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Chinese Critical Care Medicine ; (12): 1085-1092, 2023.
Article in Chinese | WPRIM | ID: wpr-1010910


OBJECTIVE@#To investigate the effect of improved nursing strategy on prognosis of older immunosuppressed patients with pneumonia and sepsis.@*METHODS@#A prospective study was conducted. The older immunosuppressed patients with pneumonia and sepsis admitted to the department of intensive care medicine and emergency intensive care unit (ICU) of Peking Union Medical College Hospital from January 2017 to July 2022 were enrolled. In the first stage (from January 2017 to December 2019), patients received the original nursing strategy (original nursing strategy group), including: (1) nurses were randomly assigned; (2) routine terminal cleaning; (3) ICU environmental cleaning twice a day; (4) oral care was performed with chlorhexidine twice a day; (5) original lung physiotherapy [head of bed elevated at 30 degree angle-45 degree angle, maintaining a Richmond agitation-sedation scale (RASS) -2 to 1, sputum aspiration as needed]. After 1 month of learning and training of the modified nursing treatment strategy for nurses and related medical staff, the patients in the second stage (from February 2020 to July 2022) received the improved nursing strategy (improved nursing strategy group). The improved nursing strategy improved the hospital infection prevention and control strategy and lung physical therapy strategy on the basis of the original nursing strategy, including: (1) nurses were fixed assigned; (2) patients were placed in a private room; (3) enhanced terminal cleaning; (4) ICU environmental cleaning four times a day; (5) education and training in hand hygiene among health care workers was improved; (6) bathing with 2% chlorhexidinegluconate was performed once daily; (7) oral care with a combination of chlorhexidine and colistin was provided every 6 hours; (8) surveillance of colonization was conducted; (9) improved lung physiotherapy (on the basis of the original lung physiotherapy, delirium score was assessed to guide early mobilization of the patients; airway drainage was enhanced, the degree of airway humidification was adjusted according to the sputum properties, achieving sputum viscosity grade II; lung ultrasound was also used for lung assessment, and patients with atelectasis were placed in high lateral position and received the lung recruitment maneuver). Baseline patient information were collected, including gender, age, underlying diseases, source of admission, disease severity scores, vital signs, ventilatory parameters, blood gas analysis, life-sustaining treatments, clinical laboratory evaluation, indicators of infection and inflammation, pathogens and drug therapy. The primary outcome was 28-day mortality, and the secondary outcomes were duration of mechanical ventilation, length of ICU stay, and ICU mortality. Multivariate Logistic regression analysis was used to determine the risk factors for 28-day death in older immunosuppressed patients with pneumonia and sepsis.@*RESULTS@#Finally, 550 patients were enrolled, including 199 patients in the original nursing strategy group and 351 patients in the improved nursing strategy group. No significant differences were found in gender, age, underlying diseases, source of admission, disease severity scores, vital signs, ventilatory parameters, blood gas analysis, life-sustaining treatments, clinical laboratory evaluation, indicators of infection and inflammation, coexisting pathogens or drug therapy between the two groups. Compared with patients in the original nursing strategy group, those in the improved nursing strategy group had significantly fewer duration of mechanical ventilation and length of ICU stay [duration of mechanical ventilation (days): 5 (4, 7) vs. 5 (4, 9), length of ICU stay (days): 11 (6, 17) vs. 12 (6, 23), both P < 0.01], and lower ICU mortality and 28-day mortality [ICU mortality: 23.9% (84/351) vs. 32.7% (65/199), 28-day mortality: 23.1% (81/351) vs. 33.7% (67/199), both P < 0.05]. Multivariate Logistic regression analysis showed that the improved nursing strategy acted as an independent protective factor in 28-day death of older immunosuppressed patients with pneumonia and sepsis [odds ratio (OR) = 0.543, 95% confidence interval (95%CI) was 0.334-0.885, P = 0.014].@*CONCLUSIONS@#Improved nursing strategy shortened the duration of mechanical ventilation and the length of ICU stay, and decreased ICU mortality and 28-day mortality in older immunosuppressed patients with pneumonia and sepsis, significantly improving the short-term prognosis of such patients.

Humans , Aged , Prospective Studies , Chlorhexidine/therapeutic use , Intensive Care Units , Pneumonia , Prognosis , Sepsis/therapy , Inflammation
Pesqui. bras. odontopediatria clín. integr ; 23: e220069, 2023. tab, graf
Article in English | LILACS, BBO | ID: biblio-1507019


ABSTRACT Objective: To study the effect of chlorhexidine on elastomeric orthodontic separators (EOS) bacterial-colonisation and gingival-health in Hall technique (HT) patients. Material and Methods: Prospective in-vivo pilot clinical study of EOS bacterial colonisation and primary-molar gingival health assessment in 20 patients (mean age 5.45±1.27 years) requiring bilateral HT crowns (40 teeth). One side received 1-minute 0.12% chlorhexidine-soaked-EOSs (Chx-EOSs), and the other side dry-EOSs (NoChx-EOSs). The EOSs were removed five-days later and underwent a bacterial enumeration technique. Plaque (PI) and Gingival (GI) indices were assessed pre-, five-days and three-months post-treatment. Wilcoxon-Signed-Rank/McNemar-Chi-square statistics were used (p<0.05). Results: Baseline unused/packaged EOSs' sterility check yielded zero colony-forming-units (CFU) per millilitre, but 100% of the used EOSs became colonised by oral-microorganisms. An overall trend of lower mean CFU count in Chx-EOSs (3.415± 0.78 x105 CFU/ml) compared to NoChx-EOSs (6.157±1.48 x105 CFU/ml) was observed (p=0.009). Both NoChx-EOSs and Chx-EOSs insertion sites showed evidence of gingivitis with no difference between PI and GI indices by site over time. Conclusion: There was a lower trend of bacterial colonization in chlorhexidine treated EOSs and an occurrence of gingivitis pre/post HT-treatment regardless of EOS type. The lack of difference in the gingival health may be inconclusive due to this pilot's low power suggesting the need for robust large scale studies.

Humans , Male , Female , Child, Preschool , Child , Orthodontics, Corrective , Chlorhexidine/therapeutic use , Oral Health , Air Microbiology , Chi-Square Distribution , Statistics, Nonparametric
J. oral res. (Impresa) ; 11(4): 1-16, jul. 21, 2022. ilus, tab
Article in English | LILACS | ID: biblio-1427359


Aim: The aim of this review was to systematically assess and report the effectiveness of chlorhexidine (CHX) mouthwash in preventing plaque accumulation and gingivitis in patients undergoing orthodontic treatment. Material and Methods: The review was prepared according to the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines and registered under PROSPERO database (CRD42020170776). Four electronic databases were systematically searched along with a complimentary manual search of orthodontic journals until June 2022. Only Randomized Control Trials (RCTs) reporting on antiplaque and antigingivitis efficacy of Chlorhexidine mouthwash compared with placebo or control in orthodontic patients were included. Risk of bias assessment was done using Cochrane ROB-2. Quantitative analysis (Random-Effects Model and Standard Mean Difference (SMD)) with 95 % confidence interval was used. Results: Six RCTs were included for qualitative analysis and four were included for quantitative analysis with a total of 211 participants. Out of six studies, 3 were judged to have a low risk of bias, two had some concerns and one of them had high risk of bias. Random effects meta-analysis performed for anti-plaque effect reported a significant reduction of -1.2 SMD for CHX at 4 to 6 weeks with low heterogeneity (I2-35%). The anti-gingivitis effect at 4 to 6 weeks was significant for CHX with a SMD of -1.03 and a moderate heterogeneity (I2-65%). Conclusion: On analyzing the available evidence a moderate level of certainty supports a short-term reduction in plaque accumulation and gingivitis in orthodontic patients subjected to rinsing with chlorhexidine oral rinse.

Objetivo: El objetivo de esta revisión fue evaluar e informar sistemáticamente la efectividad del enjuague bucal con clorhexidina (CHX) para prevenir la acumulación de placa y la gingivitis en pacientes que reciben tratamiento de ortodoncia. Material y Métodos: La revisión se preparó de acuerdo con las pautas de Preferred Reporting Items for Systematic Reviews (PRISMA) y se registró en la base de datos PROSPERO (CRD42020170776). Se realizaron búsquedas sistemáticas en cuatro bases de datos electrónicas junto con una búsqueda manual gratuita de revistas de ortodoncia hasta junio de 2022. Solo se incluyeron ensayos controlados aleatorios (ECA) que informaron sobre la eficacia antiplaca y antigingivitis del enjuague bucal con clorhexidina en comparación con placebo o control en pacientes de ortodoncia. La evaluación del riesgo de sesgo se realizó mediante Cochrane ROB-2. Se utilizó un análisis cuantitativo (modelo de efectos aleatorios y diferencia de medias estándar (SMD)) con un intervalo de confianza del 95 %. Resultados: Se incluyeron seis ECA para el análisis cualitativo y cuatro para el análisis cuantitativo con un total de 211 participantes. De los seis estudios, se consideró que tres tenían un bajo riesgo de sesgo, dos tenían algunas preocupaciones y uno de ellos tenía un alto riesgo de sesgo. El metanálisis de efectos aleatorios realizado para el efecto antiplaca informó una reducción significativa de -1,2 SMD para CHX a las 4 a 6 semanas con baja heterogeneidad (I2-35%). El efecto antigingivitis a las 4 a 6 semanas fue significativo para CHX con una SMD de -1,03 y una heterogeneidad moderada (I2-65%). Conclusión: Al analizar la evidencia disponible, un nivel de certeza moderado apoya una reducción a corto plazo en la acumulación de placa y gingivitis en pacientes ortodóncicos sometidos a enjuague con enjuague bucal con clorhexidina.

Humans , Dental Plaque/prevention & control , Gingivitis/prevention & control , Orthodontics , Chlorhexidine/therapeutic use , Orthodontic Appliances, Fixed , Mouthwashes/therapeutic use
J. bras. pneumol ; 47(1): e20190286, 2021. tab, graf
Article in English | LILACS | ID: biblio-1154691


ABSTRACT Objective: In ICU patients on mechanical ventilation (MV), ventilator-associated pneumonia (VAP) is a common infection. However, such infection can be prevented through oral care protocols. The objective of this study was to compare the efficiency of the use of chlorhexidine and oral hygiene protocols (brushing and clinical procedures) with that of the use of chlorhexidine alone (intervention group and control group, respectively) in decreasing the prevalence of VAP in patients ≥ 18 years of age admitted to the ICU and requiring MV. Methods: In this systematic review and meta-analysis, studies were identified through searches of various national and international databases, as well as of the gray literature, and were selected in accordance with eligibility criteria. Results: We evaluated six studies, involving a collective total of 1,276 patients. We classified the risk of bias as low in three studies, high in two, and uncertain in one; among the six risk domains evaluated, a low risk of bias was predominant in five. The results for random risks were similar in terms of direction and statistical magnitude-chi-square = 6.34; risk difference: −0.06 (95% CI: −0.11 to −0.02); I2 = 21%; p = 0.007. There was a decrease in the prevalence of VAP in the intervention group (n = 1,276) included in the meta-analysis. Conclusions: Protocols that include the mechanical removal of oral biofilm in combination with the use of chlorhexidine can reduce the incidence of VAP among ICU patients requiring MV.

RESUMO Objetivo: A pneumonia associada à ventilação mecânica (PAVM) é uma infecção frequente em UTI. No entanto, essa infecção pode ser evitada através de protocolos de cuidados orais. O objetivo deste estudo foi comparar a eficiência de protocolos de higiene bucal (escovação e procedimentos clínicos) aliados ao uso de clorexidina (grupo intervenção) com a de protocolos que fazem uso somente de clorexidina (grupo controle) na diminuição da prevalência da PAVM em pacientes adultos (≥ 18 anos) internados em UTI sob VM. Métodos: Nesta revisão sistemática e meta-análise, várias bases de dados nacionais e internacionais foram utilizadas para a identificação e seleção de estudos e literatura cinza seguindo critérios de elegibilidade. Resultados: Foram incluídos seis estudos, envolvendo 1.276 pacientes. Após a classificação dos estudos, três apresentaram baixo risco de viés, dois apresentaram risco de viés alto, e o risco foi incerto em um; entre os seis domínios avaliados houve predomínio de baixo risco de viés em cinco deles. Os resultados para riscos aleatórios foram semelhantes em direção e magnitude estatística - qui-quadrado = 6,34; diferença de risco: −0,06 (IC95%: −0,11 a −0,02); I2 = 21%; p = 0,007. Houve diminuição na prevalência de PAVM no grupo intervenção (n = 1.276) incluídos na meta-análise. Conclusões: Protocolos que incluem a remoção mecânica do biofilme associada ao uso de clorexidina podem reduzir a incidência de PAVM em pacientes internados em UTI sob VM.

Humans , Oral Hygiene , Chlorhexidine/therapeutic use , Pneumonia, Ventilator-Associated/prevention & control , Respiration, Artificial/adverse effects , Toothbrushing
RFO UPF ; 25(2): 291-302, 20200830. tab
Article in Portuguese | LILACS, BBO | ID: biblio-1357805


Objetivo: revisar a literatura quanto ao uso de soluções no reservatório líquido do ultrassom (US) para o tratamento das doenças periodontais, avaliando as contribuições dessa associação e as soluções mais eficazes para essa terapêutica. Métodos: foi realizada pesquisa bibliográfica nas bases de dados Public Medline (PubMed), Lilacs, Science Direct e ISI web of knowledge. As palavras-chave utilizadas foram: "periodontal disease", "ultrasonic", "cooling solution", "antimicrobial" e "irrigation". Como critérios de inclusão, foram selecionados estudos prospectivos, retrospectivos, caso controle, transversal e relatos de casos, publicados em inglês. Resultados: após pesquisa e minuciosa revisão por título e resumo de cada estudo, 15 estudos foram selecionados para avaliação dos desfechos investigados. As principais soluções associadas ao US foram povidono-iodo (PVPI), clorexidina, óleos essenciais, bicarbonato de sódio. O irrigante mais utilizado foi o PVPI, seguido por clorexidina e óleos essenciais. Os agentes podem conferir discretas melhoras no nível clínico de inserção e profundidade de sondagem, porém os resultados são controversos, já que nem todos os ensaios demonstraram efeitos positivos. Uma importante evidência observada foi em relação à redução dos níveis de microrganismos derivados do aerossol do US quando essas substâncias foram utilizadas no reservatório de água, sendo esse um aspecto positivo de seu uso como solução refrigerante ao US. Considerações finais: de modo geral, não puderam ser confirmados benefícios adicionais dos irrigantes antimicrobianos nos principais parâmetros periodontais avaliados, porém não se pode descartar o potencial uso desses agentes para a redução da dispersão de microrganismos advindos do aerossol, promovendo assim maior proteção ao paciente e ao profissional.(AU)

Objective: to review the literature regarding the use of solutions in the liquid ultrasonic (US) reservoir devices for the treatment of periodontal diseases, evaluating the benefits of this association, and the most effective solution for this therapy. Methods: bibliographic research was carried out in the Public Medline (PubMed), Lilacs, Science Direct, and ISI web of knowledge databases. The keywords used were: "periodontal disease", "ultrasonic", "cooling solution", "antimicrobial", and "irrigation". Inclusion criteria were prospective, retrospective, case-control, cross-sectional studies, and case reports published in English. Results: after a meticulous analysis of each paper by title and summary, 15 studies were selected for further investigation of clinical outcomes. The main solutions associated with US devices as coolant were PVPI, Chlorhexidine, Essential Oils and Sodium Bicarbonate. The most used coolant agent was PVPI, followed by chlorhexidine and essential oils. It has been shown that irrigating solutions can provide improvements in the clinical attachment level and probing depth, but the results are controversial since not all trials showed positive effects. Important evidence observed was the reduction of the levels of microorganisms derived from the US aerosol when these substances were used as a cooling solution. Conclusions: in general, additional benefits of coolant solutions could not be confirmed in the main periodontal parameters evaluated, however, the potential use of these agents to reduce the dispersion of microorganisms derived from the aerosol cannot be ruled out, thus promoting additional protection to the patient and professional.(AU)

Humans , Periodontal Diseases/therapy , Ultrasonic Therapy/methods , Anti-Infective Agents/therapeutic use , Povidone-Iodine/therapeutic use , Oils, Volatile/therapeutic use , Chlorhexidine/therapeutic use , Sodium Bicarbonate/therapeutic use , Cooling Agents
Rev. Asoc. Argent. Ortop. Traumatol ; 85(2): 139-146, jun. 2020.
Article in Spanish | BINACIS, LILACS | ID: biblio-1125551


Introducción: Las heridas con defectos de coberturas suponen un gran desafío a la hora de elegir un buen tratamiento que reduzca el riesgo de infección e incremente la capacidad de granulación del tejido. El objetivo de este estudio fue demostrar la utilidad del digluconato de clorhexidina para la granulación de tejidos. Materiales y Métodos: Se incluyeron 18 heridas de 16 pacientes que cumplían con los criterios de inclusión. Se realizaron curaciones ambulatorias con gasas embebidas en digluconato de clorhexidina al 20%, cada 48-72 h, hasta lograr la adecuada granulación de tejido y se tomaron fotografías de la evolución clínica de las heridas. Resultados: Se observó una adecuada granulación de las heridas en una media de 9.2 días (rango 4-25), independientemente del tamaño o de las comorbilidades. Ninguna herida presentó signos clínicos de infección durante el período de curación. Conclusiones: El uso de digluconato de clorhexidina es un adecuado método por tener en cuenta para tratar heridas, de forma ambulatoria, y así disminuir los costos hospitalarios del sistema de salud. Nivel de Evidencia: IV

Introduction: Wounds with dressing defects pose a great challenge when choosing a good treatment that may reduce the risk of infection and promote granulation tissue formation. Objective: To demonstrate the usefulness of chlorhexidine digluconate (CHG) for granulation tissue formation. Materials and Methods: Eighteen wounds (16 patients) that met the inclusion criteria were included. Wound cleansing was performed in outpatients with 20% CHG-impregnated cloths every 48-72 h, until the proper tissue granulation was achieved. Photographs of the clinical evolution of the wounds were taken. Results: The adequate wound granulation mean was of 9.2 days (4-25 days) regardless of wound size or presence of comorbidities. There were no clinical signs of infection in any wound during the healing period. Conclusions: CHG treatment is an appropriate method to be considered for outpatient injuries, which reduces the hospital costs borne by the health-care system. Level of Evidence: IV

Adult , Wound Healing , Wounds and Injuries , Chlorhexidine/therapeutic use , Soft Tissue Injuries
Rev. ADM ; 77(3): 156-161, mayo-jun. 2020.
Article in Spanish | LILACS | ID: biblio-1128800


Introducción: La instalación inmediata del implante posterior a la extracción dental se está convirtiendo en un procedimiento de rutina debido a la reducción del tiempo de tratamiento y a la preservación de las estructuras anatómicas remanentes. Sin embargo, en muchos casos esta técnica involucra dientes afectados con procesos infecciosos. Hasta ahora, no se ha descrito a ciencia cierta el grado de éxito o fracaso del implante inmediato en alvéolos infectados, ni se ha establecido un protocolo para el manejo de este tipo de casos. Objetivo: Realizar una revisión bibliográfica actualizada, para determinar qué consideraciones se deben tener para instalar un implante inmediato en alvéolos con procesos infecciosos. Conclusión: Es posible obtener las ventajas de la instalación inmediata del implante en alvéolos infectados mediante la aplicación de un adecuado manejo clínico, donde se considere un adecuado tratamiento antibiótico, acompañado de un correcto curetaje alveolar, respetar la cadena de asepsia y antisepsia, posición subcrestal del implante y obtener siempre una buena estabilidad primaria del implante (AU)

Introduction: The immediate placement of the implant after dental extraction is a procedure that every time is becoming a routine procedure due to the reduction of the treatment time and the preservation of the remaining anatomical structures. However, in many cases, this technique involves affected teeth with infectious processes. Until now, the degree of success or failure of the immediate implant in infected alveoli has not been described for sure; nor has a protocol been established for the management of these types of cases. Objective: Carry out an updated bibliographic review, to determine what considerations must be taken to install an immediate implant in alveoli with infectious processes. Conclusion: Is possible obtain the advantages of the immediate installation of the implant in infected alveoli through the application of adequate clinical management, where appropriate antibiotic treatment is considered, accompanied by proper alveolar curettage, respect the aseptic and antiseptic chain, implant subcrestal position and always obtain a good primary stability of the implant (AU)

Humans , Tooth Extraction , Tooth Socket , Immediate Dental Implant Loading , Focal Infection, Dental/therapy , Chlorhexidine/therapeutic use , Guided Tissue Regeneration , Lasers , Anti-Bacterial Agents/therapeutic use
Rev. cuba. estomatol ; 57(1): e2967, ene.-mar. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126487


RESUMEN Introducción: El té verde (Camellia sinensis) y el propóleo presentan flavonoides, que inhiben el crecimiento, metabolismo y la coagregación del Streptococcus mutans, principal agente causal de la caries dental. Objetivo: Evaluar la actividad antibacteriana in vitro del extracto etanólico del té verde (Camellia sinensis) al 10 por ciento y 20 por ciento comparado con extracto etanólico de propóleo al 10 por ciento y 20 por ciento, frente al crecimiento de cepas de Streptococcus mutans (ATCC 25175). Métodos: Estudio experimental in vitro, longitudinal, prospectivo y comparativo. El universo estuvo constituido por 90 discos de difusión y la muestra por 15 discos embebidos en té verde (Camellia sinensis) o propóleo a diferentes concentraciones, clorhexidina acuosa al 0,12 por ciento y agua destilada. El tamaño de muestra se calculó por fórmula de comparación de medias, después de realizar un estudio piloto. Se colocaron los discos de difusión embebidos en las sustancias sobre agar Mueller Hinton, sembrado con Streptococcus mutans (ATCC 25175), haciendo medición del ancho de los halos inhibitorios a las 24 y 48 h. Se aplicaron pruebas de comparación no paramétricas de Kruskal Wallis y la prueba rangos de Wilcoxon. Resultados: El máximo ancho de halo inhibitorio logrado por clorhexidina acuosa al 0,12 por ciento, extracto etanólico de té verde (Camellia sinensis) al 20 por ciento y extracto etanólico de propóleo al 20 por ciento fue a las 24 h con valores de 10,64 mm ± 0,924 mm, 6,82 mm ± 0,982 mm y 8,36 mm ± 1,286 mm, respectivamente. El extracto etanólico de té verde (Camellia sinensis) al 20 por ciento, presentó diferencias estadísticamente significativas respecto al extracto etanólico de propóleo al 20 por ciento, tanto a las 24 h (p= 0,013), como a las 48 h (p= 0,011). Conclusiones: Frente al crecimiento de cepas de Streptococcus mutans (ATCC 25175), el extracto etanólico de propóleo al 20 por ciento presenta mayor actividad antibacteriana respecto al extracto etanólico de té verde (Camellia sinensis) al 10 por ciento y 20 por ciento, actividad que disminuye con el paso del tiempo(AU)

ABSTRACT Introduction: Green tea (Camellia sinensis) and propolis contain flavonoids which inhibit the growth, metabolism and co-aggregation of Streptococcus mutans, the main causative agent of dental caries. Objective: Evaluate the antibacterial activity in vitro of 10 percent and 20 percent green tea (Camellia sinensis) ethanolic extract versus 10 percent and 20 percent propolis ethanolic extract against the growth of Streptococcus mutans (ATCC 25175) strains. Methods: An in vitro experimental prospective longitudinal comparative study was conducted. The study universe was 90 diffusion disks and the sample was 15 disks soaked up in green tea (Camellia sinensis) or propolis at various concentrations, 0.12 percent aqueous chlorhexidine and distilled water. Sample size was estimated by the comparison of means formula after conducting a pilot study. The diffusion disks soaked up in the substances were placed on Mueller Hinton agar planted with Streptococcus mutans (ATCC 25175) and the width of the inhibition haloes was measured at 24 h and 48 h. Nonparametric Kruskal-Wallis comparison tests and the Wilcoxon rank test were performed. Results: The maximum width of the inhibition halo achieved by 0.12 percent aqueous chlorhexidine, 20 percent green tea (Camellia sinensis) ethanolic extract, and 20 percent propolis ethanolic extract at 24 h was 10.64 mm ± 0.924 mm, 6.82 mm ± 0.982 mm and 8.36 mm ± 1.286 mm, respectively. The 20 percent green tea (Camellia sinensis) ethanolic extract showed statistically significant differences with respect to the 20 percent propolis ethanolic extract, both at 24 h (p= 0.013) and at 48 h (p= 0.011). Conclusions: The 20 percent propolis ethanolic extract displays greater antibacterial activity against the growth of Streptococcus mutans (ATCC 25175) strains than the 10 percent and 20 percent green tea (Camellia sinensis) ethanolic extract. This activity decreases with the passing of time(AU)

Humans , Propolis/therapeutic use , Streptococcus mutans/cytology , Chlorhexidine/therapeutic use , Camellia sinensis/adverse effects , Anti-Bacterial Agents/adverse effects , Prospective Studies , Longitudinal Studies
Asian Journal of Andrology ; (6): 28-33, 2020.
Article in English | WPRIM | ID: wpr-1009768


Inflatable penile prostheses are an important tool in the treatment of medically refractory erectile dysfunction. One of the major complications associated with these prostheses is infections, which ultimately require device explanation and placement of a new device. Over the past several decades, significant work has been done to reduce infection rates and optimize treatment strategies to reduce patient morbidity. This article reviews the current state of knowledge surrounding penile prosthesis infections, with attention to the evidence for methods to prevent infection and best practices for device reimplantation.

Humans , Male , Anti-Bacterial Agents/therapeutic use , Anti-Infective Agents, Local/therapeutic use , Antibiotic Prophylaxis/methods , Bandages , Carrier State/drug therapy , Chlorhexidine/therapeutic use , Coated Materials, Biocompatible , Device Removal , Diabetes Mellitus/epidemiology , Erectile Dysfunction/surgery , Gram-Negative Bacterial Infections/therapy , Hair Removal/methods , Immunocompromised Host/immunology , Penile Implantation/methods , Penile Prosthesis , Preoperative Care/methods , Prosthesis-Related Infections/therapy , Reoperation , Risk Factors , Spinal Cord Injuries/epidemiology , Staphylococcal Infections/therapy , Staphylococcus aureus , Staphylococcus epidermidis , Surgical Drapes , Surgical Instruments , Surgical Wound Infection/therapy
J. appl. oral sci ; 28: e20200217, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1134767


Abstract Objective Pulp revascularization is an effective treatment for immature necrotic teeth. Calcium hydroxide has been used in pulp revascularization as an intracanal medication due to its antimicrobial action and the non-exhibition of crown discoloration and cytotoxicity for stem cells from the apical papilla. Our study aimed to investigate the clinical success and quantitative radiographic changes of root development in immature traumatized teeth using calcium hydroxide plus 2% chlorhexidine gel as intracanal medication. Methodology In this retrospective study, 16 patients were treated with a standardized pulp revascularization protocol. Calcium hydroxide and 2% chlorhexidine gel were manipulated in a 1:1 (v/v) ratio and inserted into root canals with Lentulo spirals (Dentsply Maillefer, Baillaigues, Switzerland). Patients were followed up for a period from 9 to 36 months for the evaluation of clinical and radiological data. Radiographic measurements of root length, root width, apical diameter, and MTA placement from the apex were quantified using software ImageJ. Wilcoxon test and t-test were used, according to nonparametric or parametric data, respectively, for changes over time in root length, root width, and apical diameter. Results Fifteen teeth survived during the follow-up period (93.75%) and met the criteria for clinical success. Although the changes seem to be very small in many cases, significant increases in the average root length (14.28%, p<0.0001), root width (8.12%, p=0.0196), and decrease in apical diameter (48.37%, p=0.0007) were observed. MTA placement from the apex and age at the time of treatment was not significantly associated with the quantitative radiographic outcomes. Conclusions Pulp revascularization in traumatized immature teeth treated with calcium hydroxide plus 2% chlorhexidine gel as intracanal medication had high success and survival rates, showing periodontal healing and resolution of signs and symptoms. However, concerning the continued root development, the outcomes can still be considered unpredictable.

Humans , Male , Female , Child , Adolescent , Root Canal Irrigants/therapeutic use , Calcium Hydroxide/therapeutic use , Chlorhexidine/therapeutic use , Dental Pulp/blood supply , Retrospective Studies , Treatment Outcome , Dental Pulp Necrosis/drug therapy , Tooth Apex
Acta Paul. Enferm. (Online) ; 33: eAPE20180307, 2020. tab, graf
Article in Portuguese | BDENF, LILACS | ID: biblio-1100875


Resumo Objetivo Acompanhar o uso do curativo gel de clorexidina em cateter venoso central de crianças e adultos submetidos ao transplante de células-tronco hematopoéticas para verificar a ocorrência de infecção da corrente sanguínea relacionada ao cateter e irritação cutânea na vigência deste curativo. Métodos Estudo observacional e prospectivo, com 25 pacientes com cateter venoso central inserido para realização do transplante de células-tronco hematopoéticas. Diariamente avaliou-se as características do curativo, da pele, clínicas do paciente e relacionadas a infecção. Os pacientes foram acompanhados a partir do primeiro dia da inserção do CVC até a sua remoção, até o limite de 45 dias a partir da data de inserção do CVC. Resultados A infecção da corrente sanguínea relacionada ao cateter ocorreu em 28% dos pacientes, houve associação entre neutropenia febril e infecção (p<0,01). A irritação cutânea foi identificada em 24% dos pacientes. Não foi identificada associação entre infecção da corrente sanguínea relacionada ao cateter e a irritação cutânea (p=0,51). Houve associação significativa entre irritação cutânea e suspensão do uso do curativo (p=0,03). As trocas não programadas ocorreram em 50% das trocas identificadas e o principal motivo foi a presença de sangue no curativo (57,8%). Conclusão O uso do curativo gel de clorexidina em pacientes submetidos ao TCTH demonstrou ser uma medida eficaz na redução da ocorrência de infecções relacionadas ao cateter, quando comparado aos dados da literatura. Os casos de ICSRC encontrados foram associados, principalmente, à condição de neutropenia, muito comum nesta população. Os casos de irritação cutânea relacionados ao curativo identificados e a presença de sangue como principal motivo de troca não programada salientam a importância do conhecimento relacionado ao uso do curativo por parte dos enfermeiros assistenciais, a fim de criar protocolos que indiquem o uso e manejo do curativo com segurança.

Resumen Objetivo Hacer un seguimiento del uso del vendaje gel de clorhexidina en catéter venoso central (CVC) en niños y adultos sometidos al trasplante de células madre hematopoyéticas (TCMH) para verificar los casos de infección del flujo sanguíneo relacionados con el catéter (IFSRC) y la irritación cutánea durante la validez de este vendaje. Métodos Estudio observacional y prospectivo, con 25 pacientes con catéter venoso central insertado para realizar el trasplante de células madre hematopoyéticas. Diariamente se evaluaron las características del vendaje y de la piel, las características clínicas del paciente y las relacionadas con la infección. Los pacientes recibieron un seguimiento a partir del primer día de la inserción del CVC hasta su retirada, con un límite de 45 días a partir de la fecha de inserción del CVC. Resultados La infección del flujo sanguíneo relacionada con el catéter se presentó en el 28% de los pacientes, hubo relación entre neutropenia febril e infección (p<0,01). Se identificó irritación cutánea en el 24% de los pacientes. No se identificó relación entre la infección del flujo sanguíneo relacionada con el catéter y la irritación cutánea (p=0,51). Hubo relación significativa entre la irritación cutánea y la suspensión del uso del vendaje (p=0,03). Los cambios no programados sucedieron en el 50% de los cambios registrados, y el motivo principal fue la presencia de sangre en el vendaje (57,8%). Conclusión El uso del vendaje gel de clorhexidina en pacientes sometidos al TCMH demostró ser una medida eficaz para la reducción de casos de infecciones relacionadas con el catéter, en comparación con los datos de la literatura. Los casos de IFSRC encontrados se relacionaron principalmente con la condición de neutropenia, muy común en esta población. Los casos identificados de irritación cutánea relacionados con el vendaje y la presencia de sangre como principal motivo de cambio no programado resaltan la importancia del conocimiento del uso del vendaje por parte de los enfermeros asistenciales, a fin de crear protocolos que indiquen el uso y manejo seguro del vendaje.

Abstract Objective Monitor the use of chlorhexidine gel dressing in the central venous catheter of children and adults submitted to hematopoietic stem cell transplantation (HSCT) to check for catheter-related bloodstream infection and skin irritation while using this dressing. Methods This is a prospective observational study with 25 patients with central venous catheters (CVC) inserted for hematopoietic stem cell transplantation. Dressing characteristics, skin characteristics, clinical conditions of patients and infection-related characteristics were evaluated daily. Patients were monitored from the first day of CVC insertion until removal, up to 45 days from the CVC insertion date. Results Catheter-related bloodstream infection (CRBSI) occurred in 28% of all patients, with an association between febrile neutropenia and infection (p<0.01). Skin irritation was identified in 24% of patients. No association was found between catheter-related bloodstream infection and skin irritation (p=0.51). A significant association was observed between skin irritation and dressing removal (p=0.03). Unscheduled dressing changes corresponded to 50% of all dressing changes identified during the study, and the main reason was presence of blood in the dressing (57.8%). Conclusion Using chlorhexidine gel dressing in patients submitted to HSCT proved to be an effective measure to reduce the occurrence of catheter-related infections, when compared to literature data. The cases of CRBSI found in this study were mainly associated with the condition of neutropenia, which is very common in this population. The cases of dressing-related skin irritation and presence of blood as the main reason for unscheduled change highlight the importance of nurses having proper knowledge about how to use this dressing in order to create protocols for safe dressing use and handling.

Humans , Male , Female , Adult , Chlorhexidine/therapeutic use , Hematopoietic Stem Cell Transplantation , Bandages, Hydrocolloid , Catheter-Related Infections/drug therapy , Central Venous Catheters , Anti-Infective Agents, Local/therapeutic use , Prospective Studies , Observational Study
Odontol. vital ; (31): 23-30, jul.-dic. 2019. tab, graf
Article in Spanish | LILACS, BBO | ID: biblio-1091424


Resumen Objetivo: Evaluar mediante cuantificación de halos de inhibición el efecto antibacteriano de la cáscara y pulpa del capulí (Prunus serotina capulí) y del mortiño (Vaccinium floribundum), sobre cepas de Streptococcus mutans (ATCC 35668) a las 24 y 48 horas, comparado con arándano deshidratado y gluconato de clorhexidina al 0,12%. Materiales y métodos: Estudio experimental transversal in vitro, 15 cajas petri fueron utilizadas para sembrar 20ml de cultivo de cepas de Streptococcus mutans. En cada caja fueron colocados discos de fieltro impregnados con 20 μl de las sustancias evaluadas; mortiño y capulí, en pulpa y en cáscara, arándano deshidratado y gluconato de clorhexidina al 0,12% como control, distribuidos a una distancia equidistante. El análisis del efecto antibacteriano se realizó midiendo la zona de inhibición en un tiempo de 24 y 48 horas de incubación, los datos obtenidos se analizaron estadísticamente en el programa SPSS 22 mediante las pruebas paramétricas y de Kruskal Wallis. Resultados: No existió diferencia estadística significativa entre las variables analizadas, capulí y mortiño tanto en cáscara como en pulpa y clorhexidina empleada como control, en los dos períodos evaluados (p= > 0,05). Conclusiones: Los frutos rojos analizados tienen un efecto antibacteriano a las 24 y 48 horas, lo cual guarda relación con su capacidad antioxidante.

Abstract Objective: To evaluate by quantification of halos of inhibition, the antibacterial effect of the shell and pulp of capulí, (Prunus serotina capuli) and mortiño (Vaccinium floribundum), on strains of Streptococcus mutans (ATCC 35668) at 24 and 48 hours, compared with dehydrated cranberry and chlorhexidine gluconate at 0,12%. Materials and methods: In vitro cross-sectional experimental study, 15 petri dishes were used to plant 20 ul of the evaluated substances were placed in each box, mortiño, and capuli, in pulp and in shell, dehydrated cranberry and 0,12% chlorhexidine gluconate as control, distributed at an equidistant distance. The analysis of the antibacterial effect was performed by measuring the zone of inhibition in a time of 24 and 48 hours of incubation, the dataobtained were statistically analyzed in the SPSS 22 program by parametric and Kruskal Wallis tests. Results: There was no significant statistical difference between the analyzed variables, capuli and mortiño, both in skin and pulp and chlorhexidine used as control, in the two evaluated periods of time (p=>0,05). Conclusions: The red fruits analyzed have an antibacterial effect 24 and 48 hours, which is related to its antioxidant capacity.

Streptococcus/drug effects , Chlorhexidine/therapeutic use , Blueberry Plants/immunology , Dental Caries , Prunus avium/immunology
Rev. Ateneo Argent. Odontol ; 61(2): 36-40, nov. 2019. ilus
Article in Spanish | LILACS | ID: biblio-1095356


La osteonecrosis de los maxilares asociada a bifosfonatosfuedefinida como «Área de hueso expuesto en la región máxilo facial que permanece expuesta al menos por 8 semanas, siempre que los pacientes hayan sido prescriptos con bifosfonatos, y en ausencia de terapia radiante¼. (1) En la actualidad se agregó "hueso expuesto o hueso que se puede sondear a través de una fistula intra o extra oral" (2). Presentamos un caso clínico de una paciente femenina de 70 años de edad, diagnosticada con cáncer de hueso (osteosarcoma) con foco en la pelvis, historia de consumo de bifosfonatosvía endovenosa durante tres años, zolendronato 70mg, semanalmente. Al momento de la consulta, se encontraba en periodo de remisión de la enfermedad de base y sin consumo de medicación antiresortiva desde hace un año (AU)

Osteonecrosis of the jaws associated with bisphosphonates was defined as «Area of exposed bone in the maxillofacial region that remains exposed for at least 8 weeks, provided that patients have been prescribed with bisphosphonates, and in the absence of radiant therapy¼. (1) At present, "exposed bone or bone that can be probed through an intra or extra oral fistula" was added (2). We present a clinical case of a 70-year-old female patient, diagnosed with bone cancer (osteosarcoma) with a focus on the pelvis, history of consumption of bisphosphonates intravenously for three years, zolendronate 70 mg, weekly. At the time of the consultation, he was in the period of remission of the underlying disease and without consumption of antiresortive medication for a year (AU)

Humans , Female , Aged , Bone Resorption/etiology , Alveolar Bone Loss/etiology , Diphosphonates/adverse effects , Bisphosphonate-Associated Osteonecrosis of the Jaw , Chlorhexidine/therapeutic use , Amoxicillin-Potassium Clavulanate Combination/therapeutic use , Dental Service, Hospital , Bisphosphonate-Associated Osteonecrosis of the Jaw/diagnostic imaging
Rev. latinoam. enferm. (Online) ; 27: e3106, 2019. graf
Article in English | LILACS, BDENF | ID: biblio-985656


ABSTRACT Objective: to compare the effect of dry care and the application of chlorhexidine to the umbilical cord of newborns at risk of developing omphalitis. Method: systematic review with meta-analysis. Clinical trials comparing dry care with the application of clorexidine to evaluate omphalitis were selected. Methodological quality was evaluated using the Consolidated Standards of Reporting Trials. Results: the joint analysis of the studies shows a significant decrease in the risk of omphalitis in the chlorhexidine group compared to the dry care group (RR=0.58, CI: 0.53-0.64). However, in the analysis by subgroups, chlorhexidine umbilical cord care did not reduce the risk of omphalitis in hospital births (RR=0.82, CI: 0.64-1.05), in countries with a low infant mortality rate (RR=0.8, CI: 0.5-1.28), or at chlorhexidine concentrations below 4% (RR=0.55, CI: 0.31-1). Chlorhexidine acted as a protective factor at a concentration of 4% (RR=0.58, CI: 0.53-0.64), when applied in cases of home births (RR=0.57, CI: 0.51-0.62), in countries with a high infant mortality rate (RR=0.57, CI: 0.52-0.63). Conclusion: dry cord care is effective in countries with low infant mortality rate and in hospital births. However, 4% chlorhexidine for umbilical cord care protects against omphalitis in home births, in countries with a high infant mortality rate.

RESUMO Objetivo: comparar o efeito da cura a seco e da aplicação de clorexidina no cordão umbilical de recém-nascidos em risco de desenvolver onfalite. Método: revisão sistemática com metanálise. Foram selecionados os ensaios clínicos que comparavam a cura a seco com a aplicação de clorexidina para avaliar a onfalite. A qualidade metodológica foi avaliada com Consolidated Standards of Reporting Trials. Resultados: a análise conjunta dos estudos mostra uma redução significativa do risco de onfalite no grupo da clorexidina em comparação com a cura a seco (RR=0,58; IC 0,53-0,64). Entretanto, na análise por subgrupos, a cura com clorexidina não reduziu o risco de onfalite em nascimentos hospitalares (RR=0,82; IC: 0,64-1,05), nos países com baixa taxa de mortalidade infantil (RR=0,8; IC: 0,5-1,28), ou com concentrações de clorexidina abaixo de 4% (RR=0,55; IC: 0,31-1). A clorexidina atuou como fator de proteção na concentração de 4% (RR=0,58; IC: 0,53-0,64), aplicada em nascimentos no domicílio (RR=0,57; IC: 0,51-0,62), em países com taxas de mortalidade infantil elevadas (RR=0,57; IC: 0,52-0,63). Conclusão: a cura a seco é eficaz em países com baixa taxa de mortalidade infantil e em nascimentos no contexto hospitalar. No entanto, a cura com clorexidina 4% protege contra a onfalite nos nascimentos domiciliares, em países com elevada mortalidade infantil.

RESUMEN Objetivo: comparar el efecto de la cura seca y de la aplicación de clorhexidina en el cordón umbilical de los recién nacidos en el riesgo de desarrollo de onfalitis. Método: revisión sistemática con metaanálisis. Se seleccionaron ensayos clínicos que compararan la cura seca con la aplicación de clorhexidina evaluando la onfalitis. Calidad metodológica evaluada con Consolidated Standards of Reporting Trials. Resultados: el análisis conjunto de los estudios muestra una reducción significativa del riesgo de onfalitis en el grupo de clorhexidina en comparación con cura seca (RR=0,58; IC: 0,53-0,64). Sin embargo, en el análisis por subgrupos, la cura con clorhexidina no aportó reducción del riesgo de onfalitis en nacimientos hospitalarios (RR=0,82; IC: 0,64-1,05) en países con baja tasa de mortalidad infantil (RR=0,8; IC: 0,5-1,28), ni a concentraciones de clorhexidina inferiores al 4% (RR=0,55; IC: 0,31-1). La clorhexidina actuó como factor protector a concentraciones del 4% (RR=0,58; IC: 0,53-0,64), aplicada en nacimientos en el hogar (RR=0,57; IC: 0,51-0,62), en países con elevada mortalidad infantil (RR=0,57; IC: 0,52-0,63). Conclusión: la cura seca es eficaz en países con baja tasa de mortalidad infantil y nacimientos en ámbito hospitalario. Sin embargo, la cura con clorhexidina al 4% protege de onfalitis en nacimientos en el hogar, en países con elevada mortalidad infantil.

Humans , Male , Female , Infant, Newborn , Umbilical Cord/physiology , Chlorhexidine/therapeutic use , Skin Care/methods
J. oral res. (Impresa) ; 7(7): 292-297, sept. 22, 2018. tab, graf
Article in English | LILACS | ID: biblio-1120999


Introduction: the aim of this study is to determine the current trends of irrigation during root canal therapy by specialists who are members of the Chilean Endodontic Society. materials and method: a survey (survey monkey was e-mailed to the 485 members of the Chilean Endodontic Society. the instrument was translated and adapted from the survey "irrigation trends among American Association of Endodontists members: a web-based survey" applied in the USA in 2012. participants answered a set of 16 questions that included irrigant selection, irrigant concentration, the adopted protocol, techniques or devices for irrigant activation. results: 99 percent of respondents use sodium hypochlorite as the main irrigant. data indicate that 74 percent of respondents use hypochlorite at a concentration of 5 percent. most respondents (94 percent) also include EDTA in their usual practice. In addition, 90 percent of respondents reported that they activate the irrigating agent, and 94 percent confirmed that they perform a final irrigation protocol. conclusion: the majority of respondents use sodium hypochlorite as the main irrigant at a concentration of 5 percent, use ethylenediaminetetraacetic acid (EDTA) as a smear removal agent, activate the irrigant, and perform a final irrigation protocol.

Humans , Root Canal Irrigants/therapeutic use , Practice Patterns, Dentists'/statistics & numerical data , Endodontics/statistics & numerical data , Sodium Hypochlorite/administration & dosage , Sodium Hypochlorite/therapeutic use , Chile , Chlorhexidine/administration & dosage , Chlorhexidine/therapeutic use , Epidemiology, Descriptive , Surveys and Questionnaires , Smear Layer , Edetic Acid/administration & dosage , Edetic Acid/therapeutic use , Therapeutic Irrigation/methods
Int. j. odontostomatol. (Print) ; 12(2): 103-109, jun. 2018. graf
Article in Spanish | LILACS | ID: biblio-954249


RESUMEN: Los Trastornos Temporomandibulares (TTM) consisten en un conjunto de condiciones patológicas que afectan la articulación temporomandibular (ATM), los músculos de la masticación y las estructuras asociadas. Estudios epidemiológicos estiman que 40 % a 75 % de la población adulta presenta por lo menos un signo de TTM, como ruido articular y 33 % por lo menos un síntoma, como dolor facial o en la ATM. La toxina botulínica (BoNT) es una neurotoxina producida por la bacteria anaerobia Clostridium botulinum, solo la toxina A y B son utilizadas en la práctica clínica después de la aprobación de la Food and Drug Administration en 1989 y 2000; actualmente continúan siendo utilizadas para tratar varias condiciones de dolor, incluyendo la espasticidad muscular, distonia, dolor de cabeza y dolor miofascial. Las propuestas del mecanismo de acción fueron sugeridas a mediados de 1950 manifestando que esta neurotoxina posee alta afinidad con la sinapsis colinérgicas, ocasionando un bloqueo en la liberación de acetilcolina de esos terminales nerviosos, sin alterar la conducción neural de las señales eléctricas o en la síntesis de almacenamiento de acetilcolina. La inyección intramuscular en dosis y localización apropiada, provoca denervación química parcial y disminución de la contractura, sin ocasionar parálisis completa a lo que se le atribuye ser un innovador y eficaz método de tratamiento para el dolor crónico asociada con hiperactividad de los músculos masticatorios. La toxina botulínica tipo A es ser una alternativa para el control de la sintomatología dolorosa presente en los TTMs de etiología miogénica. Los autores recomiendan realizar un correcto diagnóstico, ya que la indicación de este tipo de tratamiento con diagnósticos incorrectos lleva a resultados inciertos.

ABSTRACT: Temporomandibular Disorders (TMD) is a term that was used to describe a set of pathological conditions that affect temporomandibular joint (TMJ), muscles of mastication and associated structures. Epidemiological studies estimates that 40 % to 75 % of the adult population has at least one sign of TMD, such as joint noise and 33 % presented some symptom such as facial or joint pain. Botulinum toxin is a neurotoxin produced by the anaerobic bacterium Clostridium botulinum. There are two types of toxin (A and B) used in clinical practice that were approved by Food and Drug Administration in 1989 and 2000. These medications are in use to treat various diseases including muscle spasticity, dystonia, headache and myofascial pain. The mechanisms of action were suggested in the mid-1950s, this neurotoxin seems to have an action at cholinergic synapses, causing a block in the release of acetylcholine from the nerve terminals without altering the neural conduction of the electrical signals. The synthesis and storage of acetylcholine were preserved. Intramuscular injection in appropriate doses and location causes partial chemical denervation and decreased contracture, without causing complete paralysis of muscles. Due to this features, it has been considered an innovative and effective method to treat chronic pain associated with hyperactivity of masticatory muscles. The botulinum toxin type A appears to be an alternative method for pain control present in TMDs that have myogenic etiology. The authors recommend a correct diagnosis, since the indication of this type of treatment associated with an incorrect diagnosis leads to uncertain outcomes, creating false conclusions.

Humans , Temporomandibular Joint Disorders/drug therapy , Botulinum Toxins, Type A/therapeutic use , Analgesia/methods , Pain/drug therapy , Pain Measurement , Temporomandibular Joint Disorders/complications , Temporomandibular Joint Disorders/epidemiology , Chlorhexidine/therapeutic use , Analgesics/therapeutic use
Braz. dent. j ; 29(3): 296-300, May-June 2018. tab
Article in English | LILACS | ID: biblio-951548


Abstract In the search for the ideal treatment of periodontal disease various non-surgical techniques should be considered. The objective of this study was to evaluate the efficacy of full-mouth scaling (FMS) by clinical and microbiological parameters. 670 individuals were evaluated with 230 subjects meeting the selection criteria and were divided into two groups; 115 subjects treated with FMS and 115 treated with weekly sessions of scaling and root planning (SRP). The patient population had a mean age of 51.67 years, with moderate chronic periodontitis. Subjects were evaluated prior to treatment (T1) and 90 days after execution of therapy (T2), with regards to: probing depth (PD), clinical attachment level (CAL), plaque index (PI), gingival index (GI), and microbial detection for the presence of Porphyromonas gingivalis (P.g.) and Prevotella intermedia (P.i.) by culture method and confirmed by biochemical tests. Subjects treated in the FMS group also rinsed with 0.12% chlorhexidine mouthwash for seven days following treatment. The results were analyzed using statistical Student's t-test and chi-square test. No statistically significant differences were observed for PD and CAL between T1 and T2 in both groups. For GI and PI significant difference was observed between the groups. For the evaluated microbial parameters was observed reduction of P.g. and P.i., but only for P.g. with a significant reduction in both groups. The full mouth scaling technique with the methodology used in this study provided improved clinical conditions and reduction of P.g. in subjects with moderate periodontitis, optimizing the time spent in the therapeutic execution.

Resumo Na busca do tratamento ideal da doença periodontal varias são técnicas não-cirúrgicas que podem ser consideradas. O objetivo deste estudo foi avaliar a eficácia da técnica de desinfecção total de boca (FMD, na sigla em Inglês) por parâmetros clínicos e microbiológicos. Foram avaliados 670 indivíduos com 230 indivíduos atendendo aos critérios de seleção e divididos em dois grupos; 115 indivíduos tratados com FMD e 115 tratados com sessões semanais de raspagem e alisamento corono radicular (SRP, na sigla em Inglês). A população avaliada tinha idade média de 51,67 anos, com periodontite crônica moderada. Os sujeitos foram avaliados antes do tratamento (T1) e 90 dias após a execução da terapia (T2), quanto à profundidade de sondagem (PS), nível de inserção clínica (NIC), índice de placa (IP), índice gengival (IG) e detecção microbiana da presença de Porphyromonas gingivalis (P.g.) e Prevotella intermedia (P.i.) por método de cultura e confirmada por testes bioquímicos. Os indivíduos tratados no grupo FMD também realizaram bochechos com clorexidina 0,12% durante sete dias após o tratamento. Os resultados foram analisados ​​utilizando o teste estatístico t de Student e o teste de qui-quadrado. Não foram observadas diferenças estatisticamente significativas para PS e NIC entre T1 e T2 em ambos os grupos. Para IG e IP observou-se diferença significativa entre os grupos. Para os parâmetros microbianos avaliados foi observada redução de P.g. e P.i., mas apenas para P.g. com uma redução significativa em ambos os grupos. A técnica FMD com a metodologia utilizada neste estudo proporcionou condições clínicas melhoradas e redução da P.g. Em indivíduos com periodontite moderada, otimizando o tempo gasto na execução terapêutica.

Humans , Male , Female , Adult , Middle Aged , Dental Scaling/methods , Chronic Periodontitis/therapy , Periodontal Pocket/therapy , Chlorhexidine/therapeutic use , Periodontal Index , Dental Plaque Index , Longitudinal Studies , Root Planing/methods , Periodontal Attachment Loss/therapy , Porphyromonas gingivalis/isolation & purification , Prevotella intermedia/isolation & purification , Dental Plaque/microbiology , Disinfectants/therapeutic use , Chronic Periodontitis/microbiology , Mouthwashes/therapeutic use
J. oral res. (Impresa) ; 7(4): 134-140, abr. 27, 2018. ilus, tab, graf
Article in English | LILACS | ID: biblio-1120767


Objective. to evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. methodology. four-week study conducted in San Luis Potosí, Mexico, from january to march 2017. participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. subjects were randomized and divided into three groups: group A: mouthwash based on 0.05 percent cetylpyridinium chloride (CPC) (positive control); group B: mouthwash based on probiotics (experimental); group C: placebo mouthwash (negative control). no oral hygiene practices or routines were modified; subjects were followed for 4 weeks. the primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. results. of the 45 patients included, 19 (42.2 percent) were men and 26 (57.7 percent) women, mean age was 22.8±2.07. each group consisted of 15 subjects; all subjects completed the study. there was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). however, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). conclusions. the use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. there were no statistically significant differences between the study groups.

Humans , Adolescent , Adult , Middle Aged , Chlorhexidine/therapeutic use , Probiotics/therapeutic use , Dental Plaque/prevention & control , Gingivitis/prevention & control , Anti-Infective Agents, Local/therapeutic use , Mouthwashes/therapeutic use , Periodontal Index , Pilot Projects , Mexico , Mouthwashes/chemistry
J. appl. oral sci ; 26: e20170245, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-893734


Abstract Objective To determine the effectiveness of chlorhexidine 0.12% mouthwash (CHX) after tooth extraction for the prevention of alveolar osteitis (AO). Material and methods We conducted a double-blind randomised clinical trial stratified by risk factors. We enrolled a cohort of 822 patients who underwent dental extractions, and were considered to be at risk of developing AO (previous surgical site infection, traumatic extraction, and tobacco smoking). After extraction, patients were randomly allocated for CHX group or placebo group, matched by risk factors. The primary outcome was clinical diagnosis of AO: increasing postoperative pain for 4 d within and around the socket, and total or partial breakdown of the blood clot in the socket with or without bone exposure. Results Follow-up was completed by 744 participants (372 chlorhexidine and 372 placebo). We detected no significant differences between the two groups at baseline. After completed follow-up, risk factors were equally distributed between the two groups. Overall incidence of OA was 4.97%, in which 27 participants treated with placebo (7.26%) and 10 participants treated with CHX (2.69%) developed AO. CHX reduced the incidence of AO by 63% [Absolute Risk Reduction: 4.57 (95% CI 1.5-7.7), Number Needed to Treat: 21.88 (95% CI 13.0-69.3), Fisher's exact test: p=0.006]. No adverse effects were reported. Conclusion The use of chlorhexidine 0.12% mouthwash after tooth extraction is safe and effective in reducing the incidence of AO in high-risk patients.

Humans , Male , Female , Adult , Postoperative Complications/prevention & control , Tooth Extraction/adverse effects , Chlorhexidine/therapeutic use , Dry Socket/prevention & control , Mouthwashes/therapeutic use , Placebo Effect , Double-Blind Method , Reproducibility of Results , Risk Factors , Treatment Outcome , Dry Socket/etiology , Middle Aged
Belo Horizonte; s.n; 2018. 155 p. ilus, graf, tab.
Thesis in Portuguese | LILACS, BDENF | ID: biblio-912015


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)

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