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Chronic ulcer

Anna Wickbom, Johan Bohr, Nils Nyhlin, Anders Eriksson, Annika Lapidus, Andreas Münch, Kjell-Arne Ung, Lina Vigren, Åke Öst, Curt Tysk
OBJECTIVES: Onset of microscopic colitis (MC) in patients with ulcerative colitis (UC) or Crohn's disease (CD), or vice versa, has been reported occasionally but the subject is not well described. We therefore report a retrospective observational study of such patients and review the literature. METHODS: Forty-six Swedish gastroenterology clinics were contacted about patients with diagnoses of both inflammatory bowel disease (IBD) and MC. Publications were searched on PubMed...
March 16, 2018: Scandinavian Journal of Gastroenterology
Rafael García Carretero, Maria Garrido-Ollero, Ana Martinez-Alvarez, Ana Cadenas-Vara
Chronic leg ulcers can have a major impact on the quality of life of patients. These wounds can be complex and hard to heal, as several factors may affect the outcome. Underlying conditions, bacterial growth and excess moisture may prevent wounds from healing. We describe the case of a patient with known chronic venous disease, who was admitted to our hospital for several complex, irregular and infected chronic venous ulcers in his lower legs. The management was frustrating for several months, until we began to use methacrylate powder dressing for his hard-to-heal wounds...
March 15, 2018: BMJ Case Reports
Dragana Mijac, Irena Vukovic-Petrovic, Vera Mijac, Vladimir Perovic, Natasa Milic, Srdjan Djuranovic, Daniela Bojic, Dragan Popovic, Djordje Culafic, Miodrag Krstic, Goran Jankovic, Vera Pravica, Milos Markovic
BACKGROUND: Inflammatory bowel disease (IBD) is a chronic disease of unknown etiology in which genetic factors contribute to development of disease. Single nucleotide polymorphisms (SNPs) in multidrug resistance 1 (MDR1) gene encoding transporter P-glycoprotein have been associated with IBD, but their role in disease susceptibility remains unclear. Therefore, the aim of this study was to investigate the association of three MDR1 polymorphisms, C1236T (rs1128503), G2677T/A (rs2032582) and C3435T (rs1045642), with Serbian IBD patients...
2018: PloS One
Ines Bojanic, Marinka Mravak Stipetic, Drazen Pulanic, Lana Desnica, Sanja Mazic, Branka Golubic Cepulic, Ranka Serventi Seiwerth, Radovan Vrhovac, Damir Nemet, Steven Z Pavletic
BACKGROUND: Oral chronic graft-versus-host disease (cGvHD) impairs oral function and patients' quality of life. Some lesions are refractory to local and systemic immunosuppressive therapy, and new therapeutic modalities are required. The aim of the study was to assess the efficacy and safety of topical application of autologous platelet gel (PG) in patients with oral cGvHD. STUDY DESIGN AND METHODS: PG was prepared from autologous blood and applied on ulcerous lesions using an automated system...
March 14, 2018: Transfusion
Jingping Zhang, Jingjing Huang, Kasimujiang Aximujiang, Chenbo Xu, Abulaiti Ahemaiti, Guixia Wu, Li Zhong, Kurexi Yunusi
Stress is a powerful modulator of neuroendocrine, behavioral, and immunological functions. So far, the molecular mechanisms of response to stressors still remain elusive. In the current study, after 10 days of repeated chronic stress (hot-dry environment and electric foot-shock), a murine model of combined-stress (CS) was created in the SPF Wistar rats. Meanwhile, we established an ulcerative-colitis (UC) rat model induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS)/ethanol enema according to previous studies...
March 14, 2018: Scientific Reports
Joy Ogbechi, Belinda S Hall, Thomas Sbarrato, Jack Taunton, Anne E Willis, Ronald C Wek, Rachel E Simmonds
Mycolactone is the exotoxin virulence factor of Mycobacterium ulcerans that causes the neglected tropical disease Buruli ulcer. We recently showed it to be a broad spectrum inhibitor of Sec61-dependent co-translational translocation of proteins into the endoplasmic reticulum (ER). An outstanding question is the molecular pathway linking this to its known cytotoxicity. We have now used translational profiling to better understand the reprogramming that occurs in cells exposed to mycolactone. Gene ontology identified enrichment in genes involved in cellular response to stress, and apoptosis signalling among those showing enhanced translation...
March 14, 2018: Cell Death & Disease
Xiu-Ting Yu, Yi-Fei Xu, Yan-Feng Huang, Chang Qu, Lie-Qiang Xu, Zi-Ren Su, Hui-Fang Zeng, Lin Zheng, Tie-Gang Yi, Hui-Lin Li, Jian-Ping Chen, Xiao-Jun Zhang
Ulcerative colitis (UC) is a chronic relapsing disease without satisfactory treatments, in which intestinal inflammation and disrupted intestinal epithelial barrier are two main pathogeneses triggering UC. Berberrubine (BB) is deemed as one of the major active metabolite of berberine (BBR), a naturally-occurring isoquinoline alkaloid with appreciable anti-UC effect. This study aimed to comparatively investigate the therapeutic effects of BB and BBR on dextran sodium sulfate (DSS)-induced mouse colitis model, and explore the potential underlying mechanism...
2018: PloS One
Chien-Hua Chen, Cheng-Li Lin, Chia-Hung Kao
We assessed the subsequent risk of cholelithiasis development in patients with inflammatory bowel diseases (IBDs) such as Crohn's disease (CD) or ulcerative colitis (UC). We identified 8186 patients who aged ≥20 years and were diagnosed with IBD between 2000 and 2010 as the study cohort. A total of 8186 patients without IBD were selected by frequency-matching according to age, sex, comorbidities, and the index date of diagnosis, and they were identified as the control cohort. To measure the incidence of cholelithiasis, all patients were followed up until the end of 2011...
March 14, 2018: International Journal of Environmental Research and Public Health
Dorothee Boehm, Konstantin Bergmeister, Emre Gazyakan, Thomas Kremer, Ulrich Kneser, Volker J Schmidt
AIMS: Reconstruction of breasts and chest wall deformities in female patients after severe burn injury is a challenge for reconstructive surgeons. In these patients, neither implant-based procedures nor standard free flaps are sometimes applicable because of limited skin quality and unavailability of donor sites at the abdomen, back, buttock, or medial thigh. METHODS: We present a case of a young female patient with a history of 80 % total body surface area burn after electric high-voltage injury...
March 13, 2018: Annals of Plastic Surgery
Charles N Bernstein
Corticosteroids and antibodies to tumor necrosis factor (anti-TNF) are mainstays of treatment of acutely active IBD and while anti-TNF therapy is indicated for maintenance therapy, chronic corticosteroid therapy is associated with known significant risks. Nonetheless, chronic or recurrent corticosteroid treatment in IBD is common. In this edition of the journal Lewis et al. use Medicaid and Medicare databases to contrast adverse outcomes in persons with IBD and either corticosteroid or anti-TNF use. Compared to high dose corticosteroid use, anti TNF therapy is associated with less risk for death in Crohn's disease but no statistical difference in death outcomes in ulcerative colitis...
March 2018: American Journal of Gastroenterology
Nicholas P McKenna, Amy E Glasgow, Robert R Cima, Elizabeth B Habermann
BACKGROUND: Organ space infection (OSI) after ileal pouch anal anastomosis (IPAA) is a devastating complication. The aim of this was study was to determine separately risk factors for OSI after total proctocolectomy (TPC) with IPAA and completion proctectomy (CP) with IPAA. METHODS: 4049 patients with a diagnosis of chronic ulcerative colitis undergoing TPC with IPAA or CP with IPAA between 2005 and 2015 were identified in the American College of Surgeons National Surgical Quality Improvement Program database...
March 6, 2018: American Journal of Surgery
Valerie S Marmolejo, Jonathan F Arnold
Heel ulcerations are a significant burden of care in both hospital and long-term care settings. The presence of peripheral arterial disease as a contributing factor to delayed healing is often not recognized, resulting in prolonged healing and high patient morbidity and mortality. Formal vascular evaluation and intervention is often not performed as these patients can have palpable pedal pulses while having localized ischemia of the heel. As routine noninvasive vascular studies can be affected by medial calcinosis and collateralization and do not specifically assess tissue perfusion to the heel, a false sense of security of adequate perfusion for healing can result...
March 1, 2018: Foot & Ankle Specialist
Adi Finkelstein
This narrative presents my personal reflections as a medical anthropology researcher, and my journey as a chronic patient suffering for 30 years from ulcerative colitis. My surgeon promised me "a new life" after recommending a total colectomy 20 years ago. Indeed, a new life did begin following surgery, but I find I must renegotiate the challenges and rewards of this new life nearly every day.
March 2018: Annals of Family Medicine
Ole Haagen Nielsen, Lars Rejnmark, Alan C Moss
Inflammatory bowel disease (IBD), including ulcerative colitis and Crohn's disease, is a chronic and unpredictable characterized by alternating periods of remission interspersed with relapses. In recent years accumulating support for an immunomodulating effect of vitamin D on both the innate and adaptive immune system has been presented. Through the vitamin D receptor, the active form of vitamin D, 1,25(OH)2D, induces antimicrobial peptide secretion, decrease dendritic cell activity, and promotes Th2 and regulatory T cell development and activity...
February 24, 2018: Journal of Crohn's & Colitis
Arnaud Setondji Amoussouhoui, Ghislain Emmanuel Sopoh, Anita Carolle Wadagni, Roch Christian Johnson, Paulin Aoulou, Inès Elvire Agbo, Jean-Gabin Houezo, Micah Boyer, Mark Nichter
BACKGROUND: Mycobacterium ulcerans infection, commonly known as Buruli ulcer (BU), is a debilitating neglected tropical disease. Its management remains complex and has three main components: antibiotic treatment combining rifampicin and streptomycin for 56 days, wound dressings and skin grafts for large ulcerations, and physical therapy to prevent functional limitations after care. In Benin, BU patient care is being integrated into the government health system. In this paper, we report on an innovative pilot program designed to introduce BU decentralization in Ouinhi district, one of Benin's most endemic districts previously served by centralized hospital-based care...
March 12, 2018: PLoS Neglected Tropical Diseases
Yen-I Chen, Theodore James, Amol Agarwal, Todd H Baron, Takao Itoi, Rastislav Kunda, Jose Nieto, Majidah Bukhari, Olaya Brewer Gutierrez, Omid Sanaei, Robert Moran, Lea Fayad, Mouen A Khashab
Background and study aims:  Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) in malignant gastric outlet obstruction (GOO) appears to be promising; however, its role in benign GOO is unclear. The aim of this study was to ascertain the clinical efficacy and safety of EUS-GE in benign GOO. Patients and methods : This was an international retrospective series involving 5 tertiary centers. Consecutive patients who underwent EUS-GE between 1/2013 - 10/2016 for benign GOO were included...
March 2018: Endoscopy International Open
Axel Kulcke, Amadeus Holmer, Philip Wahl, Frank Siemers, Thomas Wild, Georg Daeschlein
Worldwide, chronic wounds are still a major and increasing problem area in medicine with protracted suffering of patients and enormous costs. Beside conventional wound treatment, for instance kinds of oxygen therapy and cold plasma technology have been tested, providing an improvement in the perfusion of wounds and their healing potential, but these methods are unfortunately not sufficiently validated and accepted for clinical practice to date. Using hyperspectral imaging technology in the visible (VIS) and near infrared (NIR) region with high spectral and spatial resolution, perfusion parameters of tissue and wounds can be determined...
March 9, 2018: Biomedizinische Technik. Biomedical Engineering
Paul J Kim, Christopher E Attinger, Thomas Bigham, Robert Hagerty, Samantha Platt, Ersilia Anghel, John S Steinberg, Karen K Evans
Outpatient-based sharp debridement is considered an important element for the care of a chronic ulcer. OBJECTIVE: The aim of this study is to evaluate the change in bacterial amounts with sharp debridement in a clinical setting. MATERIALS AND METHODS: Bacterial autofluorescence, quantitative cultures, semiquantitative cultures, and qualitative speciation were performed predebridement and postdebridement during a single clinic visit. RESULTS: Thirty-six wounds were included in the analysis...
February 23, 2018: Wounds: a Compendium of Clinical Research and Practice
Abhishek Biswas, Hiren J Mehta, Michael A Jantz
A 62-year-old Hispanic woman, a resident of Puerto Rico, presented with symptoms of chronic cough and shortness of breath for the past 2 years that were slowly and progressively getting worse. She received a diagnosis of asthma on the basis of her history of symptomatic "wheezing" and had been on treatment with inhaled bronchodilators and corticosteroids with minimal symptomatic improvement. The peculiarity of her symptoms was that her dyspnea was worse when she was reclining in bed and she would often hear a "whistling" noise in her throat during those times...
March 2018: Chest
Stefan D Dojcinov, Falko Fend, Leticia Quintanilla-Martinez
The contribution of Epstein-Barr virus (EBV) to the development of specific types of benign lymphoproliferations and malignant lymphomas has been extensively studied since the discovery of the virus over the last 50 years. The importance and better understanding of the EBV-associated lymphoproliferative disorders (LPD) of B, T or natural killer (NK) cell type has resulted in the recognition of new entities like EBV+ mucocutaneous ulcer or the addition of chronic active EBV (CAEBV) infection in the revised 2016 World Health Organization (WHO) lymphoma classification...
March 7, 2018: Pathogens
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