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The resistance mechanisms of bacteria against ciprofloxacin and new approaches for enhancing the efficacy of this antibiotic
No full textFor around three decades, the fluoroquinolone (FQ) antibiotic ciprofloxacin has been used to treat a range of diseases, including chronic otorrhea, endocarditis, lower respiratory tract, gastrointestinal, skin and soft tissue, and urinary tract infections. Ciprofloxacin's main mode of action is to stop DNA replication by blocking the A subunit of DNA gyrase and having an extra impact on the substances in cell walls. Available in intravenous and oral formulations, ciprofloxacin reaches therapeutic concentrations in the majority of tissues and bodily fluids with a low possibility for side effects. Despite the outstanding qualities of this antibiotic, Salmonella typhi, Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa have all shown an increase in ciprofloxacin resistance over time. The rise of infections that are resistant to ciprofloxacin shows that new pharmacological synergisms and derivatives are required. To this end, ciprofloxacin may be more effective against the biofilm community of microorganisms and multi-drug resistant isolates when combined with a variety of antibacterial agents, such as antibiotics from various classes, nanoparticles, natural products, bacteriophages, and photodynamic therapy. This review focuses on the resistance mechanisms of bacteria against ciprofloxacin and new approaches for enhancing its efficacy
COVID-19 Vaccination, Peltzman Effect and Possible Increase in High-risk Behaviors: A Growing Concern Related to Risk Compensation and Reduced Compliance to Public Health Protective Measures after Vaccines Rollout
No full textThe world is still faced with widespread dissemination and many unanswered questions related to Coronavirus disease (COVID-19). Several candidate vaccines have been introduced against COVID-19, mostly requiring the injection of two doses and some with nearly 90-95 efficacy. All strategies against the spread of infection have focused on breaking the chain of virus transmission through protective public health measures and mass vaccination. The current situation emphasizes the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory (Peltzman Effect) states that the decrease in perceived risk through access to preventive measures may lead to increasing frequency of risky behaviors. The current pandemic has exposed people to the sense of risk compensation and behavior change in response to the perceived risk. Risk compensation phenomenon may significantly reverse the benefits of COVID-19 vaccination, especially if the vaccine is not sufficiently effective in real life or among high-risk populations. Recognition and awareness of Peltzman risk compensation are of high importance in counteracting and neutralizing the false complacency of the community, which also lends more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important to encourage mass vaccination of the population, and other NPIs must be re-established and implemented to ensure education to live with COVID-19 in parallel with daily activities and job tasks. © 2022 Bentham Science Publishers
The role of Th22 cells, from tissue repair to cancer progression
No full textCD4(+) T helper (Th) cells play a significant role in modulating host defense. In the presence of lineage specific cytokine cocktail, Naive CD4(+) T cells can differentiate into several categories with distinct cytokines profile and effector functions. Th22 cells are a recently identified subset of CD4(+) T cell, which differentiate from Naive CD4(+) T in the presence of IL-6 and TNF-alpha. Th22 characterized by the production of interleukin-22 (IL-22) and expression of aryl hydrocarbon receptor (AHR). The main function of Th22 cells is to participate in mucosal defense, tissue repair, and wound healing. However, controversial data have shown that overexpression of IL-22 can lead to pathological changes under inflammatory conditions and tumor progression. This review summarizes our knowledge about the role of Th22 and IL-22 cells in tumor progression through induction of inflammation
In silico Investigation of Lon Protease as a Promising Therapeutic Target
No full textConsidering the widespread occurrence of antibiotic resistance, the need for new therapeutic strategies is inevitable. Bacterial proteases are a broad set of enzymes that play a vital role in cell survival, stress response, and pathogenicity. This in silico study was aimed to focus on the crucial role of Lon protease in the regulation of toxin-antitoxin systems in E. coli and to design inhibitory peptides against the action of this protease. With the help of relevant servers and softwares, the communication network, the evolutionary history, and the interaction of Lon with the corresponding antitoxins were examined, following which the inhibitory peptides were designed against these interactions. The results showed that Lon protease plays a central role in the control of these systems and is a conserved protein, especially among the Enterobacteriaceae family. The docking results of the designed peptides with the Lon protease were significant. This study showed that Lon protease may have the characteristics of a new therapeutic target
Identifying and Explaining the Components Affecting for Design Preparedness Exercises of the Health System in Emergencies and Disasters: A Quality Content Analysis
No full textObjective: Running exercise courses in different sectors of the health system is one of the important steps to prepare and deploy disaster risk management programs. The present study aimed to identify and explain the components affecting the design of preparedness exercises of the health system in disasters. Methods: This study was a qualitative content analysis. Data were collected by purposeful sampling through in-depth and semi-structured individual interviews with 25 health professionals in disasters who had experience in designing, implementing, and evaluating an exercise. The data were analyzed using the content analysis method. Results: The data analysis resulted in the production of 50 initial codes, 12 subcategories, 4 main categories of "Coordination, Command, and Guidance of Exercise," "Hardware and Software Requirements of Exercise," "Organizational Exercise Resources," and "Communication and Exercise Public Information" with the original theme of "Exercise Design." Conclusion: This study provides a clear picture and rich, constructive information on the concept of designing health system preparedness exercises in disasters. The findings of this study can greatly increase the attention of senior managers in all areas of health, especially managers of prehospitals and hospitals who are in the front line of the response to disasters to design standard and scientific preparedness exercises
The status of Streptococcus pneumoniae in Iran compared to the world: a systematic review
No full textIntroduction: Streptococcus pneumoniae is a leading cause of vaccine-preventable deaths worldwide. Sero-epidemiological data on S. pneumoniae is needed in each country to monitor the burden of this important pathogen in each population. The aim of this study was to evaluate the prevalence, antibiotic resistance, prevalent serotypes and virulence factors of S. pneumoniae in Iran, compared to other parts of the world. Methods: A search via Google Scholar, Scopus, PubMed, ISI, Iranmedex, Magiran, SID and ISC was conducted for original articles investigating S. pneumoniae in Iran. The search terms were 'Streptococcus pneumoniae', 'S. pneumoniae', 'prevalence', 'antibiotic resistance', 'antimicrobial resistance', 'typing', 'serotyping', 'virulence factors', 'Iran'. Results: The overall prevalence of invasive pneumococcal disease had an increasing trend in Iran. The most common serotypes amongst Iranian population were 1, 19A, 6A/6B, 23F, 14,18C, 20, 19, 3, 6, 9V, 11A and 19F. Resistance to penicillin and co-trimoxazole had significant decreasing trends whilst resistance to erythromycin was increasing although insignificantly. The most prevalent pneumococcal virulence genes were lytA and pspC. Conclusion: Since pneumococcal serotypes differ in invasiveness, virulence, and antibiotic resistance it is important to closely monitor the changes on evolving serotypes, antibiotic resistance and virulence factors of this pathogen to be able to implement suitable prevention and therapeutic strategies. Copyright (C) 2022 Wolters Kluwer Health, Inc. All rights reserved
Worldwide prevalence of microbial agents' coinfection among COVID-19 patients: A comprehensive updated systematic review and meta-analysis
No full textBackground To provide information about pathogens' coinfection prevalence with SARS-CoV-2 could be a real help to save patients' lives. This study aims to evaluate the pathogens' coinfection prevalence among COVID-19 patients. Method In order to find all of the relevant articles, we used systematic search approach. Research-based databases including PubMed, Web of Science, Embase, and Scopus, without language restrictions, were searched to identify the relevant bacterial, fungal, and viral coinfections among COVID-19 cases from December 1, 2019, to August 23, 2021. In order to dig deeper, other scientific repositories such as Medrxiv were probed. Results A total of 13,023 studies were found through systematic search. After thorough analysis, only 64 studies with 61,547 patients were included in the study. The most common causative agents of coinfection among COVID-19 patients were bacteria (pooled prevalence: 20.97; 95 CI: 15.95-26.46; I-2: 99.9) and less frequent were virus coinfections (pooled prevalence: 12.58; 95 CI: 7.31-18.96; I-2: 98.7). The pooled prevalence of fungal coinfections was also 12.60 (95 CI: 7.84-17.36; I-2: 98.3). Meta-regression analysis showed that the age sample size and WHO geographic region did not influenced heterogeneity. Conclusion We identified a high prevalence of pathogenic microorganism coinfection among COVID-19 patients. Because of this rate of coinfection empirical use of antibacterial, antifungal, and antiviral treatment are advisable specifically at the early stage of COVID-19 infection. We also suggest running simultaneously diagnostic tests to identify other microbiological agents' coinfection with SARS-CoV-2
Association between sonographic features of thyroid nodules and cellular examination obtained by fine needle aspiration
No full textBackground: As we know, thyroid nodules are common, but many of them are benign, and this shows that sampling of nodules is not necessary to diagnose benignity.The aim of this article was to determine the diagnostic accuracy of ultrasound features for diagnosing malignant thyroid nodules in patients referred to Fajr infirmary in Ilam. Methods: This descriptive-cross-sectional study was conducted on 122 patients referred to Fajr Ilam Clinic in October 2015 to January 2018.Clinical characteristics such as age, gender, BMI and history of underlying thyroid diseases and Hashimoto's thyroiditis were collected with the help of a questionnaire.The dependence of ultrasound characteristics with thyroid malignancy was determined using a multivariate analysis test. This ultrasound feature was compared with the results of fine needle aspiration cytology and the diagnostic accuracy indices were calculated for each ultrasound feature.This article was conducted using statistical tests, chi-square, independent t-test, Mann-Whitney test, and bivariate logistic regression using Spss software. Results: The study sample included of 30(24.6) malignant and 92(75.4) benign nodules. Hypoechogenicity and microcalcification showed statistically significant positive associations with thyroid malignancy (P0.05). Hypoechogenicity had 63.3 sensitivity and 67.04 specificity, microcalcification had 60 sensitivity and 65.93 specificity. Having at least one good sonographic feature resulted in the highest sensitivity (86.67), while the presence of both features had almost perfect specificity (91.3) and the highest positive likelihood ratio (4.21). Conclusion: According to the results of this article, the presence of Microcalcification variables and Hypoechogenicity are the most important criteria in predicting thyroid malignancy, and they are Locate in the TI-RADS grading. Therefore, nodules larger than 1 cm in size with the characteristics of microcalcification and homogeneity ultrasound should be the main focus of diagnostic evaluations. Copyright © 2022 Hamedi et al.Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences
Evaluating the Genetic Diversity of Helicobacter pylori Isolates in Patients Suffering from Gastritis
No full textBackgrounds: Helicobacter pylori infections vary in severity and virulence in different populations for various reasons. There are different H. pylori strains with varying degrees of virulence. The genetic diversity of H. pylori strains in gastritis patients in different areas has not been well understood. This study aimed to evaluate the prevalence rate and different genotypes of H. pylori strains in clinical specimens of patients with gastritis in Ilam, Iran. Materials & Methods: Saliva and gastric biopsy samples were collected from 81 patients (55 males and 26 females in the age range of 20 to 90 years) referring to Ilam medical centers. After DNA extraction, the prevalence of H. pylori as well as vacA, cagA, and ureC genes was evaluated using PCR, and then each vacA-positive sample was further evaluated for m1m2 and s1s2 variants. Findings: The cagA and vacA genes were found in 27 (71) and 36 (94.7) H. pylori-positive samples, respectively. The cagA gene was detected in patients with gastric pain (44.4) and anorexia (18.51). Also, the results showed that the vacA s2m2 genotype and m2 allele were present in 32.9 of H. pylori isolates. Moreover, s2m2 and s1m2 genotypes were detected in 42.1 and 26.3 of vacA-positive samples, respectively. The lowest frequency was related to the m1 allele (17.18). Conclusion: This study results indicate a plausible relationship between the presence of some genotypes of H. pylori and the progression of gastritis, suggesting these markers as promising biomarkers to predict the disease severity. © 2022, TMU Press