Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 995
Filtrar
1.
FP Essent ; 489: 27-31, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31995352

RESUMO

Burns, whether caused by thermal, chemical, or electrical exposure, are common and often preventable. Burn injuries are most common in children. All patients with burns should undergo primary and secondary assessment, including assessment of airway, breathing, and circulation. Evaluation of the location, size, and depth of burns can help to determine the optimal setting for management. Patients with full-thickness burns, circumferential burns, or burns on the face, hands, feet, genitals, or perineum should be referred to a burn subspecialist. Minor acute pain can be managed with irrigation of the burn area with cool water, acetaminophen, or a nonsteroidal anti-inflammatory drug. Acetaminophen is the first-line treatment for pain associated with minor burns. Opioids are a mainstay of pain management for patients with severe burns. Prophylactic antibiotics are not indicated for most patients. Silver sulfadiazine is used widely as a topical therapy, and is a standard treatment for partial-thickness burns. Many other topical therapies are available but comparative data are limited. Goals of therapy are to manage pain, facilitate healing, minimize scarring, and achieve return to function.


Assuntos
Anti-Infecciosos Locais , Queimaduras , Pacientes Ambulatoriais , Queimaduras/terapia , Criança , Humanos , Sulfadiazina de Prata , Cicatrização
2.
Rev Assoc Med Bras (1992) ; 65(11): 1405-1412, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31800905

RESUMO

OBJECTIVE: to identify, through an integrative review, national studies published over the last ten years highlighting products and therapies used in burns. METHODS: integrative research with studies published in the last ten years. Including clinical studies describing the use of the already established or innovative therapies in burns and the results obtained, published in national journals in the last ten years. Excluding articles published before 2007 and those that did not present results regarding the use of products in burns. RESULTS: ten articles that met the inclusion criteria were selected. Collagenase, 1% silver sulfadiazine, and porous cellulose membrane were some of the therapies cited. CONCLUSION: the casuistry was low; however, the good results obtained with porous cellulose membrane and silver nanocrystalline dressing are highlighted, since they were used in a larger number of patients in the studies evaluated.


Assuntos
Bandagens , Queimaduras/terapia , Colagenases/administração & dosagem , Desbridamento , Membranas Artificiais , Sulfadiazina de Prata/administração & dosagem , Humanos
3.
Environ Int ; 133(Pt B): 105275, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31675563

RESUMO

After reviewing the species- and community-level ecological risk assessments (ERAs) of chemicals in the aquatic environment, the present study attempted to propose a third stage of ERA, i.e., the ecosystem-level ERA. Based on the species sensitivity distribution model (SSD) and thermodynamic theory, the exergy and biomass indicators of communities from various trophic levels (TLs) were introduced to improve ecological connotation of SSDs. The species were classified into three TLs based on algae (TL1), invertebrates (TL2), and vertebrates (TL3), and the weight of each TL was determined based on relative biomass and ß value, which indicated a holistic contribution of each species or community to the ecosystem. Then, a system-level ERA protocol was successfully established, and the community- and system-level ecological risks of 10 typical toxic micro-organic pollutants in the western area of Lake Chaohu and its inflowing rivers were evaluated. System-level ERA curves (ExSSD) were mainly affected by the community-level SSD at TL2 for most chemicals in the present study. The uncertain boundary of ExSSD was mostly related to TLs with a wider uncertain boundary, but had little relation to the weight of each TL. The results of system-level ERAs revealed that dibutyl phthalate had the highest eco-risk, whereas γ-hexachlorocyclohexane presented the lowest eco-risk. Results of the system-level ERA were not fully consistent with the those of community-level ERA owing to the lack of a sufficient dataset, SSD model type, and ecosystem structure, as indicated by the weight of each TL. The successful application of ExSSD in Lake Chaohu signifies the start of the third stage of ERA at the system-level, and it also provides a scientific basis for ecosystem-level ERA, aquatic ecosystem protection, and future water safety management. However, there were some limitations, including sufficient data dependence, neglect of ecological interactions, and neglect of environmental parameters such as natural organic matter. We propose to employ toxicogenomics to enrich the toxicity database, to simulate the interaction using the ecological dynamic model, and to introduce the chemical fate model into the system-level ERA.


Assuntos
Ecossistema , Sulfadiazina de Prata/toxicidade , Poluentes Químicos da Água/toxicidade , Animais , Organismos Aquáticos/efeitos dos fármacos , Biomassa , Monitoramento Ambiental , Lagos/química , Modelos Teóricos , Medição de Risco , Rios/química , Sulfadiazina de Prata/química , Termodinâmica , Poluentes Químicos da Água/química
4.
Ulus Travma Acil Cerrahi Derg ; 25(4): 338-342, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31297776

RESUMO

BACKGROUND: The present study was designed to compare the effectiveness of topical silver sulfadiazine (SSD) and Ankaferd Blood Stopper® (ABS) usage in experimental partial-thickness burns in rats. METHODS: Twenty-one male Wistar albino rats weighing 250-290 (range: 270+-19) g were used in the present study. A round brass probe that was specifically designed (3×3 cm diameter) was used to induce the burns in rats. After the presence of partial-thickness burns was confirmed, the rats were divided into three groups: Group 1 (ABS group) Ankaferd Blood Stopper® pad, Group 2 (SSD group) silver sulfadiazine (Silverdin®), and Group 3 (Control group) 1% isotonic saline solution-impregnated pad. The healing period was followed up clinically and histopathologically. The day on which 50% and 80% of re-epithelization at first were detected for each rat was also recorded. RESULTS: The mean times of 50% and 80% of re-epithelization at first were 10.8 days, 13.8 days, and 16.8 days in Groups 1, 2, and 3, respectively (p<0.001), and 16.4 days, 19.7 days, and 25.2 days, respectively (p<0.001). The mean inflammatory scores were also found to be better in the ABS group than in other groups (p<0.05). CONCLUSION: Our study showed that ABS has better results for the healing of the burn wound than SSD in experimental partial-thickness burns in rats.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Queimaduras/tratamento farmacológico , Extratos Vegetais/uso terapêutico , Sulfadiazina de Prata/uso terapêutico , Cicatrização/efeitos dos fármacos , Animais , Masculino , Ratos , Ratos Wistar , Fatores de Tempo
5.
Angle Orthod ; 89(6): 903-909, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31282738

RESUMO

OBJECTIVE: To compare the accuracy and computational efficiency of two of the latest deep-learning algorithms for automatic identification of cephalometric landmarks. MATERIALS AND METHODS: A total of 1028 cephalometric radiographic images were selected as learning data that trained You-Only-Look-Once version 3 (YOLOv3) and Single Shot Multibox Detector (SSD) methods. The number of target labeling was 80 landmarks. After the deep-learning process, the algorithms were tested using a new test data set composed of 283 images. Accuracy was determined by measuring the point-to-point error and success detection rate and was visualized by drawing scattergrams. The computational time of both algorithms was also recorded. RESULTS: The YOLOv3 algorithm outperformed SSD in accuracy for 38 of 80 landmarks. The other 42 of 80 landmarks did not show a statistically significant difference between YOLOv3 and SSD. Error plots of YOLOv3 showed not only a smaller error range but also a more isotropic tendency. The mean computational time spent per image was 0.05 seconds and 2.89 seconds for YOLOv3 and SSD, respectively. YOLOv3 showed approximately 5% higher accuracy compared with the top benchmarks in the literature. CONCLUSIONS: Between the two latest deep-learning methods applied, YOLOv3 seemed to be more promising as a fully automated cephalometric landmark identification system for use in clinical practice.


Assuntos
Algoritmos , Cefalometria , Sulfadiazina de Prata , Aprendizado Profundo , Reprodutibilidade dos Testes
6.
J Appl Microbiol ; 127(4): 1018-1027, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31278820

RESUMO

AIM: To evaluate the activity and effectiveness of impregnated central venous catheters (CVC) against Klebsiella pneumoniae biofilms. METHODS AND RESULTS: The antimicrobial activity and durability of impregnated-CVCs were evaluated over time and the size of zones of inhibition (ZI) was measured. Biofilm formation was observed by quantitative culture and also by scanning electron microscopy. The catheters impregnated with chlorhexidine/silver sulfadiazine (CHX/SS) reduced bacteria counts by 0·3 log and were most effective (P < 0·01) against Klebsiella pneumoniae biofilms N-acetylcysteine/levofloxacin (NAC/LEV) catheters. It was observed that the catheter impregnated with NAC/LEV had initially the largest average ZI size being statistically significant (P < 0·01). The NAC/LEV combination remained active until day 30, whereas the combination of CHX/SS was completely inactivated from day 15 on. CONCLUSIONS: The NAC/LEV combination showed greater durability on the catheters, but it was the CHX/SS combination that had the greater initial efficacy in bacterial inhibition. It was also observed that NAC/LEV-impregnated catheters do not prevent the emergence of resistant subpopulations inside the inhibition halos during antimicrobial susceptibility tests. SIGNIFICANCE AND IMPACT OF THE STUDY: Our results highlighted that the in vitro efficacy of antimicrobial-impregnated CVCs is limited by time and that their colonization occurred earlier than expected. Our data also demonstrated that NAC/LEV remained active until day 30 of evaluation and CHX/SS combination was completely inactivated from day 15 on. Our findings suggested that implantable devices should be carefully used by medical community.


Assuntos
Antibacterianos/farmacologia , Biofilmes/efeitos dos fármacos , Cateteres/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Acetilcisteína/farmacologia , Biofilmes/crescimento & desenvolvimento , Clorexidina/farmacologia , Farmacorresistência Bacteriana , Klebsiella pneumoniae/fisiologia , Levofloxacino/farmacologia , Sulfadiazina de Prata/farmacologia , Fatores de Tempo
7.
Int J Nanomedicine ; 14: 2693-2703, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354260

RESUMO

Background: Silver, incorporation with natural or synthetic polymers, has been used as an effective antibacterial agent since decades. Silver has potential applications in healthcare especially in nanoparticles form but silver sulfadiazine (AgSD) is the most efficient antibacterial agent especially for burn wound dressings. Method: In this report, mechanical, structural, and antibacterial properties of PAN nanofibers incorporation with silver sulfadiazine are mainly focused. AgSD was loaded for the first time on electrospinning as well as self-synthesized AgSD on PAN nanofibers by solution immersion method and then compared the results of both. Results: Occurrence of chemical reaction among the functional groups of AgSD and PAN were analyzed using FTIR, for both types of specimen. Morphological and surface properties of prepared nanofiber mats were characterized by scanning electron microscope, and it resulted in uniform nanofibers without bead formation. Diameter of nanofibers was slightly increased with addition of AgSD by in situ and immersion methods respectively. Nanoparticles distribution was analyzed by transmission electron microscopy. Thermal properties were analyzed by thermo-gravimetric analyzer and it was observed that AgSD decreased thermal stability of PAN which is better from biomedical perspective. X-ray diffraction declared crystalline structure of nanofiber mats. Presence of Ag and S contents in nanofiber mats was analyzed by X-ray photo spectroscopy. Antibacterial properties of nanofiber mats were investigated by disc diffusion method was carried out. E. coli and Bacillus bacteria strain were used as gram-negative and gram-positive respectively. Zone inhibition of the bacteria was used as a tool to determine effectiveness of AgSD released from PAN nanofiber mats. The antibacterial properties of PAN nanofibers impregnated with AgSD were determined with both types of bacteria strains to compare with control one. Conclusion: On the basis of characterization results it is concluded that PAN/AgSD (immersion) nanofiber mats have better structural and antibacterial properties than that of PAN/AgSD (in situ) nanofiber mats. So, from our point of view, self-synthesized AgSD is recommended for further production of nanofiber mats for antibacterial applications.


Assuntos
Resinas Acrílicas/química , Antibacterianos/farmacologia , Nanofibras/química , Sulfadiazina de Prata/farmacologia , Bacillus/efeitos dos fármacos , Módulo de Elasticidade , Escherichia coli/efeitos dos fármacos , Testes de Sensibilidade Microbiana , Nanofibras/ultraestrutura , Espectroscopia Fotoeletrônica , Espectrometria por Raios X , Espectroscopia de Infravermelho com Transformada de Fourier , Estresse Mecânico , Resistência à Tração , Termogravimetria , Difração de Raios X
8.
An Bras Dermatol ; 94(2): 204-210, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31090826

RESUMO

This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Queimaduras/tratamento farmacológico , Sulfadiazina de Prata/uso terapêutico , Cicatrização , Anti-Infecciosos Locais/farmacologia , Hospitalização , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Sulfadiazina de Prata/farmacologia , Fatores de Tempo , Resultado do Tratamento , Cicatrização/efeitos dos fármacos
9.
J Wound Care ; 28(5): 291-296, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-31067161

RESUMO

OBJECTIVE: To determine the antibacterial activity of Pakistani Beri honey in patients with infected wounds in comparison with silver sulfadiazine. METHOD: Inpatients with infected wounds at a tertiary care hospital were divided in to three equal-sized treatment groups. In Group A, patients were treated with non-Gamma irradiated Beri honey. In Group B, Gamma irradiated Beri honey was used, and in Group C silver sulfadiazine was used. Treatment was for a period of four weeks. Pus swabs were taken at day zero and weeks one and four of treatment. Bacteria were identified using the analytical profile index system API 20E, 20NE and API Staph and antimicrobial susceptibility was done as per the Clinical and Laboratory Standards Institute 2010 guidelines. RESULTS: A total of 90 patients with wounds (n=90) took part in the trial. Out of 90 wounds, 47% were post-traumatic and 37% were postoperative. Overall, average length, width and depth of Group A patients' wounds were significantly reduced (p<0.0001). Out of 144 pus swabs; 99 and 45 were Gram-negative rods and Gram-positive cocci, respectively. Among these Pseudomonas aeruginosa (n=25) and Staphylococcus aureus (n=38) were the major pathogens. Interestingly, bacterial load gradually decreased from baseline to week four due to non-Gamma irradiated Beri honey. Moreover, both the Gram-negative rods and Gram-positive cocci displayed 100% resistance to commonly used antibiotics; the most effective drugs were carbapenem and vancomycin. CONCLUSION: Pakistani Beri honey could be used as an alternative therapeutic option for the management of infected wounds.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Mel , Infecções por Pseudomonas/tratamento farmacológico , Sulfadiazina de Prata/uso terapêutico , Infecções Estafilocócicas/tratamento farmacológico , Infecção dos Ferimentos/tratamento farmacológico , Ziziphus/química , Humanos , Paquistão , Resultado do Tratamento
11.
Am J Emerg Med ; 37(6): 1184-1190, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31000315

RESUMO

BACKGROUND: Partial thickness burns are the most common form of thermal burns. Traditionally, dressing for these burns is simple gauze with silver sulfadiazine (SSD) changed on a daily basis. Foam dressings have been proposed to offer the advantage of requiring less frequent dressing change and better absorption of exudates. OBJECTIVE: To compare the impact of silver-containing foam dressing to traditional SSD with gauze dressing on wound healing of partial thickness burns. METHODS: We performed a systematic literature search using PubMed, EMBASE, CINAHL, Web of Science, Cochrane Library database and Google Scholar for trials comparing traditional SSD dressings to that of silver-containing foam dressing on wound healing in partial thickness burns <25% of the body surface area. We excluded studies that enrolled burns involving head, face, and genitals; burns older than or equal to 36 h, non-thermal burns, and immunocompromised patients. Quality of trials was assessed using the GRADE criteria. The main outcome, complete wound healing, is reported as percentages of wound with complete epithelialization after the follow up period. Relative risks of complete healing are also reported with respective 95% CI. Time to healing and pain score before, during, and after dressing change at each follow up visit are compared between the groups (means with standard deviation or medians with quartiles). RESULTS: We identified a total of 877 references, of which three randomized controlled trials (2 combined pediatric and adult trials and 1 adult trial) with a total of 346 patients met our inclusion criteria. All three trials compared silver-containing foam dressing to SSD and gauze on partial thickness burns. Moderate quality evidence indicated no significant difference in wound re-epithelialization between the groups across all three trials as confidence intervals for the relative risks all crossed 1. Although pain scores favored foam dressing at the first dressing change (7 days), there was no significant difference between the groups at the end of the treatment period at 28 days. Time to wound healing was also similar across the three trials with no statistical difference. Infection rates favored the foam-dressing group, but data were inconsistent. CONCLUSION: Moderate quality evidence indicates that there is no significant difference in wound healing between silver-containing foam dressing and SSD dressing. However, foam has the added benefit of reduced pain during the early treatment phase and potentially decreased infection rates.


Assuntos
Bandagens/classificação , Bandagens/normas , Queimaduras/terapia , Cicatrização , Administração Tópica , Queimaduras/fisiopatologia , Humanos , Manejo da Dor , Ensaios Clínicos Controlados Aleatórios como Assunto , Sulfadiazina de Prata/administração & dosagem
12.
Int J Pharm ; 564: 350-358, 2019 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-31028800

RESUMO

In the current study, two series of antimicrobial dressings conjugated with silver sulfadiazine (SSD) and silver nanoparticles (AgNPs) were developed and evaluated for chronic wound healing. Highly porous polycaprolactone (PCL)/polyvinyl alcohol (PVA) nanofibers were loaded with different concentrations of SSD or AgNPs and compared comprehensively in vitro and in vivo. SSD and AgNPs indicated a strong and equal antimicrobial activity against S. aureus. However, SSD had more toxicity against fibroblast cells over one week in vitro culture. An in vivo model of wound healing on male Wistar rats was developed with a full thickness wound. All the wound dressings indicated enough flexibility and hydrophilicity, which resulted an adequate adhesion into the wound closure. After 30 days, the control group without any treatment indicated 31% wound closure while the group treated with PCL/PVA (without antimicrobial components) indicated 44% wound closure. Presence of antimicrobial components in the PCL/PVA nanofibers resulted into a lower inflammation response leading to a faster proliferation and maturation phases. In agreement with the higher biocompatibility of AgNPs than SSD, a faster angiogenesis, epithelialization and subsequently, remodeling were observed for the wound dressings loaded with AgNPs. The group treated with the highest concentration of AgNPs showed the fastest healing process leading to a final epithelialization with 96% wound closure after 30 days. This study indicated that AgNPs have higher biocompatibility and regulate wound healing process more efficiently compared to SSD. PCL/PVA nanofibers conjugated with AgNPs are promising wound dressings for full-thickness wounds.


Assuntos
Antibacterianos/administração & dosagem , Bandagens , Nanopartículas Metálicas/administração & dosagem , Sulfadiazina de Prata/administração & dosagem , Prata/administração & dosagem , Cicatrização/efeitos dos fármacos , Animais , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Fibroblastos/efeitos dos fármacos , Humanos , Masculino , Ratos Wistar , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/crescimento & desenvolvimento
13.
An. bras. dermatol ; 94(2): 204-210, Mar.-Apr. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1001128

RESUMO

Abstract This study aims to evaluate tissue healing efficacy in burn patients treated with 1% silver sulfadiazine versus other treatments. This is a systematic literature review and meta-analysis of randomized clinical trials performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) and PICO strategy, registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the number CRD42017081057. The review found 71 studies in MEDLINE/Pubmed, 1 in Clinical Trials, 19 in the Cochrane Library, and 4 in LILACS in five manual searches. Of these, 81 studies were pre-selected. After independent analysis by two reviewers, only 11 studies met the inclusion criteria for the review. All studies (n = 11) using alternative treatments to silver sulfadiazine were shown to be superior in the mean time for complete wound healing, with statistically significant differences between experimental and control groups (p <0.00001); mean difference (- 4.26), 95% CI [- 5.96, - 2.56].


Assuntos
Humanos , Sulfadiazina de Prata/uso terapêutico , Cicatrização/efeitos dos fármacos , Queimaduras/tratamento farmacológico , Anti-Infecciosos Locais/uso terapêutico , Sulfadiazina de Prata/farmacologia , Fatores de Tempo , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento , Hospitalização , Anti-Infecciosos Locais/farmacologia
14.
Am J Vet Res ; 80(4): 325-334, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30919672

RESUMO

OBJECTIVE: To determine whether an enrofloxacin-silver sulfadiazine emulsion (ESS) labeled for treatment of otitis externa in dogs has ototoxic effects in rabbits following myringotomy. ANIMALS: 6 healthy adult New Zealand White rabbits. PROCEDURES: Rabbits were anesthetized for brainstem auditory-evoked response (BAER) tests on day 0. Myringotomy was performed, and BAER testing was repeated. Saline (0.9% NaCl) solution and ESS were then instilled in the left and right middle ears, respectively, and BAER testing was repeated prior to recovery of rabbits from anesthesia. Application of assigned treatments was continued every 12 hours for 7 days, and rabbits were anesthetized for BAER testing on day 8. Rabbits were euthanized, and samples were collected for histologic (6 ears/treatment) and scanning electron microscopic (1 ear/treatment) examination. RESULTS: Most hearing thresholds (11/12 ears) were subjectively increased after myringotomy, with BAER measurements ranging from 30 to 85 dB in both ears. All day 8 hearing thresholds exceeded baseline (premyringotomy) values; results ranged from 30 to 85 dB and 80 to > 95 dB (the upper test limit) in saline solution-treated and ESS-treated ears, respectively. All ESS-treated ears had heterophilic otitis externa, epithelial hyperplasia of the external ear canal, various degrees of mucoperiosteal edema, and periosteal new bone formation on histologic examination. Scanning electron microscopy revealed that most outer hair cells in the ESS-treated ear lacked stereocilia or were absent. CONCLUSIONS AND CLINICAL RELEVANCE: Results supported that ESS has ototoxic effects in the middle ear of rabbits. Further research is needed to confirm these findings. Myringotomized laboratory rabbits may be useful to study ototoxicity of drugs used in human medicine.


Assuntos
Enrofloxacina/toxicidade , Sulfadiazina de Prata/toxicidade , Perfuração da Membrana Timpânica/tratamento farmacológico , Membrana Timpânica/efeitos dos fármacos , Membrana Timpânica/lesões , Animais , Orelha Média/patologia , Feminino , Audição , Humanos , Masculino , Ventilação da Orelha Média , Coelhos , Membrana Timpânica/patologia
15.
Int Wound J ; 16(3): 703-712, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30895731

RESUMO

In this study, three cellular cytotoxic assays (direct contact assay, extraction assay, and cell insert assay) were applied to evaluate the effects of a concentrated surfactant gel preserved with antimicrobials and a concentrated surfactant gel with 1% silver sulfadiazine on both the mouse fibroblast cell line L929 and human dermal fibroblasts (HDFa). Also, the in vitro wound model was wounded by a 100 µL pipette tip and used to assess cell migration and wound closure after treatment with both gels. A needle-scratched membrane disruption model was used to preliminarily evaluate membrane stabilisation and the membrane-resealing effects of concentrated surfactant gels. It was demonstrated that the concentrated surfactant gel preserved with antimicrobials was not toxic to both L929 and HDFa. However, the concentrated surfactant gel with 1% silver sulfadiazine demonstrated a degree of cytotoxicity to both cell types. After treatment with a concentrated surfactant gel preserved with antimicrobials, cell movement to close the scratch gap was enhanced at 24 and 48 hours. The results also showed that cells treated with the concentrated surfactant gel preserved with antimicrobials decreased cell necrosis and improved cell resistance of the f-actin rearrangement after a needle scratch. The results demonstrated that a concentrated surfactant gel preserved with antimicrobials is non-cytotoxic and has ability to accelerate wound closure by enhancing cell mobility. Furthermore, the concentrated surfactant gel appeared to stabilise the plasma membrane and demonstrated a resealing ability and helped to retain the plasma membrane integrity and enhanced wound healing.


Assuntos
Anti-Infecciosos/uso terapêutico , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas/efeitos dos fármacos , Sulfadiazina de Prata/uso terapêutico , Tensoativos/uso terapêutico , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/tratamento farmacológico , Bandagens , Humanos , Técnicas In Vitro
16.
Pak J Pharm Sci ; 32(1): 21-28, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30772786

RESUMO

Burn injury is one of the most destructive events in the world. The Pergularia tomentosa L. is a medicinal plant that traditionally, applies for treatment of burning, in Bushehr province, Iran. Various bioactive compounds such as steroid glycosides, tannins, various vitamins, saponins, cardenolides and anthraquinones were identified into extract of the plant, which can be effective in burn wound healing. Twenty-one rats weighting every one 200±5 grams were divided equally into three groups. The second-degree burning induced on all groups. One of groups did not receive any treatment (The control group) and was treated locally with saline and eucerin. The Second group received the P. tomentosa L. as a topical ointment, and the third group received locally, a thin layer of silver sulfadiazine ointment 3% after washing the wound with saline. Afterward treatment period, the microscopic slides from histological sections were prepared. At that point, amounts of the fibroblast cells, blood vessels, wound area, necrotic tissues, and diameter of epidermis rate of wound healing were determined. Also the exterior status of wound in different days was considered. Results obtained from current study have revealed that the extract of P. tomentosa L. can significantly, cause qualitative and quantitative acceleration in healing of second degree burn wounds, due to their bioactive and vasoactive properties. In conclusion the P. tomentosa L. can is used as an overborne medicine with lower cost and side effect than the similar chemical medicines. Although, the further studies are needed on these plants, due to their some toxic effects.


Assuntos
Apocynaceae , Queimaduras/tratamento farmacológico , Fármacos Dermatológicos/administração & dosagem , Extratos Vegetais/administração & dosagem , Pele/efeitos dos fármacos , Cicatrização/efeitos dos fármacos , Administração Cutânea , Animais , Apocynaceae/química , Apocynaceae/crescimento & desenvolvimento , Queimaduras/patologia , Fármacos Dermatológicos/isolamento & purificação , Modelos Animais de Doenças , Irã (Geográfico) , Masculino , Extratos Vegetais/isolamento & purificação , Ratos , Sulfadiazina de Prata/administração & dosagem , Pele/patologia , Fatores de Tempo
17.
J Am Acad Dermatol ; 81(2): 558-567, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30802561

RESUMO

Radiation dermatitis is a common sequela of radiation therapy; up to 95% of patients will develop moderate-to-severe skin reactions. No criterion standard currently exists for the treatment of acute radiation-induced skin toxicity. It is therefore imperative to develop a greater understanding of management options available to allow clinicians to make informed decisions when managing radiation oncology patients. This literature review discusses the topical agents that have been studied for the treatment of acute radiation dermatitis, reviews their mechanisms of action, and presents a treatment algorithm for clinicians managing patients experiencing radiation dermatitis.


Assuntos
Algoritmos , Fármacos Dermatológicos/uso terapêutico , Radiodermatite/tratamento farmacológico , Doença Aguda , Corticosteroides/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Bandagens , Produtos Biológicos/uso terapêutico , Etanolaminas/uso terapêutico , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Preparações de Plantas/uso terapêutico , Radiodermatite/etiologia , Radioterapia/efeitos adversos , Sulfadiazina de Prata/uso terapêutico , Sucralfato/uso terapêutico , Vitaminas/uso terapêutico
18.
Int J Nanomedicine ; 14: 289-300, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30643407

RESUMO

Background: Silver sulfadiazine (AgSD) is widely employed as an antibacterial agent for surface burn management. However, the antibacterial activity of AgSD was restrained because of the lower drug solubility and possible cytotoxicity. Objective: This study aimed to formulate stable silver sulfadiazine/nanosuspensions (AgSD/NSs) with improved AgSD solubility and prepare a suitable carrier for AgSD/NS delivery. Nanotechnology was used to overcome the low drug dissolution rate of AgSD, while the new carrier loaded with AgSD/NS was assumed to decrease the possible cytotoxicity, enhance antibacterial activity, and promote wound healing. Methods: AgSD/NSs were prepared by high pressure homogenization method. Poloxamer 407-based thermoresponsive hydrogels were prepared by cold method as carriers of AgSD/NS to obtain AgSD/NS-loaded thermoresponsive hydrogel. Scanning electron microscope (SEM), Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) were used to measure the physicalchemical properties of AgSD/NSs and AgSD/NS-loaded gel. The cytotoxicity of the AgSD/NS-loaded gel was evaluated using methyl thiazolyltetrazolium assay with L929 mouse fibroblast cell lines. In vitro antibacterial activities of AgSD/NSs and AgSD/NS loaded gel were also measured. Results: Stable AgSD/NSs with an average particle size of 369 nm were formulated while 1.5% P407 was selected as a stabilizer. The optimized AgSD/NS thermoresponsive hydrogel exhibited the gelation temperature of approximately 30°C. A significant improvement in solubility was observed for AgSD nanoparticles (96.7%) compared with AgSD coarse powders (12.5%). The results of FTIR and XRD revealed that the physicochemical properties of AgSD/NS were reserved after incorporating into the hydrogel. The cell viability after incubation with AgSD/NS-loaded thermoresponsive hydrogel improved from 60.7% to 90.6% compared with incubation with AgSD/NS directly. Drug release profiles from the thermoresponsive hydrogel increased compared with the commercial AgSD cream, implying less application frequency of AgSD cream clinically. In vitro antibacterial studies manifested that AgSD nanocrystallization significantly enhanced the antibacterial activity compared with the AgSD coarse powder. Conclusion: The combination of AgSD nanosuspensions and thermoresponsive hydrogel effectively improved the AgSD antibacterial activity and decreased the cytotoxicity. This study also suggested that a poloxamer thermoresponsive hydrogel could be used as a delivery system for other nanocrystals to decrease possible nanotoxicity.


Assuntos
Antibacterianos/administração & dosagem , Bactérias/efeitos dos fármacos , Hidrogéis/administração & dosagem , Nanopartículas/administração & dosagem , Sulfadiazina de Prata/administração & dosagem , Temperatura , Administração Tópica , Animais , Antibacterianos/química , Anti-Infecciosos Locais/administração & dosagem , Anti-Infecciosos Locais/química , Células Cultivadas , Escherichia coli/efeitos dos fármacos , Escherichia coli/metabolismo , Fibroblastos/citologia , Fibroblastos/efeitos dos fármacos , Hidrogéis/química , Camundongos , Nanopartículas/química , Pseudomonas aeruginosa/efeitos dos fármacos , Pseudomonas aeruginosa/metabolismo , Sulfadiazina de Prata/química , Staphylococcus aureus/efeitos dos fármacos , Staphylococcus aureus/metabolismo
19.
Vet Dermatol ; 30(2): 145-e42, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30663140

RESUMO

BACKGROUND: Otitis externa is a common presenting complaint in practice. Ear infections by Pseudomonas aeruginosa are particularly problematic due to the organism's high level of resistance and ability to damage the tympanum. Treatment should be based on susceptibility testing although minimum inhibitory concentrations (MICs) are not available for all treatment options. Silver sulfadiazine has been used in cases of recurrent P. aeruginosa otitis, although a MIC for silver sulfadiazine as a single agent has not been established. OBJECTIVES: To describe susceptibility patterns of P. aeruginosa isolated from canine otitis externa and determine the MIC for silver sulfadiazine and other topical antimicrobials. ANIMALS: Thirty-six P. aeruginosa isolates were collected from client-owned dogs, suffering from otitis externa. METHODS AND MATERIALS: Susceptibility patterns were established using disc diffusion susceptibility testing against 17 antimicrobial agents. For determination of the MIC, selected strains were tested against increasing concentrations of marbofloxacin, enrofloxacin, gentamicin, polymyxin B and silver sulfadiazine using broth microdilution. RESULTS: For nine of 17 antimicrobial agents, complete resistance was seen in all isolates tested via disk diffusion susceptibility testing. Approximately 94% and 96% of isolates were susceptible to gentamicin and imipenem, respectively. These findings were consistent with broth dilution, where all strains were susceptible to gentamicin. Resistance was higher against polymyxin B and the fluoroquinolones. Silver sulfadiazine was effective in vitro with a MIC ranging from 1 to 64 µg/mL. CONCLUSIONS AND CLINICAL SIGNIFICANCE: As the MIC of silver sulfadiazine was lower than the concentration in a 1% preparation, such a product potentially represents a treatment option for dogs with P. aeruginosa otitis.


Assuntos
Anti-Infecciosos Locais/farmacologia , Anti-Infecciosos/farmacologia , Otite Externa/veterinária , Infecções por Pseudomonas/veterinária , Pseudomonas aeruginosa/efeitos dos fármacos , Animais , Cães , Gentamicinas/farmacologia , Testes de Sensibilidade Microbiana , Otite Externa/microbiologia , Polimixina B/farmacologia , Infecções por Pseudomonas/microbiologia , Sulfadiazina de Prata/farmacologia
20.
Wound Repair Regen ; 27(3): 257-267, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30675745

RESUMO

Although partial thickness burns are the most frequently reported burn injuries, there is no consensus on the optimal treatment. The objective of this study was to compare the clinical effectiveness and scar quality of Flaminal® Forte to silver sulfadiazine (Flamazine®) in the treatment of partial thickness burns. In this two-arm open label multicenter randomized controlled trial, adult patients with acute partial thickness burns and an affected total body surface area of less than 30% were randomized between Flaminal® Forte and Flamazine® and followed for 12 months. Dressing changes in the Flamazine® group were performed daily, and in the Flaminal® group during the first 3 days post burn and thereafter every other day until complete wound healing or surgery. Forty-one patients were randomly allocated to Flaminal® Forte and 48 patients to Flamazine®. The primary outcome was time to wound healing, which did not differ between the groups: median 18 days with Flaminal® Forte (range 8-49 days) versus 16 days with Flamazine® (range 7-48 days; p = 0.24). Regarding the secondary outcomes during hospital admission, there were no statistically significant differences between the groups concerning need for surgery, pain scores, pruritus, or pain-related and anticipatory anxiety. More patients in the Flaminal® group developed wound colonization (78% versus 32%, p < 0.001), but the treatment groups did not differ regarding the incidence of local infections and use of systemic antibiotics. In terms of scar quality, no statistically significant differences between both treatment groups were found regarding subjective scar assessment (Patient and Observer Scar Assessment Scale (POSAS)), scar melanin and pigmentation (DermaSpectrometer®), and scar elasticity and maximal extension (Cutometer®) during 12 month postburn. In conclusion, time to wound healing did not differ, but the use of Flaminal® Forte seemed favorable because less dressing changes are needed which lowers the burden of wound care.


Assuntos
Alginatos/uso terapêutico , Anti-Infecciosos Locais/uso terapêutico , Queimaduras/tratamento farmacológico , Cicatriz/patologia , Glucose Oxidase/uso terapêutico , Lactoperoxidase/uso terapêutico , Polietilenoglicóis/uso terapêutico , Sulfadiazina de Prata/uso terapêutico , Cicatrização/efeitos dos fármacos , Infecção dos Ferimentos/patologia , Adulto , Idoso , Alginatos/farmacologia , Anti-Infecciosos Locais/farmacologia , Queimaduras/patologia , Cicatriz/prevenção & controle , Combinação de Medicamentos , Feminino , Glucose Oxidase/farmacologia , Humanos , Lactoperoxidase/farmacologia , Masculino , Pessoa de Meia-Idade , Polietilenoglicóis/farmacologia , Reepitelização/efeitos dos fármacos , Sulfadiazina de Prata/farmacologia , Resultado do Tratamento , Cicatrização/fisiologia , Infecção dos Ferimentos/tratamento farmacológico
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA