Technique of scleral buckling for retinal detachment repair
A Peyman MD Gholam, A Meffert MD Stephen, D Conway MD FACS Mandi, Chiasson Trisha in Vitreoretinal Surgical Techniques, 2019
The purpose of scleral buckling is to close retinal breaks and relieve vitreous traction. Various materials have been used to create a scleral buckling effect, but hard silicone rubber and silicone sponges are used most commonly. Buckling material may be sutured on the surface of the sclera (exoplant) or placed beneath scleral flaps after lamellar scleral dissection (implant). Absorbable sheets of gelatin are sometimes used as an exoplant or implant to treat retinal detachment. Gelatin is predominantly hydrolyzed collagen. It is supplied as thin dehydrated sheets, which require hydration for 5–10 minutes at room temperature to make them pliable. These sheets are then cut to the desired size and are sutured to the sclera, with or without an encircling element. Multiple sheets may have to be used in order to achieve the desired buckling effect. Excessive hydration of gelatin may result in marked softening of the material, and may make subsequent handling difficult. Strips of dry gelatin may be used to fill scleral pockets that are subsequently closed with nonabsorbable sutures. This technique has been recommended for retinal detachments caused by a single retinal break and those caused by dialysis in children.19
Hydroxyethyl starch or gelatin, which is safer for the kidneys?
Elida Zairina, Junaidi Khotib, Chrismawan Ardianto, Syed Azhar Syed Sulaiman, Charles D. Sands, Timothy E. Welty in Unity in Diversity and the Standardisation of Clinical Pharmacy Services, 2017
Recently, the European Medicines Agency (EMA) has recommended reevaluating and discontinuing distribution permit of HES in July 2013. The same is also recommended by the US Food and Drug Administration (FDA). National Agency of Drug and Food Control of the Republic of Indonesia has also initiated an appeal regarding the security aspects of HES under limited conditions (Badan POM RI 2013, The US Food and Drug Administration 2013, European Medicines Agency 2013). As a result, the trends of the use of colloid fluids shift to the use of the latest generation of gelatin, which is claimed to be safer. By contrast, a systematic review and meta-analysis study was conducted by Thomas-Rueddel et al. (2012) on the safety of gelatin use in all RCTs involving adult and acute hypovolemic patients due to surgery, trauma, severe infection, or critical illness receiving gelatin, albumin, or crystalloid fluid as resuscitation fluid. The results of this study stated that the safety of gelatin under all clinical conditions cannot be confirmed. Further investigation is needed to establish its security profile (Thomas-Rueddel et al. 2012).
Utilization of Fisheries' By-Products for Functional Foods
Se-Kwon Kim in Marine Biochemistry, 2023
Gelatin is a fibrous protein derived from hydrolytic degradation of collagen, which is obtained from cartilages, skin, bones and connective tissues of various animals (Akbar et al., 2017). As a functional biopolymer, gelatin has very extensive applications in industries ranging from pharmaceuticals, cosmetics, materials, foods and photography depend on their rheological properties, that is, transparency, solubility, viscosity, gel strength and thermal stability. Moreover, the application of gelatin as functional foods is also expanding (Karim and Bhat, 2009; Gomez-Guillen et al., 2011). The global demand of gelatin is constantly increasing. World gelatin production reached 450,000 tons in 2018 with an estimated value of US$4.52 billion (Tkaczewska et al., 2018).
Management of priming fluids in cardiopulmonary bypass for adult cardiac surgery: network meta-analysis
Published in Annals of Medicine, 2023
Chen-Yang Xian-Yu, Jian-Bo Xu, Yu-Tong Ma, Nian-Jia Deng, Yu-Ting Tao, Hui-Jun Li, Teng-Yu Gao, Jing-Ying Yang, Chao Zhang
No significant advantage was observed with the use of gelatin as a priming fluid. Notably, it had the highest rate of death among all fluids. A meta-analysis demonstrated that gelatin increased the risk of allergic reactions, mortality, kidney failure and bleeding [51]. In addition, the use of gelatin as a priming fluid is more expensive than other liquids. In contrast, dextran is a more effective and safer priming fluid. This study found that patients using dextran had lower mortality, shorter mean CPB, and less blood loss 24h after surgery. In addition, no other obvious disadvantages are observed. Clinical research found that compared with albumin, the extra did not compromise organ function, and no significant difference in blood loss or transfusion volume [26]. Normally, high doses of artificial colloids impair haemostatic function, but dextran does not [26]. However, the use of dextran may also lead to allergies. Studies have shown that the incidence of allergic reactions to dextran was 21.9 per 100,000 injections (0.0219%) [52].
Diagnosis and management of hypersensitivity reactions to vaccines
Published in Expert Review of Clinical Immunology, 2020
Lucrezia Sarti, Guillaume Lezmi, Francesca Mori, Mattia Giovannini, Jean-Christoph Caubet
In particular, a hypersensitivity reaction to vaccines is attributed to porcine or bovine gelatin, in that they show important cross-reactivity. The exact mechanism for patients to become sensitized to gelatin is unknown. However, recent studies have proposed galactose-a-1,3-galactose (alpha-gal), an allergen involved in hypersensitivity reactions to red meat and after exposure to tick bites, as a potential cross-reactive allergen responsible for hypersensitivity reactions to gelatin contained in vaccines [114,115,117]. Another possible cross-reactive allergen proposed in a recent study was bovine serum albumin, a major allergen (Bos d 6) in beef and a minor allergen in cows’ milk [118]. Finally, Bogdanic J et al. showed that 16 and 38%, respectively, of beef and pork meat sensitized children, have IgE antibodies to gelatins that are cross-reactive [119].
BCS class II drug loaded protein nanoparticles with enhanced oral bioavailability: in vitro evaluation and in vivo pharmacokinetic study in rats
Published in Drug Development and Industrial Pharmacy, 2020
Nirmal M. Kasekar, Sarabjit Singh, Kisan R. Jadhav, Vilasrao J. Kadam
Gelatin is most widely used in medicine due to its biocompatibility, biodegradability, high physiological tolerance, and low immunogenicity [4]. In the record of safety for food supplement, the FDA classifies gelatin as ‘Generally Recognized as Safe’ (GRAS) [11]. Since the 1950s without serious adverse effects [12,13] gelatin derivatives are intravenously used as plasma expander (Gelafundin®, Gelafusal®). Gelsoft®, Gelseal® was successfully used as patches for vascular seal [13,14]. A further benefit of gelatin as starting material for NPs is its variety of functional groups. This allows different possibilities of surface modification [15,16], cross-linking [11,17,18], and marker coupling [19,20]. In addition, targeting-ligands [21,22] as well as various types of drugs [23–25] may be coupled.
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