INTRODUCTION: Hypertrophic scars are an unwanted and mutilating consequence of deep burns, and are further exacerbated by extensive burn injuries. Fractional CO2 laser therapy is one of the methods for complex treatment of hypertrophic scars, it has been used since 2007 [1]. Although its effectiveness has been objectively proven in clinical practice, the optimal settings parameters have not been determined. To evaluate the effect of laser therapy, previously designed evaluation tools are used, which evaluate the quality of scars well, but fail to capture specific changes for the performed laser therapy. MATERIAL AND METHODS: Fractional CO2 laser therapy of hypertrophic scars is performed at the Department of Plastic and Esthetic Surgery, University Hospital Olomouc, since 2017 and the systematic study took place in 2019-2020. In common, 25 hypertrophic scars were treated in 13 patients; each scar was treated by fractional CO2 laser therapy more than once. RESULTS: Statistical analysis detected statistically significant improvement of the texture of the scars and the improvement of overall functional and esthetic result. We found significant reduction of the height under 2 mm (62,5% of scars) in scars with the height > 2 mm before the initiation of laser therapy. Correlation analysis detected a statistically significant positive correlation between the energy of laser beam and the reduction volume of the scar protruding above the niveau of healthy surrounding tissue. Fractional CO2 laser therapy showed statistically significant efficacy in the reduction of the risks associated with full-format CO2 laser-therapy. Fractional treatment was very well tolerated by the patients. Topical 5% lidocaine gel was effective in 24 out of 25 patients. Further healing was without complications in all patients. CONCLUSION: Fractional CO2 laser therapy has achieved statistically significant improvement of the texture and reduction of hypertrophic scars and overall improvement of functional and esthetic result in our study.
- Keywords
- evaluation of efficacy and treatment protocol optimization. Acta Chir Plast. 2021, 63(4): 171–180., fractional CO2 laser, hypertrophic scars, setting parameters, therapy efficacy Klosová H., Xinopulos P., Zálešák B., Lamgová K. Fractional CO2 laser therapy of hypertrophic scars,
- MeSH
- Cicatrix, Hypertrophic * etiology pathology surgery MeSH
- Cicatrix MeSH
- Clinical Protocols MeSH
- Laser Therapy * MeSH
- Lasers, Gas * therapeutic use MeSH
- Humans MeSH
- Carbon Dioxide MeSH
- Burns * complications surgery MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Carbon Dioxide MeSH
In comparison with mammals, the fertilization of fish occurs predominantly outside the organism in a water environment, where fish spermatozoa require specific conditions to interact with oocytes. It is evident that optimal conditions for fish and mammalian spermatozoa are quite different. This paper describes a special approach to handling fish (common carp and Siberian sturgeon) spermatozoa in comparison with the samples originating from mammals (boar). This approach concerns not only the differences in the composition of the media applied but also primarily emphasizes the concrete parts of the immunofluorescence protocol determining accurate results. Individual parts of the protocol for indirect immunofluorescence of mammalian sperm were changed step by step and modified protocols were applied to immunofluorescence experiments with carp and sturgeon spermatozoa. By evaluating the changes in the integrity of the fish sperm head and flagellum, we selected the steps and corresponding conditions that are crucial for handling the fish spermatozoa. Based on our results, it may be concluded that when working with fish spermatozoa, the cells attached to the microscopic slides must not desiccate prior to the fixation, which is a usual step when working with mammalian sperm. The second crucial step is the necessity to fix the fish spermatozoa, especially when the research is focused on the structure of the flagellum. The impact of the temperature conditions is rather low, but working at low temperatures, except for the period of incubation with antibodies, leads to a higher number of unaffected cells.
- MeSH
- Fluorescent Antibody Technique veterinary MeSH
- Immunohistochemistry veterinary MeSH
- Fishes physiology MeSH
- Spermatozoa physiology MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Research Support, Non-U.S. Gov't MeSH
This article introduces a new approach in the field of network optimization based on Transmission Optimization Metric (TOM), which is aimed at improving traffic flow continuity and increasing the chances for traffic flow sustainability in a way that helps to minimize inter-packet gaps. The work is mainly focused on harsh transmission conditions in narrow-band networks. Finally, the presented approach has impact on better resource allocation as fewer attempts are necessary for successful completion of a transmission. A significant part of the article deals with parameterization of coefficients used by the TOM optimization method. Examples of analysis for several topologies of narrow-band wireless networks based on CSMA/CA and TDMA protocols are used to demonstrate various issues related to proper setting of parameters. The introduced TOM metric has the potential to become a standard for optimization, for example, in sensor networks that are characterized by the specific nature of data traffic.
- Keywords
- Transmission Optimization Metric, inter-packet gaps analysis, narrow-band networks, protocol optimization, sensor networks,
- Publication type
- Journal Article MeSH
ERAS (enhanced recovery after surgery) represents a comprehensive strategy aimed at expediting patient recovery, reducing complications, and optimizing postoperative care. The ERAS protocol encompasses recommendations for the preoperative, perioperative, and postoperative phases of patient care. Implementation of the ERAS protocol yields a multitude of benefits for both patients and the healthcare system. It shortens hospital stays, diminishes the number and severity of postoperative complications, and enhances patient's quality of life. These factors contribute to healthcare cost sav-ings and improved bed turnover efficiency. Rigorous adherence to the ERAS protocol is paramount to achieving optimal outcomes. The comprehensive ERAS strategy thus marks a paradigm shift in perioperative care and emerges as an indispensable standard in liver and pancreatic surgery.
- Keywords
- Enhanced Recovery After Surgery, complications, liver and pancreatic surgery, perioperative car, perioperative care,
- MeSH
- Liver * surgery MeSH
- Clinical Protocols standards MeSH
- Humans MeSH
- Pancreas * surgery MeSH
- Perioperative Care standards MeSH
- Postoperative Complications prevention & control MeSH
- Enhanced Recovery After Surgery * standards MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
Due to limitations in commercial diagnostic methods, this study aimed to develop a reliable real-time polymerase chain reaction (Rt-PCR) assay for early diagnosis of brucellosis. Optimization of the Rt-PCR method was performed on serum samples spiked by Brucella melitensis with different densities ranging from 101 to 108 colony-forming units (cfu)/mL; each density was prepared in ten samples. The limit of detection was investigated by using Thermo DNA extraction kit with Maxima SYBR Green Rt-PCR and two TaqMan probe-based Rt-PCR protocols performed by QuantiTect and TEMPase multiplex PCR master mixes in two thermal cyclers, which were Rotor-Gene and Bio-Rad. The validation of the optimized protocol was carried on 20 brucellosis-negative samples and 20 samples spiked with B. melitensis by using a combination of Thermo DNA extraction kit with TEMPase PCR master mix. SYBR Green Rt-PCR yielded positive results on all samples having ≥ 104 cfu/mL of B. melitensis in both thermal cyclers. Its limit of detection was 112 DNA copies per reaction. The positivity of both probe-based Rt-PCR protocols was 100% and 80% on the samples having 103 cfu/mL and 102 cfu/mL of B. melitensis, respectively. The limit of detection of probe-based protocols was defined as 4 DNA copies per reaction. The optimized Rt-PCR protocol showed high-level accuracy, precision, specificity, and sensitivity, each having a rate of 100%. The current study indicated that the TaqMan probe-based Rt-PCR protocol optimized and validated with serum samples can be reliably used for early diagnosis of brucellosis.
Hepatectomies play a crucial role in the multidisciplinary management of primary and secondary liver malignancies but are associated with significant risks, including 30-day mortality, morbidity, prolonged hospitalization, and increased resource utilization. Optimizing perioperative care remains a challenge; however, enhanced recovery programs have shown improved patient outcomes. The EUPEMEN (EUropean PErioperative MEdical Networking) protocol focuses on improving the perioperative management of liver resections through the establishment of interdisciplinary principles based on practical experience and theoretical frameworks from five European countries. This paper outlines the core elements of the EUPEMEN protocol, emphasizing strategies to minimize surgical stress, optimize perioperative care, and enhance postoperative recovery. The protocol is systematically designed to reduce postoperative mortality and morbidity, shorten hospital stays, and improve patient outcomes. The EUPEMEN guidelines address inconsistencies in surgical practice across Europe and are structured for implementation in various healthcare environments. "The protocol's approach is designed to support improvements in perioperative care standards in liver resections and may serve as a practical and efficient tool for healthcare professionals, pending further clinical validation. The EUPEMEN protocol offers a standardized, evidence-based framework to enhance perioperative management in hepatectomies. By integrating multidisciplinary principles, the main target is to eliminate complications, improve surgical outcomes, and promote faster recovery. Its implementation across diverse clinical settings may contribute to advancing perioperative care standards for liver resections in Europe.
- Keywords
- EUPEMEN project, enhanced recovery after surgery, liver resections, liver surgery, liver surgery guidelines, perioperative care, training and dissemination,
- MeSH
- Hepatectomy * methods standards MeSH
- Clinical Protocols MeSH
- Humans MeSH
- Liver Neoplasms surgery MeSH
- Perioperative Care * methods standards MeSH
- Postoperative Complications prevention & control MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Review MeSH
- Geographicals
- Europe MeSH
BACKGROUND: Exercise capacity is well known to be an important prognostic factor in patients with cardiovascular disease and among healthy persons. AIM: To determine if there are any differences between the peak exercise response during exercise treadmill testing with the individualized ramp protocol and the modified Bruce protocol in elderly patients. MATERIALS AND METHODS: The study included 40 patients (both male and female), aged 70 years and older, who had not had a baseline history of the confirmed coronary artery disease or heart failure diagnoses. All patients underwent exercise treadmill testing using modified Bruce protocol and individualized ramp protocol for 2 consecutive days. Peak heart rate, peak systolic and diastolic blood pressure, peak pressure-rate double product, exercise duration, and peak metabolic equivalents were recorded in both tests. Perceived level of exertion was evaluated using the Borg 10-point scale. RESULTS: The average duration of exercise was longer for the ramp protocol than for the modified Bruce protocol. When the modified Bruce protocol was used, patients achieved a lower workload than they did in using the ramp protocol. The rating of perceived exertion using the revised Borg scale (0 to 10) was 5.6±1.4 for the ramp protocol and 8.7±1.4 for the modified Bruce protocol, which indicates that the patients found the ramp protocol easier. CONCLUSION: In elderly patients the individualized ramp treadmill protocol allows to achieve the optimal test duration with higher degrees of workload and greater patient comfort during the test more often than does the modified Bruce protocol.
- Keywords
- elderly adults, exercise capacity, exercise treadmill testing, individualized ramp protocol, modified Bruce protocol,
- MeSH
- Blood Pressure * MeSH
- Humans MeSH
- Metabolic Equivalent MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Oxygen Consumption * MeSH
- Heart Rate * MeSH
- Physical Exertion MeSH
- Exercise Tolerance * MeSH
- Exercise Test methods MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
PURPOSE OF THE STUDY: To evaluate the clinical results and safety of fungal periprosthetic joint Infections (fPJIs) using two-stage treatment protocol. MATERIAL AND METHODS: 8 patients with fPJIs (3 hips and 5 knees) using two-stage revision were reviewed retrospectively and followed up at least 2 years. The preoperative demographic data, two-stage treatment protocol, results of microbiology and histologic workup and postoperative follow-up results (reimplantation success rate and infection free time) were recorded. RESULTS: 7 patients got successful reimplantation, with a 75% reimplantation success rate. Two patients got knee arthrodesis eventually. All patients were infection free with a median follow-up of 4.0 ± 2.0 years (range, 2-7 years). Of them, Candida species were found in 7 patients, while non-Candida specimen was only isolated in 1 patient with Aspergillus. Only 2 patients had coexisting bacterial infection (Methicillin-resistant coagulase-negative Staphylococci and Proteus mirabilis respectively). The average interval between the initial surgery and diagnosis of fPJIs was 21.50±34.79 months (range, 4-104 months). The mean time of spacer implantation was 7.75±2.77 months (range, 6-14 months). None serious complication or above knee amputation was found. DISCUSSION: fPJIs are very rare and considerable challenge after total hip or knee arthroplasty. The goal of therapy is to eradicate local infection and maintain function. Candida species were the most common pathogen. The duration between spacer placement and staged reimplantation was highly variable, and generally dependent upon the results of joint aspirates and infl ammatory markers. The current study shows that the two-stage treatment protocol is recommended for fungal periprosthetic hip and knee joint infections. CONCLUSIONS: The two-stage treatment protocol is recommended for fungal periprosthetic hip and knee joint infections. The safety and effi cacy of biantibiotical impregnated (antifungal + antibiotics) cement spacer is confi rmed. Further evidence-based work is needed to determine the optimal drug dose and reimplantation time. KEY WORDS: two-stage treatment protocol, fungal periprosthetic infections, hip spacer, knee spacer.
- MeSH
- Amputation, Surgical MeSH
- Clinical Protocols MeSH
- Knee Joint * surgery MeSH
- Humans MeSH
- Retrospective Studies MeSH
- Arthroplasty, Replacement, Knee * adverse effects MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
The performance of any communication system heavily relies on the efficient routing of interventions. This article addresses the significant issue of routing protocol selection for optimal path determination in networks. Particularly, when wireless communication occurs among mobile nodes with limited resources, such as batteries, the routing problem becomes even more challenging. This article proposes the Fuzzy Control Energy Efficient (FCEE) routing protocol to overcome these challenges. The FCEE protocol combines the Ad-Hoc On-Demand Distance Vector (AODV) protocol with fuzzy logic techniques to enhance network lifetime and performance. The proposed approach introduces a memory-based channel integrated with fuzzy logic methodologies, which effectively restricts the forwarding of unnecessary broadcast packets based on the energy availability of the operating node. Through extensive simulations, demonstrate the promising capabilities of FCEE as a routing protocol for wireless mesh networks. To further assess the effectiveness of the FCEE protocol, the proposed article compares it with two existing routing protocols: AODV and Intelligent Routing AODV (IRAODV). The simulation results shows that the FCEE routing protocol significantly enhances the reliability of the conventional AODV, providing improved link connectivity and longer route lifetimes. Additionally, our proposed protocol enhances the quality of service (QoS) for mesh routing, with an average throughput of 351.374 (Kbps) compared to 90 (Kbps) for IRAODV and 39 (Kbps) for AODV. Moreover, FCEE exhibits superior energy efficiency with an average energy consumption of 14, while IRAODV and AODV consume 40 and 90 joules, respectively. In conclusion, the FCEE routing protocol demonstrates its potential to address the challenges of efficient routing in wireless mesh networks. By leveraging fuzzy logic and integrating it with AODV, FCEE enhances network lifetime, performance, and energy efficiency, making it a promising solution for future wireless communication systems.
- Keywords
- AODV, Fuzzy logic, MANET, MESH, Memory channel, Routing protocol,
- Publication type
- Journal Article MeSH
PURPOSE: To assess the efficacy of the novel clinical formulation of fenretinide (LAU-7b) for the treatment of allergic asthma. To study the association between LAU-7b treatment in allergic asthma and the modulation of very long chain ceramides (VLCC). METHODS: We used two allergens (OVA and HDM) to induce asthma in mouse models and we established a treatment protocol with LAU-7b. The severity of allergic asthma reaction was quantified by measuring the airway resistance, quantifying lung inflammatory cell infiltration (Haematoxylin and eosin stain) and mucus production (Periodic acid Schiff satin). IgE levels were measured by ELISA. Immunophenotyping of T cells was done using Fluorescence-activated cell sorting (FACS) analysis. The analysis of the specific species of lipids and markers of oxidation was performed using mass spectrometry. RESULTS: Our data demonstrate that 10 mg/kg of LAU-7b was able to protect OVA- and HDM-challenged mice against increase in airway hyperresponsiveness, influx of inflammatory cells into the airways, and mucus production without affecting IgE levels. Treatment with LAU-7b significantly increased percentage of regulatory T cells and CD4+ IL-10-producing T cells and significantly decreased percentage of CD4+ IL-4-producing T cells. Our data also demonstrate a strong association between the improvement in the lung physiology and histology parameters and the drug-induced normalization of the aberrant distribution of ceramides in allergic mice. CONCLUSION: 9 days of 10 mg/kg of LAU-7b daily treatment protects the mice against allergen-induced asthma and restores VLCC levels in the lungs and plasma.
- Keywords
- LAU-7b, allergic asthma, fenretinide, very long chain ceramides,
- MeSH
- Allergens immunology MeSH
- Asthma drug therapy immunology metabolism MeSH
- Ceramides metabolism MeSH
- Fenretinide therapeutic use MeSH
- Clinical Protocols MeSH
- Methylcellulose chemistry MeSH
- Disease Models, Animal MeSH
- Mice MeSH
- Ovalbumin immunology MeSH
- Drug Compounding MeSH
- Pyroglyphidae immunology MeSH
- Animals MeSH
- Check Tag
- Male MeSH
- Mice MeSH
- Female MeSH
- Animals MeSH
- Publication type
- Journal Article MeSH
- Names of Substances
- Allergens MeSH
- Ceramides MeSH
- Fenretinide MeSH
- Methylcellulose MeSH
- Ovalbumin MeSH
