Risk factors for enterococcal urinary tract infections: a multinational,retrospective cohort study

European Journal of Clinical Microbiology & Infectious Diseases - Complicated urinary tract infection (cUTI) is a frequent cause of morbidity. In this multinational retrospective cohort study,...     

Newly implemented health system reform in Israel: physicians' attitudes

OBJECTIVE: To explore the attitudes of Israeli physicians towards the feasibility and potential consequences of the newly implemented health care reform. DESIGN: Physicians' attitudes were examined soon after the enactment of a National Health Insurance Law, the first element of the reform to be implemented. SETTING: A nationwide mail survey. SUBJECTS: A random sample of 2000 practicing physicians. MAIN OUTCOME MEASURES: Attitudes towards the health care system prior to the reform; predicted effects of the reform on health care and medical practice. RESULTS: Most of the respondents think that the system requires a change. Quality of community-based care is expected to increase, in contrast to hospital care. The reform is believed to exert an adverse effect on medical practice. Attitude is significantly influenced by practice setting and speciality: community setting and general practice correlate with less desire for a major change. Specialists believe that reform elements which will shift the balance towards the hospitals will have the greatest benefit on the health system. GPs, compared to specialists, are more optimistic regarding quality and accessibility of services (P<0.01). CONCLUSIONS: Our survey suggested that Israeli physicians favor a change in the health care system, despite a perceived adverse effect of the reform on medical practice. Since the reform is believed to shift the balance from the hospitals to the community, respondents support changes that will compensate for the imbalance.     

Using PEGylated nano-liposomes to target tissue invaded by a foreign body

The ability of nano (～100 nm) sterically stabilized liposomes (nSSLs) to target tissue invaded by a foreign body was demonstrated. Radioactively labeled nSSL remote loaded with the anti-inflammatory drug methylprednisolone hemisuccinate (MPS), to form nSSL–MPS, were injected i.v. to mice that, 2 or 3 weeks earlier, had either a thorn or a needle implanted in a hind leg. Twenty-four hours post-nSSL–MPS injection, animals were sacrificed, and the level of liposomes in the vicinity of the foreign body, in comparison to the tissue in the contralateral (normal) leg, was measured. The level of liposomes in the tissue surrounding the foreign body was twice as high as the level of liposomes found in the normal leg. Furthermore, the level of liposomes in the normal leg was similar to the level of liposomes measured in the legs of control animals that did not have an implanted foreign body and were treated with nSSL–MPS. The implications of these findings and the clinical applications of liposomal targeting are discussed.     

‘Attentive movement’ as a method for treating depression

The objective of this study was to examine whether ‘attentive movement’, is an effective method for treating depression. A quantitative research methodology design was used. Fifty participants took part in attentive movement group therapy sessions once a week for 12 weeks. All completed the Beck Depression Inventory (BDI) and a demographic questionnaire. A mixed-design ANOVA was performed; the between-group variables included the study groups (control/experimental) and the within-test group comparison examined measurement time (time1/time2). Results revealed a significant effect for measurement time (F (1,44) = 27.78, p < .001), which indicated a significant reduction in the symptoms of depression from the first measurement (M = .98, SD = .39) to the second measurement (M = .72, SD = .50). The level of depression following treatment in the experimental group was significantly lower than in the control group. The research hypothesis was confirmed.     

Glucocorticoids in nano-liposomes administered intravenously and subcutaneously to adjuvant arthritis rats are superior to the free drugs in suppressing arthritis and inflammatory cytokines

We have previously shown that intravenous (i.v.) treatment with sterically stabilized nano-liposomes (NSSL) actively remote-loaded with the glucocorticoid (GC) methylprednisolone hemisuccinate (NSSL-MPS) or betamethasone hemisuccinate (NSSL-BMS) significantly decreased severity of adjuvant arthritis in Lewis rats (a model of human rheumatoid arthritis) throughout all disease stages. Here, we compared i.v. or subcutaneous (s.c.) weekly treatment with each of the two NSSL-GC to weekly or daily treatment with the free drugs or with the TNF-α antagonists Infliximab and Etanercept. Therapeutic efficacy and effects on the profile of pro-inflammatory (IL-6, TNF-α, and INF-γ) and anti-inflammatory (IL-10 and TGF-β) cytokines in rat sera and splenocyte tissue culture supernatants were compared to those of the liposomal and free drugs. Both s.c. and i.v. NSSL-GC suppressed arthritis significantly, compared to higher doses of the free drugs or to TNF-α antagonists. NSSL-GC also suppressed the secretion of pro-inflammatory cytokines, but did not change the levels of TGF- β. The highly efficacious anti-inflammatory therapeutic feature of these nano-drugs makes them candidates for treatment of human rheumatoid arthritis.