Molecular typing of Clostridioides difficile isolates from clinical and non‐clinical samples in Iran

Clostridioides difficile is a major cause of nosocomial infectious diarrhea in hospitalized patients throughout the world. We aimed to characterize C. difficile isolates among hospitalized patients, hospital staffs, and hospital environment samples obtained in three tertiary care hospitals of Iran with regard to their molecular types between June 2016 and November 2017. The toxigenicity of C. difficile isolates was determined by toxigenic culture and multiplex‐PCR. Toxigenic C. difficile isolates collected were ribotyped using capillary gel electrophoresis‐based PCR and the database of WEBRIBO ( http://webribo.ages.at ). Of 500 clinical and non‐clinical samples, toxigenic C. difficile were identified in 35 of 250 stool samples (14%) and in 3 of 250 swabs (1.2%). The most frequently found ribotypes (RTs) were 039, AI‐12, and AI‐21 (15.8, 10.52, and 10.52% of all isolates, respectively). Further RTs were: 017, 001, AI‐3, AI‐15, AI‐18, AI‐10, AI‐4, and PR21195 (as new ribotype). The epidemic RTs (027 and 078) seen in the Europe, North America, and Asia were completely absent in this study.     

Effect of anodal and cathodal microamperage direct current electrical stimulation on injury potential and wound size in guinea pigs

Injury potential may have a regulatory role in the wound healing process, and exogenous electrical stimulation (ES) may mimic natural endogenous bioelectric current that can improve wound healing. Until now, the influence of externally applied ES on injury potential has not been demonstrated during the healing of acute wounds. Thirty-nine male guinea pigs were randomly divided into a control group (sham treatment) and two experimental groups: anodal and cathodal direct current (DC). A 2.5 cm-long full-thickness skin incision was made on each animal's dorsal region. Differential skin surface potential was measured before and immediately after the injury and also through day 21 of the healing period; wound surface area (WSA) was also measured throughout the 21-day healing period. Immediately after injury, wound potential significantly increased in all three groups, reaching a maximum on day 1 for the control and cathodal groups and day 3 for the anodal group (p < 0.05), then decreasing through the healing period. Wound potential returned to preinjury levels by the end of the healing period in the anodal group only. By days 19 and 21, wound potential had decreased more for the anodal group than the control group (p < 0.05). By day 15 for the anodal group and day 17 for the cathodal group, WSA had decreased more compared with the control group (p < 0.05). Anodal microamperage DC ES is appropriate for improving the healing of acute skin wounds because it causes both the wound surface to close and the wound potential to return to preinjury levels faster.     

From genes polymorphisms to mucosal expression of cytokines: evaluating IL-23/IL-17 axis in adult patients with gastritis

Background and ObjectiveChronic inflammation is the typical sign of gastritis that may shift into gastric cancer. IL-17A and IL-17F as a novel inflammatory cytokines subset of CD4+Th play the main role in inflammation. A key cytokine receptor in the inflammatory IL-17/IL-23 axis, the interleukin 23 receptor (IL23R), may be related to gastritis. We evaluated the correspondence between IL-17A G197A, IL-17F A7488G and IL23R+2199 A/C polymorphisms with TGF-β1, IL-6, IL-17, IL-21 and IL-23 mucosal mRNAs expression in uninfected H. Pylori (HP) chronic gastritis patients.Materials and MethodsTotal RNA and genomic DNA were separated from gastric biopsies of 44 patients with gastritis. Subsequently, mucosal mRNAs expression of TGF-β1, IL-6, IL-17, IL-21 and IL-23 were assessed by real-time PCR. To polymorphisms determination of IL-17A G197A, IL-17F A7488G and IL-23R +2199A/C the PCR-RFLP was used in gastric biopsies.ResultsResults point that IL-17A G197A, IL-17F A7488G and IL23R +2199A/C polymorphisms did not influence the mucosal expression of TGF-β1, IL-6, IL-17 and IL-21 (p> 0.05). In an opposite result, we don''t find a correspondence between IL-17A G197A, IL-17F A7488G polymorphisms and mucosal expression of IL-23 (p> 0.05). In a contrary, we found a correlation between IL23R +2199A/C polymorphism and mucosal expression of IL-23 in patients with chronic gastritis (p< 0.05).ConclusionThese findings propose that IL23R +2199A/C polymorphism may change the mucosal expression of IL-23 pattern in patients with gastritis disease in the absence of HP, but to support the conclusion, more research may be required.     

Simultaneous fault detection and control design for switched linear systems based on dynamic observer

The problem of simultaneous fault detection and control (SFDC) for linear continuous‐time switched systems is addressed in this paper. An H _∞ formulation of the SFDC problem using dynamic observer is presented. In essence, a single unit called detector/controller depending on the system modes is designed, where the detector is a dynamic observer, and the controller is a state feedback controller based on the dynamic observer. It is shown that the dynamic observer can be used effectively to tackle the drawbacks of the existing methods of SFDC design. Extended linear matrix inequalities (LMIs) characterization is used to reduce the conservativeness by introducing additional matrix variables, so as to eliminate the coupling of Lyapunov matrices with the system matrices. Indeed, the idea presented in this paper is based on average dwell time and conservatism reduction approaches and applying the advantages of dynamic observers, which leads to some sufficient conditions for solvability of the SFDC problem in terms of LMI feasibility conditions. Simulation results illustrate the effectiveness of the proposed design methodology. Copyright © 2011 John Wiley & Sons, Ltd.     

Vaccine against Helicobacter pylori : Inevitable approach

Over three decades have passed since the discovery of Helicobacter pylori(H. pylori), and yet many questions about its treatment remain unanswered. For example, there is no certainty regarding continued use of current antibiotic therapy against H. pylori. The bad news is that even combined regimens are also unable to eradicate bacterial colonization. The worst problem with H. pylori chemotherapy is that even if we identify the most successful regimen, it cannot eliminate the risk of re-infection. This problem is further complicated by the fact that clinicians have no information as to whether probiotics are useful or not. Moreover, to date, we have no large scale produced vaccine effective against H. pylori. Due to the relatively rapid and abundant dissemination of guidelines globally reported concerning management of gastric cancer prevention and therapeutic regimens, clinicians may choose a vaccine as better effective weapon against H. pylori. Therefore, a radical shift in adopted strategies is needed to guide ultimate decisions regarding H. pylori management. In light of failures in vaccine projects, we should identify better vaccine design targeting conserved/essential genes. The unique character and persistence of H. pylori pose obstacles to making an effective vaccine. Preferably, in developing countries, the best reasonable and logical approach is to recommend prophylactic H. pylori vaccine among children as an obligatory national program to limit primary colonization. Trying to produce a therapeutic vaccine would be postponed until later. In reality, we should not forget to prescribe narrow spectrum antibiotics. In the current review, I draw a route to define the best adopted strategy against this rogue bacterium.