Nanoemulsion of Minthostachys verticillata essential oil. In-vitro evaluation of its antibacterial activity.

Infectious diseases constitute a problem of great importance for animal and human health, as well as the increasing bacterial resistance to antibiotics. In this context, medicinal plants emerge as an effective alternative to replace the use antibiotics. The essential oil (EO) of Minthostachys verticillata (Griseb.) Epling (Lamiaceae) has demonstrated a strong antimicrobial activity. However, its instability and hydrophobicity under normal storage conditions are limitations to its use. Nanoemulsion technology is an excellent way to solubilize, microencapsulate, and protect this compound. This study aimed to obtain a nanoemulsion based on M. verticillata EO and evaluate its antibacterial activity against Staphylococcus aureus. The EO was obtained by steam distillation. Identification and quantification of their components were determined by GC-MS revealing that the dominated chemical group was oxygenated monoterpenes. Nanoemulsions (NE) were characterized by measuring pH, transmittance, separation percentage, release profile, and morphology. The effect of NE on the growth of S. aureus and cyto-compatibility was also evaluated. The results showed that NE containing a higher percentage of tween 20 exhibited higher stability with an approximated droplet size of 10 nm. The effect of encapsulation process was evaluated by GC-MS revealing that the volatile components in EO were no affected. After 24 h, 74.24 ± 0.75% of EO was released from NE and the antibacterial activity of EO was enhanced considerably by its encapsulation. The incubation of S. aureus with the NE and pure EO, show a bacterial growth inhibition of 58.87% ± 0.99 and 46.72% ± 3.32 (p < 0.05), respectively. In addition, nanoemulsión did not cause toxicity to porcine and equine red blood cells. The results obtained showed that NE could be a potential vehicle for M. verticillata EO with promissory properties to emerge as a tool for developing advanced therapies to control and combat infections.

Emergency transtracheal ventilation: assessment of breathing systems chosen by anaesthetists.

The choice of equipment for emergency transtracheal ventilation and the time taken to assemble it were surveyed in 39 anaesthetists. Thirty seven (95%) assembled a system in a median time of 104 s (interquartile range 54 s to 120 s). Systems specially constructed from oxygen tubing and connectors took longest to put together (p < 0.05). Consultants and senior registrars performed no better than senior house officers and registrars (p > 0.05). In the second part of the study we tested four anaesthetic systems which the survey revealed might be chosen for emergency transtracheal ventilation. These were: a simple length of oxygen tubing; a T-piece system; a Bain system; a jet injector. All had the appropriate connectors. The oxygen flow was measured through a 14 G venous "transtracheal' cannula on depression of the oxygen flush device on a standard Boyle's M anaesthetic machine. The jet injector was connected to the high pressure outlet. This device delivered the highest flow, 43 l.min-1 and was the only system capable of ventilating a trachea/lung model. The T-piece system, and the one constructed from oxygen tubing, delivered flows of 12.7 and 12.0 l.min-1, respectively, whereas the Bain system delivered only 4.7 l.min-1. We conclude that, except for jet ventilation, none of the systems chosen, using equipment available in the anaesthetic room, would be likely to achieve effective CO2 elimination; at best they would provide oxygenation.

A multicenter evaluation of variables affecting the predictability of creatinine clearance.

Data from 722 urine collections (627 patients) from 14 medical facilities were used to compare measured creatinine clearance values with clearance estimates calculated using three "urine-free' mathematical formulas. The influence of two patient weight variables (actual weight, lean body weight) and the level of renal function on clearance prediction was assessed. In addition, site parameters (region, facility), time parameters (month, day, day of the week), and patient parameters (age, sex, height, weight, diagnoses) were evaluated for their statistical influence on the relationship between measured clearance and estimates calculated with one of the methods. Strong, statistically significant correlations were observed between clearance values estimated with each prediction method and measured clearances. Although statistical differences were noticed between mean values predicted with each method, these differences were clinically insignificant. Use of lean body weight for calculation of creatinine excretion produced clearance estimates that were significantly lower than those obtained with actual weight and substantially closer to measured clearance values. Among patient variables, age and two specific diagnoses (congestive heart failure and pregnancy), were statistically associated with variability in the relationship between measured and predicted clearance. Interregional and interfacility differences in the measured-predicted clearance relationship, variability associated with the day of the week of collection, and tendency of the urine-free formulas to over-predict clearance support potential inaccuracy of measured clearance determination. The results suggest that inaccuracies in clearance determination, rather than inadequacies of urine-free prediction methods, account for the majority of the observed variability in the relationship.

The North Carolina Area Health Education Center program: an overview.

North Carolina has been at the forefront of the planning, development, and operation of area health education centers (AHECs). These centers have dramatically improved health manpower education and training at all professional levels. In effect, the North Carolina Area Health Education Center Program is a major decentralization and coordination of medical, dental, pharmacy, and public health education and regionalization of nursing, allied health education, medical residency training, and continuing education. The program links each of the university health science centers in North Carolina to major community hospitals that form a regional network with other institutions. The University of North Carolina at Chapel Hill School of Pharmacy has a major role in the AHEC program. A full-time faculty is located in each AHEC. In addition to providing and coordinating clinically oriented pharmaceutical services and functioning as a resource in all matters relating to drugs, they are extensions of the school's faculty. The North Carolina AHEC Program approach offers pharmacy an excellent opportunity to maximize the pharmacist's contributions to society through education and practice.