Bioactive Glass Fiber-Reinforced Plastic Composites Prompt a Crystallographic Lophelia Atoll-Like Skeletal Microarchitecture Actuating Periosteal Cambium.

The touchstone for bone replacing or anchoring trauma implants, besides resorption, includes functional ankylosis at a fixation point and replacement by viable functional neo-bone tissues. These parameters redefined the concept of "resorbability" as "bioresorbability." Interference screws are the most commonly used resorbable anchoring implants for anterior cruciate ligament (ACL) reconstruction (surgery). Over the years, the bioresorbable screw fixation armamentarium has amplified countless choices, but instability and postimplantation complications have raised concerns about its reliability and efficacy. Owing to this interest, in this work, bioactive glass fiber-reinforced plastic (BGFP) composites with (BGFPnb5) and without (BGFP5) niobicoxide composing multiplexed network modifiers are reported as bioresorbable bone-anchoring substitutes. These synergistically designed composites have a fabricated structure of continuous, unidirectional BG fibers reinforced in an epoxy resin matrix using "melt-drawing and microfabrication" technology. The BGFP microarchitecture is comprised of multiplexed oxide components that influence bioactive response in a distinctive lophelia atoll-like apatite formation. Furthermore, it assists in the proliferation, adherence, and migration of bone marrow-derived mesenchymal stem cells. It also exhibits superior physicochemical characteristics such as surface roughness, hydrophilic exposure, distinctive flexural strength, and bioresorption. Thus, it induces restorative bone osseointegration and osteoconduction and actuates periosteum function. In addition, the BGFP influences the reduction of DH5-α Escherichia coli in suspension culture, demonstrating potential antibacterial efficacy. In conclusion, the BGFP composite therapeutic efficacy demonstrates distinctive material characteristics aiding in bone regeneration and restoration that could serve as a pioneer in orthopedic regenerative medicine.

Pharmacokinetics of Oral and Intravenous Paracetamol (Acetaminophen) When Co-Administered with Intravenous Morphine in Healthy Adult Subjects.

BACKGROUND AND OBJECTIVE: Several features favor paracetamol (acetaminophen) administration by the intravenous rather than the oral route in the postoperative setting. This study compared the pharmacokinetics and bioavailability of oral and intravenous paracetamol when given with or without an opioid, morphine. METHODS: In this randomized, single-blind, parallel, repeat-dose study in healthy adults, subjects received four repeat doses of oral or intravenous 1000 mg paracetamol at 6-h intervals, and morphine infusions (0.125 mg/kg) at the 2nd and 3rd intervals. Comparisons of plasma pharmacokinetic profiles were conducted before, during, and after opioid co-administrations. RESULTS: Twenty-two subjects were included in the pharmacokinetic analysis. Observed paracetamol peak concentration (C max) and area under the plasma concentration-time curve over the dosing interval (AUC0-6) were reduced when oral paracetamol was co-administered with morphine (reduced from 11.6 to 7.25 µg/mL and from 31.00 to 25.51 µg·h/mL, respectively), followed by an abruptly increased C max and AUC0-6 upon discontinuation of morphine (to 13.5 µg/mL and 52.38 µg·h/mL, respectively). There was also a significantly prolonged mean time to peak plasma concentration (T max) after the 4th dose of oral paracetamol (2.84 h) compared to the 1st dose (1.48 h). However, pharmacokinetic parameters of paracetamol were not impacted when intravenous paracetamol was co-administered with morphine. CONCLUSIONS: Morphine co-administration significantly impacted the pharmacokinetics of oral but not intravenous paracetamol. The abrupt release of accumulated paracetamol at the end of morphine-mediated gastrointestinal inhibition following oral but not intravenous administration of paracetamol suggests that intravenous paracetamol provides a better option for the management of postoperative pain. CLINICALTRIALS. GOV IDENTIFIER: NCT02848729.

An evaluation of the biocompatibility and osseointegration of novel glass fiber reinforced composite implants: In vitro and in vivo studies.

OBJECTIVES: The aim of this study was to evaluate the in vitro biocompatibility and in vivo osseointegration of three novel bioactive glass fiber reinforced composite (GFRC) implants and to compare these with metal (Ti6Al4V) implants. METHODS: The surfaces of these experimental substrates were characterized by scanning electron microscopy (SEM), a 2D profilometer and by contact angle measurement. In vitro biological performance was assessed using MG-63 human osteoblast-like cell morphology, cell proliferation assays and the alkaline phosphatase (ALP) activity testing. Furthermore, in vivo osseointegration performance was examined by installing samples into rabbit femurs and evaluated the results using micro-CT, histology and histomorphometrical analysis; these assessments were carried out after 1, 2, 4 and 8 weeks of healing. RESULTS: The results showed that moderate surface roughness, moderate hydrophilic exposure and moderate homogenous exposure of bioactive glass fibers were present for all of the GFRC substrates. Furthermore, MG-63 cells, when cultured on all of the GFRC substrates, grew well and exhibited a more differentiated phenotype than cells grown on titanium alloy (Ti6Al4V) substrate. Histological evaluation revealed more newly-formed bone regeneration within the thread of the GFRC implants during the initial healing period. In addition, the novel GFRC implants with a bioactive Bio-fiber structure and glass particles within the epoxy resin matrix showed better bone volume/tissue volume (BV/TV) values at 4 weeks and this was accompanied by bone-implant contact (BIC) values at 8 weeks comparable to the Ti6Al4V group. SIGNIFICANCE: These findings demonstrated that novel GFRC implants seem to show improved osteogenesis and osseointegration functionality and have potential as a substitute for Ti6Al4V, or other metal-based materials, when used for clinically dental and orthopedic applications.