Vitamin D Status in Patients before Thyroidectomy.

Thyroid neoplasms (tumors) are the most common pathology of the endocrine system that requires surgery, and in most cases changes are benign. The surgical treatment of thyroid neoplasms consists in total, subtotal, or one lobe excision. Our study aimed to assess the concentration of vitamin D and its metabolites in patients before thyroidectomy. The study included 167 patients with thyroid pathology. Before the thyroidectomy procedure calcidiol (25-OHD), calcitriol (1,25-(OH)2D), and vitamin D binding protein (VDBP), as well as basic biochemical parameters, were measured using an enzyme-linked immunosorbent assay kit. Data analysis showed that the cohort of patients has a significant 25-OHD deficiency and proper concentration of 1,25-(OH)2D. Before the surgery, more than 80% of patients have extreme vitamin D deficiency (<10 ng/mL), and only 4% of the study group has proper 25-OHD concentration. Patients undergoing thyroidectomy are exposed to many complications, including calcium reduction. Our research has shown that patients prior to surgery have a marked vitamin D deficiency, an indicator that may affect their subsequent convalescence and prognosis. The results suggest that determination of vitamin D levels prior to thyroidectomy may be useful for potential consideration of supplementation when vitamin D deficiency is marked and needs to be incorporated into the good clinical management of these patients.

Permeability of Ibuprofen in the Form of Free Acid and Salts of L-Valine Alkyl Esters from a Hydrogel Formulation through Strat-M™ Membrane and Human Skin.

This paper aimed to evaluate the effect of vehicle and chemical modifications of the structure of active compounds on the skin permeation and accumulation of ibuprofen [IBU]. In vitro permeation experiments were performed using human abdominal skin and Strat-M™ membrane. The HPLC method was used for quantitative determinations. The formulations tested were hydrogels containing IBU and its derivatives and commercial gel with ibuprofen. The results obtained indicate that Celugel® had an enhancing effect on the skin penetration of IBU. The average cumulative mass of [IBU] after 24 h permeation test from Celugel® formulation through human skin was over 3 times higher than for the commercial product. Three ibuprofen derivatives containing [ValOiPr][IBU], [ValOPr][IBU], and [ValOBu][IBU] cation were evaluated as chemical penetration enhancers. The cumulative mass after 24 h of penetration was 790.526 ± 41.426, 682.201 ± 29.910, and 684.538 ± 5.599 µg IBU cm-2, respectively, compared to the formulation containing unmodified IBU-429.672 ± 60.151 µg IBU cm-2. This study demonstrates the perspective of the transdermal hydrogel vehicle in conjunction with the modification of the drug as a potential faster drug delivery system.

Assessment of the Effect of Structural Modification of Ibuprofen on the Penetration of Ibuprofen from Pentravan® (Semisolid) Formulation Using Human Skin and a Transdermal Diffusion Test Model.

The effect of transdermal vehicle (Pentravan®) on skin permeability was examined for unmodified ibuprofen (IBU) and ion pairs of ibuprofen with new L-valine alkyl esters [ValOR][IBU]. The percutaneous permeation across the human skin and transdermal diffusion test model (Strat-M® membranes) of ibuprofen and its structural modification were measured and compared using Franz diffusion cells. For comparison, the penetration of ibuprofen from a commercial product was also investigated. The cumulative amount of drug permeated through human skin at the end of the 24 h study was highest for ibuprofen derivatives containing propyl (C3), isopropyl (C3), ethyl (C2), and butyl (C4) esters. For Strat-M®, the best results were obtained with the alkyl chain length of the ester from C2 to C5. The permeation profiles and parameters were appointed, such as steady-state flux, lag time, and permeability coefficient. It has been shown that L-valine alkyl ester ibuprofenates, with the propyl, butyl, and amyl chain, exhibit a higher permeation rate than ibuprofen. The diffusion parameters of analyzed drugs through human skin and Strat-M® were similar and with good correlation. The resulting Pentravan-based creams with ibuprofen in the form of an ionic pair represent a potential alternative to other forms of the drug-containing analgesics administered transdermally. Furthermore, the Strat-M® membranes can be used to assess the permeation of transdermal preparations containing anti-inflammatory drugs.

The Influence of Oxidative Stress on Thyroid Diseases.

Thyroid diseases, including neoplasms, autoimmune diseases and thyroid dysfunctions, are becoming a serious social problem with rapidly increasing prevalence. The latter is increasingly linked to oxidative stress. There are many methods for determining the biomarkers of oxidative stress, making it possible to evaluate the oxidative profile in patients with thyroid diseases compared to the healthy population. This opens up a new perspective for investigating the role of elevated parameters of oxidative stress and damage in people with thyroid diseases, especially of neoplastic nature. An imbalance between oxidants and antioxidants is observed at different stages and in different types of thyroid diseases. The organ, which is part of the endocrine system, uses free radicals (reactive oxygen species, ROS) to produce hormones. Thyroid cells release enzymes that catalyse ROS generation; therefore, a key role is played by the internal defence system and non-enzymatic antioxidants that counteract excess ROS not utilised to produce thyroid hormones, acting as a buffer to neutralise free radicals and ensure whole-body homeostasis. An excess of free radicals causes structural cell damage, undermining genomic stability. Looking at the negative effects of ROS accumulation, oxidative stress appears to be implicated in both the initiation and progression of carcinogenesis. The aim of this review is to investigate the oxidation background of thyroid diseases and to summarise the links between redox imbalance and thyroid dysfunction and disease.

Microbiome Metabolites and Thyroid Dysfunction.

Thyroid diseases are common conditions that have a negative impact on the health of all populations. The literature sheds light on the differences in the composition of the intestinal microbiota in patients suffering from thyroid diseases compared to healthy individuals. The microbiome affects the proper functioning of the thyroid gland, and the existence of the gut-thyroid axis is discussed in the context of both thyroid diseases and intestinal dysbiosis. The purpose of this review is to describe associations between the microbiome and its metabolites and thyroid dysfunction. We try to explain the role of the microbiome in the metabolism of thyroid hormones and the impact of thyroid autoimmune diseases. In addition, we raise issues related to the influence of bacterial metabolites, such as short-chain fatty acids or secondary bile acids, in the functioning of the thyroid gland. Last but not least, we explored the interactions between the gut microbiota and therapeutics and supplements typically administered to patients with thyroid diseases.

Epilobium angustifolium L. Extracts as Valuable Ingredients in Cosmetic and Dermatological Products.

Epilobium angustifolium L. is a popular and well-known medicinal plant. In this study, an attempt to evaluate the possibility of using this plant in preparations for the care and treatment of skin diseases was made. The antioxidant, antiaging and anti-inflammatory properties of ethanolic extracts from Epilobium angustifolium (FEE) were assessed. Qualitative and quantitative evaluation of extracts chemically composition was performed by gas chromatography with mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC). The total polyphenol content (TPC) of biologically active compounds, such as the total content of polyphenols (TPC), flavonoids (TFC), and assimilation pigments, as well as selected phenolic acids, was assessed. FEE was evaluated for their anti-inflammatory and antiaging properties, achieving 68% inhibition of lipoxygenase activity, 60% of collagenase and 49% of elastase. FEE also showed high antioxidant activity, reaching to 87% of free radical scavenging using 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 59% using 2,2'-azinobis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS). Additionally, in vitro penetration studies were performed using two vehicles, i.e., a hydrogel and an emulsion containing FEE. These studies showed that the active ingredients contained in FEE penetrate through human skin and accumulate in it. The obtained results indicate that E. angustifolium may be an interesting plant material to be applied as a component of cosmetic and dermatological preparations with antiaging and anti-inflammatory properties.

Thermography in the diagnosis of carpal tunnel syndrome.

INTRODUCTION: Carpal tunnel syndrome (CTS) is a condition caused by chronic compression of the median nerve. The diagnosis is made mainly on the basis of clinical image and confirmed with electrodiagnostic testing (electromyography and nerve conduction study); however, these methods do not always aid in reaching the diagnosis of CTS. Moreover, they are invasive examinations, unpleasant for the patient and have to be performed by a qualified physician. AIM: An evaluation of the usefulness of dynamic thermography in the diagnosis of CTS. MATERIAL AND METHODS: Forty patients were included in the study group. CTS was diagnosed based on clinical examination and electromyography. Forty healthy volunteers were included in the control group. Each of the participants was examined thrice with dynamic thermography. The patient's hands were first cooled down and then a thermal camera measured their return to normal temperature. The measurement was repeated on the dorsal and volar aspects of each hand. RESULTS: The results obtained in the study show that a relief of symptoms after carpal tunnel release does not correlate with thermal image. Moreover, the return to normal hand temperature was faster in the control group. In patients with unilateral CTS, no difference was observed in thermographic images of the affected and healthy hands. CONCLUSIONS: Dynamic thermography can be useful in confirming CTS diagnosis.Dynamic thermography does not allow for objective assessment of patient's complaints in the postoperative period.This method has currently limited clinical application. Due to complexity, it presently serves mainly scientific purposes.

In Vitro Human Skin Penetration, Antioxidant and Antimicrobial Activity of Ethanol-Water Extract of Fireweed (Epilobium angustifolium L.).

Epilobium angustifolium L. is applied as an antiseptic agent in the treatment of skin diseases. However, there is a lack of information on human skin penetration of active ingredients with antioxidative potential. It seems crucial because bacterial infections of skin and subcutaneous tissue are common and partly depend on oxidative stress. Therefore, we evaluated in vitro human skin penetration of fireweed ethanol-water extracts (FEEs) by determining antioxidant activity of these extracts before and after penetration study using 2,2-diphenyl-1-picrylhydrazyl (DPPH), 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) (ABTS), and Folin-Ciocalteu methods. Microbiological tests of extracts were done. The qualitative and quantitative evaluation was performed using gas chromatography-mass spectrometry (GC-MS) and high-performance liquid chromatography (HPLC-UV) methods. The in vitro human skin penetration using the Franz diffusion chamber was assessed. The high antioxidant activity of FEEs was found. Gallic acid (GA), chlorogenic acid (ChA), 3,4-dihydroxybenzoic acid (3,4-DHB), 4-hydroxybenzoic acid (4-HB), and caffeic acid (CA) were identified in the extracts. The antibacterial activities were found against Serratia lutea, S. marcescens, Bacillus subtilis, B. pseudomycoides, and B. thuringiensis and next Enterococcus faecalis, E. faecium, Streptococcus pneumoniae, Pseudomonas aeruginosa, and P. fluorescens strains. In vitro penetration studies showed the penetration of some phenolic acids and their accumulation in the skin. Our results confirm the importance of skin penetration studies to guarantee the efficacy of formulations containing E. angustifolium extracts.

Electromyography as an intraoperative test to assess the quality of nerve anastomosis - experimental study on rats.

BACKGROUND: Many factors contribute to successful nerve reconstruction. The correct technique of anastomosis is one of the key elements that determine the final result of a surgery. The aim of this study is to examine how useful an electromyography (EMG) can be as an objective intraoperative anastomosis assessment method. METHODS: The study material included 12 rats. Before the surgery, the function of the sciatic nerve was tested using hind paw prints. Then, both nerves were cut. The left nerve was sutured side-to-side, and the right nerve was sutured end-to-end. Intraoperative electromyography was performed. After 4 weeks, the rats were reassessed using the hind paw print analysis and electromyography. RESULTS: An analysis of left and right hind paw prints did not reveal any significant differences between the length of the steps, the spread of the digits in the paws, or the deviation of a paw. The width of the steps also did not change.Electromyography revealed that immediately after a nerve anastomosis (as well as 4 weeks after the surgery), better nerve conduction was observed through an end-to-end anastomosis. Four weeks after the surgery, better nerve conduction was seen distally to the end-to-end anastomosis. CONCLUSIONS: The results indicate that in acute nerve injuries intraoperative electromyography may be useful to obtain unbiased information on whether the nerve anastomosis has been performed correctly - for example, in limb replantation.When assessing a nerve during a procedure, EMG should be first performed distally to the anastomosis (the part of the nerve leading to muscle fibers) and then proximally to the anastomosis (the proximal part of the nerve). Similar EMG results can be interpreted as a correct nerve anastomosis.The function of the distal part of the nerve and the muscle remains intact if the neuromuscular transmission is sustained.

Skin incision versus laser - the influence of different techniques on scar formation and lymphatic drainage in rats. A preliminary report.

INTRODUCTION: The constantly rising number of skin malignancies and increasing cancer awareness encourage more people to visit outpatient clinics in order to have various skin lesions removed. Despite the fact that scarring is a physiological response to any excision procedure, minimizing the size of it is a goal of every good practitioner. Therefore the question arises whether different techniques used to remove skin lesions may impact the formation and quality of skin scars. AIM: To perform an evaluation of skin scars formed by laser and surgical incisions and their influence on lymphatic outflow in rats. MATERIAL AND METHODS: Five male rats were used. Using methylene blue, the migration of dye through lymphatic channels of the lower extremity was measured. Afterwards, transverse incisions were made distally using laser and a surgical blade. Wounds were left to heal by secondary intention. After 4 weeks dye migration assessment was repeated and tissue samples were obtained for microscopic evaluation. RESULTS: Wounds after surgical incisions healed entirely. Wounds after laser treatment had not healed, with a visible area of granulation tissue and hair loss. Significantly worse dye migration was observed in rat extremities after laser therapy than after surgical incision (p = 0.007). CONCLUSIONS: The results of the study show that the size of the scar can depend on the incision technique used. Larger scars after laser therapy limit the lymphatic flow of the skin, which may have an adverse effect on mapping sentinel lymph nodes. However, this hypothesis requires further research.

Bone Healing in the Presence of a Biodegradable PBS-DLA Copolyester and Its Composite Containing Hydroxyapatite.

The healing process of the fractured bone in a presence of poly(butylene succinate-butylene dilinoleate) (PBS-DLA) copolymer containing nanosized hydroxyapatite (HAP) particles has been investigated. The PBS-DLA material containing PBS hard segments and DLA soft segments (50:50 wt %) was used to prepare a polymer/ceramic composite with 30 wt % HAP. A new PBS-DLA copolymer showed a high elasticity of 500% and 15 MPa tensile strength. Addition of HAP improved tensile strength up to 25 MPa while high elasticity has been preserved going down only to 300% of elongation at break. A polymer nanocomposite was fabricated into small elastic polymer rods 15 mm long and 1 × 2 mm in cross section and used for tibia bone fixation in rats. Mallory trichrome staining indicated that new biodegradable copolymers and its composite containing HAP have triggered the most advanced bone healing of all tested materials, thus indicating their high potential for bone tissue engineering and repair.

Genetic basis of keloid formation in wounds after cardiac surgery.

Keloid disease is the abnormal formation of scar tissue in genetically predisposed people. Among many genes which may be related to the development of keloids, transforming growth factor ß1 (TGF-ß1) is one of the most mentioned. It encodes cytokinin, which is responsible for the production of extracellular matrix and takes part in healing. Any abnormalities which arise during synthesis of the protein as a result of polymorphism or gene mutation may be the cause of healing disorders (scarring of the body); thus it is responsible for the development of keloids. The objective of this study is to determine the single nucleotide polymorphism of the gene TGF-ß1, at the position -509(rs1800469)509, to compare the obtained results in the form of three different genotypes within the analysed group (keloids) and within the control group (healthy scars), and to analyse the correlation between obtained genotypes and the occurrence of keloid disease. Seventy-three patients after cardiac surgery with scars on their sternums were examined (22 women and 51 men) in the age group from 38 to 84 years. Two groups of patients were distinguished: 37 with keloids and 36 with healthy scars. DNA taken from patients was analysed and polymorphism C(-509)T of the gene TGF-ß1 was determined. On the basis of the study it was found that the allele T in the position -509 of the gene TGF-ß1 is associated with a lower risk of keloid formation regardless of age and gender.