[Investigation of the Efficacy of Cinnamaldehyde, Cannabidiol and Eravacycline in a Malaria Model]. / Sitma Modelinde Cinnamaldehyde, Cannabidiol ve Eravacycline'in Etkinliginin Arastirilmasi.

In this study, it was aimed to investigate the antimalarial activity of cinnamaldehyde (CIN) and cannabidiol (CBD) which have shown various biological activities such as potent antimicrobial activity and eravacycline (ERA), a new generation tetracycline derivative, in an in vivo malaria model. The cytotoxic activities of the active substances were determined by the MTT method against L929 mouse fibroblasts and their antimalarial activity were determined by the four-day test in an in vivo mouse model. In this study, five groups were formed: the CIN group, the CBD group, the ERA group, the chloroquine group (CQ) and the untreated group (TAG). 2.5 x 107 parasites/mL of P.berghei-infected erythrocyte suspension was administered IP to all mice. The determined doses of active substances were given to the mice by oral gavage in accordance with the four-day test and the parasitemia status in the mice was controlled for 21 days with smear preparations made from the blood taken from the tail end of the mice. The IC50 values, which express the cytotoxic activity values of the active substances were determined as 27.55 µg/mL, 16.40 µM and 48.82 µg/mL for CIN, CBD and ERA, respectively. The mean parasitemia rate in untreated mice was 33% on day nine and all mice died on day 11. On the ninth day, when compared with the TAG group, no parasites were observed in the CIN group, while the average parasitemia was 0.08% in the CBD group and 17.8% in the ERA group. Compared to the mice in the TAG group, the life expectancy of the other groups was prolonged by eight days in the CIN group, 12 days in the CBD group and eight days in the ERA group. It has been determined that all three active subtances tested in this study suppressed the development of Plasmodium parasites in an in vivo mouse model and prolonged the life span of the mice. It is thought that the strong antimalarial activity of CIN and CBD shown in the study and the possible positive effect of ERA on the clinical course can be improved by combining them with the existing and potential antimalarial molecules.

[Antibacterial Activity and Synergistic Interaction of Various Essential Oil Components and Antibiotics]. / Çesitli Uçucu Yag Bilesenleri ile Antibiyotiklerin Antibakteriyel Etkinligi ve Sinerjik Etkilesimi.

Inappropriate and uncontrolled use of antibiotics in humans and animals leads to the emergence of multi-resistant bacteria. Before the discovery of antibiotics, plant extracts and essential oils were used for therapeutic purposes. Today, due to increasing antibiotic resistance, many studies are frequently carried out on the antimicrobial activities of natural active substances that can be a source for new drug candidates. The aim of this study was to investigate the antibacterial activity of components such as α-pinene (α-PN), p-cymene (p-CYM), carvacrol (CAR), thymol (TY) and eugenol (EG) found in the essential oils of many plants and their synergistic interaction with antibiotics. In this study, the antibacterial activity of these essential oil components and antibiotics in clinical use such as gentamicin (GEN), tetracycline (TET), tigecycline (TGC) and linezolid (LZD), against Staphylococcus aureus [methicillin resistant S.aureus (MRSA), and methicillin sensitive S.aureus (MSSA)], Escherichia coli and Pseudomonas aeruginosa strains were determined by disc diffusion and microdilution method. In addition, the interaction between the essential oil components and antibiotics was also determined by the checkerboard method. While CAR, TY and EG components showed strong antibacterial activity, the antibacterial activity of αPN and p-CYM was found to be weak. Combinations of α-pinene, carvacrol, thymol and eugenol with gentamicin and tetracycline mostly showed synergistic interactions against all bacteria. In αPN, CAR, TY and EG with GEN and TET, synergistic/partial synergistic interaction was observed against S.aureus strains, while indifferent interaction was detected in E.coli and P.aeruginosa strains. The combination of αPN and p-CYM with TGC showed synergistic interaction against E.coli and P.aeruginosa strains, and additive and indifferent interaction against S.aureus strains. On the other hand, synergistic interaction was observed against all bacterial strains in combinations of TGC and CAR, TY and EG components. Antagonistic interaction was not detected in any of the tested component-antibiotic combinations against the bacteria used in our study. A synergistic interaction between natural bioactive components and commonly used antibiotics may contribute to the effectiveness of antibiotics and components at lower doses, minimizing their potential toxic side effects and reducing treatment costs. However, more research is needed in terms of their pharmacokinetic and toxic properties to evaluate the therapeutic application potential of phytochemicals.

Does the Risk of Hypocalcemia Increase in Complementary Thyroidectomy Performed in Papillary Thyroid Cancer?

Objectives: Papillary thyroid cancer (PTC) is the most common type of thyroid cancers. In some patients, due to the histopathological features of PTC, complementary thyroidectomy (CT) may be needed to contralateral thyroid lobe after lobectomy. Hypocalcemia is the most common complication after thyroidectomy and its etiology is multifactorial. It is still controversial whether the CT increases the risk of hypocalcemia or not. In this study, we aimed to evaluate whether CT procedure increases the risk of hypocalcemia compared to total thyroidectomy (TT) in PTC patients. Methods: The data of the patients who were operated between 2015 and 2018 and diagnosed with PTC in the pre-operative or post-operative period were evaluated retrospectively, and two patient groups were formed. Group 1 included 19 patients who were diagnosed with PTC in the pathological examination after lobectomy was performed in the first operation, and after that CT was performed to the contralateral lobe. Among the patients who were diagnosed with pre-operative or post-operative PTC in the same period, 53 patients with characteristics similar to the 1st group in terms of age and gender were selected for Group 2. Biochemical parameters related to calcium metabolism in the pre-operative and post-operative periods, parathyroid autotransplantation and unintentional parathyroid gland removal, post-operative hypocalcemia, and treatment rates were compared between the two groups. Results: There were 19 patients (13 F and 6 M) with a mean age of 48.3±12.1 years and 53 patients with a mean age of 46.3±9 (40 F and 13 M) in Groups 1 and 2, respectively, and there was no significant difference between the groups in terms of age and gender. There was no significant difference in terms of pre-operative parathormone (PTH), phosphorus (P), magnesium (Mg), Vitamin D deficiency rate, parathyroid autotransplantation, and presence of parathyroid gland in thyroid specimen. Pre-operative calcium (Ca) value was 9.33±0.46 in Group 1 and lower than Group 2 (9.65±0.41) (p=0.012). There was no significant difference between the groups in terms of post-operative day 0 Ca, P, Mg, and PTH and post-operative day 1 Ca, Mg, and PTH. Post-operative day 1 P level was significantly lower in Group 1 (2.86±0.72) compared to Group 2 (3.6±0.83). Post-operative hypocalcemia rates were 21.1% and 30.2% in Groups 1 and 2, respectively, and the difference was not significant (p=0.558). In both groups, hypocalcemia was transient and permanent hypoparathyroidism was not detected. Parathyroid autotransplantation rates (10.5% vs. 3.8%; p=0.283) and the rate of unintentionally removed parathyroid gland (0 vs. 15.1; p=0.185) were similar in Groups 1 and 2, respectively. Ca and active Vitamin D administration rates in the post-operative period were similar in Group 1 and Group 2 (10.5% vs. 22.6%; respectively), and there was no significant difference between the groups in terms of receiving treatment (p=0.327). Conclusion: CT can be necessary in some patients with post-operative diagnose of PTC. CT can be performed without increased risk of hypocalcemia compared to TT.

Effect of Low-level Laser Therapy on Postoperative Pain after Root Canal Retreatment: A Preliminary Placebo-controlled, Triple-blind, Randomized Clinical Trial.

INTRODUCTION: Low-level laser therapy (LLLT) is a practical, nonpharmacologic technique for reducing pain. This study evaluated the effect of LLLT on postoperative pain after root canal retreatment (RCR). METHODS: This study enrolled patients (N = 36) who required root canal retreatment (RCR) on mandibular molar teeth, presented with periapical lesions with periapical index scores of 2 or 3, and had a pain visual analog scale (VAS) <50 and a percussion pain VAS <50. The participants were divided into 2 groups: (1) patients scheduled for RCR followed by LLLT (n = 18) and (2) patients scheduled for RCR followed by a mock LLLT (placebo) (n = 18). Postoperative pain was assessed using the VAS. Data were collected and statistically analyzed with the chi-square test, the independent sample t test, and the Mann-Whitney U test (P = .05). RESULTS: On the first 4 days, postoperative pain significantly reduced in the LLLT group compared with the placebo group (P < .05). However, no statistically significant differences in postoperative pain were found between the 2 groups after 5 and 7 days (P > .05). The number of patients who needed analgesics was lower in the LLLT group than in the placebo group (P < .05). No patient reported pain during LLLT application. CONCLUSIONS: LLLT may reduce postoperative pain after RCR of mandibular molars.

Efficacy of neuromuscular electrical stimulation in patients with COPD followed in intensive care unit.

INTRODUCTION: Serious problems on muscle strength and functional status can be seen in bedridden-patients with chronic obstructive pulmonary diseases (COPD) receiving mechanical ventilation. We aimed to investigate the impact of active extremity mobilization and neuromuscular electrical stimulation (NMES) on weaning processes, discharge from hospital and inflammatory mediators in COPD patients receiving mechanical ventilation. METHODS: Thirty conscious COPD patients (F/M:15/15) hospitalized in the intensive care unit (ICU) with diagnosis of respiratory failure were enrolled to this study. Patients were randomized into three groups, including 10 patients for each. Active extremity-exercise training and NMES were applied to Group-1, only NMES was applied to Group-2 and active extremity exercise training was applied to Group-3. Muscle strengths, mobilization duration and weaning situation were evaluated. Serum cytokine levels were evaluated. RESULTS: Lower extremity muscle-strength was significantly improved in Group-1 (from 3.00 to 5.00, P = 0.014) and 2 (from 4.00 to 5.00, P = 0.046). Upper extremity muscle strength was also significantly improved in all three groups (from 4.00 to 5.00 for all groups, P = 0.038, P = 0.046 and P = 0.034, respectively). Duration of mobilization and discharge from the ICU were similar among groups. There was a significant decrease in serum interleukin (IL)-6 level in Group-1 and in serum IL-8 level in Group-1 and Group-2 after rehabilitation. CONCLUSION: This study indicates that pulmonary rehabilitation can prevent loss of muscle strength in ICU. Nevertheless, we consider that further studies with larger populations are needed to examine the impact of NMES and/or active and passive muscle training in bedridden ICU patients who are mechanically ventilated.

Composition, antimicrobial activity and in vitro cytotoxicity of essential oil from Cinnamomum zeylanicum Blume (Lauraceae).

The essential oil from the bark of Cinnamomum zeylanicum Blume was analyzed by GC-MS and bioassays were carried out. Nine constituents representing 99.24% of the oil were identified by GC-MS. The major compounds in the oil were (E)-cinnamaldehyde (68.95%), benzaldehyde (9.94%) and (E)-cinnamyl acetate (7.44%). The antimicrobial activity of the oil was investigated in order to evaluate its efficacy against 21 bacteria and 4 Candida species, using disc diffusion and minimum inhibitory concentration methods. The essential oil showed strong antimicrobial activity against all microorganisms tested. The cytotoxic and apoptotic effects of the essential oil on ras active (5RP7) and normal (F2408) fibroblasts were examined by MTT assay and acridine orange/ethidium bromide staining, respectively. The cytotoxicity of the oil was quite strong with IC(50) values less than 20 µg/mL for both cell lines. 5RP7 cells were affected stronger than normal cells. Morphological observation of apoptotic cells indicated the induction of apoptosis at the high level of the oil, especially in 5RP7 cells. The present study showed the potential antimicrobial and anticarcinogenic properties of the essential oil of cinnamon bark, indicating the possibilities of its potential use in the formula of natural remedies for the topical treatment of infections and neoplasms.

Chemical composition, antibacterial and antifungal activity of the essential oil of Thymbra spicata L. from Turkey.

The composition of the essential oil from aerial parts of Thymbra spicata L. from Turkey was analysed by GC-MS and its in vitro antimicrobial activity was examined. GC-MS analysis of the essential oil resulted in the identification of twenty-three constituents, representing 97.04% of the oil. The major compounds detected in the essential oil were carvacrol (60.39%), gamma-terpinene (12.95%), and p-cymene (9.61%). The in vitro efficacy of the essential oil against 21 bacteria and seven Candida species was examined using disc diffusion and minimum inhibitory concentration (MIC) methods. The essential oil demonstrated strong anti-microbial activity in a wide spectrum against most microorganisms, particularly the yeasts tested. This is the first report on the anticandidal properties of the essential oil of T. spicata. In conclusion, this study confirms that T. spicata essential oil could be considered as a natural antimicrobial source.

The in vitro antioxidant and antimicrobial activities of the essential oil and methanol extracts of Achillea biebersteini Afan. (Asteraceae).

The essential oil and methanol extracts from A. biebersteinii Afan. (Asteraceae) were evaluated for their antimicrobial and antioxidant activities in vitro. The oil showed stronger antimicrobial activity than the extracts. Their antioxidant features were also evaluated using diphenyl-1-picrylhydrazyl (DPPH), inhibition of superoxide and hydroxyl radicals and inhibition of the lipid peroxidation assays. Particularly, polar subfraction of the methanol extract showed antioxidant activity. The GC-MS analysis of the oil has resulted in the identification of 23 components; piperitone, eucalyptol, camphor, chrysanthenone and borneol were the main components. Antimicrobial activity tests carried out with the fractions of the oil showed that the activity was mainly observed in those containing eucalyptol and camphor, in particular, followed by borneol and piperitone.

Antioxidant and antimicrobial activity of the essential oil and methanol extracts of Achillea millefolium subsp. millefolium Afan. (Asteraceae).

The in vitro antimicrobial and antioxidant activities of the essential oil and methanol extracts of Achillea millefolium subsp. millefolium Afan. (Asteraceae) were investigated. GC-MS analysis of the essential oil resulted in the identification of 36 compounds constituting 90.8% of the total oil. Eucalyptol, camphor, alpha-terpineol, beta-pinene, and borneol were the principal components comprising 60.7% of the oil. The oil strongly reduced the diphenylpicrylhydrazyl radical (IC(50)=1.56 micro g/ml) and exhibited hydroxyl radical scavenging effect in the Fe(3+)-EDTA-H(2)O(2) deoxyribose system (IC(50)=2.7 micro g/ml). It also inhibited the nonenzymatic lipid peroxidation of rat liver homogenate (IC(50)=13.5 micro g/ml). The polar phase of the extract showed antioxidant activity. The oil showed antimicrobial activity against Streptococcus pneumoniae, Clostridium perfringens, Candida albicans, Mycobacterium smegmatis, Acinetobacter lwoffii and Candida krusei while water-insoluble parts of the methanolic extracts exhibited slight or no activity. This study confirms that the essential oil of Achillea millefolium possesses antioxidant and antimicrobial properties in vitro.

Compositions and the in vitro antimicrobial activities of the essential oils of Achillea setacea and Achillea teretifolia (Compositae).

GC-MS analysis of the isolated essential oils from air-dried aerial parts of Achillea setacea and Achillea teretifolia, an endemic taxon, resulted in the identification of 51 constituents (79.8% of the total oil) and 42 constituents (87.1% of the total oil), respectively. Eucalyptol (1,8-cineole) was the major constituent of both oils studied (18.5 and 19.9%, respectively). The antimicrobial activities of the essential oils were individually evaluated against 14 microorganisms. Both oils exhibited inhibitory effects on Clostridium perfringens, Acinetobacter lwoffii and Candida albicans with a range of minimum inhibitory concentration values extended from 0.28 to 2.25 mg/ml. Camphor and their derivatives, borneol, terpinen-4-ol and eucalyptol (1,8-cineol) can be considered as the main antimicrobial constituents of the oils studied.