Centrala venösa infarter används inom vården för att administrera läkemedel, ge parenteral nutrition och för blodprovstagning. Indikationer på att en patient behöver en central venös infart är att patienten behöver akut vård eller långvarig intravenös administrering av läkemedel. Många av dessa patienter behöver dessutom genomgå undersökningar via datortomografen (DT), där kontrastmedel kan krävas för att undersökningen ska kunna utföras. Syfte: Syftet med litteraturöversiktet var att sammanställa kunskap om centrala venösa infarters användbarhet vid administrering av kontrastmedel i samband med DT undersökningar. Metod: En allmän litteraturöversikt som baseras på tolv kvantitativa artiklar. Resultat: I de tolv artiklarna så uppmärksammades fyra kategorier som syftar till användbarheten: Tryck och Flödeshastigheter, Kateterspetsläge, Efterspolning och Diagnostisk bildkvalitet. Flera av studierna visade på kateterspetsförskjutning i samband med en kontrastmedelsinjektion med tryckspruta på DT. Tre av de fyra studier som kontrollerade bildkvalitet visade på bra diagnostisk bildkvalitet. Slutsats: Centrala venösa infarter är användbara vid administrering av kontrastmedel under datortomografiundersökningar under förutsättning att röntgensjuksköterskan har rätt kunskap om användandet av dem. Nationella riktlinjer behövs för att underlätta röntgensjuksköterskans arbete med dem så att hanteringen av dem utförs patientsäkert. / Central venous access is used in healthcare for drug administration, blood sampling, and providing parenteral nutrition. Indications for a patient needing a central venous access are either that a patient needs urgent care or prolonged intravenous administration of drugs. Many of these patients also need to undergo examinations via computed tomography (CT), where contrast agents may be required for the examination to be performed. Purpose: The purpose of the literature review was to compile knowledge about the usability of central venous access during the administration of contrast agents in connection with CT examinations. Method: A general literature review based on twelve quantitative articles was performed. Result: In the twelve articles, four categories were observed with the aim being usefulness: Pressure and Flow Rates, Catheter Tip position, Flushing and also Diagnostic Image Quality. Several of the studies showed catheter tip displacement being in connection with a contrast injection of a syringe during the CT examinations. Three of the four studies that controlled image quality showed good diagnostic image quality. Conclusions: Central venous access is useful in the administration of contrast agents during computed tomography examinations, provided that the radiographer has the correct knowledge of their use. National guidelines are needed to facilitate the radiographers work with them so that their usability is carried out with patient safety in mind.

<p>Miniaturization of technologies to milli-, micro- and nanoscale offers numerous advantages for diagnostic and therapeutic biomedical applications. In comparison to their macro-scale counterparts, these small-scale systems are more portable, less invasive and less costly. They can facilitate rapid, sensitive and high throughput detection of abnormalities, help track disease progression, reduce sample consumption and improve therapeutic efficacy of drug delivery while decreasing systemic toxicity. Thus, there is clearly a need for creating innovative milli-, micro- and nanoscale tools that can uncover new possibilities in detection and treatment of various types of diseases. The overall objective of this dissertation was to develop novel small-scale technologies that could help enhance diagnostic and/or therapeutic outcomes in patients with cancer, opioid addiction and inflammatory bowel disease. First, we developed an echogenically stable nanodroplet ultrasound contrast agent with potential applications in extravascular molecular imaging of tumors and targeted cancer therapies. Then, we created a polymer blend microsphere system that could be integrated in prescription opioid tablets to develop an abuse-deterrent formulation against smoking. Finally, we designed a release system for localized delivery of aminosalicylates from magnetically actuated millirobots in the colon to improve therapeutic outcomes in patients suffering from inflammatory bowel disease. Overall, the technologies we developed could serve as a basis for designing diagnostic and therapeutic tools that are superior to currently existing platforms.</p>

There is a need for multifunctional polymer-particle complexes for use in biomedical applications such as for drug delivery or as MRI contrast agents where composition and stability are essential for the complexes to function. This work outlines a general methodology for rationally designing complexes stabilized with polymer brush layers using adapted star polymer models for brush extension and pair potential. Block copolymer micelles were first utilized for experimental validation by using the brush extension model to predict the size and the interaction model to predict the second virial coefficient, A2. Subsequently, the models were used to predict the size and colloidal stability of magnetite-polymer complexes using the modified Deryaguin-Verwey-Landau-Overbeek theory. Novel hydrophilic triblock copolymers comprised of poly(ethylene oxide) tailblocks and a carboxylic acid containing polyurethane center block were examined by static and dynamic light scattering (SLS and DLS), small angle neutron scattering (SANS), and densiometry. Under conditions when the charge is suppressed such as at low pH and/or high ionic strength, the polymer chains self-assemble into micelles, whereas unimers alone are present under conditions where charge effects are important, such as high pH and low ionic strength. A model for effective interaction between star polymers was used to obtain an expression for the second virial coefficient (A2) for micelles in solution. The values of A2 obtained using this method were compared with experimentally determined values for star polymers and micelles. In doing so, not only was a new means of calculating A2 a priori introduced, but the applicability of star polymer expressions to micellar systems was established. Through the analogy of micelles to sterically stabilized nanoparticles, this model was applied to water-soluble block copolymers adsorbed on magnetite nanoparticles for the purpose of tailoring a steric stabilizing brush layer. The sizes of the magnetite-polymer complexes were predicted using the star polymer model employed for the micelle study with an added layer to account for the anchor block. Colloidal stability was predicted from extended DLVO theory using the pair interaction. This work will lead to a better understanding of how to design ion-containing block copolymers for steric stabilization of metal oxide nanoparticles. / Ph. D.

Lanthanide-based nanoparticles are of interest for optical displays, catalysis, telecommunication, bio-imaging, magnetic resonance imaging, multimodal imaging, etc. These applications are possible partly because the preparation of lanthanide-based nanoparticles has made tremendous progress. Now, nanoparticles are routinely being made with a good control over size, crystal phase and even shape. Despite the achievements, little attention is given to the fundamental physical chemistry aspects, such as crystal structure, architecture, cation exchange, etc. The results of the study on the crystal structures of LnF3 nanoparticles show that the middle GdF3 and EuF3 nanoparticles have two crystal phases, which has then been tuned by doping with La3+ ions. However, the required doping level is very different from the bulk. While the results for the bulk are well explained by thermodynamic calculations, kinetics is actually responsible for the results of the undoped and doped GdF3 and EuF3 nanoparticles. The attempt to make LnF3 core-shell nanoparticles led to the finding of cation exchange, a phenomenon that upon exposure of LnF3 nanoparticles to an aqueous solution containing Ln3+ ions, the Ln3+ ions in the nanoparticles are replaced by the Ln3+ ions in the solution. The consequence of the cation exchange is that LnF3 core-shell nanoparticles are unlikely to form in aqueous media using a core-shell synthesis procedure. It has also been verified that nanoparticles synthesized using an alloy procedure do not always have an alloy structure. This means that the core-shell and alloy structure of nanoparticles in the literature may not be true. The investigation of the architecture of nanoparticles synthesized in aqueous media is extended to those synthesized in organic media. The dopant ion distribution in NaGdF4 nanoparticles has been examined. It has been found that they don’t have the generally assumed statistical dopant distribution. Instead, they have a gradient structure with one type of Ln3+ ions more concentrated towards the center and the other type more concentrated towards the surface of the nanoparticles. With the understanding of these physical insights, lanthanide-based core-shell nanoparticles are prepared using the cation exchange. These core-shell nanoparticles containing a photoluminscent core and a paramagnetic shell are promising candidates for multimodal imaging. / Graduate

Le glioblastome constitue la tumeur primitive maligne la plus fréquente et la plus agressive du système nerveux central, caractérisée par un pronostic sombre. L’infusion locale dans le parenchyme cérébral du cisplatine a présenté des résultats encourageants sur des modèles précliniques. La nanovectorisation permet de concentrer l’efficacité thérapeutique d’agents anticancéreux à leur cible. Leur fonctionnalisation par des unités d’imagerie offre la possibilité de suivre de façon non invasive par imagerie par résonance magnétique (IRM) leur biodistribution au sein du tissu lésé. Dans cette optique, un copolymère tribloc amphiphile biocompatible a été synthétisé par polymérisations par ouverture de cycle successives à partir d’un oxyde de polyéthylène (PEO). Après micellisation dans l’eau, des complexes de gadolinium ont été greffés sur la couronne de PEO et les fonctions carboxylates situées en périphérie du coeur micellaire se sont réticulées sur le cisplatine, conduisant à la formation d’une prodrogue macromoléculaire de taille nanométrique stable dans le temps. Le potentiel de ces nanoparticules bifonctionnelles comme agents de contraste IRM a été exploré à haut champ magnétique. Une telle vectorisation du cisplatine a en outre permis d’augmenter de façon significative l’accumulation du platine dans deux lignées humaines de glioblastome ainsi que la formation d’adduits à l’ADN par rapport à la drogue libre. L’implication de mécanismes biologiques sous-jacents à cette étude pose la question de l’existence d’autres cibles alternatives critiques des dérivés du platine, remettant en cause le paradigme établi depuis un demi-siècle définissant l’ADN comme la cible ultime du cisplatine. / Glioblastoma is the most frequent and aggressive primary malignant tumor of the central nervous system with a gloomy prognosis. Local infusion of cisplatin within the brain parenchyma exhibited promising results in preclinical models. Nanovectorization of anticancer agents even promotes the concentration of their therapeutic efficiency on their target. Anchorage ofimaging moieties on such smart drug delivery systems further enables the non-invasive monitoring of their biodistribution within the damaged tissue by magnetic resonance imaging (MRI). From this perspective, a biocompatible amphiphilic triblock copolymer was synthesized by successive ring-opening polymerizations from a polyethylene oxide (PEO). After micellization in water, gadolinium complexes were grafted to the PEO corona and the carboxylate functions located at the surface of the micelle’s core were able to cross-link with cisplatin. A stable nano-sized macromolecular prodrug was therefore recovered. Relaxomety measurements at a high magnetic field confirmed the intrinsic potential of these hybrid nanoparticles as alternative MRI contrast agents. Besides, cisplatin vectorization allowed for substantially increasing the accumulation of platinum compounds in two human glioblastoma cell lines as well as the subsequent formation of DNA adducts in comparison with the free drug. Biological mechanisms below this study raise the question whether critical alternative targets of platinum derivatives might exist, thus undermining the old-established paradigm that defines DNA as the ultimate target of cisplatin.

A teragnóstica de doenças tem sido extremamente marcada nos últimos anos por nanomateriais formados pela conjugação de nanopartículas a biomoléculas, pois a aplicação de tecnologias baseadas em materiais na dimensão nanométrica é capaz de aumentar a seletividade, sensibilidade e praticidade dos métodos atualmente empregados, ou mesmo criar novos métodos de diagnóstico e tratamento de doenças. Dentre os vários tipos de nanomateriais desenvolvidos, aqueles baseados em nanopartículas de ouro ou nanopartículas magnéticas apresentam propriedades químicas e físicas diferenciadas que propiciam novas possibilidades. Por exemplo, a presente tese demonstrou que nanopartículas superparamagnéticas são excelentes agentes de contraste em exames de imagem por ressonância magnética (IRM) por serem mais seguros, apresentarem melhor contraste nas imagens e possibilitarem direcionar/concentrar o material em tecidos ou tumores através de um gradiente de campo magnético aplicado. Foram feitos numerosos ensaios de toxicidade tanto in vitro quanto in vivo para assegurar a segurança da aplicação de nanopartículas no organismo, cujo potencial de uso somente se tornará uma realidade caso os nanomateriais se mostrem não tóxicos e biocompatíveis. Apesar dos significativos avanços na área da aplicação desses nanomateriais, não foram encontrados na literatura modelos capazes de explicar ou prever por quais sítios de ligação devem ocorrer as interações proteína-nanopartícula, como também não foram encontrados estudos sistemáticos acerca dos fatores que determinam a estabilidade e a funcionalidade dos nanobioconjugados (NBCs). Assim, nesta tese buscamos compreender os fatores responsáveis pela ligação/adsorção das proteínas nas nanopartículas de ouro e sua influência sobre a estabilidade das suspensões e a funcionalidade das proteínas. Desta forma, foram obtidos NBCs com propriedades adequadas para o desenvolvimento ou aprimoramento de ensaios de diagnóstico e até para o tratamento de doenças. Foi demonstrado o potencial das nanopartículas de ouro para melhorar a performance de imunoensaios do tipo ELISA, mas também podem ser utilizadas para o desenvolvimento de métodos de diagnóstico, explorando as propriedades plasmônicas das nanopartículas de ouro acopladas a técnicas como SERS, SPR e microscopia Raman confocal. / Theranostics has been intensively pursued in recent years using hybrid materials based on nanoparticles conjugated with biomolecules. This is an interesting strategy to increase the selectivity and sensitivity, as well as to improve the currently used methods facilitating their use or creating new ones. Among the various types of nanomaterials, those based on gold and magnetic nanoparticles exhibit interesting chemical and physical properties in the biological environment, differing from that of free drugs or current explored in assay methods. For example, superparamagnetic nanoparticles are excellent contrast agents for magnetic resonance image (MRI) diagnostics because they are safer, present a better contrast efficiency for imaging and can be magnetically accumulated in tissues or tumors using a magnetic field. Numerous in vitro and in vivo toxicity assays were performed to ensure the safety for medical applications. Clearly, these type of applications only will be realized if nanomaterials prove to be nontoxic and biocompatible. This imply an strict control on their structure and composition. However, despite the significant advances in the development of such nanomaterials, there were not found in the literature model systems explaining or that can be used to predict by which sites the protein-nanoparticle binding should take place. In addition, no systematic studies on the factors determining the stability and the functionality of nanobioconjugates (NBC) were found. Thus, this thesis is focused in unveiling the factors responsible for binding/adsorption of proteins on gold nanoparticles and their influence on the colloidal stability of hybrid nanoparticles suspensions while keeping the functionality of biomolecules. In fact, NBC with enhanced properties suitable for the development of diagnostic methods and even for treatment of diseases were obtained. These nanomaterials can improve the ELISA immunoassay, or other diagnosis methods can be developed by using the gold nanoparticles plasmonic properties in association with SERS, SPR and confocal Raman microscopy techniques.

L’imagerie par résonance magnétique (IRM) est un outil de choix pour la caractérisation tissulaire in vivo. Il est démontré que la mesure d’un temps caractéristique en IRM, appelé « T1 », est corrélée à la composition du tissu. Justesse et reproductibilité sont requises dans la mesure du T1 pour : i) discriminer les valeurs de T1 des tissus sains et fibrosés dont la gamme de valeurs est assez restreinte, ii) permettre la mesure avant et après injection d’agent de contraste et iii) comparer les valeurs de T1 entre sites et constructeurs. A ce jour, aucune des techniques publiées n’est en mesure de fournir une mesure de T1 « idéale ». L’objectif principal de cette thèse est d’optimiser et de valider une technique de mesure du T1 sur le myocarde, qui se propose d’allier ces deux qualités. Pour atteindre cet objectif, nous avons travaillé la séquence appelée « SMART1Map » basée sur le principe d’échantillonnage d’une courbe de saturation-récupération. Des essais sur objets tests et sur volontaires à 1,5T et 3T ont d’abord été réalisés. Bien que les valeurs moyennes de T1 mesurées chez 7 sujets étaient justes et correspondaient à la littérature (1150 ± 84 ms à 1,5T), les résultats ont montré une faible reproductibilité imputable en partie à un manque de robustesse de la séquence vis-à-vis des inhomogénéités de champ magnétique particulièrement importantes à 3T. L’optimisation (simulation, implémentation et tests) de l’impulsion radiofréquence de saturation constitutive de la séquence a été mise en œuvre à 3T, sur objets fantômes, puis sur volontaires sains. Ces travaux ouvrent la voie à la mise en place de mesure de biomarqueur IRM de la fibrose / Cardiac Magnetic Resonance Imaging (MRI) has experienced growing interest due to its great potential in myocardial tissue characterization. Myocardium T1 values can be considered a useful imaging biomarker. Although many different T1 mapping techniques already exist, accurate and precise myocardial T1 quantification remains a desired yet challenging goal. Cardiac T1 mapping necessitates high precision to: i) discriminate values within the relatively short range of T1 values in healthy and diseased tissues, ii) allow both pre and post contrast agent injection T1 assessment, which is mandatory to compute the ECV and iii) allow comparison across platforms and hospitals. It should also provide a T1 value independent of heart rate. Among published methods, not any of them offer an “ideal” T1 quantification method. The main aim of this work is to optimize and to validate a precise and accurate quantitative T1 mapping technique. In order to achieve this goal, the sequence called « SMART1Map » based on the saturation recovery curve sampling was used. The first step consisted in performing T1 measurements on phantoms and healthy volunteers at 1,5T and 3T. Although this study allowed to assess accurate myocardium T1 values close to literature ones (1150 ± 84 ms), the sequence showed a poor precision likely due to a lack of robustness to magnetic field inhomogeneties and frequency offsets. Optimization (including simulation, implementation and tests) of the saturation RF pulse used in the sequence was carried out in phantoms then on healthy subjects at 3T. From this development, fibrosis detection through T1 measurements in clinical studies can now be started at 1.5T and 3T

A teragnóstica de doenças tem sido extremamente marcada nos últimos anos por nanomateriais formados pela conjugação de nanopartículas a biomoléculas, pois a aplicação de tecnologias baseadas em materiais na dimensão nanométrica é capaz de aumentar a seletividade, sensibilidade e praticidade dos métodos atualmente empregados, ou mesmo criar novos métodos de diagnóstico e tratamento de doenças. Dentre os vários tipos de nanomateriais desenvolvidos, aqueles baseados em nanopartículas de ouro ou nanopartículas magnéticas apresentam propriedades químicas e físicas diferenciadas que propiciam novas possibilidades. Por exemplo, a presente tese demonstrou que nanopartículas superparamagnéticas são excelentes agentes de contraste em exames de imagem por ressonância magnética (IRM) por serem mais seguros, apresentarem melhor contraste nas imagens e possibilitarem direcionar/concentrar o material em tecidos ou tumores através de um gradiente de campo magnético aplicado. Foram feitos numerosos ensaios de toxicidade tanto in vitro quanto in vivo para assegurar a segurança da aplicação de nanopartículas no organismo, cujo potencial de uso somente se tornará uma realidade caso os nanomateriais se mostrem não tóxicos e biocompatíveis. Apesar dos significativos avanços na área da aplicação desses nanomateriais, não foram encontrados na literatura modelos capazes de explicar ou prever por quais sítios de ligação devem ocorrer as interações proteína-nanopartícula, como também não foram encontrados estudos sistemáticos acerca dos fatores que determinam a estabilidade e a funcionalidade dos nanobioconjugados (NBCs). Assim, nesta tese buscamos compreender os fatores responsáveis pela ligação/adsorção das proteínas nas nanopartículas de ouro e sua influência sobre a estabilidade das suspensões e a funcionalidade das proteínas. Desta forma, foram obtidos NBCs com propriedades adequadas para o desenvolvimento ou aprimoramento de ensaios de diagnóstico e até para o tratamento de doenças. Foi demonstrado o potencial das nanopartículas de ouro para melhorar a performance de imunoensaios do tipo ELISA, mas também podem ser utilizadas para o desenvolvimento de métodos de diagnóstico, explorando as propriedades plasmônicas das nanopartículas de ouro acopladas a técnicas como SERS, SPR e microscopia Raman confocal. / Theranostics has been intensively pursued in recent years using hybrid materials based on nanoparticles conjugated with biomolecules. This is an interesting strategy to increase the selectivity and sensitivity, as well as to improve the currently used methods facilitating their use or creating new ones. Among the various types of nanomaterials, those based on gold and magnetic nanoparticles exhibit interesting chemical and physical properties in the biological environment, differing from that of free drugs or current explored in assay methods. For example, superparamagnetic nanoparticles are excellent contrast agents for magnetic resonance image (MRI) diagnostics because they are safer, present a better contrast efficiency for imaging and can be magnetically accumulated in tissues or tumors using a magnetic field. Numerous in vitro and in vivo toxicity assays were performed to ensure the safety for medical applications. Clearly, these type of applications only will be realized if nanomaterials prove to be nontoxic and biocompatible. This imply an strict control on their structure and composition. However, despite the significant advances in the development of such nanomaterials, there were not found in the literature model systems explaining or that can be used to predict by which sites the protein-nanoparticle binding should take place. In addition, no systematic studies on the factors determining the stability and the functionality of nanobioconjugates (NBC) were found. Thus, this thesis is focused in unveiling the factors responsible for binding/adsorption of proteins on gold nanoparticles and their influence on the colloidal stability of hybrid nanoparticles suspensions while keeping the functionality of biomolecules. In fact, NBC with enhanced properties suitable for the development of diagnostic methods and even for treatment of diseases were obtained. These nanomaterials can improve the ELISA immunoassay, or other diagnosis methods can be developed by using the gold nanoparticles plasmonic properties in association with SERS, SPR and confocal Raman microscopy techniques.

Lanthanide elements display many remarkable and exciting properties which explain their widespread use in a number of very important biomedical tools like efficient MRI contrast agents or luminescent probes for highly sensitive assays of bioanalytes amongst other fields of application. In this context, the aim of the present work was to prepare and characterize lanthanide complexes of two ligands that feature a linear or a macrocyclic chelating unit compactly grafted onto a 1,10-phenanthroline derived moiety (phenDTPA and PhenHDO3A). The ditopic nature of the ligands allows the selective incorporation of a d6 metal ion and a lanthanide one in close proximity. The resulting rigid heterobimetallic supramolecular species show useful properties and constitute potential MRI contrast agents or new luminescent compounds depending on the type of the lanthanide and transition metal ions employed: for example, the selfassembly process of gadolinium(III) chelates around an iron(II) ion brings a remarkable increase of their relaxivity, a key parameter for use in MRI. On the other hand, association of a ruthenium and and a near infrared emitting 4f ion like ytterbium(III) gives mixed d-f structures able to harvest visible light and convert it into near infra-red signal. Visible light luminescent pH probes were also obtained with Eu3+ or Tb3+ phenHDO3A complexes.

No description available.