After completing this course, the reader will be able to:1. Carry out three communication tasks that improve the accuracy of interpretation and increase patient understanding.2. Provide recommendations for working collaboratively with medical interpreters.3. Overcome common sources of misunderstanding that result from language and cultural barriers.This article is available for continuing medical education credit at CME.TheOncologist.com. Professional medical interpreters play a crucial role in mediating language-discordant encounters between cancer patients and oncologists. Trained interpreters allow for timely information exchange that is both accurate and culturally sensitive. Rising numbers of immigrants will increase the demand for interpreters. Medical oncologists need to respond by establishing collaborative practices with interpreters or using remote interpretation services. The article provides specific recommendations for working with medical interpreters and reviews common areas of concern for patients and healthcare professionals facing language and cultural barriers. The Oncologist
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ABSTRACT
Salmonella belongs to the Enterobacteriaceae family which is widely distributed in the environment due to its adaptive capacity to stress conditions. In addition, Salmonella is able to perform a type of cell-to-cell communication called quorum sensing, which leads to differential gene expression. The quorum sensing system mediated by AI-1, acyl homoserine lactones (AHLs), is incomplete in Salmonella because the luxI homolog gene, which encodes for AI-1 synthase, is missing in the genome. However, a homologue of LuxR, known as SdiA, is present and allows the detection of signaling molecules produced by other species of bacteria, leading to regulation of gene expression, mainly related to virulence and biofilm formation. Thus, in view of the importance of quorum sensing on the physiology regulation of microorganisms, the aim of the present study was to perform a virtual screening of plant compounds and nonsteroidal anti-inflammatory drugs (NASIDs) for inhibition of quorum sensing by molecular docking and biofilm formation in Salmonella. In general, most plant compounds and all NSAIDs bound in, at least, one of the three modeled structures of SdiA proteins of Salmonella Enteritidis PT4 578. In addition, many tested compounds had higher binding affinities than the AHLs and the furanones which are inducers and inhibitors of quorum sensing, respectively. The Z-phytol and lonazolac molecules were good candidates for the in vitro inhibition tests of quorum sensing mediated by AI-1 and biofilm formation in Salmonella. Thus, this study directs future prospecting of plant extracts for inhibition of quorum sensing mechanism depending on AHL and biofilm formation. In addition, the use of inhibitors of quorum sensing and biofilm formation can be combined with antibiotics for better treatment efficacy, as well as the use of these compounds to design new drugs.
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