The antimicrobial and antioxidant activities, as well as the DNA-binding of four square-planar Pd(II) complexes, Pd(terpy)Cl+ (C1), Pd(en)Cl2 (C2), Pd(DMEAImiPr)Cl2 (C3) and Pd(dach)Cl2 (C4) (terpy = ...2,2?:6?,2??- -terpyridine, en = ethylenediamine, dach = trans-1,2-diaminocyclohexane and DMEAImiPr = N2-((1,3-dihydro-1,3-diisopropyl-4,5-dimethyl)-2H-imidazol-2- ylidene)-N1,N1-dimethyl-1,2-ethanediamine are reported. The antimicrobial activities of the Pd(II) complexes with the appropriate ligands were tested using the microdilution method against 18 strains of microorganisms, whereby the minimal inhibitory concentration (MIC) and the minimal microbicidal concentration (MMC) were determined. The antibiofilm activity of Pd(terpy)Cl+ and the corresponding ligand were determined on a formed biofilm. The intensity of antimicrobial activity varied depending on the type of microorganism and the tested compound. The C1 complex with the corresponding ligand demonstrated significantly greater overall antimicrobial activity than C2, C3 and C4. The antibacterial activity of the C1 complex was better than its antifungal activity that was overall greater than that of the positive control, fluconazole. The greatest sensitivity for C1 and L1 was with Penicillium italicum (MIC < 0.49 ?g mL-1) among the fungi, and with Proteus mirabilis ATCC 12453 (MIC = 0.98 ?g mL-1) among the tested bacteria. The tested compounds show low and moderate antibiofilm activity. The complexes showed weak antioxidant properties when tested using the DPPH (1,1-diphenyl-2- -picrylhydrazyl) method. The interaction of the metal complexes C1?C4 with calf thymus DNA (CT-DNA) was further examined by absorption (UV?Vis) and emission spectral studies (EthBr displacement studies). Overall, the investigated complexes exhibited good DNA interaction ability.
SARS-CoV-2 continues to pose a major challenge to scientists and clinicians. We examined the significance of the serum concentrations of vitamin D, albumin, and D-dimer for the severity of the ...clinical picture and mortality in COVID-19.
A total of 288 patients treated for COVID-19 infection participated in the research. The patients were treated in the period from May 2020 to January 2021. All patients were divided based on the need for oxygen therapy (Sat > 94%) into patients with mild or severe clinical pictures. The biochemical and radiographic parameters of the patients were analyzed. Appropriate statistical methods were used in the statistical analysis.
In patients with COVID-19 with confirmed severe clinical pictures, lower values of serum albumin (
< 0.0005) and vitamin D (
= 0.004) were recorded, as opposed to elevated values of D-dimer (
< 0.0005). Accordingly, the patients with fatal disease outcomes had lower levels of albumin (
< 0.0005) and vitamin D (
= 0.002), while their D-dimer (
< 0.0005) levels were elevated. An increase in the radiographic score, as a parameter for assessing the severity of the clinical picture, was accompanied by a decrease in serum albumin (
< 0.0005) and a simultaneous increase in D-dimer (
< 0.0005), without a change in the vitamin D concentration (
= 0.261). We also demonstrated the interrelations of the serum levels of vitamin D, albumin, and D-dimer in patients with COVID-19 as well as their significance as predictors of the outcome of the disease.
The significance of the predictive parameters in our study indicates the existence of an important combined role of vitamin D, albumin, and D-dimer in the early diagnosis of the most severe patients suffering from COVID-19. Reduced values of vitamin D and albumin, in combination with elevated values of D-dimer, can be timely indicators of the development of a severe clinical picture and death due to COVID-19.
Background/Aim. Coronavirus disease 2019 (COVID-19) is a predominantly respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The aim of this study was to ...determine whether there were parameters that could predict the development of a severe clinical picture and fatal outcomes in COVID-19 patients. Methods. The study involved 632 patients treated at the Clinic for Infectious Diseases, University Clinical Center Kragujevac, from June 2020 to February 2021. All patients were divided into two groups according to the need for oxygen therapy (Sat 02 < 94 %). Results. Our results showed that high body mass i ndex (BMI) was singled out as a risk factor for the development of a severe clinical picture (BMI, ORadjusted = 1.263; 95% CI = 1.117 ? 1.427; p < 0.001). Prothrombin time (ORadjusted = 1.170; 95% CI = 1.004 - 1.364; p = 0.045), as well as low albumin values (ORadjusted = 0.878; 95% CI = 0.804 - 0.958; p = 0.003), had a predictive signifi-cance for the development of a severe clinical picture. Fac-tors that were of predictive importance in patients with fatal outcomes were C-reactive protein (CRP) (ORadjusted = 1.010; 95% CI = 1.001 ? 1.019; p = 0.031), lactate dehydrogenase (LDH) (ORadjusted = 1.004; 95% CI = 1.001 ? 1.006; p = 0.002), and X-ray of the lungs (ORadjusted = 1.394; 95% CI = 1.170 ? 1.661; p < 0.001). Conclusion. The study showed that routine, clinical laboratory parameters can be important in the early detection of patients with a potentially severe clinical picture and fatal outcomes. In patients with a mild clinical picture, CRP, LDH, ferritin, and serum albumin levels may timely indicate disease progression. Monitoring these parameters is of essential importance for the timely clinical assessment of patients with COVID-19 and, thus, the prompt application of adequate therapeutic protocols in the treatment of these patients.
Over the years, transition metal complexes have exhibited significant antimicrobial and antitumor activity. It all started with cisplatin discovery, but due to the large number of side effects it ...shows, there is a growing need to find a new metal-based compound with higher selectivity and activity on more tumors.
Two novel trans-palladium(II) complexes with organoselenium compounds as ligands, Pd(L1)
Cl
(L1 = 5-(phenylselanylmethyl)-dihydrofuran-2(3H)-one) and Pd(L2)
Cl
(L2 = 2- methyl-5-(phenylselanylmethyl)- tetrahydrofuran) were synthesized, in the text referred to as Pd-Se1 and Pd-Se2. Also, a structurally similar trans-palladium(II) complex, Pd(L3)
Cl
(L3= 2,2- dimethyl-3-(phenylselanylmethyl)-tetrahydro-2H-pyran) was synthesized according to an already published work and is referred to as Pd-Se3. The interaction of synthesized complexes with DNA and bovine serum albumin was observed. Also, antimicrobial activity and in vitro testing, cell viability, and cytotoxic effects of synthesized ligands and complexes on human epithelial colorectal cancer cell line HCT-116 were studied. Molecular docking simulations were performed to understand better the binding modes of the complexes reported in this paper with DNA and BSA, as well as to comprehend their antimicrobial activity.
The interactions of the synthesized complexes with DNA and bovine serum albumin were done using UV-Vis and emission spectral studies as well as docking studies. Antimicrobial activity was tested by determining the minimum inhibitory concentrations (MIC) and minimum microbicidal concentration (MMC) using the resazurin microdilution plate method. Cytotoxic activity on cancer cells was studied by MTT test.
The Pd(II) complexes showed a significant binding affinity for calf thymus DNA and bovine serum albumin by UV-Vis and emission spectral studies. The intensity of antimicrobial activity varied with the complexes Pd-Se1 and Pd-Se3, showing significantly higher activity than the corresponding ligand. The most significant activity was shown on Pseudomonas aeruginosa. Under standardized laboratory conditions for in vitro testing, cell viability and cytotoxic effects of synthesized ligands and complexes were studied on human epithelial colorectal cancer cell line HCT-116, where Pd-Se2 showed some significant cytotoxic effects.
The newly synthesized complexes have the potential to be further investigated as metallodrugs.
Pegylated interferon alfa plus ribavirin protocol is currently considered the most efficient hepatitis C treatment. However, no evidence of costs comparison among common viral genotypes has been ...published.
We aimed to assess core drivers of hepatitis C medical care costs and compare cost effectiveness of this treatment among patients infected by hepatitis C virus with genotypes 1 or 4 (group I), and 2 or 3 (group II).
Prospective bottom-up cost-effectiveness analysis from societal perspective was conducted at Infectious Diseases Clinic, University Clinic Kragujevac, Serbia, from 2007 to 2010. There were 81 participants with hepatitis C infection, treated with peg alpha-2a interferon plus ribavirin for 48 or 24 weeks. Economic data acquired were direct inpatient medical costs, outpatient drug acquisition costs, and indirect costs calculated through human capital approach.
Total costs were significantly higher (P = 0.035) in group I (mean ± SD: 12,751.54 ± 5,588.06) compared to group II (mean ± SD: 10,580.57 ± 3,973.02). In addition, both direct (P = 0.039) and indirect (P < 0.001) costs separately were significantly higher in group I compared to group II. Separate comparison within direct costs revealed higher total cost of medical care (P = 0.024) in first compared to second genotype group, while the similar tendency was observed for total drug acquisition (P = 0.072).
HCV genotypes 1 and 4 cause more severe clinical course require more care and thus incur higher expenses compared to HCV 2 and 3 genotypes. Policy makers should consider willingness to pay threshold differentially depending upon HCV viral genotype detected.
Kidney transplantation offers better quality of life in comparison to patient dialysis. Patients with endogenous creatinine clearance 30 mL/min/1.73m2 are introduced into the kidney transplant ...program. Every patient should be assessed for a degree of eligibility for the kidney transplant procedure. Basic principles of eligibility assessment include: patient education, assessment of patient's motivation level, medical risk assessment, as well as evaluation of psychosocial status and the level of family support. Medical risk assessment involves establishing the etiology of the primary kidney disease, cardiovascular status assessment, viral status assessment, risk assessment for renal graft thrombosis, screening for early malignancy detection, assessment of mineral metabolism and bone tissue disorders, and immunological risk assessment. Identification of patients with highest degree of kidney transplant eligibility shall decrease morbidity and mortality, reduce medical costs and improve the quality of life for these patients.
The differential diagnosis of fever of unknown origin (FUO) includes more than 200 different diseases and conditions. The aim of this study was to identify the most frequent causes of FUO among adult ...patients according to gender and age.
The study included 74 patients examined from June 2010 to June 2013 at the Infectious Disease Clinic, Clinical Center Kragujevac in Serbia, according to the defined criteria for FUO. The patients were divided according to the diagnosis into four groups: infectious, malignant, rheumatic and "other diseases". A cause of febricity could not be estabilshed in a portion of subjects, and they comprised the group of undiagnosed cases.
Infectious diseases were dominant in the study, followed by rheumatic diseases, which were most frequently found in women and the elderly. The diseases recognised as the most common causes of febricity were subacute thyroiditis, subacute endocarditis, Still's disease, rheumatic polymyalgia with or without temporal arteritis, and cytomegalovirus infection. In 44% of the patients, the final diagnosis was composed of only six clinical entities.
The importance of establishing the diagnosis of rheumatic disease is especially emphasised, in line with other authors' research indicating the number of these diseases is on the rise. The diagnostic approach to FUO should always be directed to the known frequency of diseases.
The formation equilibria of the Pt(SMC)(H2O)2 complex with some biologically relevant ligands such as L-methionine (L-met) and glutathione (GSH) were studied. The stoichiometry and stability ...constants of the formed complexes are reported, and the concentration distribution of the various complex species has been evaluated as a function of pH. The reaction between PtCl2(SMC) and guanosine-5'-monophosphate (5'-GMP) was studied by H NMR spectroscopy. The NMR spectra indicated that first step is the hydrolysis of the PtCl2(SMC) complex and second step is the substitution of an aqua ligand, either in the cis or trans position with guanosine-5'-monophosphate in molar ratio 1:1. The values of rate constant showed faster substitution of coordinated H2O in the trans position to the S donor atom of S-methyl-L-cysteine, whereas the slower reaction was assigned to the displacement of the cis coordinated aqua molecule. This is due to the strong trans labilization effect of coordinated sulfur.
A retrospective study was performed to evaluate the clinical characteristics of nosocomial infections in patients with acute infection of central nervous system (ACNS infections). The study included ...1,686 patients admitted to the ICU. Of 1,686 patients, 936 (55.5%) had ACNS infection. Nosocomial infections was confirmed in 221 (23.6%) patients with ACNS infection. The most common risk factors for ICU-acquired nosocomial infections were consciousness disorder, mechanical ventilation and nasogastric tube. The coagulase - negative Staphylococcus aureus was the most frequent isolated pathogen (285 isolates, 56.5%). Results suggest that a persistently high level of therapeutic activity and persistently depressed consciousness after the ICU admission are associated with the occurrence of hospital-acquired infection in critically ill patients hospitalized at a medical ICU.
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