Cetylpyridinium Chloride as a Tool Against COVID-19

ABSTRACT: As a part of bringing knowledge to healthcare professional, our team searched in the literature the effectiveness of Cetylpyridinium Chloride over SARS-CoV-2. Objectives: Explore the efficacy of Cetylpyridinium Chloride as a mouthwash in the dental attention. Methods: A literature search was realized in PubMed (MEDLINE), with the focusing on the following words: "Cetylpyridinium Chloride", "COVID-19", "Mouthwash", up to June 30, 2020. Results: There is a few information of this biocide over lower and upper airway affection, and other microorganisms. The effect of Cetylpyridinium Chloride over SARS-CoV-2 has not been proved. Although different guidelines recommend oxidative agents as a mouthwash before dental attention. Conclusion: Cetylpyridinium chloride is a cationic biocide widely used as a disinfectant in dentistry and as a mouthwash. Nevertheless, more research is needed, to know the effectiveness of CPC over SARS-CoV-2.

RESUMEN: Como parte de entregar el conocimiento al personal medico, nuestro equipo ha realizado una búsqueda sobre la eficacia del Cloruro Cetilpiridinio (CPC) sobre el virus SARS-CoV-2. Objetivos: Explorar la eficacia del CPC como uso de colutorio en la atención dental. Material y Metodos: Busqueda en la literatura mediante Pubmed (MEDLINE), con enfoque en las palabras Cloruro Cetilpiridinio, COVID-19, Colutorio, hasta Junio 30,2020. Resultados: Existe escasa información sobre este biocida y su efecto en las vias respiratorias altas y bajas, como frente a otros microrganismos. El efecto de CPC sobre SARS-CoV- 2 no se ha visto del todo comprobado. Sin embargo diferentes protocolos de actuación dental recomiendan el uso de agentes oxidantes como colutorio previo a la atención dental. Conclusión: CPC es un biocida cationico ampliamente utilizado como desinfectante en la odontología. Sin embargo se necesita mayor evidencia cientifica para demostrar la eficiencia del CPC por sobre SARS-CoV-2.

Niveles de glucemia intraoperatoria y su relación con la morbimortalidad a corto y largo plazo en pacientes con trasplante de hígado en un hospital de alta complejidad / Levels of intraoperative glycemia and their relations to short and long term morbidity and mortality in liver transplant patients at a highly complex hospital

Resumen Objetivo: se realizó un estudio en pacientes sometidos a trasplante de hígado (TH) con el objetivo de determinar los valores de glucemia en cada una de las fases de la cirugía del TH y su relación con la morbimortalidad postoperatoria. Materiales y métodos: se identificaron los trasplantes hepáticos entre 2013 y 2015 en los registros institucionales. La información se tomó de la nota operatoria, registros de laboratorio y evoluciones de historia clínica. Se buscaron diferencias en la glucemia en las 3 fases del trasplante entre diabéticos y no diabéticos, la presencia de infección y rechazo. Resultados: en total, se estudiaron 73 pacientes trasplantados, 54,8% (n = 40) de sexo masculino, con una mediana en la edad de 59 años (rango intercuartílico [RIQ] = 52-53). El 32,9% (n = 24) tenía antecedente de diabetes mellitus (DM). Se encontraron diferencias en la glucemia inicial y final (127 mg/dL frente a 212 mg/dL) en diabéticos (p = 0,001), así como en los no diabéticos (glucemia inicial: 105 mg/dL frente a la final: 190 mg/dL) (p <0,000). La proporción de rechazo fue mayor en diabéticos (14,3%, n = 7). No se encontraron diferencias significativas en la presencia de infecciones entre diabéticos y no diabéticos. Se confirmó el diagnóstico de diabetes postrasplante en el 15,1%. Conclusiones: un adecuado control glucémico en los diferentes períodos del transoperatorio en el TH logra igualar la tasa de complicaciones a nivel infeccioso en pacientes diabéticos y no diabéticos; el rechazo continúa siendo más frecuente en pacientes diabéticos. Es necesaria una búsqueda activa de la diabetes postrasplante en cada uno de nuestros pacientes.

Abstract Objective: This study was of patients who underwent liver transplantation has the objective of determining glycemia values ​​in each phase of liver transplant surgery and their relationships with post-operative morbidity and mortality. Materials and Methods: Liver transplant patients were identified in institutional records from 2013 to 2015. The information was taken from operative notes, laboratory records and clinical histories. We searched for differences in blood glucose levels during the three phases of transplantation and compared the incidences of infections and rejections for diabetics and non-diabetics. Results: A total of 73 transplant patients were studied: 54.8% (n = 40) were male, the median age was 59 years (RIQ = 52-53), and 32.9% (n = 24) had histories of Diabetes Mellitus. Differences were found between initial and final serum glucose levels of diabetics (127 mg/dl vs. 212 mg/dl, p = 0.001) as well as in non-diabetics (105 mg/dl vs. 190 mg/dl, p < 0.000). The proportion of rejection was highest among diabetics (14.3%, n = 7). No significant differences were found in the proportions of diabetic and non-diabetic patients who developed infections. Diagnosis of post-transplant diabetes was confirmed in 15.1% of the sample. Conclusions: Adequate monitoring of blood glucose levels during all trans-operative periods of liver transplantation can equalize the rate of infectious complications in diabetic and non-diabetic patients. Rejection continues to be more frequent among diabetic patients. An active search for post-transplant diabetes is necessary for every patient.

Caracterización del estado nutricional, hábitos alimentarios y estilos de vida de estudiantes universitarios chilenos: estudio multicéntrico / Lifestyles, body mass index and sleep patterns among university students

Background Health surveys in Chile show a worrisome high prevalence of unhealthy lifestyles among adults. Aim To characterize the nutritional status, food intake and sleep patterns in university students of both genders. Material and Methods Cross sectional study in seven Chilean universities. Students from six universities answered a feeding habits survey, the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale. All were weighed and their height was measured. Results A total of 1,418 students aged 21 ± 3 years (22% males) were evaluated. Three percent were classified as underweight, 68% as normal weight, 24% as overweight and 4% as obese. Thirty three percent of males and 28% of females smoked. Twenty six percent consumed at least one glass of alcoholic beverages on the weekend, and only 18% of males and 5% of females were physically active. Men consumed unhealthy foods with a significantly higher frequency than females. Twenty seven percent had mild daytime somnolence, 24% had moderate daytime somnolence, 50% had subclinical insomnia, 19% moderate insomnia, and 1.4% had severe insomnia. Conclusions In this group of students a high frequency of unhealthy lifestyles and malnutrition caused by excess was observed. Also a high prevalence of insomnia, daytime somnolence, and inadequate sleep amounts were recorded.

Evaluation of an educational, theater-based intervention on attitudes toward organ donation in Risaralda, Colombia / Evaluación del impacto de una intervención basada en teatro sobre las actitudes hacia la donación de órganos en Risaralda, Colombia

Introduction:The shortage of organs for transplantation is aworldwide problem and the main cause is the refusal of familymembers to donate. Consent to donate is influenced by manyfactors and educational interventions are strongly recommen-ded.Objective:To evaluate the impact of an educational, theater-based strategy on the attitudes toward organ donation.Methodology:This study employed an intervention usingtheater as the central tool. The impact of this interventionon the intention to donate was assessed through a controlled,prospective, nonrandomized designed study. The sample con-sisted of 1,038 people. All the participants answered a surveythat asked about sex, age and intent to donate. Afterward, oneportion of the sample was exposed to the play, The Gift of Life,and a subsequent discussion forum that was guided by experts.The same survey was administered again after the interven-tion.Results:Before the intervention, donation attitudes were posi-tive in 68.3 percent of the responses, negative in 6.8 percent and uncertainin 24.9 percent. Females showed a greater intent to donate while agehad no apparent influence on the donation decision. Those ex-posed to the intervention were found to be more likely to do-nate and show a favorable change in attitude toward donationthan those who were not exposed to the intervention.Conclusion:An educational intervention using theater is aneffective tool to generate a short-term change in the intent todonate. Educational strategies should be employed to increasethe rates of organ donation.

Avaliaçäo de duas estrategias ventilatorias na sindrome de angustia respiratoria aguda de evolucao severa / Evaluation of two ventilatory approaches in patients with severe acute respiratory distress syndrome

Objetivo: Comparar o perfil de oxigenação,mecânica torácica e mortalidade entre duas estratégias distintas de suporte ventilatório na SARA em pacientes com escore de lesão pulmonar > 2.5. Perfil: Análise prospectiva. Local: UTI multidisciplinar de um hospital publico terciário nao universitário. Paciente: 112 pacientes de ambos os sexos com doenças de gravidade semelhante,divididos em dois grupos,um com limitação da PIP e do VT(PIP < 40cm H2O e VT < 10ml/Kg,grupo teste)e outro,exposto a um volume corrente convencional de 10ml/Kg e sem limitação da PIP(grupo controle). Resultado: Apesar de valores muito diferentes da PIP e do Vt respectivamente para os grupos teste e controle(28.9 + - 3.64vs 42.3 + - 5.36cm H2O e 7.6 + - 0.92vs 10 + - 1.10 com p < 0.05),a taxa de mortalidade não foi estatísticamente significativa entre os dois grupos s(46.2 por cento vs 50 por cento,p=0.913). A hipercapnia permissiva foi comum em todos os pacientes do grupo de teste(PaCO2=61.4+ - 11.37 mmHg). A incidência de barotrauma foi de 22 por cento. os valores do APACHE II foram respectivamente 23 + - 5 para o grupo teste e de 24 + - 4 para o grupo controle(p = 0.254). Conclusão: A ventilação com limitação do volume corrente e da pressão inspiratória máxima não influenciou a mortalidade em pacientes com SARA e LIS > 2.5