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1.
Br J Nurs ; 29(5): S6-S13, 2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32167817

RESUMO

Hard-to-heal wounds are a major public health problem that incur high economic costs. A major source of morbidity, they can have an overwhelming impact on patients, caregivers and society. In contrast to acute wound healing, which follows an 'orderly and timely reparative process', the healing of hard-to-heal wounds is delayed because the usual biological progression is interrupted. This article discusses hard-to-heal wounds, the impact they have on patients and healthcare systems, and how biofilms and other factors affect the wound-healing process. Controlling and preventing infection is of utmost importance for normal wound healing. Rational use of anti-infectious agents is crucial and is particularly relevant in the context of rising healthcare costs. Knowledge of the complex relationship between hard-to-heal wounds, biofilm formation and wound healing is vital for efficient management of hard-to-heal wounds.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Biofilmes , Cicatrização/fisiologia , Infecção dos Ferimentos , Biofilmes/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Humanos , Infecção dos Ferimentos/microbiologia , Infecção dos Ferimentos/prevenção & controle , Infecção dos Ferimentos/terapia
3.
Oral Health Prev Dent ; 18(1): 61-69, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32051972

RESUMO

PURPOSE: Despite being the gold standard antiplaque agent, chlorhexidine (CHX) has many adverse effects that make scientists search for new agents to combat biofilms as effective as CHX. Hyaluronan, also known as hyaluronic acid (HA), is a natural polysaccharide with anti-inflammatory, antioxidant and bacteriostatic properties. The objectives were to evaluate the plaque inhibitory, and anti-inflammatory effects of HA mouthwash compared to CHX and distilled water (DW) in a 4-day non-brushing model together with the participants' preference to the used products. MATERIALS AND METHODS: Thirty-three systemically and periodontally healthy subjects were included in this randomised, double-blinded, crossover clinical study. Subjects were randomly assigned into three treatment-sequence groups to use three mouthwashes one after another, in three different time periods. After professional prophylaxis at day 1, subjects refrained from all oral hygiene measures and used mouthwashes that were individually allocated to them. On day 5, scoring of plaque index (PI) according to Turetsky modification of Quigley Hein Index system, modified gingival index (MGI) and measurement of gingival crevice fluid (GCF) volume were performed. Treatment satisfaction questionnaire form was given at the end of each experimental period. RESULTS: CHX showed statistically significant reduction in PI followed by HA (p = 0.048). No statistically significant differences were detected between HA and CHX in terms of MGI and GCF volume. For HA, subjects reported significantly better taste, less sensitivity, burning sensation, mouth dryness and numbness perception compared to CHX and DW. CONCLUSIONS: CHX revealed the best plaque inhibition closely followed by HA. Early gingival inflammatory changes were found similar for CHX and HA. Furthermore, HA was well accepted with better perceptions than CHX and DW.


Assuntos
Anti-Infecciosos Locais , Placa Dentária , Gengivite , Clorexidina , Índice de Placa Dentária , Método Duplo-Cego , Humanos , Ácido Hialurônico , Antissépticos Bucais
4.
J Cardiothorac Surg ; 15(1): 5, 2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31915020

RESUMO

BACKGROUND: The saphenous vein is the most commonly used conduit for coronary artery bypass grafting (CABG). Wound healing complications related to saphenous vein harvesting are common, with reported surgical site infection rates ranging from 2 to 20%. Patients' risk factors, perioperative hygiene routines, and surgical technique play important roles in wound complications. Here we describe the perioperative routines and surgical methods of Swedish operating theatre (OT) nurses and cardiac surgeons. METHODS: A national cross-sectional survey with descriptive design was conducted to evaluate perioperative hygiene routines and surgical methods associated with saphenous vein harvesting in CABG. A web-based questionnaire was sent to OT nurses and cardiac surgeons at all eight hospitals performing CABG surgery in Sweden. RESULTS: Responses were received from all hospitals. The total response rate was 62/119 (52%) among OT nurses and 56/111 (50%) among surgeons. Chlorhexidine 5 mg/mL in 70% ethanol was used at all eight hospitals. The OT nurses almost always (96.8%) performed the preoperative skin disinfection, usually for three to 5 minutes. Chlorhexidine was also commonly used before dressing the wound. Conventional technique was used by 78.6% of the surgeons, "no-touch" by 30.4%, and both techniques by 9%. None of the surgeons used endoscopic vein harvesting. Type of suture and technique used for closing the wound differed markedly between the centres. CONCLUSIONS: In this article we present insights into the hygiene routines and surgical methods currently used by OT nurses and cardiac surgeons in Sweden. The results indicate both similarities and differences between the centres. Local traditions might be the most important factors in determining which procedures are employed in the OT. There is a lack of evidence-based hygiene routines and surgical methods.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Veia Safena/transplante , Coleta de Tecidos e Órgãos/métodos , Procedimentos Cirúrgicos Vasculares/métodos , Ponte de Artéria Coronária , Estudos Transversais , Humanos , Enfermagem de Centro Cirúrgico/métodos , Assistência Perioperatória/métodos , Padrões de Prática Médica , Fatores de Risco , Infecção da Ferida Cirúrgica/etiologia , Infecção da Ferida Cirúrgica/prevenção & controle , Inquéritos e Questionários , Técnicas de Sutura , Suturas , Suécia , Coleta de Tecidos e Órgãos/efeitos adversos , Procedimentos Cirúrgicos Vasculares/efeitos adversos
5.
FP Essent ; 489: 27-31, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31995352

RESUMO

Burns, whether caused by thermal, chemical, or electrical exposure, are common and often preventable. Burn injuries are most common in children. All patients with burns should undergo primary and secondary assessment, including assessment of airway, breathing, and circulation. Evaluation of the location, size, and depth of burns can help to determine the optimal setting for management. Patients with full-thickness burns, circumferential burns, or burns on the face, hands, feet, genitals, or perineum should be referred to a burn subspecialist. Minor acute pain can be managed with irrigation of the burn area with cool water, acetaminophen, or a nonsteroidal anti-inflammatory drug. Acetaminophen is the first-line treatment for pain associated with minor burns. Opioids are a mainstay of pain management for patients with severe burns. Prophylactic antibiotics are not indicated for most patients. Silver sulfadiazine is used widely as a topical therapy, and is a standard treatment for partial-thickness burns. Many other topical therapies are available but comparative data are limited. Goals of therapy are to manage pain, facilitate healing, minimize scarring, and achieve return to function.


Assuntos
Anti-Infecciosos Locais , Queimaduras , Pacientes Ambulatoriais , Queimaduras/terapia , Criança , Humanos , Sulfadiazina de Prata , Cicatrização
6.
Exp Parasitol ; 210: 107833, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935358

RESUMO

Safety precautions prior to contact lens usage is essential for preventing Acanthamoeba keratitis. Contact lens disinfecting solutions containing 3% hydrogen peroxide (H2O2) are known to exert amoebicidal effect against Acanthamoeba. Yet, these solutions need to be neutralized to prevent ocular irritation, which consequently may result in incomplete disinfection. In this study, amoebicidal effect of tert-butyl hydroperoxide (tBHP) was investigated and its efficacy was compared to those of hydrogen peroxide (H2O2). H2O2 and tBHP showed dose dependent amoebicidal effect, however high concentration of these compounds demonstrated cytotoxicity in human corneal epithelial (HCE) cells. To reduce their cytotoxicity, the concentrations of both compounds were diluted to 50 µM and subsequently combined with 10 µM vorinostat to enhance amoebicidal effect. Addition of vorinostat induced high amoebicidal effect against Acanthamoeba trophozoites, even at low concentrations of H2O2 or tBHP. Cellular damage induced by combined treatment of H2O2 or tBHP with vorinostat in Acanthamoeba were determined by assessing cell cycle arrest and apoptosis via FACS analysis. While 50 µM H2O2 combined with 10 µM vorinostat showed 36.26% cytotoxicity on HCE cells during 24 h exposure, 50 µM tBHP with 10 µM vorinostat did not show cytotoxicity on HCE cells. These findings suggest that the application of tBHP and vorinostat for Acanthamoeba keratitis treatment and contact lens disinfection system is highly plausible.


Assuntos
Acanthamoeba/efeitos dos fármacos , Antiprotozoários/farmacologia , Pontos de Checagem do Ciclo Celular/efeitos dos fármacos , Vorinostat/farmacologia , terc-Butil Hidroperóxido/farmacologia , Acanthamoeba/citologia , Acanthamoeba/genética , Anti-Infecciosos Locais/farmacologia , Apoptose/efeitos dos fármacos , Células Cultivadas , Córnea/citologia , Córnea/efeitos dos fármacos , Córnea/parasitologia , DNA de Protozoário/efeitos dos fármacos , DNA de Protozoário/fisiologia , Combinação de Medicamentos , Células Epiteliais/citologia , Células Epiteliais/efeitos dos fármacos , Células Epiteliais/parasitologia , Humanos , Peróxido de Hidrogênio/farmacologia
7.
Anal Bioanal Chem ; 412(2): 335-342, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31788715

RESUMO

Triclosan (TCS) is an antibacterial and antifungal compound found in many hygiene products, including toothpaste, soap, and detergents. However, this molecule can act as an endocrine disruptor and can induce harmful effects on human health and the environment. In this study, triclosan was biotransformed in vitro using human and rat liver fractions, to evaluate oxidative metabolism, the formation of reactive metabolites via the detection of GSH adducts, as well as glucuronide and sulfate conjugates using liquid chromatography coupled to high-resolution tandem mass spectrometry (LC-HRMS/MS). A deuterated analog of triclosan was also employed for better structural elucidation of specific metabolic sites. Several GSH adducts were found, either via oxidative metabolism of triclosan or its cleavage product, 2,4-dichlorophenol. We also detected glucuronide and sulfated conjugates of triclosan and its cleaved product. This study was aimed at understanding the routes of detoxification of this xenobiotic, as well as investigating any potential pathways related to additional toxicity via reactive metabolite formation. Graphical abstract.


Assuntos
Anti-Infecciosos Locais/metabolismo , Cromatografia Líquida/métodos , Espectrometria de Massas em Tandem/métodos , Triclosan/metabolismo , Animais , Glucuronídeos/metabolismo , Glutationa/metabolismo , Humanos , Microssomos Hepáticos/metabolismo , Oxirredução , Ratos , Sulfatos/metabolismo
8.
Chemosphere ; 241: 125077, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31614311

RESUMO

Triclosan (TCS) has potentially toxic effects on humans and animals. However, the possible roles and mechanisms of TCS in endothelial cells (ECs) are still unknown. Abnormal damage to ECs and vascular function is a critical process in various cardiovascular diseases, including coronary artery disease (CAD), atherosclerosis, stroke, and hypertension. Hence, we explored the potential toxicological roles of TCS in EC functions. Cell Counting Kit-8, apoptosis, transwell, wound healing, and tube-formation experiments were performed to evaluate the effects of TCS on human umbilical vein endothelial cell (HUVEC) function. Additionally, the levels of PI3K, Akt, and mTOR phosphorylation were measured by Western blot. The results indicated that TCS treatment suppressed HUVECs viability, migration and angiogenesis. TCS treatment increased the expression of inflammatory markers and ROS in cultured HUVECs. Moreover, TCS treatment inhibited PI3K/Akt/mTOR expression. All of these results reveal that TCS induces notable vascular injury and affects the viability, migration and angiogenic capacity of HUVECs, at least in part via the PI3K/Akt/mTOR signaling pathway.


Assuntos
Anti-Infecciosos Locais/toxicidade , Triclosan/toxicidade , Animais , Apoptose/efeitos dos fármacos , Aterosclerose/metabolismo , Células Endoteliais da Veia Umbilical Humana/efeitos dos fármacos , Humanos , Fosfatidilinositol 3-Quinases/metabolismo , Fosforilação , Proteínas Proto-Oncogênicas c-akt/metabolismo , Transdução de Sinais/efeitos dos fármacos , Serina-Treonina Quinases TOR/metabolismo , Testes de Toxicidade
9.
J Surg Res ; 246: 100-105, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31563829

RESUMO

BACKGROUND: Surgical site infection (SSI) is an established quality indicator and predictor for adverse patient outcomes. Multiple strategies have been established to reduce SSI; however, optimum protocol remains unclear. The aim of the study was to assess the impact of established protocol on SSI after colon surgery. METHODS: We established a colon SSI bundle in 2017, which includes a chlorhexidine prescrub followed by chloraPrep, betadine wound wash, antibiotic infused irrigation, use of closure tray, and incision coverage with silver impregnated dressing. Retrospective analysis of a 2-y (2016-2017) prospectively collected before and after analysis of all patients undergoing elective colon surgery was performed. Patients were divided into two groups: preprotocol (PP: year 2016) and postprotocol (PoP: year 2017). Patients in the two groups were matched using propensity score matching for age, gender, comorbidities, Anesthesiology Severity Score, indication of procedure, and procedure type. Outcome measures were SSI, hospital length of stay, and readmission rate. RESULTS: A total of 328 patients were analyzed, and after propensity matching, 94 patients (PP:47 and PoP:47) were included. The mean age was 63.7 ± 16.4 y, 43.6% male, and 44.6% of procedures were performed laparoscopically. There was no difference in demographics, comorbidities, and procedure details between two groups. PoP patients had significantly lower superficial (odds ratio: 0.91 [0.74-0.98]; P = 0.045) and deep SSI (odds ratio:0.97 [0.65-0.99]; P = 0.048) than PP patients. PoP patient had shorter length of stay (P = 0.049) and trend toward lower readmission rate (P = 0.098) compared with PP patients and an 85% reduction in the Centers for Medicare and Medicaid Services standardized infection rate. CONCLUSIONS: Protocol-driven patient care improves patient outcomes. SSI bundle reduced SSI in patient undergoing colon surgery. Establishing national SSI bundles will help standardize care and help optimize patient outcomes.


Assuntos
Protocolos Clínicos , Colo/cirurgia , Procedimentos Cirúrgicos Eletivos/efeitos adversos , Cuidados Pré-Operatórios/métodos , Infecção da Ferida Cirúrgica/prevenção & controle , Idoso , Antibacterianos/administração & dosagem , Anti-Infecciosos Locais/administração & dosagem , Antibioticoprofilaxia/métodos , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Estudos Prospectivos , Estudos Retrospectivos , Infecção da Ferida Cirúrgica/epidemiologia , Infecção da Ferida Cirúrgica/etiologia , Resultado do Tratamento , Estados Unidos
10.
World Neurosurg ; 133: e303-e307, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31520754

RESUMO

OBJECTIVE: To explore the safety and efficacy of hydrogen peroxide H2O2 in controlling blood loss and surgical site infection (SSI) after multisegmental lumbar spine surgery. METHODS: A total of 2626 patients who had undergone multisegmental lumbar spinal surgery from January 2015 to January 2018 were included in the present study. Stratified by the use of H2O2 irrigation, they were divided into 2 groups: the control group (n = 1345) and the experimental group (n = 1281). The demographic parameters, laboratory examination results, and surgery-related information (e.g., operative time, number of operated levels, intraoperative blood loss, postoperative drainage, postoperative SSI, extubation time), and perioperative complications were recorded. RESULTS: No significant differences were seen regarding the demographic parameters, laboratory examination results, comorbidities, and surgery-related information. The extubation time and postoperative drainage collection were lower in the experimental group (3.6 ± 0.5 vs. 4.1 ± 0.6 days, P = 0.402; 251.8 ± 67.5 vs. 291.8 ± 71.3 mL, P = 0.013). In the control group, the rate of SSI was 2.4% (32 of 1345) and included 17 superficial wound infections and 15 deep wound infections. In the experimental group, the SSI rate was 1.4% (18 of 1281; 15 with a superficial wound infection and 3 with a deep wound infection). Staphylococcus aureus was the most common organism, especially in the experimental group (66.7% vs. 50%). No statistically significant difference was found between the 2 groups in the perioperative complications, including hematencephalon, deep vein thrombosis, pulmonary embolism, and myocardial infarction (P > 0.05). Pneumocephalus was not observed in either group. CONCLUSION: The application of H2O2 in posterior lumbar interbody fusion can reduce the blood loss and incidence of SSI after surgery and was quite beneficial for controlling the increasing number of vancomycin-resistant bacteria.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Perda Sanguínea Cirúrgica/prevenção & controle , Hemostasia Cirúrgica/métodos , Peróxido de Hidrogênio/uso terapêutico , Vértebras Lombares/cirurgia , Fusão Vertebral , Infecção da Ferida Cirúrgica/prevenção & controle , Idoso , Antibacterianos/uso terapêutico , Anti-Infecciosos Locais/administração & dosagem , Antibioticoprofilaxia , Estudos de Casos e Controles , Feminino , Humanos , Peróxido de Hidrogênio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Pré-Medicação , Estudos Retrospectivos , Infecções Estafilocócicas/prevenção & controle , Irrigação Terapêutica
11.
Int J Dent Hyg ; 18(1): 116-123, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31276312

RESUMO

OBJECTIVE: To compare the effectiveness of a novel cetylpyridinium chloride (CPC)-hyaluronic acid (HA)-based mouthrinse with chlorhexidine (CHX) and placebo mouthrinses in preventing plaque and gingivitis. The secondary outcomes were calculus, extrinsic stains, oral malodour and occurrence of adverse events. METHODS: A 21-day randomized, double-blind, three-arm parallel study with random allocation of young dental students to any of the three mouthrinse groups. Thorough prophylaxis was done at baseline followed by a baseline examination for oral malodour, extrinsic stains, calculus, gingivitis and plaque by a single examiner. All the subjects used the allocated mouthrinse twice daily for 21 days and were examined again at the end of the experimental period. They were also interviewed for adverse events. Change in the scores of clinical indices was calculated and compared between the groups. RESULTS: A total of 75 subjects were included and completed the experiment. There was a significant difference for change in plaque index scores between the groups (P = .015); subjects in the placebo group experienced higher levels of plaque accumulation than the other groups. Teeth staining increased in the CHX (P < .001) and placebo groups (P = .002), but not in CPC-HA users (P = .573). No significant differences were found between the three experimental groups for change in the gingival index (P = .08), calculus scores (P = .494), oral malodour (P = .870) and reporting of adverse events (P = .249). CONCLUSIONS: CPC-HA and CHX had similar effectiveness in preventing plaque accumulation, while no differences were observed between the mouthrinses for preventing gingivitis. Dental staining was caused by CHX and the placebo mouthrinses but not by CPC-HA mouthrinse.


Assuntos
Anti-Infecciosos Locais , Gengivite , Cetilpiridínio , Clorexidina , Índice de Placa Dentária , Método Duplo-Cego , Humanos , Ácido Hialurônico , Antissépticos Bucais , Resultado do Tratamento
12.
Clin Oral Investig ; 24(1): 333-341, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31102044

RESUMO

OBJECTIVES: This study compared the clinical effects of a full-mouth disinfection (FMD) protocol for the treatment of mild-to-moderate periodontitis in type 2 diabetic and non-diabetic subjects for up to 1 year. Secondary aim was to evaluate the effects of this therapy on the salivary levels of periodontal pathogens between diabetics and non-diabetics. MATERIAL AND METHODS: Twenty-six type 2 diabetic subjects and 28 non-diabetic subjects with mild-to-moderate periodontitis received full-mouth scaling and root planing within 24 h, application of chlorhexidine digluconate (CHX) gel in pockets and tongue plus CHX rinses for 14 days. Clinical monitoring was performed at baseline, 3, 6, and 12 months post-therapy. Salivary levels of red complex bacterial species were evaluated at baseline, 6, and 12 months post-therapy by qPCR. RESULTS: Intention-to-treat analyses were performed for seven diabetics and three non-diabetics that did not return for the 12-month evaluation. Most clinical parameters improved significantly at 3, 6, and 12 months post-therapies for both groups (p < 0.05). Overall, there were no significant differences in clinical parameters between groups after therapy (p > 0.05). At 1 year, 39.3% and 50.0% of the non-diabetic and diabetic subjects, respectively, achieved the desired clinical endpoint for treatment (≤ 4 sites with probing depth ≥ 5 mm) (primary outcome variable) (p > 0.05). FMD did not promote changes in the salivary levels of pathogens in either of the groups (p > 0.05). Levels of T. forsythia were lower in diabetic than in non-diabetic subjects at 6 months post-therapy (p < 0.05). CONCLUSIONS: Type 2 diabetic subjects and systemically healthy subjects with mild-to-moderate periodontitis responded similarly to the proposed FMD protocol for up to 1 year. CLINICAL RELEVANCE: There is a general thought that diabetics do not answer as well as non-diabetics to periodontal treatments. However, this study showed that diabetics and non-diabetics respond equally to the FMD protocol. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02643771.


Assuntos
Anti-Infecciosos Locais , Periodontite Crônica , Raspagem Dentária , Diabetes Mellitus Tipo 2 , Periodontite , Aplainamento Radicular , Anti-Infecciosos Locais/uso terapêutico , Clorexidina , Desinfecção/métodos , Feminino , Humanos , Masculino , Índice Periodontal , Periodontite/terapia
13.
Int J Dent Hyg ; 18(1): 27-43, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31054209

RESUMO

OBJECTIVES: To investigate whether chlorhexidine mouthwash (CHX-MW), with an anti-discoloration system(ADS), is effective in preventing extrinsic tooth surface discoloration. Additionally, this paper seeks to evaluate whether CHX combined with an ADS maintains its efficacy with respect to reducing plaque and gingivitis scores. MATERIAL AND METHODS: MEDLINE-PubMed and Cochrane-Central were searched up to October 2018 to identify eligible studies. Papers evaluating the effect of CHX-MW+ADS compared to CHX without an ADS were included. A descriptive analysis and when feasible a meta-analysis was performed. RESULTS: Screening resulted in 13 eligible publications, presenting 16 comparisons. Six of these evaluated the MW in a non-brushing model and ten as an adjunct to toothbrushing. A descriptive analysis demonstrated that the majority showed no differences in bleeding, gingivitis and plaque scores. This was confirmed by the meta-analysis. In non-brushing experiments, the difference-of-means (DiffM) for plaque scores was 0.10 (P = 0.45, 95%CI: [-0.15; 0.34]) and for the gingival index 0.04 (P = 0.15,95%CI: [-0.02; 0.11]). The DiffM in brushing studies for plaque scores was 0.01 (P = 0.29, 95%CI: [-0.01; 0.02]) and for the gingival index 0.00 (P = 0.87,95%CI: [-0.05; 0.06]). With respect to staining scores, the meta-analysis revealed that in non-brushing studies, the standardized mean difference was 3.19 (P = 0.0005,95%CI: [-3.98; -1.41]) while in brushing studies, the DiffM was 0.12 (P = 0.95,95%CI: [-3.32; 3.55]). CONCLUSION: There is moderate quality evidence from non-brushing studies that the addition of an ADS to CHX-MW reduces tooth surface discoloration and does not appear to affect its properties with respect to gingival inflammation and plaque scores. In brushing studies, there is also moderate quality evidence that ADS does not affect the anti-plaque and anti-gingivitis efficacy of CHX. The majority of comparisons and the meta-analysis including these indicate no significant effect of ADS on tooth staining in situations where the mouthwash is used in addition to toothbrushing.


Assuntos
Anti-Infecciosos Locais , Placa Dentária , Gengivite , Descoloração de Dente , Clorexidina , Humanos , Antissépticos Bucais
15.
Sci Total Environ ; 701: 134818, 2020 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-31706213

RESUMO

Although an increasing body of evidence suggests that triclocarban, a phenyl ether classified as a contaminant of emerging concern, presents a risk to development, there is limited data available on the potential interplay of triclocarban with the developing mammalian nervous system. This study was aimed to investigate the impact of environmentally pervasive chemical triclocarban on autophagy and estrogen receptor-mediated signaling pathways in mouse neurons. The study showed that triclocarban impaired autophagy and disrupted estrogen receptor signaling in mouse embryonic neurons in primary culture. Triclocarban used at environmentally relevant concentrations inhibited the mRNA and protein expression of ESR1 and GPER1 but not ESR2. The triclocarban-induced decrease in the expression of estrogen receptors was supported by the colocalization of the receptors in mouse neurons and corresponded to hypermethylation of the Esr1 and Gper1 genes. Selective antagonists increased the effects of triclocarban, which suggests that the neurotoxic effects of triclocarban, in addition to decreasing estrogen receptor expression, are mediated via inhibition of the neuroprotective capacity of the receptors. Furthermore, Becn1 and Atg7 siRNAs potentiated the caspase-3-dependent effect of triclocarban, which points to triclocarban-induced impairment of autophagy. Indeed, triclocarban dysregulated the expression of autophagy-related genes, and caused a time-dependent inhibition of the mRNA expression of Becn1, Map1lc3a, Map1lc3b, Nup62, and Atg7, which was correlated with a decrease in the protein levels of MAP1LC3B, BECN1 and autophagosomes, but not NUP62 protein level which was increased. Intriguingly, the Esr1 and Gper1 siRNAs did not affect the level of autophagosomes, suggesting that the triclocarban-induced impairment of autophagy is independent of the triclocarban-induced disruption of estrogen receptor signaling in mammalian neurons. Because our data provided evidence that triclocarban has the capacity to impair autophagy and disrupt estrogen receptor signaling in brain neurons at an early developmental stage, we postulate to categorize the compound as a neurodevelopmental risk factor.


Assuntos
Anti-Infecciosos Locais/toxicidade , Carbanilidas/toxicidade , Receptores Estrogênicos/metabolismo , Animais , Metilação de DNA , Camundongos , Neurônios
17.
J Contemp Dent Pract ; 20(8): 952-956, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31797853

RESUMO

INTRODUCTION: Assessment of host response to inflammation will throw light on the critical role of antioxidants (AOs) and free radicle damage in the etiology of periodontal disease. The purpose of the study was to assess the level of plasma oxidative stress in those having aggressive periodontal disease before and after full-mouth disinfection. Objectives were to find the influence of full-mouth disinfection analyzing the level of thiobarbituric acid reactive substances (TBARSs), thereby quantifying the lipid peroxidation (LPO) and also the activities of reduced glutathione (GSH), glutathione peroxidase (GPX), and catalase (CAT), valuing the AO defense systems in health and disease. MATERIALS AND METHODS: The valuation composed of 30 subjects with aggressive periodontal disease and 30 healthy controls. Clinical assessment included following periodontal parameters: plaque index (PI), papillary bleeding index (PBI), probing pocket depth (PPD), and clinical attachment level (CAL). Levels of bone loss were assessed by taking full-mouth periapical radiographs. Initial periodontal therapy comprises of full-mouth disinfection which includes subgingival scaling and root planing within 24 hours combined with adjunctive chlorhexidine chemotherapy for aggressive periodontitis subject's at sites indicated. The parameters (clinical) were evaluated at the baseline and 8 weeks after initial periodontal therapy at six sites of teeth indicated. Plasma samples were taken and evaluated by standard procedures as defined in the literature. All the values were weighed and related. RESULTS: Strong positive associations were detected among periodontal parameters and TBARS, enzymatic/nonenzymatic AO levels (p < 0.05), and pre- and postperiodontal management. The plasma levels of patients with aggressive periodontitis had high levels of TBARS and displayed a substantial escalation in the activities of GSH and GPX levels in the plasma matched to the healthy individuals (p < 0.05). CONCLUSION: This paper evaluated ROS activity and AO defense before and after treatment to stimulate added periodontal investigation in this part which will give an insight into the therapeutic options with foreseeable results.


Assuntos
Periodontite Agressiva , Anti-Infecciosos Locais , Raspagem Dentária , Desinfecção , Humanos , Perda da Inserção Periodontal , Aplainamento Radicular
18.
J Contemp Dent Pract ; 20(8): 963-969, 2019 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-31797855

RESUMO

AIM: The aim of this study was to evaluate and compare two different one-stage full-mouth disinfection protocols in the treatment of chronic periodontitis by assessing dental plaque and tongue coat using BANA assay. MATERIALS AND METHODS: The present study was a prospective randomized clinical parallel arm study design including 40 healthy subjects randomly allocated into two groups, i.e., group A (Quirynen's protocol of one-stage full-mouth disinfection) and group B (Bollen's protocol of one-stage full-mouth disinfection). Subjects were assessed at baseline and six weeks using plaque index, gingival index, and sulcus bleeding index. Probing depth and relative clinical attachment level were also recorded at six weeks. Winkel tongue coat index and BANA were recorded at 8 weeks using subgingival plaque and tongue coat sample. RESULTS: Both group A and group B demonstrated statistically significant reduction in plaque index, gingival index, sulcus bleeding index, Winkel tongue coat index, reduction in probing depth, and gain in relative clinical attachment level on intragroup comparison. There was no significant difference in BANA assay score of subgingival plaque and tongue coat samples in between group A and group B. CONCLUSION: From the findings of this study, both Quirynen's protocol and Bollen's protocol of one-stage full-mouth disinfection are effective in plaque reduction and tongue coat reduction and achieve comparable clinical healing outcomes. CLINICAL SIGNIFICANCE: The difference in duration and mode of use of chlorhexidine as a chemical plaque control agent in the two treatment interventions of Quirynen's and Bollen's protocol of one-stage full-mouth disinfection did not demonstrate statistical significance in reducing sulcus bleeding index scores, reducing probing depths, and gain in relative clinical attachment levels.


Assuntos
Anti-Infecciosos Locais , Raspagem Dentária , Antissépticos Bucais , Anti-Infecciosos Locais/uso terapêutico , Índice de Placa Dentária , Desinfecção , Humanos , Boca/microbiologia , Estudos Prospectivos , Aplainamento Radicular
19.
Rev Chilena Infectol ; 36(4): 414-420, 2019 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-31859763

RESUMO

Taurolidine is a broad-spectrum antiseptic used as lock therapy solution in adult and pediatric patients with long term central venous catheters (CVC) for the prevention of catheter related bloodstream infections (CRBSI). Taurolidine doesn't induce the resistant development and has only minor and brief side effects, which makes it an alternative both as a lock therapy and for the prevention of CRBSI in this group of patients.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Infecções Relacionadas a Cateter/prevenção & controle , Cateteres Venosos Centrais/efeitos adversos , Taurina/análogos & derivados , Tiadiazinas/administração & dosagem , Humanos , Taurina/administração & dosagem
20.
Medicine (Baltimore) ; 98(45): e17932, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31702678

RESUMO

Postoperative infection is one of the most serious complications in orthopedic surgery. We have developed and use iodine-coated implants to prevent and treat postoperative infection in compromised hosts. This study evaluated outcomes using iodine-coated implants for postoperative infections.We treated 72 postoperative infected patients using iodine-coated implants. Of these, 38 were males and 34 were females, with a mean age of 59.3 years. The mean follow-up period was 5.6 years. The patients included 23 with an infection following total knee arthroplasty, 20 following total hip arthroplasty, 11 following osteosynthesis, 11 following spine surgery, 6 following tumor excision, and 1 following osteotomy. Of these, 37 underwent single-stage surgery and 35 underwent staged revision surgery. We performed staged surgery in any case with active infection. The survival of iodine-coated implants was determined using Kaplan-Meier analysis. White blood cell (WBC) and C-reactive protein (CRP) levels were measured pre- and postoperatively. To evaluate the systemic effects of iodine, serum thyroid hormone levels were examined.Five patients underwent re-revision surgery. In 3 patients, periprosthetic infection recurred at an average of 18 months after surgery. The reinfection rate was 4.2%. These patients recovered following reimplantation of iodine-coated prostheses. No patients required amputation. The survival rate of iodine-coated implants was 91%. There were no signs of infection at the latest follow-up. The median WBC level was nearly in the normal range, and CRP levels returned to normal within 4 weeks after surgery. No abnormalities of thyroid gland function were detected.Iodine-coated titanium implants can be very effective in the treatment of postoperative infections. An iodine coating can be safely applied to infected regions.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Materiais Revestidos Biocompatíveis/uso terapêutico , Iodo/administração & dosagem , Procedimentos Ortopédicos/métodos , Infecção da Ferida Cirúrgica/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Reoperação/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
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