Selenylated Imidazo [1,2-a]pyridine Induces Apoptosis and Oxidative Stress in 2D and 3D Models of Colon Cancer Cells.

Colon cancer incidence rates are increasing annually, a scenario aggravated by genetic and epigenetic alterations that promote drug resistance. Recent studies showed that novel synthetic selenium compounds are more efficient and less toxic than conventional drugs, demonstrating biocompatibility and pro-oxidant effects on tumor cells. This study aimed to investigate the cytotoxic effect of MRK-107, an imidazo [1,2- a]pyridine derivative, in 2D and 3D cell culture models of colon cancer (Caco-2 and HT-29). Sulforhodamine B results revealed a GI50 of 2.4 µM for Caco-2, 1.1 µM for HT-29, and 22.19 µM for NIH/3T3 in 2D cultures after 48 h of treatment. Cell recovery, migration, clonogenic, and Ki-67 results corroborated that MRK-107 inhibits cell proliferation and prevents cell regeneration and metastatic transition by selectively reducing migratory and clonogenic capacity; non-tumor cells (NIH/3T3) re-established proliferation in less than 18 h. The oxidative stress markers DCFH-DA and TBARS revealed increased ROS generation and oxidative damage. Caspases-3/7 are activated and induce apoptosis as the main mode of cell death in both cell models, as assessed by annexin V-FITC and acridine orange/ethidium bromide staining. MRK-107 is a selective, redox-active compound with pro-oxidant and pro-apoptotic properties and the capacity to activate antiproliferative pathways, showing promise in anticancer drug research.

Infusion from Miconia albicans (Melastomataceae) leaves exhibits anti-inflammatory and anti-hyperalgesic activities without toxicity.

ETHNOPHARMACOLOGICAL RELEVANCE: The leaves of Miconia albicans have been extensively used as a traditional medicine to treat inflammation, infection, arthritis, joint pain, and analgesia, which can be purchased easily. Nevertheless, the scientific evidence of chemical profile identification and toxicity investigation is meager. AIM OF THE STUDY: This study aimed to determine the chemical profile of Miconia albicans aqueous extract (MAAE), to investigate its anti-inflammatory and hyperalgesic effects, and toxicity (acute and repeated-dose oral) in vivo studies. MATERIALS AND METHODS: MAAE was obtained by infusion method and its chemical constituents were analyzed and annotated by LC-DAD-MS. The in vivo tests were performed with male and female Swiss mice. Toxicity studies were examined by acute (2000 mg/kg) and repeated-dose oral assays (51.2; 256; 1280 mg/kg); anti-inflammatory evaluation was performed by paw edema and leukocyte migration, and anti-hyperalgesic properties were analyzed by abdominal writhing induced by acetic acid and formalin. The animals were treated by oral means with 51.2, 256, and 1280 mg/kg of MAAE. RESULTS: Twenty-four compounds were annotated from MAAE by LC-DAD-MS, such as ellagitannins, ellagic acid derivatives, flavan-3-ol, and O-glycosylated compounds, including flavonols, triterpenes, and megastigmanes. MAAE induced no significant toxicological effects in the acute and repeated-dose oral assays at lower doses and no histological changes were observed. Hematological and biochemical showed no significant alterations. The oral administration of MAAE 256 mg/kg inhibited the edematogenic effect and reduced the leukocyte migration. In addition, MAAE decreased the abdominal writhings induced by acetic acid and the paw-licking time by formalin assay. CONCLUSION: MAAE showed a significant reduction in inflammatory levels and leukocyte migration, revealing anti-hyperalgesic properties. Additionally, MAAE revealed no acute and repeated-doses toxicities.

Protease inhibitor from Libidibia ferrea seeds attenuates inflammatory and nociceptive responses in mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Libidibia ferrea (Mart. ex. Tul.) L.P. Queiroz is a Brazilian native tree locally known as jucá and pau-ferro, and it has been used in folk medicine for relieving, asthma, bronchitis, sore throat, rheumatism, enterocolitis and fever. The anti-inflammatory properties of L. ferrea were confirmed for its stem, fruit, leaves, bark and seeds extracts, however little is known about the natural compounds that may be associated with that response. AIM OF THIS STUDY: In a normal physiological condition, many enzymes play an important role in catalyzing biological functions. Among them, proteases are of great interest. Although they take part of many biological systems, as the inflammatory process, when deregulated, proteases may cause system malfunctions, such as under- or overproduction of cytokines, or immune cells activation. Thus, protease inhibitors prevent these immune responses by regulating proteases. The objective of this study was to evaluate the anti-inflammatory and anti-nociceptive response of a protease inhibitor purified from L. ferrea seeds (LfTI). MATERIALS AND METHODS: In vitro (5, 50 and 250 µg/mL of LfTI) and in vivo (0.6, 3 e 15 mg/kg of LfTI) assays were performed. Male Swiss mice weighing 18-25 g were used for cell harvesting and for the in vivo assays. The anti-inflammatory activity was analyzed in vitro by macrophage cytotoxicity, hydrogen peroxide (H2O2) production, and cell adhesion assays; and in vivo by leukocyte recruitment, nitric oxide (NO) production, vascular permeability, paw edema and mast cell degranulation assays. The anti-nociceptive activity was evaluated through abdominal writhing test induced by acetic acid and formalin sensitization. RESULTS: Our results showed that, in vitro, LfTI is not cytotoxic. Also, LfTI (50 µg/mL) inhibited macrophage H2O2 production (48.2%), and adhesion (48.4%). LfTI (0.6, 3 e 15 mg/kg) decreased polymorphonuclear cell recruitment dose-dependently, and it inhibited NO production (53%), vascular permeability (40.7%) and paw edema at 3 mg/kg at different time, but it did not inhibit mast cell degranulation. Besides, LfTI did not inhibit either the number of writhing or the licking time in the formalin test in the second phase (inflammatory). However, LfTI (3 mg/kg) inhibited licking time at the first phase (neurogenic) in the formalin sensitization (46.1%). CONCLUSIONS: Our results show that LfTI has anti-inflammatory and antinociceptive (neurogenic pain) effects, and these effects might be associated with the inhibition of inflammatory proteases and/or protease-activated receptors activation hindering.

Antileishmanial Activity, Toxicity and Mechanism of Action of Complexes of Sodium Usnate with Lanthanide Ions: Eu(III), Sm(III), Gd(III), Nd(III), La(III) and Tb(III).

Leishmaniases are neglected diseases with limited therapeutic options. Diffuse cutaneous leishmaniasis can occur in Brazil due to Leishmania amazonensis. This study details the antileishmanial activity and cytotoxicity of complexes of sodium usnate (SAU) with lanthanide ions ([LnL3 (H2O)x] (Ln = La(III), Nd(III), Gd(III), Tb(III), Eu(III) and Sm(III); L = SAU). All lanthanide complexes were highly active and more potent than SAU against L. amazonensis promastigotes and intracellular amastigotes (Pro: IC50 < 1.50 µM; Ama: IC50 < 7.52 µM). EuL3·3H2O and NdL3·3H2O were the most selective and effective on intracellular amastigotes, with a selectivity index of approximately 7.0. In silico predictions showed no evidence of mutagenicity, tumorigenicity or irritation for all complexes. Treatment with EuL3·3H2O triggered NO release even at the lowest concentration, indicating NO production as a mechanism of action against the parasite. Incubating promastigotes with the lanthanide complexes, particularly with SmL3·4H2O and GdL3·3H2O, led to a change in the mitochondrial membrane potential, indicating the ability of these complexes to target this essential organelle. The same complexes caused cell death through cell membrane disruption, but their relationship with early or late apoptotic processes remains unclear. Thus, the inclusion of lanthanide ions in SAU improves selectivity with a promising mechanism of action targeting the mitochondria.

Baccharis trimera Infusion Reduces Macrophages Activation and High-Fat Diet-Induced Metabolic Disorders in Mice.

The aim of this study is to evaluate the efficacy of Baccharis trimera infusion on high-fat diet-induced metabolic disorders in mice and macrophages activation. This study evaluated obesity, insulin resistance, dyslipidemia and hepatic steatosis induced by a high-fat diet in Swiss mice. Cellular parameters in macrophages, such as cell viability (MTT), the production and release of nitric oxide (NO) and hydrogen peroxide (H2O2), cell spreading, cell adhesion and phagocytosis were determined. Our results showed that treatment with B. trimera prevented the mentioned conditions, except for the production of hydrogen peroxide. B. trimera prevented the development of obesity and associated comorbidities, as well as activation of macrophages. In conclusion, B. trimera is able to prevent obesity and metabolic disorders and macrophages activation, minimizing inflammation and validating the popular use of this plant tea.

Effect of Ylang-Ylang (Cananga odorata Hook. F. & Thomson) Essential Oil on Acute Inflammatory Response In Vitro and In Vivo.

The aim of this study is to evaluate the phytochemical profile, oral acute toxicity, and the effect of ylang-ylang (Cananga odorata Hook. F. & Thomson) essential oil (YEO) on acute inflammation. YEO was analyzed by gas chromatography/mass spectrometry. For in vitro tests, YEO was assessed using cytotoxicity, neutrophil chemotaxis induced by N-formyl methionyl leucyl phenylalanine (fMLP), and phagocytic activity tests. YEO was orally administered in zymosan-induced peritonitis, carrageenan-induced leukocyte rolling, and adhesion events in the in situ microcirculation model and in carrageenan-induced paw edema models. YEO (2000 mg/kg) was also tested using an acute toxicity test in Swiss mice. YEO showed a predominance of benzyl acetate, linalool, benzyl benzoate, and methyl benzoate. YEO did not present in vitro cytotoxicity. YEO reduced the in vitro neutrophil chemotaxis induced by fMLP and reduced the phagocytic activity. The oral treatment with YEO reduced the leukocyte recruitment and nitric oxide production in the zymosan-induced peritonitis model, reduced rolling and adherent leukocyte number induced by carrageenan in the in situ microcirculation model, and reduced carrageenan-induced edema and mechanical hyperalgesia. YEO did not present signs of toxicity in the acute toxicity test. In conclusion, YEO affected the leukocyte activation, and presented antiedematogenic, anti-hyperalgesic, and anti-inflammatory properties.

Lantana canescens (Kunth) inhibits inflammatory and hyperalgesic responses in murine models.

ETHNOPHARMACOLOGICAL RELEVANCE: Lantana canescens is popularly known in Brazil as "cidreirinha" or "chumbinho-branco". It is found in Pantanal biome and its flowers and leaves are used in traditional medicine to treat pain and inflammation. Information about this species is limited to the activity of isolated essential oils. Studies with different extracts, composition, and biological properties are still scarce. AIM OF THIS STUDY: The objective of this study was to evaluate the anti-inflammatory and anti-hyperalgesic activity of the hydroethanolic extract of L. canescens aerial parts. MATERIALS AND METHODS: The hydroethanolic extract L. canescens aerial parts (HELc) was analyzed using HPLC-DAD-EM. Male and female Swiss mice weighing 18-25 g were used in the in vivo assays. Acute toxicity was assessed (2000 mg/kg); anti-inflammatory activity through paw edema, mast cell degranulation and peritonitis, and anti-hyperalgesic activity through abdominal writhing assays induced by acetic acid and formalin sensitization, were evaluated using the doses of 3, 30 and 300 mg/kg. RESULTS: The phytochemical characterization of HELc confirmed the presence of glycosylated iridoids (theveside, theviridoside), verbascosides and flavonoids. The HELc did not present toxicity in the evaluated dose. HELc reduced formation of paw edema, degranulation of peritoneal mast cells and infiltration of polymorphonuclear cells into the animals peritoneal cavity. In addition, HELc decreased the number of abdominal writhing induced by acetic acid and the time of paw licking in the evaluation of formalin sensitization. CONCLUSIONS: These results confirm the anti-inflammatory and anti-hyperalgesic effects of hydroethanolic extract of L. canescens, validating the use of this plant in folk medicine.

Macrophage activation in vitro by Parachartergus fraternus venom.

Parachartergus fraternus wasp induces inflammation with a predominance of mononuclear cells, that can acquire macrophage functions at the sting site, amplifying the response. These cells can be activated by venomous animals and are involved in destruction of injurious agents and release of inflammatory mediators. The objective of this work was to evaluate the activity of P. fraternus venom (Pfv) on isolated murine macrophage function. The cells were obtained from peritoneal cavity of Swiss male mice and incubated with Pfv (2.5, 5 and 10 µg/mL). Cytotoxicity was determined using MTT assay. Adhesion and detachment were evaluated using violet crystal dye. Spreading was evaluated based on morphological parameters. Phagocytosis was performed with opsonized zymosan. Production of hydrogen peroxide (H2O2) and nitric oxide (NO) were quantified using the phenol red and Griess assays, respectively. Pfv at concentrations evaluated was not cytotoxic in MTT assay and did not cause macrophage detachment in cell culture plates. However, it increased adhesion of macrophage, spreading and phagocytosis of opsonized zymosan, as well as induced production of H2O2 and NO. Therefore, Pfv induces macrophage activation in vitro and the response of these cells can be correlated with the previously reported inflammatory process triggered by this wasp.

Association of clinical epidemiological factors to polypharmacy among patients with multiple sclerosis: real-life data / Associação de fatores clínicos epidemiológicos à polifarmácia em pacientes com esclerose múltipla: dados da vida real

INTRODUCTION: Treatment for multiple sclerosis should focus on relapse prevention and treatment, as well as symptom and disease progression control, which require the use of multiple medications. OBJECTIVE: To evaluate the association of polypharmacy and related clinical, epidemiological factors in multiple sclerosis patient cohorts. METHODS: It was conducted a prospective study of multiple sclerosis patients that held a prescription of disease-modifying drugs between January and December 2017. The medications were analyzed and classified as either long-term or as-needed medications for therapeutic objective and prescription status purposes. RESULTS: During 2017, 124 patients were attended, 106 were eligible for the study, and 81 agreed to participate. The average age was 40.95±11.69 years. The disease duration varied between 6 months and 30 years, with a median of 7 years. More than half of the multiple sclerosis patients suffered from comorbidities (54.32%), and 76.54% were categorized as polypharmacy. The comparison of polypharmacy between the groups yielded significant differences for comorbidities and employment status and regarding age between patients with polypharmacy and patients without polypharmacy of long-term medications. CONCLUSION: The age of the patient and the presence of comorbidities are important factors related to polypharmacy.

INTRODUÇÃO: O tratamento da esclerose múltipla deve ser concentrado na prevenção e tratamento de recaídas, bem como no controle da progressão dos sintomas e doenças, o que requer o uso de vários medicamentos. OBJETIVO: Avaliar a associação de polifarmácia a fatores epidemiológicos clínicos em uma coorte de pacientes com esclerose múltipla. MÉTODOS: Foi realizado um estudo prospectivo de pacientes com esclerose múltipla que possuíam prescrição de medicamentos modificadores da doença entre janeiro e dezembro de 2017. Os medicamentos foram analisados e classificados como medicamentos de longo prazo ou conforme necessário para fins terapêuticos de objetivo e status de prescrição. RESULTADOS: Durante 2017 foram atendidos 124 pacientes, destes 106 pacientes foram elegíveis para o estudo e 81 concordaram em participar. A idade média foi de 40,95±11,69 anos. A duração da doença variou entre 6 meses e 30 anos, com mediana de 7 anos. Mais da metade dos pacientes com esclerose múltipla apresentava comorbidades (54,32%) e 76,54% foram classificados com polifarmácia. A comparação da polifarmácia entre os grupos demonstrou diferenças significativas para comorbidades, e situação de trabalho, e em relação à idade entre pacientes com polifarmácia e pacientes sem polifarmácia com medicamentos de longa duração. CONCLUSÃO: A idade do paciente e a presença de comorbidades são fatores importantes relacionados à polifarmácia.

Pro-inflammatory response induced by the venom of Parachartergus fraternus wasp.

The sting of different wasp species triggers local and systemic reactions in victims that can lead to death. Parachartergus fraternus is responsible for frequent accidents in Latin America; however, few studies have been conducted on this insect and its venom. In this study, the inflammatory process induced by the venom of the P. fraternus wasp (Pfv; 100, 200, and 400 µg/kg) was characterized. Mice were used to assess paw edema, vascular permeability, mast cell degranulation, leukocyte influx, nitric oxide (NO) production, expression of inflammatory genes, and histopathological changes. Pfv triggered edema formation with a peak dose of 200 µg/kg at 10 min. There was an increase in permeability in all periods and doses evaluated, with no differences between them. The 200 µg/kg dose induced mast cell degranulation in all periods, with a peak at 15 min. This same dose induced leukocyte influx with a predominance of mononuclear cells and triggered a peak in NO production in the 12th hour. The increase in COX-2, iNOS, and IFN-γ mRNA expression occurred after 1 and 6 h, and there was an increase in IL-10 expression after 48 h. In addition, Pfv triggered edema and induced an influx of macrophages and mast cells into the injection site. Therefore, Pfv induces an inflammatory process from the first 5 min of inoculation that can persist for up to 48 h.

Pharmacological Characterization of Mouse Hind Paw Edema Induced by Parachartergus fraternus Venom.

Stings from the wasp Parachartergus fraternus occur throughout Latin America, and edema followed by pain is the main symptom presented by victims. This often limited inflammatory event has not been characterized for this species. In this work, we identified the mechanisms and possible mediators involved in this response. P. fraternus venom (100, 200, and 400 µg/kg) was injected into the hind paws of mice, and edema was evaluated at intervals of 10 min for up to 60 min and at 120, 240, and 1440 min using a digital plethysmometer. The peak of edema was observed at 10 min with a dose of 200 µg/kg. A reduction in edema was observed with indomethacin (58.1%), celecoxib (44.5%), MK886 (30.8%), and dexamethasone (53.2%). Loratadine, cimetidine, and cyproheptadine treatment reduced the edema by 54.2%, 63.9%, and 84.4%, respectively, compared with the control. Captopril and L-NAME inhibited 42.5% and 69.8%, respectively, of the edema. These results showed that the edema induced in mice by P. fraternus venom occurs early and is mediated by arachidonic acid derivatives, vasoactive amines, and nitric oxide. Together, these mediators amplify the inflammatory process, with emphasis on histamine and serotonin in triggering the edematogenic response, being more effective the use of cyproheptadine in the therapeutic approach.

Tabebuia aurea decreases hyperalgesia and neuronal injury induced by snake venom.

ETHNOPHARMACOLOGICAL RELEVANCE: Tabebuia aurea (Silva Manso) Benth. & Hook. f. ex S. Moore is used as anti-inflammatory, analgesic and antiophidic in traditional medicine, though its pharmacological proprieties are still underexplored. In the bothropic envenoming, pain is a key symptom drove by an intense local inflammatory and neurotoxic event. The antivenom serum therapy is still the main treatment despite its poor local effects against pain and tissue injury. Furthermore, it is limited to ambulatorial niches, giving space for the search of new and more inclusive pharmacological approaches. AIM OF THE STUDY: evaluation of Tabebuia aurea hydroethanolic extract (HEETa) in hyperalgesia and neuronal injury induced by Bothrops mattogrossensis venom (VBm). MATERIALS AND METHODS: Stem barks from Tabebuia aurea were extracted with ethanol and water (7:3, v/v) to yield the extract HEETa. Then, HEETa was analyzed by LC-DAD-MS and its constituents were identified. Snake venoms were extracted from adult specimens of Bothrops mattogrossensis, lyophilized and kept at -20 °C until use. Male Swiss mice, weighting 20-25 g, were used to hyperalgesia (electronic von Frey), motor impairment (Rotarod test) and tissue injury evaluation (histopatology and ATF-3 immunohistochemistry). Therefore, three experimental groups were formed: VBm (1 pg, 1 ng, 0.3 µg, 1 µg, 3 and 6 µg/paw), HEETa orally (180, 540, 720, 810 or 1080 mg/kg; 10 mL/kg, 30 min prior VBm inoculation) and VBm neutralized (VBm: HEETa, 1:100 parts, respectively). In all set of experiments a control (saline group) was used. First, we made a dose-time-response course curve of VBm's induced hyperalgesia. Next, VBm maximum hyperalgesic dose was employed to perform HEETa orally dose-time-response course curve and analyses of VBm neutralized. Paw tissues for histopathology and DRGs were collected from animals inoculated with VBm maximum dose and treated with HEETa antihyperalgesic effective dose or neutralized VBm. Paws were extract two or 72 h after VBm inoculation and DRGs, in the maximum expected time expression of ATF-3 (72 h). RESULTS: From HEETa extract, glycosylated iridoids were identified, such as catalpol, minecoside, verminoside and specioside. VBm induced a time and dose dependent hyperalgesia with its highest effect seen with 3 µg/paw, 2 h after venom inoculation. HEETa effective dose (720 mg/kg) decreased significantly VBm induced hyperalgesia (3 µg/paw) with no motor impairment and signs of acute toxicity. HEETa antihyperalgesic action starts 1.5 h after VBm inoculation and lasted up until 2 h after VBm. Hyperalgesia wasn't reduced by VBm: HEETa neutralization. Histopathology revealed a large hemorragic field 2 h after VBm inoculation and an intense inflammatory infiltrate of polymorphonuclear cells at 72 h. Both HEETa orally and VBm: HEETa groups had a reduced inflammation at 72 h after VBm. Also, the venom significantly induced ATF-3 expression (35.37 ±â€¯3.25%) compared with saline group (4.18 ±â€¯0.68%) which was reduced in HEETa orally (25.87 ±â€¯2.57%) and VBm: HEETa (19.84 ±â€¯2.15%) groups. CONCLUSION: HEETa reduced the hyperalgesia and neuronal injury induced by VBm. These effects could be related to iridoid glycosides detected in HEETa and their intrinsic reported mechanism.

Nutraceutical potential of Byrsonima cydoniifolia fruits based on chemical composition, anti-inflammatory, and antihyperalgesic activities.

In recent years, the fruits of native Brazilian plant species with anti-inflammatory property have gained prominence due to their properties comparable to traditional medicines. This study aimed to chemically characterize and evaluate the anti-inflammatory and antihyperalgesic activity of Byrsonima cydoniifolia fruit, which is widely used to manufacture ice cream and jellies. Our results revealed that the fruit exhibits flavonoid derivatives and stilbenes, as trans-piceatannol and resveratrol, as main secondary metabolites. In mice, the hydroethanolic extract of fruit reduced the edema, migration of polymorphonuclear leukocytes into the peritoneal cavity, as well as abdominal writhings. The results demonstrated, for the first time, the presence of stilbenoids in the Byrsonima genus and the anti-inflammatory and antihyperalgesic effect of Byrsonima cydoniifolia fruits, supporting its potential as a nutraceutical food.

Adulteration and Contamination of Commercial Sap of Hymenaea Species.

The Hymenaea stigonocarpa and Hymenaea martiana species, commonly known as "jatobá," produce a sap which is extracted by perforation of the trunk and is commonly used in folk medicine as a tonic. For this study, the authenticity of commercial samples of jatobá was verified by the identification of the main compounds and multivariate analysis and contamination by microbial presence analysis. The acute toxicity of the authentic jatobá sap was also evaluated. The metabolites composition and multivariate analysis revealed that none of the commercial samples were authentic. In the microbiological contamination analysis, five of the six commercial samples showed positive cultures within the range of 1,700-100,000 CFU/mL and the authentic sap produced no signs of toxicity, and from a histological point of view, there was the maintenance of tissue integrity. In brief, the commercial samples were deemed inappropriate for consumption and represent a danger to the population.

Chemical composition and anti-inflammatory activity of the leaves of Byrsonima verbascifolia.

An ethnopharmacological survey indicates that the genus Byrsonima has some medicinal species that are commonly found in the Brazilian Cerrado and has been used as an anti-inflammatory and for gastroduodenal disorders. The aim of this study was to evaluate the anti-inflammatory and antioxidant activity along with qualitative chemical characterization of the methanolic extract of the leaves of Byrsonima verbascifolia (BvME) obtained by exhaustive percolation. The data from the chemical analyses by liquid chromatography-mass spectrometry led to tentative identification of 42 compounds belonging to proanthocyanidins, galloyl quinic acid derivatives, flavonoids, and triterpene glycoside derivatives. BvME contain flavonoids and show an antioxidative activity. The methanolic extract administered intraperitoneally at doses of 50, 100, or 300 mg/kg showed a significant reduction in paw edema and modulated the neutrophil influx in a mouse model. Furthermore, the anti-edematogenic activity of the extract provided in smaller doses (12.5 and 25 mg/kg) was also demonstrated in a mouse paw edema model. The extract inhibited NO production by macrophages induced by lipopolysaccharide. We presume that the anti-inflammatory effects of BvME are due to a combination of compounds present in B. verbascifolia, including catechins (procyanidins), flavonoids, and triterpene glycosides and that these anti-inflammatory actions should be mediated, at least partly, through the inhibition of NO production. This study supports and validates the ethnopharmacological uses of B. verbascifolia as an anti-inflammatory.

Anti-inflammatory and antinociceptive activities of Croton urucurana Baillon bark.

ETHNOPHARMACOLOGICAL RELEVANCE: Croton urucurana (Euphorbiaceae) is popularly used in Brazil to treat inflammatory processes, pain, and gastric ulcers. AIM OF STUDY: To evaluate the anti-inflammatory and antinociceptive properties of the methanol extract from the bark of C. urucurana (MECu) in mice and identify its chemical constituents. MATERIALS AND METHODS: The extract was characterized by UHPLC-DAD-ESI-Q-TOF-MS/MS. Extract doses of 25, 100, and 400mg/kg were employed in the biological assays. Evaluation of anti-inflammatory activity was based on paw edema and leukocyte recruitment into the peritoneal cavity of mice, both induced by carrageenan. Abdominal writhing caused by acetic acid and duration of formalin-induced paw-licking were the models employed to evaluate antinociceptive activity. RESULTS: Ten compounds were identified in the extract: (+)-gallocatechin (1), procyanidin B3 (2), (+)-catechin (3), (-)-epicatechin (4), tembetarine (5), magnoflorine (6), taspine (7), methyl-3-oxo-12-epi-barbascoate (8), methyl-12-epi-barbascoate (9), and hardwickiic acid (10). This is the first report of compounds 2, 4, 6, 7, and 10 in C. urucurana and compound 5 in the genus Croton. In addition to inhibiting paw edema and leukocyte recruitment (particularly of polymorphonuclear cells) into the peritoneal cavity of mice, MECu reduced the number of abdominal writhings induced by acetic acid and the duration of formalin-induced paw licking. CONCLUSIONS: The methanol extract of C. urucurana bark exhibited anti-inflammatory and antinociceptive properties, corroborating its use in folk medicine. These effects may be related to the presence of diterpenes, alkaloids, and flavonoids.

Tabebuia aurea decreases inflammatory, myotoxic and hemorrhagic activities induced by the venom of Bothrops neuwiedi.

ETHNOPHARMACOLOGICAL RELEVANCE: Ethnobotanical studies show that Tabebuia aurea has been used as anti-inflammatory and for snake bite. Evaluate the effect of treatment with the hydroethanolic extract of Tabebuia aurea (HETa) on inflammatory, hemorrhagic and myotoxic activities induced by Bothrops neuwiedi (BnV) in mice. MATERIALS AND METHODS: The anti-inflammatory, antihemorragic and antimyotoxic properties of the HETa 100, 200 and 400mg/kg or BnV neutralized with HETa (1:50) were evaluated using the following animal models: BnV-induced paw edema, BnV-induced recruitment of polymorphonuclear cells into the peritoneal cavity, hemorrhagic activity, myotoxic activity and hydrogen peroxide production by peritoneal macrophages in vitro. RESULTS: HETa inhibited the paw edema and polymorphonuclear cell recruitment into the peritoneal cavity. BnV neutralized with HETa reduced the hemorrhagic activity and histopathological analysis of skeletal muscle tissue showed that the hemorrhagic area was smaller and multifocal. The leukocyte infiltrate was less intense and muscle necrosis discrete. BnV induced hydrogen peroxide production and BnV neutralized reduced this production. In addition, the HETa was nontoxic to macrophages. CONCLUSIONS: The activities of the HETa presented herein justify the popular use of Tabebuia aurea in inflammatory situations from snake bite.

In vivo and in vitro anti-inflammatory properties of Achyrocline alata (Kunth) DC.

ETHNOPHARMACOLOGICAL RELEVANCE: Achyrocline alata is a locally marketed (Mato Grosso do Sul/ Brazil) herb used in folk medicine as an anti-inflammatory and a sedative. Evaluate the anti-inflammatory properties of Achyrocline alata in both in vivo and in vitro models. MATERIALS AND METHODS: A hydroethanolic extract from inflorescences of Achyrocline alata (HEAa) was characterized by HPLC-DAD and compared to standards (chlorogenic acid; isoquercetrin; quercetin; 4,2',4'-trihydroxy-6'-methoxychalcone; gnaphalin; 3-O-methyl-quercetin; 3,5-dicaffeoyl-quinic acid and 4,5-dicaffeoyl-quinic acid). The in vivo anti-inflammatory properties of the HEAa (4, 20 and 100 mg/kg, per os) were evaluated using the following animal models: carrageenan-induced paw edema in rats, carrageenan-induced vascular permeability and peritonitis in mice and an acetic acid-induced writhing model to test antihyperalgesic activity in mice. In vitro assays were performed to study the effects of the HEAa (0.16, 0.8 and 4 mg/ml) on the cell viability, cell spreading and production of NO and H2O2 in stimulated macrophages. RESULTS: The A. alata extract inhibited the development of edema and vascular permeability, reduced polymorphonuclear cell recruitment in the acute peritonitis assay and decreased the amount of writhing induced by acetic acid. The HEAa did not increase NO/H2O2 production, while it did inhibit production when the macrophages were stimulated by LPS or PMA at all tested concentrations. In the presence of HEAa, macrophage spreading did not increase even after stimulation with LPS. Additionally, the HEAa was nontoxic to macrophages at all tested concentrations. CONCLUSIONS: The HEAa displayed anti-inflammatory and antihyperalgesic effects, which supports the use of this plant in folk medicine. These effects might be due to the flavonoids and phenylpropanoids derivatives present in the HEAa.

Potentially inappropriate medication use in institutionalized older adults according to the Beers Criteria

The need for specific care, coupled with new family arrangements, has contributed to the increasing institutionalization of elderly members. The purpose of this study was to evaluate drug use by institutionalized older adults according to Beers Criteria. This prospective, longitudinal study was conducted in the three non-profit long-stay geriatric care institutions of Campo Grande, in the Central-West region of Brazil. All subjects aged 60 years and above on November 2011 were included and followed until November 2012. Eighteen subjects were excluded and the final sample consisted of 133 individuals aged 60 to 113 years. Overall, 212 medications were used at geriatric care institution A, 532 at B, and 1329 at C. Thirty-four drugs were inappropriately prescribed 89 times at geriatric care institution A (41.98%), 49 prescribed 177 times at B (33.27%), and 91 prescribed 461 times at C (34.68%). Statistical differences in the inappropriate drug use were found between genders (p=0.007). The most commonly used potentially inappropriate medication were first-generation antihistamines (15.34%). There was a high frequency in the use of potentially inappropriate medications which can initiate marked side effects and may compromise the fragile health of institutionalized elderly. Thus, adopting the Beers Criteria in prescribing medication contributes to minimize adverse reactions and drug interactions.

A exigência de cuidados específicos, aliada aos novos arranjos familiares, tem contribuído para a crescente institucionalização dos idosos. O objetivo do presente trabalho foi avaliar o uso de medicamentos por idosos institucionalizados utilizando os Critérios de Beers. Este estudo longitudinal prospectivo foi realizado nas três instituições de longa permanência para idosos de Campo Grande, Centro-Oeste do Brasil. Todos os sujeitos com 60 anos ou mais foram incluídos em Novembro de 2011 e acompanhados até Novembro de 2012. Dezoito idosos foram excluídos, sendo a amostra final composta por 133 sujeitos com idade entre 60 e 113 anos. O total de medicamentos utilizados foi 212 na instituição A, 532 na B e 1329 na C. Foram identificados 34 medicamentos inapropriados, prescritos 89 vezes na instituição A (41.98%), 49 prescritos 177 vezes na B (67.29%) e 90 prescritos 460 vezes na C (34.61%). Este estudo demonstrou diferença estatística na utilização de medicamentos inapropriados entre os gêneros (p=0.007). Os anti-histamínicos de 1ª geração foram os medicamentos potencialmente inapropriados para idosos mais utilizados (15.34%). Houve elevada frequência no uso de MPI, os quais podem desencadear efeitos colaterais acentuados e comprometer mais a saúde fragilizada do idoso institucionalizado. Ainda, a adoção dos Critérios de Beers na prescrição contribui para minimizar as reações adversas e interações medicamentosas.

Caracterização das prescrições medicamentosas em unidade de terapia intensiva adulto / Characterization of drug prescriptions in an adult intensive care unit

OBJETIVO: Caracterizar as prescrições medicamentosas em unidade de terapia intensiva adulto em hospital universitário. MÉTODOS: Estudo unicêntrico, observacional, descritivo, transversal realizado em unidade de terapia intensiva adulto geral. A população foi constituída por todos os pacientes internados na unidade no período de janeiro a março de 2011. Foi verificada a presença dos seguintes itens na prescrição: nome do medicamento (genérico, comercial ou abreviatura), concentração, forma farmacêutica, posologia, via de administração, nome e registro do paciente na instituição, clínica e leito de internação, nome, número do conselho e assinatura do prescritor e data. Quantificou-se a porcentagem de medicamentos prescritos pertencentes à Relação Nacional de Medicamentos Essenciais, Lista de Medicamentos Essenciais da Organização Mundial da Saúde e Guia Farmacoterapêutico do Núcleo Hospital Universitário. Os medicamentos foram classificados com base no sistema Anatomical Therapeutic Chemical níveis 1 e 2. RESULTADOS: Foram analisadas 844 prescrições de 72 pacientes com média de idade de 59,04 ± 21,80, sendo 54,92% do gênero feminino. O número médio de prescrições por paciente foi 11,72 ± 11,68. O total de medicamentos prescritos foi de 12.052. Destes, 9.571(79,41%) foram prescritos pela denominação genérica. A forma farmacêutica foi a informação mais ausente na descrição dos medicamentos (8.829/73,26%). A concentração dos medicamentos foi descrita para 7.231 (60%) dos medicamentos. As informações sobre o prescritor e paciente estiveram presentes em mais de 96% das prescrições. Os medicamentos prescritos foram classificados em 13 grupos terapêuticos e 55 subgrupos. Entre os subgrupos mais prescritos, destacaram-se os antibacterianos de uso sistêmico. CONCLUSÃO: A maioria das informações analisadas esteve presente nas prescrições. Porém, dados sobre concentração e forma farmacêutica dos fármacos faltaram em grande parte das prescrições. A caracterização das mesmas nas diferentes unidades hospitalares é imprescindível para a elaboração de estratégias que visem minimizar os problemas relacionados ao uso de medicamentos.

OBJECTIVE:To characterize drug prescriptions in a university hospital adult intensive care unit. METHODS: Single-center, observational, descriptive, cross-sectional study conducted at an adult general intensive care unit. The study population included all of the unit's inpatients from January to March 2011. The following characteristics for all prescriptions recorded during this period were examined: drug name (generic, brand name or abbreviation), dosage strength, pharmaceutical form, dose, route of administration, patient name, patient registration in the institution, clinic and hospital bed as well as the name, board license number, signature of the prescriber and date of the prescription. It was quantified the percentage of prescribed drugs included in the National List of Essential Drugs, the World Health Organization Model List of Essential Medicines and the University Hospital Center Pharmacotherapy Guide. The prescribed drugs were classified based on the Anatomical Therapeutic Chemical classification system (levels 1 and 2). RESULTS: Eight hundred forty-four prescriptions were reviewed from 72 patients (mean age: 59.04 ± 21.80), 54.92% of whom were female. The mean number of prescriptions per patient was 11.72 ± 11.68. The total number of drugs prescribed was 12,052 and 9,571 (79.41%) of the drugs were prescribed using the generic name. The most frequent absent information in the drug description was the pharmaceutical form of the drug (8,829/73.26%). The dosage strength was indicated in 7,231 (60%) of the prescriptions, and the prescriber and patient information were indicated in over 96% of the prescriptions. The prescribed drugs were classified in 13 therapeutic groups and 55 subgroups. Systemic antibacterials represented one of the most frequently prescribed subgroups. CONCLUSION: Most of the reviewed information was present in the prescriptions. However, the dosage strength and pharmaceutical form were absent in many prescriptions. The characterization of prescriptions at different hospital units is essential for the development of strategies that reduce drug utilization problems.