Jatropha elliptica is a shrub distributed throughout the north and west of Brazil and reputedly possesses a wide range of therapeutical properties. The roots of this plant possess molluscicidal activity and contain terpenoids, coumarin, lignoid, steroids and alkaloid. In the present study, we assessed the schistosomicidal, miracicidal and cercaricidal activities (against Schistosoma mansoni) and molluscicidal activities (against adults and egg masses of Biomphalaria glabrata) of the alkaloid diethyl 4-phenyl-2,6-dimethyl-3,5-pyridinedicarboxylate, isolated from the ethanol extract of the rhizome of J. elliptica, have been determined. The alkaloid was 100 % lethal to adult schistosomes within 4 days at a concentration of 50 μg/mL. Alterations were observed in the schistosome tegument occasioned by treatment with the alkaloid, such as formation of vesicles and vacuolisation. The extent of tegumental damage of the worm was proportional to the time of incubation and to the concentration of compound. The alkaloid also exhibited a potent cercaricidal activity (LC100 = 2 μg/mL); it was totally ineffective against miracicidal forms of the parasite. Moreover, the alkaloid presented strong activity against adult snails (LC90 = 36.43 μg/mL) but was inactive against their egg masses. It is observed then the potential of this compound for the development of new therapies for the treatment of schistosomiasis.
When evaluating a dyspneic patient in the office, a quick initial assessment of the airway, breathing, and circulation, while gathering a brief history and focused physical examination are necessary. Most often, an acute cardiopulmonary disorder, such as CHF, cardiac ischemia, pneumonia, asthma, or COPD exacerbation, can be identified and treated. Stable patients who improve can be sent home, but those in acute distress with unstable or impending unstable conditions need to be transferred emergently to definitive care. Because of the difficult logistics involved in attempting to work up an outpatient for new onset of SOB, some patients will need to be transferred to the nearest ED for a definitive diagnosis.
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