scholarly journals Major considerations of dental care in COVID-19: an evidence-based on clinical studies and guidelines

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Milena Lazaro Zorzi ◽  
Leonardo Santos Lopes ◽  
Elias Naim Kassis
Keyword(s):  
Dental Care ◽  
Clinical Studies ◽  
Randomized Clinical Trials ◽  
Povidone Iodine ◽  
Evidence Based ◽  
Implant Dentistry ◽  
Antiseptic Solutions

Introduction: The COVID-19 pandemic has presented enormous challenges for dentists and patients. The risk of nosocomial transmission is a reality that requires the development of guidelines by the dental community to reduce the chances of infection by the new coronavirus. In this sense, it was necessary to implement alternative prophylactic techniques such as the adoption of oral rinses before dental care. Objective: To present the main considerations of clinical studies on dental care at COVID-19. Methods: The research was carried out from May 2021 to June 2021 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, following the Systematic Review-PRISMA rules. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results: One study showed that 0.2% chlorhexidine and 1% povidone-iodine oral solutions are effective pre-procedural mouthwashes against salivary SARS-CoV-2 in dental treatments. It was observed in another study that the effect of reducing the salivary load with mouthwash with CPC and PI was maintained after 6 hours. PVP-I nasal and oral antiseptic solutions are effective in inactivating SARS-CoV-2 at a range of concentrations after exposure times of 60 seconds. There is sufficient in vitro evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2. The effects against the new coronavirus in vivo still need more randomized clinical trials to prove its effectiveness. Conclusion: ACE2 receptors are highly expressed in the oral cavity, therefore, this could be a potential high-risk route for SARS-CoV-2 infection. The virus can be detected in saliva even before the appearance of symptoms of COVID-19. In this regard, randomized clinical studies have shown that some pre-procedure oral mouthwashes are effective against salivary SARS-CoV-2 in dental treatments. In addition, the American Academy of Implant Dentistry (AAID) reported on how COVID-19 impacts dental care through guidelines for general dentistry.

scholarly journals Interpretive Breakpoints for Fluconazole and Candida Revisited: a Blueprint for the Future of Antifungal Susceptibility Testing

2006 ◽  
Vol 19 (2) ◽  
pp. 435-447 ◽  
Author(s):  
M. A. Pfaller ◽  
D. J. Diekema ◽  
D. J. Sheehan
Keyword(s):  
Clinical Studies ◽  
Randomized Clinical Trials ◽  
Clinical Laboratory ◽  
Antifungal Susceptibility ◽  
Strong Relationship ◽  
National Committee ◽  
Disk Diffusion Testing ◽  
Invasive Infections

SUMMARY Developing interpretive breakpoints for any given organism-drug combination requires integration of the MIC distribution, pharmacokinetic and pharmacodynamic parameters, and the relationship between in vitro activity and outcome from both in vivo and clinical studies. Previously, the Subcommittee for Antifungal Testing of the Clinical and Laboratory Standards Institute (CLSI [formerly National Committee for Clinical Laboratory Standards]) proposed MIC interpretive breakpoints for fluconazole and Candida spp. These breakpoints were considered to be somewhat weak, because the clinical data supporting them came largely from mucosal infections and there were very few infections involving strains with elevated fluconazole MICs. We readdress the issue of fluconazole breakpoints for Candida by using published clinical and microbiologic data to provide further validation of the breakpoints proposed by the CLSI in 1997. We also address interpretive breakpoints for agar disk diffusion testing of fluconazole. The MIC distribution for fluconazole was determined with a collection of 13,338 clinical isolates. The overall MIC at which 90% of the isolates were inhibited was 8 μg/ml: 91% were susceptible (S) at a MIC of ≤8 μg/ml and 3% were resistant (R) (MIC ≥ 64 μg/ml). Similar results were obtained for 2,190 isolates from randomized clinical trials. Analysis of available data for 1,295 patient-episode-isolate events (692 represented mucosal infections and 603 represented invasive infections) from 12 published clinical studies demonstrated an overall success rate of 77%, including 85% for those episodes in which the fluconazole MIC was ≤8 μg/ml, 67% for those episodes in which the MIC was 16 to 32 μg/ml, and 42% for those episodes with resistant (MIC ≥ 64 μg/ml) isolates. Pharmacodynamic analysis demonstrated a strong relationship between MIC, fluconazole dose, and outcome. A dose/MIC ratio of ∼25 was supportive of the following susceptibility breakpoints for fluconazole and Candida spp.: S, MIC ≤ 8 μg/ml; susceptible-dose dependent (SDD), MIC = 16 to 32 μg/ml; R, MIC ≥ 64 μg/ml. The corresponding disk test breakpoints are as follows: S, ≥19 mm; SDD, 15 to 18 mm; R, ≤14 mm.

scholarly journals Efficacy and Safety of Pomegranate Medicinal Products for Cancer

2015 ◽  
Vol 2015 ◽  
pp. 1-15 ◽  
Author(s):  
Christian Vlachojannis ◽  
Benno F. Zimmermann ◽  
Sigrun Chrubasik-Hausmann
Keyword(s):  
Clinical Studies ◽  
Clinical Effectiveness ◽  
Published Data ◽  
Regulatory Guidance ◽  
Chemically Induced ◽  
Pubmed Search ◽  
Synthetic Drug

Preclinicalin vitroandin vivostudies demonstrate potent effects of pomegranate preparations in cancer cell lines and animal models with chemically induced cancers. We have carried out one systematic review of the effectiveness of pomegranate products in the treatment of cancer and another on their safety. The PubMed search provided 162 references for pomegranate and cancer and 122 references for pomegranate and safety/toxicity. We identified 4 clinical studies investigating 3 pomegranate products, of which one was inappropriate because of the low polyphenol content. The evidence of clinical effectiveness was poor because the quality of the studies was poor. Although there is no concern over safety with the doses used in the clinical studies, pomegranate preparations may be harmful by inducing synthetic drug metabolism through activation of liver enzymes. We have analysed various pomegranate products for their content of anthocyanins, punicalagin, and ellagic acid in order to compare them with the benchmark doses from published data. If the amount of coactive constituents is not declared, patients risk not benefiting from the putative pomegranate effects. Moreover, pomegranate end products are affected by many determinants. Their declaration should be incorporated into the regulatory guidance and controlled before pomegranate products enter the market.

scholarly journals REVIEW OF EVIDENCE BASED STUDY ON VYAGHRI HARITAKI AVALEHA WITH SPECIAL REFERENCE TO CERTAIN RESPIRATORY DISORDERS.

2021 ◽  
Vol 9 (01) ◽  
Author(s):  
ANJU SREEDHARAN
Keyword(s):  
Chronic Bronchitis ◽  
Clinical Studies ◽  
Health Sector ◽  
Immunomodulatory Activity ◽  
Evidence Based ◽  
Respiratory Disorders ◽  
Social Burden ◽  
Preventive Methods

ABSTRACT BACKGROUND Respiratory disorders are leading cause of morbidity and mortality that induces an economic and social burden worldwide. In today’s world, finding preventive methods and cure from these enormous challenges should be one of the priorities in the global health sector. Vyaghri haritaki avaleha is a potential Ayurveda polyherb formulation used for treating Kasa, Shwasa, Rajyakshma, Peenasa and its Rasayana properties ensures better quality of life of the patient. AIM AND OBJECTIVE Overview on Vyaghri haritaki avaleha To conduct a review on evidence-based study of Vyaghri haritaki avaleha in the management of symptoms of respiratory disorders. METHODS To conduct this study, Ayurveda research articles were obtained from Google Scholar. Total 6 studies were yielded, which included only Clinical and Pre-Clinical studies. RESULT Out of the 6 articles found (n=6), 1 article was an In-Vivo study and other 5 articles were Clinical studies on Vyaghri haritaki avaleha. Among the 5 Clinical studies, 1 study was found to be a comparative analysis between Vyaghri haritaki avaleha and Ashtang avaleha.1 study was found, where Anu taila Nasya was used as an adjuvant along with Vyaghri haritaki avaleha. Out of the 5 Clinical studies on Vyaghri haritaki avaleha, 3 studies were conducted on children. CONCLUSION This review on Vyaghri haritaki avaleha provides a better understanding of this formulation and showcases its effectiveness in treating all types of Kasa roga, Tamaka shwasa, Chronic bronchitis and Dusht Pratishaya. This review throws light on extensive use of Vyaghri haritaki avaleha in children for treating the symptoms of respiratory disorders. KEYWORDS Vyaghri haritaki avaleha, In Vivo, Clinical study, Respiratory disorders, Immunomodulatory activity, Tamaka Shwasa, Chronic Bronchitis.

scholarly journals Rethinking antiviral effects for COVID-19 in clinical studies: early initiation is key to successful treatment

2020 ◽  
Author(s):  
Shoya Iwanami ◽  
Keisuke Ejima ◽  
Kwang Su Kim ◽  
Koji Noshita ◽  
Yasuhisa Fujita ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Clinical Studies ◽  
Randomized Clinical Trials ◽  
Antiviral Treatment ◽  
Antiviral Drug ◽  
Antiviral Effect ◽  
Short Period ◽  
Effective Drugs

AbstractDevelopment of an effective antiviral drug for COVID-19 is a global health priority. Although several candidate drugs have been identified through in vitro and in vivo models, consistent and compelling evidence for effective drugs from clinical studies is limited. The lack of evidence could be in part due to heterogeneity of virus dynamics among patients and late initiation of treatment. We first quantified the heterogeneity of viral dynamics which could be a confounder in compassionate use programs. Second, we demonstrated that an antiviral drug is unlikely to be effective if initiated after a short period following symptom onset. For accurate evaluation of the efficacy of an antiviral drug for COVID-19, antiviral treatment should be initiated before or soon after symptom onset in randomized clinical trials.One Sentence SummaryStudy design to evaluate antiviral effect.

Animal Models and Alternatives in the Quality Control of Vaccines: Are In Vitro Methods or In Vivo Methods the Scientific Equivalent of the Emperor's New Clothes?

1995 ◽  
Vol 23 (1) ◽  
pp. 61-73
Author(s):  
Coenraad Hendriksen ◽  
Johan van der Gun
Keyword(s):  
Quality Control ◽  
Test Methods ◽  
In Vitro Test ◽  
Large Numbers ◽  
Alternative Approach ◽  
Inactivated Vaccines ◽  
Vitro Test

In the quality control of vaccine batches, the potency testing of inactivated vaccines is one of the areas requiring very large numbers of animals, which usually suffer significant distress as a result of the experimental procedures employed. This article deals with the potency testing of diphtheria and tetanus toxoids, two vaccines which are used extensively throughout the world. The relevance of the potency test prescribed by the European Pharmacopoeia monographs is questioned. The validity of the potency test as a model for the human response, the ability of the test to be standardised, and the relevance of the test in relation to the quality of the product are discussed. It is concluded that the potency test has only limited predictive value for the antitoxin responses to be expected in recipients of these toxoids. An alternative approach for estimating the potency of toxoid batches is discussed, in which a distinction is made between estimation of the immunogenic potency of the first few batches obtained from a seed lot and monitoring the consistency of the quality of subsequent batches. The use of animals is limited to the first few batches. Monitoring the consistency of the quality of subsequent batches is based on in vitro test methods. Factors which hamper the introduction and acceptance of the alternative approach are considered. Finally, proposals are made for replacement, reduction and/or refinement (the Three Rs) in the use of animals in the routine potency testing of toxoids.

scholarly journals Tyrosol-Enriched Tomatoes by Diffusion across the Fruit Peel from a Chitosan Coating: A Proposal of Functional Food

Foods ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 335
Author(s):  
Silvia Tampucci ◽  
Antonella Castagna ◽  
Daniela Monti ◽  
Clementina Manera ◽  
Giuseppe Saccomanni ◽  
...  
Keyword(s):  
Tomato Fruit ◽  
Storage Period ◽  
Food Matrix ◽  
Fruit Peel ◽  
Fresh Food ◽  
In Vitro Permeation ◽  
Active Transfer

Chitosan is receiving increasing attention from the food industry for being a biodegradable, non-toxic, antimicrobial biopolymer able to extend the shelf life of, and preserve the quality of, fresh food. However, few studies have investigated the ability of chitosan-based coatings to allow the diffusion of bioactive compounds into the food matrix to improve its nutraceutical quality. This research is aimed at testing whether a hydrophilic molecule (tyrosol) could diffuse from the chitosan-tyrosol coating and cross the tomato peel. To this end, in vitro permeation tests using excised tomato peel and an in vivo application of chitosan-tyrosol coating on tomato fruit, followed by tyrosol quantification in intact fruit, peel and flesh during a seven-day storage at room temperature, were performed. Both approaches demonstrated the ability of tyrosol to permeate across the fruit peel. Along with a decreased tyrosol content in the peel, its concentration within the flesh was increased, indicating an active transfer of tyrosol into this tissue. This finding, together with the maintenance of constant tyrosol levels during the seven-day storage period, is very promising for the use of chitosan formulations to produce functional tomato fruit.

scholarly journals Bactericidal activity of three different antiseptic ophthalmic preparations as surgical prophylaxis

2021 ◽  
Author(s):  
Daniele Tognetto ◽  
Marco R. Pastore ◽  
Gian Marco Guerin ◽  
Giuliana Decorti ◽  
Martina Franzin ◽  
...  
Keyword(s):  
Antimicrobial Activity ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Viable Cells ◽  
Polyethylene Glycol 1000 ◽  
Oil Concentration ◽  
Short Time ◽  
First Time ◽  
Antiseptic Solutions

Abstract Purpose In the era of antibiotic resistance, there is an increased interest in antiseptic solutions that might represent a reliable option for ocular surface disinfection. The objective of this study is to compare for the first time three different antiseptic ophthalmic preparations to assess their in vitro antimicrobial activity. Methods The antiseptic activity of three commercial ophthalmic solutions, IODIM (povidone-iodine 0.6% in hyaluronic acid vehicle—Medivis, Catania, Italy), OZODROP (nanoemulsion with ozonated oil—concentration not specified—FBVision, Ophthalmic Pharmaceuticals, Rome, Italy), and DROPSEPT (chlorhexidine 0.02% and vitamin E 0.5% Tocopherol Polyethylene Glycol 1000 Succinate—TPGS, Sooft Italia, Montegiorgio, Italy), was tested in vitro on six reference strains by time-killing assays. Viable cells were evaluated after 1, 15, 30 min; 2, 6, and 24 h exposure by seeding 100 µl of the suspension (or appropriate dilutions) on LB agar or Sabouraud-dextrose agar. All plates were incubated at 37 °C for 24 h and evaluated by manually counting the colonies. Results IODIM solution showed a very rapid microbicidal activity: the number of viable cells for all the tested strains was under the detection limit (less than 10 CFU/ml) already after 1 min exposure, and this result was maintained at every incubation time. The rapid antimicrobial activity of povidone-iodine was not replicated when testing the other two antiseptics. Conclusions The study reports the great efficacy in reducing bacterial load in a very short time of povidone-iodine 0.6% compared with other antiseptic preparations.

scholarly journals Current Knowledge on Functionality and Potential Therapeutic Uses of Donkey Milk

Animals ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 1382
Author(s):  
Mina Martini ◽  
Iolanda Altomonte ◽  
Domenico Tricò ◽  
Riccardo Lapenta ◽  
Federica Salari
Keyword(s):  
Animal Models ◽  
Randomized Clinical Trials ◽  
Current Knowledge ◽  
Saturated Fatty Acids ◽  
Cow Milk ◽  
Donkey Milk ◽  
Alpha Linolenic Acid ◽  
High Concentration

The increase of knowledge on the composition of donkey milk has revealed marked similarities to human milk, which led to a growing number of investigations focused on testing the potential effects of donkey milk in vitro and in vivo. This paper examines the scientific evidence regarding the beneficial effects of donkey milk on human health. Most clinical studies report a tolerability of donkey milk in 82.6–98.5% of infants with cow milk protein allergies. The average protein content of donkey milk is about 18 g/L. Caseins, which are main allergenic components of milk, are less represented compared to cow milk (56% of the total protein in donkey vs. 80% in cow milk). Donkey milk is well accepted by children due to its high concentration of lactose (about 60 g/L). Immunomodulatory properties have been reported in one study in humans and in several animal models. Donkey milk also seems to modulate the intestinal microbiota, enhance antioxidant defense mechanisms and detoxifying enzymes activities, reduce hyperglycemia and normalize dyslipidemia. Donkey milk has lower calorie and fat content compared with other milks used in human nutrition (fat ranges from 0.20% to 1.7%) and a more favourable fatty acid profile, being low in saturated fatty acids (3.02 g/L) and high in alpha-linolenic acid (about 7.25 g/100 g of fat). Until now, the beneficial properties of donkey milk have been mostly related to whey proteins, among which β-lactoglobulin is the most represented (6.06 g/L), followed by α-lactalbumin (about 2 g/L) and lysozyme (1.07 g/L). So far, the health functionality of donkey milk has been tested almost exclusively on animal models. Furthermore, in vitro studies have described inhibitory action against bacteria, viruses, and fungi. From the literature review emerges the need for new randomized clinical trials on humans to provide stronger evidence of the potential beneficial health effects of donkey milk, which could lead to new applications as an adjuvant in the treatment of cardiometabolic diseases, malnutrition, and aging.

scholarly journals In vitro characteristics and in vivo platelet quality of whole blood treated with riboflavin and UVA / UVB light and stored for 24 hours at room temperature

Transfusion ◽  
2021 ◽  
Vol 61 (S1) ◽  
Author(s):  
Turid Helen Felli Lunde ◽  
Lindsay Hartson ◽  
Shawn Lawrence Bailey ◽  
Tor Audun Hervig
Keyword(s):  
Whole Blood ◽  
Room Temperature

scholarly journals Persistence of intramyocardially transplanted murine induced pluripotent stem cell-derived cardiomyocytes from different developmental stages

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Gabriel Peinkofer ◽  
Martina Maass ◽  
Kurt Pfannkuche ◽  
Agapios Sachinidis ◽  
Stephan Baldus ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Stem Cell ◽  
Cell Adhesion ◽  
Developmental Stage ◽  
Pluripotent Stem Cell ◽  
Induced Pluripotent Stem Cell ◽  
Induced Pluripotent

Abstract Background Induced pluripotent stem cell-derived cardiomyocytes (iPSC-CM) are regarded as promising cell type for cardiac cell replacement therapy, but it is not known whether the developmental stage influences their persistence and functional integration in the host tissue, which are crucial for a long-term therapeutic benefit. To investigate this, we first tested the cell adhesion capability of murine iPSC-CM in vitro at three different time points during the differentiation process and then examined cell persistence and quality of electrical integration in the infarcted myocardium in vivo. Methods To test cell adhesion capabilities in vitro, iPSC-CM were seeded on fibronectin-coated cell culture dishes and decellularized ventricular extracellular matrix (ECM) scaffolds. After fixed periods of time, stably attached cells were quantified. For in vivo experiments, murine iPSC-CM expressing enhanced green fluorescent protein was injected into infarcted hearts of adult mice. After 6–7 days, viable ventricular tissue slices were prepared to enable action potential (AP) recordings in transplanted iPSC-CM and surrounding host cardiomyocytes. Afterwards, slices were lysed, and genomic DNA was prepared, which was then used for quantitative real-time PCR to evaluate grafted iPSC-CM count. Results The in vitro results indicated differences in cell adhesion capabilities between day 14, day 16, and day 18 iPSC-CM with day 14 iPSC-CM showing the largest number of attached cells on ECM scaffolds. After intramyocardial injection, day 14 iPSC-CM showed a significant higher cell count compared to day 16 iPSC-CM. AP measurements revealed no significant difference in the quality of electrical integration and only minor differences in AP properties between d14 and d16 iPSC-CM. Conclusion The results of the present study demonstrate that the developmental stage at the time of transplantation is crucial for the persistence of transplanted iPSC-CM. iPSC-CM at day 14 of differentiation showed the highest persistence after transplantation in vivo, which may be explained by a higher capability to adhere to the extracellular matrix.

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