From ancient times to the present, mankind has experienced many infectious diseases, which have mutually affected the development of society and medicine. In this paper, we review various historical ...and current infectious diseases in a five-period scheme of medical history newly proposed in this paper: (1) Classical Western medicine pioneered by Hippocrates and Galen without the concept of infectious diseases (ancient times to 15th century); (2) traditional Western medicine expanded by the publication of printed medical books and organized medical education (16th to 18th century); (3) early modern medicine transformed by scientific research, including the discovery of pathogenic bacteria (19th century); (4) late modern medicine, suppressing bacterial infectious diseases by antibiotics and elucidating DNA structure as a basis of genetics and molecular biology (20th century, prior to the 1980s); and (5) exact medicine saving human life by in vivo visualization and scientifically verified measures (after the 1990s). The historical perspectives that these five periods provide help us to appreciate ongoing medical issues, such as the present COVID-19 pandemic in particular, and remind us of the tremendous development that medicine and medical treatment have undergone over the years.
Flavonoids are plant-produced secondary metabolites that are found ubiquitously. We have previously reported that apigenin, a class of flavonoid, has unique antimicrobial activity against ...Staphylococcus aureus (S. aureus), one of the major human pathogens. Apigenin inhibited fluoroquinolone-resistant S. aureus with DNA gyrase harboring the quinolone-resistant S84L mutation but did not inhibit wild-type DNA gyrase. In this study, we describe five flavonoids, quercetin, luteolin, kaempferol, baicalein, and commercially available CID12261165, that show similar antimicrobial activity against fluoroquinolone-resistant S. aureus. Among them, CID12261165 was the most effective with MIC values of ≤ 4 mg/L against quinolone-resistant S. aureus strains. In vitro DNA cleavage and supercoiling assays demonstrated inhibitory activity of CID12261165 against mutated DNA gyrase, whereas activity against wild-type DNA gyrase was not observed. CID12261165 also inhibited quinolone-resistant Enterococci with an MIC value of 8 mg/L. While fluoroquinolone-resistant amino acid replacements can improve the fitness of bacterial cells, it is unknown why quinolone-susceptible S. aureus strains were predominant before the introduction of fluoroquinolone. The present study discusses the current discrepancies in the interpretation of antimicrobial activities of flavonoids, as well as the possible reasons for the preservation of wild-type DNA gyrase wherein the environmental flavonoids cannot be ignored.
The taxonomic classification of
species has been revised and updated several times. This study utilized average nucleotide identity (ANI) and digital DNA-DNA hybridization (dDDH) cutoff values of 95 ...and 70 %, respectively, to re-identify the species of strains deposited in GenBank as
,
and
. Of the 264 deposited
strains, 259 were correctly identified as
, but the remaining five were not. All 28 deposited
strains had been incorrectly identified as
. Four of these strains were re-identified, including two as
and one each as
and
, but the remaining 24 could not be re-identified. Similarly, all 35 deposited
strains had been incorrectly identified as
. Nineteen of these strains were re-identified, including 12 as
, four as
and one each as
,
and
. These results strongly suggest that
bacteria should be identified using ANI and dDDH analyses based on whole genome sequencing when
species are initially deposited in GenBank/DDBJ/EMBL databases.
Although infection with the methicillin-resistant Staphylococcus aureus (MRSA) clone USA300 is extremely rare in Japan, the uniquely evolved clone ΨUSA300 has been reported in Japan. An outbreak of a ...distinct USA300 clone was recently reported in an HIV/AIDS referral hospital in Tokyo. The present study investigated the evolutionary origin and genetic diversity of USA300-related clones causing regional outbreaks among people living with HIV (PLWHIV) in Tokyo. MRSA isolates collected from PLWHIV in an HIV/AIDS referral center in Tokyo were subjected to whole-genome sequencing and their genetic features were compared with those of previously described USA300 MRSA genomes. Of the 28 MRSAs isolated in 2016-2019, 23 (82.1%) were identified as USA300, with 22 (95.6%) of the latter identified as ΨUSA300. Although the genomic structure of ΨUSA300 was identical to the structures of reference USA300 strains, one clade (cluster A) was found to have acquired 29 previously identified lineage-specific mutations in a stepwise manner. The estimated divergence dates of ΨUSA300 and Cluster A were 2009 and 2012, respectively. These findings suggested that the ΨUSA300 clone had spread among PLWHIVs in Tokyo in the early 2010s, with stepwise acquisition of lineage-specific nonsynonymous mutations.
During the exploration of microbial natural resources, two strains of
Pseudomonas
, PS14
T
and PS24
T
, were isolated from samples taken from Izu Oshima, a volcanic island located 120 km southwest of ...central Tokyo. Phylogenetic analysis based on 16S rRNA gene sequences showed that PS14
T
was most similar to
Pseudomonas baetica
a390
T
(99.6%) and
Pseudomonas helmanticensis
OHA11
T
(99.5%), and that PS24
T
was most similar to
Pseudomonas qingdaonensis
JJ3
T
(98.8%) and
Pseudomonas lutea
OK2
T
(98.7%). The major fatty acids of these two strains were C
16:0
and C
17:0
cyclo, summed feature 3 (C
16:1
ω6c and/or C
16:1
ω7c), and summed feature 8 (C
18:1
ω7c and/or
18:1
ω6c). The phylogenetic analyses, DNA-DNA hybridization results and phenotypic traits indicated that PS14
T
and PS24
T
constitute two novel species,
Pseudomonas atagosis
sp. nov. (type strain PS14
T
= CECT 9940
T
, = LMG 31496
T
) and
Pseudomonas akappagea
sp. nov. (type strain PS24
T
= CECT 9941
T
, = LMG 31497
T
), respectively. The sequence data of the draft genomes of PS14
T
and PS24
T
were deposited in the GenBank database under accession numbers VXCA00000000 and VXCP00000000, respectively, and the sequence data of their 16S rRNA genes were deposited in the GenBank database under accession numbers MN396717 and MN382268, respectively.
The COVID-19 pandemic has required an increased need for rehabilitation activities applicable to patients with chronic diseases. Telerehabilitation has several advantages, including reducing clinic ...visits by patients vulnerable to infectious diseases. Digital platforms are often used to assist rehabilitation services for patients in remote settings. Although web portals for medical use have existed for years, the technology in telerehabilitation remains a novel method.
This scoping review investigated the functional features and theoretical approaches of web portals developed for telerehabilitation in patients with chronic diseases.
PubMed and Web of Science were reviewed to identify articles associated with telerehabilitation. Of the 477 nonduplicate articles reviewed, 35 involving 14 portals were retrieved for the scoping review. The functional features, targeted diseases, and theoretical approaches of these portals were studied.
The 14 portals targeted patients with chronic obstructive pulmonary disease, cardiovascular, osteoarthritis, multiple sclerosis, cystic fibrosis diseases, and stroke and breast cancer survivors. Monitoring/data tracking and communication functions were the most common, followed by exercise instructions and diary/self-report features. Several theoretical approaches, behavior change techniques, and motivational techniques were found to be utilized.
The web portals could unify and display multiple types of data and effectively provide various types of information. Asynchronous correspondence was more favorable than synchronous, real-time interactions. Data acquisition often required assistance from other digital tools. Various functions with patient-centered principles, behavior change strategies, and motivational techniques were observed for better support shifting to a healthier lifestyle. These findings suggested that web portals for telerehabilitation not only provided entrance into rehabilitation programs but also reinforced participant-centered treatment, adherence to rehabilitation, and lifestyle changes over time.
Objective Most strains of methicillin-resistant Staphylococcus aureus (MRSA) analyzed to date have been from industrialized countries, with information lacking on the epidemiology of MRSA in other ...regions of the world. The present study describes the molecular epidemiology of MRSA strains collected at a referral hospital in Surabaya City, Indonesia in 2015-2016. The similarity of strains isolated in Indonesia to known lineages of MRSA was investigated.Materials Of 45 MRSA strains isolated in Surabaya, 10 were selected by antibiotic resistance patterns and clinical features, while excluding duplicates. Methods: Whole genome sequencing was performed using a next-generation sequencer, and the complete genome sequence of one of these 10 strains was also determined by the PacBio system. The strains were subjected to molecular epidemiological analyses, including the presence of drug-resistance and virulence-related genes, the determination of sequence types and staphylococcal cassette chromosome mec (SCCmec) types and mutual phylogenetic relationships, using standard analytical tools.Results The molecular types of these MRSA strains showed significant diversity. Complete sequencing of the genome of strain IDSA1 showed that it belonged to the ST239 group, while also having unique mobile genetic elements. Conclusions: Despite the small number of MRSA strains collected in a limited area and over a short period of time, these strains were found to have arisen in many other regions of the world, suggesting that they had migrated into Indonesia through human movement. These strains also showed molecular differentiation after migrating into Indonesia.
Objective: To meet the new standard of the annual dose limit for the eye lens recommended by the International Commission on Radiation Protection, radiation doses of neuroendovascular procedures in ...Japanese institutions were investigated.Methods: Radiation doses to operators involved in 304 neuroendovascular procedures at 30 Japanese institutions were prospectively surveyed. The institutions recruited at an annual meeting of the Japanese Society for Neuroendovascular Therapy participated voluntarily. A maximum of 10 wireless dosimeters were attached to the radiation protection (RP) goggles, the ceiling-mounted RP shielding screen, and the operators’ forehead and neck over the protective clothing. Doses recorded inside the goggles were defined as eye lens doses for operators who wore RP goggles, while doses to the forehead were defined as eye lens doses for those who did not. The shielding effect rates of the protection devices were calculated, and statistical analysis was performed for the comparison of radiation doses.Results: From 296 analyzed cases, mean eye lens radiation doses per procedure were 0.088 mGy for the left eye and 0.041 mGy for the right eye. For the left eye, that dose without RP equipment was 0.176 mGy and that with RP goggles plus an RP shielding screen was 0.034 mGy. Four parameters, including left eye dose, air kerma at the patient entrance reference point, fluoroscopic time, and the total number of frames, were assessed for five types of neurovascular procedures. Of them, transarterial embolization for dural arteriovenous fistula was associated with the highest eye lens dose at 0.138 mGy. The shielding effect rates of protection goggles were 60% for the left and 55% for the right RP goggle. The mean doses to the inner and outer surfaces of the RP shielding screen were 0.831 mGy and 0.040 mGy, respectively, amounting to a shielding effect rate of 95%.Conclusion: To meet the new standard, both RP goggles and RP shielding screens are strongly recommended to be used effectively. Without proper use of radiological protection devices, the number of neuroendovascular procedures that one operator performs per year will be limited under the new guideline.
Since the discovery of the first strain in 1961 in England, MRSA, the most notorious multidrug-resistant hospital pathogen, has spread all over the world. MRSA repeatedly turned down the challenges ...by number of chemotherapeutics, the fruits of modern organic chemistry. Now, we are in short of effective therapeutic agents against MRSA prevailing among immuno-compromised patients in the hospital. On top of this, we recently became aware of the rise of diverse clones of MRSA, some of which have increased pathogenic potential compared to the classical hospital-associated MRSA, and the others from veterinary sources. They increased rapidly in the community, and started menacing otherwise healthy individuals by causing unexpected acute infection. This review is intended to provide a whole picture of MRSA based on its genetic makeup as a versatile pathogen and our tenacious colonizer.