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Chronic leg ulcers

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https://www.readbyqxmd.com/read/29660929/ecchymosis-a-novel-sign-in-patients-with-varicose-veins
#1
Ertan Yetkin, Mehmet Ileri, Johannes Waltenberger
BACKGROUND: In the absence of trauma, hematologic disease and anti-platelet use, no attention has been paid to elucidate the mechanism of ecchymosis. It has taken our attention that ecchymosis on lower limb might be a sign of varicose vein. Accordingly, we aimed to analyze and describe the frequency of leg symptoms and presence of ecchymosis in patients with varicose vein. MATERIALS AND METHODS: Four hundred and ninety four patients who had been diagnosed as having varicose vein or chronic venous insufficiency either by clinical examination or Doppler ultrasonography were included in the study...
2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29660917/medical-compression-stockings-reduce-hypertension-of-nailfold-capillaries-at-the-toe-of-patients-with-chronic-venous-insufficiency1
#2
Anja Oelert, Manuela Kittel, Martin Hahn, Hermann Haase, Michael Jünger
In five patients who suffered from chronic venous insufficiency clinical stage C4 (n = 3) and C6 (n = 2) the capillary blood pressure was measured twice by means of invasive direct cannulation of nailfold capillaries of the toe. During one measurement course the patients wore below knee medical compression stockings (40 mmHg) during the other they did not have compression therapy. With the patient in supine position, the CP was investigated by the servo-nulling technique under resting conditions and under dynamic conditions: the calf-muscle/ankle joint venous pump was simulated by means of inflating a blood pressure cuff, which surrounded the mid lower leg, to 60 mmHg for 60 s...
April 7, 2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29650567/genome-sequence-of-a-multidrug-resistant-candida-haemulonii-isolate-from-a-patient-with-chronic-leg-ulcers-in-israel
#3
Nancy A Chow, Lalitha Gade, Dhwani Batra, Lori A Rowe, Phalasy Juieng, Ronen Ben-Ami, Vladimir N Loparev, Anastasia P Litvintseva
Candida haemulonii is an emerging multidrug-resistant yeast that can cause invasive candidiasis. Here, we report the first genome sequence of C. haemulonii (isolate B11899) generated using PacBio sequencing technology. The estimated genome size was 13.3 Mb, with a GC content of 45.19%.
April 12, 2018: Genome Announcements
https://www.readbyqxmd.com/read/29644144/comparative-effectiveness-of-a-bioengineered-living-cellular-construct-and-cryopreserved-cadaveric-skin-allograft-for-the-treatment-of-venous-leg-ulcers-in-a-real-world-setting
#4
Terry Treadwell, Michael L Sabolinski, Michelle Skornicki, Nathan B Parsons
Objective: A variety of advanced biological therapies are available for the treatment of chronic wounds such as venous leg ulcers (VLUs), but real-world comparative effectiveness data that can help guide decisions around treatments are currently lacking. Approach: This analysis was designed to compare the effectiveness of a bioengineered living cellular construct (BLCC) to a cryopreserved cadaveric skin allograft (CCSA) for the treatment of VLUs. Treatment records were collected from a large wound care-specific electronic medical record database on 717 patients (799 VLUs) receiving treatment at 177 wound care centers...
March 1, 2018: Advances in Wound Care
https://www.readbyqxmd.com/read/29614628/comorbidities-in-aging-patients-with-sickle-cell-disease
#5
Samir K Ballas
Sickle cell disease (SCD) in general and sickle cell anemia in particular is a highly complex disorder both at the molecular and clinical levels. Although the molecular lesion is a single-point mutation, the sickle gene is pleiotropic in nature causing multiple phenotypic expressions that constitute the various complications of the disease. Moreover, despite the fact that SCD is a chronic malady, its manifestations are both acute and chronic. The former include, among other things, the recurrent vaso-occlusive crises (its hallmark) and acute chest syndrome...
2018: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/29607227/rivaroxaban-treatment-for-warfarin-refractory-thrombosis-in-a-patient-with-hereditary-protein-s-deficiency
#6
Koken Ameku, Mariko Higa
Protein S (PS) deficiency, an autosomal dominant hereditary thrombophilia, is more prevalent in East Asian populations than in Caucasians. PS-deficient patients have historically been administered a heparin product followed by warfarin for the treatment and secondary prevention of venous thromboembolism (VTE). However, warfarin can be ineffective or causes detrimental effects in rare cases. While direct oral anticoagulants (DOACs) are being increasingly used for the treatment and prevention of VTE, their efficacy in PS-deficient patients has not been established...
2018: Case Reports in Hematology
https://www.readbyqxmd.com/read/29601617/collagen-powder-in-wound-healing
#7
Penelope J Kallis, Adam J Friedman
Chronic wounds, such as pressure ulcers, diabetic foot ulcers, and venous leg ulcers, are associated with high costs, poor quality of life, and significant morbidity and mortality. A chronic wound develops when progression through the normal phases of wound healing goes awry, creating a hostile environment with elevated levels of pro-inflammatory cytokines, increased matrix metalloproteinases (MMPs), destruction of extracellular matrix (ECM) components, and diminished activity of growth factors and other soluble mediators...
April 1, 2018: Journal of Drugs in Dermatology: JDD
https://www.readbyqxmd.com/read/29600821/an-unusual-presentation-of-a-common-condition-allergic-contact-dermatitis
#8
Annie Price, Natalie M Stone, Keith G Harding
Allergic contact dermatitis commonly affects patients with chronic venous leg ulcers and can contribute to impaired wound healing. Many allergens have been identified, and despite the use of advanced dressings, the incidence of allergy has remained high. We discuss an unusual presentation of allergic contact dermatitis in a patient with a chronic wound. The patient's history was consistent with a recurrent venous leg ulcer, but on this occasion, the wound continued to deteriorate despite optimal treatment. This prompted further investigation, which included patch testing...
March 30, 2018: International Wound Journal
https://www.readbyqxmd.com/read/29593807/enhanced-healing-and-anti-inflammatory-effects-of-a-carbohydrate-polymer-with-zinc-oxide-in-patients-with-chronic-venous-leg-ulcers-preliminary-results
#9
Mario Adan Moreno-Eutimio, Lorena Espinosa-Monroy, Tania Orozco-Amaro, Yessica Torres-Ramos, Araceli Montoya-Estrada, Juan Jose Hicks, Ernesto Rodríguez-Ayala, Pamela Del Moral, Jose Moreno, Jorge Cueto-García
Introduction: Insufficient wound healing related to chronic inflammation of chronic venous leg ulcers (CVUs) represents an important public health problem. The aim of this study was to evaluate the effects of a carbohydrate polymer with zinc oxide therapy on CVUs. Material and methods: Forty patients with CVUs were recruited for this study and were divided into a study group and control group. Patients In the study group were instructed to use venous compression treatment andtopical carbohydrate polymer with zinc oxide twice daily, while patients In the control group were treated with only venous compression treatment...
March 2018: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/29584608/utilization-of-a-viable-human-amnion-membrane-allograft-in-elderly-patients-with-chronic-lower-extremity-wounds-of-various-etiologies
#10
Matthew Regulski
ntroduction. Chronic nonhealing wounds are a growing health care problem in the United States, afflicting more than 6.5 million patients annually. In particular, diseases that compromise skin integrity and impair normal wound healing processes, such as diabetes and peripheral vascular diseases, are becoming more common in the aging population and leading to ever-increasing incidence of these chronic nonhealing wounds. OBJECTIVE: The aim of this study is to evaluate a viable human amnion membrane allograft (vHAMA) for the treatment of chronic nonhealing wounds in elderly patients (aged > 65 years) with multiple comorbidities...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29584602/effect-of-a-new-purified-collagen-matrix-with-polyhexamethylene-biguanide-on-recalcitrant-wounds-of-various-etiologies-a-case-series
#11
Dimitrios Lintzeris, Karen Vernon, Heather Percise, Andy Strickland, Kari Yarrow, Amber White, Mary Gurganus, Susan Sherrod, Kathleen Vergin, Laura Johnson
INTRODUCTION: The management of chronic, nonhealing wounds in patients with multiple comorbidities continues to be a challenge for health care practitioners. Chronic wounds typically do not progress through the normal phases of wound healing and generally remain stagnant during the inflammatory phase, resulting in an increase in proteolytic enzymes with degradation of the extracellular matrix. Bacterial biofilm has been documented to be one of the main factors delaying wound healing, resulting in the prolongation of the inflammatory phase...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29584601/application-of-viable-cryopreserved-human-placental-membrane-grafts-in-the-treatment-of-wounds-of-diverse-etiologies-a-case-series
#12
Derek S Anselmo, James B McGuire, Ebony Love, Tracey Vlahovic
There is evidence in the literature that viable cryopreserved human placental membrane (vCHPM) grafts are effective in treating diabetic foot ulcers and venous leg ulcers. OBJECTIVE: This case series presents 3 cases of chronic ulcerations - 1 arterial ulcer (AU), 1 pressure ulcer (PU), and 1 recurrence of a pyoderma gangrenosum ulcer (PGU) - that had failed previous courses of standard wound care and were subsequently treated with vCHPM to determine if the treatment is an effective modality for treating wounds of these etiologies...
March 2018: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29561341/the-management-of-critically-colonized-and-locally-infected-leg-ulcers-with-an-acid-oxidizing-solution-a-pilot-study
#13
Robert Strohal, Martina Mittlböck, Gilbert Hämmerle
OBJECTIVE: Critical colonization or local infection is very common in chronic wounds, but clinically problematic. Because therapeutic options for these conditions are limited in number and efficacy, the study authors tested a new acid-oxidizing solution (AOS [Nexodyn]; APR Applied Pharma Research S.A., Balerna, Switzerland) to determine its ancillary antimicrobial properties and potential support for wound healing. DESIGN AND SETTING: This open-label clinical case series was conducted with a prospective, single-arm design at the Federal County Hospital in Bregenz, Austria...
April 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29558355/-cutaneous-polyarteritis-nodosa
#14
Monika Turska, Jolanta Parada-Turska
Cutaneous polyarteritis nodosa is a rare disease that affects vessels of the deep skin and the subcutaneous tissue. Its etiopathology remains unknown. It predominantly affects skin, and the main cutaneous symptoms are subcutaneous nodules, livedo reticularis, and ulcerations that are mainly located on legs. Cutaneous polyarteritis nodosa can also cause extracutaneous symptoms (fever, malaise, myalgias, arthralgias, neuropathy). It is a chronic benign disease with a relapsing course. Diagnostic criteria for this disease were recently proposed and both clinical and typical histological features must be present to confirm the diagnosis...
2018: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29545429/methacrylate-dressing-on-refractory-venous-leg-ulcers
#15
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
https://www.readbyqxmd.com/read/29513326/ftir-spectroscopy-of-chronic-venous-leg-ulcer-exudates-an-approach-to-spectral-healing-marker-identification
#16
Nicolas Cerusico, Juan P Aybar, Silvana Lopez, Silvia G Molina, Romina Chavez Jara, Maria Eugenia Sesto Cabral, Juan C Valdez, Aida Ben Altabef, Alberto N Ramos
Chronic venous leg ulcer (CVLU) arises as a chronic venous insufficiency complication and is a major cause of morbidity throughout the world. Our hypothesis is that the CVLU exudate composition is a biochemical representation of the wound clinical state. Then, Fourier Transform Infrared (FTIR) spectroscopy could be a useful and less-invasive technique to study the clinical state of the ulcer. For this, the aim of this work was to perform a spectral characterization of the exudate from CVLU using FTIR spectroscopy to identify potential healing markers...
March 7, 2018: Analyst
https://www.readbyqxmd.com/read/29509111/using-a-modified-delphi-methodology-to-gain-consensus-on-the-use-of-dressings-in-chronic-wounds-management
#17
David Russell, Leanne Atkin, April Betts, Caroline Dowsett, Francis Fatoye, Sarah Gardner, Julie Green, Chris Manu, Tracey McKenzie, Helena Meally, Louise Mitchell, Julie Mullings, Isaac Odeyemi, Andrew Sharpe, Gillian Yeowell, Nancy Devlin
OBJECTIVE: Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing...
March 2, 2018: Journal of Wound Care
https://www.readbyqxmd.com/read/29502775/pathophysiology-of-chronic-venous-disease-and-venous-ulcers
#18
REVIEW
Joseph D Raffetto
Chronic venous disease and venous leg ulceration are a common disease affecting millions of individuals. The fundamental problem is venous hypertension with resultant clinical manifestations of venous disease including varicose veins, skin changes, and venous leg ulceration. The pathophysiology leading to venous hypertension is complex and multifactorial, involving genetic predisposition, environmental factors, hormones, endothelial dysfunction, inflammatory cells and molecules and activation on the endothelium and vein wall, and disturbances in the balance of cytokines and matrix metalloproteinases...
April 2018: Surgical Clinics of North America
https://www.readbyqxmd.com/read/29497177/intermittent-mild-negative-pressure-applied-to-the-lower-limb-in-patients-with-spinal-cord-injury-and-chronic-lower-limb-ulcers-a-crossover-pilot-study
#19
Øyvind Heiberg Sundby, Ingebjørg Irgens, Lars Øivind Høiseth, Iacob Mathiesen, Eivind Lundgaard, Hanne Haugland, Harald Weedon-Fekjær, Jon O Sundhagen, Gunnar Sandbæk, Jonny Hisdal
STUDY DESIGN: Randomized, assessor-blinded crossover pilot study. OBJECTIVES: To explore the use of an intermittent negative pressure (INP) device for home use in addition to standard wound care (SWC) for patients with spinal cord injury (SCI) and chronic leg and foot ulcers before conducting a superiority trial. SETTING: Patient homes and outpatient clinic. METHODS: A 16-week crossover trial on 9 SCI patients (median age: 57 years, interquartile range [IQR] 52-66), with leg ulcers for 52 of weeks (IQR: 12-82) duration...
March 1, 2018: Spinal Cord
https://www.readbyqxmd.com/read/29493307/chronic-venous-leg-ulcer-care-putting-the-patient-at-the-heart-of-leg-ulcer-care-part-1-exploring-the-consultation
#20
Julie Green, Rebecca Jester, Robert McKinley, Alison Pooler
This article, the first of two, summarises a study that explored the lived experiences of patients with leg ulcers and the impact of this condition on their quality of life. The study had four study phases; phases 1 and 2 employed qualitative methods and are reported here. Initially, unstructured interviews were held; these revealed significant issues for the patients including the dominance of pain, issues relating to exudate and odour, social isolation and psychological effects. A checklist based on these issues was completed by the researcher during observations of routine care for these same patients; this revealed the extent and depth to which these matters were addressed...
March 2, 2018: British Journal of Community Nursing
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