The rise of antimicrobial resistance poses a significant challenge to global health. This study investigates the antimicrobial properties of Taraxacum officinale and Chelidonium majus. Taraxacum officinale, commonly known as dandelion, has been utilized for centuries in traditional medicine for its various therapeutic benefits, including treating cholecystitis, enhancing hepatic function, regulating blood pressure and cholesterol levels, and exhibiting diuretic effects. Additionally, research has indicated that infusions derived from this plant offer favorable outcomes in managing renal diseases. This study aims to assess the antimicrobial activity of extracts from Taraxacum officinale and Chelidonium majus employing qualitative screening, quantitative determination, and in vitro evaluation of anti-biofilm properties. In vitro evaluation of the antibiofilm activity of plant products revealed their ability to inhibit the development of biofilms on inert substrate; plant extracts of C. majus were found to inhibit biofilm formation in all bacterial strains tested, while tincture of T. officinale showed very good activity on gram-negative and fungal strains. The results obtained are promising, supporting further research into the biochemical characteristics of these extracts in order to formulate strategies for the control of bacterial and fungal infections in humans.
The evolution of the planet's climate is multifactorial influenced and has a dynamic over time. Many scientists have approached this controversial field, and each relies on objective but divergent statistics. Geographers have established that planet Earth is in a period of slight slow cooling, not at the level of the four prehistoric ice ages, but only at the level of the Little Ice Age from the Middle Ages which probably caused the great migration of peoples from Asia to Europe. This slow cooling is only slowed down and may even be partially reversed by anthropogenic activities. The industry produces large amounts of carbon dioxide from burning fossil fuels and other greenhouse gases. Animals produce carbon dioxide through respiration and digestion, some also methane. The waste degradation, fires, volcanic eruptions, swamps, and thawing of permafrost release carbon dioxide, methane, and other greenhouse gases into the atmosphere. Climate change exit and has always existed, but there is no scientific evidence for global warming or for climate risks other than those we already know. Public health is already facing danger, directly and indirectly, for multiple reasons, to which „climate change” is added.
The novel coronavirus, identified in December 2019, has caused a pandemic that will remain in the medical literature as SARS-CoV-2, the etiological agent of the Covid-19 disease. It was initially stated that this disease would not be more serious than the flu, in terms of prevalence, frequency of complications and mortality. Although in the country of origin the epidemic was only local, the virus spread successively to other countries, until it quickly spread to all inhabited continents and was declared a pandemic. Being a new disease and a new virus, the world panicked. The World Health Organization released guidelines to member countries, which they have implemented. Because the disease sped out of control, it became not only a health crisis but also a socio-economic one. A year later, we are still facing this disease, about which we have learned a lot but not yet all that is necessary and so the time has come for a certain summing up. The Covid-19 pandemic is a reality of current times, the year 2020 being portrayed as the “COVID year”. The international scientific community has shown that, when needed, it can collaborate beyond classical barriers. Statistics show that the virus is not very aggressive, the disease is not very serious but there are also serious, sometimes fatal complications to which appropriate measures must be applied. The risk of serious illness and life-threatening complications is statistically reduced over time, the disease being less severe now than at the beginning, so it is on a downward slope.
The biological agent most likely to be used as a biological weapon is Bacillus anthracis, which causes the anthrax infectious disease. During the Cold War, it was present in large quantities in the military arsenals of some states, and at the beginning of the 21st century was used in a series of small bioterrorist attacks. In case of occurrence of events using Bacillus anthracis, urgent and adequate qualitative and quantitative response measures are needed to manage the consequences of the attack and to reduce the effects on public health. These include complex and well-coordinated activities to ensure medical intervention for the prophylaxis, treatment and recovery of patients. General prophylaxis is achieved by vaccination, individual and collective CBRN protection, decontamination, partial and total sanitary treatment, microbiological analysis for the detection, identification and confirmation of the biological agent. Therapy for disease induced by weaponized B. anthracis differs from classic antrax disease regarding antibiotics, doses and time, resulting a large antibiotic consumption per case. Complete recovery of the patients is achieved not only in terms of restoring normal biological parameters, but also in terms of the organism’s "sterilisation" regarding the causal biological agent.
All large armies (EU and/or NATO) have pharmaceutical production facilities to provide the necessary antidotes for the troops and the population: The French Army Medical Directorate produces many military-specific pharmaceutical products in its own laboratory, the Turkish Army owns its own medicines factory, including CBRN antidotes, the US Army, in addition to a sustained drug purchase program in the pharmaceutical industry has launched a new concept: Pharmacy on demand. Providing the armed forces with antidotes is a necessity, the concept for their endowement in this sense can be based on imports (sometimes impossible to achieve) or on the national development of a specialized production structure. The design or construction of a specific production capacity for antidotes can be accomplished on multiple variants, with a complexity proportional to the identified need. The total costs are high, but the objective and implementation of effective antidote supply mechanisms is a security guarantee for the armed forces and the civilian population (through commercialization to allied forces), given the risks of terrorist threats and hybrid warfare.
The treatment of diseases is based on pharmacological and non-pharmacological means, but adequate devices are needed for their application. Medicine uses a wide range of medical devices. Currently, many medical devices are used, many of them being disposable. As recognition of the importance of medical devices, the national authority of the drug is the ANMDM (National Agency for Medicines and Medical Devices). Medical devices are indispensable for therapy, and their evolution has led to an extraordinary diversification of the field and the emergence of industry related to the pharmaceutical industry, with specific laws and regulations.
The “volatile” international context requires the strengthening of the national security measures, including in the field of CBRN and public health. The medical countermeasures for the defense are based ultimately on the prophylactic treatment (pre-exposure, intra-exposure and post-exposure) and on the curative treatment (of emergency, maintenance and recovery) of the contaminated and the sick. Depending on the rapid and correct etiological diagnosis, the appropriate treatment is immediately applied. Although in times of peace this scenario is almost non-existent, during war or terrorist attack it can be a mass pathology, like an explosive epidemic, that requires specific therapeutic means. Military medicine had and has the conceptual capacity to make antidotes for CBRN medical protection; some have been patented and/or produced as experimental models, but it has no manufacturing capacity anymore.
Given the continuous growth of the bacterial resistance phenomenon, the appropriate choice of antibiotherapy represents an important step in the treatment and prophylaxis of infectious diseases. Depending on the symptomatology, the dose required for the effective treatment of an infection may vary. Inadequate dosing not only reduces the effectiveness of the antibiotic, but also promotes the emergence of resistant bacterial strains. Also, too high of a dose increases the toxic side effects of antibiotics. Therefore, a personalised antibiotherapy according to: the patient's clinical status, body mass, associated chronic diseases, etc. represents a promising approach in the treatment of infectious diseases. The purpose of this study is to present the most important current affairs regarding the emergence of new antibiotics, the maximum doses recommended by the latest version of the "European Committee on Antimicrobial Susceptibility Testing" (EUCAST - version 9/2019) and providing an indication on whether these antibiotics are used in Romania.
The biological attack is the artificial spread by various means of pathogens that can cause serious infectious and contagious diseases as well as the spread of germ toxins that can be used by an aggressor as a means of fighting in order to reduce the troops’ fighting force, by causing serious disease outbreaks or by killing people, animals and/or plants. Biological agents are microorganisms and/or microbial, animal or plant toxins, used as specific ammunition for biological weapons or used by terrorists in "bio-chem" attacks. The risks of bioterrorism and biocrime attack in the contemporary world are real, and the history of the 20th century and the beginning of the 21st century confirms this. It is necessary for preventive measures to be implemented on the unlawful use of biological agents. Early medical and non- medical countermeasures must be prepared for the prophylaxis, treatment and cessation of the consequences of any biological attack.
In the current military-political context, with the Cold War having ended, we find ourselves in full anti-terror war, in which Romania is a direct participant, as a member of N.A.T.O. and the E.U., and the issue of biological warfare and bioterrorism is again highly topical but bearing other valences. There is information that there are still laboratories and plants specializing in the research and manufacture of biological weapons. Most of the results of such research are not intended to be published; however, a number of research guidelines that testify to the trends in the improvement of biological weapons and their means of use can be deduced from the data published by researchers from several research institutes. We believe that the threats posed by bioterrorism are real and that it is mandatory to be prepared at any time to prevent, combat and liquidate the consequences of "bio-chem" attacks, respectively the management of the consequences.
Making medical countermeasures requires documentation to assess vulnerabilities, threats and operational risks and bioterrorism through the collection and processing of specific multidisciplinary data in human medicine, veterinary, phytosanitary, the environment, defense and national security, etc. Based on retrospective data and late information (medical intelligence), we can estimate the prospective risk to public health, respectively for troops and civilian population in a given area, the area of operations. The biological military or bioterrorist attack, whether overtly or masqueraded as human or animal epidemics can cause a major biological crisis for troops and the civilian population, for domestic and wild animals, for crops or wild plants or for the environment, which remains contaminated. Therefore, it is important to constantly monitor the situation of infectious diseases in the area of responsibility (national territory, operations theaters) to assess vulnerability, threat and bioterrorist risk but also for making medical anti-bioterrorist countermeasures, which can only be effective by genuine cooperation between all specialized structures of the Ministry of Defense, other departments and the civil society.
Public health is the most important power factor of a nation, from which all other factors derive. Infectious diseases are the most important cause of morbidity and mortality in humans. Vaccination is the most important method of prophylaxis of infectious-contagious diseases. Mass implementation of vaccination prevents the occurrence of epidemics, epizootic diseases or homonymous pandemics, and at the individual level ensures the specific active immunity (total or partial). So the vaccination of the population and/or the risk groups is of strategic importance to the nation, both in peacetime and in time of war. The national antidote production along with anti-infectives (vaccines, therapeutic serums, immunomodulators, antimicrobial chemotherapies and pesticides) has a strategic importance for the health of the population and of the troops. Biological crisis situations are cases of force majeure, where the Medicines Law provides the exception for manufacturing and use, even without a "marketing authorization". The military scientific research could make micro-production of specific drugs (antidotes, antiinfectives) for the needs of the army and the risk groups of the population. An example would be the preparation of vaccines for the prophylaxis of diseases caused by BWA and bioterrorism as niche products. Nothing hinders the preparation of any medication, such as magistral and galenical preparations, or pilot batch, provided there is adequate space, equipment, staff and procedures according to the law or the exception.
Zika virus, the etiological agent of Zika fever, is transmitted by mosquitoes and has been affecting the South American continent starting with 2015. It was reported in several European countries, carried by the people who returned from Latin America, as reported by the health authorities in those countries. Today, according to the World Health Organization (WHO), the virus suspected to cause serious birth defects in the fetus has also been confirmed in 21 of the 55 countries of South America, but also in other states from Europe and North America. Zika virus is a single stranded positive sense RNA virus belonging to Flavivirus genus (family Flaviviridae) and was first identified in 1947 in Uganda rainforest Zika. The increased number of cases of microcephaly, in children from northern Brazil, suggested a connection with Zika virus, but it has not yet been proven. Also, the virus can be transmitted sexually and through blood or blood products. Diagnosis of the infection is made using Polymerase Chain Reaction (PCR). So far, there is no specific antiviral treatment or vaccine against the infection with Zika virus. The best form of prevention is to avoid mosquito bites. WHO has estimated that the spread of Zika virus, transmitted through mosquito bite, is “a global public health emergency”. The priority is to protect pregnant women and to control the mosquitoes.
The international situation requires a strengthening of the national security measures, including in the field of CBRN and public health. The upgraded microbiology laboratories from DM/ MND must be operated at full capacity for the operationalization of an integrated Platform for the research and expertise of biological war and bioterrorism agents. This is necessary for reasons of national security, for CBRN defense and for public health, in the context of biological agents of 3 and 4 risk groups’ epidemics. The existing upgraded objectives should be operationalized in order to meet the established scope: scientific research and expertise of biological agents and biological weapons, a laboratory for in vitro analysis and a bio-base for in vivo analysis. The highly secure lab allows working with any high-risk agents: biological, genetic, chemical, radiological, etc., being provided with a special room for the insertion/removal of equipment and their decontamination. Following an increase in the capability requirements concerning laboratories, we have provided in the design concept new technical parameters of the platform and the integration of new compartments with related activities of toxicology, pathology, neuro-psycho-pharmacology, bio-pharmacy, micro- pharmaceutical, specific testing activities, etc. Creating the integrated platform and its operationalization is necessary in order to meet the requirement of the national security strategy as a collective CBRN defense/protection facility and military-medical scientific research for CBRN medical protection.
Escherichia coli is the species of the genus Escherichia with the greatest epidemiological impact. Escherichia coli infections are found mainly in places with poor hygiene; the infants with ages between 1 and 3 years old are included in the category with the highest risk. It is a "fecal-oral" transmission mechanism as a result of consumption of contaminated food or water, or by "dirty hands". The foods most commonly implicated in the transmission of the infection are unpasteurized milk and milk products, beef, especially the one insufficiently cooked, unpasteurized fruit juice, lettuce and insufficiently washed vegetables. The disease has been reported worldwide, being described numerous episodes of infection with Escherichia coli that caused multiple illnesses and deaths. Escherichia coli has three types of antigens: antigen "O" (somatic), antigen "H" (flagella) and antigen "K" (capsular). Clinical manifestations are present in the form of non-specific diarrhea, a dysentery form of enteritis, choleriform enteritis, hemorrhagic colitis and hemolytic uremic syndrome (HUS). The Escherichia coli infection diagnosis is made by identifying the etiologic agent and/or by highlighting the VTI toxin in the feces. The treatment consists in precautionary antibiotherapy, hydrodynamics and electrolyte rebalancing, blood transfusions and dialysis, if in the case of renal failure. The prevention of infections with Escherichia coli is achieved by personal hygiene, food hygiene and work hygiene.
The spring of 2014 has brought a new calamity, the exotic infectious disease: Ebola Hemorrhagic Fever, which is caused by a highly contagious and pathogenic virus, transmitted directly by interpersonal contact or indirectly by common usage of objects. The epidemic which occurred in Guinea tended to expand to neighboring countries; 83 deaths have been reported on April 1st 2014. Genetic analysis have revealed that the virus that causes this epidemic is similar in a proportion of 98% to Ebolavirus Zaire (EBOV) species that were responsible for the epidemic in Democratic Republic of Congo, in 2008. The Ebola virus belongs to the Filoviridae family, Ebolavirus genus and causes Ebola Hemorrhagic Fever, with a rate of fatality of up to 90% in humans. There are five distinct species: Bundibugyo Ebolavirus (BDBV), Ebolavirus Zaire (EBOV), Reston Ebolavirus (RESTV), Sudan Ebolavirus (SUDV) and Taï Forest Ebolavirus (TAFV).
Clostridium difficile (C. difficile) is a Gram-positive sporogenous bacillus strictly anaerobic, which in the last decade has became the most important anaerobic bacterium in nosocomial human pathology. Cl.dificile is the etiological agent of more than 20% of diarrhea postantibiotics, over 95% of pseudomembranous colitis and the first cause of nosocomial infectious diarrhea in adults. Although this bacterium usually colonizes the intestine of vertebrates (the normal microbiota), the toxinogenic strains (tcdA and tcdB) are pathogenic in the digestive tract. Given the excessive use of antibiotics and the increased spores resistance, it is possible an environment contamination, with strains which may already be resistant to antibiotics. The main causes of this infection are decreased resistance to antibiotic-induced colonization, contamination with a pathogenic strain of Cl.difficile, secretion of A and/or B toxins and deficient immune response. Due to the increasing worldwide incidence of infections with C. difficile on one hand and to the discovery of new ways of transmitting the infection according with some studies regarding the genetic diversity of bacterium strains on the other hand, a new approach is necessary for C. difficile related topics..
Decontamination after terrorist attacks or industrial accidents with biological and/or chemical agents („bio-chem“) must be fast and efficient, in order to reduce the number of victims and to eliminate the consequent damages. The decontamination of living biological agents (bacteria, viruses) or nonliving ones (toxins, regulators) and toxic chemicals could be accomplished by reactions of hydrolysis in various experimental conditions, in particular in alkaline medium, reactions with amines or ammonia, alcohols, phenols etc. and by their transformation into less toxic degradation products. “Bio-chem” intentional or unintentional contamination is a real risk, towards which an effective management must be available to prevent and control it. Decontamination is an essential measure to protect the personnel and the environment. Synthesis and testing of new „bio-chem“ decontaminants, based on quaternary ammonium salts, complete the arsenal of protection against chemical and biological agents. The most effective selected substances could be produced and used for decontamination in accordance with legal procedures.
