Mesotherapy: Safety profile and management of complications.

BACKGROUND: Mesotherapy is a procedure that involves the injection of active substances into the dermis and subcutaneous tissue in order to treat several local medical and cosmetic conditions. Despite being considered as a relatively safe method, a series of adverse reactions can occur due to its wide application and lack of standardization processes. OBJECTIVES: The aim of this paper is to summarize all the mesotherapy-related complications published so far, and to provide an insight into their management. PATIENT/METHODS: Articles derived from the databases, PubMed, EMBASE, and SCOPUS, and published between 1992 and 2018, were analyzed for this review. The study was conducted according to the PRISMA guidelines. RESULTS: In this literature, there is a number of case series and isolated case reports describing various side effects of different severities. The therapeutic management of these complications is-in most cases-individualized. CONCLUSIONS: Larger systematic studies are needed in order to adequately evaluate the safety profile of mesotherapy, and in order to determine standardized therapy parameters, so as to minimize the risk of potential adverse reactions.

Características y calidad de la sangre autóloga recuperada del campo quirúrgico durante cirugía de escoliosis en pediatría / Characteristics and quality of intra-operative cell salvage in paediatric scoliosis surgery

Objetivos. Determinar las características hematológicas y microbiológicas de la sangre recuperada mediante el uso de un recuperador celular con campana centrifugadora pediátrica rígida (100 ml) en cirugía de escoliosis en pediatría y comprobar si se ajusta al estándar esperado en el paciente adulto. Material y método. Estudio de cohorte transversal, descriptivo, sobre 24 unidades consecutivas de sangre recuperada del campo quirúrgico procesadas mediante un recuperador de sangre modelo Haemolite® 2+ (Haemonetics Corp., Braintree, MA, EE. UU.). Se recogieron los datos referentes a edad, peso, abordaje (anterior o posterior) de la cirugía de escoliosis, volumen procesado y volumen de concentrado de hematíes (CH) autógeno recuperado, hemograma y hemocultivo del concentrado obtenido y la incidencia de fiebre tras la reinfusión. Resultados. El volumen procesado fue muy escaso (939 ± 569 ml) con gran variabilidad (coeficiente de variación = 0,6), a diferencia del volumen recuperado 129 ± 50 ml (coeficiente de variación = 0,38). Se estableció correlación estadísticamente significativa entre el volumen procesado y el hematocrito del CH recuperado (Pearson, r = 0,659; p = 0,001) que fue menor del esperado. Los parámetros hematológicos más relevantes de los concentrados recuperados fueron: Hb 11 ± 5,3 g dl−1; HTO: 32,1 ± 15,4%; leucocitos 5,34 ± 4,22 × 103 μl−1; plaquetas 37,88 ± 23,5 × 103 μl−1 (media ± DE). El hemocultivo del CH recuperado fue positivo en 13 casos (54,2%) en los que se aisló Staphylococcus coagulasa (−). Conclusiones. Los recuperadores celulares con campana centrifugadora de volumen fijo (incluso pediátrica) no obtienen la concentración esperada si se procesan bajos volúmenes, por lo que no son la mejor opción en el niño (AU)

Objective. To determine the haematological and microbiological characteristics of blood recovered by using a cell saver with a rigid centrifuge bowl (100 ml) in paediatric scoliosis surgery and to determine whether it conforms to the standard expected in adult patients. Material and methods. A cross-sectional, descriptive cohort study was performed on 24 consecutive red blood cell (RBC) units recovered from the surgical field and processed by a Haemolite® 2+ (Haemonetics Corp., Braintree, MA, EE. UU.) cell saver. Data were collected regarding age, weight, surgical approach (anterior or posterior), processed shed volume and volume of autologous RBC recovered, full blood count, and blood culture obtained from the RBC concentrate, and incidence of fever after reinfusion. Results. The processed shed volume was very low (939 ± 569 ml) with high variability (coefficient of variation = 0.6), unlike the recovered volume 129 ± 50 ml (coefficient of variation = 0.38). A statistically significant correlation between the processed shed volume and recovered RBC concentrate haematocrit was found (Pearson, r=.659, P=.001). Haematological parameters in the recovered concentrate were: Hb 11 ± 5.3 g dl−1; haematocrit: 32.1 ± 15.4% (lower than expected); white cells 5.34 ± 4.22 × 103 ul−1; platelets 37.88 ± 23.5 × 103 ul−1 (mean ± SD). Blood culture was positive in the RBC concentrate recovered in 13 cases (54.2%) in which Staphylococcus coagulase (−) was isolated. Conclusions. Cell salvage machines with rigid centrifuge bowls (including paediatric small volume) do not obtain the expected haematocrit if low volumes are processed, and therefore they are not the best choice in paediatric surgery (AU)

Thermotherapy, chemotherapy, and meristem culture in banana.

Bananas that provide a staple food to the millions of people are adversely affected by several viruses such as Banana bunchy Top Virus (BBTV), Banana Streak Virus (BSV), and Cucumber Mosaic Virus (CMV). These viruses are known to have a devastating effect on crop production and constraint to the international exchange and conservation of banana germplasm-a cornerstone for breeding new cultivars. The viruses are particularly problematic in vegetative propagated crops, like bananas, because of their transmission in the planting material. Different virus eradication techniques have been developed, such as thermotherapy, chemotherapy, and meristem culture for providing virus-free planting material. Meristem culture proved to be the most effective procedure to eradicate phloem-associated viruses. This method requires isolation of meristematic dome of plant under the aseptic conditions and culture in an appropriate nutrient medium to develop new virus-free plants. Thermotherapy is another widely used virus eradication technique, which is initially carried out on in vivo or in vitro plants and eventually combined with meristem culture technique. The plantlets are initially grown at 28°C day temperature and increase it by 2°C per day until reaches 40°C and the night temperature at 28°C; maintain plants at 40°C for 4 weeks; excise meristem and culture onto the regeneration medium. In chemotherapy technique, antiviral chemical compound Virazole(®) is applied on meristem culture. Combination of these techniques is also applied to improve the eradication rate.

Comparação da resistência de cimentos restauradores provisórios utilizados em Endodontia / Comparison of compressive strength of different temporary filling materials used on root canal treatment

O selamento provisório da abertura coronária, entre sessões do tratamento endodôntico, éum procedimento de rotina e de suma importância para o sucesso do tratamento, no qualdeve possuir características tais como resistência e bom selamento periférico entre outras.Este trabalho avaliou in vitro a resistência de diferentes cimentos restauradores provisóriosutilizados em Endodontia - Cimpat Branco, Cimpat Rosa, Villevie, Tempore, IRM, Citodure Coltosol. Para referida pesquisa foram confeccionados através de uma forma feita emsilicona, três corpos de prova de cada material totalizando uma amostragem de 21 corpos.Todos os cimentos foram encubados em 37°C a 100% de umidade por 7 dias. As amostrasforam levadas para uma prensa de compressão simples e através do cálculo se obtevea força máxima de resistência. Os resultados obtidos mostraram que houve diferençaestatisticamente significante ao nível de 5% entre os cimentos testados, sendo que o IRMapresentou o melhor resultado, e o Tempore demonstrou o pior resultado de resistência.

The temporary sealing of the coronary opening among sessions of the endodontic treatmentis a routine procedure and important pace for the success of the treatment, where itneeds to have characteristics such as compressive strength and good sealing ability andothers. This in vitro study evaluated the compressive strength of different temporary fillingmaterials used on root canal treatment - white Cimpat, pink Cimpat, Villevie, Tempore,IRM, Citodur and Coltosol. It was made a form to prepare 3 samples of each material,resulting 21 samples, what were incubed at 37°C in 100% humidity for 7 days. After period,the samples were put in a machine of simple compression, through a formula resulted tocompressive strength. The results showed statistical difference between groups (á<0.05).IRM showed better result, and Tempore showed worst result.

Avaliação da capacidade de descontaminação da terapia fotodinâmica no pós-operatório imediato de implantes: estudo piloto / Efficiency of photodynamic therapy in the immediate postoperative of dental implants: pilot study

Em todo ato cirúrgico para instalação de implanttes dentários ocorre uma contaminação inerente ao procedimento que pode prejudicar a cicatrização. Este projeto foi proposto para encontrar uma forma de reduzir a microbiota da área peri-implantar com a terapia fotodinâmica (PDT, do inglês photodynamic therapy). Após triagem (critérios de inclusão: normorreativos, com espaço intercalar superior, sem histórico de doença periodontal grave), cinco pacientes foram selecionados e reabilitados com implantes Standard Plus da Straumann®. Ao término da cirurgia, uma primeira coleta microbiológica peri-implantar foi efetuada (controle). Aplicou-se o corante azul de metileno a 0,005% por 5 minutos. Em seguida, a área peri-implantar foi irradiada com laser diodo de baixa potência (AsGaAl, 660 nm, 40mW), por 2 minutos, totalizando 120 J/cm(2) de densidade de energia, dividida em 4 pontos (2 na vestibular e 2 na palatina). Ao término da PDT, outra coleta microbiológica foi realizada (teste). Todo o material coletado passou pelo seguinte processo: diluições seriadas; semeadura em meios de cultura; incubação em meio anaeróbio por sete dias e contagem do número de unidades de colônias totais (UFC). O teste estatístico de Wilcoxon mostrou haver diferença significante (p < 0,001) na redução bacteriana para as UFC, tendo como mediana dessa redução 93,67%. Os resultados permitem afirmar que a PDT é um método eficaz de descontaminação da área cirúrgica no pós-operatório imediato de implantes dentários.

Microbial control: the first stage of root canal treatment.

The critical step for successful treatment of an infected root canal system is to treat the root canal in such a way as to remove as many microbes as possible (in the case of a necrotic tooth) or to maintain the sterility of the canal (in the case of a vital tooth); this is called the microbial control phase of root canal treatment. This article describes the steps required for adequate microbial control. The rationale for minimal apical file sizes and irrigation and antimicrobial medicaments required are described in detail.

Efectividad de la asepsia con cloruro de benzalconio vs. el uso de agua y jabón en la prevención de la onfalitis neonatal. Hospital de Apoyo José Alfredo Mendoza Olavarría. Tumbes 2006 / Effectiveness of aseptic benzalkonium chloride vs. using soap and water in preventing neonatal omphalitis. Hospital de Apoyo Jose Alfredo Mendoza Olavarria. Tumbes 2006

Objetivo: demostrar que la asepsia con cloruro de benzalconio es más efectiva que el uso de agua y jabón en la prevención de la onfalitis neonatal en el Hospital de Apoyo JAMO de Tumbes durante el período enero a abril del 2006. Métodos: estudio descriptivo, prospectivo, longitudinal y comparativo. Se incluyeron neonatos de ambos sexos, a término, de parto eutócico y cesárea, y se utilizó el muestreo no probabilístico de tipo accidental. El diseño fue de dos grupos, con sujetos aleatorizado y sólo con posprueba. Para la comparación de la efectividad del cloruro de benzalconio vs. El uso de agua y jabón se utilizaron las pruebas paramétricas Chi Cuadrado y t de Student. Resultados: ingresaron al estudio 84 neonatos; la mitad recibió asepsia con cloruro de benzalconio y el resto, con agua y jabón. Del total de la muestra, 82 neonatos no presentaron signos de onfalitis y sólo se evidenciaron dos casos, uno con cada tipo de antiséptico (2.4%). Sin embargo, no se encontró una relación significativa (p>0.05) entre la presencia de signos inflamatorios y el producto empleado para la asepsia. Asimismo, del total de la muestra (84 neonatos), cuatro presentaron la caída del cordón umbilical entre 3er y 5to día (uno con cloruro de benzalconio y tres con agua y jabón) mientras que a 78 neonatos se les desprendió el cordón umbilical entre el 6° y el 9° día y a dos neonatos pasados los diez días (un caso para cada antiséptico usado). Las pruebas estadísticas no mostraron relación significativa (p>0.05) entre el tiempo de caída del cordón umbilical y el tipo de antiséptico usado. Encontramos que al tasa de prevalencia de onfalitis fue de 2.38% y el tiempo promedio de aparición de los signos de onfalitis fue de cuatro días luego de utilizar ambos antisépticos.

[Management of acute wounds]. / Meist ist es mit ein paar Stichen getan.

Uncomplicated wounds can be treated immediately in the general practitioner's office. Management by a specialist is necessary only in the case of wounds involving the eyes, nose or mouth, or in the presence of other unusual features.

Achieving asepsis of banana leaves for the management of toxic epidermal necrolysis.

BACKGROUND: Banana leaf is used in many centers in India during the care of patients with toxic epidermal necrolysis (TEN) and other extensive blistering disorders. Sepsis is an important cause of death in TEN patients and use of banana leaf may be a source of such infection. AIMS: We conducted this study to detect the bacterial flora of the banana leaf and to examine various methods of rendering the leaf aseptic. METHODS: Five pieces of banana leaf, 2 x 2 cm in size, were cultured separately in blood agar as follows: One piece was heated over a flame and one was soaked in boiling water and one was autoclaved. Methylated spirit was applied over one piece and ignited. One piece was placed on the media, 'as is.' The Petri dishes were incubated examined after 48 h. RESULTS: All the pieces except the autoclaved specimen of the leaf grew coagulase-negative staphylococci (CONS) when aseptic precautions were not maintained and aerobic spore bearers when all aseptic measures were subsequently instituted during the procedure. CONCLUSION: We recommend measures to prevent possible transmission of bacterial infection by the leaf. Autoclaved and aseptically handled banana leaves may be used to reduce chance of infection in the treatment of TEN.

[Aiming toward the supply of aseptic drugs--up to acceptance of the first patient].

As the ageing society has come, a categorized medical function has been advanced. Therefore, an improvement of medical care service for home care patients has been requested. One of the services provided by community pharmacists was to visit patient to give drug management advice based on the medical insurance and homecare insurance guidelines. In 1994, the Ministry of Health and Welfare expressed a degree of pharmacist's involvement to share patient's concern and was described as "the maturity of pharmacy". At present, the third step in the division of labor in medical services has taken its root. Then, an effort to arrange the fourth step (supply of aseptic drugs) will be needed in the future. Clinical exercises by pharmacists, acquisition of aseptic preparation skills and maintenance of facilities like a clean room will be required because the supply of aseptic drugs will be the first experience for a pharmacy. Neighboring medical facilities have to be prepared for accepting a supply of aseptic drugs along with the pharmacy's preparation. This time, we could have had an opportunity to accept the HPN patient. So we would like to report our progress and challenge.

Consideraciones en torno al control ambiental de quirófanos / Considerations with regard to the environmental control of operating theatres

Partiendo de la situación existente en la industria farmacéutica por lo que se refiere a los ambientes controlados se revisa el estado de esta cuestión en quirófanos y se proponen procedimientos de diseño y control (AU)

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Evidence-based practice: tap water cleansing of leg ulcers in the community.

To establish and encourage wound management practices based on evidence, a Community Nursing Organization in metropolitan Adelaide began a series of research initiatives in 1997. Based on the results of a wound management survey, and through the processes of participatory action research with clinicians, many wound management practice changes were instigated throughout the Community Nursing Organization. One question remains unanswered: What is the evidence for the use of sterile saline or clean tap water for cleansing of leg ulcers in the community? In this paper we describe a project where we applied the three principles of planning, action and evaluation. Application of these principles enabled clinicians to collaborate in the search for evidence to support or refute tap water cleansing of leg ulcers. To conclude, we report on a pilot research project undertaken to obtain further evidence either to support or refute the use of tap water cleansing for leg ulcers in the community.

Poor quality of oocytes from Xenopus laevis used in laboratory experiments: prevention by use of antiseptic surgical technique and antibiotic supplementation.

BACKGROUND AND PURPOSE: Episodic phases of continuous poor-quality oocytes obtained from South American Clawed Frogs (Xenopus laevis) often are observed. In publications dealing with the surgical technique of oocyte removal, the frogs' robust constitution and resistance against infections provided by magainins are pointed out. For this reason, clean rather than sterile conditions for the surgical procedure are mostly recommended. However, in most instances, antibiotics are added to the buffer medium when in vitro experiments are performed using oocytes. METHODS: After a long phase of poor oocyte quality at our facility, involving oocytes that had been obtained by use of a "clean" surgical procedure, we subsequently cultured oocytes in a buffer medium containing the three antibiotics: penicillin G, gentamicin, and streptomycin. RESULTS: During DNA injection experiments, the oocytes developed black spots on their surface by postoperative day two. Pure culture of the gram-negative non-fermentative rod Pseudomonas fluorescens was obtained from the impaired oocytes; the isolate was resistant to the three antibiotics. By contrast, after aseptic surgical removal and culture of oocytes in buffer medium containing the antibiotics tetracycline and gentamicin, perfect oocytes without bacterial contamination were obtained. CONCLUSION: Whenever impaired oocyte quality is observed, microbial contamination should be considered as a possible cause.

[The specific activity of new drug forms of dibunol]. / Spetsificheskaia aktivnost' novykh lekarstvennykh form dibunola.

The specific activity of new drug forms (tablets, suppositories, ointments) of dubinal was studies on models of ischemic damage to the heart, toxic hepatitis, aseptic inflammation, damage to the skin and mucosa of the large intestine. It was found that the drug forms under study possessed a cardioprotective, hepatoprotective, anti-inflammatory, and wound-healing effect. This may serve as a prerequisite to their further clinical study.

Conversion of dietary phylloquinone to tissue menaquinone-4 in rats is not dependent on gut bacteria.

The ability of male rats to accumulate menaquinone-4 (MK-4) in tissues when fed a vitamin K-deficient diet supplemented with intraperitoneal phylloquinone (K) as the sole source of vitamin K for 14 d was assessed. In both conventionally housed controls and gnotobiotic rats, supplementation with the equivalent of 1500 microg vitamin K/kg diet increased (P < 0.001) tissue MK-4 concentrations above those of controls fed a vitamin K-deficient diet. MK-4 concentrations were approximately 5 ng/g (11 pmol/g) in liver, 14 ng/g in heart, 17 ng/g in kidney, 50 ng/g in brain and 250 ng/g in mandibular salivary glands of gnotobiotic rats. MK-4 concentrations in conventionally housed rats were higher than in gnotobiotic rats in heart (P < 0.01), brain (P < 0.01) and kidney (P < 0.05) but lower in salivary gland (P < 0.05). Cultures of a kidney-derived cell line (293) converted K to the expoxide of MK-4 in a manner that was dependent on both time of incubation and concentration of vitamin K in the media. A liver-derived cell line (H-35) was less active in carrying out this conversion. These data offer conclusive proof that the tissue-specific formation of MK-4 from K is a metabolic transformation that does not require bacterial transformation to menadione as an intermediate in the process.

Historical perspectives on health. Semmelweis: a lesson to relearn?

PIP: This paper focuses on the historical perspective on health based on Ignaz Phillipp Semmelweis's beliefs, which indicated that most hospital infections are spread manually by staff. A considerable body of circumstantial evidence supported this notion when Semmelweis, known as the "Father of Infection Control," studied the incidence of "puerperal fever", an acute febrile illness that attacked lying-in women. His study showed that the cause of puerperal fever was transmitted not only by way of cadaveric material but also by way of living organisms. The findings of the study led to his insistence that the procedure of handwashing with chlorinated lime should be routinely performed between examining different patients, thus preventing transfer of transient microorganisms to other patients. However, Semmmelweis's beliefs were largely ignored by many clinicians until recent work evidenced that the simple exercise of handwashing is not "practices de rigor" and demonstrated that hands could become contaminated from objects which have themselves been contaminated. This paper also presents the life, times, and family history of Semmelweis.^ieng