Effect of corticosteroids on the clinical course of community-acquired pneumonia: a randomized controlled trial

Introduction The benefit of corticosteroids as adjunctive treatment in patients with severe community-acquired pneumonia (CAP) requiring hospital admission remains unclear. This study aimed to evaluate the impact of corticosteroid treatment on outcomes in patients with CAP. Methods This was a prospective, double-blind and randomized study. All patients received treatment with ceftriaxone plus levofloxacin and methyl-prednisolone (MPDN) administered randomly and blindly as an initial bolus, followed by a tapering regimen, or placebo. Results Of the 56 patients included in the study, 28 (50%) were treated with concomitant corticosteroids. Patients included in the MPDN group show a more favourable evolution of the pO2/FiO2 ratio and faster decrease of fever, as well as greater radiological improvement at seven days. The time to resolution of morbidity was also significantly shorter in this group. Six patients met the criteria for mechanical ventilation (MV): five in the placebo group (22.7%) and one in the MPDN group (4.3%). The duration of MV was 13 days (interquartile range 7 to 26 days) for the placebo group and three days for the only case in the MPDN group. The differences did not reach statistical significance. Interleukin (IL)-6 and C-reactive protein (CRP) showed a significantly quicker decrease after 24 h of treatment among patients treated with MPDN. No differences in mortality were found among groups. Conclusions MPDN treatment, in combination with antibiotics, improves respiratory failure and accelerates the timing of clinical resolution of severe CAP needing hospital admission.

Regeneroidun selluloosapinnan modifiointi kestämään mikro-organismien toimintaa

Työn tavoitteena oli kehittää mikro-organismeja kestävä suoli eli makkarankuori. Työ suoritettiin modifioimalla regeneroitua selluloosaa. Modifiointiliuoksena käytettiin etikkahapon ja etikkahappoanhydridin seosta, johon lisättiin rikkihappoa katalyytiksi. Työssä etsittiin parasta yhdistelmää, joka koostui modifiointiradannopeudesta, modifiointiliuoskoostumuksesta ja erilaisista modifiointimenetelmistä. Kirjallisuusosassa käsiteltiin yleisesti asetaattikalvoja, niiden valmistusta ja ominaisuuksia. Lisäksi perehdyttiin entsyymin ominaisuuksiin ja toimintaan yleisesti. Entsyymeistä yksi otettiin lähempään tarkasteluun. Kokeissa regeneroitua selluloosaa modifioitiin liuoksessa, jonka koostumusta muunneltiin. Kokeissa oli kolme erilaista modifiointimenetelmää, joissa käytettiin neljää modifiointiliuoskoostumusta ja kolmea modifiointinopeutta. Mittauksissa tutkittiin modifioinnin vaikutusta suoliin verrattuna normaaleihin suoliin. Suolille tehtiin sekä mekaanisia että kemiallisia testejä. Kemiallisista testeistä tärkein oli testi, jossa modifioitu suoli altistettiin mikro-organismille. Tulosten perusteella valittiin paras menetelmä. Työssä havaittiin yhden menetelmän olevan muita paljon parempi. Tällä menetelmällä suoritettiin toistokokeita, jotka varmistivat jo saatuja tuloksia. Liuoskoostumusten välillä ei ollut suuria eroja, mutta kuitenkin niistä yksi osoittautui parhaimmaksi. Nopeutta oli vaikeampi määrittää, mutta siitäkin saatiin määritettyä tietty haarukka, jossa reaktio oli tehokkain.

A probable dual mode of action for both L- and D-lactate neuroprotection in cerebral ischemia.

Lactate has been shown to offer neuroprotection in several pathologic conditions. This beneficial effect has been attributed to its use as an alternative energy substrate. However, recent description of the expression of the HCA1 receptor for lactate in the central nervous system calls for reassessment of the mechanism by which lactate exerts its neuroprotective effects. Here, we show that HCA1 receptor expression is enhanced 24 hours after reperfusion in an middle cerebral artery occlusion stroke model, in the ischemic cortex. Interestingly, intravenous injection of L-lactate at reperfusion led to further enhancement of HCA1 receptor expression in the cortex and striatum. Using an in vitro oxygen-glucose deprivation model, we show that the HCA1 receptor agonist 3,5-dihydroxybenzoic acid reduces cell death. We also observed that D-lactate, a reputedly non-metabolizable substrate but partial HCA1 receptor agonist, also provided neuroprotection in both in vitro and in vivo ischemia models. Quite unexpectedly, we show D-lactate to be partly extracted and oxidized by the rodent brain. Finally, pyruvate offered neuroprotection in vitro whereas acetate was ineffective. Our data suggest that L- and D-lactate offer neuroprotection in ischemia most likely by acting as both an HCA1 receptor agonist for non-astrocytic (most likely neuronal) cells as well as an energy substrate.

Prévention des troubles du rythme cardiaque en hémodialyse: quels sont les facteurs modulables [Prevention of cardiac arrhythmias in hemodialysis: what are the modulating factors?].

La mort subite est la première cause de mortalité chez les patients souffrant d'une insuffisance rénale terminale traités par dialyse chronique. La technique de dialyse utilisée et la composition chimique du dialysat influencent l'incidence des arythmies. Des études pilotes démontrent que l'utilisation d'un dialysat sans acétate avec perfusion de bicarbonate de sodium en aval du filtre de dialyse, couplée à une modulation du profil de potassium pendant la séance de dialyse, ou acetate free biofiltration with potassium profiled dialysate, permet de réduire l'incidence des arythmies, l'intervalle QT et sa dispersion. La limitation du volume de soustraction liquidienne pendant la dialyse et l'augmentation de la concentration de calcium dans le dialysat constituent d'autres stratégies anti-arythmogènes possibles Sudden death is the first cause of mortality in patients with end stage renal disease undergoing chronic dialysis treatment. The technique of dialysis as well as the chemical composition of the dialysate can impact on the incidence of cardiac arrhythmias. Pilot studies reveal that the use of an acetate-free dialysate with a downstream filter infusion of sodium bicarbonate, coupled with a modulated potassium-profiled dialysate during hemodialysis, or acetate free biofiltration with potassium profiled dialysate, reduces the incidence of arrhythmias, the QT interval and QT dispersion. The limitation of the ultrafiltration volume during the dialysis session, and the increase in calcium concentration in the dialysate are other possible strategies to reduce cardiac arrhythmias.

Stereoselective Synthesis of (-)-Spicigerolide

(-)-Spicigerolide was enantioselectively synthesized from a protected (S)-lactaldehyde. The synthesis of the polyacetylated framework relied on two Zn-mediated stereoselective additions of alkynes to aldehydes as well as a regiocontrolled [3,3]-sigmatropic rearrangement of an allylic acetate. The pyranone moiety was constructed via ring-closing metathesis.

Direct noninvasive estimation of myocardial tricarboxylic acid cycle flux in vivo using hyperpolarized (13)C magnetic resonance.

BACKGROUND: The heart relies on continuous energy production and imbalances herein impair cardiac function directly. The tricarboxylic acid (TCA) cycle is the primary means of energy generation in the healthy myocardium, but direct noninvasive quantification of metabolic fluxes is challenging due to the low concentration of most metabolites. Hyperpolarized (13)C magnetic resonance spectroscopy (MRS) provides the opportunity to measure cellular metabolism in real time in vivo. The aim of this work was to noninvasively measure myocardial TCA cycle flux (VTCA) in vivo within a single minute. METHODS AND RESULTS: Hyperpolarized [1-(13)C]acetate was administered at different concentrations in healthy rats. (13)C incorporation into [1-(13)C]acetylcarnitine and the TCA cycle intermediate [5-(13)C]citrate was dynamically detected in vivo with a time resolution of 3s. Different kinetic models were established and evaluated to determine the metabolic fluxes by simultaneously fitting the evolution of the (13)C labeling in acetate, acetylcarnitine, and citrate. VTCA was estimated to be 6.7±1.7μmol·g(-1)·min(-1) (dry weight), and was best estimated with a model using only the labeling in citrate and acetylcarnitine, independent of the precursor. The TCA cycle rate was not linear with the citrate-to-acetate metabolite ratio, and could thus not be quantified using a ratiometric approach. The (13)C signal evolution of citrate, i.e. citrate formation was independent of the amount of injected acetate, while the (13)C signal evolution of acetylcarnitine revealed a dose dependency with the injected acetate. The (13)C labeling of citrate did not correlate to that of acetylcarnitine, leading to the hypothesis that acetylcarnitine formation is not an indication of mitochondrial TCA cycle activity in the heart. CONCLUSIONS: Hyperpolarized [1-(13)C]acetate is a metabolic probe independent of pyruvate dehydrogenase (PDH) activity. It allows the direct estimation of VTCA in vivo, which was shown to be neither dependent on the administered acetate dose nor on the (13)C labeling of acetylcarnitine. Dynamic (13)C MRS coupled to the injection of hyperpolarized [1-(13)C]acetate can enable the measurement of metabolic changes during impaired heart function.

Fate of cadmium in rat renal tubules: a micropuncture study.

Free-flow micropuncture was carried out in superficial nephrons of Munich-Wistar type rats infused acutely with Cd acetate (CdA) or Cd-DTPA (141 microM Cd). Fluid obtained from Bowman's space (BS) or end-proximal tubule sites was analyzed for Cd and inulin. The fluid/plasma Cd concentration ratio in BS averaged 0.2 and 1.0 during CdA and Cd-DTPA infusions, respectively. End-proximal tubule fractional excretion of Cd during CdA infusion averaged 0.34. Previous administration of CdA (1.0 mg/kg, 48 hr before micropuncture) increased the level of circulating Cd-metallothioneins, as measured by radioimmunoassay, but did not affect the luminal tubular uptake of Cd during CdA infusion. No net transepithelial movement of Cd-DTPA was measured. It is concluded that Cd ultrafiltered during inorganic Cd administration is taken up to a large extent by the convoluted part of proximal tubules.

CD4 expression decrease by antisense oligonucleotides. Inhibition of rat T CD4+ cell reactivity

In previous studies, we have demonstrated the inhibition of CD4 expression in rat lymphocytes treated with phorbol myristate acetate (PMA) by antisense oligonucleotides (AS-ODNs) directed against the AUG start region of the cd4 gene. The aim of the present study was to inhibit CD4 expression in lymphocytes without promoting CD4 synthesis and to determine the effect of this inhibition on CD4+ T cell function. Four 21-mer ODNs against the rat cd4 gene (AS-CD4-1 to AS-CD4-4) were used. Surface CD4 expression was measured by immunofluorescence staining and flow cytometry, and mRNA CD4 expression was measured by RT-PCR. T CD4+ cell function was determined by specific and unspecific proliferative response of rat-primed lymphocytes. After 24 hours of incubation, AS-CD4-2 and AS-CD4-4 reduced lymphocyte surface CD4 expression by 40%. This effect remained for 72 hours and was not observed on other surface molecules, such as CD3, CD5, or CD8. CD4 mRNA expression was reduced up to 40% at 24 hours with AS-CD4-2 and AS-CD4-4. After 48 hours treatment, CD4 mRNA decreased up to 27% and 29% for AS-CD4-2 and AS-CD4-4, respectively. AS-CD4-2 and AS-CD4-4 inhibited T CD4+ cell proliferative response upon antigen-specific and unspecific stimuli. Therefore, AS-ODNs against CD4 molecules inhibited surface and mRNA CD4 expression, under physiologic turnover and, consequently, modulate T CD4+ cell reactivity.

CD4 expression decrease by antisense oligonucleotides. Inhibition of rat T CD4+ cell reactivity

In previous studies, we have demonstrated the inhibition of CD4 expression in rat lymphocytes treated with phorbol myristate acetate (PMA) by antisense oligonucleotides (AS-ODNs) directed against the AUG start region of the cd4 gene. The aim of the present study was to inhibit CD4 expression in lymphocytes without promoting CD4 synthesis and to determine the effect of this inhibition on CD4+ T cell function. Four 21-mer ODNs against the rat cd4 gene (AS-CD4-1 to AS-CD4-4) were used. Surface CD4 expression was measured by immunofluorescence staining and flow cytometry, and mRNA CD4 expression was measured by RT-PCR. T CD4+ cell function was determined by specific and unspecific proliferative response of rat-primed lymphocytes. After 24 hours of incubation, AS-CD4-2 and AS-CD4-4 reduced lymphocyte surface CD4 expression by 40%. This effect remained for 72 hours and was not observed on other surface molecules, such as CD3, CD5, or CD8. CD4 mRNA expression was reduced up to 40% at 24 hours with AS-CD4-2 and AS-CD4-4. After 48 hours treatment, CD4 mRNA decreased up to 27% and 29% for AS-CD4-2 and AS-CD4-4, respectively. AS-CD4-2 and AS-CD4-4 inhibited T CD4+ cell proliferative response upon antigen-specific and unspecific stimuli. Therefore, AS-ODNs against CD4 molecules inhibited surface and mRNA CD4 expression, under physiologic turnover and, consequently, modulate T CD4+ cell reactivity.

A probable dual mode of action for both L- and D-lactate neuroprotection in cerebral ischemia.

Lactate has been shown to offer neuroprotection in several pathologic conditions. This beneficial effect has been attributed to its use as an alternative energy substrate. However, recent description of the expression of the HCA1 receptor for lactate in the central nervous system calls for reassessment of the mechanism by which lactate exerts its neuroprotective effects. Here, we show that HCA1 receptor expression is enhanced 24 hours after reperfusion in an middle cerebral artery occlusion stroke model, in the ischemic cortex. Interestingly, intravenous injection of L-lactate at reperfusion led to further enhancement of HCA1 receptor expression in the cortex and striatum. Using an in vitro oxygen-glucose deprivation model, we show that the HCA1 receptor agonist 3,5-dihydroxybenzoic acid reduces cell death. We also observed that D-lactate, a reputedly non-metabolizable substrate but partial HCA1 receptor agonist, also provided neuroprotection in both in vitro and in vivo ischemia models. Quite unexpectedly, we show D-lactate to be partly extracted and oxidized by the rodent brain. Finally, pyruvate offered neuroprotection in vitro whereas acetate was ineffective. Our data suggest that L- and D-lactate offer neuroprotection in ischemia most likely by acting as both an HCA1 receptor agonist for non-astrocytic (most likely neuronal) cells as well as an energy substrate.

Ésteres triterpênicos de Himatanthus sucuuba (Spruce) Woodson

Bioactivity-guided fractionation from hexane extract of Himatanthus sucuuba barks utilizing Cladosporium sphaerospermum led to the isolation of iridoids plumericin and isoplumericin, which showed higher inhibition against C. sphaerospermum than the antibiotic nistatin. Besides bioactive iridoids were isolated the inactive triterpenes lupeol cinnamate, alpha-amyrin cinnamate and lupeol acetate.

Triterpenos esterificados com ácidos graxos e ácidos triterpênicos isolados de Byrosonima microphylla

The hexane extract of leaves of B. microphylla afforded a mixture of triterpenes esterified with fatty acids. Analyses of spectral data of the mixture and of the derivatives obtained by a transesterification reaction with NaOMe/MeOH permitted to identify the composition of the mixtures as being 24-hydroxy-urs-12-enyl 3b-eicosanate, estearate and palmitate as well as of the 24-hydroxy-olean-12-enyl 3b-eicosanate, estearate and palmitate. From the choroform and ethyl acetate extracts were isolated the oleanolic and 3b,24-dihydroxy-urs-12-en-28-oic acids, quercetin and methyl galic ester, respectively. The compounds were identified through analysis of their spectral data.

Propriedades e aplicações de clusters trinucleares de carboxilatos de rutênio

A review with 94 references focusing on mu3-oxo-triruthenium carboxylate clusters is presented. The electronic, magnetic, electrochemical, and catalytic properties of these compounds are discussed. Main synthetic routes and structural characteristics, including their use as building blocks in supramolecular systems are described.

Combinación de sistemas de flujo de baja y alta presion para la determinacion de Mg, Ca y Sr en salmueras por espectrofotometria de absorcion atomica con llama

This article describes the combination of low- and high-pressure flow systems for the determination of Magnesium, Calcium and Strontium by flame atomic absorption spectrometry (FAAS). In the low-pressure system a short C-18 RP column (length 0,5 cm) was utilized for the preconcentration/matrix separation step, xylenol orange was used as chelating agent and tetrabutylamonium acetate for ion pair formation. The hydraulic high pressure nebulization (HHPN) was used for sample transport and sample introduction in the high pressure system. The repeatabilities and detection limits for Mg, Ca and Sr were determined and compared with those obtained by pneumatic nebulization (PN). The results show that the detection limits obtained using the HHPN for Mg, Ca and Sr are between 1.5 to 2 times better than those obtained by PN when the signal transient was measured in area. The system presented a sampling frequency of 130 h-1 for direct determination of Mg, Ca or Sr in samples of saturated sodium chloride used in the production of chlorine and sodium hydroxide.

Uma célula eletroquímica de fluxo para modificação permanente de tubo de grafite empregado em absorção atômica

A flow cell assembled on the original geometry of a graphite tube to achieve permanent chemical modifier is proposed. The graphite tube operates as the working electrode. A stainless steel tube, positioned downstream from the working electrode, was used as the auxiliary electrode. The potential value applied on the graphite electrode was measured against a micro reference electrode (Ag/AgCl) inserted into the auxiliary electrode. Palladium solutions in acetate buffer (100 mmol L-1, pH = 4.8), flowing at 0.5 mL min-1 for 60 min was used to perform the electrochemical modification. A mercury solution (1 ng) was used to evaluate the performance of the permanent palladium modifier.