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Effective pain management is vital for critically ill patients, particularly post-surgery or trauma, as it can mitigate the stress response and positively influence morbidity and mortality rates. The suboptimal treatment of pain in Intensive Care Unit (ICU) patients is often due to a lack of education, apprehensions about side effects, and improper use of medications. Hence, the engagement of pain management and anesthesiology experts is often necessary. While opioids have been traditionally used in pain management, their side effects make them less appealing. Local anesthetics, typically used for anesthesia and analgesia in surgical procedures, have carved out a unique and crucial role in managing pain and other conditions in critically ill patients. This work aims to offer a comprehensive overview of the role, advantages, challenges, and evolving practices related to the use of local anesthetics in ICUs. The ability to administer local anesthetics continuously makes them a suitable choice for controlling pain in the upper and lower extremities, with fewer side effects. Epidural analgesia is likely the most used regional analgesic technique in the ICU setting. It is primarily indicated for major abdominal and thoracic surgeries, trauma, and oncology patients. However, it has contraindications and complications, so its use must be carefully weighed. Numerous challenges exist regarding critically ill patients, including renal and hepatic failure, sepsis, uremia, and the use of anticoagulation therapy, which affect the use of regional anesthesia for pain management. Appropriate timing and indication are crucial to maximizing the benefits of these methods. The advent of new technologies, such as ultrasonography, has improved the safety and effectiveness of neuraxial and peripheral nerve blocks, making them feasible options even for heavily sedated patients in ICUs.
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Quercus species are utilized for their durable wood, providing sustenance for wildlife, conserving biodiversity, and contributing ecological, medicinal, and esthetic benefits to ecosystems and landscapes. In this study, we aimed to use the bark of three Quercus species (Q. dalechampi, Q. fraineto, and Q. petraea) for the synthesis of silver and gold nanoparticles (AgNPs and AuNPs). The aqueous extracts from the bark of Quercus sp. acted both as reducing and stabilizing agent, facilitating the rapid synthesis of AuNPs (AuQD, AuQF, and AuQP) and AgNPs (AgQD, AgQF, and AgQP). The obtained nanoparticles were characterized using UV-vis spectroscopy, TEM, DLS, and FTIR. Characterizations revealed that the nanoparticles exhibited a variety of shapes, such as polygonal, triangular, and spherical forms, with sizes ranging between 14 and 24 nm for AuNPs and 45-70 nm for AgNPs. The total phenolic content was assessed through spectroscopic methods, while several individual phenolic compounds were identified and quantified using UPLC-PDA. Furthermore, we assessed the antioxidant, antibacterial, and antifungal capacities of AuNPs, AgNPs, and raw extracts. The highest antioxidant activity was observed for raw extracts, followed by AgNPs and AuNPs, while the most potent antibacterial and antifungal activity was observed in AgQP. Moreover, cytotoxicity was examined in a human keratinocyte cell line (HaCaT). The results indicated no cytotoxic effects for AuNPs, while AgNPs and the raw extracts exhibited cytotoxic effects after 48 h of incubation. This research underscores the multifaceted utility of Quercus bark extracts in the green synthesis of metallic nanoparticles and their subsequent bioactivity assessment, suggesting promising perspectives for their application in various fields while urging cautious consideration of their cytotoxic implications.
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Multiple sclerosis (MS) is a chronic inflammatory and neurodegenerative central nervous system (CNS) disorder, characterized by focal inflammation, demyelination, irreversible axonal loss and neurodegeneration. The proposed mechanism involves auto-reactive T lymphocytes crossing the blood-brain barrier (BBB), contributing to inflammation and demyelination. Pro-inflammatory Th1 and Th17 lymphocytes are pivotal in MS pathogenesis, highlighting an imbalanced interaction with regulatory T cells. Dysbiosis in the gut microbiota, characterized by microbial imbalance is implicated in systemic inflammation, yet its exact role in MS remains elusive. Short-chain fatty acids (SCFAs), including valerate, butyrate, propionate, and acetate, produced through dietary fiber fermentation by the gut microbiota, modulate inflammation and immune responses. Particularly, butyrate and propionate exhibit pronounced anti-inflammatory effects in both the gut and CNS. These SCFAs influence regulatory T lymphocyte expression and BBB permeability. This review discusses the potential therapeutic implications of SCFA in MS, highlighting their ability to modulate the gut-brain axis and restore immune balance.
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Esclerose Múltipla , Humanos , Esclerose Múltipla/tratamento farmacológico , Propionatos , Ácidos Graxos Voláteis/metabolismo , Butiratos , Inflamação , ImunidadeRESUMO
This comprehensive review explores the utilization of chiral stationary phases (CSPs) in the context of single-column simultaneous chiral-achiral high-performance liquid chromatography (HPLC) separation methods. While CSPs have traditionally been pivotal for enantioselective drug analysis, contemporary CSPs often exhibit notable chemoselective properties. Consequently, there is a discernible trend towards the development of methodologies that enable simultaneous enantio- and chemoselective separations utilizing a single CSP-based chromatographic column. This review provides an exhaustive overview of reported HPLC methods in this domain, with a focus on four major CSP types: cyclodextrin-, glycopeptide antibiotic-, protein-, and polysaccharide-based CSPs. This article delves into the diverse applications of CSPs, encompassing various chromatographic modes such as normal phase (NP), reverse phase (RP), and polar organic (PO). This review critically discusses method development, emphasizing the additional chemoselective separation mechanisms of CSPs. It also explores possibilities for method optimization and development, concluding with future perspectives on this evolving field. Despite the inherent challenges in understanding the retention mechanisms involved in chemoselective separations, this review highlights promising trends and anticipates a growing number of simultaneous enantio- and chemoselective methods in pharmaceutical analyses, pharmacokinetic studies, and environmental sample determinations.
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Antibacterianos , Ciclodextrinas , Cromatografia Líquida de Alta Pressão/métodos , Antibacterianos/química , Glicopeptídeos/química , EstereoisomerismoRESUMO
This is the first study describing phenolics of Momordica charantia L. 'Enaja' cultivar (bitter melon) produced in Romania. Total polyphenol content, total tannin content, total flavonoid content, and antioxidant activity of bitter melon stems and leaves, young fruits, and ripe fruits grown in Romania were analysed, along with fruits imported from India. The UPLC-DAD analysis led to the identification of (+)-catechin, (-)-epicatechin, luteolin-3',7-di-O-glucoside, luteolin-7-O-glucoside and vanillic acid. (-)-Epicatechin (859 µg/g) and (+)-catechin (1677 µg/g) were the most abundant compounds in stems and leaves, while in the ripe fruits, luteolin-7-O-glucoside (310 µg/g) was the main phenolic. Stems and leaves were the most active for capturing free DPPH radicals (IC50 = 216.9 ± 11.91 µg/ml); the scavenging activity strongly correlated with the flavonoid content (r = 0.8806, r2 = 0.7754). Momordica charantia fruits from Romania, both young and ripe, are a source of polyphenols as valuable as those imported from India.
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Catequina , Momordica charantia , Antioxidantes/farmacologia , Momordica charantia/química , Romênia , Fenóis/análise , Flavonoides , Radicais Livres , Extratos Vegetais/farmacologia , Extratos Vegetais/químicaRESUMO
Introduction: Ropivacaine is a popular local anesthetic used for regional anesthesia or for pain management. Although designed as an enantiomerically pure drug, an aspect that reduces the adverse effects, its toxicological effects are still a risk. As such, biomonitoring to assure appropriate dosage and bioavailability are essential to avoid complications during or post-surgery. Methods: The study focused on developing a sensitive, selective, and accurate liquid chromatography-mass spectrometry (LCMS/MS) method which facilitates the biomonitoring of ropivacaine and its main metabolite in plasma after regional anesthesia using ropivacaine. Results and Discussion: The method was validated with regards to all relevant parameters, such as sensitivity, selectivity, accuracy, precision, and the effect of sample matrix. The method was successfully used in a pilot study, which included one patient undergoing plane block anesthesia for cardiac device implantation. The results showed the method is appropriate for its intended purpose and could even be used in other, similar applications.
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Carvedilol, a highly protein-bound beta-blocker, is used in therapy as a racemic mixture of its two enantiomers that exhibit different pharmacological activity. The aim of this study was to evaluate the stereoselective nature of its binding to the two major plasma proteins: albumin and alpha-1-acid glycoprotein. The determination of the plasma protein-binding degree for carvedilol and its enantiomers was achieved using ultrafiltration for the separation of the free fraction, followed by LC-MS/MS quantification, using two different developed and validated methods in terms of stationary phase: achiral C18 type and chiral ovomucoid type. Furthermore, molecular docking methods were applied in order to investigate and to better understand the mechanism of protein-binding for S-(-)- and R-(+)-carvedilol. A difference in the binding behavior of the two enantiomers to the plasma proteins was observed when taken individually, with R-(+)-carvedilol having a higher affinity for albumin and S-(-)-carvedilol for alpha-1-acid glycoprotein. However, in the case of the racemic mixture, the binding of the S enantiomer to alpha-1-acid glycoprotein seemed to be influenced by the presence of its antipode, although no such influence was observed in the case of albumin. The results raise the question of a binding competition between the two enantiomers for alpha-1-acid glycoprotein.
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Antagonistas Adrenérgicos beta , Carvedilol , Orosomucoide , Albumina Sérica Humana , Humanos , Albuminas , Carbazóis/química , Carvedilol/química , Cromatografia Líquida/métodos , Simulação de Acoplamento Molecular , Orosomucoide/química , Albumina Sérica Humana/química , Estereoisomerismo , Espectrometria de Massas em Tandem/métodos , Ligação Proteica , Ligação Competitiva , Antagonistas Adrenérgicos beta/químicaRESUMO
The bark resulted as a by-product after different Quercus sp. processing is a valuable alternative source of phenolic compounds (mainly tannins). Hence, the focus of the present work was to obtain eight extracts from the rhytidome of the less-studied Q. dalechampii and Q. frainetto and characterize them in terms of chemical and bioactive profiles. Ultrasound and microwave-assisted extraction methods were used for the preparation of the extracts. Total phenolic and tannin contents were assessed through classic spectrophotometric methods, while several individual phenolic compounds were identified and quantified using UPLC-PDA. Antioxidant, enzyme-inhibitory, antibacterial, and cytotoxic activities were tested using in vitro assays; additionally being evaluated was the ability of the extracts to inhibit the adherence of MRSA to suture wires. The UPLC analysis confirmed the presence of gallic acid, catechin, taxifolin, vanillic acid, epicatechin, and caffeic acid. The results showed that tested extracts were able to exert cytotoxic effects, at 6% and 3% concentrations, on confluent cells. The tested solutions inhibit α-glucosidase activity and the antibacterial potential suggested a mild to moderate effect against the Gram-positive strains. Overall, the obtained results revealed rich phenolic and tannin contents for the extracts obtained from both species through microwave-assisted extraction, probably responsible for their mild antibacterial and cytotoxic effects.
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Stroke prevention, a significant public-health concern, begins with recognizing and addressing risk factors. Interventions targeted at modifiable risk factors can effectively prevent ischemic stroke, while Omega-3 fatty acids have been shown to improve stroke outcomes. Our study aimed to investigate the relationship between ischemic-stroke risk factors and fatty acids using a prospective observational study with 274 patients. We collected clinical data on risk factors and measured fatty-acid levels using high-performance liquid chromatography coupled with mass spectrometry. We found that several risk factors, including age, sex, smoking, atrial fibrillation, dyslipidemia, and previous stroke history, had a direct relationship with fatty acids. Of these, smoking had the most significant impact, negatively impacting levels of docosahexaenoic and eicosapentaenoic acid. Conversely, dyslipidemia and atrial fibrillation positively correlated with fatty acids, particularly in female patients and those with recurrent strokes. Age was found to directly correlate with other risk factors and variations in fatty-acid ratios. The stroke rate was higher in males than females before the age of 70, but this trend reversed. Our findings suggest that better management of risk factors, particularly modifiable lifestyle factors, could improve fatty-acid profiles and the balance of Omega-3 and Omega-6 in patients with ischemic stroke.
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Fibrilação Atrial , Ácidos Graxos Ômega-3 , AVC Isquêmico , Acidente Vascular Cerebral , Masculino , Humanos , Feminino , Ácidos Graxos , AVC Isquêmico/etiologia , AVC Isquêmico/complicações , Fibrilação Atrial/complicações , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia , Ácido Eicosapentaenoico , Ácidos Docosa-HexaenoicosRESUMO
Glyphosate, and the ever growing reliance on its use in agriculture, has been a point of contention for many years. There have been debates regarding the risk and safety of using glyphosate-based herbicides as well as the effects of occupational, accidental, or systematic. Although there have been a number of studies conducted, the biomonitoring of glyphosate poses a series of challenges. Researchers attempting to determine the occupational exposure face questions regarding the most appropriate analytical techniques and sampling procedures. The present review aims to summarize and synthetize the analytical methodologies available and suitable for the purpose of glyphosate biomonitoring studies as well as discuss the advantages and disadvantages of each analytical technique, from the most modern to more well-established and older ones. The most relevant publications that have described analytical methods and published within the last 12 years were studied. Methods were compared, and the advantages and disadvantages of each methods were discussed. A total of 35 manuscripts describing analytical methods for glyphosate determination were summarized and discussed, with the most relevant one being compared. For methods that were not intended for biological samples, we discussed if they could be used for biomonitoring and approaches to adapt these methods for this purpose.
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Herbicidas , Exposição Ocupacional , Monitoramento Biológico , Exposição Ocupacional/análise , Glicina , Agricultura , GlifosatoRESUMO
Stroke is the primary cause of death and disability worldwide, with ischemic stroke up to 80% of the total cases. Lipid profile was established as a major risk factor for stroke, but recent studies show a paradoxical relationship between serum values and the outcome of stroke patients. Our study aims to analyze the impact of the classic extended lipid profile, including fatty acids as potential neuroprotective biomarkers for the outcome of ischemic stroke patients. We included 298 patients and collected clinical, paraclinical, and outcome parameters. We used a method consisting of high-performance liquid chromatography coupled with mass spectrometry to quantify serum fatty acids. We observed a negative correlation between National Institutes of Health Stroke Scale (NIHSS) at admission and total cholesterol (p = 0.040; r = -0.120), respectively triglycerides (p = 0.041; r = -0.122). The eicosapentaenoic to arachidonic acid ratio has a negative correlation, while the docosahexaenoic to eicosapentaenoic acid ratio positively correlates with all the prognostic parameters, showing a potential neuroprotective role for eicosapentaenoic acid in preventing severe ischemic stroke. The impact of the lipid profile paradox and the dependency relationship with the fatty acids represent a significant predictive factor for the functional and disability prognostic of ischemic stroke patients.
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Isquemia Encefálica , AVC Isquêmico , Acidente Vascular Cerebral , Ácido Araquidônico , Biomarcadores , Colesterol , Ácido Eicosapentaenoico , Ácidos Graxos , Humanos , TriglicerídeosRESUMO
Orodispersible tablets (ODTs) are pharmaceutical formulations used to obtain fast therapeutic effects, usually recommended for geriatric and pediatric patients due to their improved compliance, bioavailability, ease of administration, and good palatability. This study aimed to develop ODTs with cannabidiol (CBD) phytocannabinoid extracted from Cannabis sativa used in the treatment of Lennox-Gastaut and Dravet syndromes. The tablets were obtained using an eccentric tableting machine and 9 mm punches. To develop CBD ODTs, the following parameters were varied: the Poloxamer 407 concentration (0 and 10%), the type of co-processed excipient (Prosolv® ODT G2-PODTG2 and Prosolv® EasyTab sp-PETsp), and the type of superdisintegrant (Croscarmellose-CCS, and Soy Polysaccharides-Emcosoy®-EMCS), resulting in eleven formulations (O1-O11). The following dependent parameters were evaluated: friability, disintegration time, crushing strength, and the CBD dissolution at 1, 3, 5, 10, 15, and 30 min. The dependent parameters were verified according to European Pharmacopoeia (Ph. Eur.) requirements. All the tablets obtained were in accordance with quality requirements in terms of friability (less than 1%), and disintegration time (less than 180 s). The crushing strength was between 19 N and 80 N. Regarding the dissolution test, only four formulations exhibited an amount of CBD released higher than 80% at 30 min. Taking into consideration the results obtained and using the Modde 13.1 software, an optimal formulation was developed (O12), which respected the quality criteria chosen (friability 0.23%, crushing strength of 37 N, a disintegration time of 27 s, and the target amount of CBD released in 30 min of 99.3 ± 6%).
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Vitamin D deficiency has been linked to numerous health problems, including those resulting from disturbed calcium-phosphorus homeostasis, and neuropsychiatric and autoimmune disorders. Nearly one-third of the global population has suboptimal levels of vitamin D, according to epidemiological data. Vitamin D status is usually determined by measuring serum 25(OH)D, but, for decades, serum 25(OH)D measurement has been hampered by a lack of standardization. There have been many recent initiatives to develop reference substances and methods for measuring vitamin D and its metabolites, and re-evaluating the optimal values. It was also suggested that alternative biological samples could also be used, such as hair, since it has been established that lipophilic substances, such as corticosteroids, can also be found in hair. The purpose of this study was to determine the correlation between 25(OH)D3 concentrations in serum and hair, and other demographic features in 26 healthy Caucasian young adult volunteers. The determination of 25(OH)D3 and cholecalciferol was carried out using liquid chromatography coupled with mass spectrometry (LC-MS) from blood and hair samples taken at two timepoints separated by nine weeks. In the hair samples of 18 out of 26 subjects, 25(OH)D was detected at a mean (±SEM) concentration of 17.07 ± 5.375 pg/mg at the first sampling time, and 58.90 ± 25.97 pg/mg at the second sampling time. A multiple linear regression analysis revealed no effects of gender, body mass index, supplementation, or sun exposure on hair 25(OH)D3 concentrations, but supplementation and sun exposure significantly increased serum 25(OH)D3 concentrations. In addition, serum and hair 25(OH)D3 concentrations did not correlate; however, there was a strong correlation between the two sampling times for serum 25(OH)D3 concentrations. In conclusion, this study confirmed that 25(OH)D3 could be detected in human hair, but its use as a biomarker warrants further investigations since no link was found between serum 25(OH)D3 concentrations, supplementation, sun exposure, and hair 25(OH)D3 concentrations levels.
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The present project aims to evaluate Tribulus terrestris (TT) extracts by addressing various possible mechanisms of action in order to see whether the use of TT supplements in diabetes and diabetes complications is justified. Diabetic rats were divided into three groups: diabetic control group, TT extract with low protodioscin content group (TT-LPC) and TT extract with high protodioscin content group (TT-HPC). After twelve weeks of treatment, fasting blood glucose, insulin, LH, FSH and testosterone levels were measured. Both TT preparations reduced elevated blood glucose level. Insulin and luteinizing hormone levels were not significantly different compared with the control group; however, the FSH and testosterone levels were significantly higher in the TT-HPC group compared with the diabetic control group. The testosterone level is correlated in part with the protodioscin concentration in extracts and is probably mediated through an FSH-linked pathway.
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The bark of various tree species is a byproduct of the forestry industry that is not used at its full potential, considering the wide range of phytochemicals that are contained in these vegetal matrices and the health benefits that these compounds could provide for society. Our goal was to assess and compare the phytochemical composition of some hydroalcoholic spruce (Picea abies) bark extracts attained by ultrasound assisted extraction (UAE) and microwave-assisted extraction (MAE) and their antioxidant and antibacterial effects. The levels of total phenolics and tannins in the bark extracts were determined using methods based on the Folin-Ciocâlteu reagent, while specific phenolic and volatile compounds were identified and quantified using an UPLC-PDA method and a GC-FID method, respectively. After the chemical composition assessment, the antioxidant capacity (AC) was evaluated by measuring the scavenging ability against two free radicals (DPPH and ABTS). The minimum inhibitory concentration (MIC) was determined to assess the antibacterial activity of the extracts. The results indicated that the extracts produced by UAE had higher contents of polyphenols and tannins and also a higher content of the main phenolic compounds identified, catechin and epicatechin, compared to the MAE extracts. In contrast the highest content of volatile terpenoids (mainly α- and ß-pinene) was found in the MAE extracts. All of the tested extracts exhibited relatively high antioxidant activities (especially the UAE extracts) and low MICs against Gram-positive bacteria but were mildly efficient against Gram-negative bacteria. These findings show that the spruce bark might be an important source of bioactive compounds that can be easily extracted from these industrial secondary products. Various uses of this vegetal material may emerge, due to its antioxidant and antibacterial effects.
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The bark resulted after the industrial processing of wood represents a byproduct of the forestry industry, used in many suboptimal ways, being considered a natural waste. Currently, it has been highlighted that the bark of different woody plants may be an important source of several bioactive compounds, with various beneficial biological functions. The aim of this study is to evaluate and compare the chemical composition and biological activities of two different pine species (Pinus nigra and Pinus sylvestris) bark extracts. Ultrasound (UAE) and microwave (MAE) assisted extractions were performed in order to obtain the extracts. The total polyphenol (TPC) and total tannin (TTC) contents of the extracts were assessed via the Folin-Ciocâlteu method. The volatile and polyphenolic compounds were identified and quantified via a GC/MS analysis and an UPLC-PDA analysis, respectively. The antioxidant activity (AOA) was evaluated using the DPPH and ABTS assays, while the antibacterial activity was assessed using the minimum inhibitory concentration (MIC) protocol. The results showed that the Pinus sylvestris bark extracts obtained by UAE had a higher TPC, TTC and AOA, while the Pinus nigra bark extracts obtained by MAE had higher volatile compounds content (mainly α-pinene and ß-pinene). Moreover, the inhibition of the bacterial growth was more efficient in the case of Pinus sylvestris extracts, Gram-positive bacteria being the most affected, while Gram-negative strains presented a relative resistance to the tested extract concentrations. These results may indicate the potential use of the pine bark extracts as antioxidant or antibacterial agents.
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BACKGROUND: Coccidiosis represents a serious threat to the poultry industry, affecting production and causing high morbidity, mortality and significant costs resulting from treatment and prophylaxis. In-feed anticoccidials have been used for decades for managing avian coccidiosis and were very effective until drug resistance emerged. The use of natural remedies has become a promising alternative in combating coccidiosis in chickens. Therefore, the purpose of the present study was to assess the efficiency of a commercial herbal formula (H), as oral liquid preparations, in experimental chicken coccidiosis. METHODS: Two independent controlled battery experiments (BE1 and BE2) were designed and the product was tested in 3 different formulas (H1, H2 and H3): H1 contained a propylene glycol extract of Allium sativum and Thymus serpyllum; H2 contained Origanum vulgare, Satureja hortensis and Chelidonium majus; and H3 contained Allium sativum, Urtica dioica, Inula helenium, Glycyrrhiza glabra, Rosmarinus officinalis, Chelidonium majus, Thymus serpyllum, Tanacetum vulgare and Coriandrum sativum. Chickens were divided into five groups for each BE as follows: (i) uninfected untreated control (UU1, UU2); (ii) infected untreated control (IU1, IU2); (iii) infected treated with amprolium (ITA1, ITA2); and (iv, v) two experimental groups infected treated with H1 (ITH1) and H2 (ITH2) formulas in the BE1 and with H3 (ITH3-5 and ITH3-10) formula in the BE2. The chickens from infected groups were challenged with 5000 (BE1) and 50,000 (BE2) sporulated oocysts of Eimeria spp. (E. acervulina, E. tenella and E. maxima), respectively. The anticoccidial efficacy was assessed by recording the following: oocysts output (OPG), lesion score (LS), weight gain (WG), feed conversion ratio (FCR) and anticoccidial index (ACI). Additionally, polyphenolics and flavonoids (caffeic-chlorogenic acid, apigenin, kaempferol, luteolin, quercitin, quercitrin) from herb extracts found in H3 formula were determined by the liquid chromatography-tandem mass spectrometry (LC-MS/MS) method. RESULTS: H1 and H2 reduced the WG, and increased the FCR and OPG compared with controls. H1 reduced the duodenal lesions, whilst H2 reduced the caecal lesions, compared with control. H3 decreased the OPG of Eimeria spp., reduced the total lesion score and improved the zootechnical performance (weight gain and feed conversion ratio). According to ACI value, H1 and H2 had no efficacy on Eimeria spp. infection, but H3 had good to marked anticoccidial effect, the ACI being slightly greater in the group ITH3-5. According to the results of LC-MS/MS, the concentration of polyphenols in H3 formula was the highest, the sum of chlorogenic acid and caffeic acid being 914.9 µg/ml. CONCLUSIONS: H3 formula is a promising natural anticoccidial and field trials are recommended in order to validate the obtained data.