Alpha- and beta-pinene isomers act differently to control Rhipicephalus microplus (Acari: Ixodidae).

The cattle tick Rhipicephalus microplus is an ectoparasite of high importance in veterinary medicine and public health. Since synthetic chemicals used to control these ticks can select resistant strains and cause toxic effects in their hosts, there is a need to identify effective substances with fewer adverse effects. For this reason, we investigated the effects of alpha- and beta-pinene, known for their various biological effects, on the mortality and reproductive performance of R. microplus engorged female ticks. The products were diluted in a 2% Tween 80 aqueous solution. The ticks were first weighed and then immersed in the test solutions for five minutes. Then, they were dried with paper towels and fixed dorsoventrally in Petri dishes, totalling five treatment groups for each pinene and a control group treated with the solvent alone. The ticks were monitored daily for mortality, and their eggs were collected and weighed. The larval hatching rate was estimated, and the pre-oviposition and incubation periods were determined. From these data, the following parameters were calculated: egg production index, fertility rate, estimated reproduction rate, percentages of reduction in oviposition and hatching, and product efficacy. Alpha-pinene showed better results at higher concentrations, unlike beta-pinene, which was more effective at lower concentrations. The effectiveness of alpha-pinene was 74% at a concentration of 14.0 µL/mL, while beta-pinene showed 78% efficacy at 2.0 µL/mL. The results indicated for the first time different effects of two isomers in ticks, suggesting that these compounds act on R. microplus females in different ways.

Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial.

Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.

Antinociceptive action of cannabidiol on thermal sensitivity and post-operative pain in male and female rats.

This study investigated the antinociceptive potential of cannabidiol (CBD) in male and female Wistar rats. The assessment and analysis included tail withdrawal to thermal stimulation (tail flick test) and mechanical allodynia induced by plantar incision injury (von Frey test). CBD reduced acute thermal sensitivity in uninjured animals and post-operative mechanical allodynia in males and females. In the tail flick test, CBD 30 mg/kg i.p. was required to induce antinociception in males. During the proestrus phase, females did not show a statistically significant antinociceptive response to CBD treatment despite a noticeable trend. In contrast, in a separate group of rats tested during the late diestrus phase, antinociception varied with CBD dosage and time. In the post-operative pain model, CBD at 3 mg/kg decreased mechanical allodynia in males. Similarly, this dose reduced allodynia in females during proestrus. However, in females during late diestrus, the lower dose of CBD (0.3 mg/kg) reduced mechanical allodynia, although the latency to onset of the effect was slower (90 min). The effectiveness of a 10-fold lower dose of CBD during the late diestrus stage in females suggests that ovarian hormones can influence the action of CBD. While CBD has potential for alleviating pain in humans, personalized dosing regimens may need to be developed to treat pain in women.

Efficiency of mixed and rigid occlusal stabilization splints: Randomized clinical trial

Abstract Occlusal stabilization splints are the most common treatment for controlling the deleterious effects of sleep bruxism. This study aimed to evaluate the effectiveness of a low-cost, mixed occlusal splint (MOS) compared to that of a rigid splint. A randomized clinical trial was performed on 43 adults of both sexes with possible sleep bruxism and satisfactory dental conditions. They were divided into rigid occlusal splint (ROS) (n = 23) and MOS (n = 20) groups. Masticatory muscle and temporomandibular joint (TMJ) pain intensity (visual analog scale), quality of life (WHOQOL-BREF), indentations in the oral mucosa, anxiety, and depression (HADS), number of days of splint use, and splint wear were evaluated. All variables were evaluated at baseline (T0), 6 months (T6), and 12 months (T12) after splint installation (T0), and splint wear was evaluated at T6 and T12. Student's t-test, Mann-Whitney U test, non-parametric Friedman's analysis of variance for paired samples and pairwise multiple comparisons, Pearson's chi-square test, two-proportion z-test, non-parametric McNemar's and Cochran's Q, and Wilcoxon tests were used (p < 0.05). In both groups, there was a decrease in TMJ pain and pain intensity over time and improvements in the quality of life scores. At T6, there was a higher rate of splint wear in the MOS group than in the ROS group (p = 0.023). The MOS showed a higher rate of wear than the rigid splint but had similar results for the other variables. Therefore, the use of a mixed splint appears to be effective in controlling the signs and symptoms of sleep bruxism.

Evaluation of a novel real-time adaptive assist-as-needed controller for robot-assisted upper extremity rehabilitation following stroke.

Rehabilitation therapy plays an essential role in assisting people with stroke regain arm function. Upper extremity robot therapy offers a number of advantages over manual therapies, but can suffer from slacking behavior, where the user lets the robot guide their movements even when they are capable of doing so by themselves, representing a major barrier to reaching the full potential of robot-assist rehabilitation. This is a pilot clinical study that investigates the use of an electromyography-based adaptive assist-as-needed controller to avoid slacking behavior during robotic rehabilitation for people with stroke. The study involved a convenience sample of five individuals with chronic stroke who underwent a robot therapy program utilizing horizontal arm tasks. The Fugl-Meyer assessment (FM) was used to document motor impairment status at baseline. Velocity, time, and position were quantified as performance parameters during the training. Arm and shoulder surface electromyography (EMG) and electroencephalography (EEG) were used to assess the controller's performance. The cross-sectional results showed strong second-order relationships between FM score and outcome measures, where performance metrics (path length and accuracy) were sensitive to change in participants with lower functional status. In comparison, speed, EMG and EEG metrics were more sensitive to change in participants with higher functional status. EEG signal amplitude increased when the robot suggested that the robot was inducing a challenge during the training tasks. This study highlights the importance of multi-sensor integration to monitor and improve upper-extremity robotic therapy.

Alternative Postoperative Analgesia Technique for Peripheral Vascular Revascularization: A Case Report.

Peripheral arterial disease (PAD) patients often require surgical peripheral vascular revascularization (PVR), in which postoperative pain management can be challenging. This case report details a 43-year-old female patient with PAD who underwent urgent femoral popliteal bypass with an inverted ipsilateral great saphenous vein and left femoral endarterectomy. Due to contraindications for neuraxial anesthesia and the necessity for continuous anticoagulation, the procedure was performed under general anesthesia (GA) and an unconventional technique with intraoperative perineural catheter (PC) placement to guarantee adequate postoperative analgesia. The surgeon inserted the PC in the vicinity of the femoral nerve under direct visualization before surgical closure. Postoperative analgesia was successfully managed, demonstrating the effectiveness of this approach as part of a multimodal analgesia strategy. This case report suggests that such a technique, supervised by an anesthesiologist and supported by a multidisciplinary team, can provide effective postoperative pain control in PAD patients without interrupting perioperative anticoagulation. Formal protocols for similar procedures can arise, incorporating this analgesic option.

Pro-resolving role of glucagon in lipopolysaccharide-induced mice lung neutrophilia.

Prior research demonstrated that glucagon has protective roles against inflammation, but its effect on the resolution of inflammation remains elusive. Using in vitro and in vivo approaches, this study aimed to investigate the pro-resolving potential of glucagon on pulmonary neutrophilic inflammation caused by lipopolysaccharide. Lipopolysaccharide induced an increase in the proportions of neutrophils positives to glucagon receptor (GcgR) in vitro. In addition, lipopolysaccharide induced an increase in the neutrophil accumulation and expression of GcgR by the inflammatory cells in the lungs, however, without altering glucagon levels. Intranasal treatment with glucagon, at the peak of neutrophilic inflammation, reduced the neutrophil number in the bronchoalveolar lavage (BAL), and lung tissue within 24 h. The reduction of neutrophilic inflammation provoked by glucagon was accompanied by neutrophilia in the blood, an increase in the apoptosis rate of neutrophils in the BAL, enhance in the pro-apoptotic Bax protein expression, and decrease in the anti-apoptotic Bcl-2 protein levels in the lung. Glucagon also induced a rise in the cleavage of caspase-3 in the lungs; however, it was not significant. Glucagon inhibited the levels of IL-1ß and TNF-α while increasing the content of pro-resolving mediators transforming growth factor (TGF-ß1) and PGE2 in the BAL and lung. Finally, glucagon inhibited lipopolysaccharide-induced airway hyper-reactivity, as evidenced by the reduction in lung elastance values in response to methacholine. In conclusion, glucagon-induced resolution of neutrophilic inflammation by promoting cessation of neutrophil migration and a rise of neutrophil apoptosis and the levels of pro-resolving mediators TGF-ß1 and PGE2.

Assessment of awake bruxism and oral mucosa indentation in adolescents.

BACKGROUND: Oral mucosa indentations can be signs of awake bruxism (AB) in adults, but this association has not yet been verified in adolescents. OBJECTIVES: To evaluate the frequency of AB in adolescents and determine whether there is an association between AB and oral mucosa indentation. METHODS: This study enrolled 66 high school students, mean age of 16.9 (±0.54) years. Clinical inspection was performed to assess the presence or absence of tongue, cheek and lip mucosa indentation. AB was assessed by the Ecological Momentary Assessment method using the WhatsApp mobile app. Messages were sent 15 times a day, 7 days, between 8:00 AM and 7:00 PM at random times to choose one of the five oral behaviours: teeth contact, teeth clenching, teeth grinding, mandible bracing and relaxed jaw muscles. The non-parametric Mann-Whitney U-test for independent samples, Friedman test for paired samples, Friedman pairwise multiple comparisons non-parametric test, Pearson's chi-squared tests, and z-test of comparisons between two proportions were performed (p < .05). RESULTS: During the week the frequency of AB behaviours was 56.20%, teeth contact was the most frequent (37.68% ± 22.26%), significantly more frequent than other AB behaviours; there was a greater frequency of cheek indentation (27.27%) and no difference between genders in oral behaviours and indentations (p > .05). A higher frequency of AB behaviours was observed in individuals with a greater frequency of cheek indentation (p < .05). CONCLUSIONS: Teeth contact and cheek indentation were the most frequent conditions among adolescents and AB behaviours are associated with this indentation.

Influence of Binaural Beats Stimulation of Gamma Frequency over Memory Performance and EEG Spectral Density.

Similar to short-term memory, working memory cannot hold information for a long period of time. Studies have shown that binaural beats (BB) can stimulate the brain through sound, affecting working memory function. Although the literature is not conclusive regarding the effects of BB stimulation (stim) on memory, some studies have shown that gamma-BB stim (40 Hz) can increase attentional focusing and improve visual working memory. To better understand the relationship between BB stim and memory, we collected electroencephalographic data (EEG) from 30 subjects in 3 phases-a baseline, with gamma-BB stim, and control stim-in a rest state, with eyes closed, and while performing memory tasks. Both EEG data and memory task performance were analyzed. The results showed no significant changes in the memory task performance or the EEG data when comparing experimental and control conditions. We concluded that brain entrainment was not achieved with our parameters of gamma-BB stimulation when analyzing EEG power spectral density (PSD) and memory task performance. Hence, we suggest that other aspects of EEG data, such as connectivity and correlations with task performance, should also be analyzed for future studies.

The influence of fluoxetine on orthodontic tooth movement in rats.

This study aimed to evaluate the effects of chronic use of fluoxetine on the amount of orthodontic tooth movement and tissue changes in rats. A total of 192 Wistar rats were divided into 4 groups: S, 0.9% saline solution; F, 20 mg/kg of fluoxetine; SM, 0.9% saline solution with orthodontic movement; and FM, 20 mg/kg of fluoxetine with orthodontic movement. After 30 days of daily saline or fluoxetine administration, an orthodontic device (25cN) was used to mesially displace the first molar in animals of the groups SM and FM. The animals were euthanized 2, 7, 14, and 28 days after placement of the orthodontic appliances and animals of groups S and F were euthanized at the same time. The assessment of tooth movement was made in gypsum castings, the collagen neoformation was assessed by polarization microscopy, the number of osteoclasts and root resorption were evaluated using tartrate-resistant acid phosphatase, and presence of hyalinized areas was assessed by hematoxylin-eosin staining. Fluoxetine did not affect the amount of tooth displacement, percentage of collagen, number of osteoclasts, and presence of hyalinized areas (P>0.05). There was a higher frequency of root resorption areas in the FM group than in the SM group only on the second day (P<0.05). The findings of this study show that chronic use of 20 mg/kg fluoxetine does not affect the amount of tooth movement, collagen neoformation, number of osteoclasts, or hyalinized areas and does not affect root resorption until the last day of orthodontic movement.

The influence of fluoxetine on orthodontic tooth movement in rats

Abstract This study aimed to evaluate the effects of chronic use of fluoxetine on the amount of orthodontic tooth movement and tissue changes in rats. A total of 192 Wistar rats were divided into 4 groups: S, 0.9% saline solution; F, 20 mg/kg of fluoxetine; SM, 0.9% saline solution with orthodontic movement; and FM, 20 mg/kg of fluoxetine with orthodontic movement. After 30 days of daily saline or fluoxetine administration, an orthodontic device (25cN) was used to mesially displace the first molar in animals of the groups SM and FM. The animals were euthanized 2, 7, 14, and 28 days after placement of the orthodontic appliances and animals of groups S and F were euthanized at the same time. The assessment of tooth movement was made in gypsum castings, the collagen neoformation was assessed by polarization microscopy, the number of osteoclasts and root resorption were evaluated using tartrate-resistant acid phosphatase, and presence of hyalinized areas was assessed by hematoxylin-eosin staining. Fluoxetine did not affect the amount of tooth displacement, percentage of collagen, number of osteoclasts, and presence of hyalinized areas (P>0.05). There was a higher frequency of root resorption areas in the FM group than in the SM group only on the second day (P<0.05). The findings of this study show that chronic use of 20 mg/kg fluoxetine does not affect the amount of tooth movement, collagen neoformation, number of osteoclasts, or hyalinized areas and does not affect root resorption until the last day of orthodontic movement.

Identification and Characterization of Short-Term Motor Patterns in Rest Tremor of Individuals with Parkinson's Disease.

(1) Background: The dynamics of hand tremors involve nonrandom and short-term motor patterns (STMPs). This study aimed to (i) identify STMPs in Parkinson's disease (PD) and physiological resting tremor and (ii) characterize STMPs by amplitude, persistence, and regularity. (2) Methods: This study included healthy (N = 12, 60.1 ± 5.9 years old) and PD (N = 14, 65 ± 11.54 years old) participants. The signals were collected using a triaxial gyroscope on the dorsal side of the hand during a resting condition. Data were preprocessed and seven features were extracted from each 1 s window with 50% overlap. The STMPs were identified using the clustering technique k-means applied to the data in the two-dimensional space given by t-Distributed Stochastic Neighbor Embedding (t-SNE). The frequency, transition probability, and duration of the STMPs for each group were assessed. All STMP features were averaged across groups. (3) Results: Three STMPs were identified in tremor signals (p < 0.05). STMP 1 was prevalent in the healthy control (HC) subjects, STMP 2 in both groups, and STMP3 in PD. Only the coefficient of variation and complexity differed significantly between groups. (4) Conclusion: These results can help professionals characterize and evaluate tremor severity and treatment efficacy.

Anesthesia strategy for factor X deficiency coagulopathy: case report

Abstract Factor X deficiency ranks among the rarest coagulopathies and has a variable presentation spectrum. We intend to present a proposal for anesthesia protocol for individuals with the coagulopathy. The excision of an ovarian neoplasm was proposed for a 26-year-old, female, ASA II patient, with congenital Factor X deficiency. Physical examination and lab tests were normal, except for Prothrombin Time (PT) 22.1s (VR: 8-14s), International Normalized Ratio (INR) 1.99 (VR: 0.8-1.2) and Activated Partial Thromboplastin Time (aPTT) 41.4s (VR: 25-37s). We concluded that a history of bleeding should always be investigated, along with a pre-anesthetic coagulation study.

Prevalência de risco de síndrome da apneia obstrutiva do sono e fatores associados / Obstructive sleep apnea syndrome risk prevalence and associated factors in community-dwelling older adults

Objetivos: avaliar a prevalência do risco da Síndrome da Apneia Obstrutiva do Sono e seus fatores associados em idosos da comunidade atendidos em uma academia-escola universitária. Métodos: trata-se de estudo epidemiológico transversal, realizado com idosos participantes do Projeto da Terceira Idade da Universidade de Rio Verde, realizado entre abril e maio de 2019. A coleta de dados foi executada por meio da aplicação de questionário composto por avaliação sociodemográfica, antropométrica, das condições prévias de saúde, de autopercepção de saúde, de sonolência diurna excessiva, da qualidade do sono, além da avaliação de risco para desenvolver Síndrome da Apneia Obstrutiva do Sono. Resultados: entre os 75 indivíduos analisados, 50,7% apresentaram risco de Síndrome da Apneia Obstrutiva do Sono. Obesidade (p=0,001), aumento da circunferência de pescoço (p=0,004), baixo nível socioeconômico (p=0,034), baixa qualidade do sono (p=0,007) e sonolência diurna excessiva (p=0,006) apresentaram associação estatisticamente significativa com o diagnóstico da Síndrome da Apneia Obstrutiva do Sono. Conclusão: a maior parte dos indivíduos avaliados apresentou algum grau da Síndrome da Apneia Obstrutiva do Sono. Sugere-se que aqueles idosos que apresentaram algum dos fatores associados a esta condição possam passar por avaliação específica, como a polissonografia, e a criação de medidas para que a promoção da reduçã o de peso seja imediatamente instituída a fim de minimizar os riscos, a piora da síndrome bem como suas possíveis complicações.

Objectives: to evaluate the prevalence of the risk of Obstructive Sleep Apnea Syndrome and its associated factors in elderly individuals from the community who attended a University School Academy. Methods: This is a cross-sectional epidemiological study carried out with elderly participants of the Third Age Project at the University of Rio Verde, conducted between April and May 2019. Data collection was performed through the application of a questionnaire composed of sociodemographic, anthropometric assessment, previous health conditions, self-perception of health, excessive daytime sleepiness, and sleep quality, in addition to risk assessment for developing Obstructive Sleep Apnea Syndrome. Results: among the 75 individuals analyzed, 50.7% were at risk for Obstructive Sleep Apnea Syndrome. Obesity (p=0.001), increased neck circumference (p=0.004), low socioeconomic status (p=0.034), poor sleep quality (p=0.007), and excessive daytime sleepiness (p=0.006) were statistically associated with the diagnosis of Obstructive Sleep Apnea Syndrome. Conclusion: most of the evaluated individuals presented some degree of Obstructive Sleep Apnea Syndrome, it is suggested that those elderly individuals who presented any of the factors associated with this condition may undergo specific evaluation, such as polysomnography, and the creation of measures for weight reduction promotion is immediately instituted in order to minimize the risks, the worsening of the syndrome as well as its possible complications.

Gold Nanoparticles Inhibit Steroid-Insensitive Asthma in Mice Preserving Histone Deacetylase 2 and NRF2 Pathways.

BACKGROUND: Gold nanoparticles (AuNPs) can inhibit pivotal pathological changes in experimental asthma, but their effect on steroid-insensitive asthma is unclear. The current study assessed the effectiveness of nebulized AuNPs in a murine model of glucocorticoid (GC)-resistant asthma. METHODS: A/J mice were sensitized and subjected to intranasal instillations of ovalbumin (OVA) once a week for nine weeks. Two weeks after starting allergen stimulations, mice were subjected to Budesonide or AuNP nebulization 1 h before stimuli. Analyses were carried out 24 h after the last provocation. RESULTS: We found that mice challenged with OVA had airway hyperreactivity, eosinophil, and neutrophil infiltrates in the lung, concomitantly with peribronchiolar fibrosis, mucus production, and pro-inflammatory cytokine generation compared to sham-challenged mice. These changes were inhibited in mice treated with AuNPs, but not Budesonide. In the GC-resistant asthmatic mice, oxidative stress was established, marked by a reduction in nuclear factor erythroid 2-related factor 2 (NRF2) levels and catalase activity, accompanied by elevated values of thiobarbituric acid reactive substances (TBARS), phosphoinositide 3-kinases δ (PI3Kδ) expression, as well as a reduction in the nuclear expression of histone deacetylase 2 (HDAC2) in the lung tissue, all of which sensitive to AuNPs but not Budesonide treatment. CONCLUSION: These findings suggest that AuNPs can improve GC-insensitive asthma by preserving HDAC2 and NRF2.

Development of analytical method for the determination of methylphenidate, the analog ethylphenidate and their metabolite ritalinic acid in oral fluid samples by micro-QuEChERS and liquid chromatography-tandem mass spectrometry.

The aim of this study was to develop a quantitative method for the analysis of methylphenidate, the analog ethylphenidate and their metabolite ritalinic acid in oral fluid, using micro-QuEChERS extraction and liquid chromatography-tandem mass spectrometry (LC-MS/MS). Oral fluid samples were collected with Quantisal™ device, extracted by micro-QuEChERS technique and analyzed by LC-MS/MS. The developed method met the validation criteria of Academy Standards Board (ASB) Standard Practices for Method Validation in Forensic Toxicology (Standard 036, 2019) with limits of detection and quantification of 0.5 ng/mL and calibration curve from 0.5 to 50 ng/mL. Within-run imprecision was greater than 18.7% while between-run imprecision was greater than 17.0 % for all analytes. Bias did not vary more than 7.7 %. No evidence of carryover was found. Stability studies presented satisfactory results for 24 h on autosampler (10 °C), after 3 cycles of freeze/thaw, 7 days on freezer (-20 °C) and until 7 days on refrigerator (4 °C) for methylphenidate. The validated method was further successfully applied to the analysis of 5 authentic oral fluid samples collected from volunteers at parties and music festivals from different cities in Brazil. Four samples had positive results for methylphenidate and ritalinic acid, and only one sample was positive for methylphenidate. Ethylphenidate was not detected in the samples. The method showed acceptable analytical performance and is environmentally friendly, requiring reduced use of solvents and reagents, with potential to be applied to clinical and forensic analyses.

Annexin-A1-Derived Peptide Ac2-26 Suppresses Allergic Airway Inflammation and Remodelling in Mice.

Annexin-A1 (AnxA1) and its N-terminal derived peptide Ac2-26 regulate the inflammatory response in several experimental models of disorders. This study evaluated the effect of endogenous AnxA1 and its N-terminal peptide Acetyl 2-26 (Ac2-26) on allergic asthma triggered by house dust mite (HDM) extract in mice. ANXA1-/- and wildtype (WT) mice were exposed to intranasal instillation of HDM every other day for 3 weeks, with analyses performed 24 h following the last exposure. Intranasal administration of peptide Ac2-26 was performed 1 h before HDM, beginning 1 week after the initial antigen application. ANXA1-/- mice stimulated with HDM showed marked exacerbations of airway hyperreactivity (AHR), eosinophil accumulation, subepithelial fibrosis, and mucus hypersecretion, all parameters correlating with overexpression of cytokines (IL-4, IL-13, TNF-α, and TGF-ß) and chemokines (CCL11/eotaxin-1 and CCL2/MCP-1). Intranasal treatment with peptide Ac2-26 decreased eosinophil infiltration, peribronchiolar fibrosis, and mucus exacerbation caused by the allergen challenge. Ac2-26 also inhibited AHR and mediator production. Collectively, our findings show that the AnxA1-derived peptide Ac2-26 protects against several pathological changes associated with HDM allergic reaction, suggesting that this peptide or related AnxA1-mimetic Ac2-26 may represent promising therapeutic candidates for the treatment of allergic asthma.

Antihypertensive effect of Equisetum arvense L.: a double-blind, randomized efficacy and safety clinical trial.

BACKGROUND: Equisetum arvense L. (EA) is a traditional phytomedicine used as a diuretic agent worldwide and regulated strictly by European Medicine Agency (EMA) and Brazilian National Health Surveillance Agency (ANVISA). However, few studies evaluating its efficacy and safety have been published and no clinical trial assessing its antihypertensive effect has been reported to date. PURPOSE: To assess antihypertensive effect, safety and tolerability of EA compared to hydrochlorothiazide (HCTZ). METHODS: This is a double-blind randomized clinical trial, allocating 58 systemic arterial hypertension (SAH) stage I patients (both sexes, 25-65 years old) into two groups (EA and HCTZ). All patients underwent biochemical and cardiologic checkup prior to and during interventions. The EA standardized dry extract (900 mg/day) or HCTZ (25 mg/day) were administered for 3 months and follow-up visits were conducted every 30 days. Efficacy established goals were systolic blood pressure (SBP) and/or diastolic blood pressure (DBP) decreases ≥ 10.0 mmHg and/or casual blood pressure (CBP) < 140/90 mmHg. RESULTS: EA treatment demonstrated a significant antihypertensive effect, promoting a mean decrease of SBP and DBP by 12.6 and 8.1 mmHg, respectively, and resulting a CBP mean of 134.0/84.5 mmHg at the end of intervention on the SAH stage I patients (CBP mean of 148.5/95.7 mmHg). There were no significant statistical differences between EA and HCTZ interventions on blood pressure decrease, and before-after treatments regarding to biochemical tests and signs of acute toxicity, renal, hepatic and hematologic alterations. A slight trend but no significant difference were observed between adverse events from EA (3.58%) and HCTZ (4.68%) groups. CONCLUSION: EA standardized dry extract was successfully applied to the SAH stage I patient treatment, decreasing effectively SBP ad DBP values to the reference normal ranges, and demonstrating a well-tolerability profile similar to HCTZ intervention.

Determination of Drugs of Abuse in Hair by LC-MS-MS: Application to Suicide Attempts Investigation.

Considering that the use of psychoactive substances (PSs) is a risk factor to either higher intensity or frequency of suicidal behavior, hair analysis was conducted to investigate the most consumed PSs (opiates, amphetamine stimulants, marijuana, cocaine and heroin) in patients who attempted suicide and received urgent care at emergency service. Hair samples were extracted using methanol and sonicated under heating and then analyzed using liquid chromatography-tandem mass spectrometry. During validation, the method complied with international recommended criteria, with limits of detection between 0.0025 and 0.05 ng/mg and linearity between 0.1 and 4 ng/mg for methamphetamine, 3,4-methylenedioxymethamphetamine (MDMA), morphine, amphetamine, 6-acetylmorphine, 3,4-methylenedioxyamphetamine (MDA), fenproporex, diethylpropion and codeine; between 0.025 and 1 ng/mg for tetrahydrocannabinol (THC), benzoylecgonine and cocaethylene and between 0.25 and 10 ng/mg for cocaine and mazindol. A total of 109 hair samples were analyzed and segmented in 404 parts. Among all analyzed samples, 30.3% were positive for at least one PS (n = 33), such as cocaine (90.9%), codeine (12.1%), morphine (3.0%), MDMA (3.0%) and THC (3.0%). In segmental analysis of cocaine positive samples (n = 30), 76.7% of the samples indicated recent exposure to cocaine (<1 month). This same behavior was observed when analyzing codeine (n = 4) and morphine (n = 1). THC positive samples indicated exposure dated ∼4 months prior. In conclusion, the method was validated following international recommendations for the 12 most consumed PSs in Brazil, as well as two of the most common found metabolites.