The Cardiorenal Effects of Piper amalago Are Mediated by the Nitric Oxide/Cyclic Guanosine Monophosphate Pathway and the Voltage-Dependent Potassium Channels

Piper amalago L. is used in Brazilian traditional medicine to treat inflammation, chest pain, and anxiety. This study aimed to investigate the safety and the renal and cardiovascular effects of the volatile oil (VO) and the aqueous (AE) and hydroalcoholic (HE) extracts from P. amalago. The gas chromatography-mass spectrometry analyses identified 47 compounds in the VO, with β-cyclogermacrene, spathulenol, β-phellandrene, and α-pinene standing out. Among the 47 compounds also found in AE and HE by liquid chromatography-mass spectrometry, glycosylated flavones, organic acids, amino acids, and amides were highlighted. Some examples of these compounds are methoxy-methylenedioxy cis-cinnamoyl pyrrolidine, methoxy-methylenedioxy trans-cinnamoyl pyrrolidine, and cyclobutene-2,4-bis-(1,3-benzodioxol-5-methoxy-6-yl)-1,3-dicarboxapyrrolidide. The acute toxicity experiments were conducted on female rats (n = 5). The cardiorenal assays (n = 8) and evaluations of vasodilatory effects on the mesenteric vascular bed (n = 5) were conducted on male rats. In either extract or VO, there were no mortality or changes in relative weights or histopathological analysis of the organs. Urinary volume and renal electrolyte excretion were elevated significantly during repeated dose 7-day treatment with different preparations from P. amalago. None of the preparations induced hypotension or changes in cardiac electrical activity. Only HE promoted significant vasodilatory effects in rats' isolated mesenteric vascular beds. These effects were completely abolished in the presence of L-NAME plus 4-aminopyridine. Therefore, P. amalago leaves are safe and present diuretic activity after acute and repeated dose administration over 7 days. Moreover, the HE induced significant vasodilator response in rats' mesenteric vascular beds by NO/cGMP pathway and voltage-dependent K+ channels activation.

Authentication and Quality Control of the Brazilian Traditional Herb "Espinheira-Santa" (Monteverdia ilicifolia) by Morpho-Anatomy and Microscopy

The leaves of Monteverdia ilicifolia (syn. Maytenus ilicifolia), commonly called espinheira-santa, are widely used in South American traditional medicines to treat gastritis and ulcers. Several products labeled as espinheira-santa are sold as dietary supplements in retail stores and via e-commerce. Many different species with similar leaf morphology are often mistaken for Monteverdia ilicifolia and used as espinheira-santa, including Monteverdia aquifolia (Celastraceae), Citronella gongonha (Cardiopteridaceae), Jodina rhombifolia (Santalaceae), Sorocea bonplandii (Moraceae), and Zollernia ilicifolia (Fabaceae). This study aimed to characterize M. ilicifolia and distinguish it from adulterants using morphological and microscopic techniques. In addition, foreign matter and powder characteristics of botanical materials sold as "espinheira-santa" were analyzed. The morphoanatomical studies of the leaves and stems of M. ilicifolia and its five adulterant species have revealed noteworthy features that can help species identification and quality control of commercial espinheira-santa. This study showed that many commercial espinheira-santa materials were adulterated and of inferior quality.

Validation of Analytical Methods for Tacrolimus Determination in Poly(ε-caprolactone) Nanocapsules and Identification of Drug Degradation Products

The aim of this paper was to use chromatographic tools for validating an analytical method for the tacrolimus (TAC) determination in polymeric nanocapsules and for identifying the drug degradation products after alkaline stress. A rapid Ultra-High-Performance Liquid Chromatography coupled with photo-diode array (UHPLC-PDA) method was successfully performed using the following chromatographic conditions: the Shimadzu Shim-pack XR-ODS III C18 column (100 mm×2.00 mm, 2.2 μm), the mobile phase consisting of methanol and acidified ultrapure water (89:11 v/v), the flow rate of 0.55 mL·min^-1, and the ultraviolet (UV) detection at 235 nm. This method was validated as per International Council for Harmonisation (ICH) guidelines. In addition, a TAC forced degradation assay was carried out after alkaline stress and its degradation products were investigated using Liquid Chromatography coupled tandem mass spectroscopy (LC-MS/MS). The calibration curve was linear in the range of 100.0-300.0 μg·mL^-1 (r >0.9999). Accuracy was confirmed by the TAC recovery of 96.55 to 98.19%. Precision (intraday and interday) were demonstrated by relative standard deviation lower than 0.89% and 3.25%, respectively. Selectivity and robustness were also proved. The method developed it was successfully applied to quantify TAC from polymeric nanocapsules, showing a high loading efficiency rate (>96.47%). The main drug degradation product observed in a multiple reaction monitoring (MRM) experiment was m/z 844, confirming the susceptibility of TAC under alkaline conditions; this finding was first time described.

Efficacy of a Light-cured Tetracaine-based Anesthetic Gel for Rubber Dam Clamp Placement: A Triple-blind Randomized Clinical Trial

OBJECTIVES

To evaluate the efficacy of a new light-cured anesthetic gel for pain control in adults undergoing rubber dam isolation for the restorative treatment of noncarious cervical lesions (NCCLs).

METHODS AND MATERIALS

This study was a randomized, split-mouth, triple-blind, controlled trial. The sample comprised 50 adults with at least one pair of NCCLs located in the same arch but on opposite sides. Simple randomization defined the tooth to receive the light-cured tetracaine-based anesthetic gel or the placebo gel. After cotton roll isolation, the gels were applied in the gingival tissue around the tooth with the aid of the applicator tip of a syringe, left in place for 15 seconds, and light-cured for 15 seconds. Then, a #212 clamp was positioned on the tooth. If the patient reported pain, the clamp was removed, the patient filled out a pain intensity form (a 0-10 visual analog scale [VAS] and a 0-4 verbal rating scale [VRS]) and an injectable anesthetic was applied before rubber dam isolation for the restorative procedure. The absolute risk, intensity of pain, and need for rescue anesthesia were analyzed by the McNemar test and the Wilcoxon signed rank test (α=5%).

RESULTS

The odds ratio [OR] for pain (OR=3.5; 95% confidence interval [CI]=1.1 to 14.6; p=0.03) showed lower reports of pain for the light-cured anesthetic gel. One in five patients will benefit from placement of the light-cured anesthetic gel. On average, pain intensity was one VAS unit lower in those using the light-cured anesthetic gel than in those using the placebo gel. For the VRS, the pain intensity for the light-cured anesthetic gel was 0.4 units lower than the pain intensity for the placebo gel (95% CI=-0.9 to 0.07). The OR for rescue anesthesia was 2.5 (95% CI=0.7 to 10.9; p=0.18).

CONCLUSIONS

The light-cured, tetracaine-based anesthetic gel reduced the absolute risk of pain by 20% in NCCLs.

Zinc oxide and copper nanoparticles addition in universal adhesive systems improve interface stability on caries-affected dentin

This study evaluated the MMP inhibition of the zinc oxide and copper nanoparticles (ZnO/CuNp), and the effects of their addition into adhesives on antimicrobial activity (AMA), ultimate tensile strength (UTS), in vitro degree of conversion (in vitro-DC), as well as, resin-dentin bond strength (μTBS), nanoleakage (NL) and in situ-DC on caries-affected dentin. Anti-MMP activity was evaluated for several MMPs. ZnO/CuNp (0% [control]; 5/0.1 and 5/0.2 wt%) were added into Prime&Bond Active (PBA) and Ambar Universal (AMB). The AMA was evaluated against Streptococcus mutans. UTS were tested after 24 h and 28d. After induced caries, adhesives and composite were applied to flat dentin surfaces, and specimens were sectioned to obtain resin-dentin sticks. μTBS, NL, in vitro-DC and in situ-DC were evaluated after 24 h. ANOVA and Tukey's test were applied (α = 0.05). ZnO/CuNp demonstrated anti-MMP activity (p < 0.05). The addition of ZnO/CuNp increased AMA and UTS (AMB; p < 0.05). UTS for PBA, in vitro-DC, in situ-DC and μTBS for both adhesives were maintained with ZnO/CuNp (p > 0.05). However, lower NL was observed for ZnO/CuNp groups (p < 0.05). The addition of ZnO/CuNp in adhesives may be an alternative to provide antimicrobial, anti-MMP activities and improves the integrity of the hybrid layer on caries-affected dentin.

Two-year Effects of Chlorhexidine-containing Adhesives on the In Vitro Durability of Resin-dentin Interfaces and Modeling of Drug Release

OBJECTIVES

To evaluate the effects of addition of diacetate chlorhexidine (CHX) at different concentrations into two etch-and-rinse adhesive systems on CHX release, as well as the immediate (IM) and two-year (2-Y) resin-dentin microtensile bond strength (μTBS) and nanoleakage (NL).

METHODS

CHX was added to XP Bond (XP) and Ambar (AM) at concentrations of 0.0 wt% (control); 0.01 wt%; 0.05 wt%; and 0.1 to 0.2 wt%. To assess the cumulative CHX release, adhesive disks were made in a metallic matrix and after light-curing were stored in water. Ultraviolet spectrophotometric measurements of the storage solution were performed to examine the release kinetics of CHX. For μTBS and NL, the occlusal enamel of molars was removed and the adhesives were applied to the dentin surface after acid etching. After composite resin build-up, specimens were sectioned to obtain μTBS sticks. The specimens were subjected to μTBS and NL at IM and after 2-Y. In addition, specimens underwent examination for CHX using micro-Raman spectroscopy. All data were submitted to statistical analysis (α=0.05).

RESULTS

With regard to CHX release, AM showed a slower and gradual release of CHX while XP released CHX more quickly ( p<0.05), and CHX was still present in the hybrid layers after 2-Y. Both adhesives showed CHX release at 2-Y water storage. Both CHX-containing adhesives showed higher μTBS values than did the control group ( p<0.05).

Combination of Acetaminophen/Codeine Analgesics Does Not Avoid Bleaching-Induced Tooth Sensitivity: A Randomized, Triple-Blind Two-Center Clinical Trial

Bleaching-induced tooth sensitivity (TS) is highly prevalent.

OBJECTIVE

This study aimed to determine if the combination of opioids and nonopioids analgesics (Tylex) may provide a better analgesic effect.

METHOD

A triple-blind, parallel, randomized two-center clinical trial was conducted with 105 healthy patients who received either a placebo or a combination of acetaminophen/codeine. The first dose of Tylex 30 mg (acetaminophen 500 mg/codeine 30 mg) or placebo was administered one hour before the in-office bleaching (35% hydrogen peroxide), and extra doses were administered every six hours for 48 hours. The TS was recorded using a visual analog scale of 0 to 10 and a numeric rating scale of 0 to 4 in different periods: during bleaching, one hour up to 24 hours, and 24 hours up to 48 hours postbleaching. The color was measured before and one month after dental bleaching with a visual shade guide (Vita Classical), Vita Bleachedguide 3D-MASTER, and the spectrophotometer Vita Easyshade. The absolute risk of TS was evaluated using the Fisher exact test. Data of TS intensity with numeric rating scale of the two groups were compared with the Mann-Whitney U-test and the Friedman test, while data from the visual analog scale were evaluated by two-way repeated measures analysis of variance and the Tukey test for pairwise comparison. The color changes between groups were compared using the Student t-test (α=0.05).

RESULTS

No significant differences between the groups were observed in the risk and intensity of TS. The overall absolute risk of TS was approximately 96%. No significant differences between groups were observed in terms of color change ( p>0.05) for any scale.

CONCLUSION

The use of an acetaminophen/codeine combination prior to in-office bleaching does not reduce the risk and intensity of bleaching-induced TS.

Efficacy of a new light-cured anesthetic gel for clamp placement before rubber dam isolation in children: A triple-blinded randomized controlled clinical trial

PURPOSE

To evaluate the efficacy of a new light-cured anesthetic gel for pain control associated with the clamp placement for rubber dam isolation in children.

METHODS

82 children in need of sealant placement on the first permanent mandibular molars were selected to take part in this randomized, split-mouth, triple-blinded study. Before rubber dam placement, the light-cured anesthetic gel (test) or a placebo gel (control) was applied on the gingival margins of the molars. The hemi-arches were isolated with cotton rolls and the gels were applied; the anesthetic gel was light-cured. After 30 seconds, clamp #26 was positioned on tooth 36 or 46. If there was pain, the clamp was removed and rescue anesthesia was applied. The absolute risk and intensity of pain were registered using three scales: facial expression (Wong-Baker), observational (FLACC) and numerical (NRS). Data were analyzed by McNemar's test and Wilcoxon Signed Rank (α= 5%).

RESULTS

Differences were detected for the risk of pain between groups (P= 0.0002) and for the different intensity of pain scales used (P< 0.001) with positive results for the anesthetic gel.

CLINICAL SIGNIFICANCE

The new developed light-cured topical anesthetic is an alternative to infiltrative anesthesia for pain control during clamp adaptation for rubber dam isolation. Its use helps to overcome the fear of needles, which can trigger pain, anxiety and discomfort for the majority of the patients, hampering the behavior management in children.

Evaluation of larvicidal activity and ecotoxicity of linalool, methyl cinnamate and methyl cinnamate/linalool in combination against Aedes aegypti

The frequent use of synthetic pesticides to control Aedes aegypti population can lead to environmental and/or human contamination and the emergence of resistant insects. Linalool and methyl cinnamate are presented as an alternative to the synthetic pesticides, since they can exhibit larvicidal, repellent and/or insecticidal activity and are considered safe for use. The aim of this study was to evaluate the larvicidal activity of methyl cinnamate, linalool and methyl cinnamate/linalool in combination (MC-L) (1:4 ratio, respectively) against Aedes aegypti. The in vitro preliminary toxicity through brine shrimp lethality assay and hemolytic activity, and the phytotoxic potential were also investigated to assess the safety of their use as larvicide. Methyl cinnamate showed significant larvicidal activity when compared to linalool (LC₅₀ values of 35.4µg/mL and 275.2µg/mL, respectively) and to MC-L (LC₅₀ 138.0µg/mL). Larvae morphological changes subjected to the specified treatments were observed, as the flooding of tracheal system and midgut damage, hindering the larval development and survival. Preliminary in vitro toxicity through brine shrimp showed the high bioactivity of the substances (methyl cinnamate LC₅₀ 35.5µg/mL; linalool LC₅₀ 96.1µg/mL) and the mixture (MC-L LC₅₀ 57.7µg/mL). The results showed that, despite the higher larvicidal activity of methyl cinnamate, the use of MC-L as a larvicide seems to be more appropriate due to its significant larvicidal activity and low toxicity.

Topical anti-inflammatory activity of a monofloral honey of Mimosa scabrella provided by Melipona marginata during winter in southern Brazil

Melipona marginata is an endangered species of stingless bee from Brazil that produces honey with particular physicochemical features and a remarkable exotic flavor. To the best of our knowledge, this is the first report devoted to exploring the medicinal potential of this honey. Thus, the aim of this paper was to investigate the potential anti-inflammatory activity of honey extract from M. marginata on skin inflammation. The honey sample was classified as a monofloral honey of Mimosa scabrella. The presence of 11 phenolic compounds as kaempferol and caffeic acid was detected using the high-performance liquid chromatography-electrospray ionization-tandem mass spectrometry (HPLC-UV-ESI-MS) method. The anti-inflammatory activity was measured using a 12-O-tetradecanoylphorbol-13-acetate-induced ear edema model of inflammation in mice. The topical application of the M. marginata honey extract (1.0 mg/ear) was able to reduce ear edema with an inhibitory effect of 54 ± 5%. This extract decreased the myeloperoxidase activity in 75 ± 3%, which suggests a lower leucocyte infiltration that was confirmed by histological analysis. This extract also provided a reduction of 55 ± 14% in the production of reactive oxygen species. This anti-inflammatory activity could be due to a synergic effect of the phenolic compounds identified in the honey sample. Taken together, these results open up new possibilities for the use of M. marginata honey extract in skin disorders.

Clinical evaluation of chlorhexidine for the control of dental biofilm in children with special needs

OBJECTIVE

The aim of the present study was to assess two vehicles and forms of the in-home administration of chlorhexidine for the control of dental biofilm in children with special needs.

BASIC RESEARCH DESIGN

Twenty-nine children aged seven to 12 years (mixed dentition phase) participated in the study. A double-blind, placebo-controlled, cross-over clinical trial was carried out with the following treatment groups: 1 - 0.12% chlorhexidine gel (CG); 2 - placebo gel (PG); 3 - 0.12% chlorhexidine spray (CS); 4 - placebo spray (PS). Ten-day experiment periods were separated by 15-day washout intervals.

MAIN OUTCOME MEASURES

The parameters evaluated were plaque, gingival bleeding, and preferences of parents/caregivers.

RESULTS

The initial conditions were similar in each phase of the experiment (p > 0.05). The treatments with chlorhexidine (gel and spray) achieved a significant reduction (p < 0.0001) in plaque and bleeding. The placebo treatments did not achieve significant differences (p > 0.05). The parents/caregivers preferred the administration of chlorhexidine in spray form.

CONCLUSIONS

The topical administration of chlorhexidine associated to tooth brushing led to a reduction in dental biofilm and gingival bleeding in children with special needs. Administration in spray form proved easier and was preferred by parents/caregivers.