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Revista Espanola de Anestesiologia Y... Jan 2021
Topics: Hydroxyethyl Starch Derivatives; Plasma Substitutes
PubMed: 32553517
DOI: 10.1016/j.redar.2020.04.009 -
The Cleft Palate-craniofacial Journal :... Mar 2022Since the early stages of alveolar bone grafting development, multiple types of materials have been used. Iliac cancellous bone graft (ICBG) remains the gold standard. (Review)
Review
INTRODUCTION
Since the early stages of alveolar bone grafting development, multiple types of materials have been used. Iliac cancellous bone graft (ICBG) remains the gold standard.
DESIGN/METHODS
A review of literature is conducted in order to describe the different bone filling possibilities, autologous or not, and to assess their effectiveness compared to ICBG. This review focused on studies reporting volumetric assessment of the alveolar cleft graft result (by computed tomography scan or cone beam computed tomography).
RESULTS
Grafting materials fall into 3 types: autologous bone grafts, ICBG supplementary material, and bone substitutes. Among autologous materials, no study showed the superiority of any other bone origin over iliac cancellous bone. Yet ICBG gives inconsistent results and presents donor site morbidity. Concerning supplementary material, only 3 studies could show a benefit of adding platelet-rich fibrin (1 study) or platelet-rich plasma (2 studies) to ICBG, which remains controversial in most studies. There is a lack of 3-dimensional (3D) assessment in most articles concerning the use of scaffolds. Only one study showed graft improvement when adding acellular dermal matrix to ICBG. Looking at bone substitutes highlights failures among bioceramics alone, side-effects with bone morphogenetic protein-2 composite materials, and difficulties in cell therapy setup. Studies assessing cell therapy-based substitutes show comparable efficacy with ICBG but remain too few.
CONCLUSION
This review highlights the lack of 3D assessments in the alveolar bone graft materials field. Nothing dethroned ICBG from its position as the gold standard treatment at this time.
Topics: Alveolar Bone Grafting; Bone Substitutes; Bone Transplantation; Cleft Palate; Humans; Ilium; Treatment Outcome
PubMed: 33823625
DOI: 10.1177/10556656211007692 -
Advanced Healthcare Materials Jun 2023Since the 2010s, the demand for healthcare models has exceeded the prevailing resources available due to the rapid increase in the aging population in China. However, a... (Review)
Review
Since the 2010s, the demand for healthcare models has exceeded the prevailing resources available due to the rapid increase in the aging population in China. However, a significant gap in development of biomedical materials remains, especially between China and the western developed countries. Collagen is the major protein of the extracellular matrix (ECM) and has been extensively applied in medical fields. Collagen-based biomaterials (CBBs) are used to prepare dressings and dermal substitutes, surgical sutures, plasma substitutes, tissue-engineered scaffolds, and drug delivery systems; this is attributed to their exceptional biocompatibility, biodegradability, hypoimmunogenicity, and coordination between collagen hosts and tissues. This review provides thorough strides in CBB structures, crosslinking and forming technologies, and real-world applications. First, the natural origin and specific structures of animal-derived collagen and non-animal-derived collagen are introduced and compared. Second, crosslinking methods and forming technologies of CBBs across the board are discussed. Third, several examples are considered to demonstrate the practical biomedical use of CBBs and highlight cautionary notes. Finally, the underlying development directions of CBBs from an interdisciplinary perspective are outlined. This review aims to provide comprehensive mechanisms by which collagen can be uniquely and practically used as advanced biomaterial, hence providing options for augmenting its development in China.
Topics: Biocompatible Materials; Tissue Scaffolds; Collagen; Extracellular Matrix; Drug Delivery Systems; Tissue Engineering
PubMed: 36377336
DOI: 10.1002/adhm.202202042 -
Journal of Thrombosis and Haemostasis :... Apr 2024Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic disorder associated with a severe deficiency of ADAMTS-13-the protease that cleaves von... (Review)
Review
Thrombotic thrombocytopenic purpura (TTP) is a life-threatening thrombotic disorder associated with a severe deficiency of ADAMTS-13-the protease that cleaves von Willebrand factor. Plasma therapy is the current standard of care for managing acute episodes of TTP, which involves removing patient plasma and replacing it with donor plasma to raise the level of ADAMTS-13 activity. Recently, therapies aimed at replacing ADAMTS-13 have been investigated as possible substitutes or add-ons to plasma therapy for congenital and immune-mediated TTP. Enzyme replacement therapy provides recombinant ADAMTS-13 via intravenous (i.v.) infusion to restore enzyme activity. Recombinant ADAMTS-13-loaded platelets localize to the site of thrombus formation in a more concentrated manner than enzyme replacement or plasma therapy. ADAMTS-13-encoding messenger RNA aims to induce a steady supply of secreted protein and gene therapy is a potentially curative strategy. Overall, targeted ADAMTS-13 replacement therapies may provide better outcomes than plasma therapy by achieving higher levels of ADAMTS-13 activity and a more sustained response with fewer adverse events. Herein, we describe targeted ADAMTS-13 replacement therapies for the treatment of TTP and discuss the advantages and limitations of each approach.
Topics: Humans; Purpura, Thrombotic Thrombocytopenic; ADAMTS13 Protein; Blood Platelets; Plasma; Thrombosis; von Willebrand Factor
PubMed: 38142844
DOI: 10.1016/j.jtha.2023.11.030 -
Toxins Mar 2020Ribosome-inactivating proteins (RIPs) are N-glycosidases, which depurinate a specific adenine residue in the conserved α-sarcin/ricin loop (α-SRL) of rRNA. This loop... (Review)
Review
Ribosome-inactivating proteins (RIPs) are N-glycosidases, which depurinate a specific adenine residue in the conserved α-sarcin/ricin loop (α-SRL) of rRNA. This loop is important for anchoring elongation factor (EF-G for prokaryote or eEF2 for eukaryote) in mRNA translocation. Translation is inhibited after the attack. RIPs therefore may have been applied for anti-cancer, and anti-virus and other therapeutic applications. The main obstacles of treatment with RIPs include short plasma half-life, non-selective cytotoxicity and antigenicity. This review focuses on the strategies used to improve the pharmacological properties of RIPs on human immunodeficiency virus (HIV) and cancers. Coupling with polyethylene glycol (PEG) increases plasma time and reduces antigenicity. RIPs conjugated with antibodies to form immunotoxins increase the selective toxicity to target cells. The prospects for future development on the engineering of RIPs for improving their pharmacological properties are also discussed.
Topics: Animals; Anti-HIV Agents; Antineoplastic Agents; Dextrans; Humans; Polyethylene Glycols; Protein Engineering; Ribosome Inactivating Proteins
PubMed: 32182799
DOI: 10.3390/toxins12030167 -
Molecular Aspects of Medicine Apr 2022Hemoglobin (Hb) plays its vital role through structural and functional properties evolutionarily optimized to work within red blood cells, i.e., the tetrameric assembly,... (Review)
Review
Hemoglobin (Hb) plays its vital role through structural and functional properties evolutionarily optimized to work within red blood cells, i.e., the tetrameric assembly, well-defined oxygen affinity, positive cooperativity, and heterotropic allosteric regulation by protons, chloride and 2,3-diphosphoglycerate. Outside red blood cells, the Hb tetramer dissociates into dimers, which exhibit high oxygen affinity and neither cooperativity nor allosteric regulation. They are prone to extravasate, thus scavenging endothelial NO and causing hypertension, and cause nephrotoxicity. In addition, they are more prone to autoxidation, generating radicals. The need to overcome the adverse effects associated with cell-free Hb has always been a major hurdle in the development of substitutes of allogeneic blood transfusions for all clinical situations where blood is unavailable or cannot be used due to, for example, religious objections. This class of therapeutics, indicated as hemoglobin-based oxygen carriers (HBOCs), is formed by genetically and/or chemically modified Hbs. Many efforts were devoted to the exploitation of the wealth of biochemical and biophysical information available on Hb structure, function, and dynamics to design safe HBOCs, overcoming the negative effects of free plasma Hb. Unfortunately, so far, no HBOC has been approved by FDA and EMA, except for compassionate use. However, the unmet clinical needs that triggered intensive investigations more than fifty years ago are still awaiting an answer. Recently, HBOCs "repositioning" has led to their successful application in organ perfusion fluids.
Topics: Blood Substitutes; Hemoglobins; Humans; Hypertension; Oxygen
PubMed: 34776270
DOI: 10.1016/j.mam.2021.101050 -
Canadian Journal of Anaesthesia =... Aug 2021Intravascular fluids are a necessary and universal component of cardiac surgical patient care. Both crystalloids and colloids are used to maintain or restore circulating... (Review)
Review
PURPOSE
Intravascular fluids are a necessary and universal component of cardiac surgical patient care. Both crystalloids and colloids are used to maintain or restore circulating plasma volume and ensure adequate organ perfusion. In Canada, human albumin solution (5% or 25% concentration) is a colloid commonly used for this purpose. In this narrative review, we discuss albumin supply in Canada, explore the perceived advantages of albumin, and describe the clinical literature supporting and refuting albumin use over other fluids in the adult cardiac surgical population.
SOURCE
We conducted a targeted search of PubMed, Embase, Medline, Web of Science, ProQuest Dissertations and Theses Global, the Cochrane Central Register of Controlled trials, and the Cochrane Database of Systematic Reviews. Search terms included albumin, colloid, cardiac surgery, bleeding, hemorrhage, transfusion, and cardiopulmonary bypass.
PRINCIPAL FINDINGS
Albumin is produced from fractionated human plasma and imported into Canada from international suppliers at a cost of approximately $21 million CAD per annum. While it is widely used in cardiac surgical patients across the country, it is approximately 30-times more expensive than equivalent doses of balanced crystalloid solutions, with wide inter-institutional variability in use and no clear association with improved outcomes. There is a general lack of high-quality evidence for the superiority of albumin over crystalloids in this patient population, and conflicting evidence regarding safety.
CONCLUSIONS
In cardiac surgical patients, albumin is widely utilized despite a lack of high- quality evidence supporting its efficacy or safety. A well-designed randomized controlled trial is needed to clarify the role of albumin in cardiac surgical patients.
Topics: Adult; Albumins; Canada; Cardiac Surgical Procedures; Fluid Therapy; Humans; Isotonic Solutions; Plasma Substitutes; Rehydration Solutions; Systematic Reviews as Topic
PubMed: 33884561
DOI: 10.1007/s12630-021-01991-7 -
Macromolecular Bioscience Apr 2020Bleeding complications usually cause significant morbidity and mortality in civilian and military populations. In clinical application, hemostatic sponges, gauzes,... (Review)
Review
Bleeding complications usually cause significant morbidity and mortality in civilian and military populations. In clinical application, hemostatic sponges, gauzes, hydrogel, and bandages are widely used as the traditional effective hemostatic products for hemorrhage. However, the traditional hemostatic devices or agents cannot meet the requirement for treatment of massive bleeding. Therefore, the excellent hemostatic performance of hemostatic products are of great significance for saving lives. Natural polysaccharides, as the main chemical component, have been widely used in the preparation of hemostasis due to their perfect biocompatibility and biodegradability. Polysaccharide based hemostatic products are available in variety of forms, such as, hydrogel, sponges, gauze and microspheres. The purpose of the present review is to report the research progress on polysaccharide hemostatic products and technology.
Topics: Alginates; Animals; Bandages; Biocompatible Materials; Cellulose; Chitosan; Dextrans; Hemorrhage; Hemostasis; Hemostatics; Humans; Hyaluronic Acid; Hydrogels; Platelet Aggregation; Starch; Time Factors
PubMed: 32068950
DOI: 10.1002/mabi.201900370 -
Polymers Jun 2021Dermo-epidermal equivalents based on plasma-derived fibrin hydrogels have been extensively studied for skin engineering. However, they showed rapid degradation and...
Dermo-epidermal equivalents based on plasma-derived fibrin hydrogels have been extensively studied for skin engineering. However, they showed rapid degradation and contraction over time and low mechanical properties which limit their reproducibility and lifespan. In order to achieve better mechanical properties, elasticity and biological properties, we incorporated a elastin-like recombinamer (ELR) network, based on two types of ELR, one modified with azide (SKS-N) and other with cyclooctyne (SKS-Cyclo) chemical groups at molar ratio 1:1 at three different SKS (serine-lysine-serine sequence) concentrations (1, 3, and 5 wt.%), into plasma-derived fibrin hydrogels. Our results showed a decrease in gelation time and contraction, both in the absence and presence of the encapsulated human primary fibroblasts (hFBs), higher mechanical properties and increase in elasticity when SKSs content is equal or higher than 3%. However, hFBs proliferation showed an improvement when the lowest SKS content (1 wt.%) was used but started decreasing when increasing SKS concentration at day 14 with respect to the plasma control. Proliferation of human primary keratinocytes (hKCs) seeded on top of the hybrid-plasma hydrogels containing 1 and 3% of SKS showed no differences to plasma control and an increase in hKCs proliferation was observed for hybrid-plasma hydrogels containing 5 wt.% of SKS. These promising results showed the need to achieve a balance between the reduced contraction, the better mechanical properties and biological properties and indicate the potential of using this type of hydrogel as a testing platform for pharmaceutical products and cosmetics, and future work will elucidate their potential.
PubMed: 34203144
DOI: 10.3390/polym13132114 -
Revista Espanola de Anestesiologia Y... Apr 2023Fluid administration is the cornerstone in hypovolemic patient's reanimation. Clinical guidelines restrict colloid administration favouring crystalloids. Currently, we... (Observational Study)
Observational Study
INTRODUCTION
Fluid administration is the cornerstone in hypovolemic patient's reanimation. Clinical guidelines restrict colloid administration favouring crystalloids. Currently, we don't know exactly which is the daily clinical practice during the perioperative period. The objective of this study is to describe perioperative use of colloids analysing possible reasons aiming to use them.
MATERIAL AND METHODS
Prospective, cross-section, national, multicentre observational study. Fluid Day sub-study. We enrolled all patient's older than 18 years old who underwent surgery during the 24 h of the 2-days study (February, 2019, 18th and 20th). We registered demographic data, comorbidities, anaesthetic and surgical procedure data, fluids administered, perioperative bleeding and monitoring type used during the perioperative period.
RESULTS
A total of 5928 cases were analysed and 542 patients (9.1%) received any type of colloids, being hydroxiethyl-starch the most frequently used (5.1%). Patients receiving colloids suffered more longing surgery (150 [90-255] vs. 75 [45-120] min), were urgently operated (13.7 vs. 7.5%) and were more frequent classified as high risk (22 vs. 4.8%). Their recovery was mostly in critical care units (45.1 vs.15.8%). Patients with bleeding less than 500 ml received colloids in a percentage of 5.9 versus 45.9% when this figure was overcome. Patients who received colloids were anaemic more frequently: 29.4 vs. 16.3%. Colloids administration had a higher risk for transfusion (OR 15.7). Advanced monitoring also increased the risk for receiving colloids (OR 9.43).
CONCLUSIONS
In our environment with routine clinical practice, colloids administration is limited and close linked to perioperative bleeding.
Topics: Humans; Adolescent; Plasma Substitutes; Isotonic Solutions; Fluid Therapy; Prospective Studies; Colloids
PubMed: 36858277
DOI: 10.1016/j.redare.2022.03.002