Non-steroidal anti-inflammatory drugs in the era of the Covid-19 pandemic in the context of the human and the environment.

From 2019, life in the world has mainly been determined by successive waves of the COVID-19 epidemic. During this time, the virus structure, action, short- and long-term effects of the infection were discovered, and treatments were developed. This epidemic undoubtedly affected people's lives, but increasing attention is also being paid to the effects of the epidemic on the environment. Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines, a global scoping review of peer-reviewed information has been conducted on the use of over-the-counter non-steroidal anti-inflammatory drugs in the treatment of symptoms of SARS-CoV-2 infections and their positive and negative effects on the human body, the effects of non-steroidal anti-inflammatory drugs (NSAIDs) on aquatic organisms, and their adverse effects on non-target organisms. The literature from 1998 to 2021 was analysed using the Scopus®, Web of Science™ (WoS) and Google Scholar databases. As non-steroidal anti-inflammatory drugs place a heavy burden on the environment, all reports of the presence of these drugs in the environment during the pandemic period have been thoroughly analysed. Of the 70 peer-reviewed records within the scope, only 14% (n = 10) focussed on the analysis of non-steroidal anti-inflammatory drugs concentrations in wastewater and surface waters during the pandemic period. The percentage of these works indicates that it is still an open topic, and this issue should be supplemented with further reports in which the results obtained during the pandemic, which has been going on for several years, will be published. The authors hope this review will inspire scientists to investigate the problem of non-steroidal anti-inflammatory drugs in the environment to protect them for the next generation.

Selected problems in the bone union of complicated diaphyseal fractures treated with interlocking nail.

Background. This article discusses the effectiveness and technical problems encountered in the union of complications of diaphyseal fractures treated with interlocking nail. Material and methods. Between 2000-2003 we operated 35 patients for pseudoarthrosis (humerus - 6, femur - 13, tibia - 16). In a one-step procedure a plate was removed from the humerus (3 patients) or femur (4 patients), a retrograde interlocking nail was introduced, and spongy grafts were applied. In the remaining patients an external stabilizer or ZESPOL outer plate were first removed; then, after soft tissue healing, an anterograde nail was introduced sequentially using a closed technique. This method of nailing was also used in patients with plates that had previously been removed. The Dencker classification was used to evaluate outcome. Results. We achieved bone union in all cases. We observed intra- and post operative complications in 5 cases: breakage of distal locking screws in 4 patients, and breakage of 1 tibial nail. In closed nailing we encountered major difficulties in passing through the sclerotic edges of pseudoarthrosis, and it also proved extremely difficult to maintain the right direction of the reamer without a guiding wire, which was crucial for a successful operation. Conclusions. Interlocking nailing is an efficacious method of treatment of complications in fracture healing, but in some cases closed nailing of pseudoarthrosis is difficult.