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1.
Braz Oral Res ; 33: e123, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31994596

RESUMO

The objective of this study was to determine whether collagen matrix (CM) is an alternative to connective tissue graft technique (CTG) in the treatment of multiple gingival recessions (GR). The indication of CM for the treatment of multiple GR is not yet clear. More studies are needed to better understand this treatment modality, as an alternative to CTG. In this single-blind, split-mouth randomized clinical trial, fifteen patients with multiple Miller class I upper GR were selected and randomly assigned to control group (CTG) or test group (CM). Root coverage (RC) and patient-centered outcomes were evaluated at baseline and after 3, 6, and 12 months. A total of 82 GRs were treated. There was no significant difference regarding GR depth (GRD, primary outcome) between CTG (0.5 ± 0.9 mm) and CM groups (0.6 ± 1.0 mm) (p = 0.225). Percentage of RC was 82.14% in CTG and 77.7% in CM. Both groups demonstrated a gain in keratinized tissue width at 12 months (p < 0.05). Dentine hypersensitivity was effectively reduced in both groups. Postoperative pain was significantly higher in the CTG (p = 0.001). Esthetic satisfaction was high for both groups, with no significant difference (p > 0.05) between groups. After 12 months, both surgical treatments were able to promote RC, and GRD was similar in both CTG and CM groups.


Assuntos
Colágeno/uso terapêutico , Tecido Conjuntivo/transplante , Retração Gengival/cirurgia , Adolescente , Adulto , Sensibilidade da Dentina/prevenção & controle , Feminino , Seguimentos , Humanos , Modelos Lineares , Masculino , Pessoa de Meia-Idade , Duração da Cirurgia , Reprodutibilidade dos Testes , Método Simples-Cego , Estatísticas não Paramétricas , Retalhos Cirúrgicos , Fatores de Tempo , Resultado do Tratamento , Escala Visual Analógica , Adulto Jovem
2.
Klin Monbl Augenheilkd ; 237(1): 62-70, 2020 Jan.
Artigo em Alemão | MEDLINE | ID: mdl-30736077

RESUMO

BACKGROUND: Trabeculectomy for the surgical reduction of internal eye pressure is an established procedure, but the principle limitations are in postoperative wound healing. Various antimetabolites are regularly used to avoid postoperative subconjunctival scarring. The present study investigates whether the combination of an Ologen implant with bevacizumab can modify the rates of success and/or complications during trabeculectomy. METHODS: Three different groups of patients were evaluated in which trabeculectomy was performed with mitomycin C, either alone (group 1) or in combination with an Ologen implant (group 2) or with an Ologen implant with bevacizumab (group 3). The success and failure rates, changes in tension, postoperative complications and postoperative revision for pressure regulation were evaluated. The follow-up was 12 months for all eyes. RESULTS: A total of 130 eyes in 130 patients (mean age 67.74 ± 12.16 years). The number of substances applied preoperatively to reduce intraocular pressure was 2.89 ± 0.98 and the internal ocular pressure was 21.74 ± 5.49 mmHg. Twelve months postoperatively; the mean pressure was 13.14 ± 3.71 mmHg. The greatest absolute success rate (= IOD ≤ 15 mmHg without antiglaucoma medication) was in the group with exclusive goniotrepanation + mitomycin C (MMC; 72.5%), followed by the groups with Ologen (67.5%) and Ologen + bevacizumab (63.6%). The greatest failure rate (= IOD > 15 mmHg) was in the Ologen bevacizumab group (17.3%), followed by the pure Ologen group with 22.5% and the pure trabeculectomy group (12.3%). There were no significant differences in the success and failure rates. There were no serious intra- or postoperative complications in any group. The number of patients for whom it was necessary to loosen the traction thread was significantly lower in the sole Ologen group (p = 0.02). There were also no significant differences between the groups with respect to revisions. CONCLUSION: Using Ologen as drug depot for bevacizumab in a trabeculectomy (TE) with MMC is a safe and active surgical method without an increased risk of complications in comparison to pure TE with MMC or TE with MMC and Ologen implant. After 12 months, this treatment exhibited no significant advantages.


Assuntos
Bevacizumab , Glaucoma , Trabeculectomia , Idoso , Bevacizumab/administração & dosagem , Colágeno/uso terapêutico , Glaucoma/terapia , Humanos , Pressão Intraocular , Pessoa de Meia-Idade , Mitomicina , Resultado do Tratamento
3.
J Appl Oral Sci ; 27: e20180584, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31596366

RESUMO

OBJECTIVES: This study aimed to compare two different soft tissue replacement grafts in their ability to treat gingival recession defects and successfully integrate with the surrounding tissues. METHODOLOGY: Nine beagle dogs were included and followed up to 10 weeks. Sites for intervention were allocated to one of the grafting materials investigated. Treatment consisted of coronally advanced flap combined with one of the two soft tissue substitutes on a previous surgically created defect. Materials employed were porcine-derived acellular dermal matrix (ADM) [Novomatrix™ (Test)] and collagen-based matrix (CBM) [Mucograft® (Control)]. Animals were sacrificed at 2, 6, and 10 weeks postoperatively and compared using descriptive histology and histomorphometric outcomes. RESULTS: Macroscopic findings were similar between test and control groups at all intervals. After 10 weeks, both groups demonstrated successful incorporation of the grafting materials without signs of rejection and with comparable tissue integration. The histomorphometric data were similar between groups at 2 weeks; however, the test group provided greater root coverage and increase in tissue thickness than the control at 6- and 10-weeks post surgically. CONCLUSIONS: Both porcine-derived ADM and CBM revealed similar histological outcomes with successful integration and absence of adverse events. Test group provided superior outcomes regarding root coverage and increase in tissue thickness.


Assuntos
Derme Acelular , Colágeno/uso terapêutico , Retração Gengival/cirurgia , Animais , Vasos Sanguíneos/patologia , Cães , Gengiva/patologia , Gengiva/cirurgia , Retração Gengival/patologia , Teste de Materiais , Valores de Referência , Reprodutibilidade dos Testes , Retalhos Cirúrgicos , Suínos , Fatores de Tempo , Resultado do Tratamento
4.
Int Braz J Urol ; 45(5): 989-998, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31626522

RESUMO

OBJECTIVE: To evaluate the subjective and objective outcomes of MacroplastiqueR (MPQ) in women with stress urinary incontinence (SUI) secondary to intrinsic sphincter deficiency (ISD). MATERIALS AND METHODS: Following Institutional Review Board (IRB) approval, charts of non-neurogenic women with SUI secondary to ISD who underwent MPQ injection and had 6 months minimum follow-up were reviewed from a prospectively maintained database. Patients were divided into 3 groups: Naive (Group I), Prior Anti-Incontinence Surgery (Group II), and combined Prior Bulking Agent and Anti-Incontinence Surgery (Group III). Data collected included SUI self-report, Urogenital Distress Inventory (UDI-6) Question 3, and VAS Quality of Life (QoL) Questionnaire scores at baseline and in follow-up. Three-dimensional ultrasound (3DUS) evaluated volume/confi guration of MPQ. Success was defi ned after the last MPQ injection as a UDI-6 Question 3 score of 0 (dry) or 1, and no reoperation for SUI. RESULTS: From 2011-2017, 106 of 142 women met study criteria. At a median follow-up of 20 months (mean=26 months; range: 6-71), success rate was 41% for Group I, 40% for Group II, and 65% for Group III (p = 0.22). QoL scores were signifi cantly improved over baseline in all groups. There was no signifi cant difference in clinical outcome between the asymmetrical and symmetrical group on 3DUS. The completely dry rate was highest in Group III at 29%, compared to 4% for Group I and 15% for Group II (p = 0.05). CONCLUSION: MacroplastiqueR improved subjective and objective outcome measures for SUI secondary to ISD as both a primary and secondary treatment option in women.


Assuntos
Dimetilpolisiloxanos/uso terapêutico , Doenças Uretrais/complicações , Incontinência Urinária por Estresse/etiologia , Incontinência Urinária por Estresse/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Colágeno/uso terapêutico , Feminino , Humanos , Injeções , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Reoperação , Reprodutibilidade dos Testes , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento
5.
Diabetes Res Clin Pract ; 156: 107861, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31536746

RESUMO

AIMS: Because collagen is fundamental to wound healing and skin formation, collagen-containing dressing materials might be beneficial in treating diabetic foot ulcers (DFU), but supporting evidence is needed. Here, we examined the effectiveness and safety of collagen dressing material in DFU treatment. METHODS: This prospective, randomized, placebo-controlled, single-center study included patients with type 1 or 2 diabetes and palpable foot pulse who had Wagner grade 1 or 2 ulcers ≥1.0 cm2 with no signs of healing for ≥6 weeks. Patients were treated with foam dressing alone (control group) or with a porcine type I collagen dressing material (collagen group). Complete ulcer healing rate was the primary endpoint, and healing velocity and time to 50% size reduction were secondary endpoints. RESULTS: Thirty patients were included (collagen group: 17, control group: 13). There were no significant differences in demographic factors or baseline DFU characteristics. Compared to the control group, the collagen group presented a higher rate of complete healing [82.4% vs. 38.5%, P = .022], faster healing velocity (P < .05), and shorter median time to 50% size reduction (21 versus 42 days; hazard ratio = 1.94, P < .05). CONCLUSIONS: Wound management using collagen materials in DFUs showed faster and complete healing rate.


Assuntos
Colágeno/uso terapêutico , Pé Diabético/terapia , Bandagens , Colágeno/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
6.
Int J Pediatr Otorhinolaryngol ; 127: 109679, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31536855

RESUMO

The incidence of postoperative fistula following primary cleft palate repair ranges from 0% to 58%. The reported recurrence rate is between 33% and 37%, and the prognosis of a successful closure declines with each reoperation. Closure of palatal fistulas can be achieved by different techniques depending on its size and the experience of the surgeon. Local, regional and distant flaps are commonly used. Alternatively, or in addition to the previous ones, synthetic materials are becoming very popular nowadays. However, a scarcity of articles explains in detail a simple and effective method in children. We present a case report and the procedure proposed by our pediatric surgery team consisting of a three-layered repair, with a collagen membrane placed over the reconstructed nasal mucosa, and a rotational palatal mucosa flap reinforced with a fibrine sealant. This method is simple, easy to reproduce, effective and has a low rate of complications.


Assuntos
Colágeno/uso terapêutico , Mucosa Bucal/cirurgia , Mucosa Nasal/cirurgia , Fístula Bucal/cirurgia , Fístula do Sistema Respiratório/cirurgia , Retalhos Cirúrgicos , Pré-Escolar , Fissura Palatina/cirurgia , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Fístula/cirurgia , Humanos , Masculino , Fístula Bucal/etiologia , Palato Duro , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Fístula do Sistema Respiratório/etiologia , Adesivos Teciduais/uso terapêutico
7.
J Laparoendosc Adv Surg Tech A ; 29(11): 1446-1450, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31539310

RESUMO

Introduction: Symptomatic paraesophageal hernia (PEH) is an indication for surgical repair. Laparoscopic suture repair has high recurrence rates. Many surgeons prefer mesh repair to reduce PEH recurrence. Several types of mesh, synthetic and biological, are in use. Synthetic mesh has a risk of erosion and stricture, hence we preferred biological mesh repair. Our aim in this study is to assess medium-term outcomes of PEH repair with the use of biological mesh reinforcement over the cruroplasty. We also aimed to correlate clinical recurrences with radiological recurrences. Materials and Methods: This is a retrospective study of 154 consecutive patients from a single centre who underwent a standardized laparoscopic suture repair of the hiatus reinforced with an on-lay patch of Surgisis (porcine small intestine submucosa) and fundoplication. The mean age of the patients was 65 years. All patients were called for regular clinical follow-up and a barium study. Modified GERD-HRQL symptom severity instrument was used to assess postoperative symptoms and satisfaction. Results: The mean follow-up for barium swallow and clinical assessment were 28.42 ± 21.2 and 33.69 ± 23.46 months. The mean patient satisfaction score after surgery was 4.43 ± 1.09 (0-5). Follow-up barium swallow was performed in 122 (79.22%), 87 (56.49%) patients completed clinical follow-up questionnaire, and 77 (50%) had both. Symptomatic recurrence was noted in 25 (28.73%), recurrence on barium swallow 25(20.4%), and 10 (12.98%) had both. The reoperation rate was 3.25%. Mann-Whitney U test showed no statistical significance in reflux-related score between radiological recurrence group compared with no radiological recurrence (P = .06). Conclusions: Biological mesh repair of PEH is safe and well accepted by patients. There is significantly high PEH recurrence rate in long-term follow-up, even with mesh repair. Majority of these recurrences are small, asymptomatic, and the reoperation rate is very low.


Assuntos
Materiais Biocompatíveis/uso terapêutico , Colágeno/uso terapêutico , Hérnia Hiatal/cirurgia , Herniorrafia/métodos , Telas Cirúrgicas , Idoso , Animais , Feminino , Seguimentos , Fundoplicatura , Refluxo Gastroesofágico/etiologia , Refluxo Gastroesofágico/cirurgia , Hérnia Hiatal/complicações , Hérnia Hiatal/diagnóstico por imagem , Humanos , Laparoscopia , Masculino , Pessoa de Meia-Idade , Radiografia , Recidiva , Reoperação , Estudos Retrospectivos , Inquéritos e Questionários , Suturas , Suínos , Resultado do Tratamento
8.
J Surg Res ; 243: 553-559, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31382076

RESUMO

BACKGROUND: We evaluated the hemostatic efficacy and immunogenicity of CollaStat compared with FloSeal in a rabbit jejunal artery injury model. METHODS: A total of 27 experimental rabbits were used in the study. For each hemostatic agent, an injury was created in one of the right angles of the jejunal arteries originating from the vascular arcs. Time to hemostasis was determined after applying manual compression to the wound for 30 s, which was repeated a maximum of three times in cases of persistent bleeding. On postoperative day 7, the concentration of serum antithrombin antibody was measured among agent-treated and nontreated control groups. RESULTS: The mean time to hemostasis for CollaStat was significantly shorter than for FloSeal (64.0 ± 5.0 versus 84.0 ± 7.8 s; P = 0.040). There were no significant differences in rabbit serum mean anti-thrombin Ab concentration between CollaStat-treated, FloSeal -treated, and the control groups (8.43 ± 0.44 versus 8.18 ± 7.8 versus 9.58 ± 1.11 ng/mL; P = 0.065). CONCLUSIONS: According to our study, CollaStat was more efficient in achieving hemostasis in a rabbit jejunal artery injury and exhibited nonsignificant immunogenicity compared with FloSeal. These findings suggest that CollaStat has acceptable hemostatic potential for controlling significant arterial bleeding.


Assuntos
Artérias/lesões , Colágeno/uso terapêutico , Esponja de Gelatina Absorvível/uso terapêutico , Hemostasia Cirúrgica , Animais , Bovinos , Colágeno/ultraestrutura , Feminino , Humanos , Coelhos
9.
Int J Mol Sci ; 20(16)2019 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-31404991

RESUMO

Burns are physically debilitating and potentially fatal injuries. Two marine biomaterials, carboxymethyl chitosan (CMC) and collagen peptides (COP), have emerged as promising burn dressings. In this paper, sponges of carboxymethyl chitosan grafted with collagen peptide (CMC-COP) were prepared by covalent coupling and freeze drying. Scanning electron microscopy (SEM) and Fourier transform infrared (FTIR) spectroscopy were then used to characterize the prepared sponges. To evaluate the wound healing activity of the CMC-COP sponges, in vitro tests including cell viability scratch wound healing and scald wound healing experiments were performed in rabbits. Appearance studies revealed the porous nature of sponges and FTIR spectroscopy demonstrated the successful incorporation of COP into CMC. The in vitro scratch assay showed that treatment with CMC-COP sponges (at 100 µg/mL) had significant effects on scratch closure. For burn wounds treated with CMC-COP, regeneration of the epidermis and collagen fiber deposition was observed on day 7, with complete healing of the epidermis and wound on days 14 and 21, respectively. Based on the pathological examination by hematoxylin and eosinstaining, the CMC-COP group demonstrated pronounced wound healing efficiencies. These results confirmed that the CMC-COP treatment enhanced cell migration and promoted skin regeneration, thereby highlighting the potential application of these sponges in burn care.


Assuntos
Bandagens , Queimaduras/terapia , Quitosana/análogos & derivados , Colágeno/uso terapêutico , Cicatrização , Animais , Linhagem Celular , Quitosana/uso terapêutico , Feminino , Masculino , Peptídeos/uso terapêutico , Coelhos , Cicatrização/efeitos dos fármacos
10.
Mar Drugs ; 17(8)2019 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-31405173

RESUMO

This review focuses on the expanding role of marine collagen (MC)-based scaffolds for biomedical applications. A scaffold-a three-dimensional (3D) structure fabricated from biomaterials-is a key supporting element for cell attachment, growth, and maintenance in 3D cell culture and tissue engineering. The mechanical and biological properties of the scaffolds influence cell morphology, behavior, and function. MC, collagen derived from marine organisms, offers advantages over mammalian collagen due to its biocompatibility, biodegradability, easy extractability, water solubility, safety, low immunogenicity, and low production costs. In recent years, the use of MC as an increasingly valuable scaffold biomaterial has drawn considerable attention from biomedical researchers. The characteristics, isolation, physical, and biochemical properties of MC are discussed as an understanding of MC in optimizing the subsequent modification and the chemistries behind important tissue engineering applications. The latest technologies behind scaffold processing are assessed and the biomedical applications of MC and MC-based scaffolds, including tissue engineering and regeneration, wound dressing, drug delivery, and therapeutic approach for diseases, especially those associated with metabolic disturbances such as obesity and diabetes, are discussed. Despite all the challenges, MC holds great promise as a biomaterial for developing medical products and therapeutics.


Assuntos
Organismos Aquáticos/química , Materiais Biocompatíveis/farmacologia , Materiais Biocompatíveis/uso terapêutico , Colágeno/farmacologia , Colágeno/uso terapêutico , Animais , Humanos , Engenharia Tecidual/métodos , Tecidos Suporte
11.
Semin Ophthalmol ; 34(7-8): 512-517, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31449434

RESUMO

Purpose: This is the first review article examining literature specific to the use of corneal cross-linking (CXL) to treat pellucid marginal degeneration (PMD). Results: CXL appears to be an effective treatment that may halt the progression of PMD to stabilize vision. This could postpone or eliminate the need for corneal transplantation in the management of these patients. Furthermore, combining CXL with keratorefractive surgery in a single procedure has been shown to be safe and successful in improving vision in PMD patients. Conclusions: The data reported in literature is limited at this time, consisting mostly of retrospective studies with short term follow up. Further research is needed to evaluate refractive effects of combined CXL and excimer laser procedures.


Assuntos
Colágeno/uso terapêutico , Distrofias Hereditárias da Córnea/tratamento farmacológico , Substância Própria/patologia , Reagentes para Ligações Cruzadas/uso terapêutico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Distrofias Hereditárias da Córnea/diagnóstico , Topografia da Córnea , Humanos , Raios Ultravioleta
12.
Microsc Res Tech ; 82(12): 1993-1999, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31441994

RESUMO

The success of dental implants is related to the amount, quality, and composition of the alveolar bone. The placement of platelet-rich fibrin (PRF) clot associated with a resorbable collagen membrane (RCM) in a postextraction alveolus is a technique used for ridge preservation. This case report study analyzed the ultrastructural characteristics of cross-sectioned alveolar bone that received PRF and RCM using scanning electron microscopy and the inorganic composition using "energy dispersive X-ray spectrometry," in order to explore the feasibility of this method to clinical studies. Three alveolar bone samples from two male patients (37 and 58 years old), obtained in the procedure of placing the dental implant, were analyzed. Two bone samples previously received PRF and RCM (M37 and M58), the third sample represented a physiological bone formation without treatment (M37-control). The bone sample M37 showed irregularly shaped islets of calcified material intermingled with connective tissue. The other samples, from the 58-year-old patient with PRF and RCM (M58); and the other untreated bone sample from the same 37-year-old patient (M37-control) showed similar ultrastructural morphology with trabecular conformation without islets agglomerations. The inorganic composition analysis showed higher concentrations of calcium and phosphorus in both samples treated with PRF and RCM in comparison to the untreated bone sample. The Ca/P ratio was higher in the M37 sample compared to the others samples. The results showed morphology and inorganic composition differences among the treatments used, suggesting that this method is feasible to analyze parameters of the alveolar bone tissue.


Assuntos
Processo Alveolar/fisiologia , Colágeno/uso terapêutico , Implantes Dentários , Fibrina Rica em Plaquetas/metabolismo , Adulto , Processo Alveolar/ultraestrutura , Humanos , Masculino , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , Cirurgia Bucal/métodos
13.
Acta Otolaryngol ; 139(10): 833-836, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31311366

RESUMO

Background: Acellular dermal allograft (AlloDerm) and cartilage perichondrium are two common materials used for repair of tympanic membrane perforations (TMPs). To date, comparative evaluations of their efficacy have rarely been reported. Aim/objectives: To compare anatomical and audiological outcomes between AlloDerm and cartilage perichondrium in type I tympanoplasty. Methods: A total of 61 patients of TMP were studied. In total, 27 patients (Group 1) underwent AlloDerm myringoplasty, and the remaining 34 patients (Group 2) underwent perichondrium myringoplasty. Operating time, closure rate and hearing gain were compared between Groups 1 and 2. Results: Successful closure rates at 6-month follow-up were 88.9% (Group 1) and 82.4% (group 2). The average improvement of air-bone gap (ABG) was 13.5 ± 11.8 dB for Group 1 and 13.1 ± 13.1 dB for Group 2. The difference in between preoperative and 6 months postoperative ABG values was statistically significant (p < .001). Conclusions and significance: Success rates and improvement of hearing level were similar for the AlloDerm (Group 1) and the cartilage perichondrium (Group 2) groups. However, AlloDerm requires shorter operative time and avoids the incisions in the harvest of allografts. Our results suggest that AlloDerm can be recommended as an attractive alternative to cartilage grafts.


Assuntos
Derme Acelular , Cartilagem/transplante , Colágeno/uso terapêutico , Miringoplastia/métodos , Perfuração da Membrana Timpânica/cirurgia , Timpanoplastia/métodos , Adulto , Feminino , Audição , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Resultado do Tratamento
14.
Eklem Hastalik Cerrahisi ; 30(2): 91-6, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31291855

RESUMO

OBJECTIVES: This study aims to investigate the potential use and histological effects of the local administration of platelet-derived growth factor (PDGF) in the repair of full-thickness osteochondral defects in articular cartilage in an animal model. MATERIALS AND METHODS: Twenty-four adolescent 18-week-old New Zealand White rabbits with an average weight of 2500 g (range, 1600 g to 3200 g) were used in the study. The rabbits were randomly divided into three groups (n=8) as the control group (group A) and two experimental groups (groups B and C). Defects of cylindrical full-thickness (3.5 mm wide, 4 mm deep) were created in the weight-bearing area of the right knee medial femoral condyles. In group A, the defect was left empty. In group B, the defect was filled with a collagen sponge. In group C, the defect was filled with a collagen sponge impregnated with PDGF. All rabbits were followed-up for 12 weeks. Right knee medial femoral condyles were used for macroscopic and histological analyses. RESULTS: At macroscopic level, the repair tissue was similar to normal adjacent cartilage at 12 weeks in group C. The surface of the repair tissue in group C was smoother and more regular compared to groups A and B. The total histological score of defects in group C was statistically significantly superior compared to groups A and B (p<0.05). Matrix staining and immunostaining of collagen type 2 were stronger in group C compared to the other groups, indicating the presence of a tissue similar to a normal cartilage. CONCLUSION: Platelet-derived growth factor can induce repair in full-thickness defects of articular cartilage in an animal model. Thus, this study demonstrates the potential use of PDGF for full-thickness osteochondral defects.


Assuntos
Cartilagem Articular/patologia , Fator de Crescimento Derivado de Plaquetas/uso terapêutico , Animais , Colágeno/uso terapêutico , Colágeno Tipo II/metabolismo , Modelos Animais de Doenças , Articulação do Joelho , Coelhos , Distribuição Aleatória
15.
Cornea ; 38(10): 1233-1238, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31335530

RESUMO

PURPOSE: To evaluate the efficacy, predictability, and safety of combined corneal collagen cross-linking (CXL), intracorneal ring segment (ICRS) implantation, and superficial phototherapeutic keratectomy (PTK) in patients with keratoconus. METHODS: Fifty-five eyes received ICRS implantation, followed by CXL and PTK combination treatment. Patients were followed up for 6 months. Primary outcomes included Logarithm of the Minimum Angle of Resolution (LogMAR) uncorrected distance VA (UDVA) and corrected distance VA (CDVA), sphere, cylinder, mean spherical equivalent, index of surface variance, index of vertical asymmetry, keratoconus index, central keratoconus index, index of height asymmetry, and index of height decentration. Secondary outcomes were higher-order aberrations (HOAs), including HOA total, coma, spherical, secondary astigmatism, and trefoil. RESULTS: At 6 months, there was a statistically significant improvement in UDVA, CDVA, sphere, and cylinder compared with baseline (P < 0.001). UDVA improved in 14% of the eyes to 20/25 and 96% had at least 20/40 or better spectacle corrected vision; 30.9% of the eyes were within ±0.5 diopter (D), 45.5% of the eyes were within ±1.0 D, and 74.5% of the eyes were within ±2.0 D. For CDVA, 1 eye (2%) lost 3 lines (but gained UDVA), 11% lost 1 line, 38% showed no change, and 49% gained between 1 and 8 lines of vision. Eighty-eight United Arab Emiratespercent of the eyes had at least 1 line of UDVA visual improvement, 79% improved by ≥2 lines, and 69% improved by ≥3 lines. HOA total, coma, spherical aberration, and secondary astigmatism showed improvements of -0.87 (P < 0.001), -0.84 (P < 0.001), -0.10 (P = 0.002), and -0.15 (P = 0.035), respectively. CONCLUSIONS: A combined procedure of ICRS implantation, CXL, and PTK is effective, predictable, and apparently safe for patients diagnosed with moderate keratoconus.


Assuntos
Colágeno/uso terapêutico , Substância Própria/cirurgia , Reagentes para Ligações Cruzadas/uso terapêutico , Ceratocone/terapia , Fotoquimioterapia/métodos , Ceratectomia Fotorrefrativa/métodos , Riboflavina/uso terapêutico , Adolescente , Adulto , Substância Própria/diagnóstico por imagem , Topografia da Córnea , Feminino , Seguimentos , Humanos , Ceratocone/diagnóstico , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Próteses e Implantes , Desenho de Prótese , Implantação de Prótese/métodos , Estudos Retrospectivos , Resultado do Tratamento , Raios Ultravioleta , Acuidade Visual , Adulto Jovem
16.
J Cutan Med Surg ; 23(4): 413-420, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31179746

RESUMO

OBJECTIVES: It is uncertain whether dermal regeneration templates (DRTs) are helpful to reconstruct nasal defects. The aim of this study was to assess whether the aesthetic subunits determine the outcome. METHODS: In this unicentric, retrospective study, the surgical procedures and outcomes of patients who received DRTs to reconstruct nasal defects were assessed and compared with the involved aesthetic subunits. RESULTS: DRTs were used for reconstruction of 36 nasal defects in 35 patients with involvement of 76 aesthetic subunits: nasal sidewall (n = 21), nasal ala (n = 13), nasal tip/columella (n = 12, n = 1, respectively), nasal dorsum (n = 12), and extranasal aesthetic areas (n = 17). Fifty-eight nasal and 8 extranasal aesthetic subunits were reconstructed with DRTs, 10 subunits with a flap. Twenty-nine of 36 defects healed without any complications (80.5%). All reconstructed nasal tips/columella and the nasal dorsa healed without any complications. Region-specific complications were retraction of the ala rim (4/12; 33.3% of the patients with involvement of the nasal ala) and the formation of a fistula in the nasal sidewall (1/21; 4.8%). Region-specific complications of extranasal subunits were the development of an ectropium (2/3; 66.7% of the patients with involvement of the lower lid). CONCLUSIONS: DRTs can be helpful to reconstruct nasal defects. However, if the defect involves the aesthetic subunits nasal ala or the infraorbital region, different techniques should be preferred.


Assuntos
Deformidades Adquiridas Nasais/cirurgia , Neoplasias Nasais/cirurgia , Rinoplastia/métodos , Neoplasias Cutâneas/cirurgia , Pele Artificial , Ferida Cirúrgica/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sulfatos de Condroitina/uso terapêutico , Colágeno/uso terapêutico , Elastina/uso terapêutico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante de Pele , Retalhos Cirúrgicos , Resultado do Tratamento
17.
Biochim Biophys Acta Mol Cell Res ; 1866(9): 1421-1432, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31181222

RESUMO

Myocardial interstitial fibrosis (MIF) is a common finding in heart failure (HF) patients, both with preserved and reduced ejection fraction, as well as in HF animal models. MIF is associated with impaired cardiac function and worse clinical outcome. The impact of MIF is influenced not only by the quantity but also by changes in the quality of collagen fibers and in the extracellular matrix components, such as a shift in collagen types proportion, increased fibronectin polymerization and increased degree of collagen cross-linking (CCL). In particular, CCL, a process that renders collagen fibers stiffer and more resistant to degradation, is increased both in patients and animal models of HF. Importantly, in HF patients increased cardiac CCL is directly associated with increased left ventricular stiffness and a higher risk of hospitalization for HF. The aim of this review is to address the complexity of MIF in HF, focusing on CCL.


Assuntos
Colágeno/metabolismo , Matriz Extracelular/metabolismo , Fibrose/metabolismo , Insuficiência Cardíaca/metabolismo , Miocárdio/metabolismo , Animais , Colágeno/uso terapêutico , Modelos Animais de Doenças , Ventrículos do Coração/metabolismo , Humanos , Proteína-Lisina 6-Oxidase/metabolismo
18.
Carbohydr Polym ; 219: 210-218, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31151519

RESUMO

Scaffold plays a critical role in stem cell differentiation and tissue regeneration. Composite scaffolds composed of bacterial cellulose (BC) and collagen (Col) in different ratios (1:1, 3:1, 5:1) were fabricated in this study. The composite scaffolds exhibit a well-organized interconnected porous structure, significantly better physical stability than Col scaffold, and more water uptake up to 400%. They were also favorable with cell attachment and growth. After osteogenic induction of umbilical cord blood derived mesenchymal stem cells (UCB-MSCs) for 3 weeks, we found more up-regulated osteogenic markers (collagen type 1, osteocalcin, bone sialoprotein) and significantly elevated proteins and calcium deposition, particularly with BC/Col (5:1) scaffold. When PKH-26 pre-labelled MSC-loaded scaffolds were subcutaneously transplanted in a mouse model, they showed many PKH-26-labelled cells and positive signals of α-smooth muscle actin, for neovascularization in the BC/Col (5:1). The current work demonstrates that our BC/Col composites may be promising as a bone tissue-engineered scaffold.


Assuntos
Celulose/química , Colágeno/química , Gluconacetobacter xylinus/metabolismo , Engenharia Tecidual/métodos , Tecidos Suporte/química , Animais , Regeneração Óssea/efeitos dos fármacos , Diferenciação Celular/efeitos dos fármacos , Celulose/uso terapêutico , Colágeno/uso terapêutico , Humanos , Células-Tronco Mesenquimais/efeitos dos fármacos , Camundongos , Células NIH 3T3 , Osteogênese/efeitos dos fármacos
19.
Interdiscip Sci ; 11(2): 282-286, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31250289

RESUMO

AIM: Our aim was to examine existing literature, and determine if there are outcome differences between accelerated corneal collagen cross-linking (A-CXL) and conventional corneal collagen cross-linking (C-CXL). METHODS: A systematic review of the literature was conducted examining studies which compared A-CXL to C-CXL. Available studies were combined and the weighted mean difference (WMD) was calculated for range of outcome measures including maximal keratometry (Kmax), mean keratometry (Kmean) and minimum keratometry (Kmin), spherical equivalent, best corrected visual acuity (BCVA), and central corneal thickness (CCT). RESULTS: Seven eligible studies were included in our meta-analysis, with 283 eyes (135 in A-CXLand 148 in C-CXL). In the combined analysis, there was no statistically significant difference observed in Kmin or Kmax between A-CXL and C-CXL for at least 6 months after the procedure. Kmean was statistically higher in the C-CXL group in comparison with the A-CXL group for at least 6 months after the procedure (WMD - 3.15, 95% CI - 4.34 to - 1.97, p < 0.01).No statistically significant difference observed in spherical equivalent or central corneal thickness between the A-CXL group and C-CXL group for at least 6 months after the operation. The BCVA was statistically higher in the A-CXL group in comparison with the C-CXL group for at least 6 months after the procedure (WMD - 0.05, 95% CI 0.00-0.10, p < 0.05). No surgery complication was recorded in the researches. CONCLUSION: Our study demonstrated greater reductions of Kmean in the A-CXL group in comparison with the C-CXL group. Overall A-CXL is comparable to C-CXL from outcome basis.


Assuntos
Colágeno/uso terapêutico , Reagentes para Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Adolescente , Adulto , Paquimetria Corneana , Humanos , Ceratocone/fisiopatologia , Resultado do Tratamento , Acuidade Visual
20.
Medicine (Baltimore) ; 98(25): e16094, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31232951

RESUMO

AIM: To evaluate the efficacy and safety of trabeculectomy (Trab) with mitomycin-C (MMC) versus Trab with implant. METHODS: Studies published in different languages were retrieved by systematically searching Embase, PubMed, Cochrane library, China Biology Medicine disc, and Google Scholar from 1966 to April 2018, as well as manually examining the references of the original articles. The outcome measures of efficacy covered intraocular pressure, glaucoma medications reductions, and success rate. Safety evaluation was measured by relative ratio of complications. RESULTS: A total of 11 studies involving 443 participants were covered in this meta-analysis. The weighted mean difference (WMD) in the percentage of intraocular pressure (IOP) reduction (IOPR%) comparing Ologen group with MMC group was -3.69 (95% CI: -6.70 to -0.68) at 1 month, -2.69 (-5.17 to -0.21) at 3 months, -3.67 (-6.09 to -1.25)at 6 months, -3.24 (-6.08 to -0.41) at 12 months, 1.24 (-9.43 to 11.90) at 24 months, and 1.10 (-10.11 to 12.31) at 60 months, which showed that there was statistically significant difference at 1,3, 6, and12 months after the surgery. A significantly higher incidence of postsurgery hypotony (0.64 (95% Cl: 0.42 to 0.98)) and suture lysis (0.30 (95% CI: 0.10-0.93)) was observed in MMC group. However, there was no significant difference in the reduction in glaucoma medications, success rate, and incidence of other complications.Trab with 0.2 mg/mL MMC presented higher rates of complete success compared with Trab with 0.4 mg/mL MMC (P = .01). CONCLUSION: Trab with MMC was associated with a higher IOP-lowering efficacy and a higher incidence of postsurgery hypotony and suture lysis in contrast to that of Trab with Ologen.


Assuntos
Colágeno/farmacologia , Glicosaminoglicanos/farmacologia , Mitomicina/farmacologia , Próteses e Implantes/normas , Trabeculectomia/instrumentação , Colágeno/administração & dosagem , Colágeno/uso terapêutico , Glicosaminoglicanos/administração & dosagem , Glicosaminoglicanos/uso terapêutico , Humanos , Mitomicina/administração & dosagem , Mitomicina/uso terapêutico , Trabeculectomia/métodos
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