Enjuagues bucales convencionales y herbales en el tratamiento de la enfermedad periodontal / Conventional and Herbal Mouthwashes in the Treatment of Periodontal Disease

Introducción: Existen datos controversiales y pocas revisiones acerca del efecto de los enjuagues herbales como complemento en la higiene bucal de pacientes con enfermedad periodontal. La reducción en costos y efectos secundarios de estos enjuagues, en comparación con los convencionales, los colocan en una posición prometedora para el cuidado de la salud. Objetivo: Comparar el efecto de los enjuagues bucales convencionales con los enjuagues herbales en la mejora de los siguientes parámetros periodontales: índice gingival, de placa, sangrado al sondaje, profundidad al sondaje y nivel de adherencia clínica en pacientes adultos con gingivitis o periodontitis. Métodos: Se realizó la revisión en las bases de datos MEDLINE/PubMed, Scopus, Web of Science, BVS y EBSCO, para identificar ensayos clínicos donde se comparen enjuagues bucales comerciales vs. herbales, publicados entre 2018 y 2022. Siguiendo las recomendaciones PRISMA, se utilizó el sistema PICO para determinar la pregunta clínica y una ecuación de búsqueda con criterios de elegibilidad. Resultados: De 485 estudios identificados inicialmente se analizaron 25 ensayos clínicos, de los cuales la mayoría se realizaron en la India (11) y en pacientes sin problemas sistémicos (23). Las muestras evaluadas fueron desde 19 hasta 318 sujetos, con edades comprendidas entre 18 y 74 años. El menor tiempo de seguimiento fue de siete días y el mayor de 180 días. Con respecto a los enjuagues evaluados, 20 ensayos usaron clorhexidina y 18 enjuagues a base de plantas herbáceas. Así mismo, seis estudios reportaron efectos adversos y tres reportaron conflictos de interés. Conclusiones: Los aceites esenciales combinados con curcumina redujeron el índice de placa en mayor medida que el enjuague de clorhexidina, que es el estándar dorado. Así mismo, la mayoría de los enjuagues herbales estudiados tuvieron un efecto similar a este último para mejorar los parámetros periodontales(AU)

Introduction: There are controversial data and few reviews about the effect of herbal rinses as an adjunct in oral hygiene in patients with periodontal disease. The reduction in costs and side effects of these rinses, in comparison with conventional rinses, place them in a promising position for health care. Objective: To compare the effect of conventional mouthwashes with herbal rinses in the improvement of the following periodontal parameters: gingival index, plaque index, bleeding on probing, probing depth and level of clinical adherence in adult patients with gingivitis or periodontitis. Methods: A review was performed in MEDLINE/PubMed, Scopus, Web of Science, BVS and EBSCO databases to identify clinical trials comparing commercial vs. herbal mouthrinses, published between 2018 and 2022. Following PRISMA recommendations, the PICO system was used to determine the clinical question and a search equation with eligibility criteria. Results: Out of 485 studies initially identified, 25 clinical trials were analyzed, of which the majority were conducted in India (11) and in patients without systemic problems (23). The samples evaluated ranged from 19 to 318 subjects, aged 18-74 years. The shortest follow-up time was seven days and the longest was 180 days. Regarding the rinses evaluated, 20 trials used chlorhexidine and 18 used herbal rinses. Also, six studies reported adverse effects and three reported conflicts of interest. Conclusions: Essential oils combined with curcumin reduced plaque index to a greater extent than the gold standard chlorhexidine rinse. Most of the herbal rinses studied had a similar effect to the latter in improving periodontal parameters(AU)

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

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

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

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

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

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

Potencial antibacteriano de un enjuague bucal a base de Azadirachta indica (neem) sobre patógenos orales

Introducción: La alta prevalencia de enfermedades orales y los efectos colaterales de los fármacos sintéticos ha impulsado el estudio de alternativas terapéuticas como las plantas medicinales que sean seguras, efectivas y económicas para la población. Objetivo: Evaluar el potencial antibacteriano de 2 enjuagues bucal a base de Azadirachta indica (neem) sobre Streptococcus mutans y Enterococcus faecalis. Métodos: Estudio experimental. Se elaboraron 2 enjuagues bucales del extracto hidroetanólico de neen con concentraciones de 25 mg/mL y 50 mg/mL. El potencial antibacteriano se evaluó por el método de difusión en disco. Los datos fueron analizados con ANOVA y Tukey en el paquete estadístico SPSS v.26. Resultados: Para Streptococcus mutans el halo del enjuague bucal con 25 mg/mL de extracto de neem fue de 25,12 ± 0,798 mm; el de 50 mg/mL formó un halo de 29,40 ± 1,197 mm; el control negativo un halo de 8,62 ± 0,132 mm y la clorhexidina 0,12 % un halo de 17,64 ± 0,160 mm. Para Enterococcus faecalis, el halo del enjuague bucal con 25 mg/mL fue de 18,23 ± 1,150 mm; el de 50 mg/mL un halo de 20,93 ± 0,487 mm; el control negativo un halo de 7,91 ± 0,417 mm y la clorhexidina 0,12 % un halo de 16,50 ± 0,505 mm. Conclusión: Los enjuagues bucales a base de neem presentan potencial antibacteriano in vitro sobre Streptococcus mutans y Enterococcus faecalis y podrían ser utilizados en un futuro en su control y el de otros patógenos orales.

Introduction: The high prevalence of oral diseases and the side effects of synthetic drugs has promoted the study of therapeutic alternatives such as medicinal plants that are safe, effective and economical for the population. Objective: To evaluate the antibacterial potential of 2 mouthwashes based on Azadirachta indica (neem) on Streptococcus mutans and Enterococcus faecalis. Methods: Experimental study. Two mouthwashes were made from the hydroethanolic extract of neen with concentrations of 25 mg/mL and 50 mg/mL. The antibacterial potential was evaluated by the disk diffusion method. The data were analyzed with ANOVA and Tukey in the statistical package SPSS v.26. Results: For Streptococcus mutans, the halo of the mouthwash with 25 mg/mL of neem extract was 25.12 ± 0.798 mm; that of 50 mg/mL formed a halo of 29.40 ± 1.197 mm; the negative control a halo of 8.62 ± 0.132 mm and chlorhexidine 0.12% a halo of 17.64 ± 0.160 mm. For Enterococcus faecalis, the halo of the mouthwash with 25 mg/mL was 18.23 ± 1,150 mm; that of 50 mg/mL a halo of 20.93 ± 0.487 mm; the negative control a halo of 7.91 ± 0.417 mm and chlorhexidine 0.12% a halo of 16.50 ± 0.505 mm. Conclusion: Neem-based mouthwashes have in vitro antibacterial potential against Streptococcus mutans and Enterococcus faecalis and could be used in the future to control them and other oral pathogens.

Efficiency of Pyroligneous Extract from Jurema Preta (Mimosa tenuiflora [Willd.] Poiret) as an Antiseptic in Cats (Felis catus) Subjected to Ovariosalpingohysterectomy.

Pyroligneous extract of Jurema preta (Mimosa tenuiflora [Willd.] Poiret) was evaluated for its efficacy as a cutaneous antiseptic in cats (Felis catus) that were subjected to ovariosalpingohysterectomy. For this purpose, 30 cats without a defined breed were sterilized and divided into two groups. The first group was the positive control, treated with 0.5% chlorhexidine-alcohol solution, and the second group was treated with 20% pyroligneous extract of M. tenuiflora. Regardless of age and sex, all animals had visible healing at similar times. A significant reduction in bacterial growth was observed in animals treated with the extract, and no cytotoxicity was observed in the feline epithelial cells. In addition, surgical wounds of cats treated with M. tenuiflora extract exhibited improved healing. On agar plates, treatment with both chlorhexidine and M. tenuiflora extract resulted in the inhibition zones for all bacterial strains isolated from surgical wounds. Therefore, M. tenuiflora extract is demonstrated to have antiseptic effects on the surgical wounds of cats undergoing ovariosalpingohysterectomy.

Does the addition of chlorhexidine to glass ionomer cements influence its antimicrobial effect and survival rate? A systematic review.

PURPOSE: To evaluate the influence of the addition of chlorhexidine on the antimicrobial effect and on the survival of restorations performed with glass ionomer cement. METHODS: Nine databases were used to search for randomized clinical trials that compared the survival rate and the antimicrobial effect of glass ionomer cement (GIC) restorations with and without the incorporation of chlorhexidine (CHX), without restrictions on year or language. Cochrane Collaboration's Risk of Bias 2 was used to assess the risk of bias. The GRADE approach was used to assess the certainty of evidence. RESULTS: From 593 studies found, seven met the inclusion criteria. The concentration of CHX varied between 0.5 and 2%. In general, the addition of CHX to GIC promoted reductions in Streptococcus mutans and Lactobacillus acidophilus burdens when compared to those without CHX. No study showed a difference in the survival of restorations between GIC with CHX and conventional GIC. Individual risk of bias varied from low to high and the certainty of evidence was classified as very low. CONCLUSIONS: Based on a very low level of certainty, the evidence suggests that the incorporation of CHX in GIC might improve the antimicrobial effects for a short time, in addition to having little influence on the survival of the restoration.

Virucidal efficacy of chlorhexidine: a systematic review.

This study aimed to systematically review the literature about the virucidal efficacy of CHX in comparison to other substances used in the oral cavity. Electronic searches were performed in four databases (PubMed, Scopus, Embase, and Web of Science). Only studies that presented the following characteristics were included: (1) verified virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1), any Influenza, or any human coronavirus (HcoV); and (2) compared the virucidal efficacy of CHX with essential oils (Listerine®), quaternary ammonium compounds, povidone-iodine, hydrogen peroxide, negative control substance, and absence of therapy. Two researchers independently selected the studies, extracted data and evaluated the risk of bias. A narrative data synthesis was used. Twenty-five studies were included, of which 21 were in vitro and four were randomized clinical trials (RCT). Studies assessed the virucidal efficacy of CHX against Herpes Simplex Type-1 (HSV-1) (10 studies), Influenza A (InfluA) (4 studies), human coronavirus (HCoV) (4 studies) and Severe Acute Respiratory Syndrome-Related Coronavirus (SARS-CoV-2) (11 studies). Most studies demonstrated that CHX has a positive virucidal efficacy against HSV-1 and InfluA strains. However, lower efficacy was shown to InfluA strain in comparison to povidone-iodine. Lower to none virucidal efficacy of CHX is expected for HCoV and SARS-CoV-2 strains for in vitro studies. Three RCT demonstrated that CHX was able to significantly reduce the viral load of SARS-CoV-2 for a short period. CHX may present an interesting virucidal efficacy against HSV-1 and InfluA viruses. CHX also presents transient efficacy against SARS-CoV-2 when used as a mouthwash.

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

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

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

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

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

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

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

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

Once upon a time, inflammation.

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

Changes in workflow to a University Pharmacy to facilitate compounding and distribution of antiseptics for use against COVID-19.

This article is a report from an experience about a work developed by Farmácia Universitária at UFRJ (FU-UFRJ) during the nCov-19 pandemic period. The aim of this work was to describe its contribution in the production of antiseptic supplies used to prevent contagion by the new coronavirus. The work routine at the pharmacy has been changed to allow the implementation of local workflow during the pandemic, and to adapt the protection rules to meet the safety measures. FU-UFRJ started to manipulate two antiseptic formulations: 70% ethyl alcohol and gel alcohol, which are included in the National Form, manufacturing around 100 L of these formulations, weekly, to donate to different health units. The experience enabled the adaptation to emergency health standards, planning and meaningful guidance to pharmacists and technicians to attend clinics at university hospitals, vaccination center and UFRJ city hall, in order to facilitate the access to adequate hand hygiene to the population.

Once upon a time, inflammation

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

Once upon a time, inflammation

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

Treatment of Recurrent Urinary Tract Infection Symptoms with Urinary Antiseptics Containing Methenamine and Methylene Blue: Analysis of Etiology and Treatment Outcomes.

PURPOSE: Urinary antiseptics including methenamine and methylene blue are used in the symptomatic treatment of urinary tract infections (UTIs). PATIENTS AND METHODS: This was a prospective, double-blind, randomized, double-dummy safety and efficacy study of 2 urinary antiseptic combinations in the symptomatic treatment of recurrent cystitis: methenamine 120mg + methylene blue 20mg (Group A) versus acriflavine 15mg + methenamine 250mg + methylene blue 20mg + Atropa belladonna L. 15mg (Group B). All subjects underwent pretreatment urine culture and antibiotic sensitivity tests prior to 3-day oral treatment with study drug, followed by 3 days of antibiotic therapy (based on urine culture) + study drug treatment. Efficacy was evaluated using the Urinary Tract Infection Symptoms Assessment Questionnaire (UTISA). The primary endpoint was the percentage of patients presenting improvement in cystitis manifestations on the UTISA domain "Urination Regularity" at Visit 2. The primary safety variable was the incidence of treatment-related adverse events. RESULTS: A total of 144 subjects were randomized per group and 272 completed the study. Primary endpoint analysis demonstrates homogeneity between treatment groups, with 69.4% and 72.2% subjects, respectively, showing improvement in the score of the urinary regularity UTISA domain after 3 days of treatment (p= 0.87). At Visit 2, incidence of treatment-related adverse events was higher in Group B (Group A: n= 11, Group B: n= 31, p= 0.0057). CONCLUSION: Both treatments were effective in reducing UTI symptoms assessed by UTISA questionnaire after 3 days of treatment. The two regimens were comparable in incidence of adverse events, but the combination of methenamine + methylene blue resulted in fewer treatment-related adverse effects.

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

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

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

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

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

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

In vitro algicidal effect of guanidine on Prototheca zopfii genotype 2 strains isolated from clinical and subclinical bovine mastitis.

Prototheca species have increasingly been reported to be opportunistic pathogens that cause mastitis in dairy herds, and it poses an emergent problem because at present, there are no effective therapies for the treatment of protothecal mastitis. This study investigated the in vitro algicidal effect of guanidine on 75 Prototheca zopfii genotype 2 strains isolated from 75 cases of clinical and subclinical bovine mastitis. All strains were susceptible to guanidine in vitro with minimal algaecide concentrations ranging from 0·001 to 0·035%. Guanidine is known to have a high microbicidal effect and is considered to be a new generation microbicidal compound. It is not toxic to human mucous membranes and conjunctivas at low concentrations and has been used as a disinfectant in swimming pools and as an antiseptic for human wounds. The algicidal action of guanidine at low concentrations indicates that it could be an alternative disinfectant or antiseptic for cleaning of the dairy environment and milking equipment, in pre- and postdipping solutions, in the chemical dry therapy of bovine teats and even in the intramammary therapy of P. zopfii infections. This is the first report of the in vitro algicidal effect of guanidine on P. zopfii strains of animal origin. SIGNIFICANCE AND IMPACT OF THE STUDY: Prototheca zopfii genotype 2 is an opportunistic pathogen of bovine mastitis. To date, no effective therapies against protothecal mastitis have been developed. The in vitro algicidal effect of guanidine on 75 P. zopfii genotype 2 strains isolated from cows revealed that all of the isolates were susceptible to the compound at low concentrations, which indicates that guanidine may be used as an antiseptic/disinfectant for dairy milking equipment, in pre- and postdipping solutions, and as a chemical dry therapy or an intramammary therapy. This study describes the in vitro algicidal effect of guanidine on P. zopfii for the first time.

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

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

Isopropyl alcohol is as efficient as chlorhexidine to prevent contamination of blood cultures.

BACKGROUND: False-positive blood cultures can lead to unnecessary risks and misuse of antibiotics; to reduce rates of false-positives, it would be useful to determine whether use of an antiseptic with a prolonged effect is required. METHODS: Clinical study of efficacy (blinded and randomized) to compare the rate of blood culture contamination when skin antisepsis was performed with 70% isopropyl alcohol or 2% chlorhexidine gluconate in 70% isopropyl alcohol in 2 hospitals. Patients aged 16 years or older with suspected bloodstream infection who were allocated in the emergency room, internal medicine ward, or intensive care unit were included. RESULTS: Five of 563 (0.9%) blood cultures from the isopropyl arm and 10 of 539 (1.9%) from the chlorhexidine arm were contaminated. No significant differences were observed among the rate of contamination (χ2=1.27; P = .3) or the relative risk of contamination (relative risk = 2.09; 95% confidence interval, 0.72-6.07; P = .2). CONCLUSIONS: The rates of blood contamination were not different when isopropyl alcohol and chlorhexidine were compared. Isopropyl alcohol could be used for skin antisepsis before blood collection.