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Skin breakdown

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
Thomas J Scriba, Anna K Coussens, Helen A Fletcher
Immunology is a central theme when it comes to tuberculosis (TB). The outcome of human infection with Mycobacterium tuberculosis is dependent on the ability of the immune response to clear or contain the infection.In cases where this fails, the bacterium replicates, disseminates within the host, and elicits a pathologic inflammatory response, and disease ensues. Clinical presentation of TB disease is remarkably heterogenous, and the disease phenotype is largely dependent on host immune status. Onward transmission of M...
October 2016: Microbiology Spectrum
Thomas J Scriba, Anna K Coussens, Helen A Fletcher
Immunology is a central theme when it comes to tuberculosis (TB). The outcome of human infection with Mycobacterium tuberculosis is dependent on the ability of the immune response to clear or contain the infection.In cases where this fails, the bacterium replicates, disseminates within the host, and elicits a pathologic inflammatory response, and disease ensues. Clinical presentation of TB disease is remarkably heterogenous, and the disease phenotype is largely dependent on host immune status. Onward transmission of M...
August 2016: Microbiology Spectrum
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
Media Esser
Diaper dermatitis is a major issue among hospitalized infants, leading to increased medical costs, pain, risk for infection, and distress among patients and caregivers. An evidence-based algorithm for prevention and treatment of diaper dermatitis was developed and introduced in a level IV neonatal intensive care unit (NICU). Two cases are discussed as examples of severe diaper dermatitis. The first case demonstrates the final case of severe diaper dermatitis since the introduction of the algorithm. The second case demonstrates a less severe, but equally frustrating, case of diaper dermatitis that occurred after the practice of using the algorithm was established...
October 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Cathy L Wogamon
The certified nursing assistant (CNA) is the caregiver who frequently identifies the first signs and symptoms of pressure ulcers (PUs) in the long-term care setting. A quality improvement effort was implemented to explore the effect of a 1-hour CNA education program about early identification, treatment, and prevention of PUs on PU knowledge, PU incidence, and PU prevention interventions, including skin checks. All 33 CNAs employed in a care facility for residents 55+ years old were invited to participate. CNA demographic and PU education variables were obtained...
September 2016: Ostomy/wound Management
Anna Boyles, Sharon Hunt
It is estimated that around one in 500 people in the UK are living with a stoma, with approximately 21 000 operations that result in stoma formation being performed each year ( Colostomy Association, 2016 ). These people face a unique set of challenges in maintaining the integrity of their peristomal skin. This article explores the normal structure and function of skin and how the care and management of a stoma presents challenges for maintaining peristomal skin health. Particular focus is paid to the incidence of skin problems for those living with a stoma, whether it is temporary or permanent, and the factors that contribute to skin breakdown in this population...
September 22, 2016: British Journal of Nursing: BJN
Travis J Dekker, Yash Avashia, Suhail K Mithani, Andrew P Matson, Alexander J Lampley, Samuel B Adams
: Introduction Achilles tendon and posterior heel wound complications are difficult to treat. These typically require soft tissue coverage via microvascular free tissue transfer at a tertiary referral center. Here, we describe coverage of a series of posterior heel and Achilles wounds via simple, local tissue transfer, called a bipedicle fasciocutaneous flap. This flap can be performed by an orthopaedic foot and ankle surgeon, without resources of tertiary/specialized care or microvascular support...
September 23, 2016: Foot & Ankle Specialist
Nicole Boswell, Cheryl L Waker
BACKGROUND: Nurses have a primary role in promoting neonatal skin integrity and skin care management of the critically ill neonate. Adhesive products are essential to secure needed medical devices but can be a significant factor contributing to skin breakdown. Current literature does not offer a definitive answer regarding which products most safely and effectively work to secure needed devices in the high-risk neonatal population. PURPOSE: To determine which adhesive method is best practice to safely and effectively secure lines/tubes in the high-risk neonate population...
September 19, 2016: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
Ashley E J Rogers, Kristen M Eisenman, Susan A Dolan, Kristin M Belderson, Jocelyn R Zauche, Suhong Tong, Jane Gralla, Joanne M Hilden, Michael Wang, Kelly W Maloney, Samuel R Dominguez
BACKGROUND: Central line-associated blood stream infections (CLABSIs) are a source of high morbidity and mortality in children with acute myelogenous leukemia (AML). PROCEDURE: To understand the epidemiology and risk factors associated with the development of CLABSI in children with AML. METHODS: We retrospectively reviewed all patients with AML over a 5-year period between 2007 and 2011 at the Children's Hospital Colorado. Cases and controls were classified on the basis of the presence of a CLABSI as defined by the National Healthcare Safety Network...
September 12, 2016: Pediatric Blood & Cancer
Michael Zakrewsky, Samir Mitragotri
The high prevalence of skin diseases and their visible symptoms result in major physical, emotional, and economic burden for which few solutions exist. To address this unmet medical need, topical delivery of RNAi such as siRNA holds many advantages including direct access to the diseased site, potent knockdown of disease symptoms, and limited off-target effects. Unfortunately, delivering drugs into skin is extremely difficult. To address these concerns, we present RNAi robed with ionic liquid moieties. Specifically, we show that robed-siRNAs can be synthesized by a simple two-step process from bulk materials...
September 6, 2016: Journal of Controlled Release: Official Journal of the Controlled Release Society
Jennifer M Hahn, Kevin L McFarland, Kelly A Combs, Dorothy M Supp
BACKGROUND: Keloids are an extreme form of abnormal scarring that result from a pathological fibroproliferative wound healing process. The molecular mechanisms driving keloid pathology remain incompletely understood, hindering development of targeted, effective therapies. Recent studies in our laboratory demonstrated that keloid keratinocytes exhibit adhesion abnormalities and display a transcriptional signature reminiscent of cells undergoing epithelial-mesenchymal transition (EMT), suggesting a role for EMT in keloid pathology...
2016: Burns and trauma
Giuseppe Tringali, Beatrice Sampaolese, Maria Elisabetta Clementi
Pathological alterations to the retinal pigment epithelium underlie several eye diseases, which lead to visual impairment and even blindness. Exposure to ultraviolet (UV) radiation is associated with some skin and ocular pathologies; UV radiation may induce DNA breakdown and cause cellular damage through the production of reactive oxygen species (ROS), thus leading to programmed cell death. The present study aimed to investigate the production of ROS and the gene expression levels of anti‑ and proapoptotic proteins [B‑cell lymphoma 2 (Bcl‑2), Bcl‑2‑associated X protein (Bax) and caspase‑3] in human retinal pigment epithelial cells (ARPE‑19) treated with UV‑A for 5 h consecutively...
October 2016: Molecular Medicine Reports
James Shi, Antoinette Gomes, Edward Lee, Stephen Kee, John Moriarty, Henry Cryer, Justin McWilliams
PURPOSE: Transcatheter arterial embolization (TAE) is commonly used to control hemorrhage after pelvic trauma. Despite the procedures reported safety, there can be severe complications, mostly related to ischemia of embolized tissues. Our purpose was to examine the complications of trauma patients resulting from the embolization techniques utilized at our level 1 trauma center. MATERIALS AND METHODS: A retrospective chart review was conducted. One hundred and seven patients who underwent pelvic embolization between January 2003 and December 2013 were included...
August 20, 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
John P McCook, Thomas J Stephens, Lily I Jiang, Robert M Law, Vincent Gotz
PURPOSE: To examine the effect of sodium copper chlorophyllin complex on the expression of biomarkers of photoaged dermal extracellular matrix indicative of skin repair. PATIENTS AND METHODS: Following a previously published 12-day clinical assessment model, skin biopsy samples from the forearms of four healthy females with signs of photoaged skin were obtained and samples were analyzed by immunohistochemistry for key biomarkers of aging skin after each subject was treated with a test material consisting of a gel containing a liposomal dispersion of sodium copper chlorophyllin complex 0...
2016: Clinical, Cosmetic and Investigational Dermatology
Sébastien Menzinger, Aysin Kaya, Jean-Hilaire Saurat, Gürkan Kaya
BACKGROUND: Hyaluronidases are essential for the breakdown of hyaluronate (HA) in tissues and may be used to prevent the adverse effects of HA fillers. OBJECTIVES: We explored the effect of hyaluronidase on exogenous and endogenous HA in vitro and in vivo. MATERIALS AND METHODS: HA fillers were incubated with different concentrations of hyaluronidase and visualized by electrophoresis. HA fillers were injected in the skin of hairless mice, and 4 h later hyaluronidase was injected in the papules of exogenous HA...
July 2016: Dermatopathology (Basel, Switzerland)
Rachael C Saporito, David J Cohen
Atopic dermatitis (AD) is a chronic, pruritic skin disease often complicated by bacterial superinfection affecting 10.7% of American children. The pathogenesis involves a skin barrier breakdown in addition to dysfunctional innate and adaptive immune response, including an unbalanced increase in T-helper 2 cells and hyperimmunoglobulinemia E. The increased numbers of T-helper 2 cells are involved in stimulating the production of immunoglobulin E and eosinophilia by releasing interleukin-4, -5, and -13 as well as in decreasing protection against bacterial superinfection by releasing interleukin-10...
May 2016: Case Reports in Dermatology
Adriana Morales-Cárdenas, Camila Pérez-Madrid, Liliana Arias, Paulina Ojeda, María Paula Mahecha, Adriana Rojas-Villarraga, Jorge A Carrillo-Bayona, Juan-Manuel Anaya
Systemic sclerosis (SSc) is a multi-systemic autoimmune disease that mainly affects the skin, lungs, gastrointestinal tract, heart and kidneys. Pulmonary disease in patients with SSc is strongly associated with mortality. The mechanisms involved into its pathophysiology include the activation of autoimmune cells and hyperplasia of fibroblasts with an increased capacity to produce collagen and diminished collagen breakdown. Although pulmonary biopsy is the gold standard for the diagnosis of interstitial lung disease in SSc, the most commonly used method is high-resolution computed tomography due to its high sensitivity and specificity...
August 4, 2016: Autoimmunity Reviews
B Hylton, S Lidder, A Armitage, S James
UNLABELLED: PURPOSE OF THE STUDY The aim of this pilot study was to develop The Eastbourne Miami-J Protocol for care of cervical injuries within the community. Led by orthopaedic senior practitioners, a multidisciplinary approach was developed to provide education and collar care for patients on a weekly basis. MATERIALS AND METHODS A total of 51 patients (17 male and 33 female), mean age 74 years (21 to 95) with CT confirmed cervical injuries during November 2010 and May 2014 followed the Eastbourne Miami-J Protocol...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Rafi Ayub, Dario Villarreal, Robert D Gregg, Fan Gao
BACKGROUND: Transradial body-powered prostheses are extensively used by upper-limb amputees. This prosthesis requires large muscle forces and great concentration by the patient, often leading to discomfort, muscle fatigue, and skin breakdown, limiting the capacity of the amputee to conduct daily activities. Since body-powered prostheses are commonplace, understanding their optimal operation to mitigate these drawbacks would be clinically meaningful. OBJECTIVES: To find the optimal operation of the prosthesis where the activation force is minimized and the grip force is maximized...
July 28, 2016: Prosthetics and Orthotics International
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