1
|
Poudel S, Kaffash E, Zhao L, Pangeni R, Chow WN, Xu Q. Dexamethasone sodium phosphate loaded nanoparticles for prevention of nitrogen mustard induced corneal injury. Exp Eye Res 2024; 243:109902. [PMID: 38641196 DOI: 10.1016/j.exer.2024.109902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/20/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
Nitrogen mustard (NM) is a potent vesicating chemical warfare agent that is primarily absorbed through skin, inhalation, or ocular surface. Ocular exposure of NM can cause acute to chronic keratopathy which can eventually lead to blindness. There is a current lack of effective countermeasures against ocular exposure of NM despite their imperative need. Herein, we aim to explore the sustained effect of Dexamethasone sodium phosphate (DSP)-loaded polymeric nanoparticles (PLGA-DSP-NP) following a single subconjunctival injection in the management and prevention of corneal injury progression upon exposure to NM. DSP is an FDA approved corticosteroid with proven anti-inflammatory properties. We formulated PLGA-DSP-NP with zinc chelation ion bridging method using PLGA polymer, with particles of approximately 250 nm and a drug loading of 6.5 wt%. Under in vitro sink conditions, PLGA-DSP-NP exhibited a sustained drug release for two weeks. Notably, in NM injured cornea, a single subconjunctival (SCT) injection of PLGA-DSP-NP outperformed DSP eyedrops (0.1%), DSP solution, placebo NP, and saline, significantly mitigating corneal neovascularization, ulceration, and opacity for the two weeks study period. Through PLGA-DSP-NP injection, sustained DSP release hindered inflammatory cytokine recruitment, angiogenic factors, and endothelial cell proliferation in the cornea. This strategy presents a promising localized corticosteroid delivery system to effectively combat NM-induced corneal injury, offering insights into managing vesicant exposure.
Collapse
Affiliation(s)
- Sagun Poudel
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Ehsan Kaffash
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Long Zhao
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Rudra Pangeni
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Woon Nam Chow
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298, USA; Department of Pathology, Virginia Commonwealth University, Richmond, VA 23298, USA
| | - Qingguo Xu
- Department of Pharmaceutics, Virginia Commonwealth University, Richmond, VA 23298, USA; Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA 23298, USA; Center for Pharmaceutical Engineering, and Institute for Structural Biology, Drug Discovery & Development (ISB3D), Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA.
| |
Collapse
|
2
|
Huang X, Kong L, Chen W, Wang H, Zhang J, Gao Z, Xin Y, Xu W, Zuo Y. Catalytic activation of peracetic acid for pelargonic acid vanillylamide degradation by Co 3O 4 nanoparticles in-situ anchored carbon-coated MXene nanosheets: Performance and mechanism insight. J Colloid Interface Sci 2024; 657:1003-1015. [PMID: 38141470 DOI: 10.1016/j.jcis.2023.10.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/28/2023] [Accepted: 10/31/2023] [Indexed: 12/25/2023]
Abstract
Pelargonic acid vanillylamide (PAVA), a capsaicin-type dacryagogue agent utilized for counter-terrorism and riot control, possesses a low stimulus threshold. This characteristic can lead to environmental contamination following its application and may easily result in secondary stimulation to personnel. Cobalt-doped Ti3C2-MXene nanosheets (Co3O4/Ti3C2@C) were synthesized for the purpose of activating peracetic acid (PAA) and degrading PAVA. A carbon layer was coated on the surface of Ti3C2-MXene nanosheets to address the challenge of poor oxygen resistance in MXenes, thus preventing a significant decline in surface reactivity. The BET surface area of Co3O4/Ti3C2@C was expanded to 149.6 m2/g, significantly exceeding that of Ti3C2 (13.0 m2/g) and Co3O4 (56.4 m2/g). With 0.5 mg/mL of Co3O4/Ti3C2@C and 0.35 mM of PAA, 100 mg/L of PAVA was completely degraded within 60 min. The augmented BET surface area and the presence of more active sites confer remarkable PAA activation and catalytic degradation properties toward PAVA. Parameters such as initial pH, PAVA concentration, catalyst dosage, and PAA concentration on PAVA degradation were systematically assessed. Furthermore, the reusability and stability of the nanocomposite were substantiated through recycling tests. Radical quenching experiments and electron paramagnetic resonance analysis demonstrated the acetylperoxy radical (CH3CO3) as the primary species responsible for PAVA degradation. This research serves as an illustration of the utilization of MXene and transition metal activated PAA in wastewater treatment.
Collapse
Affiliation(s)
- Xingqi Huang
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Lingce Kong
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Wenming Chen
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Haibo Wang
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Jingjing Zhang
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Zhimeng Gao
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Yi Xin
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Wencai Xu
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China
| | - Yanjun Zuo
- State Key Laboratory of NBC Protection for Civilian, Research Institute of Chemical Defense, Beijing 102205, China.
| |
Collapse
|
3
|
Sinha NR, Tripathi R, Balne PK, Green SL, Sinha PR, Bunyak F, Giuliano EA, Chaurasia SS, Mohan RR. Time-dependent in situ structural and cellular aberrations in rabbit cornea in vivo after mustard gas exposure. Exp Eye Res 2022; 224:109247. [PMID: 36113569 DOI: 10.1016/j.exer.2022.109247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 08/23/2022] [Accepted: 09/07/2022] [Indexed: 11/19/2022]
Abstract
An array of corneal pathologies collectively called mustard gas keratopathy (MGK) resulting from ocular exposure to sulfur mustard (SM) gas are the most prevalent chemical warfare injury. MGK involves chronic ocular discomfort that results in vision impairment. The etiology of MGK remains unclear and poorly understood primarily due to a lack of scientific data regarding structural and cellular changes in different layers of the cornea altered by mustard vapor exposure in vivo. The goals of this study were to (a) characterize time-dependent changes in different layers of corneal epithelium, stroma, and endothelium in live animals in situ by employing state-of-the-art multimodal clinical ophthalmic imaging techniques and (b) determine if SM-induced acute changes in corneal cells could be rescued by a topical eye drop (TED) treatment using in an established rabbit in vivo model. Forty-five New Zealand White Rabbit eyes were divided into four groups (Naïve, TED, SM, and SM + TED). Only one eye was exposed to SM (200 mg-min/m3 for 8 min), and each group had three time points with six eyes each (Table-1). TED was topically applied twice a day for seven days. Clinical eye examinations and imaging were performed in live rabbits with stereo, Slit-lamp, HRT-RCM3, and Spectralis microscopy system. Fantes grading, fluorescein staining, Schirmer's tests, and applanation tonometry were conducted to measure corneal haze, ocular surface aberrations, tears, and intraocular pressure respectively. H&E and PSR staining were used for histopathological cellular changes in the cornea. In vivo confocal and OCT imaging revealed significant changes in structural and morphological appearance of corneal epithelium, stroma, and endothelium in vivo in SM-exposed rabbit corneas in a time-dependent manner compared to naïve cornea. Also, SM-exposed eyes showed loss of corneal transparency characterized by increased stromal thickness and light-scattering myofibroblasts or activated keratocytes, representing haze formation in the cornea. Neither naive nor TED-alone treated eyes showed any structural, cellular, and functional abnormalities. Topical TED treatment significantly reduced SM-induced abnormalities in primary corneal layers. We conclude that structural and cellular changes in primary corneal layers are early pathological events contributing to MGK in vivo, and efficient targeting of them with suitable agents has the potential to mitigate SM ocular injury.
Collapse
Affiliation(s)
- Nishant R Sinha
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Ratnakar Tripathi
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Praveen K Balne
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Sydney L Green
- Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Prashant R Sinha
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Filiz Bunyak
- Departments of Electrical Engineering and Computer Science, University of Missouri, Columbia, MO, USA
| | - Elizabeth A Giuliano
- Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA
| | - Shyam S Chaurasia
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA; Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology & Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Rajiv R Mohan
- Harry S. Truman Memorial Veterans' Hospital, Columbia, MO, USA; Departments of Veterinary Medicine & Surgery and Biomedical Sciences, University of Missouri, Columbia, MO, USA; Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA.
| |
Collapse
|
4
|
Mishra N, Agarwal R. Research models of sulfur mustard- and nitrogen mustard-induced ocular injuries and potential therapeutics. Exp Eye Res 2022; 223:109209. [PMID: 35961426 DOI: 10.1016/j.exer.2022.109209] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/27/2022] [Accepted: 08/02/2022] [Indexed: 11/20/2022]
Abstract
Sulfur mustard (SM) is a notorious, bifunctional alkylating vesicant that was first used in warfare during World War I in 1917 and since then has been deployed in numerous skirmishes with its most recent documented use being during the Middle Eastern conflicts. Apart from its use in combat and terrorist activities, continual threat of accidental exposure from old stockpiles and improperly discarded munitions is ever present, especially to the innocent and unassuming civilian populations. SM can cause devastating injuries, depending on the dosage of SM exposure, route of exposure, as well as the physiological conditions of the individuals exposed. The most common routes of exposure are ocular, dermal, and exposure to the lungs and respiratory tissues through inhalation. Eyes are the most susceptible organ to SM-induced toxicities owing to their high moisture content and rapidly dividing cells. Additionally, ocular injury causes the most expeditious disablement of individuals even upon whole-body exposures. Therefore, it is imperative to understand the mechanisms underlying SM-induced ocular toxicity and design therapeutic interventions to prevent/mitigate ocular injuries. Ocular SM exposure may cause a wide range of symptoms such as inflammation, lacrimation, itching, dryness, photophobia, edema of the cornea/sclera/retina/iris, conjunctivitis, degradation of the corneal layer, fusion of two or more ocular layers, neovascularization, fibrosis, and temporary or permanent structural damage to one or more ocular layers. These symptoms may lead to vision impairments, resulting in partial or complete blindness that may be permanent. The highly toxic and exceedingly notorious nature of SM makes it a highly regulated chemical, requiring very expensive licensing, security, and safety requirements; thus, the more easily accessible analogue, nitrogen mustard (NM) that mimics SM-induced toxicity and injuries is employed in plethora of studies conducted in different animal models and culture systems. This review provides a comprehensive account of the injuries and symptoms that occur upon ocular SM exposures in human patients as well as studies in animal (in vivo, ex vivo) and cell (in vitro) models of SM and NM ocular exposures. Special emphasis has been laid on highlighting the strengths and lacunae in the research as well as the possible unexplored avenues of mechanisms underlying mustard-induced ocular injury that can be explored in future research endeavors. Furthermore, development of therapeutic interventions and targets of interest in the ocular system exposed to SM and NM, based on studies in human patients as well as in vivo, ex vivo, and in vitro models has been discussed in great depth, providing a valuable knowledge database to delineate pathways associated with vesicant-induced toxicity, and strategies/diagnostic tools against SM-induced toxicity.
Collapse
Affiliation(s)
- Neha Mishra
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Rajesh Agarwal
- Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
| |
Collapse
|
5
|
Tripathi R, Balne PK, Sinha NR, Martin LM, Kamil S, Landreneau JR, Gupta S, Rodier JT, Sinha PR, Hesemann NP, Hofmann AC, Fink MK, Chaurasia SS, Mohan RR. A Novel Topical Ophthalmic Formulation to Mitigate Acute Mustard Gas Keratopathy In Vivo: A Pilot Study. Transl Vis Sci Technol 2020; 9:6. [PMID: 33200047 PMCID: PMC7645241 DOI: 10.1167/tvst.9.12.6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/09/2020] [Indexed: 01/29/2023] Open
Abstract
Purpose This pilot study investigated the in vivo therapeutic potential and tolerability of a multimodal ophthalmic formulation, topical eye drops (TED), for acute mustard gas keratopathy (MGK) using a rabbit model. Methods Twenty New Zealand White rabbits were used. Only right eyes of 18 rabbits (oculus dexter [OD]) received single sulfur mustard gas (SM) vapor injury, whereas contralateral eyes were left untreated or received TED for tolerabilty evaluation. Two rabbit eyes received no treatment and served as age-matched naive control. The four groups were: Naive (oculus sinister [OS] untreated eyes; n = 9); TED (OS treated only with TED BID for 3 days; n = 9); SM (OD exposed to SM vapor; n = 9); and SM+TED (OD exposed to SM+TED BID for 3 days; n = 9). Ocular examination in live rabbits were performed utilizing slit-lamp biomicroscopy, Fantes grading system, fluorescein staining, Schirmer's tests, pachymetry, and applanation tonometry. Cellular and molecular changes in rabbit corneas were assessed after humane euthanasia on day-3 and day-7 with histopathological and real-time polymerase chain reaction PCR techniques. Results TED to rabbit eyes was found tolerable in vivo. SM-exposed eyes showed significant increase in Fantes scores, central corneal thickness (CCT), Schirmer's test, epithelium-stroma separation, and corneal edema. TED mitigated clinical symptoms by reducing corneal edema, Fantes scores, CCT, and Schirmer's test. Further, TED decreased SM-induced corneal haze, inflammatory and profibrotic markers, transforming growth factor-TGF-β1 and cyclooxygenase-2COX-2, and damage to corneal structure, including epithelial-stromal integrity. Conclusions The developed multimodal eyedrop formulation, TED, has potential to mitigate acute MGK effectively in vivo. Translational Relevance TED is effective against MGK.
Collapse
Affiliation(s)
- Ratnakar Tripathi
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Praveen K. Balne
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Nishant R. Sinha
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Lynn M. Martin
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Sabeeh Kamil
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - James R. Landreneau
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Suneel Gupta
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Jason T. Rodier
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Prashant R. Sinha
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Nathan P. Hesemann
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Alexandria C. Hofmann
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
- Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA
| | - Michael K. Fink
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Shyam S. Chaurasia
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
| | - Rajiv R. Mohan
- Harry S. Truman Memorial Veterans’ Hospital, Columbia, MO, USA
- One-Health Vision Research Program, Departments of Veterinary Medicine and Surgery and Biomedical Sciences, College of Veterinary Medicine, University of Missouri, Columbia, MO, USA
- Mason Eye Institute, School of Medicine, University of Missouri, Columbia, MO, USA
| |
Collapse
|
6
|
Lewis CJ, Allison KP. Response to 'Chemical burns: Diphoterine untangled' by KS Alexander [Burns 2017]. Burns 2018; 44:1011-1012. [PMID: 29397237 DOI: 10.1016/j.burns.2017.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 11/20/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Christopher J Lewis
- Department of Plastic Surgery, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom.
| | - Keith P Allison
- Department of Plastic Surgery, James Cook University Hospital, Middlesbrough, United Kingdom
| |
Collapse
|
7
|
Alexander KS, Wasiak J, Cleland H. Chemical burns: Diphoterine untangled. Burns 2017; 44:752-766. [PMID: 29029860 DOI: 10.1016/j.burns.2017.09.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Revised: 08/01/2017] [Accepted: 09/15/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Diphoterine is a hypertonic, amphoteric, polyvalent and chelating decontamination solution used in the treatment of cutaneous and ocular chemical burns. Due to infrequent use by emergency physicians along with the small number of available studies, its debate in the literature as to its efficacy and safety remains inconclusive. METHODS A structured literature search was performed in MEDLINE, EMBASE BIOLOGICAL ABSTRACTS and TOXNET to June 2016 for original English-language studies reporting on the safety and effectiveness of Diphoterine. Methodological and reporting quality of pre-clinical animal studies was assessed using the Systematic Review Centre for Laboratory Animal Experimentation (SYRCLE) risk of bias tool and Animal Research: Reporting of In Vivo Experiments (ARRIVE) guidelines. Clinical studies were assessed using Chambers' criteria. RESULTS 13 studies (seven in the pre-clinical, five in the clinical setting and one mixed) met the study inclusion criteria. Pre-clinical studies showed a faster resolution of pH and reduced tissue necrosis with Diphoterine. Clinical studies showed reduced tissue necrosis/severity of symptoms, faster pH resolution and a reduction in pain when using Diphoterine. No adverse events were attributable to Diphoterine. Reporting and methodology of the studies was poor or showed a high risk of bias. CONCLUSIONS Diphoterine appears to be safe to use and is probably superior to other rinsing solutions. However, immediate decontamination is imperative and if Diphoterine is not available a different rinsing solution should be used. The methodology of the published literature for Diphoterine is generally poor and future publications should use the frameworks given as templates.
Collapse
Affiliation(s)
- K Skaria Alexander
- Victorian Adult Burns Service, The Alfred Hospital, Melbourne, Victoria, Australia.
| | - Jason Wasiak
- Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, The University of Melbourne, Victoria, Australia
| | - Heather Cleland
- Victorian Adult Burns Service, The Alfred Hospital, Melbourne, Victoria, Australia
| |
Collapse
|
8
|
Lewis C, Al-Mousawi A, Jha A, Allison K. Is it time for a change in the approach to chemical burns? The role of Diphoterine ® in the management of cutaneous and ocular chemical injuries. J Plast Reconstr Aesthet Surg 2017; 70:563-567. [DOI: 10.1016/j.bjps.2017.02.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/09/2017] [Accepted: 02/17/2017] [Indexed: 11/29/2022]
|
9
|
Abstract
Objective: Chlorobenzylidene malononitrile (CS) is the tear gas used by the police. The aim was to evaluate an amphoteric, hypertonic, and chelating rinsing solution in CS exposure. Methods: The first (CS) group of six police officers was exposed to CS only. The second (preexposure) group of eight sprayed their faces with an aqueous, hypertonic, amphoteric, and chelating solution before CS exposure. The third (postexposure) group of eight sprayed their faces with an aqueous, hypertonic, amphoteric, and chelating solution after CS exposure. The time between exiting the CS cloud and arriving at the “ready for action” checkpoint was measured. Their facial pain both inside the CS cloud and at the checkpoint was assessed (0–10 points). Results: The pain level inside the CS cloud was significantly lower in the preexposed group (5.6 ± 1.1; p = 0.01) than in the CS group (9.7 ± 0.5) and in the postexposure group (9.1 ± 0.4) where it was similar. The time interval between CS exposure and arrival at the checkpoint in the preexposure group (1:26 ± 0:44 min) was significantly shorter than both in the CS group (2:28 ± 0:25 min; p = 0.04) and postexposure group (2:30 ± 0:48 min; p = 0.02) where it was not different. The residual pain at the checkpoint in the preexposure (1.1 ± 0.4) and postexposure (1.4 ± 0.7) groups was similar with a significant lower pain level than in the CS group (2.3 ± 0.5; p = 0.02). Conclusion: CS decontamination with an aqueous, hypertonic, amphoteric, and chelating solution reduces facial pain, whereas prevention with it reduces pain and recovery time.
Collapse
Affiliation(s)
- M Brvar
- Poison Control Centre, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
10
|
XXXIII International Congress of the European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) 28–31 May 2013, Copenhagen, Denmark. Clin Toxicol (Phila) 2013. [DOI: 10.3109/15563650.2013.785188] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
|