In Vitro and In Vivo Degradation, Mechanical Properties, and Histocompatibility of Weft-Knitted Silk Mesh-Like Grafts

To investigate the degradation, mechanical properties, and histocompatibility of weft-knitted silk mesh-like grafts, we carried out the In Vitro and In Vivo silk grafts degradation assay. The In Vitro degradation experiment was performed by immersing the silk grafts in simulated body fluid for 1 year, and the results showed that the degradation rate of the silk mesh-like grafts was very slow, and there were few changes in the mechanical properties and quality of the silk mesh-like graft. In Vivo degradation assay was taken by implantation of the silk mesh-like grafts into the subcutaneous muscles of rabbits. At 3, 6, and 12 months postoperation, the rate of mass loss was 19.36%, 31.84%, and 58.77%, respectively, and the maximum load was 63.85%, 34.63%, and 10.76%, respectively of that prior to degradation. The results showed that the degradation rate of the silk graft and the loss of mechanical properties In Vivo were faster than the results obtained in the In Vitro experiments. In addition, there were no significant differences in secretion of serum IL-6 and TNF-α between the experimental and normal rabbits (P >0.05), suggesting no obvious inflammatory reaction. The findings suggest that the weft-knitted silk mesh-like grafts have good mechanical properties, histocompatibility, and In Vivo degradation rate, and therefore represent a candidate material for artificial ligament

Heat Treatment Effect on Biological Behavior of Polyetheretherketone Composites

Polyetheretherketone is a semi-crystalline thermoplastic polymer, that so with heat treatments, it is possible to get different properties which are very important for the material performance. Heat treatment is a broadly utilized to develop the semi-crystalline polymers properties. In the present investigation, annealing of polyetheretherketone (PEEK) was carried out at temperatures above its glass transition temperature (Tg) to study its effects upon the biological conduct of the control and PEEK ternary composites. The bioactivity of the specimens was evaluated by investigating the apatite formation after immersion for different periods in a simulated body fluid (SBF). The biocompatibility of specimens was assessed by MTT assay. Additionally, the antibacterial property of the specimens versus S. aureus was observed with the optical density methods. The results manifested that the formation of hydroxyapatite was obviously observed on specimens after immersion for (7 and 14 days) in the simulated body fluid (SBF). Otherwise, the results of MTT assay recorded the PEEK specimens that excited the activity of fibroblasts, and therefore a high cytocompatibility was noticed and the specimens revealed antibacterial properties against S. aureus. So, the results of the bioactivity, biocompatibility and antibacterial tests in vitro demonstrated that the heat treatment enhanced biological behavior.

STUDY OF ANTIBIOTIC-RESISTANCE AND SENSITIVITY PATTERN IN A TERTIARY CARE TEACHING HOSPITAL

Introduction: Antibiotics are helpful in bacterial infection control and management. Irrational antibiotic use leads to resistance, which puts modern medicines achievements at risk. This study aims to know antibiotic resistance and sensitivity patterns and to assess possible factors that favor the development of antibiotic resistance. Methods: It is a retrospective observational study. Data collected from June 2019 to May 2020 from the culture & sensitivity records of various clinical isolates at the Microbiology department of SMC, Vijayawada, and analyzed by descriptive statistics. Results: Total samples collected 2905. Only746 samples showed significant growth. Most commonly, isolated organisms were from Pus and Body fluids Staphylococcus aureus (31.16%), Klebsiella (23.02%), from blood samples Staphylococcus aureus (44%,) Klebsiella (32%), from urine samples Escherichia coli (27.31%),Staphylococcus aureus (16.66%). Bacteria isolated from, Blood and Pus & body fluid samples showed more resistance to Amoxicillin + Clavulanic acid, 60% &58.60%, and urine samples showed more resistance to Norfloxacin69.44%. Conclusion: In this study, bacteria isolated from, blood, pus, and body fluid samples showed more resistance to Amoxicillin + Clavulanic acid, from urine samples showed more resistance to Norfloxacin. Parenterally used drugs like aminoglycosides and vancomycin have retained their sensitivity but bacteria also showed resistance to Imipenem, Vancomycin, new combinations like Cefoperazone + Sulbactam. A culture & sensitivity test and following antibiotic stewardship guidelines before prescribing antibiotics will give good results to prevent antibiotic resistance.

Predicting Corrosion Delamination Failure in Active Implantable Medical Devices: Analytical Model and Validation Strategy

The ingress of body fluids or their constituents is one of the main causes of failure of active implantable medical devices (AIMDs). Progressive delamination takes its origin at the junctions where exposed electrodes and conductive pathways enter the implant interior. The description of this interface is considered challenging because electrochemically-diffusively coupled processes are involved. Furthermore, standard tests and specimens, with clearly defined 3-phase boundaries (body fluid-metal-polymer), are lacking. We focus on polymers as substrate and encapsulation and present a simple method to fabricate reliable test specimens with defined boundaries. By using silicone rubber as standard material in active implant encapsulation in combination with a metal surface, a corrosion-triggered delamination process was observed that can be universalised towards typical AIMD electrode materials. Copper was used instead of medical grade platinum since surface energies are comparable but corrosion occurs faster. The finding is that two processes are superimposed there: First, diffusion-limited chemical reactions at interfaces that undermine the layer adhesion. The second process is the influx of ions and body fluid components that leave the aqueous phase and migrate through the rubber to internal interfaces. The latter observation is new for active implants. Our mathematical description with a Stefan-model coupled to volume diffusion reproduces the experimental data in good agreement and lends itself to further generalisation.

Investigation of Virulence Genes of Staphylococcus aureus Isolated from Sterile Body Fluid Samples and Their Correlation with Clinical Symptoms and Outcomes

Staphylococcus aureus is the major pathogen causing nosocomial human infections and produces a variety of virulence factors that contribute to its ability to colonize and cause diseases. This study was conducted to investigate the virulence genes in S. aureus isolated from sterile body fluid samples and their correlation with clinical symptoms and outcomes. The VITEK 2® Compact system was used to perform biochemical identification and antimicrobial susceptibility tests on 33 S. aureus isolates. Virulence genes were amplified using multiplex PCR. The virulence gene patterns were analyzed by systematic cluster analysis. The frequency of methicillin-resistant S. aureus was 45.45%, and 17 virulence genes were identified. Genes encoding hemolysins showed high frequencies. The frequencies of hla, hlb, hld, and hlgB were 93.94% and that of the luk-F/S-PV was 21.21%. Except for the frequency of splB (51.52%), the remaining genes encoding invasive proteases showed frequencies greater than 81.82%. Among the patients, 100.00% had undergone invasive medical procedures and 24.00% had been treated with more than three types of antibiotic drugs. Invasive medical procedures are the main causes of infection. Resistance to antibiotic drugs and the status of carrying virulence genes were highly related to clinical symptoms and outcomes.

Measuring the Concentration of Serum Syndecan-1 to Assess Vascular Endothelial Glycocalyx Injury During Hemodialysis

Glycocalyx is present on the surface of healthy endothelium, and the concentration of serum syndecan-1 can serve as an injury marker. This study aimed to assess endothelial injury using serum syndecan-1 as a marker of endothelial glycocalyx injury in patients who underwent hemodialysis. In this single-center, retrospective, observational study, 145 patients who underwent hemodialysis at the Gifu University Hospital between March 2017 and December 2019 were enrolled. The median dialysis period and time were 63 months and 3.7 h, respectively. The serum syndecan-1 concentration significantly increased from 124.6 ± 107.8 ng/ml before hemodialysis to 229.0 ± 138.1 ng/ml after hemodialysis (P < 0.001). Treatment with anticoagulant nafamostat mesylate inhibited hemodialysis-induced increase in the levels of serum syndecan-1 in comparison to unfractionated heparin. Dialysis time and the change in the syndecan-1 concentration were positively correlated. Conversely, the amount of body fluid removed and the changes in the syndecan-1 concentration were not significantly correlated. The reduction in the amount of body fluid removed and dialysis time inhibited the change in the syndecan-1 levels before and after hemodialysis. In conclusion, quantitative assessment of the endothelial glycocalyx injury during hemodialysis can be performed by measuring the serum syndecan-1 concentration, which may aid in the selection of appropriate anticoagulants, reduction of hemodialysis time, and the amount of body fluid removed.