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Decubitus ulcer

N R Zembower, A Zhu, M Malczynski, C Qi
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To determine the prevalence of brain and spinal cord injury (BSCI) patients among all patients with Klebsiella pneumoniae carbapenemase-producing K. pneumoniae (KPC-KP) and to evaluate clinical characteristics and duration of colonization. SETTING: Tertiary care academic medical center. METHODS: Electronic medical records of BSCI patients with KPC-KP from February 2009 to December 2014 were reviewed to determine clinical characteristics...
October 18, 2016: Spinal Cord
Luis A Berrios
More than one-third of the US adult population and 17% of the youth are now obese, and obesity is associated with more than $147 billion a year in health care costs. Critical care nurses should understand the physiological differences and practice guidelines for patients with a body mass index greater than 30. The ABCD approach encompasses key clinical concepts in the management of critically ill obese and morbidly obese patients, including management of airways and breathing, minimizing nurses' back and other injuries, increasing awareness of bias, circulation problems, risks of decubitus ulcers and other skin breakdown, differences in drug calculations and metabolism, limitations in diagnostic equipment and imaging, diet and nutritional recommendations, and concerns with durable medical equipment...
October 2016: Critical Care Nurse
Hong-Lin Chen, Wang-Qin Shen, Peng Liu
Although it is among the most commonly used pressure ulcer risk assessment tools, the Braden Scale may lack strong predictive validity when used in the long-term care setting. A meta-analysis was conducted of English-language articles published in the PubMed database and Web of Science from the indices' inception through July 2015 to assess the predictive validity of the Braden Scale for pressure ulcers in long-term care residents. Search terms included pressure ulcer, pressure sore, bedsore, decubitus, long-term care, nursing home, skilled nursing facility, hospice, and Braden...
September 2016: Ostomy/wound Management
James E McCarthy, Venkat K Rao
BACKGROUND: The purpose of this article is to describe the indications, operative technique, outcomes, and systematic review of the literature on the reconstruction of patients with end-stage pressure ulcers using a fillet flap technique. In this technique, the femur, tibia, and fibula are removed from the thigh and leg, and the soft tissue is used as a pedicled, or free, myocutaneous flap for reconstruction. Long-term outcomes, salient surgical technique of flap elevation, and design are detailed for patients who had a fillet of leg flap for reconstruction of extensive pressure ulcers...
August 2016: Plastic and Reconstructive Surgery. Global Open
Tommaso Martino, Donato Melchionda, Paolo Tonti, Vincenzo De Francesco, Alessandra Lalla, Luigi Maria Specchio, Carlo Avolio
Apparently, unexplained weight loss is a common symptom experienced by patients affected by Parkinson's disease, especially in those treated by levodopa-carbidopa infusion gel (LCIG) with a poor control of dyskinesias. Weight loss is considered part of gastrointestinal dysfunction seen in patients affected by Parkinson's disease, along with gastroparesis and reduced bowel peristalsis. In patients treated with LCIG, weight loss needs to be accurately evaluated, because of possible underlying life-threatening adverse events, like duodenum decubitus ulcer...
September 10, 2016: Journal of Neural Transmission
Chakor S Vora, Niteen D Karnik, Vishal Gupta, Milind Y Nadkar, Jaimala V Shetye
INTODUCTION: An increasing number of patients require mechanical ventilation and there has been a proportional increase in patients needing prolonged mechanical ventilation (ventilated for ≥ 21 days, for atleast 6 hours per day). It accounts for about 10% of all mechanically ventilated patients. Although these patients represent a smaller proportion of intensive care unit (ICU) patients, they consume substantial ICU resources. We studied etiology, metabolic and clinical profile, complications and outcome of these patients...
October 2015: Journal of the Association of Physicians of India
Maanasa Jayachandran, Suset Rodriguez, Elizabeth Solis, Jiali Lei, Anuradha Godavarty
Significance: Noninvasive imaging approaches can provide greater information about a wound than visual inspection during the wound healing and treatment process. This review article focuses on various optical imaging techniques developed to image different wound types (more specifically ulcers). Recent Advances: The noninvasive optical imaging approaches in this review include hyperspectral imaging, multispectral imaging, near-infrared spectroscopy (NIRS), diffuse reflectance spectroscopy, optical coherence tomography, laser Doppler imaging, laser speckle imaging, spatial frequency domain imaging, and fluorescence imaging...
August 1, 2016: Advances in Wound Care
Karen A Abrashkin, Jonathan Washko, Jenny Zhang, Asantewaa Poku, Hyun Kim, Kristofer L Smith
Models addressing urgent clinical needs for older adults with multiple advanced chronic conditions are lacking. This observational study describes a Community Paramedicine (CP) model for treatment of acute medical conditions within an Advanced Illness Management (AIM) program, and compares its effect on emergency department (ED) use and subsequent hospitalization with that of traditional emergency medical services (EMS). Community paramedics were trained to evaluate and, with telemedicine-enhanced physician guidance, treat acute illnesses in individuals' homes...
August 30, 2016: Journal of the American Geriatrics Society
Mai Murata, Katsuhiro Yoshikawa, Munehisa Hiratsuka, Shigehiko Suzuki
We herein report a 62-year-old man with an extensive sacral decubitus ulcer complicated by an epidural abscess. An epidural abscess is a rare disease, but it should be considered in the differential diagnosis of a deep infection with decubitus. Moreover, the diagnosis may be late in such instances and should be carefully considered when a patient has paralysis.
July 2016: Plastic and Reconstructive Surgery. Global Open
Satoru Miyata
Trace elements are the essential nutrients. Now, 9 elements, Fe, Zn, Cu, Se, I, Go, Cr, Mn, Mo, are recognized as essential trace elements. Serum concentration of Fe, Zn and Cu are about 100 μg/dL, and have important physiological roles. Zinc needs special care because over 300 enzymes contain Zn, and zin deficiency cause various disorders. In advancing age serum Zn concentration decrease. Although the daily requirement of zinc is 10-15 mg in adults, it is necessary to supply much more zinc than adult, by the reason of low intake and low absorption in the elderly...
July 2016: Nihon Rinsho. Japanese Journal of Clinical Medicine
Siamak Moayedi, Lisa Babin
An elderly woman with a chronic decubitus sacral ulcer presented to the emergency department with sepsis. A computed tomography of her abdomen showed diffuse gas extending throughout the thoracolumbar spinal canal. Pneumorrhachis is a rare radiographic finding defined as gas within the spinal canal. There are many causes of pneumorrhachis ranging from trauma to infection. In this case the pneumorrhachis was caused by direct spread of gas-forming organisms from vertebral osteomyelitis. Emergency physicians should know about the implication of gas in the spinal canal in the setting of sepsis...
July 2016: Western Journal of Emergency Medicine
Barbara Guerard, Vincent Omachonu, S Robert Hernandez, Bisakha Sen
Self-reported changes in physical and mental health by members are an important dimension by which the quality of a Medicare Advantage (MA) plan is rated by the Centers for Medicare & Medicaid Services. To better target their interventions, MA plans need a better understanding of what observed characteristics-including clinical health conditions-predict self-reported changes in physical and mental health. This study explored how one MA plan's survey of participants' responses regarding changes in physical and mental health is associated with a set of chronic conditions as well as sociodemographic characteristics...
July 15, 2016: Population Health Management
Ethan A Winkler, John K Yue, John Frederick Burke, Praveen V Mummaneni, Geoffrey T Manley, Phiroz E Tarapore, Sanjay S Dhall
INTRODUCTION: The management of axis fractures and particularly of odontoid fractures in the elderly remains controversial. As a greater segment of the US population lives past 80, it is becoming increasingly evident that published morbidity and mortality profiles of C2 fractures in younger cohorts (55+) are not applicable to octogenarians. Consequently, there is a need for further study in this specific population. METHODS: Using the National Sample Program (NSP) of the National Trauma Data Bank (NTDB), we performed a retrospective analysis of patients with age = 80 years and traumatic C2 fracture...
August 2016: Neurosurgery
Fei Chen, Yijun Kang, Haisheng Li, Guohua Lv, Chang Lu, Jing Li, Bing Wang, Weihua Chen, Zhehao Dai
STUDY DESIGN: Retrospective analysis of 16 patients. SUMMARY OF BACKGROUND DATA: The lumbar split fracture-dislocation is a rare but severe injury, which is type C1.2.1 fracture in the AO/ASIF spine fracture classification. The axial compressive and torsional force shattered the vertebral body into two halves and displaced them rotationally. This kind of fracture is so highly unstable that the treatment is very challenging. PURPOSE: The purpose of this study was to report and compare on clinical outcome and complications of patients with lumbar split fracture-dislocation which had been treated either short- or long-segment posterior fixation and anterior fusion...
June 3, 2016: Clinical Spine Surgery
Tsung-Jung Ho, Shinn-Jong Jiang, Guang-Huey Lin, Tzong Shiun Li, Lih-Ming Yiin, Jai-Sing Yang, Ming-Chuan Hsieh, Chun-Chang Wu, Jaung-Geng Lin, Hao-Ping Chen
"Jinchuang ointment" is a traditional Chinese herbal medicine complex for treatment of incised wounds. For more than ten years, it has been used at China Medical University Hospital (Taichung, Taiwan) for the treatment of diabetic foot infections and decubitus ulcers. Three different cases are presented in this study. "Jinchuang" ointment is a mixture of natural product complexes from nine different components, making it difficult to analyze its exact chemical compositions. To further characterize the herbal ingredients used in this study, the contents of reference standards present in a subset of the ointment ingredients (dragon's blood, catechu, frankincense, and myrrh) were determined by HPLC...
2016: Evidence-based Complementary and Alternative Medicine: ECAM
Çağlar Uzun, Ayşe Erden, Ebru Düşünceli Atman, Evren Üstüner
PURPOSE: We aimed to draw attention to the lymph nodes at the inferior gluteal and ischioanal regions and evaluate the lesions accompanying them using 3.0 T magnetic resonance imaging (MRI). METHODS: In total, 22 patients (15 men, 7 women; mean age, 50±11.2 years; age range, 32-71 years) were included in this study. The patients' medical records were reviewed. MRI data were reviewed on a picture archiving and communication system workstation by two radiologists in consensus...
July 2016: Diagnostic and Interventional Radiology: Official Journal of the Turkish Society of Radiology
Akihiko Uchiyama, Kazuya Yamada, Buddhini Perera, Sachiko Ogino, Yoko Yokoyama, Yuko Takeuchi, Osamu Ishikawa, Sei-Ichiro Motegi
Ischaemia-reperfusion (I/R) is involved in the development of various organ diseases. There has been increasing evidence that cutaneous I/R injury is associated with the pathogenesis of pressure ulcers (PUs), especially at the early stage presenting as non-blanchable erythema. However, there is no evidence-based treatment for early-stage PUs. Our objective was to assess the effects of topical steroid on the development of PUs after cutaneous I/R injury in mice. Cutaneous I/R was performed by trapping the dorsal skin between two magnetic plates for 12 h, followed by plate removal...
September 2016: Experimental Dermatology
Hyun-Woo Jeong, Hyung Woo Choi, Hyeyoung Jung, Kyeong Hun Kim, Sangsoo Park
BACKGROUND: Urinary incontinence is a common problem among the elderly and patients with neurologic disability. The conventional urinary incontinence aids, such as urine-absorbing diapers, pads, and indwelling catheters, frequently cause hygienic problems. OBJECTIVE: To study the safety and efficacy of a new automatic urine disposal system that can suction and store the urine in a separate container for future disposal. METHODS: An electromechanical urine disposal system that can collect and transport the urine and cleanse and air-dry the external genitalia was developed...
September 14, 2016: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
Yulia Merkulova, Yue Shen, Leigh G Parkinson, Sheetal A Raithatha, Hongyan Zhao, Kathryn Westendorf, Mehul Sharma, Robert Chris Bleackley, David J Granville
Chronic non-healing wounds including diabetic, venous, and decubitus skin ulcers are currently lacking effective therapies. Non-healing diabetic ulcers can lead to amputations as progress into a highly chronic state before detection and existing treatments for these wounds often fail. Granzyme B (GzmB) is a serine protease that was, until recently, believed to function exclusively in cytotoxic lymphocyte-mediated apoptosis. However, during excessive or chronic inflammation, GzmB can accumulate in the extracellular milieu, retain its activity, and cleave a number of important extracellular proteins...
September 1, 2016: Biological Chemistry
Gill Norman, Jo C Dumville, Zena E H Moore, Judith Tanner, Janice Christie, Saori Goto
BACKGROUND: Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. A range of treatments with antimicrobial properties, including impregnated dressings, are widely used in the treatment of pressure ulcers. A clear and current overview is required to facilitate decision making regarding use of antiseptic or antibiotic therapies in the treatment of pressure ulcers. This review is one of a suite of Cochrane reviews investigating the use of antiseptics and antibiotics in different types of wounds...
2016: Cochrane Database of Systematic Reviews
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