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1.
Quintessence Int ; 51(9): 732-740, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901235

RESUMO

OBJECTIVE: The present study compared the efficacy of preoperative administration of paracetamol and placebo in reducing postoperative pain after routine dental treatment in children. The primary objective was to compare postoperative pain level between the groups. The secondary objective was to identify other factors that can influence postoperative pain. METHOD AND MATERIALS: A prospective, placebo-controlled parallel-group trial was conducted on two groups of children aged 5 to 12 years. One hundred and two children participated in the study, 51 in each group, 58 boys (56.9%) and 44 girls (43.1%). The average age was 7 ± 1.72 years, with no difference in age and sex between the groups. The study group received paracetamol (15 mg/kg) and the control group received placebo 15 minutes before dental treatment. Pretreatment baseline anxiety was recorded. Postoperative data were collected immediately at the end of the treatment, and by phone 2.5 hours after taking the remedy. RESULTS: The groups showed no difference in postoperative pain immediately after the treatment and 1.5 hours after treatment. The pain score was higher among children who received stainless steel crowns and combinations of crowns, pulpectomy, and extractions. CONCLUSION: Preoperative use of paracetamol has the same preemptive analgesic effect as placebo in pediatric patients who receive routine dental treatment. CLINICAL RELEVANCE: Postoperative pain can influence the willingness of children to receive consecutive treatments. Dental practitioners should prevent postoperative pain and recommend analgesia when necessary. Pain is expected after performing stainless steel crowns, pulpectomies, and extractions. The current study confirms that preoperative paracetamol has no beneficial effect.


Assuntos
Acetaminofen , Odontólogos , Manejo da Dor , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Masculino , Papel Profissional , Estudos Prospectivos
2.
Water Sci Technol ; 81(12): 2545-2558, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32857742

RESUMO

This work investigates the efficiency of LED and UV-C photo-reactors for paracetamol degradation using advanced oxidative processes. Among the evaluated processes, photo-Fenton was the most efficient for both radiations. Degradations greater than 81% (λ 197 nm) and 91% (λ 243 nm) were obtained in the kinetic study. These degradations were also observed by means of the reduction in the peaks in both spectral scanning and high-performance liquid chromatography analysis. The good fit of the Chan and Chu kinetic model shows that the degradation reaction has pseudo-first order behavior. Toxicity tests did not indicate the inhibition of growth of Lactuca sativa seeds and Escherichia coli bacterium. However, the growth of strains of the Salmonella enteritidis bacterium was inhibited in all the samples, demonstrating that only this bacterium was sensitive to solutions. The proposed empirical models obtained from the 24 factorial designs were able to predict paracetamol degradation. These models could, at the same levels assessed, be used to predict the percentage of degradation in studies using other organic compounds. The LED and UV-C photo-reactors were, when employing the photo-Fenton process, able to degrade paracetamol, thus highlighting the efficiency of LED radiation when its power (three times smaller) is compared to that of UV-C radiation.


Assuntos
Acetaminofen , Poluentes Químicos da Água , Peróxido de Hidrogênio , Ferro , Oxirredução , Raios Ultravioleta
3.
Sci Total Environ ; 738: 140352, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-32806341

RESUMO

Electro-oxidation of acetaminophen (ACT) in three different doped secondary effluents collected from a conventional Municipal Waste Water Treatment Plant (MWWTP), a MWWTP using a membrane bioreactor (WWTP MBR) and a lab-scale MBR treating source-separated urine (Urine MBR) was investigated by electro-Fenton (EF) coupled with anodic oxidation (AO) using sub-stoichiometric titanium oxide anode (Ti4O7). After 8 h of treatment, 90 ± 15%, 76 ± 3.8% and 46 ± 1.3% of total organic carbon removal was obtained for MWWTP, MWWTP-MBR and Urine-MBR respectively, at a current intensity of 250 mA, pH of 3 and [Fe2+] = 0.2 mM. Faster degradation of ACT was observed in the WWTP MBR because of the lower amount of competitive organic matter, however, >99% degradation of ACT was obtained after 20 min for all effluents. The acute toxicity of the treated effluent was measured using Microtox® tests. Results showed an initial increase in toxicity, which could be assigned to formation of more toxic by-products than parent compounds. From 3D excitation and emission matrix fluorescence (3DEEM), different reactivity was observed according to the nature of the organic matter. Particularly, an increase of low molecular weight organic compounds fluorescence was observed during Urine MBR treatment. This could be linked to the slow decrease of the acute toxicity during Urine MBR treatment and ascribed to the formation and recalcitrance of toxic organic nitrogen and chlorinated organic by-products. By comparison, the acute toxicity of other effluents decreased much more rapidly. Finally, energy consumption was calculated according to the objective to achieve (degradation, absence of toxicity, mineralization).


Assuntos
Acetaminofen , Águas Residuárias , Reatores Biológicos , Compostos Orgânicos , Oxirredução
4.
Zhonghua Er Ke Za Zhi ; 58(8): 682-683, 2020 Aug 02.
Artigo em Chinês | MEDLINE | ID: mdl-32842391

RESUMO

A 4-month-old child with skin rash for 2 days and fever for 1 day was hospitalized in the Department of Pediatrics of Erdos Central Hospital in November 2019. According to the clinical symptoms, medical history and medication history at the time of admission, it was diagnosed as urticaria with angioneuroedema. In this case, the urticaria occurred 3 days after acetaminophen administration, which is a delayed reaction.


Assuntos
Acetaminofen/efeitos adversos , Angioedema/induzido quimicamente , Anti-Inflamatórios não Esteroides/efeitos adversos , Urticária/induzido quimicamente , Acetaminofen/administração & dosagem , Anti-Inflamatórios não Esteroides/administração & dosagem , Febre , Humanos , Lactente
5.
Medicine (Baltimore) ; 99(34): e21816, 2020 Aug 21.
Artigo em Inglês | MEDLINE | ID: mdl-32846821

RESUMO

BACKGROUND: Due to the soft tissue injury and large amount of bone destruction involved, undesirable postoperative pain remains a challenge for both patients and surgeons after unicompartmental knee replacement (UKR). However, there are no studies comparing the effectiveness of oral and intravenous acetaminophen as part of a standard multimodal perioperative pain regimen after UKR. Thus, this prospective randomized study was conducted to compare pain control outcomes with postoperative oral versus intravenous acetaminophen use in adults undergoing UKR. METHODS: The institutional review board of the Traditional Chinese Medicine- western Medicine Hospital of Cangzhou approved the study protocol. This blinded and randomized study was carried out in accordance with the principles of the Helsinki Declaration. We included patients who were scheduled for UKR with an American Society of Anesthesiologists status of I to III, who were mentally competent, and who were able to give consent for enrolment in the study. Patients were randomly assigned on a 1:1 basis to receive either intravenous acetaminophen or oral acetaminophen. We ensured that the patients, care providers, and outcome assessors were blinded to the group assignment during the study period. Primary outcomes were postoperative pain at rest and during motion (knee flexion of 45°) measured using a visual analog scale score. Secondary outcomes included morphine consumption at 24, 48, and 72 hours after surgery, length of hospital stay, range of motion, daily ambulation distance, and adverse events occurrence. All statistical analyses were performed using SPSS 25.0. Differences associated with a P value of <.05 were considered statistically significant. RESULTS: It was hypothesized that patients receiving intravenous acetaminophen would exhibit similar postoperative outcomes compared with patients receiving oral acetaminophen. TRIAL REGISTRATION: This study was registered in Research Registry (researchregistry5825).


Assuntos
Acetaminofen/administração & dosagem , Artroplastia do Joelho/efeitos adversos , Dor Pós-Operatória/tratamento farmacológico , Acetaminofen/efeitos adversos , Administração Intravenosa , Administração Oral , Analgésicos Opioides/uso terapêutico , Método Duplo-Cego , Humanos , Articulação do Joelho/fisiopatologia , Tempo de Internação , Morfina/uso terapêutico , Dor Pós-Operatória/etiologia , Período Pós-Operatório , Ensaios Clínicos Controlados Aleatórios como Assunto , Amplitude de Movimento Articular , Projetos de Pesquisa , Caminhada
6.
Bull Environ Contam Toxicol ; 105(3): 351-357, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32749513

RESUMO

Sucralose is one of the most popular artificial sweeteners worldwide. Due to its high stability, persistence and low removal efficiency in wastewater treatment plants, sucralose has been used as an indicator of wastewater intrusion into aquatic systems. However, its stability has also been a reason for discussion whether sucralose's presence in surface water could indicate a recent anthropogenic input. Caffeine and acetaminophen have been considered as tracers in human impacted aquatic ecosystems and potentially good indicators of recent anthropogenic inputs into the environment due to their short half-lives in water. Here, a novel, high throughput and sensitive method based on online SPE-LC-HRMS for the determination of caffeine, sucralose and acetaminophen was developed and validated for both fresh and seawater samples and applied to environmental water samples to evaluate the efficiency of these compounds as tracers of aquatic pollution. Caffeine and sucralose were detected in > 70% of samples, while acetaminophen was only detected in 3% of samples above the MDL, demonstrating its limited environmental applicability.


Assuntos
Acetaminofen/análise , Cafeína/análise , Monitoramento Ambiental , Sacarose/análogos & derivados , Poluentes Químicos da Água/análise , Ecossistema , Florida , Humanos , Sacarose/análise , Edulcorantes/análise , Águas Residuárias/análise , Água
7.
JAMA ; 324(4): 350-358, 2020 07 28.
Artigo em Inglês | MEDLINE | ID: mdl-32721009

RESUMO

Importance: Opioid-induced ventilatory depression and hypoxemia is common, severe, and often unrecognized in postoperative patients. To the extent that nonopioid analgesics reduce opioid consumption, they may decrease postoperative hypoxemia. Objective: To test the hypothesis that duration of hypoxemia is less in patients given intravenous acetaminophen than those given placebo. Design, Setting, and Participants: Randomized, placebo-controlled, double-blind trial conducted at 2 US academic hospitals among 570 patients who were undergoing abdominal surgery, enrolled from February 2015 through October 2018 and followed up until February 2019. Interventions: Participants were randomized to receive either intravenous acetaminophen, 1 g (n = 289), or normal saline placebo (n = 291) starting at the beginning of surgery and repeated every 6 hours until 48 postoperative hours or hospital discharge, whichever occurred first. Main Outcomes and Measures: The primary outcome was the total duration of hypoxemia (hemoglobin oxygen saturation [Spo2] <90%) per hour, with oxygen saturation measured continuously for 48 postoperative hours. Secondary outcomes were postoperative opioid consumption, pain (0- 10-point scale; 0: no pain; 10: the most pain imaginable), nausea and vomiting, sedation, minimal alveolar concentration of volatile anesthetic, fatigue, active time, and respiratory function. Results: Among 580 patients randomized (mean age, 49 years; 48% women), 570 (98%) completed the trial. The primary outcome, median duration with Spo2 of less than 90%, was 0.7 (interquartile range [IQR], 0.1-5.1) minutes per hour among patients in the acetaminophen group and 1.1 (IQR, 0.1-6.6) minutes per hour among patients in the placebo group (P = .29), with an estimated median difference of -0.04 (95% CI,-0.18 to 0.11) minutes per hour. None of the 8 secondary end points differed significantly between the acetaminophen and placebo groups. Mean pain scores within initial 48 postoperative hours were 4.2 (SD, 1.8) in the acetaminophen group and 4.4 (SD, 1.8) in the placebo group (difference, -0.28; 95% CI, -0.71 to 0.15); median opioid use in morphine equivalents was 50 mg (IQR, 18-122 mg) and 58 mg (IQR, 24-151 mg) , respectively, with a ratio of geometric means of 0.86 (95% CI, 0.61-1.21). Conclusions and Relevance: Among patients who underwent abdominal surgery, use of postoperative intravenous acetaminophen, compared with placebo, did not significantly reduce the duration of postoperative hypoxemia over 48 hours. The study findings do not support the use of intravenous acetaminophen for this purpose. Trial Registration: ClinicalTrials.gov Identifier: NCT02156154.


Assuntos
Acetaminofen/administração & dosagem , Analgésicos não Entorpecentes/administração & dosagem , Hipóxia/tratamento farmacológico , Complicações Pós-Operatórias/tratamento farmacológico , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Infusões Intravenosas , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Falha de Tratamento
8.
Br Dent J ; 229(1): 15-18, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32651512

RESUMO

With dental services currently altered, dentists are being asked to provide advice, analgesia and antibiotics in situations where they would normally be offering operative care. Dentists are familiar with using analgesia for short courses for their patients, but using higher-dose regimes and for periods of over two weeks brings special challenges. This paper reviews the areas where special precautions are needed when using analgesia in the current situation.


Assuntos
Acetaminofen , Analgesia , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Anti-Inflamatórios não Esteroides , Betacoronavirus , Odontologia , Odontólogos , Humanos
9.
Lancet ; 396(10249): 467-478, 2020 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-32702298

RESUMO

BACKGROUND: The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) might be curtailed by vaccination. We assessed the safety, reactogenicity, and immunogenicity of a viral vectored coronavirus vaccine that expresses the spike protein of SARS-CoV-2. METHODS: We did a phase 1/2, single-blind, randomised controlled trial in five trial sites in the UK of a chimpanzee adenovirus-vectored vaccine (ChAdOx1 nCoV-19) expressing the SARS-CoV-2 spike protein compared with a meningococcal conjugate vaccine (MenACWY) as control. Healthy adults aged 18-55 years with no history of laboratory confirmed SARS-CoV-2 infection or of COVID-19-like symptoms were randomly assigned (1:1) to receive ChAdOx1 nCoV-19 at a dose of 5 × 1010 viral particles or MenACWY as a single intramuscular injection. A protocol amendment in two of the five sites allowed prophylactic paracetamol to be administered before vaccination. Ten participants assigned to a non-randomised, unblinded ChAdOx1 nCoV-19 prime-boost group received a two-dose schedule, with the booster vaccine administered 28 days after the first dose. Humoral responses at baseline and following vaccination were assessed using a standardised total IgG ELISA against trimeric SARS-CoV-2 spike protein, a muliplexed immunoassay, three live SARS-CoV-2 neutralisation assays (a 50% plaque reduction neutralisation assay [PRNT50]; a microneutralisation assay [MNA50, MNA80, and MNA90]; and Marburg VN), and a pseudovirus neutralisation assay. Cellular responses were assessed using an ex-vivo interferon-γ enzyme-linked immunospot assay. The co-primary outcomes are to assess efficacy, as measured by cases of symptomatic virologically confirmed COVID-19, and safety, as measured by the occurrence of serious adverse events. Analyses were done by group allocation in participants who received the vaccine. Safety was assessed over 28 days after vaccination. Here, we report the preliminary findings on safety, reactogenicity, and cellular and humoral immune responses. The study is ongoing, and was registered at ISRCTN, 15281137, and ClinicalTrials.gov, NCT04324606. FINDINGS: Between April 23 and May 21, 2020, 1077 participants were enrolled and assigned to receive either ChAdOx1 nCoV-19 (n=543) or MenACWY (n=534), ten of whom were enrolled in the non-randomised ChAdOx1 nCoV-19 prime-boost group. Local and systemic reactions were more common in the ChAdOx1 nCoV-19 group and many were reduced by use of prophylactic paracetamol, including pain, feeling feverish, chills, muscle ache, headache, and malaise (all p<0·05). There were no serious adverse events related to ChAdOx1 nCoV-19. In the ChAdOx1 nCoV-19 group, spike-specific T-cell responses peaked on day 14 (median 856 spot-forming cells per million peripheral blood mononuclear cells, IQR 493-1802; n=43). Anti-spike IgG responses rose by day 28 (median 157 ELISA units [EU], 96-317; n=127), and were boosted following a second dose (639 EU, 360-792; n=10). Neutralising antibody responses against SARS-CoV-2 were detected in 32 (91%) of 35 participants after a single dose when measured in MNA80 and in 35 (100%) participants when measured in PRNT50. After a booster dose, all participants had neutralising activity (nine of nine in MNA80 at day 42 and ten of ten in Marburg VN on day 56). Neutralising antibody responses correlated strongly with antibody levels measured by ELISA (R2=0·67 by Marburg VN; p<0·001). INTERPRETATION: ChAdOx1 nCoV-19 showed an acceptable safety profile, and homologous boosting increased antibody responses. These results, together with the induction of both humoral and cellular immune responses, support large-scale evaluation of this candidate vaccine in an ongoing phase 3 programme. FUNDING: UK Research and Innovation, Coalition for Epidemic Preparedness Innovations, National Institute for Health Research (NIHR), NIHR Oxford Biomedical Research Centre, Thames Valley and South Midland's NIHR Clinical Research Network, and the German Center for Infection Research (DZIF), Partner site Gießen-Marburg-Langen.


Assuntos
Betacoronavirus/imunologia , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vacinas Virais/efeitos adversos , Vacinas Virais/imunologia , Acetaminofen/uso terapêutico , Adenovirus dos Símios/genética , Adulto , Analgésicos não Entorpecentes/uso terapêutico , Anticorpos Neutralizantes/sangue , Anticorpos Antivirais/sangue , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Feminino , Vetores Genéticos/administração & dosagem , Humanos , Imunização Secundária , Imunoglobulina G/sangue , Masculino , Pneumonia Viral/tratamento farmacológico , Método Simples-Cego , Glicoproteína da Espícula de Coronavírus/imunologia , Linfócitos T/imunologia , Reino Unido , Vacinas Virais/administração & dosagem
10.
Yakugaku Zasshi ; 140(7): 943-947, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32612060

RESUMO

Concomitant therapy with acetaminophen (APAP) and low-dose aspirin is often used in clinical settings; however, it is unclear whether this combination is involved in the progression of chronic kidney disease (CKD). We hypothesized that concomitant therapy with APAP and low-dose aspirin may cause CKD progression. We carried out a retrospective 6-year cohort study that included all patients who received low-dose aspirin from January 2011 to December 2016 at Kaetsu Hospital. Primary outcome was defined as CKD progression at the end of the study compared with baseline. Among the 441 patients treated during the study period, we identified 89 cases of CKD progression. Multivariate regression analysis showed that exposure to APAP>50 g [odds ratio (OR), 2.68, 95% confidence interval (CI), 1.08-6.70], age increase by 1 year (OR, 1.05, 95% CI, 1.02-1.08), and diabetes mellitus (OR, 2.40, 95% CI, 1.41-4.08) had positive associations with CKD progression. Our findings suggested that concomitant therapy with APAP and low-dose aspirin increased the risk of CKD progression. Therefore, we recommend more thorough monitoring of serum creatinine when patients are on such concomitant therapy. Moreover, it is important to advise users of low-dose aspirin to avoid unnecessary use of APAP, in order to reduce the risk of CKD progression.


Assuntos
Acetaminofen/efeitos adversos , Aspirina/efeitos adversos , Insuficiência Renal Crônica/induzido quimicamente , Acetaminofen/administração & dosagem , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Aspirina/administração & dosagem , Biomarcadores , Creatinina/sangue , Complicações do Diabetes , Progressão da Doença , Quimioterapia Combinada/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/diagnóstico , Insuficiência Renal Crônica/prevenção & controle , Estudos Retrospectivos , Fatores de Risco
11.
Am J Vet Res ; 81(8): 627-634, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32701001

RESUMO

OBJECTIVE: To compare the ability of acetaminophen-codeine (AC; 15.5 to 18.5 mg/kg and 1.6 to 2.0 mg/kg, respectively) or carprofen (4.2 to 4.5 mg/kg) administered PO to attenuate experimentally induced lameness in dogs. ANIMALS: 7 purpose-bred dogs. PROCEDURES: A blinded crossover study was performed. Dogs were randomly assigned to receive AC or carprofen treatment first and then the alternate treatment a minimum of 21 days later. Synovitis was induced in 1 stifle joint during each treatment by intra-articular injection of sodium urate (SU). Ground reaction forces were assessed, and clinical lameness was scored at baseline (before lameness induction) and 3, 6, 9, 12, 24, 36, and 48 hours after SU injection. Plasma concentrations of acetaminophen, carprofen, codeine, and morphine were measured at various points. Data were compared between and within treatments by repeated-measures ANOVA. RESULTS: During AC treatment, dogs had significantly higher lameness scores than during carprofen treatment at 3, 6, and 9 hours after SU injection. Peak vertical force and vertical impulse during AC treatment were significantly lower than values during carprofen treatment at 3, 6, and 9 hours. Plasma concentrations of carprofen (R)- and (S)-enantiomers ranged from 2.5 to 19.2 µg/mL and 4.6 to 25.0 µg/mL, respectively, over a 24-hour period. Plasma acetaminophen concentrations ranged from 0.14 to 4.6 µg/mL and codeine concentrations from 7.0 to 26.8 ng/mL, whereas plasma morphine concentrations ranged from 4.0 to 58.6 ng/mL. CONCLUSIONS AND CLINICAL RELEVANCE: Carprofen as administered was more effective than AC at attenuating SU-induced lameness in dogs.


Assuntos
Doenças do Cão/tratamento farmacológico , Sinovite/veterinária , Acetaminofen/uso terapêutico , Animais , Anti-Inflamatórios não Esteroides/uso terapêutico , Carbazóis/uso terapêutico , Codeína/uso terapêutico , Estudos Cross-Over , Cães , Coxeadura Animal/tratamento farmacológico
12.
Int. j. morphol ; 38(3): 585-591, June 2020. graf
Artigo em Inglês | LILACS | ID: biblio-1098291

RESUMO

Acetaminophen (also called paracetamol, or APAP) induced nephrotoxicity is reported after accidental or intentional ingestion of an overdose of the drug. Renal tubular ultrastructural alterations induced by APAP overdose associated with the induction of biomarkers of kidney injury have not been investigated before. Also, we investigated whether the combined polyphenolic anti-inflammatory and antioxidants agents, resveratrol (RES) and quercetin (QUR) can protect against APAP-induced acute kidney injury. The model group of rats received a single dose of APAP (2 g/kg), whereas the protective group of rats was pre-treated for 7 days with combined doses of RES (30 mg/kg) and QUR (50 mg/kg) before being given a single dose of APAP. All rats were then sacrificed one day post APAP ingestion. Harvested kidney tissues were prepared for transmission electron microscopy (TEM) staining and blood samples were assayed for urea, creatinine, and biomarkers of inflammation and oxidative stress. TEM images and blood chemistry analysis showed that APAP overdose induced kidney damage as demonstrated by substantial alterations to the proximal convoluted tubule ultrastructure, and a significant (p<0.05) increase in urea, creatinine, tumor necrosis factor-alpha (TNF-a), and malondialdehyde (MDA) blood levels, which were protected by RES+QUR. These findings indicate that APAP induces alterations to the renal tubular ultrastructure, which is inhibited by resveratrol plus quercetin, which also decreases blood levels of kidney injury biomarkers.


El objetivo de este trabajo fue estudiar la nefrotoxicidad inducida por acetaminofeno (también llamado paracetamol o APAP) después de la ingestión accidental o intencional de una sobredosis de la droga. Las alteraciones ultraestructurales tubulares renales inducidas por sobredosis de APAP asociadas con la inducción de biomarcadores de daño renal no se han investigado. Además, estudiamos si los agentes combinados antiinflamatorios y antioxidantes polifenólicos, el resveratrol (RES) y la quercetina (QUR) pueden proteger contra la lesión renal aguda inducida por APAP. El grupo modelo de ratas recibió una dosis única de APAP (2 g / kg), mientras que el grupo protector de ratas se trató previamente durante 7 días con dosis combinadas de RES (30 mg / kg) y QUR (50 mg / kg) antes de recibir una dosis única de APAP. Todas las ratas se sacrificaron un día después de la ingestión de APAP. Los tejidos renales fueron preparados para el análisis a través de la microscopía electrónica de transmisión (MET). En las muestras de sangre se determinaron la urea, creatinina y los biomarcadores de inflamación y estrés oxidativo. Las imágenes MET y el análisis químico de la sangre mostraron que la sobredosis de APAP inducía daño renal, como lo demuestran las alteraciones sustanciales en la ultraestructura del túbulo contorneado proximal, y además, de un aumento significativo (p <0,05) de la urea, creatinina, factor de necrosis tumoral alfa y niveles sanguíneos de malondialdehído, protegidos por RES + QUR. Estos hallazgos indican que APAP induce alteraciones en la ultraestructura tubular renal, inhibida por el resveratrol más quercetina, que también disminuye los niveles sanguíneos de biomarcadores de daño renal.


Assuntos
Animais , Ratos , Quercetina/administração & dosagem , Resveratrol/administração & dosagem , Túbulos Renais/efeitos dos fármacos , Acetaminofen/toxicidade , Quercetina/farmacologia , Ureia/sangue , Ratos Sprague-Dawley , Creatinina/sangue , Microscopia Eletrônica de Transmissão , Modelos Animais de Doenças , Overdose de Drogas , Resveratrol/farmacologia , Túbulos Renais/patologia , Anti-Inflamatórios/administração & dosagem , Antioxidantes/administração & dosagem
13.
Sci Total Environ ; 728: 138771, 2020 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-32570322

RESUMO

This study aimed to evaluate the removal of chemical oxygen demand (COD), total Kjeldahl nitrogen (TKN), total ammonia nitrogen (TAN), total phosphorus (TP), ibuprofen, acetaminophen and ethinylestradiol of synthetic effluent simulating low-strength sewage by sequencing-batch mode constructed wetlands (CWs). To verify the feasibility of using a floating macrophyte in CWs and compare different substrates, three CWs containing light expanded clay aggregates (CWL), expanded clay with porcelain tiles (CWLP) and bricks (CWB) were planted with Pistia stratiotes. The results showed that CWB achieved the highest removals of TKN (78%), TAN (70%) and TP (46%), and CWLP achieved the highest COD removal (75%). LECA favored the removal of ibuprofen (92%, p < 0.05) when compared to bricks (77%), probably by the combination of biodegradation and sorption in the systems. The highest acetaminophen removal (71% to 96%) was observed in CWL, probably via biodegradation, but no significant differences were found between the CWs (p > 0.05). Ethinylestradiol was removed 76% in CWLP and 73% in CWB, both differing statistically from CWL (p < 0.05), demonstrating that brick and the combination of clay with porcelain were better than just clay in this hormone removal. After 188 days of operation, P. stratiotes was able to uptake nitrogen and phosphorus of approximately 0.28 g and 0.25 g in CWL, 0.33 g and 0.21 g CWLP, and 0.22 g and 0.09 g in CWB of, respectively. Adsorption of nitrogen and phosphorus onto the substrates was 0.48 g and 6.84 g in CWL, 0.53 g and 5.69 g in CWLP, and 0.36 g and 10.18 g in CWB, respectively. The findings on this study suggest that adsorption was possible the main process for TP removal onto the evaluated substrates whereas microbial activity was the most probable mechanism for TN removal in the evaluated CW systems.


Assuntos
Águas Residuárias , Poluentes Químicos da Água/análise , Acetaminofen , Biodegradação Ambiental , Etinilestradiol , Nitrogênio/análise , Fósforo , Eliminação de Resíduos Líquidos , Áreas Alagadas
14.
J Chromatogr A ; 1623: 461212, 2020 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-32505296

RESUMO

Non-ionic surfactants such as polysorbates, known as Tween™ 20 and Tween™ 80, are routinely used within the healthcare and pharmaceutical industry to enhance solubility. This work focuses on analysing the two aforementioned polysorbates, each considered at three purity levels with four model compounds, across the critical micellar concentration (CMC) range for each surfactant. Such data is of interest to investigate the influence of micelle formation upon compound-polysorbate interaction. Two analytical techniques were utilised, namely spectroscopic solubility determination and micellar liquid chromatography (MLC). In all cases it was apparent that the maximum solubility for all four compounds increased substantially at concentrations greater than the CMC and that, in most cases, a different retention profile was observed using MLC once the CMC had been exceeded. This paper is the first to have used such techniques to investigate the behaviour of these polysorbates over a series of concentrations and three levels of polysorbate purity. The findings indicate that the solubilisation potential of polysorbates differs once the CMC has been surpassed and is dependent upon the level of purity selected, i.e. compound-surfactant interactions are partially a consequence of the presence of micelles rather than monomer as well as polysorbate purity. Thus, formulators should include such polysorbates at optimised concentrations and purity if they wish to maximise their solubilisation potential.


Assuntos
Micelas , Polissorbatos/química , Acetaminofen/análise , Benzamidas/análise , Cromatografia Líquida , Hidrocortisona/análise , Solubilidade , Tensoativos/química
15.
Phytochemistry ; 177: 112425, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32535347

RESUMO

Ten undescribed cembrane-type diterpenes boscartins AL-AU, as well as five known analogues were isolated from Boswellia sacra Flueck. The relative configurations of these boscartins were established by extensive spectroscopic analysis of NMR spectra, IR and MS. The absolute configurations of boscartin AL, boscartin AN and isoincensole oxide were unequivocally assigned by single crystal X-ray diffraction. Meanwhile, the absolute configurations of boscartin AM, boscartin AP and boscartin AQ were determined by an empirical in situ formed Rh-complex ECD method. Biological evaluations showed that four compounds exhibited obvious hepatoprotective activities against paracetamol-induced HepG2 cell damage at 10 µM. Regarding neuroprotective activity, some isolates displayed moderate to evident protective effects against glutamate-induced toxicity in primary cultured fetal rat cortical neurons or oxygen-glucose deprivation toxicity in SK-N-SH Cells at 10 µM.


Assuntos
Boswellia , Diterpenos , Acetaminofen , Animais , Cristalografia por Raios X , Células Hep G2 , Estrutura Molecular , Ratos
16.
Environ Sci Pollut Res Int ; 27(28): 35208-35216, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32583113

RESUMO

Due to many folds increase in application of human and veterinary medicines, pharmaceuticals, a new category of pollutants, have emerged in our environment. They exist as residues in rivers, sewage effluents, streams, surface, ground, and potable water. Paracetamol (acetaminophen) is one such drug that is used as an antipyretic and analgesic medicine. It is a non-steroidal antiinflammatory drug (NSAID) and is easily available in the market because no medical prescription is necessary for its purchase and use. Paracetamol remains physiologically active even after their expiry period. Their detection in the environment in bioactive form has resulted in adverse effects on nontarget species. To determine the effect of paracetamol on aquatic photosynthetic organic (Cyanobacteria-Nostoc muscorum), present study was performed. Paracetamol (25 mg/L, 50 mg/L, 75 mg/L, 100, 125, and 150 mg/L) exposure showed toxic responses on the test organism by generating oxidative stress (MDA, H2O2, O2.-). Paracetamol caused a significant decrease in growth of cyanobacteria and showed EC50 113.68 mg/L after the 6th day of treatment. Photosynthetic pigments (chlorophyll, carotenoid, and phycobiliprotein) decreased with paracetamol increase. Antioxidant enzymatic (SOD, CAT, APX, GST, and GR) and osmolyte (Proline) also increased with increase in paracetamol to counteract the oxidative stress.


Assuntos
Nostoc muscorum , Acetaminofen , Anti-Inflamatórios não Esteroides/farmacologia , Antioxidantes/farmacologia , Peroxidação de Lipídeos , Estresse Oxidativo/efeitos dos fármacos
17.
PLoS One ; 15(6): e0233806, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32479539

RESUMO

BACKGROUND: Intentional self-harm is a common cause of hospital presentations in New Zealand and across the world, and self-poisoning is the most common method of self-harm. Paracetamol (acetaminophen) is frequently used in impulsive intentional overdoses, where ease of access may determine the choice of substance. OBJECTIVE: This cross-sectional study aimed to determine how much paracetamol is present and therefore accessible in urban New Zealand households, and sources from where it has been obtained. This information is not currently available through any other means, but could inform New Zealand drug policy on access to paracetamol. METHODS: Random cluster-sampling of households was performed in major urban areas of two cities in New Zealand, and the paracetamol-containing products, quantities, and sources were recorded. Population estimates of proportions of various types of paracetamol products were calculated. RESULTS: A total of 174 of the 201 study households (86.6%) had at least one paracetamol product. Study households had mostly prescription products (78.2% of total mass), and a median of 24.0 g paracetamol present per household (inter-quartile range 6.0-54.0 g). Prescribed paracetamol was the main source of large stock. Based on the study findings, 53% of New Zealand households had 30 g or more paracetamol present, and 36% had 30 g or more of prescribed paracetamol, specifically. CONCLUSIONS: This study highlights the importance of assessing whether and how much paracetamol is truly needed when prescribing and dispensing it. Convenience of appropriate access to therapeutic paracetamol needs to be balanced with preventing unnecessary accumulation of paracetamol stocks in households and inappropriate access to it. Prescribers and pharmacists need to be aware of the risks of such accumulation and assess the therapeutic needs of their patients. Public initiatives should be rolled out at regular intervals to encourage people to return unused or expired medicines to pharmacies for safe disposal.


Assuntos
Acetaminofen/administração & dosagem , Uso de Medicamentos/estatística & dados numéricos , Características da Família , Uso Indevido de Medicamentos sob Prescrição/estatística & dados numéricos , Acetaminofen/provisão & distribução , Adulto , Cidades/estatística & dados numéricos , Armazenamento de Medicamentos , Feminino , Humanos , Masculino , Nova Zelândia , Autoadministração
18.
Ann Afr Med ; 19(2): 131-136, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32499470

RESUMO

Background: Inappropriate prescribing of analgesics has a global impact on the health of elderly patients and the society. Empirical evidence on the prescription of analgesics among elderly Nigerians is scarce. Objectives: The objective of the study was to evaluate the prescription pattern of analgesics and describe the co-prescribing of gastroprotective agents with non-steroidal anti-inflammatory drugs (NSAIDs) among elderly patients at the geriatric center, University College Hospital, Ibadan. Methods: A retrospective cross-sectional, hospital-based study was carried out among elderly patients (≥60 years) who were prescribed analgesics. Using a data extraction sheet, information on demographic characteristics, drug utilization pattern, and morbidities was obtained from patients' case files via electronic health records. Results: A total of 337 patients case files were reviewed, the mean age was 72 ± 8.8 years, and 210 (62.3%) were females. There were a total of 2074 medications prescribed, with 733 (35.3%) being analgesics. Majority of the elderly patients (259, 76.9%) were on nonopioids, with 252 (74.8%) on NSAIDs. Paracetamol was the most commonly prescribed analgesics (181, 24.6%), followed by diclofenac/misoprostol (177, 24.1%), opioid analgesic prescribed was 88 (12.0%), with paracetamol/codeine 58 (65.9%), and tramadol 16 (18.2%) being the most prescribed opioid. A significant proportion of the hypertensive elderly patients (160, 78.8%; P < 0.036) were on NSAIDs. The oral route of administration (302, 89.6%) was the most common route of administration. Majority (310, 92%) of elderly patients taking NSAIDs had a co-prescription for gastroprotective agents. Conclusions: Majority of hypertensive patients were on NSAIDs. This calls for prompt awareness of rational analgesic use among the elderly to improve management and their survival.


Assuntos
Analgésicos/uso terapêutico , Anti-Inflamatórios não Esteroides/uso terapêutico , Prescrições de Medicamentos/estatística & dados numéricos , Uso de Medicamentos/estatística & dados numéricos , Padrões de Prática Médica/estatística & dados numéricos , Acetaminofen/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Anti-Inflamatórios não Esteroides/administração & dosagem , Codeína , Estudos Transversais , Diclofenaco/uso terapêutico , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria , Estudos Retrospectivos , Tramadol/uso terapêutico
19.
Clin Immunol ; 217: 108490, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32492478
20.
Water Res ; 182: 115957, 2020 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-32559665

RESUMO

This study identified specific bacterial populations that play a key role in detoxifying acetaminophen (N-acetyl-p-aminophenol, APAP) in activated sludge (AS) microbial communities. An AS bioreactor was established by feeding 100 mg/L of APAP as a sole carbon, nitrogen, and energy source. While the bioreactor increased APAP biotransformation rates significantly (0.7 d-1 to 6.1 d-1) over a month of acclimation, it selected for Pseudomonas by significantly reducing community diversity by 40% and richness by 47%. A Pseudomonas population (designated PCO) isolated from the APAP-degrading community was phylogenetically distinct from other Pseudomonas spp. previously reported as APAP-degrading isolates. PCO could remove APAP at levels up to 590 mg/L without inhibition and could also metabolize APAP-derived metabolites, 4-aminophenol, hydroquinone, and 1,4-benzoquinone at varying levels. PCO was introduced to AS at various volumes (5, 25, and 50% of the total), showing significantly enhanced APAP transformation rates (1.5, 1.9, and 2.3 d-1) compared to the control (1.2 d-1) without PCO inoculation. Overall, our study provides new insights into the phylogenetic and metabolic features of a key species population predominantly accelerating APAP breakdown in the context of AS microbial communities, which will help in the design of a biological means (bioaugmentation) of treating APAP-bearing waste streams.


Assuntos
Microbiota , Esgotos , Aclimatação , Acetaminofen , Analgésicos , Filogenia
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