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2.
ACS Biomater Sci Eng ; 8(5): 2088-2095, 2022 05 09.
Article in English | MEDLINE | ID: mdl-35452219

ABSTRACT

Ulcerative colitis (UC) is a chronic inflammatory disease, which deleteriously affects the lower end of the gastrointestinal tract, i.e., the colon and the rectum. UC affects colonic inflammatory homeostasis and disrupts intestinal barrier functions. Intestinal tissue damage activates the immune system and collectively worsens the disease condition via the production of various cytokines. Ongoing therapeutics of UC have marked limitations like rapid clearance, extensive first-pass metabolism, poor drug absorption, very low solubility, bioavailability, etc. Because of these restrictions, the management of UC demands a rational approach that selectively delivers the drug at the site of action to overcome the therapeutic limiting factors. Metallic nanoparticles (NPs) have good therapeutic efficacy against colitis, but their uses are limited due to adverse effects on the biological system. In this study, we have used biocompatible thiol-functionalized cellulose-grafted copper oxide nanoparticles (C-CuI/IIO NPs) to treat UC. The metal NPs alleviated the colitis condition as evidenced by the colon length and observed physical parameters. Analysis of histopathology demonstrated the recovery of the colon architecture damaged by dextran sulfate sodium-induced colitis. Treatment with C-CuI/IIO NPs reduced the disintegration of goblet cells and the retainment of sulfomucin. Significant downregulation of inflammatory markers like MPO activity, as well as levels of nitrite and TNF-α, was found following C-CuI/IIO NP treatment. The observations from the study suggested that intrarectal treatment of colitis with cellulose-based C-CuI/IIO NPs successfully combated the intestinal inflammatory condition.


Subject(s)
Colitis, Ulcerative , Colitis , Nanoparticles , Animals , Cellulose/adverse effects , Colitis/chemically induced , Colitis/drug therapy , Colitis, Ulcerative/chemically induced , Colitis, Ulcerative/drug therapy , Colitis, Ulcerative/metabolism , Copper/adverse effects , Mice , Nanoparticles/therapeutic use , Oxides/adverse effects , Sulfhydryl Compounds/adverse effects
3.
Sci Rep ; 11(1): 23944, 2021 12 14.
Article in English | MEDLINE | ID: mdl-34907234

ABSTRACT

Nanocomplexes systems made up natural poylymers have pharmacotechnical advantages such as increase of water solubility and a decrease of drugs toxicity. Amphotericin B (AmB) is a drug apply as anti-leishmanial and anti-fungal, however it has low water solubility and high toxicity, limiting its therapeutic application. With this in mind, the present study aimed to produce nanocomplexes composed by alginate (Alg), a natural polymer, with AmB covered by nanocrystals from bacterial cellulose (CNC). For this reason, the nanocomplexes were produced utilizing sodium alginate, amphotericin B in a borate buffer (pH 11.0). The CNC was obtained by enzymatic hydrolysis of the bacterial cellulose. To CNC cover the nanocomplexes 1 ml of the nanocomplexes was added into 1 ml of 0.01% CNC suspension. The results showed an ionic adsorption of the CNC into the Alg-AmB nanocomplexes surface. This phenomena was confirmed by an increase in the particle size and PDI decrease. Besides, nanocomplexes samples covered by CNC showed uniformity. The amorphous inclusion of AmB complex into the polysaccharide chain network in both formulations. AmB in the nanocomplexes was in supper-aggregated form and showed good biocompatibility, being significantly less cytotoxic in vitro against kidney cells and significantly less hemolytic compared to the free-drug. The in vitro toxicity results indicated the Alg-AmB nanocomplexes can be considered a non-toxic alternative to improve the AmB therapeutic effect. All process to obtain nanocomplexes and it coat was conduce without organic solvents, can be considered a green process, and allowed to obtain water soluble particles. Furthermore, CNC covering the nanocomplexes brought additional protection to the system can contribut advancement in the pharmaceutical.


Subject(s)
Amphotericin B , Cellulose , Nanoparticles , Alginates/adverse effects , Alginates/chemistry , Alginates/pharmacology , Amphotericin B/adverse effects , Amphotericin B/chemistry , Amphotericin B/pharmacology , Animals , Cellulose/adverse effects , Cellulose/chemistry , Cellulose/pharmacology , Dogs , HEK293 Cells , Hemolysis/drug effects , Humans , Nanoparticles/adverse effects , Nanoparticles/chemistry , Nanoparticles/therapeutic use
4.
J Drugs Dermatol ; 20(5): 529-533, 2021 05 01.
Article in English | MEDLINE | ID: mdl-33938690

ABSTRACT

BACKGROUND: Poly-l-lactic acid (PLLA) is an injectable volumizer with biostimulatory properties used for volumetric structural rejuvenation in patients with facial fat volume loss but has increasingly been utilized for off-face applications. OBJECTIVE: The objectives of this randomized, double-blind, placebo-controlled single center study was to assess the safety and effectiveness of PLLA for the treatment of lower extremity cellulite in adult women. METHODS: 31 healthy women were enrolled in the study. Eligible subjects received 3 treatments every 4 weeks with either PLLA (treatment group) or saline (control group) injections combined with subcision, into each of the glutes or thighs. Follow-up visits were at 1, 3, and 6 months after treatment. Assessments included live ratings, rating of standardized pictures by a blinded evaluator, patient questionnaires, safety, and tolerability ratings. RESULTS: At the 3 and 6-month follow-up, there was a statistically significant change in the global aesthetic improvement scale (GAIS) compared to baseline as assessed by blinded investigators. Significant improvements were shown in the cellulite severity scale (CSS) as well as in the subject satisfaction questionnaires. Treatments were found to be tolerable, and no severe treatment-related adverse events occurred. CONCLUSION: Repeated PLLA treatments combined with subcision are effective and safe in improving the appearance of cellulite. J Drugs Dermatol. 20(5): doi:10.36849/JDD.5380.


Subject(s)
Cellulite/drug therapy , Cellulose/administration & dosage , Cosmetic Techniques/adverse effects , Lactic Acid/administration & dosage , Mannitol/administration & dosage , Patient Satisfaction , Adult , Cellulite/diagnosis , Cellulite/psychology , Cellulose/adverse effects , Double-Blind Method , Esthetics , Female , Follow-Up Studies , Humans , Injections, Subcutaneous , Lactic Acid/adverse effects , Lower Extremity , Mannitol/adverse effects , Placebos/administration & dosage , Placebos/adverse effects , Severity of Illness Index , Surveys and Questionnaires/statistics & numerical data , Treatment Outcome
5.
Cochrane Database Syst Rev ; 3: CD007961, 2021 03 13.
Article in English | MEDLINE | ID: mdl-33719075

ABSTRACT

BACKGROUND: This is a updated version of our Cochrane Review published in Issue 6, 2012. Sexually-transmitted infections (STIs) continue to rise worldwide, imposing an enormous morbidity and mortality burden. Effective prevention strategies, including microbicides, are needed to achieve the goals of the World Heath Organization (WHO) global strategy for the prevention and control of these infections. OBJECTIVES: To determine the effectiveness and safety of topical microbicides for preventing acquisition of STIs, including HIV. SEARCH METHODS: We undertook a comprehensive search of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, LILACS, CLIB, Web of Science, ClinicalTrials.gov, WHO International Clinical Trials Registry Platform, and reference lists of relevant articles up to August 2020. In addition, we contacted relevant organisations and experts. SELECTION CRITERIA: We included randomised controlled trials of vaginal microbicides compared to placebo (except for nonoxynol-9 because it is covered in related Cochrane Reviews). Eligible participants were sexually-active non-pregnant, WSM and MSM, who had no laboratory confirmed STIs. DATA COLLECTION AND ANALYSIS: Two review authors independently screened and selected studies, extracted data, and assessed risks of bias in duplicate, resolving differences by consensus. We conducted a fixed-effect meta-analysis, stratified by type of microbicide, and assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included eight trials from the earlier version of the review and four new trials, i.e. a total of 12 trials with 32,464 participants (all WSM). We did not find any eligible study that enrolled MSM or reported fungal STI as an outcome. We have no study awaiting assessment. All 12 trials were conducted in sub-Saharan Africa, with one having a study site in the USA, and another having a site in India. Vaginal microbicides tested were BufferGel and PRO 2000 (1 trial, 3101 women), Carraguard (1 trial, 6202 women), cellulose sulphate (2 trials, 3069 women), dapivirine (2 trials, 4588 women), PRO 2000 (1 trial, 9385 women), C31G (SAVVY) (2 trials, 4295 women), and tenofovir (3 trials, 4958 women). All microbicides were compared to placebo and all trials had low risk of bias. Dapivirine probably reduces the risk of acquiring HIV infection: risk ratio (RR) 0.71, (95% confidence interval (CI) 0.57 to 0.89, I2 = 0%, 2 trials, 4588 women; moderate-certainty evidence). The other microbicides may result in little to no difference in the risk of acquiring HIV (low-certainty evidence); including tenofovir (RR 0.83, 95% CI 0.68 to 1.02, cellulose sulphate (RR 1.20, 95% CI 0.74 to 1.95, BufferGel (RR 1.05, 95% CI 0.73 to 1.52), Carraguard (RR 0.89, 95% CI 0.71 to 1.11), PRO 2000 (RR 0.93, 95% CI 0.77 to 1.14), and SAVVY (RR 1.38, 95% CI 0.79 to 2.41). Existing evidence suggests that cellulose sulphate (RR 0.99, 95% CI 0.37 to 2.62, 1 trial, 1425 women), and PRO 2000 (RR 0.95, 95% CI 0.73 to 1.23) may result in little to no difference in the risk of getting herpes simplex virus type 2 infection (low-certainty evidence). Two studies reported data on tenofovir's effect on this virus. One suggested that tenofovir may reduce the risk (RR 0.55, 95% CI 0.36 to 0.82; 224 participants) while the other did not find evidence of an effect (RR 0.94, 95% CI 0.85 to 1.03; 1003 participants). We have not reported the pooled result because of substantial heterogeneity of effect between the two studies (l2 = 85%). The evidence also suggests that dapivirine (RR 1.70, 95% CI 0.63 to 4.59), tenofovir (RR 1.27, 95% CI 0.58 to 2.78), cellulose sulphate (RR 0.69, 95% CI 0.26 to 1.81), and (Carraguard (RR 1.07, 95% CI 0.75 to 1.52) may have little or no effect on the risk of acquiring syphilis (low-certainty evidence). In addition, dapivirine (RR 0.97, 95% CI 0.89 to 1.07), tenofovir (RR 0.90, 95% CI 0.71 to 1.13), cellulose sulphate (RR 0.70, 95% CI 0.49 to 0.99), BufferGel (RR 0.97, 95% CI 0.65 to 1.45), Carraguard (RR 0.96, 95% CI 0.83 to 1.12), and PRO 2000 (RR 1.01, 95% CI 0.84 to 1.22) may result in little to no difference in the risk of acquiring chlamydia infection (low-certainty evidence). The evidence also suggests that current topical microbicides may not have an effect on the risk of acquiring gonorrhoea, condyloma acuminatum, trichomoniasis, or human papillomavirus infection (low-certainty evidence). Microbicide use in the 12 trials, compared to placebo, did not lead to any difference in adverse event rates. No study reported on acceptability of the intervention.  AUTHORS' CONCLUSIONS: Current evidence shows that vaginal dapivirine microbicide probably reduces HIV acquisition in women who have sex with men. Other types of vaginal microbicides have not shown evidence of an effect on acquisition of STIs, including HIV. Further research should continue on the development and testing of new microbicides.


Subject(s)
Anti-Infective Agents, Local/administration & dosage , Sexually Transmitted Diseases/prevention & control , Acrylic Resins/administration & dosage , Adenine/administration & dosage , Adenine/analogs & derivatives , Administration, Intravaginal , Agaricales/chemistry , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/adverse effects , Bias , Cellulose/administration & dosage , Cellulose/adverse effects , Cellulose/analogs & derivatives , Female , HIV Infections/prevention & control , Humans , Naphthalenesulfonates/administration & dosage , Placebos/administration & dosage , Polymers/administration & dosage , Pyrimidines/administration & dosage , Pyrimidines/adverse effects , Seaweed/chemistry , Tenofovir/administration & dosage , Tenofovir/adverse effects
7.
J Drugs Dermatol ; 20(1): 118-22, 2021 01 01.
Article in English | MEDLINE | ID: mdl-33400413

ABSTRACT

BACKGROUND: Since the approval of Sculptra Aesthetic, the amount of sterile water used to reconstitute the product has gradually increased in clinical practice. A retrospective chart review was conducted to evaluate patient safety associated with a larger reconstitution volume, and to investigate specific parameters for how Sculptra Aesthetic is used in a real-world clinical setting. OBJECTIVE: The primary objective of the study was to evaluate the safety of Sculptra Aesthetic when using a reconstitution volume of 7 to 10 mL, via collection of adverse events related to the product or injection procedure reported in medical records. METHODS: This was a multi-center, retrospective chart review conducted in the US. Medical records for subjects treated in the facial area with Sculptra Aesthetic reconstituted to 7–10 mL were reviewed to obtain information about demographics, treatment data, and adverse events. Each injector completed a questionnaire regarding reconstitution and injection procedures generally used. RESULTS: There were 4483 treatments performed in 1002 subjects; nearly half (48%) had 3 or 4 treatments during the studied period. Subjects most commonly received treatment in the midface/cheek area (97%), temple (94%), and jawline (54%). All injectors indicated adding lidocaine to the solution, resulting in total volumes of 8–10 mL. Adverse events were reported by 3.6% of subjects, all mild in intensity. Nodules were reported by 4 subjects (0.4%). CONCLUSION: The low number of AEs reported in this retrospective chart review suggests that facial aesthetic treatment with PLLA reconstituted to a final volume of 8–10 mL, including anesthetics, is associated with a favorable risk benefit ratio. J Drugs Dermatol. 2021;20(1):18-22. doi:10.36849/JDD.5631.


Subject(s)
Cellulose/administration & dosage , Cosmetic Techniques/adverse effects , Dermal Fillers/adverse effects , Lactic Acid/administration & dosage , Mannitol/administration & dosage , Skin Aging/drug effects , Adult , Aged , Aged, 80 and over , Cellulose/adverse effects , Cellulose/chemistry , Cosmetic Techniques/statistics & numerical data , Dermal Fillers/administration & dosage , Dermal Fillers/chemistry , Face , Female , Health Records, Personal , Humans , Injections, Subcutaneous/adverse effects , Lactic Acid/adverse effects , Lactic Acid/chemistry , Male , Mannitol/adverse effects , Mannitol/chemistry , Middle Aged , Patient Satisfaction , Retrospective Studies , Solutions , Young Adult
8.
J Drugs Dermatol ; 19(12): 1199-1203, 2020 Dec 01.
Article in English | MEDLINE | ID: mdl-33346524

ABSTRACT

BACKGROUND: Poly-L-lactic acid (PLLA) is a biodegradable, synthetic polymer that stimulates collagen production and can improve skin quality, volume, and thickness. The current reconstitution procedure for Sculptra, a PLLA-containing injectable device involves 2 hours standing time before use. OBJECTIVE: To evaluate and validate an immediate-use procedure for reconstituting a PLLA-containing injectable device. METHODS AND MATERIALS: Three batches of the product were shaken for 1 minute immediately after reconstitution with 8 mL of sterile water. Different physicochemical tests including viscosity, concentration of excipients (sodium carboxymethylcellulose and mannitol), pH, and particle size distribution were performed for standing times 0, 2, 24, and 72 hours after immediate shaking, and compared with the standard 2 hours standing time before shaking. The recovery and stability of optional addition of 1 mL of 2% lidocaine hydrochloride was also assessed. RESULTS: All physiochemical parameters evaluated were equivalent, regardless of reconstitution procedure, showing that shaking vigorously for 1 minute dissolves the excipients of the product properly without a required standing time and with no impact to the PLLA particles. There were no differences in lidocaine hydrochloride content of suspensions after 0 and 72 hours. CONCLUSION: The PLLA-containing product can be used immediately after reconstitution including vigorous shaking, as shown from physicochemical analyses. Optional addition of lidocaine hydrochloride is feasible. J Drugs Dermatol. 2020;19(12): doi:10.36849/JDD.2020.5228.


Subject(s)
Cellulose/administration & dosage , Cosmetic Techniques , Dermal Fillers/administration & dosage , Excipients/chemistry , Lactic Acid/administration & dosage , Mannitol/administration & dosage , Cellulose/adverse effects , Cellulose/chemistry , Dermal Fillers/adverse effects , Dermal Fillers/chemistry , Drug Implants , Drug Stability , Excipients/analysis , Humans , Injections, Subcutaneous/adverse effects , Injections, Subcutaneous/methods , Lactic Acid/adverse effects , Lactic Acid/chemistry , Lidocaine/administration & dosage , Lidocaine/chemistry , Mannitol/adverse effects , Mannitol/chemistry , Particle Size , Skin Aging/drug effects , Solubility , Solutions , Time Factors , Viscosity
9.
Sci Rep ; 10(1): 20835, 2020 11 30.
Article in English | MEDLINE | ID: mdl-33257713

ABSTRACT

Experiments involving food restriction are common practice in metabolic research. Under fasted conditions, mice supplement their diet with cage bedding. We aimed at identifying metabolic and microbiota-related parameters affected by the bedding type. We exposed mice housed with wooden, cellulose, or corncob cage beddings to ad libitum feeding, caloric restriction (CR), or over-night (ON) fasting. Additionally, two subgroups of the ON fast group were kept without any bedding or on a metal grid preventing coprophagy. Mice under CR supplemented their diet substantially with bedding; however, the amount varied depending on the kind of bedding. Bedding-related changes in body weight loss, fat loss, cecum size, stomach weight, fecal output, blood ghrelin levels as well as a response to glucose oral tolerance test were recorded. As fiber is fermented by the gut bacteria, the type of bedding affects gut bacteria and fecal metabolites composition of CR mice. CR wood and cellulose groups showed distinct cecal metabolite and microbiome profiles when compared to the CR corncob group. While all ad libitum fed animal groups share similar profiles. We show that restriction-related additional intake of bedding-derived fiber modulates multiple physiological parameters. Therefore, the previous rodent studies on CR, report the combined effect of CR and increased fiber consumption.


Subject(s)
Feeding Behavior/physiology , Gastrointestinal Microbiome/drug effects , Laboratory Animal Science/methods , Animals , Bacteria/genetics , Body Weight , Caloric Restriction/methods , Cellulose/adverse effects , Diet, High-Fat/methods , Dietary Fiber/metabolism , Dietary Supplements/adverse effects , Energy Intake/physiology , Feces/microbiology , Gastrointestinal Microbiome/genetics , Gastrointestinal Microbiome/physiology , Housing, Animal , Male , Mice , Mice, Inbred C57BL , Obesity/microbiology , Wood/adverse effects
10.
J Cutan Pathol ; 47(11): 1067-1072, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32713055

ABSTRACT

"Skin popping" refers to the practice of injecting drugs, most commonly heroin, subcutaneously or into granulation tissue. Pharmaceutical tablets meant for oral consumption are modified into solutions for injection. Excipients-inactive substances that serve as vehicles for medication-are often not filtered out before injection and result in abscess formation, granulomatous inflammation, and scarring. Common excipients used in the production of pharmaceutical tablets include starch, microcrystalline cellulose, magnesium stearate, silica, and polyvinylpyrrolidone (PVP). Identification of these exogenous materials is valuable in confirming the diagnosis of skin popping, especially when patients may not be forthcoming about their drug use. We present a case of subcutaneous oral medication injection in which PVP and cellulose were identified by Fourier transform infrared spectroscopy. Considering the variable cutaneous manifestations of injection drug abuse, recognition of histopathologic and chemical characteristics of exogenous material from oral medications is helpful for diagnosis and intervention.


Subject(s)
Excipients/analysis , Foreign-Body Reaction/diagnosis , Injections, Intradermal , Spectroscopy, Fourier Transform Infrared/methods , Substance-Related Disorders/diagnosis , Adult , Analgesics, Opioid/administration & dosage , Analgesics, Opioid/adverse effects , Cellulose/adverse effects , Cellulose/analysis , Excipients/adverse effects , Female , Foreign-Body Reaction/chemically induced , Humans , Oxycodone/administration & dosage , Oxycodone/adverse effects , Polyvinyls/adverse effects , Polyvinyls/analysis , Pyrrolidines/adverse effects , Pyrrolidines/analysis , Skin Diseases/chemically induced , Skin Diseases/diagnosis , Substance-Related Disorders/pathology
11.
J Cosmet Dermatol ; 19(5): 1165-1171, 2020 May.
Article in English | MEDLINE | ID: mdl-32176410

ABSTRACT

BACKGROUND: There is a growing demand for procedures to treat cellulite. Subcision™ is widely used for cellulite correction, and injectable poly-L-lactic acid (PLLA) has been shown to be an effective option for various body conditions. AIMS: Present the results of combining Subcision™ plus PLLA, in the same session, in patients with cellulite and flaccidity. PATIENTS/METHODS: Twenty-four women underwent Subcision™ followed by PLLA injections. An expert panel of dermatologists evaluated before and after photographs according to Global Aesthetic Improvement Scale (GAIS). Patients also answered a satisfaction questionnaire. RESULTS: The author describes the results, as well as number of sessions and dose used. The most frequent GAIS score was "great improvement." No nodules or granulomas appeared in the treated areas. CONCLUSION: The combination of Subcision™ plus PLLA, in the same treatment session, promotes safe and desirable results for cellulite associated with flaccidity.


Subject(s)
Cellulite/therapy , Cellulose/administration & dosage , Cosmetic Techniques/adverse effects , Dermatologic Surgical Procedures/methods , Lactic Acid/administration & dosage , Mannitol/administration & dosage , Adult , Buttocks , Cellulite/diagnosis , Cellulose/adverse effects , Combined Modality Therapy/adverse effects , Combined Modality Therapy/instrumentation , Combined Modality Therapy/methods , Cosmetic Techniques/instrumentation , Dermatologic Surgical Procedures/adverse effects , Dermatologic Surgical Procedures/instrumentation , Female , Follow-Up Studies , Humans , Injections, Subcutaneous , Lactic Acid/adverse effects , Mannitol/adverse effects , Middle Aged , Needles , Patient Satisfaction , Photography , Severity of Illness Index , Thigh , Young Adult
12.
J Cosmet Dermatol ; 19(3): 725-735, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31301106

ABSTRACT

BACKGROUND: In recent years, bacterial cellulose (BC), or biocellulose, a natural polymer synthesized by certain bacteria, has attracted great interest in dermatology and cosmetic applications. Several bioactive ingredients are currently loaded into BC masks. However, only a few studies have reported the effectiveness of such delivery systems. AIM: The aim of this study was to evaluate the effect on skin parameters of three biocellulose masks formulated to have different cosmetic effects (anti-aging, lifting, and cell renewal). In particular, skin moisturizing, skin color, skin viscoelastic properties, skin surface smoothness, wrinkle reduction, dermal homogeneity, and stratum corneum renewal were evaluated. MATERIALS AND METHODS: The study involved 69 healthy Caucasian female volunteers between 25 and 64 years, who were divided into three different studies. Biocellulose facial masks were applied using the split-face method three times a week for 4-8 weeks depending on the study. RESULTS: The results obtained from this work highlight that biocellulose masks are very well tolerated. A significant decrease in skin roughness and wrinkle breadth, and an improvement in dermal homogeneity and firmness, was observed after 2 months of treatment with "anti-aging" masks. A significant improvement in skin firmness and elasticity was observed after 1 month of treatment with "lifting" masks. Furthermore, a 1-month treatment with "cell renewal" masks promoted the production of new skin cells through a mild exfoliating action. CONCLUSIONS: This study highlights that biocellulose masks are effective delivery systems to successfully release into the skin several types of active compounds exerting many beneficial effects.


Subject(s)
Cellulose/chemistry , Cosmeceuticals/administration & dosage , Drug Carriers/chemistry , Polysaccharides, Bacterial/chemistry , Skin/drug effects , Administration, Cutaneous , Adult , Cellulose/adverse effects , Drug Carriers/adverse effects , Elasticity/drug effects , Face , Female , Gluconacetobacter xylinus/chemistry , Healthy Volunteers , Humans , Middle Aged , Polysaccharides, Bacterial/adverse effects , Regeneration/drug effects , Skin Aging/drug effects
13.
Blood Purif ; 49(4): 400-408, 2020.
Article in English | MEDLINE | ID: mdl-31865336

ABSTRACT

BACKGROUND: The biocompatibility of dialysis membranes is a determining factor in avoiding chronic microinflammation in patients under haemodialysis. Lower biocompatibility has been related to increased inflammatory status, which is known to be associated with cardiovascular events. Classically, cellulose membranes have been considered bioincompatible. A new-generation of asymmetric cellulose triacetate (CTA) membranes allows the performance of high convective transport techniques, but there have been no studies of their biocompatibility. The aim of the present study was to analyze and compare the biocompatibility characteristics of 4 membranes, including CTA, in online hemodiafiltration (OL-HDF) patients. METHODS: We included 15 patients in -OL-HDF. After a 2-week washout period with helixone membrane, each patient was treated with the 4 membranes (polyamide, polynephron, helixone and CTA) for 4 weeks in a randomized order. The other dialysis parameters were kept stable throughout the study. We studied changes in markers of the activation of the complement system, monocytes, platelets, and adhesion molecules with the 4 membranes, as well as inflammatory parameters. RESULTS: Biocompatibility was similar among the membranes. There were no sustained differences in complement activation, measured by C3a and C5a levels, or in platelet activation, determined by levels of P-selectin and platelet-derived microparticles (CD41a+). No differences were observed in activated monocyte levels (CD14+/CD16+) or in plasma levels of interleukin (IL)-1, IL-6, IL-10 or high-sensitivity C-reactive protein, although tumour necrosis factor-α levels decreased when the patients were dialyzed with CTA. No significant differences were found in markers of endothelial damage, assessed by levels of plasminogen activator inhibitor-1 and adhesion molecules (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1). CONCLUSION: The 4 membranes evaluated in this study in stable patients on OL-HDF, including the new-generation CTA, show similar biocompatibility with the methods applied.


Subject(s)
Biocompatible Materials/chemistry , Hemodiafiltration/instrumentation , Materials Testing , Membranes, Artificial , Adult , Aged , Aged, 80 and over , Biocompatible Materials/adverse effects , Cellulose/adverse effects , Cellulose/analogs & derivatives , Cellulose/chemistry , Complement Activation , Female , Humans , Interleukins/blood , Male , Middle Aged , Platelet Activation
15.
J Drugs Dermatol ; 18(9): 929-935, 2019 Sep 01.
Article in English | MEDLINE | ID: mdl-31524350

ABSTRACT

Injectable poly-L-lactic acid (PLLA) is a biodegradable synthetic polymer that stimulates collagen production, leading to gradual volume restoration. The treatment of sagging skin in body areas is still a big challenge, as there are few aesthetic procedures aiming to improve it. This article provides recommendations on the use of PLLA in the treatment of skin laxity in off-face areas, as the neck, décolletage, arms, abdomen, buttocks, and thighs, including the patient selection, product preparation, and injection techniques. The use of PLLA is a promising method for the treatment of skin laxity in corporal areas, improving body contour and appearance. Further investigation is needed to better understand the efficacy and durability of PLLA in non-facial indications and to provide the best evidence for optimal patient outcomes. J Drugs Dermatol. 2019;18(9):929-935.


Subject(s)
Cellulose/administration & dosage , Cosmetic Techniques/standards , Elasticity/drug effects , Lactic Acid/administration & dosage , Mannitol/administration & dosage , Skin Aging/drug effects , Age Factors , Cellulose/adverse effects , Cosmetic Techniques/adverse effects , Esthetics , Female , Humans , Injections, Subcutaneous/adverse effects , Lactic Acid/adverse effects , Mannitol/adverse effects , Middle Aged , Patient Selection , Practice Guidelines as Topic , Rejuvenation , Skin/drug effects , Skin/metabolism
16.
Surg Infect (Larchmt) ; 20(5): 378-381, 2019 Jul.
Article in English | MEDLINE | ID: mdl-30785856

ABSTRACT

Background: We describe the management and control of an outbreak of mediastinitis in a cardiac surgery department. Method: We performed a retrospective cohort study of 87 patients who underwent coronary artery bypass grafting (CABG), valve replacement, or both during a five-month period with a higher than normal number of cases of post-operative mediastinitis. In addition to medical records review, a survey was conducted among surgeons to estimate the frequency of cellulose-derived absorbable hemostatic (CDAH) use. Results: Eleven patients (12.5%) developed mediastinitis during the period. None of them died, and the course of the infections was benign. No differences were found between the infected and non-infected patients regarding clinical or demographic characteristics. The rate of infection by surgeon ranged from 0 to 21.4%. (p = 0.38). We found a significant linear relation between the frequency of CDAH use and the risk of infection, from 3.3% to 22.6% (p = 0.024). Cultures of unused CDAHs were negative. Cessation of product use led to no new cases for the following year and to a mediastinitis rate <1% for the following 24 months. Conclusion: We identified a cluster of undesired clinical outcomes compatible with mediastinitis that added morbidity and associated cost, but not deaths, related to the use of CDAH as a hemostatic. These data suggest keeping the use of CDAH in cardiothoracic surgery to a minimum.


Subject(s)
Cardiac Surgical Procedures/adverse effects , Cellulose/adverse effects , Disease Outbreaks , Hemostasis, Surgical/adverse effects , Hemostatics/adverse effects , Mediastinitis/epidemiology , Adult , Aged , Aged, 80 and over , Cardiac Surgical Procedures/methods , Cellulose/administration & dosage , Female , Hemostasis, Surgical/methods , Hemostatics/administration & dosage , Humans , Male , Middle Aged , Retrospective Studies , Risk Factors
17.
Am J Transplant ; 19(5): 1552-1559, 2019 05.
Article in English | MEDLINE | ID: mdl-30725518

ABSTRACT

Microcrystalline cellulose (MCC) is an insoluble material commonly used as a binder and filler in oral medications. Identification of pulmonary intravascular deposition of MCC in transbronchial biopsies from lung transplant (LT) recipients following parenteral injection of oral medications has only been reported once. A search of our surgical pathology electronic database was performed from January 1, 2000 to November 1, 2017 using the text "transplant transbronchial." The diagnosis field for all cases retrieved was then searched for the text "cellulose." These cases were queried for patient demographics and outcomes. Between January 1, 2000 and November 1, 2017, 1558 lung transplants were performed in 1476 individual patients at our institution; 12 were identified to have MCC in their lung tissue. Patients with MCC identified on biopsies were more likely to be transplanted for cystic fibrosis versus other indications and younger versus older. MCC identified in 2 of our cases was favored to be donor derived. Of the 12 patients, 6 (50%) are deceased. MCC within the pulmonary vasculature may be an indicator of increased complications, mortality, or shortened survival in LT recipients. Detecting intravascular MCC and distinguishing it from aspirated foreign material can be challenging. Awareness of the differential diagnosis for pulmonary foreign material is of paramount importance for the pathologist.


Subject(s)
Cellulose/adverse effects , Infusions, Parenteral/adverse effects , Lung Diseases/surgery , Lung Transplantation , Pharmaceutical Preparations/administration & dosage , Administration, Oral , Adolescent , Adult , Biopsy , Cystic Fibrosis/surgery , Female , Humans , Lung/immunology , Male , Middle Aged , Retrospective Studies , Tissue Donors , Young Adult
18.
Mater Sci Eng C Mater Biol Appl ; 97: 208-221, 2019 Apr.
Article in English | MEDLINE | ID: mdl-30678905

ABSTRACT

Two wood-derived cellulose nanofibril (CNF) porous scaffolds were prepared by TEMPO-oxidation and carboxymethylation. The effects of these scaffolds on the production of inflammatory cytokines by human macrophage-like cells (U937) was profiled in vitro after 1 and 3 days and in subcutaneous tissues of rats after 4 and 30 days, using PCR and Multiplex arrays. Tissue culture plates (TCP) and gelatin scaffolds served as controls in vitro and in vivo respectively. After 3 days in vitro, there was no significant difference between the effects of CNF scaffolds and TCP on the production of chemokines/growth factors and pro-inflammatory cytokines. At day 4 in vivo there was significantly higher gene expression of the anti-inflammatory IL-1Ra in the CNF scaffolds than the gelatin scaffold. Production of IL-1ß, IL-6, MCP-1, MIP-1α CXCL-1 and M-CSF was significantly less than in the gelatin, demonstrating an early mild inflammatory response. At day 30, both CNF scaffolds significantly stimulated the production of the anti-inflammatory cytokine IL-10. Unlike gelatin, neither CNF scaffold had degraded 180 days post-implantation. The slow degradation of CNF scaffolds resulted in a foreign body reaction, with high production of IL-1ß, IL-2, TNF-α, IFN-ϒ, MCP-1, MIP-1α, M-CSF, VEGF cytokines and expression of MMP-9 gene. The surface chemistry of the CNF scaffolds elicited a modest effect on cytokine production and did not shift the inflammatory profile in vitro or in vivo. The decisive role in development of the foreign body reaction was the slow degradation of the CNF scaffolds.


Subject(s)
Cellulose/chemistry , Inflammation/etiology , Nanostructures/adverse effects , Tissue Scaffolds/adverse effects , Wood/chemistry , Animals , Cell Proliferation , Cellulose/adverse effects , Cytokines/metabolism , Female , Gene Expression Regulation , Humans , Implants, Experimental , Inflammation/chemically induced , Inflammation/metabolism , Materials Testing/methods , Nanostructures/chemistry , Rats, Wistar , Tissue Scaffolds/chemistry , U937 Cells
19.
Chemosphere ; 215: 470-481, 2019 Jan.
Article in English | MEDLINE | ID: mdl-30340155

ABSTRACT

Industrial emissions can impact aquatic environments and unregulated discharges from pulp and paper factories have resulted in deposits of cellulose fiber along the Swedish coast. These deposits are contaminated by metals, but due to their unique fibrous character the extent of sorption and dispersal of the metals is unclear. Fibrous sediments were sampled at two sites in the Ångermanälven river estuary, Sweden. The partitioning of metals between the sediment, pore water and bottom water was investigated and the degree of bioavailability was evaluated. The levels of metals in the sediment were high in fibrous or offshore samples, depending on the metal, whereas the levels of dissolved metals in pore water were low or below the limit of quantification. Partition coefficients (KD) showed that sorption to the sediment was stronger at one of the fibrous sites, possibly related to the type and size of organic matter. Undisturbed bottom water samples contained low levels of both dissolved and particle bound metals, but when comparing measured metal concentrations to threshold values of ecological status and ecotoxicological assessment criteria, both sediments and bottom water may be detrimental to living organisms. In-situ re-suspension experiments showed that the concentrations of particle bound metals increased whereas the dissolved concentrations decreased. The analyzed metals are probably retained by the solid phases of the fibrous sediment or adsorbed to particles in the water, reducing their bioavailability.


Subject(s)
Cellulose/adverse effects , Ecotoxicology , Estuaries , Industrial Waste/analysis , Metals/analysis , Adsorption , Cellulose/ultrastructure , Environmental Monitoring , Sweden , Water Pollutants, Chemical/analysis
20.
Int Arch Allergy Immunol ; 178(3): 229-237, 2019.
Article in English | MEDLINE | ID: mdl-30408809

ABSTRACT

BACKGROUND: Cellulose powder (CP) has been reported as a safe and effective complementary treatment for allergic rhinitis (AR). Currently, CP has gained increasing application for clinical management worldwide, particularly in China. However, studies focusing on the effect of CP on normal human nasal epithelial cells (hNECs) and ciliary function are lacking. Here, we aimed to explore the adverse effects of CP on the activity and ciliary function of hNECs. METHODS: We biopsied ethmoid sinus or middle turbinate tissues during surgical resection from control subjects who underwent endoscopic sinus surgery for diseases other than AR. Cells were isolated and passaged, followed by differentiation in an air-liquid interface (ALI). Flow cytometry and cell viability test (cell counting kit-8) were performed to detect the cytotoxicity of CP (effects on cell proliferation) on normal hNECs. By using the ALI culture model, we investigated the effects of CP on ciliary beat frequency (CBF). RESULTS: There was a significant reduction in hNEC count at high concentrations of CP (2.5 mg/mL) at days 3 and 7 (both p < 0.05). As the concentration increased, cell death increased progressively from day 3 to day 7. However, these effects were not evident at low concentrations (0.25 mg/mL, p > 0.05). High-dose CP (2.5 mg) significantly reduced the CBF (p < 0.05). At lower concentrations (0.25-2.5 mg/mL), CP initially increased but subsequently reduced the CBF of hNECs compared with control group. CONCLUSIONS: Cytotoxicity and the suppression of ciliary beat at high concentrations justify more prudent use of CP for the management of AR.


Subject(s)
Cellulose/pharmacology , Cilia/drug effects , Nasal Mucosa/drug effects , Adult , Cell Differentiation/drug effects , Cell Survival/drug effects , Cells, Cultured , Cellulose/adverse effects , Cellulose/therapeutic use , Cilia/physiology , Dose-Response Relationship, Drug , Epithelial Cells/drug effects , Female , Humans , Male , Powders , Rhinitis, Allergic/drug therapy
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