Recent studies have proven several promising anticancer activities for cold atmospheric plasma (CAP) against a wide range of cancer cells in vitro. Recently, media treated with CAP have also found to effectively eradicate cancer cells similar to the CAP. Based on advantages, many researchers prefer to apply CAP-activated media (PAM) as an alternative to cap in the treatment of cancer. However, less has been achieved regarding the anticancer effects and anticancer mechanisms of PAM. Investigating the selective anticancerous activities of PAM, the viability of SKBR3, MCF7, ASPC-1, A-549, G-292, and SW742 cancer cell lines, as well as normal human skin fibroblasts (FMGB-1) and MCF10A cells in relation to the media activation time, and the length of exposure was studied. Also, we examined the concentration of ozone in media as a function to CAP activation time since recent studies have proposed ozone as a pivotal reactive species in the induction of cell death. Based on the result, both increasing the duration of media activation time and the length of exposure to PAM could significantly increase the anticancer activity.Nevertheless, the cytotoxicity on normal cells was either not affected or slightly increased. Among the six tested cancer cell lines, SW742 was the most resistant and SKBR3 the most susceptible cancer cell lines to PAM. Also, increasing duration of treatment with CAP resulted in a significant rise in O 3 concentration levels in media.Overall, these results suggest PAM, as a promising tool in the treatment of different cancers and O 3 formation as a probable underlying mechanism.
In this report we present the clinical features and the treatment of three children with multidrug-resistant (MDR) Acinetobacter baumannii meningitis. All three patients were referred to the Department of Pediatrics from the Department of Neurosurgery, Ankara University Medical Faculty. The clinical, laboratory and treatment characteristics of these patients are summarized in Table 1. For all patients, MDR A. baumannii meningitis was diagnosed with cerebrospinal fluid (CSF) culture isolates susceptible to colistin and resistant to other antibiotics including aminoglycosides, carbapenems, ciprofloxacin, sulbactam and piperacillin-tazobactam.Case 1: A 3-year-old girl with choroid plexus papilloma underwent surgery for the placement of a ventriculostomy catheter. Ceftriaxone was administered during surgery for prophylaxis. She had a fever (39°C) on day 7 of surgery and CSF examination showed white blood cells of 400/mm 3 , red blood cells of 10/mm 3 , protein of 60 mg/dL and glucose of 12 mg/dL and microscopic examination revealed gram-negative coccobacilli. With these results, diagnosis of meningitis was made and the patient was started on meropenem (120 mg/kg/day divided q8h) intravenously. The ventriculostomy catheter was also replaced. With the report of MDR A. baumannii grew from the CSF cultures on the second day of treatment, intravenous ampicillin-sulbactam (400 mg/kg/day divided q6h), intravenous amikacin (22.5 mg/kg/day divided q12h) and peroral rifampin (20 mg/kg/day) were added to the antibiotic regimen. CSF cultures taken on day 5 and 10 of the combination treatment remained positive for MDR A. baumannii and the antibiotic susceptibilies of these following cultures were the same as the first isolate. Intravenous colistin (50,000 IU/kg/day divided q8h) and intrathecal colistin (125,000 IU/d) was initiated on day 5 of the treatment. On day 14 meropenem, amikacin and rifampin were stopped and ampicillin-sulbactam and colistin were continued for 45 days without any serious side effects. After the sterilization of CSF (5 days after the initiation of colistin therapy) a ventriculoperitoneal shunt (VPS) was placed instead of ventriculostomy catheter.Case 2: A 14-year-old girl with medulloblastoma had a fever (39.3°C) on day 3 following intracranial surgery. She also received ceftriaxone for prophylaxis during surgery. The CSF examination showed white blood cells of 120/mm 3 , red blood cells of 10/mm 3 , protein of 114 mg/dL and glucose of 14 mg/dL. With the diagnosis of meningitis, intravenous meropenem (120 mg/kg/day divided q8h) and intravenous vancomycin (60 mg/kg/day divided q6h) were initiated. On the third day of treatment, after the confirmation of the presence of MDR A. baumannii in CSF cultures, vancomycin was changed to intravenous ampicillin-sulbactam (400 mg/kg/day divided q6h) and peroral rifampin (20 mg/kg/day) was added. The CSF became sterile 4 days after the initiation of ampicillin-sulbactam and rifampin. The patient was cured after a 4-week course of meropenem, ampicillin-sulbactam and rifa...
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