Search Results (1,493)

Endotoxins, lipopolysaccharides released from the outer membrane of Gram-negative bacteria, pose a significant risk in healthcare environments, particularly in Central Sterile Supply Departments (CSSDs), where the delivery of sterile pyrogen-free medical devices is critical for patient safety. Traditional methods for controlling endotoxins in water systems, such as ultraviolet (UV) disinfection, have proven ineffective at reducing endotoxin concentrations to comply with regulatory standards (<0.25 EU/mL). This limitation presents a significant challenge, especially in the context of reverse osmosis (RO) permeate used in CSSDs, where water typically has very low conductivity. Despite the established importance of endotoxin removal, a gap in the literature exists regarding effective chemical-free methods that can meet the stringent endotoxin limits in such low-conductivity environments. This study addresses this gap by evaluating the effectiveness of the eBooster™ electrochemical technology—featuring proprietary electrode materials and a reactor design optimized for potable water—for endotoxin removal from water, specifically under the low-conductivity conditions typical of RO permeate. Laboratory experiments using the B250 reactor achieved >90% endotoxin reduction (from 1.2 EU/mL to <0.1 EU/mL) at flow rates ≤5 L/min and current densities of 0.45–2.7 mA/cm². Additional real-world testing at three hospitals showed that the eBooster™ unit, when installed in the RO tank recirculation loop, consistently reduced endotoxin levels from 0.76 EU/mL (with UV) to <0.05 EU/mL over 24 months of operation, while heterotrophic plate counts dropped from 190 to <1 CFU/100 mL. Statistical analysis confirmed the reproducibility and flow-rate dependence of the removal efficiency. Limitations observed included reduced efficacy at higher flow rates, the need for sufficient residence time, and a temporary performance decline after two years due to a power fault, which was promptly corrected. Compared to earlier approaches, eBooster™ demonstrated superior performance in low-conductivity environments without added chemicals or significant maintenance. These findings highlight the strength and novelty of eBooster™ as a reliable, chemical-free, and maintenance-friendly alternative to traditional UV disinfection systems, offering a promising solution for critical water treatment applications in healthcare environments. Full article

Background: The emergence and spread of antimicrobial-resistant bacteria (ARB) has become an urgent global concern as a silent pandemic. When taking measures to reduce the impact of antimicrobial resistance (AMR) on the environment, it is important to consider appropriate treatment of wastewater from medical facilities. Methods: In this study, a continuous-flow wastewater treatment system using ozone and ultraviolet light, which has excellent inactivation effects, was implemented in a hospital in an urban area of Japan. Results: The results showed that 99% (2 log₁₀) of Gram-negative rods and more than 99.99% (>99.99%) of ARB comprising ESBL-producing Enterobacterales were reduced by ozone treatment from the first day after treatment, and ultraviolet light-emitting diode (UV-LED) irradiation after ozone treatment; UV-LED irradiation after ozonation further inactivated the bacteria to below the detection limit. Inactivation effects were maintained throughout the treatment period in this study. Metagenomic analysis showed that the removal of these microorganisms at the DNA level tended to be gradual in ozone treatment; however, the treated water after ozone/UV-LED treatment showed a 2 log₁₀ (>99%) removal rate at the end of the treatment. The residual antimicrobials in the effluent were benzylpenicillin, cefpodoxime, ciprofloxacin, levofloxacin, azithromycin, clarithromycin, doxycycline, minocycline, and vancomycin, which were removed by ozone treatment on day 1. In contrast, the removal of ampicillin and cefdinir ranged from 19% to 64% even when combined with UV-LED treatment. Conclusions: Our findings will help to reduce the discharge of ARB and antimicrobials into rivers and maintain the safety of aquatic environments. Full article

Biofilms are structured communities of microorganisms encased in a self-produced extracellular matrix, and they represent one of the most widespread forms of microbial life on Earth. Their presence poses serious challenges in both environmental and clinical settings. In natural and industrial systems, biofilms contribute to water contamination, pipeline corrosion, and biofouling. Clinically, biofilm-associated infections are responsible for approximately 80% of all microbial infections, including endocarditis, osteomyelitis, cystic fibrosis, and chronic sinusitis. A particularly critical concern is their colonization of medical devices, where biofilms can lead to chronic infections, implant failure, and increased mortality. Implantable devices, such as orthopedic implants, cardiac pacemakers, cochlear implants, urinary catheters, and hernia meshes, are highly susceptible to microbial attachment and biofilm development. These infections are often recalcitrant to conventional antibiotics and frequently necessitate surgical revision. In the United States, over 500,000 biofilm-related implant infections occur annually, with prosthetic joint infections alone projected to incur revision surgery costs exceeding USD 500 million per year—a figure expected to rise to USD 1.62 billion by 2030. To address these challenges, surface modification of medical devices has emerged as a promising strategy to prevent bacterial adhesion and biofilm formation. This review focuses on recent advances in chemical surface functionalization using non-antibiotic agents, such as enzymes, chelating agents, quorum sensing quenching factors, biosurfactants, oxidizing compounds and nanoparticles, designed to enhance antifouling and mature biofilm eradication properties. These approaches aim not only to prevent device-associated infections but also to reduce dependence on antibiotics and mitigate the development of antimicrobial resistance. Full article

Background: Asprosin is a relatively recently discovered glucogenic adipokine secreted during fasting that plays an important role in various biochemical processes in the body, including those connected with obesity and insulin resistance. The aim of this exploratory study was to investigate the associations between selected hormonal, anthropometric, and lifestyle-related parameters and serum asprosin concentration. As studies concerning fertility and asprosin have so far been limited to men or women with PCOS, its role in the general female population remains largely unexplored. The direction of this exploration was thus pointed toward possible connections with female fertility. Methods: The case-control study group included 56 women of reproductive age (25–42 years), who were patients of the Reproductive Health Clinic and the Clinic of Endocrinology, Diabetology, and Internal Medicine of the Medical University of Białystok, Poland. The levels of selected hormones, including anti-Müllerian hormone (AMH), estradiol, sex hormone-binding globulin (SHBG), and testosterone, body composition parameters, and a lifestyle parameter—night fasting duration—were assessed to test their associations with serum asprosin concentration. Results: A weak negative correlation was found between AMH level and serum asprosin concentration, suggesting a potential link between asprosin and ovarian reserve. Furthermore, a moderate positive correlation was found between the percentage of total body water (TBW) and serum asprosin concentration. No significant associations were observed between the levels of the other tested hormones and serum asprosin concentration, or between body composition parameters or night fasting duration and serum asprosin concentration. The multivariate model designed in the study shows that AMH, TBW, and night fasting duration explain 23.4% of asprosin variability. Conclusions: Although the nature of the study is exploratory, the findings indicate that the role of asprosin in the female population—particularly its role in fertility—requires further research. Not only is the number of available studies on asprosin insufficient, but the results of this study partly contradict what is known about the hormone from previous studies, which were largely performed with male cohorts. In addition, the results of this study suggest that asprosin may indeed be involved in mechanisms related to female fertility, particularly those connected with ovarian reserve. Nevertheless, studies performed in larger, more homogeneous populations are necessary to confirm the role of asprosin in women, including its association with female fertility. Full article

Functional recovery after traumatic brain injury (TBI) is hindered by progressive neurodegeneration resulting from neuroinflammation and other secondary injury processes. Dexamethasone (DX), a synthetic glucocorticoid, has been shown to reduce inflammation, but its systemic administration can cause a myriad of other medical issues. We aim to provide a local, sustained treatment of DX for TBI. Previously, we demonstrated that PEG-bis-AA/HA-DXM hydrogels composed of polyethyleneglycol-bis-(acryloyloxy acetate) (PEG-bis-AA) and dexamethasone-conjugated hyaluronic acid (HA-DXM) reduced secondary injury and improved motor functional recovery at 7 days post-injury (DPI) in a rat moderate controlled cortical impact (CCI) TBI model. In this study, we evaluated the effect of PEG-bis-AA/HA-DXM hydrogel on cognitive function and secondary injury at 14 DPI. Immediately after injury, hydrogel disks were placed on the surface of the injured cortex. Cognitive function was evaluated using the Morris Water Maze test, and secondary injury was evaluated by histological analysis. The hydrogel treatment group demonstrated significantly shorter latency to target, decreased distance to find the hidden target, increased number of target crossings, increased number of entries to the platform zone, and decreased latency to first entry of target zone compared to untreated TBI rats for probe test. We also observed reduced lesion volume, inflammatory response, and apoptosis in the hydrogel treatment group compared to the untreated TBI group. Full article

It is well established that combining exercise with medication may benefit functionality in individuals with PD (Parkinson’s disease). However, the long-term evolution of gait biomechanics under this combination remains poorly understood. Objectives: This study aims to analyze the evolution of spatiotemporal gait parameters, kinetics, and kinematics throughout a long-term exercise program conducted in water and on dry land. Methods: We have compared the trajectories of biomechanical variables across the treatment phases using statistical parametric mapping (SPM). A cohort of fourteen individuals with PD (mean age: 65.6 ± 12.1 years) participated in 24 sessions of aquatic exercises over three months, followed by a three-month retention phase, and then 24 additional sessions of land-based exercises. Three-dimensional gait data and spatiotemporal parameters were collected before and after each phase. Two-way ANOVA with repeated measures was used to compare spatiotemporal parameters. Results: The walking speed increased while the duration of the double support phase decreased. Additionally, the knee extensor moment consistently increased in the entire interval from midstance to midswing (20% to 70% of the stride period), approaching normal gait patterns. Regarding kinematics, significant increases were observed in both hip and knee flexion angles. Furthermore, the abnormal ankle dorsiflexion observed at the foot strike disappeared. Conclusions: These findings collectively suggest positive adaptations in gait biomechanics during the observation period. Full article

Antibiotic resistance genes (ARGs) in suburban freshwater ecosystems pose a growing public health concern by potentially reducing the effectiveness of medical treatments. This study investigated how rainfall influences ARG dynamics in Lake Katherine, a 62-hectare suburban lake in Columbia, South Carolina, over one year. Surface water was collected under both dry and post-rain conditions from three locations, and ARGs were identified using metagenomic sequencing. Statistical models revealed that six of nine ARG classes with sufficient data showed significant responses to rainfall. Three classes, Bacitracin, Aminoglycoside, and Unclassified, were more abundant after rainfall, while Tetracycline, Multidrug, and Peptide resistance genes declined. Taxonomic analysis showed that members of the Pseudomonadota phylum, especially Betaproteobacteria, were prevalent among ARG-carrying microbes. These findings suggest that rainfall can alter the distribution of ARGs in suburban lakes, highlighting the importance of routine monitoring and water management strategies to limit the environmental spread of antibiotic resistance. Full article

Background and Clinical Significance: Serratus Anterior Muscle Pain Syndrome (SAMPS) is an underdiagnosed cause of anterior chest wall pain, often attributed to myofascial trigger points of the serratus anterior muscle (SAM) or dysfunction of the Long Thoracic Nerve (LTN), leading to significant disability and affecting ipsilateral upper limb movement and quality of life. Current diagnosis relies on exclusion and physical examination, with limited treatment options beyond conservative approaches. This case report presents a novel approach to chronic SAMPS, successfully diagnosed using Sonoguided Digital Palpation (SDP) and treated with ultrasound-guided hydrodissection of the LTN using 5% dextrose in water (D5W) without local anesthetic (LA), in a patient where conventional treatments had failed. Case Presentation: A 72-year-old male presented with a three-year history of persistent left chest pain radiating to the upper back, exacerbated by activity and mimicking cardiac pain. His medical history included two percutaneous coronary interventions. Physical examination revealed tenderness along the anterior axillary line and a positive hyperirritable spot at the mid axillary line at the 5th rib level. SDP was used to visualize the serratus anterior fascia (SAF) and LTN, and to reproduce the patient’s concordant pain by palpating the LTN. Ultrasound-guided hydrodissection of the LTN was then performed using 20–30cc of D5W without LA to separate the nerve from the surrounding tissues, employing a “fascial unzipping” technique. The patient reported immediate pain relief post-procedure, with the pain reducing from 9/10 to 1/10 on the Numeric Rating Scale (NRS), and sustained relief and functional improvement at the 12-month follow-up. Conclusions: Sonoguided Digital Palpation (SDP) of the LTN can serve as a valuable diagnostic adjunct for visualizing and diagnosing SAMPS. Ultrasound-guided hydrodissection of the LTN with D5W without LA may provide a promising and safe treatment option for patients with chronic SAMPS refractory to conservative management, resulting in rapid and sustained pain relief. Further research, including controlled trials, is warranted to evaluate the long-term efficacy and generalizability of these findings and to compare D5W to other injectates. Full article

Background and Clinical Significance: Radial nerve palsy typically presents as wrist drop due to nerve compression, with conventional management often yielding prolonged recovery. We report a case where ultrasound-guided hydrodissection (HD) with 5% dextrose in water (D5W) achieved immediate functional restoration, suggesting neurapraxia as the underlying pathology. Case Presentation: A 54-year-old diabetic female presented with acute left wrist drop without trauma. Examination confirmed radial nerve palsy (MRC grade 0 wrist extension), while radiographs ruled out structural causes. Ultrasound revealed fascicular swelling at the spiral groove. Under real-time guidance, 50 mL D5W (no local anesthetic) was injected to hydrodissect the radial nerve. Immediate post-procedure assessment showed restored wrist extension (medical research council (MRC) grade 4+). At one- and three-month follow-ups, the patient maintained complete resolution of symptoms and normal function. Conclusions: This case highlights two key findings: (1) HD with D5W can serve as both a diagnostic tool (confirming reversible neurapraxia through immediate response) and therapeutic intervention, and (2) early HD may circumvent prolonged disability associated with conservative management. The absence of electrodiagnostic studies limits objective severity assessment, though ultrasound localized the lesion. While promising, these observations require validation through controlled trials comparing HD to standard care, particularly in diabetic patients with heightened compression susceptibility. Technical considerations—including optimal injectate volume and the role of adjuvant therapies—warrant further investigation. US-guided HD with D5W emerges as a minimally invasive, surgery-sparing option for acute compressive radial neuropathies, with potential to redefine treatment paradigms when applied at symptom onset. Full article

This study aimed to assess the extent of vitamin B₁ and B₆ vitamer loss during a single peritoneal dialysis (PD) session using a combination of chromatographic techniques and chemometric analysis. Dialysis effluent samples were collected from 41 PD patients (22 on continuous ambulatory peritoneal dialysis (CAPD) and 19 on automated peritoneal dialysis (APD)) during a standardised peritoneal equilibration test. Concentrations of thiamine monophosphate, thiamine diphosphate (ThDP), pyridoxine, pyridoxal (PL), and pyridoxamine were determined using high-performance liquid chromatography with a fluorescence detector. The analytical method was validated in terms of sensitivity, linearity, accuracy, and recovery. Multiple regression analysis was employed to identify potential clinical and demographic predictors of vitamin washout. All vitamers except pyridoxal 5-phosphate (PLP) were detectable in dialysis effluents. ThDP exhibited the greatest loss among the B₁ forms (ca. 0.05–0.57 mg/24 h), while PL exhibited the most significant loss among the B₆ forms (ca. 0.01–0.19 mg/24 h). Vitamin losses varied depending on the dialysis modality (continuous ambulatory peritoneal dialysis, or CAPD, versus automated peritoneal dialysis, or APD) and the peritoneal transport category. Regression analysis identified body weight, haemoglobin, and haematocrit as independent predictors of ThDP washout (R² = 0.58). No statistically robust models were established for the other vitamers. Even short medical procedures (such as single PD) can result in measurable losses of water-soluble vitamins, particularly ThDP and PL. The results emphasise the importance of personalised vitamin supplementation for PD patients and suggest that body composition and haematological parameters significantly influence the loss of thiamine. Full article

Oxidative stress directly or indirectly contributes to the development and progression of various diseases; therefore, regulating oxidative stress is a promising strategy for preventing or treating these conditions. The unique substances in soybeans, soy isoflavones, notably genistein, which have a strong antioxidant capacity, are considered to regulate various signaling pathways, alleviate oxidative stress, and improve gut microbiota imbalance as well as mitochondrial dysfunction. In this literature review, we summarize the latest research on genistein, providing evidence of its development and application as a potential drug for preventing and treating five selected diseases (Parkinson’s disease, Alzheimer’s disease, diabetes mellitus, cardiovascular disease, and cancers). The literature was searched using keywords that include tripartite combinations of genistein and oxidative stress, along with each of the five selected diseases, from PubMed, Science Direct, and Google Scholar between 2014 and 2024. According to current in vitro, in vivo, and clinical trials, we comprehensively discuss the therapeutic dose used to target various disease entities to achieve optimal efficacy and meet safety requirements. Moreover, considering the poor water solubility and limited bioavailability of genistein, strategies for improving its therapeutic efficacy, such as combining it with exercise, existing medications, and advanced technologies, as well as applying nanotechnology, were assessed. Therefore, this review aims to provide robust evidence for the development and application of genistein as a potential therapeutic agent or functional food for preventing and treating these diseases. Full article

The One Health paradigm—recognizing the interconnected health of humans, animals, and the environment—promotes the development of sustainable technologies that enhance human health while minimizing ecological impact. In this context, bio-based hydrogels have emerged as a promising class of biomaterials for advanced medical applications. Produced through biotechnological methods such as genetic engineering and microbial fermentation, these hydrogels are composed of renewable and biocompatible materials, including recombinant collagen, elastin, silk fibroin, bacterial cellulose, xanthan gum, and hyaluronic acid. Their high water content, structural tunability, and biodegradability make them ideal candidates for various biomedical applications such as wound healing, tissue regeneration, and the design of extracellular matrix (ECM)-mimicking scaffolds. By offering controlled mechanical properties, biocompatibility, and the potential for minimally invasive administration, sustainable hydrogels represent a strategic innovation for regenerative medicine and therapeutic interventions. This review discusses the characteristics and medical applications of these hydrogels, highlighting their role in advancing sustainable healthcare solutions within the One Health framework. Full article

In recent years, membranes have found extensive applications, primarily in wastewater purification and food packaging. However, petroleum-based membranes can be detrimental to the environment. For this reason, extensive studies are being conducted to identify environmentally friendly substitutes for the materials used in membrane composition. Among these materials, polylactic acid (PLA) and poly(3-hydroxybutyrate) (PHB) are two bio-sourced and biodegradable polymers that can be derived from lignocellulosic waste. These polymers also possess suitable characteristics, such as thermal resistance and mechanical strength, which make them potential candidates for replacing conventional plastics. This study provides an overview of recent advances in the production of PLA and PHB, with a focus on their extraction from lignocellulosic biomass, as well as the recent applications of these two biodegradable polymers as sustainable materials in membrane manufacturing. The advantages and limitations of membranes produced from these materials are also summarized. Lastly, an analysis of future trends is provided concerning new sources, production possibilities, and potential applications in water treatment (mainly for metal ions separation), gas separation, oil–water separation, medical applications, drug release control, and food packaging. Full article

Physical and mental health are fundamental human needs, yet modern medicine cannot always preserve them. At this point, alternative and complementary medical approaches sometimes offer significant contributions. In this context, religious healing stands out as a practice that plays a complementary role in many cultures and is frequently relied on, although it often faces criticism from the perspective of official religious doctrine. This study examines the phenomenon of “religious healing” from a sociological perspective. The provinces of Iğdır, Ağrı, and Erzurum, located in eastern Türkiye, were selected for the fieldwork. Interviews were conducted with 31 individuals who sought religious healing. The main purpose of this article is to understand the motivations of individuals who participate in such practices and how their healing experiences are transformed into religious experiences. The field data indicate that religious healing commonly involves practices such as recitation and blowing of the Qur’an, drinking blessed water, and the preparation of amulets. Feelings of helplessness and fear of social stigma are prominent in participants’ reasons for resorting to religious healers. The participants’ turn to healers can be seen as a defense mechanism, shifting blame to external forces like the evil eye, jinn, and magic, thereby reducing personal responsibility. Religion was instrumentalized to make the behavior of applying to a healer reasonable and acceptable. Full article

Affecting millions of individuals each year, chronic wounds place a substantial strain on both the healthcare system and healthcare providers, becoming a global health issue that requires a rapid and efficient solution. Unlike acute wounds that heal naturally without any external intervention, chronic wounds necessitate proper medical treatment in order to promote the wound-healing process and avoid any arising complications. However, the traditional therapeutic strategies are often limited when it comes to treating chronic wounds, which is why new approaches that facilitate the timely and effective healing of skin have been explored. Due to their unique properties, collagen-based hydrogels have been widely investigated as potential candidates for the management of chronic skin wounds, owing to their good biocompatibility, high water retention capacity, which provides a moist microenvironment, and capacity to promote cell adhesion, proliferation, migration, and differentiation for optimal tissue repair. In this context, the current paper discusses the recent advancements in collagen-based hydrogels as wound dressings, thus highlighting their potential as a future therapeutic approach for skin chronic wound care. Full article