Gastric intramucosal pH is stable during titration of positive end-expiratory pressure to improve oxygenation in acute respiratory distress syndrome

BACKGROUND: Optimal positive end-expiratory pressure (PEEP) is an important component of adequate mechanical ventilation in acute lung injury and acute respiratory distress syndrome (ARDS). In the present study we tested the effect on gastric intramucosal pH of incremental increases in PEEP level (i.e. PEEP titration) to improve oxygenation in ARDS. Seventeen consecutive patients with ARDS, as defined by consensus criteria, were included in this clinical, prospective study. All patients were haemodynamically stable, and were not receiving vasopressors. From an initial level of 5 cmH(2)O, PEEP was titrated at 2 cmH(2)O increments until the partial arterial oxygen tension was 300 mmHg or greater, peak airway pressure was 45 cmH(2)O or greater, or mean arterial blood pressure decreased by 20% or more of the baseline value. Optimal PEEP was defined as the level of PEEP that achieved the best oxygenation. The maximum PEEP was the highest PEEP level reached during titration in each patient. RESULTS: Gastric mucosal pH was measured using gastric tonometry at all levels of PEEP. The thermodilution technique was used for measurement of cardiac index. Gastric mucosal pH was similar at baseline and at optimal PEEP levels, but it was slightly reduced at maximum PEEP. Cardiac index and oxygen delivery remained stable at all PEEP levels. CONCLUSION: Incremental titration of PEEP based on improvement in oxygenation does not decrease gastric intramucosal perfusion when cardiac output is preserved in patients with ARDS

Nutritional composition, extraction, and utilization of wheat germ oil: A review

Wheat germ is a by-product of wheat milling from which wheat germ oil (WGO) can be obtained using different techniques. For a better quality WGO, techniques such supercritical fluid fractionation, molecular distillation, and other innovative methods can be adopted. WGO is composed of nonpolar lipids, glycolipids, phospholipids, alcohols, esters, alkene, aldehydes, tocopherols, n-alkanols, sterols, 4-methyl sterols, triterpenols, hydrocarbons, pigments, and volatile components. The most abundant WGO fatty acid is linoleic acid which composes 42–59% of total triglycerides followed by palmitic (16:0) and oleic acids (18:1). The stearic acid, a saturated fatty acid, is usually less than 2%. WGO is rich in tocopherols particularly vitamin E. It contains a-tocopherol and b-tocopherol which gives various health benefits to it. It is being used in medicine, cosmetic, agricultural, and food industry. Some of its applications include production of vitamins and food supplements, animal feed and biological insect control and for treating circulatory/cardiac disorders and weaknesses. More studies are required for producing better quality WGO such as application of more innovative and optimized techniques that can increase its health benefits and hence utilization. More mechanistic approaches for extraction, evaluation, and utilization of WGO can help in making this by-product of wheat processing more valuable

Mycophenolate mofetil-induced pseudotumor cerebri in a boy with autoimmune lymphoproliferative disease

Pseudotumor cerebri (PTC) is a syndrome characterized with increased intracranial pressure, normal cerebrospinal fluid content (CSF), and a normal brain on imaging studies. In this case report, PTC has been linked to mycophenolate mofetil (MMF) that has been used for autoimmune lymphoproliferative syndrome (ALPS).INTRODUCTION: Pseudotumor cerebri (PTC) is a syndrome characterized with increased intracranial pressure, normal cerebrospinal fluid content (CSF), and a normal brain on imaging studies. In this case report, PTC has been linked to mycophenolate mofetil (MMF) that has been used for autoimmune lymphoproliferative syndrome (ALPS).CASE REPORT: A 5-year-old boy, who was using MMF for 4 months because of the ALPS, suffered from occipital headache and vomiting with no other symptom. The initial physical examination was normal expect bilateral papilledema. The patient underwent a lumbar puncture which showed elevated opening pressure (590 mmH²O) but no laboratory abnormalities of the CSF. A diagnosis of PTC was established. MMF was stopped, and the child was started on an acetazolamide treatment for 2 weeks. His symptoms and complaints recovered after this treatment.DISCUSSION: According to our knowledge, we report the first case of MMF-induced PTC in a boy with ALPS. This case illustrates that despite the rarity of MMF-induced PTC, the physicians should be aware of this possibility. Furthermore, in the setting of new-onset headaches or visual changes, early ophthalmologic examination for papilledema is recommended for early diagnosis.PMID:21305306[PubMed - indexed for MEDLINE

Chemical Composition of The Essential Oil of The Flowers and Leaves of Calba Tea (Dorystoechas hastata Boiss & Helder. ex Bentham)

WOS: 000381628100034The essential oils of flower and leaves of Dorystoechas hastata Boiss & Helder. ex Bentham, grown in Turkey, was obtained by hydrodistillation and analysed by GC and GS-MS. Fourty components were identified in the flowers oil, which represented about 93.97 % of the total composition of the oil. The major constituents of the flower essential oil were myrcene (19.37 %), 1,8-cineole (14.30 %), beta-pinene (9.19 %), alpha-pinene (8.49 %) and beta-caryophyllene (6.18 %). Thirty-seven components were established in the leaves oil, making up 97.16 % of the total composition. The main constituents of the essential oil of the leaves were myrcene (20.71 %), 1,8-cineole (18.76 %), beta-pinene (12.51 %), alpha-pinene (8.54 %), bornyl acetate (7.28 %) and terpinene-4-ol (6.19 %). As seen, myrcere, 1,8-cineole and beta-pinene for both oils were the main components.Selcuk University Coordination of Scientific Research Projects (S.U.-BAP, Konya-Turkey)This study was supported by Selcuk University Coordination of Scientific Research Projects (S.U.-BAP, Konya-Turkey)

Chemical Composition and Antifungal Activity of Lavender (Lavandula stoechas) Oil

The essential oil of Lavandula stoechas was examined by GC and GC-MS. Discs (5 mmi.d.) of the tested fungi (Alternaria alternata, Fusarium oxysporum and Botritys cinerea) were inoculated separately onto each assay plate and incubated at 25 degrees C for 7 days. The oil yield of dried parts (v/dw) obtained by hydro distillation was 2.9%. Thirty-two compounds representing 98.3% of the essential oil were determined. Linalool (49.9%), linalyl acetate (14.4%), lavandulyl acetate (5.7%), alpha-terpineol (5.6%), terpinene-4-ol (5.1%), lavandulol (3.7%), (E)-beta-ocimene (2.6%) and (Z)-beta-ocimene (2.4%) were identified as the main constituents of the oil. In addition, both doses of the lavender oil showed varying levels of inhibitory effects on the mycelial growth of tested fungi used in the experiment. The results demonstrated the strongest effect on B.cinerea, followed by A.alternata and F.oxysporum. The inhibitory effect is probably dependent on the concentration of essential oils

Chemical Composition and Antifungal Activity of Lavender (Lavandula stoechas) Oil

The essential oil of Lavandula stoechas was examined by GC and GC-MS. Discs (5 mmi.d.) of the tested fungi (Alternaria alternata, Fusarium oxysporum and Botritys cinerea) were inoculated separately onto each assay plate and incubated at 25 degrees C for 7 days. The oil yield of dried parts (v/dw) obtained by hydro distillation was 2.9%. Thirty-two compounds representing 98.3% of the essential oil were determined. Linalool (49.9%), linalyl acetate (14.4%), lavandulyl acetate (5.7%), alpha-terpineol (5.6%), terpinene-4-ol (5.1%), lavandulol (3.7%), (E)-beta-ocimene (2.6%) and (Z)-beta-ocimene (2.4%) were identified as the main constituents of the oil. In addition, both doses of the lavender oil showed varying levels of inhibitory effects on the mycelial growth of tested fungi used in the experiment. The results demonstrated the strongest effect on B.cinerea, followed by A.alternata and F.oxysporum. The inhibitory effect is probably dependent on the concentration of essential oils

Antifungal activities of different essential oils against anise seeds mycopopulations

The aim of this study was to investigate the possibility of biological control of fungal species isolated from anise seeds using essential oils from medicinal plants: mint (Mentha spicata L.), sage (Salvia fruticosa L.), rosemary (Rosmarinus officinalis L.), anise (Pimpinella anisum L.), bitter fennel (Foeniculum vulgare spp. piperituum L.) and myrtle (Myrtus communis L.). Ten fungal species isolated from anise seeds: Bipolaris/Drechslera sorociniana, Fusarium subglutinans, F. vertricilioides, F. oxysporum, F. tricinctum, F sporotrichioides, F. equiseti, F. incarnatum, F proliferatum and Macrophomina phaseolina, were used in this experiment The minimum inhibitory concentrations (MIC) were determined by micro-dilution method using selected essential oils (EOs). A qualitative and quantitative chemical analyses of EOs were carried out. All EOs exhibited a significant antifungal activity against all tested fungal isolates. The myrtle EO proved to be the most potent one (MIC 0.0003-3.25 mg/mL, then mint 0.0003-7.75 mg/mL and sage 0.0003-10 mg/mL). All tested fungi were observed to have a susceptibility to all selected essential oils. These results suggest the possibility for application of the EOs in biological control of anise production

Physicochemical properties, fatty acids, phenolic compounds, and mineral contents of 12 Serbia regional and commercial almond cultivars

The oil contents of almond kernels were determined between 37.60% (Selection 25) and 49.10% (Tuono). Total carotenoid and total flavonoid contents of almond kernels varied between 0.21 mu g/g (Nessebar) and 1.85 mu g/g (Teteny Botermo) to 44.75 mg/100 g (Selection 25) and 479.13 mg/100 g (Teteny Rekord), respectively. In addition, total phenolic contents and antioxidant activity values of almond kernels changed between 6.04 mg GAE/100 g (Ne Plus Ultra) and 83.19 mg GAE/100 g (Teteny Rekord) to 4.55% (Selection 25) and 90.15% (Teteny Rekord), respectively. Oleic acid contents of almond kernel oils were determined between 61.39% (Ne Plus Ultra) and 73.51% (Texas), linoleic acid contents of oil samples varied between 16.02% (Masbovera) and 30.60% (Ne Plus Ultra). Gallic acid, 3,4-dihydroxybenzoic acid, (+)-catechin, 1,2-dihydroxybenzene, syringic acid, caffeic acid, and quercetin were the key phenolic constituents of kernels showed partly differences depending on almond varieties. Almond kernels are rich in K, P, Ca, Mg, Na, and S elements. Practical applications Almonds are used as ingredients in a variety of processed foods such as bakery and confectionery products, almond milk, and almond fermented milk. The roasted almond kernels used in desserts, salads, and ice-creams is a popular snack in Turkey. Almonds are considered to be a valuable source of plant proteins in the human diet. Almonds have recognized health benefits, due to high fatty acids, phenolics, and proteins. The most important unsaturated fatty acids of almond oils are oleic and linoleic acids. Phenolic compounds comprise a large and heterogeneous group of secondary plant metabolites distributed widely throughout the plant kingdom