. Il biofilm è costituito da popolazioni batteriche ad elevata concentrazione, protette da una robusta matrice di esopolisaccaridi che permette una forte adesione alle superfici. La formazione di biofilm porta alla perdita di efficacia degli agenti antimicrobici, con una resistenza fino a 1000 volte maggiore nei loro confronti (Uruen et al., 2020). L'obiettivo principale per contrastare le infezioni da microganismi patogeni nei pesci è l'individuazione di sostanze (possibilmente di origine naturale, ad esempio oli essenziali), che possano interferire con i biofilm patogeni. La fase iniziale di questo approccio coinvolge l'indagine di modelli in vitro di biofilm al fine di valutare l'efficacia degli agenti antibiofilm selezionati. Lo scopo del presente studio è stato l'ottimizzazione delle attuali tecniche utilizzate per la produzione di biofilm costituito da microrganismi patogeni dei pesci, per valutare l'efficacia di composti antibiofilm. Sono state evidenziate differenze nella formazione del biofilm tra i microrganismi saggiati. Yersinia ruckeri ha mostrato la migliore capacità di formare biofilm. Tutti i ceppi testati erano in grado di aderire alle piastre di polistirene e ai carapaci di gamberetti, ma vi erano notevoli differenze nella formazione del biofilm sviluppato in relazione alle superfici testate. Analizzando i carapaci di gamberetti, è stato osservato che il cristal violetto, composto di elezione per evidenziare la formazione del biofilm, non può essere utilizzato direttamente per misurare la formazione del biofilm, poiché i carapaci assorbono il cristal violetto anche in assenza di biofilm. Pertanto, il biofilm formato è stato valutato misurando la crescita dei microrganismi dopo averli staccati dalle diverse superfici (piastre di polistirene e carapaci di gamberetti). Il biofilm formato sul carapace era maggiore rispetto a quello cresciuto sul polistirene. Questo risultato è molto importante perchè un biofilm ottimale consente una corretta valutazione dell'efficacia delle sostanze antibiofilm. Il modello sperimentale descritto nel presente lavoro si è rivelato molto utile per valutare in modo ottimale l'attività antibiofilm e per identificare con precisione la dose efficace di oli essenziali, evitando l'uso di dosi inefficaci che potrebbero selezionare ceppi resistent

Improved Antimicrobial Interventions Have Benefits

Studies have shown benefits to patients from improved interventions involving antimicrobial therapy. The purpose of the present study was to evaluate prospectively the impact of improved interventions by (i) the use of TheraTrac 2, a computer software program which electronically links susceptibility testing results immediately to the pharmacy and alerts pharmacists of potential interventions, and (ii) the education of pharmacists involving microbiologic topics. The study group had the new intervention program. The control group had interventions performed the way that they had previously been done by manually reviewing hard copies of susceptibility testing data. In a 5-month period, all inpatients whose last names began with A to K were the study group; inpatients whose last names began with L to Z were controls. Three analyses were done; one analysis (analysis A) involved only patients with interventions, one analysis (analysis B) involved all patients for whom antimicrobial testing was done and who were matched for diagnosis-related groups (DRGs), regardless of whether an intervention occurred, and one analysis (analysis C) involved these DRG-matched patients by using severity-adjusted data. In analysis A, the study group had a 4.8% decreased rate of mortality, an average of a 16.5-day decreased length of stay per patient, and $20,886 decreased variable direct costs per patient. None of these differences was statistically significant. In analysis B, the study patients had a 1.2$2,626 decreased variable direct costs per patient (P = 0.008). In analysis C, the study patients had a 1.4% lower mortality rate, a 1.2-day decreased length of stay per patient, and $1,466 decreased variable direct costs per patient. In conclusion, the institution of this program caused substantial cost savings

Lung ultrasonography: what the cardiologist should know

In recent years, lung ultrasonography has acquired an important role as a valuable diagnostic tool in clinical practice. The lung is usually poorly explorable, but it provides more acoustic information in pathological conditions that modify the relationship between air, water and tissues. The different acoustic impedance of all these components makes the chest wall a powerful ultrasound reflector: this is responsible for the creation of several artifacts providing valuable information about lung pathophysiology. Lung ultrasonography helps in the diagnostic process of parenchymal and pleural pathologies, in the differential diagnosis of dyspnea and in the clinical and prognostic evaluation of the SARS-CoV-2 infection