Advances in Contact Lens Care Solutions: PVP-I Disinfectant and HAD Wetting Agents From Japan.

ABSTRACT: Half of the individuals who wear contact lenses use reusable lenses that require proper care. Improper contact lens (CL) care and using inadequate disinfecting solutions can lead to lens contamination, CL-related microbial keratitis, and Acanthamoeba keratitis. Oxidative disinfecting solutions, such as hydrogen peroxide, show higher efficacy than multipurpose solutions. Povidone-iodine (PVP-I), an oxidative disinfectant used in ophthalmic surgery, has been proven to be safe and effective. The PVP-I system, a CL disinfecting solution developed in Japan, has demonstrated excellent antimicrobial and antiviral properties. Although CL discomfort does not have a risk of ocular disorders with poor visual prognosis, such as keratitis, CL discomfort can still lead to lens dropout and thus needs to be addressed. To mitigate CL discomfort, it is essential to use disinfecting solutions containing surfactants and wetting agents that improve wettability of the lens surface. A CL solution containing hyaluronic acid derivatives (HADs) as wetting agents that permanently adhere to the lens surface to improve wettability of the lens surface was developed in Japan. There is potential for HAD to be integrated into various solutions. This article reviews the efficacy of novel PVP-I-based disinfecting solution and HAD wetting agents.

Surface Motility Favors Codependent Interaction between Pseudomonas aeruginosa and Burkholderia cenocepacia.

Interactions between different bacterial species shape bacterial communities and their environments. The opportunistic pathogens Pseudomonas aeruginosa and Burkholderia cenocepacia both can colonize the lungs of individuals affected by cystic fibrosis. Using the social surface behavior called swarming motility as a study model, we noticed intricate interactions between B. cenocepacia K56-2 and P. aeruginosa PA14. While strain K56-2 does not swarm under P. aeruginosa favorable swarming conditions, co-inoculation with a nonmotile PA14 flagellum-less ΔfliC mutant restored spreading for both strains. We show that P. aeruginosa provides the wetting agent rhamnolipids allowing K56-2 to perform swarming motility, while aflagellated PA14 appears to "hitchhike" along with K56-2 cells in the swarming colony. IMPORTANCE Pseudomonas aeruginosa and Burkholderia cenocepacia are important opportunistic pathogens often found together in the airways of persons with cystic fibrosis. Laboratory cocultures of both species often ends with one taking over the other. We used a surface motility assay to study the social interactions between populations of these bacterial species. Under our conditions, B. cenocepacia cannot swarm without supplementation of the wetting agent produced by P. aeruginosa. In a mixed colony of both species, an aflagellated mutant of P. aeruginosa provides the necessary wetting agent to B. cenocepacia, allowing both bacteria to swarm and colonize a surface. We highlight this peculiar interaction where both bacteria set aside their antagonistic tendencies to travel together.

Phenylboronic acid modified hydrogel materials and their potential for use in contact lens based drug delivery.

The use of hydrogel-based contact lens materials holds promise for ophthalmic drug delivery by increasing drug residence time, improving drug bioavailability, reducing administration frequency, and enhancing special site targeting. Issues such as ease of manufacturing, lens comfort and appropriate release kinetics must be considered. Furthermore, the high water content of hydrogel materials can result in rapid and poorly controlled release kinetics. Herein, we modified common hydrogels used in contact lens manufacturing with phenylboronic acid (PBA). PBA addresses these material design issues since boronate esters are easily formed when boron acid and diols interact, opening up a pathway for simple modification of the model lens materials with saccharide based wetting agents. The wetting agents have the potential to improve lens comfort. Furthermore, the hydrophobicity of PBA and the presence of diols can be useful to help control drug release kinetics. In this work, polymerizable 3-(acrylamido)phenylboronic acid (APBA) was synthesized and incorporated into various hydrogels used in contact lens applications, including poly(2-hydroxyethylmethacrylate) (PHEMA), polyvinylpyrrolidone (PVP) and poly(N,N-dimethyl acrylamide) (PDMA) using UV induced free radical polymerization. The APBA structure and its incorporation into the hydrogel materials were confirmed by NMR and FTIR. The materials were shown to interact with and bind wetting agents such as hyaluronan (HA) and hydroxypropyl guar (HPG) by simple soaking in an aqueous solution. The equilibrium water content of the modified materials was characterized, demonstrating that most materials are still in the appropriate range after the introduction of the hydrophobic PBA. The release of three model ophthalmic drugs with varying hydrophilicity, atropine, atropine sulfate and dexamethasone, was examined. The presence of PBA in the materials was found to promote sustained drug release due to its hydrophobic nature. The results suggest that the modification of the materials with PBA was able to not only provide a mucoadhesive property that enhanced wetting agent interactions with the materials, but had the potential to alter drug release. Thus, the modification of contact lens materials with mucoadhesive functionality may be useful in the design of hydrogel contact lenses for ophthalmic drug release and wetting agent binding.

Dewetting characteristics of contact lenses coated with wetting agents.

HYPOTHESIS: Although wetting agents have been developed to limit tear film dewetting over contact lenses, systematic analyses correlating wetting agent properties to mechanisms of the tear film destabilization are not readily available. Clarifying destabilization characteristics across key physio-chemical variables will provide a rational basis for identifying optimal wetting agents. EXPERIMENTS: We employ an in-house, in vitro platform to comprehensively evaluate drainage and dewetting dynamics of five wetting agents across seventeen different formulations and two model tear film solutions. We consider the film thickness evolution, film thickness at breakup, dewetted front propagation, and develop correlations to contact angle to compare the samples. FINDINGS: Zwitterionic wetting agents effectively stabilize the tear film by reducing the film thickness at the onset of dewetting, and delaying the propagation of dewetted regions across the lens. Furthermore, tuning wetting agent surface concentrations and utilizing binary mixtures of wetting agents can enhance wetting characteristics. Finally, despite disparities in wetting agent molecular properties, the time to dewet 50% of the lens scales linearly with the product of the receding contact angle and contact angle hysteresis. Hence, we fundamentally establish the importance of minimizing the absolute contact angle and contact angle hysteresis for effective wetting performance.

Polymeric Microfiltration Membranes Modification by Supercritical Solvent Impregnation-Potential Application in Open Surgical Wound Ventilation.

This study investigated supercritical solvent impregnation of polyamide microfiltration membranes with carvacrol and the potential application of the modified membranes in ventilation of open surgical wounds. The impregnation process was conducted in batch mode at a temperature of 40 °C under pressures of 10, 15, and 20 MPa for contact times from 1 to 6 h. FTIR was applied to confirm the presence of carvacrol on the membrane surface. In the next step, the impact of the modification on the membrane structure was studied using scanning electron and ion beam microscopy and cross-filtration tests. Further, the release of carvacrol in carbon dioxide was determined, and finally, an open thoracic cavity model was applied to evaluate the efficiency of carvacrol-loaded membranes in contamination prevention. Carvacrol loadings of up to 43 wt.% were obtained under the selected operating conditions. The swelling effect was detectable. However, its impact on membrane functionality was minor. An average of 18.3 µg of carvacrol was released from membranes per liter of carbon dioxide for the flow of interest. Membranes with 30-34 wt.% carvacrol were efficient in the open thoracic cavity model applied, reducing the contamination levels by 27% compared to insufflation with standard membranes.

Why chitosan could be apt candidate for glaucoma drug delivery - An overview.

Most of the people in the world are affected by glaucoma, which leads to irreversible blindness. Several patient friendly treatments are available, nevertheless medications lack an easy and efficient way of sustained delivery. To make the delivery with enhanced bioavailability, biodegradable and non-biodegradable polymers-based drug carriers are explored. However, ocular drug delivery issues have not been resolved yet due to less adhesiveness, poor penetration ability, pH, and temperature dependent burst releases. Chitosan is found to be effective for ocular drug delivery due to excellent physio-chemical properties in terms of overcoming the existing issues. In this review, we aim to highlight why it has been chosen and the holy grail for ocular drug delivery. Besides, we have comprehensively reviewed recent patents on chitosan as a platform for ocular drug delivery and future perspectives on factors, lacunae and challenges that need to be addressed for better ocular delivery methods for glaucoma management.

Fibrous biomaterials: Effect of textile topography on foreign body reaction.

Foreign Body Reaction (FBR) is a critical issue to be addressed when polyethylene terephthalate (PET) textile implants are considered in the medical field to treat pathologies involving hernia repair, revascularization strategies in arterial disease, and aneurysm or heart valve replacement. The natural porosity of textile materials tends to induce exaggerated tissue ingrowth which may prevent the implants from remaining flexible. The purpose of this study is to assess the influence of the textile topography of various woven substrates on the wetting properties of these substrates and on their in vitro interaction with mesenchymal stem cells (MSC) at 24 and 72 hr. The tests were performed both at yarn and fabric level under forced wetting and ingrowth conditions in order to replicate the mechanisms going on in vivo under blood pressure. Results demonstrate that cell proliferation is influenced by the textile wetting properties, which can be tuned at yarn and fabric level. In particular, it is shown that a satin weave obtained from porous spun yarn limits cell proliferation due to the high porosity of the yarn and the limited saturation index of the weave. Yarn and fabric saturation seems to play a predominant role in cell proliferation on textile substrates.

Impact of a low molecular weight hyaluronic acid derivative on contact lens wettability.

PURPOSE: To investigate the interaction of a novel low molecular weight hyaluronic acid derivative containing hydrophobic groups with soft contact lenses and its effect on lens hydrophilicity compared with a conventional form of hyaluronic acid. METHODS: This investigation studied the uptake of fluorescently-labelled hyaluronic acid and a low molecular weight hyaluronic acid derivative to four types of contact lenses using fluorescent microscopy and confocal laser scanning microscopy. Further, the four lens types were used to compare efficacy in improving hydrophilicity, as well as maintenance of contact angle measurements, in commercially available multipurpose solutions that contained either hyaluronic acid, the low molecular weight hyaluronic acid derivative, or an alternative wetting agent. RESULTS: The low molecular weight hyaluronic acid derivative was found to sorb more readily to silicone hydrogel lenses and exhibit a greater accumulation over time than conventional hyaluronic acid. Multipurpose solutions containing the low molecular weight hyaluronic acid derivative showed an increase in lens hydrophilicity through decreases in contact angle measurements when compared with those obtained from lenses treated with multipurpose solutions containing conventional hyaluronic acid or alternative wetting agents. This increase in lens hydrophilicity associated with the low molecular weight hyaluronic acid derivative was also maintained over multiple cycles in phosphate buffered saline, while alternative solutions with conventional hyaluronic acid did not. CONCLUSION: Overall, lens treatment using a low molecular weight hyaluronic acid derivative-based solution lead to improved in vitro lens hydrophilicity.

Relationships between the material properties of silicone hydrogels: Desiccation, wettability and lubricity.

Silicone hydrogels (SiHy), represent composite matrices composed of hydrophobic gas permeable silicone (Si) rich core and a surface enriched with hydrophilic polymer moieties. Their utilization in contact lens design requires number of SiHy properties (hydration, wettability, lubricity) to be optimized for the challenging conditions at the ocular surface. Typical limitations in literature are that (i) these properties are studied in isolation, monitoring only one parameter but not the rest of them, and (ii) measurements are performed with hydrated samples immediately after removal from storage solutions. Here we study the simultaneous evolution of critical material properties (evaporative loss of water, water contact angle, coefficient of friction) of different SiHy subjected to continuous blink-like desiccation/rehydration cycling. SiHy with wetting agents incorporated in their core (narafilcon A, senofilcon A) were particularly susceptible to extended desiccation. Stenfilcon A, a material with only 3% bulk Si content maintained its performance for 4 h of cycling, and delefilcon A (80% surface water content) resisted extended 8 h of desiccation/rehydration runs. Strong correlation exists between the evolution of SiHy wettability and lubricity at ≥4 h of blink-like cycling. Understanding the interplay between SiHy properties bears insights for knowledge based design of novel ophthalmic materials.

Effect of wetting agent on the dye filtration performance of ultrafiltration membrane.

In this study, the wet phase inversion method was used for fabrication of the flat sheet ultrafiltration (UF) membranes. Three different polymer types and two different wetting agents were used for the fabrication. The effect of polymer types and wetting agents were investigated on the structural and dye performance of casted membranes. Two different synthetic dyes, 100 ppm Setazol Red and 100 ppm Setazol Blue, were used for the performance test. Viscosity, contact angle, and molecular weight cut off (MWCO) of casted membranes were measured and an electro kinetic analyzer, dynamic mechanical analyzer (DMA) and scanning electron microscope (SEM) were used to determine the structural properties. While the highest water and dye permeability were obtained with PES-PEG membrane, PSf-plain membrane gave the highest removal efficiency for Setazol Red and Setazol Blue dyes, which was found to be 78.33% and 82.52%, respectively, in the conditions of neutral pH and ambient temperature. Addition of PVP and PEG wetting agents improved the structural properties and permeability of membranes, but the dye removal was decreased as against plain ones. As the retention of PEG and PVP-based PSf and PES membrane was calculated at an average of 50%, they could be used for dye retention separately or could be a candidate as a pretreatment membrane prior to nanofiltration or reverse osmosis to make their lifetime longer.

Dermatite atópica em adultos: além da pele / Atopic dermatitis in adults: beyond the skin

Introdução: A dermatite atópica (DA) é doença inflamatória da pele, recidivante e que acomete crianças e adultos e compromete a qualidade de vida destes doentes. Objetivos: Avaliar o impacto da DA moderada a grave na vida social e na qualidade de vida de pacientes adultos, assim como as suas expectativas quanto à evolução da doença e do seu tratamento. Métodos: Duzentos adultos (18 a 65 anos) com diagnóstico médico de DA moderada a grave responderam por via telefônica questionário com perguntas sobre a sua doença, interferência com o seu dia a dia, a atividade laboral, medicação em uso, assim como as suas expectativas com relação a novos tratamentos. Resultados: Na população avaliada houve predomínio de mulheres, média de idade de 37 anos, com nível elevado de escolaridade, e na sua maioria pertencentes às classes sociais A e B (68%). O tempo médio para obtenção do diagnóstico foi de 15 meses a partir dos primeiros sintomas. Lesões em dobras e pescoço, eritema, prurido e xerose foram os sinais/sintomas mais frequentes. As formas mais graves acompanharam-se por maior impacto no trabalho, autoestima e qualidade de vida. Setenta por cento procurou tratamento psicoterápico. Apesar de estarem em tratamento regular, um terço apresenta exacerbações da DA. Hidratantes e corticosteroides tópicos têm sido os mais utilizados. Em busca de cura, 90% abriria mão de objetos de desejo para iniciar tratamento de alto custo, desde que fosse eficaz. Conclusões: A DA compromete a qualidade de vida dos pacientes que buscam por soluções terapêuticas mais definitivas.

Introduction: Atopic dermatitis (AD) is a recurrent inflammatory skin disease that affects children and adults and compromises the quality of life of these patients. Objectives: To evaluate the impact of moderate-to-severe on social life and quality of life of adult patients with AD, as well as their expectations regarding new treatments. Methods: Two hundred adults aged 18 to 65 years with medical diagnosis of moderate-to-severe AD answered telephone-administered questions about their condition, impact on daily life and work, use of medication and expectations regarding new treatments. Results: In the study sample, most patients were female, their mean age was 37 years, and most of them had high level of education and belonged to upper social level (68%). The mean time to diagnosis was 15 months after the first symptoms. Lesions in folds and neck, erythema, pruritus and xerosis were the most common signs and symptoms. The most severe forms were related to greater impact on work, self-esteem and quality of life. Seventy percent sought psychotherapeutic treatment. Despite being under regular treatment, a third of patients had AD exacerbations. Moisturizers and topical corticosteroids were the most frequently used treatments. Ninety percent of respondents would forgo objects of desire to initiate a high-cost therapy as long as it was effective. Conclusions: AD compromises the quality of life of patients seeking more definitive therapeutic solutions.

Role of wetting agents and disintegrants in development of danazol nanocrystalline tablets.

Poor wetting and/or particle aggregation are the shortcomings of the dried nanocrystalline suspensions, which subsequently might hinder the superior dissolution performance of the nano-crystalline suspensions. The objective of this study was to evaluate the effect of wetting agents and disintegrants on the dissolution performance of dried nanocrystals of an active pharmaceutical ingredient (API) with poor wetting property. Danazol, a BCS Class II compound with high LogP and low polar surface area, was chosen as a model compound for this study. Danazol nanocrystalline suspension was prepared by wet-media milling and converted into powder via spray granulation either with mannitol or microcrystalline cellulose as carriers at a drug: carrier ratio of 1:9 w/w. Danazol nanocrystalline suspension showed a superior dissolution performance compared to an un-milled danazol suspension. Dried danazol nanocrystals suffered from poor wetting leading to hindered dissolution performance i.e. ~ 40% and ~ 15% drug dissolution within 15 min for the mannitol and microcrystalline cellulose-based granules, respectively. Addition of a lipophilic surfactant (i.e. docusate sodium) at a surfactant: drug ratio of 0.015: 1 w/w during granulation helped in retaining the superior drug dissolution rates i.e. more than 80% drug dissolution within 15 min for mannitol-based granules by enhancing the wettability of dried danazol nanocrystals when compared to a hydrophilic surfactant (i.e. poloxamer 188) or disintegrant (i.e. sodium starch glycolate or croscarmellose sodium). The fast-dissolving mannitol-based granules containing danazol nanocrystals and docusate sodium were compressed into a tablet dosage form. The tablets containing danazol nanocrystals with docusate sodium showed a superior dissolution performance compared to a tablet containing un-milled danazol with docusate sodium.

Síndrome genitourinario de la menopausia: recomendaciones de la Sociedad Española de Ginecología y Obstetricia / Genitourinary syndrome of menopause: recommendations from the Spanish Society of Obstetrics and Gynecology

El síndrome genitourinario de la menopausia (SGM) se definió para sustituir al término "atrofia vulvovaginal" como el conjunto de signos y síntomas genitourinarios asociados a la disminución de estrógenos. La primera línea de tratamiento para las manifestaciones vaginales del SGM son los hidratantes (evidencia IA) y lubricantes vaginales (evidencia IIB). Cuando estas medidas no son suficientes, o en casos moderados o intensos, el tratamiento de elección son los estrógenos locales (evidencia IA). Si coexisten síntomas vasomotores que afectan la calidad de vida, la indicación es el tratamiento hormonal sistémico (evidencia IA). Actualmente, se dispone de ospemifeno (evidencia IA), un modulador selectivo de los receptores vaginales de estrógenos (SERM), aprobado en Europa para el tratamiento de los síntomas moderados o graves en mujeres postmenopáusicas que no cumplen los requisitos para recibir estrógenos vaginales. Otros posibles tratamientos del SGM son el láser y la radiofrecuencia. No hay evidencia para indicar el uso de terapias alternativas y complementarias

Genitourinary syndrome of menopause (GSM) was defined to substitute the term "vaginal atrophy" as the signs and symptoms related to reduced circulating oestrogen levels. Vaginal moisturizers (evidence IA) and vaginal lubricants (evidence IIB) are the first-line treatments. If these measures are unsatisfactory, the choice treatment is local oestrogen therapy (evidence IA). In patients with vasomotor symptoms that impair quality of life, systemic hormone replacement therapy (evidence IA) is administered. Currently, a new therapy is available: ospemifene, a selective oestrogen receptor modulator that acts at vaginal level. It is approved in Europe for the treatment of moderate to severe symptoms in postmenopausal women who are not candidate to local oestrogen therapy. Ospemifene improves vaginal histology and physiology, and it has been safe and well tolerated both in clinical trials and in post-marketing surveillance studies. Other therapies for GSM are laser therapy and radiofrequency. Alternative therapies are not recommended

Amino acids as wetting agents: surface translocation by Porphyromonas gingivalis.

Our understanding of how oral microbiota adapt in response to changes in their surroundings remains limited. This is particularly true of the slow-growing anaerobes that persist below the gum line. Here, we report that the oral anaerobe Porphyromonas gingivalis strain 381 can surface translocate when sandwiched between two surfaces. We show that during movement, this bacterium alters its metabolism, specifically side products of arginine utilization including citrulline and ornithine accumulated in the translocating cells; while arginine, N-acetyl-arginine, and the polyamine putrescine, which is produced from arginine were consumed. In addition, our results indicate that movement requires modification of the surrounding environment via proteolysis, cell dispersion, cell-on-cell rolling, and sub-diffusive cell-driven motility. We also show that production of fimbriae and fimbriae-associated proteins; as well as the regulation of contact-dependent growth inhibition genes, which are known to be involved in self-nonself discrimination, and the type IX secretion system are central to surface translocation. These studies provide a first glimpse into P. gingivalis motility and its relationship to ecological variables.

Combinational Biomimicking of Lotus Leaf, Mussel, and Sandcastle Worm for Robust Superhydrophobic Surfaces with Biomedical Multifunctionality: Antithrombotic, Antibiofouling, and Tissue Closure Capabilities.

Surface wetting occurring in daily life causes undesired contaminations, which are critical issues in various fields. To solve these problems, the nonwetting property of a superhydrophobic (SH) surface has proven its utility by preventing contaminant infiltration, serious infections, or malfunction. However, the application of SH surfaces in the biomedical field has been limited due to the weak durability and toxicity of the related components. To overcome these limitations, we developed a robust and biocompatible SH surface through combinational biomimicking of three natural organisms, lotus leaf, mussel, and sandcastle worm, for the first time. Using the water-immiscible and polycationic characteristics of mussel adhesive protein (iMglue), an SH iMglue-SiO2(TiO2/SiO2)2 coating was fabricated by solution-based electrical charge-controlled layer-by-layer growth of nanoparticles (NPs). The fabricated iMglue-SiO2(TiO2/SiO2)2 SH surface showed excellent durable nonwetting properties and was applied to an intracatheter tube coating to develop antithrombotic catheters under blood flow. Furthermore, we developed a iMglue-employed SH patch for a tissue closure bandage by spraying hydrophobic SiO2 NPs on the iMglue-covered cotton pads. The prepared iMglue-employing SH patch showed perfect bifunctionality with excellent antibiofouling and tissue closure capabilities. Our work presents a novel, useful strategy for fabricating a biomedically multifunctional, robust SH surface through combinational mimicking of natural organisms.

A catecholamine neurotransmitter: epinephrine as a CO2 wet scrubbing agent.

Bio-renewables are emerging as potential materials for CO2 sorption. Epinephrine is employed as a green scrubbing agent for CO2 capturing through the formation of a metal carbamate as proved by 1H, 13C and 1H-15N NMR and ex situ ATR-FTIR spectroscopy, as well as supported by quantum-chemical calculations.

Biocidal Efficacy of a Hydrogen Peroxide Lens Care Solution Incorporating a Novel Wetting Agent.

PURPOSE: To compare the antimicrobial effects of CLEAR CARE, a 3% hydrogen peroxide (H2O2) solution formulated for simultaneous cleaning, daily protein removal, disinfection, and storage of soft (hydrophilic) hydrogel, silicone hydrogel, and gas-permeable contact lenses, and CLEAR CARE PLUS, consisting of the 3% H2O2 solution plus a novel wetting agent, polyoxyethylene-polyoxybutylene (EOBO-21). METHODS: Three lots each of the 2 solutions were incubated with 5 compendial microorganisms required by the Food and Drug Administration (FDA) 510(k) and International Organization for Standardization (ISO) 14729 stand-alone procedures, 4 clinical isolates of Gram-positive and Gram-negative bacteria, and trophozoites and cysts of 2 Acanthamoeba strains that are associated with microbial keratitis. Microbial loads were evaluated after disinfection and neutralization. RESULTS: Both solutions exceeded the FDA/ISO stand-alone primary criteria against Gram-positive and Gram-negative compendial bacteria, yeast, and mold after only 1.5-hr disinfection/neutralization. At the recommended minimum disinfection time, bacteria were reduced by 4.4 to 5.1 logs, yeast by 4.4 to 4.9 logs, and mold by 2.9 to 3.5 logs with and without organic soil. In addition, both solutions eliminated or effectively reduced populations of clinically relevant ocular bacterial isolates (4.5-5.0 logs), Acanthamoeba trophozoites (3.4-4.2 logs), and cysts (1.5-2.1 logs). CONCLUSION: Both solutions eliminated or reduced populations of FDA/ISO compendial bacteria and fungi as well as clinically relevant microorganisms and Acanthamoeba trophozoites and cysts. The addition of EOBO-21 to the 3% H2O2 lens care solution had no impact on antimicrobial activity.

Dermatitis asociada a la incontinencia.: Estado actual del conocimiento / Incontinence-associated dermatitis. Current state of knowledge

La dermatitis asociada a la incontinencia (DAI) es un tipo de dermatitis de contacto irritante, que se observa frecuentemente en pacientes con incontinencia fecal o urinaria. Se manifiesta como una inflamación de la superficie de la piel caracterizada por eritema, y en ocasiones erosión cutánea. Es una condición prevalente y clínicamente relevante, con serias repercusiones sobre el estado de salud y la calidad de vida del paciente. Su etiología es compleja y multifactorial y sus complicaciones implican la infección cutánea y la aparición de otras lesiones añadidas. Es fundamental la correcta diferenciación entre las DAI y otras lesiones cutáneas similares como paso principal para su prevención y tratamiento, y el uso de instrumentos validados para su valoración, seguimiento y monitorización. La ausencia de estudios bien planteados hace que las recomendaciones para el abordaje de la DAI se apoyen en la opinión de expertos y las mejores prácticas disponibles. Las bases de la prevención y tratamiento de la DAI son el abordaje de la incontinencia y la aplicación de un programa o protocolo estructurado de cuidados de la piel que incluya la limpieza suave, la aplicación de productos barrera y el uso de agentes tópicos hidratantes. El presente artículo intenta recoger el estado actual del conocimiento sobre los aspectos fundamentales de la DAI y su implicación para la práctica enfermera

Incontinence-associated dermatitis (IAD) is a type of irritant contact dermatitis, which is frequently observed in patients with fecal and/or urinary incontinence. It manifests as an inflammation of the surface of the skin characterized by erythema, and occasionally skin erosion. It is a prevalent and clinically relevant condition, with serious repercussions on the patient's state of health and quality of life. Its etiology is complex and multifactorial and its complications involve cutaneous infection and the appearance of other lesions added. The correct differentiation between IAD and other similar skin lesions is fundamental as the main step for their prevention and treatment, and the use of validated instruments for their assessment, follow-up and monitoring. The absence of well-designed studies means that the recommendations for the approach to the IAD are based on expert opinion and best practices available. The bases of the prevention and treatment of the IAD are the approach to incontinence and the application of a structured program or protocol of skin care that includes gentle cleansing, the application of barrier products and the use of topical moisturizing agents. The present article tries to collect the current state of knowledge about the fundamental aspects of the IAD and its implication for nursing practice

Influence of Irrigation and Wetting Agent on Fungicide Residues in Creeping Bentgrass.

Fungicides (azoxystrobin, propiconazole, pyraclostrobin, and thiophanate-methyl) were applied to field plots of creeping bentgrass established on a sand-based root zone substrate and maintained at a cutting height of 0.34 cm. The wetting agent, a modified alkylated polyol, was applied 24 h prior to fungicide application. Irrigation (0.51 cm) was applied to plots immediately after the fungicide spray. Turf was sampled nine times over 42 days to examine fungicide residues in three components of the turf profile: verdure/thatch, roots, and soil. Residues were extracted from samples and then quantified using a liquid chromatography-mass spectrometry/mass spectrometry (LC-MS/MS) procedure. The experiment was run twice. Wetting agent had little or no effect on fungicide distribution in any of the turf components. Postapplication irrigation had little effect on residues observed in the verdure/thatch component. Significant irrigation treatment effects were observed in root and soil components, but results varied among fungicides and sampling dates. Where significant effects were observed for the irrigation plus wetting agent treatment, results generally mirrored outcomes for irrigation treatment.