Friction and wear behavior of poly(vinyl alcohol)/poly(vinyl pyrrolidone) hydrogels for articular cartilage replacement

Many hydrogels have been proposed as articular cartilage replacements as an alternative to partial or total joint replacements. In the current study, poly(vinyl alcohol)/poly(vinyl pyrrolidone) (PVA/PVP) hydrogels were investigated as potential cartilage replacements by investigating their in vitro wear and friction characteristics in a pin-on-disk setup. A three-factor variable-level experiment was designed to study the wear and friction characteristics of PVA/PVP hydrogels. The three different factors studied were (a) polymer content of PVA/PVP hydrogels, (b) load, and (c) effect of lubricant. Twelve tests were conducted, with each lasting 100,000 cycles against Co-Cr pins. The average coefficient of friction for synovial fluid lubrication was a low 0.035 compared with 0.1 for bovine serum lubrication. Frictional behavior of PVA/PVP hydrogels did not follow Amonton's law of friction. Wear of the hydrogels was quantified by measuring their dry masses before and after the tests. Higher polymer content significantly reduced the wear of hydrogel samples with 15% PVA/PVP samples, showing an average dry polymer loss of 4.74% compared with 6.05% for 10% PVA/PVP samples. A trend change was observed in both the friction and wear characteristics of PVA/PVP hydrogels at 125 N load, suggesting a transition in the lubricating mechanism at the pin-hydrogel interface at the critical 125 N load.     

Were all carbapenemases created equal? Treatment of NDM-producing extensively drug-resistant <Emphasis Type="Italic">Enterobacteriaceae</Emphasis>: a case report and literature review

Purpose

There is currently a paucity of published literature focused on the treatment of infections caused by NDM-producing organisms.

Methods

We describe a case of a bacteraemia caused by an extensively drug-resistant (XDR) New Delhi metallo-β-lactamase (NDM)-producing Serratia marcescens and review the treatment options for XDR NDM-producing Enterobacteriaceae.

Results

Infections caused by New Delhi beta-lactamase (NDM)-producing Enterobacteriaceae are becoming increasingly prevalent worldwide. The presence of the enzyme results in multidrug-resistant and extensively drug-resistant phenotypes which often pose a treatment challenge. Despite this challenge, case reports and series have demonstrated good clinical outcomes with numerous treatment options in comparison to infections due to KPC-producing Enterobacteriaceae.

Conclusions

Further good-quality research focused on the treatment of NDM-producing Enterobacteriaceae is warranted.

     

In vitro effects of H1-antihistamines on histamine and PGD2 release from mast cells of human lung, tonsil, and skin

Mast cells from different anatomic sites differ in cytochemistry and response to various secretory stimuli. We have investigated whether responsiveness to the second-generation H₁-receptor antagonists, which are important first-line drugs for the relief of symptoms in patients with chronic urticaria and allergic rhinoconjunctivitis, also differs according to the site of origin of mast cells. The effects of terfenadine, ketotifen, and cetirizine were therefore examined in relation to the IgE-dependent release of histamine and prostaglandin D₂ (PGD₂) from dispersed human lung, tonsil, and skin mast cells. Terfenadine had a biphasic effect on lung and skin mast cells: at low concentrations, a concentration-dependent inhibition of histamine release from lung and skin mast cells was observed, whereas at higher concentrations the drug stimulated mediator release. Even at a high concentration, terfenadine inhibited mediator release from tonsil mast cells. Ketotifen had low potency as an inhibitor of mediator release from lung and tonsil mast cells. In skin mast cells, no inhibition of mediator release was observed below 1.0 μM, and above that concentration it induced mediator release. Cetirizine, a much less lipophilic drug than the others tested, did not induce mediator release from mast cells even at concentrations up to 100 μM. This drug showed concentration-dependent inhibition of IgE-dependent mediator release from lung and tonsil mast cells only. Our results show that human mast cells are heterogeneous with respect to modulation of mediator release by these H₁-antihistamines. In particular, differences were observed between skin mast cells and those dispersed from lung and tonsils.     

Intrathoracic goitre: A cause of the superior vena cava syndrome

Benign lesions of the mediastinum rarely produce obstruction of the innominate vessels. Two patients with intrathoracic goitre are described who presented with the superior vena cava syndrome. Venography in each case demonstrated the extent of obstruction and degree of collateral circulation. Early recognition of the association of intrathoracic goitre and superior vena caval obstruction may lead to clinical improvement with surgical treatment.