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Le comunità ospedaliere medievali in Renania – e Magonza in particolare – si distinguono non solo come centri di cura ma anche luoghi di formazione ed educazione sanitaria. Nell’Europa del tardo medioevo, caratterizzata da epidemie e guerre, le comunità ospedaliere svolgevano un ruolo essenziale offrendo rifugio e assistenza non solo ai malati ma anche ai poveri e ai pellegrini. Attraverso l’apprendistato e la pratica quotidiana, medici e infermieri non solo acquisivano conoscenze mediche, ma promuovevano anche valori di compassione e solidarietà. Attraverso uno studio storico, il presente lavoro mira a riconoscere il ruolo educativo di queste istituzioni nel contesto della storia della medicina e dello sviluppo delle strutture educative, proponendo una riflessione su come la loro eredità possa illuminare le pratiche educative sanitarie contemporanee.

Nous présentons un cas clinique illustrant l'apport du test d'activation des basophiles (TAB) dans l'exploration allergologique d'une anaphylaxie peropératoire. En effet, ces explorations sont compliquées compte-tenu des multiples molécules imputables, mais également des effets pharmacologiques de celles-ci rendant le test de réintroduction (gold standard habituel) peu réalisable de façon systématique. Le TAB se positionne comme une aide supplémentaire précieuse dans les tests in vitro pour l'exploration de ces anaphylaxies. We provide a case-report illustrating the contribution of Basophil activation Test in investigating perioperative anaphylaxis. Indeed, the diversity of molecules potentially involved, their pharmalogical actions make the reintroduction test uneasy to achieve. In such cases Basophil activation Test can be a great help in this matter. [ABSTRACT FROM AUTHOR]

Anaesthetists and pulmonologists are well trained to follow the “can’t intubate, can’t oxygenate” (CICO) protocol but the procedure is rarely practised. This case report concerns an elective patient scheduled for endobronchial ultrasound bronchoscopy (EBUS) because of suspected sarcoidosis. Based on known medical history, anaesthesia for EBUS procedure was initiated with a laryngeal mask. The airway turned out to be difficult and the patient was not ventilable despite several efforts including curarization and orotracheal intubation. Rapid desaturation imposed to apply the CICO protocol with emergency cricothyroidotomy as extreme measure but also failed. 6-handed face mask ventilation was continued. Eventually, introduction of a microlaryngeal tube of the 3rd generation laryngeal mask, placed on the fibrescope, allowed endotracheal intubation. The patient fell into pulseless electrical activity, and the CICO protocol was started. Immediate cardiopulmonary resuscitation totally recovered vital functions. In the post-operative follow-up, no temporary or permanent cardiological and neurological sequels were found, but new medical history such as inconstant use of C-PAP (Continuous Positive Airway Pressure) and a significant weight gain since the last notable difficult intubation were uncovered, which explained the patient’s compromised airways. Had this information been available prior to the scheduled operation, it would have indicated awake intubation with a local anaesthesia of the oropharynx and appropriate sedation of the patient.

Copyright of Biologie Aujourd'hui is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The modern general anesthesia is the one balanced, with orotracheal intubation, by combining drugs targeting different receptors. The selection of neuromuscular blocking agent for special circumstances in low-income countries is still a clinical dilemma. The present article reviews full format publications (n = 14) of last 5 years, following both known and new paralytic medication, both in terms of the 10 pharmacophysiological characteristics of ideal myorelaxant, as well as through the chain of patient’s specific clinical conditions. Advances in this field of pharmacology are important, but it seems that they are still to be expected.

Electroconvulsive therapy consists of the application of electric current, through electrodes placed in frontotemporal regions (bilateral) or unilateral, with the aim of inducing a seizure, controlled and monitored, and performed under general anesthesia, with the presence of a multidisciplinary team. This paper reviews the history of the application of anesthetics and muscle relaxants, which have been used for this treatment and how the anesthesiologist has positioned himself as a fundamental element for its application. [ABSTRACT FROM AUTHOR]

In many studies on breast, skin and intestinal cancers, β‐adrenergic receptor antagonists have been shown to inhibit cell proliferation and angiogenesis and increase apoptosis in cancers. Carbachol inhibits chronic myeloid leukaemia K562 cell proliferation. Beta‐blockers are known to inhibit cell progression. The aim of this study is to explain the mechanism of action of β‐adrenergic receptors agonists and antagonists on apoptosis in chronic myeloid leukaemia cells. We tried to determine the effect of combined treatment of β‐adrenergic and cholinergic drugs on adrenergic β1 and β2 gene expression, cell proliferation and apoptosis in chronic myeloid leukaemia K562 cells. Cell proliferation was evaluated by the 5‐bromo‐2‐deoxy‐uridine (BrdU) incorporation kit. Caspase 3, 8, 9 activities were measured by the caspase assay kit. Protein expression level was detected by western blotting. We found that exposure to propranolol either by combination with carbachol facilitates additive effects on inhibition of caspase 3 and 8 expression in chronic myeloid leukaemia K562 cells. However, caspase 9 expression level was increased by propranolol alone or with propranolol and carbachol combination. The combined therapy of cholinergic and adrenergic receptor drugs will decrease cell proliferation in K562 cells. This decrease in cell proliferation may be mediated by the mitochondrial‐dependent intrinsic apoptosis pathway. [ABSTRACT FROM AUTHOR]

Propósito: el propósito de la presente investigación es entender el valor epistemológico de la obra de Claude Bernard sobre un contexto actual, donde la serendipia científica permite desprenderse de ideas y teorías que se creían válidas para lograr encontrar respuesta a problemas que no han podido ser resueltos hasta el momento. Contenidos: el contenido explica la vida del autor y describe los hechos que lo llevan al quehacer médico, luego se reflexiona sobre los experimentos más notorios y que permitieron avances en el mundo, tales como, por ejemplo, el descubrimiento de la glucogénesis animal. Contribuciones: este texto es un aporte a los científicos y médicos actuales que buscan nuevas maneras de descifrar ciertos problemas que todavía no han podido ser resueltos. Los conceptos de serendipia científica, descubrimientos científicos y hallazgos por medio de la experimentación a través de la historia, permiten ser una fuente de inspiración para las nuevas generaciones de investigadores.

Strychnos is a pantropical genus of Loganiaceae (Gentianales), with approximately 200 species, that lacks a detailed worldwide phylogenetic understanding until now. We investigated the global phylogeny of the majority of Strychnos species, and evaluated morphological and key character patterns to discuss congruence between phylogenetic clades and sectional classification systems. We included 147 ITS sequences across 12 genera, with 127 samples (103 species) of Strychnos and 20 outgroup accessions (19 species) in a Bayesian analysis. Tribes Antonieae, Loganieae, and Spigelieae were supported as monophyletic, but Strychneae was resolved as polyphyletic due to the positioning of Gardneria placed outside of the Strychnos + Neuburgia clade. Strychnos was supported as strongly monophyletic with 12 strongly supported clades, but the relationships among many of these clades were not well resolved. Most of the 12 sections in the current infrageneric classification system of Strychnos were resolved as non-monophyletic, indicating the need for a revision of the sectional divisions. Characters common in species placed within the relatively more nested clades include a non-climbing habit, invasion of non-rainforest habitats, absence of tendrils, absence of secondary phloem, and elongated corolla tubes, suggesting that these characters are relatively derived conditions in the genus. Inflorescence position, fruit size, and fruit wall thickness are extremely variable and were distributed among various clades in our phylogeny. Stamen, pistil, seed and seed coat, and phytochemical characters have figured prominently in the taxonomy of the genus, but are as yet incompletely described, thus preventing significant inference about their evolution. Most of the 12 well-supported clades within Strychnos are restricted to specific continents, sometimes with limited dispersion between neighboring continents, suggesting a history of repeated cross-oceanic dispersal or vicariance patterns. The Neotropical clades nested within the African clades have the shortest branches and the most unresolved topologies, probably indicating relatively recent radiation in the Neotropics. [ABSTRACT FROM AUTHOR]

Celebrating 75 years of Anaesthesia: our past, present and future. At the time, the balance between achieving optimal neuromuscular blockade to facilitate surgery and the need to avoid excessive depth of anaesthesia was a cause of much concern, and the use of intocostrin (curare) was postulated as a new and exciting solution. Depth of anaesthesia Mallinson reminds us of Guedel's classification of clinically assessing the depth of anaesthesia. Mallinson was correct that neuromuscular blocking drugs made surgery more practicable and effective, and arguably revolutionised the practice of anaesthesia; however, he could not have foreseen their association with two of the most feared peri-operative complications for patients and anaesthetists alike: accidental awareness during general anaesthesia; and residual neuromuscular blockade following recovery from anaesthesia. [Extracted from the article]

Even though high-throughput transcriptome sequencing is routinely performed in many laboratories, computational analysis of such data remains a cumbersome process often executed manually, hence error-prone and lacking reproducibility. For corresponding data processing, we introduce Curare, an easy-to-use yet versatile workflow builder for analyzing high-throughput RNA-Seq data focusing on differential gene expression experiments. Data analysis with Curare is customizable and subdivided into preprocessing, quality control, mapping, and downstream analysis stages, providing multiple options for each step while ensuring the reproducibility of the workflow. For a fast and straightforward exploration and visualization of differential gene expression results, we provide the gene expression visualizer software GenExVis. GenExVis can create various charts and tables from simple gene expression tables and DESeq2 results without the requirement to upload data or install software packages. In combination, Curare and GenExVis provide a comprehensive software environment that supports the entire data analysis process, from the initial handling of raw RNA-Seq data to the final DGE analyses and result visualizations, thereby significantly easing data processing and subsequent interpretation., (© 2024. The Author(s).)

Curare, a paralysing poison derived from South American plants, fascinated European explorers with its deadly powers. Generations of travellers were perplexed by how animals affected by curare showed no signs of suffering. British experimenters relabelled curare as an anaesthetic and used it to restrain animals during experiments. But during the 19th century, doubts started to appear: can a paralysed animal feel pain but be unable to express it? A scientific dispute emerged as not all British physiologists accepted Claude Bernard's claim that curare affected only the motor nerves. The scientific controversy over curare reached the British parliament, and the Cruelty to Animals Act (1876) stated that curare would not be considered an anaesthetic. Nevertheless, antivivisection advocates continued to contest its use for decades. The article reveals new aspects of colonial import of bioactive plants in a case that reshaped the production of medical knowledge and presented epistemological and moral challenges. [ABSTRACT FROM AUTHOR]

Genus Erythrina (Fabaceae) comprises several species, which are widely distributed in tropical and subtropical regions of the world. The plants of this genus exhibited significant role in traditional medicine targeting different diseases. Alkaloids and flavonoids were reported as the chief bioactive constituents of this genus with a wide range of biological activities. About 143 alkaloids were isolated from Erythrina sp. Anticonvulsant, anxiolytic, curare-like activity, insecticidal and cytotoxic activities were reported for Erythrina sp. alkaloids. The present work is an overview of the isolated alkaloids from Erythrina sp. with their reported biological activities. Abbreviations: CHCl3: Chloroform; CNS: Central nervous system; DCM: Methylene chloride; DPPH: 2,2-Diphenyl-1-picrylhydrazyl; E.: Erythrina; ERα/β: Estrogen receptors α/β; EtOAc: Ethyl acetate; EtOH: Ethanol; Hep-G2: Human liver carcinoma cell lines; HIV: Human immunodeficiency virus; HL-60: Human promyelocytic leukemia cells; K-562: Human immortalized myelogenous leukemia cell line; LPS: Lipopolysaccharide; MeOH: Methanol; MOLT-4: Acute lymphoblastic leukemia cell line; nAChRs: nicotinic acetylcholine receptors; NO: Nitric oxide; NREM: non-rapid eye movement; Pet. ether: Petroleum ether; RBA: Receptor binder affinity; TRAIL: Tumor necrosis factor (TNF)-related apoptosis-inducing ligand [ABSTRACT FROM AUTHOR]

Several novel bisbenzylisoquinoline alkaloids (BBIQAs) have recently been isolated from a Matis tribe arrow poison and shown by two-electrode voltage-clamp to inhibit mouse muscle nicotinic acetylcholine receptors (nAChR). Here, using radioligand assay with Aplysia californica AChBP and radioiodinated α-bungarotoxin ([125I]-αBgt), we show that BBIQA1, BBIQA2, and d-tubocurarine (d-TC) have similar affinities to nAChR orthosteric site. However, a competition with [125I]-αBgt for binding to the Torpedo californica muscle-type nAChR revealed that BBIQAs1, 2, and 3 are less potent (IC50s = 26.3, 8.75, and 17.0 μM) than d-TC (IC50 = 0.39 μM), while with α7 nAChR in GH4C1 cells, BBIQA1 was less potent that d-TC (IC50s = 162 μM and 7.77 μM, respectively), but BBIQA2 was similar (IC50 = 5.52 μM). In inhibiting the Ca2+ responses induced by acetylcholine in Neuro2a cells expressing the mouse adult α1β1εδ nAChR or human α7 nAChR, BBIQAs1 and 2 had similar potencies to d-TC (IC50s in the range 0.75–3.08 μM). Our data suggest that BBIQA1 and BBIQA2 can inhibit adult muscle α1β1εδ nAChR by both competitive and noncompetitive mechanisms. Further experiments on neuronal α3β2, α4β2, and α9α10 nAChRs, expressed in Xenopus laevis oocytes, showed that similar potencies for BBIQAs1, 2, and d-TC. With α3β2γ2 GABAAR currents were almost completely inhibited by d-TC at a high (100 μM) concentration, but BBIQAs1 and 2 were less potent (only 40–50% inhibition), whereas in competition with Alexa Fluor 546-α-cobratoxin for binding to α1β3γ2 GABAAR in Neuro2a cells, d-TC and these analogs had comparable affinities. Especially interesting effects of BBIQAs1 and 2 in comparison with d-TC were observed for 5-HT3AR: BBIQA1 and BBIQA2 were 5- and 87-fold less potent than d-TC (IC50 = 22.63 nM). Thus, our results reveal that these BBIQAs differ from d-TC in their potencies towards certain Cys-loop receptors, and we suggest that understanding the reasons behind this might be useful for future drug design. [ABSTRACT FROM AUTHOR]

Objetiva-se neste artigo, apresentar a análise fenomenológico-hermenêutica de Martin Heidegger sobre a religião em Santo Agostinho. Justifica-se este objetivo, o fato de que, tomando por fundamento a obra Phänomenologie des Religiösen Lebens (1920-1921), especificamente a lição intitulada “Augustinismus und Neuplatonismus”, em que analisa o livro X das Confissões de Santo Agostinho, e a obra Ontologie. Hermenutik der Faktizität (1923), em que são apresentados os elementos fundamentais de uma ontologia ou fenomenologia-hermenêutica da facticidade, torna-se possível efetuar uma análise fenomenológico-hermenêutica da religião, inferindo uma concepção de religião como experiência religiosa. Assim sendo, identificando filosofia com fenomenologia, é definido o conceito de mundo de modo tripartido — mundo de si, mundo dos outros e mundo ambiente —, é explicitada a concepção de história e efetiva-se a análise fenomenológico-hermenêutica da religião com centralidade na faktische Lebenserfahrung. Deste modo, realça-se a relevância da memória para se alcançar a beata vita, as tentações da carne, dos olhos e da soberba, e a importância da categoria curare nas experiências de decadência e de acesso que o homem realiza em sua vida. Serão acrescentados ainda a esta análise, elementos inferidos da leitura da obra A verdadeira Religião (391) do pensador de Hipona, na qual desenvolve também as tentações supra mencionadas, de modo diverso ao livro X das Confissões, mas passível de aplicação da fenomenologia hermenêutica, possibilitando ampliação de análise. Conclui-se que a fenomenologia hermenêutica centra-se na existência compreendida como vida fática para compreender e interpretar a religião como experiência religiosa.

La carenza infermieristica è ormai un problema mondiale, le cui cause sono fortemente correlate tra loro e riconducibili a quattro fattori: • L'invecchiamento della popolazione infermieristica • La riduzione delle iscrizioni ai corsi universitari • Il mutamento delle condizioni lavorative • L'immagine scadente della professione infermieristica. La migrazione infermieristica è motivata dalla ricerca di sviluppo professionale, di una migliore qualità della vita e di sicurezza personale. Vi sono Paesi donatori e Paesi riceventi. Anche in Italia il fenomeno è da anni presente. Nel 2007–2010 vi è stato il boom dell'ingresso in Italia di infermieri stranieri superiore al 25%. Nel 2010 erano iscritti all'albo IPASVI 375 185 infermieri, 77% donne e 10% erano stranieri. Ogni Azienda Sanitaria ha attuato la propria strategia di risoluzione. Presso l'ASLTO2 di Torino, dapprima sono state indette gare per “Cooperative infermieristiche”, poi per “Agenzie Interinali” e attualmente sono presenti i professionisti degli “Studi Associati”. Presso la dialisi del S.G. Bosco di Torino l'esperienza è ormai decennale, strutturata e consolidata. Dal 2001 si sono alternati 30 infermieri stranieri provenienti da sei Paesi diversi, il maggiore è ancora la Romania. Il piano didattico di inserimento del neo infermiere straniero, segue quello usato presso la Struttura complessa per tutti i neo assunti e questo permette una qualità omogenea dell'assistenza e un buon livello di “integrazione” percepito dai lavoratori stranieri. (nursing)

Anaesthetists and pulmonologists are well trained to follow the "can't intubate, can't oxygenate" (CICO) protocol but the procedure is rarely practised. This case report concerns an elective patient scheduled for endobronchial ultrasound bronchoscopy (EBUS) because of suspected sarcoidosis. Based on known medical history, anaesthesia for EBUS procedure was initiated with a laryngeal mask. The airway turned out to be difficult and the patient was not ventilable despite several efforts including curarization and orotracheal intubation. Rapid desaturation imposed to apply the CICO protocol with emergency cricothyroidotomy as extreme measure but also failed. 6-handed face mask ventilation was continued. Eventually, introduction of a microlaryngeal tube of the 3 rd generation laryngeal mask, placed on the fibrescope, allowed endotracheal intubation. The patient fell into pulseless electrical activity, and the CICO protocol was started. Immediate cardiopulmonary resuscitation totally recovered vital functions. In the post-operative follow-up, no temporary or permanent cardiological and neurological sequels were found, but new medical history such as inconstant use of C-PAP (Continuous Positive Airway Pressure) and a significant weight gain since the last notable difficult intubation were uncovered, which explained the patient's compromised airways. Had this information been available prior to the scheduled operation, it would have indicated awake intubation with a local anaesthesia of the oropharynx and appropriate sedation of the patient., Learning Points: The CICO protocol was effective to manage an unanticipated difficult airway. The patient was resuscitated with the use of a microlaryngeal endotracheal tube of the 3 rd generation laryngeal mask, placed on the fibrescope.The patient's previous and current medical condition is of vital importance for the pre-operative anaesthetic assessment.Specific questioning during the pre-operative anaesthetic interview could detect events that seem to be insignificant to the patient but are significant for a diagnostic intervention in a new situation., Competing Interests: Conflicts of Interests: The Authors declare that there are no competing interests., (© EFIM 2023.)

A monograph of Curarea, a neotropical genus in the plant family Menispermaceae, is presented. Curarea is distinguished from related genera by the combination of staminate flowers with sepals in two whorls and pistillate flowers with three petals, three carpels and usually elongated carpophores bearing three sessile drupelets. Nine species are recognised, amongst them two new to science, C. gentryana from Ecuador and C. barnebyana, from Ecuador and Peru. Additionally, two new combinations, C. iquitana and C. tomentocarpa, are proposed for distinct taxa recovered in a multivariate analysis of quantitative characters of the broadly distributed and morphologically variable C. toxicofera. The anatomy and morphology of species in the genus is documented, identification key, species descriptions, distribution maps and a preliminary conservation assessment for all accepted species are also provided. Of the nine species recognised here, C. barnebyana is assigned a preliminary status of Vulnerable, C. crassa (known only from the coastal Atlantic Forest in Brazil) and C. gentryana (endemic to western Ecuador) are both assigned a preliminary status of Endangered. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Direito Internacional is the property of Revista de Direito Internacional and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Biologie Aujourd'hui is the property of EDP Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Curare, a selective skeletal muscle relaxant, has been used clinically to reduce shivering and as an anesthetic auxiliary in abdominal surgery. It is also widely used in animal experiments to block neuromuscular junction activity. Effective doses of curare diminish muscle contraction without affecting brain function, but at higher doses it is known to be lethal. However, the exact dose of curare initiating muscle relaxation vs. lethal effect has not been fully characterized in mice. In this study we carefully examined the dose-response for achieving muscle inactivity over lethality in both male and female mice (C57BL6/J). The most striking finding of this study is that female mice were highly susceptible to curare; both the EDm and LDm were at least 3-fold lower than male littermates. This study shows that gender-specific differences can be an important factor when administering skeletal muscle relaxants, particularly curare or other analogous agents targeted to the neuromuscular junction.

Copyright of Plzensky Lekarsky Sbornik is the property of Charles University Prague, Karolinum Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This article focuses on the ethno-biological expedition to the Amazon headed by Ettore Biocca between November 1962 and July 1963. Biocca, a parasitologist by training, assembled a multidisciplinary team to carry out an ethno-biological study of Amazon natives. The expedition work covered the natives' customs, myths, chants, diseases and the hallucinogenic compounds and curare they used, and took into account plants and animals common to the Amazon environment. This article aims to contribute to the understanding of the 20th-century Western approach to the Amazon people and its cultural importance. It sets out to show how Biocca's encyclopaedic work related to the centrality of Amazonia and its peoples in scientific and cultural debates on modernity and Western culture in the 1960s, and how it connects to Cold War anxieties about the disappearance of 'uncorrupted' peoples. [ABSTRACT FROM AUTHOR]

Curare is a poison obtained from different species of plants in South America, which was used in arrows by the natives. Its lethal paralyzing potential and mechanism of action began to be explored in the 19th century. In this article, we highlight the research on this poison and the fruitful exchanges between the Brazilian Emperor Dom Pedro II and the researchers João Baptista de Lacerda, Louis Couty and Alfred Vulpian who contributed to the development of experimental neurophysiology in Brazil. Vulpian found that curare does not affect the nerve itself, but acts between the nerves and the muscle, through a "ligand substance" - this Vulpian's pioneering concept is often wrongly attributed to Claude Bernard. These prestigious scientists contributed to the transnational circulation of knowledge that later yielded in the preparation of curare purified extract used for convulsive therapy and anesthesia., (© Société de Biologie, 2023.)

Planarians are rapidly developing into very useful research subjects in pharmacology and neuroscience research. Here we report that curare, a cholinergic nicotinic receptor antagonist, alleviates the nicotine-induced planarian seizure-like movements (pSLM) by up to 50 % at equimolar concentrations of nicotine and curare (1 mM), while curare alone does not induce significant pSLMs. The simplest interpretation of our data is that there are nicotine induced behaviors insensitive to curare in our experimental organism. To the best of our knowledge, this is the first report on curare-insensitive, nicotine-induced effects in any organism. [ABSTRACT FROM AUTHOR]

Mitochondrial DNA depletion syndromes are an important cause of mitochondrial cytopathies in both children and adults. We describe a newborn with multiple congenital malformations including a right aberrant subclavian artery and a trachea-oesophageal fistula in whom mitochondrial depletion syndrome was unmasked by perioperative muscle relaxation. After vecuronium infusion, the infant developed an irreversible postoperative paralysis, leading to death 32 days after surgery. The present case highlights (a) the clinical heterogeneity of mitochondrial depletion syndrome; (b) the importance of rigorous antemortem and postmortem investigations when the cause of a severe myopathy is uncertain; (c) the possible coexistence of mitochondrial depletion syndrome and congenital malformations as a result of a likely abnormal antenatal embryofetal development and (d) the importance of a careful anaesthetic management of children with mitochondrial depletion syndrome, which could be prone to complications related to the possible depressive effects on mitochondrial electron transport chain mediated by some anaesthetic agents. [ABSTRACT FROM PUBLISHER]

What medicine is and what it does, both in its individual form of medical practice and in its collective form as public health and epidemiology, can only be understood if the underlying concept of nature is understood. The essential distinction is that between producing and produced nature, between natura naturans and natura naturata. So, containing an epidemic is not successful without understanding the "nature as a whole". It would be necessary to consider the interaction of the natural biological development and spread dynamics of the infectious agent with the immunity of the host population and its environment. Where is a curative intervention in the imbalance of epidemic spread possible and in the sense of the medicus curat , i. e. the restoration of the natural balance, necessary and productive? Where is this not indicated in terms of Natura sanat ? These questions can only be answered in view of the "nature as a whole"., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Ethnopharmacological relevance Cissampelos species have a rich history of traditional use, being used for both therapeutic and toxic properties. It is traditionally applied therapeutically in a diverse range of conditions and diseases including asthma, cough, fever, arthritis, obesity, dysentery, snakebite, jaundice and heart, blood pressure and skin-related problems. Conversely, it was traditionally included in preparations of curare applied as arrow poison during hunting to cause death of animals by asphyxiation. This review unites the ethnobotanical knowledge on Cissampelos with the phytochemistry and pharmacological activity which has been explored thus far. In addition, it identifies knowledge gaps and suggests further research opportunities. Methods The available electronic literature on the genus Cissampelos was collected using database searches including Scopus, Google Scholar, Pubmed, Web of Science, etc. The searches were limited to peer-reviewed English journals with the exception of books and a few articles in foreign languages which were included. Results The literature revealed that pharmacological activity including analgesic and antipyretic, anti-inflammatory , anti-allergic, bronchodilator, immunomodulatory, memory-enhancing, antidepressant, neuroprotective, antimicrobial, antimalarial, antiparasitic, anti-ulcer, anticancer, anti-oxidant, cardiovascular, muscle-relaxant, hepatoprotective, antidiabetic, antidiarrhoeal, antifertility, and antivenom activity have been confirmed in vitro and/or in vivo for various Cissampelos species. Cissampelos pareira L. and Cissampelos sympodialis Eichl. are the most explored species of this genus and the smallest number of studies have been conducted on Cissampelos laxiflora Moldenke and Cissampelos tenuipes Engl. Many alkaloids isolated from Cissampelos such as warifteine, methylwarifteine, berberine, hayatin and hayatidin showed promising anti-allergic, immunosuppressive, antidepressant, anticancer, vasodilatory and muscle-relaxant activities. Conclusion The plants of this genus are used in traditional medicine for the treatment of various ailments. These plants are a rich source of bioactive bisbenzylisoquinoline and aporphine alkaloids together with other minor constituents. Although these plants are reputable and revered in various traditional medicine systems, many have not yet been screened chemically or pharmacologically and so there is a vast amount of research still to be conducted to validate their traditional use. [ABSTRACT FROM AUTHOR]