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1.
BMC Oral Health ; 24(1): 491, 2024 Apr 25.
Article in English | MEDLINE | ID: mdl-38664718

ABSTRACT

BACKGROUND: Recent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19. METHODS: We performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load. RESULTS: Of a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447). CONCLUSIONS: In asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings.


Subject(s)
COVID-19 , Cetylpyridinium , Mouthwashes , Saliva , Viral Load , Humans , Mouthwashes/therapeutic use , Viral Load/drug effects , Saliva/virology , Male , Female , Adult , Cetylpyridinium/therapeutic use , Middle Aged , SARS-CoV-2 , Chlorine Compounds/therapeutic use , Chlorine Compounds/pharmacology , Oxides/therapeutic use , Aged
2.
PLoS One ; 18(1): e0280377, 2023.
Article in English | MEDLINE | ID: mdl-36634129

ABSTRACT

OBJECTIVES: We aimed to conduct a systematic review on published data in order to investigate the efficacy of mouthwash products containing chlorine dioxide in halitosis. STUDY DESIGN: Systematic review and meta-analysis. METHODS: Our search was conducted on 14th October 2021. We searched the following electronic databases: MEDLINE, Embase, Scopus, Web of Science, and CENTRAL. We analysed data on adults with halitosis, included only randomised controlled trials and excluded in vitro and animal studies. The interventional groups used chlorine dioxide, and the comparator groups used a placebo or other mouthwash. Our primary outcomes were changes in organoleptic test scores (OLS) and Volatile Sulfur Compound (VSC) levels from baseline to the last available follow-up. RESULTS: We found 325 articles in databases. After the selection process, ten articles were eligible for qualitative synthesis, and 7 RCTs with 234 patients were involved in the meta-analysis. Our findings showed a significant improvement in the parameters of the chlorine dioxide group compared to the placebo group in OLS one-day data (mean difference (MD): -0.82; 95% confidence intervals (95% CIs): [-1.04 --0.6]; heterogeneity: I2 = 0%, p = 0.67); and one-week OLS data (MD: -0.24; 95% CIs: [-0.41 --0.07]; I2 = 0%, p = 0.52); and also changes in H2S one-day data (standardised mean difference (SMD): -1.81; 95% CIs: [-2.52 --1.10]); I2 = 73.4%, p = 0.02). CONCLUSION: Our data indicate that chlorine dioxide mouthwash may be a good supportive therapy in oral halitosis without known side effects.


Subject(s)
Chlorine Compounds , Halitosis , Humans , Chlorine Compounds/therapeutic use , Halitosis/drug therapy , Mouthwashes/therapeutic use , Oxides/therapeutic use , Randomized Controlled Trials as Topic
3.
Biosci Trends ; 16(6): 447-450, 2022 Dec 26.
Article in English | MEDLINE | ID: mdl-36504072

ABSTRACT

Chlorine dioxide (ClO2) is a high-level disinfectant that is safe and widely used for sterilization. Due to the limitations on preparing a stable solution, direct use of ClO2 in the human body is limited. Nasal irrigation is an alternative therapy used to treat respiratory infectious diseases. This study briefly summarizes the available evidence regarding the safety/efficacy of directly using ClO2 on the human body as well as the approach of nasal irrigation to treat COVID-19. Based on the available information, as well as a preliminary experiment that comprehensively evaluated the efficacy and safety of ClO2, 25-50 ppm was deemed to be an appropriate concentration of ClO2 for nasal irrigation to treat COVID-19. This finding requires further verification. Nasal irrigation with ClO2 can be considered as a potential alternative therapy to treat respiratory infectious diseases, and COVID-19 in particular.


Subject(s)
COVID-19 , Chlorine Compounds , Communicable Diseases , Humans , Oxides/therapeutic use , Chlorine Compounds/pharmacology , Chlorine Compounds/therapeutic use , Nasal Lavage
6.
Rev Peru Med Exp Salud Publica ; 37(4): 605-610, 2020.
Article in Spanish, English | MEDLINE | ID: mdl-33566898

ABSTRACT

OBJECTIVES: To systematically review the effectiveness and safety of chlorine dioxide solution and chlorine derivatives used in the prevention or treatment of COVID-19. METHODS: This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and follows the guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. A librarian developed and executed the search strategy; it was further reviewed by two of the authors and complemented by manual search. Randomized clinical trials, quasi-experimental studies, cohort studies, case-control studies, cross-sectional studies, and case reports were included; in vitro or animal studies were excluded. Abstract and full-text screening according to pre-defined eligibility criteria were performed by two reviewers independently using web application Rayyan QCRI. Disagreements on study selection were resolved by a third reviewer. The systematic review protocol was registered in PROSPERO (CRD42020200641). RESULTS: Neither published nor pre-print studies evaluating the use of chlorine dioxide or derivatives on SARS-CoV-2 infection were identified. The only finding was an unpublished observational study registry which has no results released yet. CONCLUSIONS: To date, there are no scientific evidence to uphold the use of chlorine dioxide or derivatives as preventive or therapeutic agents against COVID-19.


OBJETIVOS: Realizar una revisión sistemática acerca de la efectividad y seguridad del uso de dióxido de cloro y derivados del cloro, en la prevención o el tratamiento de la COVID-19. MATERIALES Y MÉTODOS: Se siguieron las pautas internacionales de elaboración de revisiones sistemáticas de PRISMA y el Manual Cochrane para revisiones sistemáticas de intervenciones. La estrategia de búsqueda la desarrolló un bibliotecario y la revisaron dos de los autores. Se complementó la búsqueda electrónica con una búsqueda manual. Se incluyeron ensayos clínicos aleatorizados, estudios cuasiexperimentales, estudios de cohorte, estudios de casos y controles, estudios de corte transversal y reportes de casos; y se excluyeron estudios in vitro o realizados en animales. Dos revisores, de forma independiente, seleccionaron los estudios según los criterios de elegibilidad definidos, usando el aplicativo web Rayyan, en caso de discordancia se hizo partícipe a un tercer revisor. El protocolo de la revisión sistemática se registró en PROSPERO (CRD42020200641). RESULTADOS: No se identificó ningún estudio publicado ni en proceso de publicación que haya evaluado el uso del dióxido de cloro o derivados del cloro, administrado por vía inhalatoria, oral o parenteral en humanos, como agente preventivo o terapéutico de la COVID-19 o en infecciones por otros coronavirus. Solo se identificó el registro de un único estudio catalogado como observacional que hasta ahora no tiene resultados. CONCLUSIONES: A la fecha, no existe evidencia científica que apoye el uso del dióxido de cloro o derivados del cloro para prevenir o tratar la COVID-19.


Subject(s)
COVID-19 Drug Treatment , Chlorine Compounds/therapeutic use , Oxides/therapeutic use , COVID-19/prevention & control , COVID-19/virology , Chlorine Compounds/adverse effects , Humans , Oxides/adverse effects , Randomized Controlled Trials as Topic , Treatment Outcome
7.
Photodiagnosis Photodyn Ther ; 27: 39-43, 2019 Sep.
Article in English | MEDLINE | ID: mdl-31125768

ABSTRACT

Cutaneous hemangiosarcoma is a malignant neoplasia that frequently occurs in dogs. The most effective treatment requires wide surgical excision of the tumor. To avoid mutilating surgeries, photodynamic therapy (PDT) could serve as an alternative treatment. This study aimed to treat cutaneous hemangiosarcomas in dogs using PDT with aluminium-chloride-phthalocyanine nanoemulsion (AlClPc-nano) as photosensitizer. Eight dogs with histopathological diagnosis of naturally occurring cutaneous hemangiosarcoma were treated. Animals were given intra and peritumoral injections of AlClPc-nano (13.3 µM). After 15 min, the masses were LED irradiated at a wavelength of 658-662 nm (80 mW potency) for 25 min (120 J/cm2 fluency). The number of sessions was based on lesion observations, with PDT sessions repeated every 7 days until the mass was no longer macroscopically visible. On that occasion, an excisional biopsy of the area was taken for histopathology analysis. Blood was collected from each animal before each PDT session and excisional biopsy for hematological analysis (blood counts; liver and kidney function). The number of PDT sessions varied from 2 to 4, depending on the size of the initial mass. Seven of the eight cases demonstrated complete remission of neoplasia. Microscopic analysis of the excisional biopsies showed necrosis and hemorrhage only, with no cancer cells, except in one case. During the treatment, inflammation and necrosis were macroscopically observed in the treated areas. The dogs did not show any alteration in blood parameters that could be related to the PDT. In conclusion, PDT with AlClPc-nano is a safe and effective treatment for cutaneous hemangiosarcoma in dogs.


Subject(s)
Emulsions/therapeutic use , Hemangiosarcoma/veterinary , Photochemotherapy/veterinary , Photosensitizing Agents/therapeutic use , Skin Neoplasms/veterinary , Aluminum Compounds/therapeutic use , Animals , Chlorine Compounds/therapeutic use , Dogs , Emulsions/adverse effects , Emulsions/chemistry , Female , Hemangiosarcoma/drug therapy , Hemangiosarcoma/pathology , Indoles/therapeutic use , Isoindoles , Male , Nanoparticles/chemistry , Photochemotherapy/adverse effects , Photochemotherapy/methods , Photosensitizing Agents/adverse effects , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology
8.
J Drugs Dermatol ; 17(5): 554-556, 2018 May 01.
Article in English | MEDLINE | ID: mdl-29742188

ABSTRACT

Chlorine dioxide complex™ is a new molecule to dermatology that is a unique, non-toxic, broad spectrum anti-microbial and keratolytic compound. Chlorine dioxide has been used as an antiseptic in industrial settings for decades, primarily in water treatment facilities for municipal water supplies and food preparation. The compound has exceptional antiseptic properties with no known potential for development of resistance. It is a true keratolytic and anti-inflammatory, but is non-toxic to human tissue due to its unique mechanism of action. Chlorine dioxide's use in consumer products was previously limited because it is inherently an unstable molecule that had to be used quickly after it was produced. However, the recent development of a complexed form of chlorine dioxide that retains its antimicrobial and keratolytic activity has allowed the development of products (AsepticMD, Aseptic Plus, Nashville, TN) that take advantage of the properties of this unique molecule. Here we report a case series demonstrating its efficacy as a cleanser in keratosis pilaris. J Drugs Dermatol. 2018;17(5):554-556.


Subject(s)
Abnormalities, Multiple/drug therapy , Chlorine Compounds/therapeutic use , Darier Disease/drug therapy , Detergents/therapeutic use , Eyebrows/abnormalities , Oxides/therapeutic use , Abnormalities, Multiple/pathology , Adolescent , Adult , Child , Chlorine Compounds/administration & dosage , Darier Disease/pathology , Detergents/administration & dosage , Eyebrows/pathology , Female , Humans , Male , Oxides/administration & dosage , Treatment Outcome , Young Adult
9.
Indian J Dent Res ; 29(1): 34-40, 2018.
Article in English | MEDLINE | ID: mdl-29442084

ABSTRACT

AIM: The aim of the present study was to compare the efficacy of herbal mouthwash and chlorine dioxide mouthwash in reduction of plaque and gingivitis. SETTINGS AND DESIGN: In a randomized clinical trial, forty patients were randomly selected and divided equally into two groups. MATERIALS AND METHODS: After professional oral prophylaxis, the clinical parameters plaque index, gingival index, and modified sulcular bleeding index were recorded at baseline, 7th day, 14th day, and 21st day. The plaque samples were collected from gingival sulcus with an absorbent sterile paper point and were stored in a thioglycollate broth, then sent for microbiological examination. The microbial colony-forming units were assessed at baseline, 7th day, 14th day, and 21st day for Streptococcus mutans, Tannerella forsythia, and Fusobacterium nucleatum. RESULTS: There was a statistical significant reduction in both clinical and microbiological parameters were observed with use of both the mouthwashes. However, herbal mouthwash was more effective in reducing the plaque and gingivitis than chlorine dioxide mouthwash. CONCLUSION: Herbal mouthwash was statistically efficacious in controlling plaque and gingivitis with potent antimicrobial activity.


Subject(s)
Chlorine Compounds/therapeutic use , Dental Plaque/drug therapy , Gingivitis/drug therapy , Mouthwashes/therapeutic use , Oxides/therapeutic use , Plant Preparations/therapeutic use , Adult , Chlorine Compounds/administration & dosage , Dental Plaque/microbiology , Dental Plaque Index , Female , Fusobacterium nucleatum/drug effects , Gingivitis/microbiology , Humans , Male , Middle Aged , Oxides/administration & dosage , Periodontal Index , Phytotherapy/methods , Plant Preparations/administration & dosage , Stem Cells/microbiology , Streptococcus mutans/drug effects , Tannerella forsythia/drug effects , Young Adult
10.
Am J Dent ; 31(6): 309-312, 2018 Dec.
Article in English | MEDLINE | ID: mdl-30658377

ABSTRACT

PURPOSE: To evaluate the efficacy of a mouthwash containing stabilized chlorine dioxide in reducing oral malodor when used as an adjunct to tooth brushing compared with the use of a placebo mouthwash. METHODS: This 8-week study in healthy subjects with clinically diagnosed intrinsic oral malodor was a 2-way crossover, double-blind, randomized, and controlled trial design, which was conducted at a single site. Subjects were randomized to receive either unflavored, non-fluoridated, and alcohol-free mouthwash containing 0.1% stabilized chlorine dioxide or a placebo mouthwash with identical bottle packaging. Both groups were provided with the same toothpaste and toothbrush. Subjects consented to the 8-week participation and were instructed to use their allocated treatment twice daily. In Phase I, quantified odor intensity [measured by an organoleptic intensity rating scale of 0-5, with 0=malodor cannot be detected and 5=very strong malodor] was independently evaluated by three calibrated judges at baseline, and after 1, 2, and 3 weeks of treatment. Following a 2-week washout period, Phase II initiated with the redistribution of test products. The subjects' organoleptic scores were assessed by the calibrated judges at baseline, and 6, 7, and 8 weeks of treatment. RESULTS: A total of 50 subjects were enrolled and randomized into the two groups. Of these, 47 subjects completed the study. The baseline organoleptic intensity scores for both groups during Phase I and Phase II were not significantly different (P= 0.224, P= 0.071, respectively). At all visits, the organoleptic scores for the placebo rinse group during both Phase I and Phase II were not significantly different. During Phase I, the mean of individual organoleptic change scores from the stabilized chlorine dioxide rinse group were significantly different from the baseline at the last two follow-up visits:Week 1 (P= 0.088), Week 2 (P= 0.001), Week 3 (P= 0.1×10-3). During Phase II, the mean of individual organoleptic change scores from the stabilized chlorine dioxide rinse group were also significantly different from the baseline at the last two follow-up visits: Week 6 (P= 0.120), Week 7 (P= 0.004), Week 8 (P= 0.002). CLINICAL SIGNIFICANCE: The results of this study suggest the daily use of a stabilized chlorine dioxide-containing unflavored mouthwash as an adjunct to brushing with fluoride toothpaste provides a clinically relevant reduction in oral malodor after 3 weeks of twice-daily use.


Subject(s)
Chlorine Compounds , Halitosis , Mouthwashes , Oxides , Chlorine Compounds/therapeutic use , Cross-Over Studies , Double-Blind Method , Halitosis/therapy , Humans , Oxides/therapeutic use
11.
Am J Dent ; 30(6): 350-352, 2017 12.
Article in English | MEDLINE | ID: mdl-29251459

ABSTRACT

PURPOSE: This is a review of the literature on nonsurgical treatment of non-healing medication related osteonecrosis of the jaw (MRONJ) utilizing a phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse. METHODS: A literature search in PubMed revealed only six case reports. MRONJ lesion site description, patient's medication history, the healing time, and the MRONJ treatment protocol followed by those authors were recorded. Additional literature review of the scientific mechanism, risks and benefits, safety and efficacy of the phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse was also performed and discussed. RESULTS: Many of the authors of the published case reports utilized 0.12% chlorhexidine as the initial mouthrinse, but the lesions did not decrease in size. After switching to a phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse for a duration ranging from 1-12 months, there was complete healing of the MRONJ lesions in all of the cases. The phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse can be helpful in the management of active MRONJ lesions as well as the prevention of recurrent MRONJ lesions in the susceptible patient population. CLINICAL SIGNIFICANCE: This literature review supports the use of phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse in the management of MRONJ lesions either as a first line of therapy or after 0.12% chlorhexidine had not been effective.


Subject(s)
Bisphosphonate-Associated Osteonecrosis of the Jaw/drug therapy , Chlorine Compounds/therapeutic use , Dental Disinfectants/therapeutic use , Oxides/therapeutic use , Humans , Osteonecrosis , Phosphates
13.
J Pharmacol Exp Ther ; 349(3): 458-69, 2014 Jun.
Article in English | MEDLINE | ID: mdl-24696041

ABSTRACT

Signal transducer and activator of transcription 3 (STAT3) has been implicated as a hub for multiple oncogenic pathways. The constitutive activation of STAT3 is present in several cancers, including gliomas (GBMs), and is associated with poor therapeutic responses. Phosphorylation of STAT3 triggers its dimerization and nuclear transport, where it promotes the transcription of genes that stimulate tumor growth. In light of this role, inhibitors of the STAT3 pathway are attractive therapeutic targets for cancer. To this end, we evaluated the STAT3-inhibitory activities of three compounds (CPA-7 [trichloronitritodiammineplatinum(IV)], WP1066 [(S,E)-3-(6-bromopyridin-2-yl)-2-cyano-N-(1-phenylethyl)acrylamide, C17H14BrN3O], and ML116 [4-benzyl-1-{thieno[2,3-d]pyrimidin-4-yl}piperidine, C18H19N3S]) in cultured rodent and human glioma cells, including GBM cancer stem cells. Our results demonstrate a potent induction of growth arrest in GBM cells after drug treatment with a concomitant induction of cell death. Although these compounds were effective at inhibiting STAT3 phosphorylation, they also displayed variable dose-dependent inhibition of STAT1, STAT5, and nuclear factor κ light-chain enhancer of activated B cells. The therapeutic efficacy of these compounds was further evaluated in peripheral and intracranial mouse tumor models. Whereas CPA-7 elicited regression of peripheral tumors, both melanoma and GBM, its efficacy was not evident when the tumors were implanted within the brain. Our data suggest poor permeability of this compound to tumors located within the central nervous system. WP1066 and ML116 exhibited poor in vivo efficacy. In summary, CPA-7 constitutes a powerful anticancer agent in models of peripheral solid cancers. Our data strongly support further development of CPA-7-derived compounds with increased permeability to enhance their efficacy in primary and metastatic brain tumors.


Subject(s)
Antineoplastic Agents/pharmacology , Brain Neoplasms/drug therapy , Glioma/drug therapy , Melanoma, Experimental/drug therapy , Melanoma, Experimental/secondary , STAT3 Transcription Factor/antagonists & inhibitors , Small Molecule Libraries/pharmacology , Animals , Antineoplastic Agents/pharmacokinetics , Antineoplastic Agents/therapeutic use , Apoptosis/drug effects , Blood-Brain Barrier/metabolism , Brain Neoplasms/metabolism , Brain Neoplasms/pathology , Cell Line, Tumor , Cell Proliferation/drug effects , Chlorine Compounds/pharmacokinetics , Chlorine Compounds/pharmacology , Chlorine Compounds/therapeutic use , Drug Screening Assays, Antitumor , Glioma/metabolism , Glioma/pathology , HEK293 Cells , Heterocyclic Compounds, 2-Ring/pharmacokinetics , Heterocyclic Compounds, 2-Ring/pharmacology , Heterocyclic Compounds, 2-Ring/therapeutic use , Humans , Melanoma, Experimental/metabolism , Melanoma, Experimental/pathology , Mice , Piperidines/pharmacokinetics , Piperidines/pharmacology , Piperidines/therapeutic use , Platinum Compounds/pharmacokinetics , Platinum Compounds/pharmacology , Platinum Compounds/therapeutic use , Pyridines/pharmacokinetics , Pyridines/pharmacology , Pyridines/therapeutic use , STAT3 Transcription Factor/genetics , Small Molecule Libraries/pharmacokinetics , Small Molecule Libraries/therapeutic use , Tissue Distribution , Tyrphostins/pharmacokinetics , Tyrphostins/pharmacology , Tyrphostins/therapeutic use
14.
Adv Skin Wound Care ; 27(1): 13-9, 2014 Jan.
Article in English | MEDLINE | ID: mdl-24343388

ABSTRACT

OBJECTIVE: The purpose of this study was to compare cosmesis at 3 to 4 months and infection in simple lacerations irrigated with normal saline (NS) versus activated chlorine dioxide (CD). DESIGN: This was a prospective, randomized trial of a convenience sample of patients. This study was approved by the institutional review board and Food and Drug Administration as a physician-sponsored trial (FDA investigational new drug no. 68762). SETTING: The study was conducted in a large urban, academic emergency department. PATIENTS: Patients aged 18 to 100 with simple, uncomplicated lacerations requiring repair that were less than 8 hours old were enrolled. INTERVENTIONS: Patients were randomized to receive either NS or CD wound irrigation. MAIN OUTCOME MEASURES: Demographics, infection, and cosmesis were analyzed and assessed. Cosmetic outcome was assessed at 3 to 4 months using a visual analog scale (VAS), wound evaluation score (WES), patient VAS (VASPt), and digital imaging VAS by 2 plastic surgeons (VASPlast). MAIN RESULTS: One hundred ninety-three patients were enrolled. Data analysis was available for 175 cases (86 NS and 89 CD). Wound infection follow-up was obtained in 74.9% of the patients. The 3- to 4-month cosmesis follow-up was 37.7% for VAS/WES, 40.0% for VASPt, and 37.7% for VASPlast. There were no significant differences in demographics, key wound characteristics, infection, adverse reactions, and cosmesis. CONCLUSION: The authors report the use of a novel antimicrobial irrigation solution. Chlorine dioxide appears to be a safe biologically acceptable antiseptic wound irrigant that does not appear to interfere with cosmetic outcomes.


Subject(s)
Anti-Infective Agents, Local/therapeutic use , Chlorine Compounds/therapeutic use , Lacerations/therapy , Oxides/therapeutic use , Wound Infection/prevention & control , Academic Medical Centers , Adolescent , Adult , Aged , Aged, 80 and over , Biocompatible Materials , Chi-Square Distribution , Emergency Service, Hospital , Female , Follow-Up Studies , Humans , Injury Severity Score , Lacerations/diagnosis , Male , Middle Aged , Pilot Projects , Prospective Studies , Reference Values , Rhode Island , Risk Assessment , Sodium Chloride/therapeutic use , Therapeutic Irrigation/methods , Treatment Outcome , Urban Population , Wound Healing/physiology , Young Adult
15.
Int J Prosthodont ; 26(6): 541-4, 2013.
Article in English | MEDLINE | ID: mdl-24179967

ABSTRACT

This study aimed to clinically evaluate the disinfection efficacy of chlorine dioxide (ClO2) for used dental instruments. An imprint culture technique demonstrated that ultrasonic cleaning of intraorally applied dental mirrors in 0.02% ClO2 for 10 minutes resulted in compete removal of microorganisms for 10 subjects. Hepatitis C virus (HCV) RNA was detected by real-time polymerase chain reaction on periodontal curettes after subgingival scaling in four HCV-infected patients and was completely removed by the same treatment procedure. Therefore, the combination of ultrasonic cleaning with ClO2 may provide an alternative to toxic disinfectants, such as glutaraldehyde and sodium hypochlorite, for disinfecting dental instruments.


Subject(s)
Chlorine Compounds/therapeutic use , Dental Disinfectants/therapeutic use , Dental Instruments , Oxides/therapeutic use , Adult , Aged , Biofilms/drug effects , Candida albicans/drug effects , Dental Instruments/microbiology , Dental Instruments/virology , Disinfection/methods , Equipment Contamination/prevention & control , Female , Glutaral/therapeutic use , Hepacivirus/drug effects , Hepatitis C/complications , Humans , Infection Control, Dental/methods , Male , Middle Aged , Sodium Hypochlorite/therapeutic use , Subgingival Curettage/instrumentation , Ultrasonics , Young Adult
16.
BJU Int ; 112 Suppl 2: 69-73, 2013 Nov.
Article in English | MEDLINE | ID: mdl-24127679

ABSTRACT

OBJECTIVE: To compare the effectiveness, safety and cost of Tristel Fuse (chlorine dioxide) with Cidex OPA (ortho-phthaldehyde; 1,2-benzenedicarboxaldehyde) in an automated endoscopic reprocessor (AER) for high-level disinfection of flexible cystoscopes. PATIENTS AND METHODS: A randomised single-blind study comparing the high-level disinfectants Tristel Fuse as a simple office-based soak and Cidex OPA using an AER was performed. Participants were 'blinded' to the agent used for disinfection of the flexible cystoscopes. All patients had negative mid-stream urine at baseline, (MSU) no symptoms suggestive of urinary tract infection (UTI) on the day of investigation, no recent antibiotic use or current indwelling urinary catheter. Patients who underwent cystoscopic biopsy during the procedure were excluded. A urine analysis was done before and 3-5 days after cystoscopy and multiple equipment cultures were performed. The Urogenital Distress Inventory (UDI-6 + two questions from the 'long-form'), symptom and quality-of-life scores were assessed before and after cystoscopy as were ease-of-use assessments and a full cost analysis. RESULTS: In all, 180 of 465 screened participants were randomised 1:1 and the mean age was 72.1 years, 17% were females and 57% of procedures were performed for bladder tumour surveillance. The urine analysis was positive in 5.4% of patients in each group and 29% (Tristel) vs 20% (Cidex) of patients had urinary leukocyturia (p = ns) after cystoscopy. The turnover (minutes per cycle) was 7.5 (Tristel) vs 26.7 (Cidex). The per-procedure costs were $11.67 (American dollars) for Tristel Fuse and $21.82 for Cidex OPA with fixed costs of $4788 for Tristel Fuse and $60,514 for Cidex OPA. CONCLUSIONS: Tristel Fuse appears to be as effective and more cost-effective than Cidex OPA for high-level disinfection of flexible cystoscopes. This has significant cost implications for the office urologist.


Subject(s)
Chlorine Compounds/therapeutic use , Cystoscopes/microbiology , Disinfectants/therapeutic use , Disinfection/methods , Glutaral/therapeutic use , Oxides/therapeutic use , o-Phthalaldehyde/therapeutic use , Adult , Aged , Aged, 80 and over , Chlorine Compounds/economics , Cross Infection/prevention & control , Disinfectants/economics , Disinfection/economics , Endoscopy , Female , Glutaral/economics , Humans , Infection Control/economics , Infection Control/methods , Male , Middle Aged , Oxides/economics , Single-Blind Method , Treatment Outcome , o-Phthalaldehyde/economics
17.
J Urol ; 190(4): 1192-9, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23648222

ABSTRACT

PURPOSE: We evaluated the effectiveness of photodynamic therapy using Radachlorin in patients with high grade, nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy who refused radical cystectomy. MATERIALS AND METHODS: Between July 2009 and December 2011 photodynamic therapy was performed in 22 men and 12 women. Radachlorin (0.5 to 0.6 mg/kg) was injected intravenously 2 to 3 hours before photodynamic therapy. After complete transurethral resection, a diffuser using a 22Fr cystoscope was placed in the bladder for irradiation with a 662 nm laser. Output beam power was adjusted to 1.8 W and the light dose was 15 J/cm(2). Photodynamic therapy was performed for 16 to 30 minutes. Recurrence after photodynamic therapy was followed by regular cystoscopy at 1, 2 and 3 months, and at 3-month intervals thereafter for up to 2.8 years. Efficacy was assessed by cystoscopy, cytology and histology, and defined as the number of patients who were tumor free after initial photodynamic therapy. RESULTS: Mean ± SD patient age was 62.94 ± 8.71 years. Average followup was 26.74 ± 6.34 months (median 28.12). As the primary efficacy outcome, the recurrence-free rate was 90.9% at 12 months, 64.4% at 24 months and 60.1% at 30 months. As the secondary efficacy outcome, there was no statistical difference in mass size, carcinoma in situ, number of previous bacillus Calmette-Guérin administrations, number of transurethral bladder resections or tumor multiplicity on Kaplan-Meier analysis (each p >0.05). No evidence of severe adverse effects was detected after photodynamic therapy. CONCLUSIONS: Photodynamic therapy with Radachlorin is a safe, effective treatment for nonmuscle invasive bladder cancer refractory or intolerant to bacillus Calmette-Guérin therapy in select patients.


Subject(s)
Carcinoma, Transitional Cell/drug therapy , Neoplasm Recurrence, Local/drug therapy , Photochemotherapy , Urinary Bladder Neoplasms/drug therapy , Adjuvants, Immunologic/adverse effects , Adjuvants, Immunologic/therapeutic use , BCG Vaccine/adverse effects , BCG Vaccine/therapeutic use , Carcinoma, Transitional Cell/pathology , Chlorine Compounds/therapeutic use , Female , Humans , Male , Middle Aged , Neoplasm Invasiveness , Photochemotherapy/adverse effects , Pilot Projects , Prospective Studies , Treatment Failure , Urinary Bladder Neoplasms/pathology
18.
J Dent ; 41 Suppl 5: e76-81, 2013 Nov.
Article in English | MEDLINE | ID: mdl-23707537

ABSTRACT

OBJECTIVES: The aim of this study was to investigate the whitening properties and rate of bleaching action of chlorine dioxide and compare them with those of hydrogen peroxide of similar concentration. METHODS: Sixty bovine central incisor crowns were ground and polished until flat surfaces were obtained. The crowns were subjected to extensive staining cycles of artificial saliva, chlorehexidine and tea before being randomly assigned to three groups: chlorine dioxide (ClO2), hydrogen peroxide (H2O2) and deionised water (H2O). The crowns in each group were subjected to seven 2 min exposure cycles in addition to an extra 30 min cycle. CIE LAB spectrophotometric measurements were taken at baseline, after each 2 min, and each extended 30 min bleaching cycle. RESULTS: L* for ClO2 specimens was significantly higher only after the first 2 min cycle (p<0.001) while for H2O2 specimens, L* significantly increased after the first two cycles (p<0.001) and continued to increase, at a slower rate, until the end of the treatment cycles. ΔE was significantly greater within H2O2 than within ClO2 specimens (p<0.001). CONCLUSION: Chlorine dioxide whitens teeth at a faster rate than hydrogen peroxide. Specimens treated with chlorine dioxide were significantly lighter than those treated with hydrogen peroxide at the end of the first 2 min application cycle, however, extended exposures did not enhance color.


Subject(s)
Chlorine Compounds/therapeutic use , Oxides/therapeutic use , Tooth Bleaching Agents/therapeutic use , Animals , Anti-Infective Agents, Local/adverse effects , Cattle , Chlorhexidine/adverse effects , Color , Dental Enamel/drug effects , Hydrogen Peroxide/therapeutic use , Incisor/drug effects , Materials Testing , Photochemotherapy/methods , Random Allocation , Saliva, Artificial/chemistry , Spectrophotometry/instrumentation , Tea , Time Factors , Tooth Crown/drug effects , Tooth Discoloration/chemically induced , Tooth Discoloration/drug therapy
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