Perioperative pain management of orthopaedic patients based on new guidelines and literature review

The pain management is an important issue of orthopedics and traumatology. The choice of therapy should be based on proper assessment of pain, monitoring and appropriate selection of analgesics. The necessary knowledge about the pharmacokinetic and pharmacodynamic profile of the drugs allows to maximize the benefits and minimize the risks associated with the use of painkillers and The proper pain management affects the time between surgical intervention and rehabilitation. In spite the of new analgesics and broadening knowledge about the mechanisms of pain, the results of treatment are unsatisfactory. Growing addiction to opioids is a major concern. A multimodal approach to pain management can provide better pain control and reduced opioid consumption. The purpose of this article was to review of the latest literature and recommendation to provide a summary of effective perioperative analgesic methods

The latest applications of photoplethysmography

The development of medicine and the ability to conduct effective therapy in increasingly severe cases createthe need to develop new methods of continuous and non-invasive monitoring of the patient’s condition. One ofthe techniques that is widely used in many fields of medicine is photoplethysmography (PPG). The analysis ofthe latest research indicates that PPG can have much more applications than the measurement of heart rateand arterial saturation of the patient — as shown by the latest research, it can be used in the measurementof many other key parameters.The optimism is the multitude of areas in which PPG monitoring is attempted. There are more and more attemptsto use photoplethysmography in diagnosis and evaluation of peripheral vascular diseases, assessment ofcirculation in diabetic patients and assessment of endothelial function. Authors are focusing on new applicationsof PPG, its advantages and limitations. Most of them agree that PPG can provide useful knowledge about thepatient’s condition while being a quick, easy-to-use and cost-effective technique.The following review was created to critically analyze the latest technical developments and uses of PPG inclinical practice. Sources for the following article were found using the PubMed database using keywords suchas “photoplethysmography”, “oxygen saturation” and “pulse oximeter”

Advances in osteosynthesis - a basic overview of modern fixation materials

The dynamic development of trauma-orthopedic surgery and accompanying material technology has led in recent years to the need for close cooperation between researchers in these fields. In a short time, thanks to the cooperation of engineers and doctors, the general approach to the method of bone anastomosis has changed significantly. The need to optimize the effects of treatment, i.e. to quickly recovery, reduce the number of postoperative complications, reduce the number of reoperations, and reduce the costs of procedures and treatment used has resulted in the development of many new technologies that have set trends in modern traumatology. The widespread use of LCP (Locking compression plate) and locking screws, the development of polymers and biopolymers with a modified chemical structure, a significant improvement in the biocompatibility and cytocompatibility of the materials used, and the implementation of products with significant micro-roughness that improve osseointegration are the well-known and commonly used effects of this cooperation today . Materials science related to orthopedics is an extremely complex and multi-threaded field. Its continuous development requires a periodic summary of the results and development directions provided, which allows faster evaluation and interpretation by researchers. The purpose of the following work is to summarize the latest research on materials and methods used in osteosynthesis in a legible way for potential recipients of this information from various fields

The influence of thickness of ACL tendon graft on long-term results of treatment

1. INTRODUCTION: Operative treatment is the treatment of choice for the most severe, third-degree ACL sprain. Many operational techniques exist, including technique using a quadruple-folded semitendinosus tendon and the technique of double-folded semitendinosus and gracilis tendons. Depending on the technique chosen, we can obtain different thicknesses of the grafts used. 2. AIM OF THE STUDY: To find a relationship between the type of surgical technique used and the thickness of the graft, as well as to assess the effect of the thickness of the applied autograft on the long-term outcome of the treatment. 3. MATERIALS AND METHODS: A retrospective study included a group of 43 patients operated on due to ACL injury. In 21 patients, the procedure was performed using the quadruple-folded semitendinosus tendon, whereas in 22 patients the procedure was performed using double-folded semitendinosus and gracilis tendons. The patients were divided into groups based on the thickness of the transplant. A special questionnaire prepared on the basis of the KOOS scale was used to assess the subjective performance of the knee. The type and thickness of the graft was determined based on the analysis of operational protocols. The statistical analysis of the results of the study was performed. The Chi-square compatibility test or chi-square compatibility test in the Yates modification were used to assess the relationship. 4. RESULTS: A relationship was found between the parameters: "general quality of life" (p = 0.01), "pain" (p = 0.005), "sports activity" (p = 0.05), "everyday activities" (p = 0, 01). There is no dependence for the "other symptoms" parameter (p = 0.1). There is no relationship between the technique used and the graft thickness (p = 0.2).  5. CONCLUSIONS: The choice of the surgical technique does not affect the final thickness of the autograft. Overall quality of life, pain, sports activity; everyday activities are the parameters of the KOOS scale, which are affected by the thickness of the transplant

Iron Doped SBA-15 Mesoporous Silica Studied by Mössbauer Spectroscopy

Mesoporous silica SBA-15 containing propyl-iron-phosphonate groups were considered to confirm their molecular structure. To detect the iron-containing group configuration the Mössbauer spectroscopy was used. Both mesoporous silica SBA-15 containing propyl-iron-phosphonate groups and pure doping agent (iron acetylacetate) were investigated using Mössbauer spectroscopy. The parameters such as isomer shift, quadrupole splitting, and asymmetry in 57Fe Mössbauer spectra were analyzed. The differences in Mössbauer spectra were explained assuming different local surroundings of Fe nuclei. On this base we were able to conclude about activation of phosphonate units by iron ions and determinate the oxidation state of the metal ion. To examine bonding between iron atoms and phosphonic units the resonance Raman spectroscopy was applied. The density functional theory (DFT) approach was used to make adequate calculations. The distribution of active units inside silica matrix was estimated by comparison of calculated vibrational spectra with the experimental ones. Analysis of both Mössbauer and resonance Raman spectra seems to confirm the correctness of the synthesis procedure. Also EDX elemental analysis confirms our conclusions

Ossification of the ligamentum flavum of the lumbosacral spine in the polish hospitalized population : a prospective cohort study

The aim of this study was to assess the prevalence, clinical features and distribution of lumbosacral ossifications of the ligamentum flavum (OLF), using MRI, CT and microCT, in hospitalized Polish patients. Patients were recruited prospectively between January 2011 and January 2013. Patients were further qualified to the study group only if CT or MRI of the lumbosacral region detected OLF. Level of OLF excision was determined by the localization of spinal stenosis. After excision the LF fragments containing OLF were stored in a 4% solution of formaldehyde until microCT assessment. A total of 184 agreed to take part in the study. In 50 patients (27.2%) OLF were found. Thus, the study group consisted of 17 women (34%) and 33 men, with a mean age of 55.4 \pm 17.2 years. OLF occurred more often in men (66%) than in women (34%) (p = 0.0014). The most common site for the localization of OLF in women, as well as in men was the L5/S1 level (60% and 53.3% respectively). The mean volume of OLF was 3.87\pm 5.27 mm^{3}\left ( 4.66 \pm 5.71 mm^{3} vs. 1.27 \pm 2.19 mm^{3}, in men and women respectively; p = 0.023 \right ). The LF were thickened in 21 (42%) patients. The mean volume of OLF in patients with normal LF was 4.78\pm 5.95 mm^{3} and in patients with thickened LF 5.33\pm 6.10 mm^{3} (p = 0.75). The prevalence of lumbosacral OLF in the Polish hospitalized population is very high. The most common site of their localization is the L5/S1 level. LF thickening is not associated with OLF formation

Testing the Validity of Patellar Measurements in Sex Estimation – A Computed Tomography Study in a Contemporary Polish Population

Introduction and purpose: Human skeleton-based sex estimation is a major topic of interest for forensic anthropologists. Various bones have been examined for sex heterogeneity. The most commonly used include skull and pelvis, however they may not always be used due to damage or fragmentation. The patella has been shown to be resistant to postmortem changes, which creates a potential use for determining the sex of unknown human remains. Materials and methods: The samples were gathered from patients examined by computed tomography angiography (CTA) of lower extremities in University Hospital No. 4 in Lublin. Exclusion criteria included patellar fractures, knee replacement and advanced osteoporosis. A total of 120 CTA examinations of 65 males and 55 females, were included in the analysis. Four measurements for every patella: craniocaudal patella dimension (CCP), transverse dimension (TP), anteroposterior dimension (APP) and patellar angle (PA), were obtained from CTA images. Results: The statistical analysis proved that sex differences of all variables, except for PA, were statistically significant (p < 0,001). Conclusions: Patellar measurements can be helpful in sex determination in the Polish population. CT is a useful tool for skeleton-based sex identification

Assessment of the effects of low molecular heparins in pulmonary embolism prophylaxis

Introduction: Pulmonary embolism (PE) is a severe condition that can be the source of significant morbidity and mortality. It is the major complication of venous thromboembolism (VTE) which, by occluding the pulmonary arterial bed may lead to an acute life-threatening state. The clinical management of patients with acute pulmonary embolism has rapidly changed over the years. After the diagnosis of the PE, the anticoagulant and thrombolytic therapy is initiated. Most commonly, low molecular weight heparins (LMWH), unfractionated heparins (UFH), fondaparinux or vitamin K antagonists are used for the anticoagulant therapy. However, LMWH are still uncertain agents, both in the PE prophylaxis and in the high-risk PE cases. Objective: The aim of the article is to assess the effects of LMWH in the pulmonary embolism prophylaxis. State of knowledge: A range of clinical and epidemiological studies have shown the relationship between the anticoagulant therapy using the LMWH in the PE prophylaxis. Lower risk of not only PE but also therapy-induced haemorrhages, blood clots and embolisms recurrences were proven in several meta-analyses. Moreover, the LMWH therapy seems to have a better impact on prevention of VTE symptoms and post-surgical embolisms than other anticoagulant agents. However, some studies have shown that the therapy using LMWH can be replaced with another anticoagulant with a comparable risk of complications. Conclusion: In the light of this informations, it is surely possible that the LMWH has a better impact in the PE prophylaxis and post-surgical complications prevention than other agents. Still, we can face various results of the studies but the effectiveness of their activity in most cases leaves no doubt for the reasonableness of their usage

Testing the Validity of Patellar Measurements in Sex Estimation – A Computed Tomography Study in a Contemporary Polish Population

JAKUBIK, Karol, JEŻAK, Mikołaj, NOWIŃSKA, Aleksandra, GRUDZIEŃ, Monika, PIECH, Piotr, KARPIŃSKA, Justyna and STAŚKIEWICZ, Grzegorz. Testing the Validity of Patellar Measurements in Sex Estimation – A Computed Tomography Study in a Contemporary Polish Population. Journal of Education, Health and Sport. 2023;20(1):156-168. eISSN 2391-8306. DOI http://dx.doi.org/10.12775/JEHS.2023.20.01.015 https://apcz.umk.pl/JEHS/article/view/46149 https://zenodo.org/record/8379001 The journal has had 40 points in Ministry of Education and Science of Poland parametric evaluation. Annex to the announcement of the Minister of Education and Science of 17.07.2023 No. 32318. Has a Journal's Unique Identifier: 201159. Scientific disciplines assigned: Physical Culture Sciences (Field of Medical sciences and health sciences); Health Sciences (Field of Medical Sciences and Health Sciences). Punkty Ministerialne z 2019 - aktualny rok 40 punktów. Załącznik do komunikatu Ministra Edukacji i Nauki z dnia 17.07.2023 Lp. 32318. Posiada Unikatowy Identyfikator Czasopisma: 201159. Przypisane dyscypliny naukowe: Nauki o kulturze fizycznej (Dziedzina nauk medycznych i nauk o zdrowiu); Nauki o zdrowiu (Dziedzina nauk medycznych i nauk o zdrowiu). © The Authors 2023; This article is published with open access at Licensee Open Journal Systems of Nicolaus Copernicus University in Torun, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author (s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial license Share alike. (http://creativecommons.org/licenses/by-nc-sa/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 08.09.2023. Revised: 15.09.2023. Accepted: 26.09.2023. Published: 27.09.2023. Testing the Validity of Patellar Measurements in Sex Estimation – A Computed Tomography Study in a Contemporary Polish Population Karol Jakubik1, Mikołaj Jeżak1, Aleksandra Nowińska1, Monika Grudzień1, Piotr Piech2, Justyna Karpińska2, Grzegorz Staśkiewicz2 1Student Research Group at the Department of Clinical and Radiological Anatomy, Medical University of Lublin, Poland 2Department of Clinical and Radiological Anatomy, Medical University of Lublin, Poland Correspondence to: Karol Jakubik [email protected] Abstract Introduction and purpose: Human skeleton-based sex estimation is a major topic of interest for forensic anthropologists. Various bones have been examined for sex heterogeneity. The most commonly used include skull and pelvis, however they may not always be used due to damage or fragmentation. The patella has been shown to be resistant to postmortem changes, which creates a potential use for determining the sex of unknown human remains. Materials and methods: The samples were gathered from patients examined by computed tomography angiography (CTA) of lower extremities in University Hospital No. 4 in Lublin. Exclusion criteria included patellar fractures, knee replacement and advanced osteoporosis. A total of 120 CTA examinations of 65 males and 55 females, were included in the analysis. Four measurements for every patella: craniocaudal patella dimension (CCP), transverse dimension (TP), anteroposterior dimension (APP) and patellar angle (PA), were obtained from CTA images. Results: The statistical analysis proved that sex differences of all variables, except for PA, were statistically significant (p < 0,001). Conclusions: Patellar measurements can be helpful in sex determination in the Polish population. CT is a useful tool for skeleton-based sex identification. Keywords: Sex Estimation; Sexual Dimorphism; Patella; Forensic Anthropology; Multidetector Computed Tomograph

Possibilities of using intestinal microflora transplantation in the treatment of gastrointestinal diseases

The number of Clostridium difficile infections (CDI) has significantly increased in Poland and throughout Europe. Their treatment involves the administration of metronidazole, vancomycin or fidaxomicin as indicated in current recommendations. Despite proper approach to the treatment, numerous recurrences of Clostridium difficile are reported. Fecal microflora transplant (FMT) is an alternative yet effective method of treatment of CDI. Moreover, this method is increasingly implemented in other disease entities.   DESCRIPTION OF THE PROBLEM: Fecal microflora transplant (FMT) is a safe method of treating intestinal dysbiosis. The therapy is based on transferring the stool suspension from a healthy human (donor) to the patient (recipient). The transplant can be performed by oral route (through the gastric/duodenal probe) or via the rectal route (colonoscopy). The donor of the FMT material must give an informed consent to have performed numerous blood and stool tests that are included in the donor selection procedures. The day before transplant, the recipient has to take the last dose of vancomycin taken in the 14-day treatment