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1.
Plast Reconstr Surg ; 145(2): 348e-359e, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985636

RESUMO

BACKGROUND: The authors developed a noncontact low-frequency ultrasound device that delivers high-intensity mechanical force based on phased-array technology. It may aid wound healing because it is likely to be associated with lower risks of infection and heat-induced pain compared with conventional ultrasound methods. The authors hypothesized that the microdeformation it induces accelerates wound epithelialization. Its effects on key wound-healing processes (angiogenesis, collagen accumulation, and angiogenesis-related gene transcription) were also examined. METHODS: Immediately after wounding, bilateral acute wounds in C57BL/6J mice were noncontact low-frequency ultrasound- and sham-stimulated for 1 hour/day for 3 consecutive days (10 Hz/90.6 Pa). Wound closure (epithelialization) was recorded every 2 days as the percentage change in wound area relative to baseline. Wound tissue was procured on days 2, 5, 7, and 14 (five to six per time point) and subjected to histopathology with hematoxylin and eosin and Masson trichrome staining, CD31 immunohistochemistry, and quantitative polymerase-chain reaction analysis. RESULTS: Compared to sham-treated wounds, ultrasound/phased-array-treated wounds exhibited significantly accelerated epithelialization (65 ± 27 percent versus 30 ± 33 percent closure), angiogenesis (4.6 ± 1.7 percent versus 2.2 ± 1.0 percent CD31 area), and collagen deposition (44 ± 14 percent versus 28 ± 13 percent collagen density) on days 5, 2, and 5, respectively (all p < 0.05). The expression of Notch ligand delta-like 1 protein (Dll1) and Notch1, which participate in angiogenesis, was transiently enhanced by treatment on days 2 and 5, respectively. CONCLUSIONS: The authors' noncontact low-frequency ultrasound phased-array device improved the wound-healing rate. It was associated with increased early neovascularization that was followed by high levels of collagen-matrix production and epithelialization. The device may expand the mechanotherapeutic proangiogenesis field, thereby helping stimulate a revolution in infected wound care.


Assuntos
Pele/lesões , Terapia por Ultrassom/métodos , Cicatrização/fisiologia , Ferimentos e Lesões/terapia , Animais , Colágeno/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Neovascularização Fisiológica/fisiologia , Pele/metabolismo , Ferimentos e Lesões/metabolismo , Ferimentos e Lesões/patologia
2.
Toxicol Lett ; 319: 111-118, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31715245

RESUMO

INTRODUCTION: Silver ion has strong antimicrobial properties and is used in a number of wound dressings. In burn models, silver-nylon dressings produce elevated silver levels in the wound along with minimal systemic effect. We evaluated systemic toxicity in a non-burn wound model to see if a similar pattern of silver ion distribution would occur. METHODS: Eight deep partial-thickness wounds each were created on the dorsum of 40 Gottingen minipigs using a Er-YAG Laser. Half were treated with a 21-day course of silver-nylon dressings (Silverlon®) and half were treated with moist gauze dressings. Wound, blood, liver and kidney silver levels, along with blood chemistry and hematology data were obtained at appropriate intervals. RESULTS: All wounds healed well with healing enhanced by silver-nylon dressings. Silver ion was demonstrable in all wounds treated with silver-nylon at day 21 and after 14 days of no further treatment. Silver ion was not detected in blood, liver or kidney of any animal treated with silver-nylon or control dressings. Liver and kidney function remained normal in all animals. CONCLUSION: A 21-day application of silver-nylon dressings to a non-burn dermal wound produces no systemic or local toxicity in Gottingen minipigs.


Assuntos
Anti-Infecciosos/toxicidade , Bandagens , Prata/toxicidade , Pele/lesões , Animais , Feminino , Masculino , Nylons , Prata/farmacocinética , Suínos , Porco Miniatura , Cicatrização
4.
Forensic Sci Int ; 305: 109998, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31707237

RESUMO

Bruising is an injury commonly observed within suspect cases of assault or abuse, yet how a blunt impact initiates bruising and influences its severity is not fully understood. Furthermore, the standard method of documenting a bruise with colour photography is known to have limitations which influence the already subjective analysis of a bruise. This research investigated bruising using a standardised blunt impact, delivered to 18 volunteers. The resulting bruise was imaged using colour, cross polarised (CP) and infrared photography. Timelines of the L*a*b* colour space were determined from both colour and CP images for up to 3 weeks. Overall, no single photographic technique out-performed the others, however CP did provide greater contrast than colour photography. L*a*b* colour space timelines were not attributable any physiological characteristics. Whilst impact force negatively correlated with BMI (R2 = 0.321), neither were associated with any measure of bruise appearance. Due to the inter-subject variability in the bruise response to a controlled infliction, none of the methods in the current study could be used to reliably predict the age of a bruise or the severity of force used in creating a bruise. A more comprehensive approach combining impact characteristics, tissue mechanics, enhanced localised physiological measures and improvements in quantifying bruise appearance is likely to be essential in removing subjectivity from their interpretation.


Assuntos
Contusões/patologia , Pele/patologia , Adulto , Fenômenos Biomecânicos , Índice de Massa Corporal , Feminino , Medicina Legal/métodos , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Fotografação/métodos , Pele/lesões , Fatores de Tempo , Adulto Jovem
5.
An Bras Dermatol ; 94(5): 553-560, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31777356

RESUMO

BACKGROUND: Skin picking disorder is a prevalent disorder frequently comorbid with depression and anxiety, which is underdiagnosed mainly by dermatologists. Assessment of skin picking disorder is based on instruments influenced by the awareness about skin picking disorder and comorbid symptoms. To date, there is no validated instrument for Brazilian individuals nor an instrument to evaluate the severity of skin lesions in an objective way. OBJECTIVES: Validate the Skin Picking Impact Scale for Brazilian Portuguese and create a photographic measurement to assess skin lesions. METHODS: The sample was assessed through the Skin Picking Impact Scale translated into Brazilian Portuguese, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Clinical Global Impression Scale. The patients' skin lesions were photographed. Photos were evaluated regarding active excoriation, crust/bleeding, exulceration, and linear lesions. RESULTS: There were 63 patients included. The Skin Picking Impact Scale translated into Brazilian Portuguese had good internal consistency (Cronbach's alpha=0.88), which tests of goodness-of-fit, showing a suitable model. The reliability of photographic measurement was 0.66, with a high internal consistency (Cronbach's alpha=0.87). Photographic measurement was not correlated with the Skin Picking Impact Scale, the Clinical Global Impression Scale, or comorbid symptoms. STUDY LIMITATIONS: Lack of a previously validated instrument to evaluate dermatillomania in the Brazilian population for comparison. CONCLUSION: The Skin Picking Impact Scale validated in Brazilian Portuguese is a good instrument to evaluate skin picking disorder. Photographic measurement is a consistent way of assessing skin lesions, but it does not reflect the impact of skin picking disorder on the individual's life.


Assuntos
Fotografação/normas , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Perfil de Impacto da Doença , Pele/lesões , Adulto , Brasil , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo , Escalas de Graduação Psiquiátrica/normas , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fatores Socioeconômicos , Estatísticas não Paramétricas , Traduções , Adulto Jovem
6.
Medicine (Baltimore) ; 98(43): e17607, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31651869

RESUMO

BACKGROUND: This study aims to provide the best possible evidence-based information on the efficacy and safety of sifalimumab for treatment of skin injury (SI) caused by systemic lupus erythematosus (SLE). METHODS: In this study, electronic databases of MEDLINE, EMBASE, Cochrane Library, PsycINFO, CINAHL Plus, Global Health, WHO Global Index Medicus, Virtual Health Library, Social Care Online, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, and China National Knowledge Infrastructure will be searched comprehensively from inceptions to June 30, 2019 without language restrictions. We will include randomized controlled trials (RCTs) on evaluating the efficacy and safety of sifalimumab for SI caused by SLE. Two investigators will conduct study selection, data extraction, and risk of bias assessment independently. We will use RevMan 5.3 Software to perform statistical analysis. RESULTS: This study will lie in the exhaustive and systematic nature of the literature search and its methods for evaluating quality and analyzing RCTs data. Considering the controversial efficacy of the treatment for sifalimumab, this study is responsible for improving the existing evidence on the efficacy and safety of sifalimumab for SI caused by SLE. CONCLUSION: The results of this study will provide latest evidence for judging whether sifalimumab is an effective intervention for patients with SI caused by SLE or not. STUDY REGISTRATION: CRD42019148225.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Fármacos Dermatológicos/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Dermatopatias/tratamento farmacológico , Pele/lesões , Anticorpos Monoclonais Humanizados , Humanos , Projetos de Pesquisa , Dermatopatias/etiologia , Revisão Sistemática como Assunto , Resultado do Tratamento
8.
BMC Complement Altern Med ; 19(1): 254, 2019 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-31511001

RESUMO

BACKGROUND: Fumaria species (Fumariacea) has traditionally been used in wound healing in Iranian folk medicine. However, with the discovery of newer agents, its use has faded off into total obscurity. This study explored the wound healing potential of a gel containing 10% Fumaria vaillantii Loisel through topical application of total extract in a model of excisional as well as incisional wound healing in albino Wistar rats. METHODS: Rats were anesthetized, and excisional skin wound was established using a sterilized surgical scissors. The animals were then treated with 10% F.vaillantii topical gel formulation along with the gel base. The treatments were administered once a day after the injury for 21 days. For topical treatment, the hydrogel was formulated and evaluated for chemical and physical characteristics. Histopathological analysis with hematoxylin and eosin (H&E) was used for microscopic examination of the skin tissues on 21-day-old sections of excision wound. To verify collagen formation, hydroxyproline determination was performed 21 days post wound healing. Breaking strength was determined in a 10-day-old incision wound by the uniaxial tensile test. RESULTS: Topical administration of F.vaillantii gel formulation significantly enhanced skin wound closure on the 6th post-wounding day compared to both gel base and the negative control, indicating an accelerated wound healing process, while a significant difference was observed on 10th and 14th post -wound days in F.vaillantii treatment compared to the negative control groups. Gel formulation prepared with a 10% F. vaillantii extract exhibited a response in terms of wound epithelialization, angiogenesis and number of hair follicles at wound area better than the gel base on the 21st post-wound day. Application of gel base produced further advantages by increasing hydroxyproline content and collagen fiber thickness. Our results on incision wound model were supported by histopathological data indicating the role of gel base in the enhancement of breaking strength. CONCLUSION: Traditional use of Fumaria species in the skin diseases was justified in this study by revealing the increase in wound healing activity after hydrogel containing F. vaillantii total extract administration.


Assuntos
Fumaria/química , Extratos Vegetais/administração & dosagem , Cicatrização/efeitos dos fármacos , Ferimentos e Lesões/tratamento farmacológico , Administração Tópica , Animais , Humanos , Hidrogéis/administração & dosagem , Hidrogéis/química , Masculino , Extratos Vegetais/química , Ratos , Ratos Wistar , Pele/efeitos dos fármacos , Pele/lesões , Pele/fisiopatologia , Ferimentos e Lesões/fisiopatologia
9.
Forensic Sci Int ; 303: 109937, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31546162

RESUMO

The detection of vitality of wounds, especially when the wounds are inflicted very close to the time of death, is one of the most challenging issues in forensic pathology. This study investigated expression levels of ATF3 and BTG2 in mouse and human skin wounds. Protein levels examined by western blot showed that there was no significant change in ATF3 and BTG2 between wounded and intact skins. However, mRNA levels demonstrated higher expression of ATF3 and BTG2 in ante-mortem contused mouse skins, compared with the intact and postmortem contused skins. Increased ATF3 and BTG2 in the level of mRNA could also be detected until 96h and 48h after death, respectively. Human wounded skin samples from forensic autopsy cases were also examined. Increased ATF3 mRNA levels were detected until 48h after autopsy in 5 of 6 cases. However, no differences were observed between wounded and intact skins for BTG2. These findings suggest that the detection of mRNA levels of ATF3, but not BTG2, can be considered as a potential marker for vital reaction of skin contusion. Postmortem human samples should be used in order to validate the availability of markers screened by animal experiment.


Assuntos
Fator 3 Ativador da Transcrição/genética , Contusões/metabolismo , RNA Mensageiro/metabolismo , Pele/metabolismo , Fator 3 Ativador da Transcrição/metabolismo , Animais , Biomarcadores/metabolismo , Genética Forense , Patologia Legal , Humanos , Proteínas Imediatamente Precoces/genética , Proteínas Imediatamente Precoces/metabolismo , Camundongos Endogâmicos BALB C , Modelos Animais , Pele/lesões , Proteínas Supressoras de Tumor/genética , Proteínas Supressoras de Tumor/metabolismo
10.
Int J Mol Sci ; 20(18)2019 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-31500245

RESUMO

Vascular remodeling and angiogenesis are required to improve the perfusion of ischemic tissues. The hypoxic environment, induced by ischemia, is a potent stimulus for hypoxia inducible factor 1α (HIF-1α) upregulation and activation, which induce pro-angiogenic gene expression. We previously showed that the tyrosine phosphatase SHP-2 drives hypoxia mediated HIF-1α upregulation via inhibition of the proteasomal pathway, resulting in revascularization of wounds in vivo. However, it is still unknown if SHP-2 mediates HIF-1α upregulation by affecting 26S proteasome activity and how the proteasome is regulated upon hypoxia. Using a reporter construct containing the oxygen-dependent degradation (ODD) domain of HIF-1α and a fluorogenic proteasome substrate in combination with SHP-2 mutant constructs, we show that SHP-2 inhibits the 26S proteasome activity in endothelial cells under hypoxic conditions in vitro via Src kinase/p38 mitogen-activated protein kinase (MAPK) signalling. Moreover, the simultaneous expression of constitutively active SHP-2 (E76A) and inactive SHP-2 (CS) in separate hypoxic wounds in the mice dorsal skin fold chamber by localized magnetic nanoparticle-assisted lentiviral transduction showed specific regulation of proteasome activity in vivo. Thus, we identified a new additional mechanism of SHP-2 mediated HIF-1α upregulation and proteasome activity, being functionally important for revascularization of wounds in vivo. SHP-2 may therefore constitute a potential novel therapeutic target for the induction of angiogenesis in ischemic vascular disease.


Assuntos
Subunidade alfa do Fator 1 Induzível por Hipóxia/química , Subunidade alfa do Fator 1 Induzível por Hipóxia/metabolismo , Complexo de Endopeptidases do Proteassoma/metabolismo , Proteína Tirosina Fosfatase não Receptora Tipo 11/genética , Pele/lesões , Animais , Hipóxia Celular , Células Cultivadas , Modelos Animais de Doenças , Células Endoteliais/citologia , Células Endoteliais/metabolismo , Feminino , Regulação da Expressão Gênica , Humanos , Sistema de Sinalização das MAP Quinases , Nanopartículas de Magnetita , Masculino , Camundongos , Mutação , Proteína Tirosina Fosfatase não Receptora Tipo 11/metabolismo , Proteólise , Pele/irrigação sanguínea , Remodelação Vascular
11.
Folia Histochem Cytobiol ; 57(3): 127-138, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31489604

RESUMO

INTRODUCTION: Diabetes mellitus (DM) is a serious, chronic metabolic disorder commonly complicated by diabetic foot ulcers with delayed healing. Metformin was found to have a wound healing effect through several mechanisms. The current study investigated the effect of both bone marrow-derived mesenchymal stem cells (BM-MSCs) and metformin, considered alone or combined, on the healing of an experimentally induced cutaneous wound injury in streptozotocin-induced diabetic rats. MATERIAL AND METHODS: Forty adult male albino rats were used. Diabetes was induced by single intravenous (IV) injection of streptozotocin (STZ). Next, two circular full thickness skin wounds were created on the back of the animals, then randomly assigned into 4 groups, ten rats each. BM-MSCs were isolated from albino rats, 8 weeks of age and labeled by PKH26 before intradermal injection into rats of Group III and IV. Groups I (diabetic positive control), II (metformin-treated, 250 mg/kg/d), III (treated with 2×106 BM-MSCs), and IV (wounded rats treated both with metformin and BM-MSCs cells). Healing was assessed 3, 7, 14, and 21 days post wound induction through frequent measuring of wound diameters. Skin biopsies were obtained at the end of the experiment. RESULTS: Gross evaluation of the physical healing of the wounds was done. Skin biopsies from the wound areas were processed for hematoxylin and eosin (H&E), Masson's trichrome staining and immunohistochemical staining for CD31. The results showed better wound healing in the combined therapy group (IV) as compared to monotherapy groups. CONCLUSIONS: Although both metformin and BM-MSCs were effective in the healing of experimentally induced skin wounds in diabetic rats, the combination of both agents appears to be a better synergistic option for the treatment of diabetic wound injuries.


Assuntos
Transplante de Células-Tronco Mesenquimais , Metformina/uso terapêutico , Cicatrização/efeitos dos fármacos , Ferimentos Penetrantes/tratamento farmacológico , Ferimentos Penetrantes/terapia , Animais , Diabetes Mellitus Experimental/induzido quimicamente , Masculino , Células-Tronco Mesenquimais/citologia , Molécula-1 de Adesão Celular Endotelial a Plaquetas/metabolismo , Ratos , Pele/lesões , Pele/patologia , Lesões dos Tecidos Moles/tratamento farmacológico , Lesões dos Tecidos Moles/terapia , Estreptozocina
12.
Clin Sports Med ; 38(4): 597-618, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31472769

RESUMO

There are numerous disorders of the skin that occur in athletes. These include infections, mechanical injury, and inflammatory skin diseases such as dermatitis, urticaria, and others. This paper discusses some of the most common athletic skin diseases.


Assuntos
Traumatismos em Atletas/diagnóstico , Traumatismos em Atletas/terapia , Dermatite de Contato/etiologia , Dermatopatias Infecciosas/terapia , Pele/lesões , Esportes , Traumatismos em Atletas/etiologia , Traumatismos em Atletas/prevenção & controle , Dermatite de Contato/diagnóstico , Dermatite de Contato/prevenção & controle , Humanos , Dermatopatias Infecciosas/diagnóstico , Dermatopatias Infecciosas/microbiologia , Urticária/diagnóstico , Urticária/etiologia , Urticária/terapia
13.
Biol Pharm Bull ; 42(9): 1446-1449, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31474706

RESUMO

During the process of skin regeneration following a skin injury, de novo hair follicle regeneration is initiated after wounding; however, these regenerated hairs are mostly unpigmented. The activation of epidermal melanocyte stem cells and their differentiation into regenerating hair follicles have been shown to be necessary for the pigmented hair regeneration after wounding. To determine the role of flavonoids in the regeneration of pigmented hairs, we applied the candidate flavonoids to the regenerating hair follicles after wounding and identified the flavonoid species that maximally induced pigmented hair regeneration. Flavonoids with two OH groups in the B-ring, such as sterubin, luteolin, and hydroxygenkwanin, showed promising effects in regenerating black pigmented hairs, while those with one OH group in the B-ring showed no significant change. Thus, flavonoids with two OH groups in their B-ring could be studied further as potential wound healing agents with the ability to regenerate pigmented hair.


Assuntos
Flavonoides/farmacologia , Cor de Cabelo , Folículo Piloso/efeitos dos fármacos , Regeneração/efeitos dos fármacos , Pele/lesões , Cicatrização/efeitos dos fármacos , Animais , Células Epidérmicas/efeitos dos fármacos , Células Epidérmicas/fisiologia , Flavonoides/química , Folículo Piloso/fisiologia , Luteolina/química , Luteolina/farmacologia , Melanócitos/efeitos dos fármacos , Melanócitos/fisiologia , Camundongos Endogâmicos C57BL , Pele/efeitos dos fármacos , Relação Estrutura-Atividade
14.
Gerokomos (Madr., Ed. impr.) ; 30(3): 134-141, sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185321

RESUMO

Objetivos: Obtener indicadores epidemiológicos actualizados para las lesiones por presión (LPP) y otras lesiones cutáneas relacionadas con la dependencia (LCRD) en centros de Atención Primaria de Salud (APS) españoles, tanto globales como ajustados. Analizar las características demográficas y clínicas de las personas con LCRD y de las lesiones. Metodología: Estudio observacional, transversal, tipo encuesta epidemiológica (5º Estudio Nacional de Prevalencia) (ENP), dirigido a centros de APS. Recogida de datos mediante formulario en línea seguro. Variables: características de los centros, número de pacientes con cada tipo de LCRD, clasificación de cada lesión, tamaño y tiempo de evolución. Se calcularon tres valores de prevalencia: prevalencia cruda poblacional, en mayores de 65 años y en personas en programas de atención domiciliaria. Resultados: Se han obtenido datos de una población de casi 763.000 personas atendidas en 98 centros de APS españoles. Un 14,3% de los centros declararon no tener ninguna persona con LCRD atendida en el momento de obtener los datos. En el grupo de personas en programas de atención domiciliaria (ATDOM), la prevalencia de LCRD fue del 6,11%. Según tipo de lesiones fueron: presión, 4,79%; humedad, 1,39%; fricción, 1,81%; combinadas, 1,05%, y desgarros cutáneos, 1,05%. Las lesiones se originaron en el mismo domicilio del paciente en un 83,3% de los casos, y solo un 16,7% eran de origen nosocomial. Conclusiones: La prevalencia de LCRD en pacientes atendidos en programas de ATDOM fue del 6,11%, siendo las LPP las lesiones más frecuentes, con un 4,79% de prevalencia (cifras similares a las del 3er ENP y suponen un ligero descenso sobre las encontradas en el 4º ENP). Tanto las LPP como el resto de LCRD son mayoritariamente producidas en el domicilio, a diferencia de la situación en hospitales en los que predominan las de origen nosocomial. La prevención de las LCRD en personas atendidas en ATDOM debe ser una prioridad


Aims: To obtain updated, global and adjusted epidemiological indicators for pressure injuries (PI) and others dependence-related skin lesions (DRSL) in Spanish primary healthcare (PHC) centres. To describe the clinical features of both people with DRSL and the lesions. Methods: Observational, cross-sectional study through a survey (5th National Prevalence Study), aimed to PHC in Spain. Data collected through a secure on-line form. Variables: characteristics of the centres, number of patients with each type of DRSL, classification of each lesion, size and time of evolution. Three prevalence values were calculated: crude population prevalence; in people over 65 years of age; and in people in home care programs (HCP). Results: Data have been obtained for a population of almost 763,000 people attended at Spanish PHC in 98 centers. 14.3% of the centres stated that they did not have any person with DRSL attended at the time of obtaining the data. In the group of persons in home care programmes, the prevalence of DRSL was 6.11%. According to the type of lesions: pressure 4.79%, moistureassociated lesions (MAL) 1.39%, friction 1.81%, combined 1.05% and skin tears 1.05%. The lesions originated in the patient's own home in 83.3% of cases, and only 16.7% were of nosocomial origin. Conclusions: The prevalence of DRSL in patients treated in was 6.11%, with PI being the most frequent lesion. Prevalence value is similar to that found in 2009 and slightly lesser than that of 2014. Both the PI and others DRSL are mostly developed in the home, unlike the situation in hospitals, where hospital-acquired injuries are predominant. So, prevention of DRSL in people in home care programmes should be a priority


Assuntos
Humanos , Masculino , Feminino , Idoso de 80 Anos ou mais , Pele/lesões , Lesão por Pressão/epidemiologia , Atenção Primária à Saúde , Enfermagem Primária , Lesão por Pressão/terapia , Estudos Transversais , Inquéritos Epidemiológicos , Inquéritos e Questionários , Análise de Dados , Medição de Risco
15.
Gerokomos (Madr., Ed. impr.) ; 30(3): 147-156, sept. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-185323

RESUMO

Objetivos: Obtener evidencias disponibles sobre la eficacia de la película transparente de polímero de acrilato o producto barrera no irritante (PBNI) en la prevención y tratamiento de lesiones de la piel. Método: Revisión de la literatura a partir de la búsqueda de ensayos clínicos aleatorizados y estudios observacionales sobre los PBNI en PubMed, CINAHL y CUIDEN, publicados entre 2009 y 2018, ya que existe una revisión sistemática anterior. Resultados: Dos estudios evidenciaron reducción de complicaciones cutáneas aplicando PBNI antes de la colocación de apósitos de sujeción para catéteres venosos centrales. Respecto a las complicaciones cutáneas de la radioterapia, un estudio observó que los PBNI solo ayudaban a retrasar la intensidad del prurito. Un trabajo sobre la prevención y tratamiento de la dermatitis por incontinencia constataba que los PBNI son una buena alternativa a las cremas barrera, ya que tienen mejor aceptabilidad y cuestan menos de aplicar y retirar. En el ámbito del exceso de exudado y sus complicaciones en la zona periulceral, dos estudios coincidieron en la efectividad de los PBNI para reducir el diámetro de la superficie, exudado y esfacelo. Conclusiones: Los PBNI ayudan a prevenir las lesiones de la piel provocadas por apósitos de catéter; en la radiodermitis solo ayudan a disminuir el prurito; en las dermatitis por incontinencia son alternativa a la cremas barrera; en el control de las complicaciones del exudado en la zona periulceral en lesiones de extremidad inferior son igual de efectivos que las cremas con zinc


Objectives: To obtain available evidence on the efficacy of transparent film of acrylate polymer or non-irritating barrier product (PBNI) in the prevention and treatment of skin lesions. Method: Review of the literature based on the search of randomized clinical trials and observational studies on PBNI in PubMed, CINAHL and CUIDEN published between 2009 and 2018, since there is a previous systematic review. Results: Two studies showed reduction of cutaneous complications by applying PBNI before the placement of fixation dressings for central venous catheters. Regarding the cutaneous complications of radiotherapy, one study observed that PBNI only helped to delay the intensity of pruritus. A work on the prevention and treatment of incontinence dermatitis found that PBNI are a good alternative to barrier creams, since they have better acceptability and cost less to apply and remove. In the area of excess exudate and its complications in the periulceral zone, two studies agreed on the effectiveness of PBNI to reduce the diameter of the surface, exudate and slough. Conclusions: PBNI helps to prevent skin lesions caused by catheter dressings, in radiodermatitis they only help to reduce pruritus, in incontinence dermatitis they are an alternative to barrier creams, in the control of the complications of exudate in the periulceral zone in lower limb injuries are just as effective as creams with zinc


Assuntos
Humanos , Acrilatos/administração & dosagem , Pele/efeitos dos fármacos , Pele/lesões , Resultado do Tratamento , Dermatopatias/prevenção & controle , Dermatite/tratamento farmacológico , Dermatite/prevenção & controle , Bandagens
16.
Br J Nurs ; 28(15): S26-S32, 2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31393764

RESUMO

The skin is the largest and one of the most important organs of the body and as such it is essential that skin integrity is maintained to preserve normal body functions as much as possible at all times. Health professionals must endeavour to minimise any pain and trauma likely to be encountered by their patients through the use of a variety of medical products and devices that are designed to adhere to the skin, especially as the use of dermatological and wound-management products in particular, that incorporate adhesives to help keep them secure and in place, has grown in line with the increasingly ageing population and changing demographics throughout the UK. This article reviews the literature related to the causes of medical-adhesive-related skin injuries (MARSIs) and the reported patient effects, in particular pain and skin trauma and highlight some 'at-risk' patient groups and potential actions to minimise risk. A sterile silicone medical adhesive remover-Appeel Sterile-is introduced and the clinical benefits highlighted through the discussion of clinical evidence and case studies undertaken on a range of patients with varied aetiologies.


Assuntos
Dor/prevenção & controle , Higiene da Pele/enfermagem , Adesivos Teciduais/efeitos adversos , Ferimentos e Lesões/prevenção & controle , Humanos , Dor/etiologia , Pele/lesões , Populações Vulneráveis , Ferimentos e Lesões/etiologia
17.
J Anim Sci ; 97(9): 3658-3668, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31373628

RESUMO

Mixing of pigs into new social groups commonly induces aggressive interactions that result in skin lesions on the body of the animals. The relationship between skin lesions and aggressive behavioral interactions in group-housed pigs can be analyzed within the framework of social genetic effects (SGE). This study incorporates the quantification of aggressive interactions between pairs of animals in the modeling of SGE for skin lesions in different regions of the body in growing pigs. The dataset included 792 pigs housed in 59 pens. Skin lesions in the anterior, central, and caudal regions of the body were counted 24 h after pig mixing. Animals were video-recorded for 9 h postmixing and trained observers recorded the type and duration of aggressive interactions between pairs of animals. The number of seconds that pairs of pigs spent engaged in reciprocal fights and unilateral attack behaviors were used to parametrize the intensity of social interactions (ISI). Three types of models were fitted: direct genetic additive model (DGE), traditional social genetic effect model (TSGE) assuming uniform interactions between dyads, and an intensity-based social genetic effect model (ISGE) that used ISI to parameterize SGE. All models included fixed effects of sex, replicate, lesion scorer, weight at mixing, premixing lesion count, and the total time that the animal spent engaged in aggressive interactions (reciprocal fights and unilateral attack behaviors) as a covariate; a random effect of pen; and a random direct genetic effect. The ISGE models recovered more direct genetic variance than DGE and TSGE, and the estimated heritabilities (h^D2) were highest for all traits (P < 0.01) for the ISGE with ISI parametrized with unilateral attack behavior. The TSGE produced estimates that did not differ significantly from DGE (P > 0.5). Incorporating the ISI into ISGE, even in a small dataset, allowed separate estimation of the genetic parameters for direct and SGE, as well as the genetic correlation between direct and SGE (rs), which was positive for all lesion traits. The estimates from ISGE suggest that if behavioral observations are available, selection incorporating SGE may reduce the consequences of aggressive behaviors after mixing pigs.


Assuntos
Bem-Estar do Animal , Comportamento Animal , Suínos/fisiologia , Agressão , Animais , Feminino , Masculino , Modelos Genéticos , Fenótipo , Pele/lesões , Suínos/genética
18.
Nat Commun ; 10(1): 3491, 2019 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-31375674

RESUMO

Despite the wide applications, systematic mechanobiological investigation of 3D porous scaffolds has yet to be performed due to the lack of methodologies for decoupling the complex interplay between structural and mechanical properties. Here, we discover the regulatory effect of cryoprotectants on ice crystal growth and use this property to realize separate control of the scaffold pore size and stiffness. Fibroblasts and macrophages are sensitive to both structural and mechanical properties of the gelatin scaffolds, particularly to pore sizes. Interestingly, macrophages within smaller and softer pores exhibit pro-inflammatory phenotype, whereas anti-inflammatory phenotype is induced by larger and stiffer pores. The structure-regulated cellular mechano-responsiveness is attributed to the physical confinement caused by pores or osmotic pressure. Finally, in vivo stimulation of endogenous fibroblasts and macrophages by implanted scaffolds produce mechano-responses similar to the corresponding cells in vitro, indicating that the physical properties of scaffolds can be leveraged to modulate tissue regeneration.


Assuntos
Materiais Biocompatíveis/química , Crioprotetores/farmacologia , Porosidade/efeitos dos fármacos , Tecidos Suporte/química , Cicatrização , Animais , Proliferação de Células , Modelos Animais de Doenças , Fibroblastos , Gelatina/química , Gelatina/efeitos dos fármacos , Humanos , Macrófagos , Masculino , Teste de Materiais/métodos , Camundongos , Cultura Primária de Células , Medicina Regenerativa/métodos , Pele/lesões , Resistência à Tração
19.
Radiat Res ; 192(4): 410-421, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31390312

RESUMO

Radiation-induced acute skin injury and consequent fibrosis are common complications of cancer radiotherapy and radiation accidents. Stromal cell-derived factor-1α (SDF-1α) and its receptor, CXC chemokine receptor 4 (CXCR4) have been shown to be involved in multiple cellular events. However, the role of SDF-1α/CXCR4 axis in radiation-induced acute injury and fibrosis of skin has not been reported. In this study, we found that the expression of SDF-1α and CXCR4 was significantly increased in irradiated skin tissues of humans, monkeys and rats, compared to their nonirradiated counterparts. Mice with keratinocyte-specific ablation of CXCR4 showed less severe skin damage than wild-type mice after receiving a 35 Gy dose of radiation. Consistently, subcutaneous injection of AMD3100, an FDA approved SDF-1α/CXCR4 inhibitor, attenuated skin injury and fibrosis induced by exposure to radiation in a rat model. Mechanically, the SDF-1α/CXCR4 axis promotes pro-fibrotic TGF-b/Smad signaling through the PI3K-MAPK signaling cascade in human keratinocyte HaCaT cells and skin fibroblast WS1 cells. AMD3100 inhibited Smad2 nuclear translocation and transcriptional activity of Smad2/3 induced by radiation, which suppressed the pro-fibrotic TGF-b/Smad signaling pathway activated by exposure. Taken together, these findings demonstrate the involvement of SDF-1α/CXCR4 axis in radiation-induced acute injury and fibrosis of skin, and indicate that AMD3100 would be an effective countermeasure against these diseases.


Assuntos
Quimiocina CXCL12/metabolismo , Lesões por Radiação/metabolismo , Receptores CXCR4/metabolismo , Pele/patologia , Pele/efeitos da radiação , Animais , Fibrose , Regulação da Expressão Gênica/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos da radiação , Técnicas de Inativação de Genes , Compostos Heterocíclicos/farmacologia , Humanos , Queratinócitos/efeitos dos fármacos , Queratinócitos/metabolismo , Queratinócitos/efeitos da radiação , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Sistema de Sinalização das MAP Quinases/efeitos da radiação , Camundongos , Fosfatidilinositol 3-Quinases/metabolismo , Lesões por Radiação/patologia , Ratos , Receptores CXCR4/deficiência , Receptores CXCR4/genética , Pele/lesões , Pele/metabolismo , Proteína Smad2/metabolismo , Fator de Crescimento Transformador beta/metabolismo
20.
Int J Mol Sci ; 20(14)2019 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-31295813

RESUMO

Wound healing starts with the recruitment of inflammatory cells that secrete wound-related factors. This step is followed by fibroblast activation and tissue construction. Sphingosine-1-phosphate (S1P) is a lipid mediator that promotes angiogenesis, cell proliferation, and attracts immune cells. We investigated the roles of S1P in skin wound healing by altering the expression of its biogenic enzyme, sphingosine kinase-1 (SphK1). The murine excisional wound splinting model was used. Sphingosine kinase-1 (SphK1) was highly expressed in murine wounds and that SphK1-/- mice exhibit delayed wound closure along with less angiogenesis and inflammatory cell recruitment. Nanoparticle-mediated topical SphK1 overexpression accelerated wound closure, which associated with increased angiogenesis, inflammatory cell recruitment, and various wound-related factors. The SphK1 overexpression also led to less scarring, and the interaction between transforming growth factor (TGF)-ß1 and S1P receptor-2 (S1PR2) signaling is likely to play a key role. In summary, SphK1 play important roles to strengthen immunity, and contributes early wound healing with suppressed scarring. S1P can be a novel therapeutic molecule with anti-scarring effect in surgical, trauma, and chronic wound management.


Assuntos
Cicatriz/metabolismo , Lisofosfolipídeos/metabolismo , Neovascularização Fisiológica , Pele/metabolismo , Esfingosina/análogos & derivados , Cicatrização , Animais , Biomarcadores , Proliferação de Células , Cicatriz/genética , Cicatriz/patologia , Modelos Animais de Doenças , Expressão Gênica , Granuloma/etiologia , Granuloma/metabolismo , Granuloma/patologia , Inflamação/etiologia , Inflamação/metabolismo , Inflamação/patologia , Camundongos , Camundongos Knockout , Neovascularização Fisiológica/genética , Fosfotransferases (Aceptor do Grupo Álcool)/genética , Fosfotransferases (Aceptor do Grupo Álcool)/metabolismo , Pele/lesões , Pele/patologia , Esfingosina/metabolismo , /metabolismo , Cicatrização/genética
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