Topical Usage Research Articles

The notion of state. Connotations of topical usage using discourse analysis

One of the most powerful political concepts in Europe, including Latvia, is the welfare state. Whether or not the Latvian language environment reveals hopes and expectations regarding the notion may be determined through a close study of the parliamentary discourse of the past five years, as well as the language user opinions regarding state. The goal of the research is to analyse the topical usage of the notion state and its connotations. As data collection tools, the study used language corpora which display the most frequent collocations and the related semantic fields of a given word. The data analysis was carried out via critical discourse analysis focusing on the dominant characteristics in the language use. The analysis found contradictory usage of the word state. Within the speeches of the members of the parliament, deviations from the definition of the state and new connotations attached to the notion were observed, implying a collective responsibility of the state instead of individual. Both language users and members of the parliament await a strict governmental management and wish to view it as an authority. The desire of a wealth-providing, generous state could signify a hope for a welfare state, albeit peculiarly interpreted.

Do patients enrolled in observational studies have better outcomes than non-participants? A retrospective analysis

Patients are commonly enrolled into clinical trials. It has been reported that these patients may have better outcomes than those not enrolled into the study. The reasoning from these improvements could be attributable to closer follow-up, better patient adherence, more health aware patients have, or reaction to observation such as the Hawthorne effect. Three hundred forty-six patients were approached for a prospective skin toxicity study in adjuvant breast cancer radiotherapy (RT) but declined participation between January 2018 and July 2019 (non-trial group). They were retrospectively reviewed and patient, treatment and RT-related characteristics, as well as the occurrence of skin reactions, and the usage of topical treatments were collected. This was compared with a comparison cohort of 349 patients who were enrolled into a previously conducted prospective study (trial group). More patients in the trial group had conventional RT (CFRT) versus hypofractionated RT (HFRT). Data was further stratified and there was no significant difference in moist desquamation, topical antibiotic usage, dressing application, home care use, topical corticoid steroid use, and oral analgesic use. There was a significantly lower pain score in the group compared with the non-trial group in both HFRT and CFRT (OR = 0.091 and OR = 0.348, p < 0.0001). Our results demonstrated no differences other than pain between the trial group and non-trial group. Therefore, in this cohort, patients enrolled into an observational trial while undergoing adjuvant breast RT demonstrated similar experiences of skin reactions. There are challenges to assessing differences between these groups, as confounding is likely. Therefore, it is recommended for future studies to additionally assess the impact of study participation on outcomes such as quality of life, quality of care received, and/or anxiety levels.

The Expression of Self and Grief in the Nineteenth Century: An Analysis through Distant Readings

When writing about grief, Peter N. Stearns and Mark Knapp (‘Historical Perspectives on Grief’, in The Emotions: Social, Cultural and Biological Dimensions, ed. Rom Harré and W. Gerrod Parrot (London: Sage Publications, 1996): 138) speculate that ‘[i]n contrast to eighteenth-century songs about death, which were set in the artificial pastoral world of shepherds and written in the third person, Victorian grief songs were personal and immediate’. Inspired by this claim, we investigated the usage of pronouns, as well as topics surrounding grief, in ballads taken from broadsides in the nineteenth century. We found that the use of first-person pronouns increases over the nineteenth century, and that this was not a linear trend; there were sharp increases in the usage of first-person pronouns beginning in 1815, which leveled off in the third quarter of the century. Additionally, we examined the usage of lyrical topics about death, grieving, negatively valenced emotion and sadness, and asked whether such topics correlated with the increased usage of first-person pronouns. We found that there was not a strong correlation with the usage of pronouns and such topics, though there was a small correlation between the usage of such pronouns and sadness and a stronger positive correlation between a focus on the present and positively valenced emotion. These findings suggest that first-person pronouns are not reliable indicators of lyrical topics surrounding grief, or vice-versa. Using personal pronouns as a measure of intimacy, we conclude that songs written in the beginning of the nineteenth century did see a rise in intimacy in song lyrics. However, this increase does not appear to be tied to songs about grief, specifically. Despite the existence of many personal grief songs in the Victorian period, our distant reading reveals linguistic trends and interrelations that challenge the intuition that nineteenth-century grief songs were more personal than earlier ones.

Osteoarthritis Preoperative Package for care of Orthotics, Rehabilitation, Topical and oral agent Usage and Nutrition to Improve ouTcomes at a Year (OPPORTUNITY); a feasibility study protocol for a randomised controlled trial

BackgroundPatients’ pre-operative health and physical function is known to influence their post-operative outcomes. In patients with knee osteoarthritis, pharmacological and non-pharmacological options are often not optimised prior to joint replacement. This results in some patients undergoing surgery when they are not as fit as they could be. The aim of this study is to assess the feasibility and acceptability of a pre-operative package of non-operative care versus standard care prior to joint replacement.Methods/designThis is a multicentre, randomised controlled feasibility trial of patients undergoing primary total knee replacement for osteoarthritis. Sixty patients will be recruited and randomised (2:1) to intervention or standard care arms. Data will be collected at baseline (before the start of the intervention), around the end of the intervention period and a minimum of 90 days after the planned date of surgery. Adherence will be reviewed each week during the intervention period (by telephone or in person). Participants will be randomised to a pre-operative package of non-operative care or standard care. The non-operative care will consist of (1) a weight-loss programme, (2) a set of exercises, (3) provision of advice on analgesia use and (4) provision of insoles. The intervention will be started as soon as possible after patients have been added to the waiting list for joint replacement surgery to take advantage of the incentive for behavioural change that this will create. The primary outcomes of this study are feasibility outcomes which will indicate whether the intervention and study protocol is feasible and acceptable and whether a full-scale effectiveness trial is warranted.The following will be measured and used to inform study feasibility: rate of recruitment, rate of retention at 90-day follow-up review after planned surgery date, and adherence to the intervention estimated through review questionnaires and weight change (for those receiving the weight-loss aspect of intervention). In addition the following information will be assessed qualitatively: analysis of qualitative interviews exploring acceptability, feasibility, adherence and possible barriers to implementing the intervention, and acceptability of the different outcome measures.DiscussionThe aims of the study specifically relate to testing the feasibility and acceptability of the proposed effectiveness trial intervention and the feasibility of the trial methods.This study forms the important first step in developing and assessing whether the intervention has the potential to be assessed in a future fully powered effectiveness trial. The findings will also be used to refine the design of the effectiveness trial.Trial registrationISRCTN registry, ID: ISRCTN96684272. Registered on 18 April 2018.

Diaper dermatitis prevalence and severity: Global perspective on the impact of caregiver behavior.

ObjectivesTo compare prevalence and severity of diaper dermatitis (DD) in infants and toddlers (babies) across three countries (China, USA, and Germany), including diapered skin measures and caregiver practices.MethodsA cross‐sectional study of 1791 babies (~600 from each country) was recruited at each clinical site. Based on regional toilet‐training habits, exclusively diaper‐wearing infants were recruited between ages 2‐8 months in China and 2‐18 months in the USA and Germany. DD was measured, as well as skin pH, transepidermal water loss (TEWL), and relative humidity (RH) in the diapered region. Caregiver habits were collected via a questionnaire and included information on hygienic practices.ResultsDiaper dermatitis was highest in the perianal area, followed by the intertriginous, genital, and buttock regions. In general, DD was significantly lower in babies in China, highest in Germany, and intermediate in the USA. This rank ordering of DD by geography was also observed in baby age 2‐8 months. The lower DD observed in China was associated with lower skin pH and TEWL on diapered skin and decreased RH in the diaper. Chinese caregivers had the highest rate of prophylactic topical product usage, the most robust cleaning of the diapered area, lack of cleansing after urine‐only diaper changes, and Chinese infants spent the least time in an overnight diaper.ConclusionsThese data suggest caregiver behaviors including prophylactic use of topical products, thorough cleaning after stooling and reduced time in an overnight diaper are associated with less DD, lower superficial skin pH, and enhanced skin barrier.

Ozonated Oils and Cutaneous Wound Healing.

Wound tissue repair is a complex and dynamic process of restoring cellular structures and tissue layers. Improvement in this process is necessary to effectively treat several pathologies characterized by a chronic delayed wound closure, such as in diabetes, and the investigation of new approaches aimed to ameliorate the wound healing process is under continuous evolution. Recently, the usage of vegetable matrices in the form of ozonated oils has been proposed, and several researchers have shown positive effects on wound healing, due to the bactericidal, antiviral, and antifungal properties of these ozonated oils. In the present review, we intend to summarize the actual state of the art of the topical usage of ozonated oil in cutaneous wounds with special emphasis to the importance of the ozonated degree of the oil.

PERANAN PASTA KULIT MANGGIS DALAM PEMBENTUKAN JARINGAN IKAT KOLAGEN PADA PROSES KESEMBUHAN ULKUS MUKOSA MULUT

Prevalence of mouth ulcer in patients who visited dental clinic ranged 27%, contributing factors as chemical trauma and infection. Topical medicine available on the market today contained some chemicals might be contraindicated in hipersensitive patient, required an alternative medication of herbal ingredients that had same efficacy, safe and no allergic. Several studies had shown that xanthone contained in rind mangosteen could act as an anti inflammatory, anti bacterial and anti alergic. Aim of this study was to investigate application of rind mangosteen paste towards collagen formation in mouth ulcer healing due to chemical and infection. The experimental research with post test control group design, randomly obtained a total sample of male Wistar rats was 24 and divided into 4 groups @ 6 tails where 2 (two) treatment groups (due to chemical and infection) smeared with mangosteen rind paste and 2 (two) other treatment groups smeared with standard medicine (PVP), then from each group decapitated the 3 rd , 7 th and 10 th day. Observation was carried out macroscopically and microscopically then the data obtained on the 10 th day performed Kruskal Wallis test. The result of this study showed time healing for chemical ulcer was 9 days (standard medicine) and 10 days (mangosteen rind paste) while infectious ulcer was 10 days (standard medicine) and 9 days (mangosteen rind paste). Role of mangosteen rind paste proved significant in formation collagen of infectious ulcer, usage of standar medicine decreased area of collagen formation on 3 rd , 7 th and 10 th day (0,133 mm; 0,083 mm; 0,059 mm) while usage of mangosteen rind paste might increase this collagen formation (0,073 mm; 0,083 mm; 0,115 mm). There was significant difference broad of collagen formation with p value = 0,016. Topical usage of mangosteen rind paste might accelerate mouth ulcer healing and increase formation of collagen in infectious mouth ulcer.

Virtual Screening of Henna Compounds Library for Discovery of New Leads against Human Thymidine Phosphorylase, an Overexpressed Factor of Hand-Foot Syndrome

Background: Capecitabine is one of the most effective and successful drugs for the treatment of uterine and colorectal cancer which has been limited in use due to occurrence of handfoot syndrome (HFS). Overexpression of human thymidine phosphorylase enzyme is predicted to be one of the main causes of this syndrome. Thymidine phosphorylase enzyme is involved in many cancers and inflammatory diseases and pyrimidine nucleoside phosphorylase family is found in a variety of organisms. Results of clinical studies have shown that topical usage of henna plant (Lawsonia inermis from the family of Lythraceae) could reduce the severity of HFS. Methods: By using in silico methods on reported compounds of henna, the present study is aimed at finding phytochemicals and chemical groups with the potential to efficiently interact with and inhibit human thymidine phosphorylase. Various compounds (825) of henna from different chemical groups (138) were virtually screened by the interface to AutoDock in YASARA Software package, against the enzyme structure obtained from X-ray crystallography and refined by homology modeling methods. Results: By virtual screening, i.e. docking of candidate ligands into the determined active site of hTP, followed by applying the scoring function of binding affinity, 71 compounds (out of 825 compounds) were estimated to have the likelihood to bind to the protein with an interaction energy higher than 10 kcal/mol (Concerning the sign of “binding energies”, please refer to the Methods section). Conclusion: Finally, diosmetin-3'-O-β-D-glucopyranoside (#219) and monoglycosylated naphthalene were respectively selected as the most potent phytochemicals and chemical groups. Flavonoid-like compounds with appropriate interaction energy were also considered as the most probable inhibitors. More investigations on henna compounds, are needed in order to approve their effectiveness and also to explore more anti-cancer, anti-inflammatory, anti-angiogenesis and even antibiotics.

Temporal topic modeling applied to aviation safety reports: A subject matter expert review

The aviation safety reporting system database has seen many applications of topic modeling and natural language processing. Its size, metadata, and narratives have made it ideal for demonstrating new models and approaches. However, less often seen is how these methods are applied by subject matter experts and subsequently interpreted. Within this article, latent Dirichlet allocation is applied to a fourteen year sample of the aviation safety reporting system database, filtered for commercial airline operations. The topics terms generated were presented to three subject matter experts, along with weighted topic narratives, and mean usage of each topic by month. A high level of inter-rater agreement was demonstrated for the conceptual themes that emerged from the selected topics. The subject matter experts were able to identify the reporter’s qualification (air traffic controllers, etc.) as well as some of the environmental, regulatory, and industry factors consistent with observed temporal trends of topic usage. Through this examination, additional suggestions are made for the process of interpretation of topic modeled themes, expanding on the work of DiMaggio, Nag, and Blei. Post facto, the study identified the increase in reported safety concerns facing flight crews following the introduction of the runway awareness and advisory system into the cockpit in 2009. Additionally, the results precipitated a change to the way the subject matter experts interpreted the narratives and their implications to industry safety. This work provides a practical validation of the use of natural language processing in sensemaking and pinpointing trends necessary for prioritizing safety activities.

The impact of allergic rhinitis on gastrointestinal disorders among young adults.

An association between allergic rhinitis (AR) and digestive diseases (DDs) has been reported; however, studies have only focused on the prevalence of DDs in populations of patients with AR. In individuals with specific DDs, the impact of AR on the frequency of clinical visits for each DD has not been studied. Moreover, the association between topical steroid usage for AR and DDs has not been investigated. Data from 16526 men and 18438 women, aged 21 to 30years, were collected from a national database. Individuals were separated into the AR and non-AR groups. Eight common DDs were studied: (1) gastroesophageal reflux disease (GERD), (2) gastritis and duodenitis, (3) peptic ulcers, (4) irritable bowel syndrome, (5) gastric functional disease, (6) intestinal functional disease, (7) gastroenteritis and colitis, and (8) constipation. The rate of each DD was compared between groups. In individuals with specific DDs, the frequency of clinical visits for each DD was also compared between groups. Between users and nonusers of topical steroids in the AR group, the rate of DDs was compared. Significant associations were observed between all eight DDs and AR in both sexes. In comparison to the non-AR group, women with AR visited clinics more frequently for gastritis/duodenitis, gastric and intestinal functional disease, gastroenteritis/colitis, and constipation, while men with AR visited clinics more frequently for gastritis/duodenitis, gastric functional disease, gastroenteritis/colitis, and constipation. Female topical-steroid users with AR had higher rates of GERD, irritable bowel syndrome, gastric or intestinal functional disease, and gastritis/colitis. Male topical-steroid users with AR had higher rates of GERD and peptic ulcers. AR was associated with DDs in both sexes. However, the influence of AR on clinical visit frequency varied among specific DD groups. Topical steroid usage for AR was associated with some DDs, but the association requires future evaluation.

Patch Testing in Allergic Contact Dermatitis over the Lower Extremities.

Background:There is an increased incidence of allergic contact dermatitis (ACD) over the lower extremities due to over-the-counter topical preparations, occupational risk, and usage of several chemicals in the manufacture of designer footwear.Aims and Objectives:The aim of the study was to identify the common allergens and polysensitization pattern involved in ACD over the lower extremities.Materials and Methods:It is a cross-sectional study, wherein a total of 80 patients were recruited over a period of 18 months. Demographic and clinical characteristics were noted. Patch test was done with the Indian standard series. Interpretation of patch test readings was read according to the International Contact Dermatitis Research Group criteria at 48 and 96 h.Results:There were 45 males and 35 females (M:F= 1.3:1). Mean age was 41.65 years. Most of the patients belonged to 21–40 years age group. Farmers, homemakers, and students were commonly affected. Most common presentation was itching, hyperpigmentation, and scaly plaques over the feet. Patch test was performed in 75% of the patients. One or more positive results were observed in 57% of the patients. Common allergens noted were potassium dichromate (35%), followed by nickel sulfate (23.5%), mercapto mix, and mercaptobenzothiazole. Potassium dichromate and nickel were the common allergens reported in males and females, respectively. Neomycin was the common medication responsible for dermatitis medicamentosa. Polysensitization was seen with mercapto mix, mercaptobenzothiazole, potassium dichromate, and fragrance mix.Conclusion:Potassium dichromate and nickel were the common allergens responsible for ACD over the lower extremities. Polysensitization was seen commonly with mercapto mix, mercaptobenzothiazole, and fragrance mix.Recommendation:Screening for usage of topical preparations and late patch test readings (96 h or more) is recommended.

Assessment of the Utilization Pattern and Related Knowledge about Topical Nasal Decongestants among the Users

Introduction&#x0D; Nasal decongestants are one of the drugs commonly prescribed by otorhinolaryngologists in their day to day practice. The excessive or inappropriate use of nasal decongestant due to rapid symptomatic relief leads to drug misuse or abuse. Inadequate knowledge about the drug usage leads to inappropriate drug usage.&#x0D; Materials and Methods&#x0D; A cross sectional study was done among 90 patients who were using topical nasal decongestants. A pre tested, pre validated questionnaire was used to assess the patient’s knowledge, the utilization pattern and the attitude towards the drug usage.&#x0D; Results &#x0D; The mean age of presentation in our study was 38.4 years. Only 14.4% of the people knew the appropriate duration of drug usage. Only 33.3% knew about the probable side effects of prolonged drug usage. There was a significant correlation between knowledge and utilisation pattern of topical nasal decongestants usage and the literacy level. Though most of the people (46.7%) started using the drug after being prescribed by a doctor, only 14.3% among them strictly adhered to doctor’s instructions.82% of the users were not much worried about the prolonged usage as 73.3% believed that prolonged use may or will surely improve their symptoms. Though 66.7% users wanted to stop prolonged usage of the drug, 76.9% had varying difficulties in stopping the drug. &#x0D; &#x0D; Conclusion&#x0D; The knowledge and the utilization pattern regarding the drug usage were very low. The same was found to be better with increase in literacy level. Health professionals should play a major role in establishing a rational drug usage.

Beneficial effect of Curcumin Nanoparticles-Hydrogel on excisional skin wound healing in type-I diabetic rat: Histological and immunohistochemical studies

Management of diabetic wounds remains a major challenge in the medical field, mostly due to incompetent outcomes of treatments. Curcumin has been documented as anti-inflammatory, antioxidant, antimicrobial and antineoplastic agent in addition to wound healing activities. However, its poor aqueous solubility and impaired skin permeation handicap its topical pharmaceutical usage. Hydrogel loaded curcumin nanoparticle (Cur-NP/HG) could overcome this pitfall and enable extended topical delivery of curcumin. Rat model of diabetes mellitus (DM) type I was induced using single injection of 70mg/kg streptozotocin (STZ) followed by full thickness skin wound. Rats were divided into 4 groups. GpI: control non-diabetic, GpII: diabetic non-treated, GpIII: diabetic treated with topical curcumin hydrogel (Cur/HG) and GpIV: diabetic treated with topical Cur-NP/HG. Histological assessment of epidermal regeneration, dermo-epidermal junction, leukocyte infiltration and collagen deposition, in addition to immunohistochemical staining for vascular endothelial growth factor (VEGF) and aquaporin-3 (AQP3) were performed. Diabetic rat possessed impaired wound closure, persistence of inflammation and decreased collagen deposition as compared to non-diabetic control. Application of Cur/HG induced partial improvement of the healing process in diabetic rats. Cur-NP/HG treatment provoked obvious improvement of the healing process with complete re-epithelization, intact dermo-epidermal junction, reorganization of the dermis with significantly increased collagen deposition and VEGF and AQP3 expression. These results illustrated that Cur-NP/HG have effectively improved the healing process in diabetic skin wound with substantial differences in the wound healing kinetics compared to wounds that received Cur/HG.

Topical tranexamic acid in spinal surgery: A systematic review and meta-analysis

Tranexamic acid (TXA) is a commonly used antifibrinolytic agent for perioperative blood conservation in several surgical specialties. Although historically administered intravenously, such systemic administration may be accompanied by severe side effects. Thus, the topical usage of TXA has been established in several fields but remains poorly evaluated in spine surgery. In this study, the authors aimed to review the medical literature on topical TXA usage in spine surgery to evaluate its safety and efficacy. We reviewed manuscripts and clinical trials exploring topical TXA usage in spine surgery published by April 1st, 2018. Postoperative blood loss volumes and hospitalization lengths of stay were evaluated with separate meta-analyses. We identified five articles and one unpublished clinical trial that were placebo-controlled and comprised 218 patients receiving topical TXA in spine surgery. Patients receiving topical TXA demonstrated significantly lower postoperative blood loss as compared to the placebo group (Standardized Mean Difference [SMD] 2.21, 95% CI 0.79–3.62, p < 0.001) and had a lower hospitalization duration (MD 0.99, 95% CI 0.49–1.49, p < 0.001). Overall, topical TXA favorably reduced postoperative blood loss and hospitalization duration in patients undergoing spinal surgery. However, further randomized controlled trials will be needed to definitively establish the optimal therapeutic doses needed for hemorrhage management, and the pharmacodynamics of tTXA in spinal surgery.

Clinical profile and risk factors of dermatophytoses: a hospital based study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Dermatophytoses are superficial mycoses which represents most common community health problem across the globe. Surveillance studies are required to understand the changing epidemiology and prevalence of causative agents to decide on appropriate therapy. This study aims to evaluate the clinical types, etiological agents and probable risk factors of dermatophytoses.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; It was a cross sectional study of 150 clinically suspected cases of dermatophytoses during six months. Sociodemographic details, clinical history and detailed examination were collected from all the subjects. Skin scrapings were sent to microbiology for direct microscopy and fungal culture.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Among the 150 subjects enrolled, males outnumbered females. Infection was mostly prevalent in the age group of 21-30 years (37.3%). Tinea cruris was the commonest clinical type (50%) followed by Tinea corporis (18.4%) and Tinea unguium (11.9%). Tricophyton rubrum was the aetiological agent isolated in majority (33%), followed by Tricophyton mentagrophytes (20%). The major risk factors of dermatophytoses were poor hygiene (32.1%), topical steroid usage (23.9%) and diabetes mellitus (20.1%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The present study has provided recent data on etiological agents of dermatophytoses and risk factors in our area. It is essential to develop measures for prevention, control of dermatophyte infections and establishment of therapeutic strategies.&lt;/p&gt;

Topical Vancomycin Reduces Surgical-Site Infections After Craniotomy: A Prospective, Controlled Study.

Surgical-site infections (SSIs) are an important cause of morbidity and mortality in neurosurgical patients. Topical antibiotics are one potential method to reduce the incidence of these infections. To examine the efficacy of topical vancomycin applied within the wound during craniotomy in a large prospective cohort study at a major academic center. Three hundred fifty-five patients were studied prospectively in this cohort study; 205 patients received 1 g of topical vancomycin powder in the subgaleal space while 150 matched control patients did not. Patients otherwise received identical care. The primary outcome variable was SSI rate factored by cohort. Secondary analysis examined cost savings from vancomycin usage estimated from hospital costs associated with SSI in craniotomy patients. The addition of topical vancomycin was associated with a significantly lower rate of SSI than standard of care alone (0.49% [1/205] vs 6% [9/150], P=.002). Based on the costs of revision surgery for infections, topical vancomycin usage was estimated to save $1367 446 per 1000 craniotomy patients. No adverse reactions occurred. Topical vancomycin is a safe, effective, and cost-saving measure to prevent SSIs following craniotomy. These results have broad implications for standard of care in craniotomy.

The Role of Antibiotics in Breast Pocket Irrigation and Implant Immersion: A Systematic Review.

Background:The usage of antibiotics and antiseptics to washout the breast pocket, or to soak the breast implant during surgery, has come under scrutiny in recent times. Guidelines from the Centers for Disease Control and Prevention give no recommendation for or against the usage of antibiotics in this regard. They do however offer a weak recommendation for washing tissues with iodophor. This systematic review aims to investigate the efficacy and impact of such topical antibiotic or antiseptic usage in reducing infection rates.Methods:A systematic electronic search was performed on the PreMEDLINE, MEDLINE, EMBASE, and CENTRAL (Cochrane) databases from inception to April 2017. Reference search was performed manually through Scopus. Results of the searches were independently screened by 2 reviewers (A.F. and P.H.). Studies involving an implant or tissue expander, with appropriate controls were included. Meta-analyses were performed where possible and data summarized when not.Results:Three retrospective cohort studies were found to fit the review requirements. No randomized control trials were found. These studies covered a period of 1996–2010 for a total of 3,768 women undergoing augmentative surgery. The usage of antibiotics in pocket washout or implant immersion resulted in lower infection rates (RR = 0.52; P = 0.004; 95% CI = 0.34–0.81).Conclusions:There is a clinical benefit in using antibiotics for breast pocket irrigation and implant immersion. However, the quality of the evidence obtained in this review is low; hence, we recommend a randomized control trial for a higher level of evidence on this important issue.

Topical Application of Adelmidrol + Trans-Traumatic Acid Enhances Skin Wound Healing in a Streptozotocin-Induced Diabetic Mouse Model.

Impaired wound healing is considered to be one of the severe complications associated with diabetes. Adelmidrol and trans-traumatic acid are commonly called Nevamast®. This gel consists precisely of 2% adelmidrol and 1% trans-traumatic acid. Thanks to its components, it is capable of favoring the natural process of skin re-epithelialization. This study tests the theory that topical usage of adelmidrol + trans-traumatic acid has important effects on the healing and closure of diabetic wounds in a streptozotocin (STZ)-induced diabetic mouse model. Diabetes was induced by intraperitoneal injection of STZ (60 mg/kg) in 0.01 M citrate buffer (pH 4.5) administrated for 5 consecutive days. After diabetes induction, two longitudinal incisions were made on the dorsum of the mice. The animals were killed between 6 and 12 days from wound induction. We found that diabetic mice compared to control mice presented: a retarded wound closure, characterized by an important reduction in the levels of transforming growth factor-β, plus an important increase of vascular endothelial growth factor and endothelial-type nitric oxide synthase expression, together with a reduction of adhesion molecules such as intercellular adhesion molecule-1 and P-selectin and a prolonged elevation of the levels of matrix metalloproteinase-9 and matrix metalloproteinase-2 in wound tissues. This study demonstrates that topical application of adelmidrol + trans-traumatic acid has important effects on the healing and closure of diabetic wounds in an STZ-induced diabetic mouse model.

Clinical evaluation of topical tacrolimus ointment usage in different stages of keratoconjunctivitis sicca in dogs

This study was conducted to investigate the effect of topical tacrolimus (0.1%) ointment in stimulating tear production in dogs with keratoconjunctivitis sicca (KCS). Thirty-six dogs (58 eyes) diagnosed with KCS were included in this study. KCS was grouped as early (E, n = 21 eyes), late (L, n = 21 eyes), and reflex tear due to corneal ulceration (R, n = 16 eyes) based on Schirmer tear test (STT) readings. The dogs in each group were randomly allotted treatment with either tacrolimus 0.1% ointment applied once daily (ET, n = 11 eyes; LT, n = 10 eyes; RT, n = 6 eyes) or cyclosporine (CsA) 0.05% eye drops instilled five times daily (EC, n = 10 eyes; LC, n = 11 eyes; RC, n = 10 eyes) for 2 months. The efficacy of the treatments was evaluated and comparison was made based on complete ophthalmic examination and a scoring system for various parameters like menace reflex, palpebral reflex, pupillary light reflex, conjunctival hyperemia, ocular discharge, corneal clarity, corneal ulceration, corneal vessel length, corneal vessel density, corneal pigmentation area, corneal pigmentation density, STT readings, fluorescein dye test, and Rose Bengal dye test. The effect of treatment was evaluated on day 15, 30, and 60 after treatments. Good quality digital photographs from a fixed distance were taken at each interval to aid subjective evaluation. Data were analyzed using one-way and repeated-measures ANOVA followed by Tukey?s HSD test, Wilcoxon signed rank test, and Kruskal?Wallis test followed by Dunn?s test to identify significant interactions. The level of significance was set to P < 0.05. Improvement in menace reflex and pupillary light reflex was observed in both treatment groups. Conjunctival hyperemia and ocular discharge decreased significantly after treatment with both of the drugs. There was no significant difference in improvement in tear production between treatment groups but tacrolimus 0.1% ointment significantly arrested the progression of pigments. The study concluded that both tacrolimus 0.1% ointment and CsA 0.05% eye drops improve tear production in KCS-affected dogs. Topical tacrolimus 0.1% ointment effectively arrests the progression of pigmentation compared to CsA 0.05% eye drops in KCS-affected dogs.

The Routine Use of Intracameral Antibiotics to Prevent Endophthalmitis After Cataract Surgery: How Good is the Evidence?

Post-operative endophthalmitis (POE) following cataract surgery is an uncommon, vision-threatening complication that has been reported to occur at rates of between approximately 0.03% and 0.2%. Prompt diagnosis and treatment of endophthalmitis is critical for minimizing vision loss, but most recent efforts have focused on the prophylactic administration of antibiotics to prevent the development of endophthalmitis. Surgeons from around the world have different topical and intracameral antibiotic usage patterns to prevent endophthalmitis, and to date no general consensus regarding best practice has emerged. Several studies have reported on the routine use of intracameral cefuroxime, moxifloxacin, and vancomycin, including a single randomized clinical trial by the European Society of Cataract and Refractive Surgery (ESCRS) in 2007. These studies have notable shortcomings, but many authors suggest that intracameral cefuroxime together with topical antibiotics probably decreases the risk of endophthalmitis. However, the deleterious effects of routine prophylactic antibiotics, which include toxicity, cost, and increasing antimicrobial resistance, among others, are noteworthy. In contrast, aseptic technique with pre-operative instillation of povidone-iodine remains the only technique supported by level I evidence to reduce the incidence of endophthalmitis. Although the routine use of intracameral antibiotics continues to increase throughout the world, data from multicenter, randomized, prospective trials is needed to provide better guidance regarding the prophylactic use of antibiotics.