RESUMEN
Silk fibroin (SF) is a natural protein extracted fromBombyx morisilkworm thread. From its common use in the textile industry, it emerged as a biomaterial with promising biochemical and mechanical properties for applications in the field of tissue engineering and regenerative medicine. In this study, we evaluate for the first time the effects of SF on cardiac bioink formulations containing cardiac spheroids (CSs). First, we evaluate if the SF addition plays a role in the structural and elastic properties of hydrogels containing alginate (Alg) and gelatin (Gel). Then, we test the printability and durability of bioprinted SF-containing hydrogels. Finally, we evaluate whether the addition of SF controls cell viability and function of CSs in Alg-Gel hydrogels. Our findings show that the addition of 1% (w/v) SF to Alg-Gel hydrogels makes them more elastic without affecting cell viability. However, fractional shortening (FS%) of CSs in SF-Alg-Gel hydrogels increases without affecting their contraction frequency, suggesting an improvement in contractile function in the 3D cultures. Altogether, our findings support a promising pathway to bioengineer bioinks containing SF for cardiac applications, with the ability to control mechanical and cellular features in cardiac bioinks.
Asunto(s)
Alginatos , Elasticidad , Fibroínas , Gelatina , Hidrogeles , Miocitos Cardíacos , Alginatos/química , Alginatos/farmacología , Fibroínas/química , Fibroínas/farmacología , Gelatina/química , Hidrogeles/química , Hidrogeles/farmacología , Animales , Miocitos Cardíacos/citología , Miocitos Cardíacos/efectos de los fármacos , Miocitos Cardíacos/metabolismo , Bioimpresión , Supervivencia Celular/efectos de los fármacos , Ingeniería de Tejidos , Tinta , Esferoides Celulares/citología , Esferoides Celulares/efectos de los fármacos , Ratas , Contracción Miocárdica/efectos de los fármacosAsunto(s)
Enfermedad Hepática en Estado Terminal/etiología , Hipotiroidismo/complicaciones , Hipotiroidismo/diagnóstico , Hígado/patología , Diagnóstico Diferencial , Femenino , Terapia de Reemplazo de Hormonas/métodos , Humanos , Hipotiroidismo/tratamiento farmacológico , Persona de Mediana Edad , Mixedema/complicaciones , Mixedema/diagnóstico , Mixedema/tratamiento farmacológico , Necrosis/diagnóstico , Tiroxina/uso terapéuticoAsunto(s)
Bencimidazoles/efectos adversos , Factor VIIa/uso terapéutico , Hematoma Subdural/tratamiento farmacológico , beta-Alanina/análogos & derivados , Anciano , Bencimidazoles/uso terapéutico , Terapia Combinada , Dabigatrán , Drenaje , Traumatismos Cerrados de la Cabeza/complicaciones , Hematoma Subdural/inducido químicamente , Hematoma Subdural/diagnóstico por imagen , Hematoma Subdural/etiología , Hematoma Subdural/cirugía , Humanos , Hidrocefalia/etiología , Hidrocefalia/cirugía , Masculino , Tiempo de Tromboplastina Parcial , Proteínas Recombinantes/uso terapéutico , Tiempo de Trombina , Tomografía Computarizada por Rayos X , beta-Alanina/efectos adversos , beta-Alanina/uso terapéuticoAsunto(s)
Antivirales/uso terapéutico , Hepatitis C Crónica/tratamiento farmacológico , Tiroxina/uso terapéutico , Antivirales/efectos adversos , Quimioterapia Combinada , Femenino , Humanos , Interferón-alfa/efectos adversos , Interferón-alfa/uso terapéutico , Persona de Mediana Edad , Ribavirina/uso terapéutico , Enfermedades de la Tiroides/inducido químicamente , Enfermedades de la Tiroides/tratamiento farmacológicoAsunto(s)
Antivirales/efectos adversos , Hepatitis C/tratamiento farmacológico , Interferón-alfa/efectos adversos , Tiroiditis/inducido químicamente , Tirotoxicosis/inducido químicamente , Autoanticuerpos/sangre , Autoanticuerpos/metabolismo , Quimioterapia Combinada/efectos adversos , Hepatitis C/sangre , Humanos , Interferón alfa-2 , Masculino , Persona de Mediana Edad , Propranolol/uso terapéutico , Proteínas Recombinantes , Pruebas de Función de la Tiroides , Tiroiditis/sangre , Tiroiditis/tratamiento farmacológico , Resultado del TratamientoRESUMEN
BACKGROUND: Interferon-alpha2b (IFN-alpha2b) is well known to cause both hyper- and hypo-thyroidism. In the former, the commonest aetiology is thyroiditis. As there is no previous data to fully characterize the entity of IFN-related thyroiditis, the aim of this study is to document in detail its evolution in a cohort of hepatitis C patients treated with pegylated IFN-alpha2b and Ribavirin (RBV). METHODS: A prospective observational study was conducted in patients who developed thyroid diseases whilst receiving combination of pegylated IFN-alpha2b and RBV for hepatitis C. The patients were followed with monthly thyrotropin (TSH). Where TSH was undetectable, free tetra- (fT4) and tri-iodothyronine (fT3) were added. Anti-thyroperoxidase (TPO), anti-thyroglobulin (Tg) and thyroid stimulating immunoglobulin (TSI) levels were also performed at diagnosis, during and at the end of IFN therapy. All patients were assessed and followed up closely with monthly TSH, fT4 and fT3 levels until the completion, after 6 and 12 months of treatment. RESULTS: There were seven females and four males over a 30-month period. All patients were found to have thyroiditis. On average, the time to the development of thyroid disease was 10 weeks and duration of disease 9 weeks. All patients eventually recovered normal biochemical thyroid function although two required short-term supplementation. CONCLUSION: Thyroiditis was found exclusively in our patients. Both the hyper- and hypo-thyroid phase can be short lived, extreme and transient in nature which warrants strict monthly TSH monitoring. Careful follow-up of all patients is mandatory as complete recovery is expected.
Asunto(s)
Antivirales/efectos adversos , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/efectos adversos , Tiroiditis/inducido químicamente , Adulto , Antivirales/uso terapéutico , Quimioterapia Combinada , Femenino , Humanos , Interferón alfa-2 , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Proteínas Recombinantes , Ribavirina/uso terapéuticoAsunto(s)
Gangrena de Fournier/patología , Gangrena de Fournier/terapia , Enfermedades de los Genitales Masculinos/patología , Enfermedades de los Genitales Masculinos/terapia , Escroto , Antibacterianos/uso terapéutico , Biopsia con Aguja , Terapia Combinada , Desbridamiento/métodos , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/diagnóstico , Estudios de Seguimiento , Gangrena de Fournier/etiología , Enfermedades de los Genitales Masculinos/etiología , Humanos , Inmunohistoquímica , Masculino , Persona de Mediana Edad , Obesidad Mórbida/complicaciones , Obesidad Mórbida/diagnóstico , Medición de Riesgo , Resultado del TratamientoRESUMEN
Hyperkalemia is a potentially fatal condition and is defined by a serum potassium level (K+) of greater than 5.5 mmol/L. The associated prevalence of cardiac arrhythmia increases directly with the degree of hyperkalemia. The danger in the majority of hyperkalemia cases is cardiac dysrhythmia, and often ventricular fibrillation or asystole is the terminating event. Although there are many previous reports addressing this threatening problem and associated therapeutic maneuvers, there have not been many previous reports citing the fatal concentration of hyperkalemia irrespective of the causes. However, it is uniformly accepted that a K+ concentration greater than 10.0 mmol/L is fatal unless urgent treatment is instituted. This report describes a case of nonfatal hyperkalemia of 14 mmol/L with intact survival and complete recovery. Potassium homeostasis is revisited, and some explanations are proffered regarding the protective mechanism against hyperkalemia, including transcellular flux, renal tubular function, and endocrine responses.
Asunto(s)
Paro Cardíaco/etiología , Hiperpotasemia/complicaciones , Reanimación Cardiopulmonar , Paro Cardíaco/terapia , Homeostasis , Humanos , Hiperpotasemia/diagnóstico , Masculino , Persona de Mediana EdadAsunto(s)
Hospitalización , Hiponatremia/etiología , Hipotiroidismo/complicaciones , Adulto , Anciano , Anciano de 80 o más Años , Australia/epidemiología , Electrólitos/sangre , Humanos , Hiponatremia/sangre , Hiponatremia/epidemiología , Hiponatremia/patología , Hipotiroidismo/sangre , Hipotiroidismo/epidemiología , Hipotiroidismo/patología , Inmunoensayo , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Valores de Referencia , Estudios Retrospectivos , Hormonas Tiroideas/sangre , Tirotropina/sangreRESUMEN
We report the successful use of r-hirudin (lepirudin) for cardiopulmonary bypass in a 67-year-old man who developed heparin-induced thrombocytopenia type II during heparin treatment of an extensive deep venous thrombosis. Lepirudin was monitored by the modified ecarin clotting time in a "mobile laboratory" set up next to the cardiac theatre, aiming for lepirudin levels of 3.5 to 4.5 microg/ml during bypass.
Asunto(s)
Puente Cardiopulmonar , Heparina/efectos adversos , Terapia con Hirudina , Trombocitopenia/inducido químicamente , Anciano , Humanos , Masculino , Monitoreo Intraoperatorio/métodos , Trombocitopenia/clasificación , Trombosis de la Vena/tratamiento farmacológicoAsunto(s)
Artralgia/etiología , Enfermedades Óseas Metabólicas/etiología , Enfermedad de Graves/complicaciones , Adulto , Antitiroideos/uso terapéutico , Artralgia/diagnóstico , Artralgia/tratamiento farmacológico , Enfermedades Óseas Metabólicas/diagnóstico , Enfermedades Óseas Metabólicas/tratamiento farmacológico , Huesos/diagnóstico por imagen , Huesos/patología , Diagnóstico Diferencial , Femenino , Enfermedad de Graves/diagnóstico , Enfermedad de Graves/tratamiento farmacológico , Humanos , Hipertiroidismo/complicaciones , Hipertiroidismo/diagnóstico , Hipertiroidismo/tratamiento farmacológico , Radiografía , Resultado del TratamientoRESUMEN
Esophageal perforation due to Candida glabrata is a rare entity. This organism is uncommonly recognized to be angio-invasive and cause gastrointestinal tract perforation. Herein, we describe a case of invasive C. glabrata infection leading to esophageal perforation in a patient undergoing hemopoietic stem cell transplantation.
Asunto(s)
Candida glabrata/crecimiento & desarrollo , Candidiasis/complicaciones , Perforación del Esófago/microbiología , Trasplante de Células Madre Hematopoyéticas/efectos adversos , Adulto , Antifúngicos/uso terapéutico , Candidiasis/tratamiento farmacológico , Candidiasis/patología , Perforación del Esófago/patología , Perforación del Esófago/cirugía , Femenino , HumanosRESUMEN
Abstract The present study describes the clinical and laboratory features of 11 patients with thyrotoxic, hypokalaemic periodic paralysis, presenting to five Melbourne teaching hospitals between 1991 and 2000. All 11 patients were Asian or Polynesian men aged 18-41 years, and most had experienced previous episodes of acute, unexplained paralysis. All cases resolved without significant morbidity. Thyrotoxic, hypokalaemic periodic paralysis is a potentially life-threatening and terrifying condition, which is often under-recognized and will present with increasing frequency in the community. The diagnosis should be considered in any Asian-Australian male presenting with sudden onset paralysis.
Asunto(s)
Parálisis Periódica Hipopotasémica/diagnóstico , Parálisis Periódica Hipopotasémica/epidemiología , Crisis Tiroidea/complicaciones , Adolescente , Adulto , Australia/epidemiología , Humanos , Parálisis Periódica Hipopotasémica/complicaciones , Parálisis Periódica Hipopotasémica/fisiopatología , Masculino , PrevalenciaRESUMEN
Pregnancy-associated osteoporosis is an uncommon condition. It predominantly affects thinly built, primigravid, lactating women. These patients can sustain vertebral fractures with minimal or no trauma, resulting in significant morbidity. The association with hypercalcaemia is rare and typically occurs during the first few months postpartum, while lactating. This condition is, however, relatively benign and patients can expect to return to normal bone mineral density 6-12 months after breast-feeding has stopped.