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Introduction: It is suggested that preoperative carbohydrate loading may have beneficial effects, which is emphasised in Enhanced Recovery After Surgery protocols (ERAS). Recent data confirmed that carbohydrate loading shortens length of hospital stay. Aim: In this systematic review we aimed to determine whether carbohydrate loading have positive effects in patients undergoing 1-day surgery. Material and methods: We searched 5 databases and identified some randomized controlled trials which were reviewed independently by two reviewers. In the end 6 RCTs were included, involving 411 patients. Studies compared effects of carbohydrate loading vs. fasting and/or placebo on the following outcomes: thirst, hunger, postoperative nausea and vomiting (PONV), fatigue, pain and postoperative insulin resistance. In most cases data are inconclusive as studies reported opposite results. Conclusions: It seems that carbohydrate loading did not have a significant impact when compared to fasting or placebo. Preoperative carbohydrate loading seems not to have significant benefits over fasting or placebo in patients qualified for 1-day surgery. [ABSTRACT FROM AUTHOR]

Implant-related infections are an emerging clinical and economic problem. Therefore, we decided to assess potential clinical usefulness and safety of silver orthophosphate microparticles (SOMPs) regarding their shape. We synthesized and then assessed antimicrobial properties and potential cytotoxicity of six shapes of SOMPs (tetrapod, cubes, spheres, tetrahedrons, branched, and rhombic dodecahedron). We found that SOMPs had a high antimicrobial effect; they were more efficient against fungi than bacteria. SOMPs exerted an antimicrobial effect in concentrations not toxic to mammalian cells: human fetal osteoblast (hFOB1.19), osteosarcoma (Saos-2), mouse preosteoblasts (MC3T3-E1), skin fibroblast (HDF), and mouse myoblast (C2C12). At higher concentration SOMPs, induced shape- and concentration-dependent cytotoxicity (according to MTT and BrdU assays). Tetrapod SOMPs had the smallest effect, whereas cubical SOMPs, the highest on cell viability. hFOB1.19 were the most resistant cells and C2C12, the most susceptible ones. We have proven that the induction of oxidative stress and inflammation is involved in the cytotoxic mechanism of SOMPs. After treatment with microparticles, we observed changes in levels of reactive oxygen species, first-line defense antioxidants-superoxide dismutase (SOD1, SOD3), and glutathione peroxidase (GPX4), metalloproteinase (MMP1, MMP3), and NF- κ B protein. Neither cell cycle distribution nor ultrastructure was altered as determined by flow cytometry and transmission electron microscopy, respectively. In conclusion, silver orthophosphate may be a safe and effective antimicrobial agent on the implant surface. Spherical-shaped SOMPs are the most promising for biomedical application., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2019 Karol P. Steckiewicz et al.)