Tissue engineering has directed a lot of effort toward the development of devices with suitable biocompatibility and mechanical properties. Chitosan has been pointed as a valuable material to be applied in scaffolds due to its antimicrobial activity and biocompatibility. Nevertheless, the low mechanical resistance associated with the requirement of toxic crosslinkers has hampered translational application of chitosan hydrogel. Herein, the use of gold nanoparticles (AuNP) as crosslinker is reported as a great strategy to obtain chitosan hydrogel without using toxic reactants. In addition, the resultant chitosan hydrogel, crosslinked by AuNP of 30 nm (AuNP30), presented outstanding properties compared to chitosan hydrogel crosslinked by glutaraldehyde. Chitosan hydrogel crosslinked by AuNP30 presented lower porosity, which provided lower swelling degree and slower degradation rate. In addition, compressive strength was about two times higher than the chitosan hydrogel crosslinked by glutaraldehyde. The crosslink by AuNP30 also increased the biocompatibility of the hydrogel. Chitosan hydrogel crosslinked by AuNP30 did not show cytotoxicity against MEF cells, whereas cell viability of cells incubated with extract from chitosan hydrogel crosslinked by glutaraldehyde was only 41%. In conclusion, the results reported herein pointed that the use of AuNP30 as crosslinker agent provided to chitosan hydrogel enhanced properties that made it suitable to application in biomedical devices.
Background: Since the introduction of continuous subcutaneous insulin infusion (CSII), the benefits have been numerous. However, adverse events (AEs) are experienced by up to 40% of users per year, exposing them to potentially fatal risks. The available evidence on the variables that trigger AEs associated with CSII remains limited, indicating the importance of studies on the subject. Aim: To propose a taxonomy based on the prevalent AEs experienced by patients from a reference diabetes mellitus (DM) center in Brazil using different CSII devices. Methods: 118 patients participated in an online interview and answered the questions of the data collection instrument. Identifying categories and subcategories of analysis contributed to constructing the AEs taxonomy. Results: The five analysis categories identified were: CSII User Interface (n = 45), CSII Alert System (n = 13), CSII Software and Connection (n = 11), CSII Durability (n = 30), and Electrical and Mechanical System of CSII (n = 60) A total of 159 AEs were identified, including conflicting alert messages and error/warning notification failures, errors resulting from engine malfunctions, data loss, patient interface deficiencies, button problems, and battery failure. Conclusions: The study describes in a taxonomic format the AEs directly associated with the use of modern CSIIs that may contribute with additional information to the Food and Drug Administration (FDA) Medical Device Report (MDR) adverse event codes. In addition to guiding educational actions in the treatment of DM and providing information for health professionals and medical device developers, prospective studies examining the frequency of such problems, including the potential psychosocial impact of this technologically advanced therapy, are needed.
Diabetes Mellitus (DM) is considered a worldwide epidemic, posing a major challenge for health systems around the world. According to the World Health Organization (WHO), 1 in 11 people lives with diabetes, indicating that there are around 684 million of diabetic patients in the world. According to data from the Brazilian Society of Diabetes, the estimated number of children and adolescents affected by DM type 1 (DM1) in Brazil is approximately 100 thousand, and the majority of them are individuals under 14 years old. DM1 is generally associated with extremely serious acute and chronic complications, due to improper blood glucose control. One of the therapies used for DM treatment is the insulin infusion pump (IIP), and although approximately 15% of DM1 patients have an absolute indication for its use, the number of patients with access to this type of treatment is still very low, especially in Brazil. The main limiting
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