N-Alkyl-2-Quinolonopyrones Demonstrate Antimicrobial Activity against ESKAPE Pathogens Including Staphylococcus aureus

Antibiotic resistance has grown significantly in the last three decades, while research and development of new antibiotic classes has languished. Therefore, new chemical frameworks for the control of microbial behavior are urgently required. This study presents a novel suite of compounds, based on a tricyclic 4-hydroxy-2H-pyrano[3,2-c]quinoline-2,5(6H)-dione core, with significant antibiotic activity against the ESKAPE pathogens Staphylococcus aureus and Enterococcus faecalis and the “accidental pathogen” Staphylococcus epidermidis. A potent analogue with an N-heptyl-9-t-Bu substitution pattern emerged as a hit with MIC levels ≤2 μg/mL across four strains of MRSA. In addition, the same compound proved highly potent against Enterococcus spp. (0.25 μg/mL).     

Revisión de la evidencia sobre la eficacia de los probióticos en la prevención de las infecciones del tracto urinario inferior y las infecciones vaginales

Objectives

To identify, critically evaluate and describe the available scientific evidence on the efficacy and safety of oral or vaginal administration of probiotics in preventing recurrent urinary tract infections and microbial or fungal vaginal infections.

Methods

An electronic search was performed in PubMed Central, the Cochrane Library and the meta-searcher TRIP databases using the terms: “Lactobacillus”, “probiotics”, “female urogenital diseases”, “urinary tract infections” and “genitourinary infections”.

Results

Of 20 studies that met the selection criteria for this review, a tendency to favor the use of probiotics was observed, especially in the population at high risk of bacterial vaginosis and fungal vulvovaginitis.

Conclusions

Probiotics are a promising option in the prevention of recurrences of lower urinary tract infections. Their use can be recommended as a safe and cost effective option especially in high risk subgroups.     

Success of targeted transperineal biopsy in patients on surveillance for grade group 1 prostate cancer

IntroductionWe aimed to determine the minimum cross-sectional ellipsoid area on magnetic resonance (MR) of intraprostatic nodules that best predicts for subsequent targeted biopsies revealing ≥ grade group (GG) 2 disease.MethodsForty-six patients previously diagnosed with GG 1 prostate adenocarcinoma who received cognitively fused, MR-guided, transperineal targeted biopsies in addition to six random biopsies were included in this analysis. A Youden cutpoint analysis was used to determine the ellipsoid area in the axial plane best predicting for ≥GG 2 disease within the targeted biopsy cores and logistic regression used to assess the result.ResultsMedian time from MR imaging to targeted biopsy was 2.4 (1.4–5.5) months. Forty of 46 (87%) patients had one nodule and 6/46 (13%) had two separate nodules on MR that received targeted biopsy. Of the 52 nodules, five (10%), 33 (63%), and 14 (27%) were Prostate Imaging-Reporting and Data System (PI-RADS) 3, 4, and 5, respectively. Thirteen (25%), six (12%), and 33 (64%) were in the anterior, medial, and posterior regions of the prostate, respectively. Median area was 0.72 (0.49–1.29) cm² (average diameter 9.5 mm). Fifteen of 46 (33%) patients had ≥1 random biopsy and 20/52 (38%) nodules had ≥1 targeted biopsy revealing ≥GG 2 disease. The optimal area cutpoint was ≥0.7 cm², with an area under the curve of 0.671 (0.510–0.832). On logistic regression, area ≥0.7 cm² was solely predictive of targeted biopsy revealing ≥GG 2 disease (odds ratio 6.5, 1.3–32.4, p=0.022).ConclusionsNodule area ≥0.7 cm² may predict for transperineal-based targeted biopsies being positive for ≥GG 2 disease when 1–2 cores are taken.     

Radiation treatment of bladder squamous cell carcinoma in a patient with spina bifida: A case report

Bladder cancer is the sixth most common cancer in Canada. While most patients present with transitional cell carcinoma, few present with squamous cell carcinoma (SCC). Risk factors for SCC include a history of chronic urinary tract infection, urothelial inflammation and indwelling catheters. We present the management of a patient with locally advanced SCC of the bladder.     

Validity and reliability of the Geriatric Anxiety Inventory in Parkinson's disease*†

Aim: To examine the psychometric properties of a novel anxiety rating scale, the Geriatric Anxiety Inventory (GAI) in Parkinson's disease (PD). Method: The predictive validity of the GAI was tested against the presence of any DSM‐IV anxiety disorders in 58 PD patients using receiver operating curve analysis. The concurrent validity of this scale was also studied against the state half of the Spielberger State Trait Anxiety Inventory (STAI). The internal consistency and test–retest reliability of the GAI were also examined. Results: The GAI displayed good concurrent validity against the STAI and the DSM‐IV. It also showed good internal consistency and test–retest reliability. Conclusions: This study suggested that the GAI is an appropriate scale to use in non‐demented PD patients.