Psychoactive Plant Database - Neuroactive Phytochemical Collection

1. J Microsc Ultrastruct. 2022 Aug 18;12(3):159-161. doi:
10.4103/jmau.jmau_17_21.  eCollection 2024 Jul-Sep.

Dapsone-induced Methemoglobinemia Case Report.

Islami MM(1).

Author information:
(1)Department of Pharmacy Practice, Faculty of Pharmacy, King Abdelaziz 
University, Jeddah, Saudi Arabia.

Methemoglobinemia is a rare disorder associated with an elevated methemoglobin 
level that occurs when hemoglobin is in the oxidized ferric ion form rather than 
reduced ferrous form. In patients with methemoglobinemia, the hemoglobin with 
oxidized ferric form cannot release oxygen to the tissues which leads to 
hypoxemia. Methemoglobinemia can be acquired or inherited. The acquired 
methemoglobinemia happens in patients after they take certain oxidizing drugs. 
This disorder is mostly treated with 2 mg/kg methylene. This disorder is mostly 
treated with 2 mg/kg methylene blue. However, administrating ascorbic acid as an 
antioxidant may also helpful, especially if a patient has taken two doses of 
methylene blue or if the use of methylene blue is contraindicated. 
Methemoglobinemia may not cure or may rebound after response to treatment, 
especially with long half-life drugs such as dapsone. As it states in the 
leaflet for methylene blue, if methemoglobinemia does not resolve after two 
doses, one should initiate another alternative. Ascorbic acid is a good 
alternative because it is an antioxidant to keep tissue from harm of free 
radicals and also has a role in reducing methemoglobin via co-factor 
nicotinamide adenine dinucleotide phosphate reeducates needed for glutathione 
metabolism. We discuss a case of methemoglobinemia treated successfully with 
oral ascorbic acid after using two doses of methylene blue. Oral ascorbic acid 
could be beneficial, especially when the patient was taken two doses of 
methylene blue.

Copyright: © 2022 Journal of Microscopy and Ultrastructure.

DOI: 10.4103/jmau.jmau_17_21
PMCID: PMC11537359
PMID: 39507646

Conflict of interest statement: There are no conflicts of interest.


2. Cureus. 2024 Oct 7;16(10):e70983. doi: 10.7759/cureus.70983. eCollection 2024 
Oct.

The Hidden Culprit: A Computed Tomography Diagnosis of H-Type Tracheoesophageal 
Fistula in an Adult Revealed After Two Decades of Pulmonary Infections.

Salek M(1), Bigi S(1), Arache H(1), El Moujahid M(1), Wakrim S(1).

Author information:
(1)Radiology, Souss Massa University Hospital, Agadir, MAR.

We report a case of a 41-year-old male with undocumented cardiopathy, managed 
with furosemide, spironolactone, digoxin, and acetylsalicylic acid, presenting 
with progressive dyspnea and recurrent respiratory infections since childhood. 
The patient exhibited worsening dyspnea over four months, escalating to New York 
Heart Association (NYHA) classification stage IV. Physical examination revealed 
lower limb edema, right pleural effusion, jugular vein distension, hepatojugular 
reflux, bilateral crepitant rales, and abdominal distension. Diagnostic workup 
showed right axis deviation on ECG, bilateral bronchial and interstitial 
syndrome on chest X-ray, and negative GeneXpert (Cepheid, Sunnyvale, California, 
United States) for Koch's bacillus. Transthoracic echocardiography indicated 
paradoxical septum and right cavity dilation. Computed tomography (CT) scan 
revealed bilateral cystic bronchiectasis, right pleural effusion, mediastinal 
and hilar lymphadenopathies, right cardiac chambers dilation, tracheal 
diverticulitis, tracheoesophageal communications, and a left main 
bronchus-esophagus fistula. Laboratory tests indicated leukocytosis with 
neutrophilia. The patient was admitted to the Intensive care unit (ICU) for 
respiratory infection management, pulmonary artery hypertension control, and 
bypass of the tracheoesophageal fistula (TEF) with a nasogastric tube pending 
surgical repair. This case highlights a probable congenital H-type TEF as the 
underlying cause of the patient's recurrent respiratory infections. TEF, 
typically diagnosed at birth, can rarely present in adulthood, with the H-type 
being a rare form. Symptoms often include recurrent pneumonia, hemoptysis, and 
meal-associated coughing. Diagnosis involves thoracic imaging and endoscopy, 
with esophagography and CT scans being critical for detecting the fistula. 
Treatment options include surgical and endoscopic interventions, with the 
cervical approach often preferred for operative correction. Early diagnosis of 
congenital TEF is crucial for preventing recurrent infections and associated 
complications. Healthcare providers should maintain vigilance for TEF in 
patients with unexplained recurrent respiratory infections, ensuring timely and 
effective management through appropriate diagnostic and therapeutic strategies.

Copyright © 2024, Salek et al.

DOI: 10.7759/cureus.70983
PMCID: PMC11539059
PMID: 39507194

Conflict of interest statement: Human subjects: Consent was obtained or waived 
by all participants in this study. Conflicts of interest: In compliance with the 
ICMJE uniform disclosure form, all authors declare the following: 
Payment/services info: All authors have declared that no financial support was 
received from any organization for the submitted work. Financial relationships: 
All authors have declared that they have no financial relationships at present 
or within the previous three years with any organizations that might have an 
interest in the submitted work. Other relationships: All authors have declared 
that there are no other relationships or activities that could appear to have 
influenced the submitted work.


3. Cureus. 2024 Oct 23;16(10):e72175. doi: 10.7759/cureus.72175. eCollection 2024
 Oct.

Intravesical Therapies for Recurrent Urinary Tract Infections: A Systematic 
Review.

Patel D(1).

Author information:
(1)Department of Urology, Gloucestershire Hospitals NHS Foundation Trust, 
Cheltenham, GBR.

Recurrent urinary tract infections (rUTIs) present a significant clinical 
challenge, particularly due to the associated overuse of antibiotics and the 
rise in antimicrobial resistance. This systematic review evaluates the current 
literature on the use of intravesical therapies as an alternative treatment for 
rUTIs. Two established primary therapies are reviewed: glycosaminoglycan (GAG) 
instillations and intravesical antibiotic instillations. Both therapies offer 
localised treatment, reducing systemic antibiotic exposure and targeting 
infection sites more directly. A literature search was conducted using PubMed 
and Cochrane Controlled Register of Trials (CENTRAL), yielding 5,963 relevant 
articles, of which seven studies met the inclusion criteria. The review 
indicates that both GAG and antibiotic instillations significantly reduce UTI 
recurrence rates and improve symptoms such as pain and urinary urgency. However, 
significant variations in treatment schedules and dosages exist, and no direct 
comparative studies between GAG instillations and intravesical antibiotics were 
found. Moreover, intravesical antibiotics show great potential in minimising 
antimicrobial resistance, though further large-scale studies are needed to 
confirm these findings. While intravesical therapies are generally 
well-tolerated, GAG instillations can cause mild irritation. Further research is 
required to optimise therapy regimens and to perform cost-benefit analyses, 
particularly considering the high costs of these therapies compared to 
traditional antibiotic prophylaxis. Randomised controlled trials comparing 
different intravesical treatments are crucial to inform future clinical 
practice.

Copyright © 2024, Patel et al.

DOI: 10.7759/cureus.72175
PMCID: PMC11540250
PMID: 39507191

Conflict of interest statement: Conflicts of interest: In compliance with the 
ICMJE uniform disclosure form, all authors declare the following: 
Payment/services info: All authors have declared that no financial support was 
received from any organization for the submitted work. Financial relationships: 
All authors have declared that they have no financial relationships at present 
or within the previous three years with any organizations that might have an 
interest in the submitted work. Other relationships: All authors have declared 
that there are no other relationships or activities that could appear to have 
influenced the submitted work.


4. Haematologica. 2024 Nov 7. doi: 10.3324/haematol.2024.285905. Online ahead of 
print.

Arsenic trioxide versus Realgar-Indigo naturalis formula in non-high-risk acute 
promyelocytic leukemia: a multicenter, randomized trial.

Chen S(1), Qin W(2), Lu X(3), Liu L(2), Zheng Y(4), Lu X(1), Wang X(1), Zhang 
X(1), Gong S(1), Wei S(1), Zhang H(5), Ding H(1), Seifollah R(1), Li J(1), Zhang 
H(1), Wu D(1), Abiona O(6), He P(1), Zhang R(7), Wald D(6), Wang H(8).

Author information:
(1)Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong 
University, Xi'an, Shaanxi Province.
(2)Department of Hematology, Tangdu Hospital, Air Force Medical University, 
Xi'an, Shaanxi Province.
(3)Department of Rheumatology, The First Affiliated Hospital of Xi'an Jiaotong 
University, Xi'an, Shaanxi Province.
(4)Department of Hematology, Baoji Central Hospital, Baoji, Shaanxi Province.
(5)Department of Oncology, Qinghai Provincial People's Hospital, Xining, Qinghai 
Province.
(6)Department of Pathology, Case Western Reserve University, Cleveland, OH.
(7)Department of Hematology, Xi'an Gaoxin Hospital, Xi'an, Shaanxi Province.
(8)Department of Hematology, The First Affiliated Hospital of Xi'an Jiaotong 
University, Xi'an, Shaanxi Province. whymed@126.com.

Realgar-Indigo Naturalis Formula (RIF) is an oral form of arsenic that is 
effective against acute promyelocytic leukemia (APL). This multicenter, 
randomized, controlled trial compared the efficacy of all-trans retinoic acid 
(ATRA) plus RIF with ATRA plus arsenic trioxide (ATO) in a simplified regimen 
for non-high-risk APL. Following induction therapy with ATRA and ATO, 
participants were randomly assigned to receive either ATRA plus ATO or ATRA plus 
RIF both in a 2-week on 2-week off schedule for consolidation therapy. Once 
achieving molecular complete remission, the regimen was administered for a total 
of 6 cycles. All of 108 eligible patients achieved hematological complete 
remission after induction therapy. The median follow-up time was 29 months. The 
primary endpoint of two-year disease-free survival was 97% in the ATRA-RIF arm 
and 98% in the ATRA-ATO arm, respectively. (The ATRA-RIF arm was found to be 
non-inferior to the ATRA-ATO arm, (P < .01), with a percentage difference of -1% 
(95%CI, -4.8 to 6.9). No deaths have been observed. Most adverse events were 
moderate. This study confirms the noninferiority of RIF to ATO for non-high-risk 
APL, while also offering a more favorable regimen schedule for post-remission 
therapy. (ClinicalTrials gov. Identifier: as NCT02899169).

DOI: 10.3324/haematol.2024.285905
PMID: 39506905


5. Langmuir. 2024 Nov 7. doi: 10.1021/acs.langmuir.4c02268. Online ahead of
print.

Fluorous and Organic Extraction Systems: A Comparison from the Perspectives of 
Coordination Structures, Interfaces, and Bulk Extraction Phases.

Ueda Y(1), Micheau C(1), Akutsu-Suyama K(2), Tokunaga K(3), Yamada M(4), Yamada 
NL(4), Bourgeois D(5), Motokawa R(1).

Author information:
(1)Materials Sciences Research Center, Japan Atomic Energy Agency, Tokai, 
Ibaraki319-1195, Japan.
(2)Neutron Science and Technology Center, Comprehensive Research Organization 
for Science and Society, Tokai, Ibaraki319-1106, Japan.
(3)Ningyo-toge Environmental Engineering Center, Japan Atomic Energy Agency, 
Tomata, Okayama 708-0698, Japan.
(4)Institute of Materials Structure Science, High Energy Accelerator Research 
Organization (KEK), Tsukuba, Ibaraki 305-0801, Japan.
(5)Institut de Chimie Séparative de Marcoule, ICSM, CEA, CNRS, ENSCM, Univ 
Montpellier, BP 13 17171, Marcoule, 30207 Bagnols-sur-Cèze, France.

Microscopic structures in liquid-liquid extraction, such as structuration 
between extractants or extracted complexes in bulk organic phases and at 
interfaces, can influence macroscopic phenomena, such as the distribution 
behavior of solutes, including extraction efficiency and selectivity. In this 
study, we correlated the macroscopic behavior of the Zr(IV) extraction from 
nitric acid solutions with microscopic structural information to understand at 
the molecular level the key factors contributing to the higher metal ion 
extraction performance in the fluorous extraction system as compared to the 
analogous organic extraction system. The fluorous and organic extraction systems 
consist of tris(4,4,5,5,6,6,7,7,7-nonafluoroheptyl) phosphate (TFP) in 
perfluorohexane and tri-n-heptyl phosphate (THP) in n-hexane, respectively. 
Extended X-ray absorption fine structure, neutron reflectometry (NR), and 
small-angle neutron scattering revealed the structural information around the 
central metal ion of the complex, at the interface, and in the bulk extraction 
phase, respectively. NR results showed that extractant molecules did not 
accumulate much at the interface in both extraction system. In the fluorous 
extraction system, extractant aggregates with a 1.46 nm radius of gyration (Rg) 
were formed after contact with nitric acid, and remained even after Zr(IV) 
extraction through the form of a 1:3 (Zr(IV):TFP) complex. In contrast, in the 
organic extraction system, only extractant dimers with Rg of 0.70 nm were formed 
and Zr(IV) is extracted through the form of a 1:2 (Zr(IV):THP) complex. We 
speculate that differences in the local coordination structure around the Zr(IV) 
ion and the structuration of the extractant molecules in the bulk extraction 
phase contribute to the high Zr(IV) extraction performance in the fluorous 
extraction system. In particular, the size of the aggregates hardly changed with 
increasing Zr(IV) concentration in the fluorous phase, which may be closely 
related to the absence of phase splitting in the fluorous extraction system.

DOI: 10.1021/acs.langmuir.4c02268
PMID: 39506552