Treatment avenues for age-related macular degeneration: Breakthroughs and bottlenecks.

Age-related macular degeneration (AMD) is a significant factor contributing to serious vision loss in adults above 50. The presence of posterior segment barriers serves as chief roadblocks in the delivery of drugs to treat AMD. The conventional treatment strategies use is limited due to its off-targeted distribution in the eye, shorter drug residence, poor penetration and bioavailability, fatal side effects, etc. The above-mentioned downside necessitates drug delivery using some cutting-edge technology including diverse nanoparticulate systems and microneedles (MNs) which provide the best therapeutic delivery alternative to treat AMD efficiently. Furthermore, cutting-edge treatment modalities including gene therapy and stem cell therapy can control AMD effectively by reducing the boundaries of conventional therapies with a single dose. This review discusses AMD overview, conventional therapies for AMD and their restrictions, repurposed therapeutics and their anti-AMD activity through different mechanisms, and diverse barriers in drug delivery for AMD. Various nanoparticulate-based approaches including polymeric NPs, lipidic NPs, exosomes, active targeted NPs, stimuli-sensitive NPs, cell membrane-coated NPs, inorganic NPs, and MNs are explained. Gene therapy, stem cell therapy, and therapies in clinical trials to treat AMD are also discussed. Further, bottlenecks of cutting-edge (nanoparticulate) technology-based drug delivery are briefed. In a nutshell, cutting-edge technology-based therapies can be an effective way to treat AMD.

Microbiological evaluation of reused catheter guides in a Brazilian hospital.

Within Brazilian hospitals, as well as in hospitals in other countries, the safety of reusing single-use medical devices is being questioned. At the same time, there has been a constant, growing increase in the number of such reprocessed products. In an attempt to evaluate such procedures, we analyzed 30 catheter guide units that were reused four times in patients at a public hospital of the state of São Paulo, Brazil. After each use, the catheter guides had been sterilized with a mixture of ethylene oxide/chlorofluorocarbons (12:88). Each unit analyzed was provided by the hospital individually packed and ready for a possible new use. For each catheter guide, a series of measurements were taken and tests run: microbial counts (pour plate), direct inoculation sterility test, bacterial endotoxin, in vitro cytotoxicity, physical evaluation by scanning electron microscopy, and microbial identification via biochemical assays. The results confirmed the presence of bacteria considered pathogenic to immunologically-compromised patients with a maximum limit of 10(4) cfu/unit (catheter guide). Furthermore, bacterial endotoxins and significant modifications of the catheter guides' physical structure were also detected. Thus, the common practice of reusing single-use devices may increase patients' risk of infection or pyrogenic reactions, adding to the total period of hospitalization.