Sodium alginate/polycaprolactone co-axial wet-spun microfibers modified with N-carboxymethyl chitosan and the peptide AAPV for Staphylococcus aureus and human neutrophil elastase inhibition in potential chronic wound scenarios

In chronic wound (CW) scenarios, Staphylococcus aureus-induced infections are very prevalent. This leads to abnormal inflammatory processes, in which proteolytic enzymes, such as human neutrophil elastase (HNE), become highly expressed. Alanine-Alanine-Proline-Valine (AAPV) is an antimicrobial tetrapeptide capable of suppressing the HNE activity, restoring its expression to standard rates. Here, we proposed the incorporation of the peptide AAPV within an innovative co-axial drug delivery system, in which the peptide liberation was controlled by N-carboxymethyl chitosan (NCMC) solubilization, a pH-sensitive antimicrobial polymer effective against Staphylococcus aureus. The microfibers' core was composed of polycaprolactone (PCL), a mechanically resilient polymer, and AAPV, while the shell was made of the highly hydrated and absorbent sodium alginate (SA) and NCMC, responsive to neutral-basic pH (characteristic of CW). NCMC was loaded at twice its minimum bactericidal concentration (6.144 mg/mL) against S. aureus, while AAPV was loaded at its maximum inhibitory concentration against HNE (50 μg/mL), and the production of fibers with a core-shell structure, in which all components could be detected (directly or indirectly), was confirmed. Core-shell fibers were characterized as flexible and mechanically resilient, and structurally stable after 28-days of immersion in physiological-like environments. Time-kill kinetics evaluations revealed the effective action of NCMC against S. aureus, while elastase inhibitory activity examinations proved the ability of AAPV to reduce HNE levels. Cell biology testing confirmed the safety of the engineered fiber system for human tissue contact, with fibroblast-like cells and human keratinocytes maintaining their morphology while in contact with the produced fibers. Data confirmed the engineered drug delivery platform as potentially effective for applications in CW care.Authors acknowledge the Portuguese Foundation for Science and Technology (FCT), FEDER funds by means of Portugal 2020 Competitive Factors Operational Program (POCI) and the Portuguese Government (OE) for funding the project PEPTEX with reference PTDC/CTMTEX/28074/2017 (POCI-01-0145-FEDER-028074). Authors also acknowledge project UIDP/00264/2020 of 2C2T and UID/QUI/00686/2020 of CQ, funded by national funds through FCT/MCTES. C.S.M. and H.P.F. also acknowledge FCT for PhD funding via scholarship 2020.08547.BD and for auxiliary researcher contract via 2021.02720.CEEIND, respectively

Acesso a Tratamento Endovascular para Acidente Vascular Cerebral Isquémico em Portugal

Introduction: Since the publication of endovascular treatment trials and European Stroke Guidelines, Portugal has re-organized stroke healthcare. The nine centers performing endovascular treatment are not equally distributed within the country, which may lead to differential access to endovascular treatment. Our main aim was to perform a descriptive analysis of the main treatment metrics regarding endovascular treatment in mainland Portugal and its administrative districts. Material and methods: A retrospective national multicentric cohort study was conducted, including all ischemic stroke patients treated with endovascular treatment in mainland Portugal over two years (July 2015 to June 2017). All endovascular treatment centers contributed to an anonymized database. Demographic, stroke-related and procedure-related variables were collected. Crude endovascular treatment rates were calculated per 100 000 inhabitants for mainland Portugal, and each district and endovascular treatment standardized ratios (indirect age-sex standardization) were also calculated. Patient time metrics were computed as the median time between stroke onset, first-door, and puncture. Results: A total of 1625 endovascular treatment procedures were registered. The endovascular treatment rate was 8.27/100 000 inhabitants/year. We found regional heterogeneity in endovascular treatment rates (1.58 to 16.53/100 000/year), with higher rates in districts closer to endovascular treatment centers. When analyzed by district, the median time from stroke onset to puncture ranged from 212 to 432 minutes, reflecting regional heterogeneity. Discussion: Overall endovascular treatment rates and procedural times in Portugal are comparable to other international registries. We found geographic heterogeneity, with lower endovascular treatment rates and longer onset-to-puncture time in southern and inner regions. Conclusion: The overall national rate of EVT in the first two years after the organization of EVT-capable centers is one of the highest among European countries, however, significant regional disparities were documented. Moreover, stroke-onset-to-first-door times and in-hospital procedural times in the EVT centers were comparable to those reported in the randomized controlled trials performed in high-volume tertiary hospitals.info:eu-repo/semantics/publishedVersio

Neuromyelitis Optica Spectrum Disorders: a Nationwide Portuguese Clinical Epidemiological Study

Introduction: Neuromyelitis optica spectrum disorder (NMOSD) is a rare disorder in which astrocyte damage and/or demyelination often cause severe neurological deficits. Objective: To identify Portuguese patients with NMOSD and assess their epidemiological/clinical characteristics. Methods: This was a nationwide multicenter study. Twenty-four Portuguese adult and 3 neuropediatric centers following NMOSD patients were included. Results: A total of 180 patients met the 2015 Wingerchuk NMOSD criteria, 77 were AQP4-antibody positive (Abs+), 67 MOG-Abs+, and 36 seronegative. Point prevalence on December 31, 2018 was 1.71/100,000 for NMOSD, 0.71/100,000 for AQP4-Abs+, 0.65/100,000 for MOG-Abs+, and 0.35/100,000 for seronegative NMOSD. A total of 44 new NMOSD cases were identified during the two-year study period (11 AQP4-Abs+, 27 MOG-Abs+, and 6 seronegative). The annual incidence rate in that period was 0.21/100,000 person-years for NMOSD, 0.05/100,000 for AQP4-Abs+, 0.13/100,000 for MOG-Abs+, and 0.03/100,000 for seronegative NMOSD. AQP4-Abs+ predominated in females and was associated with autoimmune disorders. Frequently presented with myelitis. Area postrema syndrome was exclusive of this subtype, and associated with higher morbidity/mortality than other forms of NMOSD. MOG-Ab+ more often presented with optic neuritis, required less immunosuppression, and had better outcome. Conclusion: Epidemiological/clinical NMOSD profiles in the Portuguese population are similar to other European countries.info:eu-repo/semantics/publishedVersio

Wear and corrosion interactions on titanium in oral environment : literature review

The oral cavity is a complex environment where corrosive substances from dietary, human saliva, and oral biofilms may accumulate in retentive areas of dental implant systems and prostheses promoting corrosion at their surfaces. Additionally, during mastication, micromovements may occur between prosthetic joints causing a relative motion between contacting surfaces, leading to wear. Both processes (wear and corrosion) result in a bio-tribocorrosion system once that occurs in contact with biological tissues and fluids. This review paper is focused on the aspects related to the corrosion and wear behavior of titanium-based structures in the oral environment. Furthermore, the clinical relevance of the oral environment is focused on the harmful effect that acidic substances and biofilms, formed in human saliva, may have on titanium surfaces. In fact, a progressive degradation of titanium by wear and corrosion (tribocorrosion) mechanisms can take place affecting the performance of titanium-based implant and prostheses. Also, the formation of wear debris and metallic ions due to the tribocorrosion phenomena can become toxic for human tissues. This review gathers knowledge from areas like materials sciences, microbiology, and dentistry contributing to a better understanding of bio-tribocorrosion processes in the oral environment.(undefined

Subcapsular hematoma of the liver due to intercostal anesthesic blockage after cholecystectomy: case report

L’ematoma subcapsulare del fegato (ESF) è conseguenza di lesioni causate da biopsia epatica, traumi del fegato, malattie della gravidanza, malattie parassitarie ed altre. L’approccio a queste lesioni dipende dalle manifestazioni cliniche, che possono essere sfumate; in questi casi la diagnosi è ultrasonografica. ESF più voluminosi possono manifestarsi con alterazioni emodinamiche. È qui descritto un caso di ESF causato da un blocco anestetico intercostale per il controllo del dolore post-colecistectomia. La paziente, di 34 anni, è stata sottoposta a blocco anestetico intercostale dopo colecistectomia. Dopo il blocco, la paziente ha manifestato dolori nel fianco destro, pallore e diminuzione dei livelli di ematocrito e di emoglobina. Alla laparotomia è stato osservato un ESF e realizzata una emostasia con compresse chirurgiche. La paziente ha avuto un esito soddisfacente ed è stata dimessa dopo la rimozione delle compresse. In conclusione, il blocco anestetico intercostale, come qualsiasi altro procedimento medico, non è esente da complicazioni e deve essere realizzato in casi specifici, perché esistono metodi efficaci alternativi meno invasivi per il controllo del dolore

Spontaneous rupture of giant hepatic hemangioma: a rare source of hemoperitoneum. Case report

L’emoperitoneo da rottura spontanea di un emengioma epatico è un evento clinico raro e grave con alta mortalità. Caso clinico. Una paziente di 25 anni di età, in terapia ormonale per avere una gravidanza, ha presentato un improvviso dolore addominale con distensione e vomito, massa epigastrica palpabile e pallore cutaneomucoso. La tomografia computerizzata dell’addome senza contrasto ha evidenziato una formazione capsulata nel fegato. L’esplorazione chirurgica ha rilevato un grosso tumore localizzato nella zona epato-gastrica con rottura della capsula e sanguinamento. A causa dello stretto rapporto tra massa tumorale e vena cava inferiore retro-epatica è stata realizzata la rimozione parziale del tumore. La paziente ha avuto un’evoluzione post-operatoria soddisfacente. L’esame istopatologico ha rivelato un emangioma epatico. Conclusione. L’emangioma epatico può evolvere in una rottura spontanea e causare un quadro di addome acuto emorragico. La chirurgia è necessaria e l’asportazione dell’emangioma dipenderà dalle condizioni cliniche del paziente e dal rapporto tra il tumore e le strutture vascolari epatiche. La rimozione parziale è un’alternativa sicura che può salvare la vita in caso di urgenza, come è stato descritto nel presente caso

Conflictive uses of coastal areas: a case study in a southern European coastal lagoon (Ria de Alvor, Portugal)

Estuaries and coastal lagoons are naturally stressed and highly variable ecosystems, and are also frequently exposed to strong anthropogenic pressures. Such pressures can be particularly pronounced in small systems such as the Ria de Alvor, a small tidal lagoon in southern Portugal. The Ria de Alvor is a priority area for conservation, being a RAMSAR wetland of international importance since 1996 and is part of the European Ecological Network, Natura 2000. Nevertheless, intensive anthropogenic uses exert increasing pressures on its ecological features, causing stresses and challenges which are addressed in this paper. The resources that the Ria de Alvor provides are both marine and terrestrial in nature, and are subject to various kinds of exploitation. Urban, industrial and tourist developments, as well as agriculture and animal rearing, have resulted in habitat loss and change, altered morphology and hydrodynamics, and the discharge of effluents into the system. This paper reviews the key features and issues existing in the Ria and highlights the need for more research into this and other small estuaries and their management.info:eu-repo/semantics/publishedVersio