Tri-Component Hydrogel as Template for Nanocrystalline Hydroxyapatite Deposition Using Alternate Soaking Method for Bone Tissue Engineering Applications

Composite hydrogels containing apatite-like particles can act as scaffolds for osteoblast proliferation, with applications in bone tissue engineering. In this respect, porous biocompatible hydrogels were obtained from chitosan, oxidized pullulan, and PVA in different ratios. The stability of the hydrogels was ensured both by covalent bonds between aldehyde groups of oxidized pullulan and free amino groups of chitosan, and by physical bonds formed during freeze-thaw cycles and lyophilization. The deposition of calcium phosphates was performed by alternate soaking of the porous hydrogels into solutions with calcium and phosphate ions, assuring a basic pH required for hydroxyapatite formation. The mineralized hydrogels were characterized using FTIR spectroscopy, scanning electron microscopy, X-ray diffraction, and thermogravimetric analysis, showing that inorganic particles containing between 80 and 92% hydroxyapatite were deposited in a high amount on the pore walls of the polymeric matrix. The composition of the organic matrix influenced the crystallization of calcium phosphates and the mechanical properties of the composite hydrogels. In vitro biological tests showed that mineralized hydrogels support the proliferation of MG-63 osteoblast-like cells to a greater extent compared to pristine hydrogels.

Composite Hydrogels with Embedded Silver Nanoparticles and Ibuprofen as Wound Dressing

The wound healing process is often slowed down as a result of complications from bacterial infections and inflammatory reactions. Therefore, it is necessary to develop dressings with fast antibacterial and anti-inflammatory activity that shorten the wound healing period by promoting cell migration and proliferation. Chitosan (CS)-based hydrogels have been widely studied for their antibacterial and wound healing capabilities. Herein, we developed a composite hydrogel based on CS and PVA embedding silver nanoparticles (AgNPs) with antibacterial properties and ibuprofen (Ib) as an anti-inflammatory agent. The hydrogel prepared by double physical cross-linking, with oxalic acid and by freeze-thawing, loaded with 0.225 wt.% AgNPs and 0.264 wt.% Ib, displayed good mechanical properties (compressive modulus = 132 kPa), a high swelling degree and sustained drug delivery (in simulated skin conditions). Moreover, the hydrogel showed strong antibacterial activity against S. aureus and K. pneumoniae due to the embedded AgNPs. In vivo, this hydrogel accelerated the wound regeneration process through the enhanced expression of TNF alpha IP8, by activating downstream cascades and supporting the healing process of inflammation; Cox2, which enhances the migration and proliferation of cells involved in re-epithelization and angiogenesis; MHCII, which promotes immune cooperation between local cells, eliminating dead tissue and controlling infection; the intense expression of Col I as a major marker in the tissue granulation process; and αSMA, which marks the presence of myofibroblasts involved in wound closure and indicates ongoing re-epithelization. The results reveal the potential healing effect of CS/PVA/AgNPs/Ib hydrogels and suggest their potential use as wound dressings.

Pullulan/Poly(vinyl alcohol) Hydrogels Loaded with Calendula officinalis Extract: Design and In Vitro Evaluation for Wound Healing Applications

The therapeutic efficiency of plant extracts has been limited by their poor pharmaceutical availability. Hydrogels have promising potential to be applied as wound dressings due to their high capacity to absorb exudates and their enhanced performance in loading and releasing plant extracts. In this work, pullulan/poly (vinyl alcohol) (P/PVA) hydrogels were first prepared using an eco-friendly method based on both a covalent and physical cross-linking approach. Then, the hydrogels were loaded with the hydroalcoholic extract of Calendula officinalis by a simple post-loading immersion method. Different loading capacities were investigated in terms of the physico-chemical properties, chemical composition, mechanical properties, and water absorption. The hydrogels exhibited high loading efficiency due to the hydrogen bonding interactions between polymer and extract. The water retention capacity as well as the mechanical properties decreased with the increase in the extract amount in hydrogel. However, higher amounts of extract in the hydrogel improved the bioadhesiveness. The release of extract from hydrogels was controlled by the Fickian diffusion mechanism. Extract-loaded hydrogels expressed high antioxidant activity, reaching 70% DPPH radical scavenging after 15 min immersion in buffer solution at pH 5.5. Additionally, loaded hydrogels showed a high antibacterial activity against Gram-positive and Gram-negative bacteria and were non-cytotoxic against HDFa cells.

Poloxamer/Carboxymethyl Pullulan Aqueous Systems-Miscibility and Thermogelation Studies Using Viscometry, Rheology and Dynamic Light Scattering

Thermally-induced gelling systems based on Poloxamer 407 (PL) and polysaccharides are known for their biomedical applications; however, phase separation frequently occurs in mixtures of poloxamer and neutral polysaccharides. In the present paper, the carboxymethyl pullulan (CMP) (here synthesized) was proposed for compatibilization with poloxamer (PL). The miscibility between PL and CMP in dilute aqueous solution was studied by capillary viscometry. CMP with substitution degrees higher than 0.5 proved to be compatible with PL. The thermogelation of concentrated PL solutions (17%) in the presence of CMP was monitored by the tube inversion method, texture analysis and rheology. The micellization and gelation of PL in the absence or in the presence of CMP were also studied by dynamic light scattering. The critical micelle temperature and sol-gel transition temperature decrease with the addition of CMP, but the concentration of CMP has a peculiar influence on the rheological parameters of the gels. In fact, low concentrations of CMP decrease the gel strength. With a further increase in polyelectrolyte concentration, the gel strength increases until 1% CMP, then the rheological parameters are lowered again. At 37 °C, the gels are able to recover the initial network structure after high deformations, showing a reversible healing process.

Corneal biomechanical properties in myopic and emmetropic children

OBJECTIVE

The purpose of this study was to investigate the relationship between corneal biomechanics and ocular morphology in myopic children and adolescents.

PATIENTS AND METHODS

The study included 170 right eyes, from 170 patients under the age of 18 years, who underwent a complete ophthalmologic examination, gathering the following data: spherical equivalent (SE) (under pharmacological cycloplegia), biomechanical parameters - corneal hysteresis (CH) and corneal resistance factor (CRF), structural parameters - axial length (AL) and central corneal thickness (CCT).

RESULTS

The average age of the patients was 15.26 years old (55.29% girls, 44.70% boys). Out of the 170 eyes, 111 were myopic eyes and 59 were emmetropic. Myopic eyes had a significantly lower CH (p=0.001), CRF (p=0.002) and CCT (p=0.009), and higher AL (p<0.001) than emmetropic eyes. The AL and CCT were significantly higher in myopic males, compared to myopic females (p<0.001 and 0.001). In myopes, we found statistically significant negative correlations between AL and CH (Pearson's r=-0.218), CRF (r=-0.226) and also SE (r=-0.539), and positive between SE and either CH (r=0.193) or CRF (r=0.201).

CONCLUSIONS

Corneal biomechanical properties are significantly related to myopia parameters in children.

Cationic Pullulan Derivatives Based Flocculants for Removal of Some Metal Oxides from Simulated Wastewater

Modified polysaccharides have been increasingly used as flocculants in wastewater treatment due to their non-toxicity, low price, biodegradability, etc. However, the pullulan derivatives are less used in wastewater purification processes. Therefore, this article presents some data regarding FeO and TiO₂ particle removal from model suspensions by some pullulan derivatives with pendant quaternary ammonium salt groups, trimethylammonium propyl carbamate chloride (TMAP_x-P). The influence of the polymer ionic content, dose, and initial solution concentration as well as of the dispersion pH and composition (metal oxide content, salts, and kaolin) on the separation efficacy were considered. UV-Vis spectroscopy measurements have shown a very good removal efficacy of TMAP_x-P for the FeO particles (around 95% and more), irrespective of the polymer and suspension characteristics; a lower clarification of the TiO₂ particles suspension (removal efficiency between 68% and 75%) was noticed. Both the zeta potential and the particle aggregates size measurements revealed the charge patch as the main mechanism which governs the metal oxide removal process. The surface morphology analysis/EDX data provided supplementary evidence regarding the separation process. A good removal efficiency (90%) of the pullulan derivatives/FeO flocs for the Bordeaux mixture particles from simulated wastewater was found.

PVA/Chitosan Thin Films Containing Silver Nanoparticles and Ibuprofen for the Treatment of Periodontal Disease

Local delivery of drugs or antimicrobial agents is a suitable approach in the management of periodontitis when the infection is localized deep in the pockets and does not adequately respond to mechanical debridement and/or systemic antibiotic treatment. In this context, the objective of this study was to prepare new biocomposite films with antimicrobial, anti-inflammatory, and good mechanical properties to be applied in periodontal pockets. The composite film is eco-friendly synthesized from poly(vinyl alcohol) (PVA) cross-linked with oxidized chitosan (OxCS). Silver nanoparticles (AgNps) were inserted during film synthesis by adding freshly chitosan-capped AgNps colloidal solution to the polymer mixture; the addition of AgNps up to 1.44 wt.% improves the physico-chemical properties of the film. The characterization of the films was performed by FT-IR, atomic mass spectrometry, X-ray spectroscopy, and SEM. The films displayed a high swelling ratio (162%), suitable strength (1.46 MPa), and excellent mucoadhesive properties (0.6 N). Then, ibuprofen (IBF) was incorporated within the best film formulation, and the IBF-loaded PVA/OxCS-Ag films could deliver the drug in a sustained manner up to 72 h. The biocomposite films have good antimicrobial properties against representative pathogens for oral cavities. Moreover, the films are biocompatible, as demonstrated by in vitro tests on HDFa cell lines.

Temperature/pH-Sensitive Double Cross-Linked Hydrogels as Platform for Controlled Delivery of Metoclopramide

Novel double cross-linked (DC) hydrogels with pH-/temperature-sensitive properties were designed and developed. Therefore, linear pH-sensitive poly(methyl vinyl ether-alt-maleic acid) (P(VME/MA)) macromolecules were absorbed within a thermosensitive poly(N-isopropylacrylamide-co-hydroxyethylacrylamide)-hydrogel (PNH) and, subsequently, cross-linked together through a solvent-free thermal method. As a novelty, double cross-linked hydrogels were obtained from previously purified polymers in the absence of any solvent or cross-linking agent, which are generally harmful for the body. The new DC structures were characterized by FT-IR spectroscopy, SEM, swelling kinetic measurements, and mechanical tests. The resulting scaffolds exhibited interconnected pores and a flexible pattern, compared to the brittle structure of conventional PNH. The swelling kinetics of DC hydrogels were deeply affected by temperature (25 and 37 °C) and pH (7.4 and 1.2). Furthermore, the hydrogels absorbed a great amount of water in a basic environment and displayed improved mechanical properties. Metoclopramide (Met) was loaded within DC hydrogels as a model drug to investigate the ability of the support to control the drug release rate. The results obtained recommended them as convenient platforms for the oral administration of drugs, with the release of the largest part of the active principle occurring in the colon.

New chromatographic insights on drug:cyclodextrin inclusion complexes and their potential use in drug delivery

OBJECTIVES

Cyclodextrins (CDs) play a pivotal role in the controlled release of drugs; however, their ability to gradually release drugs is here interrogated: can cyclodextrins, even those that form strong inclusion complexes, sustain a prolonged release of drugs?

METHODS

An original chromatographic approach was developed and accordingly we classified and determined drugs that form the most stable inclusion complexes with cyclodextrins. β-CD and hydroxypropyl-β-CD (HP-β-CD) were coupled to pullulan (Pul) microspheres and packed into a chromatographic column. Then, different drugs or model compounds were eluted, and values of the retention time (RT) were determined. In vitro release studies were performed for drugs that form the most stable inclusion complexes.

RESULTS

The drugs with the longest RT value form the most stable inclusion complexes with Pul/β-CD and Pul/HP-β-CD microspheres. Pul/β-CD microspheres form more stable inclusion complexes than Pul/HP-β-CD microspheres. However, in spite of their high stability, they were not able to gradually release the included drug (15 min release time). The cross-chromatographic experiments confirmed the hypothesis that in aqueous solution, drug/cyclodextrin complexes are continuously associated and dissociated.

CONCLUSIONS

If the dissociation of the guest molecule is very rapid, why is it expected that these complexes gradually release the drug?

Dual Cross-Linked Chitosan/PVA Hydrogels Containing Silver Nanoparticles with Antimicrobial Properties

Stable chitosan/PVA-based hydrogels were obtained by combining covalent and physical cross-linking methods. As covalent cross-linkers, epoxy agents with different chain lengths were used, while freeze-thaw cycles were applied for additional physical cross-linking. The chemical structure of the hydrogel was examined by FTIR spectroscopy whereas the morphology was analyzed by SEM, showing well-defined pores with dimensions of around 50 μm in diameter. It was proved that gel fraction and the network morphology were deeply influenced by the synthesis conditions. Chitosan/PVA hydrogel showed a relative high swelling rate, reaching equilibrium in the first hour. The values obtained for the elastic modulus were relatively low (3-30 kPa); as a result, these hydrogels are soft and very flexible, and are ideal candidates for medical applications as wound or oral dressings. In addition, the natural antimicrobial activity of chitosan was enhanced by in situ generation of silver nanoparticles (AgNPs) under UV irradiation. The total amount of Ag from hydrogel was determined by elemental analyses and its crystalline state was confirmed by XRD. The CS/PVA hydrogels entrapped with AgNPs exhibited high inhibitory activity against S. aureus and K. pneumonia. The vitality tests confirmed the lack of cytotoxicity of CS/PVA hydrogels without and with AgNPs.

A 3D high resolution MRI method for the visualization of cardiac fibro-fatty infiltrations

Modifications of the myocardial architecture can cause abnormal electrical activity of the heart. Fibro-fatty infiltrations have been implicated in various cardiac pathologies associated with arrhythmias and sudden cardiac death, such as arrhythmogenic right ventricular cardiomyopathy (ARVC). Here, we report the development of an MRI protocol to observe these modifications at 9.4 T. Two fixed ex vivo human hearts, one healthy and one ARVC, were imaged with an Iterative decomposition with echo asymmetry and least-square estimations (IDEAL) and a magnetization transfer (MT) 3D sequences. The resulting fat fraction and MT ratio (MTR) were analyzed and compared to histological analysis of the three regions (“ARVC triangle”) primarily involved in ARVC structural remodeling. In the ARVC heart, high fat content was observed in the “ARVC triangle” and the superimposition of the MTR and fat fraction allowed the identification of fibrotic regions in areas without the presence of fat. The healthy heart exhibited twice less fat than the ARVC heart (31.9%, 28.7% and 1.3% of fat in the same regions, respectively). Localization of fat and fibrosis were confirmed by means of histology. This non-destructive approach allows the investigation of structural remodeling in human pathologies where fibrosis and/or fatty tissue infiltrations are expected to occur.

Difficulties in maintaining electroconvulsive treatment (ECT) in a psychiatric hospital during covid19 pandemic

Introduction

ECT is an effective care with high level of recommendation. During the COVID19, new recommendations to protect patients and caregivers combined with the increasing use of medicines and medical devices (MD) for anesthesia, caused greater difficulties of supply. Even if vital for patients, it is challenging to maintain ECT in this environment.

Objectives

The aim of this study is to resume the measures implemented in order to maintain ECT during COVID19.

Methods

Retrospective analysis of measures implemented to maintain the ECT during COVID19.

Results

As FFP2 masks were restricted to intensive care units, our hospital were not supplied. After negotiations, the regional health agency (ARS) has granted us an allocation of 100 masks to maintain ECT. Our efficient stock management of personal protective equipment as well as our transparency on these stocks with ARS and sharing with other hospitals out of stock played a role in this agreement.We had to adapt our MDs references according to breaks of many ones and new recommendations. The university hospital helping us in supplying certain missing references. Considering the difficulties in supplying drugs and MDs, and limited availability of anesthetists, we have reduced the number of ECT. Prioritization of patients with vital indications had to be achieved.

Conclusions

The prioritization of some services by the regulatory agency causes many supply difficulties for the others. It would be important to reassess the priority of ECT in such crisis because most of the time other caregivers and regulatory agencies are not aware how they are vital for patients.

Alginate/poloxamer hydrogel obtained by thiol-acrylate photopolymerization for the alleviation of the inflammatory response of human keratinocytes

Hydrogel-based wound dressings have been intensively studied as promising materials for wound healing and care. The mixed-mode thiol-acrylate photopolymerization is used in this paper for alginate/poloxamer hydrogels formation. First, the alginate was modified with thiol groups using the esterification reaction with cysteamine, and second, the terminal hydroxyl groups of poloxamer were esterified with acryloyl chloride to introduce polymerizable acrylate groups. Finally, the cross-linking reaction between the two macromers was performed to produce degradable alginate/poloxamer hydrogels. The optimum conditions for the photo-initiated reaction were studied in order to obtain high gel fractions. The resulting hydrogels have high swelling capacity in simulated physiological conditions, good elasticity and strength, and appropriate porosity, some of the physico-chemical properties required for their applications as wound dressings/patches. The biological assays show that the alginate/poloxamer hydrogels induce proliferation of human keratinocyte and have an anti-inflammatory effect on lipopolysaccharides (LPS)-activated keratinocytes by inhibiting the extracellular signal-regulated kinases (ERK)/ nuclear factor (NF)-kB/ tumor necrosis factor (TNF)-α signalling pathway. Taken together, the results showed that the chemical cross-linked alginate/poloxamer hydrogels may function as a dressing/patch applied directly on the skin lesion to heal the wound by reducing the exacerbated inflammation, the main cause of wound healing delay and local infection.

Smart drug delivery system activated by specific biomolecules

Essentially, the human body can release in different disease conditions specific biomolecules such as histamines when the body encounters a toxic substance, antibodies which are part of the body's natural immune response or nitric oxide as a cardiovascular signalling molecule. Design and development of "intelligent" delivery systems able to release the therapeutic agent only in the presence of bioactive compounds was presented here. Poly(N-isopropylacrylamide-co-N-(3-aminopropyl)methacrylamide)) (poly(NIPAAm-co-APM)) was synthesized as an exciting pH/temperature sensitive copolymer. Under physiological conditions (pH = 7.4), the APM in copolymer is in the ionized state (pK_a = 8.7), highly hydrophilic and therefore the copolymer loses thermosensitive properties. Remarkably, after electrostatic interactions of APM with specific biomolecules, the copolymer restores the thermosensitive property. Thus, the microgels synthesized from this copolymer are in the "inactivated" state at normal physiological pH and temperature (pH = 7.4 and T = 36 °C). In the presence of specific biomolecules, microgels undergo "activation", shrink and expel mechanically a certain amount of drug. It must be mentioned that the pH-sensitive component plays the role of a biosensor, the biomolecule acts as a triggering agent, and the poly(NIPAAm) represents the delivery component (actuator). MTT tests showed that poly(NIPAAm-co-APM) microspheres are completely devoid of toxicity; moreover, the rabbit dermal fibroblasts vastly adhere to the surface of microspheres.

Removal of the commercial pesticides Novadim Progress, Bordeaux mixture and Karate Zeon by pullulan derivatives based flocculants

Cationic pullulan derivatives have been synthesized and evaluated, for the first time, as flocculants for the separation of the commercial pesticides, Novadim Progress (organophosphoric type), Bordeax mixture and Karate Zeon (pyrethroid type) from synthetic wastewater. The investigated polymer samples contained either pendent tertiary amine or quaternary ammonium salts groups. The separation efficiency was followed by UV-Vis spectroscopy, while the information regarding the mechanism involved in the separation of pesticide particles have been obtained by zeta potential. UV-Vis spectroscopy data showed strong pesticide particles/polycation interactions in case of Novadim Progress and Bordeaux mixture (maximum pesticide removal between 90% and 98%). Good separation efficiency (around 80%) of Karate Zeon emulsion was also noticed. The zeta potential measurements indicated that the charge neutralization was the common flocculation mechanism for the removal of these pesticides. In addition, the hydrogen bondings and chelation of copper ions by amide and/or tertiary amino groups of the polycations had a noteworthy contribution to the pesticide removal.

Chemical composition and seasonal changes in the fatty acid profile of Uruguayan “Colonia” Cheeses

The basic chemical composition and the fatty acid (FA) profile of Uruguayan Colonia cheese, consumed in the Mercosur region, were determined. 24 cheeses from different dairy farms: 10 elaborated in autumn and 14 in spring, were analyzed. Those cheeses are made from cow´s milk, whose diet was composed of 50% pasture system, 25% concentrate, and 25% silage reserves. The cheese making and ripening time were similar. Seasonal differences emerged in the profiles of saturated FA (SFA), unsaturated FA (UFA) and polyunsaturated FA (PUFA). The seasonal comparation of polyunsaturated FA (PUFA) as well as the CLA isomer such as C18:2 t10c12 showed significant differences (p < 0.05). CLA isomer such as C18:2 c9t11, showed no differences (p > 0.05). The atherogenesis index (AI) = 2.21 and thrombogenicity (IT) = 2.84, were calculated and discussed.

The Impact of Thyroid Autoimmunity on the Clinical and Diabetes Parameters of Patients with Latent Autoimmune Diabetes in Adults

AIM

We evaluated the clinical and diabetes parameters of latent autoimmune diabetes in adults (LADA) patients according to the presence of thyroid autoimmunity (TA).

MATERIALS AND METHODS

Patients with LADA (diabetes onset after 30 years of age, no need for insulin treatment for at least 6 months after diabetes onset, positive for glutamic acid decarboxylase antibodies (GADA)) were evaluated for the presence of thyroid peroxidase antibodies (TPOAb) and were subjected to clinical and laboratory evaluations of the glycated hemoglobin and basal C peptide levels. The patients were stratified into either group A (with TA) or group B (without TA).

RESULTS

We evaluated 104 (57 female and 47 male) patients with LADA. The mean age at diabetes onset was 44±10 years. The prevalence of TA among the LADA patients was 28.8% (30 patients; 23 female and 7 male). In groups A and B, the mean age at diabetes onset was 41.47±10.15 and 45.07±10 years (p=0.03), the basal C peptide level was 0.69±0.16 and 1.9±1.3 ng/ml (p<0.0001), the glycated hemoglobin level was 9.8±2.2 and 9.1±2.2 (p=0.04), and the time to insulin treatment was 3.2±2.1 years and 4.98±2.2 years (p=0.038), respectively. The use of a basal bolus insulin regimen was more frequent in group A than in group B (56.7% and 35.1%, respectively; p=0.03).

CONCLUSION

TA identifies a particular phenotype of LADA displaying a higher GADA titer, lower basal C peptide levels and poorer glycemic control.

Synthesis, characterization, and solution behavior of pullulan functionalized with tertiary amino groups

The synthesis of cationic amphiphilic pullulan having dimethylaminopropyl groups was performed in dimethyl sulfoxide using N, N′-carbonyldiimidazole as activator. The pullulan derivatives with three different substitution degrees were characterized by FTIR, 1H and 13C NMR, elemental analysis, and conductometric titrations. The aggregates characteristics were determined by steady-state fluorescence (critical aggregation concentration and polarity) and capillary viscometry measurements. Their behavior in aqueous dilute and semidilute solutions was investigated by viscosimetric experiments and fluorescence technique over the concentration range of 0.01–10 g dL−1, as a function of the degree of substitution with pendant groups. Intrinsic viscosity determined using Wolf equations provided information on the conformation of polymer chains. The results highlight the appearance of intramolecular and intermolecular aggregates and the dependence of their characteristics on the degree of substitution with pendant groups.