A Questionnaire-Based Study to Obtain a Consensus from 5 Polish Burns Centers on Eschar Removal by Bromelain-Based Enzymatic Debridement (Nexobrid®) in Burns Following the 2020 Updated European Consensus Guidelines.

BACKGROUND The supplementary treatment of burns with enzymatic debridement with Nexobrid® was approved in Europe in 2013. The 2017 European consensus guidelines on the removal of eschar in burns by bromelain-based enzymatic debridement were updated in 2020. This questionnaire-based study aimed to obtain a consensus from 5 Polish burns centers on eschar removal by Nexobrid® in burns following the 2020 updated European consensus guidelines. MATERIAL AND METHODS A panel of 5 experts representing the leading burn treatment centers in Poland (Cracow, Gryfice, Siemanowice Slaskie, Poznan, and Leczna) was convened. A modified Delphi process was implemented with panel member selection, literature review, 2 rounds of voting in which panelists were asked to evaluate the European consensus and Polish consensus building by data analysis, statements preparation, final voting, and manuscript drafting. RESULTS The knowledge and experience of experts from Poland's leading burn centers resulted in the development of guidelines, formulated as 24 statements representing the following areas: indications and usage, pain management, application principles, post-enzymatic debridement wound dressing, and early and long-term outcomes. An analysis of the 7-point Likert scale polls revealed that 23 of the 24 statements achieved 100% consensus. CONCLUSIONS The findings from this survey from 5 major centers in Poland supported the main recommendations from the 2020 updated European consensus guidelines on the removal of eschar in burns by Nexobrid® and may serve as a practical guide for surgeons who care for patients with burns in this country.

Preliminary Research on the Effect of Hyperbaric Oxygen Therapy in Patients with Post-COVID-19 Syndrome.

Negative consequences and medical complications of COVID-19 can persist for up to several months after initial recovery. These consequences can include stroke, diabetes, decreased lung diffusing capacity, sleep apnea, pulmonary fibrosis, arrhythmia, myocarditis, fatigue, headaches, muscle aches, heart rate fluctuations, sleep problems, memory problems, nervousness, anxiety, and other neurological disorders. Thirty-one patients who reported symptoms related to previous COVID-19 disease of both sexes were enrolled in the initial program. The patients underwent compression sessions in a multiplace hyperbaric chamber. Each patient underwent a cycle of 15 compressions. Before the first session, each participant completed a venous blood gas test, a Fullerton test, and two spirometry tests (one before the Fullerton test and one after the test). Patients completed psychotechnical tests, a questionnaire on quality of life (Polish version of EQ-5D-5L), and a questionnaire on specific symptoms accompanying the disease and post-infection symptoms. The results showed significant improvements in areas such as quality of life, endurance and strength, some spirometric parameters, the anion gap and lactate levels, working memory, and attention in the group of treated patients. In contrast, there were no changes in pH, pO2, pCO2, glucose, and excess alkaline values. A follow-up interview confirmed that the beneficial effects were maintained over time. Considering the results obtained, including the apparent improvement in the patient's clinical condition, it can be concluded that the use of 15 compression sessions was temporarily associated with a noticeable improvement in health and performance parameters as well as improvement in certain blood gas parameters.

Using Maggot Debridement Therapy in Treatment of Necrosis in the Forearm Caused By Docetaxel Extravasation: A Case Report.

Extravasation of doxorubicin, vincristine or vinblastine leads to necrosis, damage of the muscles and nerves, deep ulceration, as well as limb dysfunction. Necrosis and deep ulcers develop within 7 to 28 days. Like necrotomy, Lucilia sericata maggot therapy is recognised as a method enabling effective, safe and quick removal of necrotic tissue. The purpose of the study was to present local treatment of hypodermic necrosis caused by docetaxel extravasation in course of systemic cancer therapy. A woman, 59 years of age, in course of systemic therapy due to advanced cancer of the left breast (T2N1M1 CS IV) with confirmed metastases within the body of the fourth lumbar vertebra and in the liver, receiving a combination treatment with pertuzumab, trastuzumab, and docetaxel. During the therapy, a conservative treatment was applied due to extravasation for over three months. Effects in the right forearm included swelling, redness, signs of 4x10cm inflammatory infiltrate, with 1x4cm necrotic crust visible in the central region. Hypodermic necrosis was debrided using L. sericata maggots, and subsequently specialist dressings were applied to promote granulation and healing. In the case discussed here, effectiveness of MDT was rather poor, however the treatment minimised the risk of infection associated with evacuation of necrosis. Attempts to use MDT should be continued to enable more comprehensive understanding of problems related to management of necrosis in wounds developing during cancer therapy.

Historical and modern research on propolis and its application in wound healing and other fields of medicine and contributions by Polish studies.

ETHNOPHARMACOLOGICAL RELEVANCE: The history of medical application of propolis (also known as bee glue) dates back to the times of ancient Greeks, Romans, Persians and Egyptians. Honey and other bee products, including propolis, occupy an important place in Polish folk medicine. Scientific research on propolis in Poland began in the early 1960s in Zabrze and continues until now. AIM OF THE REVIEW: The aim of this review is to provide an overview of information on Polish research on propolis and its medical application with particular emphasis on studies concerning wound healing. Consequently, our goal is also to shed a new light on therapeutic potential of Polish propolis in order to support future research in the field. MATERIALS AND METHODS: A systematic review of scientific literature on propolis and its medical application was performed by using the literature databases (PubMed, Web of Science, Google Scholar). We paid special attention to papers describing the effect of propolis on skin wound healing as well as to Polish contribution to research on propolis. RESULTS: Professor Stan Scheller was the first Polish scientist dealing with propolis and its medical potential. His legacy was continued by several research teams that studied the topic in various aspects. They analyzed propolis composition, its antioxidant, anti-inflammatory, antimicrobial, antiapoptotic and anticancer properties as well as its application in dentistry and wound treatment. Burn wound healing physiology after propolis administration was thoroughly studied on pig model, whereas research on patients proved the efficacy of propolis in chronic venous leg ulcer treatment. CONCLUSION: Polish scientists have made a significant contribution to the research on propolis, its biological properties and influence on wound healing. Propolis ointments can effectively accelerate the healing process and improve healing physiology, so they can be recommended as a promising topical medication for wound treatment in the future clinical and preclinical trials.

Photodynamic therapy in colorectal cancer treatment--The state of the art in preclinical research.

BACKGROUND: Photodynamic therapy (PDT) is used in many different oncologic fields. Also in gastroenterology, where have been a few attempts to treat both the premalignant lesion and advanced colorectal cancer (CRC). This review aims to give a general overview of preclinical photodynamic studies related to CRC cells and animal studies of photodynamic effects related to CRC treatment to emphasize their potential in study of PDT mechanism, safety and efficiency to translate these results into clinical benefit in CRC treatment. MATERIALS AND METHOD: Literature on in vitro preclinical photodynamic studies related to CRC cells and animal studies of photodynamic effects related to CRC treatment with the fallowing medical subject headings search terms: colorectal cancer, photodynamic therapy, photosensitizer(s), in vitro, cell culture(s), in vivo, animal experiment(s). The articles were selected by their relevance to the topic. RESULTS: The majority of preclinical studies concerning possibility of PDT application in colon and rectal cancer is focused on phototoxic action of photosensitizers toward cultured colorectal tumor cells in vitro. The purposes of animal experiments are usually elucidation of mechanisms of observed photodynamic effects in scale of organism, estimation of PDT safety and efficiency and translation of these results into clinical benefit. CONCLUDING REMARKS: In vitro photodynamic studies and animal experiments can be useful for studies of mechanisms and efficiency of photodynamic method as a start point on PDT clinical research. The primary disadvantage of in vitro experiments is a risk of over-interpretation of their results during extrapolation to the entire CRC.

The influence of electromagnetic radiation generated by a mobile phone on the skeletal system of rats.

The study was focused on the influence of electromagnetic field generated by mobile phone on the skeletal system of rats, assessed by measuring the macrometric parameters of bones, mechanical properties of long bones, calcium and phosphorus content in bones, and the concentration of osteogenesis (osteocalcin) and bone resorption (NTX, pyridinoline) markers in blood serum. The study was carried out on male rats divided into two groups: experimental group subjected to 28-day cycle of exposures in electromagnetic field of 900 MHz frequency generated by mobile phone and a control, sham-exposed one. The mobile phone-generated electromagnetic field did not influence the macrometric parameters of long bones and L4 vertebra, it altered mechanical properties of bones (stress and energy at maximum bending force, stress at fracture), it decreased the content of calcium in long bones and L4 vertebra, and it altered the concentration of osteogenesis and bone resorption markers in rats. On the basis of obtained results, it was concluded that electromagnetic field generated by 900 MHz mobile phone does not have a direct impact on macrometric parameters of bones; however, it alters the processes of bone mineralization and the intensity of bone turnover processes and thus influences the mechanical strength of bones.

The biological activity of propolis-containing toothpaste on oral health environment in patients who underwent implant-supported prosthodontic rehabilitation.

The soft and periodontal tissues surrounding dental implants are particularly susceptible to bacteria invasion and inflammatory reactions due to complex histological structures. This study was carried out to investigate the influence of a propolis-containing hygienic agent on selected oral health parameters, oral microflora, and the condition of periodontal health. Sixteen subjects who underwent an oral rehabilitation with dental implants were selected and randomly assigned into two groups, which received a newly formulated propolis-containing toothpaste (3% (CA)) or a negative control without an active ingredient (CC). Approximal plaque index (API), oral hygiene index (OHI, debris component), and sulcus bleeding index (SBI) were assessed in three subsequent stages. During the first and last examinations, the swabs were employed for microbiological inoculation. Propolis-containing toothpaste was found to be distinctively effective in improving oral health and the occurrence of gingivitis triggered by dental plaque. The qualitative and quantitative changes in oral bacteria spectrum were observed. Antibacterial measures containing propolis might be used as a natural adjuvant to other active substances in individuals with a high risk of periodontal problems against pathogenic oral microflora.

Trace element concentration distributions in breast, lung and colon tissues.

The concentrations of Fe, Cu, Zn and Se in cancerous and benign tissues of breast, lung and intestine (colon) have been determined. In the cases when the element concentration has not been determined in all samples the Kaplan-Meier method has been used for the reconstruction of the original concentration distributions and estimation of the true mean concentrations and medians. Finally, the log-rank test has been applied to compare the elemental concentration distributions between cancerous and benign tissues of the same organ, between cancerous tissues and between benign tissues taken from different organs. Comparing benign and malignant neoplastic tissues, statistically significant differences have been found between Fe and Se concentration distributions of breast as well as for Cu and Zn in the case of lung tissues and in the case of colon tissues for Zn. The concentrations of all elements have been found to be statistically different in cancer tissues as well as in benign ones when comparing the different organs, i.e. groups 'breast-colon' and 'breast-lung'. Concentrations of Fe and Cu have been found to be statistically different in lung and colon cancerous tissues. For benign tissues of lung and colon a statistically significant difference has been found only for Zn.

[The venous ulcer therapy in use of the selected physical methods (Part 2)--The comparison analysis]. / Leczenie owrzodzen zylnych za pomoca wybranych metod fizykalnych (Czesc 2)--Badanie porównawcze.

UNLABELLED: The aim of the study was to evaluate the influence of a high voltage stimulation, sonotherapy and laser biostimulation on the process of healing of venous leg ulcers. MATERIAL AND METHODS: Four comparative groups--A, B, C and D--were made at a random from 92 patients with venous leg ulcers. The group A consisted of 26 patients, the group B--21 patients, the group C--21 patients, and the group D--24 patients. The patients in all comparative groups were treated pharmacologically. Ulcerations at the patients in the group A were additionally treated with the high voltage stimulation. However, ulcerations at the patients in the group B were treated with the sonotherapy. Ulcerations at the patients in the group C were treated with the laser biostimulation. Changes of the area, length, width and volume of the tissue defekt after above physical therapies were assessed. Changes of the pus decontamination and granulation processes were observed too. CONCLUSIONS: After treatment concluded, high voltage stimulation and ultrasound therapy had been more efficient at enhancing healing of venous leg ulcers than topical pharmacology. No significant effect of laser biostimulation on healing process was observed.

[The venous ulcer therapy in use of the selected physical methods--circumstances for clinical application]. / Leczenie owrzodzen zylnych za pomoca wybranych metod fizykalnych--przeslanki do stosowania klinicznego.

Venous ulcers are significant both surgical and dermatological problem. The chronic and recurrent natures of the disease require a search for new methods to improve treatment efficiency. Therefore, the attempts at using some physical methods are needed. The authors review the current literature on characteristics and biological effects of high voltage stimulation (HVS), ultrasound (sonotherapy) and laser biostimulation. Modern hypotheses (skin battery theory, cavitation, acoustic streaming, fotobiostimulation effect) explaining the mechanisms of applied physical factors arising in soft tissue healing process are presented too.

Selenium, copper, and zinc concentrations in intestinal cancer tissue and in colon and rectum polyps.

The prospective randomized trial was used to determine Se, Zn, and Cu concentrations in intestinal cancer tissue and colorectal polyp. We also determined the relationship among the trace element levels in cancer tissue, the localization of neoplasms, and the stage of their development. The concentrations of these trace elements were examined in cancer tissue of the colorectum in 67 patients and in the colon and rectum polyps in 42 patients using the total-reflection X-ray fluorescence (TRXRF) method. The mean concentration of Se in colorectal cancer was 0.86 microg/g tissue and was statistically higher than in the case of polyps (0.57 microg/g). The mean concentration of Zn in colorectal cancer was higher than in the polyp (14.8 microg/g and 9.84 microg/g, respectively). The determined average concentration of Cu in colorectal cancer was 3.87 microg/g tissue and was a little lower than the level of this metal in the polyp (3.94 microg/g). There was no difference in the levels of these trace elements depending on the location of the neoplasm and the stage of its development. Also, there was no difference between the concentrations of these trace elements in the cancer tissue of malignant and benign tumors after taking into consideration the sex and age of patients. During the examination, we determined significantly higher concentrations of only selenium and zinc in the cancer tissue and not in the polyp. The level of copper was lower in a malignant tumor than in a benign one.

Does low output laser stimulation enhance the healing of crural ulceration? Some critical remarks.

The objective of the experiment was to evaluate the impact of laser stimulation on crural ulceration healing. Three groups were established at random from patients with crural ulceration: A, B and C. Group A included 21 patients, group B included 22 patients and group C, 22 patients. Patients in all groups were treated with pharmaceuticals and with compressive therapy. The ulcers in group A were additionally irradiated with laser light of wavelength 810 nm, so that a dose of 4 J/cm2 was applied in each procedure. Patients in group B were additionally subjected to a blind test (with placebo in the form of quasi-laser therapy). At the end of the treatment a statistically significant reduction of the area and volume of the ulcers was found in all groups. No statistically significant difference was found between the groups in terms of average rate of change per week of the relative area of ulceration and average rate of change per week of the relative volume of ulceration. Reduction of infected area was observed in all groups, but a significant change was only observed in group C. No significant impact of laser light (lambda=810 nm, P=65 mW, p=4 J/cm2) on any of the stages of ulceration healing was observed.