RESUMEN
OBJECTIVES: To systematically review the effectiveness and safety of chlorine dioxide solution and chlorine derivatives used in the prevention or treatment of COVID-19. METHODS: This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) and follows the guidelines provided in the Cochrane Handbook for Systematic Reviews of Interventions. A librarian developed and executed the search strategy; it was further reviewed by two of the authors and complemented by manual search. Randomized clinical trials, quasi-experimental studies, cohort studies, case-control studies, cross-sectional studies, and case reports were included; in vitro or animal studies were excluded. Abstract and full-text screening according to pre-defined eligibility criteria were performed by two reviewers independently using web application Rayyan QCRI. Disagreements on study selection were resolved by a third reviewer. The systematic review protocol was registered in PROSPERO (CRD42020200641). RESULTS: Neither published nor pre-print studies evaluating the use of chlorine dioxide or derivatives on SARS-CoV-2 infection were identified. The only finding was an unpublished observational study registry which has no results released yet. CONCLUSIONS: To date, there are no scientific evidence to uphold the use of chlorine dioxide or derivatives as preventive or therapeutic agents against COVID-19.
OBJETIVOS: Realizar una revisión sistemática acerca de la efectividad y seguridad del uso de dióxido de cloro y derivados del cloro, en la prevención o el tratamiento de la COVID-19. MATERIALES Y MÉTODOS: Se siguieron las pautas internacionales de elaboración de revisiones sistemáticas de PRISMA y el Manual Cochrane para revisiones sistemáticas de intervenciones. La estrategia de búsqueda la desarrolló un bibliotecario y la revisaron dos de los autores. Se complementó la búsqueda electrónica con una búsqueda manual. Se incluyeron ensayos clínicos aleatorizados, estudios cuasiexperimentales, estudios de cohorte, estudios de casos y controles, estudios de corte transversal y reportes de casos; y se excluyeron estudios in vitro o realizados en animales. Dos revisores, de forma independiente, seleccionaron los estudios según los criterios de elegibilidad definidos, usando el aplicativo web Rayyan, en caso de discordancia se hizo partícipe a un tercer revisor. El protocolo de la revisión sistemática se registró en PROSPERO (CRD42020200641). RESULTADOS: No se identificó ningún estudio publicado ni en proceso de publicación que haya evaluado el uso del dióxido de cloro o derivados del cloro, administrado por vía inhalatoria, oral o parenteral en humanos, como agente preventivo o terapéutico de la COVID-19 o en infecciones por otros coronavirus. Solo se identificó el registro de un único estudio catalogado como observacional que hasta ahora no tiene resultados. CONCLUSIONES: A la fecha, no existe evidencia científica que apoye el uso del dióxido de cloro o derivados del cloro para prevenir o tratar la COVID-19.
Asunto(s)
Tratamiento Farmacológico de COVID-19 , Compuestos de Cloro/uso terapéutico , Óxidos/uso terapéutico , COVID-19/prevención & control , COVID-19/virología , Compuestos de Cloro/efectos adversos , Humanos , Óxidos/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del TratamientoRESUMEN
Cutaneous hemangiosarcoma is a malignant neoplasia that frequently occurs in dogs. The most effective treatment requires wide surgical excision of the tumor. To avoid mutilating surgeries, photodynamic therapy (PDT) could serve as an alternative treatment. This study aimed to treat cutaneous hemangiosarcomas in dogs using PDT with aluminium-chloride-phthalocyanine nanoemulsion (AlClPc-nano) as photosensitizer. Eight dogs with histopathological diagnosis of naturally occurring cutaneous hemangiosarcoma were treated. Animals were given intra and peritumoral injections of AlClPc-nano (13.3 µM). After 15 min, the masses were LED irradiated at a wavelength of 658-662 nm (80 mW potency) for 25 min (120 J/cm2 fluency). The number of sessions was based on lesion observations, with PDT sessions repeated every 7 days until the mass was no longer macroscopically visible. On that occasion, an excisional biopsy of the area was taken for histopathology analysis. Blood was collected from each animal before each PDT session and excisional biopsy for hematological analysis (blood counts; liver and kidney function). The number of PDT sessions varied from 2 to 4, depending on the size of the initial mass. Seven of the eight cases demonstrated complete remission of neoplasia. Microscopic analysis of the excisional biopsies showed necrosis and hemorrhage only, with no cancer cells, except in one case. During the treatment, inflammation and necrosis were macroscopically observed in the treated areas. The dogs did not show any alteration in blood parameters that could be related to the PDT. In conclusion, PDT with AlClPc-nano is a safe and effective treatment for cutaneous hemangiosarcoma in dogs.
Asunto(s)
Emulsiones/uso terapéutico , Hemangiosarcoma/veterinaria , Fotoquimioterapia/veterinaria , Fármacos Fotosensibilizantes/uso terapéutico , Neoplasias Cutáneas/veterinaria , Compuestos de Aluminio/uso terapéutico , Animales , Compuestos de Cloro/uso terapéutico , Perros , Emulsiones/efectos adversos , Emulsiones/química , Femenino , Hemangiosarcoma/tratamiento farmacológico , Hemangiosarcoma/patología , Indoles/uso terapéutico , Isoindoles , Masculino , Nanopartículas/química , Fotoquimioterapia/efectos adversos , Fotoquimioterapia/métodos , Fármacos Fotosensibilizantes/efectos adversos , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/patologíaRESUMEN
The aim of this study was to evaluate the VSC-inhibiting effect of a commercially available mouthrinse (0.1% chlorine dioxide) when compared to its placebo. A 2-step double blind, crossover, randomised study was conducted with 14 dental students with healthy periodontium, who refrained from any mechanical plaque and tongue coating control during two 4-day experimental periods. The subjects were instructed to rinse 3 times daily with the assigned product during each period. A 7-day washout interval was established. VSCs levels were measured by a sulphide monitor at the beginning (baseline) and at the end of each experimental period. Statistical analyses were performed using Wilcoxon's and Mann-Whitney's non-parametric tests. At baseline, intragroup analysis revealed that VSCs levels did not differ between groups (p > 0.05); at day 5, the use of the chlorine dioxide mouthrinse did not change the baseline VSCs scores in the control group (p > 0.05), while a 2-fold increase was observed with the use of the placebo mouthrinse (p < 0.05). Intergroup analysis showed a significant difference between the VSCs levels of the test and control groups (40.2 +/- 30.72 and 82.3 +/- 75.63 ppb, p < 0.001) at day 5. Within the limits of this study, the findings suggest that a mouthrinse containing chlorine dioxide can maintain VSCs at lower levels in the morning breath.
Asunto(s)
Antiinfecciosos Locales/uso terapéutico , Compuestos de Cloro/uso terapéutico , Halitosis/tratamiento farmacológico , Óxidos/uso terapéutico , Compuestos de Azufre/antagonistas & inhibidores , Adolescente , Adulto , Bacterias/efectos de los fármacos , Estudios Cruzados , Placa Dental/prevención & control , Método Doble Ciego , Combinación de Medicamentos , Femenino , Halitosis/prevención & control , Humanos , Masculino , Placebos , Resultado del TratamientoRESUMEN
The aim of this study was to evaluate the VSC-inhibiting effect of a commercially available mouthrinse (0.1 percent chlorine dioxide) when compared to its placebo. A 2-step double blind, crossover, randomised study was conducted with 14 dental students with healthy periodontium, who refrained from any mechanical plaque and tongue coating control during two 4-day experimental periods. The subjects were instructed to rinse 3 times daily with the assigned product during each period. A 7-day washout interval was established. VSCs levels were measured by a sulphide monitor at the beginning (baseline) and at the end of each experimental period. Statistical analyses were performed using Wilcoxon's and Mann-Whitney's non-parametric tests. At baseline, intragroup analysis revealed that VSCs levels did not differ between groups (p > 0.05); at day 5, the use of the chlorine dioxide mouthrinse did not change the baseline VSCs scores in the control group (p > 0.05), while a 2-fold increase was observed with the use of the placebo mouthrinse (p < 0.05). Intergroup analysis showed a significant difference between the VSCs levels of the test and control groups (40.2 ± 30.72 and 82.3 ± 75.63 ppb, p < 0.001) at day 5. Within the limits of this study, the findings suggest that a mouthrinse containing chlorine dioxide can maintain VSCs at lower levels in the morning breath.
O objetivo do presente estudo foi avaliar o efeito inibitório do enxaguatório de dióxido de cloro a 0,1 por cento sobre a formação dos CSVs, quando comparados a um placebo. Um estudo randomizado, cruzado, duplo cego foi conduzido com 14 estudantes de odontologia apresentando saúde periodontal, os quais se abstiveram dos hábitos de escovação dentária e limpeza da língua durante dois períodos experimentais de 4 dias. Os voluntários foram orientados a utilizar o enxaguatório designado 3 vezes ao dia conforme indicado no rótulo. Um intervalo de 7 dias foi estabelecido entre os períodos experimentais. No início ("baseline") e no final de cada período experimental, os níveis de CSVs foram medidos com o uso do monitor de sulfetos. Análise estatística foi realizada utilizando-se os testes não-paramétricos de Wilcoxon e Mann-Whitney. No "baseline", uma análise intragrupo revelou que os níveis de CSVs não diferiram entre os grupos (p > 0.05); no dia 5, o uso do dióxido de cloro não promoveu mudanças significativas nos níveis de CSVs em relação ao "baseline" no grupo controle (p > 0,05), entretanto os níveis de CSVs duplicaram com a utilização enxaguatório placebo (p < 0,05). Uma análise entre os grupos teste e controle revelou diferença significante para os níveis de CSVs (40,2 ± 30,72 e 82,3 ± 75,63 ppb, p < 0,001) no dia 5. Dentro dos limites deste estudo, os achados sugerem que o uso de enxaguatórios contendo dióxido de cloro pode promover a manutenção de baixos níveis de CSVs no hálito matinal.