Biofilms on Voice Prosthesis - Challenges and Therapeutic Insights.

After a total laryngectomy, voice rehabilitation is essential for a patient to successfully reintegrate into society. The implantation of a voice prosthesis (VP) is the gold standard to achieve this goal. Thus, the primary disadvantage of using VP is the fluid blockage and degradation caused by biofilm colonization, which requires frequent replacements, associated with a poor quality of life for the patient. Many scientists have centered their research on coming up with novel and efficient ways to combat polymicrobial biofilms, both in terms of preventing microbial adhesion and rupturing established biofilms in order to overcome this limitation. This paper aims to present the current state of the art regarding biofilm formation on VPs and composition of VPs, and to review the current anti-biofilm strategies that have proven to be successful, as well as pointing possible novel perspectives of improvement.

Magnetite Nanoparticles Functionalized with Therapeutic Agents for Enhanced ENT Antimicrobial Properties.

In the context of inefficient antibiotics, antibacterial alternatives are urgently needed to stop the increasing resistance rates in pathogens. This study reports the fabrication and characterization of four promising magnetite-based antibiotic delivery systems for ENT (ear, nose and throat) applications. Magnetite nanoparticles were functionalized with streptomycin and neomycin and some were entrapped in polymeric spheres. The obtained nanomaterials are stable, with spherical morphology, their size ranging from ~2.8 to ~4.7 nm for antibiotic-coated magnetite nanoparticles, and from submicron sizes up to several microns for polymer-coated magnetite-antibiotic composites. Cell viability and antimicrobial tests demonstrated their biocompatibility on human diploid cells and their antibacterial effect against Gram-negative (Pseudomonas aeruginosa) and Gram-positive (Staphylococcus aureus) opportunistic bacteria. The presence of the polymeric coat proved an enhancement in biocompatibility and a slight reduction in the antimicrobial efficiency of the spheres. Our results support the idea that functional NPs and polymeric microsystems containing functional NPs could be tailored to achieve more biocompatibility or more antimicrobial effect, depending on the bioactive compounds they incorporate and their intended application.

PEG-Functionalized Magnetite Nanoparticles for Modulation of Microbial Biofilms on Voice Prosthesis.

This study reports the fabrication of nanostructured coatings based on magnetite, polyethyleneglycol, and biologically active molecule (polymyxin B-PM) for producing biofilm-resistant surfaces (voice prosthesis). Magnetite nanoparticles (MNPs) have been synthesized and functionalized using a co-precipitation method and were further deposited into thin coatings using the matrix-assisted pulsed laser evaporation (MAPLE) technique. The obtained nanoparticles and coatings were characterized by X-ray diffraction (XRD), thermogravimetric analysis with differential scanning calorimetry (TGA-DSC), scanning electron microscopy (SEM), transmission electron microscopy with selected area electron diffraction (TEM-SAED), Fourier-transform infrared spectroscopy (FT-IR), and infrared microscopy (IRM). Their antibiofilm activity was tested against relevant Staphylococcus aureus and Pseudomonas aeruginosa bacterial strains. The Fe3O4@PEG/PM surface of modified voice prosthesis sections reduced the number of CFU/mL up to four orders of magnitude in the case of S. aureus biofilm. A more significant inhibitory effect is noticed in the case of P. aeruginosa up to five folds. These results highlight the importance of new Fe3O4@PEG/PM in the biomedical field.

Correlations between ultrasonography performed by the ENT specialist and pathologic findings in the management of three cases with thyroglossal duct cyst.

Thyroglossal duct cyst (TDC) has an increasing incidence. We present a series of three cases that benefited from the use of ultrasonography performed first hand by the ENT specialist. All cases underwent Sistrunk procedure and the diagnosis was confirmed by pathology results: one uncomplicated TDC, a thyroglossal duct carcinoma, and an infected TDC with the risk of becoming a diffuse cervical suppuration. Ultrasonography performed first hand by the ENT specialist enables a quick and thorough planning of the surgical procedure and management of the case.

Ultrasonographic anatomy of head and neck--a pictorial for the ENT specialist.

An increased pressure on ENT departments has evolved as head and neck pathology is showing a higher incidence and prevalence. Therefore, the ENT specialist should develop good skills in ultrasonographic examination of patients with head and neck masses. The aim of this paper is to enable the ENT specialist to identify anatomical landmarks on ultrasonographic images in order to expedite the diagnosis with a higher degree of certainty. We describe the steps for a proper ultrasound examination of the patient. We illustrate the following anatomical areas: submandibular gland, thyroid gland, parathyroid glands, oropharinx, larynx, parotid glands, etc. Moreover we emphasize the differential diagnosis that should be taken into account when examining pathology in these regions. Ultrasonographic examination of head and neck pathology is cost efficient, non irradiating and permits fast follow up with serial examination of the lesions. Furthermore one can perform an initial TNM staging of the case prior to other expensive imaging studies such as CT and MRI. We hope to raise the awareness of fellow ENT specialists in performing ultrasonography as future developments such as elastography and CEUS will increase the specificity and sensitivity of this diagnostic method.

MAPLE fabricated Fe3O4@Cinnamomum verum antimicrobial surfaces for improved gastrostomy tubes.

Cinnamomum verum-functionalized Fe3O4 nanoparticles of 9.4 nm in size were laser transferred by matrix assisted pulsed laser evaporation (MAPLE) technique onto gastrostomy tubes (G-tubes) for antibacterial activity evaluation toward Gram positive and Gram negative microbial colonization. X-ray diffraction analysis of the nanoparticle powder showed a polycrystalline magnetite structure, whereas infrared mapping confirmed the integrity of C. verum (CV) functional groups after the laser transfer. The specific topography of the deposited films involved a uniform thin coating together with several aggregates of bio-functionalized magnetite particles covering the G-tubes. Cytotoxicity assays showed an increase of the G-tube surface biocompatibility after Fe3O4@CV treatment, allowing a normal development of endothelial cells up to five days of incubation. Microbiological assays on nanoparticle-modified G-tube surfaces have proved an improvement of anti-adherent properties, significantly reducing both Gram negative and Gram positive bacteria colonization.

Treatment Options for Severe Epistaxis, the Experience of Coltea ENT Clinic.

OBJECTIVES: The study presents the experience of the Coltea ENT Clinic with the most common emergency in ENT pathology. RESULTS: The study group comprises 51.24% women and 48.76% men with 73.14% of patients (177) coming from urban areas and the remaining 26.86% (65) from rural areas. The total number of days of hospitalization is 1411, representing an average of 5.83 days / patient. Epistaxis was anterior in 80.17% of cases (194 patients) and antero-posterior in 19.83% (48 patients). 132 patients, representing 54.55% presented elevated blood pressure whereas liver and hematological disorders are uncommon etiologies. Therapeutic interventions are mostly non-surgical 207 (85.54%), the remaining 35 cases (14.46%), requiring surgery. CONCLUSIONS: Epistaxis associated with high blood pressure is found in 54.55% of the study group. In 38.02% of cases the etiology cannot be determined. Pluri-factorial etiology is common. The most difficult to control were the cases with epistaxis of hepatic etiology, in which cases the surgical solution was required.

Biohybrid nanostructured iron oxide nanoparticles and Satureja hortensis to prevent fungal biofilm development.

Cutaneous wounds are often superinfected during the healing process and this leads to prolonged convalescence and discomfort. Usage of suitable wound dressings is very important for an appropriate wound care leading to a correct healing. The aim of this study was to demonstrate the influence of a nano-coated wound dressing (WD) on Candida albicans colonization rate and biofilm formation. The modified WD was achieved by submerging the dressing pieces into a nanofluid composed of functionalized magnetite nanoparticles and Satureja hortensis (SO) essential oil (EO). Chemical composition of the EO was established by GC-MS. The fabricated nanostructure was characterized by X-ray Diffraction (XRD), Transmission Electron Microscopy (TEM), Differential Thermal Analysis (DTA) and Fourier Transform-Infrared Spectroscopy (FT-IR). The analysis of the colonized surfaces using (Scanning Electron Microscopy) SEM revealed that C. albicans adherence and subsequent biofilm development are strongly inhibited on the surface of wound dressing fibers coated with the obtained nanofluid, comparing with regular uncoated materials. The results were also confirmed by the assay of the viable fungal cells embedded in the biofilm. Our data demonstrate that the obtained phytonanocoating improve the resistance of wound dressing surface to C. albicans colonization, which is often an etiological cause of local infections, impairing the appropriate wound healing.

Magnetite nanoparticles for functionalized textile dressing to prevent fungal biofilms development.

The purpose of this work was to investigate the potential of functionalized magnetite nanoparticles to improve the antibiofilm properties of textile dressing, tested in vitro against monospecific Candida albicans biofilms. Functionalized magnetite (Fe3O4/C18), with an average size not exceeding 20 nm, has been synthesized by precipitation of ferric and ferrous salts in aqueous solution of oleic acid (C18) and NaOH. Transmission electron microscopy, X-ray diffraction analysis, and differential thermal analysis coupled with thermo gravimetric analysis were used as characterization methods for the synthesized Fe3O4/C18. Scanning electron microscopy was used to study the architecture of the fungal biofilm developed on the functionalized textile dressing samples and culture-based methods for the quantitative assay of the biofilm-embedded yeast cells. The optimized textile dressing samples proved to be more resistant to C. albicans colonization, as compared to the uncoated ones; these functionalized surfaces-based approaches are very useful in the prevention of wound microbial contamination and subsequent biofilm development on viable tissues or implanted devices.

In vitro evaluation of anti-pathogenic surface coating nanofluid, obtained by combining Fe3O4/C12 nanostructures and 2-((4-ethylphenoxy)methyl)-N-(substituted-phenylcarbamothioyl)-benzamides.

In this paper, we report the design of a new nanofluid for anti-pathogenic surface coating. For this purpose, new 2-((4-ethylphenoxy)methyl)-N-(substituted-phenylcarbamothioyl)-benzamides were synthesized and used as an adsorption shell for Fe3O4/C12 core/shell nanosized material. The functionalized specimens were tested by in vitro assays for their anti-biofilm properties and biocompatibility. The optimized catheter sections showed an improved resistance to Staphylococcus aureus ATCC 25923 and Pseudomonas aeruginosa ATCC 27853 in vitro biofilm development, as demonstrated by the viable cell counts of biofilm-embedded bacterial cells and by scanning electron microscopy examination of the colonized surfaces. The nanofluid proved to be not cytotoxic and did not influence the eukaryotic cell cycle. These results could be of a great interest for the biomedical field, opening new directions for the design of film-coated surfaces with improved anti-biofilm properties.

Modified wound dressing with phyto-nanostructured coating to prevent staphylococcal and pseudomonal biofilm development.

This paper reports a newly fabricated nanophyto-modified wound dressing with microbicidal and anti-adherence properties. Nanofluid-based magnetite doped with eugenol or limonene was used to fabricate modified wound dressings. Nanostructure coated materials were characterized by TEM, XRD, and FT-IR. For the quantitative measurement of biofilm-embedded microbial cells, a culture-based method for viable cell count was used. The optimized textile dressing samples proved to be more resistant to staphylococcal and pseudomonal colonization and biofilm formation compared to the uncoated controls. The functionalized surfaces for wound dressing seems to be a very useful tool for the prevention of wound microbial contamination on viable tissues.