Desarrollo y evaluación dermatocinética de nanopartículas con aceites esenciales para su aplicación en piel.

Los aceites esenciales representan una alternativa antioxidante para disminuir los daños provocados por los RL en la piel. Sin embargo, los AE son altamente volátiles y sensibles a la luz y al oxígeno, por lo que su nanoencapsulación representa una alternativa factible para aumentar su estabilidad física y química. Las nanocápsulas poliméricas (NC) como sistema de liberación con gran área superficial favorecerían el tiempo de residencia de los AE en la piel para asegurar su efecto dermoprotector. Este trabajo consistió en seis etapas: en la primera, los componentes de los AE de L. dentata y R. officinalis fueron identificados por CG-MS/CG-FID y se estableció su abundancia. Durante la segunda etapa, se obtuvieron las NC con los AE de L. dentata y R. officinalis por la técnica de nanoprecipitación y se evaluó su tamaño, homogeneidad, estabilidad, porcentaje de encapsulación y eficiencia de encapsulación. En la tercera etapa, se validaron dos métodos de CG-FID para cuantificar los componentes principales de los AE evaluando linealidad, límite de detección, límite de cuantificación, precisión y exactitud. En la cuarta etapa, se evaluó la actividad antioxidante de los AE libres y en NC por el ensayo de inhibición de la lipoperoxidación del ácido linoleico por el método de FTC. Después, en la quinta etapa, se evaluaron los parámetros biofísicos, tales como TEWL, contenido de agua, cantidad de sebo y pH de la piel con técnicas de bioingeniería. Finalmente, se realizó una evaluación dermatocinética ex vivo en piel de cerdo utilizando celdas de Fr

Simultaneous GC-FID Quantification of Main Components of Rosmarinus officinalis L. and Lavandula dentata Essential Oils in Polymeric Nanocapsules for Antioxidant Application

The essential oils (EO) of R. officinalis and L. dentata have been widely used due to their antioxidant activity. However, due to their high volatility, the loading of EO into polymeric nanocapsules (NC) represents an efficient way of retaining their effect in future topical administration. In this way, the quantitative determination of EO incorporated into NC is necessary for simultaneous monitoring of the main components of the EO during the nanoencapsulation process as well as for precise and exact dosing of the components used during the performance of in vitro and in vivo biological tests. In this study, EO were isolated by hydrodistillation in a Clevenger-type apparatus and characterized by GC-MS and GC-FID analyses. The major constituents of EO-R. officinalis were camphor (39.46%) and 1,8-cineole (14.63%), and for EO-L. dentata were 1,8-cineole (68.59%) and β-pinene (11.53%). A new analytical method based on GC-FID for quantification of free and encapsulated EO was developed and validated according to ICH. Linearity, limit of detection and quantification, and intra- and interday precision parameters were determined. The methods were linear and precise for the quantification of the main components of EO. The EO were encapsulated by nanoprecipitation and were analyzed by the GC-FID method validated for their direct quantification. The NC size was 200 nm with homogeneous size distribution. The quantification of the incorporated EO within a NC is an important step in NC characterization. In this way, an encapsulation efficiency of at least 59.03% and 41.15% of total EO-R. officinalis and EO-L. dentata, respectively, was obtained. Simple, repeatable, and reproducible methods were developed as an analytical tool for the simultaneous quantification of the main components of EO loaded in polymeric nanocapsules as well as their monitoring in biological assays

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

© 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseBackground: Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide. Methods: A multimethods analysis was performed as part of the GlobalSurg 3 study—a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital. Findings: Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3·85 [95% CI 2·58–5·75]; p<0·0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63·0% vs 82·7%; OR 0·35 [0·23–0·53]; p<0·0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer. Interpretation: Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised. Funding: National Institute for Health and Care Research