Percorrer por autor "Cardoso, Sara"
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- 3D-printed biosurfactant-chitosan antibacterial coating for the prevention of silicone-based associated infectionsPublication . Narciso, Francisco; Cardoso, Sara; Monge, Nuno; Lourenço, Madalena; Martin, Victor; Duarte, Noélia; Santos, Catarina; Gomes, Pedro; Bettencourt, Ana; Ribeiro, Isabel A. C.Infections associated with the surfaces of medical devices represent a critical problem due to biofilm formation and the growing resistance towards antibacterial drugs. This is particularly relevant in commonly used invasive devices such as silicone-based ones where a demand for alternative antibiofilm surfaces is increasing. In this work, an antimicrobial chitosan-biosurfactant hydrogel mesh was produced by 3D-printing. The 3D structure was designed to coat polydimethylsiloxane-based medical devices for infection prevention. Additionally, the porous 3D structure allows the incorporation of customized bioactive components. For this purpose, two biosurfactants (surfactin and sophorolipids) were biosynthesized and tested for their antimicrobial activity. In addition, the printing of surfactant-chitosan-based coatings was optimized, and the resulting 3D structures were characterized (i.e., wettability, FTIR-ATR, antimicrobial activity, and biocompatibility). Compared with surfactin, the results showed a better yield and higher antibacterial activity against Gram-positive bacteria for sophorolipids (SLs). Thus, SLs were used to produce chitosan-based 3D-printed coatings. Overall, the SLs-impregnated coatings showed the best antibacterial activity against Staphylococcus aureus planktonic bacteria (61 % of growth inhibition) and antibiofilm activity (2 log units reduction) when compared to control. Furthermore, concerning biocompatibility, the coatings were cytocompatible towards human dermal fibroblasts. Finally, the coating presented a mesh suitable to be filled with a model bioactive compound (i.e., hyaluronic acid), paving the way to be used for customized therapeutics.
- Exploring alginate/zinc oxide-based 3D-printed structures for application as customizable wound dressingsPublication . Cardoso, Sara; Martin, Victor; Leal, Catarina; Monge, Nuno; Colaço, Bruno; Gomes, Pedro; Bettencourt, Ana F.; Ribeiro, Isabel A.C.Chronic wounds represent a significant global healthcare burden due to the limited effectiveness of current therapeutic strategies. To address this critical need, we developed 3D-printed regenerative wound dressings that can be customized with antimicrobial drugs tailored to individual patient requirements. A novel semisolid extrusion ink combining the biocompatibility and printing properties of alginate (Alg) with the regenerative properties of zinc oxide (ZnO) and hydroxypropyl cellulose (HPC) was produced. Two types of dressings were successfully printed by varying the concentrations of ZnO and HPC: ZnO:HPC at 11:10 and 20:20 % (w/v). Both inks presented an adequate rheological shear-thinning behavior, resulting in wound dressings with a stable matrix structure. Moreover, to grant antimicrobial and antibiofilm activity, an octenidine (OCT)-hydrogel was loaded into the dressing’s macropores. The unloaded dressings with ZnO at 20 % (w/v) and all the OCT-loaded dressings presented antibiofilm activity, showing a biofilm reduction of ~ 75 % against S. aureus. In vitro cellular assays indicated that the unloaded dressings provided regenerative potential by showing wound closure approximately completed in 48 h, highlighting the regenerative potential of the Alg:ZnO:HPC ink. These dressings exhibited in vitro and in vivo cytocompatibility, along with regenerative potential evidenced by collagen deposition and rapid wound closure. OCT-loaded matrices retained the regenerative potential and biocompatibility of the unloaded dressings, supporting their suitability as a platform for advanced wound management.
- Improving chitosan hydrogels printability: a comprehensive study on printing scaffolds for customized drug deliveryPublication . Cardoso, Sara; Narciso, Francisco; Monge,Nuno; Bettencourt, Ana; Ribeiro, Isabel A. C.Chitosan is an interesting polymer to produce hydrogels suitable for the 3D printing of customized drug delivery systems. This study aimed at the achievement of chitosan-based scaffolds suitable for the incorporation of active components in the matrix or loaded into the pores. Several scaffolds were printed using different chitosan-based hydrogels. To understand which parameters would have a greater impact on printability, an optimization study was conducted. The scaffolds with the highest printability were obtained with a chitosan hydrogel at 2.5 wt%, a flow speed of 0.15 mm/s and a layer height of 0.41 mm. To improve the chitosan hydrogel printability, starch was added, and a design of experiments with three factors and two responses was carried out to find out the optimal starch supplementation. It was possible to conclude that the addition of starch (13 wt%) to the chitosan hydrogel improved the structural characteristics of the chitosan-based scaffolds. These scaffolds showed potential to be tested in the future as drug-delivery systems.
- Portuguese primary care physicians response rate in surveys: a systematic reviewPublication . Basílio, Nuno; Cardoso, Sara; Mendes-Nunes, José; Laranjo, Liliana; Antunes, Maria Da Luz; Heleno, BrunoIntroduction: Surveys are a useful tool in primary care. However, low response rates can introduce selection bias, impairing both external and internal validity. The aim of this study was to assess the average response rate in surveys with Portuguese general practitioners (GPs). Method: We searched the Medline, Web of Science, Scopus, Embase, PsychInfo, SciELO, IndexRMP, RCAAP, Revista Portuguesa de Medicina Geral e Familiar, Acta Médica Portuguesa and the proceedings of conferences of general practice from inception to December 2016. We included all postal, e-mail, telephone and personal surveys to primary care physicians without language restrictions. We did not assess the risk of bias of included studies since the main outcome was surveyed response rate. We performed planned subgroup analyses of the use of monetary incentives, the use of non-monetary incentives, survey delivery modes and prior contact with participants. Results: A total of 1,094 papers were identified and 37 studies were included in this review. The response rate in surveys done to Portuguese GPs was 56% (95CI 47-64%). There was substantial heterogeneity among included studies (I2=99%), but subgroup analysis did not explain this heterogeneity. Conclusion: Consistent with other published studies, the average response rate in surveys done with Portuguese GPs was 56%, with substantial variation among studies. Use of monetary incentives, one of the most effective strategies to increase response rates, was not present in any of the included studies.