Wound dressing products: A translational investigation from the bench to the market

Chronic skin wounds affect more than 40 million patients globally and represent a severe growing burden for the healthcare systems, with annual costs expected to exceed $15 billions by 2022. To satisfy the huge demand for effective wound care products, different types of wound dressings have been introduced on the market during the last decades. Based on “the moist wound healing theory” postulated by Prof Winter in 1962, bandages were initially designed to recreate the optimal wound environment to favor the healing process. Then, thanks to the advancements achieved in biomaterial design and processing, biotechnology, imaging and electronic fields, great effort has been devoted to the development of formulations able to actively participate to tissue healing. Indeed, both the literature and the market report the design of medicated wound dressings, i.e., wound care products releasing anti-microbial agents, anti-inflammatory drugs, or bioactive molecules. In this scenario, this review aims at critically describing the currently available wound care products, highlighting their proved effectiveness in wound management. Moreover, an overview of the main strategies exploited to design personalized wound dressings has been reported. Lastly, concerns on regulatory affairs and practical issues limiting the clinical translation of advanced research platforms have also been discussed

In Vitro Models of Bacterial Biofilms: Innovative Tools to Improve Understanding and Treatment of Infections

Bacterial infections are a growing concern to the health care systems. Bacteria in the human body are often found embedded in a dense 3D structure, the biofilm, which makes their eradication even more challenging. Indeed, bacteria in biofilm are protected from external hazards and are more prone to develop antibiotic resistance. Moreover, biofilms are highly heterogeneous, with properties dependent on the bacteria species, the anatomic localization, and the nutrient/flow conditions. Therefore, antibiotic screening and testing would strongly benefit from reliable in vitro models of bacterial biofilms. This review article summarizes the main features of biofilms, with particular focus on parameters affecting biofilm composition and mechanical properties. Moreover, a thorough overview of the in vitro biofilm models recently developed is presented, focusing on both traditional and advanced approaches. Static, dynamic, and microcosm models are described, and their main features, advantages, and disadvantages are compared and discussed

An ultrasound-assisted photocatalytic treatment to remove an herbicidal pollutant from wastewaters

Pollutants of emerging concern contaminate surface and ground water. Advanced oxidation processes treat these molecules and degrade them into smaller compounds or mineralization products. However, little information on coupled advanced oxidation techniques and on the degradation pathways of these pollutants is available to identify possible ecotoxic subproducts. In the present work, we investigate the ultrasound assisted photocatalytic degradation pathway of the herbicide Isoproturon. We worked in batch mode in a thermostatic glass reactor. We compared the activity of nanometric TiO2 P25 with that of Kronos 1077, a micrometric TiO2. We discuss the individual, additive and synergistic degradation action of photolysis, sonolysis, sonophotolysis, and sonophotocatalysis by varying catalyst loading and/or ultrasound power for the last three techniques. With 0.1 g L 121 catalyst, photocatalysis and sonophotopcatalysis completely degrade Isoproturon within 240 min and 60 min, respectively (>99% conversion). Sonophotocatalysis breaks Isoproturon down into smaller molecules than photocatalysis alone

Dosing antiretroviral medication when crossing time zones: a review

International tourism continues to increase worldwide, and people living with HIV and their clinicians are increasingly confronted with the problem of how to dose antiretroviral therapy during transmeridian air travel across time zones. No guidance on this topic currently exists. This review is a response to requests from patient groups for clear, practical and evidence-based guidance for travelling on antiretroviral therapy; we present currently available data on the pharmacokinetic forgiveness and toxicity of various antiretroviral regimens, and synthesize this data to provide guidelines on how to safely dose antiretrovirals when travelling across time zones

Development, Validation, and Field-Testing of an Instrument for Clinical Assessment of HIV-Associated Neuropathy and Neuropathic Pain in Resource-Restricted and Large Population Study Settings

HIV-associated sensory peripheral neuropathy (HIV-SN) afflicts approximately 50% of patients on antiretroviral therapy, and is associated with significant neuropathic pain. Simple accurate diagnostic instruments are required for clinical research and daily practice in both high- and low-resource setting. A 4-item clinical tool (CHANT: Clinical HIV-associated Neuropathy Tool) assessing symptoms (pain and numbness) and signs (ankle reflexes and vibration sense) was developed by selecting and combining the most accurate measurands from a deep phenotyping study of HIV positive people (Pain In Neuropathy Study–HIV-PINS). CHANT was alpha-tested in silico against the HIV-PINS dataset and then clinically validated and field-tested in HIV-positive cohorts in London, UK and Johannesburg, South Africa. The Utah Early Neuropathy Score (UENS) was used as the reference standard in both settings. In a second step, neuropathic pain in the presence of HIV-SN was assessed using the Douleur Neuropathique en 4 Questions (DN4)-interview and a body map. CHANT achieved high accuracy on alpha-testing with sensitivity and specificity of 82% and 90%, respectively. In 30 patients in London, CHANT diagnosed 43.3% (13/30) HIV-SN (66.7% with neuropathic pain); sensitivity = 100%, specificity = 85%, and likelihood ratio = 6.7 versus UENS, internal consistency = 0.88 (Cronbach alpha), average item-total correlation = 0.73 (Spearman’s Rho), and inter-tester concordance > 0.93 (Spearman’s Rho). In 50 patients in Johannesburg, CHANT diagnosed 66% (33/50) HIV-SN (78.8% neuropathic pain); sensitivity = 74.4%, specificity = 85.7%, and likelihood ratio = 5.29 versus UENS. A positive CHANT score markedly increased of pre- to post-test clinical certainty of HIV-SN from 43% to 83% in London, and from 66% to 92% in Johannesburg. In conclusion, a combination of four easily and quickly assessed clinical items can be used to accurately diagnose HIV-SN. DN4-interview used in the context of bilateral feet pain can be used to identify those with neuropathic pain

Estimation of the effect of SLCO1B1 polymorphisms on lopinavir plasma concentration in HIV-Infected Adults

Background—The organic anion transporting polypeptides (OATP)/SLCO family represents an important class of hepatic drug uptake transporters that mediate the sodium independent transport of a diverse range of amphipathic organic compounds, including the protease inhibitors. The SLCO1B1 521T>C (rs4149056) single nucleotide polymorphism (SNP) has been consistently associated with reduced transport activity in vivo, and we previously showed an association of this polymorphism with lopinavir plasma concentrations. The aim of this study was to develop a population pharmacokinetic (PK) model to quantify the impact of 521T>C. Methods—A population PK analysis was performed with 594 plasma samples from 375 patients receiving lopinavir/ritonavir. Non-linear mixed effects modelling was applied to explore the effects of SLCO1B1 521T>C and patient demographics. Simulations of the lopinavir concentration profile were performed with different dosing regimens considering the different alleles. Results—A one-compartment model with first-order absorption best described the data. Population clearance was 5.67 L/h with inter-patient variability of 37%. Body weight was the only demographic factor influencing clearance, which increased 0.5 L/h for every 10 kg increase. Homozygosity for the C allele was associated with a 37% lower clearance, and 14% for heterozygosity, which were statistically significant. Conclusion—These data show an association between SLCO1B1 521T>C and lopinavir clearance. The association is likely to be mediated through reduced uptake by hepatocytes leading to higher plasma concentrations of lopinavir. Further studies are now required to confirm the association and to assess the influence of other polymorphisms in the SLCO family on lopinavir PK

Assessment of control techniques for the dynamic optimization of (semi-)batch reactors

YesThis work investigates how batch reactors can be optimized to increase the yield of a desired product coupling two appealing techniques for process control and optimization: the nonlinear model predictive control (NMPC) and the dynamic real-time optimization (D-RTO). The overall optimization problem is formulated and applied to calculate the optimal operating parameters of a selected case study and the numerical results are compared to the traditional control/optimization techniques. It has been demonstrated in our previous work (Pahija et al, Selecting the best control methodology to improve the efficiency of discontinuous reactors, Computer Aided Chemical Engineering, 32, 805-810, 2013) that the control strategy can significantly affect optimization results and that the appropriate selection of the control methodology is crucial to obtain the real operational optimum (with some percent of improved yield). In this context, coupling NMPC and D-RTO seems to be the ideal way to improve the process yield. The results presented in this work have been obtained by using gPROMS® and MS C++ with algorithms of BzzMath library