Evaluating the Impact of Interventions and Improvements in Outpatient Intravenous Infusion Therapy at a Hospital in China: A Comprehensive Analysis of Prescription Patterns and Safety Measures.

Background: The excessive use of intravenous infusion in China was once a serious problem, but in recent years, attention has been paid to the phenomenon, and the government has implemented several policies to solve the problem, which has been gradually improved. Aim: This study focuses on evaluating the impact of ongoing interventions and improvements in outpatient intravenous infusion therapy. Methods: From January 2016 to December 2022, we conducted a study to gather annual data on intravenous infusion prescriptions. A data questionnaire, encompassing information on departments, clinical diagnosis, and infusion drugs, was developed for this purpose. We analyzed the changing trends of Top 10 clinical departments with higher intravenous infusion usage rates and Top 10 drugs used. We also evaluated the compliance of intravenous infusion prescriptions with management regulations and drug instructions, for further intervention in the future. Results: The analysis of intravenous infusion prescription rates revealed a gradual decrease from 10.89% to 5.63%. This reduction was statistically significant (P < 0.05). High levels of intravenous infusion use were consistently observed in emergency surgery and emergency medicine. Commonly administered drugs via infusion included antibacterial drugs, tumor medications, proton pump inhibitors, and injections of traditional Chinese medicine. Inappropriate prescriptions are often characterized by issues related to drug dosage, usage, indication, and selection. Trend analysis of unreasonable types revealed significant improvements in "Diagnosis incomplete/unwritten", "Solvent selection", "Dosing frequency", and "Treatment without indication" (P < 0.05). Conclusion: The findings of this study indicate a gradual improvement in the situation regarding intravenous infusion. However, there are still prevalent instances of unreasonable practices that need to be addressed.

Effects of instant controlled pressure drop treatment combined with refractance window drying on infusion quality of made green tea.

BACKGROUND: The study aimed to determine the effects of instant controlled decompression of steam pressure, termed as ICPD (instant controlled pressure drop) on fresh tea leaves, when combined with refractance window drying (RWD) of rolled green teas during green tea manufacturing. The ICPD steam treatment pressure (TP; 0.1-0.3 MPa), treatment time (TT; 10-20 s) and refractance window drying temperature (RWDT; 70-90 °C) were used as the processing parameters for manufacturing of green tea. RESULT: Response surface methodology was employed to enumerate the effects of ICPD process conditions and temperature of RWD on total phenolic content (TPC), total flavonoid content (TFC) and DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging activity of the green tea infusion. An optimum condition for green tea processing was found at TP 0.2 MPa, TT 20 s with RWDT at 70 °C. In comparison to made green tea manufactured without ICPD treatment, the ICPD treated green tea showed enhanced TPC, TFC and DPPH radical scavenging activity along with better colour and sensory attributes. The microstructural study of ICPD treated green tea samples showed more deformed cell surface integrity, larger stomatal pore size and cracks at the leaf surface in comparison with non-treated green tea sample. CONCLUSION: Present study reveals that an ICPD treatment at 0.2 MPa for 20 s can be used as an alternative to the traditional enzyme inactivation step of hot water treatment, for green tea leaves to improve the infusion quality in terms of increased levels of TPC and TFC and DPPH radical scavenging activity. © 2024 Society of Chemical Industry.

Clinical characteristics and risk factors analysis of 505 cases of infusion reactions in a tertiary hospital.

Background: The clinical characteristics and risk factors of infusion reactions (IRs) are inadequately described in clinical practice due to underreported cases. In the present study, we reported the current status of IRs based on an in-hospital pharmacovigilance database of a tertiary care hospital. Methods: Our study conducted a retrospective analysis of drug-induced IRs recorded at an in-hospital pharmacovigilance center between January 2015 to December 2019. The descriptive statistical analysis encompassed main causative agents, clinical manifestations, organ/system involvement and outcome. The severity of IRs was assessed with reference to the CTCAE version 5.0 criteria and we investigated risk factors associated with severe IRs. Results: During the study period, a total of 505 cases of inpatient drug-induced IRs were detected, of which 79.2% (400 cases) were classified as general IRs and 20.8% (105 cases) were categorized as severe IRs. The primary drugs responsible for these reactions were antibiotics (23%, 116 cases), with piperacillin sodium-sulbactam sodium being the most prevalent, followed by antineoplastic agents (18.4%, 93 cases) and traditional Chinese medicine injections (TCMIs) (12.9%, 65 cases). The administration of cefoperazone - sulbactam, mannatide, Shenqi Fuzheng, elemene, and diterpene ginkgolides meglumine resulted in a higher incidence of critical IRs. Among all cases of IRs, 43.2%, 41.2%, and 23.4% showed signs and symptoms of circulation, skin mucosa, and respiratory organs/systems, respectively. 9.1% of cases experienced systemic damage, while 7.1% and 5.9% of cases reported neurological and gastrointestinal related adverse reactions, respectively. The multivariate analysis revealed that alcohol consumption (OR = 2.389%, 95% CI 1.141-5.002, p = 0.021), age over 65 (OR = 1.814%, 95% CI 1.052-3.127, p = 0.032) and the utilization of contrast media (OR = 4.072%, 95% CI 1.903-8.713, p < 0.001) were identified as risk factors for the development of severe IRs. Conclusion: Understanding the clinical characteristics of IRs helps to implement effective pharmaceutical monitoring and appropriate preventive measures for susceptible populations with risk factors.

Novel agents to treat adrenal insufficiency: findings of preclinical and early clinical trials.

INTRODUCTION: Adrenal insufficiency currently affects over 300/million population, with higher morbidity and mortality compared to the general population. Current glucocorticoid replacement therapy is limited by a lack of reliable biomarkers to guide dosing, inter-patient variation in metabolism and narrow therapeutic window. Increased morbidity and mortality may relate to unappreciated under- or over-exposure to glucocorticoids and impaired cortisol circadian rhythm. New agents are required to emulate physiological cortisol secretion and individualize glucocorticoid dosing. AREAS COVERED: History of glucocorticoid therapy, current limitations, and novel chronotherapeutic glucocorticoid delivery mechanisms. Literature search incorporated searches of PubMed and Embase utilizing terms such as adrenal insufficiency, Chronocort, Plenadren, continuous subcutaneous hydrocortisone infusion (CHSI), and glucocorticoid receptor modulator. EXPERT OPINION: Glucocorticoid chronotherapy is necessary to optimize glucocorticoid exposure and minimize complications. Current oral chronotherapeutics provide improved dosing functionality, but are modifiable only in specific increments and cannot accommodate ultradian cortisol variation. Current data show improvement in quality of life but not morbidity or mortality outcomes. CHSI has significant potential for individualized glucocorticoid dosing, but would require a suitable biomarker of glucocorticoid adequacy to be implementable. Avenues for future research include determining a glucocorticoid sufficiency biomarker, development of interstitial or systemic cortisol monitoring, or development of glucocorticoid receptor modulators.

Effect of high-dose intravenous vitamin C therapy on the prognosis in patients with moderately severe and severe acute pancreatitis: protocol of a prospective, randomized, double-blinded, placebo-controlled study.

Introduction: Acute pancreatitis is a common gastrointestinal disease. The mortality of patients affected by severe acute pancreatitis (SAP) remains high. It is unclear whether high-dose intravenous vitamin C (HDIVC) therapy could improve the prognosis of these patients. The current prospective, randomized, double-blinded, placebo-controlled study will explore the effect of high-dose intravenous vitamin C therapy on the prognosis in patients with moderately severe and severe acute pancreatitis. Methods and design: A total of 418 participants with moderately severe and severe acute pancreatitis who meet the eligible criteria will be randomly assigned in a 1:1 ratio to receive treatment with HDIVC (200 mg/kg/24 h) or placebo (saline) for a period of 7 days. The primary outcome is 28-day mortality in these patients. The secondary outcomes include organ functions and interventions, laboratory tests, healthcare, and 90-day mortality. Ethics and dissemination: This protocol was approved by the institutional ethics board of the Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China (Registration Number: 2019-90). The report of the study will be published in peer-reviewed journals and presented at conferences, both nationally and internationally. Clinical trial registration: Chinese Clinical Trial Registry (ChiCTR1900022022). Version 1.5.

Efficacy and safety of different insulin infusion methods in the treatment of total parenteral nutrition-associated hyperglycemia: a systematic review and network meta-analysis.

Aims: To systematically evaluate the efficacy and safety of different insulin infusion methods in the treatment of total parenteral nutrition (TPN)-associated hyperglycemia based on published literature and the data of completed clinical trials using a network meta-analysis. Methods: A comprehensive search of PubMed, Elsevier, Web of Science, EMBASE, Medline, clinicaltrials.gov, Cochrane Library, and three Chinese databases (Wanfang Data, China National Knowledge Infrastructure, and SINOMED) up to December 15, 2022, was performed to collect information on different insulin infusion methods used for the treatment of TPN-associated hyperglycemia, and the Cochrane systematic review method was used to screen the literature, evaluate the quality of the included literature, and extract clinical characteristics for a network meta-analysis. Clinical outcomes included mean blood glucose (MBG), hypoglycemia, hospital length of stay, hyperglycemia, surgical site infection (SSI) and mean total daily insulin. Results: A total of 21 articles, including 1,459 patients, were included to analyze 6 different routes of insulin infusion, including continuous intravenous insulin infusion (CVII), continuous subcutaneous insulin infusion (CSII), subcutaneous glargine insulin (s.c. GI), the addition of regular insulin to the PN mixture (RI-in-PN), multiple subcutaneous insulin injections (MSII) and 50% of insulin administered as RI-in-PN + 50% of insulin administered as s.c. GI (50% RI-in-PN + 50% s.c. GI). The results of the network meta-analysis showed that MSII was the least effective in terms of MBG, followed by CVII. The 6 interventions were basically equivalent in terms of the hypoglycemia incidence. In terms of the length of hospital stay, patients in the CVII group had the shortest hospital stay, while the MSII group had the longest. CVII was the best intervention in reducing the incidence of hyperglycemia. The incidence of SSI was the lowest in the CSII and CVII groups, and the mean daily insulin dosage was the lowest in the CVII group. Conclusion: Current literature shows that for the treatment of TPN-associated hyperglycemia, CVII is the most effective, reducing the incidence of hyperglycemia and shortening the length of hospital stay without increasing the incidence of hypoglycemia. MSII has the worst efficacy, leading to a higher MBG and longer hospital stay, and RI-in-PN, CSII, s.c. GI and 50% RI-in-PN + 50% s.c. GI are better in terms of efficacy and safety and can be substituted for each other. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023439290.

Use of wound infusion catheters for postoperative local anaesthetic administration in cats.

OBJECTIVES: The present study aimed to document the use of the wound infusion catheter (WIC) following a variety of surgical procedures in cats, investigating complications and risk factors associated with catheter placement or local anaesthetic (LA) administration. METHODS: A retrospective, multicentric study was performed. Medical databases of eight veterinary referral hospitals from 2010 to 2021 were searched to identify records of cats where WICs were used. Information regarding signalment, type of surgery, size and type of WIC placed, and LA protocol used, as well as postoperative complications, were retrieved. RESULTS: One hundred and sixty-six cases fulfilled the inclusion criteria. Feline injection site sarcoma resection was the most common surgery. Overall complications were identified in 22/166 cats (13.2%). Thirteen cats (7.8%) experienced wound-related complications, whereas nine cats (5.4%) experienced drug-delivery complications. The only factor associated with an increased risk of complications was the amount of a single dose of LA delivered through the catheter (P <0.001). An amount higher than 2.5 ml of LA delivered at each administration was associated with an increased risk of complications. All complications were minor and self-limiting. CONCLUSIONS AND RELEVANCE: WICs were used for a large variety of surgical procedures with different protocols of LA administration as part of a multimodal analgesic plan in cats. The risk of complications was relatively low and self-limiting, suggesting its safe use in cats. Further prospective studies are required to evaluate efficacy of postoperative analgesia and to determine the suitable protocol for WIC handling and maintenance.

Biological Activities and Polyphenol Content of Qi Cha Tea®, a Functional Beverage of White Tea Containing Botanicals and Dry Botanical Extracts with European Health Claims.

Infusions of Camellia sinensis leaves have been known for their health benefits. The Bio Concentrate Assets® (ABC) method is a method of enriching organic infusion leaves (from Camellia sinensis) with organic dry and concentrated extracts using organic acacia gum, and its application to white tea has provided Qi cha tea®. In the present study, the content of tea polyphenols and caffeine, and the biochemical properties of Qi cha tea® and its botanical constituents (elderberry, tulsi, Echinacea purpurea, orange peel, lemongrass, and acacia gum) were assessed. Antioxidant and cell viability activities were determined by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) assay and MTT (3-(4, 5-dimethyl thiazol-2-yl)-2, 5-diphenyl tetrazolium bromide) assay in human Caco-2 and HCT-116 cell lines, and ascorbic acid and tamoxifen, respectively. The caffeine and polyphenol composition of Qi cha tea® was modified with less caffeine and gallic acid and more epigallocatechin gallate (EGCG) than the original white tea. The majority of the tested botanical samples including Qi cha tea® at 50 µg/mL show similar antioxidant activities, with the exception of Echinacea purpurea. The greatest effect was found for white tea. The antioxidant power of the Qi cha tea® (90% at 50 µg/mL for pressurized liquid extraction (PLE) was divided by approximately a factor of two (61% at 50 µg/mL for pressurized liquid extraction products (PLEP)), which corresponds to the 48.3% (mass/mass) white tea original content in the Qi cha tea®. Qi cha tea® shows the lowest cytotoxic activity in the viability of the two cell lines when compared to white tea. The application of the ABC method to Qi cha tea® using various botanicals and dry extract with acacia gum as blinder has allowed the development of a new innovative functional health beverage that complies with European health claims.

Safety outcomes of rapid- versus standard-infusion rate oxaliplatin.

PURPOSE: The National Comprehensive Cancer Network guidelines state that the oxaliplatin dose of 85 mg/m2 used in various gastrointestinal cancer regimens may be infused over a rapid rate of 85 min instead of the standard time of 120 min. We evaluated the safety outcomes of rapid administration of oxaliplatin compared to standard infusion. METHODS: We performed a retrospective, cohort study by chart review. Adult patients who received oxaliplatin as part of a FOLFOX, FOLFOXIRI, or FOLRINOX chemotherapy regimen from January 1, 2018, through June 30, 2021, were included. Primary outcomes were the incidence of hypersensitivity reaction (HSR) and treatment modification of oxaliplatin due to adverse drug events. Secondary outcomes included peripheral neuropathy (PN), myelosuppressive signs, and oxaliplatin-related emergency department visit and/or hospital admission. RESULTS: A total of 178 patients were included (90 and 88 in the rapid-rate and standard-rate groups, respectively). Rapid-rate oxaliplatin was not associated with increased HSR or difference in toxicity requiring dose reduction, delayed dose, or slowed infusion rate, but was associated with increased rate of permanent discontinuation of oxaliplatin, 7.8% and 1.1% in the rapid-rate group and standard-rate groups, respectively (p = 0.032). Peripheral neuropathy occurred in 72.2% and 42% of patients in the rapid-rate group and standard-rate groups, respectively (relative risk for PN, 2.09; 95%, CI: 1.43-3.04; p < .001). There were no differences in any other adverse drug event measured. CONCLUSION: Rapid-rate oxaliplatin was associated with minimal treatment modifications; however, there was an increase in PN incidence. A faster rate of oxaliplatin administration may not be worth the increased risk of PN.

Phenolic Compounds and Organic Acid Composition of Syringa vulgaris L. Flowers and Infusions.

The study aimed to determine the content of phenolic compounds (phenolic acids and flavonoids) and organic acids in dried flowers and water infusions of non-oxidised and oxidised flowers from four lilac cultivars. The diversity in the total phenolic and flavonoid content was in the flowers (18.35-67.14 and 2.03-2.65 mg g-1 DW, respectively) and infusions (14.72-47.78 and 0.20-1.84 mg per 100 mL infusion, respectively) depending the flower colour and form (oxidised and non-oxidised). Phenolic compounds and organic acids were susceptible to oxidation. Compared to infusions, flowers had more phenolic compounds and organic acids. The highest content of most phenolic compounds was confirmed for non-oxidised purple flowers (up to 7825.9 µg g-1 DW for chlorogenic acid) while in infusions for non-oxidised white flowers (up to 667.1 µg per 100 mL infusions for vanillic acid). The phenolic profile of the infusions was less diverse than that of flowers. The scavenging ability ranged from 52 to 87%. The highest organic acid content in flowers was for oxidised blue and purple flowers (2528.1 and 2479.0 µg g-1 DW, respectively) while in infusions the highest organic acid content was for oxidised purple flowers (550.1 µg per 100 mL infusions).

Comparative Phytochemical Analyses of Flowers from Primula veris subsp. veris Growing Wild and from Ex Situ Cultivation in Greece.

In the last decades, Primula veris subsp. veris (roots and flowers) has been over harvested through legal and illegal ways in Greece, due to its extremely high commercial demand, as it is used in industry because of its well-known therapeutic properties. As ex situ cultures of the plant have been already developed, in the current comparative study, the herbal teas (infusions) from both flowers of cowslip growing wild in the Prespa Lake Park (NW Greece), and from ex situ propagated and cultivated plant material, have been investigated, with the ultimate goal of assessing them qualitatively. Furthermore, through classic phytochemical studies, the ten most abundant metabolites, belonging to the chemical categories of flavonol-glycosides and methoxy flavones, have been identified and structurally determined. The chemical profile of both infusions has been further analyzed through UHPLC-HRMS, showing that they show only light differences. The total phenolic content (TPC) of both studied samples (wild and ex situ cultivation), was determined by the Folin-Ciocalteau method, followed by an antioxidant activity assay though DPPH where, in both cases, wild plants exerted higher phenolic load and stronger antioxidative properties. According to the reported results, it could be proposed that the ex situ cultivated plant material could facilitate the mass production of plants and the sustainable cultivation of cowslip in the Greek mountains.

Modelling the pesticide transfer during tea and herbal tea infusions by the identification of critical infusion parameters.

Pesticide residues in tea and herbal tea often exceed EU maximum residue limits. Consideration of the transfer of pesticides from the leaves (called transfer factors) to the brew is essential to assess the associated risk. This study identified infusion parameters influencing the transfer behaviour of 61 pesticides and elaborated a predictive model for pesticides with unknown transfer factors in black, green, herbal and flavoured teas. Tea type and the presence of flavours were the criteria that most influenced the pesticide transfer. Interestingly, infusion parameters that are individual and area dependent such as infusion time, temperature and water hardness, did not play a significant role. Beta regression models developed to characterise pesticide behaviour during infusion showed good predictions for most pesticides and revealed that log (P) was the main physico-chemical parameter to estimate the pesticide transfer. The transfer factors database and validated models are valuable tools for improving risk assessment.

Effects of the extraction techniques on the chemical composition and bioactive properties of lemon balm (Melissa officinalis L.) plants grown under different cropping and irrigation regimes.

The present study aims to determine the combined effect of cropping system and irrigation regime on the chemical composition and bioactive properties of lemon balm aerial parts. For this purpose, lemon balm plants were grown under two farming systems (conventional farming vs organic farming) and two irrigation levels (full irrigation vs deficit irrigation) and harvested twice throughout the growing period. The collected aerial parts were subjected to three different methods of extractions, namely infusion, maceration and ultrasound-assisted extraction and the obtained extracts were evaluated in terms of chemical profile and bioactivities. Five organic acids with varied composition among the tested treatments were identified in all the tested samples for both harvests, namely, citric, malic, oxalic, shikimic and quinic acid. Regarding phenolic compounds composition, the most abundant ones were rosmarinic acid, lithospermic acid A isomer I and hydroxylsalvianolic E, especially for the maceration and infusion extraction methods. Full irrigation resulted in lower EC50 values than deficit irrigation only in the treatments of the second harvest, while variable cytotoxic and anti-inflammatory effects were recorded in both harvests. Finally, in most cases the lemon balm extracts has similar or better activity than the positive controls, while the antifungal activity of lemon balm extracts was stronger than the antibacterial effects. In conclusion, the results of the present study showed that the implemented agronomic practices, as well as the extraction protocol may significantly affect the chemical profile and bioactivities of lemon balm extracts, suggesting that both the farming system and the irrigation schedule may improve the quality of the extracts depending on the implemented extraction protocol.

Correlations of kratom (Mitragyna speciosa Korth.) tea bag preparations and reported pharmacological effects.

ETHNOPHARMACOLOGICAL RELEVANCE: The use of herbal tea infusions is widespread in ethnomedicine throughout the world. One such ethnobotanical is kratom (Mitragyna speciosa Korth., Rubiaceae) which has gained considerable interest as an herbal supplement in recent years in the West beyond its native Southeast Asia. Traditional, kratom leaves are either chewed fresh or made into a tea infusion to treat fatigue, pain, or diarrhea. However, dried kratom leaf powder and hydroalcoholic extracts are more commonly used in Western countries, raising the question of exposure to kratom alkaloids and related effects. AIM OF THE STUDY: A specific kratom tea bag product was analyzed for mitragynine content using tea infusion preparation and methanolic extraction. Consumers of both the tea bag product and other kratom products completed an online anonymous survey to determine demographics, kratom use patterns, and self-reported beneficial and detrimental effects. MATERIALS AND METHODS: Kratom tea bag samples were extracted using pH-adjusted water or methanol and analyzed using an established LC-QTOF method. A modified kratom survey was distributed to consumers of the kratom tea bag products and other kratom products over a 14-month period. RESULTS: Tea infusion extraction of tea bag samples resulted in lower mitragynine levels (0.062-0.131% (w/w)) compared to methanolic extraction (0.485-0.616% (w/w)). Kratom tea bag consumers did report similar, although often milder beneficial effects compared to consumers using other kratom products. Overall self-reported health was better among kratom tea bag consumers whereas improvement of a diagnosed medical condition was less in tea bag consumers compared to those using other kratom products. CONCLUSIONS: Traditional tea infusions of Mitragyna speciosa dried leaves provide benefits to consumers despite substantially lower mitragynine content. These effects may be less pronounced but indicate that tea infusions provide a potentially safer formulation compared to more concentrated products.

Hypophosphatemia related to intravenous iron therapy with ferric carboxymaltose: A case series.

OBJECTIVES: This case series would like to highlight hypophosphatemia related to ferric carboxymaltose and its adverse clinical consequences. BACKGROUND: Intravenous iron supplementation is a good alternative to oral iron replacement in iron deficiency anaemia due to its ability to correct iron deficit with minimal infusions without incurring the gastrointestinal side effects of oral iron replacement. Ferric carboxymaltose is one common formula for intravenous iron supplementation. However, an increasingly recognised adverse side-effect of intravenous ferric carboxymaltose is hypophosphatemia. There has been increasing reports and studies highlighting hypophosphatemia related to intra-venous iron therapy. Though initially thought to be transient and asymptomatic, recent studies have shown that persistent hypophosphatemia in iron therapy can result in debilitating disease including myopathy, fractures and osteomalacia. METHODS: A retrospective analysis of all patients who had ferric carboxymaltose was performed. RESULTS: We highlight 3 cases where hyposphatemia affected the clinical outcomes. CONCLUSION: With the increased use of IV iron it is important to be aware of the high potential for hypophosphatemia secondary to ferric carboxymaltose.

Antioxidant properties and antibacterial activity of water extracts from Sambucus nigra L. under different conditions.

INTRODUCTION: In folk medicine, dried white flowers of Sambucus nigra L. are used to make infusions, decoctions, and juices. AIM: The present article aims to study and compare the antioxidant activity of aqueous solutions of leaves and flowers of Sambucus nigra L obtained at different exposure times and assess the antibacterial activity of these solutions against Escherichia coli ATCC 8739, Salmonella NCTC 6017, Listeria monocytogenes NCTC 11994, and Staphylococcus aureus ATCC 25093. MATERIALS AND METHODS: We studied the physicochemical properties of aqueous extracts of leaves (fresh) and flowers (fresh and dry) of Sambucus nigra L collected from the Rhodope region of Bulgaria. The samples from Sambucus nigra L were analyzed to determine their total phenolic content (TPC), total flavonoid content (TFC), and antioxidant activity using 1,1-diphenyl-2-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP). The diameters (in millimeters) of the growth inhibition zones of four pathogens were measured, and a comparative assessment of their antibacterial activity was made. RESULTS: The infusions of fresh blossoms and fresh leaves of Sambucus nigra L had the highest antioxidant activity at the total contact time of 30 minutes (82.7 mmol TE/100 ml) and 35 minutes (36.5 mmol TE/100 ml), respectively. The phenol-richest infusions were those made from dried flowers of Sambucus nigra L after a 30-minute contact time (86.7 mg GAE/ml). Of the four pathogens we studied, we found that the extracts affected partially only the pathogenic bacteria of Salmonella. CONCLUSIONS: The highest content of bioactive components was obtained from dried blossoms of Sambucus nigra L. for infusions with a total contact time of 30 minutes and for decoctions at a contact time of 45 minutes.

Increased growth temperature and vitamin B12 supplementation reduces the lag time for rapid pathogen identification in BHI agar and blood cultures.

Background: The rapid diagnostics of pathogens is essential to prescribe appropriate and early antibiotic therapy. The current methods for pathogen detection require the bacteria to grow in a culture medium, which is time-consuming. This increases the mortality rate and the global burden of antimicrobial resistance. Culture-free detection methods are still under development and are not used in the clinical routine. Therefore decreasing the culture time for accurate detection of infection and resistance is vital for diagnosis. Methods: In this study, we wanted to investigate easy-to-implement factors (in a minimal laboratory set-up), including inoculum size, incubation temperature, and additional supplementation ( e.g., vitamin B12 and trace metals), that can significantly reduce the lag time (t lag). These factors were arranged in simple two-level factorial designs using Gram-positive ( Escherichia coli and Pseudomonas aeruginosa) and Gram-negative ( Staphylococcus aureus and Bacillus subtilis) bacteria, including clinical isolates with known antimicrobial resistance profiles. Blood samples spiked with a clinical isolate of E. coli CCUG17620 were also tested to see the effect of elevated incubation temperature on bacterial growth in blood cultures. Results: We observed that increased incubation temperature (42°C) along with vitamin B12 supplementation significantly reduced the t lag (10 - 115 minutes or 4% - 49%) in pure clinical isolates and blood samples spiked with E. coli CCUG17620. In the case of the blood sample, PCR results also detected bacterial DNA after only 3h of incubation and at three times the CFU/mL. Conclusions: Enrichment of bacterial culture media with growth supplements such as vitamin B12 and increased incubation temperature can be a cheap and rapid method for the early detection of pathogens. This is a proof-of-concept study restricted to a few bacterial strains and growth conditions. In the future, the effect of other growth conditions and difficult-to-culture bacteria should be explored to shorten the lag phase.

Target screening method for the quantitative determination of 118 pyrrolizidine alkaloids in food supplements, herbal infusions, honey and teas by liquid chromatography coupled to quadrupole orbitrap mass spectrometry.

An analytical procedure for the screening of 118 pyrrolizidine alkaloids (PAs) was successfully validated and applied to their quantitative determination in food supplements, herbal infusions, honey, and teas. It provides the reliable analyte identification by high-resolution tandem mass spectrometry (HRMS/MS), the accurate determination of 21 regulated PAs, and broad contamination profiles. 10% of 281 analyzed samples resulted contaminated at levels above the maximum levels (MLs) of European legislation. The contamination of herbal infusions of mixed plants can represent a possible health concern (23%; mean of PA sum above ML). A high number of PAs not included in the regulation was detected in honey and herbal food supplements, but their contribution was only relevant to the overall level in honey. The results indicate the need to continue collecting contamination data in food supplements and infusions of mixed herbs and to expand the PA-pool to be monitored in honey and related products.

Evaluation of the Biological Properties of an Optimized Extract of Polygonum cuspidatum Using Ultrasonic-Assisted Extraction.

Phytochemicals are natural compounds found in plants that have potential health benefits such as antioxidants, anti-inflammatory and anti-cancer properties, and immune reinforcement. Polygonum cuspidatum Sieb. et Zucc. is a source rich in resveratrol, traditionally consumed as an infusion. In this study, P. cuspidatum root extraction conditions were optimized to increase antioxidant capacity (DPPH, ABTS+), extraction yield, resveratrol concentration, and total polyphenolic compounds (TPC) via ultrasonic-assisted extraction using a Box-Behnken design (BBD). The biological activities of the optimized extract and the infusion were compared. The optimized extract was obtained using a solvent/root powder ratio of 4, 60% ethanol concentration, and 60% ultrasonic power. The optimized extract showed higher biological activities than the infusion. The optimized extract contained 16.6 mg mL-1 resveratrol, high antioxidant activities (135.1 µg TE mL-1 for DPPH, and 230.4 µg TE mL-1 for ABTS+), TPC (33.2 mg GAE mL-1), and extraction yield of 12.4%. The EC50 value (effective concentration 50) of the optimized extract was 0.194 µg mL-1, which revealed high cytotoxic activity against the Caco-2 cell line. The optimized extract could be used to develop functional beverages with high antioxidant capacity, antioxidants for edible oils, functional foods, and cosmetics.

Ethnobotany, Biological Activities and Phytochemical Compounds of Some Species of the Genus Eryngium (Apiaceae), from the Central-Western Region of Mexico.

There are approximately 250 species of Eryngium L. distributed throughout the world, with North America and South America being centers of diversity on this continent. In the central-western region of Mexico there may be around 28 species of this genus. Some Eryngium species are cultivated as leafy vegetables, ornamental, and medicinal plants. In traditional medicine they are used to treat respiratory and gastrointestinal conditions, diabetes, and dyslipidemia, among others. This review addresses the phytochemistry and biological activities, as well as traditional uses, distribution, and characteristics of the eight species of Eryngium reported as medicinal in the central-western region of Mexico: E. cymosum, E. longifolium, E. fluitans (or mexicanum), E. beecheyanum, E. carlinae, E. comosum, E. heterophyllum, and E. nasturtiifolium. The extracts of the different Eryngium spp. have shown biological activities such as hypoglycemic, hypocholesterolemic, renoprotective, anti-inflammatory, antibacterial, and antioxidant, among others. E. carlinae is the most studied species, and phytochemical analyses, performed mainly by high-performance liquid chromatography (HPLC) and gas chromatography coupled with mass spectrometry (GC-MS), have shown its content of terpenoids, fatty acids, organic acids, phenolic acids, flavonoids, sterols, saccharides, polyalcohols, and aromatic and aliphatic aldehydes. According to the results of this review on Eryngium spp., they constitute a relevant alternative as a source of bioactive compounds for pharmaceutical, food, and other industries. However, there is a lot of research to be conducted regarding phytochemistry, biological activities, cultivation, and propagation, in those species with few or no reports.