Types of antiseptics, presentations and rules of use. / Tipos de antisépticos, presentaciones y normas de uso.

Antiseptics are chemical substances that when applied topically onto intact skin, mucous membranes or wounds partially or completely reduces the population of living microorganisms in those tissues. Different types of antiseptics are available - those most commonly used in clinical practice being alcohols, iodinated compounds and chlorhexidine. When using an antiseptic, consideration is required of its spectrum of antimicrobial activity, latency, residual effects, possible interferences of the presence of organic material with the activity of the antiseptic, its side effects, compatibility with other antiseptics, and cost. This article is part of a supplement entitled "Antisepsis in the critical patient", which is sponsored by Becton Dickinson.

Effects and Effectiveness of Cavity Disinfectants in Operative Dentistry: A Literature Review.

The degree of success in the elimination of bacteria during cavity preparation and prior to the insertion of a restoration may increase the longevity of the restoration and therefore the success of the restorative procedure. The complete eradication of bacteria in a caries-affected tooth, during cavity preparation, is considered a difficult clinical task. In addition to weakening the tooth structure, attempts to excavate extensive carious tissue completely, by only mechanical procedures, may affect the vitality of the pulp. Therefore, disinfection of the cavity preparation after caries excavation can aid in the elimination of bacterial remnants that can be responsible for recurrent caries, postoperative sensitivity, and failure of the restoration. However, the effects of disinfectants on the restorative treatment have been a major concern for dental clinicians and researchers. This review aims to explore existing literature and provide information about different materials and techniques that have been used for disinfecting cavity preparations and their effects and effectiveness in operative dentistry and, therefore, helps dental practitioners with clinical decision to use cavity disinfectants during restorative procedures. Antimicrobial effectiveness and effects on the pulp and dental restorations, in addition to possible side effects, were all reviewed in this paper.

Iodine supplementation during pregnancy and lactation. Position statement of the working group on disorders related to iodine deficiency and thyroid dysfunction of the Spanish Society of Endocrinology and Nutrition.

Severe and mild iodine deficiency during pregnancy and lactation affects thyroid function of the mother and neonate as well as the infant's neuropsychological development. Studies performed in Spain confirm that most women are iodine deficient during pregnancy and lactation. Pregnant and breast feeding women and women planning to become pregnant should take iodine supplements.

Involvement of α7 nAChR subtype in rat oxaliplatin-induced neuropathy: effects of selective activation.

Oxaliplatin, unlike other platinum anticancer agents, has only mild toxic effects on the hematopoietic, urinary and gastrointestinal systems. Its dose-limiting side effect is neurotoxicity that may evolve to a neuropathic syndrome which is difficult to treat. In this study we treated rats with oxaliplatin (2.4 mg/kg/day intraperitoneally, for 3 weeks), and observed that expression levels of the α7 nicotinic acetylcholine receptor (nAChR) subunit were dramatically decreased both in the peripheral and central nervous system. The repeated administration (30 mg/kg/day per os, for 3 weeks) of (R)-ICH3, the most active enantiomer of a novel α7 nAChR agonist, and of PNU-282987 prevented the receptor down-regulation. On the other hand, both agonists per se up-regulated the α7 nAChR subunit compared to control. (R)-ICH3 and PNU-282987 significantly reduced oxaliplatin-dependent alterations of the pain threshold when noxious or non-noxious stimuli were used. Further ex vivo analysis highlighted their neuroprotective effects in dorsal root ganglia and peripheral nerves. The two agonists did not prevent the increase in microglia cell number induced by oxaliplatin in the central nervous system. Astrocyte density was enhanced by the agonist treatment in the spinal cord, thalamus and somatosensory area 1 as opposed to the effects of oxaliplatin treatment. (R)-ICH3 and PNU-282987 per se increased glial cell number in a region-specific manner. In summary, α7 nAChR is involved in oxaliplatin-dependent neuropathology and the agonists (R)-ICH3 and PNU-282987 reduce pain and protect nervous tissue with concomitant glial activation. Since glial cells play a role both in pain and in neuroprotection, an α7 AChR-dependent modulation of glial functions is suggested to distinguish rescue signals from the pathological pain-mediating pathway.

Design of iodine-lithium-alpha-dextrin liquid crystal with potent antimicrobial and anti-inflammatory properties.

An ideal antimicrobial should be not toxic and possess board spectrum antiviral, antibacterial, antifungal activity, excluding resistance and should affect pathogen-mediated damage of host physiology including immune, nervous and endocrine systems. With the purpose of a combination of nonspecific antimicrobial action of molecular and ionized iodine with systemic immune-modulating property of the negatively charged polysaccharides a complex drug of iodine and lithium on a template of a alpha-dextrin liquid crystal was designed. The physicochemical model of iodine-lithium-alpha-dextrin (ILalphaD) is based on the human blood and the stereochemistry of moving equilibred systems of dynamically balanced organic polymers conformation complexed with the iodine and lithium molecules. Here we reviewed the antibacterial, antiviral, immune-modulating and anti-inflammatory mechanisms in vivo and in vitro as well as pharmacokinetics, metabolism, chronic toxicity, cumulative properties, embryo toxicity and carcinogenicity of ILalphaD. Clinical efficacy, tolerability and safety of ILalphaD monotherapy have been evaluated in HIV-infected patients, administered intravenously for a total of 12 infusions in 4 cycles. ILalphaD therapy contributes to anti-HIV and anti-inflammatory effects, resolution of dermatological and neurological pathology and dramatically improves the quality of life reflecting on enhanced treatment adherence. ILalphaD appears to be safe and perspective for an adjuvant therapy of bacterial and viral infections, including HIV/AIDS, hypothyroid, autoimmune and inflammatory diseases for controlling pathogen production from infected cells, immune response, inflammation and metabolism.

An in vitro study of antimicrobial activity and efficacy of iodine-generating hydrogel dressings.

OBJECTIVE: To determine the antimicrobial activity and efficacy of different formulations of novel bioxygenating hydrogel dressings (which deliver both iodine and oxygen into the wound) against various target organisms by means of an in vitro test system that more effectively mimics the conditions encountered when dressings are in contact with wounds. METHOD: Three bioxygenating hydrogels were tested: Oxyzyme, which releases low levels of iodine into the wound, and Iodozyme 402 and Iodozyme 401, which release higher levels of iodine, with Iodozyme 402 releasing twice the amount of 401. Cellulose filter disks (n = 32) were inoculated with indicator species and placed equidistant from each other as a matrix onto agar test beds. Cut squares of control or test dressings were placed on top of each disk. Kill curves were constructed from determinations of the numbers of survivors (log cfu per disk) over time by removing disk samples at various time points. RESULTS: Significant differences (p < 0.05) were observed between the controls and test samples. The order of sensitivity for Oxyzyme was Fusobacterium nucleatum, Bacteroides fragilis, Propionibacterium acnes, Staphylococcus epidermidis, methicillin-resistant Staphylococcus aureus (MRSA), Candida albicans and Pseudomonas aeruginosa. The order of efficacy of the three hydrogel dressings (Iodozyme 402, followed by Iodozyme 401 and then Oxyzyme) was the same regardless of the target species. CONCLUSION: The novel hydrogel skin surface wound dressings are broad-spectrum in activity, encompassing antibiotic-resistant organisms, anaerobes and yeasts; their antimicrobial function appears to be rapidly effective.

In vitro antibacterial effect of calcium hydroxide combined with chlorhexidine or iodine potassium iodide on Enterococcus faecalis.

Several studies have shown a higher success rate of root canal therapy when the canal is free from bacteria at the time of obturation. Treatment strategies that are designed to eliminate this microflora should include agents that can effectively disinfect the root canal. Enterococcus faecalis is often associated with persistent endodontic infections. While in vivo studies have indicated calcium hydroxide to be the most effective all-purpose intracanal medicament, iodine potassium iodide (IKI) and chlorhexidine (CHX) may be able to kill calcium hydroxide-resistant bacteria. Supplementing the antibacterial activity of calcium hydroxide with IPI or CHX preparations was studied in bovine dentine blocks. While calcium hydroxide was unable to kill E. faecalis in the dentine, calcium hydroxide combined with IKI or CHX effectively disinfected the dentine. The addition of CHX or IKI did not affect the alkalinity of the calcium hydroxide suspensions. It may be assumed that combinations also have the potential to be used as long-term medication. Cytotoxicity tests using the neutral red method indicated that the combinations were no more toxic than their pure components.