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1.
BMC Pulm Med ; 23(1): 24, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653826

RESUMO

BACKGROUND: A tracheal foreign body is a common airway aspiration that creates an emergency, which often causes unobserved respiratory problems and requires management. Iatrogenic tracheal foreign bodies are rarely observed, which results in tracheal obstruction. If the foreign body were removed from the tracheobronchial system, it would save lives. A similar case of a tracheal foreign body was focused on, which was caused by medical glue used during preoperative computed tomography localization of pulmonary nodules. CASE PRESENTATION: The foreign body was deposited in the right upper bronchi, accidentally discovered after anesthesia when a double-lumen tube was located by fiber bronchoscopy. Following a video-assisted thoracoscopic surgery, the foreign body was removed using a respiratory endoscopy without subsequent adverse consequences for the patient. CONCLUSIONS: There is a risk of complications from iatrogenic airway foreign bodies for preoperative localization of pulmonary nodules by injecting cyanoacrylate glue.


Assuntos
Corpos Estranhos , Neoplasias Pulmonares , Nódulos Pulmonares Múltiplos , Nódulo Pulmonar Solitário , Humanos , Cirurgia Torácica Vídeoassistida/métodos , Neoplasias Pulmonares/cirurgia , Neoplasias Pulmonares/etiologia , Cianoacrilatos , Nódulos Pulmonares Múltiplos/cirurgia , Tomografia Computadorizada por Raios X/métodos , Corpos Estranhos/diagnóstico por imagem , Corpos Estranhos/cirurgia , Doença Iatrogênica , Nódulo Pulmonar Solitário/etiologia , Estudos Retrospectivos
4.
Pediatr. aten. prim ; 24(96)oct.- dic. 2022. ilus
Artigo em Espanhol | IBECS | ID: ibc-214397

RESUMO

El cianocrilato es un compuesto adhesivo que se utiliza en la fabricación de “superpegamentos”. En contacto con tejidos de algodón o lana puede producir quemaduras térmicas. Por el contrario, en contacto sobre piel sana se han descrito dermatitis de contacto o alérgica pero no quemaduras. Caso clínico. Niña de 8 años que acude a urgencias tras haber derramado de manera accidental un “superpegamento” directamente sobre una mano y ambas extremidades inferiores, permaneciendo con el pegamento en contacto con la piel durante 3 horas sin poder retirarlo en domicilio. En la exploración destacaba gran eritema en varias regiones subyacentes al pegamento, sin ampollas, heridas ni sangrado. El pegamento se retiró bajo sedoanalgesia con lavavajillas líquido diluido en agua tibia, sin apreciarse solución de continuidad ni quemadura. Conclusiones. Existen numerosas medidas para la retirada de adhesivos de la piel. Escoger la opción terapéutica viene determinado, entre otros factores, por la presencia de lesiones cutáneas bajo el adhesivo. La aplicación de acetona está contraindicada en pieles con lesiones debido a que puede empeorar la irritación de las mismas. La demora hasta la retirada del adhesivo puede influir en el éxito del tratamiento; así como en la aparición de posibles secuelas (AU)


Cyanoacrylate is an adhesive used as a component in most of “super glues”. It can cause thermal burns if in contact with wool or cotton fabric. Nevertheless, in contact with intact skin it can cause contact or allergic dermatitis, but no thermal burns have been described.Clinical case: 8-year-old girl who had suffered an accidental fall of one of these glues directly on one of her hands and both lower extremities, and who had remained with the glue in contact with the skin for 3 hours. On examination we observed erythema on several regions underlying the glue, without blisters, wounds or bleeding. The glue was removed with warm water and detergent. No open wounds or burns were noticed.Conclusions: There are different ways to remove adhesives from the skin. Choosing the correct therapeutic option is determined, among other factors, by the presence of skin lesions under the adhesive. The use of acetone is contraindicated in injured skin because it can worsen the irritation. The delay in the removal of the adhesive can influence the success of the treatment and the type of treatment to be applied. (AU)


Assuntos
Humanos , Feminino , Criança , Cianoacrilatos/efeitos adversos , Dermatite de Contato/etiologia
5.
J Vis Exp ; (190)2022 12 09.
Artigo em Inglês | MEDLINE | ID: mdl-36571418

RESUMO

We present the preliminary results of a longitudinal observational study aimed at evaluating the effectiveness and safety at different short- and long-term follow-ups of vascular occlusion of the great saphenous vein (GSV) and small saphenous vein (SSV) affected by severe pathological reflux, using an innovative modified cyanoacrylate surgical glue composed of N-butyl cyanoacrylate and methacryloxy sulfolane (NBCA+MS). Ninety patients, prospectively recruited for 1 year, underwent the study with EcoColor-Doppler (ECD) to evaluate the maximum diameters of the GSV and SSV in the orthostatic position and the reflux time (RT). An RT greater than 0.5 s was considered pathologic. Clinical, etiology, anatomy, and pathophysiology (CEAP) assessment was used for the complete evaluation of each patient in the study. All the patients were treated by NBCA+MS glue to obtain vein occlusion and observed before treatment (baseline; T0), within 6 h after treatment (T1), 1 month after treatment (T2), 3 months after treatment (T3), 6 months after treatment (T4), and 1 year after treatment (T5). Chi-square (χ) analysis was performed to evaluate the effectiveness and safety of the treatment. All the patients participated in the entire duration of the study. Complete occlusion was maintained in 100% of patients at T1, 98.9% at T2 and T3, and 97.8% at T4 and T5 (p < 0.001). None of the patients suffered from post-surgical thrombosis. No blue hyperpigmentation, or paresthesia was observed during the entire observation period. Immediately after treatment, 7.7% of patients needed painkillers; 1 week after treatment, 100% of patients returned to normal life. Vascular occlusion of the great or small saphenous vein using NBCA+MS glue is a safe procedure with persistent benefits after a 1 year follow-up. This procedure can be performed with local anesthesia, allowing a quick return to normal life. Thanks to its low invasiveness, the treatment is not painful.


Assuntos
Embucrilato , Insuficiência Venosa , Humanos , Embucrilato/efeitos adversos , Insuficiência Venosa/induzido quimicamente , Insuficiência Venosa/cirurgia , Veia Safena/diagnóstico por imagem , Veia Safena/cirurgia , Cianoacrilatos/efeitos adversos , Resultado do Tratamento
6.
Medicine (Baltimore) ; 101(46): e31939, 2022 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-36401384

RESUMO

BACKGROUND: The role of endoscopy in the ligation of gastric varices (GV) remains controversial. This study aimed to evaluate the efficacy of endoscopic band ligation (EBL) using large-volume ligators for the management of non-bleeding GV in patients with cirrhosis. METHODS: One hundred fifty-eight patients with non-bleeding GV due to cirrhosis were divided randomly into 2 groups: the EBL group and the endoscopic variceal obturation (EVO) group. The EBL group underwent EBL with large-volume ligators and the EVO group underwent tissue glue injection for the treatment of GV. Follow-up endoscopy was performed 3 to 4 weeks after endoscopic treatment. Patients were followed up for ≥6 months after treatment. Eradication, complication, and recurrence rates were evaluated and compared between groups. RESULTS: The type and size of GV were similar in both groups. No significant difference was found in the mean number of treatment sessions or eradication and recurrence rates after 6 months. Ulcer bleeding occurred in 2 EBL patients (2.50%) after ligation, whereas 8 EVO patients (10.25%) experienced bleeding due to glue extrusion. The bleeding rate after endoscopic treatment significantly differed between the groups. In the EVO group, 1 patient developed renal embolism after injection and 2 patients developed sepsis. The prevalence of postoperative fever was significantly higher in the EVO group than in the EBL group. CONCLUSION SUBSECTIONS: Large-volume band ligators have similar efficacy to tissue glue for eradicating GV, however, the former is safer. Nevertheless, multicenter studies are needed to further confirm these results.


Assuntos
Varizes Esofágicas e Gástricas , Adesivos Teciduais , Humanos , Cianoacrilatos/uso terapêutico , Estudos Prospectivos , Adesivos Teciduais/uso terapêutico , Varizes Esofágicas e Gástricas/terapia , Varizes Esofágicas e Gástricas/complicações , Hemorragia Gastrointestinal/terapia , Hemorragia Gastrointestinal/cirurgia , Cirrose Hepática/complicações
7.
Allergy Asthma Proc ; 43(6): 529-532, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36335423

RESUMO

Background: 2-Octyl cyanoacrylate, a topical adhesive used for wound closure, is becoming a common cause for rashes in postsurgical patients. There is an increased number of cases of postsurgical contact dermatitis attributable to 2-octyl cyanoacrylate. Localized skin reactions to 2-octyl cyanoacrylate have been described in different case reports, but there are limited case reports of diffuse cutaneous allergic reactions. Objective: The aim of the study was to review our experience in patch testing with cyanoacrylates. Methods: We reported five cases of allergic contact dermatitis to 2-octyl cyanoacrylate, confirmed by a patch test. All the patients experienced a skin reaction a few days after surgery. The patients described an erythematous pruritic rash initially localized over the incision and that subsequently spread to surrounding areas. Two of the five patients developed a more widespread rash, which required a longer duration of systemic steroids. 2-Octyl cyanoacrylate remains an agent of low diagnostic suspicion as the possible cause of contact dermatitis after a surgical procedure. Results: All the patients, but one had a positive reaction to 2-octyl cyanoacrylate on PT. Four had a positive PT result, with one patient having a positive scratch test after a negative PT result. Testing on abraded skin further increased yield. Conclusion: Postsurgical patients should be evaluated by using a patch test if there is a clinical picture suggestive of contact dermatitis.


Assuntos
Dermatite Alérgica de Contato , Exantema , Adesivos Teciduais , Humanos , Alérgenos , Adesivos Teciduais/efeitos adversos , Cianoacrilatos/efeitos adversos , Dermatite Alérgica de Contato/diagnóstico , Dermatite Alérgica de Contato/etiologia
8.
Sci Justice ; 62(5): 556-568, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36336449

RESUMO

Previous studies have identified the potential benefit of the disulfur dinitride (S2N2) process to operationally relevant substrates. However, the majority of this work was conducted on prototype equipment that had substantial differences to the commercialised system (Recover Latent Fingerprint Technology (LFT)) in terms of design and chemical delivery. This paper evaluates the performance of Recover LFT on a problematic exhibit encountered within a fingerprint enhancement laboratory: unfired and fired ammunition. Three pseudo-operational experiments involving non-groomed, naturally handled fingermarks were conducted on the most commonly encountered types of ammunition used in crime in the United Kingdom (UK). In addition, Recover LFT was compared against Superglue Fuming followed by Basic Yellow 40 (BY40) Fluorescent Dye Staining (a commonly used alternative) to ascertain if the process provides added benefit to fingermark recovery rates. The results show that fingermark visualisation on small calibre cartridge cases remains difficult with few marks achieving enough ridge detail for comparison. However, this paper also shows that the novel Recover LFT process, which is still in its infancy and requiring optimisation, is no worse than currently implemented visualisation processes and is therefore worth further investigation.


Assuntos
Dermatoglifia , Armas de Fogo , Humanos , Cianoacrilatos , Corantes Fluorescentes , Tecnologia
9.
Sci Justice ; 62(5): 644-656, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-36336458

RESUMO

The surface structure of mint (as-issued) and handled polymer five pounds sterling banknotes was studied by atomic force microscopy and laser scanning confocal microscopy. A total of 1856 fingermarks on mint and handled banknotes from four different issuing banks (Bank of England, Bank of Scotland, Royal Bank of Scotland and Clydesdale Bank) were visualised with Vacuum Metal Deposition (VMD), Cyanoacrylate Fuming (CAF) and, on Clydesdale Bank notes, magnetic fluorescent powder. VMD was significantly more effective in developing fingermarks on handled banknotes, across all the banks studied, although effectiveness varied with issuing bank. For example, on handled Bank of England notes 45% of marks showed ridge detail with VMD development and 28% with CAF; for Bank of Scotland handled notes success rates were 17% with VMD and 1% with CAF. Microscopy of degraded banknotes showed the loss of intaglio printing and the formation of a cracked surface structure in the handled notes. These features can lead to the trapping of powder, or contaminants, increasing quantity of development agent in fingermark background between the ridges, decreasing contrast and decreasing performance of powder-based fingermark development techniques. These same features can restrict the migration of components of the fingermark, preventing fingermarks degrading through spread of material and thus reducing potential formation of empty prints, so that VMD development is not adversely affected.


Assuntos
Dermatoglifia , Polímeros , Humanos , Pós , Cianoacrilatos/química , Vácuo , Metais
10.
Retin Cases Brief Rep ; 16(6): 731-734, 2022 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-36288620

RESUMO

PURPOSE: We report use of cyanoacrylate (N-butyl-Cyanoacrylate) in previously failed retinal reattachment surgeries for chorio-retinal colobomas. We report the surgical technique, its challenges, and long-term outcomes in three patients who underwent the surgery. METHODS: A chart review of patients with chorio-retinal colobomas and retinal detachment repair with cyanoacrylate at a tertiary eye care center in Nepal. Cyanoacrylate was used to seal colobomatous retinal breaks in eyes which had undergone multiple retinal surgeries with failed outcome. RESULTS: Three eyes that were operated using cyanoacrylate were included. All three patients had attached retina and none of the patients required a long-term tamponading agent. None of the patients underwent head positioning following the surgery. All of the patients had a visual acuity gain of 3/60 or more at the end of 8 months. No adverse or inflammatory reactions were noted. CONCLUSION: We demonstrate that cyanoacrylate is safe and less resource-demanding without a requirement of second surgery to remove a tamponading agent. It could be helpful in eyes with persistent retinal detachment in colobomatous eyes. Because we were able to achieve favorable outcomes without head positioning, we believe it may also be helpful in patients who are not suitable for positioning because of bodily or bony deformities and in retinal detachment with other coexisting trauma.


Assuntos
Coloboma , Embucrilato , Descolamento Retiniano , Perfurações Retinianas , Humanos , Descolamento Retiniano/etiologia , Coloboma/complicações , Cianoacrilatos/uso terapêutico , Perfurações Retinianas/cirurgia , Vitrectomia/métodos , Estudos Retrospectivos , Recurvamento da Esclera/efeitos adversos , Resultado do Tratamento
11.
Biomed Res Int ; 2022: 5249214, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36303586

RESUMO

Tissue adhesives as a physical barrier to microorganism penetration provide an alternative method with many advantages for wound closure in surgical settings compared to the clinical standard. This raises the need of developing and conducting in vitro methods that are sensitive and reproducible to assess their microbial barrier properties. In this study, three different polyurethane-based tissue adhesives with different physicochemical properties were evaluated in comparison to Dermabond® as a clinical gold standard for topical wound closure. Here, physicochemical properties varied in lactide concentration, viscosity, processing, and the full polymerization time. To evaluate the microbial barrier function, a 5 µl aliquot of E. coli Lux inoculum containing at least 1 × 109 CFU/ml was applied to the surface of each test adhesive and sterile filter paper as the control that was placed on an agar plate and incubated at 37°C. Plates were observed for bacterial growth (morphology), the adhesion of the adhesive/filter paper, and bioluminescence after 24, 48, and 72 hours. The data presented in this in vitro model indicated that polyurethane-based tissue adhesives with lactide concentration ≥ 5% provided a suitable barrier against microbial penetration with 95% confidence of 99% efficacy for 72 h along with Dermabond®. Interestingly, the here described method was able to discriminate between the different physicochemical properties showing a better microbial barrier function with increasing lactide concentration of the adhesive. Overall, the results of this study showed the noninferiority between Dermabond® and the two abovementioned polyurethane-based tissue adhesives.


Assuntos
Adesivos Teciduais , Poliuretanos/farmacologia , Escherichia coli , Cianoacrilatos , Adesivos
12.
ACS Appl Mater Interfaces ; 14(37): 41819-41833, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36066351

RESUMO

The use of wire cerclage after sternal closure is the standard method because of its rigidity and strength. Despite this, they have many disadvantages such as tissue trauma, operator-induced failures, and the risk of infection. To avoid complications during sternotomy and promote tissue regeneration, tissue adhesives should be used in post-surgical treatment. Here, we report a highly biocompatible, biomimetic, biodegradable, antibacterial, and UV-curable polyurethane-acrylate (PU-A) tissue adhesive for sternal closure as a supportive to wire cerclage. In the study, PU-As were synthesized with variable biocompatible monomers, such as silk sericin, polyethylene glycol, dopamine, and an aliphatic isocyanate 4,4'-methylenebis(cyclohexyl isocyanate). The highest adhesion strength was found to be 4322 kPa, and the ex vivo compressive test result was determined as 715 kPa. The adhesive was determined to be highly biocompatible (on L-929 cells), biodegradable, and antibacterial (on Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus bacteria). Finally, after opening the sternum of rats, the adhesive was applied to bond the bones and cured with UV for 5 min. According to the results, there was no visible inflammation in the adhesive groups, while some animals had high inflammation in the cyanoacrylate and wire cerclage groups. These results indicate that the adhesive may be suitable for sternal fixation by preventing the disadvantages of the steel wires and promoting tissue healing.


Assuntos
Sericinas , Adesivos Teciduais , Acrilatos , Adesivos , Animais , Antibacterianos/farmacologia , Fios Ortopédicos , Cianoacrilatos , Dopamina , Inflamação , Isocianatos , Polietilenoglicóis/química , Poliuretanos/química , Ratos , Sericinas/farmacologia , Aço , Esterno/cirurgia , Adesivos Teciduais/farmacologia
13.
Int J Biol Macromol ; 221: 1251-1258, 2022 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-36070820

RESUMO

Fungicide-resistant Fusarium has become a threaten to wheat production. Novel fungicide formulations can improve the efficacy of active ingredient and minimize the emergence of resistance. Encapsulation of fungicides in biodegradable carriers, especially, in polysaccharide, is a feasible approach to develop environment-friendly and efficient formulation. This study focused on the synthesis of ethyl cellulose-based phenamacril nano-delivery system by combining emulsion-solvent evaporation and high-pressure homogenization technology to improve the control of fusarium head blight in wheat. Emulsifier 125 and Tersperse 2500 were screened from eleven commonly used surfactants. Emulsifier 125 and Tersperse 2500 in a ratio of 2:1 and phenamacril nanocapsules with the mean particle size of 152.5 ± 1.3 nm were prepared. These showed excellent storage stability and wettability on crop leaves. A bioassay comparing the nanocapsules with a commercial preparation against Fusarium graminearum showed significantly improved biological activity. This formulation could be used to effectively not only to control fusarium head blight but also delay the occurrence of resistance.


Assuntos
Fungicidas Industriais , Fusarium , Nanocápsulas , Cianoacrilatos , Triticum , Doenças das Plantas
14.
Arq Gastroenterol ; 59(3): 434-438, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36102444

RESUMO

BACKGROUND: In natural history of cirrhosis, variceal bleeding is one of the earliest decompensations to happen, and, if adequately managed, survival is improved. Gastric varices have challenges in management due to their location, size and propensity to bleed. The N-butyl 2-cyanoacrylate (NBC) glue application has emerged as definitive therapy in bleeding gastric varices. Here we present our experience with use of NBC in management of gastric and difficult cases of esophageal varices. METHODS: A total of 75 patients underwent NBC glue application for varices which included 69 patients with gastric varices and six patients with esophageal varices. All the procedures were done with flexible endoscope and sclerotherapy needle after due precautionary measures. RESULTS: Hemostasis was varices in all patients after endotherapy. The average quantity of glue used was 2.75±0.95 mL. Complete obliteration with single session of NBC application was achieved in 55 patients. Re-bleeding occurred in five patients within 5 days of index event. 20 patients had in-hospital mortality but none was related to gastrointestinal bleeding. 6-week all-cause mortality was 26 (35%). CONCLUSION: Glue therapy with NBC is a life saving therapy in patients with bleeding gastric varices and esophageal varices not amenable to endoscopic variceal ligation or sclerotherapy.


Assuntos
Embucrilato , Varizes Esofágicas e Gástricas , Varizes , Cianoacrilatos/uso terapêutico , Embucrilato/uso terapêutico , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/terapia , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Humanos , Índia , Resultado do Tratamento , Varizes/complicações
15.
Endoscopy ; 54(11): 1094-1120, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36174643

RESUMO

1: ESGE recommends that patients with compensated advanced chronic liver disease (ACLD; due to viruses, alcohol, and/or nonobese [BMI < 30 kg/m2] nonalcoholic steatohepatitis) and clinically significant portal hypertension (hepatic venous pressure gradient [HVPG] > 10 mmHg and/or liver stiffness by transient elastography > 25 kPa) should receive, if no contraindications, nonselective beta blocker (NSBB) therapy (preferably carvedilol) to prevent the development of variceal bleeding.Strong recommendation, moderate quality evidence. 2: ESGE recommends that in those patients unable to receive NSBB therapy with a screening upper gastrointestinal (GI) endoscopy that demonstrates high risk esophageal varices, endoscopic band ligation (EBL) is the endoscopic prophylactic treatment of choice. EBL should be repeated every 2-4 weeks until variceal eradication is achieved. Thereafter, surveillance EGD should be performed every 3-6 months in the first year following eradication.Strong recommendation, moderate quality evidence. 3: ESGE recommends, in hemodynamically stable patients with acute upper GI hemorrhage (UGIH) and no history of cardiovascular disease, a restrictive red blood cell (RBC) transfusion strategy, with a hemoglobin threshold of ≤ 70 g/L prompting RBC transfusion. A post-transfusion target hemoglobin of 70-90 g/L is desired.Strong recommendation, moderate quality evidence. 4 : ESGE recommends that patients with ACLD presenting with suspected acute variceal bleeding be risk stratified according to the Child-Pugh score and MELD score, and by documentation of active/inactive bleeding at the time of upper GI endoscopy.Strong recommendation, high quality of evidence. 5 : ESGE recommends the vasoactive agents terlipressin, octreotide, or somatostatin be initiated at the time of presentation in patients with suspected acute variceal bleeding and be continued for a duration of up to 5 days.Strong recommendation, high quality evidence. 6 : ESGE recommends antibiotic prophylaxis using ceftriaxone 1 g/day for up to 7 days for all patients with ACLD presenting with acute variceal hemorrhage, or in accordance with local antibiotic resistance and patient allergies.Strong recommendation, high quality evidence. 7 : ESGE recommends, in the absence of contraindications, intravenous erythromycin 250 mg be given 30-120 minutes prior to upper GI endoscopy in patients with suspected acute variceal hemorrhage.Strong recommendation, high quality evidence. 8 : ESGE recommends that, in patients with suspected variceal hemorrhage, endoscopic evaluation should take place within 12 hours from the time of patient presentation provided the patient has been hemodynamically resuscitated.Strong recommendation, moderate quality evidence. 9 : ESGE recommends EBL for the treatment of acute esophageal variceal hemorrhage (EVH).Strong recommendation, high quality evidence. 10 : ESGE recommends that, in patients at high risk for recurrent esophageal variceal bleeding following successful endoscopic hemostasis (Child-Pugh C  ≤ 13 or Child-Pugh B > 7 with active EVH at the time of endoscopy despite vasoactive agents, or HVPG > 20 mmHg), pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) within 72 hours (preferably within 24 hours) must be considered.Strong recommendation, high quality evidence. 11 : ESGE recommends that, for persistent esophageal variceal bleeding despite vasoactive pharmacological and endoscopic hemostasis therapy, urgent rescue TIPS should be considered (where available).Strong recommendation, moderate quality evidence. 12 : ESGE recommends endoscopic cyanoacrylate injection for acute gastric (cardiofundal) variceal (GOV2, IGV1) hemorrhage.Strong recommendation, high quality evidence. 13: ESGE recommends endoscopic cyanoacrylate injection or EBL in patients with GOV1-specific bleeding.Strong recommendations, moderate quality evidence. 14: ESGE suggests urgent rescue TIPS or balloon-occluded retrograde transvenous obliteration (BRTO) for gastric variceal bleeding when there is a failure of endoscopic hemostasis or early recurrent bleeding.Weak recommendation, low quality evidence. 15: ESGE recommends that patients who have undergone EBL for acute EVH should be scheduled for follow-up EBLs at 1- to 4-weekly intervals to eradicate esophageal varices (secondary prophylaxis).Strong recommendation, moderate quality evidence. 16: ESGE recommends the use of NSBBs (propranolol or carvedilol) in combination with endoscopic therapy for secondary prophylaxis in EVH in patients with ACLD.Strong recommendation, high quality evidence.


Assuntos
Varizes Esofágicas e Gástricas , Derivação Portossistêmica Transjugular Intra-Hepática , Humanos , Varizes Esofágicas e Gástricas/complicações , Varizes Esofágicas e Gástricas/diagnóstico , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiologia , Hemorragia Gastrointestinal/terapia , Carvedilol , Endoscopia Gastrointestinal , Cianoacrilatos
16.
J Cardiothorac Surg ; 17(1): 212, 2022 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-36031599

RESUMO

BACKGROUND: To compare clinical and economic outcomes after sternotomy for cardiac surgery with skin closure through 2-octyl cyanoacrylate plus polymer mesh tape (2OPMT) versus conventional absorbable sutures plus waterproof wound dressings (CSWWD). METHODS: Retrospective study using the Premier Healthcare Database. Patients undergoing a cardiac surgery requiring sternotomy with 2OPMT or CSWWD were included. Primary outcome was 60-day cumulative incidence of diagnosis for wound complications (infection, dehiscence). Secondary outcomes were index admission hospital length of stay (LOS), total hospital-borne costs, discharge status, and 60-day cumulative incidences of inpatient readmission and reoperation. After propensity score matching, outcomes were compared between the 2OPMT and CSWWD groups using bivariate multilevel mixed-effects generalized linear models. RESULTS: Overall, 7,901 2OPMT patients and 10,775 CSWWD patients were eligible for study. After propensity score matching on 68 variables, each group comprised 5,338 patients (total study N = 10,676). The 2OPMT and CSWWD groups did not differ significantly in terms of the 60-day cumulative incidences of wound complication (3.47% vs 3.47%, p = 0.996), inpatient readmission (12.6% vs. 13.6%, p = 0.354), and reoperation (10.3% vs 10.1%, p = 0.808), as well as discharge to home versus non-home setting (77.2% vs. 75.1%), p = 0.254. However, the 2OPMT group had significantly lower LOS (9.2 days vs 10.6 days, p < 0.001) and total hospital-borne costs ($50,174 vs $60,526, p < 0.001). CONCLUSIONS: This large observational study provides evidence that sternotomy skin closure with 2OPMT is associated with nearly identical 60-day cumulative incidence of wound complication as compared with CSWWD, while exhibiting a significant association with lower LOS and total hospital-borne costs. Trial registration Not applicable.


Assuntos
Procedimentos Cirúrgicos Cardíacos , Esternotomia , Bandagens , Cianoacrilatos , Humanos , Polímeros , Estudos Retrospectivos , Telas Cirúrgicas , Infecção da Ferida Cirúrgica , Suturas
17.
Nepal J Ophthalmol ; 14(27): 162-167, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-35996914

RESUMO

INTRODUCTION: Ocular Rosacea is a poly etiological chronic inflammatory disease with heterogeneous clinical manifestations. It is primarily a dermatologic disease, which often manifests in the eyes affecting eyelids, conjunctiva, and cornea. The leading role in the pathological process belongs to the disruption of regulatory mechanisms in the vascular, immune, and nervous systems. The varied manifestation can be erythematous pustular lesions on the face, chronic blepharitis, meibomian gland dysfunction, evaporative dry eye, peripheral corneal ulceration, corneal scarring, perforation, and neovascularization. CASE: We describe a rare case report of a 43-year-old male with progressive ocular manifestations of rosacea keratitis. Slit-lamp biomicroscopic examination revealed squamous blepharitis, telangiectatic vessels with obliterated meibomian glands, circumcorneal congestion, peripheral corneal perforation of 2x2 mm at 4 0 clock, shallow anterior chamber(AC) with positive seidel's in the left eye. Fundoscopy showed serous choroidal detachment(CD). Snellen's Best Corrected Visual Acuity(BCVA) was 20/240 with Intraocular pressure measured was 5 mmhg. The patient was managed with topical loteprednol, moxifloxacin, carboxymethylcellulose medications along with cyanoacrylate glue and bandage contact lens and had excellent visual acuity of 20/20 with a follow-up of 1 year. CONCLUSION: Ocular rosacea perforation has been reported in chronic cases and may not always require amniotic membrane transplant, patch grafting, or keratoplasty. If managed meticulously with cyanoacrylate glue and BCL can have excellent outcomes. Eye specialists should be alerted that the key to a successful outcome is excellent control of inflammatory activity and differentiating this non-infectious keratitis from other keratitis before commencing treatment.


Assuntos
Blefarite , Perfuração da Córnea , Ceratite , Rosácea , Adulto , Perfuração da Córnea/diagnóstico , Perfuração da Córnea/etiologia , Perfuração da Córnea/cirurgia , Cianoacrilatos/uso terapêutico , Humanos , Masculino , Rosácea/complicações , Rosácea/diagnóstico
18.
J Forensic Sci ; 67(6): 2267-2277, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35997310

RESUMO

Following a chemical incident involving chemical warfare agents or more broadly, chemical weapons, there are two possible approaches in dealing with the traditional forensic analysis of contaminated exhibits. The first is to analyze the contaminated items under safe conditions (i.e. in laboratories dedicated to the handling of such substances), while the second relies on item decontamination prior to processing them in traditional forensic laboratories. One of the main limitations of the latter is the possible degradation or destruction of traces caused by the decontamination process. Hence, it is crucial to have as much information as possible on the impact of different decontamination agents and procedures on traces. This research presents experimental results on the recovery of fingermarks on glass after the application of decontaminants typically used in case of chemical incidents. The impact of 11 decontaminants on fingermarks deposited on glass and on the subsequent enhancement with cyanoacrylate and Small Particle Reagent (SPR) was evaluated (by visual examination) by four evaluators. The results of the study demonstrated that the persistence of fingermarks on glass is highly dependent on the type of decontaminant used. Decontamination agents based on the principle of nucleophilic substitution to neutralize toxic chemicals allowed good subsequent development of fingermarks with SPR. Powdered decontaminants did not show any indication of alteration of fingermarks, whereas decontamination with oxidants leads to variable results.


Assuntos
Substâncias para a Guerra Química , Substâncias para a Guerra Química/toxicidade , Descontaminação/métodos , Vidro , Cianoacrilatos , Medicina Legal , Indicadores e Reagentes , Dermatoglifia
19.
J Vasc Surg Venous Lymphat Disord ; 10(6): 1198-1200, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35970306

RESUMO

International evidence-based guidelines recommend preoperative duplex ultrasound mapping in the assessment of chronic venous disease, and concurrent ultrasound imaging to guide superficial endovenous interventions such as endovenous laser ablation, radiofrequency ablation, cyanoacrylate adhesive closure, and sclerotherapy (ultrasound-guided sclerotherapy). Other imaging modalities such as venography, alone or in combination with computed tomography scan or magnetic resonance imaging, may be included in the preoperative assessment of a small and select group of patients to exclude central venous obstruction, certain deep venous pathologies, pelvic origin extrapelvic varices, and complex vascular malformations. The signatory scientific and medical societies recommend against the routine use of fluoroscopy and other radiation-based imaging in the investigation and treatment of superficial venous disease.


Assuntos
Varizes , Insuficiência Venosa , Austrália , Cianoacrilatos , Fluoroscopia , Humanos , Nova Zelândia , Radiologia Intervencionista , Veia Safena/cirurgia , Escleroterapia , Estados Unidos , Varizes/diagnóstico por imagem , Varizes/cirurgia , Procedimentos Cirúrgicos Vasculares , Insuficiência Venosa/diagnóstico por imagem , Insuficiência Venosa/cirurgia
20.
Biofouling ; 38(6): 593-604, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35924694

RESUMO

The deep sea survivability and biofouling characteristics of corrosion-resistant bulk carbon nanotubes (CNTs) have been studied after deployment in the Atlantic Ocean over the course of 12 months. Quantification of barnacle count, biofouling density, and non-combustible residue shows cyanoacrylate coatings increase durability and reduce the colonization of biofouling compared to as-received CNTs. Scanning electron microscopy was performed on the biofouled CNTs, and the majority of species were identified as diatoms, consisting of an ordered silica cell wall. Both the as-received and cyanoacrylate-treated CNTs were successfully acid purified to remove biogrowth, leading to complete recovery of tensile strength and electrical transport properties. Thermogravimetric analysis, scanning electron microscopy, contact angle, dynamic mechanical analysis, and current carrying capacity measurements validated the refunctionalization results. Thus, the multifunctional property recovery and enhanced durability confirms that CNTs are electrochemically stable in saltwater environments and are resilient to biofouling conditions in real-world environments after extended exposure.


Assuntos
Incrustação Biológica , Nanotubos de Carbono , Biofilmes , Incrustação Biológica/prevenção & controle , Cianoacrilatos , Microscopia Eletrônica de Varredura , Nanotubos de Carbono/química
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