The increased demand for vascular grafts for the treatment of cardiovascular diseases has led to the search for novel biomaterials that can achieve the properties of the tissue. According to this, the investigation of polyurethanes has been a promising approach to overcome the present limitations. However, some biological properties remain to be overcome, such as thrombogenicity and hemocompatibility, among others. This paper aims to synthesize polyurethanes based on castor oil and castor oil transesterified with triethanolamine (TEA) and pentaerythritol (PE) and with the incorporation of 1% chitosan. Analysis of the wettability, enzymatic degradation, mechanical properties (tensile strength and elongation at break), and thermal stability was performed. Along with the evaluation of the cytotoxicity against mouse fibroblast (L929) and human dermal fibroblast (HDFa) cells, the hemolysis rate and platelet adhesion were determined. The castor-oil-based polyurethanes with and without 1% chitosan posed hydrophobic surfaces and water absorptions of less than 2% and enzymatic degradation below 0.5%. Also, they were thermally stable until 300 °C, with tensile strength like cardiovascular tissues. The synthesized castor oil/chitosan polyurethanes are non-cytotoxic (cell viabilities above 80%) to L929 and HDFa cells and non-thrombogenic and non-hemolytic (less than 2%); therefore, they are suitable for cardiovascular applications.
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Public Health , Pulmonary Disease, Chronic Obstructive , Humans , Physical Therapy Modalities , Muscles
Dressings made with polyurethanes have been found to exhibit good and varied biological properties that make them good candidates for this application. However, as has been seen, the wound-healing process is complex, which includes four different stages. So far, the design and evaluation of polyurethane for wound dressing has focused on achieving good properties (mechanical, physicochemical, and biological), but each of them separates from the others or even directed at only one of the stages of skin wound-healing. Therefore, the aim of this systematic review is to explore the applications of polyurethanes in wound dressings and to determine whether could be designed to cover more than one stage of skin wound-healing. The PRISMA guidelines were followed. The current research in this field does not consider each stage separately, and the design of polyurethane dressings is focused on covering all the stages of wound healing with a single material but is necessary to replace polyurethanes in short periods of time. Additionally, little emphasis is placed on the hemostasis stage and further characterization of polyurethanes is still needed to correlate mechanical and physicochemical properties with biological properties at each stage of the wound-healing. Current research demonstrates an effort to characterize the materials physiochemically and mechanically, but in terms of their biological properties, most of the literature is based on the performance of histological tests of explants morphologically probing the compromised tissues, which give an indication of the potential use of polyurethanes in the generation of wound-healing dressings.
Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous disease, with pulmonary and extrapulmonary manifestations, which leads to the need to personalize the assessment and treatment of these patients. The latest updates of national and international guidelines for the management of COPD reveal the importance of respiratory rehabilitation (RR) and its role in improving symptoms, quality of life, and psychosocial sphere of patients. Within RR, the inspiratory muscle training (IMT) has received special interest, showing benefits in maximum inspiratory pressure, perception of well-being, and health status in patients with chronic heart disease, respiratory diseases, and dyspnea during exercise. The aim of this review is to assess the efficacy of IMT in COPD patients through the use of inspiratory muscle training devices, compared with respiratory rehabilitation programs without inspiratory muscle training. In the last years, many mechanical devices focused on inspiratory muscle training have been developed, some of them, such as the AirOFit PRO™, PowerBreath®, or FeelBreathe®, have shown clear benefits. The active search for candidate patients to undergo the RR program with inspiratory muscle training using this type of device in COPD patients represents an advance in the treatment of this disease, with direct benefits on the quality of life of the patients. In this article, we review the available evidence on IMT in these patients and describe the different devices used for it.
Pulmonary Disease, Chronic Obstructive , Respiratory Muscles , Breathing Exercises , Exercise Tolerance/physiology , Humans , Quality of Life , Respiratory Muscles/physiology
The appropriate titration for the personalized oxygen needs of patients with chronic obstructive pulmonary disease (COPD) and severe hypoxemia is a determining factor in the success of long-term oxygen therapy. There are no standardized procedures to assist in determining the patient's needs during the physical activities of daily life. Despite that effort tests are a wide broad approach, further research concerning the development of protocols to titrate O2 therapy is needed. The main objective of this study was to assess whether the level of oxygen titrated through the 6-minute walking test (6MWT) for patients with COPD and exertional hypoxemia is adequate to meet the patients' demand during their activities of daily living. Physiological and subjective variables were estimated for a study population during two walking tests: a 6MWT and a 20-minute walking circuit (20MWC), designed ad-hoc to reproduce daily physical activities more truthfully. The results indicate that in a significant proportion of patients, the 6MWT might not accurately predict their oxygen needs at a domiciliary environment. Therefore, the titration of the portable O2 therapy could not be optimal in these cases, with the detrimental impact on the patient's health (hyperoxia episodes), the autonomy of the oxygen device, and the decrease of time out of the home.
Polyurethanes (PUs) from Polyethylene glycol (PEG) and polycaprolactone diol (PCL) and a crosslinker, Pentaerythritol (PE), were synthetized with isophorone diisocyanate (IPDI). In this study, we investigated the effect of polyol and crosslinker composition on phase separation and thermo-mechanical properties. The properties were studied through dynamic mechanical analysis, X-ray scattering, atomic force microscopy (AFM), and thermogravimetric analysis (TGA). The results showed changes in PUs properties, microphase structure, and separation due to the composition of polyol/crosslinker blend. So, the largest concentration of PE produced multimodal loss factor patterns, indicating segment segregation while PUs with a PEG/PCL = 1 displayed a monomodal loss factor pattern, indicating a homogeneously distributed microphase separation. Additionally, the increase of the PEG concentration enhanced the damping capacity. On the other hand, agglomeration and thread-like structures of hard segments (HS) were observed through AFM. Finally, the thermal behavior of PUs was affected by chemical composition. Lower concentration of PE reduced the crosslinking; hence, the temperature with the maximum degradation rate.
Three Streptomyces strains isolated from Guaviare sediments (Colombia, South America) with cytotoxic activity against prostate cancer (PC3), breast cancer (MDA-MB-231), and lung cancer (A549) line cells were studied. The present investigation reveals the enhancement of the cytotoxic activity evaluating different values of pH, carbon sources (sucrose, glucose, xylose, maltose, and starch), and nitrogen sources (malt extract, yeast extract, meat extract, peptone, and potassium nitrate). Based on the response surface methodology, the isolates Streptomyces aburaviensis (73) had the maximum activity for lung cancer (IC50= 25.00 ± 1.86 ppm) with 4% of yeast extract, 3% of starch, and a pH value of 7. Streptomyces gramineus (386) had the maximum activity against prostate cancer (IC50= 6.14 ± 2.07 ppm) with 5% of malt extract, 3% of glucose, and a pH value of 6. Finally, Streptomyces psammoticus (519) had the maximum activity against breast cancer (IC50= 35.53 ± 2.71 ppm) with 1% of yeast extract, 4% of starch, and a pH 8. The results suggest that the ethyl acetate extracts from isolates Streptomyces aburaviensis (73), Streptomyces gramineus (386), and Streptomyces psammoticus (519) have a potential for use in pharmaceuticals as cytotoxic agents.
Breast Neoplasms/therapy , Lung Neoplasms/therapy , Prostatic Neoplasms/therapy , Streptomyces , Colombia , Female , Humans , Male , Rivers , South America , Streptomyces/isolation & purification , Streptomyces/physiology , Tumor Cells, Cultured
Polyurethanes are materials with a strong structure-property relationship. The goal of this research was to study the effect of a polyol blend composition of polyurethanes on its properties using a mixture design and setting mathematic models for each property. Water absorption, hydrolytic degradation, contact angle, tensile strength hardness and modulus were studied. Additionally, thermal stability was studied by thermogravimetric analysis. Area under the curve was used to evaluate the effect of polyol blend composition on thermal stability and kinetics of water absorption and hydrolytic degradation. Least squares were used to calculate the regression coefficients. Models for the properties were significant, and lack of fit was not (p < 0.05). Fit statistics suggest both good fitting and prediction. Water absorption, hydrolytic degradation and contact angle were mediated by the hydrophilic nature of the polyols. Tensile strength, modulus and hardness could be regulated by the PE content and the characteristics of polyols. Regression of DTG curves from thermal analysis showed improvement of thermal stability with the increase of PCL and PE. An ANOVA test of the model terms demonstrated that three component influences on bulk properties like water absorption, hydrolytic degradation, hardness, tensile strength and modulus. The PEG*PCL interaction influences on the contact angle, which is a surface property. Mixture design application allowed for an understanding of the structure-property relationship through mathematic models.
Polymers/chemistry , Polyurethanes/chemistry , Cross-Linking Reagents/chemistry , Hardness , Hydrolysis , Hydrophobic and Hydrophilic Interactions , Kinetics , Molecular Structure , Molecular Weight , Polyesters/chemistry , Polyethylene Glycols/chemistry , Propylene Glycols/chemistry , Surface Properties , Tensile Strength , Water/chemistry
INTRODUCTION: Our institution implemented the use of pre-designed labeling of intravenous drugs and fluids, administration routes and infusion pumps of to prevent medication errors. OBJECTIVE: To evaluate the effectiveness of predesigned labeling in reducing medication errors in the preparation and administration stages of prescribed medication in patients hospitalized with invasive lines, and to characterize medication errors. METHODS: This is a pre/post intervention study. Pre-intervention group: invasively administered dose from July 1st to December 31st, 2014, using traditional labeling (adhesive paper handwritten note). Post-intervention group: dose administered from January 1st to June 30th, 2015, using predesigned labeling (labeling with preset data-adhesive labels, color- grouped by drugs, labels with colors for invasive lines). Outcome: medication errors in hospitalized patients, as measured with notification form and record electronics. Tabulation/analysis Stata-10, with descriptive statistics, hypotheses testing, estimating risk with 95% confidence. RESULTS: In the pre-intervention group, 5,819 doses of drugs were administered invasively in 634 patients. Error rate of 1.4 x 1,000 administrations. The post-intervention group of 1088 doses comprised 8,585 patients with similar routes of administration. The error rate was 0.3 x 1,000 (p = 0.034). Patients receiving medication through an invasive route who did not use predesigned labeling had 4.6 times more risk of medication error than those who had used predesigned labels (95% CI: 1.25 to 25.4). The adult critically ill patient unit had the highest proportion of medication errors. The most frequent error was wrong dose administration. 41.2% produced harm to the patient. CONCLUSIONS: The use of predesigned labeling in invasive lines reduces errors in medication in the last two phases: preparation and administration.
INTRODUCCIÓN: La seguridad en la administración de medicamentos requiere sistemas de prevención de errores. Para prevenirlos, se implementó como estrategia el uso de un etiquetado prediseñado de medicamentos y fluidos intravenosos de las vías de administración y bombas de infusión. OBJETIVO: Evaluar la efectividad del etiquetado prediseñado en la disminución de errores de medicación en las fases de preparación y administración, en pacientes hospitalizados con vías invasivas. Además se busca caracterizar los errores de medicación. MÉTODOS: Estudio pre y post intervención. Grupo pre intervención: dosis de medicamentos administradas invasivamente entre el 1 de julio y el 31 de diciembre de 2014, utilizando etiquetado tradicional (papel adhesivo manuscrito). Grupo intervención: dosis de medicamentos administradas entre el 1 de enero y el 31 de junio de 2015 utilizando etiquetado prediseñado (etiquetas adhesivas con datos preestablecidos, etiquetas de colores agrupadas según fármacos, etiquetas de colores para líneas invasivas). Variable respuesta: errores de medicación en pacientes hospitalizados medido según formulario de notificación y ficha electrónica. Tabulación/análisis: Stata-10, con estadística descriptiva, test de hipótesis y estimación de riesgo con 95% de confianza. RESULTADOS: Grupo pre intervención de 5819 dosis de medicamentos por vía invasiva en 634 pacientes. Tasa de error de 1,4 por 1000 administraciones. Grupo post intervención de 8585 administraciones por igual vía en 1088 pacientes. Tasa de error 0,3 por 1000 (p=0,034). Los pacientes que recibieron medicamentos por vía invasiva y no utilizaron etiquetado prediseñado tuvieron 4,6 veces más riesgo de sufrir un error de medicación que aquellos con etiquetado prediseñado (intervalo de confianza 95%; 1,25 a 25,4). La unidad de paciente crítico adulto presentó la mayor proporción de errores. El error más frecuente fue la administración de dosis incorrecta. El 41,2% produjo algún tipo de daño al paciente. CONCLUSIONES: El uso de etiquetado prediseñado de vías y líneas invasivas contribuye a disminuir los errores de medicación en las dos últimas fases, preparación y administración.
Drug Labeling , Medication Errors/prevention & control , Medication Systems, Hospital , Pharmaceutical Preparations/administration & dosage , Administration, Intravenous , Hospitalization , Humans , Infusion Pumps
El presente estudio es acerca del análisis neuropsicológico y neurofisiológico a partir del trabajo de evaluación e intervención neuropsicológica, en el caso de una niña de edad preescolar con características de espectro autista. La niña fue evaluada por presentar retraso en el desarrollo y ausencia del lenguaje. El diagnóstico de la evaluación neuropsicológica y psicológica permitió precisar los aspectos fuertes y débiles del desarrollo psicológico de la niña y precisar las estrategias de intervención. El programa de intervención fue elaborado de acuerdo a la consideración de la edad psicológica e incluyó varias etapas de introducción y formación de la actividad lúdica con apoyos simbólicos y verbales. Se realizaron estudios neuropsicológicos y electrofisiológico de seguimiento. Los resultados permitieron observar cambios favorables en la actividad de la niña a partir del proceso de corrección neuropsicológica, permitiendo acceso a las actividades escolares y la comunicación social. Se discute que a pesar de presencia de diagnósticos desfavorables en la edad infantil con indicaciones del daño cerebral, la corrección neuropsicológica es un instrumento poderoso para superación de dificultades y desarrollo progresivo en las edades infantiles...
The following study is related to the neuropsychological and neurophysiological analysis from a neuropsychological assessment and intervention of a preschool girl with autism spectrum characteristics. The girl was evaluated due to severe developmental disorders and absence of oral expression. Neuropsychological and psychological diagnosis allowed to determine strong and weak development aspects and to establish strategies for intervention. The intervention program was conducted according to consideration of psychological age of the girl and included diverse stages of game activities with symbolic and verbal means. The result showed improvement in the girls activity such as the possibility to take part in school learning and in social communication. We discuss that even in cases of severe diagnosis and probability of brain injury, neuropsychological intervention can play an important role and be powerful instrument for overcoming of developmental difficulties and serve for progressive development in childhood...
Humans , Female , Child , Electroencephalography , Neuropsychological Tests , Autistic Disorder/diagnosis , Autistic Disorder/physiopathology , Autistic Disorder/rehabilitation
