Four new iridoids viz., plumeridoids A ( 1), B ( 2), and C ( 3) and epiplumeridoid C ( 4) were isolated from the stem bark of PLUMERIA RUBRA Linn. together with twenty-four known compounds viz., 1-( P-hydroxyphenyl)propan-1-one, isoplumericin, plumericin, dihydroplumericin, allamcin, fulvoplumerin, allamandin, plumieride, P- E-coumaric acid, 2,6-dimethoxy- P-benzoquinone, scopoletin, cycloart-25-en-3 beta,24-diol, 2,4,6-trimethoxyaniline, ajunolic acid, ursolic acid, oleanolic acid, beta-amyrin acetate, betulinic acid, lupeol and its acetate, 2,3-dihydroxypropyl octacosanoate, glucoside of beta-sitosterol, and a mixture of common sterols (stigmasterol and beta-sitosterol). Their structures were determined by means of spectroscopic data including HREIMS,(1)H NMR,(13)C NMR, 2D NMR (HMQC, HMBC, NOESY) and by comparison with published data. All but one of thirteen tested compounds exhibited antifungal, antialgal, and/or antibacterial activities.

Unsaturated fatty acids may counteract the lipotoxicity associated with saturated fatty acids. Palmitic acid induced endoplasmic reticulum (ER) stress and caused apoptotic and necrotic cell death in the renal proximal tubular cell line, NRK-52E. We investigated whether alpha-linolenic acid, an unsaturated fatty acid, protected against ER stress and cell death induced by palmitic acid or by other non-nutrient ER stress generators. Incubation of NRK-52E cells for 24h with palmitic acid produced a significant increase in apoptosis and necrosis. Palmitic acid also increased levels of three indicators of ER stress - the phosphorylated form of the eukaryotic initiation factor 2alpha (eIF2alpha), C/EBP homologous protein (CHOP), and glucose regulated protein 78 (GRP78). alpha-Linolenic acid dramatically reduced cell death and levels of all three indicators of ER stress brought about by palmitic acid. Tunicamycin, which induces ER stress by glycosylation of proteins, produced similar effects to those obtained using palmitic acid; its effects were partially reversed by alpha-linolenic acid. Salubrinal (a phosphatase inhibitor) causes increased levels of the phosphorylated form of eIF2alpha - this effect was partially reversed by alpha-linolenic acid. Palmitoleate, a monosaturated fatty acid, had similar effects to those of alpha-linolenic acid. These results suggest that part of the mechanism of protection of the kidney by unsaturated fatty acids is through inhibition of ER stress, eIF2alpha phosphorylation and consequential reduction of CHOP protein expression and apoptotic renal cell death.

The antioxidant activity of rooibos flavonoids, including the dihydrochalcones aspalathin and nothofagin and their corresponding flavone glycosides, was evaluated using the ABTS radical cation, metal chelating, and Fe(II)-induced microsomal lipid peroxidation assays. Epigallocatechin gallate (EGCG) and Trolox were used as reference standards. Optimized geometric conformers of aspalathin and nothofagin, in addition to calculated physicochemical properties, were considered to explain interaction with the microsomal membrane structure and thus relative potency of the dihydrochalcones. The most potent radical scavengers were aspalathin (IC50 = 3.33 microM) and EGCG (IC50 = 3.46 microM), followed by quercetin (IC50 = 3.60 microM) and nothofagin (IC50 = 4.04 microM). The least effective radical scavengers were isovitexin (IC50 = 1224 microM) and vitexin (IC50 > 2131 microM). Quercetin (IC50 = 17.5 microM) and EGCG (IC50 = 22.3 microM) were the most effective inhibitors of lipid peroxidation. Aspalathin (IC50 = 50.2 microM) and catechin (IC50 = 53.3 microM) displayed similar potencies. Nothofagin (IC50 = 1388 microM) was almost as ineffective as its flavone glycoside analogues.

The transfer of Cd and Zn from soils amended with sewage sludge was followed through a food chain consisting of wheat, aphids and the predator Coccinella septempunctata. Multiple regression models were generated to predict the concentrations of Cd and Zn in C. septempunctata. No significant model could be generated for Cd, indicting that the concentration of this metal was maintained within relatively narrow limits. A model predicting 64% of the variability in the Zn concentration of C. septempunctata was generated from of the concentration of Zn in the diet, time and rate of Zn consumption. The results suggest that decreasing the rate of food consumption is an effective mechanism to prevent the accumulation of Zn and that the availability of Zn in the aphid prey increased with the concentration in the aphids. The results emphasise the importance of using ecologically relevant food chains and exposure pathways during ecotoxicological studies.

The use of laparoscopy to perform all or part of hysterectomy has become widely accepted, with laparoscopic hysterectomy accounting for up to 15% of all hysterectomies performed in the United States. A recent Cochrane analysis has clearly shown that laparoscopic hysterectomy is associated with decreased length of stay and faster recovery time compared with laparotomy. There is no evidence to support a supracervical hysterectomy over a total hysterectomy in terms of frequency of pelvic support disorders or sexual function. This does not preclude the use of a supracervical hysterectomy in some clinical situations.

BACKGROUND: Increasing global expenditures on health, together with increased patient demand for quality and service, have created a need for health care management tools based on economic and quaLity-based criteria. Despite the recognition of this need, decision-support tools are Lacking. In the Israel Defense Forces (IDF), policy change and budgetary and quality constraints necessitated the development of an evidence-based managerial decision aid, to assist in providing medical services at acceptable quality and availability leveLs, while addressing economic concerns. OBJECTIVE: To develop a decision-support model for the IDF Medical Corps, that balances the conflicting considerations of service avaiLabiLity and cost. METHODS: The authors developed a manageriaL model to characterize regional secondary medical care, and to compare it to country-wide patterns and to historic regional patterns. Secondary care systems were then analyzed by specialty. Finally, the relative costs of medical encounters for each speciaLty were anaLyzed. RESULTS: Core specialties examined included dermatology, orthopedics and otolaryngology. Two-thirds of all referrals to core specialists were made to intra-organizational resources. Furthermore, several intra-organizationaL clinics were found to have short waiting times and low output indices. In response to the application of the model, IDF Medical Corps policy was updated and suppliers were reprioritized, yielding substantial savings of up to NIS 5.5 million in 2006 alone. This cost saving enabled budgetary reallocation and alternative investment in the emergency and primary health care systems. CONCLUSION: Applying efficient managerial tools can lead to cost savings and to increased quality and availability of services. These tools must effectively follow changes in the dynamics of the health care system. These changes are to be impLemented rapidly, in order to provide practical guidance for medical administrators and to enable them to infLuence the real-time utiLization of medical services.

Four novel quinonoid compounds are evaluated for their apoptotic potential against three cancer cell lines, i.e. MCF-7, HeLa and MG-63. APOPercentage assay was used for the screening of the compounds and it was established that the apoptotic potential of these compounds is cell line specific. The compound 2-(1',4'-benzoquinon-2'-yl)-5-hydroxy-7-methyl-1,4-naphthoquinone (S4) was found to be most active, which has a potential to kill approximately 99% of HeLa cancer cells in vitro after 72h at a concentration of 10muM. The compound's ability to induce specific markers of apoptosis in HeLa cells is further confirmed by DNA fragmentation and cell cycle assays.

Frequent attenders (FA) pose a significant issue to a family practice and are considered to be a major burden on the physician and on resources utilization. The socioeconomic and psychological characteristics of FA are well known, however we know little about the management of these patients. The authors reviewed the literature on the bio-psychosocial characteristics of these patients and the approach to frequent attenders. The cornerstone of coping with the problem is based on finding the motive for the visits and management of the reason without giving the opportunity for secondary gain. A comprehensive approach to FA can reduce the burden on the physician, improve the practice's function and contribute to the well-being of the patient.

6-Alkylsalicylic acids inhibit the linoleic acid peroxidation catalyzed by soybean lipoxygenase-1 (EC 1.13.11.12, type 1) competitively and without pro-oxidant effects. This activity is largely dependent on the nature of their alkyl side chains. Inhibitory activities of anacardic acids, viz. 6-pentadec(en)ylsalicylic acids, isolated from the cashew Anacardium occidentale, were initially used for comparison because their aromatic head portions are the same. Consequently, the data should be interpreted to mean that changes in the hydrophobic side chain tail portions of the molecules evaluated correlate with the specific activity determined.