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PubMed1998

Femoral Arterial Hemostasis using the Angio-Sealª System after Coronary and Vascular Percutaneous Angioplasty and Stenting.

The procedures of left cardiac catheterization and revascularization by angioplasty are associated with a substantial risk of hemorrhagic complications. This risk increases clearly in patients with an intravascular stent who require early high doses of anticoagulant therapy. The first purpose of our study was to evaluate the effectiveness of a mechanical system of femoral hemostasis (Angio-Sealª, Sherwood Davis & Geck, St. Louis, Missouri) deployed in a group of 411 consecutive patients (302 males, 109 females, mean age 59 +/- 15) who successfully underwent percutaneous angioplasty (PA) and application of an intravascular stent (378 coronary, 33 vascular). The arterial closure system consists of a small absorbable anchor and a collagen pad connected to a suture thread which, at the end of the procedure, is positioned by percutaneous introduction at the site of the femoral puncture. All the patients studied received long-term platelet anti-aggregant therapy (ticlopidine 500 mg/day and ASA 150 mg/day) for 3Ð4 days before and for one month after the procedure, and an anticoagulant regimen of heparin sodium administered via intravenous bolus (10,000 IU) during the procedure, followed by subcutaneous heparin calcium (12,500 IU/day) for 21 days. Thirteen patients were treated intravenously with 10 mg abciximab and seven received pre-procedure coumadin. The ACT when the hemostasis system was positioned was 355 +/- 43 seconds. Successful hemostasis was reached in more than 95% of the patients (394/411 pts., 95.86%). In 17 (4.14%) of the 411 patients studied, the system failed; nine (2.19%) of these were attributed by the operator to a failure of the positioning device procedure, and the remaining 8 (1.95%) were attributed to a malfunction of the system. Overall complications were observed in 23/411 (5.6%) of the patients (pts) studied; eighteen were minor non-surgical hemorrhagic complications (bleeding and/or hematoma) which occurred primarily in the first 4 hours. In 4 cases (1%) vascular surgery was necessary for femoral pseudoaneurysm repair (2 pts) and femoral hematoma (2 pts). One patient (0.24%) complained of severe claudication related to a severe stenosis in the femoral artery caused by a malpositioning of the anchor. This patient was successfully treated with balloon angioplasty and stenting of the femoral artery. The average time to early mobilization was 9 hours, and all the patients without complications were completely mobile within 12 hours after the procedure; 380/411 (92.46%) of the patients were discharged 18Ð24 hours after percutaneous angioplasty. The second purpose of our study was to compare data from 411 consecutive patients treated with the Angio-Sealª device after coronary and vascular angioplasty and stenting (Angio-Seal group), to a group of 387 consecutive patients where the femoral arterial hemostasis was obtained using manual compression after coronary angioplasty and stenting (manual compression group). We found significant differences (p < 0.01) in the most important elements concerning general patient management after the interventional procedure, with excellent improvements using the Angio-Seal device, including: successful hemostasis (95.86% vs. 88.37%); reduction of non-surgical hematomas (1.22% vs. 4.65%); reduction of surgical hematomas (0.49% vs. 2.84%); mobilization time (9 +/- 3 hours vs. 19 +/- 8 hours); and discharge within 18Ð24 hours (92.46% vs. 0.00%).

Journal Article↗

PubMed1997

"Temporary prosthesis" of the fibrotic ring for relative insufficiency of the tricuspid valve.

BACKGROUND: De Vega type suturing dosage plasty is the intervention most widely used for relative insufficiency of the tricuspid valve (TV). In fact, this operation may be considered as an equivalent of prosthetic reconstruction of the fibrotic ring, shaping a fixed orifice for passage. Intrapulmonary pressure normalized as early as during the first months after surgery in patients with the mitral-tricuspid cardiac valvular disease. Under such conditions a rigid suture (prosthesis of the anulus) at the interface of the right atrium and ventricle is not physiological. METHODS: We used Maxon CV 2-0 (D+G) suture absorbable for 6 months. Xenopericardial pads were fixed at the edge of the suture. The pads were prepared by enzymatic and chemical processing. RESULTS: Operations were performed in 7 patients, the results were followed for up to 28 months. The size of the TV fibrotic ring was measured by transesophageal ultrasonography (Hewlett-Packard SONOS 1500; OMNIPLANE) on the operating table and for 2 years postoperation. No signs af tricuspid insufficiency were detected.

Heart Valve Prosthesis Implantation↗

PubMed2005

Response of SI cortex to ipsilateral, contralateral and bilateral flutter stimulation in the cat.

BACKGROUND: While SII cortex is considered to be the first cortical stage of the pathway that integrates tactile information arising from both sides of the body, SI cortex is generally not considered as a region in which neuronal response is modulated by simultaneous stimulation of bilateral (and mirror-image) skin sites. RESULTS: Optical intrinsic signal imaging was used to evaluate the response of SI and SII in the same hemisphere to 25 Hz sinusoidal vertical skin displacement stimulation ("skin flutter") applied contralaterally, ipsilaterally, and bilaterally (simultaneously) to the central pads of the forepaws. A localized increase in absorbance in both SI and SII occurred in response to both contralateral and bilateral flutter stimulation. Ipsilateral flutter stimulation evoked a localized increase in absorbance in SII, but little or no change in SI absorbance. In the forepaw representational region of SI, however, bilateral stimulation of the central pads evoked a response substantially smaller (approximately 30-35% smaller) than the response to flutter stimulation of the contralateral central pad. CONCLUSION: The finding that the response of SI cortex to bilateral central pad flutter stimulation is substantially smaller than the response evoked by a contralateral flutter stimulus, together with the recently published observation that a region located posteriorly in SII responds with a substantially larger response to a bilateral flutter stimulus than the response evoked from the contralateral central pad, lead us to propose that the SI activity evoked by contralateral skin stimulation is suppressed/inhibited (via corticocortical connections between SII and SI in the same hemisphere) by the activity a simultaneous ipsilateral skin stimulus evokes in posterior SII.

Animals↗

PubMed1991

Reducing the leakage of body-worn incontinence pads.

The aim of this research was to evaluate the effect of various absorbent materials (fluff pulp and superabsorbent) on the leakage performance of incontinence pads. A shaped pad-and-pant system was used as the basic design and four pad types made to different specifications were compared using a double-blind technique. Forty-five elderly hospital residents who were incontinent of urine used all four pad types in a randomly allocated order. Data were recorded on more than 5000 pads over a 2-month period. Leakage was reduced by adding a second layer of fluff pulp and, whilst the addition of a superabsorbent material tended to reduce leakage further, we found no clear relationship between the amount of superabsorbent and the reduction of leakage. Other data indicated the importance of securing the pad in place with the appropriate net pants and the leakage rates of pads in relation to the amount of urine they contained. This research suggests that superabsorbent materials have great potential for reducing the leakage rate of incontinence pads but that the way in which they are incorporated into the pad, the amount of fluff pulp and the design of the pad also play an important part.

Absorption↗

PubMed1993

Energy absorption characteristics of football helmets under low and high rates of loading.

The purpose of this study was to examine the force-deformation characteristics of football helmets subjected to compressive loading on the crown surface. Tests were conducted at quasi-static and dynamic rates of loading. Energies were computed from the force-deformation data. The padding systems represented by the helmets differed in their ability to absorb energy under varying loading rates. Helmets using pneumatic or combination pneumatic-foam padding systems were the most successful while suspension helmets were able to absorb the least amount of energy. The evaluation of energy absorption characteristics is an alternative method of describing the effectiveness of football helmets in preventing head injury.

Acceleration↗

PubMedDate not supplied

[Cytokines in the diagnosis of amniotic infection syndrome].

Accumulating evidence indicates an association between intraamniotic infection and raising concentrations of amniotic cytokines, resulting in preterm labor and preterm rupture of fetal membranes, because these cytokines are able to stimulate prostaglandin biosynthesis. Therefore the purpose of our study was to investigate if quantitative determination of Il-1 beta, Il-6, Il-8 and TNF-a in amniotic fluid may be a practicable method to diagnose intraamniotic infection. Since invasive amniocentesis doesn't allow repeated cytokine detection, in case of preterm rupture of fetal membranes, amniotic fluid also was obtained by placing a sterile gauze and cotton pad into the women's vagina, absorbing draining amniotic fluid for cytokine detection. Our results clearly indicate that Il-1 beta and TNF-a are not detectable in normal pregnancy, while Il-6 and Il-8 are produced in low, but constant levels. In contrast, in amniotic fluid of patients with intraamniotic infection high amounts of Il-6 and Il-8 were found, while Il-1 beta and TNF-a bioactivity became measurable, indicating that biosynthesis was activated. These results demonstrate, that infection associated cytokines detectable in amniotic fluid are highly sensitive markers for intraamniotic infection. In case of preterm rupture of fetal membranes recovery of amniotic fluid from a vaginal pad allows monitoring of cytokine bioactivity in daily intervals to control success of antibiotic treatment.

Adult↗

PubMedDate not supplied

Choosing and using disposable body-worn continence pads.

Disposable, body-worn pads are the product most commonly chosen to contain and absorb urine and faeces (Pomfret, 2000). The cost to the NHS of supplying continence pads has been estimated at 80 million pounds per annum (Euromonitor, 1999) and is a huge financial burden on local services.

Clinical Competence↗

PubMedDate not supplied

Effects of changes in heel fat pad thickness and elasticity on heel pain.

The heel fat pad has a unique structure that is important for its shock-absorbing function. Loss of elasticity and changes in the thickness of the heel pad have been suggested as causes of heel pain. The present study of a population with heel pain shows the relationship between the thickness and elasticity of the heel fat pad and age, sex, obesity, duration of symptoms, subcalcaneal spurs, and noninvasive conservative treatment. Of 182 patients with heel pain who visited an outpatient clinic during a 3-year period, 50 (67 heels) fulfilling specific criteria were treated with a combination of nonsteroidal anti-inflammatory drugs, contrast baths, stretching exercises, and change of footwear habits. Patients were followed up for 1 year. Delayed healing, increased thickness, and decreased elasticity of the heel fat pad were found in patients who were older than 40 years, who had symptoms for longer than 12 months before treatment, and who had a large subcalcaneal spur. An increase in heel fat pad thickness with aging and increased body weight reduce the elasticity of the heel fat pad. In addition, subcalcaneal spurs diminish the elasticity of the heel fat pad and play a role in the formation of heel pain.

Adipose Tissue↗

PubMed2004

The damping properties of the venous plexus of the heel region of the foot during simulated heelstrike.

The damping mechanisms that are operational in the heel pad during the impact phase of locomotion have the important function to protect the musculo-skeletal system from injuries. How this is achieved is still not fully understood, as is for instance illustrated by the 'heel pad paradox', the observation that in vivo and in vitro experiments yielded widely different results. This paradox could so far only partially be explained. In the light of this paradox, and a previous study by our group, we conjectured that the venous plexus might contribute as a hydraulic shock absorber to the damping properties of the heel pad. To investigate this hypothesis in vivo, heel pads of 11 volunteers were subjected to pendulum impact tests, using velocities of 0.2, 0.4, and 0.6 m/s, and three physiologically different, consecutive conditions: (i) a relatively empty venous plexus, (ii) a congested venous plexus, and (iii) a decongested venous plexus. At congestion, the maximum impact force decreased slightly but significantly by 2.6% at 0.2 m/s and 1.8% at 0.4 m/s. This effect was no longer found at 0.6 m/s. Although these effects are rather small, they confirm the fundamental hypothesis that the venous plexus contributes to the damping properties of the heel pad during walking. It is likely that some underestimation of the effect has occurred.

Acceleration↗

PubMed2000

Conception of the cervico-brachial protector for motorcycle drivers.

The increasing popularity of motorcycles increases the role of motorcycle accidents as a main cause of brachial plexus injuries. In view of the high social cost of treatment of the victims it seemed desirable to devise some kind of protective clothing for motorcyclists. The protective clothing devised by teams from Department of Neurosurgery, TRICOTEXTIL--and Aeronautics and Applied Mechanics Institute, consists of the following parts: cervical collar--acting against force causing lateral bending and extension of cervical spine, shock-absorptive shoulder pads--acting against the impact energy partially absorbing it and partially transmitting to the dorsal stiff bar, dorsal stiff bar and sacroiliac belt--partially immobilizes the thoracic and lumbar spine, acts against its compression, transmits the impact energy to the iliac crests and hips. The expected biomechanical effects of the cervico-brachial protector are as follows: In brachial region it should diminish the impact energy by its partial absorption and partial transmission along dorsal stiff bar to sacroiliac belt. It should act against excessive cervical spine motion--mainly against lateral bending and extension. It should act against excessive depression of the shoulder. The protective system built in the jacket should co-operate with the helmet of motorcycle driver. It should be comfortable for the driver and conform to security standards. Prototype of the protector underwent kinetic sledge tests in Industrial Motorization Institute (PIMOT), Warsaw, with the use of Hybrid Dummy II.

Accidents, Traffic↗

PubMed2000

Reduction of lower palpebral bulge by plicating attenuated orbital septa: a technical modification in cosmetic blepharoplasty.

Bulging of the lower eyelid is regarded as a sign of aging. "Herniation" of the periorbital fat pads is traditionally regarded as the factor responsible for the change. Excision of fat pads, therefore, has been the mainstay of treatment in reducing the palpebral bulge in cosmetic blepharoplasty. The surgical excision of"excess" and "herniated" fat pads, however, causes problems such as lid ecchymosis, chemosis, lid contour irregularity, ectropion, and retrobulbar hematoma formation. The author proposes that the loss of fat pad support caused by the attenuation of the orbital septa, not herniation of the excess fat pads, is the major factor responsible for the bulge. The author further proposes that the functional integrity of the orbital septum can be restored by plicating the attenuated orbital septa with 5-0 absorbable sutures. This technique of invaginating the protruded fat pad was performed in 138 individuals (276 lower eyelids). The operation was technically simple, and the approach was "tissue friendly." The results obtained, with the exception of a mild degree of puffiness encountered soon after the surgery, were satisfactory. Morbidity was minimal.

Adult↗

PubMed2007

Do panty liners promote vulvovaginal candidiasis or urinary tract infections? A review of the scientific evidence.

Panty liners are used to absorb light menstrual flow, vaginal discharge, or urine leakage, or to maintain a clean, dry feeling. Allegations that panty liners may trap heat and moisture to promote vulvovaginal candidiasis (VVC) or promote colonization by microbes that contribute to urinary tract infections appear to be unfounded. As reviewed herein, measurements of the impact of panty liners on skin temperature and skin surface moisture had no clinically meaningful effect on cell densities of genital microflora. Epidemiological investigations of a potential link to VVC were either negative or were inconclusive because of confounding factors. Although enteric microbes reside on the vulva and perineum, no evidence exists that panty liner use promotes urethral colonization by enteric microbes. Moreover, a series of 13 randomized prospective trials of panty liners or ultra-thin pads demonstrated no clinically significant adverse effects either on the skin or on isolation frequencies or cell densities of representative genital microflora. Post-market surveillance systems suggest a low incidence of complaints. Evidence from vulvar clinic patients reveals no significant contribution of these products to persistent vulvar symptoms. Taken together, the scientific evidence supports the conclusion that panty liners are safe when used as intended and do not promote VVC or urinary tract infections.

Absorbent Pads↗

PubMed1999

Immunochromatographic membrane strip assay system for a single-class plasma lipoprotein cholesterol, exemplified by high-density lipoprotein cholesterol measurement.

In assessing risk factors of coronary heart disease, a membrane immunochromatographic system that minimizes requirements of instrument and reagent handling was investigated by utilizing high-density lipoprotein (HDL) cholesterol (HDL-C) as model analyte. The system is composed of four functional membrane strip pads connected in sequence as follows (from the bottom): immunoseparation based on the biotin-streptavidin reaction; catalytic conversion of cholesterol to hydrogen peroxide; production of a colorimetric signal; and induction of a continuous wicking of medium. For immunochromatography, a monoclonal antibody, specific to apolipoprotein B100 that is present on the surfaces of low-density lipoproteins (LDL) and very low-density lipoproteins (VLDL), with a high binding constant (5 x 10(10) L/mol), was raised and chemically conjugated to streptavidin. The conjugate was first reacted with lipoprotein particles, and this mixture was absorbed by the capillary action into the biotin pad of the system. After being transferred by medium, immunocapture of LDL and VLDL particles onto the biotin pad took place, and in situ generation of a colorimetric signal in proportion to HDL-C occurred consecutively. The capture was selective as well as effective (minimum 88% of LDL and VLDL in clinical concentration ranges), and the detection limit of the HDL-C was far lower than 20 mg per 100 mL. The same concept may also be applicable to LDL cholesterol measurement provided suitable antibodies specific to HDL and VLDL are available.

Animals↗

PubMed2006

The content and composition of lipids in the digital cushion of the bovine claw with respect to age and location--a preliminary report.

The pads of the bovine digital cushion, which serves as a shock absorber, have specific anatomical structures to cope with the substantial forces acting within the claw. To gain more information on the lipid composition and content of the pads, horn shoes from 12 slaughtered heifers and cows were removed and different samples of the pads excised with a scalpel. Pad lipids were extracted and the fatty acid composition determined by gas chromatography. Fat from perirenal and subcutaneous adipose tissues served as a comparison. Overall, this fat contained a higher quantity of extracted lipids than that of the claw pads and did not differ between heifers and cows. In contrast, lipid content in the pads was significantly higher in the cows than in the heifers. In both groups, the lipid content of the middle and abaxial pads, which are situated directly under the distal phalanx, was lower than in the pads of the other locations. The lipids in all pads contained >77% monounsaturated fatty acids (MUFA), differing sharply from the adipose tissue with values <51%. Among the polyunsaturated fatty acids (PUFA) a significantly higher proportion of arachidonic acid (AA) was found in the heifer pads than in those of the cows, whereas the proportion of AA was similar in the adipose tissue of all animals. The proportion of AA in the pad lipids also varied between the defined locations with the highest proportion found in locations that showed the lowest lipid content and was related to the age of the animal.

Age Factors↗

PubMed1994

Mongolian gerbils (Meriones unguiculatus) absorb beta-carotene intact from a test meal.

Because a yellow color has been observed in the fat pads of Mongolian gerbils fed a nonpurified diet, we designed the current study to determine whether adult male gerbils would absorb beta-carotene intact from a test meal. Thirty-five gerbils (80-90 g) were adapted to the laboratory and fed a standard purified diet free of beta-carotene for 16-19 d. Gerbils were then fed a test meal consisting of 279 nmol of beta-carotene as 10% water-soluble beadlets suspended in 0.5 mL of Ensure. Gerbils (n = 5) were killed at 0, 2, 4, 6, 12, 24 or 72 h after the test meal, blood was obtained by cardiac puncture, and tissues were taken for beta-carotene analysis. No beta-carotene was detected in serum at 0 or 72 h, whereas beta-carotene was present at all other sampling times. Serum beta-carotene peaked at 4 h, at a level of 88 nmol/L. beta-Carotene was detected in the liver of all groups; however, the concentration increased from -34 pmol/g to a maximum concentration of 926 pmol/g at 24 h after the test meal. Other tissues also contained beta-carotene. The results demonstrate that Mongolian gerbils, like ferrets and preruminant calves, absorb beta-carotene intact when beta-carotene is provided at a physiological level in a test meal. This species may be particularly useful for evaluation of the role of antioxidants, such as beta-carotene, in LDL oxidation.

Administration, Oral↗

PubMedDate not supplied

A multicenter evaluation of absorbent products for children with incontinence and disabilities.

OBJECTIVE: To evaluate all disposable pull-up-style pads (pull-ups) designed for children with learning and or physical disabilities and compare these with a representative sample of disposable diapers (diapers). DESIGN: A multicenter randomized crossover trial where all children evaluated each product. SETTING AND CHILDREN: A total of 61 community dwelling children with disabilities were recruited from 5 areas throughout the United Kingdom. Families were invited by letter to participate through their local clinical nurse specialist for continence care. INSTRUMENTS: Instruments used included a range of questionnaires (product performance, design performance, and design preference questionnaires) and pad weight and leakage diaries. METHODS: The children tested 10 products (5 pull-ups and 5 diapers) for up to 1 week per product both at home and at school. Caregivers (parents and guardians) completed the questionnaires after evaluation of individual products and design groups had been completed. They recorded wet product weights and scored pad leakage at each pad change. School staff completed an abbreviated product performance questionnaire for each product. RESULTS: There was little difference in the overall performance of the pull-ups compared with the diapers. In the pull-up group, one product performed significantly worse than the others for some performance aspects. Pull-ups worked particularly well for children able to assist with toileting and pad changes. Diapers were liked for ease of changing if the child used calipers, adapted footwear, or trousers. Diapers were more popular than pull-ups for night use, when greater absorbency was required. Neither design performed differently for school or home use. Most caregivers expressed a preference for diapers or pull-ups based on a range of individual needs, for example, level of independence in toileting, discreteness in pad change, fit, and product appearance. CONCLUSIONS: Diapers and pull-ups have different strengths and limitations, and both meet the specific needs of individual children. Although pull-ups are more expensive than diapers, their use is justified if based on a thorough assessment of individual need.

Adolescent↗

PubMed2002

Material properties of the human calcaneal fat pad in compression: experiment and theory.

The structural behaviour of the human heel pad has been studied extensively due to its ability to absorb shock, protect against excessive local stress, and reduce plantar pressures. However, the material properties of the tissue have not been adequately measured. These must be known in order to perform a finite element analysis of the effect of factors such as foot geometry and shoe/surface construction on heel pad function. Therefore, the purposes of this study were to (a). measure the viscoelastic behaviour of the fat pad in compression, and (b). to determine an appropriate constitutive equation to model the tissue. A series of unconfined compression tests were performed on 8mm diameter cylinders of fat pad tissue, consisting of quasi-static, 175, 350 mm/s and stress-relaxation tests to approximately 50% deformation. The tissue exhibited nonlinear, viscoelastic behaviour. No significant difference was found in the quasi-static behaviour between samples from different locations and orientations in the heel. The stress-relaxation tests were used to determine the time constant (tau(1)=0.5s), the 175 mm/s test to determine the relaxation coefficient (g(1)=28), and the 350 mm/s compression test to determine the material constants (C(100)=C(010)=0.01, C(200)=C(020)=0.1 Pa) of a single-phase, hyperelastic, linear viscoelastic strain energy function (r(2)=0.98).

Adipose Tissue↗

PubMed1992

Transdermal drug delivery systems of albuterol: in vitro and in vivo studies.

In vitro and in vivo experiments were conducted with double- and single-layer albuterol transdermal pads designed for once-a-day application. In the in vitro experiments, dissolution of albuterol from pads and permeation of albuterol through hairless mouse skin were monitored. In the in vivo experiments, pads were applied to the chest area of four female rhesus monkeys (Macaca mulata), and an albuterol aqueous solution was injected into the saphenous vein of the same animals in a crossover design. The amount lost from pads applied to monkeys was monitored by analysis of pad residue. Blood samples were withdrawn at regular intervals and analyzed by a high-performance liquid chromatography-fluorescence method. Skin irritation due to the pad was measured by a modified Draize score test. The amounts released from the two formulations were similar. The amount released was, however, dependent on the technique used and decreased in the following manner: pad dissolution greater than in vivo amount lost from pads applied to monkeys greater than in vitro permeation through hairless mouse skin. The pharmacokinetic parameters determined after intravenous and transdermal administration were as follows: terminal half-life, 2.26 +/- 0.45 h; apparent volume of distribution, 1935 +/- 37.2 mL.kg-1; and total body clearance, 612.0 +/- 118 mL.h-1.kg-1. The average concentrations in serum after application of single- and double-layer pads were 44.60 +/- 16.40 and 62.50 +/- 8.00 ng/mL, respectively. Further, the amount lost from pads applied to monkeys correlated with the respective amount absorbed in monkeys, as calculated from the average concentration in serum and clearance.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗