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Ethnopharmacological Relevance: Santolina species are widely used in traditional medicine in the Mediterranean region for their anti-inflammatory, antimicrobial, antispasmodic, digestive, and analgesic properties. S. impressa, a Portuguese endemism, is traditionally recognized for its beneficial anti-inflammatory properties in several gastrointestinal affections and is also used in oropharyngeal infections., Aim of the Study: The present study aims to characterize the essential oil of S. impressa growing in Portugal and validate its traditional uses by assessing the anti-inflammatory potential of its essential oil at concentrations without toxicity. The antifungal properties of the oil are also addressed, as well as, the putative mechanism of action underlying these effects., Material and Methods: The essential oil was obtained in accordance with the European Pharmacopoeia and characterized by GC and GC-MS. The anti-inflammatory potential of the oil was assessed on LPS-stimulated macrophages, through the production of nitric oxide (NO) using the Griess reaction. Putative mechanisms of action included the role of the oil as a NO scavenger, as well as its effect on the expression of two key pro-inflammatory enzymes, iNOS and COX-2 by Western blot analysis. The antifungal effect of the oil was evaluated according to the CLSI guidelines on several yeast and filamentous strains and on two major virulence factors in Candida albicans, namely germ tubes and biofilms. Ultrastructural modifications on dermatophytes were also unveiled by transmission electron microscopy., Results: S. impressa essential oil was primarily characterized by the presence of monoterpene hydrocarbons and oxygenated monoterpenes, being the main compounds β-pinene (22.5%), 1,8-cineole (10.0%), limonene (9.1%), camphor (8.1%) and β-phellandrene (8.0%). A significant decrease (ca 60.0%) in nitrite levels was observed in LPS-stimulated macrophages treated with the oil without affecting cell viability. This effect could be explained by a great reduction on iNOS expression (85.0% inhibition), thus underpinning the anti-inflammatory potential of the oil. The oil also showed a fungicidal effect, being more active against Cryptococcus neoformans, Epidermophyton floccosum and Trichophytum rubrum. For these dermatophytes, significant ultrastructural modifications in cell wall structure were detected. Strikingly, for C. albicans, the oil showed a significant anti-infective potential (at 0.07 mg/mL for germ tube inhibition and 0.02 mg/mL for biofilm disruption) before fungal growth inhibition occurred., Conclusions: Our results validate the main traditional use ascribed to S. impressa, namely its anti-inflammatory effect. In addition, an antifungal potential is pointed out, thus corroborating the antimicrobial uses and adding new value to an endemic species poorly recognized by the industry., (Copyright © 2019 Elsevier B.V. All rights reserved.)

This study was designed to evaluate the antifungal activity of Foeniculum vulgare essential oil; concomitantly, the safety of bioactive doses was also unveiled, for the first time, in several mammalian cells. The chemical characterisation was made by GC and GC-MS. Antifungal activity was evaluated against yeasts, dermatophytes and Aspergillus strains and germ tube inhibition assay was evaluated using Candida albicans. Cell viability was assessed by the MTT assay. The main constituents of the oil are E-anetol (47%), α-phellandrene (11%), α-pinene (10.1%) and fenchone (10.8%). The oil was more active against Cryptococcus neoformans and C. albicans (MICs 0.32-0.64 μL/mL) and the filamentation of C. albicans was totally inhibited with 0.08 μL/mL. The oil is safe for keratinocytes, hepatocytes and fibroblasts in concentrations up to 1.25 μL/mL, and to macrophages up to 0.64 μL/mL. These findings highlight safe bioactive concentrations that should be deeper investigated for further application in pharmaceutical industry.

Objective: To provide evidence-based guidance for the rational and safe prescription of biological therapies in children and adolescents with juvenile idiopathic arthritis (JIAs) considering the latest available evidence and the new licensed biologics., Methods: Rheumatologists and Pediatricians with expertise in Pediatric Rheumatology updated the recommendations endorsed by the Portuguese Society of Rheumatology and the Portuguese Society of Pediatrics based on published evidence and expert opinion. The level of agreement with final propositions was voted using an online survey., Results: In total, 20 recommendations to guide the use of biological therapy in children and adolescents with JIAs are issued, comprising 4 general principles and 16 specific recommendations. A consensus was achieved regarding the eligibility and response criteria, maintenance of biological therapy, and procedures in case of non-response, for each JIA category. Specific recommendations concerning safety procedures were also updated., Conclusions: These recommendations take into account the specificities of each JIA category and are intended to continuously improve the management of JIA patients.

Background: Although the survival rate has considerably improved, many patients with systemic lupus erythematosus (SLE) develop irreversible organ damage., Objectives: The objectives of this paper are to characterize cumulative damage in SLE patients and identify variables associated with its presence and severity., Methods: A cross-sectional analysis of SLE patients from the Portuguese Lupus register Reuma.pt/SLE in whom damage assessment using the SLICC/ACR-Disability Index (SDI) was available was performed. Predictor factors for damage, defined as SDI ≥ 1, were determined by logistic regression analyses. A sub-analysis of patients with severe damage (SDI ≥ 3) was also performed., Results: In total, 976 patients were included. SDI was ≥1 in 365 patients, of whom 89 had severe damage. Musculoskeletal (24.4%), neuropsychiatric (24.1%) and ocular (17.2%) domains were the most commonly affected. Older age, longer disease duration, renal involvement, presence of antiphospholipid antibodies and current therapy with steroids were independently associated with SDI ≥ 1. The subpopulation with severe damage had, in addition, a greater interval between the first manifestation attributable to SLE and the clinical diagnosis as well as and more frequently early retirement due to SLE., Conclusions: This large lupus cohort confirmed that demographic and clinical characteristics as well as medication are independently associated with damage. Additionally, premature retirement occurs more often in patients with SDI ≥ 3. Diagnosis delay might contribute to damage accrual., (© The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.)

This study evaluates the antifungal activity and mechanism of action of a new chemotype of Lavandula multifida from Portugal. The essential oil was analyzed by gas chromatography (GC) and gas chromatography/mass spectrometry (GC/MS), and the minimal inhibitory concentration (MIC) and minimal lethal concentration (MLC) of the oil and its major compounds were determined against several pathogenic fungi responsible for candidosis, meningitis, dermatophytosis, and aspergillosis. The influence of the oil on the dimorphic transition in Candida albicans was also studied, as well as propidium iodide (PI) and FUN-1 staining of C. albicans cells by flow cytometry. The essential oil was characterized by high contents of monoterpenes, with carvacrol and cis-β-ocimene being the main constituents. The oil was more effective against dermatophytes and Cryptococcus neoformans, with MIC and MLC values of 0.16 μL/mL and 0.32 μL/mL, respectively. The oil was further shown to completely inhibit filamentation in C. albicans at concentrations below the respective MIC (0.08 μL/mL), with cis-β-ocimene being the main compound responsible for this inhibition (0.02 μL/mL). The flow cytometry results suggest a mechanism of action ultimately leading to cytoplasmic membrane disruption and cell death. L. multifida essential oil may be useful in complementary therapy to treat disseminated candidosis, since the inhibition of filamentation alone appears to be sufficient to treat this type of infection.

The essential oils and supercritical CO₂ extracts of wild Smyrnium olusatrum L. growing in Sardinia (Italy) and in Portugal were investigated. For the study, oils were isolated from total plant aerial part (umbels containing seeds). The content of β-phellandrene (67.3% vs. 42.7%) and α-pinene (31.9% vs. 1.2%), respectively, the main components of Portuguese and Italian essential oils, declined during the maturation stage of the umbels. Contrarily, some other important components, particularly curzerene, germacrene B, germacrone, alexandrofuran, 1-β-acetoxyfurano-4(15)-eudesmene and 1-β-acetoxyfurano-3-eudesmene, increased in fruiting umbels. The chemical composition of the Sardinian oil is rather different from those of other origin. The composition of the supercritical extracts and the essential oils is markedly different, particularly due to the high amount of furanosesquiterpenoids in the supercritical fluid extraction. The minimal inhibitory concentration (MIC) and the minimal lethal concentration were used to evaluate the antifungal activity of the oils against Candida albicans, Candida tropicalis, Candida krusei, Candida guillermondii, Candida parapsilosis, Cryptococcus neoformans, Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis, Microsporum gypseum, Epidermophyton floccosum, Aspergillus niger, Aspergillus fumigatus and Aspergillus flavus. The oils were particularly active against dermatophyte strains and C. neoformans, with MIC values in the range of 0.32-0.64 µL mL⁻¹.

Aerial parts of wild Calamintha nepeta (L.) Savi subsp. nepeta growing spontaneously on the Mediterranean coast (Sardinia Island, Italy) and on the Atlantic coast (Portugal) were used as a matrix for the supercritical extraction of volatile oil with CO(2). The collected extracts were analysed by GC-FID and GC-MS methods and their compositions were compared with that of the essential oil isolated by hydrodistillation, but the differences were not relevant. A strong chemical variability was observed in the essential oils depending on the origin of the samples. The results showed the presence of two chemotypes of C. nepeta. In all Italian samples, pulegone, piperitenone oxide and piperitenone were the main components (64.4-39.9%; 2.5-19.1%; 6.4-7.7%); conversely, the oil extracted from Portuguese C. nepeta is predominantly composed of isomenthone (35.8-51.3%), 1,8-cineole (21.1-21.4%) and trans-isopulegone (7.8-6.0%). The minimal inhibitory concentration (MIC) and the minimal lethal concentration (MLC) were used to evaluate the antifungal activity of the oils against Candida albicans, Candida tropicalis, Candida krusei, Candida guillermondii, Candida parapsilosis, Cryptococcus neoformans, Trichophyton rubrum, Trichophyton mentagrophytes, Microsporum canis, Microsporum gypseum, Epidermophyton floccosum, Aspergillus niger, Aspergillus fumigatus and Aspergillus flavus. The Italian oil, rich in pulegone, exhibited significant antifungal activity against Aspergillus and dermatophyte strains, with MIC values of 0.32-1.25 µL mL(-1).

The chemical composition of the essential oils obtained by hydrodistillation from the aerial parts of Mentha cervina collected during the flowering and vegetative phases of the plants were investigated by GC and GC-MS. Quantitative differences were observed in the compositions, particularly in the amounts of pulegone (12.9-79.6%) and isomenthone (8.7-77.0%). Antifungal activity of the oils was evaluated by minimal inhibitory concentrations (MIC) and minimal lethal concentrations (MLC) against Candida, Apergillus and dermatophyte strains. Antifungal activity of the sample containing lower amounts of pulegone was the highest for dermatophytes, particularly for Epidermophyton floccosum with MIC and MLC values of 0.63 microL mL( - 1). Mentha cervina oils with low content of pulegone, may be an alternative as antifungal agents in dermatophytosis.

Some considerations are made about current child psychiatry research and its future challenge. We analyse some studies about parental psychopathological influence in the early relationship, mentioning obstacles and advantages of some clinical and epidemiological research methods. We emphasize the value of interaction, observation and the use of videoscopy in infant clinical research. In Portugal, the lack of motivation to work in mental health research is an impediment to establishing clinical and training priorities.