Clinical practice guidelines on leptospirosis in children 2019

Executive Summary@#Leptospirosis is a disease prevalent mostly in tropical and subtropical countries. Its potential to be a concerning problem emerges with the onset of the rainy season, as flooding and heavy rainfall facilitate disease epidemics. Among those at risk of contracting the disease are field workers, veterinarians, sewer workers, military personnel and those who swim or wade in contaminated waters. In the absence of an existing evidence-based guideline for the pediatric age group, this first edition hopes to standardize approach to diagnosis, antibiotic management, and prevention of leptospirosis. The intended users are primary care physicians, family medicine physicians, pediatricians, and other healthcare workers involved in the management of leptospirosis in children. Ten priority questions were identified by a group of experts composed of an oversight committee, a guideline writing panel, and a technical review committee. The GRADE methodology was used to determine the quality of evidence of each recommendation. The draft recommendations (summarized below) were finalized after these were presented to and voted on by a panel of stakeholders.

Phytochemical profile and nematicidal activity of a hydroalcoholic extract from Cazahuate flowers (Ipomoea pauciflora M. Martens & Galeotti) against Haemonchus contortus infective larvae

@#Haemonchus contortus (Hc) is a hematophagous parasite affecting the health and productivity of flocks. The administration of chemical anthelmintic drugs (AH) is the common method of deworming; however, generates resistance in the parasites to AH and it is a public health risk due to drug residues in milk, meat and sub-products. Natural compounds from plants are explored to diminish this parasitosis, improving their health and productivity, without the negative effects of AH. Ipomoea genus is a group of climbing plants belonging to the Convulvulaceae family possessing perennial leaves and tuberous roots. Medicinal properties has been attributed to this plant including nutritional agents, emetics, diuretics, diaphoretics, purgatives and pesticides. The objective of this study was assessing the in vitro nematocidal activity of a hydroalcoholic extract (HA-E) obtained from Ipomoea pauciflora (Cazahuate) flowers against Hc infective larvae (L3) and to identify its phytochemical profile (PhC-P). The assay was carried out using microtiter plates (MTP). Four HA-E concentrations were assessed and Ivermectin and distilled water were used as positive and negative control groups, respectively. Approximately 100 Hc L3 were deposited in each well (n=12) and incubated at 25–35°C for 7 days. Data were analyzed using ANOVA and a General Linear Model (GLM) followed by Tukey test (P<0.05). The treatments showing a concentration-dependent effect (CDE) were analyzed to identify their 50% and 90% lethal concentrations (CL50, 90) via a Probit Analysis. The highest mortality was observed at 50 mg/mL (82.64 ± 0.71%) and the lowest at 6.25 mg/mL (56.46 ± 2.49%), showing a CDE with increasing mortality from 6.25 to 50 mg/mL. The PhC-P revealed the presence of alkaloids, coumarins, flavonoids, tannins and triterpenes/ sterols. A HA-E from flowers of I. pauciflora will be considered to assess its potential use in the control of haemonchosis in small ruminants.

A comparative study of subjective and objective techniques using two‑dimensional ultrasound in the preoperative assessment of cervical and myometrial invasion in patients with endometrial cancer / Philippine Journal of Obstetrics and Gynecology

Context@#Endometrial cancer is the third most common malignancy of the female genital tract in the Philippines, following cervical and ovarian cancer. Ultrasound as the first line in imaging has a major role in preoperative treatment and planning.@*Aims@#To compare the diagnostic accuracy of subjective versus objective ultrasound measurement techniques in detecting cervical stromal invasion (CSI) and deep myometrial invasion (MI).@*Materials and Methods@#Fifty‑seven patients were enrolled in this cross‑sectional study. Deep MI and CSI were evaluated both subjectively and objectively by measuring tumor‑free distance (TFD), distance from the outer cervical os to lowest edge of the tumor border (Dist‑OCO), and distance from the internal cervical os to caudal tumor border (Dist‑ICO). Histopathological result used as the gold standard.@*Results@#Subjective assessment for deep (MI) had 79.3% sensitivity, 82.1% specificity, 82.1% positive predictive value (PPV), 82.1% negative predictive value (NPV), and 80.7%. Subjective assessment for CSI had a sensitivity, specificity, PPV, NPV, and overall accuracy of 80%, 90.4%, 44.4%, 97.9%, and 89.5%. Objective measurement (TFD ≤0.8 cm) to detect deep MI had 86.2% sensitivity, 57.1% specificity, 67.4% PPV, 80% NPV, and 71.9% overall accuracy. Adjusting TFD cutoff to 0.65 increased to 71.4% specificity, making it comparable with subjective assessment. Dist‑OCO (≤2.1 cm) yielded 100% sensitivity, 86.3% specificity, 30% PPV, 100% NPV, and 87% overall accuracy. Dist‑ICO was first used in this study, hence no cutoff yet. By using receiver operating characteristics, cutoff was 0.45 cm, which yielded a 60% sensitivity and 92% specificity (area under the curve 0.731, P = 0.09).@*Conclusions@#Subjective assessment of CSI and deep MI performs better than objective measurement techniques. TFD and Dist‑OCO as the objective measurements showed clinically comparable accuracy to subjective assessment by an expert. Dist‑ICO needs to be validated to a larger population to determine its clinical value in predicting CSI.

Is there a relationship between tonsil volume and the success of pharyngeal surgery among adult patients with obstructive sleep apnea?

Abstract Objectives: Hypertrophic palatine tonsils play a role in the blockage of the upper airway, one of the known causes of Obstructive Sleep Apnea (OSA). Therefore, it is possible that there is an association between tonsil size and the success of pharyngeal surgery during OSA treatment. The main objective of this study was to evaluate the relationship between tonsil grade and volume, as well as to establish whether a relationship exists between tonsil size and the success rate of pharyngeal surgery (tonsillectomy and pharyngoplasty with barbed sutures). Methods: This retrospective study includes forty-four adult patients who underwent tonsillectomy and pharyngeal surgery with barbed sutures for the treatment of simple snoring and OSA between January 2016 and September 2019. Patients who had been previously tonsillectomized or those for whom tonsil volume measurement was lacking were excluded. All patients underwent a pre-operative physical exploration at the clinic exam room and a sleep study. Prior to surgery a Drug Induced Sleep Endoscopy (DISE) was performed. Tonsil volume was measured intraoperatively using the water displacement method. The same sleep study was repeated six months following surgery. Results: A significant correlation was found between tonsil grade and volume and between such measurements and the blockage observed at the level of the oropharynx during the DISE. Moreover, an association was observed between tonsil volume, but not tonsil grade, and the success of tonsillectomy and pharyngoplasty with barbed sutures. A tonsil volume greater than 6.5 cm3 was linked to success during pharyngeal surgery. Conclusion: A correlation exists between tonsil grade and tonsil volume. A bigger tonsil volume is associated with a greater success rate of oropharyngeal surgery during treatment of OSA. Level of evidence: Level 3, non-randomized cohort study.

Unusual co-infection of severe malaria by Plasmodium vivax and dengue virus in Mexico

@#Malaria and dengue fever are among the most common mosquito-borne diseases worldwide; however, reports of coinfection are rare. We present a case of severe malaria and dengue coinfection in a 16-yearold female patient presenting with fever, thrombocytopenia, pleural effusion, myopericarditis, and acute respiratory distress syndrome. Dengue infection was confirmed by the presence of immunoglobin M antibodies and nonstructural protein 1, while malaria was confirmed by the presence of Plasmodium vivax in thick and thin blood smears. This is the first report of a dengue/malaria coinfection in Mexico.

Building Occupational Alliance for Therapy (BOAT) Model

@#Occupational Therapy (OT) is a profession that is not easily understood, leading to limited appreciation and misunderstanding of its therapeutic scope and areas of concern. The BOAT Model was created to guide therapists in establishing a therapeutic alliance with clients for the purpose of eliciting mutual concern, perception, and understanding of the client’s unique occupational performance issues (OPI). The model also aims to help enhance the appreciation for OT services. Two specific steps were provided as a process in achieving the outcomes stated, namely Establish and Converse. The use of appropriate therapeutic interactive styles and modes outlined in the IRM were incorporated into the model. At the end of the process, the identified OPI using the COPM will be used to advise the creation of an occupation-based evaluation and intervention that is more relevant and meaningful for the client.

Translation, cross-cultural adaptation of the lower extremity functional scale into Filipino, and analysis of its psychometric properties: A study protocol

Background@#Impairment and functional limitations from musculoskeletal conditions are evaluated using outcome measure tools. The Lower Extremity Functional Scale (LEFS) is one of the outcome measure tools (OMT) that assess the functional capacity of patients who have lower extremity conditions. It was originally developed in English and translated later into other languages; however, no Filipino version is available.@*Objective@#This study aims to translate, cross-culturally adapt the LEFS into Filipino, and evaluate its psychometric properties. @*Methods@#Using a psychometric study design, the LEFS will be translated and cross-culturally adapted into Filipino following the guidelines set by Beaton et al. and Sousa and Rojjanasrirat. These include six stages: (1) forward translation into Filipino, (2) synthesis, (3) backward translation, (4) expert committee review, (5) pilot testing/cognitive interview, and (6) psychometric testing. Filipinos with lower extremity conditions will be recruited for the pilot (n= 10) and psychometric testing (n= 200). Validity will be evaluated using face validity index, content validity index, independent t-test (knowngroup validity), and Spearman rho (concurrent validity). Reliability will be assessed using Cronbach alpha for the internal consistency and intraclass correlation coefficient for the stability. Floor and ceiling effects will also be computed. E@*Expected results@#The LEFS will be successfully translated and cross-culturally adapted into Filipino. It will be a valid and reliable outcome measure tool that physical therapists and other healthcare professionals can use for the functional assessment of patients. This study can also serve as a reference for future translation studies

The effect of fast food calorie labels on calories ordered by college students in Quezon City

Background@#There is an increasing trend of obesity in the Philippines with approximately 28.8% of adults considered overweight and 9.6% obese. This is presumably due to a shift in eating patterns towards dining out in restaurants and fast food chains for their convenience. Excess fast food consumption results in diets that are calorie dense yet nutritionally deficient due to their high levels of fat, sugar, and salt leading to increased prevalence of associated diseases such as Type 2 diabetes and cardiovascular diseases. @*Objective@#The researchers determined the effect of presenting the caloric information of fast food items on the total calories ordered among college students in private and public higher education institutions in Quezon City. @*Methodology@#A double-blind experimental research was performed with 179 students by convenience sampling. The participants were randomly assigned to a control group (without caloric labels) and an experimental group (with caloric labels). An online questionnaire was sent to each subject containing their menu and order form along with questions on their demographical data (age, sex, food allowance, BMI, physical activity). @*Results@#Using single linear regression, none of the demographic characteristics were found to be confounding variables. Using multiple linear regression analysis, it was found that the experimental group ordered significantly less calories (p-value = 0.013). @*Conclusion@#The results of the study conclude that those presented with calorie labels ordered less calories than the control.

A translation and validation study of the Filipino version of the Psoriasis Epidemiology Screening Tool (PEST) among Filipino patients with psoriasis seen at the Rizal Medical Center

Introduction@#Psoriasis is a chronic autoimmune disease that affects the skin, nails, and musculoskeletal system. Musculoskel- etal involvement, called psoriatic arthritis occurs in 10-25% of patients with psoriasis and can lead to disability if left untreated. Early detection and intervention of psoriatic arthritis has been shown to decrease morbidity. The Psoriasis Epidemiology Screening Tool (PEST) may detect the presence of psoriatic arthritis and has been validated in differ- ent countries. Currently, there is no Filipino version.@*Objectives@#To translate, adapt, and validate PEST in Filipino language.@*Methods@#In the first part of the study, PEST was translated and culturally adapted into Filipino. It was pretested in 30 participants. Three experts then assessed its content and face validity. After the content and face validity were met, 115 participants an- swered the Filipino version of the PEST questionnaire.@*Results@#The Filipino version of the PEST questionnaire was comprehensible, clear and appropriate. All questions were relevant. Some words were edited per expert recommendation. One hundred fifteen adult patients were asked to answer the question- naire. It showed good reliability at 94%.@*Conclusion@#The Filipino Version of the PEST was found to be reliable and valid. Larger samples to determine the tool’s applica- bility is recommended.

An analytic cross-sectional study on the association between barriers and enablers of breastfeeding practices among mothers in Metro Manila / The Health Sciences Journal

INTRODUCTION@#In the Philippines, several health policies have been tailored to promote breastfeeding. Statistics show that despite efforts, breastfeeding prevalence remains low. This study aims to determine the demographics and associated barriers and enablers of breastfeeding among mothers living in Metro Manila. @*METHODS@#The study used a cross-sectional analytical design through an online self-administered questionnaire on barriers and enablers answered by mothers between 15-49 years old, residing in Metro Manila.@*RESULTS@#A total of 761 responses were included in the fnal analysis. Only age was found to be signifcantly associated with the practice of breastfeeding. Barriers identifed were 1) seeing breastfeeding as timeconsuming, 2) development of sore or tender nipples, 3) previously failed breastfeeding attempts, 4) poor latching on, and 5) not enough breastmilk production. Enablers identifed were 1) seeing the practice as a good way to bond with the child, 2) presence of breastfeeding areas at work or school, 3) previous success in breastfeeding experience, 4) support from hospital staff or midwives, 5) having knowledge on whom to contact when challenged with breastfeeding, and 6) knowledge of the benefts of breastfeeding on infant and maternal health.@*CONCLUSION@#Barriers and enablers towards breastfeeding may be target points for improvement of interventions aiming to increase prevalence of breastfeeding among mothers in Metro Manila.

In vitro quorum quenching activity of eleusine indica crude ethanolic extract against pseudomonas aeruginosa and serratia marcescens

@#<p style="text-align: justify;"><strong>Introduction:</strong> Nosocomial contaminants such as Pseudomonas aeruginosa and Serratia marcescens are increasingly developing resistance to many antibiotics. One of the promising alternatives that may complement, if not substitute, the use of antibiotics is quorum quenching, the process of interfering with chemical signals that mediate communication between microorganisms. Eleusine indica, a ubiquitous grass used traditionally to treat infections, has been shown to contain metabolites, such as fatty acid derivatives and p-coumaric acid, capable of quorum quenching. To date, there has been no study on the quorum quenching activity of E. indica.</p><p style="text-align: justify;"><strong>Objectives:</strong> This study aimed to determine the in vitro activity of crude ethanolic extract of E. indica leaves against selected quorum-sensing regulated virulence factors of P. aeruginosa and S. marcescens.</p><p style="text-align: justify;"><strong>Methodology:</strong> E. indica leaves were collected, washed, air-dried, and homogenized. Following ethanolic extraction and rotary evaporation, the extract was screened for antimicrobial activity through disk diffusion test and broth microdilution assay. The quorum quenching activity of the extract against P. aeruginosa was measured through swarming motility assay, while the activity against S. marcescens was measured through swarming motility and pigment inhibition assays. The quorum quenching assays were conducted in triplicates, and analysis of variance (ANOVA) was performed to identify differences among the treatment groups.</p><p style="text-align: justify;"><strong>Results:</strong> Disk diffusion test revealed that no zones of inhibition formed against both P. aeruginosa and S. marcescens for varying concentrations of up to 200 mg/mL of the crude extract. Likewise, the MIC of the extract against both P. aeruginosa and S. marcescens was determined to be >200 mg/mL. However, it was shown that the extract, at 50 mg/mL, has statistically significant activity (p<0.05) against the swarming motility of P. aeruginosa, and it is 71.6% as effective in reducing the swarming area of the bacteria compared to cinnamaldehyde. This was not observed when the extract was tested against the swarming motility of and pigment production by S. marcescens.</p><p style="text-align: justify;"><strong>Conclusion:</strong> In this study, the quorum quenching activity of the crude ethanolic extract of E. indica leaves was found to be effective against P. aeruginosa but not against S. marcescens. The compounds that will be identified by further studies may conceivably be used as an adjunct therapy in P. aeruginosa infections and as coating agents in medical devices.</p>

Multisystem Inflammatory Syndrome In Children (MIS-C): A case series in a tertiary hospital

@#The clinical course of COVID-19 in the pediatric population has been reported to be mild in the majority of affected patients. However, a condition referred to as multisystem inflammatory syndrome in children (MIS-C) can occur with SARS-CoV-2 infection where patients can become critically ill. In this series, we describe five pediatric patients with the spectrum of MIS-C associated with SARS-CoV-2 infection.

Fulminant Hepatic Failure in a SARS-CoV-2 positive pediatric patient: A case report

@#Respiratory symptoms are the most common manifestation of COVID-19 across all age groups and it is most often associated with radiographical findings consistent with pneumonia.2 A recent systematic review estimated that 16% of children with SARS-CoV-2 infection are asymptomatic,3 or others may present with seizures, gastrointestinal bleeding or jaundice. This reports a 2-year old boy with no known co-morbidity who had a 2-week history of abdominal pain and jaundice then had a rapidly progressive course of neurological deterioration and eventual demise. He had markedly elevated liver enzymes and deranged bleeding parameters with elevated ammonia and ferritin levels. Hepatitis B and hepatitis A titers were non-reactive. He was managed as a case of hepatic encephalopathy secondary to cholestatic jaundice. His chest x-ray was normal but his SARS-CoV-2 RT PCR result was positive with a low cycle threshold. Locally, this is the first reported case of SARS-CoV-2 RT-PCR positive pediatric patient presenting as fulminant hepatic failure with no associated respiratory manifestations. Clinicians should be mindful that such presentation, however uncommon, is possible and a high index of suspicion should be maintained.

Identification of miRNAs linked to peanut nodule functional processes

microRNAs (miRNAs) are non-coding small RNAs that regulate gene expression at post-transcriptional level.Thousands of miRNAs have been identified in legumes, but studies about miRNAs linked to peanut nodulefunctionality are scarce. In this work we analyzed transcriptional changes in peanut nodules to identifymiRNAs involved in functional processes of these organs. We found 32 miRNAs precursors differentiallyexpressed in nodules compared with roots, and predicted the potential targets of their corresponding maturemiRNAs. Among them, 20 belong to 14 conserved miRNAs families and 12 are Arachis hypogaea-specificmiRNAs. Expression levels of 3 miRNAs (ahy-miR399, ahy-miR159 and ahy-miR3508) were confirmedexperimentally by qPCR. We also demonstrated that the expression of these miRNAs was not affected byinoculation of a biocontrol bacterium or a fungal pathogen. The catalogue of differentially expressed miRNAprecursors and the expression of the corresponding mature miRNA potential targets in the nodules of A.hypogaea obtained in this work is a database of strong candidates, including A. hypogaea-specific miRNAs, forthe regulation of the nodule functionality. The analysis of their role in this process will certainly lead to thecharacterization of essential regulators in these particular aeschynomenoid nodules.

Profilaxis combinada con inmunoglobulina intravenosa y plasmaféresis en pacientes altamente sensibilizados, receptores de trasplante renal o combinado hígado-riñón: experiencia en un centro médico colombiano / Combined prophylaxis with intravenous immunoglobulin and plasmapheresis in highly sensitized patients, recipients of kidney or combined liver-kidney transplant: experience in a Colombian medical center

El trasplante renal constituye la mejor opción de tratamiento para los pacientes con enfermedad renal crónica terminal. La supervivencia del injerto es de gran importancia y puede ser afectada por factores inmunológicos o no inmunológicos; esto unido al número de pacientes en las listas de espera, hace necesario definir estrategias de manejo que permitan tener mejores resultados a largo plazo. Objetivo. Determinar las características clínicas y humorales, y los desenlaces en receptores de trasplante renal o combinado hígado-riñón, altamente sensibilizados, que recibieron profilaxis combinada con inmunoglobulina intravenosa y plasmaféresis en el Hospital San Vicente Fundación, en Colombia. Materiales y métodos. Se realizó un estudio retrospectivo, observacional, descriptivo, que incluyó los pacientes trasplantados entre el 4 de julio de 2010 y el 19 de abril de 2017. Como variables se incluyeron, entre otras, la etiología de la enfermedad renal crónica, el tipo de terapia recibida, y el tiempo en lista de espera en días. Como desenlace se evaluó la presencia de rechazo, el tipo de rechazo, la pérdida del injerto, las complicaciones y la muerte. Resultados. Del total de 25 pacientes, el 100% recibió inmunoglobulina intravenosa y el 84% plasmaféresis. El 12% presentó rechazo del injerto, todos de tipo humoral, y el 20% perdió el injerto. Discusión. A pesar de la gran variedad de protocolos propuestos en la literatura, en esta población especial no se ha establecido un protocolo óptimo de inmunosupresión. El protocolo en nuestra pequeña cohorte no tuvo un impacto negativo en el porcentaje de infecciones postrasplante ni en la pérdida del injerto renal, pero sí redujo el tiempo en las listas de espera; por lo tanto, se requieren estudios adicionales para confirmar los hallazgos encontrados en este estudio

Kidney transplantation is the best treatment option for patients with terminal chronic kidney disease, regardless of the etiology, making graft survival an important feature, which may be affected by immunological or non-immunological factors. This, added to the increasing number of patients on waiting lists, makes it necessary to define management strategies for these patients that allow better long-term results. Objectives. To determine the clinical, humoral and outcome characteristics in highly sensitized recipients of kidney and simultaneous kidneyliver transplant who received combined prophylaxis with intravenous immunoglobulin and plasmapheresis therapy in a Colombian medical center. Materials and methods. A retrospective, observational, descriptive study was carried out that included the transplanted patients between July 4, 2010 and April 19, 2017. Variables included the etiology of chronic kidney disease, the type of therapy received, and waiting time in days, among others. As outcomes, the presence of rejection, type of rejection, graft loss, complications and death were evaluated. Results. From a total of 25 patients, 100% received intravenous immunoglobulin and 84% plasmapheresis. Twelve percent presented graft rejection, all humoral, and 20% lost the graft. Discussion. Despite the great variety of protocols proposed in the literature, an optimal immunosuppression protocol has not been established for this particular population. The protocol in our small cohort did not have a negative impact on the percentage of post-transplant infections nor in the loss of the renal graft, but it did reduce waiting time; therefore, additional studies are required to confirm the findings in this study

Neumonía recurrente como manifestación de secuestro pulmonar. Presentación de caso / Recurrent Pneumonia as a Manifestation of Pulmonary Sequestration. Case Report

El secuestro pulmonar es una enfermedad congénita del tracto respiratorio que compromete el parénquima pulmonar y su vasculatura, puede dividirse en intralobar o extralobar dependiendo de su relación con la pleura visceral normal. El subtipo extralobar usualmente se diagnostica prenatalmente o en los primeros meses de vida, mientras que el intralobar se presenta en adultos jóvenes. Representa aproximadamente el 0,15-6,4 % de todas las malformaciones pulmonares congénitas y no tiene diferencias respecto al sexo con una relación 1:1. Se presenta el caso de un paciente masculino adulto medio con neumonías a repetición en quien se realizan estudios imagenológicos con hallazgos tomográficos compatibles con secuestro pulmonar intralobar en el segmento basal posterior izquierdo, con el objetivo de realizar una revisión de la literatura para plantear una discusión sobre la importancia del diagnóstico adecuado y a tiempo de esta patología. Es necesario tener una alta sospecha clínica ­se trata de una enfermedad de presentación variable­, para solicitar el estudio imagenológico más adecuado, puesto que las imágenes son las que dan el diagnóstico definitivo del secuestro pulmonar. En algunos casos, el manejo se puede realizar de manera mínimamente invasiva a cargo de radiología intervencionista, como en este caso.

Pulmonary sequestration is a congenital respiratory disease that involves the pulmonary parenchyma and its vasculature. It can be divided into intralobar or extralobar depending on its relationship with normal visceral pleura. The extralobar subtype is usually diagnosed prenatally or in the first months of life, while the intralobar occurs in young adults. It represents approximately 0.15-6.4% of all congenital lung malformations and does not show differences with respect to sex with a 1:1 ratio. We present the case of an average adult male patient with recurrent pneumonia in whom multiples imaging studies are performed, with tomographic findings compatible with intralobar pulmonary sequestration in the left posterior basal segment, with the aim of performing a literature review to raise a discussion on the importance of the proper and early diagnosis of this pathology. It is necessary to have a high clinical suspicion -it is a disease of variable presentation-, to request the most appropriate imaging study, since the images are those that give the definitive diagnosis of pulmonary sequestration. In some cases, management can be performed in a minimally invasive manner by interventional radiology, as in this case.

Metabolic profiling of four synthetic stimulants, including the novel indanyl-cathinone 5-PPDi, after human hepatocyte incubation / 药物分析学报

Synthetic cathinones are new psychoactive substances that represent a health risk worldwide. For most of the 130 reported compounds, information about toxicology and/or metabolism is not available, which hampers their detection (and subsequent medical treatment) in intoxication cases. The principles of forensic analytical chemistry and the use of powerful analytical techniques are indispensable for stab-lishing the most appropriate biomarkers for these substances. Human metabolic fate of synthetic cathinones can be assessed by the analysis of urine and blood obtained from authentic consumers;however, this type of samples is limited and difficult to access. In this work, the metabolic behaviour of three synthetic cathinones (4-CEC, 4-CPrC and 5-PPDi) and one amphetamine (3-FEA) has been evalu-ated by incubation with pooled human hepatocytes and metabolite identification has been performed by high-resolution mass spectrometry. This in vitro approach has previously shown its feasibility for obtaining excretory human metabolites. 4-CEC and 3-FEA were not metabolised, and for 4-CPrC only two minor metabolites were obtained. On the contrary, for the recently reported 5-PPDi, twelve phase I metabolites were elucidated. Up to our knowledge, this is the first metabolic study of an indanyl-cathinone. Data reported in this paper will allow the detection of these synthetic stimulants in intoxi-cation cases, and will facilitate future research on the metabolic behaviour of other indanyl-based cathinones.

Anti-urolithiatic activity of sambong (Blumea balsamifera) extract in Ethylene Glycol-induced Urolithiatic Wistar Rats (Rattus norvegicus)

Objective@#The study aimed to determine if Blumea balsamifera inhibits calcium oxalate stone formation in the kidneys through determination of the number of calcium oxalate stones in the renal cortex and the percent mass of calcium oxalate.@*Methods@#Post-test only control group design was used using five treatment groups with placebo as the negative control, potassium citrate as the positive control, and 50%, 100%, and 200% sambong treatment. Urolithiasis was induced through ethylene glycol and ammonium chloride. Each treatment group was administered its corresponding treatment solution once daily for twenty-one days. Histopathologic examination and kidney homogenate analysis were done to determine the degree of deposition of calcium oxalate stones in renal tissues and the oxalate content, respectively. Statistical analyses were performed using one-way ANOVA and post hoc Gabriel's Pairwise Comparisons Test.@*Results@#The 100% sambong treatment group showed the least mean number of stones while the positive control and 50% sambong treatment group exhibited the highest anti-urolithiatic activity in terms of oxalate content of the kidney homogenate.@*Conclusion@#It can be concluded from the study that Blumea balsamifera inhibits calcium oxalate stone formation in the kidneys with the 100% and 50% sambong treatment most effective in decreasing number of stones and oxalate content of the kidney homogenate, respectively.

Primmorph extracts and mesohyls of marine sponges inhibitproliferation and migration of hepatocellular carcinoma cells in vitro / 药物分析学报

Cancer recurrence and severe side effects of currently being used chemotherapeutic agents reduce their clinical efficacy. Thus, there is a constant need to develop alternative anticancer drugs. Sustainable supply is an important challenge facing marine-based drug discovery. Primmorph, a 3D cell culture system, could provide a sustainable source to produce metabolites for anticancer drugs from marine sponges. In the present work, the anticancer activity of primmorph extracts and mesohyls of Negombata magnifica, Hemimycle arabica, Crella spinulata, and Stylissa carteri sponges was evaluated. Anti-proliferative activity was studied in terms of cytotoxicity, colony formation, cell cycle, and apoptosis. Migration was assessed by migration assay and matrix metalloproteinase activity. The expression of proliferation and migration-related genes was analyzed using real time PCR. Migration and proliferation activities of HepG2 cells were inhibited by treatment with primmorph extracts and mesohyls of N. magnifica, H. arabica, and C. spinulata. The mesohyl of S. carteri did not show any anticancer activity although the primmorph extract led to cell cycle arrest. Among the selected sponge species, the prim-morph extract of C. spinulata was the most promising anticancer agent regarding antiproliferative and antimigratory activities. In addition, primmorph extracts have the advantage of working under well-defined and controlled conditions, which allows the easy application as a bioreactor.