Strontium Substituted Tricalcium Phosphate Bone Cement: Short and Long‐Term Time‐Resolved Studies and In Vitro Properties

Due to a significant influence of strontium (Sr) on bone regeneration, Sr substituted beta-tricalcium phosphate (Sr-TCP) cement is prepared and investigated by short- and long-term time-resolved techniques. For short-term investigations, energy-dispersive X-ray diffraction, infrared spectroscopy, and, for the first time, terahertz time-domain spectroscopy techniques are applied. For long-term time-resolved studies, angular dispersive X-ray diffraction, scanning electron microscopy, mechanical tests, and behavior in Ringer solution are carried out. After 45 min of the cement setting, the Sr-TCP phase is no longer detectable. During this time period, an appearance and constant increase of the final brushite phase are registered. The compressive strength of the Sr-TCP cement increases from 4.5 MPa after 2 h of setting and reaches maximum at 13.3 MPa after 21 d. After cement soaking for 21 d in Ringer solution, apatite final product, with an admixture of brushite and TCP phases is detected. The cytotoxicity aspects of the prepared cement are investigated using NCTC 3T3 fibroblast cell line, and the cytocompatibility-by human dental pulp mesenchymal stem cells. The obtained results allow to conclude that the developed Sr-TCP cement is promising for biomedical applications for bone tissue

Point-of-care biosensor systems for cancer diagnostics/prognostics

Polymeric nanoparticles have been introduced as a delivery vehicle for active compounds in a broad range of medical applications due to their biocompatibility, stability, controlled release of active compounds, and reduced toxicity. The oral route is the most used approach for delivery of biologics to the body. The homeostasis and function of oral cavity tissues are dependent on the activity of stem cells. The present work focuses, for the first time, on the interaction between two types of polymeric nanoparticles, poly (lactic-co-glycolic acid) or PLGA and PLGA/chitosan, and two stem cell populations, oral keratinocyte stem cells (OKSCs) and stem cells from human exfoliated deciduous teeth (SHEDs). The main results show that statistical significance was observed in OKSCs uptake when compared with normal keratinocytes and transit amplifying cells after 24 h of incubation with 5 and 10 µg/mL PLGA/chitosan. The CD117 SHED subpopulation incorporated more PLGA/chitosan nanoparticles than nonseparated SHED. The uptake for PLGA/chitosan particles was better than for PLGA particles with longer incubation times, yielding better results in both cell types. The present results demonstrate that nanoparticle uptake depends on stem cell type, incubation time, particle concentration, and surface properties

Treatment of Knee Osteochondral Fractures

Osteochondral lesions (OCLs) that are frequently encountered in skeletally immature and adult patients are more common than once thought, and their incidence rate is rising. These lesions can appear in many synovial joints of the body, such as the shoulder, elbow, hip, and ankle, occurring most often in the knee. The term osteochondral lesion includes a vast spectrum of pathologies such as osteochondritis dissecans, osteochondral defects, osteochondral fractures, and osteonecrosis of the subchondral bone. When considering this, the term osteochondral fracture is preserved only for an osteochondral defect that combines disruption of the articular cartilage and subchondral bone. These fractures commonly occur after sports practice and are associated with acute lateral patellar dislocations. Many of these lesions are initially diagnosed by plain radiographs; however, a computed tomography (CT) scan or magnetic resonance imaging (MRI) can add significant value to the diagnosis and treatment. Treatment methods may vary depending on the location and size of the fracture, fragment instability, and skeletal maturity. The paper reports a 14-year-old boy case with an osteochondral fracture due to sports trauma. The medical approach involved an arthrotomy of the knee, drainage of the hematoma, two Kirschner wires (K-wires) for temporary fixation to restructure anatomic alignment, and a titanium Herbert screw fixing the fracture permanently. The patient had a favorable postoperative outcome with no residual pain, adequate knee stability, and a normal range of motion. The mobility of the knee was fully recovered

HLA Gene Polymorphisms in Romanian Patients with Chronic Lymphocytic Leukemia

Background and Objectives. Numerous genome-wide association studies have highlighted that chronic lymphocytic leukemia (CLL) is a lymphoproliferative disorder with an important genetic component. An important number of genes have been implicated in CLL etiology, with some of the most important being human leukocyte antigen (HLA) genes. The aim of this study was to analyze the association of CLL with certain HLA alleles in the Romanian population and to compare our results with previous findings. Materials and Methods. This study included 66 patients with CLL, diagnosed between 2020 and 2022, and 100 healthy controls. HLA class I and class II genes (HLA-A/B/C, HLA-DQA1/DQB1/DPA1/DPB1, and HLA-DRB1/3/4/5) were investigated using next-generation sequencing technology. Results. Several HLA alleles were strongly associated with CLL. The most important finding was that HLA-DRB1∗04:02:01 (p=0.001, OR = 1.05) and HLA-DRB3∗02:01:01 (p=0.009, OR = 1.03) have a predisposing role in CLL development. Moreover, we identified that HLA-A∗24:02:01 0.01 (p=0.01, OR = 0.38), HLA-DQA1∗05:05:01 (p=0.01, OR = 0.56), HLA-DQB1∗03:02:01 (p=0.03, OR = 0.40), and HLA-DRB4∗01:03:01 (p=0.03, OR = 0.54 alleles have protective roles. Correlations between HLA expression and gender showed that women had a higher expression of protective HLA alleles when compared to men. Conclusions. Our data are the first to indicate that in Romanian patients with CLL, the HLA-A∗24:02:01 and HLA-DQA1∗05:05:01 alleles have a protective role against CLL development, whereas HLA-DRB1∗04:02:01 and HLA-DRB3∗02:01:01alleles are positively associated with CLL

PLGA Nanoparticles Uptake in Stem Cells from Human Exfoliated Deciduous Teeth and Oral Keratinocyte Stem Cells

Polymeric nanoparticles have been introduced as a delivery vehicle for active compounds in a broad range of medical applications due to their biocompatibility, stability, controlled release of active compounds, and reduced toxicity. The oral route is the most used approach for delivery of biologics to the body. The homeostasis and function of oral cavity tissues are dependent on the activity of stem cells. The present work focuses, for the first time, on the interaction between two types of polymeric nanoparticles, poly (lactic-co-glycolic acid) or PLGA and PLGA/chitosan, and two stem cell populations, oral keratinocyte stem cells (OKSCs) and stem cells from human exfoliated deciduous teeth (SHEDs). The main results show that statistical significance was observed in OKSCs uptake when compared with normal keratinocytes and transit amplifying cells after 24 h of incubation with 5 and 10 µg/mL PLGA/chitosan. The CD117+ SHED subpopulation incorporated more PLGA/chitosan nanoparticles than nonseparated SHED. The uptake for PLGA/chitosan particles was better than for PLGA particles with longer incubation times, yielding better results in both cell types. The present results demonstrate that nanoparticle uptake depends on stem cell type, incubation time, particle concentration, and surface properties

Bone Cements Used for Hip Prosthesis Fixation: The Influence of the Handling Procedures on Functional Properties Observed during In Vitro Study

The failure of hip prostheses is a problem that requires further investigation and analysis. Although total hip replacement is an extremely successful operation, the number of revision surgeries needed after this procedure is expected to continue to increase due to issues with both bone cement types and cementation techniques (depending on the producer). To conduct a comparative analysis, as a surgeon prepared the bone cement and introduced it in the body, this study’s team of researchers prepared three types of commercial bone cements with the samples mixed and placed them in specimens, following the timeline of the surgery. In order to evaluate the factors that influenced the chemical composition and structure of each bone cement sample under specific intraoperative conditions, analyses of the handling properties, mechanical properties, structure, and composition were carried out. The results show that poor handling can impede prosthesis–cement interface efficacy over time. Therefore, it is recommended that manual mixing be avoided as much as possible, as the manual preparation of the cement can sometimes lead to structural unevenness

When Critical View of Safety Fails: A Practical Perspective on Difficult Laparoscopic Cholecystectomy

The incidence of common bile duct injuries following laparoscopic cholecystectomy (LC) remains three times higher than that following open surgery despite numerous attempts to decrease intraoperative incidents by employing better training, superior surgical instruments, imaging techniques, or strategic concepts. This paper is a narrative review which discusses from a contextual point of view the need to standardise the surgical approach in difficult laparoscopic cholecystectomies, the main strategic operative concepts and techniques, complementary visualisation aids for the delineation of anatomical landmarks, and the importance of cognitive maps and algorithms in performing safer LC. Extensive research was carried out in the PubMed, Web of Science, and Elsevier databases using the terms ”difficult cholecystectomy”, ”bile duct injuries”, ”safe cholecystectomy”, and ”laparoscopy in acute cholecystitis”. The key content and findings of this research suggest there is high intersocietal variation in approaching and performing LC, in the use of visualisation aids, and in the application of safety concepts. Limited papers offer guidelines based on robust data and a timid recognition of the human factors and ergonomic concepts in improving the outcomes associated with difficult cholecystectomies. This paper highlights the most relevant recommendations for dealing with difficult laparoscopic cholecystectomies

Failure Analysis of Ultra-High Molecular Weight Polyethylene Tibial Insert in Total Knee Arthroplasty

Knee osteoarthritis is treated based on total knee arthroplasty (TKA) interventions. The most frequent failure cause identified in surgical practice is due to wear and oxidation processes of the prothesis’ tibial insert. This component is usually manufactured from ultra-high molecular weight polyethylene (UHMWPE). To estimate the clinical complications related to a specific prosthesis design, we investigated four UHMWPE tibial inserts retrieved from patients from Clinical Hospital Colentina, Bucharest, Romania. For the initial analysis of the polyethylene degradation modes, macrophotography was chosen. A light stereomicroscope was used to estimate the structural performance and the implant surface degradation. Scanning electron microscopy confirmed the optical results and fulfilled the computation of the Hood index. The oxidation process in UHMWPE was analyzed based on Fourier-transform infrared spectroscopy (FTIR). The crystallinity degree and the oxidation index were computed in good agreement with the existing standards. Mechanical characterization was conducted based on the small punch test. The elastic modulus, initial peak load, ultimate load, and ultimate displacement were estimated. Based on the aforementioned experimental tests, a variation between 9 and 32 was found in the case of the Hood score. The oxidation index has a value of 1.33 for the reference sample and a maximum of 9.78 for a retrieved sample

Effect of Filler Types on Cellulose-Acetate-Based Composite Used as Coatings for Biodegradable Magnesium Implants for Trauma

Magnesium alloys are considered one of the most promising materials for biodegradable trauma implants because they promote bone healing and exhibit adequate mechanical strength during their biodegradation in relation to the bone healing process. Surface modification of biodegradable magnesium alloys is an important research field that is analyzed in many publications as the biodegradation due to the corrosion process and the interface with human tissue is improved. The aim of the current preliminary study is to develop a polymeric-based composite coating on biodegradable magnesium alloys by the solvent evaporation method to reduce the biodegradation rate much more than in the case of simple polymeric coatings by involving some bioactive filler in the form of particles consisting of hydroxyapatite and magnesium. Various techniques such as SEM coupled with EDS, FTIR, and RAMAN spectroscopy, and contact angle were used for the structural and morphological characterization of the coatings. In addition, thermogravimetric analysis (TGA) was used to study the effect of filler particles on polymer thermostability. In vitro cytotoxicity assays were performed on MG-63 cells (human osteosarcomas). The experimental analysis highlights the positive effect of magnesium and hydroxyapatite particles as filler for cellulose acetate when they are used alone from biocompatibility and surface analysis points of view, and it is not recommended to use both types of particles (hydroxyapatite and magnesium) as hybrid filling. In future studies focused on implantation testing, we will use only CA-based composite coatings with one filler on magnesium alloys because these composite coatings have shown better results from the in vitro testing point of view for future potential orthopedic biodegradable implants for trauma

Gut Microbiota Dysbiosis in Diabetic Retinopathy—Current Knowledge and Future Therapeutic Targets

Diabetic retinopathy is one of the major causes of blindness today, despite important achievements in diagnosis and therapy. The involvement of a gut–retina axis is thought to be a possible risk factor for several chronic eye disease, such as glaucoma, age-related macular degeneration, uveitis, and, recently, diabetic retinopathy. Dysbiosis may cause endothelial disfunction and alter retinal metabolism. This review analyzes the evidence regarding changes in gut microbiota in patients with DR compared with diabetics and healthy controls (HCs). A systematic review was performed on PubMed, Web of Science, and Google Scholar for the following terms: “gut microbiota” OR “gut microbiome” AND “diabetic retinopathy”. Ultimately, 9 articles published between 2020 and 2022 presenting comparative data on a total of 228 T2DM patients with DR, 220 patients with T2DM, and 118 HCs were analyzed. All of the studies found a distinctive microbial beta diversity in DR vs. T2DM and HC, characterized by an altered Firmicutes/Bacteroidetes ratio, a decrease in butyrate producers, and an increase in LPS-expressing and pro-inflammatory species in the Bacteroidetes and Proteobacteria phyla. The probiotic species Bifidobacterium and Lactobacillus were decreased when compared with T2DM. Gut microbiota influence retinal health in multiple ways and may represent a future therapeutic target in DR