No description available.

No description available.

Diss. (sammanfattning) Stockholm : Karol. inst., 2003. / Härtill 6 uppsatser.

Diss. (sammanfattning) Linköping : Univ., 2006. / Härtill 5 uppsatser.

No / Wound infection is a major clinical problem, yet understanding of bacterial host interactions in the skin remains limited. Microbe-derived molecules, known as pathogen-associated molecular patterns, are recognised in barrier tissues by pattern-recognition receptors. In particular, the pathogen-associated molecular pattern, lipopolysaccharide (LPS), a component of microbial cell walls and a specific ligand for Toll-like receptor 4, has been widely used to mimic systemic and local infection across a range of tissues. Here we administered LPS derived from Klebsiella pneumoniae, a species of bacteria that is emerging as a wound-associated pathogen, to full-thickness cutaneous wounds in C57/BL6 mice. Early in healing, LPS-treated wounds displayed increased local apoptosis and reduced proliferation. Subsequent healing progression was delayed with reduced re-epithelialisation, increased proliferation, a heightened inflammatory response and perturbed wound matrix deposition. Our group and others have previously demonstrated the beneficial effects of 17β-estradiol treatment across a range of preclinical wound models. Here we asked whether oestrogen would effectively promote healing in our LPS bacterial infection model. Intriguingly, co-treatment with 17β-estradiol was able to promote re-epithelialisation, dampen inflammation and induce collagen deposition in our LPS-delayed healing model. Collectively, these studies validate K. pneumoniae-derived LPS treatment as a simple yet effective model of bacterial wound infection, while providing the first indication that oestrogen could promote cutaneous healing in the presence of infection, further strengthening the case for its therapeutic use.

Source: Masters Abstracts International, Volume: 46-03, page: 1492. Adviser: Robert E. Roberts. Includes bibliographical references.

Bacterial infections are a serious problem for patients with burns and other wounds. Such burn wound infection accounts for the pathogenic bacteria by colonising onto burned areas. Therefore, the need for detection and inhibition of such bacterial colonisation requires a methodology for sensing/killing pathogenic bacteria. This research project aims to design a ‗smart‘ wound dressing system which can respond to the microbiological environment of the wound via a simple colour change and will release antimicrobials only when required. Two strains of pathogenic bacteria Staphylococcus aureus (MSSA 476) and Pseudomonas aeruginosa (PAO1) were used in the study. The non-pathogenic bacterium E.coli (DH5α) was used as a control organism as it does not secrete virulence factors and therefore does not lyse membranes of vesicles. The key contributions of this thesis are outlined below. Firstly, an initial responsive nanocapsule system was studied. The fundamental work with giant unilamellar vesicles proved such a responsive system can provide antimicrobial properties when antimicrobial agents were encapsulated within the vesicles. Secondly, partially polymerised vesicles—polydiacetylene/phospholipid vesicles were then developed to improve vesicle stability. The vesicle system was optimised by varying molar concentration of diacetylene monomers (TCDA) in order to obtain relatively stable vesicles as well as sensitivity to the toxins secreted by the pathogenic strains. Measurements proved that the polydiacetylene/phospholipid vesicles can respond to pathogenic bacteria when fluorescent dye/antimcirobials were encapsulated in the vesicles. Finally, a simple prototype dressing was constructed. Plasma polymerised maleic anhydride (pp-MA) deposited onto non-woven polypropylene was shown to be a good method to stabilise vesicles via covalent bonding. Vesicle adhered to pp-MA non-woven polypropylene showed the ability to inhibit/kill the pathogenic strains, quantified by the Japanese Industry Standard assay and also gave a fluorimetric colour response in the presence of pathogenic bacteria when a fluorescent dye is encapsulated within vesicles. Other simple prototypes were also attempted by using hydrogels (gelatine and collagen) to maintain vesicle stability as well as promote tissue healing.

Orientador: Eliana Martorano Amaral / Dissertação (mestrado) - Universidade Estadual de Campinas. Faculdade de Ciencias Medicas / Made available in DSpace on 2018-08-15T15:29:14Z (GMT). No. of bitstreams: 1 Moreira_CristianeMenabo_M.pdf: 2436149 bytes, checksum: d5b0e854b0557df822a87c69461aaeee (MD5) Previous issue date: 2010 / Resumo: Objetivo: Avaliar a efetividade e segurança do uso do eletrocautério para coagulação na da ferida operatória da cesárea. Métodos: Foi realizado um ensaio clínico piloto duplo cego controlado aleatorizado. Mulheres com indicação de cesárea, com até uma cesárea prévia, que fizeram pré-natal foram aleatorizadas na hora da cirurgia para uso ou não de eletrocautério para coagulação. As 224 voluntárias que participaram foram examinadas na alta hospitalar (3o dia) e pós-alta, no 7°.ao 10° dia e 30° ao 40° dia. Foram avaliados sinais infecciosos, hematoma, seroma e deiscência. A amostra foi calculada baseada em uma prevalência de infecção pós-alta de 14,4%, estimando-se um risco adicional de 15% para o grupo com uso de eletrocautério, totalizando 224 voluntárias. Os dados foram analizados por intenção de tratamento e a razão de risco foi calculada. Resultados: Os grupos foram similares quanto à demografia, paridade, consultas de pré-natal, índice de massa corporal e cesárea prévia. Durante a internação, apenas 2,8% das mulheres com uso de eletrocautério apresentaram complicações na ferida operatória. As taxas de complicações alcançaram 15,4% no grupo sem cautério, chegando a 23% no outro grupo, 7-10 dias pós-alta (RR=1,50 0,84-2,60). Foram observadas poucas complicações no 30° ao 40°dia e no grupo sem cautério (RR=1,15, 95% IC=0,61-2,16). A cesárea durou 105 e 100 minutos sem e com cautério, respectivamente (p=0,54). Não foi observada nenhuma arritmia cardíaca neonatal. Conclusão: O uso de cautério não se mostrou de maior risco para complicações na ferida operatória de cesárea, sendo necessários mais estudos que deem continuidade e ampliem os conhecimentos em procedimentos realizados em gestantes / Abstract: Purpose: To estimate the risk for wound complications when electrocautery is available for coagulation during cesarean section. Methods: A randomized controlled trial of using electrocautery for coagulation was performed among 224 women with none or one previous cesarean who had their pregnancy terminated with an abdominal delivery. Volunteers who accepted to participate were examined before discharge (3rd day), when the skin suture was removed (7-10 days), and 30-40 days after surgery. Infection signs, haematoma, seroma, and scar dehiscence were searched during visits. Sample size was calculated based on 14.4% prevalence of infection after discharge, estimating 15% added risk for the group using electrocautery, totalizing 224 volunteers. Unadjusted and adjusted prevalence risk (age, schooling, obesity, previous cesarean) were calculated. Results: Both groups were similar regarding demographics, parity, antenatal care, body mass index, and previous cesarean. During hospital stay, none among 96 women without electrocautery, and 2.8% of 97 women using electrocautery showed wound complications. The figures reached 15.4% and 23% respectively after 7-10 days (unadjusted RR = 1.50, 0.84-2.60). Few other complications were observed later, only among the non-intervention group (RR=1.15, 95% CI = 0.61-2.16). The lack of effect was maintained after adjusting for age, schooling, obesity, and previous cesarean (RR=1.47, 0.77-2.81). Surgical procedure lasted 105 and 100 minutes for both groups (p=0.54). No neonatal arrhythmia was observed. Conclusion: There is no evidence to recommend the use of electrocautery for coagulation during cesarean delivery. Wound complications were concentrated on post-discharge period for both groups / Mestrado / Tocoginecologia / Mestre em Tocoginecologia

Orientador: Plínio Trabasso / Texto em português e inglês / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas / Made available in DSpace on 2018-08-25T16:43:11Z (GMT). No. of bitstreams: 1 Madeira_MariaZeliadeAraujo_M.pdf: 1405070 bytes, checksum: 92d0a92bffeb8403785ffcb448a2afbb (MD5) Previous issue date: 2014 / Resumo: INTRODUÇÃO: As Infecções do Sítio Cirúrgico (ISC), compreendendo de 14% a 16% das encontradas em pacientes hospitalizados, são classificadas em incisional superficial, incisional profunda ou de órgão/cavidade. Entre 12% e 84% dessas infecções são detectadas depois que o paciente deixa o hospital, daí a importância da realização da vigilância pós-alta hospitalar. OBJETIVOS: Implementar um serviço de vigilância pós-alta de ISC em mulheres que realizaram cirurgia ginecológica em um Hospital de Ensino em Teresina-PI; monitorizar a ocorrência de ISC e sua associação com fatores de risco; caracterizar o perfil sociodemográfico desse contingente; determinar a taxa de incidência de ISC no ambulatório de ginecologia por meio da vigilância; e identificar o perfil das ISC diagnosticadas após a alta hospitalar. MÉTODO: Estudo quantitativo e prospectivo, realizado no ambulatório de ginecologia do Hospital Getúlio Vargas, o qual é de ensino público, geral, de grande porte e de referência em saúde para o Estado do Piauí e demais regiões do Norte e Nordeste do Brasil. A população foi de 1.026 mulheres egressas do hospital de ensino, que realizaram cirurgia ginecológica, no período de junho de 2011 a março de 2013. O projeto foi aprovado pelo Comitê de Ética e Pesquisa da UFPI, sob o CAAE: 0059. 045. 000.11. RESULTADOS: Utilizou-se a vigilância epidemiológica às ISC do tipo busca ativa, por 30 dias, no ambulatório de ginecologia, por meio de contato presencial e telefônico. A taxa de retorno das mulheres para o ambulatório foi de 86,6% e a incidência de ISC foi de 5,8%, destas, 71,7% foram classificadas como incisional superficial e 28,3% como incisional profunda. O tempo médio entre a cirurgia e o diagnóstico de ISC foi de 12,9 dias; a maior incidência se encontra na faixa etária de 25 a 44 anos (44,3%) de idade; procediam da capital 57,8% e, do interior do Estado, 42,2%; 63% são casadas, 61% tinham até o ensino fundamental; economicamente, 46,4% declararam renda familiar de 1 (um) salário mínimo. Os fatores de risco para o desenvolvimento de ISC foram: Tempo PO (dias), Neoplasia e Diabetes mellitus. CONCLUSÃO: Evidenciou-se o incremento da notificação de incidência de ISC, o que aponta para a importância do acompanhamento das mulheres sob vigilância pós-alta, utilizando uma estratégia sistematizada. Palavras chaves: Vigilância epidemiológica, Procedimentos Cirúrgicos em Ginecologia, Infecção de ferida operatória / Abstract: INTRODUCTION: The Surgical Site Infection (SSI) understanding 14% to 16% of those found in intern patients, and be assorted in superficial incisional SSI, deep incisional SSI, or organ or space SSI. Between 12% and 84% those infections are detected after the patient leaves hospital, hence the importance of post-discharge surveillance. OBJECTIVES: The post-discharge surveillance woman service implementation who underwent gynecological surgery in school hospital in Teresina - PI; monitor the occurrence of ISC and association with risk factors; characterizing the socio-demographic profile; appoint incidence rate (SSI) in gynecological ambulatory for surveillance method, and identify the profile of SSI misdiagnosed after discharge. METHODS: Prospective and quantitative study, accomplished in gynecological ambulatory in Getulio Vargas Hospital, which is for public education, and a large general hospital, and the health reference for the state of Piauí and further the North and Northeast regions of Brazil. The population was 1026 patient women which has undergone gynecological surgery in period from june 2011 to march 2013. The project was approved for the UFPI Research Ethics Committee, under the CAAE: 0059 045 000.11. RESULTS: It was used SSI epidemiologic surveillance, type active report for 30 days in gynecological ambulatory, by face or telephonic contact. Return rate of women to gynecological ambulatory was 86,6% and SSI incidence was 5,8%, those 71,1% was classed in superficial incisional and 28,3% deep incisional. The average time betwixt surgery and SSI diagnosis was 12,9 days; the highest incidence is in the age group 25-44 years (44.3%); came from the city (57,8%) e countryside of the State (42,2%), 63% married women, had basic education 61%, 46,4% declare having minimum wage. The risk factors to SSI development was: OP Time (days), neoplasm and Diabetes mellitus. CONCLUSION: Highlighted the increased incidence of SSI notification, pointing to the importance of accompanying the women in post-discharge surveillance, using a systematic strategy. Key words: Epidemiological surveillance, Gynecologic Surgical Procedures, Surgical wound infection / Mestrado / Ciencias Biomedicas / Doutora em Ciências Médicas

The treatment of epidermal wounds, particularly chronic wounds, is one of the most ubiquitous medical challenges and has imposed a considerable financial burden on the global health care system. Several factors in epidermal wounds lead to severe medical conditions among which infection comprises a large number of mortalities. To tackle this issue, great efforts have been made in the last decades to incorporate antimicrobial agents into wound dressings in order to inhibit microorganism colonization. Additionally, various wound monitoring systems have been developed to detect and track infections using different indicators such as bacterial by-products. However, the integration of these infection sensors with wound dressings – most of which have benefited from electrochemical detectors – has been a major bottleneck due to the electrode failure in the wound environment and the need for electrical power supply. Other approaches have focused on the development of point-of-care devices that simplify the detection of infection. This study aims to address the aforementioned challenge by developing a multifunctional hydrogel-based wound dressing – made of alginate 1.5% (w/v) – for on-site infection monitoring via colourimetric and image processing methods. Taking advantage of wound acidity as an indicator of bacterial infection, the developed wound dressing was composed of an array of pH sensors, fabricated by 3-dimensional (3D) bioprinting. Brilliant Yellow and cabbage juice as two pH-responsive dyes were immobilized in the pH sensors to facilitate a wireless wound monitoring. In this system, Brilliant Yellow afforded a higher accuracy in image processing while cabbage juice provided a better visual observation of the wound condition. The functionality of the developed dressing in detecting bacterial infection was evaluated via an ex-vivo test on pig skin samples, infected by Pseudomonas aeruginosa, and the presence of bacteria was detected within 30 minutes after the placement of the dressings on the skin samples. Moreover, the inclusion of gentamicin-loaded components into the wound dressing facilitated the inhibition of bacterial growth, which was evaluated in vitro on the same strain of bacteria. In this experiment, 2 mg/ml of gentamicin in the hydrogel led to the eradication of P. aeruginosa. This incorporation of antibiotic delivery along with the simple colourimetric infection detection holds a great promise for managing acute and chronic wounds by inhibition of bacterial growth and monitoring infection in real-time without a need for dressing removal. / Graduate / 2018-08-16