Effectiveness of non-pyrimethamine-based regimens for toxoplasma encephalitis: A systematic and meta-synthesis study

Objective: To examine the differences in effectiveness and side effects between pyrimethamine-based and non-pyrimethaminebased regimens for toxoplasma encephalitis since the availability of pyrimethamine in Indonesia is currently limited due to its withdrawal from the market. Methods: A systematic review and meta-synthesis study that was carried out by following a protocol guided by the Preffered Reporting Items for Systematic Review and Meta-analysis (PRISMA). Effectiveness measures included clinical improvement, mortality, and radiological improvement. We evaluated selected articles narratively because of the limitations of homogeneity. The risk of bias in RCTs was assessed using the Cochrane Risk of Bias tool for RCT (ROB 2.0) and cohort studies were assessed using the Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-1) tool. Research quality was assessed using the GradePro software. Results: We included two retrospective cohort studies and one RCT. Narrative outcome assessment in these three studies did not show significant difference in effectiveness between pyrimethamine-based and non-pyrimethamine-based regimens for toxoplasma encephalitis treatment. However, drug side effects were consistently higher in the pyrimethamine-based regimen. Conclusions: This study has a high risk of bias. The quality of the research also has a low recommendation value. However, the results may be considered for application if a standard regimen is not available.

Alternativas terapéuticas de la úlcera corneal infecciosa / Therapeutic alternativesfor the infectious corneal ulcer

Introducción: La úlcera corneal infecciosa es una afección frecuente en la consulta de oftalmología. Su resolución es un problema de salud a resolver, pues los tratamientos convencionales no siempre garantizan una evolución favorable de los casos diagnosticados debido a la resistencia microbiana, por lo que se siguen buscando alternativas terapéuticas. Objetivo: Describir las alternativas de tratamiento en la úlcera corneal infecciosa para minimizar sus secuelas y disminuir la ceguera por esta enfermedad. Desarrollo: La administración tópica de antibióticos de amplio espectro sigue siendo el método preferido para el tratamiento farmacológico de las úlceras corneales infecciosas, a pesar de los informes de fracasos clínicos por la resistencia a los antibióticos, por lo que se investiga acerca del uso de nuevas alternativas terapéuticas que minimicen las secuelas de esta enfermedad.Se realizó una revisión sistemática de la evidencia científica en los últimos diez años en diversos artículos, en los que se constató la aplicación de diferentes sustancias como tratamiento alternativo. Conclusiones: En la úlcera corneal infecciosa el tratamiento protocolizado combinado con sustancias alternativas, que tienen en común una actividad de amplio espectro, resultaría ser ventajoso por ser productos económicos y seguros, que han demostrado un gran poder bactericida. Se propone generalizar el uso de estos compuestos, dada la resistencia de los microorganismos al tratamiento convencional; lo que hace que la úlcera corneal sea un problema de salud a resolver.

Introduction: The infectious corneal ulcer is a frequent disorder in the ophthalmology outpatient department, its solution is a health problem to be solved, as the conventional treatments don't always guarantee a favorable clinical course of the diagnosed cases. Because of the microbial resistance, so that therapeutic alternatives are still looked for. Objective: To describe the treatment alternatives in the infectious corneal ulcer for minimizing their sequelae and to decrease blindness due to this disease. Development: The topical administration of wide spectrum antibiotics continues being the favorite method for the pharmacological treatment of the infectious corneal ulcers, in spite of the clinical failures reports caused by the resistance to antibiotics, that is why the use of new therapeutic alternatives minimizing the sequels of this disease is investigated. Method: A systematic review of the scientific evidence in the last ten years was carried out on several works, in which it was evidenced the use of different substances as alternative treatment. Conclusions: In the infectious corneal ulcer the protocolized treatment combined with alternative substances which have in common a wide spectrum activity would turn out to be advantageous as they are economic and sure products which have demonstrated a great power against bacteria. The use of these compounds could be generalized, given the resistance of organisms to the conventional treatment; what makes the corneal ulcer a health problem to be solved.

A singular oral appliance to treat obstructive sleep apnea in CPAP non-adherent patients

ABSTRACT Introduction: The most prescribed treatment option for Obstructive Sleep Apnea (OSA) is CPAP; however, its adherence is limited. Oral Appliance therapy (OAT) is frequently an option or even an adjuvant, being the mandibular advancement Oral Appliance (OAm) the most used prescription. It modifies the upper airway, improving the airway patency. OAm construction is based on the occlusal plane to disocclusion. In this study, the DIORS® appliance was used, a singular OAm, based on Neuro-Occlusal Rehabilitation concepts, that uses Camper's plane as a disocclusion reference, in order to achieve neuromuscular balance and functional stability. Objective: This study primarily aimed to assess the DIORS® effectiveness in relation to clinical and polysomnographic outcomes. It was also evaluated if the use of DIORS® is as effective as titrated CPAP to treat CPAP non-adherent patients. Methods: Twenty patients were included in this study. Objective and subjective clinical data were assessed at a sleep laboratory using all-night polysomnography, and Epworth Sleepiness Scale (ESS), taken at three moments: Baseline, CPAP titration, and using DIORS®. Analysis of respiratory parameters as apnea/hypopnea index (AHI), oxyhemoglobin saturation levels, the arousal index and daytime sleepiness were taken as criteria for a successful OAT. Results: Respiratory and arousal parameters improved in both therapies, while DIORS® promoted a better ESS. Conclusion: Results from the present work support that DIORS® is a viable and effective adjuvant therapy for patients with moderate to severe OSA non-adherent to CPAP.

RESUMO Introdução: A opção mais indicada para tratamento da apneia obstrutiva do sono (AOS) é o CPAP; contudo, a aderência é limitada. A Terapia com Aparelho Oral (TAO) é, frequentemente, uma opção, ou mesmo um adjuvante. A prescrição mais utilizada é o Aparelho Oral de avanço mandibular (AOm). O AOm modifica a via aérea superior, melhorando a patência do espaço aéreo. A construção do AOm se baseia no plano de oclusão para desoclusão. No presente estudo, usamos o DIORS®, um AOm diferente, baseado nos conceitos da Reabilitação Neuro-Oclusal (RNO), que utiliza o Plano de Camper como referência da desoclusão para alcançar o equilíbrio neuromuscular e estabilidade funcional. Objetivo: O presente estudo teve como objetivo principal abordar a eficácia do DIORS®, considerando-se os resultados clínicos e polissonográficos. Adicionalmente, foi avaliado, também, se o uso desse AOm é tão eficaz quanto a titulação do CPAP para tratar pacientes com AOS não aderentes ao CPAP. Métodos: Vinte pacientes foram incluídos neste estudo. Dados clínicos objetivos e subjetivos foram avaliados em um laboratório de sono usando polissonografia de noite inteira e a Escala de Sonolência de Epworth (ESE) observando-se três momentos: inicial, titulação do CPAP e usando o DIORS®. Os critérios de sucesso da TAO foram assumidos pela análise dos parâmetros respiratórios como Índice de Apneia e Hipopneia (IAH) e níveis de saturação de oxi-hemoglobina, o índice de despertar e a sonolência diurna. Resultados: Em ambas as terapias, os parâmetros respiratórios e de despertares melhoraram. Adicionalmente, uma melhora na ESE foi alcançada com o DIORS®. Conclusão: Os resultados do presente trabalho apoiam que o DIORS® é uma terapia adjuvante viável e bastante eficaz para pacientes com AOS moderada a grave não aderentes ao CPAP.

Efecto inhibitorio in vitro de la ftalocianina de aluminio tetrasulfonada clorada frente a Leishmania (Viannia) peruviana y Leishmania (Viannia) braziliensis / In vitro inhibitory effect of aluminum phthalocyanine tetrasulfonate chloride against Leishmania (Viannia) Peruviana and Leishmania (Viannia) Braziliensis

RESUMEN Objetivos: Evaluar la actividad fotodinámica in vitro de la ftalocianina de aluminio tetrasulfonada clorada (AlPcClS4) sobre promastigotes y amastigotes de Leishmania (Viannia) peruviana y Leishmania (Viannia) braziliensis. Materiales y métodos: La actividad del tratamiento fotodinámico empleando AlPcClS4 sobre promastigotes y amastigotes de Leishmania fue determinada mediante el método colorimétrico Metil Tiazol Tetrazolium (MTT) y PCR cuantitativo, respectivamente. Resultados: El tratamiento fotodinámico presentó un efecto inhibitorio sobre promastigotes, principalmente sobre Leishmania (V.) peruviana, en menor proporción sobre Leishmania (V.) braziliensis y sobre las formas intracelulares de ambas especies. En Leishmania (V.) peruviana, a las 24 horas posirradiación a 200 µM y 350 µM el efecto inhibitorio fue del 72,9% y 73,9%, respectivamente y a las 96 horas fue del 78,8% y 80,6%, respectivamente. En las formas intracelulares, empleando 200 µM y evaluado a las 72 horas postratamiento, se observó una inhibición del 57,8% de amastigotes de Leishmania (V.) peruviana. El IC50 fue del 56,5; 50; 44; y 39,7 µM, que corresponde a las 24, 48, 72 y 96 horas posirradiación, respectivamente. Conclusiones: El tratamiento fotodinámico empleando AlPcClS4 frente a las especies de Leishmania presentó resultados alentadores principalmente sobre Leishmania (V.) peruviana, lo cual sugiere su potencial uso como alternativa o complemento del tratamiento convencional de la leishmaniasis tegumentaria. Sin embargo, aún se requiere continuar con nuevos ensayos para determinar el índice de selectividad sobre el parásito en su forma intracelular, y desarrollar estrategias que faciliten el ingreso eficiente de la molécula hacia la célula hospedera y al parásito.

ABSTRACT Objectives: To evaluate the in vitro photodynamic activity of aluminum phthalocyanine tetrasulfonate chloride (AlPcClS4) on promastigotes and amastigotes of Leishmania (Viannia) peruviana and Leishmania (Viannia) braziliensis. Materials and methods: The activity of photodynamic therapy using AlPcClS4 on Leishmania promastigote and amastigotes was determined by the Methyl Thiazole Tetrazolium (MTT) colorimetric method and quantitative PCR, respectively. Results: Photodynamic treatment showed an inhibitory effect on promastigotes, particularly on Leishmania (V.) peruviana, to a lesser extent on Leishmania (V.) braziliensis and also on intracellular forms of both species. At 24 hours post-radiation, using concentrations of 200 μM and 350 μM, the inhibitory effect on Leishmania (V.) peruviana was 72.9% and 73.9% respectively; at 96 hours the inhibitory effect was of 78.8% and 80.6%, respectively. Regarding intracellular forms, the inhibitory effect on Leishmania (V.) peruviana amastigotes was 57.8% at 72 hours post-treatment, using a concentration of 200 μM. The IC50 was 56.5, 50, 44 and 39.7 μM, at 24, 48, 72 and 96 hours post-radiation, respectively. Conclusions: Photodynamic therapy using AlPcClS4 against Leishmania species showed encouraging results, mainly on Leishmania (V.) peruviana, suggesting a potential use as an alternative or complement to the usual treatment of tegumentary leishmaniasis. However, new trials are still required to determine the selectivity index for the intracellular form of the parasite, and to develop methods to facilitate the efficient entry of the molecule into the host cell and the parasite.

Soybean (Glycine max L) seed quality treated with timbó (Magonia pubescens A. St.-Hil) seed coat / Qualidade de sementes de soja (Glycine max L) tratadas com diasporo do tegumento de sementes de timbó (Magonia pubescens A. St.-Hil)

The objective of this study was to evaluate the effect of timbó seed coat on the physiological and sanitary quality of soybean seeds. Timbó seeds were collected from mature fruits in the Cerrado. The external layer of the seed coat was removed and crushed in a mill and used in the treatment of soybean seeds. Three lots of soybean seeds were used, from high, medium and low vigor seeds. The treatments were: powder; gel; hydroalcoholic extract; synthetic fungicide (Vitavax® - Thiram 200 sc), and untreated seeds. The physiological quality of the soybean seeds was determined by standard germination, accelerated aging, length, fresh and dry mass of seedlings. Blotter test was used to determine the sanitary quality. The statistical analyze used was a completely randomized 3 × 5 factorial design, considering three seed lots and five treatments. Treatment with the coat seed extract and gel improves the physiological quality of soybean seeds from low vigor lots. The treatment of seeds with gel decreases the incidence of Fusarium and Penicillium genus; and treatment with the powder reduced the incidence of the Cercospora genus.(AU)

O objetivo deste estudo foi avaliar o efeito do tegumento das sementes de timbó sobre a qualidade fisiológica e sanitária de sementes de soja. As sementes de timbó foram coletadas de frutos maduros, no Cerrado. A camada mais externa do tegumento das sementes foi retirada e triturada em moinho e utilizada no tratamento de sementes de soja. Foram utilizados três lotes de sementes de soja, provenientes de sementes de alto, médio e baixo vigor. Os tratamentos foram: pó, gel, extrato hidroalcoólico; fungicida sintético (Vitavax® - Thiram 200 sc) e sementes não tratadas. A qualidade fisiológica das sementes de soja foi determinada pelo teste padrão de germinação, envelhecimento acelerado, comprimento, massa fresca e seca de plântulas. Para a determinação da qualidade sanitária utilizou-se o teste de borrão (blotter test). O delineamento estatístico foi em esquema fatorial 3 × 5, inteiramente casualizado, considerando-se três lotes de sementes e cinco tratamentos. Os tratamentos com o extrato e o gel do tegumento das sementes de timbó melhoraram a qualidade fisiológica das sementes de soja provenientes de lotes de baixo vigor. O tratamento com gel do tegumento das sementes de timbó diminuiu a incidência de fungos dos gêneros Fusarium e Penicillium; e o tratamento com o pó reduziu a incidência do gênero Cercospora.(AU)

Interventional Study to Evaluate Efficacy of Acupuncture for Treating Sciatica Pain

Introduction: Low back pain has a profound impact bothdirectly and indirectly on individuals. It is estimated that 60%to 80% of any population will experience low back pain atsome point in their lives. There are number of causes for lowback pain and Sciatica is one of them. Study aimed to assessthe efficacy of Acupuncture for the management of Sciaticapain.Material and Methods: This study was conducted among 200patients attending the Outdoor Patient department at Dr D.N.Kotnis Health and Education Center. With each subject a priorinformed and written consent was obtained. A predesigned andpretested proforma was used to collect the socio demographicprofile. Severity of Pain was measured with the help of LikertScale whereas the reading on Likert scale was taken at thetime of first visit and last visit of patients for comparison ofpain. Data was first entered into MS excel sheet and then wasexported to SPSS version 20.0 for appropriate analysis.Results: Wilcoxon signed rank test was applied to determinethe efficacy of the treatment on reducing the pain, further itwas observed that the effect of the treatment was statisticallysignificant (p<0.001)Conclusion: Acupuncture provides effective relief fromSciatica pain. However initiation of treatment at young ageprovides quick response and healing by reducing suffering ofsciatica pain.

Investigation of mad honey use as an alternative treatment in patients admitted to the pulmonary clinic: Ordu, Turkey example

Abstract This study assessed mad honey use in alternative treatments. The universe of this descriptive study was patients admitted to the pulmonary disease clinic located in the Ordu province of the Black Sea region between 15 December 2014 and 15 February 2015. We did not use a sampling method and patients who agreed to participate were included in the study (n=353). In order to collect the data, we used a questionnaire prepared by the researchers. In this study, 77% of the participants stated that mad honey was beneficial to health, 44.5% used mad honey, and 53.5% consumed it daily. Furthermore, 28.7% used mad honey for asthma, 6.4% for cough, 12.1% for gastrointestinal diseases, and 3.2% for hypertension. There was a significant relationship between the gender, family structure, age, and chronic disease status of participants and the status of consuming mad honey (p<0.05). In this study, participants used mad honey for asthma, gastrointestinal diseases, hypertension, and cough. Health professionals should provide training and counseling on the health effects and risks of mad honey to improve public health.

Hydroethanolic extract of Tropaeolum majus promotes anxiolytic effects on rats

Abstract Tropaeolum majus L., Tropaeolaceae, popularly known in Brazil as 'capuchinha' is widely used due its anti-inflammatory, antiseptic, anti-hypertensive and anti-depressive properties. However, scientific investigations about its effects on the central nervous system are still scarce. This study investigated the central pharmacological actions of the prolonged treatment with a hydroethanolic extract of T. majus in male Wistar rats in the elevated plus maze and hole-board behavioral models. For this, rats were daily treated with distillated water (negative control); diazepam (1 mg/kg) or hydroethanolic extract of T. majus (75, 150 and 300 mg/kg), for 29 days (by gavage) and were submitted to elevated plus maze and hole-board. Animals treated with all hydroethanolic extract of T. majus or diazepam doses increased the percentage of entries in open arms when compared to control group. However, only treatment with diazepam increased the length of time spent in the open arms of the elevated plus maze. No differences between all groups were observed regardless rearing, grooming, stretched-attend postures and defecation rates. In the HB test, in opposite to diazepam, treatment with hydroethanolic extract of T. majus did not interfere in the exploratory activity of rats. The hydroethanolic extract of T. majus promotes anxiolytic-like effects when orally administered in rats.

Atividade antiviral e virucida de extratos hidroalcoólicos de própolis marrom, verde e de abelhas Jataí (Tetragonisca angustula) frente ao herpersvírus bovino tipo 1 (BoHV-1) e ao vírus da diarreia viral bovina (BVDV) / Antiviral and virucidal activity of hydroalcoholic extracts of propolis brown, green and jataí bees (Tetragonisca angustula) against Bovine Herpesvirus Type-1 (BoHV-1) and Bovine Viral Diarrhea Virus (BVDV)

Dentre as propriedades biológicas da própolis, a atividade antimicrobiana tem merecido destacada atenção. No presente trabalho, descreve-se a ação antiviral e virucida de três extratos hidroalcoólicos de própolis (marrom, verde e de abelhas jataí (Tetragonisca angustula), frente ao Herpesvírus Bovino tipo (BoHV-1) e ao Vírus da Diarreia Viral Bovina (BVDV). Os três extratos hidroalcoólicos foram obtidos de extração etanólica e são oriundos do sul do Brasil. A composição química dos extratos de própolis foi determinada pela cromatografia líquida de alta eficiência acoplada a espectrômetro de massas (UFLC-PDA-ESI-TOF/MS) que identificou e quantificou compostos como: ácido cafeico e ácido p-cumárico, ácido clorogênico, ácido ferúlico, além de flavonoides como a rutina. A toxicidade celular bem como a atividade antiviral dos extratos de própolis em monocamadas de células MDBK (Madin-Darby Bovine Kidney) foi avaliada através de observação microscópica e quantificada pelo teste de MTT (3-(4,5 dimetiltiazol-2yl)-2-5-difenil-2H tetrazolato de bromo). O extrato de própolis de abelhas jataí demonstrou ser menos citotóxico (1,57µg/mL), quando comparado aos extratos verde (0,78µg/mL) e marrom (0,39µg/mL). Quanto a atividade antiviral, a própolis verde demostrou maior eficácia em ambos os tratamentos celulares (pós e pré-exposição) frente ao BoHV-1 em relação aos outros extratos, ou seja, houve maior viabilidade celular quando comparada aos controles de células e vírus. Já a de jataí apresentou atividade frente aos dois vírus (BoHV-1 e BVDV) no método pré-infecção, enquanto a própolis marrom demonstrou ação apenas frente ao BoHV-1 também no método pré-infecção. Para determinação da atividade virucida foram utilizadas diferentes diluições dos vírus, bem como temperaturas e tempos distintos de incubação. A própolis verde a 37°C propiciou a maior redução no título viral (4,33log) em relação a marrom (log = 3,5log) e de jataí (log = 3,24log). No entanto, frente ao BVDV a própolis jataí apresentou os melhores resultados em ambas as temperaturas (22oC e 37oC). Portanto, os extratos avaliados apresentaram atividade antiviral e virucida frente ao BoHV-1 e BVDV, o que os torna alvo para o desenvolvimento de novos biofármacos como alternativa ao uso de antivirais comerciais em Medicina Veterinária.(AU)

Among the biological properties of propolis, the antimicrobial activity has received prominent attention. In this paper, we describe the antiviral and virucidal effect of three hydroalcoholic extracts of propolis (brown, green and jataí bees (Tetragonisca angustula), against bovine herpesvirus type-1 (BoHV-1) and bovine viral diarrhea Virus (BVDV). All hydroalcoholic extracts were obtained from ethanol extraction. The chemical composition of propolis extracts was determined by high-performance liquid chromatography coupled to mass spectrometer (UFLC-PDA-ESI-TOF/MS) to identify and quantify compounds such as caffeic acid and p-coumaric acid, chlorogenic acid, ferulic, and flavonoids such as rutin. Cell toxicity and antiviral activity of propolis extracts in monolayers of MDBK cells (Madin-Darby Bovine Kidney) were assessed by microscopic observation and quantified by the MTT assay (3- (4.5 dimethylthiazol-2yl) -2- 5-diphenyl-2H-tetrazolato bromine). Propolis extract from Jataí bees proved to be less cytotoxic (1.57mg / ml) when compared to green extracts (0.78mg / ml) and brown (0.39mg/mL). Regarding antiviral activity, propolis has shown greater efficacy in both cellular treatments (post and pre-exposure) against BoHV-1 when compared to other extracts, ie, there was increased cell viability compared to cell and virus controls. Extracts from Jataí showed activity against both viruses (BoHV-1 and BVDV) infection in the pre-test, whereas brown propolis demonstrated action only against the BoHV-1 in the pre-infection method. To determine the virucidal activity, it were used different dilutions of virus, as well as different temperatures and incubation times. The green propolis at 37°C led to a greater reduction in viral titer (4.33log) compared to brown (3.5log) and jataí (3.24log). Jataí propolis showed the best results in both temperatures (22oC and 37oC) when tested against BVDV. In summary, the evaluated extracts showed antiviral and virucidal activity against BoHV-1 and BVDV, and may be important targets for the development of new compounds as an alternative to commercial antivirals.(AU)

Transcranial Direct Current Stimulation as an Alternative Treatment in Patients with Alzheimer's Disease

Transcranial direct current stimulation (tDCS) is one of the brain stimulation techniques, which considered as an alternative treatment for Alzheimer's disease (AD). In AD, cognitive, behavior, and functional deteriorations are the result of synaptic dysfunction, neural circuit destabilization, and disrupted network activity, which are mainly caused by amyloid and tau deposition. tDCS modified neuronal resting membrane potential, synaptic plasticity, cortical neurotransmitters, astrocytes, cerebral blood flow, and functional connectivity, which could restore cognitive impairment. However, several small clinical studies that have been conducted so far have produced inconsistent results in patients with AD. Therefore, more systematic clinical studies are needed in the future.

Paraplegia secundária a tratamento com quiropraxia em paciente com mieloma múltiplo não diagnosticado / Paraplegia following massage therapy intervention in a patient with undiagnosed multiple myeloma

Introdução: Devido à disponibilidade crescente de terapias alternativas para o tratamento de dor nas costas e acesso por vezesdifícil de avaliações médicas especializadas, há um amplo uso de terapias alternativas para o tratamento de dor nas costas.Descrição do Caso: Descrevemos um caso com uma consequência catastrófica de massagem terapêutica em um paciente comsintomas iniciais de dor nas costas, resultando em paraplegia definitiva e discutimos as necessidades de diagnóstico médico paraqualquer tratamento. Discussão e Conclusão: Discutir os danos potenciais ao paciente, ao iniciar um método de tratamentoquestionável, que são o diagnóstico retardado, dano físico direto, interferência com tratamentos tradicionais, prejuízosfinanceiros e perda de tempo. Os tratamentos alternativos são ferramentas valiosas para controlar os sintomas refratários,especialmente a dor. Mas reforçamos a necessidade do rastreio médico adequado antes de realizar terapias que podem trazer...

Introduction: Due to increased number of available alternative therapies to the treatment of back pain and sometimes a difficultaccess to specialized medical evaluations, there is a widespread use of alternative therapies for the treatment of back pain.Case Description: We describe a case with a catastrophic consequence of massage therapy in a patient with initial symptomsof back pain resulting in definitive paraplegia and discuss the needs for medical diagnosis for any treatment. Discussion andConclusion: We discuss the potencial harms to the patient when initiating a questionable treatment method, which are latediagnosis, direct physical harm, interference with tradiotional treatments, financial harm and time loss. Alternative treatmentsare valuable tools to control refractory symptoms, especially pain....

Atividade in vitro de extratos brutos de duas espécies vegetais do cerrado sobre leveduras do gênero Candida / In vitro activity of crude extracts of two plant species in the Cerrado on yeast of the Candida SPP variety

Objetivou-se conhecer a atividade de Lafoensia pacari e a de Brossimum gaudichaudii, sobre leveduras do gênero Candida isoladas da mucosa vaginal. As leveduras foram isoladas a partir de esfregaço de mucosa vaginal de mulheres com ou sem sintomatologia. Realizou-se os testes de susceptibilidade em duplicata para 34 linhagens de Candida frente aos extratos brutos das espécies vegetais, nas concentrações de 50, 100 e 200 mg.mL-1. Consideraram-se como ativos os extratos que produziram halos de inibição com média a partir de 10 mm. Evidenciou-se atividade antifúngica de B. gaudichaudii na concentração de 200 mg.mL-1, enquanto que a de L. pacari mostrou-se ativo a 50 mg.mL-1. A atividade dos extratos vegetais estudados destacou-se em relação à Nistatina creme (100.000UI/4g) utilizada como controle.

This work aims to evaluate the activity of Lafoensia Pacari and Brossimum gaudichaudii on yeast of the Candida variety isolated from vaginal mucus. The yeasts were obtained from swabs of women with or without symptoms. Susceptibility testing in duplicate was carried out for 34 strains of Candida compared to crude extracts of plant species at concentrations of 50, 100 and 200 mg.mL-1. Extracts that produced inhibition zones with an average of over 10 mm were considered to be active. Antifungal activity of B. gaudichaudii at a concentration of 200-mg.mL-1 was proven, while that of L. pacari was found to be active at 50 mg.mL-1. The activity of plant extracts was revealed compared to Nystatin cream (100.000UI/4g) used for control purposes.

Emergency Microsurgical Embolectomy for the Treatment of Acute Intracranial Artery Occlusion: Report of Two Cases

BACKGROUND: The main treatment for acute arterial ischemic stroke is intravenous or intra-arterial thrombolysis within a particular time window. Endovascular mechanical embolectomy is another treatment option in the case of major artery occlusion. Endovascular mechanical embolectomy is a useful technique for restoring blood flow in patients with large-vessel occlusion, and especially in those who are contraindicated for thrombolytics or in whom thrombolytic therapy has failed. CASE REPORT: We report herein two cases of emergency microsurgical embolectomy for the treatment of acute middle cerebral artery and internal carotid artery occlusion as an alternative treatment for major artery occlusion. CONCLUSIONS: Emergency microsurgical mechanical embolectomy may be an alternative treatment option for restoring blood flow in selected patients with large-vessel acute ischemic stroke.

A Less Invasive Approach for Ruptured Aneurysm with Intracranial Hematoma: Coil Embolization Followed by Clot Evacuation

OBJECTIVE: The presence of an intracerebral hematoma from a ruptured aneurysm is a negative predictive factor and it is associated with high morbidity and mortality rates even though clot evacuation followed by the neck clipping is performed. Endovascular coil embolization is a useful alternative procedure to reduce the surgical morbidity and mortality rates. We report here on our experiences with the alternative option of endovascular coil placement followed by craniotomy for clot evacuation. MATERIALS AND METHODS: Among 312 patients who were admitted with intracerebral subarachnoid hemorrhage during the recent three years, 119 cases were treated via the endovascular approach. Nine cases were suspected to show aneurysmal intracerebral hemorrhage (ICH) on CT scan and they underwent emergency cerebral angiograms. We performed immediate coil embolization at the same session of angiographic examination, and this was followed by clot evacuation. RESULTS: Seven cases showed to have ruptured middle cerebral artery (MCA) aneurysms and two cases had internal carotid artery aneurysms. The clinical status on admission was Hunt-Hess grade (HHG) IV in seven patients and HHG III in two. Surgical evacuation of the clot was done immediately after the endovascular coil placement. The treatment results were a Glasgow Outcome Scale score of good recovery and moderate disability in six patients (66.7%). No mortality was recorded and no procedural morbidity was incurred by both the endovascular and direct craniotomy procedures. CONCLUSION: The results indicate that the coil embolization followed by clot evacuation for the patients with aneurysmal ICH may be a less invasive and quite a valuable alternative treatment for this patient group, and this warrants further investigation.

Oocyte Donation in Infertility Treatment / 대한산부인과학회지

Recent advances in assisted reproductive technology have been able to overcome the nearly all problems associated with traditional infertility factor. IVF and ET using donated oocyte has brought new hope to many couples who otherwise would remain childless, so oocyte donation can be the alternative treatment modality for specific fatal infertility patients. The high success rate of this procedure has led to its wide application in women with ovarian failure or dysfunction, at various ages and for various etiologies. Oocyte donation is also offered to patients who repeatedly fail to conceive with standard IVF. But there are many conflicting issues in this procedure such as moral, ethical, medical, legal problems. We review the technical aspects related with oocyte donation in infertility treatment and ethico-legal issue.