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1.
J Formos Med Assoc ; 123(1): 55-61, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37666718

RESUMEN

AIM: Ropeginterferon alfa-2b is a novel mono-pegylated proline-interferon. Its biweekly dosing schema has demonstrated tolerability and clinical efficacy for treating chronic hepatitis in previous clinical studies. This trial evaluates the pharmacokinetics of 400 µg ropeginterferon alfa-2b in patients with chronic hepatitis C virus (HCV) and provides the data to support the clinical utility of ropeginterferon alfa-2b at 400 µg. METHODS: Seventeen patients with chronic HCV genotype 2 were enrolled to receive a single injection of 400 µg ropeginterferon alfa-2b plus 14-day treatment of ribavirin. Pharmacokinetics, safety, and HCV RNA reduction/clearance were assessed. RESULTS: Tmax was 154.003 h and T1/2 was 114.273 h. The Cmax was 29.823 ng mL-1. AUClast was 9364.292 h∗ng mL-1 and AUCinf was 11084.317 h∗ng mL-1. All adverse events were mild or moderate, and there were no serious adverse events. A 1000-fold reduction in the geometric mean of HCV RNA was observed 14 d after the single injection of ropeginterferon alfa-2b. Two patients achieved clearance of HCV RNA, and the other five patients had HCV RNA levels lower than 200 IU mL-1. CONCLUSION: Ropeginterferon alfa-2b at 400 µg led to PK exposures associated with safety and notable clinical activity in patients with chronic HCV. This study suggests that ropeginterferon alfa-2b at 400 µg is an acceptable dosing regimen for treating chronic HCV and also provides supporting data for the clinical use of ropeginterferon alfa-2b at a higher starting dose for other indications.


Asunto(s)
Hepatitis C Crónica , Polietilenglicoles , Humanos , Antivirales/uso terapéutico , Quimioterapia Combinada , Hepacivirus/genética , Hepatitis C Crónica/tratamiento farmacológico , Polietilenglicoles/administración & dosificación , Polietilenglicoles/farmacocinética , Polietilenglicoles/uso terapéutico , Ribavirina/uso terapéutico , Resultado del Tratamiento , ARN Viral
2.
Nano Lett ; 22(21): 8413-8421, 2022 11 09.
Artículo en Inglés | MEDLINE | ID: mdl-36301201

RESUMEN

As classic shape memory polymers featuring shape reconfiguration of temporary state, covalent adaptable networks containing reversible bonds can enable permanent-state reconfigurability through topological rearrangement via dynamic bond exchange. Yet, such an attractive dual shape programmability is limited by the actuation mode of direct heat transfer and poor mechanical properties, restricting its control precision and functionality. Herein, we presented a method to create nanocomposites with photomodulated dual shape programmability and remarkable mechanical properties leading the fields of covalent adaptable networks. MXene, whose photothermal efficiency was revealed to be regulated by the etching method and delamination, was introduced into polyurethane networks. Upon adjusting the light intensity, the dual shape programmability of both permanent and temporary states could be accomplished, which exhibited potential in information recognition, photowriting paper, etc. Furthermore, owing to the dynamic transcarbamoylation at elevated temperatures, such a phototriggered dual shape programmability could be maintained after the self-healing and reprocessing.


Asunto(s)
Nanocompuestos , Polímeros , Polímeros/química , Poliuretanos , Luz , Calor
3.
J Formos Med Assoc ; 121(9): 1625-1635, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35428526

RESUMEN

Horizontal root fractures (HRF) were observed mostly in the anterior teeth of young adults due to dental injury. However, HRFs in posterior teeth (PHRF) without dental trauma cannot be neglected. The etiology and risk factors of PHRF were unclear. Lower premolars and palatal root of maxillary molars were particularly affected, indicating the specificity of this diseased entity. PHRF were mainly reported in Asian population, suggesting possible racial difference. Whereas most PHRF teeth showed symptoms mimicking endodontic and periodontal lesions, some affected teeth were asymptomatic. Periodontal pocket, soft tissue swelling, chronic pain or discomfort during mastication were commonly noted. Diagnosis of PHRF depended on thorough clinical examination, radiographic images or exploratory surgery. Intracanal bleeding and electronic apex locator confirmation during endodontic treatment were also useful for diagnosis. Flexible splinting, endodontic/periodontal treatment or root amputation were treatment strategies to preserve the fractured teeth. The aim of this narrative review is to summarize the demography, tooth and root distribution, diagnostic methods, etiology and possible related factors, clinical features, radiographic characteristics, and the treatment schemes of PHRF without dental trauma. A better understanding and identification of this particular root fracture could be achieved. The diagnostic tools and practical management are useful for clinical guides.


Asunto(s)
Fracturas de los Dientes , Raíz del Diente , Diente Premolar , Humanos , Diente Molar , Bolsa Periodontal , Tratamiento del Conducto Radicular , Adulto Joven
4.
Int J Mol Sci ; 23(4)2022 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-35216156

RESUMEN

Male pediatric survivors of cancers and bone marrow transplantation often require adjuvant chemoradiation therapy that may be gonadotoxic. The optimal methods to preserve fertility in these prepubertal males are still under investigation. This manuscript presents an in vivo experiment which involved transplantation of immature testicular tissues (ITT) from transgenic donor, to wild-type recipient mice. Donors and recipients were age-mismatched (from 20-week-old donors to 3-week-old recipients, and vice versa) and the transplantation sites involved the abdomen, skin of the head, back muscle, and scrotum. The application of poly-l-lactic acid (PLLA) scaffold was also evaluated in age-matched donors and recipients (both 3-weeks-old). To quantitively evaluate the process of spermatogenesis after ITT transplantation and scaffold application, bioluminescence imaging (BLI) was employed. Our result showed that ITT from 3-week-old mice had the best potential for spermatogenesis, and the optimal transplantation site was in the scrotum. Spermatogenesis was observed in recipient mice up to 51 days after transplantation, and up to the 85th day if scaffold was used. The peak of spermatogenesis occurred between the 42nd and 55th days in the scaffold group. This animal model may serve as a framework for further studies in prepubertal male fertility preservation.


Asunto(s)
Preservación de la Fertilidad/métodos , Infertilidad Masculina/terapia , Espermatogénesis , Testículo/citología , Ingeniería de Tejidos/métodos , Animales , Infertilidad Masculina/etiología , Masculino , Ratones , Poliésteres/química , Traumatismos Experimentales por Radiación/complicaciones , Testículo/crecimiento & desarrollo , Testículo/fisiología , Andamios del Tejido/química
5.
Int Urogynecol J ; 31(11): 2419-2425, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-32789811

RESUMEN

INTRODUCTION AND HYPOTHESIS: To describe the knowledge and perceptions of obstetric fistula (OF) among affected and unaffected women. METHODS: Twenty-five semi-structured interviews were conducted with women who had received OF repair. Three focus groups were conducted: one group of women with urinary incontinence but no OF, one group of women with OF, and one group of women without genitourinary complaints. Interviews and focus groups were conducted using the grounded theory approach. This study took place in two urban hospitals in Rwanda from April to November 2015. Transcripts were coded using MAXDA11 and analyzed using the axial technique and the constant comparative method. RESULTS: Nearly all participants correctly described OF and its symptoms, and 93% of interviewed women attributed OF to complications in vaginal delivery or cesarean section. Several participants described renouncing stigmatizing beliefs after learning about OF from the radio, health workers, or word of mouth. Still, it was found that women with OF were more knowledgeable about OF etiology than women without genitourinary conditions. CONCLUSIONS: Compared to prior studies, women's knowledge about OF appears to be more medically based, with media and health workers playing a role in reducing stigmatizing beliefs. These findings support continued investment in OF awareness campaigns, which seem to be increasing knowledge about OF and reducing stigma.


Asunto(s)
Cesárea , Fístula , Parto Obstétrico , Femenino , Humanos , Percepción , Embarazo , Investigación Cualitativa , Estigma Social
6.
Molecules ; 25(18)2020 Sep 10.
Artículo en Inglés | MEDLINE | ID: mdl-32927584

RESUMEN

Utilizing liquid rubber to toughen epoxy resin is one of the most mature and promising methods. However, the dielectric relaxation characteristics of the epoxy/liquid rubber composites have not been studied systematically, while the relaxation behaviours are a critical factor for both micro and macro properties. In this paper, hydroxyl-terminated liquid nitrile rubber (HTBN) is employed to reinforce a kind of room-temperature-cured epoxy resin. The dielectric spectrum is measured and analysed. Results show that two relaxation processes are introduced in the binary composites. The α relaxation of HTBN shows a similar temperature dependence with the ß relaxation of epoxy resin. The interfacial polarization leads to an increase of complex permittivity, which reaches its maximum at 70 °C. In addition, affected by interfacial polarization, the thermionic polarization is inhibited, and the samples with filler ratios of 15% and 25% show lower DC-conductivity below 150 °C. In addition, the α relaxation and thermionic polarization of epoxy resin obey the Vogel‒Fulcher‒Tammann law, while the interfacial polarization and DC-conductivity satisfy with the Arrhenius law. Furthermore, the fitting results of the Vogel temperature of α relaxation, glass transition temperature, apparent activation energy of interfacial polarization and DC-conductivity all decline with HTBN content. These results can provide a reference and theoretical guidance for the assessment of dielectric properties and the improvement of the formulation of liquid-rubber-toughened epoxy resin.


Asunto(s)
Resinas Epoxi/química , Nitrilos/química , Goma/química , Algoritmos , Modelos Teóricos , Temperatura
7.
Molecules ; 25(18)2020 Sep 16.
Artículo en Inglés | MEDLINE | ID: mdl-32947872

RESUMEN

Shape-memory materials are smart materials that can remember an original shape and return to their unique state from a deformed secondary shape in the presence of an appropriate stimulus. This property allows these materials to be used as shape-memory artificial muscles, which form a subclass of artificial muscles. The shape-memory artificial muscles are fabricated from shape-memory polymers (SMPs) by twist insertion, shape fixation via Tm or Tg, or by liquid crystal elastomers (LCEs). The prepared SMP artificial muscles can be used in a wide range of applications, from biomimetic and soft robotics to actuators, because they can be operated without sophisticated linkage design and can achieve complex final shapes. Recently, significant achievements have been made in fabrication, modelling, and manipulation of SMP-based artificial muscles. This paper presents a review of the recent progress in shape-memory polymer-based artificial muscles. Here we focus on the mechanisms of SMPs, applications of SMPs as artificial muscles, and the challenges they face concerning actuation. While shape-memory behavior has been demonstrated in several stimulated environments, our focus is on thermal-, photo-, and electrical-actuated SMP artificial muscles.


Asunto(s)
Órganos Artificiales , Materiales Biomiméticos/química , Polímeros/química , Elastómeros/química , Luz , Cristales Líquidos/química , Impresión Tridimensional , Robótica
8.
J Reconstr Microsurg ; 36(6): 397-402, 2020 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-32040964

RESUMEN

BACKGROUND: Immunosuppression risks are a major concern with vascularized composite allotransplantation (VCA). As an emerging strategy, the antirejection role played by mesenchymal stem cells (MSCs) is receiving attention. However, the current literature reports are inconclusive regarding the robustness of the MSC monotherapy. Using a rat forelimb VCA model, this study tested the robustness of the immunomodulation efficacy of gingival-derived MSCs (GMSCs) and bone marrow-derived MSCs (BMMSCs). METHODS: Forelimbs were transplanted on pairs of major histocompatibility complex-incompatible rats (Wistar-Kyoto donor, Lewis [LEW] recipient). Twenty-four LEW rats were randomly divided into four groups, including control (no treatment) and three treatment groups: rapamycin (2 mg/kg/day for 28 days, postoperatively), BMMSC and GMSC, both of which received donor-derived stem cells administered intravenously on postoperative days (PODs) 0, 3, 7, and 14. Rejection was considered as 80% skin necrosis of the allograft. Microcomputed tomography (µCT) was performed to evaluate healing at osteosynthesis site. On POD 14, limbs from each group underwent histological analysis and rejection grading using the Banff system. RESULTS: Both BMMSC (15.0 days) and GMSC (14.7 days) treatment failed to prolong VCA survival in comparison with the control group (13.8 days; p > 0.050), while the rapamycin significantly delayed acute VCA rejection (24.5 days; p = 0.003). Micro-CT imaging revealed no gross visual difference across all groups. Histology revealed that the control group was most severely affected (grades III and IV) followed by MSC (grade II) and rapamycin (grade I). CONCLUSION: MSC monotherapy, both BMMSC and GMSC, did not inhibit rejection in our VCA model. Skin immunogenicity is an important issue in promoting rejection, and a concomitant immunosuppression regimen should be considered to prolong allograft survival.


Asunto(s)
Células Madre Mesenquimatosas , Alotrasplante Compuesto Vascularizado , Animales , Rechazo de Injerto , Supervivencia de Injerto , Miembro Posterior , Ratas , Ratas Endogámicas Lew , Ratas Endogámicas WKY , Microtomografía por Rayos X
9.
Mov Disord ; 34(12): 1882-1890, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31505068

RESUMEN

BACKGROUND: The risk of parkinsonism after antiviral treatment against chronic hepatitis C (CHC) is unclear. OBJECTIVES: To investigate the association between CHC and parkinsonism and the efficacy of antiviral therapy. METHODS: Using the National Health Insurance Research Database of Taiwan from 2004 to 2012, patients with and without CHC, patients receiving pegylated interferon-based antiviral therapy, and those without such therapy were matched by age, gender, and comorbidities by propensity scores and followed for new diagnoses of parkinsonism and Parkinson's disease (PD). Multivariable Cox proportional hazards regression analyses were performed. RESULTS: Overall, 49,342 patients with CHC were matched with 49,342 non-CHC patients. After adjustment for confounding factors, there was a significantly increased risk (31%) of parkinsonism (hazard ratio [HR] 1.306; 95% confidence interval [CI], 1.208-1.412) in those with CHC and the risk of parkinsonism requiring anti-Parkinson medication (HR 1.323; 95% CI, 1.214-1.441). Furthermore, 23,647 untreated CHC patients were matched with 23,647 patients receiving antiviral therapy. Patients receiving antiviral therapy had a significantly lower risk of developing parkinsonism (38%; HR 0.618; 95% CI, 0.498-0.765) and a reduced risk of parkinsonism requiring anti-Parkinson medication (HR 0.651; 95% CI, 0.515-0.823). In sensitivity analyses, antiviral therapy significantly reduced the risk of parkinsonism and PD after adjustment for detection, selection, disease latency biases, and competing mortality. Our results suggest successful antiviral therapy associates with a reduced risk of hepatitis C virus-related parkinsonism compared with those with treatment failure. CONCLUSIONS: CHC infection is associated with an increased risk of parkinsonism or PD. Antiviral therapy against CHC is associated with a reduced risk of parkinsonism or PD. © 2019 International Parkinson and Movement Disorder Society.


Asunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/tratamiento farmacológico , Trastornos Parkinsonianos/epidemiología , Adulto , Anciano , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Hepatitis C Crónica/complicaciones , Humanos , Interferón-alfa/uso terapéutico , Masculino , Persona de Mediana Edad , Trastornos Parkinsonianos/complicaciones , Polietilenglicoles/uso terapéutico , Proteínas Recombinantes/uso terapéutico , Riesgo , Resultado del Tratamiento
10.
Biomacromolecules ; 17(9): 3040-7, 2016 09 12.
Artículo en Inglés | MEDLINE | ID: mdl-27536957

RESUMEN

Cytosolic drug delivery, a major route in cancer therapy, is limited by the lack of efficient and safe endosomal escape techniques. Herein, we demonstrate a reactive oxygen species (ROS)-responsive micelle composed of methoxy polyethylene glycol-b-poly(diethyl sulfide) (mPEG-PS) copolymers which can induce specific endosome escape in cancer cells by changes in the hydrophobicity of copolymers. Owing to the more ROS levels in cancer cells than normal cells, the copolymers can be converted into more hydrophilic and insert into and destabilize the cancer intracellular endosome membrane after cellular uptake. More importantly, we show that acid-intolerant drugs successfully maintain their bioactivity and cause selective cytotoxicity for cancer cells over normal cells. Our results suggest that the endosomal escape induced by hydrophobic-hydrophilic exchange of copolymers has great potential to locally and efficiently deliver biological agents (e.g., proteins and genes) in the cancer cell cytosol.


Asunto(s)
Antioxidantes/farmacología , Sistemas de Liberación de Medicamentos , Micelas , Neoplasias/tratamiento farmacológico , Polímeros/química , Especies Reactivas de Oxígeno/metabolismo , alfa-Tocoferol/farmacología , Animales , Antioxidantes/administración & dosificación , Citosol/metabolismo , Endosomas/efectos de los fármacos , Humanos , Concentración de Iones de Hidrógeno , Interacciones Hidrofóbicas e Hidrofílicas , Polietilenglicoles/química , Conejos , Células Tumorales Cultivadas , alfa-Tocoferol/administración & dosificación
11.
Dis Colon Rectum ; 59(10): 975-83, 2016 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-27602929

RESUMEN

BACKGROUND: Bowel preparation is burdensome, and less-demanding preparation procedures are needed. Few studies have investigated the effects of low-residue diet and prepackaged low-residue diet in combination with low-volume polyethylene glycol-electrolyte lavage solution during colonoscopy preparation. OBJECTIVE: We compared self-prepared low-residue diets with prepackaged low-residue diets in combination with low-volume polyethylene glycol. DESIGN: This was a single-blinded, 3-arm, multicenter, randomized controlled trial. SETTING: Colonoscopies were conducted in outpatient settings at 3 centers in Taiwan. PATIENTS: The study included 180 patients (age range, 20-75 years) who were scheduled for colonoscopy. INTERVENTIONS: Three groups were compared: group A included self-prepared, 1-day, low-residue diets with a same-day 2.0-L single-dose of polyethylene glycol; group B included prepackaged low-residue diets plus 2.0 L of polyethylene glycol; and group C included prepackaged low-residue diets plus 1.5 L of polyethylene glycol. MAIN OUTCOME MEASURES: The outcome measures were adherence, bowel-cleansing level, and patient satisfaction. RESULTS: One third of the subjects in group A, but none in the prepackaged low-residue diets groups, violated the dietary restrictions. The proportion of right-segment preparation failure was 15.0%, 1.7%, and 6.7% (p = 0.025). Accordingly, treatment B was superior to A (p = 0.008). Among subjects violating the low-residue diets guideline, the right-segment preparation failure rate was 25%. According to a multivariate analysis, low-residue diet compliance (adjusted OR = 6.55 (95% CI, 1.83-23.43)) and BMI were predictors of right-sided preparation adequacy, but the volume of polyethylene glycol ingested was not a predictor. Compared with group A, a greater proportion of subjects in groups B and C reported satisfaction. LIMITATIONS: Patients with high BMI and severe constipation were excluded from this study. This study included only an Asian population. CONCLUSIONS: The prepackaged low-residue diet provides excellent adherence, better bowel cleansing, and a better experience than a self-prepared low-residue diet. With good dietary compliance, 1.5 L of polyethylene glycol provides effective preparation.


Asunto(s)
Catárticos , Enfermedades del Colon/diagnóstico , Colonoscopía/métodos , Dietoterapia/métodos , Polietilenglicoles , Cuidados Preoperatorios/métodos , Irrigación Terapéutica/métodos , Adulto , Índice de Masa Corporal , Catárticos/administración & dosificación , Catárticos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Cooperación del Paciente , Prioridad del Paciente , Polietilenglicoles/administración & dosificación , Polietilenglicoles/efectos adversos , Tensoactivos/administración & dosificación , Tensoactivos/efectos adversos
12.
Proc Natl Acad Sci U S A ; 110(19): 7844-9, 2013 May 07.
Artículo en Inglés | MEDLINE | ID: mdl-23613588

RESUMEN

MicroRNA-122 (miR-122) facilitates hepatitis C virus replication in vitro. Serum miR-122 has been implicated as a biomarker for various liver diseases; however, its role in chronic hepatitis C remains unclear. To address this issue, 126 patients with chronic hepatitis C who completed pegylated IFN plus ribavirin therapy with sustained virologic response (SVR) or nonresponse (NR) were retrospectively included, and their pretreatment clinical profiles and treatment responses were collected. Serum miR-122 was quantified before and during treatment. Another 51 patients in SVR and NR groups were prospectively enrolled for validation. Serum miR-122 was found to be a surrogate for hepatic miR-122 and positively correlated with hepatic necroinflammation. Patients who showed complete early virologic response and SVR had significantly higher pretreatment serum miR-122 levels than those with NR (P = 0.001 and P = 0.008, respectively), especially in subgroups of patients with hepatitis C virus genotype 2 and IL-28B rs8099917 TT genotype. Patients with IL-28B TT genotype had significantly better treatment responses and higher pretreatment serum miR-122 level than those with GT or GG genotypes. Univariate analysis showed that pretreatment body mass index, γ-glutamyl transpeptidase, triglyceride, IL-28B TT genotype, and serum miR-122 are predictors for SVR. Multivariate analysis specifically in IL-28B TT genotype demonstrated that pretreatment serum miR-122 independently predicted SVR. The validation cohort confirmed a significantly greater pretreatment serum miR-122 level in patients with SVR compared with NR (P = 0.025). In conclusion, serum miR-122 may serve as a surrogate of hepatic miR-122, and a higher pretreatment serum miR-122 level can help predict virologic responses to pegylated IFN plus ribavirin therapy.


Asunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/sangre , Interferón-alfa/uso terapéutico , MicroARNs/sangre , Polietilenglicoles/uso terapéutico , Adulto , Anciano , Biopsia , Índice de Masa Corporal , Estudios de Cohortes , Femenino , Genotipo , Hepatitis C Crónica/tratamiento farmacológico , Humanos , Hígado/metabolismo , Masculino , MicroARNs/metabolismo , Persona de Mediana Edad , Análisis Multivariante , Proteínas Recombinantes/uso terapéutico , Ribavirina/administración & dosificación , Factores de Tiempo , Resultado del Tratamiento
13.
Eur Arch Otorhinolaryngol ; 273(1): 245-50, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26156227

RESUMEN

We investigated the impact of fibrin glue on postoperative drainage amount and duration in head and neck cancer patients who underwent neck dissection. This study was a prospective randomized controlled trial. Patients who were scheduled to undergo neck dissection due to head and neck cancer were eligible for this study. After receiving a detailed explanation, all patients signed an informed consent form before enrollment. Patients were then randomly assigned to the study group (fibrin glue) or control group. In the study group, 2 ml of fibrin glue (Tissucol(®); Duploject, Baxter AG) was applied on the surface of the surgical wound before closure. Basic demographic data along with tumor-related features, operation-related variables, postoperative drainage amount/duration, postoperative pain, and analgesic usage were collected and analyzed. A total of 15 patients were included in the final analyses, with eight patients in the study group and seven patients in the control group. No significant differences were found between the two groups in age, gender, primary site, clinical N stage, neck dissection levels, perioperative bleeding, postoperative drainage amount/duration, hospitalization duration, and postoperative pain status. The application of 2 ml fibrin glue by the method described herein did not reduce the postoperative drainage amount/duration nor the postoperative pain status in patients who underwent neck dissection.


Asunto(s)
Adhesivo de Tejido de Fibrina/administración & dosificación , Neoplasias de Cabeza y Cuello , Disección del Cuello , Dolor Postoperatorio/prevención & control , Hemorragia Posoperatoria/prevención & control , Cicatrización de Heridas/efectos de los fármacos , Anciano , Femenino , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/cirugía , Humanos , Masculino , Persona de Mediana Edad , Disección del Cuello/efectos adversos , Disección del Cuello/métodos , Dolor Postoperatorio/diagnóstico , Hemorragia Posoperatoria/diagnóstico , Estudios Prospectivos , Adhesivos Tisulares/administración & dosificación , Resultado del Tratamiento
14.
Eur Arch Otorhinolaryngol ; 272(11): 3475-82, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25359197

RESUMEN

The aim of this study was to investigate the factors associated with infection at the recipient site of pectoralis major myocutaneous flap (PMMF) of head and neck cancer patients. We retrospectively reviewed head and neck cancer patients who underwent PMMF reconstruction and identified those with recipient site infection. Variables of patients with and without infection were compared and associated factors were investigated by logistic regression model. A total of 478 patients were included in the final analysis and 183 patients (38.3%) developed recipient site infection. Lower margin of skin island, concurrent tracheotomy, diabetes mellitus, mandibular plate reconstruction, prior radiation, and peri-operative blood transfusion were independent factors associated with recipient site infection of PMMF. Skin island of PMMF beyond the eighth intercostal space markedly increased the risk of recipient site infection after major head and neck cancer surgery. Recognition of relevant factors associated with infection may help surgeons to identify those at risk.


Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Colgajo Miocutáneo , Músculos Pectorales/trasplante , Infección de la Herida Quirúrgica/etiología , Adulto , Femenino , Humanos , Modelos Logísticos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo
15.
Hepatology ; 57(6): 2135-42, 2013 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-23322699

RESUMEN

UNLABELLED: Patients dually infected with hepatitis C virus (HCV)/hepatitis B virus (HBV) have a higher risk of developing advanced liver disease or hepatocellular carcinoma compared with monoinfected patients. Yet, there is a similar rate of sustained virologic response (SVR) after peginterferon alfa-2a and ribavirin combination therapy in these patients compared with HCV-monoinfected patients and a high hepatitis B surface antigen (HBsAg) seroclearance rate. The durability of hepatitis C and B clearance in coinfected patients was investigated in a 5-year follow-up study. Patients with active HCV genotype 1, both HBV-coinfected (n = 97) and HBV-monoinfected (n = 110), underwent 48-week combination therapy with peginterferon alfa-2a plus ribavirin. In patients with active HCV genotype 2 or 3, both HBV-coinfected (n = 64) and monoinfected (n = 50) patients underwent 24-week combination therapy. A total of 295 (91.9%) patients completed treatment and 24 weeks posttreatment follow-up; 264 (89.5%) patients agreed to receive additional follow-up for up to 5 years after the end of treatment. After a median follow-up of 4.6 ± 1.0 years, six of the 232 patients achieving SVR developed HCV RNA reappearance, including five HCV genotype 1/HBV-coinfected patients and one HCV genotype 2/3-monoinfected patient. Subgenomic analysis of the HCV core gene indicated that five patients developed delayed recurrence of HCV infection. Overall, the cumulative recurrence rate of HCV infection was 2.3% (0.4%/year; 95% confidence interval [CI], 0.9%-5.5%). The cumulative HBsAg seroclearance rate was 30.0% (95% CI, 21.5%-42.0%); with 33.1% (95% CI, 21.8%-50.1%) in the 48-week combination therapy group and 24.3% (95% CI, 13.7%-42.9%) in the 24-week therapy group. CONCLUSION: Peginterferon alfa-2a and ribavirin therapy provides good HCV SVR durability and a high accumulative HBsAg seroclearance rate in patients who are coinfected with HCV and HBV. (HEPATOLOGY 2013;).


Asunto(s)
Antivirales/uso terapéutico , Hepatitis B/tratamiento farmacológico , Hepatitis C/tratamiento farmacológico , Interferón-alfa/uso terapéutico , Polietilenglicoles/uso terapéutico , Ribavirina/uso terapéutico , Adulto , Carcinoma Hepatocelular/virología , Coinfección/complicaciones , Coinfección/tratamiento farmacológico , Coinfección/virología , Quimioterapia Combinada , Femenino , Estudios de Seguimiento , Hepatitis B/complicaciones , Hepatitis B/virología , Virus de la Hepatitis B/genética , Hepatitis C/complicaciones , Hepatitis C/virología , Humanos , Neoplasias Hepáticas/virología , Masculino , Persona de Mediana Edad , Mutación , Regiones Promotoras Genéticas , Proteínas Recombinantes/uso terapéutico , Recurrencia , Resultado del Tratamiento , Proteínas del Núcleo Viral/genética
16.
Environ Int ; 186: 108617, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38599027

RESUMEN

Microplastics (MPs) and nanoplastics (NPs) pollution has emerged as a significant and widespread environmental issue. Humans are inevitably exposed to MPs and NPs via ingestion, inhalation, and dermal contacts from various sources. However, mechanistic knowledge of their distribution, interaction, and potency in the body is still lacking. To address this knowledge gap, we have undertaken the task of elucidating the toxicokinetic (TK) behaviors of MPs and NPs, aiming to provide mechanistic information for constructing a conceptual physiologically based toxicokinetic (PBTK) model to support in silico modeling approaches. Our effort involved a thorough examination of the existing literature and data collation on the presence of MPs in the human body and in vitro/ex vivo/in vivo biodistribution across various cells and tissues. By comprehending the absorption, distribution, metabolism, and excretion mechanisms of MPs and NPs in relation to their physicochemical attributes, we established a foundational understanding of the link between external exposure and internal tissue dosimetry. We observed that particle size and surface chemistry have been thoroughly explored in previous experimental studies. However, certain attributes, such as polymer type, shape, and biofilm/biocorona, warrant attention and further examination. We discussed the fundamental disparities in TK properties of MPs/NPs from those of engineered nanoparticles. We proposed a preliminary PBTK framework with several possible modeling approaches and discussed existing challenges for further investigation. Overall, this article provides a comprehensive compilation of existing TK data of MPs/NPs, a critical overview of TK processes and mechanisms, and proposes potential PBTK modeling approaches, particularly regarding their applicability to the human system, and outlines future perspectives for developing PBTK models and their integration into human health risk assessment of MPs and NPs.


Asunto(s)
Microplásticos , Nanopartículas , Toxicocinética , Humanos , Microplásticos/toxicidad , Medición de Riesgo , Nanopartículas/química , Nanopartículas/toxicidad , Exposición a Riesgos Ambientales , Modelos Biológicos , Distribución Tisular , Tamaño de la Partícula
17.
Water Res ; 257: 121721, 2024 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-38728782

RESUMEN

Microplastics (MPs) waste is widespread globally in water systems. The opportunistic human pathogen Pseudomonas aeruginosa can cause serious acute and chronic infections that are notoriously difficult to treat. Ciprofloxacin (CIP) is broadly applied as an anti-P. aeruginosa drug. A growing evidence reveals that antibiotic-resistance genes-carrying Pseudomonas aeruginosa were detected on MPs forming plastisphere due to their adsorbability along with high occurrence of CIP in water environments. The MPs-niched CIP-resistant P. aeruginosa has been likely to emerge as an unignorable public health issue. Here, we offered a novel approach to assess the development of CIP-resistant P. aeruginosa under MPs-antibiotic coexistence at a water region scale. By combing the adsorption isotherm models used to estimate CIP condensation around MPs and a pharmacokinetic/pharmacodynamic-based microbial population dynamic model, we predicted the P. aeruginosa development on CIP-adsorbed MPs in waters. Our assessment revealed a high antibiotic resistance in the P. aeruginosa populations (∼50 %) with a wider range of waterborne total cell counts (∼10-2-104 cfu mL-1) among water regions in that the resistance proportion was primarily determined by CIP pollution level and relative abundance of various polymer type of MPs. We implicate that water region-specific MPs were highly likely to provide media for P. aeruginosa propagation. Our results highlight the importance of antibiotic-resistant pathogen colonization-emerging environmental medium interactions when addressing global threat from MPs pollution, in the context of MPs-antibiotics co-contamination assessment and for the continued provision of water system management.


Asunto(s)
Antibacterianos , Ciprofloxacina , Microplásticos , Pseudomonas aeruginosa , Pseudomonas aeruginosa/efectos de los fármacos , Ciprofloxacina/farmacología , Antibacterianos/farmacología , Contaminantes Químicos del Agua , Farmacorresistencia Bacteriana
18.
J Adhes Dent ; 26(1): 65-78, 2024 Jan 15.
Artículo en Alemán | MEDLINE | ID: mdl-38379400

RESUMEN

PURPOSE: Multiple materials are found in the root canal after fiber-post cementation. The layer of a bioceramic-based (BC) sealer may affect the bond strength (σBS) of the fiber post in the root canal. The purpose of this study was to employ multilayer compos-ite-disk models in diametral compression to investigate whether the bond strength between a fiber post and root dentin can be in-creased by the application of a primer on the BC sealer. MATERIALS AND METHODS: The multilayers of materials in the root canal required 3D finite-element (FE) stress analyses (FEA) to pro-vide precise σBS values. First, BC sealer was characterized using x-ray powder diffraction (XRD) to determine when the sealer com-pletely set and the types of crystals formed to select which primer to apply to the sealer. We selected a 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-based primer to treat the BC sealer before post cementation. Ultra-highspeed (UHS) imaging was utilized to analyze the crack initiation interface. The obtained failure force was used in FE analysis to calculate σBS. RESULTS: UHS imaging validated the fracture interface at the post-dentin junction as FEA simulations predicted. σBS values of the fiber posts placed with various material combinations in the root canal were 21.1 ± 3.4 (only cement/ post), 22.2 ± 3.4 (BC sealer/cement/post) and 28.6 ± 4.3 MPa (10-MDP primer treated BC sealer/cement/post). The 10-MDP-treated BC sealer exhibited the highest σBS (p < 0.05). CONCLUSION: The multilayer composite disk model proved reliable with diametral compression testing. The presence of BC sealer in the root canal does not reduce σBS of the fiber post. Conditioning the BC sealer layer with 10-MDP primer before fiber-post cemen-tation increases σBS.


Asunto(s)
Recubrimiento Dental Adhesivo , Metacrilatos , Materiales de Obturación del Conducto Radicular , Materiales de Obturación del Conducto Radicular/química , Materiales de Obturación del Conducto Radicular/farmacología , Resinas Epoxi/química , Resinas Epoxi/farmacología , Cavidad Pulpar , Ensayo de Materiales , Dentina
19.
ACS Appl Mater Interfaces ; 16(1): 1502-1510, 2024 Jan 10.
Artículo en Inglés | MEDLINE | ID: mdl-38147587

RESUMEN

Development of rapid detection strategies that target potentially pathogenic bacteria has gained increasing attention due to the increasing awareness for better health and safety. In this study, we evaluate an intrinsically antimicrobial polymer, 2Gdm, which is a poly(norbornene)-based functional polymer featuring guanidinium groups as side chains, for bacterial detection by the means of triboelectric nanogenerators (TENGs) and triboelectric nanosensors (TENSs). Attachment of bacteria to the sensing layer is anticipated to alter the overall triboelectric properties of the underlying polymer layer. The positively charged guanidinium functional groups can interact with the negatively charged phospholipid bilayer of bacteria and lead to bacterial death, which can then be detected by optical microscopy, X-ray photoelectron microscopy, and more advanced self-powered sensing techniques such as TENGs and TENSs. The double bonds present along the poly(norbornene) backbone allow for thermally induced cross-linking to obtain X-2Gdm and thus rendering materials remain stable in water. By monitoring the change in voltage output after immersion in various concentrations of Gram-negative Escherichia coli (E. coli) and Gram-positive Streptococcus pneumoniae (S. pneumoniae), we have demonstrated the utility of X-2Gdm as a new polymer dielectric for autonomous bacterial detection. As the bacterial concentration increases, the amount of adsorbed bacteria also increases, resulting in a decrease in the surface potential of the X-2Gdm thin film; this reduction in surface potential can cause a decrease in the triboelectric output for both TENGs and TENSs, which serves as a key working mechanism for facile bacterial detection. TENG and TENS systems are capable of detecting E. coli and S. pneumoniae within a range of 4 × 105 to 4 × 108 CFU/mL with a limit of detection of 106 CFU/mL. This report highlights the promising prospects of employing TENGs and TENSs as innovative sensing technologies for rapid bacterial detection by leveraging the electrostatic interactions between bacterial cell membranes and cationic groups present on polymer surfaces.


Asunto(s)
Bacterias , Escherichia coli , Guanidina , Norbornanos , Poli A , Polímeros , Streptococcus pneumoniae
20.
Occup Environ Med ; 70(5): 357-9, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23322914

RESUMEN

RATIONALE AND OBJECTIVES: Obliterative bronchiolitis (OB) is a rare disease with a small number of established occupational aetiologies. We describe a case series of severe OB in workers making glass-reinforced plastics. METHODS: Workplace exposures were the likely cause after the independent diagnosis of OB in two workers laying up the fibreglass hulls of yachts; the second worker took over the job of the first after he left following a lung transplant. Presentation of these two cases at international meetings led to others identifying similar workers. MAIN RESULTS: We identified six workers with good evidence of OB. All were involved in preparing fibreglass with styrene resins, five as boat builders laying up fibreglass hulls and one during cooling-tower fabrication. The disease came on rapidly without unusual acute exposures. Two patients had lung transplants, while another died while waiting for one. Histology confirmed OB in the four with biopsies/post-mortem examinations or explanted lungs. CONCLUSIONS: A rare, potentially fatal disease occurring in six workers laying up fibreglass with styrene resins from five different worksites suggests that work exposures were the cause of their OB. The precise agent responsible awaits identification.


Asunto(s)
Bronquiolitis Obliterante/inducido químicamente , Materiales de Construcción/efectos adversos , Vidrio , Enfermedades Profesionales/inducido químicamente , Exposición Profesional/efectos adversos , Resinas Sintéticas/efectos adversos , Estireno/efectos adversos , Adulto , Contaminantes Ocupacionales del Aire/efectos adversos , Autopsia , Bronquiolitis Obliterante/patología , Bronquiolitis Obliterante/cirugía , Resultado Fatal , Humanos , Exposición por Inhalación/efectos adversos , Pulmón/efectos de los fármacos , Pulmón/patología , Trasplante de Pulmón , Masculino , Persona de Mediana Edad , Enfermedades Profesionales/patología , Enfermedades Profesionales/cirugía , Ocupaciones , Plásticos , Índice de Severidad de la Enfermedad , Navíos
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