Precision and reliability study of hospital infusion pumps: a systematic review.

BACKGROUND: Infusion Pumps (IP) are medical devices that were developed in the 1960s and generate fluid flow at pressures higher than that of normal blood pressure. Various hospital sectors make use of them, and they have become indispensable in therapies requiring continuity and precision in the administration of medication and/or food. As they are classified Class III (high risk) equipment, their maintenance is crucial for proper performance of the device, as well as patient and operator safety. The principal consideration of the pump is the volume infused, and the device demands great attention to detail when being calibrated. A lack of necessary care with this equipment can lead to uncertainty in volume and precision during the administration of substances. Because of this, it is essential to evaluate its reliability, to prevent possible failures at time of execution. This control aims at the quality of the intended infusion result, becoming an indication of quality. METHODS: This systematic review summarizes studies done over the last 10 years (2011 to December 2021) that address the reliability and accuracy of hospital infusion pumps, in order to identify planning of maintenance and/or other techniques used in management of the equipment. The Prisma method was applied and the databases utilized were Embase, MEDLINE/Pubmed, Web of Science, Scopus, IEEE Xplore, and Science Direct. In addition, similar reviews were studied in Prospero and the Cochrane Library. For data analysis, softwares such as Mendeley, Excel, RStudio, and VOSviewer were used, and Robvis helped in plotting risk of bias results for studies performed with Cochrane tools. RESULTS: The six databases selected produced 824 studies. After applying eligibility criteria (inclusion and exclusion), removing duplicates, and applying filters 1 and 2, 15 studies were included in the present review. It was found that the most relevant sources came from the Institute of Electrical and Electronics Engineers (IEEE) and that the most relevant keywords revolved around the terms ("device failure", "infusion pumps", "adverse effects", "complications", etc.). These results made clear that there remains substantial room for improvement as it relates to the study of accuracy and reliability of infusion. CONCLUSIONS: We verified that the reliability and precision analysis of hospital infusion pumps need to be performed in a more detailed and consistent way. New developments, considering the model and IP specification, are intended, clearly explaining the adopted methodology.

Biocides Used as Additives to Biodiesels and Their Risks to the Environment and Public Health: A Review.

One of the advantages of using biodiesel and its blends with diesel oil is the lower levels of emissions of particulate matter, sulfur dioxide, carbon monoxide, among others, making it less harmful to the environment and to humans. However, this biofuel is susceptible to microbial contamination and biodeterioration. In this sense, studies on the use of effective low toxicity biocides are being carried out, and this work aims to present the latest information (2008⁻2018) available in the scientific databases, on the use of biocides in biodiesel, mainly concerning their toxicity to the environment and public health. The results showed that in relation to the control of microbial contamination, the current scenario is limited, with seven publications, in which the most studied additives were isothiazolinones, oxazolidines, thiocyanates, morpholines, oxaborinanes, thiocarbamates and phenolic antioxidants. Studies regarding direct experiments with humans have not been found, showing the need for more studies in this area, since the potential growth of biodiesel production and consumption in the world is evident. Thus, there are need for more studies on antimicrobial products for use in biodiesel, with good broad-spectrum activity (bactericidal and fungicidal), and further toxicological tests to ensure no or little impact on the environment.

Pharmacokinetics of Curcumin Delivered by Nanoparticles and the Relationship with Antitumor Efficacy: A Systematic Review.

Curcumin is a polyphenolic compound, derived from Curcuma longa, and it has several pharmacological effects such as antioxidant, anti-inflammatory, and antitumor. Although it is a pleiotropic molecule, curcumin's free form, which is lipophilic, has low bioavailability and is rapidly metabolized, limiting its clinical use. With the advances in techniques for loading curcumin into nanostructures, it is possible to improve its bioavailability and extend its applications. In this review, we gather evidence about the comparison of the pharmacokinetics (biodistribution and bioavailability) between free curcumin (Cur) and nanostructured curcumin (Cur-NPs) and their respective relationships with antitumor efficacy. The search was performed in the following databases: Cochrane, LILACS, Embase, MEDLINE/Pubmed, Clinical Trials, BSV regional portal, ScienceDirect, Scopus, and Web of Science. The selected studies were based on studies that used High-Performance Liquid Chromatography (HPLC) as the pharmacokinetics evaluation method. Of the 345 studies initially pooled, 11 met the inclusion criteria and all included studies classified as high quality. In this search, a variety of nanoparticles used to deliver curcumin (polymeric, copolymeric, nanocrystals, nanovesicles, and nanosuspension) were found. Most Cur-NPs presented negative Zeta potential ranging from -25 mV to 12.7 mV, polydispersion index (PDI) ranging from 0.06 to 0.283, and hydrodynamic diameter ranging from 30.47 to 550.1 nm. Selected studies adopted mainly oral and intravenous administrations. In the pharmacokinetics analysis, samples of plasma, liver, tumor, lung, brain, kidney, and spleen were evaluated. The administration of curcumin, in nanoparticle systems, resulted in a higher level of curcumin in tumors compared to free curcumin, leading to an improved antitumor effect. Thus, the use of nanoparticles can be a promising alternative for curcumin delivery since this improves its bioavailability.

Anti-Inflammatory Activity of Pequi Oil (Caryocar brasiliense): A Systematic Review.

Disorders in the inflammatory process underlie the pathogenesis of numerous diseases. The utilization of natural products as anti-inflammatory agents is a well-established approach in both traditional medicine and scientific research, with studies consistently demonstrating their efficacy in managing inflammatory conditions. Pequi oil, derived from Caryocar brasiliense, is a rich source of bioactive compounds including fatty acids and carotenoids, which exhibit immunomodulatory potential. This systematic review aims to comprehensively summarize the scientific evidence regarding the anti-inflammatory activity of pequi oil. Extensive literature searches were conducted across prominent databases (Scopus, BVS, CINAHL, Cochrane, LILACS, Embase, MEDLINE, ProQuest, PubMed, FSTA, ScienceDirect, and Web of Science). Studies evaluating the immunomodulatory activity of crude pequi oil using in vitro, in vivo models, or clinical trials were included. Out of the 438 articles identified, 10 met the stringent inclusion criteria. These studies collectively elucidate the potential of pequi oil to modulate gene expression, regulate circulating levels of pro- and anti-inflammatory mediators, and mitigate oxidative stress, immune cell migration, and cardinal signs of inflammation. Moreover, negligible to no toxicity of pequi oil was observed across the diverse evaluated models. Notably, variations in the chemical profile of the oil were noted, depending on the extraction methodology and geographical origin. This systematic review strongly supports the utility of pequi oil in controlling the inflammatory process. However, further comparative studies involving oils obtained via different methods and sourced from various regions are warranted to reinforce our understanding of its effectiveness and safety.

Benefits of using polymeric nanoparticles in breast cancer treatment: a systematic review.

Breast cancer comprises approximately 20% of all malignant neoplasm cases globally. Due to the limitations associated with conventional therapeutic approaches, extensive investigations have been undertaken to develop novel treatments that exhibit enhanced specificity and minimized adverse effects. Consequently, the application of polymeric nanoformulations for targeted drug delivery has gained significant attention within the biomedical field. Therefore, the primary objective of this study was to explore the inherent advantages and efficacy of employing polymeric nanoformulations for drug delivery in breast cancer treatment, as compared to traditional therapies. A comprehensive literature search was conducted across prominent databases including PubMed/MEDLINE, Embase, and Scopus, utilizing specific search strings. This meticulous approach yielded a total of 12 relevant articles for in-depth analysis and discussion. The findings from the selected studies underscore the effectiveness of employing polymeric nanoparticles as a drug delivery strategy, showcasing noteworthy improvements in cellular uptake and sustained intracellular retention of encapsulated therapeutic agents. Additionally, these nanoformulations exhibited superior efficacy, safety, and drug delivery capabilities. The utilization of polymeric nanoparticles in drug delivery has demonstrated a substantial enhancement in treatment efficacy, with the ability to achieve higher concentrations of active ingredients within tumor tissues, augment cellular uptake and drug concentrations, and sustain intracellular retention. Consequently, this innovative approach prolongs drug release in lower quantities, ultimately contributing to improved treatment outcomes.

A novel N95 respirator with chitosan nanoparticles: mechanical, antiviral, microbiological and cytotoxicity evaluations.

BACKGROUND: It is known that some sectors of hospitals have high bacteria and virus loads that can remain as aerosols in the air and represent a significant health threat for patients and mainly professionals that work in the place daily. Therefore, the need for a respirator able to improve the filtration barrier of N95 masks and even inactivating airborne virus and bacteria becomes apparent. Such a fact motivated the creation of a new N95 respirator which employs chitosan nanoparticles on its intermediate layer (SN95 + CNP). RESULTS: The average chitosan nanoparticle size obtained was 165.20 ± 35.00 nm, with a polydispersity index of 0.36 ± 0.03 and a zeta potential of 47.50 ± 1.70 mV. Mechanical tests demonstrate that the SN95 + CNP respirator is more resistant and meets the safety requisites of aerosol penetration, resistance to breath and flammability, presenting higher potential to filtrate microbial and viral particles when compared to conventional SN95 respirators. Furthermore, biological in vitro tests on bacteria, fungi and mammalian cell lines (HaCat, Vero E6 and CCL-81) corroborate the hypothesis that our SN95 + CNP respirator presents strong antimicrobial activity and is safe for human use. There was a reduction of 96.83% of the alphacoronavirus virus and 99% of H1N1 virus and MHV-3 betacoronavirus after 120 min of contact compared to the conventional respirator (SN95), demonstrating that SN95 + CNP have a relevant potential as personal protection equipment. CONCLUSIONS: Due to chitosan nanotechnology, our novel N95 respirator presents improved mechanical, antimicrobial and antiviral characteristics.

In Vivo Efficacy and Toxicity of Curcumin Nanoparticles in Breast Cancer Treatment: A Systematic Review.

Breast cancer is one of the most prevalent types of malignant tumors in the world, resulting in a high incidence of death. The development of new molecules and technologies aiming to apply more effective and safer therapy strategies has been intensively explored to overcome this situation. The association of nanoparticles with known antitumor compounds (including plant-derived molecules such as curcumin) has been considered an effective approach to enhance tumor growth suppression and reduce adverse effects. Therefore, the objective of this systematic review was to summarize published data regarding evaluations about efficacy and toxicity of curcumin nanoparticles (Cur-NPs) in in vivo models of breast cancer. The search was carried out in the databases: CINAHL, Cochrane, LILACS, Embase, FSTA, MEDLINE, ProQuest, BSV regional portal, PubMed, ScienceDirect, Scopus, and Web of Science. Studies that evaluated tumor growth in in vivo models of breast cancer and showed outcomes related to Cur-NP treatment (without association with other antitumor molecules) were included. Of the 528 initially gathered studies, 26 met the inclusion criteria. These studies showed that a wide variety of NP platforms have been used to deliver curcumin (e.g., micelles, polymeric, lipid-based, metallic). Attachment of poly(ethylene glycol) chains (PEG) and active targeting moieties were also evaluated. Cur-NPs significantly reduced tumor volume/weight, inhibited cancer cell proliferation, and increased tumor apoptosis and necrosis. Decreases in cancer stem cell population and angiogenesis were also reported. All the studies that evaluated toxicity considered Cur-NP treatment to be safe regarding hematological/biochemical markers, damage to major organs, and/or weight loss. These effects were observed in different in vivo models of breast cancer (e.g., estrogen receptor-positive, triple-negative, chemically induced) showing better outcomes when compared to treatments with free curcumin or negative controls. This systematic review supports the proposal that Cur-NP is an effective and safe therapeutic approach in in vivo models of breast cancer, reinforcing the currently available evidence that it should be further analyzed in clinical trials for breast cancer treatments.

Evidence of the benefits, advantages and potentialities of the structured radiological report: An integrative review.

The structured report is a new trend for the preparation and manipulation of radiological examination reports. The structuring of the radiological report data can bring many benefits and advantages over other existing methodologies. Research and studies about the structured radiological report are highly relevant in clinical and academic subjects, improving medical practice, reducing unobserved problems by radiologists, improving reporting practices and medical diagnoses. Exposing the benefits, advantages and potential of the structured radiological report is important in encouraging the acceptance and implementation of this method by radiology professionals who are still somewhat resistant. The present review highlights the factors that contribute to the consolidation of adopting the structured radiology report methodology, addressing a variety of studies focused on the structuring of the radiological report. This integrative review of the literature is proposed by searching publications and journals databases (CAPES - Coordination of Improvement of Higher-Level Personnel, SciELO - Scientific Electronic Library Online, and PubMed - Publisher Medline) to develop a complete and unified understanding of the subject, so that it becomes a major part of evidence-based initiatives.

Evidence in Practice of Tissue Healing with Latex Biomembrane: Integrative Review.

Wound healing is a perfectly coordinated cascade of cellular, molecular, and biochemical events which interact in tissue reconstitution. Chronic diseases such as pressure ulcers (PU) and diabetes mellitus (DM) are considered risk factors for wound healing. Patients with such diseases often have higher sepsis, infection, and complication rates, since they have revascularization inhibition and low growth factor expression. Thus, latex biomembrane (LBM), a biocompatible material, derived from the latex of the rubber tree (Hevea brasiliensis) appears to create tendencies as an angiogenic-inducing tissue healing agent and as biomaterial, resulting from its structural qualities and its low cost when compared to conventional treatments. Therefore, this work aims at summarizing the results, experiments, and scientific findings that certify or recommend the use of LBM as a new technique to be applied effectively in the treatment of wounds. An integrative review was held in the BIREME, LILACS, Burns, MEDLINE, PubMed, and SciELO databases, from 2000 to 2016, using the following descriptors: "healing," "diabetes mellitus," "wounds," and "latex membrane." As a result, 600 experiments (out of 612) presented satisfactory results; however, 33% of the cases received explicit recommendations, 11% required more studies on the subjects, and 1% was denied. On the other hand, half of the studies did not expressly endorse its use, despite presenting satisfactory results. The LBM was characterized as a good therapeutic alternative in cases of wounds, including chronic diseases, such as diabetes mellitus and PU, due to its relevant potential for wound healing stimulation, acceleration of cell tissue mending and revascularization, or the reestablishment of angiogenic functions (creation of new blood vessels). The LBM was also confirmed to be safe as a biocompatible material whose structural qualities (elasticity, adaptability, impermeability, and possibility of suture), devoid of toxicity, allowed interaction between tissues and presented no hypersensitivity inducer and no antimicrobial effect.