Otilonium bromide is a cationic surfactant with established medical applications, revealing a promising dimension in its versatile nature. Beyond its conventional use, the compound demonstrates notable antifungal properties, signaling a substantial extension of its application potential. Due to the spreading drug resistance of many microorganisms to active substances and antibiotics, it is necessary to search for and create new compounds that will exhibit more aggressive mechanisms of action. Based on the methods of synthesis of otilonium bromide, new derivatives of the compound were created to broaden its applicability beyond its traditional pharmaceutical utility. Delving into the intricate synthesis processes employed, this study provides a detailed exploration of the newly created derivatives of otilonium bromide. The broadening of the applicability of otilonium bromide, especially in response to emerging challenges posed by microbial resistance, is intended to make a significant contribution to the evolving landscape of antimicrobial therapeutics. The findings not only unveil the expanded capabilities of otilonium bromide but also reveal new avenues for the development of compounds with enhanced efficacy and resilience in combating microbial threats.

Acrogenospora taiwanica, found on dead terrestrial wood from Taiwan, is described as a new species based on low ITS and RPB2 identities with other species. Although the internal transcribed spacer rDNA (ITS) sequence of this species is reproducible and sufficiently comparable to that of A. thailandica, the 3’ end cannot be aligned with that of other species. Since these ITS sequences indicate unresolved, atypical features, and ITS sequences are lacking for several other molecularly characterized species, the ITS sequences in Acrogenospora are shown to have limited suitability for species barcoding and phylogenetic analyses. Morphologically, the species can hardly be distinguished from A. sphaerocephala, A. terricola, and A. thailandica. Since Acrogenospora species are known to sporulate only under terrestrial conditions, their reports from submersed wood seem due to a convenient collection and incubation strategy rather than a submersed aquatic life cycle. The case of Acrogenospora indicates that “freshwater fungi” include a high proportion of terrestrial fungi, as this term is broadly applied to fungi that are able to grow on submersed substrates low in oxygen but sporulate only under terrestrial conditions.

Introduction: Extreme and severe cases of constipation can lead to faecal impaction. Current therapies are often both ineffective and unpleasant. The objective of this trial was to evaluate the efficacy and safety of Movicol, a polyethylene glycol (PEG) + electrolyte solution (PE6+E), as treatment for severe constipation and faecal impaction. Patients: 56 patients (aged 17 to 88 years) with a history of chronic constipation and presenting with no bowel movement for three to four days (severe constipation), or no bowel movement for at least five days (faecal impaction), were enrolled at three centres in Taiwan. Faecal loading was confirmed in all patients by abdominal and rectal examination or abdominal radiography. Patients were excluded from the study if they had a gastrointestinal obstruction, evidence of delayed gastric emptying, or if their constipation was secondary to severe inflammatory bowel disease. Treatments patients followed the same regimen: up to eight 13.8 g sachets of PEG+E (two at a time in 250ml water; maximum of 1 L/day) over a 4-6 h period each day, with 1-1.5 h between each dosing. Duration of treatment was for up to three days. Efficacy endpoints and results: Patients with either improvement (passage of a moderate to large volume of stool within four days of treatment initiation) or complete resolution (passage of moderate to large volumes of faecal matter plus the disappearance of palpable faecal masses in the abdomen and/or rectum) were considered responders. Based on bowel movement data recorded by the patients, an excellent response rate was obtained: 50/56 patients had a successful response to treatment (89.3%; 95% confidence intervals [CIs] 77.4% to 95.6%); there were 39 complete responders and 11 patients showed improvement. Investigator assessment of response was almost the same: 87.5% (95% CIs 75.3% to 94.4%). All bowel movement measurements (stool volume, number of evacuations, stool form and ease of evacuations) showed a positive improvement by Day 2. Median duration of treatment was two days. The incidence of adverse events was low, even for those side-effects such as abdominal pain and bloating, which are known undesirable consequences of PEG+E administration. No patient discontinued from the study because of an adverse event. Conclusion: PEG+E, administered orally at a dose equivalent to eight 13.8 g sachets (1 L) per day over three days, was a highly effective and well tolerated therapy for the treatment of severe constipation and faecal impaction.

Pei-Lin Lee serves as Clinical Associate Professor, School of Medicine, National Taiwan University; Consultant, Center of Sleep Disorder, National Taiwan University Hospital. Her current academic positions at international sleep societies include American Academy of Sleep Medicine Fellow and Co-Chair International Assembly; Asian Society of Sleep Medicine, Sleep Medicine Education Task Force committee member. Her current research focuses on the era of new technology and big data in sleep medicine; and intervention on sleep and metabolism in sleep disordered breathing.