[PAIN AND GUIDELINES FOR PAIN PREVENTION IN CHRONIC WOUND].

This review article describes the occurrence of painful sensation with special reference to the occurrence of pain in chronic wounds, and presents recommendations for medical treatment of pain. Treatment is focused on pharmacotherapy. The recommended basis for rational use of analgesics is the WHO 'three-degree' scale. The need for combining pharmacotherapy with non-pharmacological treatment is also stressed. The positive effect of Visible Incoherent Polarized (VIP) light on the acceleration of chronic wound healing is highlighted.

Endogenous gas gangrene after laparoscopic cholecystectomy.

Clostridial gas gangrene of the abdominal wall is rare, and it is usually associated with organ perforation, immunosuppression or gastrointestinal malignancies. In this paper we present a case of fulminant, endogenous gas gangrene in a 58-year old diabetic female with arterial hypertension and atherosclerosis, following uneventful laparoscopic cholecystectomy. She developed gas gangrene of the abdominal wall 12-hours after cholecystectomy and died 24-hours after the onset of the first symptoms, in spite of treatment.

Endogenous gas gangrene after laparoscopic cholecystectomy / Gangrena Gaseosa endógena tras la colecistectomía laparoscópica

Clostridial gas gangrene of the abdominal wall is rare, and it is usually associated with organ perforation, immunosuppression or gastrointestinal malignancies. In this paper, we present a case of fulminant, endogenous gas gangrene in a 58-year old diabetic female with arterial hypertension and atherosclerosis, following uneventful laparoscopic cholecystectomy. She developed gas gangrene of the abdominal wall 12-hours after cholecystectomy and died 24-hours after the onset of the first symptoms, in spite oftreatment.

La gangrena gaseosa clostridial de la pared abdominal es rara, y normalmente se halla asociada con la perforación de órganos, inmunosupresión o malignidades gastrointestinales. En este trabajo, se presenta un caso de gangrena gaseosa endógena fulminante en una mujer diabética de 58 años con hipertensión arterial y ateroesclerosis, tras una colecistectomía laparoscópica sin incidentes. Doce horas después de la colecistectomía, la mujer desarrolló una gangrena gaseosa de la pared abdominal, y murió 24 horas después del comienzo de los primeros síntomas, a pesar del tratamiento.

An immobilised catalase peroxidase from the alkalothermophilic Bacillus SF for the treatment of textile-bleaching effluents.

A catalase peroxidase (CP) from the newly isolated Bacillus SF was used to treat textile-bleaching effluents. The enzyme was stable at high pH values and temperatures, but was more sensitive to deactivation by hydrogen peroxide than monofunctional catalases. Based on the Michaelis-Menten kinetics of the CP, a model was developed to describe its deactivation characteristics. The enzyme was immobilised on various alumina-based carrier materials with different shapes and the specific activity increased with the porosity of the carrier. The shape of the carrier had an important influence on the release of oxygen formed during the catalase reaction from the packed-bed reactor and Novalox saddles were found to be the most suitable shape. Bleaching effluent was treated in a horizontal packed-bed reactor containing 10 kg of the immobilised CP at a textile-finishing company. The treated liquid (500 l) was reused within the company for dyeing fabrics with various dyes, resulting in acceptable colour differences of below Delta E*=1.0 for all dyes.

Characterization of a chitinase and an endo-beta-1,3-glucanase from Trichoderma harzianum Rifai T24 involved in control of the phytopathogen Sclerotium rolfsii.

Of 24 Trichoderma isolates, T harzianum Rifai (T24) showed a potential for control of the phytopathogenic basidiomycete Sclerotium rolfsii. When T24 was grown on different carbon sources, growth inhibition of S. rolfsii by the T24 culture filtrate correlated with the activity of extracellular chitinase and beta-1,3-glucanase. The 43-kilodalton (kDa) chitinase and the 74-kDa beta-1,3-glucanase were purified from the T24 culture filtrate in two and three steps, respectively, using ammonium sulphate precipitation followed by hydrophobic interaction chromatography (phenyl-Sepharose) and gel filtration (beta-1,3-glucanase). Km and Kcat were 3.8 g l(-1) and 0.71 s(-1) for the chitinase (chitin) and 1.1 g(-1) and 52 s(-1) for the beta-1,3-glucanase (laminarin). The chitinase showed higher activity on chitin than on less-acetylated substrate analogues (chitosan), while the beta-1,3-glucanase was specific for beta-1,3-linkages in polysaccharides. Both enzymes were stable at 30 degrees C, while at 60 degrees C the chitinase and the beta-1,3-glucanase were rapidly inactivated, showing half-lives of 15 and 20 min, respectively. The enzymes inhibited growth of S. rolfsii in an additive manner showing a promising ED50 (50% effective dose) value of 2.7 microg/ml.

Thermo-alkali-stable catalases from newly isolated Bacillus sp. for the treatment and recycling of textile bleaching effluents.

Three thermoalkaliphilic bacteria, which were grown at pH 9.3-10 and 60-65 degrees C were isolated out of a textile wastewater drain. The unknown micro-organisms were identified as thermoalkaliphilic Bacillus sp. Growth conditions were studied and catalase activities and stabilities compared. Catalases from Bacillus SF showed high stabilities at 60 degrees C and pH 9 (t1/2=38 h) and thus this strain was chosen for further investigations, such as electron microscopy, immobilization of catalase and hydrogen peroxide degradation studies. Degradation of hydrogen peroxide with an immobilized catalase from Bacillus SF enabled the reuse of the water for the dyeing process. In contrast, application of the free enzyme for treatment of bleaching effluents, caused interaction between the denaturated protein and the dye, resulting in reduced dye uptake, and a higher color difference of 1.3DeltaE* of dyed fabrics compared to 0.9DeltaE* when using the immobilized enzyme.

Immobilization of catalases from Bacillus SF on alumina for the treatment of textile bleaching effluents.

A catalase preparation from a newly isolated Bacillus sp. was covalently immobilized on silanized alumina using glutaraldehyde as crosslinking agent. The effect of the coupling time of the enzyme-support reaction was determined in terms of protein recovery and immobilization yield and a certain balance point was found after which the activity recovery decreased. The activity profile of the immobilized catalase at high pH and temperature was investigated. The immobilized enzyme showed higher stabilities (214 h at pH 11, 30 degrees C) at alkaline pH than the free enzyme (10 h at pH 11, 30 degrees C). The immobilized catalase was inhibited by anionic stabilizers or surfactants added to the hydrogen peroxide substrate solution.

A catalase-peroxidase from a newly isolated thermoalkaliphilic Bacillus sp. with potential for the treatment of textile bleaching effluents.

A new thermoalkaliphilic bacterium was isolated from a textile wastewater drain and identified as a new Bacillus sp. (Bacillus SF). Because of its high pH stability and thermostability, a catalase-peroxidase (CP) from this strain has potential for the treatment of textile bleaching effluents. The CP from Bacillus SF was purified to more than 70.3-fold homogeneity using fractionated ammonium sulfate precipitation, hydrophobic interaction, and anion-exchange and gel-filtration chromatography. The native CP had a molecular mass of 165 kDa and was composed of two identical subunits. The isoelectric point of the protein was at pH 6.0. Peptide mass mapping using matrix-assisted laser desorption ionization-mass spectrometry showed a homology between the CP from Bacillus SF and the CP from Bacillus stearothermophilus. The apparent Km value of the catalase activity for H2O2 was 2.6 mM and the k(cat) value was 11,475 s(-1). The enzyme showed high catalase activity and an appreciable peroxidase activity with guaiacol and o-dianisidine. The enzyme was stable at high pH, with a half-life of 104 h at pH 10 and 25 degrees C and 14 h at 50 degrees C. The enzyme was inhibited by azide and cyanide, in a competitive manner, but not by the catalase-specific inhibitor 3-amino-1,2,4-triazole.

[Treatment of pain with opioid analgesics and the role of TTS-fentanyl (Durogesic)]. / Lijecenje boli opijatnim analgeticima i mjesto TTS--fentanila (durogesic) u tom lijecenju.

Current opinions in chronic pain treatment with opioid analgesics are presented in this review. Justified use of opioid analgesics in treatment of chronic non-malignant pain in inflammatory and degenerative processes is emphasised. Advantages of opioid analgesics compared with non-opiod analgesics are stressed. New form of opioid--a patch, Durogesic TTS, recently registered in Croatia, is described. After brief review of pharmacodynamics and pharmacokinetics of Durogesic, authors experiences in both chronic malignant pain and chronic non-malignant pain treatment with this analgesic are described. Trial was performed in Pain clinic of Karlovac General Hospital as a part of international multicentric clinical trial. Regarding efficacy, compared to the previous therapy, TTS fentanyl was evaluated positively by patients, both in pain control and ease of use, and by the author, for around the clock, non-invasive administration. Slow dose adjustment in rapid illness progression was recognised as disadvantage.