Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 517
Filtrar
1.
Molecules ; 26(4)2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33670378

RESUMO

Biodegradable and antimicrobial waterborne polyurethane dispersions (PUDs) and their casted solid films have recently emerged as important alternatives to their solvent-based and non-biodegradable counterparts for various applications due to their versatility, health, and environmental friendliness. The nanoscale morphology of the PUDs, dispersion stability, and the thermomechanical properties of the solid films obtained from the solvent cast process are strongly dependent on several important parameters, such as the preparation method, polyols, diisocyanates, solid content, chain extension, and temperature. The biodegradability, biocompatibility, antimicrobial properties and biomedical applications can be tailored based on the nature of the polyols, polarity, as well as structure and concentration of the internal surfactants (anionic or cationic). This review article provides an important quantitative experimental basis and structure evolution for the development and synthesis of biodegradable waterborne PUDs and their solid films, with prescribed macromolecular properties and new functions, with the aim of understanding the relationships between polymer structure, properties, and performance. The review article will also summarize the important variables that control the thermomechanical properties and biodegradation kinetics, as well as antimicrobial and biocompatibility behaviors of aqueous PUDs and their films, for certain industrial and biomedical applications.


Assuntos
Anti-Infecciosos/química , Plásticos Biodegradáveis/química , Polímeros/química , Poliuretanos/química , Ânions/química , Ânions/uso terapêutico , Anti-Infecciosos/uso terapêutico , Plásticos Biodegradáveis/uso terapêutico , Humanos , Polímeros/uso terapêutico , Poliuretanos/uso terapêutico , Solventes/química , Tensoativos/química , Tensoativos/uso terapêutico , Água/química
2.
Int J Pharm ; 595: 120243, 2021 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-33484923

RESUMO

Cardiovascular diseases constitute a number of conditions which are the leading cause of death globally. To combat these diseases and improve the quality and duration of life, several cardiac implants have been developed, including stents, vascular grafts and valvular prostheses. The implantation of these vascular prosthesis has associated risks such as infection or blood clot formation. In order to overcome these limitations medicated vascular prosthesis have been previously used. The present paper describes a 3D printing method to develop medicated vascular prosthesis using fused deposition modelling (FDM) technology. For this purpose, rifampicin (RIF) was selected as a model molecule as it can be used to prevent vascular graft prosthesis infection. Thermoplastic polyurethane (TPU) and RIF were combined using hot melt extrusion (HME) to obtain filaments containing RIF concentrations ranging between 0 and 1% (w/w). These materials are capable of providing RIF release for periods ranging between 30 and 80 days. Moreover, TPU-based materials containing RIF were capable of inhibiting the growth of Staphylococcus aureus. This behaviour was observed even for TPU-based materials containing RIF concentrations of 0.1% (w/w). TPU containing 1% (w/w) of RIF showed antimicrobial properties even after 30 days of RIF release. Alternatively, these methods were used to prepare dipyridamole containing TPU filaments. Finally, using a dual extrusion 3D printer vascular grafts containing both drugs were prepared.


Assuntos
Antibacterianos/farmacocinética , Sistemas de Liberação de Medicamentos/métodos , Poliuretanos/química , Rifampina/farmacocinética , Tecnologia Farmacêutica/métodos , Células Sanguíneas/efeitos dos fármacos , Prótese Vascular/efeitos adversos , Preparações de Ação Retardada/química , Dipiridamol/farmacocinética , Liberação Controlada de Fármacos , Desenho de Equipamento/métodos , Células Endoteliais da Veia Umbilical Humana , Humanos , Inibidores da Agregação de Plaquetas/farmacocinética , Poliuretanos/uso terapêutico , Impressão Tridimensional , Infecções Estafilocócicas/etiologia , Infecções Estafilocócicas/prevenção & controle , Staphylococcus aureus/efeitos dos fármacos , Trombose/etiologia , Trombose/prevenção & controle
3.
BMJ Case Rep ; 13(3)2020 Mar 12.
Artigo em Inglês | MEDLINE | ID: mdl-32169975

RESUMO

Mandibular incisors show variations in their root canal anatomy from regular pattern in some cases. Magnification plays a vital role to identify those unusual canal morphologies. A certain modification in access cavity preparation is required to locate those extra canals. Not only the functional restoration but also aesthetic harmony should be restored while treating anterior teeth. In these cases, post space preparation should be done with extra care to prevent vertical root fracture. This case report illustrates the importance of proper radiograph and magnification in the successful identification and management of complex canal systems in mandibular incisors.


Assuntos
Resinas Acrílicas/uso terapêutico , Resinas Compostas/uso terapêutico , Cavidade Pulpar/diagnóstico por imagem , Incisivo/lesões , Poliuretanos/uso terapêutico , Fraturas dos Dentes/diagnóstico por imagem , Coroas/normas , Cavidade Pulpar/anatomia & histologia , Estética , Humanos , Incisivo/anatomia & histologia , Masculino , Traumatismos Mandibulares/complicações , Radiografia/métodos , Tratamento do Canal Radicular/métodos , Fraturas dos Dentes/terapia , Raiz Dentária/anatomia & histologia , Resultado do Tratamento , Adulto Jovem
4.
J Surg Res ; 243: 453-459, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31377484

RESUMO

BACKGROUND: Intra-abdominal adhesions affect up to 93% of the patients after abdominal surgery, causing small-bowel obstruction, infertility, chronic abdominal pain, and iatrogenic bowel injury at reoperation. The efficacy of five new polymer antiadhesive barriers to avoid adhesion formation is evaluated in an ischemic button model in rats. MATERIALS AND METHODS: Five new, biodegradable polyurethane and copolyester-based, antiadhesive barriers (A1, A2, A3, B1, and B2) were evaluated in separate experimental groups and compared with two control groups (hyaluronate carboxymethylcellulose barrier and no antiadhesive barrier) in an ischemic button model (n = 11 per group operated). After 14 d, the quantity and quality of the adhesions were scored macroscopically. The Kruskal-Wallis with Mann-Whitney U post hoc and the Fisher's exact tests were used for data analysis. The Bonferroni correction method was applied, and a P-value <0.007 was considered significant. RESULTS: Two animals died during surgery and follow-up. A significant reduction of adhesions to ischemic buttons was found in the A2 group (median, 3.5; interquartile range, 2.25) compared with no adhesive barrier (median, 8.0; interquartile range, 2.0) (P = 0.001). The remaining groups did not differ significantly regarding adhesion quantity or quality. Adverse events were observed in the A2, A3, and B2 groups. CONCLUSIONS: The A2 antiadhesive barrier reduced the adhesion formation significantly compared with no anti-adhesive barrier, but applicability is questionable because of extensive adverse events observed due to implantation of the anti-adhesive barrier. The Nair score appears not to be sensitive enough to detect differences in adhesion formation in this model. Future research should focus on anti-adhesive barriers that are self-adhering.


Assuntos
Poliésteres/uso terapêutico , Poliuretanos/uso terapêutico , Aderências Teciduais/prevenção & controle , Animais , Materiais Biocompatíveis , Masculino , Ratos Wistar
5.
J Wound Care ; 28(7): 469-477, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31295096

RESUMO

OBJECTIVE: Excess remnant skin is retained for use in additional grafting in case of split-thickness skin graft (STSG) failure. We hypothesise that regrafting with remnant skin offers greater efficacy and advantages in wound healing and donor site appearance. METHODS: Skin graft donor sites were assessed by comparing those regrafted with remnant skin with those treated with polyurethane foam dressing. Healing time, pain, patient satisfaction, itching sensation, skin stiffness and irregularity between regrafting and foam dressing were compared. The aesthetic satisfaction of donor site was evaluated by four board-certified plastic surgeons. The differences were tested statistically. RESULTS: A total of 39 patients received a STSG due to skin or soft tissue wounds caused by burn, trauma and cancer reconstruction. The donor site healing time was shorter with remnant skin regrafting compared with foam dressing. There was no difference with respect to donor site pain between the two treatment groups. At two weeks after skin graft, patient satisfaction was higher in those treated with remnant skin than in those treated with foam dressing. Aesthetic assessment was improved after 12 weeks. CONCLUSION: Donor site dressing using remnant skin appears to improve wound healing and enhance the aesthetic outcome of donor sites.


Assuntos
Curativos Oclusivos , Poliuretanos/uso terapêutico , Transplante de Pele/métodos , Sítio Doador de Transplante/fisiologia , Cicatrização/fisiologia , Ferimentos e Lesões/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , República da Coreia , Resultado do Tratamento , Adulto Jovem
6.
Int J Mol Sci ; 20(3)2019 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-30717200

RESUMO

The aim of this PRISMA review was to assess whether the CMI and Actifit scaffolds, when used in clinical practice, improve clinical outcomes and demonstrate the ideal biological and biomechanical properties of scaffolds: being chondroprotective, porous, resorbable, able to mature and promote regeneration of tissue. This was done by only including studies that assessed clinical outcome and used a scale to assess both integrity of the scaffold and its effects on articular cartilage via MRI. A search was performed on PubMed, EMBASE, Scopus and clinicaltrials.gov. 2457 articles were screened, from which eight studies were selected: four used Actifit, three used CMI and one compared the two. All studies reported significant improvement in at least one clinical outcome compared to baseline. Some studies suggested that the scaffolds appeared to show porosity, mature, resorb and/or have possible chondroprotective effects, as assessed by MRI. The evidence for clinical translation is limited by differences in study methodology and small sample sizes, but is promising in terms of improving clinical outcomes in the short to mid-term. Higher level evidence, with MRI and histological evaluation of the scaffold and articular cartilage, is now needed to further determine whether these scaffolds exhibit these useful properties.


Assuntos
Implantes Absorvíveis , Artroscopia/instrumentação , Colágeno/uso terapêutico , Poliésteres/uso terapêutico , Poliuretanos/uso terapêutico , Lesões do Menisco Tibial/cirurgia , Adulto , Artroscopia/métodos , Fenômenos Biomecânicos , Colágeno/química , Feminino , Humanos , Traumatismos do Joelho/patologia , Traumatismos do Joelho/cirurgia , Imagem por Ressonância Magnética , Masculino , Meniscos Tibiais/efeitos dos fármacos , Meniscos Tibiais/patologia , Meniscos Tibiais/cirurgia , Poliésteres/química , Poliuretanos/química , Porosidade , Projetos de Pesquisa , Lesões do Menisco Tibial/patologia , Tecidos Suporte , Resultado do Tratamento
7.
J Mater Chem B ; 7(5): 744-754, 2019 02 07.
Artigo em Inglês | MEDLINE | ID: mdl-32254848

RESUMO

In this study we evaluated dual-cure polyurethanes (PUs) as dental adhesives and investigated their effect on the durability of the resin-dentin bonding interface. Different novel photopolymerizable and moisture-curable PUs based on polyester polyol, polyether polyol, and hydroxyethyl methacrylates (HEMAs) were prepared, and their structural characteristics were evaluated by Fourier transform infrared spectroscopy. The tensile strength, elongation at break, and water sorption/solubility of the PU adhesives and the application for bonding with dentin were evaluated. The water sorption and solubility of the PU adhesives were significantly lower than those of two commercial control groups. The bond strength of the PU adhesives after 30 days of storage increased compared with their immediate bond strength, and the microleakage detection of Class V restorations showed less occurrence of marginal leakage compared with the commercial control groups. Cytotoxicity testing has shown that the PU adhesives have low toxicity to pulp cells. The results of this study may shift the future research focus of composite resin dental restoratives from original rigid bonding of the interface to a flexible bonding based on the use of PU adhesives. This may become a new strategy for decreasing the occurrence of microleakage and improving the durability of the bonding interface.


Assuntos
Adesivos/química , Retenção de Dentadura , Poliuretanos/uso terapêutico , Polpa Dentária/citologia , Polpa Dentária/efeitos dos fármacos , Adesivos Dentinários/química , Humanos , Teste de Materiais , Polimerização/efeitos da radiação , Poliuretanos/toxicidade , Solubilidade , Resistência à Tração
8.
J Knee Surg ; 32(5): 434-440, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29702719

RESUMO

Tendon injury is common in sports. The standard of care (SOC) for tendon repair is surgical treatment. However, restored tendons often lack complete strength and functionality, and surgical repair is often unsuccessful. This controlled laboratory study investigates the healing of an Artelon patch (AP)-augmented tendon versus tendon repair alone in a preclinical canine patellar tendon defect model. Full-thickness proximal and distal flap defects were created in the patella tendons of eight purpose-bred research mongrel dogs. Dogs were randomly allocated into either the AP-augmented repair group or the SOC group (N = 8; four knees per group). Outcomes measures included limb function and pain; range of motion (ROM) and ultrasound assessment at 2, 4, and 8 weeks; and measurements of elongation, biomechanical testing, and histology at 8 weeks. Data were compared for statistically significant differences to preoperative measures and between groups (p < 0.05). The AP group had higher limb function scores compared with the SOC group at 2, 4, and 8 weeks, with statistically significant differences observed at 2 weeks (AP: 7.1 ± 1.4, SOC: 5.5 ± 0.4, p < 0.05) and 8 weeks (AP: 9.5 ± 0.7, SOC: 7.0 ± 0.9, p < 0.05). The ROM was significantly higher for the AP group at 4 weeks (AP: 105 degrees ± 4, SOC: 89 degrees ± 5, p < 0.05). Pain scores were statistically significantly lower in the AP group at 4 (AP: 0.6 ± 0.5, SOC: 2.2 ± 0.5) and 8 weeks (p < 0.05 for both comparisons). All animals in the AP group displayed full bridging tissue at week 4, while most animals of the SOC group displayed full bridging by week 8. Minimal tendon elongation was observed in both groups. Significantly more force was required to elongate tendons in the AP group compared with the SOC group (p < 0.05). Animals with AP-augmented tendon repair show an earlier regain of function, earlier regain of range of movement, less postoperative pain, and improved tendon strength when compared with animals treated with tendon repair alone.


Assuntos
Ligamento Patelar/cirurgia , Poliuretanos/uso terapêutico , Traumatismos dos Tendões/cirurgia , Cicatrização , Animais , Materiais Biocompatíveis , Fenômenos Biomecânicos , Modelos Animais de Doenças , Cães , Masculino , Ligamento Patelar/diagnóstico por imagem , Amplitude de Movimento Articular , Tendões/cirurgia
9.
J Pediatr Surg ; 54(9): 1744-1754, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30429066

RESUMO

BACKGROUND: Pediatric patients suffering from long gap esophageal defects or injuries are in desperate need of innovative treatment options. Our study demonstrates that two different cell sources can adhere to and proliferate on a retrievable synthetic scaffold. In feasibility testing of translational applicability, these cell seeded scaffolds were implanted into piglets and demonstrated esophageal regeneration. METHODS: Either porcine esophageal epithelial cells or porcine amniotic fluid was obtained and cultured in 3 dimensions on a polyurethane scaffold (Biostage). The amniotic fluid was obtained prior to birth of the piglet and was a source of mesenchymal stem cells (AF-MSC). Scaffolds that had been seeded were implanted into their respective Yucatan mini-swine. The cell seeded scaffolds in the bioreactor were evaluated for cell viability, proliferation, genotypic expression, and metabolism. Feasibility studies with implantation evaluated tissue regeneration and functional recovery of the esophagus. RESULTS: Both cell types seeded onto scaffolds in the bioreactor demonstrated viability, adherence and metabolism over time. The seeded scaffolds demonstrated increased expression of VEGF after 6 days in culture. Once implanted, endoscopy 3 weeks after surgery revealed an extruded scaffold with newly regenerated tissue. Both cell seeded scaffolds demonstrated epithelial and muscle regeneration and the piglets were able to eat and grow over time. CONCLUSIONS: Autologous esophageal epithelial cells or maternal AF-MSC can be cultured on a 3D scaffold in a bioreactor. These cells maintain viability, proliferation, and adherence over time. Implantation into piglets demonstrated esophageal regeneration with extrusion of the scaffold. This sets the stage for translational application in a neonatal model of esophageal atresia.


Assuntos
Atresia Esofágica/cirurgia , Poliuretanos/uso terapêutico , Engenharia Tecidual/métodos , Transplante Autólogo/métodos , Animais , Modelos Animais de Doenças , Células Epiteliais/citologia , Esôfago/citologia , Suínos , Tecidos Suporte
10.
Int Wound J ; 16(2): 379-386, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30479060

RESUMO

We evaluated the efficacy and safety of a povidone-iodine (PVP-I) foam dressing (Betafoam) for donor site dressing versus a hydrocellular foam dressing (Allevyn) and petrolatum gauze. This prospective Phase 4 study was conducted between March 2016 and April 2017 at eight sites in Korea. A total of 106 consenting patients (aged ≥ 19 years, scheduled for split-thickness skin graft) were randomised 1:1:1 to PVP-I foam, hydrocellular, or petrolatum gauze dressings for up to 28 days after donor site collection. We assessed time to complete epithelialisation, proportion with complete epithelialisation at Day 14, and wound infection. Epithelialisation time was the shortest with PVP-I foam dressing (12.74 ± 3.51 days) versus hydrocellular foam dressing (16.61 ± 4.45 days; P = 0.0003) and petrolatum gauze (15.06 ± 4.26 days, P = 0.0205). At Day 14, 83.87% of PVP-I foam dressing donor sites had complete epithelialisation, versus 36.36% of hydrocellular foam dressing donor sites (P = 0.0001) and 55.88% of petrolatum gauze donor sites (P = 0.0146). There were no wound infections. Incidence rates of adverse events were comparable across groups (P = 0.1940). PVP-I foam dressing required less time to complete epithelialisation and had a good safety profile.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Emolientes/uso terapêutico , Vaselina/uso terapêutico , Poliuretanos/uso terapêutico , Povidona-Iodo/uso terapêutico , Transplante de Pele/métodos , Sítio Doador de Transplante/crescimento & desenvolvimento , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bandagens , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , República da Coreia , Sítio Doador de Transplante/cirurgia , Cicatrização/fisiologia , Infecção dos Ferimentos/prevenção & controle , Adulto Jovem
11.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 53(9): 579-584, 2018 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-30196615

RESUMO

The curing light in direct composite resin adhesive restorations is a common technique and treatment method in oral clinic. It has many advantages, such as matching the color of the teeth, less removing the hard tissues of the teeth, resistance to abrasion, good masticatory performance and so on. It has almost replaced the traditional amalgam filling in the clinical dentistry repair. However, in clinical practice, improper use of the technique can also lead to increased loss of restorations and postoperative sensitivity. The reason is related not only to the physical and chemical properties of the material itself, but also the operator's lack of understanding and mastering the properties of the light cured material, especially the use rules of the light curing lamp. To this end, in September 2017, the vice chairman of Society of Cariology and Endodontology, Chinese Stomatological Association, professor Liang Jingping, organized a part of professional experts in this field, and invited the chief expert in 3M company, Dr. Joe Oxman, held a meeting about the use principle, operation mode and specification symposium of light curing lamp. Experts at the meeting had a very heated discussion, forming the following consensus.


Assuntos
Resinas Acrílicas/uso terapêutico , Resinas Compostas/uso terapêutico , Luzes de Cura Dentária/normas , Restauração Dentária Permanente/normas , Poliuretanos/uso terapêutico , Cor , Consenso , Restauração Dentária Permanente/métodos , Humanos
12.
J Wound Care ; 27(9): 608-618, 2018 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-30204578

RESUMO

OBJECTIVE: This study assesses a novel dressing concept in venous leg ulcer (VLU) patients. It is based on boosting endogenous growth factor activities synthesised by functional granulation tissue. METHODS: Patients received treatment for eight weeks with a hydrated polyurethane-containing foam dressing plus concomitant compression therapy. Wound area reduction (WAR), percentage of wounds achieving a relative WAR of ≥40% and ≥60%, wound pain ratings for the last 24 hours and at dressing changes, EQ-5D Quality of Life questionnaire data, dressing handling and safety parameters were recorded. RESULTS: There were 128 patients who received treatment and data for 123 wound treatment courses were documented. Wound area size decreased from 13.3±9.8cm2 to 10.5±12.2cm2 at week eight and median relative WAR was 48.8%. At week eight, a relative WAR ≥40% was reached by 54.5% of the wounds, 41.5% reached a relative WAR of ≥60% and complete healing was observed in 13.5% of wounds. Median wound pain ratings (last 24 hours before dressing change) declined significantly from 30 to 15.5 (100 visual analogue scale [VAS], p=0.0001) and pain at dressing changes from 30 to 12.5 (p≤0.0001). The EQ-5D VAS rating increased from 58.4±19.2mm to 63.1±19.1mm (p=0.0059). CONCLUSION: This clinical assessment shows that the concept of boosting endogenous growth factors through hydrated polyurethanes has the potential to accelerate WAR in VLU patients while decreasing pain levels and improving quality of life parameters.


Assuntos
Curativos Hidrocoloides , Hormônio do Crescimento Humano/uso terapêutico , Poliuretanos/uso terapêutico , Úlcera Varicosa/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários
13.
Regen Med ; 13(5): 611-626, 2018 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-30132392

RESUMO

AIM: Disc herniation is a spine disease that leads to suffering and disability. Discectomy is a Janus-faced approach that relieves pain symptoms but leave the intervertebral discs predisposed to herniation. This systematic review discussed the mechanical and biological requirements for a polyurethane-based biomaterial to be used in annular repair. METHODS: Search strategy was performed in PubMed, Web of Science and Scopus databases to define the main mechanical properties, biological findings and follow-up aspects of these biomaterials. The range was limited to articles published from January 2000 to December 2017 in English language. RESULTS: The search identified 82 articles. From these, a total of 18 articles underwent a full-text analysis, and 16 studies were included in the review. CONCLUSION: The polyurethane presents suitable properties to be used as an engineered solution to re-establish the microenvironment and biomechanical features of the intervertebral disc.


Assuntos
Anel Fibroso , Deslocamento do Disco Intervertebral/terapia , Poliuretanos/uso terapêutico , Regeneração/efeitos dos fármacos , Animais , Humanos
14.
Lancet ; 392(10145): 419-430, 2018 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-30057103

RESUMO

BACKGROUND: Two billion peripheral intravenous catheters (PIVCs) are used globally each year, but optimal dressing and securement methods are not well established. We aimed to compare the efficacy and costs of three alternative approaches to standard non-bordered polyurethane dressings. METHODS: We did a pragmatic, randomised controlled, parallel-group superiority trial at two hospitals in Queensland, Australia. Eligible patients were aged 18 years or older and required PIVC insertion for clinical treatment, which was expected to be required for longer than 24 h. Patients were randomly assigned (1:1:1:1) via a centralised web-based randomisation service using random block sizes, stratified by hospital, to receive tissue adhesive with polyurethane dressing, bordered polyurethane dressing, a securement device with polyurethane dressing, or polyurethane dressing (control). Randomisation was concealed before allocation. Patients, clinicians, and research staff were not masked because of the nature of the intervention, but infections were adjudicated by a physician who was masked to treatment allocation. The primary outcome was all-cause PIVC failure (as a composite of complete dislodgement, occlusion, phlebitis, and infection [primary bloodstream infection or local infection]). Analysis was by modified intention to treat. This trial is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12611000769987. FINDINGS: Between March 18, 2013, and Sept 9, 2014, we randomly assigned 1807 patients to receive tissue adhesive with polyurethane (n=446), bordered polyurethane (n=454), securement device with polyurethane (n=453), or polyurethane (n=454); 1697 patients comprised the modified intention-to-treat population. 163 (38%) of 427 patients in the tissue adhesive with polyurethane group (absolute risk difference -4·5% [95% CI -11·1 to 2·1%], p=0·19), 169 (40%) of 423 of patients in the bordered polyurethane group (-2·7% [-9·3 to 3·9%] p=0·44), 176 (41%) of 425 patients in the securement device with poplyurethane group (-1·2% [-7·9% to 5·4%], p=0·73), and 180 (43%) of 422 patients in the polyurethane group had PIVC failure. 17 patients in the tissue adhesive with polyurethane group, two patients in the bordered polyurethane group, eight patients in the securement device with polyurethane group, and seven patients in the polyurethane group had skin adverse events. Total costs of the trial interventions did not differ significantly between groups. INTERPRETATION: Current dressing and securement methods are commonly associated with PIVC failure and poor durability, with simultaneous use of multiple products commonly required. Cost is currently the main factor that determines product choice. Innovations to achieve effective, durable dressings and securements, and randomised controlled trials assessing their effectiveness are urgently needed. FUNDING: Australian National Health and Medical Research Council.


Assuntos
Bandagens , Cateterismo Periférico/efeitos adversos , Adulto , Idoso , Cateterismo Periférico/métodos , Cateteres de Demora/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Poliuretanos/uso terapêutico , Adesivos Teciduais/uso terapêutico
15.
J Laryngol Otol ; 132(6): 523-528, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29895341

RESUMO

OBJECTIVE: To analyse the clinical outcomes of biodegradable synthetic polyurethane foam versus ribbon gauze and ear wick in the treatment of severe acute otitis externa. METHODS: Ninety-two adults with severe acute otitis externa were randomly assigned to groups receiving ear wick (n = 28), ribbon gauze (n = 34) or biodegradable synthetic polyurethane foam (n = 30). Clinical efficacy, in terms of otalgia, oedema, erythema and tenderness of the external auditory canal, was assessed before packing was applied and at follow up on the 3rd and 7th days of presentation. RESULTS: All packing materials were associated with improved otalgia and oedema on the 3rd day; however, there were significant differences between biodegradable synthetic polyurethane foam and the other packing materials, and there was no significant reduction in tenderness in the biodegradable synthetic polyurethane foam group on the 3rd day. In the ribbon gauze and ear wick groups, improvements in all clinical efficacy scores were statistically significant for all pairwise comparisons. CONCLUSION: The three packing materials were all quite effective in treating severe acute otitis externa, but ear wick and ribbon gauze were superior to biodegradable synthetic polyurethane foam for relieving signs and symptoms, especially on the 3rd day.


Assuntos
Bandagens , Otite Externa/terapia , Poliuretanos/uso terapêutico , Doença Aguda , Adulto , Biodegradação Ambiental , Dor de Orelha/etiologia , Dor de Orelha/fisiopatologia , Edema/etiologia , Edema/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Otite Externa/complicações , Otite Externa/fisiopatologia , Índice de Gravidade de Doença , Resultado do Tratamento , Adulto Jovem
16.
Plast Surg Nurs ; 38(2): 73-75, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29846338

RESUMO

In this study, absorption capacity of the most commonly used types of wound dressings was measured with an objective, quantifiable, and easily reproducible method. The use of objective measurements allowed us to perform an objective comparison of the capacity of the different types of dressings. An experimental study was performed, in which the absorptive capacity of polyurethane foams, alginate, hidrofiber, and hydrocolloid dressings was measured by using a methodology designed by the researchers. Polyurethane foams showed a higher absorption capacity than hidrofibers, alginates, and hydrocolloids when using a similar surface of dressing. A modification of dressing size after saturation was also observed, increasing its size in the case of foams and decreasing or maintaining it in the case of hidrofibers, alginates, and hydrocolloids. The results of this study show a better wound exudate management for polyurethane foams. However, when deciding which dressing to use for a specific wound, absorption capacity is not the only quality that should be taken into account, as other properties should also be considered.


Assuntos
Bandagens/normas , Drenagem/instrumentação , Exsudatos e Transudatos , Alginatos/normas , Alginatos/uso terapêutico , Bandagens/estatística & dados numéricos , Curativos Hidrocoloides/normas , Curativos Hidrocoloides/estatística & dados numéricos , Humanos , Poliuretanos/normas , Poliuretanos/uso terapêutico , Cicatrização/fisiologia
17.
J Interv Cardiol ; 31(5): 617-623, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29808511

RESUMO

OBJECTIVES: To compare outcomes in patients receiving polytetrafluoroethylene (PTFE) and polyurethane (PL) covered stents (CS) after coronary artery perforation (CAP). BACKGROUND: The prognosis of CAP has improved with the advent of CSs. Information is scarce about the outcomes of new-generation CSs. METHODS: Sixty-one patients were treated with CSs in a 5-years period (age = 77 ± 8.75% males). Procedural and clinical data were retrospectively collected. The primary endpoint was procedural success. Secondary endpoints included death and major adverse cardiac events (MACE) defined as a composite of death, myocardial infarction, target vessel, and lesion revascularization and need for surgical repair). RESULTS: Twenty-two (36%) received PL-CSs and 39 (65%) PTFE-CSs. There were no differences in procedural success (86% vs 69%, P = 0.216). Time to deliver was shorter with PL-CS despite larger length of stents (8[11] vs 15[16] min, P = 0.001; 20[5] vs 16[3] mm, P < 0.001). This group had lower rate of pericardial effusion and cardiac arrest (41% vs 72%, P = 0.028; 5% vs 26%, P = 0.045). At 1-year follow-up, MACE rates were similar (58% vs 56%, P = 1.000) with atrend toward TVR in the PL-CS arm (21% vs 5%, P = 0.083). No differences were found in mortality (26% vs 41%, P = 0.385). Each group had 1 stent thrombosis and in-stent restenosis trended higher in the PL-CS group (12% vs 3%, P = 0.223). CONCLUSIONS: Time to deliver was shorter with the PL-CS and resulted in lower rate of pericardial effusion and cardiac arrest. However, there were no significant differences in procedural success and 1-year follow-up MACE in patients treated with PL-CS or PTFE-CS.


Assuntos
Implante de Prótese Vascular/instrumentação , Vasos Coronários , Stents Farmacológicos/efeitos adversos , Intervenção Coronária Percutânea/efeitos adversos , Politetrafluoretileno/uso terapêutico , Poliuretanos/uso terapêutico , Ferida Cirúrgica/cirurgia , Lesões do Sistema Vascular , Idoso , Idoso de 80 Anos ou mais , Materiais Revestidos Biocompatíveis/uso terapêutico , Vasos Coronários/lesões , Vasos Coronários/cirurgia , Feminino , Humanos , Masculino , Desenho de Prótese , Estudos Retrospectivos , Resultado do Tratamento , Lesões do Sistema Vascular/etiologia , Lesões do Sistema Vascular/cirurgia
18.
J Hosp Med ; 13(8): 517-525, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29649341

RESUMO

BACKGROUND: Despite the popularity of peripherally inserted central catheters (PICCs), recent literature highlights their potential injurious complications. Innovative PICC materials have been developed to prevent thrombosis and infection formation (Endexo®) and antireflux valves to prevent occlusion (pressure-activated safety valve®). No large randomized controlled trial has assessed these technologies. Our primary aim was to evaluate the feasibility of a large randomized controlled efficacy trial of PICC materials and design to reduce PICC complication in pediatrics. METHODS: A randomized controlled feasibility trial was undertaken at the Lady Cilento Children's Hospital in South Brisbane, Australia, between March 2016 and November 2016. Consecutive recruitment of 150 pediatric participants were randomly assigned to receive either (1) polyurethane PICC with a clamp or (2) BioFlo® PICC (AngioDynamics Inc, Queensbury, NY). Primary outcomes were trial feasibility, including PICC failure (thrombosis, occlusion, infection, breakage, or dislodgement). Secondary outcomes were PICC complications during use. RESULTS: Protocol feasibility was established, including staff and patient acceptability, timely recruitment, no missing primary outcome data, and 0% attrition. PICC failure was 22% (16 of 74, standard care) and 11% (8 of 72, BioFlo®) corresponding to 12.6 and 7.3 failures per 1000 hours (risk ratio 0.58; 95% confidence interval, 0.21-1.43; P = .172). PICC failures were primarily due to thrombosis (standard care 7% versus BioFlo® 3%) and complete occlusion (standard care 7% versus BioFlo® 1%). No blood stream infections occurred. Significantly fewer patients with BioFlo® had PICC complications during use (15% vs 34%; P = .009). CONCLUSIONS: BioFlo® PICCs appear potentially safer for pediatrics than traditional standard care PICCs with a clamp. Further research is required to definitively identify clinical, cost-effective methods to prevent PICC failure and improve reliability.


Assuntos
Cateterismo Periférico/métodos , Desenho de Equipamento/normas , Infecções Relacionadas a Cateter/prevenção & controle , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/normas , Cateteres de Demora/efeitos adversos , Cateteres de Demora/normas , Criança , Hospitais Pediátricos , Humanos , Poliuretanos/uso terapêutico , Trombose/prevenção & controle
19.
Adv Skin Wound Care ; 31(4): 183-188, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29561343

RESUMO

OBJECTIVE: The aim of this study was to evaluate scarring at split-thickness skin graft donor sites 8 years after surgery. METHODS: At surgery, 67 patients were randomized to hydrofiber, polyurethane foam, or porcine xenograft treatment. Scars were evaluated with the Patient and Observer Scar Assessment Scale. RESULTS: Results showed significant differences in observed scar outcomes at donor sites, leaving the polyurethane foam-treated and the porcine xenograft-treated patients with the least satisfying scars. Multivariable regression analysis showed that the group treated with the xenografts had worse scores for overall opinion of the scar than did the other groups (P = .03), the most important factor being pigmentation. There was no correlation between duration of healing time and quality of the scar. CONCLUSIONS: There were significant differences among the groups, with the hydrofiber group being the most satisfied with the appearance of their scar.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Cicatriz Hipertrófica/prevenção & controle , Transplante de Pele , Infecção da Ferida Cirúrgica/prevenção & controle , Sítio Doador de Transplante , Adulto , Materiais Biocompatíveis/uso terapêutico , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Poliuretanos/uso terapêutico , Estudos Prospectivos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...