The role of Candida sp isolated from bronchoscopic samples in nonneutropenic patients

STUDY OBJECTIVES

To determine the clinical significance of Candida sp isolated from bronchoscopic samples in patients with suspected pneumonia.

DESIGN

A retrospective chart review was performed in all nonneutropenic adult patients with Candida sp isolates from respiratory secretions obtained by bronchoscopy over a 5-year period (1991 to 1995). Potential risk factors, therapeutic decisions, and outcome were recorded. Microbiological findings, chest radiograph reports, and pathologic material were reviewed. Isolates were classified as definite, probable, or indeterminate contamination, or as definite pulmonary candidiasis, on the basis of histologic findings, therapeutic decisions, and outcome.

SETTING

A 600-bed teaching hospital with 16 beds in a medical-surgical ICU.

PATIENTS

Thirty-seven consecutive patients with positive cultures for Candida sp from respiratory samples obtained by bronchoscopy were evaluated. Thirty-two of these 37 patients (86.5%) received antibiotic therapy prior to sampling, and 23 (62.2%) were intubated.

RESULTS

Contamination was classified as definite in 3 patients (8.1%) and probable in 30 others (81.0%). Contamination was indeterminate in two cases (5.4%). Two additional patients (5.4%) received antifungal agents for systemic candidiasis. No cases of pulmonary candidiasis could be demonstrated, although 24 of 28 patients showed protected specimen brush cultures > or = 10(3) cfu/mL.

CONCLUSIONS

Nonneutropenic patients with isolation of Candida sp from bronchoscopic samples, even in high concentrations, are unlikely to have invasive candidiasis. Indication for initiation of antifungal therapy should be based on histologic evidence or identification from sterile specimens.

An ethnobotanical study of medicinal and aromatic plants in the Natural Park of "Serra de São Mamede" (Portugal)

This paper reports an ethnobotanical study conducted in the year 2000 in the Natural Park of "Serra de São Mamede" (Portugal). Informal interviews involving 45 informants provided data about 165 useful plants, 150 of which had medicinal and/or aromatic use. Two hundred and twenty-four popular names were noted, 98 of which had not been documented before. The most relevant plants are mentioned in this paper, along with their local names, the parts of them used, popular uses (or troubles treated), preparation and administration processes, and citation frequency. This is the first study of medicinal and aromatic plants in Portugal to use ethnobotanical methodology.

Ethnobotany of medicinal plants used in Eastern Mallorca (Balearic Islands, Mediterranean Sea)

ETHNOPHARMACOLOGICAL RELEVANCE

This paper represents the first large-scale ethnobotanical study in the island of Mallorca, and provides significant information on pharmaceutical plant uses, built up from interviews with native people from this touristic hotspot, demonstrating its ethnopharmacological importance.

AIM OF THE STUDY

To collect, analyse and evaluate the ethnobotanical knowledge concerning medicinal plants in a north-eastern Mallorcan area (municipalities of Artà, Capdepera and Son Servera; 298 km2, 31,764 inhabitants).

MATERIALS AND METHODS

We performed semi-structured interviews with 42 informants (mean age 77; 40% women, 60% men), identified the plant taxa reported and analysed the results, comparing them with those found in the current Mallorcan ethnobotanical information and in other territories.

RESULTS

The informants reported data on 121 human medicinal plants representing 64 botanical families. Around 45 medicinal uses reported, concerning 37 species, have not or have very rarely been cited as medicinal. An index of medicinal importance is proposed.

CONCLUSIONS

All efforts addressed to compiling ethnobotanical information in industrialised or touristised areas such as Eastern Mallorca are still valuable. New possibilities can be explored to give practical value to Mallorcan ethnobotanical data in the frame of considering traditional plant knowledge as part of the islanders’ lifestyle and healthy habits.

Studies on pharmaceutical ethnobotany in the high river Ter valley (Pyrenees, Catalonia, Iberian Peninsula)

An ethnobotanical study has been carried out in the high river Ter valley (Catalonia, Iberian Peninsula) a small area located in the eastern Pyrenees, with 294 km(2) and 4526 inhabitants. Through 42 interviews with 60 informants of a mean age of 71.1, 220 species belonging to 71 botanical families were reported, 90.6% of which were used in human medicine and 7.8% in veterinary therapy. The present paper is focused on human medicinal plant uses. One fungal and four vascular plant species have not, or have very rarely been cited as medicinal, and for other taxa some very scarcely reported medicinal uses have been recorded (110 uses concerning 78 species).

Ethnobotany of Montseny biosphere reserve (Catalonia, Iberian Peninsula): plants used in veterinary medicine

The present paper deals with plants used in veterinary medicine in Montseny. An ethnobotanical survey was carried out in the Montseny massif, which is situated in north-east Catalonia (Iberian Peninsula), covers 826 km(2) and has a population of 80,000. The information was obtained through 120 ethnobotanical interviews to 180 informants. Out of 584 species reported, 351 are claimed to be used in the health field (human and veterinary medicine), 280 in human and animal food and 236 have another kind of popular use. Medicinal species represent around 16.5% of Montseny's vascular flora. In a previous paper we addressed plant use in human medicine, and the present paper deals with veterinarian uses. As a reflection of the importance of rural life in the region, at least until recent times, a substantial number of medicinal plants (89 species, representing 6% of the flora of the territory and 6.4% of all medicinal use-reports in the region) is used in veterinary medicine. These remedies are mostly for cows, calves, sheep, pigs and horses, and secondarily, to poultry, rabbits and dogs. The main ailments treated are postnatal problems, intestinal troubles, wounds and dermatological problems. In many cases, the use of these remedies in veterinary medicine is fully consistent with their use in human medicine.

Studies on pharmaceutical ethnobotany in the region of Pallars (Pyrenees, Catalonia, Iberian Peninsula). Part II. New or very rare uses of previously known medicinal plants

An ethnobotanical survey was carried out in the region called Pallars--consisting of two districts, Pallars Sobirà and Pallars Jussà--, situated in the Central Pyrenees, in North West Catalonia (Iberian Peninsula), with an approximate area of 2530 km(2) and a population of 19,000. Through interviews with 264 people, we obtained data on 437 plant species used for health care. We detected 867 unreported or uncommon uses corresponding to 272 plant species, 52 of which had never or very rarely been cited as medicinal. This is the second paper of a series intended to present the most important findings concerning the ethnopharmacology of the area studied; it includes unreported or very uncommon uses of known medicinal plant species. A previous paper reported the general results and the new or very scarcely reported medicinal vascular plants, and a further one will deal with medicinal non vascular plants.

Use of non-crop food vascular plants in Montseny biosphere reserve (Catalonia, Iberian Peninsula)

An ethnobotanical survey was carried out in the massif of Montseny (Catalonia, Iberian Peninsula), a mountainous UNESCO's biosphere reserve that summarizes the main European (from Mediterranean to subalpine) climates and landscapes. This article presents the results concerning the use of non-crop vascular food plants, numbering 132. Edible plants (75), as well as those involved in drink preparation (84) are considered. The study shows the different ways of preparation, preservation and consumption of plants. Most food plants also have uses as folk medicines in the region considered, and the relationships between foods and medicines are discussed. The presence and usage of wild relatives of cultivated plants in the territory studied are also commented upon.

Influence of pneumococcal serotype group on outcome in adults with bacteraemic pneumonia

The influence of infecting serotype group on outcome in bacteraemic pneumococcal pneumonia remains unclear. We performed a prospective, 10-yr observational study in an 800-bed teaching hospital. 299 adults diagnosed with pneumonia whose blood cultures showed growth of Streptococcus pneumoniae were included in the study. High invasive disease potential (H) serotypes included serotypes 1, 5 and 7F, which served as a reference category, were compared with low invasive disease potential (L) serotypes (3, 6A, 6B, 8, 19F, and 23F) and other (O) serotypes (non-H, non-L). The influence on outcome was determined for each group of serotypes after adjusting for underlying conditions and severity of illness at admission. Overall, 30-day mortality was 11%. H serotypes (n = 93) infected primarily younger people and presented a higher risk of complicated parapneumonic effusion or empyema (17.2 versus 5.1%; p = 0.01), with lower mortality (3.2%). The isolation of L serotypes (n = 78) was an independent risk factor for 30-day mortality (OR 7.02, 95% CI 1.72-28.61), as were Charlson score (OR 1.30, 95% CI 1.08-1.58), alcohol abuse (OR 3.99, 95% CI 1.39-11.39) and severity of illness measured by American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) criteria (OR 4.80, 95% CI 1.89-12.13). A vaccination strategy including serotypes 3, 6A, 6B, 8, 19F and 23F may improve survival in adults.

Linkage of 35S and 5S rRNA genes in Artemisia (family Asteraceae): first evidence from angiosperms

Typically in plants, the 5S and 35S ribosomal DNA (rDNA) encoding two major ribosomal RNA species occur at separate loci. However, in some algae, bryophytes and ferns, they are at the same locus (linked arranged). Southern blot hybridisation, polymerase chain reactions (PCR), fluorescent in situ hybridisation, cloning and sequencing were used to reveal 5S and 35S rDNA genomic organisation in Artemisia. We observed thousands of rDNA units at two-three loci containing 5S rDNA in an inverted orientation within the inter-genic spacer (IGS) of 35S rDNA. The sequenced clones of 26-18S IGS from Artemisia absinthium appeared to contain a conserved 5S gene insertion proximal to the 26S gene terminus (5S rDNA-1) and a second less conserved 5S insertion (5S rDNA-2) further downstream. Whilst the 5S rDNA-1 showed all the structural features of a functional gene, the 5S-rDNA-2 had a deletion in the internal promoter and probably represents a pseudogene. The linked arrangement probably evolved before the divergence of Artemisia from the rest of Asteraceae (>10 Myrs). This arrangement may have involved retrotransposons and once formed spread via mechanisms of concerted evolution. Heterogeneity in unit structure may reflect ongoing homogenisation of variant unit types without fixation for any particular variant.

Studies on pharmaceutical ethnobotany in the region of Pallars (Pyrenees, Catalonia, Iberian Peninsula). Part I. General results and new or very rare medicinal plants

An ethnobotanical survey was carried out in the region called Pallars--constituted by two districts, Pallars Sobirà and Pallars Jussà--situated in the Central Pyrenees, in North West Catalonia (Iberian Peninsula), with an approximate area of 2530 km(2) and a population of 19000. We obtained data on 437 plant species used for health care through interviews with 264 people. We detected 867 unreported or uncommon uses corresponding to 272 plant species, 52 of which had never or very rarely been cited as medicinal. To present the most important findings concerning the ethnopharmacology of the area studied, this first part includes the general results and the new or very scarcely reported medicinal vascular plants. Further papers will deal with unreported or very uncommon uses for known medicinal plant species and with medicinal non-vascular plants.

Pharmacokinetics of a new Autogel formulation of the somatostatin analogue lanreotide after a single subcutaneous dose in healthy volunteers

The pharmacokinetics/tolerability of lanreotide Autogel have been evaluated. Healthy volunteers (n = 24) first received immediate-release lanreotide as a single subcutaneous (s.c.) injection. After two days, 40 or 60 mg lanreotide Autogel was injected subcutaneously. Blood was sampled at various intervals for 56 days. Systemic/local adverse events and changes in biological profile/vital signs were recorded. Lanreotide Autogel produced a prolonged-release pharmacokinetic profile: mean area under the serum concentration-time curve from time 0 to infinity (AUC) was 53.73 +/- 8.99 and 79.48 +/- 13.06 ng mL(-1) day for 40 and 60 mg, respectively, mean peak serum concentration (C(max)) was 4.38 +/- 2.91 and 5.71 +/- 3.52 ng mL(-1), respectively, median time to reach C (minimum-maximum) was 0.50 (0.083-18.0) and 0.38 (0.083-9.01) days, respectively, mean apparent elimination half-life was 21.63 +/- 9.42 and 22.01 +/- 9.87 days, respectively, and relative bioavailability was 0.93 +/- 0.12 and 0.82 +/- 0.15, respectively. Thus, lanreotide Autogel exhibited linear pharmacokinetics for the doses studied. Pharmacokinetic profiles were similar in both genders, apart from statistically significant differences in C(max) and C(max)/AUC. The Autogel formulation of lanreotide was well tolerated, with systemic adverse events being mild/moderate. Erythema and a painless subcutaneous induration were the most common local adverse events. Lanreotide Autogel provided a prolonged dosing interval and good tolerability for treating acromegaly and carcinoid syndrome.

Genome size in Echinops L. and related genera (Asteraceae, Cardueae): karyological, ecological and phylogenetic implications

Genome size was assessed by flow cytometry in 33 species belonging to seven genera of the tribe Cardueae (Asteraceae), which can be grouped in three taxonomic complexes. 2C nuclear DNA content ranged from 1.49 to 16.98 pg, which is more than elevenfold variation. Genome size correlated well with some karyological traits. Nuclear DNA amount variations also have systematic and evolutionary implications and/or are linked to adaptations to ecological conditions.

The explosive radiation of Cheirolophus (Asteraceae, Cardueae) in Macaronesia

Background

Considered a biodiversity hotspot, the Canary Islands have been the key subjects of numerous evolutionary studies concerning a large variety of organisms. The genus Cheirolophus (Asteraceae) represents one of the largest plant radiations in the Canarian archipelago. In contrast, only a few species occur in the Mediterranean region, the putative ancestral area of the genus. Here, our main aim was to reconstruct the phylogenetic and biogeographic history of Cheirolophus with special focus on explaining the origin of the large Canarian radiation.

Results

We found significant incongruence in phylogenetic relationships between nuclear and plastid markers. Each dataset provided resolution at different levels in Cheirolophus: the nuclear markers resolved the backbone of the phylogeny while the plastid data provided better resolution within the Canarian clade. The origin of Cheirolophus was dated in the Mid-Late Miocene, followed by rapid diversification into the three main Mediterranean lineages and the Macaronesian clade. A decrease in diversification rates was inferred at the end of the Miocene, with a new increase in the Late Pliocene concurrent with the onset of the Mediterranean climate. Diversification within the Macaronesian clade started in the Early-Mid Pleistocene, with unusually high speciation rates giving rise to the extant insular diversity.

Conclusions

Climate-driven diversification likely explains the early evolutionary history of Cheirolophus in the Mediterranean region. It appears that the exceptionally high diversification rate in the Canarian clade was mainly driven by allopatric speciation (including intra- and interisland diversification). Several intrinsic (e.g. breeding system, polyploid origin, seed dispersal syndrome) and extrinsic (e.g. fragmented landscape, isolated habitats, climatic and geological changes) factors probably contributed to the progressive differentiation of populations resulting in numerous microendemisms. Finally, hybridization events and emerging ecological adaptation may have also reinforced the diversification process.

Studies on pharmaceutical ethnobotany in the regions of L'Alt Empordà and Les Guilleries (Catalonia, Iberian Peninsula)

An ethnobotanical survey was carried out in two regions (L'Alt Emporda and Les Guilleries), situated in North East Catalonia (Iberian Peninsula), with an approximate area of 800 km2 and a population of 68000. Through interviews with 73 people, data was obtained on the medicinal uses of 220 species. The most important findings are presented here concerning the ethnopharmacology of those areas. One hundred and ninty four unreported or uncommon uses corresponding to 101 plant species were detected.

Pharmaceutical ethnobotany in the Montseny biosphere reserve (Catalonia, Iberian Peninsula). General results and new or rarely reported medicinal plants

An ethnobotanical survey was carried out in the massif of Montseny, which is situated in north-east Catalonia (Iberian Peninsula), covers 826 km(2) and has a population of 80 000. From 1993 to 2000 we interviewed 180 people and collected ethnobotanical information about 351 medicinal plants, with 4023 use-reports. Through comparison with a large set of studies, we detected 501 unreported or uncommon uses that corresponded to 201 plant species, 57 of which had never or very rarely been cited as medicinal or toxic. General results and key findings on the plant ethnopharmacology (number of medicinal plants, modes of consumption, types of illnesses treated) of this area are presented here, together with information on new or rarely reported medicinal plants.

Genome size dynamics in Artemisia L. (Asteraceae): following the track of polyploidy

Polyploidy is a key factor in the evolution of higher plants and plays an important role in the variation of plant genomes, leading to speciation in some cases. During polyploidisation, different balancing processes take place at the genomic level that can promote variation in nuclear DNA content. We estimated genome size using flow cytometry in 84 populations of 67 Artemisia species and one population of Crossostephium chinense. A total of 73 sequences of nrDNA ITS and 3'-ETS were newly generated and analysed, together with previously published sequences, to address the evolution of genome size in a phylogenetic framework. Differences in 2C values were detected among some lineages, as well as an increase of genome size heterogeneity in subgenera whose phylogenetic relationships are still unclear. We confirmed that the increase in 2C values in Artemisia polyploids was not proportional to ploidy level, but 1Cx genome size tended to decrease significantly when high ploidy levels were reached. The results lead us to hypothesise that genome size in polyploids tends to a maximum as it follows saturation behaviour, in agreement with the Michaelis-Menten model. We tested different arithmetic functions with our dataset that corroborated a non-linear relationship of genome size increase in polyploids, allowing us to suggest a theoretical upper limit for the DNA content of this genus.

Ribosomal DNA, heterochromatin, and correlation with genome size in diploid and polyploid North American endemic sagebrushes (Artemisia, Asteraceae)

Subgenus Tridentatae ( Artemisia , Asteraceae) can be considered a polyploid complex. Both polyploidy and hybridization have been documented in the Tridentatae. Fluorescent in situ hybridization (FISH) and fluorochrome banding were used to detect and analyze ribosomal DNA changes linked to polyploidization in this group by studying four diploid-polyploid species pairs. In addition, genome sizes and heterochromatin patterns were compared between these populations. The linked 5S and 35S rRNA genes are confirmed as characteristic for Artemisia, and a pattern at the diploid level of three rDNA loci located at telomeric positions proved to be typical. Loss of rDNA loci was observed in some polyploids, whereas others showed additivity with respect to their diploid relatives. Genome downsizing was observed in all polyploids. Banding patterns differed depending on the pair of species analysed, but some polyploid populations showed an increased number of heterochromatic bands. FISH and fluorochrome banding were useful in determining the systematic position of Artemisia bigelovii , for which a differential pattern was found as compared with the rest of the group. Additionally, FISH was used to detect the presence of the Arabidopsis-type telomere repeat for the first time in Artemisia.

Genome size variation in the Artemisia arborescens complex (Asteraceae, Anthemideae) and its cultivars

Different wild Mediterranean populations of Artemisia arborescens from diverse locations representing its geographical distribution, as well as some of its well-known cultivars and some specimens cultivated as ornamentals in gardens, streets, roads and nurseries, were analysed for genome size. Other closely related species endemic to Macaronesia, Artemisia canariensis, Artemisia argentea, and Artemisia gorgonum, were also analysed, and their nuclear DNA amount has been related to the biogeography of this group of species. Additionally, 5 populations of the closely related Artemisia absinthium were analysed to establish comparisons. Measurements acquired by flow cytometry ranged from 8.29 to 11.61 pg for 2C values. Statistically significant differences of 2C nuclear DNA amounts with respect to factors such as insularity or domestication have been detected. However, quite a low intraspecific genome size variation has been found in these species. Furthermore, the study also addressed the possible hybrid origins and possible misidentifications of some of the supposed cultivars of A. arborescens.

Genome size in 21 Artemisia L. species (Asteraceae, Anthemideae): Systematic, evolutionary, and ecological implications

Genome size was estimated by flow cytometry in 24 populations belonging to 22 Artemisia taxa (21 species, 1 with two subspecies), which represent the distinct subgenera, life forms, basic chromosome numbers, and ploidy levels in the genus. 2C nuclear DNA content values range from 3.5 to 25.65 pg, which represents a more than sevenfold variation. DNA content per haploid genome ranges from 1.75 to 5.76 pg. DNA amount is very well correlated with karyotype length and ploidy level. Some variations in genome size have systematic and evolutionary implications, whereas others are linked to ecological selection pressures.Key words: Artemisia, Asteraceae, flow cytometry, genome size, nuclear DNA amount variation, systematics, evolution, ecology.

Variation of DNA amount in 47 populations of the subtribe Artemisiinae and related taxa (Asteraceae, Anthemideae): karyological, ecological, and systematic implications

Genome size has been estimated by flow cytometry in 47 populations of 40 species of the tribe Anthemideae (Asteraceae), mainly from Artemisia and other genera of the subtribe Artemisiinae and related taxa. A range of 2C values from 3.54 to 21.22 pg was found. DNA amount per basic chromosome set ranged from 1.77 to 7.70 pg. First genome size estimates are provided for one subtribe, 10 genera, 32 species, and two subspecies. Nuclear DNA amount correlated well with some karyological, physiological and environmental characters, and has been demonstrated as a useful tool in the interpretation of evolutionary relationships within Artemisia and its close relatives.

A phylogenetic road map to antimalarial Artemisia species

ETHNOPHARMACOLOGICAL RELEVANCE

The discovery of the antimalarial agent artemisinin is considered one of the most significant success stories of ethnopharmacological research in recent times. The isolation of artemisinin was inspired by the use of Artemisia annua in traditional Chinese medicine (TCM) and was awarded a Nobel Prize in 2015. Antimalarial activity has since been demonstrated for a range of other Artemisia species, suggesting that the genus could provide alternative sources of antimalarial treatments. Given the stunning diversity of the genus (c. 500 species), a prioritisation of taxa to be investigated for their likely antimalarial properties is required.

MATERIALS AND METHODS

Here we use a phylogenetic approach to explore the potential for identifying species more likely to possess antimalarial properties. Ethnobotanical data from literature reports is recorded for 117 species. Subsequent phylogenetically informed analysis was used to identify lineages in which there is an overrepresentation of species used to treat malarial symptoms, and which could therefore be high priority for further investigation of antimalarial activity.

RESULTS

We show that these lineages indeed include several species with documented antimalarial activity. To further inform our approach, we use LC-MS/MS analysis to explore artemisinin content in fifteen species from both highlighted and not highlighted lineages. We detected artemisinin in nine species, in eight of them for the first time, doubling the number of Artemisia taxa known to content this molecule.

CONCLUSIONS

Our findings indicate that artemisinin may be widespread across the genus, providing an accessible local resource outside the distribution area of Artemisia annua.

Ethnobotany, Phylogeny, and 'Omics' for Human Health and Food Security

Here, we propose a new term, 'ethnobotanical convergence', to refer to the similar uses for plants included in the same node of a phylogeny. This phylogenetic approach, together with the 'omics' revolution, shows how combining modern technologies with traditional ethnobotanical knowledge could be used to identify potential new applications of plants.

Recent updates and developments to plant genome size databases

Two plant genome size databases have been recently updated and/or extended: the Plant DNA C-values database (http://data.kew.org/cvalues), and GSAD, the Genome Size in Asteraceae database (http://www.asteraceaegenomesize.com). While the first provides information on nuclear DNA contents across land plants and some algal groups, the second is focused on one of the largest and most economically important angiosperm families, Asteraceae. Genome size data have numerous applications: they can be used in comparative studies on genome evolution, or as a tool to appraise the cost of whole-genome sequencing programs. The growing interest in genome size and increasing rate of data accumulation has necessitated the continued update of these databases. Currently, the Plant DNA C-values database (Release 6.0, Dec. 2012) contains data for 8510 species, while GSAD has 1219 species (Release 2.0, June 2013), representing increases of 17 and 51%, respectively, in the number of species with genome size data, compared with previous releases. Here we provide overviews of the most recent releases of each database, and outline new features of GSAD. The latter include (i) a tool to visually compare genome size data between species, (ii) the option to export data and (iii) a webpage containing information about flow cytometry protocols.