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1.
Dermatol Surg ; 50(6): 542-545, 2024 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-38460194

RESUMEN

BACKGROUND: The Tessari method is commonly used in sclerotherapy for producing foam, involving 2 syringes pushed back and forth 20 times with the use of a 3-way connector. Many factors affect the foam stability which is crucial for clinical efficacy. OBJECTIVE: This study aimed to identify the optimal pushing rate which may impact the foam stability. MATERIALS AND METHODS: Polidocanol (POL) solution (1% and 3%) was used to make sclerosant foam via the Tessari method, with a total of 20 pushes performed at different time durations: 10, 15, 20, 25, 30, 35, and 40 seconds. The foam stability was recorded using foam half-life time (FHT), and the pushing pressure to the syringe was recorded using a self-made electric device. Both FHT and the pressure among different groups were compared respectively. RESULTS: The FHT was decreased as pushing duration exceeding 20 seconds in POL 1% and 15 seconds in POL 3%. Both the highest FHT and pressure point were located in the 10-second group. CONCLUSION: It is recommended to complete 20 back-and-forth passages within 10 seconds to create stable foam.


Asunto(s)
Polidocanol , Soluciones Esclerosantes , Escleroterapia , Jeringas , Soluciones Esclerosantes/química , Soluciones Esclerosantes/administración & dosificación , Polidocanol/química , Polidocanol/administración & dosificación , Escleroterapia/métodos , Polietilenglicoles/química , Presión , Estabilidad de Medicamentos , Humanos , Factores de Tiempo , Semivida
2.
Am J Otolaryngol ; 45(4): 104259, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38547749

RESUMEN

OBJECTIVE: To assess the influence of varying retention doses of ultrasound-guided polidocanol chemical ablation for benign cystic-solid thyroid nodules. METHODS: A retrospective study was conducted from December 2019 to January 2022, including 78 patients with benign cystic-solid thyroid nodules, of which 31 received polidocanol chemical ablation alone, 23 received polidocanol chemical plus thermal ablation, and 24 received open surgery. Patients who received polidocanol chemical ablation were assigned into groups based on the retention dose of polidocanol: 0 %, 10 %, 20 %, 30 %, and 50 %. Follow-ups were done at 1, 3, 6, and 12 months postoperatively. The volume of the nodules, postoperative complications, and recurrence of the nodules were examined before treatment and during follow-up visits. RESULTS: Total operation time and intraoperative bleeding volume for patients who received ablation were substantially lower than those for patients who received open surgery (P < 0.001). Among patients in the polidocanol chemical ablation group, volume shrinkage rate of thyroid nodules in the 10 % retention dose group was significantly lower than that in the 0 % retention dose group at 1, 3, and 6 months postoperatively (P < 0.05). The 30 % retention dose group had the highest nodule shrinkage rate (98.46 ± 1.55 %) at 12 months postoperatively, which was significantly higher than that in the 50 % retention dose group (P < 0.05). Among patients in the polidocanol chemical and thermal ablation group, the volume shrinkage rate of thyroid nodules in the 10 % and 30 % retention dose groups at 1 month postoperatively was significantly lower than that in the 0 % retention dose group (P < 0.05). Although volume shrinkage rate in the 20 % retention dose group after thermal ablation was higher than that in the 0 % retention dose group, the difference was not statistically significant (P > 0.05). In terms of adverse reactions, the incidence of hoarseness and coughing was higher in the open surgery group than in the polidocanol chemical ablation and polidocanol chemical and thermal ablation groups, but there was no significant difference (P > 0.05). CONCLUSION: Chemical ablation with polidocanol was safe and effective for therapy of benign cystic-solid thyroid nodules, and the optimal retention dose may be between 20 % and 30 %. Patients with poor efficacy from chemical ablation alone can receive safe and effective treatment through thermal ablation.


Asunto(s)
Polidocanol , Soluciones Esclerosantes , Nódulo Tiroideo , Ultrasonografía Intervencional , Humanos , Polidocanol/administración & dosificación , Femenino , Masculino , Estudios Retrospectivos , Nódulo Tiroideo/diagnóstico por imagen , Nódulo Tiroideo/cirugía , Nódulo Tiroideo/patología , Persona de Mediana Edad , Adulto , Resultado del Tratamiento , Soluciones Esclerosantes/administración & dosificación , Técnicas de Ablación/métodos , Anciano
3.
Dermatol Surg ; 48(1): 72-75, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34816819

RESUMEN

BACKGROUND: Polidocanol is a safe sclerosing agent with anesthetic properties and minimal skin toxicity. OBJECTIVE: To evaluate the efficacy, safety, and recurrence rates with polidocanol sclerotherapy in the treatment of pyogenic granulomas (PGs). METHODS AND METHODS: Thirty-nine patients with PG were injected with polidocanol 1% solution. Repeat injections were given weekly in case of incomplete clinical/dermoscopic resolution, until a maximum of 3 sittings. A higher strength (3%) was used for subsequent sessions in those with a minimal response to 1% solution. A final assessment for relapses was performed at 3, 6, and 12 months. RESULTS: All 39 patients achieved complete resolution (100% clearance rate), with most (n = 26) lesions resolving after the first sitting. Side effects noted were postprocedure pain (22), erythema (2), superficial ulceration (2), paresthesias (1), prominent edema (4), thrombophlebitis (1), cyanotic discoloration (1), purpuric staining around injection site (4), and mild local pruritus (1). The procedure was well tolerated across the age spectrum (4-63 years) included. CONCLUSION: We report polidocanol to be a highly effective, safe, and cost-effective sclerosant for treatment of PGs with no recurrences or need for special postprocedure care.


Asunto(s)
Granuloma Piogénico/terapia , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/métodos , Prevención Secundaria/métodos , Adolescente , Adulto , Niño , Preescolar , Análisis Costo-Beneficio , Costos de los Medicamentos , Femenino , Granuloma Piogénico/economía , Humanos , Inyecciones Intralesiones , Masculino , Persona de Mediana Edad , Polidocanol/efectos adversos , Polidocanol/economía , Recurrencia , Soluciones Esclerosantes/efectos adversos , Soluciones Esclerosantes/economía , Escleroterapia/efectos adversos , Escleroterapia/economía , Adulto Joven
4.
Eur J Vasc Endovasc Surg ; 61(1): 128-135, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32778489

RESUMEN

OBJECTIVE: The aim of this study was to compare the effectiveness and safety of two sclerosing agents used to treat telangiectasias in the lower limbs: 0.2% polidocanol + 70% hypertonic glucose (HG) vs. 75% HG alone. METHODS: A prospective, randomised, triple blind, controlled, parallel group trial with patients randomly assigned in a 1:1 ratio between January and December 2015, with a two month follow up, from a single academic medical centre in Brazil, was carried out. Participants were women aged 18-65 years with telangiectasias on the lateral aspect of one thigh, classified as C1EpAsPn who underwent sclerotherapy in a single session with 0.2% polidocanol + 70% HG or 75% HG alone to treat the telangiectasias on an area limited by a rectangular template. The primary effectiveness endpoint was elimination of 75% of the telangiectasias within 60 days vs. the pre-treatment pattern. The length of vessels was measured on images obtained before and after treatment using ImageJ software. Safety outcomes were analysed immediately, 7 days, and 60 days after the treatment, and included pigmentation. RESULTS: A total of 115 patients were included, 98 of whom completed the study. Sclerotherapy with 0.2% polidocanol + 70% HG was significantly more effective than with 75% HG alone to treat telangiectasias in the target area (82.2% vs. 63.9%; p < .001); considering a minimum improvement of 75%, there was a 0.49 risk reduction (95% confidence interval 0.24-0.98; p = .047). No severe adverse events occurred in either group. Pigmentation was the most common minor adverse event and was significantly shorter in length in the group treated with 0.2% polidocanol + 70% HG (median 0 cm vs. 0.5 cm, respectively; p = .033). CONCLUSION: Polidocanol 0.2% plus 70% HG had better results than 75% HG alone in sclerosing telangiectasias. No severe adverse events occurred. Pigmentation occurred in both groups and was shorter in length in the group treated with 0.2% polidocanol + 70% HG.


Asunto(s)
Glucosa/uso terapéutico , Polidocanol/uso terapéutico , Soluciones Esclerosantes/uso terapéutico , Escleroterapia/métodos , Telangiectasia/tratamiento farmacológico , Adolescente , Adulto , Anciano , Método Doble Ciego , Quimioterapia Combinada , Femenino , Glucosa/administración & dosificación , Humanos , Persona de Mediana Edad , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Muslo/irrigación sanguínea , Adulto Joven
5.
Ann Vasc Surg ; 70: 501-505, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32889163

RESUMEN

BACKGROUND: The Tessari method, mixing air with the sclerosant through a 3-way tap and 2 syringes, is the most widely used method to prepare foam in foam sclerotherapy. Uniform foam with smaller bubbles has great clinical significance for venous insufficiency. We aim to modify the traditional 3-way tap to produce more uniform and stable foam with smaller bubbles. METHODS: The traditional 3-way tap was modified by inserting a porous film within its channel. EXPERIMENT DESIGN: the foam was prepared with 2 mL polidocanol plus 8 mL air plus 0.05 mL hyaluronic acid; group 1, foam prepared with 20 quick passes through a traditional 3-way tap; and groups 2-7, foam prepared using the modified 3-way tap, with 10, 12, 14, 16, 18, and 20 quick passes, respectively. The uniformity of the foam was observed under optical microscopy, and the size of bubbles quantified using the Nano measurement software. The stability of the foam was evaluated using the foam half-life time. RESULTS: The foam half-life times of groups 1-7 were 306.4, 257.4, 285.6, 304.4, 318.6, 330.2, 331.3 sec, respectively. The modified tap also produced a more uniform distribution of smaller bubbles (group 7) compared with traditional tap (group 1). CONCLUSIONS: Modified 3-way tap enhanced the stability of the sclerosant foam, with a more uniform distribution of smaller bubbles.


Asunto(s)
Polidocanol/química , Soluciones Esclerosantes/química , Escleroterapia/instrumentación , Estabilidad de Medicamentos , Diseño de Equipo , Semivida , Ensayo de Materiales , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Factores de Tiempo
6.
Dermatol Surg ; 47(6): 802-804, 2021 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-33625133

RESUMEN

BACKGROUND: Pyogenic granuloma (PG) is a benign vascular lesion that is commonly observed in the skin and mucosa. Sclerotherapy is the first-line conservative treatment option for PG. OBJECTIVE: This retrospective study aimed to evaluate the efficacy of sclerotherapy with 1.0% polidocanol for the treatment of PG. MATERIALS AND METHODS: All patients who were clinically diagnosed with PG consecutively at the Pediatric Outpatient Service of Qilu Children's Hospital of Shandong University from March 2018 to October 2019 received sclerotherapy with 1.0% polidocanol. RESULT: The procedure resulted in the complete excision of PG, with inconspicuous scars. The procedure was well-tolerated, and recurrence was not observed. Allergic reactions, cutaneous necrosis, and pigmentary changes were not observed. CONCLUSION: Sclerotherapy with 1.0% polidocanol is considered an effective treatment for PGs in children. Early treatment was associated with a more favorable outcome.


Asunto(s)
Granuloma Piogénico/terapia , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/métodos , Niño , Preescolar , Cicatriz/inducido químicamente , Cicatriz/diagnóstico , Femenino , Humanos , Lactante , Inyecciones Intralesiones/efectos adversos , Masculino , Polidocanol/efectos adversos , Recurrencia , Estudios Retrospectivos , Soluciones Esclerosantes/efectos adversos , Escleroterapia/efectos adversos , Índice de Severidad de la Enfermedad , Resultado del Tratamiento
7.
J Zoo Wildl Med ; 52(1): 117-125, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33827168

RESUMEN

The objective of this pilot study was to examine the histologic effects associated with three known sclerosing agents and their ability to induce fibrosis in the subcutaneous space between the cervicocephalic air sac and skin. In the future, these drugs may prove useful in treating birds experiencing cervicocephalic diverticula rupture. The agents used were 1% polidocanol, absolute ethanol, and doxycycline hyclate. Twelve healthy adult chickens (Gallus gallus domesticus) were used in this study. The chickens were randomly allocated into three groups denoting day of euthanasia (day 4, 7, or 14). On day 0, all agents were injected (0.2 ml) subcutaneously, in a four-point grid fashion, in both the cervical and pectoral region of each bird. After euthanasia, the skin and subcutaneous tissues corresponding to the injection sites were harvested for histologic assessment. Tissue sections were assessed for fibrosis and lymphocytic and histiocytic inflammation. A scoring system was established to rank sclerosing agents by fibrosing and inflammatory ability. In the cervical region of chickens, 1% polidocanol induced the greatest inflammatory changes by day 7. Data suggest that doxycycline hyclate may produce the greatest cutaneous and subcutaneous fibrosis overall among all groups of birds. No adverse reactions were associated with any injection. Sterile saline produced the least amount of inflammation when assessed with the scoring system. Further investigation is needed to determine the safety of injections of larger volume with these chemicals and whether these findings can be extrapolated to birds with disease.


Asunto(s)
Sacos Aéreos/patología , Pollos , Doxiciclina/farmacología , Etanol/farmacología , Polidocanol/farmacología , Animales , Doxiciclina/administración & dosificación , Quimioterapia Combinada , Etanol/administración & dosificación , Fibrosis/inducido químicamente , Fibrosis/veterinaria , Histiocitos , Inflamación/inducido químicamente , Inflamación/veterinaria , Linfocitos , Proyectos Piloto , Polidocanol/administración & dosificación , Enfermedades de las Aves de Corral/terapia , Rotura/terapia , Rotura/veterinaria , Soluciones Esclerosantes/administración & dosificación , Soluciones Esclerosantes/uso terapéutico , Piel/efectos de los fármacos , Piel/patología
8.
J Vasc Interv Radiol ; 31(4): 644-648, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-32146036

RESUMEN

PURPOSE: To demonstrate the feasibility of cystic duct embolization and chemical gallbladder ablation as an alternative to cholecystectomy in high-risk patients with calculous cholecystitis who were not candidates for surgery. MATERIALS AND METHODS: This prospective study included 10 patients with acute cholecystitis (7 males and 3 females) aged 70-91 years (average age, 81.6 years) between 2013 and 2019. A cholecystostomy catheter was inserted during the acute phase, followed by cystic duct coil embolization performed via the existing drainage tube tract. Once asymptomatic, 3% aethoxysklerol was injected into the gallbladder, and the drain was removed upon sonographic confirmation that the gallbladder remained contracted. Each phase of the procedure was performed with an interval of 2-3 weeks. Clinical, cholangiographic, and sonographic data were collected before and after drain removal at 1-month follow-up. RESULTS: Cystic duct embolization was technically successful in all patients, with no immediate post-procedure complications. Gallbladder ablation performed in 10 patients was technically successful in all of them (median follow-up, 11 months). One patient required repeat ablation at 14 months, and the prolonged biliary excretions of 1 other patient ceased only at 8 months. CONCLUSIONS: Cystic duct embolization with gallbladder ablation is a feasible procedure for patients in whom cholecystectomy is contraindicated.


Asunto(s)
Técnicas de Ablación , Colecistitis Aguda/terapia , Conducto Cístico , Embolización Terapéutica , Cálculos Biliares/terapia , Polidocanol/administración & dosificación , Técnicas de Ablación/efectos adversos , Anciano , Anciano de 80 o más Años , Colecistectomía/efectos adversos , Colecistitis Aguda/diagnóstico por imagen , Contraindicaciones de los Procedimientos , Conducto Cístico/diagnóstico por imagen , Embolización Terapéutica/efectos adversos , Estudios de Factibilidad , Femenino , Cálculos Biliares/diagnóstico por imagen , Humanos , Masculino , Polidocanol/efectos adversos , Estudios Prospectivos , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento
9.
Eur J Vasc Endovasc Surg ; 59(6): 1011-1018, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32063463

RESUMEN

OBJECTIVE: This study investigated the in vitro stability of a novel sclerosant, bleomycin polidocanol foam (BPF), for venous malformation (VM) sclerotherapy. METHODS: The study was designed with control groups treated with polidocanol (0.5%, 1%, and 3%) only. The experimental groups included 21 BPFs, which was made by dissolving bleomycin at seven different concentrations (0.1%-1.5%) in polidocanol (0.5%, 1%, and 3%). The Tessari method was used to prepare sclerosant foam with a liquid:gas ratio of 1:4 at room temperature in vitro. The foam stability was measured for each group. The decay process, one component of foam stability, was recorded with a camera. Foam decay process experiments were performed 10 times per group. The stability indices included drainage rate, drainage time, half life, and microscopic measurement of the foams (mean bubble diameter, minimum and maximum bubble diameters, wall thickness, and bubble diameter distribution). RESULTS: Compared with the control groups, the half lives of BPFs mainly increased significantly with the addition of bleomycin (p < .001). BPF with 3% polidocanol and 0.1% bleomycin recorded the highest half life (246 ± 1.6 sec), and this group also achieved the smallest bubble diameter and wall thickness (69.9 µm and 5.80 µm) among the experimental groups. For the same polidocanol concentration, the bubble diameter and wall thickness increased when bleomycin was added. CONCLUSION: Bleomycin concentrations account for different BPF stability. BPF stability mainly increased significantly with the addition of a small amount of bleomycin but this advantage was no longer apparent with increasing bleomycin dose.


Asunto(s)
Bleomicina/química , Polidocanol/química , Soluciones Esclerosantes/química , Escleroterapia/métodos , Malformaciones Vasculares/terapia , Bleomicina/administración & dosificación , Combinación de Medicamentos , Estabilidad de Medicamentos , Humanos , Polidocanol/administración & dosificación , Venas/anomalías
10.
Dermatol Surg ; 46(12): 1715-1720, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32947299

RESUMEN

BACKGROUND: Foam sclerotherapy is a common treatment of lower extremity reticular veins. The effect of different liquid-gas ratios on foam stability and efficacy has been controversial. OBJECTIVE: To evaluate the use of 2 different polidocanol (POL) to air ratios for the treatment of reticular veins of the lower extremities. METHODS AND MATERIALS: Patients with lower extremity reticular veins were randomized to foam sclerotherapy with POL mixed with 4 mL of room air for one lower extremity or 2 mL for the other lower extremity. All telangiectasias were treated with glycerin immediately after treatment of the reticular veins. Adverse events (AEs) and efficacy were evaluated by both subject and blinded investigator. RESULTS: Thirty subjects completed the study. No statistically significant difference was seen in AEs between the 2 different POL to air ratios by subject questionnaire and blinded investigator scores at all time points. Subjects and blinded investigator reported a mean improvement between 0% and 50% at Day 21 and 26% to 75% at Day 90, which was not significantly different between groups. CONCLUSION: Two different POL to air ratios, 1:2 versus 1:4, were similarly safe and efficacious for the treatment reticular veins of the lower extremities.


Asunto(s)
Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/métodos , Enfermedades Vasculares/terapia , Venas/efectos de los fármacos , Adulto , Anciano , Aire , Método Doble Ciego , Composición de Medicamentos/métodos , Femenino , Humanos , Inyecciones Intravenosas , Extremidad Inferior/irrigación sanguínea , Persona de Mediana Edad , Polidocanol/efectos adversos , Polidocanol/química , Estudios Prospectivos , Soluciones Esclerosantes/efectos adversos , Soluciones Esclerosantes/química , Resultado del Tratamiento
11.
Dermatol Surg ; 46(12): 1712-1714, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-32769523

RESUMEN

BACKGROUND: Foam sclerotherapy is an effective treatment strategy for venous malformations. Both polidocanol (POL) and bleomycin are effective sclerosants; however, no studies have reported POL-bleomycin foam. OBJECTIVE: To introduce a method for producing POL-bleomycin foam and evaluate the stability of POL-bleomycin foam with bleomycin concentrations. MATERIALS AND METHODS: Group A: 2 mL of 1% POL + 8 mL of air; Group B: 2 mL of 1% POL + 3 U bleomycin + 8 mL of air; Group C: 2 mL of 1% POL + 6 U bleomycin + 8 mL of air; Group D: 2 mL of 1% POL + 12 U bleomycin + 8 mL of air. Tessari method was used for foam generation. The foam half-life time (FHT) was used to evaluate foam stability. Five recordings were made for each group. RESULTS: The FHT was 148.6 ± 2.9 seconds in Group A, 148.8 ± 4.0 seconds in Group B, 148.4 ± 2.6 seconds in Group C, and 148.8 ± 1.6 seconds in Group D. The FHT in different groups showed no significant differences. CONCLUSION: The POL-bleomycin foam was prepared successfully and its FHT was as long as the POL foam.


Asunto(s)
Bleomicina/química , Composición de Medicamentos/métodos , Polidocanol/química , Soluciones Esclerosantes/química , Malformaciones Vasculares/terapia , Bleomicina/administración & dosificación , Combinación de Medicamentos , Estabilidad de Medicamentos , Semivida , Humanos , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/métodos , Venas/anomalías , Venas/efectos de los fármacos
12.
Dermatol Surg ; 46(12): 1514-1518, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33252459

RESUMEN

BACKGROUND: Venous malformations (VM) are common vascular malformations. Percutaneous injection of sclerosants into the lesion has become mainstream therapy. The most commonly used sclerosants are ethanol, polidocanol, bleomycin, and the like. But few articles have reported that sclerosants are more effective and safer. METHODS: We performed a search on Cochrane, Embase, PubMed, China National Knowledge Infrastructure, CBM, and Wan Fang databases of Controlled Trials (from January 1, 2010, launch up to April 10, 2019) reporting outcome of intralesional ethanol, polidocanol, and bleomycin injections in patients with VM (n ≥ 20). A meta-analysis was conducted using Rev-man 5.3 software. RESULTS: A total of 9 articles, 632 participants and 676 lesions were included. Quality of evidence was generally low. Meta-analysis showed that absolute ethanol treatment was better than polidocanol in treating VM (p = .001), and absolute ethanol elicited a better response than bleomycin (p = .01). Ethanol therapeutic effect was not statistically significant compared with ethanol alone (p = .07), but the combination effect was better than polidocanol (p = .04). Ethanol treatment showed significantly more adverse reactions than polidocanol and combination therapy. CONCLUSION: Absolute ethanol combined with polidocanol is more effective in treating VM and has fewer adverse reactions.


Asunto(s)
Etanol/administración & dosificación , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Malformaciones Vasculares/tratamiento farmacológico , Venas/anomalías , Bleomicina/administración & dosificación , Bleomicina/efectos adversos , Quimioterapia Combinada/efectos adversos , Quimioterapia Combinada/métodos , Etanol/efectos adversos , Humanos , Inyecciones Intravenosas , Polidocanol/efectos adversos , Ensayos Clínicos Controlados Aleatorios como Asunto , Soluciones Esclerosantes/efectos adversos , Resultado del Tratamiento , Venas/efectos de los fármacos
13.
Dermatol Surg ; 46(2): 249-257, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31569112

RESUMEN

BACKGROUND: Varicose veins are common clinical entities. Foam sclerotherapy is a minimally invasive and simple procedure; however, the side effects, efficacy, and stability of sclerosing foam are not ideal. OBJECTIVE: To summarize the current studies on sclerosing foam stability and promote foam sclerotherapy development. MATERIALS AND METHODS: We reviewed the literature before June 2018 and included only representatives studies on sclerosing foam stability. We summarized the foam half-life time (FHT) of polidocanol (POL) under 17 preparation conditions and the FHT of sodium tetradecyl sulfate under 21 preparation conditions. The preparation conditions included various combinations of temperature, liquid-gas ratio, preparation method, etc. RESULTS: The FHT of POL varied between 40 and 4,000 seconds under different conditions. The FHT of sodium tetradecyl sulfate varied from 25.7 to 390 seconds. The higher the drug concentration, the lower the temperature required to increase foam stability. The addition of surfactant greatly increased foam stability. For different gas compositions, the FHT sequence was as follows: CO2 < CO2 + O2 < O2 < air. CONCLUSION: Foam stability can be improved by changing the preparation conditions; therefore, the role of surfactants and predictive methods for FHT are worth investigating further.


Asunto(s)
Gases/farmacocinética , Soluciones Esclerosantes/farmacocinética , Escleroterapia/métodos , Tensoactivos/farmacocinética , Várices/terapia , Composición de Medicamentos/métodos , Estabilidad de Medicamentos , Gases/administración & dosificación , Gases/química , Semivida , Humanos , Inyecciones Intravenosas , Polidocanol/administración & dosificación , Polidocanol/química , Polidocanol/farmacocinética , Soluciones Esclerosantes/administración & dosificación , Soluciones Esclerosantes/química , Tetradecil Sulfato de Sodio/administración & dosificación , Tetradecil Sulfato de Sodio/química , Tetradecil Sulfato de Sodio/farmacocinética , Tensoactivos/administración & dosificación , Tensoactivos/química , Temperatura , Factores de Tiempo
14.
Khirurgiia (Mosk) ; (5): 87-92, 2020.
Artículo en Ruso | MEDLINE | ID: mdl-32500695

RESUMEN

OBJECTIVE: To evaluate the results of treatment of recurrent nodular goiter using sclerotherapy with polidocanol. MATERIAL AND METHODS: A comparative analysis of sclerotherapy (30 patients) and conventional surgical treatment (17 patients) of recurrent goiter was performed. RESULTS: Sclerotherapy ensures reduction of nodes (linear dimensions of nodes decreased by 14.2±1.1 mm after 3 courses), correction of endocrine imbalance in patients with functional autonomy and relief of initial signs of cervical organ compression in all patients with recurrent goiter. Sclerotherapy is associated with less pain syndrome and no need for inpatient treatment. However, the most significant advantage is reduced risk of complications. Hypoparathyroidism and laryngeal paresis developed in 53 and 24% of patients after conventional surgery while these events were not observed after sclerotherapy. CONCLUSION: Sclerotherapy with polidocanol is a perspective alternative to conventional surgery for recurrent nodular goiter.


Asunto(s)
Bocio Nodular/terapia , Polidocanol/administración & dosificación , Soluciones Esclerosantes/administración & dosificación , Bocio Nodular/cirugía , Humanos , Recurrencia , Escleroterapia/métodos , Tiroidectomía
16.
Ann Vasc Surg ; 59: 231-236, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-31009711

RESUMEN

BACKGROUND: The procedure aims to show our results with a novel nontumescent, nonthermal technique to treat varicose veins. The V-block occlusion stent is a minimally invasive device for treating reflux of the great saphenous vein (GSV). It is an office-based procedure that does not require tumescence anesthesia. The V-block stent is a self-expandable device that functions as a vein occluder and blood clot trap. Once the V-block is in place, further treatment of the saphenous vein such as ultrasound-guided sclerotherapy can be performed. The V-block device is intended to eliminate the possibility of forwarding passage of clot and sclerosant (embolization) to the deep and pulmonary circulations. METHODS: Patients were treated in an outpatient setting with the V-block occluding device. Follow-up was performed using duplex ultrasound to assess occlusion of the saphenous vein as well as the Aberdeen Varicose Vein Questionnaire and Venous Severity Scoring to determine changes in quality of life after the procedure. Patients were followed up at 1 week, 1 month, and 3 months after V-block placement. Duplex scanning was performed to confirm GSV occlusion at all follow-up visits. After deployment of the occlusion stent, a maximum of 2% polidocanol foam was injected with a double barrel syringe which simultaneously evacuated blood from the greater saphenous vein. Follow-up assessment for safety included evaluation of potential complications, device migration, and potential injury at the deployment site. RESULTS: Fifty-one symptomatic subjects with documented GSV reflux were enrolled in the study. Complete occlusion of the GSV was achieved in 98% of the patients during the 7-day postprocedural visit. There was no injury at the deployment site. No migration of the V-block device was observed. No deep vein thrombosis or any other complication was recorded. One patient of the 50 patients and 51 procedures experienced an adverse event, phlebitis that resolved under conservative therapy within 4 days with no residual effect. There was a significant improvement in the Aberdeen Vein quality of life measurements and the pain scores. After 3 years, 18 patients were willing to undergo a duplex follow-up examination. The occlusion rate after 3 years was 77.8. There were no device-related complications after this period. CONCLUSIONS: The study demonstrated a good safety and performance profile without any major adverse events. The primary end point of vein occlusion and obliteration was met.


Asunto(s)
Procedimientos Endovasculares/instrumentación , Polidocanol/administración & dosificación , Vena Safena , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/instrumentación , Stents , Várices/terapia , Anciano , Procedimientos Endovasculares/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Polidocanol/efectos adversos , Diseño de Prótesis , Calidad de Vida , Estudios Retrospectivos , Vena Safena/diagnóstico por imagen , Vena Safena/fisiopatología , Soluciones Esclerosantes/efectos adversos , Escleroterapia/efectos adversos , Encuestas y Cuestionarios , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía Doppler Dúplex , Ultrasonografía Intervencional , Várices/diagnóstico por imagen , Várices/fisiopatología
17.
J Cutan Med Surg ; 23(5): 528-536, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31167547

RESUMEN

Itch treatment is a major challenge in the dermatologist's practice. We encounter patients suffering from pruritus on a regular basis, and often lack diverse treatment options to adequately respond to the patients' needs. In the last 20 years, novel pathways have been investigated that were beyond the scope of histamine. Although most did not result in a molecule available on the Canadian market, it is interesting and important as health care providers to stay up to date with new neuronal pathways involved in itch transmission and potential new therapeutic options. In this review, we will discuss pathways targeted in new topical treatments such as antagonist of proteinase-activated receptor-2, the endocannabinoid system, neurotrophins and tropomyosin-related kinase A receptor, the transient receptor potential-vanilloid or transient receptor potential-melastatine ion channels. New systemic therapies are now focusing on antagonizing the neurokinin receptor, modulating the opioidergic system, or targeting itch cytokines such as interleukin-31.


Asunto(s)
Antagonistas de Narcóticos/uso terapéutico , Prurito/tratamiento farmacológico , Prurito/metabolismo , Administración Cutánea , Animales , Aprepitant/uso terapéutico , Capsaicina/administración & dosificación , Endocannabinoides/administración & dosificación , Humanos , Interleucinas/antagonistas & inhibidores , Interleucinas/metabolismo , Mentol/administración & dosificación , Factor de Crecimiento Nervioso/antagonistas & inhibidores , Antagonistas del Receptor de Neuroquinina-1/uso terapéutico , Polidocanol/administración & dosificación , Receptor PAR-2/antagonistas & inhibidores , Receptor trkA/antagonistas & inhibidores , Canales Catiónicos TRPM/agonistas , Canales Catiónicos TRPV/agonistas
18.
Lasers Med Sci ; 34(7): 1325-1332, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-30707327

RESUMEN

Sclerotherapy continues to be the treatment of choice for varicose veins in the legs. However, isolated treatment using microfoam or lasers requires a high number of sessions to eliminate them. In 2013, we published results about the efficacy and safety 3 years after the combined treatment with microfoam injections and subsequent application of Nd:YAG laser. The aim of this paper is to clinically evaluate the treatment of varices in a control visit after 5 years, when polidocanol microfoam is used and is immediately irradiated in the tissue with 1064-nm Nd:YAG laser beam. The outcome persistence after 5 years was studied in the legs that had received combined treatment and had been studied 3 years after treatment. Patients were contacted by phone, interviewed, and examined with echo-Doppler. Out of the 259 patients who were contacted, 221 agreed to make the appointment, although in the end, only 202 came, which meant analysing 404 legs. At 5 years, the clearance rates were very high: patients were included in class CEAP C1 showing vessels of from 0.5 to 3 mm diameter. The patients showed a high level of satisfaction. Regarding adverse effects, only 4 cases of hypopigmentation described in the previous publication persisted. Although the action mechanisms between the microfoam and the Nd:YAG laser must still be elucidated, it is notable that combining microfoam with laser exposure obtained a complete, effective treatment of legs in only 2 sessions, with high clearance rates and high level of satisfaction among patients.


Asunto(s)
Láseres de Estado Sólido , Pierna/patología , Polidocanol/administración & dosificación , Polidocanol/uso terapéutico , Várices/tratamiento farmacológico , Várices/cirugía , Terapia Combinada , Femenino , Humanos , Láseres de Estado Sólido/efectos adversos , Persona de Mediana Edad , Satisfacción del Paciente , Polidocanol/efectos adversos , Soluciones Esclerosantes/uso terapéutico , Escleroterapia/efectos adversos , Resultado del Tratamiento
19.
Vet Ophthalmol ; 22(3): 374-380, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-30716202

RESUMEN

OBJECTIVE: To describe the efficacy of the sclerosing agent 1% polidocanol in the treatment of a suspected nasolacrimal duct cyst in a dog. ANIMAL STUDIED: A 5-year-old castrated male Golden Retriever with chronic epiphora of the right eye. PROCEDURES: Ocular examination revealed epiphora and a negative Jones test of the right eye and was otherwise normal. Computed tomography with dacryocystography confirmed a cystic structure in the right ventral orbit that extended into the caudal nasal cavity adjacent to the orbit, causing partial physical obstruction of the right nasolacrimal duct. Cytologic analysis of fluid from the lesion was supportive of a diagnosis of a cyst. One percent polidocanol (compounded, People's Custom Rx, Memphis, TN) was injected into the cyst. RESULTS: Epiphora was resolved by two weeks post-injection. Repeated computed tomography with dacryocystography was performed 8 months post-injection, revealing complete resolution of the cyst and demonstrating mild enophthalmos of the right globe. CONCLUSIONS: Intralesional 1% polidocanol therapy was successful in resolving a suspected nasolacrimal duct cyst in a dog.


Asunto(s)
Quistes/veterinaria , Enfermedades de los Perros/diagnóstico , Obstrucción del Conducto Lagrimal/veterinaria , Conducto Nasolagrimal , Soluciones Oftálmicas/uso terapéutico , Polidocanol/uso terapéutico , Animales , Quistes/diagnóstico , Diagnóstico Diferencial , Enfermedades de los Perros/diagnóstico por imagen , Enfermedades de los Perros/tratamiento farmacológico , Perros , Obstrucción del Conducto Lagrimal/diagnóstico , Masculino , Soluciones Oftálmicas/administración & dosificación , Polidocanol/administración & dosificación , Tomografía Computarizada por Rayos X/veterinaria
20.
J Oral Pathol Med ; 47(9): 895-899, 2018 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-29998466

RESUMEN

OBJECTIVES: Mucocele of the minor salivary gland is usually caused when the duct is injured, mucus leaks into the tissue space and the mucous gland are obstructed, which lead to cystic lesion formation and dilatation. Currently, there are multiple therapeutic methods available with various outcomes. This study aims to provide clinical evidence of polidocanol sclerotherapy for the treatment of mucocele of the minor salivary gland. METHODS: In this study, we injected polidocanol into 112 patients who were diagnosed with mucocele of the minor salivary gland and evaluated the treatment efficacy and safety systematically. RESULTS: Of the 122 cases, 102 cases were cured, eight cases showed remarkable remission, and two cases had partial remission. No recurrence was found during follow-up, and none of the cases showed an invalid effect, resulting in a total cure rate of 91.07%. No severe side effects were observed during treatment or the follow-up period. No significant difference in efficacy between different genders was found (P = 0.490). Polidocanol sclerotherapy for mucocele on the lower lip was more effective compared to mucocele on the inferior surface of the lingual apex (P = 0.035). CONCLUSION: Polidocanol sclerotherapy showed satisfying curative effects for mucocele of the minor salivary gland without causing side effects of anesthesia, trauma, or severe pain.


Asunto(s)
Mucocele/terapia , Polidocanol/administración & dosificación , Glándulas Salivales Menores , Soluciones Esclerosantes/administración & dosificación , Escleroterapia/métodos , Adolescente , Adulto , Anciano , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento , Adulto Joven
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