RESUMO
PURPOSE: To assess the efficacy and the safety of Glubran®2 n-butyl cyanoacrylate metacryloxysulfolane (NBCA-MS) transcatheter arterial embolization (TAE) for acute arterial bleeding from varied anatomic sites and to evaluate the predictive factors associated with clinical success and 30-day mortality. METHODS: A retrospective review of consecutive patients who underwent emergent NBCA-MS Glubran®2 TAE between July 2014 and August 2016 was conducted. Variables including age, sex, underlying malignancy, cardiovascular comorbidities, coagulation data, systolic blood pressure, and number of red blood cells units (RBC) transfused before TAE were collected. Clinical success, 30-day mortality, and complication rates were evaluated. Prognostic factors were evaluated by uni- and multivariate logistic regression analyses for clinical success, and by uni- and bivariate analyses after adjustment by bleeding sites for 30-day mortality. RESULTS: 104 patients underwent technically successful embolization with bleeding located in muscles (n = 34, 32.7%), digestive tract (n = 28, 26.9%), and viscera (n = 42, 40.4%). Clinical success rate was 76% (n = 79) and 30-day mortality rate was 21.2% (n = 22). Clinical failure was significantly associated with mortality (p < 0.0001). A number of RBC units transfused greater than or equal to 3 were associated with poorer clinical success (p = 0.025) and higher mortality (p = 0.03). Complications (n = 4, 3.8%) requiring surgery occurred only at puncture site. No ischemic complications requiring further invasive treatment occurred. Mean TAE treatment time was 4.55 min. CONCLUSIONS: NBCA-MS Glubran®2 TAE is a fast, effective, and safe treatment for acute arterial bleeding whatever the bleeding site.
Assuntos
Cianoacrilatos/uso terapêutico , Embolização Terapêutica/métodos , Hemorragia/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Angiografia , Artérias , Cianoacrilatos/efeitos adversos , Embolização Terapêutica/efeitos adversos , Óleo Etiodado/uso terapêutico , Feminino , Hemorragia/mortalidade , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
OBJECTIVE: Cyanoacrylate (CYA) injection is recommended for bleeding gastric varices (GV) but with significant adverse effects. Transesophageal endoscopic ultrasound-guided therapy of large GV with a combined coil and CYA injection has shown promising results. However, it is expensive and requires technical expertise. In this study, we aimed to compare the safety and efficacy of a new method with UCYA [undiluated CYA (UCYA) followed by lipiodol-diluated CYA (DCYA)] in the management of large bleeding GV. METHODS: Fifteen consecutive patients with bleeding from large GV (>1 cm) were prospectively treated with DCYA and another 15 patients treated with UCYA retrospectively. All patients in the DCYA group underwent thoracic computed tomography scan to identify glue embolism. RESULTS: Baseline characteristics were similar between the two groups. Rates of GV obliteration and rebleeding were 100% vs 93.3% (P = 0.309) and 6.7% vs 33.3% (P = 0.06) in the DCYA and UCYA groups, respectively. One patient in the UCYA group had needle fixation which led to fatal bleeding after forceful needle extraction. In DCYA group none had glue embolism. CONCLUSIONS: Both UCYA and DCYA are effective in treating bleeding from large GV. DCYA has lower rebleeding rates and tends to have fewer adverse events than UCYA injection, although the differences are not statistically significant. Large-sample-sized prospective randomized trials are required.
Assuntos
Cianoacrilatos/uso terapêutico , Varizes Esofágicas e Gástricas/tratamento farmacológico , Hemorragia Gastrointestinal/tratamento farmacológico , Adesivos Teciduais/uso terapêutico , Adulto , Cianoacrilatos/administração & dosagem , Cianoacrilatos/efeitos adversos , Esofagoscopia/métodos , Óleo Etiodado , Feminino , Gastroscopia/métodos , Hemostase Endoscópica/métodos , Humanos , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Estudos Retrospectivos , Escleroterapia/efeitos adversos , Escleroterapia/métodos , Adesivos Teciduais/administração & dosagem , Adesivos Teciduais/efeitos adversos , Tomografia Computadorizada por Raios XRESUMO
INTRODUCTION: Circumcision is the most commonly performed surgical procedures in male children. Maine is one of 18 states in the United States which does not pay for neonatal circumcisions. The aim of this study was to perform outcomes and cost analysis of a sutureless circumcision technique versus circumcision using sutures. Specifically, we evaluated Dermaflex (2-octyl cyanoacrylate, 2-OCA) surgical glue circumcision as a cost effective, faster, and safe alternative to traditional suture circumcision. MATERIALS AND METHODS: Our study was a non-randomized series. We collected the operative details prospectively, abstracted clinical outcomes retrospectively, and performed data analysis retrospectively. One hundred and twenty-six circumcisions were performed by two pediatric urologists over a 1 year period. Suture circumcisions were performed exclusively during the first 6 months, and 2-OCA glue circumcisions were performed during the second 6 months. Billing charges were analyzed to extrapolate variable costs between the two surgical procedures. The technique used to perform the sutureless circumcision was a modification of the standard sleeve technique, with the use of monopolar diathermy instead of scalpel, and application of 2-OCA glue to approximate tissue edges. RESULTS: From Jan 2013 to Jan 2014, 72 patients underwent circumcision with suture, and 54 patients underwent circumcision with 2-OCA glue. Mean age in the glue group was 61 months (range 8-202 months), and 50 months in the suture group (range 5-215 months), p = 0.19. All cases were performed under general anesthesia, as outpatient surgery. Mean operative cut time was 18.4 min for the glue group, and 28.6 min for the suture group (p < 0.01). The 10.2 min operative time difference translated to a $378 cost savings per glue circumcision case. Complication rates were not statistically significant between the two groups. CONCLUSION: The use of 2-OCA tissue adhesive for sutureless circumcision is an alternative to the standard technique. It results in faster operative times, with a significant cost savings, while maintaining comparable complication rates to the standard suture technique. This is a viable, less expensive surgical option for patients whose circumcisions are not covered by Medicaid.
Assuntos
Circuncisão Masculina/economia , Circuncisão Masculina/métodos , Cianoacrilatos/uso terapêutico , Adesivos Teciduais/uso terapêutico , Técnicas de Fechamento de Ferimentos , Adolescente , Criança , Pré-Escolar , Circuncisão Masculina/instrumentação , Redução de Custos , Análise Custo-Benefício , Cianoacrilatos/economia , Eletrocoagulação , Humanos , Lactente , Masculino , Duração da Cirurgia , Estudos Retrospectivos , Técnicas de Sutura/economia , Adesivos Teciduais/economia , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate the behavior of castor oil-derived polyurethane as a hemostatic agent and tissue response after abdominal aortic injury and to compare it with 2-octyl-cyanoacrylate. METHODS: Twenty-four Guinea Pigs were randomly divided into three groups of eight animals (I, II, and III). The infrarenal abdominal aorta was dissected, clamped proximally and distally to the vascular puncture site. In group I (control), hemostasis was achieved with digital pressure; in group II (polyurethane) castor oil-derived polyurethane was applied, and in group III (cyanoacrylate), 2-octyl-cyanoacrylate was used. Group II was subdivided into IIA and IIB according to the time of preparation of the hemostatic agent. RESULTS: Mean blood loss in groups IIA, IIB and III was 0.002 grams (g), 0.008 g, and 0.170 g, with standard deviation of 0.005 g, 0.005 g, and 0.424 g, respectively (P=0.069). The drying time for cyanoacrylate averaged 81.5 seconds (s) (standard deviation: 51.5 seconds) and 126.1 s (standard deviation: 23.0 s) for polyurethane B (P=0.046). However, there was a trend (P=0.069) for cyanoacrylate to dry more slowly than polyurethane A (mean: 40.5 s; SD: 8.6 s). Furthermore, polyurethane A had a shorter drying time than polyurethane B (P=0.003), mean IIA of 40.5 s (standard deviation: 8.6 s). In group III, 100% of the animals had mild/severe fibrosis, while in group II only 12.5% showed this degree of fibrosis (P=0.001). CONCLUSION: Polyurethane derived from castor oil showed similar hemostatic behavior to octyl-2-cyanoacrylate. There was less perivascular tissue response with polyurethane when compared with cyanoacrylate.
Assuntos
Cianoacrilatos/farmacologia , Hemostasia Cirúrgica/métodos , Hemostáticos/farmacologia , Poliuretanos/farmacologia , Adesivos Teciduais/farmacologia , Lesões do Sistema Vascular/cirurgia , Animais , Aorta Abdominal/efeitos dos fármacos , Aorta Abdominal/patologia , Aorta Abdominal/cirurgia , Óleo de Rícino/química , Cianoacrilatos/uso terapêutico , Modelos Animais de Doenças , Fibrose , Cobaias , Hemostáticos/uso terapêutico , Masculino , Teste de Materiais , Poliuretanos/uso terapêutico , Distribuição Aleatória , Reprodutibilidade dos Testes , Fatores de Tempo , Adesivos Teciduais/uso terapêutico , Resultado do Tratamento , Lesões do Sistema Vascular/patologiaRESUMO
Introducción El uso de adhesivos tisulares puede ser una alternativa a la sutura en la fijación de la malla, pero su experiencia clínica es muy limitada. Material y métodos Estudio prospectivo y descriptivo en un grupo de 35 pacientes con hernias inguinales operados mediante hernioplastia sin sutura (20 vía abierta y 15 vía endoscópica); la prótesis se fijó con adhesivo sintético (n-hexil-α-cianoacrilato). Este grupo se ha comparado con uno control operado mediante hernioplastia utilizando suturas. Todos los pacientes seguían protocolo de cirugía mayor ambulatoria. Se han registrado variables peri- y postoperatorias. El seguimiento se realizó a la semana, al mes, a los 6 meses y al año. Resultados No ha existido morbilidad asociada con el uso del adhesivo tisular. Durante una mediana de 15 meses no se han detectado complicaciones ni recurrencias. En la hernioplastia abierta el uso del adhesivo disminuye de forma significativa el tiempo quirúrgico (30min versus 62min, p=0,001), el dolor postoperatorio (de 2,4 a 4,5 a la semana, p < 0,001) y el consumo de analgésico (de 7 a 14 días, p < 0,001). En el abordaje laparoscópico se demuestran diferencias significativas a favor del adhesivo en el dolor (p=0,001 a las 24h) y consumo de analgésicos (p <0,001). El análisis económico demuestra un ahorro anual de 117.461,2 euros (sobre 460 hernias).Conclusión El uso de un adhesivo tisular sintético (n-hexil-α-cianocrilato) es seguro como medio de fijación en las hernioplastias no complejas en pacientes sin comorbilidad, con buenos resultados postoperatorios (AU)
Introduction: The purpose of this study was to analyse the relationship between preoperative serum levels of vitamin D and postoperative hypocalcaemia after total thyroidectomy. Material and methods: A prospective observational study was conducted on 113 patients treated by total thyroidectomy due to benign disease. Preoperative vitamin D serum levels and postoperative albumin-corrected calcium and parathormone (PTH) levels were determined. Sensitivity, specificity, positive predictive value and negative predictive value ofvitamin D and PTH levels, respectively, in the diagnosis of postoperative hypocalcaemia were calculated. Results: Hypocalcaemia was diagnosed in 44 (38.9%) patients. Vitamin D levels were signifi-cantly higher in the group of patients with normal postoperative calcium (median: 25.4 pg/mL; range: 4-60), compared to those who developed hypocalcaemia (median: 16.4 pg/mL; range: 6.3-46.9) (P = .001). Postoperative hypocalcaemia was more frequent in patients with vitamin D < 30 ng/mL (39/78) (50%), than among those with normal levels (5/35) (14.2%)(P = .001). Sensitivity, specificity, positive predictive value and negative predictive value were 88% and 68%, 43% and 82%, 50% and 71%, and 85% and 80% for vitamin D and PTH, respectively. Vitamin D and PTH showed independent prognostic values on the risk of hypocalcaemia. The OR associated with vitamin D < 30 ng/mL was 4.25 (95% CI: 1.31-13.78)(P = .016), and the OR of PTH < 13 pg/mL was 15.4 (95% CI: 4.83-49.1) (P < .001).Conclusion: Vitamin D deficiency is a risk factor of hypocalcaemia after total thyroidectomy for benign goitre. The vitamin D level provides independent prognostic information, which his complementary to that given by PTH (AU)
Assuntos
Humanos , Hérnia Inguinal/cirurgia , Herniorrafia/métodos , Adesivos Teciduais/uso terapêutico , Suturas , Cianoacrilatos/uso terapêutico , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , LaparoscopiaRESUMO
BACKGROUND: Dentin hypersensitivity (DH) is a painful, exaggerated response to normal stimuli, such as cold, sweetness, and brushing. The aim of the present controlled, randomized, double-masked, non-inferiority clinical trial is to evaluate the effectiveness of cyanoacrylate in the treatment of DH when compared to the application of low-intensity laser. METHODS: The study includes 434 sensitive teeth from 62 patients. A total of 216 teeth were treated with laser and 218 with cyanoacrylate. A numeric rating scale was used to record the parameters of pain related to the stimuli at baseline and after the treatment at intervals of 24 hours and 30, 90, and 180 days. RESULTS: Both groups had significant reductions in DH. However, there was no significant difference between the two groups ≤6 months. Intragroup analysis showed that the effect of cyanoacrylate obtained at 24 hours remained for 90 days in response to air-jet test and 30 days for cold-spray test. There was a statistically significant difference between all other intragroup comparisons at the time intervals (P <0.001). CONCLUSIONS: It was concluded that cyanoacrylate is as effective as low-intensity laser in reducing DH. In addition, it is a more accessible and low-cost procedure and can be safely used in the treatment of DH.
Assuntos
Cianoacrilatos/uso terapêutico , Sensibilidade da Dentina/tratamento farmacológico , Sensibilidade da Dentina/radioterapia , Terapia com Luz de Baixa Intensidade/métodos , Adesivos Teciduais/uso terapêutico , Adolescente , Adulto , Criança , Método Duplo-Cego , Feminino , Humanos , Lasers Semicondutores/uso terapêutico , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto JovemRESUMO
Root perforations may lead to a loss of integrity in the root and periodontium, violations of the biologic periodontal distance, and injuries to periodontal tissue. This study sought to analyze the effect of root canal biomechanical preparation on the microhardness and the marginal sealing ability of different materials used to treat root perforations. Standard root perforations were performed in 96 bovine incisors. The teeth were divided into four groups (n = 24), based on the material used to treat those teeth: Mineral trioxide aggregate (MTA) (Group 1), MTA protected with cyanoacrylate (Group 2), MTA protected with glass ionomer (GI) cement (Group 3), and castor oil bean (COB) cement (Group 4). After root perforations were closed, the root canals were prepared biomechanically and teeth were sectioned longitudinally. Microleakage and microhardness of sealed perforations were assessed; microleakage data were submitted to analysis of variance (ANOVA) testing, while microhardness data were submitted to Dunnet and Tukey tests (p < 0.05). Group 4 reported the lowest amount of microleakage (0.65 mm), followed by Group 3 (1.02 mm), Group 1 (1.14 mm), and Group 2 (1.30 mm); however, no difference was detected among the groups. Groups 1-3 demonstrated significantly higher microhardness values compared to COB. It was concluded that the chemical and mechanical agents used during root canal preparation did not affect the sealing procedures. Administering surface protection to MTA did not improve microhardness or sealing.
Assuntos
Colagem Dentária , Cavidade Pulpar/lesões , Materiais Restauradores do Canal Radicular/química , Compostos de Alumínio/química , Compostos de Alumínio/uso terapêutico , Animais , Fenômenos Biomecânicos , Compostos de Cálcio/química , Compostos de Cálcio/uso terapêutico , Óleo de Rícino/química , Óleo de Rícino/uso terapêutico , Bovinos , Cianoacrilatos/química , Cianoacrilatos/uso terapêutico , Cimentos Dentários/química , Cimentos Dentários/uso terapêutico , Infiltração Dentária/classificação , Combinação de Medicamentos , Corantes Fluorescentes , Cimentos de Ionômeros de Vidro/química , Cimentos de Ionômeros de Vidro/uso terapêutico , Dureza , Umidade , Teste de Materiais , Óxidos/química , Óxidos/uso terapêutico , Rodaminas , Materiais Restauradores do Canal Radicular/uso terapêutico , Preparo de Canal Radicular/métodos , Silicatos/química , Silicatos/uso terapêutico , Propriedades de Superfície , Temperatura , Fatores de TempoAssuntos
Embolização Terapêutica , Varizes Esofágicas e Gástricas/terapia , Hemostase Endoscópica , Meios de Contraste/uso terapêutico , Cianoacrilatos/uso terapêutico , Óleo Etiodado/uso terapêutico , Fluoroscopia , Gastroscopia , Humanos , Masculino , Pessoa de Meia-Idade , Derivação Esplenorrenal Cirúrgica/efeitos adversos , Adesivos Teciduais/uso terapêuticoRESUMO
BACKGROUND: Some of the disadvantages of calcium hydroxide Ca(OH) 2 as pulp-capping material are related to the inflammatory response, and its poor sealing ability. Cyanoacrylate glue was proposed in this study as pulp-capping agent because of its sealing ability, and diprogenta, on the other hand, was proposed because of its anti-microbial and anti-inflammatory effects. The aim of this study is to evaluate and compare the histopathological response of the pulp toward cyanoacrylate and diprogenta in direct pulp capping (DPC). MATERIALS AND METHODS: Cyanoacrylate, diprogenta, and calcium hydroxide were applied on 20 permanent teeth of 6 rabbits divided into four groups, each contains five teeth, as follow: G1: Diprogenta and calcium hydroxide. G2: Cyanoacrylate. G3: Diprogenta and cyanoacrylate. G4: Calcium hydroxide (control group). RESULTS: A remarkable dentin bridge formation was found in all groups. No pulp necrosis was found in any tooth of the four groups. Pathological reactions of the pulp were found in 25%, 40%, 20%, and 100% of groups 1, 2, 3, and 4, respectively. Differences between study and control groups were found statistically significant ( P < 0.05). CONCLUSION: All materials used in this study were biocompatible and suggested to be studied further on human teeth. These materials when used in combination with Ca(OH) 2 , may give better results.
Assuntos
Polpa Dentária/efeitos dos fármacos , Agentes de Capeamento da Polpa Dentária e Pulpectomia/uso terapêutico , Animais , Antibacterianos/uso terapêutico , Anti-Inflamatórios/uso terapêutico , Betametasona/análogos & derivados , Betametasona/uso terapêutico , Materiais Biocompatíveis/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Sulfato de Cálcio , Cianoacrilatos/uso terapêutico , Polpa Dentária/irrigação sanguínea , Capeamento da Polpa Dentária/métodos , Exposição da Polpa Dentária/terapia , Restauração Dentária Temporária , Dentina Secundária/efeitos dos fármacos , Combinação de Medicamentos , Gentamicinas/uso terapêutico , Hiperemia/etiologia , Pulpite/etiologia , Coelhos , Cicatrização/efeitos dos fármacos , Sulfato de ZincoRESUMO
BACKGROUND: Chronic pain may be a long-term problem related to mesh fixation and operative trauma after Lichtenstein hernioplasty. The aim of this study was to compare the feasibility and safety of tissue cyanoacrylate glue versus absorbable sutures for mesh fixation in Lichtenstein hernioplasty. METHODS: Lichtenstein hernioplasty was performed under local anaesthesia as a day-case operation in one of three hospitals. The patients were randomized to receive either absorbable polyglycolic acid 3/0 sutures (Dexon(®); 151 hernias) or 1 ml butyl-2-cyanoacrylate tissue glue (Glubran(®); 151 hernias) for fixation of lightweight mesh (Optilene(®)). Wound complications, pain, discomfort and recurrence were identified at 1 and 7 days, 1 month and 1 year after surgery. RESULTS: A total of 302 patients were included in the study. The mean(s.d.) duration of operation was 34(12) min in the glue group and 36(13) min in the suture group (P = 0·113). The need for analgesics was similar during the first 24 h after surgery. Five wound infections (3·4 per cent) were detected in the glue group and two (1·4 per cent) in the suture group (P = 0·448). The recurrence rate at 1 year was 1·4 per cent in each group (P = 1·000). The rates of foreign body sensation, acute and chronic pain were similar in the two groups. Logistic regression analysis showed that the type of mesh fixation did not predict chronic pain 1 year after surgery. CONCLUSION: Mesh fixation without sutures in Lichtenstein hernioplasty was feasible without compromising postoperative outcome. REGISTRATION NUMBER: NCT00659542 (http://www.clinicaltrials.gov).
Assuntos
Cianoacrilatos/uso terapêutico , Hérnia Inguinal/cirurgia , Dor Pós-Operatória/etiologia , Telas Cirúrgicas , Suturas , Adesivos Teciduais/uso terapêutico , Adulto , Idoso , Assistência Ambulatorial , Analgésicos/uso terapêutico , Anestesia Local , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Ácido Poliglicólico/uso terapêutico , Recuperação de Função Fisiológica , Recidiva , Resultado do TratamentoRESUMO
BACKGROUND: In children, endoscopic sclerotherapy and variceal ligation (EVL) are the most used techniques for the treatment of gastroesophageal variceal bleeding (VB). However, these techniques achieve poor results in cases of gastric variceal bleeding, and EVL is not applicable in young infants. OBJECTIVE: Our purpose was to evaluate the feasibility, efficacy, and safety of cyanoacrylate glue injection for the treatment of gastroesophageal varices in young infants. DESIGN: Single-center prospective study. PATIENTS: From 2001 to 2005, 8 young infants (Assuntos
Cianoacrilatos/uso terapêutico
, Varizes Esofágicas e Gástricas/terapia
, Esofagoscopia/métodos
, Hemorragia Gastrointestinal/terapia
, Escleroterapia/métodos
, Atresia Biliar/complicações
, Quimioterapia Combinada
, Embucrilato/uso terapêutico
, Esofagoscópios
, Estudos de Viabilidade
, Feminino
, Seguimentos
, Humanos
, Hipertensão Portal/complicações
, Hipertensão Portal/congênito
, Lactente
, Óleo Iodado
, Masculino
, Projetos Piloto
, Veia Porta
, Estudos Prospectivos
, Recidiva
, Retratamento
, Trombose/complicações
, Adesivos Teciduais/uso terapêutico
, Deficiência de alfa 1-Antitripsina/complicações
RESUMO
Peptic ulcer bleeding is the most significant complication of ulcer disease, remaining the most important reason for upper gastrointestinal bleeding even in the era of Helicobacter eradication. Endoscopic triage and management plays a vital role in the handling of these patients, albeit in close collaboration with radiological and surgical expertise. Injection therapy, preferably with large volume epinephrine remains a core technology. Histoacryl and fibrin glue are more costly and less widely adopted alternatives. Mechanical measures are attractive and clips offer an excellent solution, particularly in soft tissues, and in combination with initial injection. Thermal methods with coagulation and coaptive axial force have similar performance characteristics. Increasingly, the combination of injection therapy with either a mechanical or thermal method appears the best option to achieve permanent haemostasis. PPIs for potent acid inhibition improves the clotting regardless of other treatment modalities. In the setting of rebleeding, patient and ulcer factors determine whether repeat endoscopy should be attempted, but the surgeon should be close at hand in this situation.
Assuntos
Hemostase Endoscópica/instrumentação , Úlcera Péptica Hemorrágica/terapia , Algoritmos , Cianoacrilatos/uso terapêutico , Endoscopia Gastrointestinal , Epinefrina/uso terapêutico , Adesivo Tecidual de Fibrina/uso terapêutico , Humanos , Hipertermia Induzida , Úlcera Péptica Hemorrágica/tratamento farmacológico , Inibidores da Bomba de Prótons/uso terapêutico , Recidiva , Soluções Esclerosantes/uso terapêutico , Somatostatina/uso terapêuticoRESUMO
AIM: The aim of this article is to present a review of over-the-counter (OTC) treatment strategies used for aphthous ulcerations and to provide results from the use of an herbal extract containing glycyrrhiza. BACKGROUND: Aphthous ulceration, a disease of the intra-oral mucosa, is a common condition of unknown etiology that is often self-managed by OTC (no prescription required) medication. REVIEW: Preparations currently on the market can be divided into several categories: local anesthetic agents, oxygenating agents, mouth rinses, and barriers - further subdivided into paste coverings such as gels or dissolvable or non-dissolvable adhesive patches containing plant extract or synthetic drugs. Other strategies include herbs, hematinic replacement, or off-label OTC drug applications. While many OTC treatments are available and accepted for use with aphthous ulceration, a review of the literature via a number of published research search engines suggests that to date there are no randomized controlled studies to demonstrate OTC preparations do more than manage symptoms. Exceptions include OTC cyanoacrylate products and CankerMelts GX patches which include glycyrrhiza (licorice) extract. The use of CankerMelts has been shown to alter the course of the condition by reducing lesion duration, size, and pain. SUMMARY: The results of the studies reviewed here suggest CankerMelts GX discs may be as effective as amlexanox (which must be prescribed) in reducing pain and speeding healing. In addition it can be applied by the patient without the adverse events associated with cyanoacrylate formulations.
Assuntos
Glycyrrhiza , Medicamentos sem Prescrição/uso terapêutico , Fitoterapia , Extratos Vegetais/uso terapêutico , Estomatite Aftosa/tratamento farmacológico , Aminopiridinas/uso terapêutico , Anestésicos Locais/uso terapêutico , Cianoacrilatos/uso terapêutico , Hematínicos/uso terapêutico , Humanos , Antissépticos Bucais/uso terapêutico , Oxidantes/uso terapêutico , Raízes de Plantas , Ensaios Clínicos Controlados Aleatórios como Assunto , Adesivos Teciduais/uso terapêuticoRESUMO
UNLABELLED: There has been a steady increase in the number of cases of methicillin-resistant Staphylococcus aureus (MRSA) otorrhea; this is a growing medical concern. For otological surgery in children, octylcyanoacrylate can be an alternative method of closure for surgical incisions. Recent in vitro studies have shown that octylcyanoacrylate is effective as an antimicrobical barrier. To date, there have been only rare reports on the antibacterial effect of octylcyanoacrylate against MRSA. The purpose of this study is to determine the antimicrobial effects of octylcyanoacrylate against the MRSA that was isolated from patients with chronic suppurative otitis media. MATERIALS AND METHODS: Clinical MRSA (n=20) bacteria and methicillin-sensitive SA (MSSA) (n=20) were obtained from patients. The susceptibilities to various antibiotics were determined by disk diffusion method. RESULTS: MSSA was sensitive to octylcyanoacrylate. The antibacterial activity of octylcyanoacrylate was weak against MRSA. CONCLUSION: Our results demonstrated that octylcyanoacrylate has slight antibacterial activity against MRSA.
Assuntos
Antibacterianos/uso terapêutico , Cianoacrilatos/uso terapêutico , Resistência a Meticilina , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Otite Média com Derrame/tratamento farmacológico , Infecções Estafilocócicas/tratamento farmacológico , Staphylococcus aureus/efeitos dos fármacos , Antibacterianos/farmacologia , Doença Crônica , Humanos , Testes de Sensibilidade MicrobianaRESUMO
PURPOSE: To compare the biocompatibility of ethyl-cyanoacrylate (ECA) and octylcyanoacrylate (OCA) wound closures to sutures in rat skin. METHODS: Twenty-four male Wistar rats were subjected to three incisions which were closed using ECA, OCA or sutures . Rats were divided into four groups which received biopsies on the 3rd, 7th, 14th or 21st post-operative days. Necrosis, inflammation, dermatitis, infection, dehiscence, cicatricial enlargement and costs were examined; the histopathology evaluated was epithelialization, deep openings, foreign substance reaction, residues of synthesis material, fibrosis, inflammation, dehiscence and necrosis. RESULTS: The tissue adhesives presented the largest dehiscence levels, and ECA the lowest cost while the other measures were similar. Regarding histopathology, deep openings were more common with OCA and granulomas were most frequently obtained with ECA. The two tissue adhesives produces less inflammation than the inicial suture from post-operative day 7, while ECA and OCA cause similar inflammatory reactions. ECA did not differ significantly from OCA and sutures on other measures. CONCLUSION: ECA was well tolerated in this study and did not induce necrosis, allergic reactions or infections, presenting several advantages in relation to OCA and sutures, including lower costs and fewer complications.
OBJETIVO: Investigar a biocompatibilidade do etil-cianoacrilato (ECA) em fechamento de pele em ratos comparativamente ao octil-cianoacrilato (OCA) e à sutura. MÉTODOS: Rattus norvegicus albinus (n=24) foram submetidos a três incisões, cada uma fechada por um dos métodos de síntese estudados. Quatro grupos (n=6) foram feitos, conforme o dia pós-operatório (DPO) em que foram eutanasiados: 3DPO, 7DPO,14DPO e 21DPO. Necrose, edema, eritema, dermatite, infecção, deiscência, alargamento cicatricial e custos foram os itens examinados; histopatologicamente avaliou-se epitelização, abertura profunda, reação de corpo estranho, resíduos de material de síntese, fibrose, reação inflamatória, deiscência e necrose. RESULTADOS: Os adesivos apresentaram os maiores níveis de deiscências, e o ECA o custo mais baixo; nos demais itens, não houve diferenças. Histopatologia: A abertura profunda foi mais comum com o OCA; ECA foi o material mais encontrado em granulomas; os adesivos foram mais brandos que a sutura a partir do 7° DPO no quesito inflamação, enquanto que o ECA causou uma reação similar ao OCA; nos outros itens, ECA não apresentou diferença importante em relação ao OCA e à sutura. CONCLUSÃO: O ECA foi bem tolerado neste grupo de estudo, sem induzir necrose, reações alérgicas e infecção, apresentando diversas vantagens de uso em relação ao OCA e à sutura.
Assuntos
Animais , Masculino , Ratos , Cianoacrilatos/uso terapêutico , Técnicas de Sutura/normas , Adesivos Teciduais/uso terapêutico , Cicatrização/efeitos dos fármacos , Materiais Biocompatíveis , Avaliação Pré-Clínica de Medicamentos , Teste de Materiais , Ratos Wistar , Pele/patologia , Resistência à TraçãoRESUMO
PURPOSE: To compare the biocompatibility of ethyl-cyanoacrylate (ECA) and octylcyanoacrylate (OCA) wound closures to sutures in rat skin. METHODS: Twenty-four male Wistar rats were subjected to three incisions which were closed using ECA, OCA or sutures . Rats were divided into four groups which received biopsies on the 3rd, 7th, 14th or 21st post-operative days. Necrosis, inflammation, dermatitis, infection, dehiscence, cicatricial enlargement and costs were examined; the histopathology evaluated was epithelialization, deep openings, foreign substance reaction, residues of synthesis material, fibrosis, inflammation, dehiscence and necrosis. RESULTS: The tissue adhesives presented the largest dehiscence levels, and ECA the lowest cost while the other measures were similar. Regarding histopathology, deep openings were more common with OCA and granulomas were most frequently obtained with ECA. The two tissue adhesives produces less inflammation than the inicial suture from post-operative day 7, while ECA and OCA cause similar inflammatory reactions. ECA did not differ significantly from OCA and sutures on other measures. CONCLUSION: ECA was well tolerated in this study and did not induce necrosis, allergic reactions or infections, presenting several advantages in relation to OCA and sutures, including lower costs and fewer complications.
Assuntos
Cianoacrilatos/uso terapêutico , Técnicas de Sutura/normas , Adesivos Teciduais/uso terapêutico , Cicatrização/efeitos dos fármacos , Animais , Materiais Biocompatíveis , Avaliação Pré-Clínica de Medicamentos , Masculino , Teste de Materiais , Ratos , Ratos Wistar , Pele/patologia , Resistência à TraçãoRESUMO
A case of a father who treated his child's facial laceration with the home supply of "superglue" having been previously misinformed that superglue is used to treat lacerations is presented. The differences between tissue adhesive and superglue are described and suggest that emergency staff should be careful to avoid using the term "superglue" when using tissue adhesives.
Assuntos
Cianoacrilatos/uso terapêutico , Traumatismos Faciais/terapia , Erros de Medicação , Adesivos Teciduais , Criança , Humanos , Lacerações/terapia , Masculino , Terminologia como AssuntoRESUMO
In a previous study, we have shown that cidofovir (CDV) and azidothymidine-triphosphate (AZT-TP) were poorly encapsulated in poly(iso-butylcyanoacrylate) (PIBCA) aqueous-core nanocapsules. This was attributed to the rapid leakage of these small and hydrophilic molecules through the thin polymer wall of the nanocapsules. In the present study, we have selected various water-soluble polymers as increasing Mw adjuvants and investigated their influence on the entrapment of mononucleotides (CDV, AZT-TP) as well as of oligonucleotides (ODN) into these PIBCA aqueous-core nanocapsules. We show here that the presence of cationic polymers (i.e. poly(ethyleneimine) (PEI) or chitosan) in the nanocapsule aqueous compartment allowed successful encapsulation of AZT-TP and ODN.
Assuntos
Portadores de Fármacos/química , Nanocápsulas/química , Nucleotídeos/administração & dosagem , Polímeros/uso terapêutico , Cátions , Quitosana/uso terapêutico , Cidofovir , Cianoacrilatos/uso terapêutico , Citosina/administração & dosagem , Citosina/análogos & derivados , Didesoxinucleotídeos , Embucrilato , Teste de Materiais , Nanocápsulas/uso terapêutico , Oligonucleotídeos/administração & dosagem , Organofosfonatos/administração & dosagem , Permeabilidade , Polietilenoimina/uso terapêutico , Solubilidade , Nucleotídeos de Timina/administração & dosagem , Água , Zidovudina/administração & dosagem , Zidovudina/análogos & derivadosRESUMO
We present a case of asymptomatic bronchial artery aneurysm that formed a fistula with part of the pulmonary artery (there was no definite fistula with the pulmonary vein). We were able to catheterize the feeding vessel but could not reach the aneurysm. We therefore injected a mixture of N-butyl-2-cyanoacrylate (NBCA; Histoacryl, B. Braun, Melsungen, Germany) and iodized oil (Lipiodol; Guerbet, Aulnay-sous-Bois, France) from the feeding vessel. The fistula, aneurysm, and feeding vessel were almost totally occluded. After embolization, the patient coughed a little; there were no other definite side effects or complications. One and 3 months later, on chest CT, the aneurysm was almost completely occupied with hyperattenuating NBCA-Lipiodol embolization. NBCA is a liquid embolization material whose time to coagulation after injection can be controlled by diluting it with Lipiodol. It is therefore possible to embolize an aneurysm, feeding vessels, and efferent vessels (in our case, it was a fistula) by using an NBCA-Lipiodol mixture of an appropriate concentration, regardless of whether the catheter can reach the aneurysm or not.
Assuntos
Aneurisma/terapia , Artérias Brônquicas , Quimioembolização Terapêutica , Cianoacrilatos/uso terapêutico , Óleo Iodado/uso terapêutico , Adulto , Aneurisma/diagnóstico por imagem , Arteriopatias Oclusivas/diagnóstico por imagem , Arteriopatias Oclusivas/terapia , Fístula Artério-Arterial/diagnóstico por imagem , Fístula Artério-Arterial/terapia , Artérias Brônquicas/anormalidades , Artérias Brônquicas/diagnóstico por imagem , Embucrilato , Feminino , Humanos , Injeções Intravenosas , Artéria Pulmonar/anormalidades , Artéria Pulmonar/diagnóstico por imagem , Tomografia Computadorizada por Raios XRESUMO
OBJECTIVES: To assess the effect of a new polymer in embolization of endoleaks using an animal model. METHODS: A modified aortic stent-graft was placed in 20 pigs. Embolization was performed at the time of graft insertion with non-cytotoxic n-butyl-2-cyanoacrylate-metacryloxysulpholane and lipiodol (0.2:0.8ratio, 2 ml). Angiography, scanning electron microscopy and immuno-histochemistry were obtained at day 0, 1 week and 3 months. RESULTS: In control animals both type I and II endoleaks were demonstrated. In treated animals, neither type-I nor type-II endoleaks were observed and a fibro-proliferative response was demonstrated within the aneurysm thrombus. CONCLUSIONS: Host vascular responses govern the fate of the excluded aneurysm. Embolization of the sac and feeding arteries with non-cytotoxic glue sealed all occlusions by stimulating a massive restenosis-like process.