Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 527
Filter
1.
Rev. SOBECC ; 25(2): 83-89, 30/06/2020.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-1102114

ABSTRACT

Objetivo: Avaliar a redução microbiana após antissepsia cirúrgica das mãos dos cirurgiões, realizada com preparação alcoólica, em diferentes tempos. Método: Estudo de prevalência, pragmático, de campo, realizado em hospital terciário do Brasil. Coletaram-se amostras microbiológicas das mãos de 54 cirurgiões após lavagem simples, para determinar a flora microbiana basal e, após a antissepsia cirúrgica alcoólica, para avaliar a redução microbiana imediata. Categorizaram-se os resultados da redução microbiana em redução leve (até 50% de redução da flora bacteriana), moderada (de 51 a 80%) e alta (acima de 80%). A pesquisa foi submetida e aprovada pelo Comitê de Ética e Pesquisa da instituição hospitalar privada, sede do estudo, e da instituição de ensino superior federal. Resultados: Nas técnicas realizadas em menos de 90 segundos, houve 80% de redução severa, 6,7% de redução moderada e 13,3% de redução leve. Nas técnicas desempenhadas em mais de 180 segundos, todas as amostras apresentaram redução de contagem bacteriana, o que não ocorreu em tempos menores de antissepsia. Conclusão: Quando a técnica e o tempo recomendados são seguidos, maior é a redução bacteriana, em comparação aos tempos menores.


Objective: To evaluate the microbial reduction after surgical hand antisepsis performed with alcohol solution at different application times among surgeons. Method: This is a pragmatic prevalence field study carried out in a Brazilian tertiary hospital. Microbiological samples were collected from the hands of 54 surgeons after simple washing to determine the baseline microbial flora and after surgical antisepsis with an alcohol solution to evaluate the immediate microbial reduction. We categorized the microbial reduction results as mild (up to 50% bacterial flora reduction), moderate (51 to 80%), and high (more than 80%). The research was submitted to and approved by the Research Ethics Committee of the private hospital (study site) and the federal institution of higher education. Results: Techniques performed in less than 90 seconds showed an 80% high reduction, 6.7% moderate reduction, and 13.3% mild reduction. In applications that lasted more than 180 seconds, all samples presented bacterial count reduction, which did not occur in shorter antisepsis times. Conclusion: When the recommended technique and time are followed, the bacterial reduction is greater compared to lower durations.


Objetivo: evaluar la reducción microbiana después de la antisepsia quirúrgica de las manos de los cirujanos, realizada con preparación alcohólica, en diferentes momentos. Método: Estudio pragmático de prevalencia de campo realizado en un hospital terciario de Brasil. Muestras microbiológicas recogidas de las manos de 54 cirujanos después de un simple lavado, para determinar la flora microbiana basal y después de la antisepsia quirúrgica alcohólica, para evaluar la reducción microbiana inmediata. Los resultados de la reducción microbiana se clasificaron como leves (hasta un 50% de reducción en la flora bacteriana), moderados (del 51 al 80%) y altos (más del 80%). La investigación fue presentada y aprobada por el Comité de Ética e Investigación de la institución del hospital privado, sede del estudio y de la institución federal de educación superior. Resultados: en las técnicas realizadas en menos de 90 segundos hubo una reducción severa del 80%; 6,7% de reducción moderada; 13,3% de ligera reducción. En las técnicas realizadas durante 180 segundos, todas las muestras presentaron una reducción en el recuento bacteriano, lo que no ocurrió en tiempos de antisepsia más cortos. Conclusión: Cuando se siguen la técnica y el tiempo recomendados, mayor es la reducción bacteriana, en comparación con los tiempos más cortos.


Subject(s)
Humans , Surgicenters , Bacterial Infections , Antisepsis , Surgeons , Infections , Anti-Infective Agents, Local
4.
Pesqui. vet. bras ; 39(11): 879-888, Nov. 2019. tab, graf, ilus
Article in English | LILACS (Americas), VETINDEX | ID: biblio-1056911

ABSTRACT

Brazil has one of the largest commercial cattle herds in the world, which naturally coexist with an enormous number of parasitic species. Southern cattle tick, Rhipicephalus (Boophilus) microplus, is among these species, interfering with animal productivity and causing losses to the beef and dairy cattle sector. The use of chemical acaricides in the control of this mite has resulted in the emergence of resistant populations. In this sense, alternative control measures using plants as sources of botanical acaricides have shown to be effective. Eugenia pyriformis Cambess is a Brazilian plant with antioxidant and antimicrobial activity; however, there are no reports on its acaricidal activity in the literature. The present study aimed to evaluate the acaricidal and larvicidal potential of E. pyriformis leaf essential oil (EO) on southern cattle tick at different stages of the reproductive cycle. E. pyriformis leaves were collected and dried, and had their EO extracted by hydrodistillation (3h) using a modified Clevenger apparatus. Chemical analysis was performed by gas chromatography coupled with mass spectrometry (GC/MS), and 32 compounds belonging to the sesquiterpene class were identified: hydrocarbons (17.98%) and oxygenated forms (81.96%), with spathulenol (43.65%) and caryophyllene oxide (12.17%) as the most common. The EO was evaluated by the Adult Immersion Test at the concentrations (500.00 to 3.12mg/mL) in which the following parameters were measured: mortality of females (%), hatchability of eggs (%), and product efficiency (%). Larvae were assessed by the Larval Packet Test at concentrations ranging from 25.00 to 0.00004mg/mL. Lethal concentrations (LC) required for killing 50 and 99.9% of adult females and larvae were determined using Probit analysis. LC50 and LC99.9 of EO were 0.06 and 24.60mg/mL and 1,208.80 and 2,538mg/mL for larvae and adult females, respectively. Action of the EO in the free-living cycle of R. (B.) microplus larvae was another parameter assessed. To this end, the larvae were deposited in pots containing Brachiaria decumbens and, after migration to the leaf apex, a solution containing LC99.9 (24.60mg/mL) of the EO was sprayed. After 24h, 72.25% of the larvae had died, indicating stability of the EO when subjected to uncontrolled temperature and humidity conditions. The mechanism of action through which the EO killed the larvae and adult females was investigated by the Bioautographic Method, which showed inhibition of 3.15mg/mL of the EO on the acetylcholinesterase (AChE) enzyme. The results found in the present experiment indicate that E. pyriformis essential oil is an alternative in the control of southern cattle tick in the larval (parasitic) and free-living cycle (non-parasitic) stages under field conditions.(AU)


O Brasil dispõe de um dos maiores rebanhos bovinos comerciais do mundo, sendo natural que junto a esse rebanho, coexista uma enorme quantidade de espécies parasitárias; dentre estes o carrapato Rhipicephalus (Boophilus) microplus que interfere na produtividade animal, causando prejuízos à pecuária de corte e leite. A utilização de acaricidas químicos no controle deste ácaro tem causado o surgimento de populações resistentes e neste sentido, controles alternativos utilizando plantas como fontes de acaricidas botânicos têm se mostrado eficazes. Eugenia pyriformis Cambess é uma planta brasileira com atividades antioxidante e antimicrobiana, entretanto não há relatos da atividade acaricida. O objetivo do presente estudo consistiu na avaliação do potencial acaricida e larvicida do óleo essencial das folhas de E. pyriformis sobre o carrapato bovino nos diferentes estágios do ciclo reprodutivo. As folhas foram coletadas, secas e o OE extraído por hidrodestilação (3 horas) em aparelho Clevenger modificado. A análise química foi realizada por cromatografia gasosa acoplada à espectrometria de massas (CG/EM) sendo identificados 32 compostos, pertencentes à classe sesquiterpenos: hidrocarbonetos (17.98%) e oxigenados (81.96%); tendo como majoritários o spathulenol (43,65%) e caryophylene oxide (12,17%). O OE foi avaliado pelo teste de imersão de adultos nas concentrações (500,00 a 3,12mg/mL) onde foram mensurados os parâmetros: mortalidade das fêmeas (%), eclodibilidade dos ovos (%) e eficiência do produto (%). As larvas foram avaliadas pelo teste de imersão larval (Larval Packet Test) nas concentrações que variaram de 25,00 a 0,00004mg/mL. Foram determinadas as concentrações letais (CLs) necessárias para matar 50 e 99,9% das fêmeas adultas e das larvas utilizando a análise de Probitos. As CL50 e CL99,9 do OE foram (0,06 e 24,60mg/mL) para as larvas e (1.208,80 e 2.538mg/mL) para as fêmeas adultas, respectivamente. Outro parâmetro avaliado em nossa pesquisa foi mensurar a ação do OE no ciclo de vida livre das larvas de R.(B.) microplus; onde as larvas foram depositadas em vasos com Brachiaria decumbens e após migração destas para o ápice das folhas, foi aspergido solução contendo a CL99,9 (24,60mg/mL) do OE. Após 24 horas, 72,25% das larvas morreram indicando que houve estabilidade do OE quando submetido a condições de temperatura e umidade não controladas. O mecanismo de ação pelo qual o OE matou as larvas e fêmeas adultas foi investigado pelo método bioautográfico, indicando uma inibição de 3,15mg/mL do óleo essencial sobre a enzima acetilcolinesterase (AChE). Os resultados encontrados no presente experimento indicaram que o óleo essencial de E. pyriformis é uma alternativa no controle do carrapato bovino no estágio larval (parasitário) e no ciclo de vida livre (estágio não parasitário) em condições de campo.(AU)


Subject(s)
Animals , Cattle , Rhipicephalus , Larvicides , Acaricides , Eugenia , Anti-Infective Agents, Local/therapeutic use
5.
Rev. cuba. estomatol ; 56(3): e1380, jul.-set. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1093237

ABSTRACT

RESUMEN Introducción: La técnica de lavado de manos quirúrgico es imprescindible para la prevención de las infecciones posoperatorias en el sitio de la intervención, lo que constituye un problema actual y en evolución. Objetivo: Determinar la técnica de lavado de manos quirúrgico con mayor eficacia sobre la flora bacteriana en estudiantes de cirugía. Métodos: Ensayo controlado, aleatorio, de tratamientos no farmacológicos. Se seleccionaron 12 estudiantes de cirugía de la Facultad de Odontología, Universidad de San Martín de Porres, que cumplían con los criterios de inclusión y exclusión. Los estudiantes se dividieron en dos grupos y se les asignó una técnica de lavado de manos quirúrgico: Grupo A: técnica de una fase, y Grupo B: técnica tradicional (tres fases); para ambas técnicas se utilizó escobilla y jabón en barra. Resultados: En el medio de cultivo agar manitol salado, la técnica tradicional presentó una mediana de 52 000 UFC/mL con un mínimo de 10 000 UFC/mL y un máximo de 56 800 UFC/mL, en comparación con la técnica de una fase que presentó 19 600 UFC/mL con un mínimo de 4 400 UFC/mL y un máximo de 38 000 UFC/mL, con un valor de p= 0,117. En el agar MacConkey, la técnica tradicional presentó una mediana de 300 UFC/mL con un mínimo de 0 UFC/mL y un máximo de 18 000 UFC/mL, en comparación con la técnica de una fase que presentó 0 UFC/mL, con un valor de p= 0,054. Conclusiones: No se mostraron diferencias estadísticamente significativas en ambos grupos(AU)


ABSTRACT Introduction: Surgical hand scrubbing is indispensable to prevent postoperative infection at the intervention site, a problem both current and in progress. Objective: Determine the most effective surgical hand scrubbing technique against bacterial flora among surgery students. Methods: A controlled randomized study was conducted of non-pharmacological treatments. Twelve surgery students were selected from the School of Dentistry at the University of San Martín de Porres who met the inclusion and exclusion criteria. The students were divided into two groups and assigned one of two surgical hand scrubbing techniques: Group A: one-step technique and Group B: traditional technique (three steps). Both techniques used bar soap and a brush. Results: In the culture medium mannitol salt agar, the traditional technique obtained a median of 52 000 CFU/mL, with a minimum 10 000 CFU/mL and a maximum 56 800 CFU/mL, whereas the one-step technique obtained a median of 19 600 CFU/mL, with a minimum of 4 400 CFU/mL and a maximum of 38 000 CFU/mL (p= 0.117). In MacConkey agar, the traditional technique obtained a median of 300 UFC/mL, with a minimum of 0 CFU/mL and a maximum of 18 000 CFU/mL, whereas the one-step technique obtained 0 UFC/mL (p= 0.054). Conclusions: No statistically significant differences were found in the groups(AU)


Subject(s)
Humans , Male , Female , Young Adult , Students, Medical , Bacterial Infections/prevention & control , Asepsis/methods , Hand Disinfection/methods , Anti-Infective Agents, Local/administration & dosage
6.
An. bras. dermatol ; 94(3): 361-362, May-June 2019. graf
Article in English | LILACS (Americas) | ID: biblio-1011102

ABSTRACT

Abstract: Perinevic dermatosis neglecta is an underestimated skin condition usually affecting children and adolescents, characterized by the appearance of dirt-like brownish pigmentation around a preexisting nevus and often a matter of concern for parents. We describe the clinical and dermoscopic findings in a case of perinaevic dermatosis neglecta and discuss the possible etiology of this phenomenon.


Subject(s)
Humans , Male , Child , Melanoma/diagnosis , Skin Diseases/diagnosis , Skin Diseases/etiology , Skin Diseases/drug therapy , Hyperpigmentation/complications , Dermoscopy , Diagnosis, Differential , Ethanol/therapeutic use , Anti-Infective Agents, Local/therapeutic use , Nevus, Pigmented/complications
7.
An. bras. dermatol ; 94(2): 204-210, Mar.-Apr. 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1001128

ABSTRACT

Abstract This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].


Subject(s)
Humans , Silver Sulfadiazine/therapeutic use , Wound Healing/drug effects , Burns/drug therapy , Anti-Infective Agents, Local/therapeutic use , Silver Sulfadiazine/pharmacology , Time Factors , Randomized Controlled Trials as Topic , Treatment Outcome , Hospitalization , Anti-Infective Agents, Local/pharmacology
8.
J. coloproctol. (Rio J., Impr.) ; 39(1): 90-93, Jan.-Mar. 2019. tab, ilus
Article in English | LILACS (Americas) | ID: biblio-984640

ABSTRACT

ABSTRACT Purpose: Treatment of persistent anal fistula implies a major challenge for surgeons, with risk of additional recurrence and potential continence impairment. We present a non-surgical treatment based on irrigation with silver nitrate 1% solution. Methods: This is a prospective study including patients with persistent anal fistula after surgery, who were treated with silver nitrate 1% solution irrigation from May 2015 to March 2017. Patients with evidence of abscess, presence of >1 external opening and those with bowel inflammatory disease were excluded. 3-5 cc of silver nitrate 1% solution were instilled through a catheter. The procedure was repeated on a weekly basis, conducting a maximum of 7 sessions per patient. Results: 18 patients (13 male, 72.2%) with a median age of 48 years old (IQR 41-55) were treated using silver nitrate 1% solution. A median of 5 sessions per patient was performed (IQR 3-6). The median follow-up period was 18 months (IQR 9-25). After the described period 8 patients' (44.4%) presented complete resolution of the fistula, 2 patients' (11.2%) were classified as partial healing and in 8 patients' (44.4%) the treatment was considered to fail. 6 patients' experienced self-limited pain during instillation, with persistence up to 24 h in 2 of them. Conclusions: Treatment with silver nitrate 1% solution is a minimally invasive procedure, with a favourable safety profile, that can be performed in an outpatients' basis achieving a complete healing rate of 44.4%. Therefore, this method should be considered for the treatment of recurrent or persistent anal fistula.


RESUMO Objetivo: O tratamento da fístula anal persistente é um grande desafio para os cirurgiões, com risco de recorrência adicional e potencial comprometimento da continência. Os autores apresentam um tratamento não cirúrgico baseado na irrigação com solução de nitrato de prata a 1%. Métodos: Este foi um estudo prospectivo incluindo pacientes com fístula anal persistente após a cirurgia que foram tratados com irrigação com solução de nitrato de prata a 1% entre maio de 2015 e março de 2017. Pacientes com evidência de abscesso, presença de mais de uma abertura externa e aqueles com doença inflamatória intestinal foram excluídos. Usando um cateter, instilou-se 3 a 5 cc. de solução de nitrato de prata a 1%. O procedimento foi repetido semanalmente, em um máximo de sete sessões por paciente. Resultados: Um total de 18 pacientes (13 homens, 72,2%) com idade mediana de 48 anos (IQR 41-55) foram tratados com solução de nitrato de prata a 1%. Uma mediana de cinco sessões por paciente foi realizada (IQR 3-6). A mediana do período de acompanhamento foi de 18 meses (IQR 9-25). Após o período descrito, oito pacientes (44,4%) apresentaram resolução completa da fístula, dois pacientes (11,2%) foram classificados como cicatrização parcial e em oito pacientes (44,4%) o tratamento falhou. Seis pacientes apresentaram dor autolimitada durante a instilação, que persistiu por até 24 horas em dois deles. Conclusões: O tratamento com solução de nitrato de prata a 1% é um procedimento minimamente invasivo, com perfil de segurança favorável, que pode ser realizado em regime ambulatorial, atingindo taxa de cura completa de 44,4%. Portanto, este método deve ser considerado para o tratamento da fístula anal recorrente ou persistente.


Subject(s)
Humans , Male , Female , Silver Nitrate/therapeutic use , Rectal Fistula/drug therapy , Therapeutic Irrigation , Anti-Infective Agents, Local/therapeutic use
9.
Rev. Univ. Ind. Santander, Salud ; 51(1): 33-42, ene.-mar. 2019. tab, graf
Article in Spanish | LILACS (Americas) | ID: biblio-1003153

ABSTRACT

Resumen Introducción: La diversidad de las formas clínicas de la leishmaniasis del Nuevo Mundo (desde formas cutáneas localizadas a diseminadas o formas mucosas) causada por especies del subgénero Viannia podría inferir en la eficacia de los tratamientos tópicos. El objetivo del presente trabajo fue determinar las características de la leishmaniasis cutánea producida por infecciones con Leishmania (V.) braziliensis y L.(V.) panamensis en ratones BALB/c y la eficacia de un mismo tratamiento tópico. Materiales y métodos: Después de la infección con cada una de las especies se realizó seguimiento de las lesiones determinando su tamaño (mm ) y características macroscópicas, cada siete días por 150 días. Las características histopatológicas (en lesiones y órganos) fueron determinadas 70, 106 y 150 días post-infección y la eficacia de un tratamiento tópico (cura de lesión y parasitológica) fue determinada después del tratamiento con un gel de miltefosina aplicado una vez al día por 20 días sobre las lesiones. Resultados: Se observó un aumento del tamaño de las lesiones en ambos grupos de ratones, sin embargo, un mayor tamaño de las lesiones e intensidad de la respuesta inflamatoria con menos alteraciones epidérmicas fue encontrada en los ratones infectados con L. (V.) braziliensis. En ningún grupo se encontraron parásitos en órganos (nódulos, bazo e hígado) ni diferencias en la efectividad del tratamiento tópico utilizado. Conclusión: La eficacia del tratamiento tópico utilizado no fue afectada por las diferencias macro y microscópicas encontradas en la leishmaniasis producida por las dos especies de Leishmania evaluadas.


Abstract Introduction: The efficacy of topical treatments could be affected by the diversity of clinical forms (localized or disseminated cutaneous forms, mucosal forms) of New World-leishmaniasis caused by species of Leishmania from the subgenus Viannia. The aim of this study was to determine the cutaneous leishmaniasis features produced after infection with Leishmania (V.) braziliensis and L. (V.) panamensis in BALB/c mice and to determine the efficacy of one topical treatment. Materials and methods: Cutaneous leishmaniasis lesions were followed up after infection determining their lesion-size (mm2) and other macroscopic characteristics every 7 days for 150 days. Histopathological patterns (in lesions and organs) were determined 70, 106 and 150 days post-infection and the efficacy (lesion and parasitological cure) of miltefosine gel applied topical once a day for 20 days was determined. Results: An increase of size-lesions was observed in both groups of mice, however, a higher lesion- size and inflammatory response but lower epidermal changes were observed in L. (V.) braziliensis compared with L. (V.) panamensis infected ones. No parasites were observed in organs (nodules, spleen and liver) and no differences were observed in the effectiveness of the used topical treatment. Conclusion: The efficacy of the topical treatment used was not affected by the macro and microscopic differences produced after infection by the two Leishmania species evaluated.


Subject(s)
Animals , Leishmania braziliensis , Leishmania guyanensis , Mice, Inbred BALB C , Anti-Infective Agents, Local
10.
Rev. bras. ciênc. saúde ; 23(2): 173-178, 2019. ilus.
Article in Portuguese | LILACS (Americas) | ID: biblio-1010305

ABSTRACT

Introdução: A Barba de timão é uma planta de origem do cerrado brasileiro, que vem sendo estudada por suas propriedades medicinais, tais como: antibacteriana, cicatrizante, coagulante sanguíneo, dentre outras. A cicatrização é um processo pelo qual o organismo tende a reparar uma lesão ou perda de tecido. Objetivo: Este trabalho compara a composição química da barba de timão com algumas pomadas cicatrizantes de origem farmacêuticas já presentes e disponíveis no mercado. Assim, pode-se relacionar a propriedade cicatrizante desta planta por meio de seus componentes químicos. Materiais e Métodos: Para realizar tal comparação, foi utilizada com amostra a planta barba de timão comercializada em mercados especializados e as pomadas, sulfato de neomicina e a sulfadiazina de prata. Para a análise multielementar, foi utilizada a espectroscopia por fluorescência de raios X (XRF). Com o espectro fornecido pela XRF foi possível comparar os elementos químicos das amostras. Conclusão: O espectro mostrou que a barba de timão tem propriedades químicas semelhantes, assemelhando-se com os componentes químicos encontrados na amostra de sulfato de neomicina, adicionada de três compostos químicos, K, Ca e Br, que também são importantes no processo de cicatrização. Ao comparar com a sulfadiazina de prata, o único elemento que se difere do fitoterápico, além do três já citados, é a Ag. (AU)


Introduction: Barba de timão is a plant of the Brazilian Cerrado origin, which is already studied for its medicinal properties, such as: antibacterial, healing, blood coagulant, etc. Healing is a process by which the body tends to repair an injury or loss of tissue. Objective: This work compares the chemical composition of barba timão with some pharmaceutical healing scouring ointments already present and used in the market. Thus, we can relate the healing properties of this plant. Material and Methods: In order to make such a comparison, it was used the barba timão plant marketed in specialized markets, and the ointments neomycin sulfate and silver sulfadiazine. For multielement analysis, X-ray fluorescence spectroscopy (XRF) was used. With the spectrum provided by the XRF it was possible to compare the chemical elements of the samples. Conclusion: The spectrum shows that the barba timão has similar chemical properties, it resembles the chemical components found in the sample of neomycin sulfate, but with three more chemical compounds that is K, Ca and Br, that are also important in the healing process. When comparing with silver sulfadiazine, the only element that differs beyond the K and Ca of the phytotherapic, is the Ag of the ointment sample. (AU)


Subject(s)
Anti-Infective Agents, Local , Ointment Bases/pharmacology
11.
Mem. Inst. Oswaldo Cruz ; 114: e180535, 2019. tab, graf
Article in English | LILACS (Americas) | ID: biblio-1002683

ABSTRACT

BACKGROUND Topical treatment of New World cutaneous leishmaniasis can be affected by bacterial coinfection, hyperkeratosis, and transdermal drug delivery. OBJECTIVE The aim of this work was to evaluate the therapeutic response and safety of the topical, sequential use of antiseptic, keratolytic, and pentamidine isethionate (PMD) creams (3-PACK kit) on CL-infected BALB/c mice. METHODS A 0.5% chlorhexidine solution (CGH), 10% salicylic acid (SA), and 3% or 6% PMD were used as antiseptic, keratolytic, and antileishmanial drugs, respectively. During the first seven days, antiseptic, followed by 10% SA gel and PMD cream, were applied topically. Subsequently, treatment was performed only with the antiseptic and PMD creams. Skin irritation, reduction of lesion size (mm2), and parasitic load were observed until 30 days of treatment were completed. FINDINGS The 3-PACK treatment using 6% PMD induced a complete lesion reduction in 3/6 mice and a partial reduction in 1/6 mice, with no parasites observed. In contrast, CGH and SA alone, along with the vehicle, were not effective (p < 0.05). Moderate to severe erythema was observed at the application site. MAIN CONCLUSION The topical 3-PACK using 6% PMD was 67% effective in the treatment of CL by Leishmania (Viannia) braziliensis. Currently, work is ongoing to improve PMD isethionate formulation and to determine a dose-response.


Subject(s)
Pentamidine/therapeutic use , Leishmania braziliensis/parasitology , Leishmaniasis, Cutaneous/prevention & control , Keratolytic Agents , Mice, Inbred BALB C , Anti-Infective Agents, Local/therapeutic use
12.
Rev. pediatr. electrón ; 15(2): 2-10, ago. 2018. tab
Article in Spanish | LILACS (Americas) | ID: biblio-994498

ABSTRACT

Introducción: Existen varias curaciones para quemaduras. La sulfadiazina de plata se ha usado por años pero las membranas microporosas son cada vez más preferidas. Objetivos: Comparar la eficiencia de las membrana microporosa (Telfa Clear®) versus sulfadiazina de plata (Platsul®) en menores de 15 años hospitalizados por quemadura. Pacientes y Métodos: Estudio de cohorte retrospectivo de 87 pacientes, dividido en 2 grupos comparables en extensión y profundidad de la quemadura, edad y sexo. Durante enero a diciembre 2007 se curaron 52 pacientes con Platsul® y desde enero a octubre 2008 se curaron 35 con Telfa Clear®. Se evalúa tiempos y extensión de reepitelización, porcentaje de injertos, costos, días de hospitalización, número de curaciones, complicaciones, almacenamiento-estabilidad y costos. Estadística no paramétrica para el análisis univariado y regresión logística multivariado en Stata 11.2. Resultados: Los pacientes curados con Platsul® se injertaron más tardíamente y presentan más curaciones. Platsul® es peor evaluado por su almacenamiento-estabilidad y mayores costos. No hay diferencia en la incidencia de infección. Conclusiones: Ambas Técnicas son eficientes en permitir reepitelización, pero Platsul® puede demorar el injerto. La Telfa Clear® es mejor evaluado por el equipo de salud en cuanto a almacenamiento y estabilidad. El menor costo de Telfa Clear® es una ventaja.


Introduction: There are several dressings for burns. Silver sulfadiazine has been used for years but microporous membranes are increasingly preferred. Objectives: To compare the efficiency of microporous membrane (Telfa Clear®) versus silver sulfadiazine (Platsul®) in children younger than 15 years old hospitalized for burns. Patients and Methodology: Retrospective cohort study of 87 patients, divided into 2 comparable groups in extent and depth of the burn, age and sex. During January to December 2007, in 52 patients Platsul® were use and in 35 patients Telfa Clear® were use from January to October 2008. The time and extent of re-epithelialization, percentage of grafts, costs, length of stay, number of dressing change, complications, storage-stability and costs are evaluated. Non-parametric statistics were used for univariate analysis and logistic regression for multivariate analysis en Stata 11.2. Results: Platsul® was associate to a later graft and had a greater number of dressing changes. Platsul® is worst rated for its storage-stability and higher costs. No difference in infection rate was observed. Conclusions: Both techniques are efficient in allowing re-epithelialization, but burns treated with Platsul® were grafted later than when Telfa Clear® was used. Telfa Clear® is best evaluated by the health team in terms of storage and stability. The cost of Telfa Clear® is presented as an advantage.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Silver Sulfadiazine/therapeutic use , Bandages , Burns/therapy , Anti-Infective Agents, Local/therapeutic use , Retrospective Studies , Treatment Outcome , Re-Epithelialization
13.
Rev. SOBECC ; 23(3): 155-159, jul.-set. 2018.
Article in Portuguese | LILACS (Americas), BDENF | ID: biblio-911465

ABSTRACT

Objetivo: Discorrer sobre a eficácia do gluconato de clorexidina e do povidona-iodo em soluções aquosas ou alcoólicas na redução de infecções do sítio cirúrgico e na contagem bacteriana da pele, no preparo pré-operatório do paciente. Método: Estudo de reflexão acerca do melhor antisséptico a ser usado no preparo cirúrgico da pele. Resultados: Verificou-se que tanto a clorexidina quanto o povidona-iodo são igualmente seguros e efetivos e que os manuais de boas práticas internacionais têm recomendado a sua utilização em soluções alcoólicas. Observou-se uma tendência na indicação da clorexidina alcoólica e a emergência de estudos que têm avaliado o uso sequencial ou concomitante da clorexidina e do povidona-iodo com resultados favoráveis a essa prática. Conclusão: Há uma tendência mundial mais favorável ao uso da clorexidina alcoólica em detrimento ao povidona-iodo. Contudo, a decisão pelo melhor agente antisséptico deve considerar cada caso clínico, (contra) indicações e situação


Objective: To discuss the efficacy of chlorhexidine gluconate and povidone-iodine in aqueous or alcoholic solutions in reducing surgical site infections and skin bacterial counts in the preoperative preparation of the patient. Method: Reflective study about the best antiseptic to use in preoperative skin preparation. Results: We found that chlorhexidine and povidone-iodine are equally safe and effective and that international guidelines for good practices have recommended their use in alcoholic solutions. We observed a trend in recommending alcoholic chlorhexidine and an emergence of studies that have evaluated the sequential or concurrent use of chlorhexidine and povidone-iodine with favorable results for this practice. Conclusion: There is a global trend that favors the use of alcoholic chlorhexidine over povidone-iodine. However, the decision about the best antiseptic agent to useshould be based on each clinical case, (contra)indications, and situation


Objetivo: Discutir sobre la eficacia del gluconato de clorhexidina y del povidona-yodo en soluciones acuosas o alcohólicas en la reducción de infecciones del sitio quirúrgico y en el recuento bacteriano de la piel en la preparación preoperatoria del paciente. Método: Estudio de reflexión acerca del mejor antiséptico a utilizarse en la preparación quirúrgica de la piel. Resultados: Se ha comprobado que tanto la clorhexidina como el povidona yodo son igualmente seguros y efectivos y que los manuales de buenas prácticas internacionales han recomendado su utilización en soluciones alcohólicas. Se observó una tendencia en la indicación de la clorhexidina alcohólica y la emergencia de estudios que han evaluado el uso secuencial o concomitante de la clorhexidina y del povidona-yodo con resultados favorables a esa práctica. Conclusión: Hay una tendencia mundial más favorable al uso de la clorhexidina alcohólica en detrimento del povidona-yodo. Sin embargo, la decisión por el mejor agente antiséptico debe considerar cada caso clínico, (contra) indicaciones y situación.


Subject(s)
Humans , Povidone-Iodine , Chlorhexidine , Anti-Infective Agents, Local , Surgical Wound Infection , Preoperative Care , Bacterial Load
14.
Hig. aliment ; 32(278/279): 102-106, 30/04/2018.
Article in Portuguese | LILACS (Americas) | ID: biblio-909990

ABSTRACT

A mastite está entre as principais enfermidades na pecuária leiteira, é considerada endêmica e onerosa para os produtores leiteiros e indústrias de laticínios. O Staphylococcus aureus está envolvido na maioria dos casos de mastite bovina, sendo disseminado de forma contagiosa. Neste sentido, o presente estudo teve como objetivo avaliar a eficiência do pré dipping, utilizando três princípios ativos comerciais para redução bacteriana do S. aureus, isolados do leite in natura, provenientes de um rebanho leiteiro localizado na região nordeste do município de Garibaldi, RS. Foram avaliadas 36 fêmeas bovinas e três antissépticos (iodo, clorexidina e ácido lático). Após a higienização, de acordo com cada experimento, foram desprezados os três primeiros jatos sendo colhidos 30 mL de leite em frascos estéreis, totalizando 144 amostras in natura, semeadas em placas de Ágar Baird Parker e procedeu- se à contagem das unidades formadoras de colônia (UFC/mL). As análises foram realizadas durante o mês de outubro de 2016. Foi evidente a redução microbiana das estirpes de S. aureus com o uso dos antissépticos, no entanto não foi suficiente para verificar uma ação bactericida. Os resultados mostraram redução significativa do crescimento do S. aureus nas amostras analisadas, a maior efetividade na redução foi verificada com o uso do iodo com 66,67%, seguido de 37,50% de redução com o uso da clorexidina e 29,17% de redução com o uso do ácido lático. A partir destes dados, conclui-se que a aplicação dos antissépticos utilizados é uma prática fundamental para reduzir a contaminação de patógenos nos tetos das bovinas, sendo medidas higienicossanitário efetivas para garantir a segurança do leite in natura.(AU)


Mastitis is among the main diseases in dairy farming, it is considered endemic and expensive for the dairy producers and industries. The bacterium Staphylococcus aureus is involved in the majority of the cases of bovine mastitis, being spread contagiously. In this regard, the present study aims to evaluate the efficiency of pre-dipping, using three commercial active principles for bacterial reduction of Staphylococcus aureus; isolated from milk in natura, proceeding from a dairy herd in the northeast region of the city of Garibaldi, RS. 36 female bovines and three antiseptics were evaluated (iodine, chlorhexidine and lactic acid). After the hygienic cleaning in accordance with each trial, the first three shots of milk were rejected and 1.01 fl oz of milk was harvested in sterile bottles, making a total of 144 samples in natura cultured in plates of Baird Parker Agar. Afterwards, the number of Colony Forming Units (CFU/fl oz) was counted. The analyses had been carried through during the month of October of 2016. The microbial reduction of the strains of S. aureus was evident with the use of antiseptics, however, it was not enough to verify a bactericidal effect. The results have shown significant reduction of the growth of S. aureus in the analyzed samples, the biggest effect in the reduction was verified with the use of iodine, 66.67%, followed by 37, 50% of reduction with the use of chlorhexidine and 29.17% of reduction with the use of lactic acid. From these data, we are able to conclude that the use of these tested antiseptics is essential to reduce the contamination of pathogens on the teats of the bovine. These are hygienicalsanitary measures effective to guarantee the aptness of milk in natura


Subject(s)
Animals , Cattle , Food Contamination/prevention & control , Milk/microbiology , Anti-Infective Agents, Local , Staphylococcus aureus/isolation & purification , Brazil , Food Samples , Mastitis, Bovine/prevention & control
15.
National Journal of Andrology ; (12): 345-348, 2018.
Article in Chinese | WPRIM (Western Pacific) | ID: wprim-689752

ABSTRACT

<p><b>Objective</b>To evaluate the effectiveness and safety of low-concentration hydrogen peroxide solution (HPS) for continuous bladder irrigation after transurethral resection of the prostate (TURP).</p><p><b>METHODS</b>We retrospectively analyzed the clinical data about 148 cases of benign prostatic hyperplasia (BPH) treated by TURP from January 2013 to January 2016. Seventy-six of the patients received postoperative continuous bladder irrigation with 0.15% HPS (group A) and the other 72 with normal saline (group B). We compared the two groups of patients in their postoperative hemoglobin (Hb) levels, duration of bladder irrigation, frequency of catheter blockage, time of catheterization, and length of hospital stay.</p><p><b>RESULTS</b>There were no statistically significant differences between the two groups of patients preoperatively in the prostate volume, International Prostate Symptoms Score, maximum urinary flow rate, postvoid residual urine, or levels of serum PSA and Hb (P > 0.05). At 48 hours after operation, a significantly less reduction was observed in the Hb level in group A than in group B ([3.38 ± 2.56] vs [7.29 ± 6.58] g/L, P < 0.01). The patients of group A, in comparison with those of group B, also showed remarkably shorter duration of postoperative bladder irrigation ([32.57 ± 5.99] vs [46.10 ± 8.79] h, P < 0.01), lower rate of catheter blockage (3.3% vs 11.8%, P < 0.01), shorter time of catheterization ([3.74 ± 0.79] vs [4.79 ± 0.93] d, P < 0.01), and fewer days of postoperative hospital stay ([4.22 ± 0.81] vs [4.67 ± 0.88] d, P < 0.01).</p><p><b>CONCLUSIONS</b>Low-concentration HPS for continuous bladder irrigation after TURP can reduce blood loss, catheter blockage, bladder irrigation duration, catheterization time, and hospital stay, and therefore deserves a wide clinical application.</p>


Subject(s)
Anti-Infective Agents, Local , Catheter Obstruction , Humans , Hydrogen Peroxide , Length of Stay , Male , Postoperative Hemorrhage , Postoperative Period , Prostatic Hyperplasia , Blood , General Surgery , Quality of Life , Retrospective Studies , Therapeutic Irrigation , Methods , Transurethral Resection of Prostate , Treatment Outcome , Urinary Bladder , Urinary Bladder Neck Obstruction , Urinary Retention
16.
National Journal of Andrology ; (12): 613-617, 2018.
Article in Chinese | WPRIM (Western Pacific) | ID: wprim-689711

ABSTRACT

<p><b>Objective</b>To study the influence of povidone-iodine (PI) versus that of the benzethonium chloride wipe (BCW) on semen collection and semen quality of sperm donors undergoing penile skin disinfection and provide some evidence for the selection of disinfection methods for semen collection.</p><p><b>METHODS</b>We used PI from August to December 2015 and BCWs from January to July 2016 for penile skin disinfection before semen collection, with two samples from each donor, one collected with and the other without penis skin disinfection (the blank control group). After semen collection, we conducted a questionnaire investigation on the influence of the two disinfection methods on semen collection and compared the semen parameters between the two groups of sperm donors.</p><p><b>RESULTS</b>Totally, 185 sperm donors were included in this study, of whom 63 underwent penile skin disinfection with PI and the other 122 with BCWs before semen collection. Statistically significant differences were found between the PI and BCW groups in the adaptability to the disinfectant and rigid disinfection procedures (P <0.05), but not in the other items of the questionnaire (P >0.05). Compared with the sperm donors of the blank control group, those of the PI group showed statistically significant difference in the percentage of progressively motile sperm (PMS) ([63.02 ± 3.18]% vs [61.45 ± 4.78]%, P<0.05), but not in the abstinence time ([4.97 ± 1.79] vs [4.7 ± 0.94] d, P >0.05), semen volume ([4.11 ± 1.54] vs [4.15 ± 1.61] ml, P >0.05), sperm concentration ([110 ± 29.6] vs [107.5 ± 31.79] ×10⁶/ml, P >0.05), or total sperm count ([439.10 ± 170.13] vs [434.02 ± 186.91] ×106/ejaculate, P >0.05), while those of the BCW group exhibited no remarkable difference in any of the above parameters (P >0.05). Among the samples with abnormal semen quality, significantly fewer were found with abnormal PMS in the BCW than in the PI group (1.64% [2/122] vs 9.68% [6/62], P <0.05). However, there were no significant differences between the PI and BCW groups in the abnormal semen volume, abnormal sperm concentration, or the rate of semen bacterial contamination (P >0.05).</p><p><b>CONCLUSIONS</b>Before semen collection from donors, penile skin disinfection with povidone-iodine may affect both the semen collection process and the quality of donor sperm, while the benzethonium chloride wipe can reduce the influence on the semen collection process and does not affect the semen parameters.</p>


Subject(s)
Anti-Infective Agents, Local , Benzethonium , Disinfection , Methods , Humans , Male , Penis , Povidone-Iodine , Semen , Semen Analysis , Skin , Sperm Count , Sperm Retrieval , Spermatozoa , Tissue Donors
17.
Rio de Janeiro; s.n; s.n; 2018. 62 p. tab, ilus, graf.
Thesis in Portuguese | LILACS (Americas), BBO | ID: biblio-964018

ABSTRACT

O objetivo principal do presente estudo, considerando a importância do controle do biofilme, foi avaliar in situ a ação antimicrobiana e análise elementar da incorporação de diacetato de clorexidina(CHX) em resinas acrílicas a base de PMMA. Além disso, avaliar ex vivo o mecanismo de lixiviação da clorexidina por até 14 dias. Primeiramente, foram recrutados 32 indivíduos para utilização de dispositivos acrílicos intraorais palatinos por 24 horas contendo 6 corpos de prova(CPs), sendo subdivididos em 2 grupos: com clorexidina (1%) e sem CHX. A avaliação da atividade antimicrobiana foi realizada por meio de contagem de colônias de microorganismos totais e Estreptococos do grupo mutans. Então, os grupos foram avaliados estatisticamente pelo teste de wilcoxon. A análise estatística aplicada foi o teste de Wilcoxon. No segundo teste, foi feita a análise elementar dos CPs(n=10) por meio das médias das intensidade dos elementos, antes e após o uso do dispositivo, por meio da fluorescência de raio X. Ao final, foi avaliado ex vivo a liberação de clorexidina cumulativa, em meio fechado contendo saliva dos indivíduos(n=5) por até 14 dias, através da ressonância magnética nuclear (RMN). As análises estatísticas da RMN, foram avaliadas pelo programa AMIX e metaboloanalyst. Os resultados mostraram, que para atividade antimicrobiana não houve diferença estatística (p>0,05) entre os grupos. Foi detectado a presença da molécula de clorexidina, antes e após a inserção dos CPs com CHX na cavidade bucal. Já para liberação de clorexidina, foi detectada a droga ao longo de 14 dias em meio fechado para a grupo teste, com liberação maior nas primeiras 24 horas. Conclui-se que, foi comprovada a presença do fármaco na resina acrílica após 24 horas em meio bucal, e seu mecanismo de lixiviação no meio fechado por até 14 dias. Porém, não foram encontrados resultados que confirmem a presença de um potencial antimicrobiano do fármaco, nas concentrações utilizadas nos corpos de prova in situ em 24 horas.


The main objective of the present study, considering the importance of biofilm control, was to evaluate in situ the antimicrobial action and elemental composition of the incorporation of chlorhexidine diacetate (CHX) in acrylic resins based on PMMA. In addition, ex vivo evaluation of the chlorhexidine release mechanism to 14 days. Firstly, 32 individuals were recruited for 24-hour palatal intraoral acrylic devices containing 6 test specimens (SPs), divided into 2 groups: with chlorhexidine (1%) and without CHX. The evaluation of the antimicrobial activity was performed by colonies count of total microorganisms and streptococci mutans group. Then, the groups were statistically evaluated by the wilcoxon test. The statistical analysis applied was the Wilcoxon test. In the second test, elemental analysis of the SPs (n = 10) was done by means of the means intensity of the elements, before and after the use of the device, by X-ray fluorescence. At the end, the release was evaluated ex vivo of cumulative chlorhexidine in a becker containing saliva of the individuals (n = 5) for 14 days, through nuclear magnetic resonance (NMR). The NMR analyzes were evaluated by AMIX and metaboloanalyst. The results showed that for antimicrobial activity there was no statistical difference (p> 0.05) between the groups. The presence of the chlorhexidine molecule was detected before and after the insertion of SPs with CHX in the oral cavity. As for chlorhexidine release, the drug was detected over 14 days in a closed medium for the test group, with a greater release in the first 24 hours. It was concluded that the presence of the drug in the acrylic resin after 24 hours in oral cavity was verified, and its release mechanism in the closed local for 14 days. However, no results were found to confirm the presence of an antimicrobial potential of the drug at the concentrations used in the in situ test specimens in 24 hours


Subject(s)
Humans , Male , Female , Adolescent , Adult , Acrylic Resins , Chlorhexidine/pharmacology , Polymethyl Methacrylate , Dental Plaque/prevention & control , Anti-Infective Agents, Local/pharmacology , Streptococcus mutans/drug effects , Magnetic Resonance Spectroscopy , Statistics, Nonparametric , Fluorescence
18.
Braz. oral res. (Online) ; 32: e7, 2018. tab, graf
Article in English | LILACS (Americas) | ID: biblio-889497

ABSTRACT

Abstract The aim of this study is to evaluate the action of paramonochlorophenol associated with Furacin followed by calcium hydroxide (CH) dressing in the control of inflammatory root resorption in cases of immediate tooth replantation with delayed endodontic treatment. A total of 28 incisors of 3 male dogs were extracted and replanted after 15 minutes, and randomly divided into 3 groups: Group I (n = 8) - endodontic treatment was performed before the extraction and replantation; Group II (n = 10) - endodontic treatment was performed 30 days after replantation and the root canal was filled with CH dressing; Group III (n = 10) - endodontic treatment was performed 30 days after replantation and root canals received temporary medication of paramonochlorophenol-Furacin followed by CH dressing. The animals were euthanized 90 days after replantation. The histomorphological events analyzed at the epithelial reattachment site were the intensity and extent of acute and chronic inflammatory processes, periodontal ligament (PDL) organization, the intensity and extent of acute and chronic inflammatory processes in the PDL space, root resorption, bone tissue, and ankylosis. Data were submitted to the Wilcoxon Signed Ranks Test for group comparison (α = 5%). In Groups I, II and III the periodontal ligament was regenerated and most of the resorption areas were repaired by newly formed cementum. The depth and extent of root resorption were significantly higher in Group II than in Group III. The use of paramonochlorophenol-furacin followed by CH dressing was more effective in controlling inflammatory root resorption after immediate tooth replantation.


Subject(s)
Animals , Male , Dogs , Root Resorption/prevention & control , Tooth Replantation/methods , Chlorophenols/pharmacology , Tooth, Nonvital/drug therapy , Anti-Infective Agents, Local/pharmacology , Nitrofurazone/pharmacology , Periodontal Ligament/drug effects , Periodontal Ligament/pathology , Root Canal Filling Materials/pharmacology , Root Canal Therapy/methods , Root Resorption/pathology , Time Factors , Tooth Root/drug effects , Tooth Root/pathology , Calcium Hydroxide/pharmacology , Random Allocation , Reproducibility of Results , Treatment Outcome , Tooth, Nonvital/pathology , Medical Illustration
19.
Belo Horizonte; s.n; 2018. 155 p. ilus, graf, tab.
Thesis in Portuguese | LILACS (Americas), BDENF | ID: biblio-912015

ABSTRACT

A infecção de sítio cirúrgico (ISC) é um grande desafio para o paciente, equipe e instituições de saúde. Um fator de risco importante na patogênese das infecções cirúrgicas ortopédicas refere-se à pele do paciente. O banho do paciente com soluções antissépticas, no pré-operatório é recomendado como medida para reduzir o risco de ISC, apesar das controvérsias. O objetivo deste estudo foi avaliar o efeito da intervenção de enfermagem, banho pré-operatório, utilizando as soluções de gluconato de clorexidina a 4%, PVP-I degermante a 10% e sabão sem antisséptico, na prevenção de ISC, em pacientes submetidos à cirurgia eletiva de artroplastia do quadril e estimar a frequência de reações alérgicas causadas pelo uso das soluções. Estudo do tipo ensaio clínico, randomizado, controlado, com mascaramento do pesquisador, paciente e estatístico, utilizando dois grupos de intervenção (clorexidina; PVP-I) e um controle (sabão sem antisséptico). A amostra foi composta por 162 pacientes adultos, submetidos à cirurgia eletiva de artroplastia total do quadril, entre agosto/2015 e outubro/2017, sem infecção no local cirúrgico e alergia às soluções e não portadores nasais de Staphylococcus aureus. A randomização foi realizada por um programa de computador. Utilizados os critérios de descontinuidade de tratamento e a análise por intenção de tratar. Cada grupo foi composto por 54 pacientes. Na consulta de enfermagem os pacientes foram orientados pela enfermeira pesquisadora a tomarem dois banhos: na véspera da cirurgia no domicílio e no dia da cirurgia no hospital. O banho no hospital foi realizado por profissional de enfermagem. Para o banho o paciente recebia um envelope pardo fechado contendo o frasco da solução sorteada, quatro esponjas e um manual que orientava sobre o procedimento. O desfecho primário foi ISC e os pacientes foram monitorados até 90 dias de pós-operatório por meio de telefonemas e nas consultas de egressos ambulatorial. O programa Statistical Package for the Social Sciences (SPSS), versão 19.0, foi utilizado para análise dos dados. O efeito aos tratamentos foi medido comparando os grupos intervenção e controle por meio da incidência de ISC, risco relativo, redução absoluta de risco. As características clínicas/epidemiológicas/cirúrgicas foram similares entre os pacientes nos três grupos. A incidência de ISC em cada grupo foi 5,5% (3/54) [IC95% 1,2-15,4]. A taxa de infecção superficial foi 4,9% e profunda 0,6%. O tempo médio para o surgimento das infecções foi 19 dias (DP ± 7,4). Não houve diferença estatística significativa entre os grupos (p=1,00). Um paciente apresentou reação alérgica com o uso da solução de PVP-I. A taxa de adesão aos dois banhos foi de 99,4% (161/162). Os resultados corroboram recentes revisões sistemáticas que não encontraram diferença nas taxas de infecção cirúrgica quando o banho pré-operatório foi realizado com soluções antissépticas ou sabão. A consulta de enfermagem no pré-operatório pode impactar a taxa de infecção profunda na cirurgia eletiva de artroplastia do quadril. O uso de soluções antissépticas pode ocasionar reações alérgicas na pele do paciente, durante o banho e precisa ser monitorada. É necessário cautela ao recomendar o banho pré-operatório com solução antisséptica como estratégia para reduzir infecção de sítio cirúrgico. A orientação do paciente no pré-operatório de cirurgia eletiva de artroplastia do quadril, quando realizada pelo enfermeiro, pode melhorar a qualidade do cuidado prestado ao paciente cirúrgico. Clinical Trials nº NCTO3001102 (AU)


Surgical site infections (SSI) are a major challenge for the patient, staff, and health institutions. An important risk factor in the pathogenesis of orthopedic surgical infections refers to the patient's skin. The patient's bath with antiseptic solutions in the preoperative period is recommended as measure to reduce the risk of SSI, despite controversies. The objective of this study was to evaluate the effect of the nursing intervention, preoperative bath, using 4% chlorhexidine gluconate solutions, 10% PVP-I and non-antiseptic soap in the prevention of SSI in patients submitted to elective hip arthroplasty surgery and the frequency of allergic reactions caused by the use of the solutions. Randomized, controlled clinical trial with masking of the researcher, patient and statistician using two intervention groups (PVP-I, chlorhexidine) and one control (non-antiseptic soap). The sample was consisted of 162 adult patients undergoing elective total hip replacement between August/2015 to October/2017, without infection at the surgical site and allergy solutions and non-nasal carriers of Staphylococcus aureus. The randomization was performed by a computer program. The criteria for treatment discontinuity and intention-to-treat analysis were used. Each group consisted of 54 patients. In nursing consultation patients were instructed by the research nurse to take two baths: the day before the surgery at home and the day of the surgery in the hospital. The bath in the hospital was performed by a nursing professional. For the bath the patient received a closed brown envelope containing the bottle of the solution drawn, four sponges, and a manual that guided about the procedure. The primary outcome was ISC and the patients were monitored up to 90 postoperative days by phone calls and outpatients visits. The Statistical Package for Social Sciences (SPSS), version 19.0, was used for analysis of the data. The effect on treatments was measured by comparing intervention and control group by incidence of ISC, Relative Risk and Absolute Risk Reduction. Clinical/epidemiological/surgical characteristics were similar among the patients of the three groups. The incidence of SSI in each group was 5.5% (3/54) [IC95% 1,2-15,4]. The superficial infection rate was 4.9% and deep 0.6%. The mean time to onset of infection was 19 days (SD ± 7.4). There was no statistically significant difference between the groups (p = 1.00). One patient presented an allergic reaction with the use of the PVP-I solution. The rate of adherence to the two baths was 99.4% (161/162). The results of this study corroborate recent systematic reviews that found no difference in surgical infection rates when the preoperative bath was performed with antiseptic solutions or soap. The preoperative nursing consultation may impact the rate of deep infection in elective hip arthroplasty surgery. The use of antiseptic solutions may cause allergic reactions on the patient's skin during bathing and needs to be monitored. Caution is required when recommending the preoperative bath with antiseptic solution as a strategy to reduce surgical site infection. The orientation of the patient in the preoperative period of elective hip arthroplasty surgeries performed by the nurse can improve the quality of care provided to the surgical patient. Clinical Trials nº. NCTO3001102..(AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Baths/nursing , Preoperative Care/nursing , Arthroplasty, Replacement, Hip/nursing , Soaps/therapeutic use , Perioperative Nursing , Surgical Wound Infection/prevention & control , Random Allocation , Chlorhexidine/therapeutic use , Academic Dissertation , Anti-Infective Agents, Local/therapeutic use
20.
Article in Chinese | WPRIM (Western Pacific) | ID: wprim-773075

ABSTRACT

To investigate the clinical effect of cleaning up the external auditory canal under otoendoscope combined with Clotrimazole Ointment in the treatment of pregnancy with otitis externa mycotica.From May 2015 to May 2017,16 cases of pregnant patients(19 ears)with otitis externa mycotica were divided into two groups:pure cleaning up group and cleaning up combined with medication group.In the pure cleaning up group,external auditory canal were only cleaned up under otoendoscope conventionally in 9 patients(11 ears),while in the cleaning up combined with medication group,Clotrimazole Ointment was topically applied after cleaning up the external auditory canal under otoendoscope in 7 patients(8 ears).After treatment of 2 weeks,the clinical curative effect,adverse reaction and average time interval to take effect were compared at the end of treatment.The total effective rate(100%)in cleaning up combined with medication group's was significantly better than that in pure cleaning up group's(81.81%)(<0.05);The average time interval to take effect in cleaning up combined with medication groupwas significantly shorter than that in pure cleaning up group's[(2.71±0.70)d vs(5.40±1.96)d,<0.05].After the two-week treatment,there was a four-week follow-up.Only one patient in pure cleaning up group relapsed.After two-week treatment by Clotrimazole Ointment,this patient was cured.Cleaning up the external auditory canal under otoendoscope combined with Clotrimazole Ointment is effective and safe for the treatment of otitis externa mycotica in pregnant women.The addition of topical application of Clotrimazole Ointment further improve the therapeutic efficacy,as compared to the conventional method of cleaning up the external auditory canal under otoendoscope.We suggest clinical application of this method.


Subject(s)
Anti-Infective Agents, Local , Clotrimazole , Ear Canal , Female , Humans , Mycoses , Therapeutics , Otitis Externa , Therapeutics , Pregnancy , Pregnancy Complications, Infectious , Therapeutics , Sensitivity Training Groups
SELECTION OF CITATIONS
SEARCH DETAIL