Search

The health system and management of medical services is a sector of major importance, considering that it concerns the entire population, emphasis should be placed on the medical act, on the motivation and training of medical personnel to provide quality health services that respond fully meet patient expectations. It should be remembered that it is easier to prevent than to treat, and primary prevention represents the basis of a healthy society and the most effective and inexpensive method to stop the occurrence and evolution of chronic diseases. In this sense, new concepts and methodologies have been developed, both worldwide and in our country, especially recently, that try to meet the needs. It is approached differently and specifically depending on the individual needs, the resources we have at hand, all of which have as the result the improvement of the medical act and the satisfaction of the patient. [ABSTRACT FROM AUTHOR]

This study aims to demonstrate the effectiveness of silver nanoparticles (Ag NPs) on multidrug-resistant (MDR) Acinetobacter baumannii (AB) strains isolated from the clinical and aquatic environment. Three types of Ag NPs were investigated for their antimicrobial, antibiofilm, and antivirulence properties on a total number of 132 AB strains isolated in the same temporal sequence from intra-hospital infections (IHIs), wastewater (WW), and surface water (SW) samples between 2019 and 2022 from different Romanian locations and characterized at the phenotypic and genotypic levels. The comparative analysis of the antimicrobial resistance (AR) profiles according to the isolation source and the geographical location demonstrated a decrease in MDR level in AB recovered from WW samples in 2022 from north-eastern/central/southern regions (N-E/C-W/analyzed strains S): 87.5/60/32.5%. The AB strains were lecithinase, caseinase, amylase, and lipase producers, had variable biofilm formation ability, and belonged to six genotypes associated with the presence of different virulence genes (ompA, csuE, bap, and bfmS). The Ag NPs synthesized with the solvothermal method exhibited an inhibitory effect on microbial growth, the adherence capacity to the inert substratum, and on the production of soluble virulence factors. We report here the first description of a powerful antibacterial agent against MDR AB strains circulating between hospitals and anthropically polluted water in Romania. [ABSTRACT FROM AUTHOR]

Objectives: Analisys of clinical course after changing antiretroviral therapy (ART) in HIV infected patients (Px) with treatment failure (TF). Methods: A retrospective study in Craiova Regional Center for Monitoring and Evaluation of HIV/AIDS from 01/01/2009 to 12/31/2009, on two groups of Px in TF with at least 3 previous ARV scheme, Px in whom a new ART scheme was introduced: group A (16 Px) according to resistance test results and previous ART schemes and group B (23 Px) depending on previous ART schemes. Results: Clinical and immunological CDC staging- group A versus B was similar : B2 stage 1 Px (6.25%)/1 Px (4.34%), B3 stage 9 Px (56.25%)/7 Px (30.43%), C2 stage 1 Px (6.25%)/2 Px (8.69%), C3 stage 5 Px (31.25%)/13 Px (56.25%), median CD4=104 vs 181 cells/mm³, median HIV-RNA=4.49 vs 4.30 lg copies/ml. Darunavir (DRV), Etravirine (ETV), Raltegravir (RAL) were included in ART of 8 Px (50%) of group A vs. 9 Px (39.14%) in group B. Clinical outcome was good in 14 Px in group A and all Px in group B. In group A, 1 Px died with lymphoma and 1 Px had cerebral toxoplasmosis. HIV-RNA level, at 4 and 12 month, in group A vs group B, were: HIV-RNA <50 copii/ml- 13 Px (81.25%) vs 18 Px (78.26%) (p> 0.05; 0.19 0.05; 0.12 0.05; 0.26