Determination of unsaturated end groups in low molecular weight poly(vinyl chloride) by 1H NMR spectroscopy of the hydroxyphenyl substituted product

Poly(vinyl chloride) of low molecular weight (the fraction extracted with a hexane/acetone mixture (vol.-ratio 3:2)) was substituted by hydroxyphenyl groups and then analyzed by ¹H NMR spectroscopy. It was established that the ¹H NMR spectra of hydroxyphenyl substituted poly(vinyl chloride) prepared by removal of HCl, allows to determine the number of unsaturated end groups and to distinguish between the structures ? CHCl? CH₂? CH?CH? CH₂Cl and ? CH₂? CHCl? CH?CH? CH₂Cl, and even between their trans and cis forms. In addition the ¹H NMR spectra of hydroxyphenyl substituted poly(vinyl chloride) prepared without removal of HCl allow to determine the total number of unsaturated end groups.     

Clinical features and outcome of maintenance hemodialysis patients with COVID-19 from a tertiary nephrology care center in Romania

Background There is limited information about the clinical characteristics, treatment and outcome of maintenance hemodialysis patients with COVID-19. Moreover, regional differences are also conceivable since the extend and severity of outbreaks varied among countries.Methods In this retrospective, observational, single-center study, we analyzed the clinical course and outcomes of 37 maintenance hemodialysis patients (median age 64 years, 51% men) hospitalized with COVID-19 from 24 March to 22 May 2020 as confirmed by real-time PCR.Results The most common symptoms at admission were fatigue (51%), fever (43%), dyspnea (38%) and cough (35%). There were 59% mild/moderate patients and 41% severe/critical patients. Patients in the severe/critical group had a significantly higher atherosclerotic burden since diabetic kidney disease and vascular nephropathies were the most common primary kidney diseases and eighty percent of them had coronary heart disease. Also, Charlson comorbidity score was higher in this group. At admission chest X-ray, 46% had ground-glass abnormalities. Overall, 60% patients received hydroxychloroquine, 22% lopinavir–ritonavir, 11% tocilizumab, 24% systemic glucocorticoids, and 54% received prophylactic anticoagulation. Seven (19%) patients died during hospitalization and 30 were discharged. The main causes of death were cardiovascular (5 patients) and respiratory distress syndrome (2 patients). In Cox regression analysis, lower oxygen saturation, anemia and hypoalbuminemia at admission were associated with increased mortality.Conclusions In conclusion, we observed a high mortality rate among maintenance hemodialysis patients hospitalized for COVID-19. Anemia, lower serum albumin and lower basal oxygen saturation at admission were factors associated with poor prognosis.     

Synthesis and characterization of a novel controlled release zinc oxide/gentamicin–chitosan composite with potential applications in wounds care

Freshly prepared ZnO nanoparticles were incorporated into a chitosan solution in weight ratios ranging from 1:1 to 12:1. Starting from the ratio of 3:1 the chitosan solution was transformed into a gel with a high consistency, which incorporates 15 mL water for only 0.1 g solid substance. The powders obtained after drying the gel were characterized by X-ray diffraction (XRD), transmission electron microscopy (TEM) and thermal analysis (TG-DSC). The electronic (UV–vis), infrared (FTIR) and photoluminescence (PL) spectra were also recorded. ZnO particles were coated with gentamicin and incorporated into the chitosan matrix, to yield a ZnO/gentamicin–chitosan gel. The release rate of gentamicin was monitored photometrically. This ZnO/gentamicin–chitosan gel proved great antimicrobial properties, inhibiting Staphylococcus aureus and Pseudomonas aeruginosa growth in both planktonic and surface-attached conditions. The results indicate that the obtained composite can be used in cutaneous healing for developing improved wound dressings, which combine the antibacterial activity of all three components with the controlled release of the antibiotic. This wound dressing maintains a moist environment at the wound interface, providing a cooling sensation and soothing effect, while slowly releasing the antibiotic. The system is fully scalable to any other soluble drug, as the entire solution remains trapped in the ZnO–chitosan gel.     

New silica nanostructure for the improved delivery of topical antibiotics used in the treatment of staphylococcal cutaneous infections

In this paper, we report the synthesis, characterization (FT-IR, XRD, BET, HR-TEM) and bioevaluation of a novel γ-aminobutiric acid/silica (noted GABA-SiO₂ or γ-SiO₂) hybrid nanostructure, for the improved release of topical antibiotics, used in the treatment of Staphylococcus aureus infections. GABA-SiO₂ showed IR bands which were assigned to Si–O–Si (stretch mode). The XRD pattern showed a broad peak in the range of 18–30° (2θ), indicating an amorphous structure. Based on the BET analysis, estimations about surface area (438.14 m²/g) and pore diameters (4.76 nm) were done. TEM observation reveals that the prepared structure presented homogeneity and an average size of particles not exceeding 10 nm. The prepared nanostructure has significantly improved the anti-staphylococcal activity of bacitracin and kanamycin sulfate, as demonstrated by the drastic decrease of the minimal inhibitory concentration of the respective antibiotics loaded in the GABA-SiO₂ nanostructure. These results, correlated with the high biocompatibility of this porous structure, are highlighting the possibility of using this carrier for the local delivery of the antimicrobial substances in lower active doses, thus reducing their cytotoxicity and side-effects.     

Zinc and nociception: a pharmacological approach

In the last decade, neurophysiological research regarding nociceptive mediation seems to suggest a possible new approach in pain management--zinc applicability. Immunohistochemical studies prove that zinc can be found in central nervous system, inside structures active in nociception. Zinc stabilizes primary afferent C fibers, nervous fibers involved in nociception. However, this phenomenon is probably only true for extreme zinc concentrations--excess or deficit. Electrophysiological studies indicate that zinc inhibits NMDA receptors, while potentiating the activity of non-NMDA receptors. All these are arguments supporting the existence of a role of endogenous zinc regarding pain transmission.     

MR imaging findings in autoimmune hepatitis: correlation with clinical staging

PURPOSE: To retrospectively evaluate the morphologic and enhancement features of the liver on magnetic resonance (MR) images obtained in patients with autoimmune hepatitis (AIH) and to determine if there is a correlation between MR imaging findings and severity of clinical disease as measured with the Mayo end-stage liver disease (MELD) score. MATERIALS AND METHODS: This study was compliant with the Health Insurance Portability and Accountability Act and approved by the institutional review board. The need for informed consent was waived. Thirty-two patients (29 female and three male patients; mean age, 44 years; age range, 14-69 years) undergoing treatment for AIH underwent unenhanced and gadolinium-enhanced MR imaging. Two radiologists reviewed all cases independently to determine the presence of patchy or heterogeneous liver enhancement, biliary duct changes, lymphadenopathy, and findings of portal hypertension. Fibrosis was graded as mild, moderate, or severe reticular (corresponding to a grading scale of 1-3) or as confluent. Agreement between radiologists was assessed by using kappa coefficients. Mean MELD scores were compared across fibrosis categories by using the Kruskal-Wallis analysis of variance. RESULTS: Of the 32 patients, two (6%) had no imaging findings of cirrhosis. Thirty patients (94%) had reticular fibrosis with a mean grade of 1.8. Six patients had confluent fibrosis, and all six had associated reticular fibrosis. Mild intrahepatic biliary duct dilatation involving the right and left lobes was observed in four patients (12%). Lymphadenopathy was observed in 12% of patients. None of the patients had hepatocellular carcinoma. There was no significant overall association between fibrosis grade and MELD score (P = .36). CONCLUSION: Although fibrosis is a common feature in AIH and is often moderate to severe, no significant correlation between fibrosis grade and MELD score was found.     

Population aging. Current issues

The aging process of the population, obviously in developed countries, involves many socio-economic and political changes. This demographic trend is due to the decreasing of birth rate and fertility rate on one hand, and, on the other hand, to the decrease of crude mortality and infant mortality rate. These mean that the rising proportion of the old people is greater cause of concern, because most of these people require considerable support, frequently in institutions, and often at public expense. Taking demographic data and trends as the starting point, the society has to focus on social protection and health policies in order to improve the quality of life for the elderly.     

Infantile spasms and West syndrome

West syndrome, an epileptic encephalopathy of infancy and early childhood with variable etiology, consist of the triad of infantile spasms, arrest or regress of psychomotor development and specific EEG pattern of hypsarrhythmia. Infantile spasms occur within the first year of life. West syndrome has proved to be resistant to treatment, although VPA and benzodiazepines have been shown to be helpful. Then is general agreement that ACTH or oral corticosteroids remain the treatment of choice, especially in idiopathic cases, which have a better prognosis.     

Synthesis of chitosan microspheres containing pendant cyclodextrin moieties and their interaction with biological active molecules

A new route to obtain chitosan derivatives containing cyclodextrin moieties as pendant groups was developed. The chitosan microspheres, obtained through crosslinking with glutaraldehyde of an acetic acid solution of chitosan, in an organic suspension medium, were reacted with chloroacyl cyclodextrins in organic basic solvents. The acyl cyclodextrin moieties are linked to the chitosan microspheres through C-N bonds, with the elimination of HCl; higher amounts of acyl cyclodextrin are linked to the microspheres with a smaller crosslinking degree. The chitosan-cyclodextrin conjugates retain higher amounts of bioactive substances (nalidixic acid, piroxicam) or of p-nitrophenol (model substance) than their parent chitosan supports, both by ionic forces and by the formation of inclusion complexes in the cyclodextrin inner cavities. After these preliminary studies, one can appreciate that the cyclodextrin-chitosan conjugates could be used as supports for chromatographic separations or controlled release drug systems.