Delayed Surgical Treatment in Patients with Chronic Carpal Tunnel Syndrome Is Still Effective in the Improvement of Hand Function.

Background and Objectives: Severe carpal tunnel syndrome (CTS) is the most common compression neuropathy in the upper extremities treated conservatively; later, when advanced, CTS is treated mostly surgically. The most prevalent symptoms comprise numbness, as well as sensation loss in the thumb, index, and middle finger, and thenar muscle strength loss, resulting in impaired daily functioning for patients. Data on the results of CTS treatment in patients with delayed surgical intervention are scarce. The aim of this study was to determine the postoperative results of chronic carpal tunnel syndrome treatment in patients with symptoms lasting for at least 5 years. Materials and Methods: A total of 86 patients (69 females, 17 males) with a mean age of 58 years reporting symptoms of CTS for at least 5 years (mean: 8.5 years) were prospectively studied. The average follow-up time was 33 months. All patients underwent the surgical open decompression of the median nerve at the wrist. A preoperative observation was composed of an interview and a clinical examination. The subjects completed the DASH (the Disabilities of the Arm, Shoulder, and Hand), PRWE (Patient-Rated Wrist Evaluation), and self-report questionnaires. Global grip strength, sensory discrimination, characteristic symptoms of CTS, and thenar muscle atrophy were examined. Postoperatively, clinical and functional examinations were repeated, and patients expressed their opinions by completing a BCTQ (Boston Carpal Tunnel Syndrome Questionnaire). Results: We found improvements in daily activities and hand function postoperatively. Overall, 88% of patients were satisfied with the outcome of surgery. DASH scores decreased after surgery from 44.82 to 14.12 at p < 0.001. PRWE questionnaire scores decreased from 53.34 to 15.19 at p < 0.001. The mean score of the BCTQ on the scale regarding the severity of symptoms was 1.48 and 1.62 on the scale regarding function after surgery. No significant differences were found in the scores between the male and female groups or between age groups (p > 0.05). A significant increase in global grip strength from 16.61 kg to 21.91 kg was observed postoperatively at p < 0.001. No significant difference was detected in the measurement of sensory discrimination (6.02 vs. 5.44). In most of the examined patients, night numbness and wrist pain subsided after surgery at p < 0.001. Thenar muscle atrophy diminished after surgery at p < 0.001. Conclusions: Most patients were satisfied with the results of CTS surgery regarding the open decompression of the median nerve even after 5 years of ineffective conservative treatment. Significant improvement of the hand function was confirmed in the functional studies.

Assessment of training and selected factors on speed and quality of performing different tasks on the endoscopic simulator.

INTRODUCTION: One of the most significant challenges nowadays is to educate and predict the predispositions of young surgeons taking into consideration that every ability has its own learning curve. AIM: To determine the influence of selected factors and examine the shape and the length of the learning curve in performing simple tasks on an endoscopic simulator. MATERIAL AND METHODS: Twenty students took part in 4 training sessions with a one-week break between sessions. They were training 12 min and performed three tasks at every session on the endoscopic simulator. To identify whether selected factors influence the time of completing tasks, the participants were asked to fill in questionnaires. All participants also completed the Minnesota Manual Dexterity Test (MMDT) to assess hand-eye coordination. RESULTS: Our research reveals that regardless of activities performed in free time, the shape of the learning curve was logarithmic. Improvement after the fourth session ranged from 50% to 75%. Performing specific activities in the free time did not influence the results achieved on the simulator. No statistically significant correlation between MMDT results and the time to accomplish each task was found. CONCLUSIONS: This study has shown that the length of the learning curve of performing simple tasks is quite short and the shape is logarithmic. It suggests that more complex exercises should be included in the training programme.

Novel Eco-Friendly Tannic Acid-Enriched Hydrogels-Preparation and Characterization for Biomedical Application.

Sodium alginate and tannic acid are natural compounds that can be mixed with each other. In this study, we propose novel eco-friendly hydrogels for biomedical applications. Thus, we conducted the following assessments including (i) observation of the structure of hydrogels by scanning electron microscope; (ii) bioerosion and the concentration of released tannic acid from subjected material; (iii) dehydrogenase activity assay to determine antibacterial activity of prepared hydrogels; and (iv) blood and cell compatibility. The results showed that hydrogels based on sodium alginate/tannic acid exert a porous structure. The immersion in simulated body fluid (SBF) results in the biomineralization process occurring on their surface while the bioerosion studies revealed that the addition of tannic acid improves hydrogels' stability proportional to its concentration. Besides, tannic acid release concentration depends on the type of hydrogels and the highest amount was noticed for those based on sodium alginate with the content of 30% tannic acid. Antibacterial activity of hydrogels was proven for both Gram-negative and Gram-positive bacteria, the hemolysis rate was below 5% and the viability of the cells was elevated with an increasing amount of tannic acid in hydrogels. Collectively, we assume that obtained materials make the imperative to consider them for biomedical applications.

QTLs for resistance to preharvest sprouting in rye (Secale cereale L.).

Grain quality of rye is often negatively affected by sprouting - a complex trait with a poorly understood genetic background and strong interaction with weather conditions. The aim of this report was to detect the main quantitative trait loci (QTLs) underlying preharvest sprouting resistance in rye, measured as a percentage of sprouted kernels after spraying spikes with water for 7 days. Simple and composite interval mapping, carried out in 3 environments on 94 F3 and F4 families of the cross between sprouting-susceptible (541) and sprouting-resistant (Ot1-3) inbred lines, revealed 5 QTLs located on chromosome arms 1RL, 2RL, 5RL, 6RL and 7RL. The significance of these QTLs was additionally proved by disruptive selection carried out on 5000 F2 plants of the 541 x Ot1-3 cross and continued to the F5 generation of recombinant inbred lines (RIL), which strongly affected allele frequencies at linked marker loci. Resistance to preharvest sprouting showed dominant inheritance except for QPhs.uas-7R.1 (recessive) and QPhs.uas-1R.1 (additive). Results of the present study suggest that introgression of 4-5 QTLs, identified in line Ot1-3, should substantially reduce sprouting risk in rye varieties.

Toxicological information conducted by Polish Poison Information Centres based on selected cases of acute intoxication.

The paper presents relatively diversified answers provided by Polish Poison Control Centres concerning the diagnosis and the treatment of the three standard acute poisonings. This diversity resulted from the lack of standardized, compatible, reliable and up-dated system of information. There is an urgent need to establish the national network of RPCC in Poland. The up-dated source of information and unified system of collecting data should be introduced as soon as possible.

[Alcohol dependent patients in family doctor's practice in Gdansk]. / Osoby uzaleznione od alkoholu w praktyce wybranych losowo lekarzy rodzinnych praktykujacych na terenie Gdanska.

Polish family doctors have been given legal rights to diagnose and treat patients with alcohol dependency. Unfortunately, majority of general practitioners do not have proper knowledge and motivation required for this kind of treatment. The aim of the study was to evaluate the preparedness of family doctors in Gdansk to diagnose and treat patients with alcohol dependency. Fifty family doctors from Gdansk were included in the study. Forty five agreed to answer the anonymous questionnaire. Forty two out of 45 family doctors did not know the basic notions connected with diagnosis and therapy of alcohol dependency. The screening tests, helpful in the diagnosis of alcohol dependency, were not used by general practitioners--42 of them (almost 94%) did not treat alcohol abusers pharmacologically, and 18 (aprox. 40%) did not have time for such patients. It seems that there is an urgent need to provide further education for general practitioners and make better use of the existing structures engaged in the diagnosis and therapy of alcohol abusers.