Clinical and Laboratory Substantiation of Improvement of the Treatment Method of Boils and Carbuncles of Maxillofacial Area

Selection of medications to apply locally for treatment of abscessive forms of boils and carbuncles of maxillofacial area still remains a debatable issue, despite their wide range. Alternative means for application use in surgical interventions in maxillofacial area are medications of natural origin. Drugs of natural origin that have anesthetic and anti-inflammatory properties include cayenne pepper fruits (Capsicum annuum). Therapeutic properties are caused by the presence in their structure of the main active ingredient – capsaicin alkaloid and other biologically active compounds (vitamins, flavonoids, minerals, etc.) which influence the main pathogenetic inflammation bonds. Capsaicin has a distinct keratoplastic effect and normalizes microcirculation in the tissues. Phytogel with anti-inflammatory and anesthetic action (patent for utility model No. 30032 “Phytogel with anti-inflammatory and anesthetic action”) was developed for clinical use based on phytosubstance of pepper cayenne fruits (patent for utility model No. 19547 “Method of obtaining phytosubstance with anti-inflammatory action”). The purpose of the study was to increase treatment efficiency of boils and carbuncles of maxillofacial area by using a medication based on the capsicum annuum fruits. Materials and methods. The analysis of inspection and treatment results of 45 patients having boils and carbuncles of maxillofacial area at abscessing stage is carried out. On the first, third, seventh and tenth day of treatment, a number of clinical indicators (presence and intensity of edema and infiltrate, condition of regional lymph nodes, presence and intensity of pain in the inflammation site, time of wound exudate clearance, intensity of regeneration, length of hospital stay treatment) and indicators obtained by laboratory methods (total number of leukocytes, leukocyte intoxication index, erythrocyte sedimentation rate) were studied and compared with the same parameters in the control group, where traditional treatment was carried out; and when using the comparison medication - 3% propolis ointment. Results and discussion. Analysis of the results showed that despite the similarity of the clinical picture and laboratory parameters on admission to the hospital, the healing of purulent wounds under the influence of capsicum annuum phytogel was more effective comparing with traditional methods of surgical treatment. Thus, wound epithelialization of patients in the experimental group No. 1 was observed on average on the seventh day, which was significantly faster than in other experimental groups. Sanation of the inflammatory focus also decreased body intoxication, which can be traced by the dynamics of changes in the degree of leukocytosis, leukocyte intoxication index, erythrocyte sedimentation rate. On the tenth day, the clinical blood parameters of patients of the experimental group No. 1 were close to the average norm. As a result, the length of stay in hospital was significantly reduced. The average bed-day for the experimental group No. 1 was 7.5 days, which is authentically less than for patients of the control and experimental group No. 2. Conclusion. According to the results of clinical and laboratory studies, the efficiency of the proposed method has been proved in comparison with traditional treatment of boils and carbuncles of maxillofacial area

Eugenol and Lippia Alba Essential Oils as Effective Anesthetics for the Amazonian Freshwater Stingray Potamotrygon Wallacei (Chondrichthyes, Potamotrygonidae)

This study assessed the potential of eugenol and the essential oil of Lippia alba (EOLA) in providing suitable anesthetic induction and recovery times, and their consequent effects on the blood and respiratory physiology, as well as the gill architecture of an Amazonian freshwater stingray, Potamotrygon wallacei, at the onset of the anesthetic event and after 48 h of recovery. Juveniles of P. wallacei (n = 12) were exposed to increasing concentrations of eugenol (75, 100, 125 and 150 µL L− 1) and EOLA (150, 175, 200 and 225 µL L− 1) in an immersion bath. Anesthetic induction was found to be faster with the use of eugenol compared to EOLA. On the other hand, the stingrays anesthetized with eugenol displayed a longer recovery time than those exposed to EOLA. The highest concentrations of eugenol caused moderate to severe histological changes in the gills. No significant changes were found for hematocrit and plasma metabolites in the stingrays anesthetized with all concentrations of both eugenol and EOLA just after the onset of anesthetic action, when compared to those recovered after 48 hours. Investigations regarding the potential use of these natural anesthetics are unprecedented for freshwater stingray species and 200 µL L− 1 EOLA is recommended as the most suitable anesthetic for use in juveniles of P. wallacei.

Improvement of Butamben Anesthetic Efficacy by the Development of Deformable Liposomes Bearing the Drug as Cyclodextrin Complex

This work was aimed at enhancing butamben (BTB) anesthetic efficacy by the “drug-in cyclodextrin (CD)-in deformable liposomes” strategy. In the study, phase-solubility studies with natural (α-, β-, γ-) and derivative (hydroxypropyl-α-and β-, sulfobutylether-β, methyl-β) CDs evidenced the highest BTB affinity for βCD and its derivatives and indicated methyl-βCD (RAMEB) as the best carrier. Drug-RAMEB complexes were prepared by different techniques and were characterized for solid-state and dissolution properties. The best BTB–RAMEB product was chosen for entrapment in the aqueous core of deformable liposomes containing stearylamine, either alone or with sodium cholate, as edge activators. Double-loaded (DL) liposomes, bearing the lipophilic drug (0.5% w/v) in the bilayer and its hydrophilic RAMEB complex (0.5% w/v) in the aqueous core, were compared to single-loaded (SL) liposomes bearing 1% w/v plain drug in the bilayer. All vesicles showed homogeneous dimensions (i.e., below 300 nm), high deformability, and excellent entrapment efficiency. DL-liposomes were more effective than SL ones in limiting drug leakage (<5% vs. >10% after a 3 months storage at 4 °C). In vivo experiments in rabbits proved that all liposomal formulations significantly (p < 0.05) increased the intensity and duration of drug anesthetic action compared to its hydroalcoholic solution; however, DL liposomes were significantly (p < 0.05) more effective than SL ones in prolonging BTB anesthetic effect, owing to the presence of the drug-RAMEB complex in the vesicle core, acting as a reservoir. DL liposomes containing both edge activators were found to have the best performance.

Hydroxide ions amplified by water entanglement underly the mechanism of general anesthesia

It is believed that inhaled anesthetics occupy hydrophobic pockets within target proteins, but how inhaled anesthetics with diverse shapes and sizes fit into highly structurally selective pockets is unknown. For hydroxide ions are hydrophobic, we determined whether hydroxide ions could bridge inhaled anesthetics and protein pockets. We found that small additional load of cerebral hydroxide ions decreases anesthetic potency. Multiple-water entanglement network, derived from Ising model, has a great ability to amplify ultralow changes in the cerebral hydroxide ion concentration, and consequently, amplified hydroxide ions account for neural excitability. Molecular dynamics simulations showed that inhaled anesthetics produce anesthesia by attenuating the formation of multiple-water entanglement network. This work suggests amplified hydroxide ions underlying a unified mechanism for the anesthetic action of inhaled anesthetics.

Etomidate anesthesia in chicks: Effect of xylazine

The current study aimed to evaluate the etomidate anesthetic action, its toxicity profile and safety alone and to determine the benefit of xylazine coadministration to enhance its anesthetic duration, efficacy and to reach a state of balanced anesthesia in chicks. By using the up-and-down technique, it was found that the hypnotic Median Effective Dose (ED50) of the etomidate was 4.30 mg/kg, IM, whereas the acute Median Toxic Dose (TD50) was 17.90 mg/kg, IM in the chicks. In response, the calculated Therapeutic Index (TI) and Standard Safety Margin (SSM) indicate that the etomidate has a wide safety margin. Etomidate injection at 4, 8 and 16 mg/kg, IM yields a significant dose-response and dependent hypnosis in the chicks by evaluating the onset of the righting reflex loss, its period and regaining from it. The combination composed of etomidate and xylazine at 5 mg/kg, IM for each, reduced the onset of hypnosis and significantly distended its period besides a significant rise of the recovery time when compared with the group receiving etomidate alone. At the same time, this coadministered drugs elicited a significant raise in analgesic efficacy. Concerning plasma glucose, Alanine Transaminase (ALT) and Aspartate Transaminase (AST) concentrations, neither etomidate nor etomidate plus xylazine differ significantly from the control group. The results of this study propose the likelihood of using etomidate as an anesthetic agent for short surgical trials in the chickens that can be more effective by using xylazine to yield balanced anesthesia without causing significant side effects.

Differences between natural sleep and the anesthetic state

The anesthetic state and natural sleep share many neurobiological features and yet are two distinct states. The hallmarks of general anesthesia include hypnosis, analgesia, akinesia and anxiolysis. These are the principal parameters by which the anesthetic state differs from natural sleep. These properties are mediated by systemic administration of a combination of agents producing balanced anesthesia. The exact nature of anesthetic narcosis is dose dependent and agent specific. It exhibits a relative lack of nociceptive response and active suppression of motor and autonomic reflexes. Surgical anesthesia displays a signature electroencephalogram pattern of burst suppression that differs from rapid eye movement sleep, representing more widespread disruption of thalamocortical connectivity, impairing information integration and processing. These differences underpin successful anesthetic action. This review explores the differences between natural sleep and anesthetic-induced unconsciousness as induced by balanced anesthesia.

A vertebrate model to reveal neural substrates underlying the transitions between conscious and unconscious states

The field of neuropharmacology has not yet achieved a full understanding of how the brain transitions between states of consciousness and drug-induced unconsciousness, or anesthesia. Many small molecules are used to alter human consciousness, but the repertoire of underlying molecular targets, and thereby the genes, are incompletely understood. Here we describe a robust larval zebrafish model of anesthetic action, from sedation to general anesthesia. We use loss of movement under three different conditions, spontaneous movement, electrical stimulation or a tap, as a surrogate for sedation and general anesthesia, respectively. Using these behavioral patterns, we find that larval zebrafish respond to inhalational and IV anesthetics at concentrations similar to mammals. Additionally, known sedative drugs cause loss of spontaneous larval movement but not to the tap response. This robust, highly tractable vertebrate model can be used in the detection of genes and neural substrates involved in the transition from consciousness to unconsciousness.