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Barraviera, Benedito
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[PMID]:28450050
[Au] Autor:Araújo MR; Kyrylenko S; Spejo AB; Castro MV; Ferreira Junior RS; Barraviera B; Oliveira ALR
[Ad] Endereço:Department of Structural and Functional Biology, Institute of Biology, University of Campinas, Campinas, Sao Paulo, Brazil.
[Ti] Título:Transgenic human embryonic stem cells overexpressing FGF2 stimulate neuroprotection following spinal cord ventral root avulsion.
[So] Source:Exp Neurol;294:45-57, 2017 08.
[Is] ISSN:1090-2430
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ventral root avulsion (VRA) triggers a strong glial reaction which contributes to neuronal loss, as well as to synaptic detachment. To overcome the degenerative effects of VRA, treatments with neurotrophic factors and stem cells have been proposed. Thus, we investigated neuroprotection elicited by human embryonic stem cells (hESC), modified to overexpress a human fibroblast growth factor 2 (FGF-2), on motoneurons subjected to VRA. Lewis rats were submitted to VRA (L4-L6) and hESC/FGF-2 were applied to the injury site using a fibrin scaffold. The spinal cords were processed to evaluate neuronal survival, synaptic stability, and glial reactivity two weeks post lesion. Then, qRT-PCR was used to assess gene expression of ß2-microglobulin (ß2m), TNFα, IL1ß, IL6 and IL10 in the spinal cord in vivo and FGF2 mRNA levels in hESC in vitro. The results indicate that hESC overexpressing FGF2 significantly rescued avulsed motoneurons, preserving synaptic covering and reducing astroglial reactivity. The cells were also shown to express BDNF and GDNF at the site of injury. Additionally, engraftment of hESC led to a significant reduction in mRNA levels of TNFα at the spinal cord ventral horn, indicating their immunomodulatory properties. Overall, the present data suggest that hESC overexpressing FGF2 are neuroprotective and can shift gene expression towards an anti-inflammatory environment.
[Mh] Termos MeSH primário: Células-Tronco Embrionárias Humanas/transplante
Radiculopatia/cirurgia
Raízes Nervosas Espinhais/patologia
[Mh] Termos MeSH secundário: Animais
Movimento Celular
Sobrevivência Celular/efeitos dos fármacos
Sobrevivência Celular/genética
Modelos Animais de Doenças
Doxiciclina/uso terapêutico
Feminino
Adesivo Tecidual de Fibrina/toxicidade
Fator 2 de Crescimento de Fibroblastos/genética
Fator 2 de Crescimento de Fibroblastos/metabolismo
Regulação da Expressão Gênica/efeitos dos fármacos
Regulação da Expressão Gênica/genética
Vetores Genéticos/fisiologia
Células-Tronco Embrionárias Humanas/metabolismo
Seres Humanos
Neurônios Motores/metabolismo
Neurônios Motores/patologia
Proteínas do Tecido Nervoso/metabolismo
Neuroglia/efeitos dos fármacos
Neuroglia/metabolismo
Radiculopatia/induzido quimicamente
Ratos
Ratos Endogâmicos Lew
Adesivos Teciduais/toxicidade
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive); 0 (Nerve Tissue Proteins); 0 (Tissue Adhesives); 103107-01-3 (Fibroblast Growth Factor 2); N12000U13O (Doxycycline)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:180218
[Lr] Data última revisão:
180218
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


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[PMID]:27778058
[Au] Autor:Michalski CW; Tramelli P; Büchler MW; Hackert T
[Ad] Endereço:Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Universitätsklinikum Heidelberg, Im Neuenheimer Feld 110, 69120, Heidelberg, Deutschland.
[Ti] Título:[Closure of pancreas stump after distal and segmental resection : Suture, stapler, coverage or anastomosis?]
[Ti] Título:Verschluss des Pankreasstumpfes bei Links- und Segmentresektion : Naht, Stapler, Deckung oder Anastomose?.
[So] Source:Chirurg;88(1):25-29, 2017 Jan.
[Is] ISSN:1433-0385
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:Postoperative pancreatic fistulas represent the most frequent complication after distal and segmental pancreatectomy and occur with a frequency of up to 50 %. There are many technical variations of pancreatic stump treatment for reduction of fistula rates after distal resection. Most of these techniques have only been analyzed in retrospective studies and the evidence for or against a specific technique is low. Several retrospective trials have been conducted with good results to compare suturing with stapled closure of the remnant and to assess the effect of a vascularized falciform ligament patch in reducing postoperative pancreatic fistula; however, in a recently published randomized trial, which analyzed closure of the remnant with a pancreaticojejunostomy compared to standard closure, these results could not be confirmed. Because stapler resection and closure is the most commonly used technique in laparoscopic distal pancreatectomy, there are a large number of studies which assessed various novel methods of improving stapling. Extended stapler compression time and mesh augmentation of the stapler line can be valid methods to reduce fistula rates. Central pancreatectomy is a relatively rarely used procedure where the right-sided pancreatic remnant is closed in the same fashion as during distal pancreatectomy and the left-sided remnant is connected to the intestines with a pancreaticojejunostomy or pancreaticogastrostomy. In conclusion, postoperative pancreatic fistula rates are still a relevant clinical problem after distal pancreatectomy and further studies on potentially improved novel techniques are required.
[Mh] Termos MeSH primário: Anastomose Cirúrgica/métodos
Pancreatectomia/métodos
Fístula Pancreática/prevenção & controle
Complicações Pós-Operatórias/prevenção & controle
Grampeamento Cirúrgico/métodos
Técnicas de Sutura
[Mh] Termos MeSH secundário: Combinação de Medicamentos
Adesivo Tecidual de Fibrina/administração & dosagem
Fibrinogênio/administração & dosagem
Seres Humanos
Pancreaticojejunostomia/métodos
Fatores de Risco
Ligamento Redondo do Fígado/cirurgia
Telas Cirúrgicas
Trombina/administração & dosagem
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Drug Combinations); 0 (Fibrin Tissue Adhesive); 0 (TachoSil); 9001-32-5 (Fibrinogen); EC 3.4.21.5 (Thrombin)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180209
[Lr] Data última revisão:
180209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161026
[St] Status:MEDLINE
[do] DOI:10.1007/s00104-016-0301-3


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[PMID]:28448728
[Au] Autor:Kim YS; Sung CH; Chung SH; Kwak SJ; Koh YG
[Ad] Endereço:Department of Orthopaedic Surgery, Center for Stem Cell & Arthritis Research, Yonsei Sarang Hospital, Seoul, Republic of Korea.
[Ti] Título:Does an Injection of Adipose-Derived Mesenchymal Stem Cells Loaded in Fibrin Glue Influence Rotator Cuff Repair Outcomes? A Clinical and Magnetic Resonance Imaging Study.
[So] Source:Am J Sports Med;45(9):2010-2018, 2017 Jul.
[Is] ISSN:1552-3365
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The mesenchymal stem cell (MSC)-based tissue engineering approach has been developed to improve the treatment of rotator cuff tears. Hypothesis/Purpose: The purpose was to determine the effect of an injection of adipose-derived MSCs loaded in fibrin glue during arthroscopic rotator cuff repair on clinical outcomes and to evaluate its effect on structural integrity using magnetic resonance imaging (MRI). The hypothesis was that the application of adipose-derived MSCs would improve outcomes after the surgical repair of a rotator cuff tear. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Among 182 patients treated with arthroscopic surgery for a rotator cuff tear, 35 patients treated with arthroscopic rotator cuff repair alone (conventional group) were matched with 35 patients who underwent arthroscopic rotator cuff repair with an injection of adipose-derived MSCs loaded in fibrin glue (injection group) based on sex, age, and lesion size. Outcomes were assessed with respect to the visual analog scale (VAS) for pain, range of motion (ROM) (including forward flexion, external rotation at the side, and internal rotation at the back), and functional measures of the Constant score and University of California, Los Angeles (UCLA) shoulder rating scale. Repaired tendon structural integrity was assessed by using MRI at a minimum of 12 months after surgery, and the mean clinical follow-up was 28.8 ± 4.2 months in the conventional group and 28.3 ± 3.8 months in the injection group. RESULTS: The mean VAS score at rest and during motion improved significantly in both groups after surgery. However, there were no significant differences between the groups at the final follow-up ( P = .256 and .776, respectively). Compared with preoperative measurements, forward flexion and external rotation at the side significantly improved at the final follow-up in both groups (all P < .05). However, no significant improvements in internal rotation at the back were observed in either group ( P = .625 and .834 for the conventional and injection groups, respectively). There were also no significant differences between the groups at the final follow-up for any of the 3 ROM positions (all P > .05). The mean Constant score and UCLA score improved significantly in both groups after surgery, but there were no significant differences between the groups at the final follow-up ( P = .634 and .302, respectively). MRI indicated a retear rate of 28.5% in the conventional group and 14.3% in the injection group ( P < .001). CONCLUSION: This study revealed that an injection of adipose-derived MSCs loaded in fibrin glue during rotator cuff repair could significantly improve structural outcomes in terms of the retear rate. There were, however, no clinical differences in the 28-month period of follow-up. Although still in the early stages of application, MSC augmentation of surgical rotator cuff repair appears useful for providing an adequate biological environment around the repair site.
[Mh] Termos MeSH primário: Artroscopia/métodos
Adesivo Tecidual de Fibrina/administração & dosagem
Transplante de Células-Tronco Mesenquimais
Lesões do Manguito Rotador/cirurgia
Adesivos Teciduais/administração & dosagem
[Mh] Termos MeSH secundário: Tecido Adiposo/citologia
Adulto
Idoso
Artroplastia
Estudos de Coortes
Feminino
Seres Humanos
Injeções
Imagem por Ressonância Magnética
Masculino
Meia-Idade
Medição da Dor
Amplitude de Movimento Articular
Manguito Rotador/diagnóstico por imagem
Manguito Rotador/cirurgia
Ombro/cirurgia
Articulação do Ombro/diagnóstico por imagem
Articulação do Ombro/cirurgia
Engenharia Tecidual
Resultado do Tratamento
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive); 0 (Tissue Adhesives)
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180205
[Lr] Data última revisão:
180205
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170428
[St] Status:MEDLINE
[do] DOI:10.1177/0363546517702863


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[PMID]:28465659
[Au] Autor:Wang X; Zhang Y; Zhou L; Wei R; Dong L
[Ad] Endereço:Tianjin Medical University Eye Hospital, Tianjin Medical University Eye Institute, College of Optometry and Ophthalmology, Tianjin Medical University, Tianjin, People's Republic of China.
[Ti] Título:Comparison of fibrin glue and Vicryl sutures in conjunctival autografting for pterygium surgery.
[So] Source:Mol Vis;23:275-285, 2017.
[Is] ISSN:1090-0535
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:PURPOSE: To compare clinical parameters and the tear levels of inflammatory cytokines between pterygium surgery using sutures or fibrin glue. METHODS: Fifty-six patients with primary pterygium were divided into the suture group and the glue group, in which the autograft was secured with 10-0 Vicryl sutures and fibrin glue, respectively. A questionnaire, slit-lamp examination, Schirmer test, and visual acuity test were performed in all participants. Real-time quantitative PCR (q-PCR) was used to analyze the expression of genes in pterygium and healthy conjunctival tissues. Based on the qPCR results and literature reports, five inflammatory cytokines, including hepatocyte growth factor (HGF), fibroblast growth factor 2 (FGF2), transforming growth factor-ß1 (TGF-ß1), matrix metalloproteinase 2 (MMP2), and tumor necrosis factor-α (TNF-α), were selected, and their protein levels were measured with enzyme-linked immunosorbent assay (ELISA) in patient tears before surgery as well as at postoperative day 1, 7, and 30. RESULTS: There are 28 patients in either the suture or the glue group. The average duration of surgery was 20.17 ± 3.23 min for the glue group and 32.42 ± 4.47 min for the suture group (p = 0.000). Visual acuity in both groups was improved (p = 0.002) after the surgical procedures. There were more symptoms in the suture group than in the glue group at postoperative day 7 (p = 0.002). Postoperative symptoms disappeared in both groups at 1 month after surgery. Recurrence was observed in one case in the glue group and in two cases in the suture group at the 6 month postoperative follow-up (p = 0.714). In comparison to the preoperative levels (4.33 ± 0.43 ng/ml for the suture group; 4.20 ± 0.26 ng/ml for the glue group), the levels of TNF-α in tears increased in the suture group (5.02 ± 0.49 ng/ml, p = 0.016) and decreased in the glue group (3.84 ± 0.35 ng/ml, p = 0.052) on postoperative day 1. The glue treatment induced higher HGF production (4.78 ± 1.25 ng/ml) than the suture treatment (3.04 ± 1.18 ng/ml) at postoperative day 1 (p = 0.020). Higher levels of TGF-ß1 in the glue group were detected at postoperative day 1 (3.71 ± 0.18 ng/ml) and postoperative day 30 (4.50 ± 0.51 ng/ml), compared to those in the suture group, respectively (2.74 ± 0.21 ng/ml, p = 0.000 for day 1; 3.36 ± 0.96 ng/ml, p = 0.017 for postoperative day 30). CONCLUSIONS: Fibrin glue is effective and safe for attaching conjunctival autografts with an easy surgical procedure, shortened operating time, and less postoperative discomfort. In the early postoperative period, the protein expression of inflammatory cytokines implicates that fibrin glue may induce accelerated healing and subdued inflammation on the ocular surface compared to sutures.
[Mh] Termos MeSH primário: Túnica Conjuntiva/transplante
Adesivo Tecidual de Fibrina/uso terapêutico
Poliglactina 910
Pterígio/cirurgia
Técnicas de Sutura
Adesivos Teciduais/uso terapêutico
[Mh] Termos MeSH secundário: Adulto
Idoso
Citocinas/genética
Ensaio de Imunoadsorção Enzimática
Feminino
Seres Humanos
Masculino
Meia-Idade
Procedimentos Cirúrgicos Oftalmológicos
Complicações Pós-Operatórias
Estudos Prospectivos
Pterígio/genética
RNA Mensageiro/genética
Reação em Cadeia da Polimerase em Tempo Real
Inquéritos e Questionários
Fatores de Tempo
Transplante Autólogo
Acuidade Visual
Técnicas de Fechamento de Ferimentos
Cicatrização/fisiologia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Cytokines); 0 (Fibrin Tissue Adhesive); 0 (RNA, Messenger); 0 (Tissue Adhesives); 34346-01-5 (Polyglactin 910)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170504
[St] Status:MEDLINE


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[PMID]:29208817
[Au] Autor:Narang P; Agarwal A
[Ad] Endereço:Narang Eye Care and Laser Centre, Ahmedabad, Gujarat, India.
[Ti] Título:Glued intrascleral haptic fixation of an intraocular lens.
[So] Source:Indian J Ophthalmol;65(12):1370-1380, 2017 Dec.
[Is] ISSN:1998-3689
[Cp] País de publicação:India
[La] Idioma:eng
[Ab] Resumo:Glued intrascleral haptic fixation of an intraocular lens (glued IOL) has evolved as a technique with various modifications that are adopted and practiced by several surgeons. With adequate and appropriate haptic tuck, glued IOL imparts a stable IOL fixation and is a secured method of secondary IOL placement with no pseudophacodonesis.
[Mh] Termos MeSH primário: Extração de Catarata/métodos
Adesivo Tecidual de Fibrina/farmacologia
Lentes Intraoculares
Esclera/cirurgia
Procedimentos Cirúrgicos sem Sutura/métodos
[Mh] Termos MeSH secundário: Seres Humanos
Desenho de Prótese
Refração Ocular
Adesivos Teciduais
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; VIDEO-AUDIO MEDIA
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive); 0 (Tissue Adhesives)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180103
[Lr] Data última revisão:
180103
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171207
[St] Status:MEDLINE
[do] DOI:10.4103/ijo.IJO_643_17


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[PMID]:28958271
[Au] Autor:Weltz AS; Sibia US; Zahiri HR; Schoeneborn A; Park A; Belyansky I
[Ti] Título:Operative Outcomes after Open Abdominal Wall Reconstruction with Retromuscular Mesh Fixation Using Fibrin Glue Transfascial Sutures.
[So] Source:Am Surg;83(9):937-942, 2017 Sep 01.
[Is] ISSN:1555-9823
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Ideal fixation techniques have not been fully elucidated at the time of complex open abdominal wall reconstruction (AWR). We compared operative outcomes and quality of life with retromuscular mesh fixation using fibrin glue (FG) versus transfascial sutures (TS). Retrospective review identified complex hernia patients who underwent open AWR with mesh from November 2012 through April 2016. Multivariate analysis examined postoperative outcomes between groups. Quality of life was assessed using the Carolinas Comfort Scale. Seventy-five patients (18 FG vs 57 TS) with mean age (54.3 vs 53.9 years, P = 0.914), body mass index (35.8 vs 34.7 kg/m2, P = 0.623) and American Society of Anesthesiologist score (2.6 vs 2.5, P = 0.617) were reviewed. No differences in wound (P = 0.072) and nonwound (P = 0.639) related complications were noted between groups. Risk of reoperations (P = 0.275) and 30-day readmissions (P = 0.137) were also comparable. The TS group was twelve times more likely to report pain at six-month follow-up compared with FG (12.29 OR, 95 per cent confidence interval 1.26-120.35, P = 0.031). No hernia recurrences were noted in either group at a mean follow-up of 390 ± 330 days. The use of FG to secure mesh in the retromuscular space during complex open AWR may be a safe alternative to penetrating transfascial fixation with potential to reduce chronic pain.
[Mh] Termos MeSH primário: Parede Abdominal/cirurgia
Técnicas de Fechamento de Ferimentos Abdominais
Adesivo Tecidual de Fibrina
Herniorrafia
Telas Cirúrgicas
Suturas
[Mh] Termos MeSH secundário: Feminino
Hérnia Ventral/cirurgia
Seres Humanos
Masculino
Meia-Idade
Qualidade de Vida
Estudos Retrospectivos
Técnicas de Sutura
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171010
[Lr] Data última revisão:
171010
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170930
[St] Status:MEDLINE


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[PMID]:28906385
[Au] Autor:Yang B; He JP; Yuan ML; Li W; Jiao H; You X; Liu XR; Zhao J; Li CL; Fu XB; Liao ZY; Yi C
[Ad] Endereço:aDepartment of Abdominal Oncology, Cancer Center and State Key Laboratory of Biotherapy bDepartment of Psychiatry cDepartment of Radiology, West China Hospital, West China Medical School, Sichuan University, Chengdu, China.
[Ti] Título:Percutaneous intratumoral injection of gemcitabine plus cisplatin mixed with fibrin glue for advanced pancreatic carcinoma: Case Report.
[So] Source:Medicine (Baltimore);96(37):e8018, 2017 Sep.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: The aim of this study was to determine the effectiveness of intratumoral injection of chemotherapeutics in improving the quality of life and survival of patients with pancreatic carcinoma. PATIENT CONCERNS: We present a case series of 5 patients with unresectable pancreatic adenocarcinoma. DIAGNOSES: Patients diagnosed with unresectable poorly differentiated pancreatic ductal adenocarcinoma by intraoperative frozen biopsyor percutaneous biopsy. INTERVENTIONS: Five patients with unresectable pancreatic adenocarcinoma received a computed tomography-guided percutaneous intratumoral injection of gemcitabine plus cisplatin mixed with fibrin glue. OUTCOMES: Mean overall survival was 16.2 ±â€Š3.7 months. Local control rates were 100% and 80% at postoperative 3 and 6 months, respectively. Mean Visual Analogue Scale pain score decreased from 7.2 ±â€Š.84 preoperatively to 2 ±â€Š1.22 at postoperative 4 weeks. There were no complications associated with the procedure. LESSONS: Percutaneous intratumoral injection of gemcitabine plus cisplatin mixed with fibrin glue for advanced pancreatic may be safe and effective.
[Mh] Termos MeSH primário: Adenocarcinoma/tratamento farmacológico
Antineoplásicos/administração & dosagem
Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem
Cisplatino/administração & dosagem
Desoxicitidina/análogos & derivados
Adesivo Tecidual de Fibrina/administração & dosagem
Neoplasias Pancreáticas/tratamento farmacológico
[Mh] Termos MeSH secundário: Adenocarcinoma/patologia
Idoso
Desoxicitidina/administração & dosagem
Quimioterapia Combinada
Feminino
Seres Humanos
Injeções Intralesionais
Masculino
Meia-Idade
Estadiamento de Neoplasias
Neoplasias Pancreáticas/patologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Antineoplastic Agents); 0 (Fibrin Tissue Adhesive); 0W860991D6 (Deoxycytidine); B76N6SBZ8R (gemcitabine); Q20Q21Q62J (Cisplatin)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171004
[Lr] Data última revisão:
171004
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170915
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008018


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[PMID]:28891851
[Au] Autor:Sugrue J; Mantilla N; Abcarian A; Kochar K; Marecik S; Chaudhry V; Mellgren A; Nordenstam J
[Ad] Endereço:1 Division of Colon and Rectal Surgery, University of Illinois at Chicago, Chicago, Illinois 2 Division of Colon and Rectal Surgery, John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois 3 Division of Colon and Rectal Surgery, Advocate Lutheran General Hospital, Park Ridge, Illinois.
[Ti] Título:Sphincter-Sparing Anal Fistula Repair: Are We Getting Better?
[So] Source:Dis Colon Rectum;60(10):1071-1077, 2017 Oct.
[Is] ISSN:1530-0358
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Sphincter-sparing repairs are commonly used to treat anal fistulas with significant muscle involvement. OBJECTIVE: The current study evaluates the trends and efficacy of sphincter-sparing repairs and determines risk factors for fistula recurrence. DESIGN AND SETTINGS: A retrospective review was performed at 3 university-affiliated teaching hospitals. PATIENTS: All 462 patients with cryptoglandular anal fistulas who underwent 573 sphincter-sparing repairs between 2005 and 2015 were included. Patients with Crohn's disease were excluded. MAIN OUTCOME MEASURES: The primary outcome was the rate of fistula healing defined as cessation of drainage with closure of the external opening. Risk factors for nonhealing were also analyzed. RESULTS: Five hundred three sphincter-sparing repairs were analyzed, whereas 70 were lost to follow-up. Two hundred twenty sphincter-sparing repairs (44%) resulted in healing, 283 (56%) resulted in nonhealing with a median follow-up of 9 (range, 1-125) months. The median time to fistula recurrence was 3 (range, 0-75) months with 79% and 91% of recurrences noted within 6 and 12 months. Patients treated with a dermal advancement flap, rectal advancement flap, or ligation of the intersphincteric tract procedure were less likely to have a recurrence than patients treated with a fistula plug or fibrin glue (p < 0.001). Over time, there was a significantly increased use of the ligation of the intersphincteric tract procedure (p < 0.001) and a significantly decreased use of fistula plugs and fibrin glue (p < 0.001); healing rates improved accordingly. There were no significant differences in healing rates with respect to patient demographics, comorbidities, or fistula characteristics. LIMITATIONS: This study was limited by its retrospective design. CONCLUSIONS: Healing rates following sphincter-sparing repairs of cryptoglandular anal fistulas are modest, but have improved over time with the use of better surgical techniques. In this study, ligation of the intersphincteric fistula tract and flaps were superior to fistula plugs and fibrin glue; the former procedures are therefore favored. See Video Abstract at http://links.lww.com/DCR/A391.
[Mh] Termos MeSH primário: Adesivo Tecidual de Fibrina/uso terapêutico
Tratamentos com Preservação do Órgão
Complicações Pós-Operatórias
Fístula Retal/cirurgia
Reoperação
Retalhos Cirúrgicos
[Mh] Termos MeSH secundário: Canal Anal/cirurgia
Feminino
Seres Humanos
Illinois
Ligadura/efeitos adversos
Ligadura/métodos
Ligadura/estatística & dados numéricos
Masculino
Meia-Idade
Tratamentos com Preservação do Órgão/efeitos adversos
Tratamentos com Preservação do Órgão/métodos
Tratamentos com Preservação do Órgão/estatística & dados numéricos
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/cirurgia
Fístula Retal/diagnóstico
Fístula Retal/fisiopatologia
Recidiva
Reoperação/métodos
Estudos Retrospectivos
Retalhos Cirúrgicos/efeitos adversos
Retalhos Cirúrgicos/estatística & dados numéricos
Resultado do Tratamento
Cicatrização
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Fibrin Tissue Adhesive)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170921
[Lr] Data última revisão:
170921
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170912
[St] Status:MEDLINE
[do] DOI:10.1097/DCR.0000000000000885


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[PMID]:28761338
[Au] Autor:Noori A; Ashrafi SJ; Vaez-Ghaemi R; Hatamian-Zaremi A; Webster TJ
[Ad] Endereço:Department of Tissue Engineering and Applied Cell Sciences, Faculty of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran.
[Ti] Título:A review of fibrin and fibrin composites for bone tissue engineering.
[So] Source:Int J Nanomedicine;12:4937-4961, 2017.
[Is] ISSN:1178-2013
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:Tissue engineering has emerged as a new treatment approach for bone repair and regeneration seeking to address limitations associated with current therapies, such as autologous bone grafting. While many bone tissue engineering approaches have traditionally focused on synthetic materials (such as polymers or hydrogels), there has been a lot of excitement surrounding the use of natural materials due to their biologically inspired properties. Fibrin is a natural scaffold formed following tissue injury that initiates hemostasis and provides the initial matrix useful for cell adhesion, migration, proliferation, and differentiation. Fibrin has captured the interest of bone tissue engineers due to its excellent biocompatibility, controllable biodegradability, and ability to deliver cells and biomolecules. Fibrin is particularly appealing because its precursors, fibrinogen, and thrombin, which can be derived from the patient's own blood, enable the fabrication of completely autologous scaffolds. In this article, we highlight the unique properties of fibrin as a scaffolding material to treat bone defects. Moreover, we emphasize its role in bone tissue engineering nanocomposites where approaches further emulate the natural nanostructured features of bone when using fibrin and other nanomaterials. We also review the preparation methods of fibrin glue and then discuss a wide range of fibrin applications in bone tissue engineering. These include the delivery of cells and/or biomolecules to a defect site, distributing cells, and/or growth factors throughout other pre-formed scaffolds and enhancing the physical as well as biological properties of other biomaterials. Thoughts on the future direction of fibrin research for bone tissue engineering are also presented. In the future, the development of fibrin precursors as recombinant proteins will solve problems associated with using multiple or single-donor fibrin glue, and the combination of nanomaterials that allow for the incorporation of biomolecules with fibrin will significantly improve the efficacy of fibrin for numerous bone tissue engineering applications.
[Mh] Termos MeSH primário: Materiais Biocompatíveis/química
Osso e Ossos
Fibrina/química
Nanocompostos/química
Engenharia Tecidual/métodos
[Mh] Termos MeSH secundário: Materiais Biocompatíveis/metabolismo
Regeneração Óssea
Osso e Ossos/citologia
Osso e Ossos/fisiologia
Adesão Celular
Diferenciação Celular
Fibrina/metabolismo
Adesivo Tecidual de Fibrina
Fibrinogênio/metabolismo
Seres Humanos
Hidrogéis
Nanomedicina/métodos
Tecidos Suporte
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Fibrin Tissue Adhesive); 0 (Hydrogels); 9001-31-4 (Fibrin); 9001-32-5 (Fibrinogen)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170802
[St] Status:MEDLINE
[do] DOI:10.2147/IJN.S124671


  10 / 4406 MEDLINE  
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[PMID]:28688644
[Au] Autor:Zhu W; Yang J; Iqbal J; Peck Y; Fan C; Wang DA
[Ad] Endereço:Division of Bioengineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore, Singapore.
[Ti] Título:A mussel-inspired double-crosslinked tissue adhesive on rat mastectomy model: seroma prevention and in vivo biocompatibility.
[So] Source:J Surg Res;215:173-182, 2017 Jul.
[Is] ISSN:1095-8673
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Seroma formation is a common postsurgical complication of breast cancer surgery. It delays wound healing and may lead to other more serious complications. Conventional methods of reducing seroma formation through suturing or placement of surgical drainage produce inconsistent clinical outcomes. Tissue adhesives are viable alternatives but most of them are unsuitable for internal use and for large-area applications because of weak tissue adhesion strength or biocompatibility issues. The aim of this study was to evaluate the efficacy and biocompatibility of a mussel-inspired double-crosslinked tissue adhesive (DCTA) in reducing seroma formation after mastectomy. MATERIALS AND METHODS: Thirty-six female Sprague-Dawley rats were randomly assigned to either the saline control group (n = 12), the TISSEEL sealant (Baxter) group (n = 12), or the DCTA group (n = 12). After performing a mastectomy and applying the corresponding treatment, the efficacy of DCTA was evaluated by measurement of seroma volume while its biocompatibility was assessed via micronuclei test and histopathologic examination. RESULTS: During the 1-wk postsurgical period, the average total seroma volume of DCTA was significantly lower than the saline control group. Importantly, the mean seroma volume in DCTA showed a decreasing trend, whereas those in TISSEEL and saline control groups showed otherwise. The application of DCTA showed no genotoxic effect on the host and no severe inflammation. CONCLUSIONS: This study demonstrates that the good tissue adhesion strength and stability of DCTA were successful in reducing seroma formation over a period of 1 wk. Furthermore, the results also showed that it is biocompatible, which makes it suitable for large-area, internal use.
[Mh] Termos MeSH primário: Materiais Biocompatíveis/uso terapêutico
Adesivo Tecidual de Fibrina/uso terapêutico
Mastectomia
Complicações Pós-Operatórias/prevenção & controle
Seroma/prevenção & controle
Adesivos Teciduais/uso terapêutico
[Mh] Termos MeSH secundário: Animais
Bivalves
Feminino
Complicações Pós-Operatórias/diagnóstico
Complicações Pós-Operatórias/patologia
Distribuição Aleatória
Ratos
Ratos Sprague-Dawley
Seroma/diagnóstico
Seroma/etiologia
Seroma/patologia
Resultado do Tratamento
[Pt] Tipo de publicação:EVALUATION STUDIES; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biocompatible Materials); 0 (Fibrin Tissue Adhesive); 0 (Tissue Adhesives)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE



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