Application of Laserobaria 2.0_S device in the treatment of hard-to-heal wounds of mixed etiology — own experience

Introduction: The formation of hard-to-heal wounds can have many causes and is most often the result of the influence of several patient health factors. Some of the most difficult to treat effectively are wounds resulting from complications of diabetes, known as diabetic foot syndrome. Material and methods: Fifty-two patients (mean age 67 years ± 11.5) were eligible. All patients had chronic wounds of varied etiology in the lower limb, the previous treatment of which had not been satisfactory. Therapy parameters were selected individually; in addition to standard therapy, topical physical agents such as light therapy, pulsed electromagnetic field, ozone therapy, and oxygen therapy were included in the treatment. Each therapeutic cycle lasted 10 consecutive days (excluding Saturdays and Sundays), and each treatment lasted approximately 1 hour. Results: The analgesic effect of PEMF therapy was reported at 60% according to the VAS scale assessment. Pain was reduced from the third day of treatments, including for patients in whom pharmacological pain relief did not produce a clear improvement. Wound improvement, through granulation, after the first 10-day treatment cycle was observed in 40.5% of patients (14 k, 7 m). Four patients dropped the continuation of treatment because they did not see healing progress. Six patients dropped out of the next treatment cycle for other reasons (high cost of therapy, long distance of the clinic from home, and other socio-economic reasons). Conclusions: The high efficiency of combining standard treatment with innovative physical treatments allows for better patient care, which accelerates the necessary therapeutic steps toward holistic patient treatment. The authors recommend further multicenter, randomized, blinded trials to develop the optimal dosage to maximize the therapeutic effect and shorten the time to complete wound closure

Myofascial Trigger Points Therapy Modifies Thermal Map of Gluteal Region

Background. (ermal imaging may be effectively used in musculoskeletal system diagnostics and therapy evaluation; thus, it may be successfully applied in myofascial trigger points assessment. Objective. Investigation of thermal pattern changes after myofascial trigger points progressive compression therapy in healthy males and females. Methods. (e study included 30 healthy people (15 females and 15 males) with age range 19–34 years (mean age: 23.1 ± 4.21). (ermograms of myofascial trigger points were taken pre- and posttherapy and consecutively in the 15th and 30th minutes. Pain reproducible by palpation intensity was assessed with numeric rating scale. Results. Progressive compression therapy leads to myofascial trigger points temperature (p 0.02) and surface (p 0.01) in males. In females no statistically significant changes were observed. Manual treatment leads to a decrease in intensity of pain reproducible by palpation in males (p 0.03) and females (p 0.048). Conclusions. (e study indicates that myofascial trigger points reaction to applied therapy spreads in time and space and depends on participants’ sex

Functional and structural studies of tolloid-like 1 mutants associated with atrial-septal defect 6

Inactive mammalian tolloid-like 1 (tll1) and mutations detected in tolloid-like 1 (TLL1) have been linked to the lack of the heart septa formation in mice and to a similar human inborn condition called atrial-septal defect 6 (ASD6; OMIM 613087, formerly ASD II). Previously, we reported four point mutations in TLL1 found in approximately 20% of ASD6 patients. Three mutations in the coding sequence were M182L, V238A, and I629V. In this work, we present the effects of these mutations on TLL1 function. Three recombinant cDNA constructs carrying the mutations and onewild-type construct were prepared and then expressed in HT-1080 cells. Corresponding recombinant proteins were analyzed for their metalloendopeptidase activity using a native substrate, chordin. The results of these assays demonstrated that in comparison with the native TLL1, mutants cleaved chordin and procollagen I at significantly lower rates. CD analyses revealed significant structural differences between the higher order structure of wild-type and mutant variants. Moreover, biosensor-based assays of binding interactions between TLL1 variants and chordin demonstrated a significant decrease in the binding affinities of the mutated variants. The results from this work indicate that mutations detected in TLL1 of ASD6 patients altered its metalloendopeptidase activity, structure, and substrate-binding properties, thereby suggesting a possible pathomechanism of ASD6

Effects of Low-Frequency Electromagnetic Field on Oxidative Stress in Selected Structures of the Central Nervous System

The aim of the study was to evaluate the effects of a 28-day exposure to a 50 Hz electromagnetic field of 10 kV/m on the oxidative stress in selected rat central nervous system (CNS) structures. Material and Methods. Twenty male Wistar rats served as experimental subjects. Ten rats were exposed to an electromagnetic field with a frequency of 50 Hz, intensity of 10 kV/m, and magnetic induction of 4.3 pT for 22 hours a day. The control group of ten rats was subject to sham exposure. Homogenates of the frontal cortex, hippocampus, brainstem, hypothalamus, striatum, and cerebellum were evaluated for selected parameters of oxidative stress. Results. Following the four-week exposure to a low-frequency electromagnetic field, the mean malondialdehyde levels and total oxidant status of CNS structures did not differ significantly between the experimental and control groups. However, the activities of antioxidant enzymes in brain structure homogenates were decreased except for frontal cortex catalase, glutathione peroxidase, and hippocampal glutathione reductase. The low-frequency electromagnetic field had no effect on the nonenzymatic antioxidant system of the examined brain structures except for the frontal cortex. Conclusion. The four-week exposure of male rats to a low-frequency electromagnetic field did not affect oxidative stress in the investigated brain structures

Increased levels of oxidative stress markers, soluble CD40 ligand, and carotid intima-media thickness reflect acceleration of atherosclerosis in male patients with ankylosing spondylitis in active phase and without the classical cardiovascular R

Objective. The primary aim of the study was to assess levels of oxidative stress markers, soluble CD40 ligand (sCD40L), serum pregnancy-associated plasma protein-A (PAPP-A), and placental growth factor (PlGF) as well as carotid intima-media thickness (IMT) in patients with ankylosing spondylitis (AS) with active phase without concomitant classical cardiovascular risk factors. Material and methods. The observational study involved 96 male subjects: 48 AS patients and 48 healthy ones, who did not differ significantly regarding age, BMI, comorbid disorders, and distribution of classical cardiovascular risk factors. In both groups, we estimated levels of oxidative stress markers, lipid profile, and inflammation parameters as well as sCD40L, serum PAPP-A, and PlGF. In addition, we estimated carotid IMT in each subject. Results. The study showed that markers of oxidative stress, lipid profile, and inflammation, as well as sCD40L, PlGF, and IMT, were significantly higher in the AS group compared to the healthy group. Conclusion. Our results demonstrate that ankylosing spondylitis may be associated with increased risk for atherosclerosis

The influence of magnetic fields in therapeutic parameters on the healing process of skin and soft tissues

W artykule przedstawiono podstawowe problemy patofizjologiczne zaburzeń gojenia się ran przewlekłych oraz wykorzystanie terapii wolnozmiennymi polami magnetycznymi, jako leczenia wspomagającego. Wolnozmienne pola magnetyczne aktywują procesy regeneracyjne w ranach przewlekłych oraz powstrzymują dalszą destrukcję tkanek, stabilizują błony komórkowe poprzez hamowanie procesów peroksydacji lipidów. W sytuacjach powikłanego gojenia ran magnetoterapia wspomaga klasyczną terapię chirurgiczną, jest bezpieczną i stosunkowo tanią metodą coraz szerzej wykorzystywaną obecnie zarówno w chirurgii, ortopedii, jak i dermatologii i rehabilitacji.The basic pathophysiological problems of disorders in chronic wound healing and the use of extremely low frequency magnetic fields, as a complement factor in the therapy are presented in the article. Extremely low frequency magnetic fields stimulate the activity of regeneration processes in chronic wounds and delay the tissues’ destruction. They inhibit the destabilisation of cellular membranes and lipid peroxidation. Magnetotherapy can be useful and practical supplement in the treatment of chronic wounds with minimal contraindication, very often used in general surgery, orthopedics, dermatology and rehabilitation

Thermal imaging application in chronic venous disease : pilot study

Thermal imaging was used for the estimation of lower-limb primary chronic venous diseases connected with an insufficiency of superficial veins. The current study was performed by means of a Thermovision A40 camera. The curves of the chosen regions of interest were performed in a research room with a stabilized temperature. Curves of the lower extremities showed that the patients suffered from a venous insufficiency characterized by a higher skin temperature connected with pathological changes in the veins. Changes seen in the lower extremities skin thermal map may be associated with blood stasis, inflammatory states and swelling. The differences in temperature distribution are due to a correlation between the medical diagnosis and the parameters obtained from duplex scanning. The results of the thermal imaging showed differences between patients’ health may suggest that a thermovision of lower extremities venous diseases can be very useful in medical diagnosis. The correlation was obtained from temperature parameters and duplex scanning. The parameters may suggest that thermovision diagnostics may be useful as a complementary method in the diagnosis of chronic venous diseases in the lower extremities

Two cases of dysplasia in heterotopic gastric mucosa in upper oesophagus

Ektopowa (heterotopowa) błona śluzowa żołądka w górnej części przełyku (HGMUE, heterotopic gastric mucosa in upper esophagus), często opisowo określana w piśmiennictwie jako „plama na wejściu” („inlet patch”), jest dostrzegana bezpośrednio pod górnym zwieraczem przełyku podczas powolnego wycofywania endoskopu ze zmienną częstotliwością od 0,1 do 10%. Wydaje się, że znaczenie kliniczne tej najczęściej bezobjawowej anomalii jest niedoceniane. W niniejszej pracy przedstawiono 2 przypadki dysplazji w obrębie makroskopowo typowej HGMUE, poruszając problem potencjalnej transformacji nowotworowej tej wrodzonej zmiany. Opisy przypadków 1. U 65-letniej pacjentki w badaniu endoskopowym stwierdzono w górnej części przełyku wygładzony, nieco zapadnięty obszar zaczerwienionej i połyskliwej błony śluzowej o wymiarach około 20 × 20 mm i ostrych granicach, wysuwając podejrzenie ektopii błony śluzowej żołądka w górnej części przełyku. W badaniu histopatologicznym stwierdzono ognisko dysplazji w obrębie HGMUE. 2. U drugiej, również 65-letniej chorej, po 2 tygodniach leczenia nadżerkowego zapalenia przełyku (Los Angeles) w badaniu kontrolnym stwierdzono wygojenie nadżerek, natomiast przy powolnym wycofywaniu endoskopu uwidoczniono bezpośrednio pod górnym zwieraczem przełyku dobrze ograniczone 2 obszary zmienionej w stosunku do otoczenia śluzówki, połyskliwej, wygładzonej i zaczerwienionej. W badaniu histopatologicznym rozpoznano 2 ektopie błony śluzowej żołądka w przełyku i wykryto w jednym z wycinków dysplazję małego stopnia. Wnioski: Mimo że w większości przypadków ektopia błony śluzowej żołądka pozostaje anomalią asymptomatyczną, to przedstawione 2 przypadki pacjentek z dysplazją w jej obrębie wskazują na możliwość transformacji nowotworowej.Ectopic (heterotopic) gastric mucosa in the upper esophagus (HGMUE), frequently referred to as an “inlet patch” in the literature, is visible directly under the upper oesophageal sphincter during a slow retraction of an endoscope with a variable frequency ranging from 0.1 to 10%. It seems that the clinical significance of this anomaly, most frequently asymptomatic, remains underestimated. By presenting 2 cases of dysplasia within the macroscopically typical HGMUE in this paper we would like to bring up the important problem of potential neoplastic transformation of this congenital change. Case study 1. An endoscopic examination carried out on a 65 year old female patient, complaining of a recurrence of heavy heartburn, discomfort in the epigastrum and other ailments of a dyspeptic character, revealed a slightly collapsed smooth area of reddened and shiny mucosa sized app. 20 × 20 mm, with well-marked borders, suspected to be HGMUE. Results of histopathological examination of the specimen collected in the upper oesophagus disclosed a focus of low grade dysplasia in the heterotopic gastric mucosa. 2. The second patient, also a 65 year old female, was treated for esophagitis erosiva (Los Angeles). A supervisory endoscopic examination carried out after 2 weeks of intensive conservative treatment, introduced with lansoprazole in a dose 2 × 30 mg, revealed almost completely healed erosions. However, it also revealed two well-defined, shiny, smooth and reddened areas of mucosa, different comparing to their surroundings, just below the upper oesophageal sphincter during a slow retraction of the endoscope. Results of the histopathological examination of the bifocal change of the mucosa revealed two ectopies. One of them contained a focus of low grade dysplasia. Conclusion: Despite the fact, that most HGMUE lesions remain asymptomatic anomalies, the two above-presented cases of patients with dysplasia in heterotopic gastric mucosa indicate the possibility of neoplastic transformation

Compression therapy in venous diseases : physical assumptions and clinical effects

Compression therapy (CT) is an established treatment method in chronic venous disease. Despite years of clinical experience, choosing the optimum compression therapy, including grade and pressure distribution, which determine the efficacy of treatment poses a challenge. The paper discusses CT physical assumptions (stiffness, elasticity, static and dynamic stiffness indices), clinical effects and contraindications to CT