Electrospun Membranes Based on Quaternized Polysulfones: Rheological Properties-Electrospinning Mechanisms Relationship.

Composite membranes based on a polymer mixture solution of quaternized polysulfone (PSFQ), cellulose acetate phthalate (CAP), and polyvinylidene fluoride (PVDF) for biomedical applications were successfully obtained through the electrospinning technique. To ensure the polysulfone membranes' functionality in targeted applications, the selection of electrospinning conditions was essential. Moreover, understanding the geometric characteristics and morphology of fibrous membranes is crucial in designing them to meet the performance standards necessary for future biomedical applications. Thus, the viscosity of the solutions used in the electrospinning process was determined, and the morphology of the electrospun membranes was examined using scanning electron microscopy (SEM). Investigations on the surfaces of electrospun membranes based on water vapor sorption data have demonstrated that their surface properties dictate their biological ability more than their specific surfaces. Furthermore, in order to understand the different macromolecular rearrangements of membrane structures caused by physical interactions between the polymeric chains as well as by the orientation of functional groups during the electrospinning process, Fourier transform infrared (FTIR) spectroscopy was used. The applicability of composite membranes in the biomedical field was established by bacterial adhesion testing on the surface of electrospun membranes using Escherichia coli and Staphylococcus aureus microorganisms. The biological experiments conducted establish a foundation for future applications of these membranes and validate their effectiveness in specific fields.

Between Pathological Prostate Cancer Lymph Nodes and Sentinel Nodes: Which Information Is the Leader?

PURPOSE: On the basis of the concept of sentinel lymph node biopsy (SLNB), SLNs should contain decisive information for clinical outcomes. In localized prostate cancer patients, this study assessed retrospectively clinical outcome after radical laparoscopic prostatectomy associated with SLNB and extensive pelvic lymph node dissection. METHODS: A total of 231 consecutive patients of intermediate to high risk were analyzed. Recurrence-free survival (RFS) was assessed with Kaplan-Meier curves. Various pathological parameters were analyzed using univariable and multivariable analyses through Cox regression analysis. The study was approved and registered under 2007-R41. RESULTS: The median follow-up was 7.1 years (95% confidence interval, 6.6-7.5). In total, 38/231 (16.5%) patients were pN1. Of these 38 patients, 27 had only SLN involvement (SLNI), 10 patients had both SLN and non-SLNI, and 1 patient had isolated non-SLNI, indicating a false-negative (FN). If the updated Briganti nomogram threshold set at >7% for recommending extensive pelvic lymph node dissection had been applied to these patients, we would have missed 44% (12/27) of patients with SLNI and 50% (5/10) of patients with SLNI and non-SLNI, as well as the FN patient. At the time of final follow-up, 84/231 (36.5%) patients had recurrence. In multivariable analysis, and regarding node status, the most significant prognostic factor was SLN with macrometastases and/or micrometastases, respectively, P = 10-3 and P < 10-3. No more information was obtained with non-SLN status. Probabilities of RFS between negative and positive SLN patients presented a major significant difference (P < 10-15) with a risk of event 8.75 times more frequent if SLN was involved than if it was metastasis-free. CONCLUSIONS: SLNB seems to contain decisive information for the clinical outcome of patients with localized intermediate- and high-risk prostate cancer patients. The question raised is thus whether immediate additional postoperative treatment should be offered to patients with metastatic SLN.

Multifunctional Hydrogels Based on Cellulose and Modified Lignin for Advanced Wounds Management.

Considering the complex process of wound healing, it is expected that an optimal wound dressing should be able to overcome the multiple obstacles that can be encountered in the wound healing process. An ideal dressing should be biocompatible, biodegradable and able to maintain moisture, as well as allow the removal of exudate, have antibacterial properties, protect the wound from pathogens and promote wound healing. Starting from this desideratum, we intended to design a multifunctional hydrogel that would present good biocompatibility, the ability to provide a favorable environment for wound healing, antibacterial properties, and also, the capacity to release drugs in a controlled manner. In the preparation of hydrogels, two natural polymers were used, cellulose (C) and chemically modified lignin (LE), which were chemically cross-linked in the presence of epichlorohydrin. The structural and morphological characterization of CLE hydrogels was performed by ATR-FTIR spectroscopy and scanning electron microscopy (SEM), respectively. In addition, the degree of swelling of CLE hydrogels, the incorporation/release kinetics of procaine hydrochloride (PrHy), and their cytotoxicity and antibacterial properties were investigated. The rheological characterization, mechanical properties and mucoadhesion assessment completed the study of CLE hydrogels. The obtained results show that CLE hydrogels have an increased degree of swelling compared to cellulose-based hydrogel, a better capacity to encapsulate PrHy and to control the release of the drug, as well as antibacterial properties and improved mucoadhesion. All these characteristics highlight that the addition of LE to the cellulose matrix has a positive impact on the properties of CLE hydrogels, confirming that these hydrogels can be considered as potential candidates for applications as oral wound dressings.

Influence of Block-Copolymers' Composition as Compatibilizers for Epoxy/Silicone Blends.

The objective of this study was to prepare crosslinked epoxy networks containing liquid silicone particles in order to improve their mechanical properties and obtain less brittle materials. Different copolymers were used as compatibilizers. These copolymers vary in their chemical composition and structure. All of the copolymers contain hydrophobic (PDMS sequences) and hydrophilic groups. The effect of their chemical structure and architecture on the morphology of the dispersed phase, and on the final physico-chemical and flexural characteristics of epoxy/silicone blends, was explored. The morphology of crosslinked formulations was studied by scanning electron microscopy (SEM), and the thermal characteristics (glass transition temperature, Tg, and curing exothermic peak) were determined by differential scanning calorimetry (DSC). The experimental results have shown that the average diameter and particle size distribution of silicone particles depend on the chemical structure and architecture of the compatibilizers. One copolymer has been identified as the best compatibilizer, allowing a lower mean diameter and particle size distribution in addition to the best mechanical properties of the final network (less brittle character). This study has consequently evidenced the possibility of creating in situ silicone capsules inside an epoxy network by adding tailored compatibilizers to epoxy/silicone formulations.

Self-Healing of Pluronic® F127 Hydrogels in the Presence of Various Polysaccharides.

Thermoresponsive Pluronic® F127 (PL) gels in water were investigated through rheological tests in different shear conditions. The gel strength was tuned with the addition of 1% polysaccharide solution. In the presence of xanthan gum (XG), the viscoelastic behavior of PL-based hydrogels was improved in aqueous environment, but the rheological behavior was less changed with the addition of XG in PBS solutions, whereas in the presence of 0.1 M NaCl, the viscoelastic parameters decreased. PL micellar networks exhibited a self-healing ability, recovering their initial structure after applying cycles of high strain. The rheological characteristics of the PL hydrogel changed with the addition of 1% polysaccharides (xanthan gum, alginate, κ-carrageenan, gellan, or chitosan). PL/polysaccharide systems form temperature-responsive hydrogels with shear thinning behavior, yield stress, and self-healing ability, being considered a versatile platform for injectable biomaterials or bioinks. Thus, in the presence of xanthan gum in aqueous medium, the gel strength was improved after applying a high strain (the values of elastic modulus increased). The other investigated natural polymers induced specific self-healing behaviors. Good performances were observed with the addition of gellan gum, alginate, and κ-carrageenan, but for high values of strain, the ability to recover the initial structure decreased. A modest self-healing behavior was observed in the presence of chitosan and xanthan gum dissolved in NaCl solution.

Poly(vinyl alcohol)/Pullulan Composite Hydrogels as a Potential Platform for Wound Dressing Applications.

Hydrogels are 3D networks with an excellent ability to retain a high amount of water or biological fluids, representing suitable candidates for wound dressing applications. They can provide a protective barrier and a moist environment, facilitating wound treatment. The present paper focuses on physical hydrogels obtained from poly(vinyl alcohol) (PVA) and pullulan (PULL) mixtures in different weight ratios by using the freezing/thawing method. Hybrid hydrogels of similar polymer compositions were prepared in the presence of 0.5% Laponite® RD. The influence of polysaccharide and clay addition on the properties of PVA hydrogels was investigated. Scanning electron microscopy showed evidence of the inner porous structure. The viscoelastic properties were investigated in different shear conditions and revealed the influence of the hydrogel composition on the network strength. The swelling behavior was followed in physiological saline solutions at 37 °C and pH = 7.4. For all samples, a quasi-Fickian diffusion mechanism was found. The delivery of neomycin sulfate was studied in similar conditions as for the swelling tests (0.15 M NaCl solutions; 37 °C; pH = 7.4) and different kinetic models were used to determine the release mechanism. The Peppas-Sahlin approach described very well the in vitro drug release mechanism from the polymeric hydrogels in the absence of clay. However, the hybrid polymer/clay hydrogels showed the best fit with the Korsmeyer-Peppas model. According to the present study, the porous membranes containing 40-60% PULL (in absence of clay) are suitable for the release of therapeutic agents at wound sites in physiological conditions.

Organophosphorus Reinforced Poly(vinyl alcohol) Nanocomposites Doped with Silver-Loaded Zeolite L Nanoparticles as Sustainable Materials for Packaging Applications.

The sustainable development of innovative eco-friendly multifunctional nanocomposites, possessing superior characteristics, is a noteworthy topic. Novel semi-interpenetrated nanocomposite films based on poly(vinyl alcohol) covalently and thermally crosslinked with oxalic acid (OA), reinforced with a novel organophosphorus flame retardant (PFR-4) derived from co-polycondensation in solution reaction of equimolar amounts of co-monomers, namely, bis((6-oxido-6H-dibenz[c,e][1,2]oxaphosphorinyl)-(4-hydroxyaniline)-methylene)-1,4-phenylene, bisphenol S, and phenylphosphonic dichloride, in a molar ratio of 1:1:2, and additionally doped with silver-loaded zeolite L nanoparticles (ze-Ag), have been prepared by casting from solution technique. The morphology of the as prepared PVA-oxalic acid films and their semi-interpenetrated nanocomposites with PFR-4 and ze-Ag was investigated by scanning electron microscopy (SEM), while the homogeneous distribution of the organophosphorus compound and nanoparticles within the nanocomposite films has been introspected by means of energy dispersive X-ray spectroscopy (EDX). It was established that composites with a very low phosphorus content had noticeably improved flame retardancy. The peak of the heat release rate was reduced up to 55%, depending on the content of the flame-retardant additive and the doping ze-Ag nanoparticles introduced into the PVA/OA matrix. The ultimate tensile strength and elastic modulus increased significantly in the reinforced nanocomposites. Considerably increased antimicrobial activity was revealed in the case of the samples containing silver-loaded zeolite L nanoparticles.

Watchful Waiting in Pediatric Acute Otitis Media: A Real Practice Approach or an Intangible Desideratum?

Acute otitis media (AOM) in children is one of the leading causes of health care visits and antibiotic prescriptions worldwide. The overall aim of the current study is twofold: 1. to analyze and discuss the antibiotic prescription patterns in AOM in children without complications or risk factors and 2. to assess to what extent the watchful-waiting approach is a real practice or a mere desideratum. We performed an electronic search in the PubMed and Embase databases from 2013 to 2023 to capture original research studies investigating antibiotic prescribing patterns for AOM in children. Among the 12 papers included in the analysis, the antibiotic prescription rate ranged from 44.8% to 98%. Our study reveals similarities regarding the use of amoxicillin as a first-line antibiotic in pediatric AOM, but also discrepancies in the watchful-waiting approach attitude and in the choice of second or third-line antimicrobial agents. The proportion of cases managed with the watchful-waiting approach ranged from 7.5% (Australia) to 55.2% (Finland). Denmark was the only country reporting penicillin V as a first-choice regimen for children with AOM, which fulfils the guidelines' recommendations. The most unsatisfying rate of amoxicillin use was recorded in Japan, contrary to the recommendations of local guidelines. The use of quinolones was reported in two out of twelve studies, with the highest proportion in Japan, where tosufloxacin was used in 21.4% of the total number of cases. The duration of the antibiotic regimens was analyzed in three out of twelve papers. Since global antibiotic overuse contributes to the emergence of antibiotic resistant bacteria, new strategies are needed to increase the rate of watchful waiting and to promote the judicious use of antibiotics.

3D Matrices for Enhanced Encapsulation and Controlled Release of Anti-Inflammatory Bioactive Compounds in Wound Healing.

Current trends in the development of wound dressings are oriented towards the use of biopolymer-based materials, due to their unique properties such as non-toxicity, hydrophilicity, biocompatibility and biodegradability, properties that have advantageous therapeutic characteristics. In this regard, the present study aims to develop hydrogels based on cellulose and dextran (CD) and to reveal their anti-inflammatory performance. This purpose is achieved by incorporating plant bioactive polyphenols (PFs) in CD hydrogels. The assessments include establishing the structural characteristics using attenuated total reflection Fourier transformed infrared (ATR-FTIR) spectroscopy, the morphology by scanning electron microscopy (SEM), the swelling degree of hydrogels, the PFs incorporation/release kinetics and the hydrogels' cytotoxicity, together with evaluation of the anti-inflammatory properties of PFs-loaded hydrogels. The results show that the presence of dextran has a positive impact on the hydrogel's structure by decreasing the pore size at the same time as increasing the uniformity and interconnectivity of the pores. In addition, there is an increased degree of swelling and of the encapsulation capacity of PFs, with the increase of the dextran content in hydrogels. The kinetics of PFs released by hydrogels was studied according to the Korsmeyer-Peppas model, and it was observed that the transport mechanisms depend on hydrogels' composition and morphology. Furthermore, CD hydrogels have been shown to promote cell proliferation without cytotoxicity, by successfully culturing fibroblasts and endothelial cells on CD hydrogels (over 80% viability). The anti-inflammatory tests performed in the presence of lipopolysaccharides demonstrate the anti-inflammatory properties of the PFs-loaded hydrogels. All these results provide conclusive evidence on the acceleration of wound healing by inhibiting the inflammation process and support the use of these hydrogels encapsulated with PFs in wound healing applications.

Radioisotope-guided Lymphadenectomy for Pelvic Lymph Node Staging in Patients With Intermediate- and High-risk Prostate Cancer (The Prospective SENTINELLE Study).

PURPOSE: Our aim was to prospectively evaluate the diagnostic accuracy of sentinel lymph node biopsy-guided lymph node dissection compared to extended pelvic lymph node dissection in patients with intermediate- or high-risk prostate cancer. MATERIALS AND METHODS: We conducted a prospective, single-arm, multicenter study at 3 tertiary centers in France between February 2012 and May 2019. Eligible patients had clinically localized intermediate- or high-risk prostate cancer. After intraprostatic injection of (99m)Tc-nanocolloid, the locations of the sentinel lymph nodes were defined by preoperative lymphoscintigraphy. Surgical excision of the sentinel lymph nodes was performed using intraoperative gamma probe guidance. After resection of the sentinel lymph nodes, extended pelvic lymph node dissection was performed in all patients. We assessed the diagnostic accuracy of the sentinel lymph node biopsy method using extended pelvic lymph node dissection as the reference standard. This trial was registered in ClinicalTrials.gov (NCT02732392). RESULTS: A total of 162 men cN0M0 (CT scan and bone scan) were enrolled: 106 (65.4%) and 56 (34.6%) patients had intermediate- and high-risk prostate cancer, respectively. The median number of nodes retrieved was 14 (mean 16, IQR 10-21) per patient. At final pathological analysis, 22 patients (13.6%) were pN+. Sensitivity, specificity, negative predictive value, and positive predictive value of sentinel lymph node biopsy method in detecting patients with at least 1 lymph node metastasis were 95.4% (95% CI, 75.1-99.7), 100% (95% CI, 96.6-100), 99.2% (95% CI, 95.5-99.9), and 100% (95% CI, 80.7-100), respectively. CONCLUSIONS: Our multicenter prospective study supports that sentinel lymph node biopsy is a very effective and sensitive method for pelvic lymph node staging in patients with intermediate- or high-risk localized prostate cancer.

The Gut Microbiome and Its Implication in the Mucosal Digestive Disorders.

The gastrointestinal (GI) tract is one of the most studied compartments of the human body as it hosts the largest microbial community including trillions of germs. The relationship between the human and its associated flora is complex, as the microbiome plays an important role in nutrition, metabolism and immune function. With a dynamic composition, influenced by many intrinsic and extrinsic factors, there is an equilibrium maintained in the composition of GI microbiota, translated as "eubiosis". Any disruption of the microbiota leads to the development of different local and systemic diseases. This article reviews the human GI microbiome's composition and function in healthy individuals as well as its involvement in the pathogenesis of different digestive disorders. It also highlights the possibility to consider flora manipulation a therapeutic option when treating GI diseases.

Ganglioneuroma of the Bladder in Association with Neurofibromatosis Type 1.

Neurofibromatosis type 1 (NF1) is a genetic disease, with autosomal dominant transmission, related to pathogenic variant of the tumor suppressor gene NF1 (17q11.2), predisposing affected subjects to a variety of benign (neurofibromas and plexiform neurofibromas) and malignant tumors. The lack of the NF1-neurofibromin gene product can cause uncontrolled cell proliferation in the central or peripheral nervous system and multisystemic involvement, and so the disease includes a heterogeneous group of clinical manifestations. Ganglioneuromas are benign tumors developing from the neural crest cells of the autonomic nervous system, considered to be part of neuroblastic tumors. Bladder localization is extremely rare in adults, and only three such cases were reported in children so far. The aim of our study, in addition to a brief review of the literature of these pathologies, is to bring to your attention the case of a sixteen year old patient with a very rare association of NF1 and bladder ganglioneuroma, who presented at the hospital with gross hematuria. Since bladder ganglioneuroma is a rare pathological condition, the differential diagnosis is difficult and imaging investigations and pathological investigations are the ones that elucidate this disease. The clinical approach of the medical multidisciplinary team involved should help the patient in managing her medical and surgical situation.

Electrospun Nanofibers Based on Polymer Blends with Tunable High-Performance Properties for Innovative Fire-Resistant Materials.

The main concern of materials designed for firefighting protective clothing applications is heat protection, which can be experienced from any uncomfortably hot objects or inner spaces, as well as direct contact with flame. While textile fibers are one of the most important components of clothing, there is a constant need for the development of innovative fire-retardant textile fibers with improved thermal characteristics. Lately, inherently fire-resistant fibers have become very popular to provide better protection for firefighters. In the current study, the electrospinning technique was applied as a versatile method to produce micro-/nano-scaled non-woven fibrous membranes based on various ratios of a poly(ether-ether-ketone) (PEEK) and a phosphorus-containing polyimide. Rheological measurements have been performed on solutions of certain ratios of these components in order to optimize the electrospinning process. FTIR spectroscopy and scanning electron microscopy were used to investigate the chemical structure and morphology of electrospun nanofiber membranes, while thermogravimetric analysis, heat transfer measurements and differential scanning calorimetry were used to determine their thermal properties. The water vapor sorption behavior and mechanical properties of the optimized electrospun nanofiber membranes were also evaluated.

One-Step Preparation of Carboxymethyl Cellulose-Phytic Acid Hydrogels with Potential for Biomedical Applications.

Hydrogels based on natural, biodegradable materials have gained considerable interest in the medical field due to their improved drug delivery profiles and tissue-mimicking architecture. In this regard, this study was devoted to the preparation and characterization of new physically crosslinked hydrogels based on carboxymethyl cellulose and an unconventional crosslinking agent, phytic acid. Phytic acid, in addition to its antioxidant and antibacterial effects, can improve the biological properties and stability of gels, without adding toxicity. Fourier transform infrared (FTIR) spectroscopy, rheological studies and thermal analysis confirmed the hydrogel formation. The influence of the ratio between the cellulose derivative and the crosslinker upon the morphological structure and water uptake was evidenced by scanning electron microscopy (SEM) and swelling measurements in simulated body fluids. Furthermore, procaine was entrapped within the hydrogels and used as a model drug for in vitro studies, which highlighted the dependence of the drug release on the phytic acid content of the matrix. The materials demonstrated antibacterial effects against Escherichia coli and Staphylococcus aureus bacteria. The biocompatibility was assessed on fibroblast cells, and according to our results, hydrogels can improve cell viability highlighting the potential of these systems as therapeutic scaffolds for skin tissue engineering.

Influence of Gel Stage from Cellulose Dissolution in NaOH-Water System on the Performances of Cellulose Allomorphs-Based Hydrogels.

Novel hydrogels were prepared starting from different cellulose allomorphs (cellulose I, II, and III), through a swelling stage in 8.5% NaOH aqueous solution, followed by freezing at low temperature (−30 °C), for 24 h. After thawing at room temperature, the obtained gels were chemical cross-linked with epichlorohydrin (ECH), at 85 °C. The swelling degrees of the hydrogels were investigated, and a complex dependence on the type of the cellulose allomorph was found. Moreover, the gel stage has been shown to play a key role in the design of hydrogels with different performances, following the series: H-CII > H-CI > H-CIII. The correlations between the allomorph type and the morphological characteristics of hydrogels were established by scanning electron microscopy (SEM). The hydrogel H-CII showed the biggest homogeneous pores, while H-CIII had the most compacted pores network, with small interconnected pores. The rheological studies were performed in similar shear regimes, and a close correlation between the strength of the gel structure and the size of the gel fragments was observed. In the case of hydrogels, it has been shown that H-CII is softer, with a lower resistance of the hydrogel (G') above the oscillation frequencies tested, but it maintains its stable structure, while H-CIII has the highest modulus of storage and loss compared to H-CI and H-CII, having a stronger and more rigid structure. The X-ray diffraction (XRD) method showed that the crystalline organization of each type of allomorph possesses a distinctive diffraction pattern, and, in addition, the chemically cross-linking reaction has been proved by a strong decrease of the crystallinity. Attenuated total reflectance Fourier transform infrared (ATR-FTIR) spectroscopy provided clear evidence of the chemical cross-linking of cellulose allomorphs with ECH, by the alteration of the crystal structure of cellulose allomorphs and by the formation of new ether bands.

Vaccine-Related Lymph Nodes: The Emerging Pitfalls of 18F-Fluorocholine and 68Ga-PSMA-11 PET/CT in the Era of COVID-19 Vaccination.

PURPOSE: Vaccination against coronavirus disease 2019 (COVID-19) is currently under worldwide deployment. The consequences of this vaccination can be seen in radiology and nuclear medicine explorations with visualization of axillary lymph nodes (LNs), as observed on ultrasonography, MRI, or 18F-FDG PET/CT.We aimed to evaluate on PET/CT the incidence of vaccine-related LNs and their characteristics after COVID-19 vaccination, using several radiopharmaceuticals different from 18F-FDG. PATIENTS AND METHODS: Between February and July 2021, all consecutive patients undergoing a whole-body PET/CT for any indication using a different radiopharmaceutical from 18F-FDG were eligible for inclusion if they had received at least 1 dose of the COVID-19 vaccine. The radiopharmaceutical administered and vaccine type were recorded for each patient. The incidence of positive vaccine-related axillary and supraclavicular LNs on PET/CT was our primary finding, along with the nodes characteristics. Statistical analyses were performed for patients with prostate cancer (PCa) to determine certain interaction factors that were associated with the detection of vaccine-related LNs. RESULTS: Of the 226 patients in our cohort study, 120 patients underwent an 18F-fluorocholine PET/CT, 79 a 68Ga-PSMA-11 PET/CT, 6 an 18F-FDOPA PET/CT, and 21 a 68Ga-DOTATOC PET/CT. A total of 67.3% of patients (152/226) received BNT162b2mRNA (Pfizer-BioNTech), 26.5% (60/226) ChAdOx1-S (AstraZeneca), 4.9% (11/226) mRNA-1273 (Moderna), and 1.3% (3/226) Ad26.COV2.S (Janssen). The incidence of positive vaccine-related axillary and supraclavicular LNs was 42.5% (51/120 patients) on PET/CT using 18F-fluorocholine and 12.7% (10/79 patients) with 68Ga-PSMA-11. None of our patients undergoing 18F-FDOPA or 68Ga-DOTATOC PET/CT presented any vaccine-related lymphadenopathy. Vaccine-related LNs were statistically associated with the nature of the radiopharmaceutical (P < 10-4), with the number of vaccine doses received (P = 0.041), with a short delay between vaccination and PET/CT realization (P < 10-5), and with a higher prostate-specific antigen level for patients with PCa (P = 0.032), but not with age or vaccine type. The vaccine-related nodes appeared in 85% of the cases, in the 30 days after vaccine injection, were limited in size and uptake, and were most often limited to the axilla level 1 area. CONCLUSIONS: Detecting positive LNs after COVID-19 vaccination is not an exclusive 18F-FDG PET/CT pattern but is common on 18F-fluorocholine and possible on 68Ga-PSMA-11 PET/CT. Confronting PET/CT findings with clinical data (such as date and site of injection) seems essential in the current pandemic context, just as it does for the radiopharmaceuticals used in PCa to avoid PET/CT misinterpretation and incorrect patient treatment. For 18F-FDOPA or 68Ga-DOTATOC PET/CT, this seems to have a lesser impact.

MWCNTs Composites-Based on New Chemically Modified Polysulfone Matrix for Biomedical Applications.

Polyvinyl alcohol (PVA) is a non-toxic biosynthetic polymer. Due to the hydrophilic properties of the PVA, its utilization is an easy tool to modify the properties of materials inducing increased hydrophilicity, which can be noticed in the surface properties of the materials, such as wettability. Based on this motivation, we proposed to obtain high-performance composite materials by a facile synthetic method that involves the cross-linking process of polyvinyl alcohol (PVA) with and aldehyde-functionalized polysulfone(mPSF) precursor, prior to incorporation of modified MWCNTs with hydrophilic groups, thus ensuring a high compatibility between the polymeric and the filler components. Materials prepared in this way have been compared with those based on polyvinyl alcohol and same fillers (mMWCNTs) in order to establish the influence of the polymeric matrix on the composites properties. The amount of mMWCNTs varied in both polymeric matrices between 0.5 and 5 wt%. Fourier transformed infrared with attenuated total reflectance spectroscopy (FTIR-ATR) was employed to confirm the changes noted in the PVA, mPSF and their composites. Hemolysis degree was investigated in correlation with the material structural features. Homogenous distribution of mMWCNTs in all the composite materials has been confirmed by scanning electron microscopy. The hydrophilicity of both composite systems, estimated by the contact angle method, was influenced by the presence of the filler amount mMWCNTs in both matrices (PVA and mPSF). Our work demonstrates that mPSF/mMWCNTs and PVA/mMWCNTs composite could be used as water purification or blood-filtration materials.

Thyroidectomy without Radioiodine in Patients with Low-Risk Thyroid Cancer.

BACKGROUND: In patients with low-risk differentiated thyroid cancer undergoing thyroidectomy, the postoperative administration of radioiodine (iodine-131) is controversial in the absence of demonstrated benefits. METHODS: In this prospective, randomized, phase 3 trial, we assigned patients with low-risk differentiated thyroid cancer who were undergoing thyroidectomy to receive ablation with postoperative administration of radioiodine (1.1 GBq) after injections of recombinant human thyrotropin (radioiodine group) or to receive no postoperative radioiodine (no-radioiodine group). The primary objective was to assess whether no radioiodine therapy was noninferior to radioiodine therapy with respect to the absence of a composite end point that included functional, structural, and biologic abnormalities at 3 years. Noninferiority was defined as a between-group difference of less than 5 percentage points in the percentage of patients who did not have events that included the presence of abnormal foci of radioiodine uptake on whole-body scanning that required subsequent treatment (in the radioiodine group only), abnormal findings on neck ultrasonography, or elevated levels of thyroglobulin or thyroglobulin antibodies. Secondary end points included prognostic factors for events and molecular characterization. RESULTS: Among 730 patients who could be evaluated 3 years after randomization, the percentage of patients without an event was 95.6% (95% confidence interval [CI], 93.0 to 97.5) in the no-radioiodine group and 95.9% (95% CI, 93.3 to 97.7) in the radioiodine group, a difference of -0.3 percentage points (two-sided 90% CI, -2.7 to 2.2), a result that met the noninferiority criteria. Events consisted of structural or functional abnormalities in 8 patients and biologic abnormalities in 23 patients with 25 events. Events were more frequent in patients with a postoperative serum thyroglobulin level of more than 1 ng per milliliter during thyroid hormone treatment. Molecular alterations were similar in patients with or without an event. No treatment-related adverse events were reported. CONCLUSIONS: In patients with low-risk thyroid cancer undergoing thyroidectomy, a follow-up strategy that did not involve the use of radioiodine was noninferior to an ablation strategy with radioiodine regarding the occurrence of functional, structural, and biologic events at 3 years. (Funded by the French National Cancer Institute; ESTIMABL2 ClinicalTrials.gov number, NCT01837745.).

COVID-19 vaccination may cause FDG uptake beyond axillary area.

BACKGROUND: The vaccination immune response may induce false-positive 18F-FDG PET/CT uptake. CASE PRESENTATION: An extended supraclavicular lymph nodal activation after coronavirus disease 2019 (COVID-19) vaccination revealed on 18F-FDG PET/CT mimics a Virchow nodule in a patient with medical history of well-differentiated appendicular adenocarcinoma. CONCLUSION: This case highlights a nodal activation beyond axillary area and the importance of documenting vaccination history at the time of scanning to avoid false-positive results.

Socio-Epidemiological Factors with Negative Impact on Infant Morbidity, Mortality Rates, and the Occurrence of Birth Defects.

In the last 30-40 years, developed countries in particular, but also developing ones, have seen an increase in life expectancy and a decrease in infant mortality and morbidity rates. These factors are due to an increase in living standards, a decrease in differences between social classes, the increased accessibility of education to women, and the implementation of some public health measures. When certain basic social and medical measures are implemented on a large scale, their benefits are first reflected in lower infant mortality rates, and only in the second stage are such benefits reflected in decreasing neonatal mortality rates and a smaller number of stillbirths. In this study, we review the literature on these factors. We extrapolate and compare this literature with data recorded in our country in the hopes of finding the reasons why Romania ranks first in the European Union in terms of infant mortality rates. We found that lowering the infant morbidity, mortality, and congenital malformation rates is an absolute priority in Romania, which requires the involvement of decision makers in taking effective measures regarding food supplementation or enhancement using folic acid, adequate counselling of couples, monitoring of all pregnancies, setting antenatal diagnosis, implementing optimal delivery management and therapeutic approaches to problematic pregnancies in other hospitals and by involving the population in health education, avoiding occupational or in-home exposure to toxic factors, avoiding drug use, and implementing disease and infection prevention measures for pregnant women.