Nosocomial infections in the intensive care unit

Nosocomial infection in the intensive care unit (ICU) is associated with increased mortality, morbidity and length of stay. It is defined as infection that begins 48 hours after admission to hospital. The commonest types are ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), urinary catheter-related infection and surgical site infection. The common pathogens include Staphylococcus aureus, Pseudomonas aeruginosa, Candida, Escherichia coli and Klebsiella species. Antimicrobial resistance is increasing and has emerged from selective pressure from antibiotic use and transmission via health workers. Prevention of infection is fundamental and can be achieved through good antimicrobial use and infection control, including hand hygiene. Grouped, easy-to-follow best practice activities called ‘care bundles’ have been developed to prevent VAP and CLABSI. Microbiological cultures are central to rapid and accurate diagnosis, which improves outcomes and reduces resistance. The principles of treatment include early antimicrobial therapy (after appropriate specimens are taken) targeted to the local microbes, then de-escalation according to culture and susceptibility results. This article summarizes the pathogenesis, risk factors, microbiology, diagnosis, prevention and treatment of VAP, CLABSI and nosocomial urinary tract infection in the adult ICU.     

Treatment Implications for Men When Switching From Male to Female Bone Mineral Density Reference Data: The Manitoba Bone Density Program

Since 2001, the International Society for Clinical Densitometry Official Position has been to use a young female normative database in women and a young male normative in men for T-scores. Several prospective studies have shown that men and women with identical hip bone mineral density (BMD) have the same fracture rates, and so there has been reconsideration of whether female reference data should be adopted for men. We studied 4691 men age 50 yr and older with baseline dual-energy X-ray absorptiometry assessments to explore how a change in BMD reference data from male to female would affect the number of men meeting National Osteoporosis Foundation (NOF) intervention criteria. We found that use of male vs female BMD reference data for T-score calculation did affect individual eligibility criteria for treatment under the NOF guidelines, but that overall differences in treatment rates were small when eligibility for treatment considered any of the NOF intervention criteria. Specifically, the majority of men who no longer qualified for treatment based upon T-scores calculated from female as opposed to male reference data would still qualify for treatment based upon other NOF intervention criteria. In addition, men only eligible for treatment under NOF criteria when using male reference data were at low fracture risk. We conclude that choice of male or female reference data for T-score calculation in men has little effect on overall treatment eligibility rates under NOF guidelines.     

Hydrogel cell patterning incorporating photocaged RGDS peptides

As we aim towards enhancing our knowledge of complex cell behaviors and developing intricate cell-based devices and improved therapeutics, it becomes imperative that we be able to control and manipulate the spatial localization of cells. Here we have developed a novel strategy to pattern cells using a hyaluronic acid hydrogel material and photocaged RGDS (Arg-Gly-Asp-Ser) peptides. In this report, we discuss the chemical synthesis and photoactive properties of the caged peptides as well as the subsequent binding of these peptides to our hydrogel base. We further demonstrate the ability of this modified hydrogel material to pattern fibroblast cells on the micron scale using near-UV light exposure through a patterned photomask to selectively switch areas of the hydrogel surface from cell non-adhesive to cell adhesive. The cells are found to adhere and proliferate along the developed line patterns for at least 2.5 days, demonstrating significantly enhanced pattern longevity in comparison with previously reported studies.     

Potential of the bioflavonoids in the prevention/treatment of ocular disorders

Objectives Flavonoids are a common group of plant polyphenols that give colour and flavour to fruits and vegetables. In recent years, flavonoids have gained importance in the pharmaceutical field through their beneficial effects on human health and are widely available as nutritional supplements. Several pharmacological actions of the bioflavonoids may be useful in the prevention or treatment of ocular diseases responsible for vision loss such as diabetic retinopathy, macular degeneration and cataract. This review aims to summarize the potential therapeutic applications of various bioflavonoids in different ocular diseases and also discusses delivery of these agents to the ocular tissues. Key findings It is apparent that the flavonoids are capable of acting on various mechanisms or aetiological factors responsible for the development of different sight threatening ocular diseases. From a drug delivery perspective, ocular bioavailability depends on the physicochemical and biopharmaceutical characteristics of the selected flavonoids and very importantly the route of administration. Summary The potential therapeutic applications of various bioflavonoids in ocular diseases is reviewed and the delivery of these agents to the ocular tissues is discussed. Whereas oral administration of bioflavonoids may demonstrate some pharmacological activity in the outer sections of the posterior ocular segment, protection of the retinal ganglionic cells in vivo may be limited by this delivery route. Systemic or local administration of these agents may yield much higher and effective concentrations of the parent bioflavonoids in the ocular tissues and at much lower doses.     

Therapeutic effect of <Emphasis Type="Italic">Linum usitatissimum</Emphasis> (flaxseed/linseed) fixed oil on acute and chronic arthritic models in albino rats

The aim of the study was to evaluate the antiulcer activity of Linum usitatissimum fixed oil against aspirin-, indomethacin-, ethanol-, reserpine-, serotonin- and stress-induced gastric ulceration in rats and histamine-induced gastric ulceration in guinea pigs. Attempts were also made to evaluate the in vitro anticholinergic and antihistaminic activity and in vivo antisecretary and antiulcer activity of oil following pylorus ligation in rats. L. usitatissimum fixed oil exhibited significant antiulcer activity against different ulcerogens in experimental animal models. The fixed oil significantly inhibited acetylcholine- and histamine-induced contraction of guinea pig and rat ileums, respectively, suggesting its anticholinergic and antihistaminic activity. The oil also exhibited significant inhibitory effect on gastric secretion/total acidity and aspirin-induced gastric ulceration in pylorus-ligated rats. The lipoxygenase inhibitory, histamine antagonistic and antisecretory (anticholinergic) effects of the oil could probably have contributed towards antiulcer activity. L. usitatissimum fixed oil may be considered to be a drug of natural origin which possesses significant antiulcer activity. The present observation is the first experimental data showing antiulcer activity of L. usitatissimum fixed oil.