Antifungal Annona muricata L. (soursop) extract targets the cell envelope of multi-drug resistant Candida albicans.

ETNOPHARMACOLOGICAL RELEVANCE: Annona muricata L. (soursop) is traditionally used in the treatment of inflammatory diseases, cancer, and infections caused by fungi. The therapeutic activity explored by its medicinal use is generally associated with its phytoconstituents, such as acetogenins and alkaloids. However, its potential antifungal bioactivity as well as its mechanism of action remains to be established. AIM OF THE STUDY: To evaluate the antifungal activity of the ethanolic extract of A. muricata leaves against multidrug-resistant Candida albicans (ATCC® 10231). MATERIAL AND METHODS: Phytoconstituents were detected by UFLC-QTOF-MS. The minimum inhibitory concentration was determined, followed by the determination of the minimum fungicidal concentration. For planktonic cells, the growth curve and cell density were evaluated. Studies to understand the mechanism of action on the cell envelope involved crystal violet permeability, membrane extravasation, sorbitol protection, exogenous ergosterol binding assay, metabolic activity, and cell viability. Furthermore, mitochondrial membrane potential was assessed. RESULTS: Our analyses demonstrated a significant inhibitory effect of A. muricata, with the ability to reduce fungal growth by 58% and cell density by 65%. The extract affected both the fungal plasma membrane and cell wall integrity, with significant reduction of the cell viability. Depolarization of the fungal mitochondrial membrane was observed after treatment with A. muricata. Rutin, xi-anomuricine, kaempferol-3O-rutinoside, nornuciferine, xylopine, atherosperminine, caffeic acid, asimilobine, s-norcorydine, loliolide, annohexocin, annomuricin, annopentocin, and sucrose were identified as extract bioactive components. CONCLUSIONS: Our findings show that the A. muricata extract is a source of chemical diversity, which acts as a potential antifungal agent with promising application to the therapy of infections caused by C. albicans.

Clinical Measures Related to Forward Shoulder Posture: A Reliability and Correlational Study.

OBJECTIVES: The purpose of this study was to examine the reliability of clinical measures related to forward shoulder posture (pectoralis minor index [PMI], scapular index [SI], abduction index [AI], acromion to the wall index [AWI] acromion to the treatment table index [ATI], and thoracic curvature [TC]), and to investigate the association (redundancy) among these measures. METHODS: Twenty-one asymptomatic participants participated in this study. Two physiotherapists were trained to perform the clinical measurements. Intraclass correlation coefficients (ICC2,k) were calculated to assess intra- and interrater reliabilities. Pearson product moment correlation was used to investigate the existence of possible redundancy between the measures that showed high intra- and interrater reliabilities. RESULTS: The measures showed ICCs between 0.30 and 0.97. Five measures, PMI, SI, AWI, ATI, and TC, showed appropriate values for intrarater reliability (ICCs 0.77-0.94), and 3 measures, AWI, ATI, and TC, for interrater reliability (ICCs 0.82-0.85). Among measures that showed acceptable intra- and interrater reliability values, 2 measures were redundant, showing high association (AWI vs ATI) (r = 0.80, P < .001). CONCLUSION: For PMI, SI, AWI, ATI, and TC measures, adequate values of intrarater reliability were observed. For AWI, ATI, and TC, adequate values of interrater reliability were found. Two pairs of measures were highly associated (PMI with SI; AWI with ATI), which indicates redundancy among them. Our results suggest that, when the same examiner performs the assessment, the combined use of the PMI, AWI, and TC measures allows a quick but comprehensive evaluation of the presence of forward shoulder posture.