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Abstract Introduction Total knee arthroplasty (TKA) is commonly performed in patients with end-stage osteoarthritis or rheumatoid arthritis of the knee to reduce joint pain, increase mobility, and improve quality of life. However, TKA is associated with moderate to severe postoperative pain, which remains a significant clinical challenge. Surgeon-administered PAI and anesthesiologist-administered iPACK have proven viable alternatives to conventional peripheral nerve blocks. This review aims to discuss which IPACK block or periarticular injection, combined or not with different peripheral nerve blocks, has better effects on postoperative rehabilitation, patient satisfaction, and overall outcome. Material and methods The literature review was performed on standards of care, current therapeutic options, a pain management protocol, and innovative treatment options for patients undergoing total knee arthroplasty. The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results The initial search yielded 694 articles. Fifty relevant articles were selected based on relevance, recentness, search quality, and citations. Six studies compared PAI to peripheral nerve block (PNB), and eight studies checked the effectiveness of adding PNB to PAI. Three studies compared iPACK to PNB, and ten reviewed the point of adding PNB to iPACK. Conclusions The literature review indicates that the best analgesic effect is obtained by combining PAI or iPACK with a peripheral nerve block, particularly with ACB, due to its analgesic, motor-sparing effect, and satisfactory analgesia.

Hydrogels based on sodium alginate (SA) and partially neutralised poly(acrylic acid) were obtained by radical polymerisation. The hydrogels were cross-linked with N,N′-methylenebisacrylamide (MBA), simultaneously grafting the resulting polymer onto SA. The findings of the FTIR spectroscopy showed that all of the hydrogels were effectively synthesized and sodium alginate was chemically bonded with the poly(sodium acrylate) matrix. DSC analysis of the melting heat and glass transition parameters indicated that the hydrogel structure had changed as a result of the cross-linking process. Sodium alginate and MBA were tested at different concentrations to determine how they affected the hydrogel properties. A very high content of the biopolymer, i.e., sodium alginate, was used in our research, up to 33 wt%. This resulted in durable and stable hydrogels with a very high ability to uptake water, comparable to hydrogels based on synthetic polymers only. The ability to swell is inversely proportional to the quantity of MBA present. By increasing the amount of sodium alginate in the hydrogel, the ability of the hydrogel to absorb water is reduced. However, water uptake remains relatively high at 350 g·g−1, even for the hydrogel with the highest SA content.

Abstract Background Adjustable gastric band (AGB) hadbeen the preferred treatment for morbid obesity because it is minimally invasive and reversible. But now it seems to be slowly becoming a historic procedure due to the disappointing effects. The aim of the study was to systematize and present the available data on revisional bariatric surgery (RBS) after AGB among Polish patients. Methods It is a multicenter, retrospective analysis of patients undergoing laparoscopic RBS after AGB in 12 Polish bariatric centers. The database included patient demographics, comorbidities and surgical outcomes. Results The group consisted of 234 patients who underwent AGB, which accounted for 29% of revisional cases recorded in the Polish Revisional Obesity Surgery Study (PROSS). 195 were women (83%), and 39 were men (17%). One hundred seventy-five patients after AGB experienced a weight regain (74.5%), 36 patients a gastric band slippage (15.0%), 14 patients had gastric band intolerance (6.0%). Types of RBS included 116 sleeve gastrectomies (SG) (49.4%), 86 Roux-en Y gastric by-passes (RYGB) (36.6%), 20 one anastomosis gastric by-passes (OAGB) (8,5%). The highest weight loss expressed as %EBMIL was observed after OAGB (63.5 ± 32.4%). Conclusions The main indication for RBS after AGB was weight regain. SG was the most frequently chosen type of RBS after AGB. RBS after AGB leads to weight loss and improvement in type 2 diabetes and hypertension with an acceptable low risk of complications. Trial registration NCT05108532.

Introduction. Perioperative pain management associated with hip surgery is challenging. The pericapsular nerve group (PENG) block is a new technique thought to provide better postoperative analgesia in addition to its motor-sparing effects.Aim. This review aims to evaluate the safety and efficacy of the PENG blockade in managing postoperative pain in patients undergoing hip surgery.Methods. The literature was reviewed through four electronic databases: PubMed, Cochrane Library, Google Scholar, and Embase. Results. The initial search yielded 416 articles. Twenty-seven relevant articles were selected based on relevance, recentness, search quality, and citations. Twelve of the studies were related to patients undergoing total hip arthroplasty. Twelve studies were related to patients undergoing total hip surgery due to hip fracture. Finally, three studies were related to patients undergoing hip arthroscopy.Conclusions. The PENG block provides superior analgesia and low opioid consumption in the first postoperative period. However, current evidence is insufficient, and there is a need for high-quality randomized, controlled trials with larger sample sizes.

Introduction: This study aimed to assess the analgesic efficacy of oxycodone at doses of 10 mg and 20 mg in dressings after surgery of burn wounds. Material and Methods: Twenty adult patients who underwent surgical treatment of third-degree burn wounds under general anaesthesia were included. Burn wounds were treated with dressings, to which oxycodone was added at 20 mg in Group 1 and 10 mg in Group 2. After the surgery, plasma oxycodone and noroxycodone concentrations were assayed, and pain intensity was assessed with Numerical Rating Scale (NRS). Results: In Group 1, no patient reported pain; in Group 2, four patients reported pain. The pain intensity, according to NRS, was 1–8. Plasma concentration of oxycodone in the blood serum was in the range of 1.24–3.15 ng/mL and 1.09–1.28 ng/mL in Group 1 and Group 2, respectively. Noroxycodone was not detected in the plasma. Adverse effects were not observed in any of the treated patients. Conclusions: Oxycodone in dressings provides patients with adequate and safe analgesia.

Introduction: This study aimed to investigate pain management, functional recovery, and stress response expressed by the neutrophile-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) after the popliteal artery and posterior knee capsule infiltration (iPACK) block combined with adductor canal block (ACB) in total knee arthroplasty (TKA). Patients and Methods: This was a prospective, double-blinded, randomised, controlled trial in a tertiary referral hospital. Three hundred and sixty-six patients were randomly allocated into the sham block group and iPACK combined with the ACB group. The primary outcome was postoperative pain scores. The secondary outcomes were opioid consumption, functional recovery expressed by a range of motion, and quadriceps strength. Also, the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated. Results: There were significant differences between the sham block and iPACK + ACB group in pain scores p < 0.0001 at all time points. Therefore, there was a significant difference in opioid consumption (p < 0.0001) and functional recovery (p < 0.0001). Also, NLR and PLR levels 12 h (p < 0.0001) and 24 h (24 h) after surgery (p < 0.0001) were much lower in the iPACK + ACB group. Conclusion: After total knee arthroplasty, the iPACK combined with ACB block group improved pain management, functional recovery, and stress response. Therefore, we strongly recommend this technique as a part of a multimodal analgesia protocol in knee surgery.

Background and Aim: Postoperative pain after scoliosis surgery is severe and usually requires long-term intravenous opioid therapy. Local anesthetic options, such as wound infiltration, are limited and include neuraxial analgesia. However, they are rarely used due to side effects and inconsistent efficacy. We report an opioid-sparing multimodal analgesia regimen with bilateral erector spinae plane blocks. This case series evaluated the analgesic effect of the bilateral bi-level erector spinae plane blocks (ESP) in congenital and neurogenic scoliosis surgery. Patients and Methods: Six pediatric patients with congenital or neurogenic scoliosis underwent posterior spinal fusion involving 5 to 12 vertebral levels. Bilateral single-injection ESPB was performed at one or two levels before incision. Preoperatively, patients received intravenous dexamethasone. General anesthesia with endotracheal intubation and volume-controlled ventilation was performed via TIVA with remifentanil and propofol. During and after the procedure, the basic hemodynamic parameters, opioid consumption, pain scores (numerical rating scale/NRS), and possible block complications were monitored. Results: All the patients experienced minimal postoperative pain levels. In addition, on the first day after surgery, they had low opioid requirements with no side effects. Conclusions: ESPB in patients undergoing congenital and neurogenic scoliosis correction surgery seems to be an essential analgesic technique that may reduce both severities of pain and opioid consumption.

Background: The immediate postoperative period after total hip arthroplasty can be associated with significant pain. Therefore, this study aimed to evaluate the effect of pericapsular nerve block on pain management and functional recovery after total hip arthroplasty. Methods: This prospective, randomized, double-blinded, placebo-controlled trial was conducted on 489 adult patients scheduled for total hip arthroplasty, ASA 1–2, operated under spinal analgesia. Participants were assigned to receive either a pericapsular nerve group (PENG) block with 20 mL of 0.5% ropivacaine or a sham block. Results: The primary outcome measure was the postoperative NRS score in motion. The secondary outcomes were cumulative opioid consumption, the time to the first opioid, and functional recovery. Demographic characteristics were similar in both groups. Intraoperative pain scores were significantly lower in patients who received the PENG block than in the control group (p < 0.0001). Also, the time to the first opioid was considerably longer in the PENG group (p < 0.0001). Additionally, 24% of PENG patients did not require opioids (p < 0.0001). Conclusions: The pericapsular nerve group showed significantly decreased opioid consumption and improved functional recovery. Pericapsular nerve group block improved pain management and postoperative functional recovery following total hip arthroplasty.

COGNITIVE MODELS OF VISUAL METAPHOR: THEORY, METHODOLOGY, ANALYSES The aim of the article is to present cognitive studies on visual metaphor: selected theories, methods and analyses. An overview of literature shows a growing interest in this area of research worldwide, especially in the light of the “visual turn”. Compared to the scholarly output of foreign researchers, publications of Polish authors are scarce and their results are not systematized. The discussion of the current state of research on visual metaphor is therefore motivated, on the one hand, by knowledge gap, and on the other, by the need to popularize and systematize this area of study in Poland.

Introduction: The Pericapsular Nerve Group (PENG) block is a novel technique that allows for analgesia of the anterior hip capsule via the articular branches of the accessory obturator nerve and femoral nerve, which have a significant role in the innervation of the hip capsule. A PENG (Pericapsular Nerves Group) blockade is effective in both adult and pediatric patients. However, no studies on patients under five are available in the literature. Herein, we describe our experience with two pediatric patients with hip dysplasia. Purpose: This study aimed to evaluate the analgesic effect of the pericapsular nerves group (PENG) in preschool children undergoing hip surgery. Patients and methods: This study included two patients, aged 4 and 2 years old, who were qualified for hip surgery. Spinal or general anesthesia with the addition of a PENG block was performed. During the procedure, the basic hemodynamic parameters were monitored. The pain was assessed using the FALCC (Face, Legs, Activity, Cry, Consolability scale) score. A dose of 15 mg/kg−1 of metamizole was administered if the FLACC score was 3. In the case of a score of 4 on the FLACC scale, the application of 0.2 mg/kg−1 of nalbuphine was ordered. Results: After the surgery, the patients received 15 mg/kg−1 IV paracetamol every 6 h to prevent rebound pain. The patient’s hemodynamic parameters were stable and within normal range. In the first 24 h period, the FLACC scores from all patients ranged from 0 to 3. One patient required metamizole 12 h after surgery. No evidence of block complications was observed. Conclusions: This case series showed that the PENG block assured opioid-free pain management and provided adequate postoperative analgesia. However, we are convinced that future randomized, controlled trials are needed in this field.

The Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons (Polish acronym: SCMiB TCHP) is a Polish specialist scientific society representing bariatric surgeons as well as specialists from other disciplines and professions cooperating with them during the provision of services in the field of bariatric and metabolic surgery, as well as the entire care process before and after surgery. The following standards constitute the minimum requirements set by the SCMiB TCHP for good practice of the basic process of bariatric care throughout its entire period, which ensure satisfactory safety and effectiveness of the obesity treatment and its metabolic complications.

Introduction: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33% of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures. Methods: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with a group of 856 patients with solitary disease operated for pHPT in the same period. Results: Among 163 patients—127 (79%) of them had two lesions, 28 (16%) had three, and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) as well for us. Treatment was surgical. Conclusions: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Diagnosis is based on PTH and calcium levels. Ultrasonography (USG), MRI, and scintigraphy are very helpful in diagnosis. Mediastinal multiglandular parathyroid disease (MGD) is associated with increased surgical treatment failures. The treatment is surgical and consists of the removal of the masses or complete parathyroidectomy. Based on this study, we support the existence of multiple adenomas and advocate the removal of only macroscopically enlarged parathyroid glands in patients with primary hyperparathyroidism.

The aim of this study was to investigate hepatic chemerin mRNA, serum chemerin concentration, and immunohistochemical staining for chemerin and and chemokine receptor-like 1 (CMKLR1) in hepatic tissue in 56 morbidly obese women with nonalcoholic fatty liver disease (NAFLD) and to search for a relationship with metabolic and histopathological features. Chemerin mRNA was assessed by quantitative real-time PCR, chemerin, and CMKLR1 immunohistochemical expression with specific antibodies, while serum chemerin concentration was assessed with commercially available enzyme-linked immunosorbent assays. Serum chemerin concentration reached 874.1 ±234.6 ng/ml. There was no difference in serum chemerin levels between patients with BMI < 40 kg/m2 and ≥ 40 kg/m2. Serum chemerin concentration tended to be higher in patients with hepatocyte ballooning, greater extent of steatosis, and definite nonalcoholic steatohepatitis (NASH). Liver chemerin mRNA was observed in all included patients and was markedly, but insignificantly, higher in those with BMI ≥ 40 kg/m2, hepatocyte ballooning, greater extent of steatosis, and definite NASH. Hepatic chemerin mRNA might be a predictor of hepatic steatosis, hepatocyte ballooning, and NAFLD activity score (NAS) but seemed not to be a primary driver regulating liver necroinflammatory activity and fibrosis. The lack of association between serum chemerin and hepatic chemerin mRNA may suggest that adipose tissue but not the liver is the main source of chemerin in morbidly obese women.

The aim of this study was to evaluate hepatic vaspin mRNA in morbidly obese women with nonalcoholic fatty liver disease (NAFLD) and to look for its relationships with metabolic and histopathological features. The study included 56 severely obese women who underwent intraoperative wedge liver biopsy during bariatric surgery. Hepatic vaspin mRNA was assessed by quantitative real-time PCR. Vaspin mRNA found in all included patients was markedly higher in patients with body mass index (BMI) ≥ 40 kg/m2 (4.59 ±3.09 vs. 0.44 ±0.33; p = 0.05). An evident but statistically insignificant difference in vaspin mRNA levels was observed between patients with and without hepatocyte ballooning (4.77 ±4.23 vs. 0.45 ±0.29, respectively), with and without steatosis (4.80 ±4.20 vs. 0.41 ±0.29, respectively), without and with fibrosis (0.25 ±0.80 vs. 6.23 ±7.2, respectively), and those without and with lobular inflammation (0.27 ±1.0 vs. 5.55 ±10.1, respectively). There was marked difference in vaspin mRNA between patients with simple steatosis/borderline nonalcoholic steatohepatitis (NASH) compared to those with definite NASH (0.24 ±0.96 vs. 10.5 ±10.4). Adiposity is an undoubted confounding factor influencing vaspin levels. Hepatic vaspin mRNA seems to be markedly elevated in morbidly obese patients with more advanced NAFLD and when hallmarks of NASH were observed. Pointing to non-linear mRNA levels within the NAFLD spectrum and an evident increase in patients with fibrosis and definite NASH, the detrimental action of vaspin cannot be excluded.

In this paper, the authors discuss the results of research on the preparation and properties of superabsorbent hydrogels based on carboxymethylated high-amylose corn starches. They were obtained by graft copolymerisation (in an aqueous environment) of acrylic acid and its sodium salt onto modified starches (with various substitution degrees DS = 0.2 and 0.8), using potassium persulfate as an initiator and N,N’-methylenebisacrylamide (MBA) as a cross-linker. Modified starches, with various DS, were used to synthesise two series of hydrogels with varying molar ratios of cross-linkers to monomers. The swelling behaviour of hydrogels was studied and their properties were estimated using the kinetic equation. The occurrence of starch–polyacrylic acid covalent interactions was demonstrated by FTIR analysis. Nonlinear rheological methods have proved to be very effective in assessing the mechanical properties of hydrogels. LAOS (large -amplitude oscillatory shear) analysis allowed the determination of the durability of the gel structure as a function of the amount of absorbed water.

The aim of the research was to develop new pectin-based hydrogels with excellent swelling properties. Superabsorbent hydrogels composed of high methylated pectin and partially neutralized poly(acrylic acid) was obtained by free radical polymerization in aqueous solution in the presence of crosslinking agent—N,N’-methylenebisacrylamide. The effect of crosslinker content and pectin to acrylic acid ratio on the swelling properties of hydrogels was investigated. In addition, the thermodynamic characteristic of hydrogels was obtained by DSC. Furthermore, the structure of pectin-based hydrogels was characterized by FTIR and GPC. It was also proved that poly(acrylic acid) is grafted on pectin particles. The results showed that introduction of small amount of pectin (up to 6.7 wt %) to poly(acrylic acid) hydrogel increase the swelling capacity, while further increasing of pectin ratio cause decrease of swelling.

A study of polyaniline (PANI) doping with various cobalt compounds, that is, cobalt(II) chloride, cobalt(II) acetate, and cobalt(II) salen, is presented. The catalysts were prepared by depositing cobalt compounds onto the polymer surface. PANI powders containing cobalt ions were obtained by one- or two-step method suspending PANI in the following acetonitrile/acetic acid solution or acetonitrile and then acetic acid solution. Moreover different ratios of Co(II) : PANI were studied. Catalysts obtained with both methods and at all ratios were investigated using various techniques including AAS and XPS spectroscopy. The optimum conditions for preparation of PANI/Co catalysts were established. Catalytic activity of polyaniline cobalt(II) supported catalysts was tested in dec-1-ene epoxidation with molecular oxygen at room temperature. The relationship between the amount of cobalt species, measured with both AAS and XPS techniques, and the activity of PANI-Co catalysts has been established.

Diagnostyka ścian paleniska kotłów energetycznych dużej mocy obecnie jest wykonywana z wózków liniowych lub rusztowań. Operator dokonuje ręcznego pomiaru zużycia w wytypowanych punktach pomiarowych, których może być nawet 20 000. W odpowiedzi na obecną metodę pomiaru w Przemysłowym Instytucie Automatyki i Pomiarów PIAP trwają prace nad prototypem systemu do zautomatyzowanej diagnostyki ścian palenisk. W skład systemu wchodzi robot wspinający się, konsola sterująca oraz oprogramowanie sterujące i realizujące obróbkę danych pozyskanych od robota. Przedstawiono wyniki opracowań oraz pierwszych testów systemu. Prototype system for diagnostic of high power boilers Abstract nowadays, diagnostics of high-energy boilers’ walls is carried out mainly from scaffoldings. Servicemen carry out manual measurements of the use of the boiler in selected points, which can be up to 20 000. In response to the current method of measuring the Industrial Research Institute for Automation and Measurements PIAP is working on a prototype system for automated diagnostic of boilers’ walls. The system consists of the climbing robot, control console and software for control and processing data obtained by the robot. The results of studies and the first tests of the system are presented in the paper.

The research was based on the analysis of plant material taken from pot experiment carried out in the years 1999–2000. The experiment was set up using a complete randomisation method and it ranged over three quantitative experimental factors: sulphur dose, sulphur form, dose and form of lime fertilizers. In the first year of the experiment the test plant was spring wheat and in the second year spring rape. Sulphur was implemented as sodium sulphate and as elementary sulphur. Sulphur fertilization was implemented before the sowing of wheat and rape. Soil liming was made using calcium carbonate and dolomite and it took place once before the experiment was set up. The purpose of this work was to determine the influence of soil supply in sulphur, calcium and magnesium on total sulphur content in the experimental plants. Wheat plants were harvested at the in stages of tillering, flowering and full maturity, while rape was harvested at the stages of plant rosette, flowering and full maturity. The applied factors influenced the changes of percentage of total sulphur content in spring forms of wheat and rape. The content of sulphur was determined by the stage of plant developement, plant organ, kind of sulphur fertilization and liming. Percentage content of total sulphur both in spring forms of wheat and rape was positively connected with the dose of sulphur implemented with fertilizers. Higher growth of sulphur content in plants took place in the series fertilized by sodium sulphate as compared to plants fertilized by the elementary form of sulphur. Soil liming by dolomite and calcium carbonate contributed to a decrease of the percentage content of total sulphur in the analysed forms of wheat and rape.

The results were based on an analysis of plant material of a two years’ pot experiment. The characteristics of plants and soil used in the experiment as well as the methods of experiment were presented in the work, which was related to total sulphur content in spring forms of wheat and rape. The analysis of plant and soil material used in the experiment was pursued in two replications and the values mentioned in tables are average. The uptake of total sulphur by spring forms of wheat and rape was calculated on the basis of percentage content of that nutrient and plant yields. Related to the experimental factors, the stage of plants development and plant organ the uptake of total sulphur by spring wheat and rape was clearly differentiated. It was stated that the biggest influence on total sulphur uptake by the analysed plants was exerted by sulphur fertilization. It was also proved that sodium sulphate influenced sulphur uptake more positively than application of elementary sulphur. In a large part total sulphur uptake was determined by soil liming. It results from the analysed data that after soil liming using both dolomite and calcium carbonate sulphur uptake by spring wheat decreased, as compared to the values observed in not limed series. In series with spring rape this regularity refers only to objects where sulphur fertilization was not implemented. In the other limed series where sulphur fertilization was also applied, total sulphur uptake increased as compared to the values observed in not limed objects. It should be added that also the form of lime fertilizer had some marginal influence on sulphur uptake, which was not much smaller in objects limed by calcium carbonate.