OLEOGEL-S10 TO ACCELERATE HEALING OF DONOR SITES: MONOCENTRIC RESULTS OF PHASE III CLINICAL TRIAL.

MATERIAL AND METHODS: Oleogel-S10, an ointment containing betulin-rich triterpene dry extract from birch bark was tested in an open, blindly evaluated, prospective, controlled, randomized multicentre study to improve wound healing in donor sites. The primary endpoint was time to wound closure, and secondary endpoints were scar related measurements at the time of wound closure, and 3 and 12 months after wound closure (POSAS, laser speckle contrast analysis, viscoelastic analysis). RESULTS: We report the results from a single centre (Department of Burns and Reconstructive Surgery, University Hospital Brno) of this phase III clinical trial. A total of 32 patients (25 men and 7 women) were included with the mean patient age of 41.8 years (SD, ±11.66). The mean extent of patients donor sites in the study was 56.77cm2 (SD, ±20.39). Median healing time of the verum group (Oleogel-S10) was 7 days (95% Confidence Interval 7-8 days) and for controls 8 days (95% CI 7-10 days). Comparison of POSAS data from the verum group revealed significantly lower values at all three time points as compared to the controls. Perfusion of scars of the verum group reached on average of 115 perfusion units at the end of treatment; the average was 69.8 perfusion units at the 3-month follow-up and 50.2 perfusion units at the 12-month follow-up. Control sites displayed significantly higher values at all time points (122.2 perfusion units, 73.9 perfusion units, 52.2 perfusion units). Significant differences were detected in the skins viscoelastic properties, with sites treated with Oleogel-S10 displaying more favourable values. CONCLUSION: In our results, we demonstrate the significant effectiveness of Oleogel-S10 in donor sites healingKeywords: Donor site, Triterpenes, Oleogel-S10, wound closure.

[Analgesia for labour in the Czech Republic in the year 2011 from the perspective of OBAAMA-CZ study - prospective national survey]. / Analgezie u porodu v Ceské republice v roce 2011 z pohledu studie OBAAMA-CZ- prospektivní observacní studie.

GOAL OF THE STUDY: The aim of national survey was to describe current practice for analgesia during labour provided by anaesthesiologists in the Czech Republic (CZE). TYPE OF THE STUDY: National prospective observational. SETTING: 49 obstetric departments in CZE. METHODS: We aimed to enrol all 97 obstetric departments in CZE and to monitor every case of anaesthetic care in peripartum period during November 2011. Data were recorded to Case Report Form with two parts (Demography 2010 and Case Report) into TrialDB database (Yale University, USA; adapted IBA, MU, CZE). Demographic data for CZE were obtained on request by ÚZIS. The data were analysed using SPSS 22. RESULTS: We enrolled 1943 cases of anaesthesiological care and 579 (29.8%) of them was to relief labour pain. Population and center weighted estimate of incidence of epidural labour analgesia was 12.5% (95% CI: 10.6% - 14.4%). Epidural analgesia was the most frequently applied via Tuohy needle G18 (97.8%), with administration of an epidural catheter G20 (95.7%), via medial approach (98.8%), in lateral position (76.7%) by the loss of resistance method (94.3%). All administrations of epidural analgesia were started by initial bolus, only in 28.2% of cases were followed continously. Always has been applied mixture of local anaesthetic with sufentanil at a dose of 3-10 mcg. Bupivacaine was most frequently used local anaesthetic (80.7%), followed by levobupivacaine (12.6%). Median concentrations both bupivacaine and levobupivacaine were 0.125% (min. 0.1%, max. 0.3%).The most common complication of epidural analgesia was repeated puncture (21.2%), blood in the catheter (1.4%), blood in the needle (1.2%), unintended puncture of the dura mater (0.7%) and transient paresthesias (0.5%). CONCLUSION: In comparison to previously published data there was trend for lower incidence of epidural analgesia for labour in the CZE.

[New therapeutic activity in geriatric psychiatry]. / Nové terapeutické aktivity v gerontopsychiatrii.

The author mentions and describes in detail three dynamically oriented psychiatric activities which proved useful and became thus an important component of comprehensive treatment of demented patients. Part of the activating programme for patients with advanced affections of memory, orientation and concentrating capacity is Training in orientation and reality (TOR). Relaxation training (TR) helps patients to get rid of the sensation of tension, fear and uncertainty. Cognitive training (KT) helps to restore and improve cognitive functions. By means of the mentioned activities the authors reinforce persisting abilities and skills. In the conclusion the authors present recommendations which make the reader familiar with suitable communication with and treatment of clients suffering from organic brain affections.