In this work, we report the development of an impedimetric biosensor for the direct, quick, and easy diagnosis of chronic Q fever. The biosensor is based on highly sensitive antigens that can selectively recognize antibodies against Coxiella burnetii. The biosensor is based on the immobilization of antigens onto a gold electrode using the EDC/NHS immobilization methodology. The detection is performed by impedance spectroscopy that monitors specific frequencies which provide the maximum sensitivity for the biosensor. Q fever antibodies that are present in the sera of patients interact selectively with the biosensor antigens, thereby altering the impedance of the biosensor surfaceand generating a large impedance change within a few seconds. The biosensor allows for the specific serological detection of chronic Q fever, while the developed system can also be modified for the detection of other biomarkers, such as the ones against acute Q fever.
Therapeutic Drug Monitoring (TDM) is potentially a useful tool that can be employed to increase the efficacy and decrease the toxicity of antifungal drugs. The aim of this narrative review is to provide an overview of the current use of TDM in clinical practice, and to present the evidence available regarding its use in proactive clinical settings for preventing and managing treatment failure. This review also presents the existing evidence regarding the association of various clinical outcomes with specific thresholds of drug concentrations in everyday practice. Articles concerning the use of TDM of triazoles in the treatment of fungal infections were retrieved through an electronic search using PubMed. In clinical practice, TDM has an increasingly important role in the management of antifungal drugs as a consequence of the improvement in the knowledge of the pharmacokinetics and pharmacodynamics of these drugs. The currently available evidence shows a direct exposure-response relationship for triazoles, though the PK/PD profile is unpredictable. Current guidelines and treatment consensus statements recommend the proactive TDM of voriconazole, posaconazole, and itraconazole to optimize dosage regimens and improve outcomes for adult and pediatric patients.
Background: Chronic Obstructive Pulmonary Disease (COPD) requires continuous patient management caused by frequent exacerbations with consequent hospitalizations and a worsening of the patient's quality of life.Pulmonary rehabilitation improves exercise tolerance, but many patients do not have access to these programs. Aim:We assumed that 3 months of controlled respiratory training (CRT), providing benefits on well-being in healthy subjects, can represent a valid strategy to improve health status and better disease management in COPD patients. Design: Quality improvement in health careSetting: Outpatients attending the rehabilitation treatment room of a single centre.Population: 34 patients with COPD (according GOLD 2019 classification) were enrolled. Methods:Patients were divided into TREAT group (n = 18, 16 males, age 73.83 ± 6.71 years) and control group (CTR: 13 males, age 74.06 ± 6.38 years).Before and after CRT a battery of psychological questionnaires were assessed.T Results: REAT group in Post-CRT, as compared to CTR, showed a reduction in depressive symptoms (BDI, p<0.05;POMS depression, p<0.05), anger (p<0.01),stress perception (PSS, p<0.05), and anxiety levels (BAI, p=0.05).Also, CRT improved general health (p<0.01) and vitality (p<0.05). Conclusions:This preliminary study demonstrated that CRT is effective to improve quality of life and well-being perception in patients with COPD.Larger studies will need to confirm the long-term clinical and psychological benefits of this holistic approach, addictive to the traditional clinical practice, not only for symptomatic COPD, but also more generally to all patients with chronic diseases. Clinical rehabilitation impact:In clinical settings, for COPD patients, who experience the chronic nature of illness, we propose an additive holistic approach to the traditional clinical practice to improve health-related quality of life, and thus, a better disease management.
Infections with bacteria, viruses, and fungi have been reported in coronavirus disease patients, however, data on these infections are still scarce.These infections are categorized as either community or hospital-acquired infections and may be described as coinfections or secondary/superinfection.The proportion of these infections varied widely across studies.Hospital-acquired infections, especially bacterial or fungal infections, are frequently complicating the course of intensive care unit (ICU) patients and associated with increased morbidity and mortality.The most common hospital-acquired superinfections are ventilator-associated pneumonia, hospital-acquired pneumonia, and bacteremia.The coprevalence of community-acquired secondary bacterial pneumonia and COVID-19 infection is unusual.Co-infection with COVID-19 and tuberculosis (TB) has also been reported.COVID-19 and TB patients frequently experience coughing, fever, and shortness of breath.This can lead to diagnostic confusion as well as worsening stigmatization of TB patients, especially in low-and middle-income countries (LMICs).Empiric antibiotics may not be required in the majority of COVID-19 patients, particularly those not severely ill.Superinfections by antibiotic-resistant bacteria have also been reported among critically ill patients with COVID-19 infection.The most prevalent identified viruses among COVID-19 patients are influenza type A, influenza type B, and respiratory syncytial virus.Patients with severe COVID-19 infection are also at risk for fungal infections such as Aspergillus, Candida, Pneumocystis, or other fungal species, which has been linked to increased morbidity and mortality such as Mucormycosis.
Neonatal hypoglycaemia is a topical problem in neonatology and paediatric endocrinology. In recent years, problems of glycaemia monitoring during first days of life have been discussed as well as the strategy for management of newborns with the syndrome of hypoglycemia and evaluation of metabolism in brain neurons has been a matter of scientific research. Scientific publications regarding the detection rate and duration of low glucose values in the early neonatal period as well as means of their correction and conducted therapy results are very scarce and ambiguous, which determines the necessity of new modern data regarding the problem considered. Purpose of the study: to study the detection rate and dynamics of clinical and laboratory manifestations of hypoglycaemia in children in the early neonatal period in order to optimise observation of newborns at the risk of developing this condition. Materials and methods: an open, retrospective, continuous, single-centre study was conducted to obtain preliminary data important for development of monitoring strategies for newborns at the risk of hypoglycaemia (neonates with high birth weight, children born to mothers with diabetes, newborns with intrauterine growth restriction). The target studied group was constituted by 522 newborns of both genders in the early neonatal period (aged 0 to 7 days). Results: the paper presents data on hypoglycaemia detection rate in newborns with risk factors for hypoglycaemia development, clinical and laboratory features of this condition, dynamics of glycaemia during the early neonatal period as well as the timing of blood glucose stabilisation (the age of normoglycaemia achievement).
Biofilms are a known important contributor to the infectious complications associated with prosthetic mesh implantation. Previous studies have demonstrated the formation of monomicrobial biofilms on surgical mesh materials by different bacterial species in vitro , but a paucity of data exists examining polymicrobial biofilm formation by antibiotic-resistant organisms, which may be more clinically relevant. Therefore, the aim of this study was to evaluate the ability of three clinical bacterial and fungal isolates to form mixed-species and single-species biofilms on five synthetic implant materials in vitro , including monofilament polypropylene, monofilament polyester, multifilament polyester, monofilament polytetrafluoroethylene (PTFE), and silicone. Methicillin-resistant Staphylococcus aureus (MRSA), multidrug-resistant Pseudomonas aeruginosa , and Candida albicans (alone or in combination) were inoculated into culture medium containing meshes and allowed to attach and propagate into mature biofilms for 48 hours at 37 o C. Additional samples were inoculated with Staphylococcus epidermidis for comparison. Biofilm biomass and the number of viable cells were quantified by crystal violet staining and colony forming units (CFU) counting, respectively. Images of polymicrobial biofilms were obtained using fluorescence microscopy of FM ® 1-43-stained meshes. All materials investigated were capable of harboring biofilms, but the relative abundance was dependent upon both material and organism type. Overall, PTFE meshes exhibited the highest levels of polymicrobial biofilm formation. When comparing monomicrobial biofilms, Pseudomonas aeruginosa demonstrated greater biomass than MRSA and Staphylococcus epidermidis on PTFE, polypropylene, and monofilament polyester, while MRSA and Staphylococcus epidermidis biomass did not differ significantly among mesh types. Thus MRSA, Pseudomonas aeruginosa , and Candida albicans can cooperatively form mature biofilms on surgical implant materials, but different mesh constructs vary in their susceptibility to biofilm formation depending upon the organism(s) present. This suggests that the type of implant material chosen for surgical procedures may affect the patient’s wound healing response and clinical outcome, particularly when used in a contaminated environment.
The burn is a physical and psychic trauma causing a modification of the body envelope and a break with the previous life by its complications and its consequences. Care must be comprehensive from first aid to reintegration through early rehabilitation and occupational therapy support centered on the person, his functional abilities, his productivity, and the activity analysis. The aim is to avoid putting the patient out of the way and to help him regain his place at the social, family, and professional level. *Correspondence to: Abdellah EL Marbouh, Department of Physical Medicine and Rehabilitation, Military Instruction-Hospital Mohammed V-Rabat, Morocco, Tel: 212661465522; E-mail: abdou.el.marbouh@gmail.com
The morphological and physiological transformations that occur during pregnancy involve hemodynamic, hormonal and biomechanical adaptations that can generate musculoskeletal disorders and reflect in various physical discomforts. Thus, in this research, the objective was to verify the main musculoskeletal alterations associated with the discomforts of pregnancy through a systematic review of the literature. The study was conducted from November of 2018 to February of 2019, by the PICO strategy, with indexes “Physiotherapy” OR “Posture” AND “Discomfort” AND “Biomechanics” OR “Pregnancy” in PubMed, Scielo and Lilacs databases. After exclusion and inclusion criteria, 25/87 localized articles were selected for data extraction. The hemodynamic, hormonal and biomechanical changes of the pregnant woman reflect in the presence of oedema, increased body weight, ligament laxity and postural changes such as head and shoulder anteriority, hyperlordosis, pelvic anteversion, knee hyperextension, base enlargement, difficulty in the gait that lead to the appearance of musculoskeletal disorders, such as neck pain, thoracic duct syndrome, lower back pain, sacroiliac pain, plantar pressure and also the compromise of postural balance. The study of these disorders provides an indication of persistent pain symptoms during pregnancy and postpartum and knowledge of these changes helps to explain why they occur and the reason for the persistence of this sometimes even limiting pain in the pregnant woman. *Correspondence to: Aline do Nascimento Benitez, School of Medical Sciences and Institute of Computing, University of Campinas, Campinas, São Paulo, Brazil, Tel: + +55 (18) 981993849; E-mail: benitez.alinenascimento@gmail.com
Background: Atherosclerosis is a major factor for cerebrovascular disease development and involves complex interplay between different cell types of the immune system with cells of the vessel wall. It can be measured by assessing the carotid intima media thickness (CIMT). A number of studies have shown variable results on the relationship between 25 (OH) D deficiency and subclinical atherosclerosis. The objectives of the present study were therefore to investigate the relationship between CIMT and Vitamin D status in the North Indian population ≥ 60 years. Methods: Patients aged ≥ 60 years who visited hospital for health check-up were enrolled and analyzed in present study. Results: 61.2 % of the subjects under study were Vitamin D deficient with mean Vitamin D level of 25.1 ± 15.6 ng/mL. The average C-IMT was 0.81 ± 0.27 mm. A significant inverse relationship was found between 25(OH) D concentration and CIMT with p = 0.003. Conclusion: Our data shows an inverse association of 25 (OH) Vitamin D concentration with CIMT in elderly subjects ≥ 60 years. These findings suggest a potential role Vitamin D deficiency in the development of subclinical atherosclerosis.
Type II diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin insensitivity, hyperglycemia, and immune dysregulation. Recent findings have shown that T2DM has a significant impact on the skeletal system, including the impairment of the fracture healing process which commonly leads to nonunion. Throughout the process, heterotypic interactions between different immune cells are required for the recruitment and differentiation of osteogenic cells vital for fracture repair. The purpose of this study was to compare inflammatory gene expression induced in T2DM with those occurring during fracture repair with a specific focus on immune cell expression. Using publicly available RNA-seq datasets and Ingenuity Pathway Analysis (IPA), we compared gene expression profiles of human diabetic and non-diabetic data to gene expression profiles of mice post-fracture. IPA core analysis of diabetic vs. non-diabetic immune gene expression revealed top canonical pathways (p-value < 1.0 x 10-6) involved in the Th1 Activation Pathway, Granulocyte Adhesion and diapedesis, and IL-7 Signaling, had an average activation z-score of -2.373, thus exhibiting a predicted inhibition when compared to non-diabetic controls. Additionally, top upstream inflammatory regulators such as TNF-α, IL-1B, and IL-6 also exhibited an average 3.5 log-fold reduction in expression. When examining gene expression in normal fracture repair, previous upstream inflammatory regulators exhibit an average 2.1 log-fold increase. Our results suggest that during fracture repair, the early immune response required for recruitment of osteogenic cells and repair is impaired in T2DM signaling. *Correspondence to: Sulie L. Chang, Seton Hall University, 400 South Orange Avenue, South Orange, NJ, USA, Tel: 973-761-9456; E-mail: sulie.chang@shu.edu
Our aims were to study the incidence, age at diagnosis, familial aggregation of cancer, clinical presentation...
Received Date: 31 May 2021 Accepted Date: 10 June 2021 Published Date: 15 June 2021 *Corresponding Author: Ozcan Deveci, Batman Medical Park Hospital, Department of Infectious Diseases and Clinical Microbiology, Batman, Turkey, E-mail: ozcandeveci1@hotmail.com Citation: Deveci O (2021). Use of Traditional Medicines for Prevention and Treatment of Covid-19. A Cross-Sectional Survey in Four African Countries. J Corona Virus. 1(2); 1-8
Gastric syphilis is an uncommon disease, presenting nonspecific clinical and histological features.We present a rare case of 17-year-old women who had 2-week abdominal pain and sought for medical help.The patient was diagnosed with gastric syphilis, concomitantly infected with Helicobacter pylori (HP) and human immunodeficiency virus (HIV).The coexistence of HP and Treponema pallidum (TP) in gastric tissue was proved by immunohistochemical (IHC) staining.Multiple infections made diagnosis difficult.Comprehensive analysis of clinical, endoscopic, serological, and histopathologic data can avoid missed diagnosis.
The current research describes the design, synthesis, and in vitro evaluate as DPPIV inhibitors for four new compounds.The design of the new compounds aimed to study the effect of replacing the 2-benzyl-piperazine ring system of a reported potent DPP IV inhibitor, IC 50 of 19 nM, with piperidine and pyrrolidine heterocyclic ring systems.The newly synthesized compounds, along with the lead compound, were studied for docking affinities and mode of interactions with the DPP active site using molecular modelling approach in an attempt to correlate between the binding parameters and the observed in vitro inhibitory activities.Compound (1), a 4-benzylpiperidine derivative, possessed a ΔG value of -8.9 Kcal/mol, and an IC 50 of 1.6 ± 0.04 µM.Compound (2), a 2-benzylpyrrolidine derivative, showed a ΔG value of -9.0 Kcal/mol, and an IC 50 of 0.3 ± 0.03 µM.Compound (3), a phenethyl-piperazine derivative, exhibited a ΔG value of -8.9 Kcal/mol, and an IC 50 of 1.2 ± 0.04 µM.Compound (4), a 4-amino-1-benzylpiperidine derivative, showed a ΔG value of -8.9 Kcal/mol, and an IC 50 of 4 ± 0.08 µM.The study revealed that compound (2), with reduced ring size into pyrrolidine in place of the lead compound piperazine ring, while retaining the benzyl substitution at the 2-position, resulted in the most active inhibitor among the four newly designed compounds; however, with less inhibitory activity in comparison to the reported 2-benzyl-piperazine lead compound.
