Development, physicochemical evaluation, and in vivo permeation studies of topical formulations containing 0.1% tacrolimus

Abstract The objective of this paper was to develop and evaluate two semi-solid pharmaceutical forms containing 0.1% tacrolimus: cream (CRT01) and gel (GLT01). For the evaluation of physicochemical stability, at times 0, 30, 60 and 90 days, at 23°C and at 40°C, High Performance Liquid Chromatography coupled with a Diode Array Detector (HPLC-DAD) was employed. This method was developed and validated for tacrolimus quantification. The occlusivity test and skin permeation assay were also performed, using an animal model (Wistar rats), and the CRT01 and GLT01 were compared to the 0.1% tacrolimus ointment (PFU01) obtained from the University Pharmacy, Federal University of Rio de Janeiro, Brazil. CRT01 and GLT01 presented a homogeneous aspect and consistency adequate for topical products, along with sensory characteristics above PFU01. They also presented adequate physicochemical stability for 90 days and a lower occlusive effect than PFU01 (p<0.05). CRT01 showed greater affinity for the skin when compared to PFU01 and GLT01, with low systemic absorption. The CRT01 semi-solid formulation was considered the most adequate one to treat patients with atopic dermatitis or other dermatologic inflammatory diseases, promoting rational use of tacrolimus

Effect of Cissus quadrangularis on Fracture Healing in Laboratory Animal / Efeito do Cissus quadrangularis na cicatrização de fraturas em animais de laboratório

Objectives: The present study was designed to examine the efficacy of Cissus quadrangularis paste on fracture healing in artificially induced fractured rabbits. Methods: Fifteen rabbits were separated into three groups namely A, B, and C. Veldt grape paste was applied in groups B and C (Treatment Group) by close reduction and open reduction methods of fracture management; respectively, while group A was kept as control. The blood parameter and fracture healing properties in all animals have been monitored and examined routinely during the study period. Results: Both treated groups revealed lower serum calcium levels (SCL) than the control group after 24 hours of fracture that became within the normal range on the 14th day. Fracture healing in the treated groups has been commenced more rapidly than the control group with complete bridging of discontinuity by a distinct osseous callus in the fracture line on day 7 and complete effacing of fracture line on day 14. Conclusion: We did not find any type of anomalousness, clinical deviations, and alteration of serum calcium level on the 14th day of the fracture in treated animals hence Veldt Grape paste could be readily applicable to the management of the fracture in animals.

Objetivos: avaliar a eficácia da pasta de Cissus quadrangularis na consolidação de fraturas em coelhos fraturados artificialmente. Metodos: quinze coelhos foram separados em três grupos (A, B e C). A pasta foi aplicada nos grupos B e C (Grupo de Tratamento) pelos métodos de redução fechada e redução aberta de gerenciamento de fraturas; respectivamente. O grupo A foi mantido como controle. O parâmetro sanguíneo e as propriedades de cicatrização de fraturas em todos os animais foram monitorados e examinados, rotineiramente, durante o período do estudo. Resultados: ambos os grupos tratados revelaram níveis séricos de cálcio (SCL) mais baixos do que o grupo controle, após 24 horas de fratura que se tornou normal no 14º dia. A cicatrização da fratura nos grupos tratados foi iniciada mais rapidamente do que o grupo controle, com ponte completa de descontinuidade por um calo ósseo distinto na linha de fratura no dia 7 e apagamento completo da linha de fratura no dia 14. Conclusao: não encontramos nenhum tipo de anomalia, desvios clínicos e alteração do nível sérico de cálcio no 14º dia da fratura nos animais tratados, portanto, a pasta Veldt Grape pode ser aplicável ao manejo da fratura em animais.

Mupirocin ointments: In vitro x In vivo bioequivalence evaluation

Abstract Bioequivalence (BE) assessment of topical drug products is a long-standing challenge. Agencies such as the Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have published several drafts in recent years suggesting different approaches as alternative to evaluate the BE. A proposed Topical Classification System (TCS) has even been discussed. Given the above, the objective of this research was to use in vitro and in vivo BE approaches to evaluate Brazilian marketed mupirocin (MPC) ointments, previously classified as TCS class The in vitro permeation test (IVPT) was performed by applying formulations to pig skin by Franz cells. The in vivo methodology was dermatopharmacokinetic (DPK). These approaches (in vivo tape stripping and IVPT) demonstrated capability of distinguishing among different formulations, thus making them useful methodologies for BE evaluation.

Walnut ointment promotes full-thickness burning wound healing: role of linoleic acid

Purpose: To investigate the active ingredients of walnut ointment (WO) and its mechanism in repairing wounds. Methods: The ingredients of WO were detected by gas chromatography­mass spectrometry. The effect of linoleic acid (LA) was tested by in vitro Alamar Blue (AB) reagent. Image J software, histological and immunohistochemical analysis were used to confirm the healing effect of LA in the porcine skin model. The animals were euthanized after the experiment by injection of pentobarbital sodium. Results: LA, 24% in WO, promotes keratinocytes and fibroblasts proliferation, which were 50.09% and 15.07% respectively higher than control (p < 0.05). The healing rate of the LA group (96.02% ± 2%, 98.58% ± 0.78%) was higher than the saline group (82.11% ± 3.37%, 88.72% ± 1.73%) at week 3 and week 4 (p < 0.05). The epidermal thickness of the LA was 0.16 ± 0.04 mm greater and the expression of the P63 and CK10 proteins was stronger in the LA group than the control (p < 0.05). Conclusions: LA, which is the main components in WO can promote full-thickness burning wounds (FBWs) by stimulating cell proliferation and differentiation.

Estudo ex vivo da elevação do pH em superfície radicular externa após agitação ultrassônica de diferentes pastas de hidróxido de cálcio / Assessment of pH increase in the external root surface after ultrasonic agitation of different calcium hydroxide pastes: Ex vivo study

Objetivo: O presente estudo teve por objetivo avaliar, ex vivo, a capacidade de elevação do pH da superfície radicular externa de diferentes pastas de hidróxido de cálcio (HC) utilizadas como medicação intracanal, além da influência da ativação ultrassônica (AUS) durante aplicação no interior do canal radicular. Métodos: Foram utilizados 100 incisivos humanos superiores unirradiculares, que tiveram os canais radiculares modelados e divididos aleatoriamente em seis grupos experimentais (n=15), de acordo com a pasta de HC, tendo como variáveis as medicações utilizadas e a ativação da pasta com AUS no momento da aplicação, além de um grupo controle (n=10): Pasta Calen; HC+clorexidina 2% gel (CX2%); e HC + água destilada. Os dentes foram mantidos imersos em água deionizada e as medidas do pH, verificadas nos períodos de 7, 14, 21 e 28 dias, com auxílio de pHmetro. Resultados: De acordo com os dados obtidos, verificou-se elevação do pH nos períodos de 7 e 14 dias em todos os grupos. Apenas os grupos em que foi utilizada a associação do HC com CX2% apresentou evolução com aumento significativo do pH ao longo dos períodos analisados (p<0,05). A ativação das pastas com AUS proporcionou incremento significativo dos valores de pH (p<0,05). Conclusão: De acordo com a metodologia empregada, pode-se concluir que todas as pastas utilizadas promovem elevação do pH no tecido dentinário, e a ativação das pastas com AUS influencia significativamente na elevação do pH no tecido dentinário (AU).

Objective: The aim of the present study was to evaluate, ex-vivo, the pH elevation capacity on the external root surface of different calcium hydroxide (HC) pastes, utilized as intracanal medication, it was also evaluated the influence of the ultrasonic activation at the application within the root canal. Methods: 100 human single root superior incisors were used, which had their root canals shaped and randomly divided into 6 experimental groups (n=15) according to the following HC pastes: Calen; HC + Chlorhex- idine 2% gel (CX2%); HC + distilled water, utilizing the medications and the ultrasonic activation of the paste at the time of the application as variables and 1 control group (n=10). The teeth were kept immersed in deionized water and the pH parameters were verified in 7, 14, 21 and 28 days with a pH measurement machine. Results: According to the data obtained, pH was elevated in the first week in all groups. Only the groups which the association of HC with CX2% was made, did show a significant increase in the pH level over the analyzed periods (p < 0,05). The activation of the pastes with US provided a significant increase in pH values (p < 0,05). Conclusion: According to the methodology used, we can conclude that all the HC pastes used, promote pH elevation in dentin tissue. And the acti- vation of the pastes with US significantly influences the pH increase in dentin tissue

Application of chen yuangao in the treatment of soft tissue injury of football players / Aplicação de chen yuangao no tratamento da lesão dos tecidos moles de jogadores de futebol / Aplicación de chen yuangao para tratar lesiones de tejidos blandos en jugadores de fútbol

ABSTRACT The treatment of soft tissue injury in football players generally includes physical therapy, anti-inflammatory and analgesic drug treatment, surgical treatment and early rest immobilization. Western medicine treatment of soft tissue injury can quickly heal the wound and relieve pain in a short time. The treatment of traditional Chinese medicine is based on the whole and must seek the root of the disease. It is believed that the occurrence of certain diseases is related to Qi, blood, liver and kidney deficiency, so we should pay attention to the overall adjustment during treatment of symptoms. In view of this, this study analyzed the effect of Chen Yuan ointment, from traditional Chinese medicine, in the treatment of soft tissue injury. Sixty-eight football players who completed ankle ligament reconstruction were divided into four groups according to the type of operation and whether Chen Yuangao-assisted rehabilitation was used or not. The results showed that the Ankle Hindfoot Function Score and the visual analog scale (VAS) score of patients in the fibula brevis tendon reconstruction Chen Yuan ointment group were 98.3 and 0.3, respectively, at the last follow-up, which were better than those in other groups, and had lower pain scores. This result shows that Chen Yuangao has a certain effect in the treatment of soft tissue injury, which can provide a research idea for the rapid rehabilitation of football players.

RESUMO O tratamento de lesões dos tecidos moles em jogadores de futebol inclui geralmente terapia física, tratamento anti-inflamatório e analgésico, tratamento cirúrgico e imobilização de repouso precoce. O tratamento de lesões nos tecidos moles, utilizando a medicina ocidental, pode curar rapidamente as lesões e aliviar a dor em pouco tempo. A medicina tradicional chinesa se baseia no todo e deve procurar a raiz da doença. Acredita-se que a ocorrência de certas doenças está relacionada à deficiência de Qi, sangue, fígado e rim do corpo humano, por isso devemos prestar atenção ao ajuste global no tratamento dos sintomas. A partir desta perspectiva, este estudo analisou o efeito da tradicional pomada chinesa Chen Yuan no tratamento de lesões dos tecidos moles. No total, 68 jogadores de futebol que fizeram reconstrução dos ligamentos do tornozelo foram divididos em quatro grupos de acordo com o tipo de operação e se a pomada Chen Yuangao ajudou ou não na reabilitação. Os resultados mostraram que o escore da função do tornozelo retropé (Ankle Hindfoot Function Score) e o escore da Escala Analógica Visual (EVA) dos pacientes do grupo pomada Chenyuan para reconstrução do tendão fibular curto foram 98,3 e 0,3, respectivamente, no último seguimento, sendo melhores do que os de outros grupos e apresentando menores níveis de dor. Estes resultados mostra que a pomada Chen Yuangao exerce certo efeito no tratamento de lesões dos tecidos moles, pode constituir uma ideia de pesquisa para a rápida reabilitação dos jogadores de futebol.

RESUMEN El tratamiento de lesiones de los tejidos blandos en jugadores de fútbol incluye generalmente terapia física, tratamiento antinflamatorio y analgésico, tratamiento quirúrgico e inmovilización de reposo precoz. El tratamiento de lesiones en los tejidos blandos, utilizando la medicina occidental, puede curar rápidamente las lesiones y aliviar el dolor en poco tiempo. La medicina tradicional china se basa en el todo y debe procurar la raíz de la enfermedad. Se cree que la ocurrencia de ciertas enfermedades está relacionada a la deficiencia de Qi, sangre, hígado y riñón del cuerpo humano, por eso debemos prestar atención al ajuste global en el tratamiento de los síntomas. A partir de esta perspectiva, este estudio analizó el efecto de la tradicional pomada china Chen Yuan en el tratamiento de lesiones de los tejidos blandos. En total, 68 jugadores de fútbol que hicieron reconstrucción de los ligamentos del tobillo fueron divididos en cuatro grupos de acuerdo con el tipo de operación y si la pomada Chen Yuangao ayudó o no en la rehabilitación. Los resultados mostraron que el escore de la función del retropié del tobillo (Ankle Hindfoot Function Score) y el escore de la Escala Analógica Visual (EVA) de los pacientes del grupo pomada Chenyuan para reconstrucción del tendón fibular corto fueron 98,3 y 0,3, respectivamente, en el último segmento, siendo mejores que los de otros grupos y presentando menores niveles de dolor. Estos resultados muestran que la pomada Chen Yuangao ejerce cierto efecto en el tratamiento de lesiones de los tejidos blandos, puede constituir una idea de investigación para la rápida rehabilitación de los jugadores de fútbol.

Efficacy and mechanism of traditional chinese medicine gel in sports-related soft tissue injury / Eficácia e mecanismo do tradicional gel da medicina chinesa em lesões desportivas de tecidos moles / Eficacia y mecanismo del gel de medicina tradicional china en lesiones deportivas de tejidos blandos

ABSTRACT Soft tissue injury is the most common disease in orthopedics, and it is also the most easily neglected disease in sports. Without timely and effective treatment, it is easy to develop into malignant strain and seriously affect life and sports. In view of this, the aim of this study is to analyze the effect and mechanism of traditional Chinese medicine gel in treating such injuries in the light of the characteristics of sports-related soft tissue injury. The right gastrocnemius muscle injury was simulated in 36 adult male rats. Chinese medicine gel and tincture were used to treat it. The contents of interleukin, alanine aminotransferase, blood urea nitrogen and prostaglandin E2 in the blood of rats under different courses of treatment were analyzed to explore recovery in four rats. The results showed that the levels of interleukin and prostaglandin E2 in the blood of rats treated with drugs were significantly lower than those in the control group (p<0.05), indicating that both drugs have obvious therapeutic effects on soft tissue injury. The content of interleukin in the blood of the Chinese medicine gel group was slightly lower than that of the tincture group, indicating that the Chinese medicine gel could affect the recovery of soft tissue injury by affecting leukocyte interleukin. This result is helpful in the treatment of soft tissue injury in sports and to further improve the therapeutic effect of traditional Chinese medicine gel.

RESUMO A lesão dos tecidos moles é a doença mais comum na ortopedia, e é também a doença mais facilmente negligenciada nos esportes. Sem tratamento ágil e eficaz, facilmente evolui para luxações malignas, afetando seriamente a vida e a prática de esportes. Em vista disso, o objetivo deste estudo é analisar o efeito e o mecanismo do gel da medicina tradicional chinesa no tratamento de tais lesões, com base nas características da lesão dos tecidos moles relacionada à prática esportiva. Estimulou-se lesão do músculo gastrocnêmio direito em 36 ratos adultos. O gel e a tintura chinesa foram usados para o tratamento. Foram analisados os conteúdos de interleucina, alanina aminotransferase, ureia sanguínea azoto e prostaglandina E2 no sangue dos ratos sob diferentes tratamentos, de modo a explorar a recuperação de quatro ratos. Os resultados mostraram que os níveis de interleucina e prostaglandina E2 no sangue dos ratos tratados com medicamentos eram significativamente inferiores aos do grupo controle (p<0.05), indicando que ambos os fármacos têm efeitos terapêuticos óbvios sobre lesões dos tecidos moles. O teor de interleucina no sangue do grupo gel chinês medicinal mostrou-se ligeiramente inferior ao do grupo tintura, indicando que o gel medicinal chinês pode afetar a recuperação da lesão nos tecidos moles, afetando o leucócito interleucina. Este resultado é útil para o tratamento de lesões dos tecidos moles relacionadas à prática esportiva e para melhorar ainda mais o efeito terapêutico do gel da medicina chinesa tradicional.

RESUMEN La lesión de los tejidos blandos es la enfermedad más común en la ortopedia, y es también la enfermedad más fácilmente descuidada en los deportes. Sin tratamiento ágil y eficaz, fácilmente evolucionan a luxaciones malignas, afectando seriamente la vida y la práctica de deportes. En vista de eso, el objetivo de este estudio es analizar el efecto y el mecanismo del gel de la medicina tradicional china en el tratamiento de tales lesiones, con base en las características de la lesión de los tejidos blandos relacionada a la práctica deportiva. Se estimuló lesión del músculo gastrocnemio derecho en 36 ratones adultos. El gel y la tintura china fueron usados para el tratamiento. Fueron analizados los contenidos de interleucina, alanina aminotransferasa, urea sanguínea, nitrógeno y prostaglandina E2 en la sangre de los ratones bajo diferentes tratamientos, de modo de explorar la recuperación de cuatro ratones. Los resultados mostraron que los niveles de interleucina y prostaglandina E2 en la sangre de los ratones tratados con medicamentos eran significativamente inferiores a los del grupo control (p<0.05), indicando que ambos fármacos tienen efectos terapéuticos obvios sobre lesiones de los tejidos blandos. El tenor de interleucina en la sangre del grupo gel chino medicinal se mostró ligeramente inferior al del grupo tintura, indicando que el gel medicinal chino puede afectar la recuperación de la lesión en los tejidos blandos, afectando el leucocito interleucina. Este resultado es útil para el tratamiento de lesiones de los tejidos blandos relacionadas a la práctica deportiva y para mejorar aún más el efecto terapéutico del gel de la medicina china tradicional.

Efeito do extrato de Bidens pilosa L, Mel e pomadas homeopática e alopática na cicatrização de feridas cutâneas de ratos Wistar / [Effect of Bidens pilosa L, Honey extract and homeopathic and allopathic ointments on the healing of skin wounds of Wistar rats]

Cicatrização de ferida é um processo dinâmico, que tem por objetivo restaurar a continuidade do tecido lesionado. No entanto, em alguns casos, é necessário favorecer condições adequadas para viabilizar o processo fisiológico. Neste estudo foram utilizados ratos Wistar, divididos aleatoriamente entre cinco grupos, com 12 animais cada, sendo eles: grupo P (Bidens pilosa L.), grupo mel, grupo Co1 (pomada comercial alopática), grupo Co2 (pomada comercial homeopática) e grupo CT (controle). As lesões foram geradas por incisão com punch de 8mm, sendo tratadas diariamente de forma tópica. Foram eutanasiados quatro animais por grupo, no terceiro, sétimo e 14º dias do experimento, e o material coletado foi armazenado em formalina 10% e encaminhado para processamento histológico. Posteriormente, realizou-se a contagem de leucócitos mononucleares, fibroblastos e neovasos e avaliou-se a arquitetura de fibras colágenas. Os resultados da contagem foram analisados pela ANOVA, seguida pelo teste de Tukey (P<0,05). O modelo experimental proposto neste estudo demonstrou que todos os tratamentos apresentaram potencial cicatrizante, com exceção do mel. A aplicação tópica do creme do extrato de Bidens pilosa L. a 10% apresentou melhor perfil anti-inflamatório; a pomada alopática apresentou boa aderência à superfície da lesão e a pomada homeopática, grande potencial angiogênico, com menor tempo de cicatrização.(AU)

Wound healing is a dynamic process that aims to restore the continuity of injured tissue. However, in some cases it is necessary to favor adequate conditions to enable the physiological process. Wistar rats were randomly divided into 5 groups with 12 animals each, namely: group P (Bidens pilosa L.), group honey, group Co1 (commercial allopathic ointment), group Co2 (commercial homeopathic ointment) and group CT (control). The lesions were generated by an 8mm punch incision and were treated topically daily. Four animals per group were euthanized on the 3rd, 7th and 14th day of the experiment and the collected material was stored in 10% formalin and sent for histological processing, after which mononuclear, fibroblasts and neovascular leukocytes were counted and collagen fiber architecture was evaluated. Counting results were analyzed by ANOVA, followed by Tukey test (p <0.05). The experimental model proposed in this study showed that all treatments had healing potential, except honey. The topical application of 10% Bidens pilosa L. extract cream showed the best anti-inflammatory profile; Allopathic ointment showed good adhesion to the surface of the lesion and homeopathic ointment showed great angiogenic potential with shorter healing time.(AU)

Wound healing effect of Pistacia lentiscus L. seed oil: confirmation of its uses in Mediterranean traditional medicine / Efecto curativo de heridas del aceite de semilla de Pistacia lentiscus L: confirmación de sus usos en medicina tradicional mediterránea

In order to evaluate the potential of this formulation (P. lentiscus L. oil-based ointment) to heal wounds, experimental wounds were done on guinea pigs and efficiency was comparatively assessed against a reference ointment, Cicaderma®. Wound contraction was performed on days 5, 10 and 15. Tissue sections were also evaluated histopathological on days 7, 14 and 21. Results showed that for all days (5, 10 and 15), the highest wound contraction values were attained for the P. lentiscus oil-based ointment treated group with wound contraction values of 19.38, 55.8 and 77.11%, respectively, as compared to the reference drug Cicaderma® where contractions were 7.97%, 49.53% and 71.44%, respectively. Vehicle and negative control groups however showed no statistically significant wound healing activity on the excision wound model. These experimental studies revealed that the P. lentiscus oil-based ointment displays remarkable wound healing activity, in accordance with its use in traditional medicine.

Con el fin de evaluar el potencial de esta formulación (ungüento a base de aceite de P. lentiscus L.) para curar heridas, se realizaron heridas experimentales en cobayos y se evaluó comparativamente su eficacia respecto de un ungüento de referencia, Cicaderma®. La contracción de la herida se realizó los días 5, 10 y 15. Las secciones de tejido también se evaluaron histopatológicamente los días 7, 14 y 21. Los resultados mostraron que para todos los días (5, 10 y 15), se obtuvieron los valores más altos de contracción de la herida para el grupo tratado con ungüento a base de aceite de P. lentiscus con valores de contracción de la herida de 19.38, 55.8 y 77.11%, respectivamente, en comparación con el medicamento de referencia Cicaderma® en donde las contracciones fueron 7.97%, 49.53% y 71.44%, respectivamente. Sin embargo, los grupos de control de vehículo y negativo no mostraron actividad de curación de heridas estadísticamente significativa en el modelo de herida por escisión. Estos estudios experimentales revelaron que la pomada a base de aceite de P. lentiscus muestra una notable actividad de curación de heridas, de acuerdo con su uso en la medicina tradicional.

Abordagem conservadora do ectrópio palpebral congênito / Conservative management of congenital eversion of the eyelids

Resumo Ectrópio palpebral congênito é o termo utilizado para descrever a ocorrência da eversão das pálpebras, seja ela superior ou inferior, presente ao nascimento. Trata-se de uma afecção rara com reduzido número de casos publicados no meio científico desde 1896, ano em que o primeiro relato foi documentado. O objetivo desse trabalho é descrever um caso de abordagem conservadora do Ectrópio Palpebral Congênito, evidenciando as suas principais características, importância do diagnóstico precoce e conduta adequada para o seu tratamento. Este é um estudo transversal, retrospectivo e documental baseado na metodologia de relato de caso que envolve um recém-nascido do sexo feminino que apresentou eversão palpebral unilateral e foi tratada de maneira conservadora, obtendo melhora do quadro com satisfatório resultado estético e funcional.

Abstract Congenital eyelid ectropion is the term used to describe the eversion of the eyelids, be it in the upper or lower lid, present at birth. It is a rare condition with a reduced number of cases published in scientific world since 1896, the year it was first reported. The objective of this work is to describe a case of Congenital Ectropion treated conservatively, emphasizing its main characteristics, importance of early diagnosis and appropriate treatment. This is a cross-sectional, retrospective and documentary study based on the methodology of case report involving a female newborn who presented unilateral palpebral eversion at birth and was treated conservatively, showing a satisfactory and functional improvement of the condition.

Caracterización físico-química de la pomada de Maytenus laevis "Chuchuhuasi" elaborada en la Farmacia Natural del Hospital III EsSalud Chimbote / Physicochemical characterization of Maytenus laevis "chuchuhuasi" ointment, elaborated at the Natural Pharmacy of Hospital III EsSalud, Chimbote

Objetivos. Determinar las características físicoquímicas de la pomada de Maytenus laevis «chuchuhuasi¼, elaborada en la Farmacia Natural del CAMEC del Hospital III EsSalud - Chimbote. Materiales y métodos. Investigación analítica-descriptiva. Se elaboró un extracto etanólico mediante maceración de 500 g. de corteza de Maytenus laevis «chuchuhuasi" con etanol 70°. Se obtuvo 500 mL de extracto con el que se realizó la prueba organoléptica por el método sensorial e identificación de metabolitos secundarios mediante la técnica de Olga Lock; asimismo, se efectuaron los siguientes análisis fisicoquímicos: determinación de pH, densidad, contenido alcohólico, sólidos totales e índice de refracción. Posteriormente, se elaboró 1 k de pomada mediante el método de fusión a 60 °C de una mezcla de 200 g de lanolina y 750 g de vaselina sólida. Luego, se agregó 2 mL de propilenglicol a 50 mL del extracto etanólico de «chuchuhuasi¼; finalmente, esta mezcla fue adicionada a la base de pomada, se removió hasta obtener una mezcla uniforme y se envasó en frascos de plástico de 30 mL de capacidad. Resultados. En el extracto etanólico de Maytenus laevis «chuchuhuasi¼ se observaron metabolitos secundarios como alcaloides, taninos, compuestos fenólicos, saponinas, quinonas, triterpenos y flavonoides; asimismo, se obtuvieron las siguientes características físicoquímicas: olor a madera, sabor astringente, color rojo marrón oscuro, aspecto homogéneo, pH 5,5, densidad relativa 0,988, contenido alcohólico 24°, sólido totales 12%, índice de refracción 1,3768. En la pomada se obtuvieron las siguientes características físicoquímicas: olor característico, aspecto homogéneo, textura suave, pH 6,62, extensibilidad 28,2 mm2, peso 30 g, índice de agua 34 mL y buena homogeneidad. Conclusiones. Se lograron determinar las características físico-químicas de la pomada de Maytenus laevis «chuchuhuasi¼.

Objectives. Determine the physical-chemical characteristics of the Maytenus laevis ointment "Chuchuhuasi", elaborated in the Natural Pharmacy of CAMEC of Hospital III EsSalud - Chimbote. Materials and methods. Analytical-descriptive research. An ethanolic extract was produced by maceration of 500 g. of Maytenus laevis bark "Chuchuhuasi" with 70o ethanol. 500 mL of ethanolic extract was obtained and the following tests were performed: Organoleptics using the sensory method and identification of secondary metabolites using the Olga Lock technique, in addition the following physical-chemical analyses were performed: pH determination, density, alcoholic content, total solids and refractive index. Subsequently, 1 kilo of ointment was produced using the 60oC fusion method of a mixture of 200 g. Lanolin and 750 g. solid Vaseline. Then 2 mL of Propylene glycol was added to 50 mL of Chuchuhuasi's ethanolic extract, eventually this mixture was added to the ointment base, removed until a uniform mixture was obtained and packaged in plastic bottles of 30 mL capacity. Results. In the ethnic extract of Maytenus laevis "Chuchuhuasi" the presence of the following secondary metabolites was observed: Alkaloids, tannins, phenolic compounds, saponins, quinons, triterpenes and flavonoids, the following physical-chemical characteristics were also obtained: Wood odor, astringent flavor, dark brown red color, homogeneous appearance; pH 5.5, relative density 0.988 alcoholic content 24°, total solid 12%, refractive index 1.3768. The following physical-chemical characteristics were obtained in the ointment: characteristic odor, homogeneous appearance, soft texture, pH 6.62, extensibility 28.2 mm2, weight 30 gr, water index 34 mL and good homogeneity. Conclusions. The physicalchemical characteristics of the Maytenus laevis "Chuchuhuasi" ointment were determined.

Capsaicin topical cream (8%) for the treatment of myofascial pain syndrome / Creme tópico de capsaicina (8%) para o tratamento da síndrome da dor miofascial

Abstract Background: Myofascial pain syndrome is a common cause of musculoskeletal pain. The objective of this study was to evaluate the potential analgesic action of 8% capsaicin cream for topical use in patients with myofascial pain syndrome. Methods: Initially, cream formulations of PLA (Placebo) and CPS (Capsaicin 8%) were developed and approved according to the current requirements of the health authority agency. The 40 participating patients were randomly assigned to the PLA and CPS groups in a double-blind fashion. Before the creams were topically administered, according to the allocation group, the local anesthetic was used for a period of 50 minutes directly in the area of interest. The cream was applied to the area of the skin over the trigger point, represented by the area with pain at palpation, in an amount of 10 g for 30 minutes in a circular area of 24 mm diameter. Subsequently, the cream was removed and the skin tolerability parameters were evaluated. The pain was measured before and during the formulation application, as well as at 1 hour, 7 days, 30 days, and 60 days after the procedure, evaluated using a verbal numerical scale (from 0 to 10: with 0 = no pain and 10 = worst pain imaginable). Results: No patient in PLA Group had hyperemia or burning sensation at the site of application, while 85% of patients in CPS Group had hyperemia or burning sensation at 15 minutes. These complaints disappeared 24 hours after the cream was removed. The pain score in CPS Group decreased steadily up to the 60th day of evaluation (p < 0.0001). Conclusion: Application of the formulations did not cause macroscopic acute or chronic skin lesions in patients, and the 8% capsaicin formulation was beneficial and well tolerated.

Resumo Justificativa: A síndrome da dor miofascial é uma causa comum de dor musculoesquelética. O objetivo deste estudo foi avaliar a potencial ação analgésica de 8% do creme de capsaicina para uso tópico em pacientes com síndrome da dor miofascial. Métodos: Inicialmente, as formulações de creme de PLA (Placebo) e CPS (Capsaicina 8%) foram desenvolvidas e aprovadas de acordo com os requisitos atuais da agência de autoridade de saúde. Os 40 pacientes participantes foram distribuídos aleatoriamente e de forma duplo-cega para os grupos PLA e CPS. Antes dos cremes serem administrados topicamente, de acordo com o grupo de alocação, o anestésico local foi usado por um período de 50 minutos diretamente na área de interesse. A administração ocorreu na área da pele sobre o ponto-gatilho, o qual apresentou a área dolorida à palpação, em uma quantidade de 10 g por 30 minutos em área circular com diâmetro de 24 mm. Posteriormente, o creme foi removido e os parâmetros de tolerabilidade à pele foram avaliados. A dor foi medida antes e durante a aplicação da formulação, bem como 1 hora, 7 dias, 30 dias e 60 dias após o procedimento avaliado pela escala numérica verbal (0 a 10, com zero sem dor e dez a pior dor imaginável). Resultados: Nenhum paciente no grupo PLA experimentou hiperemia ou sensação de queimação no local de aplicação do creme, enquanto 85% dos que experimentaram no grupo CPS apresentaram hiperemia ou sensação de queimação 15 minutos. Essas queixas desapareceram 24 horas após a remoção do creme. O escore de dor no grupo CPS diminui de forma sustentada até o 60° dia de avaliação (p < 0,0001). Conclusão: A administração das formulações não causou lesões cutâneas agudas ou crônicas macroscópicas nos pacientes e a formulação de 8% de capsaicina foi benéfica e bem tolerada.

Morphological changes in the tissue structures afeter thermal burns on the background of using dermarm wound dressing

Over the last decade, the interest in using bacterial cellulose in medicine has increased. The article publishes the data about the efficiency of healing burn wounds in rabbits in experimental conditions with the use of the DermaRM wound dressing, compared to the traditionally used Panthenol ointment and the Branolind N salve dressing

Development and evaluation of the efficiency of ointment for cheilitis treatment in patients with dental and jaw anomalies

Cheilitis is a group of chronic diseases of the vermilion border that are diverse in etiology, pathogenesis and clinical picture. The development of various forms of cheilitis is facilitated by defects of the architectonics of the lips, unhealthy lifestyle, anatomical features of the lip structure, adverse meteorological effects, decrease in specific and non-specific factors for protecting the oral cavity, the patient's psycho-emotional state, immuno-allergic factors and accompanying general somatic and dental pathologies. The issues of prevention and comprehensive treatment of lip diseases are especially relevant in dental practice. The article presents data on the prevalence of cheilitis and dentoalveolar anomalies and the need for their treatment in young people. Furthermore, the authors provide a composition justification and develop an ointment for the treatment of cheilitis in this category of patients.

Evaluation of the use of tacrolimus ointment for the prevention of hypertrophic scars in experimental model

Abstract BACKGROUND: Tacrolimus, for its activity on modulation of collagen production and fibroblast activity, may have a role in the prevention of hypertrophic scars. OBJECTIVES: Evaluate macroscopic, microscopic, metabolic, laboratory effects and side effects of the use of topical tacrolimus ointment, in different concentrations, in the prevention of hypertrophic scars. METHODS: Twenty-two rabbits were submitted to the excision of 2 fragments of 1 cm of each ear, 4 cm apart, down to cartilage. The left ear of the animals was standardized as control and Vaseline applied twice a day. The right ear received tacrolimus ointment, at concentrations of 0.1% on the upper wound and 0.03% on the lower wound, also applied twice a day. Macroscopic, microscopic, laboratory criteria and the animals' weight were evaluated after 30 days of the experiment. RESULTS: Wounds treated with tacrolimus, at concentrations of 0.1% and 0.03%, when compared to control, showed a lower average degree of thickening (p = 0.048 and p <0.001, respectively). The average of scar thickness and lymphocyte, neutrophil and eosinophil concentrations are lower in the treated wounds compared to the control (p <0.001, p=0.022, p=0.007, p=0.044, respectively). The mean concentration of lymphocytes is lower in wounds treated with a higher concentration of the drug (p=0.01). STUDY LIMITATIONS: experiment lasted only 30 days. CONCLUSIONS: Tacrolimus at the 2 concentrations evaluated reduced the severity of inflammatory changes and positively altered the macroscopic aspect of the scar in the short term. Its use was shown to be safe, with no evidence of systemic or local adverse effects.

Long-term use of topical tacrolimus ointment: a safe and effective option for the treatment of vernal keratoconjunctivitis / Uso prolongado de tacrolimus tópico: opção eficaz e segura no tratamento da ceratoconjuntivite vernal

ABSTRACT Purpose: To assess the compliance, efficacy, and safety of the long-term use of topical tacrolimus for the clinical management of vernal keratoconjunctivitis. Methods: The medical records of patients with vernal keratoconjunctivitis undergoing long-term treatment with 0.03% topical tacrolimus were retrospectively reviewed. The duration of tacrolimus use and the causes for drug discontinuation were used to assess treatment compliance. To assess drug efficacy, the need for and the number of times that topical corticosteroids were used to control symptoms were registered. Side effects related to tacrolimus use were monitored to determine drug safety. Results: The study cohort consisted of 21 patients who met the eligibility criteria. The mean duration of tacrolimus use was 41.3 ± 18.5 months. Fourteen patients (66.7%) continuously used tacrolimus, and three (14.3%) discontinued treatment following complete remission. Four patients (19%) did not use tacrolimus as prescribed or interrupted tacrolimus use on their own: two (9.5%) because of discomfort upon application and two (9.5%) because of the lack of improvement. Ten patients (47.6%) maintained disease control without the use of corticosteroids, whereas 11 (52.4%) required an average of 2.70 ± 1.35 corticosteroid cycles to control symptoms. The only reported side effect was discomfort upon application. Conclusions: Despite the small sample size and study design limitations, these results support the long-term use of topical tacrolimus as an effective and safe option for the treatment of vernal keratoconjunctivitis, with good compliance of patients to the treatment.

RESUMO Objetivo: Avaliar a aderência, a eficácia e segurança do uso prolongado de tacrolimus tópico no controle clínico da ceratoconjuntivite vernal. Métodos: Um estudo retrospectivo foi desenvolvido através da análise de prontuários de pacientes com ceratoconjuntivite vernal em tratamento prolongado com tacrolimus tópico 0,03%. A duração do tempo de uso do ta­crolimus e as causas de descontinuação da medicação foram usadas para avaliar a adesão ao tratamento. Para avaliar a eficácia da droga, a necessidade e o número de vezes em que corticoides tópicos foram utilizados para controlar os sintomas foram registrados. Os efeitos colaterais relacionados ao uso do tacrolimus foram monitorados para determinar a segurança da droga. Resultados: Vinte e um pacientes preencheram os critérios de eleição e foram incluídos no estudo. A duração média do uso de tacrolimus foi de 41,3 ± 18,5 meses. Quatorze pacientes (66,7%) usaram continuamente o tacrolimus e 3 (14,3%) descontinuaram o tratamento após a remissão completa. Quatro pacientes (19%) não usaram o tacrolimus conforme prescrito ou interromperam o uso da droga isoladamente: 2 (9,5%) por desconforto na aplicação e 2 (9,5%) pela falta de melhora. Dez pacientes (47,6%) mantiveram a doença sob controle sem o uso de corticoides, enquanto 11 (52,4%) necessitaram em média 2,70 ± 1,35 ciclos corticoides para controle dos sintomas. O único efeito adverso relatado foi desconforto na aplicação. Conclusões: Apesar do pequeno tamanho da amostra e das limitações do desenho do estudo, esses resultados suportam o uso prolongado do tacrolimus tópico como opção eficaz e segura para o tratamento da ceratoconjuntivite vernal, com boa adesão dos pacientes ao tratamento.

Influence of chlorhexidine and zinc oxide in calcium hydroxide pastes on pH changes in external root surface

Abstract The objective of this study was to assess the influence of chlorhexidine (liquid and gel) and zinc oxide in calcium hydroxide (CH) pastes on root pH in simulated external resorption. One hundred human anterior teeth with a single root canal were selected. After decoronation and root canal instrumentation, the specimens were divided into 4 experimental groups and 1 control group (without intracanal paste): CH + saline (CH+S), CH + 2% chlorhexidine liquid (CH+ CHX), CH + 2% chlorhexidine gel (CH+ CHXg), and CH + 2% chlorhexidine gel + zinc oxide (CH+ CHXg+ZnO). pH was measured using a microelectrode at 3 and 24 h, and 1, 2, 3, and 4 weeks after inserting intracanal pastes. Data were analyzed statistically using an ANOVA and Tukey's test (p < 0.05). The CH+CHXg+ZnO group had the highest pH values throughout (p<0.05). The CH+S and CH+ CHX groups had the highest pH values after 1 week and the CH+ CHXg group after 2 weeks. CH+ CHXg maintained the highest pH until the fourth week compared with CH+ CHX (p < 0.05). The control group remained at a neutral pH at all evaluated times. It can be concluded that chlorhexidine solution or gel maintained the alkaline pH of CH, and chlorhexidine gel allowed a slower decrease in pH over time. CH+ CHXg+ZnO showed the highest pH values and was an effective intracanal medication for maintaining alkaline root pH in the area of resorption.

Correspondence between try-in pastes and resin cements, and color stability of bonded lithium disilicate disks

Abstract: This study investigates the color correspondence of resin cements and try-in pastes, and the color stability of bonded lithium disilicate ceramic disks. Resin composite disks were fabricated (n = 36) to serve as the background for lithium disilicate disks prepared in two thicknesses (0.5 and 1.0 mm, n = 18 each). Two brands were used for try-in and cement procedures: Variolink Veneer and AllCem Veneer. For baseline, water was applied between the ceramic disks and their respective backgrounds to achieve the control group. This set was subjected to color measurement using an intraoral measurement device (T0). The try-in was inserted between background and ceramic, and this set was subjected to color measurement (T1). After adhesive procedures, the ceramic disk was placed under cement, and color measurement was performed with uncured cement (T2) and 24 h after light-curing (T3). Each set was immersed in distilled water and thermal-cycled, with color measurement being performed after 10,000 (T4) and 20,000 (T5) cycles. Color differences were calculated by CIELab (rEab) and CIEDE2000 (rE00). Data were analyzed by two-way ANOVA for repeated measurements and Tukey's test (α=5%). There was color correspondence of try-in and resin cement for the Variolink system, regardless of the ceramic thickness (p > 0.05). For the AllCem system, the thickness significantly influenced the color measurement (p < 0.001). The Variolink system also demonstrated color stability after 20,000 thermal cycles with rEab < 3.46 and rE00 < 2.25. It was concluded that the color correspondence between a try-in and its respective cement may vary according to resin cement composition.

Iodoform Vs Calcium Hydroxide/Zinc Oxide based pastes: 12-month findings of a Randomized Controlled Trial

Abstract This study evaluated clinical and radiographic twelve-month outcomes of root canal treatments (CT) with smear layer removal, performed in primary teeth, using two different root canal filling materials. Pulpectomy was performed on 27 primary teeth with necrosis or irreversible pulpitis, caused by dental caries or trauma, in 23 children (2-7 years old). A single trained operator performed the CT in a single visit in cases without periapical or interradicular radiolucency (PIR) or in multiple visits in cases with PIR. Participants were selected based on specific inclusion and exclusion criteria, and randomly allocated into two groups: Group 1 (G1) - iodoform paste (iodoform + camphorated parachlorophenol + ointment comprising prednisolone acetate 5.0 mg and rifamycin 1.5 mg); Group 2 (G2) - Calen®/ZO paste. Treated teeth were restored with composite resin immediately after the root canal filling. The outcomes were evaluated clinically and radiographically according to specific criteria. Two blinded and standardized evaluators assessed the radiographic outcomes. We used descriptive analyses due to the small sample size. CTs were performed due to caries lesions in 70.4% of the cases and due to trauma in 29.6%. Only one tooth of G1 was unsuccessful; hence, pulpectomy performance in both groups was not influenced by the filling material, nor by any other analyzed variable. The level of the root canal filling was better in the Calen®/ZO group. The clinical and radiographic twelve-month outcomes indicated successful treatment, independently of the root filling material used.

Ointment of Ximenes americana promotes acceleration of wound healing in rats

Abstract Purpose: To evaluate the healing potential of the Ximenia americana hydroalcoholic extract in 10% cream in excisional wound models in rats. Methods: Sixty male adults Wistar rats were submitted to skin and subcutaneous tissue surgery in the right and left thoracic regions, divided into three experimental groups: Standard submitted to treatment with only the base vehicle, Treated wounds treated with hydroalcoholic extract of X. americana applied on 10%, Lanette base and Control, untreated wounds. The treatment was performed daily and the wounds evaluated microscopically by the quantification of fibroblasts, collagen fibers and blood vessels. Results: The histomorphometric analysis showed a significant increase in the number of fibroblasts, collagen fibers and blood vessels in the treated group. Conclusion: The topical action of the cream based on Ximenia americana shows angiogenic effects and improves the replacement of collagen, suggesting its use for the development of herbal remedy in the treatment of cutaneous wound healing.