Non antimicrobial effects of antibacterial agents

Antimikrobiyal ajanlar kimyasal yapılarından dolayı bakterilere karşı aktiviteleri dışında bazı yararlı etkilere de sahiptirler. Bu etkiler antienflamatuvar, imm&uuml;nmod&uuml;lat&ouml;r, anti-kanser, anti-anjiogenik, n&ouml;roprotektif, kardiyoprotektif, gastrointestinal hareket artırıcı etki ve toksin bağlayıcı etkilerdir. Konu &ccedil;ok geniş olduğundan dolayı bu derleme t&uuml;m antibiyotiklerin antimikrobiyal dışı etkilerini i&ccedil;ermedi. Penisilinlerin serviks ve l&ouml;semik kanser h&uuml;crelerinin &ccedil;oğalmasını durdurmasında &uuml;mit vadedici etkisi ve mantar zehirlenmesi tedavisinde kullanımınından; sefalosporinlerden seftriaksonun akciğer kanserini &ouml;nleyici ve n&ouml;roprotektif etkisinden bahsedilmiştir. Tetrasiklinler uzun s&uuml;redir &uuml;zerinde durulan ve araştırılan ajanlardır ve bu gruptaki demeklosiklin, uygunsuz antidi&uuml;retik hormon salınımında kullanım onayı almıştır. Ayrıca tetrasiklinlerden doksisiklin d&uuml;ş&uuml;k dozda periodontit tedavisi i&ccedil;in onay almıştır ve antienflamatuvar etkiden sorumlu mekanizma matriks metalloproteinaz (MMP) enzimi inhibisyonudur. Ayrıca MMP inhibisyonu metastazda ve t&uuml;m&ouml;r anjiyogenezinde azaltma da sağlar. Diğer bir tetrasiklin olan minosiklin ise Alzheimer ve diğer n&ouml;rodejeneratif hastalıklarda kilit rol&uuml; olan beta-amilod sentezini azaltmakta ve ayrıca gliyal ind&uuml;klenebilir nitrik oksit (NO) sentaz salınımını ve NO aracılı n&ouml;rotoksisiteyi de inhibe etmektedir. Makrolidlerden eritromisin gastrointestinal hareket artırıcı olarak kullanılmakta, azitromisin ise kistik fibrozisli hastalarda antienflamatuvar etkiyle erken bir iyileşme sağlamaktadır. Klaritromisinin akciğer kanseri ve melanomda metastatik aktiviteyi azalttığı ve Staphylococcus aureus&rsquo;un opsonizasyon kinetiği &ccedil;alışması ile klindamisinin toksin bağlayıcı ve fagositozu artırıcı etkisi g&ouml;sterilmiştir. İlave olarak bir protein sentezi inhibit&ouml;r&uuml; olan linezolid antienflamatuvar ve anti-kanser aktiviteye sahiptir. Tetra florokinolonlar meme ve akciğer kanseri k&uuml;lt&uuml;r&uuml; h&uuml;crelerinde doza bağımlı olarak &ccedil;oğalmayı &ouml;nlemektedir. Florokinolonlar interl&ouml;kin-1 ve t&uuml;m&ouml;r nekrozis fakt&ouml;r-alfa sentezini inhibe ederek ve koloni uyarıcı fakt&ouml;r sentezini artırarak imm&uuml;nmod&uuml;lat&ouml;r etki g&ouml;stermektedir. Ayrıca farelerde siprofloksasinin hepatositleri yenileyici etkilerinden bahsedilmiştir. Gelecekte bazı antibiyotiklerin antimikrobiyal dışı etkileri bazı hastalıklarda &uuml;mit vaat edebilir olmasına rağmen insanlarda yapılacak klinik &ccedil;alışmaların sonu&ccedil;ları beklenmelidir. İlave olarak, uzumış antibiyotik kullanımında antimikrobiyallere karşı diren&ccedil; gelişmesi &ouml;nemli bir problem olarak g&ouml;r&uuml;nmektedir.Aside from their antibacterial activity, antimicrobial agents have also some useful effects due to their chemical structures. These effects include anti-inflammatory, immunomodulatory, anti-cancer, anti-angiogenic, neuroprotective, cardioprotective, augmented gastrointestinal motility, and toxin-binding. This review has not contained the non-antimicrobial effect of all antibiotics due to the fact that the issue was too comprehensive. It was discussed that penicillins are used for mushroom poisoning and have a promising effect on inhibition of proliferation of the cells of cervix carcinoma and leukemia; ceftriaxone which is a cephalosporin, has their neuroprotective effects and inhibits proliferation of lung cancer cells. Tetracyclines are agents that have been focusing on and investigating for a long time, and demeclocycline belong to this group has been approved for inappropriate anti-diuretic hormone secretion. Moreover, a low dose doxycycline that is a tetracycline has been approved for treatment of periodontitis, and the inhibition of matrix metalloproteinase (MMP) enzyme is a responsible mechanism for its anti-inflammatory action. MMP inhibition also provides a decrease in tumor angiogenesis and metastasis. Minocycline another tetracycline reduces the synthesis of beta-amyloid which plays a key role in Alzheimer and other neurodegenerative diseases, and it also inhibits a glial inducible nitric oxide (NO) synthase and NO-mediated neurotoxicity. Erythromycin that is a macrolide antibiotic is used a gastrointestinal motility augmenter; azithromycin gives an early improvement in patients with cystic fibrosis due to its anti-inflammatory action. It is shown that clarithromycin decreases the metastatic activity of melanoma and lung cancer, and clindamycin has a toxin binding and phagocytosis induction activity in a study of opsonization kinetics of Staphylococcus aureus. In addition, linezolid which is a protein synthesis inhibitor has an anti-inflammatory and anticancer activity. Tetra-fluoroquinolones dose-dependent inhibits the cell production in breast and lung cancer cell culture. Fluoroquinolones show an immunomodulatory action throughout enhancing the synthesis of colony stimulating factor and inhibiting synthesis of interleukin-1and tumor necrosis factor-alpha. Moreover, this review includes that ciprofloxacin has a hepatic regenerative activity in mice model. In the future, although non-antimicrobial effects of some antibiotics may promise for some diseases, the results of clinical studies in humans should be waited to use in clinics. Furthermore, it may prove to be a major problem that prolonged antibiotic use may cause the development of resistance against those antimicrobials.</p

Non Antimicrobial Effects of Antibacterial Agents

Aside from their antibacterial activity, antimicrobial agents have also some beneficial effects due to their chemical structures. These effects include anti-inflammatory, immunomodulatory, anti-cancer, anti-angiogenic, neuroprotective, cardioprotective, augmented gastrointestinal motility, and binding toxins. This paper does not comprise non-antimicrobial effects of all antibiotics due to the fact that the issue is very extended. We reviewed use of penicillins in mushroom poisoning and their promising inhibitor effect on proliferation of cervical carcinoma and leukemia cells. We summarized neuroprotective effect of ceftriaxone and its inhibitory potential on proliferation of lung cancer cells. Tetracyclines are agents that have been focused on and investigated for a long time, and demeclocycline that belongs to this group is used for inappropriate antidiuretic hormone secretion. Moreover, low-dose doxycycline that is also a tetracycline, has been approved for the treatment of periodontitis, and inhibition of matrix metalloproteinase enzyme is the responsible mechanism for its anti-inflammatory action. Matrix metalloproteinase inhibition also provides a decrease in tumor angiogenesis and metastasis. Minocycline, another tetracycline, reduces the synthesis of beta-amyloid which plays a key role in Alzheimer’s disease and other neurodegenerative diseases, and it also inhibits glial inducible nitric oxide (NO) synthase and NOmediated neurotoxicity. Erythromycin that is a macrolide antibiotic is used as a gastrointestinal motility augmenter; azithromycin gives an early improvement in patients with cystic fibrosis due to its anti-inflammatory effect. It has been shown that clarithromycin decreases the metastatic activity of melanoma and lung cancer in mice. In a study of Staphylococcus aureus opsonization kinetics, it has been demonstrated that clindamycin has a toxin binding and phagocytosis induction activity. In addition, linezolid, a protein synthesis inhibitor, has an anti-inflammatory and anticancer activity. Tetra-fluoroquinolones inhibit cell production in breast and lung cancer cell culture in a dose-dependent manner. Fluoroquinolones show an immunomodulatory action throughout enhancing the synthesis of colony-stimulating factor and inhibiting synthesis of interleukin-1 and tumor necrosis factor-alpha. Moreover, this review includes beneficial effects of ciprofloxacin on hepatic regeneration in mice model. Although non-antimicrobial effects of some antibiotics may show promise for some diseases in the future, the results of human clinical studies should be waited for. Furthermore, the fact that prolonged antibiotic use may cause development of resistance against those antimicrobials may cause future problems

Barotrauma Associated with Mechanical Ventilation

Amaç: Barotravma sıklığı, koruyucu mekanik ventilasyon (MV) stratejilerinin kullanılmasıyla azalmaktadır. Bu çalışmada; kliniğimiz 3. seviye yoğun bakım ünitesi (YBÜ)'nde invaziv MV uygulanan olgularda, barotravmanın gelişme sıklığı, tedavi ve prognozunun literatür eşliğinde tartışılması amaçlanmıştır.Gereç ve Yöntemler: Çalışmaya Ocak 2008-Aralık 2014 tarihleri arasında yatan olgular dahil edilmiştir. Barotravma gelişen olgular retrospektif olarak gözden geçirilmiştir. Bulgular: Yedi yıl süresince YBÜ'de yatan 1341 olgudan 861'ine invaziv MV tedavisi uygulanmış, toplam 19 olguda (%2,2) barotravma saptanmıştır. Olguların; %73,7'si erkek olup, yaş ortalaması 63,2±18,2, ortanca APACHE II skoru 18, ortanca invaziv MV süresi 168 saat bulunmuştur. Başvuruda; olguların %57,9'unda Akut Solunum Zorluğu Sendromu (ARDS) saptanmış olup, en sık (%47,4) volüm kontrol modu kullanılmıştır. Barotravma ortanca 8. günde gelişmiş, barotravma gününde; olguların %84,2'sinde pnömoni saptanmış, en sık (%47,4) basınç destekli mod uygulanmıştır. Olguların tümünde mediasten amfizemi, 16 (%84,2)'sında pnömotoraks (3'ünde bilateral), 11 (%57,9)'inde ciltaltı amfizemi mevcuttu. Pnömotoraks gelişen olguların, 15 (%83,3)'ine tüp torakostomi ve kapalı sualtı drenajı uygulanmıştır. İlk 24 saat içindeki mortalite oranı %26,3 iken, total mortalite %100 olarak saptanmıştır.Sonuç: İnvaziv MV uygulanan olgularımızda barotravma görülme sıklığı düşük olmakla beraber, prognozun kötü olduğu saptanmıştır.Objective: The incidence of barotrauma in patients who received mechanical ventilation (MV) has decreased due to protective MV strategies. This study aimed to assess the incidence, treatment, and prognosis of barotrauma in patients who received MV in our tertiary intensive care unit (ICU) and to discuss with the literature. Material and Methods: Patients hospitalized between January 2008 and December 2014 were assessed. Those who had barotrauma were retrospectively analyzed. Results: Invasive MV was performed in 861 of 1341 patients. Barotrauma was seen in 19 (2.2%) patients. These patients' (mean age, 63.2&plusmn;18.2 years; 14 males) median APACHE II score was 18, and their median duration of MV was 168 h. Acute Respiratory Distress Syndrome(ARDS) was diagnosed in 57.9% of the patients at admission, and volume-controlled ventilation was mostly used (47.4%). Barotrauma occurred on day 8 (median; range, day 4-21). Pneumonia was diagnosed in 84.2% of the patients. Pressure support ventilation was mostly used (47.4%) at the time of barotrauma. All patients had pneumomediastinum. Pneumothorax was diagnosed in 16 (84.2%) patients (bilaterally in 3 patients). Subcutaneous emphysema was seen in 11 patients (57.9%). Pneumothorax was treated by tube thoracostomy in 15 patients (83.3%). While the mortality rate was 26.3% in first 24 h, the overall mortality rate was 100%. Conclusion: The incidence of barotrauma was lower among our ICU patients who received MV, but the prognosis of these patients was poor

Evaluation of Traffic Accident Risk in In-City Bus Drivers: The Use of Berlin Questionnaire

WOS: 000436167400005PubMed ID: 29755810OBJECTIVES: Traffic accidents associated with high mortality rate may produce serious problems especially in highways. Obstructive sleep apnea (OSA) has been associated with a high risk for traffic accidents due to excessive daytime sleepiness even in in-city drivers. In the present study, it was aimed to evaluate the rate of OSA symptoms and to identify risk factors associated with traffic accidents in in-city bus drivers. MATERIAL AND METHODS: A self-administered questionnaire including demographic and anthropometric features, sleep and work schedules, Berlin questionnaire, Epworth sleepiness score (ESS), and history of traffic accidents was used. RESULTS: The questionnaire was conducted for 1400 male bus drivers (mean age, 38.0 +/- 6.4 y, body mass index, 27.8 +/- 3.9 kg/m(2)). A total of 1058 (75.6%) drivers had one or more accidents while driving bus. According to the Berlin questionnaire, 176 (12.6%) drivers were found to have high OSA risk and the accident rate was 83.0% in high-risk group, whereas 74.5% of low-risk drivers had accidents (p=0.043). The drivers with a history of traffic accident were older (p=0.030), had higher ESS (p=0.019), and were more in the high-risk OSA group according to the Berlin questionnaire (p=0.015). In multivariate linear regression analysis, traffic accident was associated with only Berlin questionnaire (p=0.015). CONCLUSION: The present results support that city bus drivers with high OSA risk according to Berlin questionnaire have increased accident rates. Therefore, we suggest using Berlin questionnaire for screening sleep apnea not only in highway drivers but also in in-city bus drivers

Pulmonary Rehabilitation Response in Elderly and Younger Patients With COPD

CHEST Annual Meeting -- OCT 22-26, 2016 -- Los Angeles, CAWOS: 000400118602240CHES

To migrate or not to migrate: the effect of institutional reforms on immigration decisions of Ottoman citizens to the US

In the age of mass migration, the US became economically crucial with the development of Atlantic trade and attracted labour flows from the rest of the world. Meanwhile, the Ottoman Empire was suffering severe economic and political problems. The Ottoman citizens of various ethnic origins, such as Turks, Jews, Armenians and Arabs, moved to different countries, including the US, for economic and political reasons. This paper examines the effect of institutional reforms in the Ottoman Empire during the Second Constitutional Era on immigration decisions of different ethnic groups to the US. Data come from the US census data of IPUMS (the Integrated Public Use Microdata Series) for 1910. The empirical results show that the institutional reforms could reduce emigration from the Ottoman Empire through granting additional civil liberties. However, this effect works heterogeneously for different ethnic groups. This result points out the importance of institutional improvements in home countries on reducing migration outflows