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1.
PM R ; 14(3): 377-382, 2022 03.
Artigo em Inglês | MEDLINE | ID: mdl-33773077

RESUMO

BACKGROUND: Few studies have evaluated the effect of final needle position on contrast flow patterns during the performance of cervical transforaminal epidural steroid injections (TFESIs). OBJECTIVE: To analyze fluoroscopically guided cervical TFESI contrast flow patterns based upon final needle tip position. DESIGN: Retrospective, observational in vivo study. SETTING: Outpatient private practice physical medicine and rehabilitation spine clinic. PARTICIPANTS: One hundred consecutive patients undergoing cervical TFESIs. INTERVENTIONS: Cervical TFESIs. MAIN OUTCOME MEASURES: Categories of contrast flow patterns including epidural, intraforaminal, "sufficient to inject," and "predominantly epidural and/or intraforaminal," based upon final needle tip position. RESULTS: Two independent observers reviewed images from 100 consecutive patients and classified injectate flow patterns stratified by needle tip position. The interrater reliability for all categories of interest was moderate, with kappa values from 0.61 to 0.76. More medially placed needles (middle third and lateral third of the articular pillars) resulted in higher rates of epidural contrast flow (75%; 95% confidence interval [CI]: 56%-94%; and 60%; 95% CI: 47%-73%) compared to needles placed lateral to the articular pillars (26%; 95% CI: 8%-44%), and higher rates of "predominantly epidural and/or intraforaminal" flow patterns with needles placed in the middle one third (75%; 95% CI: 56%-94%) and lateral one third of the articular pillars (47%; 95% CI: 34%-60%) compared to flow patterns when needles were placed lateral to the articular pillars (17%; 95% CI: 2%-32%). No needles were placed in the medial third of the articular pillars. CONCLUSIONS: More medially placed needle tips result in more optimal flow patterns during cervical TFESIs. The importance of this finding is unknown as clinical outcomes were not measured.


Assuntos
Agulhas , Esteroides , Humanos , Injeções Epidurais/métodos , Reprodutibilidade dos Testes , Estudos Retrospectivos
2.
Zhongguo Zhen Jiu ; 42(5): 549-51, 2022 May 12.
Artigo em Chinês | MEDLINE | ID: mdl-35543946

RESUMO

Professor JIAO Mian-zhai 's academic characteristics and needling essentials in acupuncture field are introduced in the paper. Professor JIAO integrated martial arts and qigong with acupuncture needling technique, and then created his own "yunzhang bafa" (eight kinds of palm movement and qi training method) and modified the basic skills for finger strength practice and needling techniques. On the base of the needling techniques exerted by both hands, he developed a set of "JIAO 's needling techniques", including the manipulations of needle insertion and withdrawal. He proposed that the compound needling techniques for reinforcing and reducing should be cooperated with the physician's respiratory rhythm. Besides, he clarified the operation timing of reinforcing and reducing techniques to ensure the full play to the curative effect of acupuncture.


Assuntos
Terapia por Acupuntura , Acupuntura , Pontos de Acupuntura , Terapia por Acupuntura/métodos , Humanos , Masculino , Movimento , Agulhas
3.
J Healthc Eng ; 2022: 1499927, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35432822

RESUMO

To evaluate the application effect of the 360° safe indwelling infusion program of peripheral venous indwelling needle in the infusion room of pediatric outpatient clinic. A total of 1,000 children who received indwelling needle infusion were randomly divided into experimental group (n = 500; 360° safe indwelling needle) and control group (n = 500; a routine indwelling needle). The incidence of indwelling needle-related complications and adverse events in the experimental group was significantly lower than that in the control group, and the number of indwelling days, indwelling needle usage rate, and parent satisfaction were significantly higher than those in the control group. The 360° safe indwelling infusion program can significantly reduce the incidence of complications and adverse events, and improve the quality of the indwelling needle infusion. The 360° safe indwelling infusion can effectively improve the comprehensive quality and safety of nursing care in the outpatient infusion room.


Assuntos
Instituições de Assistência Ambulatorial , Agulhas , Criança , Humanos
4.
Soft Matter ; 18(18): 3521-3530, 2022 May 11.
Artigo em Inglês | MEDLINE | ID: mdl-35438127

RESUMO

Needle insertion into soft biological tissues is a common process in various surgical procedures. During insertion, soft biological tissues with different water contents undergo large deformation often leading to uncontrollable cracks and tissue damage. Despite the numerous experimental studies and numerical modelling of needle-tissue interaction, the results do not show any consistency mainly due to the heterogeneity of tissue properties and opaqueness. In this context, understanding the fracture behaviour of soft tissues during needle insertion is important for minimally invasive surgeries and other medical procedures. Recently, we showed that the needle insertion into a transparent, tissue-mimicking polyacrylamide (PAAm) hydrogel causes periodic cone cracks. In this work, we systematically varied the water content of the PAAm hydrogel in the preparation state and performed needle insertion experiments using a hypodermic needle at a constant velocity to study the fracture characteristics of the PAAm hydrogel. The results show that the number of peaks, the magnitudes of the insertion forces, and corresponding cone cracks decrease with increasing water content. Furthermore, we discussed the influence of water on cone crack fracture characteristics, cone angle, periodicity, crack speed and fracture energy release rate. These results provide a better understanding of the fracture processes of soft tissues with different water concentrations such as the lung, liver, and brain during needle insertion and the control of tissue damage during needle insertion involved in medical procedures.


Assuntos
Hidrogéis , Agulhas , Encéfalo , Água
5.
Zhen Ci Yan Jiu ; 47(4): 369-76, 2022 Apr 25.
Artigo em Chinês | MEDLINE | ID: mdl-35486018

RESUMO

OBJECTIVE: To systematically review the occurrence of adverse events/adverse reactions (AEs/ARs) induced by acupoint catgut embedding therapy for psoriasis vulgaris (PV) and its safety. METHODS: Randomized controlled trials, controlled clinical trials, cohort studies, case-control studies, case-series, and case reports concerning the treatment of PV with acupoint catgut embedding therapy were searched from Chinese and English databases from their inception to January 7th, 2021. The AEs/ARs related to acupoint catgut embedding therapy for PV were subjected to descriptive statistics, followed by the analysis of possible reasons. RESULTS: Finally, 16 studies were included, involving 1 158 patients. A total of 79 cases were reported to present with mild to moderate AEs/ARs related to acupoint catgut embedding therapy for PV, and there were no serious AEs/ARs or death cases. The most common AEs/ARs were local redness, swelling, heat, and pain (31.65%,25/79), followed by low-grade fever and fatigue (29.11%,23/79), isomorphic reaction (16.46%,13/79), local induration (13.92%,11/79), and fainting (8.86%,7/79). In terms of embedding materials, catgut (93.67%,74/79) and lumbar puncture needles or other puncture needles (49.37%,39/79) were proved the most common AEs/ARs-inducing factors. The proportion of AEs/ARs resulting from treatment interval≤two weeks (67.09%,53/79) and treatment course≤eight weeks (55.70%,44/79) was relatively high. Because the incidence of AEs/ARs fails to be calcula-ted, it is not yet possible to accurately assess the risk and safety of acupoint catgut embedding therapy for PV. CONCLUSION: Available evidence suggests that in the treatment of PV, acupoint catgut embedding therapy may induce a series of mild to moderate AEs/ARs, so its clinical practice deserves attention. We should strictly grasp its indications and contraindications, and prevent the occurrence of related AEs/ARs by standardizing the operation and improving the embedding materials.


Assuntos
Terapia por Acupuntura , Psoríase , Pontos de Acupuntura , Terapia por Acupuntura/efeitos adversos , Terapia por Acupuntura/métodos , Categute/efeitos adversos , Humanos , Agulhas , Psoríase/etiologia , Psoríase/terapia
6.
Heart Surg Forum ; 25(2): E253-E255, 2022 Mar 24.
Artigo em Inglês | MEDLINE | ID: mdl-35486058

RESUMO

We report a case of a tracheal foreign body caused by a sewing needle. After about four months, the patient showed delayed dry cough and hemoptysis. The sewing needle that pierced the tracheal wall damaged the aorta, and we performed endovascular stenting to prevent arterial bleeding and removed it under a bronchoscope. The patient smoothly recovered after the operation. This case proves that treatment strategies for patients with foreign bodies in the trachea can be individualized.


Assuntos
Aorta Torácica , Corpos Estranhos , Aorta Torácica/diagnóstico por imagem , Aorta Torácica/cirurgia , Brônquios/cirurgia , Corpos Estranhos/diagnóstico , Corpos Estranhos/etiologia , Corpos Estranhos/cirurgia , Humanos , Agulhas/efeitos adversos , Traqueia/cirurgia
7.
Sci Rep ; 12(1): 6799, 2022 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-35474331

RESUMO

In this prospective single-arm study of 50 pediatric patients with acute lymphoblastic leukemia (ALL), we evaluated the clinical performance of a novel bioimpedance spinal needle system in 152 intrathecal treatment lumbar punctures (LP) of these patients. The system detects in real-time when the needle tip reaches the cerebrospinal fluid (CSF) in the spinal canal. The success was defined as getting a CSF sample and/or administering the intrathecal treatment with one needle insertion. Incidence of traumatic LP (TLP) was defined as ≥ 10 erythrocytes/µL of CSF. Post-procedural complications were monitored with a one-week diary and one-month register follow-up. The success of the first attempt was 79.5%, with the CSF detection sensitivity of 86.1%. The incidence of TLP was 17.3%. A successful first attempt was associated with a significantly lower incidence of TLP (10% vs 40%, p = 0.0015). During the week after the procedure, the incidence of post-dural puncture headache was 6%. During the follow-up, no major complications were observed. In conclusion, the novel bioimpedance spinal needle system achieved a high success rate and low incidence of TLP and other complications in pediatric patients with ALL in a real-world clinical setting, indicating clinical utility for this system in pediatric hemato-oncology.


Assuntos
Leucemia-Linfoma Linfoblástico de Células Precursoras , Punção Espinal , Criança , Humanos , Injeções Espinhais , Agulhas/efeitos adversos , Leucemia-Linfoma Linfoblástico de Células Precursoras/etiologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Estudos Prospectivos , Punção Espinal/efeitos adversos , Punção Espinal/métodos
8.
Cell Transplant ; 31: 9636897221080943, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35466714

RESUMO

Current regimen to treat patients suffering from stress urinary incontinence often seems not to yield satisfactory improvement or may come with severe side effects. To overcome these hurdles, preclinical studies and clinical feasibility studies explored the potential of cell therapies successfully and raised high hopes for better outcome. However, other studies were rather disappointing. We therefore developed a novel cell injection technology to deliver viable cells in the urethral sphincter complex by waterjet instead of using injection needles. We hypothesized that the risk of tissue injury and loss of cells could be reduced by a needle-free injection technology. Muscle-derived cells were obtained from young male piglets and characterized. Upon expansion and fluorescent labeling, cells were injected into cadaveric tissue samples by either waterjet or injection needle. In other experiments, labeled cells were injected by waterjet in the urethra of living pigs and incubated for up to 7 days of follow-up. The analyses documented that the cells injected by waterjet in vitro were viable and proliferated well. Upon injection in live animals, cells appeared undamaged, showed defined cellular somata with distinct nuclei, and contained intact chromosomal DNA. Most importantly, by in vivo waterjet injections, a significantly wider cell distribution was observed when compared with needle injections (P < .05, n ≥ 12 samples). The success rates of waterjet cell application in living animals were significantly higher (≥95%, n = 24) when compared with needle injections, and the injection depth of cells in the urethra could be adapted to the need by adjusting waterjet pressures. We conclude that the novel waterjet technology injects viable muscle cells in tissues at distinct and predetermined depth depending on the injection pressure employed. After waterjet injection, loss of cells by full penetration or injury of the tissue targeted was reduced significantly in comparison with our previous studies employing needle injections.


Assuntos
Células Musculares , Agulhas , Animais , Humanos , Masculino , Músculos , Suínos , Tecnologia , Uretra
9.
Int J Hyperthermia ; 39(1): 564-571, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35382659

RESUMO

PURPOSE: To investigate the value of three-dimensional ultrasound fusion imaging (3DUS-FI) in real-time guiding needle placement by phantom models and in vivo simulations. MATERIALS AND METHODS: Two radiologists (beginner and expert) performed needle placement using two-dimensional ultrasound (2DUS) and 3DUS-FI, respectively. In the phantom study, single-needle placement was performed by puncturing the center point of each ball and assessed based on the specimen length. Multiple-needles placement was performed by placing three needles in each ball, and their locations were confirmed by computed tomography, and assessed based on the distance deviation between needles. In the in vivo simulation study, simulated-needle placement was performed by placing a virtual ablation needle in each liver tumor and assessed by the simulated ablative cover rate and margin. RESULTS: Specimen length was significantly longer with 3DUS-FI in the beginner, whereas no significant difference was observed in the expert (2DUS vs. 3DUS-FI: beginner, 14.60 ± 2.60 mm vs. 16.25 ± 1.38 mm, p = .017; expert, 16.78 ± 1.40 mm vs. 16.95 ± 1.15 mm, p = .668). Distance deviation between needles was significantly smaller with 3DUS-FI (2DUS vs. 3DUS-FI: beginner, 25.06 ± 16.07 mm vs. 3.72 ± 1.99 mm, p < .001; expert, 11.70 ± 7.79 mm vs. 2.89 ± 1.52 mm, p < .001). The simulated ablative cover rate and margin were significantly larger with 3DUS-FI for the beginner, whereas only the latter was significantly larger for the expert (2DUS vs. 3DUS-FI: beginner, 73.55 ± 8.73% vs. 81.38 ± 11.84%, p = .001, 0.82 ± 0.97 mm vs. 2.65 ± 1.23 mm, p < .001; expert, 78.60 ± 9.91% vs. 83.24 ± 11.69%, p = .059; 1.65 ± 1.15 mm vs. 2.95 ± 1.13 mm, p < .001). CONCLUSIONS: 3DUS-FI is useful for real-time guiding precise needle placement and may be further use to improve the efficacy of liver thermal ablation.


Assuntos
Imageamento Tridimensional , Agulhas , Imageamento Tridimensional/métodos , Fígado/diagnóstico por imagem , Fígado/cirurgia , Imagens de Fantasmas , Ultrassonografia/métodos
10.
AAPS PharmSciTech ; 23(4): 103, 2022 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-35381906

RESUMO

Vaccination has produced a great improvement to the global health by decreasing/eradicating many infectious diseases responsible for significant morbidity and mortality. Thanks to vaccines, many infections affecting childhood have been greatly decreased or even eradicated (smallpox, measles, and polio). That is why great efforts are made to achieve mass vaccination against COVID-19. However, developed vaccines face many challenges with regard to their safety and stability. Moreover, needle phobia could prevent a significant proportion of the population from receiving vaccines. In this context, microneedles (MNs) could potentially present a solution to address these challenges. MNs represent single dose administration systems that do not need reconstitution or cold-chain storage. Being self-administered, pain-free, and capable of producing superior immunogenicity makes them a more attractive alternative. This review explores microneedles' types, safety, and efficacy in vaccine delivery. Preclinical and clinical studies for microneedle-based vaccines are discussed and patent examples are included.


Assuntos
COVID-19 , Vacinas , Administração Cutânea , Criança , Sistemas de Liberação de Medicamentos , Humanos , Agulhas , Tecnologia , Vacinação
11.
J Mech Behav Biomed Mater ; 130: 105187, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35364362

RESUMO

With the development of wearable technologies, the interfacial properties of skin and devices have become much more important. For research and development purposes, porcine skin is often used to evaluate device performance, but the differences between in vivo, in situ and ex vivo porcine skin mechanical properties can potentially misdirect investigators during the development of their technology. In this study, we investigated the significant changes to mechanical properties with and without perfusion (in vivo versus in vitro tissue). The device focus for this study was a skin-targeting Nanopatch vaccine microneedle device, employed to assess the variance to key skin engagement parameters - penetration depth and delivery efficiency - due to different tissue conditions. The patches were coated with fluorescent or 14C radiolabelled formulations for penetration depth and delivery efficiency quantification in vivo, and at time points up to 4 h post mortem. An immediate cessation of blood circulation saw mean microneedle penetration depth fell from ∼100 µm to ∼55 µm (∼45%). Stiffening of underlying tissues as a result of rigor mortis then augmented the penetration depths at the 4 h timepoint back to ∼100 µm, insignificantly different (p = 0.0595) when compared with in vivo. The highest delivery efficiency of formulation into the skin (dose measured in the skin excluding leftover dose on skin and patch surfaces) was also observed at this time point of ∼25%, up from ∼2% in vivo. Data obtained herein progresses medical device development, highlighting the need to consider the state and muscle tissues when evaluating prototypes on cadavers.


Assuntos
Agulhas , Pele , Administração Cutânea , Animais , Sistemas de Liberação de Medicamentos , Módulo de Elasticidade , Suínos
12.
Zhongguo Zhen Jiu ; 42(4): 402-4, 2022 Apr 12.
Artigo em Chinês | MEDLINE | ID: mdl-35403399

RESUMO

OBJECTIVE: Based on magnetic resonance imaging technology, the dangerous depth of straight needling and the safety of deep needling at Dachangshu (BL 25) are discussed, and data support is provided for standardizing deep needling at Dachangshu (BL 25). METHODS: The horizontal cross-sectional images of 148 healthy adult subjects under the spinous process of the 4th lumbar vertebra were collected by magnetic resonance instrument, the anatomical structure was analyzed, and the dangerous depth of straight needling at Dachangshu (BL 25) was measured. RESULTS: The dangerous depth of straight needling at Dachangshu (BL 25) was (11.2±1.3) cm and (11.0±1.2) cm on the left and right sides of males, and (9.8±1.3) cm and (9.7±1.3) cm on the left and right sides of females. There was a positive correlation between the dangerous depth of straight needling at Dachangshu (BL 25) and body mass index (BMI). In the case of similar body size, the dangerous depth of straight needling at Dachangshu(BL 25) in males was greater than that in females (P<0.01). CONCLUSION: At present, the deep needling at Dachangshu (BL 25) used in clinic is safe. In clinical application of the deep needling at Dachangshu (BL 25), the depth of needle insertion can be determined according to body size and gender.


Assuntos
Pontos de Acupuntura , Terapia por Acupuntura , Terapia por Acupuntura/métodos , Adulto , Feminino , Humanos , Vértebras Lombares , Imageamento por Ressonância Magnética , Masculino , Agulhas
13.
PLoS One ; 17(4): e0266194, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35390018

RESUMO

OBJECTIVES: The aim of the study was to find the lowest possible tube current and the optimal iterative reconstruction (IR) strength in abdominal imaging. MATERIAL AND METHODS: Reconstruction software was used to insert noise, simulating the use of a lower tube current. A semi-anthropomorphic abdominal phantom (Quality Assurance in Radiology and Medicine, QSA-543, Moehrendorf, Germany) was used to validate the performance of the ReconCT software (S1 Appendix). Thirty abdominal CT scans performed with a standard protocol (120 kVref, 150 mAsref) scanned at 90 kV, with dedicated contrast media (CM) injection software were selected. There were no other in- or exclusion criteria. The software was used to insert noise as if the scans were performed with 90, 80, 70 and 60% of the full dose. Consequently, the different scans were reconstructed with filtered back projection (FBP) and IR strength 2, 3 and 4. Both objective (e.g. Hounsfield units [HU], signal to noise ratio [SNR] and contrast to noise ratio [CNR]) and subjective image quality were evaluated. In addition, lesion detection was graded by two radiologists in consensus in another 30 scans (identical scan protocol) with various liver lesions, reconstructed with IR 3, 4 and 5. RESULTS: A tube current of 60% still led to diagnostic objective image quality (e.g. SNR and CNR) when IR strength 3 or 4 were used. IR strength 4 was preferred for lesion detection. The subjective image quality was rated highest for the scans performed at 90% with IR 4. CONCLUSION: A tube current reduction of 10-40% is possible in case IR 4 is used, leading to the highest image quality (10%) or still diagnostic image quality (40%), shown by a pairwise comparison in the same patients.


Assuntos
Fígado/diagnóstico por imagem , Imagens de Fantasmas/classificação , Interpretação de Imagem Radiográfica Assistida por Computador , Algoritmos , Humanos , Agulhas , Imagens de Fantasmas/normas , Doses de Radiação , Interpretação de Imagem Radiográfica Assistida por Computador/instrumentação , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Razão Sinal-Ruído , Tomografia Computadorizada por Raios X/métodos
14.
Mikrochim Acta ; 189(5): 180, 2022 04 07.
Artigo em Inglês | MEDLINE | ID: mdl-35391571

RESUMO

Dopamine (DA), epinephrine (EP), and norepinephrine (NEP) are the main catecholamine of clinical interest, as they play crucial roles in the regulation of nervous and cardiovascular systems and are involved in some brain behaviors, such as stress, panic, anxiety, and depression. Therefore, there is an urgent need for a reliable sensing device able to provide their continuous monitoring in a minimally invasive manner. In this work, the first highly nanoporous gold (h-nPG) microneedle-based sensor is presented for continuous monitoring of catecholamine in interstitial fluid (ISF). The h-nPG microneedle-based gold electrode was prepared by a simple electrochemical self-templating method that involves two steps, gold electrodeposition and hydrogen bubbling at the electrode surface, realized by sweeping the potential between + 0.8 V and 0 V vs Ag/AgCl for 25 scans in a 10 mM HAuCl4 solution containing 2.5 M NH4Cl, and successively applying a fixed potential of - 2 V vs Ag/AgCl for 60 s. The resulting microneedle-based h-nPG sensor displays an interference-free total catecholamine detection expressed as NEP concentration, with a very low LOD of 100 nM, excellent sensitivity and stability, and fast response time (< 4 s). The performance of the h-nPG microneedle array sensor was successively assessed in artificial ISF and in a hydrogel skin model at typical physiological concentrations.


Assuntos
Ouro , Nanoporos , Catecolaminas , Eletrodos , Agulhas
15.
Proc Natl Acad Sci U S A ; 119(18): e2120340119, 2022 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-35482922

RESUMO

SignificanceNeedleless delivery into the skin would overcome a major barrier to efficient clinical utilization of advanced therapies such as nanomaterials and macromolecules. This study demonstrates that controlled skin stretching (in porcine, rat, and mouse models) using a patch comprising a hypobaric chamber, to open the skin appendages, can increase the permeability of the tissue and provide a means to enable direct delivery of advanced therapies directly into the skin without the use of a needle or injection system. This technology can facilitate the self-administration of therapeutics including vaccines, RNA, and antigens, thus improving the translation of these products into effective clinical use.


Assuntos
Pele , Vacinas , Administração Cutânea , Animais , Camundongos , Agulhas , Ratos , Pele/metabolismo , Absorção Cutânea , Suínos
16.
J Pharm Pharm Sci ; 25: 93-109, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35364004

RESUMO

The transdermal route has been widely studied in the last decade due to its multiple advantages, where one of the most promising transdermal systems are microneedles, these allow the delivery of drugs in a painless way and with easy application, being very attractive for patients with chronic treatments. This review highlights the new research that develops this approach to transdermal therapies, including examples of materials and methods used for their manufacture and presenting an overview of the clinical trials currently available in Cochrane in a demonstrative way to understand the growing popularity of this strategy.


Assuntos
Sistemas de Liberação de Medicamentos , Agulhas , Administração Cutânea , Humanos , Preparações Farmacêuticas
17.
Front Immunol ; 13: 843355, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35359943

RESUMO

Biomaterials hold great promise for vaccines and immunotherapy. One emerging biomaterials technology is microneedle (MNs) delivery. MNs are arrays of micrometer-sized needles that are painless and efficiently deliver cargo to the specialized immunological niche of the skin. MNs typically do not require cold storage and eliminate medical sharps. Nearly all materials exhibit intrinsic properties that can bias immune responses toward either pro-immune or inhibitory effects. Thus, because MNs are fabricated from degradable polymers to enable cargo loading and release, understanding the immunological profiles of these matrices is essential to enable new MN vaccines and immunotherapies. Additionally, understanding the mechanical properties is important because MNs must penetrate the skin and conform to a variety of skin or tissue geometries. Here we fabricated MNs from important polymer classes - including extracellular matrix biopolymers, naturally-derived polymers, and synthetic polymers - with both high- and low-molecular-weights (MW). We then characterized the mechanical properties and intrinsic immunological properties of these designs. The library of polymer MNs exhibited diverse mechanical properties, while causing only modest changes in innate signaling and antigen-specific T cell proliferation. These data help inform the selection of MN substrates based on the mechanical and immunological requirements needed for a specific vaccine or immunotherapy application.


Assuntos
Agulhas , Vacinas , Materiais Biocompatíveis , Imunoterapia , Polímeros/química
19.
Small ; 18(18): e2106392, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35362226

RESUMO

Microneedles (MNs) are minimally invasive devices, which have gained extensive interest over the past decades in various fields including drug delivery, disease diagnosis, monitoring, and cosmetics. MN geometry and shape are key parameters that dictate performance and therapeutic efficacy, however, traditional fabrication methods, such as molding, may not be able to offer rapid design modifications. In this regard, the fabrication of MNs using 3D printing technology enables the rapid creation of complex MN prototypes with high accuracy and offers customizable MN devices with a desired shape and dimension. Moreover, 3D printing shows great potential in producing advanced transdermal drug delivery systems and medical devices by integrating MNs with a variety of technologies. This review aims to demonstrate the advantages of exploiting 3D printing technology as a new tool to microengineer MNs. Various 3D printing methods are introduced, and representative MNs manufactured by such approaches are highlighted in detail. The development of advanced MN devices is also included. Finally, clinical translation and future perspectives for the development of MNs using 3D printing are discussed.


Assuntos
Agulhas , Impressão Tridimensional , Administração Cutânea , Sistemas de Liberação de Medicamentos/métodos
20.
Mol Pharm ; 19(4): 1191-1208, 2022 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-35235330

RESUMO

The need for biocompatible polymers capable of dissolving in the skin while exhibiting reasonable mechanical features and delivery efficiency limits the range of materials that could be utilized in fabricating dissolving microneedle array patches (MAPs). The incorporation of additives, such as surfactants, during microneedle fabrication might be an alternative solution to overcome the limited range of materials used in fabricating dissolving MAPs. However, there is a lacuna in the knowledge on the effect of surfactants on the manufacture and performance of dissolving MAPs. The current study explores the role of surfactants in the manufacture and performance of dissolving MAPs fabricated from poly(vinyl alcohol) (PVA) and poly(vinyl pyrrolidone) (PVP) loaded with the model drugs, ibuprofen sodium and itraconazole. Three nonionic surfactants, Lutrol F108, Pluronic F88, and Tween 80, in solutions at varying concentrations (0.5, 1.0, and 2.0% w/w) were loaded into these dissolving MAPs. It was discovered that all of the dissolving MAPs that incorporated surfactant displayed a lower reduction in the microneedle height (≈10%) relative to the control formulation (≈20%) when subjected to a compressive force of 32 N. In addition, the incorporation of surfactants in some instances enhanced the insertion profile of these polymeric MAPs when evaluated using ex vivo neonatal porcine skin. The incorporation of surfactant into ibuprofen sodium-loaded dissolving MAPs improved the insertion depth of MAPs from 400 µm down to 600 µm. However, such enhancement was not apparent when the MAPs were loaded with the model hydrophobic drug, itraconazole. Skin deposition studies highlighted that the incorporation of surfactant enhanced the delivery efficiency of both model drugs, ibuprofen sodium and itraconazole. The incorporation of surfactant enhanced the amount of ibuprofen sodium delivered from 60.61% up to ≈75% with a majority of the drug being delivered across the skin and into the receptor compartment. On the other hand, when surfactants were added into MAPs loaded with the model hydrophobic drug itraconazole, we observed enhancement in intradermal delivery efficiency from 20% up to 30%, although this did not improve the delivery of the drug across the skin. This work highlights that the addition of nonionic surfactant is an alternative formulation strategy worth exploring to improve the performance and delivery efficiency of dissolving MAPs.


Assuntos
Sistemas de Liberação de Medicamentos , Tensoativos , Administração Cutânea , Animais , Microinjeções , Agulhas , Pele/metabolismo , Tensoativos/metabolismo , Suínos
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