Sedation with alfentanil and propofol for rhizotomies

Background: Patient safety during sedation for closed rhizotomies is improved when analgesia is optimised, rather than relying on deep sedation for patient comfort. This retrospective study determined the appropriate effect-site concentration (Ce) for alfentanil, in combination with a constant propofol infusion, for optimal pain control during sedation for closed rhizotomies. Airway maintenance is ensured by keeping patients responsive to verbal commands, albeit at the price of inevitable ventilatory depression.Method: The records of patients who received rhizotomies over a six-month period were studied retrospectively. Sixty-three outpatients were included. Patients rated the level of analgesia with each needle placement. If the Ce for alfentanil was adequate, it was kept constant. Otherwise, it was increased in 5 ng/ml increments with each needle placement until analgesia was effective, or up to the maximum Ce for alfentanil of 100 ng/ml. Propofol infusion at a constant Ce of 200 ng/ml was added.Results: Forty-eight per cent of patients reported being comfortable at a Ce for alfentanil of 70–75 ng/ml. Only 5% of patients requested the maximum Ce for alfentanil of 100 ng/ml. All of the patients experienced ventilatory depression, but a patent airway was maintained. The haemodynamic observations were within normal limits. According to the ward records, 16% of the patients complained of nausea, and there was one incident of vomiting.Conclusion: Combining alfentanil at a Ce for alfentanil of 70–100 ng/ml with propofol at 200 ng/ml is a safe and effective method for analgesia during sedation for closed rhizotomies.Keywords: alfentanil, analgesia, procedural sedation, propofol, rhizotomy, target-controlled infusio

The anti-inflammatory properties of humic substances : a mini review

Humic substances are effective in the suppression of delayed type hypersensitivity, rat paw oedema, a graftversus- host reaction and contact hypersensitivity in rats. They reduce the C-reactive protein levels of patients suffering from osteoarthritis of the knee and the wheel and flare reaction of patients suffering from hay fever. They have also been described as cardioprotective and pro-angiogenic. Toxicity studies have indicated that potassium humate is safe in humans up to a daily dosage of 1 g/kg, whereas fulvic acid is safe in humans up to a daily dosage of 1.8 g per adult. The antiinflammatory action of potassium humate can be contributed to the inhibition of the release of inflammatory-related cytokines, an adhesion molecule, oxidants and components of the complement system.http://onlinelibrary.wiley.com/journal/10.1002/(ISSN)1099-15732016-06-30hb2016School of Health Systems and Public Health (SHSPH

Lignocellulose biotechnology: issues of bioconversion and enzyme production

This review is written from the perspective of scientists working in lignocellulose bioconversion in a developing country and the aim of this review is to remind ourselves and other scientists working in related areas of lignocellulose research of the enormous economic potential of the bioprocessing of residual plant materials generally regarded as “waste”, and secondly to highlight some of the modern approaches which potentially could be used to tackle one of the major impediments, namely high enzyme cost, to speed-up the extensive commercialisation of the lignocellulose bioprocessing. Key words: lignocellulose, bioconversion, enzyme cost. African Journal of Biotechnology Vol. 2 (12), pp. 602-619, December 200

Production, purification and characterization of celullase-free xylanase from Aspergillus terreus UL 4209

Aspergillus terreus, UL 4209 strain, isolated from the soil in South Africa was used to produce an extracellular cellulase-free xylanase in shake flask cultures containing oat spelt and/or birchwoodxylans. Maximum xylanase activity (35 U/ml) was observed after 96 h at 35ºC and pH 6 in 1% oat spelt xylan. The xylanase was purified to homogeneity by gel filtration on Sephacryl S-200. This enzyme wasfound to be a single subunit protein of 22 kDa showing optimal activity at 35ºC and pH 6. The enzyme retained 95% activity at 35 - 40ºC after 4 h incubation at pH 6 and at 50ºC the half-life was 5.8 h. Theapparent Km and Vmax values were 3.57 mg/ml and 55.5 mol/min per mg protein, respectively. MALDITOF and LC mass spectroscopy gave 8 peptide ions whose sequence alignments showed that thexylanase produced by this strain has homology with those of other Aspergillus strains such as A. terreus and A. versicolor. These observations showed that our strain produced a low molecular weight,acidophilic, and thermostable xylanase that may be considered for processes operated at moderate temperatures and pH such as preparation of baked cereal food, clarification of fruit juices andsaccharification of agro-residues

An observational trial : patient profile of users of Secomet V®

Subsequent to a report published by Natasha Bolognesi in Nature Medicine in 2006 on a “herbal” product called Secomet V® researchers of the University of Pretoria undertook an observational trial to document the demographics, quality of life and disease profile of patients who purchase Secomet V®, a product that contains selenium, L-glutamin and high levels of a carbohydrate derived fulvic acid (CHD-FA). No traces of any plant extracts could be found in the product

A comparison of the leaf gel extracts of Aloe ferox and Aloe vera in the topical treatment of atopic dermatitis in Balb/c mice

Aloe vera gel is widely used in the treatment of an array of disturbances, especially skin disorders. The wound-healing effects have been attributed to its moisturizing and anti-inflammatory effects as well as its beneficial effect on the maturation of collagen. The aim of the present study is to compare the effects of topically applied extracts of Aloe ferox with that of Aloe vera on the symptoms as well as IgE levels of a mouse model of atopic dermatitis (AD). Mice were sensitized and challenged with 2,4-dinitrochlorobenzene and treated afterwards for 10 consecutive days with the gels of either A. ferox or A. vera applied topically to the affected areas. A placebo gel was used for the control mice. Blood was collected at the beginning and end of the treatment period to measure serum IgE levels. Although the gels of both the Aloe species inhibited the cutaneous inflammatory response as well as serum IgE levels in the rats, the extracts of A. ferox were superior to that of A. vera in reducing IgE levels. The gels of A. ferox and A. vera, applied topically, may be a safe and useful alternative to antihistamines and topical corticosteroids, for the treatment of patients suffering from recurring chronic AD.Grant from the House of Aloes, Albertinia, SouthAfricahttp://link.springer.com/journal/107872016-12-30hb201

Development of the Pneumococcal Genome Library, a core genome multilocus sequence typing scheme, and a taxonomic life identification number barcoding system to investigate and define pneumococcal population structure

Investigating the genomic epidemiology of major bacterial pathogens is integral to understanding transmission, evolution, colonisation, disease, antimicrobial resistance, and vaccine impact. Furthermore, the recent accumulation of large numbers of whole genome sequences for many bacterial species enhances the development of robust genome-wide typing schemes to define the overall bacterial population structure and lineages within it. Using previously published data, we developed the Pneumococcal Genome Library (PGL), a curated dataset of 30,976 genomes and contextual data for carriage and disease pneumococci recovered between 1916-2018 in 82 countries. We leveraged the size and diversity of the PGL to develop a core genome multilocus sequence typing (cgMLST) scheme comprised of 1,222 loci. Finally, using multilevel single-linkage clustering, we stratified pneumococci into hierarchical clusters based on allelic similarity thresholds, and defined these with a taxonomic life identification number (LIN) barcoding system. The PGL, cgMLST scheme, and LIN barcodes represent a high-quality genomic resource and fine-scale clustering approaches for the analysis of pneumococcal populations, which support the genomic epidemiology and surveillance of this leading global pathogen. Impact statement Many thousands of pneumococcal genomes are available in the public domain, and this creates opportunities for the scientific community to re-use existing data; however, these data are most useful when the contextual data (provenance and phenotype) are also linked to the genomes. Therefore, we created a curated, open-access database in PubMLST that contained nearly 31,000 published pneumococcal genomes and the corresponding contextual data for each genome. This large and diverse pneumococcal database was used to create a novel cgMLST scheme and multilevel clustering method to define genetic lineages with high resolution and a standardised nomenclature. These are open-access resources for all to use and provide a unified framework for the characterisation of global pneumococcal populations

Antibiotic resistance profiles and relatedness of enteric bacterial pathogens isolated from HIV/AIDS patients with and without diarrhoea and their household drinking water in rural communities in Limpopo Province South Africa

Antibiotic resistance profiles and the correlation of enteric bacterial pathogens from HIV positive individuals with and without diarrhoea and their household drinking water were determined using the KirbyBauer disk diffusion and polymerase chain reaction methods respectively. The sef gene of Salmonella enteritidis was amplified with the primer pair sefA-1 and sefA-2. The fliC gene of Salmonella typhimurium was amplified with the primer pair flicA-1 and flicA-2. Heat-labile toxin (LT) primers (Lta and LTb) were used to amplify Escherichia coli isolates and VirA1 and VirA2 for the Vir A gene of Shigella dysenteriae. Results of antibiotic resistance profiles of enteric bacterial pathogens isolated from stool samples of HIV positive and negative individuals with and without diarrhea and their household drinking water showed very similar drug resistance patterns. Over 90% of all the organisms isolated from the various study cohorts showed resistance to penicillin, cloxacillin and amoxicillin. Conversely, almost all the organisms were sensitive to ciprofloxacin, gentamycin, meropenem and imipenem. About 50% of E. coli isolated from the various study cohorts showed multiple antibiotic resistance to penicillin, amoxicillin, ampicillin, erythromycin, tetracycline, doxycycline and cotri-moxazole ( PR, AR, APR, ER, TR, DXTR, and TSR ) whereas less than 10% resistance was consistently reported for ofloxacin, gentamycin, meropenem cefotaxime, cefuroxime and imipenem ( OFXS, GMS, MEMS, CTXS, CXMS and IMIS ). The majority of Salmonella and Shigella isolates from all the groups were sensitive to ciprofloxacin, gentamicin, amikacin, meropenem, imipenem, nalidixic acid, kanamycin, piperacillin-tazo bactam, cefuroxime, doxycyclin, cefepime and ceftazidime (CIPS, GMS, AKS, MEMS, IMIS, NAS, KNS, DXTS, CXMS, CPMS, CAZS and PTZS). For Campylobacter, over 30% of the isolates were resistant to erythromycin, ampicillin, tetracycline,cotrimoxazole and ceftazidime (ER, APR TSR and CAZR) whereas over 85% were susceptible to ciprofloxacin, ofloxacin, gentamycin, amikacin, mero-penem, and nalidixic acid (CIPS, OFXS, GMS, AKS,MEMS and NAS). In addition to penicillin, amoxicillin, ampicillin and erythromycin, Aeromonas and Plesiomonas spp were more resistant to chloramphenicol, but were susceptible to ciprofloxacin, gentamycin, amikacin, meropenem, imipenem and nalidixic acid (CIPS, GMS, AKS, MEMS, IMIS and NAS). Polymerase Chain Reaction (PCR) experiments using targeted species genes of S. enteritidis, S. typhimurium, E. coli, Sh. dysenteriae showed that isolates from stool samples of HIV positive and HIV negative individuals with and without diarrhoea were also present in the household drinking water of the same study cohorts, suggesting that drinking water may have been the sources of the organisms in stool sample. Furthermore, by showing that the primers were able to amplify the genes in both clinical and environmental isolates, the link between the virulence of the pathogens was established

Genomic Analyses of >3,100 Nasopharyngeal Pneumococci Revealed Significant Differences Between Pneumococci Recovered in Four Different Geographical Regions.

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked DownloadUnderstanding the structure of a bacterial population is essential in order to understand bacterial evolution. Estimating the core genome (those genes common to all, or nearly all, strains of a species) is a key component of such analyses. The size and composition of the core genome varies by dataset, but we hypothesized that the variation between different collections of the same bacterial species would be minimal. To investigate this, we analyzed the genome sequences of 3,118 pneumococci recovered from healthy individuals in Reykjavik (Iceland), Southampton (United Kingdom), Boston (United States), and Maela (Thailand). The analyses revealed a "supercore" genome (genes shared by all 3,118 pneumococci) of 558 genes, although an additional 354 core genes were shared by pneumococci from Reykjavik, Southampton, and Boston. Overall, the size and composition of the core and pan-genomes among pneumococci recovered in Reykjavik, Southampton, and Boston were similar. Maela pneumococci were distinctly different in that they had a smaller core genome and larger pan-genome. The pan-genome of Maela pneumococci contained several >25 Kb sequence regions (flanked by pneumococcal genes) that were homologous to genomic regions found in other bacterial species. Overall, our work revealed that some subsets of the global pneumococcal population are highly heterogeneous, and our hypothesis was rejected. This is an important finding in terms of understanding genetic variation among pneumococci and is also an essential point of consideration before generalizing the findings from a single dataset to the wider pneumococcal population.Wellcome Trust Biomedical Research Fund award Wellcome Trust Research Fellowship University of Oxford John Fell Fund award Wellcome Trust Eimskipa University Fund GlaxoSmithKline Biologicals SA Landspitali University Hospital Research Fun