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1.
Int J Med Sci ; 18(16): 3708-3711, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34790043

RESUMO

Deterioration of drugs due to light exposure is one of the major concerns, especially regarding protection of high-calorie infusion solutions, lightproof covers are used in hospitals. In the absence of any set standards regarding their usage, they are often reused. This study aimed to investigate bacterial contamination of lightproof covers used in hospital wards. For this, lightproof covers which had been used or stored in wards were collected and bacterial cultures were carried out from them. Examination of the cultures revealed that bacteria were present in the used lightproof covers. The bacterial species detected in the used lightproof covers were Bacillus species Coagulase-negative Staphylococci (CNS) and Methicillin-resistant Staphylococcus aureus (MRSA). Bacillus species and CNS were also detected in lightproof covers stored in wards, whereas MRSA was not detected. Intestinal bacteria were detected in only one lightproof cover. However, no bacteria were detected from either inside or outside of the unused lightproof covers that were stored in the drugs department. After allowing the unused lightproof covers stored in the drugs department to stand for 24 h, Bacillus species and CNS were detected in only one of the covers, whereas no bacteria was detected in other covers. These results indicate that there is a risk of bacterial contamination in the reuse of lightproof covers and that they should either be disposed off properly after usage or hand, finger disinfectants should be used while handling them to prevent any possible contamination.


Assuntos
Embalagem de Medicamentos/instrumentação , Contaminação de Equipamentos , Equipamentos e Provisões Hospitalares/microbiologia , Solução Hipertônica de Glucose , Bacillus/isolamento & purificação , Infecção Hospitalar/prevenção & controle , Armazenamento de Medicamentos , Solução Hipertônica de Glucose/efeitos da radiação , Solução Hipertônica de Glucose/uso terapêutico , Hospitais , Humanos , Japão , Luz/efeitos adversos , Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Testes de Sensibilidade Microbiana , Soluções de Nutrição Parenteral/efeitos da radiação , Soluções de Nutrição Parenteral/uso terapêutico , Staphylococcus aureus/isolamento & purificação
2.
Sci Rep ; 11(1): 14638, 2021 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-34282199

RESUMO

Hypertonic dextrose prolotherapy (DPT) has been reported to be effective for temporomandibular disorders (TMDs) in clinical trials but its overall efficacy is uncertain. To conduct a systematic review with meta-analysis of randomized controlled trials (RCTs) to synthesize evidence on the effectiveness of DPT for TMDs. Eleven electronic databases were searched from their inception to October, 2020. The primary outcome of interest was pain intensity. Secondary outcomes included maximum inter-incisal mouth opening (MIO) and disability score. Studies were graded by "Cochrane risk of bias 2" tool; if data could be pooled, a meta-analysis was performed. Ten RCTs (n = 336) with some to high risk of bias were included. In a meta-analysis of 5 RCTs, DPT was significantly superior to placebo injections in reducing TMJ pain at 12 weeks, with moderate effect size and low heterogeneity (Standardized Mean Difference: - 0.76; 95% CI - 1.19 to - 0.32, I2 = 0%). No statistically significant differences were detected for changes in MIO and functional scores. In this systematic review and meta-analysis, evidence from low to moderate quality studies show that DPT conferred a large positive effect which met criteria for clinical relevance in the treatment of TMJ pain, compared with placebo injections.Protocol registration at PROSPERO: CRD42020214305.


Assuntos
Glucose/administração & dosagem , Proloterapia , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Adolescente , Adulto , Feminino , Solução Hipertônica de Glucose/administração & dosagem , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Dor/tratamento farmacológico , Dor/epidemiologia , Manejo da Dor/métodos , Manejo da Dor/estatística & dados numéricos , Proloterapia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto/estatística & dados numéricos , Articulação Temporomandibular/efeitos dos fármacos , Articulação Temporomandibular/patologia , Transtornos da Articulação Temporomandibular/epidemiologia , Resultado do Tratamento , Adulto Jovem
3.
J Cardiothorac Surg ; 16(1): 149, 2021 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-34049583

RESUMO

BACKGROUND: To retrospectively assess the efficacy of hypertonic glucose pleurodesis for treatment of chylothorax after pulmonary resection. METHODS: Out of a total of 8252 patients who underwent pulmonary resection (at least lobectomy) at department of thoracic surgery, between June 2008 and December 2015, 58 patients (0.7%) developed postoperative chylothorax. All patients received conservative treatment, including thoracic closed drainage, oral fasting, and total parenteral nutrition. RESULTS: Conservative treatment was successful in 50 (86.2%) patients, while eight patients [mean age: 58.0 years (range, 45-75)] were treated with hypertonic glucose pleurodesis. All eight patients had undergone operation for lung cancer (four squamous cell carcinomas and four adenocarcinomas). The bronchial stump was covered by pleural flap in three patients. After pleurodesis, three patients developed fever but without empyema; thoracentesis was performed in two patients. The mean time interval between pleurodesis and operation was 4.3 days (range,3-5) days. The average length of stay was 23.1 days (range, 18-31). No recurrent pleural effusion was observed over a mean follow-up duration of 28 months. CONCLUSION: Hypertonic glucose pleurodesis performed via the chest drainage tube is a viable treatment option for chylothorax after lung resection, prior to resorting to a thoracoscopic or thoracotomic ductus thoracicus ligation of the thoracic duct leak. It is a simple, safe and efficient modality associated with rapid recovery and less pain.


Assuntos
Quilotórax/terapia , Solução Hipertônica de Glucose/administração & dosagem , Neoplasias Pulmonares/cirurgia , Pleurodese/métodos , Pneumonectomia/efeitos adversos , Complicações Pós-Operatórias/terapia , Adenocarcinoma/cirurgia , Adulto , Carcinoma de Células Escamosas/cirurgia , Tubos Torácicos , Quilotórax/diagnóstico por imagem , Quilotórax/etiologia , Drenagem , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Pulmonares/efeitos adversos , Radiografia , Estudos Retrospectivos , Ducto Torácico/cirurgia
5.
BMC Microbiol ; 20(1): 203, 2020 07 09.
Artigo em Inglês | MEDLINE | ID: mdl-32646366

RESUMO

BACKGROUND: Pseudomonas aeruginosa is the most common Gram-negative pathogen responsible for chronic wound infections, such as diabetic foot infections, and further exacerbates the treatment options and cost of such conditions. Hypertonic glucose, a commonly used prolotherapy solution, can accelerate the proliferation of granulation tissue and improve microcirculation in wounds. However, the action of hypertonic glucose on bacterial pathogens that infect wounds is unclear. In this study, we investigated the inhibitory effects of hypertonic glucose on multidrug-resistant P. aeruginosa strains isolated from diabetic foot infections. Hypertonic glucose represents a novel approach to control chronic wound infections caused by P. aeruginosa. RESULTS: Four multidrug-resistant P. aeruginosa clinical strains isolated from diabetic foot ulcers from a tertiary hospital in China and the reference P. aeruginosa PAO1 strain were studied. Hypertonic glucose significantly inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa clinical strains and PAO1. Furthermore, hypertonic glucose significantly reduced the production of pyocyanin and elastase virulence factors in P. aeruginosa. The expression of major quorum sensing genes (lasI, lasR, rhlI, and rhlR) in P. aeruginosa were all downregulated in response to hypertonic glucose treatment. In a Galleria mellonella larvae infection model, the administration of hypertonic glucose was shown to increase the survival rates of larvae infected by P. aeruginosa strains (3/5). CONCLUSIONS: Hypertonic glucose inhibited the growth, biofilm formation, and swimming motility of P. aeruginosa, as well as reduced the production of virulence factors and quorum sensing gene expression. Further studies that investigate hypertonic glucose therapy should be considered in treating chronic wound infections.


Assuntos
Farmacorresistência Bacteriana Múltipla/efeitos dos fármacos , Solução Hipertônica de Glucose/farmacologia , Pseudomonas aeruginosa/crescimento & desenvolvimento , Fatores de Virulência/genética , Proteínas de Bactérias/genética , Biofilmes/efeitos dos fármacos , China , Pé Diabético/microbiologia , Regulação Bacteriana da Expressão Gênica/efeitos dos fármacos , Humanos , Testes de Sensibilidade Microbiana , Viabilidade Microbiana/efeitos dos fármacos , Elastase Pancreática/genética , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/isolamento & purificação , Pseudomonas aeruginosa/patogenicidade , Piocianina/genética , Percepção de Quorum , Centros de Atenção Terciária
6.
Ann Fam Med ; 18(3): 235-242, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32393559

RESUMO

PURPOSE: To test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA). METHODS: A single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score. The secondary outcomes were the WOMAC composite, function and stiffness scores; objectively assessed physical function test results; visual analogue scale (VAS) for knee pain; and EuroQol-5D score. All outcomes were evaluated at baseline and at 16, 26, and 52 weeks using linear mixed model. RESULTS: Randomization produced similar groups. The WOMAC pain score at 52 weeks showed a difference-in-difference estimate of -10.34 (95% CI, -19.20 to -1.49, P = 0.022) points. A similar favorable effect was shown on the difference-in-difference estimate on WOMAC function score of -9.55 (95% CI, -17.72 to -1.39, P = 0.022), WOMAC composite score of -9.65 (95% CI, -17.77 to -1.53, P = 0.020), VAS pain intensity score of -10.98 (95% CI, -21.36 to -0.61, P = 0.038), and EuroQol-5D VAS score of 8.64 (95% CI, 1.36 to 5.92, P = 0.020). No adverse events were reported. CONCLUSION: Intra-articular dextrose prolotherapy injections reduced pain, improved function and quality of life in patients with KOA compared with blinded saline injections. The procedure is straightforward and safe; the adherence and satisfaction were high.


Assuntos
Solução Hipertônica de Glucose/administração & dosagem , Osteoartrite do Joelho/tratamento farmacológico , Proloterapia/métodos , Idoso , Análise por Conglomerados , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Medição da Dor , Método Simples-Cego , Resultado do Tratamento
7.
Acta Sci Pol Technol Aliment ; 19(1): 37-45, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32227696

RESUMO

BACKGROUND: The onion is one of the most popular vegetables in the world, often used in the food industry. The purpose of this work was to determine the effect of osmotic dehydration of onions after storage in solutions containing various amounts of sucrose and sodium chloride on the course of osmoconcentration and the level of polyphenols in the dehydrated vegetables. The results could be useful to define the dehydration conditions under which a product retains the highest content of these health-promoting substances. METHODS: Onions var. Robusta were used. The vegetables were stored for six months at 0°C (air relative humidity 75–80%). They were cut into quarters just before dewatering. Samples of 20 ±1 g were dehydrated for five hours in a 40–60°Bx sucrose solution and a 5–15% NaCl solution (25°C); the weight ratio of the sample to the solution was 1:5. The contents of polyphenols and dry matter were determined. RESULTS: The use of a mixture of two osmotic agents (sucrose, sodium chloride) was more effective in the increase of dry matter content than using only sucrose. Nearly 49% dry matter content in onion was obtained by using a 60% solution (50% sucrose + 10% NaCl) for five hours. The greatest differences in the content of total polyphenols occurred during the first hour. After this time, retention amounted to 48–90%, depending on the concentration of sucrose (40–60%) and sodium chloride (5–15%). The retention of diglycosides of quercetin (mainly quercetin-3,4’-diglucoside) was lower than that of monoglycosides (mainly quercetin-4’- -glucoside). Following dehydration in a solution containing 60% sucrose and 10% NaCl, after three hours, there was about one third of the initial amount of the above-mentioned compounds in onion. CONCLUSIONS: The increase in the concentration of the hypertonic solution, being a mixture of sucrose and sodium chloride, causes a reduction in the retention of total polyphenols in osmotically dehydrated onions. The smallest losses occur after applying a 40% sucrose solution with NaCl up to 10%.


Assuntos
Dessecação , Solução Hipertônica de Glucose/química , Cebolas/química , Polifenóis/química , Solução Salina Hipertônica/química , Osmose , Cloreto de Sódio/química , Sacarose/química , Água
8.
Pak J Pharm Sci ; 33(2): 589-595, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32276902

RESUMO

This work presents a pilot method of hematological diagnosis about changes in: shape, size and rouleaux formation, cell count of leucocytes and platelet cells in the presence of different glucose [C6H12O6] and water [H2O] concentrations. The 2D microscopic images after addition of ten different glucose concentrations to normal blood (0 mM- 450 mM) revealed the lyses (disintegration) of white blood cells (WBCs). This work provides a baseline to diagnose blood disorders and complications at labs and clinical environment.


Assuntos
Plaquetas/efeitos dos fármacos , Forma Celular/efeitos dos fármacos , Solução Hipertônica de Glucose/toxicidade , Leucócitos/efeitos dos fármacos , Água/efeitos adversos , Plaquetas/metabolismo , Plaquetas/patologia , Forma Celular/fisiologia , Destilação , Relação Dose-Resposta a Droga , Solução Hipertônica de Glucose/administração & dosagem , Humanos , Hiperglicemia/sangue , Hiperglicemia/induzido quimicamente , Leucócitos/metabolismo , Leucócitos/patologia , Masculino , Água/administração & dosagem
9.
Acta Anaesthesiol Scand ; 64(5): 570-578, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31863457

RESUMO

The distribution and elimination kinetics of the water volume in infusion fluids can be studied by volume kinetics. The approach is a modification of drug pharmacokinetics and uses repeated measurements of blood hemoglobin and urinary excretion as input variables in (usually) a two-compartment model with expandable walls. Study results show that crystalloid fluid has a distribution phase that gives these fluids a plasma volume expansion amounting to 50%-60% of the infused volume as long as the infusion lasts, while the fraction is reduced to 15%-20% within 30 minutes after the infusion ends. Small volumes of crystalloid barely distribute to the interstitium, whereas rapid infusions tend to cause edema. Fluid elimination is very slow during general anesthesia due to the vasodilatation-induced reduction of the arterial pressure, whereas elimination is less affected by hemorrhage. The half-life is twice as long for saline than for Ringer solutions. Elimination is slower in conscious males than conscious females, and high red blood cell and thrombocyte counts retard both distribution and re-distribution. Children have faster turnover than adults. Plasma volume expansions are similar for glucose solutions and Ringer's, but the expansion duration is shorter for glucose. Concentrated urine before and during infusion slows down the elimination of crystalloid fluid. Colloid fluids have no distribution phase, an intravascular persistence half-life of 2-3 hours, and-at least for hydroxyethyl starch-the ability to reduce the effect of subsequently infused crystalloids. Accelerated distribution due to degradation of the endothelial glycocalyx layer has not yet been demonstrated.


Assuntos
Anestésicos/farmacocinética , Soluções Cristaloides/farmacocinética , Hidratação/métodos , Solução Hipertônica de Glucose/farmacocinética , Solução de Ringer/farmacocinética , Solução Salina/farmacocinética , Adulto , Fatores Etários , Criança , Feminino , Humanos , Cinética , Masculino , Fatores Sexuais
10.
Dermatol Surg ; 45(6): 829-835, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31136357

RESUMO

BACKGROUND: Atrophic acne facial scars still pose a treatment challenge. Needle-free high-pressure pneumatic injection has recently been introduced; however, few studies exist regarding its effectiveness. OBJECTIVE: To evaluate the efficacy and safety of pneumatic injection for treating atrophic acne scars using a 3-dimensional optical profiling system. METHODS AND MATERIALS: A pneumatic injection device with a 0.2-mm nozzle diameter, 50% pressure power, and 85-µL injection volume was used. The degree of depression was examined and analyzed using a 3-dimensional optical profiling system and clinical photographs. The patients also evaluated any side effects. Each subject underwent a single treatment session and was followed up after 1 and 2 months. RESULTS: A total of 13 atrophic acne scars from 10 Korean men and women aged 20 to 29 (mean age 25.8 ± 2.4) years were studied. The mean scar volume values were 0.964, 0.741, and 0.566 mm, respectively, at baseline, 1 month, and 2 months after the injection. Scar volumes after 2 months were significantly different compared with baseline volumes. However, there was no significant difference between the baseline and 1-month volumes. CONCLUSION: Treatment with pneumatic injection is safe and effective in reducing atrophic acne facial scars; it results in quantitative improvement in scar volumes.


Assuntos
Acne Vulgar/patologia , Atrofia/terapia , Cicatriz/terapia , Preenchedores Dérmicos/administração & dosagem , Ácido Hialurônico/administração & dosagem , Soluções/administração & dosagem , Acne Vulgar/complicações , Acne Vulgar/diagnóstico por imagem , Adulto , Atrofia/diagnóstico por imagem , Atrofia/etiologia , Atrofia/patologia , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Face , Feminino , Solução Hipertônica de Glucose/administração & dosagem , Humanos , Imageamento Tridimensional , Injeções , Masculino , Fotografação , Pressão , Estudos Prospectivos , Resultado do Tratamento , Adulto Jovem
11.
Int Wound J ; 16(4): 909-915, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30972904

RESUMO

Povidone-iodine is known for successfully treating surgical wounds; the combination between povidone-iodine and sugar, also called Knutson's formula, has been proposed to improve wound healing. Currently, no studies have investigated the effects of Knutson's formula to treat defects in wound closure following radio-chemotherapy in the head and neck region. The aim of this study is to evaluate the efficacy of Knutson's formula in improving the wound-healing process in patients who underwent radio-chemotherapy after surgery for head and neck cancer. The study, conducted from August 2013 to January 2017, included a sample of 34 patients (25 males and 9 females; age range: 60-75 years) treated with radio-chemotherapy after head and neck cancer surgery. All patients suffered from defect of wound regeneration. Patients were randomly divided into two groups: patients in the study group (n = 18) were treated with Knutson's formula; patients in the control group (n = 16) were treated with traditional topical drugs. In the study group, 16 of 18 (88.9%) patients reached complete wound closure 1 month after treatment, with no wound infections. In the control group, only three patients (18.7%) showed complete wound closure within a month; in addition, one patient required systemic antibiotic treatment because of supra-bacterial infection of the wound. In our sample, the combination of povidone-iodine and sugar had a higher success rate compared with traditional topical treatment in the treatment of wound defect closure in oncological patients who underwent radio-chemotherapy.


Assuntos
Anti-Infecciosos Locais/uso terapêutico , Antineoplásicos/efeitos adversos , Solução Hipertônica de Glucose/uso terapêutico , Neoplasias de Cabeça e Pescoço/cirurgia , Povidona-Iodo/uso terapêutico , Radioterapia/efeitos adversos , Deiscência da Ferida Operatória/etiologia , Infecção da Ferida Cirúrgica/tratamento farmacológico , Administração Tópica , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Deiscência da Ferida Operatória/fisiopatologia , Cicatrização/efeitos dos fármacos
12.
J Cosmet Dermatol ; 18(2): 487-494, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30146720

RESUMO

BACKGROUND: Transcutaneous pneumatic injection (TPI) is a minimally invasive, needle-free modality that can be used to forcefully deliver solution into soft tissues of the face and scalp. OBJECTIVE: To evaluate the effects of TPI of 5% isotonic and 20% hypertonic glucose solutions in in vivo human skin for face lifting. METHODS AND MATERIALS: A prospective, split-face, evaluator-blinded comparison study was performed on 10 Korean participants who were treated with three sessions of TPI using 5% isotonic and 20% hypertonic glucose solutions. RESULTS: The following assessment parameters were improved after TPI therapy using 5% isotonic glucose solution in descending order of mean global aesthetic improvement scale (GAIS) score: perioral expression wrinkles, zygomatic wrinkles or mid-cheek furrows, eyebrow ptosis, jowl sagging, marionette line, horizontal forehead lines, nasolabial folds, and blepharochalasis. Meanwhile, TPI therapy using 20% hypertonic glucose solution improved the following assessment parameters: zygomatic wrinkles or mid-cheek furrows, perioral expression wrinkles, eyebrow ptosis, blepharochalasis, marionette line, jowl sagging, nasolabial folds, and horizontal forehead lines. Linear mixed models revealed a significant interaction between treatment groups and time. CONCLUSION: Our data demonstrated that TPI treatment with 20% hypertonic glucose solution elicited earlier and more pronounced therapeutic responses, compared to 5% isotonic glucose solution.


Assuntos
Solução Hipertônica de Glucose/administração & dosagem , Glucose/administração & dosagem , Rejuvenescimento , Ritidoplastia/métodos , Cadáver , Estética , Feminino , Humanos , Injeções a Jato , Soluções Isotônicas , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Pele/efeitos dos fármacos , Resultado do Tratamento
13.
Adv Rheumatol ; 59: 39, 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1088635

RESUMO

Abstract Background: To evaluate the efficacy and safety of prolotherapy with hypertonic dextrose in patients with knee osteoarthritis. A systematic search was performed in electronic databases including PUBMED, SCIELO, DIALNET and Google Scholar. Main body: We searched for randomized clinical trials that evaluated therapeutic interventions in patients with knee osteoarthritis. These trials compared the effect of intra-articular and / or extra-articular infiltrations of hypertonic dextrose vs the effect of intra-articular and / or extra-articular infiltrations of other substances or some interventional procedure application, via assessing pain, physical function and secondary effects and / or adverse reactions. Ten randomized clinical trials were included in this systematic review, the total sample size comprised 328 patients treated with hypertonic dextrose (prolotherapy) vs 348 controls treated with other infiltrations such as local anesthetics, hyaluronic acid, ozone, platelet-rich plasma or interventional procedures like radiofrequency. Conclusions: In terms of pain reduction and function improvement, prolotherapy with hypertonic dextrose was more effective than infiltrations with local anesthetics, as effective as infiltrations with hyaluronic acid, ozone or radiofrequency and less effective than PRP and erythropoietin, with beneficial effect in the short, medium and long term. In addition, no side effects or serious adverse reactions were reported in patients treated with hypertonic dextrose. Although HDP seems to be a promising interventional treatment for knee OA, more studies with better methodological quality and low risk of bias are needed to confirm the efficacy and safety of this intervention.


Assuntos
Humanos , Osteoartrite do Joelho/tratamento farmacológico , Proloterapia/instrumentação , Solução Hipertônica de Glucose/uso terapêutico , Avaliação em Saúde , Resultado do Tratamento
14.
Biomater Sci ; 7(1): 220-232, 2018 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-30426979

RESUMO

For the inactivation or removal of bacterial biofilms via chemical or physical processes, it is crucial to sufficiently wet the biofilm surface. However, many bacterial biofilms efficiently resist wetting by water, oil or even organic solvents. Here, we demonstrate how exposing the surface of mature biofilm colonies to concentrated ethanol, saline or glucose solutions results in topographical changes that enable their wettability. With this approach, even omniphobic biofilm colonies become wettable towards aqueous solutions and oils. As a result of this reduced liquid repellency, the biofilms become susceptible to erosion by water which allows for their removal from the substrate they have been grown on. Moreover, bacteria within pre-treated biofilms can now be inactivated with antibiotic solutions. Thus, the biofilm treatment strategy presented here presents a new stepping stone for fighting biofilms in either industrial or medical settings.


Assuntos
Antibacterianos/farmacologia , Bactérias/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Etanol/farmacologia , Solução Hipertônica de Glucose/farmacologia , Solução Salina Hipertônica/farmacologia , Estresse Mecânico , Molhabilidade/efeitos dos fármacos
15.
J Prev Med Public Health ; 51(4): 205-212, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30071708

RESUMO

OBJECTIVES: The main purpose of this study was to quantify the risk of mortality linked to various regimens of hypertonic peritoneal dialysis (PD) solution. METHODS: A retrospective cohort study of patients using home-based PD was carried out. The prescribed regimen of glucose-based PD solution for all patients, determined on the basis of their individual conditions, was extracted from their medical chart records. The primary outcome was death. The treatment regimens were categorized into 3 groups according to the type of PD solution used: original PD (1.5% glucose), shuffle PD (1.5 and 2.5% glucose), and serialized PD (2.5 and 4.5% glucose). Multivariate analysis (using the Weibull model) was applied to comprehensively examine survival probabilities related to the explanatory variable, while adjusting for other potential confounders. RESULTS: Of 300 consecutive patients, 38% died over a median follow-up time of 30 months (interquartile range: 15-46 months). Multivariate analysis showed that a treatment regimen with continued higher-strength PD solution (serialized PD) resulted in a lower survival rate than when the conventional strength solution was used (adjusted hazard ratio, 2.6; 95% confidence interval, 1.6 to 4.6, p<0.01). Five interrelated risk factors (age, length of time on PD, hemoglobin levels, albumin levels, and oliguria) were significant predictors contributing to the outcome. CONCLUSIONS: Frequent exposure to high levels of glucose PD solution significantly contributed to a 2-fold higher rate of death, especially when hypertonic glucose was prescribed continuously.


Assuntos
Solução Hipertônica de Glucose/uso terapêutico , Nefropatias/mortalidade , Diálise Peritoneal , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Complicações do Diabetes/patologia , Feminino , Hemoglobinas/análise , Humanos , Nefropatias/terapia , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Taxa de Sobrevida , Adulto Jovem
16.
J Oral Rehabil ; 45(12): 998-1006, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30024045

RESUMO

OBJECTIVE: The aim of the systematic review was to analyse the available evidence in order to assess the efficacy of dextrose prolotherapy in improving outcomes in temporomandibular joint (TMJ) hypermobility patients as compared to placebo. METHODS: An electronic search of PubMed, Scopus, CENTRAL and Google scholar databases was performed for English language papers published up to February 2018. Randomised clinical trials (RCTs) and controlled clinical trials (CCTs) comparing dextrose prolotherapy with placebo for TMJ hypermobility were included. RESULTS: Three RCTs were included in the review. Frequency of subluxation/dislocation was reported by two trials which found no difference between dextrose and placebo. A statistical significant difference in reduction of MMO with the use of dextrose prolotherapy was seen on pooling of data (random: MD = -3.32, 95% CI -5.26 to -1.28; P = 0.0008; I2  = 0%). A statistical significant difference in pain reduction was also seen with dextrose as compared to placebo (random: MD = -1, 95% CI -1.58 to -0.42; P = 0.0007; I2  = 0%). CONCLUSION: Within the limitations of the study, dextrose prolotherapy may cause significant reduction in mouth opening and pain associated with TMJ hypermobility. Conclusions with regard to reduction of episodes of subluxation/dislocation cannot be drawn. There is a need of more high-quality RCTs with larger sample size and homogenous prolotherapy protocol to draw stronger conclusions on the effect of dextrose prolotherapy in patients with TMJ hypermobility.


Assuntos
Anestésicos Locais/administração & dosagem , Dor Facial/tratamento farmacológico , Solução Hipertônica de Glucose/administração & dosagem , Instabilidade Articular/tratamento farmacológico , Proloterapia , Transtornos da Articulação Temporomandibular/tratamento farmacológico , Dor Facial/fisiopatologia , Humanos , Injeções Intra-Articulares , Instabilidade Articular/fisiopatologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Transtornos da Articulação Temporomandibular/fisiopatologia , Resultado do Tratamento
17.
J Cosmet Dermatol ; 17(3): 373-379, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29024489

RESUMO

BACKGROUND: Intense focused ultrasound (IFUS) has demonstrated moderate efficacy for facial laxity of the aging face. Pressure- and dose-controlled transcutaneous pneumatic injections of hypertonic glucose solution (TPIG) are a minimally invasive way to deliver solution into the skin for therapeutic purposes. Recently, its application around temporal areas is known to exert early-onset lifting effects with facial contour rejuvenation. AIMS: We sought to evaluate the safety and efficacy of this novel combination regimen with IFUS and TPIG for lifting and tightening of aging face. PATIENTS AND METHODS: Twenty-two Korean subjects with mild-to-moderate facial skin laxity were evaluated after receiving a sequential single session of IFUS and TPIG treatments. Dermatologists' objective assessments for general appearance, and mid- and low faces based on photographic images were performed at 1- and 12-week post-treatment follow-ups. Patients' subjective assessments were also conducted. Skin biopsies were taken at baseline and the last visit. RESULTS: Among 22 subjects, twenty (91%) demonstrated improvement after 12-week follow-up. We also observed similarly improved state just after 1 week of treatments (82%: 18/22). Specifically, improvement of the mid-face was evident from the first week, while the progress of the low face improvement was observed at the twelve week. Subjective assessments paralleled these findings. No seriously adverse effect was observed during procedures. Histologic evaluation showed greater dermal collagen fibers throughout the dermis after treatments. CONCLUSION: Combination treatment with IFUS and TPIG has beneficial effects for skin lifting and tightening with early-onset time.


Assuntos
Técnicas Cosméticas , Solução Hipertônica de Glucose/administração & dosagem , Envelhecimento da Pele/patologia , Terapia por Ultrassom , Adulto , Idoso , Colágeno/ultraestrutura , Terapia Combinada/métodos , Técnicas Cosméticas/efeitos adversos , Face , Feminino , Solução Hipertônica de Glucose/efeitos adversos , Humanos , Injeções/efeitos adversos , Injeções/métodos , Pessoa de Meia-Idade , Satisfação do Paciente , Rejuvenescimento , Pele/patologia , Fatores de Tempo , Terapia por Ultrassom/efeitos adversos
18.
JAMA Dermatol ; 153(12): 1249-1255, 2017 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-28973414

RESUMO

Importance: Reticular veins are subdermal veins located in the lower limbs and are mainly associated with aesthetic complaints. Although sclerotherapy is the treatment of choice for reticular veins in the lower limbs, no consensus has been reached regarding to the optimal sclerosant. Objective: To compare the efficacy and safety of 2 sclerosants used to treat reticular veins: 0.2% polidocanol diluted in 70% hypertonic glucose (HG) (group 1) vs 75% HG alone (group 2). Design, Setting, and Participants: Prospective, randomized, triple-blind, controlled, parallel-group clinical trial with patients randomly assigned in a 1:1 ratio between the 2 treatment groups from March through December 2014, with 2 months' follow-up. The study was conducted in a single academic medical center. Eligible participants were all women, aged 18 to 69 years, who had at least 1 reticular vein with a minimum length of 10 cm in 1 of their lower limbs. Interventions: The patients underwent sclerotherapy in a single intervention with either 0.2% polidocanol plus 70% HG or 75% HG alone to eliminate reticular veins. Main Outcomes and Measures: The primary efficacy end point was the disappearance of the reticular veins within 60 days after treatment with sclerotherapy. The reticular veins were measured on images obtained before treatment and after treatment using ImageJ software. Safety outcomes were analyzed immediately after treatment and 7 days and 60 days after treatment and included serious adverse events (eg, deep vein thrombosis and systemic complications) and minor adverse events (eg, pigmentation, edema, telangiectatic matting, and hematomas). Results: Ninety-three women completed the study, median (interquartile range) age 43.0 (24.0-61.0) years for group 1 and 41.0 (27.0-62.0) years for group 2. Sclerotherapy with 0.2% polidocanol plus 70% HG was significantly more effective than with 75% HG alone in eliminating reticular veins from the treated area (95.17% vs 85.40%; P < .001). No serious adverse events occurred in either group. Pigmentation was the most common minor adverse event, with a 3.53% treated-vein pigmentation length for group 1 and 7.09% for group 2, with no significant difference between the groups (P = .09). Conclusions and Relevance: Sclerotherapy with 0.2% polidocanol diluted in 70% HG was superior to 75% HG alone in sclerosing reticular veins, with no statistical difference for complications. Pigmentation occurred in both groups, with no statistical difference between them. No serious adverse events occurred in either group. Trial Registration: clinicaltrials.gov Identifier: NCT02054325.


Assuntos
Solução Hipertônica de Glucose/administração & dosagem , Polietilenoglicóis/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Doenças Vasculares/terapia , Adolescente , Adulto , Idoso , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Extremidade Inferior , Pessoa de Meia-Idade , Polidocanol , Estudos Prospectivos , Escleroterapia/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Doenças Vasculares/patologia , Veias/patologia , Adulto Jovem
19.
BMC Nephrol ; 18(1): 278, 2017 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-28859606

RESUMO

BACKGROUND: Glucose is widely used as an osmotic agent in peritoneal dialysis (PD), but exerts untoward effects on the peritoneum. The potential protective effect of a reduced exposure to hypertonic glucose has never been investigated. METHODS: The cohort of PD patients attending our center which tackled the challenge of a restricted use of hypertonic glucose solutions has been prospectively followed since 1992. Small-solute transport was assessed using an equivalent of the glucose peritoneal equilibration test after 6 months, and then every year. Study was stopped on July 1st, 2008, before use of biocompatible solutions. Repeated measures in patients treated with PD for 54 months were analyzed by using (1) the slopes of the linear regression for D4/D0 ratios over time computed for each individual, and (2) a linear mixed model. RESULTS: In the study period, 44 patients were treated for a total of 2376 months, 2058 without hypertonic glucose. There was one episode of peritoneal infection every 18 patient-months. The mean of slopes of the linear regression for D4/D0 ratios was found to be significantly positive (Student's test, p < .001) and the results of the mixed model reflected a similar significant increase for D4/D0 ratios over time. These results reflected a significant decrease of small-solute transport. CONCLUSION: In this large series, minimizing the use of hypertonic glucose solutions was associated in patients on long term PD with an overall decrease of small-solute transport within 54 months, despite a high rate of peritoneal infection.


Assuntos
Solução Hipertônica de Glucose/administração & dosagem , Falência Renal Crônica/metabolismo , Falência Renal Crônica/terapia , Diálise Peritoneal/métodos , Diálise Peritoneal/tendências , Adulto , Idoso , Transporte Biológico/efeitos dos fármacos , Transporte Biológico/fisiologia , Estudos de Coortes , Feminino , Seguimentos , Humanos , Falência Renal Crônica/diagnóstico , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Resultado do Tratamento
20.
J Cosmet Laser Ther ; 19(8): 479-484, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-28665146

RESUMO

BACKGROUND: Needleless transcutaneous pneumatic injections (TPIs) are a minimally invasive way to deliver the solution into the skin for therapeutic purposes. The suggested action mechanisms of TPI therapy include mechanical stimulation, immediate tissue shrinkage and late wound healing. METHODS: Thirteen Korean patients were treated with TPI for atrophic skin disorders, including acne scars, striae albae, post-furuncle, or carbuncle scars, and horizontal wrinkles with lipoatrophy. At each TPI treatment session, a single pass was made along with the atrophic skin lesions without overlapping. Thereafter, two dermatologists objectively evaluated the clinical improvement in the lesions in the photographs via the global aesthetic improvement scale (GAIS). RESULTS: One month after the final treatment, the overall mean GAIS score was 2.3 ± 0.8. Six of the 13 (46.2%) patients exhibited clinical improvement of grade 3, five (38.5%) patients grade 2 and two (15.4%) patients grade 1. The overall mean subjective satisfaction score with the TPI treatment was 2.3 ± 0.9. Six of the 13 (46.2%) patients achieved subjective satisfaction of grade 3, six (46.2%) patients grade 2 and one (7.7%) patient grade 0. CONCLUSIONS: The present study demonstrated that the TPI treatment is effective and safe for treating atrophic skin disorders of varying causes in Korean patients.


Assuntos
Solução Hipertônica de Glucose/uso terapêutico , Dermatopatias/terapia , Adulto , Carbúnculo/terapia , Cicatriz/terapia , Feminino , Furunculose/terapia , Solução Hipertônica de Glucose/administração & dosagem , Humanos , Injeções a Jato , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , República da Coreia
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