DESARROLLO Y CARACTERIZACIÓN DE UN BIOMATERIAL CAPAZ DE SUSTITUIR EL TEJIDO ÓSEO Y LIBERAR CEFALEXINA SIMULTÁNEAMENTE

Desde hace más de un siglo, se vienen dedicando esfuerzos dirigidos a encontrar materiales con las características adecuadas para la restauración del tejido óseo en los seres humanos con el objetivo de dotar a los cirujanos de biomateriales que cumplan con las exigencias más modernas en este camp

Nanofibrous Membranes Obtained by Electrospinning for Bone Tissue Engineering and Wound Dressing Applications

Prepared in the framework of Erasmus Mundus Doctorate in Membrane Engineering (EUDIME) to obtain multiple Doctoral degrees issue by Universidad de Zaragoza, Departamento de Ingeniería Química y Tecnología del Medio Ambiente, Università della Calabria, Istituto per la Tecnologia delle Membrane (ITM), Universidade Nova de Lisboa, Facultade de Ciência e TecnologiaThe current Doctoral Thesis work has been performed under a co-supervision agreement between University of Zaragoza (Home University), University of Calabria (Host University) and Faculty of Sciences and Technology of the NOVA University of Lisbon (FCT NOVA) (Host University). This research has been carried out inside the Erasmus Mundus Doctorate in Membrane Engineering program (EUDIME), (FPA 2011-0014), funded by the European Union. This thesis focused mainly on the use of the electrospinning technique to produce different kind of membranes for biomedical applications. In particular, it described the synthesis and production of inorganic and organic nanoparticles to be used as fillers or as carriers (drug delivery system) as well as the production of electrospun nanofibrous membranes. This work was carried out within the Institute of Nanoscience of Aragon (INA), specifically in the Nanostructured Films and Particles (NFP) group under the supervision of the Professor Silvia Irusta and Dr Gracia Mendoza. Also an important part of the physico-chemical characterization was done at INA. The study of different biological signals and the use of specific techniques for membrane characterization were acquired at the University of Calabria under the supervision of Dr. Loredana De Bartolo in the Institute on Membrane Technology of the National Research Council of Italy (ITM-CNR). On the other hand, the mobility carried out at the Faculty of Sciences and Technology (FCT NOVA) of Universidade NOVA (FCT NOVA) under the supervision of Professor Ana Isabel Aguiar-Ricardo, allowed a total characterization of two asymmetric membranes following different International Standards to accomplish testing for primary wound dressing. The development of novel membranes loaded with morphogenetic proteins or antibiotic are of great interest in the field of bone tissue engineering. To promote the cellular viability and extracellular matrix production, electrospun membranes with enhanced porosity and micro-scale pores could be beneficial since increased porosity and pore size can provide a three-dimensional (3D) environment that not only facilitates cell seeding/diffusion but also provides better diffusion of nutrients and waste throughout the membranes. The addition of calcium phosphate ceramics has been extensively investigated to fabricate highly porous membranes to bone tissue engineering due to their close similar composition of bone, including excellent biocompatibility, osteoinductive and osteoconductive properties. A homogeneous distribution of the bone morphogenetic protein-loaded particles along the entire membrane could be ensuring a continuous release of the growth factor to provide the necessary biochemical cues for bone repair and regeneration. Antibiotic-loaded membranes may provide drug targeted and sustained release, avoiding the long-term oral and intravenous systematic multidrug administration, which implies toxic side effects, low delivery to the target site and low patient adherence to the treatment. Therefore, membranes loaded with antibiotics can overcome the drawbacks of the traditional therapy sustaining enhanced osteogenic properties for the successful regeneration of the bone. Another interesting biomedical application of electrospun membranes is the fabrication of efficient smart dressings for the treatment of wounds. A rapid wound healing requires developing appropriate membranes with interconnected pores that allow the oxygen diffusion and transport of metabolic waste, as well as an adequate pore size to prevent rapid dehydration and bacteria penetration. A high absorption capacity and adequate water vapor transmission will be necessary to keep a moist environment in the wound bed. Besides, if the electrospun membrane has some bactericidal properties will be better for the healing process. The main goal of this thesis was the development of fibrous membranes by electrospinning with the appropriate characteristics to be used in bone tissue engineering or as wound dressing materials. To achieve this target, several specific objectives were defined, which are described in Chapters II to V

An interpretation of the line-strength indexes in old stellar populations using an evolutionary synthesis approach

Evolutionary population synthesis models with dif­ferent metallicities have been computed in order to interpret the observed Mg_2 and Hβ, line-strength indices in old stellar popu­lations. Both indices are found to be quite insensitive to changes in the slope of the IMF and the upper mass limit. These models have been applied to three different cases, with the following results: a) Galactic globular clusters do not exhibit a significant dis­persion in age, and the metallicities of the computed models resemble those estimated for the clusters. The indices for the metal-poor globulars ([Fe/H] < -1) cannot be attained with these models due to the lack of low metallicity evolutionary tracks and stellar spectra libraries. b) The line-strength gradients observed in the elliptical gal­axy NGC 5813 are due, essentially, to intrinsic variations in metallicity, and they cannot be explained just from changes in the remaining parameters of the stellar population. c) In order to synthesize the M 32 indices we must introduce a star formation elapsed for a long time-scale , the star forrnation being still significant ≈ 5 Gyr ago

Nanofibrous membranes obtained by electrospinning for bone tissue engineering and wound dressing applications

Esta tesis doctoral se ha realizado dentro del marco de un acuerdo de co-tutela entre la Universidad de Zaragoza (Universidad de origen), la Universidad de Calabria (Universidad anfitriona) y la Facultad de Ciencias y Tecnología de la Universidad NOVA de Lisboa (FCT NOVA) (Universidad anfitriona). El trabajo de investigación se ha llevado a cabo dentro del programa de Doctorado en Ingeniería de Membranas Erasmus Mundus (EUDIME), (FPA 2011-0014), financiado por la Unión Europea. La tesis se centró principalmente en el uso de la técnica de electrohilado para producir diferentes tipos de membranas que puedan ser utilizadas en distintas aplicaciones biomédicas. Se sintetizaron y produjeron nanopartículas orgánicas e inorgánicas para ser utilizadas como rellenos o como portadores (sistema de administración de fármacos), así como membranas nanofibrosas electrohiladas. Este trabajo se llevó a cabo en el Instituto de Nanociencia de Aragón (INA), específicamente en el grupo de Nanostructured Films and Particles (NFP) bajo la supervisión de la profesora Silvia Irusta y la Dra. Gracia Mendoza. Una parte importante de la caracterización físico-química se realizó en el INA. En la Universidad de Calabria se trabajó bajo la supervisión de la Dra. Loredana de Bartolo en el Instituto de Tecnología de Membranas (ITM). Allí se utilizaron técnicas específicas tanto para la caracterización como para estudiar diferentes señales biológicas producidas por las membranas sintetizadas, bajo la supervisión. Por otro lado, la movilidad llevada a cabo en la Facultad de Ciencias y Tecnología (FCT NOVA) de la Universidade NOVA (FCT NOVA) bajo la supervisión de la profesora Ana Isabel Aguiar-Ricardo, permitió realizar una caracterización completa de dos membranas asimétricas siguiendo diferentes Normas Internacionales que establecen diferentes ensayos a realizar en apósitos primarios utilizados en heridas. El desarrollo de nuevos scaffolds cargados con proteínas morfogenéticas o antibióticos es de gran interés en el campo de la ingeniería de tejidos óseos. Scaffolds electrohilados con una microporosidad mejorada puede ser beneficioso para mejorar la viabilidad celular debido a que una alta porosidad junto a la presencia de microporos puede proporcionar un entorno tridimensional (3D) que no solamente facilita la siembra y difusión celular sino también proporciona una mejor difusión de los nutrientes y residuos a través del scaffolds. La adición de cerámica de fosfato de calcio ha sido ampliamente investigada para fabricar scaffolds altamente porosos para la ingeniería de tejidos óseos debido a que presentan una composición muy similar al hueso, incluyendo excelentes propiedades de biocompatibilidad, osteoinductivas y osteoconductoras. Partículas cargadas con proteínas morfogenéticas de hueso distribuidas homogéneamente en el scaffolds podrían asegurar una liberación continua del factor de crecimiento proporcionando de esta forma las señales bioquímicas necesarias para la reparación y regeneración ósea. Los scaffolds cargados con antibióticos pueden proporcionar una liberación sostenida del fármaco en el sitio de interés, así como el mantenimiento de propiedades osteogénicas mejoradas para la regeneración exitosa del hueso. Evitando de esta forma que se alcancen niveles de toxicidad o niveles ineficaces en la zona de interés, así como la aparición de efectos secundarios indeseados en los pacientes que provocan un rechazo a los tratamientos prolongados de fármacos por vía sistemática (vía oral e intravenosa). Otra aplicación biomédica interesante de las membranas electrohiladas es la fabricación de apósitos inteligentes eficientes para el tratamiento de heridas. Para lograr una curación rápida de la herida es necesario desarrollar membranas apropiadas con poros interconectados capaces de prevenir la deshidratación rápida y la penetración de bacterias. Para mantener un ambiente húmedo en el lecho de la herida se necesita una alta capacidad de absorción y una adecuada transmisión de vapor de agua. Además, si la membrana electrohilada presenta propiedades bactericidas facilitará el proceso de curación. El objetivo principal de esta tesis fue el desarrollo mediante electrohilado de membranas fibrosas con las características apropiadas para ser utilizadas en la ingeniería de tejidos óseos o como apósito para heridas. En los Capítulos II al V se plantean una serie de objetivos específicos con el fin de cumplir el objetivo principal. Este documento de tesis se dividió en las siguientes secciones: CAPÍTULO I, corresponde a la introducción general donde se describen los conceptos de biomateriales, scaffolds, ingeniería de tejidos y el objetivo principal de los sistemas de liberación de fármacos. Así como, la clasificación de los biomateriales y la ingeniería de tejidos según el origen de los materiales. Además se ponen de manifiesto todos los factores que deben tenerse en cuenta para desarrollar y aplicar adecuadamente los apósitos para heridas. Se mencionaron las diferentes técnicas utilizadas en la literatura haciendo énfasis en el uso de electrohilado y electropulverización para producir scaffolds o membranas para su uso en la ingeniería del tejido óseo y como apósitos para heridas. CAPÍTULO II, se enfoca en el desarrollo y mejora de andamios 3D capaces de promover una eficiente regeneración ósea junto con la liberación de antibióticos dirigidos para prevenir la colonización de bacterias. El objetivo de este trabajo fue sintetizar y caracterizar un sistema de liberación de fármacos que consiste en nanofibras electrohiladas de policaprolactona (PCL) decoradas con partículas de poli (ácido láctico-coglicólico) (PLGA) cargadas con rifampicina (RFP). Este material debe promover la reparación ósea evitando el deterioro del scaffolds provocado por una infección. Se realizó la evaluación in vitro de la capacidad bactericida del material electrohilado sintetizado contra bacterias Gram positivas (Staphylococcus aureus) y Gram negativas (Escherichia coli), así como su citocompatibilidad en cultivos 3D con osteoblastos humanos. Estos resultados se enviaron a la Revista de farmacia “International Journal of Pharmaceuitics” para su publicación en formato de artículo y está bajo revisión. CAPÍTULO III, se describe la síntesis y caracterización de membranas con estructura de núcleo-envoltura de PCL y acetato de polivinilo (PVAc) obtenidas por electrohilado. Las fibras se cargaron con nanopartículas de hidroxiapatita sintética (HAn) para aumentar la bioactividad de los materiales. Los scaffolds desarrollados se trataron con ablación láser para crear características topográficas deseadas a nivel micrométrico con el objetivo de favorecer la adhesión y crecimiento celular. Todas las membranas obtenidas presentaron una estructura de poros tridimensionalmente interconectados y el tratamiento con láser provocó un aumento en la viabilidad y densidad celular. Además, el aumento en la biocompatibilidad de los scaffolds sugiere que los microporos pequeños favorecen la adhesión y proliferación celular. Estos resultados fueron publicados en el artículo titulado “Laser-treated electrospun fibers loaded with nano-hydroxyapatite for bone tissue engineering”. Javier Aragon, Nuria Navascues, Gracia Mendoza, Silvia Irusta. International Journal of Pharmaceutics 525,112–122, 2017. DOI:10.1016/j.ijpharm.2017.04.022. CAPÍTULO IV, se refiere al desarrollo de un scaffold electrohilado compuesto por fibras con estructura de núcleo-cubierta de PCL o PCL/PVAc cargado con HAn sintética. Estas fibras se decoraron con partículas de PLGA cargadas con proteína morfogenética ósea 2 (BMP2) mediante el uso simultaneo de electrohilado coaxial y electropulverización. El objetivo de este trabajo fue evaluar las propiedades estructurales y físico-químicas así como el proceso de biodegradación de los nuevos scaffolds desarrollados y su capacidad para abordar las características arquitectónicas, bioquímicas y funcionales del tejido óseo. Para esto, se probó la bioactividad del scaffold mediante el cultivo de osteoblastos humanos sobre ellos y se monitoreo de la viabilidad celular durante 4 semanas. Se evaluó la actividad osteogénica in vitro de las células sembradas sobre los scaffolds determinando la actividad de la fosfatasa alcalina (ALP) y la expresión de osteocalcina (OCN) y osteopontina (OPN) como proteínas osteogénicas. Estos resultados fueron publicados en el artículo titulado “Polymeric electrospun scaffolds for bone morphogenetic protein 2 delivery in bone tissue engineering”. Javier Aragón, Simona Salerno, Loredana De Bartolo, Silvia Irusta and Gracia Mendoza. Journal of Colloid and Interface Science, 531 (2018) 126–137. DOI:10.1016/j.jcis.2018.07.029. El CAPÍTULO V, describe la síntesis de un apósito antimicrobiano para heridas, con una resistencia mecánica adecuada que es capaz de absorber exudados y evitar la deshidratación rápida de una herida. Se prepararon membranas asimétricas de PCL/PVAc cargadas con carvacrol (CRV) mediante el uso simultáneo de electrohilado y electropulverización. Las membranas constan de dos capas; la primera es una capa de PCL electrohilado; la segunda, una lámina de PVAc que estaría en contacto con la piel liberando a su vez el compuesto antimicrobiano. Se demostró que el uso de diferentes disolventes pueden dar lugar a la obtención de diferentes morfologías de la capa PVAc-CRV. Los valores obtenidos de elongación máxima de las membranas antes de romperse son adecuados para ser utilizados como apósitos para heridas ya que están en el mismo rango reportado de elongaciones en la piel humana. Las membranas presentan una tasa óptima de Transmisión de vapor de agua (WVTR) con valores que se encuentran en el rango requerido para mantener un buen balance entre humedad y pérdida de agua en la herida. En la primera semana, se liberó más del 60 % del CRV cargado, mientras que después de tres semanas, las membranas liberaron entre el 85 y el 100 % del CRV cargado mediante la contribución de un proceso de difusión de tipo Fickiano y la relajación delas cadenas poliméricas. Las membranas sintetizadas son candidatas potenciales para ser utilizadas como apósitos para heridas. El manuscrito que resume estos resultados se envió a la revista “Materials Science and Engineering C” y está bajo revisión (MSEC_2018_3013). CAPÍTULO VI, resume las conclusiones generales del trabajo de tesis. APÉNDICE 1, describe las principales técnicas de caracterización y los métodos para evaluar diferentes propiedades en función de las posibles aplicaciones. APÉNDICE 2, resume los artículos publicados y la participación en foros científicos durante el período de tesis. 1The current Doctoral Thesis work has been performed under a co-supervision agreement between University of Zaragoza (Home University), University of Calabria (Host University) and Faculty of Sciences and Technology of the NOVA University of Lisbon (FCT NOVA) (Host University). This research has been carried out inside the Erasmus Mundus Doctorate in Membrane Engineering program (EUDIME), (FPA 2011-0014), funded by the European Union. This thesis focused mainly on the use of the electrospinning technique to produce different kind of membranes for biomedical applications. In particular, it described the synthesis and production of inorganic and organic nanoparticles to be used as fillers or as carriers (drug delivery system) as well as the production of electrospun nanofibrous membranes. This work was carried out within the Institute of Nanoscience of Aragon (INA), specifically in the Nanostructured Films and Particles (NFP) group under the supervision of the Professor Silvia Irusta and Dr Gracia Mendoza. Also an important part of the physico-chemical characterization was done at INA.The study of different biological signals and the use of specific techniques for membrane characterization were acquired at the University of Calabria under the supervision of Dr. Loredana De Bartolo in the Institute on Membrane Technology of the National Research Council of Italy (ITM-CNR). On the other hand, the mobility carried out at the Faculty of Sciences and Technology (FCT NOVA) of Universidade NOVA (FCT NOVA) under the supervision of Professor Ana Isabel Aguiar-Ricardo, allowed a total characterization of two asymmetric membranes following different International Standards to accomplish testing for primary wound dressing.The development of novel membranes loaded with morphogenetic proteins or antibiotic are of great interest in the field of bone tissue engineering. To promote the cellular viability and extracellular matrix production, electrospun membranes with enhanced porosity and micro-scale pores could be beneficial since increased porosity and pore size can provide a three-dimensional (3D) environment that not only facilitates cell seeding/diffusion but also provides better diffusion of nutrients and waste throughout the membranes. The addition of calcium phosphate ceramics has been extensively investigated to fabricate highly porous membranes to bone tissue engineering due to their close similar composition of bone, including excellent biocompatibility, osteoinductive and osteoconductive properties. A homogeneous distribution of the bone morphogenetic protein-loaded particles along the entire membrane could be ensuring a continuous release of the growth factor to provide the necessary biochemical cues for bone repair and regeneration.Antibiotic-loaded membranes may provide drug targeted and sustained release, avoiding the long-term oral and intravenous systematic multidrug administration, which implies toxic side effects, low delivery to the target site and low patient adherence to the treatment. Therefore, membranes loaded with antibiotics can overcome the drawbacks of the traditional therapy sustaining enhanced osteogenic properties for the successful regeneration of the bone. Another interesting biomedical application of electrospun membranes is the fabrication of efficient smart dressings for the treatment of wounds. A rapid wound healing requires developing appropriate membranes with interconnected pores that allow the oxygen diffusion and transport of metabolic waste, as well as an adequate pore size to prevent rapid dehydration and bacteria penetration. A high absorption capacity and adequate water vapor transmission will be necessary to keep a moist environment in the wound bed. Besides, if the electrospun membrane has some bactericidal properties will be better for the healing process.The main goal of this thesis was the development of fibrous membranes by electrospinning with the appropriate characteristics to be used in bone tissue engineering or as wound dressing materials. To achieve this target, several specific objectives were defined, which are described in Chapters II to V.The thesis was divided in the following sections: CHAPTER I, is an introduction where the concepts of biomaterials, scaffolds and tissue engineering and the main target of drug delivery systems are described. The chapter includes the classification of biomaterials according to the origin of the materials and tissue engineering is also described as well as all the factors that must be taken into account to develop and properly apply a wound dressing are discussed. Different kind of techniques used in the literature to produce scaffolds or membranes for bone tissue engineering and wound dressings are mentioned, focusing on the use of electrospinning and electrospray to produce them. CHAPTER II, focuses on the development of enhanced 3D membranes able to promote efficient bone regeneration together with targeted antibiotic release to prevent bacteria colonization. The aim of this work was to synthesize and characterize a drug delivery system consisting of polycaprolactone (PCL) electrospun nanofibers decorated with rifampicin (RFP) loaded into poly(lactic-coglicolic acid) (PLGA) particles. This material would promote bone repair avoiding the impairment of the membrane mediated by infection. The bactericidal ability of the synthesized electrospun material was assessed In vitro against gram positive (Staphylococcus aureus) and gram negative (Escherichia coli) bacteria, as well as its cytocompatibility in human osteoblasts 3D cultures. These results are included in the accepted article entitled “Composite scaffold obtained by electro-hydrodynamic technique for infection prevention and treatment in bone repair”. Javier Aragon, Sergio Feoli, Gracia Mendoza, Silvia Irusta. International Journal of Pharmaceutics. CHAPTER III, describes the synthesis and characterization of core-shell membranes of PCL and polyvinyl acetate (PVAc) obtained by electrospinning. The fibers were loaded with synthetic hydroxyapatite nanoparticles (HAn) to increase the bioactivity of the materials. The prepared membranes were then treated by laser ablation to create desired microscale topographical features in order to favor cell adhesion and growth. All prepared membranes exhibited a three-dimensional network structure with interconnected pores; the laser treatment has modified the structural characteristics of the membrane causing an increase the cell viability and cell density. The materials biocompatibility is affected by the structural properties of the membranes, indeed smaller micropore sizes favor cell adhesion and proliferation. These results are published in the article entitled “Laser-treated electrospun fibers loaded with nano-hydroxyapatite for bone tissue engineering”. Javier Aragon, Nuria Navascues, Gracia Mendoza, Silvia Irusta. International Journal of Pharmaceutics 525,112–122, 2017. DOI:10.1016/j.ijpharm.2017.04.022. CHAPTER IV, refers to the development of a composite electrospun membrane of PCL or PCL/PVAc core–shell fibers loaded with synthetic HAn. These fibers were decorated with bone morphogenetic protein 2 (BMP2) loaded in/into PLGA particles via simultaneous electrospraying and coaxial electrospinning. The aim of this study was to evaluate the structural and physico-chemical properties and biodegradation processes of the newly developed membranes assessing their ability to address the architectural, biochemical, and functional features of bone tissue. For this purpose, the membrane bioactivity was tested by culturing human osteoblasts on the membranes and by monitoring cell viability up to 4 weeks. The In vitro osteogenic activity of cells seeded onto the membranes was evaluated by assessing alkaline phosphatase (ALP) activity and the expression of osteogenic proteins osteocalcin (OCN) and osteopontin (OPN). These results are published in the article “Polymeric electrospun scaffolds for bone morphogenetic protein 2 delivery in bone tissue engineering”. Javier Aragón, Simona Salerno, Loredana De Bartolo, Silvia Irusta and Gracia Mendoza. Journal of Colloid and Interface Science, 531 (2018) 126–137. DOI:10.1016/j.jcis.2018.07.029. CHAPTER V, describes the synthesis of an antimicrobial wound dressing material, with appropriate mechanical resistance avoiding rapid dehydration and absorbing exudates. PCL/PVAc asymmetric membranes loaded with carvacrol (CRV) were prepared by electrospinning and electrospraying simultaneously. The membranes consist of two layers: the first is an electrospun PCL sheet, the second a PVAc sheet that would be in contact with the skin releasing the antimicrobial compound. The use of different solvents results in different morphologies for the PVAc-CRV layer. The membranes exhibit mechanical properties with strain to failure values that are in the range of human skin, being adequate to be deposited over a wound surface. The samples present Water Vapor Transmission (WVTR) values in the required range to keep good moisture balance with water loss from the wound at the optimal rate. In the first week, more than 60 % of the loaded CRV was released while after three weeks membranes released between 85 to 100 % of the loaded CRV through a Fickian diffusion and diffusion due to polymer relaxation. The synthesized membranes are potential candidates to be used for wound dressing applications. The manuscript summing up these results has been submitted to a scientific journal and is currently under review. GENERAL CONCLUSIONS, summarizes the conclusions of the thesis work. APPENDIX 1, describes the main characterization techniques and the methods to evaluate different properties according to the possible applications. APPENDIX 2, summarizes the articles published and the participation in scientific forums during the thesis period.<br /

Enzymatic method of producing 4-O- β-D-galactopyranosyl-D-xylose, 4-O- β-D-galactopyranosyl-D-xylose obtained using said method, compositions containing said and the use thereof in evaluating intestinal lactase

Filing Date: 2002-06-14.-- Priority Data: ES 200101419 (2001-06-18).-- International Publication Number: WO_2002103038 (20021227).An enzymatic process to obtain 4-O-β-D-galactopyranosyl-D-xylose useful in compositions or solutions in the in vivo evaluation of intestinal lactose activity in humans, that comprises the steps of preparing a reaction mixture of D-xylose, a β-D-galactopyranoside and a reaction medium that comprises water buffered to a pH between 5.0 and 9.0; adding 10 to 1,000 units of β-D-galactosidase per gram of β-D-galactopyranoside; subjecting the reaction mixture to a reaction or a temperature between a temperature higher than the freezing point of the reaction mixture and 45ºC, for 2 to 48 hours; for the reaction by deactivation of the β-D-galactosidase; and to isolate and crystallize the fractions that contain 4-O-β-D-galactopyranosyl-D-xylose from a crystallization mixture selected between mixtures of acetone/methanol in a ratio between 5/1 to 20/1 and mixtures of acetone/water in a ratio between 5/1 to 20/1

Perfil de liberación controlada de ASA soportada en biomateriales compuestos de hidroxiapatita- POVIAC

El empleo de biomateriales como soportes de medicamentos en los sistemas de liberación controlada de drogas,1 constituye una importante aplicación que ha centrado la atención de los especialistas en las últimas dé- cadas.2 Esto es una consecuencia de los éxitos que se han alcanzado en su empleo en la cirugía reconstructiva y maxilofacial en varias especialidades médicas, tales cómo, Traumatolog ía, Ortopedia, Ortodoncia, etc.3 En estos casos, se desea la reconstrucci ón o reposición del tejido vivo y el tratamiento simultáneo de diferentes patologías

Cinética de liberación de cefalexiana desde un biomaterial compuesto por HAP-200/POVIAC/CaCO3

The main objective of this work is to study the kinetics of cefalexine release from a biomaterial compound developed recently, to show that it can be used as a controlled release system, for extended periods of time. Besides, different mathematical models were adjusted to the release profiles obtained in each formulation, with the purpose of determine the mechanism by which occurs the release of cefalexine from a composite release system. It was shown that the model proposed by Peppas and Sahlin was that the best fit presented, because, takes into account the phenomenon of Fickian diffusion and the phenomena of relaxation for polymeric chains. In all cases the effect burst was discarded, for what can affirm that almost all the medicine is occluded inside the formulations and not on the surface of these. It could be that the cefalexine is released through a phenomenon of Fickian diffusion through the pores or channels formed in the compound delivery system. Moreover, the phenomenon of relaxation for polymeric chains does not show a strong contribution to the release of cefalexine, but its inclusion in the equation, is necessary to obtain an appropriate mathematical adjustment.El objetivo principal de este trabajo es estudiar la cinética de liberación de cefalexina desde un biomaterial compuesto desarrolla- do recientemente, para demostrar que puede ser utilizado como un sistema de liberación controlada, durante periodos de tiempo pro- longados. Además se ajustaron diferentes modelos matemáticos a los perfiles de liberación obtenidos en cada formulación, con el propó- sito de determinar el mecanismo mediante el cual ocurre la libera- ción de cefalexina desde un sistema de liberación compuesto. Se demostró que el modelo propuesto por Peppas y Sahlin fue el que mejor ajuste presentó, ya que tiene en cuenta el fenómeno de difu- sión tipo Fickian y el fenómeno de relajación de las cadenas poliméricas. En todos los casos se descartó el efecto burst, por lo que se puede afirmar que casi todo el medicamento se encuentra ocluido dentro de las formulaciones y no en la superficie de éstas. Se pudo omprobar que la cefalexina es liberada mediante un fenómeno de difusión de tipo Fickian a través de los poros o canales formados en el sistema de liberación compuesto. Además, el fenómeno de relaja- ción de las cadenas poliméricas no presenta una fuerte contribución a la liberación de cefalexina, pero su inclusión en la ecuación permite obtener un adecuado ajuste matemático

Health literacy of nursing auxiliary care technicians and non-health personnel belonging to the workforce of four Spanish hospitals

Artículo[ES] Objetivo: Estimar el grado de alfabetización para la salud (AS) de las técnicas en cuidados auxiliares de enfermería (TCAE) y del personal no sanitario perteneciente a la plantilla laboral de 4 hospitales españoles. Método: Estudio descriptivo-correlacional, siendo la población diana las TCAE a quienes se preguntó, mediante formulario online HLS-EU-Q16 (Health Literacy Survey - European Union), con escala Likert de 4 valores (de 1 muy fácil a 4 muy difícil). Resultados: Respondieron 477 profesionales. Los resultados para la AS global fueron: media 1,95 ± 0,03 y mediana 1,94. El nivel de alfabetización en salud (NAS) demostró AS suficiente en 293 (61,43%) individuos. La mediana sobre la AS de los 3 componentes del cuestionario fue: cuidado sanitario = 2, prevención de enfermedades = 2 y promoción de la salud = 1,75. El ítem sobre sobre la manera de abordar problemas de salud mental es el que presentó mayor dificultad con media de 2,45 ± 0,04 y mediana igual a 2. No hubo diferencias significativas entre TCAE y el personal no sanitario. Conclusiones: El grado de AS de las TCAE resultó ser bueno, tanto a nivel global como en las dimensiones de atención y cuidado sanitario, prevención de enfermedades y promoción de la salud. Asimismo, el nivel de alfabetización en salud que se obtuvo resultó ser suficiente en la mayoría de ellas. No se encontró diferencias con el personal no sanitario perteneciente a la plantilla laboral de 4 hospitales estudiados. [EN] Objetive: To estimate the degree of health literacy (HL) of nursing auxiliary care technicians (NACT) and non-health personnel belonging to the workforce of 4 Spanish hospitals.Method: A descriptive-correlational research, with NACT as target population. They were asked, using the online form HLS-EU-Q16 (Health Literacy Survey - European Union), with a Likert scale of 4 values (from 1 very easy to 4 very difficult).Results: 477 professionals answered the form. The results for global SA were: mean 1.95 ± 0.03 and median 1.94. The health literacy level (HLL) demonstrated sufficient HL in 293 (61.43%) individuals. The median on the HL for the 3 components of the questionnaire was: health care = 2, disease prevention = 2 and health promotion = 1.75. The item about how to deal with mental health problems showed the greatest difficulty with a mean of 2.45 ± 0.04 and a median equal to 2. There were no significant differences between NACT and non-health personnel. Conclusions: The HL grade of the NACTs turned out to be good, both globally and in the dimensions of attention and health care, disease prevention and health promotion. Likewise, the level of health literacy obtained turned out to be enough in most of them. No differences were found with the non-health personnel belonging to the workforce of the 4 hospitals researched.N

INTERGROWTH-21st versus a customized method for the prediction of neonatal nutritional status in hypertensive disorders of pregnancy

Background Hypertensive disorders of pregnancy (HDP) generate complications and are one of the principal causes of maternal, foetal, and neonatal mortality worldwide. It has been observed that in pregnancies with HDP, the incidence of foetuses small for their gestational age (SGA) is twice as high as that in noncomplicated pregnancies. In women with HDP, the identification of foetuses (SGA) is substantially important, as management and follow-up are determined by this information. Objective The objective of this study was to evaluate whether the INTERGROWTH-21st method or customized birthweight references better identify newborns with an abnormal nutritional status resulting from HDP. Method A comparative analysis study was designed with two diagnostic methods for the prediction of neonatal nutritional status in pregnancies with HDP. The performance of both methods in identifying neonatal malnutrition (defined by a neonatal body mass index < 10(th) centile or a ponderal index < 10(th) centile) was assessed by calculating sensitivity, specificity, positive predictive value, negative predictive value, diagnostic odds ratio, Youden's index and probability ratios. Results The study included 226 pregnant women diagnosed with HDP. The customized method identified 45 foetuses as small for gestational age (19.9%), while the INTERGROWTH-21st method identified 27 newborns with SGA (11.9%). The difference between proportions was statistically significant (p < 0.01). Using body mass index (< 10(th) centile) as a measure of nutritional status, newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR: 4.87 (95% CI: 1.86-12.77) vs. 3.75 (95% CI: 1.49-9.43)) (DOR: 5.56 (95% CI: 1.82-16.98) vs. 4.84 (95% CI: 1.51-15.54)) Even when using Ponderal index (< 10(th) centile), newborns identified as SGA by the customized method showed a higher risk of malnutrition than those identified as SGA by INTERGROWTH-21st (RR 2.37 (95% CI: 1.11-5.05) vs. 1.68 (95% CI: 0.70-4.03))(DOR 2.62 (95% CI: 1.00-6.87) vs. 1.90 (95% CI: 0.61-5.92)). Conclusion In pregnant women with HDP, the predictive ability of the customized foetal growth curves to identify neonatal malnutrition appears to surpass that of INTERGROWTH-21st

Plasma miR-486-5p Expression Is Upregulated in Atrial Fibrillation Patients with Broader Low-Voltage Areas

Atrial fibrillation (AF) is the most common arrhythmia worldwide, affecting 1% of the population over 60 years old. The incidence and prevalence of AF are increasing globally, representing a relevant health problem, suggesting that more advanced strategies for predicting risk stage are highly needed. miRNAs mediate several processes involved in AF. Our aim was to identify miRNAs with a prognostic value as biomarkers in patients referred for AF ablation and its association with LVA extent, based on low-voltage area (LVA) maps. In this study, we recruited 44 AF patients referred for catheter ablation. We measured the expression of 84 miRNAs in plasma from peripheral blood in 3 different groups based on LVA extent. Expression analysis showed that miR-486-5p was significantly increased in patients with broader LVA (4-fold, p = 0.0002; 5-fold, p = 0.0001). Receiver operating characteristic curve analysis showed that miR-486-5p expression could predict atrium LVA (AUC, 0.8958; p = 0.0015). Also, miR-486-5p plasma levels were associated with AF-type (AUC, 0.7137; p = 0.0453). In addition, miR-486-5p expression was positively correlated with LVA percentage, left atrial (LA) area, and LA volume (r = 0.322, p = 0.037; r = 0.372, p = 0.015; r = 0.319, p = 0.045, respectively). These findings suggest that miR-486-5p expression might have prognostic significance in LVA extent in patients with AFThis research was funded by Xunta de Galicia: Programa de Consolidación de Unidades de Investigación Competitivas do SUG (GRC 2019/02), the Centro Singular de Investigación de Galicia acreditación 2019–2022 (ED431G 2019/02), the European Union European Regional Development Fund (ERDF), and National Institute of Health Fondo de Investigaciones Sanitarias, Instituto de Salud Carlos III (ISCIII) Madrid, Spain (PI18/00821, CIBERCV CB16/11/00226 and FAISCA Intramural Project 2019)S