Tissue Healing Research Articles

Comparison of the Effects of Mucosa Tissue Healing with Chlorhexidine Digluconate and Choline Salicylate in Patients Wearing a Removable Prosthetic Restoration—A RCT

Background and Objectives: A randomized, double-blind clinical trial was conducted based on the CONSORT study protocol for randomized clinical trials (NCT06531720) to compare the effectiveness of oral mucosa healing properties of 0.2% chlorhexidine digluconate (CHX) and 8.7% choline salicylate (CHS), as well as a control group (CON) with no intervention, in patients with delivered partial removable dentures (PRDs). Materials and Methods: Patients (n = 27) who were enrolled in the study were healthy subjects according to the inclusion/exclusion criteria, and they received new PRDs to complement Kennedy’s class III and IV deficiencies. During the process of adaptation to new prosthetic restorations, OMLs were formed and treated with one of two selected preparations, either CHX = 0.2% or CHS = 8.7%, in relation to the control group (CON). The wound surface area (WSA) (mm2) was measured on repeatable intraoral images taken in accordance with the examination protocol on the first control visit on day 1, day 3, day 7, day 10, and day 14 with the assistance of computer software. Results: There were no statistically significant differences between groups. The fastest effect of WSA complete reduction was observed in the CHX group after 7 days (WAS = 0.78, SD = 1.18) in comparison to CHS = 10 days (WAS = 0.44, SD = 0.90) and CON = 14 days (WAS = 0.22, SD = 0.67). The decrease in the WSA after 7 days of observation was 85.1% in the CHX group, 70.1% in the CHS group, and 59.2% in the CON group. Conclusions: The WSA decreased most rapidly after 7 days of treatment with 0.2% chlorhexidine digluconate (CHX), slightly more slowly after 10 days of treatment with 8.7% choline salicylate (CHS), and relatively most slowly in the CON group, who were not treated with any topical medication after 14 days. Oral mucosa lesions (OMLs) therapy during the process of adaptation to new removable prosthetic restorations is a very important element supporting the whole process. Topical medications containing 0.2% chlorhexidine digluconate are indicated as adjunctive therapy in the process of the supportive treatment and disinfection of oral mucosa lesions. However, this does not release the dentist from liability for the careful adjustment of the removable prosthetic restoration.

Impact of Dual-coated Silver Nanoparticle and Antibiotic Sutures on Wound Healing in Inflammatory Mouse Models

ABSTRACT Background: The use of silver nanoparticles (AgNPs) in biomedicine has emerged in a big way owing to its antibacterial and anti-inflammatory properties. We hypothesize that combining the AgNPs with antibiotics for coating sutures will enhance the antibacterial property of sutures with the added advantage of the immunomodulatory effect of AgNPs on tissue healing. Materials and Methods: Polyglactin sutures were coated with AgNPs using the dip-coating method. The uniform coating and morphology of AgNPs on the suture surface were confirmed using scanning electron microscopy (SEM). Each type of suture – polyglactin plain, antibiotic coated (Triclosan), AgNP coated, and dually coated (antibiotic and AgNP) – was assessed for their antibacterial properties against Gram-positive bacteria, Gram-negative bacteria, and anaerobes. These sutures were utilized in an abdominal and systemic inflammatory mice model for ileal anastomosis. The intestinal tissue was evaluated for acute and chronic inflammation and collagen deposition to assess the healing and inflammatory response. Results: The SEM and energy dispersive X-ray analysis showed successful coating of AgNPs on plain and antibiotic-coated sutures. In comparison with the other groups, the dually coated suture had the best in vitro antibacterial efficacy. The AgNP-coated sutures were able to decrease both acute and chronic inflammatory cell infiltration, but the collagen synthesis and deposition were enhanced. Conclusion: AgNPs can be coated on Polyglactin suture either alone or in combination with antibiotics with preserved antibacterial effects. The dual coating of sutures gives a synergistic antibacterial effect. The AgNP diminishes immune response in the presence of preserved extracellular matrix generation.

Principles of Instrumentation in Periodontics

Instrumentation in periodontics plays a crucial role in the effective management of periodontal diseases. This article explores the fundamental principles guiding instrumentation techniques used in periodontal therapy. The primary objectives include achieving optimal biofilm removal, root surface detoxification, and creating a conducive environment for tissue healing. Various instruments, such as scalers, curettes, and ultrasonic devices, are discussed in terms of their indications, advantages, and limitations. Additionally, the importance of ergonomic considerations and operator proficiency in enhancing treatment outcomes is emphasized. Understanding these principles is essential for dental practitioners to deliver comprehensive periodontal care that promotes long-term oral health and patient satisfaction.

OS EFEITOS DA LASERTERAPIA EM CICATRIZAÇÃO MAMILAR PARA MULHERES NO PROCESSO DE AMAMENTAÇÃO

INTRODUCTION: Breast milk is a great source of nutrients for the baby's immunological and psychological development, and has a strong impact on infant mortality. It all starts in the thirty-second week of gestation, as this is the time when the fetus begins to show sucking reflexes. The breastfeeding process can be very difficult, since if there is no monitoring, there may be cracks in the breasts, making the process very painful. METHODS: This is a descriptive and qualitative study, which took place in person and virtually in the city of Porto Velho/RO at the Physiotherapy School Clinic of the São Lucas University Center, with the objective of hearing reports from women/mothers who are or have been exclusively breastfeeding. Thirty-eight female women, aged 20 years and older, were selected to report their breastfeeding process as lactating women. RESULTS AND DISCUSSION: One of the reasons for this development is the incorrect breastfeeding process. The main risk factors identified were: the baby's latch on to the mother's breast, where there is incompatibility between mother and child, primary and race/color of the mother defined as white or yellow. Many lactating women end up thinking that all they have to do is let the baby latch on to the breast and perform the suction, since even the positioning of the child interferes in the process. It was also evident in the interviews that most of the women did not perform the procedure due to lack of knowledge, often not being instructed by the health professional, or for fear of the effects of the procedure, since most of the women interviewed are very young and from lower social classes, they end up having this transgression of low performance of the procedure. CONCLUSION: Laser therapy has been shown to be an effective and safe intervention in the treatment of breast fissures, a common complication during breastfeeding that can cause intense pain and difficulties in breastfeeding. By using low-level laser therapy, it is possible to promote healing of injured tissues, relieve pain and reduce inflammation, providing greater comfort to mothers and encouraging continued breastfeeding. The importance of this treatment lies in its rapid and non-invasive effect, offering an alternative to traditional therapies, such as ointments and dressings, which often do not provide immediate or complete relief. In addition, laser therapy helps to prevent early weaning, contributing to the well-being of the baby and the mother, since exclusive breastfeeding is essential in the first months of life.

Evaluation of Post-Processing on Additive Manufactured Bioresorbable Polymers for Medical Devices.

Additive manufacturing (AM) has seen massive growth in the medical device sector and an increase in the clearance of devices. Many challenges still exist in the design, development, and clinical use of AM-fabricated devices, notably the processing, annealing, and sterilization of resorbable polymers. In addition, the use of these materials continues to grow in medical devices and scaffold technologies for tissue engineering and regenerative medicine (TERM). Specifically, this study focused on the scaffold mechanical properties post-processing and throughout a simulated resorption (in vitro) study. Herein, we evaluated three (3) materials that span a range of mechanical properties and degradation rates relating to a range of tissue healing rates and mechanical properties affording the opportunity of biomimetic potentials, Caproprene 100M, Lactoflex 7415, and Lactoprene 100M. These bioresorbable polymers were additively manufactured into scaffold forms of Type V tensile bars to investigate post-processing parameters. A range of heat treatments were then performed after the AM process to induce a range of semicrystalline morphologies, and subsequently, two different sterilization techniques were performed, one based on super critical carbon dioxide and another using electron beam radiation. It was statistically shown that the heat treatment parameters and the sterilization method had statistically significant effects on the scaffold properties of each material. While material differences were responsible for the majority of the mechanical property breadth, techniques utilizing analysis of variance allowed the observation of significant effects and interactions associated with heat treatment, sterilization, and material parameters (alpha = 0.05). The characterization of the sample groups provided insight into the process-structure-property-performance relationships of the resorbable scaffold samples. It was established that the post-processing impacted the scaffold structures, and therefore, sterilization and heat treatment selections should be included within initial design considerations alongside material selection as critical for device development, especially when AM bioresorbable scaffolds for TERM.

The multiple roles of macrophages in peritoneal adhesion

AbstractPeritoneal adhesion (PA) refers to the abnormal adhesion of the peritoneum either with the peritoneum itself or with tissues and organs that is caused by abdominopelvic surgery, abdominal infection or peritoneal inflammation. PA is associated with various clinical complications, such as abdominal pain and distension, intestinal obstruction, gastrointestinal disorders and female infertility, and adversely affects the quality of life of patients. Macrophages are essential for PA formation and can undergo polarization into classically activated macrophages (M1) and alternatively activated macrophages (M2), which are influenced by the peritoneal microenvironment. By releasing proinflammatory cytokines and reactive oxygen species, M1 macrophages promote peritoneal inflammatory reactions and the resultant formation of adhesion. In contrast, M2 macrophages secrete anti‐inflammatory cytokines and growth factors to inhibit PA formation and to promote repair and healing of peritoneal tissues, and thereby play a significant anti‐inflammatory role. This review comprehensively explores the function and mechanism of macrophages and their subtypes in PA formation to gain insight into the prevention and treatment of PA based on the modulation of macrophages.

The Effect of Preformed Anatomic Provisional Restorations on Peri-Implant Mucosal Dimensions with Immediate Tooth Replacement Therapy.

Immediate Tooth Replacement Therapy (ITRT) has become popular due to its ability to reduce treatment time and provide immediate esthetic results. However, long-term challenges, such as mid-facial recession and labial bone resorption, have been reported. Anatomic temporary cylinders (ATC), which allow for efficient fabrication of provisional transitional restorations in the esthetic zone, were designed to mimic the natural emergence profile and guide mucosal tissue healing. This study examines the effect of ATCs on the fabrication of provisional restorations compared to conventional non-anatomic temporary cylinders (CTCs) in terms of peri-implant mucosal preservation and stability in patients undergoing ITRT using the dual-zone grafting technique. Parameters evaluated were peri-implant mucosal tissue thickness (PIMTT), Pink Esthetic Score (PES), and radiographic outcomes, including labial plate dimension (LPD). The use of ATCs resulted in a statistically significant increase in PIMTT compared to CTCs, suggesting better preservation of peri-implant mucosal architecture. Additionally, the ATC group exhibited a positive change in LPD, although this difference was not clinically significant. The findings indicate that ATCs may offer advantages in maintaining peri-implant mucosal stability, contributing to the esthetic and functional outcomes of implant-supported restorations. Further long-term studies are needed to validate these preliminary results. The use of anatomic temporary cylinders (ATC) in immediate tooth replacement therapy (ITRT) demonstrated improved peri-implant mucosal tissue thickness, suggesting enhanced maintenance of peri-implant mucosal architecture. This can contribute to healthier and more esthetic outcomes while potentially reducing the risk of complications such as mid-facial recession.

Ginsenoside Rg1 Promotes Wound Healing in Mice with Superficial Second-Degree Burns Through Energy Metabolism, Cell Migration, and Cell Adhesion Pathways.

Natural products are known to have distinct roles in the treatment of various diseases. However, the potential role of ginsenoside Rg1 (GRg1) in the context of scald injuries remains unclear. This study aimed to elucidate the effects of GRg1 on scald wound healing by utilizing a mouse scald wound model and administering varying concentrations of GRg1 orally. RNA sequencing (RNA-seq) was employed to identify the signaling pathways and key genes influenced by GRg1 in the wound healing process. Our findings indicate that mice treated with a low concentration of GRg1 exhibited a significantly higher wound healing rate compared with the model group and other treatment groups. Through RNA-seq, we observed that the gene expression profile in the wound tissues of the low-concentration-treated group was consistent with that of the normal control group. Furthermore, a low concentration of GRg1 was found to maintain cellular energy metabolism homeostasis by enhancing mitochondrial aerobic respiration and the tricarboxylic acid cycle. In addition, GRg1 facilitated wound healing by restoring the expression of genes associated with cell migration and adhesion. Confirming the appropriate concentration of GRg1 that accelerates tissue healing at scald sites and enhances our understanding of the efficacy and molecular mechanisms underlying the therapeutic effects of natural products in disease treatment.

Alveolar Ridge Regeneration With Open Versus Closed Healing in Damaged Extraction Sockets: A Preclinical InVivo Study.

The objective of this study was to compare open versus closed healing of soft and hard tissue following alveolar ridge preservation (ARP) procedures in damaged extraction sockets. ARP was performed in five mongrel dogs using collagenated deproteinized bovine bone mineral (cDBBM) and a resorbable non-cross-linked collagen membrane (NCCM) in damaged extraction sockets, with each socket entrance left either open (open group) or closed (closed group). Clinical wound epithelization at the socket entrance and the dimensions of keratinized tissue were evaluated over time. Additionally, the augmented ridge dimensions and new bone formation were assessed radiographically and histologically at 8 weeks after surgery. The dimensions of the socket entrance gradually decreased in the open group, and wound epithelization was almost complete within 4 weeks. The mucogingival junction was maintained more apically in the open group than in the closed group (0.14 ± 0.40 mm vs. -0.86 ± 0.71 mm [mean ± SD], p < 0.05). The augmented ridge dimensions did not differ significantly between the open and closed groups (93.1% ± 5.4% vs. 88.3% ± 11.2%, p > 0.05). Histological analyses revealed no significant differences in the amount of newly formed bone. However, membrane resorption in the crestal region was more pronounced in the open group. Open and closed healing approaches for ARP in extraction sockets with damaged buccal wall resulted in similar ridge dimensions and new bone formation. However, there was less reduction of the buccal bone crest and wider keratinized tissue width after open healing.

A novel method to detect carotid artery in-stent restenosis.

Carotid artery stenosis is a major risk factor for ischemic stroke. Despite carotid artery stenting, in-stent restenosis (ISR) remains challenging. Pigs serve as an ideal ISR model. This study aims to establish a novel porcine model of carotid ISR using open-loop and closed-loop stents and to assess ISR with optical coherence tomography (OCT) and histopathology, comparing incidence and vascular response between stent types. Twelve adult male Bama miniature pigs underwent carotid stenting with either open-loop or closed-loop stents. The animals received antiplatelet therapy pre- and postimplantation. Postimplantation evaluations at 90days included carotid digital subtraction angiography (DSA), OCT, histopathological examination, and electron microscopy. Both stent types showed ISR as detected by OCT and DSA. OCT revealed comparable neointimal proliferation within stent struts for both types, with no significant differences in stent, lumen, and neointimal dimensions. Histopathological analysis and electron microscopy provided insights into tissue responses and healing processes following stent implantation. No significant difference in ISR incidence was found between the stent types based on a χ2 test (p=.110). OCT and hematoxylin-eosin staining exhibit the highest consistency in evaluating neointimal area. The novel porcine ISR model demonstrated similar ISR outcomes for open-loop and closed-loop stents. OCT proved to be a highly consistent and valuable tool for evaluating stent and arterial conditions, comparable to histopathological findings. However, due to a small sample size, the validity of these preliminary findings requires further investigation to be confirmed.

The impact of root end filling material type and the application of bone graft on healing of periapical tissues after endodontic microsurgery (a clinical randomized controlled trial)

To evaluate the effect of combining different bioactive root-end filling materials with composite bone graft (xenogeneic mixed with autogenous bone fragments) on the healing process of periapical tissues after endodontic micro-surgery procedure. In this triple-blinded clinical trial, 56 patients were divided into 2 main groups (28 each) according to the root-end filling material and 2 subgroups according to the presence or absence of the composite bone graft material. Group I: MTA root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Group II: TotalFill root-end filling (n = 28) in which there are Sub-group A: without bone graft (n = 14) and Sub-group B: with composite bone graft (n = 14). Healthy patients whose ages range from 20 to 50 years with small-to-medium size radiolucency in CBCT related to single-rooted maxillary teeth were included in this study. Patients were assigned a number starting from 1 to 56 and were randomly allocated to four test groups (2 main groups and 2 sub-groups) following simple randomization procedure guidelines described by IBM SPSS V23 (IBM USA) statistical analysis software. This trial was triple-blind where the patient, the outcome assessors, and the main operator were blinded to the applied intervention. Every patient was evaluated clinically and by CBCT at two main observation periods: presurgical and 12-month post-operative. They were also examined and evaluated clinically and radiographically through periapical x-rays after one week, three, and six months. Statistical analysis was performed with IBM SPSS Statistics for Windows Version 23.0. Armonk, NY: IBM Corp. Of the 56 patients enrolled in the study, 49 patients were available for the final analysis. All groups showed no statistically significant differences with regard to healing or success rates at the 12-month follow-up mark. No adverse effects were encountered. Results showed that high success rates were achieved using MTA and TotalFill in the healing of periapical lesions after endodontic surgery. The addition of bone graft in small-to-medium size lesions did not affect the success rate of endodontic surgeries.

Treatment of proximal phalangeal fracture with miniature combined external fixator

To investigate the clinical effect of limited open reduction treatment of proximal phalangeal fracture with miniature external fixator combined with small incision. Between January 2020 and December 2022, 29 patients with proximal phalangeal fracture were treated with micro external fixator combined with small incision in fracture plane, including 23 males and 6 females, aged from 19 to 62 years old with an average of (36.2±21.0) years old. Five patients with open phalangeal fracture were treated with stageⅠsurgery, 24 cases of closed phalangeal fracture were treated with elective surgery. At the 6 month follow-up, the curative effect was evaluated according to the total active flexion scale (TAFS) of the American Hand Surgery Association. The fracture healing, nail path, local soft tissue healing, and complications were observed. All the 29 patients were followed up for 6 to 10 months with an average of(8.3±2.1) months, 3 patients had delayed fracture healing, 1 patient had distal skin numbness, symptoms were relieved after nutritional nerve treatment, no external fixator broken nails, no infection, the nail path and small incision healing was good, bone healing was achieved at the end of follow-up. Fracture healing time ranged from 10 to 24 with an average of (13.7±3.1) weeks. Six months after operation, according to the TAFS standard, 19 cases (227.68±4.23) were excellent, 7 cases (203.86±14.32) were good, and 3 cases (170.33±7.32) were poor. The micro-combined external fixator combined with limited incision with small incision can be used in the treatment of proximal phalangeal fracture. The operation is simple and beneficial to early functional exercise, small extensor tendon irritation, convenient second-stage removal, and high rate of excellent and good functional score in recovery period.

Effect of castor oil on esophageal stricture in rats and expression of ST-2, neopterin proteins in corrosive burn model

Corrosive esophageal burn (CEB) is a disease with high mortality and morbidity rates. The aim of this study was to determine the efficacy of castor oil, in preventing stricture development at the experimental CEB model. In addition to studying standard histopathological damage data, neopterin, IL-33, and ST-2 proteins were also studied for the first time. Fifty Wistar-Albino rats were divided into randomized 5 groups. [Sham group (G1) (n:10), Control group (G2) (n:10), Early Stage Topical Application group (G3)(n:10), Late Stage Topical Application group (G4) (n:10), Oral Application group (G5) (n:10)]. Weight measurement, esophageal length, histopathological damage score (HDS) and total stenosis score (TSS), tissue caspase-3 and VEGF staining, tissue hydroxyproline (HYP), blood TNF-alpha, IL-6, IL-33, Neopterin, and ST-2 levels were measured. In the castor oil application groups, weight gain was observed, the acute phase reaction decreased, submucosal/tunica muscularis fibrosis (TMF) and muscularis mucosal damage (MMD) were reduced, and TSS and HDS decreased. While no significant difference was detected in the ST-2 protein, which was used for the first time in this study model, a significant increase in neopterin protein was observed in the application groups. Results indicate the nutritional contribution of castor oil, as well as its tissue healing and esophageal stricture-preventing efficacy at histopathological and immune-histochemical levels.

Evaluation of cyst treatment technique, cyst type, size differences and healing by fractal analysis

AimThe aim of the study was to evaluate the trabeculation increase of treated mandibular cysts.Material and methodThe study included 26 female and 33 male patients (age mean: 38,4 years) with cysts larger than 3 cm in the posterior region of the mandible who were admitted to the same center. Two groups in treatment technique: marsupialization (n = 29) and enucleation (n = 30). Four groups in cyst types: dentigerous cyst (n = 21), keratocyst (n = 19), radicular cyst (n = 15) and residual cyst (n = 4). Cyst size was divided into two categories: smaller than 5.5 cm (n = 31) and larger than 5.5 cm (n = 28). Panoramic radiographs (PR) of the patients were analyzed at the beginning, 6. month and 12. month.ResultAt the end of the treatment, there was no statistically significant difference in terms of Fractal Analysis (FA) between patients treated with marsupialization and enucleation, but considering that the cysts in the marsupialization group were larger in size, a faster increase in FA was observed in the marsupialization group. When the cysts were grouped according to their size, it was observed that healing tissues in cysts smaller than 5.5 cm reached normal FA values faster, while healing in the middle of cysts larger than 5.5 cm took more time.ConclusionsFA is a reproducible and reliable method. In large cysts, marsupialization results in a faster recovery, but FA values at the end of treatment are similar to the enucleation group. Cysts larger than 5.5 cm show a more rapid increase in Fractal Dimension (FD). The centre of the cysts is the area that heals the latest. Studies with larger sample sizes are needed to evaluate the difference in healing between cyst types.Clinical trial numberClinical trial number: Not applicable

Microbial and Transcriptomic Landscape Associated With Neutrophil Extracellular Traps in Perianal Fistulizing Crohn's Disease.

Perianal fistulizing Crohn's disease (pfCD) poses significant healing challenges, closely associated with neutrophil extracellular traps (NETs). This study aimed to investigate the microbe-host interactions influencing NETs in pfCD. From January 2019 to July 2022, patients with pfCD were screened at Ren Ji Hospital. Patients in remission following comprehensive treatment were recruited. We documented clinical characteristics, medication regimens, healing outcomes, and infliximab levels in fistula tissues. NET positivity was confirmed by positive results in citrullinated histone H3 (CitH3) enzyme-linked immunosorbent assay (ELISA) and dual immunofluorescence staining for myeloperoxidase and CitH3. Microbial and transcriptomic profiles from fistula tissues, obtained during surgery, were analyzed using 16S rRNA gene sequencing and RNA sequencing. Differences in microbiome and transcriptomic profiles were evaluated, and their relationships were assessed using Mantel's and Spearman's coefficients. Significant differences in microbial communities were found between groups (P = .007). Representatively differential microbes such as Prevotella bivia, Streptococcus gordonii, and Bacteroides dorei were enriched in NETs-positive fistulas (P < .05). Functional analysis of microbes revealed reduced ubiquinol biosynthesis and butanoate production in NETs-negative fistulas (P < .05). Transcriptomic analysis indicated increased neutrophil and monocyte infiltration in NETs-positive fistulas, associated with pathways involving bacterial response, neutrophil chemotaxis, secretory processes, and peptidase activity (P < .05). Species prevalent in NETs-positive fistulas correlated positively with immune responses and wound healing pathways, whereas bacteria in NETs-negative fistulas correlated negatively. NETs were negatively associated with tissue infliximab levels (P = .001) and healing outcomes (P = .025). Our findings reveal unique microbial and transcriptomic signatures associated with NETs in pfCD, highlighting their profound influence on clinical outcomes.

Effects of i-PRF, A-PRF+, and EMD on Osteogenic Potential of Osteoblasts on Titanium.

The study evaluates three biologically active substances with known bone-inductive potential on previously decontaminated titanium (Ti) discs. Rough and smooth Ti surfaces were contaminated with a multispecies biofilm and cleaned with a chitosan brush. Discs were treated either with injectable-platelet-rich fibrin (i-PRF), advanced platelet-rich fibrin (A-PRF+), or enamel matrix derivatives (EMDs) before osteoblast seeding. Biocompatibility, adhesion, migration, and gene expression of runt-related transcription factor 2 (RUNX2), collagen Type I Alpha 2 (COL1a2), alkaline phosphatase (ALP), osteocalcin (OC), and osteonectin (ON) were performed. All the tested biologic agents similarly increased cell viability. Specifically, osteoblasts seeded over i-PRF and EMD-treated surfaces showed improvement in adhesion and migration and significantly increased ALP, OC, ON, RUNX-2, and COL1a2 mRNA levels up to 2.8 fold (p < 0.05) with no differences between Ti surfaces. i-PRF and EMD possess beneficial bioactive properties that enhance tissue healing and promote regeneration on thoroughly sterilized surfaces. Biologically active materials may hold the potential to influence the process of implant re-osseointegration, which warrants more research since sterilization of the affected surfaces under clinical conditions is still not reliably possible and remains one of the greatest challenges.

Mesenchymal Stem Cell Therapy Mitigates Acute and Chronic Lung Damages of Sulfur Mustard Analog Exposure

Sulfur mustard (SM) is an established chemical weapon that can result in severe damage to parts of the body. Currently, there are no effective treatments available for SM-caused damage. We aimed to investigate the therapeutic potential of adipose-derived mesenchymal stromal cells (AD-MSCs) and conditioned medium (CM-MSCs) in acute and chronic pulmonary mouse models caused by 2-chloroethyl ethyl sulfide (CEES), an SM analog. The mice were divided into 4 experimental groups:(1) CEES+AD-MSCs, (2) CEES+CM-MSCs, (3) CEES, and (4) control. The model observation time was divided into 7 days for the short and 6 months for the long term. AD-MSCs were injected into mice via intraperitoneal injection 24 hours after CEES exposure. The therapeutic effects of AD-MSCs on pulmonary tissue damage were assessed using a histopathologic assay, measuring the neutrophil count, and bronchial alveolar lavage fluid (BALF) protein level. The levels of inflammatory and anti-inflammatory cytokines were evaluated using the enzyme-linked immunosorbent assay as the outcomes of interest. Lung damage progression was reduced by AD-MSC treatment in mice after CEES injection into the peritoneum. The proportion of CD11b+F4/80+ macrophages in the peritoneum was significantly lowered by AD-MSC treatment following CEES exposure. AD-MSC administration also reduced the level of pro-inflammatory cytokines, BALF protein, and nitric oxide levels in the peritoneal cavity. By reducing inflammation and enhancing tissue healing, AD-MSCs and CM-MSC help prevent acute lung damage caused by CEES. The current study supports the use of a mouse model as a solid experimental foundation and indicates potential use for future cell treatment.

Regenerative Inflammation: The Mechanism Explained from the Perspective of Buffy-Coat Protagonism and Macrophage Polarization.

The buffy-coat, a layer of leukocytes and platelets obtained from peripheral blood centrifugation, plays a crucial role in tissue regeneration and the modulation of inflammatory responses. This article explores the mechanisms of regenerative inflammation, highlighting the critical role of the buffy-coat in influencing macrophage polarization and its therapeutic potential. Macrophage polarization into M1 and M2 subtypes is pivotal in balancing inflammation and tissue repair, with M1 macrophages driving pro-inflammatory responses and M2 macrophages promoting tissue healing and regeneration. The buffy-coat's rich composition of progenitor cells, cytokines, and growth factors-such as interleukin-10, transforming growth factor-β, and monocyte colony-stimulating factor-supports the transition from M1 to M2 macrophages, enhancing tissue repair and the resolution of inflammation. This dynamic interaction between buffy-coat components and macrophages opens new avenues for therapeutic strategies aimed at improving tissue regeneration and managing inflammatory conditions, particularly in musculoskeletal diseases such as osteoarthritis. Furthermore, the use of buffy-coat-derived therapies in conjunction with other regenerative modalities, such as platelet-rich plasma, holds promise for more effective clinical outcomes.

"Navigating the tides of recovery": early vs. delayed osteosynthesis for closed tibia fractures complicated by acute compartment syndrome - an analysis of one hundred and three cases.

In cases of closed tibia fractures with acute compartment syndrome (ACS), there is no established agreement on whether performing internal fixation at the time of closure or after healing of the fasciotomy wounds would affect the likelihood of non-union or infection risk. The study aims to compare fracture union rates, incidence of infection, and overall outcomes between early and delayed definitive fixation. Retrospective analysis of closed tibia fractures (AO/OTA 41, 42) with ACS between 2010 and 2019 with a minimum two years follow-up. The patients were grouped into group-1 (early-definitive fixation group) and group-2 (delayed-definitive fixation group). The patients were further subdivided into - 1A(early-plate osteosynthesis), 1B(early-intramedullary nail fixation), 2A(delayed-plate osteosynthesis), and 2B(delayed-intramedullary nail fixation). Incidence of ACS in closed tibia fractures was 3.85%. Of the 103 patients included, the patients with plate fixation had a significantly higher union rate in the delayed group (100% vs. 91.66%; P = 0.0001). Similarly, among patients with nail fixation, a significantly higher union rate was seen in the delayed group (96.30% vs. 85.19%; P = 0.0016). The overall incidence of infection was 22.3% (23/103). Moreover, infection was higher in the early definitive fixation group (30.16% vs. 10%; P = 0.016). With a lower incidence of infection and higher union rate among the delayed definitive fixation group, we propose to postpone the definitive fixation of closed tibia fractures complicated by ACS till the complete healing of fasciotomy wounds. This allows for adequate soft tissue healing and improvement in the biological environment of fracture, which boosts the chances of successful union and reduces infection risks.

Unveiling the Intricacies: Exploring Stepwise Initiation of Peritoneal Dialysis in a Single-Center Setting

Background and Objectives: Chronic kidney disease (CKD) poses a significant global health challenge, necessitating effective renal replacement therapies. Peritoneal dialysis (PD) offers a patient-friendly, home-based alternative to hemodialysis. The Stepwise Initiation of Peritoneal Dialysis (SIPD) method, used in the SPD group and involving a gradual introduction of PD, presents a potential advantage over traditional protocols, yet the scientific literature on its efficacy and safety is limited. Materials and Methods: We conducted a retrospective analysis of 39 end-stage renal disease patients undergoing SIPD and 78 patients receiving conventional PD (CPD) at a single center from 1 January 2010 to 31 December 2023. Patients were matched for age and sex. Surgical techniques, early and late complications, infection rates, and catheter survival were evaluated. Data were analyzed using statistical methods, including the chi-square test, t-test, and negative binomial regression. Results: The mean break-in period was significantly more extended for the SPD group (176.05 ± 154.39 days) compared to the CPD group (26.87 ± 58.45 days). Early complications were similar between groups, but late complications, including peritonitis, were significantly higher in the CPD group. The SPD group experienced fewer infection events (28 vs. 80, p = 0.043). Median catheter survival times were 1486 days for SPD and 1774 days for CPD, with no statistical difference. Age was a significant factor in peritonitis incidence, increasing with age in both groups. Conclusions: Our study suggests that SPD may reduce the incidence of catheter-related infections and peritonitis compared to CPD. The extended break-in period in SPD could enhance tissue healing and reduce biofilm formation, thereby contributing to fewer infectious complications. Despite these findings, no significant difference in overall catheter survival was observed. Further multi-center studies with larger sample sizes are recommended to confirm these results and explore the economic impact of SPD vs. CPD.