Eficácia da ozonioterapia em lesões de pele em pacientes diabéticos / Efficacy of ozone therapy on skin lesions in diabetic patients / Eficacia de la ozonoterapia en lesiones cutáneas en pacientes diabéticos

Objetivo: Avaliar as principais evidências científicas acerca da eficácia da ozonioterapia em feridas diabéticas. Métodos: Foi utilizado o modelo de revisão integrativa da literatura. A coleta de dados aconteceu no mês de maio de 2021, obtendo as bases de dados: Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrievel System Online (Medline) e Índice Bibliográfico Español en Ciencias de la Salud (IBECS), ambos acessados pela Biblioteca Virtual em Saúde (BVS), onde foram selecionados nove artigos após o processo de filtragens, critérios de inclusão e exclusão. Resultados: A ozonioterapia apresenta propriedades analgésicas, antiinflamatórias, ação fungicida, bactericida e cicatrizante. Ressalta-se, ainda, os efeitos benéficos com uso do ôzonio e suas ferramentas terapéuticas eficientes para reversão do quadro agudo e/ou crônico das lesões de pele. Conclusão: Espera-se que esta pesquisa possa contribuir para uma reflexão sobre o uso da ozonioterapia em diabéticos, pois esta técnica constatou ser segura e eficaz. (AU)

Objective: To evaluate the main scientific evidence about the effectiveness of ozone therapy in diabetic wounds. Methods: The integrative literature review model was used. Data collection took place in May 2021, obtaining the following databases: Latin American and Caribbean Literature on Health Sciences (LILACS), Medical Literature Analysis and Retrievel System Online (Medline) and Bibliographic Index Español en Ciencias de la Salud (IBECS), both accessed by the Virtual Health Library (VHL), where nine articles were selected after the filtering process, inclusion and exclusion criteria. Results: Ozone therapy has analgesic, anti-inflammatory, fungicidal, bactericidal and healing properties. The beneficial effects of using ozone and its efficient therapeutic tools for reversing the acute and/or chronic condition of skin lesions should also be highlighted. Conclusions: It is hoped that this research can contribute to a reflection on the use of ozone therapy in diabetics, as this technique was found to be safe and effective. (AU)

Objetivo: Evaluar las principales evidencias científicas sobre la efectividad de la ozonoterapia en heridas diabéticas. Métodos: Se utilizó el modelo de revisión integradora de la literatura. La recolección de datos se realizó en mayo de 2021, obteniendo las siguientes bases de datos: Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Sistema de Análisis y Recuperación de Literatura Médica en Línea (Medline) e Índice Bibliográfico Español en Ciencias de la Salud (IBECS), ambos accedidos por la Biblioteca Virtual en Salud (BVS), donde se seleccionaron nueve artículos tras el proceso de filtrado, criterios de inclusión y exclusión. Resultados: La ozonoterapia tiene propiedades analgésicas, antiinflamatorias, fungicidas, bactericidas y cicatrizantes. También deben destacarse los efectos beneficiosos del uso de ozono y sus eficaces herramientas terapéuticas para revertir la condición aguda y / o crónica de las lesiones cutáneas. Conclusiones: Se espera que esta investigación pueda contribuir a una reflexión sobre el uso de la ozonoterapia en diabéticos, ya que esta técnica resultó segura y eficaz. (AU)

Is the use of ozonated oil effective in the treatment of oral lesions? Systematic review of clinical studies / ¿Es el uso del aceite ozonizado efectivo en el tratamiento de las lesiones orales? Una revisión sistemática de estudios clínicos

Abstract The aim of this study was to perform a systematic review (SR) of the therapeutic effect of ozonated oil for oral lesions treatment. A SR was conducted according to the PRISMA guidelines. The Medline (PubMed), Embase, Cochrane Library, Scielo and LILACS were investigated, together with manual searches, to extract all publications until December 2020, including randomized and non-randomized clinical trials reporting the effects of ozonated oils on the management of oral lesions when compared with other methods. The risk of bias (RoB) of the studies included were assessed by using the RoB 2 tool and ROBINS-I. After analyzing the titles and reading the abstracts, 1932 articles were excluded; the remaining 25 passed a full-text evaluation. Ultimately, 13 articles were included in this SR. There was heterogeneity of the results regarding healing times and intervals of ozonated oil application for the treatment of each type of oral lesion, but in general, there was a shorter healing time when ozonated oil was used as therapy, and no adverse effects were reported. Despite the limited information found and the lack of rigorous methodological standards for the use of ozonated oil on oral lesions, a positive effect was suggested. The findings indicated an advantage in terms of shorter healing times when compared with other conventional treatments. No adverse effects were reported, showing safety and reliability for patient's treatment.

Resumen El objetivo de este estudio fue realizar una revisión sistemática (RS) del efecto terapéutico del aceite ozonizado sobre las lesiones orales. Se realizó una RS siguiendo las directrices PRISMA. Se realizaron búsquedas en Medline (PubMed), Embase, Cochrane Library, Scielo y LILACS, y búsquedas manuales, que abarcaron hasta diciembre de 2020, de ensayos clínicos aleatorizados y no aleatorizados que informaran sobre el efecto de los aceites ozonizados en el tratamiento de las lesiones orales en comparación con cualquier otro método. El riesgo de sesgo (RoB) de los estudios incluidos se evaluó mediante la herramienta RoB 2 y ROBINS-I. Tras analizar los títulos y leer los resúmenes, se excluyeron 1932 artículos; los 25 restantes pasaron una evaluación exhaustiva del texto completo. Finalmente, se incluyeron 13 artículos en esta RS. Hubo heterogeneidad de resultados en cuanto a los tiempos de cicatrización y los intervalos de aplicación del aceite ozonizado para el tratamiento de cada tipo de lesión oral, pero en general, hubo un menor tiempo de cicatrización cuando se utilizó el aceite ozonizado como terapia, y no se comunicaron efectos adversos. A pesar de la limitada información encontrada y de la falta de normas metodológicas rigurosas sobre el uso de aceite ozonizado en lesiones orales, se sugirió un efecto positivo del uso de aceite ozonizado para el tratamiento de lesiones orales. Los resultados indicaron una ventaja en términos de menor tiempo de curación en comparación con otros tratamientos convencionales; además, no se notificaron efectos adversos, por lo que se demostró una opción de tratamiento segura y fiable para los pacientes.

Individual and interactive effects of atmospheric PM2.5 and O3 on mortality of circulatory system diseases in Ningxia / 环境与职业医学

Background The impact of atmospheric fine particulate matter (PM2.5) and ozone (O3) on the mortality of circulatory system diseases cannot be ignored. However, whether the interaction between PM2.5 and O3 can affect population health is rarely reported and requires study. Objective To investigate the individual and interactive impacts of atmospheric PM2.5 and O3 on the mortality of circulatory system diseases in the population of Ningxia region. Methods The data of 119647 deaths due to circulatory system diseases, daily average concentrations of atmospheric pollutants, and meteorological data in Ningxia from 2013 to 2020 were retrieved. PM2.5 was divided into low, medium, and high concentrations according to the primary and secondary national limits (35 and 75 μg·m−3) of the Ambient air quality standards. Similarly, O3 was divided into low, medium, and high concentrations according to the national limits (100 and 160 μg·m−3). Using a generalized additive mixed model based on quasi Poisson distribution, the impacts of atmospheric PM2.5 and O3 as well as their interaction on the mortality of circulatory system diseases were analyzed using the population data of Ningxia region. Results During the target period, males and the ≥ 65 year group accounted for larger proportions of deaths due to circulatory system diseases (55.47% and 79.87% respectively). The daily average concentration of PM2.5 (40.25 μg·m−3) exceeded the national primary limit. In the single pollution model, the highest cumulative lag effects for mortality from circulatory system diseases were PM2.5 exposure over previous 1 d (lag01) and O3 exposure for previous 2 d (lag02), and their excess risk (ER) values were 1.03% (95%CI: 0.67%, 1.40%) and 1.02% (95%CI: 0.57%, 1.50%), respectively. The results of concentration stratification analysis showed that the most significant risks of death from circulatory system diseases [ER (95%CI): 1.12% (0.32%, 1.92%) and 0.95% (0.13%, 1.79%) respectively] were found at medium PM2.5 and O3 concentrations. The interaction analysis revealed that under, a synergistic effect on the risk of death from circulatory system diseases was identified (relative excess risk due to interaction=3.08%, attributable proportion of interaction=2.90%, synergy index=1.89) when considering the coexistence of PM2.5 and O3 above the primary limit. As the concentrations of PM2.5 and O3 increased, the synergistic effect increased the risk of death from circulatory system diseases in the general population, men, women, and the ≥ 65 years group. Conclusion Both atmospheric PM2.5 and O3 can increase the risk of death from circulatory system diseases, and the two pollutants have a synergistic effect on the risk of death from circulatory system diseases.

Short-term effects of air pollutants on outpatient volume of respiratory diseases in Guiyang / 环境与职业医学

Background Affected by concentration, composition, and population tolerance of air pollutants, the relationship between air pollutants and population health has regional differences. There is still a research gap in Guiyang. Objective To explore the short-term effects of air pollutant concentrations in low-pollution areas on the outpatient volume of respiratory diseases. Methods Spearman correlation analysis was used to evaluate the correlation between air pollutants, meteorological factors, and respiratory outpatient volume from January 1, 2013 to December 31, 2020 in Guiyang City. A single pollutant distribution lag nonlinear model and a multi-pollutant interaction model were established based on Poisson distribution. A three-dimensional diagram was drawn to display the relationship between air pollutants and respiratory outpatient volume. Quantitative analysis was conducted on the attribution risk and lag effect of air pollutant concentration on outpatient volume of respiratory diseases in Guiyang City. Results The results of the single pollutant model showed that fine particulate matter (PM2.5), nitrogen dioxide (NO2), carbon monoxide (CO), and sulfur dioxide (SO2) elevated the outpatient volume of respiratory diseases. The maximum relative risk (RR) and 95%CI values of PM2.5, NO2,CO, and SO2 appeared on Day 2, 0, 5, and 6, respectively, which were 1.019 (1.015, 1.023), 1.146 (1.122, 1.171), 1.129 (1.116, 1.143), and 1.046(1.040, 1.052), respectively. For every quartile concentration increment of PM2.5, NO2, CO, or SO2, the outpatient volume of respiratory diseases increased by 0.943% (0.111%, 1.782%), 4.050% (3.573%, 4.529%), 0.595% (0.317%, 0.874%), or 0.667% (0.235%, 1.100%), respectively. The maximum RR (95%CI) of O3 was 1.015 (1.007, 1.023) and appeared on Day 0. The results of multi-pollutant model showed that PM2.5, NO2, CO, SO2, and O3 all elevated the outpatient volume of respiratory diseases. The maximum RR values of PM2.5, NO2, CO, SO2 and O3 appeared on Day 14, 0, 5, 7 and 0, respectively, which were 1.027 (1.021, 1.034), 1.213 (1.179, 1.248), 1.059 (1.043, 1.074), 1.016 (1.005, 1.026), and 1.024 (1.015, 1.033), respectively. Compared with the single pollutant model, the RR values of PM2.5, NO2, and O3 on the outpatient volume of respiratory diseases in the multi-pollutant model showed an upward trend, while the RR values of CO and SO2 in the multi-pollutant model showed a downward trend. Conclusion The impact of low concentrations of PM2.5, NO2, CO, and SO2 on human health cannot be ignored.

The effect of ozone exposure on asthma and the potential mechanisms / 上海预防医学

Near-surface ozone is a profoundly reactive and highly oxidizing gas and one of the critical respiratory toxicants. Numerous epidemiological investigations have indicated that asthmatic individuals are the vulnerable group of ozone exposure， and there is a strong correlation between ozone exposure and asthma morbidity and mortality rates. The potential mechanisms include oxidative stress， inflammatory response， autonomic nerve impairment， and immune dysfunction. The present study summarized and discussed the effect of ozone exposure on asthma and its underlying biological mechanisms in order to galvanize public cognizance concerning the perils of ozone pollution and serve as a reference for future research on ozone exposure and asthma.

Effect of intraarticular injection of different concentrations of ozone on condylar histology of rats with early temporomandibular joint osteoarthritis / 中国组织工程研究

BACKGROUND:It has been proved in clinical and animal experiments that intraarticular injection of medical ozone can effectively improve the symptoms of temporomandibular joint osteoarthritis and slow down the progression of the disease.However,the optimal concentration and range are still controversial. OBJECTIVE:To analyze the effects of intraarticular injection of different concentrations of medical ozone on the condylar cartilage of rats with temporomandibular joint osteoarthritis. METHODS:Of the 42 rats,6 rats were randomly selected as the healthy control group,and the remaining rats were given one-time injection of sodium iodoacetate into the joint cavity to establish the temporomandibular joint osteoarthritis model.Of the 36 rats successfully modeled,6 rats were selected as the model control group,and the remaining 30 were randomly divided into 20,30,40 mg/L medical ozone groups,with 10 rats in each group.After successful modeling,the rats in the medical ozone groups were given intra-articular injection of 20,30,40 mg/L medical ozone oxygen once a week for 3 weeks,respectively,and the model and healthy control groups were injected with equal volume of saline.One week after the final injection,unilateral temporomandibular joint tissues were taken,and the level of vascular endothelial growth factor in condylar cartilage was measured by ELISA.Hematoxylin-eosin staining and saffron O-fast green staining were performed on the contralateral temporomandibular joint tissues.The modified Mankin's score was applied to evaluate the degree of histopathological changes in the temporomandibular joint. RESULTS AND CONCLUSION:Compared with the healthy control group,the vascular endothelial growth factor level in the condylar cartilage of rats was significantly increased in the model control and 20,30,40 mg/L medical ozone groups(P＜0.05).Compared with the model control group and 40 mg/L medical ozone group,the vascular endothelial growth factor level in the condylar cartilage of rats was significantly decreased in the 20 and 30 mg/L medical ozone groups(P＜0.05).Compared with the 30 mg/L medical ozone group,the vascular endothelial growth factor level in the condylar cartilage of rats was significantly decreased in the 20 mg/L medical ozone group(P＜0.05).Histological observations showed that the modified Mankin's scores in the 20,30,and 40 mg/L medical ozone groups and the model control group were higher than those in the healthy control group(P＜0.05),while the modified Mankin's scores in the 20 and 30 mg/L medical ozone groups were lower than those in the model control group and the 40 mg/L medical ozone group(P＜0.05).To conclude,intraarticular injection of medical ozone at mass concentrations of 20 and 30 mg/L significantly alleviated the progression of osteoarthritis of the temporomandibular joint in rats,especially when 20 mg/L medical ozone was injected.However,the degree of osteoarthritis in the temporomandibular joint of rats was aggravated when the mass concentration of ozone increased to 40 mg/L.

Medical ozone alleviates pain in temporomandibular joint osteoarthritis / 中国组织工程研究

BACKGROUND:Temporomandibular joint osteoarthritis can cause severe pain,which significantly affects the patient's quality of life and psychological health.Studies have found that medical ozone can effectively alleviate pain due to temporomandibular joint osteoarthritis,but its analgesic effect and mechanism are still unclear. OBJECTIVE:To explore the effects of medical ozone on pain relief in temporomandibular joint osteoarthritis and the potential mechanisms. METHODS:Twenty-four Sprague-Dawley rats were randomly divided into four groups(n=6 per group):control group,model group,air group,and medical ozone group.A sodium iodate-induced rat model of temporomandibular joint osteoarthritis was established in all groups except for the control group.After 1 week of modeling,rats in the air group and medical ozone group were injected with clean air and medical ozone,respectively,in the temporomandibular joint.The injection frequency for the air group and medical ozone group was once a week for three times in total.The von Frey mechanized pain measurement technique was used to assess the mechanical pain threshold of the temporomandibular joint in rats before and 28 days after modeling.ELISA was utilized to detect interleukin-1β in both serum and temporomandibular joint fluid at 28 days after modeling.Histopathologic changes of the temporomandibular joint were evaluated through hematoxylin-eosin staining.Additionally,the expression levels of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joint were analyzed using immunohistochemistry. RESULTS AND CONCLUSION:Compared with the control group,the mechanical pain thresholds of the temporomandibular joint in the model group were decreased at 1,3,7,14,21,and 28 days after modeling(P<0.01);and compared with the model and air groups,the mechanical pain thresholds of the temporomandibular joint in the medical ozone group were increased at 28 days after modeling(P<0.01).Compared with the control group,the level of interleukin 1β in the serum and joint fluid of rats in the model group was elevated(P<0.01);compared with the model and air groups,the level of interleukin 1β in the serum and joint fluid of rats in the medical ozone group was decreased(P<0.01).Hematoxylin-eosin staining results showed derangement and degeneration of the cartilage structure in the model group and the air group,while the derangement of the cartilage structure in the medical ozone group was less than that in the model group and the air group.Immunohistochemical staining showed that the expression of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joints of rats in the model group was elevated compared with that in the control group(P<0.01);the expression of hypoxia-inducible factor 1α and cyclooxygenase 2 in the temporomandibular joints of rats in the medical ozone group was decreased compared with that in the model group and the air group(P<0.01,P<0.05).These findings suggest that medical ozone can alleviate the pain caused by osteoarthritis of the temporomandibular joints in Sprague-Dawley rats by reducing the expression of hypoxia-inducible factor 1α,interleukin 1β,and cyclooxygenase 2.

Research progress of ozone therapy in treatment of novel coronavirus infection / 中华全科医师杂志

Recent studies have shown that ozone therapy, a widely used immunotherapy in various diseases, can play a therapeutic role in the novel coronavirus infection by enhancing lung function, reducing inflammatory reactions, and bolstering immune system performance. This article reviews the pathophysiological basis of novel coronavirus infection and the mechanisms involved in ozone therapy for its treatment, also summarizes the clinical evidence and safety assessment of ozone therapy in combating novel coronavirus infections.

Impact of ambient ozone exposure on death from cardiovascular and cerebrovascular diseases in Minhang District, Shanghai / 环境与职业医学

Background Ozone (O3) pollution has gradually become a primary problem of air pollution in recent years. Conducting epidemiological studies on the correlation between O3 concentration variation and risk of cardiovascular and cerebrovascular diseases can provide reference data for O3 risk assessment and related policy making. Objective To quantitatively evaluate the effects of O3 exposure on mortalities of cardiovascular and cerebrovascular diseases among residents in Minhang District, Shanghai. Methods Data of mortalities of cardiovascular and cerebrovascular diseases, air pollutants, and meteorological factors in Minhang District of Shanghai from January 1, 2016 to December 31, 2021 were collected. Associations between O3 concentration and the mortalities due to total cardiovascular and cerebrovascular diseases, coronary heart disease, and stroke were analyzed by generalized additive models with a quasi Poisson distribution with different lag patterns, such as current day effect (lag0), single-day lag effects (lag1-lag3), and cumulative lag effects (lag01-lag03). The subgroup analyses of age, sex, and season were conducted. Furthermore, temperature was divided into low, middle, and high levels based on the 25th percentile (P25) and the 75th percentile (P75) to perform hierarchical analyses. Increased excess risks (ER) of death from target diseases caused by a 10 µg·m−3 increase in daily maximum 8 h concentration of O3 (O3-8 h) and their 95% confidence intervals (CI) were used to indicate the effects of O3. Results The associations between O3 and the risks of death from cardiovascular and cerebrovascular diseases were statistically significant at lag2, lag3, lag02, and lag03 (P<0.05), with the greatest effect size observed at lag03. The ER values of death from cardiovascular and cerebrovascular diseases in general population, male residents, and people aged 65 years and older, from coronary heart disease in male residents, and from stroke in general population increased by 1.02% (95%CI: 0.36%, 1.69%), 1.40% (95%CI: 0.47%, 2.34%), 0.87% (95%CI: 0.19%, 1.55%), 1.96% (95%CI: 0.49%, 3.44%), and 1.02% (95%CI: 0.07%, 1.98%) for a 10 µg·m−3 increase in O3-8 h concentration at lag03, respectively. During the warm season (from April 1 to September 30), the ER values of death from cardiovascular and cerebrovascular diseases and coronary heart disease per 10 µg·m−3 increase in O3 were 1.18% (95%CI: 0.33%, 3.33%) and 2.69% (95%CI: 0.39%, 5.03%), while the O3 effect was only statistically significant on cardiovascular and cerebrovascular diseases during the cold season (from October 1 to March 31 next year). At the middle and high temperature levels, the ER values of death from cardiovascular and cerebrovascular diseases increased by 1.63% (95%CI: 0.32%, 2.96%) and 1.14% (95%CI: 0.17%, 2.12%) respectively. The two-pollutant models showed similar results after including other pollutants (carbon monoxide, nitrogen dioxide, sulfur dioxide, fine particulate matter, or inhalable particulate matter). Conclusion Ambient O3 pollution may increase the mortality risks of cardiovascular and cerebrovascular diseases, coronary heart disease, and stroke in Minhang District of Shanghai.

Ozone and peroxone disinfection of Toxocara canis eggs in water

@#Water pollution in developing countries continues to be a major health problem due to various anthropological activities that contribute to the spread of many parasitic diseases, including those caused by helminths. The aim of this study is to explore the ability of ozone and peroxone to disinfect drinking water contaminated samples with Toxocara canis eggs. The oxidants used were ozone and ozone-hydrogen peroxide combination. The treatment of Toxocara canis eggs was carried out in a 50 ml reactor with an operating volume of 10 ml. The pH conditions (5, 7 and 10) were varied for each treatment. The treatment effect was calculated by counting eggs and examining the condition of the larvae larval condition (whole, broken and hatched larvae) using an optical microscope. The experiment was carried out by exposing the eggs for 60 and 120 minutes to ozone and peroxone. The best results were obtained for helminths treated with the ozone/hydrogen peroxide combination at pH 10, with an inactivation of 79.2%. The synergistic effect of ozone combined with hydrogen peroxide allows higher helminth egg inactivation rates, demonstrating that advanced oxidation processes are a real alternative to apply in the inactivation of Toxocara canis eggs. The results obtained in this study show that the ozone and peroxone treatment could be a useful disinfection process to destroy or inactivate Toxocara canis eggs in processes commonly applied in water treatment.

Association between short-term exposure to atmospheric fine particulate matter and ozone and inflammatory indicators in peripheral blood of patients with pneumonia / 上海预防医学

ObjectiveTo explore the association between short-term exposure to atmospheric fine particulate matter （PM2.5） and ozone （O3） and systemic inflammatory indicators in patients with pneumonia， and to identify the susceptible populations. MethodsFrom September 2018 to April 2020， data of 1 480 patients admitted for pneumonia was collected from a tertiary hospital in Taiyuan City. Generalized additive models （GAMs） were used to explore the associations between PM2.5 and O3 exposure and inflammatory indicators of patients with pneumonia； and to explore the susceptibility factors and susceptible populations to PM2.5 and O3 exposures through stratified analyses. ResultsThe short-term exposure to PM2.5 was associated with changes in peripheral blood C-reation protein （CRP）， erythrocyte sedimentation （ESR）， easinophil （EOS）， neutrophil （NEU） and neutrophil-lymphocyte ratio （NLR） in patients with pneumonia， and there were different degrees of hysteresis effects， with the effect values reaching a maximum at lag03， lag03， lag0， lag03， lag03， respectively， which were 4.13% （95%CI： 0.43%‒7.84%）， 3.10% （95%CI： 0.24%‒5.97%）， 5.27% （95%CI： 3.12%‒7.42%）， 1.85% （95%CI： 0.36%‒3.34%）， and 2.53% （95%CI： 0.53%‒4.74%） for every 10 μg·m-3 of PM2.5. The changes in O3 concentration were associated with the elevation of peripheral blood PCT and ESR in patients with pneumonia， and their effect values all reached the maximum at lag01 d， every 1 μg·m-3 of O3 elevation increased by 0.38% （95%CI： 0.04%‒0.73%） and 0.47% （95%CI： 0.19%‒0.76%）， respectively. Stratified analyses showed that the associations of PM2.5 with peripheral blood CRP， ESR， NEU， and NLR in pneumonia patients were more significant in males， the elderly， and those with onset in the cold season； the associations of O3 with peripheral blood PCT and ESR in pneumonia patients were more significant in the elderly and those with onset in the warm season， and the peripheral blood CRP and PCT in female patients with pneumonia were more susceptible to the changes of O3. ConclusionShort-term exposure to atmospheric PM2.5 and O3 are positively associated with changes in inflammatory indicators in patients with pneumonia， and the effects of PM2.5 on patients with pneumonia are more extensive than those of O3， with a longer lag effect. In addition， elderly patients with pneumonia are more sensitive to air pollution， male patients with pneumonia are more sensitive to PM2.5， and female patients with pneumonia are more sensitive to O3. Cold and warm seasons can exacerbate the effects of PM2.5 and O3 on inflammatory indicators in patients with pneumonia， respectively， and the patients must be protected well.

Effects of systemic ozone administration on the fresh extraction sockets healing: a histomorphometric and immunohistochemical study in rats

Abstract Studies have highlighted numerous benefits of ozone therapy in the field of medicine and dentistry, including its antimicrobial efficacy against various pathogenic microorganisms, its ability to modulate the immune system effectively, reduce inflammation, prevent hypoxia, and support tissue regeneration. However, its effects on dental extraction healing remain to be elucidated. Objective Therefore, this study aimed to evaluate the effects of systemically administered ozone (O3) at different doses in the healing of dental extraction sockets in rats. Methodology To this end, 72 Wistar rats were randomly divided into four groups after extraction of the right upper central incisor: Group C - control, no systemic treatment; Group OZ0.3 - animals received a single dose of 0.3 mg/kg O3; Group OZ0.7 - a single dose of 0.7 mg/kg O3; and Group OZ1.0 - a single dose of 1.0 mg/kg O3, intraperitoneally. In total, six animals from each group were euthanized at 7, 14, and 21 days after the commencement of treatment. Bone samples were harvested and further analyzed by descriptive histology, histomorphometry, and immunohistochemistry for osteocalcin (OCN) and tartrate-resistant acid phosphatase (TRAP) protein expression. Results All applied doses of O3 were shown to increase the percentage of bone tissue (PBT) after 21 days compared to group C. After 14 days, the OZ0.7 and OZ1.0 groups showed significantly higher PBT when compared to group C. The OZ1.0 group presented the most beneficial results regarding PBT among groups, which denotes a dose-dependent response. OCN immunostaining was higher in all groups at 21 days. However, after seven and 14 days, the OZ1.0 group showed a significant increase in OCN immunostaining compared to C group. No differences in TRAP+ osteoclasts were found between groups and time points. Conclusion Therefore, O3 therapy at higher doses might be beneficial for bone repair of the alveolar socket following tooth extraction.

Ozone therapy improves early stages of osseointegration in ovariectomized rats

Abstract Objective the aim of this study was to analyze the influence of ozone therapy (OZN) on peri-implant bone repair in critical bones by installing osseointegrated implants in the tibia of ovariectomized rats. Methodology ovariectomy was performed on 30 Wistar rats, aged six months (Rattus novergicus), and, after 90 days, osseointegrated implants were installed in each tibial metaphysis. The study groups were divided into the animals that received intraperitoneal ozone at a concentration of 700 mcg/kg — OZ Group (n=15) — and a control group that received an intraperitoneal saline solution and, for this reason, was named the SAL group (n=15). The applications for both groups occurred during the immediate post-operative period on the 2nd, 4th, 6th, 8th, 10th, and 12th day post-surgery. At various stages (14, 42, and 60 days), the animals were euthanized, and tests were performed on their tibiae. These tests include histomorphometric and immunohistochemical analyses, computerized microtomography, sampling in light-cured resin for calcified sections, and confocal microscopy. The obtained data were then analyzed using One-way ANOVA and the Shapiro-Wilk, Kruskal-Wallis, and student t-tests (P<0.05). Results our findings indicate that the OZ group (3.26±0.20 mm) showed better cellular organization and bone neoformation at 14 days (SAL group, 0.90±1.42 mm) (P=0.001). Immunohistochemistry revealed that osteocalcin labeling was moderate in the OZ group and mild in the SAL group at 14 and 42 days post-surgery. The data from the analysis of calcified tissues (microtomography, histometric, and bone dynamism analysis) at 60 days showed no statistically significant differences between the groups (P=0.32). Conclusion it was concluded that ozone therapy anticipated the initial phases of the peri-implant bone repair process.

Effect of N-acetyl cysteine, rifampicin, and ozone on biofilm formation in pan-resistant Klebsiella pneumoniae: an experimental study

ABSTRACT BACKGROUND: To the best of our knowledge, this is the first study to evaluate the effectiveness of specific concentrations of antibiofilm agents, such as N-acetyl cysteine (NAC), rifampicin, and ozone, for the treatment of pan-resistant Klebsiella pneumoniae (PRKp). OBJECTIVES: We evaluated the effectiveness of antibiofilm agents, such as NAC, rifampicin, and ozone, on biofilm formation in PRKp at 2, 6, 24, and 72 h. DESIGN AND SETTING: This single-center experimental study was conducted on June 15, 2017, and July 15, 2018, at Istanbul Faculty of Medicine, Istanbul University, Turkey. METHODS: Biofilm formation and the efficacy of these agents on the biofilm layer were demonstrated using colony counting and laser-screened confocal microscopy. RESULTS: NAC at a final concentration of 2 μg/mL was administered to bacteria that formed biofilms (24 h), and no significant decrease was detected in the bacterial counts of all isolates (all P > 0.05). Rifampicin with a final concentration of 0.1 μg/mL was administered to bacteria that formed biofilm (24 h), and no significant decrease was detected in bacterial count (all P > 0.05). Notably, ozonated water of even 4.78 mg/L concentration for 72 h decreased the bacterial count by ≥ 2 log10. CONCLUSION: Different approaches are needed for treating PRKp isolates. We demonstrate that PRKp isolates can be successfully treated with higher concentrations of ozone.

Assessment of Efficiency of Bioactive Glass, Self-Assembling Peptide, and Ozone Remineralising Agents on Artificial Carious Lesion

ABSTRACT Objective: To assess the efficacy of bioactive glass, self-assembling peptide, and ozone-remineralizing agents on the artificial carious lesion. Material and Methods: On the extracted 60 premolar teeth, an artificial carious lesion/demineralization was created. Later, the remineralization of demineralized teeth was done with respective remineralizing agents (Group A: Calcium sodium phosphosilicate (bioactive glass), Group B: Self-assembling peptide, Group C: Ozone remineralizing agents and Group D (Control): De ionized water. The degree of demineralization and remineralization were evaluated using the Vickers Hardness Number. Results: There was a decrease in microhardness from baseline to demineralization in all the groups, and this reduction was found to be statistically considerable. After the remineralization of demineralized samples with respective remineralizing agents, there was an increase in microhardness of 312.38, 276.67, and 254.42 in groups A, B, and C, respectively. In contrast, in Group D, there were no changes. Conclusion: Bioactive glass and self-assembling peptides had higher remineralizing capacities, which can be used to treat early carious lesions.

Insuflación rectal con ozono en infecciones intestinales / Rectal Insufflation with Ozone in Intestinal Infections

Introducción: Las infecciones intestinales se relacionan con trastornos del sistema inmune y de la microbiota intestinal. Pueden ser recurrentes y producir otras alteraciones intestinales y sistémicas, que empeoran con la terapia antimicrobiana. La ozonoterapia ha sido usada en el tratamiento de infecciones intestinales. Objetivos: Recopilar información sobre los efectos biológicos, terapéuticos y la seguridad de la administración del ozono por insuflación rectal en el tratamiento de las infecciones intestinales. Métodos: Para la búsqueda de información se empleó el motor de búsqueda Google Académico. Se consultaron artículos en las bases de datos PubMed y SciELO de la Biblioteca Virtual de Salud. Además, se realizó una búsqueda general en los idiomas español e inglés, a partir de los artículos más relevantes acerca del estudio. Se utilizaron como palabras clave: infecciones, insuflación, microbioma gastrointestinal, ozono como términos más concretos. En el estudio no se aplicó ninguna restricción acerca del ámbito geográfico ni de la edad. Conclusiones: La aplicación rectal de ozono es segura, tiene acciones biológicas y terapéuticas útiles para tratar las infecciones intestinales. Actúa como inmunomodulador y protector de la microbiota intestinal, lo que permite enfrentar esta problemática de salud desde el punto de vista preventivo, curativo y de rehabilitación de los daños causados, tanto por los gérmenes como por los efectos de los antibióticos(AU)

Introduction: Intestinal infections are related to disorders of the immune system and intestinal microbiota. They can be recurrent and produce other intestinal and systemic alterations, which worsen with antimicrobial therapy. Ozone therapy has been used in the treatment of intestinal infections. Objectives: To compile information on the biological, therapeutic effects and safety of the administration of ozone by rectal insufflation in the treatment of intestinal infections. Methods: Google Scholar search engine was used for searching information. Articles were consulted in PubMed and SciELO databases of the Virtual Health Library. In addition, a general search was carried out in Spanish and English, based on the most relevant articles about the study. The keywords used were infections, insufflation, gastrointestinal microbiome, ozone as more specific terms. No restrictions on geographic area or age were applied in the study. Conclusions: The rectal application of ozone is safe, it has useful biological and therapeutic actions to treat intestinal infections, acting as an immunomodulator and protector of the intestinal microbiota, which allows us to face this health problem from a preventive, curative and rehabilitation point of view of the damage caused, both by germs and by the effects of antibiotics(AU)

Ozonoterapia como apoyo en el tratamiento de la úlcera del pie diabético. Presentación de un caso

Una de las complicaciones más comunes de la diabetes mellitus es la úlcera del pie diabético, como una fuente importante de morbilidad y mortalidad. Se presenta el caso de una paciente de 43 años, con diagnóstico de diabetes mellitus tipo 2, de siete años de evolución, remitida desde el Cuerpo de Guardia del Policlínico Universitario Dr. Mario Muñoz Monroy, de Abreus, con el diagnóstico de pie diabético neuroinfeccioso complicado con un absceso. Se realizó drenaje del absceso, modificación del tratamiento con insulina y desbridamiento de la lesión. Además, se indicó antibiótico y Heberprot-P®. Ante la ausencia de evolución satisfactoria, se realizó nuevo desbridamiento, con amputación de tercer y cuarto dedos del pie izquierdo; se retomó el tratamiento inicial, eta vez combinado con ozonoterapia vía local y rectal. A partir de la semana 18 la paciente evolucionó favorablemente, con presencia de buena granulación, desaparición gradual del dolor y aceleración del proceso de cicatrización completa de la lesión, además de conseguir un control metabólico eficiente. El caso descrito confirma la eficacia y seguridad del uso combinado del Heberprot-P® y la terapia con ozono.

One of the most common complications of diabetes mellitus is diabetic foot ulcer, as an important source of morbidity and mortality. The case of a 43-years-old patient with a diagnosis of type 2 diabetes mellitus, of seven years of evolution, referred from the Emergency Department of the Dr. Mario Muñoz Monroy University Polyclinic, Abreus, with the diagnosis of neuroinfectious diabetic foot complicated with an abscess is presented. Drainage of the abscess, modification of insulin treatment, and debridement of the lesion were performed. In addition, antibiotics and Heberprot-P® were indicated. In the absence of satisfactory evolution, new debridement was performed, with amputation of the third and fourth toes of the left foot; the initial treatment was resumed, this time combined with local and rectal ozone therapy. From week 18 on, the patient progressed favorably, with the presence of good granulation, gradual disappearance of pain and acceleration of the complete healing process of the lesion, in addition to achieving efficient metabolic control. The described case confirms the efficacy and safety of the Heberprot-P® combined use and ozone therapy.

Analysis of antimicrobial efficacy of sodium hypochlorite and ozonated water against biofilm in oval canals

Abstract This in vitro study compared the antimicrobial efficacy of 2.5% sodium hypochlorite (NaOCl) and 8 µg/mL ozonated water agitated by passive ultrasonic irrigation (PUI) or PUI combined with EndoActivator (EA) against mature multispecies biofilm. One hundred and five oval-shaped mandibular premolars were instrumented, sterilized, and inoculated with Enterococcus faecalis, Candida albicans, and Staphylococcus aureus, divided into: control group - saline; O3 group - ozonated water; O3 PUI group - ozonated water with PUI agitation; O3 PUI+EA group - ozonated water with PUI+EA agitation; NaOCl group - NaOCl; NaOCl PUI group - NaOCl with PUI agitation; and NaOCl PUI+EA group - NaOCl with PUI+EA agitation. Microbiological samples were collected before (S1) and after (S2) the disinfection procedures and the data were statistically analyzed using the Kruskal-Wallis test. In the culture method, there was significant disinfection in the O3 PUI+EA, NaOCl, NaOCl PUI, and NaOCl PUI+EA groups (p˂0.05). The combination of NaOCl with PUI+EA reduced microbial counts to zero (p˂0.05). In the qPCR method, there was a significant reduction in the total count of viable microorganisms in the O3 PUI, O3 PUI+EA, NaOCl, NaOCl PUI, and NaOCl PUI+EA groups (p˂0.05). It can be concluded that 2.5% NaOCl with and without agitation, as well as 8 µg/mL ozonated water with its action enhanced by the agitation techniques, were effective in root canal disinfection, and their antimicrobial efficacy is related to the microorganisms present in the biofilm.

Resumo Este estudo in vitro comparou a desinfecção do hipoclorito de sódio 2,5% (NaOCl) e da água ozonizada 8 µg/mL agitados pela irrigação ultrassônica passiva (PUI) e por associação da PUI com EndoActivator (EA) na redução de biofilme misto maduro. Cento e cinco pré-molares inferiores ovalados foram instrumentados, esterilizados e inoculados com Enterococcus faecalis, Candida albicans e Staphylococcus aureus, divididos em: Grupo controle: soro; Grupo O3: água ozonizada; Grupo O3 PUI: água ozonizada agitada por PUI; Grupo O3 PUI + EA: água ozonizada agitada por PUI e EA: Grupo NaOCl: hipoclorito de sódio; Grupo NaOCl PUI: hipoclorito de sódio agitado por PUI; Grupo NaOCl PUI + EA: hipoclorito de sódio agitado por PUI e EA. Amostras microbiológicas foram coletadas antes (S1) e após (S2) os procedimentos de desinfecção e os dados foram analisados estatisticamente pelo teste de Kruskal-Wallis. No método de cultura, houve desinfecção significativa nos grupos O3 PUI + EA, NaOCl, NaOCl PUI e NaOCl PUI + EA (p˂0.05), sendo que no grupo NaOCl PUI + EA não houve crescimento de microrganismo (p˂0.05). No método de qPCR, nas contagens dos microrganismos antes e após os protocolos de desinfecção, houve redução microbiana nos grupos O3 PUI, O3 PUI + EA, NaOCl, NaOCl PUI, NaOCl PUI + EA (p˂0.05). Concluiu-se que o NaOCl 2,5% com e sem agitação foi eficiente, assim como a água ozonizada 8 µg/mL potencializada pelos métodos de agitação na desinfecção e que a mesma está relacionada com os microrganismos presentes no biofilme.

Tratamiento combinado de catgutpuntura y ozonoterapia en la psoriasis vulgar. Hospital Clínico Quirúrgico Lucia Íñiguez Landín. 2019- 2021

Fundamento: la psoriasis afecta aproximadamente al 2 % de la población mundial, con amplias repercusiones biopsicosociales. Objetivo: determinar la efectividad del tratamiento combinado catgutpuntura-ozonoterapia en los pacientes con psoriasis vulgar. Métodos: estudio cuasiexperimental de intervención del tipo antes y después sin grupo de control realizado en el Hospital Lucia Íñiguez Landín, en el período abril 2019 a 2021. La población estuvo constituida por 55 pacientes; la muestra quedó conformada por 29 que cumplieron con los criterios de inclusión. Se realizó un análisis multivariado de frecuencias absolutas y relativas. Para evaluar la efectividad del tratamiento se utilizó la prueba estadística de diferencia de proporciones con un nivel de confianza de 95 %, considerándose estadísticamente significativa. Resultados: predominó el sexo femenino y el grupo de edad de 40 a 49 años. Los síndromes de insuficiencia del Yin de riñón y Xue de hígado constituyeron los más representativos. Se logró disminuir la severidad de la enfermedad en casi la totalidad de estos. Las reacciones adversas a las terapias empleadas fueron mínimas. Conclusiones: el tratamiento combinado fue considerado parcialmente efectivo.

Background: psoriasis affects approximately 2 % of the world population, with extensive biopsychosocial repercussions. Objective: to determine the effectiveness of the combined catgutpuncture-ozone therapy treatment in patients with psoriasis vulgaris. Methods: quasi-experimental intervention study of the type before and after without a control group carried out at the Lucia Íñiguez Landín Hospital, from April 2019 to 2021. 55 patients were the population; 29 patients were the sample who met the inclusion criteria. A multivariate analysis of absolute and relative frequencies was performed. To evaluate the effectiveness of the treatment, the statistical test of proportions' difference was used with a confidence level of 95%, being considered statistically significant. Results: the female sex and the age group of 40 to 49 years old predominated. Kidney Yin and liver Xue insufficiency syndromes was the most representative. It was possible to reduce the severity of the disease in almost all of them. Adverse reactions to the therapies used were minimal. Conclusions: the combined treatment was considered partially effective.

Evaluación antifúngica del ozono contra Candida albicans: estudio in vitro / Antifungal evaluation of ozone against Candida albicans: in vitro study

Introducción: la Candida albicans (C. albicans) es un patógeno fúngico que puede causar infecciones superficiales o potencialmente mortales. Los biofilms de C. albicans muestran rasgos fenotípicos únicos, el más destacado es su notable resistencia a una amplia variedad de agentes antimicóticos. Una de las alternativas para inhibir el crecimiento de este microorganismo es el ozono debido a sus propiedades bactericidas, fungicidas y virucidas; sin embargo, escasa información ha sido reportada en C. albicans. Objetivo: el objetivo de este estudio fue evaluar el efecto fungicida del ozono en C. albicans. Material y métodos: la metodología consistió en agregar ozono a tubos de ensayo con medios de caldo nutritivo en diversas concentraciones y tiempos de ozonización. El efecto fungicida fue determinado con la determinación del número de colonias de C. albicans en agar nutritivo a través de procedimiento microbiológicos estandarizados por triplicado. Resultados: todas las muestras con ozono mostraron adecuados niveles de inhibición de crecimiento del microorganismo. Además, el efecto fungicida del ozono se encontró para ser significativamente dependiente del tiempo de ozonización y de la concentración. Conclusión: el uso de terapia con ozono podría tener potencial en el control de infecciones micóticas causadas por la presencia de C. albicans (AU)

Introduction: Candida albicans (C. albicans) is a fungal pathogen that can cause superficial or life-threatening infections. Biofilms of C. albicans display unique phenotypic traits, the most prominent being their remarkable resistance to a wide variety of antifungal agents. One of the alternatives to inhibit the growth of this microorganism is ozone due to its bactericidal, fungicidal and virucidal properties; however, little information has been reported on C. albicans. Objective: the objective of this study was to evaluate the fungicidal effect of ozone on C. albicans. Material and methods: the methodology consisted in adding ozone to test tubes with nutrient broth media in various concentrations and ozonation times. The fungicidal effect was determined by determining the number of colonies of C. albicans in nutrient agar through standardized microbiological procedures in triplicate. Results: all the ozone samples showed adequate levels of growth inhibition of the microorganism. Furthermore, the fungicidal effect of ozone was found to be significantly dependent on ozonation time and concentration. Conclusion: the use of ozone therapy could have potential in the control of fungal infections caused by the presence of C. albicans (AU)