Advances in functionalization and conjugation mechanisms of dendrimers with iron oxide magnetic nanoparticles.

Iron oxide magnetic nanoparticles (MNPs) are crucial in various areas due to their unique magnetic properties. However, their practical use is often limited by instability and aggregation in aqueous solutions. This review explores the advanced technique of dendrimer functionalization to enhance MNP stability and expand their application potential. Dendrimers, with their symmetric and highly branched structure, effectively stabilize MNPs and provide tailored functional sites for specific applications. We summarize key synthetic modifications, focusing on the impacts of dendrimer size, surface chemistry, and the balance of chemical (e.g., coordination, anchoring) and physical (e.g., electrostatic, hydrophobic) interactions on nanocomposite properties. Current challenges such as dendrimer toxicity, control over dendrimer distribution on MNPs, and the need for biocompatibility are discussed, alongside potential solutions involving advanced characterization techniques. This review highlights significant opportunities in environmental, biomedical, and water treatment applications, stressing the necessity for ongoing research to fully leverage dendrimer-functionalized MNPs. Insights offered here aim to guide further development and application of these promising nanocomposites.

Culture-Negative Emphysematous Pyelonephritis as a Complication of Uncontrolled Diabetes Mellitus: A Case Report.

Emphysematous pyelonephritis (EPN) is a severe, necrotizing infection of the renal parenchyma. It is commonly found as a complication of uncontrolled diabetes mellitus (DM). EPN has a terrible prognosis unless promptly identified and treated. In this case study, a 38-year-old man with type 2 diabetes mellitus (T2DM) was admitted due to complaints of excruciating abdominal pain, vomiting, and non-adherent to his insulin medication. The patient was subsequently diagnosed with EPN. For most patients, the current course of treatment includes nephrectomy along with antimicrobial medications. In this case report, however, the patient improved with conservative treatment such as IV fluids, antibiotics, and blood glucose control.

The Nexus Between Diabetes and Depression: A Narrative Review.

Comorbid diabetes and depression are a significant public health burden as the consequences of both diseases are worsened by each other. In this study, we have compiled and analyzed findings from various studies to demonstrate that diabetes has a strong association with depression. Both have a significant impact on the quality of life, although the exact mechanisms through which these two chronic diseases affect each other remain unknown. This article discussed the shared etiological factors of comorbidity between diabetes and depression, including physiological (e.g., deregulation of the hypothalamic-pituitary-adrenal (HPA) axis, sympathetic nervous system (SNS) overactivity, microvascular dysfunction, arterial stiffening, inflammation, and cytokines), behavioral (e.g., diet and lifestyle modifications), and environmental (e.g., childhood adversity, poverty, and neighborhood environment). Included data from a range of settings have suggested that the prognosis of both diabetes and depression, in terms of complications, treatment efficacy, morbidity, and mortality, is worse for either disease when they occur concurrently than individually. The implication for the physical, mental, and social well-being of depression in diabetes causes poor self-care and adherence to medical treatment. This article also highlights the importance of regular screening and prompts the treatment of comorbid diabetes and depression with pharmacotherapy, face-to-face psychotherapy, and non-face-to-face models of alternative psychological interventions, including information and communication technologies (ICTs), computer-based diabetes self-management interventions, and digital mental health intervention, to improve the outcomes of both diseases.

Multiple Sclerosis: Therapeutic Strategies on the Horizon.

Multiple sclerosis (MS) is a chronic disease affecting the brain and the spinal cord. It is a chronic inflammatory demyelinating disease of the central nervous system. It is the leading cause of non-traumatic disability in young adults. The clinical course of the disease is quite variable, ranging from stable chronic disease to rapidly evolving debilitating disease. The pathogenesis of MS is not fully understood. Still, there has been a rapid shift in understanding the immune pathology of MS away from pure T cell-mediated disease to B cells and microglia/astrocytes having a vital role in the pathogenesis of MS. This has helped in the emergence of new therapies for management. Effective treatment of MS requires a multidisciplinary approach to manage acute attacks, prevent relapses and disease progression and treat the disabling symptoms associated with the disease. In this review, we discuss the pathogenesis of MS, management of acute relapses, disease-modifying therapies in MS, new drugs and drugs currently in trial for MS and the symptomatic treatment of MS.  All language search was conducted on Google Scholar, PubMed, MEDLINE, and Embase till February 2022. The following search strings and medical subheadings (MeSH) were used: "Multiple Sclerosis", "Pathogenesis of MS", and "Disease-modifying therapies in MS". We explored literature on the pathogenic mechanisms behind MS, management of acute relapses, disease-modifying therapies in MS and symptomatic management.

Gastroesophageal Reflux Disease and Asthma: A Narrative Review.

Gastroesophageal reflux disease (GERD) is defined by retrograde reflux of gastric contents to the esophagus leading to various signs and symptoms that range from heartburn/regurgitation to the development of extraesophageal respiratory syndromes like asthma. Although a cause-effect relationship has been proposed, evidence suggests that these two entities share a complex mechanism that may be reciprocal to each other. The understanding of the underlying mechanisms is imperial due to the fact that asthmatic patients may benefit from reflux therapy with subsequent improvement in pulmonary function testing and quality of life. This study has revised available literature in order to provide evidence for a nexus between GERD and asthma based on clinical correlation, pathophysiology, and pharmacologic management.

Cardio-Metabolic Disease and Polycystic Ovarian Syndrome (PCOS): A Narrative Review.

Polycystic ovarian syndrome (PCOS) is considered the most common endocrine disorder affecting females in today's world. Although it has been primarily studied and discussed in terms of its reproductive symptoms such as infertility, amenorrhea or oligomenorrhea, acne, hirsutism, and mood disorders, there is yet another unexplored and under-diagnosed category in the PCOS spectrum of diseases: its cardio-metabolic consequences. PCOS patients are prone to these abnormalities from a very young age, increasing their morbidity and mortality rates compared to their regular counterparts. The usual pathogenesis of PCOS is a culmination of several genetic and environmental factors. Regarding its cardio-metabolic aspects, insulin resistance (IR) is said to be the single most important cause of a variety of metabolic risk factors, including type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), dyslipidemia, obesity, and hypertension (HTN), whereas a few other non-traditional factors such as C-reactive protein (CRP), carotid intima-media thickness (IMT), coronary artery calcification (CAC), and endothelial dysfunction are also said to be increased in PCOS patients, further increasing their risk of complications due to cardiovascular diseases (CVD). A timely diagnosis and adequate treatment of these risk factors by using lifestyle interventions, diet, and/or medications are essential to reduce the burden of PCOS in today's world. This article has highlighted an array of traditional and non-traditional cardio-metabolic consequences PCOS patients are prone to and their systematic pathogenesis. In addition, an outline of recommendations has been given in the pharmacological and non-pharmacological sections of this article, which may benefit doctors in managing this challenging condition.

Fibromyalgia and Depression: A Literature Review of Their Shared Aspects.

Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread, persistent pain that lasts more than three months without an evident organic lesion. FM has been considered controversial throughout history due to its validity as a diagnosis being constantly in question. Most patients diagnosed with FM are females. FM has been associated with multiple conditions, including irritable bowel and psychiatric disorders. Among all associated conditions, depression has been frequently found in patients with FM. Studies suggest that depression negatively affects the outcome of patients with FM. Moreover, a bidirectional relation between FM and depression has been depicted: depression increases the risk of FM being diagnosed later in life, as well as FM increases the risk of developing depression. In this article, we discussed aspects that FM and depression share and that might link both diseases, such as certain elements they seem to share in their pathophysiology: predisposing and triggering factors, central sensitization and kindling, areas of the brain implicated in both pain modulation and mood regulation, and hypothalamic-pituitary-adrenal axis (HPA axis) alterations. In addition, we highlighted the prevalence of depression in patients with FM, overlapping symptoms between FM and depression and how to assess them, and treatment strategies that have shown effective management of both conditions when concomitant. Due to the improvement of many aspects of FM when depression is appropriately targeted, screening for depression in patients with FM, despite its difficulty, has been encouraged.

Novel Slippery Liquid-Infused Porous Surfaces (SLIPS) Based on Electrospun Polydimethylsiloxane/Polystyrene Fibrous Structures Infused with Natural Blackseed Oil.

Hydrophobic fibrous slippery liquid-infused porous surfaces (SLIPS) were fabricated by electrospinning polydimethylsiloxane (PDMS) and polystyrene (PS) as a carrier polymer on plasma-treated polyethylene (PE) and polyurethane (PU) substrates. Subsequent infusion of blackseed oil (BSO) into the porous structures was applied for the preparation of the SLIPS. SLIPS with infused lubricants can act as a repellency layer and play an important role in the prevention of biofilm formation. The effect of polymer solutions used in the electrospinning process was investigated to obtain well-defined hydrophobic fibrous structures. The surface properties were analyzed through various optical, macroscopic and spectroscopic techniques. A comprehensive investigation of the surface chemistry, surface morphology/topography, and mechanical properties was carried out on selected samples at optimized conditions. The electrospun fibers prepared using a mixture of PDMS/PS in the ratio of 1:1:10 (g/g/mL) using tetrahydrofuran (THF) solvent showed the best results in terms of fiber uniformity. The subsequent infusion of BSO into the fabricated PDMS/PS fiber mats exhibited slippery behavior regarding water droplets. Moreover, prepared SLIPS exhibited antibacterial activity against Staphylococcus aureus and Escherichia coli bacterium strains.

Modulation of salt-induced stress impact in Gladiolus grandiflorus L. by exogenous application of salicylic acid.

Salinity is challenging threats to the agricultural system and leading cause of crop loss. Salicylic acid (SA) is an important endogenous signal molecule, which by regulating growth and physiological processes improves the plant ability to tolerate salt stress. Considering the prime importance of Gladiolus grandiflorus (L.) in the world's cut-flower market, the research work was undertaken to elucidate salinity tolerance in G. grandiflorus by exogenous application of SA irrigated with saline water. Results revealed that increasing salinity (EC: 2, 4 and 6 dS m-1) considerably altered morpho-growth indices (corm morphology and plant biomass) in plants through increasing key antioxidants including proline content and enzymes activity (superoxide dismutase, catalase and peroxidase), while negatively affected the total phenolic along with activity of defense-related enzymes (phenylalanine ammonia lyase, and polyphenol oxidase activity). SA application (50-200 ppm) in non-saline control or saline conditions improved morpho-physiological traits in concentration-dependent manners. In saline conditions, SA minimized salt-stress by enhancing chlorophyll content, accumulating organic osmolytes (glycine betaine and proline content), total phenolic, and boosting activity of antioxidant and defense-related enzymes. Principle component analysis based on all 16 morphological and physiological variables generated useful information regarding the classification of salt tolerant treatment according to their response to SA. These results suggest SA (100 or 150 ppm) could be used as an effective, economic, easily available and safe phenolic agent against salinity stress in G. grandiflorus.

Slippery Liquid-Infused Porous Polymeric Surfaces Based on Natural Oil with Antimicrobial Effect.

Many polymer materials have found a wide variety of applications in biomedical industries due to their excellent mechanical properties. However, the infections associated with the biofilm formation represent serious problems resulting from the initial bacterial attachment on the polymeric surface. The development of novel slippery liquid-infused porous surfaces (SLIPSs) represents promising method for the biofilm formation prevention. These surfaces are characterized by specific microstructural roughness able to hold lubricants inside. The lubricants create a slippery layer for the repellence of various liquids, such as water and blood. In this study, effective antimicrobial modifications of polyethylene (PE) and polyurethane (PU), as commonly used medical polymers, were investigated. For this purpose, low-temperature plasma treatment was used initially for activation of the polymeric surface, thereby enhancing surface and adhesion properties. Subsequently, preparation of porous microstructures was achieved by electrospinning technique using polydimethylsiloxane (PDMS) in combination with polyamide (PA). Finally, natural black seed oil (BSO) infiltrated the produced fiber mats acting as a lubricating layer. The optimized fiber mats' production was achieved using PDMS/PA mixture at ratio 1:1:20 (g/g/mL) using isopropyl alcohol as solvent. The surface properties of produced slippery surfaces were analyzed by various microscopic and optics techniques to obtain information about wettability, sliding behavior and surface morphology/topography. The modified PE and PU substrates demonstrated slippery behavior of an impinged water droplet at a small tilting angle. Moreover, the antimicrobial effects of the produced SLIPs using black seed oil were proven against Gram-positive Staphylococcus aureus (S. aureus) and Gram-negative Escherichia coli (E. coli).

A Complicated Case of COVID-19-Induced Inferolateral Wall Myocardial Infarction Successfully Treated With Streptokinase.

The treatment of myocardial infarction (MI) in coronavirus disease 2019 (COVID-19)-positive patients is both controversial and challenging, particularly in a healthcare setup unable to fulfill COVID-19 protocols. In this report, we describe a case of a COVID-19-positive patient admitted with COVID-19 pneumonia treated symptomatically with a non-rebreathing mask, dexamethasone, remdesivir, and low-molecular-weight heparin (LMWH). On day two of the hospital stay, the patient developed inferolateral wall myocardial infarction (MI) without hemodynamic instability. He was treated successfully with thrombolytic (streptokinase) with no severe complications. However, his hospital stay was further complicated by decreasing oxygen saturation and rising inflammatory markers including procalcitonin and IL-6, suggesting superimposed bacterial infection. Thereafter, he was placed on BiPAP oxygen, and aggressive antibiotic therapy including tigecycline along with clindamycin and moxifloxacin was initiated. He showed gradual daily improvements and was discharged after a prolonged hospital stay. To decrease the exposure and spread of COVID-19 infection among the healthcare workers, when there is a deficiency in medical staff, and no negative-pressure catheterization laboratory, thrombolytic can be used for treatment in low-risk, hemodynamically stable MI during this pandemic. However, this needs further research.

Preparation of Progressive Antibacterial LDPE Surface via Active Biomolecule Deposition Approach.

The use of polymers in all aspects of daily life is increasing considerably, so there is high demand for polymers with specific properties. Polymers with antibacterial properties are highly needed in the food and medical industries. Low-density polyethylene (LDPE) is widely used in various industries, especially in food packaging, because it has suitable mechanical and safety properties. Nevertheless, the hydrophobicity of its surface makes it vulnerable to microbial attack and culturing. To enhance antimicrobial activity, a progressive surface modification of LDPE using the antimicrobial agent grafting process was applied. LDPE was first exposed to nonthermal radio-frequency (RF) plasma treatment to activate its surface. This led to the creation of reactive species on the LDPE surface, resulting in the ability to graft antibacterial agents, such as ascorbic acid (ASA), commonly known as vitamin C. ASA is a well-known antioxidant that is used as a food preservative, is essential to biological systems, and is found to be reactive against a number of microorganisms and bacteria. The antimicrobial effect of grafted LDPE with ASA was tested against two strong kinds of bacteria, namely, Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli), with positive results. Surface analyses were performed thoroughly using contact angle measurements and peel tests to measure the wettability or surface free energy and adhesion properties after each modification step. Scanning electron microscopy (SEM) and atomic force microscopy (AFM) were used to analyze the surface morphology or topography changes of LDPE caused by plasma treatment and ASA grafting. Surface chemistry was studied by measuring the functional groups and elements introduced to the surface after plasma treatment and ASA grafting, using Fourier transform infrared (FTIR) spectroscopy and X-ray photoelectron spectroscopy (XPS). These results showed wettability, adhesion, and roughness changes in the LDPE surface after plasma treatment, as well as after ASA grafting. This is a positive indicator of the ability of ASA to be grafted onto polymeric materials using plasma pretreatment, resulting in enhanced antibacterial activity.