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[PMID]:29267501
[Au] Autor:Peng HM; Wang LC; Zhai JL; Weng XS; Feng B; Wang W
[Ad] Endereço:Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
[Ti] Título:Effectiveness of preoperative decolonization with nasal povidone iodine in Chinese patients undergoing elective orthopedic surgery: a prospective cross-sectional study.
[So] Source:Braz J Med Biol Res;51(2):e6736, 2017 Dec 18.
[Is] ISSN:1414-431X
[Cp] País de publicação:Brazil
[La] Idioma:eng
[Ab] Resumo:Staphylococcus aureus colonization in the nares of patients undergoing elective orthopedic surgery increases the potential risk of surgical site infections. Methicillin-resistant S. aureus (MRSA) has gained recognition as a pathogen that is no longer only just a hospital-acquired pathogen. Patients positive for MRSA are associated with higher rates of morbidity and mortality following infection. MRSA is commonly found in the nares, and methicillin-sensitive S. aureus (MSSA) is even more prevalent. Recently, studies have determined that screening for this pathogen prior to surgery and diminishing staphylococcal infections at the surgical site will dramatically reduce surgical site infections. A nasal mupirocin treatment is shown to significantly reduce the colonization of the pathogen. However, this treatment is expensive and is currently not available in China. Thus, in this study, we first sought to determine the prevalence of MSSA/MSRA in patients undergoing elective orthopedic surgery in northern China, and then, we treated the positive patients with a nasal povidone-iodine swab. Here, we demonstrate a successful reduction in the colonization of S. aureus. We propose that this treatment could serve as a cost-effective means of eradicating this pathogen in patients undergoing elective orthopedic surgery, which might reduce the rate of surgical site infections.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/uso terapêutico
Procedimentos Cirúrgicos Eletivos
Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos
Cavidade Nasal/microbiologia
Procedimentos Ortopédicos
Povidona-Iodo/uso terapêutico
[Mh] Termos MeSH secundário: Administração Intranasal
Adulto
Anti-Infecciosos Locais/economia
Antibioticoprofilaxia/economia
Antibioticoprofilaxia/métodos
China
Estudos Transversais
Procedimentos Cirúrgicos Eletivos/economia
Feminino
Seres Humanos
Masculino
Staphylococcus aureus Resistente à Meticilina/crescimento & desenvolvimento
Meia-Idade
Cavidade Nasal/efeitos dos fármacos
Procedimentos Ortopédicos/economia
Complicações Pós-Operatórias/prevenção & controle
Povidona-Iodo/economia
Estudos Prospectivos
Reprodutibilidade dos Testes
Infecções Estafilocócicas/prevenção & controle
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180308
[Lr] Data última revisão:
180308
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171222
[St] Status:MEDLINE


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[PMID]:29310372
[Au] Autor:Kim CS; Kim SS; Bae EH; Ma SK; Kim SW
[Ad] Endereço:Department of Internal Medicine.
[Ti] Título:Acute kidney injury due to povidone-iodine ingestion: A case report.
[So] Source:Medicine (Baltimore);96(48):e8879, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Povidone-iodine is a broad-spectrum antiseptic applied topically to treat wounds and prevent their infection. There have been several case reports of acute kidney injury (AKI) in burn patients after povidone-iodine irrigation and in patients receiving the substance as a sclerotherapy agent for management of lymphocele after renal transplantation. However, biopsy-confirmed AKI after ingestion of povidone-iodine has not previously been described. PATIENT CONCERNS: A 47-year-old man who had apparently ingested povidone-iodine solution and presented with nausea, vomiting, and reduced urine output. Laboratory data revealed blood urea nitrogen of 124 mg/dL, serum creatinine of 6.3 mg/dL, impaired liver function, and leukocytosis. Urine iodine/creatinine ratio was markedly elevated. DIAGNOSES: Acute tubular necrosis and interstitial nephritis secondary to povidone-iodine ingestion. INTERVENTIONS: The patient was admitted to the intensive care unit and underwent continuous venovenous hemodiafiltration. Kidney biopsy showed acute tubular necrosis and interstitial nephritis. Unstained sections showed tan objects in the tubular lumina that were suspected to be povidone-iodine casts. Corticosteroid therapy (1 mg/kg/day) was started after kidney biopsy. OUTCOMES: Renal function recovered after hemodialysis and corticosteroid medication, but not completely. LESSONS: We have reported the first case of biopsy-confirmed AKI accompanied by increased urine iodine concentration following povidone-iodine ingestion.
[Mh] Termos MeSH primário: Lesão Renal Aguda/induzido quimicamente
Anti-Infecciosos Locais/envenenamento
Povidona-Iodo/envenenamento
[Mh] Termos MeSH secundário: Lesão Renal Aguda/terapia
Corticosteroides/uso terapêutico
Biópsia
Seres Humanos
Testes de Função Renal
Masculino
Meia-Idade
Diálise Renal
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Adrenal Cortex Hormones); 0 (Anti-Infective Agents, Local); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008879


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[PMID]:29261737
[Au] Autor:Barroso LF; Cazella SP; Nepomuceno AB; Toscano L; Castilho LÂS; Furlan EMR; Messias A; Scott IU; Jorge R
[Ad] Endereço:Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo-USP, Ribeirão Preto, São Paulo, Brazil.
[Ti] Título:Comparative efficacy of two different topical povidone-iodine 5% regimens in reducing conjunctival bacterial flora: A randomized parallel double-masked clinical trial.
[So] Source:PLoS One;12(12):e0189206, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The increasing prevalence of multi-resistant bacteria is a major public health concern. Infections acquired during ophthalmic surgery are devastating. The purpose of the current study is to compare the proportion of eyes with negative bacterial cultures on all tested media after 1 versus 3 sequential drops of povidone-iodine (PI) 5% into the inferior conjunctival fornix. METHODS: Patients were randomly assigned to receive 1 (PI group) drop (at time 28 minutes) or 3 (PI plus group) sequential drops (at time 0, 20 minutes and 28 minutes) of PI 5% into the inferior conjunctival sac of one randomly selected eye. A swab culture was obtained from the inferior conjunctival fornix 5 minutes before and 30 minutes after time 0. Central corneal thickness (CCT) was measured shortly before time 0 and shortly after time 30. Conjunctival swabs were incubated aerobically in enriched Thioglycolate liquid medium (meat broth) and in three solid culture media (chocolate agar, trypticase soy agar with 5% sheep blood, and Sabouraud agar). RESULTS: There was no significant difference in the proportion of negative cultures after intervention between groups (p = 0.1638). Also in the PI group (n = 59), the proportion of eyes with negative cultures after PI (79.7%) did not differ significantly from baseline (76.3%; p = 0.7539). However in the PI plus group (n = 61), the proportion of eyes with all negative cultures after PI (85.3%) was significantly higher than before PI (70.5%) (p = 0.0177). There was no significant difference in mean CCT before and after the intervention in both groups. CONCLUSION: Instillation of 3 sequential drops of PI was associated with a significant increase in the proportion of eyes with all negative cultures, while instillation of a single drop of PI was not associated with a significant increase in the proportion of negative cultures. Further study is warranted to determine whether the difference between the PI administration regimens is also associated with differences in the rates of postoperative ocular infections.
[Mh] Termos MeSH primário: Bactérias/efeitos dos fármacos
Túnica Conjuntiva/microbiologia
Povidona-Iodo/administração & dosagem
Povidona-Iodo/farmacologia
[Mh] Termos MeSH secundário: Administração Tópica
Paquimetria Corneana
Demografia
Método Duplo-Cego
Farmacorresistência Bacteriana/efeitos dos fármacos
Feminino
Seres Humanos
Modelos Lineares
Masculino
Meia-Idade
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171221
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0189206


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[PMID]:28963158
[Au] Autor:Patrick S; McDowell A; Lee A; Frau A; Martin U; Gardner E; McLorinan G; Eames N
[Ad] Endereço:Centre for Experimental Medicine, School of Medicine Dentistry and Biomedical Sciences, Queen's University of Belfast, 97 Lisburn Road, Belfast, BT9 7BL, UK.
[Ti] Título:Antisepsis of the skin before spinal surgery with povidone iodine-alcohol followed by chlorhexidine gluconate-alcohol povidone iodine-alcohol applied twice for the prevention of contamination of the wound by bacteria: a randomised controlled trial.
[So] Source:Bone Joint J;99-B(10):1354-1365, 2017 Oct.
[Is] ISSN:2049-4408
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: The aim of this study was to determine whether the sequential application of povidone iodine-alcohol (PVI) followed by chlorhexidine gluconate-alcohol (CHG) would reduce surgical wound contamination to a greater extent than PVI applied twice in patients undergoing spinal surgery. PATIENTS AND METHODS: A single-centre, interventional, two arm, parallel group randomised controlled trial was undertaken, involving 407 patients who underwent elective spinal surgery. For 203 patients, the skin was disinfected before surgery using PVI (10% [w/w (1% w/w available iodine)] in 95% industrial denatured alcohol, povidone iodine; Videne Alcoholic Tincture) twice, and for 204 patients using PVI once followed by CHG (2% [w/v] chlorhexidine gluconate in 70% [v/v] isopropyl alcohol; Chloraprep with tint). The primary outcome measure was contamination of the wound determined by aerobic and anaerobic bacterial growth from samples taken after disinfection. RESULTS: The detection of viable bacteria in any one of the samples taken after disinfection (culture-positive) was significantly lower in the group treated with both PVI and CHG than in the group treated with PVI alone (59 (29.1%) 85 (41.7%), p = 0.009; odds ratio 0.574; 95% confidence interval, 0.380 to 0.866). CONCLUSIONS: Antisepsis of the skin with the sequential application of PVI and CHG more effectively reduces the contamination of a surgical wound than PVI alone. Cite this article: 2017;99-B:1354-65.
[Mh] Termos MeSH primário: Antissepsia/métodos
Clorexidina/análogos & derivados
Etanol/administração & dosagem
Procedimentos Neurocirúrgicos
Povidona-Iodo/administração & dosagem
Cuidados Pré-Operatórios/métodos
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Administração Tópica
Anti-Infecciosos Locais/administração & dosagem
Clorexidina/administração & dosagem
Esquema de Medicação
Combinação de Medicamentos
Feminino
Seres Humanos
Masculino
Doenças da Coluna Vertebral/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 0 (Drug Combinations); 3K9958V90M (Ethanol); 85H0HZU99M (Povidone-Iodine); MOR84MUD8E (chlorhexidine gluconate); R4KO0DY52L (Chlorhexidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171001
[St] Status:MEDLINE
[do] DOI:10.1302/0301-620X.99B10.BJJ-2017-0291.R1


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[PMID]:28796683
[Au] Autor:Caissutti C; Saccone G; Zullo F; Quist-Nelson J; Felder L; Ciardulli A; Berghella V
[Ad] Endereço:Department of Experimental Clinical and Medical Science, DISM, Clinic of Obstetrics and Gynecology, University of Udine, Udine, and the Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, Naples, Italy; the Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, Pennsylvania; and the Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, Rome, Italy.
[Ti] Título:Vaginal Cleansing Before Cesarean Delivery: A Systematic Review and Meta-analysis.
[So] Source:Obstet Gynecol;130(3):527-538, 2017 Sep.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To assess the efficacy of vaginal cleansing before cesarean delivery in reducing postoperative endometritis. DATA SOURCES: MEDLINE, Ovid, EMBASE, Scopus, Clinicaltrials.gov, and Cochrane Library were searched from their inception to January 2017. METHODS OF STUDY SELECTION: Selection criteria included all randomized controlled trials comparing vaginal cleansing (ie, intervention group) with a control group (ie, either placebo or no intervention) in women undergoing cesarean delivery. Any method of vaginal cleansing with any type of antiseptic solution was included. The primary outcome was the incidence of endometritis. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of relative risk (RR) with 95% CI. TABULATION, INTEGRATION, AND RESULTS: Sixteen trials (4,837 women) on vaginal cleansing immediately before cesarean delivery were identified as relevant and included in the review. In most of the included studies, 10% povidone-iodine was used as an intervention. The most common way to perform the vaginal cleansing was the use of a sponge stick for approximately 30 seconds. Women who received vaginal cleansing before cesarean delivery had a significantly lower incidence of endometritis (4.5% compared with 8.8%; RR 0.52, 95% CI 0.37-0.72; 15 studies, 4,726 participants) and of postoperative fever (9.4% compared with 14.9%; RR 0.65, 95% CI 0.50-0.86; 11 studies, 4,098 participants) compared with the control group. In the planned subgroup analyses, the reduction in the incidence of endometritis with vaginal cleansing was limited to women in labor before cesarean delivery (8.1% compared with 13.8%; RR 0.52, 95% CI 0.28-0.97; four studies, 440 participants) or those with ruptured membranes (4.3% compared with 20.1%; RR 0.23, 95% CI 0.10-0.52; three studies, 272 participants). CONCLUSION: Vaginal cleansing immediately before cesarean delivery in women in labor and in women with ruptured membranes reduces the risk of postoperative endometritis. Because it is generally inexpensive and a simple intervention, we recommend preoperative vaginal preparation before cesarean delivery in these women with sponge stick preparation of povidone-iodine 10% for at least 30 seconds. More data are needed to assess whether this intervention may be also useful for cesarean deliveries performed in women not in labor and for those without ruptured membranes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO International prospective register of systematic reviews, https://www.crd.york.ac.uk/PROSPERO/, CRD42017054843.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/administração & dosagem
Cesárea
Povidona-Iodo/administração & dosagem
Infecção da Ferida Cirúrgica/prevenção & controle
Vagina
[Mh] Termos MeSH secundário: Administração Intravaginal
Feminino
Seres Humanos
Gravidez
Cuidados Pré-Operatórios
Ensaios Clínicos Controlados Aleatórios como Assunto
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170811
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002167


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[PMID]:28772013
[Au] Autor:Goudarzi M; Yaghooti AA; Marashi S
[Ad] Endereço:Department of Anesthesiology and Critical Care, Tehran University of Medical Sciences, Tehran, Iran.
[Ti] Título:Comment to "Intraoperative apnea in children after buffered 5% povidone-iodine site sterilization for strabismus surgery".
[So] Source:Paediatr Anaesth;27(9):975, 2017 09.
[Is] ISSN:1460-9592
[Cp] País de publicação:France
[La] Idioma:eng
[Mh] Termos MeSH primário: Apneia
Povidona-Iodo
[Mh] Termos MeSH secundário: Anti-Infecciosos Locais
Criança
Seres Humanos
Esterilização
Estrabismo
[Pt] Tipo de publicação:LETTER; COMMENT
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170804
[St] Status:MEDLINE
[do] DOI:10.1111/pan.13192


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[PMID]:28700086
[Au] Autor:Norman G; Christie J; Liu Z; Westby MJ; Jefferies JM; Hudson T; Edwards J; Mohapatra DP; Hassan IA; Dumville JC
[Ad] Endereço:Division of Nursing, Midwifery & Social Work, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester Academic Health Science Centre, Jean McFarlane Building, Oxford Road, Manchester, UK, M13 9PL.
[Ti] Título:Antiseptics for burns.
[So] Source:Cochrane Database Syst Rev;7:CD011821, 2017 07 12.
[Is] ISSN:1469-493X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Burn wounds cause high levels of morbidity and mortality worldwide. People with burns are particularly vulnerable to infections; over 75% of all burn deaths (after initial resuscitation) result from infection. Antiseptics are topical agents that act to prevent growth of micro-organisms. A wide range are used with the intention of preventing infection and promoting healing of burn wounds. OBJECTIVES: To assess the effects and safety of antiseptics for the treatment of burns in any care setting. SEARCH METHODS: In September 2016 we searched the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), Ovid MEDLINE, Ovid MEDLINE (In-Process & Other Non-Indexed Citations), Ovid Embase, and EBSCO CINAHL. We also searched three clinical trials registries and references of included studies and relevant systematic reviews. There were no restrictions based on language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that enrolled people with any burn wound and assessed the use of a topical treatment with antiseptic properties. DATA COLLECTION AND ANALYSIS: Two review authors independently performed study selection, risk of bias assessment and data extraction. MAIN RESULTS: We included 56 RCTs with 5807 randomised participants. Almost all trials had poorly reported methodology, meaning that it is unclear whether they were at high risk of bias. In many cases the primary review outcomes, wound healing and infection, were not reported, or were reported incompletely.Most trials enrolled people with recent burns, described as second-degree and less than 40% of total body surface area; most participants were adults. Antiseptic agents assessed were: silver-based, honey, Aloe Vera, iodine-based, chlorhexidine or polyhexanide (biguanides), sodium hypochlorite, merbromin, ethacridine lactate, cerium nitrate and Arnebia euchroma. Most studies compared antiseptic with a topical antibiotic, primarily silver sulfadiazine (SSD); others compared antiseptic with a non-antibacterial treatment or another antiseptic. Most evidence was assessed as low or very low certainty, often because of imprecision resulting from few participants, low event rates, or both, often in single studies. Antiseptics versus topical antibioticsCompared with the topical antibiotic, SSD, there is low certainty evidence that, on average, there is no clear difference in the hazard of healing (chance of healing over time), between silver-based antiseptics and SSD (HR 1.25, 95% CI 0.94 to 1.67; I = 0%; 3 studies; 259 participants); silver-based antiseptics may, on average, increase the number of healing events over 21 or 28 days' follow-up (RR 1.17 95% CI 1.00 to 1.37; I = 45%; 5 studies; 408 participants) and may, on average, reduce mean time to healing (difference in means -3.33 days; 95% CI -4.96 to -1.70; I = 87%; 10 studies; 979 participants).There is moderate certainty evidence that, on average, burns treated with honey are probably more likely to heal over time compared with topical antibiotics (HR 2.45, 95% CI 1.71 to 3.52; I = 66%; 5 studies; 140 participants).There is low certainty evidence from single trials that sodium hypochlorite may, on average, slightly reduce mean time to healing compared with SSD (difference in means -2.10 days, 95% CI -3.87 to -0.33, 10 participants (20 burns)) as may merbromin compared with zinc sulfadiazine (difference in means -3.48 days, 95% CI -6.85 to -0.11, 50 relevant participants). Other comparisons with low or very low certainty evidence did not find clear differences between groups.Most comparisons did not report data on infection. Based on the available data we cannot be certain if antiseptic treatments increase or reduce the risk of infection compared with topical antibiotics (very low certainty evidence). Antiseptics versus alternative antisepticsThere may be some reduction in mean time to healing for wounds treated with povidone iodine compared with chlorhexidine (MD -2.21 days, 95% CI 0.34 to 4.08). Other evidence showed no clear differences and is of low or very low certainty. Antiseptics versus non-antibacterial comparatorsWe found high certainty evidence that treating burns with honey, on average, reduced mean times to healing in comparison with non-antibacterial treatments (difference in means -5.3 days, 95% CI -6.30 to -4.34; I = 71%; 4 studies; 1156 participants) but this comparison included some unconventional treatments such as amniotic membrane and potato peel. There is moderate certainty evidence that honey probably also increases the likelihood of wounds healing over time compared to unconventional anti-bacterial treatments (HR 2.86, 95% C 1.60 to 5.11; I = 50%; 2 studies; 154 participants).There is moderate certainty evidence that, on average, burns treated with nanocrystalline silver dressings probably have a slightly shorter mean time to healing than those treated with Vaseline gauze (difference in means -3.49 days, 95% CI -4.46 to -2.52; I = 0%; 2 studies, 204 participants), but low certainty evidence that there may be little or no difference in numbers of healing events at 14 days between burns treated with silver xenograft or paraffin gauze (RR 1.13, 95% CI 0.59 to 2.16 1 study; 32 participants). Other comparisons represented low or very low certainty evidence.It is uncertain whether infection rates in burns treated with either silver-based antiseptics or honey differ compared with non-antimicrobial treatments (very low certainty evidence). There is probably no difference in infection rates between an iodine-based treatment compared with moist exposed burn ointment (moderate certainty evidence). It is also uncertain whether infection rates differ for SSD plus cerium nitrate, compared with SSD alone (low certainty evidence).Mortality was low where reported. Most comparisons provided low certainty evidence that there may be little or no difference between many treatments. There may be fewer deaths in groups treated with cerium nitrate plus SSD compared with SSD alone (RR 0.22, 95% CI 0.05 to 0.99; I = 0%, 2 studies, 214 participants) (low certainty evidence). AUTHORS' CONCLUSIONS: It was often uncertain whether antiseptics were associated with any difference in healing, infections, or other outcomes. Where there is moderate or high certainty evidence, decision makers need to consider the applicability of the evidence from the comparison to their patients. Reporting was poor, to the extent that we are not confident that most trials are free from risk of bias.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/uso terapêutico
Apiterapia/métodos
Infecções Bacterianas/terapia
Queimaduras/complicações
Queimaduras/terapia
Cicatrização
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/uso terapêutico
Anti-Infecciosos Locais/efeitos adversos
Infecções Bacterianas/etiologia
Bandagens
Clorexidina/uso terapêutico
Desinfetantes/uso terapêutico
Seres Humanos
Merbromina/uso terapêutico
Preparações de Plantas/uso terapêutico
Povidona-Iodo/uso terapêutico
Ensaios Clínicos Controlados Aleatórios como Assunto
Sulfadiazina de Prata/uso terapêutico
Hipoclorito de Sódio/uso terapêutico
Sulfadiazina/uso terapêutico
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; RESEARCH SUPPORT, NON-U.S. GOV'T; REVIEW
[Nm] Nome de substância:
0 (Aloe vera gel); 0 (Anti-Bacterial Agents); 0 (Anti-Infective Agents, Local); 0 (Disinfectants); 0 (Plant Preparations); 0N7609K889 (Sulfadiazine); 85H0HZU99M (Povidone-Iodine); DY38VHM5OD (Sodium Hypochlorite); M0T18YH28D (Merbromin); R4KO0DY52L (Chlorhexidine); W46JY43EJR (Silver Sulfadiazine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170713
[St] Status:MEDLINE
[do] DOI:10.1002/14651858.CD011821.pub2


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[PMID]:28697103
[Au] Autor:Uppal S; Bazzi A; Reynolds RK; Harris J; Pearlman MD; Campbell DA; Morgan DM
[Ad] Endereço:Departments of Obstetrics & Gynecology and Surgery and the Institute of Healthcare Policy and Innovation, University of Michigan, Ann Arbor, and the Department of Obstetrics and Gynecology, St. John Hospital and Medical Center, Detroit, Michigan.
[Ti] Título:Chlorhexidine-Alcohol Compared With Povidone-Iodine for Preoperative Topical Antisepsis for Abdominal Hysterectomy.
[So] Source:Obstet Gynecol;130(2):319-327, 2017 Aug.
[Is] ISSN:1873-233X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare preoperative chlorhexidine-alcohol topical antiseptic agent with povidone-iodine in patients undergoing abdominal hysterectomy for benign indications. METHODS: A retrospective cohort study of patients undergoing abdominal hysterectomy from July 2012 to February 2015 in the Michigan Surgical Quality Collaborative was performed. The primary exposure was the use of chlorhexidine-alcohol or povidone-iodine. The primary outcome was surgical site infection within 30 days. Multivariable logistic regression and propensity score matching analysis were done to estimate the independent association of skin antiseptic choice on the rate of surgical site infection. RESULTS: Of the total 4,259 abdominal hysterectomies included, chlorhexidine-alcohol was used in 70.5% (n=3,005) and povidone-iodine in 29.5% (n=1,254) of surgeries. The overall unadjusted rate of any surgical site infection was 2.9% (95% CI 2.5-3.5; n=124). The unadjusted rate of surgical site infection 2.6% (95% CI 2.1-3.3; n=79) for chlorhexidine-alcohol and 3.6% (95% CI 2.7-4.8; n=45; P=.09) for the povidone-iodine group. Using multivariate logistic regression and adjusting for differences between populations in patient demographic factors (age and body mass index), medical comorbidities (American Society of Anesthesiologists class and diabetes status), perioperative variables (estimated blood loss, surgical time, intraoperative adhesions, and antibiotic categories), and hospital characteristics (bed size and teaching status), we estimate that patients receiving chlorhexidine-alcohol had 44% lower odds of developing a surgical site infection (adjusted odds ratio 0.56, 95% CI 0.37-0.85, P=.01). Propensity score matching (one to one) yielded 808 patients in the chlorhexidine-alcohol group and 845 patients in the povidone-iodine group. In the matched groups, the rate of surgical site infection was 1.5% (95% CI 0.8-2.6; n=12) for the chlorhexidine-alcohol group and 4.7% (95% CI 3.5-6.4; n=40) for the povidone-iodine group (P<.001). CONCLUSION: In abdominal hysterectomy performed for benign indications, chlorhexidine-alcohol-based skin antisepsis is associated with overall lower odds of surgical site infection compared with povidone-iodine.
[Mh] Termos MeSH primário: Antissepsia/métodos
Clorexidina/administração & dosagem
Histerectomia/métodos
Povidona-Iodo/administração & dosagem
Cuidados Pré-Operatórios/métodos
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Anti-Infecciosos Locais/administração & dosagem
Estudos de Coortes
Feminino
Seres Humanos
Meia-Idade
Razão de Chances
Estudos Retrospectivos
Infecção da Ferida Cirúrgica/epidemiologia
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 85H0HZU99M (Povidone-Iodine); R4KO0DY52L (Chlorhexidine)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170712
[St] Status:MEDLINE
[do] DOI:10.1097/AOG.0000000000002130


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[PMID]:28666212
[Au] Autor:Shirato M; Nakamura K; Kanno T; Lingström P; Niwano Y; Örtengren U
[Ad] Endereço:Laboratory for Redox Regulation, Tohoku University Graduate School of Dentistry, 4-1 Seiryo-machi, Aoba-ku, Sendai 980-8575, Japan. Electronic address: shirato@dent.tohoku.ac.jp.
[Ti] Título:Time-kill kinetic analysis of antimicrobial chemotherapy based on hydrogen peroxide photolysis against Streptococcus mutans biofilm.
[So] Source:J Photochem Photobiol B;173:434-440, 2017 Aug.
[Is] ISSN:1873-2682
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:A recently developed antimicrobial technique utilizing hydroxyl radicals generated by hydrogen peroxide (H O ) photolysis represents a promising new therapy for preventing and treating dental caries. The present study compared the antimicrobial time-kill kinetics of H O photolysis, conventional antiseptics, and antimicrobial photodynamic therapy (aPDT) against biofilm-forming Streptococcus mutans (cariogenic bacteria) grown on hydroxyapatite disks. H O photolysis was performed by irradiating the biofilm immersed in 3% H O with 365-nm light-emitting diode (LED) light at an irradiance of 1000mW/cm for up to 1.5min. Antiseptic treatments consisted of 0.2% chlorhexidine gluconate, 0.5% povidone-iodine, and 3% H O . The biofilm was immersed in each antiseptic for up to 4min. aPDT was performed by irradiating the biofilm immersed in 100µM methylene blue or toluidine blue O with 655-nm laser light at 1000mW/cm for up to 4min. Based on the time-kill assay, the decimal reduction value (D-value) of each treatment was determined. With a D-value of 0.06min, H O photolysis exhibited the highest bactericidal effect against biofilm-forming S. mutans. In contrast, antiseptics and aPDT exerted a slower bactericidal effect, with D-values of 0.9-2.7min. In conclusion, the antimicrobial technique based on H O photolysis using 365-nm LED represents a strong adjunctive chemotherapy for dental caries treatment.
[Mh] Termos MeSH primário: Anti-Infecciosos/farmacologia
Biofilmes/efeitos dos fármacos
Peróxido de Hidrogênio/farmacologia
Streptococcus mutans/fisiologia
[Mh] Termos MeSH secundário: Biofilmes/efeitos da radiação
Clorexidina/análogos & derivados
Clorexidina/farmacologia
Durapatita/química
Cinética
Luz
Microscopia Confocal
Fotólise/efeitos dos fármacos
Fotólise/efeitos da radiação
Povidona-Iodo/farmacologia
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents); 85H0HZU99M (Povidone-Iodine); 91D9GV0Z28 (Durapatite); BBX060AN9V (Hydrogen Peroxide); MOR84MUD8E (chlorhexidine gluconate); R4KO0DY52L (Chlorhexidine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170701
[St] Status:MEDLINE


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[PMID]:28609415
[Au] Autor:Ridder WH; Oquindo C; Dhamdhere K; Burke J
[Ad] Endereço:*OD, PhD, FAAO †OD, FAAO ‡MD, PhD §BSc Marshall B. Ketchum University, Southern California College of Optometry, Fullerton, California (WHR, CQ); and Allergan, Inc., Irvine, California (KD, JB).
[Ti] Título:Effect of Povidone Iodine 5% on the Cornea, Vision, and Subjective Comfort.
[So] Source:Optom Vis Sci;94(7):732-741, 2017 Jul.
[Is] ISSN:1538-9235
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To determine the effects of povidone iodine 5% (Betadine 5%) applied to the eye on visual function, corneal integrity, and subjective complaints. METHODS: Ten subjects were chosen to participate in this study (average age 40.6 ± 19.6; age range 22-68). LogMAR acuity, contrast sensitivity, corneal fluorescein staining, and subjective complaints were measured before and after 60 µl of Betadine 5% or saline were applied to one eye (eligibility visit, baseline, 5, 30, and 60 minutes and 4 and 24 hours post-application). Contrast sensitivity at 14 cpd was determined with a spatial two-alternative, forced choice procedure (Beethoven software). The National Eye Institute (NEI) grid pattern was used to grade corneal staining with sodium fluorescein. To avoid the detrimental effects of sodium fluorescein administration on functional vision, the corneal staining baseline was measured at the eligibility visit. Subjective complaints were monitored using the Schein dry eye questionnaire. RESULTS: The data were analyzed with an ANOVA. Saline administration did not alter logMAR acuity, contrast sensitivity, corneal fluorescein staining, or subjective complaints at any visit. Betadine administration significantly reduced the logMAR acuity, compared to baseline and the saline data, at the 30- and 60-minute visits (all P values <.05). The contrast sensitivity was significantly reduced compared to the baseline and the saline results at 5, 30, and 60 minutes after Betadine application (all P values <.05). The Betadine significantly increased the Schein questionnaire score, compared both to baseline and the saline data, at the 1- and 4-hour visits (all P values <.05). Total corneal staining and the maximum NEI sector staining were significantly different from baseline and from the saline results at every visit (all P values <.05). CONCLUSIONS: Betadine 5% application significantly decreases epithelial integrity of the cornea, decreases functional vision, and increases subjective complaints.
[Mh] Termos MeSH primário: Anti-Infecciosos Locais/farmacologia
Córnea/efeitos dos fármacos
Conforto do Paciente
Povidona-Iodo/farmacologia
Acuidade Visual/efeitos dos fármacos
[Mh] Termos MeSH secundário: Administração Tópica
Adulto
Idoso
Sensibilidades de Contraste/efeitos dos fármacos
Sensibilidades de Contraste/fisiologia
Córnea/fisiopatologia
Feminino
Fluorofotometria
Seres Humanos
Masculino
Meia-Idade
Soluções Oftálmicas
Estudos Prospectivos
Coloração e Rotulagem
Inquéritos e Questionários
Acuidade Visual/fisiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Infective Agents, Local); 0 (Ophthalmic Solutions); 85H0HZU99M (Povidone-Iodine)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:171116
[Lr] Data última revisão:
171116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.1097/OPX.0000000000001091



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