Search Results (10,203)

Objective: Cardiopulmonary bypass (CPB) via the right axillary artery (RAA) has become an alternative perfusion strategy, especially in complex aortic procedures. This study delineates our technique and outcome with direct axillary cannulation utilizing the Seldinger technique, which we adopted as the standard perfusion strategy in the sternum-sparing minimally invasive total coronary revascularization via left anterior thoracotomy (TCRAT) using CPB. Methods: From November 2019 to December 2023, a total of 413 consecutive patients underwent nonemergent isolated coronary artery bypass grafting (CABG) via left anterior minithoracotomy on CPB with peripheral cannulation via the RAA and cardioplegic cardiac arrest, using this technique as a default strategy in the daily routine. All patients had multivessel coronary artery disease. The primary outcome was intraoperative cannulation-related complications (bleeding, revision, ischemia, wound healing complications). The secondary outcome was cannulation-related events during follow-up (blood pressure differences, incidence of brachial plexus injury, clinical signs of circulatory problems of arm and hand, re-interventions). Mean midterm follow-up was 18.7 ± 12.3 [1.1–51.2] months. During follow-up, 16 patients died. Overall, a total of 397 patients (344 male; 67.6 ± 9.7 [32–88]) were included for follow-up (100%). Results: The RAA was successfully cannulated in 100% of patients. A cannula size of 16 Fr was used in 34.6%, 18 Fr in 63.9% and 20 Fr in 1.5% of all patients. There was no intraoperative bleeding complication. In two patients, intraoperative revision of the RAA was required, necessitating a venous patch repair. At follow-up, there were no differences between the systolic and diastolic blood pressure or the pressure gradients between the right and left arm. Transient numbness of the right hand was observed in two patients. Permanent numbness was not observed. No patient needed further intervention or surgical revision of the RAA. Conclusions: The right axillary cannulation is feasible and safe in terms of vascular injury and brachial plexus injury with excellent in-hospital and follow-up outcome. Full article

Pathogen infection in animals and plants is recognized in a relatively similar manner by the interaction of pattern recognition receptors on the host cell surface with pathogen-associated molecular patterns on the pathogen surface. Previous work demonstrates that animal pathogenic bacteria can be recognized by plant receptors and alter transcriptome. In this work, we have hypothesized that exposure to human parasites, Cryptosporidium parvum and Giardia lamblia, would also trigger pathogen response in plants, leading to changes in transcriptome. Detached Arabidopsis leaves were exposed for one hour to heat-inactivated Cryptosporidia or Giardia. The transcriptome profile showed large changes in gene expression with significant overlap between two parasites, including upregulated GO terms “cellular response to chitin”, “response to wounding”, “response to oomycetes”, “defense response to fungus”, “incompatible interaction”, and “activation of innate immune response”, and downregulated GO terms “positive regulation of development”, “cell surface”, “regulation of organ growth”, “wax biosynthetic process”, “leaf and shoot morphogenesis”. Uniquely downregulated GO terms in response to Cryptosporidia were GO terms related to chromatin remodelling, something that was not reported before. To conclude, it appears that while Cryptosporidia or Giardia are not pathogens of Arabidopsis, this plant possesses various mechanisms of recognition of pathogenic components of parasites. Full article

Promoting rapid healing is a concern in skin wound treatment, as the increased pain and the loss of functional ability when wounds become chronic create a complex problem to manage. This scoping review aimed to explore the literature and synthesize existing knowledge on the therapeutic use of CO₂ in treating cutaneous wounds. The literature was selected using previously defined inclusion and exclusion criteria, and 22 articles were selected for data extraction. The most researched type of injury was chronic wounds located on the extremities of the limbs. Carboxytherapy was performed in five different ways: subcutaneous, intradermal, or intralesional injections; in hot water baths with temperatures ranging from 30 to 42 °C; transcutaneous application; intra-abdominal insufflation; and a paste for transcutaneous local application. The main effects of CO₂ therapy described were as follows: improved blood flow and local oxygenation, reduction of the inflammatory process, increased collagen production, and improved clinical aspects of wounds, with faster healing. Carboxytherapy can be considered a good alternative for treating skin wounds, although further studies should be pursued to elucidate its molecular mechanisms and enhance its efficacy. Full article

Diabetic foot syndrome is often associated with inflammation. The aim of this study was to evaluate the impact of improved blood supply on the change in the clinical status and culturable bacteriota of chronic wounds. Patients with diabetic foot and peripheral arterial disease with a Rutherford score of 5 or 6 were included (n = 23). The blood supply to the limb was assessed with laboratory tests and two time-point qualitative cultures using a wound biopsy. The baseline parameters of the blood supply to the limb were Transcutaneous Oxygen Perfusion (TCPO2) of 15.0 mmHg, an Ankle Brachial Index (ABI) of 0.7, and a Toe Brachial Index (TBI) of 0.1, with an average Wound, Infection, Inflammation (WIfI) score of 5.7 (high). The most frequently isolated pathogens were Staphylococcus aureus (26.1%), followed by the Enterobacteriaceae family and Pseudomonas spp. (13.0%, each). Negative cultures were present in 47.8% (n = 11). The control parameters of blood supply improved; TCPO2 was 38.5 mmHg, the ABI was 0.9, and the TBI was 0.3, with a reduction in the average WIfI score to 3.7 (mild), while total colony-forming units (CFUs) increased by 13.5%. No cases of reocclusion or restenosis were observed during the study; however, small amputations were performed in two patients (8.7%). Five (21.7%) ulcers were significantly reduced and two (8.7%) progressed, while a negative culture at follow-up was obtained in five fewer patients than at baseline and nine patients presented growth despite having an initial negative result. Quantitative reduction was obtained in four (17.4%) cases. Pathogen distribution at follow-up resembled baseline findings. Optimizing clinical environments (enhancing blood flow and controlling inflammation) in general over focusing singularly on microbiota composition or revascularization seems to be crucial and arguably outweighed the impact of microbial change alone; in particular, reperfusion may increase the conditions to bacterial growth at the first stage. Full article

The aerial parts (Herba Saniculae) and the underground parts (Radix Saniculae) of Sanicula europaea (sanicle) have been used traditionally in Austrian folk medicine to treat wounds. Interestingly, in the Austrian vernacular, “Radix Saniculae” can also refer to the underground parts of Cardamine enneaphyllos. This ambiguity can lead to mistakes in using these two plants and, importantly, adulterations. The present work aims to shed light on using Radix Saniculae as a wound-healing agent. Thus, the main components in the aerial and the scarcely investigated underground parts of Sanicula europaea were identified and compared to the underground parts of Cardamine enneaphyllos. For this purpose, different analytical techniques were employed: TLC, HPLC-DAD/ELSD, UHPLC-ESI-MS, and GC-MS. The main components in both Sanicula and Cardamine plant extracts were saccharides. Both parts of Sanicula europaea showed similar compositions: hydroxycinnamic acid derivatives and triterpene saponins. In contrast, the underground parts of Cardamine enneaphyllos contain two glucosinolates and their breakdown products. These findings suggest the same wound-healing activity for the underground parts of Sanicula europaea as was already found for its aerial parts. The glucosinolates detected in Cardamine enneaphyllos substantiate its use in wound healing. Nevertheless, the presented analytical methods allow for easy discovery of adulterations. Full article

Cellulose hydrogels derived from agave bagasse were formulated to promote the regeneration of gingival connective tissue in lagomorphs. Three treatment modalities were randomly implanted in the gingival diastema area in 16 rabbits. The general characteristics were analyzed and histopathological studies were carried out at 4, 8, 12, and 16 weeks. A chi-squared test was performed using IBM-SPSS version 25, indicating that cellulose hydrogels implanted in lagomorph’s gingival tissue showed the presence of greater angiogenesis and fibrogenesis at the four evaluation intervals during 16 consecutive weeks. The presence of inflammatory infiltrates had no significant impact. No significant changes were observed in body weight and water and food intake. This suggests that hydrogels contribute to the regeneration and/or repair of oral connective tissue, showing angiogenesis and fibrogenesis in 50 to 100% of rabbits tested with hydrogel cellulose membrane. Regarding angiogenesis, in the specimens where membranes were implanted, its presence predominated in all variants (50%), followed by diffuse angiogenesis (37.5%), and finally the absence of angiogenesis (12.5%). Full article

Clinopodium vulgare L. is a valuable medicinal plant with various beneficial effects on health. In this study, water extracts from the aerial part of the wild and in vitro cultured C. vulgare plants were obtained. The polyphenol, flavonoid content and antioxidant activity of the extracts as well as their antitumor efficiency against a panel of cell lines were analyzed. The ability of C. vulgare to inhibit cancer cell migration and induce apoptosis in the tumor cells was examined by wound healing assay and fluorescence microscopic methods. The effect of the extracts on the cell cycle progression of the tumor cells was analyzed by flow cytometry. The presented results show that the antitumor activity of the extracts from in vitro cultured plants was similar to and even exceeded that of the wild plants. The cell viability and migration assays demonstrate the selective anticancer effect of the extract and significant inhibition of cancer cell proliferation and motility. The fluorescence microscopy and cell cycle analyses indicate that the antitumor activity of the in vitro plant extract was related to both antiproliferative and proapoptotic effects. These results show that C. vulgare plants obtained by in vitro micropropagation and cultivated ex vitro are promising candidates for anticancer drug therapy. Full article

Trifolirhizin is an important flavonoid glycoside reported from the roots of medicinal plants such as Astragalus membranaceus, Sophora tonkinensis, Ononis vaginalis, Euchresta formosana, Sophora Subprostrate, Ononis spinose, and Sophora flavescens. It is considered one of the important constituents responsible for the various medicinal properties of these medicinal plants. Studies have revealed the multiple pharmacological properties of trifolirhizin: anti-inflammatory, antioxidant, antibacterial, anti-ulcerative colitis, antiasthma, hepatoprotective, osteogenic, skin-whitening, wound-healing, and anticancer (against various types of cancers). Mechanistic studies of trifolirhizin showed that it could act on important target genes and pathways such as the NF-κB-MAPK, EGFR-MAPK, AMPK/mTOR, and PI3K/Akt signaling pathways. These pathways are also implicated in various other diseases, suggesting the potential of trifolirhizin in therapeutic applications. Initial pharmacokinetic studies support the therapeutic candidature of trifolirhizin and provide the initial track that may be pursued for its development. Still, a compilation of pharmacological activities and target pathways of trifolirhizin is missing in the literature. This review uniquely compiles the pharmacological properties and mechanistic insights of trifolirhizin, addressing critical gaps in its therapeutic development and proposing strategies for future research. Full article

Background: Medial arterial calcification (MAC), a distinct form of vascular pathology frequently coexisting with peripheral arterial disease (PAD), poses unique challenges in limb salvage among patients with diabetes, chronic kidney disease, and end-stage renal disease. This study examines the incidence of MAC and its impact on limb salvage outcomes over a decade of experience at a tertiary limb salvage center. Methods: A retrospective review of all complex lower extremity (LE) reconstructions using local flap (LF) or free tissue transfer (FTT), performed from July 2011 to September 2022, was conducted. Patients were classified into MAC and No MAC groups based on pedal radiography evaluations using the Ferraresi MAC scoring system. The primary outcomes were major lower extremity amputation (MLEA), the need for postoperative vascular intervention, major adverse limb events (MALE; defined as the composite of any unplanned reoperation, MLEA, or postoperative revascularization attempt), and mortality. Results: During the study period, a total of 430 LE reconstructions were performed with LF or FTT. A total of 323 cases (75.1%) demonstrated no MAC while the remaining 107 (24.9%) demonstrated MAC. The MAC group exhibited significantly higher rates of diabetes, PAD, and renal disease. With a follow-up duration of 17.0 (IQR: 33.9) months, the MAC group demonstrated a significantly higher rate of MLEA (24.3% vs. 13.0%, p = 0.006), postoperative vascular intervention (23.4% vs. 8.7%, p < 0.001), MALE (57.0% vs. 25.7%, p < 0.001), and mortality (28.0% vs. 9.9%, p < 0.001). Multivariate analysis identified MAC as independently predictive of MALE (OR: 1.8, CI: 1.1–3.0, p = 0.033). Conclusion: MAC is prevalent among surgical candidates for limb salvage. Patients with MAC represent a significant medical and reconstructive challenge. Radiographic screening for MAC should be considered in all limb salvage candidates with LE wounds, especially in those with diabetes and kidney disease. Assessing MAC is important for better evaluating risk factors and surgical options so as to optimize outcomes in this challenging population. Full article

Background/Objectives: This study investigates for the first time the use of the prilling technique in combination with solvent evaporation to produce nano- and submicrometric PLGA particles to deliver properly an active pharmaceutical ingredient. Curcumin (CCM), a hydrophobic compound classified under BCS (Biopharmaceutics Classification System) class IV, was selected as the model drug. Methods: Key process parameters, including polymer concentration, solvent type, nozzle size, and surfactant levels, were optimized to obtain stable particles with a narrow size distribution determined by DLS analysis. Results: Particles mean diameter (d₅₀) 316 and 452 nm, depending on drug-loaded cargo as Curcumin-loaded PLGA nanoparticles demonstrated high encapsulation efficiency, assessed via HPLC analysis, stability, and controlled release profiles. In vitro studies revealed a faster release for lower drug loadings (90% release in 6 h) compared to sustained release over 7 days for higher-loaded nanoparticles, attributed to polymer degradation and drug-polymer interactions on the surface of the particles, as confirmed by FTIR analyses. Conclusions: These findings underline the potential of this scalable technique for biomedical applications, offering a versatile platform for designing drug delivery systems with tailored release characteristics. Full article

Our work describes the green synthesis of silver sulfide nanoparticles (Ag₂S NPs) and their formulation into polycaprolactone fibers (PCL), aiming to improve the multifunctional biological performance of PCL membranes as scaffolds. For this purpose, an extract of rosemary (Salvia rosmarinus) was employed as a reducing agent for the Ag₂S NPs, obtaining irregular NPs and clusters of 5–60 nm, with a characteristic SPR absorption at 369 nm. Ag₂S was successfully incorporated into PCL fibers by electrospinning using heparin (HEP) as a stabilizer/biocompatibility agent, obtaining nanostructured fibers with a ca. 500–800 nm diameter. Different amounts of Ag₂S NPs (0.05, 0.5, and 1 wt.%) enhanced the nanostructured membranes’ surface polarity and mechanical performance, with a controlled ion release after 6 days submerged in PBS solution, determined by cyclic voltammetry. As a result, PCL/HEP/Ag₂S scaffolds exhibit high antibacterial performance (80–90%) at early stages of contact (3 h) against E. coli and S. aureus. Also, cytotoxicity analysis demonstrated that the nanostructured membranes are biocompatible and exhibit high fibroblast cell regeneration, which is optimal for their application as scaffolds. To validate the regenerative response of PCL/HEP/Ag₂S scaffolds, controlled wounds were induced in Wistar rats, presenting a favorable healing response by contact with PCL/HEP/Ag₂S 1%, compared with the untreated wound. Our results indicated that nanostructured scaffolds enable the development of novel nanomaterials with multifunctional biological performance. Full article

Opioids are a challenging class of drugs due to their dual role. They alleviate pain, but also pose a risk of dependency, or trigger constipation, particularly in cancer patients, who require the more potent painkillers in more advanced stages of the disease, closely linked to pain resulting from general inflammation, bone metastases, and primary or secondary tumour outgrowth-related nerve damage. Clinicians’ vigilance considering treatment with opioids is necessary, bearing in mind extensive data accumulated over decades that have reported the contribution of opioids to immunosuppression, tumour progression, or impaired tissue regeneration, either following opioid use during surgical tumour resection and post-surgical pain treatment, or as a result of other diseases like diabetes, where chronic wounds healing constitutes a challenge. During last few years, an increasing trend for seeking relationships between opioids and epithelial–mesenchymal transition (EMT) in cancer research can be observed. Transiently lasting EMT is desirable during wound healing, but in cancer, or vital organ fibrogenesis, EMT appears to be an obstacle to overcome, forcing to adjust treatment strategies that would reduce the risk for worsening of the disease outcome and patient prognosis. The same opioid may demonstrate promoting or inhibitory effect on EMT, dependently on various conditions in particular clinical cases. We have summarized current findings on this issue to uncover some rules that govern opioid-mediated EMT induction or repression; however, many aspects still remain to be elucidated. Full article

Linezolid is an oxazolidinone antibiotic and is considered a last-resort treatment option for serious infections caused by problematic Gram-positive pathogens, including vancomycin-resistant enterococci. The present study aimed to explore the linezolid resistance mechanisms and genomic characteristics of two vancomycin-susceptible Enterococcus faecalis isolates from Bulgaria. The strains designated Efs2503-bg (inpatient from Pleven) and Efs966-bg (outpatient from Varna) were recovered from wounds in 2018 and 2023, respectively. Antimicrobial susceptibility testing, whole-genome sequencing, multilocus sequence typing, and phylogenomic analysis based on 332 linezolid-resistant E. faecalis genomes were performed. Efs2503-bg was high-level resistant to linezolid (MIC > 256 mg/L) and displayed the G2576T mutation affecting three of the four 23S rDNA loci. Efs966-bg (MIC = 8 mg/L) carried a plasmid-located optrA determinant surrounded by fexA and ermA. No mutations in the genes encoding for ribosomal proteins L3, L4, and L22 were detected. The isolates belonged to the sequence types ST6 (Efs2503-bg) and ST1102 (Efs966-bg). Phylogenomic analysis revealed that Efs2503-bg and Efs966-bg are genetically distinct, with a difference of 12,051 single-nucleotide polymorphisms. To our knowledge, this is the first report of linezolid-resistant enterococci in Bulgaria. Although the global incidence of linezolid-resistant enterococci is still low, their emergence is alarming and poses a growing clinical threat to public health. Full article

Stem cells are unique, undifferentiated cells that have the ability to both replicate themselves and develop into specialized cell types. This dual capability makes them valuable in the development of regenerative medicine. Current development in stem cell research has widened their application in cell therapy, drug discovery, reproductive cloning in animals, and cell models for various diseases. Although there are substantial studies revealing the treatment of human degenerative diseases using stem cells, this is yet to be explored in livestock animals. Many diseases in livestock species such as mastitis, laminitis, neuromuscular disorders, autoimmune diseases, and some debilitating diseases are not covered completely by the existing drugs and treatment can be improved by using different types of stem cells like embryonic stem cells, adult stem cells, and induced pluripotent stem cells. This review mainly focuses on the use of stem cells for disease treatment in livestock animals. In addition to the diseases mentioned, the potential of stem cells can be helpful in wound healing, skin disease therapy, and treatment of some genetic disorders. This article explores the potential of stem cells from various sources in the therapy of livestock diseases and also their role in the conservation of endangered species as well as disease model preparation. Moreover, the future perspectives and challenges associated with the application of stem cells in livestock are discussed. Overall, the transformative impact of stem cell research on the livestock sector is comprehensively studied which will help researchers to design future research work on stem cells related to livestock diseases. Full article