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antibiotic delivery

Cristina Prat, Alicia Lacoma
BACKGROUND: Acute and chronic respiratory tract infections are a common cause of inappropriate antimicrobial prescription. Antimicrobial therapy leads to the development of resistance and the emergence of opportunistic pathogens that substitute the indigenous microbiota. METHODS: This review explores the major challenges and lines of research to adequately establish the clinical role of bacteria and the indications for antimicrobial treatment, and reviews novel therapeutic approaches...
October 2016: International Journal of Infectious Diseases: IJID
Matthew P Schreiber, Andrew F Shorr
Ventilator-associated pneumonia (VAP) is a distinct clinical entity characterized by an onset after 48 hours of the application of mechanical ventilation (MV). Protocols exist to aid in the prevention of VAP, but this infection carries a devastating impact on patient morbidity and potentially mortality. Areas covered: In this review we present key concepts from existing guidelines to aid clinicians. Challenges remain in defining this disease and, most importantly appropriate empiric antimicrobial treatment is the main determinant of outcome...
October 24, 2016: Expert Review of Anti-infective Therapy
M Kochlamazashvili, Kh Khatiashvili, M Butsashvili, O Chubinishvili, Sh Khetsuriani, G Kamkamidze
In Georgia, causative agents among infants with systemic infections are generally not identified and "neonatal sepsis" is usually diagnosed and treated without determining the etiology. The objective of this study was to estimate the role of viral pathogens (Herpesviridae and Enteroviruses) among neonates with generalized infections. A cross-sectional study was performed among neonates younger than <8 weeks admitted to a neonatal intensive care unit (NICU) at the two largest pediatric hospitals in Tbilisi, Georgia...
September 2016: Georgian Medical News
Magdalena M Sakowska, Megan V Thomas, Saxon Connor, Ross Roberts
BACKGROUND: In measuring quality of health-care delivery, digital infrastructure is essential. The aim at this tertiary centre was to create a hospital-wide workflow system that collected data prospectively as part of daily practice. METHODS: In moving towards an electronic health record, a hospital-wide integrated workflow system was introduced in 2013, which electronically managed the perioperative patient journey while simultaneously facilitating surgical audit...
October 21, 2016: ANZ Journal of Surgery
Richard Kalisa, Stephen Rulisa, Thomas van den Akker, Jos van Roosmalen
BACKGROUND: The WHO Maternal Near Miss (MNM) approach was developed to evaluate and improve quality of obstetric care worldwide. This study aimed to study the incidence of MNM and quality of care at a district hospital in rural Rwanda by applying this approach. METHODS: A facility based, prospective cohort study conducted at a district hospital in rural Rwanda between June 2013 and December 2014. Subjects were followed from time of admission to discharge or death...
October 21, 2016: BMC Pregnancy and Childbirth
Po C Liu, Yi T Lee, Chun Y Wang, Ya-Tang Yang
We describe a low cost, configurable morbidostat for characterizing the evolutionary pathway of antibiotic resistance. The morbidostat is a bacterial culture device that continuously monitors bacterial growth and dynamically adjusts the drug concentration to constantly challenge the bacteria as they evolve to acquire drug resistance. The device features a working volume of ~10 ml and is fully automated and equipped with optical density measurement and micro-pumps for medium and drug delivery. To validate the platform, we measured the stepwise acquisition of trimethoprim resistance in Escherichia coli MG 1655, and integrated the device with a multiplexed microfluidic platform to investigate cell morphology and antibiotic susceptibility...
September 27, 2016: Journal of Visualized Experiments: JoVE
Chris R Triggle, David J Triggle
Preclinical Research With the almost global availability of the Internet comes the expectation of universal accessibility to knowledge, including scientific knowledge-particularly that generated by public funding. Currently this is not the case. In this Commentary we discuss access to this knowledge, the politics that govern peer review and publication, and the role of this knowledge as a public good in medicine. With the almost global availability of the Internet comes the expectation of universal accessibility to knowledge, including scientific knowledge-particularly that generated by public funding...
October 21, 2016: Drug Development Research
Yushu Yin, Georgia Papavasiliou, Olga Y Zaborina, John C Alverdy, Fouad Teymour
The human gastrointestinal tract is the primary site of colonization of multidrug resistant pathogens and the major source of life-threatening complications in critically ill and immunocompromised patients. Eradication measures using antibiotics carry further risk of antibiotic resistance. Furthermore, antibiotic treatment can adversely shift the intestinal microbiome toward domination by resistant pathogens. Therefore, approaches directed to prevent replacement of health promoting microbiota with resistant pathogens should be developed...
October 19, 2016: Annals of Biomedical Engineering
Peter Nilsson
A number of chronic disease conditions tend to cluster in families with an increased risk in first-degree relatives, but also an increased risk in second-degree relatives. This fact is most often referred to as the heritability (heredity) of these diseases and explained by the influence of genetic factors, or shared environment, even if the more specific details or mechanism leading to disease are not known. New methods have to be explored in screening studies and register linkage studies to define and measure consequences of a positive family history of disease...
September 2016: Journal of Hypertension
Kim Robyn Kennedy, Assoc Prof Kirsten Auret
BACKGROUND: Febrile neutropenia is a life-threatening complication of chemotherapy. The widely dispersed population of Australia creates challenges for rural patients in accessing healthcare services. Cancer treatment is particularly burdensome with patients being forced to relocate to the city for treatment, or to endure long and repeated journeys to the city. This study aimed to assess the safety of chemotherapy in a rural centre with a General Physician-led model, by analysing febrile neutropenia in Albany Hospital, a regional cancer centre in Western Australia...
October 18, 2016: Internal Medicine Journal
Martin Carberry, John Harden
Early identification of patients with sepsis is key to the delivery of the sepsis 6 bundle including antibiotic therapy within an hour.[1-3] Demand versus capacity challenges in the Emergency Department (ED) led to delays in antibiotic and sepsis 6 delivery. An alerting tool was developed that provided criteria for Scottish Ambulance Service (SAS) Paramedics to alert the ED of potential sepsis patients. Data from patients presenting to the ED prior to the alerting process commencing (n=50) and during alerting (n=50) were analysed, a questionnaire was used to ascertain feedback from all staff groups; nurses doctors, and paramedics (n=38)...
2016: BMJ Quality Improvement Reports
Christopher A Benner, Erika Mora, Emily Mueller, F Jacob Seagull, Kelly Walkovich, Kaleena Johnson, Schuyler Halverson, Ed Rothman, George Hucks, John G Younger, Michele M Nypaver
OBJECTIVES: Febrile neutropenic pediatric patients are at heightened risk for serious bacterial infections, and rapid antibiotic administration (in <60 minutes) improves survival. Our objectives were to reduce the time-to-antibiotic (TTA) administration and to evaluate the effect of overall emergency department (ED) busyness on TTA. METHODS: This study was a quality improvement initiative with retrospective chart review to reduce TTA in febrile children with underlying diagnosis of cancer or hematologic immunodeficiency who visited the pediatric ED...
October 4, 2016: Pediatric Emergency Care
Rima Rachid, Talal A Chatila
PURPOSE OF REVIEW: The rise in the prevalence of food allergy over the past decades has focused attention of factors that may impact disease development, most notably the gut microbiota. The gut microbial communities play a crucial role in promoting oral tolerance. Their alteration by such factors as Cesarean section delivery, diet and antibiotics may influence disease development. This review highlights recent progress in our understanding of the role of the gut microbiota in the development of food allergy...
September 28, 2016: Current Opinion in Pediatrics
Kam Lun Hon, Michael Ho Ming Chan, Ming Him James Ng, Chi Cheung Ho, Yin Ching Kathy Tsang, Wing Hung Tam, Chung Shun Ho
OBJECTIVE: Maternal drug abuse may influence neonatal outcomes. We compared neonatal outcomes of patients with urine screened positive for commonly abused drugs (CAD) versus those who were screened negative, and reviewed the pattern of drugs detected at a university teaching hospital. METHODS: Urine samples collected from babies with suspected illicit drug exposure who were admitted to the neonatal unit were sent for comprehensive drug screen (CDS) performed by liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS)...
October 10, 2016: Current Clinical Pharmacology
Paul M Arnaboldi, Mariya Sambir, Christina D'Arco, Lauren A Peters, Jos F M L Seegers, Lloyd Mayer, Alison A McCormick, Raymond J Dattwyler
Yersinia pestis, one of history's deadliest pathogens, has killed millions over the course of human history. It has attributes that make it an ideal choice to produce mass casualties and is a prime candidate for use as a biological weapon. When aerosolized, Y. pestis causes pneumonic plague, a pneumonia that is 100% lethal if not promptly treated with effective antibiotics. Currently, there is no FDA approved plague vaccine. The current lead vaccine candidate, a parenterally administered protein subunit vaccine comprised of the Y...
October 13, 2016: Vaccine
Zhicheng Wang, Jia Nong, Robert B Shultz, Zhiling Zhang, Veronica J Tom, Ravi K Ponnappan, Yinghui Zhong
Many mechanisms contribute to the secondary injury cascades following traumatic spinal cord injury (SCI). However, most current treatment strategies only target one or a few elements in the injury cascades, and have been largely unsuccessful in clinical trials. Minocycline hydrochloride (MH) is a clinically available antibiotic and anti-inflammatory drug that has been shown to target a broad range of secondary injury mechanisms via its anti-inflammatory, anti-oxidant, and anti-apoptotic properties. However, MH is only neuroprotective at high concentrations...
October 5, 2016: Biomaterials
Nour Zoaby, Janna Shainsky-Roitman, Samah Badarneh, Hanan Abumanhal, Alex Leshansky, Sima Yaron, Avi Schroeder
Injectable drug delivery systems that autonomously detect, propel towards, and ultimately treat the cancerous tissue, are the future of targeted medicine. Here, we developed a drug delivery system that swims autonomously towards cancer cells, where it releases a therapeutic cargo. This platform is based on viable bacteria, loaded with nanoparticles that contain the chemotherapeutic-antibiotic drug doxorubicin. The bacteria ferry across media and invade the cancer cells, increasing their velocity in the presence of nutrients that are present within the tumor microenvironment...
October 12, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Leise Riber, Mette Burmølle, Martin Alm, Stefan M Milani, Peter Thomsen, Lars H Hansen, Søren J Sørensen
The spread of antimicrobial resistance, usually mediated by horizontal transfer of plasmids, limits the options of treating bacterial infections and thereby poses a crucial human health problem. The disturbance of plasmid stability within bacterial species in clinical environments serves as a novel strategy to reduce the development and dissemination of antibiotic resistance. We tested the ability of irgasan to destabilize plasmids from Escherichia coli K-12 cells when added directly into liquid growth medium at concentrations below levels of marked bacterial growth inhibition, or when released into liquid growth medium from irgasan-impregnated Interpenetrating Polymer Network (IPN) silicone hydrogel objects, a novel technology developed as drug-delivery platform...
October 12, 2016: Plasmid
Marcus J Goudie, Benjamin M Brainard, Chad W Schmeidt, Hitesh Handa
Infection and thrombosis are the two leading complications associated with blood contacting medical devices, and have led to active materials that can delivery antibiotics or antithrombotic agents. Two key characteristics of these materials are the ability to produce controlled delivery, as well as minimal systemic delivery of the agent outside of the device site. Nitric oxide (NO) releasing materials are attractive as NO plays pivotal roles in the body's natural defense against bacterial infection, as well as regulation of platelet adhesion and activation...
October 14, 2016: Journal of Biomedical Materials Research. Part A
Giuseppe Losurdo, Mariabeatrice Principi, Andrea Iannone, Enzo Ierardi, Alfredo Di Leo
Celiac disease (CD) is the most common autoimmune enteropathy, triggered by a deregulated immune response to gliadin. It has been hypothesized that human intestinal microbiota may interfere with the pathogenesis of the disease and in the clinical course of CD. In the present review, we analyzed the microbiota alterations observed in the course of CD, how they may influence the pathogenesis of CD, and the possible applications for a microbiota modulation in CD. In detail, most of the current literature underlined that the dysbiosis in CD is hallmarked by an increase in gram-negative and Bacteroidetes species, and by a decrease in Bifidobacteria and Lactobacilli...
November 2016: Journal of Clinical Gastroenterology
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