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Iron overload is a frequent consequence in transfusion-dependent myelodysplastic syndromes (MDSs), which often requires iron chelation therapy (ICT). Interestingly, ICT may sometimes induce a hematologic improvement that leads to significant reduction or complete interruption of blood transfusions. This phenomenon has been recently described in MDS treated with the new oral chelator deferasirox. Here we briefly review the literature about this phenomenon and discuss the possible biological mechanisms underlying hematologic effects of deferasirox in MDS, starting from a new paradigmatic case in whom both hemoglobin level and platelet count improved, inducing transfusion-independence, soon after starting the treatment with deferasirox., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

NF-kB is reported to be constitutively activated in a percentage of high-risk myelodysplastic syndrome carrying cytogenetic aberrations. Only few data are reported on the use of proteasome inhibitors in this subset of patients. We performed a study on efficacy and safety of bortezomib as a single agent in patients with myelodysplastic syndromes (MDS). Bortezomib was administered at 1.3mg/m(2) with a 1, 4, 8, 11-day schedule every 28 days, in 19 patients with IPSS low/intermediate 1 or intermediate2/high risk. Six out of 19 patients received all planned eight cycles. Hematologic toxicity was recorded in all patients, especially grade 3/4 neutropenia and grade 3/4 thrombocytopenia; non-hematologic side effects were recorded in 7 patients, but events were all of grade 1/2 toxicity. According to IWG 2006 criteria, 4 out of 19 patients (21%) achieved erythroid response and 9 patients (47%) showed stable disease. In patients with erythroid response bone marrow WT1 levels decreased from a median of 109 copies at baseline to a median of 14 copies at the end of treatment, whereas in patients with stable disease, median WT1 copies increased either in bone marrow and peripheral blood. In conclusion, bortezomib used alone in MDS shows modest hematologic efficacy but appears to affect the WT1 gene expression, which is typically increased in these diseases., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

To compare the efficiency of novel mitogenic agents and traditional mitosis inductors, 18 patients with splenic marginal zone lymphoma (SMZL) were studied. Three cultures using oligodeoxynucleotide (ODN) plus interleukin-2 (IL-2), or TPA, or LPS were setup in each patient. Seventeen/18 cases with ODN + IL2 had moderate/good proliferation (94, 4%) as compared with 10/18 cases with TPA and LPS (55%) (P = .015); 14/18 (77, 7%) cases with ODN + IL2 had sufficient good quality of banding as compared with 8/18 cases (44, 4%) with TPA and LPS. The karyotype could be defined from ODN + IL2-stimulated cultures in all 18 patients, 14 of whom (77, 7%) had a cytogenetic aberration, whereas clonal aberrations could be documented in 9 and in 3 cases by stimulation with LPS and TPA, respectively. Recurrent chromosome aberrations in our series were represented by aberrations of chromosome 14q in 5 patients, by trisomy 12 and 7q deletion in 4 cases each, and by abnormalities involving 11q and 13q in two cases each. These findings show that stimulation with ODN + IL2 offers more mitotic figures of better quality and results in an increased rate of clonal aberrations in SMZL, making this method ideal for prospective studies aiming at the definition of the prognostic impact of cytogenetic aberrations in this disorder.

This was a retrospective, comparative study focused on the extended follow-up of 192 transfusion-dependent patients with myelodysplastic syndromes treated (n. 83) or not treated (n. 109) with recombinant erythropoietin alpha (r-EPO) as single agent during the course of their disease. The results supported the safety of this treatment in the long term and also showed a significant survival advantage (median 52 months vs. 31 months, p<0.0095) in responding patients as compared to non-responding ones or to subjects never treated with r-EPO. At multivariate analysis, response to r-EPO maintained an independent prognostic value on OS., (Copyright (c) 2010 Elsevier Ltd. All rights reserved.)

Systemic AL amyloidosis is associated with nearly 15% of cases of multiple myeloma, but data on the frequency and significance of amyloid deposits in the bone marrow of patients affected by multiple myeloma without clinical signs of systemic amyloidosis are scanty. Bone marrow smears of 166 unselected patients affected by multiple myeloma (126 at diagnosis and 40 after treatment) were stained with Congo red and studied by transmission and birefringence microscopy. Both focal and diffuse storages were considered positive. Overall, 67 patients were positive and 99 were negative to Congo red and apple-green birefringence. In particular, 51 of the 126 patients studied at diagnosis and 16 of the 40 patients with advanced disease were positive. Seventeen patients were reassessed after a mean follow-up of 32 months (range: 6-91): disappearance of amyloid deposits was verified in three cases, all responsive to bortezomib-based regimens. The preliminary data available suggest that amyloid deposition in the marrow of myeloma patients is frequent, as it can be traced in nearly 40% of cases. We failed to find correlations between bone marrow amyloid deposits and immunoglobulin type, disease stage, plasma cells percentage, hemoglobin, calcium, creatinine, albumin, or beta(2)microglobulin. Significantly higher incidence of moderate/severe peripheral neuropathy was found in patients with marrow amyloid exposed to potentially neurotoxic antineoplastic agents. Further studies and prolonged follow-up are needed to validate our findings and to define possible prognostic aspects.

Bone marrow neovascularisation supports plasma cell tumour progression in patients with multiple myeloma (MM), and is partially sustained by bone marrow macrophages through their angiogenic and vasculogenic activities. As such, macrophages may be a target for antivascular treatment in MM. Here, we show that bortezomib (BZ) and zoledronic acid (ZOL) display distinct and synergistic inhibitory effects on cell proliferation, adhesion, migration and expression of angiogenic cytokines (i.e.: VEGF, bFGF, HGF and PDGF). Similar effects were found on capillarogenic organisation and expression of vascular markers in cells which became vasculogenic. VEGFR2 and ERK1/2 phosphoactivation as well as NF-kappaB activity were also inhibited. Overall these data provide evidence that the exposure of bone marrow macrophages in MM during the treatment with ZOL and BZ, alone and or in combination, impacts their angiogenic and vasculogenic properties, suggesting that these cells may be considered as a target of both drugs in MM patients., (Copyright 2009 Elsevier Ltd. All rights reserved.)

Multiple myeloma (MM) is a neoplastic disorder affecting elderly people. The treatment for all patients with MM was, for about 40 years, based on the combination of melphalan plus prednisone, with a very low rate of complete remissions and a survival that remained unacceptably low (about 36 months). Diverse factors, including comorbidity, performance status, decreased physiologic reserve, and potential undertreatment, contribute to these poor outcomes. Recently, however, the reduced treatment-related morbidity and mortality associated with autologous stem-cell transplantation and the availability of effective new drugs with acceptable toxicity, such as thalidomide, lenalidomide and bortezomib, have greatly modified the traditional treatment paradigms in older patients with MM, challenging, in some cases, the definition of elderly and rapidly transforming the traditional palliative treatments to a new global therapeutic strategy, with the final objective of significantly improving the quality and the duration of life for elderly people with this disease. In this review, we report updated data for the front-line treatment of MM in the elderly population, examining the role of new drugs combined with melphalan or their incorporation within more complex combinations, including other so-called conventional drugs such as (pegylated)-doxorubicin, cyclophosphamide, and dexamethasone. We also assess the role of autologous and allogeneic stem-cell transplantation with adjusted conditioning regimens in selected elderly patients.

Thalidomide represents one of the most relevant therapeutic advances for patients with multiple myeloma over the last 10 years. Despite some toxicities, it has demonstrated significant efficacy in elderly patients, as well as in the setting of younger subjects receiving autologous stem cell transplantation. Here, we report and discuss the clinical results achieved with thalidomide alone or in combination with dexamethasone or other drugs, such as melphalan, cyclophosphamide, doxorubicin and bortezomib, in previously untreated myeloma patients.

We investigated the effects of a single s.c. injection of peg-filgrastim in 32 patients with multiple myeloma who underwent autologous stem cell transplantation (AuSCT) as first line treatment. For comparison, 32 myeloma patients with similar characteristics and receiving standard daily administration of filgrastim were matched. Overall, there were no statistically significant differences between peg-filgrastim and filgrastim in terms of tolerability, marrow recovery, severity of neutropenia, incidence and duration of febrile neutropenia, documented infections and transfusions. However, some favourable trends or effects in favour of peg-filgrastim were observed. This was confirmed by a review of the published papers about this topic.

The treatment of multiple myeloma has seen significant changes from the initial use of melphalan to the introduction of stem cell transplantation and, most recently, to the era of novel targeted agents. Melphalan still remains as a reference drug for combination regimens, including emerging newer therapeutic options, either used at a standard dose for initial or salvage treatments in patients who are not eligible for more intensive therapies, or in conjunction with new molecules within high-dose chemotherapy programs. In this review, the authors analyze old and novel regimens, including melphalan for the treatment of newly diagnosed or relapsed/resistant patients with multiple myeloma in the clinical settings of standard chemotherapy, as well as autologous or allogeneic stem cell transplantation.

We investigated the antibacterial activity of sub-inhibitory concentrations of ethanolic extract of propolis (EEP), and its effect on the antibacterial activity of some antibiotics. Some clinically isolated Gram-positive strains were used. Moreover, sub-inhibitory concentrations of EEP were used to value its action on some important virulence factors like lipase and coagulase enzymes, and on biofilm formation in Staphylococcus aureus. Our results indicated that EEP had a significant antimicrobial activity towards all tested clinical strains. Adding EEP to antibacterial tested drugs, it drastically increased the antimicrobial effect of ampicillin, gentamycin and streptomycin, moderately the one of chloramphenicol, ceftriaxon and vancomycin, while there was no effect with erithromycin. Moreover, our results pointed out an inhibitory action of EEP on lipase activity of 18 Staphylococcus spp. strains and an inhibitory effect on coagulase of 11 S. aureus tested strains. The same EEP concentrations showed a negative interaction with adhesion and consequent biofilm formation in S. aureus ATCC 6538P.

Propolis is a resinous substance collected by honeybees from plant sources. Its antimicrobial activity has been well documented but little is specifically known about its activity on virulence factors of Candida albicans. The aim of this work was therefore to evaluate in vitro the propolis effect on yeast-mycelial conversion (Y-M), extracellular phospholipase activity and fungal adhesion to epithelial cells. The two propolis samples used significantly inhibited the C. albicans strains tested, showing a rapid (between 30 seconds and 15 minutes), dose-dependent cytocidal activity and an inhibitory effect on Y-M conversion at a concentration of 0.22 mg/ml. Moreover, the hyphal length was reduced even at lower propolis concentration. Propolis also caused a dose- and time-dependent inhibition of phospholipase activity. No clear effect was shown on adherence to buccal epithelial cells and surface structure hydrophobicity, but damage to the plasma membrane structure was demonstrated with the Propidium Iodide test.

Fenticonazole is a chiral antifungal agent, used in therapy as the racemic mixture. The investigation on the chirality of fenticonazole is reported in this study. rac-Fenticonazole was resolved by HPLC and by capillary electrophoresis (CE). The chiral stationary phase (CSP), used in HPLC, was Daicel OD-H, a commercial phase, which allowed the separate collection of the two enantiomers. The chiral selectors used for CE were some cyclodextrin derivatives. The analysis time required from CE was about the half the HPLC enantioseparation time. The biological activity of the rac-mixture and each individual enantiomer was tested against Cryptococcus neoformans and two Aspergillus nidulans strains. The minimum inhibitory concentration (MIC) evaluation showed that the eutomer was the enantiomer chromatographically more retained and had a longer migration time in the electrophoretic enantioseparation. The CD spectrum of the eutomer showed a positive Cotton effect., (Copyright 2002 Wiley-Liss, Inc.)

Objective: To verify whether the prototypical long pentraxin PTX3 represents an indicator of the activity of small-vessel vasculitis., Methods: Concentrations of PTX3, a pentraxin induced in endothelium by cytokines, were measured by enzyme-linked immunosorbent assay in the sera of 43 patients with Churg-Strauss syndrome, Wegener's granulomatosis, and microscopic polyangiitis. PTX3 was also measured in the sera of 28 patients with systemic lupus erythematosus (SLE), 22 with rheumatoid arthritis, and 16 with CREST syndrome (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasias). Serum concentrations of C-reactive protein (CRP) were measured by immunoturbidimetry. The cells involved in PTX3 production in vivo were identified in skin biopsy samples., Results: Patients with active vasculitis had significantly higher concentrations of PTX3 than did those with quiescent disease (P < 0.001). PTX3 levels in the latter group were similar to those in healthy controls. PTX3 levels were higher in patients with untreated vasculitis and lower in patients who underwent immunosuppressive treatments (P < 0.005). In contrast, patients with active SLE had negligible levels of the pentraxin. PTX3 levels did not correlate with CRP levels in vasculitis patients. Endothelial cells produced PTX3 in active skin lesions., Conclusion: PTX3 represents a novel acute-phase reactant produced at sites of active vasculitis.

The antifungal activity of Melaleuca alternifolia Maiden (Myrtaceae) essential oil against yeasts (Candida spp., Schizosaccharomyces pombe, Debaryomyces hansenii) and dermatophytes (Microsporum spp. and Tricophyton spp.) is reported. We focused on the ability of tea tree oil to inhibit Candida albicans conversion from the yeast to the pathogenic mycelial form. Moreover we carried out broth microdilution test and contact tests to evaluate the killing time. M. alternifolia essential oil inhibited the conversion of C. albicans from yeast to the mycelial form at a concentration of 0.16% (v/v). The minimum inhibitory concentrations (MICs) ranged from 0.12% to 0.50% (v/v) for yeasts and 0.12% to 1% (v/v) for dermatophytes; the cytocidal activity was generally expressed at the same concentration. These results, if considered along with the lipophilic nature of the oil which enables it to penetrate the skin, suggest it may be suitable for topical therapeutic use in the treatment of fungal mucosal and cutaneous infections.

Aims: The influence of an antioxidant, propyl gallate (PG), on the in vitro antifungal activity of itraconazole and fluconazole, was investigated to determine whether PG could increase the antifungal activity and reduce strain resistance., Methods and Results: Susceptibility tests were performed against azole-resistant isolates of Candida albicans by the microbroth dilution method in the presence of PG at 400 microg ml-1. PG-triazole combination brought about a marked reduction of inhibitory azole concentration. In particular, the MIC90 for itraconazole and fluconazole dropped from 1 microg ml-1 to 0.125 microg ml-1 and from > 64 microg ml-1-8 microg ml-1, respectively., Conclusion: It is likely that more than one mechanism is involved in the above synergistic interaction, including effects of PG on ATP synthesis, thus reducing the ABC transporters activity, or an effect on the target of azole, i.e. the P-450 cytochrome., Significance and Impact of the Study: The PG-triazole combination may have a role in future topical antifungal strategies but other studies are warranted.

Technological evolution allowed to record high fidelity traces that--when analysed by complex mathematical systems--may provide extremely detailed and new information about all the factors involved in the determinism of pulse wave. Suprasystolic waves, i.e. those recorded immediately before systolic pressure, may be regarded as similar to aortic pressure waves evaluated during cardiac catheterization. Suprasystolic dP/dt max was calculated from the profile of pulse wave recorded by the DynaPulse, an automatic portable non-invasive oscillometric method to simultaneously measure BP and analyse arterial waveforms, in 10 normal healthy subjects (age 37 +/- 5) and 5 subjects with ischaemic dilatative cardiomyopathy (age 41 +/- 7) whose ejection fraction--invasively assessed--was < 40%. The 24 h dP/dt max curves were analysed by parametric and non parametric tests. We found a significant difference (p < 0.001) in the average 24-h dP/dt max between healthy subjects (471 +/- 36.7 mmHg/sec) and patients with impaired cardiac function (271 +/- 54.2 mmHg/sec). The average daytime and nighttime dP/dt max values showed significantly higher values in normal subject in comparison to patients with heart failure (daytime 7.23 h: 529 +/- 74 mmHg/s versus 227 +/- 64 mmHg/s, p < 0.001; nighttime: 572 +/- 82 mmHg/s versus 202 +/- 67 mmHg/s, p < 0.001). We also found a difference in the occurrence of acrophases, at similar blood pressure value, i.e. the highest dP/dt values occurred during the night in normal subject, the opposite in ischaemic patients. Furthermore, the dP/dt max correlates only with systolic blood pressure.

BACKGROUND: The modern developments in engineering allow one to record the speed at which the blood pressure rises on the advancing pulse wave front. It was possible to obtain this through the conversion of a conventional pulse from a single suprasystolic oscillation to the oscillometric envelope into its first derivative with respect to time. OBJECTIVE: The aim of this study was to report a preliminary comparison between healthy subjects and patients with heart failure as a first step towards the clinical ujse of this first derivative of a time-dependent function (dP/dt).METHODS: For 10 normal healthy subjects (aged 37 +/- 5 yhears) and five subjects with ischaemic cardiomyopathy (aged 41 +/- 7 years), whose ejection fractions (invasively assessed) wee < 40%, we evaluated six sequential oscillometric measurements of blood pressure obtain by using a Dynapulse Ps5000 (Pulse Metric, San Diego, California, USA) device, which simultaneously records blood pressure and analyses every arterial waveform. The mean and SD of (dP/dt)max for each subject were calculated, together with the relative mean distribution and the significance of the differences. RESULTS: The data show that (dP/dt)max of subjects with an impairment of cardiac function is less than normal. The mean (dP/dt)max of normalk subjects was significantly different (P < 0.05) from that of patients with ischaemic cardiomyopathy and lower than normalk ejection fractions. CONCLUSION: These preliminary results allowed us to raise the hypothesis that this parameter, being representative of the cardiac function, because many data are obtained, is extremely useful for monitoring changes during daily activities or to outline the nycthoemeral rhythm. We have to test the hypotheses that the analyses of the correlations between (dP/dt)max and other haemodynamic parameters may be used in the pathphysiological study of cardiomyopathies and that the comparison of differences in (dP/dt)max can be used in the evaluation of the effects of the treatment.

The cardiovascular complication represents the principal effect of death in patients uraemics cronics. The hypertension is one of most cause; for this, the control of hypertension is one important objective in this patients. The introduction of dynamic monitoring permit to estimate the adeguatesse of hypertension control or the appearance of extradialitic hypotension. The dynamic monitoring permit to value the difference in two groups, young and elderly and to conform the hypertension therapy.

We followed for a period of six months, 54 patients of over 60 years old, submitted to hemodialitic treatment. We gave human recombinant erythropoietin, average dosage 50 UI/Kg subcutaneously on alternative days, folic acid and iron supplements together with a proteic supply of 1.2 g/Kg/die (35 Kcal/Kg). The medullary response has been monitored with hematochemical tests; blood pressure and nutritional conditions have been evaluated. Furthermore, the patients were given a questionnaire to evaluate their quality of life. At the end of the follow up, 50 patients responded positively to therapy. These patients showed an increase of RBC (from 2,789,780 +/- 259,310 to 3,313,110 +/- 472,780 p < 0.001) of HCT (from 21.86% +/- 2.16% to 27.18 +/- 2.74% p < 0.0001) and of Hb (from 7.72 +/- 1.12 g/dl to 9.28 +/- 0.98 g/dl p < 0.006). Total protein and albumin increased too. Furthermore they showed a progressive increase of "performance status". Our results confirm efficacy of erythropoietin in the treatment of anemia in elderly hemodialized patients.

In the literature there are few studies evaluating carotid vascular atherosclerotic involvement in patients with essential arterial hypertension. Nowadays with new non-invasive methodological methods, such as Doppler-echotomography, it is possible to evaluate accurately structural vascular and cardiac changes. In this study we evaluated the relationship between carotid vascular structural changes and cardiac left ventricular mass index in 15 normotensive subjects and in 15 patients with essential hypertension. We performed a B-mode echotomography (7.5 MHz) of a common carotid in order to measure the diameter of the vessel and intima-media wall thickness. In the same subjects we determined echocardiographic left ventricular mass index and we measured arterial pressure by sphygmomanometric method. There was no statistical significant difference in the two groups except that in systolic, diastolic and mean arterial pressure (96 +/- 2 vs 123 +/- 2 mmHg, p < 0.01), left ventricular mass index (102 +/- 3 vs 118 +/- 3 g/m2, p < 0.01) and in the common carotid intima media wall thickness (0.91 +/- 0.01 vs 2.23 +/- 0.02 mm). In the normotensive subject mean arterial pressure correlated significantly with age (r = 0.699) and with common carotid arterial diameter (r = 0.523) (both p < 0.05). In hypertensive patients, on the contrary, mean arterial pressure correlated with left ventricular mass index (r = 0.523), carotid arterial diameter (r = 0.627) and common carotid intima media wall thickness (r = 0.847). These results demonstrate that in hypertensive patients cardiac abnormalities accompanied vascular structural changes.

The carotid artery is one of the most important sites in the progression of atherosclerotic lesions. Atherosclerosis is known to be determined by a variety of factors, among which arterial hypertension is one of the most important. Blood pressure control by antihypertensive treatment is thus of great benefit in management of atherosclerosis, particularly in view of the direct action of some classes of antihypertensive agents on atheromatous lesions. Today, modern diagnostic technique allow a non-invasive examination of the artery wall (B-mode ultrasound and pulsed-Doppler), so that early detection of structural and functional alterations is possible. In order to evaluate the efficacy of the long term blood pressure reduction in the progression and/or in the regression of cardiovascular structural abnormalities, we studied intima-media thickness and arterial compliance during one-year antihypertensive treatment with a new calcium-antagonist, lacidipine, or a diuretic hydrochlorothiazide. In both groups we observed a comparable blood pressure reduction (lacidipine: from 166 +/- 5/100 +/- 1 to 142 +/- 4/88 +/- 2 mmHg; hydrochlorothiazide: from 154 +/- 5/102 +/- 2 to 140 +/- 4/88 +/- mmHg; both p < 0.01). On the contrary, only in patients treated with lacidipine did we obtain a significant improvement in carotid blood flow (383 +/- 16 vs 411 +/- 16 ml/min p <) and in arterial compliance (0.8 +/- 0.1 vs 1.2 +/- 0.2 cm/dyne p < 0.01). Indeed, we observed a different behaviour of the intima-media thickness in the two groups (lacidipine: 1.11 +/- 1.4 vs 1.13 +/- 1.5 mm n.s.; hydrochlorothiazide: 1.15 +/- 0.15 vs 1.21 +/- 0.17 mm p < 0.06). Our results demonstrate that an effective antihypertensive treatment with calcium antagonists may influence the progression of carotid vascular abnormalities.

The aim of this investigation was to compare the contact action of econazole sulfosalicylate (E-SSA) on mycetes (Candida albicans, Cryptococcus neoformans, Aspergillus fumigatus, Trichophyton rubrum, T. cutaneum, Pityrosporum sp.), Gram-positive bacteria (Staphylococcus aureus, Streptococcus faecalis) and Gram-negative bacteria (Escherichia coli, Citrobacter freundii) with that exerted by econazole nitrate (E-NIT). The results show E-SSA activity greater than E-NIT (in particular against mycetes and Gram-negative bacteria). The E-SSA contact activity trials illustrated certain properties of this imidazole sulfosolicylate such as: absence of latency time, antimicrobial activity proportional to its concentration, when a high concentration is used, given the limiting influence of pH and ionic strength of the medium. The higher E-SSA contact activity, in relation to E-NIT, can be correlated to its greater lipophylia considering also the lipophylic properties of SSA and the scarce dissociation of E-SSA.

Sodium dioctyl sulfosuccinate (SDSS), an anionic surfactant used at a non-antimicrobial concentration, increased the sensitivity of Candida albicans to fluconazole in complex media (such as Sabouraud). The conditions were assessed to determine the in vitro sensitivity to fluconazole. In this connection, the use of a liquid medium at a non-alkaline pH is important. The presence of SDSS in complex media does not seem to affect the neutralization of a particular substances but favours the activity of fluconazole.

The in-vitro antimicrobial activity of miconazole sulfosalicylate (M.SSA) has been investigated on mycetes (Candida albicans, Cryptococcus neoformans, Aspergillus niger, Trichophyton mentagrophytes), Gram-positive bacteria (Staphylococcus aureus, Streptococcus faecalis) and Gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens and Proteus vulgaris) in comparison with miconazole nitrate (M.NIT). The results showed M.SSA has a greater activity than M.NIT, particularly on mycetes and Gram-negative bacteria. The study of activity by contact with M.SSA showed some characteristics of this sulfosalicylate imidazole, such as the lack of a latency time, an antimicrobic action related directly to the concentration, the limited influence of pH and ionic strength of medium used. The greater activity by contact of M.SSA than M.NIT could be related to its higher lipophilia (due also to the lipophilic characteristics of SSA) and, therefore, to increased interaction with the cell membrane.

The in vitro activities of new sulfosalicylic salts of econazole (E.SSA) and miconazole (M.SSA) have been investigated in comparison with the respective nitrate (NIT) salts and sulfosalicylic acid (SSA) alone. The results reveal good antimicrobial activity of M.SSA and E.SSA against different strains of Candida, dermatophytes, moulds, Gram-positive bacteria and Trichomonas vaginalis. The MIC values demonstrate that M.SSA is more active than M.NIT on Candida and T. vaginalis. E.SSA was also more active than E.NIT on T.vaginalis. Both SSA and sodium sulfosalicylate (NaSSA) were practically without activity by themselves. Finally, the pH variations did not significantly modify the activity of the SSA salts, suggesting that their greater activity could be due to better lipophilic activity of these compounds with respect to the nitrate salts.

The synthesis and antifungal activities of new 1,5-diarylpyrrole derivatives are reported. Antimicrobial data in comparison with pyrrolnitrin show that N-methylpiperazinylamides exhibit very poor activity against Candida albicans and Candida sp. while acid and ester derivatives are inactive. Vice-versa many acid or amide derivatives show interesting antibacterial activity. The results obtained are discussed on the basis of structure-activity relationships.

Dequalinium is a quaternary ammonium salt. From about 30 years Dequalinium (D.C.) was used in the treatment of the initial respiratory organs infections. It can be given orally and topically yet it cannot be given systemically cause its probable systemic toxicity. D.C. has a wide range of antimicrobial activity that is extended to Gram positive, Gram negative bacteria, protozoa and yeast. Its mechanism of action is directed to the cytoplasmatic membrane where D.C. caused its damage and consequently release of cellular components. Our study has been evaluated the antimicrobial activity of D.C. both as commercial product that pure substance. We tested 27 Gram positive bacteria, 49 Gram negative bacteria, 83 strains of fungi, we also tested the antimicrobial activity of D.C. commercial product and pure substance against 8 strains of protozoa; Trichomonas vaginalis. The antimicrobial activity was estimated in some experimental conditions, (cultural and no cultural conditions); in these experiments we can observed that the commercial product presents higher activity than pure substance. In cultural condition commercial product presents antimicrobial activity against Gram positive and negative bacteria and yeast; its interesting to evaluate that bacteria, that are resistant to the common antimicrobial agents were inhibited by D.C. tinture and pure substances. Our data exhibit that serum didn't interfere until the 2% concentration with the antimicrobial activity of D.C., moreover this antimicrobial activity is not influenced by the inoculum size until 10(5) cell/ml. D.C. presents higher activity at alkaline pH than acid pH but strains of C. albicans were killed by D.C. at acid pH. In no cultural conditions D.C. has demonstrated a rapid antimicrobial activity in short contact time (15 minute); the cells of some microorganisms were killed in 60 minutes. Against mycelial form, the commercial product demonstrates good activity higher than pure substance. The activity of D.C. against the formation of germ-tube from blastospores of C. albicans in N-acetyl-glucosamine solution (no culture medium) was markedly high; this is very important because in C. albicans the germ-tube production and yeast-mycelial conversion are prominent for pathogenicity and resistance to host defences. Our data demonstrate the good activity of D.C. against Trichomonas vaginalis; we can also observed that the antimicrobial activity of commercial product is higher than pure substance.(ABSTRACT TRUNCATED AT 400 WORDS)

LY121019 is a cyclic peptide antibiotic of the echinocandin group, which is characterized by strong anti-Candida activity (in particular against Candida albicans) as well as by low experimental toxicity. Its anti-Candida activity is thought to be due to an inhibition of the synthesis of beta-glucan, an essential cell wall polysaccharide. The different composition of culture media or the presence of animal serum did not show adverse effects on LY121019's anti-Candida activity and the addition of reducing compounds such as cysteine and hydroquinone did not manifest a negative influence. Analogously the anti-Candida activity was not influenced when C. albicans was grown under aeration. The activity of LY121019 was very high against the mycelial form of C. albicans even when this form was developed in the presence of animal serum.

The amount of glycogen in vaginal liquids decreases with Trichomonas vaginalis and this is connected with T. vaginalis activity in specimens. A glycogen-hydrolysed casein medium ("glycogen medium") added to vaginal liquid is a valid maintenance medium for T. vaginalis and therefore enables a direct test for antitrichomonas drugs to be performed.

Chlorhexidine increases the activity of itraconazole against Candida isolates; itraconazole-chlorhexidine combinations show synergistic activity in culture media. The activity of itraconazole is discussed.

Sodium dichloroisocyanurate is a chlorinated cleaner. It was used for swimming pool sanitation and for the sterilisation of linen. Not recently ago sodium dichloroisocyanurate has substituted hypochlorite for the sterilisation of infant feeding bottles and teats. Sodium dichloroisocyanurate is soluble in water; this condition causes the hydrolysis of sodium dichloroisocyanurate in hypochlorous acid, that is the active agent, isocyanurate and isocyanurate chlorine. These compounds form a chlorine protein that carry out microbicidal activity. In a toxicology study has been shown that no severe changes in the normal metabolic function occurred, furthermore sodium dichloroisocyanurate has not shown teratogenic effects at the concentration of 200 mg/kg. The antimicrobial activity of sodium dichloroisocyanurate was evaluated against Gram negative bacteria such as E. coli or Salmonella typhimurium and against some fungi. This study illustrates a rapid antimicrobial activity using concentrations. Our study concentrated on the antimicrobial activity of sodium dichloroisocyanurate in some experimental conditions. We tested 66 strains of fungi, 28 Gram positive bacteria and 29 Gram negative bacteria. We also evaluated the antimicrobial activity of sodium dichloroisocyanurate against protozoa such as Trichomonas vaginalis. The antimicrobial activity was evaluated in cultural conditions and non cultural conditions; in these experiments we observed similar action in both the commercial product and pure substance. In cultural conditions sodium dichloroisocyanurate shows a good activity against fungi and bacteria, moreover it can be observed that the serum didn't interfere with its activity. In a non cultural condition the Candida was killed rapidly by the sodium dichloroisocyanurate but this activity is influenced by the growth phase of the yeast. Against mycelial form such as Penicillium and Aspergillus the sodium dichloroisocyanurate needs a longer contact time than yeast form for its activity. It is interesting to note that well known bacteria, that are resistant to the common antimicrobial agents, such as Pseudomonas aeruginosa, were inhibited by sodium dichloroisocyanurate in a rapid bactericidal action. Our data demonstrates that no significant adverse influence on the activity of sodium dichloroisocyanurate was shown by pH and by temperature even if in some experimental conditions increased activity was noticed at pH = 6.6. The sodium dichloroisocyanurate has demonstrated good activity against Trichomonas vaginalis. This fact extends the broad-spectrum activity of sodium dichloroisocyanurate to the protozoa. In conclusion, sodium dichloroisocyanurate has demonstrated a good activity against all tested strains, furthermore its activity did not decrease in the presence of 1% of organic substance (serum etc.).(ABSTRACT TRUNCATED AT 400 WORDS)