Improving diaper design to address incontinence associated dermatitis

<p>Abstract</p> <p>Background</p> <p>Incontinence associated dermatitis (IAD) is an inflammatory skin disease mainly triggered by prolonged skin contact with urine, feces but also liberal detergent use when cleansing the skin. To minimize the epidermal barrier challenge we optimized the design of adult incontinence briefs. In the fluid absorption area we interposed a special type of acidic, curled-type of cellulose between the top sheet in contact with the skin and the absorption core beneath containing the polyacrylate superabsorber. The intention was to minimize disturbance of the already weak acid mantle of aged skin. We also employed air-permeable side panels to minimize skin occlusion and swelling of the stratum corneum.</p> <p>Methods</p> <p>The surface pH of diapers was measured after repeated wetting with a urine substitute fluid at the level of the top sheet. Occlusive effects and hydration of the stratum corneum were measured after a 4 hour application of different side panel materials by corneometry on human volunteers. Finally, we evaluated skin symptoms in 12 patients with preexisting IAD for 21 days following the institutional switch to the optimized diaper design. Local skin care protocols remained in place unchanged.</p> <p>Results</p> <p>The improved design created a surface pH of 4.6 which was stable even after repeated wetting throughout a 5 hour period. The "standard design" briefs had values of 7.1, which is alkaline compared to the acidic surface of normal skin. Side panels made from non-woven material with an air-permeability of more than 1200 l/m²/s avoided excessive hydration of the stratum corneum when compared to the commonly employed air-impermeable plastic films. Resolution of pre-existing IAD skin lesions was noted in 8 out of 12 patients after the switch to the optimized brief design.</p> <p>Conclusions</p> <p>An improved design of adult-type briefs can create an acidic pH on the surface and breathable side panels avoid over-hydration of the stratum corneum and occlusion. This may support the epidermal barrier function and may help to reduce the occurrence of IAD.</p

The Square Pyramidal Hydride Cation [RuH(dcpe)2]+, dcpe = Bis(dicyclohexylphosphino)ethane. Structures of [RuH(dcpe)2]+[BPh4]- and of the Zwitterionic {(η6-C6H5)BPh3}RuH(dcpe)

Two hydrido ruthenium complexes could be isolated from the reaction between RuCl2(DMSO)4 (DMSO = dimethyl sulfoxide) and the chelating 1,2-bis(dicyclohexylphosphino)ethane (dcpe) and [BPh4]-. These are [RuH(dcpe)2]+[BPh4]- with a five-coordinate, 16 valence electron cation and the neutral zwitterionic 18 valence electron compound {(η6-C6H5)BPh3}RuH(dcpe). The relative amounts of these products depend on the reaction conditions. If NaBPh4 is replaced by NH4PF6 or added after the reaction with the diphosphine has gone to completion, the 16 valence electron species [RuH(dcpe)2]+ is the only product. Reducing the size of the diphosphine chelate to 1,1-bis(dicyclohexylphosphino)methane (dcpm) has a large effect on the reaction course. Either trans-RuHCl(dcpm)2 or trans-RuCl2(dcpm)2 is formed, depending on the conditions. X-ray structures of [RuH(dcpe)2]+[BPh4]- (monoclinic, P2/c, a = 24.936(5) Å, b = 12.633(3) Å, c = 25.801(5) Å, β = 102.86(3)°, V = 7924(3) Å3, Z = 4, R = 0.062, Rw = 0.1694) and {(η6-C6H5)BPh3}RuH(dcpe) (monoclinic, P21/n, a = 14.321(5) Å, b = 19.716(7) Å, c = 17.100(5) Å, β = 107.60°, V = 4602(3) Å3, Z = 4, R = 0.0648, Rw = 0.1873) have been determined. A nearly planar arrangement of the four P atoms exists around Ru in the five-coordinate cation, implying a distorted square pyramid. This structural motif has not been observed previously for a d6 RuL5 system with a P4X donor set. {(η6-C6H5)BPh3}RuH(dcpe) represents an example for the noninnocent behavior of the “noncoordinating” [BPh4]- anion. The coordinated six-membered ring displays a boatlike distortion with the BPh3 “substituent” and the para-carbon of the coordinated ring displaced away from the metal

The Aza-Cope Rearrangement in Transition Metal Complexes. Construction of an Unsaturated C7-Ligand from Butadiyne and an Allylic Amine

cis-RuCl2(L2)2 reacts with butadiyne in the presence of NaPF6 to give the butatrienylidene intermediate trans-[RuCl(L2)2CCCCH2]+, which can be trapped with tertiary amines to afford the ammoniobutenynyl complexes trans-[RuCl(L2)2CCC(NR3) CH2]+ (L2 = dppm; R = Et, Pr). The respective N-allyl derivatives trans-[RuCl(L2)2CCC((NMe2)allyl) CH2]+ (L = dppm, depe) rearrange under ambient conditions via an aza-Cope process to the amino-substituted allenylidene complexes trans-[RuCl(L2)2 CCC(NMe2)(CH2)2CHCH2]+