Application of methylene blue for the prevention and treatment of COVID-19: A narrative review.

The newest virus from the SARS family of viruses called acute syndrome-coronavirus-2 (SARS-CoV-2), which causes COVID-19 disease, was identified in China at the end of 2019. In March 2020, after it spread to 29 additional countries, it was declared a pandemic by the World Health Organization (WHO). SARS-CoV-2 infection mainly starts through the respiratory tract and causes a wide spectrum of symptoms from asymptomatic infections to acute respiratory distress syndrome with multi-organ failure and vasoplegic shock. Among the many immunomodulatory and antiviral drugs that have been studied for the treatment of COVID-19, methylene blue (MB) may play an influential role. This article reviews the history of MB applications, the antiviral effects of MB against SARS-CoV-2, and the results of in vivo and in vitro studies of the use of MB in COVID-19. Based on studies, MB can simultaneously affect most of the host's harmful responses caused by SARS-CoV-2 infection due to its multiple properties, including anti-hypoxemia, anti-oxidant, immune system modulator, and antiviral. The use of MB is associated with a reduction in the possibility of getting infection, and mortality, and can be used as a safe, effective, cheap, and available treatment option with minimal side effects for the clinical management of COVID-19.

Effectiveness of two photosensitizer-mediated photodynamic therapy for treating moderate peri-implant infections in type-II diabetes mellitus patients: A randomized clinical trial.

PURPOSE: This study evaluated the impact of Fox Green (FG) against methylthioninium chloride (MTC)-facilitated photodynamic therapy (PDT) as an adjunctive to manual scaling (MS) on the peri­implant clinical and cytokine parameters in type-2 diabetes mellitus (DM) patients with peri­implantitis. METHODS: Patients were divided into group-A comprising 13 patients who received adjunctive FG-PDT using a diode laser (wavelength: 810 nm; irradiation power: 300 mW; irradiation time: 30 s; fluence: 56 Jcm-2), group-B comprising 12 patients who received adjunctive MTC-PDT using a diode laser (wavelength: 660 nm; irradiation power: 100 mW; irradiation time: 120 s/site; fluence: 30 Jcm-2), and group-C comprising 13 patients who received MS alone [control group]). After diagnosing the diabetics with peri­implantitis (established on eligibility criteria), a structured questionnaire was used to gather the information of the participants. Plaque (PS) and bleeding scores (BS), along with peri­implant probing scores (PPS) and peri­implant bone loss (PIBL), together with immunological variables (interleukin [IL]-6, tumor necrosis factor-alpha [TNF-α], and advanced glycation end products [AGEs]) were measured in all study group participants at baseline, 3-month, and 6-month follow-ups. RESULTS: A significant reduction was observed for PS, BS, and PPS within all tested groups at each follow-up visits compared from their baseline values (p<0.05). However, a substantial decrease in PIBL was observed in all study group patients at 6-month follow-up as compared to 3-month follow-up (p<0.05). Regarding the levels of IL-6 and TNF-α, a substantial reduction was observed in all study groups until 6-month from their baseline scores (p<0.05). However, no changes were observed in the levels of AGEs in any group at either visit (p>0.05). CONCLUSION: In DM patients with periimplantitis, adjunctive FG-PDT and MTC-PDT exhibited comparable outcomes in terms of peri­implant clinical as well as pro-inflammatory characteristics than MS alone among peri­implantitis patients with DM.

Interfacial charge transfer of Carrisa edulis fruit extract capped Co3O4 nanoparticles on the surface of MK30: An efficient photocatalytic removal of methylthioninium chloride and tetracycline organic pollutants.

The in-depth usage of organic pollutants by pharmaceutical industries constitutes a major contaminant to the bodies of water due to their solubility, great mobility, ability to get attached to water bodies for a long period of time, and low biodegradability. Due to these, it may further cause disease and change the ecosystem of aqueous and other living organisms. Accordingly, effective removal of organic contaminants from waste water is a vital step in reducing the hazards. Photocatalysis is a potential technique for removing hazardous organic pollutants from wastewater. In this work, a simple ultra-sonication assisted approach, a series of Carrisa edulis fruit extract capped Co3O4 nanoparticles decorated on Montmorillonite K30 nanosheets (Co3O4/MK30) were prepared. The inherent physicochemical appearance and optical properties of as-prepared nanomaterials were investigated using a variety of analytical techniques. TEM analysis depicted the spherical shape of the Co3O4 NPs with the size of 11.25 nm. The degradation of methylthioninium chloride as a dye and tetracycline drug pollutants has been investigated in this study using individual and simultaneous photocatalysis systems in the presence of pure Co3O4 NPs and different ratios of Co3O4/MK30 nanocomposites. Owing to the generation of OH and O2 radicals, the 20% loaded Co3O4 on MK30 had the best photocatalytic performance of methylthioninium chloride (98.12%) and tetracycline degradation (87.4%), on exposing it to visible light. This research introduces a new design for MK30-based nanomaterials and proposes its use in environmental challenges.

GO-TiO2 as a Highly Performant Photocatalyst Maximized by Proper Parameters Selection.

The synthesis and characterization of novel graphene oxide coupled to TiO2 (GO-TiO2) was carried out in order to better understand the performance of this photocatalyst, when compared to well-known TiO2 (P25) from Degussa. Thus, its physical-chemical characterization (FTIR, XRD, N2 isotherms and electrochemical measurements) describes high porosity, suitable charge and high electron mobility, which enhance pollutant degradation. In addition, the importance of the reactor set up was highlighted, testing the effect of both the irradiated area and distance between lamp and bulb solution. Under optimal conditions, the model drug methylthioninium chloride (MC) was degraded and several parameters were assessed, such as the water matrix and the catalyst reutilization, a possibility given the addition of H2O2. The results in terms of energy consumption compete with those attained for the treatment of this model pollutant, opening a path for further research.

Differences in examination results of small anastomotic fistula after radical gastrectomy with afterward treatments: A case report.

BACKGROUND: Gastrografin swallow, methylthioninium chloride test, and computed tomography (CT) are the main methods for postoperative anastomotic fistula detection. Correct selection and application of examinations and therapies are significant for the early diagnosis and treatment of small anastomotic fistulas after radical gastrectomy, which are conducive to postoperative recovery. CASE SUMMARY: A 44-year-old woman underwent radical total gastrectomy for laparoscopic gastric cancer. The patient developed a fever after surgery. The methylthioninium chloride test and early CT suggested no anastomotic fistula, but gastrografin swallow and late CT showed the opposite result. The fistula was successfully closed using an endoscopic clip. The methylthioninium chloride test, gastrografin, and CT performed on different postoperative dates for small esophagojejunostomy fistulas are different. The size of the anastomotic fistula is an important factor for the success of endoscopic treatment. CONCLUSION: The advantages and limitations of the diagnosis of different examinations of small esophagojejunostomy fistulas are noteworthy. The size of the leakage of the anastomosis is an important basis for selecting the repair method.

Towards sustainable removal of methylthioninium chloride by using adsorption-electroradical regeneration.

The current need for effective regeneration processes to be used in valorization of spent adsorbent demands the research of novel alternative techniques such as application of Advances Oxidation Processes. In this sense, the recent application of electroradical (ER) processes turned out to be very promising in terms of the drugs degradation from different environments. Thus, in this study, harnessing of a low cost natural adsorbent, Tunisian bentonite (BE), was evaluated for the removal of a model drug such as methylthioninium chloride (MC), and then its regeneration by ER processes was demonstrated. Initially, the BE was characterized and the adsorption of the MC was studied. This process followed a pseudo-first order kinetic and Langmuir isotherm fitted well to data reaching uptake values around 145-155 mg g-1. After that, BE regeneration by an ER process such as electro-Fenton process was ascertained. Due to the high buffering capacity of the BE, the addition of citric acid (1 mM) was necessary in order to assure the acidic medium to favor the oxidation reaction. By operating under optimized experimental conditions (current intensity 300 mA, pH 3, Fe2+ (1 mM) and citric acid (1 mM)) near complete adsorbent regeneration was achieved after 300 min of treatment and the pseudo-first-order model fitted well the degradation data. Furthermore, the adsorbent was efficiently used in successive cycles of adsorption-regeneration without operational problems that proved the efficiency of this technology. From the obtained results, a side-by-side configuration was designed and simulated, confirming the viability of the design at large scale.

Determination of Content and Related Substances of Methylthioninium Chloride Injection by HPLC / 中国药师

Objective:To establish an HPLC method for the determination of methylthioninium chloride injection and its related substances. Methods:Octadecylsilane bonded silica was used as the filler. A Waters Symmetry C18 column (150 mm × 4. 6 mm, 5μm) was used with the mobile phase of 0. 3% phosphoric acid solution-acetonitrile (70∶ 30). The detection wavelength was 246 nm and the column temperature was 30℃. The flow rate was 1. 0 ml·min-1 and the injection volume was 10μl. Results:The separation degree of methylthioninium chloride peak and impurity peaks was good. Methylthioninium chloride within the range of 2. 0-60. 0 μg· ml-1showed a good linear relationship (r=0. 9998). Impurity A within the range of 0. 2-3. 2 μg·ml-1 showed a good linear relation-ship (r=0. 999 6). The average recovery of methylthioninium chloride was 99. 75% and RSD was 0. 86% (n=9). Conclusion:The method is simple, accurate and specific with high precision. It can be used to determine the content of methylthioninium chloride injec-tion and its related substances.

Staining with methylthioninium chloride for the diagnosis of fungal keratitis.

The aim of this study was to investigate the potential efficacy of staining with methylthioninium chloride (MC) for the diagnosis of fungal keratitis. A total of 70 cases of fungal keratitis were included in the study from January 2009 to December 2010. The corneal scraping specimens of the patients were collected and stained with MC or a 10% potassium hydroxide (KOH)-based smear prior to microscopic examination. The staining results were confirmed with fungal culture and strain identification, which are recognized as 'gold standards' for the diagnosis of fungal keratitis. Among the 70 cases of fungal keratitis, 58 cases were positive and the positive rate was 82.86%. MC staining showed a positive rate of 62.86%, with higher levels of sensitivity (70.69%) and specificity (34.61%) compared with staining with the 10% KOH-based smear. The KOH-based smear showed a positive rate of 44.29% (P<0.05), a level of sensitivity of 44.83% (P<0.05) and a specificity of 17.95% (P<0.05). In addition, the MC staining showed false positive and negative rates of 25.00 and 29.31%, respectively, an accuracy index of 5.30% and positive and negative predictive values of 93.18 and 34.61%, respectively. The results indicate that MC staining is a fast and effective method for the early diagnosis of fungal keratitis.

Personalized medicine in Alzheimer's disease and depression.

Latest research in the mental health field brings new hope to patients and promises to revolutionize the field of psychiatry. Personalized pharmacogenetic tests that aid in diagnosis and treatment choice are now becoming available for clinical practice. Amyloid beta peptide biomarkers in the cerebrospinal fluid of patients with Alzheimer's disease are now available. For the first time, radiologists are able to visualize amyloid plaques specific to Alzheimer's disease in live patients using Positron Emission Tomography-based tests approved by the FDA. A novel blood-based assay has been developed to aid in the diagnosis of depression based on activation of the HPA axis, metabolic, inflammatory and neurochemical pathways. Serotonin reuptake inhibitors have shown increased remission rates in specific ethnic subgroups and Cytochrome P450 gene polymorphisms can predict antidepressant tolerability. The latest research will help to eradicate "trial and error" prescription, ushering in the most personalized medicine to date. Like all major medical breakthroughs, integration of new algorithms and technologies requires sound science and time. But for many mentally ill patients, diagnosis and effective therapy cannot happen fast enough. This review will describe the newest diagnostic tests, treatments and clinical studies for the diagnosis and treatment of Alzheimer's disease and unipolar, major depressive disorder.

Recurrent urinary tract infections: evaluation of the prophylactic efficacy of urinary antiseptics methenamine and methylthioninium chloride / Infecções do trato urinário recorrentes: avaliação da eficácia profilática dos anti-sépticos urinários metenamina e cloreto de metiltionínio

Introduction: Urinary tract infection (UTI) is a very common condition in clinical practice, affecting an estimated 50% of all adult women during a lifetime. The most common causative agent is E. coli UTI may also be caused by S. saprophyticus, Enterobacteria (Klebsiella sp and Serratia sp.), Enterococcus sp., and P. aeruginosa. Recurrent UTIs occur at least twice per semester or three times a year. Prophylactic measures to prevent recurrent UTIs include changes in contraception methods, cranberry products, increased fluid intake, urination after intercourse, vaginal estrogen therapy for post-menopausal women, antibiotics, and urinary tract antiseptic agents. Objectives: To evaluate the use of a combination of methenamine and methylthioninium chloride in the prophylaxis of recurrent uncomplicated lower UTIs, with respect to: · Signs and symptoms of UTI· Etiologic agent(s)· Recurrence rates· Need for antibiotic therapy in case of recurrence · Incidence of adverse events associated with the treatment, including any reported alterations of laboratory testsMaterials & methods: A descriptive, analytic, restrospective study was performed at Hospital Universitário Constantino Otaviano - UNIFESO. Medical charts from patients presenting recurrent uncomplicated lower UTI attended from 2001-present were analyzed, including the following information: Demographic data (age, gender, weight, ethnicity, living conditions) medical history/ signs and symptoms of UTI identification of treatment and dosing regimens treatment duration recurrence rates and need for antibiotic therapy in case of recurrence other medications prescribed and records of adverse events. Results: E. coli was identified as etiologic agent in 80% of the patients. Following antibiotic therapy, all patients received prophylactic treatment with the combination of methenamine and methylthioninium chloride. Treatment duration ranged from three to six months. Adverse events were observed in 13/60 patients...

Introdução: A infecção do trato urinário é bastante comum na prática clínica, afetando aproximadamente 50% de todas as mulheres adultas em algum momento da vida. O agente etiológico mais comum é a E. coli. A ITU pode também ser causada por S. saprophyticus, Enterobactérias (Klebsiella sp. e Serratia sp.), Enterococcus sp. e P. aeruginosa. ITUs recorrentes ocorrem ao menos duas vezes por semestre ou três vezes ao ano. Medidas profiláticas para prevenir a recorrência incluem alterações nos métodos contraceptivos, produtos de oxicoco, aumento da ingestão de fluidos, micção após a relação sexual, e terapia vaginal de estrogênio para mulheres em pós-menopausa, bem como antibióticos e anti-sépticos urinários. Objetivos: Avaliar o uso da combinação de de metentamina e cloreto de metiltionínio na profilaxia de ITUs recorrentes não-complicados, com respeito à: · Sinais e sintomas de ITU · Agente etiológico · Número de recorrências · Necessidade de terapia antibiótica em caso de recorrência · Incidência de efeitos adversos do tratamento, inclusive quaisquer alterações de exames laboratoriais. Materiais e métodos: Foi realizado um estudo descritivo, analítico, retrospectivo no Hospital Universitário Constantino Otaviano – UNIFESO. Prontuários médicos disponíveis de pacientes apresentando ITU recorrente não complicada, atendidos de 2001-presente foram analisados, incluindo-se as seguintes informações: dados demográficos (idade, sexo, peso, etnia, condições habitacionais) histórico médico/ sinais e sintomas de ITU identificação do tratamento e regime de tratamento recorrência necessidade de tratamento antibiótico no caso de recorrência outros medicamentos prescritos e registro de efeitos adversos. Resultados: E. coli foi identificado como agente etiológico em 80% dos pacientes. Após terapia antibiótica, todos os pacientes receberam tratamento profilático com a combinação de metenamina e cloreto de metiltionínio. A duração do tratamento variou entre três a seis meses...

Study on Quantitative Detection of Bacterial Endotoxins in Methylthioninium Chloride Injection / 中国药房

OBJECTIVE:To establish a method for detecting bacterial endotoxins in methylthioninium chloride injection (MCI) quantitatively. METHODS: Kinetic turbidimetric limulus test was applied to detect bacterial endotoxins in MCI quantitatively, and compared with gel-clot method. RESULTS: MCI was un-interfered with the test for bacterial endotoxins at the concentration of 0.125 mg?mL-1; the content of bacterial endotoxins in all samples tested (10 mg?mL-1) were not more than 0.25 EU?mg -1, which were in accordance with the result of gel-clot method. CONCLUSIONS: Kinetic turbidimetric limulus test provides a new way to detect bacterial endotoxins in MCI quantitatively.