Tracheal compression by brachiocephalic arterial trunk: a rare cause of failed endotracheal intubation.

Encountering and managing an unanticipated difficult airway are among the many challenges faced by anaesthesiologists. Due to the intimate anatomical relationship between the thoracic vasculature and the trachea, an anatomical variation could potentially lead to airway compression. This clinical case report documents a failed intubation in an adult patient caused by undiagnosed extrinsic tracheal compression from the brachiocephalic arterial trunk, a rare condition. After a thorough investigation and diagnostic clarification, a safe anaesthetic plan following the predictable difficult airway guidelines was established to enable surgery. Anaesthesiologists should consider rare vascular causes as potential contributors to difficult airway scenarios, thereby enhancing their expertise.

The Sustainable Bioactive Dyeing of Textiles: A Novel Strategy Using Bacterial Pigments, Natural Antibacterial Ingredients, and Deep Eutectic Solvents.

The textile industry stands as a prominent contributor to global environmental pollution, primarily attributable to its extensive reliance on synthetic dyes, hazardous components, and solvents throughout the textile dyeing and treatment processes. Consequently, the pursuit of sustainable textile solutions becomes imperative, aimed at replacing these environmentally unfriendly constituents with biobased and bioactive pigments, antibacterial agents, and, notably, natural solvents. Achieving this goal is a formidable yet indispensable challenge. In this study, the dyeing ability of the crude gel prodigiosin, produced by non-pathogenic bacteria Serratia plymuthica, was investigated on various multifiber fabrics at different conditions (temperature and pH) and by using salts and alternative mordants (the conventional Ferrous Sulphate (FeSO4) and a new bio-mordant, L-Cysteine (L-Cys)). Additionally, a novel gel-based Choline chloride (ChCl)/Lactic acid (LA) (1:2) deep eutectic solvent (DES) dyeing medium was studied to replace the organic solvents. Nylon fabrics dyed with 3.0% over the weight of the fiber (owf) L-Cys at pH = 8.3 had improved color fastness to washing, while the gel-based ChCl/LA (1:2) DES dyebath provided a better color fastness to light. Moreover, nylon fabrics under these conditions exhibited remarkable antimicrobial activity against Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa). In conclusion, the utilization of the crude gel-based prodigiosin pigment demonstrates a distinct advantage in dyeing textile materials, aligning with the growing consumer demand for more eco-friendly and sustainable products. Additionally, the application of the natural reducing agent L-Cys, previously untested as a bio-mordant, in conjunction with the use of gel-based DES as a dyeing medium, has showcased improved colorimetric and antibacterial properties when applied to nylon that is dyed with the crude gel prodigiosin pigment.

Upcycling Wool Waste into Keratin Gel-Based Nanofibers Using Deep Eutectic Solvents.

Millions of tons of wool waste are produced yearly by textile industries, which may become a serious environmental hazard in the near future. Given this concern, it is crucial to explore strategies to reduce the amount of wool waste generated worldwide and adopt more sustainable practices for dissolving and regenerating wool keratin (WK) from textile waste. Most traditional methods involve the use of expensive, toxic, harmful, and poorly biodegradable compounds. To overcome these limitations and facilitate the reuse of wool waste through a cascade valorization strategy, researchers have started testing the use of deep eutectic solvents (DES) as a more sustainable and eco-friendly alternative for WK dissolution and regeneration. In this study, the potential of two different DES mixtures, Choline chloride (ChCl): Urea and L-Cysteine (L-Cys): Lactic acid (LA), was explored for dissolving wool waste. Subsequently, the gels obtained based on DES-WK were blended with polyvinyl alcohol (PVA) in different ratios to produce nanofibers using the electrospinning technique. The PVA/L-Cys: LA DES-WK proved to be the most effective DES mixture for fabricating WK gel-based nanofibers. Furthermore, their antioxidant and antimicrobial abilities were evaluated, thus confirming their bioactivity. The results obtained revealed that this approach to valorizing textile waste offers a unique avenue for the development of sustainable functional materials with potential applications in various biomedical and industrial fields.

Electrospun wound dressings with antibacterial function: a critical review of plant extract and essential oil incorporation.

Among the many different types of wound dressings, nanofiber-based materials produced through electrospinning are claimed to be ideal because of their advantageous intrinsic properties and the feasibility of employing several strategies to load bioactive compounds into their structure. Bioactive compounds with antimicrobial properties have been incorporated into different wound dressings to promote healing as well as prevent and treat bacterial infections. Among these, natural products, such as medicinal plant extracts and essential oils (EOs), have proven particularly attractive thanks to their nontoxic nature, minor side effects, desirable bioactive properties, and favorable effects on the healing process. To this end, the present review provides an exhaustive and up-to-date revision of the most prominent medicinal plant extracts and EOs with antimicrobial properties that have been incorporated into nanofiber-based wound dressings. The most common methods used for incorporating bioactive compounds into electrospun nanofibers include: pre-electrospinning (blend, encapsulation, coaxial, and emulsion electrospinning), post-electrospinning (physical adsorption, chemical immobilization, and layer-by-layer assembly), and nanoparticle loading. Furthermore, a general overview of the benefits of EOs and medicinal plant extracts is presented, describing their intrinsic properties and biotechniques for their incorporation into wound dressings. Finally, the current challenges and safety issues that need to be adequately clarified and addressed are discussed.

Food Wastes and Microalgae as Sources of Bioactive Compounds and Pigments in a Modern Biorefinery: A Review.

The United Nations 2030 Agenda for Sustainable Development has created more pressure on countries and society at large for the development of alternative solutions for synthetic and fossil fuel derived products, thus mitigating climate change and environmental hazards. Food wastes and microalgae have been studied for decades as potential sources of several compounds that could be employed in various fields of application from pharmaceutical to textile and packaging. Although multiple research efforts have been put towards extracting rich compounds (i.e., phenolic compounds, tocopherols, and tocotrienols) from these sources, they still remain overlooked as two major sources of bioactive compounds and pigments, mainly due to inefficient extraction processes. Hence, there is a growing need for the development of optimized extraction methods while employing non-organic solvent options following the main principles of green chemistry. This review will focus on delivering a clear and deep analysis on the existing procedures for obtaining bioactive compounds and pigments from food wastes derived from the most consumed and produced fruit crops in the world such as apples, oranges, cherries, almonds, and mangoes, and microalgal biomass, while giving light to the existing drawbacks in need to be solved in order to take full advantage of the rich properties present in these two major biorefinery sources.

Ultrasound-assisted extraction of bioactive pigments from Spirulina platensis in natural deep eutectic solvents.

Spirulina platensis biopigments have been documented as a potential source of nutritional, physiological, and pharmacological purposes due to the presence of bioactive pigments, total phenolic content (TPC) and the consequent antioxidant activity that these compounds present. Bioextracts market has increased in the last decades and is a key option for replacing fossil-derived products and promote the transition for a bio-based economy. To take advantage of these compounds more effectively, optimized extraction processes must be researched and used in biomass sources. The present study focused on optimizing the ultrasound-assisted extraction (UAE) using response surface methodology. Three factor and three level Box-Behnken design was used to optimize the extraction of bioactive pigments, and to investigate the effects of three independent variables, x 1: extraction temperature (40-60 °C), x 2: extraction cycle time (20-40 min), and x 3: solvent-to-biomass ratio (50-70 mL/mg) on total pigment yield, antioxidant assay, and TPC (dependent variables). A second-order polynomial model was used for predicting the responses. Statistically, the model was validated using an analysis of variance. Results revealed that ultrasound-assisted temperature, time, and solvent-to-biomass ratio had a significant (p < 0.05) influence on the total pigment yield, while temperature and solvent-to-biomass ratio had a significant influence in the antioxidant activity, and temperature significantly influenced the total pigment yield. For total pigment yield, antioxidant activity, and total phenol content, the R 2 values of the models generated were 0.8627, 0.8460, and 0.9003, respectively, indicating that the models developed based on second-order polynomials were satisfactorily accurate for analyzing interactions between parameters. Desirability functions showed that the optimal extraction parameters were temperature: 60 °C, extraction cycle time: 20 min; and a solvent-to-biomass ratio of 70 mL/mg. Under optimal conditions, experimental values for total pigment yield, total phenol content expressed as gallic acid equivalent (GAE), and antioxidant activity expressed as Trolox equivalent (TRE) were: 165.19 ± 1.01 mg/g Dry Matter (DM), 36.50 ± 0.98 mg GAE/g DM, and 37.98 ± 0.58 mg TRE/g DM, respectively. The experimental values showed a good agreement with the predicted values with residual standard low 1% under optimum conditions. This optimized ultrasound-assisted method in natural eutectic solvents is effective and scalable to a green extraction of the bioactive pigments from Spirulina platensis with potential application to food, pharmaceutical, functional materials, and packaging.

Sustainable Packaging Material Based on PCL Nanofibers and Lavandula luisieri Essential Oil, to Preserve Museological Textiles.

The connection with textiles is one of the oldest traditions in humanity, and in the historical scenario, textiles and clothing deal with material culture. Therefore, preservation is of the utmost importance to keep this important heritage. Packaging and protection of museological textiles is imperative due to the risks that these articles suffer, mainly concerning the attack of microorganisms that promote the acceleration of their degradation, and it is still necessary to create a proper packing material. In the present work we describe a bibliographic review about the museological scenario, focused on the packaging for preservation of textile articles, as well as the techniques usually used in preventive material conservation. Future perpsctives for the improvement in the conservation of museological textiles are also given. This research aims to produce a sustainable material based on polycaprolactone (PCL), with and without antimicrobial function by incorporating Lavandula luisieri essential oil (EO), in the form of a non-woven substrate for museological packaging. A comparison was made with the most frequently used materials, such as raw cotton and a non-woven polyester. The results demonstrated that both PCL and PCL + EO obtained a good characterization for museological application with good breaking strength and excellent whiteness index. In addition, PCL + EO showed a high bacterial reduction when compared with other protective materials frequently used in museums. Therefore, these findings emphasize the potential use of this material as an innovative protective antibacterial museological packaging solution, able to safeguard and preserve textile museum and clothing collections for longer and for future generations.

Quadratus lumborum block: are we aware of its side effects? A report of 2 cases / Bloqueio do quadrado lombar: estamos cientes de seus efeitos colaterais? Relato de dois casos

Abstract Background and objectives The quadratus lumborum block was initially described in 2007 and aims at blocking the same nerves as the ones involved on the Transverse Abdominis Plane block, while accomplishing some visceral enervation as well due to closer proximity with the neuroaxis and sympathetic trunk. Given its versatility, we have successfully used it in a wide range of procedures. We report two cases where we believe the dispersion of local anesthetic is likely to have led to a previously undescribed complication. Clinical reports We report two cases in which we performed a quadratus lumborum type II block and general anesthesia for total gastrectomy and right hemicolectomy. There were no noteworthy events while performing the block and inducing general anesthesia, but within 30-40 min serious hypotension and tachycardia were noted. As other motives for hypotension were ruled out, the event was interpreted as block-induced sympatholysis due to cephalad dispersion of the local anesthetic to the paravertebral and epidural space, and successfully managed with ephedrine and increase of the crystalloid infusion rate. Conclusions The quadratus Lumborum block is safe to execute and provides effective abdominal wall and visceral analgesia. However, the possibility of eliciting undesired episodes should prompt caution when performing this block and practitioners should thereafter remain vigilant. Questions regarding ideal dosing, volumes, timing of block and pertinence of catheters remain to be answered.

Resumo Justificativa e objetivos O bloqueio do quadrado lombar foi primeiramente descrito em 2007 e tem como objetivo o bloqueio dos mesmos nervos envolvidos no bloqueio do plano transverso abdominal, ao atingir algumas inervações viscerais, bem como devido à maior proximidade com o neuroeixo e cadeia simpática. Dada a sua versatilidade, temos usado esse bloqueio com sucesso em uma grande variedade de procedimentos. Relatamos dois casos nos quais acreditamos que a dispersão do anestésico local pode ter levado a uma complicação não descrita previamente. Relatos clínicos Relatamos dois casos nos quais realizamos o bloqueio do quadrado lombar tipo II e anestesia geral para gastrectomia total e hemicolectomia direita. Não houve eventos notáveis durante o bloqueio e a indução da anestesia geral, mas, dentro de 30 a 40 minutos, observamos grave hipotensão e taquicardia. Como outros motivos para a hipotensão foram descartados, o evento foi interpretado como simpatólise induzida pelo bloqueio devido à dispersão cefálica do anestésico local para os espaços paravertebral e epidural e tratado com sucesso com efedrina e aumento da taxa de infusão de cristaloides. Conclusões O bloqueio do quadrado lombar oferece segurança na execução e fornece analgesia eficaz à parede abdominal e vísceras. Porém, a possibilidade de provocar episódios indesejáveis requer cautela em sua execução e, por conseguinte, os médicos precisam estar atentos. As questões relacionadas à dosagem ideal, aos volumes, ao tempo de bloqueio e à pertinência dos cateteres permanecem indefinidas.

Amino Acid-Based Material for the Complementary Therapy of Decubitus Ulcers.

Chronic wounds, pressure sores, lesions, and infections of microbial origin in bedridden, paralyzed, or malnutrition patients remain the object of study of many researchers. A variety of factors behind the development of these disorders are related to the patient's immune system, making it unable to respond effectively to the treatment of the wound. These factors can be properly controlled, giving particular importance to the ethiology and stage of the wound, as well as the time periods corresponding to the replacement of the dressings. The present research reports a novel foam/soft material, L-Cys-g-PCL, with an application for decubitus/pressure ulcers, especially for wounds with a difficult healing process due to infections and constant oxidation of the soft tissues. During this work, the interactions between S. aureus and L-Cys-g-PCL foam were studied under conditions that simulate decubitus ulcers; namely, pH and exudate. The effects of duration of grafting (1 or 8 h) and pH (7.0 and 8.9) on wettability, surface energy, swelling, and porosity were also evaluated. Results showed an effective microbicidal activity exhibiting an inhibition ratio of 99.73% against S. aureus. This new L-Cys-g-PCL soft material showed saftey to contact skin, ability to be shaped to fill in sunken holes (craters) - pressure ulcers stage III - and to act as a smart material responsive to pH, which can be tailored to develop better swelling properties at alkaline pH where exudates are normally higher, so as to address exudate self-cleaning and prevention of desiccation..

Biofunctionalization of cellulosic fibres with L-cysteine: assessment of antibacterial properties and mechanism of action against Staphylococcus aureus and Klebsiella pneumoniae.

The main purpose of this work is to obtain a cotton-based textile material functionalized with L-cysteine (L-cys) to achieve an antimicrobial effect with potential application in biomedical, geriatric or pediatric textiles. The binding capacity of L-cys to cotton fibres was assessed through different functionalization strategies--surface activation and exhaustion processes. A subsequent analysis of the possible antibacterial action against Staphylococcus aureus and Klebsiella pneumoniae was performed according with the Japanese International standard (JISL, 2008). To determine the mechanism of action of L-cys on the selected strains, flow cytometry was used. The results revealed that the exhaustion process was performed with success to confer bioactivity to the treated fabric, as assessed by an effective antibacterial effect against both Gram-positive and Gram-negative bacteria, and successfully linkage of L-cys was observed via FTIR with a durable effect demonstrated after the washing tests (fastness to washing). It was also observed that L-cys exerts a bacteriostatic effect against both bacterial strains, since there were alterations in the metabolic activity of the microorganisms after the application of the bioactive textile which was shown by the CTC (cyanoditolyl tetrazolium chloride) staining used in flow cytometry. This study shows a new and successful biotechnological process to develop antibacterial textiles through the functionalization of cotton fibres with L-cys which presents a broad range of applications in healthcare, since L-cys is a natural antibacterial compound, non-toxic and affects pathogenic bacteria related to hospital infections.