Does high-dose metformin cause lactic acidosis in type 2 diabetic patients after CABG surgery? A double blind randomized clinical trial

Metformin is a dimethyl biguanide oral anti-hyperglycemic agent. Lactic acidosis due to metformin is a fatal metabolic condition that limits its use in patients in poor clinical condition, consequently reducing the number of patients who benefit from this medication. In a double blind randomized clinical trial, we investigated 200 type 2 diabetic patients after coronary artery bypass surgery in the open heart ICU of the Mazandaran Heart Center, and randomly assigned them to equal intervention and control groups. The intervention group received regular insulin infusion along with 2 metformin 500 mg tablets every twelve hours, while the control group received only intravenous insulin with 2 placebo tablets every twelve hours. Lactate level, pH, base excess, blood glucose and serum creatinine were measured over five 12 h periods, with data averaged for each period. The primary outcome in this study was high lactate levels. Comparison between the 2 groups was made by independent Student’s t-test. To compare changes in multiple measures in each group and analysis of group interaction, a repeated measurement ANOVA test was used

Nanocellulose: A New Biopolymer for Biomedical Application

International audienceOn one side, growing environmental concerns about fossil resources depletion and their impact on our ecosystems leaves mankind with no choice but to increase the use of alternative raw materials. Nature-derived polymers, or so-called biobased polymers or biopolymers, are nowadays more and more investigated to replace traditional polymers and open new research perspectives due to their specific properties. On the other side, aging population and increasing incidence of chronic diseases and disabilities require permanent efforts to develop innovative medical care products. This chapter focuses on the synergies that are born to address those two challenges. Past and current trends in the use of biopolymers for medical care applications are described with a focus on cellulose under its different forms and derivatives. Among them, nanocellulose has been tremendously investigated by the scientific community in the past two decades. Its two main identified families, namely, cellulose nanofibrils (CNF) and cellulose nanocrystals (CNC), are described in this chapter. Their origin and their lab-scale and industrial production processes as well as health and toxicology aspects will be addressed. CNF use for medical care product development is finally presented