ABSTRACT
The present study aimed at investigating the chemical composition of essential oil extracted from Brazilian propolis and the susceptibility of Staphylococcus aureus, Staphylococcus epidermides, Streptococcus pyogenes and Escherichia coli to this substance. The essential oil was obtained by steam distillation of propolis and examined by gas chromatography/mass spectrometry (GC/MS). In addition, the agar diffusion method using filter paper disks was employed. Antibacterial activity was measured as equivalent diameters of inhibition zones (in millimeters) after incubation at 37ºC for 24 hours. From the 26 identified constituents, Beta-caryophyllene (12.7 percent), acetophenone (12.3 percent) and Beta-farnesene (9.2 percent) were found to be major components. New components, namely linalool, methyl hydrocinnamate, ethyl hydrocinnamate, alfa-ylangene, gama-elemene and valencene, are reported for the first time to be present in propolis essential oil. This oil also exhibited antibacterial activity.
Subject(s)
Bees , Oils, Volatile , Propolis/pharmacology , Propolis/chemistry , Escherichia coli , Staphylococcus aureus , Staphylococcus epidermidis , Streptococcus pyogenesABSTRACT
The species Alpinia purpurata is scarcely cited as to ethnopharmacology and phytochemistry. This study aimed to analyze bioactive compounds through high-performance liquid chromatography (HPLC). Hydroalcoholic crude extract was obtained from A. purpurata dried leaves. Folin-Ciocalteau method was used to quantify total phenols, using gallic acid as standard. The obtained result was 15.6 mg GAE g-1. The crude extract was partitioned with the solvents ethyl acetate and butanol, followed by thin-layer chromatography (TLC) and HPLC. The flavonoids kaempferol-3-O-glucuronide and rutin were detected at a higher concentration in ethyl acetate and butanolic extracts. The butanolic extract contains the highest flavonoid percentage (94.3 percent). A. purpurata presents important flavonoids of therapeutic use, already verified for A. zerumbet. This is the first study verifying the presence of flavonoids in A. purpurata extracts.
A espécie Alpinia purpurata apresenta poucas citações referentes a etnofarmacologia e fitoquímica. Este estudo propõe a análise de substâncias bioativas através da técnica de cromatografia líquida de alta eficiência (CLAE). O extrato bruto hidroalcóolico foi obtido a partir de folhas secas de A. purpurata. A quantificação de fenóis totais foi realizada pelo método de Folin-Ciocalteau, usando ácido gálico como padrão. Como resultado, foi verificado 15,6 mg EAG g-1. O extrato bruto foi particionado com os solventes acetato de etila e butanol e depois analisado por cromatografia em camada delgada e CLAE. Nos extratos acetato de etila e butanólico foi detectada a presença dos flavonóides kaempferol-3-O-glicuronídeo e rutina, em maior concentração. O extrato butanólico contém a maior porcentagem de flavonóides (94,3 por cento). Esta espécie possui flavonóides importantes no uso terapêutico, já antes verificados para a espécie A. zerumbet. Este é o primeiro trabalho que verifica a presença de flavonóides em extratos de A. purpurata.
Subject(s)
Flavonoids/analysis , Chromatography, High Pressure Liquid/methods , Alpinia/physiology , Rutin/analysis , /analysis , Zingiberaceae , Polyphenols/pharmacokineticsABSTRACT
BACKGROUND: The assessment of health-related quality of life gains increasing importance in pediatric practice. In the field of rheumatic health conditions in young people only a few studies about this topic are available. Within a European study health-related quality of life of children and adolescents with idiopathic arthritis was assessed. The results of the German sample will be presented. PATIENTS: A total of N=88 children and adolescents with juvenile idiopathic arthritis (57% female) between 8 und 16 years were included in the study. METHOD: Children and adolescents filled in a questionnaire. Health-related quality of life was assessed with the DISABKIDS instrument. RESULTS: No age or gender effects on health-related quality of life were detected. The variable "limitation of mobility" as well as the item "pain" showed the strongest relationship with the health-related quality of life dimensions. CONCLUSIONS: Health-related quality of life is decisively influenced by the consequences of the health condition. For clinical practice the study showed that patients with mobility limitations and/or pain need heightened attention which should especially concentrate on the social and mental dimensions of health-related quality of life.
Subject(s)
Arthritis, Juvenile/psychology , Quality of Life/psychology , Adaptation, Psychological , Adolescent , Age Factors , Arthritis, Juvenile/diagnosis , Child , Child, Preschool , Disability Evaluation , Female , Germany , Humans , Male , Mobility Limitation , Pain/psychology , Sex Factors , Sick Role , Social Adjustment , Surveys and QuestionnairesABSTRACT
There are about 1.2-1.6 million psoriasis sufferers in Germany. In about a third of these, the disease manifests before the age of 20. A classic complication of psoriasis is psoriasis arthritis (PsA), which, from the latest figures, effects about 20% of all psoriasis patients. PsA also starts in childhood and is included under the term juvenile idiopathic arthritis (JIA). The expert round table discussion which took place in 2006 in Wörlitz elaborated the recommendations for the classification, comprehensive diagnostics and therapy of effected children and adolescents. As controlled studies are lacking, the treatment of PsA has been empirically based and carried out in analogy with the treatment of other forms of JIA. The use of methotrexate (MTX) shows a good success rate. In 2004, about a third of the patients found in the core documentation, including over 80% of children and adolescents undergoing a primary therapy, were treated with MTX, a quarter in combination with other medication. A total of 7% of all and 16% of those undergoing primary therapy were treated with etanercept, most (>80%) in combination with basis medication, usually MTX. Consensus opinion indicated that an early, and intensive local skin therapy should be applied in order to reduce inflammatory activity. If PsA is present, the early use of non-steroid anti-inflammatories as well as local therapy of the joints with the intra-articular application of glucocorticosteroids is recommended. The primary medication should preferentially be MTX, if necessary combined with other therapies. In cases of a severe, episodic progression as well as high inflammatory activity, systemic glucocorticosteroids should be considered. Further studies addressing both the clinical course of jPsA compared to the adult manifestation as well as optimal therapeutic procedures should be initiated in the near future.
Subject(s)
Practice Guidelines as Topic , Psoriasis/diagnosis , Psoriasis/therapy , Rheumatology/standards , Adolescent , Arthritis, Psoriatic/diagnosis , Arthritis, Psoriatic/therapy , Child, Preschool , Female , Germany , Humans , Male , Practice Patterns, Physicians'/standardsABSTRACT
Rheumatic diseases in childhood and adolescence differ from those of adulthood according to type, manifestation, treatment and course. A specialized therapy, starting as early as possible, improves the prognosis, can prevent long-term damage and saves the costs of long-term care. Only a specialized pediatric care system can guarantee optimum quality of the processes involved and the results for rheumatology in childhood and adolescence within a global financial system. This requires adequate structural quality of the specialized clinics and departments for pediatric rheumatology. The management of rheumatic diseases in childhood and adolescence is comprehensive and requires a multidisciplinary, specialized and engaged team which can cover the whole spectrum of rheumatic diseases with their various age-dependent aspects. In order to guarantee an adequate, cost-efficient routine, a specialized center which concentrates on inpatient care should treat at least 300 patients with pediatric rheumatic diseases per year. The diagnoses should be divided among the various disease categories with at least 70% of them involving inflammatory rheumatic diseases. For the inpatient care of small children, an accompanying person (parent) is necessary, requiring adequate structures and services. Patient rooms as well as diagnostic (radiography, sonography, etc.) and therapeutic services (physiotherapy, occupational therapy, pool, etc.) must be adequate for small children and school children as well as adolescents. Suitable mother-child units must also be provided and a school for patients is required within the clinic. A pediatric rheumatologist must be available 24 h a day, and it must be possible to reach other specialists within a short time. For painful therapeutic procedures, age-appropriate pain management is obligatory. A continuous adjustment of these recommendations to changing conditions in health politics is intended.
Subject(s)
Hospital Departments/standards , Hospital Design and Construction/statistics & numerical data , Hospitals, Pediatric/standards , Hospitals, Special/standards , Patient Care Team/standards , Quality Assurance, Health Care/standards , Rheumatic Diseases/therapy , Adolescent , Child , Cost-Benefit Analysis/standards , Early Diagnosis , Germany , Health Services Needs and Demand/standards , Humans , Outcome Assessment, Health Care/standards , Rheumatic Diseases/diagnosis , Specialization/standardsABSTRACT
OBJECTIVE: We sought to measure self-reported health related quality of life (HRQOL) and psychosocial adaptation in children and adolescents with juvenile idiopathic arthritis (JIA) and reactive arthritis and to determine factors associated with these outcomes. METHODS: We interviewed 72 children and adolescents with chronic arthritis, age 8-16, about HRQOL (KINDL-R-Questionnaire) and functional ability in activities of daily living (Childhood Health Assessment Questionnaire-CHAQ). Mothers reported behavior problems (Child Behavior Checklist-CBCL). RESULTS: Children and adolescents with juvenile idiopathic arthritis and reactive arthritis reported lower HRQOL compared to normative data in several areas. Children reported lower QOL in the dimensions self-esteem; adolescents reported lower QOL in the dimensions physical well being and total QOL. Almost 20% of the sample appeared to have serious behavior problems, mostly social isolation and depression/anxiety. Functional limitations affected HRQOL and behavior problems. Inpatient children and adolescents and those with shorter disease duration reported lower QOL than outpatient children and adolescents and those with longer disease duration. Best predictors for impaired HRQOL were functional limitations, social isolation and depression/anxiety. CONCLUSIONS: Self-reported HRQOL and behavior problems may be relevant outcome measures in children and adolescents with chronic arthritis and useful to monitor psychosocial support in this population.
Subject(s)
Activities of Daily Living , Arthritis, Juvenile/epidemiology , Arthritis, Reactive/epidemiology , Child Behavior Disorders/epidemiology , Depression/epidemiology , Quality of Life , Adaptation, Psychological , Adolescent , Arthritis, Juvenile/diagnosis , Arthritis, Reactive/diagnosis , Child , Child Behavior Disorders/diagnosis , Comorbidity , Depression/diagnosis , Female , Germany/epidemiology , Humans , Male , Psychology , Risk Assessment/methods , Risk Factors , Severity of Illness IndexABSTRACT
OBJECTIVE: To describe a registry set up to monitor children treated with etanercept in Germany and Austria. METHODS: Giannini's criteria, duration of morning stiffness, number of swollen, tender and contracted joints, adverse events, and reasons for discontinuation were assessed. RESULTS: 322 patients with juvenile idiopathic arthritis (JIA) and 12 additional patients with non-JIA rheumatic diagnoses were included. Therapeutic efficacy was observed from one month after treatment was started. The number of patients with significant improvement and the degree of improvement increased during the first year. The mean (SD) number of tender and swollen joints decreased from 9 (9) and 8.4 (9) to 3.0 (6.5) and 4.5 (7) after one month, and to 2.2 (5.5) and 3.3 (5.5) after three months; morning stiffness decreased from 45 (65) minutes to 12 (30) and 7 (19) after one and three months (p<0.001 for all). Using Gianinni's criteria of 30%, 50%, and 70% improvement, a therapeutic response in JIA patients was achieved in, respectively, 66%, 54%, and 30% after one month, 78%, 61%, and 38% after three months, and 83%, 72%, and 52% after six months. Therapeutic efficacy was lower in patients with systemic onset arthritis. Overall tolerability was good: in 592 patient treatment-years there were 69 reports of adverse events in 56 patients, including one CNS demyelination. There were no opportunistic infections or lupus-like reactions. Treatment was discontinued in 53 JIA patients, in 25 because of lack of efficacy. CONCLUSION: Etanercept treatment was safe and led to a significant improvement in most JIA patients resistant to conventional treatment.
Subject(s)
Antirheumatic Agents/therapeutic use , Arthritis, Juvenile/drug therapy , Immunoglobulin G/therapeutic use , Receptors, Tumor Necrosis Factor/therapeutic use , Registries , Adrenal Cortex Hormones/therapeutic use , Antirheumatic Agents/adverse effects , Austria , Child , Drug Therapy, Combination , Etanercept , Germany , Humans , Immunoglobulin G/adverse effects , Methotrexate/therapeutic use , Remission Induction , Severity of Illness Index , Treatment OutcomeABSTRACT
Fourteen extracts from Brazilian traditional medicinal plants used to treat infectious diseases were used to look for potential antimicrobial activity against multiresistant bacteria of medical importance. Staphylococcus aureus strains were susceptible to extracts of Punica granatum and Tabebuia avellanedae. The minimum inhibitory concentrations (MICs) of the total extracts and of additional fractions of these plants were determined by employing strains of methicillin-resistant (MRSA) and -sensitive (MSSA) S. aureus, including isolates of the PFGE clone A, which is prevalent in Brazil and two ATCC reference strains. A mixture of ellagitannins isolated from P. granatum and two naphthoquinones isolated from T. avellanedae demonstrated antibacterial activity against all S. aureus strains tested. Semi-synthetic furanonaphthoquinones (FNQs) showed lower MICs than those exhibited by natural occurring naphthoquinones. The results indicate that these natural products can be effective potential candidates for the development of new strategies to treat MRSA infections.
Subject(s)
Hydrolyzable Tannins , Naphthoquinones/pharmacology , Plants, Medicinal , Staphylococcus aureus/drug effects , Brazil , Humans , In Vitro Techniques , Lythraceae , Methicillin Resistance , Microbial Sensitivity Tests , Naphthoquinones/administration & dosage , Naphthoquinones/chemistry , Naphthoquinones/isolation & purification , Phytotherapy , Plant Extracts/administration & dosage , Plant Extracts/pharmacology , Staphylococcal Infections/drug therapy , Staphylococcal Infections/microbiology , Staphylococcus aureus/isolation & purification , Tabebuia , Tannins/administration & dosage , Tannins/chemistry , Tannins/isolation & purification , Tannins/pharmacologyABSTRACT
São analisadas as características microscópicas entre os caules de Lippia alba e de Melissa officinalis, ambas conhecidas no Brasil como "ervas cidreiras" e consumidas pela população em virtude de suas propriedades sedativas e antiespasmódicas. A análise dos cortes transversais dos seus caules, que geralmente aparecem misturados às folhas das duas espécies em estudo, auxilia a diagnose da matéria prima vegetal.
The microscopic characteristics of the stems of Lippia alba and Melissa officinalis, both known in Brazil as "erva cidreira" and consumed by the population in virtue of their sedative and antispasmodic properties, were analyzed. Analysis of the transverse section these stems, which often appear mixed with the leaves of the two species, help in the differentiation of the raw plant material.
ABSTRACT
We report the results of the cross-cultural adaptation and validation into the German language of the parent's version of two health related quality of life instruments. The Childhood Health Assessment Questionnaire (CHAQ) is a disease specific health instrument that measures functional ability in daily living activities in children with juvenile idiopathic arthritis (JIA). The Child Health Questionnaire (CHQ) is a generic health instrument designed to capture the physical and psychosocial well-being of children independently from the underlying disease. The German CHAQ was fully validated with 3 forward and 3 backward translations, while the CHQ has already been published and therefore it was revalidated. A total of 197 subjects were enrolled: 142 patients with JIA (5% systemic onset, 13% polyarticular onset, 8% extended oligoarticular subtype, and 74% persistent oligoarticular subtype) and 55 healthy children. The CHAQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular and extended oligoarticular subtypes having a higher degree of disability, pain, and a lower overall well-being when compared to their healthy peers. Also the CHQ clinically discriminated between healthy subjects and JIA patients, with the polyarticular onset and extended oligoarticular subtypes having a lower physical and psychosocial well-being when compared to their healthy peers. In conclusion the German versions of the CHAQ-CHQ are reliable, and valid tools for the functional, physical and psychosocial assessment of children with JIA.
Subject(s)
Arthritis, Juvenile/diagnosis , Cross-Cultural Comparison , Health Status , Surveys and Questionnaires , Adolescent , Child , Cultural Characteristics , Disability Evaluation , Female , Germany , Humans , Language , Male , Psychometrics , Quality of Life , Reproducibility of ResultsABSTRACT
Vernonioside B2 isolated from the methanol extract of the Brazilian herb Vernonia condensata Baker was evaluated in vivo for analgesic and antiinflammatory activities. The compound reduced writhings (93.28%) and Evans blue dye diffusion (91.80%) induced by acetic acid (0.1 N) in a dose-dependent manner.
Subject(s)
Analgesics/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Asteraceae , Glucosides/therapeutic use , Pain/prevention & control , Plants, Medicinal , Acetic Acid , Analgesics/pharmacology , Animals , Anti-Inflammatory Agents/pharmacology , Dose-Response Relationship, Drug , Glucosides/pharmacology , Male , Mice , Pain/chemically induced , Pain Measurement/drug effects , Plant Extracts/pharmacology , Plant Extracts/therapeutic useABSTRACT
Eosinophilic fasciitis (EF) is characterized by symmetrical scleroderma-like induration of skin over one or more distal extremities, peripheral eosinophilia, absence of Raynaud phenomenon and visceral involvement and a favourable response to systemically administered corticosteroids. Like other scleroderma-like disorders EF is rarely described in children. We report renal involvement in a 17-year-old boy with EF. Urinalysis disclosed proteinuria. Prior to corticosteroid therapy renal biopsy was performed which revealed ischemic collapse of glomerular capillaries and atrophy of tubules of the cortex. Electron-microscopic studies showed hyperplasia of the renin-producing epitheloid cells in the juxtaglomerular apparatus. Few other publications have depicted renal involvement in EF of quite different character. In these cases renal biopsy and histological classification is warranted because of prognostic and therapeutic implications.
Subject(s)
Eosinophilia/complications , Fasciitis/complications , Kidney Diseases/etiology , Kidney/pathology , Adolescent , Humans , Kidney Diseases/pathology , MaleABSTRACT
To evaluate the effect and tolerance of intraarticular Triamcinolonehexacetonide (TCH) in the course of chronic coxitis in juvenile chronic arthritis (JCA) in an open uncontrolled study. Since 1990 we treated patients < 16 years of age suffering from chronic coxitis with 1 mg/TCH/KG body weight. The patients were checked again 4-8 weeks after the treatment. Clinical and ultrasound courses were recorded with the help of ultrasound and joint scores. The evaluation took place 6, 12, 24 and 36 months after the treatment. At that time we give a report on the 12 months follow-up of 37 hip joints and the 24 months follow-up of 20 hip joints. The immediate effect of TCH influencing mobility, pain sensitivity and joint effusions of the patients is impressing. The long term effect of TCH has to be evaluated by regular check ups for at least 2 years. An individual comparison with the not treated contralateral joint would be desired if ethically justifiable. Most patients suffering from polyarticular diseases with a long course of coxitis needed more than one injection of TCH (mean reinjection time 5.8 months). Any avascular necrosis of the femoral heads or other complications were not observed.
