Antimicrobial Efficacy of the Use of Mouthwash with Cetylpiridinium Chloride for Aerosol Producing Procedures. A Systematic Review / Eficacia antimicrobiana del uso del enjuague bucal con cloruro de cetilpiridinio en procedimientos que generan aerosoles. Revisión sistemática

Abstract The present research aims to determine the antimicrobial efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), before aerosol producing dental procedures. A data search was performed during August 2021 in five databases MEDLINE (PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Randomized clinical trials (RCTs) were included based on the PICO question, comparing the efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), versus other mouthwashes and water, before aerosol producing dental procedures, papers in English, Spanish and Portuguese were included without time limits. The risk of the included studies was evaluated with the tool RoB 2.0. Number of registration PROSPERO N° CRD42021275982. 120 papers were obtained in the preliminary search, discarding those that didn't comply with the selection criteria, leaving only 3 studies. These papers reported the use of cetylpyridinium chloride (CPC) was effective for the reduction of bacteria during the ultrasonic prophylactic procedure. The use of CPC mouthwashes previous to the dental treatment with ultrasonic prophylaxis showed only antibacterial capacity.

Resumen El presente trabajo de investigación tiene como objetivo determinar la eficacia antimicrobiana de los colutorios a base de cloruro de Cetilpiridinio (CPC), previo a tratamientos dentales que generen aerosol. Se realizó una búsqueda bibliográfica hasta agosto del 2021 en cinco bases de datos: MEDLINE (vía PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) y Google Scholar. Se incluyeron ensayos clínicos aleatorizados (ECAs), basándose en la pregunta PICOS, que compare la eficacia del colutorio a base de cloruro de Cetilpiridinio (CPC) con otro colutorio, placebo o agua, previo a un tratamiento dental que genere aerosol, en los idiomas español, inglés o portugués y sin límite de tiempo. El riesgo de los estudios incluidos se evaluó con la herramienta RoB 2.0. Número de registro PROSPERO N° CRD42021275982. Se obtuvo un total de 120 artículos en la búsqueda preliminar, descartando aquellos que no cumplían con los criterios de selección, quedando sólo 3articulos. Estos artículos informaron que el uso de CPC es efectivo para la reducción de bacterias durante el procedimiento de profilaxis con ultrasonido. El uso de los enjuagues bucales a base de CPC previo al tratamiento dental de profilaxis con ultrasonido sólo tiene eficacia antibacteriana.

Soluciones antisépticas en la prevención de infección de herida quirúrgica en pacientes operados por apendicitis aguda complicada prevención de infección de herida quirúrgica

Introducción: La infección de la herida quirúrgica en apendicitis aguda complicada es frecuente. Objetivo: El objetivo fue comparar la solución Dakin y la Superoxidativa para prevenir infecciones de herida quirúrgica en pacientes con apendicitis aguda complicada. Métodos: Estudio comparativo, transversal, en 104 pacientes con apendicitis aguda complicada (Edad media: 36.29 años, 69(66.43%) hombres). Grupo-1: 52 pacientes, con lavado de herida quirúrgica con solución Dakin modificada. Grupo-2: 52 pacientes con solución superoxidativa (Microdacyn®). Se administró ceftriaxona 1 gr antes de la cirugía, se realizó apendicectomía convencional y cierre de pared con Vicryl-1 y Nylon-2/0. Se evaluó herida quirúrgica 7 días después de la operación, registrando presencia de pus, edema, eritema y calor local. Se utilizaron X2 y t de Student. Resultados: Se presentó infección de herida quirúrgica en 11(10.6%) pacientes; 3(5.8%) pacientes del Grupo-1 y 8(15.4%) del Grupo-2 (p=0.1). Conclusión: Ambas soluciones son útiles para prevenir infecciones de herida quirúrgica en pacientes con apendicitis aguda complicada.

Introduction: The infection of the surgical wound in a complicated acute appendicitis is common. Objective: The objective was to compare Dakin and Superoxidative solutions in preventing surgical wound infections in patients with complicated acute appendicitis. Methods: Comparative, cross-sectional study of 104 patients with complicated acute appendicitis (Average age: 36.29 years, 69 (66.43%) men). Group-1: 52 patients, with surgical wound wash using modified Dakin's solution. Group-2: 52 patients with superoxidative solution (Microdacyn®). Ceftriaxone 1 gr was administered before surgery, conventional appendectomy was performed, and the wall was closed with Vicryl-1 and Nylon-2/0. The surgical wound was evaluated 7 days after the operation, noting the presence of pus, edema, erythema, and local heat. Chi-squared (X2) and Student's t-tests were used. Results: Surgical wound infection occurred in 11 (10.6%) patients; 3 (5.8%) patients from Group-1 and 8 (15.4%) from Group-2 (p=0.1). Conclusion: Both solutions are useful in preventing surgical wound infections in patients with complicated acute appendicitis.

A retrospective review of calls to the Poisons Information Helpline of the Western Cape during the first 6 months of the COVID-19 pandemic in South Africa

Background: Since the start of the coronavirus disease 2019 (COVID-19) pandemic, poison centres worldwide have reported an increase in exposures to chemicals used for infection prevention. Increased availability and use could lead to an increase in exposures. Potential effects on a South African Poison Information Helpline were unknown, therefore a study was performed to describe changes in call volume and profile of poison exposures. Methods: A retrospective analysis was conducted on an observational database of telephone enquiries. All human-related poisoning exposure call data collected from 01 March to 31 August during 2018, 2019 and 2020 were extracted and analyzed. Summary statistics were used to describe all variables. Results: The total number of calls were 5137, 5508, and 5181 in 2018, 2019, 2020, respectively. The monthly call number during 2020 was mostly less than in 2019. More calls were received from the public calls (39.4% vs 33.1%) and for accidental exposures (65.6% vs 62.3%) increased during 2020 compared to 2019. Exposures to pharmaceuticals decreased by 14.8% from 2019 to 2020, while exposures to eucalyptus oil more than doubled from 21 in 2019 to 43 during 2020. Exposures to antiseptics and disinfectants increased by 60.4%, mainly due to hand sanitizers exposure which showed a 26-fold increase from 2019 (n = 6) to 2020 (n = 156). Conclusion: A change in the profile of poison exposures was observed during the COVID-19 pandemic. Lockdown regulations and greater availability of antiseptics and disinfectants probably led to the increase in exposures. Although symptoms were mostly mild, the public should be educated on safe storage and proper use of all chemicals.

Acción antibacteriana de colutorios de uso ortodóntico sobre Streptococcus Mutans / Antibacterial action of mouthwashes for orthodontic use on Streptococcus Mutans / Ação antibacteriana de bochechos para uso ortodôntico sobre Streptococcus Mutans

El tratamiento con ortodoncia fija produce en los pacientes una mayor acumulación de biofilm dental, siendo necesario una adecuada higiene bucal complementada con colutorios bucales. OBJETIVO: el propósito de este estudio fue evaluar la acción antibacteriana de colutorios de uso ortodóntico sobre el Streptococcus Mutans en pacientes con aparatología ortodóncica fija. MATERIALES Y MÉTODO: se realizó un estudio de diseño cuasiexperimental, comparativo, de corte longitudinal, de abordaje cuantitativo ciego simple, con un tamaño de muestra de 20 pacientes distribuidos en dos grupos de estudio para el recuento de UFC, además un control positivo y otro negativo para determinar el halo inhibitorio. RESULTADOS: los colutorios bucales Vitis® Orthodontic y Ortolacer tuvieron una disminución en el recuento de las UFC de Streptococcus Mutans hasta un 48,3% (p=0,00) y 53,2% (p=0,00) respectivamente; asimismo, hay una mayor acción antibacteriana sobre el Streptococcus Mutans del colutorio Vitis® Orthodontic que el colutorio Ortolacer (p-valor=0,009); así mismo, con un p valor = 0,000 < 0,05 a las 24 y 48 horas existe una diferencia estadística significativa en anaerobiosis que indica que el colutorio Vitis® Orthodontic genera un mayor halo inhibitorio sobre el Streptococcus Mutans. CONCLUSIONES: los colutorios bucales Vitis® Orthodontic y Ortolacer disminuyen el recuento de las UFC de Streptococcus Mutans en pacientes. Además, ambos colutorios en anaerobiosis tienen acción inhibitoria sobre el Streptococcus Mutans. Sin embargo, hay una mayor acción antibacteriana del colutorio Vitis® Orthodontic sobre el Streptococcus Mutans.

Fixed orthodontic treatment produces a greater accumulation of dental biofilm in patients, and adequate oral hygiene complemented with mouthwashes is necessary. OBJECTIVE: the purpose of this study was to evaluate the antibacterial action of mouthwashes for orthodontic use on Streptococcus Mutans in patients with fixed orthodontic appliances. MATERIALS AND METHODS: A quasi-experimental, comparative, longitudinal, single-blind, quantitative approach study was carried out with a sample size of 20 patients distributed in two study groups for the CFU count, as well as a positive and a negative control to determine the inhibitory halo. RESULTS: vitis Orthodontic and Ortolacer mouthwashes had a decrease in the CFU count of Streptococcus Mutans up to 48.3% (p=0.00) and 53.2% (p=0.00) respectively; likewise, there is a greater antibacterial action on Streptococcus Mutans of Vitis® Orthodontic mouthwash than Ortolacer mouthwash (p-value=0.009); Likewise, with a p-value = 0.000 < 0.05 at 24 and 48 hours there is a significant statistical difference in anaerobiosis indicating that Vitis® Orthodontic mouthwash generates a greater inhibitory halo on Streptococcus Mutans. CONCLUSIONS: Vitis® Orthodontic and Ortholacer mouthrinses decrease the CFU count of Streptococcus Mutans in patients. In addition, both mouthwashes in anaerobiosis have inhibitory action on Streptococcus Mutans. However, there is a greater antibacterial action of Vitis® Orthodontic mouthwash on Streptococcus Mutans.

O tratamento ortodôntico fixo leva a um aumento do acúmulo de biofilme dentário nos pacientes, e é necessária uma higiene bucal adequada complementada com lavagens bucais. OBJETIVO: o objetivo deste estudo foi avaliar a ação antibacteriana de lava bucais para uso ortodôntico em Streptococcus Mutans em pacientes com aparelhos ortodônticos fixos. MATERIAIS E MÉTODOS: um estudo quase-experimental, comparativo, longitudinal, monobloco e quantitativo foi realizado com uma amostra de 20 pacientes distribuídos em dois grupos de estudo para a contagem da UFC, assim como um controle positivo e um negativo para determinar a auréola inibitória. RESULTADOS: os enxaguatórios bucais Vitis® Orthodontic e Ortolacer tiveram uma redução na contagem de Streptococcus Mutans na UFC de até 48,3% (p=0,00) e 53,2% (p=0,00) respectivamente; também, há uma maior ação antibacteriana no Streptococcus Mutans de Vitis® Orthodontic de que os enxaguatórios bucais Ortolacer (p=0,009); Da mesma forma, com um valor p = 0,000 < 0,05 às 24 e 48 horas há uma diferença estatística significativa na anaerobiose indicando que Vitis® Orthodontic mouthwash gera uma maior auréola inibitória no Streptococcus Mutans. CONCLUSÕES: Vitis® Orthodontic e Ortolacer mouthrinses diminuem a contagem de CFU de Streptococcus Mutans em pacientes. Além disso, ambos os bochechos em anaerobiose têm ação inibitória sobre Streptococcus Mutans. Entretanto, há uma maior ação antibacteriana do Vitis® Orthodontic mouthwash em Streptococcus Mutans.

Estudo prospectivo tecnológico e científico de antissépticos para prevenir a disseminação de SARS-CoV-2 e outros vírus patogênicos

Introdução: o coronavírus identificado em humanos, o SARS-CoV-2, levou a Organização Mundial da Saúde (OMS) a definir o COVID-19 como uma pandemia. Essa classificação se deve à sua disseminação em diversos países, o que mostra a transmissibilidade desse vírus. O controle da doença exigia isolamento social e observação do que seria o principal meio de disseminação: as mãos. A assepsia destes passou a ser destacada e as substâncias utilizadas para ela foram questionadas. Objetivo: este trabalho é uma análise qualitativa e quantitativa de artigos e patentes da etapa de estudos sobre o desenvolvimento de formulações antissépticas para controle da disseminação de vírus. Resultados: a análise do banco de dados revelou que há poucos estudos sobre eficácia antisséptica antiviral e existência limitada de tecnologia aplicada. Conclusão: o controle da pandemia causada pelo SARS-CoV-2 exigirá o desenvolvimento e validação de meios antisépticos.

Introducción: el coronavirus identificado en humanos, SARS-CoV-2, hizo que la Organización Mundial de la Salud (OMS) definiera al COVID-19 como una pandemia. Esta clasificación se debe a su diseminación en varios países, lo que muestra la transmisibilidad de este virus. El control de la enfermedad requirió el aislamiento social y la observación de lo que sería el principal modo de propagación: las manos. Se empezó a destacar la asepsia de estas y a cuestionar las sustancias utilizadas para ello. Objetivo: este trabajo es un análisis cualitativo y cuantitativo de artículos y patentes de la etapa de estudios sobre el desarrollo de formulaciones antisépticas para controlar la propagación de virus. Resultados: el análisis de las bases de datos reveló que hay pocos estudios sobre la eficacia antiséptica antiviral y existencia limitada de tecnología aplicada. Conclusión: el control de la pandemia provocada por el SARS-CoV-2 demandará el desarrollo y validación de medios antisépticos.

SUMMARY Introduction: the coronavirus identified in humans, SARS-CoV-2, caused the World Health Organization (WHO) to define COVID-19 as a pandemic. This classification is due to its dissemination in several countries, which shows the transmissibility of this virus. Controlling the disease required social isolation and observation of what would be the main mode of spread: the hands. The asepsis of these began to be highlighted and the substances used for it were questioned. Objective: this work is a qualitative and quantitative analysis of articles and patents from the stage of studies on the development of antiseptic formulations to control the spread of viruses. Results: database analysis revealed that there are few studies on antiviral antiseptic efficacy and limited existence of applied technology. Conclusion: the control of the pandemic caused by SARS-CoV-2 will require the development and validation of antiseptic means.

Once upon a time, inflammation

Inflammation has accompanied humans since their first ancestors appeared on Earth. Aulus Cornelius Celsus (25 BC-50 AD), a Roman encyclopedist, offered a still valid statement about inflammation: "Notae vero inflammationis sunt quatuor: rubor et tumor cum calore and dolore", defining the four cardinal signs of inflammation as redness and swelling with heat and pain. While inflammation has long been considered as a morbid phenomenon, John Hunter (18th century) and Elie Metchnikoff (19th century) understood that it was a natural and beneficial event that aims to address a sterile or an infectious insult. Many other famous scientists and some forgotten ones have identified the different cellular and molecular players, and deciphered the different mechanisms of inflammation. This review pays tribute to some of the giants who made major contributions, from Hippocrates to the late 19th and first half of the 20th century. We particularly address the discoveries related to phagocytes, diapedesis, chemotactism, and fever. We also mention the findings of the various inflammatory mediators and the different approaches designed to treat inflammatory disorders.(AU)

Úlcera de Lipschütz: reporte de un caso y revisión bibliográfica / Lipschütz Ulcer: a case report and a literature review

Resumen: ANTECEDENTES: Las úlceras de Lipschütz son lesiones vulvovaginales dolorosas, de aparición aguda y desaparición espontánea en 2 a 6 semanas, no dejan secuelas ni son recurrentes a largo plazo. Su etiopatogenia es incierta, alrededor de 70% se consideran idiopáticas. En los estudios más recientes se ha demostrado su asociación con agentes infecciosos, sobre todo con el virus de Epstein-Barr. El diagnóstico se establece por exclusión y su tratamiento se basa en el control sintomático, cicatrizantes, analgésicos y antisépticos. CASO CLÍNICO: Paciente de 15 años, con úlceras vulvares de aparición súbita acompañadas de cuadro catarral. Se indicó tratamiento local con cicatrizante, antiséptico y antiinflamatorio; al cabo de tres semanas se observó la desaparición de las lesiones y la negatividad de las pruebas que descartó el origen infeccioso. Se estableció el diagnóstico de úlcera de Lipschütz. CONCLUSIONES: La úlcera de Lipschütz es infrecuente y los niños son quienes más la padecen. Debido al carácter de desaparición espontánea y a la juventud de las pacientes, es decisivo establecer el correcto diagnóstico diferencial.

Abstract: BACKGROUND: Lipschütz Ulcers are painful, acute onset and self-limiting vulvovaginal lesions that can frequently be associated with prodromal symptoms, disappearing in 2-6 weeks without any sequelae. 70% of cases present idiopathic etiopathogenesis, and are related to Epstein-Barr virus, among others. The diagnosis is made by exclusion and its treatment is based on symptomatic control and the promotion of correct healing, using analgesics, cicatrizers and antiseptics. CASE REPORT: A 15-year-old girl reported the acute apparition of ulcerative vulvar lesions coinciding with systemic catarrhal symptoms. Local treatment with healing, antiseptic and anti-inflammatory lotions was prescribed, and after three weeks, she was reevaluated, observing the disappearance of the lesions and the negativity of the tests to rule out infectious origin, for which she was diagnosed with a Lipschütz ulcer. CONCLUSIONS: Lipschütz ulcer is rare and children are the ones who suffer most from it. Due to the spontaneous disappearance character and the youthfulness of the patients, it is decisive to establish the correct differential diagnosis.

A Case of Corneal Chemical Injury by High-dose Ethanol during Orbital Wall Fracture Repair

PURPOSE: To report a case of chemical injury of the cornea caused by high-dose ethanol during orbital wall fracture repair. CASE SUMMARY: A 56-year-old male presented with pain after blowout fracture repair surgery. During the surgery, 2% hexethanol solution (2% chlorhexidine and 72% ethanol mixture), which was used for disinfection of the face, flowed into the left eye. Conjunctival injection in the left limbus, a large corneal epithelial defect, and severe stromal edema were subsequently observed. The patient was treated with topical antibiotics, steroids, and autologous serum eye drops. After 1 week, the corneal epithelial defect was improved, but at the second month of therapy, recurrent corneal erosion with deterioration of the endothelial cell function occurred. Anterior stromal puncture and laser keratectomy were performed. The corneal epithelial defect and erosion improved, but the endothelial cell density was severely decreased. CONCLUSIONS: The 2% hexethanol solution is usually used for preoperative skin disinfection, but it contains a high concentration of ethanol. The surgeon should be aware that high concentrations of ethanol may result in severe corneal damage, including corneal endothelial dysfunction and limbal cell deficiency.

Antisépticos y desinfectantes: apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología / Antiseptics and disinfectants: aiming at rational use. Recommendations of the Advisory Committee on Healthcare Associated Infections. Sociedad Chilena de Infectología

Proper use of antiseptics and disinfectants, is an essential tool to prevent the spread of infectious agents and to control of healthcare-associated infections (HAI). Given the increasing importance of environmental aspects, as well as several advances and updates in the field of its proper use at local and intemational level, the SOCHINF HAI Advisory Committee considers that it is necessary to develop a guide for the rational use of antiseptics and disinfectants, which it will provide consistent scientific basis with that purpose.

El adecuado uso de antisépticos y desinfectantes, es una herramienta esencial para evitar la diseminación de agentes infecciosos y el control de infecciones asociadas a la atención de salud (IAAS). Dada la importancia creciente de aspectos ambientales, diversos avances y actualizaciones en el ámbito de su correcta utilización en el ámbito local e internacional, el Comité Consultivo de IAAS de Sociedad Chilena de Infectología considera necesario la estructuración de una guía de utilización racional de antisépticos y desinfectantes, que proporcione bases científicas coherentes con dicho propósito.

Antifungal activity of synthetic antiseptics and natural compounds against Candida dubliniensis before and after in vitro fluconazole exposure

ABSTRACT INTRODUCTION: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.

Content Determination of Antiseptics in Anshen Bunao Oral Liquid by HPLC / 中国药房

OBJECTIVE:To establish a method for the determination of antiseptics in Anshen bunao oral liquid. METHODS:HPLC method was adopted. The determination was performed on Agilent Zorbax SB-C18 column with mobile phase consisted of ace-tonitrile-0.05% phosphorice acid solution (gradient elution) at the flow rate of 1.0 mL/min. The detection wavelength was set at 236 nm,and column temperature was 30℃. The injection volume was 10μL. RESULTS:The linear range of benzoic acid and eth-ylparaben were 12.85-128.54 μg/mL(r=0.9999)and 4.05-40.48 μg/mL(r=0.9998),respectively. The limits of quantitation were 0.514,1.012 μg/mL. The limits of detection were 0.171,0.353 μg/mL. RSDs of precision,stability and reproducibility tests were all lower than 1.0%. The recoveries were 99.38%-100.21%(RSD=0.31%,n=6),97.96%-100.72%(RSD=0.91%,n=6). CON-CLUSIONS:The method is simple and accurate,and can be used for content determination of antiseptics in Anshen bunao oral liq-uid.

Efecto antimicrobiano de una solución de superoxidación con pH neutro para desinfección de cavidades clase I / Effectiveness of a neutral pH super-oxidized solution for antimicrobial disinfection of class I cavities

Objetivo: determinar la disminución de la carga bacteriana en dentina de cavidades clase I posterior a la aplicación de clorhexidina 2 por ciento en comparación con la aplicación de solución de superoxidación con pH neutro. Material y métodos: Se realizó un estudio transversal clínico, a 30 pacientes en el Área de Clínicas de la Facultad de Estomatología en la Universidad Autónoma de San Luis Potosí, de los cuales se obtuvieron 60 muestras en cavidades clase I en primeros y segundos molares inferiores permanentes, previas al tratamiento y 60 posteriores que se dividieron en tres grupos, grupo control (n = 20), grupo A correspondiente a clorhexidina al 2 por ciento (n = 20) y grupo B correspondiente a solución de superoxidación con pH neutro (n = 20), posteriormente las muestras fueron llevadas al laboratorio donde se realizó una dilución seriada, para posteriormente sembrar las muestras en placas de agar soya tripticaseina y hacer el conteo de UFC después de haber sido incubadas 24 horas. Resultados: Se realizó una comparación de todos los grupos en cuanto a la disminución de carga bacteriana pretratamiento y postratamiento. Se observó diferencia es tadística significativa en el grupo tratado con clorhexidina al 2 por ciento (p < 0.01) mientras que en los grupos tratados con agua destilada y solución de superoxidación con pH neutro no fueron significativas, ambas con una (p > 0.05) entre las muestras pretratamiento y postratamiento. Conclusiones: Se logró obtener muestras en primeros y segundos molares inferiores en las que se cuantificaron microorganismos previos y posteriores al tratamiento mediante la cuantificación de UFC. Se encontraron diferencias significativas entre grupos, por lo que podemos decir de acuerdo con nuestros resultados que la clorhexidina al 2 por ciento tiene mayor efecto antimicrobiano en la desinfección de cavidades clase I que la solución de superoxidación con pH neutro.

background: Dental caries is a disease characterized by demineralization of the hard tissues of the tooth. If left untreated, it leads to cavitation, discomfort, pain, and the eventual loss of the tooth. A range of antiseptics have been used to eliminate microorganisms from cavities, one of the most common being chlorhexidine, due to the advantages it offers. Nowadays there are products available that offer not only the same microbicidal capacity, but also a greater half-life and superior tissue compatibility. One new option for cavity disinfection is pH neutral super-oxidation solution. Objective: To determine the decrease in bacterial load in the dentin of class I cavities following the application of 2% chlorhexidine compared to a neutral pH over-super-oxidized solution. Material and methods:A clinical cross-sectional study was conducted involving a total of 30 patients at the Faculty of Stomatology Clinics of the Autonomous University of San Luis Potosí, from whom 60 samples were obtained from class I cavities in first and second permanent lower molars prior to treatment and 60 following...

Evaluation of the antifungal activity of plant extracts and oral antiseptics against Candida albicans / Avaliação da atividade antifúngica de extratos vegetais e antissépticos bucais em Candida albicans

Objective: Oral candidiasis is the most common fungal infection of the oral cavity, and Candida albicans is the most frequently isolated species. Material and Methods: In this study, the potential antifungal effect of extracts from Gossypium hirsutum L., Arctium lappa, Equisetum sp., Cecropia pachystachya Trécul and Pogostemon heyneanus plants were evaluated on non-adhered cells of C. albicans, and the effect of oral antiseptics A (cetylpyridinium chloride 0.500 mg), B (chlorhexidine gluconate 0.12%), C (hydrogen peroxide 1.5%) and D (thymol, eucalyptol, menthol and methyl salicylate) were evaluated on non-adhered cells and biofilms of C. albicans, using turbidimetry and minimal inhibitory concentration (MIC) of the extracts and the maximal inhibitory dilution (MID) of the antiseptics. Results: The most promising results on non-adhered cells were obtained with Cecropia pachystachya Trécul extracts, with MIC values between 7.81 and 3.91 μg/mL. Antiseptics A and B showed the lowest MID values, between 0.20 and 0.10% (Kruskal-Wallis, p < 0.0001). Regarding biofilm inhibition, the MID values found were similar for the tested antiseptics, varying from 50% to 0.20% (Kruskal-Wallis, p = 0.6915). Conclusion: These results show that some plant extracts has potential use in the prevention and treatment of oral candidiasis...

Objetivo: A candidíase oral é a infecção fúngica mais comum na cavidade oral e Candida albicans é a espécie frequentemente relacionada. Material e Métodos: Neste estudo foi avaliado o potencial efeito antifúngico de extratos das plantas Gossypium hirsutum L., Arctium lappa, Equisetum sp., Cecropia pachystachya Trécul. e Pogostemon heyneanus sobre células não aderidas de C. albicans e o efeito dos antissépticos bucais A (cloreto de cetilpiridínio 0,500 mg); B (gluconato de clorexidina 0,12%); C (peróxido de hidrogênio 1,5%) e D (timol, eucaliptol, mentol e salicilato de metila) sobre células não aderidas e biofilmes de Candida albicans. A susceptibilidade dos isolados clínicos de C. albicans foi avaliada através da determinação da inibição de crescimento celular por turbidimetria e por determinação da Concentração Inibitória Mínima (CIM) dos extratos e da Máxima Diluição Inibitória (MDI) dos antissépticos. Resultados: Os resultados mais promissores dos testes com células não aderidas foram obtidos com extratos de Cecropia pachystachya Trécul., com valores de CIM entre 7,81 e 3,91 μg/ mL. Os antissépticos A e B apresentaram os menores valores de MDI, entre 0,20 e 0,10% (Kruskal-Wallis, p < 0,0001). Em relação a inibição de formação de biofilmes, os valores de MDI encontrados foram similares para os antissépticos testados, variando de 50% a 0,20% (Kruskal-Wallis, p = 0,6915). Conclusão: Os resultados mostraram que todos os antissépticos bucais e extratos vegetais analisados apresentaram atividade antifúngica contra os isolados de C. albicans, e as espécies medicinais apresentam potencial uso na prevenção e tratamento de candidíase oral...

Disponibilidad de antisépticos obsoletos e infecciones nosocomiales en unidades de cuidados intensivos de hospitales de México / Availability of antiseptics obsolete and nosocomial infections in intensive care units of hospitals in Mexico

Objetivo: Analizar la relación entre la existencia de políticas para el manejo de antisépticos, la presencia de antisépticos obsoletos y la prevalencia de infecciones nosocomiales (IN) en unidades de cuidados intensivos de hospitales públicos. Material y métodos: Análisis ecológico en 41 hospitales de 3 instituciones públicas de salud en México. Mediante regresión lineal se estimó la asociación entre la prevalencia de IN con la existencia de políticas y la presencia de antisépticos obsoletos. Resultados: Se observó una alta prevalencia de antisépticos inadecuados, particularmente peróxido de hidrógeno (46.7%). Los hospitales con antisépticos obsoletos tuvieron una prevalencia de IN 7 puntos porcentuales más elevada (p=0.001) en comparación con aquellos que carecían de éstos. Aquellos que contaban con evidencia de políticas para el manejo de antisépticos tuvieron una prevalencia 2 puntos porcentuales menor. Conclusiones: Nuestros hallazgos sugieren que la selección adecuada de antisépticos puede redundar en mejorar la seguridad del paciente.

Objective: To analyze the relationship between explicit policies for antiseptics handling, the presence of obsolete antiseptics and nosocomial infections prevalence in intensive care units public hospitals. Methods: An ecological analysis was conducted involving 41 general hospitals of three public health institutions. We use linear regression to estimate the association between hospital-level nosocomial infection prevalence and existence of antiseptics policy and obsolete antiseptics presence. Results: Adjusting by potential confounders, hospitals where had obsolete antiseptics had seven points higher prevalence of nosocomial infection (p=0.001). Those who had evidence of handling policies antiseptics had two points prevalence lower. There was high prevalence of inadequate antiseptics, particularly hydrogen peroxide (46.7%). Conclusions: Our findings confirm that proper selection of antiseptics can lead to improved patient safety. Antiseptics obsolete, even in suitable compounds presence, correlated with higher nosocomial infection prevalence.

Efeito antifúngico de agentes químicos sobre leveduras com potencial patogênico isoladas de ambiente hospitalar veterinário / Antifungal effect of chemical agents in yeasts with pathogenic potential isolated from veterinary hospital environment

Os ambientes hospitalares podem albergar micro-organismos patogênicos e oportunistas, capazes de infectar, particu- larmente, os indivíduos imunossuprimidos. O processo de limpeza e desinfecção assume importância capital para o controle de tais doenças. O presente trabalho avaliou a suscetibilidade de leveduras isoladas de superfícies de ambiente hospitalar veterinário frente a quatro desinfetantes/antissépticos comumente utilizados na rotina de desinfecção. O teste de microdiluição em caldo foi realizado com 24 isolados leveduriformes frente ao hipoclorito de sódio 4%, cloreto de benzalcônico 2%, clorexidina-cetrimida 6,6% e derivado de cloro-fenol 3%. A clorexidina-cetrimida, cloreto de ben- zalcônio e derivado de cloro-fenol foram eficazes em todos os isolados com concentração inibitória mínima e concen- tração fungicida inferiores à concentração recomendada pelo fabricante. Por outro lado, a ação fungicida do hipoclorito de sódio em 79,1% dos isolados testados foi obtida na concentração recomendada pelo fabricante, com desempenho inferior aos demais desinfetantes avaliados.

Hospital environments can have pathogens and opportunistic pathogens, important for immunocompromising individuals. The process of cleaning and disinfection constitutes an important measure for the control of these diseases. This study evaluated the sensitivity of yeasts isolated from surfaces of nosocomial veterinary environment to four disinfectants/antiseptics used in the routine of disinfection. The test of broth microdilution was carried in 24isolates of yeasts against 4% sodium hypochlorite, 2% benzalkonium chloride, 6.6% chlorexidine-cetrimide and 3% chloro-phenol derivate. Chlorexidine-cetrimide, benzalkonium chloride and chloro-phenol derivate were efficient in all isolates with minimal inhibitory concentration and minimal fungicide concentration lower than the concentra- tion recommended by manufacturer. By other hand, fungicide action of the sodium hypochlorite in the concentration recommended by the manufacturer was verified in 79.1% of the isolated tested, with the lower performance of than the others evaluated disinfectants.

Antisépticos: una visión química / The antiseptic ones: a chemical vision

En la actualidad, los antis‚pticos son ampliamente usados en hospitales y en otros centros de salud en una variedad de aplicaciones tópicas y de superficie. Los antis‚pticos son sustancias qu¡micas que se aplican sobre pie, heridas o cortes, con la finalidad de destruir o inhibir el crecimiento de microorganismos patógenos. En el presente trabajo se busca resaltar el conocimiento qu¡mico necesario, tales como la composición, concentración qu¡mica y modo de acción de tres de los antisépticos m sésencillos y de uso común como son el alcohol, agua oxigenada y el alcohol yodado.

Antiseptics are extensively used in hospitals and other health care settings for a variety of topical and hard-surface applications. There are chemicals that are applied on skin, wounds or cuts, in order to destroy or inhibit the growth of pathogenic microorganisms. This paper seeks to highlight the necessary chemical knowledge, such as composition, chemical concentration and mode of action of three antiseptics simple and commonly used, such as alcohol, peroxide and iodine alcohol.

Estudio de utilización de fenazopiridina en la atención médica ambulatoria en la seguridad social / Phenazopyridine: A drug utilization research in the Costa Rican Social Security

Justificación: fenazopiridina es un medicamento analgésico urinario oral; cuenta con una amplia experiencia histórica de uso y, bajo el paradigma de medicina basada en evidencia, tiene poco fundamento de alta calidad para sustentar su valor terapéutico. Objetivo: analizar el perfil de la utilización de la fenazopiridina en la práctica clínica habitual dentro de la Seguridad Social, a nivel de consulta ambulatoria, en los tres niveles de atención y por un periodo de 30 días. Procedimientos: en enero de 2011, en una unidad de cada nivel de atención: Área de Salud de Santa Bárbara, Clínica Dr. Carlos Durán y Hospital Dr. Calderón Guardia, se analizó el reporte de despacho por farmacia de la fenazopiridina, con el fin de preparar un perfil cuantitativo. En el análisis cualitativo de la prescripción, se revisó una muestra al azar de 30 expedientes de pacientes atendidos durante ese periodo en cada unidad, con un formulario prediseñado para el efecto. Resultados: durante 1 mes, tres unidades despacharon 381 prescripciones a los pacientes, mayormente mujeres. La prescripción varió entre 3 y 90 tabletas; la mayoría (60,43%) con solo 10 tabletas para tratamiento. Se documentó la anotación del medicamento y la dosis en un 54,55% de los expedientes. La dosis diaria prescrita (DDP) fue 100 mg TID, equivalente a 300 mg/d, en la mitad de los pacientes, y en las unidades del primer y segundo nivel de atención; seguida de 100 mg BID (33,33%). Un 54,55% de los pacientes tenían diagnóstico de infección del tracto urinario (89% mujeres); de estos, un 89,89% recibió también antibióticos. La duración varió entre 1 y 30 días, y se prolongó más en unidades del segundo y tercer nivel. Conclusión: la utilización es parcial y razonablemente adecuada, apoya el supuesto de efectividad seguridad, sobre todo en el contexto de la atención médica en el primero y segundo niveles de atención. La diversidad en los hábitos de prescripción requiere mejorar su empleo y desarrollar ...

Background: Phenazopiridine is an oral urinary tract analgesic; an extensive historical experience of use and, under the paradigm of evidence-based medicine, its therapeutic value is not supported by high quality explanations. Aim: To analyze the use of phenazopiridine in everyday clinical practice, at an ambulatory level, in the three different levels of attention in the Costa Rican social security during a period of 30 days. Methods: In January 2011, electronic pharmacy records from a first, second and third level health center; Health Area of Santa Barbara, Dr. Carlos Durán Clinic and Dr. Calderón Guardia Hospital, respectively, were obtained to establish the quantitative characteristics of the prescription of phenazopiridine. For the qualitative analysis of the prescription, a random sample of 30 medical records of patients treated during that period in each unit was considered using an instrument previously designed for said task. Results: During one month, three study units prescribed phenazopiridine to 381 patients, mostly females. Prescription varied from 3 to 90 tablets; most patients (60.43%) received only 10 tablets for their treatment regime. In 54.55% of the medical records, the diagnosis and prescription was documented. The daily-prescribed dose (DPD) was 100mg thrice a day, equivalent to 300mg per day in half of the patients; and in the first and second level of attention followed by 100mg twice a day (33.3%). A total of 55.4% of the patients had been diagnosed with urinary tract infection (89% female); of these an 89.9% received also antibiotic treatment. The duration of treatment varied between 1 to 30 days, with more prolonged use in the second and third level of attention. Conclusion: The use of phenazopiridine is partial and reasonably adequate, thus supporting the efficacy-safety criteria in the context of first and second level attention centers. The diversity in the prescription patterns requires improvement in ...

Avaliação da atividade antimicrobiana de antissépticos e desinfetantes utilizados em um serviço público de saúde / Evaluation of antimicrobial activity antiseptics and disinfectants used in a public health service / Evaluación de la actividad antimicrobiana de los antisépticos y desinfectantes utilizados en un servicio de salud pública

O estudo teve como objetivo determinar in vitro a atividade antimicrobiana de antissépticos e desinfetantes utilizados no serviço de atenção primária à saúde de uma cidade do norte do Paraná, utilizando microrganismos padronizados pelo Instituto Nacional de Controle de Qualidade em Saúde da Fundação Oswaldo Cruz. Para tanto, foram realizadas análises da atividade antimicrobiana e da estabilidade química de três diferentes antissépticos e um desinfetante utilizados no serviço de atenção primária à saúde. A partir das análises realizadas no primeiro, sétimo, décimo quarto e vigésimo primeiro dias, após a abertura dos frascos, verificou-se que as amostras mantiveram sua atividade antimicrobiana in vitro em relação às cepas padronizadas, evidenciadas pela ausência de crescimento de unidades formadoras de colônias e estabilidade química dos princípios ativos dos antissépticos. O estudo permitiu verificar a eficácia das amostras frente a análises microbiológicas in vitro utilizando microrganismos padronizados.

The study aimed to determine the in vitro antimicrobial activity of antiseptics and disinfectant used in the care service primary health of a city in northern Paraná, using microorganisms standardized by the National Institute of Quality Control in Health, Oswaldo Cruz Foundation. For this purpose, we performed tests of antimicrobial activity and chemical stability of three samples of antiseptic and one disinfectant used in the service. From the analysis performed the first, seventh, fourteenth and twenty-first day after the opening of the bottles, it was found that the samples retained their activity in vitro antimicrobial regarding standardized strains, as evidenced by the absence of growth of colony-forming units and maintaining the chemical stability. The study demonstrated the efficacy of the samples against analysis microbiological in vitro using standardized microorganisms.

El objetivo del estudio fue determinar la actividad antimicrobiana in vitro de los antisépticos y desinfectante utilizados en el servicio de atención primaria de salud en una ciudad en el norte de Paraná, utilizando microorganismos estandarizado por el Instituto Nacional de Control de Calidad en Salud, Fundación Oswaldo Cruz. Con este fin, se realizó un análisis actividad antimicrobiana y la estabilidad química de tres muestras de un antiséptico y desinfectante utilizado en el servicio. Del análisis realizado en el primer, siete, catorce y veintiuno días, después de la apertura de las botellas, se encontró que las muestras mantuvieron su actividad antimicrobiana in vitro frente a cepas estándar, evidencia la ausencia de crecimiento de unidades formadoras de colonias y el mantenimiento de la estabilidad química. El estudio demostró la eficacia de las muestras en contra de organismos microbiológicos utilizando estandarizados in vitro.

Comparação de Dois Métodos de Antissepsia Pré-operatória de Mãos em Cirurgia Bucal / Comparison Between Two Methods of Preoperative Antisepsis of Hands in Oral Surgery

Objetivo: Este trabalho teve como objetivo avaliar a eficácia da escovação pré-operatória, efeito imediato e residual de dois antissépticos na redução bacteriana das mãos, previamente a procedimentos cirúrgicos bucais ambulatoriais. Metodologia: Para a realização do experimento, foram selecionados 20 acadêmicos de odontologia, que participaram de quatro grupos experimentais: grupo I, utilizando o polivinilpirrolidona-iodo (PVP-I) a 10% degermante associado à técnica de escovação cirúrgica, promovendo antissepsia mecânica e química; grupo II, PVP-I a 10% e o método de lavagem cirúrgica, realizando somente antissepsia química; grupo III, clorexidina a 2% associado à técnica de escovação cirúrgica; grupo IV, clorexidina a 2% realizando a técnica de lavagem cirúrgica. Resultado: Como resultado do efeito residual, o grupo I apresentou, em média, de 71% de redução bacteriana; o grupo II apresentou 83%; o grupo III, 97% de ação antimicrobiana, e o grupo IV demonstrou aproximadamente 97% de efeito bactericida. Conclusão: Ao se observar em dois grupos que utilizaram a mesma solução antisséptica em relação ao método de lavagem cirúrgica das mãos, ou seja, sem o uso de artefatos, este apresentou resultados melhores ou, no mínimo, semelhantes quanto à redução bacteriana em relação à técnica convencional de escovação cirúrgica. Com relação à solução antisséptica, a clorexidina apresentou maior redução da carga microbiana que o PVP-I.

Purpose: The purpose of this study was to evaluate the effectiveness of preoperative brushing, the immediately and residual effect of the antiseptics on bacterial reduction of hands, before the oral surgical procedures. Methodology: To the experiment, were selected 20 students of dentistry, who participated in four experimental groups: group I, using povidone-iodine (PVP-I) 10% degerming associated with hand-scrubbing, mechanical and chemical antisepsis; group II, PVP-I 10% and hand-rubbing, performing only chemical antisepsis; group III, digluconate of the chlorhexidine 2% solution degermante with hand-scrubbing; group IV, chlorhexidine 2% and hand-rubbing. Results: As a result of residual effect, the group I made on average 71% of bacterial reduction, while the group II showed 83%; group III resulted in 97% of antimicrobial action, the group IV showed approximately 97% of bactericidal effect. Conclusion: Noting that both groups used the same anti-septic solution to hand-rubbing method showed better at least similar results in bacterial reduction than hand-scrubbing. About the anti-septic solution the chlorhexidine showed greater reduction of microbial load that the PVP-I.

Antimicrobial activity of Lippia sidoides Cham. (Verbenaceae) essential oil against Staphylococcus aureus and Escherichia coli / Atividade antimicrobiana do óleo essencial de Lippia sidoides Cham. (Verbenaceae) contra Staphylococcus aureus e Escherichia coli

The antibacterial effect of Lippia sidoides (rosemary pepper) essential oil was tested against the bacteria Staphylococcus aureus and Escherichia coli isolated from homemade Minas cheese produced in Brazil. The Minimum Inhibitory Concentration (MIC) determined in the Dilution Test was 13 µL oil mL-1 for both bacteria, which characterizes inhibitory action in broth for a 24-hour interaction period. The Minimum Bactericidal Concentration (MBC) determined in the Suspension Test, with one minute of contact, was 25 µL oil mL-1 for both tested bacteria, obtaining at this concentration a bactericidal effect of 99.9 percent on the viable bacterial cells from each sample. Results demonstrated the bacterial activity of Lippia sidoides essential oil against S. aureus and E. coli, suggesting its use as an antibacterial agent in foods.

O efeito antibacteriano do óleo essencial da Lippia sidoides (alecrim-pimenta) foi testado contra as bactérias Staphylococcus aureus e Escherichia coli isoladas de queijo minas artesanal, produzido no Brasil. A Concentração Inibitória Mínima (CIM) determinada por Teste de Diluição foi de 13 µL de óleo mL-1 para as duas bactérias, o que caracteriza ação inibitória em caldo durante vinte quatro horas de interação. A Concentração Bactericida Mínima (CBM) determinada através de Teste de Suspensão, com um minuto de contato, foi de 25 µL de óleo mL-1 para ambas as bactérias testadas, obtendo-se a esta concentração o efeito bactericida de 99,9 por cento sobre as células bacterianas viáveis em cada uma das amostras. Os resultados demonstraram atividade bactericida do óleo essencial de Lippia sidoides contra S. aureus e E. coli, sugerindo a possibilidade do uso como agente antibacteriano em alimentos.