Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 628
Filtrar
1.
Neurourol Urodyn ; 40(1): 502-508, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33410544

RESUMO

AIMS: Bulking agents are a minimally invasive treatment option for women with stress urinary incontinence (SUI) or stress-predominant mixed urinary incontinence (MUI). The aim of this study was to evaluate long-term efficacy and safety following treatment with Bulkamid as a primary procedure for SUI or stress-predominant MUI. METHODS: This was an Institutional Review Board-approved single-center retrospective study of female patients with SUI or stress-predominant MUI who had undergone injection with Bulkamid since 2005 and had completed 7 years of follow up. The primary endpoint was patient satisfaction measured on a four-point scale as cured, improved, unchanged, or worse. Secondary outcomes included the number of incontinence pads used, International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF) scores, Visual Analog Scale Quality of Life (VAS QoL), reinjection rates, and perioperative and postoperative complications. RESULTS: A total of 1,200 patients were treated with Bulkamid since 2005 and of these, 388 (32.3%) had completed 7 years of follow-up. A total of 67.1% of the patients reported feeling cured or improved if Bulkamid was a primary procedure, 11.1% reported no change, and 2.3% reported worsening of incontinence. A total of 19.5% of patients received a subsequent other incontinence procedure. The ICIQ-UI SF was reduced by 8.6 points. VAS QoL improved by a mean of 4.3 points. Postoperative complications were transient. Prolonged bladder emptying time was reported in 15.3% of patients and urinary tract infection in 3.5%. CONCLUSIONS: Bulkamid injections are an effective and safe first-line treatment option for women with SUI or stress-predominant MUI providing durable outcomes at 7 years.


Assuntos
Resinas Acrílicas/uso terapêutico , Materiais Biocompatíveis/uso terapêutico , Hidrogéis/uso terapêutico , Incontinência Urinária por Estresse/tratamento farmacológico , Resinas Acrílicas/farmacologia , Idoso , Materiais Biocompatíveis/farmacologia , Feminino , Humanos , Hidrogéis/farmacologia , Masculino , Resultado do Tratamento
2.
Radiology ; 298(2): 458-465, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33350893

RESUMO

Background Data are limited regarding comparison between nonspherical polyvinyl alcohol (PVA) particles and tris-acryl gelatin microspheres (TAGM) in uterine artery embolization (UAE). Purpose To compare pain after UAE with PVA versus TAGM for treatment of symptomatic fibroids. Materials and Methods In this randomized clinical trial, participants were assigned to be administered nonspherical PVA (355-550 µm) or TAGM (500-700 µm). Both groups were administered fentanyl-based intravenous patient-controlled analgesia during the first 24 hours after UAE and rescue analgesics. Neutrophil-to-lymphocyte ratio was measured to assess inflammatory response. Contrast-enhanced MRI 1 day after UAE was used to evaluate dominant fibroid necrosis and ischemia of normal myometrium. Symptom severity score and health-related quality-of-life score were assessed before and 3 months after UAE. Variables measured over time were analyzed by using the generalized estimating equation method. Results A total of 54 participants (mean age, 44 years ± 4 [standard deviation]) were evaluated (27 participants in each group). Although pain scores and fentanyl dose were not different during the first 24 hours, use of rescue analgesics was higher in the PVA group (33% vs 11%; P = .049). After embolization, symptom severity score and health-related quality-of-life score were not different between groups (symptom severity score: 16 [interquartile range, 6-22] for PVA vs 19 [interquartile range, 9-34] for TAGM, P = .45; health-related quality-of-life score: 93 [interquartile range, 80-97] for PVA vs 89 [interquartile range, 84-96] for TAGM, P = .41). Changes in neutrophil-to-lymphocyte ratio from before to 24 hours after UAE were greater in the PVA group (3.9 [interquartile range, 2.7-6.8] for PVA and 2.5 [interquartile range, 1.5-4.6] for TAGM; P = .02). Rates of complete dominant fibroid necrosis were not different between groups, but transient global uterine ischemia of normal myometrium was more frequent in the PVA group (44% vs 15%; P = .04). Conclusion When used in uterine artery embolization, polyvinyl alcohol particles and tris-acryl gelatin microspheres resulted in similar pain scores and fentanyl dose. Polyvinyl alcohol resulted in a greater inflammatory response, higher rates of rescue analgesic use, and more frequent transient global uterine ischemia. © RSNA, 2020 See also the editorial by Spies and Frenk in this issue.


Assuntos
Resinas Acrílicas/uso terapêutico , Gelatina/uso terapêutico , Leiomioma/terapia , Dor/prevenção & controle , Álcool de Polivinil/uso terapêutico , Embolização da Artéria Uterina/métodos , Adulto , Método Duplo-Cego , Feminino , Humanos , Resultado do Tratamento
3.
Medicine (Baltimore) ; 99(22): e20386, 2020 May 29.
Artigo em Inglês | MEDLINE | ID: mdl-32481425

RESUMO

Use of polyacrylate-polyalcohol copolymer (PPC) after endoscopic correction (EC) of vesico-ureteral reflux (VUR) is highly effective but is associated with a higher risk of obstructive complications (OC) compared with other implants. We undertook a STROBE compliant retrospective investigation and studied the OC risk factors to increase the practical safety of PPC.Overall, 798 patients (464 [58.1%] girls and 334 [41.9%]) boys) from 5 hospitals in whom PPC was routinely used were evaluated retrospectively. The patients were subdivided into 2 groups. Group I consisted of 754 (94.5%) children (449 [59.5%] girls and 305 [40.5%] boys) without OC. Median age was 41 months [Q1: 18.0; Q3: 81.0]. Group II comprised 44 (5.5%) patients (29 [65.9%] boys and 15 [34.1%] girls) experiencing OC, and their median age was 21.5 months [Q1: 12.0; Q3: 43.0]. Clinical and renal ultrasound examinations were carried out 1 day and 1 month after EC, and then every 6 months after EC. At the follow-up examination approximately 6 months after EC, voiding cysto-urethrography (VCUG) was performed. All patients with OC underwent diuretic renography.OC occurred in 44 (5.5%) of 798 children, in some cases as late as 60 months after endoscopic injection of the bulking agent PPC for correction of VUR. Univariate analysis revealed that younger age (P < .001), higher grade of VUR (P < .001), male gender (P < .001), second injection (P = .003), and EC injection using hydrodistension implantation technique (HIT; P < .001) represented significant risk factors. At multivariate analysis, only male gender (P = .0078), younger age (P = .0044), HIT technique (P < .0001), and second injection (P = .04) represented significant risk factors for the occurrence of OC.We identified young age, male gender, high reflux grade, HIT technique, and second endoscopic injections as factors associated with the risk of OC after EC of VUR using PPC as a bulking agent. Thus, patients who have undergone EC with PPC must be monitored sonographically for occurrence of OC for at least 60 months after the intervention.


Assuntos
Resinas Acrílicas/uso terapêutico , Polímeros/uso terapêutico , Obstrução Ureteral/etiologia , Ureteroscopia/métodos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de Risco , Ureteroscopia/efeitos adversos , Refluxo Vesicoureteral
4.
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
5.
Acta Radiol ; 61(9): 1287-1296, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31955609

RESUMO

BACKGROUND: Uterine fibroid embolization (UFE) is an effective treatment for uterine leiomyomata. Optimizing the choice of embolic agents is imperative to achieve better patient outcomes with maximum resource utilization. PURPOSE: To evaluate the efficacy and cost-effectiveness of trisacryl gelatin microspheres (TAGM) versus combined TAGM and gelatin sponge (GS) embolization in the treatment of symptomatic uterine leiomyomata. MATERIAL AND METHODS: Between July 2007 and December 2010, 106 consecutive patients underwent UFE with TAGM. Between January 2011 and December 2016, 123 consecutive patients underwent UFE with a combination of TAGM/GS. The primary outcomes were successful infarction rate (≥90% infarction) of the dominant leiomyoma and percentage reduction in uterine and dominant leiomyoma volume on MRI at six months. Secondary outcomes included adverse event rates, pain scores, and change in clinical symptoms at six months. The embolic agents utilized per procedure were recorded and a cost-effectiveness analysis was performed. RESULTS: Baseline characteristics of both groups were similar. Successful infarction was achieved in 93.2% of the TAGM group and 94.6% of the TAGM/GS group (P = 0.52). Reduction in uterine volume (TAGM 40.7%, TAGM/GS 44.4%, P = 0.16) and dominant leiomyoma volume (TAGM 47.6%, TAGM/GS 50.1%, P = 0.29) at six months was similar. No significant difference was observed in symptom improvement at six months (P = 0.8). The mean number of TAGM vials utilized and cost per procedure was 6.3 and $1688.40 for TAGM embolization and 3.6 and $979.50 for TAGM/GS embolization, respectively. CONCLUSION: Primary and secondary outcomes were comparable when performing UFE with TAGM versus combined TAGM/GS. The combined use of TAGM/GS reduced the mean cost of embolic agents by 42%.


Assuntos
Resinas Acrílicas/uso terapêutico , Gelatina/uso terapêutico , Leiomioma/terapia , Embolização da Artéria Uterina/métodos , Neoplasias Uterinas/terapia , Adulto , Meios de Contraste , Análise Custo-Benefício , Feminino , Humanos , Leiomioma/diagnóstico por imagem , Imageamento por Ressonância Magnética , Meglumina/análogos & derivados , Compostos Organometálicos , Medição da Dor , Estudos Retrospectivos , Neoplasias Uterinas/diagnóstico por imagem
6.
Int J Artif Organs ; 43(5): 343-347, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31739725

RESUMO

PURPOSE: Patients with maxillofacial deformities always seek for aesthetic prosthesis. Recently, three-dimensional printing technologies have been used for dental treatments on such patients. CASE REPORT: A 24-year-old man reported to the Department of Prosthodontics for replacement of his missing right ear induced by a trauma. A magnet-retained auricular prosthesis was planned for the patient. Three-dimensional scanning was performed on the healthy side by using a three-dimensional optical scanner and the data were mirrored. The mirrored image was then imported to a software and a virtual model of the future prosthesis was obtained for the defect side. A three-dimensional printer was used to fabricate a negative mold for the mirrored image by using additive manufacturing. Initially, an impression of the defect side was made; then, the cast model was obtained in a dental flask. Magnets of the prosthesis were inserted to the acrylic resin framework on the cast model. Room temperature vulcanized silicone elastomer was mixed and poured into the three-dimensionally fabricated mold. Then, the flask was placed over the negative mold firmly. After polymerization of the silicone, the auricular prosthesis was delivered to the patient and the patient was instructed to clean the prosthesis daily. CONCLUSIONS: Three-dimensional printing technology was used for the fabrication of the patient's missing ear. This method eliminated the conventional laboratory steps and reduced the number of stages of the fabrication of a silicone prosthesis. The negative mold of the defect side allowed us a direct fabrication of the silicone prosthesis without a need for waxing or flasking procedures.


Assuntos
Amputação Traumática/cirurgia , Orelha Externa/lesões , Prótese Maxilofacial , Impressão Tridimensional , Implantação de Prótese/métodos , Resinas Acrílicas/uso terapêutico , Materiais Biocompatíveis/uso terapêutico , Desenho Assistido por Computador , Humanos , Masculino , Desenho de Prótese , Elastômeros de Silicone/uso terapêutico , Resultado do Tratamento , Adulto Jovem
7.
J Pediatr Urol ; 15(5): 484-490, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31591047

RESUMO

OBJECTIVE: The objective of this study was to review the literature to compare the efficacy and complications of polyacrylate-polyalcohol copolymer (PPC) and polyacrylamide hydrogel (PAHG) with the current standard of care, dextranomer/hyaluronic acid (Dx/HA), when used to treat VUR in the paediatric population. METHODS: PubMed, Embase and Cochrane databases were searched. Keywords included Vesicoureteral reflux (VUR), endoscopic; endoscopic injection, endoscopic treatment, dulking material, dextranomer/hyaluronic acid copolymer, polyacrylate-polyalcohol copolymer, Deflux, Dexell, Vantris, Bulkamid, outcome, treatment and children. Prospective or retrospective studies comparing PAHG/PPC directly with Dx/HA were included for review. RESULTS: Four studies were identified comparing PPC with Dx/HA. All studies showed superior efficacy (on micturating cystourethrogram (MCUG) at 3 months) of PPC over Dx/HA. However, 1 study identified a significantly higher rate of vesicoureteric junction obstruction (VUJO) in the PPC group. One study was identified comparing PAHG with Dx/HA which showed similar efficacy on 3-month MCUG. CONCLUSIONS: Current data suggest PPC confers a higher resolution rate of VUR and PAHG confers comparable resolution rates for VUR compared with Dx/HA in the paediatric population. However, the incidence of late-onset VUJO in one study is concerning, and high-quality randomised controlled trials with long-term follow-up are needed before making further recommendations.


Assuntos
Resinas Acrílicas/uso terapêutico , Dextranos/uso terapêutico , Ácido Hialurônico/uso terapêutico , Hidrogéis/uso terapêutico , Refluxo Vesicoureteral/terapia , Criança , Humanos
9.
Clin Exp Dent Res ; 5(4): 413-419, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31452952

RESUMO

Increased concerns about the safety of amalgam restorations in children have resulted in many dental schools emphasizing the teaching of alternative dental materials. This study investigated the current teaching of different dental materials for use in posterior teeth in the United States predoctoral pediatric dentistry programs. In 2011, the authors invited the chairs of the predoctoral pediatric dentistry departments in all accredited dental schools at that time (N = 57) to participate in an internet-based survey. Descriptive statistics were calculated to describe the frequency of using different restorative materials. Regression models were developed to explore the factors related to the use of dental restorations in predoctoral pediatric clinics. Among the 44 dental schools that responded (77% response rate), 74% used amalgam, and 93% used composite in primary posterior teeth. Glass ionomer was used by 61% of the schools in primary posterior teeth. Placing amalgam in primary posterior teeth was associated with programs that treated more 3-5-year-old patients (ß = .302, p < .043), whereas the use of glass ionomer was associated with having students serving at off-site satellite dental clinics (ß = .015, p < .012). In general, having departments with chairs who had positive attitudes towards Minimal Invasive Dentistry (MID) used composite (ß = .091, p < .0001) and glass ionomer (ß = 103, p < .0001) more frequently and were less likely to use amalgam (ß = -.077, p < .005) in primary posterior teeth. Although teaching MID concepts in predoctoral pediatric clinics in dental schools is increasing, the use of amalgam in posterior primary and permanent teeth is still widely practiced.


Assuntos
Amálgama Dentário/uso terapêutico , Dentística Operatória/tendências , Educação em Odontologia/tendências , Odontopediatria/tendências , Resinas Acrílicas/uso terapêutico , Adolescente , Criança , Pré-Escolar , Resinas Compostas/uso terapêutico , Clínicas Odontológicas/estatística & dados numéricos , Clínicas Odontológicas/tendências , Dentística Operatória/educação , Dentística Operatória/métodos , Dentística Operatória/estatística & dados numéricos , Educação em Odontologia/estatística & dados numéricos , Humanos , Odontopediatria/educação , Odontopediatria/métodos , Odontopediatria/estatística & dados numéricos , Faculdades de Odontologia/estatística & dados numéricos , Faculdades de Odontologia/tendências , Dióxido de Silício/uso terapêutico , Dente Decíduo , Estados Unidos
10.
J Dent ; 88: 103163, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31276747

RESUMO

OBJECTIVES: Although there is some consensus that carious lesions in early stages (non-cavitated) could be treated using sealants, neither the type of materials nor their use in lesions with localized enamel breakdown (microcavitated) has been reported To compare the efficacy of resin or glass ionomer (GI) sealants in arresting microcavitated carious lesions (ICDAS 3) in first permanent molars. MATERIALS AND METHODS: A double-blinded randomized controlled clinical trial was conducted in 41 healthy 6 to 11-year-old children. At the baseline examination, each subject had at least one carious lesion classified as ICDAS 3 on the first permanent molar. One hundred fifty-one lesions were randomized into: Group 1: resin sealants (76 lesions) and Group 2: GI sealant (75 lesions). Carious lesion progression was assessed clinically and radiographically. Progression and retention failure were the outcomes used for group comparisons at p-value<0.05. RESULTS: After a two-year follow-up, only one lesion progressed to ICDAS 5, without statistically significant differences between the groups (χ2(1) = 0.90, p = 0.53). Radiographically, 100 lesions (98%) were arrested and 2 (2%) showed radiographic progression, without differences between groups (χ2(1) = 0.93, p = 0.93). At 2 years, complete retention was observed in 77% of the resin-based and in 83% of the GI sealants, without statistical differences between type of sealant (χ2(1) = 0.71, p = 0.48). The multilevel mixed model demonstrated that location and type of sealant did not affect retention rates (χ2(1) = 24,98, p < 0.001). CONCLUSION: Sealing ICDAS 3 carious lesions in permanent molars appears to be effective in arresting lesions after a two-year follow-up. Clinicaltrials.gov: RCTICDAS3/2015. CLINICAL SIGNIFICANCE: Minimally invasive approaches for carious lesion management have been promoted. Using sealants for the treatment of microcavitated lesions (ICDAS 3) appears predictable in the routine practice, without predilection for resin or glass ionomer materials. In addition to preserving tooth structure, this strategy reduces chair-time, dental fear and costs, and increases coverage to dental care.


Assuntos
Resinas Acrílicas/uso terapêutico , Cárie Dentária/prevenção & controle , Cimentos de Ionômeros de Vidro/uso terapêutico , Selantes de Fossas e Fissuras/uso terapêutico , Resinas Acrílicas/química , Criança , Resinas Compostas/química , Resinas Compostas/uso terapêutico , Método Duplo-Cego , Cimentos de Ionômeros de Vidro/química , Humanos , Dente Molar/patologia , Selantes de Fossas e Fissuras/química , Dióxido de Silício
11.
Clin Exp Dent Res ; 5(3): 276-283, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31249709

RESUMO

Unlike other oral care products, there are limited technologies in the denture adhesive category with the majority based on polymethyl vinyl ether/maleic anhydride (PVM/MA) polymer. Carbomer-based denture adhesives are less well studied, and there are few clinical studies directly comparing performance of denture adhesives based on different technologies. This single-centre, randomised, three-treatment, three-period, examiner-blind, crossover study compared a carbomer-based denture adhesive (Test adhesive) with a PVM/MA-based adhesive (Reference adhesive) and no adhesive using incisal bite force measurements (area over baseline over 12 hr; AOB0-12) in participants with a well-made and at least moderately well-fitting complete maxillary denture. Eligible participants were randomised to a treatment sequence and bit on a force transducer with increasing force until their maxillary denture dislodged. This procedure was performed prior to treatment application (baseline) and at 0.5, 1, 3, 6, 9, and 12 hr following application. Forty-four participants were included in the modified intent-to-treat population. AOB0-12 favoured both Test adhesive to No adhesive (difference: 2.12 lbs; 95% CI [1.25, 3.00]; p < 0.0001) and Reference adhesive to No adhesive (difference: 2.76 lbs; 95% CI [1.89, 3.63]; p < 0.0001). There was a numerical difference in AOB0-12 for Test versus Reference adhesive (-0.63 lbs; [-1.51, 0.25]); however, this was not statistically significant (p = 0.1555). Treatments were generally well tolerated. Both PVM/MA and carbomer-based denture adhesives demonstrated statistically significantly superior denture retention compared with no adhesive over 12 hr, with no statistically significant difference between adhesives.


Assuntos
Resinas Acrílicas/uso terapêutico , Adesivos/uso terapêutico , Força de Mordida , Carboximetilcelulose Sódica/uso terapêutico , Retenção de Dentadura/métodos , Maleatos/uso terapêutico , Polietilenos/uso terapêutico , Polímeros/uso terapêutico , Adesivos/química , Idoso , Idoso de 80 Anos ou mais , Carboximetilcelulose Sódica/química , Estudos Cross-Over , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polímeros/química , Método Simples-Cego
12.
J Equine Vet Sci ; 77: 57-62, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31133317

RESUMO

Osteoarthritis is one of the most common disease processes effecting equine athletes, causing up to 60% of all lameness. This prospective longitudinal study reports on the effect of treatment of carpal and metacarpophalangeal joint lameness with 2.5% cross-linked polyacrylamide hydrogel (PAAG). A total of 49 flat-racing Thoroughbreds at a single training facility were included in the study. The results show a significant improvement in lameness grades at weeks 1 (P < .01), 4 (P < .001), 12 (P < .001), and 24 (P < .001) when compared to baseline lameness at week 0. This pilot study suggests that 2.5% cross-linked PAAG is a safe and effective joint treatment for managing joint lameness in Thoroughbred racehorses and warrants further blinded and controlled studies to fully evaluate the efficacy of the 2.5% cross-linked PAAG and its mode of action.


Assuntos
Resinas Acrílicas/uso terapêutico , Doenças dos Cavalos/tratamento farmacológico , Coxeadura Animal/tratamento farmacológico , Animais , Cavalos , Estudos Longitudinais , Projetos Piloto , Estudos Prospectivos
13.
J Fr Ophtalmol ; 42(6): 642-654, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30929965

RESUMO

Lacrycon® is a preservative-free hypotonic artificial tear for the treatment of dry eye syndrome containing hyaluronic acid, carbomer, and glycerol. Lacrycon has been used for many years; this is the first comprehensive review of clinical efficacy and tolerability. Eight clinical studies (1992-2013) were reviewed. Comparators included phosphate-buffered saline (Phase I) and active controls (Phase II: Lacrisol™; Phase III: Gel-larmes™, Lacrisol, Hyalistil®, Vismed®, or the currently prescribed tear substitute). Administration schedules varied from 3 to 8 instillations per day for 7 to 84 days, and evaluation timepoints varied between studies. Pre-corneal retention of Lacrycon was 22% better than phosphate-buffered saline in terms of AUC (P=0.048). Patients' evaluation of efficacy was better for Lacrycon than Gel-larmes on Day 15 and 45 (P<0.05) and similar on Day 90 (P>0.05); there was no difference (P>0.05) versus Hyalistil (Day 30) or Vismed (Day 35 and 85). Functional tests were either in favor of Lacrycon (P<0.05) (fluorescein test [versus Gel-larmes/Lacrisol/Hyalistil], tear break-up time [TBUT] and rose Bengal test, Schirmer I test, and tear meniscus [versus Lacrisol]), or there was no difference between treatments (P>0.05) (fluorescein test [versus Vismed], TBUT and rose Bengal test [versus Gel-larmes], Schirmer I test [versus Gel-larmes/Lacrisol/Hyalistil/VisMed], tear meniscus [versus Lacrisol/Hyalistil], Oxford Grading Score, OSDI, van Bijsterveld score, and conjunctival hyperemia [versus Vismed]). Lacrycon was better tolerated than most comparators and had a similar safety profile to Vismed. No comparison showed favored the comparator over Lacrycon. These good efficacy, tolerability and safety data support the use of Lacrycon in dry eye syndrome.


Assuntos
Resinas Acrílicas/uso terapêutico , Síndromes do Olho Seco/tratamento farmacológico , Glicerol/uso terapêutico , Ácido Hialurônico/uso terapêutico , Lubrificantes Oftálmicos/uso terapêutico , Ensaios Clínicos como Assunto , Esquema de Medicação , Humanos , Lubrificantes Oftálmicos/efeitos adversos , Lubrificantes Oftálmicos/química
14.
Clin Exp Nephrol ; 23(6): 825-833, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30771042

RESUMO

PURPOSE: To assess the safety and effectiveness of transcatheter arterial embolization (TAE) with tris-acryl gelatin microspheres for patients with symptomatic enlarged polycystic liver disease (PCLD). MATERIALS AND METHODS: This prospective study was approved by our hospital's institutional review board and planned for patients with symptoms related to enlarged PCLD, such as distended abdomen, gastrointestinal obstruction and abdominal pain. Hemi-hepatic embolization with tris-acryl gelatin microspheres was performed in the hepatic artery supplying the hepatic lobe that showed the predominant presence of cysts. Each patient underwent an assessment of liver function, a questionnaire survey about symptoms, measurement of the estimated volume of the whole liver before and after TAE, and an assessment of complications associated with TAE. RESULTS: Five patients (four females, one male; mean age 52.6 ± 9.1 years) were treated. All five patients successfully completed TAE. The left lobe was treated in three patients and the right in two. After TAE, post-embolization syndrome and transient elevation of white blood cells, aspartate aminotransferase, and alanine aminotransferase occurred in all patients, but none developed hepatic insufficiency or severe complications. The mean whole liver volume was 7406 ± 2323 mL before TAE, and 6995 ± 2139 mL (95.1 ± 5.2% of the pre-therapeutic value) at 3 months and 6855 ± 2246 mL (93.3 ± 9.7%) at 12 months after TAE. Three of the five patients reported an improvement of clinical symptoms within 12 months after TAE. CONCLUSION: TAE with microspheres can be a safe and effective treatment for symptomatic enlarged PCLD.


Assuntos
Resinas Acrílicas/uso terapêutico , Cistos/terapia , Embolização Terapêutica/estatística & dados numéricos , Gelatina/uso terapêutico , Hepatopatias/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos
15.
Cochrane Database Syst Rev ; 2: CD001532, 2019 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-30784039

RESUMO

BACKGROUND: Vesicoureteric reflux (VUR) results in urine passing retrograde up the ureter. Urinary tract infections (UTI) associated with VUR have been considered a cause of permanent renal parenchymal damage in children with VUR. Management has been directed at preventing UTI by antibiotic prophylaxis and/or surgical correction of VUR. This is an update of a review first published in 2004 and updated in 2007 and 2011. OBJECTIVES: The aim of this review was to evaluate the available evidence for both benefits and harms of the currently available treatment options for primary VUR: operative, non-operative or no intervention. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Specialised Register to 3 May 2018 through contact with the Information Specialist using search terms relevant to this review. Studies contained in the Specialised Register are identified through search strategies specifically designed for CENTRAL, MEDLINE, and EMBASE; handsearching conference proceedings, and searching the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA: RCTs in any language comparing any treatment of VUR and any combination of therapies. DATA COLLECTION AND ANALYSIS: Two authors independently determined study eligibility, assessed quality and extracted data. Dichotomous outcomes were expressed as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CI. Data were pooled using the random effects model. MAIN RESULTS: Thirty four studies involving 4001 children were included. Interventions included; long-term low-dose antibiotics, surgical reimplantation of ureters, endoscopic injection treatment, probiotics, cranberry products, circumcision, and oxybutynin. Interventions were used alone and in combinations. The quality of conduct and reporting of these studies was variable, with many studies omitting crucial methodological information used to assess the risk of bias. Only four of the 34 studies were considered at low risk of bias across all fields of study quality. The majority of studies had many areas of uncertainty in the risk of bias fields, reflecting missing detail rather than stated poor design.Low-dose antibiotic prophylaxis compared to no treatment/placebo may make little or no difference to the risk of repeat symptomatic UTI (9 studies, 1667 children: RR 0.77, 95% CI 0.54 to 1.09; low certainty evidence) and febrile UTI (RR 0.83, 95% CI 0.56 to 1.21; low certainty evidence) at one to two years. At one to three years, antibiotic prophylaxis made little or no difference to the risk of new or progressive renal damage on DMSA scan (8 studies, 1503 children: RR 0.73, 95% CI 0.33 to 1.61; low certainty evidence). Adverse events were reported in four studies with little or no difference between treatment groups (1056 children: RR 0.94, 95% CI 0.81 to 1.08; ), but antibiotics increased the likelihood of bacterial drug resistance threefold (187 UTIs: RR 2.97, 95% CI 1.54 to 5.74; moderate certainty evidence).Seven studies compared long-term antibiotic prophylaxis alone with surgical reimplantation of ureters plus antibiotics, but only two reported the outcome febrile UTI (429 children). Surgery plus antibiotic treatment may reduce the risk of repeat febrile UTI by 57% (RR 0.43, 95% CI 0.27 to 0.70; moderate certainty evidence). There was little or no difference in the risk of new kidney defects detected using intravenous pyelogram at 4 to 5 years (4 studies, 572 children, RR 1.09, 95% CI 0.79 to 1.49; moderate certainty evidence)Four studies compared endoscopic injection with antibiotics alone and three reported the outcome febrile UTI. This analysis showed little or no difference in the risk of febrile UTI with endoscopic injection compared to antibiotics (RR 0.74, 95% CI 0.31 to 1.78; low certainty evidence). Four studies involving 425 children compared two different materials for endoscopic injection under the ureters (polydimethylsiloxane (Macroplastique) versus dextranomer/hyaluronic acid polymer (Deflux), glutaraldehyde cross-linked (GAX) collagen (GAX) 35 versus GAX 65 and Deflux versus polyacrylate polyalcohol copolymer (VANTRIS)) but only one study (255 children, low certainty evidence) had the outcome of febrile UTI and it reported no difference between the materials. All four studies reported rates of resolution of VUR, and the two studies comparing Macroplastique with Deflux showed that Macroplastique was probably superior to dextranomer/hyaluronic acid polymer (3 months: RR 0.50, 95% CI 0.33 to 0.78; 12 months: RR 0.54 95% CI 0.35 to 0.83; low certainty evidence)Two studies compared probiotic treatment with antibiotics and showed little or no difference in risk of repeat symptomatic UTI (RR 0.82 95% CI 0.56 to 1.21; low certainty evidence)Single studies compared circumcision with antibiotics, cranberry products with no treatment, oxybutynin with placebo, two different surgical techniques and endoscopic injection with no treatment. AUTHORS' CONCLUSIONS: Compared with no treatment, the use of long-term, low-dose antibiotics may make little or no difference to the number of repeat symptomatic and febrile UTIs in children with VUR (low certainty evidence). Considerable variation in the study designs and subsequent findings prevented drawing firm conclusions on efficacy of antibiotic treatment.The added benefit of surgical or endoscopic correction of VUR over antibiotic treatment alone remains unclear since few studies comparing the same treatment and with relevant clinical outcomes were available for analysis.


Assuntos
Infecções Urinárias/prevenção & controle , Refluxo Vesicoureteral/terapia , Resinas Acrílicas/uso terapêutico , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Criança , Colágeno/uso terapêutico , Dextranos/uso terapêutico , Dimetilpolisiloxanos/uso terapêutico , Feminino , Febre/etiologia , Febre/prevenção & controle , Humanos , Ácido Hialurônico/uso terapêutico , Rim/anormalidades , Masculino , Probióticos/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Reimplante , Ureter/cirurgia , Infecções Urinárias/complicações , Refluxo Vesicoureteral/complicações
16.
J Plast Reconstr Aesthet Surg ; 72(5): 848-862, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30658951

RESUMO

This article is a follow up to "Early and late complications of polyalkimide gel (Bio-Alcamid)".1 It is a summary of late complications that have developed in patients treated with Bio-Alcamid for HIV lipoatrophy following extended follow up of 10 years.


Assuntos
Resinas Acrílicas/efeitos adversos , Preenchedores Dérmicos/efeitos adversos , Síndrome de Lipodistrofia Associada ao HIV/cirurgia , Resinas Acrílicas/uso terapêutico , Preenchedores Dérmicos/uso terapêutico , Humanos , Cirurgia Plástica/efeitos adversos , Cirurgia Plástica/métodos
17.
Tidsskr Nor Laegeforen ; 139(2)2019 01 29.
Artigo em Inglês, No | MEDLINE | ID: mdl-30698387

RESUMO

Periurethral injection offers an alternative to the current main method for surgical treatment of stress incontinence in women, which is a polypropylene sling that is placed without tension below the mid-urethra. Injection therapy is a simple, gentle method that provides significant improvement in the degree of leakage and quality of life, but the results are not on a par with the polypropylene sling. Injection therapy may be relevant when the main method is not suitable or desired.


Assuntos
Resinas Acrílicas/uso terapêutico , Hidrogéis/uso terapêutico , Incontinência Urinária por Estresse/terapia , Resinas Acrílicas/efeitos adversos , Feminino , Humanos , Hidrogéis/efeitos adversos , Injeções/métodos , Resultado do Tratamento , Uretra
18.
J Prosthodont ; 28(1): e110-e117, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29888488

RESUMO

PURPOSE: Acrylic resin properties are susceptible to change over the duration of use, thereby decreasing prosthesis longevity. To make the material less susceptible to the action of external agents such as stain-causing liquids and cleaning solutions, polishing procedures are recommended. A specific mechanical polishing procedure performed regularly was evaluated regarding the biofilm adhesion, surface roughness (Ra), color stability (ΔE), and mass changes in acrylic resin artificial teeth. MATERIALS AND METHODS: Sixty artificial teeth divided into two groups (n = 30) were immersed in distilled water (WT) and coffee (CF). These groups were then subdivided (n = 10) according to the type of polishing procedure administered: no polishing, biweekly polishing (once every 2 weeks) (pol 1), or monthly polishing (once a month) (pol 2), using aluminum oxide paste and a felt polishing wheel attached to an electric motor at a speed of 3000 rpm. Properties were evaluated at baseline and after 4, 8, 12, and 24 months of simulated immersion. At the end, the adhesion of Candida albicans and Streptococcus mutans multispecies biofilm in all groups was assessed. RESULTS: The CF group showed an increased Ra and weight, and a significantly greater ΔE compared to the WT group. The polishing procedure reduced Ra and minimized the stains caused by coffee, without losing mass, with the biweekly regime more effective than the monthly regime. Also, polishing reduced the adhesion of biofilm in the CF groups, again with the biweekly regime the most effective. CONCLUSIONS: When performed regularly, the mechanical polishing procedure tested reduces the changes in artificial teeth subjected to immersion in coffee, with the biweekly frequency most effective regarding the properties evaluated.


Assuntos
Resinas Acrílicas/uso terapêutico , Aderência Bacteriana , Biofilmes , Polimento Dentário , Pigmentação em Prótese , Dente Artificial , Candida albicans/crescimento & desenvolvimento , Polimento Dentário/efeitos adversos , Polimento Dentário/métodos , Streptococcus mutans/crescimento & desenvolvimento , Propriedades de Superfície
19.
J Prosthodont ; 28(1): e383-e394, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29855127

RESUMO

PURPOSE: The purpose of this in vitro study was to evaluate the cytotoxic and apoptotic effects of seven new-generation all-ceramic materials for CAD/CAM (Lava Ultimate [LU], VITA Mark II [VM], InCoris TZI [IC], IPS e.max CAD [EM], VITA Suprinity [VS], Cerasmart [CS], IPS Empress CAD [EC]) and six provisional materials (Protemp 4 [PT], Telio CAD [TC], CAD-Temp [CT], Telio Lab [TL], Temdent Classic [TD], Telio CS C&B [TS]) on L929 mouse fibroblast cells. MATERIALS AND METHODS: 24 disc-shaped specimens (∅ = 5 mm, h = 2 mm) were prepared from each test material. Medium extracts were collected at the 1st, 3rd, and 7th days for each group and tested using the L929 cell line. Cytotoxicity was evaluated using XTT assay, and apoptosis was determined by Annexin-V/PI staining. Data were analyzed using one-way ANOVA, Tukey's multiple comparison tests at a significance level of p < 0.05. RESULTS: The cell viability results among all-ceramic material groups after the 1st and 7th days of incubation periods showed statistically significant differences (p < 0.05). There were significant differences within the ceramic groups in different incubation periods regarding apoptosis rate (p < 0.05). Throughout the entire test period, LU and VM from the CAD/CAM all-ceramic materials and PT and TC from the provisional restoration materials showed cell viability higher than 90%. EC and TD showed the lowest cell viability and highest apoptosis rates in their own groups. For the provisional materials, there were significant differences in cell viability and apoptosis rate in all the incubation periods for each material (p < 0.05). CONCLUSIONS: Although some new-generation CAD/CAM and provisional restoration materials display slight cytotoxicity values, the results are still within the reliable range, and they can safely be used in clinical conditions.


Assuntos
Cerâmica/uso terapêutico , Fibroblastos/efeitos dos fármacos , Resinas Acrílicas/efeitos adversos , Resinas Acrílicas/uso terapêutico , Animais , Apoptose/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Cerâmica/efeitos adversos , Resinas Compostas/efeitos adversos , Resinas Compostas/uso terapêutico , Materiais Dentários/efeitos adversos , Materiais Dentários/uso terapêutico , Porcelana Dentária/efeitos adversos , Porcelana Dentária/uso terapêutico , Técnicas In Vitro , Camundongos
20.
Urol J ; 16(4): 361-365, 2019 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-30318569

RESUMO

PURPOSE: To compare the efficacy of two bulking agents, Dextranomer-Hyaluronic Acid (DxHA) and Polyacrylate-Polyalcohol Copolymer (PPC) used for endoscopic treatment of vesicoureteral reflux (VUR). MATERIALS AND METHODS: We endoscopically treated 125 patients (89 girls and 36 boys) diagnosed with VUR grades I-V, comprising a total of 174 refluxing ureters (RUs). Patients were categorized into two groups, 99 (56,9%) RUs were treated with DxHA (Group 1) and 75 (43,1%) RUs with PPC (Group 2). RUs treated with both bulking agents were excluded. The success of treatment was evaluated with postoperative VCUG at 3- and 12-months after the endoscopic procedure, only complete resolution of VUR was considered as treatment success. Data was collected and analyzed retrospectively. Statistical calculations were performed using the Chi-square test. RESULTS: After a single injection 80,0% (60/75) and 68,7% (68/99 RUs) of RUs resolved completely when treated with PPC and DxHA, respectively (P = .094). A second injection of PPC healed another 10 RUs (total 93,3%), whereas DxHA resolved additional 16 RUs (total 84,8%) (P = .097). A third injection was needed for 1 RU, treated with PPC and another 3 RUs with DxHA. Twelve months post-operatively, we achieved a total resolution rate of 94,7% (71/75 RUs) with PPC, while DxHA successfully treated 87,9% (87/99) of RUs (P = .125). CONCLUSIONS: DxHA and PPC showed no statistically significant differences neither in the number of injections needed nor in the total success rate after 12 months of follow-up.


Assuntos
Resinas Acrílicas/uso terapêutico , Cistoscopia , Dextranos/uso terapêutico , Ácido Hialurônico/uso terapêutico , Polímeros/uso terapêutico , Refluxo Vesicoureteral/tratamento farmacológico , Refluxo Vesicoureteral/cirurgia , Pré-Escolar , Feminino , Humanos , Masculino , Estudos Retrospectivos , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...