Prostate tissue ablation and drug delivery by an image-guided injectable ionic liquid in ex vivo and in vivo models.

Benign prostatic hyperplasia and prostate cancer are often associated with lower urinary tract symptoms, which can severely affect patient quality of life. To address this challenge, we developed and optimized an injectable compound, prostate ablation and drug delivery agent (PADA), for percutaneous prostate tissue ablation and concurrently delivered therapeutic agents. PADA is an ionic liquid composed of choline and geranic acid mixed with anticancer therapeutics and a contrast agent. The PADA formulation was optimized for mechanical properties compatible with hand injection, diffusion capability, cytotoxicity against prostate cells, and visibility of an x-ray contrast agent. PADA also exhibited antibacterial properties against highly resistant clinically isolated bacteria in vitro. Ultrasound-guided injection, dispersion of PADA in the tissue, and tissue ablation were tested ex vivo in healthy porcine, canine, and human prostates and in freshly resected human tumors. In vivo testing was conducted in a murine subcutaneous tumor model and in the canine prostate. In all models, PADA decreased the number of viable cells in the region of dispersion and supported the delivery of nivolumab throughout a portion of the tissue. In canine survival experiments, there were no adverse events and no impact on urination. The injection approach was easy to perform under ultrasound guidance and produced a localized effect with a favorable safety profile. These findings suggest that PADA is a promising therapeutic prostate ablation strategy to treat lower urinary tract symptoms.

Distribution of genetically characterized yeasts and its antifungals susceptibility in the hospital environment.

Candida spp. is one of the main pathogens associated with nosocomial infection in Brazil and worldwide. The aim of this study was to evaluate the distribution of Candida yeasts in the ICU and their susceptibility to the antifungal agents terbinafine and fluconazole. The samples were collected by swabbing nine surfaces in the ICU of a hospital located in Pelotas, RS. These isolates were genetically characterized by sequencing the internal transcript spacer (ITS) using the primers ITS1 and ITS4. The test against antifungals was performed by Microdilution in Broth (CLSI-M27-A4). 64 yeasts identified as Candida parapsilosis (45.31%; n = 29), Meyerozyma (Pichia) guilliermondii (28.12%; n = 18), Claviceps lusitaneae (25%; n = 16) and Candida tropicalis (1, 56%; n = 1) mostly at the counter used for handling medicines and food distribution (68.75%; n = 44). Susceptibility to antifungals varied between species. These results describe potentially pathogenic Candida species as contaminants in the ICU environment. The study environment is a potential source of exogenous infection for hospitalized patients.

Use of single-cannula venous-venous extracorporeal life support in the management of life-threatening airway obstruction.

The use of venous-venous extracorporeal life support (VV ECLS) for the endoscopic management of airway obstruction has been rarely reported. In most instances, ECLS has been used in the setting of cardiopulmonary resuscitation in which venoarterial ECLS was initiated as part of resuscitation. We report a patient with a bulky primary tumor of the tracheal carina presenting with airway obstruction who was managed with intraoperative single-cannula VV ECLS to facilitate endoscopic interventions leading to more definitive airway security.