Effective treatment of hospital wastewater with high-concentration diclofenac and ibuprofen using a promising technology based on degradation reaction catalyzed by Fe0 under microwave irradiation.

Real hospital wastewater was effectively treated by a promising technology based on degradation reaction catalyzed by Fe0 under microwave irradiation in this work. Fe0 powders were synthesized and characterized by different techniques, resulting in a single-phase sample with spherical particles. Optimum experimental conditions were determined by a central composite rotatable design combined with a response surface methodology, resulting in 96.8% of chemical oxygen demand reduction and 100% organic carbon removal, after applying MW power of 780 W and Fe0 dosage of 0.36 g L-1 for 60 min. Amongst the several organic compounds identified in the wastewater sample, diclofenac and ibuprofen were present in higher concentrations; therefore, they were set as target pollutants. Both compounds were completely degraded in 35 min of reaction time. Their plausible degradation pathways were investigated and proposed. Overall, the method developed in this work effectively removed high concentrations of pharmaceuticals in hospital wastewater.

Gamma-hexalactone flavoring causes DNA lesion and modulates cytokines secretion at non-cytotoxic concentrations.

BACKGROUND: The γ-hexalactone is a flavoring agent for alcoholic beverages, teas, breads, dairy products, coffees, buttery products among others. It presents low molecular weight and exhibits sweet fruity aroma with nuances of nuts. As far as we know, both literature and government regulations have gaps regarding the safe use of the γ-hexalactone. In this context, the main objective of this work was to evaluate the effects of γ-hexalactone through in silico and in vitro approaches. METHODS: The in silico analysis was performed through four free online platforms (admetSAR, Osiris Property Explorer®, pkCSM platform and PreADMET) and consisted of comparative structural analysis with substances present in databases. The computational prediction was performed in the sense of complement and guide the in vitro tests. Regarding in vitro investigations, screening of cytotoxicity (assessed by cell proliferation and viability parameters) in lymphocytes exposed to γ-hexalactone for 72 h were carried out previously to determine non-cytotoxic concentrations. Following this screening, concentrations of 5.15, 0.515, and 0.0515 µM were selected for the study of the respective potentials: genotoxic (assessed by DNA comet assay), chromosomal mutation (analysis of micronucleus frequency) and immunomodulatory (cytokine quantification using ELISA immunoassay). The results of in vitro assays were compared by one-way analysis of variance (ANOVA), followed by Bonferroni's post hoc test, conducted by statistic software. RESULTS: The platform PreADMET pointed out that γ-hexalactone is potentially mutagenic and carcinogenic. The comet assay data corroborate with these results demonstrating that γ-hexalactone at 5.15 µM caused lymphocytes DNA damage. In relation to cytokine secretion, the results indicate that lymphocytes were activated by γ-hexalactone at non-cytotoxic concentrations, involving an increase in the IL-1 levels in all tested concentrations, ranging from approximately 56 to 93%. The γ-hexalactone only at 5.15 µM induced increase in the levels of IL-6 (~ 60%), TNF-α (~ 68%) and IFN-γ (~ 29%), but decreased IL-10 (~ 46%) in comparison with the negative control (p < 0.05). No change was observed in total lymphocytes or in cell viability at the concentrations tested. CONCLUSIONS: In summary, the γ-hexalactone demonstrated immunomodulatory and genotoxic effects at non-cytotoxic concentrations in healthy lymphocytes.

Structure-based design of δ-lactones for new antifungal drug development: susceptibility, mechanism of action, and toxicity.

Dermatophytes are the etiological agents of cutaneous mycoses, including the prevalent nail infections and athlete's foot. Candida spp. are opportunistic and emerging pathogens, causing superficial to deeper infections related to high mortality rates. As a consequence of prolonged application of antifungal drugs, the treatment failures combined with multidrug-resistance have become a serious problem in clinical practice. Therefore, novel alternative antifungals are required urgently. δ-Lactones have attracted great interest owing to their wide range of biological activity. This article describes the antifungal activity of synthetic δ-lactones against yeasts of the genus Candida spp. and dermatophytes (through the broth microdilution method), discusses the pathways by which the compounds exert this action (toward the fungal cell wall and/or membrane), and evaluates the toxicity to human leukocytes and chorioallantoic membrane (by the hen's egg test-chorioallantoic membrane). Two of the compounds in the series presented broader spectrum of antifungal activity, including against resistant fungal species. The mechanism of action was related to damage in the fungal cell wall and membrane, with specific target action dependent on the type of substituent present in the δ-lactone structure. The damage in the fungal cell was corroborated by electron microscopy images, which evidenced lysed and completely altered cells after in vitro treatment with δ-lactones. Toxicity was dose dependent for the viability of human leukocytes, but none of the compounds was mutagenic, genotoxic, or membrane irritant when evaluated at higher concentrations than MIC. In this way, δ-lactones constitute a class with excellent perspectives regarding their potential applications as antifungals.

Synergistic antifungal activity of the lipophilic fraction of Hypericum carinatum and fluconazole

ABSTRACT Hypericum species, Hypericaceae, are recognized as a source of therapeutical agents. Purified fractions and isolated compounds have been shown antimicrobial activity. As the indiscriminate use of antifungals and the increase of infections caused by emerging species are leading to the search of new alternative treatments, the aim of this study was to continue the study with Hypericum carinatum Griseb. lipophilic fraction, rich in phloroglucinol derivatives, investigating the effect of its association with fluconazole against emerging yeasts (Candida krusei, C. famata, C. parapsilosis and Cryptococcus neoformans). The synergistic activity between H. carinatum lipophilic fraction and fluconazole was assessed by two methodologies for multiple dose–response analysis: checkerboard and isobologram. Regarding synergistic experiments, the effect of the association was higher than the effect of fluconazole alone against Candida krusei and C. famata isolates (MIC fluconazole decreased about eight and four folds, respectively), suggesting that, somehow, H. carinatum lipophilic fraction compounds are facilitating the action of this drug. On the other hand, when tested against Cryptococcus neoformans and C. parapsilosis, fluconazole showed better results than the association. Thus, against Candida krusei and C. famata, the lipophilic fraction of H. carinatum was able to reduce the MIC values of fluconazole and could be considered as a potential alternative to be used against emerging yeast species.

Bifunctional fluorescent benzimidazo[1,2-α]quinolines for Candida spp. biofilm detection and biocidal activity.

Biofilms provide an ideal environment for protecting the microbial cells from damage caused by humoral and cellular immune system components, promoting resistance, infections and increasing mortality and morbidity of patients in health facilities. In an attempt to provide an innovative solution for preventing contamination in hospital environments, this study evaluated nine structural complementary fluorescent benzimidazo[1,2-α]quinolines as bifunctional agents that both detect and have biocidal activity against yeast biofilms on stainless steel surfaces. The benzimidazoles' staining capability was determined by a fluorescence microscopy study and spraying the substance on yeast biofilm contaminated stainless steel surfaces. Furthermore, their in vitro human leukocyte cytotoxicity was evaluated with trypan blue and their biocidal activity was determined as the minimum inhibitory concentration against Candida tropicalis, C. albicans and C. parapsilosis strains. Moreover, scanning electron micrographs were recorded to study the biocidal activity. This resulted in the identification of 7, which presents all the desired characteristics (such as solubility) and capabilities (staining and biocide activity against all tested biofilm forming yeast strains) at the same time. As such, benzimidazole 7 has the potential to guarantee the use of disinfected medical and surgical instruments in clinical and surgical procedures, consequently, contributing to an increased safety for patients.

Evaluation of genotoxic and cytotoxic effects of hydroalcoholic extract of Euphorbia tirucalli (Euphorbiaceae) in cell cultures of human leukocytes.

Euphorbia tirucalli (L.), commonly known as aveloz, has been indiscriminately used in popular medicine to treat various illnesses. However, some components can have devastating consequences. Injury to a cell's genetic material can cause mutations, cancer, and cell death. Our main goal in this work was to evaluate the genotoxic and cytotoxic effects of E. tirucalli extract on human leukocytes. For this purpose, we performed a phytochemical analysis to evaluate the plant's components. In the second step, we treated cultured human leukocytes with different concentrations of the dry extract of the plant and then evaluated the oxidative and genotoxic profiles of these leukocytes. We found that at 1% and 10% concentrations, the aveloz extract acted as a genotoxic agent that could damage DNA and increase oxidative damage. We conclude that despite its popular use, aveloz can act as a genotoxic agent, especially when it contains phorbol ester. Aveloz's indiscriminate use might actually promote tumors and therefore carry a considerable genetic risk for its users.

Tratamento endoscópico do cisto odontogênico com extensão intra-sinusal

Cistos odontogênicos são lesões pouco comuns que podem ocorrer após inflamação da polpa dentária. A abordagem terapêutica destes cistos é realizada em consultórios odontológicos e, dependendo de sua extensão, pode ocasionar a formação de fístula oroantral e rinossinusite crônica. O objetivo deste trabalho é propor o tratamento videoendoscópico do cisto odontogênico com expressão em seio maxilar. Realizou-se um estudo retrospectivo de quatro casos de cistos de origem dentária, com extensão intra-sinusal, complicados com fístula oroantral e sinusite crônica de seio maxilar após curetagem em consultório odontológico. Utilizamos a técnica videoendoscópica via transmaxilar para acessarmos o cisto intra-sinusal. Os quatro pacientes apresentaram resolução do quadro infeccioso e cicatrização da fístula oroantral, sem recidiva durante o seguimento. A cirurgia videoendoscópica é um método seguro e efetivo para tratamento do cisto odontogênico descrito, podendo contribuir para prevenir a formação de fístula oroantral e supuração de seio maxilar.

Enfisema subcutâneo e pneumomediastino após amigdalectomia: relato de caso / Onset of subcutaneous emphysema and pneumomediastinum after tonsillectomy: a case report

Várias complicacões podem estar relacionadas a procedimentos cirúrgicos na área de cabeca e pescoco. Entre elas, o pneumomediastino, pneumotórax e enfisema subcutâneo ocorrem raramente. Relatamos o caso de uma paciente submetida a tonsilectomia palatina que evoluiu com enfisema subcutâneo da região cervical, torácica e pneumomediastino. Em cirurgias de tonsilas palatinas devem ser observados cuidados com a intubacão, uso de máscara sob pressão positiva com oxigênio na recuperacão anestésica, atos cirúrgicos intempestivos e uso de aparelhos que proporcionem lesão excessiva na loja tonsiliana a fim de se evitar as complicacões descritas.

Onset of subcutaneous emphysema and pneumomediastinum after tonsillectomy: a case report.

Several complications can be related to surgical approaches of head and neck regions. Among those, there are rare conditions such as pneumomediastinum, pneumothorax and subcutaneous cervical emphysema. This study reports a case of a patient that developed pneumomediastinum, pneumothorax and subcutaneous emphysema after undergoing tonsillectomy. In order to reduce these complications in surgical approaches such as tonsillectomy, care should be taken with intubation, use of oxygen mask for positive pressure ventilation during anesthesia recovery, aggressive surgical maneuvers and use of surgical instruments that may cause deep tonsillar injuries.

[Endoscopic treatment of odontogenic cyst with intra-sinusal extension]. / Tratamento endoscópico do cisto odontogênico com extensão intra-sinusal.

Odontogenic cyst is a common lesion that can happen after inflammation of the dental pulp. The therapeutic approach of these cysts is made at dentist's offices, and depending on their extension, they may develop oroantral fistula and chronic sinusitis. The objective of this study is to propose the videoendoscopic treatment of the odontogenic cyst with expression in the maxillary sinus. We made a retrospective study of four cases of cysts of dental origin, with intra-sinusal extension, complicated with oroantral fistula and chronic sinusitis of maxillary sinus after curettage in a dentist's office. We used the videoendoscopic technique through transmaxillary approach to access the intra-sinusal cyst. All the four patients presented resolution of the infectious manifestation and healing of the oroantral fistula, without recurrence within two years of follow-up. Videoendoscopic surgery is a safe and effective method for the management of odontogenic cysts with extension to maxillary sinus, and it may prevent oroantral fistula formation and chronic sinusitis.

Ressecção Parcial de Palato (RPP) para tratamento de roncopatia pela Técnica de Quesada e Perelló: resultados / Partial Resection of the Palate in the treatment of snoring by Quesada & Perelló technique: results

Roncopatia é uma entidade relativamente comum, presente em 38 por cento das mulheres e 40 por cento dos homens, com importantes implicações sociais. Várias técnicas são descritas na literatura para a correção da hipertrofia do palato mole, associadas a outros procedimentos, com o propósito de remissão dos sintomas. OBJETIVO: Para estudar os resultados da técnica proposta por Quesada e Perelló, denominada Ressecção Parcial do Palato (RPP), avaliamos a remissão do ronco, as complicações e o conforto pós-operatório do paciente. FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: 28 pacientes foram arrolados no estudo, de abril de 1994 a agosto de 2000, mas apenas 23 preencheram os critérios de inclusão, com queixas de ronco sem alterações compatíveis com apnéia obstrutiva. Todos os pacientes apresentavam classificação de Fujita tipo I ou II e foram avaliados com polissonografia, tomografia computadorizada e exame otorrinolaringológico completo. RESULTADOS: Após 6 meses, a remissão dos sintomas foi total em 12 casos (42 por cento), parcial em 9 (32 por cento) e inalterado em 2 (7 por cento); 5 pacientes não completaram o acompanhamento de seis meses. CONCLUSÃO: A técnica de Ressecção Parcial do Palato proposta por Quesada et al. e Perelló mostrou-se segura e eficaz no tratamento do ronco.

Blastomicose óssea / Bone blastomycosis

A Blastomicose sul-americana é uma doença granulomatosa crônica, causada pelo Paracoccidioides brasiliensis, cuja principal manifestaçäo é pulmonar, podendo disseminar-se por vários órgäos. O acometimento ósseo pela Blastomicose é raro, podendo apresentar-se associado à doença sistêmica ou isolado. Os autores descrevem um caso de Blastomicose Össea, fazendo revisäo dos aspectos etiopatogênicos, clínicos, diagnósticos, diagnótico diferencial, tratamento medicamentoso e cirúrgico do envolvimento ósseo pela doença