Antibacterial Activity of Selected Silver Nanoparticles Coatings - Our Initial Experience

Nanoparticles exhibits chemical and physical properties significantly different to their macro-scale counterparts composed of the same substance (due higher surface/volume ratio, colour, solubility, diffusivity,material strength, toxicity, thermodynamic, magnetic, optical and other properties) and may have unique impacts on health and environment. Extremelly small size (1-100 nm) enables them to enter the human body through usual or unusual routes, pass through cell membranes, or cross the blood-brain barrier. Gravity loses impact and importance, surface tension and Van der Waals constants has more importance in system of nano particles. Nanotechnology is already used in various applications, with potential tobe applied at any stage in food industry: production, preservation, processing, packaging,transport, nanobarcodes for food authenticity and tracing, labelling, keeping the quality of food products, extend the products shelf-life, removal of undesirable tastes, flavours or allergens from food products, nano (bio)sensors for food safety, water filtration. Risks of nanotechnology are still unknown and unpredictable. Initial scientific studies showed negative effects on living organisms and a potential for serious threat to human health. Authorities of the most developed countries, have set up, guidance documents and procedures for nanoenabled products based on existing regulations, appropriate in vitro and in vivo ADME studies (absorption, distribution, metabolism and excretion) and requirements for standardised and harmonised analytical test methods for proper risk assesments, clear identification and characterization of nano-hazards. Nanotechnology in medicine (Nanomedicine) apply for rapid and sensitive detection of pathogenic bacteria and low levels of viruses, in small sample volumes, at lower costs than current in-use technologies. This advance in early detection enables accurate and prompt treatment. Nano-robots to make repairs at the cellular level are under development. Rapid and sensitive detection methods, based on nano (bio) senzors, are developed for food-borne pathogens E. coli, especially E. coli O157:H7, S. aureus, S. typhimurium, C. jejuni, E. cloacae, B. subtilis, L. monocytogenes. Detection sensor to detect bacterial biofilm formation on surfaces are under development. New strategies to combat multydrug resistant microorganisms (MDR) are urgently needed and nanomaterials are very promising approach. Small size provides large surface of nanoparticles and at least 50% of molecules will react to the microorganisms. Metal nanomaterials (silver, gold, copper, titanium, zinc, magnesium,cadmium, and alumina) possess advantage of unique antimicrobial activities. Scientists offers also new complex antibacterial and antiviral nano systems on the basis of metal oxides or intermetallic oxide compounds (such as TiO2, ZrO2, SnO and SiO2). Inside the human body ionic silver quickly combines with chloride to form an insoluble compound called silver chloride which is far less reactive than metallic silver nanoparticles. Some studies established that silver ions has strongest bactericidal effect, cooper and gold weaker one. In our preliminary study on antibacterial activity of several different compositions of nanoparticle coatings (titanium, inox and silver), we found antimicrobial activity of silver, double composition of titanium and silver against Staphylococcus aureus and Staphylococcus epidermidis, but not for E. coli, Pseudomonas aeruginosa, Listeria monocytogenes and Candida albicans. More extensive studies will follow. Key words: Nanoscience, nanoparticles, silver, ions, biofilm, antimicrobial, antibiotic, resistance

Моите посебни потреби – надарени за цртање, надарени за музика

Здружението Центар за детско уметничко изразување, музикотерапија и психо-физичка релаксација “ЏУНЏУЛЕ“ од Скопје го потврдува учеството на проф. Д-р Милка Здравковска Јанкуловска како евалватор и рецензент во истражувачкиот проект “Моите посебни потреби – надарени за цртање, надарени за музика“, реализиран во текот на 2013г. со финансиска поддршка на Министерството за култура на РМ по договор бр.11- 4272/1 од 20.03.2013г

E-government information communication system and transparency: an overview of the situation in the Republic of Macedonia

The modern benefits that result from the introduction of the latest technological advances in the management process in the state are certainly associated with the introduction and principles of e-Government information communication system. The Republic of Macedonia is a developing country and it makes efforts to catch up with modern trends and enable more responsible governance, which will be in accordance with the principles of good governance, which are incepted and based on the highest constitutive act of the state as well as on the relevant legislation, which addresses the issues of good governance of the administrative bodies. This paper gives a review of the implementation of the concept of e-Government in the Republic of Macedonia. The main goal of this paper is to present the projects implemented under the “National Strategy for e-Government 2010-2012” and its benefits in terms of improving transparency of government institutions. Based on a review of the legislation, strategic government documents and projects, it can be concluded that theimplementation of e-Government offers great opportunities for increasing the level of openness and transparency of government in order to establish better communication and flow of information

Unusual appearance of Stenotrophomonas maltophilia in entubated patients hospitalized in Clinic for anestesiology, reanimation and intensive care) - KARIL Skopje

Stenotrophomonas maltophilia-associated infection is increasingly recognized as an nosocomial infection which occurs, in immunosuppressed individuals but not exclusively. Many strains of the bacterium manifest resistance to multiple antibiotics. It is considered an environmental bacterium, although little is known of the epidemiology of S. maltophilia, its sources and reservoirs. Even less is known of pathogenic mechanisms and virulence factors and this, reflects over difficulties in distinguishing colonization from true infection, which has fostered the view that the bacterium is essentially non-pathogenic.This study is generaly case report of unusual isolation of originated from medical devices (endotracheal tubes) used to support immunosuppressed surgical patients in KARIL and attempt to distinguish colonization from infection. During our continious monitoring procedure in KARIL, we have isolated 9 multi-drug resistant strains of Stenotrophomonas maltophilia (100% resistance to cefixime, ceftriaxone, cefuroxime, cefotaxime, coamoxiclav,imipenem). Automatic VITEK technique has been used for identification as well as for antibiotik susceptibility testing, to confirm traditional microbiological tecniques (morphology of colonies on blood agar plates and positive oxidase test,diskdifussion method and E-test).All patients suffered from traumatic haemoragical shock syndrome. Clinical significance has been confirmed in 2 cases with clinical signs for lower respiratory infection (high body temperatute 38.5oC, and Ro confirmation). These patients have been treated with clindamycin and ceftriaxone with recovering period in 4 days. Keywords:Stenotrophomonas maltophilia, ICU, clinical significance, endotracheal tub

Epidemiological characteristics of people with cardiovascular diseases in the region of Shtip

Cardiovascular diseases are the main death cause in the developing, and in the developed countries worldwide. For diagnosing cardiovascular disease and stratification of risks, knowing the risk factors which influence the occurring of the disease is needed. With modification risk factors can lead to reversible changes. Aim: Showing the distribution of patients with cardiovascular diseases in the region of Shtip, treated in Private health facility “Zlatko Stojmenov” in Shtip in the period 2010-2015, according to specified epidemiological variables: age, gender, family anamnesis, working status/employment, smoking habits, alcohol consuming, and diagnosis. Materials and methods: The paper is a retrospective research, conducted in the period from 01.01.2010 to 31.12.2015 in Private health facility “Zlatko Stojmenov” in Shtip. According to specified epidemiological variables, all the patients from the region of Shtip treated from cardiovascular diseases in that period are being analyzed. Data are provided by medical documentation, i.e. health records of each patient treated. For making this paper descriptive and analytic epidemiological method is being used. Results: In Private health facility “Zlatko Stojmenov” in Shtip in the period 2010 – 2015 the total number of patients treated from cardiovascular diseases is 1728. The biggest part of the patients were in the age group from 51 to 80 years. 892 (51,62%) patients were men, and 836 (48,38%) were women. 717 (41,49%) had positive family anamnesis, smoking habit confirmed 722 (41,78%), and alcohol consuming habit 353 (20,43%) of the patients. Most of the patients, from all age groups, have diagnosed arterial hypertension – 110, then angina pectoris -120, and chronic ischemic heart disease – 125. From the total number of patients treated in the examined period, 489(28,30%) patients were employed, and 1239(71,70%) were unemployed and retired people. Conclusion: Modern way of living and the dynamic pace coming from it are increasing the stress and all risk factors which lead to occurrence of cardiovascular diseases. The number of patients suffering from cardiovascular diseases in the region of Shtip is increasing. The fact that this diseases are occurring more often among young, working people is concerning

Potential application of silver nanoparticles coatings as antimicrobials

World is heading towards post-antibiotic era and bacterial resistance to antibiotics present a growing concern as a „Major global threat“ to public health. New strategies to combat мulty drug resistant microorganisms (MDR) are urgently needed and nanomaterials looks very promising. Extremelly small size (1-100 nm) enables nanoparticles to enter the human body through cell membranes or cross the blood-brain barrier. Metal nanomaterials (silver, gold, copper, titanium, zinc, magnesium, cadmium, and alumina) possess unique antimicrobial activities. Silver ions showed strongest bactericidal effect, cooper and gold weaker one. Ionic silver is water soluble while metallic silver is not. Inside the human body ionic silver cannot survive, because quickly combines with chloride to form an insoluble silver chloride which is far less reactive than metallic silver nanoparticles which can survive inside the body beacuse they are unaffected by chloride. Silver ions are non-toxic to human cells in low concentrations. Theories and hypothesis about mechanism of antimicrobial action of silver ions includes: - Interaction of electrostatic forces between bacterial cells (negative charge) and silver ions (positively charged), - Oxidation and destruction of bacterial cytoplasm, - Direct influence on DNA, increasing quantity of intracellular free radicals, - Inhibition of the transmembrane transport of Na+ and Ca++ - Inhibition of enzymes of the respiratory chain, - Reaction with Peptidoglycans blocking transfer of oxygen into bacterial cells In our preliminary study of several different compositions of nanoparticle coatings (titanium, inox and silver), we found antimicrobial activity of silver and double composition of titanium and silver against Staphylococcus aureus and Staphylococcus epidermidis, but not against E. coli, Pseudomonas aeruginosa, Listeria monocytogenes and Candida albicans. More extensive studies will follow. Key words: Nanoparticles, silver, ions, antimicrobial, antibiotic, resistance

Commonly isolated pathogens and Antibiotic susceptibility testing in patients with decubitus hospitalized at a tertiary care hospital in Stip

Background: The increasing rates of hospital infections, plays an important role in the development of chronic, delayed wound healing. Bacterial resistance and multidrug resistance to commonly used antibiotics have created a great problem in the management of different infections. The aim of this study was to identify isolated pathogens from swab samples in patents with decubitus, taken at a tertiary care hospital in Stip and to determine microbial susceptibility to antibiotics. Methods: The colonies grown were identified based on colony morphology, Gram stains and biochemical tests. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion technique. Results: All suspected swab samples taken from patients with decubitus were processed, and all samples (100%) were culture positive. The most common isolated gram-positive bacteria was Staphylococcus aureus, among which 50% contained MRSA and other 50% were found to have multidrug resistance to penicillin, macrolides, cephalosporines, clindamycin, folate synthesis inhibitors and quinolones. Conclusion: Our study is the first surveillance study that examined the antimicrobial susceptibilities in patients with decubitus hospitalized at clinical for tertiary care in Stip. The rate of isolated pathogen (methicillin resistant S. aureus) was found to be high and requires additional activities and measures to be taken to improve the clinical outcome of patients

Commonly Isolated Pathogens from Postoperative Wounds and Antibiotic Susceptibility Testing At a Tertiary Care Hospital in Stip, North Macedonia

The increasing rates of hospital infections and bacterial resistance to commonly used antibiotics have created huge problem in the management of different infections. The objective of this study was to identify isolated pathogens from swab samples of postoperative wounds taken at a tertiary care hospital in Stip and to determine microbial susceptibility to antibiotics. Therefore, a total of 139 wound swab samples from two different departments (surgery and orthopedics) at a tertiary care hospital were processed using standard microbiological techniques. The colonies grown were identified based on colony morphology, Gram stains, and biochemical tests for accurate microbial identification. Antimicrobial susceptibility testing was performed by Kirby–Bauer disc diffusion technique. Among total 139 wound swab samples processed, from a total of 2344 operated patients, 100 samples (4,3%) were culture positive. The most common isolated gram-positive bacteria were Staphylococcus aureus (27 samples), among which 44% contained MRSA and Enterococcus(9 samples) among which 50% were found to have multidrug resistance to penicillin, macrolides, cephalosporines, clindamycin, folate synthesis inhibitors and quinolones. The most common isolated gram-negative bacteria were Escherichia coli (17 samples) and Pseudomonas aeruginosa (13 samples) among which 50% were found to have multidrug resistance to beta-lactam antibiotic, chloramphenicol, folate synthesis inhibitors and quinolones. The highest percentage of isolated pathogens was found in the samples obtained from the orthopaedic department.Gram-negative infections were predominant. Increased rate of MRSA resistance and multidrug resistance was noted

An Update on Brucellosis: Endemic and Potential Global re-Emerging Zoonotic and Foodborne Disease

Brucellosis is a re-emerging zoonotic disease, which spreads in different ways: respiratory (inhalation), contact, alimentary (consumption of unpasteurized milk and contaminated dairy products) or a combination of these. The disease has existed in the Republic of Macedonia since 1980, with over 12.000 reported and confirmed human cases. All neighbouring and many other European countries have also reported existence of brucellosis with significantly different incidence. Brucellosis remains a rare disease in EU/EEA. In 2014, 354 confirmed cases of brucellosis were reported by 18 EU/EEA countries. The highest rates were reported by Greece (135), Spain (60) and Portugal (50). The control of brucellosis is very complicated due to large reservoirs in domestic and wild animals. The control of animal brucellosis is imperative for the control of human brucellosis. Key words: brucella, brucellosis, food-borne, re-emerging, reservoirs, zoonotic

The effectiveness of cannabinoids for the treatment of cachexia in HIV-positive patients

Knowledge of the role of the endocannabinoid system in the modulation of immune functions, the influence of mood, the regulation of appetite, gives us the right to think about the possibility of use of cannabinoids for the treatment of cachexia. Cachexia, also known as weight loss syndrome, is a common problem in patients with human immunodeficiency virus (HIV). Weight loss syndrome is defined as a loss of at least 10% of the body weight. In HIV-positive patients, weight loss syndrome has been associated with chronic diarrhea, fatigue, and fever for at least 30 days. This serious situation leads to significant morbidity and mortality for these patients. The use of cannabinoids to improve appetite and regain weight in HIV-positive patients is recommended, but it is unclear whether they are truly safe and effective. MARINOL (dronabinol), 2.5, 5 or 10 mg tablets is the only synthetic cannabinoid (tetrahydrocannabinol (THC) isomer) intended for oral administration and FDA approved for two indications: treatment of anorexia associated with weight loss in people with acquired immune deficiency syndrome (or HIV-positive patients) and vomiting caused by chemotherapy in people whose nausea and vomiting have not improved with usual antiemetics. In the United States, Marinol is treated as a non narcotic drug with a very low risk of physical and mental dependence (categorized into level III of controlled substances). The dosage for treatment of weight loss depends on tolerability, from 1 x 2.5 mg /day to 2 x 10 mg /day. The medicine is stated to be taken before meals: before dinner when is administered once daily or before breakfast and dinner if the total dose is divided into twice daily intake. An online literature review published by June 2018 identified a total of six randomized clinical trials (RCTs) that were conducted to evaluate the effects of dronabinol for the treatment of cachexia in HIV-positive patients. They included a total of 298 patients. In 5 of the six studies conducted, the effects of dronabinol were compared with placebo, and in only one study the effects of dronabinol were compared with megestrol acetate. Only one of the six studies was classic placebo-controlled study that reported the effects of dronabinol on body weight correction, while in other studies the effects of dronabinol on body weight correction were secondary notification. This study is also the only study on which base indication for dronabinol are approved. Studies show that dronabinol at doses of 5mg /day stimulates weight gain compared with placebo. Dronabinol compared to megestrol showed a lack of effect. The conclusion of these studies, however, is that use of cannabinoids can have a positive effect on improving appetite and weight gain in HIV-positive patients