Quasi-Static, Poiseuille Flow of Analgesics from an Elastomeric Pump: Theoretical Determination of Infusion Times and Toxicity Conditions

Background: Elastomeric pumps (elastic balls into which analgesics or antibiotics can be inserted) push medicines through a catheter to a nerve or blood vessel. Since elastomeric pumps are small and need no power source, they fit easily into a pocket during infusion, allowing patient mobility. Elastomeric pumps are widely used and widely studied experimentally, but they have well-known problems, such as maintaining reliable flow rates and avoiding toxicity or other peak-and-trough effects. Objectives: Our research objective is to develop a realistic theoretical model of an elastomeric pump, analyze its flow rates, determine its toxicity conditions, and otherwise improve its operation. We believe this is the first such theoretical model of an elastomeric pump consisting of an elastic, medicine-filled ball attached to a horizontal catheter. Method: Our method is to model the system as a quasi-Poiseuille flow driven by the pressure drop generated by the elastic sphere. We construct an engineering model of the pressure exerted by an elastic sphere and match it to a solution of the one-dimensional radial Navier-Stokes equation that describes flow through a horizontal, cylindrical tube. Results: Our results are that the model accurately reproduces flow rates obtained in clinical studies. We also discover that the flow rate has an unavoidable maximum, which we call the “toxicity bump”, when the radius of the sphere approaches its terminal, unstretched value—an effect that has been observed experimentally. Conclusions: We conclude that by choosing the properties of an elastomeric pump, the toxicity bump can be restricted to less than 10% of the earlier, relatively constant flow rate. Our model also produces a relation between the length of time that the analgesic fluid infuses and the physical properties of the fluid, of the elastomeric sphere and the tube, and of the blood vessel into which the analgesic infuses. From these, we conclude that elastomeric pumps can be designed, using our simple model, to control infusion times while avoiding toxicity effects.

3D additive manufactured composite scaffolds with antibiotic-loaded lamellar fillers for bone infection prevention and tissue regeneration

Bone infections following open bone fracture or implant surgery remain a challenge in the orthopedics field.In order to avoid high doses of systemic drug administration,optimized local antibiotic release from scaffolds is required.3D additive manufactured(AM)scaffolds made with biodegradable polymers are ideal to support bone healing in non-union scenarios and can be given antimicrobial properties by the incorporation of antibiotics.In this study,ciprofloxacin and gentamicin intercalated in the interlamellar spaces of magnesium aluminum layered double hydroxides(MgAl)andα-zirconium phosphates(ZrP),respectively,are dispersed within a thermoplastic polymer by melt compounding and subsequently processed via high temperature melt extrusion AM(~190◦C)into 3D scaffolds.The inorganic fillers enable a sustained antibiotics release through the polymer matrix,controlled by antibiotics counterions exchange or pH conditions.Importantly,both antibiotics retain their functionality after the manufacturing process at high temperatures,as verified by their activity against both Gram+and Gram-bacterial strains.Moreover,scaffolds loaded with filler-antibiotic do not impair human mesenchymal stromal cells osteogenic differentiation,allowing matrix mineralization and the expression of relevant osteogenic markers.Overall,these results suggest the possibility of fabricating dual functionality 3D scaffolds via high temperature melt extrusion for bone regeneration and infection prevention.

Nanomaterial-based strategies in antimicrobial applications:Progress and perspectives

The dramatic increase of microbial resistances against conventional available antibiotics is a huge challenge to the effective treatment of infectious disease and thus becoming a daunting global threat of major concern,which necessitates the development of innovative therapeutics.Nanomaterial-based antimicrobial strategies have emerged as novel and promising tools to combat lethal bacteria and recalcitrant biofilm,featuring the abilities to evade existing drug resistance-related mechanisms.In this review,recent advances in“state-of-the-art”nanosystems which acting either as inherent therapeutics or nanocarriers for the precise delivery of antibiotics,are comprehensively summarized.Those nanosystems can effectively accumulate at the infectious sites,achieve multifunctional synergistic antibacterial efficacy,and provide controlled release of antibiotics in response to endogenous or exogenous stimulus(e.g.,low pH,enzymes,or illumination).Especially,the nanoplatform that integrated with photothermal/photodynamic therapy(PTT/PDT)can enhance the bacterial destruction and biofilm penetration or ablation.In addition,nanoparticle-based approaches with enzymatically promoting bacterial killing,anti-virulence,and other mechanisms were also involved.Overall,this review provides crucial insights into the recent progress and remaining limitations of various antimicrobial nanotherapeutic strategies,and enlightens the further developments in this field simultaneously,which eventually benefiting public health.