RESUMO
Key Clinical Message: This case signifies the importance of recognizing DIAIH within the context of antibiotic therapy, especially in older adults and even shortly after common drug exposures for treating UTI. Abstract: Various drugs can induce immune-mediated liver damage and in rare instances may lead to autoimmune hepatitis. Here we report an 84-year-old woman who developed autoimmune hepatitis less than 3 weeks after treatment for urinary tract infection with the antibiotic nitrofurantoin. She presented with jaundice, right upper quadrant abdominal pain, nausea, and vomiting. In the absence of a history of an autoimmune disorder or elevated liver enzymes in the past; elevated liver enzymes after a short course of Nitrofurantoin and the presence of smooth muscle antibodies strongly suggested autoimmune hepatitis, which was confirmed through biopsy sample analysis. The patient scored 7 points on the Naranjo adverse reaction probability scale. The patient's rapid recovery within 1 month of prednisone therapy supports the association of liver damage with nitrofurantoin use.
RESUMO
Biopolymers, especially polysaccharides and proteins, are the promising green replacement for petroleum based polymers. Due to their innate properties, they are effectively used in biomedical applications, especially tissue engineering, wound healing, and drug delivery. The fibrous morphology of biopolymers is essentially required for the effectiveness in these biomedical applications. Electrospinning (ES) is the most advanced and robust method to fabricate nanofibers (NFs) and provides a complete solution to the conventional methods issues. However, the major issues regarding fabricating polysaccharides and protein nanofibers using ES include poor electrospinnability, lack of desired fundamental properties for a specific application by a single biopolymer, and insolubility among common solvents. The current review provides the main strategies for effective electrospinning of the major biopolymers. The key strategies include blending major biopolymers with suitable biopolymers and optimizing the solvent system. A systematic literature review was done to provide the optimized solvent system of the major biopolymers along with their best possible biopolymeric blend for ES. The review also highlights the fundamental issues with the commercialization of ES based biomedical products and provides future directions to improve the fabrication of biopolymeric nanofibers.
