Influence of L-arginine oral supplementation on oxidative stress in patients with intermittent claudication

Wstęp. Sugeruje się, że podanie L-argininy osobom z niedoborem NO jest racjonalną metodą zarówno zwiększania wytwarzania NO przez śródbłonek, jak i zmniejszenia uwalniania wolnych rodników. W ostatnich latach wykazano, że takie postępowanie lecznicze może być skuteczne u chorych z miażdżycowym niedokrwieniem kończyn dolnych. Cel pracy. Celem pracy była ocena wpływu 28-dniowej doustnej suplementacji L-argininy na stężenie NO oraz parametry całkowitego potencjału antyoksydacyjnego osocza u chorych z chromaniem przestankowym. Materiał i metody. Badano 16 chorych w wieku 42–74 lat leczonych w Klinice Chirurgii Ogólnej i Naczyń AM w Poznaniu z rozpoznaną miażdżycą tętnic kończyn dolnych w II stopniu wg klasyfikacji Fontaine’a, którzy otrzymywali L-argininę w dawce 3 x 4 g/d. Chorych poddano miesięcznej obserwacji klinicznej w celu określenia tolerancji terapii i wychwycenia ewentualnych działań niepożądanych. W trakcie badania, tzn. w 0, 7, 14 i 28 dniu u każdego chorego przeprowadzono pełne badania podmiotowe i przedmiotowe z określeniem dystansu chromania przestankowego i wartości wskaźnika kostka-ramię, a także pobierano krew w celu oznaczenia stężenia tlenku azotu oraz całkowitego potencjału antyoksydacyjnego osocza. Wyniki. Po podaniu L-argininy u wszystkich chorych nastąpiła poprawa kliniczna w postaci wydłużenia dystansu przejścia bezbólowego. Zaobserwowano wzrost stężenia NO i całkowitego potencjału antyoksydacyjnego osocza po 3 h, 7, 14 i 28 dniach podawania L-argininy. Wnioski. Doustna suplementacja L-argininy powoduje istotne zwiększenie stężenia NO oraz TAS u chorych z chromaniem przestankowym.Background. It is suggested that the administration of L-arginine to patients with NO deficiency is the rational method both of increasing NO production by the endothelium and decreasing the free radical release. In the last year it was proved that this therapeutic procedure could be successful in patients with atherosclerotic ischaemia of the lower extremities. Aim of the study. The aim of this study was the estimation of the influence of 28-day L-arginine oral supplementation on NO concentration and the parameters of total antioxidant status (TAS) in patients with intermittent claudication. Material and methods. 16 patients (8 female and 8 male) were examined diagnosed with atherosclerosis of the lower extremities in Fontaine’s II stage and receiving L-arginine in the dose of 3 x 4 g/day. During the study patients were under accurate clinical observation whose aim was to evaluate drug tolerance and to notice possible adverse effects of L-arginine used in therapy. During the study in 0, after 3 h, and on the 7th, 14th, and 28th day, subjective and objective examinations were conducted with evaluation of the intermittent claudication distance. From every patient the blood samples were taken for the determination of NO concentration and TAS. Results. After L-arginine treatment in all patients we observed clinical improvement, such as elongation of intermittent claudication distance. We noticed the increase of NO-concentration and higher TAS after 3 h, 7, 14 and 28 days of L-arginine treatment. Conclusions. Oral supplementation of L-arginine causes a significant increase of NO-concentration and TAS in patients with intermittent claudication

The influence of oral supplementation of L-arginine on intermittent claudication in patients with peripheral arterial disease of the lower extremities

Background. More and more data indicate that the increase of production of free radicals by the endothelium with simultaneously decreasing synthesis and/or increasing nitric oxide (NO) degradation is the basis of changes in atheromatous vessel structure and reactivity. It is suggested that the administration of L-arginine to patients with NO deficiency is the rational method both of increasing NO production by the endothelium and decreasing the free radical release. In the last year it has been proven that this therapeutic procedure could be successful in patients with atherosclerotic ischaemia of lower extremities. The aim of this study was the estimation of the influence of 28-day L-arginine oral supplementation on intermittent claudication in patients with peripheral arterial occlusive disease. Material and methods. The authors studied 48 patients (25 men/23 women) with peripheral arterial disease - Fontaine II. They were randomly divided into two groups: group I - 24 patients receiving L-arginine 3 × 4 g/day and group II - 24 patients receiving placebo 3 × 4 g/day. During the study patients were under strict clinical observation, the aim of which was to evaluate drug tolerance and to observe possible adverse effects of L-arginine used in therapy. During the study at 0 h, after 3 h, and on the 7th, 14th, and 28th days subjective and objective examinations were conducted with evaluation of pain-free distance and total walking distance. Results. After L-arginine treatment clinical improvement was observed in all patients, such as elongation of pain-free walking distance (from 80 m at the beginning to 438 m at the end) and total walking distance (from 158 m to 687 m), while there was no clinical improvement in patients with placebo. Conclusions. In patients with peripheral arterial occlusive disease Fontaine stage II oral supplementation of L-arginine results in elongation of pain-free and total walking distance.Wstęp. Coraz więcej danych wskazuje, że zwiększone wytwarzanie wolnych rodników przez śródbłonek z równoczesnym zmniejszeniem syntezy i/lub zwiększoną degradacją tlenku azotu (NO) leży u podstaw zmian w strukturze i reaktywności miażdżycowo zmienionych naczyń. Sugeruje się, że podanie L-argininy osobom z niedoborem NO jest racjonalną metodą zarówno zwiększania wytwarzania NO przez śródbłonek, jak i zmniejszenia uwalniania wolnych rodników. W ostatnich latach wykazano, że takie postępowanie lecznicze może być skuteczne u chorych z miażdżycowym niedokrwieniem kończyn dolnych. Celem pracy był ocena wpływu 28-dniowej doustnej suplementacji L-argininą na chromanie przestankowe u chorych z miażdżycowym niedokrwieniem kończyn dolnych. Materiał i metody. Badano 48 chorych leczonych w Klinice Chirurgii Ogólnej i Naczyń Akademii Medycznej w Poznaniu z rozpoznaną miażdżycą tętnic kończyn dolnych w II stopniu według klasyfikacji Fontaine’a. Chorych losowo podzielono na dwie grupy: I grupa chorych otrzymywała L-argininę w dawce 3 × 4 g na dobę, natomiast II grupa - placebo w dawce 3 × 4 g na dobę. Chorych poddano miesięcznej obserwacji klinicznej w celu określenia tolerancji terapii i odnotowania ewentualnych działań niepożądanych. W w 0., 7., 14. i 28. dniu u każdego chorego przeprowadzono pełne badanie podmiotowe i przedmiotowe z określeniem dystansu przejścia bezbólowego i maksymalnego. Wyniki. Po podaniu L-argininy nastąpiła znaczna poprawa kliniczna w postaci wydłużenia dystansu przejścia bezbólowego (od 80 m na początku badania do 438 m w końcowym punkcie obserwacji) i maksymalnego (od 158 m w 0. dniu badania do 687 m w 28. dniu), podczas gdy w grupie chorych otrzymujących placebo takiej korzyści nie odnotowano. Wnioski. Doustna suplementacja L-argininy w dawce 3 × 4 g na dobę istotnie wydłuża dystans przejścia bezbólowego i maksymalnego u chorych z chromaniem przestankowym

Buffer influence on magnetic dead layer, critical current and thermal stability in magnetic tunnel junctions with perpendicular magnetic anisotropy

We present a thorough research on Ta/Ru-based buffers and their influence on features crucial from the point of view of applications of MTJs, such as critical switching current and thermal stability. We investigate devices consisting of buffer/FeCoB/MgO/FeCoB/Ta/Ru multilayers for three different buffers: Ta 5 / Ru 10 / Ta 3, Ta 5 / Ru 10 / Ta 10 and Ta 5 / Ru 20 / Ta 5 (all thicknesses in nm). In addition, we study systems with a single FeCoB layer deposited above as well as below the MgO barrier. The crystallographic texture and the roughness of the buffers are determined by means of XRD and atomic force microscopy measurements. Furthermore, we examine the magnetic domain pattern, the magnetic dead layer thickness and the perpendicular magnetic anisotropy fields for each sample. Finally, we investigate the effect of the current induced magnetization switching for nanopillar junctions with lateral dimensions ranging from 1 {\mu}m down to 140 nm. Buffer Ta 5 / Ru 10 / Ta 3, which has the thickest dead layer, exhibits a large increase in the thermal stability factor while featuring a slightly lower critical current density value when compared to the buffer with the thinnest dead layer Ta 5 / Ru 20 / Ta 5

Wpływ leków wazoaktywnych na potencjał antyoksydacyjny i funkcje śródbłonka u chorych z przewlekłym niedokrwieniem kończyn dolnych w stadium IIb według klasyfikacji Fontaine’a

Background. Atherosclerotic lower limb ischemia is the most important cause of intermittent claudication. Patients with intermittent claudication are at relatively low risk of limb loss. Therefore the predominant therapeutic approach in this group of patients is conservative treatment. The objective of this study was a comparison of bencyclane versus pentoxifilline effects on the clinical picture (pain free walking distance and maximum walking distance) and selected parameters of oxidative stress including blood level of nitric oxide (NO) and total antioxidant status of the plasma in patients with chronic lower limb ischaemia (Fontaine IIb). Material and methods. Adult patients (60 subjects) with claudication distance shorter than 200 m (Fontaine II b) were divided into three groups: I. 20 patients administered bencyclane 200 mg i.v. for 7 days followed by 2 × 200 mg orally for 21 days; II. 20 patients administered pentoxifilline 300 mg i.v. for 7 days followed by 2 × 600 mg orally for 21 days; III. 20 patients administered placebo i.v. for 7 days followed by 2 × 1 tablet orally for 21 days. In all patients walking distance until first pain, maximum walking distance and ankle brachial index (ABI) were measured. In all patients blood samples were taken on days 0, 7, 14 and 28 of the treatment and blood levels of nitric oxide (NO) and plasma total antioxidant status (TAS) were measured. Results. Statistically significant increase in pain-free walking distance i.e. 127 &#177; 37.95 m in patients administered bencyclane (p < 0.001) and 125.29 &#177; 41.10 m in patients administered pentoxifilline (p < 0.001) was observed. Total antioxidant status (TAS) of the plasma and blood levels of nitric oxide also increased in patients treated with bencyclane and pentoxifilline (p < 0.05). Conclusions. The administration of bencyclane and pentoxifilline is an effective therapeutic approach for patients with Fontaine II b chronic limb ischaemia. No significant differences were found in efficacy of the two active treatments in the study.Wstęp. Miażdżycowe niedokrwienie kończyn dolnych jest najważniejszą przyczyną wywołującą chromanie przestankowe. Chorzy z chromaniem przestankowym są obarczeni stosunkowo niewielkim ryzykiem utraty kończyny. Z tego powodu dominującym sposobem leczenia tej grupy chorych jest terapia zachowawcza. Celem pracy było porównanie wpływu bencyklanu i pentoksyfiliny na obraz kliniczny (dystans przejścia bezbólowego i maksymalnego) i na wybrane parametry stresu oksydacyjnego, czyli stężenie tlenku azotu (NO) we krwi i całkowity potencjał antyoksydacyjny osocza pacjentów z przewlekłym niedokrwieniem kończyn dolnych (stadium IIb). Materiał i metody. Badaną grupę stanowili dorośli pacjenci (60 osób) z chromaniem przestankowym poniżej 200 m (stadium IIb niedokrwienia wg klasyfikacji Fontaine&#8217;a) podzieleni na 3 grupy: grupa I - 20 chorych otrzymujących bencyklan w dawce 200 mg i.v. przez 7 dni i 2 × 200 mg p.o. przez 21 dni; grupa II - 20 chorych, otrzymujących pentoksyfilinę w dawce 300 mg i.v. przez 7 dni i 2 × 600 mg p.o. przez 21 dni; grupa III - 20 chorych otrzymujących placebo i.v. przez 7 dni i 2 × 1 tabl. p.o. przez 21 dni. U wszystkich pacjentów przeprowadzono: badanie dystansu przejścia do pierwszego bólu (PFWD), maksymalnego (MWD) i zmierzono wskaźnik kostka-ramię (ABI). Od badanych pobrano krew w: 0., 7., 14. i 28. dniu podawania leków i oznaczono w surowicy krwi stężenie tlenku azotu (NO) i całkowity potencjał antyoksydacyjny osocza (TAS). Wyniki. Stwierdzono znamienne statystycznie zwiększenie dystansu przejścia bezbólowego, czyli 127,00 &#177; 37,95 m w grupie chorych przyjmujących bencyklan (p < 0,001) i 125,29 &#177; 41,10 m u chorych otrzymujących pentoksyfilinę (p < 0,001). W grupie pacjentów stosujących bencyklan i pentoksyfilinę wzrastała wartość całkowitego potencjału antyoksydacyjnego osocza i stężenie tlenku azotu (p < 0,05). Wnioski. Zastosowanie bencyklanu i pentoksyfiliny jest skuteczną formą terapii u chorych z przewlekłym niedokrwieniem kończyn w klasie IIb według klasyfikacji Fontaine&#8217;a. Nie stwierdzono istotnych różnic w skuteczności działania obu badanych preparatów

Retro-Auricular Approach to the Fractures of the Mandibular Condyle: A Systematic Review

This systematic review was conducted to evaluate the retro-auricular trans-meatal approach (RA) to mandibular head fractures. Fractures of the mandibular head (8%) are a specific type of mandibular condyle fractures (34%). Despite numerous complications of conservative treatment, e.g., limited mobility and even ankylosis of the temporomandibular joint, as well as shortening of the mandibular ramus resulting in malocclusion, surgical intervention in this type of fracture is still problematic. The main problems with the dominant pre-auricular approach are the high risk of paralysis of the facial nerve and persistence of a visible scar. An attractive alternative is RA, which, despite its long history, has been described in English very few times, i.e., in only two clinical trials described in three articles in the last 21 years. According to these studies, RA gives a minimum of 90% of ideal positions of bone fragments and an always fully preserved function of the facial nerve in the course of long-term observation. RA allows the application of long screws for fixation, which provide good stabilization. In addition, new types of headless screws leave a smooth, non-irritating bone surface, and the immediate future may be dominated by their resorbable varieties. RA can, therefore, be treated as a very favorable access to fractures of the mandibular head, especially due to the protection of the facial nerve and the possibility of providing a stable and predictable fixation

Maxillary Sinus Pleomorphic Adenoma: A Systematic Review

Background: Pleomorphic adenoma (PA), also known as a mixed tumor, is a neoplasm of the glandular tissue. The maxillary sinus (MS) is an atypical location of PA; however, as an empty cavity inside the bone, it predisposes tumors to develop unnoticed. The aim of the following systematic review was to identify and characterize the diagnostics and prognosis of maxillary sinus pleomorphic adenoma (MSPA). Methods: The cases of MSPA that underwent treatment and were observed for possible recurrence were qualified for the review. The medical databases were searched using the following engines: ACM, BASE, Google Scholar and PubMed. The risk of bias was assessed using the JBI Critical Appraisal Tool for Case Reports. The extracted data were tabulated and summarized in a descriptive manner. Results: To the best knowledge of the authors, only seven cases of MSPA were described in the last 20 years. Relapse occurred in three of these cases and malignant transformation occurred in two. The longest recorded time without recurrence was 4 years. The size of the detected MSPA in the largest dimension ranged in various cases from 40 to 60 mm, with an average of 48 mm. Discussion: All but one of the seven included reports showed flaws during the risk of bias assessment. Only in two of seven reported cases was there no reason to suspect that the tumor had penetrated the sinus from the oral or nasal cavity. The MS is disadvantageous as a location as tumors occupying the entire volume of the sinus are often diagnosed. Recurrences and malignant transformations seem to be frequent and often remain undetected for a prolonged period. Other information: This research received no external funding. OSF Registries number: 8KVGM

Maxillary Sinus Pleomorphic Adenoma: A Systematic Review

Background: Pleomorphic adenoma (PA), also known as a mixed tumor, is a neoplasm of the glandular tissue. The maxillary sinus (MS) is an atypical location of PA; however, as an empty cavity inside the bone, it predisposes tumors to develop unnoticed. The aim of the following systematic review was to identify and characterize the diagnostics and prognosis of maxillary sinus pleomorphic adenoma (MSPA). Methods: The cases of MSPA that underwent treatment and were observed for possible recurrence were qualified for the review. The medical databases were searched using the following engines: ACM, BASE, Google Scholar and PubMed. The risk of bias was assessed using the JBI Critical Appraisal Tool for Case Reports. The extracted data were tabulated and summarized in a descriptive manner. Results: To the best knowledge of the authors, only seven cases of MSPA were described in the last 20 years. Relapse occurred in three of these cases and malignant transformation occurred in two. The longest recorded time without recurrence was 4 years. The size of the detected MSPA in the largest dimension ranged in various cases from 40 to 60 mm, with an average of 48 mm. Discussion: All but one of the seven included reports showed flaws during the risk of bias assessment. Only in two of seven reported cases was there no reason to suspect that the tumor had penetrated the sinus from the oral or nasal cavity. The MS is disadvantageous as a location as tumors occupying the entire volume of the sinus are often diagnosed. Recurrences and malignant transformations seem to be frequent and often remain undetected for a prolonged period. Other information: This research received no external funding. OSF Registries number: 8KVGM

The Administration of Hyaluronic Acid into the Temporomandibular Joints’ Cavities Increases the Mandible’s Mobility: A Systematic Review and Meta-Analysis

Objectives: The purpose of this systematic review with meta-analysis is to identify clinical studies concerning the impact of intra-articular administration of hyaluronic acid (HA) on mandibular mobility and to make an attempt at determining the efficacy of HA in this indication. Methods: The review included primary studies involving groups of at least 10 patients who were diagnosed with pain in the temporomandibular joint and who were injected with hyaluronic acid as the only intervention. The outcomes pursued were changes in mandibular mobility and pain intensity. Four databases of medical articles were searched, including PubMed and BASE. The risk of bias was assessed using the Cochrane methodology tools. The therapy‘s efficacy was calculated in the domains of mandibular abduction, protrusive movement, lateral mobility, and pain relief. For these values, the regression and correlation with variables characterizing the interventions were analyzed. Results: In total, 16 reports on 20 study groups with a total of 1007 patients qualified for the review. The mean effectiveness in the domain of mandibular abduction over the 6-month follow-up period was 122% of the initial value, and the linear regression model can be expressed as 0.5x + 36. The level of pain in the same time frame decreased to an average of 29%. The severity of pain 6 months after the beginning of treatment positively correlates with the number of injections per joint (0.63), the total amount of drug administered in milliliters (0.62), and the volume of drug administered monthly per joint (0.50). Limitations: In some studies, the patient groups were heterogeneous in terms of diagnosis. The studies varied depending on the joint into which the HA was administered. The synthesized studies differed with regard to the method of measuring the mandible abduction amplitude. Conclusions: The increase in the amplitude of mandibular abduction was expressed as the quotient of the mean values during the observation periods, and the initial value was achieved in all study groups, and in the linear regression model, it was 0.5 mm on average per month. Multiple administrations of the drug may reduce the analgesic effectiveness of the treatment

Intra-Articular Injections into the Inferior versus Superior Compartment of the Temporomandibular Joint: A Systematic Review and Meta-Analysis

This systematic review and meta-analysis aimed to validate the hypothesis that intra-articular injections into the inferior temporomandibular joint compartment are more efficient than analogous superior compartment interventions. Publications reporting differences between the above-mentioned techniques in the domains of revealing articular pain, decreasing the Helkimo index, and abolishing mandibular mobility limitation were included. Medical databases covered by the Bielefeld Academic Search Engine, Google Scholar, PubMed, ResearchGate, and Scopus engines were searched. The risk of bias was assessed using dedicated Cochrane tools (RoB2, ROBINS-I). The results were visualized with tables, charts, and a funnel plot. Six reports describing five studies with a total of 342 patients were identified. Of these, four trials on a total of 337 patients were qualified for quantitative synthesis. Each eligible report was at moderate risk of bias. From 19% to 51% improvement in articular pain, 12–20% lower Helkimo index, and 5–17% higher maximum mouth opening were observed. The evidence was limited by the small number of eligible studies, discrepancies regarding the substances used, possible biases, and the differences in observation times and scheduled follow-up visits. Despite the above, the advantage of inferior over superior compartment temporomandibular joint intra-articular injections is unequivocal and encourages further research in this direction

Treatment of Mandibular Hypomobility by Injections into the Temporomandibular Joints: A Systematic Review of the Substances Used

Introduction: Hyaluronic acid, steroids and blood products are popularly injected into the temporomandibular joint (TMJs) to relieve pain and increase the extent of mandibular abduction. The purpose of this review is to identify other injectable substances and to evaluate them in the above-mentioned domains. Material and methods: The review included articles describing clinical trials of patients treated with intra-articular injections with or without arthrocentesis. Results: The following emerging substances were initially evaluated to be effective in treating TMJ pain and increasing the amplitude of mandibular abduction: analgesics, dextrose with lidocaine, adipose tissue, nucleated bone marrow cells and ozone gas. Discussion: Better effects of intra-articular administration are achieved by preceding the injection with arthrocentesis. Conclusions: The most promising substances appear to be bone marrow and adipose tissue