Effects of the epiretinal membrane on the outcomes of intravitreal dexamethasone implantation for macular edema secondary to branch retinal vein occlusion / Os efeitos de uma membrana epirretiniana nos resultados da implantação de dexametasona intravítrea para edema macular secundário à oclusão de ramo da veia retiniana

ABSTRACT Purpose: To investigate the effects of epiretinal membrane formation on the clinical outcomes of intravitreal dexamethasone implantation for macular edema secondary to branch retinal vein occlusion. Methods: This retrospective interventional case series includes the treatment of naive patients with macular edema secondary to non-ischemic branch retinal vein occlusion who underwent intravitreal dexamethasone implantation. The patients were divided into two groups as follows: Group 1 (n=25), comprised of patients with macular edema secondary to branch retinal vein occlusion without epiretinal membrane, and Group 2 (n=16), comprised of patients with macular edema secondary to branch retinal vein occlusion with an epiretinal membrane. Corrected visual acuity, central macular thickness, and central macular volume values were measured before and after treatment. The clinical outcomes of the groups were compared. Results: Mean age and male-to-female ratio were similar between the two groups (p>0.05, for both). The baseline and final corrected visual acuity values, central macular thickness, and central macular volumes of the groups were similar (p>0.05, for all). All the parameters were significantly improved after intravitreal dexamethasone implantation treatment (p<0.001, for all). The changes in central macular thickness and volume were also similar (p>0.05, for both). The mean number of intravitreal dexamethasone implantations was 2.1 ± 1.0 (range, 1-4) in Group 1 and 3.0 ± 1.2 (range, 1-5) in Group 2 (p=0.043). Conclusion: Epiretinal membrane formation had no effects on the baseline and final clinical parameters, including corrected visual acuity and central macular thickness and volume. The only parameter affected by the presence of epiretinal membrane formation is the number of intravitreal dexamethasone implantations, a greater number of which is needed for macular edema secondary to branch retinal vein occlusion with an epiretinal membrane.

RESUMO Objetivo: Investigar os efeitos da formação de uma membrana epirretiniana nos resultados clínicos da implantação intravítrea de dexametasona para edema macular secundário à oclusão de um ramo da veia retiniana. Métodos: Esta série retrospectiva de casos intervencionais inclui o tratamento de indivíduos com edema macular secundário à oclusão não isquêmica de um ramo da veia retiniana, sem tratamento prévio e que foram submetidos a implantação intravítrea de dexametasona. Os indivíduos foram divididos em dois grupos: Grupo 1 (n=25), composto por indivíduos com edema macular secundário à oclusão de um ramo da veia retiniana sem a presença de uma membrana epirretiniana, e Grupo 2 (n=16), composto por indivíduos com edema macular secundário à oclusão de um ramo da veia retiniana com a presença de uma membrana epirretiniana. Os valores da acuidade visual corrigida, espessura macular central e volume macular central foram obtidos antes e após o tratamento. Os resultados clínicos dos grupos foram comparados. Resultados: A média de idade e a proporção entre homens e mulheres foram semelhantes nos dois grupos (p>0,05 para ambos os valores). Os valores iniciais e finais da acuidade visual corrigida, espessura macular central e volume macular central foram semelhantes nos dois grupos (p>0,05 para todos os valores). Todos os parâmetros melhoraram significativamente após o tratamento com implante de dexametasona intravítrea (p<0,001 para todos os parâmetros) e as alterações na espessura macular central e no volume macular central também foram semelhantes (p>0,05 para ambos os valores). O número médio de implantações intravítreas de dexametasona foi 2,1 ± 1,0 (faixa de 1-4) no Grupo 1 e 3,0 ± 1,2 (faixa de 1-5) no Grupo 2 (p=0,043). Conclusão: A formação de uma membrana epirretiniana não tem efeitos sobre os parâmetros clínicos iniciais e finais, incluindo a acuidade visual corrigida, a espessura macular central e o volume macular central. O único parâmetro afetado pela formação de uma membrana epirretiniana é o número de implantações intravítreas de dexametasona, sendo necessário um número maior de implantações em casos de edema macular secundário à oclusão de um ramo da veia retiniana com a presença de uma membrana epirretiniana.

Anesthetic considerations in patients with implantable devices and chronic pain surgery / Consideraciones anestésicas en pacientes con dispositivos implantables y para cirugía de dolor crónico

Abstract The use of advanced invasive techniques for the control of chronic pain in patients with multiple comorbidities is becoming increasingly common. Neuromodulation offers a new management alternative involving the infusion of one or more drugs into the epidural or intrathecal space through a fully implantable infusion pump. It also involves spinal stimulation, a minimally invasive technique in which electrodes are positioned in the epidural space and connected to a pulse generator that is implanted subcutaneously and generates pulses designed to suppress the noxious stimulus. This article will describe the anesthetic considerations in cases of implantable drug delivery systems, and spinal and peripheral nerve stimulation devices. Additionally, patients with electrical or drug neuromodulation devices may present to anesthetic practice for surgical indications unrelated to their chronic pain pathology. Hence the importance of being familiar with the basic components of these devices, how they work, what drugs they use and the potential associated complications in the perioperative context, in order to ensure proper management and patient safety.

Resumen Cada vez es más común el empleo de técnicas invasivas avanzadas para el control del dolor crónico en paciente con múltiples comorbilidades. La neuro-modulación ofrece una nueva alternativa de manejo, que involucra la infusión de uno o más medicamentos en el espacio epidural o intratecal a través de una bomba de infusión totalmente implantable. También incluye la estimulación espinal, una técnica mínimamente invasiva que consiste en el posicionamiento de electrodos en el espacio epidural, conectados a un generador de pulso que se implanta subcutáneo y genera pulsos que buscan suprimir el estímulo nocivo. En este artículo se hará la descripción de las consideraciones anestésicas que se deben tener con sistemas de liberación de medicamentos implantables, dispositivos de estimulación medular y de nervio periférico. Adicionalmente, pueden aparecer pacientes portadores de dispositivos de neuromodulación eléctrica o medicamentosa que deben recibir anestesia para someterse a cirugía por razones diferentes a su patología de dolor crónico y deben conocerse sus implicaciones anestésicas. Por lo anterior, es importante conocer y estar familiarizados con los componentes básicos de dichos dispositivos: funcionamiento, medicamentos que utilizan y las potenciales complicaciones que se puedan tener con estos en el contexto perioperatorio, para garantizar un manejo adecuado y la seguridad del paciente.

Comparison of the efficacy of conbercept and intravitreal dexamethasone implant Ozurdex in the treatment of diabetic macular edema / 中华实验眼科杂志

Objective:To compare the efficacy and safety of intravitreal injection of anti-vascular endothelial growth factor drug conbercept and intravitreal dexamethasone implant Ozurdex in the treatment of diabetic macular edema (DME).Methods:A randomized controlled clinical study was performed.Thirty-six DME patients (36 eyes) were enrolled in Weifang Eye Hospital from March 2018 to June 2019.The patients were randomized into Ozurdex group and conbercept group via a random number table, with 18 eyes in each group.Patients received Ozurdex injection once, which was maintained for 6 months, or conbercept injection once a month for 3 times according to grouping.Before and after treatment, the best corrected visual acuity (BCVA) was examined with the International Standard Visual acuity chart and converted to logarithm of minimal angle resolution unit.The intraocular pressure (IOP) was measured using a non-contact tonometer.The central retinal thickness (CRT) was detected by optical coherence tomography (OCT).This study followed the Declaration of Helsinki and was approved by the Ethics Committee of Weifang Eye Hospital.Results:All patients were followed up for 6 months.In Ozurdex group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection was 0.59±0.22, 0.53±0.20, 0.41±0.16, 0.38±0.19 and 0.56±0.19, respectively.The BCVA at 1 month, 3 and 4 months after the first injection were better than that before injection, and the differences were statistically significant (all at P<0.05).In conbercept group, the BCVA pre-injection and at 1 month, 3, 4, 6 months after the first injection were 0.60±0.23, 0.51±0.17, 0.29±0.13, 0.56±0.18 and 0.60±0.18, respectively.The BCVA at 1 month and 3 months after the first injection were better than that before injection, showing statistically significant differences (all at P<0.05).The CRT at 1 month, 3 and 4 months after the first injection were significantly lower than that before treatment in both the two groups (all at P<0.05).The CRT pre-injection was (498.61±77.14)μm in Ozurdex group, which was significantly higher than (462.17±48.74)μm at 6 months after the first injection ( P<0.05).No significant difference in CRT was found between pre-injection and 6 months after the first injection in conbercept group ( P>0.05).The incidence of high IOP in Ozurdex group was 33.3%(6/18), which was higher than 5.56%(1/18) in conbercept group, with a significant difference ( χ2=4.433, P=0.035).No adverse effects such as aggravation of cataract, lens injury, endophthalmitis, vitreous hemorrhage and retinal detachment was found during the follow-up. Conclusions:For DME, both conbercept and Ozurdex can improve BCVA and reduce CRT.Ozurdex shows durable efficacy and needs fewer injections than conbercept, but conbercept has less effect on IOP and is safer than Ozurdex.

Unintentional injection of a dexamethasone implant into the crystalline lens: a case report / Injeção não intencional de implante de dexametasona no cristalino: relato de caso, acompanhamento e desfecho

ABSTRACT The intravitreal dexamethasone implant is a sustained-release anti-inflammatory drug system that releases 0.7 mg of dexamethasone into the vitreous cavity. The following case report describes a rare complication: accidental injection of the dexamethasone implant into the crystalline lens. A 73-year-old woman was diagnosed with central retina vein occlusion and cystoid macular edema. Initial tSreatment included three monthly intravitreal doses of anti-vascular endothelial growth factor treatment, which was not successful. Treatment was then modified to an intravitreal dexamethasone implant. Ten weeks later, the implant was observed in the posterior cortex of the crystalline lens. Because no improvement had occurred, the patient underwent phacoemulsification surgery, during which part of the lens migrated into the vitreous cavity. Therefore, 23-gauge pars plana complete vitrectomy was performed with trans-surgical administration of intravitreal aflibercept. Crystalline lens injury due to an intravitreal dexamethasone implant is a rare complication and typically results from the injection procedure. Immediate surgical or conservative approaches should be considered on an individual basis.

RESUMO O implante intravítreo de dexametasona é um sistema anti-inflamatório de liberação sustentada que libera 0,7 mg de dexametasona na cavidade vítrea. O relato de caso a seguir descreve uma complicação rara: injeção acidental do implante de Dexametasona no cristalino. Uma mulher de 73 anos foi diagnosticada com oclusão da veia central da retina e edema macular cistóide. O tratamento inicial incluiu três doses intravítreas mensais de tratamento com fator de crescimento endothelial anti-vascular, que não tiveram sucesso. O tratamento foi então mudado para um implante intravítreo de dexametasona. Dez semanas depois, o implante foi observado no córtex posterior do cristalino. Como não houve melhora, a paciente foi submetida à cirurgia de facoemulsificação, durante a qual parte do cristalino migrou para a cavidade vítrea. Portanto, foi realizada vitrectomia completa via pars plana 23-gauge com administração de aflibercepte intravítreo durante a cirurgia. Lesões no cristalino devido a implantes intravítreos de dexametasona são uma complicação rara e geralmente resulta do procedimento de injeção. Abordagens cirúrgicas ou conservadoras imediatas devem ser consideradas caso a caso.

Dexamethasone intravitreal implant in the crystalline lens: a case report / Implante intravítreo de dexametasona nas lentes do cristalino: um relato de caso

ABSTRACT This report describes the therapeutic effects and outcomes of an accidental injection of an intralenticular sustained-release dexamethasone implant (Ozurdex®) in three patients with diabetic macular edema. All three patients underwent accidental injections of sustained-release intravitreal dexamethasone implants into the crystalline lens by the same surgeon. After the accidental injection of Ozurdex® into the crystalline lens, a remarkable reduction in the macular edema and an improvement in visual acuity were observed, suggesting that a positive outcome can be achieved without immediate surgery.

RESUMO Este estudo descreve os efeitos terapêuticos e os resultados de uma injeção acidental de implante intralenticular de dexametasona de liberação sustentada (Ozurdex®) em três pacientes com edema macular diabético. Todos os três pacientes foram submetidos a injeções acidentais de implantes intravítreos de dexametasona de liberação sustentada na lente do cristalino pelo mesmo cirurgião. Após a injeção acidental de Ozurdex® na lente do cristalino, observou-se uma redução notável no edema macular e uma melhora na acuidade visual, sugerindo que um resultado positivo pode ser alcançado sem cirurgia imediata.

Optical biometry-based axial length alterations after intravitreal dexamethasone implant / Alterações do comprimento axial com base na biometria óptica após o implante de dexametasona intravítrea

ABSTRACT Purpose: To investigate changes in axial length after intravitreal dexamethasone implantation in patients with macular edema. Methods: We performed a prospective comparative study of 46 patients with unilateral macular edema, due to diabetic retinopathy, retinal vein occlusion, and non-infectious uveitis, who underwent dexamethasone implantation. The fellow eyes of the patients were considered the control group. The central macular thickness was measured by spectral-domain optical coherence tomography, and axial length was measured by IOLMaster 700 optical coherence biometry. We compared axial length and central macular thickness values within the groups. Results: In the study group, the baseline central macular thickness was 460.19 ± 128.64 mm, significantly decreasing to 324.00 ± 79.84 mm after dexamethasone implantation (p=0.000). No significant change in central macular thickness measurements was seen in the control group (p=0.244). In the study group, the baseline axial length was 23.16 ± 0.68 mm, significantly increasing to 23.22 ± 0.65 mm after dexamethasone implantation (p=0.039). However, the control group exhibited no significant change in axial length (p=0.123). Conclusions: In addition to significantly reducing central macular thickness measurements, intravitreal dexamethasone implantation also significantly changes optical biometry-based axial length measurements.

RESUMO Objetivo: Investigar alterações no comprimento axial após implante de dexametasona intravítrea em pacientes com edema macular. Métodos: Foi realizado um estudo prospectivo e comparativo de 46 pacientes com edema macular unilateral, devido à retinopatia diabética, oclusão da veia retiniana e uveíte não infecciosa, que foram submetidos ao implante de dexametasona. Os olhos contralateral de cada paciente foram considerados o grupo controle. A espessura macular central foi medida por tomografia de coerência óptica de domínio espectral, e o comprimento axial foi medido por meio de biometria de coerência óptica de domínio espectral e o comprimento axial foi medido pela biometria de coerência óptica com IOLMaster 700. Comparamos o comprimento axial e os valores da espessura macular central dentro dos grupos. Resultados: No grupo de estudo, a espessura macular basal foi de 460,19 ± 128,64 mm, diminuindo significativamente para 324,00 ± 79,84 mm após o implante de dexametasona (p=0,000). Nenhuma mudança significativa nas medidas da espessura macular central foi observada no grupo controle (p=0,244). No grupo de estudo, o comprimento axial basal foi de 23,16 ± 0,68 mm, aumentando significativamente para 23,22 ± 0,65 mm após o implante de dexametasona (p=0,039). No entanto, o grupo controle não apresentou alteração significativa no comprimento axial (p=0,123). Conclusões: Além de reduzir significativamente as medidas da espessura macular central, o implante de dexametasona intravítrea também altera significativamente as medidas de comprimento axial baseadas na biometria óptica.

Prevenção de gestações não planejadas com implante subdérmico em mulheres da Cracolândia, São Paulo / Preventing unplanned pregnancies with subdermal etonogestrel implant in woman living in Cracolândia, São Paulo

Introdução: As drogas ilícitas promovem danos sociais e à saúde. Muitas mulheres que consomem drogas estão em situação de rua, trocam sexo para sua compra e não fazem contracepção adequada. Entre essas mulheres vulneráveis há aumento no risco de doenças sexualmente transmissíveis (DST) e de gestações não planejadas, com consequente aumento de abortos e partos prematuros, além de efeitos sobre o recém-nascido que, na sua maioria, tem como destino viver com parentes ou esperar por adoção em abrigos. A busca pela redução desses danos deve passar pela promoção de ações para uma maior integração social e de prevenção de gestações não planejadas por meio do implante de etonogestrel. Objetivo: Usar o implante subdérmico de etonogestrel para a prevenção de gestação não planejada entre mulheres usuárias de drogas ilícitas e de redução de danos.Método: Foram inseridos 106 implantes de etonogestrel em mulheres da Cracolândia, região central da cidade de São Paulo, onde foram colhidas informações na anamnese geral e específica em 101 usuárias de drogas ilícitas. Nessas foram feitos exames em 54 para diagnóstico de DST e de câncer de colo do útero.Resultado: Entre as mulheres usuárias de drogas que fizeram a inserção do implante 41,6%usam o crack como droga de preferência e 48,5% fazem associação com álcool e 85,2% como tabaco. Em relação à contracepção 36,7% das mulheres não usam qualquer método contraceptivo.Houve aumento na morbidade gestacional, 16,1% delas tiveram aborto e 20,6%filhos prematuros.Conclusão: O implante subdérmico de etonogestrel é indicação precisa para a prevenção de gravidez não planejada entre mulheres usuárias de drogas, reduz o risco de morbidade gestacional e neonatal, além de promover redução no dano social.

Introduction: Illicit drugs promote social and health harm. Many female illicit drug users live on the streets, exchanging sex to buy drugs leaving aside proper contraception methods. This situation facilitates the occurrence of sexually transmitted diseases (STD) and unplanned pregnancies among these women in such vulnerable conditions, causing an increase in abortion and premature birth as well as direct effects on the newborn, which often are abandoned or forced to live with relatives. The efforts to reduce such damages must involve the realization of activities that stimulate greater social inclusion, and prevent unplanned pregnancies through the etonogestrel implant. Objective: Use the subdermal etonogestrel implant to prevent unplanned pregnancy among female illicit drug users as a mean of social inclusion and social damage control. Method: The project applied 106 etonogestrel implants in women living in Cracolândia, central region of São Paulo, where information regarding general and specific history of 101 female drug users was collected. Also, from these 101 users, exams were performed in 54 women in order to diagnose STD and uterine cervix cancer. Result: Among the 106 women who had implant insertion, 41.6% use crack as main drug, in which 48.5% associate the drug with alcohol and 85.2% with tobacco. Regarding contraception methods, 36.7% do not use any kind of contraceptive method. As for pregnancy conditions, an increase in gestational morbidity was stated, where 16.1% had abortion and20.6% had premature deliveries. Conclusion: The etonogestrel subdermal implant is a precise indication to prevent unplanned pregnancy among female drug users, because it reduces the risk of gestational and neonatal morbidity, promoting also a reduction in social damage.

Effects of Intra-Abdominal Implantation of Sustained-Releasing Fluorouracil on Expressions of Survivin, Caspase-3 and CD44V6 in Patients with Colorectal Cancer / 天津医药

Objectives To observe the pre and post-operational changes of the expressions of survivin, caspase-3 and CD44V6 in patients with colorectal cancer after intra-abdominal implantation of sustained releasing fluorouracil. Meth-ods Sixty-four patients with colorectal cancer (Dukes’stage of B and C) were divided into treatment group and control group, 32 patients in each group. The standard radical surgery was performed in two groups of patients. The fluorouracil im-plants were implanted intra-abdominally in treatment group. The peripheral blood levels of surviving and caspase-3 were de-tected by RT-PCR. The level of CD44V6 was detected by flow cytometry in two groups of patients. Results There were no significant differences in levels of survivin, caspase-3 and CD44V6 before surgery between two groups (P>0.05). The level of survivin (0.362 ± 0.183) was significantly lower at 14 days after operation in treatment group than that of control group (0.585±0.207), but the level of caspase-3 (2.001±0.146) was significantly higher than that of control group (1.654±0.111). The levels of CD44V6 were significantly lower in treatment group (1.857±0.535) and control group (3.471±0.496) after opera-tion than those before operation (9.557±1.170 and 9.729±0.943, P＜0.05), and the level of CD44V6 was significantly lower in treatment group than that of control group (P＜0.05). Conclusion The implant for the sustained release of fluorouracil showed a positive impact on micrometastases and prognosis of colorectal cancer, while improved the long-term efficacy of postoperative colorectal cancer.

Implante intravítreo de liberação crônica de dexametasona (Ozurdex®) para o tratamento de edema macular por retinose pigmentar: relato de caso / Intravitreal implantation of Ozurdex® chronic delivery system for management of macular edema related to retinitis pigmentosa: case report

Retinose pigmentar indica um grupo heterogêneo de doenças genéticas oculares raras em que tanto bastonetes quanto cones estão danificados, levando a um prognóstico ruim com eventual perda da visão. Descrevemos o caso de mulher de 22 anos com edema macular recorrente devido à retinose pigmentar. Obteve-se sucesso terapêutico após o tratamento com o implante intravítreo de dexamentasona (Ozurdex®, Allergan,USA).

Retinitis pigmentosa denotes a heterogeneous group of rare genetic diseases in which both rods and cones eye are damaged. It is a disease of poor prognosis. We describe the case of a 22 years old woman successfully treated with intravitreal implant of dexamentasone (OZURDEX®, Allergan, USA) for the treatment of macular edema due to retinitis pigmentosa.

Avaliação da mucosa sinusal do coelho à presença de implante biodegradável / Assessing the maxillary sinus mucosa of rabbits in the presence of biodegradable implants

Pensando em melhorar a qualidade de vida dos pacientes com doenças do humor vítreo, os oftalmologistas começaram a utilizar recentemente implantes biodegradáveis com corticoide. Estes mesmos implantes podem ser uma alternativa no tratamento da RSC e, para isso, realizamos um estudo experimental em seios maxilares de coelhos. OBJETIVO: Avaliar histologicamente a mucosa de seio maxilar de coelhos após a colocação de implante biodegradável de prednisolona. MÉTODO: Dezoito coelhos foram divididos aleatoriamente em dois grupos: Grupo 1: no seio maxilar esquerdo foi inserido um implante biodegradável com prednisolona; Grupo 2: No seio maxilar esquerdo foi inserido um implante biodegradável sem medicação. Os seios maxilares do lado direito serviram como controle. Após 7, 14 e 28 dias foram escolhidos aleatoriamente três coelhos de cada grupo e a resposta tecidual inflamatória foi avaliada. RESULTADOS: Foi encontrada diferença não significativa de inflamação na mucosa, quando comparamos o grupo de coelhos que receberam implantes com e sem medicação com o grupo controle; ou quando comparamos o grupo que recebeu implante com prednisolona com o grupo que recebeu implante sem medicação. CONCLUSÃO: Não foram observados sinais de toxicidade ou inflamação na mucosa do seio maxilar do coelho à presença do implante com ou sem prednisolona.

In an attempt to improve the quality of life of patients with vitreous humor disease, ophthalmologists began offering steroid-eluting biodegradable implants to their patients. These implants can be used as an alternative treatment for CRS and this is why this experimental study was carried out on rabbit maxillary sinuses. OBJECTIVE: This study aims to assess the histology of the mucosa of the maxillary sinuses of rabbits after the placement of a prednisolone-eluting biodegradable implant. METHOD: Eighteen rabbits were randomly divided into two groups: group 1 - subjects had drug-eluting implants placed on their left maxillary sinuses; group 2 - subjects had non-drug-eluting implants placed on their left maxillary sinuses. The right maxillary sinuses served as the controls. After seven, 14, and 28 days three rabbits in each group were randomly picked to have their tissue inflammatory response assessed. RESULTS: Levels of mucosal inflammation were not significantly different between the groups with and without drug-eluting implants and the control group, or when the groups with drug-eluting implants and non-drug-eluting implants were compared. CONCLUSION: Signs of toxicity or mucosal inflammation were not observed in the maxillary sinuses of rabbits given prednisolone-eluting implants or non-drug-eluting implants.

The safety evaluation of laparoscopic-guided ~(125)I seed implantation in the treatment of recurrent gynecologic malignancies / 中国医师杂志

Objevtive To investigate the safety of laparoscopic resection and ~(125)I seed implantation for recurrent gynecologic malignancies. Methods Laparoscopic surgery and ~(125)I seed implantation were used in five patients. All complications were recorded. Environmental radiation dose was detected at different distance from radioactive source and different time after operation with-γ-ray equipment. Results The procedure was safely achieved in all five patients. No serious complication was found. All patients experienced slight pain at the implant site and temporary vulva dropsy. With the increase of the distance from radioactive source and time passing, the radiation dose decreased quickly. The detected dose was close to a natural background radiation dose at the distance of 50cm from radioactive source and after 6 months. Conclusions Laparoscopic resection and ~(125)I seed implantation are safe to patient and environment.

Sistemas biodegradáveis contendo acetato de prednisolona para administração orbitária / Biodegradable systems containing prednisolone acetate for orbital administration

OBJETIVO: O presente estudo objetivou o desenvolvimento e a avaliação de um sistema biodegradável de liberação de fármacos com característica de liberação prolongada, destinado à administração orbitária de acetato de prednisolona (AP). MÉTODOS: O sistema desenvolvido, na forma de microesferas (MEs) de poli-e-caprolactona (PCL) contendo o AP, foi obtido pelo método de evaporação de solvente. As MEs foram caracterizadas por microscopia eletrônica de varredura (MEV), calorimetria diferencial exploratória (DSC), avaliação do teor de encapsulação e pelo perfil de liberação in vitro. O perfil de liberação in vivo foi avaliado em coelhos após administração peribulbar de uma suspensão aquosa das MEs. A biocompatibilidade local do sistema foi verificada por meio de análise histopatológica da região de implantação. RESULTADOS: Após obtenção das MEs, a análise morfológica por MEV mostrou a viabilidade do método de obtenção do sistema. O teor de AP encapsulado foi de 43 ± 7 por cento e pode ser considerado bastante satisfatório. A caracterização do sistema por DSC, além de confirmar a sua estabilidade, não indicou a existência de interação entre o fármaco e o polímero. O estudo de liberação in vitro indicou que o sistema apresenta perfil de liberação prolongada. O estudo in vivo confirmou o perfil de liberação prolongado do AP a partir das MEs, sugerindo, também, a viabilidade do sistema devido à ausência de toxicidade local. CONCLUSÃO: O conjunto dos resultados obtidos neste trabalho é relevante e credencia o sistema desenvolvido como uma possível alternativa ao tratamento de orbitopatias inflamatórias.

PURPOSE: The present study aimed to evaluate an injectable extended-release formulation of prednisolone acetate (PA) for orbital administration. METHODS: Microspheres (MEs) of poly-e-caprolactone (PCL) containing PA were developed by the method of solvent evaporation. The MEs obtained were characterized by scanning electron microscopy (SEM), differential scanning calorimetry (DSC), encapsulation efficiency and in vitro release profile. The in vivo release profile was evaluated in rabbits after periocular injection of an aqueous suspension of MEs. The local biocompatibility of the system was verified by histopathologic analysis of the deployment region. RESULTS: After MEs preparation, morphological analysis by SEM showed the feasibility of the employed method. The content of PA encapsulated was 43 ± 7 percent and can be considered as satisfactory. The system characterization by DSC technique, in addition to confirm the system stability, did not indicate the existence of interaction between the drug and the polymer. The in vitro release study showed the prolonged-release features of the developed system. Preliminary in vivo study showed the absence of local toxicity and confirmed the prolonged release profile of PA from MEs, suggesting the viability of the developed system for the treatment of orbital inflammatory diseases. CONCLUSION: The results obtained in this work are relevant and accredit the system developed as a possible alternative to the treatment of inflammatory orbitopathy.

Therapeutic effects analysis of patients with stage Ⅲ gastric carcinoma administrated fluorouracil implants during radical gastrectomy / 肿瘤研究与临床

Objective To investigate the therapeutic effects of fluorouracil implants in Stage Ⅲgastric carcinoma patients after radical gastreetomy. Methods The general state of health and cumulative survival of 200 stage Ⅲ gastric carcinoma patients undergone radical gastrectomy from January, 1999 to, December 2002 in the People's Hospital of Zhongshan City were analyzed, in which only 120 patients administrated fluorouracil implants during radical gastreetomy. The therapeutic effects of fluorouracil implants in stage Ⅲ gastric carcinoma patients after radical gastrectomy were observed. Results The differences of weight (P = 0.041), HGB(P =0.024), Plt(P =0.017), CEA(P =0.001), CA19-9(P =0.003) were significant between two groups. The incidence rate of nausea/emesis in group T (28 %) was higher than that in group O(17 %, P = 0.006), and incidence rates of myelosuppression(P =0.81), diarrhea(P =0.72), hepatic function lesion(P =0.97) and renal function lesion(P =0.20) were no significant. The cumulative 5-year survival rate of group T(45 %) was higher than that in group O (15 %, P =0.002). Conclusion Fluorouracil implants can improve the therapeutic effects on gastric carcinoma patients undergone radical gastrectomy.