Nanotechnology has ushered in a new era of medical innovation, offering unique solutions to longstanding healthcare challenges. Among nanomaterials, copper and copper oxide nanoparticles stand out as ...promising candidates for a multitude of medical applications. This article aims to provide contemporary insights into the perspectives and challenges regarding the use of copper and copper oxide nanoparticles in medicine. It summarises the biomedical potential of copper-based nanoformulations, including the progress of early-stage research, to evaluate and mitigate the potential toxicity of copper nanomaterials. The discussion covers the challenges and prospects of copper-based nanomaterials in the context of their successful clinical translation. The article also addresses safety concerns, emphasizing the need for toxicity assessments of nanomedicines. However, attention is needed to solve the current challenges such as biocompatibility and controlled release. Ongoing research and collaborative efforts to overcome these obstacles are discussed. This analysis aims to provide guidance for the safe and effective integration of copper nanoparticles into clinical practice, thereby advancing their medical applications. This analysis of recent literature has highlighted the multifaceted challenges and prospects associated with copper-based nanomaterials in the context of their translation from the laboratory to the clinic. In particular, biocompatibility remains a formidable hurdle, requiring innovative solutions to ensure the seamless integration into the human body. Additionally, achieving the controlled release of therapeutic agents from copper nanoparticles poses a complex challenge that requires meticulous engineering and precise design.
Introduction
Delirium is a frequent and serious complication of cardiac surgery. However, the knowledge regarding pathogenesis of postoperative delirium is limited.
Objectives
To investigate whether ...increased levels of monocyte chemoattractant protein-1 (MCP-1) and hyper-sensitive C-Reactive Protein (hsCRP) are associated with postoperative delirium in cardiac surgery patients.
Methods
Patients were examined and screened for major depressive disorder (MDD) and cognitive impairment one day preoperatively, using the Mini International Neuropsychiatric Interview and The Mini-Mental State Examination Test. Blood samples were collected pre- and postoperatively for hsCRP and chemokine levels. Following surgical interventions, the Confusion Assessment Method for the Intensive Care Unit and the Memorial Delirium Assessment Scale with the cut-off score 10 were used to diagnose delirium.
Results
Postoperative delirium screening was found positive in 34% (61 of 177) of patients. Both, pre- and postoperative hsCRP, and preoperative MCP-1 levels were associated with postoperative delirium in univariate comparisons; p=0.001; p=0.0004; p < 0.001, respectively. However, according to a multivariate stepwise logistic regression analysis only MCP-1 concentration raised before surgery was independently associated with postoperative delirium, and related to advancing age of participants (Spearman’s Rank Correlation 0.192; p=0.0103). According to ROC analysis, the most optimal cut-off for MCP-1 concentration in predicting the development of delirium was 371.81 ng/ml with sensitivity of 77.0% and specificity of 58.6%.
Conclusions
The present study suggests that raised preoperative MCP-1 concentration is independently associated with delirium after cardiac surgery. Preoperative monitoring of pro-inflammatory markers combined with regular surveillance may be helpful in the prediction and early detection of postoperative delirium in this patient group.
Introduction
Coronary-artery bypass graft (CABG) surgery is known to improve cardiac function and decrease mortality, albeit, this method of treatment is associated with a high risk of postoperative ...delirium. The pathophysiology of delirium after cardiac surgery is largely unknown.
Objectives
To investigate whether oxidative stress reflected by decreased preoperative and postoperative plasma antioxidant capacity (AC) is independently associated with delirium after cardiac surgery. Furthermore, to assess whether the association between AC and the level of soluble receptor for advanced glycation end-products (sRAGE) exists.
Methods
The patients were examined 1 day preoperatively with the Mini International Neuropsychiatric Interview and MMSE test to screen for depression, anxiety disorders, and for cognitive impairment, respectively. Blood samples for AC and sRAGE levels were collected both preopertively and postoperatively. The CAM ICU and MDAS were used within the first 5 days postoperatively to screen for a diagnosis of delirium.
Results
Postoperative delirium developed in 34% (61 of 177) of participants. Multivariate stepwise logistic regression analysis revealed that patients with low baseline AC are at significantly increased risk of developing delirium. Moreover, preoperative AC levels were inversly correlated with postoperative sRAGE concentrations (Spearman’s Rank Correlation -0.198; p<0.05). The most optimal cutoff values of the preoperative and postoperative AC that predict the development of delirium were 1.720 mM and 1.893 mM, respectively.
Conclusions
Decreased plasma AC levels are associated with delirium after cardiac surgery and inversly correlated with post-surgery sRAGE concentration. This may be an important pathophysiological consideration in the increased risk of postoperative delirium seen in cardiac surgery patients.
Summary
Background
Although sublingual immunotherapy (SLIT) has been used with increasing frequency, the data on the efficacy of SLIT in pediatric asthma are limited.
Aim
The aim of our study was to ...evaluate the efficacy and the safety of high‐dose SLIT given pre‐seasonally and co‐seasonally in an ultra‐rush scheme in children with bronchial asthma allergic to grass pollen.
Methods
Fifty children with asthma, aged 6–17, sensitive to grass pollen, participated in the 2‐year prospective, randomized, double‐blind, placebo‐controlled trial, to investigate the efficacy and safety of SLIT (Staloral 300 IR, Stallergenes SA, 25 μg major allergens) as a standardized extract of five grass pollen with ultra‐rush induction.
Results
SLIT significantly improved asthma symptom scores (41% vs. placebo group), reduced nasal symptoms (25% vs. placebo group) and the use of rescue medications (10% vs. placebo group), improved forced expiratory volume in 1 s, but had no effect on ocular symptoms, nasal hyper‐reactivity, peak expiratory flow and forced expiratory volume between 25% and 75% of vital capacity. Serum levels of immunoglobulin E and IgG4 did not change after SLIT. After the second season of SLIT, an improvement in bronchial hyperresponsiveness was observed; however, compared with placebo, this effect was not significant. Among all subjects in SLIT group, predominantly local reactions have been recorded in 59% of subjects in the first year of treatment and in 35% in the second.
Conclusions
Our study indicated that high‐dose ultra‐rush, co‐seasonal SLIT given for 2 years, was safe and reduced a multiple symptom–medication score.
Tissue engineering (TE) is a rapidly growing interdisciplinary field, which aims to restore or improve lost tissue function. Despite that TE was introduced more than 20 years ago, innovative and more ...sophisticated trends and technologies point to new challenges and development. Current challenges involve the demand for multifunctional bioscaffolds which can stimulate tissue regrowth by biochemical curves, biomimetic patterns, active agents and proper cell types. For those purposes especially promising are carefully chosen primary cells or stem cells due to its high proliferative and differentiation potential. This review summarized a variety of recently reported advanced bioscaffolds which present new functions by combining polymers, nanomaterials, bioactive agents and cells depending on its desired application. In particular necessity of study biomaterial-cell interactions with in vitro cell culture models, and studies using animals with in vivo systems were discuss to permit the analysis of full material biocompatibility. Although these bioscaffolds have shown a significant therapeutic effect in nervous, cardiovascular and muscle, tissue engineering, there are still many remaining unsolved challenges for scaffolds improvement.
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•Challenges, limitations and future prospects in tissue engineering are presented.•Strategies for enhanced neural, cardiovascular and muscle regeneration are discussed.•Topographical, mechanical and chemical guiding enhance nerves regeneration.•Multifunctional scaffolds provide cardiac tissue-like environment.•Hybrid biomaterials mimic and improve regeneration of muscle tissue.
Abstract
We hypothesised that measuring changes in urinary levels of EV and miR will predict the onset of acute kidney injury in cardiac surgery patients. The study was performed in the cohort of the ...REVAKI-2 trial. Urine samples were collected before and 24 h after the procedure from 94 cardiac surgery patients. Urinary particle concentrations and size distribution were assessed using NanoSight. EV derivation and levels were measured using flow cytometry. Samples from 10 selected patients were sequenced, and verification was performed with advanced TaqMan assays in samples from all patients. Urinary particle concentrations significantly increased in patients with AKI after surgery, with the percentage of EV positive for CD105 and β1-integrin also increasing. Pre-surgery podocalyxin-positive EV were significantly lower in patients with AKI. Their levels correlated with the severity of the injury. Pre-operative miR-125a-5p was expressed at lower levels in urine from patients with AKI when adjusted for urinary creatinine. Levels of miR-10a-5p were lower after surgery in AKI patients and its levels correlated with the severity of the injury. Pre-operative levels of podocalyxin EVs, urinary particle concentrations and miR-125a-5p had moderate AKI predictive value and, in a logistic model together with ICU lactate levels, offered good (AUC = 82%) AKI prediction.
Kinesin‐1 drives the movement of diverse cargoes, and it has been proposed that specific kinesin light chain (KLC) isoforms target kinesin‐1 to these different structures. Here, we test this ...hypothesis using two in vitro motility assays, which reconstitute the movement of rough endoplasmic reticulum (RER) and vesicles present in a Golgi membrane fraction. We generated GST‐tagged fusion proteins of KLC1B and KLC1D that included the tetratricopeptide repeat domain and the variable C‐terminus. We find that preincubation of RER with KLC1B inhibits RER motility, whereas KLC1D does not. In contrast, Golgi fraction vesicle movement is inhibited by KLC1D but not KLC1B reagents. Both RER and vesicle movement is inhibited by preincubation with the GST‐tagged C‐terminal domain of ubiquitous kinesin heavy chain (uKHC), which binds to the N‐terminal domain of uKHC and alters its interaction with microtubules. We propose that although the TRR domains are required for cargo binding, it is the variable C‐terminal region of KLCs that are vital for targeting kinesin‐1 to different cellular structures.
Experimental studies suggest that mechanical cell washing to remove pro-inflammatory components that accumulate in the supernatant of stored donor red blood cells (RBCs) might reduce inflammation and ...organ injury in transfused patients.
Cardiac surgery patients at increased risk of large-volume RBC transfusion were eligible. Participants were randomized to receive either mechanically washed allogenic RBCs or standard care RBCs. The primary outcome was serum interleukin-8 measured at baseline and at four postsurgery time points. A mechanism substudy evaluated the effects of washing on stored RBCs in vitro and on markers of platelet, leucocyte, and endothelial activation in trial subjects.
Sixty adult cardiac surgery patients at three UK cardiac centres were enrolled between September 2013 and March 2015. Subjects received a median of 3.5 (interquartile range 2–5.5) RBC units, stored for a mean of 21 (sd 5.2) days, within 48 h of surgery. Mechanical washing reduced concentrations of RBC-derived microvesicles but increased cell-free haemoglobin concentrations in RBC supernatant relative to standard care RBC supernatant. There was no difference between groups with respect to perioperative serum interleukin-8 values adjusted mean difference 0.239 (95% confidence intervals −0.231, 0.709), P=0.318 or concentrations of plasma RBC microvesicles, platelet and leucocyte activation, plasma cell-free haemoglobin, endothelial activation, or biomarkers of heart, lung, or kidney injury.
These results do not support a hypothesis that allogenic red blood cell washing has clinical benefits in cardiac surgery.
ISRCTN 27076315.
•polymer coating-dependent topographical and mechanical changes of the surface were detected.•polymer coated bioactive glass scaffolds were characterized with higher average roughness.•polymer coated ...bioactive glass scaffolds were characterized with lower stiffness in the nanoscale.
Composite scaffolds of bioactive glass (SiO2-CaO) and bioresorbable polyesters: poly-l-lactic acid (PLLA) and polycaprolactone (PCL) were produced by polymer coating of porous foams. Their structure and mechanical properties were investigated in micro and nanoscale, by the means of scanning electron microscopy, PeakForce Quantitative Nanomechanical Property Mapping (PF-QNM) atomic force microscopy, micro-computed tomography and contact angle measurements.
This is one of the first studies in which the nanomechanical properties (elastic modulus, adhesion) were measured and mapped simultaneously with topography imaging (PF-QNM AFM) for bioactive glass and bioactive glass – polymer coated scaffolds. Our findings show that polymer coated scaffolds had higher average roughness and lower stiffness in comparison to pure bioactive glass scaffolds. Such coating-dependent scaffold properties may promote different cells-scaffold interaction.
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•Applications and current trends in the chemistry of POMs were summarised.•Novel strategy to form advanced multifunctionalized POM clusters was presented.•The need to develop POMs and ...their applications is demonstrated.
This paper reports the most interesting applications of polyoxometalates (POMs) over the last five years, highlighting the relationship between their complex nature, properties, and chemical structure. POMs are a well-known class of metal–oxygen nanoclusters with tunable size and structure. Owing to their various properties, they have attracted great attention in the fields of current socioeconomic interest, such as materials science, catalysis, hydrogen production, environmental protection, and advanced medicine.The role of the characteristic structure of this class of compounds and the role played in the apllications discussed have been emphasised.
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