Unusual case of bullous emphysema with superimposed pneumonia.

Bullous emphysema is a chronic obstructive pulmonary disease (COPD) that results from chronic inflammation of the lung parenchyma leading to alveolar destruction. Etiology includes tobacco smoking and alpha-1 antitrypsin deficiency. In this article, we present a rare case of bullous emphysema in a nonsmoker with no genetic predisposition or social risk factors presenting with productive cough, fatigue, and shortness of breath. The patient was diagnosed with bullous emphysema with superimposed pneumonia based on clinical and radiological findings. The patients acute complaints were treated successfully with antibiotics, supplemental oxygen, systemic steroids, and, nebulizer treatments. With this case report the authors highlight an unusual presentation of pneumonia in a patient with underlying bullous emphysema. Environmental exposure is often overlooked and the outcomes cannot be turned to favor without a comprehensive approach in patient management from history and physical to deciding the right treatment and follow-up protocols.

Gellan gum-based bi-polymeric hydrogel scaffolds loaded with Rosuvastatin calcium: A useful tool for tendon tissue regeneration.

Statins have been long used in tissue engineering, besides their marketed hypolipidemic benefits. The aim of this research was to sustain the release of rosuvastatin calcium from bi-polymeric hydrogel scaffolds. A bi-polymer blend technique was used to enhance the mechanical properties of the fabricated hydrogels. Briefly, hydrogels were prepared via crosslinking gellan gum as the main polymer together with a secondary polymer in the presence of Ca2+. The fabricated hydrogels were assessed in terms of % swelling capacity, hydrolytic degradation and % drug released to determine the most efficient carrier system. The selected hydrogel exhibited a swelling capacity of 131.45±1.49 % following 3 weeks in an aqueous environment with a % weight loss of 15.73±1.86 % after 4 weeks post-equilibrium in aqueous medium. The results ensure a proper window for adequate drug diffusion and nutrient exchange. Sustained release was attained where 94.61±2.77 % of rosuvastatin was released at the 4-week mark. Later, FT-IR and DSC, were carried out and suggested the successful crosslinking and formation of new matrix. SEM images demonstrated the porous surface of the hydrogel while a Young's modulus of 888.558±73.549 kPa indicated the suitability of the hydrogel for soft tissue engineering. In-vivo testing involved implanting the selected hydrogel at precisely surgical cuts in the Achilles tendon of male Wistar Albino rats. Upon visual and microscopic evaluation, enhanced rates of fibrous tissue formation, vascularization and collagen expression were clearly noticed in the treatment group.

Polymeric nanocomposite hydrogel scaffold for jawbone regeneration: The role of rosuvastatin calcium-loaded silica nanoparticles.

Bones are subject to different types of damages ranging from simple fatigue to profound defects. In serious cases, the endogenous healing mechanism is not capable of healing the damage or restoring the normal structure and function of the bony tissue. The aim of this research was to achieve a sustained delivery of rosuvastatin and assess its efficacy in healing bone tissue damage. Rosuvastatin was entrapped into silica nanoparticles and the system was loaded into an alginate hydrogel to be implanted in the damaged tissue. Silica nanoparticles were formulated based on a modified Stöber technique and alginate hydrogel was prepared via sprinkling alginate onto silica nanoparticle dispersion followed by addition of CaCl2 to promote crosslinking and hydrogel rigidification. The selected nanoparticle formulation possessed high % drug content (100.22±0.67%), the smallest particle size (221.00±7.30 nm) and a sustained drug release up to 4 weeks (98.72±0.52%). The fabricated hydrogel exhibited a further delay in drug release (81.52±4.81% after 4 weeks). FT-IR indicated the silica nanoparticle formation and hydrogel crosslinking. SEM visualized the porous and dense surface of hydrogel. In-vivo testing on induced bone defects in New Zealand rabbits revealed the enhanced rate of new bone tissue formation, its homogeneity in color as well as similarity in structure to the original tissue.

Conventional and Recent Trends of Scaffolds Fabrication: A Superior Mode for Tissue Engineering.

Tissue regeneration is an auto-healing mechanism, initiating immediately following tissue damage to restore normal tissue structure and function. This falls in line with survival instinct being the most dominant instinct for any living organism. Nevertheless, the process is slow and not feasible in all tissues, which led to the emergence of tissue engineering (TE). TE aims at replacing damaged tissues with new ones. To do so, either new tissue is being cultured in vitro and then implanted, or stimulants are implanted into the target site to enhance endogenous tissue formation. Whichever approach is used, a matrix is used to support tissue growth, known as 'scaffold'. In this review, an overall look at scaffolds fabrication is discussed, starting with design considerations and different biomaterials used. Following, highlights of conventional and advanced fabrication techniques are attentively presented. The future of scaffolds in TE is ever promising, with the likes of nanotechnology being investigated for scaffold integration. The constant evolvement of organoids and biofluidics with the eventual inclusion of organ-on-a-chip in TE has shown a promising prospect of what the technology might lead to. Perhaps the closest technology to market is 4D scaffolds following the successful implementation of 4D printing in other fields.

Design and characterization of highly porous curcumin loaded freeze-dried wafers for wound healing.

The goal of this research was to evaluate the beneficial effects of topical curcumin loaded freeze-dried wafers in wound healing. Curcumin wafers were fabricated by cross-linking of chitosan with beta glycerophosphate under magnetic stirring. Composite wafers were prepared by the addition of sodium hyaluronate. Wafers were fabricated by freeze-drying technique. The resulted wafers were examined by naked eye and their dimensions were measured using a caliper. % Drug content, in-vitro release and % water uptake tests were conducted to characterize the fabricated wafers. Porosity testing, compressive mechanical behavior, morphological examination using scanning electron microscopy, thermal behavior using differential scanning calorimetry and Fourier transform infrared spectroscopy were all carried out on the optimized cross-linked wafers followed by their microbiological assays and cytotoxicity studies. The results showed that the optimized wafers possessed high water uptake capabilities while entertaining very high porosity levels (86-89%). Microbiological assay revealed the superiority of the selected curcumin wafers versus free curcumin in bacterial growth inhibition against Staphylococcus epidermidis and Staphylococcus aureus (MRSA) bacteria. The anti-inflammatory effects of the selected curcumin wafers were evaluated against pro-inflammatory cytokines. The results suggested that they were significantly better than free curcumin in lowering cytokines levels. To conclude, the obtained findings revealed that curcumin wafers offered a promising solution in the field of wound healing.

Design and Characterization of Spray-Dried Proliposomes for the Pulmonary Delivery of Curcumin.

PURPOSE: The goal was to directly deliver curcumin, a natural polyphenolic anticancer and anti-inflammatory compound, to the lung tissues with minimal systemic exposure through the fabrication of proliposomes, overcoming its poor aqueous solubility and oral bioavailability. METHODS: Nano-spray drying was employed to prepare proliposomes using hydroxypropyl beta-cyclodextrin as a carrier. Lecithin and cholesterol were used as lipids, stearylamine and Poloxamer 188 were added as positive charge inducer and a surfactant, respectively. Different characterization parameters were evaluated like percentage yield, entrapment efficiency, drug loading, aerodynamic particle size, in vitro release besides morphological examination. Cytotoxicity studies on cell line A549 lung tumor cells as well as in vivo lung pharmacokinetic studies were also carried. RESULTS: The optimized formulations showed superior aerosolization properties coupled their enhanced ability to reach deep lung tissues with a high % of fine particle fraction. Cytotoxicity studies using MTT assay demonstrated enhanced growth inhibitory effect on lung tumor cells A549 and significant reduction of proinflammatory cytokines such as tumor necrosis factor-α, interleukin-6 and interleukin-10 compared to the pure drug. Results of lung pharmacokinetic tests confirmed the superiority of proliposomal curcumin over curcumin powder in both, the rate and extent of lung tissue absorption, as well as the mean residence time within the lung tissues. CONCLUSION: The pulmonary delivery of curcumin-loaded proliposomes as dry powder provides a direct approach to lung tissues targeting while avoiding the limitations of the oral route and offering a non-invasive alternative to the parenteral one.

Respiratory Tract: Structure and Attractions for Drug Delivery Using Dry Powder Inhalers.

Respiratory tract is one of the oldest routes for drug delivery. It can be used for local and systemic drug deliveries. Inhalation therapy has several advantages over oral. It delivers the drug efficiently to the lung with minimal systemic exposure, thus avoiding systemic side effects common with oral route. In this review, different types of inhaler devices are illustrated like metered dose inhalers (MDIs), dry powder inhalers (DPIs), nebulizers, and the new soft mist inhalers (SMIs). Since dry powder is more stable than when in liquid form, we will discuss in detail DPIs highlighting different techniques utilized in preparation of dry powders with or without carrier to improve flowability and drug delivery to deep lungs. Types of DPIs are briefly discussed with examples from the market. Several mechanisms for particle deposition are mentioned with factors governing the process. Pharmacokinetic profile of the inhaled particles is detailed starting from the dissolution, followed by the rapid absorption and ending with systemic clearance. New technologies like 3D printing in pulmonary field are also highlighted.