In vitro antiviral activity against rotavirus and astrovirus infection exerted by substances obtained from Achyrocline bogotensis (Kunth) DC. (Compositae).

BACKGROUND: Achyrocline bogotensis has been traditionally used to treat infections of skin, respiratory, tract urinary and other infections, but not to treat viral gastrointestinal disease. In this study, this Colombian native medicinal plant was investigated by its in vitro anti-rotavirus and anti-astrovirus activity. METHODS: Several extracts and fractions phytochemically obtained from A. bogotensis were evaluated initially for their cell toxicity on MA104 and Caco2 cells and then for their anti-rotavirus (RRV) and anti-astrovirus (Yuc8) activity following three strategies: pre-treatment of cells (blocking effect), direct viral activity (virucidal effect) and post-treatment of infected cells (reduction of viral yield post-infection). In addition qualitative chemical studies were developed for the active compounds. RESULTS: Non-toxic concentrations of a fraction obtained exhibited antiviral activity against both viruses characterized by a virucidal effect and by the reduction of the infectious particles produced post-infection. Steroids, sterols, terpenes, phenols, flavonoids and sesquiterpenlactones were identified qualitatively in the active fraction. CONCLUSIONS: A. bogotensis contains substances with in vitro antiviral activity against rotavirus and astrovirus. This study confirms their anti-microbial properties and describes by the first time its antiviral activity in vitro.

Pharmacodynamics of fosfomycin: insights into clinical use for antimicrobial resistance.

The aim of this study was to improve the understanding of the pharmacokinetic-pharmacodynamic relationships of fosfomycin against extended-spectrum beta-lactamase (ESBL)-producing Escherichia coli strains that have different fosfomycin MICs. Our methods included the use of a hollow fiber infection model with three clinical ESBL-producing E. coli strains. Human fosfomycin pharmacokinetic profiles were simulated over 4 days. Preliminary studies conducted to determine the dose ranges, including the dose ranges that suppressed the development of drug-resistant mutants, were conducted with regimens from 12 g/day to 36 g/day. The combination of fosfomycin at 4 g every 8 h (q8h) and meropenem at 1 g/q8h was selected for further assessment. The total bacterial population and the resistant subpopulations were determined. No efficacy was observed against the Ec42444 strain (fosfomycin MIC, 64 mg/liter) at doses of 12, 24, or 36 g/day. All dosages induced at least initial bacterial killing against Ec46 (fosfomycin MIC, 1 mg/liter). High-level drug-resistant mutants appeared in this strain in response to 12, 15, and 18 g/day. In the study arms that included 24 g/day, once or in a divided dose, a complete extinction of the bacterial inoculum was observed. The combination of meropenem with fosfomycin was synergistic for bacterial killing and also suppressed all fosfomycin-resistant clones of Ec2974 (fosfomycin MIC, 1 mg/liter). We conclude that fosfomycin susceptibility breakpoints (≤64 mg/liter according to CLSI [for E. coli urinary tract infections only]) should be revised for the treatment of serious systemic infections. Fosfomycin can be used to treat infections caused by organisms that demonstrate lower MICs and lower bacterial densities, although relatively high daily dosages (i.e., 24 g/day) are required to prevent the emergence of bacterial resistance. The ratio of the area under the concentration-time curve for the free, unbound fraction of fosfomycin versus the MIC (fAUC/MIC) appears to be the dynamically linked index of suppression of bacterial resistance. Fosfomycin with meropenem can act synergistically against E. coli strains in preventing the emergence of fosfomycin resistance.

Patologías tratadas con oxigenoterapia hiperbárica en el Hospital Central de la Defensa / Pathologies treated with hyperbaric oxygen therapy in The Central Hospital of Defense

INTRODUCCIÓN: La oxigenoterapia hiperbárica (OHB) es una modalidad terapéutica que se fundamenta en la obtención de presiones parciales de oxígeno elevadas en sangre, al respirar oxígeno puro, en el interior de una cámara hiperbárica a una presión superior a la atmosférica. Sus acciones incluyen efectos hemodinámicos, acciones sobre la inmunidad y el transporte de O2. Este amplio espectro de efectos facilita que sus recomendaciones puedan incluir una gran variedad de indicaciones, algunas de ellas controvertidas. OBJETIVOS: Conocer las patologías de los pacientes tratados con OHB en la Comunidad Autónoma de Madrid (CAM) y revisar la evidencia científica al respecto. MÉTODO: En la actualidad la cámara hiperbárica del Servicio de MSB (Medicina Subacuática) del HCD (Hospital Central de la Defensa) es la de referencia en la CAM. Se revisaron las historias clínicas de los pacientes atendidos entre Febrero 2013 y Junio 2014. Se recogieron las siguientes variables: 1) Enfermos aceptados y desestimados para el tratamiento. 2) Edad y sexo de los pacientes tratados. 3) Patología por la que se indicaba el tratamiento. 4) Complicaciones observadas en relación con la OHB. RESULTADOS: Se aceptaron para tratamiento 113 enfermos procedentes de 15 Hospitales de la CAM. Se desestimaron para tratamiento con OHB a 22 pacientes por patologías o tratamientos activos que no hacían aconsejable el tratamiento con OHB en ese momento. El 59,82 % eran hombres y el 40,18 % mujeres. Edad media 64,72 años. Las indicaciones principales de tratamiento fueron las lesiones radio inducidas 52,21 % de los casos (n=59) y las úlceras y heridas de evolución tórpida con mala respuesta a tratamiento convencional 23 % de los casos (n=26). El tratamiento tuvo que ser suspendido en 8 pacientes (7,14 % de los tratados) por mala tolerancia o complicaciones leves. DISCUSIÓN Y CONCLUSIONES: Las indicaciones de OHB en nuestra muestra comprenden un amplio número de patologías. Las lesiones radio inducidas son la indicación más frecuente de los enfermos tratados con OHB en el HCD. En este grupo destaca la osteorradionecrosis de mandíbula (ORNM) tras radioterapia (RT) en tumores de cabeza y cuello. Todas las indicaciones de OHB de la muestra presentada cuentan con estudios que avalan su uso, aunque no existen para ninguna de ellas estudios randomizados controlados, doble ciego. Las complicaciones que observamos en el tratamiento con OHB en nuestra muestra son leves por lo que la podemos considerar un tratamiento seguro. Creemos que la OHB ofrece una gran oportunidad para investigar la evidencia científica firme que avale sus indicaciones en discusión

INTRODUCTION: Hyperbaric oxygen therapy (HBOT) is a therapeutic modality that is based on obtaining high partial pressures of oxygen in blood, breathing pure oxygen inside a hyperbaric chamber at a pressure above atmospheric. Their actions include hemodynamic effects, actions on immunity and O2 transport. This broad spectrum of effects makes its recommendations may include a variety of indications, some of them controversial. OBJECTIVES: To know the pathologies of patients treated with HBO in the Autonomous Community of Madrid (CAM) and review the scientific evidence for this. METHOD: At present the hyperbaric chamber MSB Service (Underwater Medicine) HCD (Central Hospital of Defense) is the reference in the CAM. The medical records of patients treated between February and June-13-14 were reviewed. The following variables were collected: 1) Sick accepted and rejected for treatment. 2) Age and sex of patients treated. 3) Patho-logy for which treatment is indicated. 4) Complications observed in connection with HBO. RESULTS: 113 patients accepted for treatment from 15 hospitals in the CAM. Were rejected for HBO therapy for pathologies 22 patients or active treatments did not advisable HBO therapy at that time. The 59.82% were male and 40.18% female. Mean age 64.72 years. The main indica-tions for treatment were within lesions induced 52.21% of cases (n = 59) and ulcers and wounds torpid with poor response to conventional treatment 23% of cases (n = 26). The treatment had to be suspended in 8 patients (7.14% treated) by poor tole-rance or mild complications. DISCUSSION AND CONCLUSIONS: The indications for HBO in our sample comprises a large number of pathologies. Radio induced injuries are the most common indication for patients treated with HBO in the HCD. In this group highlights the jaw osteoradionecrosis (ORNM) after radiotherapy (RT) in head and neck tumors. All indications OHB sample have presented studies supporting its use, although there are none for randomized controlled trials, double-blind. The complications observed in the HBO treatment in our sample are mild so we can consider it a safe treatment. We believe that HBO offers a great opportunity to investigate the firm scientific evidence to support its indications discussion

Optimised empiric triple and concomitant therapy for Helicobacter pylori eradication in clinical practice: the OPTRICON study.

BACKGROUND: Empiric triple therapy for Helicobacter pylori should be abandoned when clarithromycin resistance rate is >15-20%. Optimisation of triple therapy (high-dose acid suppression and 14-day duration) can increase eradication rates by 10%. AIM: To compare the efficacy and safety of optimised triple (OPT-TRI) and nonbismuth quadruple concomitant (OPT-CON) therapies. METHODS: Prospective multicentre study in 16 Spanish centres using triple therapy in clinical practice. In a 3-month two-phase fashion, the first 402 patients received an OPT-TRI therapy [esomeprazole (40 mg b.d.), amoxicillin (1 g b.d) and clarithromycin (500 mg b.d) for 14 days] and the last 375 patients an OPT-CON treatment [OPT-TRI therapy plus metronidazole (500 mg b.d)]. RESULTS: Seven-hundred seventy-seven consecutive patients were included (402 OPT-TRI, 375 OPT-CON). The OPT-CON therapy achieved significantly higher eradication rates in the per-protocol [82.3% (95% CI = 78-86%) vs. 93.8% (91-96%), P < 0.001] and intention-to-treat analysis [81.3% (78-86%) vs. 90.4% (87-93%), P < 0.001]. Adverse events (97% mild/moderate) were significantly more common with OPT-CON therapy (39% vs. 47%, P = 0.016), but full compliance with therapy was similar between groups (94% vs. 92%, P = 0.4). OPT-CON therapy was the only significant predictor of successful eradication (odds ratio, 2.24; 95% CI: 1.48-3.51, P < 0.001). The rate of participating centres achieving cure rates ≥ 90% favoured OPT-CON therapy (OPT-TRI 25% vs. OPT-CON 62%). CONCLUSIONS: Empiric OPT-CON therapy achieved significantly higher cure rates (>90%) compared to OPT-TRI therapy. Addition of metronidazole to OPT-TRI therapy increased eradication rates by 10%, resulting in more mild adverse effects, but without impairing compliance with therapy.

Interactions of sulforaphane and dimethyl sulfoxide with methyl methanesulfonate, urethane, 4-nitroquinoline-1-oxide and hydrogen peroxide in the Drosophila melanogaster wing spot test.

Sulforaphane (SF) is an isothiocyanate present in Brassicaceae, vegetables that induce the detoxification of electrophiles and reactive oxygen species. SF has been correlated with chemoprevention mechanisms against degenerative diseases. We tested if the SF had an effect against methyl methanesulfonate (MMS), urethane (URE), 4-NQO and H(2)O(2). SF (>95% purity, 0.14, 0.28, 0.56 mM) was diluted in a DMSO/Tw80/EtOH mixture (DTE) corresponding to 25, 50, 100% of lyophilized broccoli. The SF treatment (0.14 mM) was positive for small spots in the ST cross and negative in the HB cross. In the HB cross, SF (0.28 mM) was genotoxic. In the ST cross, the SF treatments showed a tendency to reduce the genotoxic damage caused by MMS, which could be explained by the radical scavenging action of the DTE mixture. In the ST cross, the frequency of small spots in the SF 0.14 mM/URE treatment was similar to that of Water/URE, which can be explained by a DTE and SF scavenger action. In both crosses, the results for the direct oxidants, 4-NQO and H(2)O(2), were different and must be related to differential modulation of CYPs expression and the SF and DTE scavenger properties.

Prognostic significance of thymidylate synthase, dihydropyrimidine dehydrogenase and thymidine phosphorylase protein expression in colorectal cancer patients treated with or without 5-fluorouracil-based chemotherapy.

BACKGROUND: Low tumour expression levels of thymidylate synthase (TS), dihydropyrimidine dehydrogenase (DPD) and thymidine phosphorylase (TP) have been linked with improved outcome for colorectal cancer (CRC) patients treated with 5-fluorouracil (5-FU). It is unclear whether this occurs because such tumours have better prognosis or they are more sensitive to 5-FU treatment. PATIENTS AND METHODS: Associations between TS, DPD and TP levels, determined by tissue microarrays and immunohistochemistry, and survival was evaluated in 945 CRC patients according to treatment status. RESULTS: Low TS and DPD expression associated with worse prognosis in stage II [hazard ratio (HR) = 1.69, 95% confidence interval (CI) (1.09-2.63) and HR = 1.92 (95% CI 1.23-2.94), respectively] and stage III CRC patients treated by surgery alone [HR = 1.39 (95% CI 0.92-2.13) and HR = 1.49 (95% CI 1.02-2.17), respectively]. Low TS, DPD and TP associated with trends for better outcome in stage III patients treated with 5-FU [HR = 0.81 (95% CI 0.49-1.33), HR = 0.70 (95% CI 0.42-1.15) and HR = 0.66 (95% CI 0.39-1.12), respectively]. CONCLUSION: Low TS and DPD expression are prognostic for worse outcome in CRC patients treated by surgery alone, whereas low TS, DPD and TP expression are prognostic for better outcome in patients treated with 5-FU chemotherapy. These results provide indirect evidence that low TS, DPD and TP protein expression are predictive of good response to 5-FU chemotherapy.

Phytotoxic and fungitoxic activities of the essential oil of kenaf (Hibiscus cannabinus L.) leaves and its composition.

The chemical composition of the essential oil of kenaf (Hibiscus cannabinus) was examined by GC-MS. Fifty-eight components were characterized from H. cannabinus with (E)-phytol (28.16%), (Z)-phytol (8.02%), n-nonanal (5.70%), benzene acetaldehyde (4.39%), (E)-2-hexenal (3.10%), and 5-methylfurfural (3.00%) as the major constituents. The oil was phytotoxic to lettuce and bentgrass and had antifungal activity against Colletotrichum fragariae, Colletotrichum gloeosporioides, and Colletotrichum accutatum but exhibited little or no algicidal activity.

Extracts of Flourensia cernua (L): volatile constituents and antifungal, antialgal, and antitermite bioactivities.

The chemical components of tarbush (Flourensia cernua) leaves were fractionated by extracting successively with hexanes, diethyl ether, and ethanol. Volatile profiles of each fraction were identified by using GC-MS. The hexanes fraction contained mostly monoterpenoids, while the ethanol fraction volatiles were primarily sesquiterpenoids. Crude fractions were tested for activity against fungi, algae, and termites. Application of as little as 1 microg of the essential oil from the hexanes fraction was sufficient to provide visible antifungal activity in bioautography assays. The diethyl ether fraction showed selective activity against the cyanobacterium responsible for the 2-methylisoborneol-induced off-flavor sometimes associated with catfish farming operations. All three fractions exhibited a high degree of antitermite activity.

Extracts of Flourensia cernua reduce consumption of alfalfa pellets by sheep.

Effects of three extracts (hexanes, ether, and ethanol) from tarbush (Flourensia cernua) on intake of alfalfa pellets by lambs were examined. Forty-five ewe lambs were fed one of five treatments for five days (randomized complete block, three lambs per block on each treatment). Treatments were alfalfa pellets (CON) or alfalfa pellets plus ethanol carrier (CAR), hexanes extract (HEX), ether extract (ETH), or ethanol extract (ETOH). Extracts were applied to alfalfa pellets at the same concentration as in an equivalent amount of tarbush (as fed basis) in experiment 1 and at 10-fold dilutions of that concentration in experiment 2. Treatments were isolated from tarbush leaves by using a sequential extraction with hexanes, diethyl ether, and 100% ethanol. Lambs received 640 g of alfalfa pellets (dry matter basis) each morning and intake was monitored during a 20-min interval. Lambs were maintained and fed alfalfa pellets (4.7% of body weight) as one group except during this interval. In experiment 1, mean intake by lambs during the 20-min interval was 361, 393, 204, 212, and 228 g for CON, CAR, HEX, ETH, and ETOH, respectively (SEM = 28.9). All three extracts decreased intake (P < 0.001) compared to CON or CAR. Intake did not differ among the three extracts (HEX, ETH, and ETOH) or between the two controls (CON and CAR). Mean intake did not differ among treatments in experiment 2 (468, 455, 389, 381, and 431 g for CON, CAR, HEX, ETH, and ETOH, respectively; SEN = 30.5; P = 0. 187). Several compounds are probably responsible for the low palatability and differential use of tarbush typically exhibited by livestock.

[Acceptance and use of medicinal plants in family medicine]. / Aceptación y uso de herbolaria en medicina familiar.

OBJECTIVE: To explore the degree of usage of therapeutic medical plants among the patients, physicians and health workers in a local Family Medical Care Unit of the Mexican Institute of Social Security (IMSS)). MATERIAL AND METHODS: A transversal descriptive study was performed. A questionnaire focusing on two variables was designed and validated. It was applied to 60 family physicians, a randomized sample of 130 health workers and another of 264 patients of the Family Mediccal Care Unit. Response percentage was 78%. RESULTS: The study found that 83% of family physicians accept the therapeutic use of herbal medicine; moreover, 75% use it as a therapeutic resource. Among health workers, acceptance and use was 100%, while in patients the level of acceptance was of 92% and of use it was 90%. Differences between groups are significant (p < 0.05). The more frequently used plants are Gordolobo (Gnaphalium sp.), Eucalyptus (Eucalyptus sp., probably E. globulus), spearmint (Mentha sp.), camomile (Matricaria chamomilla) and prickly pear cladodes (the vegetative parts of the prickly pear, Opuntia sp. Probably Opuntia ficus indica). CONCLUSIONS: This information agrees with previous reports about Mexico, however, in this case, data were gathered in urban areas where physicians have been trained in the biomedical paradigm of medicine.

Colitis cystica profunda: imaging diagnosis and conservative treatment: report of two cases.

UNLABELLED: Rectally localized colitis cystica profunda can simulate mucosecretory carcinoma. PURPOSE AND METHODS: Because endoscopic examination and barium enema do not clarify the diagnosis, other diagnostic imaging methods such as transrectal ultrasonography, computerized tomography, or magnetic resonance imaging are needed. RESULTS: Transrectal ultrasonography identifies multiple cysts in the rectal submucosa, with areas of echorefringent fibrosis between cysts, and confirms the absence of lymph node involvement or invasion of the muscular layer. Findings with computerized tomography and magnetic resonance imaging have not previously been described for colitis cystica profunda. With computerized tomography, the lesion appears as a noninfiltrating entity in the submucosa, with loss of perirectal layers of fatty tissue and thickening of the levator ani muscle. With nuclear magnetic imaging, nodulations produce intense signals that increase in T2, illustrating the mucoprotein content of the cysts. The presence in surgical biopsy material of large, whole cysts confirms the diagnosis. CONCLUSION: Reeducation of bowel habits aimed at avoiding straining and a high-fiber diet together with bulk laxatives can lead to complete remission of lesions in 6 to 18 months.