Clinical efficacy of new α-bisabolol mouthwashes in postoperative complications of maxillofacial surgeries: a randomized, controlled, triple-blind clinical trial.

OBJECTIVES: The present study aimed to evaluate the efficacy of α-bisabolol (BISA)-based mouthwashes in the oral hygiene of patients submitted to oral and maxillofacial surgery. MATERIALS AND METHODS: A randomized, controlled, triple-blind clinical trial was conducted with 30 patients, undergoing oral and maxillofacial surgery. Three types of mouthwashes were developed, based at 0.12% chlorhexidine, 0.5% BISA, and 0.12% chlorhexidine + 0.5% BISA. The patients were evaluated in the preoperative and postoperative period, divided into three groups according to the mouthwash to be used. In the postoperative period, the oral hygiene quality of the patients was evaluated through the simplified oral hygiene index; the healing of the wounds was evaluated observing the presence of suture dehiscence and/or infection, and the pain was established using the Visual Analogue Scale. The antiseptic effect of the mouthwashes was evaluated in vitro. RESULTS: There were no differences in the efficacy of BISA-containing mouthwashes for oral hygiene, healing, and pain, compared to chlorhexidine based at 0.12%. There were no differences in the antiseptic activity of chlorhexidine and chlorhexidine + α-bisabolol-based mouthwashes. CONCLUSION: The results indicate that BISA-based mouthwashes have clinical efficacy, in the improvement of oral hygiene and wound healing, as well as in the reduction of postoperative pain. CLINICAL RELEVANCE: Considering that BISA has analgesic, antimicrobial, and anti-inflammatory properties, it is relevant to evaluate the efficacy of BISA-based mouthwashes in the oral hygiene of patients undergoing oral and maxillofacial surgery, seeking a better postoperative recovery.

IL17A polymorphism and elevated IL17A serum levels are associated with oral lichen planus.

OBJECTIVE: The aim of this study was to evaluate the association of IL17A G197A polymorphism and serum levels with oral lichen planus (OLP) susceptibility and clinical presentation. SUBJECTS AND METHODS: Eighty-three individuals diagnosed with OLP and 99 healthy controls (C) were consecutively recruited. All participants had desquamating oral mucosal cells collected and DNA isolated for IL17A (G197A) genotyping. Blood samples of 42 OLP individuals and 23 healthy controls were collected for evaluation of IL17A serum levels. RESULTS: IL17A G197A genotypes were associated with an increased chance of having OLP (GA/AA × GG, OR = 3.44, 95% CI = 1.87-6.33, p < .001). Overall A carriers (GA or AA) were more common in OLP (38.1%) than in C (20.2%; OR = 2.43, 95% CI = 1.53-3.87, p < .001). Serum levels of IL17A were higher among patients with OLP than in healthy controls (reticular, p = .0003; erosive, p < .001), but no difference was found among the disease types. CONCLUSIONS: IL17A G197A is associated with a higher susceptibility of developing OLP and these patients seem to present a considerable increase in IL17A serum levels. These findings suggest that Th17 cells, and IL17A in particular, may play a pivotal role in OLP pathogenesis.

Iron isotope fingerprints of redox and biogeochemical cycling in the soil-water-rice plant system of a paddy field.

The iron isotope composition was used to investigate dissimilatory iron reduction (DIR) processes in an iron-rich waterlogged paddy soil, the iron uptake strategies of plants and its translocation in the different parts of the rice plant along its growth. Fe concentration and isotope composition (δ56Fe) in irrigation water, precipitates from irrigation water, soil, pore water solution at different depths under the surface water, iron plaque on rice roots, rice roots, stems, leaves and grains were measured. Over the 8.5-10cm of the vertical profiles investigated, the iron pore water concentration (0.01 to 24.3mg·l-1) and δ56Fe (-0.80 to -3.40‰) varied over a large range. The significant linear co-variation between Ln[Fe] and δ56Fe suggests an apparent Rayleigh-type behavior of the DIR processes. An average net fractionation factor between the pore water and the soil substrate of Δ56Fe≈-1.15‰ was obtained, taking the average of all the δ56Fe values weighted by the amount of Fe for each sample. These results provide a robust field study confirmation of the conceptual model of Crosby et al. (2005, 2007) for interpreting the iron isotope fractionation observed during DIR, established from a series of laboratories experiments. In addition, the strong enrichment of heavy Fe isotope measured in the root relative to the soil solution suggest that the iron uptake by roots is more likely supplied by iron from plaque and not from the plant-available iron in the pore water. Opposite to what was previously observed for plants following strategy II for iron uptake from soils, an iron isotope fractionation factor of -0.9‰ was found from the roots to the rice grains, pointing to isotope fractionation during rice plant growth. All these features highlight the insights iron isotope composition provides into the biogeochemical Fe cycling in the soil-water-rice plant systems studied in nature.

Effect of the use of combination uridine triphosphate, cytidine monophosphate, and hydroxycobalamin on the recovery of neurosensory disturbance after bilateral sagittal split osteotomy: a randomized, double-blind trial.

The change in neurosensory lesions that develop after bilateral sagittal split osteotomy (BSSO) was explored, and the influence of the application of combination uridine triphosphate (UTP), cytidine monophosphate (CMP), and hydroxycobalamin (vitamin B12) on patient outcomes was assessed. This was a randomized, controlled, double-blind trial. The study sample comprised 12 patients, each evaluated on both sides (thus 24 sides). All patients fulfilled defined selection criteria. Changes in the lesions were measured both subjectively and objectively. The sample was divided into two patient groups: an experimental group receiving medication and a control group receiving placebo. The statistical analysis was performed using SPSS software. Lesions in both groups improved and no statistically significant difference between the groups was observed at any time. 'Severe' injuries in the experimental group were more likely to exhibit a significant improvement after 6 months. Based on the results of the present study, it is concluded that the combination UTP, CMP, and hydroxycobalamin did not influence recovery from neurosensory disorders.

Modifying effect of prenatal care on the association between young maternal age and adverse birth outcomes.

OBJECTIVES: The objectives were to investigate the prevalence of adverse birth outcomes according to maternal age range in the city of Rio de Janeiro, Brazil, in 2002, and to evaluate the association between maternal age range and adverse birth outcomes using additive interaction to determine whether adequate prenatal care can attenuate the harmful effect of young age on pregnancy outcomes. METHODS: A cross-sectional analysis was performed in women up to 24 years of age who gave birth to live children in 2002 in the city of Rio de Janeiro. To evaluate adverse outcomes, the exposure variable was maternal age range, and the outcome variables were very preterm birth, low birth weight, prematurity, and low 5-minute Apgar score. The presence of interaction was investigated with the composite variable maternal age plus prenatal care. The proportions and respective 95% confidence intervals were calculated for adequate schooling, delivery in a public maternity hospital, and adequate prenatal care, and the outcomes according to maternal age range. The chi-square test was used. The association between age range and birth outcomes was evaluated with logistic models adjusted for schooling and type of hospital for each prenatal stratum and outcome. Attributable proportion was calculated in order to measure additive interaction. RESULTS: Of the 40,111 live births in the sample, 1.9% corresponded to children of mothers from 10-14 years of age, 38% from 15-19 years, and 59.9% from 20-24 years. An association between maternal age and adverse outcomes was observed only in adolescent mothers with inadequate prenatal care, and significant additive interaction was observed between prenatal care and maternal age for all the outcomes. CONCLUSION: Adolescent mothers and their newborns are exposed to greater risk of adverse outcomes when prenatal care fails to comply with current guidelines.

The history of dentistry and medicine relationship: could the mouth finally return to the body?

The relationship between dentistry and medicine has been acknowledged throughout the history of humanity. This relationship was documented in ancient medicine accounts, and has survived until the present day, accompanied by the evolution of molecular technologies. Although we have had very important researchers' contributions in this interdisciplinary area, mainly after the 18th century, the knowledge on oral infections is still ignored by or unknown to the majority of clinical dentists and physicians. These circumstances could be changed through a broader divulgation of this complex relationship, both in the dentistry and in the medicine areas, which in turn would have a significant impact in systemic health worldwide. This movement has already started, as was observed in a World Health Assembly resolution which called for oral health to be integrated into chronic disease prevention programs in 2007. This was a significant indicator of changing perceptions of oral health over the past several decades. This brief review reports the evolution through time of the knowledge on the association between dental infections and systemic diseases, as well as the paths which we could take to consolidate this historical trend.

Experimental benznidazole encephalopathy: I. Clinical-neurological alterations.

Benznidazole (N-benzyl-2-nitro-1-imidazoleacetamide) is an antiprotozoan agent of the nitroimidazole group used extensively in South America to treat Chagas' disease. In humans, its most important side effect is peripheral polyneuropathy, the frequency of which is dose related. To evaluate this effect, we administered benznidazole to adult, male, mongrel dogs at doses ranging from 5 to 40 mg/kg/day (0.5 to 4 times the dose used to treat chagasic patients). Subsequent neurological examination revealed apathy, ataxia, spastic tetraplegia with hyperreflexia of stretching reflexes, balance disorders and asymmetrical gait. These alterations appeared earlier and were more intense at the higher doses. Drug withdrawal also left dose- and time-dependent sequelae like ataxia, hypertonia, hyperreflexia and alterations of balance. No peripheral neuropathy was detected. The present findings suggest that a careful reevaluation of the side effects of benznidazole in humans is necessary.

Experimental benznidazole encephalopathy: II. Electroencephalographic and morphological alterations.

We describe electroencephalographic (EEG) and morphological alterations in the CNS of dogs treated with benznidazole. The relationship between dose, duration of treatment and intensity of lesions observed was examined and used to establish anatomo-clinical associations. Two predominant EEG patterns were noted in treated dogs. Most of the animals (Group I) that received acute treatment with high doses (30 mg/kg/day) for 15 days followed by treatment at a lower dose (10 mg/kg/day) exhibited a type 2, EEG pattern, i.e., low voltage desynchronized with fast activity (LVFA). In contrast, most of the animals (Group II) that received short-term acute treatment with high doses (40 mg/kg/day) for 7 days followed by chronic treatment at lower doses (20 and 5 mg/kg/day) presented a type 1 EEG pattern. high voltage diffuse with slow activity (HVSA). Even after the drug was discontinued, the animals presented mild EEG alterations. These alterations. observed during and after treatment with benznidazole, suggest the presence of encephalopathy with multifocal characteristics. Several morphological alterations were observed in the animals, the most important being: lymphocytic inflammatory infiltrate, neuronal degeneration, satellitosis, demyelination and axonal degeneration, microglial proliferation, necrosis and gliosis. Such alterations involved the meninges, cerebral cortex, hemispheric white matter and subcortical gray matter, brain stem, cerebellum, and, less frequently, the spinal cord. No histopathological alterations were detected in the peripheral nerves. All encephalic levels were involved in all animals treated although the use of the high doses for 15 days (Group I) appeared to result in more lesions in the subcortical gray matter and the lower brainstem when compared to the use of high doses for 7 days (Group II) which led to greater involvement of the cerebral cortex, hemispheric white matter, cerebellum and medulla.

Pituitary-testicular axis in benznidazole-treated rats.

Benznidazole is used extensively throughout Latin America as an antiparasitic chemotherapeutic agent against chagasic infection. We have shown that rats chronically treated with 80 mg benznidazole kg-1 day-1 for 30 days present severe testicular atrophy and arrest of spermatogenesis. In the present experiments, plasma levels of testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin (Prl) were investigated in rats receiving 10, 40 and 80 mg benznidazole kg-1 day-1 for 30 days. No significant change in T, LH, or Prl levels was observed in treated rats (P greater than 0.05). Plasma FSH concentration, however, was markedly increased (P less than 0.05) by benznidazole treatment (40 and 80 mg kg-1 day-1) and remained high for 90 days after drug treatment was discontinued.

Pituitary-testicular axis in benznidazole-treated rata

Benznidazole is used extensively throughout Latin America as an antiparasitic chemotherapeutic agent against chagasica infection. We have shown that rats chronically treated with 80 mg benznidazole Kg-1 day-1 for 30, days present severe testicular atrophy and arrest of spermatognesis. In the present experiments, plasma levels of testosterone (T), luteinizing hormone (LH), follicle stimulating hormone (FSH) and prolactin (Prl- were inbestigated in rats receiving 10, 40 and 80 mg benznidazole Kg-1 day-1 for 30 days. No significant change in T, LH or Prl levels was observed in treated rats (P > 0.05). Plasma FSH concentration, however, was markedly invreased (P < 0.05 by benzidazole treatment (40 and 80 mgKg-1 day-1) and remained high for 90 days after drug treatment was discontinued

Testes alterations in pubertal benznidazole-treated rats.

To determine the side effects of benznidazole, an antiparasitic chemotherapeutic agent against chagasic infection, rats were treated with 80 mg benznidazole kg-1 day-1, p.o., for 30 days, while controls received the vehicle. Treated animals developed severe testicular atrophy (0.25 +/- 0.02 g/100 g vs 0.44 +/- 0.02 g/100 g for the controls), though plasma testosterone level, relative weight of seminal vesicles and prostate were similar to those of the controls. Histological examination of the testes revealed a statistically significant alteration in the spermatogenic process with a marked decrease in the frequency of meiosis, number of tubular sections with mature spermatids and depletion of germinal epithelium.