[Value of adjuvant physiotherapy in postoperative pain management]. / Stellenwert der physikalischen Therapie und Physiotherapie in der postoperativen Schmerztherapie.

In times of limited financial and human resources the application of adjuvant physiotherapy postoperatively in orthopaedic patients requires reevaluation. In the early postoperative course physiotherapy improves the patients' mobility. However, it is not able to reduce the need for pain medication. It is intended to minimize complications and to mobilize and motivate the patients early. In contrast, massages are of minor importance in the immediate postoperative course and are applied only in a few selected cases. Cryotherapy plays a major role especially after shoulder and knee surgery. On the other hand, transcutaneous electrical nerve stimulation (TENS) and acupuncture are applied only in selected patients after orthopaedic surgery, e.g., after limb amputation.

Translucency parameter of colorants for maxillofacial prostheses.

The masking power of various generic, dry mineral earth, and flocking colorants dispersed in medical-grade silicone elastomer was investigated. Reflectance measurements were made by diffuse reflectance spectrophotometry using black and white backings. These data were reduced to optical scattering and absorption coefficients through the use of the Kubelka-Munk reflectance theory. The color difference between a 0.13-cm-thick layer of the colored elastomer placed on an ideal black backing and this layer on an ideal white backing was calculated and established as a translucency parameter. Using analysis of variance and stepwise comparison testing, significant differences were found among the translucency parameters of the colorants. Since these colorants differ substantially in their ability to mask underlying colors and since the translucency of maxillofacial material is an important aspect of color measurement and natural appearance, differences in these colorants go beyond their obvious differences in color.

Glutamine dipeptide-supplemented parenteral nutrition maintains intestinal function in the critically ill.

BACKGROUND/AIMS: Long-term total parenteral nutrition is accompanied with mucosal atrophy and subsequent malabsorption syndrome. Current information attests the important role of glutamine in maintaining intestinal structure and function. The aim of this study was to investigate the effect of glutamine dipeptide supplementation on small intestinal absorption capacity during critical illness. METHODS: Twelve intensive care unit patients were uniformly randomized to receive isonitrogenous (0.26 g nitrogen.kg-1.day-1) and isoenergetic (155 kJ.kg-1.day-1) parenteral nutrition over 9 days. The control group received a conventional amino acid solution (1.5 g amino acids.kg-1.day-1), and the test group received a complete amino acid solution containing the dipeptide L-alanyl-L-glutamine (20 g/L). On days 8 and 9, a modified D-xylose test was performed. RESULTS: Excretion of D-xylose during the 5-hour test period was 7.4 +/- 1.1 g (test) vs. 3.8 +/- 0.9 g (control) (P < 0.05). The 2-hour serum D-xylose concentration was 38.7 +/- 3.0 (test) vs. 27.8 +/- 2.9 mg/100 mL (control) (P < 0.05). Kinetic evaluation showed higher maximum D-xylose blood concentration and higher values for the area under the curve with the peptide. CONCLUSIONS: The results strongly suggest that glutamine dipeptide-containing total parenteral nutrition prevents intestinal atrophy and increased permeability associated with glutamine-free parenteral nutrition.