Biomedical subjects

M Santin

Publications and source records attributed to M Santin.

At least 19 recordsLinked to original sources

PubMed2006

In vivo assessment of the osteointegrative potential of phosphatidylserine-based coatings.

The successful implantation of titanium-based implants for orthopaedic and dental applications is often hindered because of their mobility, which arises because of a lack of direct binding of the metal surface to the mineral phase of the surrounding bone. Ceramic coatings, although ensuring the integration of the implant within the tissue, are unstable and carry risks of delamination and of failure. Recently, a novel biomimetic approach has been developed where porous titanium implants are coated with calcium-binding phospholipids able to catalyse the nucleation of discrete apatite crystals after only 30 min incubation in simulated body fluids. The present work assesses the osteointegrative potential of this new class of coatings in an in vivo rabbit model and compares its performance with those of bare porous titanium and hydroxyapatite-coated titanium. The data obtained show that phosphatidylserine-based coatings, whilst resorbing, drive the growing bone into apposition with the metal surface. This is in contrast to the case of bare titanium.

Animals↗

PubMed2006

Chemical-physical characterization and in vitro preliminary biological assessment of hyaluronic acid benzyl ester-hydroxyapatite composite.

HYAFF11 is a biocompatible, biodegradable benzyl ester of hyaluronic acid. However, in order to use it for orthopedic application, its mechanical performance needs to be improved. In this study, a novel composite based on HYAFF11 polymer matrix reinforced with hydroxylapatite (HA) has been developed. Its advantage is having a similar component of the mineral phase of bone resulting in favorable osteoconductive properties. The present study has examined the compressive mechanical and surface chemical-physical properties of the novel HYAFF11-HA composite. Preliminary biological investigations, including pH and cytotoxicity studies of the material extracts, have also been performed using an in vitro primary human osteoblast-like cell model. Moreover, protein, especially fibronectin adsorption has been investigated following incubation in culture medium and human plasma. The results show a grainy surface topography composed mainly of C, P, and Ca, with a Ca/P atomic ratio indicating HA on the composite surface. Mechanical analysis shows an improvement of the compressive properties of HYAFF11 matrix, both in the dry and swollen states, with values in the range of that of spongy bone. No cytotoxic effects and no inhibition of cell proliferation have been observed in the presence of the material extracts with pH values within acceptable ranges for cell vitality. Protein studies reveal a similar pattern, but a higher amount of fibronectin following incubation in human plasma when compared with culture medium. The results show that the novel HYAFF11-HA composite shows a great potential for application in orthopedic fields, especially as vertebral trabecular bone substitute.

Biocompatible Materials↗

PubMed2004

Group B streptococcal disease in nonpregnant adults: incidence, clinical characteristics, and outcome.

A retrospective review of 150 cases of group B streptococcal disease in nonpregnant adults over an 8-year period was performed in a single tertiary-care teaching hospital to determine the incidence, clinical spectrum, and outcome of the disease. Incidence increased from 0.53 cases per 1,000 admissions in the 1993-1994 period to 0.96 cases per 1,000 admissions in 1999-2000 (P=0.013, chi-square test for trend). Bacteremia also increased from 0.15 to 0.42 cases per 1,000 admissions over the same period of time (P=0.005, chi-square test for trend). The mean age of the patients was 61.4 years, and 92% had at least one underlying disease. Bacteremia was detected in 60.9% of patients in whom blood cultures were performed. Fourteen (9.3%) patients died. Factors independently associated with an increased risk of dying were shock at diagnosis (OR, 23.96; 95%CI, 3.44-166.57; P=0.001) and cancer (OR, 4.96; 95%CI, 1.43-17.20; P=0.012). Group B streptococcal disease in nonpregnant adults is on the rise in the hospital investigated, particularly in persons with underlying conditions. The clinical spectrum of the disease ranges from localized to severe bacteremic infections. Shock at diagnosis and cancer are factors independently associated with a higher fatality rate.

Adult↗

PubMed2004

Incidence and molecular typing of Mycobacterium kansasii in a defined geographical area in Catalonia, Spain.

A retrospective population-based study was conducted between January 1990 and December 1998 to investigate the incidence of Mycobacterium kansasji disease and the heterogeneity of the isolates in a well-defined geographical area in Catalonia, Spain. A total of 136 patients were identified. Overall incidence and incidence in AIDS patients was 1.5 (95% CI 1.2-1.8) and 1089.6 (95% CI 689-1330) cases/100,000 persons per year respectively, which is comparable to that reported from most of other geographical areas. Surprisingly, although 7 subtypes of M. kansasii have been consistently reported, in the present study 91 of the 93 isolates (97.8%) tested for genotype were subtype I, regardless of HIV status of the patients. In conclusion, the high rate of infection observed in the AIDS population contributes significantly to the burden of the M. kansasii disease in our area. M. kansasii disease in our geographical area was almost exclusively caused by subtype I regardless of HIV status.

Acquired Immunodeficiency Syndrome↗

PubMed2004

Factors inducing in-stent restenosis: an in-vitro model.

In-stent restenosis is caused by the proliferation of the smooth muscle cells (SMCs) following a host response towards the implanted device. However, the precise biochemical and cellular mechanisms are still not completely understood. In this paper, the behaviour of SMCs has been investigated by an in vitro model where the cells were stimulated by platelet derived growth factor (PDGF) on tissue-like substrates as well as on biomaterials such as stainless steel (St) and diamond-like carbon (DLC)-coated St. The results demonstrated that SMCs have a completely different adhesion mode on St and become particularly prone to proliferation and pro-inflammatory cytokine secretion under PDGF stimulus. This would suggest that restenosis may caused by the accidental contact of the SMC with the St substrate under an inflammatory insult.

Carbon↗

PubMed2003

Identification of assemblage A Giardia in white-tailed deer.

Fecal samples were collected from hunter-killed white-tailed deer (Odocoileus virginianus) during a managed hunt in a central Maryland county. Fecal samples were cleaned of debris and concentrated by CsCl density gradient centrifugation and stained with MerIFluor reagents. Stained samples were examined by fluorescent microscopy for the presence of Giardia sp. cysts. One of 26 samples was found to be positive for Giardia sp. Polymerase chain reaction amplification using primers directed to the beta-giardin and TPI genes identified the same sample as the only positive one. Sequencing of the beta-giardin and TPI genes revealed that the Giardia sp. belonged to assemblage A, a genotype infectious for humans and also reported in a small percentage of cattle. This is the first report of assemblage A Giardia sp. in deer and suggests that deer could be a potential source of infectious cysts for humans and cattle.

Animals↗

PubMed2003

Mycobacterium kansasii disease among patients infected with human immunodeficiency virus type 1: improved prognosis in the era of highly active antiretroviral therapy.

OBJECTIVE: To investigate changes in survival and trends in occurrence of Mycobacterium kansasii disease in HIV-infected patients after implementation of highly active antiretroviral therapy (HAART). METHODS: Retrospective analysis of cases of M. kansasii infection diagnosed at the Hospital Universitari de Bellvitge, Barcelona, Spain, between 1991 and 2002. As HAART was introduced at the end of 1996, the study period was divided into periods A (1991-1996) and B (1997-2002). RESULTS: During the study period 44 cases of active M. kansasii disease were identified. The median number of cases per year was five in period A and two in period B. There were no differences in clinical presentation between the two periods. The estimated 24-month survival rate was 16% for period A and 65% for period B (P = 0.0065). Both HAART (RR 11.2; 95% CI 3.8-33.9; P < 0.001) and non-disseminated disease (RR 2.45; 95% CI 1.1-5.2; P = 0.02) were independently associated with longer survival. CONCLUSIONS: A substantial improvement in the outcome and a fall in new cases of M. kansasii in patients infected with HIV-1 was observed in our institution, mainly as a consequence of the introduction of effective antiretroviral therapy. Antiretroviral treatment should be encouraged in these patients, even in cases of severe immunosuppression.

Adult↗

PubMed2002

Contamination of Atlantic coast commercial shellfish with Cryptosporidium.

Shellfish (oysters and/or clams) were obtained from 37 commercial harvesting sites in 13 Atlantic coast states from Maine to Florida and one site in New Brunswick, Canada. Gill washings from each of 25 shellfish at each site were examined by immunofluorescence microscopy (IFA) for oocysts of Cryptosporidium. Gill washings from another 25 shellfish at each site were grouped into five pools of five shellfish each. DNA from each pool was utilized for PCR and genotyping. Oocysts were found in 3.7% of 925 oysters and clams examined by IFA in shellfish from New Brunswick and 11 of 13 states. Cryptosporidium DNA was detected by PCR in 35.2% of 185 pools. Cryptosporidium parvum genotypes 1 and 2, and Cryptosporidium meleagridis,all of which have been identified in infected humans, were identified at 37.8% of the sites. Gill washings from every site were tested for the presence of infectious oocysts by biological assay in neonatal BALB/c mice but no mice were found infected, suggesting that either the oocysts were no longer infectious or infections in mice were below the level of detection. Collectively, these findings indicate that Cryptosporidium species, indicative of pollution from human and animal feces and potentially infectious for humans, were found in commercial shellfish from 64.9% of sites examined along the Atlantic coast by either microscopy or molecular testing. Previous reports link periods of high rainfall with the elevated numbers of pathogen contaminated shellfish. Because shellfish in the present study were examined during a period of exceptionally low precipitation, the data are thought to underestimate the number of Cryptosporidium contaminated shellfish likely to be found during periods of normal or above normal precipitation.

Animals↗

PubMed1999

In vitro evaluation of the inflammatory potential of the silk fibroin.

Silk fibroin membranes recently have been suggested as matrices for biomedical applications, such as guided tissue regeneration and burn wound dressings. The aim of this study was to evaluate the inflammatory potential of fibroin films and to compare the fibroin films with two model materials with completely different physico-chemical properties: poly(styrene) and poly(2-hydroxyethyl methacrylate). Fibroin bound lower levels of fibrinogen than did the two synthetic polymers while the same amounts of adsorbed human plasma complement fragment C3 and IgG were detected. Studies of the binding strength of C3 to fibroin, evaluated by a novel experimental procedure, indicated the occurrence of strong hydrophobic interactions at the interface. The activation of the mononuclear cells by fibroin, measured as interleukin 1beta production, was lower than the reference materials. Adhesion experiments showed the ability of the macrophages to adhere to fibroin by filopodia without a complete spreading of the cells. The results achieved in this study demonstrate that the interactions of fibroin with the humoral components of the inflammatory system were comparable with those of the two model surfaces while the degree of activation and adhesion of the immunocompetent cells appeared more limited.

Adsorption↗

PubMed1999

Effect of the urine conditioning film on ureteral stent encrustation and characterization of its protein composition.

The goal of this study was to characterize the protein composition of the conditioning film deposited onto the surface of ureteral stents during in vivo implantation and to relate its presence to the precipitation of calcium crystals. The protein pattern of the conditioning film of implanted nonencrusted and encrusted urological stents was assessed by SDS-PAGE and Western blot of the desorbed species. The results obtained highlighted different electrophoresis profiles between nonencrusted and encrusted stents. Western blot showed the ubiquitous presence of albumin, while Tamm-Horsfall Protein and alpha1-microglobulin adsorption was limited to nonencrusted devices. By an in vitro dynamic model in which artificial urine was flowed through the lumen of control and retrieved nonencrusted stents, we demonstrated that the organic layer remarkably enhanced crystal precipitation and aggregation events on the surface.

Adsorption↗

PubMed1999

Collagen-bound alpha1-microglobulin in normal and healed tissues and its effect on immunocompetent cells.

The mechanisms devoted to the protection of the extracellular matrix collagen from the inflammatory insult are not fully understood. We investigated the presence of the immunosuppressive glycoprotein alpha1-microglobulin in healed tissues such as scars and periprosthetic membranes, comparing them with normal skin. Immunohistochemistry showed that alpha1-microglobulin was mainly present along collagen fibrils and in the epidermis. The presence of this protein was confirmed by Western blot of the tissue homogenates, while ELISA showed lower levels in the healed tissues. In vitro, the purified alpha1-microglobulin bound collagen by a cooperative mechanism and attenuated the collagen-induced activation of the mononuclear cells.

Blotting, Western↗

PubMed1998

Possible role of alpha-1-microglobulin in mediating bacterial attachment to model surfaces.

Urine proteins in the molecular weight range of 9-137 kDa deposit to an equal extent from pooled human urine onto glass (12.7 +/- 1.9 micrograms/cm) and polystyrene (11.8 +/- 1.8 micrograms/cm). Selective desorption of the proteins was achieved by washing with water or water/isopropanol mixtures. Irrespective of the washing process, proteins of molecular weight greater than 90 kDa remained associated with both surfaces while water washings alone removed most low molecular weight material. A 29 kDa protein, alpha-1-microglobulin, was removed from glass by water washing but required a 30% (v/v) isopropanol wash to desorb from polystyrene, implying attachment via hydrophobic bonding. The adhesion to polystyrene surfaces of Pseudomonas aeruginosa B4, a clinical isolate from a urinary tract infection (UTI), was strongly associated with the presence of alpha-1-microglobulin, which may be acting as a mediator of bacterial adhesion.

Adsorption↗

PubMed1998

Changes in serum conditioning profiles of glutaraldehyde-crosslinked collagen sponges after their treatment with calcification inhibitors.

The purpose of this study was to evaluate the effects of the calcification inhibitors FeCl3 and sodium dodecyl sulfate (SDS) on the morphology of glutaraldehyde-crosslinked type I collagen sponges and on their serum conditioning. Scanning electron microscopy (SEM) showed that the morphology of the sponges, already modified by glutaraldehyde crosslinking, underwent further changes after treatment of the hydrogels with inhibitors. Coral-like structures were found to branch from the bulk of the material especially in the case of SDS-treated samples. The composition and morphology of the conditioning layers was characterized after 48 h incubation in serum by SDS-polyacrylamide gel electrophoresis-immunoblot of the adsorbed proteins, by energy-dispersive X-ray analysis of the elements (EDX), and by SEM of the conditioned surfaces. All the samples showed the adsorption of proteins with molecular weights ranging from 10 to 203 kD. However, the peculiar adsorption of an approximately 10-kD band (complement C3 fragment) and of fibronectin were detected in the case of glutaraldehyde-crosslinked collagen. On the other hand, glutaraldehyde-crosslinked collagen treated with 0.1M FeCl3 showed the remarkable adsorption of a 29-kD band. The glutaraldehyde-crosslinked hydrogels showed the massive precipitation of crystals on their exposed surfaces, whereas a disordered network structure surrounding the collagen fibrils was found in the case of the samples pretreated with inhibitors. A predominant precipitation of sodium and chloride was detected in all the sponges, although the ratio between the peaks changed from from one hydrogel to another. The results reported in this article clearly indicate that the treatments with SDS and FeCl3 change the surface conditioning of collagen sponges, suggesting a possible role of deposited serum solutes in affecting mineralization processes on bioprosthesis.

Blood Physiological Phenomena↗

PubMed1998

Adsorption of serum alpha-1-microglobulin onto biomaterials.

The adsorption of alpha-1-microglobulin (alpha-1-m) from serum to the surface of polymers with different physicochemical properties was investigated. Enzyme-linked immunosorbent assay showed binding of this protein to the surface of polystyrene (PS), polyvinyl chloride (PVC) and a polyurethane, Chronoflex, after water washing, but only trace levels could be detected on two polymethacrylate derivatives, polymethyl methacrylate and poly(2-hydroxyethyl methacrylate). alpha-1-m was selectively desorbed from the five materials by sequential washes of serum-conditioned surfaces with isopropanol solutions at increasing concentrations. The presence of alpha-1-m in the washing supernatants was detected by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The relative binding strength of alpha-1-m to each surface was evaluated as the isopropanol (IsoPOH) concentration required to desorb the protein from that surface. Analysis of bound proteins by SDS-PAGE conclusively demonstrated the binding of a range of serum proteins, including alpha-1-m, to all polymer systems, but with varying binding strengths. The majority of protein was removed by water washing for the polymethacrylate polymers, while varying concentrations of IsoPOH were required to desorb proteins from PS, PVC and Chronoflex. There was a correlation between the hydrophobic nature of the material, determined by water contact angle measurements, and adsorption of alpha-1-m. Immunoblotting of isopropanol-eluted proteins by alpha-1-m antibodies showed the positive staining of a 29 kDa protein as well as selected bands within a molecular weight range of 40 200 kDa, suggesting the adsorption of this protein as both free and complexed forms. The ability of alpha-1-m to adsorb on to material surfaces and to participate in events relevant to the biocompatibility of a polymer, such as bacterial infection or inflammation control, suggests the need for further characterization of the properties of this protein.

Journal Article↗

PubMed1998

Changes in the surface conditioning of calcium-salt crystals treated with physiological and alkaline urine.

OBJECTIVE: To study, using an in vitro model, the early phases of deposition of urinary components onto the surface of calcium-salt crystals treated with physiological and alkaline urine. MATERIALS AND METHODS: Calcium carbonate, oxalate and phosphate crystals were incubated in either freshly collected 'physiological' urine (pH 5.5) or with urine at pH 8.0. The surface conditioning was characterized using sodium-dodecyl sulphate-polyacrylamide gel electrophoresis immunoblot profiles of the adsorbed proteins and by Fourier transform infrared spectroscopy. Crystal morphology and aggregation were assessed using scanning electron microscopy. RESULTS: The patterns of protein adsorption from physiological urine showed the ubiquitous adsorption of bands within 51-86 kDa, while Tamm-Horsfall protein (THP) and alpha 1-microglobulin were found only in calcium oxalate crystals. Less aggregation was detected in calcium oxalate and phosphate crystals treated in urine at pH 5.5, while a new crystalline phase was deposited on calcium carbonate surfaces. Incubation in alkaline urine led to changes in the protein electrophoretic profiles, with a significant variation in the morphology of the inorganic phase only in calcium phosphate crystals. CONCLUSIONS: The binding of urinary proteins onto crystals depends on the chemistry of the surface and on the physicochemical composition of the urine. THP, albumin, alpha 1-microglobulin and a 20 kDa protein were able to bind calcium crystals under different circumstances. Except for THP, there was no clear relationship between the adsorption of proteins on crystals and the re-arrangement of the inorganic phase.

Blotting, Western↗

PubMed1997

Adhesion of bacteria to stainless steel and silver-coated orthopedic external fixation pins.

Bacterial adhesion to silver-coated orthopedic external fixation pins was compared with stainless steel controls in an in vitro study. Using five bacterial isolates from wound infections, the silver coating was found to reduce adhesion for Escherichia coli, Pseudomonas aeruginosa, and two strains of Staphylococcus aureus while the converse applied for Staphylococcus haemolyticus. When placed in human serum, both surfaces were conditioned to a similar extent with serum proteins; this conditioning lead to further reductions in bacterial adhesion, ultimately approaching similar levels for both stainless steel and silver-coated samples.

Bacterial Adhesion↗

PubMed1997

Adsorption of alpha-1-microglobulin from biological fluids onto polymer surfaces.

A recent study in our laboratory has identified the potential role of urine-derived alpha-1-microglobulin (alpha-1-m) in mediating Pseudomonas aeruginosa adhesion to polystyrene, while other workers have suggested a possible role of the protein in the immunological response. Due to the ubiquitous presence of alpha-1-m in body fluids, the adsorption of the protein from serum, cerebrospinal fluid, urine and used continuous ambulatory peritoneal dialysis fluid onto polystyrene was investigated. The treated surfaces were sequentially immersed in water and increasingly concentrated isopropanol-water solutions in order to selectively desorb bound proteins on the basis of their binding strength. Sodium dodecyl sulphate-polyacrylamide gel electrophoresis of the wash supernatants showed different protein desorption profiles for each biological fluid, despite the qualitative similarity between the protein composition of the fluids, and highlighted the uptake of alpha-1-m from each fluid to the surface. In the case of urine, the analysis was extended to commercial polyurethane and silicone stents. The ease of desorption of urine-derived alpha-1-m could be correlated with surface hydrophobicity of the stent biomaterial.

Adsorption↗

PubMed1997

Hospital care for persons with AIDS in the European Union.

This study estimates the current and future hospital resources for AIDS patients in the European Union (EU), using multinational scenario analysis (EU Concerted Action BMH1-CT-941723). In collaboration with another EU-project ('Managing the Costs of HIV Infection'), six national European studies on the utilization of hospital care for AIDS have been selected to provide the data for our analysis. The selection criteria involve recentness, quality, comparability, accessibility and representativeness. Baseline hospital resource utilization is estimated for hospital inpatient days and outpatient contracts, using a standardized approach controlling for two severity stages of AIDS (chronic stage and late stage). The epidemiological part of the study is based on standard models for backcalculating HIV incidence and projecting AIDS incidence, prevalence and mortality. In the next step, baseline resource utilization is linked to epidemiological information in a mixed prevalence and mortality-based approach. Several scenarios render different future epidemiological developments and hospital resource needs. For the year 1999, hospital bed needs of 10,000-12,700 in the EU are indicated, representing an increase of 20-60% compared to the estimated current (1995) level. The projected range for 1999 corresponds to a maximum of 0.65% of all hospital beds available in the EU. The growth in the number of outpatient hospital contacts is projected to possibly exceed that of inpatient days up to 1.82 million in 1999. Our methodology illustrates that estimation of current and future hospital care for AIDS has to be controlled for severity stages, to prevent biases. Further application of the multinational approach is demonstrated through a 'what-if' analysis of the potential impact of combination triple therapy for HIV/AIDS. Estimation of the economic impact of other diseases could as well benefit from the severity-stages approach.

Acquired Immunodeficiency Syndrome↗