Torsades de pointes induced by erythromycin

We describe two patients who develop torsades de pointes in a temporal relationship to the intravenous administration of erythromycin lactobionate in the absence of other drugs or metabolic abnormalities known to cause the arrhythmia. We also review the current literature regarding this topic, including other case histories and the evidence for erythromycin's effect on cardiac tissue. Due to the increasing use of erythromycin in clinical practice, we believe it is important that all physicians be made aware of this potential complication, which was not recognized at our institutions until these patients were seen by one of us (B.G.).

Hydrogels formed by anammox extracellular polymeric substances: structural and mechanical insights

The recovery of biopolymers from the waste sludge produced in wastewater treatments and their application in other industrial sectors, would substantially increase the environmental and economical sustainability of the process, promoting the development of a circular economy. In this study, extracellular polymeric substances (EPS) extracted from anammox granular waste sludge, were investigated and characterized. Rheological and differential scanning calorimetry measurements on EPS aqueous dispersions indicate the formation of an extended 3-D network above a threshold concentration, with a clear dependence of the mechanical and water retention properties on EPS content. The structural characterization, performed with transmission electron microscopy and small angle X-ray scattering, reveals the presence of functional amyloids as putative structural units, observed for the first time in an EPS-based hydrogel. As a proof of concept of the applicative potential, we explored the water and grease resistance provided to paper by an EPS coating. These results shed light on the structural details of EPS-based hydrogels, and pave the way for the possible use of EPS-based materials as a cheap, eco-friendly alternative to commonly adopted paper coatings, in line with a circular economy pattern for wastewater treatment.

Thermal insulation with 2D materials: liquid phase exfoliated vermiculite functional nanosheets

Phyllosilicates are layered materials possessing unique thermal properties, commonly exploited in their multilayered crystalline form as refractory insulators and heating elements. A more versatile use of such materials, however, would require their existence in the form of inks and dispersions ready to be patterned. Within this framework, the liquid-phase exfoliation of low-cost, low-purity materials such as bulk multiphasic minerals and powders represents an economically advantageous approach for the production of 2D nano-sized objects with a defined composition, size and morphology. Here, ultrasound-assisted exfoliation and shear-mixing of a multi-phasic vermiculite in mild acidic aqueous solutions were employed to successfully obtain dispersions of mono- and few-layer thick clay nanosheets. The exfoliated materials were thoroughly investigated through granulometry, X-Ray Diffraction (XRD), specific surface area measurements and AFM imaging. Despite the fact that the lateral size and the thickness distribution of exfoliated flakes obtained with the two approaches appear similar, the ultrasound-assisted exfoliation process yielded a larger amount of mono- and bi-layer thick flakes as well as materials with a higher specific surface area. XRD analysis revealed that the use of ultrasound waves in an acidic environment results in the complete exfoliation of the vermiculite layer, whereas the use of shear forces under the same conditions results in the exfoliation of hydrobiotite and mica crystalline phases. Thermal conductivity measurements provided clear evidence on how the structural changes - arising from the exfoliation process - have a direct impact on the properties of the exfoliated clay. Remarkably, compared to the raw material, the thermal conductivity of the exfoliated material decreases by 25%, reaching the ultra-low thermal conductivity regime (<0.1 W m^-1 K^-1). Our approach may enable in the future the generation of patterns of thermal insulators onto different surfaces by applying vermiculite nanosheets in the form of dispersions and printable inks.

Enhanced formation of hydroxyapatites in gelatin/imogolite macroporous hydrogels

HYPOTHESIS

Gelatin is widely investigated for the fabrication of synthetic scaffolds in bone tissue engineering. Practical limitations to its use are mainly due to the fast dissolution rate in physiological conditions and to the lack of pores with suitable dimensions for cell permeation. The aim of this work is to exploit imogolite clays as nucleation sites for the growth of calcium phosphates in gelatin-based hydrogels and to take advantage of a cryogenic treatment to obtain pores of ∼100µm.

EXPERIMENTS

We evaluated the effect of imogolites and a biocompatible cross-linker on the gelatin network in terms of morphology, thermal and rheological behavior. The hydrogels were cryogenically-treated and characterized to investigate the modification of the polymer network, both at the micro- and nano-scale. The samples were mineralized to investigate the effect of imogolites on the formation of calcium phosphates.

FINDINGS

The interaction between gelatin, imogolite and cross-linker leads to the modification of the hydrogel structure at the micro-scale, while minor effects are detected at the nano-scale. The cryogenic procedure is successful in generating pores with the desired size, while the presence of imogolites in the hydrogel promotes hydroxyapatites formation. These results demonstrate that imogolites can be effectively employed as functional fillers in polymer-based scaffolds.

Design and characterization of a composite material based on Sr(II)-loaded clay nanotubes included within a biopolymer matrix

This paper reports on the preparation, characterization, and cytotoxicity of a hybrid nanocomposite material made of Sr(II)-loaded Halloysite nanotubes included within a biopolymer (3-polyhydroxybutyrate-co-3-hydroxyvalerate) matrix. The Sr(II)-loaded inorganic scaffold is intended to provide mechanical resistance, multi-scale porosity, and to favor the in-situ regeneration of bone tissue thanks to its biocompatibility and bioactivity. The interaction of the hybrid system with the physiological environment is mediated by the biopolymer coating, which acts as a binder, as well as a diffusional barrier to the Sr(II) release. The degradation of the polymer progressively leads to the exposure of the Sr(II)-loaded Halloysite scaffold, tuning its interaction with osteogenic cells. The in vitro biocompatibility of the composite was demonstrated by cytotoxicity tests on L929 fibroblast cells. The results indicate that this composite material could be of interest for multiple strategies in the field of bone tissue engineering.

Adsorption of Amino Acids and Glutamic Acid-Based Surfactants on Imogolite Clays

Aluminum oxide surfaces are of utmost interest in different biotech applications, in particular for their use as adjuvants (i.e., booster of the immune response against infectious agents in vaccines production). In this framework, imogolite clays combine the chemical flexibility of an exposed alumina surface with 1D nanostructure. This work reports on the interaction between amino acids and imogolite, using turbidimetry, ζ-potential measurements, and Fourier transform infrared spectroscopy as main characterization tools. Amino acids with different side chain functional groups were investigated, showing that glutamic acid (Glu) has the strongest affinity for the imogolite surface. This was exploited to prepare a composite material made of a synthetic surfactant bearing a Glu polar head and a hydrophobic C₁₂ alkyl tail, adsorbed onto the surface of imogolite. The adsorption of a model drug (rhodamine B isothiocyanate) by the hybrid was evaluated both in water and in physiological saline conditions. The findings of this paper suggest that the combination between the glutamate headgroup and imogolite represents a promising platform for the fabrication of hybrid nanostructures with tailored functionalities.

Aspiration pneumonia. A threat when deglutition is compromised

Aspiration results from abnormal structure or from dysfunction during the oral, pharyngeal, or esophageal stage of deglutition. Chemically induced inflammation of the lungs and obstruction of the airways may ensue. Feeding and swallowing problems may occur at any age, but they are particularly prevalent in the elderly, and the morbidity and mortality that result from impaired oral intake are now recognized as a major geriatric problem. Aspiration pneumonitis and/or pneumonia has a high morbidity and mortality rate. Medical management is mainly aimed at supportive care with the hope of resolution over time. Complications demand aggressive measures. Prevention of aspiration is apt to be more rewarding than treatment of consequences. All predisposing factors should be carefully assessed by the physician and modified whenever possible.