Combining species sensitivity distribution (SSD) model and thermodynamic index (exergy) for system-level ecological risk assessment of contaminates in aquatic ecosystems.

After reviewing the species- and community-level ecological risk assessments (ERAs) of chemicals in the aquatic environment, the present study attempted to propose a third stage of ERA, i.e., the ecosystem-level ERA. Based on the species sensitivity distribution model (SSD) and thermodynamic theory, the exergy and biomass indicators of communities from various trophic levels (TLs) were introduced to improve ecological connotation of SSDs. The species were classified into three TLs based on algae (TL1), invertebrates (TL2), and vertebrates (TL3), and the weight of each TL was determined based on relative biomass and ß value, which indicated a holistic contribution of each species or community to the ecosystem. Then, a system-level ERA protocol was successfully established, and the community- and system-level ecological risks of 10 typical toxic micro-organic pollutants in the western area of Lake Chaohu and its inflowing rivers were evaluated. System-level ERA curves (ExSSD) were mainly affected by the community-level SSD at TL2 for most chemicals in the present study. The uncertain boundary of ExSSD was mostly related to TLs with a wider uncertain boundary, but had little relation to the weight of each TL. The results of system-level ERAs revealed that dibutyl phthalate had the highest eco-risk, whereas γ-hexachlorocyclohexane presented the lowest eco-risk. Results of the system-level ERA were not fully consistent with the those of community-level ERA owing to the lack of a sufficient dataset, SSD model type, and ecosystem structure, as indicated by the weight of each TL. The successful application of ExSSD in Lake Chaohu signifies the start of the third stage of ERA at the system-level, and it also provides a scientific basis for ecosystem-level ERA, aquatic ecosystem protection, and future water safety management. However, there were some limitations, including sufficient data dependence, neglect of ecological interactions, and neglect of environmental parameters such as natural organic matter. We propose to employ toxicogenomics to enrich the toxicity database, to simulate the interaction using the ecological dynamic model, and to introduce the chemical fate model into the system-level ERA.

Effects of an enrofloxacin-silver sulfadiazine emulsion in the ears of rabbits with perforated tympanic membranes.

OBJECTIVE: To determine whether an enrofloxacin-silver sulfadiazine emulsion (ESS) labeled for treatment of otitis externa in dogs has ototoxic effects in rabbits following myringotomy. ANIMALS: 6 healthy adult New Zealand White rabbits. PROCEDURES: Rabbits were anesthetized for brainstem auditory-evoked response (BAER) tests on day 0. Myringotomy was performed, and BAER testing was repeated. Saline (0.9% NaCl) solution and ESS were then instilled in the left and right middle ears, respectively, and BAER testing was repeated prior to recovery of rabbits from anesthesia. Application of assigned treatments was continued every 12 hours for 7 days, and rabbits were anesthetized for BAER testing on day 8. Rabbits were euthanized, and samples were collected for histologic (6 ears/treatment) and scanning electron microscopic (1 ear/treatment) examination. RESULTS: Most hearing thresholds (11/12 ears) were subjectively increased after myringotomy, with BAER measurements ranging from 30 to 85 dB in both ears. All day 8 hearing thresholds exceeded baseline (premyringotomy) values; results ranged from 30 to 85 dB and 80 to > 95 dB (the upper test limit) in saline solution-treated and ESS-treated ears, respectively. All ESS-treated ears had heterophilic otitis externa, epithelial hyperplasia of the external ear canal, various degrees of mucoperiosteal edema, and periosteal new bone formation on histologic examination. Scanning electron microscopy revealed that most outer hair cells in the ESS-treated ear lacked stereocilia or were absent. CONCLUSIONS AND CLINICAL RELEVANCE: Results supported that ESS has ototoxic effects in the middle ear of rabbits. Further research is needed to confirm these findings. Myringotomized laboratory rabbits may be useful to study ototoxicity of drugs used in human medicine.

Development of silver sulfadiazine loaded bacterial cellulose/sodium alginate composite films with enhanced antibacterial property.

Sodium alginate (SA) and bacterial cellulose (BC) are widely used in many applications such as scaffolds and wound dressings due to its biocompatibility. Silver sulfadiazine (AgSD) is a topical antibacterial agents used as a topical cream on burns. In the study, novel BC/SA-AgSD composites were prepared and characterized by SEM, FTIR and TG analyses. These results indicate AgSD successfully impregnated into BC/SA matrix. The swelling behaviors in different pH were studied and the results showed pH-responsive swelling behaviors. The antibacterial performances of BC/SA-AgSD composites were evaluated with Escherichia coli, Staphylococcus aureus and Candida albicans. Moreover, the cytotoxicity of BC/SA-AgSD composites was performed on HEK 293 cells. The experimental results showed BC/SA-AgSD composites have excellent antibacterial activities and good biocompatibility, thus confirming its utility as potential wound dressings.

Silver sulfadiazine loaded chitosan/chondroitin sulfate films for a potential wound dressing application.

Silver sulfadiazine (AgSD) loaded chitosan/chondroitin sulfate (CHI/CS) films were formed to be applied as a potential wound dressing material. The liquid uptake capacity of both, CHI/CS and CHI/CS/AgSD, films exhibited a pH-dependent behavior. Tensile tests showed that the amount of CS used to form the films and the further incorporation of AgSD affect the mechanical properties of the films. In vitro AgSD-release assays showed that the CHI/CS mass ratio influences the AgSD release rate. All the investigated CHI/CS/AgSD films sustain the AgSD release up to 96h at physiological pH. Antibacterial activity and cell viability assays showed that all the CHI/CS/AgSD films have activity against Pseudomonas aeruginosa and Staphylococcus aureus but they were not toxic to Vero cells. The results presented in this work indicate that the CHI/CS/AgSD exhibits potential to be applied as a wound dressing material.

Silver-coated dressing acticoat caused raised liver enzymes and argyria-like symptoms in burn patient.

BACKGROUND: Treatment of acute burn wounds with silver sulfadiazine (SSD) has raised concern about potential silver toxicity. Numerous adverse reactions and side effects have been reported and an increasing resistance to SSD, especially in Pseudomonas strains, have motivated researchers to search for an alternative wound dressing. METHODS: Recently, a silver-coated wound dressing Acticoat (Smith & Nephew, Inc.) has become available for use in burn patients. It is a three-ply dressing, consisting of an inner rayon/polyester absorptive core between two layers of silver-coated, high-density polyethylene mesh. In a moist environment, the nanocrystals of silver are released and improve the microbial control in the wound. RESULTS: After 1 week of local treatment with Acticoat in a young, previously healthy 17-year-old boy with 30% mixed depth burns, hepatotoxicity and argyria-like symptoms, a grayish discoloration of the patient's face, appeared. The silver levels in plasma (107 microg/kg) and urine (28 microg/kg) were clearly elevated, as well as the liver enzymes. As soon as the local application of Acticoat was aborted, the clinical symptoms and liver enzymes returned to the normal values. CONCLUSIONS: This is the first report on silver toxicity in a patient with 30% burns who received Acticoat for local treatment. Due to substantial experiences with adverse SSD reactions and side effects, it is appropriate to keep the possibility of a toxic silver effect in burn patients treated with Acticoat silver-coated wound dressing in mind. The silver levels in plasma and/or urine should be monitored.

Cytotoxicity of topical antimicrobial agents used in burn wounds in Australasia.

BACKGROUND: Burn sepsis is a leading cause of mortality and morbidity in patients with major burns. The use of topical antimicrobial agents has helped improve the survival of these patients. Silvazine (Sigma Pharmaceuticals, Melbourne, Australia) (1% silver sulphadiazine and 0.2% chlorhexidine digluconate) is used exclusively in Australasia, and there is no published study on its cytotoxicity. This study compared the relative cytotoxicity of Silvazine with 1% silver sulphadiazine (Flamazine (Smith & Nephew Healthcare, Hull, UK)) and a silver-based dressing (Acticoat (Smith & Nephew Healthcare, Hull, UK)). METHODS: Dressings were applied to the centre of culture plates that were then seeded with keratinocytes at an estimated 25% confluence. The plates were incubated for 72 h and culture medium and dressings then removed. Toluidine blue was added to stain the remaining keratinocytes. Following removal of the dye, the plates were photographed under standard conditions and these digital images were analysed using image analysis software. Data was analysed using Student's t-test. RESULTS: In the present study, Silvazine is the most cytotoxic agent. Seventy-two hour exposure to Silvazine in the present study results in almost no keratinocyte survival at all and a highly statistically significant reduction in cell survival relative to control, Acticoat and Flamazine (P<0.001, P<0.01, P<0.01, respectively). Flamazine is associated with a statistically significant reduction in cell numbers relative to control (P<0.05), but is much less cytotoxic than Silvazine (P<0.005). CONCLUSION: In this in-vitro study comparing Acticoat, Silvazine and Flamazine, Silvazine shows an increased cytotoxic effect, relative to control, Flamazine and Acticoat. An in-vivo study is required to determine whether this effect is carried into the clinical setting.

Possibility of wound dressing using poly(L-leucine)/poly(ethylene glycol)/poly(L-leucine) triblock copolymer.

ABA-type block copolymers (abbreviated as LEL) composed of poly(L-leucine) (PLL) as the A component and poly(ethylene glycol) (PEG) as the B component were synthesized by ring-opening polymerization of L-leucine N-carboxyanhydride initiated by primary amino group located at both ends of PEG chain. A silver sulfadiazine (AgSD)-impregnated wound dressing of sponge type was prepared by the lyophilization method. Morphological structure of this wound dressing by scanning electron microscopy was observed to be composed of a dense skin layer and a porous inner layer. Equilibrium water content of LEL wound dressing increased with an increase in PEG content in the block copolymer due to the hydrophilicity of PEG. AgSD release from AgSD-impregnated wound dressing in PBS buffer (pH = 7.4) was dependent on PEG content in the block copolymer. Release of AgSD was increased in proportion to the PEG content in the copolymer. Antibacterial capacity of AgSD-impregnated wound dressing was examined in agar plate against Pseudomonas aeruginosa and Staphylococcus aureus. It was found that the suppression of bacterial proliferation in the wound dressing was dependent upon the PEG content. In cytotoxicity test, cell damage did not occur by the release of AgSD from the LEL sponge matrix of AgSD-medicated wound dressing. In in vivo test, granulous tissue formation and wound contraction for the AgSD- and dehydroepiandrosterone-impregnated LEL-2 wound dressing were faster than for any other groups.

Bone marrow toxicity by silver sulfadiazine.

The effect of silver sulfadiazine (SSD) on the production of granulocytes and macrophages was studied in a murine model of cutaneous injury. Application of SSD daily to mice receiving a 10 percent full-thickness total body surface area burn injury failed to demonstrate consistent suppression of the bone marrow at one, four or seven days postinjury. Mice undergoing a 10 percent full-thickness skin excision (SE) and daily SSD application (SE plus SSD) had a near 50 percent reduction in total peripheral blood leukocyte counts in comparison with a control group and untreated mice that were skin-excised (SE-U) (p < 0.03) to 0.002) on day one postinjury and maintained this reduction compared with SE-U at days four and seven postinjury. The absolute number of granulocytes in SE plus SSD was only 10 percent of control or SE-U (p < 0.04 to 0.002) at day one postinjury and remained less than SE-U at four and seven days postinjury. Femoral bone marrow assay of granulocyte-macrophage progenitor cells (GM-CFC) revealed a marked reduction in nucleated bone marrow cells for SE plus SSD compared with respect to control at days one and seven and SE-U at days four and seven (p < 0.02 to 0.001). GM-CFC were significantly depressed in SE plus SSD on day one compared with C and SE-U and day four compared with SE-U (p < 0.01 to 0.001), but returned to control values by day seven. When SSD (0.5 to 500.0 micrograms per milliliter) was added to culture plates containing maximally stimulated normal murine or human bone marrow cells, the colony count was depressed in a dose-dependent manner. In vitro SSD is directly cytotoxic to myelopoietic tissue, and in vivo, alters the myeloid cell compartment. These observations in combination may explain the transient leukopenia frequently observed in patients receiving topical chemoprophylaxis with SSD.

Cytotoxicity to human leukocytes by topical antimicrobial agents used for burn care.

We tested two topical antimicrobial agents (TAAs), silver sulfadiazine and mafenide acetate, to determine their cytotoxic effects when human lymphocytes and neutrophils were incubated with the agents in vitro for 30 minutes. Dilute concentrations of both TAAs markedly inhibited neutrophil respiratory burst activity and mitogen-stimulated lymphocyte proliferation (p < 0.05). The components of silver sulfadiazine (silver and sulfadiazine) were separately tested, and each component inhibited both neutrophil and lymphocyte functions. Mafenide acetate markedly decreased intracellular Ca+2 flux in lymphocytes. The effects of the TAAs were partially reversed when cells were washed and resuspended in medium after they were exposed in vitro to the TAAs. Commonly used TAAs may contribute to local immune dysfunction in the patient with burns. Because evidence suggests that T lymphocytes may participate in wound healing, prolonged treatment with TAAs may also effect certain aspects of wound healing.

Evaluation of a synthetic wound dressing capable of releasing silver sulfadiazine.

A silver sulfadiazine-impregnated poly-L-leucine wound dressing, AgSD-medicated wound dressing, was evaluated for antibacterial capacity against Pseudomonas aeruginosa and cytotoxicity to human fibroblasts and human epidermal keratinocytes. This wound dressing contained 0.4 mg AgSD/cm2. Antibacterial capacity was examined on experimentally infected wound surfaces (3.4 x 10(4) P. aeruginosa organisms/gm) on the dorsum of mice. The AgSD-medicated wound dressing showed effective bacterial control. Cytotoxicity was examined on a monolayer of cells formed in culture dishes. Cellular damage was reduced by the controlled release of AgSD from the hydrophobic poly-L-leucine sponge matrix of the AgSD-medicated wound dressing. Cytotoxicity of the AgSD-medicated wound dressing was much lower than that of 1% AgSD cream.

In vitro toxicity of topical antimicrobial agents to human fibroblasts.

Topical antimicrobial agents are essential to optimal burn care. However, exposure of WI-38 human diploid fibroblasts (ATCC CCL 75) and fresh donor human dermal fibroblasts to silver sulfadiazine and mafenide acetate results in a significant reduction in cell proliferation, as determined by hemocytometer cell counts and total matrix protein assays, within 48 hr of exposure. Changes in cellular morphology and progressive deterioration of cytoplasmic organelles and the nucleus are seen with phase-contrast microscopy and transmission electron microscopy. These findings may explain the clinical observation of delayed wound healing after the use of topical antimicrobial agents.

Patch testing with silver sulfadiazine cream.

23 patients who had used silver sulfadiazine cream were patch tested. No reactions to the active principle occurred but 2 vehicle components, cetyl alcohol and propylene glycol, were positive. No sulfonamide-sensitive subject reacted to silver sulfadiazine. There is no evidence that silver sulfadiazine has a contact sensitizing potential or that it is contra-indicated for patients with a history of sulfonamide hypersensitivity.