Analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds

BackgroundThe aim of this study was to assess the analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds.Patients and methodsTwenty adult patients, who underwent surgical treatment of third–degree burn wounds under general anesthesia, were included. Two of the patients underwent surgery twice. During surgery, patients received 50–100 μg fentanyl every 20–30 min and, after surgery, patients received 100 mg ketoprofen twice daily. Additionally, ten patients (group 1) received 50 μg sufentanil added to the burn wound dressings soaked in octenidine and phenoxyethanol while 10 patients (group 2) received 25 μg sufentanil added to the same dressings. The rescue analgesic, which was administered when pain intensified, was 5 mg subcutaneous morphine. Plasma sufentanil concentrations were assayed at 1, 2, 3, and 6 h after surgery completion and when pain was reported, along with pain intensity evaluation.ResultsSufentanil was not detected in the serum of any patients. Rescue morphine was given during the postoperative period (24 h) in one patient in group 1 (who underwent surgery twice) and three patients in group 2. The mean sufentanil concentration in dressings was higher in group 1 (0.13 ± 0.03) than group 2 (0.06 ± 0.03 μg/mL; p < 0.001). The group 1 patient who received rescue morphine had a sufentanil concentration of 0.10 μg/mL, which was the lowest concentration in group 1. Group 2 patients who received rescue morphine had sufentanil concentrations of at least two–fold lower (0.03–0.05 μg/mL). No adverse effects were observed.ConclusionsSufentanil in dressings after burn wound surgery provides effective and safe analgesia and the sufentanil concentration in dressings should be ≥0.10 μg/mL in a solution of octenidine and phenoxyethanol.     

Total Hip Arthroplasty in Patients With Osteoarthritis Associated With Legg-Calve-Perthes Disease: Perioperative Complications and Patient-Reported Outcomes

BackgroundComplications and patient-reported outcomes (PROs) of total hip arthroplasty (THA) in patients with Legg-Calve-Perthes disease (LCPD) have demonstrated variable results. The purpose of this study was to use a validated grading scheme to analyze complications associated with THA in patients with residual LCPD deformities. Second, we report PROs and intermediate-term survivorship in this patient population.MethodsA retrospective, single-center review was performed on 61 hips in 61 patients who underwent THA for residual Perthes disease. Average patient age was 42 years and 26% of hips had previous surgery. Complications were determined and categorized using a validated grading scheme that included five grades based on the treatment required to manage the complication and on persistent disability. PROs were compared from preoperative to most recent follow-up time points.ResultsMajor complications (grade III) occurred in three patients (5%) which each required a second surgical intervention. The most common minor grade I or II complications (11.5%) were asymptomatic heterotopic ossification (3.3%). Patients were lengthened on the surgical side an average of 1.4 cm with no nerve palsies. All patient PROs improved from preoperative to postoperative time points with the modified Harris Hip Score improving from 46.9 preoperatively to 85.4 postoperatively (P < .01). Patients free from revision for any reason at final follow-up (5.6 years; range 2-13 years) was 98.4% with one patient needing a revision of their femoral component.ConclusionsTHA for the sequelae of the LCPD has an acceptable complication rate and provides excellent patient reported outcomes at mid-term follow-up.     

Inhibition of cyclooxygenase-2 indirectly potentiates antitumor effects of photodynamic therapy in mice.

PURPOSE: The aim of the present study was to potentiate the antitumor effectiveness of photodynamic therapy (PDT). A cDNA microarray analysis was used to evaluate the gene expression pattern after Photofrin-mediated PDT to find more effective combination treatment with PDT and inhibitor(s) of the identified gene product(s) overexpressed in tumor cells. EXPERIMENTAL DESIGN: Atlas Mouse Stress Array was used to compare the expression profile of control and PDT-treated C-26 cells. The microarray results have been confirmed using Western blotting. Cytostatic/cytotoxic in vitro assay as well as in vivo tumor models were used to investigate the antitumor effectiveness of PDT in combination with cyclooxygenase (COX) 2 inhibitors. RESULTS: PDT induced the expression of 5 of 140 stress-related genes. One of these genes encodes for COX-2, an enzyme important in the tumor progression. Inhibition of COX-2 in vitro with NS-398, rofecoxib, or nimesulide, or before PDT with nimesulide did not influence the therapeutic efficacy of the treatment. Administration of a selective COX-2 inhibitor after PDT produced potentiated antitumor effects leading to complete responses in the majority of treated animals. CONCLUSIONS: COX-2 inhibitors do not sensitize tumor cells to PDT-mediated killing. However, these drugs can be used to potentiate the antitumor effectiveness of this treatment regimen when administered after tumor illumination.     

The Effect of Tin on Microstructure and Properties of the Al-10 wt.% Si Alloy

In this paper, the results from studies regarding near-eutectic Al-Si alloys with Sn as an alloying addition are presented. In most Al-Si alloys, tin is regarded as a contaminant; thus, its amount is limited to up to 0.3 wt.%. The few studies that can be found in the literature regarding the behaviour of tin in aluminium alloys suggest the beneficial effect of this element on selected properties. However, these results were obtained for hypereutectic Al-Si alloys or wrought aluminium alloys. In our studies, the influence of tin contents of up to 1.7 wt.% was determined on the AlSi10 alloy. Thermal analysis, measurements of the mechanical properties of the cast and heat-treated alloy, metallographic observations (light microscopy, scanning electron microscopy), and EDS (X-ray energy dispersive spectrometry) measurement allowed us to fully describe the effect of tin on the aluminium alloy. The results of the thermal analysis showed changes in the range of the α-Al solution crystallisation and the α+β eutectic through a decrease in the alloy’s solidification start point and eutectic solidification point. As a result, the elongation of the alloy was more than double in the AlSi10Sn1.7 alloy, with an A5 value of 8.1% and a tensile strength that was above 200 MPa.     

Comparison of Mechanical Properties of Composites Reinforced with Technical Embroidery,UD and Woven Fabric Made of Flax Fibers

The main purpose of the article is to present the possibilities of producing composite reinforcement with the use of a computer embroidery machine. The study below presents the results of strength tests of composites containing technical embroidery, woven fabric, and UD fabric as the reinforcement. Each of the samples was made of the same material—flax roving. The samples differed from each other in the arrangement of layers in the reinforcement. The composites were made using the infusion method with epoxy resin. The embroidery was made on a ZSK embroidery machine, type JCZA 0109-550. A total of 12 types of composites were produced and tested. The test material was subjected to strength tests—tensile strength, tensile elongation, and shear strength, on the INSTRON machine. As the research showed, the use of technical embroidery as a composite reinforcement increases its tensile strength. Furthermore, the use of embroidery is a vertical reinforcement of the composite and prevents the formation of interlayer cracks. The technology of technical embroidery allows for optimizing the mechanical values of the composite reinforcement.     

Development of a CT Image Analysis Model for Cast Iron Products Based on Artificial Intelligence Methods

This paper presents an assessment of the possibility of using digital image classifiers for tomographic images concerning ductile iron castings. The results of this work can help the development of an efficient system suggestion allowing for decision making regarding the qualitative assessment of the casting process parameters. Special attention should be focused on the fact that automatic classification in the case of ductile iron castings is difficult to perform. The biggest problem in this aspect is the high similarity of the void image, which may be a sign of a defect, and the nodular graphite image. Depending on the parameters, the tests on different photos may look similar. Presented in this article are test scenarios of the module analyzing two-dimensional tomographic images focused on the comprehensive assessment by convolutional neural network models, which are designed to classify the provided image. For the purposes of the tests, three such models were created, different from each other in terms of architecture and the number of hyperparameters and trainable parameters. The described study is a part of the decision-making system, supporting the process of qualitative analysis of the obtained cast iron castings.