Trichilia monadelpha bark extracts inhibit carrageenan-induced foot-oedema in the 7-day old chick and the oedema associated with adjuvant-induced arthritis in rats.

Trichilia monadelpha (Thonn) JJ De Wilde (Meliaceae) bark extract is used in African traditional medicine for the management of various disease conditions including inflammatory disorders such as arthritis. The present study was undertaken to evaluate the anti-inflammatory properties of aqueous (TWE), alcoholic (TAE) and petroleum ether extract (TPEE) of T. monadelpha using the 7-day old chick-carrageenan footpad oedema (acute inflammation) and the adjuvant-induced arthritis model in rats (chronic inflammation). TWE and TPEE significantly inhibited the chick-carrageenan footpad oedema with maximal inhibitions of 57.79±3.92 and 63.83±12 respectively, but TAE did not. The reference anti-inflammatory drugs (diclofenac and dexamethasone) inhibited the chick-carrageenan-induced footpad oedema, with maximal inhibitions of 64.92±2.03 and 71.85±15.34 respectively. Furthermore, all the extracts and the reference anti-inflammatory agents (diclofenac, dexamethasone, methotrexate) inhibited the inflammatory oedema associated with adjuvant arthritis with maximal inhibitions of 64.41±5.56, 57.04±8.57, 62.18±2.56%, for TWE, TAE and TPEE respectively and 80.28±5.79, 85.75±2.96, 74.68±3.03% for diclofenac, dexamethasone and methotrexate respectively. Phytochemical screening of the plant bark confirmed the presence of a large array of plant constituents such as alkaloids, glycosides, flavonoids, saponins, steroids, tannins and terpenoids, all of which may be potential sources of phyto-antiinflammatory agents. In conclusion, our work suggests that T. monadelpha is a potential source of antiinflammatory agents.

Antibacterial, anti-inflammatory, and antioxidant effects of the leaves and stem bark of Glyphaea brevis (Spreng) Monachino (Tiliaceae): A comparative study.

BACKGROUND: Glyphaea brevis (Spreng) Monachino (Tiliaceae) have traditional uses in the management of conditions characterized by infections, inflammatory disorders and oxidative stress. The paper aims to report the comparative data on the leaves and stem bark of Glyphaea brevis with respect to their antibacterial, anti-inflammatory and antioxidant effects. MATERIALS AND METHODS: The antibacterial effects of the 70% ethanol extracts of the leaves and stem bark were determined using the agar well diffusion and micro dilution assays. The anti-inflammatory activity was assessed using the carrageenan-induced oedema model in 7-day old cockerels. Using the DPPH free radical scavenging, total antioxidant and total phenol content assays, the antioxidant potential of the extract was assessed. RESULTS: The bark extract had the higher antibacterial effect against 6 of the 8 microorganisms used. Noteworthy are its activity against Bacillus subtilis and Enterococcus faecalis with lowest MIC value of 500 µg/mL respectively. In doses of 30, 100 and 300 mg/kg, both extracts reduced the carrageenan-induced oedema in 7-day old cockerels. Based on the ED(50) values, both extracts demonstrated similar potencies (ED(50) =21.00 mg/kg). The stem bark extract exhibited higher free radical scavenging activity (IC(50) = 1.392 mg/mL) compared to the leaf extract (IC(50) = 9.509 mg/mL). In the total phenol content, the bark extract showed higher content (15.91 mg/g of dry mass) compared to the leaf extract (2.68 mg/g dry mass). Both extracts demonstrated equal potencies in the total antioxidant capacity determinations (0.60 mg/g dry weight of extract). CONCLUSIONS: The results of this work provide scientific evidence for the traditional uses of Glyphaea brevis.

Wealthy nations called on to boost support efforts. Five-year plan estimated to cost $9.2 billion.

Using the 20-year mark in the history of AIDS as a catalyst, the United Nations and other international organizations have called upon the world's wealthier nations to increase attention, support, and funding to HIV/AIDS prevention and treatment efforts. This call to action included a series of meetings with business and political leaders and culminated in the first United Nations General Assembly Special Session on HIV/AIDS, held in June.

Comparison of six-month outcome of coronary artery stenting in patients <65, 65-75, and >75 years of age.

We studied 1,238 patients receiving 1,880 coronary stents. In-hospital outcomes were divided by age into <65 years (n = 747, group 1), 65 to 75 years (n = 326, group 2), and >75 years (n = 165, group 3). Procedural success was 97.2%, 95.1%, and 98.8% in groups 1, 2, and 3, respectively (p = NS). There was 1 death (group 1). Myocardial infarction occurred in 1.2%, 2.8%, and 1.8%, bypass surgery occurred in 0.9%, 1.8%, and 1.2%, and repeat balloon angioplasty in 0.3%, 0.6%, and 0% of patients in groups 1, 2, and 3, respectively (p = NS for all comparisons). Vascular complications occurred in 2.8%, 4.9%, and 6.1% in groups 1, 2, and 3, respectively (p <0.05). Six-month follow-up of patients was divided by age: <65 years (n = 564, group 1); 65 to 75 years (n = 221, group 2); and >75 years (n = 122, group 3). Event-free survival was 94.5%, 90.5%, and 89.3% for groups 1, 2, and 3, respectively (p = NS). Death occurred in 0.4%, 0.5%, and 1.6%; myocardial infarction occurred in 1.2%, 2.3%, and 1.6%, and target vessel revascularization in 4.3%, 8.6%, and 7.4% for groups 1, 2, and 3, respectively (p = NS for all comparisons). Thus, coronary stenting produced favorable in-hospital and 6-month outcomes in all 3 age groups. Age itself should not preclude patients from undergoing coronary stenting.

Outmigration for coronary bypass surgery in an era of public dissemination of clinical outcomes.

BACKGROUND: Since 1989, New York State has disseminated comparative information on outcomes of coronary bypass surgery to the public. It has been suggested that this program played a significant role in the 41% decrease in the risk-adjusted mortality rate between 1989 and 1992. We hypothesized that some high-risk patients had migrated out of state for surgery. METHODS AND RESULTS: We reviewed 9442 isolated coronary bypass operations performed from 1989 through 1993 to assess referral patterns of case-mix and outcome. Expected and risk-adjusted mortality rates were computed using logistic regression models derived from the Cleveland Clinic and New York State databases. A mortality comparison was performed using the 1980 to 1988 time period as a historical control. Patients from New York (n=482) had a higher frequency of prior open heart surgery (44.0%) than patients from Ohio (n=6046) (21.5%, P<.001), other states (n=1923) (37.4%, P=.008), and other countries (n=991) (17.3%, P<.001). They were also more likely to be in NYHA functional class III or IV (47.6% versus Ohio 42.7%, P=.037; other states, 41.2%, P=.011; other countries, 34.1%, P=.001). The expected mortality rate was thus higher than among other referral cohorts. The observed 5.2% mortality rate among these patients was significantly greater than the 2.9%, 3.1%, and 1.4% mortality rates observed for patients from Ohio (P=.004), other states (P=.028), and other countries (P<.001). These differences in outcome were not apparent between 1980 and 1988 among referrals from within the United States. CONCLUSIONS: Public dissemination of outcome data may have been associated with increased referral of high-risk patients from New York to an out-of-state regional medical center.