Antibiofilm activity of promethazine against ESBL-producing strains of Escherichia coli in urinary catheters.

The bacterium Escherichia coli is one of the main causes of urinary tract infections. The formation of bacterial biofilms, especially associated with the use of urinary catheters, contributes to the establishment of recurrent infections and the development of resistance to treatment. Strains of E. coli that produce extended-spectrum beta-lactamases (ESBL) have a greater ability to form biofilms. In addition, there is a lack of drugs available in the market with antibiofilm activity. Promethazine (PMZ) is an antihistamine known to have antimicrobial activity against different pathogens, including in the form of biofilms, but there are still few studies of its activity against ESBL E. coli biofilms. The aim of this study was to evaluate the antimicrobial activity of PMZ against ESBL E. coli biofilms, as well as to assess the application of this drug as a biofilm prevention agent in urinary catheters. To this end, the minimum inhibitory concentration and minimum bactericidal concentration of PMZ in ESBL E. coli strains were determined using the broth microdilution assay and tolerance level measurement. The activity of PMZ against the cell viability of the in vitro biofilm formation of ESBL E. coli was analyzed by the MTT colorimetric assay and its ability to prevent biofilm formation when impregnated in a urinary catheter was investigated by counting colony-forming units (CFU) and confirmed by scanning electron microscopy (SEM). PMZ showed bactericidal activity and significantly reduced (p < 0.05) the viability of the biofilm being formed by ESBL E. coli at concentrations of 256 and 512 µg/ml, as well as preventing the formation of biofilm on urinary catheters at concentrations starting at 512 µg/ml by reducing the number of CFUs, as also observed by SEM. Thus, PMZ is a promising candidate to prevent the formation of ESBL E. coli biofilms on abiotic surfaces.

In vitro evaluation of cytotoxic potential of essential oil extracted from leaves of Croton heliotropiifolius Kunth in human tumor cells.

Croton heliotropiifolius Kunth, popularly known as "velame," is a shrub that resides in northeastern Brazil. The essential oil of C. heliotropiifolius contains high concentrations of volatile compounds in the leaves and is widely used in folk medicine for many purposes as an antiseptic, analgesic, sedative, and anti-inflammatory agent. Due to the apparent limited amount of information, the aim of this study was to determine the cytotoxic potential of essential oil extracted from leaves of C. heliotropiifolius, utilizing different human cancer cell lines (HL-60, leukemia; HCT-116, colon; MDA-MB435, melanoma; SF295, glioblastoma) and comparison to murine fibroblast L929 cell line. The chemical characterization of the essential oil revealed the presence of large amounts of monoterpenes and sesquiterpenes, the majority of which were aristolene (22.43%), germacrene D (11.38%), ɣ-terpinene (10.85%), and limonene (10.21%). The essential oil exerted significant cytotoxicity on all cancer cells, with low activity on murine L929 fibroblasts, independent of disruption of cell membranes evidenced by absence of hemolytic activity. The cytotoxicity identified was associated with oxidative stress, which culminated in mitochondrial respiration dysfunction and direct or indirect DNA damage (strand breaks and oxidative damage), triggering cell death via apoptosis. Our findings suggest that extracts of essential oil of C. Heliotropiifolius may be considered as agents to be used therapeutically in treatment of certain cancers.

Antimicrobial potential of a biosurfactant gel for the prevention of mixed biofilms formed by fluconazole-resistant C. albicans and methicillin-resistant S. aureus in catheters.

Dual-species biofilms formed by Candida albicans and Staphylococcus aureus have high virulence and drug resistance. In this context, biosurfactants produced by Pseudomonas aeruginosa have been widely studied, of which a new derivative (RLmix_Arg) stands out for possible application in formulations. The objective of this study was to evaluate the antibiofilm activity of RLmix_Arg, both alone and incorporated in a gel prepared with Pluronic F-127, against dual-species biofilms of fluconazole-resistant C. albicans (FRCA) and methicillin-resistant S. aureus (MRSA) in impregnated catheters. Broth microdilution tests, MTT reduction assays of mature biofilms, impregnation of RLmix_Arg and its gel in peripheral venous catheters, durability tests and scanning electron microscopy (SEM) were performed. RLmix_Arg showed antimicrobial activity against Candida spp. and S. aureus, by reducing the cell viability of mixed biofilms of FRCA and MRSA, and preventing their formation in a peripheral venous catheter. The incorporation of this biosurfactant in the Pluronic F-127 gel considerably enhanced its antibiofilm activity. Thus, RLmix_Arg has potential application in gels for impregnation in peripheral venous catheters, helping to prevent development of dual-species biofilms of FRCA and MRSA.

Automated, High-Throughput Screening of Hybrid Elastin-like Polypeptide/Polysaccharide Multilayer Film Deposition.

The self-assembled layer-by-layer technique has attracted a great deal of attention as a method for engineering bio-functional surfaces under mild chemical conditions. The production of multilayer films, starting from newly designed building blocks, may be laborious, considering the inherent limitations for anticipating how minimal changes in the macromolecular composition may impact both film deposition and performance. This paper presents an automated, high-throughput approach to depositing polyelectrolyte multilayers (PEMs) in multiwell plates, enabling the screening of nearly 100 film formulations in the same process. This high-throughput layer-by-layer (HT-LbL) method runs in an affordable, fully commercial platform using Python-coded routines that can be easily adapted for the materials science lab settings. The HT-LbL system was validated by investigating the deposition of polysaccharide-based films in multiwell plates, probing the absorbance signal of ionically stained polyelectrolyte multilayers (PEMs) prepared in one single batch. The HT-LbL method was also used to investigate the deposition of PEMs with a small library of genetically engineered elastin-like polypeptides (ELPs) with different levels of ionizable and hydrophobic amino acid residues. The deposition of ELP/chitosan films was assessed based on the signal of fluorescently labeled species (chitosan or ELP-mCherry), demonstrating that both electrostatic and hydrophobic residues are essential for film buildup. The growth and surface properties of ELP-mCherry/chitosan films also seemed susceptible to the assembly pH, forming a higher film growth and a rougher and more hydrophobic surface for both polyelectrolytes deposited under a low ionization degree. Overall, this study illustrates the challenge of predicting the growth and properties of multilayer films and how the HT-LbL can accelerate the development of multilayer films that demand high levels of testing and optimization.

Peri-implant tissue changes at sites treated with alveolar ridge preservation in the aesthetic zone: Twenty-two months follow-up of a randomized clinical trial.

AIM: To compare tissue changes at implant sites previously treated with two biomaterials for alveolar ridge preservation (ARP) in the aesthetic zone, 1 year after restoration. MATERIALS AND METHODS: Sixty-six participants were treated with ARP using demineralized bovine bone mineral (DBBM) or DBBM +10% of collagen (DBBM-C), both covered with a collagen matrix (CM). Dental implants were placed, and definitive crowns were installed. Silicon impressions were taken before tooth extraction (T0), 2 weeks after crown insertion (T1) and 1 year after restoration (T2). Mid-facial mucosal level change (MLC), soft tissue thickness changes (TT), and marginal bone loss (MBL) were analysed using inter-group comparisons. RESULTS: Fifty-four participants were included in the analysis. The mid-facial level change between T0-T1 and T1-T2 showed no statistical difference between DBBM and DBBM-C. Between T0 and T1 for soft tissue thickness, DBBM performed significantly better at 3 and 5 mm below the mucosal margin. From T1 to T2, no significant differences between groups were found at any level for soft tissue thickness and MBL. CONCLUSION: At the aesthetic zone, advanced recession from tooth extraction to crown placement can be expected at sites treated with ARP regardless of biomaterial used. However, after crown insertion, tissue stability can be predicted.

Selective outcome reporting in root coverage randomized clinical trials.

BACKGROUND: Outcome discrepancies between protocols and respective publications represent a concerning bias. The purpose of this study was to assess the prevalence of selective outcome reporting (SOR) in root coverage randomized clinical trials (RCTs). METHODS: Published root coverage RCTs (July 2005 to March 2020) were included if a corresponding protocol could be identified in a public registry. Discrepancies between protocol and its correspondent publication(s) were compared regarding primary and secondary outcomes and other study characteristics. Associations between trial characteristics and SOR were evaluated. RESULTS: Forty four studies (54 publications) were included. The majority of studies (77.3%) were retrospectively registered. SOR was frequent (40.9% of trials) and consisted of primary outcome downgrade (22.7%); secondary outcome upgrade (11.4%); new primary outcome introduced in publication (25%); protocol primary outcome omitted from publication (13.6%) and discrepancy in primary outcome timing (18.2%). SOR was unclear in 20.5% of studies and favoured statistical significance in 12 studies (27.3%). SOR was significantly associated with study significance (p < 0.001) and unclear outcome definition in the publication (p < 0.001). Only a third (32.8%) of primary outcomes were completely defined. CONCLUSIONS: The present study identified high prevalence of SOR in root coverage RCTs.

Effects of ketamine in methicillin-resistant Staphylococcus aureus and in silico interaction with sortase A.

Methicillin-resistant Staphylococcus aureus (MRSA) is one of the main human pathogens and is responsible for many diseases, ranging from skin infections to more invasive infections. These infections are dangerous and expensive to treat because these strains are resistant to a large number of conventional antibiotics. Thus, the antibacterial effect of ketamine against MRSA strains, its mechanism of action, and in silico interaction with sortase A were evaluated. The antibacterial effect of ketamine was assessed using the broth microdilution method. Subsequently, the mechanism of action was assessed using flow cytometry and molecular docking assays with sortase A. Our results showed that ketamine has a significant antibacterial activity against MRSA strains in the range of 2.49-3.73 mM. Their mechanism of action involves alterations in membrane integrity and DNA damage, reducing cell viability, and inducing apoptosis. In addition, ketamine had an affinity for S. aureus sortase A. These results indicate that this compound can be used as an alternative to develop new strategies to combat infections caused by MRSA.

Chemopreventive effect of troxerutin against hydrogen peroxide-induced oxidative stress in human leukocytes through modulation of glutathione-dependent enzymes.

Troxerutin is a natural flavonoid present abundantly in tea, coffee, olives, wheat, and a variety of fruits and vegetables. Due to its diverse pharmacological properties, this flavonoid has aroused interest for treatment of various diseases, and consequently prompted investigation into its toxicological characteristics. The aim of this study was to evaluate the genotoxic and mutagenic effects and chemoprotective activity attributed to troxerutin using human peripheral blood leukocytes (PBLs) through several well-established experimental protocols based upon different parameters. Data demonstrated that troxerutin (100 to 1000 µM) induced no marked cytotoxic effect on PBLs after 24 hr, and did not produce strand breaks and mutagenicity. Regarding chemoprevention, this flavonoid attenuated cytotoxicity, genotoxicity, and mutagenicity initiated by hydrogen peroxide (H2O2) in human PBLs. Further, troxerutin demonstrated no marked cytotoxic effect on PBLs and exerted a protective effect against oxidative stress induced by H2O2 through modulation of GSH-dependent enzymes.

Microbiological evaluation of an experimental denture cleanser containing essential oil of Lippia sidoides.

The antimicrobial activity of an experimental solution containing essential oil of Lippia sidoides for denture cleaning was evaluated by (1) minimum inhibitory (MIC) and fungicidal/bactericidal concentration (MFC/MBC) tests against Candida albicans, Staphylococcus aureus, and Pseudomona aeruginosa; (2) the metabolic activity of C. albicans biofilm formed on flat-bottom microplates and denture base specimens based on the reduction of 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT); and (3) scanning electron microscopy, to evaluate the fungal biofilm morphology. The solution showed antimicrobial action against the pathogens tested (C. albicans - MIC and MFC: 19.53 µg ml-1, S. aureus - MIC and MBC: 78.12 µg ml-1, P. aeruginosa - MIC: 625 µg ml-1, MBC: 2,500 µg ml-1), reduced the metabolic activity of C. albicans biofilm up to 97%, and caused cell wall damage at low concentrations (195.3-390.6 µg ml-1) and in short time periods (20 min). Therefore, the experimental solution has the potential to be used as an alternative in the prevention and treatment of denture-induced infections.

Comparative analysis of dimensional alterations following extraction of maxillary molars using three-dimensional images' superimposition: a CBCT study.

The aims of this study were to (i) evaluate the bone alterations following maxillary molar extraction and (ii) identify the factors associated with bone alterations using a tomographic analysis. Cone Beam Computer Tomographies (CBCTs) of 17 subjects with 25 maxillary molars were analyzed, before and, in average, 12 months following extraction. Fifty CBCTs were segmented as 3D models that were used as reference for analysis. Cross-sectional planes were established to measure the dimensional changes in the vertical, horizontal aspects, and the area of the alveolar bone. Associations between root divergence, initial bone location related to the maxillary sinus, and the thickness of buccal and palatal bone at baseline was assessed using mixed-effect models. Overall, the average reduction in vertical bone height was 35.23% (2.61 ± 1.76 mm). The mean reduction of area of alveolar process and horizontal bone width were 18.89% (56.08 ± 44.23 mm2) and 65.10% (8.33 ± 4.51 mm), respectively. There was a marginal significant association between horizontal bone changes and the thickness of palatal bone (p = 0.05). The results of the present study indicated that following maxillary molar extraction, significant dimensional changes occur in both the vertical and horizontal directions. The vertical changes were mainly attributed to remodeling on the coronal aspect of the alveolar ridge and sinus pneumatization was rare.

Antifungal Activity of N-(4-Halobenzyl)amides against Candida spp. and Molecular Modeling Studies.

Fungal infections remain a high-incidence worldwide health problem that is aggravated by limited therapeutic options and the emergence of drug-resistant strains. Cinnamic and benzoic acid amides have previously shown bioactivity against different species belonging to the Candida genus. Here, 20 cinnamic and benzoic acid amides were synthesized and tested for inhibition of C. krusei ATCC 14243 and C. parapsilosis ATCC 22019. Five compounds inhibited the Candida strains tested, with compound 16 (MIC = 7.8 µg/mL) producing stronger antifungal activity than fluconazole (MIC = 16 µg/mL) against C. krusei ATCC 14243. It was also tested against eight Candida strains, including five clinical strains resistant to fluconazole, and showed an inhibitory effect against all strains tested (MIC = 85.3-341.3 µg/mL). The MIC value against C. krusei ATCC 6258 was 85.3 mcg/mL, while against C. krusei ATCC 14243, it was 10.9 times smaller. This strain had greater sensitivity to the antifungal action of compound 16. The inhibition of C. krusei ATCC 14243 and C. parapsilosis ATCC 22019 was also achieved by compounds 2, 9, 12, 14 and 15. Computational experiments combining target fishing, molecular docking and molecular dynamics simulations were performed to study the potential mechanism of action of compound 16 against C. krusei. From these, a multi-target mechanism of action is proposed for this compound that involves proteins related to critical cellular processes such as the redox balance, kinases-mediated signaling, protein folding and cell wall synthesis. The modeling results might guide future experiments focusing on the wet-lab investigation of the mechanism of action of this series of compounds, as well as on the optimization of their inhibitory potency.

Interplay of the Assembly Conditions on Drug Transport Mechanisms in Polyelectrolyte Multilayer Films.

The layer-by-layer film deposition is a suitable strategy for the design and functionalization of drug carriers with superior performance, which still lacks information describing the influence of assembly conditions on the mechanisms governing the drug release process. Herein, traditional poly(acrylic acid)/poly(allylamine) polyelectrolyte multilayers (PEM) were explored as a platform to study the influence of the assembly conditions such as pH, drug loading method, and capping layer deposition on the mechanisms that control the release of calcein, the chosen model drug, from PEM. Films with 20-40 bilayers were assembled at pH 4.5 or 8.8, and the drug loading process was carried out during- or post-film assembly. Release data were fitted to three release models, namely, Higuchi, Ritger-Peppas, and Berens-Hopfenberg, to investigate the mechanism governing the drug transport, such as the apparent diffusion and the relaxation time. The postassembly drug loading method leads to a higher drug loading capacity than the during-assembly method, attributed to the washing out of calcein during film assembly steps in the latter method. Higuchi's and Ritger-Peppas' model analyses indicate that the release kinetic constant increased with the number of bilayers for the postassembly method. The opposite trend is observed for the during-assembly method. The Berens-Hopfenberg release model enabled the decoupling of each drug transport mechanism's contribution, indicating the increase of the diffusion contribution with the number of bilayers for the postassembly method at pH 4.5 and the increase of the polymer relaxation contribution for the during-assembly method at pH 8.8. Deborah's number, which represents the ratio of the polymer relaxation time to the diffusion time, follows the trends observed for the relaxation contribution for the conditions investigated. The deposition of the capping phospholipid layer over the payload also favored the polymer relaxation contribution in the drug release, featuring new strategies to investigate the drug release in PEM.

Tracking Sulfonated Polystyrene Diffusion in a Chitosan/Carboxymethyl Cellulose Layer-by-Layer Film: Exploring the Internal Architecture of Nanocoatings.

Since chitosan presents the ability to interact with a wide range of molecules, it has been one of the most popular natural polymers for the construction of layer-by-layer thin films. In this study, depth-profiling X-ray photoelectron spectroscopy (XPS) was employed to track the diffusion of sulfonated polystyrene (SPS) in carboxymethyl cellulose/chitosan (CMC/Chi) multilayers. Our findings suggest that the CMC/Chi film does not constitute an electrostatic barrier sufficient to block diffusion of SPS, and that diffusion can be controlled by adjusting the diffusion time and the molecular weight of the polymers that compose the CMC/Chi system. In addition to monitoring the diffusion, it was also possible to observe a process of preferential interaction between Chi and SPS. Thus, the nitrogen N 1s peak, due to functional groups found exclusively in chitosan chains, was the key factor to identifying the molecular interactions involving chitosan and the different polyanions. Accordingly, the presence of a strong polyanion such as SPS shifts the N 1s peak to a higher level of binding energy. Such results highlight that understanding the fundamentals of polymer interactions is a major step to fine-tuning the internal architecture of LbL structures for specific applications (e.g., drug release).

Comparison between two bone substitutes for alveolar ridge preservation after tooth extraction: Cone-beam computed tomography results of a non-inferiority randomized controlled trial.

AIM: To test the non-inferiority of demineralized bovine bone mineral (DBBM) compared to DBBM with 10% collagen (DBBM-C) for maintenance of bone volume after tooth extraction in the anterior maxilla. MATERIALS AND METHODS: Sixty-six patients were randomly treated with DBBM or DBBM-C, both of which were covered with a collagen matrix for ridge preservation in the anterior maxilla. Cone-beam computed tomographic analysis was performed immediately and 4 months after treatment. The primary outcome, for which non-inferiority of DBBM was tested, was change in the horizontal ridge width 1 mm below the buccal alveolar crest (HW-1) 4 months after extraction. RESULTS: Four months after extraction, HW-1 measured -1.60 mm ± 0.82 mm for DBBM-C, while the DBBM group showed a mean loss of -1.37 mm ± 0.84 mm (p = 0.28, 0.23 [95% CI: -0.19; 0.64]). The horizontal ridge width at 3 mm (HW-3) showed -0.98 mm (±0.67 mm) for DBBM-C and -0.84 mm (±0.62 mm) for DBBM (p = 0.40, 0.12 [95% CI: -0.19; 0.45]), and the horizontal ridge width at 5 mm (HW-5) showed -0.67 mm (±0.47 mm) for DBBM-C and -0.56 mm (±0.48 mm) for DBBM (p = 0.36, 0.11 [95% CI: -0.13; 0.34]). CONCLUSIONS: The present clinical trial demonstrated non-inferiority of DBBM compared to DBBM-C for maintenance of alveolar bone volume 4 months after tooth extraction in the anterior maxilla.

Clinical treatment of necrotizing ulcerative gingivitis: a case report with 10-year follow-up.

The aim of this case report is to describe the diagnosis and treatment of a patient with necrotizing ulcerative gingivitis. An 18-year-old man with no systemic problems reported with chief complaints of gingival bleeding during toothbrushing and spontaneous pain. Clinical examination revealed significant plaque accumulation on the surfaces of all teeth as well as papillary necrosis involving mainly the anterior teeth. Treatment included an initial phase of supragingival plaque and calculus removal along with at-home use of 0.12% chlorhexidine gluconate mouthrinse twice a day for 30 days. After the initial phase, subgingival scaling was performed, and regular oral hygiene methods were resumed by the patient. After active therapy was completed, a periodontal maintenance regimen was established, and the patient was recalled for periodontal maintenance therapy. Follow-up occurred weekly throughout treatment, monthly for the first 6 months posttreatment, and 2-3 times a year during the periodontal maintenance therapy. Clinical results after 10 years showed that this approach controlled the acute phase and maintained the patient's periodontal health over time.

Action mechanism of naphthofuranquinones against fluconazole-resistant Candida tropicalis strains evidenced by proteomic analysis: The role of increased endogenous ROS.

The increased incidence of candidemia in terciary hospitals worldwide and the cross-resistance frequency require the new therapeutic strategies development. Recently, our research group demonstrated three semi-synthetic naphthofuranquinones (NFQs) with a significant antifungal activity in a fluconazole-resistant (FLC) C. tropicalis strain. The current study aimed to investigate the action's preliminary mechanisms of NFQs by several standardized methods such as proteomic and flow cytometry analyzes, comet assay, immunohistochemistry and confocal microscopy evaluation. Our data showed C. tropicalis 24 h treated with all NFQs induced an expression's increase of proteins involved in the metabolic response to stress, energy metabolism, glycolysis, nucleosome assembly and translation process. Some aspects of proteomic analysis are in consonance with our flow cytometry analysis which indicated an augmentation of intracellular ROS, mitochondrial dysfunction and DNA strand breaks (neutral comet assay and γ-H2AX detection). In conclusion, our data highlights the great contribution of ROS as a key event, probably not the one, associated to anti-candida properties of studied NFQs.

Narrow- and regular-diameter implants in the posterior region of the jaws to support single crowns: A 3-year split-mouth randomized clinical trial.

OBJECTIVES: The objective of this 3-year split-mouth randomized controlled clinical study was to compare narrow-diameter implants (NDIs) to regular-diameter implants (RDIs) in the posterior region of the jaws (premolars and molars) in regards to (i) the marginal bone level (MBL) and (ii) implant and prosthesis survival and success rates. MATERIAL AND METHODS: A total of 22 patients were included in the study. Each patient received at least one implant of each diameter (Ø3.3 and Ø4.1 mm), placed either in the maxilla or mandible to support single crowns. A total 44 implants (22 NDIs and 22 RDIs) were placed and included in the study. Twenty-one implants were placed in the premolar, whereas 23 were placed in molar areas. Radiographic evaluations to access the MBL were performed immediately after implant placement, 1 and 3 years after implant loading. Peri-implant clinical variables including probing pocket depth (PPD) and bleeding on probing (BoP) were obtained after crown delivery, 1 and 3 years after loading. Furthermore, the survival and success rates of the implants and prosthesis were also evaluated. RESULTS: Twenty patients were able to complete the study. There was no statistically significant difference regarding MBL between groups at implant placement (p = .084), 1-year (p = .794) and 3-year (p = .598) time intervals. The mean peri-implant bone loss at 3-year follow-up was -0.58 ± 0.39 mm (95% CI: -0.751 to -0.409) and -0.53 ± 0.46 mm (95% CI: -0.731 to -0.329) for NDIs and RDIs, respectively. BoP was present at 15% and 10% of NDIs and RDIs, respectively, at 3-year follow-up. PPD >5 mm was observed in 5% and 0% of the implants of NDIs and RDIs, respectively, at 3-year follow-up. At the 3-year examination, the implant success rates were in the NDIs and RDIs sites, respectively, 95% and 100%. The corresponding values for prosthesis success rates were 90% for NDIs and 95% for RDIs. CONCLUSION: The present study demonstrated that NDIs placed to support single crowns in the posterior region did not differ to RDIs in regards to MBL, implant survival, and success rates.

Low-level laser therapy combined to functional exercise on treatment of fibromyalgia: a double-blind randomized clinical trial.

This study aims to investigate the effects of low-level laser therapy (LLLT) combined to a functional exercise program on treatment of FM. A double-blind and placebo-controlled randomized clinical trial composed of 22 women divided into two groups: placebo group (functional exercise program associated with placebo phototherapy n = 11) and laser group (same exercise program associated with active phototherapy; n = 11). Each session lasted from 40 to 60 min and was performed three times a week for 8 weeks. Phototherapy (808 nm, 100 mW, 4 J, and 142.85 J/cm2 per point) was bilaterally applied to different points of the quadriceps (8), hamstrings (6), and triceps sural muscles (3) immediately after each exercise session. Pre- and post-intervention evaluations regarding pain (sites, intensity, and threshold), functional performance (balance, functional tests), muscle performance (flexibility and isokinetic variables), depression, and quality of life were conducted. A reduction in pain and improvement in functional and muscular performance, depression, and quality of life were observed in both groups (p < 0.05); however, with no significant differences between them (p > 0.05). In conclusion, the benefic effects of functional exercise were not improved by combination with LLLT.

In vitro anti-Candida activity of selective serotonin reuptake inhibitors against fluconazole-resistant strains and their activity against biofilm-forming isolates.

Recent research has shown broad antifungal activity of the classic antidepressants selective serotonin reuptake inhibitors (SSRIs). This fact, combined with the increased cross-resistance frequency of the genre Candida regarding the main treatment today, fluconazole, requires the development of novel therapeutic strategies. In that context, this study aimed to assess the antifungal potential of fluoxetine, sertraline, and paroxetine against fluconazole-resistant Candida spp. planktonic cells, as well as to assess the mechanism of action and the viability of biofilms treated with fluoxetine. After 24 h, the fluconazole-resistant Candida spp. strains showed minimum inhibitory concentration (MIC) in the ranges of 20-160 µg/mL for fluoxetine, 10-20 µg/mL for sertraline, and 10-100.8 µg/mL for paroxetine by the broth microdilution method (M27-A3). According to our data by flow cytometry, each of the SSRIs cause fungal death after damaging the plasma and mitochondrial membrane, which activates apoptotic signaling pathways and leads to dose-dependant cell viability loss. Regarding biofilm-forming isolates, the fluoxetine reduce mature biofilm of all the species tested. Therefore, it is concluded that SSRIs are capable of inhibit the growth in vitro of Candida spp., both in planktonic form, as biofilm, inducing cellular death by apoptosis.

Performance of cone beam computed tomography and conventional intraoral radiographs in detecting interproximal alveolar bone lesions: a study in pig mandibles.

BACKGROUND: Cone beam computed tomography (CBCT) has been largely used in dentistry. Nevertheless, there is lack of evidence regarding CBCT accuracy in the diagnosis of early periodontal lesions as well as the correlation between accuracy and lesion size. The aim of this study was to evaluate accuracy of CBCT and conventional intraoral radiographs in detecting different-sized interproximal bone lesions created in pig mandibles. The hypothesis was that CBCT accuracy would be superior to radiographs in detecting incipient bone lesions. METHODS: Twenty swine dry mandibles were used, totalizing 80 experimental sites. Four groups were created according to exposure time to perchloric acid 70-72%: controls (no exposure), 2-hour exposure, 4-hour exposure, and 6-hour exposure. Standardized CBCT and conventional intraoral radiographs were taken and analyzed by two trained radiologists. The presence of lesions in the dry mandible was considered the gold standard. Sensitivity, specificity, and accuracy in detecting different-sized bone lesions were calculated for CBCT and intraoral radiographs. RESULTS: Accuracy of CBCT ranged from 0.762 to 0.825 and accuracy of periapical radiography ranged from 0.700 to 0.813, according to examiner and time of acid exposure. Inter-examiner agreement varied from slight to fair, whereas intra-examiner agreement varied from moderate to substantial. CONCLUSIONS: CBCT performance was not superior to that provided by conventional intraoral radiographs in the detection of interproximal bone loss.