Treatment of acute occlusion of the retinal arteries

In five patients with obstruction of the retinal arteries, three with emboli, the circulation was reestablished by bulbus massage, intravenous administered acetazolamide and theophylamine. The patients were further treated with salicyclic acid for six months. An improvement of vision was obtained with maintained over a 2-year period. The basis of the present treatment occlusive arterial disorders in the retinal is discussed.

Antiproliferative effects on tumour cells and promotion of keratinocyte wound healing by different lichen compounds

Five compounds representative of major structural classes of lichen polyketides, VIZ. (+)-usnic (1), salazinic (2), vulpinic (3), gyrophoric (4), and evernic acids (5), were investigated for their ability to affect cell proliferation or wound healing, two functional targets of relevance for research on cancer or tissue regeneration. The experiments were carried out on MM98 malignant mesothelioma cells, A431 vulvar carcinoma cells, and HaCaT keratinocytes. The NRU and CV cytotoxicity assays showed high toxicity for (+)-usnic acid, intermediate toxicity for vulpinic acid, and low toxicity for salazinic, gyrophoric and evernic acids. Scratch wounding experiments on HaCaT monolayers, in the presence of subtoxic doses of lichen compounds, showed strong wound closure effects by (+)-usnic and gyrophoric acid, an intermediate effect by vulpinic and salazinic acids, and no effect by evernic acid. A combination of (+)-usnic and gyrophoric acids gave a further increase in the wound closure rates. The results of a cell migration test correlated with the wound healing data. In conclusion, (+)-usnic acid might be a particularly interesting compound for the prevention of hyperproliferation syndromes, while (+)-usnic and gyrophoric acids qualify as interesting leads in the promotion of tissue regeneration.

The effect of salsalate on insulin action and glucose tolerance in obese non-diabetic patients: results of a randomised double-blind placebo-controlled study

AIM/HYPOTHESIS

Low-grade inflammation may contribute to obesity-related insulin resistance and has been associated with increased risk of type 2 diabetes mellitus. The present study evaluated whether treatment with salsalate, a traditional anti-inflammatory medication, would improve insulin action in obese non-diabetic individuals.

METHODS

The study was a randomised, double-blind, placebo-controlled, parallel trial conducted at the inpatient clinical research unit of the NIDKK (Phoenix, AZ, USA). Participants were 54 adults (18 to 45 years of age) with BMI >or= 30 kg/m(2). The intervention was salsalate (3 g/day, n = 28) or identical placebo (n = 26) for 7 days. The allocation was kept concealed by giving the investigator only a number corresponding to a vial of placebo or salsalate sequentially randomised in blocks by sex. Main outcomes were changes in insulin action assessed as rate of glucose disposal (R (d)) by euglycaemic-hyperinsulinaemic clamp (insulin infusion rate 40 mU m(-2) min(-1)) and glucose tolerance by 75 g OGTT.

RESULTS

The study was completed by 47 participants, of which 40 were analysed (salsalate n = 22, placebo n = 18). Salsalate treatment resulted in decreased fasting plasma glucose concentration (mean [SD]; 4.83 [0.28] vs 5.11 [0.33] mmol/l, p = 0.001) and glucose AUC during the OGTT (p = 0.01), and in increased R (d) (20 [8] vs 18 [6] micromol [kg estimated metabolic body size](-1) min(-1), p = 0.002), while there was no significant change in these variables with placebo (p > 0.3 for all). The effect of salsalate on R (d) disappeared (p = 0.9) after normalising to increased insulin concentrations (701 [285] vs 535 [201] pmol/l, p < 0.0001) measured during the clamp. No side effects of salsalate were observed during the study.

CONCLUSIONS/INTERPRETATION

The glucose-lowering potential of salicylates appears to be due to effects on insulin concentration rather than improved insulin action. Salicylate-based compounds may be useful for the treatment and prevention of type 2 diabetes.

Effect of herbal, essential oil, and chlorhexidine mouthrinses on the composition of the subgingival microbiota and clinical periodontal parameters

OBJECTIVE

The purpose of the present investigation was to determine if antimicrobial mouthrinses with different formulations could affect the composition of the subgingival microbiota and clinical parameters of adjacent tissues in periodontal maintenance subjects.

METHODS

One-hundred and sixteen subjects, who had been treated for chronic periodontitis and were in a maintenance program, were randomly assigned one of four mouthrinses, to be used twice daily for three months. The mouthrinses were herbal 1, herbal 2, essential oil, and chlorhexidine. Clinical measurements and subgingival plaque samples were taken at baseline and at three months. Plaque samples were individually evaluated for 18 test species/taxa using checkerboard DNA-DNA hybridization. Significance of differences between baseline and three months for both microbiological and clinical parameters were determined using the Wilcoxon Signed Ranks test. Significance of difference among groups for change in clinical and microbiological parameters was determined using analysis of covariance (ANCOVA), adjusting for baseline values.

RESULTS

Shifts in species proportions differed significantly for 9/18 test species/taxa among the four mouthrinse groups. Streptococcus and Capnocytophaga species were reduced most in the herbal rinse groups, while Veillonella parvula was reduced most in the essential oil and chlorhexidine groups. Actinomyces were also markedly reduced in the chlorhexidine group. Mean Plaque (PI) and Gingival Indices (GI) were reduced between baseline and three months in each group. Results emphasize that chlorhexidine (p < 0.001) and herbal (p < 0.05) rinses significantly reduced PI. Some subjects in each group responded better than others.

CONCLUSION

All four mouthrinses tested produced shifts in the composition of subgingival microbiota, although the results differed among the groups. The observed microbial changes were accompanied by improvements in clinical parameters in the periodontal maintenance subjects.

[Antimicrobial activity determination of the preparations used in comprehensive treatment of patients with parodontitis]

Determination of antimicrobic activity of the preparations of Metrogyl denta, Cholisal and Solcoseryl on the complex culture of microorganisms employing the developed procedure was carried out. Degree of the antimicrobic action manifestation of each preparation was revealed.

A manganese-superoxide dismutase/catalase mimetic extends survival in a mouse model of human prion disease

Animal models, and human postmortem studies, of prion disease have demonstrated the presence of heightened oxidative stress in the brain, with additional findings supporting the likelihood that the normal isoform of prion protein directly contributes to neuronal antioxidant defences. Although such data are consistent with the postulate that oxidative stress plays a salient pathogenic role in prion disease, it remains possible that oxidative damage represents a secondary or relatively less important phenomenon in neurons already rendered dysfunctional from other primary insults. To provide further insights into the relative pathogenic importance of oxidative stress, we employed a potent manganese-superoxide dismutase/catalase mimetic, EUK-189, as a therapeutic in our mouse model of human prion disease. A significant but relatively modest prolongation of survival in EUK-189-treated mice was observed, which correlated with reductions in oxidative, especially nitrative, damage to proteins when compared to untreated disease controls. Lesion profiling also revealed reductions in spongiform change in specific brain regions of terminally sick EUK-189-treated mice. Our results are consistent with heightened oxidative stress playing a pathogenic role in prion disease but underscore the need for more biologically potent and, most likely, broader spectrum antioxidant treatments if more successful amelioration is to be achieved.

In vivo antiplaque efficacy of combined antimicrobial dentifrice and rinse hygiene regimens

PURPOSE

To evaluate using digital plaque image analysis the antiplaque efficacy of oral care regimens including use of antimicrobial toothpaste in combination with antimicrobial mouthrinse.

METHODS

16 subjects completed the study protocol including: (1) initial treatment phase, all subjects used a standard sodium fluoride dentifrice with 2x/day brushing, (2) second treatment phase, subjects were randomized to two treatment groups: stannous fluoride/sodium hexametaphosphate dentifrice or sodium fluoride triclosan/copolymer dentifrice; (3) third treatment phase, the group using stannous fluoride dentifrice rinsed with alcohol-free cetylpyridinium chloride mouthrinse and the group using triclosan dentifrice rinsed with essential oil mouthrinse. During each phase, plaque levels were assessed in the morning before toothbrushing (AM), post-brushing in the morning (PB) and in the afternoon (PM).

RESULTS

Stannous fluoride dentifrice was superior to triclosan dentifrice in plaque growth inhibition between toothbrushing. Both mouthrinses provided additional plaque prevention benefits when used with antimicrobial dentifrices. The cetylpyridinium chloride mouthrinse and stannous fluoride dentifrice regimen was particularly effective, building accretive efficacy over time. Average plaque reductions exceeded 50% vs. sodium fluoride dentifrice alone. Chemotherapeutic dentifrices and rinses increase plaque control used alone and particularly in combination. The stannous fluoride-cetylpyridinium chloride regimen showed the greatest benefits.

Interventions for treating lymphocytic colitis

BACKGROUND

Lymphocytic colitis is a cause of chronic diarrhea. Therapy is based mainly on case series and uncontrolled trials, or by extrapolation of data for treating collagenous colitis, a related disorder. This review was performed to identify therapies for lymphocytic colitis that have been proven in randomized controlled trials.

OBJECTIVES

To determine effective treatments for patients with clinically active lymphocytic colitis.

SEARCH STRATEGY

The MEDLINE, PUBMED and EMBASE databases were searched using the search criteria "microscopic colitis" or "lymphocytic colitis" and "treatment" or "therapy" or "management" to identify relevant papers published between 1970 and December 2007. Manual searches from the references of identified papers and relevant review papers were performed. Abstracts from major gastroenterological meetings were searched to identify research submitted in abstract form only. The trial registry website www.ClinicalTrials.gov was searched to identify registered but unpublished trials. Finally, the Cochrane Central Register of Controlled Trials and the Cochrane Inflammatory Bowel Disease and Functional Bowel Disorders Group Specialized Trials Register were searched for other studies.

SELECTION CRITERIA

Five randomized controlled trials were identified. Three of these studies, which assessed bismuth subsalicylate vs. placebo, budesonide vs. placebo, and mesalazine vs. mesalazine vs. cholestyramine in treating active disease, are included in this review.

DATA COLLECTION AND ANALYSIS

Data were extracted independently by each author onto 2x2 tables (treatment versus placebo or active comparator and response versus no response). For therapies assessed in one trial only, P values were derived using the chi-square test.

MAIN RESULTS

Forty-one patients were enrolled in the trial studying budesonide (9 mg/day for 6 weeks versus placebo). Budesonide was more effective than placebo at inducing both clinical (P = 0.004; NNT = 3) and histological responses (P = 0.04; NNT = 3). Forty-one patients were enrolled in the study assessing mesalazine versus mesalazine plus cholestyramine. A high proportion of patients in each group responded to treatment. However, no statistically significant difference in clinical response was found between the two treatment groups (P = 0.95). Five patients were enrolled in the trial studying bismuth subsalicylate (nine 262 mg tablets daily for 8 weeks vs. placebo). There were no differences in clinical (P=0.10) or histological responses (P=0.71) in patients treated with bismuth subsalicylate compared with placebo.

AUTHORS' CONCLUSIONS

A single trial studying budesonide suggests that it may be effective for the treatment of active lymphocytic colitis. An ongoing placebo-controlled trial may confirm the benefit of budesonide. There is weaker evidence that mesalazine with or without cholestyramine may be effective for the treatment of lymphocytic colitis, but this benefit needs to be confirmed in a placebo-controlled study. No conclusions can be made regarding bismuth subsalicylate. These agents require further study before they can be recommended as treatment options for lymphocytic colitis. Further trials studying interventions for lymphocytic colitis are warranted.

[Holisal in the complex treatment of periodontal disease]

The aim of our research was to evaluate efficiency of medicine Cholisal in complex treatment of periodontitis. During the research 36 patients with periodontitis (from 18 to 36 years old) were examined and treated. The patients were divided into 3 groups according to severity of periodontitis. Each group included 12 patients. For studying the efficiency of treatment both objective and subjective data was used. In case of mild severity of disease clinical indices were: HI=2,1+/-0,75; Ghi=1,4+/-0,67; Gi=1,7+/-0,78, PI=0,8+/-0,34. In case of moderate severity of disease clinical indices were: HI=2,57+/-1,02; GHI=2,18+/-0,81; GI=1,95+/-0,8, PI=3,9+/-1,1. In case of severe disease - HI=3,9+/-1,25, GHI=2,5+/-0,8, GI=2,9+/-1,2, PI=7,8+/-1,62. Clinical study has shown that Cholisal enables successful treatment of periodontitis. It has prolonged, antiinflamatory, deodorant and analgesic effect. Our investigation revealed that xolisale can be recommended in complex treatment of periodontal disease.

Effect of smoking on failure of H. pylori therapy and gastric histology in a high gastric cancer risk area of Colombia

It has been proposed that eradication of Helicobacter pylori infection is a sound strategy for gastric cancer prevention. Several factors including smoking have been associated to treatment failure rates. This study aimed to evaluate the smoking effect on the efficacy of H. pylori therapy, as well as on the histological parameters in the gastric mucosa from subjects from a high gastric cancer risk area. Two-hundred-sixty-four Colombian subjects with gastric precancerous lesions who participated in a chemoprevention trial, received anti-H. pylori treatment at baseline and had data recorded on cigarette use, were included in this study. A detailed histopathological assessment of the gastric mucosa was performed in biopsies taken before any intervention. H. pylori eradication was assessed in gastric biopsies at 36 months post-treatment. The overall eradication rate was 52.3%; rates of 41.3% and 57.1% were observed for active-smokers and non-smokers, respectively. Multivariate logistic regression analysis showed that smokers had a 2-fold higher probability of failure in Helicobacter pylori eradication than non-smokers (OR: 2.0; 95% CI: 1.01-3.95). At baseline, active-smokers had a higher score of intestinal metaplasia compared to non-smokers. In the corpus mucosa, active-smokers showed lower scores of H. pylori density, total inflammation, neutrophil infiltration, and mucus depletion than non-smokers. In the antrum, no significant differences were observed between active-smokers and non-smokers. In summary, in patients who smoked, H. pylori treatment was less effective. Smoking cessation may benefit H. pylori eradication rates.

The intestinal anti-inflammatory effects of the novel agent UR-1505 in the TNBS model of rat colitis are mediated by T-lymphocyte inhibition

UR-1505 is a novel pentafluoropropoxy derivative of salicylic acid, selected from a series of salicylate derivatives, according to their activity as inhibitors of T-lymphocyte activation. This study describes the anti-inflammatory activity of UR-1505 on trinitrobenzenesulphonic acid-induced colitis in rat, an experimental model that resembles to Crohn's disease (CD), as well as its in vitro effects on T-cells and bone marrow-derived macrophages (BMDM) activation. UR-1505 showed intestinal anti-inflammatory effect, associated with reduced colonic levels of TNFalpha and LTB(4), inhibition of the expression of IFNgamma and iNOS, and lower colonic leukocyte infiltration. The in vitro assays revealed that UR-1505 also inhibited T-lymphocyte proliferation and IL-12/IFNgamma production, two of the main pro-inflammatory cytokines involved in the pathogenesis of CD. However, UR-1505 did not modify LPS- nor IFNgamma-induced activation in BMDM. Thus, UR-1505 specifically affects T-cells without modifying the activation of BMDM. In conclusion, the intestinal anti-inflammatory activity of UR-1505 seems to be mediated by a reduction in the recruitment of immune cells to the inflammatory foci, together with the inhibition of T-cell activation. These results suggest that UR-1505 may be an interesting candidate to be explored for the treatment of CD.

Neuroprotective Effects of the Ras Inhibitor S-Trans-Trans-Farnesylthiosalicylic Acid, Measured by Diffusion-Weighted Imaging after Traumatic Brain Injury in Rats

Ras proteins play a role in receptor-mediated signaling pathways and are activated after traumatic brain injury. S-trans-trans-farnesylthiosalicylic acid (FTS), a synthetic Ras inhibitor, acts primarily on the active, GTP-bound form of Ras and was shown to improve neurobehavioral outcome after closed head injury (CHI) in mice. To gain a better understanding of the neuroprotective mechanism of FTS, we used diffusion-weighted imaging (DWI) in a rat model of CHI. Apparent diffusion coefficients (ADC) and transverse relaxation times (T2) were measured in injured rat brains after treatment with vehicle or FTS (5 mg/kg). Neuroprotection by FTS was also assessed in terms of the neurological severity score. One week after injury, significantly better recovery was observed in the FTS-treated rats than in the controls (p = 0.0191). T2 analysis of the magnetic resonance images revealed no differences between the two groups. In contrast, they differed significantly in ADC, particularly at 24 h post-CHI (p < 0.05): in the vehicle-treated rats ADC had decreased to approximately 26% below baseline, whereas it had increased to about 10% above baseline in the FTS-treated rats. As the magnitude of ADC reduction is strongly linked to blood perfusion deficit, these results suggest that the neuroprotective mechanism of FTS might be related to an improvement in cerebral perfusion. We propose that FTS, which is currently being tested in humans for anti-cancer indications, should also be considered as a new strategy for the management of head injury.

[Efficacy of an antiseptic dialysis of purulent wounds in the dentofacial region with hyvalix]

The article presents data proving the possibility of using the solutions of "Hyvalix" medication for an antiseptic preparation of septic cavities after lancing of abscesses and phlegmons of dentofacial region. It was shown the efficacy of "Hyvalix" medication in comparison with traditional solutions of antiseptic means.

The effect of two root canal sealers on the retentive strength of glass fibre endodontic posts

This study was undertaken to examine the effect of eugenol-containing and non-eugenol-containing root canal sealers on the retention strength of glass fibre endodontic posts (ParaPost Fibre White) luted with a resin cement (ParaPost cement). We also examined the mode of failure that occurred visually by using scanning electron microscopy. Seventy-two single rooted, recently extracted, premolar teeth were root canal treated and randomly divided into two groups. Group 1 was obturated with gutta percha and a calcium hydroxide-based sealer (Sealapex, Kerr). Group 2 was obturated with gutta percha and a eugenol-based sealer (Tubli-Seal Kerr). The teeth were stored for 1 week in distilled water at 37 degrees C and then prepared for 9 mm posts with a 1.40-mm drill. The matching glass fibre post was luted with a resin cement following the manufacturer's instructions. The samples were stored for 1 week and thermocycled. The posts were removed from the root canals using a calibrated testing machine in tensile mode. The mean dislodging force for group 1 was 190.46 N and for group 2 was 183.8 N, with standard deviations of 54.9 and 56.0 N respectively. The t-test indicated no significant difference between the two groups. Failure of the posts occurred mainly within the resin layer. This study showed that under experimental conditions there was no statistically significant difference between Sealapex sealer and Tubli-Seal sealer on the retention of glass fibre posts using a resin cement.

Tendencia en la utilización de antiagregantes en la Comunidad Valenciana (2000-2005)

BACKGROUND

Platelet antiaggregants are basic drugs for preventing ischemic arterial diseases. This study is aimed at ascertaining the trend in their use in Primary Care in the Autonomous Community of Valencia during the 2000-2005 period.

METHODS

Descriptive study of the use of platelet antiaggregants (ATC code: B01AC) dispensed charged to the National Health System in the Autonomous Community of Valencia in Primary Care. Data given in defined daily doses (DDD) per 1000 inhabitants per day.

RESULTS

In 2005, three drugs totalled 98% of all those prescribed overall (acetyl salicylicacid (ASA) 66%, clopidogrel 23% and triflusal 9%). Oral antiaggregant use rose by 23% within the 2000-2005 period (from 29.6 to 36.5 DDD/1000 inhab./day). Clopidogrel showed a 218% increase, whilst ASA was the most used drug, with quite a stable percentage of use throughout said time period (nearing 70%). The expense generated by this group of drugs doubled, clopidogrel having been the highest-cost drug/DDD (2.14 EUROS), its use having totalled 23% of all antiaggregants yet the expense thereof having totalled 76% of the total expenditure.

CONCLUSIONS

The use of antiaggregants increased in the Autonomous Community of Valencia during the time period under study. The utilization of ASA remained stable, whilst clopidogrel increased its market share despite the treatment guide recommendations and the restrictions on its use. The consumption of clopidogrel noticeably contributed to the drug spending for this group.