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prevention pressure injury

Robert N Goldstone, Michael C McCormack, Rachel L Goldstein, Srivalleesha Mallidi, Mark A Randolph, Michael T Watkins, Robert W Redmond, William G Austen
OBJECTIVE: We hypothesized that decreasing vein compliance would protect the vein against stretch injury and reduce intimal hyperplasia (IH). BACKGROUND: Although arteriovenous fistulas (AVFs) are the criterion standard for vascular access, their effectiveness is limited by poor patency with 40% to 60% failing due to IH. Venous stretch injury from exposure to arterial pressure induces IH. Photochemical tissue passivation (PTP) crosslinks adventitial collagen, decreasing vein compliance to resemble that of an artery...
October 17, 2016: Annals of Surgery
Argyrios Chronopoulos, Gabriele Thumann, James Schutz
Positive vitreous pressure (PVP) occurs during anterior segment intraocular surgery associated with acute hypotony and is characterized by forward displacement of the lens-iris diaphragm with shallowing of the anterior chamber resistant to reformation, repeated iris prolapse, and, in severe cases, zonular rupture and vitreous or lens prolapse that can lead to a cascade of intraoperative complications. PVP is particularly common during penetrating keratoplasty (PK), conventional nuclear expression cataract extraction, and repair of anterior open globe injury...
October 14, 2016: Survey of Ophthalmology
Daniele Ottinger, Jamie Hicks, Sarah Wilson, Kim Sperber, Keely Power
BACKGROUND: Premature infants have an increased risk for developing skin breakdown. Perceivably noninvasive interventions may have detrimental effects on the infant's skin. PURPOSE: This case presentation describes an extreme case of nasal breakdown associated with nasal continuous positive airway pressure (nCPAP). METHODS: Highlighted is the vital importance of proper placement, along with appropriate apparatus size, in the efforts to prevent skin breakdown...
October 7, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Mohamed Balaha, Samah Kandeel, Waleed Barakat
Carvedilol is an anti-oxidant non-selective β-blocker used for reduction of portal blood pressure, prophylaxis of esophageal varices development and bleeding in chronic liver diseases. Recently, it exhibited potent anti-inflammatory, anti-fibrotic, anti-proliferative and anti-carcinogenic effects. In the present study, we evaluated the possible suppressive effect of carvedilol on circulating and hepatic IL-6 levels responsible for hepatocarcinogenesis in a rat model of hepatic cirrhosis. Besides, its effect on hepatic STAT-3 levels, function tests, oxidative stress markers, and hydroxyproline content, hepatic tissue histopathological changes and immunohistochemical expression of E & N-cadherin...
October 13, 2016: Toxicology and Applied Pharmacology
Ashley E Mohrman, Mahmoud Farrag, He Huang, Stephan Ossowski, Stephanie Haft, Leah P Shriver, Nic D Leipzig
Syringomyelia is a condition of the spinal cord in which a syrinx, or fluid-filled cavity, forms from trauma, malformation, or general disorder. Previous work has shown that in noncanalicular syringomyelia irregular flow and pressure conditions enhance the volumetric growth of syrinxes. A better understanding of the underlying molecular pathways associated with syrinx formation will unveil targets for treatments and possibly prevention of syringomyelia in the future. In this study, we performed an established surgical induction of a syrinx using quisqualic acid and kaolin injections in rats to characterize the injury at the molecular level by RNA sequencing and metabolomics techniques at three and six weeks post-injury...
October 13, 2016: Journal of Neurotrauma
(no author information available yet)
BACKGROUND: The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. METHODS: We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015...
October 8, 2016: Lancet
Loreto Lollo, Andreas Grabinsky
BACKGROUND: Acute lower extremity compartment syndrome (CS) is a condition that untreated causes irreversible nerve and muscle ischemia. Treatment by decompression fasciotomy without delay prevents permanent disability. The use of intracompartmental pressure (iCP) measurement in uncertain situations aids in diagnosis of severe leg pain. As an infrequent complication of lower extremity trauma, consequences of CS include chronic pain, nerve injury, and contractures. The purpose of this study was to observe the clinical and functional outcomes for patients with lower extremity CS after fasciotomy...
July 2016: International Journal of Critical Illness and Injury Science
Alexandra Mani, Chryssoula Staikou, Iosifina Karmaniolou, Nikolaos Orfanos, Anastassios Mylonas, Tzortzis Nomikos, Agathi Pafiti, Apostolos Papalois, Nikolaos Arkadopoulos, Vassilios Smyrniotis, Kassiani Theodoraki
AIM OF THE STUDY: To investigate the pulmonary oxidative stress and possible protective effect of N-Acetylcysteine (NAC) and Desferoxamine (DFX)in a porcine model subjected to hemorrhagic shock. MATERIALS AND METHODS: Twenty-one pigs were randomly allocated to Group-A (sham, n = 5), Group-B (fluid resuscitation, n = 8) and Group-C (fluid, NAC and DFX resuscitation, n = 8). Groups B and C were subjected to a 40-min shock period induced by liver trauma, followed by a 60-min resuscitation period...
August 15, 2016: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Katsumi Kadekawa, Tsuyoshi Majima, Naoki Kawamorita, Hiroki Okada, Tsuyoshi Yoshizawa, Kenichi Mori, Pradeep Tyagi, Kimio Sugaya, Naoki Yoshimura
AIMS: In order to clarify whether an alpha1A/D-adrenoceptor (α1 A/D-AR) antagonist, naftopidil, or a phosphodiesterase type 5 (PDE5) inhibitor, tadalafil, prevents bladder wall remodeling after spinal cord injury (SCI), we examined the bladder and urethral activity as well as ischemic and fibrotic changes in the bladder using SCI rats with or without naftopidil or tadalafil treatment. METHODS: Adult female Sprague-Dawley rats were divided into four groups: (1) normal (spinal cord intact); (2) vehicle SCI; (3) naftopidil SCI; and (4) tadalafil SCI groups...
October 4, 2016: Neurourology and Urodynamics
Chia-Hua Tai, Mei-Yu Hsu
BACKGROUND: Noninvasive positive pressure ventilation (NPPV) provides ventilation without tracheal intubation. Facial pressure injury is a recognized complication of this technique, making the prevention of facial pressure injuries an important issue for NPPV patients. PURPOSE: The present study compared the effects of foam dressing and hydrocolloid dressing in preventing facial pressure injuries in NPPV patients. METHODS: A randomized clinical trial was used to evaluate participants that were referred from the intensive care unit of a medical center in eastern Taiwan...
October 2016: Hu Li za Zhi the Journal of Nursing
Daniel W Spaite, Chengcheng Hu, Bentley J Bobrow, Vatsal Chikani, Bruce Barnhart, Joshua B Gaither, Kurt R Denninghoff, P David Adelson, Samuel M Keim, Chad Viscusi, Terry Mullins, Duane Sherrill
STUDY OBJECTIVE: Survival is significantly reduced by either hypotension or hypoxia during the out-of-hospital management of major traumatic brain injury. However, only a handful of small studies have investigated the influence of the combination of both hypotension and hypoxia occurring together. In patients with major traumatic brain injury, we evaluate the associations between mortality and out-of-hospital hypotension and hypoxia separately and in combination. METHODS: All moderate or severe traumatic brain injury cases in the preimplementation cohort of the Excellence in Prehospital Injury Care study (a statewide, before/after, controlled study of the effect of implementing the out-of-hospital traumatic brain injury treatment guidelines) from January 1, 2007, to March 31, 2014, were evaluated (exclusions: <10 years, out-of-hospital oxygen saturation ≤10%, and out-of-hospital systolic blood pressure <40 or >200 mm Hg)...
September 27, 2016: Annals of Emergency Medicine
Björn Tampe, Ulrike Steinle, Désirée Tampe, Julienne L Carstens, Peter Korsten, Elisabeth M Zeisberg, Gerhard A Müller, Raghu Kalluri, Michael Zeisberg
Acute kidney injury (AKI) and progressive chronic kidney disease (CKD) are intrinsically tied syndromes. In this regard, the acutely injured kidney often does not achieve its full regenerative capacity and AKI directly transitions into progressive CKD associated with tubulointerstitial fibrosis. Underlying mechanisms of such AKI-to-CKD progression are still incompletely understood and specific therapeutic interventions are still elusive. Because epigenetic modifications play a role in maintaining tissue fibrosis, we used a murine model of ischemia-reperfusion injury to determine whether aberrant promoter methylation of RASAL1 contributes causally to the switch between physiological regeneration and tubulointerstitial fibrogenesis, a hallmark of AKI-to-CKD progression...
September 27, 2016: Kidney International
Peter Onody, Peter Aranyi, Zsolt Turoczi, Rita Stangl, Andras Fulop, Emese Dudas, Gabor Lotz, Attila Szijarto
AIMS AND OBJECTIVES: Acute renal failure is a severe complication of lower extremity major arterial reconstructions, which could even be fatal. Levosimendan is a dual-acting positive inotropic and vasodilatory agent, which is suspected to have protective effects against cardiac ischemia. However, there is no data available on lower limb or remote organ ischemic injuries therefore the aim of the study was to investigate the effect of levosimendan on lower limb ischemia-reperfusion injury and the corollary renal dysfunction...
2016: PloS One
H Ozkan, T Ege, K Koca, N Can, Y Yurttas, S Tunay
The aim of the current study was to assess the changes of plantar foot pressures with pedobarography in -patients with Achilles tendon repair by minimally -invasive surgical technique. This retrospective study consisted of 15 consecutive patients who were treated for acute Achilles' tendon repair with minimally invasive technique in our clinic in a two year period between 2010 and 2012. All patients were male. The mean age was 28.7 years (24-42) and the mean follow-up time was 2.3 years (1.5- 3). All patients had sports related Achilles' tendon rupture and all had undergone surgery in 24-48 hours...
August 2016: Acta Orthopaedica Belgica
Marliese Dion Nist, Elizabeth A Rodgers, Brenda M Ruth, C Briana Bertoni, Thomas Bartman, Leah A Keller, James W Dail, Renee Gardikes-Gingery, Edward G Shepherd
BACKGROUND: Skin injuries are common among neonatal intensive care unit (NICU) patients and may lead to significant complications. Standardized methods of preventing, detecting, and treating skin injuries are needed. PURPOSE: The aim of this project was to standardize the assessment, documentation, and tracking of skin injuries among hospitalized neonatal patients and to determine the incidence of pressure ulcers in this patient population. METHODS: (1) Creation of an interdisciplinary skin team to identify skin injuries through weekly skin rounds...
October 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Xiaoming Zhang, Vinoth Ranganthan, Vernon W Lin
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Shawn Nguyen, Mitchell McDowell, John Schlechter
Casting is a routine procedure used for fracture care in the pediatric population. The purpose of this review is to provide pearls and pitfalls that our institution has learned from previous literature. When applying the cast, we recommend using cotton padding for the liner and fiberglass or plaster depending on how much swelling is expected. A well-molded cast must be applied in order to prevent further fracture displacement. Cast valving is a valuable technique that allows a decrease in pressure which prevents discomfort and complications like compartment syndrome...
September 18, 2016: World Journal of Orthopedics
Kirsten Morrissey, Hilary Fairbrother
More than 1.7 million traumatic brain injuries occur in adults and children each year in the United States, with approximately 30% occurring in children aged < 14 years. Traumatic brain injury is a significant cause of morbidity and mortality in pediatric trauma patients. Early identification and management of severe traumatic brain injury is crucial in decreasing the risk of secondary brain injury and optimizing outcome. The main focus for early management of severe traumatic brain injury is to mitigate and prevent secondary injury, specifically by avoiding hypotension and hypoxia, which have been associated with poorer outcomes...
October 2016: Pediatric Emergency Medicine Practice
Lijun Liu, Jian Wu, David J Kennedy
Cardiac remodeling occurs after cardiac pressure/volume overload or myocardial injury during the development of heart failure and is a determinant of heart failure. Preventing or reversing remodeling is a goal of heart failure therapy. Human cardiomyocyte Na(+)/K(+)-ATPase has multiple α isoforms (1-3). The expression of the α subunit of the Na(+)/K(+)-ATPase is often altered in hypertrophic and failing hearts. The mechanisms are unclear. There are limited data from human cardiomyocytes. Abundant evidences from rodents show that Na(+)/K(+)-ATPase regulates cardiac contractility, cell signaling, hypertrophy and fibrosis...
2016: Frontiers in Physiology
Jin Chen, Bo Zhang, Wei Chen, Jian-Yi Kang, Kui-Jun Chen, Ai-Min Wang, Jian-Min Wang
The development of high-energy weapons could increase the velocity of projectiles to well over 1000 m/s. The nature of the injuries caused by the ballistic impact of projectiles at velocities much faster than 1000 m/s is unclear. This study characterizes the mechanical and biochemical alterations caused by high-speed ballistic impact generated by spherical steel ball to the hind limbs of the pig. That the local and distal injuries caused by hypervelocity ballistic impact to the living body are also identified...
2016: SpringerPlus
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