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Use of a selective enzymatic debridement agent(Nexobrid■)for wound management:Learning curve

World Journal of Dermatology 2017年第2期6卷 32-41页

作者： ricardo palao Jorge Aguilera-Sáez Jordi Serracanta Jose Manuel Collado Bruce Patrik Dos Santos Juan Pedro Barret Plastic Reconstructive and Burns Unit ServiceVall d'Hebron University Hospital

AIM To evaluate the efficacy of Nexobrid~? in the initial management of burns and lessons learned with the *** From January 27^(th) 2015 until January 25^(th) 2016, 25 patients aged between 18-94 years old with deep partial and full thickness burns were treated with Nexobrid~? covering 1%-30% of their total body surface area(TBSA). The debridement was applied in the first 96 h post-injury following the protocol suggested for Nexobrid~?. In patients with burns of more than 15% TBSA a second application of Nexobrid~? was performed. After the removal of the product-4 h post application and after a 2 h period of wet dressing-we used several products to cover the wound like Suprathel~?, Biobrane~?, Mepitel~? with wet dressing, silver sulphadiazine 1% cream, and in some cases even autografts. We treated patients with inhalation injury as well. All the procedures were done under deep sedation, regional blocks in extremities or general anaesthesia in the intensive care unit room or in the operating *** After these first 25 cases, we have observed that patients with partial thickness burns treated with Nexobrid~?, experienced great benefits in the reduction of the need for autografting compared with the standard of care. This isbecause after selective enzymatic debriding of the burn scar we can distinguish different wound beds, which can coexist in the same patient, and we also managed to associate each one to its ability to epithelize. In major burns, besides the improvement in wound healing, we observed an important improvement in their general state. This may be because SIRS significantly improved through a bloodless debridement of necrotic tissue, decreasing the requirements of vasoactive drugs and fluid resuscitation. Circumferential burns also benefited from enzymatic debridement, observing a decrease in the number of compartment syndromes and the need for escharotomies. At present, we have not observed a positive effect in the evolution and o

关键词： Burns Eschar Debridement Enzymatic debridement Wound bed Nexobrid■ Epithelialization Dermis preservation Autograft

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Exenatide Response in an Adolescent’s Morbid Obesity

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Pharmacology & Pharmacy 2014年第4期5卷 419-424页

作者： ricardo Soriano Sanchez Alfonso Lopez Ruiz M. Angeles Nunez Sanchez Noelia Victoria Garcia-Talavera Espin Amparo Meoro Aviles Maria Teresa Gallego Garcia Cristina del Peso Gilsanz Jose Soriano palao Collaborative Groups of the Diabetes Obesity Unit of the Hospital Reina Sofia Unidad de Diabetes y Obesidad del area VII Murcia Este Hospital General Universitario Reina Sofía de MurciaMurcia Espana

Adolescent obesity is a health problem worldwide. Drug therapy for obesity in children is only acceptable if done within the framework of a comprehensive weight loss, prevention of comorbidities, including health education, changes in lifestyles, diet and exercise. These pharmacological treatments indicate that mainly young patients did not respond to standard measures and developing complications. The role of bariatric surgery, with or without the use of drugs is subject to further research to elucidate its role among the various treatment options for these patients. Currently being studied a wide range of drugs to those included gastrointestinal hormones. Scientific information regarding the use of exenatide in obese patients without diabetes is still limited. The use of exenatide in adolescents with morbid obesity may represent a therapeutic complement invaluable, effective and free of complications, and prevents future bariatric surgery.

关键词： Type 2 Diabetes Mellitus Exenatide Adolescent Obestity

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Optimization of Exenatide plus Detemir Treatment for Morbid Obese Patients with Insulin Dependent Diabetes Resistant to Conventional Treatment. Effect of Exenatide on Patients with Mellitus Diabetes Type 2

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Pharmacology & Pharmacy 2014年第4期5卷 433-443页

作者： Alfonso Lopez Ruiz Maria Angeles Nunez Sanchez Noelia Victoria Garcia-Talavera Espin Amparo Meoro Aviles Cristina del Peso Gilsanz ricardo Soriano Sanchez Maria Teresa Gallego Garcia Jose Soriano palao Maria Dolores Ortuno Sacramento Tomas Navarro Collaborative Groups of the Diabetes and Obesity Unit of the Hospital Reina Sofia Unidad de Diabetes y Obesidad del área VII Murcia Este Hospital General Universitario Reina Sofía de Murcia Murcia Espa&ntildea

The purpose of this study was to analyze the effects of the treatment with Exenatide joint to insulin detemir. The study was carried out with obese patients with type 2 diabetes mellitus (DM2) and deficient control, despite intensive insulin therapy combined with oral antidiabetics. A longitudinal study was made with 15 patients controlled by the Endocrinology and Nutrition Section of the Reina Sofía University Hospital, Murcia. These patients were treated with Exenatide joint to insulin during 3, 6 and 12 months. Statistically meaningful differences (p < 0.05) were observed in the reduction of HbA1c in the 3 and 6 months treatment groups (initial HbA1c: 9.55% ± 1.086%, weight: 119.94 kg, insulin requirement: 0.71 IU/kg/day;after 3 months: HbA1c: 7.77% ± 1.164%, weight: 98.13 kg, insulin requirement: 0.59 IU/kg/day;after 6 months: HbA1c: 7.21%, weight: 97.93 kg, insulin requirement: 0.55 IU/kg/day). It was observed that the association of Exenatide and insulin promotes an improvement in several indicators such as weight, body mass index (BMI), systolic pressure (SP), diastolic pressure (DP), triglycerides (TG), cLDL, cHDL and total cholesterol (TC), in patients with diabetes resistant to conventional therapy. However, these improvements were statistically no significant (p < 0.05). It is possible to talk of a reduction of cardiovascular risk factors in patients with Exenatide, being thus a suitable option for this kind of individuals. It is important to emphasize the fact that our study showed bigger body-weight reductions results after 6 and 12 months, as compared to the researches quoted.

关键词： Type 2 Diabetes Mellitus Exenatide Cardiovascular Risk Physical and Biochemical Parameters

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