Three techniques for the determination of perindopril through derivatization with 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole.

In addition to its pure form, three accurate, rapid, and simple methods have been established for determining perindopril (PRD) in its tablet form. At pH 9.0 using a borate buffer, developing the three designated methods was successful according to the reaction between PRD and 4-chloro-7-nitrobenzo-2-oxa-1,3-diazole (NBD-Cl) and the formation of a chromogen (with a yellow color) measurable at 460 nm using the spectrophotometric method (Method I). In addition, the produced chromogen was assessed using the spectrofluorimetric method (Method II) at 535 nm following excitation at 461 nm. Afterward, the same reaction product was separated and determined using the HPLC method with fluorescence detection (Method III). A Promosil C18 stainless steel column (Q7 5 mm particle size, 250-4.6 mm) has proven suitable for separation. The mobile phase adjustment was made at pH 3.0, with a 1.0 mL min -1 flow rate; its composition was methanol-sodium dihydrogen phosphate, 0.02 M (60: 40, v/v). Through concentration ranges of 5.0-60.0, 0.5-6.0, and 1.0-10.0 µg mL-1, the calibration curves were rectilinear for Methods I, II, and III, respectively, with limits of quantification (LOQ) of 1.08, 0.16 and 0.19 µg mL-1 as well as limits of detection (LOD) of 0.36, 0.05 and 0.06 µg mL-1. The developed methods were implemented to estimate PRD in tablets, and a comparison between the obtained outcomes utilizing the developed methods as well as obtained from the official method revealed that they were comparable. The official BP method was based on dissolving PRD in anhydrous acetic acid and titrating with 0.1 M perchloric acid, then the potentiometric determination of the end-point. The designated methods were also implemented in content uniformity testing with satisfying results. The reaction pathway proposal was speculated, and according to ICH Guidelines, the statistical evaluation of the data was performed. The three proposed methods were confirmed to be green, eco-friendly and safe to environment using Green Analytical procedure index (GAPI) method.

Modified resin infiltration of non-, micro- and cavitated proximal caries lesions in vitro.

OBJECTIVE: Infiltrant resin (IR) is currently indicated for non-cavitated caries lesions. However, modifying the technique might expand its indication spectrum to micro-cavitated lesions. The present study aimed to evaluate the penetration/filling ability of a newly developed micro-filled infiltrant resin (MFIR) in non-, micro- and cavitated natural caries lesions. MATERIALS AND METHODS: Proximal lesions in 120 extracted human teeth with ICDAS-2 (n = 30), 3 (n = 45) and 5 (n = 45) lesions were etched with 15% hydrochloric acid gel for 2 min and allocated to one of the following treatments; IR: lesions (ICDAS-2, 3 and 5; each n = 15) were treated with commercial infiltrant resin for 3 min. MFIR: experimental MFIR [55 wt% IR plus 45 wt% organic fillers] was applied to lesions (ICDAS-2, 3 and 5; each n = 15) for 3 min. IR + FC: IR was applied for 3 min, light-cured, and cavities (ICDAS-3 and 5; each n = 15) filled with flowable composite (FC). Percentage infiltration of the demineralized enamel (Inf.%) and percentage filling of the cavity (Fill.%) were analyzed using dual-fluorescence staining and confocal microscopy. RESULTS: No significant differences in Inf.% (range of medians: 57%-100%) were observed between different treatments (p > 0.05; Kruskal-Wallis) within each ICDAS-code. Fill.% of cavities was significantly higher in groups MFIR (median in ICDAS-3/-5: 100%/100%) and IR + FC (100%/100%) than IR (25%/38%) (p < 0.05). CONCLUSION: MFIR showed similar penetration into natural lesions as the commercial infiltrant, but better ability to fill cavitated areas. CLINICAL RELEVANCE: MFIR and IR + FC might provide a new micro-invasive treatment for small cavitated proximal lesions.

Micro-filled resin infiltration of fissure caries lesions in vitro.

OBJECTIVES: The aim of this in vitro study was to evaluate three treatment modalities [infiltrant resin (IR), micro-filled infiltrant resin (MFIR), infiltrant-sealant-combination (ISC)] regarding both their abilities to penetrate lesions differing in ICDAS-codes and to fill fissures and cavities. MATERIALS AND METHODS: Extracted human molars (n=90) showing fissure caries lesions with and without cavitations were etched with 15% hydrochloric acid (HCl) that was mixed with abrasives and a 15% HCl-solution (1:1). The etching gel was rubbed for 30s within the fissure and, if eligible, within the cavity using a brush. After this pretreatment an infiltrant (Icon; DMG; IR) or an infiltrant mixed with microfillers (MFIR) was applied. ISC included the application of an infiltrant followed by a fissure sealant (Helioseal; Ivoclar Vivadent) From each tooth slices showing a non-cavitated (based on ICDAS-2) or cavitated lesion part (based on ICDAS-3/5) were prepared. Lesion (LA) and penetration areas (PA) as well as the completeness of fissure and cavity filling were analyzed using dual staining and confocal laser scanning microscopy. RESULTS: Percentage penetration (PP) was calculated as 100×PA/LA. PP [median (25th/75th)] did not differ significantly between IR [95 (86/100)%], MFIR [93 (62/100)%] or ISC [89 (67/97)%] (p>0.05; Kruskal-Wallis test). All three materials filled about 90% of the dimensions of fissures and cavities (p>0.05; Kruskal-Wallis test). CONCLUSION: It can be concluded that MFIR seems to be suitable to fill fissures and cavities like a fissure sealant and that it penetrates fissure caries lesions similarly deep as the conventional infiltrant after an experimental etching regime. CLINICAL SIGNIFICANCE: The MFIR seems to combine advantages of the fissure sealing and the caries infiltration procedure.

Detecting Secondary Caries Lesions: A Systematic Review and Meta-analysis.

Secondary caries lesions are the main late complication of dental restorations, limiting their life span and generating costs by repeated reinterventions. Accurate detection of secondary lesions is crucial for estimating the true burden of the disease and allocating appropriate treatments. We aimed to assess the accuracy of detection methods for secondary caries lesions. Clinical or in vitro studies were included that investigated the accuracy of 5 detection methods--visual, tactile, radiography, laser fluorescence, quantitative light-induced fluorescence--of natural or artificially induced secondary lesions, as verified against an established reference test. Sensitivity, specificity, positive and negative likelihood ratios, as well as diagnostic odds ratios were calculated and publication bias assessed. From 1,179 screened studies, 23 were included. Most studies were performed in vitro, on permanent posterior teeth, and had high risk of bias or applicability concerns. Lesions were on proximal (14 studies) or other surfaces and adjacent to amalgam (16 studies) or tooth-colored materials. Visual (n = 11), radiographic (n = 13), and laser fluorescence detection (n = 8) had similar sensitivities (0.50 to 0.59) and specificities (0.78 to 0.83), with visual and laser fluorescence assessment being more accurate on nonproximal surfaces and adjacent to composites, respectively. Tactile assessment (n = 7) had low accuracy. Light-induced fluorescence (n = 3) was sensitive on nonproximal surfaces but had low specificities. Most analyses seemed to suffer from publication bias. Despite being a significant clinical and dental public health problem, detection of secondary caries lesions has been assessed by only a few studies with limited validity and applicability. Visual, radiographic and laser-fluorescence detection might be useful to detect secondary lesions. The validity of tactile assessment and quantitative light-induced fluorescence remains unclear at present.

PM10 and asthma medication in schoolchildren.

The authors found that the use of asthma medication among elementary schoolchildren was associated with particulate pollution (particulate matter < 10 microm in aerodynamic diameter [PM10]) in a locale where PM10 consisted primarily of coarse fraction material derived from road sanding and reentrained volcanic ash. School nurses' records in 12 neighborhood schools located close to an ambient air monitoring station were abstracted, and the numbers of oral and inhaled doses of asthma medication given daily over a period of 2.5 yr were calculated. Time-series regression models, adjusted for autocorrelation, were developed, with temperature, time trend, day of the week, and month as additional variables. Regression models were estimated, and a lagged moving average of PM10 for 7, 14, 21, and 28 days was used. All models showed positive and significant coefficients for PM10 during periods when asthma medication was administered to the schoolchildren. However, the 21-day moving average was the best fit to the model.

Lack of transmission of hepatitis C virus following needlestick accidents.

Healthcare workers (HCWs) have an occupational risk of infection with hepatitis C virus (HCV). However, data regarding the magnitude of this risk are limited. We conducted a prospective study on a cohort of 24 HCWs who were exposed to HCV by needlestick injuries involving 25 patients. All source patients were viremic with a mean HCV-RNA level of 1.65 megagenomic equivalents per milliliter. At least 64% of patients were infected with HCV serotype 4 (Simmond's classification). After a follow up period of at least 6 months, none of the exposed HCWs acquired HCV. Thus, HCV does not seem to be easily transmitted by needlestick injuries. However, further large-scale studies are needed for a more accurate estimation of the risk of transmission.

Intraoperative vascular endoscopy: early and late results.

In a prospective study, 60 consecutive cases of vascular endoscopy were analyzed to examine the role of angioscopy in infrainguinal vascular procedures. A total of 52 patients had 60 separate vascular endoscopy procedures performed as an adjunct to various vascular procedures; results of intraoperative arteriography were available in 38 of 60 cases. All patients were followed for at least 42 months. The 19 patients who underwent thrombectomy with angioscopy were compared with 19 age-matched control subjects who underwent infrainguinal thrombectomy without angioscopy to evaluate the influence of angioscopy on primary and secondary patency rates. Angioscopy allowed observation of 50 lesions; angiography failed to detect three. These findings altered surgical management in 24 cases (40%). Primary patency rates for the control and experimental thrombectomy groups were 38.8% and 6.5% at 42 months, respectively (p = 0.010 based on log-rank test). Secondary patency rates for the control and experimental groups at 42 months were 63.8% and 49%, respectively (p = 0.521). The limb salvage rate was 89% at 42 months for both groups (p = 0.973). Angioscopy provides the clinician with a direct view while he or she is performing vascular procedures. However, there was no statistical improvement in secondary patency and limb salvage rates. Furthermore, the use of angioscopy during thrombectomy may increase the propensity for subsequent intervention as evidenced by the frequency of changes in surgical management and the lower primary patency rate.

Antibacterial activity of the new quinolone CI-960 (PD 127391) against clinical isolates at a major tertiary care center in Saudi Arabia.

The antibacterial activity of the new fluoroquinolone CI-960 (PD 127391) was evaluated against 1,162 clinical isolates and compared with other quinolones and various commonly used antibiotics. CI-960 was highly effective against members of Enterobacteriaceae inhibiting 626 of the 629 isolates at a less than or equal to 0.03 to 0.12 microgram/ml concentration. All the 305 isolates of Pseudomonas aeruginosa, Xanthomona maltophilia, and Acinetobacter were susceptible to CI-960. It was the only effective drug against 10 multi-resistant isolates of pseudomonads and Acinetobacter. All staphylococci, including methicillin-resistant Staphylococcus aureus, were inhibited by less than or equal to 0.03-0.5 microgram/ml of CI-960. Like other drugs of its class, it had little activity against enterococci.