In - Vitro Propagation and Antimycotic Potential of Extracts and Essential Oil of Roots of Aristolochia Bracteolata Linn. (Aristolochiaceae)

In spite of the therapeutic importance of Aristolochia bracteolata Linn. in Nigerian ethnomedicine, it is largely collected from the wild. Owing to the acclaimed potency of the plant and the difficulty in treating candidiasis, the anticandidal activity and in vitro propagation of the plant were investigated. Phytochemical screening and preparation of extracts of the roots were done using standard procedures. Clinical isolates of Candida albicans were screened against extracts and essential oil of Aristolochia bracteolata root using agar-well diffusion method. Minimum Inhibitory Concentration (MIC) of the ethanol extract was determined using broth dilution method. The nodal cuttings of A. bracteolata were cultured on Murashige and Skoog (MS) basal media. A. bracteolata contained alkaloids, saponins and cardenolides. The water extract was inactive on all isolates. The ethanol extract (500 mg/ml) and essential oil (undiluted) exhibited anticandidal activity on 9 out of 10 isolates at 10¹ − 10⁶ cfu/ml inoculums concentration. Green growth and callus formation were observed in explants cultured on MS basal media after 30 days. A. bracteolata could be a source of anticandidal phytomedicine and the in vitro propagation confirmed its sustainability as anticandidal agent.     

Phytochemical and In Vitro Antimicrobial Assay of the Leaf Extract of Newbouldia Laevis

The methanolic leaf extract of Newbouldia laevis was subjected to preliminary phytochemical screening and in-vitro antimicrobial tests. The extract revealed the presence of flavonoids, tannins, terpenes, steroidal and cardiac glycosides. The antimicrobial activity of the plant extract was assayed by the agar plate disc diffusion and nutrient broth dilution techniques. Test microorganisms were Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Salmonella typhi, Klebsiella spp. and Candida albicans; all the organisms were laboratory isolates. The extract inhibited the growth of all the test organisms especially against Klebsiella spp. and S. aureus which had mean inhibition zone of 42.3±1.5 and 32.3±1.5 mm respectively. The results showed minimum inhibitory concentration (MIC) of 1.563 mg/ml against Escherichia coli and Klebsiella spp. and 3.125 mg/ml against Pseudomonas aeruginosa, Staphylococcus aureus and Salmonella typhi. The minimal bactericidal concentration (MBC) against Escherichia coli and Staphylococcus aureus was 0.39 mg/ml. This study has justified the traditional use of this plant for the treatment of stomach discomfort, diarrhea, dysentery and as a remedy for wound healing whose causative agents are some of the organisms used in this study.     

In Vitro Activities of Isavuconazole and Comparator Antifungal Agents Tested against a Global Collection of Opportunistic Yeasts and Molds

Isavuconazole is a new broad-spectrum triazole with a favorable pharmacokinetic and safety profile. We report the MIC distributions for isavuconazole and 111 isolates of Candida (42 Candida albicans, 25 Candida glabrata, 22 Candida parapsilosis, 14 Candida tropicalis, and 8 Candida krusei isolates), as determined by Clinical and Laboratory Standards Institute (CLSI) and European Committee on Antimicrobial Susceptibility Testing (EUCAST) broth microdilution (BMD) methods. Also, the relative activities of isavuconazole, itraconazole, fluconazole, posaconazole, voriconazole, and the three echinocandins were assessed against a recent (2011) global collection of 1,358 isolates of Candida spp., 101 of Aspergillus spp., 54 of non-Candida yeasts, and 21 of non-Aspergillus molds using CLSI BMD methods. The overall essential agreement (EA) (±2 log₂ dilutions) between the CLSI and EUCAST methods was 99.1% (EA at ±1 log₂ dilution, 90.1% [range, 80.0 to 100.0%]). The activities of isavuconazole against the larger collection of Candida spp. and Aspergillus spp. were comparable to those of posaconazole and voriconazole; the MIC₉₀ values for isavuconazole, posaconazole, and voriconazole against Candida spp. were 0.5, 1, and 0.25 μg/ml and against Aspergillus spp. were 2, 1, and 1 μg/ml, respectively. Isavuconazole showed good activities against Cryptococcus neoformans (MIC₉₀, 0.12 μg/ml) and other non-Candida yeasts (MIC₉₀, 1 μg/ml) but was less potent against non-Aspergillus molds (MIC₉₀, >8 μg/ml). Isavuconazole MIC values for three mucormycete isolates were 4, 1, and 2 μg/ml, whereas all three were inhibited by 1 μg/ml posaconazole. Isavuconazole demonstrates broad-spectrum activity against this global collection of opportunistic fungi, and the CLSI and EUCAST methods can be used to test this agent against Candida, with highly comparable results.     

Qualitative Phytochemical Screening and In Vitro Antimicrobial Effects of Methanol Stem Bark Extract of Ficus Thonningii (Moraceae)

The methanolic stem bark extract of Ficus thonningii (Moraceae) was subjected to preliminary phytochemical screening and in vitro antimicrobial tests. The phytochemical tests was carried out using standard methods of analysis and these investigations revealed the presence of alkaloids, anthraquinones, carbohydrates, flavonoids, saponins and tannins. The antimicrobial activity of the plant extract was assayed using the agar plate disc diffusion and nutrient broth dilution techniques. Test micro organisms were: Escherichia coli, Klebsiella spp, Pseudomonas aeruginosa, Salmonella typhi (Gram-negative), Staphylococcus aureus and Streptococcus spp. (Gram-positive). The extracts inhibited the growth of all the test organisms at different concentrations especially against Pseudomonas aeruginosa and Streptococcus spp. which had mean inhibition zone of 33.33±7.33 mm and 32.33±2.51 mm respectively. The results showed the MIC of 10 mg ml⁻¹ against pseudomonas and 1.25 against remaining organisms tested. The MBC against Staphylococcus aureus was 2.5 mg ml⁻¹ and that of Streptococcus spp. was found to be 0.625mg ml⁻¹. The extracts showed varied inhibitory activity against the organisms studied.     

In vivo hypoglycemic effect of methanolic fruit extract of Momordica charantia L

Background

Momordica charantia L. is a medicinal plant commonly used in the management of diabetes mellitus.

Objectives

We investigated the blood glucose lowering effect of the methanolic fruit extract of the Ugandan variety of M. charantia L. in alloxan-induced diabetic albino rats.

Methods

500g of M. charantia powder were macerated in methanol and the extract administered to two groups of alloxan-induced diabetic rats. The first group received 125mg/kg, the second 375mg/kg and a third group 7mg/kg of metformin. A fourth group received 1ml normal saline. Fasting blood glucose (FBG) levels were measured at 0.5,1,2,3,5,8 and 12 hours and compared using one-way ANOVA.

Results

There was an initial rise in FBG for 1 hour after administration of extracts followed by steep reductions. Significant reduction in FBG occurred at 2 hours for 125mg/kg of extract (−3.2%, 313±25.9 to 303±25.0mg/dL, p = 0.049), 375mg/kg of extract (−3.9%, 356±19.7 to 342±20.3mg/dL, p = 0.001), and metformin (−2.6%, 344±21.7 to 335±21.1mg/dL, p = 0.003) when compared to normal saline. The maximum percentage reduction in FBG by both extracts occurred between 3 and 12 hours post dose.

Conclusions

The methanolic fruit extract of M. charantia exhibits dose dependent hypoglycaemic activity in vivo.     

Detection of Candida dubliniensis in Oropharyngeal Samples from Human Immunodeficiency Virus-Infected Patients in North America by Primary CHROMagar Candida Screening and Susceptibility Testing of Isolates

Candida dubliniensis has been associated with oropharyngeal candidiasis in patients infected with human immunodeficiency virus (HIV). C. dubliniensis isolates may have been improperly characterized as atypical Candida albicans due to the phenotypic similarity between the two species. Prospective screening of oral rinses from 63 HIV-infected patients detected atypical dark green isolates on CHROMagar Candida compared to typical C. albicans isolates, which are light green. Forty-eight atypical isolates and three control strains were characterized by germ tube formation, differential growth at 37, 42, and 45°C, identification by API 20C, fluorescence, chlamydoconidium production, and fingerprinting by Ca3 probe DNA hybridization patterns. All isolates were germ tube positive. Very poor or no growth occurred at 42°C with 22 of 51 isolates. All 22 poorly growing isolates at 42°C and one isolate with growth at 42°C showed weak hybridization of the Ca3 probe with genomic DNA, consistent with C. dubliniensis identification. No C. dubliniensis isolate but only 18 of 28 C. albicans isolates grew at 45°C. Other phenotypic or morphologic tests were less reliable in differentiating C. dubliniensis from C. albicans. Antifungal susceptibility testing showed fluconazole MICs ranging from ≤0.125 to 64 μg/ml. Two isolates were resistant to fluconazole (MIC, 64 μg/ml) and one strain was dose dependent susceptible (MIC, 16 μg/ml). MICs of other azoles, including voriconazole, itraconazole, and SCH 56592, for these isolates were lower. C. dubliniensis was identified in 11 of 63 (17%) serially evaluated patients. Variability in phenotypic characteristics dictates the use of molecular and biochemical techniques to identify C. dubliniensis. This study identifies C. dubliniensis in HIV-infected patients from San Antonio, Tex., and shows that C. dubliniensis is frequently detected in those patients by using a primary CHROMagar screen.     

Isavuconazole MIC distribution of 29 yeast species responsible for invasive infections (2015–2017)

ObjectivesIsavuconazole is a recent extended-spectrum triazole with activity against yeasts. However, few data are available about the in vitro activity of rare yeast species. We report the MIC distribution of isavuconazole compared with fluconazole for a large collection of common or rare yeasts.MethodsIsavuconazole and fluconazole MICs were determined using the EUCAST method for 1457 clinical isolates, mainly recovered from invasive infections, belonging to 29 species. They were sent to the National Reference Centre for Invasive Mycoses & Antifungals between January 2015 and October 2017 and species identification was performed using a polyphasic approach (matrix-assisted laser desorption/ionization time of flight analysis and a molecular method).ResultsIsavuconazole had effective in vitro activity against Cryptococcus neoformans (MIC90 < 0.25 mg/L), the five most common Candida spp. (MIC90 ≤ 0.5 mg/L for Candida albicans, Candida glabrata, Candida tropicalis, Candida parapsilosis, and Candida krusei) and also against the majority of rare species, including Candida kefyr and Candida lusitaniae. A few isolates of C. albicans (0.7%, 3/404), C. glabrata (2.7%, 5/184), C. tropicalis (1.0%, 1/96) and C. parapsilosis (0.8%, 1/127) exhibited MIC ≥4 mg/L. All were also resistant to fluconazole according to the EUCAST breakpoints. Some isolates with isavuconazole MIC ≥4 mg/L were also observed among rarer species: Meyerozyma guilliermondii (8.7%, 2/23), Wickerhamomyces anomalus (10.0%, 1/10). Other rare species Saprochaete clavata, Magnusiomyces capitatus, and Rhodotorula mucilaginosa had high MIC50 (≥1 mg/L) and MIC90 (≥4 mg/L) and could be considered as resistant to isavuconazole.ConclusionsWe confirmed the good in vitro activity of isavuconazole against common Candida, Cryptococcus species and the majority of the rare yeast species studied.     

A Multi-Center,Double-Blind Randomized Controlled Phase III Clinical Trial to Evaluate the Antiviral Activity and Safety of DA-2802 (Tenofovir Disoproxil Orotate) and Viread (Tenofovir Disoproxil Fumarate) in Chronic Hepatitis B Patients

BackgroundTenofovir disoproxil fumarate (TDF, Viread^®) had been used as a standard treatment option of chronic hepatitis B (CHB). This clinical trial was conducted to evaluate the efficacy and safety of DA-2802 (tenofovir disoproxil orotate) compared to TDF.MethodsThe present study was a double blind randomized controlled trial. Patients with CHB were recruited from 25 hospitals in Korea and given DA-2802 at a dose of 319 mg once daily or Viread^® at a dose of 300 mg once daily for 48 weeks from March 2017 to January 2019. Change in hepatitis B virus (HBV) DNA level at week 48 after dosing compared to baseline was the primary efficacy endpoint. Secondary efficacy endpoints were proportions of subjects with undetectable HBV DNA, those with normal alanine aminotransferase (ALT) levels, and those with loss of hepatitis B envelop antigen (HBeAg), those with loss of hepatitis B surface antigen (HBsAg). Adverse events (AEs) were also investigated.ResultsA total of 122 patients (DA-2802 group: n = 61, Viread^® group: n = 61) were used as full analysis set for efficacy analysis. Mean age, proportion of males, laboratory results and virologic characteristics were not different between the two groups. The change in HBV DNA level at week 48 from baseline was −5.13 ± 1.40 in the DA-2802 group and −4.97 ± 1.40 log₁₀ copies/mL in the Viread^® group. The analysis of primary endpoint using the nonparametric analysis of covariance showed statistically significant results (P < 0.001), which confirmed non-inferiority of DA-2802 to Viread^® by a prespecified noninferiority margin of 1. The proportion of undetectable HBV DNA was 78.7% in the DA-2802 group and 75.4% in the Viread^® group (P = 0.698). The proportion of subjects who had normal ALT levels was 75.4% in the DA-2802 group and 73.3% in the Viread^® group (P = 0.795). The proportion of those with HBeAg loss was 8.1% in the DA-2802 group and 10.8% in the Viread^® group (P = 1.000). No subject showed HBsAg loss. The frequency of AEs during treatment was similar between the two groups. Most AEs were mild to moderate in severity.ConclusionDA-2802 is considered an effective and safe treatment for patients with CHB.Trial RegistrationClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT02967939","term_id":"NCT02967939"}}NCT02967939     

Biological Activities of Schefflera Leucantha

This study investigated various biological activities of the ethanolic extract of dried ground leaves of Schefflera leucantha Viguier (Araliaceae). The extract possessed very low cytotoxicity to brine-shrimp with the LC₅₀ of 4,111.15µg/ml; the significant antioxidant activity on DPPH with the EC₅₀ of 71.90µg/ml; the inhibitory activity on mushroom tyrosinase with the IC₅₀ of 10.53mg/ml using the dopachrome microplate-assay. The extract of 5–20mg/ml range in the agar dilution assay were active against various pathogenic microbial (11 species, 11 strains), with the minimum inhibitory concentration (MIC) of 5mg/ml against Clostridium spp.; MIC=10mg/ml against enteropathogens as Bacteroides spp., Enterococcus faecalis ATCC 29212, Lactobacillus spp., Peptococcus spp. and Streptococcus mutans; MIC=10mg/ml against a pneumonia causing bacteria Klebsiella pneumoniae and a dermatopathogen as Propionibacterium acnes; MIC=20mg/ml against dermatopathogens as Staphylococcus aureus ATCC 6538, Streptococcus spp. and Candida albicans ATCC 90028. TLC fingerprints of the specific extracts from the leaf powder exhibited zones of steroids-terpenes and flavonoids. HPLC fingerprint of the flavonoid extract was performed.     

Antifungal activity of nitroxoline against Candida auris isolates

ObjectivesTo investigate the in vitro activity of nitroxoline against a molecularly characterized collection of clinical Candida auris isolates.MethodsThirty-five clinical isolates of C. auris from diverse sources representing all five different C. auris clades were included in the study. Nitroxoline activity was assessed using broth microdilution. Additionally, susceptibility testing by disc diffusion was assessed on RPMI-1640 and Müller–Hinton agar plates. Minimal inhibitory concentrations of the antifungals fluconazole, voriconazole, amphotericin B and anidulafungin were determined.ResultsNitroxoline MICs ranged from 0.125 to 1 mg/L (MIC_50/90 0.25/0.5 mg/L). Compared with amphotericin B (MIC >1 mg/L in 4/35 isolates), anidulafungin (MIC >0.06 mg/L in 26/35 isolates) and fluconazole (MIC >4 mg/L in 31/35 isolates), in vitro activity of nitroxoline was high. Isolates belonging to clade I had marginally lower nitroxoline MICs (range 0.125–0.5 mg/L, mean MIC 0.375 mg/L) compared with clade III (range 0.5–1 mg/L, mean MIC 0.7 mg/L; p = 0.0094). The correlation of MIC and inhibition zones by disc diffusion was good when using RPMI-agar for disc diffusion, with a Pearson's correlation coefficient of –0.74 (95% CI –0.86 to –0.54).ConclusionsNitroxoline has excellent in vitro activity against C. auris isolates, with MICs of 0.125–1 mg/L (for comparison, the EUCAST breakpoint for uncomplicated urinary tract infection with Escherichia coli is ≤ 16 mg/L). It is an approved, well-tolerated antimicrobial that achieves high urinary concentrations after oral administration and could be a useful treatment option in C. auris candiduria.     

Neutralization Profiles of Sera from Human Immunodeficiency Virus (HIV)-Infected Individuals: Relationship to HIV Viral Load and CD4 Cell Count

The relationship of the neutralizing activity (NA) profile of sera from human immunodeficiency virus (HIV)-infected individuals to the HIV viral load and the absolute CD4 count was examined. The NA of 24 serum samples against autologous isolates (AI) and HIV type 1 strain MN was examined. Three NA patterns were recognized. Nine sera neutralized both AI and MN (+/+), six sera neutralized MN but not AI (−/+), and nine sera failed to neutralize both AI and MN (−/−). The identification of the three neutralization patterns (+/+, −/+, and −/−) indicated that resistance to neutralization was progressive. A reciprocal relationship between the viral burden of the patients and the NA profiles was observed. The nine subjects with a −/− NA profile had a plasma viral load of ≥5 × 10⁴ copies/ml and a cellular viral burden of ≥1,122 infectious units per million viable cells, which were significantly different from those of the other groups (P < 0.02). These patterns were independent of the phenotypic characteristics of the virus. Longitudinally, subjects with a −/− profile at baseline gained their HIV-specific NA by 24 weeks of antiretroviral therapy when this was associated with a ≥1-log₁₀ decline in the plasma HIV viral load. The sera from week 24 from some patients were able to neutralize both the 24-week and the baseline dominant virus isolates. A change in CD4 cell count of 50 or more in either direction predicted a −/− or +/+ profile. The verification of the autologous NA profile might be important in selecting patients who may benefit from immune-based therapies involving neutralizing monoclonal antibodies.     

Antimicrobial Potentials of Silver Colloidal (Nanorods) on Clinical Isolates in Bayelsa State,Nigeria

Antimicrobial resistance in developing countries has long been an issue of major concern. Nanotechnology has become an eye opener for the intervention on multiple drug resistance organisms. In this study we investigated the antimicrobial potentials of Silver Nitrate (nanorods) solution used in managing infectious diseases, the Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) of the product against microbial isolates were determined using standard microbiological techniques. The mean MIC and MBC of silver nitrate solution on fungi (0.16 µg/ml and 0.29 µg/ml respectively) was significantly lower than that of Gram positive organisms (2.35µg/ml and 2.62µg/ml) and Gram negative organisms (2.05 µg/ml and 2.10 µg/ml). Of all the Gram positive organisms, Staphylococcus spp recorded the lowest mean MIC and MBC while in the Gram negative organisms group, E. coli isolates showed the lowest mean MIC and MBC of the silver nitrate solution, though not significantly different from the other isolates. In conclusion, results from this study revealed that Silver Nitrate(nanorods) may have be broad spectrum in activity, but with higher antifungal potentials.     

Anti-Inflammatory and Antimicrobial Activities of Hippocratea Indica Root Bark and Poga Oleosa Fruits

The methanolic extracts of Hippocratea indica root bark and Poga oleosa fruits were investigated for anti-inflammatory and antimicrobial activities. Both extracts inhibited carrageenan-induced paw oedema significantly in rats in a dose-dependent manner in 4 h. H. indica inhibited oedema significantly at the minimal dose (125 mg/ml, p< 0.05) from 2 h onward, and gave 100% inhibition in 4 h. at 250 mg/kg. It was shown to be a more potent anti-inflammatory agent than P. oleosa. Also, H. indica extract exhibited greater antimicrobial activity against tested bacteria, with Staphylococcus aureus being the most susceptible bacterium (MIC, 16 mg/ml). Both plants were inactive against Candida albicans. These results confirm the anti-inflammatory and antibacterial activities of the two plants.     

Antibacterial Activity of Extracts of Three Croton Species Collected in Mpumalanga Region in South Africa

The antibacterial activities of three Croton species were compared using bioautography and the serial microdilution methods. The methanolic extracts of all the species had low activity against Escherichia coli. The highest activity was observed with Croton megalobotrys against Enterococcus faecalis with a minimal inhibitory concentration (MIC) value of 0.02 mg/ml. Croton steenkapianus extracts were the least active of the species investigated, only managing an MIC value of 0.625 mg/ml against Pseudomonas aeruginosa. Croton megalobotrys leaf powder was serially extracted using solvents of various polarities. The lowest MIC value (0.06 mg/ml) of the serially extracted fractions was observed with acetone against Pseudomonas aeruginosa. The liquid-liquid fractions of the methanol extract of Croton megalobotrys were also tested. The lowest MIC value of 0.02 mg/ml was observed with n-hexane fraction against Enterococcus faecalis. The carbon tetrachloride fraction was further fractionated using column chromatography with silica as the immobile phase. The resulting seven fractions were tested for activity following the bioassay-guided practice, and it emerged that the first three fractions had active compounds against Staphylococcus aureus when the bioautography method was used.     

Preclinical Evaluation of a Novel Polymer-free Everolimus-eluting Stent in a Mid-term Porcine Coronary Restenosis Model

BackgroundTitanium dioxide films exhibit good biocompatibility and may be effective as drug-binding matrices for drug-eluting stents. We conducted a mid-term evaluation of a novel polymer-free everolimus-eluting stent using nitrogen-doped titanium dioxide film deposition (TIGEREVOLUTION^®) in comparison with a commercial durable polymer everolimus-eluting stent (XIENCE Alpine^®) in a porcine coronary restenosis model.MethodsTwenty-eight coronary arteries from 14 mini-pigs were randomly allocated to TIGEREVOLUTION^® stent and XIENCE Alpine^® stent groups. The stents were implanted in the coronary artery at a 1.1–1.2:1 stent-to-artery ratio. Eleven stented coronary arteries in each group were finally analyzed using coronary angiography, optical coherence tomography, and histopathologic evaluation 6 months after stenting.ResultsQuantitative coronary analysis showed no significant differences in the pre-procedural, post-procedural, and 6-month lumen diameters between the groups. In the volumetric analysis of optical coherence tomography at 6 months, no significant differences were observed in stent volume, lumen volume, and percent area stenosis between the groups. There were no significant differences in injury score, inflammation score, or fibrin score between the groups, although the fibrin score was zero in the TIGEREVOLUTION^® stent group (0 vs. 0.07 ± 0.11, P = 0.180).ConclusionPreclinical evaluation, including optical coherence tomographic findings 6 months after stenting, demonstrated that the TIGEREVOLUTION^® stent exhibited efficacy and safety comparable with the XIENCE Alpine^® stent, supporting the need for further clinical studies on the TIGEREVOLUTION^® stent.     

Antimicrobial activity of extracts of Terminalia catappa root

The effect against bacteria of petroleum ether (60-80 degrees C), chloroform and methanolic extract of dried root of Terminalia catappa Linn. (combrataceae) was employed by cup plate agar diffusion method. The chloroform extract showed prominent antimicrobial activity against S. aureus and E. coli as compared to other tested microorganisms, while petroleum ether extract was devoid of antimicrobial activity. The methanolic: extract exhibited MIC of 0.065 mg/ml against E. coli. and chloroform extract exhibited MIC of 0.4 mg/ml against S. aureus The chloroform has well as methanolic extracts showed good antimicrobial activity against Gram positive and Gram negative microorganisms.     

Cooling Capacity of Transpulmonary Cooling and Cold-Water Immersion After Exercise-Induced Hyperthermia

ContextCold-water immersion (CWI) may not be feasible in some remote settings, prompting the identification of alternative cooling methods as adjunct treatment modalities for exertional heat stroke (EHS).ObjectiveTo determine the differences in cooling capacities between CWI and the inhalation of cooled air.DesignRandomized controlled clinical trial.SettingLaboratory.Patients or Other ParticipantsA total of 12 recreationally active participants (7 men, 5 women; age = 26 ± 4 years, height = 170.6 ± 10.1 cm, mass = 76.0 ± 18.0 kg, body fat = 18.5% ± 9.7%, peak oxygen uptake = 42.7 ± 8.9 mL·kg⁻¹·min⁻¹).Intervention(s)After exercise in a hot environment (40°C and 40% relative humidity), participants were randomized to 3 cooling conditions: cooling during passive rest (PASS; control), CWI, and the Polar Breeze thermal rehabilitation machine (PB) with which participants inspired cooled air (22.2°C ± 1.0°C).Main Outcome Measure(s)Rectal temperature (T_REC) and heart rate were continuously measured throughout cooling until T_REC reached 38.25°C.ResultsCooling rates during CWI (0.18°C·min⁻¹ ± 0.06°C·min⁻¹) were greater than those during PASS (mean difference [95% CI] of 0.16°C·min⁻¹ [0.13°C·min⁻¹, 0.19°C·min⁻¹]; P < .001) and PB (0.15°C·min⁻¹ [0.12°C·min⁻¹, 0.16°C·min⁻¹]; P < .001). Elapsed time to reach a T_REC of 38.25°C was also faster with CWI (9.71 ± 3.30 minutes) than PASS (−58.1 minutes [−77.1, −39.9 minutes]; P < .001) and PB (−46.8 minutes [−65.5, −28.2 minutes]; P < .001). Differences in cooling rates and time to reach a T_REC of 38.25°C between PASS and PB were not different (P > .05).ConclusionsTranspulmonary cooling via cooled-air inhalation did not promote an optimal cooling rate (>0.15°C·min⁻¹) for the successful treatment of EHS. In remote settings where EHS is a risk, access and use of treatment methods via CWI or cold-water dousing are imperative to ensuring survival.Trial RegistryClinicalTrials.gov (NCT0419026).     

Determination of Antimicrobial Effect,Antioxidant Activity and Phenolic Contents of Desert Truffle in Turkey

Terfezia boudieri Chatin (Scop.) Pers., is a famous macrofungus in the world as well as in Turkey for its pleasant aroma and flavour. People believe that this mushroom has some medicinal properties. Therefore, it is consumed as food and for medicinal purposes. Chloroform, acetone and methanol extracts of T. boudieri were tested to reveal its antimicrobial activity against four Gram-positive and five Gram-negative bacteria, and one yeast using a micro dilution method. In this study, the highest minimum inhibitory concentration (MIC) value was observed with the acetone extract (MIC, 4.8 µg/mL) against Candida albicans. Maximum antimicrobial effect was also determined with the acetone extract (MIC, 39–78 µg/mL). The scavenging effect of T. boudieri on 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radicals was measured as 0.031 mg/mL at 5 mg/mL concentration, and its reducing power was 0.214 mg/mL at 0.4 mg/mL. In addition, the phenolic contents were determined as follows: the catechin was 20 mg/g, the ferulic acid was 15 mg/g, the p-coumaric acid was 10 mg/g, and the cinnamic acid was 6 mg/g. The results showed that T. boudieri has antimicrobial activity on the gram negative and positive bacteria as well as yeast, and it also has a high antioxidant capacity. Therefore, T. boudieri can be recommended as an important natural food source.     

Killing kinetics of cefuroxime againstStreptococcus pneumoniae in an in vitro model simulating serum concentration profiles after intramuscular administration

The killing kinetics of cefuroxime against 25Streptococcus pneumoniae isolates with penicillin MICs of <0.1, 0.1–1.0 and 2 mg/l were studied in an in vitro model simulating the serum concentration profile in healthy adults following a single intramuscular injection of 500 mg. Cefuroxime was bactericidal against the isolates with exquisite or slightly diminished susceptibility to penicillin (–4 and –3.9 log10 cfu/ml killing, respectively) during the 6 h incubation period. In contrast, there was only a 2.8 log10 cfu/ml reduction in the initial inoculum of six of the eight isolates resistant to penicillin (MIC 2 mg/l). The two remaining penicillin-resistant isolates (cefuroxime MIC 8 mg/l) only showed a 2 log10 cfu reduction in the initial inoculum.     

Antimycobacterial Evaluation of Fifteen Medicinal Plants in South Africa

Fifteen plant species were collected from the Nelspruit Botanical Garden based on a list of plants provided by Phytomedicine Programme at the University of Pretoria and their ethnopharmacological information. Hexane, dichloromethane (DCM), acetone and methanolic extracts were screened for antimycobacterial activity against Mycobacterium smegmatis. The acetone extract of Milletia stulhimannii was the most active, showing activity against Mycobacterium smegmatis with minimum inhibitory concentration (MIC) value of 0.13 mg/ml. Acetone extracts for all plants had lower MIC values ranging between 0.11–1.25 mg/ml against M. smegmatis. Milletia stulhimannii, Albizia gummifera, Xanthocercis zambesiaca and Barringtonia racemosa have shown great potential as anti-tuberculosis agents. They were active against M. smegmatis with average MIC values of acetone extracts of 0.13 mg/ml.