Analgesic and anti-inflammatory effects of Mangifera indica L. extract (Vimang)

Vimang is an aqueous extract of Mangifera indica used in Cuba to improve the quality of life in patients suffering from elevated stress. To assess its possible analgesic and antiinflammatory effects, the results of a standard extract evaluation are presented. Analgesia was determined using acetic acid-induced abdominal constriction and formalin-induced licking. Antiinflammatory effects were evaluated using carrageenan- and formalin-induced oedema. Vimang (50-1000 mg/kg, p.o.) exhibited a potent and dose-dependent antinociceptive effect against acetic acid test in mice. The mean potency (DE(50)) was 54.5 mg/kg and the maximal inhibition attained was 94.4%. Vimang (20-1000 mg/kg, p.o.) dose-dependently inhibited the second phase of formalin-induced pain but not the first phase. The DE(50) of the second phase was 8.4 mg/kg and the maximal inhibition was 99.5%, being more potent than indomethacin at doses of 20 mg/kg. Vimang (20-1000 mg/kg, p.o.) significantly inhibited oedema formation (p < 0.01 or p < 0.05) of both carrageenan- and formalin-induced oedema in rat, guinea-pigs and mice (maximal inhibitions: 39.5, 45.0 and 48.6, respectively). The inhibitions were similar to those produced by indomethacin and sodium naproxen, p.o. The different polyphenols found in Vimang could account for the antinociceptive and antiinflammatory actions reported here for the first time for M. indica bark aqueous extract.     

A laboratory and clinical evaluation of single‐use instruments for tonsil and adenoid surgery

Objectives: To compare the quality and consistency of single‐use adenotonsillectomy instruments available in the UK with reusable instruments and examine their performance in a clinical setting. Design: A laboratory assessment of each reusable instrument created a detailed specification for the respective single‐use equivalent. A surveillance system monitored the performance of a selected set of specified single‐use instruments. Setting: Single‐use instruments were withdrawn shortly after their introduction in 2001. Persisting concerns from the Spongiform Encephalopathy Advisory Committee led to an investigation into the feasibility of continuing to use such instruments. Main outcome measures: The numbers of instruments from each set judged as unacceptable or as good as the original. The number and cause of instrument failure during clinical surveillance. Results: Between 40% and 93% of the instruments on each set were as good as the original and between 0% and 40% of the instruments were unacceptable from six sets of steel and one set of polymer instruments. 4151 procedures were monitored between 1 February 2003 and 31 March 2004 using a total of 41 376 instruments. Problems were reported with 335 (0.8%) instruments, 46% attributable to instrument design, 14% to poor design control and 13% to instruments escaping quality control systems. Following correction of the faults, between 1 January 2004 and 31 March 2004 the problem rate fell to 0.4%. Conclusions: High quality single‐use instruments for tonsil and adenoid surgery are available in the UK. Some companies offered inferior instruments not fit for their purpose. The procurement, introduction and subsequent clinical approval of single‐use instruments requires a radically different approach to that currently applied to the purchase of reusable surgical equipment. Careful monitoring of their introduction is essential.     

The human serum resistance associated gene is ubiquitous and conserved in Trypanosoma brucei rhodesiense throughout East Africa.

The human serum resistance associated (SRA) gene isolated from a Ugandan strain of Trypanosoma brucei rhodesiense has been shown to be capable by itself of conferring the trait of human infectivity on T.b. brucei by transfection. This gene has also been identified in several other isolates of T.b. rhodesiense, but not in the other human pathogenic trypanosome in Africa, T.b. gambiense, casting doubt on its ubiquity and function. Here, we show that this gene occurs in T.b. rhodesiense from sleeping sickness foci throughout East Africa (Ethiopia, Uganda, Kenya, Tanzania, Zambia, Botswana), but is not found in T.b. brucei isolates or any other trypanosomes of subgenus Trypanozoon. SRA genes from 10 T.b. rhodesiense isolates from five disease foci were compared and were 97.9-99.7% homologous, with three minor sequence variants. PCR amplification of this gene forms the basis of a new test to identify T.b. rhodesiense. This is the first molecular marker identified for T.b. rhodesiense, despite intensive efforts over the past 20 years. It will be invaluable for identification of animal reservoir hosts and detection of T.b. rhodesiense in its tsetse fly vector. Strain typing using minisatellite markers showed considerable genetic heterogeneity between T.b. rhodesiense isolates, despite the presence of the conserved SRA gene. These results are consistent with the hypothesis that new T.b. rhodesiense strains arise by genetic exchange among T. brucei ssp. spreading the SRA gene and thereby the trait for human serum resistance and human infectivity.     

Evaluation of the effect of methylphenidate by computed tomography, electroencephalography, neuropsychological tests, and clinical symptoms in children with attention-deficit/hyperactivity disorder: A prospective cohort study

Background: Stimulant drugs are the most commonly used treatments for attention-deficit/hyperactivity disorder (ADHD), although the mechanism of action of these drugs is still not entirely understood.Objective: The aim of this study was to investigate the effects of the psychostimulant drug methylphenidate (MPH) on regional cerebral blood flow (rCBF), electrical activity of the brain, and clinical symptoms in children with ADHD using single-photon emission computed tomography (SPECT), electroencephalography (EEG), and neuropsychological tests.Methods: In this prospective cohort study, pediatric outpatients received MPH for 3 months at a mean dose of 1 mg/kg · d (range, 0.5-1.5 mg/kg · d). They were then administered the Wechsler Intelligence Scale for Children-Revised, the Bender Visual-Motor Gestalt Test (BGT), EEG, and SPECT of the brain. The parents and/or teacher of each child were asked to complete the Conners' Parent Rating Scale (CPRS), the Conners' Teacher Rating Scale (CTRS), and the Turgay Diagnostic and Statistical Manual of Mental Disorders Fourth Edition-based Child and Adolescent Behavior Disorders Screening and Rating Scale (T-DSM-IV-S). All of the evaluations were performed at baseline and after 3 months of MPH treatment. Each child underwent a Stroop test as an activation method 15 minutes before the SPECT procedure.Results: Sixty patients were assessed for inclusion. Twenty-one children (18 boys [85.7%], 3 girls [14.3%]; mean [SD] age, 9.7 [1.7] years; range, 8-13 years) with a diagnosis of ADHD were included in and completed the study. Mean (SD) BGT scores before MPH treatment compared with after MPH treatment were significantly decreased (9.8 [4.2] vs 6.3 [3.4]; Z = -3.27; P = 0.001). After treatment with MPH, the visual SPECT results suggested that low rCBF was normalized in the right frontotemporal areas in 10 children with ADHD. After treatment, 12 patients (57.1%) had no change in EEG activity, 5 (23.8%) had improvement, and 4 (19.0%) had worsening activity. Patients who had improvement or no worsening on EEG after MPH treatment were associated with significant improvement after MPH treatment compared with before treatment in mean (SD) CTRS scores (25.9 [14.3] vs 35.0 [14.4]; P = 0.003), teachers' T-DSM-IV-S total score (25.1 [14.2] vs 38.4 [18.7]; P = 0.005), and CPRS scores (mothers scores: 29.7 [16.6] vs 42.6 [17.2], P = 0.002; fathers' scores: 29.4 [16.8] vs 41.9 [23.7], P = 0.004). No significant difference was found in these scores in the patients whose EEG findings showed deterioration after MPH treatment. The quantitative values for SPECT observed before treatment compared with those observed after 3 months of MPH treatment were not found to be significantly different in any areas of the brain.Conclusions: MPH use over 3 months was associated with improvement from baseline in visual-motor function and behavioral disorders in these children and adolescents with ADHD. However, no significant difference in rCBF or electrical activity in the brain was observed in this small study.