Use of Tissue-Glue–Coated Collagen Sponge (TachoSil) to Repair Minor Cerebral Dural Venous Sinus Lacerations

2015 ◽  
Vol 11 (1) ◽  
pp. 32-36 ◽  
Author(s):  
Roberto Gazzeri ◽  
Marcelo Galarza ◽  
Claudio Fiore ◽  
Giorgio Callovini ◽  
Alex Alfieri
Keyword(s):  
Bleeding Time ◽  
Fixed Combination ◽  
Bleeding Control ◽  
Efficacy And Safety ◽  
Tissue Glue ◽  
Venous Sinuses ◽  
Tissue Sealant ◽  
Dural Venous Sinus ◽  
Coated Collagen ◽  
Control Quantity

Abstract BACKGROUND Significant hemorrhage may occur from the cerebral venous sinuses during the dural separation from the bone flap, particularly in elderly patients. It is important to achieve an urgent hemostatic control. OBJECTIVE To evaluate the efficacy and safety of a new fixed combination tissue sealant (TachoSil) in patients with bleeding from lacerations of cerebral venous sinuses. METHODS Between September 2012 and June 2014, 57 patients (39 female, 18 male) presenting with iatrogenic tears of the superior sagittal or transverse/sigmoid sinuses were treated with a topical fibrin sealant patch. Intraoperative source of bleeding, time to bleeding control, quantity of sealant sponge used, and postoperative complications were evaluated. Time to hemostasis was used as the primary end point. RESULTS Effective hemostasis, defined as cessation of bleeding after application of topical hemostatic agent, was achieved no later than 4 minutes in all except 5 patients with persistent bleeding from the sinus. In these 5 cases, bleeding was finally stopped after application of a new larger layer of TachoSil Sponge (2 cases) or gelatin hemostatic matrix (2 cases) or fibrin glue (1 case) over the layer of TachoSil. CONCLUSION We report our experience with a new hemostasis technique to manage bleeding from iatrogenic lacerations of cerebral venous sinuses.

scholarly journals The efficacy and safety of the timolol/dorzolamide fixed combination vs latanoprost in exfoliation glaucoma

Eye ◽  
2003 ◽  
Vol 17 (1) ◽  
pp. 41-46 ◽  
Author(s):  
A G P Konstas ◽  
V P Kozobolis ◽  
I Tersis ◽  
J Leech ◽  
W C Stewart
Keyword(s):  
Fixed Combination ◽  
Efficacy And Safety ◽  
Exfoliation Glaucoma

scholarly journals Fixed combinations of glaucoma medications

2015 ◽  
Vol 143 (9-10) ◽  
pp. 626-631 ◽  
Author(s):  
Nikola Babic
Keyword(s):  
Intraocular Pressure ◽  
Fixed Combination ◽  
Pressure Control ◽  
Line Treatment ◽  
Efficacy And Safety ◽  
First Line ◽  
Advantages And Disadvantages ◽  
Role Efficacy ◽  
Indications For Use ◽  
First Line Treatment

The first line treatment in the management of glaucoma is topical medical therapy. Many patients with glaucoma require multiple medications for adequate intraocular pressure control. For patients who need multi-dose regimens to control intraocular pressure, fixed combinations offer convenience, efficacy and safety. This review summarizes the role, efficacy, mechanism of action and indications for use of modern fixed combination of topical glaucoma medications. The review shows the advantages and disadvantages of a prescribing fixed combination in daily clinical practice.

Efficacy and Safety of a Fixed Combination of Glycyrrhizic Acid and Essential Phospholipids in Non-Alcoholic Fatty and Alcoholic Liver Disease: Results from Randomized Placebo-Controlled Trials

2021 ◽  
Vol 76 (6) ◽  
pp. 595-603
Author(s):  
Igor V. Maev ◽  
Alexey O. Bueverov ◽  
Artem V. Volnukhin
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Alcoholic Liver Disease ◽  
Fatty Liver Disease ◽  
Glycyrrhizic Acid ◽  
Fixed Combination ◽  
Efficacy And Safety ◽  
Alcoholic Fatty Liver ◽  
Essential Phospholipids ◽  
Alcoholic Fatty Liver Disease

Background. Drug treatment of non-alcoholic fatty and alcoholic liver disease remains an urgent, unsolved problem. Due to the commonality of many pathogenetic mechanisms and predictors of progression, a universal approach to the search for a therapeutic agent can be considered. Aims pooled analysis of the results of two multicenter, randomized, double-blind, placebo-controlled studies of a fixed combination of glycyrrhizic acid and essential phospholipids in two dosage forms to study its efficacy and safety in non-alcoholic fatty and alcoholic liver disease, in the presence and absence of predictors of disease progression. Methods. The pooled analysis included 180 patients with non-alcoholic fatty liver disease (Gepard study) and 120 patients with alcoholic liver disease (Jaguar study). Patients of the main group received a fixed combination of 5.0 g intravenous jet 3 times a week for the first 2 weeks; then 2 capsules 3 times a day for the next 10 weeks. Patients in the control group received placebo according to the same scheme. The total duration of treatment was 12 weeks in the Gepard study (1 course of stepwise therapy) and 24 weeks in the Jaguar study (2 courses of stepwise therapy). A comparative analysis of the efficacy and safety of a fixed combination and a placebo was carried out, in the presence and absence of predictors of progression, separately for each nosology and in a mixed sample. Results. In patients with non-alcoholic fatty and alcoholic liver disease who received the fixed combination, in contrast to the placebo group, there was a statistically more significant decrease in the level of biochemical markers of inflammation alanine aminotransferase, aspartate aminotransferase, adiponectin, and the value of the AktiTest index. There was no negative trend in the NAFLD fibrosis score; more significant positive dynamics of FibroTest is shown. Predictors of disease progression hyperglycemia, hyperlipidemia, age did not have a negative impact on the results in the study group. The efficacy of the study drug was noted in patients with non-alcoholic fatty liver disease and normal body weight; data were obtained indicating its possible effectiveness with a high activity of the inflammatory process associated with alcoholic liver damage. The frequency of adverse events in the study and control groups was comparable. Conclusions. Based on a generalized analysis of the results of two studies, promising directions for the study and use of a fixed combination of glycyrrhizic acid and essential phospholipids were identified: non-alcoholic fatty liver disease without obesity, alcoholic steatohepatitis of high activity (as an adjuvant); steatohepatitis of non-alcoholic and alcoholic etiology, combined with hyperglycemia and hyperlipidemia.

Hemostatic Efficacy and Safety of the Novel Medical Adhesive, MAR VIVO-107, in a Rabbit Liver Resection Model

2018 ◽  
Vol 59 (1-2) ◽  
pp. 48-57 ◽  
Author(s):  
Kenji Fukushima ◽  
Hirokazu Tanaka ◽  
Pramod Kadaba Srinivasan ◽  
Kerstin Pawlowsky ◽  
Babette Kögel ◽  
...  
Keyword(s):  
Body Weight ◽  
Liver Resection ◽  
Blood Loss ◽  
Fibrin Glue ◽  
Bleeding Time ◽  
Study Groups ◽  
Saline Group ◽  
Efficacy And Safety ◽  
The Mean ◽  
Hemostatic Efficacy

Background: Topical hemostatic agents are useful when hepatic hemorrhage is difficult to control. The aim of this study was to evaluate the hemostatic efficacy and safety of a biodegradable polyurethane-based adhesive, MAR VIVO-107 (MAR), in comparison with a clinically used fibrin glue. Methods: Thirty female New Zealand white rabbits were randomly assigned to 3 study groups as follows: MAR (n = 10), fibrin glue (n = 10), and saline groups (n = 10). After standardized partial liver resection was performed, each agent was immediately applied to the wound area. Bleeding time until hemostasis and blood loss were recorded. After 7 days, body weight, hematology parameters, and serum levels of aspartate aminotransferase, alanine aminotransferase, and lactate dehydrogenase were measured. Simultaneously, the severity of intra-abdominal adhesion was evaluated. Results: The mean bleeding time in the MAR (38 ± 10 s) and fibrin glue groups (65 ± 17 s) was significantly shorter than that in the saline group (186 ± 12 s). Similarly, the mean blood loss in the MAR (9 ± 3 g) and fibrin glue groups (9 ± 3 g) was significantly less than that in the saline group (23 ± 4 g). No significant differences in bleeding time and blood loss were found between the MAR and fibrin glue groups. The postoperative survival rate was 100% in all the groups. Body weight as well as hematological and serum biochemical values on day 7 were within the small and physiological range when compared with the preoperative baseline values, and significant differences were not detected among the MAR, fibrin glue, and saline groups. The severities of adhesion were similar between the 3 groups. Conclusion: Our data demonstrated that MAR was not inferior to fibrin glue in terms of hemostatic efficacy and safety.

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