Temporary ectropion therapy by adhesive taping: a case study

<p>Abstract</p> <p>Introduction</p> <p>Various surgical procedures are available to correct paralytic ectropion, which are applied in irreversible facial paresis. Problems occur when facial paresis has an unclear prognosis, since surgery of the lower eyelid is usually irreversible. We propose a simple method to correct temporary ectropion in facial palsy by applying an adhesive strip.</p> <p>Patients and methods</p> <p>Ten patients with peripheral facial paresis and paralytic ectropion were treated with an adhesive strip to correct paralytic ectropion. We used "Steri-Strips" (45 × 6.0 mm), which were taped on the carefully cleaned skin of the lower eyelid and of the adjacent zygomatic region until the prognosis of the paresis was clarified. In addition to the examiner's evaluation of the lower lacrimal point in the lacrimal lake, subjective improvement of the symptoms was assessed using a visual analogue scale (VAS, 1–10).</p> <p>Results</p> <p>9 patients reported a clear improvement of the symptoms after adhesive taping. There was a clear regression of tearing (VAS (median) = 8; 1 = no improvement, 10 = very good improvement), the cosmetic impairment of the adhesive tape was low (VAS (median) = 2.5; 1 = no impairment, 10 = severe impairment) and most of the patients found the use of the adhesive strip helpful. There was slight reddening of the skin in one case and well tolerated by the facial skin in the other cases.</p> <p>Conclusion</p> <p>The cause and location of facial nerve damage are decisive for the type of surgical therapy. In potentially reversible facial paresis, procedures should be used that are easily performed and above all reversible without complications. Until a reliable prognosis of the paresis can be made, adhesive taping is suited for the temporary treatment of paralytic ectropion. Adhesive taping is simple and can be performed by the patient.</p

The influence of an attachment-related stimulus on oxytocin reactivity in poly-drug users undergoing maintenance therapy compared to healthy controls

Background: Substance use disorders (SUDs) have been described as a dysfunctional way to compensate for deficiencies in that person’s underlying attachment system. Furthermore, the neuropeptide oxytocin (OT), which is a critical component of the neurobiology of the attachment system, has been shown to effectively reduce addictive behavior and therefore has been discussed as a potential medication in SUD treatment. This study investigates variation in peripheral OT plasma levels as a function of exposure to an attachment-related stimulus in SUD patients compared to healthy controls (HCs). Methods: A total sample of 48 men, 24 inpatients in maintenance treatment who were diagnosed with poly-drug use disorder (PUD) and 24 HC, was investigated. A 15-min exposure to the Adult Attachment Projective Picture System (AAP) was used as an attachment-related stimulus and coded for attachment status. Blood samples before and after the AAP-assessment were taken and assayed for OT levels. Variation in baselines level of OT was examined in relation to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST), the Adult Attachment-Scale (AAS), and the Brief Symptom Inventory (BSI). Results: Following the AAP stimulus controls showed no significant difference in OT levels elevation from baseline compared to the PUD group’s OT levels. Furthermore, in the PUD group only OT-baseline-levels may be negatively associated with the AAS subscale “Comfort with Closeness” and “Anxiety” and lifetime substance use. Discussion: Our results suggest that peripheral OT levels in poly-drug users undergoing maintenance treatment are not significantly different in responsiveness to an attachment related stimulus compared to HC. With regard to non-significant tendencies observed in this study which hint toward decreased OT-reactivity in the PUD group, further research is needed to explore this hypothesis with increased statistical power

Translation of angiotensin-converting enzyme 2 upon liver- and lung-targeted delivery of optimized chemically modified mRNA

Changes in lifestyle and environmental conditions give rise to an increasing prevalence of liver and lung fibrosis, and both have a poor prognosis. Promising results have been reported for recombinant angiotensin-converting enzyme 2 (ACE2) protein administration in experimental liver and lung fibrosis. However, the full potential of ACE2 may be achieved by localized translation of a membrane-anchored form. For this purpose, we advanced the latest RNA technology for liver- and lung-targeted ACE2 translation. We demonstrated in vitro that transfection with ACE2 chemically modified messenger RNA (cmRNA) leads to robust translation of fully matured, membrane-anchored ACE2 protein. In a second step, we designed eight modified ACE2 cmRNA sequences and identified a lead sequence for in vivo application. Finally, formulation of this ACE2 cmRNA in tailor-made lipidoid nanoparticles and in lipid nanoparticles led to liver- and lung-targeted translation of significant amounts of ACE2 protein, respectively. In summary, we provide evidence that RNA transcript therapy (RTT) is a promising approach for ACE2-based treatment of liver and lung fibrosis to be tested in fibrotic disease models