Melaleuca alternifolia essential oil in a natural product-based formulation: Antimicrobial and healing effects in Staphylococcus aureus-infected wounds.

Owing to its exposed nature, the skin can be injured by various factors, including by Staphylococcus aureus, which inhabits its innate microbiota. Treatment of infected wounds presents an important challenge, making it imperative to develop new treatment options. Plant-derived formulations, such as those containing Melaleuca alternifolia essential oil (MaEO), are used for wound treatment because of their healing, anti-inflammatory, and antimicrobial properties. This study presents a cream containing 2% MaEO (2% CMa) and evaluates its effects in an S. aureus-infected wound murine model. The 2% CMa was subjected to quality control testing and pH and analysis of density, organoleptic characteristics, and microbiological effects. The quality control parameters all revealed the good stability of the 2% CMa. The formulation strongly reduced the S. aureus ATCC 6538 colony-forming unit (CFU) count in an ex vivo porcine skin model. In the murine model, daily topical application of 2% CMa reduced the severity and size of S. aureus-infected wounds and the bacterial load. These effects may be due to the presence of terpinen-4-ol, which exhibits anti-inflammatory activity. Based on these findings, the formulation exhibits good quality and safety. We suggest the topical application of this formulation, which exhibited an antimicrobial effect, as an interesting treatment strategy for wound healing.

Natural products as a control measure of the Achatina fulica (Gastropoda: Achatinidae) / Produtos naturais como medida de controle do molusco Achatina fulica (Gastropoda: Achatinidae)

Achatina fulica is a terrestrial mollusk known as the giant African snail that is related to environmental, economic, urban, and public health problems. As control measures for this mollusk, cooking salt (NaCl) and calcium oxide (CaO) are used, and baits are composed of metaldehyde. However, these measures have environmental toxicity and impact the soil. In this way, natural products have been tested on this mollusk to discover and develop a substance to combat this urban and agricultural pest. This article aims to evaluate studies involving natural products to control the population of Achatina fulica. Articles and works published in books were included in the present work. A total of 1,103 works were found during the search. Of these, 14 works met the objective of these review and were included in this article. The tests do not possess methodological standardization, do not have a maximum concentration to be considered active, or a maximum exposure time. A lack of standardization in the methodology of tests on A. fulica was observed. The performance of tests on other life stages of the mollusk, as well as tests that analyze other parameters, are essential. Only one article analyzed presented phytochemical analysis. No ecotoxicity tests were reported either. Some extracts showed promising results, highlighting the aqueous extract of Capsicum frutescens. More studies investigating the molluscicidal activity of natural products on A. fulica are needed. It is very relevant that the new studies present a phytochemical analysis of the tested extracts, as well as ecotoxicity studies.

Achatina fulica é um molusco terrestre conhecido como caramujo gigante africano que está relacionado a problemas ambientais, econômicos, urbanos e de saúde pública. Como medidas de controle para esse molusco, são utilizados sal de cozinha (NaCl) e óxido de cálcio (CaO), e as iscas são compostas de metaldeído. No entanto, essas medidas têm toxicidade ambiental e impactam o solo. Desta forma, produtos naturais foram testados neste molusco para descobrir e desenvolver uma substância para combater esta praga urbana e agrícola. Este artigo tem como objetivo avaliar estudos envolvendo produtos naturais para controle da população de Achatina fulica. Artigos e trabalhos publicados em livros foram incluídos no presente trabalho. Um total de 1.103 trabalhos foram encontrados durante a pesquisa. Destes, 14 trabalhos atendiam ao objetivo desta revisão e foram incluídos neste artigo. Os testes não possuem padronização metodológica, não possuem concentração máxima para serem considerados ativos ou tempo máximo de exposição. Observou-se uma falta de padronização na metodologia de testes em A. fulica. A realização de testes em outras fases da vida do molusco, bem como testes que analisem outros parâmetros, são essenciais. Apenas um artigo analisado apresentou análise fitoquímica. Também não foram relatados testes de ecotoxicidade. Alguns extratos apresentaram resultados promissores, com destaque para o extrato aquoso de Capsicum frutescens. Mais estudos investigando a atividade molusquicida de produtos naturais sobre A. fulica são necessários. É muito relevante que os novos estudos apresentem uma análise fitoquímica dos extratos testados, bem como estudos de ecotoxicidade.

Impacto de una intervención educativa en el conocimiento y manejo de residuos peligrosos biológico-infecciosos / Impact of an educational intervention on the knowledge and management of infectious biological hazardous waste

Introducción: el personal de enfermería tiene una participación fundamental en el manejo de los residuos peligrosos biológico-infecciosos (RPBI) durante la atención en salud, situación que hace indispensable el conocimiento respecto a la peligrosidad y riesgo en el manejo de estos residuos. Objetivo: evaluar el impacto de una intervención educativa acerca del conocimiento y manejo de RPBI, en el personal de enfermería de un hospital general regional. Metodología: estudio cuasi experimental, pretest/postest, prospectivo y longitudinal. Se realizó una intervención educativa, y antes y después de esta se aplicó un cuestionario para evaluar conocimientos relacionados con RPBI y una lista de cotejo del Modelo Institucional para la Prevención de Infecciones Nosocomiales (MIPRIN) para evaluar el manejo de RPBI. Resultados: la intervención educativa demostró un efecto positivo en los conocimientos del personal de enfermería en relación con el manejo de RPBI. En la evaluación pretest se obtuvo un porcentaje de conocimientos de 65.2% y en la postest fue de 78.3% (p < 0.001). Respecto al cumplimiento en el manejo de RPBI, hubo un incremento; sin embargo, no se puede atribuir a la intervención, puesto que se evaluó por servicio y no de manera directa con los participantes. Conclusión: la intervención educativa mostró cambios significativos en los conocimientos y el manejo de RPBI del personal de enfermería.

Introduction: Nursing staff represent an important percentage in the management of biological hazardous waste (BHW) during health care, a situation that makes this knowledge essential regarding the danger and risk in handling these wastes. Objective: To evaluate the impact of an educational intervention about the knowledge and management of BHW in the nursing staff of a regional general hospital. Methods: quasi-experimental, pre-test/post-test, prospective and longitudinal study. An educational intervention was carried out; before and after this intervention, a questionnaire was administered to evaluate knowledge related to BHW and a checklist of the Institutional Model for the Prevention of Nosocomial Infections (MIPRIN, according to its initials in Spanish) to evaluate the management of BHW. Results: The educational intervention showed a positive effect in the nursing staff's knowledge in relation to BHW. In the pre-test evaluation a knowledge percentage of 65.2% was obtained and in the post-test evaluation it was 78.3% (p < 0.001). Regarding compliance in the management of BHW there was an increase; however, it cannot be attributed to the intervention, since it was evaluated by service and not directly with the participants.

Biosimilar-to-Biosimilar Switching: What is the Rationale and Current Experience?

Over time, clinicians have become increasingly comfortable embracing the prescription of biosimilars-highly similar versions of innovator or reference biological agents-for their patients with inflammatory diseases. Although a switch from a reference product to a licensed biosimilar version (or vice versa) is a medical decision robustly supported by the stepwise accumulation of clinical trial evidence concerning comparable safety, immunogenicity, and efficacy between these products, a switch from one biosimilar to another biosimilar of the same reference product, or a cross-switch, is not. Similarity among biosimilars of a reference product is not a regulatory agency concern and therefore is unlikely to be investigated in randomized controlled trials in the foreseeable future. Yet in clinical practice, across a diverse range of patients, the option to cross-switch from one biosimilar to another can and does arise for valid reasons such as convenience or tolerability issues, or driven by third parties (e.g., payers). In the absence of clinical trial data, clinicians must attempt to objectively evaluate the emerging real-world cross-switching evidence within the context of what is known about the science underpinning a designation of biosimilar. That knowledge then needs to be integrated with what clinicians know about their patients and their disease on a case-by-case basis. This review aims to consolidate relevant emerging real-world data and other key information about biosimilar-to-biosimilar cross-switching for prescribing clinicians. In the absence of clear clinical guidelines addressing this topic at present, this review may serve to facilitate discretionary and educated treatment decision making.

Nanocarriers as Administration Systems of Natural Products.

Natural products are an important source of bioactive molecules. However, the development of biological applications based on these compounds is hindered by intrinsic problems in their solubility, volatility, degradation, and bioavailability. Nanocarriers as drug administration systems promise to overcome these limitations by providing controlled and directed delivery. This review aims to present 1) the most frequently used nanocarriers as natural product administration systems, based on the progress of controlled and directed release, and 2) the challenges associated with the use of nanocarriers as therapeutic agents.

Pharmaceuticals agents for preventing NSAID-induced gastric ulcers: a patent review.

INTRODUCTION: Nonsteroidal anti-inflammatory drugs (NSAIDs) are a class of drugs widely used due to their pharmacological potential, demonstrating anti-inflammatory, analgesic, or antipyretic activity. However, prolonged use of these medications can lead to the development of gastric ulcers in patients. This review aimed to find patents for drugs with an anti-inflammatory and gastroprotective character to treat NSAID-induced gastric ulcers. AREAS COVERED: For the treatment of NSAID-induced gastric ulcers, formulations with different action mechanisms were found, including donors of nitric oxide, heterocyclic compounds, and natural products. EXPERT OPINION: Many of the structures found have already been used in clinic settings and others, and according to the results found, they are promising for the treatment of gastric ulcers.

Biological drug therapy for ocular angiogenesis: Anti-VEGF agents and novel strategies based on nanotechnology.

Currently, biological drug therapy for ocular angiogenesis treatment is based on the administration of anti-VEGF agents via intravitreal route. The molecules approved with this purpose for ocular use include pegaptanib, ranibizumab, and aflibercept, whereas bevacizumab is commonly off-label used in the clinical practice. The schedule dosage involves repeated intravitreal injections of anti-VEGF agents to achieve and maintain effective concentrations in retina and choroids, which are administrated as solutions form. In this review article, we describe the features of different anti-VEGF agents, major challenges for their ocular delivery and the nanoparticles in development as delivery system of them. In this way, several polymeric and lipid nanoparticles are explored to load anti-VEGF agents with the aim of achieving sustained drug release and thus, minimize the number of intravitreal injections required. The main challenges were focused in the loading the molecules that maintain their bioactivity after their release from nanoparticulate system, followed the evaluation of them through studies of formulation stability, pharmacokinetic, and efficacy in in vitro and in vivo models. The analysis was based on the information published in peer-reviewed published papers relevant to anti-VEGF treatments and nanoparticles developed as ocular anti-VEGF delivery system.

Retratamento com surfactante em prematuros de muito baixo peso: preditores de risco e sua influência nos resultados neonatais / Retreatment with surfactant in very low birth weight preterm infants: risk predictors and their influence on neonatal outcomes

ABSTRACT Objective: To assess clinical predictors and outcomes associated to the need for surfactant retreatment in preterm infants. Methods: Retrospective cohort study, including very low birth weight preterm infants from January 2006 to December 2015 who underwent surfactant replacement therapy. Beractant was used (100 mg/kg), repeated every six hours if FiO2 ≥0.40. The subjects were classified into two groups: single surfactant dose; and more than one dose (retreatment). We evaluated maternal and neonatal predictors for the need of retreatment and neonatal outcomes associated to retreatment. Results: A total of 605 patients (44.5%) received surfactant; 410 (67.8%) one dose, and 195 (32.2%) more than one dose: 163 (83.5%) two doses and 32 (16.4%) three doses. We could not find clinical predictors for surfactant retreatment. Retreatment was associated to a greater chance of BPD in infants >1000 g (RR 1.78; 95%CI 1.30‒2.45) and ≤1000 g (RR 1.33; 95%CI 1.04‒1.70), in infants with gestational age<28 weeks (RR 1.56; 95%CI 1.12‒2.18) and ≥28 weeks (RR 1.50; 95%CI 1.17‒1.92), in neonates with early sepsis (RR 1.48; 95%CI 1.20‒1.81), and in infants not exposed to antenatal corticosteroids (RR 1.62; 95%CI 1.20‒2.17) Conclusions: We could not find predictor factors associated to surfactant retreatment. The need for two or more doses of surfactant was significantly related to bronchopulmonary dysplasia.

RESUMO Objetivo: Avaliar preditores clínicos e resultados associados à necessidade de retratamento com surfactante. Métodos: Coorte retrospectiva com prematuros de muito baixo peso, no período de janeiro de 2006 a dezembro de 2015, em uso de terapia de reposição de surfactante. O surfactante utilizado foi beractante (100 mg/kg), repetido a cada seis horas se FiO2≥0.40. Foram analisados dois grupos: dose única de surfactante e mais de uma dose (retratamento). Foram avaliados preditores maternos e neonatais para retratamento e resultados neonatais. Resultados: 605 pacientes (44,5%) receberam surfactante; 410 (67,8%) uma dose e 195 (32,2%) mais de uma dose: 163 (83,5%) duas doses e 32 (16.4%) três doses. Não foram encontrados fatores associados ao retratamento com surfactante. A displasia broncopulmonar (DBP) foi associada ao retratamento (p<0.01). A presença de retratamento aumentou a chance de ocorrência de DBP em neonatos >1000 g (RR 1,78; IC95% 1,30‒2,45) e ≤1000 g (RR 1,33; IC95% 1,04‒1,70), em recém-nascidos com idade gestacional <28 semanas (RR 1,56; IC95% 1,12‒218) e ≥28 semanas (RR 1,50; IC95% 1,17‒1,92), naqueles com sepse precoce (RR 1,48; IC95% 1,20‒1,81), e nos que não foram expostos ao corticoide antenatal (RR 1,62; IC95% 1,20‒2,17). Conclusões: Não encontramos fatores preditores associados à necessidade de retratamento. A necessidade de duas ou mais doses de surfactante está associada à displasia broncopulmonar.

RETREATMENT WITH SURFACTANT IN VERY LOW BIRTH WEIGHT PRETERM INFANTS: RISK PREDICTORS AND THEIR INFLUENCE ON NEONATAL OUTCOMES.

OBJECTIVE: To assess clinical predictors and outcomes associated to the need for surfactant retreatment in preterm infants. METHODS: Retrospective cohort study, including very low birth weight preterm infants from January 2006 to December 2015 who underwent surfactant replacement therapy. Beractant was used (100 mg/kg), repeated every six hours if FiO2 ≥0.40. The subjects were classified into two groups: single surfactant dose; and more than one dose (retreatment). We evaluated maternal and neonatal predictors for the need of retreatment and neonatal outcomes associated to retreatment. RESULTS: A total of 605 patients (44.5%) received surfactant; 410 (67.8%) one dose, and 195 (32.2%) more than one dose: 163 (83.5%) two doses and 32 (16.4%) three doses. We could not find clinical predictors for surfactant retreatment. Retreatment was associated to a greater chance of BPD in infants >1000 g (RR 1.78; 95%CI 1.30‒2.45) and ≤1000 g (RR 1.33; 95%CI 1.04‒1.70), in infants with gestational age<28 weeks (RR 1.56; 95%CI 1.12‒2.18) and ≥28 weeks (RR 1.50; 95%CI 1.17‒1.92), in neonates with early sepsis (RR 1.48; 95%CI 1.20‒1.81), and in infants not exposed to antenatal corticosteroids (RR 1.62; 95%CI 1.20‒2.17). CONCLUSIONS: We could not find predictor factors associated to surfactant retreatment. The need for two or more doses of surfactant was significantly related to bronchopulmonary dysplasia.

Reduction of biologics in rheumatoid arthritis: a systematic review and meta-analysis.

The effects of dose reduction or spacing of all types of biologics in rheumatoid arthritis has not been consistently assessed in systematic reviews. We aimed to assess the effects of biologics reduction compared with dose maintenance in patients with rheumatoid arthritis in low disease activity or remission. We performed a systematic review with meta-analysis according to a previously registered protocol (PROSPERO registration: CRD42017069080); and searched MEDLINE, Embase, Scopus, Cochrane Library and trial registers up to July, 2020. Two researchers selected, extracted and assessed the risk of bias of controlled trials that randomized patients to reduction/spacing or dose maintenance of biologics. Low disease activity, disability and other clinically important outcomes were summarized in random effect meta-analyses. We rated the certainty of evidence according to the Grading of Recommendations Assessment, Development, and Evaluation approach. We included ten studies (n = 1331 patients), which assessed reduction or spacing of abatacept, adalimumab, certolizumab pegol, etanercept, or tocilizumab. Risk of bias was high in over half of trials, mainly due to lack of blinding. No statistically significant difference was found in low disease activity (RR = 0.90; 95% CI 0.78-1.04; I2 = 60%, very low certainty), and other outcomes. Subgroup analysis of blinded studies led to homogeneous results, which remained heterogeneous in open-label studies. Reduction or spacing biologics did not affect disease activity and other important outcome. Changes in the doses regimen should consider patient preferences, considering the low certainty of evidence.

Impact of biologic DMARDs on quality of life: 12-month results of a rheumatic diseases cohort using the Brazilian EQ-5D tariff.

OBJECTIVES: To evaluate the association between biological Disease-Modifying Anti-Rheumatic Drugs (bDMARDs) use and quality of life (QoL) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS). PATIENTS AND METHODS: We evaluated adult patients prescribed biological DMARDs whose quality of life was evaluated at six and 12 months. The EuroQol 5 dimensions (EQ-5D) was used with the Brazilian tariff. RESULTS: Patients receiving bDMARDs had significant improvements in quality of life after 6 and 12 months (p < 0.001), regardless of the rheumatic condition and the therapeutic regimen (bDMARDs vs bDMARDs plus synthetic DMARDs) (ANCOVA; p > 0.05). At the end of one year, 62.6% of the participants presented significant clinical improvement in QoL. According to a sensitivity analysis, QoL results in the complete case analysis and in the multiple imputation model yielded similar conclusions. Patients with two or more comorbidities and worse QoL and disability status on baseline presented worse QoL at 12 months when compared to those with better disability status on baseline. Baseline clinical disease measured by activity indexes (BASDAI and CDAI) did not influence QoL after 12 months of bDMARD treatment. Pain and malaise were the EQ-5D domain that most influenced quality of life. CONCLUSION: Patients with rheumatoid arthritis, ankylosing spondylitis, and psoriatic arthritis displayed significantly better QoL levels following treatment with DMARDs.

Are we treating women patients with real axial spondyloarthritis?

INTRODUCTION: During the last years, regulatory agencies raised some relevant concerns with regard to the possibility of administrating biological therapy (BT) to non-SpA patients. Especially, the possibility of treating women with fibromyalgia as non-radiographic axSpA (nr-axSpA) was mentioned. OBJECTIVES: To evaluate if the gender distribution and clinical pattern of patients with axSpA initiating biological therapy (BT) was modified in clinical practice after its approval for non radiographic-axSpA (nr-axSpA). METHODS: Baseline dataset from a prospective ongoing cohort including all patients with axSpA treated with BT at the Rheumatology Department of University Hospital La Paz, Madrid, Spain, was analysed. Patient's characteristics and disease activity parameters were collected. Based on the approval indication date of BT for nr-axSpA, patients were classified in two periods according to the starting date for the first BT: period 1 (before 2013) and period 2 (during or after 2013). Gender distribution and disease' characteristics were compared between both groups using Chi-square and Student-t tests. RESULTS: In total, 385 patients initiated BT: 266 (69%) in period 1 and 119 (31%) in period 2. No significant differences between both periods were observed regarding gender distribution (38% and 39% of women; p = 0.8). Out of those patients with nr-axSpA initiating BT in period 2, the majority (60%) were men. Women starting BT in period 2 had significantly higher systemic inflammation and mobility restriction compared with women in period 1 [median (interquartile range) CRP 10.2 mg/l (3.0-24.9) vs 3.2 mg/l (2.0-9.4); p = 0.02 and BASMI 2.7 (1.8-3.5) vs. 2.0 (1.2-2.6); p = 0.01, respectively]. In addition, they also presented significantly higher disease activity [BASDAI 6.5 (5.4-8.0) vs. 5.8 (4.6-6.8); p = 0.02; ASDAS, mean (SD) 3.6 ± 3.4 vs. 3.2 ± 1.0; p = 0.02, respectively] and more functional limitation [BASFI 5.7 (3.8-6.7) vs. 4.3 (2.0-6.1); p = 0.01, respectively] than men treated in period 2. CONCLUSIONS: In our clinical practice, the frequency of women who started BT did not increase since their approval for nr-axSpA. Women treated with BT after 2012 had more objective disease activity parameters than before their approval for nr-axSpA treatment.

Qualidade e eficiência de produtos naturais no tratamento preservativo das madeiras de Araucaria angustifolia, Eucalyptus viminalis e Pinus taeda / Quality and efficiency of natural products in the preservative treatment of the woods of Araucaria angustifolia, Eucalyptus viminalis, and Pinus taeda

A madeira, devido sua constituição orgânica, é altamente suscetível a agentes biodeterioradores, tornando-se essencial o tratamento preservativo àquelas que apresentam baixa durabilidade natural. Atualmente, os principais produtos utilizados no tratamento preservativo da madeira são o CCA e o CCB, os quais em razão da sua constituição são tóxicos ao meio ambiente e a saúde humana. Frente à essa situação, torna-se essencial o desenvolvimento de estudos acerca de produtos naturais que apresentem ação biocida, podendo assim ser utilizado no tratamento de madeira, conferindo maior proteção e aumentando a vida útil da peça. Levando em consideração esta perspectiva, o presente estudo teve por objetivo avaliar a qualidade (penetração e retenção) e eficiência de preservantes naturais aplicados no tratamento das madeiras de Araucaria angustifolia, Eucalyptus viminalis e Pinus taeda, submetidas ao apodrecimento acelerado em condições de laboratório. As madeiras das três espécies foram submetidas ao tratamento preservante com tanino, tall oil e óleo de nim, utilizando o método de imersão rápida a frio, na concentração de 5% do produto preservante, por cinco minutos. Na sequência foram avaliadas através do ensaio de apodrecimento acelerado sob à ação dos fungos apodrecedores Trametes versicolor e Gloeophyllum trabeum, seguindo as recomendações das normas ASTM D 2017 (2005) e ASTM D 1413...(AU)

Wood, due to its organic constitution, is highly susceptible to biodeterioration agents, making preservative treatment essential to those with low natural durability. Currently, the main products used in the preservative treatment of wood are CCA and CCB, which because of their constitution, are toxic to the environment and human health. Faced with this situation, it is essential to develop studies on natural products that have a biocidal action and thus can be used in the wood treatment, giving greater protection and increasing the lifespan of the piece. Considering this perspective, the present study aims to assess the quality (penetration and retention) and the efficiency of natural preservatives applied to the treatment of Araucaria angustifolia, Eucalyptus viminalis, and Pinus taeda, subjected to accelerated rotting under laboratory conditions. The woods of the three species were submitted to preservative treatment with tannin, tall oil, and neem oil, using the cold quick immersion method at the concentration of 5% of the product preservative solution for five minutes. In the sequence, they were assessed by the accelerated rotting test under the action of rotting fungi Trametes versicolor and Gloeophyllum trabeum, following the recommendations of ASTM D 2017 (2005) and ASTM D 1413 (1999). Based on the results, it was observed that P. taeda wood showed the best...(AU)

Menthol as a natural anesthetic for guppy / Mentol como anestésico natural para guppy

O objetivo deste estudo foi avaliar diferentes concentrações de mentol para anestesia de fêmeas adultas, machos adultos e juvenis de guppy (Poecilia reticulata). Para isto, foram utilizadas 30 fêmeas adultas (0,379 ± 0,108 g), 30 machos adultos (0,220 ± 0,049 g) e 30 juvenis (0,033 ± 0,016 g). Os animais foram expostos, individualmente, a cinco concentrações de mentol (50, 100, 150, 200 e 250 mg L-1), seis peixes por concentração, sendo avaliados os tempos de indução e recuperação anestésica e a mortalidade até 96 h após a realização do experimento. A concentração de 50 mg L-1 não induziu a anestesia em nenhum dos grupos avaliados. As concentrações de 100 e 250 mg L-1 ocasionaram a mortalidade de 100% dos adultos (machos e fêmeas) e juvenis, respectivamente. As concentrações de 150 a 250 mg L-1 e 150 a 200 mg L-1 de mentol demonstram eficácia e segurança para anestesia de adultos (machos e fêmeas) e juvenis de guppy, respectivamente.(AU)

The objective of this study was to evaluate different menthol concentrations for the anesthesia of adult females, adult males, and juvenile guppy (Poecilia reticulata). To this end, 30 adult females (0.379 ± 0.108 g), 30 adult males (0.220 ± 0.049 g), and 30 juveniles (0.033 ± 0.016 g) were used. The animals were individually exposed to five concentrations of menthol (50, 100, 150, 200, and 250 mg L-1), six fish per concentration. The induction times, anesthetic recovery, and mortality up to 96 h after the experiment were evaluated. The concentration of 50 mg L-1 did not induce anesthesia in any of the studied groups. The concentrations of 100 and 250 mg L-1 resulted in 100% mortality in the adults (male and female) and juveniles, respectively. The concentrations from 150 to 250 mg L-1 and from 150 to 200 mg L-1 of menthol were efficient and safe for use as anesthesia for guppy adults (male and female) and juveniles, respectively.(AU)

Qualidade e eficiência de produtos naturais no tratamento preservativo das madeiras de Araucaria angustifolia, Eucalyptus viminalis e Pinus taeda / Quality and efficiency of natural products in the preservative treatment of the woods of Araucaria angustifolia, Eucalyptus viminalis, and Pinus taeda

A madeira, devido sua constituição orgânica, é altamente suscetível a agentes biodeterioradores, tornando-se essencial o tratamento preservativo àquelas que apresentam baixa durabilidade natural. Atualmente, os principais produtos utilizados no tratamento preservativo da madeira são o CCA e o CCB, os quais em razão da sua constituição são tóxicos ao meio ambiente e a saúde humana. Frente à essa situação, torna-se essencial o desenvolvimento de estudos acerca de produtos naturais que apresentem ação biocida, podendo assim ser utilizado no tratamento de madeira, conferindo maior proteção e aumentando a vida útil da peça. Levando em consideração esta perspectiva, o presente estudo teve por objetivo avaliar a qualidade (penetração e retenção) e eficiência de preservantes naturais aplicados no tratamento das madeiras de Araucaria angustifolia, Eucalyptus viminalis e Pinus taeda, submetidas ao apodrecimento acelerado em condições de laboratório. As madeiras das três espécies foram submetidas ao tratamento preservante com tanino, tall oil e óleo de nim, utilizando o método de imersão rápida a frio, na concentração de 5% do produto preservante, por cinco minutos. Na sequência foram avaliadas através do ensaio de apodrecimento acelerado sob à ação dos fungos apodrecedores Trametes versicolor e Gloeophyllum trabeum, seguindo as recomendações das normas ASTM D 2017 (2005) e ASTM D 1413...

Wood, due to its organic constitution, is highly susceptible to biodeterioration agents, making preservative treatment essential to those with low natural durability. Currently, the main products used in the preservative treatment of wood are CCA and CCB, which because of their constitution, are toxic to the environment and human health. Faced with this situation, it is essential to develop studies on natural products that have a biocidal action and thus can be used in the wood treatment, giving greater protection and increasing the lifespan of the piece. Considering this perspective, the present study aims to assess the quality (penetration and retention) and the efficiency of natural preservatives applied to the treatment of Araucaria angustifolia, Eucalyptus viminalis, and Pinus taeda, subjected to accelerated rotting under laboratory conditions. The woods of the three species were submitted to preservative treatment with tannin, tall oil, and neem oil, using the cold quick immersion method at the concentration of 5% of the product preservative solution for five minutes. In the sequence, they were assessed by the accelerated rotting test under the action of rotting fungi Trametes versicolor and Gloeophyllum trabeum, following the recommendations of ASTM D 2017 (2005) and ASTM D 1413 (1999). Based on the results, it was observed that P. taeda wood showed the best...

Menthol as a natural anesthetic for guppy / Mentol como anestésico natural para guppy

O objetivo deste estudo foi avaliar diferentes concentrações de mentol para anestesia de fêmeas adultas, machos adultos e juvenis de guppy (Poecilia reticulata). Para isto, foram utilizadas 30 fêmeas adultas (0,379 ± 0,108 g), 30 machos adultos (0,220 ± 0,049 g) e 30 juvenis (0,033 ± 0,016 g). Os animais foram expostos, individualmente, a cinco concentrações de mentol (50, 100, 150, 200 e 250 mg L-1), seis peixes por concentração, sendo avaliados os tempos de indução e recuperação anestésica e a mortalidade até 96 h após a realização do experimento. A concentração de 50 mg L-1 não induziu a anestesia em nenhum dos grupos avaliados. As concentrações de 100 e 250 mg L-1 ocasionaram a mortalidade de 100% dos adultos (machos e fêmeas) e juvenis, respectivamente. As concentrações de 150 a 250 mg L-1 e 150 a 200 mg L-1 de mentol demonstram eficácia e segurança para anestesia de adultos (machos e fêmeas) e juvenis de guppy, respectivamente.

The objective of this study was to evaluate different menthol concentrations for the anesthesia of adult females, adult males, and juvenile guppy (Poecilia reticulata). To this end, 30 adult females (0.379 ± 0.108 g), 30 adult males (0.220 ± 0.049 g), and 30 juveniles (0.033 ± 0.016 g) were used. The animals were individually exposed to five concentrations of menthol (50, 100, 150, 200, and 250 mg L-1), six fish per concentration. The induction times, anesthetic recovery, and mortality up to 96 h after the experiment were evaluated. The concentration of 50 mg L-1 did not induce anesthesia in any of the studied groups. The concentrations of 100 and 250 mg L-1 resulted in 100% mortality in the adults (male and female) and juveniles, respectively. The concentrations from 150 to 250 mg L-1 and from 150 to 200 mg L-1 of menthol were efficient and safe for use as anesthesia for guppy adults (male and female) and juveniles, respectively.

Psoriasis and pregnancy in the biologic era, a feared scenario. What do we do now?

Psoriasis is a chronic, multifactorial inflammatory disease; its clinical severity can vary widely. Treatment of severe cases during pregnancy is of special interest. To date there is scarce information available and most data comes from other medical specialties that use similar treatments. Immunosuppressors are strongly discouraged during pregnancy and breastfeeding. Amongst biologic agents, anti-TNFα having been the longest on the market has allowed for the most experience. It is known that transplacental transport of these drugs does not occur until gestational week 22, once organogenesis is completed. Within this group certolizumab pegol, seems to be the safest choice, as its molecular structure does not cross the placental barrier. Beyond pregnancy, it is important to take into account these drugs' half-life and passage to breast milk, as well as its impact on neonatal immunization.

Long-term breastfeeding influences disease activity in a low-income juvenile idiopathic arthritis cohort.

To determine the influence of breastfeeding duration in the clinical activity of low-income juvenile idiopathic arthritis (JIA). Ninety-one JIA patients followed in Fortaleza-CE, Brazil, were cross-sectionally evaluated from May 2015 to April 2016. Breastfeeding duration was obtained by interviewing mothers. Mean age was 14.6 ± 5.2 years with 10.31 ± 3.7 years of disease duration. Polyarticular category predominated, with 39 (42.8%) patients, followed by 23 (25.3%) oligoarticular and 17 (18.7%) enthesitis-related. Forty-seven (61.8%) were receiving methotrexate isolated or combined to leflunomide, which was used by 12 (15.4%); 30 (32.9%) were on biologic DMARD with 16 (53.3%) etanercept, 8 (26.7%) adalimumab, 3 (10%) tocilizumab, and 1 (3.3%) each on infliximab, abatacept, and canakinumab. Mean(SD) CHAQ and JADAS27 were 0.37 ± 0.36 and 5.03 ± 6.1, respectively and 22 (24%) had permanent joint deformities. No family declared monthly income over US$900.00 and 32 (37.2%) earned less than US$300.00. Eighty-three (91%) were ever breastfed; over two-thirds were breastfed for more than 3 months. Those breastfed for more than 6 months had less joint deformities and a tendency to lower JADAS27 and CHAQ scores using minimally adjusted general linear or logistic models, as appropriate. Parental smoking or literacy and family income did not differ regarding breastfeeding time. This is a low-income JIA cohort with the highest breastfeeding prevalence ever reported. Breastfeeding over 6 months was associated with less disease activity.Key Point• Long-term breastfeeding benefits juvenile idiopathic arthritis.

Cryopreserved amniotic membrane and umbilical cord particulate for managing pain caused by facet joint syndrome: A case series.

Treatment of back pain due to facet joint syndrome has been a challenge for physicians since its recognition ∼80 years ago. Intra-articular injections of steroids, local anesthetics, and phenol have been widely adopted despite their known shortcomings. Recently, intra-articular injection of amniotic membrane-umbilical cord (AMUC) has been utilized in various orthopedic indications, including those involving synovial joints, due to its reported anti-inflammatory properties. Herein, use of AMUC for facet joint syndrome was evaluated.A single-center case series was conducted on patients presenting with pain caused by facet joint syndrome, confirmed by single blocking anesthetic injection and treated using a single intra-articular injection of 50 mg particulate AMUC (CLARIX FLO) suspended in preservative-free saline. Patient reported back pain severity (numerical scale 0-10) and opioid use were compared between baseline and 6 months following treatment.A total of 9 patients (7 males, 2 females), average age 52.1 ±â€Š15.9 years, were included. Five patients with cervical pain had a history of trauma, 1 patient had suffered lumbar facet injury and 3 had degenerative lumbar facet osteoarthritis. All patients had severe pain prior to injection (8.2 ±â€Š0.8) and 4 (44%) were taking opioids (>100 morphine milligram equivalents). Six-month post-treatment, average pain had decreased to 0.4 ±â€Š0.7 (P <.05). All patients had ceased use of prescription pain medications, including opioids. No adverse events, repeat procedures, or complications were reported.Intra-articular injection of AMUC appears to be promising for managing facet pain and mitigating opioid use. Further investigation with larger sample size is warranted.

Application of Autologous Platelet-Rich Plasma on Tooth Extraction Site Prevents Occurence of Medication-Related Osteonecrosis of the Jaws in Rats.

This study evaluated the effects of local application of autologous platelet-rich plasma (PRP) on the tooth extraction site of rats presenting the main risk factors for medication-related osteonecrosis of the jaw (MRONJ). For seven weeks, senile rats were submitted to systemic treatment with vehicle (VEH and VEH-PRP) or 100 µg/Kg of zoledronate (ZOL and ZOL-PRP) every three days. After three weeks, the first lower molar was extracted. VEH-PRP and ZOL-PRP received PRP at the tooth extraction site. Euthanasia was performed at 28 days postoperatively. Clinical, histopathological, histometric and immunohistochemical analyses were carried out in histological sections from the tooth extraction site. ZOL showed lower percentage of newly formed bone tissue (NFBT), higher percentage of non-vital bone tissue (NVBT), as well as higher immunolabeling for TNFα and IL-1ß. In addition, ZOL presented lower immunolabeling for PCNA, VEGF, BMP2/4, OCN and TRAP. VEH and ZOL-PRP showed improvement in the tooth extraction site wound healing and comparable percentage of NFBT, VEGF, BMP2/4 and OCN. Local application of autologous PRP proved a viable preventive therapy, which is safe and effective to restore tissue repair capacity of the tooth extraction site and prevent the occurrence of MRONJ following tooth extraction.