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Purpose: Volar rim fractures of the distal radius are a spectrum of pathology that must be well identified and treated to achieve good outcomes and avoid surgical failures. New devices of fragment specific fixation have been developed during the last decades to fix this fragment. The purpose of this retrospective study was to evaluate the ability of APTUS® wrist distal radius system to securely fix different types of volar rim fractures. Methods: Patients with at least 1 year of follow-up and a preoperative CT-scan evaluation of the fracture pattern were included in the study. Clinical, radiological and functional outcomes were assessed. Results: Sixty-eight patients with an average follow-up of 34, 1 months (12–61) were included in the study. There were no clinical and radiological complications, including loss of reduction, device failure and tendon ruptures. No patients required hardware removal. Wrist range of motion in flexion–extension averaged 96°, while in pronation–supination 144°. At final follow-up mean visual analogue scale pain was 1,8. Questionnaires, as dissabilities of the arm, shouldder and hand (DASH) score and patient-related wrist evolution (PRWE) score were 6,6 and 3 respectively. Grip strenght measured 86% compared to the normal side. Conclusion: APTUS® wrist presents a versatile set of fragment specific fixation plates able to easily and securely fix all types of volar rim fracture. The system can be used with other devices without any kind of interference between them. When correctly placed and used with the right indications, no late complications can be recorded. [ABSTRACT FROM AUTHOR]

The skin is the absorption site for drug substances intended to treat loco-regional diseases, although its barrier properties limit the permeation of drug molecules. The growing knowledge of the skin structure and its physiology have supported the design of innovative nanosystems (e.g. liposomal systems) to improve the absorption of poorly skin-permeable drugs. However, despite the dozens of clinical trials started, few topically applied liposomal systems have been authorized both in the EU and the USA. Indeed, the intrinsic complexity of the topically applied liposomal systems, the higher production costs, the lack of standardized methods and the more stringent guidelines for assessing their benefit/risk balance can be seen as causes of such inefficient translation. The present work aimed to provide an overview of the physicochemical and biopharmaceutical characterization methods that can be applied to topical liposomal systems intended to be marketed as medicinal products, and the current regulatory provisions. The discussion highlights how such methodologies can be relevant for defining the critical quality attributes of the final product, and they can be usefully applied based on the phase of the life cycle of a liposomal product: to guide the formulation studies in the early stages of development, to rationally design preclinical and clinical trials, to support the pharmaceutical quality control system and to sustain post-marketing variations. The provided information can help define harmonized quality standards able to overcome the case-by-case approach currently applied by regulatory agencies in assessing the benefit/risk of the topically applied liposomal systems. [ABSTRACT FROM AUTHOR]

Curcumin (CURC) is endowed with many pharmacological properties, among these anti-inflammatory, antioxidant, antimicrobial, and anticancer activity. Unfortunately, CURC is basically water-insoluble and undergoes a rapid photodegradation, chemical degradation, and metabolism. CURC stability and solubility can be improved by the complexation with cyclodextrins, which are cyclic oligosaccharides with a hydrophilic outer surface and a lipophilic cavity. Thus, in this work, the formation of the inclusion complex between the semisynthetic hydroxypropyl-β-cyclodextrin (HPβCD) and CURC has been studied by means of phase solubility, differential scanning calorimetry and isothermal calorimetry experiments to assess the formation, stoichiometry and affinity constant of the obtained inclusion complexes. The thermodynamics of the complex formation has been studied in different hydroalcoholic solutions and the experiments have been performed at physiological and acidic pH to verify the effect of the ionization state on the efficacy of complex formation. Results show the relevance in the choice of the pH, solvent, and mixing time on the formation of the inclusion complex between active drug(s) and HPβCD. [ABSTRACT FROM AUTHOR]

This work describes the development of liposomes encapsulating curcumin (CURC) aiming to provide insights on the influence of CURC on the thermodynamic and skin permeation/penetration features of the vesicles. CURC-loaded liposomes were prepared by hydration of lipid film, in the 0.1–15% CURC:DPPC w/w ratio range. The obtained formulations were characterized for their size distribution, zeta potential and vesicle deformability, along with their thermodynamic properties and ex vivo skin penetration/permeation ability. Liposome size was 110–130 nm for all formulations, with fairly narrow size distribution (polydispersity index was ≤0.20) and a zeta potential mildly decreasing with CURC loading. DSC outcomes indicated that CURC interferes with the packing of DPPC acyl chains in liposome bilayer when CURC percentage was at least 10%, leading to a more fluid state than blank and low-payload vesicles. Consistently, the deformability index of liposomes with 15% CURC:DPPC was strongly increased compared to other formulations. This is congruent with ex vivo skin penetration/permeation results, which showed how more deformable liposomes showed an improved deposition in the epidermis, which acts as a reservoir for the active molecule. Altogether, results hint at a possible application of high payload liposomes for improved topical dermal accumulations of actives. [ABSTRACT FROM AUTHOR]

Quercetin (QCT) is a flavonoid possessing many activities, such as neuro-/cardioprotective, anti-inflammatory and anticancer, but its pharmacological application is severely curtailed by its low water solubility and in vivo bioavailability. The formation of a QCT–hydroxypropyl-β-cyclodextrin (HPβCD) host–guest complex is promising to improve QCT therapeutic potential. Therefore, here the heat effects of HPβCD solutions with QCT solutions in water–ethanol solvents at different concentrations were studied by calorimetric titration, and the stability of molecular complexes was assessed by UV–Vis spectrophotometry. Calorimetric titrations revealed the formation of a QCT/HPβCD host–guest complex with a stoichiometric ratio of 1:1 in X(EtOH) = 0.00, 0.05 and 0.10 molar fractions of solvents at pH = 7.0 and pH = 8.1. Thermodynamic parameters of the complex formation reaction (lgK; ΔrH; TΔrS) were obtained in these experimental conditions. Differently, no complex formation was noticed in water–ethanol mixed solvent when ethanol volume fraction exceeded 0.2 at neutral and alkaline pH, as well as a volume fraction higher than 0.1 at acidic pH. Furthermore, the results of differential scanning calorimetry tests run on dried HPβCD after dissolution in hydroalcoholic solutions indicated that ethanol and water compete for the complexation within the hydrophobic cavity of HPβCD. This explains the decreased QCT complexation efficacy in the presence of ethanol beyond 0.1 or 0.2 volume fraction. [ABSTRACT FROM AUTHOR]

Quercetin (QCT), a flavonoid derived from many fruits and vegetables, is endowed with manifold biological properties, such as the ability to elicit a strong inhibitory effect on the growth of several tumor cell lines. Unfortunately, the pharmacological application of QCT is severely restricted by its inherent hydrophobicity and consequent low in vivo bioavailability. The therapeutic potential of QCT can be unraveled by enhancing its solubility through the formation of a host-guest complex with hydroxypropyl-β-cyclodextrin (HPβCD). In this study, HPβCD·QCT complex has been obtained in liquid phase, at 37 °C and under a prolonged mixing (72 h), and using two buffers at pH = 3.6 and pH = 8.0. Phase solubility and differential scanning calorimetry (DSC) studies revealed that, at pH = 8.0, the complex was obtained with a 1:1 stoichiometric ratio and a strong enhancement of QCT solubility, while in acidic buffer complex formation was significantly thwarted. The affinity constant was calculated by isothermal calorimetry at pH = 8 and was found to be 489 ± 38 M, in good agreement with the value indirectly obtained from phase solubility tests 394 ± 101 M. The results confirmed the formation of the inclusion complex between QCT and HPβCD and highlight the importance of the choice of the appropriate solvent, pH, temperature and mixing time on the formation of host guest inclusion complex with active ingredient(s) and HPβCD. [ABSTRACT FROM AUTHOR]

Radiocapitellar prosthetic arthroplasty is a fascinating new option in the treatment of complex lesions of the elbow. The device has been developed in order to treat primitive and post-traumatic radiocapitellar degenerative arthritis, while preserving the ulnohumeral joint of the elbow. Compared to a radial head resection, it avoids valgus and axial instability of the elbow and forearm preventing ulnohumeral degeneration. Seven patients have been reviewed with a mean of follow-up of 40 months. Two of them presented with an acute trauma and five of them with a post-traumatic degenerative arthritis involving the radial compartment of the elbow. The patients' evaluation was performed using DASH and Mayo elbow performance score (MEPS). Implant overstuffing, loosening and degenerative changes of the ulnohumeral joint have been monitored with X-ray controls. All patients presented with a marked improvement in elbow function, no signs of overstuffing or ulnohumeral degeneration were observed. Two patients developed a clinically asymptomatic aseptic loosening of the radial press-fit stem. The radiocapitellar prosthetic arthroplasty shows convincing results in the treatment of symptomatic radiocapitellar degenerative arthritis. It has also been effective in acute trauma scenarios in the presence of major osteoarticular wearing or loss of the entire radiocapitellar joint. [ABSTRACT FROM AUTHOR]

Purpose: Vitamin K1 (VK1) is a molecule abundant in some species of leaf vegetables with beneficial effects in humans following administration on the skin. This work investigates the possibility to use formulations based on lipid vesicles, namely liposomes, transfersomes and ethosomes, suitable to be administered on the skin by nebulization and alternative to fat semisolid preparations present on the market. Methods: Lipid vesicles encapsulating VK1 were prepared and characterized. Ex-vivo experiments on Franz cells were carried out to study the VK1 accumulation/permeation in/through the skin. Vesicles interaction with the skin was investigated by confocal laser scanning microscopy (CLSM) and attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. Results: All developed carriers were stable following long-term storage and were not altered following nebulization. In ex-vivo experiments, vesicles with the highest deformability index, namely transfersomes and ethosomes, led to an enhanced VK1 accumulation/permeation into/through the skin. Interestingly, the nebulization of the vesicles led to a further increase of VK1 accumulation into the skin. Conclusions: In conclusion, to achieve a local effect of VK1 on the skin, the topical nebulization of VK1-containing transfersomes could offer a good compromise between a high VK1 penetration into the skin and a limited permeation through it. [ABSTRACT FROM AUTHOR]

Polymer chain entanglements in organic solvents can be considered a key parameter in the formation of non-spherical beads when electrospraying is employed. The shape of micro/nanometric drug delivery systems plays a major role since it can affect circulation, extravasation, distribution and in vivo clearance of the devices. In this frame, we investigated the influence of polymer processing parameters on the design of polylactic- co-glycolic acid non-spherical microdevices loaded with triamcinolone acetonide (TrA), a sparingly water soluble corticosteroid, prepared by electrospraying technique through a one-step process. In particular, we verified that the formation of non-spherical MDs is related to the presence of entanglements among polymer chains to select the optimal solution to be sprayed. The addition of TrA did not substantially affect the particle morphology in terms of size, size distribution and circularity at all the tested drug loadings. Furthermore, the drug could be released for a prolonged period, with controlled and reproducible kinetics for over 3 weeks. The mathematical modeling of release profiles highlighted that the release is mainly driven by degradation, at a higher extent in the case of low drug loading. [ABSTRACT FROM AUTHOR]

Drug-eluting beads (DEBs) are embolising devices in clinical use for the treatment of liver cancer by transarterial chemoembolisation. In this study, release kinetics of doxorubicin (DOX) and irinotecan (IRI) were investigated by experimental evaluations and mathematical modeling, based on Langmuir isotherm and two phenomenological models (Boyd/Bhaskar) developed to determine the actual mechanisms controlling drug release rate. The model was validated through release studies, in particular by assessing how drug loading, ionic strength of the release medium and device swelling during release influence drug release kinetics. Results demonstrated that IRI is released much faster than DOX, and that DEB volume strongly depends upon drug loading and fractional release. This effect was properly taken into account in developing the mathematical model. Experimental results were well fit by numerical simulations, and two different rate-controlling mechanisms were found to govern DOX and IRI delivery. [ABSTRACT FROM AUTHOR]

In tissue engineering, the recapitulation of natural sequences of signaling molecules, such as growth factors, as occurring in the native extracellular matrix (ECM), is fundamental to support the stepwise process of tissue regeneration. Among the manifold of tissue engineering strategies, a promising one is based on the creation of the chrono-programmed presentation of different signaling proteins. This approach is based upon the integration of biodegradable microspheres, loaded with suitable protein molecules, within scaffolds made of collagen and, in case, hyaluronic acid, which are two of the fundamental ECM constituents. However, for the design of bioactivated gel-like scaffolds the determination of release kinetics must be performed directly within the tissue engineering template. In this work, biodegradable poly(lactic-co-glycolic)acid (PLGA) microspheres were produced by the multiple emulsion-solvent evaporation technique and loaded with rhodamine-labelled bovine serum albumin (BSA-Rhod), a fluorescent model protein. The microdevices were dispersed in collagen gels and collagen-hyaluronic acid (HA) semi-interpenetrating networks (semi-IPNs). BSA-Rhod release kinetics were studied directly on single microspheres through confocal laser scanning microscopy (CLSM). To thoroughly investigate the mechanisms governing protein release from PLGA microspheres in gels, BSA-Rhod diffusion in gels was determined by fluorescence correlation spectroscopy (FCS), and water transport through the microsphere bulk was determined by dynamic vapor sorption (DVS). Moreover, the decrease of PLGA molecular weight and glass transition temperature (Tg) were determined by gel permeation chromatography (GPC) and differential scanning calorimetry (DSC), respectively. Results indicate that protein release kinetics and delivery onset strongly depend on the complex interplay between protein transport through the PLGA matrix and in the collagen-based release media, and water sequestration within the scaffolds, related to the scaffold hydrophilicity, which is dictated by HA content. The proper manipulation of all these features may thus allow the obtainment of a fine control over protein sequential delivery and release kinetics within tissue-engineering scaffolds. [ABSTRACT FROM AUTHOR]

Protein release from poly( d, l-lactide-co-glycolide) (PLGA) microspheres in an aqueous environment is governed by the diffusion of the protein through an autocatalytically degrading polymeric matrix. Many attempts have been made to model the release rate of proteins from biodegrading matrices, but the transport parameters involved in the process are not fully established at the microscale level. The aim of this work was to develop a new mathematical model taking into account the temporal evolution of the radial protein distribution during release, and to provide physical insight into the relation between local transport features and microsphere degradation. The model was validated by comparing its predictions with the experimentally determined protein concentration profiles in PLGA microspheres loaded with tetramethylrhodamine-labelled bovine serum albumin (BSA-Rhod) as a model protein. Morphological studies were carried out by scanning electron microscopy (SEM), while release kinetics and time-dependent BSA-Rhod concentration profiles within the microspheres were studied by a confocal laser scanning microscopy (CLSM)-assisted technique. The model, based on a modification of Fick’s second law of diffusion, could closely fit the experimental protein radial distribution profiles in the microspheres as a function of time. It is also a useful tool to ab initio design protein release devices using degrading matrices. [ABSTRACT FROM AUTHOR]