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International Journal of Molecular... Apr 2024This study investigates the efficacy of a thermo-responsive N-acetylcysteine (NAC) hydrogel on wound healing and oral ulcer recovery. Formulated by combining NAC with...
This study investigates the efficacy of a thermo-responsive N-acetylcysteine (NAC) hydrogel on wound healing and oral ulcer recovery. Formulated by combining NAC with methylcellulose, the hydrogel's properties were assessed for temperature-induced gelation and cell viability using human fibroblast cells. In vivo experiments on Sprague Dawley rats compared the hydrogel's effects against saline, NAC solution, and a commercial NAC product. Results show that a 5% NAC and 1% methylcellulose solution exhibited optimal outcomes. While modest improvements in wound healing were observed, significant enhancements were noted in oral ulcer recovery, with histological analyses indicating fully regenerated mucosal tissue. The study concludes that modifying viscosity enhances NAC retention, facilitating tissue regeneration. These findings support previous research on the beneficial effects of antioxidant application on damaged tissues, suggesting the potential of NAC hydrogels in improving wound care and oral ulcer treatment.
Topics: Wound Healing; Acetylcysteine; Animals; Rats; Humans; Hydrogels; Rats, Sprague-Dawley; Oral Ulcer; Regeneration; Fibroblasts; Male; Temperature; Cell Survival
PubMed: 38732054
DOI: 10.3390/ijms25094835 -
Cureus May 2024The pain associated with lower extremity arterial disease is difficult to treat, even with lower extremity revascularization. We sought to evaluate in-hospital and...
INTRODUCTION
The pain associated with lower extremity arterial disease is difficult to treat, even with lower extremity revascularization. We sought to evaluate in-hospital and post-operative opioid usage in patients with different disease severities and treatments for lower extremity vascular disease.
METHODS
A retrospective review was performed for all hospital encounters for patients with an International Classification of Diseases (ICD) code consistent with lower extremity arterial disease admitted to a single center between January 2018 and March 2023. Cases included patients admitted to the hospital with a primary diagnosis of lower extremity arterial disease. These patients were subdivided based on disease severity, treatment type, and comorbid diagnosis of diabetes mellitus. The analysis focused on in-hospital opioid use frequency and dosage among these patients. The control group (CON) included encounters for patients admitted with a secondary diagnosis of lower extremity atherosclerotic disease. A total of 438 patients represented by all the analyzed encounters were then reviewed for the number and type of vascular procedures performed as well as opioid use in the outpatient setting for one year.
RESULTS
Critical limb ischemia (CLI) encounters were more likely to use opioids as compared to the CON and peripheral arterial disease (PAD) without rest pain, ulcer or gangrene groups (CLI 67.9% (95% CI: 63.6%-71.6%) versus CON 52.1% (95% CI: 48.5%-55.7%), < 0.001 and CLI 67.9% (95% CI: 63.6%-71.6%) versus PAD 50.2% (95% CI: 42.6%-57.4%), < 0.001). Opioid use was also more common in encounters for gangrene and groups treated with revascularization (REVASC) and amputation (AMP) as compared to CON (gangrene 74.5% (95% CI: 68.5%-82.1%) versus CON 52.1% (95% CI: 48.5%-55.7%), < 0.01; REVASC 58.3% (95% CI: 57.3%-66.4%) versus CON 52.1% (95% CI: 48.5%-55.7%), =0.01; and AMP 72.3% (95% CI: 62.1%-74.0%) versus CON 52.1% (95% CI: 48.5%-55.7%), < 0.01). Significantly increased oral opioid doses per day (MME/day) were not noted for any of the investigated groups as compared to the CON. In the outpatient setting, 186 (42.5% (95% CI: 37.2%-46.4%)) patients were using opioids one month after the most recent vascular intervention. By one year, 31 (7.1% (95% CI: 1.30%-7.70%)) patients were still using opioids. No differences in opioid usage were noted for patients undergoing single versus multiple vascular interventions at one year. Patients undergoing certain vascular surgery procedures were more likely to be using opioids at one year.
CONCLUSION
Patients with CLI and gangrene as well as those undergoing vascular treatment have a greater frequency of opioid use during hospital encounters as compared to those patients with less severe disease and undergoing conservative management, respectively. However, these findings do not equate to higher doses of opioids used during hospitalization. Patients undergoing multiple vascular procedures are not more likely to be using opioids long-term (at one year) as compared to those patients treated with single vascular procedures.
PubMed: 38726358
DOI: 10.7759/cureus.59963 -
Anaerobe May 2024This paper reports a case of Bacteroides fragilis induced spondylitis. Diagnosis was confirmed through blood culture and metagenomic sequencing of pus for pathogen...
This paper reports a case of Bacteroides fragilis induced spondylitis. Diagnosis was confirmed through blood culture and metagenomic sequencing of pus for pathogen detection. Due to persistent lumbar pain, surgical intervention became imperative, resulting in favorable postoperative outcomes. A detailed patient history revealed a severe episode of oral ulceration two weeks before symptom onset, although a direct link to the infection remained elusive. Leveraging insights from this case, we conducted a comprehensive literature review on B. fragilis spondylitis, elucidating clinical manifestations, diagnostic methodologies, and therapeutic strategies.
PubMed: 38718918
DOI: 10.1016/j.anaerobe.2024.102863 -
Frontiers in Pharmacology 2024Recurrent aphthous ulcer (RAU) had high prevalence and lacked widely recognized treatment. Total glucosides of paeony (TGP) was used in the treatment of RAU in recent...
Recurrent aphthous ulcer (RAU) had high prevalence and lacked widely recognized treatment. Total glucosides of paeony (TGP) was used in the treatment of RAU in recent years. This study was to summarize the efficacy and safety of TGP in the treatment of RAU. We searched eight commonly used databases for relevant studies that published before 1 November 2023. Primary outcome was visual analogue scale (VAS). Secondary outcomes included overall response rate, significant response rate, ulcer healing time, interval, number of ulcers, and serum inflammatory factors. We conducted the meta-analysis, assessed risk of bias and the confidence of the evidence, by using Stata 15.0, Review Manager 5.4, and Gradepro. Nine randomized controlled trials (RCTs) encompassing 883 patients with RAU were included in the final analysis. The VAS in the TGP group was lower than that in the control group ( = -1.18, = -1.58 to -0.78, < 0.001, moderate-certainty evidence), subgroup analysis suggested longer (>8 weeks) medication and observation led to a more significant reduction in pain ( = 0.02). Moreover, TGP had higher overall response rate ( = 1.18, = 1.04 to 1.33, = 0.008, very low-certainty evidence) and significant response rate ( = 1.72, = 1.38 to 2.14, < 0.001, very low-certainty evidence), accelerated ulcer healing ( = -1.79, = -2.67 to -0.91, < 0.001, low-certainty evidence), and extended intervals ( = 23.60, = 14.17 to 33.03, < 0.001, very low-certainty evidence). The efficacy of TGP in reducing the number of ulcers showed no significant difference compared to the control group ( = -1.66, = -3.60 to 0.28, = 0.09, low-certainty evidence). Moreover, TGP treatment was associated with a higher incidence of abdominal symptoms ( = 3.27, = 1.62 to 6.60, < 0.001). TGP appears to hold promise as a widely-used clinical therapeutic option for treating RAU. Nevertheless, further rigorous studies of high quality are required to validate its effectiveness. : https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=471154, Identifier CRD42023471154.
PubMed: 38716235
DOI: 10.3389/fphar.2024.1378782 -
BMC Oral Health May 2024Oral traumatic ulcerative lesions (OTUL) are commonly encountered in clinical practice, yet there is limited research on their clinical characteristics and traumatic...
BACKGROUND
Oral traumatic ulcerative lesions (OTUL) are commonly encountered in clinical practice, yet there is limited research on their clinical characteristics and traumatic etiological factors. This retrospective study aimed to analyze the age, gender, clinical characteristics, and traumatic etiological factors in a large cohort of patients with OTUL and provide valuable insights for dental clinicians to optimize patient care and prevention strategies.
METHODS
A total of 1543 patients with OTUL were enrolled in this study. Age, gender, medical history, clinical characteristics and traumatic etiological factors were collected and analyzed. Logistic regression analysis was performed to determine the significance of age and gender as factors related to OTUL.
RESULTS
The study revealed significant variations in clinical characteristics and traumatic etiological factors among different age groups and between genders. Logistic regression analysis demonstrated that both age and gender were significant factors related to OTUL.
CONCLUSION
The clinical characteristics of OTUL and traumatic etiological factors appear to be significantly different according to age and gender. More targeted prevention strategies should be implemented for all age and gender groups.
Topics: Humans; Male; Female; Retrospective Studies; Adult; Sex Factors; Middle Aged; Age Factors; Oral Ulcer; Adolescent; Young Adult; Aged; Child; Child, Preschool; Risk Factors; Aged, 80 and over
PubMed: 38715009
DOI: 10.1186/s12903-024-04312-8 -
AME Case Reports 2024The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019 caused the global pandemic. Oral and dermatological manifestations of...
BACKGROUND
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) at the end of 2019 caused the global pandemic. Oral and dermatological manifestations of coronavirus disease 2019 (COVID-19) such as xerostomia, aphthous-like lesions, ulcers, tongue depapillation, necrotizing gingivitis, and taste disorders, including the loss of taste and salivary gland infections are being reported. This study aims to describe a case of oral ulcers following COVID-19 infection.
CASE DESCRIPTION
We present the case of a 95-year-old male patient hospitalized in follow-up care and rehabilitation unit, of Minimes Geriatric Clinic, Toulouse, France. He had an alteration in his general health in the context of COVID-19 infection detected by reverse transcription polymerase chain reaction (RT-PCR). Six days after the admission, the patient complained of a strong burning sensation of the mouth, especially on the tongue and the lips' mucosa. Intraoral examination revealed painful erosive areas on the lateral edges of the tongue and the mucous side of the lower lip. The proposed treatment to reduce the burning sensation was based on general analgesics (morphine sulfate), mouthwash with sodium bicarbonate, the application of a lidocaine-based oral anesthetic and healing gel and a comfort-oriented diet. Thirteen days later, the patient reported a gradual improvement.
CONCLUSIONS
A diverse range of oral manifestations has been observed in patients with a history of COVID-19 infection. These oral ulcers significantly impact the quality of life of the individual, causing intense pain, stress, and difficulties in eating, with repercussions on nutritional status, especially in older individuals. Our case underscores the importance of oral examinations and the role of dentists in the management of patients with SARS-CoV-2.
PubMed: 38711897
DOI: 10.21037/acr-23-158 -
Nan Fang Yi Ke Da Xue Xue Bao = Journal... Apr 2024To investigate the therapeutic effect of seed shell extract on oral ulcer in rats and its underlying mechanism.
OBJECTIVE
To investigate the therapeutic effect of seed shell extract on oral ulcer in rats and its underlying mechanism.
METHODS
The contents of polyphenols and flavonoids in seed shells were determined by Folin-phenol assay and aluminum nitrate colorimetry, respectively. DPPH·, ABTS·, ·OH and·O scavenging experiments were performed to evaluate the antioxidant activities of seed shell extract . In a rat model of oral ulcer induced by burning with glacial acetic acid, the therapeutic effect of seed shell extract was assessed by detecting changes in serum levels of oxidative factors by enzyme-linked immunosorbent assay (ELISA) and observing pathological changes of the ulcerous mucosa using HE staining; the therapeutic mechanism of the extract was explored by detecting the expression levels of Keap1, Nrf2, Nes-Nrf2 and HO-1 proteins in ulcerous mucosa using Western blotting.
RESULTS
The ethyl acetate extract of seed shells contained 306.74±1.04 mg/g polyphenols and 23.43±0.61 mg/g flavonoids and had IC values for scavenging DPPH· and ABTS· free radicals of 3.42 ± 0.97 μg/mL and 3.32 ± 0.90 μg/mL, respectively. In the rat models, the ethyl acetate extract significantly ameliorated oral mucosal ulcer, increased serum CAT level, and decreased serum MDA level. The protein expression levels of Nes-Nrf2 and HO-1 were increased and Keap1 protein expression was lowered significantly in the ulcerous mucosa of the rats after treatment with the extract (<0.05 or 0.01).
CONCLUSION
The therapeutic effect of seed shell extract on oral ulcers in rats is mediated probably by activation of the Keap1/Nrf2/HO-1 signaling pathway.
Topics: Animals; Rats; Seeds; Antioxidants; Plant Extracts; Oral Ulcer; NF-E2-Related Factor 2; Flavonoids; Kelch-Like ECH-Associated Protein 1; Male; Polyphenols; Nymphaeaceae
PubMed: 38708514
DOI: 10.12122/j.issn.1673-4254.2024.04.22 -
Biomedicine & Pharmacotherapy =... Jun 2024To improve the biological and toxicological properties of Mefenamic acid (MA), the galactosylated prodrug of MA named MefeGAL was included in polymeric solid dispersions...
OBJECTIVE
To improve the biological and toxicological properties of Mefenamic acid (MA), the galactosylated prodrug of MA named MefeGAL was included in polymeric solid dispersions (PSs) composed of poly(glycerol adipate) (PGA) and Pluronic® F68 (MefeGAL-PS). MefeGAL-PS was compared with polymeric solid formulations of MA (MA-PS) or a mixture of equal ratio of MefeGAL/MA (Mix-PS).
METHODS
The in vitro and in vivo pharmacological and toxicological profiles of PSs have been investigated. In detail, we evaluated the anti-inflammatory (carrageenan-induced paw edema test), analgesic (acetic acid-induced writhing test) and ulcerogenic activity in mice after oral treatment. Additionally, the antiproliferative activity of PSs was assessed on in vitro models of colorectal and non-small cell lung cancer.
RESULTS
When the PSs were resuspended in water, MefeGAL's, MA's and their mixture's apparent solubilities improved due to the interaction with the polymeric formulation. By comparing the in-vivo biological performance of MefeGAL-PS with that of MA, MefeGAL and MA-PS, it was seen that MefeGAL-PS exhibited the same sustained and delayed analgesic and anti-inflammatory profile as MefeGAL but did not cause gastrointestinal irritation. The pharmacological effect of Mix-PS was present from the first hours after administration, lasting about 44 hours with only slight gastric mucosa irritation. In-vitro evaluation indicated that Mix-PS had statistically significant higher cytotoxicity than MA-PS and MefeGAL-PS.
CONCLUSIONS
These preliminary data are promising evidence that the galactosylated prodrug approach in tandem with a polymer-drug solid dispersion formulation strategy could represent a new drug delivery route to improve the solubility and biological activity of NSAIDs.
Topics: Animals; Mefenamic Acid; Mice; Drug Delivery Systems; Humans; Male; Edema; Anti-Inflammatory Agents; Prodrugs; Analgesics; Cell Proliferation; Anti-Inflammatory Agents, Non-Steroidal; Stomach Ulcer; Poloxamer
PubMed: 38703503
DOI: 10.1016/j.biopha.2024.116647 -
Avicenna Journal of Medicine Jan 2024The incidence of ulcer pressure in the high care unit (HCU) was relatively high and could be reliably predicted using tools such as the Norton and Jackson/Cubbin...
The incidence of ulcer pressure in the high care unit (HCU) was relatively high and could be reliably predicted using tools such as the Norton and Jackson/Cubbin scales. However, other risk factors, such as age, gender, consciousness, systemic condition, duration of treatment, and use of restraint, may contribute to the occurrence of ulcer pressure. This study was conducted to analyze the relationship of various risk factors for pressure ulcers and prediction of ulcer pressure, using Norton and Jackson/Cubbin scale, to incident pressure ulcers in HCU patient. This study utilized a prospective cross-sectional study design to analyze various risk factors for ulcer pressure development in a patient admitted to the HCU, including age, gender, blood profile, consciousness, duration of treatment, and use of restraint. The Norton and Jackson/Cubbin scale was employed to predict pressure ulcers. The relationship between the risk factors and the prediction of pressure ulcer incidents was evaluated using multiple logistic binary regression analysis. Both the Norton and Jackson/Cubbin scales predicted a lower risk of pressure ulcer development (60.98 and 99.02%, respectively). This prediction is consistent with the low incidence of pressure injuries found, which is only 4.39%. Furthermore, the relationship between the identified risk factor (gender, duration of treatment in HCU and use of restraint) and the prediction and incident of pressure ulcer was not significant ( > 0.05). Thus, it is suggested that these risk factors may not strong predictors of pressure ulcer development. This study's result indicated no significant relationship exists between possible identified risk factors and the development of pressure ulcers in HCU patients. However, the Norton and Jackson/Cubbin scales were reliable predictors of pressure ulcer occurrence, with both scales predicting a lower risk of pressure ulcer development.
PubMed: 38694142
DOI: 10.1055/s-0043-1777420 -
Fitoterapia Jul 2024Anogeissus leiocarpus (DC.) Guill. & Perr. belongs to the family Combretaceae and is used both by African traditional medical practitioners and livestock rearers to... (Review)
Review
Anogeissus leiocarpus (DC.) Guill. & Perr. belongs to the family Combretaceae and is used both by African traditional medical practitioners and livestock rearers to treat diseases such as African trypanosomiasis, animal diarrhoea, asthma, cancer, cough, diabetes, dysentery, erectile dysfunction, fever, giardiasis, helminthiases, meningitis, menstrual disorders, monkeypox, oral infections, poliomyelitis, sickle cell anaemia, snake bites, toothache, urinary schistosomiasis, and yellow fever. Some of these activities have been associated with the presence of polyphenols in the plant which include ellagic acid derivatives, flavonoids, stilbenes, tannins, and triterpenes. Several bioactive molecules have been identified from A. leiocarpus. These include the main active constituents, ellagitannins, ellagic acid derivates, flavonoids and triterpenes. Pharmacological studies have confirmed its antibacterial, antifungal, antihyperglycemic, antihypertensive, antimalarial, antioxidative, antiparasitic, antitumour and anti-ulcer effects. The stem bark has been investigated mainly for biological activities and phytochemistry, and it is the most mentioned plant part highlighted by the traditional users in ethnomedicinal surveys. In vitro and in vivo models, which revealed a wide range of pharmacological actions against parasites causing helminthiasis, leishmaniasis, malaria and trypanosomiasis, have been used to study compounds from A. leiocarpus. Because of its uses in African traditional medicine and veterinary practices, A. leiocarpus has received considerable attention from researchers. The current review provides a comprehensive overview and critical appraisal of scientific reports on A. leiocarpus, covering its traditional uses, pharmacological activities and phytochemistry.
Topics: Phytochemicals; Medicine, African Traditional; Combretaceae; Humans; Plant Extracts; Animals; Plant Bark
PubMed: 38692415
DOI: 10.1016/j.fitote.2024.105979