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1.
Cesk Patol ; 57(1): 40-43, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33910347

RESUMO

Iatrogenic hydrophilic polymer embolization (HPE) is an underrecognised complication of endovascular procedures. In certain instances, HPE and related complications may lead to patiens death. Incidence of this phenomenon is not known. We evaluated retrospectively all autopsies of patients with a history of endovascular intervention performed by one pathology resident during a period of 8 months. There were 10 cases, which were examined histochemically and in polarized light.  We detected HPE in 2 of the 10 cases. In both cases the involved organ were lungs. Hydrophilic polymer embolization is a potential and easy-to-miss complication of endovascular procedures. It must be considered during histological examination of autoptic material.


Assuntos
Embolia , Embolização Terapêutica , Embolização Terapêutica/efeitos adversos , Humanos , Interações Hidrofóbicas e Hidrofílicas , Doença Iatrogênica , Polímeros/efeitos adversos , Estudos Retrospectivos
2.
Int J Mol Sci ; 21(24)2020 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-33322781

RESUMO

Amine-coated biodegradable materials based on synthetic polymers have a great potential for tissue remodeling and regeneration because of their excellent processability and bioactivity. In the present study, we have investigated the influence of various chemical compositions of amine plasma polymer (PP) coatings and the influence of the substrate morphology, represented by polystyrene culture dishes and polycaprolactone nanofibers (PCL NFs), on the behavior of vascular smooth muscle cells (VSMCs). Although all amine-PP coatings improved the initial adhesion of VSMCs, 7-day long cultivation revealed a clear preference for the coating containing about 15 at.% of nitrogen (CPA-33). The CPA-33 coating demonstrated the ideal combination of good water stability, a sufficient amine group content, and favorable surface wettability and morphology. The nanostructured morphology of amine-PP-coated PCL NFs successfully slowed the proliferation rate of VSMCs, which is essential in preventing restenosis of vascular replacements in vivo. At the same time, CPA-33-coated PCL NFs supported the continuous proliferation of VSMCs during 7-day long cultivation, with no significant increase in cytokine secretion by RAW 264.7 macrophages. The CPA-33 coating deposited on biodegradable PCL NFs therefore seems to be a promising material for manufacturing small-diameter vascular grafts, which are still lacking on the current market.


Assuntos
Aminas/química , Materiais Revestidos Biocompatíveis/farmacologia , Músculo Liso Vascular/efeitos dos fármacos , Miócitos de Músculo Liso/efeitos dos fármacos , Nanofibras/química , Plasma/química , Polímeros/química , Aminas/efeitos adversos , Aminas/imunologia , Aminas/farmacologia , Animais , Adesão Celular/efeitos dos fármacos , Adesão Celular/imunologia , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Materiais Revestidos Biocompatíveis/efeitos adversos , Materiais Revestidos Biocompatíveis/química , Macrófagos/efeitos dos fármacos , Macrófagos/metabolismo , Camundongos , Músculo Liso Vascular/citologia , Músculo Liso Vascular/crescimento & desenvolvimento , Miócitos de Músculo Liso/metabolismo , Nanofibras/efeitos adversos , Espectroscopia Fotoeletrônica , Plasma/imunologia , Poliésteres/química , Polímeros/efeitos adversos , Polímeros/farmacologia , Células RAW 264.7 , Ratos , Propriedades de Superfície/efeitos dos fármacos , Tecidos Suporte/efeitos adversos , Tecidos Suporte/química
4.
Cochrane Database Syst Rev ; 6: CD013165, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32588430

RESUMO

BACKGROUND: Hyperkalaemia is a common electrolyte abnormality caused by reduced renal potassium excretion in patients with chronic kidney diseases (CKD). Potassium binders, such as sodium polystyrene sulfonate and calcium polystyrene sulfonate, are widely used but may lead to constipation and other adverse gastrointestinal (GI) symptoms, reducing their tolerability. Patiromer and sodium zirconium cyclosilicate are newer ion exchange resins for treatment of hyperkalaemia which may cause fewer GI side-effects. Although more recent studies are focusing on clinically-relevant endpoints such as cardiac complications or death, the evidence on safety is still limited. Given the recent expansion in the available treatment options, it is appropriate to review the evidence of effectiveness and tolerability of all potassium exchange resins among people with CKD, with the aim to provide guidance to consumers, practitioners, and policy-makers. OBJECTIVES: To assess the benefits and harms of potassium binders for treating chronic hyperkalaemia among adults and children with CKD. SEARCH METHODS: We searched the Cochrane Kidney and Transplant Register of Studies up to 10 March 2020 through contact with the Information Specialist using search terms relevant to this review. Studies in the Register are identified through searches of CENTRAL, MEDLINE, and EMBASE, conference proceedings, the International Clinical Trials Register (ICTRP) Search Portal and ClinicalTrials.gov. SELECTION CRITERIA: Randomised controlled trials (RCTs) and quasi-randomised controlled studies (quasi-RCTs) evaluating potassium binders for chronic hyperkalaemia administered in adults and children with CKD. DATA COLLECTION AND ANALYSIS: Two authors independently assessed risks of bias and extracted data. Treatment estimates were summarised by random effects meta-analysis and expressed as relative risk (RR) or mean difference (MD), with 95% confidence interval (CI). Evidence certainty was assessed using GRADE processes. MAIN RESULTS: Fifteen studies, randomising 1849 adult participants were eligible for inclusion. Twelve studies involved participants with CKD (stages 1 to 5) not requiring dialysis and three studies were among participants treated with haemodialysis. Potassium binders included calcium polystyrene sulfonate, sodium polystyrene sulfonate, patiromer, and sodium zirconium cyclosilicate. A range of routes, doses, and timing of drug administration were used. Study duration varied from 12 hours to 52 weeks (median 4 weeks). Three were cross-over studies. The mean study age ranged from 53.1 years to 73 years. No studies evaluated treatment in children. Some studies had methodological domains that were at high or unclear risks of bias, leading to low certainty in the results. Studies were not designed to measure treatment effects on cardiac arrhythmias or major GI symptoms. Ten studies (1367 randomised participants) compared a potassium binder to placebo. The certainty of the evidence was low for all outcomes. We categorised treatments in newer agents (patiromer or sodium zirconium cyclosilicate) and older agents (calcium polystyrene sulfonate and sodium polystyrene sulfonate). Patiromer or sodium zirconium cyclosilicate may make little or no difference to death (any cause) (4 studies, 688 participants: RR 0.69, 95% CI 0.11, 4.32; I2 = 0%; low certainty evidence) in CKD. The treatment effect of older potassium binders on death (any cause) was unknown. One cardiovascular death was reported with potassium binder in one study, showing that there was no difference between patiromer or sodium zirconium cyclosilicate and placebo for cardiovascular death in CKD and HD. There was no evidence of a difference between patiromer or sodium zirconium cyclosilicate and placebo for health-related quality of life (HRQoL) at the end of treatment (one study) in CKD or HD. Potassium binders had uncertain effects on nausea (3 studies, 229 participants: RR 2.10, 95% CI 0.65, 6.78; I2 = 0%; low certainty evidence), diarrhoea (5 studies, 720 participants: RR 0.84, 95% CI 0.47, 1.48; I2 = 0%; low certainty evidence), and vomiting (2 studies, 122 participants: RR 1.72, 95% CI 0.35 to 8.51; I2 = 0%; low certainty evidence) in CKD. Potassium binders may lower serum potassium levels (at the end of treatment) (3 studies, 277 participants: MD -0.62 mEq/L, 95% CI -0.97, -0.27; I2 = 92%; low certainty evidence) in CKD and HD. Potassium binders had uncertain effects on constipation (4 studies, 425 participants: RR 1.58, 95% CI 0.71, 3.52; I2 = 0%; low certainty evidence) in CKD. Potassium binders may decrease systolic blood pressure (BP) (2 studies, 369 participants: MD -3.73 mmHg, 95%CI -6.64 to -0.83; I2 = 79%; low certainty evidence) and diastolic BP (one study) at the end of the treatment. No study reported outcome data for cardiac arrhythmias or major GI events. Calcium polystyrene sulfonate may make little or no difference to serum potassium levels at end of treatment, compared to sodium polystyrene sulfonate (2 studies, 117 participants: MD 0.38 mEq/L, 95% CI -0.03 to 0.79; I2 = 42%, low certainty evidence). There was no evidence of a difference in systolic BP (one study), diastolic BP (one study), or constipation (one study) between calcium polystyrene sulfonate and sodium polystyrene sulfonate. There was no difference between high-dose and low-dose patiromer for death (sudden death) (one study), stroke (one study), myocardial infarction (one study), or constipation (one study). The comparative effects whether potassium binders were administered with or without food, laxatives, or sorbitol, were very uncertain with insufficient data to perform meta-analysis. AUTHORS' CONCLUSIONS: Evidence supporting clinical decision-making for different potassium binders to treat chronic hyperkalaemia in adults with CKD is of low certainty; no studies were identified in children. Available studies have not been designed to measure treatment effects on clinical outcomes such as cardiac arrhythmias or major GI symptoms. This review suggests the need for a large, adequately powered study of potassium binders versus placebo that assesses clinical outcomes of relevance to patients, clinicians and policy-makers. This data could be used to assess cost-effectiveness, given the lack of definitive studies and the clinical importance of potassium binders for chronic hyperkalaemia in people with CKD.


Assuntos
Quelantes/uso terapêutico , Terapia por Quelação/métodos , Hiperpotassemia/tratamento farmacológico , Potássio , Insuficiência Renal Crônica/complicações , Idoso , Causas de Morte , Quelantes/efeitos adversos , Terapia por Quelação/efeitos adversos , Doença Crônica , Humanos , Hiperpotassemia/etiologia , Hiperpotassemia/mortalidade , Pessoa de Meia-Idade , Polímeros/efeitos adversos , Polímeros/uso terapêutico , Poliestirenos/efeitos adversos , Poliestirenos/uso terapêutico , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Silicatos/efeitos adversos , Silicatos/uso terapêutico
5.
Rev. esp. cardiol. (Ed. impr.) ; 73(3): 225-231, mar. 2020. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-195364

RESUMO

INTRODUCCIÓN Y OBJETIVOS: Los resultados de los pacientes con reestenosis de stents farmacoactivos (SFA) son peores que los de pacientes con reestenosis de stents metálicos. No se sabe si está relacionado o no con la presencia de recubrimiento de polímero. Se compararon los resultados tras la intervención sobre la reestenosis del stent (RS) de SFA sin polímero y SFA recubiertos de polímero duradero. MÉTODOS: Se incluyó a los pacientes del estudio aleatorizado ISAR-TEST 5 sometidos a un nuevo intervencionismo percutáneo por RS durante el seguimiento. Se analizaron los resultados angiográficos a los 6 y a los 8 meses y los eventos clínicos a los 2 años, y se compararon los 2 grupos en función del tipo de stent. Las diferencias entre uno y otro grupo se ajustaron mediante análisis multivariable. RESULTADOS: Se incluyó a 326 pacientes con RS: 220 de SFA sin polímero y 106 de SFA con polímero. Se dispuso de angiografía de control del 83,4% de los pacientes. No se observaron diferencias entre los grupos en cuanto a reestenosis binaria recurrente (el 31,7 y el 27,0%; p = 0,38; pajustada=0,29). A los 2 años, el objetivo compuesto de muerte, infarto de miocardio o nueva revascularización de la lesión diana fue similar en los 2 grupos (el 35,7 frente al 34,0%; HR=1,04; IC95%, 0,70-1,55; p = 0,83; pajustada=0,79). Las tasas de nueva revascularización de la lesión diana de ambos grupos también fueron comparables (el 29,8 y el 31,5%; HR=0,91; IC95%, 0,60-1,39; p = 0,68; pajustada=0,62). CONCLUSIONES: No se encontraron diferencias entre los pacientes sometidos a reintervención por RS de SFA en cuanto a eventos clínicos o angiográficos en función del tipo de stent, con o sin polímero


INTRODUCTION AND OBJECTIVES: Outcomes of patients undergoing percutaneous intervention for drug-eluting stent (DES) restenosis are poorer than those in patients with bare-metal stent restenosis. It is unknown if this is related to the presence of polymer coating. We sought to compare outcomes after interventions for in-stent restenosis (ISR) of polymer-free DES vs durable polymer DES. METHODS: Patients enrolled in the ISAR-TEST 5 randomized trial who underwent repeat percutaneous intervention for ISR during follow-up were included. Angiographic outcomes at 6 to 8 months and clinical outcomes at 2 years were analyzed and compared between 2 groups according to whether the restenosed stent was a polymer-free or a durable polymer DES. Multivariate analysis was used to adjust for differences between groups. RESULTS: A total of 326 patients with ISR were included: 220 with ISR in polymer-free DES and 106 with ISR in durable polymer DES. Angiographic follow-up was available for 83.4% of patients. No difference was observed in recurrent binary restenosis between the 2 groups (31.7% vs 27.0%; P=.38; Padjusted=.29). At 2 years, the composite of death, myocardial infarction, or repeat target lesion revascularization were similar between the 2 groups (35.7% vs 34.0%; HR=1.04, 95%CI, 0.70-1.55; P=.83; Padjusted=.79). The rate of repeat target lesion revascularization was also similar in the 2 groups (29.8% vs 31.5%; HR=0.91, 95%CI, 0.60-1.39; P=.68; Padjusted=.62). CONCLUSIONS: In patients undergoing reintervention for DES-ISR, we found no evidence of differences in outcomes according to whether the restenosed stent was a polymer-free or durable polymer DES


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Reestenose Coronária/terapia , Stents Farmacológicos , Polímeros , Angioplastia Coronária com Balão , Causas de Morte , Reestenose Coronária/etiologia , Reestenose Coronária/mortalidade , Stents Farmacológicos/efeitos adversos , Estimativa de Kaplan-Meier , Análise Multivariada , Infarto do Miocárdio/epidemiologia , Revascularização Miocárdica/estatística & dados numéricos , Polímeros/efeitos adversos , Retratamento/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento
8.
Clin Hemorheol Microcirc ; 74(2): 189-200, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31476149

RESUMO

Drag-reducing polymers (DRPs) was previously demonstrated to increase blood flow, tissue perfusion, and reduce vascular resistance. The purpose of this study was to investigate the effect of DRPs on pulmonary vascular remodeling and right ventricular dysfunction in a rat model of chronic hypoxia-induced pulmonary hypertension (HPH). A total of forty male Wistar rats were randomly and equally assigned into four experimental groups (Group I: normoxia + saline, Group II: normoxia + PEO, Group III: hypoxia + saline, Group IV: hypoxia + PEO) and maintained in normoxia (21% O2) or hypobaric hypoxia (10% O2). After four weeks, comparisons were made of the following aspects: the mean pulmonary arterial pressure (mPAP), right ventricular systolic pressure (RVSP), right ventricular hypertrophy, wall thickness of pulmonary trunk and arteries, internal diameter of pulmonary arteries, cardiomyocyte cross-sectional area (CM CSA), and ultrastructure of right ventricular. Treatment with PEO in Group IV attenuated the increases in RVSP and mPAP (40.5±7.2 and 34.7±7.0 mmHg, respectively, both P < 0.05), compared with Group III. Distal vascular remodeling was visible as a significant increase in medial wall thickness (64.2±12.3% vs. 43.95±7.0%, P < 0.01) and a remarkable decrease in internal diameter of small pulmonary arteries (35.2±9.7µ m vs. 50.4±14.7µ m, P < 0.01) in Group III, to a greater extent than that detected in Group IV. Nevertheless, no significant histopathological differences in medial wall thickness was observed in pulmonary trunk between Group III and Group IV (P > 0.05), denoting that PEO chiefly attenuated the remodeling of small pulmonary arteries rather than main arteries in hypoxic environment. Infusion of DRPs (intravenous injection twice weekly) also attenuated the index of right ventricular hypertrophy, protected against the increase of cardiomyocyte cross-sectional area, and provided protection for cardiac ultrastructure. DRP treatment with intravenous injection elicited a protective effect against pulmonary vascular remodeling and right ventricular dysfunction in the rat model of HPH. DRPs may offer a new potential approach for the treatment of HPH, which may have theoretical significance and application value to society.


Assuntos
Hipóxia Celular/fisiologia , Hipertensão Pulmonar/fisiopatologia , Polímeros/efeitos adversos , Remodelação Vascular/fisiologia , Disfunção Ventricular Direita/complicações , Animais , Doença Crônica , Modelos Animais de Doenças , Masculino , Ratos , Ratos Wistar
9.
Rev Esp Cardiol (Engl Ed) ; 73(3): 225-231, 2020 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-30878234

RESUMO

INTRODUCTION AND OBJECTIVES: Outcomes of patients undergoing percutaneous intervention for drug-eluting stent (DES) restenosis are poorer than those in patients with bare-metal stent restenosis. It is unknown if this is related to the presence of polymer coating. We sought to compare outcomes after interventions for in-stent restenosis (ISR) of polymer-free DES vs durable polymer DES. METHODS: Patients enrolled in the ISAR-TEST 5 randomized trial who underwent repeat percutaneous intervention for ISR during follow-up were included. Angiographic outcomes at 6 to 8 months and clinical outcomes at 2 years were analyzed and compared between 2 groups according to whether the restenosed stent was a polymer-free or a durable polymer DES. Multivariate analysis was used to adjust for differences between groups. RESULTS: A total of 326 patients with ISR were included: 220 with ISR in polymer-free DES and 106 with ISR in durable polymer DES. Angiographic follow-up was available for 83.4% of patients. No difference was observed in recurrent binary restenosis between the 2 groups (31.7% vs 27.0%; P=.38; Padjusted=.29). At 2 years, the composite of death, myocardial infarction, or repeat target lesion revascularization were similar between the 2 groups (35.7% vs 34.0%; HR=1.04, 95%CI, 0.70-1.55; P=.83; Padjusted=.79). The rate of repeat target lesion revascularization was also similar in the 2 groups (29.8% vs 31.5%; HR=0.91, 95%CI, 0.60-1.39; P=.68; Padjusted=.62). CONCLUSIONS: In patients undergoing reintervention for DES-ISR, we found no evidence of differences in outcomes according to whether the restenosed stent was a polymer-free or durable polymer DES.


Assuntos
Reestenose Coronária/terapia , Stents Farmacológicos , Polímeros , Idoso , Angioplastia Coronária com Balão , Causas de Morte , Reestenose Coronária/etiologia , Reestenose Coronária/mortalidade , Stents Farmacológicos/efeitos adversos , Feminino , Humanos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Infarto do Miocárdio/epidemiologia , Revascularização Miocárdica/estatística & dados numéricos , Polímeros/efeitos adversos , Retratamento/estatística & dados numéricos , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento
10.
Crit Rev Food Sci Nutr ; 60(12): 2034-2051, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31210053

RESUMO

Food research is constantly searching for new ways to replace sugar. This is due to the negative connotations of sugar consumption on health which has driven consumer demand for healthier products and is reflected on a national level by the taxation of sugary beverages. Sugar alcohols, a class of polyols, are present in varying levels in many fruits and vegetables and are also added to foods as low calorific sweeteners. The most commonly used polyols in food include sorbitol, mannitol, xylitol, erythritol, maltitol, lactitol and isomalt. Of these, microorganisms can produce sorbitol, mannitol, xylitol and erythritol either naturally or through genetic engineering. Production of polyols by microbes has been the focus of a lot of research for its potential as an alternative to current industrial scale production by chemical synthesis but can also be used for in situ production of natural sweeteners in fermented products using microbes approved for use in foods. This review on the generation of these natural sweetening compounds by microorganisms examines the current understanding and methods of microbial production of polyols that are applicable in the food industry. The review also considers the health benefits and effects of polyol usage and discusses regulations which are applicable to polyol use.


Assuntos
Biotecnologia/métodos , Dieta Saudável , Rotulagem de Alimentos , Tecnologia de Alimentos/legislação & jurisprudência , Tecnologia de Alimentos/métodos , Polímeros/metabolismo , Polímeros/farmacologia , Eritritol/biossíntese , Eritritol/metabolismo , Humanos , Polímeros/efeitos adversos , Xilitol/biossíntese , Xilitol/metabolismo
11.
Clin Transl Gastroenterol ; 10(12): e00103, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31800544

RESUMO

INTRODUCTION: Patients with irritable bowel syndrome (IBS) identify food as a trigger for the onset or worsening of gastrointestinal symptoms. Despite this, there is no published validated contemporaneous food and symptom diary to investigate the association between diet and IBS symptoms. The objective of this prospective observational study was to assess the construct validity of a novel food diary and symptom questionnaire, the Food and Symptom Times (FAST) diary, and the predictive validity of the food diary component with relation to fiber and fermentable oligosaccharides, disaccharides, monosaccharides, and polyols consumption and subsequent gastrointestinal symptoms. METHODS: Fifty-one participants with IBS completed the FAST diary and several legacy instruments. The relationship between the FAST gastroenterological symptoms and legacy instruments was examined using Spearman correlation coefficients. Further statistical analysis investigated the relationship between diet and postprandial gastrointestinal symptoms. RESULTS: Consistent with a priori predictions, the FAST symptoms showed moderate correlations with the most similar Patient-Reported Outcome Measurement Information System gastrointestinal scales (0.328-0.483, P < 0.05) and the most similar Gastrointestinal Symptom Rating Scale questions (0.303-0.453, P < 0.05), with the exception of the weakly correlated subscale constipation for both instruments (-0.050 to -0.119, P > 0.05). The IBS-Quality of Life instrument showed moderate correlations with the FAST symptom abdominal swelling/distension (0.313-0.416, P < 0.05). The consumption of a high fermentable oligosaccharides, disaccharides, monosaccharides, and polyols meal was associated with participants with IBS-D experiencing abdominal bloating and participants with IBS-C not experiencing abdominal swelling (P < 0.05). The consumption of fiber was correlated with abdominal fullness and bloating in participants with IBS-C (P < 0.05). DISCUSSION: The FAST diary validly measures gastrointestinal symptoms as they occur in people with IBS and correlates these symptoms with specific aspects of diet.


Assuntos
Registros de Dieta , Alimentos/efeitos adversos , Síndrome do Intestino Irritável/diagnóstico , Medidas de Resultados Relatados pelo Paciente , Adolescente , Adulto , Fibras na Dieta/efeitos adversos , Feminino , Humanos , Síndrome do Intestino Irritável/etiologia , Masculino , Monossacarídeos/efeitos adversos , Oligossacarídeos/efeitos adversos , Polímeros/efeitos adversos , Valor Preditivo dos Testes , Estudos Prospectivos , Qualidade de Vida , Adulto Jovem
12.
ACS Appl Mater Interfaces ; 11(51): 47739-47749, 2019 Dec 26.
Artigo em Inglês | MEDLINE | ID: mdl-31774643

RESUMO

Polymeric carbon nitride (PCN), which demonstrates unique properties, has been widely explored, mostly in photocatalysis; however, the evaluation of its biocompatibility is still needed. Herein, the cytocompatibility of PCN with different lateral size distributions (A-PCN with 160 nm, B-PCN with 20 nm, and C-PCN with 10 nm dominating lateral sizes) was investigated. The viability of three cell lines (L929, MCF-7, and HepG2) has been determined using cell counting kit-8 (CCK-8), neutral red uptake (NRU), and lactate dehydrogenase (LDH) leakage assays. It was found that the highest cytotoxicity of PCN was observed for flakes with a lateral size of ∼20 nm (B-PCN) in three cell lines after 48 h of exposition. The uptake process of B-PCN sheets labeled with fluorescein isothiocyanate (FITC) by cells was also the most effective. Confocal laser scanning microscopy and atomic force microscopy revealed the nanomaterial distribution throughout the cytoplasm and perinuclear region. The results demonstrated the correlation among size, internalization process, and cytocompatibility of the tested polymeric carbon nitride structures.


Assuntos
Nanoestruturas/química , Nitrilas/química , Polímeros/química , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Células Hep G2 , Humanos , L-Lactato Desidrogenase/metabolismo , Células MCF-7 , Microscopia Confocal , Nitrilas/efeitos adversos , Polímeros/efeitos adversos , Sincalida/metabolismo
13.
Toxicol Ind Health ; 35(10): 638-646, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31771499

RESUMO

The guanidine family of antimicrobial agents, which includes polyhexamethylene guanidine phosphate (PHMG) and oligo(2-(2-ethoxy)ethoxyethyl) guanidinium chloride (PGH), and chlorophenol biocidal chemicals such as 2,4,4'-trichloro-2'-hydroxydiphenyl ether (triclosan) are used in various occupational and environmental biocidal applications. The excipient propylene glycol (PG) is used to dissolve the active ingredients. The skin sensitization (SS) potential of these substances has not been systemically investigated and is still debated. Moreover, mixtures of PHMG, PGH, or triclosan with PG have not been evaluated for SS potency. An in vivo assay known as the local lymph node assay: 5-bromo-2-deoxyuridine-flow cytometry method (LLNA: BrdU-FCM) was recently adopted as an alternative testing method and was used to address these issues. Via the LLNA: BrdU-FCM, PHMG, PGH, and triclosan were predicted to be sensitizers, while PG was predicted to be a nonsensitizer. In addition, d-limonene, which is used as a flavoring in various consumer products, was also predicted to be a sensitizer, although no unanimous conclusion has been reached regarding its SS potential. Mixtures of PHMG, PGH, triclosan, or d-limonene with PG at ratios of 9:1, 4:1, and 1:4 (w/w) were all positive in terms of SS potential, indicating that the PG excipient does not influence the SS predictions of these chemicals. Since humans can be occupationally and environmentally exposed to mixtures of excipients with active ingredients, the present study may give insight into further investigations of the SS potentials of various chemical mixtures.


Assuntos
Guanidinas/efeitos adversos , Hipersensibilidade Imediata/induzido quimicamente , Polímeros/efeitos adversos , Propilenoglicóis/efeitos adversos , Pele/efeitos dos fármacos , Triclosan/efeitos adversos , Animais , Relação Dose-Resposta a Droga , Excipientes/efeitos adversos , Excipientes/química , Feminino , Guanidinas/química , Limoneno , Ensaio Local de Linfonodo , Camundongos , Camundongos Endogâmicos BALB C , Polímeros/química , Propilenoglicóis/química , Triclosan/química
14.
Adv Healthc Mater ; 8(23): e1901031, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31664793

RESUMO

The incomplete removal of bone tumors leads to increased local recurrence and poor prognosis. To prevent ostoperative tumor recurrence and simultaneously repair surgery-caused bone defects, there is a need of great significance to develop implantable biomaterials possessing both cancer cell-killing ability and excellent bioactivity. In this work, a functionalized titanium-based implant is successfully fabricated by loading curcumin (CUR) onto cyclodextrin based polymer (pCD) modified titanium dioxide (TiO2 ) nanorod arrays. Herein, a polydopamine (pDA) assisted film is implemented as a first coating layer onto the surface of the TiO2 nanoarrays to guarantee the robust anchorage of the pCD. The pCD coating acts as a reservoir for CUR, allowing for efficient drug loading and sustained release of anticancer drugs. Studies show that the CUR-modified surfaces (TiO2 /pDA/pCD/CUR) can significantly promote apoptosis of osteosarcoma cells in vitro by inducing mitochondrial dysfunction caused by the ROS overproduction, and meanwhile, effectively inhibit the tumor growth in vivo. Moreover, such functionalized implants with surface density of loaded CUR at 22.48 µg cm-2 or lower support the attachment and proliferation of osteoblasts in vitro. These results successfully demonstrate that as-prepared TiO2 /pDA/pCD/CUR constructs have combined anticancer performance and good biocompatibility, which has great promise for the surgical therapy of bone tumors.


Assuntos
Celulose/química , Curcumina/química , Curcumina/uso terapêutico , Ciclodextrinas/química , Osteossarcoma/tratamento farmacológico , Polímeros/química , Titânio/química , Animais , Linhagem Celular , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Humanos , Espectroscopia de Ressonância Magnética , Camundongos , Camundongos Nus , Microscopia Eletroquímica de Varredura , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Nanotubos/química , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Espectroscopia Fotoeletrônica , Polímeros/efeitos adversos , Espécies Reativas de Oxigênio/metabolismo , Espectroscopia de Infravermelho com Transformada de Fourier , Titânio/efeitos adversos
15.
No Shinkei Geka ; 47(8): 869-875, 2019 Aug.
Artigo em Japonês | MEDLINE | ID: mdl-31477630

RESUMO

A 41-year-old woman underwent coil embolization for subarachnoid hemorrhage associated with a ruptured anterior cerebral artery(A1)aneurysm. Approximately 3 weeks later, MRI revealed right cerebral white matter changes with extensive edema and enhancement lesions. Even though she was asymptomatic, we suspected an allergic reaction to the hydrophilic coating polymer and initiated steroid treatment. After tapering and discontinuing the steroid treatment, follow-up MRI revealed development of white matter lesions;thus, steroid treatment was reinitiated. Progression and regression of the lesions occurred repeatedly, and she was radiologically stable at almost 1 year after coiling. We speculated that these white matter lesions were foreign body granulomas that reacted to the hydrophilic coating of the endovascular device. Overall, an allergic reaction to hydrophilic coating polymer could occur as a delayed complication after coil embolization and that progression and regression of the lesions could repeatedly occur in rare cases.


Assuntos
Aneurisma Roto , Edema Encefálico , Embolização Terapêutica , Hipersensibilidade , Aneurisma Intracraniano , Polímeros , Adulto , Prótese Vascular , Edema Encefálico/etiologia , Embolização Terapêutica/efeitos adversos , Feminino , Humanos , Polímeros/efeitos adversos , Hemorragia Subaracnóidea/terapia
16.
AIDS Rev ; 21(3): 126-134, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31532397

RESUMO

Persistent coinfection with the hepatitis B/D viruses (HDV) represents the most severe form of viral hepatitis. Hepatitis D often leads to liver cirrhosis, hepatic decompensation, and hepatocellular carcinoma. The current treatment options are limited as only pegylated interferon-alpha (PEG-IFNa) has efficacy against HDV. However, treatment response is still unsatisfactory with 25-40% HDV RNA suppression after 1-2 years. In addition, late HDV RNA relapses have been described during long-term follow-up. Fortunately, new treatment options for patients with chronic hepatitis delta are now on the horizon. The hepatocyte entry inhibitor bulevirtide (formerly myrcludex B) and the farnesyl transferase inhibitor lonafarnib are currently explored in patients with chronic hepatitis delta in Phase 3 clinical studies. The nucleic acid inhibitor REP-2139-Ca and PEG-IFN-lambda are studied in Phase 2 trials. We here summarize data on the efficacy of these new antiviral drugs and the existing safety data on the treatment of HDV infection.


Assuntos
Antivirais/administração & dosagem , Hepatite D/tratamento farmacológico , Interferon-alfa/administração & dosagem , Lipopeptídeos/administração & dosagem , Ácidos Nucleicos/administração & dosagem , Piperidinas/administração & dosagem , Polímeros/administração & dosagem , Piridinas/administração & dosagem , Antivirais/efeitos adversos , Ensaios Clínicos Fase II como Assunto , Ensaios Clínicos Fase III como Assunto , Coinfecção/tratamento farmacológico , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Hepatite B Crônica/tratamento farmacológico , Vírus Delta da Hepatite/efeitos dos fármacos , Humanos , Interferon-alfa/efeitos adversos , Lipopeptídeos/efeitos adversos , Ácidos Nucleicos/efeitos adversos , Piperidinas/efeitos adversos , Polímeros/efeitos adversos , Piridinas/efeitos adversos , Recidiva , Resultado do Tratamento
17.
Int J Nanomedicine ; 14: 4383-4395, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31354267

RESUMO

Background: The bioactive compounds glycyrrhizin (GL) and thymoquinone (TQ) have been reported for antidiabetic activity in pure and nanoformulation (NF) form. However, the antidiabetic effect of a combined nanoformulation of these two has not been reported in the literature. Here, a combinational nanomedicine approach was investigated to enhance the antidiabetic effects of the two bioactive compounds of GL and TQ (GT), in type 2 diabetic rats in reference to metformin. Methods: Two separately prepared NFs of GL (using polymeric nanoparticles) and TQ (using polymeric nanocapsules) were mixed to obtain a therapeutic cargo of nanomedicine and then characterized with respect to particle size, stability, morphology, chemical interaction, and in vivo behavior. Additionally, NFs were evaluated for their cytotoxic effect on Vero cell lines compared to the pure form. This nanomedicine was administered orally, both independently and in combination (pure form or NF) for 21 successive days to type 2 diabetic rats and the effect assessed in term of body weight, fasting blood-glucose level, and various biochemical parameters (such as lipid-profile parameters and HbA1c). Results: When these nanomedicines were applied in combined rather than individual forms, significant decreases in blood glucose and HbA1c and significant improvements in body weight and lipid profile were observed, despite them containing lower amounts than the pure forms. The treatment of diabetic rats with GL and TQ, when administered independently in either pure or NF forms, did not lead to favorable trends in any studied parameters. Conclusion: The administration of combined GT NFs exhibited significant improvement in studied parameters. Improvements in antidiabetic activity could have been due to a synergistic effect of combined NFs, leading to enhanced absorption of NFs and lesser cytotoxic effects compared to pure bioactive compounds. Therefore, GT NFs demonstrated potential as a new medicinal agent for the management of diabetes.


Assuntos
Diabetes Mellitus Experimental/tratamento farmacológico , Composição de Medicamentos , Hipoglicemiantes/uso terapêutico , Nanopartículas/química , Polímeros/química , Animais , Benzoquinonas/farmacologia , Benzoquinonas/uso terapêutico , Glicemia/metabolismo , Peso Corporal/efeitos dos fármacos , Varredura Diferencial de Calorimetria , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/patologia , Feminino , Hemoglobina A Glicada/metabolismo , Ácido Glicirrízico/uso terapêutico , Hipoglicemiantes/administração & dosagem , Lipídeos/química , Nanopartículas/ultraestrutura , Niacinamida , Polímeros/efeitos adversos , Ratos Wistar , Espectroscopia de Infravermelho com Transformada de Fourier , Estreptozocina
18.
Vasc Endovascular Surg ; 53(7): 606-608, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31272303

RESUMO

Hydrophilic polymer coatings are now widely applied to catheters and other intravascular devices used in neurovascular, cardiovascular, and peripheral vascular procedures. Emboli consisting of these materials have been previously identified in biopsies and autopsies following pulmonary infarction, stroke, gangrene, or death. We report a case involving a nonhealing foot ulcer that appeared following cardiac catheterization, stenting, and automatic implanted cardiac defibrillator (AICD) implantation in a patient without other evidence of significant peripheral artery disease. An 85-year-old woman with chronic atrial fibrillation, aortic valve stenosis, and coronary artery disease underwent coronary stenting and AICD implantation for ventricular tachycardia and syncope. She developed a toe ulcer shortly thereafter, which did not respond to standard treatment. A histological examination following amputation of the toe found amorphous basophilic material in capillaries adjacent to the edge of the ulcer, which was similar to material associated with hydrophilic polymer coatings. Ischemia and infarcts following endovascular procedures should not be presumed to result from thrombus or vascular disease, even if intravascular devices appear intact or properly placed after the procedure. To help establish the incidence of ischemia caused by hydrophilic polymer device coatings, if excision of ischemic or infarcted tissue after endovascular procedures using coated devices becomes necessary, the tissue should be evaluated microscopically. Surgeons should also consider the tolerance of distal organs to infarct or ischemia when selecting coated intravascular devices.


Assuntos
Materiais Revestidos Biocompatíveis/efeitos adversos , Embolia/etiologia , Úlcera do Pé/etiologia , Migração de Corpo Estranho/etiologia , Isquemia/etiologia , Polímeros/efeitos adversos , Dedos do Pé/irrigação sanguínea , Idoso de 80 Anos ou mais , Amputação , Angiografia , Biópsia , Embolia/diagnóstico por imagem , Embolia/cirurgia , Feminino , Úlcera do Pé/diagnóstico por imagem , Úlcera do Pé/fisiopatologia , Úlcera do Pé/cirurgia , Migração de Corpo Estranho/diagnóstico por imagem , Migração de Corpo Estranho/cirurgia , Humanos , Interações Hidrofóbicas e Hidrofílicas , Isquemia/diagnóstico por imagem , Isquemia/fisiopatologia , Isquemia/cirurgia , Fluxo Sanguíneo Regional , Dedos do Pé/cirurgia , Resultado do Tratamento
19.
Clin Transl Gastroenterol ; 10(7): e00060, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31335356

RESUMO

INTRODUCTION: Fecal incontinence (FI) is a common complaint and is often associated with diarrhea and urgency. Foods high in fermentable oligo-, di-, and mono-saccharides and polyols (FODMAP) cause symptoms of diarrhea and urgency. Therefore, this study assesses the impact of a low FODMAP diet on the occurrence of FI due to loose stool. METHODS: This study is a retrospective chart review of patients with FI seen in the Michigan Bowel Control Program clinic between August 2012 and December 2017. Patients who had FI with loose stool without red flag signs and who were recommended a low FODMAP diet and underwent formal dietary instruction with a Michigan Medicine dietician were included. RESULTS: Sixty-five patients with FI who underwent formal dietary teaching were included in this study. Eighty-eight percent of the patients were white, and 87% were women with a mean age of 62 years (±14 years). Additionally, the chart review showed that 35% of the patients had FI daily, 21.5% had FI weekly, and 5% had FI monthly. About 64.6% of the patients (42) had reported a reduction in their FI symptoms with the low FODMAP diet. There was no demographic or clinical characteristic that predicted the response to a low FODMAP diet. DISCUSSION: In this case series, dietary manipulation with a low FODMAP diet was a useful tool to treat patients who suffer from FI due to loose stool. Further confirmatory, prospective randomized controlled trials are required to see the true efficacy of a low FODMAP diet in patients who suffer with FI.


Assuntos
Dieta com Restrição de Carboidratos/métodos , Incontinência Fecal/dietoterapia , Incontinência Fecal/fisiopatologia , Idoso , Diarreia/etiologia , Dissacarídeos/efeitos adversos , Incontinência Fecal/epidemiologia , Feminino , Fermentação/fisiologia , Humanos , Masculino , Michigan/epidemiologia , Pessoa de Meia-Idade , Monossacarídeos/efeitos adversos , Oligossacarídeos/efeitos adversos , Polímeros/efeitos adversos , Estudos Retrospectivos , Resultado do Tratamento
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