Eficacia del apósito de gluconato de clorhexidina sobre las infecciones relacionadas con el catéter de hemodiálisis / Efficacy of Chlorhexidine Gluconate Dressing on Catheter-Related Infections in Hemodialysis

Introducción: El uso de catéteres venosos centrales para hemodiálisis se relaciona con un mayor desarrollo de complicaciones infecciosas, por lo que las Guías de Práctica Clínica recomiendan diferentes estrategias para disminuir dichas complicaciones, sin indicación clara sobre el apósito a utilizar en la cura del orificio de salida. Objetivo: Comparar la tasa de infecciones relacionadas con el catéter de dos pautas de cura del orificio de salida del catéter venoso central de hemodiálisis: apósito con gluconato de clorhexidina al 2% frente a clorhexidina en solución al 2%, cubierta con apósito de poliuretano semipermeable autoadhesivo. Material y Método: Estudio experimental, controlado, aleatorizado en pacientes en hemodiálisis a través de catéter venoso central para comparar dos pautas de cura, grupo control: clorhexidina en solución al 2% cubierta con apósito de poliuretano semipermeable autoadhesivo y grupo intervención: apósito con gluconato de clorhexidina al 2%. Se recogieron datos socioclínicos y relacionados con las complicaciones infecciosas. Se realizó un análisis descriptivo e inferencial.. Resultados: Se estudiaron 50 pacientes, 25 en cada grupo. El grupo intervención presentó dos infecciones del orificio de salida y el grupo control, presentó doce casos (OR: 0,176, IC 95%: 0,039-0,790; p=0,013). El grupo intervención presentó un caso de bacteriemia frente a dos episodios del grupo control (OR: 0,533, IC 95%: 0,048-5,892; p=ns). Conclusión: La cura con apósito con gluconato de clorhexidina al 2% es una medida protectora frente a la infección del orificio de salida en comparación con la cura con clorhexidina en solución al 2% y apósito de poliuretano. (AU)

Introduction: The use of central venous catheters for hemodialysis is associated with a higher incidence of infectious complications, leading Clinical Practice Guidelines to recommend various strategies to reduce such complications, with no clear indication of the dressing to use for catheter exit site care. Objectives: To compare the infection rate related to the catheter exit site using two different protocols: dressing with 2% chlorhexidine gluconate versus 2% chlorhexidine solution, both covered with self-adhesive semi-permeable polyurethane dressing for central venous catheters used in hemodialysis. Material and Method: An experimental, controlled, randomized study was conducted in hemodialysis patients with central venous catheters to compare two care protocols. The control group received a 2% chlorhexidine solution covered with a self-adhesive semi-permeable polyurethane dressing, while the intervention group received a dressing with 2% chlorhexidine gluconate. Socio-clinical and infection-related data were collected, and descriptive and inferential analyses were performed. Results: A total of 50 patients were studied, with 25 in each group. The intervention group had two exit site infections, while the control group had twelve cases (OR: 0.176, 95% CI: 0.039-0.790; p=0.013). The intervention group had one case of bacteremia compared to two cases in the control group (OR: 0.533, 95% CI: 0.048-5.892; p=ns). Conclusion: Dressing with 2% chlorhexidine gluconate is a protective measure against exit site infection compared to dressing with 2% chlorhexidine solution and polyurethane dressing. (AU)

Effect of zinc on oropharyngeal mucositis in children with acute leukemia undergoing chemotherapy

BACKGROUND: Oropharyngeal mucositis (OM) is one of the main side-effects of oncological therapy. There is no treatment to prevent its occurrence, but some zinc-based therapies have been proven to help in decreasing its in-tensity. The objective of this study was to determine the effect of zinc in OM in children with acute leukemia in the early stages of oncological treatment. MATERIAL AND METHODS: This quasi-experimental study evaluated OM in 2 groups (control group: conventional hospital management, and experimental group: administration of 50 mg of zinc gluconate daily plus conventional hospital management). OM severity was recorded at a two-month follow-up. RESULTS: Forty-nine patients (26 in the control group and 23 in the experimental group) were included. The mean age of the patients was 11.1 ± 2.7 years; 65.3% had a diagnosis of pre-B acute lymphoblastic leukemia. The incidences of OM in the control group and the experimental group were 46.2% and 26.1%, respectively, but the difference was not significant. Based on a negative binomial regression model, females had, on average, 1.5 more days with OM (p = 0.002), and patients assigned to the experimental group had, on average, 2 less days with OM than the control group (p = 0.001). The pain score was higher in the control group (p = 0.0009), as was the mean score on the WHO scale (p = 0.0012). CONCLUSIONS: Zinc facilitated a reduction in the severity and duration of OM; further studies focusing on children are needed to confirm the effects of this trace element

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Effect of zinc supplementation on superoxide dismutase activity in patients with ulcerative rectocolitis / Efecto de la suplementación de zinc sobre la actividad de la enzima superóxido dismutasa (SOD) en pacientes con colitis ulcerosa

Introduction: Ulcerative rectocolitis is characterized by diffuse mucosal inflammation and oxidative stress. Thus, the organism activates the antioxidant defence system in an attempt to reduce the excessive production of reactive oxygen species or neutralize them. Objective: This study evaluated the effect of zinc supplementation on the activity of the enzyme superoxide dismutase (SOD) in patients with ulcerative rectocolitis. Methods: The study included 24 patients, aged between 20 and 59 years and diagnosed with ulcerative rectocolitis, in the remission stage of the disease, who were divided into two groups: experimental - deficient in zinc (n=12) and control - normal or high zinc (n=12). Only the first group underwent supplement intervention, in the form of zinc gluconate (30 mg Zn/day), taken daily in the morning, fasted for 60 days. Plasma and erythrocyte zinc concentrations were determined by flame atomic absorption spectrophotometer. The erythrocyte SOD activity was determined in vitro according to the methodology recommended by the manufacturer Randox. Results and Discussion: Zinc supplementation caused a significant increase in the plasma concentrations of the mineral, and showed a significant reduction in erythrocyte zinc, remaining within normal limits. The SOD activity was high in patients of both the experimental and control groups, with no difference after supplementation. Conclusion: This study demonstrates that zinc supplementation improves the homeostatic condition of the mineral, with no change in SOD activity, as a marker of oxidative stress in patients with ulcerative rectocolitis (AU)

Introducción: La colitis ulcerosa se caracteriza por la inflamación difusa de la mucosa y el estrés oxidativo. De esta forma, el cuerpo activa el sistema de defensa antioxidante en un intento de reducir la producción excesiva de especies reactivas de oxígeno, así como poder neutralizarlos. Objetivo: Este estudio evaluó el efecto de la suplementación de zinc sobre la actividad de la enzima superóxido dismutasa en pacientes con colitis ulcerosa. Métodos: El estudio incluyó 24 pacientes, con edades comprendidas entre 20 y 59 años y con diagnóstico de colitis ulcerosa en fase de remisión de la enfermedad. Los pacientes fueron divididos en dos grupos: experimental - deficiencia de zinc (n = 12) y control - normales o con altos contenido de zinc (n = 12). El grupo experimental se sometió a tratamiento con suplemento de drogas, en forma de gluconato de zinc (30 mg Zn / día), administrada diariamente por la mañana en ayunas durante 60 días. Las concentraciones en plasma y los eritrocitos de zinc se determinaron por espectrofotometría de absorción atómica de llama. La actividad de la superóxido dismutasa (SOD) se determinó por el método de eritrocitos in vitro utilizando el kit de Randox. Resultados y Discusión: La suplementación de zinc causó un aumento significativo en las concentraciones plasmáticas de mineral y mostró una reducción significativa en los eritrocitos, permaneciendo dentro de los límites normales. La actividad de SOD fue mayor en los pacientes de los grupos experimentales y de control, sin diferencias después de la suplementación. Conclusión: El estudio evidenció que la administración de suplementos de zinc mejora la condición homeostática del mineral, sin ningún cambio en la actividad de SOD, como un marcador de estrés oxidativo en pacientes con colitis ulcerosa (AU)