Efficacy of antimicrobials in preventing resistance in solid organ transplant recipients:A systematic review of clinical trials

BACKGROUND In the absence of effective antimicrobials,transplant surgery is not viable,and antirejection immunosuppressants cannot be administered,as resistant infections compromise the life-saving goal of organ transplantation.AIM To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.METHODS A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses.This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents(prophylactic or therapeutic)aimed at preventing antimicrobial resistance.The search strategy involved analyzing multiple databases,including PubMed/MEDLINE,Web of Science,Embase,Scopus,and SciELO,as well as examining gray literature sources on Google Scholar.A comprehensive electronic database search was conducted from the databases’inception until May 2024,with no language restrictions.RESULTS After the final phase of the eligibility assessment,this systematic review ultimate-ly included 7 articles.A total of 2318 patients were studied.The most studied microorganisms were cytomegalovirus,although vancomycinresistant enterococci,Clostridioides difficile,and multidrug-resistant Enterobacterales were also analyzed.The antimicrobials used in the interventions were mainly maribavir,valganciclovir,gancic-lovir,and colistin-neomycin.Of concern,all clinical trials showed significant proportions of resistant microorga-nisms after the interventions,with no statistically significant differences between the groups(mean resistance 13.47%vs 14.39%),except for two studies that demonstrated greater efficacy of maribavir and valganciclovir(mean resistance 22.2%vs 41.1%in the control group;P<0.05).The total reported deaths in three clinical trials were 75,and there were 24 graft rejections in two studies.CONCLUSION All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions.More high-quality randomized clinical trials are needed to corroborate these results.

Acute Impact of Artificial Sweetener, Aspartame on Blood Parameter in Mice

Aspartame (APM) or L-aspartyl-L-phenylalanine methyl ester, a common artificial non-saccharide sweetener used as a sugar substitute in many foods and beverages, has shown some side effects on consumers. The objective of the present study is to study the acute impact of various doses of daily ingestion of APM on blood parameters of mice. Sixty healthy 3 months old male mice raised in the departmental animal house were divided into five groups i.e. the control were fed normal diet and tap water, while other 4 groups (12 each) were daily orally fed with 1 mL of either 40, 500, 1000 or 1500 mg/Kg b wt, dissolved in distilled water using gavages for consecutive 5 weeks. Fresh blood samples collected directly from the heart at dissection were subjected to complete blood counting (CBC) using automated blood analyzer (Cell DYN-1700) in addition to manual differential Leucocytes (WBC) counting. There has been a significant increase (p ≤ 0.01) in WBC counts starting from the lowest dose (40 mg/Kg·b·wt);significant decrease (p ≤ 0.01) in both Hemoglobin percentages (Hb%) and in Lymphocyte percentages (p ≤ 0.004) in comparison with control. It is concluded that the ingestion of aspartame using the above doses has acute impact and is not dose-dependent on blood parameters which could exert further, on the long run, health risks on to other tissues of consumers.

Selective Mono-Ozonolysis of a Cyclic 1,5,9-Cyclododecatrien

Some unsaturated compounds with the required （Z,Z）-double bonds configuration are synthesized through controlled ozonolysis process of 1,5,9-cyclododecatriene by determining the necessary amount of ozone passing through to selectively guarantee the breakage of a double bond while leaving other two bonds as （Z,Z）. The products were diagnosed by using NMR spectrum, infrared （IR） and mass spectrometer techniques. It is concluded that these products could widely be used in the synthesis of insect pheromones instead of insecticides and as useful intermediate compounds in many chemical reactions.

Prevalence of Two Gastrointestinal Parasites <i>Entamoeba histolytica</i>and <i>Giardia lamblia</i>within Samarra City, Iraq

The prevalence of two gastrointestinal parasites the Entamoeba histolytica and Giardia lamblia parasites and their impact on some blood parameters, i.e. packed cell volume (PCV), hemoglobin (Hb%) and total protein (TP) of a total 780 patients (children and adults) admitted to Samarra General Hospital were assessed. Samples of fresh feces were collected in normal physiological saline and examined using Olympic microscopes. The frequency of the parasite E. histolytica was 12.8% (46.3% male and 53.6% female). The highest frequency of infection of E. histolytica (13.8%) was found at age group (1 - 5 years old) followed by <1 year old children while the lowest (7.4%) was at ages (>41 years old). The highest rate of infection (33.9%) was found in September and the lowest (2.2%) in January. Similarly, the general infection frequency of the parasite G. lamblia was 3.9% with the highest rate at ages 1 - 20 years old and the lowest rate was 7.3% for >50 years old. The monthly, highest rate of infection (5.2%) was in August and least (2.2%) in January (2.2%). The frequency of total protein (TPD) in the blood relevant to the presence of parasite E. histolytica and G. lamblia was 4.6% and 1%, respectively. It is concluded that the above two parasites are the most common gastrointestinal parasite in Iraq whose pathogenesis to be which is likely to escalate during the summer seasons and at low hygienic services environment. There has been an irrelevance neither to anemia nor total protein deficiency. It is recommended that Ministry of Health in Iraq should not share the global idea of defining the giardiasis as a neglected disease.

Exam Stress Induces Hormonal Changes amongst Students of the <i>Al-Haweeja</i>Technical College

Sixty students from both genders aged 19 - 22 years old at College of Technology undertaking halfterm exams of 2012-2013 are encountered in this study. Blood samples were collected twice, i.e. before the exam inside the halls and during the rest time, to compare levels of some hormones, e.g. cortisol from all students, testosterone in male only and both estrogen and progesterone in female students. The female group was further subdivided into two subgroups, 15 each i.e. at the first half of the menstrual cycle (follicular phase) and second group at the second half of the menstrual cycle (luteal phase). The levels of cortisol had significantly (p ≤ 0.05) raised from 12.3 ± 3.6 to 32.3 ± 4.2 ng/mL and from 11.6 ± 1.8 to 31.6 ± 7.3 ng/mL in both male and female students, respectively during exams in comparison with rest times. However, the levels of testosterone had significantly dropped (p ≤ 0.05) from 6.63 ± 1.8 to 2.1 ± 0.4 ng/mL during the test-time. In female students, the levels of both estrogens and progesterone had significantly (p ≤ 0.05) increased, i.e. in follicular from 202 ± 38 to 365 ± 22 and from 64.6 ± 8.0 to 160 ± 37 ng/mL at luteal phases, respectively and from 0.74 ± 0.03 to 1.5 ± 0.04 in follicular and 14.4 ± 2.4 to 29 ± 4.2 ng/mL at luteal phase, respectively in progesterone during the exam in comparison with rest times. These results indicate that all students had sustained stress during the exam-time which might have disturbed the regulation of various hormones in both genders consequently leading to further health effects.

Activity of the Enzyme Gamma-Glutamyl Transferase (GGT) as a Prognostic Tool for Heart Failures

Heart failure (HF) incidence could cause further complications to other body organs, which might sometimes be fatal, and is accompanied by various biochemical alterations i.e. enzymatic changes. The objective of this study was to measure the activity of gamma glutamyl transferase (GGT) as an early diagnostic indicator for HF patients;and to isolate the iso-enzymes for the purpose of finding the Michaelis-Menten constant (Km) and the maximum velocity Vmax of each iso-enzymes which enable follow up the development of HF disease. Samples of blood sera were collected from 120 patients of both genders (70 males and 50 female, aged 30 - 38 years old). Partial purification of iso-enzyme GGT was performed by precipitation, gel filtration, and ion exchange of the two iso-enzyme (I and II). The purity of the enzyme was confirmed by using Sodium dodecyl sulfate-polyacryl amide gel electrophoresis (SDS-PAGE) into two clear bands. The results were compared with other 80 samples of healthy volunteers whose ages ranged between 25 - 78 years old, used as control. There has been a significant increase (p ≤ 0.01) in the activity of the enzyme GGT in the heart failure patient (66.9 ± 1.7 IU/L) in comparison with control (12.07 ± 0.60 IU/L). It is concluded that measurements of the iso-enzyme GGT could well benefit as a clear indicator criteria in prognosis of heart failure.

Acute Impact of the Artificial Sweetener Aspartame on the Ultrastructures of Hepatocyte in Mice

A non-saccharide artificial sweetener, aspartame (L-aspartyl-L-phenylalanine methyl ester) is used worldwide as a sugar substitute in many foods and beverages. The objective of this work was to clarify the acute impact of various doses of daily ingestion of Aspartame at the cellular level of the liver tissues in mice. Sixty adult male mice were divided into five groups including control fed normal diet and tap water, while other 4 groups (12 each) were daily fed orally with 1 mL of either 40, 500, 1000 and 1500 mg/Kg b.wt. APM dissolved in distilled water using gavages for consecutive 5 weeks. Liver samples fixed in 10% formalin were cut as 5 μm using Leica microtome and the sections were stained with both routine Heamatoxylene and Eosin (H & E) as well as Transmission electron Microscope (TEM). Histological results showed cellular changes in the hepatic tissues which were proportional with the increased doses. The hepatocytes had developed fatty droplets in the cytoplasm of almost all cells, loss of nuclei, necrosis detectable at LM level. Lymphatic nodules were also generated around the triads and the central hepatic veins as well as intracellular gaps with higher doses. The TEM results demonstrated degradation of mitochondria indicating the direct acute effects of the aspartame on hepatic tissues which all were proportional with the increased doses. It is concluded that the daily ingestion of aspartame, even at lower doses, has acute effects and is dose dependant on hepatic cells which could exert further risks onto other tissues of consumers on the long run.

Impact of Some Antibiotics on Bacteria Isolated from Appendices in Kirkuk Province, Iraq

A bacteriological study of 50 appendectomy cases for patients diagnosed by physicians to be appendicitis, within Kirkuk province was carried out to isolate the habitat bacteria of appendix and to assess the impact of some antibiotics on isolated bacterial species from the appendices. The age of patients ranged between 3 - 45 year old (21 male and 29 female). The culture results showed 94% single isolate with 2% negative growth and 4% mixed growth were obtained. The gram positive bacteria isolate formed (11.77%) less than gram negative (88.23%). The total isolates represented 51 included Escherichia coli 34 (66.66%), followed by Enterococcus faecalis 3 (5.89%), Klebsiella pneumonia 3 (5.89%), Citrobacter youngae 2 (3.92%), Raultella terrigena 2 (3.92%), Pseudomonas aeruginosa 2 (3.92%), Enterrobacter cloacae 1 (1.96%), Serratia fonticola 1 (1.96%), Entercoccus faecium 1 (1.92%), Staphylococcus epidermides 1 (1.96%) and Staphylococcus xylosus 1 (1.96%). The Staphylococcus xylosus was the first time to be isolated in Kirkuk city while both of Raultella terrigena and Citrobacter youngae were isolated for the first time in appendix samples. Only 16 various antibiotics were tested against Enterobacteriaceae and Pseudomonas aeruginosa while 12 and 7 against Staphylococcus sp. and Enterococcus sp., respectively. The Imipenem and Amikacin were found to be most effective antibiotics against all Enterobacteriaceae isolates and Pseudomonas aeruginosa while Ampicillin, Piperacillin, Ceftazidime, Augmentin, and Cephalothin were ineffective against all isolated bacteria. The Penicillin and Vancomycin were effective against gram positive bacteria.

Protective Effect of Cranberry Extracts against Oxidative Stress and DNA Damage Induced by Diclofenac Sodium in Kidney of Male Albino Rate

This work aimed to find the effect of cranberry extract (75 and 150 mg/kg&middot;b&middot;w) and vit. C (1 g/kg&middot;b&middot;w orally) on renal toxicity induced by Diclofenac sodium in male albino rats. Treated rats with diclofenac sodium with a concentration 150 mg/kg&middot;b&middot;w, expressed a significant increase in several parameters includes, plasma total cholesterol, LDL-cholesterol, and triglyceride as well as renal nitric oxide (NO), tumor necrosis factor-alfa (TNF-α) and TBARS. In addition, a significant reduction in renal superoxide dismutase (SOD), GSH, catalase (CAT) and plasma HDL. The present results explain that, using cranberry extract and vit. C resulted in increasing the level of GSH, CAT and SOD as well as gene expression of renal SOD, CAT and IL-22 and reduce the level of TBARs significantly which led to preventing renal tissue damage. Our results also revealed that cranberry extract can protect DNA from damage as obtained from comet essay. TM-U was elevated in DCLF treated group when compared with normal. However cranberry extract was able to reduce this elevation in dose dependant manner. Histological features in H&E taken to different groups also mirrors this findings. DCLF causes many changes in renal tissue include infiltration by inflammatory cells, attenuated glomeruli, apoptosis in tubular epithelia.

Novel Palladium （II） Selective Membrane Electrode Based on Phenyl Disulfide

PVC （a poly vinyl chloride） membrane was prepared by using phenyl disulfide as a carrier for selective determination of Pd （II） ion. The membrane can be worked well over a wide concentration range （1.0 × 106-1.0 × 10-1） M with a slope 29.53 mV/decade and a limit of detection （1.77× 10-7） M. The measured of response time was 9 s. It was found to be selective and useable within the pH range （3.0-7.0）. The lifetime of membrane sensor prepared could be used for at least 4 months. The electrode was successfully used as an indicator electrode in potentiometric titration of palladium ion with EDTA.