Characterization of silver particles in the stratum corneum of healthy subjects and atopic dermatitis patients dermally exposed to a silver-containing garment.

Silver is increasingly being used in garments to exploit its antibacterial properties. Information on the presence of silver nanoparticles (AgNPs) in garments and their in vivo penetration across healthy and impaired skin from use is limited. We investigated the presence of AgNPs in a silver containing garment and in the stratum corneum (SC) of healthy subjects (CTRLs) and individuals with atopic dermatitis (AD). Seven CTRLs and seven AD patients wore a silver sleeve (13% Ag w/w) 8 h/day for five days on a forearm and a placebo sleeve on the other forearm. After five days, the layers of the SC were collected by adhesive tapes. The silver particles in the garment and SC were characterized by scanning electron microscopy with energy dispersive X-ray analysis (SEM-EDX) and atomic force microscopy (AFM). AFM and SEM revealed the presence of sub-micrometre particles having a broad range of sizes (30-500 nm) on the surface of the garment that were identified as silver. On the SC tapes collected from different depths, aggregates with a wide range of sizes (150 nm-2 µm) and morphologies were found. Most aggregates contained primarily silver, although some also contained chlorine and sulfur. There was no clear difference in the number or size of the aggregates observed in SC between healthy and AD subjects. After use, AgNPs and their aggregates were present in the SC at different depths of both healthy subjects and AD patients. Their micrometre size suggests that aggregation likely occurred in the SC.

[Spontaneous, atraumatic rupture of the spleen in a young man]. / Een atraumatische spontane miltruptuur bij een jonge man.

BACKGROUND: A spontaneous, atraumatic splenic rupture is a splenic rupture without a history of trauma. Rupture of this type may occur in a healthy patient but may also be seen in the context of an underlying neoplastic, haematological, infectious or local inflammatory condition. CASE DESCRIPTION: A 30-year-old man presented to the emergency department with acute pain in the left shoulder, thorax and upper abdomen, accompanied by signs of haemodynamic instability. No history of trauma was reported. Because the clinical symptoms could fit various abdominal and thoracic conditions, he was sent for a CT scan. This revealed a splenic rupture with haemoperitoneum. Emergency laparotomy and splenectomy were performed. Anamnestic, histopathological and other supplementary investigations revealed no indications of underlying pathology so that a diagnosis of "atraumatic idiopathic splenic rupture" was made. CONCLUSION: It is clinically difficult to diagnose a spontaneous, atraumatic rupture of the spleen due to the overlap in presentation with other, more common abdominal and thoracic conditions. A CT scan is essential to detect such a rupture promptly in order to provide appropriate surgical intervention.

Percutaneous penetration of silver from a silver containing garment in healthy volunteers and patients with atopic dermatitis.

Human data on dermal absorption of silver under "in use" scenario are scarce which hampers health risk assessment. The main objective of the present study was to determine percutaneous penetration of silver after dermal exposure to silver containing garment in healthy individuals and atopic dermatitis (AD) patients. Next to assess pro-inflammatory effect of silver in the skin. Healthy subjects (n=15) and patients with AD (n=15) wore a sleeve containing 3.6% (w/w) silver on their lower arms for 8h during 5 consecutive days. The percutaneous penetration parameters were deduced from the silver concentration-depth profiles in the stratum corneum (SC) collected by adhesive tapes. Furthermore, silver was measured in urine samples collected before and after exposure. Inflammatory response was assessed by measuring IL-1α and IL-1RA in the exposed and non-exposed skin sites. Dermal flux of silver in healthy subjects and AD patients was respectively 0.23 and 0.20 ng/cm(2)/h. The urine silver concentrations showed no increase after exposure. Furthermore, exposure to silver did not lead to the changes in the profiles of IL-1α and IL-1RA. Dermal absorption of silver under "real life scenario" was lower than the current reference dose. Furthermore, dermal exposure did not lead to altered expression of inflammatory IL-1 cytokines in the skin.

Pilot study on the identification of silver in skin layers and urine after dermal exposure to a functionalized textile.

Silver (Ag) is increasingly used in consumer products like functionalized textiles and medical devices owing to its strong antimicrobial activity which is largely assigned to Ag ions released after oxidation of metallic Ag. To increase generation of Ag ions, in various products Ag is often present as nanoparticles. Ideally, Ag ions would remain on the surface of the skin to combat the bacteria and the uptake of Ag into the body should be limited. However, the Ag ions might penetrate across the skin into the body leading to adverse health effects. Data on in vivo uptake of Ag due to dermal exposure are scarce partly caused by the lack of suitable analytical approaches for the determination of Ag in biological matrices, but strongly needed to enable risk assessment of skin exposure to (nano) Ag containing products. With the developed approach, the presence of Ag in a functionalized textile is confirmed by using scanning electron microscopy (SEM). After in vivo dermal exposure to Ag containing textile material under ׳׳in use׳׳ exposure scenarios, the outermost layers of the skin (Stratum Corneum, SC) were sampled by using adhesive tapes with a size of 3.8cm(2). Different leaching and dissolution procedures of Ag from biological samples prior analysis by inductively coupled plasma mass spectrometry (ICPMS) have been evaluated. The developed method results in a limit of detection (LOD) of 2ng Ag per removed SC layer. The method allows the measurement of the Ag concentrations at different depths of the SC enabling the deduction of the percutaneous penetration kinetics. Due to the possible bio distribution within the whole body, an indirect exposure matrix (urine) was studied too. The detection power of the method permits measuring the ultra-trace concentrations of Ag in urine before and after dermal exposure; LOD is 0.010µg Ag/L urine.