A method has been developed for the synthesis of granular polymeric materials with immobilized N-chloro-sulfonamide groups. Commercially available resin polymers widely applied for the preparation of ion exchangers have been used as polymer carriers. The elaborated technological conditions make it possible to modify these resins with a high conversion degree, without deteriorating the strength characteristics, and with the possibility of regulating the concentration of active chlorine over a wide range (up to 11 % w/w). The structure of the synthesized polymers was confirmed by IR spectroscopy data. To determine the concentration of functional groups, a special method of iodometric titration has been developed. The processes of emission of active chlorine from synthesized polymers into aqueous solutions have been studied. It has been shown that this process significantly depends on the composition of the solution: no release of active chlorine into distilled water is observed, and when using tap water, its concentration is reached 5–8 mg/dm3 and remains up to 30 days when the granules are in water. The processes of activation of active chlorine emission by compounds of amine nature have been studied, the corresponding kinetic curves of the dependence between change in the concentration of active chlorine in solution and the used activator are presented. It has been found that the nature of the used activator strongly affects, among other things, the stability of the obtained chlorine-active solutions. Taurine and sulfamic acid are found to be the optimal activators for obtaining stable solutions of active chlorine of high concentration. The composition of the N-chloro-taurin solution obtained in this way has been additionally analyzed by UV spectroscopy. Thus, the synthesized polymers make it possible to quickly in situ obtain high-purity solutions of active chlorine without the use of special electrochemical equipment. The polymers themselves are compact, stable, and can be repeatedly regenerated
The search for new effective means for combating pathogenic microorganisms is one of the most important tasks of modern medicine. The main reason for the need for such studies is the obvious tendency to increase of the resistance of pathogenic microorganisms to the compounds used for these purposes, observed over the past few decades. Leading international organizations recognize the problem of the evolution of «superbacteria» as a global threat to humanity. Compounds of active chlorine are extremely effective biocidal agents. However, for the number of reasons, classic chlorine-active drugs (solutions of sodium hypochlorite, hypochlorous acid, chloramines, etc.) have limited use in medicine. This work is aimed at the study of the properties of new forms of active chlorine. Technology has been developed for the chemical immobilization of active chlorine donor groups on granular and fibrous polymer carriers. Polymers have been obtained, which contain 5-20 % of the active chlorine and are highly stable. It was shown that upon contact of such polymers with a medium containing ammonium salts or impurities of protein structure, emission of active chlorine occurs in an amount equivalent to the quantity of such impurities. Methods have been developed for the express manufacture of high-purity solutions of active chlorine (hypochlorous acid, chlortaurin) by activating these polymers with special activators. High antimicrobial activity of such solutions has been proved. It was shown that the polymers themselves also exhibit high microbicidal activity. The possibility of using fibrous forms of chlorine-active polymers as an antimicrobial component of a wound dressing has been investigated. The absence of toxicity of such dressings has been proved. It has been shown that the application of dressings on uninfected wounds speeds up the healing process. The application of dressings on infected wounds prevents the progress of inflammatory processes and significantly reduces the number of pathogenic microorganisms in wound secretions. Thus, synthesized polymers with immobilized active chlorine may be promising for use in water and air disinfection systems, for detoxification of hospital effluents, the rapid production of antimicrobial solutions, as well as for the manufacture of prolonged-action antiseptic wound dressings that protect wounds from secondary infection, that is especially important for military and disaster medicine. Keywords: disinfection, antiseptics, active chlorine, immobilization, antiseptic solutions, antimicrobial activity, reparative activity, wound dressings. For citation: Toropin VM, Murashevych BV, Stepanskyi DO, Toropin MV, Kremenchutskiy HM., Burmistrov KS. New forms of immobilized active chlorine and its potential applications in medicine. Journal of the National Academy of Medical Sciences of Ukraine. 2019;25(3):340–52
Розроблення, створення перев'язувальних матеріалів, що не мають токсичного впливу на організм, виявляють виражену антимікробну дію та не викликають резистентність хвороботворних мікроорганізмів, а також прискорюють процес епітелізації, -актуальна проблема сучасної медицини.Мета роботи -оцінювання токсикологічних характеристик перев'язувального матеріалу з вмістом активного хлору 6 % і 9 % при одноразовому нанесенні на шкіру, а також вивчення дії перев'язувального матеріалу на швидкість епітелізації неінфікованої ранової поверхні, визначення його антимікробної та ранозагоювальної активності in vivo на моделі рани, що інфікована S. аureus АТСС 6538.Матеріали та методи. Для оцінювання безпеки застосування та фармакологічної активності in vivo виконали експериментальне вивчення пов'язок з іммобілізованим полімерним N-хлорсульфонамідом натрію та N,N-дихлорсульфонамідом. Визначення токсикологічних характеристик досліджуваного перев'язувального матеріалу при одноразовому нанесенні на шкірні покриви виконали на лабораторних щурах і кроликах за загальноприйнятою методикою, вивчення ранозагоювальної дії -в тесті Л. Н. Попової, антимікробної активності in vivo -на моделі рани, що інфікована вшиванням шовкової нитки, просоченої добовою культурою S. аureus АТСС 6538.Результати. Фармакологічними дослідженнями гострої токсичності тест-зразків матеріалів із вмістом активного хлору 6 % і 9 % при одноразовому нанесенні на шкірні покриви щурів і кролів встановлено, що аплікації не призводили до випадків загибелі, а також змін у поведінці тварин, споживанні ними корму, води. Швидкість епітелізації неінфікованої поверхні рани за умов застосування пов'язок як з N-хлорсульфонамідом натрію, так і з N,N-дихлорсульфонамідом до завершення періоду спостереження (14 доба) вірогідно значущо збільшувалася в середньому в 1,5 раза порівняно з тваринами групи УДК: 541(183.12+64):615.1 ГУ «Днепропетровская медицинская академия МЗ Украины», г. Днипро, 2 ГВУЗ «Украинский государственный химико-технологический университет», г. Днипро A -концепция и дизайн исследования; B -сбор данных; C -анализ и интерпретация данных; D -написание статьи; E -редактирование статьи; F -окончательное утверждение статьи Разработка и создание перевязочных материалов, не оказывающих токсического действия на организм, проявляющих выраженное антимикробное действие и не вызывающих резистентность болезнетворных микроорганизмов, а также ускоряющих процесс эпителизации, -актуальная задача современной медицины.Цель работы -оценка токсикологических характеристик перевязочного материала с содержанием активного хлора 6 % и 9 % при одноразовом нанесении на кожные покровы, а также изучение действия перевязочного материала на скорость эпителизации неинфицированной раневой поверхности и определение его антимикробной и ранозаживляющей активности in vivo на модели раны, инфицированной S. аureus АТСС 6538.Материалы и методы. Для оценки безопасности применения и фармакологической активности in vivo проведено экспериментальное изучение повязок с иммобилизированным полимерным N-хлорсульфонами...
Virucidal properties of N-chlorosulfonamides immobilized on fibrous styrene-divinylbenzene copolymers have been studied. Corresponding materials with different functional group structures and chlorine content have been synthesized on FIBAN polymer carriers in the form of staple fibers and non-woven fabrics. The study has been conducted in general accordance with EN 14476 standard on poliovirus type-1 and adenovirus type-5. It has been found that all tested samples exhibit pronounced virucidal activity: regardless of the carrier polymer form, sodium N-chlorosulfonamides inactivated both viruses in less than 30 s, and N,N-dichlorosulfonamides—in 30–60 s. The main mechanism of action of these materials, obviously, consists in the emission of active chlorine from the functional group into the treated medium under the action of the amino groups of virus fragments and cell culture. Considering the previously described antimicrobial and reparative properties of such materials, as well as their satisfactory physical and mechanical properties, the synthesized polymers are promising for the creation of medical devices with increased resistance to microbial contamination, such as protective masks, filter elements, long-acting wound dressings, and others.
The aim of the work was to evaluate the antimicrobial activity of polymeric materials with immobilized N-Chlorosulfonamide groups against multidrug-resistant hospital strains of common microorganisms and to determine the resistance to microbial penetration of these materials. Materials and methods: the studied samples were copolymers of styrene with divinylbenzene in the form of staple fibre and non-woven fabric with immobilized N-Chlorosulfonamide groups of various structures. Hospital strains of microorganisms have been isolated from clinical material; their antibiotic sensitivity has been determined by the Kirby-Bauer method. The agar diffusion method determines the antimicrobial activity of the polymers. Resistance to microbial penetration of samples of non-woven fabric has been determined by the membrane filtration method. Results: polymer samples have been synthesized with immobilized N-Chlorosulfonamide groups in the Na- and H-forms, and with the N, N-dichlorosulfonamide group, with chlorine concentration range 3.7 - 12.5 %. All samples demonstrated pronounced antimicrobial activity against both standard and hospital strains. Due to the higher specific surface area, staple fibre is generally more efficient. An increase in the zone of inhibition of the growth of microorganisms was observed with an increase in the concentration of immobilized chlorine. All the studied fabric samples are impermeable to S. aureus. The control samples containing the free sulfonamide group did not show antimicrobial properties. Conclusions: synthesized chlorine-active polymers have a pronounced antimicrobial activity against multidrug-resistant microorganisms, demonstrate high resistance to microbial penetration and therefore are promising for creating a wide range of medical products on their basis: dressings, protective masks, antimicrobial filters, etc.
Chronic myelomonocytic leukosis (CMML) is rarely diagnosed and amounts to 1 per 100 thousand of adults per year, more often in men over 60 years. The clinical case of the rare, prolonged course of myelodysplastic chronic myelomonocytic leukosis (MD-CMML) in a middle-aged woman with rapid transformation into acute monocytic leukemia (AMoL-M5в) with the atypical fulminant course is presented. A retrospective analysis of the course of the disease drew attention to the severe vasculitis suffered by the patient 19 years ago, which could be regarded as the debut of CML in the presence of characteristic pathological changes in the hemogram. Non-pronounced clinical manifestations in the form of moderate cervical lymphadenopathy, skin lesions in the form of transient erythema, spotty eruptions over the next 10 years, fit into the clinical picture of MD-CMML. A detailed picture of the disease was observed after viral infection, bronchitis, antibiotic therapy. Absence of significant blastemia and severe inhibition of normal hematopoiesis with expressed extramedular manifestations of the disease in the patient were not typical for the course of AMoL-M5b in this case. The progression of skin lesions was noteworthy, which gave reason for unfavorable prognosis. For several weeks, the spread of erythematous elements was observed throughout the body with itching, not controlled by antihistamines and corticosteroid drugs; the appearance of maculopapular rashes, merging in places; small-point hemorrhages like vasculitis over the entire surface of the skin. Notable was the development of severe hemorrhagic syndrome without severe thrombocytopenia, significant changes in the coagulogram, as a manifestation of early severe coagulopathy.
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