Anti-inflammatory and anti-arthritic effects of compounds from Buddleja coriacea.

Buddleja coriacea (B. coriacea) commonly known as 'Kiswara' is used as infusions for stomach and joint pain. This study aims to evaluate the in vitro and in vivo anti-inflammatory and anti-arthritic activity was evaluated by measuring inflammatory parameters (TNF-α, C-reactive protein and Fibrinogen) in murine models of the aqueous extract and isolated compounds of B. coriacea. A bio-guided phytochemical analysis based on NMR/MS was performed identifying three (1-3) compounds of the aqueous extract. All compounds inhibited the production of TNF-α in RAW 264.7 cell line, with IC50 of 13.44 (1), 1.13 (2) and 0.57 µM (3), respectively. In addition, compounds 2 and 3 decreased the levels of TNF-α, C-reactive protein and fibrinogen at a concentration of 5 mg/kg in murine models. Our research shows that the compounds isolated from B. coriacea have anti-inflammatory and anti-arthritic properties, providing scientific evidence for the traditional use of this plant species.

Anti-inflammatory, pro-proliferative and antimicrobial potential of the compounds isolated from Daemonorops draco (Willd.) Blume.

ETHNO-PHARMACOLOGICAL RELEVANCE: Daemonorops draco (D. draco) commonly known as "Dragon's blood" is one of the most used plants by Momok, Anak Dalam and Talang Mamak tribes from Indonesia as a remedy for wound healing. AIM OF THE STUDY: This study aimed to identify the extract, fractions and compounds responsible for the anti-inflammatory and pro-proliferative activities of the D. draco resin. Additionally, the antimicrobial activity against two bacteria and one yeast species was analysed. MATERIALS AND METHODS: Bio-guided isolation of compounds with anti-inflammatory, pro-proliferative and antimicrobial activities from the D. draco resin was carried out by measuring: the inhibition of NF-κB and activation of Nrf2 in THP-1, HaCaT, NIH-3T3 cells; cell proliferation in NIH-3T3 and HaCaT cells; and the antimicrobial effect on E. coli, S. aureus and C. albicans. RESULTS: Guided isolation by bioassay gave rise to the isolation and characterisation by nuclear magnetic resonance and mass spectrometry of three compounds: 1 (Bexarotene), 2 (Taspine) and 3 (2-hydroxy-1-naphthaldehyde isonicotinoyl hydrazone). All compounds showed NF-κB inhibitory activity with IC50 values of 0.10-0.13, 0.22-0.24 and 3.75-4.78 µM, respectively, while the positive control, Celastrol, had an IC50 of 7.96 µM. Likewise, all compounds showed an activating effect of Nrf2 with EC50 values of 5.34-5.43, 163.20-169.20 and 300.82-315.56 nM, respectively, while the positive control, CDDO-Me, had an EC50 of 0.11 nM. In addition, concerning the pro-proliferative activity, compound 1 (IC50 = 8.62-8.71 nM) showed a capacity of 100%, compound 2 (IC50 = 166-171 nM) showed a capacity of 75%, and compound 3 (IC50 = 469-486 nM) showed a capacity of 65%, while FSB 10% (positive control) had a pro-proliferative activity of 100% in the NIH3T3 cell lines (fibroblasts) and HaCaT (keratinocytes). Finally, all the compounds showed antimicrobial activity with MIC values of 0.12-0.16, 0.31-0.39 and 3.96-3.99 µM, respectively, in S. aureus, E. coli and C. albicans strains, while the positive control, Ofloxacin, had a MIC of 27.65 µM. CONCLUSION: This study managed to isolate, for the first time, three compounds (Bexarotene, Taspine and 2-hydroxy-1-naphthaldehyde isonicotinoyl hydrazone) from the resin of D. draco, with anti-inflammatory, and pro-proliferative as well as antimicrobial activities.

Tratamiento endovascular de un aneurisma micótico en aorta torácica por Salmonella / Endovasular treatment of a mycotic aneurysm in the thoracic aorta due to salmonella

Introducción. Los aneurismas micóticos continúan siendo una entidad clínica muy poco frecuente en el campode nuestra especialidad y un desafío en su tratamiento por la elevada morbimortalidad derivada de ellos y de las característicasdel propio paciente. Caso clínico. Varón de 65 años que fue remitido urgentemente a nuestro centro por hallazgode reciente aparición de un aneurisma de aorta torácica de morfología y localización atípica durante una tomografía axialcomputarizada (TAC). Entre sus antecedentes destacaba que era un paciente inmunosuprimido por diabetes mellitus y unlinfoma tratado hacía un año. Dos meses antes de realizarse la TAC para el control del linfoma, había presentado un cuadrode diarrea y bacteriemia por Salmonella que se trató con antibióticos, sin remisión clínica completa. Ante los antecedentesclínicos de inmunosupresión y bacteriemia por Salmonella y los hallazgos radiológicos, la alta sospecha diagnósticafue de aneurisma micótico en la aorta torácica y se decidió tratar al paciente mediante una endoprótesis aórtica y antibioterapiaprolongada. No hubo complicaciones durante el procedimiento ni en el postoperatorio. El paciente se encuentraasintomático y con excelente evolución clínica desde hace tres años. Conclusión. El tratamiento endovascular combinadocon una antibioterapia prolongada puede ser una alternativa al tratamiento quirúrgico convencional con toracotomíaen el manejo de los aneurismas micóticos en la aorta torácica descendente(AU)

Introduction. Mycotic aneurysms are still a very rare clinical condition within our speciality and theirtreatment poses a challenge due to the high rates of morbidity and mortality deriving from them and the characteristicsof the patients themselves. Case report. A 65-year-old male who was referred to our centre urgently after a recent aneurysmwith an abnormal morphology and location was discovered in the thoracic aorta during the course of a computerisedaxial tomography (CAT) scan. Relevant events in the patient’s history included his being immunosuppressed because ofdiabetes mellitus and a lymphoma that had been treated a year earlier. Two months before performing the CAT scan tomonitor the lymphoma, he had presented diarrhoea and bacteraemia due to Salmonella, which was treated withantibiotics, although without full remission of the clinical symptoms. In view of the clinical history of immunosuppressionand bacteraemia due to Salmonella and the findings in the imaging studies, the main diagnostic suspicionwas a mycotic aneurysm in the thoracic aorta and the decision was made to treat the patient by means of an aortic stentand prolonged antibiotic therapy. There were no complications during the operation or in the post-operative period. Thepatient has been asymptomatic and his clinical course has been excellent for the last three years. Conclusions. Endovasculartreatment combined with prolonged antibiotic therapy can be an alternative to conventional surgical treatmentinvolving a thoracotomy in the management of mycotic aneurysms in the descending thoracic aorta(AU)

[Nodular alveolar pattern of presentation for amiodarone pulmonary toxicity]. / Patrón alveolar nodular como forma de presentación de la toxicidad pulmonar por amiodarona.

Amiodarone is a triiodinated antiarrhythmic drug that accumulates in alveolar macrophages. Its use is limited by its high rate of associated pulmonary toxicity, estimated at 5-7%. Radiologic findings for pulmonary toxicity caused by amiodarone are unspecific and varied. The most common finding is subpleural reticular-type interstitial thickening, predominately in the bases of the lungs. However, the presence of parenchymal nodules is an uncommon presentation. We report the case of a woman treated with amiodarone that presented multiple nodular lesions at plain-film radiography and high-resolution CT that were compatible with pulmonary toxicity caused by amiodarone at pathologic examination.

Treatment of long-term intravascular catheter-related bacteraemia with antibiotic-lock therapy.

BACKGROUND: Bacteraemia is a major complication associated with the use of long-term intravascular catheters. Conservative treatment using antibiotic-lock therapy (ALT) has been shown to be useful in some studies, but the evidence supporting its impact in clinical care is still scarce. METHODS: We evaluated the outcome of the episodes of catheter-related bacteraemia (CRB) associated with long-term intravascular devices used for chemotherapy or parenteral nutrition and that were managed with ALT during a 44 month period in our hospital. Episodes of CRB associated with catheters implanted in the same department during the same period, and that were managed with only systemic antibiotics were used as a control group. Antibiotic-lock solution consisted of a heparin solution of 20 IU/mL including vancomycin (for Gram-positive microorganisms) or ciprofloxacin or gentamicin (for Gram-negative bacilli), all at a concentration of 2 mg/mL. ALT was used for a minimum of 8-12 h/day, during 5-14 days. Effectiveness was assessed by clinical and microbiological criteria. RESULTS: A total of 801 long-term intravascular devices were placed in 105 patients during this period. There were 127 episodes of bacteraemia documented in these patients, with 92 being CRB. Of these, 48 episodes fulfilled inclusion criteria for the analysis. Nineteen episodes were treated with ALT plus systemic antibiotics, and 29 episodes were treated only with systemic antibiotics. Isolated microorganisms were similar in the two groups. The catheter had to be removed during therapy in one episode in the antibiotic-lock group and in seven episodes in the control group. Relapse of the bacteraemia with the same microorganism after stopping therapy was observed in two and three patients in the study group and the control group, respectively. Overall, successful treatment was achieved in 84% and 65% of the episodes in the antibiotic-lock group and the control group, respectively (P = 0.27). CONCLUSIONS: ALT appears as an effective conservative treatment in the management of CRB associated with long-term intravascular devices (84% in the present series), especially in infections caused by coagulase-negative staphylococci.

Patrón alveolar nodular como forma de presentación de la toxicidad pulmonar por amiodarona / Nodular alveolar pattern of presentation for amiodarone pulmonary toxicity

La amiodarona es un antiarrítmico triyodado que se deposita en los macrófagos alveolares, cuyo uso se ve limitado por su toxicidad pulmonar que presenta una incidencia estimada del 5-7%. Los hallazgos radiológicos de la toxicidad pulmonar por amiodarona son inespecíficos y variados, siendo el más frecuente un engrosamiento intersticial de tipo reticular subpleural de predominio en bases. La presencia de nódulos parenquimatosos es, sin embrago, una forma infrecuente de presentación de esta entidad. Exponemos el caso de una mujer en tratamiento con amiodarona que presentaba en la radiología simple de tórax y tomografía computarizada (TC) de alta resolución múltiples lesiones nodulares cuyo posterior estudio anatomopatológico confirmaba su compatibilidad con toxicidad pulmonar por amiodarona

Amiodarone is a triiodinated antiarrhythmic drug that accumulates in alveolar macrophages. Its use is limited by its high rate of associated pulmonary toxicity, estimated at 5-7%. Radiologic findings for pulmonary toxicity caused by amiodarone are unspecific and varied. The most common finding is subpleural reticular-type interstitial thickening, predominately in the bases of the lungs. However, the presence of parenchymal nodules is an uncommon presentation. We report the case of a woman treated with amiodarone that presented multiple nodular lesions at plain-film radiography and high-resolution CT that were compatible with pulmonary toxicity caused by amiodarone at pathologic examination

[In vitro study with techniques of imaging of the composition of urinary calculi]. / Estudio in vitro mediante técnicas de imagen de la composición de los cálculos urinarios.

Pre-treatment knowledge of the lithiasic composition can be useful to design the most appropriate therapeutic scheme for each kind of stone. The relationship between the stone's densitometry information provided by the different imaging techniques, conventional radiology (RX), computerized axial tomography (CAT) and dual energy radiographic densitometry (DO) is analyzed, as well as the elemental composition determined by the microanalysis of fragments obtained post-lithotrity using a scanning electronic microscope (SEM) associated to X-ray dispersion energy (XDE). 60 stones, 12 for each pure composition selected (calcium oxalate mono and dihydro, phosphocarbonate, magnesium ammonium phosphate and uric acid), were studied with XR, CAT and DO and were later subjected to lithofragmentation in vitro. Fragments analysis was carried out post-lithotrity with SEM associated to XDE. The X-ray does not allow to establish the composition of some calculi. CAT quantifies the mineral contents of the oxalocalcic and infective calculi and differentiates the uric acid from the other compositions because the mean density values are under 500 Hounsfield Units. DO evaluates the lithiasic content in phosphocarbonate salts which are structurally similar to bone hydroxyapatite.

[Comparative analysis of lithiasic fragmentation induced by extracorporeal and direct contact sources]. / Análisis comparativo de la fragmentación litiásica inducida por las fuentes extracorpóreas y de contacto directo.

An in vitro experimental study on stone fragmentation was conducted on 114 calculi analyzed by infrared spectrophotometry. Four energy sources were utilized: electrohydraulic, piezoelectric, ultrasound and pulsed laser. We analyzed stone susceptibility to fragmentation (particles < 3 mm), pulverization (particles < 1 mm) and stone fragility (amount of energy/mg of calculus fragmented into particles < 3 mm) for each type of energy source of each of the following 6 stone compositions: calcium oxalate monohydrate, calcium oxalate dihydrate, magnesium ammonium phosphate, phosphate carbonate, uric acid and phosphate oxalate. The calcium oxalate dihydrate calculi were the most susceptible to fragmentation and the infective calculi (magnesium ammonium phosphate and phosphate carbonate) were the most susceptible to pulverization. The piezoelectric energy showed the highest capacity for fragmentation and pulverization of calculi. Stone fragility depended on each stone type and the energy source utilized.

Recurrent massive pleural effusion as a late complication of radiotherapy in Hodgkin's disease.

We report a very unusual case of a patient with recurrent massive PEs eight years after mediastinal radiotherapy for HD, in which evidence of lymphomatous recurrence could not be demonstrated. The diagnosis of PE as a complication of radiation is presumptive, and other disorders causing PE must be excluded. This condition requires symptomatic treatment and a close follow-up of the patient.