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1.
Int J Nanomedicine ; 15: 6935-6944, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33061360

RESUMO

Introduction: Nanoparticle solutions have been studied to improve antimicrobial effect. The aim of this study was to develop, characterize, and evaluate the in vitro and in vivo antiseptic efficacy of 0.25% aqueous-based chlorhexidine nanoemulsion (NM-Cl 0.25% w/v). Methods: The NM-Cl 0.25% w/v (2.5mg/mL) and free chlorhexidine nanoemulsion (FCN; same composition of NM-Cl without the molecule of chlorhexidine) were synthetized by the spontaneous emulsification method. Characterization analyses of physical and chemical properties were performed. The NM-Cl 0.25% w/v was compared with chlorhexidine 0.5% alcohol base (CS-Cl 0.5%) in vitro studies (microdilution study and kill curve study), and in vivo study (antisepsis of rats dorsum). Kruskal-Wallis test was used between groups and inside the same group, at different sample times and the Mann-Whitney test was performed when difference was detected. Results: The NM-Cl 0.25% w/v presented adequate physicochemical characteristics for a nanoemulsion, revealing a more basic pH than FCN and difference between zeta potential of NM-Cl 0.25% w/v and FCN. The NM-Cl 0.25% w/v and CS-Cl 0.5% solutions were more effective on Gram-positive than on Gram-negative bacteria (p≤0.05). NM-Cl 0.25% w/v presented upper antiseptic effect in the microdilution study and residual antiseptic effect was maintained for a longer time when compared to CS-Cl 0.5% (kill curve study). The four-fold (minimal inhibitory concentration) of NM-Cl 0.25% were the formulations with most durable effect within those tested, presenting residual effect until T6 for both bacteria. In the in vivo study, both formulations (NM-Cl 0.25% w/v and CS-Cl 0.5%) had a reduction of the microorganisms in the skin of the rats (p<0.0001) not revealing any difference between the formulations at different times, showing the antiseptic effect of NM-Cl (p≤0.05). Conclusion: Both in vitro and in vivo experiments demonstrated that NM-Cl showed promising future as an antiseptic for cutaneous microbiota.


Assuntos
Anti-Infecciosos Locais/farmacologia , Clorexidina/farmacologia , Emulsões/química , Nanoestruturas/química , Animais , Anti-Infecciosos Locais/química , Clorexidina/química , Emulsões/farmacologia , Etanol/química , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Masculino , Testes de Sensibilidade Microbiana , Nanoestruturas/uso terapêutico , Ratos Wistar , Pele/efeitos dos fármacos , Pele/microbiologia
2.
J Otolaryngol Head Neck Surg ; 49(1): 77, 2020 Oct 27.
Artigo em Inglês | MEDLINE | ID: mdl-33109269

RESUMO

BACKGROUND: The COVID-19 pandemic has raised concerns of inadvertent SARS-CoV-2 transmission to healthcare workers during routine procedures of the aerodigestive tract in asymptomatic COVID-19 patients. Current efforts to mitigate this risk focus on Personal Protective Equipment, including high-efficiency filtration as well as other measures. Because the reservoir for SARS-CoV-2 shedding is in the nasopharynx and nasal and oral cavities, the application of viricidal agents to these surfaces may reduce virus burden. Numerous studies have confirmed that povidone-iodine inactivates many common respiratory viruses, including SARS-CoV-1. Povidone-iodine also has good profile for mucosal tolerance. Thus, we propose a prophylactic treatment protocol for the application of topical povidone-iodine to the upper aerodigestive tract. CONCLUSION: Such an approach represents a low-cost, low-morbidity measure that may reduce the risks associated with aerosol-generating procedures performed commonly in otorhinolaryngology operating rooms.


Assuntos
Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/epidemiologia , Povidona-Iodo/administração & dosagem , Adulto , Aerossóis , Anti-Infecciosos Locais/administração & dosagem , Infecções por Coronavirus/prevenção & controle , Humanos , Boca , Pneumonia Viral/prevenção & controle
3.
Am J Dent ; 33(5): 235-238, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33017524

RESUMO

PURPOSE: To evaluate the in vitro antimicrobial effect of low- and high-viscosity experimental mouthrinses containing cetylpyridinium chloride (CPC) and 4-isopropyl-3-methylphenol (IPMP) on Streptococcus pneumoniae, Klebsiella pneumoniae, Porphyromonas gingivalis, Streptococcus mutans, and Candida albicans. METHODS: Low- and high-viscosity experimental mouthrinses containing 0.05% CPC and 0.1% IPMP were fabricated. Non-viscous mouthrinses containing either CPC- or IPMP were used as controls. The antimicrobial activity (sterilization or exposure time) of mouthrinses was evaluated based on the bactericidal criterion of <10¹ viable cells in 0.1 mL of culture medium. RESULTS: The sterilization time of the low-viscosity experimental mouthrinse was shorter than that of the high-viscosity mouthrinse. However, whereas a 10-minute exposure to the low-viscosity mouthrinse resulted in no viable cells of C. albicans, neither the CPC- or IPMP mouthrinses had an antimicrobial effect for the same exposure time. These findings show that the low-viscosity experimental mouthrinse containing anodal CPC and neutral IPMP exhibited superior antimicrobial effects against pneumonia- and oral infection-related bacteria compared with the control mouthrinses. CLINICAL SIGNIFICANCE: In Japan, the oral care with the low-viscosity experimental mouthrinse containing CPC and IPMP as alternatives to those based on chlorhexidine are available for preventing the development of pneumonia- and oral infection-related bacteria.


Assuntos
Anti-Infecciosos Locais/farmacologia , Cetilpiridínio/farmacologia , Cresóis , Antissépticos Bucais/farmacologia , Viscosidade
4.
Medicine (Baltimore) ; 99(44): e22910, 2020 Oct 30.
Artigo em Inglês | MEDLINE | ID: mdl-33126347

RESUMO

INTRODUCTION: Using mobile phones for communication in emergency departments is a common practice; however, several studies have demonstrated that they may act as vectors for bacteria and viruses. This study evaluated the effectiveness of plastic wrapping in decreasing bacterial contamination on mobile phone surfaces. METHOD: We used culture dishes and a luminometer to detect bacterial colonies and contamination on the phone surfaces. RESULT: Our experiment showed that bacterial colonies exist on mobile phones before and after work. We found that wiping with 75% alcohol sanitizers effectively reduces the number of colonies on either a mobile phone or a temporary plastic covering. In addition, we found that bacterial colonies do not contaminate or adhere to plastic wrap any easier than to mobile phones. CONCLUSION: These results demonstrated the effectiveness of plastic wrap for protecting mobile phone surfaces against bacterial colonization. In addition, applying a layer of plastic wrap protects the phone from potential damage due to the alcohol.


Assuntos
Bactérias , Telefone Celular , Infecção Hospitalar , Desinfecção/métodos , Serviço Hospitalar de Emergência , Contaminação de Equipamentos/prevenção & controle , Equipamentos e Provisões Hospitalares , Etanol/farmacologia , Anti-Infecciosos Locais/farmacologia , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecção Hospitalar/microbiologia , Infecção Hospitalar/prevenção & controle , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/normas , Equipamentos e Provisões Hospitalares/microbiologia , Equipamentos e Provisões Hospitalares/normas , Humanos , Administração de Materiais no Hospital/métodos , Plásticos , Equipamentos de Proteção/microbiologia
6.
Rev Assoc Med Bras (1992) ; 66Suppl 2(Suppl 2): 124-129, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32965370

RESUMO

An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.


Assuntos
Anti-Infecciosos Locais/farmacologia , Clorexidina/farmacologia , Coronavirus/efeitos dos fármacos , Desinfetantes/farmacologia , Povidona-Iodo/farmacologia , Infecções por Coronavirus/epidemiologia , Desinfecção , Humanos , Pandemias , Pneumonia Viral/epidemiologia
7.
S Afr Med J ; 110(8): 751-752, 2020 06 11.
Artigo em Inglês | MEDLINE | ID: mdl-32880300

RESUMO

In endeavouring to mitigate the spread of the SARS-CoV-2 virus, a concerning practice of spraying individuals with disinfectant via so-called 'disinfection tunnels' has come to light. The Allergy Society of South Africa supports the World Health Organization in strongly condemning all human spraying, owing to lack of efficacy and potential dangers, especially to patients with coexisting allergic conditions.


Assuntos
Anti-Infecciosos Locais/efeitos adversos , Infecções por Coronavirus/prevenção & controle , Desinfetantes/efeitos adversos , Desinfecção/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Alergia e Imunologia , Anti-Infecciosos Locais/administração & dosagem , Betacoronavirus , Desinfetantes/administração & dosagem , Humanos , África do Sul , Organização Mundial da Saúde
8.
Trials ; 21(1): 785, 2020 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-32928313

RESUMO

OBJECTIVES: 1- To compare the effectiveness of 1% Hydrogen peroxide, 0.2% Povidone-Iodine, 2% hypertonic saline and a novel solution Neem extract (Azardirachta indica) in reducing intra-oral viral load in COVID-19 positive patients. 2- To determine the salivary cytokine profiles of IL-2, IL-4, IL-6, IL-10, TNF-α, IFN-γ and IL- 17 among COVID-19 patients subjected to 1% Hydrogen peroxide, 0.2% Povidone-Iodine, 2% hypertonic saline or Neem extract (Azardirachta indica) based gargles. TRIAL DESIGN: This will be a parallel group, quadruple blind-randomised controlled pilot trial with an add on laboratory based study. PARTICIPANTS: A non-probability, purposive sampling technique will be followed to identify participants for this study. The clinical trial will be carried out at the Aga Khan University Hospital (AKUH), Karachi, Pakistan. The viral PCR tests will be done at main AKUH clinical laboratories whereas the immunological tests (cytokine analysis) will be done at the Juma research laboratory of AKUH. The inclusion criteria are laboratory-confirmed COVID-19 positive patients, male or female, in the age range of 18-65 years, with mild to moderate disease, already admitted to the AKUH. Subjects with low Glasgow coma score, with a history of radiotherapy or chemotherapy, who are more than 7 days past the onset of COVID- 19 symptoms, or intubated or edentulous patients will be excluded. Patients who are being treated with any form of oral or parenteral antiviral therapy will be excluded, as well as patients with known pre-existing chronic mucosal lesions such as lichen planus. INTERVENTION AND COMPARATOR: Group A (n=10) patients on 10 ml gargle and nasal lavage using 0.2% Povidone-Iodine (Betadiene® by Aviro Health Inc./ Pyodine® by Brooks Pharma Inc.) for 20-30 seconds, thrice daily for 6 days. Group B (n=10) patients will be subjected to 10 ml gargle and nasal lavage using 1% Hydrogen peroxide (HP® by Karachi Chemicals Products Inc./ ActiveOxy® by Boumatic Inc.) for 20-30 seconds, thrice daily for 6 days. Group C will comprised of (n=10) subjects on 10ml gargle and nasal lavage using Neem extract solution (Azardirachta indica) formulated by Karachi University (chemistry department laboratories) for 20-30 seconds, thrice daily for 6 days. Group D (n=10) patients will use 2% hypertonic saline (Plabottle® by Otsuka Inc.) gargle and nasal lavage for a similar time period. Group E (n=10) will serve as positive controls. These will be given simple distilled water gargles and nasal lavage for 20-30 seconds, thrice daily for six days. For nasal lavage, a special douche syringe will be provided to each participant. Its use will be thoroughly explained by the data collection officer. After each use, the patient is asked not to eat, drink, or rinse their mouth for the next 30 minutes. MAIN OUTCOMES: The primary outcome is the reduction in the intra-oral viral load confirmed with real time quantitative PCR. RANDOMISATION: The assignment to the study group/ allocation will be done using the sealed envelope method under the supervision of Clinical Trial Unit (CTU) of Aga Khan University, Karachi, Pakistan. The patients will be randomised to their respective study group (1:1:1:1:1 allocation ratio) immediately after the eligibility assessment and consent administration is done. BLINDING (MASKING): The study will be quadruple-blinded. Patients, intervention provider, outcome assessor and the data collection officer will be blinded. The groups will be labelled as A, B, C, D or E. The codes of the intervention will be kept in lock & key at the CTU and will only be revealed at the end of study or if the study is terminated prematurely. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): As there is no prior work on this research question, so no assumptions for the sample size calculation could be made. The present study will serve as a pilot trial. We intend to study 50 patients in five study groups with 10 patients in each study group. For details, please refer to Fig. 1 for details. TRIAL STATUS: Protocol version is 7.0, approved by the department and institutional ethics committees and clinical trial unit of the university hospital. Recruitment is planned to start as soon as the funding is sanctioned. The total duration of the study is expected to be 6 months i.e. August 2020-January 2021. TRIAL REGISTRATION: This study protocol was registered at www.clinicaltrials.gov on 10 April 2020 NCT04341688 . FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2). Fig. 1 Flow diagram of study-participants' timeline.


Assuntos
Azadirachta , Betacoronavirus , Infecções por Coronavirus , Peróxido de Hidrogênio/administração & dosagem , Pandemias , Extratos Vegetais/administração & dosagem , Pneumonia Viral , Povidona-Iodo/administração & dosagem , Solução Salina Hipertônica/administração & dosagem , Carga Viral , Adulto , Anti-Infecciosos Locais/administração & dosagem , Betacoronavirus/efeitos dos fármacos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Feminino , Hospitalização , Humanos , Masculino , Monitorização Imunológica/métodos , Antissépticos Bucais/administração & dosagem , Lavagem Nasal/métodos , Pneumonia Viral/diagnóstico , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Carga Viral/efeitos dos fármacos , Carga Viral/métodos
9.
Medicine (Baltimore) ; 99(39): e22218, 2020 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-32991414

RESUMO

BACKGROUND: Chlorhexidine and silver sulfadiazine coated central venous catheters (CSS-CVC) may cause loss of antimicrobial efficacy due to friction between the CVC surface and sheer stress caused by the blood flow. Therefore, the aim of this study was to investigate the antibacterial efficacy of CSS-CVC at various flow rates using a bloodstream model. METHODS: Each CVC was subjected to various flow rates (0.5, 1, 2, and 4 L/min) and wear-out times (0, 24, 48, 72, 96, and 120 hours), and the optical density (OD) 600 after a Staphylococcus aureus incubation test was used to determine the antibacterial effect of CSS-CVC. RESULTS: In the 0.5 L/min group, there was no significant change in the OD600 value up to 120 hours compared with the baseline OD600 value for CSS-CVC (P > .467). However, the OD600 values of CSS-CVC in the 1 L/min (P < .001) and 2 L/min (P < .001) groups were significantly reduced up to 72 hours, while that in the 4 L/min (p < 0.001) group decreased rapidly up to 48 hours. CONCLUSION: This study suggests that there is a doubt whether sufficient antibacterial function can be maintained with prolonged duration of catheter placement.


Assuntos
Anti-Infecciosos Locais/farmacologia , Velocidade do Fluxo Sanguíneo , Cateterismo Venoso Central/instrumentação , Clorexidina/farmacologia , Sulfadiazina de Prata/farmacologia , Antibacterianos/farmacologia , Anti-Infecciosos Locais/administração & dosagem , Infecções Relacionadas a Cateter/prevenção & controle , Cateteres Venosos Centrais/normas , Clorexidina/administração & dosagem , Humanos , Modelos Biológicos , Projetos Piloto , Sulfadiazina de Prata/administração & dosagem
10.
J Int Acad Periodontol ; 22(3): 166-173, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32980829

RESUMO

AIMS: The purpose of the present study was to compare the effect of a new mouth wash formulation consisting of chlorhexidine and chitosan on dental plaque and its reduction to that of chlorhexidine or chitosan alone. MATERIALS AND METHODS: This study was a single-blind randomized clinical trial with a parallel group design of 3 months duration. Patients (20-40 years) who fulfilled the inclusion and exclusion criteria were assigned equally to group 1: chlorhexidine (0.2%), group 2: chitosan (0.5%) or group 3: chlorhexidine - chitosan combination group. The clinical parameters were recorded at baseline, 6weeks and at 3months. All patients received thorough oral prophylaxis and were instructed to rinse with 10ml of mouthwash twice daily for 1 minute. RESULTS: The combination of chitosan and chlorhexidine showed a statistically significant reduction (p less than0.05) in plaque indices from baseline at all time intervals when compared to that of chlorhexidine or chitosan alone. CONCLUSIONS: Our study demonstrates that by unifying the properties of chitosan and chlorhexidine may result in a superior antiplaque effect than that of chlorhexidine alone.


Assuntos
Anti-Infecciosos Locais , Quitosana , Placa Dentária , Gengivite , Anti-Infecciosos Locais/uso terapêutico , Clorexidina/uso terapêutico , Placa Dentária/tratamento farmacológico , Placa Dentária/prevenção & controle , Índice de Placa Dentária , Humanos , Antissépticos Bucais , Método Simples-Cego
11.
Mikrobiyol Bul ; 54(3): 490-496, 2020 Jul.
Artigo em Turco | MEDLINE | ID: mdl-32755523

RESUMO

Myiasis is defined as follows; some flies lay their eggs and larvae on live organs and tissues or on cavities of nose, eye, ear and etc of humans or animals and the larvae develop there and cause pathological disorders. One of the rare types of myiasis is the urogenital myiasis. This condition has been associated with covering urogenital area with clothes in almost all populations and therefore, less chance for flies to reach this site and lay their eggs. Low socio-cultural level and poor hygiene conditions are stated as the most important risk factors of myiasis. On the other hand, toilets within the human living spaces are ideal environments for fly larvae that are fed on bacteria as they contain moisture and a microbial environment. It is stated that especially in case of the presence of an underlying infection, flies are more prone to lay their eggs or larvae on this area due to the bad smell. In this case report, a patient with a moderate sociocultural level with no underlying chronic disease, no open wound in the genital area and no urinary tract infection was presented. A 53-year-old female patient living with her family in an apartment flat in the city center of Konya admitted to the outpatient clinic of infectious diseases with the complaint of moving worms in her urine. The patient stated that she had seen maggots while urinating for two weeks and that she passed her urine into a container to be sure that the maggots were coming from her urine, upon seeing the maggots there she has admitted to the hospital. The Larvae were defined as the fourth stage larvae of Psychoda spp. No open lesions or wounds were seen in genitourinary area of the patient who had no complaints other than mild urinary burning. Complete blood count test results of the patient were normal and there was no growth in her urine culture. It was stated that other family members whom she lived with did not have similar complaints. The patient was diagnosed as genitourinary myiasis caused byPsychoda spp. and informed about the relationship between hygiene and the disease. And urinary antiseptics were initiated as the treatment for the patient. After the treatment, no larvae were seen in the urine of the patient. In conclusion, many regions are suitable for Psychoda type of adult flies to live in our country due to the climate conditions. It is considered that infestation may develop in patients with less risk factors in terms of urogenital myiasis, that larvae may increase in number of patients who are not treated or followed up and that the infestation may become chronic and results in more serious clinical conditions. The necessary treatment and follow-up must be performed in such cases and the patients should be educated about the relationship between infestation and hygiene.


Assuntos
Doenças Urogenitais Femininas , Miíase , Psychodidae , Sistema Urogenital , Animais , Anti-Infecciosos Locais/uso terapêutico , Feminino , Doenças Urogenitais Femininas/diagnóstico , Doenças Urogenitais Femininas/tratamento farmacológico , Doenças Urogenitais Femininas/parasitologia , Humanos , Larva , Pessoa de Meia-Idade , Miíase/diagnóstico , Miíase/tratamento farmacológico , Miíase/urina , Fatores de Risco , Resultado do Tratamento , Sistema Urogenital/parasitologia
12.
Dan Med J ; 67(9)2020 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-32800064

RESUMO

INTRODUCTION: Childhood irritant contact dermatitis (ICD) is the most common cause for developing chronic hand eczema as an adult. The COVID-19 reopening in Denmark included regulations introducing frequent hand washing. The aim of the present study was to evaluate if frequent hand washing increases the incidence of ICD in children. METHODS: We conducted an observational study in Denmark during the reopening of schools and daycare facilities for children aged 0-12 years (April 22nd to May 1st 2020). A questionnaire was sent out to parents in four municipalities consisting of 20 questions about frequency of hand washing, use of hand sanitiser, symptoms of ICD, atopic dermatitis, allergy and predispositions. RESULTS: The study included 6,273 children. In children without any prior symptoms of dermatitis, 42.4% experienced ICD (dry, red and itchy skin) due to increased hand hygiene. Schoolchildren had a 1.5 times greater relative risk of developing ICD than preschool children. Frequency of hand washing was a strong risk factor, whereas this was not the case for alcohol-based hand sanitiser. Hand washing 7-10 times/day and >10 times/day increased the relative risk by 1.83 and 2.23 times, respectively. CONCLUSIONS: A higher frequency of hand washing during the COVID-19 reopening increased the incidence of ICD in children. Hand hygiene is essential in our fight against novel coronavirus, but prophylactic initiatives are important to reduce the possible long-term consequences of ICD in children. FUNDING: none TRIAL REGISTRATION: Clinicaltrials.gov (NCT04375410).


Assuntos
Anti-Infecciosos Locais/efeitos adversos , Betacoronavirus , Infecções por Coronavirus/complicações , Dermatite Irritante/etiologia , Pneumonia Viral/complicações , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Dinamarca/epidemiologia , Dermatite Irritante/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pandemias , Pneumonia Viral/epidemiologia
13.
Plast Reconstr Surg ; 146(2): 301-308, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32740580

RESUMO

BACKGROUND: Infections are challenging complications of implant-based breast reconstruction and augmentation. They pose a clinical challenge, with significant economic implications. One proposed solution is implant irrigation at the time of placement. There is no consensus on the optimal irrigant solution. METHODS: The authors tested the relative efficacy of 10% povidone-iodine, Clorpactin, Prontosan, triple-antibiotic solution, or normal saline (negative control) against two strains each of methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis. Sterile, smooth silicone implant disks were immersed in irrigant solution, then incubated in suspensions of methicillin-resistant S. aureus or S. epidermidis overnight. The disks were rinsed and sonicated to displace adherent bacteria from the implant surface, and the displaced bacteria were quantified. Normalized values were calculated to characterize the relative efficacy of each irrigant. RESULTS: Povidone-iodine resulted in reductions of the bacterial load by a factor of 10 to 10 for all strains. Prontosan-treated smooth breast implant disks had a 10-fold reduction in bacterial counts for all but one methicillin-resistant S. aureus strain. In comparison to Prontosan, triple-antibiotic solution demonstrated a trend of greater reduction in methicillin-resistant S. aureus bacterial load and weaker activity against S. epidermidis strains. Clorpactin reduced the recovered colony-forming units for only a single strain of S. epidermidis. Povidone-iodine demonstrated the greatest efficacy against all four strains. However, Clorpactin, triple-antibiotic solution, and Prontosan demonstrated similar efficacies. CONCLUSIONS: Povidone-iodine was the most efficacious of the irrigants at reducing methicillin-resistant S. aureus and S. epidermidis contamination. Given the recent lifting of the U.S. Food and Drug Administration moratorium, larger clinical studies of povidone-iodine as a breast implant irrigant solution are warranted. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, V.


Assuntos
Anti-Infecciosos Locais/administração & dosagem , Biofilmes/efeitos dos fármacos , Implante Mamário/efeitos adversos , Implantes de Mama/microbiologia , Infecções Relacionadas à Prótese/prevenção & controle , Bacitracina/administração & dosagem , Benzenossulfonatos/administração & dosagem , Implante Mamário/instrumentação , Cefazolina/administração & dosagem , Combinação de Medicamentos , Gentamicinas/administração & dosagem , Humanos , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Povidona-Iodo/administração & dosagem , Infecções Relacionadas à Prótese/microbiologia , Soluções , Staphylococcus epidermidis/efeitos dos fármacos , Staphylococcus epidermidis/isolamento & purificação , Irrigação Terapêutica/métodos
14.
J Hosp Infect ; 106(2): 264-270, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32800826

RESUMO

The World Health Organization (WHO) hand-rub formulations have been in use around the world for at least the past 10 years. The advent of coronavirus disease 2019 (COVID-19) has further enhanced their use. We reviewed published efficacy data for the original and modified formulations. Only efficacy data according to the European Norms (EN) were found. The bactericidal efficacy of the original formulations was, under practical conditions, partly insufficient (EN 1500, only effective in 60 s; EN 12791, efficacy too low in 5 min). The first modification with higher alcohol concentrations improves their efficacy as hygienic hand rub (effective in 30 s). The second (0.725% glycerol) and third (0.5% glycerol) modification improves their efficacy for surgical hand preparation (effective in 5 and 3 min). The original and second modified formulations were tested and demonstrate activity against enveloped viruses including severe acute resiratory syndrome coronavirus 2 (SARS-CoV-2) in 30 s. The ethanol-based formulation is also active against some non-enveloped test viruses in 60 s (suspension tests, EN 14476). In-vivo data on the formulations would provide a more reliable result on the virucidal efficacy on contaminated hands but are currently not available. Nevertheless, the most recent modifications should be adopted for use in healthcare.


Assuntos
2-Propanol/normas , Anti-Infecciosos Locais/normas , Infecções por Coronavirus/prevenção & controle , Desinfetantes/normas , Guias como Assunto , Desinfecção das Mãos/normas , Controle de Infecções/normas , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Betacoronavirus , Humanos , Organização Mundial da Saúde
15.
Br J Oral Maxillofac Surg ; 58(8): 924-927, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32859459

RESUMO

The proximity to the patient during dental care, high generation of aerosols, and the identification of SARS-CoV-2 in saliva have suggested the oral cavity as a potential reservoir for COVID-19 transmission. Mouthwashes are widely-used solutions due to their ability to reduce the number of microorganisms in the oral cavity. Although there is still no clinical evidence that they can prevent the transmission of SARS-CoV-2, preoperative antimicrobial mouth rinses with chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), povidone-iodine (PVP-I), and hydrogen peroxide (H2O2) have been recommended to reduce the number of microorganisms in aerosols and drops during oral procedures. This paper therefore aims to provide a comprehensive review of the current recommendations on the use of mouthwashes against the COVID-19 pandemic and to analyse the advantages and disadvantages of most conventional antiseptic mouthwashes used in dentistry.


Assuntos
Anti-Infecciosos Locais , Infecções por Coronavirus , Antissépticos Bucais , Pandemias , Pneumonia Viral , Betacoronavirus , Clorexidina , Odontologia , Humanos , Peróxido de Hidrogênio
18.
Acta Odontol Latinoam ; 33(1): 45-49, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32621599

RESUMO

The gutta-percha cones used in endodontic treatment are produced in aseptic conditions and their composition includes zinc oxide, which is responsible for antibacterial activity. However, there is the possibility of microbial contamination by manipulation, aerosol or during storage. Although several chemical agents have been tested for their decontamination, there is no consensus on the best disinfection protocol to be used. The aim of this study was to evaluate the decontamination of gutta-percha cones contaminated with the bacteria Enterococcus faecalis, by using chlorhexidine digluconate (CHX) and sodium hypochlorite (NaClO) at different concentrations for short exposure times. For this purpose, gutta-percha cones (size 40) were selected at random from a sealed box and immersed for 1 min in a microbial suspension. Then they were immersed in specific Petri dishes for different groups containing: CHX 2%, NaClO 1% or NaClO 2.5% for 30 s or 1 min, and subsequently placed in tubes containing BHI broth. After incubating the tubes for 48 h, it was observed that 1% and 2.5% NaClO and 2% CHX were effective for decontaminating the cones at those exposure time intervals. Microbial growth was detected in one of the replicates of the group with CHX applied for 30 s. To prevent the possibility of failures at this stage, the exposure time of gutta-percha cones to the decontaminating agent should not be reduced.


Assuntos
Clorexidina/análogos & derivados , Descontaminação/métodos , Desinfetantes de Equipamento Odontológico/farmacologia , Enterococcus faecalis/efeitos dos fármacos , Guta-Percha , Irrigantes do Canal Radicular/farmacologia , Hipoclorito de Sódio/farmacologia , Esterilização/métodos , Anti-Infecciosos Locais , Clorexidina/farmacologia , Desinfetantes de Equipamento Odontológico/administração & dosagem , Enterococcus faecalis/isolamento & purificação , Contaminação de Equipamentos/prevenção & controle , Humanos , Materiais Restauradores do Canal Radicular , Irrigantes do Canal Radicular/administração & dosagem , Hipoclorito de Sódio/administração & dosagem
19.
J Contemp Dent Pract ; 21(5): 494-499, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32690830

RESUMO

AIM: This study aimed to compare the effects of subgingival delivery of 2% curcumin gel and 0.2% chlorhexidine gel as an adjunct to scaling and root planing (SRP) on clinical and microbiological parameters in the management of patients with chronic periodontitis. MATERIALS AND METHODS: In total, 25 systemically healthy individuals with age group ≥30 years diagnosed with chronic periodontitis were included in the study. The study was a double-blind split-mouth randomized control clinical trial. Two sites were selected in each patient and were randomly allocated to experimental and control sites. At baseline, measurements of site-specific periodontal parameters and collection of subgingival plaque sample were done. After full-mouth SRP, subgingival delivery of 2% curcumin gel in experimental sites and 0.2% chlorhexidine gel in control sites was done. At 1 and 3 months, subgingival plaque samples were collected again and site-specific periodontal parameters were measured. RESULTS: The experimental group (2% curcumin gel) showed statistically significant improvements in periodontal [i.e., sulcus bleeding index (SBI), probing pocket depth (PPD), and relative attachment level (RAL)] and microbiologic parameters in the form of colony-forming units (CFUs) in comparison with control group (0.2% chlorhexidine gel). CONCLUSION: Subgingival delivery of curcumin has shown effective anti-inflammatory and antibacterial properties. Since it is biologically accepted by the patients and its delivery in periodontal pockets can be recommended as an adjunct to SRP therapy for the treatment of patients with localized, moderate chronic periodontitis and in patients under the periodontal maintenance phase. CLINICAL SIGNIFICANCE: Curcumin being a herbal agent may be excellent alternative to chlorhexidine. It is biologically accepted by the patients and can be recommended as an adjunct to SRP in the treatment of localized moderate chronic periodontitis and periodontal maintenance patients.


Assuntos
Anti-Infecciosos Locais , Periodontite Crônica , Curcumina , Clorexidina , Raspagem Dentária , Humanos , Aplainamento Radicular
20.
Surg Clin North Am ; 100(4): 787-806, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32681877

RESUMO

Since the dawn of humanity, wounds have afflicted humans, and healers have held responsibility for treating them. This article tracks the evolution of wound care from antiquity to the present, highlighting the roles of surgeons, scientists, culture, and society in the ever-changing management of traumatic and iatrogenic injuries.


Assuntos
Cicatrização/fisiologia , Ferimentos e Lesões/história , Antibacterianos/história , Anti-Infecciosos Locais/história , Conflitos Armados/história , Antigo Egito , Grécia Antiga , História do Século XV , História do Século XVI , História do Século XVII , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , História Medieval , Humanos , Medicina Militar/história , Pinturas , Mundo Romano/história , Infecção dos Ferimentos/história , Infecção dos Ferimentos/prevenção & controle
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