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Boomslang (Dispholidus typus) bites are rare in South Africa. This snake's venom is known to be potently haemotoxic, producing a consumptive coagulopathy through the activation of clotting factors II, X, and possibly IX. Monovalent Boomslang antivenom, produced by the South African Vaccine Producers, is highly effective in treating patients who present with haemotoxic envenomation. The majority of health care centres in South Africa do not stock this antivenom due to cost concerns and because envenomation from this snake is so infrequent; this may have lethal consequences for a patient presenting to any such a centre. The usual antivenom dose for effective treatment of a Boomslang bite is two 10 ml vials. We present a case of severe Boomslang envenomation, secondary to a man being bitten on bilateral upper limbs while inside his house, which required three vials of antivenom to treat effectively.
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Colubridae , Mordeduras de Serpentes , Masculino , Animais , Humanos , Antivenenos/uso terapêutico , Mordeduras de Serpentes/terapia , África do SulRESUMO
Xanthogranuloma is a rare benign tumour, part of the non-Langerhans cell histiocytosis group, uncommon in adults and even less common in the paranasal sinuses. Despite its benign nature, it mimics neoplasm due to its local effects which can have serious functional consequences depending on the anatomical location. We present the rare case of a young lady who presented insidiously with a maxillary sinus xanthogranuloma and was treated with endoscopic resection. Tissue diagnosis is of paramount importance to guide correct further investigations and management, and we discuss the potential challenge in identifying such a rarely seen pathology.
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BACKGROUND: A structured approach to perioperative patient management based on an enhanced recovery pathway protocol facilitates early recovery and reduces morbidity in high income countries. However, in low- and middle-income countries (LMICs), the feasibility of implementing enhanced recovery pathways and its influence on patient outcomes is scarcely investigated. To inform similar practice in LMICs for total hip and knee arthroplasty, it is necessary to identify potential factors for inclusion in such a programme, appropriate for LMICs. METHODS: Applying a Delphi method, 33 stakeholders (13 arthroplasty surgeons, 12 anaesthetists and 8 physiotherapists) from 10 state hospitals representing 4 South African provinces identified and prioritised i) risk factors associated with poor outcomes, ii) perioperative interventions to improve outcomes and iii) patient and clinical outcomes necessary to benchmark practice for patients scheduled for primary elective unilateral total hip and knee arthroplasty. RESULTS: Thirty of the thirty-three stakeholders completed the 3 months Delphi study. The first round yielded i) 36 suggestions to preoperative risk factors, ii) 14 (preoperative), 18 (intraoperative) and 23 (postoperative) suggestions to best practices for perioperative interventions to improve outcomes and iii) 25 suggestions to important postsurgical outcomes. These items were prioritised by the group in the consecutive rounds and consensus was reached for the top ten priorities for each category. CONCLUSION: The consensus derived risk factors, perioperative interventions and important outcomes will inform the development of a structured, perioperative multidisciplinary enhanced patient care protocol for total hip and knee arthroplasty. It is anticipated that this study will provide the construct necessary for developing pragmatic enhanced care pathways aimed at improving patient outcomes after arthroplasty in LMICs.
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Artroplastia de Quadril/normas , Artroplastia do Joelho/normas , Consenso , Técnica Delphi , Pessoal de Saúde/normas , Assistência Perioperatória/normas , Artroplastia de Quadril/métodos , Artroplastia do Joelho/métodos , Humanos , Assistência Perioperatória/métodos , África do Sul/epidemiologiaRESUMO
The alleviation of pain and prevention of suffering are key aspects of animal welfare. Unfortunately, analgesic drugs are not available for all species. White rhinoceros (Ceratotherium simum), representing one of such species, which survive poaching attempts inflicted with severe facial injuries and gunshot wounds, nonetheless require analgesic support. To improve treatment conditions, this study explored the use of carprofen for the treatment of pain and inflammation in white rhinoceros. The pharmacokinetics of 1 mg/kg intramuscular carprofen was evaluated in six healthy white rhinoceros. The half-life of λz and mean residence time was 105.71 ± 15.67 and 155.01 ± 22.46 hr, respectively. The area under the curve and the maximum carprofen concentration were 904.61 ± 110.78 µg ml-1 hr-1 and 5.77 ± 0.63 µg/ml, respectively. Plasma TXB2 inhibition demonstrated anti-inflammatory properties and indicated that carprofen may be effective for a minimum of 48 hr in most animals. With its long half-life further indicating that a single dose could be effective for several days, we suggest that carprofen may be a useful drug for the treatment of white rhinoceros.
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Analgesia/veterinária , Analgésicos/farmacocinética , Carbazóis/farmacocinética , Perissodáctilos/metabolismo , Tromboxanos/antagonistas & inibidores , Analgesia/métodos , Analgésicos/administração & dosagem , Analgésicos/sangue , Analgésicos/farmacologia , Animais , Carbazóis/administração & dosagem , Carbazóis/sangue , Carbazóis/farmacologia , Feminino , Meia-Vida , Injeções Intramusculares/veterinária , Masculino , Perissodáctilos/sangueRESUMO
INTRODUCTION: The Merck Adenovirus-5 Gag/Pol/Nef HIV-1 subtype-B vaccine evaluated in predominately subtype B epidemic regions (Step Study), while not preventing infection, exerted vaccine-induced immune pressure on HIV-1 breakthrough infections. Here we investigated if the same vaccine exerted immune pressure when tested in the Phambili Phase 2b study in a subtype C epidemic. MATERIALS AND METHODS: A sieve analysis, which compares breakthrough viruses from placebo and vaccine arms, was performed on 277 near full-length genomes generated from 23 vaccine and 20 placebo recipients. Vaccine coverage was estimated by computing the percentage of 9-mers that were exact matches to the vaccine insert. RESULTS: There was significantly greater protein distances from the vaccine immunogen sequence in Gag (p=0.045) and Nef (p=0.021) in viruses infecting vaccine recipients compared to placebo recipients. Twenty-seven putative sites of vaccine-induced pressure were identified (p<0.05) in Gag (n=10), Pol (n=7) and Nef (n=10), although they did not remain significant after adjustment for multiple comparisons. We found the epitope sieve effect in Step was driven by HLA A∗02:01; an allele which was found in low frequency in Phambili participants compared to Step participants. Furthermore, the coverage of the vaccine against subtype C Phambili viruses was 31%, 46% and 14% for Gag, Pol and Nef, respectively, compared to subtype B Step virus coverage of 56%, 61% and 26%, respectively. DISCUSSION: This study presents evidence of sieve effects in Gag and Nef; however could not confirm effects on specific amino acid sites. We propose that this weaker signal of vaccine immune pressure detected in the Phambili study compared to the Step study may have been influenced by differences in host genetics (HLA allele frequency) and reduced impact of vaccine-induced immune responses due to mismatch between the viral subtype in the vaccine and infecting subtypes.
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Vacinas contra a AIDS/imunologia , Infecções por HIV/prevenção & controle , HIV-1/imunologia , Imunidade Ativa , Produtos do Gene gag do Vírus da Imunodeficiência Humana/imunologia , Produtos do Gene nef do Vírus da Imunodeficiência Humana/imunologia , Vacinas contra a AIDS/administração & dosagem , Adenoviridae , Estudos de Coortes , Método Duplo-Cego , Epitopos/genética , Epitopos/imunologia , Feminino , Frequência do Gene , Antígeno HLA-A2/genética , Antígeno HLA-A2/imunologia , Humanos , Masculino , Tamanho da Amostra , Cobertura Vacinal , Vacinas Sintéticas/administração & dosagem , Vacinas Sintéticas/imunologia , Produtos do Gene gag do Vírus da Imunodeficiência Humana/genética , Produtos do Gene nef do Vírus da Imunodeficiência Humana/genética , Produtos do Gene pol do Vírus da Imunodeficiência Humana/genética , Produtos do Gene pol do Vírus da Imunodeficiência Humana/imunologiaAssuntos
Assistência Odontológica/ética , Odontólogos/ética , Ética Odontológica , Técnicas Cosméticas/economia , Assistência Odontológica/economia , Assistência Odontológica/legislação & jurisprudência , Estética Dentária , Humanos , Consentimento Livre e Esclarecido/ética , Consentimento Livre e Esclarecido/legislação & jurisprudência , Imperícia/legislação & jurisprudência , Marketing de Serviços de Saúde , África do SulRESUMO
INTRODUCTION: The otorhinolaryngology department at Northwick Park Hospital uses the Tristel wipes system for cleaning nasendoscopes in the outpatient clinics. This system uses chlorine dioxide as its only disinfectant. The manufacturer claims the system provides safe sterilisation of nasendoscopes. However, there appear to be no reports in the literature to date that evaluate the efficacy of this system in a clinical setting. The aim of this study was to evaluate the 'in use' efficacy of Tristel wipes in decontaminating nasendoscopes and to identify any significant contamination between cleaning and usage. METHODS: A total of 31 cleaning episodes were performed. Each cleaning episode included two swabs after cleaning the scopes, one from the tip and the other from the handle. Another two swabs from the same areas were also taken before application to the patient. The microbiology unit evaluated all swabs for bacterial, fungal and mycobacterial growth. RESULTS: Overall, 123 swabs from 31 cleaning episodes were tested. None of the swabs taken from the tips (n=31) or handles (n=31) after cleaning with Tristel wipes developed any organism growth. Furthermore, none of the swabs taken from the tip of the scopes before using on patients (n=31) developed any growth. Of the 31 swabs taken from the handle before use, 3 developed significant staphylococcal growth. CONCLUSIONS: In our study, the 'in use' efficacy of Tristel wipes in cleaning the scopes of bacteria, fungi and mycobacteria was 100%. Attention to hand hygiene and the use of gloves should be considered when handling the cleaned scopes to minimise the risk of contamination between cleaning and application to patients.
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Compostos Clorados , Desinfetantes , Desinfecção/métodos , Endoscópios/microbiologia , Contaminação de Equipamentos/prevenção & controle , Óxidos , Infecção Hospitalar/prevenção & controle , Humanos , Estudos Prospectivos , Método Simples-Cego , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/isolamento & purificaçãoRESUMO
BACKGROUND: In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. METHODS: An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. FINDINGS: The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new structures. CONCLUSION: The group's learning supported a view of change that sees the organisation as a living system in which information flow, participation and the development of resilience are key aspects. These themes fit well into an understanding of change based on complexity theory. If managers of the health system wish to enhance organisational change, then their goal may need to shift from optimising health care delivery in a mechanistic model to optimising health care workers in a living system.
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Inovação Organizacional , Equipe de Assistência ao Paciente/organização & administração , Atenção Primária à Saúde/organização & administração , Pesquisa sobre Serviços de Saúde , Humanos , Relações Interprofissionais , Satisfação no Emprego , Liderança , Cultura Organizacional , Equipe de Assistência ao Paciente/tendências , Atenção Primária à Saúde/tendências , Pesquisa Qualitativa , África do SulRESUMO
The management of patients with chronic orofacial pain is a challenge which faces the dental profession daily. These cases can easily be misdiagnosed, overtreated or undertreated. There is a very real danger also of classifying patients as suffering from a psychological condition when in fact they are suffering from organic disease. A series of cases illustrating these problems are presented in order to highlight the pitfalls and to suggest ways to overcome them. Diagnosis is central to all of these cases. Guidelines for the management of these patients are presented.
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Necrose da Polpa Dentária/diagnóstico , Pulpite/diagnóstico , Reabsorção da Raiz/diagnóstico , Odontalgia/etiologia , Adulto , Idoso , Carcinoma de Células Escamosas/complicações , Carcinoma de Células Escamosas/diagnóstico , Doença Crônica , Necrose da Polpa Dentária/complicações , Feminino , Humanos , Masculino , Neoplasias Maxilares/complicações , Neoplasias Maxilares/diagnóstico , Pessoa de Meia-Idade , Pulpite/complicações , Tratamento do Canal Radicular , Reabsorção da Raiz/complicaçõesRESUMO
The use of steroids during rhinoplasty to reduce post-operative periorbital oedema and ecchymosis has been advocated. A number of randomized controlled trials have demonstrated the benefit of steroids in rhinoplasty. The aim of this study was to determine current UK practice in the use of steroids during rhinoplasty performed by otolaryngologists. A postal survey of consultant otolaryngologists in the UK was conducted. We received 203 responses, with 115 consultants performing 12 or more rhinoplasties per year. Only 28 consultants (24 per cent) used steroids routinely in patients undergoing rhinoplasty and of these 11 used a protocol, although this was unpublished. Dexamethasone was the most common steroid used (82 per cent), being administered as a single intravenous dose of 8 mg in the majority of cases (54 per cent). There was no correlation between the use of steroids and the number of rhinoplasties performed by individual consultants. Despite the evidence supporting the use of steroids to reduce post-operative sequelae following rhinoplasty, only a minority of consultants in the UK appear to use them as part of their practice.
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Rinoplastia/estatística & dados numéricos , Esteroides/administração & dosagem , Anti-Inflamatórios/administração & dosagem , Dexametasona/administração & dosagem , Esquema de Medicação , Equimose/prevenção & controle , Edema/prevenção & controle , Pesquisas sobre Atenção à Saúde/métodos , Humanos , Doenças Orbitárias/prevenção & controle , Complicações Pós-Operatórias/prevenção & controle , Reino UnidoRESUMO
BACKGROUND Many psychotropic drugs modify sensory and/or psychomotor functions involved in car driving and as such they can be a causative factor in road accidents. AIM To investigate the effects of the administration of milnacipran, a serotonin and noradrenaline dual-action antidepressant, on the sensory and psychomotor skills implicated in car driving and to determine any possible interactions with the effect of alcohol. METHODS Double-blind, placebo-controlled four-sequence cross-over design with 12 healthy volunteers. Laboratory tests designed to explore motor responses to auditory and visual stimuli and equilibrium on a sensory platform, as well as tests in a real on-road car driving situation, were carried out before the drug administration (control) and at the end of each sequence. RESULTS There was no significant difference in the results of laboratory tests between groups receiving milnacipran compared to placebo. In a real driving situation there were no significant effects of milnacipran. In addition, milnacipran did not accentuate the negative effects of alcohol. CONCLUSIONS Milnacipran, administered at 50 mg b.i.d. to healthy volunteers, does not modify the psychomotor skills required for driving.
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The purpose of the study was to evaluate the biocompatibility of electrochemically activated aqueous solutions on experimental animals. Nine rabbits were subjected to acute eye irritation/corrosion tests, nine rabbits to acute dermal irritation/corrosion and 30 rats to acute oral toxicity (LD50) tests. No significant negative effects were noted. Considering the relatively high levels of exposure of the animals to the solutions and the low levels in the anticipated real clinical situation it is argued that these solutions are indeed biocompatible.
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Materiais Biocompatíveis/toxicidade , Desinfetantes/toxicidade , Administração Cutânea , Animais , Queimaduras Químicas/classificação , Conjuntivite/classificação , Eletroquímica , Eritema/classificação , Olho/efeitos dos fármacos , Queimaduras Oculares/classificação , Feminino , Concentração de Íons de Hidrogênio , Intubação Gastrointestinal , Irritantes/toxicidade , Dose Letal Mediana , Masculino , Modelos Animais , Coelhos , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Pele/efeitos dos fármacos , Cloreto de Sódio/químicaRESUMO
Smad proteins are central mediators of the transcriptional effects of transforming growth factor beta (TGF-beta) superfamily that regulate a wide variety of biological processes. Smad7, an inhibitory Smad protein that prevents TGF-beta signaling by interacting with the activated type I TGF-beta receptor, was recently shown to induce sensitization of cells to different forms of cell death. Here we examined the effect of Smad7 on the c-Jun N-terminal kinase (JNK) cascade and investigated the role of this cascade in both the inhibitory and apoptotic functions of Smad7. The transient and stable expression of Smad7 caused a strong and sustained activation of JNK. Expression of a dominant-interfering mutant of mitogen-activated protein kinase kinase 4, which completely abolished Smad7-induced activation of JNK, had no effect on Smad7-mediated inhibition of TGF-beta signaling, indicating that the inhibitory function of Smad7 is independent of the JNK cascade. In contrast, expression of the dominant-interfering mutant of mitogen-activated protein kinase kinase 4 impaired the ability of Smad7 to promote cell death. These experiments reveal a novel link between Smad7 and the JNK cascade, which is essential for potentiation of cell death by this inhibitory Smad.
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Apoptose , Proteínas de Ligação a DNA/metabolismo , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Proteínas Quinases Ativadas por Mitógeno/fisiologia , Transativadores/metabolismo , Animais , Células COS , Linhagem Celular , Fragmentação do DNA , Cães , Ativação Enzimática , Genes Dominantes , Genes Reporter , Humanos , Immunoblotting , Proteínas Quinases JNK Ativadas por Mitógeno , Camundongos , Fosforilação , Plasmídeos/metabolismo , Ligação Proteica , Transdução de Sinais , Proteína Smad7 , Fatores de Tempo , Transfecção , Células Tumorais CultivadasRESUMO
OBJECTIVES: To assess the incremental diagnostic yield of testing vestibulo-ocular (VOR) gain with high-frequency pseudo-random rotational chair (PsRRC) over testing with bithermal electronystagmography caloric tests in the dizzy patient, particularly in detecting bilateral vestibular loss. PATIENTS AND METHODS: One hundred ninety-eight patients presenting with dizziness underwent PsRRC and caloric testing. The VOR gain on PsRRC was measured at 0.32 to 5.0 Hz, with gain categorized as normal or decreased. PsRRC results were compared with caloric responses, also categorized as normal, or into graded categories of unilateral or bilateral vestibular loss. RESULTS: Reduced PsRRC gain was found in 29 (15%) patients, and reduced caloric tests responses in 70 (35%), with 25 (13%) having bilateral loss. Of patients with reduced chair gain, 25 of 29 (86%) demonstrated bilateral caloric loss. PsRRC gain was normal in most patients with unilateral caloric weakness, but was decreased in all patients with bilateral caloric weakness. The probability of a patient with completely normal caloric responses having an abnormal rotation chair in this study group was under 1% (1 of 128). CONCLUSIONS: PsRRC testing does not offer much additional diagnostic benefit when caloric responses are normal. It is useful in specific conditions, such as unilateral caloric loss for which the patient is not compensating, borderline caloric loss when traditional water caloric tests cannot be used, or for monitoring progressive bilateral vestibular loss.
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Testes Calóricos , Dominância Cerebral , Eletronistagmografia , Doença de Meniere/diagnóstico , Reflexo Vestíbulo-Ocular , Testes de Função Vestibular , Adulto , Dominância Cerebral/fisiologia , Humanos , Doença de Meniere/fisiopatologia , Reflexo Anormal/fisiologia , Reflexo Vestíbulo-Ocular/fisiologia , Rotação , Processamento de Sinais Assistido por ComputadorRESUMO
The Sma and Mad related (Smad) family proteins are critical mediators of the transforming growth factor-beta (TGF-beta) superfamily signaling. After TGF-beta-mediated phosphorylation and association with Smad4, Smad2 moves to the nucleus and activates expression of specific genes through cooperative interactions with DNA-binding proteins, including members of the winged-helix family of transcription factors, forkhead activin signal transducer (FAST)-1 and FAST2. TGF-beta has also been described to activate other signaling pathways, such as the c-Jun N-terminal Kinase (JNK) pathway. Here, we show that activation of JNK cascade blocked the ability of Smad2 to mediate TGF-beta-dependent activation of the FAST proteins. This inhibitory activity is mediated through the transcriptional factor c-Jun, which enhances the association of Smad2 with the nuclear transcriptional corepressor TG-interacting factor (TGIF), thereby interfering with the assembly of Smad2 and the coactivator p300 in response to TGF-beta signaling. Interestingly, c-Jun directly binds to the nuclear transcriptional corepressor TGIF and is required for TGIF-mediated repression of Smad2 transcriptional activity. These studies thus reveal a mechanism for suppression of Smad2 signaling pathway by JNK cascade through transcriptional repression.
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Proteínas de Ligação a DNA/metabolismo , Regulação da Expressão Gênica , Proteínas de Homeodomínio/metabolismo , MAP Quinase Quinase 4 , MAP Quinase Quinase Quinase 1 , Proteínas Quinases Ativadas por Mitógeno/metabolismo , Proteínas Repressoras/metabolismo , Transdução de Sinais/fisiologia , Transativadores/metabolismo , Fator de Crescimento Transformador beta/metabolismo , Animais , Células COS , Chlorocebus aethiops , Proteínas de Ligação a DNA/genética , Fatores de Transcrição Forkhead , Proteínas de Homeodomínio/genética , Humanos , Proteínas Quinases JNK Ativadas por Mitógeno , Quinases de Proteína Quinase Ativadas por Mitógeno/genética , Proteínas Serina-Treonina Quinases/genética , Proteínas Repressoras/genética , Proteína Smad2 , Transativadores/genética , Fatores de Transcrição/genética , Transcrição Gênica , Células Tumorais CultivadasRESUMO
AIM: The aim of this in vitro study was to evaluate the antimicrobial effectiveness of electro-chemically activated water (ECA) as an endodontic irrigation solution. METHODOLOGY: The root canals of 60 caries-free, single-rooted, adult, maxillary, anterior human teeth were instrumented and irrigated in a similar method to that used for in vivo root canal treatment. The external root surface of each tooth was sealed, maintaining the access cavities patent and the root canals were inoculated with a suspension containing four bacteria. The teeth were randomly divided into four groups (n = 15). Each group was irrigated ultrasonically with one of the following solutions: distilled water (control), NaOCl (3.5%), and ECA, the latter at pHs 7.0 and 9.0. Antimicrobial effectiveness was established directly after irrigation and again 7 days later, by counting colony-forming units on blood agar plates and by spectrophotometric analysis. RESULTS: Large numbers of bacteria were present in the canals of teeth irrigated with distilled water. No bacteria were observed following irrigation with NaOCl. Neither of the ECA solutions were found to be effective against all the bacteria. Although some reduction in the number of bacteria was evident in the ECA groups, this was not statistically significant (P > 0.05) when compared to sodium hypochlorite. CONCLUSION: Within the confines of this study ECA did not demonstrate antimicrobial effectiveness.
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Bactérias Anaeróbias/efeitos dos fármacos , Desinfetantes/farmacologia , Irrigantes do Canal Radicular/farmacologia , Água/farmacologia , Adulto , Aggregatibacter actinomycetemcomitans/efeitos dos fármacos , Aggregatibacter actinomycetemcomitans/crescimento & desenvolvimento , Bactérias Anaeróbias/crescimento & desenvolvimento , Contagem de Colônia Microbiana , Cavidade Pulpar/microbiologia , Enterococcus faecalis/efeitos dos fármacos , Enterococcus faecalis/crescimento & desenvolvimento , Humanos , Concentração de Íons de Hidrogênio , Análise por Pareamento , Porphyromonas gingivalis/efeitos dos fármacos , Porphyromonas gingivalis/crescimento & desenvolvimento , Prevotella intermedia/efeitos dos fármacos , Prevotella intermedia/crescimento & desenvolvimento , Hipoclorito de Sódio/farmacologiaRESUMO
An acetone/water extract of the fodder legume Onobrychis viciifolia afforded arbutin, kaempferol, quercetin, rutin, afzelin, the branched quercetin-3-(2(G)-rhamnosylrutinoside), the amino acid L-tryptophan, the inositol (+)-pinitol, and relatively high concentrations of sucrose (ca. 35% of extractable material). Acid-catalyzed cleavage of the condensed tannins with phloroglucinol afforded catechin, epicatechin and gallocatechin as the terminal and extender units, but epigallocatechin was only present in extender units. The condensed tannins in O. viciifolia presumably consist of hetero- and homopolymers containing both procyanidin and prodelphinidin units. Comparison of data from the present study and the literature suggests that sainfoin tannins have a highly variable composition with cis:trans ratios ranging from 47:53 to 90:10 and delphinidin:cyanidin ratios from 36:64 to 93:7. The composition of terminal and extender units in sainfoin tannins seems to be cultivar specific.
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Produtos Biológicos/análise , Fabaceae/química , Plantas Medicinais , Taninos/análise , Espectroscopia de Ressonância MagnéticaRESUMO
AIM: A new product, electro-chemically activated water, was compared to NaOCl for its cleaning effect on root canal walls. METHODOLOGY: Root canal treatment was carried out on two groups of extracted teeth with one of the irrigants being used in each group. The control group received no treatment. All teeth were split and the canal walls viewed in a scanning electron microscope. RESULTS: The canal walls of the control group were covered by debris and bacteria. Sodium hypochlorite produced clean surfaces with the dentinal tubules open in some areas and occluded by the smear layer in other areas; in some areas bacteria were visible inside or under the smear layer. Electro-chemically activated water produced markedly cleaner surfaces, removing the smear layer in large areas. CONCLUSIONS: The cleaning efficacy of electro-chemically activated water in root canals was considered to be superior to NaOCl.