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Oedema management

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https://www.readbyqxmd.com/read/29152709/perioperative-gastrointestinal-problems-in-the-icu
#1
Annika Reintam Blaser, Joel Starkopf, Pieter-Jan Moonen, Manu L N G Malbrain, Heleen M Oudemans-van Straaten
Gastrointestinal (GI) problems after surgery are common and are not limited to patients undergoing abdominal surgery. GI function is complicated to monitor and is not included in organ dysfunction scores widely used in the ICUs. In most cases, it recovers after surgery, if systemic and local inflammation and perfusion improve, gut oedema resolves, and analgosedation is reduced. However, perioperative GI problems may have severe consequences and increase the risk of death if not recognized and managed in a timely manner...
November 20, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29120684/managing-exudate-and-maceration-in-venous-leg-ulceration-within-the-acute-health-setting
#2
Annemarie Brown
Exudate has beneficial effects in normal wound healing but detrimental consequences for chronic wounds. Practitioners need to identify and treat its cause, and manage the exudate and prevent if from damaging periwound skin. Management involves dressings of the most appropriate absorbency and other products, and avoiding maceration of periwound skin; compression therapy is the gold standard treatment for treating oedema and venous leg ulceration. Nurses in acute settings may not have the skills to implement or maintain compression therapy; this article is intended for nurses who may have to manage these patients temporarily while they are admitted to secondary care and may not have the skills...
November 8, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29119743/managing-chronic-oedema-and-wet-legs-in-the-community-a-service-evaluation
#3
Melanie Thomas, Karen Morgan, Ioan Humphreys, Diane Jehu, Linda Jenkins
Patients with chronic oedema and 'wet legs' are frequently seen in the community setting, with research indicating that more than half of community nurses' caseloads are patients with chronic oedema. However, a lack of nurse education and standardised care pathways for this condition has been identified. In June 2016, the Welsh Government supported the development of the On the Ground Education Project (OGEP), which aimed to raise community nurses' awareness and recognition of chronic oedema and wet legs, to improve the management of these conditions, and to support the efficient use of community nurses' time and resources...
November 8, 2017: Nursing Standard
https://www.readbyqxmd.com/read/29117007/ocular-features-of-cerebro-costo-mandibular-syndrome
#4
Zoya Hameed, Simon Taylor, Dan Lindfield
Cerebro-costo-mandibular syndrome is a rare hereditary disorder characterised by micrognathia, posterior rib gaps, and secondary developmental delay. Patients often require ventilation and feeding support throughout life. We describe the first reported ophthalmic findings of CCMS and propose that defects in choroidal permeability lead to chronic macular oedema and refractory aqueous misdirection syndrome. Here we discuss the medical and surgical management concerns of recurrent angle closure and raised intraocular pressure in a CCMS patient...
November 7, 2017: Journal of Glaucoma
https://www.readbyqxmd.com/read/29091504/chronic-oedema-on-the-ground-education-programme
#5
Tessa Watts, Ruth Davies
The impact of chronic oedema on community nurses' work, the NHS and those directly affected by the condition is immense. As chronic oedema prevalence is projected to rise and financial austerity continues, innovative, sustainable solutions that ensure positive outcomes for patients must be found. This paper reports findings from a focus group (n=3) investigation of the effects of an innovative workplace education intervention designed to enhance community nurses' knowledge for practice in chronic oedema prevention and management in Wales...
November 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/29090846/the-relation-study-efficacy-and-safety-of-ranibizumab-combined-with-laser-photocoagulation-treatment-versus-laser-monotherapy-in-npdr-and-pdr-patients-with-diabetic-macular-oedema
#6
Gabriele E Lang, Sandra Liakopoulos, Jessica Vögeler, Claudia Weiß, Georg Spital, Maria-Andreea Gamulescu, Chris Lohmann, Peter Wiedemann
PURPOSE: To assess efficacy and safety of intravitreal ranibizumab 0.5 mg plus laser (COMBI) versus laser monotherapy (LASER) in patients with visual impairment due to diabetic macular oedema (DME) in either nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) and to analyse the relevance of inner versus outer retinal thickness. METHODS: In this double-masked, multicentre phase IIIb study, patients (N = 128) were randomized (2:1) to receive COMBI (n = 85) versus LASER (n = 43)...
November 1, 2017: Acta Ophthalmologica
https://www.readbyqxmd.com/read/29090269/a-rash-decision-the-hazards-of-the-wrongful-use-of-adrenaline
#7
Madalena Coutinho Cruz, Ramiro Sá Carvalho, Pedro Modas Daniel, Rui Cruz Ferreira
Anaphylaxis is life-threatening and should be addressed urgently. Its treatment is not without side effects and an accurate diagnosis must be made to prevent potential harm by the wrongful use of medication. A 46-year-old woman with hypertension treated with angiotensin converting enzyme inhibitor (ACEI) presented to the emergency department with non-pitting oedema of the face and limbs. A hasty diagnosis of anaphylaxis was made and intravenous adrenaline administered. The patient developed a myocardial infarction caused by coronary artery spasm that required invasive intervention...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29084002/central-arteriovenous-anastomosis-to-treat-resistant-hypertension
#8
Vikas Kapil, Paul A Sobotka, Mel D Lobo, Roland E Schmieder
PURPOSE OF REVIEW: Novel, interventional treatments have emerged in the last decade for the treatment of resistant hypertension. This review focuses on a unique device that creates a fixed calibre, central iliac arteriovenous anastomosis that is significantly different in haemodynamic and safety profile from traditional haemodialysis fistulae. The background, physiology, and clinical data to date will be presented. RECENT FINDINGS: The single, randomized, controlled clinical trial using the ROX coupler in patients with resistant hypertension demonstrated substantial reductions in both office and ambulatory blood pressure to 12-month postimplantation...
October 27, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29076801/quality-of-care-of-treatment-for-uncomplicated-severe-acute-malnutrition-provided-by-lady-health-workers-in-pakistan
#9
Eleanor Rogers, Muhammad Ali, Shahid Fazal, Deepak Kumar, Saul Guerrero, Imtiaz Hussain, Sajid Soofi, Jose Luis Alvarez Morán
OBJECTIVE: To assess the quality of care provided by lady health workers (LHW) managing cases of uncomplicated severe acute malnutrition (SAM) in the community. DESIGN: Cross-sectional quality-of-care study. SETTING: The feasibility of the implementation of screening and treatment for uncomplicated SAM in the community by LHW was tested in Sindh Province, Pakistan. An observational, clinical prospective multicentre cohort study compared the LHW-delivered care with the existing outpatient health facility model...
October 27, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/29064119/in-chronic-spontaneous-urticaria-high-numbers-of-dermal-endothelial-cells-but-not-mast-cells-are-linked-to-recurrent-angio-oedema
#10
D Terhorst, I Koti, K Krause, M Metz, M Maurer
BACKGROUND: Chronic spontaneous urticaria (CSU) is an inflammatory skin disorder characterized by recurrent weals, angio-oedema or both. Recent studies have shown that the number of endothelial cells is increased in the skin of patients with CSU, but the underlying mechanisms and clinical implications of this are unclear. AIM: To evaluate whether mast cell (MC) or endothelial cell (EC) numbers correlate with CSU and whether they are relevant for disease duration, disease activity or the presence of clinical features...
October 24, 2017: Clinical and Experimental Dermatology
https://www.readbyqxmd.com/read/29063730/fibroblast-growth-factors-in-the-management-of-spinal-cord-injury
#11
REVIEW
Yulong Zhou, Zhouguang Wang, Jiawei Li, Xiaokun Li, Jian Xiao
Spinal cord injury (SCI) possesses a significant health and economic burden worldwide. Traumatic SCI is a devastating condition that evolves through two successive stages. Throughout each of these stages, disturbances in ionic homeostasis, local oedema, ischaemia, focal haemorrhage, free radicals stress and inflammatory response were observed. Although there are no fully restorative cures available for SCI patients, various molecular, cellular and rehabilitative therapies, such as limiting local inflammation, preventing secondary cell death and enhancing the plasticity of local circuits in the spinal cord, were described...
October 24, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/29056991/atherosclerotic-renovascular-disease-epidemiology-treatment-and-current-challenges
#12
REVIEW
Diana Vassallo, Philip A Kalra
The neutral results of recent large randomized controlled trials comparing renal revascularization with optimal medical therapy in patients with atherosclerotic renovascular disease (ARVD) have cast doubt on the role of revascularization in the management of unselected patients with this condition. However, these studies have strengthened the evidence base for the role of contemporary intensive medical vascular protection therapy and aggressive risk factor control in improving clinical outcomes in ARVD. Patients presenting with 'high-risk' clinical features such as uncontrolled hypertension, rapidly declining renal function or flash pulmonary oedema are underrepresented in these studies; hence these results may not be applicable to all patients with ARVD...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29039127/dermotaxis-v-s-loop-suture-technique-for-closure-of-fasciotomy-wounds-a-study-of-50-cases
#13
Naveen Mittal, Robin Bohat, Jagandeep Singh Virk, Payal Mittal
Fasciotomy incisions lead to large, unsightly, chronic wounds after surgical intervention. Classic management was to use split-thickness skin grafts, but this leads to insensate skin with reports that as many as 23% of patients are dissatisfied by the appearance of the wound. Since no skin loss has occurred with the fasciotomy incision, utilizing the dermal properties of creep, stress relaxation and load cycling, closure can be achieved in a better way. We describe using dermotaxis for skin edge approximation that is done using inexpensive equipment available readily in any standard operating room...
October 16, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29031913/chronic-pain-and-pain-processing-in-parkinson-s-disease
#14
REVIEW
Pierre J Blanchet, Christine Brefel-Courbon
Pain is experienced by the vast majority of patients living with Parkinson's disease. It is most often of nociceptive origin, but may also be ascribed to neuropathic (radicular or central) or miscellaneous sources. The recently validated King's Parkinson's Disease Pain Scale is based on 7 domains including musculoskeletal pain, chronic body pain (central or visceral), fluctuation-related pain, nocturnal pain, oro-facial pain, pain with discolouration/oedema/swelling, and radicular pain. The basal ganglia integrate incoming nociceptive information and contribute to coordinated motor responses in pain avoidance and nocifensive behaviors...
October 12, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/29029098/genital-granulomatosis-in-male-and-female-patients-with-crohn-s-disease-clinical-presentation-and-treatment-outcomes
#15
F Dederichs, I Iesalnieks, M Sladek, Ch Tzivinikos, R Hansen, C Muñoz, P Pavli, M N Cavicchi, V Abitbol, J-F Rahier, S R Vavricka, K Katsanos, E Domènech
Background: Genital granulomatosis (GG) is a metastatic form of Crohn's Disease (CD), characterized by granulomatous inflammation of the genital skin without contact to the gastrointestinal tract. Little is known about GG as most publications are case reports or small series, and only sporadic in male cases. Methods and Aims: Cases of GG were retrospectively collected through the Collaborative Network For Exceptionally Rare case reports project of the European Crohn´s and Colitis Organization...
September 27, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/29027008/lateral-epicondylitis-associations-of-mr-imaging-and-clinical-assessments-with-treatment-options-in-patients-receiving-conservative-and-arthroscopic-managements
#16
Ji Young Jeon, Min Hee Lee, In-Ho Jeon, Hye Won Chung, Sang Hoon Lee, Myung Jin Shin
OBJECTIVES: We assessed the implications of MR imaging with clinical history in lateral epicondylitis management by evaluating imaging and clinical features in patients with lateral epicondylitis treated conservatively or operatively. METHODS: Sixty patients with lateral epicondylitis treated conservatively (n = 38) or operatively (n = 22) from 2011-2015 were included. MR imaging findings of common extensor tendon (CET), lateral collateral ligament (LCL) complex, muscle oedema, ulnar nerve and elbow joint were reviewed...
October 12, 2017: European Radiology
https://www.readbyqxmd.com/read/29026819/the-role-of-dynamic-ultrasound-in-the-immediate-conservative-treatment-of-volar-plate-injuries-of-the-pip-joint-a-series-of-78-patients
#17
Franck Marie Leclère, Lukas Mathys, Bettina Juon, Esther Vögelin
INTRODUCTION: The management of volar plate avulsion fractures in the context of a stable joint and a bony fragment of less than 30% has traditionally been conservative. This study was performed to assess volar plate healing with high-resolution ultrasound in order to provide early full mobilization. MATERIAL AND METHODS: Between January 2012 and December 2013, 78 patients with volar plate injuries of the proximal interphalangeal (PIP) joints (42 distortions and 36 dislocations) were treated conservatively in our department for volar plate avulsion fracture associated with stable joint and bony fragment inferior to 30% of the intra-articular surface assessed both by radiography and ultrasound...
August 2017: Plastic Surgery
https://www.readbyqxmd.com/read/29020719/diagnosis-and-management-of-nephrotic-syndrome
#18
Oonagh McCloskey, Alexander P Maxwell
Nephrotic syndrome is defined by a triad of clinical features: oedema, substantial proteinuria (> 3.5 g/24 hours) and hypoalbuminaemia (< 30 g/L). It is often associated with hyperlipidaemia, thromboembolism and an increased risk of infection. Nephrotic syndrome develops following pathological injury to renal glomeruli. This may be a primary problem, with a disease specific to the kidneys, or secondary to a systemic disorder such as diabetes mellitus. The most common cause in children is minimal change glomerulonephritis...
February 2017: Practitioner
https://www.readbyqxmd.com/read/28986407/ferumoxytol-enhanced-magnetic-resonance-imaging-in-acute-myocarditis
#19
Colin G Stirrat, Shirjel R Alam, Thomas J MacGillivray, Calum D Gray, Marc R Dweck, Kevin Dibb, Nick Spath, John R Payne, Sanjay K Prasad, Roy S Gardner, Saeed Mirsadraee, Peter A Henriksen, Scott Ik Semple, David E Newby
OBJECTIVES: Ultrasmall superparamagnetic particles of iron oxide (USPIO)-enhanced MRI can detect tissue-resident macrophage activity and identify cellular inflammation within tissues. We hypothesised that USPIO-enhanced MRI would provide a non-invasive imaging technique that would improve the diagnosis and management of patients with acute myocarditis. METHODS: Ten volunteers and 14 patients with suspected acute myocarditis underwent T2, T2* and late gadolinium enhancement (LGE) 3T MRI, with further T2* imaging at 24 hours after USPIO (ferumoxytol, 4 mg/kg) infusion, at baseline and 3 months...
October 6, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28979560/a-case-study-of-likely-wild-type-cardiac-transthyretin-amyloidosis-causing-rapid-deterioration
#20
Thomas Davies, Aarash Saleh, Gerry Coghlan, Carol Whelan, Banwari Agarwal
We present the case of an 88-year-old gentleman who presented to hospital septic with bilateral leg cellulitis, pulmonary oedema and hypotension. He had no history of heart disease but had had bilateral carpal tunnel releases. His condition deteriorated with refractory hypotension in spite of fluid filling, inotropic and vasopressor support. His echocardiogram showed an infiltrative cardiomyopathy with a speckled myocardium, severe concentric left and right ventricular increased wall thickness, diastolic dysfunction, biatrial dilatation and restrictive physiology in keeping with cardiac amyloidosis...
May 2017: J Intensive Care Soc
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