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1.
Braz Oral Res ; 33: e092, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31576904

RESUMO

This study evaluated the effect of antimicrobial photodynamic therapy (aPDT) on the endodontic treatment of apical periodontitis (AP). AP was induced in 48 premolars of 6 dogs. After biomechanical preparation, the teeth were divided into 4 groups: Calcium-Hydroxide (CH)/120d and CH/180d: root canals filled with CH-based dressing for 15 days before obturation; aPDT/120d and aPDT/180d: conditioning with phenothiazine photosensitizer (10 mg/mL) for 1 minute and irradiation with diode laser in the same session as obturation. Root filling was performed with AH Plus sealer. After the experimental periods, animals were euthanized and teeth were submitted for histology. HE staining was performed for descriptive analysis of the periapical region, measurement of apical periodontitis and for inflammatory cells, and blood vessels count. Immunohistochemistry was performed for osteopontin (OPN) and alkaline phosphatase (ALP). Data were analyzed statistically by two-way ANOVA and chi-square test (α = 5%). Teeth in Group CH/120d presented only a slightly enlarged periodontal ligament (PL) with advanced repair. Group aPDT/120d presented the PL moderately enlarged, with moderate inflammatory infiltrate and few collagen fibers. The same pattern was observed at 180 days. AP lesions in CH-treated groups were smaller than those in aPDT-treated groups (p < 0.001) with more blood vessels (p < 0.0001), regardless of the evaluation period, without significant differences in the number of inflammatory cells (p > 0.05). CH-treated groups showed significantly more intense immunostaining for ALP and OPN (p < 0.001) in both periods. Although aPDT stimulated angiogenesis and expression of bone formation markers, the two-session endodontic treatment with CH-based dressing promoted better apical periodontitis repair.


Assuntos
Cimentos para Ossos/uso terapêutico , Hidróxido de Cálcio/uso terapêutico , Periodontite Periapical/tratamento farmacológico , Fotoquimioterapia/métodos , Tratamento do Canal Radicular/métodos , Animais , Vasos Sanguíneos/efeitos dos fármacos , Regeneração Óssea/efeitos dos fármacos , Imuno-Histoquímica , Neovascularização Fisiológica/efeitos dos fármacos , Periodontite Periapical/patologia , Reprodutibilidade dos Testes , Fatores de Tempo , Resultado do Tratamento
2.
Medicine (Baltimore) ; 98(39): e17355, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31574879

RESUMO

BACKGROUND: Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH. METHODS: The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied. DISCUSSION: Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention. TRIAL REGISTRATION: NCT03904641.


Assuntos
Anti-Infecciosos/uso terapêutico , Hipoplasia do Esmalte Dentário/tratamento farmacológico , Fotoquimioterapia/métodos , Criança , Hipoplasia do Esmalte Dentário/microbiologia , Dentina , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Método Simples-Cego , Resultado do Tratamento
3.
Chem Commun (Camb) ; 55(69): 10226-10229, 2019 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-31380870

RESUMO

A formulation of self-assembled peptido-nanomicelles has been developed for a combinational treatment of SDT, PDT and chemotherapy to nasopharyngeal carcinoma. In vitro cellular tests and in vivo mice therapy proved effective for targeted tumor growth inhibition. These merits provided a novel approach to non-invasive cancer treatments.


Assuntos
Corantes Fluorescentes/uso terapêutico , Carcinoma Nasofaríngeo/terapia , Peptídeos/uso terapêutico , Rosa Bengala/uso terapêutico , Animais , Linhagem Celular Tumoral , Terapia Combinada/métodos , Corantes Fluorescentes/administração & dosagem , Humanos , Camundongos Nus , Micelas , Carcinoma Nasofaríngeo/patologia , Peptídeos/administração & dosagem , Fotoquimioterapia/métodos , Rosa Bengala/administração & dosagem , Terapia por Ultrassom/métodos
4.
Medicine (Baltimore) ; 98(27): e16275, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31277154

RESUMO

BACKGROUND: Halitosis is the term used to define an unpleasant odor emanating from the mouth. However, no studies have evaluated the causes and treatment of halitosis in the population of older adults with denture. METHODS: A randomized, controlled trial is proposed. The patients will be divided into 2 groups: G1: older adults who wear complete dentures and will be treated with tongue scraper (n = 20); G2 older adults who wear complete dentures and will be treated with PDT (n = 20). If the halitosis persists, the participants will be submitted to hygiene procedures for the mucosa and dentures. The evaluation of halitosis will be made before and after treatments, with OralChroma. If the halitosis is solved, the participants will return after 1 week for an additional evaluation. Oral Health Impact Profile (OHIP-14) will be administered by a calibrated examiner on the day the patient history is taken (baseline) and 1 week after treatment for halitosis. DISCUSSION: This protocol will determine the effectiveness of photodynamic therapy regarding the reduction of halitosis in older adults with complete denture. TRIAL REGISTRATION: This protocol was registered in ClinicalTrial.gov, under number NCT03960983. It was first posted and last updated in May 23, 2019. https://clinicaltrials.gov/ct2/show/NCT03960983.


Assuntos
Prótese Total/efeitos adversos , Halitose/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto/métodos , Idoso , Seguimentos , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Método Simples-Cego , Fatores de Tempo
5.
BMC Ophthalmol ; 19(1): 153, 2019 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-31324161

RESUMO

BACKGROUND: There is no consensus on the optimal initial treatment for polypoidal choroidal vasculopathy (PCV). Our study aimed to report the efficacy of repeated injections of intravitreal ranibizumab with or without photodynamic therapy for the treatment of PCV and to determine the possible factors predictive of visual outcomes. METHODS: The results of the initial treatment of 40 patients with PCV with 3 monthly injections of ranibizumab were retrospectively reviewed. We compared the results in terms of the best corrected visual acuity (BCVA), the central retinal thickness (CRT), the number of injections, the regression rates of polyps and the rates of the reduction of subretinal fluid. RESULTS: At the 3-month follow-up, the mean BCVA was significantly increased by 7.3 ± 12.4 letters compared to baseline (p < 0.01). At the 12-month follow-up, the mean BCVA was increased by 3.4 ± 15.4 letters compared to baseline, and there was no significant difference (p > 0.05). The mean CRT at the 12-month follow-up was 593.58 ± 243.64 µm, with an average decrease of 101.55 ± 256.07 µm compared to baseline (p < 0.01). Fifteen eyes (18.8%) showed the complete regression of polyps, and 22 eyes (27.5%) showed a reduction in polyps. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were significant independent factors that were predictive of improved VA at the final follow-up. CONCLUSIONS: Three monthly injections of ranibizumab as an initial treatment could significantly improve VA in PCV patients in the short term. At 12 months postinjection, ranibizumab treatment could stabilize VA in most PCV patients. The baseline VA, the reduction in subretinal fluids and the greatest lesion diameter were predictive factors for the relative improvement of VA at the final follow-up.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Neovascularização de Coroide/tratamento farmacológico , Ranibizumab/uso terapêutico , Idoso , Feminino , Humanos , Injeções Intravítreas , Masculino , Pessoa de Meia-Idade , Fotoquimioterapia/métodos , Pólipos/tratamento farmacológico , Estudos Retrospectivos , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores , Acuidade Visual
6.
Semin Ophthalmol ; 34(6): 436-441, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31309849

RESUMO

Purpose: To evaluate the efficacy and safety of oral eplerenone in cases of central serous chorioretinopathy (CSCR) refractory to photodynamic therapy (PDT). Methods: 19 patients with chronic CSCR and persistent subretinal fluid (SRF) were treated with oral eplerenone for 6 months, starting at a dose of 25 mg/day for 4 weeks and then 50 mg/day for 5 months. All patients underwent visual acuity measurement and optical coherence tomography (OCT), while fluorescein angiography was also performed at baseline, before treatment. Resolution of SRF, changes in retinal thickness and BCVA changes at month 6 and 12 post-treatment initiation were assessed. In addition, creatinine and electrolyte test was done on each patient every month for potential complications. Results: Two out of 19 cases were excluded, since one presented with hyperkaliemia 15 days after eplerenone intake and one with skin rash one day after the treatment initiation. At month 12, 88.2% of patients exhibited visual acuity improvement and 76.4% SRF resolution, while in 11.8% of patients SRF remained stable. Conclusions: This study has shown that eplerenone is safe and effective in cases of chronic CSCR, refractory to previous PDT.


Assuntos
Coriorretinopatia Serosa Central/tratamento farmacológico , Eplerenona/administração & dosagem , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Acuidade Visual/fisiologia , Administração Oral , Adulto , Coriorretinopatia Serosa Central/diagnóstico , Coriorretinopatia Serosa Central/fisiopatologia , Corioide/patologia , Doença Crônica , Relação Dose-Resposta a Droga , Feminino , Angiofluoresceinografia , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Antagonistas de Receptores de Mineralocorticoides/administração & dosagem , Estudos Prospectivos , Retina/patologia , Tomografia de Coerência Óptica , Resultado do Tratamento
7.
Chem Commun (Camb) ; 55(64): 9471-9474, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31328205

RESUMO

A hydrogel drug cargo based on 2D tungsten nitride nanosheets was fabricated. It exhibits stable NIR-II responsive photothermal properties and drug release behaviour. Moreover, this hydrogel shows excellent tumour ablation efficiency in vivo via NIR-II triggered multiple chemo/photothermal therapy.


Assuntos
Antineoplásicos/uso terapêutico , Hidrogéis , Hipertermia Induzida , Raios Infravermelhos , Nanoestruturas/química , Fotoquimioterapia/métodos , Tungstênio/química , Linhagem Celular Tumoral , Sistemas de Liberação de Medicamentos , Humanos
8.
J Nanobiotechnology ; 17(1): 78, 2019 Jul 03.
Artigo em Inglês | MEDLINE | ID: mdl-31269964

RESUMO

BACKGROUND: The construction of a multifunctional drug delivery system with a variety of advantageous features, including targeted delivery, controlled release and combined therapy, is highly attractive but remains a challenge. RESULTS: In this study, we developed a MoS2-based hyaluronic acid (HA)-functionalized nanoplatform capable of achieving targeted delivery of camptothecin (CPT) and dual-stimuli-responsive drug release. HA was connected to MoS2 via a disulfide linkage, forming a sheddable HA shell on the surface of MoS2. This unique design not only effectively prevented the encapsulated CPT from randomly leaking during blood circulation but also significantly accelerated the drug release in response to tumor-associated glutathione (GSH). Moreover, the MoS2-based generated heat upon near-infrared (NIR) irradiation could further increase the drug release rate as well as induce photothermal ablation of cancer cells. The results of in vitro and in vivo experiments revealed that MoS2-SS-HA-CPT effectively suppressed cell proliferation and inhibited tumor growth in lung cancer cell-bearing mice under NIR irradiation via synergetic chemo-photothermal therapy. CONCLUSIONS: The as-prepared MoS2-SS-HA-CPT with high targeting ability, dual-stimuli-responsive drug release, and synergistic chemo-photothermal therapy may provide a new strategy for cancer therapy.


Assuntos
Antineoplásicos Fitogênicos/administração & dosagem , Camptotecina/administração & dosagem , Dissulfetos/química , Portadores de Fármacos/química , Molibdênio/química , Nanopartículas/química , Neoplasias/diagnóstico por imagem , Neoplasias/terapia , Animais , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Terapia Combinada , Liberação Controlada de Fármacos , Feminino , Corantes Fluorescentes/química , Humanos , Ácido Hialurônico/química , Hipertermia Induzida , Raios Infravermelhos , Camundongos Nus , Transplante de Neoplasias , Oxirredução , Fotoquimioterapia/métodos
9.
Chem Commun (Camb) ; 55(67): 9904-9914, 2019 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-31360938

RESUMO

The successful clinical application of the three generation platinum anticancer drugs, cisplatin, carboplatin and oxaliplatin, has promoted research interest in metallodrugs; however, the problems of drug resistance and adverse effects have hindered their further application and effects. Thus, scientists are searching for new anticancer metallodrugs with lower toxicity and higher efficacy. The ruthenium complexes have emerged as the most promising alternatives to platinum-based anticancer agents because of their unique multifunctional biochemical properties. In this review, we first focus on the anticancer applications of various ruthenium complexes in different signaling pathways, including the mitochondria-mediated pathway, the DNA damage-mediated pathway, and the death receptor-mediated pathway. We then discuss the functionalization and cancer-targeting designs of different ruthenium complexes in conjunction with other therapies such as photodynamic therapy, photothermal therapy, radiosensitization, targeted therapy and nanotechnology for precise cancer therapy. This review will help in designing and accelerating the research progress regarding new anticancer ruthenium complexes.


Assuntos
Antineoplásicos/química , Complexos de Coordenação/química , Rutênio/química , Animais , Antineoplásicos/uso terapêutico , Complexos de Coordenação/uso terapêutico , Descoberta de Drogas , Humanos , Estrutura Molecular , Terapia de Alvo Molecular , Nanopartículas/química , Fotoquimioterapia/métodos , Medicina de Precisão , Relação Estrutura-Atividade
10.
Rom J Ophthalmol ; 63(1): 68-74, 2019 Jan-Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31198900

RESUMO

Objective. To determine the effect of corneal cross-linking (CXL) on the anterior and posterior corneal indices in terms of their repeatability and change as measured with Pentacam. Methods. Thirty eyes of 30 patients with progressive keratoconus undergoing CXL were enrolled. At each visit (pre-CXL, 6 and 12 months after CXL), imaging were done twice, one hour apart to determine the repeatability index (RI) and intra-class correlation coefficient (ICC). For same session measurements, we computed the intra-session repeatability. We also calculated 4 measures of change by subtracting baseline from 1-year results and determined the repeatability of measures of change. Results. There was no significant difference between the intra-session RI at baseline, 6 months, and 12 months for anterior Kmax-3mm (P=0.609), anterior Kmin-3mm (P=0.548), Kmax-8mm (P=0.860), posterior Kmax-3mm (P=0.717), posterior Kmin-3mm (P=0.548), Q-value-6mm (P=0.890), central corneal thickness (P=0.751), minimum corneal thickness (P=0.787), or anterior chamber depth (P=0.760). The ICCs for these indices were higher than 0.9. For keratoconus indices, there was no significant difference between the intra-session RI at baseline and follow-ups (P>0.05), and the ICC were higher than 0.9 except for baseline and 6-month index of height asymmetry (IHA). The ICC for all 1-year measures of change were more than 0.75 except for posterior corneal indices and IHA. Conclusion. Pentacam repeatability of different indices is not affected by CXL. However, the change of indices showed high variance, which should be taken into consideration, especially in systematic reviews because inter-study differences can be due to low repeatability of the measures of change.


Assuntos
Córnea/diagnóstico por imagem , Reagentes para Ligações Cruzadas/uso terapêutico , Ceratocone/tratamento farmacológico , Fotoquimioterapia/métodos , Riboflavina/uso terapêutico , Adolescente , Adulto , Córnea/efeitos dos fármacos , Paquimetria Corneana , Topografia da Córnea , Feminino , Seguimentos , Humanos , Ceratocone/diagnóstico , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Acuidade Visual , Adulto Jovem
11.
Cornea ; 38(7): 864-867, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31170104

RESUMO

PURPOSE: To assess corneal thickness changes with isotonic riboflavin (RF) solution with hydroxylpropyl methylcellulose in patients undergoing accelerated corneal collagen crosslinking (CXL) with and without an eyelid speculum. METHODS: Fifty-two eyes of 48 patients with progressive keratoconus were enrolled in this study. The patients in this study were divided into 2 groups: in group 1 an eyelid speculum was removed during 20-minute RF (0.1%) + hydroxylpropyl methylcellulose (Mediocross M; Avedro Inc, Waltham, MA) instillation, and in group 2 the eyelid speculum was retained in place during the entire CXL procedure. All patients underwent accelerated CXL using continuous ultraviolet-A (UVA) light exposure at 9 mW/cm for 10 minutes; total energy dose was 5.4 J/cm. Intraoperative ultrasound pachymetry measurements were obtained before and after epithelial removal, after RF loading, and after UVA light exposure at 5 and 10 minutes. RESULTS: The preoperative pachymetric measurements decreased in both groups after the removal of epithelium [group 1 (n = 26): -25 µm, group 2 (n = 26): -31 µm, P = 0.234]. Although the thinnest pachymetry significantly increased after soaking in both group 1 (52.26 µm) and group 2 (27.88 µm, P < 0.001), closure of the eyelids during RF instillation further increased the pachymetry readings (P < 0.0001). The corneal thickness remained stable in both groups during UVA irradiation at 5 and 10 minutes (P > 0.05). CONCLUSIONS: Closure of the eyelids further induces corneal swelling that may offer an advantage to improve safety of the procedure particularly in thin corneas.


Assuntos
Colágeno/metabolismo , Córnea/efeitos dos fármacos , Derivados da Hipromelose/uso terapêutico , Ceratocone/tratamento farmacológico , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Adolescente , Adulto , Criança , Reagentes para Ligações Cruzadas/uso terapêutico , Feminino , Humanos , Derivados da Hipromelose/farmacologia , Masculino , Fotoquimioterapia/instrumentação , Fármacos Fotossensibilizantes/farmacologia , Riboflavina/farmacologia , Instrumentos Cirúrgicos , Raios Ultravioleta , Adulto Jovem
12.
Nat Commun ; 10(1): 2412, 2019 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-31160596

RESUMO

Peptide self-assemblies with multiple nanostructures have great potentials in functional biomaterials, and yet the tedious and costly covalent peptide modification and the lack of facile controllability on self-assembly morphology retard the peptide-related exploration. Here we report a simple approach to fabricate a supramolecular peptide that shows programmable self-assembly with multiple morphologies and application in photodynamic therapy. Pillar[5]arene-based host-guest recognition is used to construct a supramolecular peptide, which simplify the peptide modification and promote the controllability of the self-assembly behavior. Due to the ERGDS sequences on the exterior surfaces and hydrophobic cores of self-assemblies, the nanoparticles formed from the supramolecular peptide are suitable vehicles to encapsulate a photosensitizer for photodynamic therapy. In vitro and in vivo studies demonstrate that the inherent targeting capability and supramolecular strategy greatly boost its photodynamic therapeutic efficiency. This supramolecular peptide holds promising potentials in precise cancer therapy and perspectives for the peptide modification.


Assuntos
Calixarenos/síntese química , Nanopartículas , Peptídeos/síntese química , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/administração & dosagem , Células A549 , Sistemas de Liberação de Medicamentos , Células Endoteliais , Humanos , Porfirinas/administração & dosagem
13.
Curr Opin Ophthalmol ; 30(4): 220-228, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31170100

RESUMO

PURPOSE OF REVIEW: To review the efficacy of intrastromal corneal ring segments (ICRS) for keratoconus and with other interventions such as contacts lens, keratoplasty, and corneal collagen cross-linking. RECENT FINDINGS: Changes in ICRS thickness and size, combination of procedures, and the adaptation of a more sophisticated classification system have broadened our application of ICRS. Recent studies have shown the long-term efficacy of ICRS in visual acuity, keratometry, and astigmatism. SUMMARY: Studies have demonstrated the short-term and long-term efficacy of ICRS implantation in patients with keratoconus.


Assuntos
Substância Própria/cirurgia , Ceratocone/cirurgia , Próteses e Implantes , Implantação de Prótese/métodos , Colágeno/metabolismo , Lentes de Contato , Substância Própria/metabolismo , Reagentes para Ligações Cruzadas/uso terapêutico , Humanos , Ceratocone/metabolismo , Fotoquimioterapia/métodos , Resultado do Tratamento , Acuidade Visual/fisiologia
14.
Cornea ; 38(8): 1049-1057, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31169612

RESUMO

PURPOSE: To evaluate the safety, efficacy, and stability of topography-guided partial PRK combined with corneal cross-linking (CXL) (the Athens Protocol [AP]) in pediatric patients with keratoconus over a 4-year follow-up period. METHODS: This prospective study included 39 keratoconic eyes of 21 patients younger than 18 years with clinical and imaging evidence of keratoconus progression. Partial topography-guided excimer laser ablation in conjunction with high-fluence CXL was performed in all patients according to the AP. Uncorrected distance visual acuity, corrected distance visual acuity, refraction, keratometry, endothelial cell density, topography, and tomography using both Scheimpflug and optical coherence tomography (OCT) were evaluated for 4 years postoperatively. RESULTS: At 4 years postoperative, there was significant improvement in mean uncorrected distance visual acuity from 0.51 ± 0.31 (decimal) to 0.65 ± 0.26 (decimal; P < 0.05). Mean corrected distance visual acuity improved from 0.71 ± 0.22 (decimal) preoperatively to 0.81 ± 0.19 (decimal; P < 0.05), respectively. Mean flat keratometry (K1) and mean steep keratometry (K2) readings reduced from 44.95 ± 3.71 D and 49.32 ± 5.05 D, respectively, preoperatively to 43.14 ± 2.95 D and 46.28 ± 4.87 D, respectively, (P < 0.05) at 4 years. The mean anterior maximum keratometry (Kmax) reading reduced from 56.81 ± 2.94 D preoperatively to 48.11 ± 3.17 D at 48 months. The mean index of height decentration was 0.105 ± 0.054 µm preoperatively and 0.049 ± 0.024 (P < 0.05) at 4 years postoperative. Mean preoperative corneal thickness at the thinnest point was 436.7 ± 42.6 µm preoperatively, 392.50 ± 45.68 µm at 12 months postoperative, and 418.42 ± 17.01 µm at 4-year follow-up. Late-onset deep corneal haze, a potential intrinsic complication of this technique in pediatric patients, was encountered in 2 cases at least 1 year after the procedure. CONCLUSIONS: Long-term results of the AP seem to be safe and effective in pediatric patients, with marked improvement in visual function and keratometric symmetry indices.


Assuntos
Reagentes para Ligações Cruzadas , Ceratocone/terapia , Fotoquimioterapia/métodos , Ceratectomia Fotorrefrativa/métodos , Cirurgia Assistida por Computador/métodos , Adolescente , Criança , Protocolos Clínicos , Colágeno/metabolismo , Terapia Combinada , Substância Própria/metabolismo , Topografia da Córnea/métodos , Feminino , Humanos , Ceratocone/tratamento farmacológico , Ceratocone/metabolismo , Ceratocone/cirurgia , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Refração Ocular/fisiologia , Riboflavina/uso terapêutico , Tomografia de Coerência Óptica , Raios Ultravioleta , Acuidade Visual/fisiologia
15.
Cornea ; 38(8): 986-991, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31180339

RESUMO

PURPOSE: To evaluate the changes in anterior corneal topography induced by short-time wear of scleral contact lenses (SLs) in keratoconic subjects with and without a history of corneal cross-linking (CXL). METHODS: Nine keratoconic patients (14 eyes) were fitted with 18.5 mm SLs for optical rehabilitation. Subjects were divided into 2 groups: 7 eyes without a history of CXL (Non-CXL group) and 7 with a history of CXL (CXL group). Corneal topography was performed at baseline and after 2 and 5 hours of lens wear. The differences for simulated flat (Kflat), steep (Ksteep) and maximal (Kmax) corneal curvatures, central corneal astigmatism (CCA), and central cornea thickness were evaluated. RESULTS: No statistically significant difference was detected between Non-CXL and CXL groups in any of these measures. Statistically significant flattening was detected in Ksteep Repeated measures analysis of variance ([RM-ANOVA), F (2,24) = 11.32, P < 0.0001], CCA [RM-ANOVA, F (2,24) = 15.34, P < 0.0001], and Kmax [RM-ANOVA, F (2,24) = 19.10, P < 0.0001). From baseline to 5 hours of SL wear, Ksteep decreased on average from 53.1 to 52.4 D, Kmax decreased from 56.7 to 55.8 D, and CCA decreased from 7.2 to 6.3 D. Kmax showed a trend toward more flattening in the Non-CXL group. Central cornea thickness showed significant thickening over time from baseline (451 µm) to 5 hours (458 µm) of SL wear [RM-ANOVA, F (1,12) = 319.3, P < 0.0001]. CONCLUSIONS: Short-term scleral lens wear in keratoconic patients may cause flattening of the anterior cornea. A history of CXL treatment does not guarantee corneal shape stability after scleral lens wear. Practitioners should be aware of these changes because scleral lens wear may mask the signs of keratoconus progression.


Assuntos
Lentes de Contato , Córnea/fisiopatologia , Topografia da Córnea , Reagentes para Ligações Cruzadas , Ceratocone/fisiopatologia , Ceratocone/terapia , Fotoquimioterapia/métodos , Adulto , Colágeno/metabolismo , Substância Própria/metabolismo , Feminino , Humanos , Ceratocone/tratamento farmacológico , Masculino , Fármacos Fotossensibilizantes/uso terapêutico , Riboflavina/uso terapêutico , Esclera , Acuidade Visual/fisiologia , Adulto Jovem
17.
Adv Mater ; 31(33): e1901965, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31237375

RESUMO

Antibacterial photocatalytic therapy has been reported as a promising alternative water disinfection technology for combating antibiotic-resistant bacteria. Numerous inorganic nanosystems have been developed as antibiotic replacements for bacterial infection treatment, but these are limited due to the toxicity risk of heavy metal species. Organic semiconductor photocatalytic materials have attracted great attention due to their good biocompatibility, chemically tunable electronic structure, diverse structural flexibility, suitable band gap, low cost, and the abundance of the resources they require. An all-organic composite photocatalytic nanomaterial C3 N4 /perylene-3,4,9,10-tetracarboxylic diimide (PDINH) heterostructure is created through recrystallization of PDINH on the surface of C3 N4 in situ, resulting in enhanced photocatalytic efficiency due to the formation of a basal heterostructure. The absorption spectrum of this composite structure can be extended from ultraviolet to near-infrared light (750 nm), enhancing the photocatalytic effect to produce more reactive oxygen species, which have an excellent inactivation effect on both Gram-negative and positive bacteria, while demonstrating negligible toxicity to normal tissue cells. An efficient promotion of infectious wound regeneration in mice with Staphylococcus aureus infected dermal wounds is demonstrated. This all-organic heterostructure shows great promise for use in wound disinfection.


Assuntos
Antibacterianos/química , Imidas/química , Nitrilos/química , Perileno/análogos & derivados , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/química , Semicondutores , Animais , Antibacterianos/uso terapêutico , Antibacterianos/toxicidade , Catálise , Sobrevivência Celular , Escherichia coli/efeitos dos fármacos , Feminino , Luz , Camundongos , Camundongos Endogâmicos BALB C , Células NIH 3T3 , Nanoestruturas/química , Nitrilos/uso terapêutico , Nitrilos/toxicidade , Perileno/química , Fármacos Fotossensibilizantes/uso terapêutico , Fármacos Fotossensibilizantes/toxicidade , Porfirinas/uso terapêutico , Porfirinas/toxicidade , Espécies Reativas de Oxigênio/metabolismo , Staphylococcus aureus/efeitos dos fármacos , Cicatrização , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia
18.
Surg Clin North Am ; 99(3): 439-456, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31047034

RESUMO

Esophageal and gastric carcinomas are prevalent malignancies worldwide. In contrast to the poor prognosis associated with advanced stages of disease, early stage disease has a favorable prognosis. Early stage gastric cancer (ESGC) is defined as cancer in which the depth of invasion is limited to the submucosal layer of the stomach on histologic examination, regardless of lymph node status. ESGC that meets standard or expanded criteria can be treated via endoscopic mucosal resection and endoscopic submucosal dissection. Similar indications for endoscopic interventions exist for gastroesophageal junction and esophageal malignancies."


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Junção Esofagogástrica , Neoplasias Gástricas/cirurgia , Técnicas de Ablação/métodos , Adenocarcinoma/diagnóstico , Idoso , Esôfago de Barrett/diagnóstico , Esôfago de Barrett/cirurgia , Detecção Precoce de Câncer , Neoplasias Esofágicas/diagnóstico , Feminino , Gastroscopia/métodos , Humanos , Laparoscopia/métodos , Fotoquimioterapia/métodos , Fatores de Risco , Biópsia de Linfonodo Sentinela/métodos , Neoplasias Gástricas/diagnóstico , Neoplasias Gástricas/tratamento farmacológico , Resultado do Tratamento
19.
Surg Clin North Am ; 99(3): 555-569, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31047042

RESUMO

In patients with advanced esophageal or gastric cancer, it is highly likely that palliation of symptoms will become a focus of treatment. Dysphagia and obstruction are the most common complaints, and many of these patients can be treated with endoscopic interventions to alleviate symptoms. Bleeding, perforation, and nutritional issues are common problems. Attempts at palliation should be guided by thoughtful discussions regarding patients' goals of care. Owing to the high morbidity and mortality in patients with limited life expectancy, a strategy of working from the least invasive to the most invasive interventions should be guided by the patient's goals.


Assuntos
Neoplasias Esofágicas/terapia , Cuidados Paliativos/métodos , Neoplasias Gástricas/terapia , Coagulação com Plasma de Argônio/métodos , Braquiterapia/métodos , Quimiorradioterapia/métodos , Criocirurgia/métodos , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/terapia , Dilatação/métodos , Endoscopia Gastrointestinal/métodos , Etanol/administração & dosagem , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/terapia , Perfuração Intestinal/etiologia , Perfuração Intestinal/terapia , Terapia a Laser/métodos , Estadiamento de Neoplasias/métodos , Apoio Nutricional , Fotoquimioterapia/métodos , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Stents Metálicos Autoexpansíveis
20.
Graefes Arch Clin Exp Ophthalmol ; 257(7): 1365-1372, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31037490

RESUMO

PURPOSE: To study the changes in the choroidal vascular pattern of the deep choroidal layer and choriocapillaris in the eyes with central serous chorioretinopathy (CSC) before versus after photodynamic therapy (PDT) as visualized by optical coherence tomography angiography (OCTA). METHODS: This comparative case series study included patients who underwent a half-dose of PDT as a therapy for CSC. Using OCTA and manually shifting the reference level into the deep choroidal layer, we assessed the density of the deep choroidal vascular layer and choriocapillaris. RESULTS: The study included 20 patients (17 men; mean age, 43.3 ± 10.9 years), with two patients showing bilateral CSC. In the eyes affected by CSC, the mean vascular density of the deep choroidal layer and choriocapillaris increased significantly from 54.2 ± 6.7% at baseline to 58.0 ± 4.7% at 1 month after PDT (P = 0.002) and from 58.1 ± 2.7% at baseline to 60.5 ± 2.7% at 1 month after PDT (P = 0.004), respectively. The difference between affected and unaffected eyes was significantly larger at baseline than at 1 month after PDT (deep choroidal layer 4.79 ± 6.02 versus 0.39 ± 3.46, P = 0.002; choriocapillaris 4.26 ± 3.94 versus 1.25 ± 3.44, P = 0.002) and larger than at 3 months after baseline (n = 11 patients), when the affected and unaffected fellow eyes no longer differed significantly (P = 0.66 and P = 0.37, respectively). As a corollary, the width of the large choroidal vessels in the deep choroidal layer decreased after the PDT. Comparing assessments by two blinded examiners revealed a kappa value of 0.90, indicating a good agreement for examination of the deep choroidal layer. CONCLUSION: In conclusion, OCTA can be helpful to visualize the deep choroidal vascular layer by manually shifting the reference layer deeper into the choroid.


Assuntos
Coriorretinopatia Serosa Central/diagnóstico , Corioide/irrigação sanguínea , Angiofluoresceinografia/métodos , Fotoquimioterapia/métodos , Vasos Retinianos/patologia , Tomografia de Coerência Óptica/métodos , Verteporfina/uso terapêutico , Adulto , Capilares/patologia , Coriorretinopatia Serosa Central/tratamento farmacológico , Corioide/patologia , Feminino , Seguimentos , Fundo de Olho , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Fotossensibilizantes/uso terapêutico , Estudos Prospectivos , Acuidade Visual
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