Epidemiology and outcome of invasive fungal disease in children after hematopoietic cell transplantation or treated for malignancy: Impact of national programme of antifungal prophylaxis

The objective of the study was the analysis of incidence and outcome of invasive fungal disease (IFD) in children treated for malignancy (PHO, paediatric hematology‐oncology) or undergoing hematopoietic cell transplantation (HCT) over a period of six consecutive years in nationwide study. A total number of 5628 patients with newly diagnosed malignancies and 971 patients after HCT (741 allo‐HCT and 230 auto‐HCT) were screened for infectious complications in biennial reports. IFD incidence was lower among PHO patients: 8.8% vs 21.2% (P < .0001) and survival from IFD was better: 94.2% vs 84.1% (P < .0001). Auto‐HCT patients had lower incidence (10.9% vs 24.4%) and lower mortality than allo‐HCT patients. Introduction of national antifungal prophylaxis programme in HCT and acute leukaemia patients decreased incidence of IFD in HCT (from 23.1% to 13.4%) and AML on conventional chemotherapy (from 36% to 23%) but not in ALL patients during chemotherapy. In multivariate analysis, the incidence of IFD was higher in patients after HCT, diagnosed for ALL, AML or NHL, and in patients > 10 years old. Factors contributing to death with infection were as follows: undergoing HCT, diagnosis of acute leukaemia (ALL or AML) and duration of treatment of infection > 21 days. In conclusion, the incidence of IFD in allo‐HCT and in AML patients on chemotherapy has decreased after introduction of national programme of antifungal prophylaxis, while the incidence of IFD in ALL patients on chemotherapy did not change significantly. The outcome of IFD both in PHO and HCT patients has largely improved in comparison with historical international data.     

How the Duration and Mode of Photopolymerization Affect the Mechanical Properties of a Dental Composite Resin

Composite materials are the most common materials in use in modern dentistry. Over the years, the methods of photopolymerization of composite materials have been improved with the use of various devices, such as quartz tungsten halogen lamps (QTHs), light-emitting diode units (LEDs), plasma-arc lamps and argon-ion lasers. This study aimed to compare the mechanical properties of a composite material, depending on the time and mode of photopolymerization. One hundred and forty rectangular specimens (25 × 2 × 2 mm) and forty-two disc-shaped samples (5 mm diameter and 2 mm thickness) were prepared from shade A2 Boston composite resin. Samples were cured using the following seven photopolymerization protocols: four fast-cure modes (full power for 3, 5, 10, and 20 s), two pulse-cure modes (5 and 10 shots of 1 s exposures at full power), and one step-cure mode (soft start with a progressive cycle lasting 9 s). Specimens were subjected to a flexural strength test, Vickers microhardness test, and FTIR spectroscopy test. A 2-factor ANOVA and post-hoc tests were carried out to assess the differences in the flexural strength parameter between the tested groups of samples before and after aging. A mixed-model ANOVA was carried out to assess the differences in the Vickers microhardness parameter between the tested groups of samples before and after aging. The lowest values of flexural strength (p < 0.001) and Vickers microhardness (p < 0.001) were obtained for the 3 s mode for the pre- and post-aging groups. The FTIR mapping tests showed a much more homogeneous chemical structure of the composite after 20 s of continuous irradiation, compared to the sample irradiated for 5 s in the continuous mode. The mode and cure time affects the mechanical properties of the composite resin. Appropriate selection of the cure mode and time ensures better mechanical properties of composite resin. This suggests that the survival of dental restorations within the oral cavity could be extended by using longer photopolymerization durations.     

Iron-Based Metal-Organic Frameworks as a Theranostic Carrier for Local Tuberculosis Therapy

Purpose

The purpose of the study was initial evaluation of applicability of metal organic framework (MOF) Fe-MIL-101-NH₂ as a theranostic carrier of antituberculous drug in terms of its functionality, i.e. drug loading, drug dissolution, magnetic resonance imaging (MRI) contrast and cytotoxic safety.

Methods

Fe-MIL-101-NH₂ was characterized using X-ray powder diffraction, FTIR spectrometry and scanning electron microscopy. The particle size analysis was determined using laser diffraction. Magnetic resonance relaxometry and MRI were carried out on phantoms of the MOF system suspended in polymer solution. Drug dissolution studies were conducted using Franz cells. For MOF cytotoxicity, commercially available fibroblasts L929 were cultured in Eagle’s Minimum Essential Medium supplemented with 10% fetal bovine serum.

Results

MOF particles were loaded with 12% of isoniazid. The particle size (3.37–6.45 μm) depended on the micronization method used. The proposed drug delivery system can also serve as the MRI contrast agent. The drug dissolution showed extended release of isoniazid. MOF particles accumulated in the L929 fibroblast cytoplasmic area, suggesting MOF release the drug inside the cells. The cytotoxicity confirmed safety of MOF system.

Conclusions

The application of MOF for extended release inhalable system proposes the novel strategy for delivery of standard antimycobacterial agents combined with monitoring of their distribution within the lung tissue.

     

Exposure to nonmicrobial N-glycolylneuraminic acid protects farmers' children against airway inflammation and colitis

1. Download high-res image (199KB)
2. Download full-size image

     

<Emphasis Type="Italic">N</Emphasis>-Acetylcysteine and Ceftriaxone as Preconditioning Strategies in Focal Brain Ischemia: Influence on Glutamate Transporters Expression

Glutamate (Glu) plays a key role in excitotoxicity-related injury in cerebral ischemia. In the brain, Glu homeostasis depends on Glu transporters, including the excitatory amino acid transporters and the cysteine/Glu antiporter (xc-). We hypothesized that drugs acting on Glu transporters, such as ceftriaxone (CEF, 200 mg/kg, i.p.) and N-acetylcysteine (NAC, 150 mg/kg, i.p.), administered repeatedly for 5 days before focal cerebral ischemia in rats and induced by a 90-min middle cerebral artery occlusion (MCAO), may induce brain tolerance to ischemia. We compared the effects of these drugs on brain infarct volume, neurological deficits and the mRNA and protein expression of the Glu transporter-1 (GLT-1) and xc- with the effects of ischemic preconditioning and chemical preconditioning using 3-nitropropionic acid. Administration of CEF and NAC significantly reduced infarct size and neurological deficits caused by a 90-min MCAO. These beneficial effects were accompanied by changes in GLT-1 expression caused by a 90-min MCAO at both the mRNA and protein levels in the frontal cortex, hippocampus, and dorsal striatum. Thus, the results of this study suggest that the regulation of GLT-1 and xc- plays a role in the development of cerebral tolerance to ischemia and that this regulation may be a novel approach in the therapy of brain ischemia.     

Metabolically Doping of 3D Diatomaceous Biosilica with Titanium

Diatoms represent, in terms of species number, one of the largest groups of microalgae that have the ability to synthesize phenomenal mineral composites characterized by complex hierarchical structures. Their shells, called frustules, create intricately ornamented structures, reminiscent of the most sophisticated, natural mosaics. Ordinated pore systems perforate siliceous walls of the frustules with diameters ranging from nano to micro-scale, forming openwork three-dimensional silica structures. The use of these features is one of the main challenges in developing new technological solutions. In this study we assess the ability of selected diatom species (Pseudostaurosira trainorii) for metabolic insertion of soluble titanium from the culture medium into the structure of amorphous silica cell walls by its cultivation in laboratory conditions. The study is aimed at obtaining new and strengthening the already existing optical properties of diatomaceous biosilica. The physicochemical properties of the obtained materials have been studied using a series of instrumental methods.     

The principle of nondirectiveness in genetic counseling. Different meanings and various postulates of normative nature

Medicine, Health Care and Philosophy - The article aims at organizing multifaceted discourse on the concept of nondirectiveness in the practice of genetic counseling. The analysis of areas where...     

Analysis of the Microbiome on the Surface of Corroded Titanium Dental Implants in Patients with Periimplantitis and Diode Laser Irradiation as an Aid in the Implant Prosthetic Treatment: An Ex Vivo Study

The paper presents the optimization of diode laser irradiation of corroded dental implants in order to reduce the number of microorganisms associated peri-implantitis. The research included the identification of microorganisms on the surface of removed dental implants in patients with peri-implantitis and the assessment of the biocidal effectiveness of the diode laser against these microorganisms. Laser desorption/mass spectrometry (MALDI-TOF MS) was used to identify microorganisms and metagens were examined by next generation sequencing (NGS). Irradiation was performed with a diode laser with a wavelength of λ = 810, operating mode: 25 W/15.000 Hz/10 μs, average = 3.84 W with the number of repetitions t = 2 × 15 s and t = 3 × 15 s. The structure and surface roughness of the implants were analysed before and after laser irradiation by optical profilometry and optical microscopy with confocal fixation. In total, 16 species of Gram-positive bacteria and 23 species of Gram-negative bacteria were identified on the surface of the implants. A total of 25 species of anaerobic bacteria and 12 species with corrosive potential were detected. After diode laser irradiation, the reduction in bacteria on the implants ranged from 88.85% to 100%, and the reduction in fungi from 87.75% to 96.77%. The reduction in microorganisms in the abutment was greater than in the endosseous fixture. The applied laser doses did not damage, but only cleaned the surface of the titanium implants. After 8 years of embedding, the removed titanium implant showed greater roughness than the 25-year-old implant, which was not exposed to direct influence of the oral cavity environment. The use of a diode laser in an optimised irradiation dose safely reduces the number of microorganisms identified on corroded dental implants in patients with peri-implantitis.     

Design of Sodium Alginate/Gelatin-Based Emulsion Film Fused with Polylactide Microparticles Charged with Plant Extract

This study aimed at designing emulsion films based on sodium alginate, gelatin, and glycerol, and their modification by the addition of lipids (cottonseed oil and beeswax). Film composition with the most promising properties was further modified by the incorporation of polylactide (PLA) microparticles with Calendula officinalis flower extract. PLA microspheres were obtained by the emulsion/solvent evaporation method. The size distribution of oily particles in emulsions was investigated. Mechanical properties, moisture content, UV-Vis spectra, and the color of films were analyzed, while biophysical skin parameters were assessed after their application to the skin. Moreover, the contact angles were measured, and the surface free energy of polymeric films was determined. An investigation of the amount of Calendula officinalis flower extract which can be incorporated into PLA microparticles was performed. The modification of the composition of films significantly influenced their physicochemical properties. The selected active ingredient in the form of plant extract was successfully incorporated into polymeric microparticles that were further added into the developed emulsion film. The condition of the skin after the application of obtained emulsion films improved. The prepared materials, especially containing microparticles with plant extract, can be considered for designing new cosmetic forms, such as cosmetic masks, as well as new topical formulations for pharmaceutical delivery.