This systematic review aimed to summarize the available data on the treatment of pulmonary contusions with exogenous surfactants, determine whether this treatment benefits patients with severe pulmonary contusions, and evaluate the optimal type of surfactant, method of administration, and drug concentration. Three databases (MEDline, Scopus, and Web of Science) were searched using the following keywords: pulmonary surfactant, surface-active agents, exogenous surfactant, pulmonary contusion, and lung contusion for articles published between 1945 and February 2023, with no language restrictions. Four reviewers independently rated the studies for inclusion, and the other four reviewers resolved conflicts. Of the 100 articles screened, six articles were included in the review. Owing to the limited number of papers on this topic, various types of studies were included (two clinical studies, two experiments, and two case reports). In all the studies, surfactant administration improved the selected ventilation parameters. The most frequently used type of surfactant was Curosurf® in the concentration of 25 mg/kg of ideal body weight. In most studies, the administration of a surfactant by bronchoscopy into the segmental bronchi was the preferable way of administration. In both clinical studies, patients who received surfactants required shorter ventilation times. The administration of exogenous surfactants improved ventilatory parameters and, thus, reduced the need for less aggressive artificial lung ventilation and ventilation days. The animal-derived surfactant Curosurf® seems to be the most suitable substance; however, the ideal concentration remains unclear. The ideal route of administration involves a bronchoscope in the segmental bronchi.

• MeSH
• bronchoskopie metody   MeSH
• lidé MeSH
• plicní surfaktanty * aplikace a dávkování   terapeutické užití   MeSH
• poškození plic * farmakoterapie   etiologie   MeSH
• syndrom dechové tísně * farmakoterapie   etiologie   MeSH
• umělé dýchání metody   MeSH
• výsledek terapie MeSH
• zhmoždění * farmakoterapie   MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH

Pneumoperitoneum jako nález na zobrazovacích vyšetřeních není vždy jasnou známkou perforační náhlé příhody břišní. Nález je nutné dát do souvislosti s klinickým stavem a obtížemi pacienta, jelikož se může jednat o spontánní či nechirurgické pneumoperitoneum. Tento stav je opakovaně popisován, avšak velice často opomíjen. V této práci přinášíme kazuistiku pacienta s nechirurgickým pneumoperitoneem, kde, ačkoliv bylo postupováno podle doporučení, nebyla nalezena očekávaná intraabdominální patologie vysvětlující obtíže pacienta.

Pneumoperitoneum as a finding on imaging examinations is not always a sign of acute abdomen due to gastrointestinal perforation. These findings must be viewed in connection with the clinical condition and personal history of each patient because they may also indicate a non-surgical or spontaneous pneumoperitoneum. This condition is repeatedly described but very often neglected. This paper presents the case report of a patient with non-surgical pneumoperitoneum where, despite proceeding according to the guidelines, no expected intra-abdominal pathology explaining the patient’s problems was found.

• Klíčová slova
• nechirurgické pneumoperitoneum,
• MeSH
• akutní bolest břicha diagnostické zobrazování   MeSH
• laparotomie metody   MeSH
• lidé MeSH
• pneumatosis cystoides intestinalis * diagnostické zobrazování   MeSH
• pneumoperitoneum diagnostické zobrazování   etiologie   patologie   MeSH
• senioři MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• kazuistiky MeSH

INTRODUCTION: Adhesions are the most common cause of long-term morbidity after abdominal surgery and most often cause various forms of intestinal passage disorders ranging from partial obstruction to complete, life-threatening intestinal obstruction. The aim of the present study was to evaluate the protective effect of intraperitoneally administered lipid emulsions on the formation of adhesions in larger animal model, as the lubricating effect of phospholipids and the mechanical barrier of the lipid component are combined with the anti-inflammatory effect of fish oil. METHODS: Thirty-one female domestic pigs were randomly divided into three groups. At the end of the surgical procedure, a lipid emulsion or saline solution was applied intraperitoneally. After 14 days, an independent macroscopic, histological and immunohistochemical evaluation of the adhesions were performed. RESULTS: Intraperitoneal administration of lipid emulsions significantly reduced the incidence of intra-abdominal adhesions. Microscopic examination demonstrated a significant reduction in the number of inflammatory elements and the amount of collagen in the adhesions, especially after administration of the fish oil-based emulsion. A simultaneous decrease in neovascularization was observed in the adhesions. Evaluation of the intestinal anastomosis did not reveal significant differences in healing between the groups. CONCLUSION: Intraperitoneal administration of lipid emulsions can reduce the development of postoperative intra-abdominal adhesions by the combined action of phospholipids as important lubricants and lipids as a mechanical barrier. Their effect is caused by a reduction in proinflammatory and profibrotic mediators. At the same time, intraperitoneal administration of lipid emulsions does not impair healing of the anastomosis in larger animal model.

• MeSH
• adheze tkání etiologie   prevence a kontrola   patologie   MeSH
• anastomóza chirurgická metody   MeSH
• emulze MeSH
• pooperační komplikace * prevence a kontrola   patologie   MeSH
• rybí oleje * terapeutické užití   MeSH
• zvířata MeSH
• Check Tag
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• randomizované kontrolované studie veterinární MeSH

Kolorektální trauma se v soudobých válečných konfliktech vyskytuje v 5–10 %. Nejčastější příčinou je střelné nebo střepinové poranění, kontuzně-lacerační mechanismus je ve válečné zóně ojedinělý. I přes moderní léčebné postupy je ale zatíženo vysokou mírou morbidity, zejména pokud není včas diagnostikováno a léčeno. Management chirurgické léčby upřesňují jednoduchá skórovací schémata – colon injury scale, rectal injury scale a Flintův skórovací systém. Resekční výkony tračníku s primární nebo odloženou anastomózou nemají vyšší riziko komplikovaného hojení a v dnešní době jsou upřednostňovány před konstrukcí terminálních stomií. Ty jsou indikovány při závažné oběhové nestabilitě při hemoragicko-traumatickém nebo septickém šoku s pokročilou difuzní peritonitidou. K traumatu intraperitoneálního segmentu rekta se přistupuje stejně jako k tračníku. Poranění extraperitoneálního rekta bez devastace měkkých tkání může být ošetřeno transanální suturou nebo i bez ní. Naopak devastující poranění rekta spolu s měkkými tkáněmi pánve se mají primárně zajistit derivační stomií a odloženou rekonstrukcí. Presakrální drenáž nebo laváž rekta již nejsou doporučovány.

The rate of colorectal trauma is 5–10 % in modern war conflicts. The most common causes include gunshots or shrapnel injuries; the contusion-laceration mechanism occurs in sporadic cases in the war zone. Despite modern surgical procedures, however, it is associated with a high rate of morbidity, especially if it is not diagnosed and treated in time. Surgical management is specified by simple scoring schemes – the colon injury scale, rectal injury scale and the Flint grading system. Colonic resection with primary or delayed anastomosis is not associated with a higher risk of complicated healing and is nowadays preferred over the construction of terminal stomas. These are indicated only for cases with severe hemodynamic instability in traumatic-hemorrhagic or septic shock with severe diffuse peritonitis. Trauma to the intraperitoneal segment of the rectum is treated in the same way as trauma to the colon. An extraperitoneal rectal injury without soft tissue devastation can be treated with or without a transanal suture. On the contrary, devastating injuries to the rectum including the pelvic soft tissues should be primarily controlled with a stoma with delayed reconstruction. Presacral drainage or rectal stump lavage are no longer recommended.

• MeSH
• anastomóza chirurgická MeSH
• kolon chirurgie   diagnostické zobrazování   zranění   MeSH
• lidé MeSH
• penetrující rány * chirurgie   diagnostické zobrazování   MeSH
• poranění břicha chirurgie   diagnostické zobrazování   MeSH
• rektum chirurgie   diagnostické zobrazování   zranění   MeSH
• válečná poranění * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• práce podpořená grantem MeSH

PURPOSE: The aim of this experimental study was to test the method of prevention of postoperative complications, especially infectious, in partial dehiscence following stapler anastomosis in rectal surgeries. METHODS: The method includes the application of a hyaluronic acid-based gel in combination with triclosan, which has antibacterial properties. The gel was applied to the space around the rectum with an artificial, precisely defined dehiscence so that the dehiscence was separated from the rest of pelvis and the peritoneal cavity to avoid the spread of infection. The study included 30 female pigs. The rectosigmoid colon was mobilized and transected completely. Anastomosis was constructed with circular staplers. A perforator was then used to create precisely defined artificial dehiscence. Subsequently the lesser pelvis was filled with hyaluronic gel such that the site of artificial dehiscence was covered completely. RESULTS: All animals survived for 14 days until the second-look revision with no signs of failure in the anastomosis healing, local inflammation, and sepsis or postoperative complications, such as chills, refusal of liquid or feed, abdominal distension, and bowel obstruction. CONCLUSION: Hyaluronic acid applied as a precursor solution around the rectal anastomosis fills the lesser pelvis perfectly. It prevents the leakage of intestinal contents in the lesser pelvis. Triclosan as an antibacterial substance prevents the spread of inflammation in the pelvis or even in the abdominal cavity.

• MeSH
• anastomóza chirurgická metody   MeSH
• antibakteriální látky terapeutické užití   MeSH
• kyselina hyaluronová MeSH
• lidé MeSH
• nádory rekta * chirurgie   MeSH
• netěsnost anastomózy MeSH
• pánev chirurgie   MeSH
• pooperační komplikace prevence a kontrola   MeSH
• prasata MeSH
• rektum chirurgie   MeSH
• triclosan * MeSH
• zánět MeSH
• zvířata MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Background: Liver resection is a surgical procedure associated with a high risk of hepatic failure that can be fatal. One of the key mechanisms involves ischemia-reperfusion damage. Building on the well-known positive effects of hydrogen at mitigating this damage, the goal of this work was to demonstrate the antioxidant, anti-inflammatory, and anti-apoptotic effects of inhaled hydrogen in domestic pigs during major liver resection. Methods: The study used a total of 12 domestic pigs, 6 animals underwent resection with inhaled hydrogen during general anesthesia, and 6 animals underwent the same procedure using conventional, unsupplemented, general anesthesia. Intraoperative preparation of the left branch of the hepatic portal vein and the left hepatic artery was performed, and a tourniquet was applied. Warm ischemia was induced for 120 minutes and then followed by liver reperfusion for another 120 minutes. Samples from the ischemic and non-ischemic halves of the liver were then removed for histological and biochemical examinations. Results: An evaluation of histological changes was based on a numerical expression of damage based on the Suzuki score. Liver samples in the group with inhaled hydrogen showed a statistically significant reduction in histological changes compared to the control group. Biochemical test scores showed no statistically significant difference in hepatic transaminases, alkaline phosphatase (ALP), lactate dehydrogenase (LD), and lactate. However, a surprising result was a statistically significant difference in gamma-glutamyl-transferase (GMT). Marker levels of oxidative damage varied noticeably in plasma samples. Conclusions: In this experimental study, we showed that inhaled hydrogen during major liver resection unquestionably reduced the level of oxidative stress associated with ischemia-reperfusion damage. We confirmed this phenomenon both histologically and by direct measurement of oxidative stress in the organism.

• Publikační typ
• časopisecké články MeSH

A combination of hard sphere and high internal phase emulsion templating gives a platform for synthesizing hierarchically porous polymers with a unique topology exhibiting interconnected spherical features on multiple levels. Polymeric spheres are fused by thermal sintering to create a 3D monolithic structure while an emulsion with a high proportion of internal phase and monomers in the continuous phase is added to the voids of the previously constructed monolith. Following polymerization of the emulsion and dissolution of the templating structure, a down-replicating topology is created with a primary level of pores as a result of fused spheres of the 3D monolithic structure, a secondary level of pores resulting from the emulsion's internal phase, and a tertiary level of interconnecting channels. Thiol-ene chemistry with divinyladipate and pentaerythritol tetrakis(3-mercaptopropionate) is used to demonstrate the preparation of a crosslinked polyester with overall porosity close to 90%. Due to multilevel porosity, such materials are interesting for applications in bone tissue engineering, possibly simulating the native sponge like bone structure. Their potential to promote ossteointegration is tested using human bone derived osteoblasts. Material-cell interactions are evaluated and they reveal growth and proliferation of osteoblasts both on surface and in the bulk of the scaffold.

• MeSH
• emulze chemie   MeSH
• kosti a kostní tkáň fyziologie   MeSH
• lidé MeSH
• modul pružnosti MeSH
• osteoblasty cytologie   MeSH
• polymethylmethakrylát chemie   MeSH
• poréznost MeSH
• teplota MeSH
• tkáňové inženýrství metody   MeSH
• tkáňové podpůrné struktury chemie   MeSH
• tvrdost MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

• MeSH
• biotechnologie MeSH
• polymery MeSH
• výzkum MeSH
• Publikační typ
• příležitostné publikace MeSH
• sborníky MeSH

• Konspekt
• Fyziologie člověka a srovnávací fyziologie
• NLK Obory
• chemie, klinická chemie
• fyziologie

• Klíčová slova
• apremilast,
• MeSH
• biologická terapie MeSH
• imunosupresiva MeSH
• inhibitory fosfodiesterasy 4 terapeutické užití   MeSH
• komorbidita MeSH
• kvalita života MeSH
• lidé středního věku MeSH
• lidé MeSH
• methotrexát aplikace a dávkování   terapeutické užití   MeSH
• pruritus MeSH
• psoriáza * farmakoterapie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

Blends of two biodegradable polymers, poly(lactic acid) (PLA) and poly(ϵ-caprolactone) (PCL), with strong synergistic improvement in mechanical performance were prepared by melt-mixing using the optimized composition (80/20) and the optimized preparation procedure (a melt-mixing followed by a compression molding) according to our previous study. Three different PLA polymers were employed, whose viscosity decreased in the following order: PLC ≈ PLA1 > PLA2 > PLA3. The blends with the highest viscosity matrix (PLA1/PCL) exhibited the smallest PCL particles (d∼0.6μm), an elastic-plastic stable fracture (as determined from instrumented impact testing) and the strongest synergistic improvement in toughness (>16× with respect to pure PLA, exceeding even the toughness of pure PCL). According to the available literature, this was the highest toughness improvement in non-compatiblized PLA/PCL blends ever achieved. The decrease in the matrix viscosity resulted in an increase in the average PCL particle size and a dramatic decrease in the overall toughness: the completely stable fracture (for PLA1/PCL) changed to the stable fracture followed by unstable crack propagation (for PLA2/PCL) and finally to the completely brittle fracture (for PLA3/PCL). The stiffness of all blends remained at well acceptable level, slightly above the theoretical predictions based on the equivalent box model. Despite several previous studies, the results confirmed that PLA and PCL could behave as compatible polymers, but the final PLA/PCL toughness is extremely sensitive to the PCL particle size distribution, which is influenced by both processing conditions and PLA viscosity. PLA/PCL blends with high stiffness (due to PLA) and toughness (due to PCL) are very promising materials for medical applications, namely for the bone tissue engineering.

• MeSH
• polyestery analýza   MeSH
• polymery MeSH
• viskozita * MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH