Medicinal properties of Thymus vulgaris essential oil: a review

Globally, the interest in essential oils has been steadily increasing over the last decades due to their beneficial health effects and the wide range of applications that are directly linked to a variety of pharmacological and biological activities. Thymus vulgaris L., also called common or garden thyme is a small perennial herb, which has been used over the years as food additive, but also as a valuable cure in several pathologies. It is believed that the medicinal properties of Thymus vulgaris are attributed to its essential oil, which is a mixture of monoterpenes. Moreover, the therapeutic properties of this essential oil are due to its main compounds, namely the terpenoid thymol and its phenol isomer carvacrol. Several investigations have indicated that thyme oil possesses strong antiseptic, antimicrobial, antifungal, antioxidant effects and therefore, all the aforementioned features make this essential oil a promising remedy in human and veterinary medicine fields. The aim of the present study was to review and highlight the medicinal attributes of Thymus vulgaris essential oil, apart from its nutritional value, in order to identify novel alternative cures in the treatment of both humans and animals diseases

Evaluation of the therapeutic potential of some apicultural products with essential oils for cutaneous wounds in cats and dogs

Honey represents a valuable product, which has been widely used for its therapeutic benefits in various disease conditions. Moreover, honeydew honey has been scientifically recognised for its antioxidant, anti- microbial and wound healing properties and it is used clinically, as a topical treatment for wound infections. In addition to this, a plethora of studies have revealed that propolis, sea buckthorn essential oil and thyme essential oil are basic aids in the treatment of wounds and other skin conditions. The aim of the present research was to determine the clinical effectiveness of two natural dressings, based on honeydew honey, combined either with soft propolis extract and thyme essential oil, either with sea buckthorn essential oil, with the purpose of minimizing the antibioresistance phenomenon within the small animal clinics. Their therapeutic value has been evaluated in feline and canine distinct types of cutaneous wounds, by topical application. The honeydew honey, soft propolis extract and sea buckthorn essential oil were provided by "Apilife Sibiu" company, located in Romania, while the thyme essential oil was purchased from "Young Living" company. The products were applied on uncomplicated acute and complicated cutaneous wounds in dogs and cats. In the treatment of six patients with uncomplicated acute wounds, we found an inceased efficacy of the dressing containing honeydew honey and sea buckthorn essential oil, while in the treatment of six patients with complicated cutaneous wounds, the dressing based on honeydew honey, soft propolis extract and thyme essential oil has proven to be highly effective. All in all, based on the results obtained in conjunction with other studies in the field, we recommend the implementation of apicultural products with addition of essential oils in the prevention and therapy of various forms of cutaneous wounds in animals

Recent advances and emerging therapies in anaplastic thyroid carcinoma [version 1; referees: 3 approved]

Anaplastic thyroid cancer is a rare and aggressive thyroid cancer with an overall survival measured in months. Because of this poor prognosis and often advanced age at presentation, these patients have traditionally been treated palliatively and referred for hospice. However, recent progress using novel therapies has energized the field, and several promising clinical trials are now available for these patients. This review will highlight this progress and the potential treatments that could pave the way to improved outcomes and quality of life for patients with this disease

Salvage pembrolizumab added to kinase inhibitor therapy for the treatment of anaplastic thyroid carcinoma

Abstract Background Anaplastic thyroid carcinoma (ATC) is a rare but deadly form of thyroid cancer. Kinase inhibitors kinase inhibitors have shown clinical efficacy in the management of ATC, however, eventually these tumors acquire resistance to KI and patients succumb to their disease. Salvage therapy in this setting is limited. As ATC tumors diffusely express the programmed cell death protein ligand (PD-L1), anti- programmed cell death protein (PD-1) drugs such as pembrolizumab offer therapeutic potential. We sought to explore the efficacy of adding pembrolizumab to kinase inhibitors at progression in ATC. Methods We retrospectively reviewed the charts of ATC patients initiated on pembrolizumab in combination with KI at the time of progression on kinase inhibitors at MD Anderson Cancer Center between August 2016 and August 2017. Efficacy was evaluated with best overall response (BOR) using RECISTv1.1 criteria. Progression free survival (PFS) from the start of pembrolizumab and overall survival (OS) from the start of kinase inhibitors, as well as from the time of addition of pembrolizumab were calculated. Results Twelve patients were treated with combination kinase inhibitors plus pembrolizumab at the time of progression on their KI therapy. Median age at initiation of pembrolizumab was 60 years (range 47–84 years). BOR was as follows: 5/12 (42%) had partial response, 4/12 (33%) had stable disease and 3/12 (25%) had progressive disease. Median OS from the start of kinase inhibitor was 10.43 months (95% CI = 6.02, 14.83, range 5.4–40 months). Median OS and PFS from the addition of pembrolizumab were 6.93 months (95% CI = 1.7, 12.15, range 3–15.9 months) and 2.96 months (95% CI = 2.2, 3.7, range 0.57–13.14 months), respectively. Fatigue, anemia and hypertension were the most common AEs encountered on these combinations. Therapy had to be discontinued in 2 patients due to drug induced rash and altered mental status likely from progression of disease. Conclusion In a subset of ATC patients, pembrolizumab may be an effective salvage therapy added to kinase inhibitors at the time of progression on these drugs. However, better treatment strategies aimed at incorporating immunotherapy in patients with ATC should be explored. Frontline combination of KI with immunotherapy should be studied in prospective clinical trials

Additional file 2: of Salvage pembrolizumab added to kinase inhibitor therapy for the treatment of anaplastic thyroid carcinoma

Figure S1. Patient number 10 who had a PR with a tumor regression of 47% on the combination of pembrolizumab and lenvatinib continues to have a response at the time of data analysis. Axial post contrast CT images through the chest demonstrates right lower lobe pulmonary nodule (red arrow) and pleural based left lower lobe nodularity (yellow arrow) on baseline scan(A) with treatment response on subsequent follow up imaging at 5 months (B) and 8 months (C). (PDF 256 kb

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London