The Safety and Antimicrobial Properties of Stabilized Hypochlorous Acid in Acetic Acid Buffer for the Treatment of Acute Wounds—a Human Pilot Study and In Vitro Data

2021 ◽  
pp. 153473462110156
Author(s):  
Ewa A. Burian ◽  
Lubna Sabah ◽  
Klaus Kirketerp-Møller ◽  
Elin Ibstedt ◽  
Magnus M. Fazli ◽  
...  
Keyword(s):  
Pilot Study ◽  
Hypochlorous Acid ◽  
Treatment Time ◽  
Donor Site ◽  
Antimicrobial Properties ◽  
Prolonged Treatment ◽  
Wound Irrigation ◽  
The Mean ◽  
And Performance

Acute wounds may require cleansing to reduce the risk of infection. Stabilized hypochlorous acid in acetic buffer (HOCl + buffer) is a novel wound irrigation solution with antimicrobial properties. We performed a first-in-man, prospective, open-label pilot study to document preliminary safety and performance in the treatment of acute wounds. The study enrolled 12 subjects scheduled for a split-skin graft transplantation, where the donor site was used as a model of an acute wound. The treatment time was 75 s, given on 6 occasions. A total of 7 adverse events were regarded as related to the treatment; all registered as pain during the procedure for 2 subjects. One subject had a wound infection at the donor site. The mean colony-forming unit (CFU) decreased by 41% after the treatment, and the mean epithelialization was 96% on both days 14 (standard deviation [SD] 8%) and 21 (SD 10%). The study provides preliminary support for the safety, well-tolerance, and efficacy of HOCl + buffer for acute wounds. The pain was frequent although resolved quickly. Excellent wound healing and satisfying antimicrobial properties were observed. A subsequent in vitro biofilm study also indicated good antimicrobial activity against Pseudomonas aeruginosa with a 96% mean reduction of CFU, when used for a treatment duration of 15 min ( P < .0001), and a 50% decrease for Staphylococcus aureus ( P = .1010). Future larger studies are needed to evaluate the safety and performance of HOCl + buffer in acute wounds, including the promising antimicrobial effect by prolonged treatment on bacterial biofilms.

Anti-biofilm activity of antimicrobial hypochlorous wound irrigation solutions compared to common wound antiseptics and bacterial resilience in an innovative in-vitro human plasma biofilm model (hpBIOM)

2020 ◽  
Author(s):  
Julian-Dario Rembe ◽  
Lioba Franziska Huelsboemer ◽  
Manuela Besser ◽  
Ewa K. Stuermer
Keyword(s):  
Human Plasma ◽  
Chronic Wounds ◽  
Treatment Time ◽  
Clinical Situation ◽  
Prolonged Treatment ◽  
Wound Irrigation ◽  
Biofilm Model ◽  
Octenidine Dihydrochloride ◽  
Challenging Environment

Abstract Background Biofilms pose a relevant factor for wound healing impairment in chronic wounds. With 78% of all chronic wounds being affected by biofilms, research in this area is of high priority, especially since data for evidence-based selection of appropriate antimicrobials and antiseptics is scarce. Therefore, the objective of this study was to evaluate the anti-biofilm efficacy of commercially available hypochlorous wound irrigation solutions compared to established antiseptics. Methods Using an innovative complex in-vitro human plasma biofilm model (hpBIOM), quantitative reduction of P. aeruginosa , S. aureus and MRSA biofilms by three hypochlorous irrigation solutions (two <0.08% and one 0.2% NaClO) were compared to 0.1% octenidine-dihydrochloride/phenoxyethanol (OCT/PE) and 0.04% polyhexanide (PHMB). Efficacy was compared to a non-challenged planktonic approach as well as with increased substance volume over the prolonged treatment course (up to 72h). Qualitative visualisation of biofilms was performed by scanning electron microscopy (SEM). Results Both tested antiseptics (OCT/PE and PHMB) induced significant biofilm reductions within 72h, whereby OCT/PE in an increased volume even managed complete eradication of P. aeruginosa and MRSA biofilms after 72h. The tested hypochlorous wound irrigation solutions however achieved no relevant penetration and eradication of biofilms, despite increased volume and exposure. Only 0.2% NaClO managed a low reduction over prolonged treatment time. Conclusion The results in the here used complex human plasma biofilm model closely mimic the clinical situation of a high challenging environment for antimicrobials to perform in. Under these conditions, the low-dosed hypochlorous wound irrigation solutions are significantly less effective than antiseptics and thus unsuitable for biofilm eradication.

scholarly journals Nitazoxanide, a Potential Drug for Eradication ofHelicobacter pylori with No Cross-Resistance to Metronidazole

1998 ◽  
Vol 42 (11) ◽  
pp. 2836-2840 ◽  
Author(s):  
Francis Mégraud ◽  
Alessandra Occhialini ◽  
Jean François Rossignol
Keyword(s):  
Pilot Study ◽  
Dna Analysis ◽  
Random Amplified Polymorphic Dna ◽  
Acquired Resistance ◽  
Anaerobic Bacteria ◽  
Antimicrobial Properties ◽  
Cross Resistance ◽  
Treatment Regimens ◽  
H Pylori

ABSTRACT Nitazoxanide, a thiazolide compound, and its desacetyl derivative, tizoxanide, have antimicrobial properties against anaerobic bacteria, as well as against helminths and protozoa. Because the treatment ofHelicobacter pylori infection may be jeopardized by metronidazole resistance, nitazoxanide and tizoxanide were tested in vitro against these bacteria. The MICs of these two compounds were determined by agar dilution and were compared to those of metronidazole. Exposure to subinhibitory concentrations of nitazoxanide was also carried out by the method of Szybalski (W. Szybalski and V. Bryson, J. Bacteriol. 64:489–499, 1952). The MICs of nitazoxanide and tizoxanide for 103 strains ranged from 0.25 to 8 μg/ml, with the MIC at which 50% of strains are inhibited (MIC50) being 1 μg/ml and the MIC90 being 4 μg/ml, and no resistant strain was detected, whereas strains resistant to metronidazole were detected. When 10 strains were successively subcultured on medium containing nitazoxanide, no significant change in the MICs of this compound was observed. A pilot study of nitazoxanide for the treatment of H. pyloriinfection was carried out with 86 patients in association with 20 mg of omeprazole. An eradication rate of 83% (95% confidence interval, 64% to 94%) was obtained in a per-protocol analysis in the group receiving 1 g of nitazoxanide orally twice daily, and a few side effects were observed. The failures could not be explained by the selection of resistant strains since the MICs of nitazoxanide were similar for six pairs of isolates (proven to be the same strain by random amplified polymorphic DNA analysis in four cases) cultured before and after the treatment failure. Nitazoxanide exhibits good antimicrobial activity against H. pylori without the problem of acquired resistance which is encountered with metronidazole and has been demonstrated to have a satisfactory effect in a dose-ranging pilot study. It is therefore a good candidate to be included in treatment regimens aimed at the eradication of H. pylori.

scholarly journals Fracture Resistance of a Bulk-Fill and a Conventional Composite and a Combination of Both for Coronal Restoration of Severely Damaged Primary Anterior Teeth

2019 ◽  
Author(s):  
Shahram Mosharrafian ◽  
Maryam Shafizadeh ◽  
Zeinab Sharifi
Keyword(s):  
Fracture Resistance ◽  
Treatment Time ◽  
Testing Machine ◽  
Anterior Teeth ◽  
Significant Difference ◽  
Group 3 ◽  
The Mean ◽  
Group 2 ◽  
One Way Anova

Objectives: This study aimed to compare the fracture resistance of a bulk-fill and a conventional composite and a combination of both for coronal restoration of severely damaged primary anterior teeth. Materials and Methods: In this in vitro experimental study, 45 primary anterior teeth were randomly divided into three groups. After root canal preparation, the canals were filled with Metapex paste such that after the application of 1 mm of light-cure liner, 3 mm of the coronal third of the canal remained empty for composite post fabrication. Filtek Z250 conventional composite was used in group 1, Sonic-Fill bulk-fill composite was used in group 2 and Sonic-Fill with one layer of Filtek Z250 as the veneering were used in group 3. Adper Single Bond 2 was used in all groups. The teeth were thermocycled, and fracture resistance was measured by a universal testing machine. The mode of fracture was categorized as repairable or irreparable. Data were analyzed using one-way ANOVA. Results: The mean fracture resistance was 307.00±74.72, 323.31±84.28 and 333.30±63.96 N in groups 1 to 3, respectively (P=0.55). The mean fracture strength was 14.53±2.98, 15.08±2.82 and 15.26±3.02 MPa in groups 1 to 3, respectively (P=0.77). The frequency of repairable mode of failure was 80% for the conventional, 73.6% for the bulk-fill and 80% for the bulk-fill plus conventional group, with no significant difference (P>0.05). Conclusions: Bulk-fill composites can be used for coronal reconstruction of severely damaged primary anterior teeth similar to conventional composites to decrease the treatment time in pediatric patients.

Mini-midline in difficult intravenous access patients in emergency department: A prospective analysis

2019 ◽  
Vol 21 (4) ◽  
pp. 449-455
Author(s):  
Emanuele Gilardi ◽  
Rosangela Giannuzzi ◽  
Kidane WoldeSellasie ◽  
Alfonso Piano ◽  
Mauro Pittiruti ◽  
...  
Keyword(s):  
Emergency Department ◽  
Emergency Room ◽  
Treatment Time ◽  
Venous Catheter ◽  
Cost Effective ◽  
Venous Access ◽  
Prolonged Treatment ◽  
Intravenous Access ◽  
Peripheral Venous Access ◽  
The Mean

Background: “Difficult intravenous access” patients represent a challenge within an emergency department as they often require many attempts to insert a peripheral short cannula in the emergency room or during the whole hospitalization. This can lead to many problems in terms of patient discomfort, increase of cost, and prolonged treatment time. Objectives: This study aimed to reduce the number of attempts needed for a short-cannula insertion or preventing insertion of a central vascular access by placing an ultrasound-guided long cannula during the emergency department visit. Material and methods: The insertion of mini-midline was monitored within an emergency room in 50 patients considered difficult intravenous access patients, who failed two attempts at peripheral venous access insertion and/or required the use of an alternative vascular device. Results: A total of 46 patients out of 50 were monitored. In 38 (82%) patients, the device was removed due to the end of the indication, and in six of them, it was replaced by a central venous catheter. Two devices were left inside even after discharge and were then removed at the end of indication. In eight (17%) patients, the device was removed due to accidental removal (4) and malfunction (4). In all the cases, the average duration of the insertion procedure was 10 min. The mean dwell time accounted to 7 and 9 days. Conclusion: The insertion of a mini-midline as part of the first emergency room visit in selected patients is a rapid, safe, and cost-effective procedure, which can provide the patient with stable venous access during the all hospitalization time.

scholarly journals The In Vivo Toxicity and Antimicrobial Properties for Electrolyzed Oxidizing (EO) Water-Based Mouthwashes

Materials ◽  
2020 ◽  
Vol 13 (19) ◽  
pp. 4299 ◽  
Author(s):  
Yi-Ling Hsieh ◽  
Jiun-Cheng Yao ◽  
Sung-Chih Hsieh ◽  
Nai-Chia Teng ◽  
You-Tai Chu ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Hypochlorous Acid ◽  
Treatment Time ◽  
Reduction Rate ◽  
Antimicrobial Properties ◽  
Antimicrobial Efficacy ◽  
Plate Count ◽  
Microbial Count ◽  
In Vivo Toxicity

The objective of this study was to verify the feasibility of electrolyzed oxidizing (EO) water as a mouthwash through the evaluation of its in vivo toxicity by embryonic zebrafish and antimicrobial efficacy against Streptococcus mutans (S. mutans). Methodology: Each 1.5–3.0 g of sodium chloride (NaCl), sodium bromide (NaBr), or calcium chloride (CaCl2) were added into an electrolyzer with 300 mL of DD water to produce electrolyzed oxidizing (EO) water. A zebrafish embryo assay was used to evaluate acute toxicity of specimens. Antimicrobial property was conducted with 100 μL microbial count of 1 × 108 cfu/mL S. mutans to blend with each 10 mL specimen of chlorhexidine (CHX) gluconate or hypochlorous acid (HOCl) for various time points. The concentration of viable microorganisms was assessed according to individually standardized inoculum by a plate-count method. Results: Among the EO water produced from NaCl, NaBr, and CaCl2, the EO water from NaCl showed a relatively low mortality rate of zebrafish embryos and was chosen for a detailed investigation. The mortality rates for the groups treated with EO water containing 0.0125% and 0.0250% HOCl were not statically different from those of a negative control, however the mortality rate was 66.7 ± 26.2% in 0.2% CHX gluconate for the same treatment time of 0.5 min. All of the HOCl or 2.0% CHX gluconate groups showed >99.9% antimicrobial effectiveness against S. mutans; while the 0.2% CHX gluconate group showed a bacterial reduction rate of 87.5% and 97.1% for treatment times of 0.5 min and 1.0 min, respectively. Conclusions: Except for the 0.2% CHX gluconate, all the HOCl specimens and 2.0% CHX gluconate revealed similar antimicrobial properties (>99.9%) against S. mutans. The EO water comprised of both 0.0125% and 0.0250% HOCl showed >99.9% antimicrobial efficacy but with little in vivo toxicity, illuminating the possibility as an alternative mouthwash for dental and oral care.

scholarly journals Effect of Galla Chinensis on Remineralization of Early Dentin Lesion

2020 ◽  
Vol 14 (04) ◽  
pp. 651-656
Author(s):  
Hend Mahmoud Abdel-Azem ◽  
Ahmed Fawzy Abo Elezz ◽  
Rehab Khalil Safy
Keyword(s):  
Treatment Time ◽  
Analysis Data ◽  
Environmental Scanning ◽  
X Ray ◽  
Parametric Data ◽  
Significant Difference ◽  
Ph Cycling ◽  
The Mean ◽  
Post Hoc

Abstract Objective This study aimed to investigate the efficacy of the Galla chinensis extract (GCE) on early dentin lesion remineralization. Materials and Methods Seventy-two dentin specimens were divided into three groups according to the treatment solution. In group S1, specimens were treated with GCE; in group S2, the specimens were treated with sodium fluoride (NaF); meanwhile, specimens of group S3 were treated with distilled water (DW). Each group was further subdivided into two subgroups according to the treatment time (1 minute and 5 minutes). An in vitro pH-cycling model for 12 days was done. Subsequently, surface microhardness (SMH) of the specimens, elemental analysis, and their micromorphological appearance were evaluated. Statistical Analysis Data were statistically analyzed. One-way analysis of variance was used to compare numerical (parametric) data between more than two separate groups followed by post hoc Tukey. Results There was no significant difference between the mean SMH of dentin between NaF and GCE groups. Regarding the time, the 5-minute treatment with NaF and DW groups recorded higher mean SMH value of dentin than the 1-minute treatment group. Meanwhile, for GCE groups, the 1-minute immersion recorded higher mean SMH value than the 5-minute immersion without any significant difference between them. The microhardness results were confirmed by environmental scanning electron microscope and energy dispersive X-ray analysis results. Conclusion GCE could be used as an effective alternative for dentin remineralization.

Antibiotic-loaded tantalum may serve as an antimicrobial delivery agent

2019 ◽  
Vol 101-B (7) ◽  
pp. 848-851 ◽  
Author(s):  
P. Sautet ◽  
S. Parratte ◽  
T. Mékidèche ◽  
M. P. Abdel ◽  
X. Flécher ◽  
...  
Keyword(s):  
Antimicrobial Properties ◽  
Revision Arthroplasty ◽  
Inhibition Zone ◽  
Zone Of Inhibition ◽  
Interobserver Reproducibility ◽  
Porous Tantalum ◽  
Inhibition Zones ◽  
The Mean ◽  
Antibiotic Release

AimsThe aims of this study were to compare the mean duration of antibiotic release and the mean zone of inhibition between vancomycin-loaded porous tantalum cylinders and antibiotic-loaded bone cement at intervals, and to evaluate potential intrinsic antimicrobial properties of tantalum in an in vitro medium environment against methicillin-sensitive Staphylococcus aureus (MSSA).Materials and MethodsTen porous tantalum cylinders and ten cylinders of cement were used. The tantalum cylinders were impregnated with vancomycin, which was also added during preparation of the cylinders of cement. The cylinders were then placed on agar plates inoculated with MSSA. The diameter of the inhibition zone was measured each day, and the cylinders were transferred to a new inoculated plate. Inhibition zones were measured with a Vernier caliper and using an automated computed evaluation, and the intra- and interobserver reproducibility were measured. The mean inhibition zones between the two groups were compared with Wilcoxon’s test.ResultsMSSA was inhibited for 12 days by the tantalum cylinders and for nine days by the cement cylinders. At day one, the mean zone of inhibition was 28.6 mm for the tantalum and 19.8 mm for the cement group (p < 0.001). At day ten, the mean zone of inhibition was 3.8 mm for the tantalum and 0 mm for the cement group (p < 0.001). The porous tantalum cylinders soaked only with phosphate buffered solution showed no zone of inhibition.ConclusionCompared with cement, tantalum could release antibiotics for longer. Further studies should assess the advantages of using antibiotic-loaded porous tantalum implants at revision arthroplasty. Cite this article: Bone Joint J 2019;101-B:848–851.

scholarly journals The Lifestyle Eating and Performance (LEAP) Program for Improving Quality of Life in Women With PCOS: A Pilot Study of Dietitian-Directed Therapy

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1123-1123
Author(s):  
Nadine Braunstein ◽  
Michal Hogan ◽  
Rafael Diaz Escamilla
Keyword(s):  
Quality Of Life ◽  
Pilot Study ◽  
Immunoglobulin E ◽  
Food Allergies ◽  
Registered Dietitians ◽  
Activation Assay ◽  
The Mean ◽  
And Performance

Abstract Objectives To investigate the effectiveness of the Lifestyle Eating and Performance (LEAP) program for reducing health-related Quality of Life (QoL) symptoms in women with Polycystic Ovary Syndrome (PCOS). Methods A retrospective chart review was conducted of PCOS clients seen by registered dietitians from a private group practice during 2010–2018. The in-vitro Leukocyte Activation Assay (LAA-MRT) was used to identify hidden non-immunoglobulin E (non-IgE) mediated food allergies and chemical sensitivities. The registered dietitians developed a patient-tailored oligoantigenic diet program for each subject. The LEAP program is an elimination diet built on the selection of less reactive food and chemicals based on the LAA-MRT results. A symptom survey was used to assess the QoL at the first visit and each follow-up visit. The severity of symptoms over the past month was recorded and quantified based on the frequency of the symptoms from a scale of 0 (low) to 4 (high) with a minimum score of 0 and a maximum of 248 points. Descriptive statistics were created and reported as means for continuous variables. Mixed model analysis of variance (ANOVA) was performed using R Studio Version 1.1.414 . The study received Institutional Review Board (IRB) approval by California State University Sacramento. Results Subjects’ (n = 42) mean age was 35.2 years, and BMI was 34.4 kg/m2. The mean symptoms score at baseline was 72.5. After a personal eating plan was implemented based on the LAA-MRT results (mean 18.1 days following the plan), scores reduced to 29.3 (P &lt; 0.001). The mean score at the second follow-up (mean 44.1 days) was 19.9 (P &lt; 0.001), and at the third (mean 60.0 days) was 14.7 (P &lt; 0.001). Conclusions Findings from this pilot study highlight that a comprehensive, tailored dietary program can effectively achieve improvements in QoL for women living with PCOS. Funding Sources There was no funding for this research.

scholarly journals The antimicrobial and cytotoxic effects of a copper-loaded zinc oxide phosphate cement

2020 ◽  
Vol 24 (11) ◽  
pp. 3899-3909
Author(s):  
Torsten Wassmann ◽  
Andrea Schubert ◽  
Felix Malinski ◽  
Martin Rosentritt ◽  
Sebastian Krohn ◽  
...  
Keyword(s):  
Zinc Oxide ◽  
Antimicrobial Properties ◽  
Marginal Gap ◽  
Cytotoxic Effects ◽  
Fixed Prosthodontics ◽  
Clinical Recommendation ◽  
The Mean ◽  
Low Cytotoxicity

Abstract Objectives Evidence about modifications of dental luting materials to minimize biological failure at the “marginal gap” between teeth and fixed prosthodontics is scarce. We compared a copper-modified (Co-ZOP) and a conventional zinc oxide phosphate cement (ZOP) in terms of antimicrobial and cytotoxic potentials in vitro and in vivo. Materials and methods Specimens of ZOP and Co-ZOP were characterized by the mean arithmetic roughness (Ra) and surface free energy (SFE). Powder components were examined using scanning electron microscopy (SEM). Energy-dispersive X-ray spectroscopy (EDX) showed elemental material compositions. In vitro microbial adhesion was shown using SEM, luminescence, and fluorescence assays. CCK-8 assays of mouse fibroblasts (L929) and human gingival fibroblasts (GF-1) were performed after 6, 24, and 48 h of specimen incubation. In vivo, ZOP and Co-ZOP specimens were applied intraorally for 12 h; biofilm accumulation was shown using SEM. Results Ra of ZOP and Co-ZOP showed no significant differences; SFE was significantly higher for Co-ZOP. EDX exhibited minor copper radiation for Co-ZOP, none for ZOP. In vitro fungal adhesion to Co-ZOP was significantly higher than to ZOP; in vitro streptococcal adhesion, cytotoxicity, and in vivo biofilm formation were not significantly different. Conclusions Co-ZOP showed low surface allocations of copper with no improved antimicrobial properties compared with conventional ZOP in vitro or in vivo. Clinical relevance Antimicrobial effects and low cytotoxicity of biomaterials are important for the clinical outcome. Based on our in vitro and in vivo results, no clinical recommendation can be given for the tested Co-ZOP.

Relation of Statistically Significant, Abnormal, and Typical WAIS-R VIQ-PIQ Discrepancies to Full Scale IQs

2000 ◽  
Vol 16 (2) ◽  
pp. 107-114 ◽  
Author(s):  
Louis M. Hsu ◽  
Judy Hayman ◽  
Judith Koch ◽  
Debbie Mandell
Keyword(s):  
Graphical Method ◽  
The United States ◽  
Full Scale ◽  
True Score ◽  
Absolute Value ◽  
Normative Population ◽  
The Us ◽  
The Mean ◽  
And Performance ◽  
Quadratic Models

Summary: In the United States' normative population for the WAIS-R, differences (Ds) between persons' verbal and performance IQs (VIQs and PIQs) tend to increase with an increase in full scale IQs (FSIQs). This suggests that norm-referenced interpretations of Ds should take FSIQs into account. Two new graphs are presented to facilitate this type of interpretation. One of these graphs estimates the mean of absolute values of D (called typical D) at each FSIQ level of the US normative population. The other graph estimates the absolute value of D that is exceeded only 5% of the time (called abnormal D) at each FSIQ level of this population. A graph for the identification of conventional “statistically significant Ds” (also called “reliable Ds”) is also presented. A reliable D is defined in the context of classical true score theory as an absolute D that is unlikely (p < .05) to be exceeded by a person whose true VIQ and PIQ are equal. As conventionally defined reliable Ds do not depend on the FSIQ. The graphs of typical and abnormal Ds are based on quadratic models of the relation of sizes of Ds to FSIQs. These models are generalizations of models described in Hsu (1996) . The new graphical method of identifying Abnormal Ds is compared to the conventional Payne-Jones method of identifying these Ds. Implications of the three juxtaposed graphs for the interpretation of VIQ-PIQ differences are discussed.

Sign in / Sign up

Export Citation Format

Share Document