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1.
Bioengineering (Basel) ; 11(5)2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38790283

RESUMO

To address the limitations of alginate and gelatin as separate hydrogels, partially oxidized alginate, alginate dialdehyde (ADA), is usually combined with gelatin to prepare ADA-GEL hydrogels. These hydrogels offer tunable properties, controllable degradation, and suitable stiffness for 3D bioprinting and tissue engineering applications. Several processing variables affect the final properties of the hydrogel, including degree of oxidation, gelatin content and type of crosslinking agent. In addition, in 3D-printed structures, pore size and the possible addition of a filler to make a hydrogel composite also affect the final physical and biological properties. This study utilized datasets from 13 research papers, encompassing 33 unique combinations of ADA concentration, gelatin concentration, CaCl2 and microbial transglutaminase (mTG) concentrations (as crosslinkers), pore size, bioactive glass (BG) filler content, and one identified target property of the hydrogels, stiffness, utilizing the Extreme Boost (XGB) machine learning algorithm to create a predictive model for understanding the combined influence of these parameters on hydrogel stiffness. The stiffness of ADA-GEL hydrogels is notably affected by the ADA to GEL ratio, and higher gelatin content for different ADA gel concentrations weakens the scaffold, likely due to the presence of unbound gelatin. Pore size and the inclusion of a BG particulate filler also have a significant impact on stiffness; smaller pore sizes and higher BG content lead to increased stiffness. The optimization of ADA-GEL composition and the inclusion of BG fillers are key determinants to tailor the stiffness of these 3D printed hydrogels, as found by the analysis of the available data.

2.
Microsc Res Tech ; 87(7): 1552-1565, 2024 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-38430214

RESUMO

Corrosion of dental implants is one of the most critical factors in the failure of implant treatments. Generally, corrosion depends on the type of material used in implants and the chemical composition of the oral environment. Due to the antibacterial activities, mouthwashes and chlorhexidine gels are often used after implant surgery. Ti6Al4V is commonly used in manufacturing dental implants. The present study aims to investigate the corrosion behavior of the Ti6Al4V alloy under different concentrations of chlorhexidine (0.12%, 0.2%,and 2%) during 2- and 24-h immersion. This way corrosion may be minimized while obtaining an antibacterial environment around the implant. In this regard, the electrochemical behavior of the specimens was investigated using polarization and impedance tests, and then their morphology, cross-section and nano-tribological behavior were evaluated using atomic force microscopy, scanning electron microscopy, energy dispersive x-ray spectroscopy, and nano-scratch test. The results show that using chlorhexidine solution with a concentration of 0.12% could yield a lower corrosion rate and material loss after implant surgery. RESEARCH HIGHLIGHTS: Open circuit potential values increase with immersion time, which suggests multistage passivation of the surface during immersion in chlorhexidine. Specimens in 0.12% chlorhexidine show improved thermodynamic corrosion resistance. Nano-scratch testing demonstrates higher scratch resistance for specimens in 0.12% chlorhexidine solution after 2-h immersion. Higher chlorhexidine concentration than 0.12% and longer immersion times decrease the resistance of the formed passive layer.


Assuntos
Ligas , Clorexidina , Implantes Dentários , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Titânio , Clorexidina/química , Titânio/química , Ligas/química , Corrosão , Teste de Materiais , Propriedades de Superfície , Espectrometria por Raios X , Humanos
3.
Materials (Basel) ; 17(2)2024 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-38255542

RESUMO

This study investigates the improvement in the compressive strength of cellulose/cement-based composites. Methyl cellulose (MC), carboxymethyl cellulose (CMC), and hydroxypropyl cellulose (HPMC) are separately used as the cellulose phase with different wt%. Graphene oxide (GO) and zoledronic acid (ZOL) are used as additives for bone regeneration for various formulations. Utilizing Extreme Gradient Boosting (XGB) modeling, this research demonstrates the roles of the choice of the cellulose phase, wt% of cement phase, % gelatin, % citric acid, degradation time, and concentration of GO and ZOL in influencing compressive strength. The XGB regression model, with an R2 value of 0.99 (~1), shows the predictive power of the model. Feature importance analysis demonstrates the significance of cellulose choice and the addition of chitosan in enhancing compressive strength. The correlation heatmap reveals positive associations, emphasizing the positive influence of HPMC and CMC compared with MC and the substantial impact of chitosan and citric acid on compressive strength. The model's predictive accuracy is validated through predicted compressive strength values with experimental observations, providing insights for optimizing cellulose-reinforced cements and enabling tailored material design for enhanced mechanical performance.

4.
Artigo em Inglês | MEDLINE | ID: mdl-38126329

RESUMO

When skeletal and cardiac tissues are damaged, surgical approaches are not always successful and tissue regeneration approaches are investigated. Reports in the literature indicate that silica nanoparticles and bioactive glasses (BGs), including silicate bioactive glasses (e.g., 45S5 BG), phosphate glass fibers, boron-doped mesoporous BGs, borosilicate glasses, and aluminoborates, are promising for repairing skeletal muscle tissue. Silica nanoparticles and BGs have been combined with polymers to obtain aligned nanofibers and to maintain controlled delivery of nanoparticles for skeletal muscle repair. The literature indicates that cardiac muscle regeneration can be also triggered by the ionic products of BGs. This was observed to be due to the release of vascular endothelial growth factor and other growth factors from cardiomyocytes, which regulate endothelial cells to form capillary structures (angiogenesis). Specific studies, including both in vitro and in vivo approaches, are reviewed in this article. The analysis of the literature indicates that although the research field is still very limited, BGs are showing great promise for muscle tissue engineering and further research in the field should be carried out to expand our basic knowledge on the application of BGs in muscle (skeletal and cardiac) tissue regeneration. Impact statement This review highlights the potential of silica particles and bioactive glasses (BGs) for skeletal and cardiac tissue regeneration. These biomaterials create scaffolds triggering muscle cell differentiation. Ionic products from BGs stimulate growth factors, supporting angiogenesis in cardiac tissue repair. Further research is required to expand our know-how on silica particles and BGs in muscle tissue engineering.

5.
J Intensive Med ; 3(4): 352-364, 2023 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-38028633

RESUMO

Background: Ventilator-associated pneumonia (VAP) represents a common hospital-acquired infection among mechanically ventilated patients. We summarized evidence concerning ventilator care bundles to prevent VAP. Methods: A systematic review and meta-analysis were performed. Randomized controlled trials and controlled observational studies of adults undergoing mechanical ventilation (MV) for at least 48 h were considered for inclusion. Outcomes of interest were the number of VAP episodes, duration of MV, hospital and intensive care unit (ICU) length of stay, and mortality. A systematic search was conducted in the MEDLINE, the Cochrane Library, and the Web of Science between 1985 and 2022. Results are reported as odds ratio (OR) or mean difference (MD) with 95% confidence intervals (CI). The PROSPERO registration number is CRD42022341780. Results: Thirty-six studies including 116,873 MV participants met the inclusion criteria. A total of 84,031 participants underwent care bundles for VAP prevention. The most reported component of the ventilator bundle was head-of-bed elevation (n=83,146), followed by oral care (n=80,787). A reduction in the number of VAP episodes was observed among those receiving ventilator care bundles, compared with the non-care bundle group (OR=0.42, 95% CI: 0.33, 0.54). Additionally, the implementation of care bundles decreased the duration of MV (MD=-0.59, 95% CI: -1.03, -0.15) and hospital length of stay (MD=-1.24, 95% CI: -2.30, -0.18) in studies where educational activities were part of the bundle. Data regarding mortality were inconclusive. Conclusions: The implementation of ventilator care bundles reduced the number of VAP episodes and the duration of MV in adult ICUs. Their application in combination with educational activities seemed to improve clinical outcomes.

6.
Adv Eng Mater ; 25(17)2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37982016

RESUMO

Herein, fullerenol (Ful), a highly water-soluble derivative of C60 fullerene with demonstrated antioxidant activity, is incorporated into calcium phosphate cements (CPCs) to enhance their osteogenic ability. CPCs with added carboxymethyl cellulose/gelatin (CMC/Gel) are doped with biocompatible Ful particles at concentrations of 0.02, 0.04, and 0.1 wt v%-1 and evaluated for Ful-mediated mechanical performance, antioxidant activity, and in vitro cellular osteogenesis. CMC/gel cements with the highest Ful concentration decrease setting times due to increased hydrogen bonding from Ful's hydroxyl groups. In vitro studies of reactive oxygen species (ROS) scavenging with CMC/gel cements demonstrate potent antioxidant activity with Ful incorporation and cement scavenging capacity is highest for 0.02 and 0.04 wt v%-1 Ful. In vitro cytotoxicity studies reveal that 0.02 and 0.04 wt v%-1 Ful cements also protect cellular viability. Finally, increase of alkaline phosphatase (ALP) activity and expression of runt-related transcription factor 2 (Runx2) in MC3T3-E1 pre-osteoblast cells treated with low-dose Ful cements demonstrate Ful-mediated osteogenic differentiation. These results strongly indicate that the osteogenic abilities of Ful-loaded cements are correlated with their antioxidant activity levels. Overall, this study demonstrates exciting potential of Fullerenol as an antioxidant and proosteogenic additive for improving the performance of calcium phosphate cements in bone reconstruction procedures.

7.
Biomed Phys Eng Express ; 9(6)2023 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-37651988

RESUMO

3D printing is an effective method to prepare 3D scaffolds for tissue engineering applications. However, optimization of printing conditions to obtain suitable mechanical properties for various tissue engineering applications is costly and time consuming. To address this problem, in this study, scikit-learn Python machine learning library was used to apply four machine learning-based approaches which are ordinary least squares (OLS) linear regression, random forest (RF), light gradient Boost (LGBM), extreme gradient boosting (XGB) and artificial neural network models to understand the relationship between 3D printing parameters and tensile strength of poly(lactic acid) (PLA). 68 combinations of process parameters for nozzle temperature, printing speed, layer height and tensile strength were used from investigated research papers. Then, datasets were divided as training (80%) and test (20%). After building the OLS linear regression, RF, LGBM, XGB and artificial neural network models, the correlation heatmap and feature importance of each printing parameter for tensile strength values were determined, respectively. Then, the tensile strength was predicted for real datasets to evaluate the performance of the models. The results demonstrate that XGB model was the most successful in predicting tensile strength among the studied models with anR2value of 0.98 and 0.94 for train and test values, respectively. A closeR2value for the train and test also indicated that there was no overfitting of the data to the model. Finally, SHAP analysis shows significance of each feature on prediction of tensile strength. This study can be extended for independent variables including nozzle pressure, strut size and molecular weight of PLA and dependent variables such as elongation and elastic modulus of PLA which may be a powerful tool to predict the mechanical properties of scaffolds for tissue engineering applications.

8.
Biomed Mater ; 18(5)2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37604161

RESUMO

In this study, 3D printed porous poly(lactide-co-glycolide) (PLGA) and its nanocomposites with 5 wt. % hydroxyapatite (HA) and 0.5, 1 and 2 wt. % carboxyl-functionalized multi-walled carbon nanotube (CNT) scaffolds were fabricated by using extrusion-based printing. The printing parameters were optimized by rheological studies. The rheological studies demonstrated shear thinning properties for all compositions and an increase in storage modulus was observed after the addition of CNT. Porous PLGA/HA/CNT scaffolds were printed by applying a pressure of 4.76 bar at 125 °C. The addition of 0.5 wt. % of CNT reduced the strut size and increased the porosity from 42% to 60%. The increase in storage modulus and decrease in strut size were related to hydrogen bonding between CNT, HA and PLGA which ultimately improved shape fidelity. The scaffolds were characterized by analysis of their chemical structure, water contact angle measurement,in vitrobioactivity test, biodegradation test, mechanical analysis, andin vitrocell studies. The scaffolds were found to be more hydrophilic by the incorporation of CNTs. Also, degradation studies showed that the microstructure of the scaffold became more stable with the addition of HA and CNT. The compressive modulus of PLGA/HA/CNT2 scaffold was found to be 548.5 MPa, which is found suitable to replace cancellous bone. The scaffolds were found to be highly biocompatible which is possibly due to alignment of CNT and PLGA during 3D printing process. Alizarin red staining indicated improvement of mineralization of MC3T3-E1 cells on the CNT incorporated porous 3D scaffolds. The results suggest that the produced porous 3D printed PLGA/HA/CNT scaffolds are promising for bone regeneration applications.

9.
Biomed Mater ; 18(5)2023 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-37582377

RESUMO

Aligned biodegradable fibers incorporating bioactive glass particles are being highly investigated for tissue engineering applications. In this study, 5, 7 and 10 wt% melt-derived 1393B3 borate glass (BG) microparticles (average size: 3.15 µm) were incorporated in 83 wt% polycaprolactone (PCL) and 17 wt% gelatin (GEL) (83PCL/17GEL) solutions to produce aligned electrospun composite nanofiber mats. Addition of 5 wt% BG particles significantly increased the alignment of the nanofibers. However, further incorporation of BG particles led to reduced degree of alignment, likely due to an increase of viscosity. Mechanical tests indicated a tensile modulus and tensile strength of approximately 51 MPa and 3.4 MPa, respectively, for 5 wt% addition of 1393B3 BG microparticles, values considered suitable for soft tissue engineering applications. However, with the increasing amount of 1393B3 BG, the nanofiber mats became brittle. Contact angle was reduced after the addition of 5 wt% of 1393B3 BG particles from∼45° to∼39°. Cell culture studies with normal human dermal fibroblast (NHDF) cells indicated that 5 wt% 1393B3 BG incorporated nanofiber mats were cytocompatible whereas higher doping with 1393B3 BGs reduced biocompatibility. Overall, 5 wt% 1393B3 BG doped PCL/GEL nanofiber mats were aligned with high biocompatibility exhibiting desirable mechanical properties for soft tissue engineering, which indicates their potential for applications requiring aligned nanofibers, such as peripheral neural regeneration.


Assuntos
Nanofibras , Humanos , Gelatina , Boratos , Poliésteres , Engenharia Tecidual
10.
ACS Appl Bio Mater ; 6(4): 1431-1444, 2023 04 17.
Artigo em Inglês | MEDLINE | ID: mdl-36943415

RESUMO

Osteochondral tissue regeneration is quite difficult to achieve due to the complexity of its organization. In the design of these complex multilayer structures, a fabrication method, 3D printing, started to be employed, especially by using extrusion, stereolithography and inkjet printing approaches. In this paper, the designs are discussed including biphasic, triphasic, and gradient structures which aim to mimic the cartilage and the calcified cartilage and the whole osteochondral tissue closely. In the first section of the review paper, 3D printing of hydrogels including gelatin methacryloyl (GelMa), alginate, and polyethylene glycol diacrylate (PEGDA) are discussed. However, their physical and biological properties need to be augmented, and this generally is achieved by blending the hydrogel with other, more durable, less hydrophilic, polymers. These scaffolds are very suitable to carry growth factors, such as TGF-ß1, to further stimulate chondrogenesis. The bone layer is mimicked by printing calcium phosphates (CaPs) or bioactive glasses together with the hydrogels or as a component of another polymer layer. The current research findings indicate that polyester (i.e. polycaprolactone (PCL), polylactic acid (PLA) and poly(lactide-co-glycolide) (PLGA)) reinforced hydrogels may more successfully mimic the complex structure of osteochondral tissue. Moreover, more recent printing methods such as melt electrowriting (MEW), are being used to integrate polyester fibers to enhance the mechanical properties of hydrogels. Additionally, polyester scaffolds that are 3D printed without hydrogels are discussed after the hydrogel-based scaffolds. In this review paper, the relevant studies are analyzed and discussed, and future work is recommended with support of tables of designed scaffolds. The outcome of the survey of the field is that 3D printing has significant potential to contribute to osteochondral tissue repair.


Assuntos
Engenharia Tecidual , Alicerces Teciduais , Alicerces Teciduais/química , Engenharia Tecidual/métodos , Hidrogéis/farmacologia , Hidrogéis/química , Poliésteres/química , Polímeros , Impressão Tridimensional
11.
Curr Psychol ; : 1-10, 2023 Feb 23.
Artigo em Inglês | MEDLINE | ID: mdl-36852082

RESUMO

Healthcare workers (HCWs) also became the main protagonist of the tragic pandemic story. They have had a markedly higher risk of becoming infected with COVID-19. Outside work, healthcare workers with children have experienced mental health challenges, including the worry that they may carry COVID-19 home and infect their children. Based on these, the current study aimed to examine the effect of parental COVID-19 anxiety on emotional exhaustion and identify the roles of resilience, prosocialness, and optimism in this relationship. The findings demonstrated that prosocialness moderated the relationship between personal COVID-19 anxiety and emotional exhaustion by alleviating the depleting effects of personal COVID-19 anxiety. At the same time, prosocialness reinforced the negative effect of resilience on emotional exhaustion. On the other side, optimism moderated the relationship between parental COVID-19 anxiety and resilience by alleviating the adverse effect of parental COVID-19 anxiety. Moreover, it buffered the exacerbating effect of parental anxiety on personal anxiety. In conclusion, promoting personal resources (i.e., resilience, prosocialness, and optimism) seems an excellent way to mitigate the adverse consequences of the pandemic on mental health. Furthermore, the increment in parental mental health problems during COVID-19 pandemic may have long-term effects on children. Considering this perspective, we need to develop a proactive approach for parents' now and children's futures.

12.
ACS Biomater Sci Eng ; 8(12): 5273-5283, 2022 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-36379050

RESUMO

Mesoporous bioactive glasses (MBGs) exhibit a high surface area and a highly ordered mesoporous structure. MBGs have potential for both hard and soft tissue engineering applications. MBGs may be doped with biologically active ions to tailor their biological activity. Boron is being widely studied as a dopant of bioactive glasses. Recently, research has demonstrated the potential of boron-containing bioactive glasses for muscle regeneration. In this study, boron-containing MBGs, 10B-MBG and 18B-MBG nanoparticles, were produced by a microemulsion-assisted sol-gel approach for potential muscle regeneration applications. First, X-ray diffraction (XRD), Fourier transform infrared (FTIR), and energy-dispersive X-ray spectroscopy (EDX) analyses were conducted to study the chemical structure and composition of the nanoparticles. To examine the nanoparticle morphology, scanning electron microscopy (SEM) and transmission electron microscopy (TEM) images were analyzed. Both SEM images and particle size distribution determined by dynamic light scattering (DLS) indicated a decrease of the average particle size after boron doping. TEM images indicated a slit-shaped mesoporous structure of nanoparticles for all compositions. The ζ potential was measured, and a negative surface charge was found for all study groups due to the presence of silanol groups. Cytocompatibility and fluorescence microscopy studies were also carried out. The results indicated that low concentrations (0.1 and 1 mg mL-1) of all MBG nanoparticles led to high viability of C2C12 cells. Fluorescence microscopy images indicated that at lower nanoparticle concentrations (0.1 and 1 mg mL-1), C2C12 cells appeared to differentiate into myotubes, which was indicated by a spindle-shaped morphology. For 10 mg mL-1 concentration of nanoparticles, C2C12 cells had a lower aspect ratio (estimated qualitatively by inspection of the images), which implied a lower degree of differentiation. Boron-doped MBG nanoparticles in reduced concentrations are suitable to induce differentiation of C2C12 cells into myotubes, indicating their potential for applications in muscle tissue repair.


Assuntos
Materiais Biocompatíveis , Boro , Boro/farmacologia , Porosidade , Sobrevivência Celular , Diferenciação Celular , Músculos
13.
ACS Appl Bio Mater ; 5(8): 3608-3622, 2022 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-35816417

RESUMO

Since the early 2000s, borate bioactive glasses (BBGs) have been extensively investigated for biomedical applications. The research so far indicates that BBGs frequently exhibit superior bioactivity and bone healing capacity compared to silicate glasses. They are also suitable candidates as drug delivery devices for infection or disease treatment such as osteoporosis. Additionally, BBGs are also an excellent option for wound healing applications, which includes the availability of commercial (FDA approved) microfibrous BBG dressings to treat chronic wounds. By addition of modifying ions, the bone or wound healing capacity of BBGs can be enhanced. For instance, addition of copper ions into BBGs was shown to drastically increase blood vessel formation for wound healing applications. Moreover, addition of ions such as magnesium, strontium, and cobalt improves bone healing. Other recent research interest related to BBGs is focused on nerve and muscle regeneration applications, while cartilage regeneration is also suggested as a potential application field for BBGs. BBGs are commonly produced by melt-quenching; however, sol-gel processing of BBGs is emerging and appears to be a promising alternative. In this review paper, the physical and biological characteristics of BBGs are analyzed based on the available literature, the applications of BBGs are discussed, and future research directions are suggested.


Assuntos
Boratos , Vidro , Regeneração Óssea , Boratos/farmacologia , Estrôncio , Cicatrização
14.
Materials (Basel) ; 14(12)2021 Jun 16.
Artigo em Inglês | MEDLINE | ID: mdl-34208692

RESUMO

AD is a chronic neurodegenerative disease. Many different signaling pathways, such as Wnt/ß-catenin, Notch, ROS/JNK, and PI3K/Akt/mTOR are involved in Alzheimer's disease and crosstalk between themselves. A promising treatment involves the uses of flavonoids, and one of the most promising is curcumin; however, because it has difficulty permeating the blood-brain barrier (BBB), it must be encapsulated by a drug carrier. Some of the most frequently studied are lipid nanocarriers, liposomes, micelles and PLGA. These carriers are further conjugated with brain-targeting agents such as lactoferrin and transferrin. In this review paper, curcumin and its therapeutic effects, which have been examined in vivo, are analyzed and then the delivery systems to the brain are addressed. Overall, the analysis of the literature revealed great potential for curcumin in treating AD and indicated the challenges that require further research.

15.
Mater Sci Eng C Mater Biol Appl ; 120: 111758, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33545899

RESUMO

The aim of this work was to develop injectable bone substitutes (IBS) consisting of zoledronic acid (ZOL) and graphene oxide (GO) for the treatment of osteoporosis and metastasis. The powder phase was consisting of tetra calcium phosphate (TTCP), dicalcium phosphate dihyrate (DCPD) and calcium sulfate dihyrate (CSD), while the liquid phase comprised of methylcellulose (MC), gelatin and sodium citrate dihyrate (SC), ZOL and GO. The structural analysis of IBS samples was performed by Fourier Transform Infrared Spectroscopy (FTIR). Injectability, setting time and mechanical strength were investigated. Additionally, in vitro properties of synthesized IBS were analyzed by means of bioactivity, ZOL release, degradation, pH variation, PO43- ion release and cell studies. Overall, all IBS exhibited excellent injectability results with no phase separation. The setting time of the IBS was prolonged with ZOL incorporation while the prolonging effect decreased with GO incorporation. The mechanical properties decreased with ZOL addition and increased with the incorporation of GO. The maximum compressive strength was found as 25.73 MPa for 1.5GO0ZOL incorporated IBS. In vitro results showed that ZOL and GO loaded IBS also revealed clinically suitable properties with controlled release of ZOL, pH value and PO43- ions. In in vitro cell studies, both the inhibitory effect of ZOL and GO loaded IBS on MCF-7 cells and proliferative effect on osteoblast cells were observed. Moreover, the prepared IBS led to proliferation, differentiation and mineralization of osteoblasts. The results are encouraging and support the conclusion that developed IBS have promising physical and in vitro properties which needs to be further validated by gene expression and in vivo studies.


Assuntos
Substitutos Ósseos , Grafite , Força Compressiva , Ácido Zoledrônico/farmacologia
16.
Turk J Med Sci ; 51(2): 555-561, 2021 04 30.
Artigo em Inglês | MEDLINE | ID: mdl-32950047

RESUMO

Background/aim: The primary purpose of this study is to report the experience on the extracorporeal membrane oxygenation (ECMO) process for patients in the critical care unit (CCU) of an emergency department of a tertiary hospital in Turkey, from cannulation to decannulation, including follow-up procedures. Materials and methods: This retrospective and observational study included eight patients who received ECMO from January 2018 to January 2020. We evaluated the demographics, indications for ECMO, laboratory values, Respiratory ECMO Survival Prediction, Survival After Veno-Arterial ECMO and ECMO net scores, the management process, and patient outcomes. Blood gas analyses done after the first hour of ECMO initiation and the reevaluation of the patients' Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores in the 24th hour of ECMO were recorded. Results: The mean age was 52.7 ± 14.2 years. The median duration of the ECMO run was 81 (min­max: 4­267) h, and the mean length of CCU stay was 10.2 ± 6.7 days. Of the 8 patients studied, 5 (62.5%) had veno-arterial and 3 (37.5%) had veno-venous ECMO. Three patients were successfully weaned (37.5%). The overall survival-to-discharge rate was 25%. Carbon dioxide levels were significantly decreased 1 h after ECMO initiation (P = 0.038) as well as the need for vasopressors. Lactate levels were lower in decannulated patients. Changes in the APACHE II score were more consistent with the clinical deterioration in patients than SOFA score changes were. Conclusions: In the early phase of ECMO, vital signs improve, and the need for vasopressors and carbon dioxide levels decrease. Thus, CCUs in Emergency Departments with ECMO capabilities could potentially be designed, and emergency department ECMO algorithms could be tailored for critically ill patients in addition to out-of-hospital cardiac arrest patients.


Assuntos
Reanimação Cardiopulmonar/métodos , Estado Terminal/terapia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Oxigenação por Membrana Extracorpórea/métodos , Insuficiência Cardíaca/terapia , Adulto , Idoso , Dióxido de Carbono , Cuidados Críticos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Insuficiência Respiratória/terapia , Estudos Retrospectivos , Resultado do Tratamento
17.
Sci Rep ; 10(1): 7827, 2020 05 08.
Artigo em Inglês | MEDLINE | ID: mdl-32385391

RESUMO

Zoledronic acid (ZOL) is a third generation bisphosphonate which can be used as a drug for the treatment of osteoporosis and metastasis. In this study, graphene oxide (GO) is conjugated with ZOL, and the nanostructured material is evaluated in terms viability, proliferation and differentiation. Furthermore, the associated morphological changes of bone marrow-derived mesenchymal stem cells (BM-MSC), and Michigan Cancer Foundation-7 (MCF-7) breast cancer cells, as well as the effect of the drugs on mineralization of BM-MSCs are investigated using a variety of characterization techniques including Fourier Transform Infrared Spectroscopy (FTIR), scanning electron microscopy (SEM) as well as alamar blue, acridine orange, and alizarin red assays. Nanostructured ZOL-GO with an optimum performance is synthesized using ZOL and GO suspensions with the concentration of 50 µM and 2.91 ng/ml, respectively. ZOL-GO nanostructures can facilitate the mineralization of BM-MSC cells, demonstrated by the formation of clusters around the cells. The results obtained confirm the performance of ZOL-GO nanostructures as promising drug complexes for the treatment of osteoporosis and metastasis.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Grafite/farmacologia , Nanoestruturas/química , Osteoporose/tratamento farmacológico , Ácido Zoledrônico/farmacologia , Neoplasias da Mama/patologia , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Feminino , Grafite/química , Humanos , Células MCF-7 , Metástase Neoplásica , Osteoporose/patologia , Ácido Zoledrônico/química
18.
Materials (Basel) ; 11(4)2018 Apr 14.
Artigo em Inglês | MEDLINE | ID: mdl-29662018

RESUMO

In this study, a novel injectable bone substitute (IBS) was prepared by incorporating a bioceramic powder in a polymeric solution comprising of methylcellulose (MC), gelatin and citric acid. Methylcellulose was utilized as the polymeric matrix due to its thermoresponsive properties and biocompatibility. 2.5 wt % gelatin and 3 wt % citric acid were added to the MC to adjust the rheological properties of the prepared IBS. Then, 0, 20, 30 and 50 wt % of the bioceramic component comprising tetracalcium phosphate/hydroxyapatite (TTCP/HA), dicalcium phosphate dehydrate (DCPD) and calcium sulfate dehydrate (CSD) were added into the prepared polymeric component. The prepared IBS samples had a chewing gum-like consistency. IBS samples were investigated in terms of their chemical structure, rheological characteristics, and mechanical properties. After that, in vitro degradation studies were carried out by measurement of pH and % remaining weight. Viscoelastic characteristics of the samples indicated that all of the prepared IBS were injectable and they hardened at approximately 37 °C. Moreover, with increasing wt % of the bioceramic component, the degradation rate of the samples significantly reduced and the mechanical properties were improved. Therefore, the experimental results indicated that the P50 mix may be a promising candidates to fill bone defects and assist bone recovery for non-load bearing applications.

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