Focused Cardiac Ultrasonography: Current Applications and Future Directions

Focused cardiac ultrasonography is performed by clinicians at the bedside and is used in time‐sensitive scenarios to evaluate a patient's cardiovascular status when comprehensive echocardiography is not immediately available. This simplified cardiac ultrasonography is often performed by noncardiologists using small, portable devices to augment the physical examination, triage patients, and direct management in both critical care and outpatient settings. However, as the use of focused cardiac ultrasonography continues to expand, careful consideration is required regarding training, scope of practice, impact on patient outcomes, and medicolegal implications. In this review, we examine some of the challenges with rapid uptake of this technique and explore the benefits and potential risk of focused cardiac ultrasonography. We propose possible mechanisms for cross‐specialty collaboration, quality improvement, and oversight.     

Extraction of phenolic components from an Aloe vera (Aloe barbadensis Miller) crop and their potential as antimicrobials and textile dyes

The present work focuses on the use of solid and agricultural residues from Aloe vera crops, as a source of antimicrobial agents and textile dyes. The roots from an A. vera plantation post-harvest were extracted with ethyl acetate, purified and phytochemically characterized to obtain five metabolites: aloesaponarin-I (1), deoxyerythrolaccin (2), lacaic acid D methyl ester (3), aloesaponarin-II (4), and aloesaponol-I (5). Acid hydrolysis of the solid industrial residue gave aloe-emodin (6) as the main product with a good yield. All of the components were tested for the first time against phytopathogenic bacteria strains, and deoxyerythrolaccin and lacaic acid D methyl ester were active against Xanthomonas campestris with MIC values of 46.86 and 93.75 μg/mL, respectively. Aloesaponarin-I and aloe-emodin, the main products, were tested as dyes for polyester fabrics using different mordants and pH bath conditions. The colour of each material was investigated in terms of the CIELAB L*, a* and b* values, and the colour fastness to light and washing was investigated according to the Mexican standard methods (NMX-A-074-INNTEX-2005; NMX-A-105-B02-INNTEX-2010). Aloesaponarin-I dyed polyester bright yellow but the final colour was very sensitive to the pH of the dye bath. Aloe-emodin dyed polyester deep yellow, and the fabrics showed good colour fastness to light and to domestic laundering. This study provides evidence that the phenolic components obtained from agricultural residues of the aloe industry can be useful organic alternatives as antimicrobial agents and textile dyes.     

The role of the microbiota in periodontal disease

The last decade has witnessed unparalleled advances in our understanding of the complexity of the oral microbiome and the compositional changes that occur in subgingival biofilms in the transition from health to gingivitis and to destructive periodontal disease. The traditional view, which has held sway for the last 2 decades, that disease is characterized by the outgrowth of a consortium, or consortia, of a limited number of potentially pathogenic organisms, has given way to an alternative paradigm. In this new view, the microbiological changes associated with disease represent whole-scale alterations to the overall microbial population structure and to the functional properties of the entire community. Thus, and in common with other microbially mediated diseases of the gastrointestinal tract, the normally balanced, symbiotic, and generally benign commensal microbiome of the tooth-associated biofilm undergoes dysbiosis to a potentially deleterious microbiota. Coincident with progress in defining the microbiology of these diseases, there have been equally important advances in our understanding of the inflammatory systems of the periodontal tissues, their control, and how inflammation may contribute both to the development of dysbiosis and, in a deregulated state, the destructive disease process. One can therefore speculate that the inflammatory response and the periodontal microbiome are in a bidirectional balance in oral health and a bidirectional imbalance in periodontitis. However, despite these clear insights into both sides of the host/microbe balance in periodontal disease, there remain several unresolved issues concerning the role of the microbiota in disease. These include, but are not limited to, the factors which determine progression from gingivitis to periodontitis in a proportion of the population, whether dysbiosis causes disease or results from disease, and the molecular details of the microbial stimulus responsible for driving the destructive inflammatory response. Further progress in resolving these issues may provide significant benefit to diagnosis, treatment, and prevention.