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Antibacterial Activity of Hypericum Erectum</i
Abstract
In recent years, the potential of oral care in preventing aspiration pneumonia has been recognized. Consuming drinks is thought to be an easy and effective method of oral care, and the antibacterial activities of various drinks have been examined. However, the side effects associated with, for example, caffeine as an ingredient in tea (e.g. sleep disorders) need to be taken into consideration. As yet, a safe caffeine-free tea to be taken orally to prevent aspiration pneumonia has not been reported. Thus, in the present study we evaluated the antibacterial effects of hot water extracts of four teas, namely Hypericum Erectum, Crataegus cuneata, Rosa canina, and Matricaria rectita, thought to be caffeine-free. The effects of the extracts against 19 bacteria and 1 fungus were investigated by the dilution plate technique. In addition, the components of the teas were analyzed by HPLC analysis. The strongest antibacterial activity was observed for the hot water extract of H. erectum, which exhibited significant activity against oral bacteria, including Streptococcus oralis. However, the H. erectum extract did not kill microbiota, such as Escherichia coli and Lactobacillus casei. Neither hypericin nor caffeine, both of which have notable side effects, were detected in the H. erectum extract following HPLC analysis. These results suggest that H. erectum tea may be a good candidate for simple, safe oral care to prevent aspiration pneumonia in the elderly.
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Hypericin is a natural photosensitizer used in photodynamic therapy (PDT), which has shown in vitro antifungal effect against Candida spp. The aim of this study was to evaluate the in vitro fungicidal effect of hypericin-PDT on dermatophytes. Trichophyton rubrum and Trichophyton mentagrophytes strains were incubated with different concentrations of hypericin for different times and exposed to light-emitting diode lamp (602 ± 10 nm, 10.3 mW cm(-2), and fluence 37 J cm(-2)). Using the optimal incubation time, 60 min, a 3-log fungicidal effect was achieved with hypericin concentration ranges of 10-20 μM for T. rubrum and 20-50 μM for T. mentagrophytes (p = 0.95). Confocal fluorescence microscopy showed the localization of hypericin inside the dermatophytes diffusely distributed in the cytoplasm of conidia and hyphae and outside the nucleus. In conclusion, hypericin-PDT has a fungicidal effect in vitro on dermatophytes. Hypericin seems to be a promising photosensitizer to treat localized dermatophytic infections such as tinea pedis and onychomycosis.
Background
Pregnant women consume caffeine daily. The aim of this study was to examine the association between maternal caffeine intake from different sources and (a) gestational length, particularly the risk for spontaneous preterm delivery (PTD), and (b) birth weight (BW) and the baby being small for gestational age (SGA).
Methods
This study is based on the Norwegian Mother and Child Cohort Study conducted by the Norwegian Institute of Public Health. A total of 59,123 women with uncomplicated pregnancies giving birth to a live singleton were identified. Caffeine intake from different sources was self-reported at gestational weeks 17, 22 and 30. Spontaneous PTD was defined as spontaneous onset of delivery between 22+0 and 36+6 weeks (n = 1,451). As there is no consensus, SGA was defined according to ultrasound-based (Marsal, n = 856), population-based (Skjaerven, n = 4,503) and customized (Gardosi, n = 4,733) growth curves.
Results
The main caffeine source was coffee, but tea and chocolate were the main sources in women with low caffeine intake. Median pre-pregnancy caffeine intake was 126 mg/day (IQR 40 to 254), 44 mg/day (13 to 104) at gestational week 17 and 62 mg/day (21 to 130) at gestational week 30. Coffee caffeine, but not caffeine from other sources, was associated with prolonged gestation (8 h/100 mg/day, P <10-7). Neither total nor coffee caffeine was associated with spontaneous PTD risk. Caffeine intake from different sources, measured repeatedly during pregnancy, was associated with lower BW (Marsal-28 g, Skjaerven-25 g, Gardosi-21 g per 100 mg/day additional total caffeine for a baby with expected BW 3,600 g, P <10-25). Caffeine intake of 200 to 300 mg/day increased the odds for SGA (OR Marsal 1.62, Skjaerven 1.44, Gardosi 1.27, P <0.05), compared to 0 to 50 mg/day.
Conclusions
Coffee, but not caffeine, consumption was associated with marginally increased gestational length but not with spontaneous PTD risk. Caffeine intake was consistently associated with decreased BW and increased odds of SGA. The association was strengthened by concordant results for caffeine sources, time of survey and different SGA definitions. This might have clinical implications as even caffeine consumption below the recommended maximum (200 mg/day in the Nordic countries and USA, 300 mg/day according to the World Health Organization (WHO)) was associated with increased risk for SGA.
We examined tea extracts, (-) epigallocatechin gallate (EGCg) and theaflavin digallate (TF3) for their antimicrobial and microbicidal activities against Mycoplasma. Green tea and black tea showed antimicrobial activities against M. pneumoniae. At a concentration of 0.2% green tea and black tea showed microbicidal activities against M. pneumoniae and M. orale but not against M. salivarium. Extracts of pu-erh tea showed a slight microbicidal activity against M. pneumoniae and M. orale. EGCg purified from green tea and TF3 from black tea markedly showed microbicidal activities against M. pneumoniae. M. orale and M. salivarium. These results suggest that tea and catechins can be used as prophylactic agents against Mycoplasma pneumoniae infection.
In six healthy subjects with a history of caffeine-induced wakefulness caffeine kinetics were compared to with those in six subjects not affected by caffeine. The data indicated that the former have a longer plasma t 1/2 (mean 7.4 and 4.2 hr) and slower plasma clearance (mean 1.2 and 1.7 ml . min-1 . kg-1) of caffeine. Plasma caffeine concentration at midnight, 8 hr after afternoon coffee, is higher in those with caffeine-attributed insomnia. Those reporting "coffee wakefulness" also tend to drink less coffee. We conclude that the rate of caffeine metabolism is a determinant of individual variation in the effect of drinking coffee on sleep.
To examine whether oral care contributes to preventing ventilator-associated pneumonia (VAP) in ICU patients.
Nonrandomized trial with historical controls.
A medical-surgical ICU in a university hospital.
1,666 mechanically ventilated patients admitted to the ICU.
Oral care was provided to 1,252 patients who were admitted to the ICU during period between January 1997 and December 2002 (oral care group), while 414 patients who were admitted to the ICU during period between January 1995 and December 1996 and who did not receive oral care served as historical controls (non-oral care group).
Incidence of VAP(episodes of pneumonia per 1000 ventilator days) in the oral care group was significantly lower than that in the non-oral care group (3.9 vs 10.4). The relative risk of VAP in the oral care group compared to that in the non-oral care group was 0.37, with an attributable risk of -3.96%. Furthermore, length of stay in ICU before onset of VAP was greater in the oral care than in the non-oral care group (8.5+/-4.6 vs 6.3+/-7.5 days). However, no significant difference was observed in either duration of mechanical ventilation or length of stay between the groups (5.9+/-10.8 vs 6.0+/-8.8 days and 7.5+/-11.5 vs 7.2+/-9.5 days, respectively). Pseudomonoas aeruginosa was the most frequently detected bacteria in both groups. Number of potentially pathogenic bacteria in oral cavity was significantly reduced by single oral care procedure.
Oral care decreased the incidence of VAP in ICU patients.
Pulmonary nosocomial infection.
The in vitro antimicrobial activity of commercial coffee extracts and chemical compounds was investigated on nine strains of enterobacteria. The antimicrobial activity investigated by the disc diffusion method was observed in both the extracts and tested chemical compounds. Even though pH, color, and the contents of trigonelline, caffeine, and chlorogenic acids differed significantly among the coffee extracts, no significant differences were observed in their antimicrobial activity. Caffeic acid and trigonelline showed similar inhibitory effect against the growth of the microorganisms. Caffeine, chlorogenic acid, and protocatechuic acid showed particularly strong effect against Serratia marcescens and Enterobacter cloacae. The IC(50) and IC(90) for the compounds determined by the microtiter plate method indicated that trigonelline, caffeine, and protocatechuic acids are potential natural antimicrobial agents against Salmonella enterica. The concentrations of caffeine found in coffee extracts are enough to warrant 50% of the antimicrobial effect against S. enterica, which is relevant to human safety.
A new series of mangostin analogs of natural alpha-mangostin from mangosteen was prepared and their antimycobacterial activity was evaluated in vitro against Mycobacterium tuberculosis H37Ra. The results showed that the monoalkyl tetrahydro alpha-mangostin analogs displayed increased antimycobacterial activity as compared with the lead natural xanthone, alpha-mangostin. Among the tested compounds, 6-methoxytetrahydro alpha-mangostin (16) exhibited the most potent antimycobacterial activity with minimum inhibitory concentration (MIC) of 0.78 mu g/mL. The activity of the monoalkylated and monoacylated tetrahydro alpha-mangostins decreases as the length of carbon chain increases. The methyl ether analog was also active against the multi-drug-resistant (MDR) strains with pronounced MICs of 0.78-1.561 mu g/mL.
Cited By (since 1996):1, Export Date: 18 October 2014
Caffeine is consumed in various forms during pregnancy, has increased half-life during pregnancy and crosses the placental barrier. Small for gestational age (SGA) is an important perinatal outcome and has been associated with long term complications. We examined the association between maternal caffeine intake and SGA using National Birth Defects Prevention Study data. Non-malformed live born infants with an estimated date of delivery from 1997-2007 (n = 7,943) were included in this analysis. Maternal caffeine exposure was examined as total caffeine intake and individual caffeinated beverage type (coffee, tea, and soda); sex-, race/ethnic-, and parity-specific growth curves were constructed to estimate SGA births. Crude and adjusted odds ratios (aORs) and 95 % confidence intervals were estimated using unconditional logistic regression. Interaction with caffeine exposures was assessed for maternal smoking, vasoconstrictor medication use, and folic acid. Six hundred forty-eight infants (8.2 %) were found to be SGA in this analysis. Increasing aORs were observed for increasing intakes of total caffeine and for each caffeinated beverage with aORs (adjusting for maternal education, high blood pressure, and smoking) ranging from 1.3 to 2.1 for the highest intake categories (300+ mg/day total caffeine and 3+ servings/day for each beverage type). Little indication of additive interaction by maternal smoking, vasoconstrictor medication use, or folic acid intake was observed. We observed an increase in SGA births for mothers with higher caffeine intake, particularly for those consuming 300+ mg of caffeine per day. Increased aORs were also observed for tea intake but were more attenuated for coffee and soda intake.
The incidence and prevalence of aspiration pneumonia (AP) are poorly defined. They increase in direct relation with age and underlying diseases. The pathogenesis of AP presumes the contribution of risk factors that alter swallowing function and predispose to the oropharyngeal bacterial colonization. The microbial etiology of AP involves Staphylococcus aureus, Haemophilus influenzae and Streptococcus pneumoniae for community-acquired AP and Gram-negative aerobic bacilli in nosocomial pneumonia. It is worth bearing in mind the relative unimportance of anaerobic bacteria in AP. When we choose the empirical antibiotic treatment, we have to consider some pathogens identified in oropharyngeal flora. Empirical treatment with antianaerobics should only be used in certain patients. According to some known risks factors, the prevention of AP should include measures in order to avoid it.
If tea can be shown to have an inhibitory effect on the growth of Streptococcus mutans there can be a basis for using it as an agent for reducing caries.
The aim of the study was to determine the effect of aqueous and organic extracts of three types of tea (green, oolong, and black tea) on the growth of S. mutans.
In vitro study.
Qualitative and quantitative phytochemical analysis of the three types of tea was done. Organic extracts of methanol and ethanol and aqueous extracts (50% and 100%) of tea were prepared. Fifty microliters of these extracts were inoculated into wells prepared on Mueller-Hinton agar plates that had been previously smeared with S. mutans. The agar plates were incubated at 37C for 24 hours. A similar procedure was followed using 0.2% chlorhexidine, which served as the positive control.
Analysis of variance (ANOVA), post hoc Tukey test, Student's 't ' test (two-tailed, dependent), and Student's 't' test (two-tailed, independent) were used for analysis of the data.
All the phytochemicals were found to be higher in oolong tea. Both aqueous and organic extracts of oolong tea showed greatest zones of inhibition, followed by green tea and black tea. Aqueous extracts of oolong and green tea showed greater zone of inhibition than chlorhexidine. All the three types of tea inhibited growth of S. mutans. The greatest inhibition was observed with aqueous extract of oolong tea.
Oolong tea extracts (aqueous and organic) showed a greater inhibitory effect on the growth of S. mutans than the other tea extracts .
A persistent need exists for effective treatment agents for mycobacterial infections. This research investigated the effectiveness of the Hypericum perforatum herb (commonly known as St John's wort; SJW) in its growth inhibition of mycobacteria. A SJW extract was effective at inhibiting five nonpathogenic Mycobacterium isolates and Bacillus subtilis, but not Escherichia coli. Quantitative studies of concentration sensitivity to the SJW extract were performed with minimal bactericidal concentrations (MBC) ranging from 0.33 to 2.66 mg extract/mL. The SJW compounds hyperforin (Hfn), hypericin (Hpn), and pseudohypericin (Phn) were quantified in the extract using HPLC. The SJW extract solution of 133 mg extract/mL used in this study contained 2.3 mg Hfn/mL, 0.8 mg Hpn/mL, and 2.1 mg Phn/mL. Purified Hfn, Hpn, and Phn were tested for inhibitory activity against Mycobacterium JLS (M. JLS) at similar concentrations used in the crude extract. While Hfn was inhibitory at 46 µg/mL, none of the purified SJW constituents were bactericidal at concentrations corresponding to SJW treatments. Scanning electron microscopy (SEM) analysis of SJW-treated M. JLS cells showed changes in cell surface morphology. Copyright © 2012 John Wiley & Sons, Ltd.
Hypericin is a natural photosensitizer considered for the new generation of photodynamic therapy (PDT) drugs. The aim of this study was to evaluate the in vitro fungicidal effect of hypericin PDT on various Candida spp., assessing its photocytotoxicity to keratinocytes (HaCaT) and dermal fibroblasts (hNDF) to determine possible side effects. A 3 log fungicidal effect was observed at 0.5 McFarland for two Candida albicans strains, Candida parapsilosis and Candida krusei with hypericin concentrations of 0.625, 1.25, 2.5 and 40 μm, respectively, at a fluence of 18 J cm(-2) (LED lamp emitting at 602 ± 10 nm). To obtain a 6 log reduction, significantly higher hypericin concentrations and light doses were needed (C. albicans 5 μM, C. parapsilosis 320 μM and C. krusei 320 μM; light dose 37 J cm(-2)). Keratinocytes and fibroblasts can be preserved by keeping the hypericin concentration below 1 μm and the light dose below 37 J cm(-2). C. albicans appears to be suitable for treatment with hypericin PDT without significant damage to cutaneous cells.
Febrifuquinone (1), a new vismione-anthraquinone coupled pigment and a new bianthrone named adamabianthrone (2), were isolated respectively, from the roots of Psorospermum febrifugum and from the bark of Psorospermum adamauense along with eight known compounds including: two bianthrones [(bianthrone A(1) (3) and bianthrone A(2b)], one vismione [(vismione D (4)], one anthrone (3-geranyloxyemodin anthrone) and four anthraquinones [(1,8-dihydroxy-3-isoprenyloxy-6-methylanthraquinone, emodin (5), 3-geranyloxy-1,8-dihydroxy-6-methylanthraquinone and 2-geranyl-1,8-dihydroxy-6-methylanthraquinone]. Their structures were determined using modern spectroscopic methods including one and two dimensional-NMR techniques as well as MS. Compounds 1 and 2 showed significant antimicrobial activities against a wide range of bacteria and fungi.
Hypericin, a photodynamic plant quinone, readily inactivated murine cytomegalovirus (MCMV), Sindbis virus, and human immunodeficiency virus type 1 (HIV-1), especially on exposure to fluorescent light. Sindbis virus was significantly more sensitive than MCMV. The inactivated MCMV, when used to infect cells, was incapable of synthesizing early or late viral antigens. In addition to this direct virucidal effect, when hypericin was added to cells infected with viable MCMV, inhibition was also observed, particularly when the compound was added in the first two hours of infection. Again the antiviral effect was augmented by visible light. At effective antiviral concentrations, there were no discernible adverse effects on cultured cells. Thus hypericin appears to have two modes of antiviral activity: one directed at the virions, possibly on membrane components (although other virion targets cannot be ruled out), and the other directed at virus-infected cells. Both activities are substantially enhanced by light. Other recent studies on the antiviral activities of hypericin have not considered the role of light, and it is conceivable that apparent discrepancies between their results may have reflected different conditions of light exposure.
We found that extracts of Japanese green tea leaves inhibited the growth of various bacteria causing diarrheal diseases. All tea samples tested showed antibacterial activity against Staphylococcus aureus, S. epidermidis, Vibrio cholerae O1, V. cholerae non O1. V. parahaemolyticus, V. mimicus, Campylobacter jejuni and Plesiomonas shigelloides. None of the tea samples had any effect on the growth of V. fluvialis, Aeromonas sobria, A. hydrophila, Pseudomonas aeruginosa, Salmonella enteritidis, enteroinvasive Escherichia coli, enterohemorrhagic E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, Enterobacter cloacae or Yersinia enterocolitica. Salmonella and Shigella showed susceptibilities different depending on the kind of Japanese green tea. Japanese green tea showed also bactericidal activity over S. aureus, V. parahaemolyticus and even enteropathogenic E. coli which was not sensitive when tested by cup method. The bactericidal activity was shown even at the drinking concentration in daily life.
A prospective study of 54 cases of pulmonary infection following aspiration was performed. Specimens utilized for bacteriologic study were either transtracheal aspirates, empyema fluid or blood. Appropriate anaerobic bacteriologie methods were employed. Anaerobic bacteria were recovered in 50 patients (93 per cent) and were the only pathogens in 25 (46 per cent). The predominant species were Bacteroides melanino-genicus, Fusobacterium nucleatum and anaerobic or microaerophilic gram-positive cocci. Bacteroides fragilis, which is resistant to many commonly used antibiotics, was recovered in nine patients (17 per cent). Aerobic and facultative bacteria were present in 29 patients (54 per cent), but anaerobes were present concurrently in all but 4. Enteric gram-negative bacilli and pseudomonads were particularly common in patients whose disease developed in the hospital. Eleven patients with mixed aerobic and anaerobic infections were treated successfully with antibiotics which were active only against the anaerobic isolates, thereby further implicating the pathogenic role of these microorganisms. The results indicate that anaerobes play a key role in most cases of infection following aspiration.
A coffee beverage obtained from instant dark coffee that had been previously shown to possess high antibacterial activity, was acidified (pH 2) and extracted with ethyl acetate. After alkalinization (pH 12) the aqueous phase was re-extracted with the organic solvent. The acidic and basic extracts were evaporated to dryness and the aqueous phase freeze-dried. Residues were dissolved in sterile water and assayed for antibacterial activity against two reference bacteria (Staphylococcus aureus ATCC 25923 and Streptococcus mutans 9102). The acidic extract was found to be highly active and was separated by gel permeation chromatography (GPC) into five fractions. Fractions GPC4 and GPC5 were found to possess antibacterial activity: most of the activity was evident in fraction GPC5. These fractions were separated by RP-HPLC using a gradient elution with methanol water as mobile phase. Both GPC fractions gave an active subfraction with methanol-water (70:30, v/v). The experimental conditions used to separate the antibacterial compound that originates during the roasting process, indicate that it possesses low molecular mass (probably no more than 200 Da), weak acidic properties and an lambda(max) at 205 nm. The very small amount of this compound isolated from roasted coffee, indicates that it may be a very strong antibacterial agent.
Pseudohypericin and hypericin, the major photosensitizing constituents of Hypericum perforatum, are believed to cause hypericism. Since hypericin has been proposed as a photosensitizer for photodynamic cancer therapy, the photocytotoxicity of its congener pseudohypericin has been investigated. The presence of foetal calf serum (FCS) or albumin extensively inhibits the photocytotoxic effect of pseudohypericin against A431 tumour cells, and is associated with a large decrease in cellular uptake of the compound. These results suggest that pseudohypericin, in contrast to hypericin, interacts strongly with constituents of FCS, lowering its interaction with cells. Since pseudohypericin is two to three times more abundant in Hypericum than hypericin and the bioavailabilities of pseudohypericin and hypericin after oral administration are similar, these results suggest that hypericin, and not pseudohypericin, is likely to be the constituent responsible for hypericism. Moreover, the dramatic decrease of photosensitizing activity of pseudohypericin in the presence of serum may restrict its applicability in clinical situations.
The antibacterial activities of flavonoids were found by the paper disk method to be enhanced by combining or mixing them. The combinations of quercetin and quercitrin, quercetin and morin, and quercetin and rutin were much more active than either flavonoid alone. Although rutin did not show activity in itself, the antibacterial activities of quercetin and morin were enhanced in the presence of rutin. The antibacterial activities of flavonoids, in combination with morin and rutin, were evaluated, based on the minimum inhibition concentration (MIC) in a liquid culture, by using Salmonella enteritidis and Bacillus cereus as the test bacteria. The activities of galangin, kaempherol, myricetin and fisetin were each enhanced in the presence of rutin when S. enteritidis was used as the test bacterium. The MIC value for kaempherol was markedly decreased by the addition of rutin. Morin inhibited DNA synthesis, and this effect was promoted by rutin at a concentration of 25 microg/ml.
Nineteen patients with pneumonia due to Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, or Escherichia coli were treated with 4 to 18 g of cephapirin daily. There were three treatment failures. One patient each with pneumonia due
to E. coli or S. pneumoniae died despite apparent eradication of the pathogen. Lobar pneumonia due to K. pneumoniae progressed during therapy in a third patient to lung gangrene, necessitating pneumonectomy. Five additional patients with
pneumococcal pericarditis or septic bursitis, empyema, cannula-associated bacteremia, and thoractomy wound infection due to
S. aureus were cured. All isolates of S. aureus, S. pneumoniae, and group A Streptococcus were inhibited by 0.8 μg of cephapirin per ml; minimal inhibitory concentrations of cephalothin were similar. Ninety percent
of K. pneumoniae, 85% of Proteus mirabilis, 73% of E. coli, and 30% of Enterobacter were inhibited by 12.5 μg cephapirin per ml. All isolates of Pseudomonas, Serratia and indole-positive Proteus had a cephapirin minimal inhibitory concentration of [Formula: see text] 100 μg/mg. Serum concentrations after intravenous
and intramuscular injection were similar to those reported for cephalothin. The intramuscular injections were moderately painful,
and intravenous infusions caused phlebitis in three of nine patients treated with doses up to 18 g per day. Cephapirin appears
comparable to cephalothin in vitro and is an effective agent in treatment of infection due to S. aureus and S. pneumoniae.
Streptococcus mutans, known to be an aetiologic agent of dental caries, also causes infective endocarditis (IE), although a comparison of isolates from the oral cavity and infected heart valve of the same patient has not been reported. In the present study, infected heart valve and dental plaque samples from a patient with IE were analysed. Broad-range PCR with DNA sequencing revealed that 50 clones from the dental plaque isolates were composed of oral streptococci and periodontopathic bacteria, whereas only Streptococcus mutans was detected in 50 clones from the heart valve. Eighteen strains of Streptococcus mutans were isolated from dental plaque and seven from the heart valve, and the biochemical properties of each were in accordance with those of Streptococcus mutans. DNA fingerprinting analysis revealed that all the oral isolates of Streptococcus mutans had similar patterns, which were different from those of the isolates from the infected heart valve. Western blotting using glucosyltransferase (GTF)-specific antiserum showed that the seven strains from the heart valve lacked the three types of intact GTF. In addition, the sucrose-dependent adhesion rates of these isolates were significantly lower than those of the oral isolates (P<0.001). Furthermore, the isolates from the heart valve were less susceptible to erythromycin and kanamycin. These results indicate that the properties of the Streptococcus mutans strains isolated from the infected valve were different from those of typical oral strains, which may be related to the effects of IE.
Evidence is building that dental plaque and inflammatory periodontal disease may contribute to the initiation and/or progression of certain lung diseases. Pneumonia is an acute infection of the lung, demonstrating the following respiratory signs and symptoms: cough; shortness of breath; increased respiratory rate; sputum production; and chest pain. Pneumonia may also induce nonspecific systemic symptoms, including fever, fatigue, muscle aches, and lack of appetite. Although pneumonia can be caused by viruses or fungi, bacteria are the most frequent cause of this infection and are the most easily treatable. Pneumonia often affects individuals with impaired host defense systems, for example, conditions with defects in antibody production, phagocytosis, ciliary function, or reduced CD4+ T-lymphocyte counts, as seen in acquired immunodeficiency syndrome (AIDS) (7). Other underlying respiratory diseases, such as chronic obstructive pulmonary disease, can also lead to pneumonia. Community-acquired pneumonia is defined as infection occurring in any individual living in the community (7). The annual cost for the treatment of community-acquired pneumonia exceeds $9 billion and affects 4 million adults per year in the USA, c. 20% of whom are admitted to a hospital for treatment. The rate of pneumonia ranges from 8 to 15 per 1000 persons per year, with infants and the elderly having the greatest risk for infection. Rates of pneumonia are higher for men than for women and for black people than for white people. Risk factors for community-acquired pneumonia include alcoholism, asthma, immunosuppression, and age >70 years. Dementia, seizures, congestive heart failure, cerebrovascular disease, tobacco smoking, alcoholism, and chronic obstructive pulmonary disease are risk factors for pneumococcal pneumonia, the most common cause of community-acquired pneumonia. Evidence is building that an unhygienic oral environment and resulting oral diseases, such as inflammatory gingivitis and periodontitis, can negatively affect systemic health. A straightforward connection between the oral cavity and a specific systemic disease is that between dental plaque, periodontal disease, and lung disease. Accumulating evidence suggests that poor oral health may influence lung function and increase the risk for bacterial lung infection (pneumonia), especially in high-risk patient populations. Three populations for developing pneumonia are the focus of this review: nursing home residents; people hospitalized with acute illness; and those hospitalized who require mechanical ventilation as a result of respiratory failure. In the past decade there has been an evolution in the classification of pneumonia. Previously, pneumonia was classified as either community acquired or hospital acquired. Hospital- acquired pneumonia was defined as pneumonia occurring with onset >48 hours after admission to hospital. This classification scheme was straightforward and easy to apply. However, in the past decade the classification scheme has evolved, relating to the shift of care for various conditions from the hospital to the outpatient setting for delivery of services such as antibiotic therapy, cancer chemotherapy, wound management, outpatient dialysis centers, and short-term rehabilitation. This shift in care from the hospital to the outpatient, home setting or nursing
Methanol-acetone extracts from aerial parts of seven entities of the genus Hypericum [H. perforatum L. subsp. perforatum, H. perforatum L. subsp. veronense (Schrank) Ces., H. montanum L., H. hyssopifolium Chaix, H. hirsutum L., H. hircinum L. subsp. majus (Aiton) N. Robson, H. tetrapterum Fr.] growing in the Appennino Umbro-Marchigiano (central Italy) were tested in vitro for their antimicrobial activity against two Gram-positive bacteria (Staphylococcus aureus and Enterococcus faecalis), two Gram-negative bacteria (Escherichia coli and Pseudomonas aeruginosa) and the yeast Candida albicans, by the Kirby-Bauer agar diffusion method. The two H. perforatum subspecies were particularly active against Gram-positive and Gram-negative bacteria, supporting the use of these plants in the traditional medicine of central Italy to treat wounds, skin and infectious diseases. However significant values of inhibition were given also by H. hirsutum against S. aureus and P. aeruginosa, and by H. hyssopifolium, H. hircinum subsp. majus and H. tetrapterum against C. albicans. These results suggest that hypericin and hyperforin are the main components responsible for antimicrobial activity, but not the only ones, as other extracts, showing a low level of these compounds, possess evident activity. Isolation of pure compounds from the most active extracts is in progress.
The aim of this review article is to examine the associations between periodontal diseases and common systemic diseases, namely diabetes, respiratory diseases, cardiovascular diseases and osteoporosis. A substantial number of review articles have been published to elucidate the relationships between these diseases; however, none provide a complete overview on this topic from the aspects of definition, classification, clinical characteristics and manifestations, inter-relationships and interactions, proposed schematic mechanisms, clinical implications and management of periodontal patients with these systemic diseases. The aim of this article is to provide an overall understanding and general concepts of these issues in a concise and inter-related manner.
The effect of mouthwash on bacterial population in saliva
- M Hasegawa
- K Hisaka
- S Tsunemi
Hasegawa M, Hisaka K, Tsunemi S, et al. The effect of mouthwash on bacterial population in saliva. Jpn J conserv Dent. 1989;32:1060-1065. in Japanese.
Screening of Mexican medical plants for antibacterial activity
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- A Nagayama
- F Abe
Yasunaka K, Nagayama A, Abe F, et al. Screening of Mexican medical plants for antibacterial activity. Bull Cent
Res Inst Fukuoka Univ E Interdiscip Sci. 2003;1:99-106. in Japanese.