Efficacy of Chlorine Dioxide as an Endodontic Irrigant for Pulp Dissolution in vitro

Determine the efficacy of 5 % chlorine dioxide as an endodontic irrigant for pulp dissolution. Thirty five samples of human dental pulp were obtained, previously weighed and immersed in three solutions= 5 % ClO 2, 5.25 % NaOCl and saline (control group), for 10 minutes at 32 ºC; they were dried and reweighed. Then the weight loss was compared to the original weight and analyzed statistically. 5.25 % NaOCl and 5 % ClO 2 dissolved the dental pulp samples more effectively than saline (p> 0.001). No statistically significant difference was found between the tissue dissolving proper ties of 5.25 % NaOCl and 5 % ClO2 (p=0.893). 5 % ClO2 is effective in dissolving human dental pulp tissue.

El objetivo de este estudio fue determinar la eficacia del dióxido de cloro al 5 % como irrigante endodóntico para la disolución pulpar. Se obtuvieron 35 muestras de pulpa dental humana, se pesaron previamente y se sumergieron en tres soluciones= 5 % ClO2, 5.25 % NaOCl y suero fisiológico (grupo control), durante 10 minutos a 32ºC; se secaron y se pesaron de nuevo. Luego se comparó la pérdida de peso del peso original y se analizó estadísticamente. NaOCl al 5.25 % y ClO2 al 5 % disolvieron las muestras de pulpa dental con más eficacia que el suero fisiológico (p> 0.001). No se encontró diferencias estadísticamente significativas entre las propiedades de disolución de tejido de NaOCl al 5.25 % y ClO2 al 5 % (p=0.893) ClO2 al 5 % es eficaz para disolver tejido de pulpa dental humana.

Comparison of the effect of two disinfectants on the independent waterway disinfection of a periodontal ultrasonic scaler / 口腔疾病防治

Objective @#To compare the disinfection effect of 3% (v/v) hydrogen peroxide and 500 mg/L chlorine-containing disinfectants in the independent waterway of a periodontal ultrasonic scaler to provide a reference for clinical waterway disinfection management in stomatology departments.@*Methods @#The 18 ultrasonic scalers were randomly divided into 3 groups of 6 units: the control group, experimental group 1 (3% hydrogen peroxide disinfectant group), and experimental group 2 (500 mg/L chlorine-containing disinfectant group). The replaceable parts of the independent waterway pipes of the 3 groups of ultrasonic scalers were replaced, and the water supply was supplied with sterile distilled water (DW). In the control group, special treatment was not applied to the nonreplaceable pipe part. In experimental group 1, the 3% hydrogen peroxide was used to disinfect nonreplaceable pipelines. In experimental group 2, the nonreplaceable part was disinfected with the 500 mg/L chlorine-containing disinfectant. The water sample was taken from the outlet of the scaler working part in the three groups for monitoring before disinfection, immediately after disinfection and 10 consecutive days after disinfection. Bacteria in the water samples were cultured for the colony counts. Then, the bacterial culture data were compared between groups. The qualified criterion of the water sample was that the number of bacterial colonies was less than or equal to 100 CFU/mL. After disinfection, a bacterial species mass spectrometry identification analysis was carried out when the number of bacterial colonies in each group exceeded the standard for the first time. Biofilms from the inner wall of the tube in the three groups were observed under an electron microscope on the 10th day after disinfection.@*Results @#There were no significant differences between the three groups before disinfection (F = 2.549, P = 0.111). The number of bacterial colonies in the spout of 6 scalers in the control group all exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas melonis, Herbaspirillum huttiense, and Ralstonia pickettii. Compared with those in the control group, the number of bacterial colonies in experimental group 1 decreased significantly for 1-2 days after disinfection (P<0.05) and reached the standard. On the 3rd day after disinfection, the number of bacterial colonies of group 1 increased rapidly and exceeded the standard, and three kinds of bacteria were cultured: Sphingomonas, Herbaspirillum huttiense, and Ralstonia pickettii. For experimental group 2, the number of bacterial colonies decreased significantly compared to the control group on Days 1 to 6 after disinfection, but the number of bacterial colonies increased slightly from the 7th day after disinfection and exceeded the standard. Two kinds of bacteria were cultured: Herbaspirillum huttiense and Ralstonia pickettii. The average number of bacterial colonies 10-day after disinfection in experimental group 2 was lower than that in experimental group 1(P<0.001). Under an electron microscope, the biofilm thickness of the two experimental groups was significantly lower than that of the control group. @* Conclusion @# There is water pollution in the independent waterway of a periodontal ultrasound scaler. Three percent hydrogen peroxide and 500 mg/L chlorine disinfectant both have effective disinfection effects on the outlet water of scalers, and the effect of 500 mg/L chlorine disinfectant is better than that of 3% hydrogen peroxide. The use of 3% hydrogen peroxide to disinfect periodontal ultrasound scaler-independent waterways is recommended for disinfection every other day, and disinfection once a week is recommended for the use of 500 mg/L chlorine disinfectant.

Exposição ao gás cloro e padrões evolutivos da síndrome da disfunção reativa das vias aéreas: uma revisão sistemática / Chlorine gas exposure and evolutive patterns of reactive airways dysfunction syndrome: a systematic review

Resumo Introdução: o cloro é o gás irritante a que as pessoas estão comumente expostas no cotidiano. Um dos seus efeitos tóxicos é a síndrome da disfunção reativa das vias aéreas (SDRA). Objetivo: resumir as principais evidências dos padrões evolutivos da SDRA. Métodos: Revisão sistemática da literatura de artigos publicados entre setembro de 1985 e julho de 2021 no repositório da Universidade de São Paulo (USP) e nas bases BVS/LILACS, PubMed/Medline e SciELO. Foram utilizados os descritores "cloro" e "asma ocupacional" associados à "síndrome da disfunção reativa das vias aéreas" ou "asma induzida por irritantes". Dois revisores independentes selecionaram e avaliaram a qualidade dos estudos, com apoio do checklist do Instituto Joanna Briggs. Resultados: selecionaram-se 22 estudos: 11 séries de casos, oito relatos de caso e três estudos transversais. Os estudos selecionados abrangeram 1.335 participantes de 11 países, e apenas 170 tiveram diagnóstico de SDRA com evolução documentada. Destes, 115 (65%) foram devido à exposição ocupacional. Os padrões evolutivos mais frequentes foram persistência prolongada dos sintomas, alterações espirométricas e/ou hiper-responsividade brônquica, principalmente no ambiente ocupacional. Observou-se falta de padronização no relato de informações adequadas. Conclusões: a cronicidade foi o padrão evolutivo da SDRA mais frequente. Houve falta de informação apropriada que impediu uma análise adequada dos resultados.

Abstract Introduction: chlorine is the most irritant gas to which people are commonly exposed to daily. One of its toxic effects is reactive airway dysfunction syndrome (RADS). Objective: this study aims to summarize the evidence from the evolutive patterns of RADS. Methods: this systematic review study was conducted using the databases of the University of São Paulo repository, BVS/LILACS, PubMed/Medline, and SciELO. Studies from September 1985 to July 2021 with "chlorine" and "occupational asthma" as descriptors, associated with "reactive airway dysfunction syndrome" or "irritant-induced asthma," were included. These articles were assessed by two independent reviewers. The study's quality was assessed using the Joanna Briggs checklist. Results: a total of 22 studies were retrieved, including 11 case series, 8 case reports, and 3 cross-sectional studies. The selected studies covered 1.335 participants from 11 countries, and only 170 had a diagnosis of RADS with documented evolution. Of these, 115 (65%) were due to occupational exposure. The most frequent RADS evolutive pattern was the long-term persistence of symptoms, spirometric alterations, and/or bronchial hyperresponsiveness, mainly in the occupational setting. A lack of standardization of adequate information reporting was found. Conclusions: chronicity was the most frequent RADS evolutive pattern.

Dióxido de cloro: la verdad toxicológica y el riesgo de las noticias falsas

El dióxido de cloro es una sustancia que se ha usado como desinfectante para tratar el agua de consumo humano. A las dosis usadas en este escenario no se han asociado compromisos toxicológicos para el ser humano. Químicamente, el dióxido de cloro se caracteriza por reaccionar con diversas moléculas y generar estrés oxidativo en los microorganismos y en las células. A pesar de no ser un medicamento ni estar aprobado por las agencias reguladoras, se ha promovido su uso como una solución milagrosa; sin embargo, no hay ninguna evidencia científica que lo respalde. De otro lado, sí hay evidencia de que puede generar toxicidad aguda, y posiblemente crónica, para el ser humano.

Summary Chlorine dioxide has been used as a disinfectant to treat water for human consumption, at the doses used in this scenario, human poisoning has not been described. Chemically, chlorine dioxide is characterized by reacting with various molecules, and generating oxidative stress in microorganisms, and in human cells. Chlorine dioxide is not a medicine, and it is not approved by regulatory agencies. Chlorine dioxide has been promoted as a miracle solution, yet there is no scientific evidence to back it up. On the other hand, there is evidence, that it can generate acute poisoning and possibly chronic poisoning in humans.

Assessing the bleaching effect of an experimental stabilized chlorine dioxide agent used for internal bleaching purposes

Aim Assessing the intracoronal bleaching effectiveness of an experimental chlorine dioxide product, based on the walking bleach technique. Methods Extracted bovine incisors were artificially stained with bovine blood and filled with zinc phosphate cement at cementoenamel junction level. Teeth were divided into 3 groups (n=10): (SP) sodium perborate added with distilled water, (CD) chlorine dioxide and (C) control - dry cotton inserted into the pulp chamber. Bleaching agents were used at 0, 7 and 14 days. VITA Easyshadetm (∆Eab) was used to analyze tooth color at the 7th, 14th and 21st days, based on the CIE2000 system. Data were analyzed through ANOVA and Tukey's test. Results There were no statistically significant differences in Δb, ΔE, ΔE00 and ΔWID between CD and the control group. These parameters have shown significant differences between CD and SP, which differed from the control. However, they did not show significant differences either in the control group or in CD at the 7th, 14th and 21st days. Values recorded for SP at the 7th day differed from those recorded at the 14th and 21st days. Δa has shown differences within the same group at the 7th, 14th and 21st days. There was no difference between groups, when they were compared at the same day (7th and 14th). The control group differed from SP at the 21st day. CD did not differ from the other two groups. ΔL did not show differences between groups and times. Conclusion Stabilized chlorine dioxide (0.07%, at pH 3.5) should not be used as intracoronal bleaching agent along with the walking bleach technique.

Interpretación gasométrica avanzada en el paciente crítico / Advanced gasometric interpretation in critical patient / Interpretação gasométrica avançada no paciente crítico

Resumen: La interpretación gasométrica de forma rápida es muy útil en urgencias, ya que establecer de manera oportuna un diagnóstico es de suma importancia. Existen herramientas que nos permiten igualar la sensibilidad de los métodos complejos de Stewart. Evaluar la gasometría de manera tradicional, dependiendo de la escuela preferida: utilizando sólo el bicarbonato o el exceso de base; tiene baja sensibilidad diagnóstica cuando nos enfrentamos a escenarios donde existe más de un trastorno metabólico asociado. Proponemos los siguientes cinco pasos: evaluar el pH, déficit de base, anión gap, exceso de base y el índice cloro/sodio, que son importantes para identificar de manera rápida y sensible una gasometría en pacientes críticos.

Abstract: The interpretation of a gasometry of rapid form is very useful in an emergency department since to establish in an opportune way a diagnosis performs supreme importance. There exists hardware that allows us to equal the sensibility of the complex m ethods of Stewart. To evaluate the gasometry of a traditional way, depending on the favorite school: using only the bicarbonate or the base excess, it has low diagnostic sensibility when we face stages where more than one metabolic associate disorder exists. We propose the following five steps: to evaluate the pH, deficit of base, anion gap, excess of base, and the index chlorine/sodium, which are important to identify rapidly and sensitively a gasometry in critical patients.

Resumo: A interpretação gasométrica rápida é muito útil em emergências, pois é de suma importância estabelecer um diagnóstico em tempo hábil. Existem ferramentas que nos permitem igualar a sensibilidade dos métodos complexos de Stewart. Avaliar a gasometria da forma tradicional, dependendo da escola preferida: usando apenas bicarbonato ou excesso de base, tem baixa sensibilidade diagnóstica diante de cenários onde há mais de um distúrbio metabólico associado. Propomos as 5 etapas a seguir: avaliação do pH, déficit de base, lacuna aniônica, excesso de base e relação cloreto/sódio, importantes para identificar de forma rápida e sensível os gases sanguíneos em pacientes críticos.

Could polyhexanide and chlorine dioxide be used as an alternative to chlorhexidine? A systematic review

ABSTRACT BACKGROUND: Maintenance of oral microbiota balance is the simplest way to prevent infectious oral diseases, through controlling dental biofilm. Combined use of mouthwash and mechanical removal has been shown to be a very effective way for this. OBJECTIVES: To identify clinical studies comparing the antimicrobial effect and possible adverse effects and/or side effects of chlorhexidine-based mouthwashes with those of mouthwashes containing chlorine dioxide and/or polyhexanide, for controlling oral microbiota. DESIGN AND SETTING: Systematic review designed by the stomatology sector of postgraduation in applied dental sciences of Bauru Dentistry School, University of São Paulo, Brazil. METHODS: A systematic review was conducted using online databases (PubMed, Embase, Web of Science and Science Direct) up to April 8, 2020. The search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS: The studies included comprised eight articles published between 2001 and 2017. A total of 295 young adults, adults and elderly people were evaluated (males 44.75% and females 55.25%). Three articles compared polyhexanide with chlorhexidine and five articles compared chlorine dioxide with chlorhexidine. No studies comparing all three mouthwashes were found. The concentrations of the study solutions were quite varied, and all rinses had an antimicrobial effect. In four studies, it was stated that no side effects or adverse effects had been found. Three studies did not address these results and only one study addressed side effects and/or adverse effects. CONCLUSION: Mouthwashes containing chlorine dioxide and polyhexanide are viable alternatives to chlorhexidine, since they reduce oral biofilm and have little or no reported side or adverse effects.

Comparison of two types of disinfectants on the disinfection of the fixed end of the table suction pipe in the oral comprehensive treatment table / 口腔疾病防治

Objective@#To compare the disinfection effects of 500 mg/L chlorine-containing disinfectant and 3% hydrogen peroxide disinfectant applied to the threaded plastic hose at the fixed end of the saliva suction pipe of the oral comprehensive treatment table after diagnosis and treatment of patients in stomatology to provide a basis for clinical cleaning and disinfection.@* Methods @#The fixed ends of saliva suction pipes of 12 comprehensive treatment tables in the dental pulp department and maxillofacial surgery were selected as the research objects. The absorption was randomly divided into two groups and a control group: experimental group 1 with 500 mg/L chlorine disinfectants and experiment 2 group with 3% hydrogen peroxide disinfectant rinse disinfection and the control group with 0.9% sterile saline flushing pipe once a week for four weeks. Before and after washing and disinfection, samples from the inner wall of the threaded plastic hose interface were collected for bacterial culture and colony count, and colony counts within and between groups were compared before and after disinfection. Statistical analysis was conducted using SPSS 24.0 software.@*Results@#The baseline number of bacterial colonies in the first three groups was balanced, with no statistically significant difference (χ2 = 0.538, P = 0.764). The number of bacterial colonies after washing and disinfection was lower than that before washing and disinfection. The difference between 500 mg/L chlorine-containing disinfectant and 3% hydrogen peroxide disinfectant before and after disinfection was highly significant (Z = -4.801, P<0.001; Z = -4.429, P<0.001). There was no significant difference between the disinfection effect of 500 mg/L chlorine-containing disinfectant and 3% hydrogen peroxide disinfectant, but they were both better than the control group (χ2 = 18.070, P<0.001).@*Conclusion@#Disinfecting the saliva suction pipe with disinfectant between diagnosis and treatment can effectively reduce the bacterial contamination at the fixed end threaded plastic hose interface of the saliva suction pipe. The disinfection method is simple and convenient, and it is worth applying in the oral clinic.

Tendencias de búsqueda en Internet sobre dióxido de cloro en ocho países de Latinoamérica durante la pandemia por COVID-19 / Trends of Internet search about chlorine dioxide in eight Latin American countries during the COVID-19 pandemic

La infodemiología e infovigilancia son métodos informáticos para el análisis y seguimiento de los datos de Internet, y permiten tomar conciencia de las situaciones y crear políticas sanitarias. Este estudio se propuso analizar las tendencias de búsqueda de dióxido de cloro y términos equivalentes en Internet (chlorine dioxide solution, CDS; miracle mineral solution, MMS), en relación con la morbilidad y mortalidad por COVID-19 en ocho países de Latinoamérica. Para ello se utilizó Google Trends; el período examinado fue del 1ro de marzo al 25 de noviembre de 2020. Se calculó la media móvil por 7 días para el volumen relativo de búsqueda (VRB), la tasa de morbilidad y mortalidad. Para la asociación de las variables cuantitativas, se utilizó el coeficiente de correlación de Spearman con un nivel de significancia p < 0,05. El país con mayor interés de búsqueda fue Bolivia; el de menor interés, Brasil. El análisis del VRB con la tasa de morbilidad y mortalidad fue diferente entre países. Los picos máximos de VRB de Colombia y Chile, en abril, y de México, Ecuador y Bolivia, en julio, coincidieron con la emisión de alertas sanitarias sobre dióxido de cloro. La mayoría mostró una correlación significativa moderada y baja entre el VRB y el número de casos confirmados y muertes diarias por COVID-19. El comportamiento de las búsquedas, diferenciado entre países, podría indicar mayor interés por el tema dióxido de cloro en pandemia; lo cual se explicaría por la difusión de alertas sanitarias de organismos de salud internacionales, regionales y locales(AU)

Infodemiology and infovigilance are computer methods for the analysis and monitoring of Internet data, and allow awareness of situations and creation of health policies. This study aimed to analyze the search trends for chlorine dioxide and equivalent terms on the Internet (chlorine dioxide solution, CDS; miracle mineral solution, MMS), in relation to COVID-19 morbidity and mortality in eight Latin American countries. Google Trends was used for this purpose; the period reviewed was from March 1st to November 25th 2020. The 7-day moving average for relative search volume (VRB), morbidity and mortality rate were calculated. For the association of quantitative variables, the Spearman correlation coefficient was used with a significance level p < 0.05. The country with the highest search interest was Bolivia; the one with the least interest, Brazil. The analysis of the VRB with the morbidity and mortality rate was different between countries. The maximum VRB peaks of Colombia and Chile, in April, and of Mexico, Ecuador and Bolivia, in July, coincided with the issuance of health alerts on chlorine dioxide. Most showed a moderate and low significant correlation between VRB and the number of confirmed cases and daily deaths from COVID-19. The behavior of the searches, differentiated between countries, could indicate greater interest in the topic of chlorine dioxide during the pandemic; this would be explained by the dissemination of health alerts from international, regional and local health agencies(AU)

Influência do pH na formação de subprodutos orgânicos halogenados na oxidação com cloro da água superficial para consumo humano do rio Pardo, RP, Brasil / Influence of pH on the formation of halogenated organic by-products in the pre-oxidation step with chlorine in the treatment of surface water for human consumption

A busca por fontes alternativas de recursos hídricos é indispensável tornando a captação de água superficial uma opção viável para complementar o abastecimento público, porém, suas características exigem tratamento adequado para o consumo. O contato do cloro com a matéria orgânica (MO) presente em águas pode resultar na formação de diversas substâncias carcinogênicas, como os trialometanos (THM). A ausência de estudos sobre a característica predominante da matéria orgânica precursora no rio Pardo deixa uma preocupação quanto à tecnologia a ser empregada no tratamento da água, que deverá ser de ciclo completo com uma etapa complementar de pré-oxidação com cloro seguida de adsorção em carvão ativado pulverizado para garantir a remoção de microcontaminantes. O estudo foi conduzido no rio Pardo, inserido na Unidade de Gerenciamento de Recursos Hídricos (UGRHI-4), Ribeirão Preto, estado de São Paulo. A quantificação dos SOH foi realizada no cromatógrafo a gás modelo CG 2010 Marca Shimadzu com detector de captura de elétrons e a aquisição de dados foi obtida por um microcomputador com software para cromatografia CG Real Times Analysis. De modo geral, os parâmetros analisados para o rio Pardo demonstraram que o manancial se encontra dentro dos parâmetros da CONAMA n° 357 (2005) e CONAMA n° 430 (2011) considerados ideais para um rio de classe 2. Os parâmetros analisados neste trabalho podem contribuir com conhecimento para dar subsídio para seleção da tecnologia de tratamento de água do rio Pardo, sendo ela de ciclo completo devido a sua alternância na turbidez ao longo do ano. Dentre os SOH investigados pelo trabalho, foram encontrados apenas cinco (5), sendo esses o Clorofórmio, Dicloroacetonitrila, Bromodiclorometano, Cloro Hidrato e Tricloropropanona. O Clorofórmio e Cloro Hidrato tiveram suas maiores concentrações de 76 µg·L-1 e 68 µg·L-1, respectivamente. De forma geral, os compostos quantificados se encontram abaixo dos preconizado pela Portaria GM/MS nº 888 de 2021. Ao comparar os diferentes pH é possível observar uma tendência de aumento na formação de Trialometanos conforme o aumento no valor de pH. Entretanto, devido a faixa de pH empregada ter sido restrita entre 6,0 e 9,0 a análise estatística não nos permite afirmar que há uma associação direta entre o pH e a formação de SOH

The search for alternative sources of water resources is indispensable, making the capture of surface water a viable option to complement the public supply, however, its characteristics require adequate treatment for consumption. The contact of chlorine with organic matter (OM) present in water can result in the formation of several carcinogenic substances, such as trihalomethanes (THM). The absence of studies on the predominant characteristic of the precursor organic matter in the Pardo River leaves a concern about the technology to be used in the water treatment, which should be a complete cycle with a complementary step of pre-oxidation with chlorine followed by adsorption on charcoal activated powder to ensure the removal of microcontaminants. The study was conducted on the Pardo River, located at the Water Resources Management Unit (UGRHI-4), Ribeirão Preto, state of São Paulo. The quantification of SOH was performed in a gas chromatograph model CG 2010 Shimadzu brand with electron capture detector and the data acquisition was obtained by a microcomputer with software for chromatography CG Real Times Analysis. In general, the parameters analyzed for the Pardo River showed that the source is within the parameters of CONAMA No. 357 (2005) and CONAMA No. 430 (2011) considered ideal for a class 2 river. The parameters analyzed in this work can contribute with knowledge to subsidize the selection of water treatment technology for the Pardo River, which is a complete cycle due to its alternation in turbidity throughout the year. Among the SOH investigated by the work, only five (5) were found, these being Chloroform, Dichloroacetonitrile, Bromodichloromethane, Chlorohydrate and Trichloropropanone. Chloroform and Chlorine Hydrate had their highest concentrations of 76 µg·L-1 and 68 µg·L-1, respectively. In general, the quantified compounds are below those recommended by Ordinance GM/MS nº 888 of 2021. When comparing the different pHs, it is possible to observe a tendency towards an increase in the formation of Trihalomethanes as the pH value increases. However, because the pH range used was restricted to between 6.0 and 9.0, the statistical analysis does not allow us to state that there is a direct association between pH and the formation of SOH

Guía de actuación y abordaje frente a intoxicación por dióxido de cloro/clorito de sodio, a partir de la experiencia de los CIAT de América Latina / Guidelines for action and approach to chlorine dioxide/sodium chlorite poisoning based on the experience of the CIATs in Latin America

Resumen El 11 de marzo de 2020, la Organización Mundial de la Salud, declaró la pandemia a nivel mundial por la COVID-19. Ante este escenario, los centros de información y asesoramiento toxicológico (CIAT) de América Latina comenzaron a recibir consultas por exposición/intoxicación a dióxido de cloro/clorito de sodio y sus compuestos relacionados, por desvío de uso, destinado a la prevención y/o tratamiento de la COVID-19 sin aval científico alguno ni contar con registro sanitario para ese fin. A través de la Red de Toxicología de América Latina y el Caribe (RETOXLAC), se comprobó que no eran hechos aislados, sino que se estaba produ ciendo el mismo fenómeno en toda la región y que existían antecedentes de intoxicaciones con dichos productos y alertas desde hace más de una década, con indicaciones no aprobadas, para el tratamiento de distintas patologías como SIDA, cáncer, esclerosis lateral amiotrófica ELA, malaria, autismo, entre otras, sin evidencia. Ante esta realidad, los CIAT presentan una revisión de los signos y síntomas observados según la vía de ingreso, basados en la comunicación de riesgo en salud; proponiéndose pruebas de apoyo al diagnóstico, algoritmo de tratamiento para las intoxicaciones y modelo de ficha clínica para la vigilancia epidemiológica de los casos atendidos. Recomendamos a las autoridades y organismos responsables, reforzar las acciones tendientes a la vigilancia, control y prevención de este tipo de intoxicaciones, producto del mal uso de un desinfectante no autorizado para fines terapéuticos/médicos.

Abstract On March 11th, 2020, the World Health Organization declared a global pandemic due to COVID-19. Faced with this sce- nario, the Poison Control Centers (CIATs for its initials in spanish) in Latin America began to receive consultations for exposure/poi- soning to chlorine dioxide/sodium chlorite and its related compounds for their use aimed to prevent or treat COVID-19 without any scientific endorsement or having a sanitary registry for that purpose. It was found through the Toxicology Network of Latin America and the Caribbean (RETOXLAC) that they were not isolated events but rather that the same phenomenon was occurring throughout the region and that there has been a history of poisoning and alerts with these products for more than a decade with unapproved indications for the treatment of different pathologies such as AIDS, cancer, amyotrophic lateral sclerosis (ALS), malaria, autism, among others, without evidence. In the light of this situation, the CIATs present a review of the signs and symptoms observed ac- cording to the route of exposure based on health risk communication; proposing tests to support the diagnosis, an algorithm for poisoning treatment, and a model of a clinical record for the epidemiological surveillance of the assisted cases. We recommend to the authorities and responsible organisms reinforce the actions aimed at surveillance, control, and prevention of this type of poisoning due to the misuse of an unauthorized disinfectant for therapeutic or medical purposes.

Enfoque de tratamiento integral del paciente intoxicado por dióxido de cloro y derivados del cloro / Comprehensive therapy approach for patients affected by chloride dioxide and chlorine derivative poisoning

RESUMEN Durante la emergencia sanitaria debida al SARS-CoV-2 y ante la ausencia de una terapéutica específica surgieron tratamientos sin evidencia científica, conllevando a un contexto de infodemia sobre el uso de dióxido de cloro y derivados del cloro, cuyas medidas de elaboración, distribución y administración no son reguladas, exponiendo a un gran número de personas a dicho producto pudiendo llevar a contextos de intoxicación y muerte. En este escenario el artículo presentado tiene el objetivo de brindar al personal de salud, un enfoque de tratamiento integral del paciente intoxicado por estos productos a nivel prehospitalario, que consiste en realizar un protocolo donde se valore el escenario de la exposición del paciente (uso de equipo de protección personal, triaje, descontaminación, entre otros), se realice la evaluación primaria y una evaluación secundaria (revaloración continua del paciente) y a nivel hospitalario (evaluación sistemática del paciente, identificación de la vía de exposición y aplicación de uso de antídoto en escenarios específicos); así como medidas de prevención tanto para el personal de salud como para la población general.

ABSTRACT During the sanitary emergency due to SARS-CoV-2, and considering the absence of specific therapy against this condition, many therapy approaches with no underlying scientific evidence appeared, leading to infodemics with many publications about the use of chloride dioxide and chlorine derivatives, without any regulation on manufacturing, distribution, and administration of such products; and so many people developed multiple symptoms, leading to intoxication and death. In this context, this paper aims to offer healthcare personnel, a comprehensive pre-hospital therapy approach for patients affected by the aforementioned compounds. The idea is to perform a protocol where the scenario for patients' exposure is determined (use of personal protective equipment, triage, decontamination, and the like), primary and secondary assessments are to be performed (continuously reassessing the affected patient). Later, hospital management is to be performed (systematic patient's assessment, identifying the exposure route and use of an antidote when necessary for specific cases); and establishing prevention measures for both healthcare personnel and the general population.

Avaliação da formação de trihalometanos na água de abastecimento público da cidade de Cáceres (MT), Brasil / Evaluation of trihalomethane formation in public water supply in the city of Cáceres, Brazil

RESUMO Estudos recentes vêm demonstrando que a aplicação de cloro poderia levar à formação de trihalometanos (THM), que ocorre quando o cloro reage com a matéria orgânica natural, também denominada de precursora de THM e presente em águas naturais. A United States Environmental Protection Agency (USEPA) classificou os THM como prováveis carcinogênicos para humanos. Com o objetivo de avaliar os níveis de THM na água destinada ao abastecimento público na cidade de Cáceres/MT, foram coletadas amostras de água em três pontos distintos: P1 na água bruta, P2 na saída do reservatório e P3 na rede de abastecimento, por um período de um ano (agosto de 2018 a junho de 2019), com frequência bimestral. Além dos THM, foram monitorados os parâmetros de turbidez, cor, pH e cloro residual livre. Os resultados de água bruta demonstraram que o fenômeno natural denominado "decoada" aumentou as concentrações de turbidez e cor aparente no período enchente/cheia pelo intenso processo de decomposição que ocorre nesse momento, elevando os níveis de matéria orgânica na água bruta. Quanto à água tratada, valores de turbidez fora do preconizado foram detectados. Os níveis de THMs chegaram próximo (0,09518 mg.L-1 - P2) de atingir o VMP de 0,1 mg.L-1 em consequência da presença de precursores. Os valores de THM foram maiores em P2 pelo fato de esse ponto apresentar medição maior de cloro residual livre em relação a P3. Todavia, notou-se uma forte correlação entre THM e turbidez (p < 0,05 e R² = 0,67), o que demonstra que o parâmetro de turbidez pode ser um indicativo da presença de precursores de THM.

ABSTRACT Recent studies have shown that the application of chlorine could lead to the formation of trihalomethanes (THM), which occurs when chlorine reacts with natural organic matter (NOM), also known as precursors of THM, present in natural waters. The United States Environmental Protection Agency (USEPA) has classified THM as probable carcinogens for humans. In order to assess the levels of trihalomethanes in water destined for public supply in the city of Cáceres, state of Mato Grosso, Brazil, water samples were collected from three different points: P1, at raw water; P2, at the outlet of the reservoir; and P3, at the supply network, for a period of one year (from August 2018 to June 2019), with bimonthly frequency. In addition to THM, the parameters of turbidity, color, pH, and free residual chlorine were monitored. The results of raw water demonstrated that the natural phenomenon called "decoada" increased the concentrations of turbidity and apparent color in the flood/spate period, due to the intense decomposition process that occurs in this period, increasing the levels of organic matter in raw water. As for treated water, turbidity values outside the recommended values were detected. THM levels (0.09518 mg.L-1 - P2) almost reached the MPV of mg.L-1, as a result of the presence of precursors. The THM values were higher in P2 because this point presents a higher concentration of free residual chlorine in relation to P3. However, there was a strong correlation between THM and turbidity (p < 0.05 and R² = 0.67), thus demonstrating that the turbidity parameter may be indicative of the presence of THM precursors.

Dióxido de cloro y su repercusión en las tendencias de búsquedas en internet durante la pandemia por la COVID-19 / Chlorine dioxide: its impact on internet search trends in times of COVID-19 / Dióxido de cloro e seu impacto nas tendências de pesquisa da Internet durante a pandemia de COVID-19

RESUMEN Introducción: El creciente número de casos de COVID-19 a nivel mundial han dado paso al deterioro de la de salud mental y la investigación de nuevos tratamientos; esto ha dado lugar a una explosión de búsquedas en internet de palabras clave. Objetivo: En esta investigación se ha descrito el uso de Google Trends para medir las búsquedas en internet de términos asociados a la pandemia por COVID-19 en distintas regiones de Perú y su potencial para realizar investigaciones en salud. Método: Se midió la tendencia de búsquedas en internet del término "dioxido de cloro" en el período entre el 3 de junio al 3 de septiembre de 2020. Se utilizaron los datos de Google Trends sobre una fracción de las búsquedas de las palabras clave, y se analizaron los resultados de acuerdo con una ubicación geográfica dada y un período definido. Resultados: Se encontró que los países que presentaron mayor nivel de búsqueda para dicho término fueron Bolivia, Perú, Ecuador, Argentina y México. Se encontró correlación positiva alta entre el nivel de búsqueda en Argentina y el número de casos en este país, a comparación de Perú, Ecuador y México, donde la correlación fue positiva muy baja. En el caso de Bolivia, se presentó una correlación negativa muy baja. Google Trends podría, además, definir potencialmente el momento y la ubicación adecuada para practicar estrategias de comunicación de riesgos a las poblaciones afectadas. Conclusiones: Existe correlación entre en número de casos y las búsquedas de dióxido de cloro como medida médica contra la COVID-19.

ABSTRACT Introduction: The increasing worldwide number of cases of COVID-19 has led to the deterioration of mental health and researches of new treatments; this has resulted in an explosion of keyword searches on Internet. Objective: This research has described the use of Google Trends to measure the search queries in internet for terms associated with the COVID-19 pandemic in different regions of Peru as well as its potential to conduct research on health aspects. Method: It was measured the search trends in internet for the term "chlorine dioxide" in the period from June 3 to September 3, 2020. Google trends data were used on a fraction of the keyword searches, and the outcomes were analyzed according to the geographic location and defined period. Results: It was found a higher tendency of searching related terms in Bolivia, Perú, Ecuador, Argentina, and México. A high positive correlation was found between the level of search in Argentina and the number of COVID-19 cases in this country, unlike Peru, Ecuador and Mexico, where the correlation was very low. Instead, in Bolivia there was a very low negative correlation. Google Trends could also potentially define the appropriate time and location to practice risk communication strategies to affected populations. Conclusions: An appropriate risk communication could help to prevent the excessive information intakes, which often causes concern or panic in different populations.

RESUMO Introdução: O crescente número de casos de COVID-19 em todo o mundo tem dado lugar à deterioração da saúde mental e à investigação de novos tratamentos; Isso levou a uma explosão de pesquisas de palavras-chave na Internet. Objetivo: Esta pesquisa descreveu o uso do Google Trends para medir buscas na internet por termos associados à pandemia COVID-19 em diferentes regiões do Peru e seu potencial para a realização de pesquisas em saúde. Método: A tendência das pesquisas na internet do termo "dióxido de cloro" foi medida no período entre 3 de junho e 3 de setembro de 2020. Os dados do Google Trends foram usados ​​em uma fração das pesquisas pelas palavras-chave, e os resultados foram analisados ​​de acordo com uma determinada localização geográfica e um período definido. Resultados: Constatou-se que os países com maior nível de busca por esse termo foram Bolívia, Peru, Equador, Argentina e México. Foi encontrada uma alta correlação positiva entre o nível de pesquisa na Argentina e o número de casos neste país, em comparação com Peru, Equador e México, onde a correlação foi muito baixa positiva. No caso da Bolívia, houve uma correlação negativa muito baixa. O Google Trends também pode definir o momento e o local certos para praticar estratégias de comunicação de risco para as populações afetadas. Conclusões: Há correlação entre o número de casos e as pesquisas de dióxido de cloro como medida médica contra o COVID-19.

Presencia de Acanthamoeba spp. en piscinas recreativas al aire libre de la ciudad de Córdoba, Argentina / Presence of Acanthamoeba spp. in outdoor recreational swimming pools in Córdoba city, Argentina / Presença de Acanthamoeba spp. em piscinas recreativas ao ar livre da cidade de Córdoba, Argentina

Resumen El objetivo del estudio fue determinar la presencia de Acanthamoeba spp. en piscinas de uso recreacional, al aire libre, de la ciudad de Córdoba, Argentina. Se recolectaron 30 muestras de agua correspondientes a un total de 10 piscinas. Estas se sembraron en agar no nutritivo en presencia de Escherichia coli en solución de Page. Luego de 72 horas de incubación a 37 °C, la identificación genérica se realizó mediante criterios morfológicos. La prueba de transformación amebo-flagelar se realizó para diferenciar amebas de vida libre que desarrollan trofozoítos flagelados, como Naegleria. Se midieron parámetros fisicoquímicos en cada una de las piscinas. Se identificó Acanthamoeba spp. en el 20% del total de las muestras. Las piscinas en las que se aisló este parásito presentaron niveles no detectables de cloro residual, pH moderadamente alcalino y temperatura templada. Este estudio demuestra la presencia de Acanthamoeba spp. en piscinas recreativas de Córdoba, lo que puede representar un potencial riesgo para la salud pública.

Abstract The aim of the study was to determine the presence of Acanthamoeba spp. in outdoor recreational pools, in Córdoba city, Argentina. Thirty water samples corresponding to a total of 10 pools were collected. These samples were sown on a non-nutritive agar in the presence of Escherichia coli in Pages's solution. After 72 hours of incubation at 37 °C, the generic identification was done based on morphological criteria. The amoebo-flagellate transformation test was performed to differentiate from genera that develop flagellated trophozoites, such as Naegleria. Physicochemical parameters were measured in each of the pools. Acanthamoeba spp. was identified in 20% of the samples. The pools, where this parasite was isolated, presented undetectable levels of residual chlorine, moderately alkaline pH and warm temperature. This study demonstrates the presence of Acanthamoeba spp. in recreational pools in Córdoba, which may represent a potential risk to public health.

Resumo O objetivo do estudo foi determinar a presença de Acanthamoeba spp. em piscinas para uso recreativo, ao ar livre, na cidade de Córdoba, Argentina. Foram coletadas 30 amostras de água correspondentes a um total de 10 piscinas. Elas foram semeadas em ágar não nutritivo na presença de Escherichia coli em solução de Page. Após 72 horas de incubação a 37 °C, a identificação genérica foi realizada utilizando critérios morfológicos. O teste de transformação amebo-flagelar foi realizado para diferenciar amebas de vida livre que desenvolvem trofozoítos flagelados, como Naegleria. Parâmetros físico-químicos foram medidos em cada uma das piscinas. Acanthamoeba spp. foi identificada em 20% do total das amostras. As piscinas onde este parasita foi isolado apresentaram níveis indetectáveis de cloro residual, pH moderadamente alcalino e temperatura temperada. Esse estudo demonstra a presença de Acanthamoeba spp. em piscinas recreativas de Córdoba, o que pode representar um risco potencial para a saúde pública.

Activating effect of extracellular histones on heparinase in chlorine-induced acute lung injury / 中国职业医学

OBJECTIVE: To investigate the induction and activation of heparinase by extracellular histones in acute respiratory distress syndrome(ARDS) induced by chlorine in mice.METHODS: The specific pathogen free adult male C57 BL/6 mice were randomly divided into control group, chlorine injured group, histone injured group, anti-histone antibody group and heparinase inhibitor group, with six mice in each group.The mice in the control group and histone injured group were exposed to clean air, and the mice in the other three groups were exposed to chlorine gas at a dose of 580.0 mg/m~3 for 30 minutes by systemic dynamic inhalation.Mice in the histone injured group were injected with 50 mg/kg body weight calf thymus histone by tail vein.One hour before exposure, mice in the anti-histone antibody group were pretreated with 20 mg/kg body weight anti-histone H4 antibody by tail vein injection, and mice in the heparinase inhibitor group were injected with 2 mg/kg body weight OGT2115(heparinase inhibitor). The other three groups were given equal volume of 0.9% sodium chloride solution by tail vein injection. After 24 hours of exposure, arterial blood was collected for blood gas analysis and the lung tissue was collected for histopathological examination. The protein level of heparinase in lung tissue were detected using enzyme-linked immunosorbent assay, and the activity of heparinase were detected by measuring the product of heparan degradation. The protein expression of pro-heparinase and active heparinase were detected by Western blotting.RESULTS: The dyspnea developed of mice in the chlorine injured group and histone injured group, diffuse inflammation occurred in lung tissue, the oxygenation index in arterial blood decreased(all P<0.05), and the protein level and activity of heparinase in lung tissue, as well as the relative expression of pro-heparinase and active heparinase were increased compared with the control group(all P<0.05). The dyspnea, hypoxemia and acute lung injury of mice in the anti-histone antibody group were alleviated, and the protein level of heparinase in lung tissue, as well as the relative expression levels of pro-heparinase and active heparinase were decreased(all P<0.05), compared with chlorine injury group and histone injury group.The dyspnea, hypoxemia and acute lung injury were alleviated in the heparinase inhibitor group, and the activity of heparinase and the relative expression of pro-heparinase in the lung tissue were decreased compared with the chlorine injury group(all P<0.05). CONCLUSION: During the occurrence and development of chlorine-induced ARDS in mice, extracellular histones aggravate lung injury by inducing the expression and activation of heparinase. Acute lung injury can be alleviated by inhibiting the expression and activation of heparinase.

Acetic Acid Versus Chlorine Tablet Solution as Disinfectant of Non-Critical Environmental Surfaces

Objectives@#This study aims to determine the bactericidal activity of 4% acetic acid versus chlorine tablets against gram negative and gram-positive microorganisms based on percentage reduction of microorganisms in hospital surfaces and suggest that it may be an effective alternative disinfectant.@*Methodology@#This was an experimental study where microbiological sampling of hospital surfaces was used to determine bacterial growth. The study was conducted from November to December 2020 at National Children’s Hospital, a 200 bed capacity tertiary government hospital catering to children 0 to less than 19 years old. Non-critical hospital surfaces such as beds, bed rails and bedside tables were swabbed before and after intervention cleaning with chlorine tablets or 4% acetic acid solution. @*Result@#Pre-swabbing, hospital surfaces showed the presence of Bacillus sp., Klebsiella pneumoniae and Coagulase Negative Staphylococcus (CONS). Post-application of 4% acetic acid solution resulted to 100% reduction of Bacillus sp., 70.8% reduction of CONS, and 19.5% reduction of Klebsiella pneumoniae while post-application of chlorine tablet solution showed 100% reduction of Klebsiella pneumoniae and CONS and 95.2% reduction of Bacillus species. @*Conclusion@#The use of 4% acetic acid solution significantly reduced more gram-positive than gram-negative organisms and is a highly effective disinfectant against Bacillus sp. but is not effective against gram-negative organisms as it does not fulfil the criteria of at least 90 percent reduction in bacterial growth. Chlorine tablet solution is a more effective disinfectant against gram-negative organisms than gram-positive organisms. Acetic acid 4% solution is not an effective alternative disinfectant to chlorine tablet solution, the currently used hospital disinfectant, but maybe used as an adjunct for better reduction of hospital environmental pathogens.

Dióxido de cloro y derivados del cloro para prevenir o tratar la COVID-19: revisión sistemática / Chlorine dioxide and chlorine derivatives for the prevention or treatment of COVID-19: a systematic review

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

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

Caracterización epidemiológica de las exposiciones a dióxido de cloro/clorito de sodio en el contexto de la pandemia COVID-19: Reporte de los centros toxicológicos de América Latina / Epidemiological characterization of exposures to chlorine dioxide/ sodium chlorite in the context of the COVID-19 pandemic: Report of Poison Control Centers in Latin America

Resumen Los centros de información y asesoramiento toxicológico CIATs de América Latina, en el contexto de la pandemia de COVID-19, recibieron una serie de llamadas para consultas y asesoramientos relacionados con el uso de dióxido de cloro/clorito de sodio, que se estaban empleando en el tratamiento o prevención de dicha enfermedad. Dentro de la legislación vigente en los países de América Latina, no se contemplan productos farmacéuticos registrados para uso en humanos, ni se tiene evidencia de registros sanitarios en Europa, Canadá o Estados Unidos para tal fin, que contengan dióxido de cloro o clorito de sodio. Esta publicación, compila la información registrada como parte de la estadística del trabajo de ocho CIATs correspondientes a igual número de países de América Latina. Se identificó sexo, edad, sintomatología, circunstancia y grado de severidad de los 56 casos de pacientes intoxicados con dióxido de cloro/clorito de sodio registrados en el período del 15 de marzo al 30 de septiembre de 2020 en estos ocho países. Los resultados obtenidos confirman que la causa más común fue por mal uso, y el lugar de ocurrencia fue el hogar o sus alrededores, siendo el mayor porcentaje adultos jóvenes comprendidos entre 30 y 49 años. Los síntomas de intoxicación más frecuentemente encontrados fueron gastrointestinales, seguidos de cardiovasculares y respiratorios. La vía de ingreso al organismo en la mayoría de los casos fue por vía oral, reportándose algunos casos por vía inhalatoria, y en el 50% de los casos se constituyeron casos de severidad moderada, severa o fatal (3 fallecimientos). Este estudio contribuye a generar información relevante para las diferentes autoridades sanitarias, los ministerios de salud, las entidades encargadas de inspección, vigilancia y control de los países en los que se comercializan estos productos de manera ilegal por medio de redes sociales y promoviéndolos para uso en humanos para prevenir o curar COVID-19.

Abstract The Poison Control Centers in Latin America, in the context of COVID-19 pandemic, received a series of calls for consultations and recommendations related to the use of chlorine dioxide/sodium chlorite, in the treatment or prevention of CO-VID-19. Under current legislation in Latin America, no pharmaceutical products are registered for use in humans that contain chlorine dioxide or sodium chlorite, nor is there evidence of sanitary registries in Europe, Canada, or the United States for this purpose. This publication compiles the information registered by eight Poison Control Centers that correspond to the same number of Latin American countries. Sex, age, symptoms, circumstance, and degree of severity of the 56 cases of patients poisoned with chlorine dioxide/ sodium chlorite registered in the period from March 15th to September 30th, 2020 were identified. The results obtained confirm that the most common cause of poisoning was unintentional misuse, all of which occurred at home or its surroundings, with the highest percentage of registered cases being young adults between 30 and 49 years old. The most frequent symptoms of intoxication were gastrointestinal, followed by cardiovascular and respiratory. The route of exposure in most cases was oral, with some cases reported by inhalation; 48.2% of the cases were of moderate, severe, or fatal (3 deaths). This study contributes to the generation of relevant information for different health authorities, ministries of health, entities in charge of inspection, surveillance, and control in countries where these products are illegally marketed through social networks and promoted for use in humans to prevent or cure COVID-19.

Análise do teor de cloro ativo e ph de soluções de hipoclorito de sódio / Analysis of the active chlorine content and ph of sodium hypochlorite solutions

O objetivo do presente estudo é verificar o teor de cloro ativo e pH das soluções de hipoclorito de sódio nas concentrações de 0,5%, 1% e 2,5% adquiridas em lojas de material odontológico de Teresina - PI. Analisou-se 11 amostras medindo o teor de cloro ativo através do método da titulometria e pH utilizando pHmetro eletrônico. Observou-se que as substâncias analisadas se encontravam com o teor de cloro acima do especificado nos rótulos e pH alcalino, sendo apenas uma das amostras com o teor abaixo do especificado e pH menor que 9. De acordo com os resultados, conclui-se que as amostras avaliadas com soluções de hipoclorito de sódio dotam de concentrações de cloro diferentes daquelas especificadas nos rótulos.

One of the most important stages of endodontic treatment is the chemical-mechanical preparation that aims to generate cleaning, with the use of chemical irrigation solutions and instruments that help to sanitize the canal. The objective of the present study is to verify the active chlorine content and pH of the sodium hypochlorite solutions at the concentrations of 0.5%, 1% and 2.5% obtained at dental material stores in Teresina - PI. The 11 samples were analyzed by measuring the active chlorine content using the titration method and pH using electronic pH meter. It was observed that the substances analyzed were chlorine content higher than specified on the labels and alkaline pH, being only one of the samples with chlorine content below the specified and pH less than 9. According to the results, it was concluded that samples tested with sodium hypochlorite solutions were contained chlorine concentrations different from those specified on the labels.