Interobserver Agreement and Satisfaction With the use of Telemedicine for Evaluating low Back Pain: A Primary, Observational, Cross-Sectional, Analytical Study.

STUDY DESIGN: A primary, observational, cross-sectional, analytical study. OBJECTIVE: The development of a framework for systematic telemedicine (TM) for orthopedic physicians in frequent clinical care may increase agreement in diagnosis and satisfaction among users of TM. Therefore, this study aimed to estimate the agreement in the diagnosis of low back pain (LBP) between TM, systematized by a self-completed digital questionnaire, and face-to-face (FF) care in patients with LBP. METHODS: This study included adults up to 75 years of age with LBP for more than 6 weeks. They were evaluated at 2 independent time points (TM and FF) by different orthopedists with 3 different levels of expertise. Professionals evaluated the sample without prior knowledge of the diagnosis, and each orthopedist provided a diagnosis. Diagnostic agreement was the primary outcome. Secondary outcomes were the duration of the visit and satisfaction among healthcare professionals. RESULTS: A total of 168 participants were eligible, of whom 126 sought care through TM and 122 sought FF care (mean age, 47 years [range, 18-75 years]; 66.4% women). The agreement among professionals regarding the diagnosis was moderate (kappa = .585, P = .001). TM was faster than FF (11.9 minutes (standard deviation = 4.1) vs 18.6 (SD = 6.9), P < .001). Professional satisfaction was higher among spine specialists than among orthopedic residents and orthopedists who were not specialists in spine surgery. CONCLUSION: Agreement in diagnosis was moderate for TM, with a 30% shorter visit duration than FF. Satisfaction varied by professional expertise and was higher among spine specialists than among professionals with other expertise.

Licochalcone A-loaded solid lipid nanoparticles improve antischistosomal activity in vitro and in vivo.

Aim: To isolate licochalcone A (LicoA) from licorice, prepare LicoA-loaded solid lipid nanoparticles (L-SLNs) and evaluate the L-SLNs in vitro and in vivo against Schistosoma mansoni. Materials & methods: LicoA was obtained by chromatographic fractionation and encapsulated in SLNs by a modified high shear homogenization method. Results: L-SLNs showed high encapsulation efficiency, with satisfactory particle size, polydispersity index and Zeta potential. Transmission electron microscopy revealed that L-SLNs were rounded and homogenously distributed. Toxicity studies revealed that SLNs decreased the hemolytic and cytotoxic properties of LicoA. Treatment with L-SLNs showed in vivo efficacy against S. mansoni. Conclusion: L-SLNs are efficient in reducing worm burden and SLNs may be a promising delivery system for LicoA to treat S. mansoni infections.

Studies with emulsion containing trans-resveratrol: in vitro release profile and ex vivo human skin permeation.

Resveratrol is a phenolic compound that has been widely studied in the last years because of its extensive pharmacological properties. It also has physicochemical properties that are adequate for diffusion through the human skin. An analytical method by high performance liquid chromatography was developed and validated for its determination in transdermal emulsion, as well in receptor media and skin layers. The trans-resveratrol release kinetic followed the Higushi's model (R(2) = 0.9926) with steady-state diffusion flux and lag time of 138.5 µg cm(-2) h(-1) and 0.49 h, respectively. It showed a percentage at 64.96 % for permeation. Thus, the results suggest that the emulsion studied is a potential vehicle for transresveratrol administration by transdermal route.

Potential of the essential oil from Pimenta pseudocaryophyllus as an antimicrobial agent.

This study evaluated the effectiveness of the essential oil of Pimenta pseudocaryophyllus in inhibiting the growth of the main bacteria responsible for bad perspiration odor (Staphylococcus epidermidis, Proteus hauseri, Micrococcus yunnanensis and Corynebacterium xerosis). The chemical profile of the essential oil was evaluated by high-resolution gas chromatography (HR-GC) and four constituents were identified, eugenol being the major component (88.6%). The antimicrobial activity was evaluated by means of the turbidimetric method, using the microdilution assay. The minimum inhibitory concentration (MIC) values of the essential oil ranged from 500 to 1,000 µg mL⁻¹. Scanning electron microscope (SEM) observations confirmed the physical damage and morphological alteration of the test bacteria treated with the essential oil, reference drugs and eugenol. The findings of the study demonstrated that this essential oil can be used in the formulation of personal care products.

Influence of salivary secretory immunoglobulin A level on the pain experienced by orthodontic patients.

BACKGROUND: Pain, a common experience reported by patients under orthodontic treatment, results from force application to the teeth and trauma caused by attrition of brackets and wires against the underlying oral mucosa. The main protection of the mucosa is secretory immunoglobulin A (sIgA), which may play a fundamental role in integrity maintenance and whose production may be reduced as a result of the stress of orthodontic treatment. The aim of this study was to assess sIgA levels in the saliva and their correlation with oral pain intensity in adults and children after the installation of fixed orthodontic appliances. MATERIAL/METHODS: Twenty patients (10 children, age 11-13 years; 10 adults, age 18-37 years) were assessed before treatment, after bracket bonding, and after initial arch wire insertion. Saliva was sampled for sIgA analysis, and oral pain was assessed through a visual analog scale. RESULTS: Although there was a trend toward reduction of the salivary sIgA levels during the initial arch phase in the children, and during the bonding and initial arch phases in the adults, this finding was not significant. CONCLUSIONS: There was a trend toward a negative correlation of oral pain intensity and salivary sIgA levels in the children, which may indicate the importance of sIgA for oral protection during orthodontic treatment, interfering with the pain experienced by the patients.