Antiseptic with modern wound dressings in the treatment of venous leg ulcers: clinical and microbiological aspects.

OBJECTIVE: To assess the impact of a two-period treatment on the clinical condition, bacteriological changes and results of treatment of venous leg ulcers (VLU) using octenidine dihydrochloride. METHOD: Patients with a VLU were recruited and treated with octenidine dihydrochloride for one month, after which they were randomised and treated with hydrocolloids or foam dressings. The wounds were clinically assessed for the amount of necrotic tissue, granulation tissue, epithelialisation, amount of exudate and pain level. During the first period, bacterial colonisation and antimicrobial efficacy of octenidine dihydrochloride were also evaluated. In the second period the efficacy of treatment, time of treatment and healing rate were investigated. RESULTS: In the group of 50 VLU patients, all wounds (100%) improved after the first treatment period. No clinical signs of infection were observed. Statistically significant changes were observed in all the clinical parameters studied in the treated groups of VLU patients, including reduction of necrotic tissue, the amount of exudate and of pain, as well as increased granulation and epithelialisation. In the second period including treatment with the two dressings, no differences were observed in treatment efficacy, time of treatment or healing rate. CONCLUSION: As used in this study, octenidine dihydrochloride proved to be effective and useful, changing the clinical condition of VLU, preparing the wound for future treatment with modern dressings. High microbicidal activity of octenidine was observed, both against Gram-negative and Gram-positive bacteria isolated from the ulcers. Octenidine dihydrochloride caused an eradication of multiresistant strains (88%) as well as of bacteria qualified as alert-pathogens (100%) in the treated wounds after four weeks. However, no differences in the effects, time or rate of healing of VLU with two dressings were found in the second period. No side effects or significant local intolerance reactions used for treatment were observed.

Effect of Kinesiology Taping on breast cancer-related lymphedema: a randomized single-blind controlled pilot study.

The aim of the study was to assess the efficacy of Kinesiology Taping (KT) for treating breast cancer-related lymphedema. Sixty-five women with unilateral stage II and III lymphedema were randomly grouped into the KT group (K-tapes, n = 20), the Quasi KT group (quasi K-tapes, n = 22), or the MCT group (multilayered compression therapy group, n = 23). Skin care, 45 min pneumatic compression therapy, 1 h manual lymphatic drainage, and application of K-tape/Quasi K-tapes/multilayered short-stretch bandages were given every treatment session, 3 times per week for 1 month. Patient evaluation items included limb size and percentage edema. Comparing the changes in K-tapes with quasi K-tapes changes, there were no significant differences (P > 0.05). The edema reduction of multilayered bandages was much better than in results observed in taping groups. The KT appeared to be ineffective at secondary lymphedema after breast cancer treatment. The single-blind, controlled pilot study results suggest that K-tape could not replace the bandage, and at this moment it must not be an alternative choice for the breast cancer-related lymphedema patient. The trial is registered with ACTRN12613001173785.

Effect of Laser Irradiation at Different Wavelengths (940, 808, and 658 nm) on Pressure Ulcer Healing: Results from a Clinical Study.

THE AIM OF THE STUDY WAS TO ASSESS THE EFFICACY OF LASER THERAPY (AT DIFFERENT WAVELENGTHS: 940, 808, and 658 nm) for treating pressure ulcers. The primary endpoint in this trial included both the percentage reduction of the ulcer surface area and the percentage of completely healed wounds after one month of therapy (ulcer healing rate). The secondary endpoint was the ulcer healing rate at the follow-up evaluation (3 months after the end of the study). In total, 72 patients with stage II and III pressure ulcers received laser therapy once daily, 5 times per week for 1 month using a (GaAlAs) diode laser with a maximum output power of 50 mW and continuous radiation emission. Three separate wavelengths were used for the laser treatment: 940 nm (group I), 808 nm (group II), and 658 nm (group III). An average dose of 4 J/cm(2) was applied. In group IV, a placebo was applied (laser device was turned off). The laser therapy at a wavelength of 658 nm appeared to be effective at healing pressure ulcers. The wavelengths of 808 and 940 nm did not have any effect in our study.

Stan scheller: the forerunner of clinical studies on using propolis for poor and chronic nonhealing wounds.

For hundreds of years poor and chronic nonhealing wounds have constituted a serious problem to medicine. What is more, treating such wounds is an expensive let alone a long-lasting process. The following paper describes Professor Scheller's achievements in using propolis for poor and chronic non-healing wounds. The authors' intention was to present the results connected with the use of the ethanolic extract propolis, in the treatment of patients suffering from burns, venous crural ulceration, local sacral bone pressure ulcers, suppurative osteitis and arthritis, suppurative postoperative local wound complications, and infected traumatic wounds.

Topical treatment of nonhealing venous leg ulcer with propolis ointment.

An investigation of effectiveness of topical treatment of nonhealing chronic venous leg ulcers with propolis ointment was conducted. 56 patients were included in the study and randomized into two groups. In group 1, there were 28 patients (ulceration area: 6.9-9.78 cm(2)) treated by means of topical propolis ointment application and short stretch bandage compression. In group 2, there were 29 patients (ulceration area: 7.2-9.4 cm(2)) treated by means of Unna boot leg compression without topical propolis treatment. In the study, the efficacy of both treatment methods in patients with resistive venous leg ulcers was compared. The ulceration of patients from group 1 healed completely after 6 weeks of therapy in all cases. In all patients from group 2, the process of healing was longer but successfully completed after 16 weeks of the therapy. We found that an adjunctive propolis ointment treatment increases the efficacy of the short stretch bandage compression stocking, and this combined treatment is more effective than Unna's boot compression alone.

The effect of neuromuscular electrical stimulation on quadriceps strength and knee function in professional soccer players: return to sport after ACL reconstruction.

The aim of this study was to assess the clinical efficacy and safety of NMES program applied in male soccer players (after ACL reconstruction) on the quadriceps muscle. The 80 participants (NMES = 40, control = 40) received an exercise program, including three sessions weekly. The individuals in NMES group additionally received neuromuscular electrical stimulation procedures on both right and left quadriceps (biphasic symmetric rectangular pulses, frequency of impulses: 2500 Hz, and train of pulses frequency: 50 Hz) three times daily (3 hours of break between treatments), 3 days a week, for one month. The tensometry, muscle circumference, and goniometry pendulum test (follow-up after 1 and 3 months) were applied. The results of this study show that NMES (in presented parameters in experiment) is useful for strengthening the quadriceps muscle in soccer athletes. There is an evidence of the benefit of the NMES in restoring quadriceps muscle mass and strength of soccer players. In our study the neuromuscular electrical stimulation appeared to be safe for biomechanics of knee joint. The pathological changes in knee function were not observed. This trial is registered with Australian and New Zealand Clinical Trials Registry ACTRN12613001168741.

Copper, zinc, and selenium in whole blood and thyroid tissue of people with various thyroid diseases.

We investigated the possible differences among the concentrations of copper, zinc, and selenium, and their mutual relations in the whole blood and thyroid tissue of patients with various thyroid disorders. Trace elements were determined by total-reflection X-ray fluorescence. The mean levels of these metals in blood as well as the mean Cu/Zn, Cu/Se, and Zn/Se ratios in the patients with thyroid cancer were significantly higher that in other patients and the control groups. However, the mean Zn and Se concentrations in the thyroid cancer tissue were significantly lower than in the thyroid tissue of other patients. In addition, the mean Cu/Zn and Cu/Se ratios in the thyroid cancer tissue were significantly higher than in the patients with other thyroid diseases. We confirm that the highest levels of copper and zinc as well as the Cu/Zn, Cu/Se, and Zn/Se ratios in the whole blood of the patients with thyroid cancer may suggest the progression of the proliferation process in the thyroid gland. We suggest that the low concentrations of zinc and selenium in the thyroid tissue confirm their participation in the carcinogenic process.

Concentration of selenium in the whole blood and the thyroid tissue of patients with various thyroid diseases.

We investigated the possible differences between the concentrations of selenium in the whole blood and thyroid tissue of patients with thyroid disease. The study comprises 41 women with nodular goiter, 19 women and 2 men with thyroid cancer, 18 women with Graves' disease, and 7 women with thyroiditis. The concentration of selenium was determined by the TRXRF method. The lowest mean selenium level was achieved in the whole blood of women with Graves' disease and the highest in the whole blood of healthy people. In the thyroid cancer tissue, we found the lowest concentration of selenium and the highest in the thyroid gland of women with nodular goiter and Graves' disease. The low selenium levels in the thyroid tissue may increase thyroid cancer risk.

Zn concentration in thyroid tissue and whole blood of women with different diseases of thyroid.

The Zn concentration in thyroid tissue and whole blood of patients with Graves' disease, thyroid cancer, and nodular goiter disease was determined using the total-reflection X-ray fluorescence method. The dependence of obtained concentrations on the clinical stage of the examined disease, histopathological grading, and kind of analyzed material (thyroid tissue and blood) was studied. The determined concentration of Zn was the lowest in the thyroid tissue of patients with thyroid cancer (23.1 microg/g) and it was the highest in the case of Graves' disease (41.7 microg/g), whereas in the blood samples, the reverse results were found (7.1 microg/g and 4.8 microg/g, respectively). The physical basis of the method used, the experimental setup, and the procedure of sample preparation are described.

Recurrent laryngeal nerve palsy after thyroid cancer surgery: a laryngological and surgical problem.

Recurrent laryngeal nerve paralysis is one of the most frequent complications after thyroid surgery due to goiter and cancers. A higher probability of this complication occurs after secondary procedure of the thyroid and in malignant cases. The symptoms may differ and depend on many factors. Generally, patients need careful ENT and surgical care including diagnosis and treatment. Four hundred and sixty-six patients who underwent thyroid operation due to cancer were analyzed. The group was composed of 227 papillary carcinoma, 87 follicular carcinoma, 51 medullary carcinoma, and 101 anaplastic carcinoma. Two hundred and fifty-three total thyroidectomies, 82 lobectomies and subtotal second lobe operations, 91 subtotal thyroidectomies, and 40 biopsies (wedge resections) were performed. In all 426 total and subtotal thyroidectomies an attempt to identify the recurrent laryngeal nerves was carried out. For 360 patients (77%) the surgical procedure was primary and for 106 patients (23%) the operation was secondary. Preoperative and postoperative laryngoscopic examinations were performed in all patients. Every patient with palsy underwent special laryngological procedures if needed (tracheotomy, phoniatric rehabilitation, conservative treatment and surgery in lack of improvement). The rate of postoperative vocal cord paralysis was 4.7%. The permanent palsy rate was 3.5%. In 1.2% recovery was observed. Of the 4.7% palsy rate, 3.2% concerned unilateral palsy and 1.5% bilateral pathology. Using the chi2 test, no significant differences between the rate of unilateral and bilateral paralysis and between temporary and permanent paralysis were found. On the basis of our material and results, identification the recurrent laryngeal nerves should be mandatory at surgery, thereby avoiding paralysis. Special laryngological procedures and surgical care from the beginning of paralysis are necessary for patients with vocal cord palsy. It allows to diagnose and treat patients with quite good results.

[High voltage electrical stimulation in leg ulcer's treatment]. / Elektrostymulacja wysokonapieciowa w leczeniu owrzodzen zylnych podudzi.

The results of leg ulcers treatment in two comparative groups, A and B, are presented in the article. In the group A 22 patients with leg ulcers were treated with the use of high voltage electrical stimulation. In the group B 20 patients with leg ulcers were treated actively with the use of traditional methods. The average time of treating patients subjected to electrical stimulation was 7 weeks and in the control group the average time of treatment was 6 weeks. The healing progress was estimated on the basis of rate of wounds surfaces and volumes changes per week and their proportional changes. In the group A the average rate of ulcer surface decreasing was 1.4 cm2 per week and the average volume diminishing in this group was 1.0 cm2 per week. These indicators in the group B were respectively 1.0 cm2 and 0.6 cm3. In the group A wound surface decreased by 73.4% during the treatment and wound volume by 91.3%. In the group B these indicators were respectively 46.9% and 67.6%. After the treatment all indicators estimating the progress of wound healing in the groups A and B proved the statistically significant increases. The proportional indicators of wounds surfaces and volumes were significantly higher in the group A than in the group B.

[Estimation of gasometry in umbilical cord blood and spirometry parameters at parturients in different positions]. / Ocena gazometrii krwi pepowinowej w zaleznosci od wartosci wybranych parametrów spirometrycznych u rodzacych w róznych pozycjach.

Estimation of umbilical cord blood gasometry is one of the test employed to postnatal state of newborns. This easy investigation can present the grade of newborns' blood oxygenation, which correlate with maternal lungs' ventilation. Because the spirometry parameters are more convenience in vertical position.

[Spirometry parameters of women in various positions of delivery]. / Ocena parametrów spirometrycznych u rodzacych w róznych pozycjach.

UNLABELLED: Position in labour depends mostly on women's preferences, and is chosen instinctively in order to reduce labour pain. Between two different positions: vertical and horizontal, the first of them seems to guarantee more convenient gas exchange in maternal lungs. DESIGN: To prove that the vertical position in labour increase spirometry parameters in comparison with horizontal one. METHODS: Women were divided into two groups according to position in labour and spirometry examination were performed in second period of labour. Group I were composed of 17 women in vertical position whereas group II--19 women in horizontal one. RESULTS: Whole of analysed spirometral parameters had higher values in group I (8.2%-17.1%), but the increase wasn't statistically significant (p < 0.05).

Modern application of high voltage stimulation for enhanced healing of venous crural ulceration.

The objective of this paper was to evaluate the effect of high voltage stimulation (HVS) on the process of healing of crural ulceration. Three comparative groups of patients, A, B and C, were drawn at random from patients with venous crural ulceration. Thirty-three patients in group A were subjected to treatment with HVS. In the course of treatment, doubled-peak monophasic impulses of a total duration of 0.1 ms and frequency of 100 Hz were applied. The voltage was 100 V. Group B, made up of 32 patients treated with topically applied medicine, and group C, made up of 14 patients treated with Unna's boot were used as control. In all patients in all groups (A, B and C) a significant reduction in wound size in relation to baseline was found. The rate of wound area change was highest in group A. The rate of pus cleansing was significantly highest in group A. The degree of granulation after 2 weeks was significantly greater in group A than in the other groups (P<0.003). High voltage stimulation was an efficient method of enhancement of the healing of crural ulceration.

[Testing the osmotic-diffusion properties for the membranous dressing Bioprocess]. / Badanie wlasciwosci osmotyczno-dyfuzyjnych opatrunku membranowego Bioprocess.

In order to determine of the osmotic-diffusive properties of membranous dressing Bioprocess, which is a microfibrous network of homogeneous cellulose produced in biosynthesis by Acetobacter, the hydraulic permeability (Lp), reflection (sigma) and diffusive permeability (omega) coefficients were measured. The values of these coefficients showed that this membrane possess a low selectivity. This amount it easy permeable for solvent (water) as well as for solutions (aqueous solutions of glucose, sucrose, ethanol, NaCl or KCl). Thus, it attend a demands make for polymeric materials used in therapy of scald and ulceration.

Circadian variations of serum triiodothyronine, thyroxine, corticosterone and lipids in starved rats.

Circadian variation of serum triiodothyronine (T3), thyroxine (T4), corticosterone (B) and lipids was studied in male Wistar rats after one week of the starvation. The animals were adopted to 12:12 h light-dark cycle (lights on from 7.00 to 19.00 h) and tap water was available ad libitum. Blood samples were drawn at 3 h intervals along a 24 h span. The hormone levels were measured by RIA kits, plasma lipids by photometric method. The results were evaluated by cosinor method. The presence of a circadian rhythm of T3 and B was found in control rats. The starvation resulted in changed circadian rhythm of T3 with lower values of mesor and amplitude, and while acrophase shifted from 14.48 to 2.12. In addition, the starvation induced circadian rhythm of T4 with acrophase at 1.00. The circadian rhythm of B showed significantly higher values of mesor and amplitude, while acrophase shifted from 17.42 to 4.06. The concentration of lipids was changed in the animals deprived of food as compared with controls.