May Measurement Month 2019: an analysis of blood pressure screening results from Ecuador.

Arterial hypertension is a growing burden worldwide, leading to over 10.8 million deaths each year. In Ecuador, it is the main risk factor for the major cause of death, coronary, and cerebrovascular disease [GBD 2017 Risk Factor Collaborators. Global, regional, and national comparative risk assessment of 84 behavioral, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet 2018;392:1923-1994]. The May Measurement Month Campaign in 2019 (MMM19) is a global initiative of the International Society of Hypertension aimed at raising awareness of high blood pressure (BP) and to act as a temporary solution to the lack of screening programs worldwide. A volunteer cross-sectional survey was carried out in May 2019 across 42 health centres in Ecuador. The average age was 51 (SD ±17.6) years. Blood pressure measurement, the definition of hypertension (mean of the second and third BP measurement ≥140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 15 885 volunteers participated in MMM19. After multiple imputation, 6654 (41.9%) had hypertension. Of individuals not receiving antihypertensive medication, 2383 (20.5%) were hypertensive. Of individuals receiving antihypertensive medication, 1004 (23.5%) had uncontrolled BP. May Measurement Month 2019 was the largest BP screening campaign done in Ecuador. In the survey, including 6654 participants with hypertension, only 49.1% had their BP values controlled (<140/90 mmHg). May Measurement Month 2019 demonstrated a high prevalence of hypertension among volunteer screenees in our country. The high percentage of persons untreated or with uncontrolled hypertension while on pharmacologic treatment suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of health care providers and the healthcare system in Ecuador.

May Measurement Month 2018: an analysis of blood pressure screening results from Ecuador.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. May Measurement Month (MMM) is a global initiative by the International Society of Hypertension (ISH) aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May 2018. A volunteer cross-sectional survey was carried out in May 2017 across 33 health centres. Blood pressure measurement, the definition of hypertension (HTN) (mean of the 2nd and 3rd BP measurement ≥ 140/90 mmHg or who were medicated for high BP), and statistical analysis followed the standard MMM protocol. In total, 11 922 individuals (53.7% female) were screened during MMM18. After multiple imputation, 4563 (38.3%) had HTN. Of individuals not receiving antihypertensive medication, 1302 (15.0%) were hypertensive. Of individuals receiving antihypertensive medication, 933 (28.6%) had uncontrolled BP. MMM18 was the largest BP screening campaign done in Ecuador. Hypertension was detected in 38.4% of those screened and almost 4 out of 10 were either not on treatment or were not controlled to the BP goal. These results suggest that appropriate screening can help to identify a significant number of people with high BP. These data should attract the attention of doctors and health care system in Ecuador.

Introduction of a sEMG Sensor System for Autonomous Use by Inexperienced Users.

Wearable devices play an increasing role in the rehabilitation of patients with movement disorders. Although information about muscular activation is highly interesting, no approach exists that allows reliable collection of this information when the sensor is applied autonomously by the patient. This paper aims to demonstrate the proof-of-principle of an innovative sEMG sensor system, which can be used intuitively by patients while detecting their muscular activation with sufficient accuracy. The sEMG sensor system utilizes a multichannel approach based on 16 sEMG leads arranged circularly around the limb. Its design enables a stable contact between the skin surface and the system's dry electrodes, fulfills the SENIAM recommendations regarding the electrode size and inter-electrode distance and facilitates a high temporal resolution. The proof-of-principle was demonstrated by elbow flexion/extension movements of 10 subjects, proving that it has root mean square values and a signal-to-noise ratio comparable to commercial systems based on pre-gelled electrodes. Furthermore, it can be easily placed and removed by patients with reduced arm function and without detailed knowledge about the exact positioning of the sEMG electrodes. With its features, the demonstration of the sEMG sensor system's proof-of-principle positions it as a wearable device that has the potential to monitor muscular activation in home and community settings.

May Measurement Month 2017: analysis of the blood pressure screening results in Ecuador-Americas.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Previous hypertension surveys in Ecuador, showed that there was a prevalence of 28% of adults with hypertension in 1999, 53% in adults between 60 and 75 years in 2010, and. 9.3% in people between 18 and 59 years in 2012 [Freire WB, Ramírez-Luzuriaga MJ, Belmont P, Mendieta MJ, Silva-Jaramillo MK, Romero N, Sáenz K, Piñeiros P, Gómez LF, Monge R. Tomo I: Encuesta Nacional de Salud y Nutrición de la población ecuatoriana de cero a 59 años. ENSANUT-ECU 2012. Ministerio de Salud Pública/Instituto Nacional de Estadísticas y Censos. Quito-Ecuador 2014]. The May Measurement Month (MMM) is a global initiative aimed at raising awareness of high BP that can temporarily address the lack of screening programmes worldwide. Verbal informed consent was obtained from respondents. We enrolled 16 sites for the measurement of arterial BP and completion of the MMM17 questionnaire, the most important sites being: Guayaquil, Quito, Cuenca, Milagro, Esmeraldas, Duran, Naranjito, and Machala. We administered the MMM17 survey on 6984 people, of which 50.5% of them were men and 48.4% were women. Mean age was 46.62 ± 17.71 SD. The crude mean BP was 115/74 mmHg. Of the 6984 people who completed the survey, we had 1522 that were already taking anti-hypertensive treatment. The number of people with hypertension (≥140 or ≥90 or on treatment for hypertension) was 1968/6982 (28.2%) persons. The number of people with hypertension of those not receiving treatment was 446/5460 (8.2%) and the number of people receiving treatment but with controlled and uncontrolled BP was 1136/1522 (74.6%) and 386/1522 (25.4%), respectively. MMM17 was the largest BP screening campaign undertaken in Ecuador. We identified 446 people with hypertension that were not receiving any treatment and 386 people with uncontrolled hypertension. These results suggest that opportunistic screening can identify significant numbers with raised BP.

Anthraquinones from Vismia mexicana.

Vismia mexicana (Clusiaceae) is a small tropical tree found from Mexico to Honduras. The CH2Cl2/MeOH extract from the leaves has been reported to have inhibitory properties against reverse transcriptase of human immunodeficiency virus type 1 (HIV-1 RT). In order to characterize some of its chemical constituents, the EtOAc-soluble fraction of this extract was subjected to column chromatography. A new natural product was isolated and designated vismiaquinone D [1-hydroxy-6-methoxy-7,8-(3',3'-dimethyl-pyrano) anthraquinone]. In addition, vismiaquinone was obtained. The structures of vismiaquinone and vismiaquinone D were determined by 1H and 13C NMR spectroscopy, unambiguous assignments were achieved with DEPT, HSQC, and HMBC experiments, and corroborated by X-ray diffraction studies. The isolated anthraquinones were tested against HIV-1 RT. However, none showed relevant activity, suggesting that other compounds in this extract may be responsible for its HIV-1 RT inhibitory properties.

Antibacterial, Trichomonacidal, and Cytotoxic Activities of Pleopeltis crassinervata Extracts.

Pleopeltis crassinervata is a fern documented in ethnobotanical records for its use in Mexican traditional medicine to treat gastric disorders and mouth ulcers. Consequently, conducting biological and pharmacological assays is crucial to validate the therapeutic efficacy of this plant within the context of traditional medicine. In the present study, we investigated the biological activity of extracts and fractions obtained from P. crassinervata organs against bacteria (Salmonella typhimurium, Salmonella typhi, Staphylococcus aureus, Proteus mirabilis, Shigella flexneri, Bacillus subtilis, Escherichia coli) and Trichomonas vaginalis using in vitro models. The precipitate fraction obtained from the frond methanolic extract showed significant antibacterial activity (minimal inhibitory concentration [MIC] 120 µg/mL) against the Staphylococcus aureus strain and was effective against both Gram-positive and Gram-negative bacteria. The hexane fraction also obtained from frond methanolic extract, showed a trichomonacidal effect with an IC50 of 82.8 µg/mL and a low cytotoxic effect. Hsf6 exhibited the highest activity against T. vaginalis, and the GC-MS analysis revealed that the predominant compound was 16-pregnenolone. The remaining identified compounds were primarily terpene-type compounds.

Advances in EMG measurement techniques, analysis procedures, and the impact of muscle mechanics on future requirements for the methodology.

Muscular coordination enables locomotion and interaction with the environment. For more than 50 years electromyography (EMG) has provided insights into the central nervous system control of individual muscles or muscle groups, enabling both fine and gross motor functions. This information is available either at individual motor units (Mus) level or on a more global level from the coordination of different muscles or muscle groups. In particular, non-invasive EMG methods such as surface EMG (sEMG) or, more recently, spatial mapping methods (High-Density EMG - HDsEMG) have found their place in research into biomechanics, sport and exercise, ergonomics, rehabilitation, diagnostics, and increasingly for the control of technical devices. With further technical advances and a growing understanding of the relationship between EMG and movement task execution, it is expected that with time, especially non-invasive EMG methods will become increasingly important in movement sciences. However, while the total number of publications per year on non-invasive EMG methods is growing exponentially, the number of publications on this topic in journals with a scope in movement sciences has stagnated in the last decade. This review paper contextualizes non-invasive EMG development over the last 50 years, highlighting methodological progress. Changes in research topics related to non-invasive EMG were identified. Today non-invasive EMG procedures are increasingly used to control technical devices, where muscle mechanics have a minor influence. In movement science, however, the effect of muscle mechanics on the EMG signal cannot be neglected. This explains why non-invasive EMG's relevance in movement sciences has not developed as expected.

Hypoglycemic Activity of Aqueous Extracts from Catharanthus roseus.

Introduction. Catharanthus roseus (L.) is used in some countries to treat diabetes. The aim of this study was to evaluate the hypoglycemic activity of extracts from the flower, leaf, stem, and root in normal and alloxan-induced diabetic mice. Methods. Roots, leaves, flowers, and stems were separated to obtain organic and aqueous extracts. The blood glucose lowering activity of these extracts was determinate in healthy and alloxan-induced (75 mg/Kg) diabetic mice, after intraperitoneal administration (250 mg/Kg body weight). Blood samples were obtained and blood glucose levels were analyzed employing a glucometer. The data were statistically compared by ANOVA. The most active extract was fractioned. Phytochemical screen and chromatographic studies were also done. Results. The aqueous extracts from C. roseus reduced the blood glucose of both healthy and diabetic mice. The aqueous stem extract (250 mg/Kg) and its alkaloid-free fraction (300 mg/Kg) significantly (P < 0.05) reduced blood glucose in diabetic mice by 52.90 and 51.21%. Their hypoglycemic activity was comparable to tolbutamide (58.1%, P < 0.05). Conclusions. The best hypoglycemic activity was presented for the aqueous extracts and by alkaloid-free stem aqueous fraction. This fraction is formed by three polyphenols compounds.

Anti-toxoplasma, antioxidant and cytotoxic activities of Pleopeltis crassinervata (Fée) T. Moore hexane fraction.

The apicomplexan parasite Toxoplasma gondii (T. gondii) causes toxoplasmosis in humans. Pyrimethamine and sulfadiazine that are the drugs of choice to treat the disease, produce severe side effects as well as failure treatments because of drug resistance; thus, novel anti-Toxoplasma compounds are needed and natural compounds can be a good source to obtain them, as medicinal plants have been used to control other apicomplexan parasites. Pleopeltis crassinervata (P. crassinervata) is a fern used in some rural areas of Mexico to treat among other malaises, mouth ulcers, gastrointestinal problems and parasites. Therefore, the efficacy of extracts and fractions obtained from P. crassinervata fronds was evaluated on the viability of T. gondii RH strain tachyzoites by the Stytox green method. RH is the prototypical type 1 Toxoplasma strain, isolated for the first time from the brain of a patient boy named R. H. Its phytochemical profile, MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay, Hep-2 cytotoxicity and antioxidant activity by ABTS (2,2'-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) and DPPH (2,2-diphenyl-1-picrylhydrazyl) methods, were also assessed. Hexane fraction exhibited the highest anti-Toxoplasma activity with an IC50 of 16.90 µg/mL. This fraction did not show antioxidant activity and contained at least 2 terpenoid type compounds with retention factor (Rf) of 0.75 and 0.86. The fraction was not toxic to the host cells in doses up to 50 µg/mL. P. crassinervata frond hexane fraction seems to be a good candidate to obtain possible anti-Toxoplasma compounds. This study is the first to report the biological, antioxidant and cytotoxic activity of P. crassinervata fern.

Trypanocidal constituents in plants: 7. Mammea-type coumarins.

Calophyllum brasiliense and Mammea americana (Clusiaceae) are two trees from the tropical rain forests of the American continent. A previous screening showed high trypanocidal activity in the extracts of these species. Several mammea-type coumarins, triterpenoids and biflavonoids were isolated from the leaves of C. brasiliense. Mammea A/AA was obtained from the fruit peels of M. americana. These compounds were tested in vitro against epimastigotes and trypomastigotes of Trypanosoma cruzi, the etiologic agent of Chagas disease. The most potent compounds were mammea A/BA, A/BB, A/AA, A/BD and B/BA, with MC100 values in the range of 15 to 90 microg/ml. Coumarins with a cyclized gamma,gamma-dimethylallyl substituent on C-6, such as mammea B/BA, cyclo F + B/BB cyclo F, and isomammeigin, showed MC100 values > 200 microg/ml. Several active coumarins were also tested against normal human lymphocytes in vitro, which showed that mammea A/AA and A/BA were not toxic. Other compounds from C. brasiliense, such as the triterpenoids, friedelin, canophyllol, the biflavonoid amentoflavone, and protocatechuic and shikimic acids, were inactive against the epimastigotes. The isopropylidenedioxy derivative of shikimic acid was inactive, and its structure was confirmed by X-ray diffraction. Our results suggest that mammea-type coumarins could be a valuable source of trypanocidal compounds.

A Phenolic Fraction from Catharanthus roseus L. Stems Decreases Glycemia and Stimulates Insulin Secretion.

Catharanthus roseus (L.) G. (C. roseus) is a medicinal plant used traditionally for diabetes mellitus control. Several compounds of an alkaloidal nature have been proposed as hypoglycemic principles. However, little attention has been paid to other compounds in this plant that could also participate in this hypoglycemic activity. This study aimed to analyze the hypoglycemic effect of a polyphenolic fraction from C. roseus, as well as its action on insulin secretion and expression in RINm5F cells. Methods. An alkaloid-free aqueous extract was obtained from C. roseus stems. The hypoglycemic effect of different doses of this extract was evaluated in normal and streptozotocin-induced diabetic mice. This extract was fractionated by bipartition, and the resultant fractions were assessed by their hypoglycemic effects. Subsequently, the fraction with the greater hypoglycemic activity was added to the RINm5F cells, and the expression and secretion of insulin were analyzed. The antioxidant activity was determined by the DPPH method and through chromatographic analysis of the most active fraction by HPLC, using an Econosphere C18 column. Results. The aqueous alkaloid-free extract of C. roseus stems significantly reduced blood glucose in normal and diabetic mice. The fractionation of this extract provided three fractions, one of which (a precipitate) showed significant reductions in glycemia at 6 h (48.1 and 64.5% in normal and diabetic mice, respectively). This precipitate contained phenolic compounds and saponins. Its chromatographic analysis showed that it is formed by several phenolic compounds; gallic acid (0.053%) and chlorogenic acid (0.216%) were identified and quantified. Conclusion. The phenolic fraction of C. roseus containing gallic acid and chlorogenic acid had a hypoglycemic effect that may be explained by an increase in insulin secretion.

A Potential Alternative against Neurodegenerative Diseases: Phytodrugs.

Neurodegenerative diseases (ND) primarily affect the neurons in the human brain secondary to oxidative stress and neuroinflammation. ND are more common and have a disproportionate impact on countries with longer life expectancies and represent the fourth highest source of overall disease burden in the high-income countries. A large majority of the medicinal plant compounds, such as polyphenols, alkaloids, and terpenes, have therapeutic properties. Polyphenols are the most common active compounds in herbs and vegetables consumed by man. The biological bioactivity of polyphenols against neurodegeneration is mainly due to its antioxidant, anti-inflammatory, and antiamyloidogenic effects. Multiple scientific studies support the use of herbal medicine in the treatment of ND; however, relevant aspects are still pending to explore such as metabolic analysis, pharmacokinetics, and brain bioavailability.

An overview of colorimetric assay methods used to assess survival or proliferation of mammalian cells.

The aim of this review is to briefly describe some colorimetric methods that are commonly used to evaluate a new chemical entity (NCE) on cell cultures in non-clinical oncology discovery research. These methods have the distinct advantage over other techniques in that they can be applied and used in a cell monolayer or a suspension culture. Both protein assay determination and cell viability assays may be conducted using these culture systems. The viability of cell cultures is routinely assessed by utilizing the metabolic capacity of cells which biochemically convert chemicals (usually color dyes) which can then be conveniently measured at specific wavelengths using a multi-well plate reader. Resazurin (Alamar Blue) is an example of one of these metabolically active compounds. Resazurin is a nontoxic dye that can also be used to measure migration and cellular invasion without resorting to sacrifice of the cells during the test procedure. Another is 5-bromo-2-deoxyuridine (bromodeoxyuridine or BrdU) which is a thymidine analog that incorporates into the DNA of dividing cells during the S-phase of the cell cycle. We will also discuss the colorimetric version of the traditional 3H-thymidine incorporation and immunoenzymatic assay used to measure DNA synthesis and its application to discovery research.

Cytotoxic activity of four Mexican medicinal plants.

Ibervillea sonorae Greene, Cucurbita ficifolia Bouché, Tagetes lucida Cav and Justicia spicigera Scheltdd are Mexican native plants used in the treatment of different illnesses. The ethanolic extract of J. spicigera and T. lucida as well as aqueous extracts from I. sonorae, C. ficifolia, T. lucida and J. spicigera were investigated using sulforhodamine B assay. These extracts were assessed using two cell line: T47D (Human Breast cancer) and HeLa (Human cervix cancer). Colchicine was used as the positive control. Data are presented as the dose that inhibited 50% control growth (ED50). All of the assessed extracts were cytotoxic (ED50 < 20 microg/ml) against T47D cell line, meanwhile only the aqueous extract from T. lucida and the ethanolic extract from J. spicigera were cytotoxic to HeLa cell line. Ethanolic extract from J. spicigera presented the best cytotoxic effect. The cytotoxic activity of J. spicigera correlated with one of the popular uses, the treatment of cancer.

Hematopoietic activity of Smilax aristolochiaefolia (zarzaparrilla) in mice with aplastic anemia.

Smilax aristolochiaefolia (Liliaceae) has been used in Mexican traditional medicine for the treatment of tumors, leprosy, anemia and as a tonic for skin infections and anemia. Aplastic anemia (AA) was induced in CD1 mice 8-12 weeks old distributed 10 animals each in Groups VSC, AA, AASa and AAr. Groups AA, AASa and AAr received benzene (2 ml/kg diluted v/v with corn oil) subcutaneously every three days until 20 dosages had been administered. The vehicular solution control group (VSC) received corn oil and the HC group (healthy control) received saline solution. Two days after the last benzene inoculation, groups AA and HC were bled and sacrificed to count blood and bone marrow cells. Group AASa received an aqueous S. aristolochiaefolia (0.4 g/kg) solution orally on days 3, 5 and 7 after the last dosage of benzene, meanwhile group AAr received no treatment after induction of AA (self recovery). On day 9 these groups were bled and sacrificed to count blood and bone marrow cells. Mice with aplastic anemia treated with S. aristolochiaefolia extract, recovered normal platelet levels and nucleated bone marrow cells as compared with the control, but the counts of erythrocytes and leukocyte were lower than controls (p<0.005). The aqueous extract of S. aristolochiaefolia (zarzaparrilla) restores hematopoeisis in the bone marrow of mice with aplastic anemia.

Etnobotánica, micrografía analítica de hojas y tallos y fitoquimica de Cuphea aequipetala Cav. (Lythraceae): una contribución a la farmacopea herbolaria de los Estados Unidos Mexicanos (FHEUM) / Ethnobotany, analytical micrograph of leaves and stems and phytochemistry of Cuphea aequipetala Cav. (Lythraceae): a contribution to the herbal pharmacopoeia of the United Mexican States (FHEUM)

Cuphea aquipetala Cav. (Hierba del cancer) is used in Mexican traditional medicine. In the present work, its most frequent medicinal applications were determined through interviews, revision of herbarium specimens, and bibliography. The quoted applications were: to treat pounds and wounds. For these purposes, the drug (leaf and stem) is prepared and administered as infusion, or as poultice. In order to provide data for inclusion of this species in the Herbal Pharmacopoeia of the United Mexican States (FHEUM) we describe its leaf architecture and diagnostic anatomical characters of drug,. The anatomical study revealed that the three types of trichomes observed can aid to differentiate this species from other Cuphea species. Anatomical variation was observed mainly in the midrib of the leaf. Leaf architecture is first described for this species, and provides the basis for future comparisons. In addition, the acetone-water extract of the aerial parts previously reported as cytotoxic activity against DU-145 (human prostate carcinoma) and HCT-15 (human colon carcinoma), showed the presence of polyphenolic compounds of the type of hydrolysable and condensed tannins, mannitol was isolated and identified.

Cuphea aquipetala Cav., Lythraceae (Hierba del cáncer) es utilizada en la medicina tradicional mexicana. En el presente trabajo se determinó mediante entrevistas, consultas de herbario y revisión bibliográfica sus aplicaciones médicas más frecuentes, a saber: para tratar golpes y heridas, para lo cual la droga (hoja y tallo) es preparada en infusión, o administrada en emplastos. Con la finalidad de aportar datos que ayuden a la inclusión de esta especie en la Farmacopea Herbolaria de los Estados Unidos Mexicanos (FHEUM), se describen la arquitectura foliar y los caracteres anatómicos de la droga. El estudio anatómico reveló que los tres tipos de tricomas reconocidos en la especie estudiada apoyan a diferenciarla de otras especies de Cuphea sp. Se observó variación anatómica principalmente en la nervadura central de la hoja. La arquitectura foliar se describe por primera vez para la especie y sienta las bases para futuras comparaciones. Por otra parte, el extracto acetona-agua de las partes aéreas que previamente ha sido reportado con actividad citotóxica contra células DU-145 (carcinoma de próstata humano) y HCT-15 (carcinoma de colon humano) mostró la presencia de compuestos polifenólicos del tipo de los taninos hidrolizables, taninos condensados, y se aisló manitol.

Cytotoxic activity of Cuphea aequipetala.

Cuphea aequipetala (Lytraceae) is a perennial plant that has been used in Mexican traditional medicine to treat different types of tumors since prehispanic times. In the present work the cytotoxic potential of different fractions from acetone-water extract from the whole plant was investigated using a sulforhodamine B assay. Fractions were subjected to a bioscreening assay using several cell lines: HEp-2 (human larynx carcinoma), HCT-15 (human colon cancer) and DU-145 (human prostate carcinoma). Colchicine was used as positive control. Data are presented as the dose that inhibited 50.0% control growth (ED50). The cytotoxic activity is selective since the ED50 is different for the three cell lines employed. The highest activity was seen against the DU-145 cell line. "E" and PB1 fractions had the highest cytotoxic activities with ED50 values of 0.418 and 2.40 microg/ml respectively, on the DU-145 cell line. The "E" fraction was a yellow powder; it was methanol soluble and contained at least four separate components when separated by thin-layer chromatography. PB1 was a solid with metallic appearance; it was water soluble and its two dimensional chromatography showed 9 spots. These fractions have cytotoxic actives because their ED50 is less than 20 microg/ml and they will be further characterized.

Trypanocidal constituents in plants: 7. Mammea-type coumarins

Calophyllum brasiliense and Mammea americana (Clusiaceae) are two trees from the tropical rain forests of the American continent. A previous screening showed high trypanocidal activity in the extracts of these species. Several mammea-type coumarins, triterpenoids and biflavonoids were isolated from the leaves of C. brasiliense. Mammea A/AA was obtained from the fruit peels of M. americana. These compounds were tested in vitro against epimastigotes and trypomastigotes of Trypanosoma cruzi, the etiologic agent of Chagas disease. The most potent compounds were mammea A/BA, A/BB, A/AA, A/BD and B/BA, with MC100 values in the range of 15 to 90 g/ml. Coumarins with a cyclized ,-dimethylallyl substituent on C-6, such as mammea B/BA, cyclo F + B/BB cyclo F, and isomammeigin, showed MC100 values > 200 g/ml. Several active coumarins were also tested against normal human lymphocytes in vitro, which showed that mammea A/AA and A/BA were not toxic. Other compounds from C. brasiliense, such as the triterpenoids, friedelin, canophyllol, the biflavonoid amentoflavone, and protocatechuic and shikimic acids, were inactive against the epimastigotes. The isopropylidenedioxy derivative of shikimic acid was inactive, and its structure was confirmed by X-ray diffraction. Our results suggest that mammea-type coumarins could be a valuable source of trypanocidal compounds.