Variation in risk factors of dementia among four elderly patient cohorts

AIM: To examine variation in risk factors that contributed to dementia among four elderly cohorts by race and gender. METHODS: We examined 2008 Tennessee Hospital Discharged database for vascular factors that play a role in both stroke and dementia. Risk factors for dementia were examined for black and white patients aged 65+. Four race-gender groups of patients-white males(WM), black males(BM), white females(WF), and black females(BF) were compared for prevalence of dementia and stroke. A logistic model predicting dementia in each group separately used several vascular factors affectingdementia directly or indirectly through stroke. RESULTS: Three point six percent of patients hospitalized in 2008 had dementia and dementia was higher among females than males(3.9% vs 3.2%, P 0.001), and higher among blacks than whites(4.2% vs 3.5%, P 0.000). Further, BF had higher prevalence of dementia than WF(4.2% vs 3.8%, P 0.001); similarly BM had more dementia than WM(4.1% vs 3.1%, P 0.001). In logistic regression models, however, different patterns of risk factors were associated with dementia in four groups: among WF and WM, hypertension, diabetes, congestive heart failure, and stroke predicted dementia. Among BF and BM, only stroke and diabetes were related to dementia.CONCLUSION: Aggressive management of risk factors(hypertension and diabetes) may subsequently reduce stroke and dementia hospitalization.     

Treatment of osteoarticular infections with clindamycin in adults

The main characteristics of clindamycin are adequate for treatment of osteoarticular infections (OAI): good bone diffusion, broad spectrum of antibacterial activity and oral use.     

Comparison of neurological clinical manifestation in patients with hemorrhagic and ischemic stroke

BACKGROUND: Cerebrovascular accident (CVA) is the third leading cause of death and disability in developed countries. Anyone suspected of having a stroke should be taken immediately to a medical facility for diagnosis and treatment. The symptoms that follow a stroke aren't significant and depend on the area of the brain that has been affected and the amount of tissue damaged. Parameters for predicting long-term outcome in such patients have not been clearly delineated, therefore the aim of this study was to investigate this possibility and to test a system that might practicably be used routinely to aid management and predict outcomes of individual stroke patients.     

Serum retinol levels are positively correlated with hemoglobin concentrations,independent of iron homeostasis: a population-based study

Micronutrient interactions give rise to complex issues that have an impact on preventive strategies when multiple micronutrient deficiencies coexist. The aim of this population-based study was to determine the prevalence of vitamins A and E and iron deficiencies among women 15 to 49 years of age in the northern Persian Gulf region. We hypothesized that serum retinol levels may show correlations with hemoglobin (Hb) concentrations, independent of iron status. A total of 1242 nonpregnant women of reproductive age were selected via a multistage stratified random cluster sampling technique. Serum ferritin and soluble transferrin receptor levels were measured using enzyme immunoassay techniques. Serum retinol (vitamin A) and α-tocopherol (vitamin E) were determined for 727 women by high-performance liquid chromatography. The prevalence of anemia (Hb <12 g/dL), iron deficiency (serum ferritin <15 μg/L), and iron deficiency anemia was 8.7%, 25.4%, and 4.6%, respectively. Vitamin A (<0.7 μmol/L) and vitamin E (<11.6 μmol/L) deficiencies were found in 1.2% and 5.9% of the studied population, respectively. Multiple regression analysis revealed that serum retinol levels exhibit a significant association with Hb concentrations after controlling for serum ferritin levels, anemia associated with chronic disease, and risk factors for anemia. Therefore, most nonpregnant women of reproductive age in the northern Persian Gulf were found to have adequate serum vitamin A and E levels. However, the status of anemia and iron deficiency anemia could be considered a mild public health problem in this region. On the basis of multivariate analyses, we conclude that low serum retinol levels may contribute to anemia, independent of iron homeostasis.     

HPLC-based activity profiling for antiplasmodial compounds in the traditional Indonesian medicinal plant Carica papaya L

Ethnopharmacological relevance

Leaf decoctions of Carica papaya have been traditionally used in some parts of Indonesia to treat and prevent malaria. Leaf extracts and fraction have been previously shown to possess antiplasmodial activity in vitro and in vivo.

Materials and methods

Antiplasmodial activity of extracts was confirmed and the active fractions in the extract were identified by HPLC-based activity profiling, a gradient HPLC fractionation of a single injection of the extract, followed by offline bioassay of the obtained microfractions. For preparative isolation of compounds, an alkaloidal fraction was obtained via adsorption on cationic ion exchange resin. Active compounds were purified by HPLC–MS and MPLC–ELSD. Structures were established by HR-ESI-MS and NMR spectroscopy. For compounds 5 and 7 absolute configuration was confirmed by comparison of experimental and calculated electronic circular dichroism (ECD) spectroscopy data, and by X-ray crystallography. Compounds were tested for bioactivity in vitro against four parasites (Trypanosoma brucei rhodesiense, Trypanosoma cruzi, Leishmania donovani, and Plasmodium falciparum), and in the Plasmodium berghei mouse model.

Results

Profiling indicated flavonoids and alkaloids in the active time windows. A total of nine compounds were isolated. Four were known flavonols – manghaslin, clitorin, rutin, and nicotiflorin. Five compounds isolated from the alkaloidal fraction were piperidine alkaloids. Compounds 5 and 6 were inactive carpamic acid and methyl carpamate, while three alkaloids 7–9 showed high antiplasmodial activity and low cytotoxicity. When tested in the Plasmodium berghei mouse model, carpaine (7) did not increase the survival time of animals.

Conclusions

The antiplasmodial activity of papaya leaves could be linked to alkaloids. Among these, carpaine was highly active and selective in vitro. The high in vitro activity could not be substantiated with the in vivo murine model. Further investigations are needed to clarify the divergence between our negative in vivo results for carpaine, and previous reports of in vivo activity with papaya leaf extracts.