Antiseptic Drugs Research Articles

Mechanistic insights into antifungal potential of Alexidine dihydrochloride and hexachlorophene in Candida albicans: a drug repurposing approach.

Candida albicans has been listed in the critical priority group by the WHO in 2022 depending upon its contribution in invasive candidiasis and increased resistance to conventional drugs. Drug repurposing offers an efficient, rapid, and cost-effective solution to develop alternative therapeutics against pathogenic microbes. Alexidine dihydrochloride (AXD) and hexachlorophene (HCP) are FDA approved anti-cancer and anti-septic drugs, respectively. In this study, we have shown antifungal properties of AXD and HCP against the wild type (reference strain) and clinical isolates of C. albicans. The minimum inhibitory concentrations (MIC50) of AXD and HCP against C. albicans ranged between 0.34 and 0.69 µM and 19.66-24.58 µM, respectively. The biofilm inhibitory and eradication concentration of AXD was reported comparatively lower than that of HCP for the strains used in the study. Further investigations were performed to understand the antifungal mode of action of AXD and HCP by studying virulence features like cell surface hydrophobicity, adhesion, and yeast to hyphae transition, were also reduced upon exposure to both the drugs. Ergosterol content in cell membrane of the wild type strain was upregulated on exposure to AXD and HCP both. Biochemical analyses of the exposed biofilm indicated reduced contents of carbohydrate, protein, and e-DNA in the extracellular matrix of the biofilm when compared to the untreated control biofilm. AXD exposure downregulated activity of tissue invading enzyme, phospholipase in the reference strain. In wild type strain, ROS level, and activities of antioxidant enzymes were found elevated upon exposure to both drugs. FESEM analysis of the drug treated biofilms revealed degraded biofilm. This study has indicated mode of action of antifungal potential of alexidine dihydrochloride and hexachlorophene in C. albicans.

Surgical antisepsis in Russia: historical parallels

The origins of surgery and the improvement of surgical practices did not always guarantee a favorable surgical outcome. Even a masterfully performed operation could lead to a purulent-inflammatory process. Even at the stage of empirical development of medicine, before the great microbiological discoveries, an understanding was formed about a certain “substrate” that penetrates the surgical wound from the external environment and causes its suppuration. Supporters of the contagionist theory called it contagium, and supporters of the miasmatic theory considered the external (air) environment as such a source. The ideas of the supporters of the contagionist theory of the occurrence of purulent-septic complications in surgery in the middle of the 18th century are reflected in the works of D.S. Samoilovich and I.F. Semmelweis; the latter proved the transmission of the infectious principle by the surgeon’s hands, which became the starting point for the development of preventive antiseptics. In historical retrospect, the technology and means used for surgical hand antisepsis in Russia were analyzed from the mid-18th to the early 20th centuries. Moreover, literary sources for the period from 1783 to 2023 were analyzed, containing information about the antiseptic treatment of surgeons’ hands. Historical, descriptive, evaluative, analytical, and bacteriological research methods were used. As an experiment, the original antiseptic recipe described by D.S. Samoilovich (1783) was restored, and its effectiveness was confirmed. During surgical practices in Russia, starting from the mid-18th century, facts about the use of drugs with antiseptic activity for hand treatment are described. It is shown how, in historical retrospect, views on the final result of surgical antisepsis changed: from partial to complete destruction of microorganisms, preventing their entry from the deep layers of the skin, to the destruction of transient microflora and reduction of the abundance of resident microflora. Despite the influence of the English (J. Lister) and German (P. Fürbringer, J.F. Ahlfeld) surgical schools on the development of antiseptics in Russia, it retained its originality, determined by the needs of society and the possibility of using certain chemical antiseptics and their compositions for its implementation. The contribution of domestic surgeons to the improvement of antiseptic technologies and drugs in military field conditions is shown (N.I. Pirogov, A.M. Zabludovsky, D.I. Tatarinov et al.).

Modern trends in the treatment of bacterial vaginosis in primigravida in the first half of gestation

Pregnancy with bacterial vaginosis (BV) is accompanied by a high risk of various obstetric and perinatal complications, including miscarriage, preterm birth, placental dysfunction, premature rupture of membranes, chorionamnionitis, polyhydramnios, etc. Screening for BV is carried out in the first half of pregnancy during the registration of a woman, however, taking into account the gestational age, many drugs with antimicrobial and antiseptic effects are categorically contraindicated, as they have an embryo- and fetotoxic effect.Timely detection and correction of microbiocenosis disorders of the birth canal is an extremely important element to prevent a number of obstetric and perinatal complications. A balanced approach in the treatment of vaginal dysbiosis consists in the use of modern combined antiseptic preparations for local treatment, which do not contain antibacterial components and are safe for use during pregnancy.The objective: to determine the effectiveness of the treatment of BV in primigravida women in the first half of pregnancy.Materials and methods. 126 primigravida women aged 18–35 years in the first half of pregnancy were examined during pregnancy registration. The participants were selected randomly.The main group included 36 primigravida women with a gestation period of up to 20 weeks with a diagnosis of BV according to the Amsel and Hay–Ison criteria, who were treated with a combined antiseptic drug (chlorhexidine and chlorophyllipt) – suppository vaginally twice a day, the course of treatment – 5 days. The control group included 30 primigravida women with a gestational age of up to 20 weeks with vaginal normocenosis.For all women the pH of vaginal secretions was determined, followed by microscopy of a native smear, stained according to Gram, and a cultural study was performed. Adherence to the Amsel criteria was also determined, followed by evaluation by the Hay–Ison criteria. The clinical effect was evaluated according to clinical examination data before and on the 6th day of treatment with a combined antiseptic drug (chlorhexidine and chlorophyllipt) using bacterioscopic and bacteriological methods.Results. A normal pH was observed only in every fifth part of examined pregnant woman (28 women – 22.2%), while in the rest patients the acidity of the vaginal environment was not normal. Normocenosis was observed only among 1/3 of primigravida women (37 women – 29.4%). A third of the patients were diagnosed with BV (36 women - 28.6%), every fifth pregnant woman – vulvovaginal candidiasis (28 women - 22.2%).In healthy pregnant women (control group, n=30), the main component of the microbiocenosis was Lactobacillus spp. with a small content of facultatively anaerobic microorganisms. In the main group Atopobium vaginae (38.9%), Gardnerella vaginalis (33.3%), Prevotella bivia (27.8%), Candida spp. (22.2%), as well as Lactobacillus spp. in low titers were dominated. Before the treatment all 36 pregnant women of the main group corresponded to the 3rd type according to the Hay–Ison criteria with the dominance of Gardnerella vaginalis and/or Mobiluncus morphotypes and a small number or complete absence of lactobacilli, which served as the basis for establishing the diagnosis of BV. After treatment type 1 (94.4%) was found in 34 pregnant women, and type 2 (5.6%) – in 2 pregnant women.The results of the microbiological study indicate the normalization of the content of the biotope with the predominance of Lactobacillus spp. in women of the main group, in whom the indicators were similar to the control group.Conclusions. Since pregnancy with BV is accompanied by a high risk of obstetric and perinatal complications, the premorbid background of which is laid already in the first half of pregnancy, there is an urgent need to carry out the birth canal sanitation. The drugs of choice for the BV in the first half of pregnancy are local combined agents of a wide spectrum of action.A universal antiseptic with an anti-inflammatory effect, which includes two components – chlorhexidine and chlorophyllipt, fully meets the recommendations for efficiency and safety and can be used for the BV in the first half of pregnancy.

Carbon screen‐printed electrodes modified with SiO2‐CuO‐glucose oxidase film for toxicity assessment using bacteria as indicator systems

AbstractA portable voltammetric sensor for toxicity assessment was developed based on a screen‐printed carbon electrode modified with SiO2‐CuO‐glucose oxidase (GOx) film. The method is based on the detection of the metabolic activity of E. coli towards glucose as an indicator systems in the presence of antiseptic drugs as model toxic compounds. CuO particles exhibited catalytic activity toward hydrogen peroxide produced by the GOx‐induced oxidation of glucose. A well‐defined reduction peak was registered at E=−0.50 V (vs. Ag/AgCl). The metabolism of glucose by E. coli resulted in a decrease in analytical signal of glucose with the increasing bacteria content in the range of 0.8×109–5.0×109 CFU mL−1 with a calculated limit of detection (LOD) of 0.59×109 CFU mL−1. To evaluate the effect of antiseptics the biosensor was tested in E. coli solution with chlorhexidine (CHD) or decamethoxine (DMT). A linear dependence of glucose consumption by E. coli solution on the antiseptic concentration was obtained in the range of 3.0–12.0 μg mL−1 for CHG and 1.0–12.0 μg mL−1 for DMT, respectively. The developed third generation biosensor showed satisfactory stability and reproducibility of the analytical response. A modified electrode can be used for at least two months.

Гострий риноcинусит у дитячому віці - нове вирішення старої проблеми

Acute inflammation of the mucous membrane of the nose and paranasal sinuses (acute rhinosinusitis (ARS)) is a fairly common pathology in pediatrics and otorhinolaryngology. The aim of the research was to improve the effectiveness of treatment children with ARS by introducing a combination complex of natural plant extracts "Sinudafen" and effervescent isotonic seawater solution "Sparklin" and to investigate the effect of the proposed complex treatment on the frequency of repeated ARS. Materials and methods. The study was conducted between February and December 2023 in two independent centers. The study included 98 patients with signs of ARS. The Main group - 67 patients who received "Sinudafen" and "Sparklin" for 10-14 days, symptomatic and/or etiotropic therapy if necessary. The Control group - 31 patients who received standard therapy. The results. The examination carried out on the 14th day showed that, compared to standard treatment, the patients of the Main group had a statistically significantly lower risk of maintaining such local symptoms of ARS (edema of the mucous membrane and mucous secretions from the nose). With the faster rates of recovery of children in the Main group, the pharmacological load on patients decreased significantly. The use of "Sinudafen" and "Sparklin" in comparison reduced the need to prescribe antibacterial and antiseptic drugs in the acute period. Better clinical dynamics was accompanied by a reduction in the length of hospitalization, the use of "Sinudafen" + "Sparklin" increased the chances of reducing the duration of the acute period within ≤4 days. Conclusions. The use of "Sinudafen" and "Sparklin" complex in the treatment of children with ARS allows for a 3.8-fold increase in the chances of recovery within ≤4 days. The proposed complex treatment reduces the need for antibiotics/anesthetics by 15.8 times and reduces the risk of repeated episodes of ARS by 18.2 times during the 6-month follow-up period. The use of "Sinudafen" with "Sparklin" is characterized by good tolerability, absence of side effects, high adherence, and also reduces the cost of treatment of one episode of ARS by 50%. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

ОПЫТ ЛЕЧЕНИЯ ПОСЛЕРОДОВОГО ЭНДОМЕТРИТА У КОРОВ

The purpose of the study is to conduct a comparative analysis of the therapeutic effectiveness of a local antiseptic drug based on tea tree essential oil for acute postpartum catarrhal endometritis in cows. The study was conducted at the Department of VNB, Obstetrics and Physiology of Farm Animals of the Krasnoyarsk State Agrarian University, on the basis of the dairy farm of the Balakhta District of the Krasnoyarsk Region. The object of the study is red-motley cows. Research methods: obstetric and gynecological medical examination of breeding stock; the diagnosis of acute postpartum catarrhal-purulent endometritis was established during a clinical and gynecological examination of fresh cows, which inclu-ded thermometry, rectal and vaginal examination. The diagnosis was considered confirmed when pathological discharge of a catarrhal nature appeared from the uterus during rectal massage. Two experimental groups of fresh cows were formed according to the principle of analogues (based on live weight, age, lactation, clinical manifestation of the form of acute endometritis). In the 1st experimental group, scheme № 1 was used: a 25 % oil solution of tea tree essential oil was administered intrauterinely in a dose of 20 ml daily once a day until clinical recovery; eleovit 8 ml was administered intramuscularly on the 1st and 5th days of treatment; uteroton 10 ml was administered intramuscularly daily once a day for 3 days; 0.05 % chlorhexidine solution 200 ml – intravaginally; rectal massage of the uterus once a day. In the 2nd experimental group, treatment regimen № 2 was used, which differed from regimen № 1 by using a 50 % oil solution of tea tree essential oil in a similar dosage. The best therapeutic effect in the treatment of acute catarrhal endometritis was obtained using scheme № 2 using a 50 % oil solution of tea tree essential oil. Du¬ring the seven-day course of treatment, therapeutic effectiveness was obtained in 60.0 % of cases; prolongation of the course of therapy led to the recovery of all animals in this experimental group. The ave¬rage duration of treatment for the group was 8.0 days.

Local Warm Alkaline Hydrogen Peroxide Solutions and Targeted Temperature Management Improve the Treatment of Chronic Wounds

Introduction: To date, there is no systematic review of the effect of local hypo-, normo- and hyperthermia on the processes of local interaction of antiseptics with dense biological masses covering the surface of chronic wounds. Accelerated and reliable cleansing of the wound surface from purulent masses still remains an unsolved problem of surgery. Methods: 6 inventions were found from beginning to 1986 in databases such as EAPATIS, BYPATENTS, DWPI, DEPATISnet, PATENTSCOPE, Espacenet, RUPTO, USPTO, CIPO, CNIPA, KIPRIS, PatSearch, J-PlatPat, Google Patents and TPO. Due to the small number of inventions, methodological heterogeneity, and differences in the content of their claims, a quantitative meta-analysis could not be performed. Results: The prospects of innovative proposals on the influence of local hypothermia and local hyperthermia on the process of local interaction of antiseptic drug solutions with purulent masses and blood on the surface of chronic wounds have been analyzed. The results of the included studies were presented only qualitatively (descriptively). Conclusion: The first review of inventions presents formulations of invented drugs created by physicochemical repurposing of hydrogen peroxide from antiseptic to pyolytics, mucolytics, hemolytics, expectorants and oxygen-releasing antihypoxants. Warm alkaline hydrogen peroxide solutions (WAHPSs) have been shown to rapidly and reliably dissolve thick purulent masses, blood clots and dried blood spots, turning them into a lush oxygenating foam. Temperature regimes that optimize the sanitizing and washing action of WAHPSs in the treatment of chronic wounds and accelerate hemostasis in parenchymatous bleeding are specified.

The effect of local use of etiotropic drugs on the oropharyngeal microbiota in children with acute respiratory infection

Introduction. The microbiota of the oral cavity and oropharynx, actively interacts with the epithelium of the mucous membrane and the immune system, creates antagonistic conditions for the growth and reproduction of pathogens. Microbiocenosis-preserving therapy can provide conditions for maintaining colonization resistance and reduce the likelihood of adhesion of respiratory viruses.Aim. To evaluate the effect of local use of various antimicrobial drugs on the microbiota of the oropharyngeal mucosa in children with acute respiratory infection.Materials and methods. 120 children (5–10 years old) with acute respiratory infection were divided into three groups, in which they were used as part of complex therapy: in group 1st – hexetidine-containing aerosol, in group 2nd – a children’s spray containing gramicidin S and cetylpyridinium chloride, in the 3rd – 0.01% solution of benzyldimethyl-myristoylamino-propylammonium. On the 1st and 12th days of observation, participants had a throat swab taken to study the state of the oropharyngeal microbiota using 16S rRNA sequencing. The results obtained were compared with those of healthy peers.Results. According to sequencing data, the microbiota of participants in all groups before treatment differed from the microbiota of healthy peers in terms of alpha and beta diversity, as well as in the results obtained by the nearest balance method. Local use of antiseptic drugs influenced the microbiota at the level of species and genera of microorganisms. After treatment in the 2nd group, in contrast to the 1st and 3rd, statistically significant changes in the balances at the level of microorganism species were revealed towards the indicators of healthy peers.Conclusions. A combined drug containing cetylpyritinium chloride and the bacteriocin-like antimicrobial peptide gramicidin S demonstrated no negative effect on commensal microbiota and contributed to the stabilization of the regional microbiota.

Study of the Antimicrobial Activity of Staphylococcal Bacteriophage on a Model of an Infected Skin Wound

The purpose of this study was to investigate the antimicrobial activity of staphylococcal bacteriophage on a model of a skin wound infected with Staphylococcus aureus. The study of antimicrobial activity was carried out in vivo by experimental modeling of a skin wound infected with S.aureus in the interscapular region in nonlinear male rats. All manipulations with animals were performed in accordance with the requirements of regulatory documentation overseeing the management of laboratory animals and work with them. The results obtained indicate the pronounced antimicrobial activity of staphylococcal bacteriophage in conditions of wound infection when applied externally, which is confirmed by a decrease in the degree of bacterial contamination of wound discharge, as well as a decrease in inflammatory phenomena, both at the local level in the form of a decrease in hyperemia, and generalized in the form of a decrease in C-reactive protein levels, total leukocyte count, as well as a decrease in the leukocyte inflammatory index. The identified antimicrobial effect is comparable to the external use of an antiseptic drug — a solution of chlorhexidine digluconate 0.05%, however, when assessing microbial contamination, it was found that the bacteriophage exhibits more pronounced antibacterial activity. Thus, the staphylococcal bacteriophage showed pronounced antimicrobial activity in a model of a skin wound infected with S.aureus, confirmed by a decrease in the number of colonies of the microorganism in the wound discharge, as well as a decrease in the severity of inflammation.

The efficacy of using modern antiseptic drugs in ointment form in the treatment of pyoderma and secondarily infected dermatoses

BACKGROUND: Pyoderma is one of the most common diseases of the skin and its derivatives. Traditionally, topical antibacterial drugs are used as first-line drugs, but the growth of antibiotic resistance limits their use, and therefore the search for new promising forms of antiseptic drugs remains an urgent task. An antiseptic agent must have a wide antimicrobial spectrum, not irritate the skin and mucous membranes, and remain active for a long time; the antiseptic benzyldimethyl-myristoylamino-propylammonium ointment meets all these requirements.
 AIM: to evaluate the efficacy and safety of 0.5% benzyldimethyl-myristoylamino-propylammonium ointment in the treatment of pyoderma and secondarily infected dermatoses.
 MATERIALS AND METHODS: We followed 36 patients with identified polyresistance to topical antibacterial drugs aged 18 to 63 year. 1st group consisted of 22 patients with clinical forms of superficial pyoderma: superficial folliculitis ― 8 (36.4%) cases, sycosis vulgaris ― 4 (18.2%), impetigo vulgaris ― 4 (18.2%), dry streptoderma ― 3 (13.6%), paronychia ― 3 (13.6%). The 2nd cohort included 14 human test subjects with secondarily infected dermatosis: nummular eczema ― 6 cases (42.8%), atopic dermatitis ― 5 (35.8%), secondarily infected contact allergic dermatitis ― 3 (21.4%).
 RESULTS: As a result of monotherapy with 0.5% benzyldimethyl-myristoylamino-propylammonium ointment in the pyoderma group, clinical recovery (with DIDS=0) was observed in 91.7% of the subjects. The most common dermoscopic pattern was a necrotic rod, the final one was a light red background. Comprehensive treatment of secondarily infected dermatosis in patients of group II, a clinical cure was stated in 71.4% of cases, which is associated with the predominance of chronic, recurrent dermatoses in this cohort of the study, it was noted that dermatosis has a moderate effect on their lives. Initially, during dermatoscopy, there were signs of an acute stage of examination (yellow scales/crusts, punctate vessels, hemorrhages), after therapy ― a stationary stage (white scales).
 CONCLUSION: Miramistin ointment 0.5% has demonstrated high tolerability and efficacy against various forms of superficial pyoderma and secondarily infected dermatosis and can be recommended for effective use in clinical practice.

The influence of therapeutic physical factors on the dynamics of the clinical condition and quality of life of patients with peri-implantitis

BACKGROUND: The use of dental implants, being the gold standard in the dental rehabilitation of edentulous patients, is often accompanied by the development of inflammatory complications leading to loss of the implant. Common methods in dental practice for the prevention and treatment of peri-implantitis based on local antiseptic and antibacterial drugs and periodic measures of professional oral hygiene are limited and do not contribute to solving the existing problem.
 AIM: Assessment of the clinical effectiveness and dynamics of the quality of life of patients with peri-implantitis during complex therapy using mesodiencephalic modulation, ozone therapy and their combination.
 MATERIALS AND METHODS: the study was carried out with the participation of 116 patients with peri-implantitis of classes I and II according to S.A. Jovanovic. All patients were divided into 4 groups using simple fixed randomization. The first group (control; n=28) received standard dental therapy, including professional oral hygiene and local use of antiseptics. In the second group (comparison group 1; n=29), in addition to standard therapy, a course of ozone therapy was performed, for which the peri-implant area was irrigated with ozonated saline solution with an ozone concentration of 2.5–5.5 μg/ml for 15 minutes. In the third group (comparison group 2; n=30), standard treatment was supplemented with a course of MDM therapy. Patients of the fourth group (main group; n=29), along with standard treatment, received complex treatment, including a course of ozone therapy and MDM therapy. The results were assessed after the end of therapy based on the dynamics of dental indices, the osseointegration parameter of the implant and the level of quality of life of the patients.
 RESULTS: A course of use of various treatment regimens was accompanied by a significant improvement in the clinical and dental status of patients, but the severity of the effect was different in the groups. To a lesser extent, positive changes were identified in the control group. Additional course use of therapeutic physical factors (ozone and MDM therapy) was accompanied by a significant increase in regression of complaints and improvement in objective indicators of dental status. Achieving the maximum positive result was clearly evident in the main group with the complex use of the studied physiotherapeutic factors. The use of the correlation adaptometry method to assess the clinical effectiveness of various treatment regimens for peri-implantitis made it possible to establish that under the influence of the integrated use of ozone and MDM therapy, the most pronounced decrease in mutual correlations between the studied parameters is observed. This indicates an increase in functional reserves and adaptive capabilities of patients in the main group.
 CONCLUSION: the results obtained convincingly prove the high effectiveness of the complex use of therapeutic physical factors in the implementation of a therapeutic strategy aimed at eliminating inflammatory manifestations in the area of dental implants and improving the quality of life of patients.

Acute Non-Lymphoblastic Leukemias Presenting with Gingival Hyperplasia: Diagnosis and Management Updates

Background: Leukemias represent a heterogeneous group of hematological malignancies, which are characterized by the disordered proliferation of neoplastic hematopoietic cells, with the diffuse bone marrow involvement. Most frequent oral findings in leukemias are cyanotic or erythematous gingival hyperplasia with or without necrosis, petechiae, ecchymoses, mucosal ulcers and hemorrhage. Gingival hyperplasia is reported as a consistent symptom, which forwards patients for a dentistry consultation, that may lead to an early diagnosis of acute leukemias. The recognition of gingival enlargement as an initial oral manifestation of leukemic involvement assumes major practical significance, especially for the early diagnosis of non-lymphoblastic leukemias. Objectives: The aims of researches were the evaluation of diagnosis and management of hyperplastic gingivitis in acute leukemias. Material and Methods: The patients' follow-up and treatment were realized at the comprehensive cancer center. Our observational, analytical and descriptive study enrolled 8 patients with acute leukemias, who were treated at the Institute of Oncology from Moldova between 2012-2023. The diagnosis was asserted by the bone marrow aspiration with cytochemical reactions, tissue biopsy, buccal swab, or fine needle aspiration cytology. The immunophenotyping was performed in selected cases. The types of acute leukemias were assessed and distinguished according to the 2017 Revision of WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues. This prospective study was related to the hospitalized and outpatient care. Results: Hyperplastic gingivitis developed in cases with myelomonocytic and monocytic acute leukemias. The leukemia patients were admitted to the Institute of Oncology with a history of fatigue, fever, bone pain, gingival bleeding and enlargement detected by dentistry and family doctors from the consulting centers. ECOG-WHO performance score was 2-3. The intra-oral examination revealed generalized gingival hyperplasia. There were the amounts of plaque and calculus, which did not justify the enlargement degree. The gingiva was spongy and painless on palpation, with solitary sectors of necrosis and mucosal bleeding. Multiple soft and tender lymph nodes ranging from 0.8-1.5 cm in diameter were palpable bilaterally in the cervical and axillary regions. Splenomegaly of various degree was revealed by ultrasound scan in all patients. Complete blood count values ranged between: Hb 66-104 g/l, RBC 2.3-3.7 x 10 12/l, WBC 11.3-47.2 x 10 9/l, PLT 17.0-115.0 x 10 9/l, blast cells 17-65%. The bone marrow aspiration detected hypercellularity, myeloid and monocytic blast cells (31.0-58.0%), as well as monocytes (9.0-14.0%). The studied cases were not suggestive of presence of FLT3 mutations. Hyperplastic gingivitis regressed in 5 (62.5%) cases after the achievement of complete (4 patients) and partial (1 patient) hematological responses under the first-line combined chemotherapy with conventional doses of cytarabine, anthracyclines and etoposide (2 patients). Local treatment included daily administration of oral steroids, antiseptic and hemostatic drugs. The narrative review of the recent references revealed that 37-53% of patients with monocytic and myelomonocytic leukemias were reported to develop gingival hyperplasia. Conclusions: Hyperplastic gingivitis emerges in acute leukemias mostly due to the gingival infiltration with neoplastic blast cells. Gingival hyperplasia may regress under the combined chemotherapy and local treatment in patients with complete or partial hematological responses. Early diagnosis and treatment, thus, can increase the leukemia patients' prospects for complete hematological and local responses.

Current aspects of the treatment of acute tonsillopharyngitis: the place of topical therapy

The problem of acute tonsillopharyngitis remains relevant despite a huge amount of research. According to modern clinical guidelines, practically the only indication for prescribing systemic antibacterial therapy remains the GAS etiology of acute tonsillopharyngitis. At the same time, in clinical practice there are often cases of patients independently and unjustifiably starting to take systemic antibacterial drugs due to severe pain, which they were unable to relieve with the use of topical drugs. Most cases of acute tonsillopharyngitis are of a viral etiology. According to the modern guidelines, there is almost the one and only indication for antibiotics in patients with acute tonsillitis. Taking into account, the timing of a standard microbiological study, special clinical scales are used to quickly assess the clinical picture, according to which the patient scores a certain number of points depending on whether certain criteria are met. The most widely used is the McIsaac scale, which takes into account, in addition to the clinical picture, the patient’s age. At the same time, in clinical practice there are often cases of patients independently and unjustifiably starting to take systemic antibacterial drugs due to severe pain, which they were unable to relieve with the use of topical drugs. Thus, timely prescription of topical drugs effective for pain relief occupies an important place in the management of patients with both viral and bacterial acute tonsillopharyngitis. The article presents a series of clinical cases of acute tonsillopharyngitis, which can be characterized by the complexity of differential diagnosis. Using their own observations as an example, the authors demonstrate the importance of timely effective topical therapy, in particular with the antiseptic drug Mitraseptin-PRO (benzyldimethylmyristoylaminopropylammonium).

Study of the antibacterial efficacy of an antiseptic drug activated by low-frequency and high-frequency ultrasound in an experiment

The aim of the work was an experimental study of the effectiveness of activation of an antiseptic drug, using low-frequency and high-frequency ultrasound, against pathogenic microorganisms obtained from periodontal pockets. As a result of automatic cultivation of clinical strains: S. sanguis, P. intermedia, C. albicans, revealed more pronounced antimicrobial effect of Miramistin activated by low-frequency ultrasound (26.5 kHz) compared with the activation of this drug by high-frequency ultrasound (880 kHz). In the treatment of inflammatory periodontal diseases, in order to obtain a pronounced antimicrobial effect, preference should be given to the combined effects of low-frequency ultrasound and the antiseptic drug Miramistin 0.01%.

Experimental study of the antibacterial efficacy of an antiseptic drug activated by ultrasound of different frequencies

Aim. To study the antibacterial efficacy of the antiseptic drug Miramistin, activated by ultrasound of different frequencies, against pathogenic microorganisms of periodontal pockets, in an experiment. Materials and methods. As an antiseptic drug, the drug Miramistin 0.01% was used, which was activated using ultrasound of different frequencies: high-frequency (880 kHz) in continuous mode for 4 minutes, low-frequency (26.5 kHz) in continuous mode for 2 minutes. To conduct the study, clinical strains of microorganisms obtained from periodontal pockets with moderate periodontitis were used: S. sanguis, S. pyogenes, P. intermedia, C. albicans. The study was carried out using automatic programmable cultivation, using the RTS-8 system. The studied samples of the antiseptic drug were previously diluted in a nutrient broth in a ratio of 2:200. Results. In the course of the study, it was found that with respect to pathogenic microorganisms obtained from periodontal pockets with moderate periodontitis, Miramistin in a dilution of 2:200, activated by low-frequency ultrasound, showed more pronounced antibacterial effect compared to Miramistin activated by high-frequency ultrasound. Conclusions. In the treatment of periodontitis, to suppress the vital activity of pathogenic microorganisms, preference should be given to the combined effects of low-frequency ultrasound and the antiseptic drug Miramistin.

Synthesis of novel metal silica nanoparticles exhibiting antimicrobial potential and applications to combat periodontitis

Periodontitis is a severe form of gum disease caused by bacterial plaque that affects millions of people and has substantial worldwide health and economic implications. However, current clinical antiseptic and antimicrobial drug therapies are insufficient because they frequently have numerous side effects and contribute to widespread bacterial resistance. Recently, nanotechnology has shown promise in the synthesis of novel periodontal therapeutic materials. Nanoparticles are quickly replacing antibiotics in the treatment of bacterial infections, and their potential application in dentistry is immense. The alarming increases in antimicrobial resistance further emphasize the importance of exploring and utilizing nanotechnology in the fight against tooth diseases particularly periodontitis. We developed 16 different combinations of mesoporous silica nanomaterials in this study by ageing, drying, and calcining them with 11 different metals including silver, zinc, copper, gold, palladium, ruthenium, platinum, nickel, cerium, aluminium, and zirconium. The antibacterial properties of metal-doped silica were evaluated using four distinct susceptibility tests. The agar well diffusion antibacterial activity test, which measured the susceptibility of the microbes being tested, as well as the antibacterial efficacy of mesoporous silica with different silica/metal ratios, were among these studies. The growth kinetics experiment was used to investigate the efficacy of various metal-doped silica nanoparticles on microbial growth. To detect growth inhibitory effects, the colony-forming unit assay was used. Finally, MIC and MBC tests were performed to observe the inhibition of microbial biofilm formation. Our findings show that silver- and zinc-doped silica nanoparticles synthesized using the sol-gel method can be effective antimicrobial agents against periodontitis-causing microbes. This study represents the pioneering work reporting the antimicrobial properties of metal-loaded TUD-1 mesoporous silica, which could be useful in the fight against other infectious diseases too.

Method and technology for drug repurposing based on changes in the physicochemical properties of dosage forms: experience of use in Russia

Controlled local hyperthermia and hypothermia are important factors in drug pharmacodynamics and pharmacokinetics because changing the temperature of drugs changes their physicochemical properties. In this regard, a controlled change in the temperature of the drug and/or the body part with which the drug interacts, relative to the level of human body temperature (hyperthermia or hypothermia) forms the basis of temperature pharmacology. To analyze the authors publications on the problem of methodology and technology for repurposing drugs based on changes in the physicochemical properties of dosage forms. A controlled change in the temperature of the drug and/or the part of the body with which the drug interacts; a change in acid (alkaline), osmotic activity, and the degree and quality of carbonation and/or oxygen-forming activity of medicinal solutions; and a change in the concentration of medicinal solution ingredients. On the basis of the used methods, the reprofiling of a number of drugs has been achieved. The author proposed reprofiling a 4% potassium chloride solution from the group of macroelements and microelements used to regulate acid-base balance with a resorptive effect (when administered intravenously to the whole body) into a group of vasoconstrictive drugs used to stop bleeding when applied to by a single irrigation of the bleeding surface. Cooling certain drugs and tissues at their interaction sites to 18C20C (via an ice pack or its substitute) inhibits metabolism and function, ensuring the conversion of many drugs into anti-ischemic drugs by reducing the need for tissues in oxygen. A targeted change in the physicochemical properties of known drugs combined with local hyperthermia allows them to be converted into expectorant, pyrolytic (astringent), hemolytic, thrombolytic (hemostatic), detergent, bleaching, cleaning, and other drugs, including antiseptic and cauterizing (necrotizing) drugs, very reliably, quickly, and inexpensively. Thus, 40 years ago, pharmacologists of the Russian Federation established the foundation for a novel method of drug development known today as repurposing of existing drugs. Today, it is evident that reprofiling may rapidly, inexpensively, and effectively give existing drugs a new purpose.

Gelatin-based hydrogel with antiseptic properties: synthesis and properties

The work presents the results of research on the formation of a hydrogel polymer matrix during the gelatin crosslinking with a dioxirane derivative of poly(ethylene glycol) and experiments on studying their properties. The crosslinking process of type A gelatin using poly(ethylene glycol) diglycidyl ether (PEGDE 500) was optimized by changing the gelatin: PEGDE ratio without using any other factors. The properties of the obtained hydrogels were studied, in particular the gel fraction amount, the degree of swelling in different media, mechanical properties, pore size, cytotoxicity, the ability to absorb and release antiseptic drugs, and bactericidal properties of hydrogel samples filled with an antiseptic agent (chlorhexidine). The crosslinking reaction has been found to be the most efficient at gelatin: PEGDE 500 ratio ranging from 1:3 to 1:5. In this case, the formation of highly elastic hydrogels with maximum fraction amount and high mechanical properties was observed (the samples were not destroyed under compression). Moreover, only within this ratio range, the obtained hydrogels retained their shape when heated to 40 °C. The pore sizes of the swollen hydrogel clearly depend on the crosslinker content. The high values of the degree of swelling in the exudate-simulating fluid in combination with mechanical strength allow the development of wound dressings based on hydrogels of the developed composition. Crosslinking of gelatin with PEGDE 500 allows to obtain gelatin-based hydrogels in a controlled manner which does not require subsequent purification steps. The resulting material does not exhibit cytotoxicity during in vitro studies on living cells. The hydrogel filled with an antiseptic drug is capable of releasing it by 50% within the first day into the medium of saline and exudate-simulating fluid. The antimicrobial properties of the hydrogel containing chlorhexidine are confirmed by the effective inhibition of the growth of Escherichia coli and Staphylococcus aureus bacteria.

Research Design of the Release of Amizon, Decametoxine, and Chlorhexidine from the Composition of Dental Medicinal Films

Introduction: The treatment of most diseases in dentistry is related to the local application of antiseptic drugs that regulate the microbiocenosis in the oral cavity. The study of pharmacodynamic and kinetic parameters of the release of active pharmaceutical ingredients (APIs) from the dosage form (DF) is an important task. In this study, we tried to evaluate the release of APIs from developed dental medicinal films (DMF) produced on a polymeric basis. Methods: To confirm the antimicrobial activity of the three developed DMF with amizon, decamethoxine and chlorhexidine digluconate, a statistical analysis and mathematical processing of the research results were carried out. Results: Statistical processing made it possible to organize the results of our earlier studies, in which the concentrations of three APIs (amizon, decamethoxine, and chlorhexidine digluconate) were determined during their diffusion from the polymer base of the DMF to the aqueous dispersion medium (0.9% sodium chloride solution). Due to performed statistical calculations, regarding the reliability of APIs release, it was determined that the time duration of complete release of the three active substances from the polymer base was different, which will ultimately affect the duration of the pharmacological effect of the APIs in the patient's body. Conclusion: In the manufacture of DMF on a polymeric base of hydrophilic type, it is necessary to take into account the release time of each API, according to the composition of the polymeric coatings.

Comparative evaluation of the effectiveness of light activation of photosensitizers in photodynamic therapy of periodontitis using different wavelengths

Dentists are always in quest of new methods for the treatment of periodontal diseases, and photodynamic therapy (PDT) is considered one of the most effective methods. A significant improvement in the clinical pic-ture was obtained in all patients throughout the control period of observation of the patients as a result of the treatment with the use of PDT. According to the data from research study it can be said that photodynamic therapy is an effective and gentle method of antibacterial treatment of inflammatory periodontal diseases, which can be effectively used to prevent exacerbations of chronic inflammatory periodontal diseases, to achieve a long-term positive effect and to refuse, in some cases, from surgical methods of treatment. There is a signifi-cant increase in the duration of remission of the disease, improvement of microcirculatory blood circulation in per-iodontal tissues and a small microbial contamination of periodontal pockets of patients treated with photodynam-ic therapy in the long term compared with groups of patients treated with only antiseptic and antibacterial drugs.