scholarly journals Compatibility of evolutionary responses to constituent antibiotics drive resistance evolution to drug pairs

2021 ◽  
Author(s):  
Leonie Johanna Jahn ◽  
Daniel Simon ◽  
Mia Jensen ◽  
Charles Bradshaw ◽  
Mostafa Mostafa Hashim Ellabaan ◽  
...  
Keyword(s):  
Combination Therapy ◽  
Large Scale ◽  
Bacterial Resistance ◽  
De Novo ◽  
Drug Combinations ◽  
World Health ◽  
Resistance Evolution ◽  
Evolution Experiment ◽  
Health Organization ◽  
The Individual

Abstract Antibiotic combinations are considered a relevant strategy to tackle the global antibiotic resistance crisis since they are believed to increase treatment efficacy and reduce resistance evolution (World Health Organization and Global Tuberculosis Programme, 2016). However, studies of the evolution of bacterial resistance to combination therapy have focused on a limited number of drugs and have provided contradictory results (Hegreness et al., 2008; Lipsitch and Levin, 1997; Munck et al., 2014). To address this gap in our understanding, we performed a large-scale laboratory evolution experiment, adapting 8 replicate lineages of Escherichia coli to a diverse set of 22 different antibiotics and 33 antibiotic pairs. We found that combination therapy significantly limits the evolution of de novo resistance in E. coli, yet different drug combinations vary substantially in their propensity to select for resistance. In contrast to current theories, the phenotypic features of drug pairs are weak predictors of resistance evolution. Instead, the resistance evolution is driven by the relationship between the evolutionary trajectories that lead to resistance to a drug combination and those that lead to resistance to the component drugs. Drug combinations requiring a novel genetic response from target bacteria compared to the individual component drugs significantly reduce resistance evolution. These data support combination therapy as a treatment option to decelerate resistance evolution and provide a novel framework for selecting optimized drug combinations based on bacterial evolutionary responses.

The relevance of dietetic approach of Ayurveda from the perspective of COVID-19 pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 748-752
Author(s):  
Swapnali Khabade ◽  
Bharat Rathi ◽  
Renu Rathi
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Healthy Person ◽  
World Health ◽  
Physical And Mental Health ◽  
Leading Role ◽  
Global Pandemic ◽  
The People ◽  
The World ◽  
Health Organization ◽  
The Individual

A novel, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes severe acute respiratory syndrome and spread globally from Wuhan, China. In March 2020 the World Health Organization declared the SARS-Cov-2 virus as a COVID- 19, a global pandemic. This pandemic happened to be followed by some restrictions, and specially lockdown playing the leading role for the people to get disassociated with their personal and social schedules. And now the food is the most necessary thing to take care of. It seems the new challenge for the individual is self-isolation to maintain themselves on the health basis and fight against the pandemic situation by boosting their immunity. Food organised by proper diet may maintain the physical and mental health of the individual. Ayurveda aims to promote and preserve the health, strength and the longevity of the healthy person and to cure the disease by properly channelling with and without Ahara. In Ayurveda, diet (Ahara) is considered as one of the critical pillars of life, and Langhana plays an important role too. This article will review the relevance of dietetic approach described in Ayurveda with and without food (Asthavidhi visheshaytana & Lanhgan) during COVID-19 like a pandemic.

scholarly journals Gold Nanoparticles: Can They Be the Next Magic Bullet for Multidrug-Resistant Bacteria?

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 312
Author(s):  
Mohammad Okkeh ◽  
Nora Bloise ◽  
Elisa Restivo ◽  
Lorenzo De Vita ◽  
Piersandro Pallavicini ◽  
...  
Keyword(s):  
Gold Nanoparticles ◽  
Bacterial Resistance ◽  
Multidrug Resistant ◽  
World Health ◽  
Resistant Bacteria ◽  
Magic Bullet ◽  
Global Challenge ◽  
Gold Silver ◽  
Inorganic Nanomaterials ◽  
Health Organization

In 2017 the World Health Organization (WHO) announced a list of the 12 multidrug-resistant (MDR) families of bacteria that pose the greatest threat to human health, and recommended that new measures should be taken to promote the development of new therapies against these superbugs. Few antibiotics have been developed in the last two decades. Part of this slow progression can be attributed to the surge in the resistance acquired by bacteria, which is holding back pharma companies from taking the risk to invest in new antibiotic entities. With limited antibiotic options and an escalating bacterial resistance there is an urgent need to explore alternative ways of meeting this global challenge. The field of medical nanotechnology has emerged as an innovative and a powerful tool for treating some of the most complicated health conditions. Different inorganic nanomaterials including gold, silver, and others have showed potential antibacterial efficacies. Interestingly, gold nanoparticles (AuNPs) have gained specific attention, due to their biocompatibility, ease of surface functionalization, and their optical properties. In this review, we will focus on the latest research, done in the field of antibacterial gold nanoparticles; by discussing the mechanisms of action, antibacterial efficacies, and future implementations of these innovative antibacterial systems.

Engaging older people in healthy and active lifestyles: a systematic review

2015 ◽  
Vol 36 (10) ◽  
pp. 2036-2060 ◽  
Author(s):  
JULIA MENICHETTI ◽  
PIETRO CIPRESSO ◽  
DARIO BUSSOLIN ◽  
GUENDALINA GRAFFIGNA
Keyword(s):  
Systematic Review ◽  
Health Promotion ◽  
World Health ◽  
Active Ageing ◽  
Individual Level ◽  
Active Lifestyles ◽  
Health Organization ◽  
The Individual ◽  
Health Promotion Interventions ◽  
Older Citizens

ABSTRACTIn 2002, the World Health Organization emphasised the concept of active ageing to manage and increase the last third of life. Although many efforts have been made to optimise treatment management, less attention has been paid to health promotion initiatives. To date, few shared guidelines exist that promote an active life in healthy older targets. To fill this gap, we conducted a systematic review to map health promotion interventions that targeted an active and healthy ageing among older citizens. Articles containing the key term active ageing and seven synonyms were searched for in the electronic databases. Because we were interested in actions aimed to promote healthier lifestyles, we connected the string with the term health. A total of 3,918 titles were retrieved and 20 articles were extracted. Twelve of the 20 studies used group interventions, five interventions targeted the individual level and three interventions targeted the community level. Interventions differed for the health focus of the programmes, which ranged from physical activity interventions to social participation or cognitive functioning. Most of the studies aimed to act on psychological components. The review suggests that different interventions promoted for active ageing are effective in improving specific healthy and active lifestyles; however, no studies were concerned directly with a holistic process of citizen health engagement to improve long-term outcomes.

Pharmacogenetics of Metformin

2021 ◽  
Vol 1 (6) ◽  
pp. 123-129
Author(s):  
Alrahman Joneri
Keyword(s):  
American Diabetes Association ◽  
Glucose Utilization ◽  
Medical Condition ◽  
World Health ◽  
First Line ◽  
Glucose Levels ◽  
Normal Limits ◽  
The World ◽  
Health Organization ◽  
The Individual

Hyperglycemia is a medical condition in which an increase in glucose levels in the blood exceeds normal limits. Hyperglycemia is one of the typical signs of diabetes mellitus (DM). The World Health Organization (WHO) predicts an increase in the number of people with DM which is a global health threat. Diabetes is the leading cause of kidney failure, and the leading cause of heart disease and stroke, in adults. Metformin, which is a biguanide group, is recommended by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes as the first-line oral therapy for DM and is the most widely used oral medication worldwide. Metformin can also increase peripheral glucose utilization and ultimately decrease the production of fatty acids and triglycerides. Some of the individual differences that underlie the variation in response to metformin.

Implementing the Sphere Project’s standards for patient’s healthcare rights in the disaster zone: The experience of the Israeli field hospital in post-quake Nepal

2021 ◽  
Vol 16 (1) ◽  
pp. 59-66
Author(s):  
Deganit Kobliner-Friedman, RN, MPH ◽  
Ofer Merin, MD ◽  
Eran Mashiach, MD ◽  
Reuven Kedar, MD ◽  
Shai Schul, MHA ◽  
...  
Keyword(s):  
Disaster Response ◽  
Sexual Exploitation ◽  
World Health ◽  
Field Hospital ◽  
Medical Teams ◽  
Health Organization ◽  
The Individual ◽  
The Right ◽  
Israel Defense Forces ◽  
Privacy And Confidentiality

Emergency medical teams (EMTs) encounter chaos upon arriving at the scene of a disaster. Rescue efforts are utilitarian and focus on providing the technical aspects of medical care in order to save the most lives at the expense of the individual. This often neglects the basic healthcare rights of the patient. The Sphere Project was initiated to develop universal humanitarian standards for disaster response.The increase in the number of EMTs led the World Health Organization (WHO) to organize standards for disaster response. In 2016, the WHO certified the Israel Defense Forces Field Hospital (IDF-FH) as the first to be awarded the highest level of accreditation (EMT-3). This paper presents the IDF-FH’s efforts to protect the patient’s healthcare rights in a disaster zone based on the Sphere Principles.These core Sphere Principles include the right to professional medical treatment; the right to dignity, privacy, and confidentiality; the right for information in an understandable language; the right to informed consent; the obligation to maintain private medical records; the obligation to adhere to universal ethical standards, to respect culture and custom and to care for vulnerable populations; the right to protection from sexual exploitation and violence; and the right to continued treatment.

scholarly journals Atypical and anaplastic meningiomas in a public hospital in São Paulo State, Brazil

2015 ◽  
Vol 73 (9) ◽  
pp. 770-778 ◽  
Author(s):  
Benedicto Oscar Colli ◽  
Carlos Gilberto Carlotti Junior ◽  
João Alberto Assirati Junior ◽  
Vicente de Paulo Martins Coelho Junior ◽  
Luciano Neder
Keyword(s):  
Multivariate Analysis ◽  
Public Hospital ◽  
Operative Mortality ◽  
De Novo ◽  
Univariate Analysis ◽  
World Health ◽  
Karnofsky Performance Scale ◽  
Grade Ii ◽  
Health Organization ◽  
Performance Scale

Atypical/anaplastic (World Health Organization (WHO) grades II and III) are less common and have poorer outcomes than benign meningiomas. This study aimed to analyze the outcome of patients with these tumors.Method Overall/recurrence-free survivals (RFS) and the Karnofsky Performance Scale of 52 patients with grades II (42) and III (9) meningiomas surgically treated were analyzed (uni/multivariate analysis).Results Total/subtotal resections were 60.8%/35.3%. Patients <60 years-old and grade II tumors had longer survival. Grade II tumors, total resection andde novo meningioma had better RFS (univariate analysis). Patients >60 years-old, de novo meningioma and radiotherapy had longer survival and patients <60 years-old and with grade II tumors had longer RFS (multivariate analysis). Recurrence rate was 51% (39.2% Grade II and 66.7% Grade III). Operative mortality was 1.9%.Conclusion Age <60 years-old, grade II tumors and de novomeningiomas were the main predictors for better prognosis among patients with grades II and III meningiomas.

scholarly journals The Genomic Basis of Rapid Adaptation to Antibiotic Combination Therapy in Pseudomonas aeruginosa

2020 ◽  
Author(s):  
Camilo Barbosa ◽  
Niels Mahrt ◽  
Julia Bunk ◽  
Matthias Graßer ◽  
Philip Rosenstiel ◽  
...  
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Combination Therapy ◽  
Bacterial Resistance ◽  
Efflux Pump ◽  
Regulatory Gene ◽  
Opportunistic Pathogen ◽  
Regulatory Function ◽  
Central Target ◽  
Resistance Evolution ◽  
Intergenic Regions

Abstract Combination therapy is a common antibiotic treatment strategy that aims at minimizing the risk of resistance evolution in several infectious diseases. Nonetheless, evidence supporting its efficacy against the nosocomial opportunistic pathogen Pseudomonas aeruginosa remains elusive. Identification of the possible evolutionary paths to resistance in multidrug environments can help to explain treatment outcome. For this purpose, we here performed whole-genome sequencing of 127 previously evolved populations of P. aeruginosa adapted to sublethal doses of distinct antibiotic combinations and corresponding single-drug treatments, and experimentally characterized several of the identified variants. We found that alterations in the regulation of efflux pumps are the most favored mechanism of resistance, regardless of the environment. Unexpectedly, we repeatedly identified intergenic variants in the adapted populations, often with no additional mutations and usually associated with genes involved in efflux pump expression, possibly indicating a regulatory function of the intergenic regions. The experimental analysis of these variants demonstrated that the intergenic changes caused similar increases in resistance against single and multidrug treatments as those seen for efflux regulatory gene mutants. Surprisingly, we could find no substantial fitness costs for a majority of these variants, most likely enhancing their competitiveness toward sensitive cells, even in antibiotic-free environments. We conclude that the regulation of efflux is a central target of antibiotic-mediated selection in P. aeruginosa and that, importantly, changes in intergenic regions may represent a usually neglected alternative process underlying bacterial resistance evolution, which clearly deserves further attention in the future.

scholarly journals Myelodysplastic syndrome: classification and prognostic systems

2011 ◽  
pp. 25-33
Author(s):  
Rosangela Invernizzi ◽  
Agnese Filocco
Keyword(s):  
Clinical Information ◽  
Scoring Systems ◽  
Classification Systems ◽  
World Health ◽  
Individual Risk ◽  
Information Classification ◽  
Definition Of ◽  
Health Organization ◽  
The Individual ◽  
Prognostic Scoring Systems

Myelodysplastic syndromes (MDS) are acquired clonal disorders of hematopoiesis, that are characterized most frequently by normocellular or hypercellular bone marrow specimens, and maturation that is morphologically and functionally dysplastic. MDS constitute a complex hematological problem: differences in disease presentation, progression and outcome have made it necessary to use classification systems to improve diagnosis, prognostication and treatment selection. On the basis of new scientific and clinical information, classification and prognostic systems have recently been updated and minimal diagnostic criteria forMDS have been proposed by expert panels. In addition, in the last few years our ability to define the prognosis of the individual patient with MDS has improved. In this paper World Health Organization (WHO) classification refinements and recent prognostic scoring systems for the definition of individual risk are highlighted and current criteria are discussed. The recommendations should facilitate diagnostic and prognostic evaluations in MDS and selection of patients for new effective targeted therapies.

scholarly journals THE HUMAN RIGHT TO HEALTH: A RETROSPECTIVE ANALYSIS AFTER 70 YEARS OF INTERNATIONAL RECOGNITION

2018 ◽  
pp. 24-42
Author(s):  
MARÍA DALLI
Keyword(s):  
Human Rights ◽  
Right To Health ◽  
World Health ◽  
Health Coverage ◽  
Human Right ◽  
The Sustainable Development ◽  
Cultural Rights ◽  
Health Organization ◽  
The Individual ◽  
The Right

In 1948, the General Assembly of the United Nations adopted the first international text recognising universal human rights for all; the Universal Declaration of Human Rights. Article 25 recognises the right to an adequate standard of living, which includes the right to health and medical care. On the occasion of the 70th anniversary of the Declaration, this article presents an overview of the main developments that have been made towards understanding the content and implications of the right to health, as well as an analysis of some specific advancements that aim to facilitate the enforcement thereof. These include: a) the implication of private entities as responsible for right to health obligations; b) the Universal Health Coverage goal, proposed by the World Health Organization and included as one of the Sustainable Development Goals; and c) the individual complaints mechanism introduced by the Optional Protocol to the International Covenant on Economic, Social and Cultural Rights (adopted on the 10th December 2008, 60 years after the UDHR).

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