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BMJ Clinical Evidence Jul 2015Burns are classified according to depth. This overview concerns the treatments for partial-thickness burns, which can be expected or have the potential to heal... (Review)
Review
INTRODUCTION
Burns are classified according to depth. This overview concerns the treatments for partial-thickness burns, which can be expected or have the potential to heal spontaneously (superficial partial-thickness and mid-dermal partial-thickness burns). Injuries that involve the deeper part of the dermis and require surgical treatments to achieve healing are not the focus of this overview.
METHODS AND OUTCOMES
We conducted a systematic overview and aimed to answer the following clinical question: What are the effects of treatments for partial-thickness burns? We searched: Medline, Embase, The Cochrane Library, and other important databases up to January 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this review).
RESULTS
At this update, searching of electronic databases retrieved 322 studies. After deduplication and removal of conference abstracts, 193 records were screened for inclusion in the overview. Appraisal of titles and abstracts led to the exclusion of 160 studies and the further review of 33 full publications. Of the 33 full articles evaluated, two systematic reviews and two RCTs were added at this update. We performed a GRADE evaluation for 30 PICO combinations.
CONCLUSIONS
In this systematic overview, we categorised the efficacy for 10 interventions, based on information relating to the effectiveness and safety of alginate dressing, biosynthetic dressing, chlorhexidine-impregnated paraffin gauze dressing, hydrocolloid dressing, hydrogel dressing, paraffin gauze dressing, polyurethane film, silicone-coated nylon dressing, silver-impregnated dressing, and silver sulfadiazine cream.
Topics: Bandages; Bandages, Hydrocolloid; Burns; Chlorhexidine; Humans; Paraffin; Silver; Silver Sulfadiazine; Wound Healing
PubMed: 26173045
DOI: No ID Found -
Clinical and Experimental Dermatology Jun 2022Eczema (atopic dermatitis; AD) is a very common itchy skin condition affecting 1 in 5 children and up to 1 in 10 adults worldwide. The skin of eczema sufferers is prone... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Eczema (atopic dermatitis; AD) is a very common itchy skin condition affecting 1 in 5 children and up to 1 in 10 adults worldwide. The skin of eczema sufferers is prone to redness, irritation and dryness because it does not form an effective barrier, i.e. the ability of the skin to stop irritants, allergens and microorganisms getting into the body. Skin barrier dysfunction is a hallmark of AD. The regular and liberal (600 g/week for an adult) use of emollients is recommended for all patients with eczema), even between episodes of itching and redness, to soften and soothe the skin. In England alone, almost 9 million prescriptions for emollient creams were issued in 2018, at a cost of over £50 million. Despite this widespread use, relatively little is known about how commonly prescribed emollient creams affect the skin's barrier, and thus the role of moisturizers in AD development and progression remains unclear. We set out to compare three different types of emollient cream and a no-treatment control.
AIM
To compare the barrier-strengthening properties of a new moisturizer containing urea and glycerol (urea-glycerol cream; UGC), with those of a glycerol-containing moisturizer (glycerol cream; GC), a simple paraffin cream (PC) with no humectant, and a no-treatment control (NTC).
METHODS
This was an observer-blinded prospective Phase 2 within-subject multilateral single-centre randomized controlled trial in adults with AD (Clinical Trials #NCT03901144). The intervention involved 4 weeks of treatment, twice daily, with the three products applied to one of four areas on the forearms the (the fourth area was the untreated control, randomized allocation). Skin properties [dryness, transepidermal water loss (TEWL), hydration and natural moisturizing factor (NMF) levels] were assessed before, during and after treatment to see what happened to the skin's barrier. The primary outcome was skin sensitivity to the irritant sodium lauryl sulfate (SLS) after treatment. We performed tests on the skin before and after treatment to see what happened to the skin's barrier.
RESULTS
In total, 49 patients were randomized, completed treatment and included in the analysis. UGC significantly reduced the response to SLS as indicated by a reduction in TEWL compared with NTC (-9.0 g/m /h; 95% CI -12.56 to -5.49), with PC (-9.0 g/m /h; 95% CI -12.60 to -5.44) and with GC -4.2 g/m /h; 95% CI 7.76 to -0.63). Skin moisturization improved at sites treated with UGC compared with NTC and PC, and this was accompanied by concordant changes in dryness and NMF levels. Subgroup analysis suggested FLG-dependent enhancement of treatment effects.
CONCLUSION
The study showed that not all emollient creams for eczema are equal. The simple paraffin-based emollient, which represents the most widely prescribed type of emollient cream in England, had no effect on the skin's barrier and reduced the skin's NMF. UGC markedly improved the skin's barrier and protected against irritation. GC performed better than PC, but not as well as UGC. UGC strengthened the skin barrier through a mechanism involving increased NMF levels in the skin, and imparted protection from SLS-induced irritation. By helping correct a major pathophysiological process, UGC has the potential to improve the long-term control of AD. The results show that different emollient creams have different effects on our skin, and only certain types have the ability to improve the skin's barrier and protect against irritants that trigger eczema.
Topics: Adult; Child; Dermatitis, Atopic; Eczema; Emollients; Glycerol; Humans; Irritants; Paraffin; Prospective Studies; Pruritus; Skin Cream; Urea; Water Loss, Insensible
PubMed: 35167133
DOI: 10.1111/ced.15141 -
JAMA Oncology Aug 2023Xerostomia is a major toxic effect associated with intensity-modulated radiotherapy (IMRT) for oropharyngeal cancers.
Weekly Adaptive Radiotherapy vs Standard Intensity-Modulated Radiotherapy for Improving Salivary Function in Patients With Head and Neck Cancer: A Phase 3 Randomized Clinical Trial.
IMPORTANCE
Xerostomia is a major toxic effect associated with intensity-modulated radiotherapy (IMRT) for oropharyngeal cancers.
OBJECTIVE
To assess whether adaptive radiotherapy (ART) improves salivary function compared with IMRT in patients with head and neck cancer.
DESIGN, SETTING, AND PARTICIPANTS
This phase 3 randomized clinical trial was conducted in 11 French centers. Patients aged 18 to 75 years with stage III-IVB squamous cell oropharyngeal cancer treated with chemoradiotherapy were enrolled between July 5, 2013, and October 1, 2018. Data were analyzed from November 2021 to May 2022.
INTERVENTIONS
The patients were randomly assigned (1:1) to receive standard IMRT (without replanning) or ART (systematic weekly replanning).
MAIN OUTCOMES AND MEASURES
The primary end point was the frequency of xerostomia, measured by stimulating salivary flow with paraffin. Secondary end points included salivary gland excretory function measured using technetium-99m pertechnetate scintigraphy, patient-reported outcomes (Eisbruch xerostomia-specific questionnaire and the MD Anderson Symptom Inventory for Head and Neck Cancer questionnaire), early and late toxic effects, disease control, and overall and cancer-specific survival.
RESULTS
A total of 132 patients were randomized, and after 1 exclusion in the ART arm, 131 were analyzed: 66 in the ART arm (mean [SD] age at inclusion, 60 [8] years; 57 [86.4%] male) and 65 in the standard IMRT arm (mean [SD] age at inclusion, 60 [8] years; 57 [87.7%] male). The median follow-up was 26.4 months (IQR, 1.2-31.3 months). The mean (SD) salivary flow (paraffin) at 12 months was 630 (450) mg/min in the ART arm and 584 (464) mg/min in the standard arm (P = .64). The mean (SD) excretory function of the parotid gland at 12 months, measured by scintigraphy, improved in the ART arm (48% [17%]) compared with the standard arm (41% [17%]) (P = .02). The 2-year-overall survival was 76.9% (95% CI, 64.7%-85.4%) in both arms.
CONCLUSIONS AND RELEVANCE
This randomized clinical trial did not demonstrate a benefit of ART in decreasing xerostomia compared with standard IMRT. No significant differences were found in secondary end points except for parotid gland excretory function, as assessed by scintigraphy, or in survival rates.
TRIAL REGISTRATION
ClinicalTrials.gov Identifier: NCT01874587.
Topics: Humans; Male; Female; Radiotherapy, Intensity-Modulated; Paraffin; Head and Neck Neoplasms; Xerostomia; Parotid Gland; Oropharyngeal Neoplasms
PubMed: 37261806
DOI: 10.1001/jamaoncol.2023.1352 -
Frontiers in Cellular and Infection... 2023In this study, we used real-time quantitative PCR (RQ-PCR) to rapidly detect and in formalin-fixed, paraffin-embedded (FFPE) samples, targeting 18SrRNA gene and...
BACKGROUND
In this study, we used real-time quantitative PCR (RQ-PCR) to rapidly detect and in formalin-fixed, paraffin-embedded (FFPE) samples, targeting 18SrRNA gene and 28SrRNA gene. Identification of and was analysed by combining RQ-PCR (18SrRNA and 28SrRNA) with RQ-PCR (18SrRNA and 28SrRNA).
OBJECTIVES
The aims of this study were to compare the diagnostic performances of four RQ-PCR assays as single and combined diagnostic and identification tools.
METHODS
We collected 12 control group samples and 81 experimental group samples diagnosed by histopathology, including mucormycosis (19 patients, 21 FFPE samples), aspergillosis (54 patients, 57 FFPE samples) and mucormycosis with aspergillosis (3 patients, 3 FFPE samples). All samples were detected by four RQ-PCR tests to compare and analyze diagnostic performance.
RESULTS
The sensitivities of 18SrRNA and 28SrRNA were both 75%, with the tests having specificities of 97.10% and 94.20%. The sensitivities of 18SrRNA and 28SrRNA were 73.33% and 65%, with the tests having specificities of 87.88% and 81.82%. The values of the evaluation indexes of the combined detection of 28SrRNA and 18SrRNA (M28A18) were the highest with a kappa coefficient value of 0.353, followed by M18A18. M28A18 had a sensitivity of 67.90% and a specificity of 100%.
CONCLUSIONS
We recommend using the combination of RQ-PCR and RQ-PCR as a screening tool to detect samples suspected of mucormycosis and/or aspergillosis.
Topics: Humans; Mucorales; Mucormycosis; Paraffin; Paraffin Embedding; Aspergillus; Real-Time Polymerase Chain Reaction; Aspergillosis; Sensitivity and Specificity
PubMed: 36936757
DOI: 10.3389/fcimb.2023.1082347 -
Actas Dermo-sifiliograficas Dec 2014
Topics: Adult; Granuloma, Foreign-Body; Humans; Male; Paraffin; Penile Diseases
PubMed: 24907865
DOI: 10.1016/j.ad.2014.04.009 -
Journal of Oleo Science Aug 2023Raw materials suitable for a sustainable society have attracted interest in the cosmetics industry. We focused on rice bran as a sustainable material and evaluated the...
Raw materials suitable for a sustainable society have attracted interest in the cosmetics industry. We focused on rice bran as a sustainable material and evaluated the gelation behavior of paraffin extracted from rice bran (rice paraffin) against liquid paraffin, squalane, jojoba oil, and silicone oil. In addition, the frictional properties of the prepared organogel on an artificial skin surface were evaluated using a sinusoidal motion friction evaluation system. Rice paraffin solidified all oils even at the lowest wax concentration of 5 wt%. The hardness and kinetic friction coefficient μ increased with an increase in the wax composition. The hardness and μ of organogels solidified with rice paraffin were smaller than those of gels solidified with petroleum-derived paraffin. These differences are caused by the smaller carbon amount of rice paraffin. The friction parameters depended on the type of oil: the μ of RLG composed of rice and liquid paraffin was greater than that of the other three oils (R, L, and G denote rice paraffin, liquid paraffin, and gel, respectively). These findings promote the development of lipsticks and cleansing gels consisting of sustainable development goal-responsive raw materials.
Topics: Paraffin; Oryza; Mineral Oil; Friction; Oils; Gels; Rice Bran Oil
PubMed: 37468272
DOI: 10.5650/jos.ess23023 -
JAMA Dermatology Oct 2022Nonmelanoma skin cancers (NMSCs) are primarily diagnosed through paraffin section histologic analysis of skin biopsy specimens that requires days to weeks before a...
IMPORTANCE
Nonmelanoma skin cancers (NMSCs) are primarily diagnosed through paraffin section histologic analysis of skin biopsy specimens that requires days to weeks before a formal diagnosis is reported. Two-photon fluorescence microscopy (TPFM) has the potential for point-of-care diagnosis of NMSC and other dermatologic conditions, which could enable same-visit diagnosis and treatment.
OBJECTIVE
To demonstrate that TPFM imaging of NMSC can occur within minutes of obtaining biopsies and provide similar histological features to those of conventional histology and evaluate TPFM diagnostic performance with respect to conventional histology.
DESIGN, SETTING, AND PARTICIPANTS
This comparative effectiveness pilot study examined 29 freshly excised biopsies from confirmed NMSC lesions in patients presenting for treatment. Biopsies underwent imaging immediately with TPFM on site at Rochester Dermatologic Surgery (Victor, New York) between October 2019 and August 2021. The imaged biopsies were subsequently submitted for paraffin histology to produce coregistered images. Twelve of these coregistered image pairs (41.4%) were used as a training set. Fifteen (51.7%) were used in a masked evaluation by a board-certified dermatopathologist. Two (6.9%) were excluded from the study before evaluation because they could not be coregistered.
MAIN OUTCOMES AND MEASURES
Sensitivity, specificity, and accuracy of TPFM for NMSC biopsies were evaluated compared with conventional histology.
RESULTS
Fourteen of the 15 biopsy specimens (93.3%) in the evaluation set were identically diagnosed with TPFM and paraffin histology. The TPFM had 100% sensitivity (95% CI, 48%-100%), 100% specificity (95% CI, 69%-100%), and 100% accuracy (95% CI, 78%-100%) for basal cell carcinoma diagnosis. For squamous cell carcinoma diagnosis, TPFM had 89% sensitivity (95% CI, 52%-100), 100% specificity (95% CI, 54%-100%), and 93% accuracy (95% CI, 68%-100%). For overall NMSC diagnosis, TPFM had a 93% sensitivity (95% CI, 66%-100%), 100% specificity (95% CI, 3%-100%), and 93% accuracy (95% CI, 68%-100%). Examination of the 1 discordant pair revealed mismatched imaging planes as the source of error.
CONCLUSIONS AND RELEVANCE
The results of this comparative effectiveness pilot study suggest that TPFM captures histological characteristics of NMSC that are present in conventional histology, which reveals its potential as a rapid, point-of-care diagnostic alternative that does not need extensive sample preparation or retraining for image evaluation. Further validation of TPFM imaging performed for a larger cohort is needed to fully evaluate its diagnostic accuracy and potential effect within the field.
Topics: Humans; Pilot Projects; Paraffin; Dermatology; Carcinoma, Basal Cell; Skin Neoplasms; Biopsy; Microscopy, Fluorescence
PubMed: 36069886
DOI: 10.1001/jamadermatol.2022.3628 -
Chemosphere Jul 2023Electronic waste is a source of both legacy and emerging flame retardants to the environment, especially in regions where sufficient waste handling systems are lacking....
Electronic waste is a source of both legacy and emerging flame retardants to the environment, especially in regions where sufficient waste handling systems are lacking. In the present study, we quantified the occurrence of short- and medium chain chlorinated paraffins (SCCPs and MCCPs) and dechloranes in household chicken (Gallus domesticus) eggs and soil collected near waste disposal sites on Zanzibar and the Tanzanian mainland. Sampling locations included an e-waste facility and the active dumpsite of Dar es Salaam, a historical dumpsite in Dar es Salaam, and an informal dumpsite on Zanzibar. We compared concentrations and contaminant profiles between soil and eggs, as free-range chickens ingest a considerable amount of soil during foraging, with potential for maternal transfer to the eggs. We found no correlation between soil and egg concentrations or patterns of dechloranes or CPs. CPs with shorter chain lengths and higher chlorination degree were associated with soil, while longer chain lengths and lower chlorination degree were associated with eggs. MCCPs dominated the CP profile in eggs, with median concentrations ranging from 500 to 900 ng/g lipid weight (lw) among locations. SCCP concentrations in eggs ranged from below the detection limit (LOD) to 370 ng/g lw. Dechlorane Plus was the dominating dechlorane compound in all egg samples, with median concentrations ranging from 0.5 to 2.8 ng/g lw. SCCPs dominated in the soil samples (400-21300 ng/g soil organic matter, SOM), except at the official dumpsite where MCCPs were highest (65000 ng/g SOM). Concentrations of dechloranes in soil ranged from below LOD to 240 ng/g SOM, and the dominating compounds were Dechlorane Plus and Dechlorane 603. Risk assessment of CP levels gave margins of exposure (MOE) close to or below 1000 for SCCPs at one location.
Topics: Animals; Chickens; Tanzania; Paraffin; Soil; Environmental Monitoring; Hydrocarbons, Chlorinated; Waste Disposal Facilities; China
PubMed: 37037350
DOI: 10.1016/j.chemosphere.2023.138646 -
Journal of Cancer Research and... Dec 2022Cytomorphological distinction between hepatocellular carcinoma and metastatic tumors to the liver may be difficult, especially when these have poor differentiation. The...
BACKGROUND
Cytomorphological distinction between hepatocellular carcinoma and metastatic tumors to the liver may be difficult, especially when these have poor differentiation. The present study was done to assess the diagnostic utility of hepatocyte paraffin-1 (HepPar-1), CD10, and CD34 in differentiating hepatocellular carcinoma from metastatic carcinoma.
MATERIALS AND METHODS
Ultrasound-guided fine-needle aspiration was performed on 50 patients with space-occupying lesions of liver suspicious for malignancy on clinical/radiologic findings. The cytological assessment was done on smears stained with May-Grünwald-Giemsa and hematoxylin and eosin. Cell blocks were prepared, and immunostaining for HepPar-1, CD10, and CD34 was done.
RESULTS
In these 50 patients, hepatocellular carcinoma was diagnosed in 7 and metastatic tumors in 43 cases. The sensitivity of smears in diagnosing hepatocellular carcinoma was 100% and the specificity was 95.3%, while the sensitivity and specificity of cell block were 100%. A canalicular pattern of CD10 immunoreactivity had a 100% positive predictive value for diagnosing hepatocellular carcinoma. CD10 had a sensitivity of 57.1% and 41.9% in identification of HCC and metastatic tumors, respectively. For the diagnosis of hepatocellular carcinoma, the sensitivity of CD34 was 85.7% and the specificity of sinusoidal pattern of immunoreactivity was 100%. The sensitivity and specificity of granular cytoplasmic staining pattern of HepPar-1 were 100% in hepatocellular carcinoma.
CONCLUSIONS
The staining patterns of HepPar-1, CD10, and CD34 are highly specific in distinguishing hepatocellular carcinoma from metastasis. These three immunomarkers should be included in the immunocytochemical panel for differentiating hepatocellular carcinoma from metastatic carcinoma to the liver.
Topics: Humans; Liver Neoplasms; Carcinoma, Hepatocellular; Paraffin; Immunohistochemistry; Biomarkers, Tumor; Diagnosis, Differential; Antigens, CD34; Hepatocytes; Cell Adhesion Molecules
PubMed: 36510999
DOI: 10.4103/jcrt.JCRT_467_20