Comparison of the therapeutic efficacy of magneto-LED therapy and magnetostimulation applied as the adjuvant treatment of venous leg ulcers - preliminary study

PURPOSE

Venous leg ulcers are chronic wounds that are difficult to cure. The aim of the study was to compare the therapeutic efficacy of two methods of physical medicine - magneto-LED therapy and magnetostimulation, applied as adjuvant treatment in the treatment of venous leg ulcers.

METHODS

The study included 81 patients, 37 male (45.6%) and 44 female (54.3%) ones, age range between 45 and 90 years, with venous leg ulcers. The patients were assigned to two study groups: magneto-LED therapy (group 1) or magnetostimulation (group 2). In both groups, a total of 40 daily procedures were performed. Wound healing was evaluated using computerized planimetry and the pain intensity on numeric rating scale.

RESULTS

After treatment, the decrease in healing rate in group 1 was statistically significantly higher in comparison to group 2 (p < 0.001), while a statistically significant reduction in the surface area of ulcers was obtained, amounting on the average from 6.34 ± 1.29 cm2 to 2.31 ± 1.25 cm2 in group 1 (p < 0.001), and from 6.52 ± 1.20 cm2 to 4.79 ± 1.17 cm2 in group 2 (p < 0.001). The percentage changes of ulcers area in group 1 (64.21 ± 17.94%) were statistically significantly greater as compared to group 2 (25.87 ± 14.07%) (p < 0.001). After treatment, the decrease in pain relief in group 1 was statistically significantly higher in comparison to group 2 (p = 0.006), while pain intensity after treatment decreased statistically significantly in both compared groups of patients (p < 0.001).

CONCLUSIONS

Magneto-LED therapy and magnetostimulation caused significant reduction of surface area of the treated venous leg ulcers and pain intensity, yet magneto-LED therapy was more efficient. Both evaluated methods also significantly reduced pain intensity.

Magnetic Resonance Imaging in Breast Cancer Tissue In Vitro after PDT Therapy

Photodynamic therapy (PDT) is increasingly used in modern medicine. It has found application in the treatment of breast cancer. The most common cancer among women is breast cancer. We collected cancer cells from the breast from the material received after surgery. We focused on tumors that were larger than 10 mm in size. Breast cancer tissues for this quantitative non-contrast magnetic resonance imaging (MRI) study could be seen macroscopically. The current study aimed to present findings on quantitative non-contrast MRI of breast cancer cells post-PDT through the evaluation of relaxation times. The aim of this work was to use and optimize a 1.5 T MRI system. MRI tests were performed using a clinical scanner, namely the OPTIMA MR360 manufactured by General Electric HealthCare. The work included analysis of T1 and T2 relaxation times. This analysis was performed using the MATLAB package (produced by MathWorks). The created application is based on medical MRI images saved in the DICOM3.0 standard. T1 and T2 measurements were subjected to the Shapiro-Wilk test, which showed that both samples belonged to a normal distribution, so a parametric t-test for dependent samples was used to test for between-sample variability. The study included 30 sections tested in 2 stages, with consistent technical parameters. For T1 measurements, 12 scans were performed with varying repetition times (TR) and a constant echo time (TE) of 3 ms. For T2 measurements, 12 scans were performed with a fixed repetition time of 10,000 ms and varying echo times. After treating samples with PpIX disodium salt and bubbling with pure oxygen, PDT irradiation was applied. The cell relaxation time after therapy was significantly shorter than the cell relaxation time before PDT. The cells were exposed to PpIX disodium salt as the administered pharmacological substance. The study showed that the therapy significantly affected tumor cells, which was confirmed by a significant reduction in tumor cell relaxation time on the MRI results.

Utility of 1.5 Tesla MRI Scanner in the Management of Small Sample Sizes Driven from 3D Breast Cell Culture

The aim of this work was to use and optimize a 1.5 Tesla magnetic resonance imaging (MRI) system for three-dimensional (3D) images of small samples obtained from breast cell cultures in vitro. The basis of this study was to design MRI equipment to enable imaging of MCF-7 breast cancer cell cultures (about 1 million cells) in 1.5 and 2 mL glass tubes and/or bioreactors with an external diameter of less than 20 mm. Additionally, the development of software to calculate longitudinal and transverse relaxation times is described. Imaging tests were performed using a clinical MRI scanner OPTIMA 360 manufactured by GEMS. Due to the size of the tested objects, it was necessary to design additional receiving circuits allowing for the study of MCF-7 cell cultures placed in glass bioreactors. The examined sample's volume did not exceed 2.0 mL nor did the number of cells exceed 1 million. This work also included a modification of the sequence to allow for the analysis of T1 and T2 relaxation times. The analysis was performed using the MATLAB package (produced by MathWorks). The created application is based on medical MR images saved in the DICOM3.0 standard which ensures that the data analyzed are reliable and unchangeable in an unintentional manner that could affect the measurement results. The possibility of using 1.5 T MRI systems for cell culture research providing quantitative information from in vitro studies was realized. The scanning resolution for FOV = 5 cm and the matrix was achieved at a level of resolution of less than 0.1 mm/pixel. Receiving elements were built allowing for the acquisition of data for MRI image reconstruction confirmed by images of a phantom with a known structure and geometry. Magnetic resonance sequences were modified for the saturation recovery (SR) method, the purpose of which was to determine relaxation times. An application in MATLAB was developed that allows for the analysis of T1 and T2 relaxation times. The relaxation times of cell cultures were determined over a 6-week period. In the first week, the T1 time value was 1100 ± 40 ms, which decreased to 673 ± 59 ms by the sixth week. For T2, the results were 171 ± 10 ms and 128 ± 12 ms, respectively.

Photodynamic Therapy and Cardiovascular Diseases

Cardiovascular diseases are the third most common cause of death in the world. The most common are heart attacks and stroke. Cardiovascular diseases are a global problem monitored by many centers, including the World Health Organization (WHO). Atherosclerosis is one aspect that significantly influences the development and management of cardiovascular diseases. Photodynamic therapy (PDT) is one of the therapeutic methods used for various types of inflammatory, cancerous and non-cancer diseases. Currently, it is not practiced very often in the field of cardiology. It is most often practiced and tested experimentally under in vitro experimental conditions. In clinical practice, the use of PDT is still rare. The aim of this review was to characterize the effectiveness of PDT in the treatment of cardiovascular diseases. Additionally, the most frequently used photosensitizers in cardiology are summarized.

Photodynamic Therapy for Eye, Ear, Laryngeal Area, and Nasal and Oral Cavity Diseases: A Review

Photodynamic therapy (PDT) has emerged as a promising modality for the treatment of various diseases. This non-invasive approach utilizes photosensitizing agents and light to selectively target and destroy abnormal cells, providing a valuable alternative to traditional treatments. Research studies have explored the application of PDT in different areas of the head. Research is focusing on a growing number of new developments and treatments for cancer. One of these methods is PDT. Photodynamic therapy is now a revolutionary, progressive method of cancer therapy. A very important feature of PDT is that cells cannot become immune to singlet oxygen. With this therapy, patients can avoid lengthy and costly surgeries. PDT therapy is referred to as a safe and highly selective therapy. These studies collectively highlight the potential of PDT as a valuable therapeutic option in treating the head area. As research in this field progresses, PDT may become increasingly integrated into the clinical management of these conditions, offering a balance between effectiveness and minimal invasiveness.

Biomechanical properties of masseter muscle assessed through myotonometry in patients with temporomandibular disorder treated with ultrasound therapy: a randomized comparative study

BACKGROUND

The aim of the study was to make an objective quantitative assessment of effectiveness of procedures with the use of a therapeutic dose of ultrasounds in this nosological entity, in connection with improved biomechanical properties and alleviation of pain experienced in masseter muscles.

METHODS

The study included 40 patients with temporomandibular disorder. In group 1 (N.=20) ultrasound therapy (1.2 W/cm2) was carried out, while in group 2 (N.=20) sham therapy was applied. A total of 10 procedures were performed. Myotonometric measurements and assessment of pain intensity were carried out before treatment and after the completion of procedures.

RESULTS

The analysis revealed a significant difference (P=0.011) between the values of decrement (D) measured on day 0 (2.08±0.45 [log]) and day 4 (1.80±0.55 [log]) in group 1. In group 2 no statistically significant differences were noted between the results obtained on consecutive days of the therapeutic cycle. A statistically significant difference in values of decrement (D) between group 1 (1.80±0.55 [log]) and group 2 (2.23±0.51 [log]) was noted on day 4 of the experiment (P=0.021). Both in group 1 and in group 2, a statistically significant reduction of pain intensity (VAS Scale) was obtained.

CONCLUSIONS

The masseter muscle was more elastic during ultrasound therapy. However, the effect was transient. The analgesic effect was also observed in the control group; therefore, a placebo effect cannot be excluded.

Immunomodulatory Effect of Hypericin-Mediated Photodynamic Therapy on Oral Cancer Cells

In 2020, there were 377,713 new oral and lip cancer diagnoses and 177,757 deaths. Oral cancer is a malignancy of the head and neck region, and 90% of cases are squamous cell carcinomas (OSCCs). One of the alternative methods of treating pre-cancerous lesions and oral cancer is photodynamic therapy (PDT). In addition to the cytotoxic effect, an important mechanism of PDT action is the immunomodulatory effect. This study used the OSCC (SCC-25) cell line and the healthy gingival fibroblast (HGF-1) line. A compound of natural origin-hypericin (HY)-was used as the photosensitizer (PS). The HY concentrations of 0-1 µM were used. After two hours of incubation with PS, the cells were irradiated with light doses of 0-20 J/cm2. The MTT test determined sublethal doses of PDT. Cell supernatants subjected to sublethal PDT were assessed for interleukin 6 (IL-6), soluble IL-6 receptor alpha (sIL-6Ralfa), sIL-6Rbeta, IL-8, IL-10, IL-11 IL-20, IL-32, and Pentraxin-3 using the Bio-Plex ProTM Assay. The phototoxic effect was observed starting with a light dose of 5 J/cm2 and amplified with increasing HY concentration and a light dose. HY-PDT affected the SCC-25 cell secretion of sIL-6Rbeta, IL-20, and Pentraxin-3. HY alone increased IL-8 secretion. In the case of HGF-1, the effect of HY-PDT on the secretion of IL-8 and IL-32 was found.

Photodynamic Therapy and Immunological View in Gastrointestinal Tumors

Gastrointestinal cancers are a specific group of oncological diseases in which the location and nature of growth are of key importance for clinical symptoms and prognosis. At the same time, as research shows, they pose a serious threat to a patient's life, especially at an advanced stage of development. The type of therapy used depends on the anatomical location of the cancer, its type, and the degree of progression. One of the modern forms of therapy used to treat gastrointestinal cancers is PDT, which has been approved for the treatment of esophageal cancer in the United States. Despite the increasingly rapid clinical use of this treatment method, the exact immunological mechanisms it induces in cancer cells has not yet been fully elucidated. This article presents a review of the current understanding of the mode of action of photodynamic therapy on cells of various gastrointestinal cancers with an emphasis on colorectal cancer. The types of cell death induced by PDT include apoptosis, necrosis, and pyroptosis. Anticancer effects are also a result of the destruction of tumor vasculature and activation of the immune system. Many reports exist that concern the mechanism of apoptosis induction, of which the mitochondrial pathway is most often emphasized. Photodynamic therapy may also have a beneficial effect on such aspects of cancer as the ability to develop metastases or contribute to reducing resistance to known pharmacological agents.

Selected Cytokines and Metalloproteinases in Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a collective term for two diseases: ulcerative colitis (UC) and Crohn's disease (CD). There are many factors, e.g., genetic, environmental and immunological, that increase the likelihood of these diseases. Indicators of IBDs include extracellular matrix metalloproteinases (MMPs). The aim of this review is to present data on the role of selected cytokines and metalloproteinases in IBD. In recent years, more and more transcriptomic studies are emerging. These studies are improving the characterization of the cytokine microenvironment inside inflamed tissue. It is observed that the levels of several cytokines are consistently increased in inflamed tissue in IBD, both in UC and CD. This review shows that MMPs play a major role in the pathology of inflammatory processes, cancer, and IBD. IBD-associated inflammation is associated with increased expression of MMPs and reduced ability of tissue inhibitors of metalloproteinases (TIMPs) to inhibit their action. In IBD patients in tissues that are inflamed, MMPs are produced in excess and TIMP activity is not sufficient to block MMPs. This review is based on our personal selection of the literature that was retrieved by a selective search in PubMed using the terms "Inflammatory bowel disease" and "pathogenesis of Inflammatory bowel diseases" that includes systematic reviews, meta-analyses, and clinical trials. The involvement of the immune system in the pathophysiology of IBD is reviewed in terms of the role of the cytokines and metalloproteinases involved.

Life-Threatening Endocrinological Immune-Related Adverse Events of Immune Checkpoint Inhibitor Therapy

Malignant neoplasms are currently one of the leading causes of morbidity and mortality worldwide, posing a major public health challenge. However, recent advances in research in cancer biology and immunity have led to the development of immunotherapy, which is now used on an everyday basis in cancer treatment in addition to surgical treatment, classical cytostatics, and radiotherapy. The efficacy of immunotherapy has promoted the great popularity of this treatment among patients, as well as significant research interest. The increasing number of patients being treated with immunotherapy not only reassures physicians of the efficacy of this technique but also shows the wide spectrum of side effects of this therapy, which has not been considered before. Immune-related adverse events may affect many systems and organs, such as digestive, cardiovascular, respiratory, skin, or endocrine organs. Most complications have a mild or moderate course, but there are life-threatening manifestations that are essential to be aware of because if they are not properly diagnosed and treated on time, they can have fatal consequences. The purpose of this paper was to present the results of a literature review on the current state of knowledge on life-threatening endocrine side effects (such as adrenal crisis, thyroid storm, myxoedema crisis, diabetic ketoacidosis, and severe hypocalcaemia) of immune checkpoint inhibitors to provide information on symptoms, diagnostics, and management strategies.

Cellular Mechanisms of Singlet Oxygen in Photodynamic Therapy

In this review, we delve into the realm of photodynamic therapy (PDT), an established method for combating cancer. The foundation of PDT lies in the activation of a photosensitizing agent using specific wavelengths of light, resulting in the generation of reactive oxygen species (ROS), notably singlet oxygen (1O2). We explore PDT's intricacies, emphasizing its precise targeting of cancer cells while sparing healthy tissue. We examine the pivotal role of singlet oxygen in initiating apoptosis and other cell death pathways, highlighting its potential for minimally invasive cancer treatment. Additionally, we delve into the complex interplay of cellular components, including catalase and NOX1, in defending cancer cells against PDT-induced oxidative and nitrative stress. We unveil an intriguing auto-amplifying mechanism involving secondary singlet oxygen production and catalase inactivation, offering promising avenues for enhancing PDT's effectiveness. In conclusion, our review unravels PDT's inner workings and underscores the importance of selective illumination and photosensitizer properties for achieving precision in cancer therapy. The exploration of cellular responses and interactions reveals opportunities for refining and optimizing PDT, which holds significant potential in the ongoing fight against cancer.

Quality of Life in Patients with Venous Leg Ulcers Treated by Means of Local Hyperbaric Oxygen Therapy or Local Ozone Therapy-A Single Center Study

Background and Objectives: Venous leg ulcers pose a significant medical problem worldwide. The complexity of the problem determines the need for further interdisciplinary activities that will improve the quality of life for treated patients. This study compared the quality of life of patients with venous leg ulcers who received local hyperbaric oxygen therapy or local ozone therapy procedures as part of comprehensive treatment. Materials and Methods: The study included 129 patients (62 men and 57 women) with venous leg ulcers. Group I underwent local hyperbaric oxygen therapy (HBOT), and Group II underwent local ozone therapy (OZONE). In both groups, the patients' quality of life was assessed before the start of the treatment cycle, as well as 10 weeks and 6 months after the completion of the treatment, by means of the EQ-5D-5L questionnaire and the Polish shortened version of the SF-36 scale. Results: After completing the respective therapeutic cycle, both groups showed statistically significant (p < 0.001) improvement in quality of life, according to the EQ-5D-5L questionnaire and the SF-36 scale. Differences were noted between the 1st examination (before treatment) and the 2nd examination (10 weeks after treatment), as well as the 3rd examination (6 months after treatment). In the EQ-5D-5L assessment of anxiety and depression, self-care, and activities of daily living 6 months after the end of treatment, better results were found in the group of patients treated with local hyperbaric oxygen therapy (p < 0.001). In this group, 6 months after the end of the treatment, a statistically significantly higher result on the EQ-VAS scale was also obtained (73.09 ± 19.8 points vs. 68.03 ± 17.37 points, p = 0.043). However, in the SF-36 assessment performed 6 months after the end of treatment, better results-a statistically significantly lower value of the quality of life index-were recorded in the group of patients treated with local ozone therapy (103.13 ± 15.76 points vs. 109.89 ± 15.42 points, p < 0.015). Conclusions: Hyperbaric oxygen therapy and local ozone therapy procedures have a beneficial effect on improving the quality of life of patients with venous leg ulcers.

Crohn's Disease: Basic Characteristics of the Disease, Diagnostic Methods, the Role of Biomarkers, and Analysis of Metalloproteinases: A Review

Crohn's disease is a chronic inflammatory bowel disease that affects the ileum and/or large intestine. At the same time, it can also affect any other part of the human body, i.e., from the mouth to the anus. In Crohn's disease, the physiology and functioning of the epithelial barrier are inhibited due to the correlation of various factors, such as the environment, genetic susceptibility or intestinal microbiota. The symptoms are very troublesome and cause a significant reduction in quality of life, sometimes occurring with paralyzing permanent damage to the digestive tract, requiring enteral or parenteral nutrition throughout life. In order to make a proper and accurate diagnosis, an appropriately selected diagnostic path in a given clinical entity is necessary. Standard diagnostic methods are: laboratory examination, histopathological examination, endoscopic examination, X-ray, computed tomography, ultrasound examination and magnetic resonance imaging. Medical biology and the analysis of metalloproteinases have also proved helpful in diagnosing changes occurring as a result of Crohn's disease. Here we provide a thorough review of the latest reports on Crohn's disease and its genetic conditions, symptoms, morphology, diagnosis (including the analysis of Crohn's disease biomarkers, i.e., metalloproteinases) and treatment.

An Analysis of the Content of Metalloproteinases in the Intestinal Wall of Patients with Crohn's Disease

One of the inflammatory bowel diseases is Crohn's disease. Although this term has been used in the medical community since 1932, a significant increase in the number of publications occurs at the end of the 20th century and the beginning of the 21st century. Crohn's disease is a disease that cannot be fully cured. In many cases, it is chronic, i.e., recurrent. All preventive and therapeutic measures taken by doctors are aimed at inhibiting the development of the disease and minimizing the occurrence of any potential "side effects" resulting from the developing disease. One of the diagnostic methods is the qualitative and quantitative determination of metalloproteinases in inflammatory tissues and in the blood. The aim of the study was the quantitative and qualitative determination of metalloproteinases in inflammatory bowel tissues in patients diagnosed with Crohn's disease. The in vitro study was performed on surgical tissues from patients diagnosed with Crohn's disease. The results show that in inflammatory tissues the concentration of metalloproteinases -3, -7, -8, -9 was higher compared to tissues taken from the resection margin without signs of inflammation, defined as healthy. The experiment confirmed that the biochemical test, which is the determination of metalloproteinases in tissues, is a useful diagnostic tool to differentiate inflammatory from non-inflammatory tissues.

Photodynamic Therapy of Breast Cancer in Animal Models and Their Potential Use in Clinical Trials-Role of the Photosensitizers: A Review

In this article, we reviewed the use of photodynamic therapy (PDT) for breast cancer (BC) in animal models. These in vivo models imitate the cancer disease progression, aid diagnosis, as well as create opportunities to assess treatment during the approval process for the new drug. BC ranks first among women's cancers. Nowadays, there are many diagnostic methods and therapy options for BC but the majority of them have severe side effects. This article discusses the advantages and some disadvantages of the use of small and large animals used for BC models. A literature review showed that the majority of studies have used large animal models, and recently there has been more interest in developing BC in small animal models. BC cell lines such as MCF-7, BT-474, MDA-MB-231, and 4T1 are commercially available for two-dimensional and three-dimensional in vitro cell cultures and subcutaneous models. The purpose of this article is to discuss the performance of PDT in animal models and its further clinical implications. PDT is known to be a non-invasive therapy, which uses monochromatic light and energy to excite photosensitizers (PSs) for the generation of reactive oxygen species as the required factors. Herein, we discuss the use of five photosensitizers in BC models such as chlorin e6 (Ce6), methylene blue, indocyanine green, 5-aminolevulinic acid, and meta-tetra(hydroxyphenyl)chlorin. The database PubMed and Scopus were searched for keywords: 'photodynamic therapy', 'breast cancer', 'animal model', 'clinical studies', and 'photosensitizer(s)'. The PDT search results in animal experiments and its effect on a living organism indicate the possibility of its application in clinical trials on women with local and disseminated BC. The availability and accessibility of small and large BC animal models enable the progress and trial of cancer drugs for innovative technologies and new diagnostics and treatments.

Application of Topical Hyperbaric Oxygen Therapy and Medical Active Dressings in the Treatment of Arterial Leg Ulcers-A Pilot Study

Leg ulcers are a very serious worldwide medical problem. When the ulcer is extensive and deep the prognosis is usually unfavorable. The treatment requires comprehensive solutions that take into account modern specialized medical dressings, and more and more often, selected methods in the field of physical medicine. The study included 30 patients (13 women-43.4% and 17 men-56.6%) with chronic arterial ulcers of the lower limbs. The mean age of the treated patients was 65.63 ± 8.77 years. Patients were randomly assigned to two study groups. In group 1 (16 patients), specialist ATRAUMAN Ag medical dressings and local hyperbaric oxygen therapy treatments were used. In group 2 (14 patients), only specialized ATRAUMAN Ag dressings were used. The treatment was carried out for 4 weeks. The progress of healing ulcers was assessed by using the planimetric method, while the intensity of pain ailments was assessed by the visual analog VAS scale. In both study groups, a statistically significant reduction in the mean surface area of the treated ulcers was obtained, respectively, from 8.53 ± 1.71 cm² to 5.55 ± 1.11 cm² in group 1 (p < 0.001) and 8.43 ± 1.51 cm² to 6.28 ± 1.13 cm² in group 2 (p < 0.001). There was also a statistically significant reduction in the intensity of pain ailments, respectively: 7.93 ± 0.68 points to 5.00 ± 0.63 points in group 1 (p < 0.001) and 8.00 ± 0.67 points to 5.64 ± 0.49 points in group 2 (p < 0.001). The percentage change in ulcer area from baseline in group 1 was 34.6 ± 8.47% and was statistically significantly greater than in group 2 (25.23 ± 6.01%) (p = 0.003). In turn, the percentage assessment of the pain intensity assessed in the VAS scale in group 1 was 36.97 ± 6.36% and was statistically significantly higher compared to group 2 (29.34 ± 4.77%) (p = 0.002). The addition of local hyperbaric oxygen therapy treatments as a supplement to the therapy with the use of specialized medical dressings improves the effectiveness the arterial ulcers treatment of the lower limbs in terms of reducing the ulceration area and reducing pain ailments.

Effect of Hypericin-Mediated Photodynamic Therapy on the Secretion of Soluble TNF Receptors by Oral Cancer Cells

Squamous cell carcinoma is the most common cancer of the head and neck region. In addition to the classic surgical treatment method, alternative therapy methods are sought. One such method is photodynamic therapy (PDT). In addition to the direct cytotoxic effect, it is essential to determine the effect of PDT on persistent tumor cells. The study used the SCC-25 oral squamous cell carcinoma (OSCC) cell line and the HGF-1 healthy gingival fibroblast line. A compound of natural origin-hypericin (HY)-was used as a photosensitizer (PS) at concentrations of 0-1 µM. After two hours of incubation with the PS, the cells were irradiated with light doses of 0-20 J/cm². The 3-[4,5-dimethylthiazol-2-yl]-2,5-diphenyltetrazolium bromide (MTT) test was used to determine sublethal doses of PDT. Cell supernatants subjected to sublethal PDT were assessed for soluble tumor necrosis alpha receptors (sTNF-R1, sTNF-R2). The phototoxic effect was observed starting with a light dose of 5 J/cm² and amplified with the increase in HY concentration and light dose. A statistically significant increase in sTNF-R1 secretion by SCC-25 cells was demonstrated after the PDT with 0.5 µM HY and irradiation with 2 J/cm² (sTNF-R1 concentration = 189.19 pg/mL ± 2.60) compared to the control without HY and irradiated with the same dose of light (sTNF-R1 concentration = 108.94 pg/mL ± 0.99). The baseline production of sTNF-R1 was lower for HGF-1 than for SCC-25, and secretion was not affected by the PDT. The PDT had no effect on the sTNF-R2 production in the SCC-25 or HGF-1 lines.

The Influence of Combined Physical Therapy Procedures on Oxygen Partial Pressure in Tissues Surrounding Ulcer in Patients With Venous Leg Ulcers

Venous ulcers in lower legs remain a profound treatment problem in contemporary medicine. Proper healing requires, among other things, sufficient blood supply and provision of suitable amount of oxygen to the treated tissues. The aim of the study was to assess the influence of combined physical therapy applied in patients with chronic venous leg ulcers on the oxygen partial pressure values. Fifty-four patients (25 females and 29 males), in the age range of 38 to 89 years with chronic venous leg ulcers, underwent a cycle of 15 procedures with the use of Laserobaria-S device. During a procedure, the patient's lower limb was simultaneously exposed to oxygen having the pressure of 1.5 ATA, low-frequency magnetic field, and low-energy light radiation. Before procedures, directly after the first procedure, as well as on completion of the entire therapeutic cycle, the patients underwent oxygen partial pressure measurements in the tissues surrounding the ulceration area, by means of transcutaneous oximetry, with the use of Medicap Précise 8008s device. The combined physical therapy shows a statistically significant increase of oxygen partial pressure values in tissues surrounding the ulceration, from the average of 68.63 ± 17.04 mm Hg before commencing the therapeutic cycle, to the average of 74.20 ± 18.92 mm Hg after the first procedure (P < .001) and to the average value of 83.79 ± 20.74 mm Hg (P < .001) after completion of therapeutic cycle. Combined physical therapy procedures cause a statistically significant increase of oxygen partial pressure values in tissues surrounding the ulceration, assessed using the objective method of transcutaneous oximetry, both in women and men.

Cellular 1H MR Relaxation Times in Healthy and Cancer Three-Dimensional (3D) Breast Cell Culture

Noninvasive measurements of ¹H Magnetic Resonance Imaging (MR) relaxation times in a three-dimensional (3D) cell culture construct are presented. Trastuzumab was used as a pharmacological component delivered to the cells in vitro. The purpose of this study was to evaluate the Trastuzumab delivery by relaxation times in 3D cell cultures. The bioreactor has been designed and used for 3D cell cultures. Four bioreactors were prepared, two with normal cells and two with breast cancer cells. The relaxation times of HTB-125 and CRL 2314 cell cultures were determined. An immunohistochemistry (IHC) test was performed before MRI measurements to confirm the amount of HER2 protein in the CRL-2314 cancer cells. The results showed that the relaxation time of CRL2314 cells is lower than normal HTB-125 cells in both cases, before and after treatment. An analysis of the results showed that 3D culture studies have potential in evaluating treatment efficacy using relaxation times measurements with a field of 1.5 Tesla. The use ¹H MRI relaxation times allows for the visualization of cell viability in response to treatment.

Assessing the Usefulness of Testing Standing Flexion in the Posterior Superior Iliac Spines for Functional Diagnostics of the Sacroiliac Joints

Introduction: Sacroiliac joint dysfunctions are common among patients visiting physiotherapy offices. The main symptom of these dysfunctions is pain in the lumbosacral region of the spine. Taking the frequency of its occurrence into account, it is important to conduct an appropriate diagnosis that enables the implementation of proper treatment.

Risk Factors for Injury in CrossFit®-A Retrospective Analysis

CrossFit^® is a physical activity program and sport which is based on functional movements performed at high intensity and with high variability of exercises. It develops all motor skills. The study included 424 athletes (266 men and 158 women) from twelve centers in Poland, actively practicing CrossFit^® between 18 and 60 years of age. A questionnaire consisting of 25 questions was used, which was divided into four subsections concerning the characteristics of the sample, training routine, injuries, and information about environment. In total, 48% of respondents participating in the study suffered at least one injury during their entire training history. The injuries suffered most often involved shoulder joint and lumbar spine. Men were found to face a higher risk of injury than women, at 32.78% vs. 15.33% (p = 0.027). The shorter the training period, the smaller the number of injuries observed among the trainees. It was also noted that the shorter the training period, the lower the number of injuries that occurred (p = 0.041). An increase in the number of training sessions per week did not increase the incidence of injuries (p > 0.05). Performing isometric exercises during warm-up reduced the likelihood of injury during CrossFit^® training itself (p = 0.012). Training despite of concomitant acute pain had a significant adverse effect on the incidence of injuries (p = 0.002). The most common risk factors for injury in the CrossFit^® training process include, in particular: gender, training experience, and length of training sessions. Proper warm-up including isometric exercises and training conducted without accompanying pain symptoms reduces the risk of injury.

Topical Hyperbaric Oxygen Therapy Versus Local Ozone Therapy in Healing of Venous Leg Ulcers

BACKGROUND

the treatment of venous leg ulcers still poses a difficult interdisciplinary medical problem. The aim of this study was to compare the therapeutic efficacy of local hyperbaric oxygen therapy with local ozone therapy in the treatment of venous leg ulcers.

MATERIALS

this study included 114 patients; 60 males (52.63%) and 54 females (47.36%) of ages ranging between 39 and 88 years (mean age: 68.9 ± 9.8 years) with venous leg ulcers, who underwent topical hyperbaric oxygen therapy (group I) and local ozone therapy (group II). In each of the study groups, the patients underwent 30 therapeutic procedures lasting 30 min each. The progress in wound healing was evaluated by computerized planimetry, and the intensity of pain was assessed with the use of the Visual Analogue Scale (VAS).

RESULTS

in both groups of treated patients, a statistically significant (p = 0.000001) reduction in the area of treated ulcers was achieved. In group I, the wound area decreased by an average of 69.67 ± 22.52%, from 7.55 ± 2.99 cm² to 2.78 ± 2.43 cm², and in group II, by an average of 41.33 ± 21.31%, from 7.36 ± 2.82 cm² to 4.62 ± 2.76 cm². In both groups of patients, a statistically significant (p = 0.000001) reduction in the intensity of pain ailments was observed: in group I, by an average of 0.55 ± 0.54 points, and in group II, by an average of 2.33 ± 0.82 points on the VAS scale.

CONCLUSIONS

local hyperbaric oxygen therapy and local ozone therapy cause a statistically significant reduction in the surface area of venous leg ulcers as well as in the intensity of pain. Better results were observed after the application of local hyperbaric oxygen therapy procedures.

Are the mechanical properties of Achilles tendon altered in CrossFit athletes? Reliability and accuracy of myotonometry

PURPOSE

Tendons adapt to loads affecting them by changing tendons' mechanical and morphological properties. The aim of the study was to investigate the influence of involvement in sport activities in the form of CrossFit training by individuals of different age upon the mechanical properties of Achilles tendon.

METHODS

231 people participated in the study. One group consisted of subjects who trained CrossFit as amateurs, the other group comprised subjects who were not physically active. Achilles tendon was studied for various positions of the ankle joint: 0° DF/PF, 10° DF, 20° DF, 20° PF and 40° PF. The following mechanical and viscoelastic tendon properties were measured using MyotonPRO: frequency [Hz], stiffness [N/m], decrement [log], relaxation time [ms] and creep [De]. The results have been compared in reference to physical activity, BMI, age and length of training history.

RESULTS

Both the tension and stiffness increased with degree of Achilles tendon stretching and decreased as it contracted. Higher values have been noted in the group of people in training and with higher BMI values. The elasticity of Achilles tendon decreased with plantar flexion increase. Lower elasticity has been recorded in the group in training and with higher BMI. No significant influence of age and length of training history upon the parameters achieved has been noted.

CONCLUSIONS

The specificity of CrossFit training and accompanying mechanical load result in development of adaptation changes in Achilles tendon, in the form of its higher tone/tension and stiffness, as well as lower elasticity.

The Impact of Coronavirus Infection on Health-Related Quality of Life in Amateur CrossFit Athletes

BACKGROUND

The aim of this study was to assess how the disease, developing over the course of coronavirus infection, affects the quality of life of athletes practicing amateur sports who are not burdened with comorbidities.

METHODS

The study included 102 amateur CrossFit athletes (54 (53%) women and 48 (47%) men) who had been infected with SARS-CoV-2, but were not hospitalized. The training experience of the respondents ranged from 1.5 to 15 years (average: 6.7 ± 3.8 years). The quality of life was assessed with EQ-5D-5L and Clinical COPD Questionnaire (CCQ), which was used to assess the quality of life specific to the respiratory system, and the severity of dyspnea was assessed using the MRC questionnaire.

RESULTS

The training experience did not differ statistically significantly between men and women (p = 0.595). The quality of life in men according EQ-5D-5L was statistically significantly higher than in the case of women (0.979 ± 0.028 vs. 0.942 ± 0.073 (p < 0.001), respectively), and in EQ-VAS it was significantly higher in men than in women (85.64 ± 10.4 vs. 72.5 ± 19.36 points (p < 0.001)). The assessment of dyspnea by means of mMRC showed its higher intensity in women than in men. The differences were not statistically significant (p = 0.195). In men, a significantly lower result of the quality of life was noted in the CCQ questionnaire: 0.71 ± 0.57 vs. 1.14 ± 0.84 points (p = 0.009).

CONCLUSIONS

The HRQOL, which surveyed amateur CrossFit after COVID-19, was higher in men than in women. People practicing strength- and strength-endurance-based sports rated their quality of life as the highest. Most of the subjects observed a slight intensification of dyspnea. The findings can be used for future healthcare measures to be applied in the population of CrossFit athletes.

Advancements in photodynamic therapy of esophageal cancer

The poor prognosis of patients with esophageal cancer leads to the constant search for new ways of treatment of this disease. One of the methods used in high-grade dysplasia, superficial invasive carcinoma, and sometimes palliative care is photodynamic therapy (PDT). This method has come a long way from the first experimental studies to registration in the treatment of esophageal cancer and is constantly being improved and refined. This review describes esophageal cancer, current treatment methods, the introduction to PDT, the photosensitizers (PSs) used in esophageal carcinoma PDT, PDT in squamous cell carcinoma (SCC) of the esophagus, and PDT in invasive adenocarcinoma of the esophagus. For this review, research and review articles from PubMed and Web of Science databases were used. The keywords used were "photodynamic therapy in esophageal cancer" in the years 2000-2020. The total number of papers returned was 1,000. After the review was divided into topic blocks and the searched publications were analyzed, 117 articles were selected.

Cone Beam Computed Tomography in the Assessment of the Effectiveness of Physical Therapy with the Use of the Electromagnetic Field Combined with Light Radiation Emitted by LEDs in the Treatment of Inflammation of the Paranasal Sinuses-A Case Study

Modern high-resolution volumetric tomography, commonly known as cone beam computed tomography (CBCT), is one of the most innovative imaging techniques which can provide views of anatomical structures not attainable by conventional techniques. Magnetic field LED therapy is a physical therapy method, combining the effects of the Extremely Low Frequency-Electromagnetic Field (ELF-EMF) and high-power light radiation emitted by Light Emitting Diodes (LEDs). The method has been widely applied in the treatment and rehabilitation of complications of many medical conditions, including in dentistry. The aim of this study was to use CBCT to assess the effectiveness of the simultaneous use of electromagnetic field and LED light in the physical therapy of paranasal sinusitis. Treatments employing the electromagnetic field combined with LED light were administered to a 39-year-old female outpatient of the physiotherapy ward for rehabilitation therapy of paranasal sinusitis. Normal sinus pneumatization was restored almost completely. Reduction in the swelling of the sinus mucosa was so significant that even the pneumatization of the ethmoid bulla was restored. Physical therapy with the simultaneous use of ELF-EMF and LED light was found to be effective in the rehabilitation of the patient with paranasal sinusitis. Positive effects of the treatment were confirmed by CBCT findings.

Topical Ozone Therapy—A Novel Modality in the Treatment of a Complicated Wound after Knee Joint Ligament Operation as a Consequence of Traffic Accident—Case Report

Background and objectives: For many years, medicine has been looking for effective methods to be used in the treatment of chronic wounds. Pharmacological treatment is insufficient and does not give expected results of treatment. In the comprehensive treatment of wounds, physical medicine methods have been used, which are characterized by high efficiency and safety as well as relatively low costs of the therapy. Efficient application of a novel therapeutic modality in the form of topical ozone therapy in the treatment of a difficult-to-heal wound of the left knee joint after surgery due to the rupture of the anterior cruciate ligament and damage to the medial meniscus because of a previous road accident in a 61-year-old female patient is presented. Methods: Topical ozone therapy treatment in the form of the “Ozone bag” with the use of an oxygen-ozone mixture (2.86% ozone and 97.14% of oxygen) with a concentration of 40 µg/mL was applied to the wound area. The therapeutic cycle consisted of two series of 10 treatment sessions lasting 20 min each, performed every day for 5 days a week, and carried out for 6 weeks. Results: Topical ozone therapy caused complete healing of the complicated wound remaining after orthopaedic surgery, which allowed the patient to live independently without experiencing pain, to move without elbow crutches, and to perform daily activities independently and ultimately to return to work.

Photon Upconversion in Small Molecules

Upconversion (UC) is a process that describes the emission of shorter-wavelength light compared to that of the excitation source. Thus, UC is also referred to as anti-Stokes emission because the excitation wavelength is longer than the emission wavelength. UC materials are used in many fields, from electronics to medicine. The objective of using UC in medical research is to synthesize upconversion nanoparticles (UCNPs) composed of a lanthanide core with a coating of adsorbed dye that will generate fluorescence after excitation with near-infrared light to illuminate deep tissue. Emission occurs in the visible and UV range, and excitation mainly in the near-infrared spectrum. UC is observed for lanthanide ions due to the arrangement of their energy levels resulting from f-f electronic transitions. Organic compounds and transition metal ions are also able to form the UC process. Biocompatible UCNPs are designed to absorb infrared light and emit visible light in the UC process. Fluorescent dyes are adsorbed to UCNPs and employed in PDT to achieve deeper tissue effects upon irradiation with infrared light. Fluorescent UCNPs afford selectivity as they may be activated only by illumination of an area of diseased tissue, such as a tumor, with infrared light and are by themselves atoxic in the absence of infrared light. UCNP constructs can be monitored as to their location in the body and uptake by cancer cells, aiding in evaluation of exact doses required to treat the targeted cancer. In this paper, we review current research in UC studies and UCNP development.

Endothelial Function Assessment by Flow-Mediated Dilation Method: A Valuable Tool in the Evaluation of the Cardiovascular System

Cardiovascular diseases (CVDs) in the course of atherosclerosis are one of the most critical public health problems in the world. Endothelial cells synthesize numerous biologically active substances involved in regulating the functions of the cardiovascular system. Endothelial dysfunction is an essential element in the pathogenesis of atherosclerosis. Thus, the assessment of endothelial function in people without overt CVD allows for a more accurate estimate of the risk of developing CVD and cardiovascular events. The assessment of endothelial function is primarily used in scientific research, and to a lesser extent in clinical practice. Among the tools for assessing endothelial function, we can distinguish biochemical and physical methods, while physical methods can be divided into invasive and non-invasive methods. Flow-mediated dilation (FMD) is based on the ultrasound assessment of changes in the diameter of the brachial artery as a result of increased blood flow. FMD is a non-invasive, safe, and repeatable test, but it must be performed by qualified and experienced medical staff. The purpose of this paper is to present the literature review results on the assessment of endothelial function using the FMD method, including its methodology, applications in clinical practice and research, limitations, and future perspectives.

Local Hyperbaric Oxygen Therapy in the Treatment of Diabetic Foot Ulcers

Background: Diabetes mellitus is one of the most common metabolic diseases. The most serious complication of diabetes is diabetic foot ulcer, which affects several million people around the world each year. In recent years, increasingly modern methods of physical medicine including hyperbaric oxygen therapy have been used often in the complex therapy of this complication. Methods: This study included 45 patients, 24 male (53.3%) and 21 female (46.6%), whose age was between 49 and 83 years (mean age: 66.7 ± 8.8 years) with diabetes lasting for 1.5-18 years, who underwent local hyperbaric oxygen therapy at the pressure of 2.5 ATA (30 exposures for 30 min each) due to diabetic foot ulcers. The progress in wound healing before and after the end of therapy was evaluated by computerized planimetry, and the pain intensity was assessed with the use of a VAS. Results: The analysis of results showed a statistically significant reduction in the wound surface area after the treatment, from 8.54 ± 3.34 cm to 4.23 ± 3.23 cm² (p = 0.000001). In 5 patients (11.1%), the wounds were healed completely. In 25 patients (55.5%), the topical state of the wound surface was significantly decreased by 50% on average. There was also a significant reduction in the perceived pain on the VAS in all examined patients from 4.64 ± 1.68 points before treatment to 1.51 ± 0.92 points after treatment (p = 0.000001). Conclusions: The application of local HBO therapy in the treatment of diabetic foot ulcers accelerates the ulcer healing process, as judged in objective planimetric assessment, and reduces the intensity of perceived pain ailments.

Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice?

Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components.

Local Ozone Therapy in Complex Treatment of Venous Leg Ulcers: Ozone therapy for venous leg ulcers

A significant health problem in many countries of the world is the occurrence of hard to heal leg ulcers. In recent years modern methods of physical medicine in comprehensive treatment have been used often including ozone therapy. The study included 54 patients, 25 male and 29 female in age between 39 and 87 years (mean age: 66.7 ± 11.9 years) with venous leg ulcers who underwent a cycle of local ozone therapy. The progress in wound healing was evaluated by computerized planimetry and pain intensity was assessed with use a visual analog scale (VAS) . As a result of the applied local ozone therapy a statistically significant reduction of the ulcer area was achieved from median 7.1 (5.6-9.4) cm2 to 4.4 (3-7) cm2 (P = .000001), which was on median 38.74 (27.27-51.42)% compared to the baseline values ​​before the start of the therapy. In 2 patients (3.7%) the ulcers were completely healed. 18 patients (33.3%) achieved a reduction in ulcer area of ​​more than 50% of the baseline value and the remaining 34 patients (63%) also achieved a reduction in ulcer area. A statistically significant in the percentage of surface area was observed in the group of 19 patients suffering from > 5 years of age compared to the group of 35 patients suffering from ≤5 years (median 50 (32.03-67.16)% versus 33.96 (23.71-45); P = .033178), while percentage changes in ulcer surface area did not differ significantly between all other subgroups of patients. There was also a statistically significant reduction in the intensity of pain in VAS scale in all patients, median 6 (5-7) points before treatment versus 4.4 (3-7) points after treatment, P = .000001). Local ozone therapy of venous leg ulcers accelerate the healing process of ulcers in objective planimetric assessment and reduce the intensity of pain ailments.

Nitrotyrosine, Nitrated Lipoproteins, and Cardiovascular Dysfunction in Patients with Type 2 Diabetes: What Do We Know and What Remains to Be Explained?

Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases (CVDs), which are the most important cause of morbidity and mortality in the population of patients living with DM. DM is associated with lipid metabolism disorders characterized by a decrease in the high-density lipoprotein blood concentration, an increase in the triglyceride blood concentration, and the presence of modified lipoproteins not routinely measured in clinical practice. Nitrated lipoproteins are produced by the nitration of the tyrosyl residues of apolipoproteins by myeloperoxidase. There is some evidence from the research conducted showing that nitrated lipoproteins may play a role in the development of cardiovascular dysfunction, but this issue requires further investigation. It was found that the nitration of HDL particles was associated with a decrease in caspase-3 and paraoxonase-1 activity, as well as a decrease in the activity of cholesterol transport via ABCA1, which reduces the protective effect of HDL particles on the cardiovascular system. Less information has been collected about the role of nitrated LDL particles. Thus far, much more information has been obtained on the relationship of nitrotyrosine expression with the presence of cardiovascular risk factors and the development of cardiovascular dysfunction. The purpose of this paper is to provide an extensive review of the literature and to present the most important information on the current state of knowledge on the association between nitrotyrosine and nitrated lipoproteins with dysfunction of the cardiovascular system, especially in patients living with DM. Moreover, directions for future research in this area were discussed.

Tibiotalocalcaneal Arthrodesis in Osteoarthritis Deformation of Ankle and Subtalar Joint: Evaluation of Treatment Results

Tibiotalocalcaneal arthrodesis (TTCA) is an increasingly used method of stiffening the ankle and subtalar joints in advanced degenerative deformities. The study group consisted of 19 men who were subjected to intramedullary and intraosseous arthrodesis using an intramedullary nail. The average age of patients was 46 (range 19-68) years. The main indication for surgical treatment was post-traumatic arthrosis 11 (58%). In the studied group, clinical condition was assessed using the American Orthopedic Foot and Ankle Score (AOFAS) classification, quality of life using the SF-12 scale, and assessment of pain intensity using the visual-analog scale (VAS) scale. The above parameters were evaluated before surgery (under 2 years), intermediate (from 2 to 5 years), and late (over 5 years) postoperative period. The clinical condition on the AOFAS scale improved from an average of 20.6 points before tibiotalocalcaneal arthrodesis to 63.5 after the procedure. The result was statistically significant (p < .0001). Analyzing the results using the SF-12 scale, a statistically significant increase was found. In the physical sphere of Physical Health Component Score-12 (p = .0004) and in the mental sphere of Mental Health Component Score-12 (p = .030). The intensity of pain assessed in the VAS scale, decreased in all three periods-p < .05. The strongest analgesic effect was observed in the early postoperative follow-up period. Tibiotalocalcaneal arthrodesis using an intramedullary nail causes a significant improvement in the clinical condition according to the AOFAS classification, enabling most patients to move independently, a significant improvement quality of life assessed in the SF-12 scale and a significant reduction of pain ailments assessed in the VAS scale, especially in the early postoperative period.

Pathogenesis and Clinical Significance of In-Stent Restenosis in Patients with Diabetes

Diabetes mellitus (DM) is a strong risk factor for the development of cardiovascular diseases such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease (PAD). In the population of people living with DM, PAD is characterised by multi-level atherosclerotic lesions as well as greater involvement of the arteries below the knee. DM is also a factor that significantly increases the risk of lower limb amputation. Percutaneous balloon angioplasty with or without stent implantation is an important method of the treatment for atherosclerotic cardiovascular diseases, but restenosis is a factor limiting its long-term effectiveness. The pathogenesis of atherosclerosis in the course of DM differs slightly from that in the general population. In the population of people living with DM, more attention is drawn to such factors as inflammation, endothelial dysfunction, platelet dysfunction, blood rheological properties, hypercoagulability, and additional factors stimulating vascular smooth muscle cell proliferation. DM is a risk factor for restenosis. The purpose of this paper is to provide a review of the literature and to present the most important information on the current state of knowledge on mechanisms and the clinical significance of restenosis and in-stent restenosis in patients with DM, especially in association with the endovascular treatment of PAD. The role of such processes as inflammation, neointimal hyperplasia and neoatherosclerosis, allergy, resistance to antimitotic drugs used for coating stents and balloons, genetic factors, and technical and mechanical factors are discussed. The information on restenosis collected in this publication may be helpful in planning further research in this field, which may contribute to the formulation of more and more precise recommendations for the clinical practice.

The role of photodynamic therapy in breast cancer - A review of in vitro research

Breast cancer is the most common cancer affecting women and the incidence of occurrence is increasing. Currently, there are many methods of detecting and treating breast cancer. Some treatments have a number of side effects. Photodynamic therapy (PDT) is a minimally invasive method of treatment which uses monochromatic light of low to medium energy to excite previously applied photosensitizers (PS) for ROS production. The purpose of this article is to present a general overview of the use of PDT in in vitro studies of various cancer cell lines. A literature search for articles corresponding to the topic of this review was performed using the PubMed and Scopus databases using the following keywords: 'photodynamic therapy', 'breast cancer', and 'photosensitizer(s).' Much of the reviewed literature is based on evaluations of the cytotoxic potential of various PSs, particularly against the MCF-7 cell line, and enhancement of PDT potential with nanotechnology. Research on photodynamic effects in vitro may be helpful in the pre-clinical search for optimal methods for in vivo clinical treatment.

Advantages of using toothpaste containing propolis and plant oils for gingivitis prevention and oral cavity hygiene in cleft lip/palate patients

BACKGROUND

The anti-inflammatory and antibacterial action of preparations used during oral hygiene procedures is particularly important in patients with oral cleft. Few reports have been published assessing the influence of natural products on the state of the oral cavity in patients with oral cleft. The aim of this study was to assess the effect of toothpaste containing Polish propolis and plant oils on oral cavity health in patients with oral cleft treated orthodontically.

MATERIALS AND METHODS

A total of 50 patients aged 9-16 years old (20 females, 23 males) were selected and randomly assigned into two groups. Group (A) received toothpaste with Polish propolis, tea tree oil, menthol, and rosemary oil. Group (B) received toothpaste without active ingredients (placebo). A baseline assessment was followed by an oral hygiene index (OHI, debris OHI-D, and calculus OHI-C component) and gingival bleeding index (GBI) after 35 days. The methodology of the oral condition assessment included the presence of cleft malformation as a dysmorphic of the anterior maxilla segment.

RESULTS

In group A, improvement in oral cavity hygiene assessed for incisors and molars was found (OHI-T p = 0.011). For the gingival condition, a decrease in the gingival bleeding index - total (GBI-T p = 0.002), as well as for the incisors (GBI-I p = 0.007) and molars (GBI-M p = 0.017) was found.

CONCLUSIONS

This research confirms the biological effectiveness of toothpaste with Polish propolis and plant oils. These results may be clinically useful for improving preventative oral care and for control of oral infectious diseases during orthodontic treatment in patients with oral cleft.

Photodynamic Therapy in Orthodontics: A Literature Review

Treatment of malocclusions using fixed orthodontic appliances makes it difficult for patients to perform hygiene procedures. Insufficient removal of bacterial biofilm can cause enamel demineralization, manifesting by visible white spot lesions or periodontal diseases, such as gingivitis periodontitis or gingival hyperplasia. The classic methods of preventing the above problems include, in addition to proper hygiene, ultrasonic scaling, periodontal debridement, and oral rinses based on chlorhexidine. New alternative methods of reducing plaque around brackets are being developed. There is a growing interest among researchers in the possibility of using photodynamic therapy in orthodontics. A literature search for articles corresponding to the topic of this review was performed using the PubMed and Scopus databases and the following keywords: ‘photodynamic therapy’, ‘orthodontics’, and ‘photosensitizer(s)’. Based on the literature review, two main directions of research can be distinguished: clinical research on the use of photodynamic therapy in the prevention of white spot lesions and periodontal diseases, and ex vivo research using a modified orthodontic adhesive by adding photosensitizers to them. Methylene blue is the most frequently used photosensitizer in clinical trials. The effectiveness of antimicrobial photodynamic therapy is mainly compared to the ultrasonic scaler as a single therapy or as an adjunct to the ultrasonic scaler. In their conclusions, the researchers most often emphasize the effectiveness of antimicrobial photodynamic therapy in reducing microbial levels in patients treated with fixed appliances and the possibility of using it as an alternative to routine procedures aimed at maintaining a healthy periodontium. The authors suggest further research on the use of photodynamic therapy to prove the validity of this method in orthodontics. It should also not be forgotten that proper hygiene is the basis for maintaining oral cavity health, and its neglect is a contraindication to orthodontic treatment.

Photodynamic therapy in the treatment of oral squamous cell carcinoma - The state of the art in preclinical research on the animal model

BACKGROUND

Oral cavity squamous cell carcinoma is a common cancer of the head and neck region. Due to the frequency of diagnoses, high rate of mortality, mutilating nature of classic therapy and numerous complications, new methods of treatment are being sought. One promising solution for treatment that is utilized in many fields of oncology is photodynamic therapy. The purpose of this article is to present a general overview of the use of photodynamic therapy in preclinical in vivo studies on the animal model.

MATERIAL AND METHODS

A literature search for articles corresponding to the topic of this review was performed using the PubMed and MEDLINE databases using the following keywords: 'oral cavity squamous cell carcinoma,' 'photodynamic therapy,' 'photosensitizer(s),' 'in vivo', and 'animal model'.

RESULTS

Based on the literature review, the two most used animal models can be distinguished in research on the use of photodynamic therapy for oral squamous cell carcinoma. Studies mainly focus on the evaluation of tumor growth inhibition after using therapies with various photosensitizers on the murine or hamster cheek pouch models.

CONCLUDING REMARKS

The animal model is a part of preclinical research. Unfortunately, each of the models has its limitations, so it is difficult to extrapolate the results to clinical trials.

Evaluation of the therapeutic efficacy of active specialistic medical dressings in the treatment of decubitus

INTRODUCTION

Treatment of decubitus ulcers is a grave medical problem. In many cases, it is difficult to cure a pressure ulcer, especially when it is deep and extensive, and prognosis is usually unfavourable. Treatment of decubitus ulcers requires new specialist dressings, which play an important role in the healing process.

AIM

To evaluate therapeutic efficacy of active specialist medical dressings in the treatment of decubitus.

MATERIAL AND METHODS

Research involved 40 patients - 18 (45%) women and 22 (55%) men, suffering from decubitus ulcers of different size and depth, localized in the sacral region, lasting from 1.5 to 30 months. Patients were randomly assigned to two research groups (20 people each), were treated for 4 weeks with 2 different specialist dressings. ATRAUMAN Ag, which contains silver ions, was used in the first group, while paraffin gauze of BACTIGRAS type was used in the second group. An assessment of pressure ulcers' healing progress was done with a planimetric method, which evaluates the wound surface area.

RESULTS

The analysis results showed a significant statistical decrease in an average decubitus ulcer surface area in both research groups: in the first group by 60.2% (p = 0.001), and in the second group by 32.95% (p < 0.001), which speaks in favour of dressings with silver ions as having better therapeutic effectiveness.

CONCLUSIONS

Using specialist dressings results in a significant decrease in the decubitus ulcer surface area, depending on the type of dressing and active substances contained within, while silver ions support curative effectiveness of the dressing used.

Therapeutic efficacy of physical combined therapy in the treatment of venous crural ulcers

OBJECTIVES

Venous crural ulcer is a serious medical problem indeed, which is connected with patients' suffering and long term treatment generating high cost. The prognosis is unfavourable in many cases, as complete treatment of ulceration, when it is profound or really extensive is difficult to achieve, and sometimes impossible altogether. The aim of the study was to evaluate the therapeutic efficacy of treatment of venous crural ulcers with the use of multifunctional device LASEROBARIA-S, designed for combined physical therapy procedures.

METHOD

147 succeeding patients (67 women and 80 men) diagnosed with venous crural ulcer participated in the study, with age varied between 41 and 79 years (average age - 70.2 years). The patients underwent a 60 day cycle of combined physical therapy, with the use of multifunctional device LASEROBARIA-S, during which therapy the lower extremity of the patient was placed in the therapeutic chamber and simultaneously subjected to the action of: local oxygen hyperbaria, low-frequency variable magnetic field and low energy light radiation emitted by semiconductor LED diodes. Prior to the therapeutic cycle and after its completion, planimetric measurements of the area of ulcer and the assessment of pain intensity with use of VAS scale were performed, in relation to selected factors potentially affecting therapeutic effects of applied therapy, as: sex and age of patients, as well as initial size of the ulcer and duration of the ulcer presence.

RESULTS

After the completion of therapeutic cycle, statistically significant reduction of the area of treated ulcer was found, by 5.4 cm² on the average (16.3 cm² vs 10.5 cm²) (p < 0.05). Moreover, as a result of the combined therapy procedures performed, the statistically significant lowering of the intensity of pain sensation experienced by patients, assessed by means of VAS scale, was obtained (2.55 points vs 0.48 points) (p < 0.05). The obtained improvement was not dependent statistically significantly on any of analysed selected factors potentially affecting regenerative and analgesic effect of applied therapy.

CONCLUSIONS

The application of combined physical therapy with the use of LASEROBARIA-S device results in significant reduction of the area of the venous crural ulcer surface, as well as reduction of the intensity of accompanying pain complaints and this therapeutic effect was not dependent on sex and age of patients, as well as initial size of the ulcer and duration of the ulcer presence.

Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes

Diabetes mellitus is an important risk factor for the development of cardiovascular diseases. Peripheral arterial disease affecting lower limb arteries is one of the clinical manifestations of atherosclerosis. The frailty syndrome (Frailty) is a problem associated with diminution of physiological reserves. The ankle-brachial index is a commonly used tool for diagnosing peripheral arterial disease (PAD). The usefulness of the ankle-brachial index (ABI) is limited in people with diabetes because of calcification of the middle layer of arteries. In this population, toe-brachial index should be measured. Frailty may be associated with worse prognosis for patients undergoing revascularization. Amputation may be an important factor leading to the development of Frailty. The risk of amputation and the prognosis after revascularization may be modified by some medications and blood glucose levels. The purpose of this paper is to review the literature about the association between PAD, especially in patients living with diabetes and Frailty.

Gastrointestinal symptoms in the course of COVID-19

COVID-19 is an infectious disease caused by novel coronavirus SARS-CoV-2, a betacoronavirus comprised of single-stranded ribonucleic acid (RNA), the first time reported in December 2019 as pneumonia with unknown etiology in Wuhan City in China. It is a very important current problem for public health worldwide. A typical clinical course includes dyspnoea, dry cough and fever. In the presented paper we conducted the literature review and described the most important facts within the current state of knowledge about symptomatology and pathophysiology of gastrointestinal dysfunction in the course of COVID-19. Data about prevalence of gastrointestinal symptoms in the course of COVID-19 show wide divergence in the cited literature. Generally, the most common reported digestive symptoms were loss of appetite, nausea and vomiting. Liver injury in the course of COVID-19 is also an important and not well understood problem. The virus has high affinity to cells containing angiotensin- -converting enzyme 2 (ACE2) protein. Digestive symptoms of COVID-19 may be associated with ACE2 expression in epithelial cells in upper oesophagus, ileum and colon. Previous scientific reports have elucidated the role of ACE2 in modulating intestinal inflammation and diarrhoea.

Comparison of the efficacy of topical hyperbaric oxygen therapy alone vs a combination of physical methods including topical hyperbaric oxygen therapy, magnetotherapy, and low-energy light therapy in the treatment of venous leg ulcers

The aim of the study was to compare the therapeutic efficacy of topical hyperbaric oxygen therapy alone vs a combination of physical methods including topical hyperbaric oxygen therapy, magnetotherapy and low-energy light therapy in the treatment of venous leg ulcers. Thirty-six patients were treated with topical oxygen hyperbaria and 29 patients were treated with a combination of physical methods. The assessment of ulcer surface area with use of a planimetric method, pain intensity with use of Laitinen scale and quality of life by means of EuroQol scale were performed. In both groups a statistically significant (P < .05) reduction of ulcer surface area has been obtained, but in patients treated with combined physical therapy average percentage reduction of ulcer surface area (36.44% ± 11.04%) was statistically significantly (P = .00001) bigger as compared to other group (13.65% ± 8.32%). In both groups of patients statistically significant (P < .05) reduction of frequency and intensity of pain, reduced intake of analgesic drugs and reduction of limitations of physical activity, as well as statistically significant improvement of quality of life have been observed, but in patients treated with combined physical therapy an average increase in the score in EuroQoL scale (61.03 ± 7.14) was statistically significantly (P = .00001) bigger as compared to other group (25.27 ± 8.16). It was concluded that topical hyperbaric oxygen therapy alone and a combination of physical methods cause significant reduction of ulcer surface area, reduction of pain intensity, as well as improvement of the quality of life, but a combination of physical methods is more efficient.

The role of autofluorescence, photodynamic diagnosis and Photodynamic therapy in malignant tumors of the duodenum

This article presents the current state of knowledge and a review of the literature in terms of the prevalence, etiopathogenesis, differential diagnosis, management, prognosis, and treatment of malignant tumors of the duodenum. The role of autofluorescence and photodynamic diagnosis as an emerging treatment method for rarely o ccurring duodenal malignant neoplasms .. We selected publications which can be found in databases such as The National Center for Biotechnology Information, U.S. National Library of Medicine (PubMed), The American Chemical Society, The American Association of Pharmaceutical Sciences and The American Society for Photobiology and The Canada Institute for Scientific and Technical Information.

The Influence of Hypericin-Mediated Photodynamic Therapy on Interleukin-8 and -10 Secretion in Colon Cancer Cells

The aim of this study was to measure the secretion of interleukin (IL)-8 and -10 during an elicited immune response following sublethal doses of hypericin-mediated photodynamic therapy (HY-PDT) in experimental models of residual colon cancer cells in vitro. Investigations were performed on the cancer cell lines SW480 and SW620. Each cell line was exposed to 3 different concentrations of the photosensitizer HY and various doses of irradiation. The cell metabolic activity using an MTT assay was performed and then the measurement of IL-8 and IL-10 secretion was achieved using the Bio-Plex ProTMAssay. There was a statistically significant amplification of IL-8 secretion during HY-PDT in the SW620 cell line (at 1 J/cm2: P = .01, 5 J/cm2: P = .002, and 10 J/cm2: P = .025) and a statistically significant decrease in IL-8 during HY-PDT in the SW480 cell line (at 1 J/cm2: P = .05, 5 J/cm2: P = .035, and 10 J/cm2: P = .035). No statistically significant differences in IL-10 concentration were found following HY-PDT in the SW480 (at 1 J/cm2: P > .4, 5 J/cm2: P = .1, and 10 J/cm2: P = .075) or in the SW620 cell line (at 1 J/cm2: P > .4, 5 J/cm2: P > .4, and 10 J/cm2: P > .4). HY-PDT can both eliminate and control a primary tumor via cytotoxic effects, and at sublethal doses, it can affect IL release by colon cancer cells. In this experiment, this influence depended on the level of tumor cell metastatic activity.

Clinical Trials and Basic Research in Photodynamic Diagnostics and Therapies from the Center for Laser Diagnostics and Therapy in Poland

The purpose of this review is to present an overview of the development of photodiagnostic and photodynamic therapy (PDD and PDT) techniques in Poland. The paper discusses the principles of PDD, including fluorescent techniques in determining precancerous conditions and cancers of the skin, digestive tract, bladder and respiratory tract. Methods of PDT of cancer will be discussed and the current state of knowledge as well as future trends in the development of photodynamic techniques will be presented, including the possibility of using photodynamic antimicrobial therapy. Research pioneers in photodynamic medicine such as Thomas Dougherty are an inspiration for the development of methods of PDD and PDT in our Clinic. The Center for Laser Diagnostics and Therapy in Bytom, Poland, promotes the propagation of PDD and PDT through the training of clinicians and raising awareness among students in training and the general public. Physicians at the Center are engaged in photomedical research aimed at clinical implementation and exploration of new avenues in photomedicine while optimizing existing modalities. The Center promotes dissemination of clinical results from a wide range of topics in PDD and PDT and serving as representative authorities of photodynamic medicine in Poland and Europe.