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1.
Khirurgiia (Mosk) ; (5): 81-86, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32500694

RESUMO

Increase of the frequency of soft tissues pyoinflammatory diseases and purulent-septic complications against the background the antibiotic-resistance of organism dictates the necessity of search of rational new surgical technologies and preparations with the intense bactericidal effect. Period of the connective tissue (cicatrix) formation on a place of wound defect of the operated purulent abscess of soft tissue (PAST) is defined by the speed of the granulations and epithelial tissue formation. Therefore, one of the task of experimental surgery is search of new methods of the effective postoperative influence on terms of the regeneration and complete obliteration of the PAST cavity. The perspective direction in treatment of surgical infection is application of metals nanoparticles. In treatment of pyoinflammatory processes it is applied the preparation Eplan and also zinc oxide nanoparticles which have bactericidal, antiinflammatory and regenerative effects. However, till now it was not carried out experimental works on modelling and surgical treatment of PAST with local application of the laser technologies in combinations with Eplan and metals nanoparticles.


Assuntos
Abscesso/terapia , Antibacterianos/uso terapêutico , Nanopartículas Metálicas/uso terapêutico , Infecções dos Tecidos Moles/terapia , Abscesso/tratamento farmacológico , Abscesso/cirurgia , Antibacterianos/administração & dosagem , Combinação de Medicamentos , Humanos , Terapia a Laser , Nanopartículas Metálicas/administração & dosagem , Pomadas/administração & dosagem , Pomadas/uso terapêutico , Infecções dos Tecidos Moles/tratamento farmacológico , Infecções dos Tecidos Moles/cirurgia , Supuração/tratamento farmacológico , Supuração/cirurgia , Supuração/terapia , Óxido de Zinco/administração & dosagem , Óxido de Zinco/uso terapêutico
2.
Khirurgiia (Mosk) ; (5): 102-108, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32500699

RESUMO

Hemorrhoidal disease is the most common proctologic disease and the search for new treatment methods, as well as an in-depth understanding of the mechanisms underlying effects of well-known agents on disease pathogenesis still remain relevant. There have been long recognized the effects of the E.coli bacterial culture suspension (BCS) as a therapeutic means eliciting decreased exudation during inflammation, wound healing, tissue regeneration, and stimulated immunity. Here, based on recent findings related to innate and adaptive immune cells, we set out to present mechanisms accounting for some effects coupled to commensal bacteria, particularly inactivated E.coli BCS, which are important for understanding pathogenesis-related action of drug Posterisan and Posterisan forte, and outline their broad application in therapy of hemorrhoids. Based on the analysis, it was concluded that such effects are mediated via multi-pronged and complementary interactions between diverse human receptors expressed in the anorectal region cells and microbial components: NOD ligands, metabolites, enzymes, heat shock proteins and nucleic acids, which lead to production of pro-inflammatory cytokines by anodermal colonocytes, innate and adaptive immune cells, neurons in the submucosal plexus covered by transitional zone epithelium, and hemorrhoid plexus endothelium. Based on current concepts, it may be plausible that E.coli BCS-derived biologically active components contained in drug Posterisan are capable of exerting both positive local and systemic effects, which extend our understanding and substantiate its use in hemorrhoidal disease. The effectiveness of using Posterisan and Posterisan forte is corroborated by their indications in real-life clinical practice, both as a conservative therapy as well as after surgical interventions.


Assuntos
Escherichia coli , Hemorroidas/terapia , Canal Anal/microbiologia , Escherichia coli/isolamento & purificação , Hemorroidas/imunologia , Hemorroidas/microbiologia , Humanos , Pomadas/administração & dosagem , Soluções/administração & dosagem
3.
Int J Pharm Compd ; 24(2): 163-167, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32196479

RESUMO

Asthma, which affects nearly 1 in every 12 people, is a large problem in the U.S. Asthma results in a cost of $56 billion dollars in various hospital bills and inconveniences. Many treatments of asthma use delivery methods (e.g., inhalers, tablets, capsules) that cannot be used by many patients if they have medical conditions that weaken their ability to inhale or swallow. This study's purpose was to examine the use of topically applied creams as a potential alternative to the use of conventional asthma medications. To test if a cream could work to treat asthma, a cream was developed with a drug normally taken orally that was combined with a cream base that was found most suitable to deliver the drug. The cream was then tested in-situ with mice as the test subject. The cream was applied to the backs of four groups of three mice for 0.5 hours, 1.5 hours, 5 hours, and 7 hours. Blood samples were taken after the respective times, and the quantity of the drug was analyzed in a mass spectrometer. The results showed that a cream delivered enough of an asthma drug to match the bioavailability of an average adult taking montelukast sodium. With this new delivery method, a cream can be used to treat asthma, which can also relieve the discomfort of asthma patients who are unable to use inhaled drugs and even possibly save lives of those unable to use traditional methods of delivery.


Assuntos
Asma , Pomadas/administração & dosagem , Adulto , Animais , Asma/tratamento farmacológico , Estudos de Viabilidade , Humanos , Camundongos , Comprimidos/química
4.
Pharm Res ; 37(2): 20, 2020 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-31897770

RESUMO

PURPOSE: The purpose of this study was (a) to suggest a novel dermatopharmacokinetic (DPK) approach from which pharmacokinetic parameters relevant to the bioequivalence (BE) assessment of a topical formulation can be deduced while circumventing the need for numerous measurements and assumptions, and (b) to investigate whether this approach enables the correct conclusion of BE and bioinequivalence (BIE). METHODS: Bioequivalent and bioinequivalent formulations of acyclovir were compared versus a reference product (Zovirax®). Tape Stripping was conducted at only one dose duration during the uptake phase to generate drug content in stratum corneum versus time profiles, each time point corresponding to one stripped layer. Nonlinear mixed effect modeling (ADAPT5®) (MLEM algorithm) was used to fit the DPK data and to estimate the rate (Kin) and extent (FS) of drug absorption/input into the skin. Results were evaluated using the average BE approach. RESULTS: Estimated exposure metrics were within the usual BE limits for the bioequivalent formulation (FS: 102.4 [90%CI: 97.5-107.7]; Kin: 94.2 [90%CI: 83.7-106.0]), but outside those limits for the bioinequivalent formulation (FS: 43.4 [90%CI: 27.9-67.6]; Kin: 54.5 [90%CI: 36.6-81.1]). CONCLUSIONS: The proposed novel DPK approach was shown to be successful, robust and applicable to assess BE and BIE correctly between topical formulations.


Assuntos
Pomadas/química , Administração Cutânea , Disponibilidade Biológica , Química Farmacêutica/métodos , Epiderme/efeitos dos fármacos , Feminino , Humanos , Masculino , Pomadas/farmacocinética , Pomadas/farmacologia , Pele/efeitos dos fármacos , Absorção Cutânea/fisiologia , Equivalência Terapêutica
5.
Pharm Res ; 37(3): 36, 2020 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-31965346

RESUMO

PURPOSE: We describe the preparation of injectable polymeric paste (IPP) formulations for local and sustained release of drugs. Furthermore, we include the characterization and possible applications of such pastes. Particular attention is paid to characteristics relevant to the successful clinical formulation development, such as viscosity, injectability, degradation, drug release, sterilization, stability performance and pharmacokinetics. METHODS: Paste injectability was characterized using measured viscosity and the Hagen-Poiseuille equation to determine injection forces. Drug degradation, release and formulation stability experiments were performed in vitro and drug levels were quantified using HPLC-UV methods. Pharmacokinetic evaluation of sustained-release lidocaine IPPs used five groups of six rats receiving increasing doses subcutaneously. An anti-cancer formulation was evaluated in a subcutaneous tumor xenograft mouse model. RESULTS: The viscosity and injectability of IPPs could be controlled by changing the polymeric composition. IPPs demonstrated good long-term stability and tunable drug-release with low systemic exposure in vivo in rats. Preliminary data in a subcutaneous tumor model points to a sustained anticancer effect. CONCLUSIONS: These IPPs are tunable platforms for local and sustained delivery of drugs and have potential for further clinical development to treat a number of diseases.


Assuntos
Portadores de Fármacos/química , Composição de Medicamentos/métodos , Pomadas/química , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Anilidas/química , Anilidas/farmacologia , Animais , Antineoplásicos/química , Antineoplásicos/uso terapêutico , Docetaxel/química , Docetaxel/farmacologia , Liberação Controlada de Fármacos , Estabilidade de Medicamentos , Humanos , Injeções , Lidocaína/química , Lidocaína/farmacocinética , Masculino , Camundongos , Camundongos Nus , Neoplasias Experimentais , Nitrilos/química , Nitrilos/farmacologia , Neoplasias da Próstata/tratamento farmacológico , Ratos , Compostos de Tosil/química , Compostos de Tosil/farmacologia , Viscosidade
6.
Cochrane Database Syst Rev ; 1: CD001836, 2020 01 20.
Artigo em Inglês | MEDLINE | ID: mdl-31978262

RESUMO

BACKGROUND: It is estimated that up to 1% of people in high-income countries suffer from a leg ulcer at some time in their life. The majority of leg ulcers are associated with circulation problems; poor blood return in the veins causes venous ulcers (around 70% of ulcers) and poor blood supply to the legs causes arterial ulcers (around 22% of ulcers). Treatment of arterial leg ulcers is directed towards correcting poor arterial blood supply, for example by correcting arterial blockages (either surgically or pharmaceutically). If the blood supply has been restored, these arterial ulcers can heal following principles of good wound-care. Dressings and topical agents make up a part of good wound-care for arterial ulcers, but there are many products available, and it is unclear what impact these have on ulcer healing. This is the third update of a review first published in 2003. OBJECTIVES: To determine whether topical agents and wound dressings affect healing in arterial ulcers. To compare healing rates and patient-centred outcomes between wound dressings and topical agents. SEARCH METHODS: The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature and Allied and Complementary Medicine databases, the World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov trials register to 28 January 2019. SELECTION CRITERIA: Randomised controlled trials (RCTs), or controlled clinical trials (CCTs) evaluating dressings and topical agents in the treatment of arterial leg ulcers were eligible for inclusion. We included participants with arterial leg ulcers irrespective of method of diagnosis. Trials that included participants with mixed arterio-venous disease and diabetes were eligible for inclusion if they presented results separately for the different groups. All wound dressings and topical agents were eligible for inclusion in this review. We excluded trials which did not report on at least one of the primary outcomes (time to healing, proportion completely healed, or change in ulcer area). DATA COLLECTION AND ANALYSIS: Two review authors independently extracted information on the participants' characteristics, the interventions, and outcomes using a standardised data extraction form. Review authors resolved any disagreements through discussion. We presented the data narratively due to differences in the included trials. We used GRADE to assess the certainty of the evidence. MAIN RESULTS: Two trials met the inclusion criteria. One compared 2% ketanserin ointment in polyethylene glycol (PEG) with PEG alone, used twice a day by 40 participants with arterial leg ulcers, for eight weeks or until healing, whichever was sooner. One compared topical application of blood-derived concentrated growth factor (CGF) with standard dressing (polyurethane film or foam); both applied weekly for six weeks by 61 participants with non-healing ulcers (venous, diabetic arterial, neuropathic, traumatic, or vasculitic). Both trials were small, reported results inadequately, and were of low methodological quality. Short follow-up times (six and eight weeks) meant it would be difficult to capture sufficient healing events to allow us to make comparisons between treatments. One trial demonstrated accelerated wound healing in the ketanserin group compared with the control group. In the trial that compared CGF with standard dressings, the number of participants with diabetic arterial ulcers were only reported in the CGF group (9/31), and the number of participants with diabetic arterial ulcers and their data were not reported separately for the standard dressing group. In the CGF group, 66.6% (6/9) of diabetic arterial ulcers showed more than a 50% decrease in ulcer size compared to 6.7% (2/30) of non-healing ulcers treated with standard dressing. We assessed this as very-low certainty evidence due to the small number of studies and arterial ulcer participants, inadequate reporting of methodology and data, and short follow-up period. Only one trial reported side effects (complications), stating that no participant experienced these during follow-up (six weeks, low-certainty evidence). It should also be noted that ketanserin is not licensed in all countries for use in humans. Neither study reported time to ulcer healing, patient satisfaction or quality of life. AUTHORS' CONCLUSIONS: There is insufficient evidence to determine whether the choice of topical agent or dressing affects the healing of arterial leg ulcers.


Assuntos
Úlcera da Perna/terapia , Pomadas/uso terapêutico , Cicatrização , Administração Tópica , Artérias , Curativos Hidrocoloides , Humanos , Curativos Oclusivos , Ensaios Clínicos Controlados Aleatórios como Assunto , Úlcera Varicosa/terapia
7.
Obstet Gynecol ; 135(2): 311-318, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31923074

RESUMO

OBJECTIVE: To compare pain control during vulvar biopsy after either application of 5% lidocaine-prilocaine cream or injection of 1% lidocaine. METHODS: In a single-site randomized trial, patients who needed vulvar biopsy on a non-hair-bearing surface were recruited from a gynecologic oncology clinic to compare lidocaine-prilocaine cream (placed at least 10 minutes before biopsy) with lidocaine injection (at least 1 minute prior). A sample size of 53 participants in each arm (N=106) was planned. Pain was recorded using a 100 mm visual analog scale at three time points: baseline, after application of anesthesia, and after biopsy. The primary outcome was highest pain score recorded. Secondary outcomes were pain score at biopsy, patient experience, and tolerability and acceptability. Linear regression was used to compare the primary outcome between arms while controlling for baseline vulvar pain. A convenience analysis was performed in March 2019. RESULTS: From October 2018 to March 2019, 38 patients completed informed consent and were randomized. Participants were women with median age of 60 years. Most characteristics between groups were similar. Nineteen were analyzed in the lidocaine-prilocaine group, and 18 were analyzed in the lidocaine injection group. The median highest pain score in the lidocaine-prilocaine group was 20.0 mm vs 56.5 mm in the lidocaine injection group. Controlling for baseline pain, the highest pain score in the lidocaine-prilocaine arm was 25.7 mm lower than in the lidocaine injection arm (95% CI [-45.1 to -6.3]; P<.01). Patients randomized to lidocaine-prilocaine had a significantly better experience than those receiving injected lidocaine (median experience score 2.0 mm vs 17.0 mm; P=.02). CONCLUSION: Lidocaine-prilocaine cream before vulvar biopsy resulted in a lower maximum pain score and a significantly better patient rating of the biopsy experience when compared with lidocaine injection. Lidocaine-prilocaine cream, alone, is a reasonable option to use for vulvar biopsy. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov, NCT03654417.


Assuntos
Biópsia por Agulha/métodos , Combinação Lidocaína e Prilocaína/uso terapêutico , Lidocaína/uso terapêutico , Bloqueio Nervoso/métodos , Vulva/patologia , Idoso , Anestésicos Locais/uso terapêutico , Feminino , Humanos , Injeções , Modelos Lineares , Pessoa de Meia-Idade , Pomadas , Dor/prevenção & controle , Manejo da Dor , Medição da Dor , Satisfação do Paciente , Períneo , Vulva/cirurgia
8.
Support Care Cancer ; 28(3): 1481-1489, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31273506

RESUMO

PURPOSE: We conducted a randomized, double-blind, vehicle-controlled clinical trial to investigate the use of a new proprietary hyaluronan (HA) formulation for the prevention of acute skin toxicity in breast cancer patients undergoing radiotherapy (RT). METHODS: Thirty women with breast cancer undergoing whole breast RT were enrolled. Each patient was randomly assigned to HA formulation (study cream, S) on the medial or lateral half of the irradiated breast and the control cream (placebo, P) on the other half. The primary endpoint was physician's evaluation of skin symptoms at week 5 during RT and week 2 post-RT. We also collected patients' independent assessment of skin after RT, patient's product preference, and an independent physician panel assessment of skin reactions based on photographs. RESULTS: Twenty-eight patients were evaluable. On physician's evaluation, there was no significant difference in radiation dermatitis between S and P and no overall preference to either cream at week 5 during or week 2 post-RT. More patients preferred S in evaluating skin appearance and skin reactions, but this did not reach statistical significance. Univariate analysis showed that physicians had an overall preference to the S cream at week 2 post-RT in patients with larger breasts. On the independent panel assessment, 3 reviewers saw no significant difference in radiation toxicity, whereas one reviewer reported better skin outcome with S cream at week 5. CONCLUSIONS: We found a nonstatistically significant patient preference but overall no significant radioprotective effects for this HA formulation compared with placebo except in patients with larger breasts. TRIAL REGISTRATION: The study was registered at www.clinicaltrials.gov (NCT02165605).


Assuntos
Neoplasias da Mama/radioterapia , Mama/anormalidades , Ácido Hialurônico/uso terapêutico , Hipertrofia/prevenção & controle , Lesões por Radiação/prevenção & controle , Radiodermatite/prevenção & controle , Adulto , Idoso , Mama/efeitos dos fármacos , Mama/efeitos da radiação , Método Duplo-Cego , Feminino , Humanos , Pessoa de Meia-Idade , Pomadas , Radiodermatite/tratamento farmacológico , Pele/patologia , Pele/efeitos da radiação
9.
Mater Sci Eng C Mater Biol Appl ; 106: 110056, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31753372

RESUMO

Proanthocyanidins (PCs), a component of grape seed extract (GSE), have recently being used for the treatment of wounds. However, poor absorption, poor stability and rapid elimination from the systemic circulation limit its acceptance. In addressing these problems, we herein report the development of PCs based nanoformulations (PCs/SOLU) for the first time based on 1% GSE and assessed its wound healing potential in-vivo on the wistar rats. GSE and PCs/SOLU nanodispersions 1% were prepared by incorporating them into the ointment base via uniform mixing to form ointment which could be easily applied topically to wounds. The antibacterial activity of PCs/SOLU against gram positive and gram-negative bacteria strains proved that the cell membranes became more permeable with disrupted cell structure. While carrageenan and histamine induced rat paw edema analyses show there was no inflammatory signs in animals treated with 1 wt% of PCs/SOLU nanodispersion. Excision wound measuring about 3 cm in depth was created on the wistar rats. The ointment was applied topically on the wounded site and the wound contraction was measured daily. Grape seed extract (GSE) ointment, ointment base and povidone­iodine (Povi-Iod) ointment of about 1% was used as the control, positive and negative standards. PCs/SOLU nanodispersion heals the wound by mobilising the fibroblasts in the wound site and inhibits the inflammatory response through decreased expression of monocyte. The macroscopical, immunological and histopathological assessments revealed that PCs/SOLU nanodispersion ointment usage improves the cell adhesion and proliferation.


Assuntos
Nanoestruturas/química , Pomadas/farmacologia , Proantocianidinas/química , Cicatrização/efeitos dos fármacos , Administração Tópica , Animais , Edema/induzido quimicamente , Edema/tratamento farmacológico , Edema/patologia , Eritrócitos/citologia , Eritrócitos/efeitos dos fármacos , Eritrócitos/metabolismo , Feminino , Bactérias Gram-Negativas/efeitos dos fármacos , Bactérias Gram-Positivas/efeitos dos fármacos , Extrato de Sementes de Uva/química , Hemólise/efeitos dos fármacos , Humanos , Masculino , Pomadas/química , Pomadas/uso terapêutico , Polietilenoglicóis/química , Polivinil/química , Proantocianidinas/farmacologia , Proantocianidinas/uso terapêutico , Ratos , Ratos Wistar , Pele/patologia
10.
Int J Nanomedicine ; 14: 7729-7741, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31806958

RESUMO

Background: Recently, several studies demonstrate the possible role of zinc oxide (ZnO) in the protection of several skin diseases, but less is known about the role of ZnO nanoparticles in the inflammatory skin disease. So, this study was designed to confirm the pivotal role of the nano zinc oxide cream in the alleviation of lead oxide (PbO) induced-allergic dermatitis in rats. Materials and methods: Two concentrations (1% and 6%) of ZnONPs creams were prepared and characterized prior to being used in the study. A total number of 30 male Wistar rats were randomly divided into six groups. Group 1 (negative control), groups 2&3 (either 1% or 6% ZnONPs control groups), group 4 (PbO), groups 5&6 (co-treatment of each ZnONPs concentration+PbO). All rats in different groups were observed daily to determine the severity of dermal gross lesions. Histopathological studies, mRNA analysis, and oxidative stress evaluations were performed on the affected skin tissue. Immunohistochemical studies were performed to evaluate the expression of cluster of differentiation CD4, CD8 and intercellular adhesion molecules ICAM-1 in different groups. Results: PbO caused extensive skin oxidative damage manifested by a significant increase in MDA level with a decrease in GSH content and CAT activity. The results of histopathological and immunohistochemical examinations revealed that topical application of PbO for 14 days led to severe allergic dermatitis with remarkable elevations in the number of CD4+ T-helper, CD8+ T-cytotoxic lymphocytes, and ICAM-1 expression. On the other hand, noticeable improvements were recorded in all the previous toxicopathological parameters among the groups treated by either 1% or 6% ZnO-NPs cream. However, the best results were observed in the group treated with 1% ZnO-NPs cream. Conclusion: Our findings suggest that 1% of ZnO-NPs cream is safe when applied topically on the inflamed skin. Moreover, it had anti-inflammatory and antioxidant effects so that, it is recommended to use the 1% ZnO-NPs cream to avert the dermal toxicity-induced by PbO.


Assuntos
Dermatite Alérgica de Contato/tratamento farmacológico , Chumbo/toxicidade , Nanopartículas Metálicas/uso terapêutico , Óxidos/toxicidade , Substâncias Protetoras/farmacologia , Óxido de Zinco/farmacologia , Administração Tópica , Animais , Antioxidantes/química , Antioxidantes/farmacologia , Dermatite Alérgica de Contato/etiologia , Dermatite Alérgica de Contato/patologia , Modelos Animais de Doenças , Masculino , Malondialdeído/metabolismo , Nanopartículas Metálicas/química , Pomadas/química , Pomadas/farmacologia , Estresse Oxidativo/efeitos dos fármacos , Substâncias Protetoras/administração & dosagem , Substâncias Protetoras/química , Ratos Wistar , Óxido de Zinco/administração & dosagem , Óxido de Zinco/química
11.
Indian J Pharmacol ; 51(5): 316-322, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31831920

RESUMO

OBJECTIVES: The objective of this study was to carry out a head-to-head comparison of topical sucralfate combined with mupirocin versus mupirocin alone in the treatment of chronic skin ulcers with respect to both effectiveness and safety. MATERIALS AND METHODS: A parallel-group, open-label, randomized, controlled trial (CTRI/2015/12/006443) was carried out with patients suffering from skin ulcers of Wagner grading 1 or 2 persisting for over 4 weeks. Ninety-six patients were recruited in total, and the modified intention-to-treat analysis dataset included 44 participants treated with mupirocin 2% and 46 treated with combined mupirocin 2% and sucralfate 7% ointment. Both medications were applied topically thrice daily for 6 weeks. Ulcer area assessed using millimeter graph paper and wound infection score assessed on a three-point scale were effectiveness measures. Treatment-emergent adverse reactions that were reported by patients or observed by the investigators were recorded. RESULTS: The median ulcer area was significantly reduced in the combined treatment group at the end of treatment. Clinically, 41.3% of the participants in the combined group showed complete ulcer healing at 6 weeks compared to 18.18% in the mupirocin alone group (P = 0.022). The wound infection score declined significantly from baseline by the end of 3 weeks of treatment in both the groups. The frequency of qualitative wound attributes, namely pain, discharge, and erythema, remained comparable between the groups except for discharge which disappeared completely from all remaining ulcers in the combined group but was still present in 11.36% of the participants treated with mupirocin alone (P = 0.025) at 6 weeks. Adverse events were few, all local, mild, and tolerable. CONCLUSIONS: The wound healing effect of topical sucralfate adds to the antimicrobial effect of mupirocin toward the overall improvement of chronic skin ulcers. The effect of combined topical treatment needs comparison with other topical medications and wound healing strategies.


Assuntos
Mupirocina/administração & dosagem , Úlcera Cutânea/tratamento farmacológico , Sucralfato/administração & dosagem , Cicatrização/efeitos dos fármacos , Administração Cutânea , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Antibacterianos/efeitos adversos , Antiulcerosos/administração & dosagem , Antiulcerosos/efeitos adversos , Doença Crônica , Quimioterapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mupirocina/efeitos adversos , Pomadas , Sucralfato/efeitos adversos , Resultado do Tratamento , Adulto Jovem
12.
Mar Drugs ; 17(12)2019 Dec 06.
Artigo em Inglês | MEDLINE | ID: mdl-31817687

RESUMO

Fucoidan, a fucose-rich polysaccharide from brown algae, has been used for transdermalformulations targeting inflammatory skin conditions, for the treatment of thrombosis, vascularpermeability diseases, subcutaneous wounds, and burns. However, the pharmacokinetics offucoidan after topical application has not been described. In this study, an ointment (OF)containing 15% fucoidan was topically applied to rats at the doses of 50-150 mg/g. The anti-Xaactivity was selected as the biomarker, and the amidolytic assay method was validated and appliedfor pharmacokinetic studies of fucoidan. Fucoidan in OF penetrated the skin and distributed intothe skin, striated muscle, and plasma with AUC0-48 = 0.94 µg·h/g, 2.22 µg·h/g, and 1.92 µg·h/mL,respectively. The longest half-life for fucoidan was observed in plasma, then in striated muscle andskin. It was found that the pharmacokinetics of fucoidan after topical OF application was linear, inthe range of 50-150 mg/kg. No accumulation of fucoidan in plasma was observed after repeatedtopical applications of 100 mg/kg during five days. Our results support the rationality of topicalapplication of formulations with fucoidan.


Assuntos
Fármacos Dermatológicos/farmacocinética , Polissacarídeos/farmacocinética , Absorção Cutânea , Administração Cutânea , Animais , Área Sob a Curva , Fármacos Dermatológicos/administração & dosagem , Relação Dose-Resposta a Droga , Meia-Vida , Masculino , Pomadas , Polissacarídeos/administração & dosagem , Ratos , Distribuição Tecidual
13.
Br J Community Nurs ; 24(Sup12): S12-S17, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31804887

RESUMO

Reduction of chronic wound pain has the potential to improve patients' quality of life, expedite the healing process and, ultimately, relieve pressure on community services. Despite this, education on pain assessment in the management of chronic wounds is lacking. This literature review seeks to provide evidence-based recommendations to reduce chronic wound pain and inform the practice of community nurses. The results of a thematic analysis indicate that a honey dressing or native collagen matrix dressing and conditioning exercises for the lower leg can reduce pain, and nitroglycerin ointment is especially effective. The review also highlights the need for an individualised approach to the assessment and treatment of pain in patients with chronic wounds.


Assuntos
Dor Crônica/enfermagem , Dor Crônica/prevenção & controle , Enfermagem em Saúde Comunitária , Ferimentos e Lesões/fisiopatologia , Anestésicos Locais/administração & dosagem , Apiterapia , Bandagens , Doença Crônica , Dor Crônica/etiologia , Colágeno/uso terapêutico , Terapia por Exercício , Mel , Humanos , Nitroglicerina/administração & dosagem , Pomadas , Qualidade de Vida , Cicatrização/fisiologia , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/fisiopatologia , Ferimentos e Lesões/terapia
14.
Zhongguo Zhong Yao Za Zhi ; 44(18): 3903-3907, 2019 Sep.
Artigo em Chinês | MEDLINE | ID: mdl-31872723

RESUMO

Cream formula has been mostly used to treat deficiency syndrome. Currently,it has been used to recuperate the body,promote health against aging,and prevent and treat chronic disease. In modern medicine,there are only treatment concepts and methods of diseases,but lack of concepts of " deficiency syndrome" and " restoring deficiency". The concepts of " deficiency syndrome" and " restoring deficiency" could effectively supplement and improve the diagnosis and treatment scheme of some modern diseases. Refractory heart failure,dilated cardiomyopathy,ischemic cardiomyopathy,and valvular heart disease belong to the traditional category of " consumptive disease". The cream formula with the efficacy of restoring deficiency can not only alleviate symptoms and improve the quality of life,but also improve the structure and function of the heart,reduce the dosage of diuretics and the number of hospitalizations,and achieve the purpose of secondary prevention in the treatment of severe heart failure,dilated cardiomyopathy,ischemic cardiomyopathy and valvular heart disease. The cream formula for treating chronic heart failure include Shenqi Pills,Zhenwu Decoction,Yougui Pills,Wuling Powder,Linggui Zhugan Decoction,Danggui Shaoyao Powder,Lizhong Decoction,Buzhong Yiqi Decoction,Guipi Decoction,Yupingfeng Powder,Guizhi Decoction. Long-term administration of cream formula could not only resist aging,but also play an irreplaceable role in the secondary prevention of acute and critical diseases.


Assuntos
Cardiomiopatias/tratamento farmacológico , Medicamentos de Ervas Chinesas/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Doenças das Valvas Cardíacas/tratamento farmacológico , Humanos , Medicina Tradicional Chinesa , Pomadas
15.
Environ Health Perspect ; 127(11): 117004, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31774309

RESUMO

BACKGROUND: Newborns in neonatal intensive care units (NICUs) are in contact with a variety of medical products whose production might include synthetic chemicals with hormonal activity. OBJECTIVES: Our aim was to assess the content of bisphenol A (BPA) and parabens (PBs) and the hormone-like activities of a subset of medical products commonly used in NICUs in prolonged intimate contact with NICU newborns. METHODS: Fifty-two NICU items were analyzed, determining the concentrations of BPA and PBs [methyl- (MeP), ethyl- (EtP), propyl- (PrP), and butylparaben (BuP)] and using the E-Screen and PALM-luciferase assays to measure the in vitro (anti-)estrogenic and (anti-)androgenic activity, respectively, of the extracts. Items found to have elevated BPA/PB content or hormone-like activities were further extracted using leaching methodologies. RESULTS: BPA was found in three-fifths and PBs in four-fifths of tested NICU items, and ∼25% and ∼10% of extracts evidenced estrogenic and anti-androgenic activity, respectively. The highest BPA content was found in the three-way stopcock (>7.000 ng/g), followed by patterned transparent film dressing, gastro-duodenal feeding tubes, sterile gloves, single-lumen umbilical catheters, and intravenous (IV) infusion extension sets (concentrations ranged from 100 to 700 ng/g BPA). A total PB concentration (∑PBs) >100 ng/g was observed in several items, including light therapy protection glasses, patterned transparent film dressing, winged IV catheters, IV infusion extension sets, and textile tape. The highest estrogenic activity [>450 pM estradiol equivalent (E2eq)] was found in small dummy nipples, three-way stopcocks, and patterned transparent film dressing and the highest anti-androgenic activity [>5 mM procymidone equivalent units per gram (Proceq/g)] in small dummy nipples and three-way stopcocks. DISCUSSION: According to these findings, neonates might be exposed to multiple sources of BPA and PBs in NICUs via inhalation, dermal, oral, and IV/parenteral routes. There is a need to address the future health implications for these extremely vulnerable patients and to adopt precautionary preventive measures as a matter of urgency. https://doi.org/10.1289/EHP5564.


Assuntos
Compostos Benzidrílicos/análise , Exposição Ambiental/análise , Unidades de Terapia Intensiva Neonatal , Parabenos/análise , Fenóis/análise , Suplementos Nutricionais/análise , Equipamentos e Provisões , Humanos , Recém-Nascido , Pomadas/análise , Têxteis/análise
16.
Pharm Biol ; 57(1): 799-806, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31760838

RESUMO

Context: Cinnamomum verum J. Presl. (Lauraceae) has a high number of polyphenols with insulin-like activity, increases glucose utilization in animal muscle, and might be beneficial for diabetic patients.Objective: This study evaluated the effectiveness of an ointment prepared from Cinnamomum verum hydroethanolic extract on wound healing in diabetic mice.Materials and methods: A total of 54 male BALB/c mice were divided into three groups: (1) diabetic non-treated group mice that were treated with soft yellow paraffin, (2 and 3) mice that were treated with 5 and 10% C. verum. Two circular full-thickness excisional wounds were created in each mouse, and the trial lasted for 16 d following induction of the wound. Further evaluation was made on the wound contraction ratio, histopathology parameters and mRNA levels of cyclin D1, insulin-like growth factor 1 (IGF-1), glucose transporter-1 (GLUT-1), total antioxidant capacity, and malondialdehyde of granulation tissue contents. HPLC apparatus was utilized to identify the compounds.Results: The HPLC data for cinnamon hydroethanolic extract identified cinnamaldehyde (11.26%) and 2-hydroxyl cinnamaldehyde (6.7%) as the major components. A significant increase was observed in wound contraction ratio, fibroblast proliferation, collagen deposition, re-epithelialization and keratin biosynthesis in the C. verum-treated groups in comparison to the diabetic non-treated group (p < 0.05). The expression level of cyclin D1, IGF1, GLUT 1 and antioxidant capacity increased in the C. verum-treated groups in comparison to the diabetic non-treated group (p < 0.05).Conclusions: Topical administration of C. verum accelerated wound healing and can possibly be employed in treating the wounds of diabetic patients.


Assuntos
Cinnamomum/química , Queratinas/efeitos dos fármacos , Extratos Vegetais/farmacologia , Reepitelização/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Administração Tópica , Animais , Antioxidantes/efeitos adversos , Diabetes Mellitus Experimental/induzido quimicamente , Fator de Crescimento Insulin-Like I/metabolismo , Queratinas/biossíntese , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Pomadas , Polifenóis , Pele/efeitos dos fármacos , Estreptozocina/farmacologia
17.
J Otolaryngol Head Neck Surg ; 48(1): 52, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640785

RESUMO

Cold agglutinin disease (CAD) is a rare condition leading to blood agglutination and autoimmune hemolytic anemia. Cutaneous ischemia resulting from CAD in the head and neck is uncommon. Treatment regimens and outcomes vary widely in the literature and no clear protocol exists. This manuscript describes a patient with CAD who developed severe ischemia of the nose that resolved completely without sequellae following a medical regimen of aspirin, low molecular weight heparin, nitroglycerin ointment and hyperbaric oxygen therapy (HBOT). To our knowledge, this is the first reported case where nitroglycerin ointment or HBOT was successfully employed in the treatment of this complication.


Assuntos
Anemia Hemolítica Autoimune/complicações , Oxigenação Hiperbárica , Isquemia/terapia , Nariz/irrigação sanguínea , Administração Tópica , Idoso de 80 Anos ou mais , Anticoagulantes/uso terapêutico , Terapia Combinada , Enoxaparina/administração & dosagem , Feminino , Humanos , Isquemia/tratamento farmacológico , Isquemia/etiologia , Nitroglicerina/administração & dosagem , Pomadas , Vasodilatadores/administração & dosagem
18.
J Drugs Dermatol ; 18(10): 1002-1004, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31584778

RESUMO

Lanolin alcohol is a high cholesterol containing naturally derived material used as a skin protectant in wound healing petrolatum-based ointments. It is a highly purified fraction of lanolin wool wax that has been identified as a possible cause of allergic contact dermatitis. This 3-center study enrolled 499 subjects who underwent a variety of in-office surgical procedures followed by application of a wound healing ointment containing lanolin alcohol without antibiotics. No allergic contact dermatitis was identified in the 499 subjects who completed the study. The lack of allergic contact dermatitis observed may be due to the proprietary highly purified lanolin alcohol utilized in the study formulation. This is not the lanolin alcohol preparation found on the standard dermatology patch test tray. Not all lanolin alcohols are equal. This is an important consideration when examining the reported incidence of allergic contact dermatitis to lanolin alcohol and the absence of allergic contact dermatitis demonstrated in this research. J Drugs Dermatol. 2019;18(10):1002-1004.


Assuntos
Dermatite Alérgica de Contato/epidemiologia , Lanolina/efeitos adversos , Vaselina/efeitos adversos , Ferida Cirúrgica/tratamento farmacológico , Adolescente , Adulto , Idoso , Estudos de Coortes , Dermatite Alérgica de Contato/etiologia , Feminino , Humanos , Lanolina/administração & dosagem , Masculino , Pessoa de Meia-Idade , Bases para Pomadas , Pomadas , Vaselina/administração & dosagem , Prevalência , Resultado do Tratamento , Cicatrização/efeitos dos fármacos , Adulto Jovem
19.
Pediatr Dermatol ; 36(6): 926-928, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31588604

RESUMO

Prolidase deficiency is a rare autosomal recessive disorder characterized by cutaneous ulcers, facial dysmorphism, recurrent infections, and intellectual disability. We report a unique case of a 6-year-old boy with prolidase deficiency and Crohn's disease who presented with lower extremity ulcers. Cutaneous ulcers due to prolidase deficiency are historically resistant to treatment, and we report success with the novel use of topical tacrolimus.


Assuntos
Inibidores de Calcineurina/uso terapêutico , Úlcera da Perna/tratamento farmacológico , Deficiência de Prolidase/complicações , Tacrolimo/uso terapêutico , Administração Tópica , Criança , Humanos , Úlcera da Perna/genética , Masculino , Pomadas
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