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Nathan Goodyear

American Journal of Obstetrics & Gynecology Home Page - 0 views

  • M1 macrophages are characterized by the secretion of reactive oxygen species and proinflammatory cytokines and chemokines and can be identified via the cell surface marker CD86
  • M2 macrophages secrete growth factors and antiinflammatory immune modulators and can be identified by the cell surface marker CD206
  • an overzealous M2 response can also lead to excess tissue deposition and fibrosis
  • ...14 more annotations...
  • Studies of similar meshes that are used in hernia repair have demonstrated that all polypropylene meshes induce a prolonged inflammatory response at the site of implantation
  • the long-term presence of activated inflammatory cells, such as macrophages at the mesh tissue interface, can impact negatively the ability of the mesh to function as intended.
  • All M1 proinflammatory and M2 proremodeling cytokines and chemokines were increased in mesh explants as compared with nonmesh tissue (Table 3Table 3), which indicated a robust, active, and ongoing host response to polypropylene long after implantation
  • Comparison of the ratio of the M2 proremodeling cytokines (IL-10+IL-4) with the M1 proinflammatory cytokines (TNF-α+IL-12p70) revealed a decrease in mesh explants as compared with controls (P = .003), which indicated a shift towards a proinflammatory profile.
  • Mesh explants contained a higher number of total cells/×200 field when compared with controls (682.46 ± 142.61 cells vs 441.63 ± 126.13 cells; P < .001) and a lower ratio of M2:M1 macrophages (0.260 ± 0.161 cells vs 1.772 ± 1.919; P = .001), which supported an ongoing proinflammatory response.
  • the host response was proportional to the amount of material in contact with the host
  • A persistent foreign body response was observed in mesh-tissue complexes that were excised from women who required surgical excision of mesh months to years after mesh implantation
  • The host response was characterized by a predominance of macrophages with an increase in both proinflammatory and proremodeling cytokines/chemokines along with increased tissue degradation, as evidenced by increased MMP-2 and -9
  • Mesh-tissue complexes removed for mesh exposure had increased pro–MMP-9 that indicated a proinflammatory and tissue destruction–type response
  • The presence of macrophages, elevated cytokines, chemokines, and MMPs in tissue-mesh complexes that were excised from patients with exposure or pain suggests that polypropylene mesh elicits an ongoing host inflammatory response
  • In the presence of a permanent foreign body, the implant is surrounded with a fibrotic capsule because it cannot be degraded
  • For hernia meshes, if the fibers are too close (<1 mm), the fibrotic response to neighboring fibers overlaps, or “bridges,” and results in “bridging fibrosis” or encapsulation of the mesh
  • Gynemesh PS has a highly unstable geometry when loaded that resulted in pore collapse and increasing stiffness of the product
  • mesh shrinkage (50-70%) has been described to occur after transvaginal insertion of prolapse meshes
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    Mesh and the abnormal immune response.
Nathan Goodyear

AUGS : AUGS and ACOG Committee Opinion: The Use of Vaginal Mesh for Pelvic Organ Prolap... - 0 views

  • 7% to 20%
  • mesh erosion was the most common complication, occurring in 5–19% of vaginal repairs using mesh
  • overall rate of mesh exposure was 18.8%
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    good review of data on complications of vaginal mesh surgery.  The rate of erosion found to be up to 20% in multiple studies.
Nathan Goodyear

Transvaginal repair of genital prolapse: preliminary results of a new tension-free vagi... - 0 views

  • Mesh exposure occurred in five patients (4.7%)
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    mesh erosion rate of 4.7%.
Nathan Goodyear

Mesh implants: An overview of crucial mesh parameters - 0 views

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    vaginal mesh
Nathan Goodyear

Histological Inflammatory Response to Transvaginal Polypropylene Mesh for Pelvic Recons... - 0 views

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    vaginal mesh elicits chronic foreign body reaction
Nathan Goodyear

Inflammatory Reaction as Determinant of Foreign Body Reaction Is an Early and Susceptib... - 0 views

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    vaginal mesh
Nathan Goodyear

Exploring the basic science of prolapse meshes - 0 views

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    Mesh implantation, here in the vaginal area, increases both M1 and M2 maturation migration. M1 increases pro-inflammatory signaling and processes and M2 promotes remodeling/healing... Both increase, but M1 increases more than M2 proportionally. M2 can increase the bridge scaring that can occur as well as the potential for immune suppression and autoimmune/cancer implications
Nathan Goodyear

Management of Mesh Complications after SUI and POP Repair: Review and Analysis of the C... - 0 views

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    nice review of complications associated with vaginal mesh POP surgery.  The exposure rate was quoted at up to 10% by the review, but one study found the erosion rate to be 18% in slings, a much less complicated surgery compared to POP surgery.
Nathan Goodyear

Fulltext | Transvaginal mesh procedures for prolapse, analyzing its outcome rates and c... - 0 views

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    erosion/extrusion rate of vaginal mesh placement is up to 17.3% in study.
Nathan Goodyear

Prospective clinical assessment of the transvaginal mesh technique for treatment of pel... - 0 views

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    only abstract available here, but vaginal mesh exposure was found in 18.8% in 5 year prospective study of 95 women.
wheelchairindia9

Karma Ergo 115 Wheelchair - 0 views

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    Ergo Wheelchair features an ergonomic "S" shaped seat that provides the perfect shape to fit the human body to relieve pressure, increase stabilization, weight distribution and lower the risk of pressure sores and scoliosis. Ergonomic wheelchair series provides users with a large selection of ultra lightweight wheelchairs that can help improve life. This series has features that include a high strength lightweight frame, foldable and easy to store, breathable anti-bacterial, anti-staining, removable and machine washable cushion. Also includes the exclusive S-Shape Seating System, which provides increased stability, better weight distribution and lowers the risk of pressure sores and spinal injury. Karma S Ergo 115 Wheelchair: This model features our S-Shape Seating System and is our number one best seller for many reasons. At a mere 11.3 kg in weight with detachable foot rest and many features such as removable machine washable and dry-able cushions treated by AEIGIS treated anti-microbial coated seating system. Karma S-Ergo 115 Wheelchair Features: Ergonomic Handrims & S-Shape Ergonomic Seating System Fixed armrest w/ wider concave armpads Swing In & Away Footrests Backrest Pouch attached to the upholstery 24" flat free polyurethane tires, high tread, flat free wheels Seat width: 16"x17" or 18"x17" or 20"x 17" Silver 1/4" Aegis Anti-Bacterial Upholstery, washable Folding backrest / folding seat for easy traveling "Tube-in Center" foot-plate, assures better side leg support High strength, starting weight at only 11.3 kg. (w/o footrests) 7×1" Polyurethane front casters Upholstery: Black breathable mesh bottom & top AEIGIS Frame Color: Pearl Silver or Rose Red Weight Capacity of 115 kg. Karma S-Ergo 115 Wheelchair Measurements: Seat Width 16 inch., 18 inch., 20 inch. Seat Depth 17 inch. Armrest Height 8 inch. Seat Height 19 inch. Back Height 17 inch. Overall Height 36 inch. Overall Open Width 23 inch., 25 inch., 27 inch
Nathan Goodyear

Pathological findings in explanted vaginal mesh - ScienceDirect - 0 views

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    vaginal mesh and chronic inflammation
Nathan Goodyear

http://ec.europa.eu/health/scientific_committees/emerging/docs/surgical_co_harris3.pdf - 0 views

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    vaginal mesh and inflammation
Nathan Goodyear

Mesh complications in female pelvic floor reconstructive surgery and their management: ... - 0 views

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    mesh erosion
Nathan Goodyear

http://www.ics.org/Abstracts/Publish/105/000763.pdf - 0 views

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    vaginal mesh erosion rates found to vary from 0.3% to 23% in 5 year study.
wheelchairindia9

Karma S-Ergo 105 Manual Wheelchair - 0 views

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    Ergonomic chairs are designed to confirm to a person's physical dimensions, allowing them to sit naturally and comfortably for long periods of time, while reducing the risk of pressure ulcers. Ergonomic system (Intelligent s-shaped ergonomic seating) provides efficient pressure relief by spreading weight over a greater area, at the same time provides stabilization and reduced sliding. With their lightweight frames and seats designed to reduce or prevent pressure points, ergonomic wheelchairs provide a comfortable option for mobility impaired users who have the upper body strength to propel themselves, or a caregiver strong enough to do so. Karma Ergo Lite 2501 Wheelchair: The extremely lightweight Ergo Lite 2501 Transport Wheelchair weighs only 8.16 kg. and features an ergonomically-designed seat and backrest, making it one of the most comfortable transport chairs on the market. The folding seat and backrest make the S-Ergo ideal for storage or travel, and the built in AEGIS anti-bacterial cushion provides added comfort and support. Despite its light weight, the S-Ergo features a 115 kg. weight capacity along with large, 14" flat-free polyurethane rear tires. Karma Ergo Lite 2501 Wheelchair Features: Lightest transporter on the market! Patented S-Style Ergonomic Seat Frame 6061 T-6 Aircraft-grade Aluminum Only 18 lb . (w/ footrests) Built in Silver Aegis Anti-bacterial Cushion Fixed Armrests w/Concaved Armpads Pocket Behind Backrest & Small Carry Pouch on Each Armrest 6" x 1" Polyurethane Front Casters 16" x 17" or 18" x 17" Seat Width S-Style Ergonomic Seat 14" Rear Polyurethane, High Tread, Flat Free Wheels 3-Stage handle brake: allows light to firm grip for lock Folding Backrest/ Folding Seat for Transporting in Vehicle or Travel Fixed Footrests w/ Extra Wide Footplates Frame Color: Pearl Silver Weight Capacity of 100 kg Ergonomic Transporter w/ handle brakes Karma Ergo Lite 2501 Wheelchair Measurements: Seat Width 16 inch., 18
Nathan Goodyear

FOREIGN BODY REACTION TO BIOMATERIALS - 0 views

  • We have demonstrated that biomaterial-adherent cells can undergo material-dependent apoptosis both in vitro and in vivo, thus rendering macrophages nonfunctional while the surrounding environment of the implant or biomaterial remains unaffected
  • Adherent inflammatory cell apoptosis has been described as an important mechanism for the persistence of cardiovascular device infection where apoptosis is induced by shear stress in cardiovascular devices.
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    mesh and inflammation
Nathan Goodyear

New considerations in the use of vaginal mesh for prolapse repair. - PubMed - NCBI - 0 views

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    only abstract available here, but vaginal erosion rate found to be 7-20%.
Nathan Goodyear

Indications, Contraindications, and Complications of Mesh in Surgical Treatment of Pelv... - 0 views

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    Maude database has erosions as the highest reported complication.
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