Nano-Oxy: Diabetic ulcer treatment using oxygen nanoparticles concept as innovation in reducing amputation rates and antibiotics usage

Diabetes mellitus is a metabolic disease characterized by chronic hyperglycemia caused by defects in insulin secretion, insulin reactions, or both. More than one third of diabetic patients have complications in the form of diabetic ulcers, and half are infected, and 15% of these infections require limb amputation. High cost expenditure and risks of microbial resistance to antibiotics also adds the complexity of the problem. The purpose of this literature review is to offer Nano-Oxy, using oxygen in nanoparticle size, as an alternative diabetic ulcer treatment. Literature searching was conducted through online search method. Oxygen therapy has been widely used to treat diabetic ulcers, including hyperbaric oxygen therapy (HOT) and topical oxygen therapy (TOT). Both of them have good results on diabetic ulcer therapy. Oxygen can act as an antimicrobial agent through the activation mechanism of neutrophils and macrophages which play a role in phagocytosis process and ROS regeneration. Nano-Oxy has advantages than the previous therapy, such as it does not cause barotrauma, oxygen poisoning, and low risk of burning. The mechanism of how Nano-Oxy works is similar with the Micro-nanobubbles (MNBs) concept. The negatively charged surface of MNBs can prevent them from aggregating, attracts particles, and help remove debris. MNBs also generate free radicals while shrinking in water, which contribute to its antibacterial effect. In addition, Nano-oxygen technology can be applied externally, but still have effect on the intended target cells. Therefore, Nano-oxygen can be used as a diabetic ulcer therapy to replace the role of antibiotics.

Assessment of life quality in the patients with duodenal ulcer treated by melatonin therapy of under conditions of European North

Objective: to estimate the quality of life (QOL) in the patients with duodenal ulcers residing in the North European part of Russia and treated by melatonin therapy in addition to standard anti-ulcer therapy using the GSRS questionnaire. Materials and methods: the study involved 80 patients with uncomplicated duodenal ulcer in the acute stage randomized into 2 groups: group I (n= 40) given three-component treatment (omeprazole, clarithromycin, amoxicillin) with the addition of melatonin and group 2 (control, n=40) given the same therapy but without melatonin. Taking into account the peculiarities of photoperiodicity in the study region, group 1 was subdivided into subgroups A and B and group 2 into subgroups C and D (A and C- received treatment from March to August; and B and D-from September to February). The quality of life was assessed based on the Russian-language version of GSRS before and on day 14 after onset of therapy. The clinical picture of the disease in groups 1 and 2 before treatment was dominated by abdominal (AU) and reflux (RS) syndromes. On 14 after onset of therapy, life quality improved in both groups but to a lesser degree in group 2 than in group 1 due to significantly more pronounced abdominal pain and reflux syndrome as well as worse results of evaluation from GSRS. In all subgroups, the number of GSRS points on the whole and for each scale of the questionnaire decreased on the 14th day of therapy . However, subgroup C showed a higher prevalence of abdominal pain and reflux syndrome than subgroup A as well as poorer GSRS-based estimates. Subgroup B differed in a similar way from subgroup D. Conclusion: anti-ulcer therapy in combination with melatonin is more effective than without it especially if started in a period of growing daylight duration and its maximum.

Terapias compressivas no tratamento de úlcera venosa: estudo bibliométrico

Introdução: Úlceras de origem venosas são lesões cutâneas que geralmente acometem o terço inferior das pernas. O tratamento dessas feridas é dinâmico e depende da evolução das fases da reparação tecidual. Esse tratamento inclui métodos clínicos e cirúrgicos, sendo a terapia compressiva o método não cirúrgico mais frequentemente utilizado. Dentre as terapias compressivas, destacam-se as bandagens inelásticas e elásticas, meias elásticas e pressão pneumática intermitente. Objetivo: O presente estudo pretendeu identificar o perfil da produção científica nacional e internacional que descrevesse terapia compressiva e úlcera venosa classificando-o de acordo com: cronologia de publicação, procedência, periódicos em que estão publicadas, avaliação do “Qualis” — Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes), distribuição da abordagem metodológica, análise do conteúdo das publicações e comparar, quando possível, os dados apresentados nessa revisão. Método: Estudo bibliométrico realizado nas bases de dados Medline, Lilacs e CINAHL no qual se utilizaram os descritores “Varicose Ulcer/therapy”, “Compression Bandages”, “Wound Healing” e o operador booleano AND entre os anos de 2009 a 2013. Resultados: Foram selecionados 47 artigos; a maioria publicada em 2012 (n = 12; 25,53%), nos Estados Unidos (n=14; 29,78%) e Reino Unido (n=14; 29,78%), em revistas de especialidade vascular (n=19; 40,42%), com avaliações A2 (n=13; 27,65%) e B1 (n=13; 27,65%). A maior parte da metodologia utilizada nos estudos selecionados era tipo “estudos clínicos” (n= 30; 63,82%). Dentre os estudos clínicos e metanálises, apenas 30% (n= 14) apresentavam como objetivo principal avaliação da terapia compressiva e pretenderam estudar comparativamente eficácia de bandagens elásticas, inelásticas, meias elásticas, pressão pneumática intermitente e ausência de terapia compressiva no tratamento de úlceras venosas. Conclusão: Há preocupação da comunidade científica com a busca do tratamento eficaz para as úlceras venosas, porém a distribuição mundial de publicações é desigual. Evidenciou-se que a terapia compressiva não é o objeto principal na maioria dos trabalhos selecionados, o que leva ao interesse em terapias adjuvantes ou complementares a essa. Ficou evidente a necessidade da terapia compressiva, porém não há consenso sobre qual pressão deva ser utilizada para se obter melhores resultados na cicatrização; portanto, são necessários mais estudos que avaliem as interferências das diversas pressões sobre o processo de reparo tecidual. Também há carência de estudos que comprovem a ação da pressão pneumática intermitente com associações ou não de bandagens elásticas.