RESUMO
A detailed computational study was performed to investigate the conformational changes of flap region and the mechanism underlying the binding of the inhibitor TMC-126 to HIV-1 protease (PR1) and its mutant variants through molecular dynamics simulations in conjunction with the molecular mechanics Poisson-Boltzmann (MM-PBSA) free energy calculation. Further, we have studied the effectiveness of the inhibitor against HIV-2 protease (PR2). The MM-PBSA calculation suggests that TMC-126 loses its potency against mutant variants and PR2 compared to wild-type PR1 mainly due to the loss in intermolecular electrostatic interactions. The potency of the inhibitor decreases in the order: wild type PR1 > M46L > MDR20 > I50V > PR2 > V32I > A28S. Our study reveals that the flap of PR1 adopts a semi-open conformation due to the mutation I50V or MDR20. The dissimilar nature of the movement of the flap tip of both monomers is evident from the dynamic cross-correlation map. The protein structural network analysis displays that mutation causes structural rearrangements and changes the communication path between residues. Overall, we believe our study may help explore and accelerate the development of novel HIV-1/HIV-2 protease inhibitors with better potency.
Assuntos
Fármacos Anti-HIV/farmacologia , Protease de HIV/metabolismo , Simulação de Dinâmica Molecular , Sulfonamidas/farmacologia , Uretana/análogos & derivados , Uretana/farmacologiaRESUMO
The newly-designed hemostatic sealant, Hydrofit, was developed in Japan and consists of a urethane-based polymer without blood products. By applying Hydrofit gel to an anastomosis site on the aorta, water contact initiates a chemical change in the forming elastomer which adheres rapidly and tightly. We experienced an extirpation of Hydrofit gel that had been applied 4 years and 8 months previously in a 42-year-old female who underwent aortic valve replacement and graft replacement of the ascending aorta. The Hydrofit left around the aortic graft suture line was without infection and functioned very well as an elastic sealant for a long period.
Assuntos
Implante de Prótese Vascular , Implante de Prótese de Valva Cardíaca , Técnicas Hemostáticas , Hemostáticos/uso terapêutico , Uretana/uso terapêutico , Adulto , Anastomose Cirúrgica , Feminino , Géis , Humanos , Fatores de Tempo , Resultado do Tratamento , Uretana/análogos & derivadosRESUMO
There is a great demand for the synthesis of acrylate based thermoset shape memory polymer (SMP) associated with one monomer and one crosslinker such as tert-butyl acrylate (t-BA) with poly (ethylene glycol) dimethacrylate (PEGDMA). The present work describes the synthesis of a new thermoset SMP wherein a second monomer such as diurethane dimethacrylate (DUDMA) has been added to the existing tBA + PEGDMA SMP matrix. The synthesized thermoset shape memory polymer exhibited a glass transition temperature (Tg) of 55 °C, higher Young's Modulus of 3.23 GPa, transmittance of 95% and 100% shape recovery. The SMP exhibited response to both thermal and chemical stimuli. The shape recovery rate of the SMP network is 20 s compared to 24 s observed for SMP based on tBA + PEGDMA. The obtained SMP is very transparent and possesses higher stiffness (8 MPa) and hence may be suitable for biomedical shape memory lens and orthopedic application.
Assuntos
Materiais Inteligentes , Acrilatos , Teste de Materiais , Metacrilatos , Polietilenoglicóis , Uretana/análogos & derivadosRESUMO
Ethyl carbamate (EC) is a carcinogen toxicant, commonly found in fermented foods and beverages. The carcinogenic and toxic possibility of EC is thought to be related to its metabolite vinyl carbamate (VC). However, we found interesting mechanisms underlying VC-induced toxicity in this study, which were greatly different from EC. We first conducted a simple synthesis procedure for VC and found that VC possessed higher toxicity but failed to regulate levels of reactive oxygen species, glutathione, and autophagy. Notably, VC treatment resulted in upregulation of lysosomal pH, which was responsible for its cytotoxicity. Cyclic adenosine monophosphate (cAMP) pretreatment could enhance restoration of lysosomal acidity and ameliorate VC-induced damage. Inhibition of protein kinase A and cystic fibrosis transmembrane conductance regulator can block cAMP-induced cytoprotection. Together, our results provided the evidence for novel mechanisms of toxicity and possible protection method under VC exposure, which might give new perspectives on the study of EC-induced toxicity.
Assuntos
Carcinógenos/toxicidade , Lisossomos/química , Lisossomos/efeitos dos fármacos , Uretana/análogos & derivados , Ácidos/metabolismo , Linhagem Celular , AMP Cíclico/metabolismo , Glutationa/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Lisossomos/metabolismo , Espécies Reativas de Oxigênio/metabolismo , Uretana/toxicidadeRESUMO
[6]-Gingerol from ginger has received considerable attention as a potential cancer therapeutic agent because of its chemopreventive and chemotherapeutic effects, as well as its safety. In the current study, we examined [6]-gingerol as a natural scavenger of nine ultimate chemical carcinogens to which we are frequently exposed: glycidamide, styrene oxide, aflatoxin B1 exo-8,9-epoxide, ß-propiolactone, ethylene oxide, propylene oxide, 2-cyanoethylene oxide, chloroethylene oxide, and vinyl carbamate epoxide. To evaluate [6]-gingerol efficacy, we expanded our research with the examination of glutathione-the strongest natural scavenger in human cells. The corresponding activation free energies were calculated using Hartree-Fock method with three flexible basis sets and two implicit solvation models. According to our results, [6]-gingerol proves to be an extremely effective scavenger of chemical carcinogens of the epoxy type. On the other hand, with the exception of aflatoxin B1 exo-8,9-epoxide, glutathione represents a relatively poor scavenger, whose efficacy could be augmented by [6]-gingerol. Moreover, our quantum mechanical study of the alkylation reactions of chemical carcinogens with [6]-gingerol and glutathione provide valuable insights in the reaction mechanisms and the geometries of the corresponding transition states. Therefore, we strongly believe that our research forms a solid basis for further computational, experimental and clinical studies of anticarcinogenic properties of [6]-gingerol as well as for the development of novel chemoprophylactic dietary supplements. Finally, the obtained results also point to the applicability of quantum chemical methods to studies of alkylation reactions related to chemical carcinogenesis.
Assuntos
Anticarcinógenos/química , Anticarcinógenos/farmacologia , Carcinógenos/química , Carcinógenos/farmacologia , Catecóis/química , Catecóis/farmacologia , Álcoois Graxos/química , Álcoois Graxos/farmacologia , Aflatoxina B1 , Alquilação , Linhagem Celular , Quimioprevenção , Compostos de Epóxi/farmacologia , Óxido de Etileno/análogos & derivados , Zingiber officinale/química , Humanos , Propiolactona , Uretana/análogos & derivadosRESUMO
In this article, a series of medical poly(ester-urethane)s (PEUs) with varying uniform-size hard segment content were prepared via one-step chain extension of poly(ε-caprolactone)s with aliphatic urethane diisocyanate, and the corresponding films were obtained by solvent evaporation technique. The chemical structures of polymers were confirmed by 1H NMR, FT-IR and GPC. The effect of uniform-size hard segment content on the physicochemical properties of PEU films, including thermal properties, mechanical properties, crystallization behavior, water-swelling behavior and in vitro degradability, was extensively researched. The PEU films exhibiting similar thermal transition and thermal stability indicated that the uniform-size hard segment content had little effect on the thermal properties. Two obvious glass transition temperatures observed in DSC curves manifested a microphase separation structure, which endowed the PEU films excellent mechanical properties with ultimate stress of 34.6-51.2 MPa and strain at break of 898-1485%. And with the increase of uniform-size hard segment content, the initial modulus and ultimate stress increased, while the strain at break decreased. Due to the compact physical-linking network structure formed by the denser hydrogen bonds, the PEU films exhibited low water-swellability of less than 1.5 wt% and low degradation rate in vitro. The weight loss of the PEU films in degradation test was less than 1 wt% at the first four months and the time of films becoming fragments was more than 15 months. Cytotoxicity test of film extracts was conducted with L929 mouse fibroblasts, and the relative growth rate approached or exceeded 75%, indicating an acceptable cytocompatibility. For the excellent mechanical properties, slow biodegradability, non-toxic degradation products and adequate cytocompatibility, the PEUs containing uniform-size hard segments possess a high potential to be applied as long-term implant biomaterials.
Assuntos
Materiais Biocompatíveis/química , Materiais Biocompatíveis/síntese química , Metacrilatos/química , Poliésteres/química , Poliuretanos/química , Uretana/análogos & derivados , Espectroscopia de Ressonância Magnética , Teste de Materiais , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície , Uretana/químicaRESUMO
Natural biopolymers have many attractive medical applications; however, complications due to fibrosis caused a reduction in diffusion and dispersal of nutrients and waste products. Consequently, severe immunocompatibility problems and poor mechanical and degradation properties in synthetic polymers ensue. Hence, the present study investigates a novel hydrogel material synthesized from caprolactone, ethylene glycol, ethylenediamine, polyethylene glycol, ammonium persulfate, and tetramethylethylenediamine via chemo-enzymatic route. Spectroscopic analyses indicated the formation of polyurea and polyhydroxyurethane as the primary building block of the hydrogel starting material. Biocompatibility studies showed positive observation in biosafety test using direct contact cytotoxicity assay in addition to active cellular growth on the hydrogel scaffold based on fluorescence observation. The synthesized hydrogel also exhibited (self)fluorescence properties under specific wavelength excitation. Hence, synthesized hydrogel could be a potential candidate for medical imaging as well as tissue engineering applications as a tissue expander, coating material, biosensor, and drug delivery system.
Assuntos
Materiais Biocompatíveis/química , Hidrogéis/química , Células-Tronco Mesenquimais/citologia , Polímeros/química , Uretana/análogos & derivados , Animais , Materiais Biocompatíveis/síntese química , Células Cultivadas , Hidrogéis/síntese química , Teste de Materiais , Polímeros/síntese química , Coelhos , Engenharia Tecidual , Alicerces Teciduais/química , Uretana/síntese química , Uretana/químicaRESUMO
Commercially available dental adhesives fail to chemically unite the demineralized collagen matrix with resinous materials within the resin-dentin interface. Sub-micron separations between the collagen fibrils and polymerized resin provide the backdrop for bond deterioration. Here, novel isocyanate-terminated urethane methacrylate precursors (UMP) were synthesized with the capacity to bond chemically to dentin collagen via covalent and hydrogen bonds. Collagen grafted with UMP also copolymerized with other methacrylate resin monomers, thereby producing a monoblock of chemically-linked biocomposite. The viscosity, degree of conversion and biocompatibility of UMP are comparable with commercially available resin monomers. An experimental adhesive containing 40% UMP demonstrated co-polymerization capability, good infiltration capacity and achieved higher immediate bond strength to dentin than the control commercially available adhesive. Improvement of dentin bonding by incorporation of UMP into dentin adhesives justifies future evaluation of the potential of these UMP-based adhesives in extending the longevity of resin-dentin bonds. STATEMENT OF SIGNIFICANCE: Composite-adhesive restorations have become an indispensable treatment modality in contemporary restorative dentistry. While the inability of these adhesives to bond chemically with collagen undermines the bond quality. This study describes a novel isocyanate-terminated urethane multi methacrylate precursors (UMP) which can bridge dentinal matrix collagen with adhesive resin by covalent and hydrogen bonds. Furthermore, an experimental UMP-based adhesive shows better co-polymerization capability, good infiltration capacity and higher immediate bond strength than the putatively effective adhesive Single Bond 2. The new chemical bonding mechanism based on UMP would theoretically produce more stable bonding interface that are more resistant to degradation.
Assuntos
Colágeno/química , Polpa Dentária/metabolismo , Adesivos Dentinários , Dentina/química , Células-Tronco/metabolismo , Uretana , Polpa Dentária/citologia , Adesivos Dentinários/química , Adesivos Dentinários/farmacologia , Humanos , Teste de Materiais , Células-Tronco/citologia , Uretana/análogos & derivados , Uretana/química , Uretana/farmacologiaRESUMO
A number of naturally occurring compounds such as paclitaxel, vinblastine, combretastatin, and colchicine exert their therapeutic effect by changing the dynamics of tubulin and its polymer form, microtubules. The identification of tubulin as a potential target for anticancer drugs has led to extensive research followed by clinical development of numerous compounds from several families. In this paper we report on the design, synthesis and in vitro evaluation of a group of thiocolchicine derivatives, modified at ring-B, labelled here compounds 4-14. These compounds have been obtained in a simple reaction of 7-deacetyl-10-thiocolchicine 3 with eleven different alcohols in the presence of triphosgene. These novel agents have been checked for anti-proliferative activity against four human cancer cell lines and their mode of action has been confirmed as colchicine binding site inhibition (CBSI) using molecular docking. Molecular simulations provided rational tubulin binding models for the tested compounds. On the basis of in vitro tests, derivatives 4-8 and 14 demonstrated the highest potency against MCF-7, LoVo and A549 tumor cell lines (IC50 valuesâ¯=â¯0.009-0.014⯵M). They were more potent and characterized by a higher selectivity index than several standard chemotherapeutics including cisplatin and doxorubicin as well as unmodified colchicine. Further, studies revealed that colchicine and its several derivatives arrested MCF-7 cells in mitosis, while its selected derivatives caused microtubule depolymerization.
Assuntos
Antineoplásicos/química , Antineoplásicos/farmacologia , Proliferação de Células/efeitos dos fármacos , Colchicina/análogos & derivados , Uretana/análogos & derivados , Uretana/farmacologia , Antineoplásicos/síntese química , Linhagem Celular Tumoral , Colchicina/síntese química , Colchicina/química , Colchicina/farmacologia , Desenho de Fármacos , Ensaios de Seleção de Medicamentos Antitumorais , Humanos , Mitose/efeitos dos fármacos , Modelos Moleculares , Simulação de Acoplamento Molecular , Neoplasias/tratamento farmacológico , Neoplasias/metabolismo , Tubulina (Proteína)/metabolismo , Moduladores de Tubulina/síntese química , Moduladores de Tubulina/química , Moduladores de Tubulina/farmacologia , Uretana/síntese químicaRESUMO
Despite great potential, the delivery of genetic materials into cells or tissues of interest remains challenging owing to their susceptibility to nuclease degradation, lack of permeability to the cell membrane, and short in vivo half-life, which severely restrict their widespread use in therapeutics. To surmount these shortcomings, we developed a bioinspired in situ-forming pH- and temperature-sensitive injectable hydrogel depot that could control the delivery of DNA-bearing polyplexes for versatile biomedical applications. A series of multiblock copolymer, comprised of water-soluble poly(ethylene glycol) (PEG) and pH- and temperature-responsive poly(sulfamethazine ester urethane) (PSMEU), has been synthesized as in situ-forming injectable hydrogelators. The free-flowing PEG-PSMEU copolymer sols at high pH and room temperature (pH 8.5, 23 °C) were transformed to stable gel at the body condition (pH 7.4, 37 °C). Physical and mechanical properties of hydrogels, including their degradation rate and viscosity, are elegantly controlled by varying the composition of urethane ester units. Subcutaneous administration of free-flowing PEG-PSMEU copolymer sols to the dorsal region of Sprague-Dawley rats instantly formed hydrogel depot. The degradation of the hydrogel depot was slow at the beginning and found to be bioresorbable after two months. Cationic protein or DNA-bearing polyplex-loaded PEG-PSMEU copolymer sols formed stable gel and controlled its release over 10 days in vivo. Owing to the presence of urethane linkages, the PEG-PSMEU possesses excellent adhesion strength to wide range of surfaces including glass, plastic, and fresh organs. More importantly, the hydrogels effectively adhered on human skin and peeled easily without eliciting an inflammatory response. Subcutaneous implantation of PEG-PSMEU copolymer sols effectively sealed the ruptured skin, which accelerated the wound healing process as observed by the skin appendage morphogenesis. The bioinspired in situ-forming pH- and temperature-sensitive injectable adhesive hydrogel may provide a promising platform for myriad biomedical applications as controlled delivery vehicle, adhesive, and tissue regeneration.
Assuntos
Adesivos/química , Técnicas de Transferência de Genes , Hidrogéis/química , Cicatrização/efeitos dos fármacos , Adesivos/administração & dosagem , Adesivos/farmacologia , Administração Cutânea , Animais , DNA/administração & dosagem , Feminino , Células HEK293 , Humanos , Hidrogéis/administração & dosagem , Hidrogéis/farmacologia , Concentração de Íons de Hidrogênio , Interações Hidrofóbicas e Hidrofílicas , Injeções , Camundongos , Camundongos Endogâmicos BALB C , Polietilenoglicóis/química , Células RAW 264.7 , Ratos , Ratos Sprague-Dawley , Sulfametazina/análogos & derivados , Temperatura , Uretana/análogos & derivadosRESUMO
UV-curable gels, which polymerise into long-lasting films upon exposure to UVA, have been identified as potential topical drug carriers for the treatment of nail diseases. Limitations of such films include incomplete drug release and low ungual drug permeation. The aim of the work herein was therefore to investigate two strategies, namely: (1) increasing drug release from the film, and (2) increasing nailplate permeability, with the ultimate goal of enhancing ungual drug permeation. To increase drug release via Strategy 1, a UV-LED lamp (whose emitted light was suboptimal for gel polymerisation) was used, and it was hypothesised that such a lamp would result in films that are less polymerised/cross-linked and where the drugs are less 'trapped'. Indeed, the suboptimal lamp influenced polymerisation, such that the films were thinner, had lower glass transition temperatures and enabled a slightly greater (by 15%) drug release of one of the two drugs tested. However, the greater drug release had only a modest impact on ungual drug permeation. To evaluate Strategy 2, i.e. increase nailplate permeability, chemical ungual enhancers, 2-mercaptoethanol (ME), 2-methyl pyrrolidone (NMP), PEG 200 and water were incorporated within the UV-cured films. These chemicals caused increased ungual drug permeation, with ME showing the greatest (by 140%), and water showing the least (by 20%) increase in the amount of drug permeated by day 30. Surprisingly, these chemicals also caused increased drug release from the films, with ME once again having the greatest effect (by 51%) and water the least effect (by 12%). It seems that these chemicals were increasing ungual drug permeation via their influence on drug release (i.e. via their impact on the film) as well as via their influence on the nail itself. We conclude that, of the two strategies tested, the second strategy proved to be more successful at enhancing ungual drug permeation.
Assuntos
Portadores de Fármacos , Mercaptoetanol/farmacologia , Morfolinas/administração & dosagem , Unhas/efeitos dos fármacos , Polímeros/efeitos da radiação , Terbinafina/administração & dosagem , Raios Ultravioleta , Absorção Fisiológica/efeitos dos fármacos , Administração Tópica , Adolescente , Adulto , Idoso , Composição de Medicamentos , Liberação Controlada de Fármacos , Humanos , Cinética , Mercaptoetanol/química , Metacrilatos/química , Metacrilatos/efeitos da radiação , Pessoa de Meia-Idade , Morfolinas/química , Morfolinas/metabolismo , Unhas/metabolismo , Permeabilidade , Polietilenoglicóis/química , Polietilenoglicóis/farmacologia , Polimerização , Polímeros/química , Pirrolidinas/química , Pirrolidinas/farmacologia , Solubilidade , Tecnologia Farmacêutica/métodos , Terbinafina/química , Terbinafina/metabolismo , Uretana/análogos & derivados , Uretana/química , Uretana/efeitos da radiação , Água/química , Água/farmacologia , Adulto JovemRESUMO
INTRODUCTION: Contract research organization (CRO) support is largely included in clinical trial management, although its effect in terms of time savings and benefit has not yet been quantified. We performed a retrospective multicenter analysis of lung cancer trials to explore differences in term of trial activation timelines and accrual for studies with and without CRO involvement. MATERIALS AND METHODS: Results regarding study timelines from feasibility data to first patient enrollment were collected from 7 Italian thoracic oncology departments. The final accruals (screened/enrolled patients) are reported. We considered CRO/sponsor-administered and CRO-free trials according to who was responsible for the management of the crucial setup phases. RESULTS: Of 113 trials, 62 (54.9%) were CRO-administered, 34 (30.1%) were sponsor-administered, and 17 (15.0%) were CRO-free. The median time from feasibility invitation to documentation obtainment was 151 days in the CRO-administered trials versus 128 in the sponsor-administered and 120 in the CRO-free trials. The time from document submission to contract signature was 142 days in the CRO-administered versus 128 in the sponsor-administered and 132 in the CRO-free trials. The time from global accrual opening to first patient enrollment was 247 days for the CRO-administered versus 194 in the sponsor-administered and 151 in the CRO-free trials. No significant differences were observed in terms of the median overall timeline: 21 months in the CRO-administered, 15 in the sponsor-administered, and 18 months in the CRO-free studies (P = .29). CONCLUSION: Although no statistically significant differences were identified, the results of our analysis support the idea that bureaucratic procedures might require more time in CRO-administered trials than in sponsor-administered and CRO-free studies. This bureaucratic delay could negatively affect Italian patients' screening and enrollment compared with other countries.
Assuntos
Academias e Institutos/organização & administração , Serviços Contratados , Neoplasias Pulmonares/epidemiologia , Oncologia/organização & administração , Fluoreto de Sódio , Uretana/análogos & derivados , Academias e Institutos/economia , Ensaios Clínicos como Assunto , Administração Financeira , Humanos , Itália/epidemiologia , Oncologia/economia , Apoio à Pesquisa como Assunto , Estudos RetrospectivosRESUMO
Targeting the transcription factor NRF2 has been recognized as a feasible strategy for cancer prevention and treatment, but many of the mechanistic details underlying its role in cancer development and progression are lacking. Therefore, careful mechanistic studies of the NRF2 pathway in cancer initiation and progression are needed to identify which therapeutic avenue-activation or inhibition-is appropriate in a given context. Moreover, while numerous reports confirm the protective effect of NRF2 activation against chemical carcinogenesis little is known of its role in cancer arising from spontaneous mutations. Here, we tested the effects of NRF2 modulation (activation by sulforaphane or inhibition by brusatol) in lung carcinogenesis using a chemical (vinyl carbamate) model in A/J mice and a genetic (conditional KrasG12D oncogene expression, to simulate spontaneous oncogene mutation) model in C57BL/6J mice. Mice were treated with NRF2 modulators before carcinogen exposure or KrasG12D expression to test the role of NRF2 in cancer initiation, or treated after tumor development to test the role of NRF2 in cancer progression. Lung tissues were analyzed to determine tumor burden, as well as status of NRF2 and KRAS pathways. Additionally, proliferation, apoptosis, and oxidative DNA damage were assessed. Overall, NRF2 activation prevents initiation of chemically induced cancer, but promotes progression of pre-existing tumors regardless of chemical or genetic etiology. Once tumors are initiated, NRF2 inhibition is effective against the progression of chemically and spontaneously induced tumors. These results have important implications for NRF2-targeted cancer prevention and intervention strategies.
Assuntos
Neoplasias Pulmonares/genética , Fator 2 Relacionado a NF-E2/genética , Animais , Anticarcinógenos/farmacologia , Apoptose/efeitos dos fármacos , Apoptose/genética , Carcinogênese/efeitos dos fármacos , Carcinogênese/genética , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/genética , Dano ao DNA/efeitos dos fármacos , Dano ao DNA/genética , Progressão da Doença , Isotiocianatos/farmacologia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Estresse Oxidativo/efeitos dos fármacos , Estresse Oxidativo/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Quassinas/farmacologia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Sulfóxidos , Carga Tumoral/efeitos dos fármacos , Carga Tumoral/genética , Uretana/análogos & derivados , Uretana/farmacologiaRESUMO
A fast and facile synthesis of a series of 4-nitrophenyl 2-azidoethylcarbamate derivatives as activated urea building blocks was developed. The N-Fmoc-protected 2-aminoethyl mesylates derived from various commercially available N-Fmoc-protected α-amino acids, including those having functionalized side chains with acid-labile protective groups, were directly transformed into 4-nitrophenyl 2-azidoethylcarbamate derivatives in 1 h via a one-pot two-step reaction. These urea building blocks were utilized for the preparation of a series of urea moiety-containing mitoxantrone-amino acid conjugates in 75-92% yields and parallel solution-phase synthesis of a urea compound library consisted of 30 members in 38-70% total yields.
Assuntos
Aminoácidos/química , Fluorenos/química , Nitrofenóis/química , Bibliotecas de Moléculas Pequenas/química , Ureia/análogos & derivados , Uretana/análogos & derivados , Aminoácidos/síntese química , Azidas/síntese química , Azidas/química , Técnicas de Química Combinatória/economia , Técnicas de Química Combinatória/métodos , Fluorenos/síntese química , Micro-Ondas , Nitrofenóis/síntese química , Bibliotecas de Moléculas Pequenas/síntese química , Ureia/síntese química , Uretana/síntese químicaRESUMO
Infections continue to be one of the leading causes of morbidity and mortality in liver transplant recipients. We retrospectively reviewed the symptomatic infectious episodes that occurred during the first year post-transplant to determine time of onset, causative pathogens and cell-mediated immunity response patterns. Ninety-eight of the 202 (48.5%) recipients enrolled developed at least one infectious episode. The total number of infectious episodes was 135: 77 (57.1%) bacterial, 45 (33.3%) viral and 13 (9.6%) fungal. The most frequently isolated bacteria were Escherichia coli (21 isolates) and Klebsiella pneumoniae (19 isolates). Overall, extended-spectrum beta lactamase-producing and methicillin-resistant organisms were responsible for 29 (29/77; 37.7%) infectious episodes. Members of the herpes virus group, in particular cytomegalovirus (34/45 viral infections, 75.5%), were detected. Candida species (9 isolates) followed by Aspergillus species (4 isolates) were isolated. The majority of infections (63%) occurred during the early post-transplant phase (<1 month), whereas only 8/135 episodes (5.9%) were detected after the sixth month (late phase). Significantly lower median ImmuKnow® intracellular ATP values in patients who developed bacterial and fungal infections compared to infection-free patients were observed (P < 0.0001 and P = 0.0016, respectively), whereas patients who developed a viral infection had a median intracellular ATP level not statistically different compared to uninfected patients (P = 0.4). Our findings confirm that bacteria are responsible for the majority of symptomatic infections and occur more frequently during the first month post-transplant. The ImmuKnow® measurements can be a useful tool for identifying patients at high risk of developing infection, particularly of fungal and bacterial etiology.
Assuntos
Doenças Transmissíveis/epidemiologia , Doenças Transmissíveis/etiologia , Suscetibilidade a Doenças , Imunidade Celular , Transplante de Fígado , Complicações Pós-Operatórias/epidemiologia , Trifosfato de Adenosina/análise , Adulto , Idoso , Idoso de 80 Anos ou mais , Bactérias/classificação , Bactérias/isolamento & purificação , Doenças Transmissíveis/patologia , Citosol/química , Feminino , Fungos/classificação , Fungos/isolamento & purificação , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fluoreto de Sódio , Transplantados , Uretana/análogos & derivados , Vírus/classificação , Vírus/isolamento & purificação , Adulto JovemRESUMO
Infections are the leading cause of morbidity and mortality in liver transplant (LT) recipients. We studied timeline, spectrum of infection, system involved, and antimicrobial resistance in 64 patients undergoing live donor LT with 6-month follow-up. Of 64 patients, 38 (59.5%) patients had 103 infectious episodes, 10 patients had single infectious episode and 28 patients had two or more infectious episodes. 96 (93.2%) were bacterial and Candida infections were in 7 (6.8%). Early phase had 30 (29.1%) episodes; intermediate phase 25 (24.2%) and late phase 48 (46.6%). Mortality was 11/64 (17.1%). Knowledge of timeline, aetiological agent and antimicrobial resistance is useful to guide empirical therapy and infection prevention.
Assuntos
Infecções Bacterianas/epidemiologia , Infecções Bacterianas/microbiologia , Candidíase/epidemiologia , Candidíase/microbiologia , Resistência Microbiana a Medicamentos , Transplante de Fígado , Transplantados , Infecções Bacterianas/mortalidade , Candidíase/mortalidade , Feminino , Seguimentos , Humanos , Masculino , Complicações Pós-Operatórias , Prevalência , Estudos Prospectivos , Fluoreto de Sódio , Análise de Sobrevida , Uretana/análogos & derivadosRESUMO
BACKGROUND: Infections are an important cause of morbidity and mortality after burn injuries. Here, we describe the time line of infections and pathogens after burns. METHODS: A retrospective study was performed in a large tertiary care burn center from 2004-2013. Analyses were performed on health care-associated infections (HAIs) meeting Centers for Disease Control and Prevention criteria and on all positive cultures. Incidence rates per 1,000 days were calculated for specific HAI categories and pathogens and across hospitalization time (week 1, weeks 2-3, and week ≥4). RESULTS: Among 5,524 patients, the median burn size was 4% of total body surface area (interquartile range, 2%-10%). Of the patients, 7% developed an HAI, of whom 33% had >1 HAI episode. Gram-positive bacteria were isolated earlier, and gram-negative bacteria were isolated later during hospitalization. Of 1,788 bacterial isolates, 44% met criteria for multidrug resistance, and 23% met criteria for extensive drug resistance. Bacteria tended to become increasingly resistant to antibiotics as time from admission increased. CONCLUSIONS: We observed differences in infection type, pathogen, and antibiotic-resistant bacterium risk across time of hospitalization. These results may guide infection prevention in various stages of the postburn admission.
Assuntos
Bactérias/classificação , Bactérias/isolamento & purificação , Infecções Bacterianas/microbiologia , Infecções Bacterianas/patologia , Queimaduras/complicações , Infecção Hospitalar/microbiologia , Infecção Hospitalar/patologia , Adulto , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Medição de Risco , Fluoreto de Sódio , Centros de Atenção Terciária , Uretana/análogos & derivadosRESUMO
Photocurable emulsion inks for use with solid freeform fabrication (SFF) to generate constructs with hierarchical porosity are presented. A high internal phase emulsion (HIPE) templating technique was utilized to prepare water-in-oil emulsions from a hydrophobic photopolymer, surfactant, and water. These HIPEs displayed strong shear thinning behavior that permitted layer-by-layer deposition into complex shapes and adequately high viscosity at low shear for shape retention after extrusion. Each layer was actively polymerized with an ultraviolet cure-on-dispense (CoD) technique and compositions with sufficient viscosity were able to produce tall, complex scaffolds with an internal lattice structure and microscale porosity. Evaluation of the rheological and cure properties indicated that the viscosity and cure rate both played an important role in print fidelity. These 3D printed polyHIPE constructs benefit from the tunable pore structure of emulsion templated material and the designed architecture of 3D printing. As such, these emulsion inks can be used to create ultra high porosity constructs with complex geometries and internal lattice structures not possible with traditional manufacturing techniques.
Assuntos
Tinta , Metacrilatos/química , Polímeros/química , Impressão Tridimensional/instrumentação , Estirenos/química , Uretana/análogos & derivados , Emulsões , Interações Hidrofóbicas e Hidrofílicas , Processos Fotoquímicos , Polimerização , Porosidade , Propriedades de Superfície , Raios Ultravioleta , Uretana/química , ViscosidadeRESUMO
In order to induce esophageal muscle cells' orientation, the silicon wafer with prototype 1 and prototype 2 was designed. Prototype 1 has micro-channels of 200 µm width and 30 µm depth with 30 µm wide wall as the interval. Prototype 2 has channels of 100 µm width and 30 µm depth with a discontinuous wall which has 30 µm gap for each 100 µm channel. The poly(ester urethane) scaffolds with pattern prototype 1 and prototype 2 were fabricated using solution casting method and abbreviated as PU1 and PU2, respectively. Silk fibroin was grafted individually on PU1 and PU2 surface (PU1-SF, PU2-SF) using our previous protocol, aiming at improving scaffolds' biocompatibility. The primary esophageal smooth muscle cell was seeded to evaluate the scaffolds' cytocompatibility in vitro. Characterizations like MTT assay, immunocytochemistry, scanning electron microscope, and Western blotting were applied. After that, poly(ester urethane) scaffolds with double patterns, prototype 1 on the exterior, and prototype 2 in the lumen were implanted into the rabbit esophagous to test the regeneration of the muscle tissue. Results from these preliminary tests showed that the growth and differentiation of primary smooth muscle cells were promoted, but also the muscle tissue with endocircular and exolongitudinal architecture was in regenerating, against non-constitution in the animals without the patterned scaffold or with poly(ester urethane) plane membrane at the defaulted sites. This micro-channel pattern together with silk fibroin grafting and vascular endothelial growth factor coating greatly promoted the regeneration of esophageal muscle with normal histological structure.
Assuntos
Esôfago/fisiologia , Fibroínas/química , Músculo Liso/fisiologia , Miócitos de Músculo Liso/citologia , Miócitos de Músculo Liso/transplante , Regeneração , Alicerces Teciduais/química , Animais , Materiais Biocompatíveis/química , Proliferação de Células , Sobrevivência Celular , Células Cultivadas , Esôfago/cirurgia , Poliésteres/química , Coelhos , Uretana/análogos & derivadosRESUMO
The article shows the role off Jeremic Alexander in the discovery and development of the first methods of intravenous anesthesia in the world.