Antimicrobial mechanisms of ortho-phthalaldehyde action

Biocides generally have multiple biochemical targets. Such a feature easily entangles the analysis of the mechanisms of antimicrobial action. In this study, the action of the dialdehyde biocide ortho-phtalaldehyde (OPA), on bacteria, was investigated using the Gram-negative Pseudomonas fluorescens. The targets of the biocide action were studied using different bacterial physiological indices. The respiratory activity, membrane permeabilization, physico-chemical characterization of the bacterial surfaces, outer membrane proteins (OMP) expression, concomitant influence of pH, contact time and presence of bovine serum albumin (BSA) on respiratory activity, morphological changes and OPA-DNA interactions were assessed for different OPA concentrations. With the process conditions used, the minimum inhibitory concentration was 1500 mg/l, the concentration to promote total loss of bacterial culturability was 65 mg/l and the concentration needed to inactivate respiratory activity was 80 mg/l. These data are evidence that culturability and respiratory activity were markedly affected by the biocide. OPA lead, moreover, to a significant change in cell surface hydrophobicity and induced propidium iodide uptake. Such results suggest cytoplasmic membrane damage, although no release of ATP was detected. At pH 5, the bactericidal action of OPA was stronger, though not influenced by BSA presence. Nevertheless, at pH 9, BSA noticeably (p < 0.05) impaired biocide action. A time-dependent effect in OPA action was evident when contemplating respiratory activity variation, mainly for the lower exposure times. Scanning electron microscopy allowed to detect bacterial morphological changes, translated on cellular elongation, for OPA concentrations higher than 100 mg/l. Interferences at DNA level were, however, restricted to extreme biocide concentrations. The overall bactericidal events occurred without detectable OMP expression changes. In conclusion, the results indicated a sequence of events responsible for the antimicrobial action of OPA: it binds to membrane receptors due to cross-linkage; impairs the membrane functions allowing the biocide to enter through the permeabilized membrane; it interacts with intracellular reactive molecules, such as RNA, compromising the growth cycle of the cells and, at last, with DNA.     

Mild balanoposthitis.

AIM--To identify and study cases of mild balanoposthitis (MBP) with penile pathology among patients observed at a dermatology clinic over an 18-month period. MATERIALS--The study included 321 patients with penile pathology. The term MBP was used to describe balanoposthitis of a localised, inflammatory nature with few, non-specific symptoms and a tendency to become chronic or recur. Two hundred and seventy had diseases clearly identifiable by clinical examination or laboratory tests; 51 cases were diagnosed as MBP and these patients had blood tests (to evaluate immune status) and microbiological examination; when these proved negative, a series of patch tests was also used. RESULTS--Of the 51 patients diagnosed as having MBP, the cause was ascertained in 34 cases (infection, mechanical trauma, contact irritation, contact allergy, etc.), whereas no specific aetiological factor was detected to explain the symptoms in the remaining 17 cases.     

Behavior of Eosinophil Counts in Recovered and Deceased COVID-19 Patients over the Course of the Disease

Knowledge about the immune responses against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, particularly regarding the function of eosinophils, has been steadily emerging recently. There exists controversy regarding the implications of eosinophils in the coronavirus disease 2019 (COVID-19)’s pathology. We report a retrospective cohort study including the comparison of leukocyte counts in COVID-19 patients, considering the outcomes of recovery (n = 59) and death (n = 60). Among the different types of leukocytes, the eosinophil counts were those that showed the greatest difference between recovered and deceased patients. Eosinopenia (eosinophil count < 0.01 × 10⁹/L) was more frequently observed in deceased than recovered patients (p = 0.0012). The eosinophil counts more rapidly increased and showed a greater proportion over the course of the disease in the recovered than deceased patients. Furthermore, the estimated survival rate was greater in patients without eosinopenia than in patients with eosinopenia (p = 0.0070) during hospitalization. Importantly, recovered but not deceased patients showed high negative correlations of the eosinophils with the neutrophil-to-lymphocyte ratio (NLR) and neutrophil counts at Day 9 of the onset of clinical symptoms (p ≤ 0.0220). Our analysis suggests that eosinopenia may be associated with unfavorable disease outcomes and that the eosinophils have a beneficial function in COVID-19 patients, probably contributing by controlling the exacerbated inflammation induced by neutrophils.     

Neonatal anthropometry at 3400 m above sea level compared with INTERGROWTH 21st standards*

Objective: To determine the 3rd, 10th, 50th, 90th and 97th percentile of weight, length and head circumference (HC) of male and female neonates born at 3400 m above sea level and compare with published INTERGROWTH 21st standards.

Methods: Observational, transverse analytical study conducted in the National Hospital Adolfo Guevara Velazco of the ESSALUD hospital system in Cusco, Peru, at 3400 m altitude, during the period of January 2005 to December 2010. Using inclusion criteria, 7635 newborns were selected. The 3rd, 10th, 50th, 90th and 97th percentiles for the anthropometric measurements of birthweight, length and HC were determined for each sex and the results analyzed via polynomial regression for each percentile in order to compare the results with INTERGROWTH 21st standards.

Results: No statistically significant difference was observed with the exception of female HC at the 97th percentile when compared with the INTERGROWTH 21st standards.

Conclusions: Based on tables generated in the present study, neonatal anthropometric percentiles at term at 3400 m above sea level demonstrate no appreciable difference with INTERGROWTH 21st standards with the exception of female HC at the 97th percentile.