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https://www.readbyqxmd.com/read/28531254/frailty-status-at-admission-to-hospital-predicts-multiple-adverse-outcomes
#1
Ruth E Hubbard, Nancye M Peel, Mayukh Samanta, Leonard C Gray, Arnold Mitnitski, Kenneth Rockwood
Aims: frailty is proposed as a summative measure of health status and marker of individual vulnerability. We aimed to investigate the discriminative capacity of a frailty index (FI) derived from interRAI Comprehensive Geriatric Assessment for Acute Care (AC) in relation to multiple adverse inpatient outcomes. Methods: in this prospective cohort study, an FI was derived for 1,418 patients ≥70 years across 11 hospitals in Australia. The interRAI-AC was administered at admission and discharge by trained nurses, who also screened patients daily for geriatric syndromes...
May 22, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28526612/histomorphological-observation-of-surgical-debridement-combined-with-negative-pressure-therapy-in-treatment-of-diabetic-foot
#2
Jiao-Yun Dong, Fei Song, Chun Qing, Shu-Liang Lu
PURPOSE: To further study the mechanism of epithelization on the fascia side of the flap after surgical incision and the treatment of the negative pressure therapy. METHODS: With the patients' informed consent, parts of tissue samples were obtained from a 51-year-old diabetic patient who was suffering lower extremity ulcers. The samples were processed with hematoxylin and eosin (HE) staining and Masson trichrome staining. The keratin 19, keratin 15 and carcino-embryonic antigen (CEA) were immunohistochemically detected...
April 20, 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28523836/a-case-series-of-verrucae-vulgares-mimicking-hyperkeratosis-in-individuals-with-diabetic-foot-ulcers
#3
D R Quast, M A Nauck, F G Bechara, J J Meier
BACKGROUND: Diabetic foot ulcers are a common complication in the advanced stages of diabetes mellitus. Certain lesions may be refractory to usual treatments with prolonged healing. In these cases, differential diagnoses to classical ulcers should be considered. Although plantar warts are a common and easy-to-diagnose finding in the general population, diagnosis can be challenging in people with diabetic foot ulcers, as they mimic hyperkeratosis in these people. CASE REPORT: We report seven cases of people with diabetic foot ulcers and verrucae vulgares mimicking treatment-refractory hyperkeratosis, presenting to our centre between 2014 and 2016...
May 19, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28521750/data-for-improvement-and-clinical-excellence-a-report-of-an-interrupted-time-series-trial-of-feedback-in-home-care
#4
Kimberly D Fraser, Anne E Sales, Melba Andrea B Baylon, Corinne Schalm, John J Miklavcic
BACKGROUND: There is substantial evidence about the effectiveness of audit with feedback, but none that we know have been conducted in home care settings. The primary purpose of the Data for Improvement and Clinical Excellence - Home Care (DICE-HC) project was to evaluate the effects of an audit and feedback delivered to care providers on home care client outcomes. The objective of this paper is to report the effects of feedback on four specific quality indicators: pain, falls, delirium, and hospital visits...
May 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28513869/transition-of-intravenous-treprostinil-to-oral-therapy-in-a-patient-with-functional-class-iv-chronic-thromboembolic-pulmonary-hypertension
#5
Kristina M Thurber, Breann M Williams, Ruth E Bates, Robert P Frantz
Chronic thromboembolic pulmonary hypertension (CTEPH) occurs when pulmonary emboli fail to resolve with anticoagulation. For patients with inoperable or residual CTEPH, riociguat is currently the only therapy approved by the United States Food and Drug Administration. However, some patients with CTEPH may require therapy beyond riociguat, such as intravenous prostacyclins, which can present significant administration challenges in patients with complex comorbid conditions. We describe a 42-year-old man with T12 paraplegia complicated by CTEPH (functional class IV with substantial right ventricular dysfunction) and severe pressure ulcers...
May 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28513212/an-optical-fiber-based-smart-textile-smart-socks-to-manage-biomechanical-risk-factors-associated-with-diabetic-foot-amputation
#6
Bijan Najafi, Hooman Mohseni, Gurtej S Grewal, Talal K Talal, Robert A Menzies, David G Armstrong
OBJECTIVE: This study aimed to validate a smart-textile based on fiber-optics for simultaneous measurement of plantar temperature, pressure, and joint angles in patients with diabetic peripheral neuropathy (DPN). METHODS: After in-vitro validation in the laboratory, 33 eligible subjects with DPN were recruited (age: 58 ± 8 years, BMI: 31.5 ± 8 kg/m(2)) for assessing plantar pressure and temperature during habitual gait-speed in a clinical-setting. All participants were asked to walk at their habitual speed while wearing a pair of sensorized socks made from highly flexible fiber optics (SmartSox)...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28512923/the-braden-scale-a-standard-tool-for-assessing-pressure-ulcer-risk-predicts-early-outcomes-after-liver-transplantation
#7
Vinay Sundaram, Jane Lim, Danielle M Tholey, Sentia Iriana, Irene Kim, Vignan Manne, Nicholas N Nissen, Andrew S Klein, Tram T Tran, Walid S Ayoub, Barry Schlansky
The Braden Scale is a standardized tool to assess pressure ulcer risk, that is reported for all hospitalized patients in the United States (US) per requirements of the Center for Medicare and Medicaid Services. Previous data has shown the Braden Scale can predict both frailty and mortality risk in patients with decompensated cirrhosis. Our aim was to evaluate the association of Braden Scale score with short-term outcomes after liver transplantation (LT). We performed a retrospective cohort study of deceased-donor LT recipients at two centers, and categorized them according to the Braden Scale at hospital admission as low (>18), moderate (16-18), or high risk (<16) for pressure ulcer...
May 17, 2017: Liver Transplantation
https://www.readbyqxmd.com/read/28512689/long-term-results-of-fibular-achilles-tenodesis-westin-s-tenodesis-for-paralytic-pes-calcaneus-is-hypercorrection-avoidable-a-longitudinal-retrospective-study
#8
Helder Henzo Yamada, Patricia Maria Moraes de Barros Fucs
PURPOSE: The purpose of this study was to review all cases of patients submitted to Westin's tenodesis, who had calcaneus feet secondary to myelomeningocele sequel, in order to evaluate the anatomical change provided by surgery and also to verify, in a long-term follow-up, the inversion of the deformity depending on the patient's age. METHODS: In this longitudinal retrospective study, all medical records of patients with myelomeningocele sequelae submitted to Westin's tenodesis from 1993 to 2013 in a public university hospital were reviewed...
May 16, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28512404/painful-leg-ulceration-in-a-poorly-controlled-hypertensive-patient-a-case-report-of-martorell-ulcer
#9
Harsimran Kaur Malhi, Ali Didan, Stefan Ponosh, Sujith Prasad Kumarasinghe
Martorell ulcer is a form of lower limb ulceration, preceded by a small area of excruciating pain. It often appears as a solitary lesion on the outer aspect of the lower limb, and is primarily associated with poorly controlled hypertension and diabetes. Treatment of the ulcer involves awareness and early correct diagnosis, adequate control of blood pressure, management of infection, and wound care. We describe a 77-year-old diabetic and hypertensive woman presenting with excruciating pain in her right lower lateral leg leading to a necrotic ulcer...
January 2017: Case Reports in Dermatology
https://www.readbyqxmd.com/read/28508548/a-prospective-evaluation-of-methylene-blue-and-gentian-violet-dressing-for-management-of-chronic-wounds-with-local-infection
#10
Kevin Y Woo, Jolene Heil
The objective of this prospective, non-randomised study was to evaluate the performance of an antibacterial foam dressing containing methylene blue and gentian violet (Hydrofera Blue Classic dressing(®) ) for the management of chronic wounds with local infection. Patients in this study were ≥18 years of age (n = 29), and each had at least one chronic wound ≥1 cm(2) in size that showed signs of localised infection or critical colonisation but with good potential for healing based on clinical assessment...
May 16, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28502905/inhibition-of-proinflammatory-mediators-by-coumaroyl-lupendioic-acid-a-new-lupane-type-triterpene-from-careya-arborea-on-inflammation-induced-animal-model
#11
Rayhana Begum, Manjur Ali Sheliya, Showkat R Mir, Ekta Singh, Manju Sharma
ETHNOPHARMACOLOGICAL RELEVANCE: Careya arborea Roxb. (Lecythidaceae) is a large tree found throughout India in deciduous forests and grasslands. C. arborea is traditionally used in tumors, inflammation, anthelmintic, bronchitis, epileptic fits, astringents, antidote to snake-venom, skin disease, diarrhea, dysentery with bloody stools, dyspepsia, ulcer, tooth ache, and ear pain. AIM OF THE STUDY: In our previous work, the methanolic extract of Careya arborea stem bark showed significant anti-inflammatory activity...
May 11, 2017: Journal of Ethnopharmacology
https://www.readbyqxmd.com/read/28494507/subepidermal-moisture-detection-of-pressure-induced-tissue-damage-on-the-trunk-the-pressure-ulcer-detection-pud-study-outcomes
#12
Barbara M Bates-Jensen, Heather E McCreath, Anabel Patlan
We examined the relationship between subepidermal moisture measured using surface electrical capacitance and visual skin assessment of pressure ulcers at the trunk location (sacral, ischial tuberosities) in 417 nursing home residents residing in 19 facilities. Participants were on average older (mean age of 77 years), 58% were female, over half were ethnic minorities (29% African American, 12% Asian American, and 21% Hispanic), and at risk for pressure ulcers (mean score for Braden Scale for Predicting Pressure Ulcer Risk of 15...
May 11, 2017: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/28489215/negative-pressure-therapy-for-the-treatment-of-complex-wounds
#13
Renan Victor Kümpel Schmidt Lima, Pedro Soler Coltro, Jayme Adriano Farina
The objective of this study is to evaluate the effectiveness of negative pressure therapy (NPT) in the treatment of complex wounds, with emphasis on its mechanisms of action and main therapeutic indications. We searched the Pubmed / Medline database for articles published from 1997 to 2016, and selected the most relevant ones. The mechanisms of action of NPT involveboth physical effects, such as increased perfusion, control of edema and exudate, reduction of wound dimensions and bacterial clearance, and biological ones, such as the stimulation of granulation tissue formation, microdeformations and reduction of Inflammatory response...
January 2017: Revista do Colégio Brasileiro de Cirurgiões
https://www.readbyqxmd.com/read/28488305/the-use-of-medicinal-plants-in-venous-ulcers-a-systematic-review-with-meta-analysis
#14
Anderson L Freitas, Carla A Santos, Carlos As Souza, Marco Ap Nunes, Ângelo R Antoniolli, Wellington B da Silva, Francilene A da Silva
The aim of this study was to systematically review the use of medicinal plants for the treatment of varicose ulcers. The databases used in the search were: Medline/Pubmed, Scopus, Cinhal, Lilacs and Web of Science. The selection process was divided into two phases: the reading of titles and abstracts and the full reading of selected articles. The item description was compared with the checklist of the Consolidated Standards of Reporting Trials. The initial search produced 3505 articles and seven were selected for inclusion in the systematic review...
May 9, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28487791/a-horned-viper-bite-victim-with-pres
#15
Ahmed Mustafa Ibrahim, Tarek Talaat ElSefi, Maha Ghanem, Akram Muhammad Fayed, Nesreen Adel Shaban
Neurological complications of snake bites have been well documented in the literature as neuromuscular paralysis and cerebrovascular complications; posterior reversible encephalopathy syndrome was rarely described. A 23-year-old lady presented near full term of her pregnancy with a horned snake Cerastes cerastes bite; after successful delivery she started complaining of altered mental status and visual disturbance with ulceration over the site of the snake bite. On admission, the patient had Glasgow Coma Score of 12, blood pressure 130/80 mmHg, temperature 38°C, sinus tachycardia at 120 beats per minute, severe dehydration, and reduction in visual acuity to "hand motion" in both eyes with poor light projection and sluggish pupillary reactions...
2017: Case Reports in Neurological Medicine
https://www.readbyqxmd.com/read/28485879/evidence-for-silver-in-wound-care-meta-analysis-of-clinical-studies-from-2000-2015
#16
Joachim Dissemond, Johannes Georg Böttrich, Horst Braunwarth, Jörg Hilt, Patricia Wilken, Karl-Christian Münter
BACKGROUND: Given that the scientific evidence for silver in wound care is generally considered insufficient, there is uncertainty among users regarding its clinical use. MATERIAL AND METHODS: A group of experts evaluated the clinical studies on silver in wound management published from 2000-2015. RESULTS: Overall, 851 articles were identified, 173 of which were included and categorized. There were 31 randomized controlled trials (RCTs) and eight cohort studies...
May 2017: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
https://www.readbyqxmd.com/read/28482622/nonlinear-dynamics-of-skin-blood-flow-response-to-mechanical-and-thermal-stresses-in-the-plantar-foot-of-diabetics-with-peripheral-neuropathy
#17
Fuyuan Liao, Yih-Kuen Jan
BACKGROUND: Diabetic foot ulcers (DFU) are a major complication in diabetics. Impaired microvascular reactivity is a major contributor to the development of DFU and has been traditionally quantified by time-domain or frequency-domain measures of skin blood flow (SBF). These measures, however, are unable to characterize the changes of nonlinear dynamics of SBF associated with diabetes and peripheral neuropathy. OBJECTIVE: The objective of this study was to investigate altered nonlinear dynamics of skin blood flow in the plantar foot of diabetics with peripheral neuropathy...
May 5, 2017: Clinical Hemorheology and Microcirculation
https://www.readbyqxmd.com/read/28475447/accuracy-of-ultrasound-thermography-and-subepidermal-moisture-in-predicting-pressure-ulcers-a-systematic-review
#18
A L Oliveira, Z Moore, T O Connor, D Patton
OBJECTIVE: Our aims were to: establish the clinical significance of ultrasound, thermography, photography and subepidermal moisture (SEM) measurement; determine the accuracy of ultrasound, thermography, photography and SEM measurement in detecting skin/tissue damage; determine the relative accuracy of one of these assessment methods over another; make recommendations for practice pertaining to assessment of early skin/tissue damage. METHOD: The following databases, Cochrane Wounds Group Specialised Register, The Cochrane Central Register of Controlled Trials, Ovid MEDLINE, Ovid EMBASE, Elsevier version, EBSCO CINAHL, ClinicalTrials...
May 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28475443/evaluation-of-skin-perfusion-pressure-to-assess-refractory-foot-ulcers
#19
M Kawai, S Mihara, S Takahagi, K Iwamoto, T Hiragun, M Hide
OBJECTIVE: The number of patients with foot gangrene caused by critical ischaemia and severe infection is increasing significantly in developed countries. The measurement of perilesional skin blood flow by skin perfusion pressure (SPP) is useful to select the appropriate treatment of gangrenous lesions, in that it is not affected by calcifications of blood vessels. However, the prognosis of a foot ulcer may also be affected by the level of blood sugar and infections. This study aimed to validate the use of SPP in cases of foot gangrene and ulcers in patients with and without diabetes mellitus (DM) and infection...
May 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28472912/controlled-delivery-of-bioactive-molecules-for-the-treatment-of-chronic-wounds
#20
J Anjana, V K Rajan, R Biswas, R Jayakumar
A cut or break on the surface of the skin is usually referred to as a wound. Any wound has a potential to heal by itself through a complex cascade of events. However, some wounds show delayed healing due to their underlying physiology and are referred to as chronic wounds like diabetic ulcers, venous ulcers, pressure ulcers and chronic infected ulcers. Extensive care has to be taken for the management of chronic wounds and these have become a major concern in the current medical scenario. The use of bioactive molecules or in other words the molecules that can actively interact with the wound environment and help in wound healing are gaining much importance...
May 3, 2017: Current Pharmaceutical Design
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