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AAPS PharmSciTech ; 20(6): 237, 2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31243601


Nanoparticles for colon-drug delivery were designed and evaluated to solve many discrepancy issues as insufficient drug amount at diseased regions, high adverse effects of released drugs, and unintentionally premature drug release to noninflamed gastrointestinal regions. Herein, the prepared budesonide-loaded Eudragit S 100/Capryol 90 nanocapsules for the treatment of inflammatory bowel disease. Nanocapsules were prepared efficiently by nanoprecipitation technique and composed mainly of the pH-sensitive Eudragit S 100 polymeric coat with a semisynthetic Capryol 90 oily core. Full 31 × 21 factorial design was applied to obtain optimized nanocapsules. Optimal nanocapsules showed mean particle size of 171 nm with lower polydispersity index indicating the production of monodispersed system and negative zeta-potential of - 37.6 mV. Optimized nanocapsules showed high encapsulation efficiency of 83.4% with lower initial rapid release of 10% for first 2 h and higher rapid cumulative release of 72% after 6 h. The therapeutic activity of the prepared budesonide-loaded nanocapsules was evaluated using a rat colitis model. Disease activity score, macroscopical examination, blood glucose level, and histopathological assessment showed marked improvements over that free drug suspension. Obtained results demonstrate that the budesonide-loaded Eudragit S 100 nanocapsules are an effective colon-targeting nanosystem for the treatment of inflammatory bowel disease. Capryol 90 was found to be a successful, and even preferred, alternative to benzyl benzoate, which is commonly employed as the oil core of such nanocapsules.

Ácido Acético/toxicidade , Budesonida/uso terapêutico , Colite/tratamento farmacológico , Glucocorticoides/uso terapêutico , Nanocápsulas , Ácidos Polimetacrílicos/administração & dosagem , Animais , Budesonida/administração & dosagem , Colite/induzido quimicamente , Modelos Animais de Doenças , Sistemas de Liberação de Medicamentos , Liberação Controlada de Fármacos , Glucocorticoides/administração & dosagem , Concentração de Íons de Hidrogênio , Ratos , Ratos Wistar
J Pediatr Surg ; 53(8): 1461-1463, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29680277


OBJECTIVE: To detect whether grafting the incised plate during Snodgrass repair would improve outcome. MATERIALS AND METHODS: Sixty patients with primary distal hypospadias were included. Patients were equally randomized using closed envelop method to either Snodgrass or grafted tubularized incised plate repair (GTIP). All operations were performed by a single surgeon. All intaroperative data were recorded. All patients were followed up for 1 year. Success was defined as slit shaped meatus at the tip of the glans with no stenosis, fistula or diverticulum. RESULTS: All 60 patients were evaluated at 1 year of follow-up. Mean age at surgery was 40±15months. Both groups were comparable as regard to patients' age, meatus location, length and width and depth of urethral plate and glans width. Success was documented in 29/30 patients (96.7%) in the Snodgrass group. The only complication was meatal stenosis in one patient, whereas success was documented in 28/30 patients (93.3%) in the GTIP group. The two failures were secondary to partial glans dehiscence. Success rate was not statistically different. Flow rate data at 1 year showed insignificant difference between both groups as regards Q-max and voiding time. The only statistically significant difference between both groups was a longer operative time 106±12min in the GTIP group compared to only 77±9 for the Snodgrass group (p = 0.005). CONCLUSIONS: Snodgrass and GTIP techniques for primary distal hypospadias repair have similar outcome. With a significantly shorter operative time, Snodgrass repair remains the first choice for primary distal hypospadias repair. TYPE OF THE STUDY: Prospective randomized study. LEVEL OF EVIDENCE: Level I.

Hipospadia/cirurgia , Procedimentos Cirúrgicos Reconstrutivos/métodos , Retalhos Cirúrgicos , Uretra/cirurgia , Procedimentos Cirúrgicos Urológicos Masculinos/métodos , Pré-Escolar , Fístula/cirurgia , Seguimentos , Humanos , Lactente , Masculino , Estudos Prospectivos , Resultado do Tratamento
Urology ; 101: 161-162, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27993712


Bladder neck closure (BNC) is the ultimate bladder neck reconstruction. If reconstruction fails, closure must be considered as it gives the highest continence rate. The vast majority of BNCs are performed through an abdominal approach (either transvesical or extravesical approach), but perineal approach remains an option for BNC with considerable success rate. Perineal hernia, which is defined as protrusion of abdominal contents through the perineal defect, is a very rare complication after urologic procedures. We report a case of perineal hernia post perineal BNC.

Epispadia/cirurgia , Hérnia/etiologia , Herniorrafia/métodos , Períneo , Complicações Pós-Operatórias/etiologia , Telas Cirúrgicas , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Criança , Hérnia/diagnóstico , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/cirurgia , Reoperação , Tomografia Computadorizada por Raios X , Bexiga Urinária/diagnóstico por imagem , Bexiga Urinária/cirurgia , Urografia
Urolithiasis ; 44(4): 327-32, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26781741


Stone culture has been frequently investigated following percutaneous nephrolithotomy (PNL) in the last decade. We aimed to crucially define the clinical role of stone culture in modifying the treatment plan in patients with postoperative sepsis. Between June 2012 and April 2013, a total of 79 consecutive PNL procedures were included. Perioperative data were prospectively maintained. Preoperative urine sample, retrieved stone fragments and postoperative nephrostomy tube urine sample were cultured and antibiotic sensitivity tests were performed. The occurrence of at least two of the systemic inflammatory response syndrome (SIRS) events during their inpatient stay was diagnostic of SIRS. The antibiotic regimen utilized and its modifications were reported. The preoperative culture was positive in 26 patients (32.9 %). The culture of stone fragments showed significant bacterial growth in 23 (29.1 %) cases. Significant growth on stone culture was significantly associated with the presence of preoperative urinary catheters and positive preoperative urine culture (P = 0.001, 0.006 respectively). Postoperative culture was positive in only six patients (7.6 %). SIRS was diagnosed in the first postoperative day in 12 patients (15.2 %). Leukocytosis was the only predictor of SIRS. Neither preoperative culture, stone culture nor postoperative culture was predictor of SIRS. Stone culture was positive in four patients with SIRS. Stone culture changed the treatment plan in only one patient. Our data do not support the routine implementation of stone culture in the PNL workup, as it did not indicate a change of antibiotic regimen in most of the cases.

Cálculos Renais/microbiologia , Cálculos Renais/cirurgia , Nefrostomia Percutânea , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Bactérias/isolamento & purificação , Feminino , Humanos , Cuidados Intraoperatórios , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Síndrome de Resposta Inflamatória Sistêmica/tratamento farmacológico , Síndrome de Resposta Inflamatória Sistêmica/microbiologia , Urina/microbiologia , Adulto Jovem
Arab J Urol ; 13(4): 277-81, 2015 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-26609447


OBJECTIVE: To identify patient and stricture characteristics predicting failure after direct vision internal urethrotomy (DVIU) for single and short (<2 cm) bulbar urethral strictures. PATIENTS AND METHODS: We retrospectively analysed the records of adult patients who underwent DVIU between January 2002 and 2013. The patients' demographics and stricture characteristics were analysed. The primary outcome was procedure failure, defined as the need for regular self-dilatation (RSD), redo DVIU or substitution urethroplasty. Predictors of failure were analysed. RESULTS: In all, 430 adult patients with a mean (SD) age of 50 (15) years were included. The main causes of stricture were idiopathic followed by iatrogenic in 51.6% and 26.3% of patients, respectively. Most patients presented with obstructive lower urinary tract symptoms (68.9%) and strictures were proximal bulbar, i.e. just close to the external urethral sphincter, in 35.3%. The median (range) follow-up duration was 29 (3-132) months. In all, 250 (58.1%) patients did not require any further instrumentation, while RSD was maintained in 116 (27%) patients, including 28 (6.5%) who required a redo DVIU or urethroplasty. In 64 (6.5%) patients, a redo DVIU or urethroplasty was performed. On multivariate analysis, older age at presentation [odds ratio (OR) 1.017; P = 0.03], obesity (OR 1.664; P = 0.015), and idiopathic strictures (OR 3.107; P = 0.035) were independent predictors of failure after DVIU. CONCLUSION: The failure rate after DVIU accounted for 41.8% of our present cohort with older age at presentation, obesity, and idiopathic strictures independent predictors of failure after DVIU. This information is important in counselling patients before surgery.

Retin Cases Brief Rep ; 3(1): 68-9, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-25390844


BACKGROUND: Bancroftian filariasis is focally endemic in Egypt. There have been many reports of intraocular filariasis; the question of why one filarial nematode should cause ocular disease while another does not may be related to the behavior of the microfilaria and the location of the cross-reacting ocular antigen. METHODS: A 35-year-old woman with a white worm approximately 3 disk diameters in length penetrating the left macula, moving in the vitreous cavity, with a part of its length in the vitreous cavity while the rest was embedded subretinally, is described. Pars plana vitrectomy was performed and the worm was aspirated successfully. RESULTS: Parasitologic study of the aspirated worm identified juvenile Wuchereria bancrofti. Ivermectin 150 µg/kg was given orally to the patient after identification of the worm. Six weeks later, the patient's visual acuity had improved to 20/200. CONCLUSION: Intravitreal parasites should be surgically removed as soon as possible.