Antimicrobial resistance (AR) is one of the most important public health challenges worldwide as it represents a serious complication that is able to increase the mortality, morbidity, disability, hospital stay and economic burden related to infectious diseases. As such, the spread of AR–pathogens must be considered as an emergency, and interdisciplinary approaches must be undertaken in order to develop not only drugs, but holistic strategies to undermine the epidemic and pathogenic potentials of multi-drug resistant (MDR) pathogens. One of such approaches has focused on the use of antimicrobial nanoparticles (ANPs), as they have demonstrated to possess strong antimicrobial effects on MDR pathogens. On the other hand, the ability of bacteria to develop resistance to such agents is minimal. In this way, ANPs may seem a good choice for the development of new drugs, but there is no certainty about their safety, which may delay its translation to the clinical setting. As MDR pathogens are quickly becoming more prevalent and drug development is slow and expensive, there is an increasing need for the rapid development of new strategies to control such agents. We hereby explore the possibility of designing ANP-based devices such as surgical masks and fabrics, wound dressings, catheters, prostheses, dentifrices, water filters, and nanoparticle-coated metals to exploit the potential of such materials in the combat of MDR pathogens, with a good potential for translation into the clinical setting.
The off-label use of antiviral and antimalarial drugs has been considered by many researchers as a fast and relatively safe alternative to provide therapeutic options to treat COVID-19, but the assessment of such drug-specific effectiveness in this regard is far from complete. Especially, the current body of knowledge about COVID-19 therapeutics needs more data regarding drug effectiveness and safety in the severely ill patients with comorbidities. In the present article, we retrospectively analyze data from 61 patients that received treatment with chloroquine, lopinavir/ritonavir, both drugs administered together, or a standard treatment with no antiviral drugs, and the study was carried in severely ill patients. We found that either drug is ineffective at treating COVID-19, as they are not able to reduce hospitalization length, mortality, C-reactive protein (CRP), lactate dehydrogenase (LDH), d-Dimer, or ferritin, or to enhance gasometric parameters, lymphocytes, total leukocytes, and neutrophil levels, whereas both drugs administered together decrease circulating lymphocytes, increase LDH and ferritin levels, and more importantly, enhance mortality. In this way, our results show that both drugs are ineffective and even potentially harmful alternatives against SARS-CoV-2.
Objective: to assess new strategies in order to promptly diagnose small intestine diverticulitis. Methods: we thoroughly analyzed a case series of small intestine diverticulitis in order to describe three of the typical presentations of such disease (intestinal perforation, intestinal obstruction and obstruction developing perforation). A systematic review of the literature was then conducted in five different scientific databases using six different keywords. Imaging technique's sensitivity for small intestine diverticulitis was assessed, as well as the frequency of signs and symptoms of such pathology. A complete description of the signs and symptoms of acute abdomen-type pathologies was also investigated in order to provide differential traits to distinguish small intestine diverticulitis. Results: No pathognomonic signs or symptoms were detected for the pathology, although we found that all the other pathologies in the “acute abdomen” type of diseases have distinguishing traits that could be used to perform a differential diagnosis of small intestine diverticulitis. Moreover, contrast-enhanced computed tomography is the best imaging technique for the confirmation of such disease, when guided by an initial suspicion. Conclusion: Small intestine diverticulitis cannot be diagnosed by clinical exploration only, but patients that have acute abdomen characteristics, and are negative to signs and symptoms that are characteristic of the other diseases in its type should be suspected for such disease. The aforementioned suspicion may guide a better imaging technique selection and exploration through it.
Lophomoniasis produces dysfunctions in gas interchange that relates with lung infiltration. 2)Lophomoniasis relates with the elevation of renal and hepatic failure markers. 3)Lophomoniasis associates with longlasting immune hyporesponsiveness that may facilitate further respiratory infections.
Nephrolithiasis is a condition that in most cases requires the use of either shock wave lithotripsy or intracorporeal laser lithotripsy. Although both treatments are considered to be non-invasive, or minimally invasive, respectively, some reports have shown that they produce mechanical and/or thermal damage to the renal tissues, and at least the shock wave lithotripsy is also involved in the induction of ischemia-reperfusion at the kidneys. As such, a predominantly innate immune response arises where monocytes/macrophages, natural killer cells and neutrophils are involved in the amplification of kidney damage, whereas M2 macrophages and T-regulatory cells are involved in the mitigation of such inflammation-dependent damage. In this way, the modulation of inflammation during the therapeutic process may be an adequate target to limit lithotripsyinduced kidney injury. However, much specific research is needed in order to propose a pharmacological strategy for this. HighlightsThe safety of a widely-used therapy is discussed.Shock wave lithotripsy produces mechanical damage.Intracorporeal laser lithotripsy produces thermal damage.
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