Human enhancement: could you become infected with a computer virus?

Experiments demonstrating human enhancement through the implantation of technology in healthy humans have been performed for over a decade by some academic research groups. More recently, technology enthusiasts have begun to realize the potential of implantable technology such as glass capsule RFID transponders. In this paper it is argued that implantable RFID devices have evolved to the point whereby we should consider the devices themselves as simple computers. Presented here is the infection with a computer virus of an RFID device implanted in a human. Coupled with our developing concept of what constitutes the human body and its boundaries, it is argued that this study has given rise to the world’s first human infected with a computer virus. It has taken the wider academic community some time to agree that meaningful discourse on the topic of implantable technology is of value. As developments in medical technologies point to greater possibilities for enhancement, this shift in thinking is not too soon in coming.

Evaluation of negative photo-patternable PDMS for the encapsulation of neural electrodes

This communication examines the suitability of a photo-patternable polydimethylsiloxane (PP-PDMS) elastomer as an insulating material for implantable microelectrodes. PP-PDMS is produced by mixing a photoinitiator (2-hydroxy-2-methylpropiophenone) with the PDMS base and curing agent. Subsequent exposure to UV radiation and development of the elastomeric “photo-resist” allows for the definition of well-defined openings within the PP-PDMS film. The dielectric constants of PP-PDMS and PDMS are similar (ε ≈ 2.6, f <;1MHz). Gold film microelectrodes patterned on glass or a PDMS substrate are encapsulated with PP-PDMS, while recording sites as small as 104 μm2 can be obtained in the PP-PDMS layer. The cytotoxicity of the PP-PDMS was preliminary tested in vitro by culturing 3T3 fibroblasts in PP-PDMS extracts. No adverse effects were observed in cultures exposed to PP-PDMS films initially leached in isopropanol solvent for 48h.

Advances in ophthalmic drug delivery

Various strategies for ocular drug delivery are considered; from basic formulation techniques for improving availability of drugs; viscosity enhancers and mucoadhesives aid drug retention and penetration enhancers promote drug transport into the eye. The use of drug loaded contact lenses and ocular inserts allows drugs to be better placed where they are needed for more direct delivery. Developments in ocular implants gives a means to overcome the physical barriers that traditionally prevented effective treatment. Implant technologies are under development allowing long term drug delivery from a single procedure, these devices allow posterior chamber diseases to be effectively treated. Future developments could bring artificial corneas to eliminate the need for donor tissue and one-off implantable drug depots lasting the patient’s lifetime.

Controlled Drug Release from Ureasil-Polyether Hybrid Materials

Flexible, transparent, and insoluble urea-cross-linked polyether-siloxane hybrids presenting a tunable drug delivery pattern were prepared using the sol-gel method from PEO (poly(ethylene oxide)) and PPO (poly(propylene oxide)) functionalized at both chain ends with triethoxysilane. Different polyether chain lengths were used to control the urea/siloxane (named ureasil) node density, flexibility, and swellability of the hybrid network. We herein demonstrate that the drug release from swellable hydrophilic ureasil-PEO hybrids can be sustained for some days, whereas that from the unswellable ureasil-PPO hybrids can be sustained for some weeks. This outstanding feature conjugated with the biomedically safe formulation of the ureasil cross-linked polyether-siloxane hybrid widens their scope of application to include the domain of soft and implantable drug delivery devices.

Reduced in vitro immune response on titania nanotube arrays compared to titanium surface

Material surfaces that provide biomimetic cues, such as nanoscale architectures, have been shown to alter cell/biomaterial interactions. Recent studies have identified titania nanotube arrays as strong candidates for use in interfaces on implantable devices due to their ability to elicit improved cellular functionality. However, limited information exists regarding the immune response of nanotube arrays. Thus, in this study, we have investigated the short- and long-term immune cell reaction of titania nanotube arrays. Whole blood lysate (containing leukocytes, thrombocytes and trace amounts of erythrocytes), isolated from human blood, were cultured on titania nanotube arrays and biomedical grade titanium (as a control) for 2 hours and 2 and 7 days. In order to determine the in vitro immune response on titania nanotube arrays, immune cell functionality was evaluated by cellular viability, adhesion, proliferation, morphology, cytokine/chemokine expression, with and without lipopolysaccharide (LPS), and nitric oxide release. The results presented in this study indicate a decrease in short- and long-term monocyte, macrophage and neutrophil functionality on titania nanotube arrays as compared to the control substrate. This work shows a reduced stimulation of the immune response on titania nanotube arrays, identifying this specific nanoarchitecture as a potentially optimal interface for implantable biomedical devices. © 2013 The Royal Society of Chemistry.

Tissue-engineering-based Strategies for Regenerative Endodontics

Stemming from in vitro and in vivo pre-clinical and human models, tissue-engineering-based strategies continue to demonstrate great potential for the regeneration of the pulp-dentin complex, particularly in necrotic, immature permanent teeth. Nanofibrous scaffolds, which closely resemble the native extracellular matrix, have been successfully synthesized by various techniques, including but not limited to electrospinning. A common goal in scaffold synthesis has been the notion of promoting cell guidance through the careful design and use of a collection of biochemical and physical cues capable of governing and stimulating specific events at the cellular and tissue levels. The latest advances in processing technologies allow for the fabrication of scaffolds where selected bioactive molecules can be delivered locally, thus increasing the possibilities for clinical success. Though electrospun scaffolds have not yet been tested in vivo in either human or animal pulpless models in immature permanent teeth, recent studies have highlighted their regenerative potential both from an in vitro and in vivo (i.e., subcutaneous model) standpoint. Possible applications for these bioactive scaffolds continue to evolve, with significant prospects related to the regeneration of both dentin and pulp tissue and, more recently, to root canal disinfection. Nonetheless, no single implantable scaffold can consistently guide the coordinated growth and development of the multiple tissue types involved in the functional regeneration of the pulp-dentin complex. The purpose of this review is to provide a comprehensive perspective on the latest discoveries related to the use of scaffolds and/or stem cells in regenerative endodontics. The authors focused this review on bioactive nanofibrous scaffolds, injectable scaffolds and stem cells, and pre-clinical findings using stem-cell-based strategies. These topics are discussed in detail in an attempt to provide future direction and to shed light on their potential translation to clinical settings.

Biofilme estafilocócico: prevenção, detecção da produção e determinação do perfil de resistência a antimicrobianos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estimulação elétrica com eletrodos não implantáveis no tratamento da bexiga hiperativa em adultos: revisão sistemática de ensaios clínicos randonizados

Pós-graduação em Bases Gerais da Cirurgia - FMB

Controlled swollen and drug release from urea-cross-linked polyether/siloxane hybrids

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Age-Related Maximum Heart Rate Among Ischemic and Nonischemic Heart Failure Patients Receiving beta-Blockade Therapy

Background: Equations to predict maximum heart rate (HRmax) in heart failure (HF) patients receiving beta-adrenergic blocking (BB) agents do not consider the cause of HF. We determined equations to predict HRmax in patients with ischemic and nonischemic HF receiving BB therapy. Methods and Results: Using treadmill cardiopulmonary exercise testing, we studied HF patients receiving BB therapy being considered for transplantation from 1999 to 2010. Exclusions were pacemaker and/or implantable defibrillator, left ventricle ejection fraction (LVEF) >50%, peak respiratory exchange ratio (RER) <1.00, and Chagas disease. We used linear regression equations to predict HRmax based on age in ischemic and nonischemic patients. We analyzed 278 patients, aged 47 +/- 10 years, with ischemic (n = 75) and nonischemic (n = 203) HF. LVEF was 30.8 +/- 9.4% and 28.6 +/- 8.2% (P = .04), peak VO2 16.9 +/- 4.7 and 16.9 +/- 5.2 mL kg(-1) min(-1) (P = NS), and the HRmax 130.8 +/- 23.3 and 125.3 +/- 25.3 beats/min (P = .051) in ischemic and nonischemic patients, respectively. We devised the equation HRmax = 168 - 0.76 x age (R-2 = 0.095; P = .007) for ischemic HF patients, but there was no significant relationship between age and HRmax in nonischemic HF patients (R-2 = 0.006; P = NS). Conclusions: Our study suggests that equations to estimate HRmax should consider the cause of HF. (J Cardiac Fail 2012;18:831-836)

Metodologia de avaliação metrológica da medição de energia para analisadores de desfibriladores e cardioversores

Neste artigo descreve-se uma pesquisa na qual se desenvolveu um analisador de desfibriladores e cardioversores e se executou sua avaliação metrológica, sendo apresentados os resultados obtidos. A avaliação das incertezas de medição do analisador foi realizada de acordo com as determinações da versão brasileira do EA-4/02 - Expressão da Incerteza de Medição de Calibração publicado pelo INMETRO. Os resultados obtidos mostraram-se adequados às exigências de exatidão determinadas pelas normas ANSI/AAMI DF2 (American..., 1996) e ANSI/AAMI DF80 (American..., 2003), tendo apresentado uma incerteza expandida relativa para as medições de energia igual a 1,0% no pior caso. Nesta pesquisa foi também realizada uma análise da incerteza definicional do processo de calibração utilizado e avaliou-se a capacidade do processo. Para os cálculos da capacidade do processo, foi determinado um erro máximo para as medições de energia igual a 5% ou 1,0 J, o que for maior. Este erro máximo é igual a 1/3 do erro máximo admissível para a energia entregue pelos desfibriladores, em outras palavras, é igual ao erro máximo admissível para um instrumento de medição pela Norma ANSI/AAMI DF2 (American..., 1996). Os resultados obtidos para a capacidade do procedimento de calibração mostraram-se adequados para as especificações de um analisador de desfibriladores e cardioversores, tendo obtido como resultado, no pior caso, um índice de capacidade Cm igual a 2,87, que é bem superior, portanto, a 1,0, sendo este o limite mínimo para que o procedimento seja considerado capaz de calibrar a medição de energia sem atribuir uma incerteza definicional demasiadamente grande.

Estudo das complicações do cateter totalmente implantável em oncologia pediátrica: Comparação entre a punção da veia jugular interna e da veia subclávia no implante do cateter

Objetivo: Avaliar, por estudo prospectivo, a incidência de complicações relacionadas ao implante e uso de cateteres de longa permanência totalmente implantáveis (CLP) em crianças com câncer, comparando o implante por punção em veia subclávia (SCL) com o implante por punção em veia jugular interna (J). Método: estudo prospectivo com randomização da escolha da punção em veia subclávia ou veia jugular interna para o implante do cateter. Foram considerados como desfechos as complicações que levaram a retirada ou revisão do cateter. Resultados: 83 implantes foram randomizados no período de janeiro de 2004 a abril de 2006 e acompanhados até março de 2008. Dos 83 implantes selecionados 6 foram excluídos, permanecendo 43 pacientes no grupo SCL e 34 no grupo J. Não houve diferença estatística entre os dois grupos em relação à: distribuição por idade, sexo, número de leucócitos no implante, número de plaquetas, tipo de internação para cirurgia (ambulatorial ou não), se houve quimioterapia prévia ao implante e quanto ao tipo de cateter. Na avaliação das complicações se observou, incidência de infecção de 20% no grupo SCL e 11% no grupo J (p: 0,44), incidência de embolia de 23% no grupo SCL e 8% no grupo J (p: 0,11), e incidência de complicações total de 51% no grupo SCL e 23% no grupo J (p 0,02). A média do tempo de permanência do cateter foi de 12,6 meses para o grupo SCL e 14,8 para o grupo J (p: 0,38). A análise por regressão logística mostrou que o peso (p: 0,001) é um fator de risco envolvido com a infecção; e o peso (p: 0,020) e a marca do cateter (p: 0,03) são fatores de risco para embolia. Conclusões: há maior incidência de complicações tardias no grupo SCL. Os pacientes com menor peso tiveram risco maior de desenvolver infecção. Pacientes com menor peso e a marca do cateter são fatores de risco para a ocorrência de embolia do cateter

Differenziamento macrofagico: gli effetti dei polimeri sintetici

Research for new biocompatible and easily implantable materials continuously proposes new molecules and new substances with biological, chemical and physical characteristics, that are more and more adapted to aesthetic and reconstructive surgery and to the development of biomedical devices such as cardiovascular prostheses. Two classes of polymeric biomaterials seem to meet better these requirements: “hydrogels” , which includes polyalkylimide (PAI) and polyvinylalcohol (PVA) and “elastomers”, which includes polyurethanes (PUs). The first ones in the last decade have had a great application for soft tissue augmentation, due to their similarity to this tissue for their high water content, elasticity and oxygen permeability (Dini et al., 2005). The second ones, on the contrary, are widely used in cardiovascular applications (catheters, vascular grafts, ventricular assist devices, total artificial hearts) due to their good mechanical properties and hemocompatibility (Zdrahala R.J. and Zdrahala I.J., 1999). In the biocompatibility evaluation of these synthetic polymers, that is important for its potential use in clinical applications, a fundamental aspect is the knowledge of the polymers cytotoxicity and the effect of their interaction with cells, in particular with the cell populations involved in the inflammatory responses, i.e. monocyte/macrophages. In consideration of what above said, the aim of this study is the comprehension of the in vitro effect of PAI, PVA and PU on three cell lines that represent three different stages of macrophagic differentiation: U937 pro-monocytes, THP-1 monocytes and RAW 264.7 macrophages. Cytotoxicity was evaluated by measuring the rate of viability with MTT, Neutral Red and morphological analysis at light microscope in time-course dependent experiments. The influence of these polymers on monocyte/macrophage activation in terms of cells adhesion, monocyte differentiation in macrophages, antigens distribution, aspecific phagocytosis, fluid-phase endocitosis, pro-inflammatory cytokine (TNF-α, IL-1β, IL-6) and nitric oxide (NO) release was evaluated. In conclusion, our studies have indicated that the three different polymeric biomaterials are highly biocompatible, since they scarcely affected viability of U937, THP-1 and RAW 264.7 cells. Moreover, we have found that even though hydrogels and polyurethane influences monocyte/macrophage differentiation (depending on the particular type of cell and polymer), they are immunocompatible since they not induced significantly high cytokine release. For these reasons their clinical applications are strongly encouraged.

Propuesta de mejora de la coordinación temprana vertical y horizontal de asignaturas

[ES]En este artículo se aborda el proceso de elaboración de proyectos docentes en la Universidad de Las Palmas de Gran Canaria y se propone un nuevo esquema de gestión en su fase inicial de diseño y corrección para su aprobación anual. Esta propuesta pretende reducir el tiempo que dedican los profesores y la administración de servicios a esta tarea así como a facilitar la coordinación horizontal y vertical temprana a distintos niveles. Esta propuesta es perfectamente implantable con herramientas Web 2.0 de libre distribución y gratuitas.

Ruolo del test da sforzo cardiopolmonare nei pazienti affetti da cardiomiopatia ipertrofica in età pediatrica

Background Decreased exercise capacity, and reduction in peak oxygen uptake are present in most patients affected by hypertrophic cardiomyopathy (HCM) . In addition an abnormal blood pressure response during a maximal exercise test was seen to be associated with high risk for sudden cardiac death in adult patients affected by HCM. Therefore exercise test (CPET) has become an important part of the evaluation of the HCM patients, but data on its role in patients with HCM in the pediatric age are quite limited. Methods and results Between 2004 and 2010, using CPET and echocardiography, we studied 68 children (mean age 13.9 ± 2 years) with HCM. The exercise test was completed by all the patients without adverse complications. The mean value of achieved VO2 max was 31.4 ± 8.3 mL/Kg/min which corresponded to 77.5 ± 16.9 % of predicted range. 51 patients (75%) reached a subnormal value of VO2max. On univariate analysis the achieved VO2 as percentage of predicted and the peak exercise systolic blood pressure (BP) Z score were inversely associated with max left ventricle (LV) wall thickness, with E/Ea ratio, and directly related with Ea and Sa wave velocities No association was found with the LV outflow tract gradient. During a mean follow up of 2.16 ± 1.7 years 9 patients reached the defined clinical end point of death, transplantation, implanted cardioverter defibrillator (ICD) shock, ICD implantation for secondary prevention or myectomy. Patients with peak VO2 < 52% or with peak systolic BP Z score < -5.8 had lower event free survival at follow up. Conclusions Exercise capacity is decreased in patients with HCM in pediatric age and global ventricular function seems being the most important determinant of exercise capacity in these patients. CPET seems to play an important role in prognostic stratification of children affected by HCM.