| 1. |
- Ali, Abdullah, 1985-, et al.
(författare)
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Relationship between sensorial and physical characteristics of topical creams : A comparative study on effects of excipients
- 2022
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Ingår i: International Journal of Pharmaceutics. - : Elsevier B.V.. - 0378-5173 .- 1873-3476. ; 613
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Tidskriftsartikel (refereegranskat)abstract
- Rising consumer demands for safer, more natural, and sustainable topical products have led to increased interest in finding alternative excipients, while retaining functionality and cosmetic appeal. Particle-stabilized Pickering creams have emerged as possible alternatives to replace traditional surfactant-stabilized creams and are thus one of the focuses in this study. The aim of this paper was to study relationships between sensorial characteristics and physical properties to understand how different excipients affect these aspects, comparing one starch particle–stabilized and three surfactant-stabilized formulations. A human panel was used to evaluate sensorial perception, while physical properties were deduced by rheology and tactile friction, together with in vivo and ex vivo skin hydration measurements. The results show that sensorial attributes related to the application phase can be predicted with rheology, while afterfeel attributes can be predicted with tactile friction studies. Differences in rheological and sensory properties among surfactant-based creams could mainly be attributed to the type of emollients used, presence of thickeners and surfactant composition. Differences between surfactant-based creams and a Pickering cream were more evident in relation to the afterfeel perception. Presence of starch particles in the residual film on skin results in high tactile friction and low perception of residual coating, stickiness, greasiness, and slipperiness in sensorial afterfeel. © 2021 The Authors
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| 2. |
- Fernando, Germain J. P., et al.
(författare)
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Safety, tolerability, acceptability and immunogenicity of an influenza vaccine delivered to human skin by a novel high-density microprojection array patch (Nanopatch (TM))
- 2018
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Ingår i: Vaccine. - : ELSEVIER SCI LTD. - 0264-410X .- 1873-2518. ; 36:26, s. 3779-3788
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Tidskriftsartikel (refereegranskat)abstract
- Background: Injection using needle and syringe (Namp;S) is the most widely used method for vaccination, but requires trained healthcare workers. Fear of needles, risk of needle-stick injury, and the need to reconstitute lyophilised vaccines, are also drawbacks. The Nanopatch (NP) is a microarray skin patch comprised of a high-density array of microprojections dry-coated with vaccine that is being developed to address these shortcomings. Here we report a randomised, partly-blinded, placebo-controlled trial that represents the first use in humans of the NP to deliver a vaccine. Methods: Healthy volunteers were vaccinated once with one of the following: (1) NPs coated with split inactivated influenza virus (A/California/07/2009 [H1N1], 15 mu g haemagglutinin (HA) per dose), applied to the volar forearm (NP-HAIFA), n = 15; (2) NPs coated with split inactivated influenza virus (A/California/07/2009 11-11N1 I, 15 mu g HA per dose), applied to the upper arm (NP-HA/UA), n = 15; (3) Fluvaxe (R) 2016 containing 15 mu g of the same H1N1 HA antigen injected intramuscularly (IM) into the deltoid (IM-HA/D), n = 15; (4) NPs coated with excipients only, applied to the volar forearm (NP-placebo/FA), n = 5; (5) NPs coated with excipients only applied to the upper arm (NP-placebo/UA), n = 5; or (6) Saline injected IM into the deltoid (IM-placebo/D), n = 5. Antibody responses at days 0, 7, and 21 were measured by haemagglutination inhibition (HAI) and microneutralisation (MN) assays. Findings: NP vaccination was safe and acceptable; all adverse events were mild or moderate. Most subjects (55%) receiving patch vaccinations (HA or placebo) preferred the NP compared with their past experience of IM injection with Namp;S (preferred by 24%). The antigen-vaccinated groups had statistically higher HAI titres at day 7 and 21 compared with baseline (p amp;lt; 0.0001), with no statistical differences between the treatment groups (p amp;gt; 0.05), although the group sizes were small. The geometric mean HAI titres at day 21 for the NP-HA/FA, NP-HA/UA and IM-HA/D groups were: 335 (189-593 95% CI), 160 (74-345 95% CI), and 221 (129-380 95% CI) respectively. A similar pattern of responses was seen with the MN assays. Application site reactions were mild or moderate, and more marked with the influenza vaccine NPs than with the placebo or IM injection. Interpretation: Influenza vaccination using the NP appeared to be safe, and acceptable in this first time in humans study, and induced similar immune responses to vaccination by IM injection. (C) 2018 The Author(s). Published by Elsevier Ltd.
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| 3. |
- Guorgis, Ghassan, et al.
(författare)
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Actinic Keratosis Diagnosis and Increased Risk of Developing Skin Cancer : A 10-year Cohort Study of 17,651 Patients in Sweden
- 2020
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Ingår i: Acta Dermato-Venereologica. - Uppsala, Sweden : Society for the Publication of Acta Dermato - Venereologica. - 0001-5555 .- 1651-2057. ; 100:8
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Tidskriftsartikel (refereegranskat)abstract
- Actinic keratosis is the most common actinic lesion in fair-skinned populations. It is accepted as an indicator of actinic skin damage and as an occasional precursor of squamous cell carcinoma. The aim of this study was to investigate, in a cohort of patients with a diagnosis of actinic keratosis, the relative risk of developing skin cancer during a follow-up period of 10 years. This registry-based cohort study compared a cohort of 2,893 individuals in south-eastern Sweden, who were diagnosed with actinic keratosis during the period 2000 to 2004, with a matched-control cohort of 14,668 individuals without actinic keratosis during the same inclusion period. The subjects were followed for 10 years to identify skin cancer development in both cohorts. Hazard ratios with 95% confidence intervals (95% CI) were used as risk measures. Individuals in the actinic keratosis cohort had a markedly higher risk for all skin cancer forms compared with the control cohort (hazard ratio (HR) 5.1, 95% CI 4.7-5.6). The relative risk was highest for developing squamous cell carcinoma (SCC) (HR 7.7, 95% CI 6.7-8.8) and somewhat lower for basal cell carcinoma (BCC) (HR 4.4, 95% CI 4.1-5.0) and malignant melanoma (MM) (HR 2.7 (2.1-3.6). Patients with a diagnosis of actinic keratosis were found to be at increased risk of developing SCC, BCC and MM in the 10 years following diagnosis of actinic keratosis. In conclusion, a diagnosis of actinic keratosis, even in the absence of documentation of other features of chronic sun exposure, is a marker of increased risk of skin cancer, which should be addressed with individually directed preventive advice.
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| 4. |
- Henricson, Joakim, 1977-, et al.
(författare)
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Micropuncture closure following high density microarray patch application in healthy subjects
- 2022
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Ingår i: Skin research and technology. - : Wiley. - 0909-752X .- 1600-0846. ; 28:2, s. 305-310
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Tidskriftsartikel (refereegranskat)abstract
- Background The high-density microarray patch (HD-MAP) promises to be a robust vaccination platform with clear advantages for future global societal demands for health care management. The method of action has its base not only in efficient delivery of vaccine but also in the reliable induction of a local innate physical inflammatory response to adjuvant the vaccination process. The application process needs to induce levels of reactivity, which are acceptable to the vaccine, and from which the skin promptly recovers. Materials and methods 1 x 1 cm HD-MAP patches containing 5000, 250-mu m long microprojections were applied to the skin in 12 healthy volunteers. The return of skin barrier function was assessed by transepidermal water loss (TEWL) and reaction to topical histamine challenge. Results Skin barrier recovery by 48 h was confirmed for all HD-MAP sites by recovered resistance to the effects of topical histamine application. Conclusions Our previous observation, that the barrier disruption indicator TEWL returns to normal by 48 h, is supported by this papers demonstration of return of skin resistance to topical histamine challenge in twelve healthy subjects.
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| 5. |
- Jonasson, Hanna, 1981-, et al.
(författare)
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Water and hemoglobin modulated gelatin-based phantoms to spectrally mimic inflamed tissue in the validation of biomedical techniques and the modeling of microdialysis data
- 2022
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Ingår i: Journal of Biomedical Optics. - Bellingham, WA, United States : SPIE - International Society for Optical Engineering. - 1083-3668 .- 1560-2281. ; 27:7
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Tidskriftsartikel (refereegranskat)abstract
- Significance: Tissue simulating phantoms are an important part of validating biomedical optical techniques. Tissue pathology in inflammation and oedema involves changes in both water and hemoglobin fractions.Aim: We present a method to create solid gelatin-based phantoms mimicking inflammation and oedema with adjustable water and hemoglobin fractions.Approach: One store-bought gelatin and one research grade gelatin were evaluated. Different water fractions were obtained by varying the water-to-gelatin ratio. Ferrous stabilized human hemoglobin or whole human blood was added as absorbers, and the stability and characteristics of each were compared. Intralipid® was used as the scatterer. All phantoms were characterized using spatial frequency domain spectroscopy.Results: The estimated water fraction varied linearly with expected values (R2 = 0.96 for the store-bought gelatin and R2 = 0.99 for the research grade gelatin). Phantoms including ferrous stabilized hemoglobin stayed stable up to one day but had methemoglobin present at day 0. The phantoms with whole blood remained stable up to 3 days using the store-bought gelatin.Conclusions: A range of physiological relevant water fractions was obtained for both gelatin types, with the stability of the phantoms including hemoglobin differing between the gelatin type and hemoglobin preparation. These low-cost phantoms can incorporate other water-based chromophores and be fabricated as thin sheets to form multilayered structures.
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| 6. |
- Magnusson, Henrik, 1977-, et al.
(författare)
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Sustainable effect of individualised sun protection advice on sun protection behaviour : a 10-year follow-up of a randomised controlled study in primary care.
- 2019
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Ingår i: BJGP open. - London, United Kingdom : Royal College of General Practitioners. - 2398-3795. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the light of increasing skin cancer incidences worldwide, preventive measures to promote sun protection in individuals with risky sun habits have continued relevance and importance.AIM: To report the long-term effect of individualised sun protection advice given in primary health care (PHC), on sun habits and sun protection behaviour.DESIGN & SETTING: In 2005, 309 PHC patients were enrolled in a randomised controlled study performed in a Swedish PHC setting.METHOD: At baseline, the study participants completed a Likert scale-based questionnaire, mapping sun habits, propensity to increase sun protection, and attitudes towards sun exposure, followed by randomisation into three intervention groups, all receiving individualised sun protection advice: in Group 1 (n = 116) by means of a letter, and in Group 2 (n = 97) and 3 (n = 96) communicated personally by a GP. In Group 3, participants also underwent a skin ultraviolet-sensitivity phototest, with adjusted sun protection advice based on the result. A repeated questionnaire was administered after 3 and 10 years.RESULTS: Statistically significant declines were observed in all groups for sun exposure mean scores over time. When using a cumulative score, according to the Sun Exposure and Protection Index (SEPI), significantly greater decrease in SEPI mean score was observed in Groups 2 and 3 (GP), compared to Group 1 (letter); P<0.01. The addition of a phototest did not enhance the effect of the intervention.CONCLUSION: Individualised sun protection advice mediated verbally by the GP can lead to sustained improvement of sun protective behaviour.
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| 7. |
- Nyman, Erika, 1976-, et al.
(författare)
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Hyaluronic Acid Accelerates Re-epithelialization and Alters Protein Expression in a Human Wound Model
- 2019
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Ingår i: Plastic and Reconstructive Surgery - Global Open. - : Lippincott Williams & Wilkins. - 2169-7574. ; 7:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hyaluronic acid (HA), a large glycosaminoglycan involved in proliferation, migration, and tissue repair, is suggested to be an important factor for keratinocyte activation and re-epithelialization. The experimental hypothesis of this study was that HA accelerates re-epithelialization, and we aimed to investigate the effect of exogenous intradermal HA during deep dermal, incisional wound healing in vivo in humans, the primary endpoint being re-epithelialization. Methods: A total of 8 standardized deep dermal incisional wounds (depth 1.6mm, width 1.8mm) per subject were induced in 10 healthy volunteers. Two of the wound sites per subject were pretreated with injections of HA and 2 with saline solution. At 2 time points (24 hours and 14 days), 2 biopsies for each treatment group (one for histology and one for proteomics) were taken. Skin erythema was measured at 24-hour intervals for 14 days as a surrogate measurement of inflammation. Results: At 24 hours, 8 of 9 wounds pretreated with HA showed complete re-epithelization, whereas none of the wounds pretreated with saline had re-epithelized. Wounds pretreated with HA also showed a 10-fold regulation of 8 identified proteins involved in wound healing compared to wounds treated with saline solution. No difference in inflammation, as measured as erythema, could be seen between any of the groups. Conclusions: We conclude that HA accelerates re-epithelialization and stimulates an altered protein expression in vivo in human deep dermal incisional skin wounds, but has no effect on the inflammation process as measured by erythema.
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| 8. |
- Toll John, Rani, 1975-, et al.
(författare)
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A cool response : the influence of ambient temperature on capillary refill time
- 2018
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Ingår i: Journal of Biophotonics. - : Wiley-VCH Verlagsgesellschaft. - 1864-063X .- 1864-0648. ; 11:6
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo describe the effect of low ambient temperature on skin temperature and capillary refill (CR) time in forehead, sternum and finger pulp.MethodsAn observational, nonrandomized experimental study on 15 healthy subjects (6 females) in a cold room (8°C). Outcome measures were skin temperature and quantified CR test after application of a standardized blanching pressure (9 N/cm2) using digital photographic polarization spectroscopy to generate CR times.ResultsThe finger pulp showed marked temperature fall and prolonged CR times (>10 seconds). The CR registrations of the forehead and sternum were more comparable to curves observed in a control material at room temperature, and skin temperature falls were less marked. CR times were not prolonged in forehead measurements. At the sternum, some individuals showed CR times beyond guideline recommendations despite only a marginal reduction in skin temperature.ConclusionsLow ambient temperature is a strong independent factor for CR time at peripheral sites. Reservation about sternum as a site of measurement is warranted since cold provocation produced prolonged CR times in some individuals. We found that the forehead is the most thermostable of the 3 sites and thus the preferred site to avoid ambient temperature artifact in measuring CR time.
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| 9. |
- Toll, Rani, 1975-
(författare)
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To See or Not to See : A Study on Capillary Refill
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Assessment of the critically ill is traditionally based on vital signs (blood pressure, pulse, respiratory rate, temperature and level of consciousness). Altered vital signs are, however, late indicators of deranged hemodynamics pointing to a need for additional, more sensitive markers of circulatory compromise. In the beginning of the 20th century, the capillary refill (CR) time evolved as a possible, non-invasive adjunct to early prediction of the outcome in the critically ill. The manoeuvre entails application of blanching pressure on the skin of the finger pulp or sternum for 5 seconds. After release of the pressure, the observer estimates time in seconds for the skin to return to original colour. This time is hypothesized to reflect the dynamics of the microcirculation and its possible connection with hemodynamics. In the 1980s the “normal capillary refill time” was set to < 2 seconds and later extended to 3 seconds, without a clear scientific foundation. Naked-eye estimations of CR time met increasing scepticism in the 1990s due to subjectivity and poor prognostic value for shock or death. Several basic traits, such as age and sex, as well as ambient temperature, were also shown to independently influence the CR time. Various methods have evolved with the capability to measure CR time quantitatively, one of which is Polarisation Spectroscopy Imaging (PSI). PSI measures the Red Blood Cell (RBC) concentration in tissue (e.g. the skin) and can be used to measure CR time.Objectives: The purpose of this study was to establish basic characteristics for quantified CR (qCR), identify possible influencing factors in healthy subjects and to investigate how this relates to current practice. We also sought to identify technical demands for transfer of the technique into clinical studies. In paper I we analysed the (qCR) time characteristics at 5 different skin sites (forehead, sternum, volar forearm, finger pulp and dorsum finger). The objective of paper II was to investigate the inter- and intra-observer variability of naked eye CR assessments of different professions, nurses, doctors and secretaries (representing laymen). In paper III we observed the effect of low ambient temperature on the qCR time in different skin sites. In paper IV, we transferred the equipment from a laboratory to a clinical setting in the Emergency Department (ED) for application on potentially critically ill patients. In this study we evaluated the most important factors determining a reliable data collection and influencing the amount of data possible to analyse.Methods: qCR time was measured in a total of 38 volunteers and 10 patients in different skin sites (2-5 skin sites) at different ambient temperatures. PSI (TiVi 600 and 700, WheelsBridge AB, Linköping, Sweden) was used to determine the rapid temporal changes in RBC concentration in skin during the CR manoeuvre. Films using a range of the first measurements from paper I were shown for assessment to 48 observers working in the ED.Results: In paper I we could delineate qCR curves and suggest 2 possible equivalents to the naked-eye observed CR time which we named Time to Return to Baseline 1 (tRtB1) and Time to Peak (tpk). We demonstrated differences in qCR-curves depending on skin site and possibly due to skin temperature. In paper II we showed a poor inter- and intra-observer reproducibility in visually estimating the CR time regardless of profession (clinicians or laymen). Paper III demonstrated a rapid effect of ambient temperature on qCR time in peripheral skin sites such as finger pulp. The forehead, regarded as a more central skin site was the most temperature stable site and showed least variability in qCR time as determined using tRtB1. Paper IV, a study on patients in an ED setting, yielded assayable data in 80% of the measurements. We identified critical performance parameters to address in the further development of a more robust, easy-to-use device for future validation of the possible relevance of qCR in patient triage and monitoring.Conclusions: CR time can be quantified using PSI. Quantified CR time demonstrated a large variability between different skin sites, specifically, skin temperature was shown to be an important factor influencing qCR time, particularly at the fingertip. Naked-eye estimates of CR time were highly variable, both within and between observers. Agreement between quantified CR time and naked-eye estimates was poor. The prototypic PSI technique was feasible in a clinical setting and, with further improvements, clinical evaluation of qCR in relation to relevant patient outcomes will be possible.
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