Device life of tracheoesophageal voice prostheses is limited due to deterioration of the polymers. A group of 55 postlaryngectomy patients fitted with a Provox voice prosthesis have been studied prospectively during 6 months. Thirty-seven prostheses were replaced due to a dysfunctional valve mechanism. Although colonization with Candida species was highly associated with destruction of the silicone material, other upper respiratory tract commensals, e.g. Staphylococcus aureus, were also demonstrated. Electron microscopy of the contaminated devices showed colonization and disruption of the silicone material by penetrating yeast hyphae. During the study a remarkable increase of intratracheal phonatory pressures was assessed with progressive colonization of the prostheses.
A double-blind randomized trial was conducted among 36 laryngectomees to assess the influence of a buccal bioadhesive slow-release tablet containing miconazole nitrate on the lifetime of the Provox voice prosthesis. All patients colonized with Candida spp and treated with miconazole showed a significant decrease of colonization at the end of the study. Intratracheal phonatory pressures were remarkably higher after 2 months of follow-up in the placebo group. No local or systemic adverse reactions to miconazole were observed during this study. Patient compliance was acceptable according to regular miconazole determination in saliva samples. The device lifetime was significantly higher in patients treated with miconazole even after 1 year of follow-up. The use of a buccal bioadhesive slow-release tablet containing an antimycotic agent proves to be an adequate method of preventing fungal colonization and deterioration of silicone voice prostheses.
In this paper we present a cross layer topology preserving channel selection protocol for a two interface wireless mesh network. The presented protocol is a cluster driven channel selection protocol, preserving a single interface to maintain connectivity and using the other interface to participate in small clusters. The clusters are organized by an independent set clustering algorithm, in which the cluster head dictates the operating channel for the local cluster. We show that the channel selection algorithm doubles the capacity for both a regular grid and a random topology.
The bioadhesive characteristics of thermally modified starch/polyacrylic acid (PAA) tablets, containing miconazole nitrate, were determined. The detachment force and work of adhesion were significantly affected by the ratio of drum-dried waxy maize starch and PAA. Pure PAA showed the highest detachment force and work of adhesion while the lowest force and work of adhesion were observed for pure starch. There was a pronounced effect of molecular weight of PAA on the bioadhesive characteristics. Miconazole nitrate did not influence bioadhesion up to a concentration of 30%. The influence of additives was negligible and fluctuations of pH did not influence the bioadhesive strength of the tablet.
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