Mantenimiento de niveles plasmáticos de levetiracetam en infusión paliativa subcutánea, continua y prolongada mediante infusores elastoméricos / Maintenance of plasma levels of levetiracetam in subcutaneous, continuous and prolonged palliative infusion by elastomeric infusors

No disponible

Wearable, Ultrawide-Range, and Bending-Insensitive Pressure Sensor Based on Carbon Nanotube Network-Coated Porous Elastomer Sponges for Human Interface and Healthcare Devices.

Flexible and wearable pressure sensors have attracted a tremendous amount of attention due to their wider applications in human interfaces and healthcare monitoring. However, achieving accurate pressure detection and stability against external stimuli (in particular, bending deformation) over a wide range of pressures from tactile to body weight levels is a great challenge. Here, we introduce an ultrawide-range, bending-insensitive, and flexible pressure sensor based on a carbon nanotube (CNT) network-coated thin porous elastomer sponge for use in human interface devices. The integration of the CNT networks into three-dimensional microporous elastomers provides high deformability and a large change in contact between the conductive CNT networks due to the presence of micropores, thereby improving the sensitivity compared with that obtained using CNT-embedded solid elastomers. As electrical pathways are continuously generated up to high compressive strain (∼80%), the pressure sensor shows an ultrawide pressure sensing range (10 Pa to 1.2 MPa) while maintaining favorable sensitivity (0.01-0.02 kPa-1) and linearity ( R2 ∼ 0.98). Also, the pressure sensor exhibits excellent electromechanical stability and insensitivity to bending-induced deformations. Finally, we demonstrate that the pressure sensor can be applied in a flexible piano pad as an entertainment human interface device and a flexible foot insole as a wearable healthcare and gait monitoring device.

Uso de elastômero para delimitação do término do preparo em modelos odontológicos / Use of elastomer for delimitation of the preparation terminal edge in dental models

A comunicação entre o dentista e o técnico de prótese dentária é fundamental para o tratamento. A técnica convencional de troquelização de modelos consiste em sua individualização na região dos preparos através do recorte e eliminação do gesso fora do espaço correspondente ao sulco gengival na região do término. O objetivo deste artigo é descrever dois casos clínicos nos quais foi utilizada uma técnica inovadora de troquelização de modelos.

Communication between the dentist and the dental prosthesis technician is fundamental for treatments. The conventional technique of die casting models consists of their individualization in the preparations region, through plaster cutting and elimination outside the space corresponding to the gingival sulcus in the terminal region. The aim of this article is to describe two clinical cases in which an innovative technique of die casting models was used.

Usefulness of Hospital at Home in nosocomial infections: advantages and limitations / Utilidad de la Hospitalización a Domicilio en las infecciones nosocomiales: ventajas y limitaciones

Hospital at Home units allows ambulatory treatment and monitoring of complex and serious infections. Nosocomial infections produce an extension of the stay in hospital often specifying long intravenous treatments without any effective oral alternatives. Daily dosing of antimicrobial are easier to administer at home. The use of portable programmable pump infusion and elastomeric devices allow efficient and safe infusions for most antimicrobials at home. Some antibiotics against multidrug-resistant organisms of recent introduction have a suitable profile for outpatient intravenous treatment (AU)

Las unidades de Hospitalización a Domicilio permiten el tratamiento y control ambulatorio de infecciones graves y complejas. Las infecciones nosocomiales suponen una prolongación de la estancia hospitalaria precisando con frecuencia largos tratamientos intravenosos sin alternativa eficaz oral. Los antimicrobianos más sencillos de administrar en domicilio son aquellos con dosis única diaria. La utilización de bombas programables portátiles de infusión y de dispositivos elastoméricos permite infundir con eficacia y seguridad la mayoría de antimicrobianos. Algunos de los antibióticos frente a microorganismos multirresistentes de reciente introducción tienen un perfil muy adecuado para el tratamiento intravenoso ambulatorio (AU)

Novel ankle orthosis with elastomer-embedded flexible joint.

In this study, we propose a new ankle orthosis with elastomer-embedded flexible joints (EEFJ), composed of C-shaped springs and 3D-printed circular elastomer. This orthosis was designed to reduce burden on the tibialis anterior muscle (TA) and to achieve clearance between the tip of the toe and the ground. Fabrication method, strength testing, and gait analysis were conducted. According to the results of strength testing, the combination of the C-spring with 0.3 mm and 0.5 mm thickness and the elastomer with 30% and 60% filling density performs a supporting torque of 0.7-2.3 Nm to plantarflexion. In contrast, torques in the other directions were relatively small. According to the results of gait experiments in seven healthy young subjects, the proposed orthosis successfully reduced activation of TA on initial contact and in the swing phase, and range of motion on initial contact.

Eficacia y seguridad en la infusión subcutánea de oxicodona mediante infusor elastomérico de larga duración / Efficacy and safety of oxycodone subcutaneous infusion using a long-term elastomeric infusion device

No disponible

Complications after use of elastomeric pressure-indicating media at 24-hour follow-up visit for immediate maxillary complete removable dental prosthesis: A clinical report.

Various pressure-indicating media are available to assess the adaptation of the intaglio surface of a removable dental prosthesis at the insertion and follow-up appointments. This clinical report describes the use of an elastomer that entered the maxillary sinus through an undetected oroantral communication at the 24-hour follow-up for an immediate maxillary complete removable dental prosthesis. A Caldwell-Luc sinusotomy procedure was required to remove the material, and the patient required over 1 year of healing time before his reported symptoms resolved.

Elastómeros en bloqueos periféricos. Nuestra experiencia / Peripheral blockade with elastomeric pumps. Our experience

No disponible

Polydimethylsiloxane elastomer injection in the management of the patulous eustachian tube.

OBJECTIVE: To determine the effectiveness of augmentation surgery using polydimethylsiloxane elastomer injection for the management of patulous eustachian tube. METHOD: All patients were treated with eustachian tube injection augmentation performed via a combined transnasal-transoral endoscopic approach. Clinical presentation, volume of injection, complications and initial response were all prospectively recorded. Longer-term follow up was conducted through structured telephone interviews using previously described patient-reported outcome measures. RESULTS: Overall, 8 of 11 patients (73 per cent) derived complete or significant symptom improvement; 1 patient had significant improvements but was dissatisfied, and in 2 patients the symptoms were unchanged. The eight satisfied patients showed improvement in their quality-of-life scores. CONCLUSION: This study describes an effective treatment option for patulous eustachian tube. Unlike many prior published reports, previously described patient-reported outcome measures were utilised in order to allow more direct comparison.

Development of Biodegradable Poly(citrate)-Polyhedral Oligomeric Silsesquioxanes Hybrid Elastomers with High Mechanical Properties and Osteogenic Differentiation Activity.

Biodegradable elastomeric biomaterials have attracted much attention in tissue engineering due to their biomimetic viscoelastic behavior and biocompatibility. However, the low mechanical stability at hydrated state, fast biodegradation in vivo, and poor osteogenic activity greatly limited bioelastomers applications in bone tissue regeneration. Herein, we develop a series of poly(octanediol citrate)-polyhedral oligomeric silsesquioxanes (POC-POSS) hybrids with highly tunable elastomeric behavior (hydrated state) and biodegradation and osteoblasts biocompatibility through a facile one-pot thermal polymerization strategy. POC-POSS hybrids show significantly improved stiffness and ductility in either dry or hydrated conditions, as well as good antibiodegradation ability (20-50% weight loss in 3 months). POC-POSS hybrids exhibit significantly enhanced osteogenic differentiation through upregulating alkaline phosphatase (ALP) activity, calcium deposition, and expression of osteogenic markers (ALPL, BGLAP, and Runx2). The high mechanical stability at hydrated state and enhanced osteogenic activity make POC-POSS hybrid elastomers promising as scaffolds and nanoscale vehicles for bone tissue regeneration and drug delivery. This study may also provide a new strategy (controlling the stiffness under hydrated condition) to design advanced hybrid biomaterials with high mechanical properties under physiological condition for tissue regeneration applications.

Biodegradable elastomers for biomedical applications and regenerative medicine.

Synthetic biodegradable polymers are of great value for the preparation of implants that are required to reside only temporarily in the body. The use of biodegradable polymers obviates the need for a second surgery to remove the implant, which is the case when a nondegradable implant is used. After implantation in the body, biomedical devices may be subjected to degradation and erosion. Understanding the mechanisms of these processes is essential for the development of biomedical devices or implants with a specific function, for example, scaffolds for tissue-engineering applications. For the engineering and regeneration of soft tissues (e.g., blood vessels, cardiac muscle and peripheral nerves), biodegradable polymers are needed that are flexible and elastic. The scaffolds prepared from these polymers should have tuneable degradation properties and should perform well under long-term cyclic deformation conditions. The required polymers, which are either physically or chemically crosslinked biodegradable elastomers, are reviewed in this article.

25th anniversary article: Rational design and applications of hydrogels in regenerative medicine.

Hydrogels are hydrophilic polymer-based materials with high water content and physical characteristics that resemble the native extracellular matrix. Because of their remarkable properties, hydrogel systems are used for a wide range of biomedical applications, such as three-dimensional (3D) matrices for tissue engineering, drug-delivery vehicles, composite biomaterials, and as injectable fillers in minimally invasive surgeries. In addition, the rational design of hydrogels with controlled physical and biological properties can be used to modulate cellular functionality and tissue morphogenesis. Here, the development of advanced hydrogels with tunable physiochemical properties is highlighted, with particular emphasis on elastomeric, light-sensitive, composite, and shape-memory hydrogels. Emerging technologies developed over the past decade to control hydrogel architecture are also discussed and a number of potential applications and challenges in the utilization of hydrogels in regenerative medicine are reviewed. It is anticipated that the continued development of sophisticated hydrogels will result in clinical applications that will improve patient care and quality of life.

Bombas elastoméricas. Tratamiento del dolor postoperatorio / Postoperative pain management using elastomeric pumps

Las bombas elastoméricas de infusión son dispositivos monouso que permiten la administración de fármacos de manera continua, segura y sencilla. Ayudan a mantener los niveles plasmáticos del fármaco estables y una analgesia adecuada para un control del dolor agudo, lo cual supone mejorar la calidad de vida de los pacientes, por lo que resultan una alternativa eficaz para el tratamiento del dolor (AU)

Elastomeric infusions pumps are single use devices that permit continuous drugs infusion in a safe and simple way .They help to maintain drugs plasma level stability and analgesia in order to control acute pain and improves patients quality of life, which are an effective alternative for de treatment of pain (AU)

A prospective non-randomized two-centre study of patients with passive faecal incontinence after birth trauma and patients with soiling after anal surgery, treated by elastomer implants versus rectal irrigation.

AIM: This study is a prospective evaluation of patients with passive faecal incontinence and patients with soiling treated by elastomer implants and rectal irrigation. PATIENTS AND METHODS: Patients with passive faecal incontinence after birth trauma resulting from a defect of the internal sphincter and patients with soiling after previous anal surgery were included. All patients underwent endo-anal ultrasound, magnetic resonance imaging, and anal manometry. The patients with passive faecal incontinence were initially treated by anal sphincter exercises and biofeedback therapy during half a year. The patients completed incontinence scores, a quality of life questionnaire, and a 2-week diary card. RESULTS: The elastomer group consisted of 30 males and 45 females with a mean age of 53 years (25-77). The rectal irrigation group consisted of 32 males and 43 females with a mean age of 50 years (25-74). At 6 months follow-up, 30 patients with soiling of the rectal irrigation group and only nine patients of the elastomer group were completely cured (p = 0.02). Only three patients with passive faecal incontinence were cured in the rectal irrigation group and none in the elastomer group. Three distal migrations of elastomer implants required removal at follow-up. CONCLUSIONS: After patients had performed anal sphincter exercises, no clear improvement of passive faecal incontinence was obtained by elastomer implants or rectal irrigation. However, rectal irrigation is far more effective than elastomer implants in patients with soiling.

Analgesia invasiva domiciliaria en el manejo del dolorpostoperatorio en cirugía mayor ambulatoria mediantebombas elastoméricas intravenosas / No disponible

Introducción: el dolor postoperatorio moderado-severo sigue siendo un problema en cirugía ambulatoria, ya que provoca problemas de flujo de pacientes, retrasando el alta de los pacientes, siendo uno de los principales motivos de reingreso en los hospitales, y por tanto un importante indicador de calidad de estas Unidades. El empleo de técnicas analgésicas invasivas domiciliarias, en todos sus regímenes, puede controlar el dolor postoperatorio en estas intervenciones y permitir incluirlas en los programas de cirugía ambulatoria. Objetivos: el objetivo de nuestro estudio es valorar la viabilidad y la seguridad de la utilización de bombas de perfusión continua elastoméricas para la administración de analgesia endovenosa continua domiciliaria, a la vez que valorar la eficacia analgésica y el grado de satisfacción de los pacientes intervenidos en régimen ambulatorio. Material y métodos: estudio retrospectivo de 463 pacientes. Una vez intervenidos bajo estrategia de analgesia multimodal, se les coloca dos tipos diferentes de bombas elastoméricas endovenosas (elastómero de dexketoprofeno o de metamizol). La intensidad del dolor, para evaluar la necesidad de analgesia de rescate, se cuantifica con la escala visual analógica o con la escala verbal simple. En el domicilio (24 horas tras la cirugía), la Unidad de Atención Domiciliaria revisa los efectos secundarios, alteraciones del sueño, intensidad del dolor, necesidad de analgesia de rescate y grado de satisfacción. Resultados: un 69% de los pacientes presentaron dolor de carácter leve o ausencia de dolor tras la intervención y únicamente 16 de los 463 pacientes presentaron dolor de carácter severo. El 27% de los pacientes necesitaron analgesia de rescate y un 9% de los pacientes presentaron efectos secundarios atribuibles a los fármacos analgésicos (4% vómitos, 2% mareos, 2,5% somnolencia y 0,5% insomnio). Ningún paciente tuvo que ser reingresado después del alta. Un 83% de los pacientes mostró un alto grado de satisfacción, un 16% de los pacientes satisfacción moderada y un 0,2% poca satisfacción. Conclusión: nuestro estudio demuestra la viabilidad y seguridad de la utilización de infusores elastoméricos endovenosos como método de analgesia postoperatoria, que permiten controlar los casos de dolor moderado a severo en procedimientos aplicados a la cirugía ambulatoria. Sin embargo se necesitan más estudios comparativos con técnicas analgésicas convencionales, así como con diferentes regímenes de infusión (AU)

Introduction: moderate to severe postoperative pain is still a problem in outpatient surgery, since it causes patient flow problems and delays the discharge of patients, being one of the major causes of re-hospitalization and hence a relevant quality indicator of these Units. The use of home invasive analgesic techniques, in all their regimes, can be effective for the management of postoperative pain in these surgical procedures and allow them to be included in outpatient surgery programs. Objectives: the aim of our study was to determine the feasibility and safety of the use of elastomeric continuous perfusion pumps for the administration of home continuous endovenous analgesia, as well as to assess analgesic effectiveness and degree of satisfaction of patients undergoing outpatient surgerys. Material and methods: we conducted a simple retrospective study in 463 patients. After the surgical procedure was performed under multimodal analgesia, two differents elastomeric endovenous pumps (dexketoprofeno pump or metamizol pump) were used. Pain intensity by means of a visual analog scale and a plain oral scale, the need for supplemental analgesics. At home (24 hours after the surgical operation), the Home Care Unit checked side effects, sleep disorders, pain intensity, need of rescue analgesia and degree of satisfaction. Results: 69% of the patients report absence or slight pain 24 h after the surgical operation, just 16 out of 463 patients of the study had severe pain. The 27% of patients required rescue therapy and the 9% of the patients reported side effects attributable to analgesics (4% of the patient vomited, 2% had dizziness, 2,5% drowsiness and 0,5% insomnia). No patient required readmission after discharge. A 83% of patients reported a high degree of satisfaction, a 16% of patients moderate satisfaction and a 0,2% poor satisfaction with the infusion system and the procedure. Conclusion: our study has shown the feasibility and safety of the use of endovenous elastomeric infusion pumps as a method of postoperative analgesia that allow to manage cases of moderate or severe pain after outpatient surgical procedures. However, further studies are required to compare this technique with conventional analgesic techniques, as well as with different infusion regimes (AU)

[Diagnostics and planning of orthodontic treatment of patients with crowded teeth position with the use of elastomeric correcting splints].

3D scanning of plaster jaw models and further processing of the received data in editing program for three dimensional models Rapid Form 2006 Basis is one of the used methods of diagnostics of patients with crowded teeth position (measurement of anthropometric parameters of jaw models, dental arches symmetry, sizes and forms of dentitions). On 3D jaw models with crowded teeth position there were planned trajectories of gradual single tooth displacement in such a way that to move them in new correct position. Prescribing determined step with which the tooth would be moved there was made a series of individual plastic jaw models corresponding to each stage of treatment by stereolithographic method. On the received models there was made a series of elastomeric correcting splints producing some pressure upon teeth and making for their displacement.

Elastomer femoroplasty prevents hip fracture displacement In vitro biomechanical study comparing two minimal invasive femoroplasty techniques.

UNLABELLED: The purpose of this study was to test femur strength and the ability to prevent fracture displacement of two minimal invasive Elastomer femoroplasty techniques. METHODS: A total of sixteen fixed human cadaveric femur pairs were used. From each pair one femur was randomly assigned for Elastomer femoroplasty. In these femora we drilled a 3.5mm entrance in the lateral cortex. Cavities for the Elastomer were created by: group A, balloon and group B an excentric drill. All femora were fractured by simulating a fall on the greater trochanter. Neck-shaft-angles on plain anterior posterior radiographs were measured to determine fracture displacement. FINDINGS: There was no significant difference in fracture load between controls and treated femora for group A, 2904N (SD 1091) versus 2803N (SD 627) and group B, 2773N (SD 747) versus 2597N (SD 834). In group A the mean displacement was 35° (SD 14) for the control femora and 3° (SD 2) for the treated femora (P<0.001). In group B the mean displacement was 38° (SD 10) for the controls and 8° (SD 13) for the treated femora (P<0.001). INTERPRETATION: The results of this study show that minimal invasive Elastomer femoroplasty prevents fracture displacement of the proximal femur. We found no significant compromise in load-to-fracture after minimal invasive balloon or excentric drill femoroplasty.

Force degradation in orthodontic elastic chains / Degradação de forças em correntes elásticas ortodônticas

Purpose: This in vitro study aimed to analyze the force degradation of four commercial brands of orthodontic elastics chain (Morelli, Ormco, TP, and Unitek) over 21 days. Methods: The elastics chains were stretched and maintained at a standardized distance equivalent to a force of 150 g. The amount of force generated by the elastics chains were measured by using a dynamometer (ZEUZAN 300 g) at intervals of 30 minutes, 7, 14, and 21 days. Data were analyzed by ANOVA and Tukey's test at the 5% level of significance. Results: There was a reduction of 5% to 15% in the amount of force generated by the elastic chains after 30 minutes and of 22% to 47% after 21 days of elastic activation. Conclusion: Unitek chains displayed the highest percentage of force degradation, while TP exhibited the smallest percentage of force degradation and showed the greatest stability at all intervals tested.

Objetivo: Este estudo teve por objetivo analisar a degradação da força gerada por quatro marcas comerciais de elásticos ortodônticos em cadeia (Morelli, Ormco, TP e Unitek) em função do tempo. Metodologia: Os elásticos foram mantidos continuamente estirados a uma distância equivalente à força de 150 g. A leitura da quantidade de força gerada pelas correntes elásticas foi mensurada utilizando-se um dinamômetro da marca ZEUZAN 300 g, nos intervalos: 30 minutos, 7, 14, 21 dias. Os resultados foram analisados por ANOVA e teste de Tukey ao nível de significância de 0,05. Resultados: Verificou-se uma redução na quantidade de força gerada pelos elásticos de 5% a 15% em 30 minutos de teste e de 22% a 47% em 21 dias de estiramento constante. Conclusão: A marca Unitek obteve um maior percentual de degradação de força, enquanto a marca TP um menor percentual de degradação de força mostrando comportamento mais estável em todos os intervalos de tempo testados.

Análisis coste-efectividad de la PCA postoperatoria frente a la infusión continua elastomérica de tramadol y metamizol / Cost-effectiveness of patient-controlled analgesia compared to continuous elastomeric pump infusion of tramadol and metamizole

OBJETIVOS: Existen pocos datos relativos al coste-efectividad de los sistemas de analgesia controlada por el paciente (PCA) en el postoperatorio. El presente estudio compara desde esta perspectiva la PCA con una infusión elastomérica continua. MATERIAL Y MÉTODO: Estudio prospectivo, controlado y aleatorizado en 50 pacientes ASA I o II sometidas a cirugía mayor ginecológica, que evalúa durante las primeras 48 horas de postoperatorio la efectividad, los efectos secundarios, la satisfacción y los costes derivados de la administración de una pauta PCA i.v de metamizol y tramadol (Grupo PCA), frente a la infusión elastomérica continua de la misma solución analgésica (Grupo Elastómero). RESULTADOS: La efectividad analgésica y los efectos secundarios de las pautas fueron similares, aunque más pacientes del Grupo Elastómero precisaron rescates analgésicos con morfina (61% frente al 33% del grupo PCA; p < 0,05). El 81% de las pacientes del Grupo PCA repetirían el tratamiento analgésico frente a sólo el 56% del grupo Elastómero -p = 0,05-). El número medio de intervenciones de enfermería fue de 16 y 19 para los grupos PCA y Elastómero respectivamente. Los gastos medios de los tratamientos (no incluida la bomba PCA facilitada por la industria) ascendieron en el grupo PCA a 41,35 euros frente a los 56,22 euros del grupo Elastómero. CONCLUSIONES: Ambas pautas presentaron una eficacia analgésica parecida aunque la PCA resultó más satisfactoria, a la vez que el elastómero fue más caro. En las condiciones particulares de nuestro estudio la PCA postoperatoria resultó más ventajosa que la infusión continua elastomérica (AU)

OBJECTIVES: Little information is available on the cost-effectiveness of postoperative patient-controlled analgesia (PCA). The present study compared PCA to continuous infusion by elastomeric pump. MATERIAL AND METHODS: Fifty ASA 1 or 2 patients undergoing major gynecologic surgery were enrolled for a randomized controlled trial to evaluate the effectiveness and costs derived from intravenous PCA with metamizole and tramadol compared to continuous infusion of the same analgesic solution by elastomeric pump in the 48 hours following surgery. Patient satisfaction and side effects were also recorded. RESULTS: The analgesic effectiveness and side effects of the 2 regimens were similar, although 61% of patients in the elastomeric pump group needed morphine for rescue analgesia compared to 33% in the PCA group (P<.05). In the PCA group, 81% of the patients said they would repeat the analgesic treatment compared to only 56% in the elastomeric pump group (P=.05). The mean number of nursing interventions was 16 for the PCA group and 19 for the elastomeric pump group. The mean cost of the treatment (not including the PCA pump, provided by the manufacturer) was €41.35 for the PCA group and €56.22 for the elastomeric pump group. CONCLUSIONS: The analgesic efficacy of the 2 regimens was similar. However, patient satisfaction was greater with PCA and use of an elastomeric pump was more expensive. In the setting of the present study, postoperative PCA proved to be more advantageous than continuous elastomeric pump infusion (AU)

Elastic device facilitating delayed primary closure of sternal wound infection.

PURPOSE: Management of the sternal wound after extensive debridement continues to be a resource-intensive problem in cardiac surgery. There are a number of techniques available to achieve definitive closure of these wounds, all of which have limited effectiveness or are associated with serious complications. This article describes the use of a novel elastic system that approximates these wounds gradually, achieving dynamic wound closure. The purpose of this study is to evaluate the efficacy of this system. DESCRIPTION: We report our initial series of 3 patients who underwent dynamic wound closure using a novel elastomer system after debridement for sternal wound infection. EVALUATION: All patients achieved satisfactory healing with a mean duration of 29 days of treatment without additional procedures. CONCLUSIONS: Dynamic wound closure is an effective and feasible method of dealing with the open sternotomy wound after debridement.