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International Journal of Molecular... Nov 2021Surgical reconstruction in anterior cruciate ligament (ACL) ruptures has proven to be a highly effective technique that usually provides satisfactory results. However,... (Review)
Review
Surgical reconstruction in anterior cruciate ligament (ACL) ruptures has proven to be a highly effective technique that usually provides satisfactory results. However, despite the majority of patients recovering their function after this procedure, ACL reconstruction (ACLR) is still imperfect. To improve these results, various biological augmentation (BA) techniques have been employed mostly in animal models. They include: (1) growth factors (bone morphogenetic protein, epidermal growth factor, granulocyte colony-stimulating factor, basic fibroblast growth factor, transforming growth factor-β, hepatocyte growth factor, vascular endothelial growth factor, and platelet concentrates such as platelet-rich plasma, fibrin clot, and autologous conditioned serum), (2) mesenchymal stem cells, (3) autologous tissue, (4) various pharmaceuticals (matrix metalloproteinase-inhibitor alpha-2-macroglobulin bisphosphonates), (5) biophysical/environmental methods (hyperbaric oxygen, low-intensity pulsed ultrasound, extracorporeal shockwave therapy), (6) biomaterials (fixation methods, biological coatings, biosynthetic bone substitutes, osteoconductive materials), and (7) gene therapy. All of them have shown good results in experimental studies; however, the clinical studies on BA published so far are highly heterogeneous and have a low degree of evidence. The most widely used technique to date is platelet-rich plasma. My position is that orthopedic surgeons must be very cautious when considering using PRP or other BA methods in ACLR.
Topics: Anterior Cruciate Ligament; Anterior Cruciate Ligament Injuries; Anterior Cruciate Ligament Reconstruction; Bone Substitutes; Genetic Therapy; Humans; Hyperbaric Oxygenation; Intercellular Signaling Peptides and Proteins; Mesenchymal Stem Cell Transplantation; Transplantation, Autologous
PubMed: 34830448
DOI: 10.3390/ijms222212566 -
Annals of Hepatology 2020Infections are a frequent complication and a major cause of death among patients with cirrhosis. The important impact of infections in general and especially spontaneous... (Review)
Review
Infections are a frequent complication and a major cause of death among patients with cirrhosis. The important impact of infections in general and especially spontaneous bacterial peritonitis on the course of disease and prognosis of patients with cirrhosis has been recognized for many years. Nevertheless, such importance has recently increased due to the comprehension of infection as one of the most prominent risk factors for patients to develop acute-on-chronic liver failure. Furthermore, the issue of infections in cirrhosis is a focus of increasing attention because of the spreading of multidrug resistant bacteria, which is an emerging concern among physicians assisting patients with cirrhosis. In the present paper, we will review the current epidemiology of infections in patients with cirrhosis and particularly that of infections caused by resistant bacteria, demonstrating the relevance of the subject. Besides, we will discuss the current recommendations on diagnosis and treatment of different kinds of infections, including spontaneous bacterial peritonitis, and we will highlight the importance of knowing local microbiological profiles and choosing empirical antibiotic therapy wisely. Finally, we will debate the existing evidences regarding the role of volume expansion with albumin in patients with cirrhosis and extraperitoneal infections, and that of antibiotic prophylaxis of spontaneous bacterial peritonitis.
Topics: Albumins; Anti-Bacterial Agents; Bacterial Infections; Drug Resistance, Multiple, Bacterial; Fluid Therapy; Humans; Liver Cirrhosis; Peritonitis; Plasma Substitutes; Risk Assessment; Risk Factors; Treatment Outcome
PubMed: 32533951
DOI: 10.1016/j.aohep.2020.04.010 -
Clinics in Podiatric Medicine and... Oct 2019Use of orthobiologics in sports medicine and musculoskeletal surgery has gained significant interest. However, many of the commercially available and advertised products... (Review)
Review
Use of orthobiologics in sports medicine and musculoskeletal surgery has gained significant interest. However, many of the commercially available and advertised products are lacking in clinical evidence. Widespread use of products before fully understanding their true indications may result in unknown adverse outcomes and may also lead to increased health care costs. As more products become available, it is important to remain judicial in use and to practice evidence-based medicine. Likewise, it is important to continue advances in research in hopes to improve surgical outcomes. This article reviews clinical evidence behind common orthobiologics in the treatment of foot and ankle pathology.
Topics: Ankle Injuries; Biological Products; Bone Transplantation; Foot Injuries; Humans; Platelet-Rich Plasma; Sports Medicine
PubMed: 31466571
DOI: 10.1016/j.cpm.2019.06.006 -
Advanced Materials (Deerfield Beach,... Oct 2023Engineered skin substitutes derived from human skin significantly reduce inflammatory reactions mediated by foreign/artificial materials and are consequently easier to...
Engineered skin substitutes derived from human skin significantly reduce inflammatory reactions mediated by foreign/artificial materials and are consequently easier to use for clinical application. Type I collagen is a main component of the extracellular matrix during wound healing and has excellent biocompatibility, and platelet-rich plasma can be used as the initiator of the healing cascade. Adipose mesenchymal stem cell derived exosomes are crucial for tissue repair and play key roles in enhancing cell regeneration, promoting angiogenesis, regulating inflammation, and remodeling extracellular matrix. Herein, Type I collagen and platelet-rich plasma, which provide natural supports for keratinocyte and fibroblast adhesion, migration, and proliferation, are mixed to form a stable 3D scaffold. Adipose mesenchymal stem cell derived exosomes are added to the scaffold to improve the performance of the engineered skin. The physicochemical properties of this cellular scaffold are analyzed, and the repair effect is evaluated in a full-thickness skin defect mouse model. The cellular scaffold reduces the level of inflammation and promotes cell proliferation and angiogenesis to accelerate wound healing. Proteomic analysis shows that exosomes exhibit excellent anti-inflammatory and proangiogenic effects in collagen/platelet-rich plasma scaffolds. The proposed method provides a new therapeutic strategy and theoretical basis for tissue regeneration and wound repair.
PubMed: 37342075
DOI: 10.1002/adma.202303642 -
Journal of Chromatography. A Aug 2020A recent article in Journal of Chromatography A 1561 (2018) 67-75 authored by J.-L. Wang, E. Alasonati, P. Fisicaro, M. F. Benedetti, and M. Martin and having the title...
A recent article in Journal of Chromatography A 1561 (2018) 67-75 authored by J.-L. Wang, E. Alasonati, P. Fisicaro, M. F. Benedetti, and M. Martin and having the title Theoretical and experimental investigation of the focusing position in asymmetrical flow field-flow fractionation (AF4) is discussed. It is found that some statements and conclusions are to some degree questionable or confusing. In addition the experiments to measure the focusing position were not well defined. Authors' assumption of the constancy of the cross-flow velocity along the channel is pointed out to actually be valid as evidenced by a theoretical analysis as well as experimental findings in the literature. Claims that a "fingering" phenomenon of a focused blue dextran stripe would contribute to overall band broadening are contradicted.
Topics: Dextrans; Fractionation, Field Flow; Humans
PubMed: 32507331
DOI: 10.1016/j.chroma.2020.461268 -
Anesthesia and Analgesia Aug 2020
Topics: Humans; Hydroxyethyl Starch Derivatives; Morbidity; Propensity Score
PubMed: 33031683
DOI: 10.1213/ANE.0000000000004917 -
Molecules (Basel, Switzerland) Aug 2022Dextran, a renewable hydrophilic polysaccharide, is nontoxic, highly stable but intrinsically biodegradable. The α-1, 6 glycosidic bonds in dextran are attacked by... (Review)
Review
Dextran, a renewable hydrophilic polysaccharide, is nontoxic, highly stable but intrinsically biodegradable. The α-1, 6 glycosidic bonds in dextran are attacked by dextranase (E.C. 3.2.1.11) which is an inducible enzyme. Dextranase finds many applications such as, in sugar industry, in the production of human plasma substitutes, and for the treatment and prevention of dental plaque. Currently, dextranases are obtained from terrestrial fungi which have longer duration for production but not very tolerant to environmental conditions and have safety concerns. Marine bacteria have been proposed as an alternative source of these enzymes and can provide prospects to overcome these issues. Indeed, marine bacterial dextranases are reportedly more effective and suitable for dental caries prevention and treatment. Here, we focused on properties of dextran, properties of dextran-hydrolyzing enzymes, particularly from marine sources and the biochemical features of these enzymes. Lastly the potential use of these marine bacterial dextranase to remove dental plaque has been discussed. The review covers dextranase-producing bacteria isolated from shrimp, fish, algae, sea slit, and sea water, as well as from macro- and micro fungi and other microorganisms. It is common knowledge that dextranase is used in the sugar industry; produced as a result of hydrolysis by dextranase and have prebiotic properties which influence the consistency and texture of food products. In medicine, dextranases are used to make blood substitutes. In addition, dextranase is used to produce low molecular weight dextran and cytotoxic dextran. Furthermore, dextranase is used to enhance antibiotic activity in endocarditis. It has been established that dextranase from marine bacteria is the most preferable for removing plaque, as it has a high enzymatic activity. This study lays the groundwork for the future design and development of different oral care products, based on enzymes derived from marine bacteria.
Topics: Animals; Bacteria; Dental Caries; Dental Plaque; Dextranase; Dextrans; Fungi; Humans; Sugars
PubMed: 36080300
DOI: 10.3390/molecules27175533 -
Facial Plastic Surgery : FPS Oct 2023Critical-sized bone defects are a reconstructive challenge, particularly in the craniomaxillofacial (CMF) skeleton. The "gold standard" of autologous bone grafting has... (Review)
Review
Critical-sized bone defects are a reconstructive challenge, particularly in the craniomaxillofacial (CMF) skeleton. The "gold standard" of autologous bone grafting has been the work horse of reconstruction in both congenital and acquired defects of CMF skeleton. Autologous bone has the proper balance of the protein (or organic) matrix and mineral components with no immune response. Organic and mineral adjuncts exist that offer varying degrees of osteogenic, osteoconductive, osteoinductive, and osteostimulative properties needed for treatment of critical-sized defects. In this review, we discuss the various mostly organic and mostly mineral bone graft substitutes available for autologous bone grafting. Primarily organic bone graft substitutes/enhancers, including bone morphogenic protein, platelet-rich plasma, and other growth factors, have been utilized to support de novo bone growth in setting of critical-sized bone defects. Primarily mineral options, including various calcium salt formulation (calcium sulfate/phosphate/apatite) and bioactive glasses have been long utilized for their similar composition to bone. Yet, a bone graft substitute that can supplant autologous bone grafting is still elusive. However, case-specific utilization of bone graft substitutes offers a wider array of reconstructive options.
Topics: Animals; Horses; Bone Substitutes; Bone Transplantation; Calcium Phosphates; Bone Regeneration
PubMed: 37473765
DOI: 10.1055/s-0043-1770962 -
Molecules (Basel, Switzerland) Oct 2019The cellular transport process of DNA is hampered by cell membrane barriers, and hence, a delivery vehicle is essential for realizing the potential benefits of gene... (Review)
Review
The cellular transport process of DNA is hampered by cell membrane barriers, and hence, a delivery vehicle is essential for realizing the potential benefits of gene therapy to combat a variety of genetic diseases. Virus-based vehicles are effective, although immunogenicity, toxicity and cancer formation are among the major limitations of this approach. Cationic polymers, such as polyethyleneimine are capable of condensing DNA to nanoparticles and facilitate gene delivery. Lack of biodegradation of polymeric gene delivery vehicles poses significant toxicity because of the accumulation of polymers in the tissue. Many attempts have been made to develop biodegradable polymers for gene delivery by modifying existing polymers and/or using natural biodegradable polymers. This review summarizes mechanistic aspects of gene delivery and the development of biodegradable polymers for gene delivery.
Topics: Animals; Biological Transport; Chitosan; Dextrans; Endosomes; Gene Transfer Techniques; Genetic Therapy; Glucans; Humans; Hyaluronic Acid; Hydrolysis; Lysosomes; Nanoparticles; Polyethyleneimine; Polylysine
PubMed: 31627389
DOI: 10.3390/molecules24203744 -
Shock (Augusta, Ga.) Oct 2019Perftoran, which has been rebranded as Vidaphor for marketing in North America, is an emulsion of perfluorocarbons in a surfactant and electrolyte mixture. It was... (Review)
Review
Perftoran, which has been rebranded as Vidaphor for marketing in North America, is an emulsion of perfluorocarbons in a surfactant and electrolyte mixture. It was developed in Russia as an oxygen-carrying intravenous plasma additive for hemorrhagic anemia and ischemic conditions from various etiologies. It was approved for clinical use in Russia in 1996 and used by the Russian Armed Forces and in civilian medical care. It was also approved in Mexico from 2005 to 2010. It has been reportedly administered to over 35,000 patients with significant evidence of benefit and relatively mild and manageable adverse effects. It may have significant potential for use in hemorrhagic shock if human red blood cells are not available, and for several other applications including treatment of vascular gas embolism, cerebral or spinal trauma, and regional ischemia. It is different from other perfluorocarbon preparations under development in the United States in that it uses a different primary perfluorocarbon (perfluorodecalin) and a surfactant (Proxanol 268) instead of egg-yok phospholipid as the emulsion vehicle. Perftoran has a much smaller particle size resulting in milder adverse effects. It has been safely administered to more patients than any oxygen carrier currently under development. A newly formed United States Corporation (FluorO2 Therapeutics, Inc.) intends to manufacture the product in the United States under GMP standards and make it available for clinical use in Mexico and Latin America and pursue research to support eventual approval in the United States for human and veterinary use. This article will briefly review key information about this product and provide references for the interested reader.
Topics: Blood Substitutes; Fluorocarbons; Humans; Oxygen; United States
PubMed: 29189604
DOI: 10.1097/SHK.0000000000001063