In vitro activity of telithromycin against Haemophilus influenzae at epithelial lining fluid concentrations

<p>Abstract</p> <p>Background</p> <p><it>Haemophilus influenzae </it>is one of the main aetiological agents of community-acquired respiratory tract infections. The primary aim of this study was to evaluate the antibacterial activity of telithromycin against <it>H. influenzae </it>clinical isolates showing different pattern of resistance in comparison with azithromycin and clarithromycin at 1/4 ×, 1/2 ×, 1 ×, 2 ×, 4 × minimum inhibitory concentration (MIC) and to peak concentrations in epithelial lining fluid (ELF). The secondary aim was to determine the influence of CO₂enriched atmosphere on bacterial susceptibility.</p> <p>Results</p> <p>Telithromycin showed high activity against <it>H. influenzae</it>, including strains susceptible to β-lactams (n = 200), β-lactamase producer (n = 50) and β-lactamase negative ampicillin resistant (BLNAR) (n = 10), with MIC from ≤0.03 to 4 mg/L, and MIC₅₀/MIC₉₀of 1/2 mg/L with susceptibility rate of 100%, and minimum bactericidal concentrations (MBC) from 2 to 4-fold higher than the MIC. Azithromycin was the most active tested macrolide (range: 0.25 – 4 mg/L; MIC₅₀/MIC₉₀: 1/2 mg/L), comparable to telithromycin, while clarithromycin showed the highest MICs and MBCs (range: 0.25 – 8 mg/L; MIC₅₀/MIC₉₀: 2/8 mg/L). In time-kill studies, telithromycin showed a bactericidal activity at the higher concentrations (4 – 2 × MIC and ELF) against all the strains, being complete after 12 – 24 hours from drug exposition. At MIC concentrations, at ambient air, bactericidal activity of telithromycin and azithromycin was quite similar at 12 hours, and better than that of clarithromycin. Besides, telithromycin and clarithromycin at ELF concentrations were bactericidal after 12 hours of incubation for most strains, while 24 hours were needed to azithromycin to be bactericidal. Incubation in CO₂significantly influenced the MICs and MBCs, and only slightly the <it>in vitro </it>killing curves.</p> <p>Conclusion</p> <p>Telithromycin showed an <it>in-vitro </it>potency against <it>H. influenzae </it>comparable to azithromycin, with an <it>in-vitro </it>killing rate more rapid and superior to clarithromycin at 2X-MIC against β-lactamase producers and BLNAR strains, and to azithromycin at ELF concentrations against β-lactamase negative strains. Against all strains, MICs and MBCs were lower in the absence of CO₂for the tested antibiotics, showing an adverse effect of incubation in a CO₂environment. The <it>in-vitro </it>potency together with the tissue concentrations of the antimicrobial, should be considered in predicting efficacy.</p

PEMBERDAYAAN MASYARAKAT PESISIR BERBASIS TECHNOPRENEURSHIP PADA KAWASAN TELUK TOMINI DI DESA MUARA BONE

Muara Bone Village is one of the villages in Bone District which is located on the coast. Thus, some people work as fishermen. Apart from fishing, the people of Muara Bone have a number of jobs, namely: farmers, village officials, and small business owners such as Small and Medium Industries (IKM) Mie Berkah 99. This IKM has problems and constraints related to branding and corporate identity which are less attractive to consumers. The author and MBKM KKN students made initial observations to identify the deficiencies of the IKM. After learning about the problems with IKM Mie Berkah 99, MBKM KKN students helped the company's branding by making company logos, billboards, neon boxes, new packaging designs, and social media as a means of promotion to a wider market

Effectiveness, Safety, and Appropriateness in the Use of the Fixed-Ratio Combination of Insulin Glargine and Lixisenatide in Type 2 Diabetes: The ENSURE Retrospective Real-World Study

Introduction Pivotal trials documented glycemic benefits of fixed-ratio combination of insulin glargine 100 U/mL and lixisenatide (iGlarLixi), with no weight gain and low hypoglycemia risk in type 2 diabetes (T2D). This study aimed at assessing effectiveness and patterns of use of iGlarLixi in a real-world setting. Methods This was a retrospective, multicenter, study, based on electronic medical records. All patients initiating iGlarLixi from May 2018 to July 2020 were considered. Results Overall, 25 centers provided data on 675 patients initiating iGlarLixi with the following characteristics: age 66.4 +/- 10.1 years, 54.2% men, T2D duration 15.5 +/- 11.5 years, HbA1c 8.6 +/- 1.4%, body mass index (BMI) 30.8 +/- 5.3 kg/m(2), 45.1% already treated with basal insulin, and 21.9% with basal bolus (+/- oral hypoglycemic agents). Metformin and sodium-glucose cotransporter-2 inhibitors were used in 76.0% and 0.9% of patients, respectively. Combinations of iGlarLixi with other glucose-lowering drugs such as sulfonylureas or short-acting insulin were found in 32.4% of patients. Effectiveness of iGlarLixi (N = 184) showed that HbA1c declined by 0.77% [95% confidence interval (CI) -1.00, -0.54] after 6 months. In combination with metformin and/or SGLT-2i (N = 117), HbA1c declined by -0.92% (95% CI -1.22, -0.62) and weight significantly decreased by 1.21 kg. iGlarLixi dose was suboptimally titrated. Safety data (N = 171) showed incidence rates of blood glucose <= 70 and < 54 mg/mL of 0.26 and 0.05 events per person-month during 6 months, respectively, with a risk reduction of about 75% with respect the 6 months before iGlarLixi initiation. No severe hypoglycemia was reported. Conclusion In adults with T2D, effectiveness and safety of iGlarLixi were documented in a real-world setting; appropriateness of use and adequate titration should be urgently improved so that clinical practice outcomes become more comparable to clinical trials results. Further real-world studies on the effect of iGlarLixi therapy are warranted

UPAYA MENINGKATKAN KESEJAHTERAAN MASYARAKAT NELAYAN PESISIR DESA LOPO MELALUI PENGEMBANGAN BENGKEL JASA REPARASI MESIN KETINTING

The aim of implementing this service is to improve the welfare of the coastal fishing community of Lopo village through the development of a ketinting machine repair service workshop. The methods used in implementation are lectures, discussions, questions and answers, mentoring tutorials, and direct demonstration practices. Implementation is carried out through initial observation, namely observing potential and identifying problems in the village and then determining solutions for the target audience. Through this service activity, it can be concluded that the activity has been successfully carried out by 1) Establishing a ketinting machine repair shop to serve the fishing community. 2) The target audience is able to practice managing a ketinting machine service shop independently after receiving intensive assistance from the service team. 3) The fishing community of Lopo Village is gradually becoming aware of the importance of regular machine maintenance as well. 4) The ketinting machine repair service workshop in the village will minimize machine repair time so that fishing communities' livelihood activities at sea can run smoothly

Treatment intensification following glucagon‐like peptide‐1 receptor agonists in type 2 diabetes: Comparative effectiveness analyses between different basal insulins. RESTORE‐G real‐world study

Abstract Aim: To compare the effectiveness of different basal insulins (BI) prescribed as an add-on to or switch from glucagon-like peptide-1 receptor agonist (GLP-1 RA) therapy. Materials and Methods: Retrospective, real-world data from electronic medical records of 32 Italian diabetes clinics were used, after propensity score adjustment, to compare effectiveness after 6 months of treatment with second- versus first- generation BI (2BI vs. 1BI) or glargine 300 U/ml versus degludec 100 U/ml (Gla-300 vs. Deg-100), when added to (ADD-ON) or in substitution of (SWITCH) GLP-1 RA. Only comparisons, including a minimum of 100 patients per group, were per- formed to ensure adequate robustness of the analyses. Results: In the ADD-ON cohort (N = 700), greater benefits of 2BI versus 1BI were found in glycated haemoglobin {HbA1c; estimated mean difference: 0.32% [95% confidence interval (CI) 0.62; 0.02]; p = .04} and fasting blood glucose [FBG; 20.73 mg/dl (95% CI 35.62; 5.84); p = .007]. In the SWITCH cohort (N = 2097), greater benefits of 2BI versus 1BI were found in HbA1c [ 0.22% (95% CI 0.42; 0.02); p = .03], FBG [ 10.15 mg/dl (95% CI 19.04; 1.26); p = .03], and body weight [ 0.67 kg (95% CI 1.30; 0.04); p = .04]. In the SWITCH cohort starting 2BI (N = 688), marked differences in favour of Gla-300 versus Deg-100 weredocumented in HbA1c [ 0.89% (95% CI 1.26; 0.52); p < .001] and FBG [ 17.89 mg/dl (95% CI 32.45; 3.33); p = .02]. Using propensity score matching as a sensitivity analysis, the benefit on HbA1c was confirmed [ 0.55% (95% CI –1.02; 0.08); p = .02]. BI titration was suboptimal in all examined cohorts. Conclusions: 2BI are a valuable option to intensify GLP-1 RA therapy. Switching to Gla-300 versus Deg-100 was associated with greater HbA1c improvement

Low grade epithelial stromal tumour of the seminal vesicle

<p>Abstract</p> <p>Background</p> <p>The mixed epithelial stromal tumour is morphologically characterised by a mixture of solid and cystic areas consisting of a biphasic proliferation of glands admixed with solid areas of spindle cells with variable cellularity and growth patterns. In previous reports the seminal vesicle cystoadenoma was either considered a synonym of or misdiagnosed as mixed epithelial stromal tumour. The recent World Health Organisation Classification of Tumours considered the two lesions as two distinct neoplasms. This work is aimed to present the low-grade epithelial stromal tumour case and the review of the literature to the extent of establishing the true frequency of the neoplasm.</p> <p>Case presentation</p> <p>We describe a low-grade epithelial stromal tumour of the seminal vesicle in a 50-year-old man. Computed tomography showed a 9 × 4.5 cm pelvic mass in the side of the seminal vesicle displacing the prostate and the urinary bladder. Magnetic resonance was able to define tissue planes between the lesion and the adjacent structures and provided useful information for an accurate conservative laparotomic surgical approach. The histology revealed biphasic proliferation of benign glands admixed with stromal cellularity, with focal atypia. After 26 months after the excision the patient is still alive with no evidence of disease.</p> <p>Conclusion</p> <p>Cystoadenoma and mixed epithelial stromal tumour of seminal vesicle are two distinct pathological entities with different histological features and clinical outcome. Due to the unavailability of accurate prognostic parameters, the prediction of the potential biological evolution of mixed epithelial stromal tumour is still difficult. In our case magnetic resonance imaging was able to avoid an exploratory laparotomy and to establish an accurate conservative surgical treatment of the tumour.</p

PENGEMBANGAN MODUL PRAKTIKUM MEKANISME ENGINE SEPEDA MOTOR 4 LANGKAH BERBASIS PROBLEM BASED LEARNING

ABSTRACT The study aims to develop a module of motor mechanics four-step motorcycle based problem based learning on the mechanical engineering education program of the gorontalo state college of engineering. Research in the development of the module lab uses RD (research and development) development methods. The research method referred to the 4-d model (four-d models). Based on research and analysis of already conducted validation data analysis it can be concluded that the validation of the module's practical-based problem learning on its engine engine trainer tool 4 steps from the engine engine aspect of media worthiness are defined as worthy by the validator atan 80% percentage, and of the appropriatical value of these service modules is gained a feasibility percentage of 91.50%.Keywords: development, module practical, the problem of based learning

PENGEMBANGAN MEDIA PEMBELAJARAN IGNITION SYSTEM SEPEDA MOTOR PADA MATA KULIAH TEKNIK SEPEDA MOTOR

This research is motivated by the need for motorcycle ignition system learning media in motorcycle engineering courses, especially motorcycle ignition system material. This study develops learning media as learning aids according to the learning styles of Mechanical Engineering Education students who are more inclined to kinesthetic learning styles. The purpose of this study was to develop and test the feasibility of motorcycle ignition system learning media in motorcycle engineering courses. To develop and test the feasibility of the media, the method used in this research is Research Development, with a 4D model (define, design, develop, and disseminate). The development procedure begins with (1) describing the initial state, (2) data collection, (3) product design, (4) design validation, (5) design revision, (6) product manufacturing (7) product validation, (8) revision product, (9) final product, (10) dissemination. Data collection techniques were carried out by means of observation, interviews, and questionnaires. This study produced motorcycle Ignition System learning media and the results of measuring the feasibility of the media with an average percentage value of design experts 89.15, material experts 90.76%, media experts 93.84, and user response 90.00%. The sum of the average scores of all grades is 90.18. The conclusion of the development of motorbike Ignition System learning media can be said to be very feasible to use

Penguatan Pemberdayaan Masyarakat Berbasis Sociopreneurship Melalui Potensi Lokal Menjadi Produk Inovasi Unggulan Menuju SDGs

The purpose of implementing this community service is to strengthen community empowerment based on sociopreneurship through local potential to become superior innovation products towards SDGs. The location of the service was carried out in Salinggoha Village which is located in Walea Besar District, Tojo Una-una Regency, Central Sulawesi Province. The method used is based on sociopreneurship, which is a business whose concept originates from social issues in the community through: (1) increasing awareness/attitude, insight/knowledge and community skills, (2) creating superior products and village innovation products that can help the community's economy, and (3) empowerment regarding the importance of forming MSME groups in advancing the village economy. The results of this community service activity are 1) Main Product of Coconut Oil Village, Salinggoha Village Originality, 2) Featured Product of Shredded Fish Typical of Salinggoha, and 3) Product Innovation of Crispy Banana  Blossom Chips. It is our hope that in the future the knowledge that we provide to the community can be well received and applied by the community so that later it can bring Salinggoha Village to a better direction

Treatment intensification following glucagon-like peptide-1 receptor agonist treatment in type 2 diabetes: The RESTORE-G real-world study

Background and aims: To assess intensification approaches with basal insulin (BI) following glucagon-like peptide-1 receptor agonist (GLP-1 RA) treatment in type 2 diabetes (T2D). Methods and results: Real-world data were collected in electronic medical records by 32 Italian diabetes clinics between 2011 and 2021. Primary endpoint was the proportion of insulin-naïve T2D patients treated with GLP-1 RA who initiated (add-on or switch) BI. Secondary endpoints were: treatment approaches, mean time to BI start, effectiveness and safety. Among 7,962 eligible patients, BI was prescribed to 3,164 (39.7%; 95%CI 38.7; 40.8): 67.6% switched to BI (22.1% also starting 1e3 injections of short-acting insulin), 22.7% added BI while maintaining GLP-1 RA, and 9.7% switched to a fixed-ratio combination of GLP-1 RA and BI (FRC). Median time since the first GLP-1 RA to BI/FRC prescription was 27.4 (IQ range 11.8e53.5) months. In this study 60.3% of patients did not start BI/FRC, among whom 15.2% intensified GLP-1 RA therapy with other oral agents. Effectiveness and safety were documented in all inten- sification approaches with BI/FRC, but HbA1c level at intensification time of 9.0% and subopti- mal BI titration suggested clinical inertia. Use of second generation BI and add-on to GLP-1 RA schemes increased over time and effectiveness improved. Conclusion: Clinical inertia should be overcome using innovative insulin options. Timely combi- nation therapy of BI and GLP-1 RA is a valuable choice