Assesment of selected parameters depending on the size of abdominal wall incision in patients subjected to minilaparotomy due to benign gynaecological diseases

Abstract Objectives: Considering the enormous advantages of minimally invasive surgery, attempts to introduce less invasive trans-abdominal incisions might represent an alternative to classic gynecologic surgery. The aim of this study is to assess the feasibility and clinical outcome of minilaparotomy in patients operated due to benign gynecological diseases and to analyze selected parameters with regard to the abdominal wall incision size. Design: In this retrospective study, we have described our experience with 26 patients, undergoing minilaparotomy for benign adnexal or uterine diseases. Material and methods: 26 patients with benign uterine or adnexal diseases, hospitalized from November 2003 until March 2006 at the Department of Surgical and Endoscopic Gynecology at the Polish Mother‘s Memorial Hospital – Research Institute in ¸ode, had undergone successful surgical treatment by means of minilaparotomy. The following procedures were included in the analysis: myomectomy (17 patients), ovarian cystectomy (3 patients), myomectomy and ovarian cystectomy at the same time (3 patients), bilateral salpingo-oophorectomy (1 patient), supracervical hysterectomy (1 patient) and total abdominal hysterectomy with salpingo – oophorectomy (1 patient). Results: The patients’ mean age and BMI were 33.85 years (14 – 50) and 22.95 (18.73 – 45.17), respectively. The mean operative time was 72.69 min (45 – 120). The diameter of trans-abdominal incision was 3 – 6cm and the mean diameter of removed lesions was 76.88 mm (47 – 200). The mean intraoperative decrease of haematocrit and haemoglobin value was 4,8% (0.2 – 12.4) and 1,4 g/dl (0.2 – 3.7), respectively. Blood transfusion was required in case of 3 patients but only in one case it was caused by intraoperative blood loss. There were no significant intra- or postoperative complications. 16 patients needed analgesics for 2.33 days after surgery. Body temperature up to 38°C was observed in 4 patients for 2.5 days. The average time of hospitalization after the surgery was 4.58 days. We have noted a negative correlation between the size of trans-abdominal incision and several factors: operative time, intraoperative blood loss, period of analgesic therapy and time of hospitalization after the surgery. None of these factors was correlated with patients’ age or BMI. One-month follow up after the surgery revealed satisfactory wound healing and no complains in case of all patients. All patients deemed the cosmetic effect of the surgery very good. Conclusion: Minilaparotomy seems to be a very simple, useful and safe surgical technique, which might be an alternative to laparotomy in the management of benign gynecologic diseases. Minilaparotomy is of great value, especially in situations when laparoscopic or vaginal approach is too complicated or too dangerous due to technical reasons

Assesment of selected parameters depending on the size of abdominal wall incision in patients subjected to minilaparotomy due to benign gynaecological diseases

Abstract Objectives: Considering the enormous advantages of minimally invasive surgery, attempts to introduce less invasive trans-abdominal incisions might represent an alternative to classic gynecologic surgery. The aim of this study is to assess the feasibility and clinical outcome of minilaparotomy in patients operated due to benign gynecological diseases and to analyze selected parameters with regard to the abdominal wall incision size. Design: In this retrospective study, we have described our experience with 26 patients, undergoing minilaparotomy for benign adnexal or uterine diseases. Material and methods: 26 patients with benign uterine or adnexal diseases, hospitalized from November 2003 until March 2006 at the Department of Surgical and Endoscopic Gynecology at the Polish Mother‘s Memorial Hospital – Research Institute in ¸ode, had undergone successful surgical treatment by means of minilaparotomy. The following procedures were included in the analysis: myomectomy (17 patients), ovarian cystectomy (3 patients), myomectomy and ovarian cystectomy at the same time (3 patients), bilateral salpingo-oophorectomy (1 patient), supracervical hysterectomy (1 patient) and total abdominal hysterectomy with salpingo – oophorectomy (1 patient). Results: The patients’ mean age and BMI were 33.85 years (14 – 50) and 22.95 (18.73 – 45.17), respectively. The mean operative time was 72.69 min (45 – 120). The diameter of trans-abdominal incision was 3 – 6cm and the mean diameter of removed lesions was 76.88 mm (47 – 200). The mean intraoperative decrease of haematocrit and haemoglobin value was 4,8% (0.2 – 12.4) and 1,4 g/dl (0.2 – 3.7), respectively. Blood transfusion was required in case of 3 patients but only in one case it was caused by intraoperative blood loss. There were no significant intra- or postoperative complications. 16 patients needed analgesics for 2.33 days after surgery. Body temperature up to 38°C was observed in 4 patients for 2.5 days. The average time of hospitalization after the surgery was 4.58 days. We have noted a negative correlation between the size of trans-abdominal incision and several factors: operative time, intraoperative blood loss, period of analgesic therapy and time of hospitalization after the surgery. None of these factors was correlated with patients’ age or BMI. One-month follow up after the surgery revealed satisfactory wound healing and no complains in case of all patients. All patients deemed the cosmetic effect of the surgery very good. Conclusion: Minilaparotomy seems to be a very simple, useful and safe surgical technique, which might be an alternative to laparotomy in the management of benign gynecologic diseases. Minilaparotomy is of great value, especially in situations when laparoscopic or vaginal approach is too complicated or too dangerous due to technical reasons

Current advances in~information quantum technologies - critical issues

This article reviews chosen topics related to the development of Information Quantum Technologies in the major areas of measurements, communications, and computing. These fields start to build their ecosystems which in the future will probably coalesce into a homogeneous quantum information layer consisting of such interconnected components as quantum internet, full size quantum computers with efficient error corrections and ultrasensitive quantum metrology nodes stationary and mobile. Today, however, the skepticism expressing many doubts about the realizability of this optimistic view fights with a cheap optimism pouring out of some popular press releases. Where is the truth? Financing of the IQT by key players in research, development and markets substantially strengthens the optimistic side. Keeping the bright side with some reservations, we concentrate on showing the FAST pace of IQT developments in such areas as biological sciences, quantum evolutionary computations, quantum internet and some of its components

A new approach to ticagrelor-based de-escalation of antiplatelet therapy after acute coronary syndrome. A rationale for a randomized, double-blind, placebo-controlled, investigator-initiated, multicenter clinical study

© 2021 Via Medica. This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license. https://creativecommons.org/licenses/by/4.0/The risk of ischemic events gradually decreases after acute coronary syndrome (ACS), reaching a stable level after 1 month, while the risk of bleeding remains steady during the whole period of dual antiplatelet treatment (DAPT). Several de-escalation strategies of antiplatelet treatment aiming to enhance safety of DAPT without depriving it of its efficacy have been evaluated so far. We hypothesized that reduction of the ticagrelor maintenance dose 1 month after ACS and its continuation until 12 months after ACS may improve adherence to antiplatelet treatment due to better tolerability compared with the standard dose of ticagrelor. Moreover, improved safety of treatment and preserved anti-ischemic benefit may also be expected with additional acetylsalicylic acid (ASA) withdrawal. To evaluate these hypotheses, we designed the Evaluating Safety and Efficacy of Two Ticagrelor-based De-escalation Antiplatelet Strategies in Acute Coronary Syndrome — a randomized clinical trial (ELECTRA-SIRIO 2), to assess the influence of ticagrelor dose reduction with or without continuation of ASA versus DAPT with standard dose ticagrelor in reducing clinically relevant bleeding and main-taining anti-ischemic efficacy in ACS patients. The study was designed as a phase III, randomized, multicenter, double-blind, investigator-initiated clinical study with a 12-month follow-up.Peer reviewedFinal Published versio

Paliwa z odpadów dla dywersyfikacji źródeł energii

The dynamics of economic development determines the need to develop technologies for waste recycling especially the acquisition of condensed fuels for the needs of the local diversification of energy sources. In a short time, Poland will probably lack its own produced electricity. To apply the process of diversification of energy sources, by developing methods of generating energy from waste, it becomes crucial to protect the environment. The use of cogeneration technology based on fuels derived from waste, in particular concentrated oil and gas fuels, is becoming more common and provides the basis for securing the energy supply in the preferred diversification process. Plastic waste processing in the controlled depolymerization process, which is the reverse of the polymerization process for hydrocarbon recovery – uses petroleum derivatives its production. At present, the greatest interest arises in the material recovery of plastics and rubber in the process of anaerobic thermal decomposition (thermolysis/pyrolysis), which is used on an industrial scale and consists in the degradation of polymer bonds into low molecular weight. The imperative of a modern economy is to obtain energy from fuels from waste treatment, including hazardous waste, preferably in the cogeneration process. The fuel obtained from waste may be used to obtain thermal or electric energy in order to diversify energy sources. The article presents innovative Polish technologies of obtaining fuel in processes of anaerobic thermal decomposition mainly of elastomeric and polymeric waste (including hazardous ones) for direct application in power generators of various power.Dynamika rozwoju gospodarczego determinuje potrzebę rozwoju technologii recyklingu odpadów, w szczególności pozyskiwania paliw skondensowanych na potrzeby lokalnej dywersyfikacji źródeł energii. W niedługim czasie, w Polsce prawdopodobnie będzie brakowało wyprodukowanej własnym sumptem energii elektrycznej. Stosowanie procesu dywersyfikacji źródeł energii ma za zadanie, opracowanie metody wytwarzania energii z odpadów w celu ochrony środowiska. Zastosowanie technologii kogeneracji opartej na paliwach pozyskiwanych z odpadów, w szczególności skoncentrowanych paliw typu olej i gaz, staje się coraz bardziej powszechne i daje podstawę bezpieczeństwa dostaw energii w preferowanym procesie jej dywersyfikacji. Obecnie największe zainteresowanie budzi odzysk materiałów z tworzyw sztucznych i gumy w procesie beztlenowego rozkładu termicznego (termolizy/pirolizy), który stosuje się na skalę przemysłową. Polega on na degradacji wiązań polimerowych do niskiej masy cząsteczkowej. Imperatywem nowoczesnej gospodarki jest pozyskiwanie energii z paliw pochodzących z przetwarzania odpadów, w tym niebezpiecznych, najkorzystniej w procesie kogeneracji. Pozyskane z odpadów paliwa mogą znaleźć zastosowanie w produkcji energii cieplnej lub elektrycznej w celu dywersyfikacji źródeł energii. W artykule przedstawione zostały innowacyjne polskie technologie pozyskiwania paliw w procesach beztlenowego rozkładu termicznego, głównie odpadów elastomerowych i polimerowych (w tym niebezpiecznych), do bezpośredniego zastosowania w agregatach prądotwórczych o zróżnicowanej mocy

Influence of Ti3C2Tx MXene and Surface-Modified Ti3C2Tx MXene Addition on Microstructure and Mechanical Properties of Silicon Carbide Composites Sintered via Spark Plasma Sintering Method

This article presents new findings related to the problem of the introduction of MXene phases into the silicon carbide matrix. The addition of MXene phases, as shown by the latest research, can significantly improve the mechanical properties of silicon carbide, including fracture toughness. Low fracture toughness is one of the main disadvantages that significantly limit its use. As a part of the experiment, two series of composites were produced with the addition of 2D-Ti3C2Tx MXene and 2D-Ti3C2Tx surface-modified MXene with the use of the sol-gel method with a mixture of Y2O3/Al2O3 oxides. The composites were obtained with the powder metallurgy technique and sintered with the Spark Plasma Sintering method at 1900 °C. The effect adding MXene phases had on the mechanical properties and microstructure of the produced sinters was investigated. Moreover, the influence of the performed surface modification on changes in the properties of the produced composites was determined. The analysis of the obtained results showed that during sintering, the MXene phases oxidize with the formation of carbon flakes playing the role of reinforcement. The influence of the Y2O3/Al2O3 layer on the structure of carbon flakes and the higher quality of the interface was also demonstrated. This was reflected in the higher mechanical properties of composites with the addition of modified Ti3C2Tx. Composites with 1 wt.% addition of Ti3C2Tx M are characterized with a fracture toughness of 5 MPa × m0.5, which is over 50% higher than in the case of the reference sample and over 15% higher than for the composite with 2.5 wt.% addition of Ti3C2Tx, which showed the highest fracture toughness in this series

Microstructure and Mechanical Properties of Alumina Composites with Addition of Structurally Modified 2D Ti₃C₂ (MXene) Phase

This study presents new findings related to the incorporation of MXene phases into ceramic. Aluminium oxide and synthesised Ti3C2 were utilised as starting materials. Knowing the tendency of MXenes to oxidation and degradation, particularly at higher temperatures, structural modifications were proposed. They consisted of creating the metallic layer on the Ti3C2, by sputtering the titanium or molybdenum. To prepare the composites, powder metallurgy and spark plasma sintering (SPS) techniques were adopted. In order to evaluate the effectiveness of the applied modifications, the emphasis of the research was placed on microstructural analysis. In addition, the mechanical properties of the obtained sinters were examined. Observations revealed significant changes in the MXenes degradation process, from porous areas with TiC particles (for unmodified Ti3C2), to in situ creation of graphitic carbon (in the case of Ti3C2-Ti/Mo). Moreover, the fracture changed from purely intergranular to cracking with high participation of transgranular mode, analogously. In addition, the results obtained showed an improvement in the mechanical properties for composites with Ti/Mo modifications (an increase of 10% and 15% in hardness and fracture toughness respectively, for specimens with 0.5 wt.% Ti3C2-Mo). For unmodified Ti3C2, enormously cracked areas with spatters emerged during tests, making the measurements impossible to perform