Medical, pharmaceutical, and nutritional applications of 3D-printing technology in diabetes

AIMS

Despite numerous studies covering the various features of three-dimensional printing (3D printing) technology, and its applications in food science and disease treatment, no study has yet been conducted to investigate applying 3D printing in diabetes. Therefore, the present study centers on the utilization and impact of 3D printing technology in relation to the nutritional, pharmaceutical, and medicinal facets of diabetes management. It highlights the latest advancements, and challenges in this field.

METHODS

In this review, the articles focusing on the application and effect of 3D printing technology on medical, pharmaceutical, and nutritional aspects of diabetes management were collected from different databases.

RESULT

High precision of 3D printing in the placement of cells led to accurate anatomic control, and the possibility of bio-printing pancreas and β-cells. Transdermal drug delivery via 3D-printed microneedle (MN) patches was beneficial for the management of diabetes disease. 3D printing supported personalized medicine for Diabetes Mellitus (DM). For instance, it made it possible for pharmaceutical companies to manufacture unique doses of medications for every diabetic patient. Moreover, 3D printing allowed the food industry to produce high-fiber and sugar-free products for the individuals with DM.

CONCLUSIONS

In summary, applying 3D printing technology for diabetes management is in its early stages, and needs to be matured and developed to be safely used for humans. However, its rapid progress in recent years showed a bright future for the treatment of diabetes.

A simple and cost-effective synthesis route using itaconic acid to prepare a magnetic ion-imprinted polymer for preconcentration of Pb (II) from aqueous media

A new Pb (II) magnetic ion-imprinted polymer (Pb-MIIP) was successfully investigated for the selective extraction of Pb (II) from an aqueous solution. MIIP nanostructures were developed using itaconic acid-coated iron oxide nanoparticles (Fe₃O₄@ITA) as a novel magnetic core, ITA as a functional monomer and chelating agent, ethylene glycol dimethacrylate (EGDMA) as a cross-linker, and 2,2-azobisisobutyronitrile (AIBN) as an initiator. The triple application of ITA in the synthesis and reduction of the number of compounds in the preparation of the MIIP, in addition to being economical, reduces the possibility of side reactions. The synthesized products were followed and confirmed in each step by instrumental and microscopic methods. The limit of detection of the Pb (II)-MIIP method was 0.21 μg L^-1. Under the optimal conditions, the recovery (R%) was >90% with a relative standard deviation (RSD%) of <4.9%. The synthesized MIIP was reusable and successfully used to extract Pb (II) from tap water samples.

Intraspecific differences in Androctunus crassicauda venom and envenomation symptoms

Envenomation by Androctunus crassicauda is very frequent in Iran, especially in the south-west. This scorpion is one of the six scorpions whose venom is used to prepare anti-venom. Using HPLC, we discovered venom components of A. crassicauda varies from one specimen to another depending on geographical location, and this result is confirmed by those first found in various symptoms of A. crassicauda sting in envenomed persons from two separate geographical places (north and south of Khuzestan province). There was a significant relationship between symptoms and location of envenomation by A. crassicauda. Muscle spasm was more dominant in envenomed people from Northern cities, and venom chromatogram analysis showed the presence of at least six main sharp peaks in Northern A. crassicauda rather than Southern A. crassicauda. It shows intraspecific differences in venom of A. crassicauda that must be considered in treatment of stung people from different geographical locations as well as in the preparation of anti-venom. See also Figure 1(Fig. 1).

Association between convalescent plasma treatment and mortality in COVID-19: a collaborative systematic review and meta-analysis of randomized clinical trials

BACKGROUND

Convalescent plasma has been widely used to treat COVID-19 and is under investigation in numerous randomized clinical trials, but results are publicly available only for a small number of trials. The objective of this study was to assess the benefits of convalescent plasma treatment compared to placebo or no treatment and all-cause mortality in patients with COVID-19, using data from all available randomized clinical trials, including unpublished and ongoing trials (Open Science Framework, https://doi.org/10.17605/OSF.IO/GEHFX ).

METHODS

In this collaborative systematic review and meta-analysis, clinical trial registries (ClinicalTrials.gov, WHO International Clinical Trials Registry Platform), the Cochrane COVID-19 register, the LOVE database, and PubMed were searched until April 8, 2021. Investigators of trials registered by March 1, 2021, without published results were contacted via email. Eligible were ongoing, discontinued and completed randomized clinical trials that compared convalescent plasma with placebo or no treatment in COVID-19 patients, regardless of setting or treatment schedule. Aggregated mortality data were extracted from publications or provided by investigators of unpublished trials and combined using the Hartung-Knapp-Sidik-Jonkman random effects model. We investigated the contribution of unpublished trials to the overall evidence.

RESULTS

A total of 16,477 patients were included in 33 trials (20 unpublished with 3190 patients, 13 published with 13,287 patients). 32 trials enrolled only hospitalized patients (including 3 with only intensive care unit patients). Risk of bias was low for 29/33 trials. Of 8495 patients who received convalescent plasma, 1997 died (23%), and of 7982 control patients, 1952 died (24%). The combined risk ratio for all-cause mortality was 0.97 (95% confidence interval: 0.92; 1.02) with between-study heterogeneity not beyond chance (I2 = 0%). The RECOVERY trial had 69.8% and the unpublished evidence 25.3% of the weight in the meta-analysis.

CONCLUSIONS

Convalescent plasma treatment of patients with COVID-19 did not reduce all-cause mortality. These results provide strong evidence that convalescent plasma treatment for patients with COVID-19 should not be used outside of randomized trials. Evidence synthesis from collaborations among trial investigators can inform both evidence generation and evidence application in patient care.

A randomized clinical trial evaluating the immunomodulatory effect of convalescent plasma on COVID-19-related cytokine storm

Evaluating the effect of convalescent plasma (CP) on some cytokine storm indices in severe COVID-19 patients. Totally, 62 patients were randomly assigned into two groups for this clinical trial. Patients in the intervention group received one unit (500 mL) plasma on the admission day plus standard drugs while the controls merely received standard treatments. Eventually, primary and secondary outcomes were evaluated. In the CP group, compared with controls, the mean levels of lymphocytes and IL-10 significantly increased while the levels of IL-6, TNF-α, and IFN-γ decreased (p < 0.05). The length of in-hospital stay, and mortality rate did not significantly reduce in the CP group compared with controls (p > 0.05) while WHO severity scores remarkably improved (p = 0.01), despite the higher frequency of underlying diseases among the CP group (66.7%) vs. controls (33.3%). Although CP has a remarkable immunomodulatory and antiviral potential to improve the cytokine storm and disease severity in COVID-19 patients, it did not considerably affect the mortality rate.

Validation of red cell distribution width as a COVID-19 severity screening tool

AIM

The aim of this study is the predictive validation of red cell distribution width (RDW) in COVID-19 patients.

METHOD

In total, 331 COVID-19 patients were classified as 'severe' and 'nonsevere' groups based on the WHO standard criteria. The levels of RDW standard deviation (SD) were evaluated as both continuous and categorical variables. Multivariate statistical analyses were used.

RESULTS

RDW-SD ≤43 and ≤47 fl thresholds showed high specificity (90.1-91.4%) for diagnosing nonsevere illness and no risk of death. RDW-SD >47 indicated severe illness and a high mortality risk while 43

CONCLUSION

RDW-SD levels may be a potent independent predictor of the infection severity and mortality probability in COVID-19 patients.

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Key Words

• COVID-19
• RDW-SD
• mortality
• red cell distribution width

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MESH Headings Collapse

Grants

• Ahvaz Jundishapur University of Medical Sciences

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Affiliation(s)

Mandana Pouladzadeh Department of Emergency Medicine, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
Mehdi Safdarian Nanotechnology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
Parastoo Moradi Choghakabodi Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran
Fatemeh Amini Department of Persian medicine, School of Medicine, Shiraz University of Medical Sciences, Ahvaz, 61357-15794, Iran
Alireza Sokooti Department of Pathology, Razi Hospital, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, 61357-15794, Iran

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Metal-coded hydrogel magnetic molecularly imprinted polymer for preconcentration and cleanup of sarcosine: Determination in urine; coupled to on-column capillary electrophoresis

In this study, sarcosine metal-coded hydrogel magnetic molecularly imprinted polymer (Hydro-MeC-MMIP) has been fabricated and coupled to on-column derivatization capillary electrophoresis (CE). As a metal-coding approach, sarcosine-Cu²⁺-ligand (Sar-Cu²⁺-L) chelate complex was introduced as a template to overcome the problems associated with the fabrication of MMIP for a small molecule having limited functional groups such as sarcosine. To our best knowledge, it is the first time that methacrylamide (MA) coated Fe₃O₄ (Fe₃O₄@MA) with abounded reactive double-bound on the surface has been used as a magnetic core in the one-pot synthesis of MMIPs. As prepared, Hydro-MeC-MMIP was characterized by different microscopic, spectroscopic, and thermal gravimetric methods. Hydro-MeC-MMIP was used to extract and preconcentrate sarcosine in the urine sample with no treatment and dilution. Sarcosine was quantified by on-column derivatization capillary electrophoresis equipped with a photodiode array detector. A mixture of thirteen amino acids was separated with a total run time of 12 min. Three structural analogs, including alanine, sarcosine, and glycine, were significantly resolved. Under optimal experimental conditions, the method's detection and quantification limits were 9.93 and 33.10 ng mL^-1, respectively. The linear range of 50-2000 ng mL^-1 and 96% recovery, along with the relative standard deviation of 6.07% (n = 6) for the target amino acid, were obtained. This method provides a simple, low-cost, fast, and efficient tool for extracting and quantifying sarcosine in the urine. The present method can address inconsistency in evaluating sarcosine as a candidate biomarker for prostate cancer with a simple CE/UV; no need for a sophisticated detection system such as a mass spectrometer.

Chemical profiling and anti-psoriatic activity of marine sponge (Dysidea avara) in induced imiquimod-psoriasis-skin model

Since Marine sponge Dysidea avara is regarded as a source of anti-inflammatory compounds, we decided to evaluate its potential anti-psoriatic activity in a psoriasis Imiquimod-induced in the mouse model. Psoriatic mice were treated with three different methanolic extracts of Dysidea avara compared with betamethasone-treated mice in in- vivo studies. Clinical skin severity was assessed with the psoriasis area index (PASI), whilst ELISA detected the expression of TNF-α, IL-17A, and IL-22. Dysidea avara activity was studied by employing GC-MS (to distinguish compounds), HPTLC (for skin permeation and accumulation), and SEA DOCK to predict single compound potential anti-inflammatory activity. After 7 days of treatment, mice treated with Dysidea avara displayed a dose-dependent, statistically significant improvement compared to controls (p< 0.001). In line with the clinical results, ELISA revealed a statistically significant decrease in IL-22, IL-17A, and TNF-α after treatment; the same SEA DOCK analysis suggests a possible anti-psoriatic activity of the extracts.

A fast and simple method for determination of β-carotene in commercial fruit juice by cloud point extraction-cold column trapping combined with UV-Vis spectrophotometry

Cloud point extraction with cold column trapping (CPE-CCT) was used for the rapid preconcentration and UV-Vis spectroscopy of beta-carotene in fruit juice samples. A central composite design was employed to optimize parameters such as pH, incubation time, cloud point temperature and surfactant concentration. A detection limit of 0.01 mg/L of beta-carotene (3S_B/m), a coefficient of determination of 0.998 and a linear range of 0.04-10 mg/L were obtained. The CPE-CCT method was confirmed in comparison with the corresponding direct HPLC standard method. A simple, portable and cost-effective device was also utilized. Owing to eliminating centrifugation, the conditions of CPE-CCT were more moderate and its sample handling easier compared to conventional CPE.

Metformin loaded cholesterol-lysine conjugate nanoparticles: A novel approach for protecting HDFs against UVB-induced senescence

Cellular senescence is one of the hallmarks of aging. Since senescence of dermal fibroblasts has been reported in vivo, reduction of the deleterious effects of these cells, has been considered an important intervention to counteract skin aging. Promising anti-aging effect of metformin has been reported. However, permeation of metformin due to its high hydrophilicity through skin epidermal barriers is limited. In this study, solid lipid nanoparticles (SLNs) of metformin were designed with the newly synthesized cholesterol-lysine conjugate as lipid for topical delivery of metformin. Characterization of SLNs strongly confirmed the effect of cholesterol-lysine conjugate on increasing entrapment of metformin. The designed SLNs with particle size of 283 nm and spherical morphology represented controlled drug release up to 18 days. Fluorescent tracking of SLNs on mice skin samples showed an increase in epidermal penetration. SLNs containing metformin showed anti-senescence effects on UVB-induced senescence of human dermal fibroblasts, this effect was confirmed by senescence-associated β-galactosidase staining, RT q-PCR and cell cycle analyses. Furthermore, our drug-free SLNs showed anti-senescence effects, suggesting that they can be a suitable carrier for phytochemicals with anti-aging effect or other hydrophilic compounds which have constraints permeating skin.

Rapid microwave-assisted distillation–precipitation polymerization for the synthesis of magnetic molecular imprinted polymers coupled to HPTLC determination of perphenazine in human urine

Microwave-assisted distillation–precipitation polymerization (MWDPP) for the synthesis of magnetic molecularly imprinted polymers (MMIPs) under atmospheric pressure is reported.

Protocol Adherence in Prehospital Medical Care Provided for Patients with Chest Pain and Loss of Consciousness; a Brief Report

INTRODUCTION

Although many protocols are available in the field of the prehospital medical care (PMC), there is still a notable gap between protocol based directions and applied clinical practice. This study measures the rate of protocol adherence in PMC provided for patients with chest pain and loss of consciousness (LOC).

METHOD

In this cross-sectional study, 10 educated research assistants audited the situation of provided PMC for non-traumatic chest pain and LOC patients, presenting to the emergency department of a tertiary level teaching hospital, compare to national recommendations in these regards.

RESULTS

101 cases with the mean age of 56.7 ± 12.3 years (30-78) were audited (55.4% male). 61 (60.3%) patients had chest pain and 40 (39.7%) cases had LOC. Protocol adherence rates for cardiac monitoring (62.3%), O2 therapy (32.8%), nitroglycerin administration (60.7%), and aspirin administration (52.5%) in prehospital care of patients with chest pain were fair to poor. Protocol adherence rates for correct patient positioning (25%), O2 therapy (75%), cardiac monitoring (25%), pupils examination (25%), bedside glucometery (50%), and assessing for naloxone administration (55%) in prehospital care of patients with LOC were fair to poor.

CONCLUSION

There were more than 20% protocol violation regarding prehospital care of chest pain patients regarding cardiac monitoring, O2 therapy, and nitroglycerin and aspirin administration. There were same situation regarding O2 therapy, positioning, cardiac monitoring, pupils examination, bedside glucometery, and assessing for naloxone administration of LOC patients in prehospital setting.

Does calcium score in great pelvic vessels predict colorectal anastomotic leakage? A prospective study of one hundred anastomoses

BACKGROUND

Anastomotic leakage is one of the most severe surgical complications following surgery. This prospective study was designed to investigate an association between the calcification in the descending aorta and its major branches using a calcium-scoring software and colorectal anastomotic leakage.

METHODS

From January 2012 to March 2013, one hundred patients underwent surgeries involving colorectal anastomosis procedures. Calcium score in descending aorta and great pelvic vessels was measured using the Syngo-CT 2006G-W software. A questionnaire was completed containing demographic and underlying risk factors suspicious to be associated with anastomotic leakage, in addition to surgical characteristics data.

RESULTS

55 males and 45 females entered the study with the mean age of 63.70±7.17 years. The average duration time of surgery was 149.30±20.24 minutes. The type of surgery was elective for 90 patients and emergency for 10 others. The mean calcium score was higher in greater arteries as in abdominal aorta and common iliac arteries in comparison to the other pelvic vessels. Comparing two groups of patients with and without anastomotic leakage, the calcium score was higher in descending aorta and all great pelvic vessels of patients with colorectal anastomotic leakage (P<0.001). One patient (1%) died due to postoperative anastomotic leakage two weeks after the surgery.

CONCLUSIONS

Atherosclerotic calcification in the descending aorta and its major branches can be considered as a risk factor in the development of colorectal anastomotic leakage. (Acta gastroenterol. belg., 2016, 79, 415-420).