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1.
Bone Joint J ; 102-B(2): 186-190, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32009434

RESUMO

AIMS: The aim of this study was to analyze the complications and outcomes of treatment in a series of previously untreated patients with a primary aneurysmal bone cyst (ABC) who had been treated by percutaneous sclerosant therapy using polidocanol. METHODS: Between January 2010 and December 2016, 56 patients were treated primarily with serial intralesional sclerosant injections. Their mean age was 20 years (1 to 54). The sites involved were clavicle (n = 3), humeri (n = 11), radius (n = 1), ulna (n = 3), hand (n = 2), pelvis (n = 12), femur (n = 7), tibia (n = 13), fibula (n = 3), and foot (n = 1). After histopathological confirmation of the diagnosis, 3% polidocanol (hydroxypolyaethoxydodecan) was injected into the lesion under image intensifier guidance. Patients were evaluated clinically and radiologically every six to eight weeks. In the absence of clinical and/or radiological response, a repeat sclerosant injection was given after eight to 12 weeks and repeated at similar intervals if necessary. RESULTS: There were no complications of treatment. One patient was lost to follow-up. Overall, 46/55 (84%) of lesions healed after one or more injections of polidocanol: 24/55 (44%) patients healed with a single injection, and 43/55 (78%) within two injections. Of these 46, four (9%) patients developed local recurrence, two of whom healed with a repeat sclerosant injection. Thus, 44/55 (80%) patients of primary ABC healed with sclerotherapy. The mean follow-up was 62 months (20 to 111). The local recurrence free survival (LRFS) with percutaneous sclerosant therapy with polidocanol was 100%, 98% (95% confidence interval (CI) 85 to 100) and 93% (95% CI 78 to 98) at two, three, and five years, respectively. CONCLUSION: Percutaneous sclerotherapy using polidocanol is a safe, effective, minimally invasive and inexpensive method of treating a primary ABC of the limbs or pelvis. Cite this article: Bone Joint J 2020;102-B(2):186-190.


Assuntos
Cistos Ósseos Aneurismáticos/terapia , Polidocanol/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Injeções Intralesionais , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
2.
J Drugs Dermatol ; 18(11): 1124-1127, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31741355

RESUMO

Polidocanol is an FDA-approved sclerosant indicated for treating uncomplicated spider veins and reticular veins in the lower extremities. Despite restrictions against compounding drugs that are essentially copies of FDA-approved or commercially available products, polidocanol is also available from compounding pharmacies and outsourcing facilites. Compounded drug products are not FDA-approved and have not undergone premarket FDA review for safety, effectiveness, and quality. Seven samples of polidocanol were obtained from three compounding pharmacies and analyzed using high pressure liquid chromatography. None of the samples contained the labeled concentration of polidocanol and five contained excessive levels of impurities. Since the potency and purity of compounded polidocanol injection cannot be assured, physicians who use these products should consider FDA-approved products to ensure optimal safety and efficacy. J Drugs Dermatol. 2019;18(11):1124-1127.


Assuntos
Polidocanol/química , Soluções Esclerosantes/química , Varizes , Cromatografia Líquida de Alta Pressão , Composição de Medicamentos , Humanos
3.
Stomatologiia (Mosk) ; 98(4): 60-64, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31513152

RESUMO

The aim of the study was to assess the effectiveness of ultrasound-guided use of the foam form of ethoxysclerol for the treatment of venous malformations of the maxillofacial area. The study involved clinical and ultrasound examination data of 60 patient allowing to determine treatment tactics and optimal volume of injected foam sclerosant as well as the role of ultrasound for monitoring of the treatment. The results proved the efficacy of 3% foam ethoxysclerol for less invasive treatment of venous maxillofacial malformations.


Assuntos
Escleroterapia , Malformações Vasculares , Face/patologia , Humanos , Polidocanol , Soluções Esclerosantes , Resultado do Tratamento , Malformações Vasculares/terapia
4.
J Laparoendosc Adv Surg Tech A ; 29(9): 1135-1143, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31313965

RESUMO

Introduction: The first-line treatment for gastric variceal rebleeding in cirrhotic patients is endoscopic cyanoacrylate injection. We focused on the efficacy and prognosis of cyanoacrylate combined with Lauromacrogol® for gastric varices (GV) in a retrospective study of long-term follow-up. Materials and Methods: One hundred thirty patients with cirrhosis and GV from March 2011 to February 2013 were included. Sixty-eight patients underwent endoscopic cyanoacrylate injection with Lauromacrogol and 62 patients without Lauromacrogol. The median follow-up was 40.1 and 38.8 months, respectively. Results: The volumes of cyanoacrylate used for the GV eradication in the Lauromacrogol group were significantly lower than those in the Ethiodol® group (1.6 ± 0.8 versus 2.1 ± 1.2 mL, P = .029). No ectopic embolisms were observed during follow-up. The 1- and 3-year rebleeding-free rate did not differ between groups (83.7% and 59.2% versus 75.8% and 62.5%; P = .797). The same was observed for mortality (86.6% and 83.5% versus 85.5% and 83.7%; P = .955). New portal venous thrombosis (PVT) and progression of previous partial PVT were independently associated with rebleeding (hazard ratio [HR] 5.127, 95% confidence interval [CI], 2.430-10.817, P = .000) and death (HR 10.093, 95% CI, 3.988-25.548, P = .000). Conclusions: Endoscopic cyanoacrylate injection with Lauromacrogol might minimize the required dosage of cyanoacrylate, but it did not improve rebleeding rate or survival. Exacerbation of PVT was associated with rebleeding and death.


Assuntos
Cianoacrilatos/administração & dosagem , Endoscopia do Sistema Digestório/métodos , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/terapia , Polidocanol/administração & dosagem , Varizes Esofágicas e Gástricas/diagnóstico , Feminino , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Prognóstico , Recidiva , Estudos Retrospectivos , Fatores de Risco , Soluções Esclerosantes/administração & dosagem
5.
J Dermatol ; 46(9): 770-776, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31270853

RESUMO

The efficacy of lauromacrogol injection therapy and intralesional triamcinolone for infantile hemangiomas (IH) has been well documented recently, but with an increase in serious or rare adverse reactions. The aim of this study is to investigate the safety concerns regarding intralesional injection of lauromacrogol combined with triamcinolone for IH and to study its effect on infant growth and development. A total of 1039 IH patients who were subjected to intralesional injection of lauromacrogol combined with triamcinolone in the Plastic Surgery Department of Shandong Provincial Hospital between 1 January 2015 and 31 May 2018 were enrolled in this study. When the dose of lauromacrogol and triamcinolone was less than 3.5 and 2.0 mg/kg respectively, no serious side-effects were observed. The adverse event rate reported was 7.7%. Among the 405 patients not subjected to propranolol before the last injection, the study included three modes of treatment response: regression (82.7%), stabilization (13.8%) and failure (3.5%). By comparing height and weight to the reference standards and also by comparisons between the same-sex groups, our results confirmed that there was no significant effect on children's height and weight, regardless of whether the injection therapy was combined with oral propranolol at the appropriate dose and with more than 4-week intervals. Intralesional injection of lauromacrogol combined with triamcinolone in the treatment of IH was highly safe and effective.


Assuntos
Desenvolvimento Infantil/efeitos dos fármacos , Hemangioma/tratamento farmacológico , Polidocanol/efeitos adversos , Soluções Esclerosantes/efeitos adversos , Antagonistas Adrenérgicos beta/administração & dosagem , Antagonistas Adrenérgicos beta/efeitos adversos , Estatura/efeitos dos fármacos , Peso Corporal/efeitos dos fármacos , Relação Dose-Resposta a Droga , Quimioterapia Combinada/efeitos adversos , Quimioterapia Combinada/métodos , Feminino , Seguimentos , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Humanos , Lactente , Injeções Intralesionais , Masculino , Polidocanol/administração & dosagem , Propranolol/administração & dosagem , Propranolol/efeitos adversos , Estudos Retrospectivos , Soluções Esclerosantes/administração & dosagem , Resultado do Tratamento , Triancinolona/administração & dosagem , Triancinolona/efeitos adversos
6.
Medicine (Baltimore) ; 98(26): e16201, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31261565

RESUMO

BACKGROUND: To compare the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of gastric variceal bleeding (GVB) caused by liver cirrhosis with the traditional sandwich method no accompanied by lauromacrogol via a meta-analysis. METHODS: The Cochrane Library, Pubmed, the China National Knowledge Infrastructure (CNKI) database, the Chinese Wanfang database, and the Chongqing VIP database were searched to identify cohort studies comparing modified to traditional sandwich method in the treatment of GVB with liver cirrhosis. The relative risk for hemostasis rate, gastric varices (GV) remission rate, re-bleeding rate, the incidence of post-operative complications (pain, fever, ulcer or erosion, ectopic embolism), and all-cause mortality were calculated. The mean difference for average tissue adhesive dosage per case was calculated. Relevant data were analyzed with the Reviewer Manager 5.3.5. RESULTS: Four cohort studies with a total of 587 patients were included in this meta-analysis. In the treatment of GVB with liver cirrhosis, compared with the traditional sandwich method, the modified sandwich method was associated with a higher GV remission rate (RR: 1.24, 95% CI: 1.09-1.42; P = .001) according to the pooled results. There were no statistically significant differences between the 2 methods in the rate of hemostasis, re-bleeding, pain, fever, ulcer or erosion, ectopic embolism, and all-cause mortality (P ≧ .05). CONCLUSIONS: This meta-analysis indicated that the modified sandwich method with lauromacrogol is more effective than the traditional sandwich method without lauromacrogol. Due to the limited number of studies and samples, more RCT studies are needed to further validate the efficacy and safety of the modified sandwich method with lauromacrogol in the treatment of GVB with liver cirrhosis.


Assuntos
Varizes Esofágicas e Gástricas/terapia , Hemorragia/terapia , Cirrose Hepática/terapia , Escleroterapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia/etiologia , Humanos , Cirrose Hepática/complicações , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Adesivos Teciduais/uso terapêutico
7.
Int J Mol Sci ; 20(13)2019 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-31261943

RESUMO

BACKGROUND: To induce a moderate chronic ocular hypertension (OHT) by injecting polidocanol, a foamed sclerosant drug, in the aqueous humor outflow pathway. METHODS: Intraocular pressure (IOP) was monitored for up to 6 months. Pattern and full-field electroretinogram (PERG and ERG) were recorded and retinal ganglion cells (RGC) and retinal nerve fiber layer (RNFL) thickness were assessed in vivo with optical coherence tomography (OCT) and ex vivo using Brn3a immunohistochemistry. RESULTS: In the first 3 weeks post-injection, a significant IOP elevation was observed in the treated eyes (18.47 ± 3.36 mmHg) when compared with the control fellow eyes (12.52 ± 2.84 mmHg) (p < 0.05). At 8 weeks, 65% (11/17) of intervention eyes had developed an IOP increase >25% over the baseline. PERG responses were seen to be significantly reduced in the hypertensive eyes (2.25 ± 0.24 µV) compared to control eyes (1.44 ± 0.19 µV) (p < 0.01) at week 3, whereas the ERG components (photoreceptor a-wave and bipolar cell b-wave) remained unaltered. By week 24, RNFL thinning and cell loss in the ganglion cell layer was first detected (2/13, 15.3%) as assessed by OCT and light microscopy. CONCLUSIONS: This novel OHT rat model, with moderate levels of chronically elevated IOP, and abnormal PERG shows selective functional impairment of RGC.


Assuntos
Modelos Animais de Doenças , Glaucoma/etiologia , Polidocanol/toxicidade , Soluções Esclerosantes/toxicidade , Animais , Glaucoma/metabolismo , Glaucoma/patologia , Injeções Intraoculares , Pressão Intraocular , Masculino , Ratos , Ratos Wistar , Fator de Transcrição Brn-3A/metabolismo
8.
Ann Vasc Surg ; 59: 231-236, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31009711

RESUMO

BACKGROUND: The procedure aims to show our results with a novel nontumescent, nonthermal technique to treat varicose veins. The V-block occlusion stent is a minimally invasive device for treating reflux of the great saphenous vein (GSV). It is an office-based procedure that does not require tumescence anesthesia. The V-block stent is a self-expandable device that functions as a vein occluder and blood clot trap. Once the V-block is in place, further treatment of the saphenous vein such as ultrasound-guided sclerotherapy can be performed. The V-block device is intended to eliminate the possibility of forwarding passage of clot and sclerosant (embolization) to the deep and pulmonary circulations. METHODS: Patients were treated in an outpatient setting with the V-block occluding device. Follow-up was performed using duplex ultrasound to assess occlusion of the saphenous vein as well as the Aberdeen Varicose Vein Questionnaire and Venous Severity Scoring to determine changes in quality of life after the procedure. Patients were followed up at 1 week, 1 month, and 3 months after V-block placement. Duplex scanning was performed to confirm GSV occlusion at all follow-up visits. After deployment of the occlusion stent, a maximum of 2% polidocanol foam was injected with a double barrel syringe which simultaneously evacuated blood from the greater saphenous vein. Follow-up assessment for safety included evaluation of potential complications, device migration, and potential injury at the deployment site. RESULTS: Fifty-one symptomatic subjects with documented GSV reflux were enrolled in the study. Complete occlusion of the GSV was achieved in 98% of the patients during the 7-day postprocedural visit. There was no injury at the deployment site. No migration of the V-block device was observed. No deep vein thrombosis or any other complication was recorded. One patient of the 50 patients and 51 procedures experienced an adverse event, phlebitis that resolved under conservative therapy within 4 days with no residual effect. There was a significant improvement in the Aberdeen Vein quality of life measurements and the pain scores. After 3 years, 18 patients were willing to undergo a duplex follow-up examination. The occlusion rate after 3 years was 77.8. There were no device-related complications after this period. CONCLUSIONS: The study demonstrated a good safety and performance profile without any major adverse events. The primary end point of vein occlusion and obliteration was met.


Assuntos
Procedimentos Endovasculares/instrumentação , Polidocanol/administração & dosagem , Veia Safena , Soluções Esclerosantes/administração & dosagem , Escleroterapia/instrumentação , Stents , Varizes/terapia , Idoso , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polidocanol/efeitos adversos , Desenho de Prótese , Qualidade de Vida , Estudos Retrospectivos , Veia Safena/diagnóstico por imagem , Veia Safena/fisiopatologia , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Inquéritos e Questionários , Fatores de Tempo , Resultado do Tratamento , Ultrassonografia Doppler Dupla , Ultrassonografia de Intervenção , Varizes/diagnóstico por imagem , Varizes/fisiopatologia
10.
Chemosphere ; 224: 212-219, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30822727

RESUMO

Non-ionic surfactants (Triton X-100 and Brij 30) and core-crosslinked amphiphilic polymer (CCAP) nanoparticles were used as extractants in the ex situ soil washing of silt loam soil contaminated with large quantities of petroleum oil, and their soil-washing performances were compared. Following washing with the surfactants, highly turbid aqueous solutions containing large numbers of soil and petroleum oil particles were produced. In contrast, the CCAP nanoparticles successfully extracted the petroleum oils from the soil samples without the formation of such a turbid aqueous solution. In addition, the CCAP nanoparticles extracted 96% of the petroleum oils, which is a significantly larger quantity than that by Brij 30 and Triton X-100 under equivalent conditions. Indeed, owing to their crosslinked micelle-like structure, the CCAP nanoparticles maintained their nanostructure even upon contact with a highly contaminated silt loam soil matrix, thereby resulting in the extraction of only the hydrophobic oily contaminants from the soil matrix and avoiding the formation of dispersions of soil particles and hydrophobic contaminants. As such, CCAP nanoparticles could be considered as suitable washing materials for highly contaminated silt loam soils.


Assuntos
Nanopartículas/química , Petróleo/análise , Polímeros/química , Poluentes do Solo/análise , Solo/química , Tensoativos/química , Recuperação e Remediação Ambiental , Micelas , Octoxinol/química , Polidocanol/química , Solo/normas
11.
Lasers Med Sci ; 34(7): 1325-1332, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30707327

RESUMO

Sclerotherapy continues to be the treatment of choice for varicose veins in the legs. However, isolated treatment using microfoam or lasers requires a high number of sessions to eliminate them. In 2013, we published results about the efficacy and safety 3 years after the combined treatment with microfoam injections and subsequent application of Nd:YAG laser. The aim of this paper is to clinically evaluate the treatment of varices in a control visit after 5 years, when polidocanol microfoam is used and is immediately irradiated in the tissue with 1064-nm Nd:YAG laser beam. The outcome persistence after 5 years was studied in the legs that had received combined treatment and had been studied 3 years after treatment. Patients were contacted by phone, interviewed, and examined with echo-Doppler. Out of the 259 patients who were contacted, 221 agreed to make the appointment, although in the end, only 202 came, which meant analysing 404 legs. At 5 years, the clearance rates were very high: patients were included in class CEAP C1 showing vessels of from 0.5 to 3 mm diameter. The patients showed a high level of satisfaction. Regarding adverse effects, only 4 cases of hypopigmentation described in the previous publication persisted. Although the action mechanisms between the microfoam and the Nd:YAG laser must still be elucidated, it is notable that combining microfoam with laser exposure obtained a complete, effective treatment of legs in only 2 sessions, with high clearance rates and high level of satisfaction among patients.


Assuntos
Lasers de Estado Sólido , Perna (Membro)/patologia , Polidocanol/administração & dosagem , Polidocanol/uso terapêutico , Varizes/tratamento farmacológico , Varizes/cirurgia , Terapia Combinada , Feminino , Humanos , Lasers de Estado Sólido/efeitos adversos , Pessoa de Meia-Idade , Satisfação do Paciente , Polidocanol/efeitos adversos , Soluções Esclerosantes/uso terapêutico , Escleroterapia/efeitos adversos , Resultado do Tratamento
12.
Artigo em Chinês | MEDLINE | ID: mdl-30704167

RESUMO

Objective: To investigate the efficacy and safety of percutaneous lauromacrogol injection (PLI) in treatment of cystic or predominantly cystic thyroid nodules. Methods: A total of 114 cystic thyroid nodules and 61 predominantly cystic thyroid nodules with pain or uncomfort or aesthetic complaints were offered PLI. Therapeutic success rates and side effects were evaluated. From October 2012 to December 2015,114 patients with cystic thyroid nodules and 61 with predominantly cystic thyroid nodules with pain or uncomfortable or aesthetic complaints at the outpatient clinic of the First Affiliated Hospital of Wenzhou Medical University were offered percutaneous lauromacrogol sclerotherapy. Cytological results were benign. This study was a prospective trial. Ultrasonography sound examination was performed in all patients before treatment. The baseline data of all the patients and the data of the patients examined at the follow-up of 1, 3, 6 and 12 months were analyzed. Therapeutic success rate (nodule volume reduction >50%) and safety were observed. The data of nodule volume reduction ratio and the function of thyroid were normal distribution and analyzed by Mann-Whitney test and t test. The data of nodule volume, symptoms score and cosmetic score were skewed distribution, which were indicated with median and analyzed by nonparamentic test. Results: The mean volume of the cystic thyroid nodules was reduced from 12.5 cm(3) before PLI to 0.2 cm(3) at 12 months after PLI (χ(2)=266.175, P<0.001), with a therapeutic success rate of 100%, and the mean volume of the predominantly cystic thyroid nodules was reduced from 10.5 cm(3) before PLI to 2.0 cm(3) at 12 months after PLI (χ(2)=203.122, P<0.001) with a therapeutic success rate of 93.4%(57/61). Pressure symptom score and cosmetic grade were significantly improved at 12 months after PLI in patients with cystic or predominantly cystic thyroid nodules. Pressure symptom score and cosmetic grade in patients with cystic thyroid nodules were Z=-6.126 and Z=-13.735, respectively; pressure symptom score and cosmetic grade in patients with predominantly cystic thyroid nodules were Z=-3.126 and Z=-7.212, respectively (all P<0.001) . There no significant difference in the thyroid functions before and after PLI in two groups of patients (all P>0.05) . The side effects of PLI were mild. Conclusion: PLI is a safe and effective alternative to treat benign cystic or predominantly cystic thyroid nodules.


Assuntos
Cistos/terapia , Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Doenças da Glândula Tireoide/terapia , Nódulo da Glândula Tireoide/terapia , Ultrassonografia de Intervenção , Humanos , Polidocanol/efeitos adversos , Estudos Prospectivos , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Resultado do Tratamento
13.
Vet Ophthalmol ; 22(3): 374-380, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30716202

RESUMO

OBJECTIVE: To describe the efficacy of the sclerosing agent 1% polidocanol in the treatment of a suspected nasolacrimal duct cyst in a dog. ANIMAL STUDIED: A 5-year-old castrated male Golden Retriever with chronic epiphora of the right eye. PROCEDURES: Ocular examination revealed epiphora and a negative Jones test of the right eye and was otherwise normal. Computed tomography with dacryocystography confirmed a cystic structure in the right ventral orbit that extended into the caudal nasal cavity adjacent to the orbit, causing partial physical obstruction of the right nasolacrimal duct. Cytologic analysis of fluid from the lesion was supportive of a diagnosis of a cyst. One percent polidocanol (compounded, People's Custom Rx, Memphis, TN) was injected into the cyst. RESULTS: Epiphora was resolved by two weeks post-injection. Repeated computed tomography with dacryocystography was performed 8 months post-injection, revealing complete resolution of the cyst and demonstrating mild enophthalmos of the right globe. CONCLUSIONS: Intralesional 1% polidocanol therapy was successful in resolving a suspected nasolacrimal duct cyst in a dog.


Assuntos
Cistos/veterinária , Doenças do Cão/diagnóstico , Obstrução dos Ductos Lacrimais/veterinária , Ducto Nasolacrimal , Soluções Oftálmicas/uso terapêutico , Polidocanol/uso terapêutico , Animais , Cistos/diagnóstico , Diagnóstico Diferencial , Doenças do Cão/diagnóstico por imagem , Doenças do Cão/tratamento farmacológico , Cães , Obstrução dos Ductos Lacrimais/diagnóstico , Masculino , Soluções Oftálmicas/administração & dosagem , Polidocanol/administração & dosagem , Tomografia Computadorizada por Raios X/veterinária
17.
Asian Cardiovasc Thorac Ann ; 27(2): 93-97, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30525867

RESUMO

BACKGROUND: Pulmonary resection is, by far, the primary cause of bronchial fistula. This is a severe complication because of its morbidity and mortality and the related consumption of resources. Definitive closure continues to be a challenge with several therapeutic options, but none are optimal. We describe our experience in bronchoscopic application of ethanolamine and lauromacrogol 400 for the treatment of post-resection bronchial fistulas. METHODS: Clinical records of 8 patients treated using this technique were collected prospectively. The diagnosis of a fistula was confirmed by flexible bronchoscopy. Sclerosis was indicated in the context of multimodal treatment. Sclerosant injection was performed under general anesthesia with a Wang 22G needle through a flexible bronchoscope. The procedure was repeated at 2-week intervals until definitive closure of the fistula was confirmed. RESULTS: Fistula closure was achieved in 7 (87.5%) of the 8 patients, with persistence of the fistula in one patient who could not complete the treatment because of recurrence of his neoplastic pathology. No recurrence or complications related to the technique were registered. CONCLUSIONS: Bronchoscopic sclerosis by means of submucosal injection of lauromacrogol 400 or ethanolamine should be part of the multimodal treatment of bronchopleural fistula after lung resection, pending further studies that contribute to the accurate establishment of optimal indications for this procedure.


Assuntos
Fístula Brônquica/terapia , Broncoscopia , Etanolamina/administração & dosagem , Pneumonectomia/efeitos adversos , Polidocanol/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Idoso , Fístula Brônquica/diagnóstico por imagem , Fístula Brônquica/etiologia , Broncoscopia/efeitos adversos , Etanolamina/efeitos adversos , Humanos , Masculino , Pessoa de Meia-Idade , Polidocanol/efeitos adversos , Estudos Prospectivos , Soluções Esclerosantes/efeitos adversos , Escleroterapia/efeitos adversos , Fatores de Tempo , Resultado do Tratamento
18.
Ecotoxicol Environ Saf ; 169: 335-343, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30458400

RESUMO

An effective bioaugmentation strategy was developed for the removal of alcohol ethoxylates (AEs) from municipal wastewater. An AE-degrading strain, Pseudomonas sp. LZ-B, was isolated from an activated sludge. Strain LZ-B was able to degrade 96.8% of 200 mg/L C12E4 (Brij 30) within 24 h and showed significant biomass increase and removal of total oxygen concentration (TOC). The optimal degradation temperature and pH value were 37 °C and 6.0, respectively. The strain demonstrated greater potential to degrade five different molecular weight AEs within 5 days. HPLC-MS/MS analysis demonstrated that the major metabolites obtained were polyethylene glycol (PEG) and carboxylated AE chains. Activated sludge has a low ability to remove AEs. After inoculation of strain LZ-B into the activated sludge reactor, Strain LZ-B successfully colonized the activated sludge, and AE removal efficiency increased to more than 95% when the hydraulic retention time (HRT) was 10 h. After strain LZ-B cleaved the AE chains, the sludge microbial communities easily removed PEG fragments to facilitate complete biodegradation of AEs. This is the first report describing bioaugmentation to increase AE degradation in an activated sludge system.


Assuntos
Reatores Biológicos/microbiologia , Polidocanol/análise , Pseudomonas/crescimento & desenvolvimento , Esgotos/química , Poluentes Químicos da Água/análise , Purificação da Água/métodos , Biomassa , Pseudomonas/isolamento & purificação , Esgotos/microbiologia , Águas Residuárias/química
19.
Curr Drug Deliv ; 16(1): 86-92, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30246640

RESUMO

BACKGROUND: Chrysin is a strong inhibitor of breast cancer resistance protein (BCRP) but it is practically insoluble in water. Effective solubilization of chrysin is critical for its pharmaceutical application as an absorption enhancer via inhibition of BCRP-mediated drug efflux. OBJECTIVE: This study aimed to develop an effective oral formulation of chrysin to improve its in vivo effect as an absorption enhancer. METHOD: Solid dispersions (SDs) of chrysin were prepared with hydrophilic carriers having surface acting properties and a pH modulator. In vitro and in vivo characterizations were performed to select the optimal SDs of chrysin. RESULTS: SDs with Brij®L4 and aminoclay was most effective in increasing the solubility of chrysin by 13-53 fold at varying drug-carrier ratios. Furthermore, SDs significantly improved the dissolution rate and extent of drug release. SDs (chrysin: Brij®L4: aminoclay=1:3:5) achieved approximately 60% and 83% drug release within 1 h and 8 h, respectively, in aqueous medium, while the dissolution of the untreated chrysin was less than 13%. XRD patterns indicated the amorphous state of chrysin in SDs. The SD formulation was effective in improving the bioavailability of topotecan, a BCRP substrate in rats. Following oral administration of topotecan with the SDs of chrysin, the Cmax and AUC of topotecan was enhanced by approximately 2.6- and 2-fold, respectively, while the untreated chrysin had no effect. CONCLUSION: The SD formulation of chrysin with Brij®L4 and aminoclay appeared to be promising in improving the dissolution of chrysin and enhancing its in vivo effect as an absorption enhancer.


Assuntos
Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/antagonistas & inibidores , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Flavonoides/farmacologia , Absorção Intestinal/efeitos dos fármacos , Neoplasias/tratamento farmacológico , Membro 2 da Subfamília G de Transportadores de Cassetes de Ligação de ATP/metabolismo , Administração Oral , Animais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Disponibilidade Biológica , Argila/química , Detergentes/química , Composição de Medicamentos/métodos , Avaliação Pré-Clínica de Medicamentos , Flavonoides/química , Flavonoides/uso terapêutico , Células HT29 , Humanos , Interações Hidrofóbicas e Hidrofílicas , Masculino , Polidocanol/química , Ratos , Ratos Sprague-Dawley , Solubilidade , Topotecan/farmacologia , Topotecan/uso terapêutico , Água/química
20.
Acta Radiol ; 60(5): 593-601, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30111191

RESUMO

BACKGROUND: Percutaneous therapy with various sclerosants is an established treatment of venous malformations in general. We investigated the safety and effectiveness of polidocanol in the craniofacial region. PURPOSE: To present and evaluate our subjective and objective mid- and long-term results of patients with craniofacial venous malformations (CFVM) after percutaneous sclerotherapy using polidocanol. MATERIAL AND METHODS: Twenty patients with CFVM treated by percutaneous sclerotherapy were followed up and asked to fill in a questionnaire comparing levels of the following CFVM-related symptoms before and after treatment: pain; functional impairment; cosmetic deformities; and impairment in daily life. Additionally, both size reduction as well as procedural-related complication rates were analyzed. RESULTS: Evaluation of the questionnaire revealed an improvement or complete relief of CFVM-related symptoms with significant reduced impairment in daily life after percutaneous sclerotherapy. Eighteen (90%) patients noticed a post-sclerotherapy improvement of at least one of their corresponding symptoms and expressed satisfaction with regard to their treatment. For 13 patients, a > 50% size reduction of the CFVM could be observed, while seven exhibited a < 50% size reduction. One minor complication was encountered in 56 treatment sessions (1.8%). CONCLUSION: Percutaneous sclerotherapy using polidocanol is a well-tolerated treatment for CFVM with a low complication rate. Size reduction and positive results with improvement of different clinical symptoms can be achieved.


Assuntos
Polidocanol/uso terapêutico , Soluções Esclerosantes/uso terapêutico , Escleroterapia/métodos , Malformações Vasculares/terapia , Face , Humanos , Pescoço , Estudos Retrospectivos , Inquéritos e Questionários , Resultado do Tratamento
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