Evaluation of EGCG Loading Capacity in DMPC Membranes.

Catechins are molecules with potential use in different pathologies such as diabetes and cancer, but their pharmaceutical applications are often hindered by their instability in the bloodstream. This issue can be circumvented using liposomes as their nanocarriers for in vivo delivery. In this work, we studied the molecular details of (-)-epigallocatechin-3-gallate (EGCG) interacting with 1,2-dimyristoyl- sn-glycero-3-phosphocholine (DMPC) monolayer/bilayer systems to understand the catechin loading ability and liposome stability, using experimental and computational techniques. The molecular dynamics simulations show the EGCG molecules deep inside the lipid bilayer, positioned below the lipid ester groups, generating a concentration-dependent lipid condensation. This effect was also inferred from the surface pressure isotherms of DMPC monolayers. In the polarization-modulated infrared reflection absorption spectra assays, the predominant effect at higher concentrations of EGCG (e.g., 20 mol %) was an increase in lipid tail disorder. The steady-state fluorescence data confirmed this disordered state, indicating that the catechin-induced liposome aggregation outweighs the condensation effects. Therefore, by adding more than 10 mol % EGCG to the liposomes, a destabilization of the vesicles occurs with the ensuing release of entrapped catechins. The loading capacity for DMPC seems to be limited by its disordered lipid arrangements, typical of a fluid phase. To further increase the clinical usefulness of liposomes, lipid bilayers with more stable and organized assemblies should be employed to avoid aggregation at large concentrations of catechin.

Neural stem cell differentiation by electrical stimulation using a cross-linked PEDOT substrate: Expanding the use of biocompatible conjugated conductive polymers for neural tissue engineering.

BACKGROUND: The use of conjugated polymers allows versatile interactions between cells and flexible processable materials, while providing a platform for electrical stimulation, which is particularly relevant when targeting differentiation of neural stem cells and further application for therapy or drug screening. METHODS: Materials were tested for cytotoxicity following the ISO10993-5. PEDOT: PSS was cross-linked. ReNcellVM neural stem cells (NSC) were seeded in laminin coated surfaces, cultured for 4 days in the presence of EGF (20 ng/mL), FGF-2 (20 ng/mL) and B27 (20 µg/mL) and differentiated over eight additional days in the absence of those factors under 100Hz pulsed DC electrical stimulation, 1V with 10 ms pulses. NSC and neuron elongation aspect ratio as well as neurite length were assessed using ImageJ. Cells were immune-stained for Tuj1 and GFAP. RESULTS: F8T2, MEH-PPV, P3HT and cross-linked PEDOT: PSS (x PEDOT: PSS) were assessed as non-cytotoxic. L929 fibroblast population was 1.3 higher for x PEDOT: PSS than for glass control, while F8T2 presents moderate proliferation. The population of neurons (Tuj1) was 1.6 times higher with longer neurites (73 vs 108 µm) for cells cultured under electrical stimulus, with cultured NSC. Such stimulus led also to longer neurons. CONCLUSIONS: x PEDOT: PSS was, for the first time, used to elongate human NSC through the application of pulsed current, impacting on their differentiation towards neurons and contributing to longer neurites. GENERAL SIGNIFICANCE: The range of conductive conjugated polymers known as non-cytotoxic was expanded. x PEDOT: PSS was introduced as a stable material, easily processed from solution, to interface with biological systems, in particular NSC, without the need of in-situ polymerization.

Heparinized Acellular Hydrogels for Magnetically Induced Wound Healing Applications.

The control of angiogenesis has the potential to be used for regulation of several pathological and physiological processes, which can be instrumental on the development of anticancer and wound healing therapeutical approaches. In this study, mesenchymal stem/stromal cells (MSCs) were seeded on magnetic-responsive gelatin, with or without heparin functionalization, and exposed to a static 0.08 T magnetic field (MF), for controlling their anti-inflammatory and angiogenic activity, with the aim of accelerating tissue healing. For the first time, it was examined how the amount of heparin and magnetic nanoparticles (MNPs) distributed on gelatin scaffolds affected the mechanical properties of the hydrogels and the morphology, proliferation, and secretome profiling of MSCs. The findings demonstrated that the addition of MNPs and heparin affects the hydrogel swelling capacity and renders distinct MSC proliferation rates. Additionally, MF acts as a topographical cue to guide MSCs alignment and increases the level of expression of specific genes and proteins that promote angiogenesis. The results also suggested that the presence of higher amounts of heparin (10 µg/cm3) interferes with the secretion and limits the capacity of angiogenic factors to diffuse through the hydrogel and into the culture medium. Ultimately, this study shows that acellular heparinized hydrogels efficiently retain the angiogenic growth factors released by magnetically stimulated MSCs thus rendering superior wound contraction (55.8% ± 0.4%) and cell migration rate (49.4% ± 0.4%), in comparison to nonheparinized hydrogels (35.2% ± 0.7% and 37.8% ± 0.7%, respectively). Therefore, these heparinized magnetic hydrogels can be used to facilitate angiogenesis in various forms of tissue damage including bone defects, skin wounds, and cardiovascular diseases, leading to enhanced tissue regeneration.

Effectiveness of a group education session on adherence with APAP in obstructive sleep apnea--a randomized controlled study.

PURPOSE: Auto-titrating continuous positive airway pressure (APAP) is an effective treatment for obstructive sleep apnea/hypopnea syndrome (OSAHS). We investigated whether a single group education session on APAP therapy is effective in promoting adherence among patients with OSAHS. METHODS: This prospective, randomized, controlled, parallel group study included patients newly diagnosed with OSAHS who met criteria for APAP therapy. Patients were randomized into a study group and a control group. All patients in the study group were assigned to a single group education session, 1 month after beginning APAP therapy. RESULTS: We evaluated 146 patients. The median percentage of APAP usage days was 88.3 %, with a median duration per day of use of 6.02 h; 59 % were classified as adherent. Overall, no significant difference in adherence was seen between the study and the control groups. Analyzing patient subgroups, the group session significantly improved APAP adherence among males and patients who were younger (<65 years old), obese (BMI ≥ 35 kg/m(2)), non-sleepy (Epworth sleepiness scale ≤ 11), smokers or past smokers, had hypertension or nocturia and those with non-severe OSAHS. CONCLUSION: To maximize the impact of group education sessions and, by that, saving resources, it may be important to select patients likely to benefit from these sessions.

Magnetic-Responsive Liposomal Hydrogel Membranes for Controlled Release of Small Bioactive Molecules-An Insight into the Release Kinetics.

This work explores the unique features of magnetic-responsive hydrogels to obtain liposomal hydrogel delivery platforms capable of precise magnetically modulated drug release based on the mechanical responses of these hydrogels when exposed to an external magnetic field. Magnetic-responsive liposomal hydrogel delivery systems were prepared by encapsulation of 1,2-dipalmitoyl-sn-glycero-3-phosphocoline (DPPC) multilayered vesicles (MLVs) loaded with ferulic acid (FA), i.e., DPPC:FA liposomes, into gelatin hydrogel membranes containing dispersed iron oxide nanoparticles (MNPs), i.e., magnetic-responsive gelatin. The FA release mechanisms and kinetics from magnetic-responsive liposomal gelatin were studied and compared with those obtained with conventional drug delivery systems, e.g., free liposomal suspensions and hydrogel matrices, to access the effect of liposome entrapment and magnetic field on FA delivery. FA release from liposomal gelatin membranes was well described by the Korsmeyer-Peppas model, indicating that FA release occurred under a controlled diffusional regime, with or without magnetic stimulation. DPPC:FA liposomal gelatin systems provided smoother controlled FA release, relative to that obtained with the liposome suspensions and with the hydrogel platforms, suggesting the promising application of liposomal hydrogel systems in longer-term therapeutics. The magnetic field, with low intensity (0.08 T), was found to stimulate the FA release from magnetic-responsive liposomal gelatin systems, increasing the release rates while shifting the FA release to a quasi-Fickian mechanism. The magnetic-responsive liposomal hydrogels developed in this work offer the possibility to magnetically activate drug release from these liposomal platforms based on a non-thermal related delivery strategy, paving the way for the development of novel and more efficient applications of MLVs and liposomal delivery systems in biomedicine.

EGFR exon mutation distribution and outcome in non-small-cell lung cancer: a Portuguese retrospective study.

Epidermal growth factor receptor (EGFR) mutations play a predictive role in advanced stages of non-small-cell lung cancer (NSCLC) patients. We conducted this study in order to assess EGFR status in a Portuguese population and its role in NSCLC patients' outcomes. Patients were submitted to EGFR assessment by high-resolution melting and/or direct sequencing. Kaplan-Meier curve was used to assess overall survival and progression-free survival (PFS). Two hundred forty eight out of 322 participants were assessed for EGFR status. Forty-two patients (16.9 %) presented EGFR-mutated status: one patient (2.4 %) presented exon 18; 21 patients (50 %), exon 19; one patient (2.4 %), exon 20; and 18 patients (45.2 %), exon 21 mutations, p < 0.001. PFS was not assessed (n.a.) for patient with exon 18 mutation, and for the other patients with mutations, it was 7 months (3.96-10.03) (exon 19), <1 month (exon 20), and 7 months (0-14.2) (exon 21) (p = 0.027). Overall survival (OS) was 11 months (exon 18), 11 months (1-18) (exon 19), 1 month (exon 20), and 7.5 months (2-70) (exon 21) (p = n.a). This study suggests that the EGFR mutation is herein observed in a higher proportion than expected for a Caucasian population, and OS is a little less than that published in the literature.

Association between EGF +61 genetic polymorphisms and non-small cell lung cancer increased risk in a Portuguese population: a case-control study.

Epidermal growth factor (EGF) and its receptor play critical roles in non-small cell lung cancer (NSCLC) carcinogenesis. A functional polymorphism in the EGF gene has been linked to increased cancer susceptibility. This study aimed to evaluate the role of the EGF +61A/G polymorphism as risk factors in NSCLC patients. For the present case-control study, we analyzed 112 NSCLC and 126 cancer-free controls from Portugal. Following DNA isolation from peripheral blood, EGF +61A/G polymorphism was assessed by polymerase chain reaction-restriction fragment length polymorphism. Univariate and multivariate logistic regression analyses were used to calculate odds ratio (OR) and 95 % confidence intervals (95 % CI). False-positive report probability was also assessed. The EGF +61 genotypes frequencies in NSCLC were AA (23.2 %), AG (51.8 %), and GG (25 %) and in controls, AA (40.5 %), AG (41.3 %), and GG (18.3 %). When compared to the reference genotype (EGF +61A/A), we found a statistically significant association between EGF +61 A/G (OR = 2.142, 95 % CI 1.170-3.924) and EGF +61G/G (OR = 2.398, 95 % CI 1.157-4.968) genotypes and susceptibility to development of NSCLC. Furthermore, stratification by sex revealed a trend to increased risk of males carrying +61A/G genotype for developing NSCLC (OR = 2.044, 95 % CI 0.998-4.188) when compared to A/A genotype. Our data suggest an increased risk to develop NSCLC in Portuguese population carrying the EGF +61A/G and +61G/G genotypes.

Traumatic Isolated Thumb Carpometacarpal Joint Dislocation - Report of Two Clinical Cases.

Isolated thumb carpometacarpal joint dislocation is a rare lesion that accounts for less than 1% of all hand lesions. The authors present two cases of traumatic isolated thumb carpometacarpal joint dislocation. One of them was treated with closed reduction and cast immobilization, and the other was treated with closed reduction, Kirschner-wires pinning, and cast immobilization. The first patient had a good functional outcome and showed no signs of thumb carpometacarpal instability. The patient treated with Kirschner wires presented signs of clinical instability and radiological subluxation. Isolated thumb carpometacarpal dislocation is a rare lesion that can cause joint instability, which interferes with the normal function of the hand and can lead to articular degenerative changes. The best management of this lesion is still controversial, since there is lack of evidence in the literature showing superiority of one treatment over the other.

The impact of blue light in monolayers representing tumorigenic and nontumorigenic cell membranes containing epigallocatechin-3-gallate.

Natural products such as epigallocatechin-3-gallate (EGCG) have been suggested for complementary treatments of cancer, since they lower toxic side effects of anticancer drugs, and possess anti-inflammatory and antioxidant properties that inhibit carcinogenesis. Their effects on cancer cells depend on interactions with the membrane, which is the motivation to investigate Langmuir monolayers as simplified membrane models. In this study, EGCG was incorporated in zwitterionic dipalmitoyl phosphatidyl choline (DPPC) and anionic dipalmitoyl phosphatidyl serine (DPPS) Langmuir monolayers to simulate healthy and cancer cells membranes, respectively. EGCG induces condensation in surface pressure isotherms for both DPPC and DPPS monolayers, interacting mainly via electrostatic forces and hydrogen bonding with the choline and phosphate groups of the phospholipids, according to data from polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS). Both monolayers become more compressible upon interaction with EGCG, which may be correlated to the synergy between EGCG and anticancer drugs reported in the literature. The interaction with EGCG is stronger for DPPC, leading to stronger morphological changes in Brewster angle microscopy (BAM) images and higher degree of condensation in the surface pressure isotherms. The changes induced by blue irradiation on DPPC and DPPS monolayers were largely precluded when EGCG was incorporated, thus confirming its antioxidant capacity for both types of membrane.

Effect of blue light irradiation on the stability of phospholipid molecules in the presence of epigallocatechin-3-gallate.

In this paper, we report on the effects from epigallocatechin-3-gallate (EGCG), a phytochemical flavonoid present in green tea, on Langmuir monolayers of 1,2-dipalmitoyl-sn-glycero-3-[phospho-rac-(1-glycerol) (sodium salt) (DPPG), including experiments with blue light irradiation. EGCG was found to interact with both the DPPG headgroups and hydrophobic tails, thus affecting the lipid packing according to surface pressure and surface potential isotherms and polarization-modulated infrared reflection absorption spectroscopy (PM-IRRAS) data. Blue light irradiation caused considerable changes in the surface pressure isotherms and PM-IRRAS spectra of DPPG monolayers, but the effects were considerably less when EGCG was present. For the surface pressure isotherms, for instance, no irradiation effect could be measured for mixed EGCG-DPPG monolayers. It is concluded that EGCG protected the DPPG molecules from degrading upon blue light irradiation, which means that EGCG may be a preventive and therapeutic agent to decrease photosensitivity of phospholipids to blue light oxidative damage, a pathogenic mechanism in skin disorders.

On the role of epigallocatechin-3-gallate in protecting phospholipid molecules against UV irradiation.

Catechin molecules such as epigallocatechin-3-gallate (EGCG) are capable of attenuating the biomolecular damage induced by UV radiation, possibly through molecular mechanisms involving the cell membranes. In this study, we confirmed the protective role of EGCG against UV of 1,2-dipalmitoyl-sn-glycero-3-[phospho-rac-(1-glycerol) (sodium salt) (DPPG) in liposomes and cast films. The incorporation of EGCG increased the stability of DPPG liposomes as indicated by UV-vis absorption spectra. Using 2D correlation spectroscopy to analyse the spectra, we found that DPPG and EGCG are co-helpers and complement each other against degradation induced by UV. At the molecular level, UV irradiation affects the phosphate and carbonyl groups of DPPG, in addition to triggering the oxidation and opening of the pyrogallol ring of EGCG. Since EGCG can be incorporated into liposomes and is a strong shield against UV radiation, one may envisage its use in anti-ageing and sunscreen creams, and in dermal drug delivery.

Polycaprolactone/Gelatin Nanofiber Membranes Containing EGCG-Loaded Liposomes and Their Potential Use for Skin Regeneration.

Polymeric scaffolds incorporating plant-derived compounds, produced by electrospinning, have attracted attention in the field of skin tissue engineering. This study evaluates the sustained antioxidant activity of polycaprolactone (PCL)/gelatin nanofibers prepared by electrospinning and incorporating loaded liposomes of epigallocatechin-3-gallate (EGCG), a strong antibacterial and antioxidant molecule found in green tea, that significantly accelerates the wound-healing process. The morphology and the structural properties of the membranes were characterized by scanning electron microscopy (SEM) and FTIR spectroscopy. Results revealed that the EGCG released from PCL+gelatin nanofibers scavenges the toxic ROS species generated by exposure to either H2O2 or UV radiation and slows down the oxidation events associated with damage. This study provides the basis for development of promising nanofiber formulations containing EGCG that might enhance repair/regeneration of skin tissue.

Traumatic Isolated Thumb Carpometacarpal Joint Dislocation - Report of Two Clinical Cases / Luxação traumática isolada da articulação trapéziometacárpica - Relato de dois casos clínicos

Abstract Isolated thumb carpometacarpal joint dislocation is a rare lesion that accounts for less than 1% of all hand lesions. The authors present two cases of traumatic isolated thumb carpometacarpal joint dislocation. One of them was treated with closed reduction and cast immobilization, and the other was treated with closed reduction, Kirschner-wires pinning, and cast immobilization. The first patient had a good functional outcome and showed no signs of thumb carpometacarpal instability. The patient treated with Kirschner wires presented signs of clinical instability and radiological subluxation. Isolated thumb carpometacarpal dislocation is a rare lesion that can cause joint instability, which interferes with the normal function of the hand and can lead to articular degenerative changes. The best management of this lesion is still controversial, since there is lack of evidence in the literature showing superiority of one treatment over the other.

Resumo A luxação traumática isolada da articulação trapézio-metacárpica é uma lesão rara que faz parte de menos de 1% de todas as lesões de mãos. Os autores apresentam dois casos de luxação traumática isolada da articulação trapézio-metacárpica. Um dos casos foi tratado com redução fechada e imobilização com gesso, e o outro foi tratado com redução fechada, fixação com fios Kirschner, e imobilização com gesso. O primeiro paciente teve um bom resultado funcional e não mostrou sinais de instabilidade trapeziometacarpal. O paciente tratado com fios Kirschner apresentou sinais de instabilidade clínica e subluxação radiológica. A luxação isolada da articulação trapeziometacarpal é uma lesão rara que pode causar instabilidade articular que interfere com a funcionalidade normal da mão e pode resultar em mudanças articulares degenerativas. O melhor manejo dessa lesão ainda é controverso, já que ainda faltam evidências na literatura que mostrem a superioridade de um tratamento em relação ao outro.

Acute fibrinous and organizing pneumonia: A report of 13 cases in a tertiary university hospital.

INTRODUCTION: Acute fibrinous and organizing pneumonia (AFOP) is a rare diffuse pulmonary disease, but it is not yet known whether it is a distinct form of interstitial pneumonia or simply a reflection of a tissue sampling issue. METHODS: Cross-sectional evaluation of clinical and radiological findings, treatments, and outcomes for patients with histologically confirmed AFOP at a tertiary university hospital between 2002 and 2015. RESULTS: Thirteen patients (7 women, 53.8%) with a mean ±â€ŠSD age of 53.5 ±â€Š16.1 years were included. The main symptoms were fever (69.2%), cough (46.2%), and chest pain (30.8%). All patients presented a radiological pattern of consolidation and 5 (38.5%) had simultaneous ground-glass areas. Histology was obtained by computed tomography-guided transthoracic biopsy in 61.5% of cases and by surgical lung biopsy in the remaining cases. Several potential etiologic factors were identified. Eight patients (61.5%) had hematologic disorders and 3 had undergone an autologous hematopoietic cell transplant. Two (15.4%) had microbiologic isolates, 5 (38.4%) had drug-induced lung toxicity, and 2 (15.4%) were classified as having idiopathic AFOP. In addition to antibiotics and diuretics used to treat the underlying disease, the main treatment was corticosteroids, combined in some cases with immunosuppressants. Median survival was 78 months and 6 patients (46.2%) were still alive at the time of analysis. CONCLUSION: Our findings for this series of patients confirm that AFOP is a nonspecific reaction to various agents with a heterogeneous clinical presentation and clinical course that seems to be influenced mainly by the severity of the underlying disorder.

The impact of polymorphic variations in the 5p15, 6p12, 6p21 and 15q25 Loci on the risk and prognosis of portuguese patients with non-small cell lung cancer.

INTRODUCTION: Polymorphic variants in the 5p15, 6p12, 6p21, and 15q25 loci were demonstrated to potentially contribute to lung cancer carcinogenesis. Therefore, this study was performed to assess the role of those variants in non-small cell lung cancer (NSCLC) risk and prognosis in a Portuguese population. MATERIALS AND METHODS: Blood from patients with NSCLC was prospectively collected. To perform an association study, DNA from these patients and healthy controls were genotyped for a panel of 19 SNPs using a Sequenom® MassARRAY platform. Kaplan-Meier curves were used to assess the overall survival (OS) and progression-free survival (PFS). RESULTS: One hundred and forty-four patients with NSCLC were successfully consecutively genotyped for the 19 SNPs. One SNP was associated with NSCLC risk: rs9295740 G/A. Two SNPs were associated with non-squamous histology: rs3024994 (VEGF intron 2) T/C and rs401681 C/T. Three SNPs were associated with response rate: rs3025035 (VEGF intron 7) C/T, rs833061 (VEGF -460) C/T and rs9295740 G/A. One SNP demonstrated an influence on PFS: rs401681 C/T at 5p15, p = 0.021. Four SNPs demonstrated an influence on OS: rs2010963 (VEGF +405 G/C), p = 0.042; rs3025010 (VEGF intron 5 C/T), p = 0.047; rs401681 C/T at 5p15, p = 0.046; and rs31489 C/A at 5p15, p = 0.029. CONCLUSIONS: Our study suggests that SNPs in the 6p12, 6p21, and 5p15 loci may serve as risk, predictive and prognostic NSCLC biomarkers. In the future, SNPs identified in the genomes of patients may improve NSCLC screening strategies and therapeutic management as well.