Search results

1

BIOAVAILABILITY OF DRUGS FROM SUPPOSITORIES IN CLINICAL PRACTICE AFTER 1995

100%

Hermann J., Hermann T. W.

Acta Poloniae Pharmaceutica - Drug Research

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2020

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vol. 77

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issue 3

417-421

EN

Abstract: A review has been supposed to be arranged on the literature published between 1996 and 2018 concerning applications of suppositories in clinical practice. The rectal route of drug administration has been in use for centuries particularly in children, elderly and comatose patients as well as in palliative care and preterm infants undergoing painful procedures. Morphine, salbutamol, methadone, lidocaine, propranolol, theophylline, and mianserin, which allow to avoid the hepatic first-pass effect, are examples of preference of rectal route over oral one. Only two main classes of antibiotics (β-lactams and macrolides) have been studied recently after the rectal route of their administration. With the help of modern pharmaceutics and novel RDDS, higher bioavailability and controlled release of the drug have become possible. A number of antiepileptic drugs can be given rectally either for acute seizure control or in maintenance therapy. UC can be effectively treated with topical formulations and is superior to rectal corticosteroids. To suppositories most often used in Europe and the United States for their local treatments belong: bisacodyl, glycerol, mesalazine, diclofenac, glyceryl trinitrate, budesonide, prednisolone, and hydrocortisone. Suppositories applied for treatment of systemic conditions are more numerous.

2

Restorative Proctocolectomy for Emergency Cases of Ulcerative Colitis

81%

Hermann J., Sękowska M., Drews M.

Polish Journal of Surgery

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2007

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vol. 79

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issue 4

265-268

EN

Restorative proctocolectomy was performed for urgent indications in three stages and for elective purposes in two stages for ulcerative colitis (UC). Since the three-step procedure makes enormous demands on the patients, there was an attempt to introduce a primary pouch anal anastomosis for urgent indications in selected cases.The aim of the study was to compare early complications in patients after having undergone Hartmann's procedure with those that had restorative proctocolectomy for urgent indications in UC, based on the authors' experience and the literature.Material and methods. The medical records of 211 patients who underwent an operation for UC in this clinic from 1996 through 2005 were retrospectively evaluated. There were 107 (51%) males and 104 (49%) females in this study; the mean age was 38 years. The median duration of disease was 3 years.Results. An operation was performed in 77 (36%) patients for urgent indications. Finally, the study was entered by 60 (28%) patients after exclusion of the high-risk patients. All the patients were divided into two groups. The first group consisted of 25 (42%) patients who underwent the Hartmann's procedure, whereas the second group comprised 35 (58%) patients who had the pouch operation. There was no postoperative mortality in the surveyed group. Respiratory failure occurred in 6 (24%) patients after Hartmann's operation and in 5 (14%) patients who underwent the pouch procedure. Intra-abdominal sepsis developed in 3 (12%) patients after colectomy and in 5 (14%) after pouch-anal anastomosis. Wound dehiscence was present in 2 (8%) patients undergoing Hartmann's operation and in 3 (9%) after the pouch procedure. Bowel obstruction occurred in 1 patient after the former operation and in 2 (6%) patients after the latter one. Wound infection was diagnosed in 5 (20%) patients after colectomy and in 7 (20%) after proctocolectomy. Differences between the investigated groups of patients were not statistically significant.Results. The three-stage procedure with Hartmann's colectomy is the treatment of choice for urgent indications in UC.Primary restorative proctocolectomy is performed for urgent indications in acute UC in selected group of patients without septic signs due to a similar morbidity as the group of patients who had Hartmann's procedure.

3

Bioavailability of mesalazine from two coated formulation tablets

81%

Hermann T. W., Główka F. K., Hermann J., Zabel M.

Acta Poloniae Pharmaceutica - Drug Research

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2019

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vol. 76

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issue 1

67-73

EN

HPLC methodology with a fluorescent detector is suitable for bioavailability studies of investigated generic tablets Mesalazine 250 mg (Jelfa, Poland) versus standard Salofalk tablets (Dr. Falk, Germany). The investigations were completed in ten healthy subjects in a double way crossover design. Only one bioavailability parameter – time for maximum mesalazine plasma concentration (tmax ) and overall elimination rate constants are significantly greater for the above standard tablets. The parameters like maximum plasma drug concentration (Cmax), lag time for absorption (Tlag), biological half-life time (t1/2 ) are also more favorable for the standard, but these values are not significantly different.

4

Sublay Incisional Hernia Repair with Composite Mesh in Patients with Additional Abdominal Disorders

81%

Hermann J., Ratajczak A., Meissner W.

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issue 11

550-553

EN

The authors present two patients operated on for large incisional hernias with additional abdominal disorders requiring surgical treatment. The first patient was scheduled for cholecystectomy whereas the second one for partial resection of the small bowel. Since those hernias did not qualify for classical operations due to extensive destruction of the muscular and fascial layers of the abdominal wall the patients underwent repair with modern composite meshes. Those meshes can be applied directly on the bowel loops. Of the two patients a polyester mesh coated with polyethylene-glycol-glycerol-oxidized bovine atelocollagen was applied in the former whereas a polypropylene monofilament mesh coated with a layer of silicone in the latter. Those biomaterials coating the visceral surface of the meshes prevent them from adherence to the bowel loops. What is more, inflammatory response to the foreign body with following adhesion formation and as a result either bowel obstruction or enterocutaneous fistulas can be reduced. The postoperative course was uneventful in both patients in spite of the operations being performed in the contaminated field.

5

Treatment of the Hemorrhoids and Anal Mucosal Prolapse Using Elastic Band Ligature - Early and Long Term Results

71%

Sękowska M., Kościński T., Wierzbicki T., Hermann J., Drews M.

Polish Journal of Surgery

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2011

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vol. 83

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issue 12

654-661

EN

The aim of the study was to evaluate the results of the treatment of internal hemorrhoids and anal mucosal prolapse using elastic band ligation and to compare this method to chosen surgical procedures.Material and methods. The study included 648 patients (363 males and 285 females). 474 patients were treated using an elastic band ligature and 174 patients underwent surgical hemorrhoidectomy. The average age of the patients in both groups was similar - 49 years.The treatment tolerance was evaluated in the prospective study group. The intensity and duration of pain was assessed on the first and second postoperative day using a Verbal Rating Scale.Results. 86.5% of the patients were cured using Barron's procedure, success rate for second-degree hemorrhoids was 89% and for third degree - 85.2%. Surgical hemorrhoidectomy was effective in 92% of patients. Early failure of elastic ligature was noted in 2.5% of patients. The recurrences of hemorrhoidal symptoms were observed in 11% of Barron's group and in 8% after hemorrhoidectomy. The intensity of pain was much higher among patients after surgical hemorrhoidectomy. The average of the pain score in the 4th hour was 0.3 for the elastic band ligation and 1.4 for the surgical treatment. In the 24th hour - 0.2 and 1.7 respectively. Mean postoperative stay was 3.8 days.Conclusions. Rubber band ligation is highly effective and well tolerated. Relatively minor pain following this procedure is found in only 9.5% of patients. The disadvantages of surgical hemorrhoidectomy are: important postoperative pain and long time of wound healing that impair the recovery to professional activity.

6

Migration of biomaterials used in gastroenterological surgery

61%

Ratajczak A., Kościński T., Banasiewicz T., Lange-Ratajczak M., Hermann J., Bobkiewicz A., Drews M.

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vol. 85

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issue 7

377-380

EN

Mesh biomaterials have become the standard in the treatment of hernias, regardless the location. In addition to the obvious advantages of the methods based on implantable biomaterials, one should be aware of the possible complications, such as their migration to the abdominal organs. Material and methods. The study group comprised patients operated at the Department of General, Gastroenterological Oncology, and Plastic Surgery during the period between 2008 and 2011, due to hernia surgery with mesh implantation. We also analysed the number of patients operated, due to complications of mesh migration during the same period. Results. 368 patients were subject to mesh implantation, due to hernias during the period between 2008 and 2011. Three patients underwent surgery because of symptomatic migration of the mesh (ileus, fistula). Conclusions. The frequency of mesh migration is difficult to determine because of the different criteria of migration, observation period, and other factors. In patients after mesh implantation the potential migration of the biomaterial should be considered in case of unclear or acute abdominal symptoms.

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