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To prolong the duration of polymer erosion over existing approaches for sustained local drug delivery, we investigated a new bioerodible system based on hydrolytically activated in situ formation of interpolymer complexes in binary blends of high MW poly(vinyl methyl ether-co-maleic anhydride) (PVMMA) and poly(ethylene oxide) (PEO). In an aqueous environment of use, the hydrophobic PVMMA component of the blend undergoes hydrolysis converting the anhydride to free carboxylic acid groups which in turn form in situ intermolecular complexes with the PEO component of the blend. The formation of such hydrogen-bonded complexes with a condensed structure at the blend surface helps to retard the further progression of polymer erosion and drug release. The effects of PVMMA/PEO composition on blend morphology, polymer erosion and drug release were evaluated with the aid of fluorescence labeled PVMMA. The results show a decrease in miscibility in PVMMA/PEO blend with increasing PEO content. At low PEO contents (below 40%), the in vitro rate of release of a model drug metronidazole decreases with increasing PEO content, resulting in extended release duration over several days. On the other hand, excessive phase separation at PEO contents above 40% gives rise to higher rate and shorter duration of drug release.
PRP successfully created a scaffold for regenerative endodontic treatment; however, treatment outcomes did not differ significantly between PRP and conventional BC scaffold.
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The critical concentrations of sensitivity and resistance for meropenem versus anaerobic bacterias were analyzed. It is demonstrated the meropenem is a powerful inhibitor of the microorganisms of the Bacteroides groups (MIC90 < 1 mg/l), Prevotella > Porphyromonas, Fusobacterium, Veillonella, Clostridium perfringens is inhibited at a MIC < 0.06 mg/l. The MIC of meropenem versus C. difficile is 2 mg/l. They are also highly susceptible to the Propionibacterium, Peptostreptococcus and Peptococcus type microorganisms. Meropenem is comparable to imipenem and is more active than piperacillin, metronidazole and clindamycin. The mechanism of action and acquisition of resistance versus meropenem is evaluated and discussed. The percentage of highly resistant strains (MIC > 256 mg/l) isolated in the Hospital Gregorio Marañón in Madrid (Spain) is low (1.2%). The influence of pH on the in vitro activity of the carbapenémicos is also analyzed providing experimental data suggesting that meropenem maintains its bactericide activity more effectively in low pH conditions (5.6). Finally, the authors analyze the literature and the evidence reported regarding the use of meropenem in clinical practice, as a treatment of intraabdominal infections with a clinical response of 91%-100% and bacteriologic efficacy of 84%-95%.
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Fidaxomicin is sporicidal and may be associated with a reduced time to resolution of diarrhoea when used to treat patients with Clostridium difficile infection (CDI). This study investigated whether fidaxomicin for treatment of all patients with CDI reduced C. difficile environmental contamination. Surfaces in the rooms of 66 hospitalized patients treated with metronidazole and/or vancomycin and 68 hospitalized patients treated with fidaxomicin were sampled. Patients treated with fidaxomicin were less likely to contaminate their environment (25/68, 36.8%) than patients treated with metronidazole and/or vancomycin (38/66 57.6%) (P = 0.02). Treatment with fidaxomicin was associated with reduced environmental contamination with C. difficile.
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A total of 1266 patients were included. 178 isolates were cultured: 128 from patients without prior eradication therapy, 50 from patients after failed eradication. Primary resistance to clarithromycin, levofloxacin and metronidazole were 17.2%, 9.4% and 10.2%, respectively. Secondary resistance to clarithromycin, levofloxacin and metronidazole were 64%, 18% and 44%, respectively. Prior eradication was associated with a higher risk of clarithromycin as well as metronidazole resistance (OR=8.1; 95% CI 3.8-17.1 and OR 5.7; 95% CI 2.5-13, respectively).
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More than 50% of the human population have long-term Helicobacter pylori infection, causing, in some cases, severe diseases such as peptic ulcers and stomach cancer. In the last few years several extra-gastrointestinal disorders have been associated with H. pylori infection. This review summarized the current medical literature, identified through hand searching and MEDLINE research, including our own studies, with regard to H. pylori and skin diseases. From the literature it can be seen that the role of H. pylori in skin diseases is still a controversial subject. Randomized controlled trials with adequate masking and sample sizes are still lacking. The best evidence comes from studies investigating chronic urticaria in which chronic urticaria disappeared in many patients with H. pylori infection after careful eradication of the H. pylori. Moreover, there are promising recent reports of beneficial H. pylori eradication in Behçet's disease, pruritus cutaneus, prurigo chronica, prurigo nodularis and in some patients with lichen planus, but not in rosacea or psoriasis. Before any conclusions with respect to other skin diseases such as atopic dermatitis, Schoenlein-Henoch Purpura, Sweet's syndrome, Sjögren syndrome or systemic sclerosis may be drawn, additional randomized, double-blinded and placebo-controlled studies including adequate diagnostic schedules, sufficient eradication treatment protocols, confirmation of eradication and adequate control groups are needed. The cutaneous pathology of H. pylori is far from being clear, but it is speculated that the systemic effects may involve increased mucosal permeability to alimentary antigens, immunomodulation, an autoimmune mechanism or the impairment of vascular integrity.
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This paper reports the findings obtained using two new compounds belonging to the 5-nitroimidazole family: sulphuridazole (V1) and sulphonidazole (V2). We first assessed their antimicrobial activity on Clostridia spp. and then extended the study to Gram-positive and Gram-negative aerobic microorganisms and to Candida albicans. Their MICs were compared with those of metronidazole. The findings show that the antibacterial and antimycotic activity of sulphonidazole is greater than that of sulphuridazole, while metronidazole is not active against any aerobic organism. It also emerges that the NO2 group is indispensable for all the microorganisms assayed and that sulphuridazole and sulphonidazole are the first two 5-nitroimidazoles active against C. albicans. The redox potentials of the 5-nitroimidozoles studied suggest that their action mechanism is mainly based on redox processes.
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Sequential therapy achieves a higher eradication rate than standard triple therapy in Taiwan. The novel treatment can be used as a first-line therapy for H. pylori infection for Taiwanese.
In the last 20 years, changes in world technology have occurred which have allowed for the rapid transport of people, food, and goods. Unfortunately, antibiotic residues and antibiotic-resistant bacteria have been transported as well. Over the past 20 years, the rise in antibiotic-resistant gene carriage in virtually every species of bacteria, not just oral/respiratory bacteria, has been documented. In this review, the main mechanisms of resistance to the important antibiotics used for treatment of disease caused by oral/respiratory bacteria--including beta-lactams, tetracycline, and metronidazole--are discussed in detail. Mechanisms of resistance for macrolides, lincosamides, streptogramins, trimethoprim, sulfonamides, aminoglycosides, and chloramphenicol are also discussed, along with the possible role that mercury resistance may play in the bacterial ecology.
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A total of 85 patients (average age 46.9 years) were enrolled in the study. Successful eradication rate for H. pylori was 72.5% in Group A and 64.1% in Group B, with no significant difference between the two groups. 11.6% (5/43) of patients from group A and 31.0% (13/42) from group B reported at least one adverse event. The adverse events of all 18 patients disappeared after the therapy ceased.
We aimed to assess the resistance of H. pylori to clarithromycin and metronidazole, in patients with and without previous eradication treatment, in a geographic area from the north of Spain. We also analyzed the evolution of resistance rates and its relationships with annual antibiotic consumption.
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The results indicate that excess amounts of metronidazole are able to increase the expression level of these genes at the transcriptional stage.