Evaluation of the Leishmanicidal Activity of Rutaceae and Lauraceae Ethanol Extracts on Golden Syrian Hamster (Mesocricetus auratus) Peritoneal Macrophages.

Traditional medicine has provided a number of therapeutic solutions for the control of infectious agents, cancers, and other diseases. After screening a wide variety of Colombian plant extracts, we have identified promising antileishmanial activity in ethanol extracts from Ocotea macrophylla (Lauraceae) and Zanthoxyllum monophyllum (Rutaceae). In this study, we evaluated the in vitro activity of two ethanol extracts, one from Ocotea macrophylla and the other from Zanthoxyllum monophyllum and one alkaloid fraction of ethanol extract of Zanthoxyllum monophyllum, on peritoneal macrophages isolated from golden Syrian hamsters (Mesocricetus auratus) infected with Leishmania panamensis and Leishmania major promastigotes. All of the extracts studied displayed promising (≥2) selectivity indices (S/I), the most significant of which were for ethanol extract of Zanthoxyllum monophyllum against Leishmania panamensis (S/I=12) and alkaloid fraction of ethanol extract of Zanthoxyllum monophyllum against Leishmania major (S/I=11). These results support the use of ethanol extracts and alkaloid fractions isolated from Ocotea macrophylla and Zanthoxyllum monophyllum, respectively; as therapeutic options for cutaneous leishmaniasis.

Antiseptic-impregnated central venous catheters: their evaluation in burn patients.

Central venous catheter-related infections are an important source of morbidity and mortality in burn patients. Antiseptic impregnated catheters have been recommended to prevent infections related to central venous lines in high-risk patients who require short-term catheters. This prospective, randomized, and controlled study compared the efficacy of standard and antiseptic devices in reducing catheter-related infections in burn patients. Twenty-two patients were included in the study with an average age of 47.6 yr and an average burned total body surface area of 38.7%. Thirty-eight silver-sulphadiazine, chlorhexidine catheters were compared with 40 non-antiseptic catheters. No differences in bacteraemia or colonization rates were observed between standard and antiseptic-coated catheters. Antiseptic catheters were more effective in reducing S. epidermidiscolonization than standard catheters (4% vs 31%, p < 0.01). However, Gram-negative bacilli were responsible more often than Gram-positive cocci for catheter tip colonization (53% vs 46%) and they were responsible for all the bacteraemias (5.1%) related to catheters in the present study. We conclude that antiseptic-impregnated catheters could be more effective for Gram-positive cocci and could therefore be less effective in patients with high Gram-negative bacilli bloodstream infection prevalence, as burn patients are.

Peri-Operative Bacteraemia in Burn Patients. What Does it Mean?

Bacteraemias during burn wound manipulation are frequent, especially following burn wound excision. However, these bacteraemias seem not to have any clinical consequences, and their treatment is therefore controversial. Over a 20-month period 35 surgical debridement procedures were recorded prospectively in 18 burn patients. Blood culture samples were drawn before, during, and after surgical excision. Bacteraemias were found in ten out of the 35 patients (28%), and 16 of the 105 blood samples (15%) were positive. All three blood samples were positive in one case ("primary bacteraemia"), while others were "transient bacteraemia". Six positive blood cultures were considered to be "bacteraemias induced by wound manipulation" and seven "bacteraemias of unknown source". Bacteraemias of unknown source were not recorded at any time while "bacteraemias induced by wound manipulation" were recorded after day 5 post-burn. Patients with more than 40% TBSA had 4.3 times more bacteraemic risk than patients with less extensive TBSA. Blood pressure and white blood cell variations were observed in bacteraemic patients but without any clinical relevance. We conclude that bacteraemic rates were high and that there were two different patterns of bacteraemia- both transient and with no clinical relevance.

Massage in hypertrophic scars.

Various attempts have been made to intervene with the formation of hypertrophic scarring (HTS) or to ameliorate it once it has developed, but none have yet proved effective. Massage therapy is routinely used by therapists for the treatment of various conditions, and there have been reports of increased scar pliability and decreased scar banding with the use of massage. This study examines the use of friction massage over a 3-month period in a group of 30 pediatric patients with HTS. The patients were randomly assigned to receive either therapeutic massage sessions of 10 minutes per day in combination with treatment with pressure garments or they were treated with pressure garments alone. A modified Vancouver Burn Scar Assessment Scale was used to measure the characteristics of the identified scars (10 cm by 10 cm) before and after the implementation of massage therapy. The study failed to demonstrate any appreciable effects of massage therapy on the vascularity, pliability, and height of the HTS studied, although there were reports of a decrease in pruritus in some patients. Further studies, with prolonged treatment intervals, are necessary to conclusively demonstrate the ineffectiveness of this therapy for HTS.

Pulsed electromagnetic fields in experimental cutaneous wound healing in rats.

Electromagnetic fields are now being used in many diseases such as osseous, ligamental, cartilaginous, or nervous reparation, diabetes, and myocardial or cerebral ischemia. Although many publications show the usefulness of magneto-therapy, discrepancies exist about the utility of electromagnetic fields in skin wound healing. The objective of this work was to study the effect of pulsed electromagnetic fields on wound healing in rats. Twenty-two male Wistar rats were used; a circular lesion was made in the back of each animal. They were divided into three groups: group C (control) with sham treatment (n = 8), group NF, treated with topical nitrofurazone solution (n = 7), and group PEMF, treated with pulsed electromagnetic fields of 20 mT (n = 7). The treatments were 35 minutes twice a day. The absolute and relative values of the area and perimeter of the wounds showed significantly lower values in the PEMF group at days 7, 14, and 21 compared with those in group C (p < 0.01, analysis of variance), whereas the PEMF group showed significantly lower values at day 21 only compared with the NF group (p < 0.01, analysis of variance). The results suggest a significant beneficial stimulation in the wound healing process in rats treated with PEMF, which could lead to the development of a practical tool for research and clinical use.

[Effect of magnetic fields on skin wound healing. Experimental study]. / Efecto de campos magnéticos sobre la cicatrización de la piel estudio experimental.

Although there are many publications on the usefulness of magneto-therapy, discrepancies exist about the utility of electromagnetic fields in skin wound healing. The objective of this work was to study the effect of electromagnetic fields on wound healing in rats. Thirty six male Wistar rats were used; a rectangular lesion was made in the back of each animal (4.2 cm x 2.3 cm). They were divided into 3 groups: group C (control) with sham treatment; group C50, treated with continuous electromagnetic fields of 5 mT (50 Gauss) and group P200, treated with pulsed electromagnetic fields of 20 mT (200 G). The treatments were of 30 minutes a day during 21 days. The corporal weights (Table 1) and the wound longitudinal and transversal maximal axis (Figures 1, 2) were weekly recorded and the data was evaluated by analysis of variance. On day 14, the P200 group showed the maximal longitudinal axis which was smaller than that of group C (p < 0.01). On day 21 in both treated groups the maximal longitudinal axis was smaller than that of group C (p < 0.01); besides the axis was smaller in the P200 group than in the C50 group (p < 0.05). No statistical differences were observed in the remaining data. The results showed a facilitating effect of electromagnetic fields on wound healing in rats. Pulsed electromagnetic fields seem to have a precocious and larger healing effect than continuous electromagnetic fields.

The use of the modified Thomas splint for a patient with cultured epidermal autografts.

UNLABELLED: Because of the difficulty in handling a patient with cultured epidermal autografts in pressure areas of the limbs, we have adopted a splint that is easy to apply, allows an easy access to the wound, and is well tolerated by the patient. HYPOTHESIS: Avoiding pressure in areas with autografts is recommended. This is the reason we have used a splint that avoids the pressure and the secretion buildup. This technique helps a better "take of the grafts." METHODS: We have modified the original Thomas splint in two ways: (1) the use of a distant and upper appliance that allows to correct the foot's flexion; and (2) the use of an appliance that can be regulated, is inflatable, and can be removed, allowing the change of pressure in different areas. We have used this method with one patient with a deep degree of circumferential burn in both lower limbs. The splint has been maintained and the elevation changed every day for 15 days. Traction has been made with the use of the Kirschner stirrup. RESULTS: The dressing was changed easily and without patient pain. Good mobility was possible, with genital hygiene and grafts that were taken in 70% of the cultured epidermal autografts. CONCLUSION: This method allows maintenance of the legs in functional position during dressing changes and avoids pressure and chafing. It decreases the loss of the autograft for mechanical effects.

Motor unit involvement in human acute Chagas' disease.

Thirty five patients with acute Chagas' disease who demonstrated parasitaemia at the time of the investigation were submitted to a detailed electromyographical study. With their muscles at rest, 12 patients showed fibrillation potentials and/or positive sharp waves. On volitional contraction, 7 had short duration motor unit potentials (MUPs) and low polyphasic MUPs. On motor and sensory nerve fibers conduction studies, 20 disclosed values below the lower control limit within one or more nerves. Finally, 12 patients produced a muscle decremental response on nerve supramaximal repetitive stimulation. The findings signal that primary muscle involvement, neuropathy and impairement of the neuromuscular transmission, either isolated or combined, may be found in the acute stage of human Chagas' disease.

Motor unit involvment in human acute Chagas' disease

Treinta e cinco pacientes con el diagnóstico de enfermedad de Chagas en su etapa aguda, todos con parasitemia positiva en el momento de la investigación, fueron sometidos a estudio electromiográfico por técnicas convencionales. En reposo, 12 de ellos mostraron fibrilaciones y/o potenciales positivos. Durante la contracción voluntária, en 7 pacientes los potenciales de unidad motora eran bifásicos de corta duración y polifásicos de baja amplitud. En 20 se encontró disminución de la velocidad de conducción motora y/o sensitiva en uno o mas de los nervios explorados. Finalmente, 12 pacientes mostraron caida de la amplitud del potencial muscular evocado por estímulo nervioso repetitivo supramáximo. Los hallazgos hechos señalan que durante la fase aguda de la enfermedad de Chagas en el hombre puede producirse alteración primária del músculo, neuropatía y compromiso de la transmisión neuromuscular, en forma aislada o combinadas entre si

Increased urinary excretion of thromboxane B2 and 2,3-dinor-TxB2 in cyclosporin A nephrotoxicity.

Cyclosporin A (CsA) administration to rats is associated with a selective increase in urinary excretion of immunoreactive thromboxane B2 (i-TxB2), the stable breakdown product of TxA2. The exaggerated synthesis of TxA2 may play a role in the reduction of glomerular filtration rate (GFR) observed both in animals and humans undergoing CsA treatment. The present study was designed to get further insight into the origin of the abnormal i-TxB2 urinary excretion. Rats given orally CsA (50 mg/kg/day) for 30 days had a significant increase in the urinary excretion of both 2,3-dinor-TxB2 and TxB2 measured by technique of capillary column gas chromatography-negative ion chemical ionization mass spectrometry (HRGC-NICIMS). Urinary TxB2 is more likely to reflect the renal synthesis of the parent compound, whereas 2,3-dinor-TxB2 is considered to reflect the amount of TxB2 formed in the circulation. Experiments in isolated perfused kidney (IPK) taken from animals given CsA for 30 days showed a lower percentage increase in urinary TxB2 over vehicle treated animals. Moreover in IPK the ratio 2,3-dinor-TxB2/TxB2 was lower than in vivo. The amount of i-TxB2 detectable in serum of animals given CsA was not different from that of control animals. In contrast, isolated glomeruli taken from rats given CsA had an increase in their TxA2 synthesis measured as i-TxB2 in the supernatants. Ultrastructural studies on kidney specimens from animals given CsA showed a focal glomerular endothelial damage together with a marked infiltration of blood borne cells of monocyte-macrophage type in the glomerular tuft. In contrast, kidney specimens taken from IPK preparations were devoid of inflammatory cells. In vitro CsA did not interfere with platelet arachidonic acid (AA) metabolism as shown by a normal i-TxB2 generation in vitro by rat platelet-rich plasma (PRP) exposed to CsA and then challenged with AA or ADP. Similarly isolated glomeruli and isolated proximal tubules from normal rats when challenged with CsA in vitro converted AA into TxA2 normally. It is suggested that the cause of the increased urinary excretion of 2,3-dinor-TxB2 is the consequence of intrarenal platelet and macrophage activation, probably triggered by the endothelial damage. The parallel increase in the urinary excretion of unmetabolized TxB2 is likely to reflect a concomitant activation of resident renal cell AA metabolism induced by CsA.

Tertatolol ameliorates renal function in rats with chronic renal failure.

Tertatolol is a new beta-blocking agent which induces renal vasodilation in experimental animals and humans and increases glomerular filtration rate (GFR), diuresis and natriuresis. The mechanisms underlying renal effects of tertatolol are not known. Our aims were to establish whether tertatolol influences renal function by a systemic or by an intrarenal effect and to assess whether tertatolol could maintain GFR in chronic renal failure. Tertatolol but not propranolol when given as i.v. bolus injection at the dose of 25 and 50 micrograms/kg. b.w. induces a significant increase in GFR and perfusate flow rate (PFR) in an isolated perfused kidney model [GFR: tertatolol, 25 micrograms/kg; preinjection: 0.477 +/- 0.077 ml/min/g of kidney; 30 min postinjection: 0.996 +/- 0.114 ml/min/g of kidney. Tertatolol (50 micrograms/kg) preinjection: 0.517 +/- 0.040 ml/min/g of kidney; 30 min postinjection: 0.879 +/- 0.035 ml/min/g of kidney. Propranolol (500 micrograms/kg) preinjection: 0.574 +/- 0.045 ml/min/g of kidney; 30 min postinjection: 0.538 +/- 0.029 ml/min/g of kidney. PFR: tertatolol, 25 micrograms/kg, preinjection: 30.00 +/- 0.79 ml/min; 30 min postinjection: 36.20 +/- 2.58 ml/min. Tertatolol (50 micrograms/kg) preinjection: 29.30 +/- 1.44 ml/min; 30 min postinjection: 38.01 +/- 1.87 ml/min. Propranolol (500 micrograms/kg) preinjection: 28.70 +/- 1.04 ml/min; 30 min postinjection: 28.30 +/- 0.91 ml/min]. In the same preparation tertatolol significantly increases urine flow rate and Na+ excretion [urine flow rate: tertatolol (25 micrograms/kg) preinjection: 28.28 +/- 4.10 microliter/min; 60 min postinjection: 38.23 +/- 6.74 microliter/min. Tertatolol (50 micrograms/kg) preinjection: 24.02 +/- 0.63 microliter/min; 60 min postinjection: 33.18 +/- 2.07 microliter/min.(ABSTRACT TRUNCATED AT 250 WORDS)