Francis Derk1, Troy Wilde2,
Tim Pham2, Mike Griffiths3
1South Texas VA Medical Center (San Antonio, United States)
2UTHSC (San Antonio, United States)
3AOTI (Oceanside, United States)
Treatment and outcomes_of_fingertip_injuries_at_a.17Zendy Cipriani
This study examined outcomes of 100 fingertip injuries treated at Bellevue Hospital between January and May 2011. 64% healed without surgery, 18% required surgery, and 18% were lost to follow up. Those requiring surgery tended to have larger defects, volar oblique injuries, exposed bone, and distal phalanx fractures. While treatment algorithms exist, the study found that many fingertip injuries can be treated nonoperatively to achieve good function and sensation and allow for earlier return to work.
Cutimed® Epiona is a new 3D MatrixTM technology that was shown to fast-track healing in a clinical study of 31 patients with chronic wounds. After 3 weeks, the mean reduction in wound area was almost 40% and 14 wounds were reduced by 50% or more. Complete wound healing occurred in 3 wounds within 3 weeks. The study demonstrated Cutimed® Epiona's ability to enhance tissue generation and promote healing in stalled wounds through its unique porous structure and scaffold that mimics the extracellular matrix.
This document summarizes an article about volunteer surgeons providing care to wounded soldiers in Iraq and Afghanistan. It discusses the senior visiting surgeon program established by the American College of Surgeons that allows surgeons to volunteer their time. The volunteer rotation described involved caring for patients at Landstuhl Regional Medical Center in Germany as part of the complex medical evacuation process bringing wounded soldiers from war zones to the United States for further treatment and recovery.
This document summarizes 5 studies that compared maggot debridement therapy (MDT) to conventional debridement therapy (CDT) for wound healing. Most studies found MDT to be as effective as or better than CDT at removing dead tissue from wounds. Specifically, 2 studies found MDT removed only dead tissue, allowing faster healing, while 1 study found no difference in healing rates between MDT and CDT. The studies examined wounds in patients with diabetes and chronic wounds. Overall, the studies suggest MDT is a viable alternative to CDT, especially for wounds that require fast debridement.
This study analyzed 44 cases of penetrating pelvic injury (PPI) that underwent laparotomy at a hospital in Juarez, Mexico over one year. Most injuries were from gunshots. The small bowel was the most commonly injured organ. Therapeutic laparotomies were performed in 61.4% of cases where injuries required intervention. Major complications included surgical site infections. The mortality rate was 20%, primarily due to hypovolemic shock. Despite the safety of non-operative management of PPI in other settings, the lack of advanced imaging technology in this developing world hospital meant laparotomy remained the standard of care for penetrating pelvic trauma.
This document discusses limiting radiation exposure from diagnostic imaging procedures like CT scans. It provides context about radiation dosage terms and compares the effective radiation dose of different medical imaging exams. While medical imaging only accounts for around 50% of radiation exposure in the US, it may be responsible for about 1% of cancer cases. The document examines balancing radiation risks, which are higher for younger patients and females, with clinical benefits on a case-by-case basis using the ALARA principle to keep radiation as low as reasonably possible. It analyzes the risks and benefits of 4DCT for imaging hyperfunctional parathyroid glands as an example.
This study compared two methods of fixing polypropylene mesh during open inguinal hernia repair surgery: fibrin glue fixation versus suture fixation. The study included 60 patients undergoing unilateral inguinal hernia repair who were divided into two groups. The results showed that surgery time was significantly shorter when using fibrin glue fixation compared to suture fixation. Patients who received fibrin glue fixation also reported significantly less pain in the first post-operative day, first post-operative week, and one month after surgery. There were no significant differences in complications between the two groups. The study concluded that fibrin glue provided an effective alternative to sutures for fixing mesh with benefits including shorter surgery time and less post-operative pain.
Tollerabilità e sicurezza delle attuali terapie biologiche per la psoriasi ne...Merqurio
This study evaluated the safety and tolerability of biological therapies for psoriasis in 103 patients in Italy over 6 years. Four biological therapies were studied: efalizumab, etanercept, infliximab, and adalimumab. Infliximab had a significantly higher rate of being discontinued due to severe adverse events compared to etanercept and efalizumab. Efalizumab and etanercept demonstrated more favorable safety profiles compared to infliximab. While more patients responded to infliximab initially, long-term tolerability was higher for efalizumab and etanercept due to their better safety profiles and compliance with therapy.
Treatment and outcomes_of_fingertip_injuries_at_a.17Zendy Cipriani
This study examined outcomes of 100 fingertip injuries treated at Bellevue Hospital between January and May 2011. 64% healed without surgery, 18% required surgery, and 18% were lost to follow up. Those requiring surgery tended to have larger defects, volar oblique injuries, exposed bone, and distal phalanx fractures. While treatment algorithms exist, the study found that many fingertip injuries can be treated nonoperatively to achieve good function and sensation and allow for earlier return to work.
Cutimed® Epiona is a new 3D MatrixTM technology that was shown to fast-track healing in a clinical study of 31 patients with chronic wounds. After 3 weeks, the mean reduction in wound area was almost 40% and 14 wounds were reduced by 50% or more. Complete wound healing occurred in 3 wounds within 3 weeks. The study demonstrated Cutimed® Epiona's ability to enhance tissue generation and promote healing in stalled wounds through its unique porous structure and scaffold that mimics the extracellular matrix.
This document summarizes an article about volunteer surgeons providing care to wounded soldiers in Iraq and Afghanistan. It discusses the senior visiting surgeon program established by the American College of Surgeons that allows surgeons to volunteer their time. The volunteer rotation described involved caring for patients at Landstuhl Regional Medical Center in Germany as part of the complex medical evacuation process bringing wounded soldiers from war zones to the United States for further treatment and recovery.
This document summarizes 5 studies that compared maggot debridement therapy (MDT) to conventional debridement therapy (CDT) for wound healing. Most studies found MDT to be as effective as or better than CDT at removing dead tissue from wounds. Specifically, 2 studies found MDT removed only dead tissue, allowing faster healing, while 1 study found no difference in healing rates between MDT and CDT. The studies examined wounds in patients with diabetes and chronic wounds. Overall, the studies suggest MDT is a viable alternative to CDT, especially for wounds that require fast debridement.
This study analyzed 44 cases of penetrating pelvic injury (PPI) that underwent laparotomy at a hospital in Juarez, Mexico over one year. Most injuries were from gunshots. The small bowel was the most commonly injured organ. Therapeutic laparotomies were performed in 61.4% of cases where injuries required intervention. Major complications included surgical site infections. The mortality rate was 20%, primarily due to hypovolemic shock. Despite the safety of non-operative management of PPI in other settings, the lack of advanced imaging technology in this developing world hospital meant laparotomy remained the standard of care for penetrating pelvic trauma.
This document discusses limiting radiation exposure from diagnostic imaging procedures like CT scans. It provides context about radiation dosage terms and compares the effective radiation dose of different medical imaging exams. While medical imaging only accounts for around 50% of radiation exposure in the US, it may be responsible for about 1% of cancer cases. The document examines balancing radiation risks, which are higher for younger patients and females, with clinical benefits on a case-by-case basis using the ALARA principle to keep radiation as low as reasonably possible. It analyzes the risks and benefits of 4DCT for imaging hyperfunctional parathyroid glands as an example.
This study compared two methods of fixing polypropylene mesh during open inguinal hernia repair surgery: fibrin glue fixation versus suture fixation. The study included 60 patients undergoing unilateral inguinal hernia repair who were divided into two groups. The results showed that surgery time was significantly shorter when using fibrin glue fixation compared to suture fixation. Patients who received fibrin glue fixation also reported significantly less pain in the first post-operative day, first post-operative week, and one month after surgery. There were no significant differences in complications between the two groups. The study concluded that fibrin glue provided an effective alternative to sutures for fixing mesh with benefits including shorter surgery time and less post-operative pain.
Tollerabilità e sicurezza delle attuali terapie biologiche per la psoriasi ne...Merqurio
This study evaluated the safety and tolerability of biological therapies for psoriasis in 103 patients in Italy over 6 years. Four biological therapies were studied: efalizumab, etanercept, infliximab, and adalimumab. Infliximab had a significantly higher rate of being discontinued due to severe adverse events compared to etanercept and efalizumab. Efalizumab and etanercept demonstrated more favorable safety profiles compared to infliximab. While more patients responded to infliximab initially, long-term tolerability was higher for efalizumab and etanercept due to their better safety profiles and compliance with therapy.
Tashia Seeba - Antibiotics and maxillofacial fractures Tashia Seeba
This study evaluated the necessity of routine antibiotic administration to prevent surgical wound infections in patients undergoing treatment for maxillofacial fractures. The study retrospectively analyzed 67 patients with 114 fractures who were divided into 3 groups: no antibiotics, penicillin antibiotics, or cefotaxime antibiotics. The overall surgical wound infection rate was 16.66%. Statistical analysis found no significant difference in infection rates between the groups, suggesting that prophylactic antibiotics may not alter the risk of surgical wound infections in patients with maxillofacial fractures. Delay in treatment and use of catgut sutures were found to have a positive correlation with higher infection rates.
1) The document discusses major shifts in the treatment of breast cancer over the past 100 years, moving away from Halsted's radical mastectomy approach.
2) Six randomized trials have shown that breast-conserving surgery plus radiation has equivalent survival rates to mastectomy, though local recurrence rates are sometimes higher with breast-conserving options.
3) Adjuvant chemotherapy was initially controversial but multiple studies have confirmed it improves disease-free and overall survival, providing evidence that systemic therapy is more important than local control alone.
Post-operative Wound Infection in Cases operated in a Tertiary Level Hospital Jaipur (Rajasthan) India-Wound infection is the second commonest nosocomial infection and most troublesome disorder of wound healing. This study was carried out on 100 post-operative cases of Surgical Unit 1st of General Surgery Department of Sawai Man Singh Hospital, Jaipur (Rajasthan) India in years 2014.
After interview of these, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Results were inferred by Chi-square test and unpaired‘t’ test. Among all operative cases 21% were found infected. Cases, who were operated in emergency have significantly more post-operative wound infection. Mean age and mean postoperative stay of cases with post-operative infected wound was significantly higher than in cases without post-operative infected wound. But mean pre-operative stay, mean duration of operation and type of operation was not associated with post-operative wound infection. Pre-operative antibiotics lowered the occurrence of post-operative wound infection. Maximum proportion of causative agent found in post-operative infected wound was Staphylococci (90.48%) followed with Streptococci, E. Coli, Klebsella and Pseudomonas.
This study reviewed 232 patients with low-grade (Spetzler-Martin Grade I-II) brain arteriovenous malformations (AVMs) who underwent surgical resection. The key findings were:
1) AVM resection was successful in all patients and confirmed angiographically in 94% with no residual AVMs found.
2) Overall good functional outcomes (mRS 0-1) were found in 78% at last follow-up, with 97% improved or unchanged from their preoperative status.
3) Patients with unruptured AVMs had better functional outcomes (91% good) than those with ruptured AVMs (65% good), but equivalent relative outcomes (96-98% improved
This study analyzed over 300,000 fractures in 18 bones to identify risk factors for fracture nonunion using a large US health claims database. The overall nonunion rate was 4.9%. Certain fractures like scaphoid, tibia/fibula and femur fractures had nonunion rates over 10%. Multiple risk factors were associated with increased odds of nonunion on multivariate analysis, including open fractures, multiple concurrent fractures, prescription NSAID and opioid use, anticoagulant use, and osteoarthritis with rheumatoid arthritis - all increasing the risk of nonunion by over 50%. The probability of nonunion can be estimated based on patient characteristics and fracture severity available at initial presentation.
Whole body ct adult versus ped centers (iep)bahlinnm
1) The study analyzed over 30,000 pediatric trauma patients treated at level I or II adult or pediatric trauma centers to compare the use of whole body CT (WBCT) scans between facilities.
2) It found WBCT scans were used significantly more often on pediatric patients treated at adult trauma centers (31.4%) compared to pediatric centers (17.6%).
3) After adjusting for factors, pediatric patients treated at adult centers were 1.8 times more likely to receive a WBCT, increasing their radiation risk without improving outcomes, as mortality did not differ between the groups. The study concludes guidelines are needed to minimize unnecessary WBCT use across centers.
This document reviews current treatment strategies for spinal compression fractures and potential future directions. The major current treatment strategies are conservative pain management and vertebral augmentation procedures like vertebroplasty and kyphoplasty. However, there is a lack of consensus on the optimal treatment approach. Prospective clinical trials with new biomarkers are needed to better assess treatment efficacy and develop clearer guidelines. The document provides an overview of common pain management strategies like NSAIDs, opioids, and bisphosphonates as well as vertebral augmentation procedures and calls for future research to establish standardized treatment pathways.
Correlation of Her-2 neu over-expression with clinico pathological features o...Apollo Hospitals
The classical clinico pathological features such as tumour
size, axillary node status, histological type and grade have a
well-established prognostic role in breast cancer.
This study compared outcomes of 120 burn patients who underwent either early excision and grafting (E&G) within 4-7 days, or delayed excision and grafting (D&G) within 1-4 weeks. Significant differences favored the E&G group: fewer culture-positive wounds, better graft take, shorter post-graft hospital stay, and no mortality. While early excision improves outcomes, the optimal timing requires further study. However, this study supports performing excision as early as possible when stabilization has occurred.
This document discusses isolated head injuries in pediatric trauma patients and the association with shock and hypotension. The key points are:
1) A study found that among pediatric patients with isolated head injuries, rates of hypotension were highest in those aged 0-4 years, with 1/3 of hypotension cases associated with isolated head injuries in that age group.
2) Several potential causes for this association between isolated head injuries and hypotension in young pediatric patients were hypothesized, including neurogenic or autonomic responses.
3) Due to the risks of cerebral edema from large fluid volumes, providers may need to adjust treatment to include early vasopressors or anticholinergic drugs to support blood pressure in these
This document discusses the use of focused assessment with computed tomography (FACTT) in the evaluation and management of trauma patients. It provides an overview of FACTT, describing how it allows for a rapid, whole-body CT scan to identify life-threatening injuries. The document notes several benefits of FACTT, including earlier diagnosis, targeted therapy, and improved outcomes. It also discusses algorithms and protocols for FACTT and presents several case examples demonstrating its use in identifying various injuries.
Nurse-led pre-operative assessment ensures patients are prepared for surgery through a systematic 4-stage process: 1) collecting medical history, 2) nursing assessment, 3) ordering relevant investigations/tests, and 4) providing information. This identifies risks and needs to improve outcomes by reducing cancellations. Pre-operative assessment by nurses trained to advanced levels can provide equivalent care to doctors. Effective communication among the healthcare team during assessment benefits patients.
MANAGEMENT OF COMPLICATIONS AFTER LRP: HOW TO IMPROVE EARLY CONTINENCE AND MA...Eduard Garcia Cruz
Mi presentación en las jornadas "MINIMALLY INVASIVE PROSTATE SURGERY" en Oporto del 24 y 25 de enero del 2014 - "Gestión de las complicaciones después de la prostatectomía radical laparoscópica (PRL): Cómo mejorar la incontinencia temprana y gestionar la disfunción eréctil".
This study analyzed 138 patients treated for hand trauma at a plastic surgery unit in Pakistan between 2008-2009. The majority of patients were young males whose hands were injured by machines at work. The most common injuries were bone fractures and cuts/lacerations. Over 5% of injuries resulted in amputation of part of the hand. Most patients received surgical treatment such as wire fixation or tendon repair. The average hospital stay was 10.7 days. The study concluded that hand trauma disproportionately affects young male workers exposed to machinery and is associated with high rates of amputation. Most injuries stem from preventable occupational hazards.
This document summarizes the process used to develop a new definition and clinical criteria for identifying septic shock in adults. A task force conducted a systematic review of existing studies, a Delphi consensus process, and analysis of large clinical databases. Based on these analyses, the task force agreed on a new definition of septic shock and identified hypotension requiring vasopressors and an elevated serum lactate level as criteria for identifying adult patients with septic shock. These criteria were validated in separate clinical databases and shown to identify a patient group with significantly higher mortality compared to other commonly reported definitions of septic shock.
The document discusses parotid gland disorders that necessitated parotidectomy. It summarizes that:
- The majority (90.47%) of cases involved benign pathology, most commonly pleomorphic adenoma. Superficial parotidectomy was the most common surgery.
- Post-operative complications occurred in about 30% of cases, most frequently greater auricular nerve paresis (15%) or facial nerve transient paresis (8%).
- Fine needle aspiration cytology (FNAC) was found to be a useful diagnostic tool for parotid gland tumors, with 98.24% specificity and 83.33% sensitivity for detecting malignancy.
Diagnostic Efficacy of Ultra-High-Field MRS in Glioma PatientsUzay Emir
This study tested the efficacy of ultra-high-field (7T) magnetic resonance spectroscopy (MRS) for predicting molecular characteristics of glioma tumors by visual inspection of MRS spectra. Participants in a workshop correctly identified the IDH mutation status in 11 out of 13 glioma patients by visually inspecting 7T MRS spectra, demonstrating the potential of 7T MRS for non-invasive glioma diagnosis and precision medicine strategies. While 2-HG detection is challenging at lower field strengths, 7T MRS provides improved detection and resolution of metabolic biomarkers like 2-HG that can help classify glioma molecular subtypes.
This study evaluated outcomes of 28 patients with intracranial meningiomas treated with hypofractionated radiosurgery. Most tumors were treated with 22.5-30 Gy delivered in 5 fractions. With a mean follow up of 32.6 months, the local tumor control rate was 100% with only one instance of marginal progression. Symptoms improved or resolved in over 66% of patients who originally presented with symptoms. Side effects occurred in 4 patients but the permanent morbidity rate was low at 3.5%. Hypofractionated radiosurgery provided high tumor control with a low risk of side effects, even for large tumors greater than 9 cm3.
This study retrospectively analyzed outcomes of 27 patients who underwent surgery for chondrosarcomas originating in the sacrum between 1992-2014. It found that en bloc resection was associated with longer hospital stays than intralesional surgery. En bloc resection also resulted in greater loss of motor, bowel and bladder function compared to intralesional surgery, though the results were not statistically significant. The 5-year and 10-year overall survival rates for the entire group were 53% and 37.8% respectively, with a higher rate seen for unilateral nerve root resection versus bilateral resection. The study aims to help assess functional outcomes and quality of life for patients with this rare type of cancer.
Comparision of different imaging techniques used for chronic woundseSAT Journals
Abstract Many people suffer from chronic wounds .It is a major problem in healthcare .worldwide. The treatments of chronic wounds include monitoring colour and size (area or volume) of the wound at regular intervals. This evaluation is often based on qualitative observation and manual measurements of the wound. Now a days there several researchers are developing technologies to assess the clinical improvement of chronic wounds. This paper aims to provide a study on imaging technologies applied to chronic wounds. A study on imaging technologies applied to chronic wounds is presented. Their reliability, precision, and usage are compared. The methods are divided into three categories: planimetric techniques, volumetric Technique and tissue classification. Keywords: chronic wounds, 2D, 3D, imaging, techniques, tissue classification
Tashia Seeba - Antibiotics and maxillofacial fractures Tashia Seeba
This study evaluated the necessity of routine antibiotic administration to prevent surgical wound infections in patients undergoing treatment for maxillofacial fractures. The study retrospectively analyzed 67 patients with 114 fractures who were divided into 3 groups: no antibiotics, penicillin antibiotics, or cefotaxime antibiotics. The overall surgical wound infection rate was 16.66%. Statistical analysis found no significant difference in infection rates between the groups, suggesting that prophylactic antibiotics may not alter the risk of surgical wound infections in patients with maxillofacial fractures. Delay in treatment and use of catgut sutures were found to have a positive correlation with higher infection rates.
1) The document discusses major shifts in the treatment of breast cancer over the past 100 years, moving away from Halsted's radical mastectomy approach.
2) Six randomized trials have shown that breast-conserving surgery plus radiation has equivalent survival rates to mastectomy, though local recurrence rates are sometimes higher with breast-conserving options.
3) Adjuvant chemotherapy was initially controversial but multiple studies have confirmed it improves disease-free and overall survival, providing evidence that systemic therapy is more important than local control alone.
Post-operative Wound Infection in Cases operated in a Tertiary Level Hospital Jaipur (Rajasthan) India-Wound infection is the second commonest nosocomial infection and most troublesome disorder of wound healing. This study was carried out on 100 post-operative cases of Surgical Unit 1st of General Surgery Department of Sawai Man Singh Hospital, Jaipur (Rajasthan) India in years 2014.
After interview of these, swab from post-operative wound was taken and sent for culture and sensitivity test in Microbiology. Results were inferred by Chi-square test and unpaired‘t’ test. Among all operative cases 21% were found infected. Cases, who were operated in emergency have significantly more post-operative wound infection. Mean age and mean postoperative stay of cases with post-operative infected wound was significantly higher than in cases without post-operative infected wound. But mean pre-operative stay, mean duration of operation and type of operation was not associated with post-operative wound infection. Pre-operative antibiotics lowered the occurrence of post-operative wound infection. Maximum proportion of causative agent found in post-operative infected wound was Staphylococci (90.48%) followed with Streptococci, E. Coli, Klebsella and Pseudomonas.
This study reviewed 232 patients with low-grade (Spetzler-Martin Grade I-II) brain arteriovenous malformations (AVMs) who underwent surgical resection. The key findings were:
1) AVM resection was successful in all patients and confirmed angiographically in 94% with no residual AVMs found.
2) Overall good functional outcomes (mRS 0-1) were found in 78% at last follow-up, with 97% improved or unchanged from their preoperative status.
3) Patients with unruptured AVMs had better functional outcomes (91% good) than those with ruptured AVMs (65% good), but equivalent relative outcomes (96-98% improved
This study analyzed over 300,000 fractures in 18 bones to identify risk factors for fracture nonunion using a large US health claims database. The overall nonunion rate was 4.9%. Certain fractures like scaphoid, tibia/fibula and femur fractures had nonunion rates over 10%. Multiple risk factors were associated with increased odds of nonunion on multivariate analysis, including open fractures, multiple concurrent fractures, prescription NSAID and opioid use, anticoagulant use, and osteoarthritis with rheumatoid arthritis - all increasing the risk of nonunion by over 50%. The probability of nonunion can be estimated based on patient characteristics and fracture severity available at initial presentation.
Whole body ct adult versus ped centers (iep)bahlinnm
1) The study analyzed over 30,000 pediatric trauma patients treated at level I or II adult or pediatric trauma centers to compare the use of whole body CT (WBCT) scans between facilities.
2) It found WBCT scans were used significantly more often on pediatric patients treated at adult trauma centers (31.4%) compared to pediatric centers (17.6%).
3) After adjusting for factors, pediatric patients treated at adult centers were 1.8 times more likely to receive a WBCT, increasing their radiation risk without improving outcomes, as mortality did not differ between the groups. The study concludes guidelines are needed to minimize unnecessary WBCT use across centers.
This document reviews current treatment strategies for spinal compression fractures and potential future directions. The major current treatment strategies are conservative pain management and vertebral augmentation procedures like vertebroplasty and kyphoplasty. However, there is a lack of consensus on the optimal treatment approach. Prospective clinical trials with new biomarkers are needed to better assess treatment efficacy and develop clearer guidelines. The document provides an overview of common pain management strategies like NSAIDs, opioids, and bisphosphonates as well as vertebral augmentation procedures and calls for future research to establish standardized treatment pathways.
Correlation of Her-2 neu over-expression with clinico pathological features o...Apollo Hospitals
The classical clinico pathological features such as tumour
size, axillary node status, histological type and grade have a
well-established prognostic role in breast cancer.
This study compared outcomes of 120 burn patients who underwent either early excision and grafting (E&G) within 4-7 days, or delayed excision and grafting (D&G) within 1-4 weeks. Significant differences favored the E&G group: fewer culture-positive wounds, better graft take, shorter post-graft hospital stay, and no mortality. While early excision improves outcomes, the optimal timing requires further study. However, this study supports performing excision as early as possible when stabilization has occurred.
This document discusses isolated head injuries in pediatric trauma patients and the association with shock and hypotension. The key points are:
1) A study found that among pediatric patients with isolated head injuries, rates of hypotension were highest in those aged 0-4 years, with 1/3 of hypotension cases associated with isolated head injuries in that age group.
2) Several potential causes for this association between isolated head injuries and hypotension in young pediatric patients were hypothesized, including neurogenic or autonomic responses.
3) Due to the risks of cerebral edema from large fluid volumes, providers may need to adjust treatment to include early vasopressors or anticholinergic drugs to support blood pressure in these
This document discusses the use of focused assessment with computed tomography (FACTT) in the evaluation and management of trauma patients. It provides an overview of FACTT, describing how it allows for a rapid, whole-body CT scan to identify life-threatening injuries. The document notes several benefits of FACTT, including earlier diagnosis, targeted therapy, and improved outcomes. It also discusses algorithms and protocols for FACTT and presents several case examples demonstrating its use in identifying various injuries.
Nurse-led pre-operative assessment ensures patients are prepared for surgery through a systematic 4-stage process: 1) collecting medical history, 2) nursing assessment, 3) ordering relevant investigations/tests, and 4) providing information. This identifies risks and needs to improve outcomes by reducing cancellations. Pre-operative assessment by nurses trained to advanced levels can provide equivalent care to doctors. Effective communication among the healthcare team during assessment benefits patients.
MANAGEMENT OF COMPLICATIONS AFTER LRP: HOW TO IMPROVE EARLY CONTINENCE AND MA...Eduard Garcia Cruz
Mi presentación en las jornadas "MINIMALLY INVASIVE PROSTATE SURGERY" en Oporto del 24 y 25 de enero del 2014 - "Gestión de las complicaciones después de la prostatectomía radical laparoscópica (PRL): Cómo mejorar la incontinencia temprana y gestionar la disfunción eréctil".
This study analyzed 138 patients treated for hand trauma at a plastic surgery unit in Pakistan between 2008-2009. The majority of patients were young males whose hands were injured by machines at work. The most common injuries were bone fractures and cuts/lacerations. Over 5% of injuries resulted in amputation of part of the hand. Most patients received surgical treatment such as wire fixation or tendon repair. The average hospital stay was 10.7 days. The study concluded that hand trauma disproportionately affects young male workers exposed to machinery and is associated with high rates of amputation. Most injuries stem from preventable occupational hazards.
This document summarizes the process used to develop a new definition and clinical criteria for identifying septic shock in adults. A task force conducted a systematic review of existing studies, a Delphi consensus process, and analysis of large clinical databases. Based on these analyses, the task force agreed on a new definition of septic shock and identified hypotension requiring vasopressors and an elevated serum lactate level as criteria for identifying adult patients with septic shock. These criteria were validated in separate clinical databases and shown to identify a patient group with significantly higher mortality compared to other commonly reported definitions of septic shock.
The document discusses parotid gland disorders that necessitated parotidectomy. It summarizes that:
- The majority (90.47%) of cases involved benign pathology, most commonly pleomorphic adenoma. Superficial parotidectomy was the most common surgery.
- Post-operative complications occurred in about 30% of cases, most frequently greater auricular nerve paresis (15%) or facial nerve transient paresis (8%).
- Fine needle aspiration cytology (FNAC) was found to be a useful diagnostic tool for parotid gland tumors, with 98.24% specificity and 83.33% sensitivity for detecting malignancy.
Diagnostic Efficacy of Ultra-High-Field MRS in Glioma PatientsUzay Emir
This study tested the efficacy of ultra-high-field (7T) magnetic resonance spectroscopy (MRS) for predicting molecular characteristics of glioma tumors by visual inspection of MRS spectra. Participants in a workshop correctly identified the IDH mutation status in 11 out of 13 glioma patients by visually inspecting 7T MRS spectra, demonstrating the potential of 7T MRS for non-invasive glioma diagnosis and precision medicine strategies. While 2-HG detection is challenging at lower field strengths, 7T MRS provides improved detection and resolution of metabolic biomarkers like 2-HG that can help classify glioma molecular subtypes.
This study evaluated outcomes of 28 patients with intracranial meningiomas treated with hypofractionated radiosurgery. Most tumors were treated with 22.5-30 Gy delivered in 5 fractions. With a mean follow up of 32.6 months, the local tumor control rate was 100% with only one instance of marginal progression. Symptoms improved or resolved in over 66% of patients who originally presented with symptoms. Side effects occurred in 4 patients but the permanent morbidity rate was low at 3.5%. Hypofractionated radiosurgery provided high tumor control with a low risk of side effects, even for large tumors greater than 9 cm3.
This study retrospectively analyzed outcomes of 27 patients who underwent surgery for chondrosarcomas originating in the sacrum between 1992-2014. It found that en bloc resection was associated with longer hospital stays than intralesional surgery. En bloc resection also resulted in greater loss of motor, bowel and bladder function compared to intralesional surgery, though the results were not statistically significant. The 5-year and 10-year overall survival rates for the entire group were 53% and 37.8% respectively, with a higher rate seen for unilateral nerve root resection versus bilateral resection. The study aims to help assess functional outcomes and quality of life for patients with this rare type of cancer.
Comparision of different imaging techniques used for chronic woundseSAT Journals
Abstract Many people suffer from chronic wounds .It is a major problem in healthcare .worldwide. The treatments of chronic wounds include monitoring colour and size (area or volume) of the wound at regular intervals. This evaluation is often based on qualitative observation and manual measurements of the wound. Now a days there several researchers are developing technologies to assess the clinical improvement of chronic wounds. This paper aims to provide a study on imaging technologies applied to chronic wounds. A study on imaging technologies applied to chronic wounds is presented. Their reliability, precision, and usage are compared. The methods are divided into three categories: planimetric techniques, volumetric Technique and tissue classification. Keywords: chronic wounds, 2D, 3D, imaging, techniques, tissue classification
The aim of this study was to investigate the role of diffusion imaging in the evaluation of response to neoadjuvant
breast cancer treatment by correlating apparent diffusion coefficient (ADC) value changes with pathological response.
From June 2007 to June 2009, all consecutive patients with histopathologically confirmed breast cancer undergoing neoadjuvant
chemotherapy were enrolled. All patients underwent magnetic resonance imaging (MRI) (including diffusion
sequence) before and after neoadjuvant treatment. The ADC values obtained using two different methods of region of interest
(ROI) placement before and after treatment were compared with MRI response (assessed using RECIST 1.1 criteria)
and pathological response (assessed using Mandard’s classification).
Fifty-one women (mean age 48.41 years) were included in this study. Morphological MRI (RECIST classification) well evaluated
the responder status after chemotherapy (TRG class; area-under-the-curve 0.865). Mean pretreatment ADC values
obtained with the two different methods of ROI placement were 1.11 and 1.02 · 10)3 mm2 ⁄ seconds. Mean post-treatment
ADC values were 1.40 and 1.35 · 10)3 mm2 ⁄ seconds, respectively. A significant inverse correlation between mean ADC
increase and Mandard’s classifications was observed for both the methods of ADC measurements. Diagnostic performance
analysis revealed that the single ROI method has a superior diagnostic accuracy compared with the multiple ROIs method
(accuracy: 82% versus 74%). The coupling of the diffusion imaging with the established morphological MRI provides superior
evaluation of response to neoadjuvant chemotherapy treatment in breast cancer patients compared with morphological
MRI alone. There is a potential in the future to optimize patient therapy on the basis of ADC value changes. Additional
works are needed to determine whether these preliminary observed changes in tumor diffusion are a universal response to
tumor cell death, and to more fully delineate the ability of ADC value changes in early recognizing responder from
nonresponder patients.
ADVANCES IN WOUND CARE: THE TRIANGLE OF WOUND ASSESSMENTGNEAUPP.
This document introduces the Triangle of Wound Assessment, a new framework for comprehensive wound assessment. It consists of separately evaluating the wound bed, wound edge, and periwound skin. This addresses limitations of prior tools by integrating assessment of the periwound skin and providing guidance on goals, care planning, and interventions. The Triangle of Wound Assessment facilitates early identification and treatment of issues in all three zones to improve patient outcomes. It provides a simple, intuitive way to consistently include periwound skin in wound assessment and document wound status over time.
HRV in trauma patients during prehospital transportRachel Russo, MD
1) The study found that prehospital heart rate variability (HRV), specifically standard deviation of normal-to-normal R-R intervals (SDNN), predicted patients with a base excess ≤-6, those requiring life-saving procedures, and those classified as seriously injured better than routine trauma criteria or vital signs.
2) When used alone as a triage tool, SDNN had a sensitivity of 80%, specificity of 75%, and accuracy of 76% for predicting life-saving interventions, outperforming other prehospital measures.
3) Incorporating SDNN into trauma triage criteria models improved prediction of outcomes compared to models without SDNN, better discriminating patients who were seriously or minimally injured
The document summarizes three studies related to amputation prevention programs:
1) A retrospective analysis found that a comprehensive amputation prevention program at a community hospital decreased amputation rates from an average of 8.2% before the program to an average of 2.54% after, as more patients received diagnostic testing and interventions.
2) A treatment protocol for diabetic foot ulcers and Charcot deformities achieved successful limb salvage in 92% of patients through staged reconstruction and proper pre-operative vascular evaluation.
3) Implementing skin perfusion pressure (SPP) testing identified 80% of patients as having peripheral artery disease who had normal ankle-brachial indices, allowing for improved treatment and no major amputations
IJRET : International Journal of Research in Engineering and Technology is an international peer reviewed, online journal published by eSAT Publishing House for the enhancement of research in various disciplines of Engineering and Technology. The aim and scope of the journal is to provide an academic medium and an important reference for the advancement and dissemination of research results that support high-level learning, teaching and research in the fields of Engineering and Technology. We bring together Scientists, Academician, Field Engineers, Scholars and Students of related fields of Engineering and Technology.
Wound dehiscence in surgical procedures and its relationship to increased mor...AI Publications
This study aims to determine outcomes for Wound dehiscence in surgical procedures and its relationship to increased mortality. Twenty-five patients were collected from different hospitals in Iraq with intestinal obstruction, and they were distributed into two groups according to gender (15 males, ten females), and the average age ranged between 25-50 years. This retrospective study included those patients who were after bowel surgery at different hospitals in Iraq between January 6, 2020, and May 27, 2021, where information was obtained by reviewing clinical records.The statistical analysis program IBM SPSS SOFT 18 was also relied upon for the purpose of knowing the true value and standard regression in addition to the percentage of healthy variables to patients. Microsoft Excel 2013 was used for the purpose of describing and analysing demographic data. the results which found of this study collected 25 patients, and MEAN VALUE with slandered div of age patients was 39.4800 ± 6.8, and the type of anaesthesia used in this study was general anaesthesia. Causes of the bowel surgery according to the sex of the patients were (Mesenteric Ischaemia for one female patient and three male patients and Blunt trauma was one patient for both sexes. Bowel surgery, according to emergency basis and elective basis, was the emergency basis for 19 patients and elective for six patients. Association between Surgery * sex * presence of leaks Cross-tabulation were nine patients for an emergency basis and one patient for Elective. In this study, the mortality rate was higher for males than for females (1.4 patients), respectively and we concluded that there is a statistical relationship between the death rate and its prevalence among men
This study evaluated D-dimer levels in 220 patients with suspected acute aortic dissection over 24 hours. D-dimer levels were significantly higher in patients with acute aortic dissection compared to other conditions. Using a cutoff of 500 ng/mL, D-dimer had high sensitivity of 96.6% and moderate specificity of 46.6% for diagnosing acute aortic dissection within 24 hours. D-dimer performed best within the first 6 hours, with an area under the curve of 0.94 for diagnosing acute aortic dissection, suggesting it may help rule out aortic dissection early in presentation.
The study examined the effects of high-voltage pulsed current (HVPC) electrical stimulation on chronic leg ulcers. 27 subjects with 42 chronic leg ulcers were randomly assigned to receive either HVPC or sham treatment 3 times per week for 4 weeks. Wound size and appearance were assessed initially and after treatment. HVPC reduced wound size by an average of 44.3% compared to 16.0% for sham treatment, indicating HVPC can accelerate healing of chronic leg ulcers.
This survey aimed to assess clinicians' use of stereotactic radiotherapy and targeted therapies for metastatic renal cell carcinoma and determine support for future clinical trials. The primary objective was to evaluate the proportion of clinicians using radiotherapy for metastatic renal cell carcinoma. Secondary objectives included evaluating the proportion using targeted therapies and radiotherapy simultaneously, stopping targeted therapies for radiotherapy, and supporting further research. The online survey was distributed to members of urology and oncology groups in Australia and New Zealand to collect data on current practices. Results and conclusions will be presented at an upcoming conference.
Preoperative leukocytosis as predictor of intraabdominal injury in penetratin...Juan de Dios Díaz Rosales
This document summarizes a study on using preoperative leukocytosis as a predictor of intraabdominal injury in patients with penetrating abdominal trauma. The study included 231 patients who underwent exploratory laparotomy for abdominal trauma. Patients were divided into two groups: those with therapeutic laparotomy who had intraabdominal injuries (Group I), and those with non-therapeutic laparotomy who did not have intraabdominal injuries (Group II). The study found that 74.2% of patients in Group I had leukocytosis levels over 12,500/mm3, compared to only 27.7% of patients in Group II, indicating leukocytosis over 12,500/mm3 may help predict which patients have intra
This study prospectively evaluated 54 patients with ovarian sex cord-stromal tumors (OSCST) to develop diagnostic standards and risk-adapted treatment strategies. Most patients presented with stage IA tumors confined to the ovary and were followed regularly, while some with stage IC or higher received cisplatin-based chemotherapy. After a median follow-up of 59 months, event-free survival was 86% and overall survival was 89%. Prognosis correlated with stage, and chemotherapy seemed effective for advanced-stage tumors. The study provides a standardized approach to classify and treat OSCST.
Duke OHNS Lumbar Drain AN Poster 44x44 vfinalMatthew Crowson
- The study examines whether the pre-operative use of a lumbar drain reduces post-operative cerebrospinal fluid leaks in patients undergoing acoustic neuroma resection.
- 282 patients were included in the study, with 220 receiving a pre-operative lumbar drain and 62 not receiving one. No significant difference was found in CSF leak rates between the two groups.
- While CSF leaks are a common complication, the routine use of pre-operative lumbar drains is not recommended due to the 5.3% complication rate associated with lumbar drain use and no evidence that it decreases CSF leak rates.
Abstract—Colorectal cancer is leading cancer-related public health problem. This study was conducted to determine the effect of High-Dose-Rate intraluminal brachytherapy (HDR-BT) with or without interstitial brachytherapy during neoadjuvant chemoradiation for locally advanced rectal cancer. This randomized contrial was conducted on 28 patients attended with locally advanced rectal cancer (T3, T4 or N+) treated initially with concurrent capecitabine (800 mg/m2 twice daily for 5 days per week) and pelvic external beam radiation therapy (45Gy in 25 Fractions) after one week MRI for all patients; received intraluminal HDR-BT with 4Gy x 2 Fractions with one week interval for those had gross residual disease within 1cm of rectal wall and receiveed intraluminal and interstitial brachytherapy with 4Gy x 2 Fractions with one week interval for those had gross residual disease far from 1cm of rectal wall. All patients underwent surgery within 4-8 week after completion of neoadjuvant therapy. In the control group which were not randomized, twenty-eight patients underwent neoadjuvant chemoradiation (45Gy in 25 Fraction with concurrent capecitabine 800mg/m2 twice daily for 5 days per week) followed by surgery. It was found that in HDR-BT group pathologic complete response (pCR), pathologic partial response (pPR) and pathologic response rates (pCR+pPR) based on AJCC TNM staging for colorectal cancer were %35.7, %35.7, and %71.4 respectively. The pCR, pPR, and pRR were %25, %17, and %42 in the control group respectively. pCR, pPR, and pRR were improved with HDR-BT. However, only response rate improvement was statistically significant (p=0.031). There was no a statistically significant difference in the complications between the two groups (p > 0.05). So it can be concluded that HDR intraluminal with or without interstitial brachytherapy may be an effective method of dose escalation technique in neoadjuvant chemoradiation therapy of locally advanced rectal cancer with higher response rate and manageable side effects.
Effectiveness of Low-Level Lasers in the Management of Recurrent Aphthous Sto...DrHeena tiwari
This study assessed the effectiveness of low-level lasers in treating recurrent aphthous stomatitis. 30 subjects with minor, major, or herpetiform aphthae were treated with lasers and their pain was evaluated using VAS scores. For all groups, pain was significantly less after 24 hours and further reduced at 72 hours compared to pre-treatment levels. At 1 week, pain scores were minimal or zero. The results demonstrated that low-level lasers provide effective pain relief and accelerated healing for recurrent aphthous stomatitis lesions.
”DVT Prevention What Works BestSHINE BELL, .docxodiliagilby
This document summarizes a presentation on deep vein thrombosis (DVT) prevention strategies. It begins with an objective to determine the most effective DVT prophylaxis and presents a PICO question comparing pharmacological, mechanical and combination interventions. A literature review found mixed results, with some studies favoring pharmacological prophylaxis alone or in combination with mechanical. The presentation evaluates pros and cons of different prophylaxis types and recommends increased nursing education and a standardized DVT assessment tool. It concludes that further research is needed to determine the best prophylaxis approach in acute care settings.
Extracorporeal shockwave therapy (ESWT) has analgesic and anti-inflammatory effects. With the evolu- tion and comprehension of its biological and physical mechanisms, the application of ESWT on other pathologies has also been studied, especially in musculoskeletal diseases. Recently, studies on animal models have shown its angiogenic capacity and a higher rate of local re-epithelization. These small stud- ies led to few trials using low-energy, radial ESWT to treat problematic chronic skin ulcers. Skin ulcers have diverse etiologies, ranging from pressure ulcers, burns, venous or arterial ulcers, and even diabetic ulcers. Their treatment is usually a challenge, due to the long-term treatment and high costs.
Similar to EWMA 2013 - Ep543 - Evidence based wound conversation algorithm utilizing the University of Texas wounds and classification system (20)
EWMA 2014 - EP502 A LABORATORY EVALUATION OF THE BLOOD ABSORPTION PROPERTIES ...EWMA
This study compared the blood absorption properties of 5 surgical dressings (A-E). An in vitro experiment added bovine blood to dressings at a constant rate, measuring absorption capacity and dispersion. Dressing A (Mepilex Border Post-Op) absorbed the largest volume of blood before reaching the dressing edges or leaking, with good dispersion throughout. The results indicate Dressing A will require fewer dressing changes and better protect wounds from contamination compared to the other dressings tested.
EWMA 2014 - EP499 MANAGEMENT OF AN INFECTED DIABETIC FOOT WITH SPECIALIZED DR...EWMA
This document presents two case studies of patients with diabetic foot infections. Both patients, aged 29 and 52, underwent surgical debridement and partial amputation of the infected toes. Controlling the infection and exudate levels in the wounds proved difficult, requiring the use of various antimicrobial dressings over a 4-month period. Through a combination of wound bed preparation, surgical debridement, and specialized dressings, the treatment was ultimately successful in controlling the infections and promoting wound healing.
EWMA 2014 - EP498 USE OF NEGATIVE PRESSURE THERAPY IN CONJUNCTION WITH A PROT...EWMA
Este documento describe el caso de un paciente diabético con una ulcera grave en el pie que fue tratada con éxito mediante la aplicación combinada de terapia de presión negativa y una matriz moduladora de proteasas. El tratamiento promovió el rápido crecimiento de tejido de granulación, permitiendo cubrir las estructuras óseas expuestas y prevenir infecciones. La matriz aceleró la epitelización y contracción de la herida, logrando su cierre total en 60 días. El uso combinado de estas tecnologías es una altern
EWMA 2014 - EP496 CONTEMPORARY SILVER DRESSINGS IN THE TREATMENT OF INFECTED ...EWMA
Ivan Poromanski and Yordan Milev evaluated the use of silver-coated dressings in managing cavitary wounds after bone resection for infected neuropathic diabetic foot. In three cases of patients with osteomyelitis of the foot, residual bone defects were filled with either silver-coated alginate/foam dressings or silver alginate filler. The dressings were changed every 48-72 hours with offloading. Systemic antibiotics were used for no more than 10 days until soft tissue infection subsided. The cavitary wounds healed within 42 days and plantar ulcers healed within 14-21 days, which was shorter than usual treatment times. The higher price of silver dressings was offset by fewer dressing changes
EWMA 2014 - EP495 TOTAL CONTACT CASTING – A SOUTH AFRICAN APPROACH TOWARDS OF...EWMA
This study evaluated two total contact casting (TCC) systems for offloading diabetic foot ulcers and stabilizing Charcot feet in South Africa. System B, which used a washable, water resistant inner lining, demonstrated better patient adherence and aeration compared to System A. Both systems effectively reduced plantar pressures and healed wounds within 36 days on average. The study concluded that TCC is the gold standard for offloading but more training is needed for healthcare professionals to incorporate it widely in practice.
Este estudio buscó detectar factores de riesgo de pie diabético en personas con diabetes mediante consultas de enfermería. Se evaluó a 56 pacientes con diabetes tipo 1 o 2 sin lesiones en los pies. Más del 30% presentaron alto riesgo de desarrollar pie diabético debido a factores como baja escolaridad, falta de educación sobre el cuidado de los pies, antecedentes de úlceras y amputaciones, y calzado y corte de uñas inadecuados. El estudio concluye que es necesario fortalecer
EWMA 2014 - EP490 THE CHARACTERISTICS OF WOUND PAIN ASSOCIATED WITH DIABETES-...EWMA
This study examined the prevalence and characteristics of wound pain in diabetes-related foot ulcers. It found that over 50% of patients reported experiencing wound pain based on formal pain assessment tools, even though some did not report pain to their podiatrist. Pain was described as tender, brief, or intermittent. Both neuropathic and neuroischaemic ulcers had low reported pain intensity and little effect on quality of life. The study concludes wound pain may be underassessed clinically and more research is needed to understand differences in pain between ulcer types.
EWMA 2014 - EP485 EVALUATION OF MR ANGIOGRAPHY RESULTS IN DIABETIC FOOT PATIENTSEWMA
This document evaluates the results of MR angiography (MRA) in diabetic foot patients to detect peripheral arterial disease (PAD). A cross-sectional study of 100 diabetic patients with clinical symptoms of PAD found that while 32% had abnormal ankle brachial index measurements, 63.4% showed abnormalities on MRA. The conclusion is that while ankle brachial index is trustworthy for detecting severe ischemia, MRA should be used for other degrees of ischemia as it can detect more cases of abnormality than ankle brachial index alone. More patients need to be studied to determine what types of abnormalities found on MRA are associated with outcomes like healing or amputation.
EWMA 2014 - EP483 THE EFFECTS OF DIABETIC FOOT ULCER (DFU) WOUND FLUID PH ON ...EWMA
This study examined the effect of diabetic foot ulcer (DFU) wound fluid pH on the presence of bacteria. Wound fluid was collected from 55 patients with DFUs and tested for pH and bacteria. A variety of bacteria were found, most commonly Staphylococcus and Streptococcus species. Higher pH wound fluid (>7.5) was associated with some bacterial species while others were found more often at neutral pH (<7.5). DFUs with clinical signs of infection had significantly higher pH than non-infected wounds. The results suggest that wound fluid pH, especially values over 7.2, could help identify silent infections and inform treatment decisions.
EWMA 2014 - EP482 COMPARISON OF ANGIOGRAPHIC FINDINGS BETWEEN PATIENTS WITH N...EWMA
This document compares angiographic findings between patients with non-healing diabetic foot ulcers (DFUs) with and without Charcot foot (CF). It found that patients with CF and DFUs had less severe peripheral arterial disease (PAD) based on angiographic findings compared to DFU patients without CF, however revascularization rates were equal between the two groups. The study assessed 29 CF patients and 48 non-CF patients with DFUs who underwent lower limb angiography. It found patients without CF had significantly more frequent presence of severe PAD (Graziani class 4 and higher) versus the CF group.
EWMA 2014 - EP477 EVALUATION OF FOOT SELF CARE KNOWLEDGE AND PRACTICES IN SAU...EWMA
This study assessed foot self-care knowledge and practices in 350 Saudi patients with diabetes referred to a specialized diabetes care center. While 42.6% had excellent knowledge of how diabetes affects foot health, only 17.7% demonstrated good ability to identify and apply appropriate foot self-care practices. Most patients acquired knowledge through media rather than primary health care clinics. The quality of knowledge from primary care clinics did not translate to better ability to practice self-care compared to other sources of knowledge. The study concludes current foot self-care education and knowledge is unsatisfactory and calls for a national diabetes control program delivering unified, evidence-based education through healthcare providers and media to prevent limb loss.
EWMA 2014 - EP476 DIABETIC FOOT ULCER HEALING IN RELATIONSHIP WITH INITIAL TR...EWMA
This study examined the relationship between initial transcutaneous oxygen pressure (TcPO2) measurements and healing of diabetic foot ulcers over 6 and 12 months. TcPO2 is a non-invasive method to detect peripheral arterial disease. The study found that 76% of patients had a TcPO2 of ≤30mmHg and 81% had a TcPO2 of ≤40mmHg, indicating peripheral arterial disease. Healing rates were higher in patients with a TcPO2 >30mmHg or >40mmHg. Using a TcPO2 threshold of 40mmHg rather than 30mmHg showed higher sensitivity and negative predictive value for predicting healing. The study concludes that a TcPO2 threshold
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Dr. Tan's Balance Method.pdf (From Academy of Oriental Medicine at Austin)GeorgeKieling1
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Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
Academy of Oriental Medicine at Austin
About AOMA: The Academy of Oriental Medicine at Austin offers a masters-level graduate program in acupuncture and Oriental medicine, preparing its students for careers as skilled, professional practitioners. AOMA is known for its internationally recognized faculty, award-winning student clinical internship program, and herbal medicine program. Since its founding in 1993, AOMA has grown rapidly in size and reputation, drawing students from around the nation and faculty from around the world. AOMA also conducts more than 20,000 patient visits annually in its student and professional clinics. AOMA collaborates with Western healthcare institutions including the Seton Family of Hospitals, and gives back to the community through partnerships with nonprofit organizations and by providing free and reduced price treatments to people who cannot afford them. The Academy of Oriental Medicine at Austin is located at 2700 West Anderson Lane. AOMA also serves patients and retail customers at its south Austin location, 4701 West Gate Blvd. For more information see www.aoma.edu or call 512-492-303434.
STUDIES IN SUPPORT OF SPECIAL POPULATIONS: GERIATRICS E7shruti jagirdar
Unit 4: MRA 103T Regulatory affairs
This guideline is directed principally toward new Molecular Entities that are
likely to have significant use in the elderly, either because the disease intended
to be treated is characteristically a disease of aging ( e.g., Alzheimer's disease) or
because the population to be treated is known to include substantial numbers of
geriatric patients (e.g., hypertension).
- Video recording of this lecture in English language: https://youtu.be/RvdYsTzgQq8
- Video recording of this lecture in Arabic language: https://youtu.be/ECILGWtgZko
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Osvaldo Bernardo Muchanga-GASTROINTESTINAL INFECTIONS AND GASTRITIS-2024.pdfOsvaldo Bernardo Muchanga
GASTROINTESTINAL INFECTIONS AND GASTRITIS
Osvaldo Bernardo Muchanga
Gastrointestinal Infections
GASTROINTESTINAL INFECTIONS result from the ingestion of pathogens that cause infections at the level of this tract, generally being transmitted by food, water and hands contaminated by microorganisms such as E. coli, Salmonella, Shigella, Vibrio cholerae, Campylobacter, Staphylococcus, Rotavirus among others that are generally contained in feces, thus configuring a FECAL-ORAL type of transmission.
Among the factors that lead to the occurrence of gastrointestinal infections are the hygienic and sanitary deficiencies that characterize our markets and other places where raw or cooked food is sold, poor environmental sanitation in communities, deficiencies in water treatment (or in the process of its plumbing), risky hygienic-sanitary habits (not washing hands after major and/or minor needs), among others.
These are generally consequences (signs and symptoms) resulting from gastrointestinal infections: diarrhea, vomiting, fever and malaise, among others.
The treatment consists of replacing lost liquids and electrolytes (drinking drinking water and other recommended liquids, including consumption of juicy fruits such as papayas, apples, pears, among others that contain water in their composition).
To prevent this, it is necessary to promote health education, improve the hygienic-sanitary conditions of markets and communities in general as a way of promoting, preserving and prolonging PUBLIC HEALTH.
Gastritis and Gastric Health
Gastric Health is one of the most relevant concerns in human health, with gastrointestinal infections being among the main illnesses that affect humans.
Among gastric problems, we have GASTRITIS AND GASTRIC ULCERS as the main public health problems. Gastritis and gastric ulcers normally result from inflammation and corrosion of the walls of the stomach (gastric mucosa) and are generally associated (caused) by the bacterium Helicobacter pylor, which, according to the literature, this bacterium settles on these walls (of the stomach) and starts to release urease that ends up altering the normal pH of the stomach (acid), which leads to inflammation and corrosion of the mucous membranes and consequent gastritis or ulcers, respectively.
In addition to bacterial infections, gastritis and gastric ulcers are associated with several factors, with emphasis on prolonged fasting, chemical substances including drugs, alcohol, foods with strong seasonings including chilli, which ends up causing inflammation of the stomach walls and/or corrosion. of the same, resulting in the appearance of wounds and consequent gastritis or ulcers, respectively.
Among patients with gastritis and/or ulcers, one of the dilemmas is associated with the foods to consume in order to minimize the sensation of pain and discomfort.
- Video recording of this lecture in English language: https://youtu.be/Pt1nA32sdHQ
- Video recording of this lecture in Arabic language: https://youtu.be/uFdc9F0rlP0
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
This presentation gives information on the pharmacology of Prostaglandins, Thromboxanes and Leukotrienes i.e. Eicosanoids. Eicosanoids are signaling molecules derived from polyunsaturated fatty acids like arachidonic acid. They are involved in complex control over inflammation, immunity, and the central nervous system. Eicosanoids are synthesized through the enzymatic oxidation of fatty acids by cyclooxygenase and lipoxygenase enzymes. They have short half-lives and act locally through autocrine and paracrine signaling.
Gene therapy can be broadly defined as the transfer of genetic material to cure a disease or at least to improve the clinical status of a patient.
One of the basic concepts of gene therapy is to transform viruses into genetic shuttles, which will deliver the gene of interest into the target cells.
Safe methods have been devised to do this, using several viral and non-viral vectors.
In the future, this technique may allow doctors to treat a disorder by inserting a gene into a patient's cells instead of using drugs or surgery.
The biggest hurdle faced by medical research in gene therapy is the availability of effective gene-carrying vectors that meet all of the following criteria:
Protection of transgene or genetic cargo from degradative action of systemic and endonucleases,
Delivery of genetic material to the target site, i.e., either cell cytoplasm or nucleus,
Low potential of triggering unwanted immune responses or genotoxicity,
Economical and feasible availability for patients .
Viruses are naturally evolved vehicles that efficiently transfer their genes into host cells.
Choice of viral vector is dependent on gene transfer efficiency, capacity to carry foreign genes, toxicity, stability, immune responses towards viral antigens and potential viral recombination.
There are a wide variety of vectors used to deliver DNA or oligo nucleotides into mammalian cells, either in vitro or in vivo.
The most common vector system based on retroviruses, adenoviruses, herpes simplex viruses, adeno associated viruses.
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Giloy in Ayurveda - Classical Categorization and SynonymsPlanet Ayurveda
Giloy, also known as Guduchi or Amrita in classical Ayurvedic texts, is a revered herb renowned for its myriad health benefits. It is categorized as a Rasayana, meaning it has rejuvenating properties that enhance vitality and longevity. Giloy is celebrated for its ability to boost the immune system, detoxify the body, and promote overall wellness. Its anti-inflammatory, antipyretic, and antioxidant properties make it a staple in managing conditions like fever, diabetes, and stress. The versatility and efficacy of Giloy in supporting health naturally highlight its importance in Ayurveda. At Planet Ayurveda, we provide a comprehensive range of health services and 100% herbal supplements that harness the power of natural ingredients like Giloy. Our products are globally available and affordable, ensuring that everyone can benefit from the ancient wisdom of Ayurveda. If you or your loved ones are dealing with health issues, contact Planet Ayurveda at 01725214040 to book an online video consultation with our professional doctors. Let us help you achieve optimal health and wellness naturally.
Nutritional deficiency Disorder are problems in india.
It is very important to learn about Indian child's nutritional parameters as well the Disease related to alteration in their Nutrition.
EWMA 2013 - Ep543 - Evidence based wound conversation algorithm utilizing the University of Texas wounds and classification system
1. Francis Derk1, Troy Wilde2,
Tim Pham2, Mike Griffiths3
1South Texas VA Medical Center (San Antonio, United States)
2UTHSC (San Antonio, United States)
3AOTI (Oceanside, United States)
2. To develop a structured and detailed evidence based
wound conversion algorithm, incorporating advanced
present day wound therapies & utilizing the University
of Texas Wound classification system as its matrix.
The algorithm is evidenced based and formulates a
singular or multi modal approach from simple to
highly complex phases.
The algorithm is intended to provide the clinician with
a retrograde methodology, intended to drive the
wound to healing by converting higher grade wounds
to lesser grade levels and finally to full healing.
3. The authors conducted evidence based research
analysis using various treatment approaches, including
all available wound modalities; evidence based
analysis, and numerous clinical applications with
established wound protocols, single and or multi
modal processes, wound treatments and outcomes.
The University of Texas Wound Classification system
serves as the framework, along with standardized
definitions of infection, laboratory test limits, and
ischemia parameters.
4. >1.30 Poorly compressible vessels,
arterial calcification
0.90–1.30 Normal
0.60–0.89 Mild arterial obstruction
0.40–0.59 Moderate obstruction
<0.40 Severe obstruction
Classic signs:
Inflammation (erythema,
warmth, tenderness,
ain or induration
purulent secretions
Presence of systemic findings
of infection (fever, chills,
night sweat, nausea, vomiting,
malaise)
Secondary signs:
Non-purulent secretions,
friable or discolored
granulation tissue,
undermining of wound edges,
foul odor)
Stages
Stage A: No infection or ischemia
Stage B: Infection present
Stage C: Ischemia present
Stage D: Infection and ischemia present
Grading
Grade 0: Epithelialized wound
Grade 1: Superficial wound
Grade 2: Penetrates to tendon or capsule
Grade 3: Penetrates to bone or joint
UTHSCA WOUND CLASSIFICATION SYSTEM
ERYTHROCYTE
SEDIMENTATION
RATE (ESR)
TEST
Westergren
NORMAL
VALUE
Child 0-10 mm/hour
Adult (male) 0-15 mm/hour
Adult (female 0-20 mm/hour
Adult 4.5-11.0
Neutrophils Bands
3-5% (total
WBC count)
Segs 54-62%
Lymphocytes 25-33%
Monocytes 3-7%
Eosinophils 1-3%
Basophils 0-0.75%
Leukocyte (WBC) Normal Values
Ischemia, PVD and PAD: Defined by ABI/NIV studies, ultrasound, clinical wound assessment including
necrosis, eschar, gangrene, lack of lower extremity and pedal pulses, findings consisting of pallor,
cyanosis, lack of digital hair growth, and advanced studies including MRA and Angiography.
Definitions
Ankle-brachial Index (ABI)
Interpretation
Infected wound: per infectious disease
guidelines the presence of infection is
defined by ≥ 2 classic findings of
inflammation or purulence
5. In clinical practice within a large wound care center, the
algorithm has validated and has been found to be
especially useful when treating higher grade wounds
which may require surgical intervention, a multi-
disciplinary team approach, wound staging, and
advanced adjunctive therapies.
We found that classifying a wound, determining
etiology, and taking a holistic approach that progressed
the wound from more severe to less severe grades
resulted in better outcomes.
6. Wounds
Stage C
Location
GRADE 1
Stage BStage A Stage D
Size
Assessment
of edema
Nutritional
Status
PMH
Biologicals
TWO2
Offloading
Wound
Debridement
Wound Bed
preparation
Topicals
Daily wound
care
Monitor decrease in size
Wound
Conversion to
lesser grade
Montior WBC, CRP,
Sed Rate
X-rayC&S
Surgery/debridement
Eliminate
Infection
Consider Infectious
Disease consult prn
Vascular Assessment
NIVs/ABIs
Transcutaneous O2
Angiogram/MRA
No Vascular
Intervention
Vascular
intervention
TWO2
Build Wound Matrix
Wound
Conversion
Montior WBC, CRP,
Sed Rate
C&S X-rays
Eliminate
Infection
Antibiosis
Surgical Debridement
TWO2
Vascular Assessment
NIVs/ABIs
Transcutaneous O2
Angiogram/MRA
Wound
Conversion
Depth
Wound base
Granular/Non-granular
Non-Granular / FibrousGranular
Conversion to Granular
Wound Bed
Denotes Multi-modality
Therapy: prn
TWO2
(2)
(10, 17, 19)
(10, 17, 19) (13, 19)
(12, 18)
(1,10, 19)
(12, 18)
(5, 9)
(3, 5) (8)
(10, 17, 19)
(5, 16)
(6, 19)
(6, 19)
(12,18)
(10, 11, 13, 17, 19)
(5, 9)
(3,5) (8)
(10, 17, 19)
(12,18)
(6, 19)
(6, 19)
Evidence Based Wound Conversion
Algorithm for
University of Texas Grade 1 Wounds
and Classification System
Infected Ischemic Infected / IschemicNo Infection or Ischemia
(11,15)
(11,15)
TWO2
Topical Wound Oxygen
7. Wound
Stage C
Location
GRADE 2
Stage BStage A Stage D
Size
Assessment
of edema
Nutritional
Status
PMH
Biologicals TWO2
Offloading
Wound Matrix
Assessment
Wound Bed
preparation
Topicals
Monitor decrease in
size and depth
Wound
Conversion to
Grade 1
Montior WBC, CRP,
Sed Rate
X-raysC&S
Surgery/debridement
Eliminate
Infection ID Consult
Vascular Assessment
NIVs/ABIs
Transcutaneous O2
Angiogram/MRA
No Vascular
Intervention
Vascular
intervention
TWO2
Build Wound Matrix
Wound
debridement
Montior WBC, CRP,
Sed Rate
C&S X-rays
Eliminate
Infection
Antibiosis
Surgical Intervention
TWO2
Vascular Assessment
NIVs/ABIs
Transcutaneous O2
Angiogram/MRA
Depth
Granular
Bed
Tendon / Capsule
Exposure
Negative
Pressure
Build Wound Matrix
Multi-modal
Therapy
Cam Boot
TCC
MRI
Serial Films
Monitor Labs
Monitor wound
Monitor C&S
Manage necrotic /
escharotic tissue prn
Monitor
granulation tissue
Consider Negative
Pressure adjunct
Ascertain elimination of
Infection
Vascular intervention
or Non-intervention
Continue TWO2
Wound base
Granular/Non-granular
Denotes Multi-modality
Therapy: prn
MRI
Negative
Pressure
Monitor wound
Build wound matrix
TWO2
(2)
(10, 11, 19)
(13, 19)
(10, 17, 19)
(12, 18)
(12, 18)
(12, 18)
(12, 18)
(4, 19)
(4, 19)
(4, 19)
(10, 11, 13, 17, 19)
(1)(10, 11, 17, 19)
(5, 9)
(3, 5)
(8)
(10, 17, 19)
(5, 16)
(10, 11, 13,
17, 19)
(10, 11, 13,
17, 19)
(10, 17, 19)
(6, 19)
(6, 19)
(6, 19)
(10, 17, 19)
(3, 5) (8)
(5, 9)
Infected / IschemicNo Infection or Ischemia Infected Ischemic
(11,15) (11,15)
TWO2
Topical Wound Oxygen
Evidence Based Wound Conversion
Algorithm for
University of Texas Grade 2 Wounds
and Classification System
8. Wound
Stage C
Location
GRADE 3 Stage BStage A Stage D
Size
Assessment
of edema
Nutritional
Status
PMH
Biologicals
TWO2
Offloading
Wound Matrix
Assessment
Wound Bed
preparation
Topicals
Monitor decrease in size and depth
Wound Conversion to
lesser grade/lesser depth
Monitor WBC, CRP,
Sed Rate
X-raysC&S
Surgery/debridement
Eliminate Infection
ID Consult prn
Vascular Assessment
NIVs/ABIs
Transcutaneous O2
Angiogram/MRA
Vascular intervention
TWO2
Build Wound Matrix
Wound
debridement
Montior WBC, CRP,
Sed Rate
C&S X-rays
Eliminate
Infection
Antibiosis
Surgical /Vascular
Intervention
TWO2
NIVs/ABIs
Transcutaneous O2
Angiogram/MRA
Depth
Granular Wound
Base
Negative
Pressure
Build Wound Matrix
Multi-modal
Therapy
Cam Boot /TCC
MRI
Serial Films
Monitor Labs
Monitor wound Manage necrotic
/escharotic tissue
Monitor
granulation tissue
Consider Negative
Pressure adjunct
Limb Salvage
Amputation prn
Fibrous
Tissue
Surgery/debridement prn
TWO2
Wound Conversion
to lesser grade
Amputation
TWO2
HBO2
May not be
a Candidate
HBO2
May Stage for
further Surgery
Continue with
TWO2
Wound base
Granular/Non-granular
Bone
(2)
(10, 11, 19)
(10, 11,
19)
(10, 17, 19)
(10, 17,
19)
(10, 17, 19)
(12, 18)
(12, 18)
(12, 18)
(12, 18)
(10, 11, 19)
(4, 19)
(4, 19)
(10, 17, 19)
(12, 18)
(13, 19)
(10, 11,
17, 19)
(1)
(5, 9)
(3, 5) (3, 5)(8)
(8)
(5, 9)
(5, 16)
(6, 10)
(6, 19)
(7, 14)
(7, 14)
(6, 19)
(6, 19) (6, 19)
Denotes Multi-modality
Therapy: prn
No Infection or Ischemia Infected Ischemic Infected / Ischemic
(11,15)
(11,15)
TWO2 Topical Wound Oxygen
Evidence Based Wound Conversion
Algorithm for
University of Texas Grade 3 Wounds
and Classification System
9. The authors propose a holistic Wound Conversion Algorithm as a
retrograde, step-wise therapeutic intervention guide for wound
healing, that has been validated in daily clinical practice in a busy
wound care center.
The wound conversion algorithm utilizes a blended approach of
evidenced based modality use, advanced wound therapies, and
practical field application which have yielded positive results.
Future publication encompassing clinical based outcome evidence
utilizing the algorithm will be forthcoming.
The authors fully expect modification of this algorithm with future
advances with modalities in wound care, but propose a useful tool
in wound care at the present.
10. 1. Armstrong, David, and Et Al. "Quality of Life in Healing Diabetic Wounds Does the End Justify the Means?" THE JOURNAL OF FOOT & ANKLE SURGERY (2008): 278-
82. Web.
2. Arnold, Meghan, and Adrian Barbul. "Nutrition and Wound Healing." Plastic and Reconstructive Surgery 117.7s (2006): 42-56.
3. Bernard, Louis, Ilker Uçkay, Albert Vuagnat, Mathieu Assal, Richard Stern, Peter Rohner, and Pierre Hoffmeyer. "Two Consecutive Deep Sinus Tract Cultures Predict
the Pathogen of Osteomyelitis☆." International Journal of Infectious Diseases (2009): n. pag. Print.
4. Birke-Sorensen, H., M. Malmsjo, P. Rome, and Et Al. "Evidence-based Recommendations for Negative Pressure Wound Therapy: Treatment Variables (pressure
Levels, Wound Filler and Contact Layer) – Steps towards an International Consensus." Journal of Plastic, Reconstructive & Aesthetic Surgery 64 (2011): S1-S16.
Print.
5. Crouzet, J., and L.p Lavigne. "Diabetic Foot Infection: A Critical Review of Recent Randomized Clinical Trials on." International Journal of Infectious Diseases 15
(2011): 601-10. Print
6. Datillo, Phillip. "Critical Limb Ischemia: Endovascular Strategies for Limb Salvage." Progress in Cardiovascular Diseases 54 (2011): 47-60. Print.
7. Duzgun, A., H. Satir, O. Ozozan, B. Saylam, B. Kulah, and F. Coskun. "Effect of Hyperbaric Oxygen Therapy on Healing of Diabetic Foot Ulcers." The Journal of Foot
and Ankle Surgery 47.6 (2008): 515-19. Print.
8. Elgazzar, Abdelhamid H., Hussein M. Abdel-Dayem, James D. Clark, and Harry R. Maxon. "Multimodality Imaging of Osteomyelitis." European Journal of Nuclear
Medicine 22.9 (1995): 1043-063. Print.
9. Fleischer, Adam E., James S. Wrobel, Andrea Leonards, Scott Berg, Daniel P. Evans, Robert L. Baron, and David G. Armstrong. "Post-treatment Leukocytosis Predicts
an Unfavorable Clinical Response in Patients with Moderate to Severe Diabetic Foot Infections." The Journal of Foot and Ankle Surgery 50.5 (2011): 541-46. Print.
10. Frykberg, Robert G. "The Science Of Advanced Wound Care: What Should You Be Using In Your Office?" Superbones West Conference. Las Vegas. 24 Oct. 2010.
Lecture.
11. Goldman, Robert, and Et Al. "More than One Way to Measure a Wound: An Overview of Tools and Techniques." ADV SKIN WOUND CARE 15 (2002): 236-45.
12. Gordillo, Gayle M., Sashwati Roy, Savita Khanna, Richard Schlanger, Sorabh Khandelwal, Gary Phillips, and Chandan K. Sen. "Topical Oxygen Therapy Induces
Vascular Endothelial Growth Factor Expression And Improves Closure Of Clinically Presented Chronic Wounds." Clinical and Experimental Pharmacology and
Physiology 35.8 (2008): 957-64.
13. Jones, I., L. Currie, and R. Martin. "A Guide to Biological Skin Substitutes." British Journal of Plastic Surgery 55.3 (2002): 185-93. Print.
14. Kalani, Majid. "Hyperbaric Oxygen (HBO) Therapy in Treatment of Diabetic Foot Ulcers." Journal of Diabetes and Its Complications 16 (2002): 153-58. Print.
15. Lavery, Lawrence, and Et Al. "Classification of Diabetic Foot Wounds." THE JOURNAL OF FOOT AND ANKLE SURGERY 35.6 (1996): 528-31.
16. Lipsky, Benjamin, Anthony Berendt, and Et Al. "2012 Infectious Diseases Society of America Clinical Practice Guideline for the Diagnosis and Treatment of Diabetic
Foot Infections." Clinical Infectious Diseases 54.12 (2012): 132-73.
17. Nusbaum, Aron G. "Effective Method to Remove Wound Bacteria: Comparison of Various." Journal of Surgical Research 176 (2012): 701-07. Print.
18. Orsted HL, Poulson R, and the Advisory Group. Evidence-based practice standards for the use of topical pressurised
oxygen therapy. Int Wound J 2012; doi: 10.1111/j.1742-481X.2012.00956.
19. Rogers, Lee C. “Key Concepts From The 2010 Consensus Statement On Diabetic Foot Ulcerations.” Superbones West Conference, Las Vegas, 24 Oct 2010: Lecture
20. Armstrong, David G, Lavery, Lawrence A, Harkless, Lawrence B. “Validation of a Diabetic Wound Classification System.” Diabetes Care 21 (1998): 855-859.
21. Tahir, Khan, Farooqui, Falahat, Niazi, Khusrow. “Critical Review of the Ankle Brachial Index.” Current Cardiology Reviews 2008: 101-106
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