id
stringlengths 11
17
| article_id
stringlengths 8
11
| path
stringlengths 11
60
| section_title
stringlengths 1
1.33k
| educational_score
float64 0
5.16
| domain
stringclasses 4
values | document_type
stringclasses 5
values | domain_scores
listlengths 0
3
| document_type_scores
listlengths 0
4
| text
stringlengths 1
110k
| authors
listlengths 0
8.02k
| article_url
stringlengths 3
63
| license_type
stringclasses 1
value | license_url
stringclasses 15
values | language
stringclasses 45
values | language_score
float64 0
1
|
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
PMC11277877_p31
|
PMC11277877
|
sec[2]/sec[0]/p[5]
|
3.1. Transcatheter Edge-to-Edge Repair (TEER) of the Tricuspid Valve
| 4.273438 |
biomedical
|
Study
|
[
0.9287109375,
0.07080078125,
0.0006327629089355469
] |
[
0.869140625,
0.0810546875,
0.0184326171875,
0.031402587890625
] |
PASCAL transcatheter valve repair system. The PASCAL Repair System (Edwards Lifesciences, Irvine, CA, USA) comprises an extension and two clasps that firmly hold onto the TV . The clasps may be handled separately and adjusted until the ultimate equipment is delivered, enabling the gradual leaflet apprehension. The device is inserted using a 22 Fr TF method and was initially developed for the treatment of MR . In 2018 , the first instance of TV implantation utilizing the PASCAL Repair System was documented in a patient suffering from severe/torrential TR. After a 30-day period, the patient’s NYHA class decreased from IV to II, there was a refinement in the 6 min walk test, and an enhanced quality-of-life score. The transthoracic echocardiogram during the follow-up examination showed a decrease in TR to a moderate level. Following the initial case presentation of the PASCAL Repair System for TR, a paper was published detailing the first-in-human compassionate use experience including 28 individuals . The procedural success rate was 86%, with no procedural mortality events. During the 30-day follow-up period, two patients passed away and one patient’s death was attributed to a probable cardiac etiology, while the other patient died owing to a rehospitalization for heart failure. The findings of the one-year follow-up showed a survival rate of 93% and 86% of patients had sustained moderate or less TR. Approximately 90% of the cases exhibited NYHA functional class I or II and shown improvement in the 6 min walk test. The CLASP TR early feasibility trial released the 30-day adverse events in 2021 . The trial had a total of 34 individuals, out of whom 29 underwent implantation of the PASCAL Repair System. After 30 days, there were no deaths related to cardiovascular issues and 85% of the cases saw a decrease in TR of at least one grade, while 70% experienced a decrease of at least two grades .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p32
|
PMC11277877
|
sec[2]/sec[1]/p[0]
|
3.2. Tricuspid Valve Replacement
| 2.677734 |
biomedical
|
Other
|
[
0.9892578125,
0.0088348388671875,
0.002056121826171875
] |
[
0.0207366943359375,
0.962890625,
0.0139617919921875,
0.0024242401123046875
] |
Table 3 summarizes the transcatheter valves that are currently available for implantation in the tricuspid position.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p33
|
PMC11277877
|
sec[2]/sec[1]/p[1]
|
3.2. Tricuspid Valve Replacement
| 4.277344 |
biomedical
|
Study
|
[
0.99560546875,
0.004058837890625,
0.00030422210693359375
] |
[
0.95458984375,
0.0074462890625,
0.03662109375,
0.0012664794921875
] |
EVOQUE tricuspid valve replacement system. The EVOQUE system (Edwards Lifesciences, Irvine, CA, USA) is a bioprosthetic THV made of bovine tissue attached to a self-expanding metal (nickel–titanium) frame for support . It is administered using a 28 Fr TF system and is then secured within the TV . The EVOQUE valve is available in several sizes (52 mm, 48 mm, and 44 mm) to effectively treat a wide spectrum of TV conditions and anatomical alternations. The initial case was documented in 2020 by Fam et al. in a solitary individual, with procedural success, and after 6 months, minimal residual TR, NYHA class I symptomatology, and convalescent quality-of-life . The TRISCEND trial, conducted at many centers, examined the safety and efficacy of this valve in a total of 132 patients . By the 6-month mark, all 43 cases who were present for follow-up witnessed a decrease in TR to mild or below and 89% of them showed an improvement in their NYHA class, reaching class I or II and enhancement in their overall quality of life. The initial success of the EVOQUE valve has led to the initiation of the TRISCEND II study , which randomized more than 700 individuals to either the EVOQUE valve or optimal medical care . The initial results of this trial were presented in the Transcatheter Cardiovascular Therapeutics (TCT) congress in San Francisco in 2023. After 30 days, the primary composite safety endpoint was observed in 27.4% of the 95 cases, lower than the historical safety data following TV surgery (43.8%). The two most often observed adverse events were severe bleeding (10.5%) and requirement for permanent pacing (14.7%), while the rate of cardiovascular death was 3.2%. At 6 months, EVOQUE valve implantation significantly reduced TR, with 98.8% of the individuals having moderate TR or lower, and 78% of the cases no or negligible TR. Ultimately, the enhancements in both quality of life and functional status were much better with EVOQUE, demonstrated by a win ratio of 4.6 .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p34
|
PMC11277877
|
sec[2]/sec[1]/p[2]
|
3.2. Tricuspid Valve Replacement
| 4.097656 |
biomedical
|
Study
|
[
0.98681640625,
0.0126953125,
0.000446319580078125
] |
[
0.90673828125,
0.08642578125,
0.004055023193359375,
0.00293731689453125
] |
GATE system. The GATE system (NaviGate Cardiac Structures, Lake Forest, CA, USA) is a self-expanding THV made of nitinol and is covered with pericardial membrane. It is shaped somewhat like a truncated cone, and it has 12 winglets and 12 graspers to securely attach the device in the TV. The THV can be deployed either by a 42 Fr internal jugular approach or transatrially with a mini thoracotomy . The stent comes in five sizes (36, 40, 44, 48, and 52 mm) to meet various anatomical contingencies and in 2017 it was tested in two patients, both of whom had a successful procedure . Subsequently, 34 patients received the valve, with effective delivery in 85% of them. The procedure was performed using a transatrial route in 25 patients and a transjugular (TJ) approach in 4 individuals. At 30 days follow-up, 17% of the cases needed conversion to surgery, and 24% died in the transatrial group and 33% died in the transjugular group. Due of the unexpectedly high mortality rate, researchers are presently studying a bigger population over a longer period of time .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p35
|
PMC11277877
|
sec[2]/sec[1]/p[3]
|
3.2. Tricuspid Valve Replacement
| 4.058594 |
biomedical
|
Study
|
[
0.9951171875,
0.00452423095703125,
0.0003223419189453125
] |
[
0.8408203125,
0.151123046875,
0.00539398193359375,
0.00287628173828125
] |
INTREPID system. The INTREPID system (Medtronic, Fridley, MN, USA) is an innovative biological, self-expanding stent THV made of nitinol and bovine membrane. It may be inserted through a 35 Fr venous approach, and it is offered in three different exterior frame sizes (43 mm, 46 mm, or 50 mm), accompanied by an interior stent frame of 27 mm. Its main advantage is that it does not rely on leaflet capture for anchoring . Instead, it is secured by deploying a wide, atrial brim on the atrial side of the THV. A study conducted between 2015 and 2017 involved 50 patients with procedural success in 98% with the THV in the MV position. In 2020, a small study documented the use of the device in the TV in three patients, with effective delivery in all of them. A preliminary study is now being conducted in the USA to assess the viability of employing the system for treating TV conditions .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p36
|
PMC11277877
|
sec[2]/sec[1]/p[4]
|
3.2. Tricuspid Valve Replacement
| 4.105469 |
biomedical
|
Study
|
[
0.998046875,
0.0014925003051757812,
0.00021791458129882812
] |
[
0.93798828125,
0.02703857421875,
0.033599853515625,
0.0012044906616210938
] |
LuX-Valve. The LuX-Valve (Jenscare Biotechnology, Zhejiang, China) is another self-expanding, nitinol THV using bovine tissue to form the three leaflets. The valve is equipped with an atrial disc and a septal anchor, which has two graspers for securely attaching the leaflets . The delivery may be performed using a 32 Fr catheter through a small-incision thoracotomy. The device is offered in three sizes of discs, 50 mm, 60 mm, and 70 mm, and two sizes of THVs, 26 mm and 28 mm. The initial use in human subjects was documented in 2020 and encompassed a cohort of 12 individuals . All patients had procedural success; however, there was one mortality event within 30 days after the procedure. Another study, conducted in 35 patients, demonstrated a procedural success rate of 100% and a 30-day mortality rate of 6%. It is worth mentioning that, like the INTREPID system, the LuX-Valve has been effectively inserted into a minimum of five patients who already had pacemaker leads, without causing any interruption .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11277877_p37
|
PMC11277877
|
sec[2]/sec[1]/p[5]
|
3.2. Tricuspid Valve Replacement
| 4.183594 |
biomedical
|
Study
|
[
0.9931640625,
0.0063629150390625,
0.0003075599670410156
] |
[
0.93603515625,
0.0211334228515625,
0.0406494140625,
0.002208709716796875
] |
TricValve—Transcatheter Bicaval Valve System. The TricValve is a TF prosthesis with two self-expanding caval THVs, manufactured in Austria. This THV is designed with an inner bulge to enhance its stability and avoid displacement. Furthermore, it has a skirt to minimize any PVL, and an exposed upper section to provide unobstructed circulation through the vein. The inferior vena cava (IVC) THV has a better radial force to provide stability and a skirt to prevent occlusion of the hepatic vein. THV implantation needs to be initiated at a high position to enhance stability and enable re-adjustment of up to 80% of the implantation. During the installation of the IVC THV, it is important to note that the THV includes a piece that is covered, and its upper part needs to be positioned close to the junction of the RA. Superior vena cava (SVC) sealing is feasible for individuals with a cardiovascular implantable electronic device (CIED) who have leads that are overridden by the THV. This procedure circumvents classic structural limitations of the TV procedures and can be conducted without the need for general anesthesia. The TRICUS EURO trial, which examined 35 patients, reported a procedural success rate of 94% . However, one case of THV migration occurred, but no embolization was observed. At the six-month follow-up, there were no notable disparities in echocardiographic data, with a substantial reduction in loop diuretic dose, Kansas City Cardiomyopathy Questionnaire (KCCQ) score, and NYHA class .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p38
|
PMC11277877
|
sec[2]/sec[2]/p[0]
|
3.3. Tricuspid Valve-in-Valve and Valve-in-Ring
| 3.951172 |
biomedical
|
Review
|
[
0.99658203125,
0.002529144287109375,
0.000789642333984375
] |
[
0.1351318359375,
0.143310546875,
0.7197265625,
0.002044677734375
] |
The durability of surgical TV prosthesis is inferior to that of other prosthetic valves . The decision to utilize mechanical prostheses in the TV when repair is not possible is less frequent compared to left-sided valve treatment approaches, mostly due to the increased likelihood of prostheses thrombosis in the low-pressure environment . Furthermore, the utilization of the bioprosthetic valves might potentially increase the incidence of prostheses failure, characterized by either regurgitation or stenosis. In many patients with many comorbidities, a redo surgical procedure is generally impractical. As a result, the potential for transcatheter valve-in-valve (TVIV) and transcatheter valve-in-ring (TVIR) procedures becomes an appealing choice .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11277877_p39
|
PMC11277877
|
sec[2]/sec[2]/p[1]
|
3.3. Tricuspid Valve-in-Valve and Valve-in-Ring
| 3.988281 |
biomedical
|
Review
|
[
0.9921875,
0.006626129150390625,
0.0010118484497070312
] |
[
0.12261962890625,
0.281494140625,
0.59228515625,
0.0038776397705078125
] |
The TVIV and TVIR techniques have been thoroughly explained in the past . The usual access approach is the TF; however, in certain situations with horizontally positioned valves, access through the jugular vein may be employed. Presently, there are two THVs that are available for utilization: the Melody THV manufactured by Medtronic in Minneapolis, Minnesota, and the SAPIEN 3 THV manufactured by Edwards Lifesciences in Irvine, CA, USA. Furthermore, TVIR is a viable option for patients who already have pacemaker leads, and the process of jailing the device lead is often safe and well-tolerated. Nevertheless, if the patient is pacing-dependent, it is crucial to closely monitor the lead impedance and thresholds right after the device is implanted to guarantee optimal performance . An important consideration regarding the implantation of a transcatheter valve in a tricuspid valve ring, is that open rings are mostly used in this surgery, which do not provide full support for transcatheter valves, thus limiting the number of cases that can be treated by this approach.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999994 |
PMC11277877_p40
|
PMC11277877
|
sec[2]/sec[2]/p[2]
|
3.3. Tricuspid Valve-in-Valve and Valve-in-Ring
| 4.183594 |
biomedical
|
Study
|
[
0.99169921875,
0.00807952880859375,
0.0003452301025390625
] |
[
0.98876953125,
0.006725311279296875,
0.0035247802734375,
0.0009284019470214844
] |
In 2011 was the first successful TVIV utilizing a 23 mm SAPIEN valve and then subsequent case reports and registries have further substantiated the efficacy of this treatment option . The TVIV registry reported a procedural success rate of 99%, among whom 62% were implanted a Melody THV, while the other patients received a SAPIEN THV. After a median follow-up period of around 400 days, 14% of the cases died, with five of them dying within 30 days. Crucially, the results were not influenced by the type of THV that was inserted .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p41
|
PMC11277877
|
sec[2]/sec[3]/p[0]
|
3.4. Critical Appraisal of Transcatheter Tricuspid Valve Therapies
| 3.949219 |
biomedical
|
Review
|
[
0.99365234375,
0.004520416259765625,
0.0016765594482421875
] |
[
0.010833740234375,
0.023956298828125,
0.96435546875,
0.0009250640869140625
] |
Severe TV conditions have significant adverse outcomes and have unclear guidelines for their treatment options, resulting in a high risk of death after surgery. Considering the hesitancy in performing isolated TV surgery, especially after left-sided heart valve surgery, transcatheter treatment appeals as a promising alternative for managing the increased morbidity arising from this condition. Interventionalists now have more percutaneous choices for TV pathologies, with TEER devices accumulating evidence that facilitates mainstream adaptation. Although more data are available for these devices, transcatheter TVR arises as a promising alternative for the future; however, outcome data are currently scarce and additional evaluation is warranted.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p42
|
PMC11277877
|
sec[3]/p[0]
|
4. Transcatheter Pulmonary Valve Therapies
| 3.908203 |
biomedical
|
Other
|
[
0.99462890625,
0.004669189453125,
0.000919342041015625
] |
[
0.2210693359375,
0.7646484375,
0.007251739501953125,
0.0069732666015625
] |
The Melody THV, developed by Medtronic Inc. in the United States, initially appeared by deploying a novel 18 mm THV on a 12-year-old child by Bonhoeffer et al. . This THV consisted of a bovine jugular vein across a platinum stent. This procedure was performed on a 12-year-old child by Bonhoeffer and colleagues. The latest version of this THV consists of the same tissue that has been embroidered into a stent from platinum. It is accessible in two sizes (20 and 22 mm) and it is implanted via the Medtronic Ensemble device, which employs a “balloon-in-balloon” mechanism .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p43
|
PMC11277877
|
sec[3]/p[1]
|
4. Transcatheter Pulmonary Valve Therapies
| 3.986328 |
biomedical
|
Study
|
[
0.99853515625,
0.0012063980102539062,
0.00047516822814941406
] |
[
0.99072265625,
0.006023406982421875,
0.0031032562255859375,
0.00031828880310058594
] |
Prior to its utilization in the USA, European centers already had extensive competence with the Melody THV. Lurz et al. presented a study on 155 patients, achieving a remarkable success rate of 96.7% . They observed an absence from the need for repeat operation of 70% within ~6 years, and noted they further decreased at experienced centers . In 2015, the United States Investigational Device Exemption trial released data on the medium-to-long-term outcomes . They included 171 patients, and 148 of them successfully received THVs. The absence of re-operation cases after 60 months was 76%. The Melody THV obtained a CE mark certification in 2006, while the FDA awarded its full approval in 2015 .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p44
|
PMC11277877
|
sec[3]/p[2]
|
4. Transcatheter Pulmonary Valve Therapies
| 4.132813 |
biomedical
|
Study
|
[
0.998046875,
0.0017337799072265625,
0.0002803802490234375
] |
[
0.99658203125,
0.002147674560546875,
0.0012187957763671875,
0.0002149343490600586
] |
The Edwards Sapien XT THV, developed in USA, received FDA authorization for its use in the PV in 2016. The THV is composed of bovine pericardium attached to a cobalt chromium stent. The stent is equipped with a skirt on its bottom exterior section to reduce PVL . The COMPASSION study included a total of 81 individuals, out of which 69 received this THV. The study found that these patients had a 93.7% rate of not requiring further intervention within a period of 36 months. Furthermore, there are studies being conducted to assess the effectiveness of the Edwards Sapien 3 THV . This THV offers an alternative of a 20 mm size and is considered more suitable for delivering the THV into the RVOT. An analysis of a cohort of 56 patients in Germany indicates that the procedural success rate was great, and there were no instances where further procedures were required over the 24 months follow-up period .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p45
|
PMC11277877
|
sec[3]/p[3]
|
4. Transcatheter Pulmonary Valve Therapies
| 3.859375 |
biomedical
|
Other
|
[
0.990234375,
0.00811004638671875,
0.001895904541015625
] |
[
0.039154052734375,
0.95703125,
0.001186370849609375,
0.0024566650390625
] |
The Venus p valve, manufactured in China, is an innovative THV that incorporates leaflets from porcine pericardium within a self-expanding nitinol stent. The central section has dimensions ranging from 22 to 36 mm and an outline ranging from 20 to 35 mm. The central and distal ends are expanded to create a cylindrical structure, which aids in securing the device in the RVOT and the major pulmonary vessels .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11277877_p46
|
PMC11277877
|
sec[3]/p[4]
|
4. Transcatheter Pulmonary Valve Therapies
| 3.953125 |
biomedical
|
Other
|
[
0.99462890625,
0.00323486328125,
0.00211334228515625
] |
[
0.08721923828125,
0.90966796875,
0.0020847320556640625,
0.0011806488037109375
] |
The Pulsta valve, developed in South Korea, is a distinct THV device that has a comparable principle. The device is equipped with a self-expanding double-strand nitinol body, onto which porcine pericardium leaflets are attached. The THV is offered in diameters ranging from 18 to 28 mm, with intervals of 2 mm. The stent structure has a length of 28–38 mm, which is contingent on the dimensions of the THV. The ends of the structure are flared outwards by an additional 4 mm compared to the outside diameter in order to provide attachment .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p47
|
PMC11277877
|
sec[4]/p[0]
|
5. Special Considerations—Valve-in-Valve Procedures
| 4.070313 |
biomedical
|
Other
|
[
0.97412109375,
0.0244140625,
0.0013675689697265625
] |
[
0.0980224609375,
0.87841796875,
0.0164031982421875,
0.007236480712890625
] |
The implantation of a THV inside a bioprosthetic valve often involves a less intricate process. The danger of coronary constriction is reduced due to the inability to excessively expand the THV and typically pre-stenting is unnecessary. The category of the bioprosthetic device is essential as its inner diameter directly determines the size of the THV. There are several presentations of valve fracture, which involve using a high-pressure balloon to expand the prothesis to a width equal to or slightly greater than its outer diameter . This prevents the occurrence of patient prosthesis mismatch (PPM) in the future. Fracture can be safely conducted in the PV before the deployment of the THV. It is important to evaluate the structure of the coronary arteries while evaluating the possibility for prosthesis fracture .
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11277877_p48
|
PMC11277877
|
sec[5]/p[0]
|
6. Conclusions
| 3.917969 |
biomedical
|
Review
|
[
0.99658203125,
0.002201080322265625,
0.001102447509765625
] |
[
0.0311126708984375,
0.01027679443359375,
0.9580078125,
0.0005865097045898438
] |
Currently, percutaneous valve treatment is a well-established therapy option for individuals with MR and rheumatic MS who are at a high risk for surgery. The most recent demonstration of the advantages of TEER in selected patients has shown its effectiveness in treating secondary MR. Nevertheless, the efficacy of percutaneous repair and replacement for primary MR has not yet been revealed. However, additional research is required to determine if mitral repair and replacement should be rejected or utilized in conjunction, particularly in relation to the compatibility of the prosthesis with the anatomy of every person. The adaptation of an implant is accompanied by significant economical limitations. Consequently, in the future, individuals with uncommon anatomical features may still only have the option of undergoing open surgery.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p49
|
PMC11277877
|
sec[5]/p[1]
|
6. Conclusions
| 3.664063 |
biomedical
|
Other
|
[
0.9970703125,
0.00241851806640625,
0.0007176399230957031
] |
[
0.1160888671875,
0.6142578125,
0.26708984375,
0.002506256103515625
] |
The clinical implementation of percutaneous TV procedures is still in its early stages. The progress of the research has probably been hindered by the absence of acknowledged influence of TR on the clinical presentation and the prognosis. Nevertheless, it now serves as an appealing option for individuals who have isolated secondary TR, as a second option to a potentially hazardous surgical procedure. However, all the necessary stages in creation of a novel THV design still need to be completed for percutaneous TV procedures.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277877_p50
|
PMC11277877
|
sec[5]/p[2]
|
6. Conclusions
| 3.910156 |
biomedical
|
Review
|
[
0.998046875,
0.0013933181762695312,
0.0006203651428222656
] |
[
0.1629638671875,
0.0109710693359375,
0.8251953125,
0.0008249282836914062
] |
Percutaneous PV replacement has had significant advancements in the last ten years and is now a widely used procedure for treating patients with impaired RVOT function. The short- and midterm outcomes are generally favorable, with a low and tolerable incidence of morbidity and mortality. In an ideal scenario, further advancements will lead to the development of more compact and adaptable delivery methods. Given the recent implantation of the present THVs and the limited follow-up, it is imperative to collect future data in order to ascertain the overall durability of these devices and the specific forms of valve failure that may occur. In addition, as many patients have narrower and obstructed passages, even in a developing environment, implementing novel surgical methods to enable greater growth of these tiny and obstructed passages might have substantial therapeutic advantages.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277877_p51
|
PMC11277877
|
sec[5]/p[3]
|
6. Conclusions
| 2.390625 |
biomedical
|
Other
|
[
0.9296875,
0.06256103515625,
0.0079193115234375
] |
[
0.001232147216796875,
0.994140625,
0.002399444580078125,
0.0023441314697265625
] |
Considering the intricate nature of MV, TV, and PV conditions, as well as the growing range of therapeutic options available, it is crucial for the Heart Team to engage in the discussion to ensure that each patient is provided with a suitable treatment based on current scientific data.
|
[
"Nikolaos Ktenopoulos",
"Odysseas Katsaros",
"Anastasios Apostolos",
"Maria Drakopoulou",
"Grigorios Tsigkas",
"Constantinos Tsioufis",
"Periklis Davlouros",
"Konstantinos Toutouzas",
"Antonios Karanasos"
] |
https://doi.org/10.3390/life14070842
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p0
|
PMC11277889
|
sec[0]/p[0]
|
1. Introduction and Background
| 3.941406 |
biomedical
|
Other
|
[
0.57666015625,
0.41796875,
0.0052337646484375
] |
[
0.10211181640625,
0.83056640625,
0.042327880859375,
0.02508544921875
] |
International and local guidelines support early and recurrent anticipatory goals-of-care discussions for patients who are dying or medically unstable, or who face a critical illness or complication . In South Australia, the standardised electronic 7-Step Pathway resuscitation plan ( Additional File S1 in Supplementary Materials ) serves as the primary document for resuscitation planning in all public tertiary centres, including decisions about goals of care and cardiopulmonary resuscitation (CPR). After discussions between a clinician and the patient or their substitute decision-maker, decisions about future care are recorded using a template featuring tick-box options (such as ‘No CPR’, ‘Not for intubation’, or ‘For full resuscitation’) and a free-text box available to document alternative care directives including a palliative approach. Clinicians may consider initiating a resuscitation plan based on triggers including objective clinical deterioration, meeting indicators from the Supportive and Palliative Care Indicators Tool , or the reasonable likelihood of mortality within 12 months. The triggers for implementing a resuscitation plan and the format of the 7-Step resuscitation plan share many characteristics with similar processes in place around the world .
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11277889_p1
|
PMC11277889
|
sec[0]/p[1]
|
1. Introduction and Background
| 3.859375 |
biomedical
|
Other
|
[
0.6865234375,
0.305419921875,
0.00835418701171875
] |
[
0.0105438232421875,
0.9208984375,
0.05755615234375,
0.01114654541015625
] |
Resuscitation plans documented in an electronic medical record provide succinct and readily accessible information about patients’ resuscitation preferences during acute deterioration. The early completion of a resuscitation plan (defined as within 48 h of unplanned hospital admission) offers several benefits. It allows meaningful patient involvement before they become too unwell or confused to participate actively , and removes a potentially emergent decision-making burden for a distressed surrogate . Furthermore, early resuscitation plans reduce the use of unwanted, costly, and burdensome interventions for patients, and reduce the loss of dignity and suffering for the patient and their family at the end of life . For patients who survive to discharge or do not require an Intensive Care Unit (ICU) admission, a resuscitation plan serves as an opportunity to honour patient autonomy, individualise their journey, and minimise harmful or non-beneficial interventions in the future.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p2
|
PMC11277889
|
sec[0]/p[2]
|
1. Introduction and Background
| 3.693359 |
biomedical
|
Study
|
[
0.8818359375,
0.11480712890625,
0.003391265869140625
] |
[
0.96435546875,
0.02880859375,
0.002475738525390625,
0.004207611083984375
] |
At this tertiary centre, replacing stand-alone No-CPR orders with comprehensive plans resulted in a marked increase in documented resuscitation planning. In 2017, documentation was completed in the first 48 h in two-thirds of Australian general medicine inpatients aged over 70 years; double the rates for similar patients admitted in 2011 . Despite this widespread adoption and guidelines recommending early documentation , patient demographics for early resuscitation planning in the Australian inpatient population remain unknown. Additionally, in terms of understanding the disparities in outcomes, particularly ICU admission and mortality rates among patients with early, delayed or no resuscitation plans necessitates further investigation.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p3
|
PMC11277889
|
sec[1]/p[0]
|
2. Objectives
| 4.007813 |
biomedical
|
Study
|
[
0.97509765625,
0.0239105224609375,
0.001132965087890625
] |
[
0.99755859375,
0.0014638900756835938,
0.00046372413635253906,
0.0005679130554199219
] |
The study had two primary objectives. The first is to identify patient groups most likely to have a resuscitation plan or not during their admission using demographic and hospital data. This objective was further refined by comparing characteristics of patients with an early resuscitation plan to those patients for whom documentation was completed after 48 h of admission (referred to as a delayed resuscitation plan). By separately analysing patient characteristics in relation to mortality rates, we aimed to ascertain if any disparities existed between respective groups and if this aligned with the presence or absence of resuscitation planning.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p4
|
PMC11277889
|
sec[1]/p[1]
|
2. Objectives
| 3.375 |
biomedical
|
Study
|
[
0.974609375,
0.0237884521484375,
0.0018262863159179688
] |
[
0.9951171875,
0.0039520263671875,
0.0004074573516845703,
0.0006055831909179688
] |
The second objective was to establish differences in the timing and completion rates of resuscitation plans between those who died or those who were admitted to the ICU. By examining mortality and ICU admission rates across these categories, we sought to provide insights into the impact of timely resuscitation planning on patient outcomes.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p5
|
PMC11277889
|
sec[2]/sec[0]/p[0]
|
3.1. Design
| 3.574219 |
biomedical
|
Study
|
[
0.98974609375,
0.0087738037109375,
0.0015058517456054688
] |
[
0.99853515625,
0.0005741119384765625,
0.00036716461181640625,
0.0003993511199951172
] |
This retrospective study was conducted at a South Australian adult tertiary care centre with approximately 800 inpatient beds. Data were extracted from de-identified electronic patient records for individuals admitted to an inpatient service through the emergency department between 1 January 2021 and 30 June 2021. Elective admissions, day-stay patients (defined as stay <24 h), and mental health admissions were excluded from the study. Four “unknown” or “intersex” patients were also excluded in recruitment.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p6
|
PMC11277889
|
sec[2]/sec[1]/p[0]
|
3.2. Outcome Measures
| 2.466797 |
biomedical
|
Study
|
[
0.68310546875,
0.31103515625,
0.006130218505859375
] |
[
0.9658203125,
0.0249176025390625,
0.0020236968994140625,
0.007366180419921875
] |
Patients were categorised into those with and without a documented resuscitation plan. Patients with a resuscitation plan were then further analysed based on the timing of their documented discussions. The content of individual plans was not analysed. Outcome measures included presence and timing of a completed resuscitation plan, inpatient mortality, and ICU admission.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p7
|
PMC11277889
|
sec[2]/sec[1]/p[1]
|
3.2. Outcome Measures
| 3.695313 |
biomedical
|
Study
|
[
0.93798828125,
0.059234619140625,
0.0029964447021484375
] |
[
0.9970703125,
0.001682281494140625,
0.0005011558532714844,
0.0008878707885742188
] |
Demographic data collected included age, gender, primary spoken language, Aboriginal and/or Torres Strait Islander (hereafter, respectfully, Indigenous Australian) status, admitting clinical unit, and time of admission. Medical and surgical patients were defined based on the admitting specialty service. In instances of intra-hospital transfer, the final admitting unit was used. Age was categorised as less than seventy, or seventy years and over. Timing of admission was analysed as in-hours (08:00–16:59 h) compared with out-of-hours (17:00–07:59 h). English-proficient patients were compared with patients with limited English proficiency (LEP)—non-English speakers, those with an unknown documented primary language, and those with English as a second language. Indigenous Australians were compared to non-Indigenous patients; 569 patients who did not state their heritage were excluded from analysis for this variable only. Gender comparison was between male and female. ICU admission was compared between patients with recorded time spent in the ICU versus zero hours in the ICU; 116 patients with no recorded ICU length of stay were excluded from the analysis of ICU outcomes.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11277889_p8
|
PMC11277889
|
sec[2]/sec[2]/p[0]
|
3.3. Statistical Analysis
| 3.181641 |
biomedical
|
Study
|
[
0.998046875,
0.0004649162292480469,
0.0013580322265625
] |
[
0.99365234375,
0.005985260009765625,
0.0003082752227783203,
0.0001264810562133789
] |
Binary outcomes were used for all demographic data to maximise statistical power. Chi-square tests were employed to compare binary data outcomes, with a p -value < 0.05 indicating probable significance and a p -value < 0.001 indicating statistical significance.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p9
|
PMC11277889
|
sec[2]/sec[3]/p[0]
|
3.4. Ethics
| 1.084961 |
other
|
Other
|
[
0.2381591796875,
0.01152801513671875,
0.75048828125
] |
[
0.00998687744140625,
0.98876953125,
0.0005774497985839844,
0.0008516311645507812
] |
Prior to the commencement of this project, it was reviewed by the Human Research Ethics Committee at Central Adelaide Local Health Network (CALHN) Research Services. This service confirmed that no triggers for ethical review were present. No triggers for ethical review were present and individual consent was not obtained given the retrospective nature of the study.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p10
|
PMC11277889
|
sec[3]/p[0]
|
4. Results
| 2.767578 |
biomedical
|
Study
|
[
0.75048828125,
0.245361328125,
0.00414276123046875
] |
[
0.978515625,
0.01294708251953125,
0.0011148452758789062,
0.007602691650390625
] |
Over the six-month study period, there were a total of 13,718 patients admitted from the emergency department. Resuscitation plans were completed for 5745 (42%) of these patients. Of this group with documented resuscitation plans, 5107 (89%) plans were completed early in admission. Below, a breakdown of all admissions and those who died is provided [ Table 1 ].
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p11
|
PMC11277889
|
sec[3]/p[1]
|
4. Results
| 3.628906 |
biomedical
|
Study
|
[
0.9853515625,
0.012359619140625,
0.00218963623046875
] |
[
0.99755859375,
0.0013751983642578125,
0.000598907470703125,
0.0003407001495361328
] |
Several factors were significantly associated with resuscitation plan completion. These included admission under a medical unit, female gender, age over 70 years, having LEP, and non-Indigenous status . Admissions in-hours was probably a significant factor for increased plan completion rates ( p = 0.003). Early resuscitation plan completion was significantly associated with admission under a medical team , and trends were observed for in-hours admission ( p = 0.026), age over 70 years , female gender ( p = 0.039), and non-Indigenous status . English-speaking proficiency did not affect the timing of completion.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p12
|
PMC11277889
|
sec[3]/sec[0]/p[0]
|
4.1. Mortality Outcomes and Resuscitation Plan Status
| 3.060547 |
biomedical
|
Study
|
[
0.9560546875,
0.04132080078125,
0.0023975372314453125
] |
[
0.99365234375,
0.004123687744140625,
0.0007381439208984375,
0.0013370513916015625
] |
Risk of death was significantly higher for patients admitted under a medical team, aged over 70 years , and those who had LEP . The risk of death was also higher for patients admitted out-of-hours ( p = 0.023) with no significant difference between genders or Indigenous Australian status. Notably, 497 (92%) of the 540 patients who died had a documented resuscitation plan before death.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
PMC11277889_p13
|
PMC11277889
|
sec[3]/sec[0]/p[1]
|
4.1. Mortality Outcomes and Resuscitation Plan Status
| 3.380859 |
biomedical
|
Study
|
[
0.77734375,
0.218505859375,
0.004039764404296875
] |
[
0.98388671875,
0.01042938232421875,
0.0011386871337890625,
0.004337310791015625
] |
Among the 5745 patients with a documented plan, 497 (9%) died during their admission, compared to 43 (0.54%) of 7973 patients without a resuscitation plan . There were 5248 (91%) patients with a resuscitation plan that survived to discharge. Death without a resuscitation plan was more likely for patients admitted under a surgical unit, patients aged less than 70 years, and patients identifying as Indigenous Australian . Strikingly, 33% of Indigenous Australian deaths occurred with no resuscitation plan in place compared to only 6% in non-Indigenous patient deaths.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p14
|
PMC11277889
|
sec[3]/sec[0]/p[2]
|
4.1. Mortality Outcomes and Resuscitation Plan Status
| 2.107422 |
biomedical
|
Study
|
[
0.60546875,
0.381103515625,
0.01325225830078125
] |
[
0.9072265625,
0.07745361328125,
0.0021533966064453125,
0.0133209228515625
] |
Of patients with an early resuscitation plan, 9% died during their admission compared with 14.4% of those with late plans . Among patients who died, those with early resuscitation plans were more likely to be admitted under medicine , be female , or be aged over 70 .
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p15
|
PMC11277889
|
sec[3]/sec[1]/p[0]
|
4.2. ICU Outcomes and Resuscitation Plan Status
| 3.236328 |
biomedical
|
Study
|
[
0.833984375,
0.1622314453125,
0.0038242340087890625
] |
[
0.9873046875,
0.0084686279296875,
0.0013408660888671875,
0.0030727386474609375
] |
A resuscitation plan was not a barrier to ICU admission with 460 (8.2%) patients with a plan passing through the ICU during their hospital stay. ICU admission was only slightly more common in patients without a resuscitation plan (9.7% vs. 8.2%, respectively; p = 0.002). ICU admission was, however, markedly more common in those with a delayed plan versus an early resuscitation plan .
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11277889_p16
|
PMC11277889
|
sec[3]/sec[1]/p[1]
|
4.2. ICU Outcomes and Resuscitation Plan Status
| 2.392578 |
biomedical
|
Study
|
[
0.70849609375,
0.285888671875,
0.005615234375
] |
[
0.939453125,
0.046478271484375,
0.0017709732055664062,
0.01247406005859375
] |
As shown in Table 2 , 1233/13,602 (9%) patients were admitted to the ICU during their inpatient stay, amongst whom 38% had a resuscitation plan completed at any time and 62% did not.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
PMC11277889_p17
|
PMC11277889
|
sec[4]/sec[0]/p[0]
|
5.1. Resuscitation Plan Completion and Mortality
| 4.085938 |
biomedical
|
Study
|
[
0.99658203125,
0.00302886962890625,
0.0004515647888183594
] |
[
0.99853515625,
0.0004096031188964844,
0.0008144378662109375,
0.00019621849060058594
] |
The prevalence of resuscitation plan completion in our study was substantially higher (42%) than the previously reported 11.9% of No-CPR orders in Australian hospitals . Patients more likely to have a resuscitation plan completed included those admitted under medical specialties, in-hours admissions, females, those aged over 70 years, those with LEP, and non-Indigenous Australians. Most resuscitation plans were completed early in admission (89%), and patients admitted under a medical team were more likely than surgical patients to have an early resuscitation plan. There was a trend of early completion in patients admitted in-hours, females, those over the age of 70 years, and non-Indigenous Australians. Language proficiency influenced the presence but not the timing of completion. Apart from the Indigenous Australian and LEP observations, these findings align with research about No-CPR orders from Japan , where, of those patients who survived to discharge, older patients, medical admissions, and females were most likely to have No-CPR orders in their health care record. Mori et al. also demonstrated an association between early resuscitation plans and lower mortality rates when compared to delayed plans.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p18
|
PMC11277889
|
sec[4]/sec[0]/p[1]
|
5.1. Resuscitation Plan Completion and Mortality
| 2.972656 |
clinical
|
Study
|
[
0.355224609375,
0.63916015625,
0.0057830810546875
] |
[
0.87841796875,
0.08685302734375,
0.00469970703125,
0.0298614501953125
] |
Of patients with a resuscitation plan, 9% died during their admission compared with 0.54% of those without a plan in place. This is not a surprising finding given that all clinical deterioration, critical illness, and anticipated death are triggers for proactive resuscitation planning. While the majority of patients who died had a resuscitation plan recorded (92%), 8% did not. These patients and their families were potentially denied the opportunity to participate in end-of-life care planning.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p19
|
PMC11277889
|
sec[4]/sec[0]/p[2]
|
5.1. Resuscitation Plan Completion and Mortality
| 2.970703 |
biomedical
|
Study
|
[
0.9453125,
0.05096435546875,
0.0038471221923828125
] |
[
0.99365234375,
0.004589080810546875,
0.0005955696105957031,
0.0011501312255859375
] |
Patients overlooked for a resuscitation plan before death were more likely to be younger, male, and admitted under surgical specialties, and identify as Indigenous Australian. Patients with these characteristics were also more likely to have a delayed plan. Younger, surgical patients had a significantly lower crude mortality rate [ Table 1 ] than their older, medical counterparts and this may have contributed to their being overlooked for resuscitation plans prior to death; the suggested triggers for initiating a discussion about resuscitation planning may not have been recognised.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p20
|
PMC11277889
|
sec[4]/sec[0]/p[3]
|
5.1. Resuscitation Plan Completion and Mortality
| 2.201172 |
biomedical
|
Study
|
[
0.974609375,
0.02056884765625,
0.004787445068359375
] |
[
0.9501953125,
0.045654296875,
0.0020465850830078125,
0.0021114349365234375
] |
Female patients were more likely to have a resuscitation plan, yet men have a shorter life expectancy and have a greater burden of disease than women . Previous research has identified that men are more reluctant to talk about death or impending death than women , which may partly explain the lower rates of resuscitation plan completion in the male patient cohort.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p21
|
PMC11277889
|
sec[4]/sec[0]/p[4]
|
5.1. Resuscitation Plan Completion and Mortality
| 3.962891 |
biomedical
|
Study
|
[
0.98876953125,
0.0091705322265625,
0.00220489501953125
] |
[
0.99755859375,
0.0011911392211914062,
0.0011653900146484375,
0.0002987384796142578
] |
Indigenous Australians exhibited significantly lower resuscitation plan completion rates and a higher likelihood of dying without a completed plan, despite similar in-hospital mortality rates compared to non-Indigenous Australians ( Table 1 ). They were 5.5 times more likely to die without a resuscitation plan than non-Indigenous patients. There is a paucity of published data about qualitative and quantitative outcomes concerning Indigenous Australians and acute resuscitation planning in tertiary centres. The existing research exploring palliative care indicates lower-quality end-of-life care for Indigenous Australian patients . This is potentially related to practitioners’ discomfort and misunderstanding when discussing death in an unfamiliar cultural context . Moreover, Indigenous Australians experience a markedly decreased life expectancy compared to the general population and access aged-care packages at a younger age . This suggests that triggers for discussions are different for this population, and practitioners may not be comfortable recognising or discussing potential death during admission with Indigenous Australians.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
PMC11277889_p22
|
PMC11277889
|
sec[4]/sec[0]/p[5]
|
5.1. Resuscitation Plan Completion and Mortality
| 3.460938 |
biomedical
|
Study
|
[
0.98095703125,
0.0163726806640625,
0.002727508544921875
] |
[
0.99609375,
0.00286102294921875,
0.0006527900695800781,
0.0004584789276123047
] |
Increased resuscitation plan completion in patients with LEP was unexpected. A previous qualitative study suggested that speaking a language other than English is perceived as a barrier to patients accessing health and services in the context of advance care resuscitation planning . In a study of resuscitation status and end-of-life decision-making in the ICU in the United States, LEP patients had lower rates of No-CPR orders and advance directive completion . As the LEP cohort had a higher mortality, this may partly explain the increased rate of end-of-life care planning documented in this group.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p23
|
PMC11277889
|
sec[4]/sec[0]/p[6]
|
5.1. Resuscitation Plan Completion and Mortality
| 3.009766 |
biomedical
|
Study
|
[
0.91650390625,
0.08001708984375,
0.0032939910888671875
] |
[
0.98388671875,
0.01177215576171875,
0.0017881393432617188,
0.0023822784423828125
] |
Out-of-hours admissions were associated with higher mortality rates, consistent with previous studies ; yet, resuscitation plan completion for patients who died remained similar regardless of admission timing. This suggests that end-of-life care discussions may occur more frequently with patients at a higher risk of deterioration, irrespective of admission time.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p24
|
PMC11277889
|
sec[4]/sec[1]/p[0]
|
5.2. Resuscitation Plan Completion and ICU Admission
| 4.078125 |
biomedical
|
Study
|
[
0.9814453125,
0.0179290771484375,
0.0006113052368164062
] |
[
0.994140625,
0.0028839111328125,
0.0023632049560546875,
0.0007619857788085938
] |
All patients admitted to the ICU warrant a resuscitation discussion within 48 h of their visit to promote patient autonomy and anticipate complications . Despite the universally critical illness in this cohort, the prevalence of resuscitation plans among patients admitted to the ICU was less than the hospital-wide cohort, with 62% of ICU-admitted patients having no plan ( Table 2 ). A US-based cohort study found a similar prevalence of resuscitation orders among patients admitted to the ICU—36.6% in their study . Delayed resuscitation plan completion was associated with a higher likelihood of an ICU admission and increased mortality rates compared to early completion, emphasising the importance of timely end-of-life care planning.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p25
|
PMC11277889
|
sec[4]/sec[1]/p[1]
|
5.2. Resuscitation Plan Completion and ICU Admission
| 3.017578 |
biomedical
|
Study
|
[
0.95703125,
0.040802001953125,
0.0022907257080078125
] |
[
0.986328125,
0.0103302001953125,
0.0014972686767578125,
0.001750946044921875
] |
Most resuscitation plans were completed for patients who neither died nor required ICU admission, indicating the potential use of these plans in lower-acuity settings to guide future care decisions. Recent studies found that the increased use of resuscitation plans was not associated with a significant change in the rates of ICU admissions or invasive interventions , which would support our finding of the significant use of resuscitation plans in a lower-acuity cohort.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p26
|
PMC11277889
|
sec[5]/p[0]
|
6. Limitations
| 3.902344 |
biomedical
|
Study
|
[
0.99853515625,
0.0012226104736328125,
0.0004410743713378906
] |
[
0.9990234375,
0.000408172607421875,
0.0004963874816894531,
0.00014781951904296875
] |
This was a single-centre, retrospective study that may not reflect findings in other Australian or international centres, and limits generalisability. These data cannot be extrapolated to obstetric, paediatric, intersex, mental health, nor elective admissions. COVID-19 was thought not to have a significant impact on this study. During the study period, there were 242 cases of COVID reported across the entire state of South Australia . An analysis of demographic factors did not include potentially relevant variables such as socioeconomic status, rurality, educational background, specific languages, or cultural considerations that could influence resuscitation planning and outcomes. The study relied on electronic health records, which may contain inaccuracies or incomplete information. Resuscitation plans were not analysed for their specific content or quality, which likely has an impact on patient outcomes. Detailed patient preferences and family involvement in decision-making were not considered. Further research into the underlying causes for observed disparities would assist in creating solutions for the vulnerable demographic populations described.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p27
|
PMC11277889
|
sec[6]/p[0]
|
7. Conclusions
| 3.505859 |
clinical
|
Study
|
[
0.32861328125,
0.66845703125,
0.003177642822265625
] |
[
0.70703125,
0.2369384765625,
0.017547607421875,
0.038299560546875
] |
At this centre, CPR and goals-of-care discussions are no longer an exclusively end-of-life occurrence, with 91% of patients with a documented resuscitation plan surviving to hospital discharge. Patients with early resuscitation plans had lower mortality and ICU admission rates compared to those with delayed plans, and only a minority of patients died without a plan in place. Overall, this suggests clinicians incorporate anticipatory planning into the early assessment and admission work-up for non-elective patients, in accordance with local and international guidelines.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
PMC11277889_p28
|
PMC11277889
|
sec[6]/p[1]
|
7. Conclusions
| 3.101563 |
biomedical
|
Study
|
[
0.78125,
0.2132568359375,
0.005367279052734375
] |
[
0.97998046875,
0.014312744140625,
0.0018091201782226562,
0.0037364959716796875
] |
Whilst total resuscitation plan completion rates were high, with most inpatients discussing goals of care before death, these discussions were occurring inconsistently across patient demographics. There were lower rates of early and total resuscitation plan completion for male patients, those under a surgical specialty, and those under 70 years old, and markedly lower rates for Indigenous Australians relative to their respective counterparts. Furthermore, 62% of patients admitted to the ICU did not have a resuscitation plan completed during their admission despite all these patients meeting the trigger criteria due to the severity of their illness.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
PMC11277889_p29
|
PMC11277889
|
sec[6]/p[2]
|
7. Conclusions
| 2.640625 |
biomedical
|
Other
|
[
0.8525390625,
0.10784912109375,
0.039459228515625
] |
[
0.00371551513671875,
0.98681640625,
0.00792694091796875,
0.0013799667358398438
] |
Addressing disparities in resuscitation plan completion rates and ensuring equitable access to end-of-life care discussions are crucial steps towards improving patient-centred care and clinical outcomes. Further efforts are warranted to promote the consistent and timely engagement in resuscitation planning across all patient populations.
|
[
"Sara L. Schaefer",
"Campbell H. Thompson",
"Samuel Gluck",
"Andrew E. C. Booth",
"Colette M. Dignam"
] |
https://doi.org/10.3390/jcm13144098
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p0
|
39057315
|
sec[0]/p[0]
|
1. Introduction
| 3.976563 |
biomedical
|
Review
|
[
0.99609375,
0.00229644775390625,
0.0016546249389648438
] |
[
0.0305328369140625,
0.0836181640625,
0.884765625,
0.0009870529174804688
] |
The fight against infectious disease has remained an ever-evolving challenge in the landscape of healthcare. The ability of pathogens to develop resistance against conventional drug treatments goes through various mechanisms as shown in Figure 1 , and it has decreased the effectiveness of therapeutic interventions. Thus, it is necessary to develop innovative strategies in drug delivery to combat the complexities of microbial resistance. The World Health Organization (WHO) updated the Bacterial Priority Pathogens List (BPPL) 2024, including 15 families of antibiotic-resistant bacteria classified into critical, high, and medium categories for prioritization. The BPPL addresses current challenges and provides essential guidance for policymakers, national health authorities, and others involved in decisions about the R&D of new antibiotics and treatments and investment. Compared with the 2017 list, the dynamic nature of antimicrobial resistance (AMR) necessitated implementations. Leveraging the BPPL as a global tool, customizing the list to fit country and regional contexts, can accommodate variations in pathogen distribution and the AMR burden .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p1
|
39057315
|
sec[0]/p[1]
|
1. Introduction
| 3.4375 |
biomedical
|
Other
|
[
0.99365234375,
0.0041961669921875,
0.002147674560546875
] |
[
0.01215362548828125,
0.6953125,
0.286865234375,
0.0056304931640625
] |
This introductory part will provide a comprehensive overview, emphasizing the significance of anti-infective drug delivery, the challenges linked with traditional methods, and the importance of gentamicin and vancomycin in battling infectious threats .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p2
|
39057315
|
sec[0]/sec[0]/p[0]
|
Overview of the Significance of Anti-Infective Drug Delivery
| 3.9375 |
biomedical
|
Review
|
[
0.9970703125,
0.0020809173583984375,
0.0009198188781738281
] |
[
0.043975830078125,
0.1717529296875,
0.7822265625,
0.0019311904907226562
] |
The delivery of anti-infective drugs represents a critical aspect in developing effective and targeted therapies against microbial infections. The ability of anti-infective drug delivery extends beyond the boundaries of traditional treatments, resulting in a paradigm shift in how we can tackle infectious diseases. Unlike non-infectious diseases, the fluctuating and adaptive nature of pathogens requires a site-specific drug-delivery approach, one that provides optimal drug concentrations at the site of infection while reducing systemic side effects .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p3
|
39057315
|
sec[0]/sec[0]/p[1]
|
Overview of the Significance of Anti-Infective Drug Delivery
| 4.175781 |
biomedical
|
Review
|
[
0.99560546875,
0.0024394989013671875,
0.0020503997802734375
] |
[
0.0157928466796875,
0.005401611328125,
0.97802734375,
0.0005559921264648438
] |
The need to focus on more performing anti-infective drug delivery is based on the fact that gaining therapeutic success goes beyond the mere potency of the drugs themselves. The complex interplay of host–pathogen interactions, the immune system, and medication pharmacokinetics need a personalized and precise approach to administration. An anti-infective drug delivery strategy aims to increase the bioavailability of therapeutic agents, prolong efficacy, and overcome the barriers posed by the blood–brain barrier (BBB) or biofilm formations, which represent the common obstacles to infectious disease treatment . Thus, to overcome the global surge in antibiotic resistance and the drawback of systemic administration’s inability to maintain optimal drug concentrations at the infection site, it is necessary to exploit different delivery strategies, such as targeted and/or localized drug delivery. In this context, the strategic use of nano drug-delivery platforms enables targeted drug delivery, minimizing the risk of resistance development and maximizing the therapeutic impact. Wide literature is available on this topic because nowadays it is a hot topic for health and healthcare management .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p4
|
39057315
|
sec[0]/sec[0]/p[2]
|
Overview of the Significance of Anti-Infective Drug Delivery
| 4.0625 |
biomedical
|
Review
|
[
0.99072265625,
0.00567626953125,
0.0033702850341796875
] |
[
0.00382232666015625,
0.0027217864990234375,
0.99267578125,
0.0007371902465820312
] |
The goal of this review is to provide insight into the research papers published on innovative nanosized drug delivery systems based on gentamycin and vancomycin and to discuss the opportunity of their repurposing through nano drug delivery system formulations. These two antibiotic drugs have been selected because (i) gentamicin is the first-line drug used to treat suspected or confirmed infections caused by Gram-negative bacteria and (ii) vancomycin is an example of an antibiotic drug used to treat serious Gram-positive bacterial infections.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p5
|
39057315
|
sec[1]/p[0]
|
2. Challenges Associated with Infection Therapies Based on Traditional Drug Formulations
| 3.886719 |
biomedical
|
Review
|
[
0.9990234375,
0.0009198188781738281,
0.0002980232238769531
] |
[
0.31787109375,
0.109619140625,
0.57080078125,
0.0016984939575195312
] |
Traditional drug formulations, while useful in many therapeutic areas, present significant obstacles when applied to anti-infective medicines. Antibiotics used systemically often result in insufficient drug concentrations at the infection site, necessitating greater doses, which can contribute to systemic toxicity. Furthermore, variability in patient responses, driven by factors, such as the immunological status and comorbidities, hampers the predictability of therapy outcomes .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p6
|
39057315
|
sec[1]/p[1]
|
2. Challenges Associated with Infection Therapies Based on Traditional Drug Formulations
| 4.144531 |
biomedical
|
Review
|
[
0.998046875,
0.0012540817260742188,
0.0007171630859375
] |
[
0.148681640625,
0.09136962890625,
0.75830078125,
0.00179290771484375
] |
As you look at the variety of infections, each of which presents distinct obstacles in terms of drug delivery, the need for creative new and more performing strategies becomes necessary. For example, treating biofilm-associated conditions is challenging due to the protective shield provided by biofilm matrices. Microbial biofilms are complex microbial communities encased in extracellular polymeric substances (EPSs) that confer adaptive resistance and physical protection to the cells within. Biofilms can be composed of a single microorganism or a mixture of bacteria, fungi, archaea, protozoa, and yeasts. The three-dimensional structure of a biofilm encompasses channels that control the release of gases and nutrients. Biofilms can be up to 5000 times more tolerant to antibiotics than planktonic bacterial cells and are often associated with chronic infections. Since biofilms are rarely completely eliminated, even after prolonged treatment with antibiotics, they can recur after a period of clinical quiescence and present characteristics of greater resistance to traditional therapies.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p7
|
39057315
|
sec[1]/p[2]
|
2. Challenges Associated with Infection Therapies Based on Traditional Drug Formulations
| 3.974609 |
biomedical
|
Study
|
[
0.99951171875,
0.00044155120849609375,
0.00017845630645751953
] |
[
0.73974609375,
0.06201171875,
0.1971435546875,
0.0012874603271484375
] |
One of the most frequent conditions is the medical device-related biofilm that is rising as an infection issue due to the widespread use of medical devices implanted in the human body (i.e., prosthesis). Free-floating bacterial cells can aggregate to form biofilms on the implanted medical device surface, and this poses a severe threat to the life and health of patients. Device-associated infections usually occur during treatment, where some microorganisms originate from the host. The pathogenesis of medical-device-associated infections is related to microorganisms in complex communities that adhere to and grow on device surfaces forming a biological container. Medical device-related biofilms can consist of single or multiple species, depending primarily on the type of device and the time it is left in the patient’s body.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p8
|
39057315
|
sec[1]/p[3]
|
2. Challenges Associated with Infection Therapies Based on Traditional Drug Formulations
| 4.023438 |
biomedical
|
Study
|
[
0.99951171875,
0.00040602684020996094,
0.00025343894958496094
] |
[
0.69189453125,
0.05657958984375,
0.250732421875,
0.0009675025939941406
] |
Intracellular pathogens, such as Mycobacterium tuberculosis , Salmonella spp., and Francisella tularensis , are especially challenging to be eradicated since they invade host cells and survive inside them. This infecting behavior protects the intracellular pathogens from both antibiotics and the host immune systems, making them extremely recalcitrant to being completely eradicated. Moreover, the infected cells can act as “Trojan horses”, delivering the bacteria to noninfected tissues, and this mechanism contributes to treatment failure and recurring infections.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p9
|
39057315
|
sec[1]/p[4]
|
2. Challenges Associated with Infection Therapies Based on Traditional Drug Formulations
| 4.140625 |
biomedical
|
Review
|
[
0.99609375,
0.00226593017578125,
0.0015783309936523438
] |
[
0.034881591796875,
0.005603790283203125,
0.958984375,
0.0006189346313476562
] |
These challenges highlight the demand for innovative therapeutic delivery techniques able to cross cellular barriers and reach the infection’s hidden reserves . Nanoparticle-based techniques provide a varied and adaptable response to these issues. Nanoparticles’ unique physicochemical features, such as size, surface charge, and biodegradability, can be used to optimize drug delivery for certain illnesses. These platforms enable the encapsulation of anti-infective drugs, preventing degradation, facilitating controlled release, and increasing bioavailability at the target site . Innovation in drug administration also addresses the essential issue of patient therapeutic adherence, which is a major concern in infectious disease management. Traditional oral antibiotic regimens frequently require strict adherence to prescribed schedules, which can be difficult for patients, especially in resource-limited settings. Nanoparticle-based therapy, with the possibility for extended-release and a reduced dose frequency, provides a more patient-friendly option, potentially enhancing treatment results and lowering the risk of resistance through improved adherence due to less frequent dosing, which makes treatment easier to follow .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39057315_p10
|
39057315
|
sec[2]/p[0]
|
3. Gentamicin and Vancomycin
| 3.630859 |
biomedical
|
Other
|
[
0.9970703125,
0.0020809173583984375,
0.0007495880126953125
] |
[
0.029510498046875,
0.5703125,
0.39697265625,
0.0034942626953125
] |
Antibiotics represent a crucial weapon in the constant battle against bacterial infections. Among these, gentamicin and vancomycin occupy a prominent position, thanks to their unique properties and role in fighting against various pathogens. However, due to the growing incidence of antibiotic resistance, their effectiveness is exposed to serious risks, resulting in some cases being ineffective in eradicating infections.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p11
|
39057315
|
sec[2]/sec[0]/p[0]
|
3.1. Gentamicin
| 4.542969 |
biomedical
|
Study
|
[
0.9990234375,
0.0005130767822265625,
0.000232696533203125
] |
[
0.89013671875,
0.014404296875,
0.093505859375,
0.0016918182373046875
] |
Gentamicin is a member of the aminoglycoside class of antibiotics. It was isolated in 1963 by Weinstein and colleagues from the soil fungus Micromonospora purpura (of the Actinomycete group). It was introduced in the USA in 1969. It is a “complex” of gentamicin’s C 1 , C 1a , and C 2 and also gentamicin A, which differs from the other members of the complex but is similar to kanamycin C. Figure 2 a shows the gentamicin C sulfate chemical structure as reported in the European Pharmacopeia. The different gentamicin conformers are basically due to diverse R1, R2, and R3 substitutions. The two amino sugars joined in a glycosidic linkage to a hexose nucleus (2-deoxystreptamine) make gentamicin an aminoglycoside aminocyclitol. It is a highly water-soluble polar cation at pH 6–8, while it is moderately soluble in ethanol, methanol, and acetone and insoluble in benzene and halogenated hydrocarbons. It melts with decomposition in the range of 200–250 °C. Gentamicin antibiotic activity is inhibited by acid pH and divalent cations.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p12
|
39057315
|
sec[2]/sec[0]/p[1]
|
3.1. Gentamicin
| 4.035156 |
biomedical
|
Other
|
[
0.99755859375,
0.0018596649169921875,
0.0003654956817626953
] |
[
0.14599609375,
0.82373046875,
0.026611328125,
0.003520965576171875
] |
Gentamicin is effective against both Gram-positive and Gram-negative organisms and particularly useful for the treatment of severe Gram-negative infections. It works by irreversibly inhibiting the protein synthesis essential for bacterial cell survival. Gentamycin specifically binds to the 16S ribosomal RNA aminoacyl site of the 30S ribosomal subunit, which is responsible for protein translation . This binding interferes with the formation of peptide bonds, leading to non-functional and incomplete protein synthesis, ultimately killing the bacteria .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p13
|
39057315
|
sec[2]/sec[0]/p[2]
|
3.1. Gentamicin
| 4.226563 |
biomedical
|
Review
|
[
0.9912109375,
0.007904052734375,
0.0008864402770996094
] |
[
0.08685302734375,
0.2247314453125,
0.6806640625,
0.00786590576171875
] |
The primary application of gentamycin involves treating serious infections caused by Gram-negative bacteria, such as Pseudomonas aeruginosa , Klebsiella pneumoniae , and Escherichia coli . It is often employed as a last-line therapy against multidrug-resistant bacteria because of its broad-spectrum activity. Gentamycin is mostly administered intravenously or intramuscularly, with the dosage and duration tailored to the specific infection and patient profile . For example, in bacterial Peritonitis , gentamicin is used for the short-term prevention and treatment of soft tissue infection associated with abdominoperineal resections or operations on the small or large bowel . The usual adult dose for systemic infections is 1 mg/kg IM or IV infusion every 8 h. Also, in Pseudomonas aeruginosa infections, gentamycin is effective against these severe Gram-negative infections. The usual adult dose for life-threatening infections is an initial dose of 5 mg/kg IM or IV infusion per day, given in divided doses three to four times a day . The peak serum concentrations of gentamicin are reached after 30 to 90 min of administration via the parenteral route. The molecule is polar and water soluble, and thus, its distribution in the central nervous system and general cells is low, while the eight cranial nerves (vestibular area of hear) and kidneys are its target organs.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39057315_p14
|
39057315
|
sec[2]/sec[0]/p[3]
|
3.1. Gentamicin
| 4.164063 |
biomedical
|
Study
|
[
0.9990234375,
0.0009546279907226562,
0.00015461444854736328
] |
[
0.87158203125,
0.0933837890625,
0.0325927734375,
0.0023403167724609375
] |
As far as renal toxicity is concerned, it should be mentioned that most gentamicin is excreted unmetabolized via glomerular filtration, which enables a urinary concentration, in the renal cortex, almost 100-fold higher than the serum. This mechanism makes the kidney one of the target organs of the drug, and, due to the extremely high concentration reached in kidneys, reversible renal damage can develop in terms of mild proteinuria and a reduction in the glomerular filtration rate. Toxic effects can also develop in the vestibular area, leading to deafness. The damage to the vestibular portion of the eighth cranial nerve appears to be greater than that to the cochlear portion. This often appears with high-pitched tinnitus. Ototoxicity is more frequent with long-term gentamicin therapy.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p15
|
39057315
|
sec[2]/sec[0]/p[4]
|
3.1. Gentamicin
| 4.234375 |
biomedical
|
Study
|
[
0.99951171875,
0.00039196014404296875,
0.000141143798828125
] |
[
0.95654296875,
0.0025501251220703125,
0.040313720703125,
0.0004057884216308594
] |
The co-administration of gentamicin together with other antibacterials, such as beta-lactams, for example carbenicillin, shows a synergistic effect to treat infections caused by Pseudomonas aeruginosa . The synergistic activity is not only important for the treatment of complex infections but can also contribute to dose optimization and reduced adverse effects. Gentamicin is eliminated mainly via renal excretion with a mean half-life of 75 min after intravenous administration and 104 min after oral administration. Because of the gentamicin renal excretion prevalence, a low rate of creatinine clearance (renal impairment) is associated with a longer gentamicin half-life. Some pathologic conditions, such as fever, anemia, and severe burns, may result in a transient shorter half-life and lower gentamicin serum concentrations. Since gentamicin is distributed in extracellular fluids, a change in the body fluid balance and increased metabolism rate caused by these pathological states can affect gentamicin serum levels and the half-life.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p16
|
39057315
|
sec[2]/sec[0]/p[5]
|
3.1. Gentamicin
| 2.431641 |
biomedical
|
Other
|
[
0.99658203125,
0.0009121894836425781,
0.002719879150390625
] |
[
0.107421875,
0.8876953125,
0.0029048919677734375,
0.0018205642700195312
] |
Some substances, such as chondroitin sulfate, may decrease the excretion rate of gentamicin raising its serum level .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p17
|
39057315
|
sec[2]/sec[0]/p[6]
|
3.1. Gentamicin
| 3.951172 |
biomedical
|
Study
|
[
0.99951171875,
0.0003314018249511719,
0.00016760826110839844
] |
[
0.82666015625,
0.1558837890625,
0.0164337158203125,
0.0010547637939453125
] |
Bacteria can develop resistance to gentamicin through various mechanisms, such as enzymatic modification of the drug, mutations in the ribosomal binding site, and efflux pumps that expel the antibiotic, as depicted in Figure 1 . This resistance primarily concerns Gram-negative bacteria, such as Pseudomonas aeruginosa , where multidrug resistance is increasingly prevalent .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p18
|
39057315
|
sec[2]/sec[1]/p[0]
|
3.2. Vancomycin
| 4.582031 |
biomedical
|
Study
|
[
0.9990234375,
0.0006384849548339844,
0.00023031234741210938
] |
[
0.82177734375,
0.0146636962890625,
0.1610107421875,
0.00237274169921875
] |
Vancomycin was isolated in 1956 from Amycolatopsis orientalis (also known as Streptomyces orientalis , Nocardia orientalis ). Vancomycin is stable at a pH range of 3–5 and usually stored at 2–8 °C. However, its stability can be dependent on factors, such as the temperature, concentration, and pH . It belongs to the glycopeptide antibiotic class; its structure consists of a seven-membered peptide chain forming a tricyclic ring system to which the disaccharide formed by vancosamine and glucose is linked . The N -terminal amino acid leucine is critical for vancomycin’s antibacterial activity, which is known for its effectiveness against Gram-positive bacteria, particularly methicillin-resistant Staphylococcus aureus (MRSA). It particularly inhibits cell wall synthesis in bacterial cells. Vancomycin’s mechanism of action resides in its binding to the D-alanyl-D-alanine residues, the building blocks of the peptidoglycan layer, preventing the formation of cross-links essential for cell wall integrity. This weakened cell wall leads to bacterial death or lysis .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p19
|
39057315
|
sec[2]/sec[1]/p[1]
|
3.2. Vancomycin
| 4.089844 |
biomedical
|
Other
|
[
0.9912109375,
0.0084228515625,
0.0004992485046386719
] |
[
0.114013671875,
0.62841796875,
0.2481689453125,
0.009185791015625
] |
Vancomycin is a critical lifeline for patients with infections caused by resistant Gram-positive bacteria, including MRSA and Vancomycin-resistant Enterococcus (VRE). It is often used as a last resort where other antibiotics have failed. It is also used for the treatment of Clostridium difficile-associated diarrhea and enterocolitis caused by Staphylococcus aureus , including methicillin-resistant strains. Vancomycin is generally administered intravenously, and because its oral absorption is poor, it is orally administered only to treat intestine infections. It is eliminated in 24 h mainly through kidney excretion with a bi-phasic elimination half-life, with the initial half-life being relatively quick and a terminal half-life of 4 to 6 h in healthy adults with a normal renal function. The elimination half-life is significantly prolonged in patients with renal dysfunction. The dosage and therapy duration should be repeatedly monitored due to potential kidney toxicity .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p20
|
39057315
|
sec[2]/sec[1]/p[2]
|
3.2. Vancomycin
| 3.550781 |
biomedical
|
Other
|
[
0.9990234375,
0.0006284713745117188,
0.0004944801330566406
] |
[
0.1595458984375,
0.81982421875,
0.019012451171875,
0.0017080307006835938
] |
Vancomycin resistance is comparatively less common as compared to other antibiotics; still, the cases of MRSA and VRE infections are gradually increasing. This creates a significant threat, as treatment options become limited for such infections. The mechanisms of vancomycin resistance include modification of the cell wall target and acquisition of alternative cell wall synthesis pathways .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p21
|
39057315
|
sec[2]/sec[2]/p[0]
|
3.3. Beyond Resistance: Other Concerns and Strategies for Sustainable Use
| 3.994141 |
biomedical
|
Review
|
[
0.9912109375,
0.00734710693359375,
0.0016689300537109375
] |
[
0.01540374755859375,
0.15234375,
0.82958984375,
0.0027561187744140625
] |
Both gentamicin and vancomycin show a limited spectrum. Gentamicin primarily targets Gram-negative bacteria, while vancomycin focuses on Gram-positive pathogens. This limitation requires the use of additional antibiotics to cover other bacterial strains in mixed infections . Strategies for the sustainable use of these antibiotics and in general for improving antibiotic therapy can be listed. First of all, the judicious use of antibiotic drugs and their utilization only when necessary and for the shortest effective duration is recommended to minimize selective pressure for resistant bacteria. Developing new antibiotics, particularly those targeting resistant bacteria, or combining multiple therapies, is critical to maintain a robust strategy against evolving pathogens and enhance effectiveness to delay the emergence of resistance. Moreover, rapid and accurate diagnostic tools to identify the specific bacterial pathogen and its resistance profile are significant for deciding on the appropriate antibiotic therapy to act promptly on the infection.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39057315_p22
|
39057315
|
sec[2]/sec[2]/p[1]
|
3.3. Beyond Resistance: Other Concerns and Strategies for Sustainable Use
| 3.972656 |
biomedical
|
Review
|
[
0.98388671875,
0.0088043212890625,
0.00714111328125
] |
[
0.0019893646240234375,
0.004756927490234375,
0.9921875,
0.0008893013000488281
] |
Vancomycin and gentamicin are an example of a perfect combination for a dual approach in anti-infective therapy due to their complementary modes of action. The goal is to establish a synergistic platform that addresses a wide range of bacterial illnesses, decreasing the danger of resistance development and maximizing therapeutic outcomes by combining their capabilities within nanodrug delivery systems . The importance of the anti-infective drug delivery strategy, highlighted by the difficulties associated with conventional techniques, and the indispensable function of drugs, such as vancomycin and gentamicin, paves the way for an extensive investigation of nanoparticle-based strategies in the sections that follow in this review.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p23
|
39057315
|
sec[3]/p[0]
|
4. Rationale for Nanoparticle-Based Drug Delivery
| 3.582031 |
biomedical
|
Study
|
[
0.99951171875,
0.00017189979553222656,
0.0005283355712890625
] |
[
0.853515625,
0.0256500244140625,
0.12030029296875,
0.0004711151123046875
] |
The combination of nanoparticles with antibiotics, either through encapsulation or conjugation, has been thoroughly studied, and still it is because nanosized drug delivery systems offer considerable advantages over traditional drug formulations. Different types of nanosized drug delivery systems have been reported in the literature as carriers for antibiotics. As shown in Figure 4 , they have various morphologies, also depending on their composition.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p24
|
39057315
|
sec[3]/p[1]
|
4. Rationale for Nanoparticle-Based Drug Delivery
| 3.847656 |
biomedical
|
Review
|
[
0.998046875,
0.0004200935363769531,
0.0013799667358398438
] |
[
0.11248779296875,
0.386474609375,
0.5,
0.0009450912475585938
] |
The Web of Sciences (WOS) reports 16,527 papers published on this topic up to today . In general, among the advantages of nanoparticulate carriers, the following should be mentioned: (i) the ability to offer controlled and prolonged drug release, allowing the drug to remain in the therapeutic window in the body for a longer time, improving therapeutic effectiveness while also reducing the frequency of drug administration, thus increasing patient compliance ; (ii) the possibility of achieving target delivery through nanoparticle engineering with ligands on its surface, which can specifically bind to receptors on target cells. This increases treatment efficacy by ensuring that the drug is mainly delivered where it needs to be administered, while also reducing side effects by limiting drug exposure to non-target tissues .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p25
|
39057315
|
sec[3]/p[2]
|
4. Rationale for Nanoparticle-Based Drug Delivery
| 4.03125 |
biomedical
|
Study
|
[
0.99951171875,
0.00022685527801513672,
0.0002111196517944336
] |
[
0.953125,
0.000934600830078125,
0.045562744140625,
0.00017523765563964844
] |
As far as antibiotics are concerned, nanosized drug delivery systems can increase antibiotic bioavailability through an increase in the apparent drug solubility (a higher surface-area-to-volume ratio permits more drug molecules to be exposed to the corresponding medium), membrane permeation, and antibiotic stability, ensuring that a greater proportion of the medicine reaches its intended site of action. This is especially useful for drugs, such as gentamicin and vancomycin, which are poorly absorbed (less than 1% of the dose is absorbed following oral or rectal administration) in the body . Thus, nanoparticles as carriers for gentamicin and vancomycin have been investigated mainly in the last 10 years, as reported by the WOS citation report and shown in Figure 5 ; 796 and 1087 papers have been published, respectively, on gentamicin and vancomycin encapsulation in nanosized drug delivery systems in the time range between the years 1985 and 2024.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p26
|
39057315
|
sec[3]/p[3]
|
4. Rationale for Nanoparticle-Based Drug Delivery
| 3.794922 |
biomedical
|
Other
|
[
0.9990234375,
0.0004286766052246094,
0.00044846534729003906
] |
[
0.34619140625,
0.58251953125,
0.07012939453125,
0.00098419189453125
] |
The specific advantages of nanoparticles as carriers for gentamicin and vancomycin can be highlighted as follows: (i) protection from antibiotic degradation (the slow release of the antibiotic prevents it from immediate exposure and degradation), (ii) ability to reduce antibiotic toxicity, and (iii) to overcome antibiotic resistance .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p27
|
39057315
|
sec[3]/p[4]
|
4. Rationale for Nanoparticle-Based Drug Delivery
| 4.097656 |
biomedical
|
Study
|
[
0.9990234375,
0.0004544258117675781,
0.0005440711975097656
] |
[
0.7509765625,
0.0012140274047851562,
0.2471923828125,
0.00035190582275390625
] |
Table 1 and Table 2 report some examples of experimental works on various nanosized delivery systems loaded with gentamicin and vancomycin, highlighting the material nanoparticles are made of and their preparation techniques. The majority of examples found in the literature refer to polymer nanoparticles loaded with gentamicin or vancomycin, the polymers being either synthetic, such as poly-alfa-hydroxyacids, or natural, such as chitosan. The most frequent techniques reported to prepare the polymer nanoparticles loaded either with gentamicin or vancomycin are the traditional ones, i.e., emulsion solvent evaporation (or double emulsion solvent evaporation) when synthetic biodegradable polymers, such as polylactide-co-glycolide (PLGA), polyethylenglcol-co-polylactide-co-glycolide (PEG-PLGA/PLGAH) or polyurethane, are used as carriers, and ionotropic gelation when polymers of a natural origin, such as chitosan, are used as carriers. Both antibiotics have also been combined with inorganic nanoparticles made of silver, silica, and iron that can be external stimulus-responsive carriers. Nanosized systems loaded with gentamicin or vancomycin were tested on popular bacteria, such as Staphylococcus aureus ( S. aureus ), Escherichia coli ( E. coli ), and Pseudomonas aeruginosa ( P. aeruginosa ). As said, these are taken as an example of very frequent and severe infections from Gram-positive bacteria (i.e., methicillin-resistant Staphylococcus aureus (MRSA)) and Gram-negative infections (i.e., P. aeruginosa in patients affected by cystic fibrosis) that are difficult to be treated and that show a high tendency to eradicate.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p28
|
39057315
|
sec[4]/sec[0]/p[0]
|
5.1. Polymeric Nanoparticles
| 3.566406 |
biomedical
|
Other
|
[
0.99853515625,
0.0006170272827148438,
0.0009374618530273438
] |
[
0.0526123046875,
0.93505859375,
0.0118408203125,
0.000644683837890625
] |
Polymer nanoparticles are submicron-sized polymeric colloidal particles, with sizes ranging from 10 to 200 nm. They are generally composed of natural or synthetic polymers and can encapsulate a range of drugs, including anti-infective agents, such as gentamicin and vancomycin .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p29
|
39057315
|
sec[4]/sec[0]/p[1]
|
5.1. Polymeric Nanoparticles
| 4.109375 |
biomedical
|
Study
|
[
0.99951171875,
0.00031256675720214844,
0.00024199485778808594
] |
[
0.9873046875,
0.000270843505859375,
0.01248931884765625,
0.00012183189392089844
] |
A wide range of polymeric nanoparticles has been studied and developed to deliver antibiotics. They have shown promising results in preclinical and clinical studies, proving their potential for drug delivery. As reported in Table 1 , various authors investigated the encapsulation of gentamicin sulfate into polymer nanosized drug delivery systems. The papers found in the literature report three main strategies: (i) encapsulation of GS into polymer nanoparticles, (ii) encapsulation of gentamicin into nanofibrous patches, and (iii) loading GS and/or GS NPs into nanofibrous patches. The antimicrobial effect of GS-loaded nanosized drug delivery systems is always tested towards P. aeruginosa and S. aureus , which are among the most frequently identified pathogens towards which GS is active. As far as drug release is concerned, the main mechanism of GS release from polymer nanoparticles relies on the Higuchi kinetic model based on Fickian diffusion. A burst release, accounting for 20–40% of GS release in the first hour of incubation is highlighted, due to the amount of drug closer to the NP surface and depending on the polymer matrix composition.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p30
|
39057315
|
sec[4]/sec[0]/p[2]
|
5.1. Polymeric Nanoparticles
| 4.125 |
biomedical
|
Study
|
[
0.99951171875,
0.00017702579498291016,
0.0001881122589111328
] |
[
0.99755859375,
0.00022864341735839844,
0.0019292831420898438,
0.00006693601608276367
] |
For example, Y. Sun and colleagues and R. Dorati and colleagues investigated the encapsulation of GS in nanoparticles made from polylactide-co-glycolide (PLGA), a poly-alfa-hydroxy acid whose biocompatibility and biodegradability is well known and approved for human use by international regulatory agencies. Y. Sun and colleagues focused their work on the nanoparticle preparation process using plain PLGA and a conventional double emulsion solvent evaporation method to prepare GS-loaded PLGA nanoparticles. They extensively studied the process variables and concluded that PVA and PLGA concentrations were critical factors in determining the particle structure and size. The NP size increased up to the micron size when the PVA concentration increased, and GS release was affected by the particle porosity. Therefore, the gentamicin-loaded PLGA nanoparticles could be tuned using the double emulsion evaporation method with different parameters, including the PVA (surfactant) concentration and PLGA concentration, resulting in effective antibacterial activity.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p31
|
39057315
|
sec[4]/sec[0]/p[3]
|
5.1. Polymeric Nanoparticles
| 4.339844 |
biomedical
|
Study
|
[
0.99951171875,
0.00040841102600097656,
0.0002065896987915039
] |
[
0.9970703125,
0.0002715587615966797,
0.0022716522216796875,
0.00014412403106689453
] |
Dorati and colleagues carried out a detailed study on a gentamicin-loaded biodegradable nanoparticle (NP) formulation using modified PLGA polymers, such as uncapped polylactide-co-glycolide (PLGA-H) and polylactide-co-glycolide-co-polyethylenglycol (PLGA-PEG) blends; a solid-oil-in water technique was used as an NP preparation method. The work was focused on a screening design to optimize the drug payload, NP size and size distribution, NP stability, and resuspension after freeze-drying. The authors concluded that the particle size and drug content (DC) were mostly affected by the polymer concentration. By studying the experimental parameter through a 2 3 screening design, i.e., the polymer blend composition (PLGA-PEG and PLGA-H), polyvinylalcohol (PVA), and methanol concentrations into the aqueous phase, they were able to increase the drug content up to 10.5 w / w %. The stirring rate resulted in the most influencing factor for the size distribution (PDI): 700 rpm permitted a homogeneous NP dispersion (PDI = 1) with an average NP size of 200 nm to be obtained. Nanoparticle lyophilization was studied by adding cryoprotectants, polyvinypirrolidone K17 and K32, and sodium carboxymetylcellulose. The freeze-drying protocol was optimized through a mixture design, obtaining a free resuspendable freeze-dried powder made from stable NPs with a suitable size and payload. The powder was tested on clinical bacterial isolates demonstrating that after encapsulation, gentamicin sulfate kept its activity. Moreover, the authors carried out a kinetic study on in vitro GS release from the NPs highlighting that GS release follows the Higuchi model with a release Fickian diffusion mechanism.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p32
|
39057315
|
sec[4]/sec[0]/p[4]
|
5.1. Polymeric Nanoparticles
| 4.28125 |
biomedical
|
Study
|
[
0.99951171875,
0.000263214111328125,
0.00021946430206298828
] |
[
0.99853515625,
0.00023698806762695312,
0.0013494491577148438,
0.00008237361907958984
] |
The interest in loading GS into polymer patches, namely nanofibrous polymer ones, has been demonstrated in several works. Another example is the work of Pisani and colleagues They investigated polylactide- co -polycaprolactone electrospun nanofiber matrices as a carrier for GS demonstrating prolonged drug release and an increase in its antimicrobial effect. Electrospun matrices can be used on severe burns to prevent infections, implanted into gingival cavities for local infection treatment, or applied after tooth extraction. Their advantage lies in a controlled delivering of high antibiotic concentrations directly to the site of action while minimizing systemic concentrations, thereby reducing drug side effects . Y. Sun and colleagues loaded the PLGGA-loaded GS NPs with size of 130 nm into nanofibrous polyurethane patches via electrospinning obtaining wound-healing patches with antibacterial activity. The paper demonstrates the ability of this drug delivery system to slow down the release of GS from NPs embedded into the nanofibers, by keeping their antibacterial effect . The key to the incorporation of the NPs into the nanofiber scaffolds lies in the process of electrospinning and the properties of the other materials involved. The authors synthesized the GS-loaded PLGA NPs via a double emulsion solvent evaporation method, as reported above. During electrospinning, the solvent (DCM) rapid evaporation causes the polymer (PU/PEO) to solidify, encapsulating the PLGA NPs within the nanofiber scaffolds. The authors found that the purified PLGA NPs were uniformly and individually incorporated into the PU/PEO nanofiber scaffolds. The presence of PEO in the mixture significantly improved the compatibility of PLGA NPs and PU, resulting in a well-dispersed distribution of PLGA NPs in the nanofiber scaffolds. This suggests that the PLGA NPs, despite PLGA being soluble in DCM, can be successfully incorporated into the nanofiber scaffolds due to the rapid solidification of the PU/PEO during electrospinning and the compatibility among PLGA, PU, and PEO.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p33
|
39057315
|
sec[4]/sec[0]/p[5]
|
5.1. Polymeric Nanoparticles
| 4.132813 |
biomedical
|
Study
|
[
0.99951171875,
0.00033736228942871094,
0.0001634359359741211
] |
[
0.98486328125,
0.0005106925964355469,
0.014434814453125,
0.00016546249389648438
] |
Dhal and colleagues investigated GS-loaded PLGA nanoparticles loaded into pullulan films (PNP-F) for the treatment of a nosocomial infection or surgical site infection. The author’s focus was on the sterilization of PNP-F with EtO treatment. They demonstrated that EtO treatment did not cause any effects in the in vitro disintegration time, % of drug loading, and antimicrobial effectiveness, but led to a change in the PNF-F mechanical properties due to the plasticization effect. Moreover, PNP-F was stable at 25 ± 2 °C/RH 60 ± 5% storage conditions for 3 months only; thus, 15 °C was proposed as the storage temperature, and the authors also suggested controlled humidity storage conditions, because of the deliquescent nature of GS. GS nanoparticles embedded in the pullulan films resulted in slow GS release, up to 192 h, and the wound healing assay confirmed the PNP-F effectiveness towards a fibroblast cell line (NIH-3T3) in facilitating the growth and inhibition of colonies of P. aeruginosa and S. aureus. In vivo studies indicated faster healing without scar formation in incisions receiving PNP-F compared to marketed GS cream and untreated incisions. Thus, the authors concluded that PNP-F can be explored as an alternative for the management of nosocomial infections or surgical site infections.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p34
|
39057315
|
sec[4]/sec[0]/p[6]
|
5.1. Polymeric Nanoparticles
| 4.0625 |
biomedical
|
Study
|
[
0.99951171875,
0.0002532005310058594,
0.00017702579498291016
] |
[
0.98681640625,
0.0003635883331298828,
0.01275634765625,
0.0001270771026611328
] |
Gentamicin has also been formulated into nanosized drug delivery systems made from chitosan, also exploiting the antibacterial properties of this natural polymer. Simpson and colleagues formulated stable chitosan and TPP particles capable of loading various GS concentrations up to 65% and whose size ranged from 100 to 400 nm, with PDI (less than 0.5) and negative zeta potentials. In vitro antimicrobial release studies against P. aeruginosa and MRSA demonstrated effectiveness, with up to 90% release over 7 days, achieving significant bacterial reduction within 3 h for the formulation with the highest drug concentration. Comparative efficacy analysis revealed promising results compared to existing formulations. These findings indicate potential applications in enhancing bone healing and preventing or treating infections, either through incorporation into scaffolds or hydrogels or as standalone treatments. Further research, especially in vivo studies, is necessary to validate and expand on these promising results .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39057315_p35
|
39057315
|
sec[4]/sec[0]/p[7]
|
5.1. Polymeric Nanoparticles
| 2.224609 |
biomedical
|
Study
|
[
0.99560546875,
0.0005154609680175781,
0.00382232666015625
] |
[
0.6376953125,
0.325439453125,
0.035003662109375,
0.0017328262329101562
] |
Concerning VM, a lower number of papers have been found in the literature about vancomycin encapsulation in polymer nanoparticles.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p36
|
39057315
|
sec[4]/sec[0]/p[8]
|
5.1. Polymeric Nanoparticles
| 3.617188 |
biomedical
|
Study
|
[
0.9990234375,
0.0001176595687866211,
0.0008101463317871094
] |
[
0.9951171875,
0.0024433135986328125,
0.0021228790283203125,
0.00009417533874511719
] |
An interesting work on VM encapsulation was written by Cerchiara and colleagues about VM-loaded chitosan nanoparticles embedded in Spanish broom fibers making a wound dressing. The chitosan nanoparticles were prepared via ionic gelation with tripolyphosphate, and they were loaded with VM. The focus of this paper was to propose the Spanish broom as alternative to cotton in wound healing bandages. However, the paper also highlights the ability of the Spanish broom to retain VM-loaded chitosan NPs and to achieve suitable VM release .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p37
|
39057315
|
sec[4]/sec[0]/p[9]
|
5.1. Polymeric Nanoparticles
| 4.140625 |
biomedical
|
Study
|
[
0.99951171875,
0.0003046989440917969,
0.00017535686492919922
] |
[
0.9990234375,
0.00022113323211669922,
0.0006031990051269531,
0.00007039308547973633
] |
VM encapsulation in poly(lactic-co-glycolic acid) and polylactic acid pH-sensitive polymers were experimented on in order to overcome VM drawbacks, such as the strong pH-dependent charge, tendency to aggregate, low bioavailability, and poor cellular uptake, and to deliver VM specifically at a slightly acidic pH corresponding to infection sites. The NPs were prepared using a simple and reproducible method, establishing strong electrostatic interactions between VM and the (co)polymers’ end groups with VM payloads up to 25 wt%. The drug-loading mechanism was investigated using solid-state nuclear magnetic resonance spectroscopy. The NPs remained stable during storage and did not release the incorporated drug at a neutral pH, whereas slight acidification of the medium triggered the rapid release of VM. These compartmentalized NPs have potential applications for controlled VM release at infection sites with a local acidic pH .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p38
|
39057315
|
sec[4]/sec[0]/p[10]
|
5.1. Polymeric Nanoparticles
| 3.943359 |
biomedical
|
Study
|
[
0.9990234375,
0.00011354684829711914,
0.0010528564453125
] |
[
0.99755859375,
0.0018014907836914062,
0.0006489753723144531,
0.00005418062210083008
] |
As far as VM release from polymer NPs, it strongly depends on the type of polymer, its charge, and interaction with VM, which has a strong pH-sensitive dependent charge. While the Higuchi model with Fickian diffusion is represented, also the non-Fickian release of VM from trimethylchitosan NPs was demonstrated by Xu and colleagues .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999995 |
39057315_p39
|
39057315
|
sec[4]/sec[0]/p[11]
|
5.1. Polymeric Nanoparticles
| 3.888672 |
biomedical
|
Study
|
[
0.99951171875,
0.00022208690643310547,
0.0002818107604980469
] |
[
0.9970703125,
0.0017824172973632812,
0.0007948875427246094,
0.00011074542999267578
] |
Exploiting differences at the infectious site is becoming more attractive for the development of a new smart therapy that requires the drug to remain inactive in the physiological environment and exert its effect triggered by cues at the disease site. For this aim, a smart delivery system for on-demand antibiotic release, by exploiting the bacterial microenvironment at the infection site, was studied .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p40
|
39057315
|
sec[4]/sec[0]/p[12]
|
5.1. Polymeric Nanoparticles
| 4.132813 |
biomedical
|
Study
|
[
0.99951171875,
0.0002987384796142578,
0.0001475811004638672
] |
[
0.9990234375,
0.0002911090850830078,
0.0005536079406738281,
0.00008344650268554688
] |
A vancomycin-encapsulated pH-responsive solid lipid nanoparticle (SLN) system was fabricated using acid-cleavable lipid SA-3 M (abbreviated as VM-FB_SA-3M_SLNs). The nanoparticle showed long-term stability up to 3 months under neutral pH. Under the acidic conditions of bacterial infection, SA-3 M was degraded to release the vancomycin cargo. A further in vivo study using a mouse wound infection model demonstrated the enhanced antimicrobial activity and reduced inflammatory responses of wound sites treated with vancomycin-loaded SLN .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p41
|
39057315
|
sec[4]/sec[0]/p[13]
|
5.1. Polymeric Nanoparticles
| 4.0625 |
biomedical
|
Study
|
[
0.99951171875,
0.00020503997802734375,
0.0001493692398071289
] |
[
0.9990234375,
0.00038814544677734375,
0.0003731250762939453,
0.00006031990051269531
] |
Mohapatra and colleagues developed a magnetic-stimulus-responsive vancomycin drug delivery system based on chitosan microbeads embedded with magnetic nanoparticles. In this study, they demonstrated that this DDS has the potential to burst-release higher amounts of drugs on multiple instances of the magnetic stimulus, several hours or days (16 days) apart as needed, and thus might enable us to maintain or control drug concentrations in the targeted infectious location.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p42
|
39057315
|
sec[4]/sec[0]/p[14]
|
5.1. Polymeric Nanoparticles
| 4.144531 |
biomedical
|
Study
|
[
0.99951171875,
0.00018405914306640625,
0.00017952919006347656
] |
[
0.9990234375,
0.0004875659942626953,
0.0006160736083984375,
0.00006395578384399414
] |
Mas, N.; and co-workers developed mesoporous silica nanoparticles (MSNs) able to release the vancomycin in the presence of bacteria. MSNs were functionalized with N-[(3-trimethoxysilyl)propyl] ethylendiamine triacetic acid trisodium salt (TMS-EDTA) and capped with the cationic polymer ε-pLys via electrostatic interactions with the negatively charged NPs surface. The presence of bacteria ( E. coli , Salmonella typhi , and Erwinia carotovora ) triggers pore uncapping, due to the adhesion of the ε-pLys gatekeeper with the negatively charged bacterial wall, which allows for the release of the entrapped cargo.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p43
|
39057315
|
sec[4]/sec[1]/p[0]
|
5.2. Inorganic Nanoparticles
| 4.152344 |
biomedical
|
Study
|
[
0.99951171875,
0.00016629695892333984,
0.00014257431030273438
] |
[
0.99609375,
0.0004401206970214844,
0.003490447998046875,
0.00008821487426757812
] |
Vancomycin has been conjugated with inorganic nanoparticles, and various papers demonstrate enhanced antibacterial activity for VM-immobilized nanoparticles, by lowering the MIC with respect to free VM, for all tested bacteria. For example, VM-conjugated gold nanoparticles outperformed VM alone by 64-fold . Rashid and colleagues conjugated VM with oxide magnetite (Fe 3 O 4 ) nanoparticles through a ligand exchange technique that employs the catechol group of Dopamine to anchor DOPA to iron oxide nanoparticles. The surface of the resulting Fe 3 O 4 /DOPA nanoparticles contains amino (–NH 2 ) groups that are conjugated with VM via a coupling reaction between the –NH 2 group of dopamine and the –COOH group of vancomycin
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
39057315_p44
|
39057315
|
sec[4]/sec[1]/p[1]
|
5.2. Inorganic Nanoparticles
| 4.089844 |
biomedical
|
Study
|
[
0.99951171875,
0.00022780895233154297,
0.00017952919006347656
] |
[
0.99853515625,
0.00018608570098876953,
0.001056671142578125,
0.00006532669067382812
] |
Hagbani and colleagues , aimed to improve the VM antibacterial potential through gold nano-formulations. They employed a simple one-pot approach to synthesize VM-loaded gold nanoparticles (V-GNPs), utilizing vancomycin’s reducing abilities to create V-GNPs from gold ions. UV-visible spectroscopy confirmed the synthesis of V-GNPs, revealing a surface plasmon resonance peak at 524 nm. Transmission electron microscopy revealed a nanoparticle size of around 24 nm, whereas dynamic light scattering estimated a hydrodynamic diameter of 77 nm. Zeta-potential measurements were used to study the stability of V-GNPs, which revealed a zeta potential of −18 mV. The study found that VM-functionalized gold nanoparticles may be a feasible nano-platform for fighting bacterial resistance.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999998 |
39057315_p45
|
39057315
|
sec[4]/sec[1]/p[2]
|
5.2. Inorganic Nanoparticles
| 4.105469 |
biomedical
|
Study
|
[
0.99951171875,
0.0002570152282714844,
0.0001609325408935547
] |
[
0.9990234375,
0.0002624988555908203,
0.0005984306335449219,
0.0000699758529663086
] |
Sharma, D. and Chaudhary, A. aimed to develop an efficient antibacterial agent through the simple, robust, and eco-friendly one-pot synthesis of GS-conjugated gold nanoparticles (G-GNPs), which served as both a reducing and stabilizing agent. The resulting nanoparticles were characterized, revealing a spherical form with a hydrodynamic diameter of about 15 nm and high stability. G-GNPs effectively inhibited the growth of Gram-positive and Gram-negative bacteria, including E. coli DH5α, ATCC 25922, and S. aureus MTCC 31601. Interestingly, the G-GNPs showed remarkable efficacy against GS-resistant Escherichia fergusonii ATCC 354691. The study found that the produced G-GNPs, which displayed little cytotoxicity toward the mouse myoblast C2C12 cell line, have tremendous potential against Gram-positive, Gram-negative, and drug-resistant bacteria.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999999 |
39057315_p46
|
39057315
|
sec[4]/sec[1]/p[3]
|
5.2. Inorganic Nanoparticles
| 4.128906 |
biomedical
|
Study
|
[
0.99951171875,
0.000263214111328125,
0.00014257431030273438
] |
[
0.99853515625,
0.0002593994140625,
0.0011701583862304688,
0.00008571147918701172
] |
Bhattacharya and Neogi reported the development of a novel antibiotic agent by coating iron oxide nanoparticles with GS. These nanoparticles were obtained via a co-precipitation approach, and their surfaces were functionalized with GS . The average particle size was found to be approximately 14 nm for unmodified nanoparticles and 10 nm for modified nanoparticles. The drug-release profile of the coated NPs showed a quick burst effect followed by gradual sustained release. In vitro tests against various Gram-positive and Gram-negative bacterial strains revealed that the drug–NP combination had significant antibacterial activity. The minimum inhibitory concentration (MIC) data indicated that small amounts, such as 0.2 mg/mL of drug-capped particles, may cause around 98% bacterial death. The new aspect of the work is the drug capping of the nanoparticles, which preserves both iron oxide superparamagnetic and medical properties. This formulation has been shown to be extremely blood compatible .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p47
|
39057315
|
sec[4]/sec[2]/p[0]
|
5.3. Liposomes
| 3.841797 |
biomedical
|
Other
|
[
0.998046875,
0.0011730194091796875,
0.0009784698486328125
] |
[
0.040985107421875,
0.86474609375,
0.0928955078125,
0.00146484375
] |
Liposomes are microscopic, spherical vesicles made up of phospholipids, the fundamental building blocks of cell membranes. This specific characteristic makes them particularly suitable for drug delivery due to several advantages, such as biocompatibility, versatility in encapsulating both lipophilic and hydrophilic compounds, potential for target delivery, and controlled release of the encapsulated drugs.
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999996 |
39057315_p48
|
39057315
|
sec[4]/sec[2]/p[1]
|
5.3. Liposomes
| 4.089844 |
biomedical
|
Study
|
[
0.99951171875,
0.00019216537475585938,
0.00016570091247558594
] |
[
0.99853515625,
0.00022017955780029297,
0.0010814666748046875,
0.0000584721565246582
] |
A study by Mugabe, Azghani, and Omri found that liposome-mediated GS administration is efficient against resistant strains of P. aeruginosa obtained from cystic fibrosis patients. The encapsulation efficiency of all liposomal preparations ranged from 4% to 5.18% of the initial drug concentration in solution. When liposomes in different compositions (1,2-dimyristoyl-sn-glycero-3-phosphocholine, 1,2-dipalmitoyl-sn-glycero-3-phosphocholine and 1,2-distearoyl-sn-glycero-3-phosphocholine + cholesterol in 2:1) were incubated in normal human pooled plasma or PBS at 4 °C or 37 °C for 48 h, 60–70% of the encapsulated GS (from 4 to 5.18% encapsulation efficiency) was retained .
|
[
"Silvia Pisani",
"Shafia Tufail",
"Mariella Rosalia",
"Rossella Dorati",
"Ida Genta",
"Enrica Chiesa",
"Bice Conti"
] |
https://doi.org/10.3390/jfb15070194
|
N/A
|
https://creativecommons.org/licenses/by/4.0/
|
en
| 0.999997 |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.