Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 3.329
Filtrar
1.
Pol Merkur Lekarski ; 48(287): 331-334, 2020 Oct 23.
Artigo em Inglês | MEDLINE | ID: mdl-33130793

RESUMO

Among the high-tech methods of wound therapy, the leading place belongs to the technology of manufacture and use of cryolyophilized tissues and bioorganic drugs. Crushed xenoderm's powder stimulates the regenerative processes of the skin and improves the healing process of wounds, as it is enriched with macro- and microelements, amino acids and other cellular elements necessary for skin regeneration. AIM: The aim of this work was to study the wound-healing effectiveness of the developed gel "Xeliogel" on the animal model of aseptic superficial burns. MATERIALS AND METHODS: Evaluation of the degree of catabolism and membrane-destructive processes was performed by determining the marker enzymes of cytolysis - aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in serum, total protein and middle molecular mass in animals with experimental thermal burns. The developed gel "Xeliogel" was applied to the animals for therapeutic purposes. "Xeliogel" is based on aqueous extraction of xenoderm and with lidocaine hydrochloride. In the second group for comparison the Solcoseryl was applied in the form of a gel (Switzerland). This medicine belongs to the group containing active pharmaceutical ingredients of natural origin, namely protein-free dialysate from the blood of calves, and is intended for the treatment of burns of I-II degrees. RESULTS: When using the developed gel "Xeliogel" in experimental thermal burns, normalization of total protein was observed on 14-th days, which is on 7 days faster than under burn conditions, decrease the levels of ALT and AST in the serum with a return to a normal on a 7 day, relative to the control pathology group. In the groups of animals, on whose burn wounds "Xeliogel" gel was applied, already on the 14-th day endogenous intoxication was significantly reduced by 29 % compared with the control group of animals. During the experiment to reduce the area of the wound surface, it was determined that the developed gel "Xeliogel" showed a pharmacological effect similar to the comparison drug "Solkoseryl" gel. CONCLUSIONS: On the model of aseptic burn injury in rats, was determined that the developed gel provides a significant reduction in necrotic processes, the level of endogenous intoxication against the background of restoring the level of total protein in the circulating blood. The results of the research confirm the effectiveness of using the developed gel "Xeliogel" for local treatment of burns of I-II degrees, as the duration of treatment of burns reduced by 4 days compared to the control group and the developed gel is similar to the comparison drug.


Assuntos
Queimaduras , Animais , Queimaduras/tratamento farmacológico , Bovinos , Humanos , Ratos , Pele , Cicatrização
2.
Curr Opin Anaesthesiol ; 33(5): 633-638, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32826629

RESUMO

PURPOSE OF REVIEW: Ketamine has been used for decades for a variety of indications. Beyond the historical benefits and effects of ketamine, newer developments have occurred worthy of an update. This review will discuss common uses and indications for ketamine in the perioperative setting, as well as highlight newer indications in recent years. RECENT FINDINGS: Multiple studies have examined the use of ketamine in a variety of environments, as ketamine has become more popular in emergency rooms and ICUs. Ketamine may be particularly beneficial in management of burn patients, who often require multiple procedures over the course of their treatment. Ketamine's role in the ongoing opioid crisis has been of particular interest, with multiple studies evaluating its potential role in managing both acute and chronic pain conditions. Ongoing studies examining the role of ketamine in treatment of depressions show promise as well. SUMMARY: Ketamine is regaining popularity in the field of anesthesia and beyond. New studies provide insight on the many indications and use that anesthesia providers may encounter during their perioperative care of patients. Ongoing research is needed to further elucidate ketamine's effects on the management of psychiatric conditions and potential indications for ketamine metabolites.


Assuntos
Analgesia , Analgésicos/farmacologia , Anestesia , Anestésicos Dissociativos/farmacologia , Queimaduras/tratamento farmacológico , Depressão/tratamento farmacológico , Ketamina/farmacologia , Dor/tratamento farmacológico , Humanos , Manejo da Dor , Período Perioperatório
3.
Zhonghua Shao Shang Za Zhi ; 36(6): 458-464, 2020 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-32594705

RESUMO

Objective: To systematically evaluate the safety and efficacy of dexmedetomidine combined with ketamine during dressing changes in burn patients using meta-analysis. Methods: Foreign language databases including PubMed, Cochrane Central, Embase, and Web of Science were searched with the terms of " burns, dexmedetomidine, ketamine, and dressing" , and Chinese databases including Chinese Journal Full-Text Database, Wanfang Data, and China Academic Journal Network Publishing Database were searched with the terms in Chinese version of ",,,,," to retrieve the publicly published randomized controlled trials on the application of dexmedetomidine combined with ketamine for sedation and analgesia during dressing changes in burn patients from the establishment of each database to March 2019. The outcome indexes included systolic blood pressure at 5 minutes after administration, arousal restlessness score, ketamine dosage, dressing change time, body movement/recovery time, pain score, Ramsay sedation scores at 10 minutes after the start of dressing change and 1 hour after dressing change, physician satisfaction score, neuropsychological symptoms, nausea and vomiting times, nausea and vomiting score. RevMan 5.3 and Stata 14.0 statistical software were used to conduct a meta-analysis of eligible studies. Results: A total of 396 burn patients were included in 7 articles, including 198 patients in dexmedetomidine+ ketamine group who received dexmedetomidine and ketamine for sedation and analgesia, and 198 patients in ketamine alone group who received ketamine alone for sedation and analgesia. The bias risks of the seven studies included were uncertain. Compared with those of ketamine alone group, the systolic blood pressure at 5 minutes after administration, arousal restlessness score, nausea and vomiting score of patients in dexmedetomidine+ ketamine group were significantly decreased, with standardized mean differences of -13.89, -0.84, and -0.99 (95% confidence interval=-20.89--6.89, -1.17--0.52, -1.31--0.68, P<0.01), the Ramsay sedation score at 10 minutes after the start of dressing change and that at 1 hour after dressing change were significantly increased, with standardized mean differences of 1.53 and 0.72 (95% confidence interval=1.05-2.02, 0.13-1.31, P<0.05 or P<0.01), and the number of neuropsychological symptom and number of nausea and vomiting were significantly reduced, with relative risks of 0.20 and 0.16 (95% confidence interval=0.07-0.58, 0.05-0.58, P<0.01). The patients in the two groups were similar in ketamine dosage, dressing change time, body movement/recovery time, pain score, and physician satisfaction score. There was no publication bias in dressing change time or ketamine dosage (P>0.05), while the other indexes might have publication bias (P<0.05). Conclusions: Compared with ketamine alone, combination of dexmedetomidine and ketamine during dressing changes in burn patients can reduce the occurrence of restlessness, nausea and vomiting, neuropsychological symptoms, and other complications, better stabilize blood pressure, and enhance sedation effect.


Assuntos
Queimaduras , Dexmedetomidina/uso terapêutico , Ketamina/uso terapêutico , Bandagens , Queimaduras/tratamento farmacológico , China , Humanos , Hipnóticos e Sedativos
4.
Psychopharmacology (Berl) ; 237(8): 2327-2343, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32399631

RESUMO

RATIONALE: The c-Jun N-terminal kinase (JNK) pathway and neurotrophic factor dysregulation play a critical role in the pathogenesis of neurobehavioral disorders (anxiety and depression). Targeting the JNK pathway and BDNF/VEGF signaling may signify a new avenue for the treatment of neurobehavioral disorders. OBJECTIVES: The present study investigated the effect of matrine (Mat) against anxiety- and depressive-like emotional status in an acute mouse model of burn injury and explores its underlying mechanism. METHODS: In the mouse model of thermal injury, anxiety- and depression-related behaviors were evaluated using the elevated plus-maze test, the light-dark box test, the open-field test, the forced swimming test, and the tail suspension test. The JNK/caspase-3 and BDNF/VEGF proteins were determined by immunohistochemistry. Additionally, proinflammatory cytokine, antioxidant, nitric oxide, and corticosterone levels were also measured. RESULTS: The results showed that treatment with Mat significantly improves anxiety- and depressive-like behaviors. It remarkably reduced the levels of proinflammatory cytokines, malondialdehyde, and nitric oxide in the hippocampus and prefrontal cortex of a mouse brain. It considerably improved burn-induced alteration in the antioxidant status, corticosterone, and BDNF/VEGF. It also inhibited burn-induced apoptotic signaling by downregulating the expression of JNK/caspase-3. Similarly, it prevented DNA damage and histopathological changes in the dentate gyrus of the hippocampus. Furthermore, molecular docking results showed that Mat possess better binding affinity for JNK/caspase-3 and BDNF/VEGF proteins. CONCLUSIONS: These findings provide convincing evidence that Mat improves anxiety- and depressive-like emotional status through modulation of JNK-mediated inflammatory, oxidative stress, apoptotic, and BDNF/VEGF signaling in an acute mouse model of burn injury.


Assuntos
Alcaloides/metabolismo , Fator Neurotrófico Derivado do Encéfalo/metabolismo , Queimaduras/metabolismo , Caspase 3/metabolismo , Sistema de Sinalização das MAP Quinases/fisiologia , Quinolizinas/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo , Alcaloides/farmacologia , Alcaloides/uso terapêutico , Animais , Ansiolíticos/metabolismo , Ansiolíticos/farmacologia , Ansiolíticos/uso terapêutico , Ansiedade/tratamento farmacológico , Ansiedade/metabolismo , Fator Neurotrófico Derivado do Encéfalo/antagonistas & inibidores , Queimaduras/tratamento farmacológico , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Masculino , Aprendizagem em Labirinto/efeitos dos fármacos , Aprendizagem em Labirinto/fisiologia , Camundongos , Simulação de Acoplamento Molecular/métodos , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/fisiologia , Quinolizinas/farmacologia , Quinolizinas/uso terapêutico , Fator A de Crescimento do Endotélio Vascular/antagonistas & inibidores
5.
Rev. Soc. Esp. Dolor ; 27(2): 127-132, mar.-abr. 2020. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195854

RESUMO

El manejo del dolor es una pieza crítica en el cuidado general del niño quemado. El dolor neuropático es una de sus consecuencias frecuentes, el cual puede aparecer al inicio o durante el proceso de cicatrización de heridas, acompañándose de sintomatología predominantemente por estimulación del sistema nervioso simpático, siendo su manejo un reto importante. El bloqueo del plano del erector espinal (ESP) es una técnica regional novedosa que se ha utilizado en diferentes tipos de cirugía, con resultados prometedores. Actualmente, el bloqueo ESP en la población pediátrica se viene realizando para cirugías de tórax, abdomen, cadera y genitales, con solo pocos informes. Hasta donde sabemos, el bloqueo ESP para dolor neuropático en niños aún no se ha reportado. El presente informe sugiere que el bloqueo ESP torácico realizado a nivel T4 podría proporcionar una analgesia amplia y efectiva en el dolor neuropático además de regular la sintomatología simpática, secundaria a los cambios fisiopatológicos relacionados con el grado de quemadura


Pain management is a critical piece in the general care of the burned child. Neuropathic pain is one of its frequent consequences, which may appear at the beginning or during the wound healing process, accompanied by symptoms predominantly due to stimulation of the sympathetic nervous system, its management being an important challenge. The spinal erector plane (ESP) block is a novel regional technique that has been used in different types of surgery, with promising results. Currently, the ESP block in the pediatric population has been performed for thorax, abdomen, hip and genital surgeries, with only a few reports. As far as we know, ESP block for neuropathic pain in children has not yet been reported. The present report suggests that the thoracic ESP blockade performed at the T4 level could provide a wide and effective analgesia in neuropathic pain in addition to regulating sympathetic symptomatology, secondary to the pathophysiological changes related to the degree of burn


Assuntos
Humanos , Feminino , Lactente , Bloqueio Nervoso/métodos , Nervos Espinhais/efeitos dos fármacos , Queimaduras/complicações , Neuralgia/tratamento farmacológico , Anestesia Local/métodos , Queimaduras/tratamento farmacológico , Manejo da Dor/métodos , Dipirona/administração & dosagem , Tramadol/administração & dosagem , Morfina/administração & dosagem
6.
Sci Rep ; 10(1): 6338, 2020 04 14.
Artigo em Inglês | MEDLINE | ID: mdl-32286492

RESUMO

Burn injury is common, and antimicrobial agents are often applied immediately to prevent wound infection and excessive inflammatory response. Although inflammation is essential for clearing bacteria and creating an environment conducive to the healing process, it is unclear what time-frame inflammation should be present for optimal wound healing. This study critically investigated the role of early inflammation in burn wound healing, and also revealed the molecular mechanisms underlying the pro-healing effects of silver nanoparticles (AgNPs). We created a burn injury mouse model using wild-type and Smad3-/- mice, which were topically treated with AgNPs at different post-burn days, and examined the healing processes of the various groups. We also delineated the molecular pathways underlying the anti-inflammation and pro-healing effects of AgNPs by morphological and histological analysis, immuno-histochemistry, and western blotting. Our results showed that (1) AgNPs regulated pro-inflammatory cytokine IL-6 production of keratinocytes and neutrophils infiltration through KGF-2/p38 signaling pathway, (2) Topical AgNPs treatment immediately after burn injury significantly supressed early inflammation but resulted in delayed healing, (3) A short delay in AgNPs application (post-burn day 3 in our model) allowed early inflammation in a controlled manner, and led to optimal burn wound healing. Thus, our current study showed that some degree of early inflammation was beneficial, but prolonged inflammation was detrimental for burn wound healing. Further evaluation and clinical translation of this finding is warranted.


Assuntos
Queimaduras/tratamento farmacológico , Nanopartículas Metálicas/administração & dosagem , Nanopartículas Metálicas/uso terapêutico , Prata/uso terapêutico , Cicatrização , Animais , Queimaduras/metabolismo , Fator 7 de Crescimento de Fibroblastos/metabolismo , Interleucina-6/genética , Interleucina-6/metabolismo , Masculino , Nanopartículas Metálicas/química , Camundongos , Camundongos Endogâmicos C57BL , Transdução de Sinais , Prata/administração & dosagem , Prata/química , Proteína Smad3/genética , Proteínas Quinases p38 Ativadas por Mitógeno/metabolismo
7.
Hosp Pract (1995) ; 48(3): 137-145, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32326780

RESUMO

BACKGROUND: There are known demographic and clinical patterns related to burn injuries and care associated with national and global geography. Still, limited data sources exist to facilitate the study of trends in the regionalization of burn care. OBJECTIVES: The current study aims to investigate the demographics and clinical characteristics of patients that presented to the Emergency Department (ED) and were subsequently admitted for treatment to the inpatient unit of a regional burn center. METHODS: This retrospective, single-center study was conducted between 1 February 2018 and 31 July 2019, of ED patients who presented with a burn injury and were subsequently admitted to the hospital. RESULTS: We identified 329 patients with burn injuries requiring hospitalization. The median age was 22 years [IQR 2-53], and 195 (59%) subjects were males. Monthly and seasonal variations in admissions were identified. The majority of burns occurred at home (84%) and secondary to a scalding injury (59%). The lower extremity was the most common site of injury (29%). Most subjects received antibiotics (59%) and narcotic analgesia (56%) in the ED. The median hospital length of stay was four days [IQR 2-11]. Many subjects did not require surgical intervention (64%) and did not experience complications (79%). CONCLUSIONS: In this study, we describe the demographics and clinical characteristics of patients that presented to the ED and were subsequently admitted to a regional burn center. Analyzing the epidemiological information and clinical management of burns may better prepare healthcare providers to offer care to patients with burn injuries.


Assuntos
Unidades de Queimados/estatística & dados numéricos , Queimaduras/epidemiologia , Queimaduras/fisiopatologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Adolescente , Adulto , Analgésicos Opioides/administração & dosagem , Antibacterianos/administração & dosagem , Queimaduras/tratamento farmacológico , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores Socioeconômicos , Adulto Jovem
8.
Eur J Pharmacol ; 872: 172958, 2020 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-32001222

RESUMO

The deteriorating effects of heat stress abrogate the therapeutic implications of human Wharton's jelly derived mesenchymal stem cells (hWJMSCs) transplanted in burn wounds. Topically applied green tea extract comprising epigallocatechin-3-gallate (EGCG) is known to repair burn wounds. Here, we investigated the protective role of EGCG priming of hWJMSCs against heat-induced stress in vitro along with the involved underlying mechanism. EGCG ameliorated heat-induced injuries as demonstrated by significantly improved cell morphology, viability, triggered cell migration and enhanced expression of heat shock proteins. In addition, decreased lactate dehydrogenase release and reduced percentage of senescent and apoptotic cells were observed. EGCG priming alleviated the detrimental effects of thermal stress in hWJMSCs as observed by significant down-regulation in expression of BCL2 associated X (BAX), interleukin 6 (IL6), and interleukin 1 beta (IL1ß) genes, while proliferating cell nuclear antigen (PCNA), BCL2 like 1 (BCL2L1), vascular endothelial growth factor (VEGF), transforming growth factor beta 1 (TGFß1), hepatocyte growth factor (HGF) and interleukin 4 (IL4) genes were up-regulated. Accompanying gene expression data, EGCG primed cells exposed to heat stress also exhibited remarkably increased secretion of VEGF, HGF, epidermal growth factor (EGF), stromal-derived factor 1 (SDF1) proteins while the reduced release of IL-6, and tumor necrosis factor-alpha (TNF-α) proteins. Further, synergistic activation of extracellular-signal-regulated kinase (ERK) and protein kinase B (PKB/AKT) proteins was observed. These findings suggest that EGCG priming might enhance the therapeutic efficacy of hWJMSCs in the burnt tissue through regulation of ERK and AKT signaling pathways, and improved cellular responses.


Assuntos
Queimaduras/tratamento farmacológico , Catequina/análogos & derivados , Temperatura Alta/efeitos adversos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Células-Tronco Mesenquimais/efeitos dos fármacos , Queimaduras/patologia , Catequina/farmacologia , Catequina/uso terapêutico , Células Cultivadas , Humanos , Células-Tronco Mesenquimais/metabolismo , Células-Tronco Mesenquimais/patologia , Cultura Primária de Células , Proteínas Proto-Oncogênicas c-akt/metabolismo , Geleia de Wharton
9.
Curr Pharm Biotechnol ; 21(10): 997-1004, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32077820

RESUMO

BACKGROUND: Burn is still an important global public health challenge. Wound colonization of antibiotic resistant bacteria such as Acinetobacter baumannii can lead to high morbidity and mortality in burn patients. The aim of this study was to evaluate the inhibitory effect of tazobactam on efflux pump, which can cause aminoglycoside resistant in A. baumannii isolated from burn patients. METHODS: In this study, 47 aminoglycoside resistant A. baumannii spp. were obtained from burn patients, admitted to the Shahid Motahari Burns Hospital in Tehran, Iran, during June-August 2018. The inhibitory effect of tazobactam against adeB such as efflux pump was evaluated by Minimum Inhibitory Concentration (MIC) determination of amikacin alone and in combination with tazobactam. Fractional Inhibitory Concentration index (FIC) was used to determine the efficacy of tazobactam/ amikacin combination. Further, semi-quantitative Real- Time PCR was performed to quantify the expression rates of the adeB gene before and after addition of tazobactam/amikacin. RESULTS: The MIC values were significantly reduced when a combined amikacin and tazobactam was utilized. The most common interaction observed was synergistic (78.2%), followed by.additive effects (21.8%), as per FIC results. The adeB mRNA expression levels were found to be downregulated in 60.7% of isolates treated with tazobactam. CONCLUSION: Tazobactam can have impact on resistance to aminoglycoside by inhibiting efflux pump. Thus, the combination of tazobactam with amikacin can be used as an alternative treatment approach in multidrug resistant A. baumannii infections.


Assuntos
Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Amicacina/farmacologia , Antibacterianos/farmacologia , Queimaduras/microbiologia , Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Tazobactam/farmacologia , Infecções por Acinetobacter/tratamento farmacológico , Acinetobacter baumannii/genética , Acinetobacter baumannii/isolamento & purificação , Queimaduras/tratamento farmacológico , Farmacorresistência Bacteriana Múltipla/genética , Sinergismo Farmacológico , Genes Bacterianos , Humanos , Irã (Geográfico) , Testes de Sensibilidade Microbiana
10.
J Ethnopharmacol ; 252: 112570, 2020 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31945402

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Lime Salve (L.S) has been well documented from the 9th to the 19th century AD by traditional Iranian medicine (TIM) as an effective remedy for burn healing. AIM OF THE STUDY: The present study was undertaken to evaluate the healing effect and related underlying mechanisms of Lime Salve in a model of deep second-degree thermal burn in male Wistar rats. MATERIALS AND METHOD: L.S was made up of a combination of refined calcium hydroxide powder, beeswax and sesame oil and its quality control was assessed. A deep second-degree burn was created by a hot plate in 48 male Wistar rats. Afterwards, they were randomly divided into four groups including normal saline (C group), L.S (T group), basement of formulation composed of beeswax and sesame oil (B group) and silver sulfadiazine (S group). On days 5, 10, 17 and 24, the wounds were digitally photographed by a camera and after sacrifice of the rats, skin samples were obtained for performing qRT-PCR, immunohistochemistry staining and histological examination. RESULTS: L.S prominently augmented the wound closure rate, neovascularization on day 10 and collagen formation on days 17 and 24 in comparison with the C group. Furthermore, the Salve-exposed specimens showed a significant higher epithelialization during the experiment with a peak on day 24. qRT-PCR also showed that on day 10, VEGF and TGF-ß1 genes were significantly higher in the T group as compared with the C group. Also, MMP-9 and MMP-2 genes had a significant peak of expression on day 17 and rapid reduction of expression on day 24. Expression levels of IL-6 and TNF-α genes peaked on day 10 in the T group, followed by a progressive reduction until the end of the examination. CONCLUSION: L.S could effectively accelerate the healing process of deep second-degree burn wounds and therefore, it may be recommended as a promising topical medication for treating burn wounds in the future clinical trials.


Assuntos
Queimaduras/tratamento farmacológico , Hidróxido de Cálcio/uso terapêutico , Óleo de Gergelim/uso terapêutico , Ceras/uso terapêutico , Animais , Irã (Geográfico) , Masculino , Medicina Tradicional , Ratos Wistar , Pele/efeitos dos fármacos , Pele/patologia , Cicatrização/efeitos dos fármacos
11.
Sci Rep ; 10(1): 1032, 2020 01 23.
Artigo em Inglês | MEDLINE | ID: mdl-31974417

RESUMO

We analyzed the potential antibacterial effects of two different PdB against methicillin-resistant S. aureus and P. aeruginosa. The third-degree burn wound healing effects of PdB was also studied. Blood samples were obtained from 10 healthy volunteers and biological assays of the PdB were performed and the antimicrobial activity against MRSA and P. aeruginosa was determined using disk diffusion (DD), broth microdilution (BMD), and time-kill assay methods. 48 Wistar albino rats were burned and infected with MRSA. Two groups were injected PdB, the control groups were treated with plasma and received no treatment respectively. In the next step, the rats were euthanized and skin biopsies were collected and histopathologic changes were examined. The results of DD and BMD showed that both PdB performed very well on MRSA, whereas P. aeruginosa was only inhibited by F-PdB and was less susceptible than MRSA to PdBs. The time-kill assay also showed that F-PdB has an antibacterial effect at 4 hours for two strains. Histopathological studies showed that the treated groups had less inflammatory cells and necrotic tissues. Our data suggest that PdB may possess a clinical utility as a novel topical antimicrobial and wound healing agent for infected burn wounds.


Assuntos
Antibacterianos/uso terapêutico , Plaquetas/química , Extratos Celulares/uso terapêutico , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/tratamento farmacológico , Animais , Materiais Biocompatíveis/uso terapêutico , Queimaduras/tratamento farmacológico , Queimaduras/microbiologia , Testes de Sensibilidade a Antimicrobianos por Disco-Difusão , Humanos , Masculino , Staphylococcus aureus Resistente à Meticilina/efeitos dos fármacos , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/efeitos dos fármacos , Ratos , Ratos Wistar , Infecções Estafilocócicas/tratamento farmacológico
12.
Int J Pharm ; 578: 119075, 2020 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-31991187

RESUMO

Hydrogels formed through reversible supramolecular interactions may attain self-healing in the in situ environment. However, the low grafting degree of functional groups and steric hindrance effect of polymer backbones significantly reduced the self-healing efficacy and kinetics. To overcome these deficiencies, we designed a novel hydrogel via non-covalent host-guest interaction between ß-cyclodextrin modified hyaluronic acid (HA-CD) and adamantane modified 4-arm-PEG (4-arm-PEG-Ad). The multi-armed monomer enabled to increase the number of functional groups and avoid steric hindrance effects, offering more efficient host-guest interaction. The insoluble dexamethasone could be loaded in the ß-CDs' hydrophobic cavities. The designed hydrogels exhibited excellent self-healing properties. The mechanical strengths, swelling rate and release of dexamethasone could be adjusted by adding 4-arm-PEG-Ad. The novel hydrogels significantly improved the therapeutic effect of the dexamethasone in burn wound healing. Herein, these hydrogels had great potential for direct, convenient, and efficient delivery of hydrophobic drugs and improved their therapeutic effects.


Assuntos
Adamantano , Sistemas de Liberação de Medicamentos , Ácido Hialurônico , Hidrogéis , Polietilenoglicóis , beta-Ciclodextrinas , Células 3T3 , Adamantano/administração & dosagem , Adamantano/química , Animais , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/química , Queimaduras/tratamento farmacológico , Sobrevivência Celular/efeitos dos fármacos , Reagentes para Ligações Cruzadas/administração & dosagem , Reagentes para Ligações Cruzadas/química , Dexametasona/administração & dosagem , Dexametasona/química , Liberação Controlada de Fármacos , Ácido Hialurônico/administração & dosagem , Ácido Hialurônico/química , Hidrogéis/administração & dosagem , Hidrogéis/química , Interações Hidrofóbicas e Hidrofílicas , Camundongos , Polietilenoglicóis/administração & dosagem , Polietilenoglicóis/química , Ratos Sprague-Dawley , Cicatrização/efeitos dos fármacos , beta-Ciclodextrinas/administração & dosagem , beta-Ciclodextrinas/química
13.
Int J Med Sci ; 17(1): 33-44, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31929736

RESUMO

Background: Burn injury induces long-term skeletal muscle pathology. We hypothesized EPO could attenuate burn-induced muscle fiber atrophy. Methods: Rats were allocated into four groups: a sham burn group, an untreated burn group subjected to third degree hind paw burn, and two burn groups treated with weekly or daily EPO for four weeks. Gastrocnemius muscle was analyzed at four weeks post-burn. Results: EPO attenuated the reduction of mean myofiber cross-sectional area post-burn and the level of the protective effect was no significant difference between two EPO-treated groups (p=0.784). Furthermore, EPO decreased the expression of atrophy-related ubiquitin ligase, atrogin-1, which was up-regulated in response to burn. Compared to untreated burn rats, those receiving weekly or daily EPO groups had less cell apoptosis by TUNEL assay. EPO decreased the expression of cleaved caspase 3 (key factor in the caspase-dependent pathway) and apoptosis-inducing factor (implicated in the caspase-independent pathway) after burn. Furthermore, EPO alleviated connective tissue overproduction following burn via transforming growth factor beta 1-Smad2/3 pathway. Daily EPO group caused significant erythrocytosis compared with untreated burn group but not weekly EPO group. Conclusion: EPO therapy attenuated skeletal muscle apoptosis and fibrosis at four weeks post-burn. Weekly EPO may be a safe and effective option in muscle wasting post-burn.


Assuntos
Queimaduras/tratamento farmacológico , Eritropoetina/farmacologia , Debilidade Muscular/tratamento farmacológico , Atrofia Muscular/tratamento farmacológico , Animais , Apoptose/efeitos dos fármacos , Queimaduras/genética , Queimaduras/metabolismo , Queimaduras/patologia , Caspase 3/genética , Tecido Conjuntivo/crescimento & desenvolvimento , Tecido Conjuntivo/metabolismo , Modelos Animais de Doenças , Eritropoetina/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Humanos , Proteínas Musculares/genética , Debilidade Muscular/genética , Debilidade Muscular/metabolismo , Debilidade Muscular/patologia , Músculo Esquelético/crescimento & desenvolvimento , Músculo Esquelético/metabolismo , Músculo Esquelético/patologia , Atrofia Muscular/genética , Atrofia Muscular/metabolismo , Atrofia Muscular/patologia , Ratos , Proteínas Ligases SKP Culina F-Box/genética , Transdução de Sinais/efeitos dos fármacos , Proteína Smad2/genética , Fator de Crescimento Transformador beta1/genética
14.
Int J Mol Sci ; 21(2)2020 Jan 08.
Artigo em Inglês | MEDLINE | ID: mdl-31936277

RESUMO

Burn wounds are highly debilitating injuries, with significant morbidity and mortality rates worldwide. In association with the damage of the skin integrity, the risk of infection is increased, posing an obstacle to healing and potentially leading to sepsis. Another limitation against healing is associated with antibiotic resistance mainly due to the use of systemic antibiotics for the treatment of localized infections. Nanotechnology has been successful in finding strategies to incorporate antibiotics in nanoparticles for the treatment of local wounds, thereby avoiding the systemic exposure to the drug. This review focuses on the most recent advances on the use of nanoparticles in wound dressing formulations and in tissue engineering for the treatment of burn wound infections.


Assuntos
Queimaduras/tratamento farmacológico , Nanopartículas/uso terapêutico , Cicatrização , Infecção dos Ferimentos/tratamento farmacológico , Antibacterianos/uso terapêutico , Bandagens , Queimaduras/microbiologia , Queimaduras/patologia , Humanos , Nanopartículas/química , Sepse/microbiologia , Sepse/prevenção & controle , Pele/efeitos dos fármacos , Pele/microbiologia , Pele/patologia , Engenharia Tecidual/métodos , Infecção dos Ferimentos/patologia
15.
Arch Microbiol ; 202(5): 995-1004, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31915886

RESUMO

Burn infections caused by Pseudomonas aeruginosa pose a major complication in wound healing. This study aimed to determine the antimicrobial effect of metal ions, graphene (Gr), and graphene oxide (GO), individually and in combination, against the planktonic and biofilm states of two antimicrobially resistant clinical strains of P. aeruginosa each with different antibiotic resistance profiles. Minimum inhibitory, minimum bactericidal, and fractional inhibitory concentrations were performed to determine the efficacy of the metal ions and graphene composites individually and their synergy in combination. Crystal violet biofilm and XTT assays measured the biofilm inhibition and metabolic activity, respectively. Molybdenum, platinum, tin, gold, and palladium ions exhibited the greatest antimicrobial activity (MIC = 7.8-26.0 mg/L), whilst GO and Gr demonstrated moderate-to-no effect against the planktonic bacterial cells, irrespective of their antibiograms. Biofilms were inhibited by zinc, palladium, silver, and graphene. In combination, silver-graphene and molybdenum-graphene inhibited both the planktonic and biofilm forms of the bacteria making them potential candidates for development into topical antimicrobials for burns patients infected with antibiotic-resistant P. aeruginosa.


Assuntos
Antibacterianos/farmacologia , Queimaduras/microbiologia , Grafite/farmacologia , Metais Pesados/farmacologia , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/efeitos dos fármacos , Biofilmes/crescimento & desenvolvimento , Queimaduras/tratamento farmacológico , Humanos , Testes de Sensibilidade Microbiana , Plâncton/efeitos dos fármacos , Infecções por Pseudomonas/microbiologia , Prata/farmacologia
16.
Biomater Sci ; 8(6): 1622-1637, 2020 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-31967622

RESUMO

The existence of diabetes and microbial infection in burn wounds makes the healing process more complex. Herein, we synthesize a collagen based hybrid scaffold incorporated with a silica-resorcinol composite and cross-linked with an oxidized fenugreek seed polysaccharide to stimulate scar-less healing in chronic wounds with type-I diabetes and microbial infection. The spectroscopic analyses of the hybrid scaffolds reveal the chemical and structural integrity of collagen. The hybrid scaffolds are shown to be appropriate for in vivo tissue regeneration through cytocompatibility and hemocompatibility studies. Scaffolds were applied to diabetic albino rats induced with chronically infected burn wounds with respective controls. Histological and immunohistochemical analyses of the granulation tissue collected from the hybrid scaffold treated animal groups showed improved angiogenesis, reepithelialization and TGF-ß3 expression, which eventually led to scar-less wound healing. The results confirm that the prepared hybrid collagen scaffold could be used for effective scar-less wound healing in chronic burn wounds.


Assuntos
Infecções Bacterianas/tratamento farmacológico , Queimaduras/tratamento farmacológico , Diabetes Mellitus Experimental/tratamento farmacológico , Diabetes Mellitus Tipo 1/tratamento farmacológico , Mananas/administração & dosagem , Trigonella/química , Animais , Queimaduras/etiologia , Queimaduras/microbiologia , Colágeno/química , Diabetes Mellitus Experimental/induzido quimicamente , Diabetes Mellitus Experimental/complicações , Diabetes Mellitus Tipo 1/induzido quimicamente , Diabetes Mellitus Tipo 1/complicações , Masculino , Mananas/química , Mananas/farmacologia , Microesferas , Extratos Vegetais/química , Ratos , Resorcinóis/química , Dióxido de Silício/química , Estreptozocina , Resultado do Tratamento
17.
s.l; RedARETS; ene. 2020.
Não convencional em Espanhol | LILACS, BRISA/RedTESA | ID: biblio-1095210

RESUMO

INTRODUCCIÓN: Se puede formar tejido cicatricial después de una cirugía, trauma o diversas afecciones inflamatorias. Las cicatrices pueden crear muchas funciones adversas, efectos cosméticos y estructurales, y a veces efectos psicológicos, eso puede afectar la vida diaria de los pacientes (Kerwin et al., 2014). El mecanismo de reparación de cicatrices a nivel molecular no es bien comprendido (Gladstone et al., 2010). BÚSQUEDA: Ensayos randomizados controlados o ensayos no randomizados, meta-análisis y evaluaciones de tecnologías que evalúen el uso de toxina botulínica en el tratamiento de las heridas y/o cicatrices cutáneas. MÉTODOS: De las 3 revisiones sistemáticas con metaanálisis encontradas se seleccionaron dos con alto nivel de confianza de acuerdo con la herramienta AMSTAR-2 que evaluaron Toxina botulínica A frente a placebo. Se evaluó el sesgo de los estudios incluidos y se realizaron perfiles de evidencia utilizando la metodología GRADE con el programa GRADE-PRO GDT teniendo en cuenta los desenlaces seleccionados como criticos o importantes. RESULTADOS: a. Evaluado en postquirúrgico de cirugía reciente, sobre piel previamente sana. b. Heterogeneidad entre estudios I2 27% y p 0,10. c. Evaluado en cocatriz hipertrófica o queloide.


Assuntos
Humanos , Ferimentos e Lesões/tratamento farmacológico , Queimaduras/tratamento farmacológico , Toxinas Botulínicas Tipo A/uso terapêutico , Avaliação da Tecnologia Biomédica , Análise Custo-Benefício
18.
Infect Disord Drug Targets ; 20(1): 49-55, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30727922

RESUMO

INTRODUCTION: Plasmid-induced quinolone resistance has raised a great concern in the treatment of serious infections worldwide. The aims of this study were to determine the antibiotic susceptibility, the frequency of qepA, aac(6')-Ib and qnr genes by PCR and sequencing, and typing of the resistant isolates using repetitive extragenic palindromic sequence-based PCR (REPPCR) in Pseudomonas aeruginosa isolated from burn wound infections. METHODS: In the current cross-sectional study, 149 P. aeruginosa were isolated from the burn wound samples of patients admitted to Motahari hospital in Tehran, Iran, from February to December 2016. The bacterial isolates were identified using standard laboratory methods and their antibiotic susceptibility to quinolones was evaluated using the standard Kirby-Bauer method, according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. The presence of aac(6')-Ib, qepA, qnrA, qnrB4, qnrB and qnrS genes was assessed using PCR and sequencing methods and clonal relationship of the resistant isolates was evaluated using REP-PCR method. RESULTS: All (100%) isolates showed complete resistance to used quinolone compounds in this study. The qnr and qepA genes were not found, but all (100%) isolates were positive for the presence of aac(6')-Ib gene and the sequencing revealed that all (100%) belong to the aac(6')-Ib-cr variant. REP-PCR showed that the studied isolates belonged to three distinct clones of A (77.9%), B (18.1%), and C (4%). CONCLUSION: The findings of the present study indicated the presence of aac(6')-Ib-cr variant and lack of the contribution of qnr and qepA in the emergence of resistance to quinolones in P. aeruginosa isolated from burn patients. Considering the importance of clonal spread of these resistant isolates and their significant role in the development of clinical infections, especially in patients with burns, more attention should be paid to the prevention of the dissemination of these resistant isolates.


Assuntos
Queimaduras/microbiologia , Farmacorresistência Bacteriana , Plasmídeos/genética , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação , Quinolonas/farmacologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas de Bactérias/genética , Queimaduras/tratamento farmacológico , Estudos Transversais , Feminino , Humanos , Irã (Geográfico) , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/genética , Quinolonas/uso terapêutico , Análise de Sequência de DNA , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia , Adulto Jovem
19.
Biol Trace Elem Res ; 193(2): 456-465, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31111309

RESUMO

Healing of injuries caused by exposure to heat has been discussed in many studies, although a few drugs have been shown to produce satisfactory results. In this study, 100 healthy mice randomly allocated into four categories (each = 25 mice) were analyzed. A deep second-degree burn on the back of each mouse was created. The burns were dressed daily with either AgNPs or silver sulfadiazine over 28 days of treatment. Safety evaluation of the AgNP treatment was performed by measuring the deposition rate of silver in the liver, brain, and kidney of treated mice. In the murine burn model, the speed of wound healing and the antibacterial effect of AgNPs were better than those in the silver sulfadiazine group. Burn wounds treated with SSD appeared to display a greater degree of inflammation as notable by the three clinical signs of the inflammatory process such as redness and swelling which appeared to be less after wounds treated with AgNPs. Also, AgNP treatment modified leukocytic infiltration and reduced collagen degeneration in treated mice and enhanced healing processes that were confirmed by morphological and histological investigations. Beside the potential significant effects of AgNPs on reduction of some microorganism counts that routinely isolated from burn wounds included aerobic organisms as Staphylococcus aureus and Escherichia coli when compared to both SSD and control groups. The deposition kinetics of AgNPs revealed lower distribution in the liver, brain, and kidney than that in silver sulfadiazine-treated mice with respect to both SSD and control groups.


Assuntos
Queimaduras/tratamento farmacológico , Nanopartículas Metálicas/uso terapêutico , Prata/farmacologia , Pele/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Animais , Encéfalo/metabolismo , Queimaduras/microbiologia , Modelos Animais de Doenças , Escherichia coli/efeitos dos fármacos , Rim/metabolismo , Fígado/metabolismo , Nanopartículas Metálicas/química , Camundongos , Prata/química , Prata/farmacocinética , Sulfadiazina de Prata/farmacocinética , Sulfadiazina de Prata/farmacologia , Pele/metabolismo , Pele/microbiologia , Staphylococcus aureus/efeitos dos fármacos , Distribuição Tecidual
20.
Int J Biol Macromol ; 144: 781-790, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31678100

RESUMO

The present study investigates the purification, structure and in vitro antioxidant activities of a novel water soluble polysaccharide (LWSP) extracted from Linum usitatissimum L. seeds and evaluates the in vivo wound healing performance on CO2 laser fractional burn in a rat model. LWSP is a heteropolysaccharide that consists of glucose, mannose, xylose and arabinose. Three different tests were used to evaluate the antioxidant activity of this carbohydrate. The scavenging activity against 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid (ABTS) radical at a concentration of 5 mg/ml was 99.77%. The total antioxidant capacity of LWSP at 12 mg/ml was equivalent to 166.61 µg acsorbic acid. LWSP displayed a high protection effect against DNA damage induced byhydroxyl radical. No hemolytic activity was observed towards human erythrocytes. LWSP was tested in functional properties. The results showed good emulsion properties and high water (WHC) and oil holding (OHC) capacities (11.23 and 1.05%, respectively). In addition, the application of LWSP on the burn wound site in rat model increased significantly the percentage of burn contraction (98.6%) after 8 days of injury. According to the histological assessment, the LWSP-treated group had a higher content of hydroxyproline (846. 67 ±â€¯92.28 mg/g tissue) than the other groups. Overall, the findings demonstrate that the application of this novel LWSP may open promising opportunities for burn wound healing in modern medicine.


Assuntos
Antioxidantes/química , Queimaduras/tratamento farmacológico , Linho/química , Extratos Vegetais/química , Polissacarídeos/química , Sementes/química , Cicatrização/efeitos dos fármacos , Animais , Antioxidantes/farmacologia , Benzotiazóis/química , Linhagem Celular , Emulsões/química , Eritrócitos/citologia , Depuradores de Radicais Livres/metabolismo , Humanos , Interações Hidrofóbicas e Hidrofílicas , Hidroxiprolina/metabolismo , Lasers , Masculino , Extratos Vegetais/farmacologia , Polissacarídeos/farmacologia , Ratos Wistar , Ácidos Sulfônicos/química
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA