Eligibility and efficacy of a CPC- and CHX-based antiviral mouthwash for the elimination of SARS-CoV-2 from the saliva: A randomized, double-blind, controlled clinical trial.

AIM: This study aimed at investigating the efficacy of a 0.05% cetylpyridinium chloride-0.05% chlorhexidine (CPC-CHX) mouthwash in reducing viral load in the saliva as compared with sterile water. MATERIALS AND METHODS: Forty SARS-CoV-2 positive patients were asked to dispense 4 mL of saliva. Half the patients rinsed for 60 s with 15 mL CPC-CHX, and the remaining patients rinsed with sterile water (control). Four millilitres of saliva were collected after 15, 30 and 60 min after rinsing. Quantitative reverse transcriptase polymerase chain reaction (RT-qPCR) and enzyme-linked immunosorbent assay (ELISA) specific for SARS-CoV-2 nucleocapsid protein were performed. For ELISA, the intact (representing the active virus) to total virus load (I/T) was calculated. RESULTS: SARS-CoV-2 copy numbers/mL from RT-qPCR tended to decrease in the control group, whereas in the CPC-CHX group, an increase was observed after T30. However, mixed linear model analysis revealed no statistical differences between groups (p = .124), time points (p = .616) and vaccinated or non-vaccinated patients (p = .953). Similarly, no impact of group (p = .880), time points (p = .306) and vaccination (p = .711) was observed for I/T ratio values. CONCLUSIONS: Within the limitation of this study, there was no evidence that the intervention reduced salivary SARS-CoV-2 viral load during the course of 60 min. Therefore, commonly used pre-procedural rinsing might not be clinically relevant.

Earplugs during the first night after cardiothoracic surgery may improve a fast-track protocol.

BACKGROUND: Sleep deprivation after major surgery is common and associated with worse outcome. Noise is one important reason for sleep fragmentation, which contributes to enhanced morbidity. The purpose of this work was to evaluate the impact of earplugs on patients' sleep quality during their first night after cardiothoracic surgery to eventually improve an existing fast-track concept. METHODS: Sixty-three patients undergoing cardiothoracic surgery eligible for a postoperative fast-track regimen on our cardiothoracic post anesthesia care unit (C-PACU) were prospectively included. They were randomized to either sleep with or without earplugs. Quality of sleep was measured using questionnaires for patients and nurses. Required pain medications, pain intensity, and length of hospital stay were secondary outcome variables. RESULTS: Twenty-seven patients were randomized to the intervention group (earplugs) and 36 to the control group. Mean (SD) age was 61 (12) years. Self-reported quality of sleep was better in the intervention group (median, IQR [range]: 3, 2-4 [1-5] vs. 4, 3-5 [1-5]; scale: 1, "excellent," to 5, "very poor"; P=0.025). Patients of the intervention group also experienced less severe pain (P=0.047) despite similar dosages of administered analgesics and expressed improved satisfaction regarding their C-PACU stay (P=0.032). CONCLUSIONS: Implementation of the use of earplugs in a fast-track concept following cardiothoracic surgery is efficient and easy. Earplugs improved the quality of sleep as well as patient satisfaction and attenuated pain intensity. They may thereby contribute to a faster recovery, less morbidity, and reduced costs.

Measuring the Capacity to Love: Development of the CTL-Inventory.

Objective: The individual capacity to love (CTL) has been linked to various mental health parameters and is considered to be an important outcome parameter of psychotherapeutic treatment. However, empirical examinations of the concept have not been conducted up to now. The aim of this study was to develop a valid and reliable instrument for the assessment of CTL [Capacity to Love Inventory (CTL-I)] as a trait of personality, which is shown to be related to clinically relevant symptoms and conditions. Method: Four independent healthy samples in Austria (n = 547, n = 174, and n = 85) and Poland (n = 240) were assessed by a prototype of the CTL-I and its final shorter version in a confirmatory factor analysis (CFA). Internal consistency of the total questionnaire and each subscale was assessed by Cronbach alpha. External validity was measured against Beck Depression Inventory, Quality of Relationship Inventory, Sociosexual Orientation Inventory, Pathological Narcissism Inventory, and Narcissistic Personality Inventory according to the theoretical framework of the CTL concept. Further test-retest reliability was assessed. Results: The CFA confirmed 41 items in six dimensions: Interest in the life project of the other, Basic trust, Humility and gratitude, Common ego ideal, Permanence of sexual passion, and Acceptance of loss/jealousy/mourning. The Cronbach alphas of the total CTL-I and its subscales ranged between 0.67 and 0.90 in all samples, suggesting a valid construct. The CTL-I was moderately positively associated with quality of relationship (Support r = 0.63, Conflict r = -0.66, and Depth r = 0.66) and inversely associated with symptoms of depression (r = -0.37), pathological narcissism (r = -0.29) and promiscuity (r = -0.42). The test-retest reliability of the total CTL-I was high with r = 0.81, suggesting the stability of answers over time. Conclusion: The proposed 41-item version of the CTL-I is a psychometrically sound and validated instrument measuring six dimensions of the concept of the CTL. The reported negative associations with clinically relevant parameters such as depression, pathological narcissism and promiscuity as well as associations with relationship qualities such as conflicts, support, and depth warrant its future use in burdened populations including couples in clinical settings.