https://repositorium.sdum.uminho.pt/bitstream/1822/14053/1/file.pdf

Natural–origin polymers as carriers and scaffolds for biomolecules and cell delivery in tissue engineering applications

Matrices and scaffolds for delivery of bioactive molecules in bone and cartilage tissue engineering.

There is a steady increase in the number of cancer survivors, that is people diagnosed with cancer (Aziz 2003), worldwide. This is due, in a large part, to the dramatic advances in cancer treatment and management (Aziz 2002; Aziz 2003), growing attention to multidisciplinary post-treatment care (Demark-Wahnefried 2000; Stull 2007), and healthier lifestyles (Demark-Wahnefried 2005; Stull 2007). These factors and trends especially when considered in light of an aging population (Aziz 2008; Stewart 2003), suggest that we can continue to expect increasing numbers of cancer survivors with greater expected length of survival. Ensuring the quality of that survival thus becomes a key priority. The objectives are as follows: To evaluate the effectiveness of exercise on overall HRQoL outcomes and specific HRQoL domains (e.g. physical, psychological, economic, social, and spiritual well-being, and key disease and/or treatment symptoms such as sexual functioning, neuropathy or cognitive changes, and chronic fatigue) among adult post-treatment cancer survivors (i.e. people with a history of cancer who are beyond active treatment, excluding those who are terminally ill and receiving hospice). We will focus on post-treatment cancer survivors so that we can evaluate the effectiveness of exercise on HRQoL without having to adjust for the adverse effects of cancer and/or its treatment on HRQoL. 1. A secondary objective is to examine the effectiveness of exercise on HRQoL outcomes among adult post-treatment cancer survivors stratified by the following: 2. Age at diagnosis (i.e. less than 65 years or greater than or equal to 65 years); 3. Age at trial enrolment (i.e. less than 65 years or greater than or equal to 65 years); 4. Sex; 5. Type of prescribed exercise (i.e. aerobic, anaerobic, combination); 6. Physical condition prior to cancer treatment (i.e. obesity, heart disease, smoking status, asthma); 7. Intensity of exercise (i.e. mild, moderate, vigorous); and Format of exercise (i.e. individual or group, professionally led or not, home or group facility).

Exercise interventions on health related quality of life for cancer survivors

Low back pain (LBP) is a common and disabling disorder in western society. The management of LBP comprises a range of different intervention strategies including surgery, drug therapy, and non-medical interventions. The objective of the present study is to determine the effectiveness of physical and rehabilitation interventions (i.e. exercise therapy, back school, transcutaneous electrical nerve stimulation (TENS), low level laser therapy, education, massage, behavioural treatment, traction, multidisciplinary treatment, lumbar supports, and heat/cold therapy) for chronic LBP. The primary search was conducted in MEDLINE, EMBASE, CINAHL, CENTRAL, and PEDro up to 22 December 2008. Existing Cochrane reviews for the individual interventions were screened for studies fulfilling the inclusion criteria. The search strategy outlined by the Cochrane Back Review Groups (CBRG) was followed. The following were included for selection criteria: (1) randomized controlled trials, (2) adult (≥18 years) population with chronic (≥12 weeks) non-specific LBP, and (3) evaluation of at least one of the main clinically relevant outcome measures (pain, functional status, perceived recovery, or return to work). Two reviewers independently selected studies and extracted data on study characteristics, risk of bias, and outcomes at short, intermediate, and long-term follow-up. The GRADE approach was used to determine the quality of evidence. In total 83 randomized controlled trials met the inclusion criteria: exercise therapy (n = 37), back school (n = 5), TENS (n = 6), low level laser therapy (n = 3), behavioural treatment (n = 21), patient education (n = 1), traction (n = 1), and multidisciplinary treatment (n = 6). Compared to usual care, exercise therapy improved post-treatment pain intensity and disability, and long-term function. Behavioural treatment was found to be effective in reducing pain intensity at short-term follow-up compared to no treatment/waiting list controls. Finally, multidisciplinary treatment was found to reduce pain intensity and disability at short-term follow-up compared to no treatment/waiting list controls. Overall, the level of evidence was low. Evidence from randomized controlled trials demonstrates that there is low quality evidence for the effectiveness of exercise therapy compared to usual care, there is low evidence for the effectiveness of behavioural therapy compared to no treatment and there is moderate evidence for the effectiveness of a multidisciplinary treatment compared to no treatment and other active treatments at reducing pain at short-term in the treatment of chronic low back pain. Based on the heterogeneity of the populations, interventions, and comparison groups, we conclude that there are insufficient data to draw firm conclusion on the clinical effect of back schools, low-level laser therapy, patient education, massage, traction, superficial heat/cold, and lumbar supports for chronic LBP.

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A systematic review on the effectiveness of physical and rehabilitation interventions for chronic non-specific low back pain

Biocompatibility of hydrogel-based scaffolds for tissue engineering applications

Evaluation of sericin/collagen membranes as prospective wound dressing biomaterial

In this study, nanocomposite collagen scaffolds incorporating gold nanoparticles (AuNPs) were prepared for wound healing applications. Initially, dose ( 20 nm) of AuNPs that were not cytotoxic on HaCat keratinocytes and 3T3 fibroblasts were determined. Both collagen sponges and AuNP-incorporated nanocomposites (CS-Au) were cross-linked with glutaraldehyde (CS-X and CS-AuX). Incorporation of AuNPs into cross-linked scaffolds enhanced their stability against enzymatic degradation and increased the tensile strength. Hydrolytic degradation of CS-Au group was also less than CS after seven days. Upon confirming in vitro biocompatibility of the scaffolds with cytotoxicity assays, cell attachment and proliferation tests and the in vivo efficacy for healing of full-thickness skin wounds were investigated by applying CS-X, CS-AuX or a commercial product (Matriderm®) onto defect sites and covering with Ioban® drapes. Defects were covered only with drapes for untreated control group. The wound areas were examined with histopathological and biomechanical tests after 14 days of operation. CS-AuX group was superior to untreated control and Matriderm®; it suppressed the inflammation while significantly promoting granulation tissue formation. Inflammatory reaction against CS-AuX was milder than CS-X. Neovascularization was also higher in CS-AuX than other groups, though the result was not significant. Wound closure in CS-X (76%), CS-AuX (69%), and Matriderm® (65%) were better than untreated control (45%). CS-AuX group had the highest tensile strength (significantly higher than Matriderm®) and modulus (significantly higher than Matriderm® and CS-X), indicating a faster course of dermal healing. Further studies are also needed to investigate whether higher loading of AuNPs affects these results positively in a statistically meaningful manner. Overall, their contribution to the enhancement of degradation profiles and mechanical properties, their excellent in vitro biocompatibility, and tendency to accelerate wound healing are encouraging the use of AuNPs in collagen sponges as potent skin substitutes in the future.

Collagen/gold nanoparticle nanocomposites: A potential skin wound healing biomaterial.

The aim of this prospective study was to investigate the effects of early onset rehabilitation program on shoulder mobility, functional status, lymphedema, and the incidence of postoperative complications in patients who had modified radical mastectomy. Fifty-seven women were randomly assigned to either treatment group or home exercise program groups, which were consisted of 27 and 30 patients, respectively. After removal of the drains, the patients were instructed to 15 sessions of individual rehabilitation program and continued with home-based physical activity program. The home exercise program groups only received a form including the exercises, which could be performed by themselves after removal of the drains. Range of motion of the shoulder joint and upper extremity circumferential difference were measured. Functional status was assessed by functional index score. Each patient was assessed preoperatively and then postoperatively at fifth day and first, third, and sixth months. The improvement in measurements of flexion, abduction, and adduction movements of the shoulder joint and the functional questionnaire scores were significantly better in treatment group. There was no statistically significant difference in the development of lymphedema and postoperative complications in both groups. Early onset rehabilitation program after modified radical mastectomy provides improvement in shoulder mobility and functional capacity without causing adverse effect in postoperative period.

The effectiveness of early rehabilitation in patients with modified radical mastectomy.

Cellulose acetate based 3-dimensional electrospun scaffolds for skin tissue engineering applications.

Synopsis CLX (celecoxib) is a highly hydrophobic non-steroidal anti-inflammatory drug with high plasma protein binding. We describe here the encapsulation of CLX in MLVs (multilamellar vesicles) composed of DSPC (1,2-distearoyl-sn-glycero-3phosphocholine) and variable amounts of cholesterol. The effects of cholesterol content on liposome size, percentage drug loading and in vitro drug release profiles were investigated. Differential scanning calorimetry and FTIR (Fouriertransform infrared) spectroscopy were used to determine molecular interactions between CLX, cholesterol and DSPC. The phase transition temperature (Tm) of vesicles was reduced in a synergistic manner in the presence of both CLX and cholesterol. Encapsulation efficiency, loading and release of CLX decreased with increasing cholesterol content. FTIR results indicated that this decrease was due to a competition between CLX and cholesterol for the co-operativity region of the phospholipids. In the presence of cholesterol, CLX was pushed further into the hydrophobic core of the bilayer. However, MLVs prepared with DSPC only (without cholesterol) exhibited the lowest ability for drug retention after 72 h. Our results indicated that CLX, without the requirement of modifications to enhance solubilization, can be encapsulated and released from liposomal formulations. This method of drug delivery may be used to circumvent the low bioavailability and systemic side effects of oral CLX formulations.

Dilek Keskin

Papers

Evaluation of sericin/collagen membranes as prospective wound dressing biomaterial

Collagen/gold nanoparticle nanocomposites: A potential skin wound healing biomaterial.

The effectiveness of early rehabilitation in patients with modified radical mastectomy.

Cellulose acetate based 3-dimensional electrospun scaffolds for skin tissue engineering applications.

Celecoxib-loaded liposomes: effect of cholesterol on encapsulation and in vitro release characteristics.