Analgesic Efficacy of Oxycodone in Postoperative Dressings after Surgical Treatment of Burn Wounds: A Randomised Controlled Trial.

INTRODUCTION: This study aimed to assess the analgesic efficacy of oxycodone at doses of 10 mg and 20 mg in dressings after surgery of burn wounds. MATERIAL AND METHODS: Twenty adult patients who underwent surgical treatment of third-degree burn wounds under general anaesthesia were included. Burn wounds were treated with dressings, to which oxycodone was added at 20 mg in Group 1 and 10 mg in Group 2. After the surgery, plasma oxycodone and noroxycodone concentrations were assayed, and pain intensity was assessed with Numerical Rating Scale (NRS). RESULTS: In Group 1, no patient reported pain; in Group 2, four patients reported pain. The pain intensity, according to NRS, was 1-8. Plasma concentration of oxycodone in the blood serum was in the range of 1.24-3.15 ng/mL and 1.09-1.28 ng/mL in Group 1 and Group 2, respectively. Noroxycodone was not detected in the plasma. Adverse effects were not observed in any of the treated patients. CONCLUSIONS: Oxycodone in dressings provides patients with adequate and safe analgesia.

Microwave Control of Reynoutria japonica Houtt., Including Ecotoxicological Aspects and the Resveratrol Content in Rhizomes.

Japanese knotweed (Reynoutria japonica Houtt.) is Poland's invasive weed, for which there is no efficient control method. The rhizomes of this species are rich in resveratrol. In this work, we evaluated (1) the effectiveness of electromagnetic microwaves (MV) in destroying Japanese knotweed using an original device, HOGWEED (MV of 2450 MHz), (2) the ecotoxic effect of the MV on the soil environment, and (3) the resveratrol content in knotweed rhizomes after MV treatment. The field studies were carried out in 2022 in southern Poland. Cut plants were MV-treated for times of 5.0-25.0 min. The MV efficiency was checked 10 and 56 days after treatment (DAT). After MV treatment, fresh soil samples were taken to analyze their ecotoxicity. As a result, at 56 DAT, knotweed was controlled if MV was used for at least 20.0 min. The MV did not affect the soil ecotoxicity. The MV-treated soils were classified as non-toxic or low-toxic. To analyze the resveratrol content, healthy knotweed rhizomes were dug out, treated with MV in the laboratory at 2.5-10.0 min, and analyzed for resveratrol content in HPLC-MS/MS. As a result, the resveratrol in the rhizomes significantly decreased in a time-dependent manner following MV exposure.

Morphine (10, 20 mg) in a Postoperative Dressing Used with Patients After Surgical Debridement of Burn Wounds: A Prospective, Double-Blinded, Randomized Controlled Trial.

Objective: This is the first clinical trial to evaluate the analgesic effect of 10 and 20 mg of morphine used in a postoperative dressing with patients after surgical debridement of burn wounds. Approach: In this randomized controlled trial, 20 adult patients with third-degree flame burns, who had undergone surgical debridement under general anesthesia, were randomly assigned to either group A, whose members were treated with a burn dressing that contained 10 mg of morphine, or group B, whose members were treated with a burn dressing that contained 20 mg of morphine; the dressing was also soaked with octenidine and phenoxyethanol in the case of both groups. The plasma morphine concentrations were measured 1, 2, 3, and 6 h after surgery, while the level of pain intensity was determined on the Numeric Pain Rating Scale (NRS), and the occurrence of side effects was observed. Results: The serum morphine concentration levels were very low, but statistically different between the two groups at all time points. The NRS value was similar in both groups at all time points (p > 0.05). Despite this, in group B, the NRS value was 0 in all patients in postoperative hours 1, 2, and 3. No adverse effect of morphine sulfate was observed in any patient. Innovation: This project is the first clinical study to have demonstrated that morphine administered in dressings in concentrations of 0.02-0.08 mg/mL significantly reduces the occurrence of pain. Conclusion: The use of morphine in dressings after surgical treatment of burn wounds is very effective when it comes to pain management and is safe for the patient.

Uso de verde de indocianina en cirugía reconstructiva y quemaduras / The use of indocyanine green in reconstructive surgery and burns: the literature review

Resumen El verde de indocianina es un tinte que se ha utilizado en medicina durante varias décadas. Tiene una serie de aplicaciones, incluida la cirugía reconstructiva y las quemaduras. Permite detectar áreas de tejido con perfusión reducida, lo que reduce el riesgo de complicaciones posoperatorias en forma de procesos de cicatrización alterados y necrosis. La técnica de imágenes que utiliza este tinte, permite observar los cambios en la fluorescencia en tiempo real y que, se ha demostrado, ocurren entre las capas superficiales y profundas en las quemaduras. Esto permite un diagnóstico cualitativo y cuantitativo de la profundidad de la quemadura, lo que se traduce en la elección de un tratamiento adicional. Se aprecia la importancia particular de este método en la prevención de la necrosis cutánea con el complejo areola-pezón durante la reconstrucción mamaria simultánea. Se necesitan más ensayos controlados aleatorios prospectivos para considerarlo el "método de elección" en la práctica clínica.

Indocyanine green is a dye that has been used in medicine for several decades. It has a number of applications, including reconstructive surgery and burns. It allows the detection of areas of tissue with reduced perfusion, which reduces the risk of postoperative complications in the form of altered healing processes and necrosis. The imaging technique that uses this dye allows us to observe the changes in fluorescence in real time that have been shown to occur between the superficial and deep layers in burns. This allows a qualitative and quantitative diagnosis of the depth of the burn, which results in the choice of additional treatment. The particular importance of this method in the prevention of skin necrosis with the areolanipple complex is appreciate during simultaneous breast reconstruction. More prospective randomized controlled trials are needed to consider it the 'method of choice' in clinical practice.

Analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds.

BACKGROUND: The aim of this study was to assess the analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds. PATIENTS AND METHODS: Twenty adult patients, who underwent surgical treatment of third-degree burn wounds under general anesthesia, were included. Two of the patients underwent surgery twice. During surgery, patients received 50-100 µg fentanyl every 20-30 min and, after surgery, patients received 100 mg ketoprofen twice daily. Additionally, ten patients (group 1) received 50 µg sufentanil added to the burn wound dressings soaked in octenidine and phenoxyethanol while 10 patients (group 2) received 25 µg sufentanil added to the same dressings. The rescue analgesic, which was administered when pain intensified, was 5 mg subcutaneous morphine. Plasma sufentanil concentrations were assayed at 1, 2, 3, and 6 h after surgery completion and when pain was reported, along with pain intensity evaluation. RESULTS: Sufentanil was not detected in the serum of any patients. Rescue morphine was given during the postoperative period (24 h) in one patient in group 1 (who underwent surgery twice) and three patients in group 2. The mean sufentanil concentration in dressings was higher in group 1 (0.13 ± 0.03) than group 2 (0.06 ± 0.03 µg/mL; p < 0.001). The group 1 patient who received rescue morphine had a sufentanil concentration of 0.10 µg/mL, which was the lowest concentration in group 1. Group 2 patients who received rescue morphine had sufentanil concentrations of at least two-fold lower (0.03-0.05 µg/mL). No adverse effects were observed. CONCLUSIONS: Sufentanil in dressings after burn wound surgery provides effective and safe analgesia and the sufentanil concentration in dressings should be ≥0.10 µg/mL in a solution of octenidine and phenoxyethanol.

Coccygodynia - pathogenesis, diagnostics and therapy. Review of the writing.

Coccygodynia is a problem with a small percentage (1%) of the population suffering from musculoskeletal disorders. This pain is often associated with trauma, falling on the tailbone, long cycling, or by women after childbirth. The reason for the described problem can be the actual morphological changes. Idiopathic coccygodynia causes therapeutic difficulties to specialists of many fields. Unsatisfactory treatment, including coccygectomy tends to seek new solutions. They belong to them techniques exploited in the manual therapy which in their spectrum hold: direct techniques - per rectum as well as indirect techniques taking into account distant structures of the motor organ, remaining in dense interactions with the coccygeal part. Idiopathic coccygodynia is a result perhaps from exaggerated tension the muscle of the levator ani, coccygeus and gluteus maximus as well as from irritating soft tissue structures surrounding the coccyx: of sacrococcygeum, sacrospinale, and sacrotuberale ligament. Unfortunately we can't see them in objective examinations so as: the RTG, MR or TK, therefore constitute the both diagnostic and therapeutic problem. For describing the problem a writing of the object was used both from the field of the surgery and of manual therapy. Detailed and multifaceted knowledge about causes of the described problem allows more accurately to categorize the patient to the appropriate group and helps to select the best procedure of treatment.

Intraspinal migration of a Kirschner wire as a late complication of acromioclavicular joint repair: a case report.

BACKGROUND: Penetrating neck trauma involving foreign bodies is a rare event in European countries. Due to its relatively high mortality rate, the correct management strategy must be initiated from the beginning to prevent fatal complications. In the medical literature, there are only a few cases describing foreign bodies penetrating the cervical spine. Because of its rareness, many trauma centers lack the proper routine to adequately manage such injuries. CASE PRESENTATION: This case report describes a 34-year-old white man of Central European descent with Kirschner wire migration and perforation of his vertebral foramen. He underwent acromioclavicular joint repair surgery 7 years ago, presented with a painful sensation around the area of his left clavicle and left side of his neck after a motorcycle accident. No neurological deficit was detected. CONCLUSIONS: In such cases, a thorough radiological evaluation of the spinal cord and the surrounding vasculature is mandatory for a complete understanding of the extent of the injury and determining the proper surgical management. In cases of vertebral artery trauma both an endovascular and an open approach can be contemplated.

Effect of headgroup on electrical conductivity of self-assembled monolayers on mercury: n-alkanethiols versus n-alkaneselenols.

The relative efficiencies of electron tunneling across self-assembled monolayers (SAMs) of n-alkanethiols and n-alkaneselenols, CH(3)-(CH(2))(n)-XH, where n = 8, 9, 11, and X = S or Se, deposited on mercury electrodes were measured via electroreduction of Ru(NH(3))(6)(3+) in aqueous solutions. Electron tunneling rates across the monolayer films decay exponentially with the monolayer thickness with a tunneling coefficient, beta = 1.1 +/- 0.1 per CH(2) irrespective of the identity of the -XH headgroup. Electron tunneling rates across n-alkanethiol monolayers are ca. 4-fold larger than the rates measured across n-alkaneselenol monolayers containing the same number of carbon atoms, signifying the importance of headgroup/metal contact resistance in electron transfer through SAMs on mercury.

Scanning electrochemical microscopy of DNA monolayers modified with Nile Blue.

Scanning electrochemical microscopy (SECM) is used to probe long-range charge transport (CT) through DNA monolayers containing the redox-active Nile Blue (NB) intercalator covalently affixed at a specific location in the DNA film. At substrate potentials negative of the formal potential of covalently attached NB, the electrocatalytic reduction of Fe(CN)6(3-) generated at the SECM tip is observed only when NB is located at the DNA/solution interface; for DNA films containing NB in close proximity to the DNA/electrode interface, the electrocatalytic effect is absent. This behavior is consistent with both rapid DNA-mediated CT between the NB intercalator and the gold electrode as well as a rate-limiting electron transfer between NB and the solution phase Fe(CN)6(3-). The DNA-mediated nature of the catalytic cycle is confirmed through sequence-specific and localized detection of attomoles of TATA-binding protein, a transcription factor that severely distorts DNA upon binding. Importantly, the strategy outlined here is general and allows for the local investigation of the surface characteristics of DNA monolayers both in the absence and in the presence of DNA binding proteins. These experiments highlight the utility of DNA-modified electrodes as versatile platforms for SECM detection schemes that take advantage of CT mediated by the DNA base pair stack.

[Influence of material on biocompatibility of intraocular lenses]. / Wplyw materialu na biokompatybilnosc soczewek wewnatrzgalkowych.

There are many types of intraocular lenses (IOL), different in optic features and materials. The first indication for IOL implantation was aphakia after cataract surgery. The problem of aphakia exists as long as cataract is treated, that is at least 45 hundreds of years. Correction of aphakia using glasses is uncomfortable for patients and even impossible in some cases. The invention of an artificial intraocular lens was a crucial event in the history of ophthalmology. Nowadays there are more indications for cataract surgery and implantation of intraocular lens, including correction of refractive errors. The first intraocular lenses were made of rigid plastic: polymethylmethacrylate (PMMA). In present times foldable intraocular lenses made of soft material: silicone, hydrogel and acrylic compounds are also produced. In this paper 4 groups of intraocular lenses: PMMA, silicone, hydrogel, acrylic and their influence on biocompatibility are discussed. This article contains also description of two types of IOL biocompatibility: uveal and capsular. Their clinical aspects, especially posterior capsule opacification are discussed. Factors affecting biocompatibility are shortly described. Some historical applications of IOL are presented. Regarding the latest experimental studies on improving IOL biocompatibility, results of IOL surface modification tests are presented. New perspective technologies of intraocular artificial lens production such as single crystal materials are also discussed.

[Diagnostic difficulties in differentiating of arteriovenous fistula -- case report]. / Trudnosci diagnostyczne w róznicowaniu przetoki tetniczo-zylnej -- opis przypadku.

Arteriovenous carotid-cavernous fistula is an abnormal connection between the dural branches of carotid artery or vertebral artery and the dural sinuses. Its clinical manifestations can resemble the crucial signs of thyroid orbitopathy, an inflammatory disorder of the orbit associated with Graves' disease. Therefore, differential diagnosis of thyroid orbitopathy and the congestion of the orbit seen in arteriovenous fistula is often clinically and radiologically confused. This is the case report of the simultaneous occurrence of dural arteriovenous fistula in 59 years old woman. The first manifestation was unilateral exophthalmia. After Computer Tomography and Magnetic Resonance Imaging were performed, the preliminary diagnosis of thyroid orbitopathy was established. The response of eye disorder to corticosteroid treatment resulted in evident deterioration. This prompted a reconsideration of the diagnosis and a new evaluation of the patient with sensitive techniques, leading to the final diagnosis of arteriovenous fistula.

In situ wiring of single molecules into an electrical circuit via electrochemical distance tunneling spectroscopy.

The electrical conductance of single n-alkanethiol and alpha,omega-alkanedithiol molecules was measured via in situ distance tunneling spectroscopy in aqueous 0.1 M KOH solution. The statistical analysis of the conductance values show that the alpha,omega-alkanedithiol molecule trapped in the STM break junction can adopt two distinct geometries that result in "lower" and "higher" conductivity values. In contrast, n-alkanethiol molecules trapped in the junction show only a single conductivity value characteristic for a particular molecule. Furthermore, the "lower" conductivity value determined for alpha,omega-alkanedithiol is virtually identical to the electrical conductivity of the n-alkanethiol containing the same number of atoms in the backbone. Moreover when the STM tip is polarized to electrochemical potential preventing a chemical reaction between the terminal -SH group and Au, only "lower" conductivity values are observed for alpha,omega-alkaneditiols.

In situ electrochemical distance tunneling spectroscopy of ds-DNA molecules.

The electrical conductance of ds-DNA duplexes containing 8-14 base pairs modified at both ends with a -(CH(2))(6)-SH linker was measured in a buffered aqueous solution using electrochemically controlled distance tunneling spectroscopy. The tunneling experiment with self-complementary 5'-(GC)(n)()-3'-(CH(2))(6)-SH (n = 4-7) duplexes attached covalently to a gold STM tip and a Au(111) electrode shows a wide distribution of currents independent of the ds-DNA length. The voltage-induced horizontal orientation of ds-DNA within the junction results in decreased electrical conductance. The lower currents are also observed for ds-DNA molecules containing a single CA base mismatch.

[What's new in fracture treatment at the beginning of the 21st century?--part I]. / Co nowego w leczeniu zlaman na poczatku XXI wieku?--czesc I.

We decided to instruct ourselves of the scientific world literature at the beginning of the 21st century regarding the treatment of fractures. We wanted to convince ourselves if there is a real progress in this area. In the following chapters concerning particular body regions we present the contemporary experiences in the diagnostics, treatment, visible tendencies and directions of the development.

[What's new in fracture treatment at the beginning of the XXI century?--Part II]. / Co nowego w leczeniu zlaman na poczatku XXI wieku?--Czesc II.

We decided to instruct ourselves of the scientific world literature of the beginning of the XXI century concerning the treatment of fractures. We wanted to convince ourselves if there is a real progress in this area. In the following chapters concerning particular body regions we present the contemporary experiences in the diagnostics, treatment, visible tendencies and directions of the development.

Electrochemical wiring of alpha, omega-alkanedithiol molecules into an electrical circuit.

The intrinsic electrical conductivity of alpha, omega-alkanedithiol increases if both ends of the molecule are covalently bonded to metallic contacts.

Long-range electron transfer through monolayers and bilayers of alkanethiols in electrochemically controlled Hg[bond]neling junctions.

The rates of electron tunneling through monolayers and bilayers of alkanethiols self-assembled in a potentiostatically controlled Hg-Hg junction are reported. An alkanethiolate monolayer is formed in situ on one or both Hg drops via oxidative adsorption at the controlled potential. Subsequently, the Hg drops are brought into contact using micromanipulators. The junction formation is instantly followed by the flow of a steady-state tunneling current between the two electrodes. A plot of the logarithm of the tunneling current density vs the total number of carbon atoms in each junction yields identical tunneling coefficients, beta = 1.06 +/- 0.04/-CH(2)- and beta = 1.02 +/- 0.07/-CH(2)-, for monolayers and bilayers of alkanethiols, respectively. Careful examination of the tunneling data indicates that the solvent and ions are ejected from the junction area. The tunneling current recorded for a bilayer of 1-octanethiol or 1-nonanethiol is ca. 2-fold larger than a corresponding tunneling current recorded for monolayers of 1-hexadecanethiol or 1-octadecanethiol, respectively. This result is explained in terms of weak electronic coupling across the noncovalent molecule/electrode interface.

Fracture, osteosynthesis, union of fractured bones - historical reflections.

This article presents the review of the achievement and progress in fracture treatment from ancient ages till XXth century. There was shown the development of the conservative treatment - creating the suitable immobilizing splints, casts and the first surgical procedures, equipment, plates, screws, nails for the osteosynthesis. Besides there were presented the first observations and remarks of former researcher on biology of the fracture healing process.

Why do fractures of long bones heal faster in patients with coexisting brain injury?

Healing of fractured long bones is faster in patients with coexisting brain injury. This phenomenon has been observed for many years but it is not clearly explained. So far it has not been settled if the problem has its origin in Central Nervous System or represents systemic response on a severe trauma. The following article presents the literature review concerning this issue.

Functional bracing of humeral schaft fractures in osteoporotic patients.

Introduction. There are many treatment methods in use, both surgical and non-surgical, for fractures of the shaft of the humeral bone.
Material and methods. We did a prospective study of the effectiveness of functional bracing for humeral shaft fractures in 8 selected patients with osteoporosis, aged 56-78. Evaluation was based on radiographic signs of bone union, the quality of reduction, and the functioning of the ulnar and gleno-humeral joints and the upper extremity as a whole.
Results. In all the cases studied, good and fast bone union was achieved with varying degrees of residual deformation, without detectable influence of the latter on the functional result.
Conclusions. The method in use proved to be very effective, since early, good function of the injured extremity was restored and patient satisfaction was very high.