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The Cochrane Database of Systematic... Apr 2014Fingertip entrapment injuries, which involve lacerations to the pulp and nail and often a fracture of the underlying bone, commonly occur in children, usually as the... (Review)
Review
BACKGROUND
Fingertip entrapment injuries, which involve lacerations to the pulp and nail and often a fracture of the underlying bone, commonly occur in children, usually as the result of a crushing injury. Treatment is either conservative (wound cleaning and fingertip dressing)or surgical (repair of lacerations, reduction and stabilisation of fractures); however, no consensus currently exists regarding the most appropriate treatment modality.
OBJECTIVES
To assess the effects (benefits and harms) of surgical and conservative interventions for fingertip entrapment injuries in children. We aimed to compare: different methods of conservative treatment; surgical versus conservative treatment; different methods of surgical treatment; and different methods of management after initial conservative or surgical treatment.
SEARCH METHODS
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (The Cochrane Library), MEDLINE, EMBASE, the World Health Organization Clinical Trials Registry Platform and reference lists of articles up to 30 April 2013. We did not apply any restrictions based on language or publication status.
SELECTION CRITERIA
Randomised controlled trials (RCTs) and quasi-RCTs comparing interventions for treating fingertip entrapment injuries in children.The primary outcomes were fingertip function, nail growth, nail deformity and adverse events such as infection.
DATA COLLECTION AND ANALYSIS
Two authors independently screened studies for inclusion, assessed the risk of bias in each included trial and extracted data.We resolved disagreements through discussion.
MAIN RESULTS
We included two RCTs examining a total of 191 young children, 180 of whom were included in the analyses. The two trials tested different comparisons. Both trials were at high risk of bias, particularly from lack of blinding of participants and personnel, and of outcome assessment. The trials did not record fingertip function, nail growth or nail deformity. The quality of the evidence for the reported outcomes was judged to be 'low' using the GRADE approach (i.e. further research is very likely to have an important impact on our confidence in the estimate of the effect and is likely to change the estimate).One trial compared a seven-day course of antibiotics with no antibiotics after formal surgical repair of fingertip entrapment injuries.One child in each group had an infection at day seven (1/66 antibiotic group versus 1/69 no antibiotic group; RR 1.05, 95% CI 0.07 to 16.37). Both participants with infections had a more severe injury (partial fingertip amputation).The other trial compared two different dressings (silicone net and paraffin gauze) for use after either surgical or initial conservative management of fingertip entrapment injuries. It reported that two of 20 children in the silicone group versus one of 25 in the paraffin group had complications of wound infection (RR 2.50, 95% CI 0.24 to 25.63) and that one of 20 children in the silicone group versus two of 25 in the paraffin group had skin necrosis (RR 0.63, 95% CI 0.06 to 6.41). All complications healed with conservative treatment. The results for mean healing times and mean number of dressing changes were similar between groups but benefits of either silicone or paraffin dressings could not be excluded (silicone mean 4.1 weeks versus paraffin mean 4.0 weeks;MD 0.10 weeks, 95% CI-0.61 to 0.81); (silicone mean 4.3 dressing changes versus paraffin mean 4.2 dressing changes; MD 0.10, 95% CI -0.57 to 0.77). The trial found that a silicone dressing was less likely to adhere to the wound or cause distress for the child at the one-week dressing change.
AUTHORS' CONCLUSIONS
There is a lack of evidence from RCTs to inform all key treatment decisions for the management of fingertip entrapment injuries in children.Given that the quality of evidence is low from one trial, we do not have conclusive evidence that prophylactic use of antibiotics after surgical repair fails to reduce risk of infection. The two children who experienced infection had more severe wounds.Similarly, the low quality evidence from one trial has not enabled us to draw firm conclusions regarding the effect on healing time or complications (infection, skin necrosis) at four-week follow-up between a silicone net dressing and a paraffin gauze dressing when applied post-surgery or after simple wound irrigation; however, the silicone net dressing may be easier to remove in the first week.Further RCTs are required in this area, preferably comparing surgical with conservative methods of managing fingertip entrapment injuries. Outcome assessment should include fingertip function, nail growth and nail deformity for a minimum of three months posttreatment.
Topics: Anti-Bacterial Agents; Bandages; Child; Child, Preschool; Finger Injuries; Humans; Infant; Paraffin; Randomized Controlled Trials as Topic; Silicones; Time Factors; Wound Healing
PubMed: 24788568
DOI: 10.1002/14651858.CD009808.pub2 -
BMC Ophthalmology Jul 2022To determine the percentage of patients who have silicone droplets in the vitreous after treatment with different anti-Vascular Endothelial Growth Factor (anti-VEGF)...
BACKGROUND
To determine the percentage of patients who have silicone droplets in the vitreous after treatment with different anti-Vascular Endothelial Growth Factor (anti-VEGF) intravitreal injections (IVI) and how symptomatic they are.
METHODS
One hundred fifty-two eyes of 140 patients who had at least received an IVI were recruited for this study. Data collection included the number and type of IVI (aflibercept, ranibizumab and bevacizumab) and the follow-up time. A complete ophthalmologic examination was carried out and patients were classified in four groups according to the amount of silicone droplets found in dilated fundoscopy (nonexistent, scarce, moderate and abundant). Measurement of intraocular pressure (IOP) was also carried out. An interview was conducted to report the presence and intensity of the symptomatology.
RESULTS
Silicone oil droplets were reported in 109 eyes (71.7%). A positive correlation was found between the number of IVIs received and the quantity of droplets found, especially when aflibercept was used. Posterior vitreous detachment (PVD) was present in 65.8% of the patients, showing a positive correlation with the number of bubbles. Regarding the symptomatology, 60 eyes (39.5%) had floaters and the disturbance was reported to be 4 out of 10. The group with a moderate amount of silicone droplets had the highest percentage of floaters (60%). No statistical differences in the IOP were found between groups, although the group with abundant droplets had a higher mean IOP.
CONCLUSION
A high prevalence of silicone droplets in vitreous of patients who undergo IVI treatment was found. It appears to have little impact on symptomatology and rise of IOP.
Topics: Angiogenesis Inhibitors; Bevacizumab; Glaucoma; Humans; Intraocular Pressure; Intravitreal Injections; Prevalence; Ranibizumab; Silicone Oils; Silicones; Vascular Endothelial Growth Factor A
PubMed: 35883113
DOI: 10.1186/s12886-022-02536-2 -
Journal of Indian Prosthodontic Society 2021The aim is to study the effect of freshly placed composite build-ups on setting of additional silicone impression materials.
AIM
The aim is to study the effect of freshly placed composite build-ups on setting of additional silicone impression materials.
SETTINGS AND DESIGN
In vitro - experimental study.
MATERIALS AND METHODS
Three composite materials; Build-It™ F. R™, Filtek™ Bulk Fill flow and Filtek™ Z350 and three light-bodied additional silicone impression materials; Elite HD+, Aquasil LV Ultra and Express™ were used. Cylindrical-shaped specimens were made of each material (diameter 15 mm and height 10 mm). The silicone specimens were brought into contact with the composite specimens, which were either freshly cured (9 groups, n = 90) or cured and then stored in normal saline for 1 week (9 groups, n = 90). Shore A hardness (SAH) scores of silicone surfaces were recorded following the ASTM D2240-5 standards for shore A Durometer testing. Six measurements were made per each silicone surface and medians were calculated. Kruskal-Wallis and Mann-Whitney tests (SPSS v20) were used to check statistical significant differences between all groups and paired comparisons, respectively (P < 0.05).
STATISTICAL ANALYSIS USED
Kruskal-Wallis and Mann-Whitney tests.
RESULTS
The SAH scores of additional silicones in direct contact with freshly placed composites were significantly less than SAH scores of additional silicones in direct contact with composites specimens aged for 1 week in 7 out of 9 combinations (P < 0.05). Only when Express™ and Elite HD+ were applied over freshly placed Filtek™ Bulk Fill flow, the SAH scores difference was not statistically significant to SAH scores of matching combinations applied after 1 week of composite storage.
CONCLUSIONS
Freshly placed composite might affect setting of additional silicone impression materials. Dentists should carefully assess final impression on areas of prepared teeth that have received composite fillings recently.
Topics: Aged; Hardness; Humans; Materials Testing; Silicon; Silicones
PubMed: 33938869
DOI: 10.4103/jips.jips_606_20 -
Biomacromolecules Nov 2022A type of ultrathin films has been developed for suppressing capsule formation induced by medical silicone implants and hence reducing the inflammation response to such...
Ultrathin Nanostructured Films of Hyaluronic Acid and Functionalized β-Cyclodextrin Polymer Suppress Bacterial Infection and Capsular Formation of Medical Silicone Implants.
A type of ultrathin films has been developed for suppressing capsule formation induced by medical silicone implants and hence reducing the inflammation response to such formation and the differentiation to myofibroblasts. The films were each fabricated from hyaluronic acid (HA) and modified β-cyclodextrin (Mod-β-CyD) polymer which was synthesized with a cyclodextrin with partially substituted quaternary amine. Ultrathin films comprising HA and Mod-β-CyD or poly(allylamine hydrochloride) (PAH) were fabricated by using a layer-by-layer dipping method. The electrostatic interactions produced from the functional groups of Mod-β-CyD and HA influenced the surface morphology, wettability, and bio-functional activity of the film. Notably, medical silicone implants coated with PAH/HA and Mod-β-CyD multilayers under a low pH condition exhibited excellent biocompatibility and antibiofilm and anti-inflammation properties. Implantation of these nanoscale film-coated silicones showed a reduced capsular thickness as well as reduced TGFβ-SMAD signaling, myofibroblast differentiation, biofilm formation, and inflammatory response levels. We expect our novel coating system to be considered a strong candidate for use in various medical implant applications in order to decrease implant-induced capsule formation.
Topics: Humans; Hyaluronic Acid; Polymers; Silicones; beta-Cyclodextrins; Bacterial Infections
PubMed: 36130109
DOI: 10.1021/acs.biomac.2c00687 -
PloS One 2021The catheter is the only intravascular portion of an implanted port and plays a crucial role in catheter related complications. Both polyurethane and silicone are...
INTRODUCTION
The catheter is the only intravascular portion of an implanted port and plays a crucial role in catheter related complications. Both polyurethane and silicone are biocompatible materials which are utilized for catheter manufacturing, but their correlation to complications remains controversial. The aim of this study was to try to analyze the relationship between catheter materials and complications.
MATERIALS AND METHODS
A total of 3144 patients who underwent intravenous port implantation between March 2012 and December 2018 at Chang Gung Memorial Hospital, Linkou, Taiwan were recruited. Of these, 1226 patients received silicone catheter port implantation and 1679 received polyurethane catheter ports. Case matching was done prior to analysis and catheter related complications and cumulative complication incidence for each group were compared.
RESULTS
Intergroup differences were identified in entry vessel (p = 0.0441), operation year (p < 0.0001), operation method (p = 0.0095), functional period (p < 0.0001), patient follow up status (p < 0.0001), operating time for vessel cutdown (p < 0.0001) and wire assisted approach (p = 0.0008). Stratified by specific entry vessel, no statistical difference was found in complication rate or incidence between the silicone and polyurethane groups. We further compared the cumulative complication incidence of the silicone and polyurethane groups, and also found no statistical difference (p = 0.4451).
CONCLUSION
As long as external stress forces generated by surrounding structures and focused on potential weak points are avoided, both silicone and polyurethane materials provide sufficient structural stability to serve as reliable vascular access for patients.
Topics: Administration, Intravenous; Catheterization, Central Venous; Catheters, Indwelling; Equipment Failure; Female; Humans; Incidence; Male; Middle Aged; Physical Functional Performance; Polyurethanes; Silicones; Taiwan; Vena Cava, Superior
PubMed: 34705838
DOI: 10.1371/journal.pone.0253818 -
Contact Lens & Anterior Eye : the... Dec 2021The present study aimed to estimate how orientation position, recovery time, and contact lens decentration, associated with visual performance, may vary on several... (Observational Study)
Observational Study
PURPOSE
The present study aimed to estimate how orientation position, recovery time, and contact lens decentration, associated with visual performance, may vary on several designs of the most recent toric silicone-hydrogel toric contact lenses in two-time different moments.
METHODS
To evaluate the toric silicone-hydrogel toric contact lens position and stability, it was conducted with a prospective, observational, randomized, and single-center case series including 95 astigmatic eyes wearing four toric silicone-hydrogel toric contact lenses for two weeks. Orientation and decentration were analyzed with ImageJ software from video-frames extracted with a Python application. Recovery time was evaluated after 45 degrees of inferior-temporal misorientation.
RESULTS
Evaluation of misorientation after 20 min of wear revealed the highest amount for Saphir RX, -20.41 ± 10.84 deg, and lowest for Air Optix Aqua for Astigmatism, -1.43 ± 7.48 deg. The highest horizontal misalignment was found for Air Optix Aqua for Astigmatism, -0.627 ± 0.330 mm, and lowest for Biofinity Toric, 0.004 ± 0.270 mm. Vertical misalignment presented the highest value for Acuvue Vita for Astigmatism, -0.652 ± 0.369 mm, and lowest for Air Optix Aqua for Astigmatism, -0.126 ± 0.231 mm. Recovery time showed the highest amount for Saphir RX, 80.70 ± 33.26 s, and lowest for Biofinity Toric 43.67 ± 23.70 s. Only Air Optix Aqua for Astigmatism presented significant differences after two-week of wear for misorientation (P = 0.02) and horizontal misalignment (P < 0.001). When pairwise comparisons are made between toric silicone-hydrogel toric contact lenses, significant differences (P < 0.001) are found.
CONCLUSIONS
Although there was acceptable fitting, based upon decentration, orientation, and recovery with the study contact lenses, the stabilization and profile design used in the Air Optix Aqua for Astigmatism helped to minimize rotation and vertical misalignment. In addition, the peri-ballast and thickness profile of the Biofinity Toric improved rotational recovery and horizontal misalignment compared to the other contact lenses. Finally, lenses with a better fitting profile showed better visual performance.
Topics: Astigmatism; Contact Lenses, Hydrophilic; Humans; Hydrogels; Prospective Studies; Silicones
PubMed: 33846086
DOI: 10.1016/j.clae.2021.03.004 -
Journal of Chromatography. A Mar 2008This review presents a brief outline and novel developments of electrophoretic separation in microfluidic chips. Distinct characteristics of microchip electrophoresis... (Review)
Review
This review presents a brief outline and novel developments of electrophoretic separation in microfluidic chips. Distinct characteristics of microchip electrophoresis (MCE) are discussed first, in which sample injection plug, joule heat, channel turn, surface adsorption and modification are introduced, and some successful strategies and recognized conclusions are also included. Important achievements of microfluidic electrophoresis separation in small molecules, DNA and protein are then summarized. This review is aimed at researchers, who are interested in MCE and want to adopt MCE as a functional unit in their integrated microsystems.
Topics: Adsorption; DNA; Dimethylpolysiloxanes; Electrophoresis, Microchip; Proteins; Silicones; Spectrophotometry, Ultraviolet; Surface Properties; Temperature
PubMed: 18207148
DOI: 10.1016/j.chroma.2007.11.119 -
ACS Applied Materials & Interfaces May 2020Biofilm formation is most commonly combatted with antibiotics or biocides. However, proven toxicity and increasing resistance of bacteria increase the need for...
Biofilm formation is most commonly combatted with antibiotics or biocides. However, proven toxicity and increasing resistance of bacteria increase the need for alternative strategies to prevent adhesion of bacteria to surfaces. Chemical modification of the surfaces by tethering of functional polymer brushes or films provides a route toward antifouling coatings. Furthermore, nanorough or superhydrophobic surfaces can delay biofilm formation. Here we show that submicrometer-sized roughness can outweigh surface chemistry by testing the adhesion of to surfaces of different topography and wettability over long exposure times (>7 days). Gram-negative and positive bacterial strains are tested for comparison. We show that an irregular three-dimensional layer of silicone nanofilaments suppresses bacterial adhesion, both in the presence and absence of an air cushion. We hypothesize that a 3D topography can delay biofilm formation (i) if bacteria do not fit into the pores of the coating or (ii) if bending of the bacteria is required to adhere. Thus, such a 3D topography offers an underestimated possibility to design antibacterial surfaces that do not require biocides or antibiotics.
Topics: Bacterial Adhesion; Biofouling; Escherichia coli; Glass; Hydrocarbons, Fluorinated; Micrococcus luteus; Nanostructures; Pseudomonas fluorescens; Silicones; Wettability
PubMed: 32142252
DOI: 10.1021/acsami.9b22621 -
Aesthetic Surgery Journal Mar 2022
Topics: Foreign-Body Migration; Humans; Particle Size; Silicones
PubMed: 34695179
DOI: 10.1093/asj/sjab377 -
Daru : Journal of Faculty of Pharmacy,... Jun 2021To develop and validate a simple and consistent reversed phase high performance liquid chromatography (RP-HPLC) method for the estimation of Levonorgestrel (LNG) drug...
RP-HPLC method validation for fast extraction and quantification of Levonorgestrel drug from silicone based intrauterine device intended for in-process and finished formulation.
BACKGROUND
To develop and validate a simple and consistent reversed phase high performance liquid chromatography (RP-HPLC) method for the estimation of Levonorgestrel (LNG) drug from silicone based intrauterine device.
METHODS
Sample solution was prepared using tetrahydrofuran (THF) as solvent for the drug extraction, and RP-HPLC analysis was performed using Luna C18 analytical column (150 × 4.6 mm, 5 μm, 100 Å - Phenomenex), with a mobile phase consisting of a mixture of acetonitrile and water (50:50, v/v) at a flow rate of 1.0 ml/min and injection volume of 20 μl. Detection was carried out at 241 nm in PDA detector, with a total run time of 15 min. The method was validated in accordance with ICH guidelines. Method applicability was tested for optimizing formulation using quality-by-design approach, to check the stability and content uniformity of levonorgestrel-silicone mixture (core blend), and quantifying the amount of LNG from commercially available silicone based formulation.
RESULTS
The retention time for LNG drug was obtained at 8.5 min (± 0.3 min). A linear relationship was observed over the concentration range of 2.6-15.6 μg/ml with the correlation coefficient (r) value 0.9999. The method was found to be precise within the acceptable limit (RSD < 2%) and the drug recovery from the intrauterine device was found in the range 99.78-100.0%. Content uniformity for different prototypes developed was observed in the range of 91.6-101.4%, and assay of optimized core blend was in the range of 97.78-106.79% during the 10 days of retention period for stability studies.
CONCLUSION
The validated method is found to be a simple, accurate, precise, reproducible, and hence can be used for the routine analysis of LNG such as in-process, quality control and stability assays of silicone based intrauterine devices by RP-HPLC.
Topics: Chromatography, High Pressure Liquid; Chromatography, Reverse-Phase; Contraceptive Agents, Female; Intrauterine Devices; Levonorgestrel; Reproducibility of Results; Silicones
PubMed: 33934266
DOI: 10.1007/s40199-021-00396-7