Nanocomplexes systems made up natural poylymers have pharmacotechnical advantages such as increase of water solubility and a decrease of drugs toxicity. Amphotericin B (AmB) is a drug apply as ...anti-leishmanial and anti-fungal, however it has low water solubility and high toxicity, limiting its therapeutic application. With this in mind, the present study aimed to produce nanocomplexes composed by alginate (Alg), a natural polymer, with AmB covered by nanocrystals from bacterial cellulose (CNC). For this reason, the nanocomplexes were produced utilizing sodium alginate, amphotericin B in a borate buffer (pH 11.0). The CNC was obtained by enzymatic hydrolysis of the bacterial cellulose. To CNC cover the nanocomplexes 1 ml of the nanocomplexes was added into 1 ml of 0.01% CNC suspension. The results showed an ionic adsorption of the CNC into the Alg-AmB nanocomplexes surface. This phenomena was confirmed by an increase in the particle size and PDI decrease. Besides, nanocomplexes samples covered by CNC showed uniformity. The amorphous inclusion of AmB complex into the polysaccharide chain network in both formulations. AmB in the nanocomplexes was in supper-aggregated form and showed good biocompatibility, being significantly less cytotoxic in vitro against kidney cells and significantly less hemolytic compared to the free-drug. The in vitro toxicity results indicated the Alg-AmB nanocomplexes can be considered a non-toxic alternative to improve the AmB therapeutic effect. All process to obtain nanocomplexes and it coat was conduce without organic solvents, can be considered a green process, and allowed to obtain water soluble particles. Furthermore, CNC covering the nanocomplexes brought additional protection to the system can contribut advancement in the pharmaceutical.
Bacterial NanoCellulose: what future? Portela da Gama, Francisco Miguel; Dourado, Fernando
Bioimpacts,
01/2018, Letnik:
8, Številka:
1
Journal Article
Recenzirano
Odprti dostop
Acetic acid bacteria (AAB) have been used in various fermentation processes. Of several ABB, the bacterial nanocellulose (BNC) producers, notably Komagataeibacter xylinus, appears as an interesting ...species, in large part because of their ability in the secretion of cellulose as nano/microfibrils. In fact, BNC is characterized by a native nanofibrillar structure, which may outperform the currently used celluloses in the food industry as a promising novel hydrocolloid additive. During the last couple of years, a number of companies worldwide have introduced some BNC-based products to the market. The main aim of this editorial is to underline the BNC potentials.
Background and purpose
Anti-TNFα agents emerged in inflammatory bowel disease (IBD) as an effective option in situations that, otherwise, would be refractory to medical therapy. Cytomegalovirus ...infection may present with a high spectrum of manifestations and lead to high
morbidity and mortality
. However, its clinical significance in IBD course remains unknown and data on its association with anti-TNFα are limited.
Aims
This study aims to evaluate cytomegalovirus (CMV) infection/disease in patients with IBD treated with anti-TNFα; if possible, possible risk factors associated with CMV infection/disease in IBD patients under anti-TNFα as well as the influence of CMV infection/disease in IBD course would be determined.
Methods
During three consecutive years, all IBD patients starting infliximab in our department were included. Cytomegalovirus status before anti-TNFα was evaluated. Data regarding IBD, therapeutic and IBD course after infliximab, were recorded. CMV analysis was performed with polymerase chain reaction (PCR)-cytomegalovirus in peripheral blood and colonoscopy with biopsies (histopathology/immunohistochemistry).
Results
We included 29 patients: female—83%; Crohn’s disease–51.8%, ulcerative colitis—44.8%, non-classified colitis—3.4%; 23 cytomegalovirus seropositive. Median follow-up: 19 months (3–36). During follow-up, 14 patients were under combination therapy with azathioprine and 5 did at least 1 cycle of corticosteroids. Twenty-one patients responded to infliximab. We registered 8 exacerbations of IBD. Four patients discontinued infliximab: none had CMV infection. We documented 1 case of intestinal cytomegalovirus infection—detected in biopsies performed
per
protocol in an asymptomatic UC patient, who responded to valganciclovir without infliximab discontinuation.
Conclusions
Infliximab, with/without immunosuppression, does not confer an increased risk of (re)activation of cytomegalovirus. Cytomegalovirus was not responsible
neither for significant morbidity nor mortality
in IBD.
Según las series, aproximadamente un 30% de los pacientes corregidos de Fallot mediante parche transanular pueden tener comprometida la funcionalidad de la válvula tricúspide en el momento del ...reemplazo valvular pulmonar (RVP). Esta insuficiencia tricuspídea (IT) es secundaria a la dilatación progresiva del ventrículo derecho, pudiendo existir causas intrínsecas de la cirugía correctora inicial. En la actualidad, está claramente establecido que la IT ensombrece el pronóstico de los pacientes con afección izquierda y la tendencia es a corregir cada vez más esta válvula en aras de una mejor supervivencia y clase funcional. En el caso de los pacientes corregidos de Fallot con parche transanular en el momento del RVP no existe una evidencia tan clara al respecto. Diversos estudios tratan de abordar la cuestión, todos ellos retrospectivos, la mayoría con escaso número de pacientes, con una potencia estadística limitada y susceptibles a errores y sesgos, llegando a conclusiones dispares.
Aprovechando un caso clínico típico repasaremos los estudios realizados hasta el momento, intentando esclarecer algunos aspectos en el manejo de este tipo de pacientes. ¿Reparar o no reparar la tricúspide?
According to the series, approximately 30% of corrected Fallot with transannular patch surgery may have compromised tricuspid valve functionality at the time of pulmonary valve replacement. This tricuspid regurgitation is secondary to the progressive dilation of the right ventricle, and there may be intrinsic causes of the initial corrective surgery. At present it is clearly established that tricuspid regurgitation darkens the prognosis of patients with left pathology and the trend is to increasingly correct this valve in the interest of better survival and functional class. In the case of patients corrected for Fallot at the time of pulmonary valve replacement, there is not such clear evidence in this regard. Various studies try to address the issue, all of them retrospective, most with a small number of patients, with limited statistical power and susceptible to errors and biases, reaching disparate conclusions.
Taking advantage of a typical clinical case, we will review the studies carried out so far, trying to clarify some aspects in the management of this type of patients. To repair or not to repair the tricuspid?
Background Inflammatory bowel disease (IBD) entails physical, psychological, and social burden and holds a significant impact on quality of life. Experiential avoidance, cognitive fusion, shame, and ...self-criticism have been identified as possible therapeutic targets for improving mental health in people with IBD. Traditional face-to-face psychological therapy continues to provide obstacles for patients seeking assistance. Online psychological therapies centered on acceptance, mindfulness, and compassion have been shown to improve psychological distress in other populations. Objective This paper presents the study protocol of a two-arm Randomized Controlled Trial (RCT) of an ACT and compassion-based, online intervention – eLIFEwithIBD - on the improvement of psychological distress, quality of life, work and social functioning, IBD symptom perception, illness-related shame, psychological flexibility, and self-compassion. Methods The eLIFEwithIBD intervention is an adaptation of the LIFEwithIBD programme (delivered through an in-person group format) and entails an ACT, mindfulness, and compassion-based intervention designed to be delivered as an e-health tool for people with IBD. This protocol outlines the structure and contents of the eLIFEwithIBD intervention. Participants were recruited by an advertisement on the social media platforms of Portuguese Associations for IBD in January 2022. A psychologist conducted a brief interview with 80 patients who were interested in participating. Fifty-five participants were selected and randomly assigned to one of two conditions experimental group (eLIFEwithIBD + medical TAU; n = 37) or control group (medical TAU; n = 18). Outcome measurement took place at baseline, post-intervention, and 4-month follow-up. All analyses are planned as intent-to-treat (ITT). Results The eLIFEwithIBD intervention is expected to empower people with IBD by fostering psychological strategies that promote illness adjustment and well-being and prevent subsequent distress. The eLIFEwithIBD aims to gain a novel and better understanding of the role of online contextual behavioral interventions on improving the quality of life and mental health of people with IBD. Clinical Trial Registration https://classic.clinicaltrials.gov/ct2/show/NCT05405855 , NCT05405855.
Background:
Ulcerative colitis (UC) has a large impact on patients' lives. Clinical course studies of population‐based cohorts contribute to our understanding of the disease as it progresses. We ...reviewed the clinical course of UC as reported in adult population‐based longitudinal cohort studies.
Methods:
A MEDLINE literature search to identify all adult population‐based studies published up to June 2010 with data on the clinical course of UC was performed. Demographic and clinical data were reviewed.
Results:
Twenty‐two studies reporting data from seven prospective longitudinal cohorts were identified. Extension from initial location varied from 10%–19% of the patients after 5 years of disease and from 11%–28% after 10 years in two of the cohorts. Disease activity appeared to improve over the disease course. The majority of patients had relapses in the first years of disease. The cumulative relapse rate varied from 67%–83% after 10 years of disease. From 1962–2004 a decreasing trend in the proportion of colectomies was observed. Most colectomies were performed during the first 2 years of disease and in patients with pancolitis. Salycilates were the most consumed medication followed by systemic steroids, immunosuppressors, and antitumor necrosis factors, with the latter two showing a substantial increased intake over time. Mortality increased with disease duration.
Conclusions:
This review shows how the clinical course of UC has changed over time and alerts to the need for more prospective cohort studies to evaluate long‐term outcomes especially to study the impact of biologic agents on UC. (Inflamm Bowel Dis 2012;)
The NOTION trial compares transcatheter aortic valve implantation versus surgical aortic valve replacement in low-risk patients. Looking carefully at the outcomes of this trial, there is no doubt ...that the transcatheter aortic valve implantation results were outstanding. The same thing cannot be said for the results of the surgery. We tried to understand the reason for that.
Endometriosis is a relatively common gynecological condition in women of reproductive age. The rectosigmoid region is the most commonly affected segment when the gastrointestinal tract is involved. A ...differential diagnosis of colorectal neoplasia is difficult because of the similar clinical, endoscopic, and radiology findings. A 42-year-old female presented with abdominal distention and was subsequently diagnosed with a large bowel obstruction in the rectum. A temporary colostomy was performed, and endoscopy revealed a rectal mass obstructing the rectum. The biopsy showed normal mucosa, and it was difficult to exclude rectal malignancies even after the imaging workup. Endoscopic ultrasound demonstrated a hypoechoic lesion below the rectal mucosa, and fine needle aspiration confirmed the diagnosis of bowel endometriosis. Bowel endometriosis is a challenging diagnosis. Endoscopic ultrasound- guided fine-needle aspiration is useful for acquiring adequate samples for histological confirmation and a definitive diagnosis of bowel endometriosis.
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