Various surgical techniques in the comprehensive treatment of decubitus ulcers

Background. Decubitus ulcers (pressure ulcers) resulting from inhibited circulation to body parts under pressure from body weight constitute a particularly difficult problem in the treatment and rehabilitation of patients with tetra- and paraplegia. The present article describes a comprehensive treatment program for decubitus ulcers developed and realized in cooperation between the Rehabilitation Clinic and the Department of Plastic Surgery at the University Hospital of the Bydgoszcz Medical University.
Material and methods. Ten patients of varying age with decubitus ulcers in various parts of the body are described, with particular emphasis on the program of preoperative treatment to reduce infections and prepare the patient for surgery and subsequent rehabilitation, and on the proper choice of surgical technique.
Results. The surgical techniques used to repair decubitus wounds are described. Of the ten patients, six recovered from surgery with no complications whatsoever, while four experienced post-operative infections that delayed healing. In no case, however, was the operation unsuccessful and all the patients eventually returned to rehabilitation.
Conclusion. Effective cooperation between rehabilitation and plastic surgery in cases of decubitus ulcer provides a very good outcome.     

Proprioception as one of the factors deciding on the model of rehabilitation after reconstruction of ACL

Injuries of the knee joint with ACL tears are causing frontal instability of the knee. In cases of second and third degree instability it is advised to operate - reconstruction of anterior crucial ligament. The operation is the beginning of a rehabilitation program. It is very importand to rebuild static and dynamic proprioception of the knee. In the paper we present most recent opinions on that problem. We explain the role of proprioception on the knee function, also we present a hypothetical model of rehabilitation programme in different activity.     

Ghee Butter from Bovine Colostrum Reduces Inflammation in the Mouse Model of Acute Pancreatitis with Potential Involvement of Free Fatty Acid Receptors

Acute pancreatitis (AP) is an inflammatory disease that causes severe tissue damage. Ghee butter from bovine colostrum (GBBC) is a clarified butter produced by heating milk fat to 40 °C and separating the precipitating protein. As colostrum mainly contains fatty acids (FAs), immunoglobulins, maternal immune cells, and cytokines, we hypothesized that it may exert anti-inflammatory effects. We investigated the effects of GBBC on experimental AP in mice. Two intraperitoneal (ip) injections of L-arginine (8%) were given 1 h apart to generate the AP murine model. After 12 h from the first L-arginine injection, mice were divided into the following experimental groups: AP mice treated with GBBC (oral gavage (po) every 12 h) and non-treated AP mice (po vehicle every 12 h). Control animals received vehicle only. At 72 h, mice were euthanized. Histopathological examination along with myeloperoxidase (MPO) and amylase/lipase activity assays were performed. In a separate set of experiments, FFAR1 and FFAR4 antagonists were used to verify the involvement of respective receptors. Administration of GBBC decreased MPO activity in the pancreas and lungs along with the microscopical severity of AP in mice. Moreover, treatment with GBBC normalized pancreatic enzyme activity. FFAR1 and FFAR4 antagonists tended to reverse the anti-inflammatory effect of GBBC in mouse AP. Our results suggest that GBBC displays anti-inflammatory effects in the mouse model of AP, with the putative involvement of FFARs. This is the first study to show the anti-inflammatory potential of a nutritional supplement derived from GBBC.     

Long-term untreated streptozotocin-diabetes leads to increased expression and elevated activity of prostaglandin H2 synthase in blood platelets

In diabetes-related states of chronic hyperglycaemia elevated concentrations of glucose may alter the functioning of platelet enzymes involved in arachidonic acid metabolism, including prostaglandin H₂ synthase (cyclooxygenase) (PGHS, COX). Therefore, the principal aim of this study was to assess the effects of experimental chronic hyperglycaemia on platelet PGHS-1 (COX-1) expression and activity. Blood platelet activation and reactivity were assessed in Sprague–Dawley rats with the 5-month streptozotocin (STZ) diabetes. The PGHS-1 abundance in platelets was evaluated with flow cytometry and Western blotting, while its activity monitored using a high resolution respirometry and the peroxidase fluorescent assay. The production of prostaglandin E₂ (PGE₂) and thromboxane B₂ (TXB₂) in platelets were assayed immunoenzymatically. Circulating platelets from diabetic were characterised by increased size, elevated ‘priming’ and altered reactivity, compared to non-diabetic animals. Both Western blot analysis and flow cytometry revealed significantly elevated expressions of platelet PGHS-1 in STZ-diabetic rats (p?0.05). We also observed significantly elevated platelet PGHS-1-related arachidonic acid metabolism in diabetic vs. non-diabetic animals, with the use of polarographic (p?0.05) and total activity assay (p?0.001). Such increases were accompanied by the elevated production of PGE₂ (p?0.001) and TXB₂ (p?0.05) in diabetic animals. The increased PGHS-1-dependent oxygen consumption and the total activity of PGHS-1 in diabetic animals remained very significant (p?相似文献   

Bacterial Endocarditis Following Rubber Band Ligation in a Patient with a Ventricular Septal Defect: Report of a Case and Guideline Analysis

Rubber band ligation is a common option used to treat symptomatic internal hemorrhoids. Severe complications such as pelvic sepsis are a rare occurrence. We report a case of endocarditis leading to septic pulmonary and renal emboli following single-quadrant rubber band ligation. The patient had a known ventricular septal defect and developed low back pain and fever after ligation of a right anterior internal hemorrhoid. He was found to have septic pulmonary emboli, a renal wedge septic infarct, and a large vegetation on his membranous ventricular septal defect requiring operative intervention. Before this report, rubber band ligation has not been associated with endocarditis. According to several guidelines, this patient did not require antibiotic prophylaxis. It is unclear whether prophylaxis could have prevented this complication. Surgeons utilizing rubber band ligation need to be familiar with all potential complications. Reprints are not available.     

Microstructure and Properties of Electroless Ni-P/Si3N4 Nanocomposite Coatings Deposited on the AW-7075 Aluminum Alloy

The article presents the results of mechanical and tribological tests of Ni-P/Si₃N₄ nanocomposite coatings deposited on the AW-7075 aluminum alloy using the chemical reduction method. The influence of the chemical composition on the Vickers microhardness determined by the DSI method was examined. The nanocomposite layers were made of Si₃N₄ silicon nitride in a polydisperse powder with a particle size ranging from 20 to 25 nm. The influence of the content of the dispersion layer material on the adhesion to the substrate was analyzed. The abrasive wear was tested and determined in the reciprocating motion using the “ball-on-flat” method. The surface topography was examined by the contact method with the use of a profilometer. Based on the obtained test results, it was found that the Ni-P/Si₃N₄ layers produced in the bath with the Si₃N₄ nanoparticle content in the amount of 2 g/dm³ are more resistant to wear and show greater adhesion than the Ni-P/Si₃N₄ layers deposited in the bath with 5 g/dm³ of the dispersion phase. NiP/Si₃N₄ layers provide protection against abrasive wear under various loads and environmental conditions.