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Triple-negative breast cancer (TNBC) is an aggressive type of tumor that tends to recur in women. It is characterized by the absence of hormonal receptors, making it challenging to diagnosis and treatment. In this study, we investigated the anti-tumor effects of a pro-oxidant naphthoquinone derivative called bromo-naphthoquinone (BrNQ) isolated and combined with the antioxidant tannic acid (TA) in order to improve treatment. We used tumor cell lines MDA-MB-231 and HCC-70, as well as normal breast cells, HB4a, as control. Initially, viability assays conducted within 72 hours showed that the combination of compounds had a synergistic and notable cytotoxic effect on the tumor cells. The increased cytotoxicity appeared to be linked to changes in the cellular redox status, as indicated by a significant rise in reactive oxygen species (ROS) and though alterations in the level of thiol. The treatment also induced apoptosis, inhibited proliferation, and reduced migration, particularly in the MDA-MB-231 cell line. Furthermore, relevant changes were detected in the expression of Bcl-2, BAX, FAS, and BIRC-5, while no significant alteration in the expression of NOXs was observed. In conclusion, our findings suggested that the combination of BrNQ and TA though the ability to change redox status in tumor cells could act as a potential adjuvant treatment modality for improve prognosis in TNBC. [ABSTRACT FROM AUTHOR]

Total lung-sparing tracheobronchial sleeve resections are a step forward in the treatment of low-grade bronchial tumors in which minimal resection margins are required to achieve complete control of the disease. This study retrospectively collected data on patients who underwent total lung-sparing procedures for low-grade tracheobronchial tumors at 2 thoracic surgical centers from January 1984 to October 2019. The study included 98 patients, 46 –female (47%) and 52 –male (53%), with a median age of 39 years (range, 7 to 70 years). Thirty-four patients underwent operative endoscopy before surgery (32 had laser treatment, and 2 had endobronchial stenting). The surgical resections were as follows: 9 (9%), tracheal carina; 18 (18%), second carina; 31 (32%), left main bronchi; 25 (26%), right main bronchi; and 15 (15%), intermediate bronchus. The median length of the resected bronchus was 2.2 cm. The median postoperative in-hospital stay was 8 days, and no perioperative mortality was observed. Postoperative complications were recorded in 26-patients (27%). The final histologic classification was as follows: 37 typical carcinoids (38%); 10 atypical carcinoids (10%); 29 adenoid cystic carcinomas (30%); 15 mucoepidermoid carcinomas (15%); 6 inflammatory myofibroblastic tumors (6%); and 1 glomic tumor (1%). Twenty-two patients had positive resection margins and underwent adjuvant radiotherapy. Three patients with adenoid cystic carcinoma had recurrences (1 local and 2 systemic). After a median follow-up time of 54.5 months (range, 4 to 360 months), the overall actuarial 5-year survival was 97%. Total lung-sparing tracheobronchial sleeve resection for low-grade malignant disease requires advanced surgical skills, but the hospital morbidity and mortality are very low. This technique is adequate and safe for highly selected patients with low-grade endobronchial malignant diseases, and its use should be encouraged in experienced centers. [ABSTRACT FROM AUTHOR]

Reconstruction of the anterior chest wall defect after sternectomy is a challenge for cardiothoracic surgeons. In 2010, the Padua group published the first case of cadaveric sternum transplantation after sternectomy. This multicenter study reports the clinical indications and early and long-term results of sternal chondral allograft transplantation. This is a retrospective multicenter study from 7 academic centers. We collected demographic data, surgical indications, technical details, and early postoperative results. The complications, long-term stability, and tolerance of the allografts were also analyzed. Between January 2008 and December 2019, 58 patients underwent sternectomy followed by reconstruction using cadaveric-cryopreserved sternochondral allografts. Thirty-two patients were male, median age 63.5 years (interquartile range, 50-72 years). Indications for sternectomy were secondary sternal tumors (n = 13), primary sternal tumors (n = 15), and nonneoplastic disease (n = 30). Thirty patients underwent total sternectomy, 16 lower-body sternectomy, and 12 upper-body manubrium resection. The 30-day mortality was 5%; overall morbidity was 31%. Six early reoperations were necessary because of bleeding (n = 1), titanium plate dislocation (n = 1), and resuture of the skin in the lower part of the incision (n = 4). Overall, 5-year survival was 74%. In all the survived patients, the reconstructions were stable and free from mechanical or infective complications. The main indications for sternal allograft implantation were complex poststernotomy dehiscence followed by primary or secondary tumor involvement of the sternum. The collected results demonstrate that sternochondral allograft transplantation is a safe and effective method in reconstructing the anterior chest wall after sternectomy. Further studies to demonstrate the integration of the bone grafts into the patients' sternal wall will be made. [ABSTRACT FROM AUTHOR]

Pluronic F127 ® was associated with a carbomer homopolymer type B, as a model polymer blend to evidence the information provided by rheological and mechanical analyses on the development of bioadhesive thermoresponsive systems. The mechanical analysis enabled to observe that 20% (w/w) Pluronic F127 ® -polymer blends were harder, more adhesive, more mucoadhesive, more compressive and less soft. In addition, continuous flow rheometry demonstrated that the systems were plastic with rheopexy (15%, w/w, Pluronic F127 ® ) or thixotropic (20%, w/w, Pluronic F127 ® ). Oscillatory rheometry exhibited the increase of temperature, and the polymeric concentration increases the elasticity of the formulations. Moreover, correlation index showed that softness and textural analysis can be correlated and complementary, whereas adhesiveness cannot be correlated to mucoadhesion and is less specific. Rheological interaction parameter and gelation temperature showed that 15/0.25-polymer blend is suitable for pharmaceutical and biomedical application, since it can be administered in the liquid form and be gelled in the application site with proper mucoadhesion that can suggest an improved clinical efficacy. Therefore, the mechanical and rheological analyses are useful to characterize and select the best bioadhesive thermoresponsive formulation for the proposed treatment with improved performance. [ABSTRACT FROM AUTHOR]

Polycarbophil is widely used in a variety of pharmaceutical formulations, mainly for their strong ability to adhere to the epithelial and mucous barriers (bio/mucoadhesion). On the other hand, its association with the thermoresponsive polymer (poloxamer 407) has been poorly explored. This work investigates the rheological, mechanical and mucoadhesive properties of polymer blends containing polycarbophil and poloxamer 407, in order to select the best formulations for biomedical and pharmaceutical applications. Mechanical (hardness, compressibility, adhesiveness, softness, and mucoadhesion) and rheological characteristics (consistency index, yield value and hysteresis area) showed that 20% (w/w) poloxamer 407- polymer blends exhibited higher values parameters. However, the rheological interaction parameter, which was more sensible than the mechanical interaction parameter, revealed higher synergism for systems comprising 15% (w/w) poloxamer 407, due to the system organization and polymers' properties. Furthermore, gelation temperatures were appropriated, suggesting that polymer blends can be used as biomedical materials, and displaying easy administration, enhanced retention and prolonged residence time at the site of application. Therefore, rheological, mechanical and mucoadhesive characterization provided a rational basis for selecting appropriated systems, useful for mucoadhesive drug delivery systems and biomedical applications. [ABSTRACT FROM AUTHOR]

The development of binary polymeric mixtures (polymer blends) containing bioadhesive and thermoresponsive polymers can provide new materials for biomedical applications, with higher contact, increased adhesion, prolonged residence time, protection, and in determined cases, secured absorption of an active agent from the site of application. Mixtures were prepared using a wide range of poloxamer 407 and Carbopol 971P ® amounts. The rheological (flow and oscillatory), sol–gel transition temperature, mechanical (hardness, compressibility, adhesiveness, cohesiveness and elasticity), softness, and mucoadhesive properties of formulations were investigated. Moreover, the interaction between the different proportions of polymers was also analyzed. Continuous shear and oscillatory rheometry identified the plastic flow with various degrees of thixotropy, besides the viscoelastic behavior of formulations. The determination of gelation temperature displayed values ranged from 27.17 to 41.09 °C. It was also found that low carbomer concentrations were enough to provide positive interaction parameter. However, the highest values were obtained for the polymeric blends with higher concentration of poloxamer 407. The mucoadhesion and softness index were greater in preparations containing 20% (w/w) poloxamer 407. The rheological, mechanical and mucoadhesive properties of the polymeric blends can be manipulated by changing the concentrations of the polymers and they suggest the blends are worthy of biomedical applications. [ABSTRACT FROM AUTHOR]

The extracorporeal membrane oxygenation (ECMO) is a technical option to support cardiorespiratory function during double lung transplantation (DLT). To date, intraoperative ECMO support during DLT seems to give excellent results when planned and used prophylactically, on the other hand the need to use an emergency unplanned ECMO support seems to increase significantly the postoperative morbidity and mortality. The primary endpoint of our study was to search for any factors that could significantly influence the risk of unplanned intraoperative ECMO support. The perioperative and one-year outcome analysis of patients who underwent unplanned ECMO were the secondary endpoints. Records of 95 patients who underwent DLT at our institution between January 2016 and December 2019 were retrospectively reviewed. Patients who underwent lung transplantation with elective intraoperative cardio-circulatory support were excluded from the study. Patients who underwent DLT with unplanned intraoperative ECMO (50 patients, Group A) were compared with no ECMO patients (45 patients, Group B). Group A patients showed more preoperative pulmonary artery hypertension (PAH), NYHA class>3, low cardiac-index, higher lactate and dose of inotropes during anesthesia induction. Group A more frequently received donors with higher PCO2 and with cerebral ischemic or hemorrhagic cause of death. After regression analyses PAH (OR7.42), PaCO 2 of donors (OR6.29) were the major risk factors for unplanned ECMO. The postoperative period was more complicated for patients requiring intraoperative ECMO. The failure to wean from ECMO at the end of surgery further increase the risk of post-operative morbidity (OR8.43) and mortality (OR4.21). Group A showed a higher in-hospital mortality (24%vs7%, p<0.05). Survival at 1 year was 81% for group B and 57% for group A respectively (p=0.01). The PAH and a higher PaCO2 of the donor were risk factors for unplanned ECMO. These results support the hypothesis that resolving critical intraoperative events by an unplanned ECMO does allow the intervention to be completed but then is reflected in a worse outcome, in particular after weaning failure at the end of surgery. Identifying a preoperative risk profile could be useful to use prophylactic ECMO and thus avoid the establishment of critical intraoperative events. [ABSTRACT FROM AUTHOR]