Sample records for leg ulcer caused

  1. Differential diagnosis of leg ulcers.

    PubMed

    Pannier, F; Rabe, E

    2013-03-01

    Leg and foot ulcers are symptoms of very different diseases. The aim of this paper is to demonstrate the differential diagnosis of leg ulcers. The majority of leg ulcers occur in the lower leg or foot. In non-venous ulcers the localization in the foot area is more frequent. The most frequent underlying disease is chronic venous disease. In 354 leg ulcers, Koerber found 75.25% venous leg ulcers, 3.66% arterial leg ulcers, 14.66% ulcers of mixed venous and arterial origin and 13.5% vasculitic ulcers. In the Swedish population of Skaraborg, Nelzen found a venous origin in 54% of the ulcer patients. Each leg ulcer needs a clinical and anamnestic evaluation. Duplex ultrasound is the basic diagnostic tool to exclude vascular anomalies especially chronic venous and arterial occlusive disease. Skin biopsies help to find a correct diagnosis in unclear or non-healing cases. In conclusion, chronic venous disease is the most frequent cause of leg ulcerations. Because 25% of the population have varicose veins or other chronic venous disease the coincidence of pathological venous findings and ulceration is very frequent even in non-venous ulcerations. Leg ulcers without the symptoms of chronic venous disease should be considered as non-venous. PMID:23482536

  2. Ehlers-Danlos Syndrome Type VIII: A Rare Cause of Leg Ulcers in Young Patients

    PubMed Central

    Lucas, Antoine; Piérard, Gérald E.; Hermanns-Lê, Trinh; De Paepe, Anne; Dupuy, Alain

    2013-01-01

    Ehlers-Danlos syndrome type VIII (EDS-VIII) is a very rare autosomal dominant disease characterized by early-onset periodontitis associated with features of Ehlers-Danlos syndrome. We report a 32-year-old man whose chronic leg ulcer led to the diagnosis of EDS-VIII. He had severe periodontitis with complete loss of permanent teeth and skin fragility with thin skin, atrophic scars, and brownish atrophic pretibial plaques. Leg ulcer is not a prominent feature of EDS-VIII. We suggest adding EDS-VIII to the list of rare diseases accounting for chronic leg ulcers, if this case report prompts others to report leg ulcers associated with EDS-VIII. PMID:24198978

  3. [Differential diagnosis and work up of chronic leg ulcers].

    PubMed

    Spoljar, Sanja

    2014-10-01

    Many factors contribute to the pathogenesis of leg ulcers. The main causes are chronic venous insufficiency, peripheral arterial occlusive disease (PAOD) and diabetes. Some leg ulcers are caused by combinations of these well-known etiologic factors. The most common cause of PAOD is arteriosclerosis. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of leg ulcers. Less frequent causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infections, primary skin disease, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is made upon medical history, clinical picture, palpation of arteries, functional testing and serologic testing. Device-based diagnostic testing should be performed for additional clarification. Also, lesion biopsy should be taken for histopathology, direct immunofluorescence, bacteriology and mycology. The knowledge of differential diagnosis is essential for ensuring treatment success in a patient with leg ulcer. PMID:25326987

  4. [Martorell Hypertensive Ischaemic Leg Ulcer.

    PubMed

    Nobbe, S; Hafner, J

    2014-10-21

    Martorell hypertensive ischaemic leg ulcer (HYTILU) represents an important differential diagnosis of painful leg ulcerations. Stenotic subcutaneous arteriolosclerosis in patients with long-standing arterial hypertension finally leads to skin infarction. The typical histological changes are very similar in Martorell HYTILU and calciphylaxis. This raises the hypothesis that the two entities may have a common pathogenesis. Martorell HYTILU presents as an extremely painful ulcer that is regularly located at the laterodorsal lower leg or at the Achilles tendon. Because of its inflammatory and violaceous wound edges and its tendency to progression, clinicians unaware of the diagnosis Martorell HYTILU might misdiagnose pyoderma gangrenosum or necrotising cutaneous vasculitis start an immunosuppressive treatment and avoid surgical diagnostic and therapeutic procedures. Instead, necrosectomy and split skin grafting are the treatment of choice for Martorell HYTILU. PMID:25333521

  5. Topical Haemotherapy for Leg Ulcers

    Microsoft Academic Search

    B. Triquet; P. Ruffieux; C. Mainetti; D. Salomon; J.-H. Saurat

    1994-01-01

    Several growth factors, present in the plasma or delivered by blood cells, are involved in wound healing. We have treated 15 chronic atonic leg ulcers by topical application of autologous heparinized blood under a hydrocolloidal dressing. This ‘topical haemotherapy’ (THT) was applied every other day. After the first THT, 30% of the fibrinonecrotic material had already been removed. After a

  6. Treatment of the leg ulcers by skin grafting.

    PubMed

    Jank?nas, Vytautas; Rimdeika, Rytis; Pilipaityte, Loreta

    2004-01-01

    The ulcers, located below the knees and remaining for 6 weeks and more, are called trophic leg ulcers. The leg ulcers of different etiology disable 0.8-1% of total Earth population. It was found that blood vessel problems in legs account for more than 80% of ulcers; even 65% from these are caused by venous diseases. In Lithuania about 8000 patients suffer from venous trophic ulcers. Regardless of modern methods the treatment of leg ulcers remains an extremely expensive process. The treatment cost of trophic ulcers is the highest of all surgical wounds and also requires a lot of personal investments. In order to assess the efficiency of autodermoplastics in the treatment of large venous ulcers in legs a prospective study was carried out of 111 patients who were treated in the Department of Plastic Surgery and Burns of Kaunas University of Medicine Hospital from January 2001 to January 2004. The data was analyzed exceptionally of the operated 54 patients with venous origin ulcers open for more 6 months or exceeding 50 cm2. The above-mentioned patients were prepared for surgery by dressing the wounds with hydrocolloid Granuflex bandages and were operated by transplanting a 0.2-0.3 mm thick skin graft. The results were estimated by the surgeon during the dressings after the operation. The graft was taken in 35 (64.81%) cases; in 19 (35.19%) cases the graft was partially not taken and there were no cases when it was not taken at all. We came to the conclusions that skin graft transplantation is efficient in treatment of trophic venous leg ulcers larger than 50 cm2 and cures the trophic leg ulcers of vein origin completely in 2-3 weeks for 64.81% patients. PMID:15170411

  7. Compression and venous surgery for venous leg ulcers.

    PubMed

    Mosti, Giovanni

    2012-07-01

    This article reviews published data on the effects of surgery and compression in the treatment of venous ulcers and the best options for compression therapy. Randomized controlled studies reveal that surgery and compression have similar effectiveness in healing ulcers but surgery is more effective in preventing recurrence. Most leg ulcers have a venous pathophysiology and occur because of venous ambulatory hypertension caused by venous reflux and impairment of the venous pumping function. Proposed surgical interventions range from crossectomy and stripping to perforator vein interruption and endovascular procedures (laser, radiofrequency). More conservative procedures (foam sclerotherapy, conservative hemodynamic treatment) have also been proposed. PMID:22732375

  8. Insufficient Tetanus Vaccination Status in Patients with Chronic Leg Ulcers

    Microsoft Academic Search

    A. Körber; N. Graue; J. Rietkötter; E. Kreuzfelder; S. Grabbe; J. Dissemond

    2008-01-01

    Background: Tetanus disease is caused by Clostridium tetani and is one of the most common infectious diseases worldwide. Despite international recommendations for patients with a chronic leg ulcer, there has been a distinctive lack of protection provided by vaccination for these patients in the past decades. Methods: Within the context of our prospective clinical investigation we consecutively determined the concentrations

  9. Venous Leg Ulcerations: A Treatment Update

    Microsoft Academic Search

    Ronda S. Farah; Mark D. P. Davis

    2010-01-01

    Opinion statement  Selecting the appropriate treatment for venous leg ulcerations is essential for optimal wound healing and patient quality\\u000a of life. Compression therapy remains the mainstay of treatment for these wounds. Compression methods should be carefully selected\\u000a and tailored for compatibility with patients’ daily life. Pain management should not be neglected. When response to compression\\u000a therapy is limited, adjuvant therapy such

  10. [Efficacy of dermoplasty and the dermal equivalent in treatment of vast leg ulcers of mixed genesis].

    PubMed

    Andreev, D Iu; Abramova, N V; Blinova, M I; Pinaev, G P

    2013-01-01

    The most frequent causes of leg ulcers (90-95%) are chronic venous insufficiency (45-60%), obliterating atherosclerosis of the lower extremity arteries (10-20%), diabetes mellitus (15-25%) and their combinations (10-15%). The leg ulcers, specified as pyoderma gangrenosum, are the rare and severe pathology, which is very often misdiagnosed. The case history of a 58-year old female patient with vast leg ulcers of the both shanks is analyzed. The leg ulcers were caused by pyoderma gangrenosum and chronic venous insufficiency due to the varicose disease. Complete epithelization of both ulcers was achieved by means of dermoplasty combined using the dermal equivalent against the background of system immunosuppressive therapy. PMID:23808240

  11. Klinefelter's syndrome presenting with leg ulcers.

    PubMed

    De Morentin, Helena Martinez; Dodiuk-Gad, Roni P; Brenner, Sarah

    2004-01-01

    A 54-year-old man of Persian origin presented to our department with a 1-year history of ulcers on the right leg that had been unresponsive to numerous topical treatments, accompanied by lymphedema of the right leg. Medical history included hypergonadotropic hypogonadism, which had not been further investigated. He was treated for 20 years with testosterone IM once monthly, which he stopped a year before the current hospitalization for unclear reasons. The patient reported no congenital lymphedema. Physical examination revealed two deep skin ulcers (Figure 1) on the right leg measuring 10 cm in diameter with raised irregular inflammatory borders and a boggy, necrotic base discharging a purulent hemorrhagic exudate. Bilateral leg pitting edema and right lymphangitis with lymphadenitis were noted. He had low head hair implantment, sparse hair on the body and head, hyperpigmentation on both legs, onychodystrophia of the toenails (mainly the large toe and less prominent on the other toes), which was atrophic lichen-planus-like in appearance and needed no trimming (Figure 2), normal hand nails, oral thrush, and angular cheilitis. Other physical findings were gynecomastia, pectus excavatum, small and firm testicles, long extremities, asymmetrical goiter, systolic murmur 2/6 in left sternal border, and slow and inappropriate behavior. The patient's temperature on admission was 39 degrees C. Blood cultures were negative for bacterial growth. Results of laboratory investigations included hemoglobin (11.2 g/dL), hematocrit (26.8%), normal mean corpuscular volume and mean corpuscular hemoglobin volume, and red blood cell distribution width (16%). Blood smear showed spherocytes, slight hypochromia, anisocytosis, macrocytosis, and microcytosis. Blood chemistry values were taken for iron (4 micro g/dL [normal range 40-150 micro g/dL]), transferrin (193 mg/dL [normal range 220-400 mg/dL]), ferritin (1128 ng/mL [normal range 14-160 ng/mL]), transferrin saturation (1.5% [normal range 20%-55%]), serum folate (within normal limits), and vitamin B12 (within normal limits). Direct Coombs' test equaled positive 2 + IgG. All these values indicated anemia of chronic diseases combined with hemolytic anemia. Further blood work-up tested antinuclear antibody (positive <1:80 homogeneous pattern), rheumatoid factors (143 IU/mL [positive >8.5 IU/mL]), C-reactive protein (286 mg/L [normal range 0-5 mg/L]), anticardiolipin IgM antibody (9.0 monophosphoryl lipid U/mL [normal range 0-7.00 MPL U/mL]) and antithrombin III activity (135% [normal range 74%-114%]). Results of other blood tests were within normal limits or negative, including lupus anticoagulant, beta2 glycoprotein, anticardiolipin IgG Ab, anti-ss DNA Ab, C3, C4, anti-RO, anti-LA, anti-SC-70, anti-SM Ab, P-ANCA, C-ANCA, TSH, FT4, anti-T microsomal, antithyroglobulin, protein C activity, protein S free, cryoglobulins, serum immunoelectrophoresis, VDRL, hepatitis C antibodies, hepatitis B antigen, and human immunodeficiency virus. Endocrinological work-up examined luteinizing hormone (22.9 mIU/mL [normal range for adult men 0.8-6 mIU/mL]), follicle stimulating hormone (49.7 mIU/mL [normal range for adult men 1-11 mIU/mL]), testosterone (0.24 ng/mL [normal range for adult men 2.5-8.0 ng/mL]), bioavailable testosterone (0.02 ng/mL [normal range for adult men >0.6 ng/mL]), and percent bioavailable test (8.1% [normal value >20%]). These results indicate hypergonadotropic hypogonadism. Plasminogen activator inhibitor 1 was 6 U (normal value 5-20 U/mL). Karyotyping performed by G-banding technique revealed a 47 XXY karyotype, which is diagnostic of Klinefelter's syndrome. Doppler ultrasound of the leg ulcers disclosed partial thrombus in the distal right femoral vein. X-rays and bone scan displayed osteomyelitis along the right tibia. Histological examination of a 4-mm punch biopsy from the ulcer border revealed hyperkeratosis, acanthosis, hypergranulosis, and mixed inflammatory infiltrate containing eosinophils compatible with chronic ulcer. Multiple vessels were seen, compatible with a h

  12. Ulcer pain in patients with venous leg ulcers related to antibiotic treatment and compression therapy.

    PubMed

    Akesson, Nina; Oien, Rut Frank; Forssell, Henrik; Fagerström, Cecilia

    2014-09-01

    The aim of this study was to compare venous leg ulcer patients with and without ulcer pain to see whether ulcer pain affected the use of antibiotic treatment and compression therapy throughout healing. A total of 431 patients with venous leg ulcers were included during the study period. Every patient was registered in a national quality registry for patients with hard-to-heal leg, foot, and pressure ulcers. A high incidence of ulcer pain (57%) was found when the patients entered the study. Patients with ulcer pain had been treated more extensively with antibiotics both before and during the study period. Throughout healing there was a significant reduction of antibiotic use among patients in the 'no pain' group, from 44% to 23% (P=0.008). There was no significant difference between the two groups concerning compression therapy (85% vs. 88%), but 12% of patients in the 'pain' group did not get their prescribed compression compared with 6% of patients in the 'no pain' group. The groups did not differ significantly in terms of ulcer duration, ulcer size or healing time. This study shows a high incidence of ulcer pain, confirming that pain has a great impact on patients with venous leg ulcers. Results further suggest that the presence of ulcer pain increases the prescription of antibiotics but does not affect the use of compression therapy. Several advantages were found from using a national quality registry. The registry is a valuable clinical tool showing the importance of accurate diagnosis and effective treatment. PMID:25191864

  13. Squamous cell carcinoma developed on chronic venous leg ulcer.

    PubMed

    Sîrbi, Adelina Gabriela; Florea, Marius; P?tra?cu, Virgil; Rotaru, Maria; Mogo?, Dan Gabriel; Georgescu, Claudia Valentina; M?rg?ritescu, Nicolae Drago?

    2015-01-01

    Chronic venous leg ulcers (VLU), especially long-lasting non-healing ulcers, are among the risk factors for squamous cell carcinoma (SCC). Malignant transformation of a VLU is a rare finding and the relative risk of carcinomatous transformation is quite low (about 5.8). SCC arising in the context of a VLU has a particularly aggressive behavior. A 76-year-old male patient with no relevant medical familial history, with chronic venous insufficiency CEAP C6 for 10 years [recurrent leg ulcers with favorable outcome (healing) after specific local and systemic treatment], showing for about three years one ulcerated lesion located on the anterior upper third of the right calf non-responsive to specific treatment, which subsequently increased their size and merged. Biopsy sample was taken. Histopathology showed epidermal acanthosis, papillomatosis, intense parakeratosis, pseudoepitheliomatous hyperplasia, dysplasia and moderately differentiated squamous cell carcinoma with areas of acantholysis. Immunohistochemistry (Ki67, EMA, cytokeratin 34?E12 and p63) was performed and all types of immunostaining were moderately to intense positive. Above-knee leg amputation and specific oncologic treatment were proposed as possible curative solutions but the patient refused. Ten months after diagnosis and discharge form the Department of Dermatology, the patient died. Patients with chronic venous leg ulcers and clinically suspicious lesions should be evaluated for malignant transformation of the venous lesion. When diagnosed, malignancy complicating a chronic venous leg ulcer requires a resolute treatment as it may be fatal. PMID:25826522

  14. Venous leg ulcer management: single use negative pressure wound therapy.

    PubMed

    Dowsett, Caroline; Grothier, Lorraine; Henderson, Valerie; Leak, Kathy; Milne, Jeanette; Davis, Lynn; Bielby, Alistair; Timmons, John

    2013-06-01

    A number of leg ulcer specialist/tissue viability specialists from across the UK were invited to evaluate PICO (Smith and Nephew, Hull) as a treatment for venous leg ulcers also in conjunction with a variety of compression bandages and garments. Patients across 5 sites had PICO applied in conjunction with compression therapy. This group of treating clinicians were then asked to give feedback on the outcome of the patients on whom they had used the new device. All feedback was recorded at a meeting and this was used to create a guideline for use. PMID:24156166

  15. Mycobacterium Chelonae: Nonhealing Leg Ulcers Treated Successfully With an Oral Antibiotic

    Microsoft Academic Search

    Shawn Terry; Nigel H. Timothy; John J. Zurlo; Ernest K. Manders

    Leg ulcers plague mankind with prolonged suffer- ing and disability. The differential diagnosis is broad, and major causes include circulatory disor- ders, neuropathies, and infectious diseases. In the absence of a circulatory disturbance or neuropathy, and when conventional aerobic and anaerobic cul- tures are negative, the diagnosis of a mycobacterial infection should be considered. We report on an uncommon but

  16. Which dressings reduce inflammation and improve venous leg ulcer healing.

    PubMed

    Raffetto, Joseph D

    2014-05-19

    Chronic venous leg ulcers (VLU) affect around 1% of the adult population in the Western world. The impact of VLU is both social and economic, with significant expenditures on active venous ulcers to provide medical treatment and eventual healing. At the core of VLU is venous hypertension which affects the venous macrocirculation. The changes incurred in venous hemodynamics leads to microcirculatory changes affecting the postcapillary venule and surrounding tissues. Inflammation by leukocytes affecting the venous endothelium, promotes a complex cascade and activation of adhesion molecules expression, chemokines and cytokines released, altered growth factor responses, and activation of protease (e.g. tPA) and proteinase (e.g. MMPs) activity that causes dysregulation and compromise of tissue integrity with eventual dermal damage and ulcer development. A critical component to treating VLU is correcting the abnormal venous hemodynamics and compression therapy. Unfortunately, VLU recurrence ranges between 30-70%, and other modalities in therapy along with compression are required. The goal for adjuvant products is to restore the balance from an inflammatory chronic wound to that of a reparative wound that will promote provisional matrix and epithelialization. There are many products on the market that can be used as adjuvant to compression therapy, but it must be recognized that there is a paucity of clinical trials that have evaluated the clinical effectiveness of specific products with clearly defined end points, and most importantly a healed VLU with a low recurrence rate. This review will discuss the fundamentals of VLU inflammation, and evaluate the available literature that may have benefit in reducing inflammation and lead to effective VLU healing. PMID:24843103

  17. Percutaneous foam sclerotherapy for venous leg ulcers.

    PubMed

    Bush, R; Bush, P

    2013-10-01

    The technique of foam sclerotherapy directed at the distal most vessels, draining the ulcer bed was first described in 2010, with excellent penetration into the underlying venous network possible with this technique. Thirty-five patients have now been treated with this technique as the initial treatment at Midwest Vein Laser, USA. There have been no complications with this technique and rapid healing occurred within 4-8 weeks after the initial treatment in 90% of the patients, and all ulcers were healed at 4 months. Here we present the representative case of a 67-year-old man treated with a modified technique that used a percutaneous approach via reticular or spider veins at the margin of the ulcer bed. PMID:24142137

  18. Wound Teleconsultation in Patients with Chronic Leg Ulcers

    Microsoft Academic Search

    Wolfgang Salmhofer; Rainer Hofmann-Wellenhof; Gerald Gabler; Karin Rieger-Engelbogen; Dieter Gunegger; Barbara Binder; Thomas Kern; Helmut Kerl; H. Peter Soyer

    2005-01-01

    Background: The treatment of chronic leg ulcers requires frequent assessments of local wound status and adjustment of therapy. The availability of reasonably priced photographic equipment and quick electronic transfer of high-quality digital images should make it possible that the assessment of wound status can be made by remote experts. Objective: This study examines the feasibility of using teledermatology for wound

  19. Onychomycosis in patients with chronic leg ulcer and toenail abnormalities*

    PubMed Central

    Cabete, Joana; Galhardas, Célia; Apetato, Margarida; Lestre, Sara

    2015-01-01

    Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects. PMID:25672317

  20. Onychomycosis in patients with chronic leg ulcer and toenail abnormalities.

    PubMed

    Cabete, Joana; Galhardas, Célia; Apetato, Margarida; Lestre, Sara

    2015-01-01

    Nails have a limited number of reactive patterns to disease. Accordingly, toenail changes of different etiologies may mimic onychomycosis. OBJECTIVE To determine the prevalence of toenail onychomycosis among patients with leg ulcer and toenail abnormalities attending a dermatology clinic. METHODS A cross-sectional study was conducted through the analysis of clinical records and results of mycological examination. RESULTS A total of 81 patients were included, with a median age of 76.0 years. Most ulcers were of venous etiology, followed by those of mixed and arterial pathogenesis. The mycological evaluation confirmed the diagnosis of onychomycosis in 27.2% of the patients. The etiologic agent was a dermatophyte in 59.1% of isolates in nail samples, while Trichophyton interdigitale was the most frequent fungal species (40.9%). CONCLUSIONS Most toenail abnormalities in patients with chronic leg ulcer were not onychomycosis. This study highlights the importance of systematic mycological examination in these patients, in order to avoid overtreatment with systemic antifungals, unnecessary costs and side effects. PMID:25672317

  1. Venous leg ulcers: Impact and dysfunction of the venous system.

    PubMed

    Gordon, Phyllis; Widener, Jeanne M; Heffline, Melody

    2015-06-01

    Management of chronic venous leg ulcers (VLU) can be frustrating for both patient and practitioner. It is a significant source of disability and cost of care. Before the practitioner enters the management phase of VLU care, it is helpful to understand the impact of VLUs. Additionally, it is essential to understand the structure and function of the venous system and manifestations indicative of a dysfunction of the system. This article focuses on the epidemiology, structure, and function of the venous system as well as clinical manifestations and prevention. PMID:26025148

  2. Oesophageal ulcer caused by warfarin.

    PubMed Central

    Loft, D. E.; Stubington, S.; Clark, C.; Rees, W. D.

    1989-01-01

    Oesophageal injury is a well recognized complication of certain oral medications but warfarin has not been implicated previously. We present a case of an oesophageal ulcer occurring in a patient with mitral regurgitation taking warfarin, and demonstrate a delayed oesophageal tablet transit time. PMID:2594605

  3. Effectiveness of an acellular synthetic matrix in the treatment of hard-to-heal leg ulcers.

    PubMed

    Harding, Keith; Aldons, Pat; Edwards, Helen; Stacey, Michael; Finlayson, Kathleen; Gibb, Michelle; Jenkins, Liz; Shooter, Gary; Lonkhuyzen, Derek Van; Lynam, Emily; Heinrichs, Eva-Lisa; Upton, Zee

    2014-04-01

    Hard-to-heal leg ulcers are a major cause of morbidity in the elderly population. Despite improvements in wound care, some wounds will not heal and they present a significant challenge for patients and health care providers. A multi-centre cohort study was conducted to evaluate the effectiveness and safety of a synthetic, extracellular matrix protein as an adjunct to standard care in the treatment of hard-to-heal venous or mixed leg ulcers. Primary effectiveness criteria were (i) reduction in wound size evaluated by percentage change in wound area and (ii) healing assessed by number of patients healed by end of the 12?week study. Pain reduction was assessed as a secondary effectiveness criteria using VAS. A total of 45 patients completed the study and no difference was observed between cohorts for treatment frequency. Healing was achieved in 35·6% and wound size decreased in 93·3% of patients. Median wound area percentage reduction was 70·8%. Over 50% of patients reported pain on first visit and 87·0% of these reported no pain at the end of the study. Median time to first reporting of no pain was 14?days after treatment initiation. The authors consider the extracellular synthetic matrix protein an effective and safe adjunct to standard care in the treatment of hard-to-heal leg ulcers. PMID:23834253

  4. Barrett's ulcer: cause of spontaneous oesophageal perforation.

    PubMed Central

    Limburg, A J; Hesselink, E J; Kleibeuker, J H

    1989-01-01

    We report two patients, who presented within six months with the classic clinical picture of 'spontaneous' oesophageal perforation, which was caused by a perforated Barrett's ulcer. These two cases underline the importance of postoperative endoscopy in ruling out intrinsic oesophageal disease as the cause of the rupture in every patient, who survives this life threatening condition. PMID:2707641

  5. The analgesic effect of electrostimulation (WoundEL(®) ) in the treatment of leg ulcers.

    PubMed

    Leloup, Pauline; Toussaint, Pascal; Lembelembe, Jean-Paul; Célérier, Philippe; Maillard, Hervé

    2014-02-12

    This study aims to demonstrate the analgesic efficacy of electrostimulation (ES), a recognised treatment for leg ulcers. Patients treated by ES for leg ulcers between 2011 and 2013 were included in the study. The pain score obtained with the numerical rating scale (NRS) was reported before the start of the ES (D0), after 3?days (D3) and 1?week following treatment initialisation. The analgesic treatments (AT) were reported at each assessment. Seventy-three patients were included (mean age 75·19?years): 31 venous leg ulcers, 21 mixed venous leg ulcers, 2 arterial ulcers, 17 hypertensive ischaemic ulcers, 1 Hydrea®-induced ulcer and an amputation stump ulcer. The NRS at D0 was on average 5·3 (median?=?6) while it was 2·2 at D7 (median?=?2), that is P?leg ulcers, with a clear impact on the NRS score and especially on the decrease in analgesic consumption. PMID:24618089

  6. Guts & Glory H. pylori: Cause of Peptic Ulcer

    Microsoft Academic Search

    Ashley Johnson; Bryan Kratz; Lorraine Scanlon; Alina Spivak

    Summary Due to the 1983 discovery of H. pylori bacteria as the leading cause of peptic ulcers, the understanding of the disease dramatically changed. We now know that stress and spicy foods are not the leading causes of peptic ulcers. Symptoms including acute abdominal pain, vomiting of blood, and weight loss are characteristic of peptic ulcers. Ulcers form because of

  7. Expression of elastase and fibrin in venous leg ulcer biopsies: a pilot study of pentoxifylline versus placebo.

    PubMed

    Mirshahi, S; Soria, J; Mirshahi, M; Soria, C; Lenoble, M; Vasmant, D; Cambazard, F; Claudy, A

    1995-01-01

    The pathogenesis of venous leg ulcers is based on the leakage of fibrinogen leading to a pericapillary fibrin cuff and plugging of capillaries by white blood cells. On the basis of a previous work, we had assumed that the key event in the pathogenesis of venous leg ulcers is related to inflammation generated by activated white blood cells that accumulate under unrelieved blood pressure, because in ulcer biopsies we had detected the presence of tumor necrosis factor-alpha (TNF-alpha) in intracapillary monocytes, elastase in the polymorphonuclear leukocytes near the vessels, and a pericapillary undegraded fibrin cuff causing a diffusion barrier to oxygen. This concept was developed because TNF-alpha synthesized by activated monocytes is responsible for many deleterious effects. It has a potent mitogenic effect on fibroblasts, leading to new collagen deposition and angiogenesis, it induces an increase in collagenase production, it acts through upregulation of an intracellular adhesion molecule (ICAM-1), leading to leukocyte sequestration and consequently a release of toxic metabolites by the polymorphonuclear cells, an early step in chronic inflammation, it activates the coagulation pathway via a marked increase in monocyte-associated tissue factor (TF) procoagulant activity, and it inhibits fibrinolysis by promoting the release of PAI-1, contributing to undegraded fibrin deposition. Therefore, we were interested in evaluating, in patients with venous leg ulcers, the effect of pentoxifylline administered at 1,200 mg daily (versus placebo) for 2-months, as this drug induces a decrease in TNF-alpha synthesis and also blocks its activity. This pilot assay was performed in blind. Evolution of several parameters in ulcer biopsies are analyzed: TNF-alpha, intact fibrin, fibrin degradation products, ICAM-1, TF, and elastase. Pentoxifylline administration induced a decrease of local elastase and of fibrin deposit. These results support the hypothesis that accumulation of activated leukocytes is the key event in venous leg ulcers. PMID:8699846

  8. Novel Wound Healing Powder Formulation for the Treatment of Venous Leg Ulcers

    PubMed Central

    Ghatnekar, Angela V.; Elstrom, Tuan; Ghatnekar, Gautam S.; Kelechi, Teresa

    2011-01-01

    Chronic venous disorders are common in the Western world. The current treatment of venous leg ulcers is unsatisfactory despite the availability of well-documented standards of care. Patients today are interested in alternative approaches to modern medicine. We have developed a wound-healing powder containing natural ingredients with absorptive, aromatic, antiseptic, and anti-inflammatory synergistic properties. This report describes 3 cases that were successfully treated with the powder, demonstrating the potential of herbal remedies in the clinical treatment of venous leg ulcers. PMID:24527167

  9. Vasculopathy, inflammation, and blood flow in leg ulcers of patients with sickle cell anemia

    PubMed Central

    Minniti, Caterina P.; Delaney, Kara-Marie H.; Gorbach, Alexander M.; Xu, Dihua; Lee, Chyi-Chia Richard; Malik, Nitin; Koroulakis, Antony; Antalek, Matthew; Maivelett, Jordan; Peters-Lawrence, Marlene; Novelli, Enrico M.; Lanzkron, Sophie M.; Axelrod, Karen C.; Kato, Gregory J.

    2013-01-01

    Chronic leg ulcers are frequent and debilitating complications of sickle cell anemia. Inadequate blood supply has been postulated to be an important factor in their occurrence and delayed healing. Little is known about their microcirculatory and histopathological changes. We evaluated the microcirculation of lower extremity ulcers with laser speckle contrast imaging and infrared thermography and obtained clinical and laboratory characteristics in 18 adults with sickle cell anemia and chronic leg ulcers. Skin biopsies were obtained in four subjects. Subjects had markers of severe disease, anemia, high degree of hemolysis, inflammation, and thrombophilia. The highest blood flow was present in the ulcer bed, progressively less in the immediate periwound area, and an unaffected control skin area in the same extremity. Microscopic examination showed evidence of venostasis, inflammation, and vasculopathy. Blood vessels were increased in number, had activated endothelium and evidence of thrombosis/recanalization. High blood flow may be due to chronic inflammation, cutaneous vasodilatation, venostasis, and in situ thrombosis. These changes in skin microcirculation are similar to chronic venous ulcers in the non-sickle cell disease (SCD) population, thus suggesting that leg ulcers may be another end-organ complication with endothelial dysfunction that appears in patients with SCD at a younger age and with higher frequency than in the general population. PMID:23963836

  10. Randomized clinical trial of three-layer tubular bandaging system for venous leg ulcers.

    PubMed

    Weller, Carolina D; Evans, Sue M; Staples, Margaret P; Aldons, Pat; McNeil, John J

    2012-01-01

    The safety and efficacy of three-layer (3L) tubular bandaging as a treatment for venous ulcer healing has not been evaluated despite its use in many clinical settings to treat people with venous leg ulcers. We evaluated the safety and efficacy of 3L tubular bandage compared with short-stretch compression bandage to heal venous ulcers in a multicenter, open-label, parallel-group, randomized controlled trial. We randomized 45 patients with venous leg ulcers of up to 20?cm(2) area and an ankle brachial pressure index of >0.8 from hospital outpatient wound clinics in Victoria and Queensland, Australia. We measured time to healing and percentage reduction of wound size from baseline to week 12. Secondary outcomes were proportion of ulcers healed, self-reported compliance of compression bandage, and health-related quality of life, costs, recurrence rates, and adverse events. A total of 27 ulcers healed, the proportion of healed ulcers was higher for the 3L group (17/23 [74%] vs. 10/22 [46%]) (p?=?0.05). Reported bandage tolerance at all treatment visits was 21 (91%) in 3L group vs. 17 (73%) (p?=?0.10). There was no difference between the groups in adverse events. Costs were substantially less in 3L group. PMID:23061541

  11. Coagulation factor V gene mutation associated with activated protein C resistance leading to recurrent thrombosis, leg ulcers, and lymphedema: successful treatment with intermittent compression

    Microsoft Academic Search

    Dominik Peus; Sherko v Schmiedeberg; Andreas Pier; Rüdiger E Scharf; Artur Wehmeier; Thomas Ruzicka; Jean Krutmann

    1996-01-01

    Activated protein C resistance is the most frequent cause of venous thrombosis. We describe a patient with extensive ulcerations and severe lymphedema of the legs after recurrent thrombosis. Laboratory tests revealed a pathologic activated protein C resistance and a reduced functional protein S. The underlying genetic defect was identified as a heterozygous coagulation factor V mutation. A combined therapeutic approach

  12. An overview of technologies related to care for venous leg ulcers

    Microsoft Academic Search

    Meghan Sarah Hegarty; Edward Grant; Lawrence Reid Jr.

    2010-01-01

    Venous leg ulcers remain a major problem in the United States, with spending reaching more than $1 billion annually. Current treatment options for this condition center around the use of compression therapy delivered by bandages, medical-grade stockings, or pneumatic compression devices. While these forms of therapy can produce dramatic improvements, cost and patient compliance remain an issue. In parallel with

  13. Hard-to-heal venous-lymphatic leg ulcers: a special case.

    PubMed

    Silva, José António; Filipe, Rosário; Esteves Cardoso, Manuel; Andriessen, Anneke

    In the treatment of this 56-year-old male, the aim was to attend to his multiple pathologies, reducing his venous-lymphatic oedema on both legs, closing the extended ulcers and improving his quality of life. The patient received treatment in a community-based wound healing clinic. After various local therapies were not successful, the wounds were cleansed with saline and covered with a biocellulose dressing (BWD) and polyhexanide (PHMB), after which a short-stretch bandage system was applied. Compression was then switched to a tubular compression system. At day 0, both lower legs had significant oedema and circumferential venous-lymphatic ulcers, and the left leg showed signs of inflammation. However, at day 8, inflammation, oedema and ulcer area had reduced. After 2 months, the ulcers were almost closed and the oedema had reduced to a level where the tubular compression system could be applied. Treatment using BWD and compression and good adherence to this regimen led to ulcer closure. This improved the patients' quality of life significantly. PMID:22874827

  14. Venous leg ulcers: Summary of new clinical practice guidelines published August 2014 in the Journal of Vascular Surgery.

    PubMed

    Widener, Jeanne M

    2015-06-01

    The Society for Vascular Surgery(®) (SVS) and the American Venous Forum (AVF) published guidelines for the management of venous leg ulcers in August 2014. The goal of this article (Part 2) is to summarize the guidelines that address diagnosis and treatment recommendations published jointly by the SVS and AVF that may affect the nursing practice of vascular nurses. Specific sections include wound evaluation, therapies used on the wound bed itself, compression, and operative or endovascular management. Part 1, published elsewhere in this issue, addressed the epidemiology and financial impact of ulcers, venous anatomy, pathophysiology of venous leg ulcer development, clinical manifestations, and prevention of venous leg ulcers. These 2 parts together provide a comprehensive summary of the joint SVS and AVF guidelines for care of venous leg ulcers. PMID:26025149

  15. Prevalence of skin problems and leg ulceration in a sample of young injecting drug users

    PubMed Central

    2014-01-01

    Background Drug users suffer harm from the injecting process, and clinical services are reporting increasing numbers presenting with skin-related problems such as abscesses and leg ulcers. Skin breakdown can lead to long-term health problems and increased service costs and is often the first indication of serious systemic ill health. The extent of skin problems in injecting drug users has not previously been quantified empirically, and there is a dearth of robust topical literature. Where skin problems have been reported, this is often without clear definition and generic terms such as ‘soft tissue infection’ are used which lack specificity. The aim of this study was to identify the range and extent of skin problems including leg ulceration in a sample of injecting drug users. Definitions of skin problems were developed and applied to descriptions from drug users to improve rigour. Methods Data were collected in needle exchanges and methadone clinics across Glasgow, Scotland, from both current and former drug injectors using face-to-face interviews. Results Two hundred participants were recruited, of which 74% (n?=?148) were males and 26% (n?=?52) were females. The age range was 21–44 years (mean 35 years). Just under two thirds (64%, n?=?127) were currently injecting or had injected within the last 6 months, and 36% (n?=?73) had previously injected and had not injected for more than 6 months. Sixty per cent (n?=?120) of the sample had experienced a skin problem, and the majority reported more than one problem. Most common were abscesses, lumps, track marks and leg ulcers. Fifteen per cent (n?=?30) of all participants reported having had a leg ulcer. Conclusions This is an original empirical study which demonstrated unique findings of a high prevalence of skin disease (60%) and surprisingly high rates of leg ulceration (15%). Skin disease in injecting drug users is clearly widespread. Leg ulceration in particular is a chronic recurring condition that is costly to treat and has long-term implications for drug users and services caring for current or former injectors long after illicit drug use has ceased. PMID:25119472

  16. A Repeat Validated Population Questionnaire of a Defined Swedish Population Verifies Reduction in Leg Ulcer Prevalence Over Time.

    PubMed

    Forssgren, Alexandra; Nelzén, Olle

    2015-06-24

    This study was performed to measure if the introduced interventions in leg ulcer care in a selected Swedish county yield a detectable reduction in leg ulcer prevalence in the population. A validated postal questionnaire sent to 10,000 (9,868) randomly selected 30-89 year olds in the Skaraborg county (255,042 inhabitants). All positive responders were telephone interviewed and verified ulcer patients were clinically examined including assessment of arterial/venous circulation with hand-held Doppler and, where indicated, duplex ultrasound scanning. All results were compared with numbers from 1990 (initial study). The response rate was 82% (8,070/9,868), 200 active ulcers and 290 previous ulcers. The calculated prevalence was 0.75% for 30-89 years and 1.05% for 50-89 years (2.1% in 1990). The leg ulcer prevalence was reduced by 32% (0.52% compared to 0.77% in 1990), and the relative risk was reduced by 50% (95%, CI 0.36-0.69). The study shows a true reduction in leg ulcer prevalence detectable in the population supporting a successful care of leg ulcer patients. PMID:25655638

  17. Overview of guidelines for the prevention and treatment of venous leg ulcers: a US perspective

    PubMed Central

    White-Chu, E Foy; Conner-Kerr, Teresa A

    2014-01-01

    Comprehensive care of chronic venous insufficiency and associated ulcers requires a multipronged and interprofessional approach to care. A comprehensive treatment approach includes exercise, nutritional assessment, compression therapy, vascular reconstruction, and advanced treatment modalities. National guidelines, meta-analyses, and original research studies provide evidence for the inclusion of these approaches in the patient plan of care. The purpose of this paper is to review present guidelines for prevention and treatment of venous leg ulcers as followed in the US. The paper further explores evidence-based yet pragmatic tools for the interprofessional team to use in the management of this complex disorder. PMID:24596466

  18. The Use of Biatain Ag in Hard-to-Heal Venous Leg Ulcers: Meta-Analysis of Randomised Controlled Trials

    PubMed Central

    Leaper, David; Münter, Christian; Meaume, Sylvie; Scalise, Alessandro; Mompó, Nacho Blanes; Jakobsen, Birte Petersen; Gottrup, Finn

    2013-01-01

    Background Venous leg ulcers are common, troublesome, and their failure to heal is often related to a heavy bio-burden. Ionized silver has both anti-inflammatory and antimicrobial properties. The ulcer healing properties of the silver releasing foam dressing Biatain Ag has been examined in 4 randomized controlled trials (RCTs). Aim To evaluate ulcer healing through a meta-analytic approach after treatment with either Biatain Ag or a non-active dressing. Patients and Methods 685 subjects with pure or mixed hard-to-heal venous leg ulcers were included in the meta-analysis. Results Biatain Ag showed a significant treatment effect (p<0.0001), responder rate (p<0.001), and healing rate (p?=?0.002). Conclusion The meta-analysis of the 4 RCTs provided statistical significant evidence to support the use of Biatain Ag dressing in treatment of hard-to-heal venous leg ulcers. PMID:23843984

  19. Elevated Levels of Coagulation Factor VIII in Patients With Venous Leg Ulcers.

    PubMed

    Criado, Paulo Ricardo; Alavi, Afsaneh; Kirsner, Robert S

    2014-05-25

    Chronic venous disease affects millions of people around the world. Venous valvular incompetencies and venous reflux, often a result of outflow obstruction are important contributors to venous disease. The prevalence of thrombophilia is increased in patients with chronic venous insufficiency (CVI). The recognition of underlying thrombophilia particularly in young patients opens new avenues in the management and prevention plan. We emphasize on the consideration of workup for coagulopathy, especially factor VIII deficiency in young patients with venous disease. We report 3 patients with chronic leg ulcers and high levels of FVIII:C activity in plasma and other associated thrombophilic factors. We highlight the need to get a workup done for thrombophilia in young patients with recurrent and chronic leg ulcers related to venous insufficiency or livedoid vasculopathy. Further studies with larger sample sizes are required to define the definite indications for the thrombophilia workups. PMID:24861090

  20. New single-layer compression bandage system for chronic venous leg ulcers.

    PubMed

    Lee, Gillian; Rajendran, Subbiyan; Anand, Subhash

    A new single-layer bandage system for the treatment of venous leg ulcers has been designed and developed at the University of Bolton. This three-dimensional (3D) knitted spacer fabric structure has been designed by making use of mathematical modelling and Laplace's law. The sustained graduated compression of the developed 3D knitted spacer bandages were tested and characterized, and compared with that of commercially available compression bandages. It was observed that the developed 3D single-layer bandage meets the ideal criteria stipulated for compression therapy. The laboratory results were verified by carrying out a pilot user study incorporating volunteers from different age groups. This article examines the insight into the design and development of the new 3D knitted spacer bandage, along with briefly discussing the issues of compression therapy systems intended for the treatment of venous leg ulcers. PMID:19718001

  1. Recruitment rates and reasons for community physicians' non-participation in an interdisciplinary intervention study on leg ulceration

    Microsoft Academic Search

    Oliver R Herber; Wilfried Schnepp; Monika A Rieger

    2009-01-01

    BACKGROUND: This article describes the challenges a research team experienced recruiting physicians within a randomised controlled trial about leg ulcer care that seeks to foster the cooperation between the medical and nursing professions. Community-based physicians in North Rhine-Westphalia, Germany, were recruited for an interdisciplinary intervention designed to enhance leg ulcer patients' self-care agency. The aim of this article is to

  2. Novel Wound Healing Powder Formulation for the Treatment of Venous Leg Ulcers

    Microsoft Academic Search

    Angela V. Ghatnekar; Tuan Elstrom; Gautam S. Ghatnekar; Teresa Kelechi

    Chronic venous disorders are common in the Western world. The current treatment of venous leg ulcers is unsatisfactory despite the availability of well-documented standards of care. Patients today are interested in alternative approaches to modern medicine. We have developed a wound-healing powder containing natural ingredients with absorptive, aromatic, antiseptic, and anti-inflammatory synergistic properties. This report describes 3 cases that were

  3. The views of district nurses on their level of knowledge about the treatment of leg and foot ulcers

    Microsoft Academic Search

    Ruth Haram; Elisabeth Ribu; Tone Rustøen

    2003-01-01

    Objective: The aim was to survey the views of a sample of district nurses on their own level of knowledge about the treatment of leg and foot ulcers and what they considered to be the most important issues in wound treatment. Design: A descriptive design was used. Setting and subjects: The subjects were all the nurses who treated leg and

  4. Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of São Paulo State, Brazil*

    PubMed Central

    Wachholz, Patrick Alexander; Masuda, Paula Yoshiko; Nascimento, Dejair Caitano; Taira, Cecilia Midori Higashi; Cleto, Norma Gondim

    2014-01-01

    BACKGROUND Chronic leg ulcer may have an impact on patients' quality of life. OBJECTIVES This study aimed to identify the impact of leg ulcers on patient's quality of life using the Dermatology Life Quality Index and to define the main factors correlated with this perception. METHOD Cross-sectional, non-probabilistic sampling study. We included patients with chronic leg ulcers being treated for at least 3 months. A sociodemographic and clinical survey was conducted to assess the profile of the ulcers. We administered a screening for depressive symptoms and the Dermatology Life Quality Index. We performed a descriptive statistical analysis, chi-square test and Mann-Whitney test for categorical data, Pearson for numeric variables, and multiple regression for categorical data. RESULTS Forty-one patients were assessed. Their mean age was 61.78 years. Venous ulcers (48.8%) were the most prevalent. Seventy-three percent of the sample perceived no impact/low impact on quality of life in the past week, and 26.8% perceived moderate/high impact. A multiple regression analysis identified the causes of lesion, pain related to the ulcers, time of onset, and severity of the depressive symptoms as the variables that had an influence on quality of life. CONCLUSIONS The majority of the sample perceived low or no impact of the condition on the quality of the life. The variables etiology of the lesion (p<0.001), pain related to the ulcers (p=0.001), time of onset (p=0.006), and severity of the depressive symptoms (p<0.001) had an influence on the quality of life, suggesting the need for further studies with more robust designs to confirm the causal relationship between these characteristics and quality of life. PMID:24626651

  5. Leg ulcer nursing care in the community: a prospective cohort study of the symptom of pain

    PubMed Central

    2013-01-01

    Background Chronic wounds are managed almost entirely by community nurses. Almost all individuals with leg ulcers report acute pain usually related to dressing change. Little is known about pain after healing. The purpose of this study was to explore the course of pain from baseline to time of healing of leg ulcers (venous or mixed etiology). In order to understand this phenomenon and develop implications for nursing practice, objectives included: 1) Measure incidence and prevalence of pain at baseline and healing; 2) Describe characteristics associated with leg ulcer pain at baseline; 3) Identify predictors of leg ulcer pain at healing. Methods Data were from one randomized controlled trial (2004-2008) of 424 individuals with leg ulcers in the community receiving evidence-informed nursing management. The primary outcome was pain at the time of healing. Predictive factors included demographic, circumstance of living, clinical and ulcer characteristics. Multivariable logistic regression identified the subset of predictors of pain at healing. Odds ratios (OR) and 95% confidence intervals (CI) are reported. Results Eighty-two percent of participants reported pain at baseline and 32% at healing. Five percent with no pain at baseline reported pain at healing. Thirty-seven percent reported moderate to severe pain at baseline and 11% at healing. Twenty percent of all those who healed reported pain interfered with work moderately to extremely at time of healing. Being female (OR=1.64, 95% CI 1.00, 2.68, p=0.05), use of short-stretch vs. four-layer bandages (OR=1.73, 95% CI 1.06, 2.82, p=0.03), lower SF-12 PCS (OR=0.97, 95% CI 0.94, 0.99, p=0.02) and MCS (OR=0.98, 95% CI 0.95-1.00, p=0.04) scores, use of non-steroidal anti-inflammatory drugs (OR=2.28, 95% CI 1.06, 4.88, p=0.03), and tender pain (OR=2.17, 95% CI 1.29, 3.66, p=<0.01) were associated with pain at time of healing. Conclusions Pain is an issue on admission for chronic wounds and at healing, yet 58% with moderate to severe pain on admission were not taking pain medication(s). Future studies should examine the role of pain at healing and at subsequent ulcer recurrence. Mobility and other factors that may contribute to pain at time of healing should also be assessed. Community nurses are encouraged to consider pain when planning care on admission and also after wound healing, when most patients are discharged from care. Trial registration ClinicalTrials.gov, NCT00202267 PMID:23388350

  6. Chronic venous disease and venous leg ulcers: An evidence-based update.

    PubMed

    Kelechi, Teresa J; Johnson, Jan J; Yates, Stephanie

    2015-06-01

    Chronic venous disease (CVD) is a complex chronic vascular condition with multifaceted primary and secondary etiologies leading to structural and functional changes in veins and valves and blood flow of the lower legs. As a consequence, a spectrum of clinical manifestations arise, ranging from symptoms of mild leg heaviness and achiness to debilitating pain, and signs of skin changes, such as eczema and hemosiderosis, to nonhealing, heavily draining venous leg ulcers (VLUs). Triggers such as trauma to the skin are responsible for a large majority of VLU recurrences. Diagnostic testing for venous reflux includes ultrasound imaging; unfortunately, there are no diagnostic tests to predict VLUs. The hallmark of treatment of both CVD and VLUs is compression. Leg elevation, exercise, and wound management with dressings and advanced healing technologies that provide an environment conducive to healing should focus on reducing pain, necrotic debris, drainage, and odor, as well as preventing infection. VLUs that become chronic without evidence of healing over a 4-week period respond best to multidisciplinary wound experts within a framework of patient-centered care. Nurses are in key positions to provide early recognition of the signs and symptoms as well as initiate prompt diagnostic and promote early treatment to offset the progression of the disease and improve quality of life. PMID:26025146

  7. EMLA and Lidocaine Spray: A Comparison for Surgical Debridement in Venous Leg Ulcers

    PubMed Central

    Cuomo, Roberto; D'Aniello, Carlo; Grimaldi, Luca; Nisi, Giuseppe; Botteri, Gaia; Zerini, Irene; Brandi, Cesare

    2015-01-01

    Objective: In this study the author proposes to compare eutectic mixture of local anesthetics (EMLA) and an odontoiatric spray solution of 10% Lidocaine (Ecocain) for surgical debridement in venous leg ulcers. Approach: Fifty patients were recruited and randomly assigned into two groups (A, B). All of them have venous leg ulcer in the medial and/or lateral malleolar region. Group A: topical anesthetic EMLA with film occlusion. Group B: topical anesthesia with Ecocain. The author proceeded to surgical debridement after local anesthesia. A questionnaire and a visual analog scale (VAS) were administered to assess the amount of pain felt during the debridement and during the following 6?h. Results: The analysis of the VAS revealed no major significant differences statistically. The analysis of the questionnaires showed patients treated with Ecocain took more analgesic drugs. Analysis of the timing and quality of procedure showed that Ecocain reduced the timing of debridement and dressing change, improving the outpatient management and patient compliance. Innovations: For rapid debridement, the most appropriate is to use Ecocain. Conclusion: Methods of local anesthesia are multiple and must be identified according to the needs of the patient and the surgeon trying to get the best anesthesia with minimal use of time and resources. PMID:26029486

  8. [Take of mesh grafts in chronic leg ulcer patients improves by vacuum-assisted closure device].

    PubMed

    Dissemond, J; Körber, A; Grabbe, S

    2006-04-01

    Vacuum-assisted closure (V.A.C.) is an established therapeutic option in the management of acute and chronic granulating wounds. In recent years, little data has been published concerning skin graft transplantation and postoperative V.A.C. therapy. We report a consecutive case series of 54 patients with chronic leg ulcer who received a total of 74 mesh grafts. A postoperative V.A.C. therapy was performed in 28 mesh grafts, and 46 mesh grafts were treated with standard gauze therapy. In the V.A.C. group, 92.9 % grafts showed complete healing. In the treatment group without postoperative V.A.C. therapy, 67.4 % of the mesh grafts had taken. Differential analysis revealed a correlation in patients over 70 years of age or in patients suffering from diabetes mellitus or dermato-lipo-sclerosis. Particularly patients with diabetes mellitus and of greater age exhibited improved take rates in the V.A.C. group. The results of our study demonstrate for the first time the significant benefit of V.A.C. therapy after mesh-graft-transplantation in chronic leg ulcer patients as evaluated in a clinical trial with a control group. PMID:16575672

  9. [Clinical trial of Pulvo 47 Neomycin in the treatment of leg ulcer (author's transl)].

    PubMed

    Privat, Y

    Pulva 47 Neomycine was tested in 30 patients suffering from a leg ulcer, 11 of those were surinfected. Half the ulcers dated back over 6 months. The would preparation included a careful cleaning with a permanganate or dakin's solution. In most of the cases, the product was applied on a once a day basis during an average period of 30 days. In 12 patients, the severity of the infection needed an additional antibiotherapy administered orally. The results were expressed in relation to the activity on the infection and wound healing. In 28 patients, the signs of infection disappeared completely. The wound healing effect was very satisfying in 22 patients (19 of them had varicose or post-phlebitis ulcers). The value of the results is independent on the date of onset and on the area of the lesions. The tolerance was good; only 4 patients suffered from itching after the application of the compound. It is mainly through his wound healing effect that Pulvo 47 Neomycine represents a progress compared to other similar specialties. PMID:224488

  10. Therapeutic effectiveness of a Mimosa tenuiflora cortex extract in venous leg ulceration treatment.

    PubMed

    Rivera-Arce, Erika; Chávez-Soto, Marco Antonio; Herrera-Arellano, Armando; Arzate, Silvia; Agüero, Juan; Feria-Romero, Iris Angélica; Cruz-Guzmán, Angélica; Lozoya, Xavier

    2007-02-12

    The cortex of Mimosa tenuiflora is a popular remedy utilized in Mexico for the treatment of skin lesions. Modern studies support the existence in this cortex of compounds with cicatrizing properties. In the present study the therapeutic effectiveness of an extract elaborated with this bark in the treatment of venous leg ulceration disease was explored. A randomized, double-blind, placebo-controlled clinical trial was conducted with ambulatory patients distributed into two groups, one receiving a hydrogel containing 5% of a crude extract standardized in its tannin concentration (1.8%), while the control group, was administered the same hydrogel but without addition of the extract. In both aseptic washings were performed initially followed by topical application of the corresponding hydrogel and dressing. Follow-up lasted 13 weeks and ulcer healing was determined through measurement of the lesion area by digital-photographic parameters. Therapeutic effectiveness occurred in all patients of the extract group; after the 8th treatment week, ulcer size was reduced by 92% as mean value in this group, whereas therapeutic effectiveness was observed only in one patient of the control group (chi(2), p=0.0001). No side effects were observed in any patient in either group. PMID:17088036

  11. Abnormal foot pressures alone may not cause ulceration.

    PubMed

    Masson, E A; Hay, E M; Stockley, I; Veves, A; Betts, R P; Boulton, A J

    1989-07-01

    Both rheumatoid arthritis and diabetes have been associated with the development of abnormally high pressures under the feet, and ulceration has been considered to be a problem in both conditions. In order to examine further the relationship between high foot pressure, neurological abnormalities, and ulceration, we have studied two groups of patients: (a) 38 diabetic patients and (b) 37 patients with rheumatoid arthritis who had similar clinical abnormalities of the feet. Thirty-two percent of diabetic patients had a history of plantar ulceration compared with none of the rheumatoid group (p less than 0.01). However, the diabetic group had considerably more severe neuropathy (peroneal nerve motor conduction velocity 35.4 +/- 4.8 m s-1 vs 44.4 +/- 5.2 m s-1 (mean +/- SD), p less than 0.001; vibration perception threshold 33.5 +/- 13.4 vs 16.9 +/- 10.9, p less than 0.001), with a similar frequency of elevated plantar pressures (51% vs 61%, NS). These data emphasize the importance of the loss of sensory awareness in the pathogenesis of diabetic foot ulceration, and suggest that high pressure alone is not a direct cause of ulceration. PMID:2527680

  12. Influence of psychosocial factors on coping and living with a venous leg ulcer.

    PubMed

    Peart, Joanna

    2015-06-01

    This clinical focus and literature review describe the effect of psychosocial factors on coping and living with a venous leg ulcer (VLU). The associated stressors of living with a VLU include: pain, loss of self-esteem, and social isolation, with subsequent negative emotions that could potentially lead to anxiety and depression. The ability to cope with a VLU depends upon the individual, with some patients employing negative coping strategies such as denial, depending on the stage of the illness and level of acceptance reached ( Husband, 2001 ; Brown, 2014 ). Psychosocial interventions by health professionals have been shown to reduce the stress of living with a VLU, to improve a patient's coping ability, and subsequently enhance wound healing. This article highlights the importance of holistic assessment and joint treatment planning, to incorporate patients' psychosocial needs and individual coping methods in order to reduce the associated stress of living with a VLU. PMID:26052991

  13. Prevalence rate for inherited thrombophilia in patients with chronic and recurrent venous leg ulceration.

    PubMed

    Wiszniewski, Adam; Bykowska, Ksenia; Bilski, Radoslaw; Ja?kowiak, Wojciech; Proniewski, Jacek

    2011-01-01

    The aim of the study was to determine the prevalence rate for inherited thrombophilia (IT) in patients with chronic (CVU) and recurrent venous leg ulceration. We also investigated and evaluated the severity of the clinical pattern of CVU in patients with and without IT. We examined 110 patients with CVU (the study group) and 110 healthy subjects (the control group). We prepared a questionnaire to be completed by each study participant. Ultrasound Doppler color imaging or/and duplex ultrasonography was performed to evaluate the efficiency of the venous system. The ankle-brachial index was calculated to determine the efficiency of the arterial system. We examined both groups for the presence of IT. IT was diagnosed in 30% of study group and in 1.8% of control group. Our diagnoses of deep vein thrombosis (DVT) were based on medical interviews, physical examinations, and an ultrasonography of the venous system and concerned 64 study group patients (58.2%), 35 of whom (31.8%) experienced recurrent DVT. Proximal and/or distal DVT was determined in an interview and/or by an ultrasonography performed for all patients with CVU and IT. In 94% of these patients, DVT was recurrent, and in 88% of patients with CVU and IT, we observed recurrent DVT and CVU. It recurred more often and persisted longer when compared to patients with CVU and no IT, despite similar management. No differences were observed in ulcer size, localization, or pain level related to ulceration between patients with CVU and IT and those with CVU and no IT. PMID:22092793

  14. Root Cause Analysis of Gastroduodenal Ulceration After Yttrium-90 Radioembolization

    SciTech Connect

    Lam, Marnix G. E. H. [Stanford University School of Medicine, Division of Interventional Radiology (United States); Banerjee, Subhas [Stanford University School of Medicine, Division of Gastroenterology and Hepatology (United States)] [Stanford University School of Medicine, Division of Gastroenterology and Hepatology (United States); Louie, John D.; Abdelmaksoud, Mohamed H. K. [Stanford University School of Medicine, Division of Interventional Radiology (United States)] [Stanford University School of Medicine, Division of Interventional Radiology (United States); Iagaru, Andrei H. [Stanford University School of Medicine, Division of Nuclear Medicine and Molecular Imaging (United States)] [Stanford University School of Medicine, Division of Nuclear Medicine and Molecular Imaging (United States); Ennen, Rebecca E.; Sze, Daniel Y., E-mail: dansze@stanford.edu [Stanford University School of Medicine, Division of Interventional Radiology (United States)

    2013-12-15

    IntroductionA root cause analysis was performed on the occurrence of gastroduodenal ulceration after hepatic radioembolization (RE). We aimed to identify the risk factors in the treated population and to determine the specific mechanism of nontarget RE in individual cases. Methods: The records of 247 consecutive patients treated with yttrium-90 RE for primary (n = 90) or metastatic (n = 157) liver cancer using either resin (n = 181) or glass (n = 66) microspheres were reviewed. All patients who developed a biopsy-proven microsphere-induced gastroduodenal ulcer were identified. Univariate and multivariate analyses were performed on baseline parameters and procedural data to determine possible risk factors in the total population. Individual cases were analyzed to ascertain the specific cause, including identification of the culprit vessel(s) leading to extrahepatic deposition of the microspheres. Results: Eight patients (3.2 %) developed a gastroduodenal ulcer. Stasis during injection was the strongest independent risk factor (p = 0.004), followed by distal origin of the gastroduodenal artery (p = 0.004), young age (p = 0.040), and proximal injection of the microspheres (p = 0.043). Prolonged administrations, pain during administration, whole liver treatment, and use of resin microspheres also showed interrelated trends in multivariate analysis. Retrospective review of intraprocedural and postprocedural imaging showed a probable or possible culprit vessel, each a tiny complex collateral vessel, in seven patients. Conclusion: Proximal administrations and those resulting in stasis of flow presented increased risk for gastroduodenal ulceration. Patients who had undergone bevacizumab therapy were at high risk for developing stasis.

  15. The journey to chronic pain: a grounded theory of older adults' experiences of pain associated with leg ulceration.

    PubMed

    Taverner, Tarnia; Closs, S José; Briggs, Michelle

    2014-03-01

    This study aimed to develop a grounded theory to describe and explain the experience of pain and its impact, as reported by the individuals who had pain associated with chronic leg ulceration. The Strauss and Corbin grounded theory approach was used. In-depth interviews were undertaken with 11 people aged ? 65 years from Leeds in the north of England. All participants were cared for by home care nurses and had painful leg ulceration. The emergent grounded theory centered on a core category of "The journey to chronic pain." The theory suggested a trajectory consisting of three phases that the patient experiences, where the end result is a chronic pain syndrome. In phase 1, leg ulcer pain has predominantly acute nociceptive properties, and if this is not managed effectively, or ulcers do not heal, persistent pain may develop with both nociceptive and neuropathic properties (i.e., phase 2). If phase 2 pain is not managed effectively, patients may then develop refractory long-term pain (phase 3). Those who progress to phase 3 tend to experience negative consequences such as insomnia, depression, and suicidal ideation. Only when health care professionals understand and acknowledge the persistent and long-term nature of the pain in this patient group can the pain be managed effectively. PMID:23402894

  16. A Comparison of the Efficacy and Cost of Different Venous Leg Ulcer Dressings: A Retrospective Cohort Study

    PubMed Central

    Hussain, Syed M. Asim

    2015-01-01

    Objective. To compare the efficacy and cost-effectiveness of simple nonadherent dressings with other more expensive dressing types in the treatment of venous leg ulcers. Study Design. Retrospective cohort study. Location. The leg ulcer clinic at the University Hospital of South Manchester. Subjects and Methods. The healing rates of twelve leg ulcer patients treated with simple nonadherent dressings (e.g., NA Ultra) were compared with an equal number of patients treated with modern dressings to determine differences in healing rates and cost. Main Outcome Measures. Rate of healing as determined by reduction in ulcer area over a specified period of time and total cost of dressing per patient. Results. Simple nonadherent dressings had a mean healing rate of 0.353?cm2/week (standard deviation ± 0.319) compared with a mean of 0.415?cm2/week (standard deviation ± 0.383) for more expensive dressings. This resulted in a one-tailed p value of 0.251 and a two-tailed p value of 0.508. Multiple regression analysis gave a significance F of 0.8134. Conclusion. The results indicate that the difference in healing rate between simple and modern dressings is not statistically significant. Therefore, the cost of dressing type should be an important factor influencing dressing selection. PMID:25954532

  17. Management of leg ulcers in patients with chronic venous insufficiency: the experience of a Dermatology Clinic in Bucharest, Romania.

    PubMed

    Salavastru, C M; Nedelcu, L E; Tiplica, G-S

    2012-01-01

    Venous ulcers are the most severe skin manifestation of chronic venous insufficiency. Treatment is complex and it is performed according to the stage of the disease. It includes changes of lifestyle, compressive therapy, phlebotropic medication, topical therapy of the ulcer, antibiotic therapy (topical and systemic), sclerotherapy, and surgical treatment. Patients with venous leg ulcers that attend the Second Dermatology Clinic of Colentina Clinical Hospital, are treated both as inpatients and as outpatients. They benefit from topical treatment and bandaging performed by specialized medical personnel in separate treatment room with strictly monitored conditions of asepsis and antisepsis. A follow-up study of these patients was made from January 1, 2009 to December 31, 2011. The average age of patients was 65.9 years (± 14.2), most of them being in the eight decade of life (31.9%). In almost half of the cases (44.2%), the patients spent more than 1 week in the hospital. Bacteriological investigations from the ulcers were performed in 55.1% of patients and the most frequent infectious agents were found to be Staphylococcus aureus (26.3%) and Enterobacter spp. (17.2%). Treatment of leg ulcer patients proves to be a long and complex one, a systematic and organized approach being needed in order to obtain healing of the wound. PMID:22950557

  18. Non-healing leg ulcers in a patient with dystrophic calcification and crest syndrome: a challenging clinical case.

    PubMed

    Al-Najjar, Mahmoud; Jackson, Mark J

    2011-10-01

    The management of non-healing leg ulcers in patients with CREST syndrome and subdermal calcification is rarely reported in medical literature. Only one similar case was found in the literature (1). Dealing with such patients can be a challenge for wound specialists. In this article, we discuss the clinical progress of an interesting case of extensive non-healing leg ulcers in a CREST patient with dystrophic calcification. The combination of systemic physiological deficits and immune compromise, along with the local physical abnormalities associated with the wound pose a complex multifactorial aetiological mix. There is no conclusive data on the optimal management of these wounds in CREST patients. It seems that ablation of the calcific deposits may offer some hope. PMID:21827631

  19. An adolescent with sickle cell anaemia experiencing disease-related complications: priapism and leg ulcer – a management challenge

    PubMed Central

    Vasconcelos, Alexandra; Prior, Ana Rita; Ferrão, Anabela; Morais, Anabela

    2012-01-01

    Sickle-cell anaemia (SCA) is a multi-system disease, associated with episodes of acute illness and progressive organ damage. Disease severity shows substantial variation and it is often a burden for adolescents. Complications such as leg ulcer and priapism have a significant impact on quality of life. There are still no definitive treatment guidelines available. Considering the embarrassing nature of priapism and the dire consequences for erectile dysfunction, it is important to inform patients, parents and providers about the relationship of SCA to prolonged painful erections. This article will review the pathophysiology and treatment options of SCA focusing the complications of leg ulcers, priapism, cholelithiasis and retinopathy. The case study of a 14-year-old boy is used to present a management challenge of multiple SCA-related complications. PMID:22605005

  20. Decreased Hematocrit-To-Viscosity Ratio and Increased Lactate Dehydrogenase Level in Patients with Sickle Cell Anemia and Recurrent Leg Ulcers

    PubMed Central

    Connes, Philippe; Lamarre, Yann; Hardy-Dessources, Marie-Dominique; Lemonne, Nathalie; Waltz, Xavier; Mougenel, Danièle; Mukisi-Mukaza, Martin; Lalanne-Mistrih, Marie-Laure; Tarer, Vanessa; Tressières, Benoit; Etienne-Julan, Maryse; Romana, Marc

    2013-01-01

    Leg ulcer is a disabling complication in patients with sickle cell anemia (SCA) but the exact pathophysiological mechanisms are unknown. The aim of this study was to identify the hematological and hemorheological alterations associated with recurrent leg ulcers. Sixty-two SCA patients who never experienced leg ulcers (ULC-) and 13 SCA patients with a positive history of recurrent leg ulcers (ULC+) - but with no leg ulcers at the time of the study – were recruited. All patients were in steady state condition. Blood was sampled to perform hematological, biochemical (hemolytic markers) and hemorheological analyses (blood viscosity, red blood cell deformability and aggregation properties). The hematocrit-to-viscosity ratio (HVR), which reflects the red blood cell oxygen transport efficiency, was calculated for each subject. Patients from the ULC+ group were older than patients from the ULC- group. Anemia (red blood cell count, hematocrit and hemoglobin levels) was more pronounced in the ULC+ group. Lactate dehydrogenase level was higher in the ULC+ group than in the ULC- group. Neither blood viscosity, nor RBC aggregation properties differed between the two groups. HVR was lower and RBC deformability tended to be reduced in the ULC+ group. Our study confirmed increased hemolytic rate and anemia in SCA patients with leg ulcers recurrence. Furthermore, our data suggest that although systemic blood viscosity is not a major factor involved in the pathophysiology of this complication, decreased red blood cell oxygen transport efficiency (i.e., low hematocrit/viscosity ratio) may play a role. PMID:24223994

  1. Transplantation of autologous keratinocyte suspension in fibrin matrix to chronic venous leg ulcers: improved long-term healing after removal of the fibrin carrier

    Microsoft Academic Search

    ANKE HARTMANN; JENNIFER QUIST; HENNING HAMM; E. B. Brocker; PETER FRIEDL

    2008-01-01

    BACKGROUND: The transplantation of keratinocytes suspended in fibrin carrier represents a candidate regimen for chronic ulcer treatment in an outpatient setting. We evaluated the integration and survival of autologous individualized keratinocytes applied within fibrin matrix onto chronic venous leg ulcers in vivo. Parallel in vitro culture was used to validate keratinocyte survival and apoptosis in fibrin compared to collagen matrix

  2. Use of weekly, low dose, high frequency ultrasound for hard to heal venous leg ulcers: the VenUS III randomised controlled trial

    PubMed Central

    2011-01-01

    Objective To assess the clinical effectiveness of weekly delivery of low dose, high frequency therapeutic ultrasound in conjunction with standard care for hard to heal venous leg ulcers. Design Multicentre, pragmatic, two arm randomised controlled trial. Setting Community and district nurse led services, community leg ulcer clinics, and hospital outpatient leg ulcer clinics in 12 urban and rural settings (11 in the United Kingdom and one in the Republic of Ireland). Participants 337 patients with at least one venous leg ulcer of >6 months’ duration or >5 cm2 area and an ankle brachial pressure index of ?0.8. Interventions Weekly administration of low dose, high frequency ultrasound therapy (0.5 W/cm2, 1 MHz, pulsed pattern of 1:4) for up to 12 weeks plus standard care compared with standard care alone. Main outcome measures Primary outcome was time to healing of the largest eligible leg ulcer. Secondary outcomes were proportion of patients healed by 12 months, percentage and absolute change in ulcer size, proportion of time participants were ulcer-free, health related quality of life, and adverse events. Results The two groups showed no significant difference in the time to healing of the reference leg ulcer (log rank test, P=0.61). After adjustment for baseline ulcer area, baseline ulcer duration, use of compression bandaging, and study centre, there was still no evidence of a difference in time to healing (hazard ratio 0.99 (95% confidence interval 0.70 to 1.40), P=0.97). The median time to healing of the reference leg ulcer was inestimable. There was no significant difference between groups in the proportion of participants with all ulcers healed by 12 months (72/168 in ultrasound group v 78/169 in standard care group, P=0.39 for Fisher’s exact test) nor in the change in ulcer size at four weeks by treatment group (model estimate 0.05 (95% CI –0.09 to 0.19)). There was no difference in time to complete healing of all ulcers (log rank test, P=0.61), with median time to healing of 328 days (95% CI 235 to inestimable) with standard care and 365 days (224 days to inestimable) with ultrasound. There was no evidence of a difference in rates of recurrence of healed ulcers (17/31 with ultrasound v 14/31 with standard care, P=0.68 for Fisher’s exact test). There was no difference between the two groups in health related quality of life, both for the physical component score (model estimate 0.69 (–1.79 to 3.08)) and the mental component score (model estimate –0.93 (–3.30 to 1.44)), but there were significantly more adverse events in the ultrasound group (model estimate 0.30 (0.01 to 0.60)). There was a significant relation between time to ulcer healing and baseline ulcer area (hazard ratio 0.64 (0.55 to 0.75)) and baseline ulcer duration (hazard ratio 0.59 (0.50 to 0.71)), with larger and older ulcers taking longer to heal. In addition, those centres with high recruitment rates had the highest healing rates. Conclusions Low dose, high frequency ultrasound administered weekly for 12 weeks during dressing changes in addition to standard care did not increase ulcer healing rates, affect quality of life, or reduce ulcer recurrence. Trial registration ISRCTN21175670 and National Research Register N0484162339 PMID:21385806

  3. The trigeminal trophic syndrome: an unusual cause of nasal ulceration

    Microsoft Academic Search

    Seetha U Monrad; Jeffrey E Terrell; David M Aronoff

    2004-01-01

    Trigeminal trophic syndrome (TTS) is an unusual complication after peripheral or central damage to the trigeminal nerve, characterized by anesthesia, paresthesias, and ala nasi ulceration. We describe a patient with classic TTS after trigeminal rhizotomy who underwent several extensive evaluations for nasal ulceration and received prolonged immunosuppressive therapy for a presumed autoimmune disorder before the correct diagnosis was made. An

  4. Principles and technique of foam sclerotherapy and its specific use in the treatment of venous leg ulcers.

    PubMed

    Simka, Marian

    2011-09-01

    Invention of foam sclerotherapy has significantly changed the current phlebological practice. Compared with liquid sclerosants, obliterating foam is more efficient, especially for the closure of larger veins. This review discusses clinical aspects of foam sclerotherapy with a focus on its use for the treatment of venous leg ulceration, including the rationale for its use in the treatment of these chronic wounds, physicochemical mechanisms responsible for stability and disintegration of sclerosant foam, pathomechanism of neurologic adverse events seen after foam sclerotherapy, and techniques that can increase efficacy of this procedure and lower frequency of adverse events. PMID:21856975

  5. Ulcers

    MedlinePLUS

    ... your stomach makes. What about other medicines? Several other medicines can be used to help treat ulcers. Two types of medicines (H2 blockers and proton pump inhibitors) reduce the amount of acid that ...

  6. Cost-Effective Use of Silver Dressings for the Treatment of Hard-to-Heal Chronic Venous Leg Ulcers

    PubMed Central

    Jemec, Gregor B. E.; Kerihuel, Jean Charles; Ousey, Karen; Lauemøller, Sanne Lise; Leaper, David John

    2014-01-01

    Aim To estimate the cost-effectiveness of silver dressings using a health economic model based on time-to-wound-healing in hard-to-heal chronic venous leg ulcers (VLUs). Background Chronic venous ulceration affects 1–3% of the adult population and typically has a protracted course of healing, resulting in considerable costs to the healthcare system. The pathogenesis of VLUs includes excessive and prolonged inflammation which is often related to critical colonisation and early infection. The use of silver dressings to control this bioburden and improve wound healing rates remains controversial. Methods A decision tree was constructed to evaluate the cost-effectiveness of treatment with silver compared with non-silver dressings for four weeks in a primary care setting. The outcomes: ‘Healed ulcer’, ‘Healing ulcer’ or ‘No improvement’ were developed, reflecting the relative reduction in ulcer area from baseline to four weeks of treatment. A data set from a recent meta-analysis, based on four RCTs, was applied to the model. Results Treatment with silver dressings for an initial four weeks was found to give a total cost saving (£141.57) compared with treatment with non-silver dressings. In addition, patients treated with silver dressings had a faster wound closure compared with those who had been treated with non-silver dressings. Conclusion The use of silver dressings improves healing time and can lead to overall cost savings. These results can be used to guide healthcare decision makers in evaluating the economic aspects of treatment with silver dressings in hard-to-heal chronic VLUs. PMID:24945381

  7. Strategies and approaches towards evidence-based practice in the management of chronic leg ulcers by nurses working in the community in Kronoberg County, Sweden and the East Riding & Hull, UK

    Microsoft Academic Search

    Britt-Lousie Anderson

    2003-01-01

    Aim: This paper reports one aspect of a study concerning management of chronic leg ulcers by nurses working in the community in Kronoberg County, Sweden (KC) and the East Riding & Hull, UK (ER). Our study focus was to describe reported evidence-based practice in leg ulcer care in two samples of nurses from two countries. The paper describes the overall

  8. Chronic venous ulceration of leg associated with peripheral arterial disease: an underappreciated entity in developing country.

    PubMed

    Nag, Falguni; De, Abhishek; Hazra, Avijit; Chatterjee, Gobinda; Ghosh, Arghyaprasun; Surana, Trupti V

    2014-10-01

    Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle-Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non-invasive outpatient department (OPD)-based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries. PMID:23170845

  9. The trigeminal trophic syndrome: an unusual cause of nasal ulceration.

    PubMed

    Monrad, Seetha U; Terrell, Jeffrey E; Aronoff, David M

    2004-06-01

    Trigeminal trophic syndrome (TTS) is an unusual complication after peripheral or central damage to the trigeminal nerve, characterized by anesthesia, paresthesias, and ala nasi ulceration. We describe a patient with classic TTS after trigeminal rhizotomy who underwent several extensive evaluations for nasal ulceration and received prolonged immunosuppressive therapy for a presumed autoimmune disorder before the correct diagnosis was made. An understanding of the predisposing factors and clinical presentation of TTS is important to ensure a timely diagnosis of this difficult-to-treat illness. Differentiation of TTS from malignancy, infection, or vasculitis is possible on the basis of clinical history, tissue biopsy, and serologic evaluation. PMID:15153901

  10. Success Rate of Split-Thickness Skin Grafting of Chronic Venous Leg Ulcers Depends on the Presence of Pseudomonas aeruginosa: A Retrospective Study

    Microsoft Academic Search

    Trine Høgsberg; Thomas Bjarnsholt; Jens Schiersing Thomsen; Klaus Kirketerp-Møller; Markus M. Heimesaat

    2011-01-01

    The last years of research have proposed that bacteria might be involved in and contribute to the lack of healing of chronic wounds. Especially it seems that Pseudomonas aeruginosa play a crucial role in the healing. At Copenhagen Wound Healing Centre it was for many years clinical suspected that once chronic venous leg ulcers were colonized (weeks or months preoperatively)

  11. The clinical feasibility of natural medicine, venotonic therapy and horsechestnut seed extract in the treatment of venous leg ulceration: a descriptive survey

    Microsoft Academic Search

    Matthew J Leach

    2004-01-01

    Background: The primary treatment of choice for venous leg ulceration (VLU) is compression therapy, however serious clinical issues demand the development of new treatments. An extract believed to promote VLU healing is Horsechestnut Seed Extract (HCSE).Methods: The clinical feasibility of HCSE in VLU was explored in a two-stage design. The second stage presented here, was a descriptive survey exploring current

  12. Testing the effectiveness of a self-efficacy based exercise intervention for adults with venous leg ulcers: protocol of a randomised controlled trial

    PubMed Central

    2014-01-01

    Background Exercise and adequate self-management capacity may be important strategies in the management of venous leg ulcers. However, it remains unclear if exercise improves the healing rates of venous leg ulcers and if a self-management exercise program based on self-efficacy theory is well adhered to. Method/design This is a randomised controlled in adults with venous leg ulcers to determine the effectiveness of a self-efficacy based exercise intervention. Participants with venous leg ulcers are recruited from 3 clinical sites in Australia. After collection of baseline data, participants are randomised to either an intervention group or control group. The control group receive usual care, as recommended by evidence based guidelines. The intervention group receive an individualised program of calf muscle exercises and walking. The twelve week exercise program integrates multiple elements, including up to six telephone delivered behavioural coaching and goal setting sessions, supported by written materials, a pedometer and two follow-up booster calls if required. Participants are encouraged to seek social support among their friends, self-monitor their weekly steps and lower limb exercises. The control group are supported by a generic information sheet that the intervention group also receive encouraging lower limb exercises, a pedometer for self-management and phone calls at the same time points as the intervention group. The primary outcome is the healing rates of venous leg ulcers which are assessed at fortnightly clinic appointments. Secondary outcomes, assessed at baseline and 12 weeks: functional ability (range of ankle motion and Tinetti gait and balance score), quality of life and self-management scores. Discussion This study seeks to address a significant gap in current wound management practice by providing evidence for the effectiveness of a home-based exercise program for adults with venous leg ulcers. Theory-driven, evidence-based strategies that can improve an individual’s exercise self-efficacy and self-management capacity could have a significant impact in improving the management of people with venous leg ulcers. Information gained from this study will provide much needed information on management of this chronic disease to promote health and independence in this population. Trial registration Australian New Zealand Clinical Trials Registry ACTRN12612000475842. PMID:25277416

  13. Silver treatments and silver-impregnated dressings for the healing of leg wounds and ulcers: a systematic review and meta-analysis.

    PubMed

    Carter, Marissa J; Tingley-Kelley, Kimberly; Warriner, Robert A

    2010-10-01

    Previous systematic reviews of silver-impregnated dressings have been contradictory regarding the healing of leg wounds/ulcers. Our systematic review was restricted to randomized controlled trials. Cochrane Library, Scopus, and MEDLINE databases were searched using the term "silver" in combination with "wound" or "ulcer" (and plural versions) without date/language restriction. Study quality was assessed and meta-analysis conducted for complete wound healing, wound size reduction, and healing rates. Overall study quality was fair with most studies having some bias. Evidence for wound healing using individual studies was poor. Meta-analyses found strong evidence for wound healing based on wound size reduction but no evidence based on complete wound-healing or healing rates. Although our results provide some evidence that silver-impregnated dressings improve the short-term healing of wounds and ulcers, long-term effects remain unclear. Clinical trial data with longer follow-up times are needed to address these issues. PMID:20471135

  14. Treatment of chronic diabetic lower leg ulcers with activated protein C: a randomised placebo-controlled, double-blind pilot clinical trial.

    PubMed

    Whitmont, Kaley; McKelvey, Kelly J; Fulcher, Gregory; Reid, Ian; March, Lyn; Xue, Meilang; Cooper, Alan; Jackson, Christopher J

    2015-08-01

    Lower leg ulcers are a serious and long-term complication in patients with diabetes and pose a major health concern because of the increasing number of patients diagnosed with diabetes each year. This study sought to evaluate the clinical benefit of topical activated protein C (APC) on chronic lower leg ulcers in patients with diabetes. Twelve patients were randomly assigned to receive either APC (N = 6) or physiological saline (placebo; N = 6) in a randomised, placebo-controlled, double-blind pilot clinical trial. Treatment was administered topically, twice weekly for 6 weeks with final follow-up at 20 weeks. Wound area was significantly reduced to 34·8 ± 16·4% of week 0 levels at 20 weeks in APC-treated wounds (p = 0·01). At 20 weeks, three APC-treated wounds had completely healed, compared to one saline-treated wound. Full-thickness wound edge skin biopsies showed reduced inflammatory cell infiltration and increased vascular proliferation following APC treatment. Patient stress scores were also significantly reduced following APC treatment (p < 0·05), demonstrating improved patient quality of life as assessed by the Cardiff Wound Impact Questionnaire. This pilot trial suggests that APC is a safe topical agent for healing chronic lower leg ulcers in patients with diabetes and provides supporting evidence for a larger clinical trial. PMID:23848141

  15. Compression and venous ulcers.

    PubMed

    Stücker, M; Link, K; Reich-Schupke, S; Altmeyer, P; Doerler, M

    2013-03-01

    Compression therapy is considered to be the most important conservative treatment of venous leg ulcers. Until a few years ago, compression bandages were regarded as first-line therapy of venous leg ulcers. However, to date medical compression stockings are the first choice of treatment. With respect to compression therapy of venous leg ulcers the following statements are widely accepted: 1. Compression improves the healing of ulcers when compared with no compression; 2. Multicomponent compression systems are more effective than single-component compression systems; 3. High compression is more effective than lower compression; 4. Medical compression stockings are more effective than compression with short stretch bandages. Healed venous leg ulcers show a high relapse rate without ongoing treatment. The use of medical stockings significantly reduces the amount of recurrent ulcers. Furthermore, the relapse rate of venous leg ulcers can be significantly reduced by a combination of compression therapy and surgery of varicose veins compared with compression therapy alone. PMID:23482538

  16. Ulcerative Colitis

    MedlinePLUS

    Ulcerative colitis (UC) is a disease that causes inflammation and sores, called ulcers, in the lining of the rectum and colon. It is one of a group of diseases called inflammatory bowel disease. UC can happen at ...

  17. Effectiveness and tissue compatibility of a 12-week treatment of chronic venous leg ulcers with an octenidine based antiseptic--a randomized, double-blind controlled study.

    PubMed

    Vanscheidt, Wolfgang; Harding, Keith; Téot, Luc; Siebert, Jörg

    2012-06-01

    The aim of this study was to evaluate the cytotoxic effect of octenidine dihydrochloride/phenoxyethanol (OHP) found in vitro by conducting a randomized, double-blind controlled clinical study focusing on its safe and effective use in chronic venous leg ulcers. In total, 126 male and female patients were treated with either OHP (n = 60) or Ringer solution (n = 66). The treatment lasted over a period of maximum 12 weeks. For the assessment of the wound-healing process, clinical outcome parameters were employed, that is, time span until 100% epithelization, wound status and the wound surface area were analysed. Side effects were recorded during the study period. The median time to complete ulcer healing was comparable between the OHP and Ringer solution groups (92 versus 87 days; P = 0·952), without being influenced by wound size or duration of the target ulcer (P-values: 0·947/0·978). In patients treated with OHP, fewer adverse events (AEs) were observed compared with the Ringer group (17% versus 29% of patients reported 20 versus 38 AEs). OHP is well suitable for the treatment of chronic wounds without cytotoxic effects. Furthermore, OHP does not impair the wound healing in chronic venous ulcers. PMID:22074592

  18. Leg cramps in pregnancy caused by chronic compartment syndrome and relieved by fasciotomy after childbirth

    PubMed Central

    Orlin, Jan Roar; Øen, Jarle; Andersen, John Roger; Tjugum, Ivar Jostein; Westbye, Hans Jacob; Roska, Jomar; Aasved, Helene; Hjelmeland, Kjersti

    2014-01-01

    Key Clinical Message A case of intolerable leg pain in pregnancy, caused by Chronic Compartment Syndrome (CCS), is presented. Increasing amounts of opioids were given throughout the pregnancy. Anesthetical dilemmas and surgery are discussed. In conclusion, early surgery rather than opioids is recommended. PMID:25356260

  19. Prevention of metabolic alterations caused by suspension hypokinesia in leg muscles of rats

    NASA Technical Reports Server (NTRS)

    Tischler, M. E.; Jaspers, S. R.; Fagan, J. M.

    1983-01-01

    Rats were subjected to tail-cast suspension hypokinesia for 6 days with one leg immobilized in dorsal flexion by casting. Control animals were also tail-casted. The soleus, gastrocnemius and plantaris muscles of uncasted hypokinetic legs were smaller than control muscles. Dorsal flexion prevented atrophy of these muscles and caused the soleus to hypertrophy. The anterior muscles were unaffected by hypokinesia. The smaller size of the soleus of the uncasted leg relative to the dorsal flexed and weight bearing limbs correlated with slower protein synthesis and faster proteolysis. The capacity of this muscle to synthesize glutamine (gln), which carries nitrogenous waste from muscle was also measured. Although tissue homogenates showed higher activities of gln synthetase, the rate of de novo synthesis was not altered in intact muscle but the tissue ratio of gln/glutamate was decreased. Glutamate and ATP were not limiting for gln synthesis, but availability of ammonia may be a limiting factor for this process in hypokinesia.

  20. Protective effect of collagen derivates on the ulcerative lesions caused by oral administration of ethanol.

    PubMed

    Castro, G A; Sgarbieri, V C; Carvalho, J E; Tinti, S V; Possenti, A

    2007-03-01

    The protective effect of beef and pig collagen hydrolysates and their fractions were tested as anti-ulcerogenic agents in rats (weighing 250-350 g) against ulcerative lesions caused by ethanol. Beef and pig collagen hydrolysates were fractionated by ultrafiltration into different molecular weight fractions. The protocol employed a negative and a positive control and a single dose of the experimental samples given by intragastric intubation. The beef collagen did not present a dose-response correlation in the ethanol model, whereas pig collagen showed a logarithmic dose-response relationship. Beef collagen hydrolysate decreased the ulcerative lesion index of 55% versus a 61% decrease for pig collagen hydrolysate at the same dosage (750 mg/kg of body weight). No significant differences were found (P > .05) between the hydrolysates and their fractions. PMID:17472480

  1. Restless Legs

    MedlinePLUS

    Restless legs syndrome (RLS) causes a powerful urge to move your legs. Your legs become uncomfortable when you are lying down or sitting. Some ... asleep. In most cases, there is no known cause for RLS. In other cases, RLS is caused by a ...

  2. Leg ulcer and osteomyelitis due to methicillin-susceptible Staphylococcus aureus infection after fracture repair treatment: a case highlighting the potential role of prostaglandin E? vasodilator.

    PubMed

    Bentivegna, Erminia; Citarrella, Emanuele; Vivaldi, Roberto; De Luca, Dario; Maira, Giovanna Grazia; Casuccio, Alessandra; Di Carlo, Paola

    2015-03-01

    Prostaglandins appear to reduce biofilm formation and chronicization of infections, and stimulate a rapid and effective clearance of infecting micro-organisms. We report a case of recovery from methicillin-susceptible Staphylococcus aureus (MSSA) osteomyelitis after multidisciplinary management with antibiotics, anti-thrombotics and prostaglandin E1 (PGE1) vasodilator, in a patient with tibial plateau fracture repaired with internal fixation devices. A 47-year-old HIV-negative male with chronic ulcer on the proximal third of the left leg was admitted to the Orthopaedic Unit of the Orestano Clinic in Palermo, Italy, for suspected osteomyelitis. A biopsy of the skin ulcer and blood cultures were performed and resulted positive for MSSA. Labelled leukocyte scintigraphy confirmed osteomyelitis. No clinical improvement was observed after combined antibiotic treatment with rifampicin plus trimethoprim-sulfamethoxazole. The patient underwent a 4-day therapeutic cycle: PGE1 (alprostadil 60 mg/day IV) combined with nadroparin calcium plus gentamicin, followed by treatment with aminaftone plus sulodexide plus levofloxacin. At discharge, the patient's painful symptoms had completely resolved and the ulcer had cicatrized; recovery from osteomyelitis was confirmed by scintigraphy. This treatment protocol including PGE1 may result in a significant improvement in quality of life and functional status of patients with a reduction in direct and indirect costs and economic benefit for the National Health Service. PMID:25819055

  3. A Real World, Observational Registry of Chronic Wounds and Ulcers

    ClinicalTrials.gov

    2014-10-29

    Diabetic Foot; Varicose Ulcer; Pressure Ulcer; Surgical Wound Dehiscence; Vasculitis; Skin Ulcer; Leg Ulcer; Wounds and Injuries; Pyoderma; Peripheral Arterial Disease; Diabetic Neuropathies; Lymphedema; Venous Insufficiency; Diabetes Complications; Amputation Stump

  4. Evaluation of the bacterial diversity among and within individual venous leg ulcers using bacterial tag-encoded FLX and Titanium amplicon pyrosequencing and metagenomic approaches

    PubMed Central

    2009-01-01

    Background Approximately 1 out of every 100 individuals has some form of venous insufficiency, which can lead to chronic venous disease and Venous Leg Ulcer (VLU). There are known underlying pathologies which contribute to the chronic nature of VLU including biofilm phenotype infections. Results Using pyrosequencing based approaches we evaluated VLU to characterize their microbial ecology. Results show that VLU infections are polymicrobial with no single bacterium colonizing the wounds. The most ubiquitous and predominant organisms include a previously uncharacterized bacteroidales, various anaerobes, Staphylococcus, Corynebacterium, and Serratia. Topological analysis of VLU show some notable differences in bacterial populations across the surface of the wounds highlighting the importance of sampling techniques during diagnostics. Metagenomics provide a preliminary indication that there may be protozoa, fungi and possibly an undescribed virus associated with these wounds. Conclusion The polymicrobial nature of VLU and previous research on diabetic foot ulcers and surgical site infections suggest that the future of therapy for such wounds lies in the core of the logical and proven multiple concurrent strategy approach, which has been termed "biofilm-based wound care" and the use of individualized therapeutics rather than in a single treatment modality. PMID:19860898

  5. Clinical evaluation of the efficacy and safety of a medical device in various forms containing Triticum vulgare for the treatment of venous leg ulcers – a randomized pilot study

    PubMed Central

    Romanelli, Marco; Macchia, Michela; Panduri, Salvatore; Paggi, Battistino; Saponati, Giorgio; Dini, Valentina

    2015-01-01

    This study was carried out to assess the efficacy and tolerability of the topical application of an aqueous extract of Triticum vulgare (TV) in different vehicles (cream, impregnated gauzes, foam, hydrogel, and dressing gel) for the treatment of venous lower leg ulcers. Fifty patients were randomized to receive one of the five investigational vehicles. Treatment was performed up to complete healing or to a maximum of 29 days. The wound size reduction from baseline was the primary efficacy variable, which was measured by means of a noninvasive laser scanner instrument for wound assessment. In all groups, apart from the foam group, a similar trend toward the reduction of the surface area was observed. The cream showed the greatest effect on the mean reduction of the lesion size. At last visit, six ulcers were healed: two in the cream group, three in the gauze group, and one in the dressing gel group. In the patients treated with the cream, the gauzes, the hydrogel, and the dressing gel, the reduction of lesion size was 40%–50%; the reduction was smaller in the foam group. No impact in terms of age on the healing process was found. The Total Symptoms Score decreased in all groups during the study; a greater efficacy in terms of signs/symptoms was observed in the patients treated with the gauzes. In the dressing gel group, one patient had an infection of the wound after 3 weeks of treatment and 2 of colonization, leading to a systemic antibiotic treatment. The events were judged as nonrelated to the device used. On the basis of the results, it could be argued that the medical device may be useful in the treatment of chronic venous ulcers. PMID:26060395

  6. Causes of Ring-Related Leg Injuries in Birds – Evidence and Recommendations from Four Field Studies

    PubMed Central

    Griesser, Michael; Schneider, Nicole A.; Collis, Mary-Anne; Overs, Anthony; Guppy, Michael; Guppy, Sarah; Takeuchi, Naoko; Collins, Pete; Peters, Anne; Hall, Michelle L.

    2012-01-01

    One of the main techniques for recognizing individuals in avian field research is marking birds with plastic and metal leg rings. However, in some species individuals may react negatively to rings, causing leg injuries and, in extreme cases, the loss of a foot or limb. Here, we report problems that arise from ringing and illustrate solutions based on field data from Brown Thornbills (Acanthiza pusilla) (2 populations), Siberian Jays (Perisoreus infaustus) and Purple-crowned Fairy-wrens (Malurus coronatus). We encountered three problems caused by plastic rings: inflammations triggered by material accumulating under the ring (Purple-crowned Fairy-wrens), contact inflammations as a consequence of plastic rings touching the foot or tibio-tarsal joint (Brown Thornbills), and toes or the foot getting trapped in partly unwrapped flat-band colour rings (Siberian Jays). Metal rings caused two problems: the edges of aluminium rings bent inwards if mounted on top of each other (Brown Thornbills), and too small a ring size led to inflammation (Purple-crowned Fairy-wrens). We overcame these problems by changing the ringing technique (using different ring types or larger rings), or using different adhesive. Additionally, we developed and tested a novel, simple technique of gluing plastic rings onto metal rings in Brown Thornbills. A review of studies reporting ring injuries (N?=?23) showed that small birds (<55 g body weight) are more prone to leg infections while larger birds (>35 g) tend to get rings stuck over their feet. We give methodological advice on how these problems can be avoided, and suggest a ringing hazard index to compare the impact of ringing in terms of injury on different bird species. Finally, to facilitate improvements in ringing techniques, we encourage online deposition of information regarding ringing injuries of birds at a website hosted by the European Union for Bird Ringing (EURING). PMID:23300574

  7. Ileocolic Intussusception Caused by a Giant Ulcerating Lipoma of Bauhin's Valve: an Unusual Cause of Intestinal Obstruction in the Adult.

    PubMed

    Gys, B; Haenen, F; Gys, T

    2015-04-01

    We report a case of intestinal obstruction in a 73-year-old woman caused by ileocolic intussusception. The underlying cause was a giant submucosal ulcerating lipoma (6?×?3.3?×?3.8 cm) extending from the superior mucosal lip of Bauhin's valve. Abdominal ultrasonography showed a pathognomonic target-like mass appearing as multiple concentric rings. CT scan confirmed the diagnosis. Because of apparent obstruction, a laparotomy with right hemicolectomy and ileocolic anastomosis was performed. Lipomas most frequently occur in the cecum and ascending colon where they represent the most common submucosal mesenchymal tumor. They typically occur in elderly women with an incidence that varies from 0.15 to 0.56 %. Pain, rectal bleeding, and obstruction are typical symptoms. When faced with an intussusception in children, reduction with air per rectum can be performed. In adults, however, malignant cell spreading and seeding is of big concern. Since approximately 20-50 % of all underlying causes are malignant, explorative surgery is favored in adults. PMID:25972625

  8. A severe case of esophageal ulcer causing a tight stricture despite long-term D-penicillamine treatment.

    PubMed

    Yapali, Suna; Turan, Ilker; Ozutemiz, Omer; Tekesin, Oktay

    2014-12-01

    D-penicillamine has long been used in the management of rheumatic diseases due to the effects on inhibition of collagen synthesis. Herein, we report a severe case of esophageal ulcer causing a tight stricture extending through the distal esophagus despite the long-term D-penicillamine treatment in a patient with Wilson's disease. D-penicillamine would theoretically be expected to contribute to the healing of an esophageal ulcer. However, the drug failed to have a favorable outcome, which is notable and worth reporting. PMID:25234939

  9. Ulcerative Porokeratosis

    Microsoft Academic Search

    T. Watanabe; T. Murakami; H. Okochi; K. Kikuchi; M. Furue

    1998-01-01

    A 54-year-old man presented with multiple annular plaques since infancy. During the intake of nifedipine and nitroglycerin over a period of 6 years, reddish, eruptive and ulcerative changes were seen in the pre-existing skin lesions on the penis, scrotum and legs. In addition to a typical cornoid lamella, histological examination revealed a band-like infiltration beneath the epidermis, liquefaction degeneration of

  10. Successful treatment of a colonic ulcer penetrating the urinary bladder caused by the administration of calcium polystyrene sulfonate and sorbitol.

    PubMed

    Shioya, Takeshi; Yoshino, Masanori; Ogata, Masao; Shibuya, Tetsuo; Tokunaga, Akira; Matsumoto, Koshi; Tajiri, Takashi

    2007-10-01

    A 77-year-old woman was urgently admitted for the treatment of diabetic ketoacidosis and a duodenal ulcer hemorrhage in March 1999. She had a history of diabetes and angina pectoris. After admission, she received oral calcium polystyrene sulfonate and sorbitol to treat hyperkalemia. Nine days later, severe abdominal pain developed. A colonoscopic examination revealed a sigmoid colonic ulcer and stenosis; the patient was treated conservatively. At a 1-year follow-up examination, the colonic stenosis was found have worsened; pneumaturia developed in January 2001. The patient was found to have a sigmoidovesical fistula and underwent sigmoidectomy and partial resection of the ileum and urinary bladder. The histological findings were a benign colonic ulcer with the infiltration of inflammatory cells, mainly lymphocytes. Rhomboidal, dark violet Kayexalate crystals were observed on microscope examination in the submucosa in both the first and second colonic biopsy specimens. We concluded that the colonic ulcer and the sigmoidovesical fistula had been caused by the administration of calcium polystyrene sulfonate and sorbitol. Reports of colonic perforation as a result of the administration of calcium polystyrene sulfonate and sorbitol are rare. Here, we report the successful treatment of a colonic ulcer that had penetrated the urinary bladder. PMID:17965530

  11. Low-frequency ultrasound for patients with lower leg ulcers due to chronic venous insufficiency: a report of two cases.

    PubMed

    Maher, Sara F; Halverson, Jessica; Misiewicz, Rob; Reckling, Trisha; Smart, Ojas; Benton, Carol; Schoenherr, Dawn

    2014-02-01

    Low-frequency ultrasound may facilitate debridement and healing of chronic wounds, including lower leg wounds in patients with chronic venous insufficiency (CVI). To evaluate the use of a low-frequency ultrasound (LFU) device with a curette, two patients with CVI and chronic wounds were treated for a period of 2 to 3 weeks. A 63-year-old woman with rheumatoid arthritis and two wounds, one on the right lower leg (250 cm³) and one wound on the left medial leg (0.80 cm³), present for 12 months; and a 77-year-old man with cardiopulmonary issues with seven wounds, three on the left medial calf (1.2 cm³, 11.40 cm³, and 0.72 cm³), one on the left anterior calf (0.30 cm³), two on the right posterior calf (0.90 cm³, 0.30 cm³), and one on the right anterior calf (0.14 cm³), present for 3 months consented to participate in the study. Both patients received low-intensity (50-70 ?m), low-frequency (35 kHz) ultrasound at an intensity of 50% through a saline mist in addition to antimicrobial dressing with silver, a multilayer compression bandage system applied at every visit, and pain medication as needed. Both patients received treatments every 1 to 3 weeks that were not timed. Treatment continued until no additional slough or other necrotic tissue could be removed from the wound bed; the female patient received two treatment sessions and the male received three. Average wound volume did not change significantly from the first to last treatment session (t(8)-1.2, P = 0.26). Five wounds (56%) with initial measurements of 0.8 cm³, 0.72 cm³, 0.3 cm³, 0.3 cm³, and 0.14 cm³ reduced in volume by 100%. Mean wound characteristic scores changed significantly (P <0.05) for amount of fibrin, periwound skin, drainage amount, and color. In addition, the number of wounds filled with slough decreased from 89% at the first session to 22% at the final treatment session. The results of this study suggest LFU may have been beneficial for these patients with CVI. Additional studies using larger sample sizes are needed to evaluate the effect of this treatment on a variety of chronic wounds and to compare its effectiveness to other debridement methods. PMID:24515985

  12. A randomised comparative trial on the use of a hydrogel with tepescohuite extract (Mimosa tenuiflora cortex extract-2G) in the treatment of venous leg ulcers.

    PubMed

    Lammoglia-Ordiales, Lorena; Vega-Memije, Maria Elisa; Herrera-Arellano, Armando; Rivera-Arce, Erika; Agüero, Juan; Vargas-Martinez, Felipe; Contreras-Ruiz, José

    2012-08-01

    Tepescohuite is an extract obtained from the bark of the Mimosa tenuiflora tree and is used as an empirical treatment in wounds for its healing and antiseptic properties. Venous leg ulcers (VLUs) are a common health care problem in most countries with a high rate of morbidity. The standard of care is moist interactive healing and compression; however, the ideal topical treatment is yet to be established. This study is designed to evaluate the effectiveness and safety of M. tenuiflora cortex extract (MTC-2G) in the treatment of VLUs in an Interdisciplinary Wound and Ostomy Care Center (IWOCC). A randomised, placebo-controlled, double blind clinical trial was conducted to compare the use of a hydrogel containing MTC-2G with the hydrogel alone in VLUs. The study included all patients with venous ulcers referred to the IWOCC. Laboratory tests and tissue biopsies were performed at the beginning and at the end of the study. The patients were instructed to daily cleansing followed by topical application of the hydrogel and compression. Forty-one patients were included, 22 patients received the MTC-2G and 19 patients received the hydrogel only. Of the 41 patients, 32 completed the study, 18 in the experimental arm and 14 in the control group, 19 were women and 13 men. The mean age of the subjects was 60 years. The mean time from presentation was 38 months. The mean surface reduction was 6·29 cm(2) [confidence interval (IC) 95%: 3·28-9·29] (P = 0·0001) in the MTC-2G group and 5·85 cm(2) (95% CI: 3·58-8·12) (P = 0·001) in the hydrogel group. There was no significant difference between the groups (P = 0·815). No changes in the laboratory parameters were noted. In the histology, there were not any differences between groups either. A hydrogel containing MTC-2G was not superior to a hydrogel alone in the treatment of VLUs. PMID:22128789

  13. [Effects of mono-, poly- and composite probiotics on the ulceration caused by restraint stress].

    PubMed

    Virchenko, O V; Falalyeyeva, T M; Beregova, T V; Spivak, M Y; Lazarenko, L M; Demchenko, O M

    2015-01-01

    It was studied the effect of probiotic strains of Bifidobacterium animalis VKL, Bifidobacterium animalis VKB and Lactobacillus casei IMVB-7280, and their mixtures on erosive and ulcerative lesions of the gastric mucosa (GM) of rats. GM was induced by water-immersion restraint stress. It was found that investigated probiotics did not have gastroprotective properties under a single and seven-day prophylactic administration. However, multiprobiotics (polyprobiotic Bifidobacterium animalis VKL and Bifidobacterium animalis VKB and composite probiotic Bifidobacterium animalis VKL, Bifidobacterium animalis VKB and Lactobacillus casei IMVB-7280) reduced the erosive and ulcerative lesions and the intensity of bleeding in rat GM when given within 14 days. It was shown that one of the mechanisms of antiulcer preventive effect of the multistrain probiotics is the restoration of pro/antioxidant balance in the GM under the stress action. The obtained results show the effectiveness of poly- and composite probiotics in the gastric ulcer prevention. PMID:26040033

  14. Gastrointestinal symptoms resembling ulcerative proctitis caused by larvae of the drone fly Eristalis tenax.

    PubMed

    Desoubeaux, Guillaume; Gaillard, Julien; Borée-Moreau, Diane; Bailly, Éric; Andres, Christian R; Chandenier, Jacques

    2014-04-01

    We report a case of facultative intestinal myiasis due to larvae of the drone fly Eristalis tenax, also named the rat-tailed maggots. The development of larvae in the lower bowel was responsible for non-specific gastrointestinal symptoms that resembled ulcerative proctitis. The diagnosis was established upon the observation of four spontaneously excreted mobile larvae. The definite identification of the E. tenax species was made possible by scanning electron microscopy. The clinical outcome was satisfactory. PMID:24766340

  15. Epizootic ulcerative syndrome caused by Aphanomyces invadans in captive bullseye snakehead Channa marulius collected from south Florida, USA

    SciTech Connect

    Saylor, Ryan [University of West Florida; Miller, Debra [University of Georgia; Vandersea, Mark [National Oceanic and Atmospheric Admin; Bevelhimer, Mark S [ORNL; Schofield, Pamela [U.S. Geological Survey; Bennett, Wayne [University of West Florida

    2010-02-01

    Epizootic ulcerative syndrome (EUS) caused by the oomycete Aphanomyces invadans is an invasive, opportunistic disease of both freshwater and estuarine fishes. Originally documented as the cause of mycotic granulomatosis of ornamental fishes in Japan and as the cause of EUS of fishes in southeast Asia and Australia, this pathogen is also present in estuaries and freshwater bodies of the Atlantic and gulf coasts of the USA. We describe a mass mortality event of 343 captive juvenile bullseye snakehead Channa marulius collected from freshwater canals in Miami-Dade County, Florida. Clinical signs appeared within the first 2 d of captivity and included petechiae, ulceration, erratic swimming, and inappetence. Histological examination revealed hyphae invading from the skin lesions deep into the musculature and internal organs. Species identification was confirmed using a species-specific PCR assay. Despite therapeutic attempts, 100% mortality occurred. This represents the first documented case of EUS in bullseye snakehead fish collected from waters in the USA. Future investigation of the distribution and prevalence of A. invadans within the bullseye snakehead range in south Florida may give insight into this pathogen-host system.

  16. Intractable duodenal ulcer caused by transmural migration of gossypiboma into the duodenum - a case report and literature review

    PubMed Central

    2014-01-01

    Background Gossypiboma is a term used to describe a mass that forms around a cotton sponge or abdominal compress accidentally left in a patient during surgery. Transmural migration of an intra-abdominal gossypiboma has been reported to occur in the digestive tract, bladder, vagina and diaphragm. Open surgery is the most common approach in the treatment of gossypiboma. However, gossypibomas can be extracted by endoscopy while migrating into the digestive tract. We report a case of intractable duodenal ulcer caused by transmural migration of gossypiboma successfully treated by duodenorrhaphy. A systemic literature review is provided and a scheme of the therapeutic approach is proposed. Case presentation A 61-year-old Han Chinese man presented with intermittent epigastric pain for the last 10 months. He had undergone laparoscopic cholecystectomy conversion to open cholecystectomy for acute gangrenous cholecystitis 10 months ago at another hospital. Transmural migration of gossypiboma into the duodenum was found. Endoscopic intervention failed to remove the entire gauze, and duodenal ulcer caused by the gauze persisted. Surgical intervention was performed and the gauze was removed successfully. The penetrated ulcer was repaired with duodenorrhaphy. The postoperative period was uneventful. We systematically reviewed the literature on transmural migration of gossypiboma into duodenum and present an overview of published cases. Our PubMed search yielded seven reports of transmural migration of retained surgical sponge into the duodenum. Surgical interventions were necessary in two patients. Conclusion Transmural migration of gossypiboma into the duodenum is a rare surgical complication. The treatment strategies include endoscopic extraction and surgical intervention. Prompt surgical intervention should be considered for emergent conditions such as active bleeding, gastrointestinal obstruction, or intra-abdominal sepsis. For non-emergent conditions, surgical intervention could be considered for intractable cases in which endoscopic extraction failed. PMID:24917191

  17. An interesting cause of esophageal ulcer etiology: Multiple myeloma of IgG kappa subtype

    PubMed Central

    Pehlivan, Yavuz; Sevinc, Alper; Sari, Ibrahim; Gulsen, Murat T; Buyukberber, Mehmet; Kalender, Mehmet E; Camci, Celalettin

    2006-01-01

    Multiple myeloma is a neoplasm of mature and immature plasma cells. A 50-year-old woman with lumbago, dysphagia, and left arm pain was presented. Upper endoscopical examination was performed. There was an exudate-covered ulcer in the distal esophagus, located at 30-32 cm from the incisors, covering the whole mucosa. Histopathological examination of the specimens obtained from the lesion showed the involvement of plasma cells consistent with multiple myeloma of IgG kappa subtype. Esophageal involvement of multiple myeloma should be kept in mind in patients presenting with dysphagia. PMID:16610044

  18. Cause for controversy? Infliximab in the treatment of ulcerative colitis: an update

    PubMed Central

    Lawlor, Garrett; Moss, Alan C

    2009-01-01

    Infliximab is a monoclonal antibody against tumor necrosis factor (TNF) which has become an established therapy for Crohn’s disease over the last 10 years. Given the similarities between Crohn’s disease and ulcerative colitis (UC), it is no surprise that gastroenterologists have used infliximab in patients with UC who have failed other therapies. Although the initial controlled trials with infliximab in steroid-refractory disease were unimpressive, subsequent controlled trials have demonstrated the efficacy of infliximab in both moderate to severe disease, and as rescue-therapy to avoid colectomy. The long-term remission rates, colectomy-sparing effects, and the impact of concomitant immunomodulator therapy, remain to be determined in these patients. Whether infliximab is a superior strategy to cyclosporine in patients with steroid-refractory disease is controversial. This review examines the data on the efficacy and safety of infliximab as an induction and maintenance agent for UC. PMID:21694839

  19. Use of wound dressings to enhance prevention of pressure ulcers caused by medical devices.

    PubMed

    Black, Joyce; Alves, Paulo; Brindle, Christopher Tod; Dealey, Carol; Santamaria, Nick; Call, Evan; Clark, Michael

    2015-06-01

    Medical device related pressure ulcers (MDR PUs) are defined as pressure injuries associated with the use of devices applied for diagnostic or therapeutic purposes wherein the PU that develops has the same configuration as the device. Many institutions have reduced the incidence of traditional PUs (sacral, buttock and heel) and therefore the significance of MDR PU has become more apparent. The highest risk of MDR PU has been reported to be patients with impaired sensory perception, such as neuropathy, and an impaired ability for the patient to communicate discomfort, for example, oral intubation, language barriers, unconsciousness or non-verbal state. Patients in critical care units typify the high-risk patient and they often require more devices for monitoring and therapeutic purposes. An expert panel met to review the evidence on the prevention of MDR PUs and arrived at these conclusions: (i) consider applying dressings that demonstrate pressure redistribution and absorb moisture from body areas in contact with medical devices, tubing and fixators, (ii) in addition to dressings applied beneath medical devices, continue to lift and/or move the medical device to examine the skin beneath it and reposition for pressure relief and (iii) when simple repositioning does not relieve pressure, it is important not to create more pressure by placing dressings beneath tight devices. PMID:23809279

  20. Systemic candidiasis in farm-reared red-legged partridges (Alectoris rufa) caused by Leucosporidium spp

    PubMed Central

    2012-01-01

    Background This report describes the results of radiological, histological and molecular examination of three farm-reared red-legged partridges (Alectoris rufa) affected by candidiasis. Case presentation Three juvenile farm-reared red-legged partridges in a batch of 100 of the same species were sent for clinical and pathological investigations. The owner referred of a sudden isolation of the sick animals, with apathy, diarrhea, ruffled plumage and respiratory rattles. Post mortem total body lateral projection radiograph showed an increased perihilar interstitial pattern and air bronchogram signs due to lung edema. At necropsy, carcasses showed cachexia; the pericloacal region was soiled by diarrheic fecal material. From the mouth to the intestine, a mucous yellowish fluid was present on a slightly reddish mucosa. Histopathology showed slight edema and congestion with different free fungal elements, referable to blastospores, hyphae and pseudohyphae. Biomolecular exam identified the most similar sequences as belonging to Leucosporidium scottii. Conclusion To our knowledge, this case report describes for the first time this fungal species as a causative agent of candidiasis in birds. PMID:22709925

  1. Neuroleptics as a cause of painful legs and moving toes syndrome.

    PubMed

    Azzi, Jacques; Atweh, Samir; Saade, Nayef; Jabbour, Rosette

    2014-01-01

    Painful legs and moving toes syndrome is rare. It is predominantly diagnosed in middle-aged adults following a history of spinal cord surgery or trauma. The syndrome consists of abnormal repetitive movements, most commonly in the lower extremities, accompanied by pain in the affected limb. Pain usually precedes the movements. We report a case in a young patient that we believe was induced by the intake of a low-potency neuroleptic, which was prescribed to him for anxiety. The patient was treated with carbamazepine with mild relief of pain and later on with botulinum injection, which significantly reduced the movements and mildly improved the pain. After stopping the treatment, the beneficial effect lasted for about 3 months after which his condition gradually returned to its initial state. PMID:25535220

  2. An integrated approach in the treatment of varicose ulcer.

    PubMed

    Patil, Deepa; Jahagirdhar, Sangeeta H; Toshikhane, Hemant D

    2013-01-01

    Venous ulcers (stasis ulcers, varicose ulcers) are the wounds occurring due to inappropriate functioning of venous valves, usually of the legs. It is one of the most serious chronic venous insufficiency complications. The overall incidence rate is 0.76% in men and 1.42% in women. When a venous valve gets damaged, it prevents the backflow of blood, which causes pressure in the veins that leads to hypertension and, in turn, venous ulcers. These are mostly along the medial distal leg, which is often very painful, can bleed, and get infected. Treating varicose ulcers is a difficult task to the physician and a nightmare to the suffering patients, though a good number of the treatment principles are mentioned and practiced in allied sciences. In Ayurveda, this condition is considered as du??a vra?a. It can be managed with the specific s'odhana therapy. So, the same treatment protocol was used to treat the case discussed here, i.e. with Nitya virecana and by Basti karma. The wound was successfully treated and, therefore, is discussed in detail. PMID:24501445

  3. First Report of Myiasis Caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in a Diabetic Foot Ulcer Patient in Argentina

    PubMed Central

    Olea, María Sofía; Centeno, Néstor; Aybar, Cecilia Adriana Veggiani; Ortega, Eugenia Silvana; Galante, Guillermina Begoña; Olea, Luis

    2014-01-01

    Myiasis is usually caused by flies of the Calliphoridae family, and Cochliomyia hominivorax is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucumán Province for a consultation concerning an ulcer in his right foot, where the larval specimens were found. The identification of the immature larvae was based on their morphological characters, such as the cylindrical, segmented, white yellow-coloured body and tracheas with strong pigmentation. The larvae were removed, and the patient was treated with antibiotics. The larvae were reared until the adults were obtained. The adults were identified by the setose basal vein in the upper surface of the wing, denuded lower surface of the wing, short and reduced palps, and parafrontalia with black hairs outside the front row of setae. The main factor that favoured the development of myiasis is due to diabetes, which caused a loss of sensibility in the limb that resulted in late consultation. Moreover, the poor personal hygiene attracted the flies, and the foul-smelling discharge from the wound favoured the female's oviposition. There is a need to implement a program for prevention of myiasis, in which the population is made aware not only of the importance of good personal hygiene and home sanitation but also of the degree of implication of flies in the occurrence and development of this disease. PMID:24623889

  4. First report of myiasis caused by Cochliomyia hominivorax (Diptera: Calliphoridae) in a diabetic foot ulcer patient in Argentina.

    PubMed

    Olea, María Sofía; Centeno, Néstor; Aybar, Cecilia Adriana Veggiani; Ortega, Eugenia Silvana; Galante, Guillermina Begoña; Olea, Luis; Juri, María Julia Dantur

    2014-02-01

    Myiasis is usually caused by flies of the Calliphoridae family, and Cochliomyia hominivorax is the etiological agent most frequently found in myiasis. The first case of myiasis in a diabetic foot of a 54-year-old male patient in Argentina is reported. The patient attended the hospital of the capital city of Tucumán Province for a consultation concerning an ulcer in his right foot, where the larval specimens were found. The identification of the immature larvae was based on their morphological characters, such as the cylindrical, segmented, white yellow-coloured body and tracheas with strong pigmentation. The larvae were removed, and the patient was treated with antibiotics. The larvae were reared until the adults were obtained. The adults were identified by the setose basal vein in the upper surface of the wing, denuded lower surface of the wing, short and reduced palps, and parafrontalia with black hairs outside the front row of setae. The main factor that favoured the development of myiasis is due to diabetes, which caused a loss of sensibility in the limb that resulted in late consultation. Moreover, the poor personal hygiene attracted the flies, and the foul-smelling discharge from the wound favoured the female's oviposition. There is a need to implement a program for prevention of myiasis, in which the population is made aware not only of the importance of good personal hygiene and home sanitation but also of the degree of implication of flies in the occurrence and development of this disease. PMID:24623889

  5. Restless Legs Syndrome

    MedlinePLUS

    ... page from the NHLBI on Twitter. What Is Restless Legs Syndrome? Restless legs syndrome (RLS) is a disorder that causes a strong ... treatments. Rate This Content: NEXT >> November 1, 2010 Restless Legs Syndrome Clinical Trials Clinical trials are research studies that ...

  6. Ulcerative colitis

    MedlinePLUS

    Inflammatory bowel disease - ulcerative colitis; IBD - ulcerative colitis ... Burger D, Travis S. Conventional medical management of inflammatory bowel disease. Gastroenterology ... . Kornbluth A, Sachar DB, et al. ...

  7. [Leg swelling].

    PubMed

    Schellong, S M; Wollina, U; Unger, L; Machetanz, J; Stelzner, C

    2013-11-01

    Leg swelling is an extremely frequent symptom with a broad variety of largely differing causes. The most important mechanisms behind the symptom include venous and lymphatic pathology, volume overload, increased capillary permeability, and lowered oncotic pressure. Therefore, the most frequent diseases associated with leg swelling are deep vein thrombosis and chronic venous insufficiency, primary or secondary lymphedema, cardiac failure, hypoproteinemia due to liver or renal failure, idiopathic cyclic edema, and drug-induced edema. Lipedema as a misnomer represents an important differential diagnosis. History and physical examination, when based on a sound knowledge of the diseases of interest, enable a conclusive diagnosis in most cases. Additional test are required in only a minority of patients. The present review discusses pathophysiology and clinical features of the most prevalent types of leg swelling. Finally, a brief guide to differential diagnosis is given. PMID:24264570

  8. Other Causes of Leg Pain | NIH MedlinePlus the Magazine

    MedlinePLUS

    ... a muscle in the same position for a long time Injuries caused by: A torn or overstretched muscle (strain) Hairline crack in the bone (stress fracture) Inflamed tendon (tendinitis) Shin splints—pain in the ...

  9. Extensive oral mucosal ulcerations caused by misuse of a commercial mouthwash.

    PubMed

    Moghadam, B K; Gier, R; Thurlow, T

    1999-08-01

    This case report describes severe mucosal injuries following misuse of an undiluted over-the-counter mouthwash with a high alcohol content (70%), oil of peppermint and arnica. The mouthwash was to be diluted 5:1 with water. The patient used undiluted solution to better treat her self-diagnosed "contagious gum infection." She experienced burning sensation with each rinse and developed severe mucosal injuries subsequently. Her oral condition improved within 48 hours following discontinuation of use of the mouthwash and application of a mixture of Benadryl Elixir, Maalox Plain, and 2% viscous Lidocaine. A detailed history and review of a patient's medical condition will help to differentiate self-induced mucosal injuries from those caused by an allergic reaction or skin diseases. PMID:10467509

  10. Effect of psychotropic drugs on gastric ulcers induced by immobilization: Increased protective effect of amitriptyline caused by chlordiazepoxide

    NASA Technical Reports Server (NTRS)

    Blum, J. E.; Huerlimann, A.

    1980-01-01

    Amitriptyline, but not chlordiazepoxide, protects rats from the occurrence of gastric erosions and ulcers following immobilization. When, however, chlordiazepoxide is given together with amitriptyline the protective effect of the latter is markedly increased.

  11. Leg ulcer as a manifestation of eosinophilic vasculitis in a patient with hepatitis C virus infection, medicated with pegylated interferon/ribavirin.

    PubMed

    Resende, Cristina; Pereira, Teresa; Ventura, Filipa; Brito, Celeste

    2015-01-01

    Cryoglobulinaemic vasculitis is a complication of hepatitis C virus (HCV) infection, responding to treatment with pegylated interferon (peg-IFN)/ribavirin (RIB), but vasculitis may first appear after treatment with peg-IFN/RIB. A 35-year-old man with HCV infection presented to our department with a 2-month history of a 3.3×3?cm ulcer localised on the right shin, with a regular border, on a violaceous base. Histopathological examination revealed a leucocytoclastic vasculitis, rich in eosinophils. The patient had been treated with peg-IFN/RIB 10?months prior and treatment was discontinued after 2?months because of the appearance of arthralgias and neuropathy. Laboratory investigations revealed positive cryoglobulins, elevation of rheumatoid factor and reduction of C4 after treatment with peg-IFN/RIB. Dressings with a hydrocellular foam were placed and after 2?months the ulcer resolved. We presented this case because of the rarity of development of a cryoglobulinaemic vasculitis in a patient with HCV infection, previously treated with peg-IFN/RIB. PMID:26065548

  12. Colonization and population growth of Yellow-legged Gull Larus cachinnans in southeastern Poland: causes and influence on native species

    Microsoft Academic Search

    PIOTR SKORKA; JOANNA D. WOJCIK; RAFAL MARTYKA

    2005-01-01

    The Yellow-legged Gull Larus cachinnans was first recorded in Poland in the 1980s. We analysed the probable factors responsible for its successful colonization of new areas. We also expected that such a large species should affect populations of other colonial waterbirds. We studied the breeding and feeding ecology in the largest inland colony of the Yellow- legged Gull in Poland,

  13. Ulcerative Colitis

    NSDL National Science Digital Library

    Patient Education Institute

    This patient education program discusses ulcerative colitis and explains the anatomy of the digestive system, causes, symptoms, diagnosis, and treatment options for this disease. This resource is a MedlinePlus Interactive Health Tutorial from the National Library of Medicine, designed and developed by the Patient Education Institute. NOTE: This tutorial requires a special Flash plug-in, version 4 or above. If you do not have Flash, you will be prompted to obtain a free download of the software before you start the tutorial. You will also need an Acrobat Reader, available as a free download, in order to view the Reference Summary.

  14. Low-dose aspirin is a prominent cause of bleeding ulcers in patients who underwent emergency endoscopy

    Microsoft Academic Search

    Masayuki Nakayama; Ryuichi Iwakiri; Megumi Hara; Hibiki Ootani; Ryo Shimoda; Seiji Tsunada; Hiroyuki Sakata; Kazuma Fujimoto

    2009-01-01

    Objective  This study aimed to clarify the current situation of bleeding peptic ulcers and examined the temporal changes in the pathogenic\\u000a mechanisms requiring emergency endoscopy.\\u000a \\u000a \\u000a \\u000a Patients and methods  Study subjects were 285 bleeding peptic ulcer patients who received emergency endoscopy in Saga Medical School Hospital between\\u000a 2000 and 2007. The ratios of H. pylori infection, NSAID use and low-dose aspirin use were

  15. The swollen leg.

    PubMed

    Young, J R

    1977-01-01

    Systemic causes of leg edema include idiopathic cyclic edema, heart failure, cirrhosis, nephrosis and other hypoproteinemic states. Lymphedema may be primary, or secondary to neoplasm, lymphangitis, retroperitoneal fibrosis and, rarely (in the U.S.), filariasis. Thrombophlebitis and chronic venous insufficiency are not uncommon causes. Finally, infection, ischemia, lipedema, vascular anomalies, tumors and trauma can be responsible for the swollen leg. PMID:188330

  16. A randomized, controlled, double-blind prospective trial with a Lipido-Colloid Technology-Nano-OligoSaccharide Factor wound dressing in the local management of venous leg ulcers.

    PubMed

    Meaume, Sylvie; Truchetet, François; Cambazard, Frédéric; Lok, Catherine; Debure, Clélia; Dalac, Sophie; Lazareth, Isabelle; Sigal, Michèle-Léa; Sauvadet, Anne; Bohbot, Serge; Dompmartin, Anne

    2012-01-01

    Venous leg ulcers (VLUs) are the most prevalent chronic wounds in western countries with a heavy socioeconomic impact. Compression therapy is the etiologic treatment of VLU but until now no wound dressing has been shown to be more effective than another. The aim of this study was to assess the efficacy of a new dressing in the management of VLU. Adult patients presenting a noninfected VLU and receiving effective compression therapy were enrolled in this randomized, controlled, double-blind trial. The VLUs were assessed every 2 weeks for 8 weeks. The primary study outcome was the relative Wound Area Reduction (WAR, in %), and the secondary objectives were absolute WAR, healing rate, and percentage of wounds with >40% surface area reduction. One hundred eighty-seven patients were randomly allocated to treatment groups. Median WAR was 58.3% in the Lipido-Colloid Technology-Nano-OligoSaccharide Factor (TLC-NOSF) dressing group (test group) and 31.6% in the TLC dressing group (control group) (difference: -26.7%; 95% confidence interval: -38.3 to -15.1%; p = 0.002). All other efficacy outcomes were also significant in favor of the TLC-NOSF dressing group. Clinical outcomes for patients treated with the new dressing are superior to those patients treated with the TLC dressing (without NOSF compound), suggesting a strong promotion of the VLU healing process. PMID:22681551

  17. Foot, leg, and ankle swelling

    MedlinePLUS

    ... Certain medications may also cause your legs to swell: Antidepressants, including MAO inhibitors (such as phenelzine and ... ask questions like the following: What body parts swell? Your ankles, feet, legs? Above the knee or ...

  18. Capsaicin and Gastric Ulcers

    Microsoft Academic Search

    M. N. Satyanarayana

    2006-01-01

    In recent years, infection of the stomach with the organism Helicobacter Pylori has been found to be the main cause of gastric ulcers, one of the common ailments afflicting humans. Excessive acid secretion in the stomach, reduction in gastric mucosal blood flow, constant intake of non-steroid anti-inflammatory drugs (NSAIDS), ethanol, smoking, stress etc. are also considered responsible for ulcer formation.The

  19. Restless legs syndrome

    MedlinePLUS

    Restless legs syndrome (RLS) is a nervous system problem that causes you to feel an unstoppable urge to get ... There is no specific test for restless legs syndrome. Your health ... do a physical exam. You may have blood tests and other exams ...

  20. Low body stores of iron and restless legs syndrome: a correctable cause of insomnia in adolescents and teenagers

    Microsoft Academic Search

    Meir H Kryger; Kazuo Otake; John Foerster

    2002-01-01

    Background: It has been shown that restless legs syndrome (RLS) in adults may be linked to abnormalities in iron stores. Whether reduced iron stores play a role in children is not clear.Methods: We evaluated the status of iron stores and sleep in three teenagers who presented with severe sleep onset insomnia, subjective sleep latency exceeding 60 min and excessive daytime

  1. Wound care in venous ulcers.

    PubMed

    Mosti, G

    2013-03-01

    Wound dressings: ulcer dressings should create and maintain a moist environment on the ulcer surface. It has been shown that in an ulcer with a hard crust and desiccated bed, the healing process is significantly slowed and sometimes completely blocked so favouring infection, inflammation and pain. In contrast a moist environment promotes autolytic debridement, angiogenesis and the more rapid formation of granulation tissue, favours keratinocytes migration and accelerates healing of wounds. Apart from these common characteristics, wound dressings are completely different in other aspects and must be used according to the ulcer stage. In necrotic ulcers, autolytic debridement by means of hydrogel and hydrocolloids or with enzymatic paste is preferred. In case of largely exuding wounds alginate or hydrofibre are indicated. When bleeding occurs alginate is indicated due to its haemostatic power. Where ulcers are covered by granulation tissue, polyurethane foams are preferred. When infection coexists antiseptics are necessary: dressing containing silver or iodine with large antibacterial spectrum have proved to be very effective. In the epithelization stage polyurethane films or membranes, thin hydrocolloids or collagen based dressings are very useful to favour advancement of the healing wound edge. Despite these considerations, a Cochrane review failed to find advantages for any dressing type compared with low-adherent dressings applied beneath compression. Surgical debridement and grafting of wounds, negative wound pressure treatment: surgical and hydrosurgical debridement are indicated in large, necrotic and infected wounds as these treatments are able to get rid of necrotic, infected tissue very quickly in a single surgical session, thereby significantly accelerating wound bed preparation and healing time. Negative wound pressure treatment creating a negative pressure on ulcer bed is able to favour granulation tissue and shorten healing time. In case of hard-to-heal leg ulcers such as large, deep, infected and long-lasting venous ulcers, sharp debridement and skin grafting may favour and shorten ulcer healing. PMID:23482540

  2. Pain in pressure ulcers.

    PubMed

    Reddy, Madhuri; Keast, David; Fowler, Evonne; Sibbald, R Gary

    2003-04-01

    Integrating pain management into a treatment paradigm for pressure ulcers can lead to improved outcomes. An approach to wound bed preparation that addresses the cause and patient-centered concerns--as well as local wound care factors of moisture balance, debridement, and bacterial balance--can be integrated with the Krasner model of chronic wound pain. The risk factors for pressure ulcers are well known, but pain may be an important contributor to immobility and the development of pressure ulcers. Pain is also an important signal of wound-related infections. Strategies must be developed to control the cyclic acute pain of dressing changes and the noncyclic acute pain of wound debridement. Spinal cord injured and elderly, cognitively impaired patients with pressure ulcers present special challenges in pain management. PMID:12856291

  3. Mucormycosis Caused byRhizopus microsporusvar.microsporus: Cellulitis in the Leg of a Diabetic Patient Cured by Amputation

    Microsoft Academic Search

    BURTON C. WEST; ARNOLD D. OBERLE; ANDKYUNG J. KWON-CHUNG

    1995-01-01

    Mucormycosis accompanied the development of bacterial infection in the leg of a diabetic African-American man. Local injury, diabetic ketoacidosis, renal insufficiency, and antimicrobial therapy were factors that con- tributedtothepathogenesisofthemucormycosis.ThecellulitiswascausedinpartbyRhizopusmicrosporusvar. microsporusandwascuredbyamputation.Wereportthisunusualcaseofmucormycosistoemphasizethevalue of fungal identification, to illustrate a dramatic and successful clinical result, and to draw attention to an apparentroleforbacterialinfectionanditstreatmentinthepathogenesisofmucormycosis.Itisthethirdcase report of mucormycosis in a human in whichR. microsporusvar.microsporuswas definitively identified as

  4. Cushing's ulcer: Further reflections

    PubMed Central

    Kemp, William J.; Bashir, Asif; Dababneh, Haitham; Cohen-Gadol, Aaron A.

    2015-01-01

    Background: Brain tumors, traumatic head injury, and other intracranial processes including infections, can cause increased intracranial pressure and lead to overstimulation of the vagus nerve. As a result, increased secretion of gastric acid may occur which leads to gastro-duodenal ulcer formation known as Cushing's ulcer. Methods: A review of original records of Dr. Harvey Cushing's patients suffering from gastro-duodenal ulcers was performed followed by a discussion of the available literature. We also reviewed the clinical records of the patients never reported by Cushing to gain his perspective in describing this phenomenon. Dr. Cushing was intrigued to investigate gastro-duodenal ulcers as he lost patients to acute gastrointestinal perforations following successful brain tumor operations. It is indeed ironic that Harvey Cushing developed a gastro-duodenal ulcer in his later years with failing health. Results: Clinically shown by Cushing's Yale Registry, a tumor or lesion can disrupt this circuitry, leading to gastroduodenal ulceration. Cushing said that it was “reasonable to believe that the perforations following posterior fossa cerebellar operations were produced in like fashion by an irritative disturbance either of fiber tracts or vagal centers in the brain stem.” Conclusion: Harvey Cushing's pioneering work depicted in his Yale registry serves as a milestone for continuing research that can further discern this pathway. PMID:25972936

  5. Macular lymphocytic arteritis: first clinical presentation with ulcers.

    PubMed

    Llamas-Velasco, M; García-Martín, P; Sánchez-Pérez, J; Sotomayor, E; Fraga, J; García-Diez, A

    2013-04-01

    Macular lymphocytic arteritis describes a recently reported entity, clinically characterized by asymptomatic hyperpigmented macules on the lower limbs, without association of systemic diseases. Histopathologically it is characterized by a lymphocytic arteritis with a hyalinized fibrin ring. We report a new case presenting with ulceration, a finding not previously described. A 25-year-old Hispanic woman was evaluated for a 1-year history of a gradually progressive, asymptomatic eruption that begins at level of both knees and progressively affects both legs and feet. She also referred recently appeared ulcers on inner right ankle without previous traumatism. Physical examination revealed multiple fairly well-defined light brown and faint pink patches with petechiae on as well as retiform crusts and livedoid lesions on inner right ankle. Both types of lesions were biopsied showing lymphocytic arteritis with fibrinoid necrosis and thrombus. There were no relevant laboratory alterations. The clinical peculiarity of our case is the clinical image of the lesions mimicking a pigmented purpuric dermatosis and the presence of a non-traumatic ulcer which could be explained because chronic lymphocytic damage may cause ischemic damage. Ulceration in our case supports consideration of macular arteritis as a latent form of cutaneous polyarteritis nodosa. PMID:23384039

  6. Cutaneous Ulcer as Leading Symptom of Systemic Cytomegalovirus Infection

    PubMed Central

    Guo, Richard F.; Gebreab, Frew H.; Tang, Emily Hsiang-Ho; Piao, Zhe; Lee, Steve S.; Perez, Mario L.

    2015-01-01

    Cytomegalovirus (CMV) infection rarely manifests with skin ulcerations. We describe a case report of a 64-year-old woman with chronic immunosuppression for treatment of mixed connective tissue disease, presenting with new onset leg ulcerations after a recent change in immunosuppressive regimen. She subsequently developed fulminant hepatitis, encephalopathy, and pancytopenia and was found to have severe systemic CMV viremia. Skin ulcer biopsy was positive by immunohistochemical staining for CMV infected endothelial cells. Both systemic disease and skin ulcer rapidly improved after stopping immunosuppression and administering intravenous ganciclovir. New onset skin ulcers in an immunosuppressed individual, especially with recent changes in immunosuppressive regimen, should raise the suspicion of reactivation of CMV. PMID:25785212

  7. [A cutaneous ulcer induced by fungi of the genus Fusarium].

    PubMed

    Negroni, R; Martino, O; Robles, A M; Orduna, T; Arechavala, A; Brusca, S; Helou, S

    1997-01-01

    A case of cutaneous hyalohyphomycosis, due to Fusarium oxysporum, in a 40 years old man is presented. The patient came from Paraguay where he worked in a tropical rural area. His disease had begun 2 months before his admission as a skin ulcer located in the left leg. Clinical characteristics, diagnosis methods, differential diagnosis with other ulcers of the legs in tropical areas as well as therapeutic measures are discussed in this presentation. PMID:9265228

  8. Pterygotus legs

    NSDL National Science Digital Library

    2001-03-01

    Eurypterids have a pair of paddle-like swimming legs located at the back edge of the head. These legs are connected to the body by toothplates or "gnathobases." The toothplates border a slit-like mouth and are lined by teeth. The large slab pictured above (also from Passage Gulf, NY) contains a complete swimming leg (center) connected to a partial toothplate (upper right) and another partial toothplate (lower center) with a series of thorn-like teeth (left side).

  9. Discriminant value of dyspeptic symptoms: a study of the clinical presentation of 221 patients with dyspepsia of unknown cause, peptic ulceration, and cholelithiasis

    Microsoft Academic Search

    N J Talley; D McNeil; D W Piper

    1987-01-01

    This study aims to determine whether the features of dyspepsia can discriminate a subgroup of patients who present with non-ulcer dyspepsia from other diagnostic categories. The following groups were studied: One hundred and thirteen patients with endoscopically confirmed non-ulcer dyspepsia in the absence of clinical, biochemical or radiological evidence of other gastrointestinal diseases or disorders, termed essential dyspepsia; Fifty five

  10. Phakomatosis pigmentovascularis IIb with hypoplasia of the inferior vena cava and the right iliac and femoral veins causing recalcitrant stasis leg ulcers.

    PubMed

    Park, Jong-Gap; Roh, Kee-Young; Lee, Hyun-Jeong; Ha, Seog-Jun; Lee, Jun-Young; Yun, Sang Seob; Lim, Keun Woo; Song, Kyung Sup; Kim, Jin-Wou

    2003-08-01

    We present a patient with phakomatosis pigmentovascularis (PPV) type IIb accompanied with venous hypoplasia, from the inferior vena cava to the superficial femoral vein. Although it is not obvious whether this vascular anomaly, which is probably congenital, is coincidental or not, it is possible that the 2 diseases have some relationship each other, because PPV is thought to result from abnormal vasomotor activity during the embryonic period. In the diagnosis of type II PPV, careful examination and several studies are required to determine systemic involvement that may include large vessel changes. PMID:12894112

  11. Dietary restriction causes chronic elevation of corticosterone and enhances stress response in red-legged kittiwake chicks

    USGS Publications Warehouse

    Kitaysky, A.S.; Kitaiskaia, E.V.; Wingfield, J.C.; Piatt, J.F.

    2001-01-01

    Release of corticosterone in hungry kittiwake chicks facilitates begging and allows them to restore depleted energy reserves by increasing parental food provisioning. However, in order to avoid detrimental effects of chronic elevation of corticosterone, chicks might suppress adrenocortical activity in response to prolonged food shortages. In this study we examined temporal dynamics of corticosterone release in red-legged kittiwake (Rissa brevirostris) chicks exposed to prolonged restrictions in energy content and/or nutritional quality (low versus high lipid content) of their food. Starting at the age of 15 days, chicks were fed either high- or low-lipid fish at 40%, 65%, and 100% of ad libitum energy intake. Body mass measurements and baseline plasma samples were taken on a weekly basis after beginning of the treatment. After 3 weeks of treatment, chicks were exposed to a standardized acute handling and restraint stress protocol, where in addition to a baseline sample, three plasma samples were taken at intervals up to 50 min. We found that food-restricted chicks had lower body mass, chronically (during 2-3 weeks) elevated baseline and higher acute stress-induced levels of corticosterone compared to chicks fed ad libitum. Low lipid content of food further exacerbated these effects. An increase in baseline levels of corticosterone was observed within a week after energy requirements of food-restricted chicks exceeded their daily energy intake. A tendency for suppression of adrenocortical activity was observed in treatments fed low-lipid diets only at the end of the experiment. We suggest that nest-bound chicks, if food-stressed, might suffer deleterious effects of chronic elevation of corticosterone.

  12. [Skin ulcers in a returning traveler].

    PubMed

    Ebiner, Jérome; Gaide, Olivier; Pedrazzini, Baptiste

    2015-04-22

    We present the case of a 71 year old man returning from a back-packer trip in exotic countries. He presented several non-healing legs ulcers for three months. After many investigations, the bacterial culture gave us the answer. PMID:25946756

  13. Dutch Venous Ulcer guideline update.

    PubMed

    Maessen-Visch, M Birgitte; de Roos, Kees-Peter

    2014-05-19

    The revised guideline of 2013 is an update of the 2005 guideline "venous leg ulcer". In this special project four separate guidelines (venous leg ulcer, varicose veins, compression therapy and deep venous disorders) were revised and developed simultaneously. A meeting was held including representatives of any organisation involved in venous disease management including patient organizations and health insurance companies. Eighteen clinical questions where defined, and a new strategy was used to accelerate the process. This resulted in two new and two revised guidelines within one year. The guideline committee advises use of the C of the CEAP classification as well as the Venous Clinical Severity Score (VCSS) and a Quality of life (QoL) score in the assessment of clinical signs. These can provide insight into the burden of disease and the effects of treatment as experienced by the patient. A duplex ultrasound should be performed in every patient to establish the underlying aetiology and to evaluate the need for treatment (which is discussed in a separate guideline). The use of the TIME model for describing venous ulcers is recommended. There is no evidence for antiseptic or antibiotic wound care products except for a Cochrane review in which some evidence is presented for cadexomer iodine. Signs of infection are the main reason for the use of oral antibiotics. When the ulcer fails to heal the use of oral aspirin and pentoxifylline can be considered as an adjunct. For the individual patient, the following aspects should be considered: the appearance of the ulcer (amount of exudate) according to the TIME model, the influence of wound care products on moisturising the wound, frequency of changing compression bandages, pain and allergies. The cost of the dressings should also be considered. Education and training of patients t improves compliance with compression therapy but does not influence wound healing rates. PMID:24843102

  14. Leg discomfort: beyond the joints.

    PubMed

    Berger, Douglas

    2014-05-01

    Although simple characterization of discomfort as cramps, heaviness, shooting pains, and so forth can be misleading, history and examination are key to accurate diagnosis. Absence of both dorsalis pedis and posterior tibial pulses strongly suggests peripheral arterial disease (PAD), and the presence of either pulse makes PAD less likely. Hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) are a common cause of lower extremity myalgias. Restless legs syndrome causes nocturnal discomfort but must be distinguished from confounding“mimics." Neurologic causes of leg symptoms include lumbar spinal stenosis, radiculopathy, distal symmetric polyneuropathy, and entrapment neuropathy. Many common causes of leg discomfort can be managed conservatively. PMID:24758955

  15. Leg muscles

    NSDL National Science Digital Library

    Uwe Gille (None; )

    2007-07-29

    Like many areas of the body, the legs contain bones, muscles, tendons, and ligaments. All of these are needed for movement. Muscles contract and lengthen as movement occurs. Muscles become shorter when they contract.

  16. Combined NADPH Oxidase 1 and Interleukin 10 Deficiency Induces Chronic Endoplasmic Reticulum Stress and Causes Ulcerative Colitis-Like Disease in Mice

    PubMed Central

    Tréton, Xavier; Pedruzzi, Eric; Guichard, Cécile; Ladeiro, Yannick; Sedghi, Shirin; Vallée, Mélissa; Fernandez, Neike; Bruyère, Emilie; Woerther, Paul-Louis; Ducroc, Robert; Montcuquet, Nicolas; Freund, Jean-Noel; Van Seuningen, Isabelle; Barreau, Frédérick; Marah, Assiya; Hugot, Jean-Pierre; Cazals-Hatem, Dominique; Bouhnik, Yoram; Daniel, Fanny; Ogier-Denis, Eric

    2014-01-01

    Ulcerative colitis (UC) is a chronic inflammatory bowel disease affecting the rectum which progressively extents. Its etiology remains unknown and the number of treatments available is limited. Studies of UC patients have identified an unbalanced endoplasmic reticulum (ER) stress in the non-inflamed colonic mucosa. Animal models with impaired ER stress are sensitive to intestinal inflammation, suggesting that an unbalanced ER stress could cause inflammation. However, there are no ER stress-regulating strategies proposed in the management of UC partly because of the lack of relevant preclinical model mimicking the disease. Here we generated the IL10/Nox1dKO mouse model which combines immune dysfunction (IL-10 deficiency) and abnormal epithelium (NADPH oxidase 1 (Nox1) deficiency) and spontaneously develops a UC-like phenotype with similar complications (colorectal cancer) than UC. Our data identified an unanticipated combined role of IL10 and Nox1 in the fine-tuning of ER stress responses in goblet cells. As in humans, the ER stress was unbalanced in mice with decreased eIF2? phosphorylation preceding inflammation. In IL10/Nox1dKO mice, salubrinal preserved eIF2? phosphorylation through inhibition of the regulatory subunit of the protein phosphatase 1 PP1R15A/GADD34 and prevented colitis. Thus, this new experimental model highlighted the central role of epithelial ER stress abnormalities in the development of colitis and defined the defective eIF2? pathway as a key pathophysiological target for UC. Therefore, specific regulators able to restore the defective eIF2? pathway could lead to the molecular remission needed to treat UC. PMID:25014110

  17. Colonic motility in ulcerative colitis

    PubMed Central

    Antonelli, Elisabetta; Villanacci, Vincenzo; Baldoni, Monia; Dore, Maria Pina

    2014-01-01

    Background Inflammatory conditions affecting the gut may cause motility disturbances, and ulcerative colitis – one of the main disorders among the inflammatory bowel diseases – may display abnormal colonic motility. Aim To review the abnormalities of the large bowel in ulcerative colitis, by considering the motility, laboratory (in vitro) and pathological studies dealing with this topic. Methods A comprehensive online search of Medline and the Science Citation Index was carried out. Results Patients with ulcerative colitis frequently display colonic motor abnormalities, including lack of contractility, an increase of propulsive contractile waves, an excessive production of nitric oxide, vasoactive intestinal polypeptide nerves, interleukin 1 beta, neurotensin, tachykinins levels and the weaker action of substance P, likely related to a neuromuscular dysfunction due to the inflammatory process. Conclusions A better understanding of the pathophysiological grounds of altered colonic motility in ulcerative colitis may lead to a more in-depth knowledge of the accompanying symptoms and to better and more targeted therapeutic approaches. PMID:25452840

  18. Differentiating nocturnal leg cramps and restless legs syndrome.

    PubMed

    Rana, Abdul Qayyum; Khan, Fatima; Mosabbir, Abdullah; Ondo, William

    2014-07-01

    Leg pain and discomfort are common complaints in any primary physician's clinic. Two common causes of pain or discomfort in legs are nocturnal leg cramps (NLC) and restless leg syndrome (RLS). NLC present as painful and sudden contractions mostly in part of the calf. Diagnosis of NLC is mainly clinical and sometimes involves investigations to rule out other mimics. RLS is a condition characterized by the discomfort or urge to move the lower limbs, which occurs at rest or in the evening/night. The similarity of RLS and leg cramps poses the issue of errors in diagnosing and differentiating the two. In this paper we review the pathopysiology of each entity and their diagnosis as well as treatment. The two conditions are then compared to appreciate the differences and similarities. Finally, suggestions are recommended for complete assessment. PMID:24931546

  19. Leg CT scan

    MedlinePLUS

    CAT scan - leg; Computed axial tomography scan - leg; Computed tomography scan - leg; CT scan - leg ... 2008:chap 2. Shaw AS, Dixon AK. Multidetector computed tomography. In: Adam A, Dixon AK, eds. Grainger & Allison's ...

  20. Leg Problems

    MedlinePLUS

    MENU Return to Web version Leg Problems See complete list of charts. Follow this chart for more information about pain and swelling in ... warmth in your calf? Yes You may have DEEP VENOUS THROMBOSIS, a clot in ... 7. Do you have twisted dark blue or purple veins near the surface of ...

  1. Effectiveness of olive oil for the prevention of pressure ulcers caused in immobilized patients within the scope of primary health care: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background Pressure ulcers are considered an important issue, mainly affecting immobilized older patients. These pressure ulcers increase the care burden for the professional health service staff as well as pharmaceutical expenditure. There are a number of studies on the effectiveness of different products used for the prevention of pressure ulcers; however, most of these studies were carried out at a hospital level, basically using hyperoxygenated fatty acids (HOFA). There are no studies focused specifically on the use of olive-oil-based products and therefore this research is intended to find the most cost-effective treatment and achieve an alternative treatment. Methods/design The main objective is to assess the effectiveness of olive oil, comparing it with HOFA, to treat immobilized patients at home who are at risk of pressure ulcers. As a secondary objective, the cost-effectiveness balance of this new application with regard to the HOFA will be assessed. The study is designed as a noninferiority, triple-blinded, parallel, multi-center, randomized clinical trial. The scope of the study is the population attending primary health centers in Andalucía (Spain) in the regional areas of Malaga, Granada, Seville, and Cadiz. Immobilized patients at risk of pressure ulcers will be targeted. The target group will be treated by application of an olive-oil-based formula whereas the control group will be treated by application of HOFA to the control group. The follow-up period will be 16 weeks. The main variable will be the presence of pressure ulcers in the patient. Secondary variables include sociodemographic and clinical information, caregiver information, and whether technical support exists. Statistical analysis will include the Kolmogorov-Smirnov test, symmetry and kurtosis analysis, bivariate analysis using the Student’s t and chi-squared tests as well as the Wilcoxon and the Man-Whitney U tests, ANOVA and multivariate logistic regression analysis. Discussion The regular use of olive-oil-based formulas should be effective in preventing pressure ulcers in immobilized patients, thus leading to a more cost-effective product and an alternative treatment. Trial registration Clinicaltrials.gov identifier: NCT01595347. PMID:24152576

  2. A programme to reduce acquired pressure ulcers in care homes.

    PubMed

    Thompson, Trish Morris; Marks-Maran, Di

    2015-06-24

    Prevention of pressure ulcers is a major health concern, especially for older people. Much of the literature related to prevention of pressure ulcers focuses on hospital-acquired pressure ulcers. There is less literature related to prevention of pressure ulcers in care homes. This article presents a review of the literature related to prevention of pressure ulcers in care homes and an ambitious project undertaken by one care home provider to raise awareness of pressure ulcers, provide training in prevention and monitor and evaluate pressure ulcers in over 200 care home across the UK. Known as MI SKIN, the project involves ongoing training to all levels of care staff, a robust system of monitoring pressure ulcers and a mechanism to investigate and learn from any incident of pressure ulcer using root cause analysis. PMID:26110989

  3. [Relationship between disaster stress and peptic ulcers].

    PubMed

    Kanno, Takeshi; Iijima, Katsunori; Koike, Tomoyuki; Shimosegawa, Tooru

    2015-07-01

    There had been several reports about the increasing of peptic ulcers under a large-scale disaster or a war. But in human, it was still unclear that a severe psychological stress itself cause peptic ulcer independently of two major causes (Helicobacter pylori infection and nonsteroidal anti-inflammatory drugs). After Great East Japan earthquake in March 11th, 2011, one of the five most powerful earthquakes in the world since modern record keeping began in 1900, we also noticed remarkable increasing of patients with peptic ulcer in wide stricken area. Reports after this gigantic earthquake gave us two new important viewpoints. Disaster (psychological) stress possibly induce peptic ulcer independently of two major causes. And, people living in refugee shelter immediately after a disaster are strong risk group of peptic ulcer bleeding as well as an intake of anti-thrombotic agents. PMID:26165082

  4. Vesicular, ulcerative, and necrotic dermatitis of reptiles.

    PubMed

    Maas, Adolf K

    2013-09-01

    Vesicular, ulcerative, and necrotic dermatologic conditions are common in captive reptiles. Although these conditions have distinct differences histologically, they are commonly sequelae to each other. This article examines the anatomy and physiology of reptile skin; discusses reported causes of vesicular, ulcerative, and necrotic dermatologic conditions; and reviews various management options. PMID:24018035

  5. Restless legs syndrome in the elderly.

    PubMed Central

    O'Keeffe, S. T.; Noel, J.; Lavan, J. N.

    1993-01-01

    The prevalence and significance of restless legs syndrome was assessed in 307 patients presenting to an acute-care geriatric medical service. Fifteen patients (5%) had restless legs syndrome; 13 (87%) of these patients had insomnia and 10 (67%) reported troublesome or frequent leg symptoms. Of 147 patients with current insomnia, iron deficiency (serum ferritin < 18 ng/ml) was present in 4/13 (31%) patients with restless legs and 8/134 (6%) patients without restless legs (P < 0.025). Improvement in symptoms of restless legs was noted with iron repletion. These findings suggest that restless legs syndrome is relatively common in the elderly and causes significant discomfort and sleep disturbance. Iron deficiency is a common and treatable cause. PMID:8255834

  6. Haemophilus ducreyi Associated with Skin Ulcers among Children, Solomon Islands

    PubMed Central

    Chi, Kai-Hua; Vahi, Ventis; Pillay, Allan; Sokana, Oliver; Pavluck, Alex; Mabey, David C.; Chen, Cheng Y.; Solomon, Anthony W.

    2014-01-01

    During a survey of yaws prevalence in the Solomon Islands, we collected samples from skin ulcers of 41 children. Using PCR, we identified Haemophilus ducreyi infection in 13 (32%) children. PCR-positive and PCR-negative ulcers were phenotypically indistinguishable. Emergence of H. ducreyi as a cause of nongenital ulcers may affect the World Health Organization’s yaws eradication program. PMID:25271477

  7. Haemophilus ducreyi associated with skin ulcers among children, Solomon Islands.

    PubMed

    Marks, Michael; Chi, Kai-Hua; Vahi, Ventis; Pillay, Allan; Sokana, Oliver; Pavluck, Alex; Mabey, David C; Chen, Cheng Y; Solomon, Anthony W

    2014-10-01

    During a survey of yaws prevalence in the Solomon Islands, we collected samples from skin ulcers of 41 children. Using PCR, we identified Haemophilus ducreyi infection in 13 (32%) children. PCR-positive and PCR-negative ulcers were phenotypically indistinguishable. Emergence of H. ducreyi as a cause of nongenital ulcers may affect the World Health Organization's yaws eradication program. PMID:25271477

  8. Factors related to venous ulceration: a cross-sectional study.

    PubMed

    Vlajinac, Hristina; Marinkovic, Jelena; Maksimovic, Milos; Radak, Djordje

    2014-10-01

    The aim of the study was to determine the factors related to venous ulceration. Patients with venous ulceration (278 patients) were compared with 1401 patients in other categories of clinical classification of venous disease (clinical, etiologic, anatomic, and pathophysiological [CEAP]). Demographic, anthropometric, and clinical data were collected. Univariate and multivariate logistic regression analyses were used. According to multivariate analyses, risk factors for venous ulceration were age, male sex, personal history of superficial and deep venous thrombosis, diabetes, high blood pressure, skeletal or joint disease in the legs and emphysema or chronic obstructive pulmonary disease, higher body mass index and physical inactivity, parental history of ankle ulcer as well as reflux in deep and perforator veins, deep obstruction, and combination of reflux and obstruction. It seems reasonable to pay special attention to patients in whom the postulated risk factors for venous ulceration are present. PMID:24165114

  9. An application of Brookhaven National Laboratory`s hot particle methodology for determining the most effective beta particle energy in causing skin ulcers

    SciTech Connect

    Schaefer, C.

    1994-11-01

    The purpose of this project was to compare the effectiveness of hot particles with different energy betas in producing ulcers on skin. The sources were man-made hot particles similar in size and activity to those found in the commercial nuclear power industry. Four different particle types were used. These were thulium (Tm-170) with a 0.97 MeV maximum energy beta, ytterbium (Yb-175) with a maximum beta energy of 0.47 MeV, scandium (Sc-46) with a 0.36 MeV beta, which was used as a surrogate for cobalt-60 (0.31 MeV beta) and uranium (in the carbide form) with an average maximum beta energy of about 2.5 MeV. Since higher energy beta particles penetrate further in skin, they will affect a higher number and different populations of target cells. The experiments were designed as threshold studies such that the dose needed to produce ulcers ten percent of the time (ED 10%) for each particle type could be compared against each other.

  10. Ulcerative colitis - discharge

    MedlinePLUS

    Inflammatory bowel disease - ulcerative colitis - discharge; Ulcerative proctitis - discharge; Colitis - discharge ... Baumgart DC and Sandborn WJ. Inflammatory bowel disease: clinical aspects and ... Clark M, Colombel JF, Feagan BC, Fedorak RN, ...

  11. Cancer complicating chronic ulcerative and scarifying mucocutaneous disorders

    SciTech Connect

    Kaplan, R.P. (Univ. of California, Los Angeles (USA))

    1987-01-01

    Skin affected by a burn cancer is scarred, ulcerated, and often appears as erythema ab igne clinically in adjacent skin. The latent period in burn scar malignancy is much longer for SCC than BCC. Malignant melanoma and various sarcomas are reported to arise in burn scars, too. The other extreme on the temperature scale can less often result in enough permanent acral damage that poor wound healing may eventually result in cancer, usually SCC. About 1% of patients with chronic osteomyelitis develop cancer, usually SCC in sinus tracts. As with tumors arising in burn scars and chronic leg ulcers of varied etiology, black patients are disproportionately overrepresented in osteomyelitic malignancy. In nearly all of the patients with radiation-induced skin cancer, concomitant radiodermatitis is present. As with burn scar and osteomyelitic cancer, x-ray related cancer has a long latent period. Similar to burn scar cancer, SCC predominates in osteomyelitis and occurs on the extremities. BCC, when it arises, is more common on the face and neck in burn- and radiation-induced tumors. Multiple tumors are frequent as is recurrence in x-ray malignancy. Mortality is high: one out of three to four patients with burn scar, osteomyelitic, and radiation cancer die of dermatosis-related malignancy. Recently, radioactivity-contaminated gold rings have been implicated in causing SCC. Carcinoma tends to occur in irradiated benign dermatoses whereas sarcomas tend to complicate irradiated malignancies. Stasis ulceration and anogenital fistulae may rarely lead to cancer, SCC in the former and adenocarcinoma in the latter. SCC can rarely develop in four related conditions (acne conglobata, dissecting perifolliculitis of the scalp, hidradenitis suppurativa, and pilonidal sinus) after a lengthy latent period; prognosis is poor with a high metastatic rate. 147 references.

  12. Nocturnal eating/drinking syndrome with restless legs syndrome caused by neuroleptics improved by Yi-Gan San add-on treatment: a case report.

    PubMed

    Kawabe, Kentaro; Ueno, Shu-ichi; Hosoda, Yoshiki; Horiguchi, Jun

    2012-01-01

    Nocturnal eating/drinking syndrome is characterized by awakening in the middle of the night, getting out of bed, and consuming large quantities of food quickly and uncontrollably. We report a middle-aged male patient with schizophrenia who had nocturnal eating/drinking syndrome with restless legs syndrome whose condition improved with the administration of the herbal medicine Yi-Gan San (Yokukan-San in Japanese). PMID:23151467

  13. 20Hz whole body vibration training fails to counteract the decrease in leg muscle volume caused by 14 days of 6° head down tilt bed rest

    Microsoft Academic Search

    Jochen Zange; Joachim Mester; Martina Heer; Götz Kluge; Anna-Maria Liphardt

    2009-01-01

    A 6° head down tilt bed rest (HDT) was used to simulate the effects of muscle unloading in space. We tested whether vibration\\u000a training (VT) reduces the decrease in leg muscle volume induced by 14 days HDT. In two study phases eight healthy male subjects\\u000a received both (1) HDT and VT or (2) HDT and a control intervention. Twice daily five

  14. Triggers for Willis Ekbom Disease / Restless Legs Syndrome

    MedlinePLUS

    ... willis-ekbom.org Triggers for Willis-Ekbom Disease/ Restless Legs Syndrome The exact cause of Willis-Ekbom disease or WED, formerly known as restless legs syndrome (RLS), is unknown. We do know that WED/ ...

  15. Restless Legs Syndrome

    MedlinePLUS

    NINDS Restless Legs Syndrome Information Page Condensed from Restless Legs Syndrome Fact Sheet Table of Contents (click to jump to sections) ... Trials Organizations Additional resources from MedlinePlus What is Restless Legs Syndrome? Restless legs syndrome (RLS) is a neurological disorder ...

  16. Leg lengthening.

    PubMed

    Bridgman, S A; Bennet, G C; Evans, G A; Stirling, J

    1993-04-01

    The combined experience of the Royal Hospital for Sick Children, Glasgow and the Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry in lengthening 52 lower limb segments with the Orthofix device is reviewed. Forty-eight segments were lengthened by callotasis, 24 in patients with achondroplasia. Attempted lengthening with chondrodiatasis was performed in 4 patients with leg length discrepancy. With callotasis, planned lengthening was achieved in 43/48 (90%) of segments. There was a small number of significant complications. Angulation or buckling of the new bone was the commonest major complication, and was seen in 10% of segments. Pin tract infection was the predominant minor complication. Premature union was noted commonly in the femurs of achondroplastics, but could usually be overcome with manipulation under anaesthesia. We confirm that callotasis achieves its objectives with fewer complications and operations than the commonly used Wagner method which it should supersede. By contrast, we had major complications in all cases with chondrodiatasis and have abandoned this method. PMID:8478826

  17. Retrograde mechanochemical ablation of the small saphenous vein for the treatment of a venous ulcer.

    PubMed

    Moore, Hayley M; Lane, Tristan Ra; Franklin, Ian J; Davies, Alun H

    2014-10-01

    We present the first case of retrograde ablation of the small saphenous vein to treat active venous ulceration. A 73-year-old gentleman with complicated varicose veins of the left leg and a non-healing venous ulcer despite previous successful endovenous treatment to his left great saphenous vein underwent mechanochemical ablation of his small saphenous vein with the ClariVein® system, under local anaesthetic, using a retrograde cannulation technique. Post-operatively the patient had improved symptomatically and the ulcer size had reduced. This report highlights that patients with small saphenous vein incompetence and active ulceration can be treated successfully with retrograde mechanochemical ablation. PMID:24347131

  18. [Treatment and prevention of erosive and ulcerative lesions in the stomach and duodenum caused by intake of non-steroidalanti-inflammatory drugs].

    PubMed

    Luzina, E V

    2014-01-01

    Therapy with non-steroidal anti-inflammatory drugs (NSAIDs) is a diffcult task. Good anti-inflammatory effect increases the risk of gastrointestinal complications with a frequency of 10-50%. The risk further increases with age (above 60-70 yr), the history of ulcer disease concomitant intake of acetylsalicylic acid, anticoagulants, and glucocorticosteroids. Long-term antisecretory therapy with proton pump inhibitors, e.g., esomeprazole, was shown to be an effective prophylactic tool. This drug maintains the intragastric pH value above 4 for 15 hr on the average. The risk of erosive and ulceraive lesions in the stomach and duodenum significantly decreases by selective cyclooxygenase-2 inhibitors, e.g., coxibs, that however increase the risk of thrombotic cardiovascular complications. The author proposes recommendations on the use of NSAIDs in the patients at risk of serious gastrointestinal and cardiovascular pathology. Naproxen in combination with proton pitmp inhibitors is the drug of choice among NSAIDs. Vimovo is a fixed combination of naproxen and esomeprazole. Results of comparative studies on the efficacy of vimovo and celecoxib are presented along with the data on the safety of this. combination compared with that of naproxen monotherapy PMID:25790707

  19. Recurrence of chronic venous ulcers on the basis of clinical, etiologic, anatomic, and pathophysiologic criteria and air plethysmography

    Microsoft Academic Search

    Huey B. McDaniel; William A. Marston; Mark A. Farber; Robert R. Mendes; Lewis V. Owens; Mary L. Young; Patty F. Daniel; Blair A. Keagy

    2002-01-01

    Introduction: Leg ulcers associated with chronic venous insufficiency (CVI) frequently recur after healing. The risk of recurrence has not been well defined for patients in different anatomic and hemodynamic groups. We reviewed the risk of ulcer recurrence on the basis of clinical, etiologic, anatomic, and pathophysiologic criteria and hemodynamic characteristics of the affected limb as assessed with air plethysmography (APG).

  20. Evaluation of foot ulcers in diabetic patients.

    PubMed

    Quddus, M A; Uddin, M J

    2013-07-01

    This is a prospective observational study of 50 cases of diabetic foot ulcer conducted from June 2010 to May 2011 in the Department of Surgery of Shaheed Ziaur Rahman Medical College Hospital and the Diabetic Hospital, Bogra. This study revealed that diabetic foot ulcers are not uncommon complication in our country. The purpose of the study was to undergo a thorough evaluation of diabetic foot ulcers for better management as well as better outcome of patients. The maximum age group of this study was 41-50 years; mean±SD age was 55±15 years and male to female ratio was 1.4:1. This study showed that diabetic foot ulcers were more common in low-socio-economic group, among smokers, among poor glycemic controlled group and long duration of diabetics. In this series, 92% patients had peripheral neuropathy, 22% had foot deformity and 70% patients had vascular insufficiency in the foot and legs. In this series, 68% patients presented early diabetic complication i.e. 44% patients belonged to grade '0' and 24% patients belonged to Grade 1, which were suitable for safety of the limb or reducing major amputation if treated properly. PMID:23982544

  1. Leukemia cutis presenting as a scrotal ulcer.

    PubMed

    Zax, R H; Kulp-Shorten, C L; Callen, J P

    1989-08-01

    A patient with acute nonlymphocytic leukemia developed a painful scrotal ulcer thought initially to be caused by infection. The lesion failed to heal with oral antibiotic therapy and local wound care. Histopathologic examination of a biopsy specimen revealed an infiltrate of leukemic cells. This cutaneous lesion heralded the relapse of acute myelogenous leukemia. A review of the literature indicates that acute nonlymphocytic leukemia rarely presents as an ulcer or on the genitalia, thus emphasizing the uniqueness of this case regarding morphology, and site of presentation. To our knowledge, this is the first case of leukemia cutis presenting as a scrotal ulcer. Therefore leukemia cutis should be added to the differential diagnosis of chronic genital ulcers. Also, because a variety of skin lesions may signify the relapse of leukemia, any skin lesion in a patient with leukemia should be examined by biopsy. PMID:2754075

  2. Gnawing Pains, Festering Ulcers, and Nightmare Suffering: Selling Leprosy as a Humanitarian Cause in the British Empire, c. 1890-1960.

    PubMed

    Vongsathorn, Kathleen

    2012-12-01

    When British attention was drawn to the issue of leprosy in the Empire, humanitarian organisations rose to take on responsibility for the 'fight against leprosy'. In an effort to fundraise for a distant cause at a time when hundreds of charities competed for the financial support of British citizens, fundraisers developed propaganda to set leprosy apart from all other humanitarian causes. They drew on leprosy's relationship with Christianity, its debilitating symptoms, and the supposed vulnerability of leprosy sufferers in order to mobilise Britain's sense of humanitarian, Christian, and patriotic duty. This article traces the emergence of leprosy as a popular imperial humanitarian cause in modern Britain and analyses the narratives of religion, suffering, and disease that they created and employed in order to fuel their growth and sell leprosy as a British humanitarian cause. PMID:24932060

  3. Gastric ulceration in horses

    Microsoft Academic Search

    Richard Hepburn

    2011-01-01

    Equine gastric ulceration syndrome (EGUS) was first described in 1986 and is common in all types of horses. The clinical signs are variable and often vague but EGUS can be easily diagnosed following thorough history taking and physical examination, and confirmed using gastroscopy. Ulcers can be effectively treated and prevented by introducing changes in management practices and instituting drug therapy.

  4. Vasculitic Peripheral Ulcerative Keratitis

    Microsoft Academic Search

    Elisabeth M Messmer; C. Stephen Foster

    1999-01-01

    The onset of peripheral ulcerative keratitis in the course of a connective tissue disorder, such as rheumatoid arthritis, relapsing polychondritis, or systemic lupus erythematosus, may reflect the presence of potentially lethal systemic vasculitis. Moreover, peripheral ulcerative keratitis may be the first sign of systemic necrotizing vasculitis in patients with Wegener’s granulomatosis, polyarteritis nodosa, microscopic polyangiitis, or Churg-Strauss syndrome. Although the

  5. [Restless legs syndrome].

    PubMed

    Droste, Dirk W; Diederich, Nico

    2007-01-01

    About 7% of the population are affected by the restless legs syndrome (RLS). The most invalidating subjective complaints are dysesthesia / pain / an urge to move the legs (46%), an alteration of sleep (38%), and difficulties in performing activities of daily life (7%). The onset of the disease is variable, ranging from childhood (often unrecognised) to old age. The clinical course is generally chronic with phases of spontaneous remission. The cause of RLS is probably mainly genetic with a dysfunction of iron and dopamine metabolism accentuated by peripheral factors (neuropathy, radiculopathy, and temperature). There are secondary forms of RLS, such as iron deficiency (under debate), side effects of drugs (that can be stopped), renal insufficiency, radiculopathy, and neuropathy. RLS can come up during pregnancy, in particular in the last trimenon. Treatment of aggravating factors and sleep hygiene are general measures. Drug treatment of the RLS comprises levodopa, dopaminergic drugs, opioids, and antiepileptic drugs; however, drug treatment is only necessary in about a third of the affected. PMID:17953080

  6. Treatment and prognosis in peptic ulcer bleeding.

    PubMed

    Laursen, Stig Borbjerg

    2014-02-01

    Peptic ulcer bleeding is a frequent cause of admission. Despite several advances in treatment the 30-day mortality seems unchanged at a level around 11%. Use of risk scoring systems is shown to be advantageous in the primary assessment of patients presenting with symptoms of peptic ulcer bleeding. Studies performed outside Denmark have demonstrated that use of risk scoring systems facilitates identification of low-risk patients suitable for outpatient management. Nevertheless, these systems have not been implemented for routine use in Denmark. This is mainly explained by concerns about the external validity due to considerable inter-country variation in patients' characteristics. In recent years, transcatheter arterial embolization (TAE) has become increasingly used for achievement of haemostasis in patients with peptic ulcer bleeding not responding to endoscopic therapy. As rebleeding is associated with poor outcome TAE could, in theory, also be beneficial as a supplementary treatment in patients with ulcer bleeding responding to endoscopic therapy. This has not been examined previously. Several studies have concluded that peptic ulcer bleeding is associated with excess long-term mortality. These findings are, however, questioned as the studies were based on life-table analysis, unmatched control groups, or did not perform adequate adjustment for comorbidity. Treatment with blood transfusion is, among patients undergoing cardiac bypass surgery, shown to increase the long-term mortality. Despite frequent use of blood transfusion in treatment of peptic ulcer bleeding a possible adverse effect of on long-term survival has not been examined in these patients. PMID:24495895

  7. Novel therapeutic approaches to gastric and duodenal ulcers: an update.

    PubMed

    Dajani, E Z; Klamut, M J

    2000-07-01

    Over the last 25 years, a remarkable revolution in the pathophysiology and treatment of gastric and duodenal ulcers has occurred. Effective therapies were developed not only to heal ulcers, but also to cure most patients. The two principal causes for gastric and duodenal ulcers are either infection with Helicobacter pylori or the use of non-steroidal anti-inflammatory drugs (NSAIDs). With H. pylori eradication, gastric and duodenal ulcers are rapidly becoming historical diseases. This communication reviews the salient pharmacology of the novel anti-ulcer drugs currently in development, with particular emphasis on the treatment of gastric and duodenal ulcers. Intense research is currently focused on the development of proton pump inhibitors primarily for the treatment and prevention of gastroesophageal reflux disease. The older proton pump inhibitors, omeprazole and lansoprazole, are effective in healing gastric and duodenal ulcers. Furthermore, both drugs are effective in eradicating H. pylori when given with various antibiotics. Pantoprazole, rabeprazole and esomeprazole are new proton pump inhibitors, which appear to have comparable therapeutic profiles with omeprazole and lansoprazole. Rebamipide is a new mucosal protective drug, which is effective in healing gastric ulcers. Polaprezinc and nocloprost are also mucosal protective drugs, which are in clinical development. However, none of these three cytoprotective drugs have been evaluated for their efficacy in eradicating H. pylori when given in combination with antibiotics. Likewise, no published literature exists on the use of these drugs for preventing NSAID-induced ulcers. With the rapid eradication of H. pylori currently happening in the developed world, the therapeutic challenge is now directed toward preventing NSAID-associated ulcer. Significant reduction of NSAID-induced ulcers is achieved by using continuous prophylactic anti-ulcer therapy (misoprostol or omeprazole) or by using NSAIDs possessing selective COX-2 inhibitory activity. However, outcome clinical studies are needed to compare the adjuvant anti-ulcer therapies given with COX-1 inhibitors versus the selective COX-2 inhibitors given alone. PMID:11060758

  8. Allergy as a factor in surface ulcers, varicose veins, phlebitis and thrombosis

    Microsoft Academic Search

    John A. Turnbull

    1945-01-01

    Conclusions  \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a The causes and symptoms of varicose veins, together with their sequelae, varicose ulcer, thrombosis and phlebitis, are reviewed.\\u000a \\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a Attention is called to the fact that\\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a \\u000a a) \\u000a \\u000a most of these conditions occur most frequently in the legs, but\\u000a \\u000a \\u000a \\u000a \\u000a b) \\u000a \\u000a thrombosis, in particular, while it has been observed in all parts of the body, is more frequent in the

  9. [Restless-legs syndrome].

    PubMed

    Karroum, E; Konofal, E; Arnulf, I

    2008-01-01

    Restless-legs syndrome (RLS) is a sensorimotor disorder, characterized by an irresistible urge to move the legs usually accompanied or caused by uncomfortable and unpleasant sensations. It begins or worsens during periods of rest or inactivity, is partially or totally relieved by movements and is exacerbated or occurs at night and in the evening. RLS sufferers represent 2 to 3% of the general population in Western countries. Supportive criteria include a family history, the presence of periodic-leg movements (PLM) when awake or asleep and a positive response to dopaminergic treatment. The RLS phenotypes include an early onset form, usually idiopathic with a familial history and a late onset form, usually secondary to peripheral neuropathy. Recently, an atypical RLS phenotype without PLM and l-DOPA resistant has been characterized. RLS can occur in childhood and should be distinguished from attention deficit/hyperactivity disorder, growing pains and sleep complaints in childhood. RLS should be included in the diagnosis of all patients consulting for sleep complaints or discomfort in the lower limbs. It should be differentiated from akathisia, that is, an urge to move the whole body without uncomfortable sensations. Polysomnographic studies and the suggested immobilization test can detect PLM. Furthermore, an l-DOPA challenge has recently been validated to support the diagnosis of RLS. RLS may cause severe-sleep disturbances, poor quality of life, depressive and anxious symptoms and may be a risk factor for cardiovascular disease. In most cases, RLS is idiopathic. It may also be secondary to iron deficiency, end-stage renal disease, pregnancy, peripheral neuropathy and drugs, such as antipsychotics and antidepressants. The small-fiber neuropathy can mimic RLS or even trigger it. RLS is associated with many neurological and sleep disorders including Parkinson's disease, but does not predispose to these diseases. The pathophysiology of RLS includes an altered brain-iron metabolism, a dopaminergic dysfunction, a probable role of pain control systems and a genetic susceptibility with nine loci and three polymorphisms in genes serving developmental functions. RLS treatment begins with the elimination of triggering factors and iron supplementation when deficient. Mild or intermittent RLS is usually treated with low doses of l-DOPA or codeine; the first-line treatment for moderate to severe RLS is dopaminergic agonists (pramipexole, ropinirole, rotigotine). In severe, refractory or neuropathy-associated RLS, antiepileptic (gabapentin, pregabalin) or opioid (oxycodone, tramadol) drugs can be used. PMID:18656214

  10. Ulcer necrotic legs as first manifestation of protein S deficiency

    Microsoft Academic Search

    V. Vicente; I. Alberca; M. D. Tabernero; A. López Borrasca

    1987-01-01

    Protein S is a vitamin K-dependent plasma protein which increases the rate of inactivation of factor Va by activated protein C. Recently, several families with members affected by a hereditary deficiency of this protein asociated with thrombosis have been reported [1-3]. Generally, the first thrombotic event in these patients appears towards the end of the second decade of life. In

  11. Ulcer healing time and antibiotic treatment before and after the introduction of the Registry of Ulcer Treatment: an improvement project in a national quality registry in Sweden

    PubMed Central

    Öien, Rut F; Forssell, Henrik W

    2013-01-01

    Objectives To investigate changes in ulcer healing time and antibiotic treatment in Sweden following the introduction of the Registry of Ulcer Treatment (RUT), a national quality registry, in 2009. Design A statistical analysis of RUT data concerning the healing time and antibiotic treatment for patients with hard-to-heal ulcers in Sweden between 2009 and 2012. Setting RUT is a national web-based quality registry used to capture areas of improvement in ulcer care and to structure wound management by registering patients with hard-to-heal leg, foot and pressure ulcers. Registration includes variables such as gender, age, diagnosis, healing time, antibiotic treatment, and ulcer duration and size. Population Every patient with a hard-to-heal ulcer registered with RUT between 2009 and 2012 (n=1417) was included. Main outcome measures Statistical analyses were performed using Stata V.12.1. Healing time was assessed with the Kaplan-Meier analysis and adjustment was made for ulcer size. A log-rank test was used for equality of survivor functions. Results According to the adjusted registry in December 2012, patients’ median age was 80?years (mean 77.5?years, range 11–103?years). The median healing time for all ulcers, adjusted for ulcer size, was 146?days (21?weeks) in 2009 and 63?days (9?weeks) in 2012 (p=0.001). Considering all years between 2009 and 2012, antibiotic treatment for patients with hard-to-heal ulcers was reduced from 71% before registration to 29% after registration of ulcer healing (p=0.001). Conclusions Healing time and antibiotic treatment decreased significantly during 3?years after launch of RUT. PMID:23959752

  12. Sustaining pressure ulcer prevention in practice.

    PubMed

    McDonagh, Vanessa

    This article describes a campaign to eliminate avoidable grade 2-4 pressure ulcers at University Hospitals Coventry and Warwickshire Trust. The 100 Days Free strategy used traditional educational approaches along with ward-based power training and social media to engage staff and update practice. Root cause analysis has been vital in providing feedback to staff and identifying training needs. PMID:23696992

  13. NGF, a useful tool in the treatment of chronic vasculitic ulcers in rheumatoid arthritis.

    PubMed

    Tuveri, M; Generini, S; Matucci-Cerinic, M; Aloe, L

    2000-11-18

    Vasculitic necrosis and ulceration of the skin are frequent complications of connective tissue diseases and are very difficult to heal. We treated chronic vasculitic leg ulcers in rheumatoid arthritis and systemic sclerosis by topical application of nerve growth factor (NGF). In all patients with rheumatoid arthritis, NGF led to rapid healing, whereas less striking results were obtained in patients with systemic sclerosis. The efficacy of NGF could be due to its promoting activity on keratinocytes proliferation and vascular neoangiogenesis. We suggest that topical application of NGF could represent a powerful pharmacological tool for the treatment of vasculitic ulcers. PMID:11095266

  14. Plantar decubitus ulcers in rats and rabbits.

    PubMed

    Honma, M; Kast, A

    1989-07-01

    A high incidence of plantar decubitus ulcers, 35% in males and 22 or 45% in females, respectively, occurred in rats of two carcinogenicity studies independent of the bedding used, hard or soft wood chips. Among rabbits kept in chrome-plated wire cages, about 2-year-old female breeders suffered from the plantar ulcers, but not their male partners of the same age group. The causes of the foot disease appear to be manifold, however, in our cases the lesions could be prevented in both species by housing on a cage floor made from flattened stainless wire. PMID:2792208

  15. Pressure ulcer prevention.

    PubMed

    Edlich, Richard F; Winters, Kathryne L; Woodard, Charles R; Buschbacher, Ralph M; Long, William B; Gebhart, Jocelynn H; Ma, Eva K

    2004-01-01

    The purpose of this collective review is to outline the predisposing factors in the development of pressure ulcers and to identify a pressure ulcer prevention program. The most frequent sites for pressure ulcers are areas of skin overlying bony prominences. There are four critical factors contributing to the development of pressure ulcers: pressure, shearing forces, friction, and moisture. Pressure is now viewed as the single most important etiologic factor in pressure ulcer formation. Prolonged immobilization, sensory deficit, circulatory disturbances, and poor nutrition have been identified as important risk factors in the development of pressure ulcer formation. Among the clinical assessment scales available, only two, the Braden Scale and Norton Scale, have been tested extensively for reliability and/or validity. The most commonly used risk assessment tools for pressure ulcer formation are computerized pressure monitoring and measurement of laser Doppler skin blood flow. Pressure ulcers can predispose the patient to a variety of complications that include bacteremia, osteomyelitis, squamous cell carcinoma, and sinus tracts. The three components of pressure ulcer prevention that must be considered in any patient include management of incontinence, nutritional support, and pressure relief. The pressure relief program must be individualized for non-weight-bearing individuals as well as those that can bear weight. For those that can not bear weight and passively stand, the RENAISSANCE Mattress Replacement System is recommended for the immobile patient who lies supine on the bed, the stretcher, or operating room table. This alternating pressure system is unique because it has three separate cells that are not interconnected. It is specifically designed so that deflation of each individual cell will reach a ZERO PRESSURE during each alternating pressure cycle. The superiority of this system has been documented by comprehensive clinical studies in which this system has been compared to the standard hospital bed as well as to two other commercially available pressure relief mattresses. The most recent advance in pressure ulcer prevention is the development of the ALTERN8* seating system. This seating system provides regular periods of pressure relief and stimulation of blood flow to skin areas while users are seated. By offering the combination of pressure relief therapy and an increase in blood flow, the ALTERN8* reportedly creates an optimum pressure ulcer healing environment. Foam is the most commonly used material for pressure reduction and pressure ulcer prevention and treatment for the mobile individual. For those immobilized individuals who can achieve a passive standing position, a powered wheelchair that allows the individual to achieve a passive standing position is recommended. The beneficial effects of passive standing have been documented by comprehensive scientific studies. These benefits include reduction of seating pressure, decreased bone demineralization, increased blander pressure, enhanced orthostatic circulatory regulation, reduction in muscular tone, decrease in upper extremity muscle stress, and enhanced functional status in general. In the absence of these dynamic alternating pressure seating systems and mattresses, there are enormous medicolegal implications to the healthcare facility. Because there is not sufficient staff to provide pressure relief to rotate the patient every 2 hours in a hospital setting, with the exception of the intensive care unit, the immobile patient is prone to develop pressure ulcers. The cost of caring for these preventable pressure ulcers may now be as high as 60,000 dollars per patient. The occupational physical strain sustained by nursing personnel in rotating their patients has led to occupational back pain in nurses, a major source of morbidity in the healthcare environment. PMID:15447627

  16. Acute motor sensory polyneuropathy (AMSAN) complicating active ulcerative colitis with a patchy distribution.

    PubMed

    Zezos, Petros; Mpoumponaris, Alexandros; Koutsopetras, Petros; Vounotrypidis, Periklis; Molyvas, Epaminondas; Vadikolias, Konstantinos; Moschos, Ioannis; Kouklakis, Georgios

    2007-01-01

    We report a case of acute motor and sensory neuropathy during a flare of ulcerative colitis. A 28-year-old male presented with a flare of distal ulcerative colitis despite treatment with mesalamine enemas and suppositories simultaneously with rapidly deteriorating weakness and needle sensation in both legs. Neurological assessment showed axonal sensorimotor polyneuropathy affecting mainly the lower limbs and to a lesser extent the upper limbs. Colonoscopy revealed moderately to severe active ulcerative colitis with a patchy distribution involving the rectum and the right colon. Vitamin and folic acid levels were normal. Virological, immunological and other laboratory tests were negative except for positive anti-ganglioside antibodies (anti-GM1). Ulcerative colitis and polyneuropathy improved when patient was treated with immunosuppressive therapy (corticosteroids, immunoglobulin and azathioprine). Peripheral polyneuropathy is a rare extraintestinal manifestation of ulcerative colitis and it is probably associated with an autoimmune pathogenetic mechanism. PMID:17715640

  17. Thyroid Storm Precipitated by Duodenal Ulcer Perforation

    PubMed Central

    Natsuda, Shoko; Nakashima, Yomi; Horie, Ichiro; Kawakami, Atsushi

    2015-01-01

    Thyroid storm is a rare and life-threatening complication of thyrotoxicosis that requires prompt treatment. Thyroid storm is also known to be associated with precipitating events. The simultaneous treatment of thyroid storm and its precipitant, when they are recognized, in a patient is recommended; otherwise such disorders, including thyroid storm, can exacerbate each other. Here we report the case of a thyroid storm patient (a 55-year-old Japanese male) complicated with a perforated duodenal ulcer. The patient was successfully treated with intensive treatment for thyroid storm and a prompt operation. Although it is believed that peptic ulcer rarely coexists with hyperthyroidism, among patients with thyroid storm, perforation of a peptic ulcer has been reported as one of the causes of fatal outcome. We determined that surgical intervention was required in this patient, reported despite ongoing severe thyrotoxicosis, and reported herein a successful outcome. PMID:25838951

  18. Diabetic foot ulcerations: an overview.

    PubMed

    Daniels, T R

    1998-09-01

    The development of a diabetic neuropathic ulcer is a multifactorial process with an emphasis on mechanical abnormalities. In the absence of vascular compromise, up to 90 percent of neuropathic ulcers will heal with proper ulcer debridement, treatment of infection and relief of weight from the ulcerated area. A thorough understanding of the etiology of a neuropathic ulcer is an essential component in the appropriate management of these patients. Treatment of the diabetic neuropathic ulcer is a multidisciplinary clinical problem and each member of the team has a unique role to play. PMID:9866607

  19. Healing of venous ulcers using compression therapy: Predictions of a mathematical model.

    PubMed

    Flegg, Jennifer A; Kasza, Jessica; Darby, Ian; Weller, Carolina D

    2015-08-21

    Venous Leg Ulceration (VLU) is a chronic condition for which healthcare systems worldwide face rising treatment costs. VLU can be due to sustained venous hypertension which causes the veins to become cuffed with fibrin, inhibiting the supply of nutrients to the wound site. For patients that cannot tolerate compression therapy with an inelastic short stretch (SS) bandage, the mainstay treatment, an elastic three layered (3L) bandage is an alternative. In this paper, a mathematical model is developed to investigate whether the healing of venous ulcers under SS and 3L bandages occurs at different rates and to postulate the reason for any difference. The two treatments were applied to a simplified wound geometry, under the assumption that the rate limiting step of healing is the supply of oxygen to the wounded tissue. Clinical data of wound size over time under the two treatments from Weller et al. (2012) was used to fit key, unknown, model parameters using a least squares approach. Numerical results are presented for the oxygen distribution within the wound space, using the fitted parameter values. The 3L bandage allows more oxygen flow into the wound than the SS bandage and, hence, the 3L bandage results in faster healing, however the difference is more significant for wounds of larger initial size. The model can be used as a predictive tool in a clinical setting to estimate the time to heal for a wound of a given initial size, treated with either a SS or 3L bandage. PMID:25957521

  20. Epstein-Barr virus associated oesophageal ulcers in AIDS.

    PubMed Central

    Kitchen, V S; Helbert, M; Francis, N D; Logan, R P; Lewis, F A; Boylston, A W; Pinching, A J; Harris, J R

    1990-01-01

    Epstein-Barr virus (EBV) associated ulceration has not previously been included in the differential diagnosis of oesophageal ulcers in AIDS. We report five cases of oesophageal ulceration in homosexual men with advanced human immunodeficiency virus infection in whom this was considered to be the most likely cause. DNA in situ hybridisation studies showed EBV in biopsy material from three of four patients with oesophageal ulcers and in none of three controls. Of other viruses studied, only human papillomavirus was present, and this was found in both patients and control subjects. These findings support the hypothesis that EBV is an aetiological factor in some cases of AIDS-associated oesophageal ulceration. Images p1224-a PMID:2174817

  1. Gastric ulcer in Karachi.

    PubMed

    Ahmed, W; Qureshi, H; Alam, S E; Zuberi, S J

    1992-09-01

    Of 138 endoscopically or surgically confirmed cases of gastric ulcer, 102 (74%) were males and 36 (26%) females. Both sexes were affected most commonly in the 6th decade of life. Pain, vomiting and gastrointestinal bleeding were the major presenting symptoms, with a median duration of 6 months. Cigarette smoking was the most common (44%) addiction and 10% were on analgesics or nonsteroidal anti-inflammatory drugs (NSAID). Family history of ulcer was uncommon (2%) and no predilection for any blood group was noted. Among males 53% were skilled workers while 94% of females were housewives. Forty five percent patients were migrants from India and the rest belonged to different provinces of Pakistan. Presentation and behaviour of different sites of gastric ulcers though varied but the results were not significant. Healing rates with H2 receptor antagonists were 33% at 4 weeks and 78% at 8 weeks. PMID:1433804

  2. Restless legs syndrome.

    PubMed

    Mileti?, Vladimir; Relja, Maja

    2011-12-01

    Being of the most frequent causes of insomnia, which in the end leads to chronic fatigue, inadequate performance of daily activities, and serious disruption of quality of living, restless legs syndrome (RLS) is nowadays not only a serious medical problem but a socio-economical one as well. Prevalence of the disorder in general population is estimated at 5 to 15%. Family history is positive in over 50% of idiopathic RLS patients which points to genetic basis of the disorder. The characteristics of the secondary or acquired form of RLS are symptoms that start later in life as well as a rapid progression of the disease. On the other hand, idiopathic RLS more often starts at a younger age and the prognoses are better. Over twenty disorders and conditions are brought in connection with secondary RLS. Although the cause of primary RLS is still unknown, there is a strong connection between central metabolism of iron as well as dopamine levels and RLS manifestation. A differential diagnosis of RLS includes a wide specter of motor and sensory disorders. Diagnosis is based on clinical features and the history of disease. To correctly diagnose idiopathic RLS one must first eliminate secondary causes of RLS and then also exclude any disorders with clinical features that mimic those of RLS. It has been estimated that some 20 to 25% of patients need pharmacological therapy. Best initial therapy is the application of nonergot dopamine agonists. Anticonvulsants, benzodiazepines and opioides can be given to patients who are refractory to dopaminergic therapy, those suffering from RLS with emphasized painful sensory component and those with RLS connected with insomnia. PMID:22397285

  3. Venous ulcers of the lower limb: Where do we stand?

    PubMed

    Chatterjee, Sasanka S

    2012-05-01

    Venous ulcers are the most common ulcers of the lower limb. It has a high morbidity and results in economic strain both at a personal and at a state level. Chronic venous hypertension either due to primary or secondary venous disease with perforator paucity, destruction or incompetence resulting in reflux is the underlying pathology, but inflammatory reactions mediated through leucocytes, platelet adhesion, formation of pericapillary fibrin cuff, growth factors and macromolecules trapped in tissue result in tissue hypoxia, cell death and ulceration. Duplex scan with colour flow is the most useful investigation for venous disease supplying information about patency, reflux, effects of proximal and distal compression, Valsalva maneuver and effects of muscle contraction. Most venous disease can be managed conservatively by leg elevation and compression bandaging. Drugs of proven benefit in venous disease are pentoxifylline and aspirin, but they work best in conjunction with compression therapy. Once ulceration is chronic or the patient does not respond to or cannot maintain conservative regime, surgical intervention treating the underlying venous hypertension and cover for the ulcer is necessary. The different modalities like sclerotherapy, ligation and stripping of superficial varicose veins, endoscopic subfascial perforator ligation, endovenous laser or radiofrequency ablation have similar long-term results, although short-term recovery is best with radiofrequency and foam sclerotherapy. For deep venous reflux, surgical modalities include repair of incompetent venous valves or transplant or transposition of a competent vein segment with normal valves to replace a post-thrombotic destroyed portion of the deep vein. PMID:23162226

  4. Can't Curb the Urge to Move? Living with Restless Legs Syndrome

    MedlinePLUS

    ... t Curb the Urge to Move? Living With Restless Legs Syndrome Staying active is usually a good thing. But ... move goes to unwelcome extremes for people with restless legs syndrome. The condition can cause throbbing, pulling or creeping ...

  5. Drug cutaneous side effect: focus on skin ulceration.

    PubMed

    D'Epiro, S; Salvi, M; Luzi, A; Mattozzi, C; Luci, C; Macaluso, L; Marzocca, F; Salvo, V; Cantisani, C; Paolino, G; Calvieri, S; Richetta, A G

    2014-01-01

    Skin ulcers are defined as tissue loss interesting the deeper layers of the dermis and hypodermis, with low tendency to spontaneous healing. They cause disability related to pain, risk of infection and amputation, chronic management, requiring working absence with notably economic burden. The major cause is often related to underlying vascular disease, infections, tumors, autoimmunity, trauma, even if literature occasionally reported several cases of drug inducing skin ulceration. Most of drugs involved are chemotherapy agents and more recently molecular target therapies. Evidences supporting these drugs as the major cause of skin ulcers include delay of onset after therapy initiation, improvement after withdrawal of the drug, recurrence after its reintroduction and, sometimes, simultaneous occurrence of other skin lesions that have previously been reported to be associated with these agents. Attention should be reserved to patients undergoing antineoplastic agents, especially if previously affected by predisposing comorbidities, considering such side effect as possible differential diagnosis for skin ulceration in neoplastic patients. PMID:25203350

  6. A Matched Case-Control Study of a Novel Acid-Pump Antagonist and Proton-Pump Inhibitor for the Treatment of Iatrogenic Ulcers Caused by Endoscopic Submucosal Dissection

    PubMed Central

    Kim, Yong Gil; Kim, Tae Nyeun

    2010-01-01

    Background/Aims Revaprazan, a novel acid-pump antagonist, and proton-pump inhibitors (PPIs) have pH-independent effects on ulcer healing. The addition of a PPI promotes the cell restitution rate as well as vessel regeneration and maturation for ulcer repair. Revaprazan is known to protect the mucosa by increasing the prostaglandin concentration. Methods We reviewed the medical records of patients who underwent endoscopic submucosal dissection (ESD) for gastric neoplasia at Yeungnam University Hospital between January 2008 and May 2009. We conducted a matched case-control study to compare the healing rates effected by revaprazan and rabeprazole. Results Each group consisted of 30 patients. The baseline characteristics did not differ significantly between the two groups. Stage S1 disease was observed in 97% and 100% of patients after 8 weeks of treatment in the revaprazan and rabeprazole groups, respectively. In the revaprazan group, only one patient had stage H2 disease: a 54-year-old man with a 5.5-cm lesion after ESD of the ulcer, type IIa early gastric cancer, and adenocarcinoma. No serious adverse effects occurred during the treatment period in either group. Conclusions The safety and efficacy profiles of revaprazan and rabeprazole are similar for the treatment of ESD-induced ulcers. PMID:20479909

  7. Leg or foot amputation

    MedlinePLUS

    ... days. Before leaving the hospital, you will begin learning how to: Use a wheelchair or a walker Stretch your muscles to make them stronger Strengthen your arms and legs Begin walking with a walking aid and parallel bars Start ...

  8. Legs of Mesolimulus

    NSDL National Science Digital Library

    2001-03-01

    This specimen of the horseshoe crab Mesolimulus displays the impression of three segmented arms. Although capable of walking on these legs, modern horseshoe crabs use them mainly for burrowing for prey (clams and worms).

  9. Treatment of solitary rectal ulcer syndrome with high-fiber diet and abstention of straining at defecation

    Microsoft Academic Search

    V. van den Brandt-Grädel; K. Huibregtse; G. N. J. Tytgat

    1984-01-01

    Twenty-one patients with a solitary ulcer of the rectum were treated with instructions for a high-fiber diet and abstention of straining at defecation, since there is evidence that the solitary ulcer syndrome is caused by chronic mechanical and ischemic trauma, by hard stools, and intussusception of the mucosa. In 15 patients disappearance of symptoms and complete ulcer healing was obtained

  10. Genital Ulcerative Pyoderma Gangrenosum in Behçet's Disease: A Case Report and Review of the Literature

    PubMed Central

    Ozuguz, Pinar; Kacar, Seval Dogruk; Manav, Vildan; Karaca, Semsettin; Aktepe, Fatma; Ulu, Sena

    2015-01-01

    Behçet's disease (BD), first described by Hulusi Behcet, is a multisystemic disease characterized by recurrent oral and genital ulcerations, ocular and cutaneous lesions, arthritis and vascular disease. Pyoderma gangrenosum (PG) is a rare, chronic, sterile pustular and progressive ulcerative process of unknown cause; sometimes can participate in the differential diagnosis of Behcet's ulceration. A 33-year-old woman complained a severe genital ulcer. She had a purulent oozing and stinky ulceration on the right side of labium minor measuring 5-8 cm. A punch biopsy at ulcer margin showed that the lymphocytic panniculitis was extending to the subcutaneous fat tissue without fibrin deposition or necrotic changes in the vessel wall. Based on the clinical and histological findings, she was diagnosed as genital ulcerative PG, which occurred during the exacerbation of BD. PMID:25657430

  11. Roles of NSAIDs and aspirin in bleeding peptic ulcers

    Microsoft Academic Search

    Ryuichi Iwakiri; Kazuma Fujimoto

    2008-01-01

    Upper gastrointestinal bleeding is one of the most common complications associated with peptic ulcer disease. In Japan, most\\u000a patients were infected by Helicobacter pylori and the infection was considered to be one of the major causes of bleeding ulcers. Exposure to non-steroidal anti-inflammatory\\u000a drugs (NSAIDs) and low dose aspirin are known to be other important risk factors of upper gastrointestinal

  12. [Conservative therapy of peptic ulcer].

    PubMed

    Clémençon, G H

    1980-10-11

    Ulcer disease is the product of different pathogenetic mechanisms which destroy the balance between protection and aggregation in the human organism. Investigation of such errors of physiologic balance in the human organism is in full swing, and has provided the theoretical elements for appropriate therapy. Therapy for ulcer disease must take into consideration the patient's personality as well as the surrounding conditions. Though duodenal and gastric ulcer show many different characteristics, therapy does not greatly differ. Food and antacids neutralize hydrochloric acid already produced and bind bile acids and other substances which have been regurgitated from the duodenum into the stomach. Furthermore, very potent inhibitors of acid secretion are available, such as the H2-receptor-antagonist cimetidine, and pirenzepine. Antacids, inhibitors of acid secretion and placebo may lead to disappearance of symptoms, but it should be borne in mind that abut one third of patients with an ulcer recurrence remain asymptomatic. Pain and other symptoms of active ulcer disease usually disappear as early as a few days after initiating therapy. On average the healing ratio of ulcers is higher with pharmacologically active substances than with placebo. In the present state of knowledge, endoscopic follow-up of ulcer disease is to be recommended not only because active ulcer disease and ulcer recurrences may be asymptomatic, but, above all, because of the risk of malignancy in gastric ulcer. PMID:6106967

  13. Persistent nicorandil induced oral ulceration

    PubMed Central

    Healy, C M; Smyth, Y; Flint, S R

    2004-01-01

    Four patients with nicorandil induced ulceration are described, and the literature on the subject is reviewed. Nicorandil induced ulcers are very painful and distressing for patients. Clinically they appear as large, deep, persistent ulcers that have punched out edges. They are poorly responsive to topical steroids and usually require alteration of nicorandil treatment. The ulceration tends to occur at high doses of nicorandil and all four cases reported here were on doses of 40 mg per day or greater. In these situations reduction of nicorandil dose may be sufficient to promote ulcer healing and prevent further recurrence. However, nicorandil induced ulcers have been reported at doses as low as 10 mg daily and complete cessation of nicorandil may be required. PMID:15201264

  14. Metastable legged-robot locomotion

    E-print Network

    Byl, Katie

    2008-01-01

    A variety of impressive approaches to legged locomotion exist; however, the science of legged robotics is still far from demonstrating a solution which performs with a level of flexibility, reliability and careful foot ...

  15. Legged locomotion on sand

    NASA Astrophysics Data System (ADS)

    Li, Chen; Umbanhowar, Paul; Komsuoglu, Haldun; Koditschek, Daniel; Goldman, Daniel

    2009-11-01

    To understand how and why animals modulate foot kinematics to achieve effective locomotion on granular media, we study the speed of a six-legged robot with c-shaped legs, SandBot, moving on granular media for varying volume fraction, ?, limb frequency, f, and gait timing parametersfootnotetextLi et. al, PNAS, 106, 3029, 2009. Speed is determined by step length which in turn depends on limb penetration. At low f and high ? penetration is small, step length is large, and SandBot advances with a rotary walking gait in which c-legs rotate about their centers by slipping relative to stationary grains. In the opposite extreme, grains cannot support the robot; its underside always contacts the ground and it advances slowly via thrust generated as the c-legs translate through the grains. For varied gait parameters, high speeds are only observed in a small area of parameter space. A yield stress based model predicts the speed and reveals that performance is maximized when gait parameters minimize limb acceleration and interference, and limbs utilize the solidification properties of the media.

  16. Legged locomotion on sand

    NASA Astrophysics Data System (ADS)

    Li, Chen; Umbanhowar, Paul; Komsuoglu, Haldun; Koditschek, Daniel; Goldman, Daniel

    2009-11-01

    To understand how and why animals modulate foot kinematics to achieve effective locomotion on granular media, we study the speed of a six-legged robot with c-shaped legs, SandBot, moving on granular media for varying volume fraction, ?, limb frequency, f, and gait timing parameters.footnotetextLi et. al, PNAS, 106, 3029, 2009 Speed is determined by step length which in turn depends on limb penetration. At low f and high ? penetration is small, step length is large, and SandBot advances with a rotary walking gait in which c-legs rotate about their centers by slipping relative to stationary grains. In the opposite extreme, grains cannot support the robot; its underside always contacts the ground and it advances slowly via thrust generated as the c-legs translate through the grains. For varied gait parameters, high speeds are only observed in a small area of parameter space. A yield stress based model predicts the speed and reveals that performance is maximized when gait parameters minimize limb acceleration and interference, and limbs utilize the solidification properties of the media.

  17. Towards a legged chip

    Microsoft Academic Search

    Timir Datta; Pamela Abshire; John A. Turner

    2011-01-01

    We describe a substrate for a Legged Chip, a CMOS integrated circuit with built in actuation mechanisms for motion. We have designed and fabricated a custom integrated circuit using a commercial 0.5?m CMOS technology which implements walking gait control. The circuit specifications and physical implementation have been designed to take into consideration the addition of thermal actuators through low- temperature

  18. Leg lengthening and shortening

    MedlinePLUS

    BONE LENGTHENING This series of treatments involves several surgeries, a long recovery period, and a number of risks. However, it can add up to 6 inches of length to a leg. The child will be under general anesthesia. This means the child is asleep ...

  19. Playing soccer with legged robots

    Microsoft Academic Search

    Manuela Velosot; William Uthert; M. Fijita; Minoru Asadas; H. Kitano

    1998-01-01

    Sony has provided a remarkable platform for research and development in robotic agents, namely fully autonomous legged robots. In this paper, we describe our work using Sony's legged robots to participate at the RoboCup'98 legged robot demonstration and competition. Robotic soccer represents a very challenging environment for research into systems with multiple robots that need to achieve concrete objectives, particularly

  20. Chronic Lower Leg Pain in Athletes

    PubMed Central

    Brewer, Rachel Biber; Gregory, Andrew J. M.

    2012-01-01

    Context: Chronic lower leg pain in athletes can be a frustrating problem for patients and a difficult diagnosis for clinicians. Myriad approaches have been suggested to evaluate these conditions. With the continued evolution of diagnostic studies, evidence-based guidance for a standard approach is unfortunately sparse. Evidence Acquisition: PubMed was searched from January 1980 to May 2011 to identify publications regarding chronic lower leg pain in athletes (excluding conditions related to the foot), including differential diagnosis, clinical presentation, physical examination, history, diagnostic workup, and treatment. Results: Leg pain in athletes can be caused by many conditions, with the most frequent being medial tibial stress syndrome; chronic exertional compartment syndrome, stress fracture, nerve entrapment, and popliteal artery entrapment syndrome are also considerations. Conservative management is the mainstay of care for the majority of causes of chronic lower leg pain; however, surgical intervention may be necessary. Conclusion: Chronic lower extremity pain in athletes includes a wide differential and can pose diagnostic dilemmas for clinicians. PMID:23016078

  1. Quality of ulcer healing in gastrointestinal tract: Its pathophysiology and clinical relevance

    PubMed Central

    Arakawa, Tetsuo; Watanabe, Toshio; Tanigawa, Tetsuya; Tominaga, Kazunari; Fujiwara, Yasuhiro; Morimoto, Ken’ichi

    2012-01-01

    In this paper, we review the concept of quality of ulcer healing (QOUH) in the gastrointestinal tract and its role in the ulcer recurrence. In the past, peptic ulcer disease (PUD) has been a chronic disease with a cycle of repeated healing/remission and recurrence. The main etiological factor of PUD is Helicobacter pylori (H. pylori), which is also the cause of ulcer recurrence. However, H. pylori-negative ulcers are present in 12%-20% of patients; they also recur and are on occasion intractable. QOUH focuses on the fact that mucosal and submucosal structures within ulcer scars are incompletely regenerated. Within the scars of healed ulcers, regenerated tissue is immature and with distorted architecture, suggesting poor QOUH. The abnormalities in mucosal regeneration can be the basis for ulcer recurrence. Our studies have shown that persistence of macrophages in the regenerated area plays a key role in ulcer recurrence. Our studies in a rat model of ulcer recurrence have indicated that proinflammatory cytokines trigger activation of macrophages, which in turn produce increased amounts of cytokines and chemokines, which attract neutrophils to the regenerated area. Neutrophils release proteolytic enzymes that destroy the tissue, resulting in ulcer recurrence. Another important factor in poor QOUH can be deficiency of endogenous prostaglandins and a deficiency and/or an imbalance of endogenous growth factors. Topically active mucosal protective and antiulcer drugs promote high QOUH and reduce inflammatory cell infiltration in the ulcer scar. In addition to PUD, the concept of QOUH is likely applicable to inflammatory bowel diseases including Crohn’s disease and ulcerative colitis. PMID:23002355

  2. Effectiveness of intermittent electrical stimulation for the prevention of deep pressure ulcers

    Microsoft Academic Search

    Leandro R. Solis; Daniel Hallihan; Richard E. Uwiera; Vivian K. Mushahwar

    Pressure ulcers are a common medical complication associated with individuals who, due to injury or disease have compromised mobility and\\/or sensation. Pressure ulcers that start at the bone-muscle interfaces are the most perilous, as they can cause extensive damage to the deep tissue layers before exhibiting any signs in the skin. Lack of oxygenation to the tissue and the cascade

  3. Hyperbaric oxygen therapy of diabetic foot ulcers, transcutaneous oxymetry in clinical decision making

    Microsoft Academic Search

    Juha Niinikoski

    2003-01-01

    The foot ulcer is one of most common and devastating complications of diabetes and is associated with considerable morbidity and mortality. The major causes of these ulcers are ischemia\\/hypoxia, neuropathy, and infection, and they often coexist. Despite conventional therapy including revascularization procedures when appropriate, three situations lead frequently to amputation: persistent critical limb ischemia, soft tissue infection, and impaired wound

  4. Histiocytic sarcoma with fatal duodenal ulcers.

    PubMed

    Akishima, Yuri; Akasaka, Yoshikiyo; Yih-Chang, Ger; Ito, Kinji; Ishikawa, Yukio; Lijun, Zhang; Kiguchi, Hideko; Lipscomb, Gary; Strong, Jack P; Ishii, Toshiharu

    2004-01-01

    Histiocytic sarcoma is an uncommon neoplasm of mature histiocytes with very poor outcome. We report an autopsy case of a true histiocytic sarcoma with characteristic symptoms of so-called "malignant histiocytosis of the intestine". The liver and spleen were enlarged, with remarkable tumor cell infiltration in the hepatic sinusoids and splenic sinuses. Tumor cells aggregated to form sporadic nodular lesions in the liver, which often showed coagulative necrosis. Infarcted lesions also occurred at the splenic subcapsular area. In addition, tumor cell infiltration was noted in the sinuses of bone marrow and lymph node. Tumor cells often demonstrated moderate pleomorphism with multinucleated giant cells. They were positive for CD68 and negative for T- and B-cell lineage markers, megakaryocytic markers, and CD30. Various examinations were done to rule out infection-associated hemophagocytic syndrome, and the absence of infectious diseases was revealed. Thus, the diagnosis of histiocytic sarcoma was made. Apart from these lesions, multiple ulcerations, some with fatal perforation, were found in the esophagus and duodenum. They showed only non-specific inflammatory changes without tumor cell involvement. The ulcers probably derived from ischemic condition through an embolic process caused by tumor cell infiltration elsewhere in the blood vessels at the periphery of the ulcers. PMID:15310151

  5. Leg size and muscle functions associated with leg compliance

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.; Doerr, Donald F.; Flores, Jose F.; Hoffler, G. Wyckliffe; Buchanan, Paul

    1988-01-01

    The relationship between the leg compliance and factors related to the size of leg muscle and to physical fitness was investigated in ten healthy subjects. Vascular compliance of the leg, as determined by a mercury strain gauge, was found to be not significantly correlated with any variables associated with physical fitness per se (e.g., peak O2 uptake, calf strength, age, body weight, or body composition. On the other hand, leg compliance correlated with the calf cross-sectional area (CSA) and the calculated calf volume, with the CSA of calf muscle being the most dominant contributing factor (while fat and bone were poor predicators). It is suggested that leg compliance can be lowered by increasing calf muscle mass, thus providing structural support to limit the expansion of leg veins.

  6. Pressure ulcer good practice published.

    PubMed

    2015-06-17

    Patients admitted to hospital or a nursing home should have a pressure ulcer risk assessment within six hours of admission, the National Institute for Health and Care Excellence has said. PMID:26080953

  7. Laparoscopic Surgery for Ulcerative Colitis

    PubMed Central

    Stocchi, Luca

    2010-01-01

    Laparoscopic techniques have become increasingly used in the treatment of ulcerative colitis: in experienced hands, they are safe and feasible. Recovery advantages have not been consistently demonstrated and functional results have been comparable to open surgery. Other possible benefits and costs issues have also been inconsistent. Further investigation on the role of laparoscopic surgery for ulcerative colitis with larger populations and longer follow-up with a focus on recovery parameters, quality of life, and costs are needed. PMID:22131895

  8. Quality of life in patients with venous stasis ulcers and others with advanced venous insufficiency.

    PubMed

    Tracz, Edyta; Zamojska, Ewa; Modrzejewski, Andrzej; Zaborski, Daniel; Grzesiak, Wilhelm

    2015-01-01

    The quality of life (QoL) in patients with advanced venous insufficiency (including venous stasis ulcers, skin discoloration, stasis eczema, and lipodermatosclerosis) assessed using the Clinical Etiological Anatomical Pathophysiological (CEAP) and Venous Clinical Severity Score (VCSS) classifications is presented. Also, disease features such as: intensity of pain, edema and inflammatory response that exerted the most profound effect on different domains of QoL are reported. The global QoL in patients with lower leg venous ulcerations was relatively similar to that observed in other patients with chronic venous insufficiency. The presence of venous ulcerations was associated with lower QoL in a Physical domain. Significant correlations were found between pain intensity and the values of Physical, Physiological, Level of Independence and Environmental domains, between edema intensity and Social domain as well as between the intensity of inflammatory response and Physical and Spiritual domains. PMID:25658932

  9. LEGS data acquisition facility

    SciTech Connect

    LeVine, M.J.

    1985-01-01

    The data acquisition facility for the LEGS medium energy photonuclear beam line is composed of an auxiliary crate controller (ACC) acting as a front-end processor, loosely coupled to a time-sharing host computer based on a UNIX-like environment. The ACC services all real-time demands in the CAMAC crate: it responds to LAMs generated by data acquisition modules, to keyboard commands, and it refreshes the graphics display at frequent intervals. The host processor is needed only for printing histograms and recording event buffers on magnetic tape. The host also provides the environment for software development. The CAMAC crate is interfaced by a VERSAbus CAMAC branch driver.

  10. Effects of Introduced Mosquitofish and Bullfrogs on the Threatened California Red-Legged Frog

    Microsoft Academic Search

    Sharon P. Lawler; Deborah Dritz; Terry Strange; Marcel Holyoak

    1999-01-01

    Exotic species have frequently caused declines of native fauna and may contribute to some cases of amphibian decline. Introductions of mosquitofish ( Gambusia affinis ) and bullfrogs ( Rana catesbeiana ) are suspected to have caused the decline of California red-legged frogs ( Rana aurora draytonii ). We tested the ef- fects of mosquitofish and bullfrog tadpoles on red-legged frog

  11. Control of a Bow Leg Hopping Robot

    Microsoft Academic Search

    Ben Brown; Garth Zeglin

    1998-01-01

    The bow leg hopper is a new design for a locomoting system with a resilient, flexible leg. It features a passive stance phase and natural pitch stability. It is controlled with actuators that configure the leg angle and stored leg energy during flight. During stance, the actuators are me- chanically decoupled from the leg and the stored energy is released.

  12. Venous ulcer: late complication of a traumatic arteriovenous fistula.

    PubMed

    Young, Calvin J; Dardik, Alan; Sumpio, Bauer; Indes, Jeff; Muhs, Bart; Ochoa Chaar, Cassius I

    2015-05-01

    Arteriovenous fistula (AVF) formation after penetrating trauma is a well-described phenomenon. However, diagnosis of traumatic AVF is frequently delayed as patients often do not have hard signs of vascular injury at the initial presentation. Late complications of traumatic AVF include arterial and venous dilatation, distal ischemia, venous congestion, and congestive heart failure. This case report describes a traumatic femoral AVF causing distal venous ulceration 3 years after the injury. The AVF was treated with open repair. In the operating room, the Nicoladoni-Branham sign was elicited. The ulcer healed at 1 month and has not recurred at 1-year follow-up. PMID:25725283

  13. Inclined leg jack-up platform with flexible leg guides

    SciTech Connect

    Goldman, J.; Bennett, R.M.

    1992-03-17

    This patent describes an offshore platform assembly. It comprises a floatable hull having wells extending vertically therethrough; a plurality of inclined supporting legs secured to the hull and movable between a first, retracted position and a second, hull supporting position; flexible guide means for absorbing bending moments and forces acting on a leg chord of a corresponding leg which moves through a flexible guide means during elevation of the hull, each of the guide means being positioned in a corresponding well of the hull; means for elevating the hull with respect to the supporting legs; and wherein each of the flexible guide means is movable to a limited degree along a horizontal plane to absorb bending moments and forces acting on a corresponding leg while the hull is being elevated to an operating level.

  14. Effects of audio-visual stimulation on the incidence of restraint ulcers on the Wistar rat

    NASA Technical Reports Server (NTRS)

    Martin, M. S.; Martin, F.; Lambert, R.

    1979-01-01

    The role of sensory simulation in restrained rats was investigated. Both mixed audio-visual and pure sound stimuli, ineffective in themselves, were found to cause a significant increase in the incidence of restraint ulcers in the Wistar Rat.

  15. Ulcerative colitis flair induced by mesalamine suppositories hypersensitivity.

    PubMed

    Ding, Hao; Liu, Xiao-Chang; Mei, Qiao; Xu, Jian-Ming; Hu, Xiang-Yang; Hu, Jing

    2014-04-01

    Mesalamine suppositories have been used widely for the treatment of distal ulcerative colitis and considered to be safer than systemic administration for its limited systemic absorption. However, previous studies have shown that mesalamine suppository occasionally causes severe hypersensitivity reactions including fever, rashes, colitis exacerbation and acute eosinophilic pneumonia. Here we present a 25-year-old woman with ulcerative colitis with bloody diarrhea accompanied by abdominal pain and fever which were aggravated after introduction of mesalamine suppositories. In light of symptom exacerbation of ulcerative colitis, increased inflammatory injury of colon mucosa shown by colonoscopy and elevated peripheral eosinophil count after mesalamine suppositories administration, and the Naranjo algorithm score of 10, the possibility of hypersensitivity reaction to mesalamine suppositories should be considered, warning us to be aware of this potential reaction after administration of mesalamine formulations even if it is the suppositories. PMID:24707159

  16. Pressure ulcers: Current understanding and newer modalities of treatment.

    PubMed

    Bhattacharya, Surajit; Mishra, R K

    2015-01-01

    This article reviews the mechanism, symptoms, causes, severity, diagnosis, prevention and present recommendations for surgical as well as non-surgical management of pressure ulcers. Particular focus has been placed on the current understandings and the newer modalities for the treatment of pressure ulcers. The paper also covers the role of nutrition and pressure-release devices such as cushions and mattresses as a part of the treatment algorithm for preventing and quick healing process of these wounds. Pressure ulcers develop primarily from pressure and shear; are progressive in nature and most frequently found in bedridden, chair bound or immobile people. They often develop in people who have been hospitalised for a long time generally for a different problem and increase the overall time as well as cost of hospitalisation that have detrimental effects on patient's quality of life. Loss of sensation compounds the problem manifold, and failure of reactive hyperaemia cycle of the pressure prone area remains the most important aetiopathology. Pressure ulcers are largely preventable in nature, and their management depends on their severity. The available literature about severity of pressure ulcers, their classification and medical care protocols have been described in this paper. The present treatment options include various approaches of cleaning the wound, debridement, optimised dressings, role of antibiotics and reconstructive surgery. The newer treatment options such as negative pressure wound therapy, hyperbaric oxygen therapy, cell therapy have been discussed, and the advantages and disadvantages of current and newer methods have also been described. PMID:25991879

  17. Interdigital ulcer: an unusual presentation of Candida infection.

    PubMed

    Luo, Di-Qing; Yang, Wei; Wu, Liang-Cai; Liu, Jun-Hua; Chen, Wen-Na

    2011-11-01

    Interdigital ulcer is an exceptionally rare condition while erosio interdigitalis blastomycetica is common for candidiasis. Four Chinese patients with Candida interdigital ulcers were reported. The exudates were examined directly and cultured for fungi. Skin biopsies were stained with haematoxylin-eosin and periodic acid Schiff. There were a man and three women (age range: 34-56 years) who presented with 1- to 3-month history of chronic cutaneous ulcer on the interdigital web of hand or foot. The lesions were located on hand for one woman, and on the left foot for the rest. The patients had poor response to the previous treatment of topical steroids and oral antimicrobials. Candida albicans was isolated from a man and two women, Candida tropicalis from another woman. Biopsy specimens revealed yeast and mycelium as well as inflammatory infiltrate in necrotic tissue in two patients; only inflammatory cells in the other two. The patients had complete remission with oral itraconazole and topical bifonazole cream therapy for 3- to 5-week. Candida species may cause interdigital ulcer on hand or foot. Oral itraconazole and topical bifonazole may be an optional therapy for such an ulcer. PMID:21615540

  18. Pressure ulcers: Current understanding and newer modalities of treatment

    PubMed Central

    Bhattacharya, Surajit; Mishra, R. K.

    2015-01-01

    This article reviews the mechanism, symptoms, causes, severity, diagnosis, prevention and present recommendations for surgical as well as non-surgical management of pressure ulcers. Particular focus has been placed on the current understandings and the newer modalities for the treatment of pressure ulcers. The paper also covers the role of nutrition and pressure-release devices such as cushions and mattresses as a part of the treatment algorithm for preventing and quick healing process of these wounds. Pressure ulcers develop primarily from pressure and shear; are progressive in nature and most frequently found in bedridden, chair bound or immobile people. They often develop in people who have been hospitalised for a long time generally for a different problem and increase the overall time as well as cost of hospitalisation that have detrimental effects on patient's quality of life. Loss of sensation compounds the problem manifold, and failure of reactive hyperaemia cycle of the pressure prone area remains the most important aetiopathology. Pressure ulcers are largely preventable in nature, and their management depends on their severity. The available literature about severity of pressure ulcers, their classification and medical care protocols have been described in this paper. The present treatment options include various approaches of cleaning the wound, debridement, optimised dressings, role of antibiotics and reconstructive surgery. The newer treatment options such as negative pressure wound therapy, hyperbaric oxygen therapy, cell therapy have been discussed, and the advantages and disadvantages of current and newer methods have also been described. PMID:25991879

  19. Options for Treating Restless Legs Syndrome

    MedlinePLUS

    ... Consumer Summary – Aug. 30, 2013 Options for Treating Restless Legs Syndrome Formats View PDF (PDF) 759 kB Download Audio ( ... or physician assistant. Understanding Your Condition What is restless legs syndrome? Restless legs syndrome (RLS) is a disorder of ...

  20. The Risk of Gastric Cancer in Patients with Duodenal and Gastric Ulcer: Research Progresses and Clinical Implications

    Microsoft Academic Search

    Zunwu Zhang

    2007-01-01

    Introduction  Although controversial, clinicians generally consider patients who present with gastric ulcer to have an increased risk of\\u000a gastric cancer, while the risk for patients with duodenal ulcer is reduced in comparison with that of the general population.\\u000a Infection with Helicobacter pylori and the use of non-steroidal anti-inflammatory drugs (NSAIDs) are the major causes for peptic ulcers, but their roles in

  1. Ulcerative Lichen Planus in Childhood

    PubMed Central

    Padmini, Chiyadu; Bai, K. Yellamma; Chaitanya, Vinil; Reddy, M. Shilpa

    2013-01-01

    Lichen planus (LP) is a chronic inflammatory mucocutaneous condition which is relatively common in adults but rarely affects children. The present study is a report on an unusual case of ulcerative oral LP involving the dorsum of tongue in a 12-year-old boy. Patient complained of painful oral lesion on the tongue which was burning in nature and obstructing talking and eating spicy foods. On intraoral examination, a white ulcerative lesion on the dorsum of tongue was observed. Diagnosis was made based on clinical examination and histopathological features. We instituted local treatment and patient responded well to the treatment. Although rarely reported in childhood, lichen planus should be considered in a differential diagnosis of hyperkeratotic, reticular, and ulcerative lesions of the oral mucosa in children. PMID:24455324

  2. Kayexalate-induced colonic ulcer.

    PubMed

    Albeldawi, Mazen; Gaur, Varun; Weber, Luke

    2014-08-01

    A 61-year-old male presents to the emergency room with complaints of fatigue, dizziness and bright red blood per rectum (BRBPR) for 2 days. Past medical history was significant for gastroesophageal reflux disease, non-steroidal anti-inflammatory drug (NSAID) induced ulcer, and end-stage renal disease (GFR < 30) status post 2 failed renal grafts. Pertinent medications include pantoprazole and sodium polystyrene sulfonate in sorbitol (Kayexalate 30 g/d orally). On esophagogastroduodenoscopy (EGD) there was a single shallow, flat, non-bleeding gastric ulcer (3 mm) in the pre-pyloric region of the stomach with no stigmata of bleeding. A colonoscopy was performed showing evidence of colitis and localized ulcerations in the cecum which were biopsied. Histopathology revealed basophilic, nonpolarizable, rhomboid-like crystals without evidence of necrosis. PMID:24759345

  3. Novel Roles of Local Insulin-Like Growth Factor-1 Activation in Gastric Ulcer Healing

    PubMed Central

    Nguyen, Tom; Chai, Jianyuan; Li, Aihua; Akahoshi, Tomohiko; Tanigawa, Tetsuya; Tarnawski, Andrzej S.

    2007-01-01

    The precise role of insulin-like growth factor (IGF)-1 in gastric ulcer healing is unknown. In experimental rat gastric ulcers, we examined expression of IGF-1 mRNA and protein by reverse transcriptase-polymerase chain reaction or enzyme-linked immunosorbent assay and immunostaining, respectively. In cultured rat gastric epithelial RGM1 cells, we examined effects of exogenous IGF-1 on cell migration, re-epithelialization, and proliferation—essential components of ulcer healing. We also examined whether IGF-1 induces cyclooxygenase (COX)-2 expression and determined the role of phosphatidylinositol 3-kinase and mitogen-activated protein kinase signaling pathways in mediating IGF-1 actions. Gastric ulceration triggered an approximately threefold increase in IGF-1 expression in epithelial cells of the ulcer margins (P < 0.001 versus control), especially in cells re-epithelizing granulation tissue and in mucosa in proximity to the ulcer margin. Treatment of RGM1 cells with IGF-1 caused a dramatic increase in actin polymerization, an eightfold increase in cell migration (P < 0.001), a 195% increase in cell proliferation (P < 0.05), and a sixfold increase in COX-2 expression (P < 0.01). Inhibitor of phosphatidylinositol 3-kinase abolished IGF-1-induced RGM1 cell migration and proliferation, actin polymerization, and COX-2 expression. The up-regulation of IGF-1 in gastric ulcer margin accelerates gastric ulcer healing by promoting cell re-epithelization, proliferation, and COX-2 expression via the phosphatidylinositol 3-kinase pathway. PMID:17392162

  4. Benign gastric ulceration in pernicious anemia

    Microsoft Academic Search

    J. Reid; T. V. Taylor; S. Holt; R. C. Heading

    1980-01-01

    Summary Benign gastric ulceration occurred in a patient with pernicious anemia in association with aspirin therapy. Previous reports of benign gastric ulceration in patients with achlorhydria are reviewed, and the potential role of aspirin in the pathogenesis of benign ulceration in the absence of acid is discussed.

  5. Aspirin, gastrointestinal bleeding, and peptic ulcer

    Microsoft Academic Search

    M. Levrat; R. Lambert

    1960-01-01

    Summary  1. We have observed 52 cases of digestive attacks provoked by aspirin; 13 were cases of nonhemorrhagic peptic ulcer with 1 perforated ulcer; 39 were cases of gastrointestinal hemorrhage.2. Among the hemorrhages, radiological proof of the peptic ulcer was obtained in 15 cases, and X-ray evidence was noted in 21 cases (isolated hemorrhages). In the 3 cases of the latter

  6. Acute Pancreatitis Due to a Duodenal Ulcer

    PubMed Central

    Pyeon, Sung Ik; Kim, Yong Tae; Lee, Ban Seok; Lee, Sang Ho; Lee, Jae Nam; Cheong, Jae Hoon; Oh, Kong Jin

    2014-01-01

    Duodenal ulcers and acute pancreatitis are two of the most commonly encountered gastrointestinal diseases among the general population. However, duodenal ulcer-induced pancreatitis is very rarely reported worldwide. This report elaborates on a distinct medical treatment that contributes to partial or complete treatment of acute pancreatitis induced by a duodenal ulcer scar. PMID:25505728

  7. Design of robotic quadruped legs

    E-print Network

    McKenzie, Jacob Elijah

    2012-01-01

    Prized for their performance on prepared surfaces, wheeled vehicles are often limited in mobility by rough and unstructured terrain. Conversely, systems that rely on legs have shown promising rough terrain performance but ...

  8. Getting Your Sea Legs

    PubMed Central

    Stoffregen, Thomas A.; Chen, Fu-Chen; Varlet, Manuel; Alcantara, Cristina; Bardy, Benoît G.

    2013-01-01

    Sea travel mandates changes in the control of the body. The process by which we adapt bodily control to life at sea is known as getting one's sea legs. We conducted the first experimental study of bodily control as maritime novices adapted to motion of a ship at sea. We evaluated postural activity (stance width, stance angle, and the kinematics of body sway) before and during a sea voyage. In addition, we evaluated the role of the visible horizon in the control of body sway. Finally, we related data on postural activity to two subjective experiences that are associated with sea travel; seasickness, and mal de debarquement. Our results revealed rapid changes in postural activity among novices at sea. Before the beginning of the voyage, the temporal dynamics of body sway differed among participants as a function of their (subsequent) severity of seasickness. Body sway measured at sea differed among participants as a function of their (subsequent) experience of mal de debarquement. We discuss implications of these results for general theories of the perception and control of bodily orientation, for the etiology of motion sickness, and for general phenomena of perceptual-motor adaptation and learning. PMID:23840560

  9. [Crooked and short legs. Historical retrospect].

    PubMed

    Rüttimann, B; Böni, T

    2000-09-01

    In the past rickets, poliomyelitis, and tuberculosis of the knee joint were the main causes for deformities and shortening of the children's legs. Orthotics played a major role in treatment and rehabilitation, and they were often used for life. In the nineteenth century orthopaedic surgeons developed procedures such as tenotomy, osteoclasis, osteotomy, excision of joints and arthrodesis, combined with conservative therapy or instead of it. In an incessant attempt to control wound suppuration--before Lister's antiseptic principle and aseptic practices were available--the "subcutaneous" approach was inaugurated for tendon and bone surgery. PMID:11091996

  10. Helicobacter pylori and peptic ulcer disease.

    PubMed Central

    Feldman, M; Peterson, W L

    1993-01-01

    Medical therapy for duodenal or gastric ulcer disease has traditionally involved gastric acid antisecretory therapy for 4 to 8 weeks to promote initial healing and indefinitely to prevent recurrences of ulcer. The discovery of Helicobacter pylori in most patients with peptic ulcer disease has led to a change in this approach. Therapy designed to eradicate H pylori may facilitate ulcer healing with acid antisecretory agents and, more important, may greatly reduce the incidence of ulcer recurrence, obviating the need for maintenance antisecretory therapy. Regimens designed to eradicate H pylori are difficult to comply with, however, and are associated with adverse effects in some patients. In this article we review the diagnosis and treatment of H pylori infection in patients with peptic ulcer disease and make recommendations regarding the use of conventional ulcer therapies and therapies designed to eradicate H pylori. PMID:8279151

  11. Prevention and management of diabetic foot ulcers.

    PubMed

    Turns, Martin

    2015-03-01

    As part of an annual foot review, trained and competent personnel should examine patients' feet to detect risk factors for ulceration. Foot examination with shoes and stockings removed should include: palpation of foot pulses; testing foot sensations using 10g monofilament or vibration; inspection for significant callus or deformed nails; inspection for any structural deformity; asking about any previous ulceration; checking for signs of ulceration; asking about any pain; and inspecting footwear. Following assessment, a foot risk classification score should be given. The person with diabetes should then be informed of their risk score, with education offered regarding future foot-care management. Diabetic foot complications include ulceration, Charcot foot, painful neuropathy, gangrene and amputation. Risk factors for ulceration include non-palpable pulses, insensate foot, significant callus, deformed nails, history of previous ulcer or amputation, tissue damage or signs of ulceration, foot pain and unsuitable footwear. PMID:25757381

  12. Leg recirculation in horizontal plane locomotion

    Microsoft Academic Search

    A. Wickramasuriya; J. Schmitt

    2009-01-01

    A protocol prescribing leg motion during the swing phase is developed for the planar lateral leg spring model of locomotion.\\u000a Inspired by experimental observations regarding insect leg function when running over rough terrain, the protocol prescribes\\u000a the angular velocity of the swing-leg relative to the body in a feedforward manner, yielding natural variations in the leg\\u000a touch-down angle in response

  13. Prophylactic antibiotics for the prevention of cellulitis (erysipelas) of the leg: results of the U.K. Dermatology Clinical Trials Network’s PATCH II trial

    PubMed Central

    2012-01-01

    Summary Background Cellulitis (erysipelas) of the leg is a common, painful infection of the skin and underlying tissue. Repeat episodes are frequent, cause significant morbidity and result in high health service costs. Objectives To assess whether prophylactic antibiotics prescribed after an episode of cellulitis of the leg can prevent further episodes. Methods Double-blind, randomized controlled trial including patients recently treated for an episode of leg cellulitis. Recruitment took place in 20 hospitals. Randomization was by computer-generated code, and treatments allocated by post from a central pharmacy. Participants were enrolled for a maximum of 3 years and received their randomized treatment for the first 6 months of this period. Results Participants (n = 123) were randomized (31% of target due to slow recruitment). The majority (79%) had suffered one episode of cellulitis on entry into the study. The primary outcome of time to recurrence of cellulitis included all randomized participants and was blinded to treatment allocation. The hazard ratio (HR) showed that treatment with penicillin reduced the risk of recurrence by 47% [HR 0·53, 95% confidence interval (CI) 0·26–1·07, P = 0·08]. In the penicillin V group 12/60 (20%) had a repeat episode compared with 21/63 (33%) in the placebo group. This equates to a number needed to treat (NNT) of eight participants in order to prevent one repeat episode of cellulitis [95% CI NNT(harm) 48 to ? to NNT(benefit) 3]. We found no difference between the two groups in the number of participants with oedema, ulceration or related adverse events. Conclusions Although this trial was limited by slow recruitment, and the result failed to achieve statistical significance, it provides the best evidence available to date for the prevention of recurrence of this debilitating condition. PMID:21910701

  14. A student apparatus for recording action potentials in cockroach legs

    Microsoft Academic Search

    THOMAS M. LINDER; JOHN PALKA

    potentials. As an action potential moves down an axon, ionic current flows in the extracellular spaces, causing electrical potential differences. In the cockroach leg, these potential differences may be >1 mV. The unusually large amplitude of the potentials is probably a consequence of the comparatively narrow extra- cellular spaces and thus high extracellular electrical resistances. Other types of sensors are

  15. Management of ulcers in lymphoedematous limbs

    PubMed Central

    Karnasula, Vishnu M.

    2012-01-01

    Lymphoedema is a progressive condition that can have a marked physical and psychological impact on affected patients and significantly reduce the quality of life. The ulcers on chronic lymphoedema patient, which often also makes it impossible for them to work. If left untreated, tends to progress or worsen. Ulcers in lymphoedema patients, therefore, represent not only a medical but also a psychological problem. The treatment is often regarded as being worse than it actually is. In our study of more than 25 years shows around 10% cases are due to chronic lymphodema. Ulcers of chronic lymphoedema are classified into four stages according to their presentation. Their management depends upon their stage of presentation. Patients with chronic lymphoedema and ulceration require a different approach to treatment. The specific issues associated with managing the patient with lymphoedematous ulceration include, limb shape distortion i.e., elephantiasis, care of the skin creases and folds, and swelling of the toes and fore foot. Stage I ulcers will heal with conservative treatment without any surgical intervention. Stage II ulcers needs debridement of the wound and split-thickness skin grafting. The most difficult to treat are the stage III and IV ulcers, due to associated skin changes and reduced vascularity. These cases need debulking along with excision of the ulcer. In order to prevent recurrence of the ulcer in all the four stages needs prolonged follow-up and limb care. PMID:23162225

  16. Endoscopic management of peptic ulcer disease.

    PubMed Central

    Laws, H L; McKernan, J B

    1993-01-01

    OBJECTIVE: This article reviews the authors' experience with endoscopic management of duodenal ulcer and ulcers occurring after a previous drainage procedure. SUMMARY BACKGROUND DATA: Patients with complications of duodenal ulcer and ulcers occurring after a previous drainage procedure still require surgical management. Virtually all operations for duodenal ulcer include some form of vagotomy. American surgeons in academic centers prefer highly selective vagotomy in suitable candidates. Video-directed laparoscopic and thoracoscopic operations have been done for all complications of duodenal ulcer except for acute hemorrhage. METHODS: The authors have performed laparoscopic operation on eight patients with intractable chronic duodenal ulcer, seven patients with gastroesophageal reflux disease combined with duodenal ulcer, one patient with chronic duodenal ulcer and gastric outlet obstruction, and one patient with acute perforation. Operations performed included omentopexy, anterior seromyotomy plus post truncal vagotomy, and highly selective vagotomy. Seven patients had a simultaneous Nissen fundoplication; and the patient with obstruction underwent concomitant pyloroplasty and vagotomy. Six patients with intestinal ulcers occurring after a previous drainage procedure were treated with thoracoscopic vagotomy. Techniques used are shown. RESULTS: There has been one recurrent ulcer in the laparoscopic group after anterior seromyotomy plus posterior truncal vagotomy. The patient treated by omentopexy for duodenal perforation recovered gastrointestinal function promptly with no further difficulty, but eventually died of primary medical disease. Patients undergoing thoracoscopic vagotomy have all become asymptomatic. Postoperative hospital stay after highly selective vagotomy, anterior seromyotomy plus posterior truncal vagotomy, or thoracoscopic vagotomy was 1-5 days. CONCLUSIONS: Laparoscopic management of duodenal ulcers is feasible. Larger numbers of patients with longer follow-up are essential. Ulcers occurring after a drainage procedure deserve thoracoscopic vagotomy. PMID:8489318

  17. Gastrointestinal ulcers, role of aspirin, and clinical outcomes: pathobiology, diagnosis, and treatment

    PubMed Central

    Cryer, Byron; Mahaffey, Kenneth W

    2014-01-01

    Peptic ulcer disease is a major cause of morbidity and mortality in the US with more than six million diagnoses annually. Ulcers are reported as the most common cause of hospitalization for upper gastrointestinal (GI) bleeding and are often a clinical concern due to the widespread use of aspirin and nonsteroidal anti-inflammatory drugs, both of which have been shown to induce ulcer formation. The finding that Helicobacter pylori infection (independent of aspirin use) is associated with the development of ulcers led to a more thorough understanding of the causes and pathogenesis of ulcers and an improvement in therapeutic options. However, many patients infected with H. pylori are asymptomatic and remain undiagnosed. Complicating matters is a current lack of understanding of the association between aspirin use and asymptomatic ulcer formation. Low-dose aspirin prescriptions have increased, particularly for cardioprotection. Unfortunately, the GI side effects associated with aspirin therapy continue to be a major complication in both symptomatic and asymptomatic patients. These safety concerns should be important considerations in the decision to use aspirin and warrant further education. The medical community needs to continue to improve awareness of aspirin-induced GI bleeding to better equip physicians and improve care for patients requiring aspirin therapy. PMID:24741318

  18. [Digital ulcers in systemic scleroderma].

    PubMed

    Belz, D; Hunzelmann, N; Moinzadeh, P

    2014-11-01

    Digital ulcers (DU's) are one of the main symptoms of systemic scleroderma and occur in approximately 60% of all scleroderma patients. Due to possible complications such as infections, gangrene or amputation, they require regular medical attention and a good wound treatment by doctors and nursing staff. A definition of DU's has not yet been established. In 2009 the European League Against Rheumatism (EULAR) published guidelines for the treatment of DU's. An improvement of the healing of active ulcers has been described with Iloprost. Bosentan significantly reduced the frequency of occurrence of new DU's. In some small studies PDE-5 inhibitors appear helpful. Further studies with other therapeutic approaches will follow in the next few years. PMID:25336296

  19. Cancer morbidity in ulcerative colitis

    Microsoft Academic Search

    P Prior; S N Gyde; J C Macartney; H Thompson; J A Waterhouse; R N Allan

    1982-01-01

    Cancer morbidity at all sites has been studied in a series of 676 patients with ulcerative colitis under long-term review, of whom more than two-thirds had extensive disease, and the level and pattern of risk over time examined. Age-, sex-, and site-specific incidence rates were used to compute the number of cancers that might have been expected to occur. A

  20. Ulcerative colitis with inflammatory polyposis in a teenage boy: A case report

    PubMed Central

    Feng, Jin-Shan; Ye, Ying; Guo, Can-Can; Luo, Bo-Tao; Zheng, Xue-Bao

    2015-01-01

    Ulcerative colitis in addition to inflammatory polyposis is common. The benign sequel of ulcerative colitis can sometimes mimic colorectal carcinoma. This report describes a rare case of inflammatory polyposis with hundreds of inflammatory polyps in ulcerative colitis which was not easy to distinguish from other polyposis syndromes. A 16-year-old Chinese male suffering from ulcerative colitis for 6 mo underwent colonoscopy, and hundreds of polyps were observed in the sigmoid, causing colonic stenosis. The polyps were restricted to the sigmoid. Although rectal inflammation was detected, no polyps were found in the rectum. A diagnosis of inflammatory polyposis and ulcerative colitis was made. The patient underwent total colectomy and ileal pouch anal anastomosis. The patient recovered well and was discharged on postoperative day 8. Endoscopic surveillance after surgery is crucial as ulcerative colitis with polyposis is a risk factor for colorectal cancer. Recognition of polyposis requires clinical, endoscopic and histopathologic correlation, and helps with chemoprophylaxis of colorectal cancer, as the drugs used postoperatively for colorectal cancer, ulcerative colitis and polyposis are different. PMID:25624746

  1. Preventing in-facility pressure ulcers as a patient safety strategy: a systematic review.

    PubMed

    Sullivan, Nancy; Schoelles, Karen M

    2013-03-01

    Complications from hospital-acquired pressure ulcers cause 60,000 deaths and significant morbidity annually in the United States. The objective of this systematic review is to review evidence regarding multicomponent strategies for preventing pressure ulcers and to examine the importance of contextual aspects of programs that aim to reduce facility-acquired pressure ulcers. CINAHL, the Cochrane Library, EMBASE, MEDLINE, and PreMEDLINE were searched for articles published from 2000 to 2012. Studies (any design) that implemented multicomponent initiatives to prevent pressure ulcers in adults in U.S. acute and long-term care settings and that reported pressure ulcer rates at least 6 months after implementation were selected. Two reviewers extracted study data and rated quality of evidence. Findings from 26 implementation studies (moderate strength of evidence) suggested that the integration of several core components improved processes of care and reduced pressure ulcer rates. Key components included the simplification and standardization of pressure ulcer-specific interventions and documentation, involvement of multidisciplinary teams and leadership, use of designated skin champions, ongoing staff education, and sustained audit and feedback. PMID:23460098

  2. Lower Extremity Ulcers in Systemic Sclerosis: Features and Response to Therapy

    PubMed Central

    Shanmugam, Victoria K.; Price, Patricia; Attinger, Christopher E.; Steen, Virginia D.

    2010-01-01

    Nondigital lower extremity ulcers are a difficult to treat complication of scleroderma, and a significant cause of morbidity. The purpose of this study was to evaluate the prevalence of nondigital lower extremity ulcers in scleroderma and describe the associations with autoantibodies and genetic prothrombotic states. A cohort of 249 consecutive scleroderma patients seen in the Georgetown University Hosptial Division of Rheumatology was evaluated, 10 of whom had active ulcers, giving a prevalence of 4.0%. Patients with diffuse scleroderma had shorter disease duration at the time of ulcer development (mean 4.05 years ± 0.05) compared to those with limited disease (mean 22.83 years ± 5.612, P value .0078). Ulcers were bilateral in 70%. In the 10 patients with ulcers, antiphospholipid antibodies were positive in 50%, and genetic prothrombotic screen was positive in 70% which is higher than expected based on prevalence reports from the general scleroderma population. Of patients with biopsy specimens available (n = 5), fibrin occlusive vasculopathy was seen in 100%, and all of these patients had either positive antiphospholipid antibody screen, or positive genetic prothrombotic profile. We recommend screening scleroderma patients with lower extremity ulcers for the presence of anti-phospholipid antibodies and genetic prothrombotic states. PMID:20827313

  3. AUTOANTIBODIES IN HUMAN ULCERATIVE COLITIS

    PubMed Central

    Broberger, Ove; Perlmann, Peter

    1959-01-01

    Sera from 30 children, suffering from ulcerative colitis, were examined for the presence of antibodies capable of reacting with antigens of normal human tissue. It was possible to demonstrate that most of the sera contained a precipitating and hemagglutinating factor, reacting with a constituent of human colonic tissue. This constituent was obtained, within 1 hour after death, from colonic tissue of newborn babies who had died without feeding. It could also be prepared from fetal tissue. The antigen can be extracted with phenol-water at 65°C. and seems to be a polysaccharide. The precipitating factor in the sera of the patients behaves electrophoretically as a ?-globulin. Phenol-water extracts from liver and from kidney also reacted positively with the sera from certain patients. There are indications which suggest that the antigen obtained from these tissues is identical with that from colon. Sera from 38 healthy children did not give any reactions with the extracts used. In additional controls, the sera of 32 children with various diseases, all of suspected autoimmune origin, were also tested. A few of these reacted positively with the phenol-water extracts from the organs mentioned above. Most likely, the antigen reacting in these cases is different from that reacting with the antibodies in the sera from patients with ulcerative colitis. The possible role of the antibodies in the pathogenesis of ulcerative colitis and the mechanism of their formation are discussed. PMID:13804543

  4. The effects of sulodexide on both clinical and molecular parameters in patients with mixed arterial and venous ulcers of lower limbs

    PubMed Central

    Serra, Raffaele; Gallelli, Luca; Conti, Angela; De Caridi, Giovanni; Massara, Mafalda; Spinelli, Francesco; Buffone, Gianluca; Caliò, Francesco Giuseppe; Amato, Bruno; Ceglia, Simona; Spaziano, Giuseppe; Scaramuzzino, Luca; Ferrarese, Alessia Giovanna; Grande, Raffaele; de Franciscis, Stefano

    2014-01-01

    Background Mixed venous and arterial ulcers account for approximately 15%–30% of all venous leg ulcerations. Several studies have shown that matrix metalloproteinases (MMPs) and neutrophil gelatinase-associated lipocalin (NGAL) play a central role in the pathophysiology of venous and arterial diseases. Some studies have shown the efficacy of glycosaminoglycans, such as sulodexide (SDX), in treating patients with leg ulcers. The aim of this study was to evaluate clinical effects of SDX and its correlation with MMPs and NGAL expression in patients with mixed arterial and venous leg ulcers. Methods Patients eligible for this study were of both sexes, older than 20 years, and with a clinical and instrumental diagnosis of mixed ulcer. Results Fifty-three patients of both sexes were enrolled and divided into two groups by means of randomization tables. Group A (treated group) comprised 18 females and ten males (median age: 68.7 years) treated with standard treatment (compression therapy and surgery) + SDX (600 lipoprotein lipase-releasing units/day intramuscularly) for 15 days followed by SDX 250 lipase-releasing units every 12 hours day orally for 6 months as adjunctive treatment. Group B (control group) comprised 17 females and eight males (median age: 64.2 years) treated with standard treatment only (compression therapy and surgery). The type of surgery was chosen according to anatomical level of vein incompetence: superficial venous open surgery and/or subfascial endoscopic perforating surgery. In all enrolled patients, blood samples were collected in order to evaluate the plasma levels of MMPs and NGAL through enzyme-linked immunosorbent assay. These results were compared to another control group (Group C) of healthy individuals. Moreover, biopsies of ulcers were taken to evaluate the tissue expression of MMPs and NGAL through Western blot analysis. Our results revealed that SDX treatment is able to reduce both plasma levels and tissue expression of MMPs improving the clinical conditions in patients with mixed ulcers. Conclusion Inhibition of MMPs could represent a possible therapeutic intervention to limit the progression of leg ulceration. In particular, our findings demonstrate the efficacy of SDX in patients with mixed arterial and venous chronic ulcers of the lower limbs. PMID:24872682

  5. Promethus Hot Leg Piping Concept

    SciTech Connect

    AM Girbik; PA Dilorenzo

    2006-01-24

    The Naval Reactors Prime Contractor Team (NRPCT) recommended the development of a gas cooled reactor directly coupled to a Brayton energy conversion system as the Space Nuclear Power Plant (SNPP) for NASA's Project Prometheus. The section of piping between the reactor outlet and turbine inlet, designated as the hot leg piping, required unique design features to allow the use of a nickel superalloy rather than a refractory metal as the pressure boundary. The NRPCT evaluated a variety of hot leg piping concepts for performance relative to SNPP system parameters, manufacturability, material considerations, and comparison to past high temperature gas reactor (HTGR) practice. Manufacturability challenges and the impact of pressure drop and turbine entrance temperature reduction on cycle efficiency were discriminators between the piping concepts. This paper summarizes the NRPCT hot leg piping evaluation, presents the concept recommended, and summarizes developmental issues for the recommended concept.

  6. Non-contact optical imaging of healing and non-healing diabetic foot ulcers

    NASA Astrophysics Data System (ADS)

    Godavarty, A.; Khandavilli, Y.; Jung, Y.-J.; Rao, P. N. S.

    2015-03-01

    Diabetic foot ulcer is the most devastating complication of diabetes that is still un-recognized. The treatment costs of these ulcers are very high to eventually save the leg/foot from amputation. To date, clinicians employ visual inspection of the wound site during its standard 4-week of healing process via monitoring of surface granulation. There is a need to develop on-site, low-cost imaging tools that can monitor the wound healing process periodically during the standard 4-week treatment process. A novel ultra-portable near-infrared optical scanner (NIROS) has been developed at the Optical Imaging Laboratory that can perform non-contact 2D area imaging of the wound site. Non-contact optical imaging studies were carried on diabetic subjects with foot ulcers (at Somesh Diabetic Foot Clinic, India) that were of healing and non-healing nature. A 710 nm LED source and a compact NIR sensitive camera were employed during non-contact imaging of the diabetic foot in order to obtain the near-infrared absorption images. From these preliminary studies it was observed that the non-healing wounds had a greater absorption contrast with respect to the normal site, unlike in the healing wounds. Demonstrating the ability of NIROS to differentiate healing vs. non-healing wounds in diabetic subjects can potentially impact early intervention in the treatment of diabetic foot ulcers.

  7. Chronic exertional compartment syndrome of the leg

    PubMed Central

    2010-01-01

    Chronic exertional compartment syndrome (CECS) is an underdiagnosed cause of chronic exertional leg pain. The syndrome most commonly occurs in young adult recreational runners, elite athletes, and military recruits. CECS is caused by increased intracompartmental pressure within a fascial space; however, the mechanism of why pain occurs is unknown. Symptoms are classically pain in the affected compartment at the same time, distance, or intensity of exercise. CECS is a clinical diagnosis; however, it is confirmed by intracompartmental pressure testing. Fasciotomy is the treatment of choice for athletes who would like to maintain the same level of activity. Athletes who have a release of the anterior and lateral compartments have a high success rate. PMID:21063498

  8. Lipschütz Genital Ulceration Associated with Mumps

    Microsoft Academic Search

    Johan Chanal; Agnès Carlotti; Hélène Laude; Nadège Wallet-Faber; Marie-Françoise Avril; Nicolas Dupin

    2010-01-01

    Lipschütz ulcers are characterised by a first flare of non-sexually related acute genital ulcers (AGU) occurring in adolescent girls. Epstein-Barr primary infection is the most frequently reported aetiology but other infectious agents are probably implicated. We report the first case of mumps associated with an AGU in a 21-year-old girl. She presented a bilateral parotitis with genital ulcers, and serology

  9. Vitamin U therapy of peptic ulcer.

    PubMed

    CHENEY, G

    1952-10-01

    Vitamin U, administered as raw cabbage juice to 100 patients with peptic ulcer, was apparently effective in promoting the rapid healing of uncomplicated peptic ulcers. The evidence of therapeutic benefit was (1) the rapid relief of the symptom, pain, without the use of any set plan of symptomatic treatment, and (2) ulcer crater healing time (determined roentgenographically) considerably shorter than in groups of cases, reported in the literature, in which "standard" types of diet and drug therapy were employed. PMID:13009468

  10. Acute Achilles tendinopathy: effect of pain control on leg stiffness.

    PubMed

    Maquirriain, J; Kokalj, A

    2014-03-01

    Tendinopathies are a major cause of disability in the athletic population; the main purpose of the treatment of these injuries is to reduce pain and improve function. The aim of this study was to evaluate the effect of NSAIDs on leg stiffness of patients suffering acute unilateral Achilles tendinopathy. Twenty-eight eligible male athletes (aged 39.1 ± 10.3 y) suffering acute Achilles tendinopathy were treated with etoricoxib (120 mg oral once daily) during 7 days. Pain (100-mm visual analogue scale-VAS), analgesic effect (percentage of 100-mm VAS reduction), and leg stiffness were evaluated pre- and post- anti-inflammatory treatment. Results of this study showed that over the 7-day treatment period, etoricoxib provided significant relief of Achilles tendon pain (VAS) compared to that experienced at baseline: 54.5 ± 21.6 and 24.5 ± 24.8, respectively (p<0.001). Leg stiffness showed a significant improvement after one-week NSAID therapy: LSR 0.89 ± 0.1 vs. 0.97 ± 0.1; (p=0.02). In conclusion, findings of this study demonstrated that patients suffering acute unilateral Achilles tendinopathy increased their leg stiffness of the affected side after oral anti-inflammatory therapy. Effective control of tendon pain in the acute phase of such sports-related injuries may contribute to improve capabilities associated with high performance like leg stiffness. PMID:24583548

  11. [Differential diagnosis of leg edema].

    PubMed

    Fries, R

    2004-04-15

    Both generalized and localized edema needs to be submitted to a differential diagnostic investigation. In the case of edema affecting the lower extremities, in particular the Stemmer sign which is the inability to tent the skin at the dorsum of the toes is a useful distinguishing aid. If there is acute unilateral swelling of a leg, other processes with diffuse space-consuming processes need to be distinguished from deep venous thrombosis and secondary lymphedema. Chronic bilateral leg edema is usually due to a venous flowoff obstruction (stasis edema). Less commonly, lipedema or a primary lymphedema may be responsible for the swelling. PMID:15222499

  12. Effects of gabapentin enacarbil on restless legs syndrome and leg pain in dementia with Lewy bodies.

    PubMed

    Fujishiro, Hiroshige

    2014-06-01

    Restless legs syndrome (RLS) is a common neurological disorder. Dementia with Lewy bodies (DLB) is the second most common form of neurodegenerative dementia after Alzheimer's disease. Both RLS and DLB can be effectively treated by dopaminergic medications, suggesting the role of dopamine dysfunction in the pathogenesis of both diseases. Here, I report on a Japanese woman with probable DLB and RLS who was treated with gabapentin enacarbil, a non-dopaminergic agent. Because a dopamine agonist, a first-line therapy for moderate to severe RLS, caused the occurrence of metamorphopsia, an alternative treatment of gabapentin enacarbil was used; this treatment improved the patient's RLS without worsening her psychiatric symptoms. An alternative treatment is desirable for DLB patients with RLS because they often experience intolerable side-effects with a dopamine agonist, especially visual hallucinations. Administering gabapentin enacarbil also improved the continuous leg pain that occurred in conjunction with the development of RLS. Although the neurobiological mechanism in the development of pain remains unclear, a range of non-dopaminergic structures likely mediated pain processing in DLB in the present case based on neuropharmacological results. This is the first report reporting the effects of gabapentin enacarbil for RLS and leg pain in a DLB patient with psychiatric symptoms. PMID:24528871

  13. High Cost of Stage IV Pressure Ulcers

    PubMed Central

    Brem, Harold; Maggi, Jason; Nierman, David; Rolnitzky, Linda; Bell, David; Rennert, Robert; Golinko, Michael; Yan, Alan; Lyder, Courtney; Vladeck, Bruce

    2010-01-01

    Objective To calculate and analyze the cost of treatment for stage IV pressure ulcers. Methods A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed for a maximum of 29 months and analyzed. Costs directly related to the treatment of pressure ulcers and their associated complications were calculated. Results Nineteen patients with stage IV pressure ulcers (11 hospital-acquired and 8 community-acquired) were identified and their charts reviewed. The average hospital treatment cost associated with stage IV pressure ulcers and related complications was $129,248 for hospital-acquired ulcers during one admission, and $124,327 for community-acquired ulcers over an average of 4 admissions. Conclusions The costs incurred from stage IV pressure ulcers are much greater than previously estimated. Halting the progression of early stage pressure ulcers has the potential to eradicate enormous pain and suffering, save thousands of lives, and reduce healthcare expenditures by millions of dollars. PMID:20887840

  14. Gastric emptying abnormal in duodenal ulcer

    SciTech Connect

    Holt, S.; Heading, R.C.; Taylor, T.V.; Forrest, J.A.; Tothill, P.

    1986-07-01

    To investigate the possibility that an abnormality of gastric emptying exists in duodenal ulcer and to determine if such an abnormality persists after ulcer healing, scintigraphic gastric emptying measurements were undertaken in 16 duodenal ulcer patients before, during, and after therapy with cimetidine; in 12 patients with pernicious anemia, and in 12 control subjects. No difference was detected in the rate or pattern of gastric emptying in duodenal ulcer patients before and after ulcer healing with cimetidine compared with controls, but emptying of the solid component of the test meal was more rapid during treatment with the drug. Comparison of emptying patterns obtained in duodenal ulcer subjects during and after cimetidine treatment with those obtained in pernicious anemia patients and controls revealed a similar relationship that was characterized by a tendency for reduction in the normal differentiation between the emptying of solid and liquid from the stomach. The similarity in emptying patterns in these groups of subjects suggests that gastric emptying of solids may be influenced by changes in the volume of gastric secretion. The failure to detect an abnormality of gastric emptying in duodenal ulcer subjects before and after ulcer healing calls into question the widespread belief that abnormally rapid gastric emptying is a feature with pathogenetic significance in duodenal ulcer disease.

  15. Refractory duodenal ulcers (nonhealing duodenal ulcers with standard doses of antisecretory medication)

    Microsoft Academic Search

    Martin J. Collen; Valerie J. Stanczak; Cecelia A. Ciarleglio

    1989-01-01

    To evaluate possible differences between patients with refractory duodenal ulcers and those with duodenal ulcers that respond to standard doses of antisecretory medications, we determined basal acid outputs by nasogastric suction and daily smoking histories in 75 patients with endoscopically documented active duodenal ulcers. Patients were treated for at least eight weeks with standard doses of antisecretory medications and endoscopic

  16. Application of platelet-rich plasma accelerates the wound healing process in acute and chronic ulcers through rapid migration and upregulation of cyclin A and CDK4 in HaCaT cells.

    PubMed

    Kim, Sung-Ae; Ryu, Han-Won; Lee, Kyu-Suk; Cho, Jae-We

    2013-02-01

    Application of autologous platelet-rich plasma (PRP) has been used for chronic wound healing. The aim of this study was to evaluate the effect of PRP on the wound healing processes of both acute and chronic ulcers and the underlying molecular mechanisms involved. We treated 16 patients affected by various acute and chronic ulcers with PRP. We performed molecular studies of cell proliferation, migration assays, immunoblotting and chloramphenicol acetyltransferase (CAT) assays in PRP-treated HaCaT keratinocyte cells. PRP treatment induced increased rates of cell proliferation and cell migration of HaCaT cells. In addition, the expression of cyclin A and cyclin dependent kinase (CDK) 4 proteins was markedly increased with a low concentration (0.5%) of PRP treatment in HaCaT cells. In 11 patients with chronic ulcers, including stasis ulcers, diabetic ulcers, venous leg ulcers, livedoid vasculitis, claw foot and traumatic ulcers, 9 patients showed 90-100% epithelization after 15.18 days. In 5 patients with acute ulcers, such as dehiscence, open wound and burn wound, 80-100% epithelization was achieved between 4 to 20 days. Topical application of PRP to acute and chronic skin ulcers significantly accelerated the epithelization process, likely through upregulation of the cell cycle regulatory proteins cyclin A and CDK4. PMID:23242428

  17. Antioxidant Therapies for Ulcerative Dermatitis: A Potential Model for Skin Picking Disorder

    PubMed Central

    George, Nneka M.; Whitaker, Julia; Vieira, Giovana; Geronimo, Jerome T.; Bellinger, Dwight A.; Fletcher, Craig A.; Garner, Joseph P.

    2015-01-01

    Skin Picking Disorder affects 4% of the general population, with serious quality of life impacts, and potentially life threatening complications. Standard psychoactive medications do not help most patients. Similarly, Mouse Ulcerative Dermatitis (skin lesions caused by excessive abnormal grooming behavior) is very common in widely used inbred strains of mice, and represents a serious animal welfare issue and cause of mortality. Treatment options for Ulcerative Dermatitis are largely palliative and ineffective. We have proposed mouse Ulcerative Dermatitis as a model for human Skin Picking Disorder based on similar epidemiology, behavior, and its comorbidity and mechanistic overlap with hair pulling (trichotillomania). We predicted that mouse Ulcerative Dermatitis would be treated by N-Acetylcysteine, as this compound is highly effective in treating both Skin Picking Disorder and Trichotillomania. Furthermore, we hypothesized that N-Acetylcysteine’s mode of action is as a precursor to the production of the endogenous antioxidant glutathione in the brain, and therefore intranasal glutathione would also treat Ulcerative Dermatitis. Accordingly, we show in a heterogenous prospective trial, the significant reduction in Ulcerative Dermatitis lesion severity in mice receiving either N-acetylcysteine (oral administration) or glutathione (intranasal). The majority of mice treated with N-acetylcysteine improved slowly throughout the course of the study. Roughly half of the mice treated with glutathione showed complete resolution of lesion within 2-4 weeks, while the remainder did not respond. These findings are the first to show that the use of N-acetylcysteine and Glutathione can be curative for mouse Ulcerative Dermatitis. These findings lend additional support for mouse Ulcerative Dermatitis as a model of Skin Picking Disorder and also support oxidative stress and glutathione synthesis as the mechanism of action for these compounds. As N-Acetylcysteine is poorly tolerated by many patients, intranasal glutathione warrants further study as potential therapy in Skin Picking, trichotillomania and other body-focused repetitive behavior disorders. PMID:26167859

  18. Help-Seeking for Pre-Ulcer and Ulcer Conditions of Mycobacterium ulcerans Disease (Buruli Ulcer) in Ghana

    PubMed Central

    Ackumey, Mercy M.; Gyapong, Margaret; Pappoe, Matilda; Weiss, Mitchell G.

    2011-01-01

    This study examined sociocultural features of help-seeking for Buruli ulcer–affected persons with pre-ulcers and ulcers in a disease-endemic area in Ghana. A sample of 181 respondents were purposively selected. Fisher's exact test was used to compare help-seeking variables for pre-ulcers and ulcers. Qualitative phenomenologic analysis of narratives clarified the meaning and content of selected quantitative help-seeking variables. For pre-ulcers, herbal dressings were used to expose necrotic tissues and subsequently applied as dressings for ulcers. Analgesics and left-over antibiotics were used to ease pain and reduce inflammation. Choices for outside-help were influenced by the perceived effectiveness of the treatment, the closeness of the provider to residences, and family and friends. Health education is required to emphasize the risk of self-medication with antibiotics and the importance of medical treatment for pre-ulcers, and to caution against the use of herbs to expose necrotic tissues, which could lead to co-infections. PMID:22144453

  19. Rotational joint for prosthetic leg

    NASA Technical Reports Server (NTRS)

    Jones, W. C.; Owens, L. J.

    1977-01-01

    Device is installed in standard 30 millimeter tubing used for lower leg prosthetics. Unit allows proper rotation (about 3 degrees) of foot relative to the hip, during normal walking or running. Limited rotational movement with restoring force results in a more natural gait.

  20. Why Dont Whales Have Legs?

    NSDL National Science Digital Library

    S. Bedell

    In this lesson, students are given a variety of materials and are asked to design a heat loss experiment that will result in a reasonable explanation of why whales do not have legs. Students will learn that natural selection favors a body design that is energy efficient.

  1. A Leg (or Three) to Stand On

    NSDL National Science Digital Library

    Molly Weinburgh

    2003-03-01

    The three "legs" on which science instruction rests are the content of science, process of science, and the nature of science. Each leg performs its own function and need not be competitive with the others. This article uses the metaphor of a three-legged stool to remind teachers that good science instruction must have a balance that is both stable and engaging.

  2. OCEAN DRILLING PROGRAM LEG 179 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 179 SCIENTIFIC PROSPECTUS HAMMER DRILLING and NERO Dr. Jack Casey Chief.S.A. Tom Pettigrew Chief Engineer, Leg 179 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station, Texas 77845-9547 U.S.A. Dr. D. Jay Miller Staff Scientist, Leg 179 Ocean

  3. OCEAN DRILLING PROGRAM LEG 100 REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 100 REPORT NORTHEASTERN GULF OF MEXICO Philip D Rabinowitz Co-Chief Scientist, Leg 100 Ocean Drilling Program Texas A&M University College Station, TX 77843 William J. Merrell Co-Chief Scientist, Leg 100 Ocean Drilling Program Texas A&M University College Station, TX 77843

  4. Water strider robots with microfabricated hydrophobic legs

    Microsoft Academic Search

    Kenji Suzuki; Hideaki Takanobu; Kota Noya; Hiroyuki Koike; Hirofumi Miura

    2007-01-01

    This paper discusses biomimetic water strider robots that have microfabricated hydrophobic legs. Various kinds of supporting legs with hydrophobic microstructures on their surfaces were developed using MEMS (micro electromechanical systems) techniques. The lift and pull-off forces of these supporting legs were analyzed theoretically and then measured. The experimental results were in good agreement with the calculations. Two different mechanisms for

  5. Navigation Planning for Legged Robots Thesis Proposal

    E-print Network

    improvement for legged locomotion, including actuator and mechanism design, balance control and robustnessNavigation Planning for Legged Robots Thesis Proposal Joel Chestnutt The Robotics Institute Hirukawa November 15, 2006 Abstract As legged robots gain the abilities to walk and balance on more than

  6. How Is Restless Legs Syndrome Treated?

    MedlinePLUS

    ... page from the NHLBI on Twitter. How Is Restless Legs Syndrome Treated? Restless legs syndrome (RLS) has no cure. If a condition or ... effects. Rate This Content: NEXT >> November 1, 2010 Restless Legs Syndrome Clinical Trials Clinical trials are research studies that ...

  7. [Extensive ulcerations in children: The difficulty diagnosing pyoderma gangrenosum].

    PubMed

    Ramli, I; Rachadi, H; Amarouch, H; Rimani, M; Senouci, K; Benzekri, L; Hassam, B

    2015-07-01

    Pyoderma gangrenosum is an amicrobial neutrophilic dermatosis of unknown cause with a chronic course. We report a case in a 30-month-old child who presented with progressive and painful skin ulcers. Lesions were quickly extensive, refractory to local and systemic antibiotic therapy. Histopathology of the skin biopsies confirmed the diagnosis of ulcerative pyoderma gangrenosum. Only 4% of the cases reported in the literature are in children below the age of 4 years. This neutrophilic dermatosis is associated in half of the cases with a systemic disease. The treatment is based on corticosteroids. Immunosuppressant drugs such as tacrolimus, cyclosporine, and mycophenolate mofetil may be effective for pyoderma gangrenosum refractory to corticosteroids. Currently, anti-TNF is a promising treatment for refractory PG. PMID:26047747

  8. Adult Dermatomyositis with Bleeding Ulcer in the Pharynx

    PubMed Central

    Kusano, Junko; Takahashi, Yuka

    2014-01-01

    Dermatomyositis (DM) is one of the idiopathic inflammatory myopathies caused by complement-mediated vasculopathy or vasculitis in the muscle. Although the gastrointestinal (GI) mucosa has been reported to be involved as a result of vasculitis or vasculopathy, ulceration in the pharynx is a rare manifestation of DM. A 54-year-old woman complaining of muscle weakness in the extremities, low-grade fever, and dysphagia was diagnosed as having DM. Despite medical treatment with corticosteroids and immunosuppressive agents, her DM progressed rapidly, leading to exacerbation of the dysphagia. About 3 weeks after undergoing tracheostomy as a preventive measure against aspiration, the patient developed intractable respiratory tract hemorrhage. Repeated laryngoendoscopy revealed a bleeding ulceration in the pharynx that required hemostasis with electric cautery under general anesthesia. No bleeding recurred thereafter. Histopathologically, the pharynx exhibited nonspecific inflammatory cell infiltration in the muscle tissue. This rare manifestation may be considered in cases of DM with unexplainable airway bleeding. PMID:25328739

  9. Spinal Subdural Abscess: A Rare Complication of Decubitus Ulcer

    PubMed Central

    Usoltseva, Natalia; Medina-Flores, Rafael; Rehman, Ateeq; Samji, Swetha; D’Costa, Matthew

    2014-01-01

    Spinal subdural abscess (SSA) is an uncommon entity. The exact incidence is unknown, with very few cases reported in the literature. This condition may result in spinal cord compression, thus constituting a medical and neurosurgical emergency. The pathogenesis of SSA is not well-described, and the available knowledge is based on case observations only. There is only one case report that describes direct seeding from decubitus ulcers as a possible mechanism for development of SSA. We report a case of subacute onset of quadriplegia in a male patient, age 55 years, due to spinal cord compression from SSA and superimposed spinal subdural hematoma. The direct seeding from decubitus ulcers is thought to be the cause of infection in our patient. We present this case of SSA to elucidate and review the predisposing factors, pathogenesis, clinical presentation, diagnostic modalities, and treatment regarding management of this rare disorder. PMID:24667217

  10. Duodenal ulceration in a patient with celiac disease and plasminogen I deficiency: coincidence or cofactors?

    PubMed

    Veres, Gabor; Korponay-Szabó, Ilma; Maka, Erika; Glasz, Tibor; Mamula, Petar; Schuster, Volker; Tefs, Katrin; Schuster, Volker; Tefs, Katrin; Papp, Maria; Dezsöfi, Antal; Arató, Andras

    2011-11-01

    Celiac disease (CD) is a gluten-dependent inflammatory disease of the small bowel that affects up to 1% of the worldwide population. Despite severe mucosal abnormalities including total villous atrophy and autoantibody deposition, duodenal ulcer is not a feature of CD. However, a recent study found an elevated rate of peptic ulcer disease in patients with CD. Plasminogen deficiency (PLD) is an autosomal recessive disease that causes pseudomembranous lesions in different organs, but gastrointestinal involvement is rare. Here we report the case of a 6-year-old girl who had a sudden onset of hematemesis caused by duodenal ulcer. On the basis of mucosal atrophy, elevated celiac antibody levels, decreased plasminogen serum activity, and homozygous missense mutation R216H in the plasminogen gene, CD and PLD were diagnosed. This report is, to our knowledge, the first description of the 2 entities, and results of our double-immunofluorescent studies also suggest that both diseases may have a role in the ulceration process. Excessive amounts of fibrin deposition due to PLD caused the distortion of the vessels and was responsible for the unusual celiac immunoglobulin A and tissue transglutaminase 2 in vivo binding pattern. On the basis of this result, patients with CD and unknown cause of gastrointestinal ulcer may require investigation for PLD. PMID:21969282

  11. [Pressure in nursing care: Outcomes of a prevalence study of pressure ulcers in Austrian hospitals and nursing homes].

    PubMed

    Grosschädl, Franziska; Lohrmann, Christa

    2011-06-01

    For decades pressure ulcers have been internationally serious and frequent nursing relevant problems. It causes enormous suffering to the affected and high costs for society. Prevalence studies about pressure ulcers indicate the extent of this disease. Subsequently targeted measures can be planned in order to prevent pressure ulcers. There are already some international prevalence surveys of pressure ulcers, which reported prevalence data from 0.06 per cent to 83.6 per cent in hospitals and nursing homes. A comparison of these studies is limited due to their differences in methodology, population and the definition of prevalence and pressure ulcer. Prevalences for pressure ulcers were hardly available so far in Austria. Therefore in the context of the National Prevalence Survey Care-related Data (LPZ) prevalence data, quality indicators and data on the prevention and treatment of pressure ulcers were standardized collected with a scientifically tested questionnaire for the first time in austrian health institutions. This survey entitles to compare the results between participating institutions and countries. 2353 hospital patients and nursing home residents in 17 austrian institutions participated. The prevalence in the risk group was 12.2 per cent (excluding grade one pressure ulcer: eight percent) forthe patients and seven per cent (excluding grade one pressure ulcer: 5.9 Prozent) for the residents. Most of the wounds were acquired on the heels. This study also found that prevention activities of pressure ulcers were used more often in the nursing homes than in hospitals. Compared to the prevalence of published studies the identified prevalence of pressure ulcers is low. Regular participation in prevalence surveys is advisable, so that institutions examine themselves objectively in terms of quality of care as well. PMID:21735635

  12. Colonoscopic evaluation in ulcerative colitis

    PubMed Central

    Paine, Elizabeth R.

    2014-01-01

    Colonoscopic evaluation is an important tool in the evaluation of ulcerative colitis (UC). UC is divided by disease extent into proctitis, proctosigmoiditis, left-sided colitis, and pan-colitis. In addition, a cecal or peri-appendiceal patch and backwash ileitis are associated with UC. The extent and behavior of UC has been characterized further using various indices and scoring systems; among these systems is the Mayo Score, which is widely used in current clinical trials for new medications. As these medical therapies for UC have developed, achieving mucosal healing with medications has become an important therapeutic objective. PMID:24879406

  13. Operative Debridement of Pressure Ulcers

    Microsoft Academic Search

    Jessica Schiffman; Michael S. Golinko; Alan Yan; Anna Flattau; Marjana Tomic-Canic; Harold Brem

    2009-01-01

    Background  Infection in severe pressure ulcers can lead to sepsis with a 6-month mortality as high as 68%.\\u000a \\u000a \\u000a \\u000a Methods  Operative records of 142 consecutive operative debridements on 60 patients in a dedicated wound healing inpatient unit were\\u000a reviewed, from the Wound Electronic Medical Record, for identification of key steps in debridement technique, mortality, unexpected\\u000a returns, and time to discharge following debridement.\\u000a \\u000a \\u000a \\u000a Results  The

  14. Effect of Lower Body Positive Pressure on Fluid Turnover in Human Legs

    NASA Astrophysics Data System (ADS)

    Matsuo, Satoshi; Onishi, Hiroshi; Kawai, Yasuaki

    We have developed a device for walking rehabilitation which has a treadmill in a lower body positive pressure (LBPP) chamber to unload the lower extremities. In this review, we summarize the present knowledge of effects of gravity, LBPP, and walking on leg fluid turnover in standing human. Prolonged standing caused swelling in the legs due to an effect of hydrostatic pressure. Circumferences of leg gradually increased during standing still and reached a plateau level after 30-40 minutes. Exposure to LBPP significantly improved the swelling in the thigh, suggesting that the LBPP possibly reduces fluid filtration by decreasing transmural pressure gradient in the capillaries and/or increases lymphatic outflow from the tissue. Walking also decreased the leg swelling by muscle pump activity, and this effect was further enhanced by applying LBPP. These results suggest that applying LBPP can change the body fluid turnover, resulting in a decrease in the tissue fluid of the legs in standing and walking human.

  15. Arterial thrombosis in ulcerative colitis: Case report

    Microsoft Academic Search

    Dimitrios A. Mikroulis; George D. Antypas; Spyridon D. Fournogerakis; Paul N. Antoniadis; Anastasios M. Rigas

    1999-01-01

    Arterial thrombosis is a rare complication of ulcerative colitis with many difficulties in its treatment. The pathogenesis of thrombosis is not well known and many factors are implicated such as elevated fibrinogen, increased platelet count, and decreased antithrombin III levels. We report a case of a 43-year-old man with ulcerative colitis and sudden and refractory thrombosis of the brachial and

  16. Ulcerative colitis flare with splenic ven thrombosis

    PubMed Central

    Bozkurt, Huseyin Sancar; Kara, Banu; Citil, Serdal

    2015-01-01

    Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events. Here, we present a 28-year-old man with active ulcerative pancolitis presenting via splenic vein thrombosis and left renal superior infarct that was not associated with a surgical procedure.

  17. Current and emerging biologics for ulcerative colitis.

    PubMed

    Park, Sung Chul; Jeen, Yoon Tae

    2015-01-01

    Conventional medical treatment for ulcerative colitis can have limited efficacy or severe adverse reactions requiring additional treatment or colectomy. Hence, different biological agents that target specific immunological pathways are be-ing investigated for treating ulcerative colitis. Anti-tumor necrosis factor (TNF) agents were the first biologics to be used for treating inflammatory bowel disease. For example, infliximab and adalimumab, which are anti-TNF agents, are be-ing used for treating ulcerative colitis. Recently, golimumab, another anti-TNF agent, and vedolizumab, an anti-adhesion therapy, have been approved for ulcerative colitis by the U.S. Food and Drug Administration. In addition, new medications such as tofacitinib, a Janus kinase inhibitor, and etrolizumab, another anti-adhesion therapy, are emerging as therapeutic agents. Therefore, there is a need for further studies to select appropriate patient groups for these biologics and to improve the outcomes of ulcerative colitis treatment through appropriate medical usage. PMID:25547087

  18. Current and Emerging Biologics for Ulcerative Colitis

    PubMed Central

    Park, Sung Chul; Jeen, Yoon Tae

    2015-01-01

    Conventional medical treatment for ulcerative colitis can have limited efficacy or severe adverse reactions requiring additional treatment or colectomy. Hence, different biological agents that target specific immunological pathways are being investigated for treating ulcerative colitis. Anti-tumor necrosis factor (TNF) agents were the first biologics to be used for treating inflammatory bowel disease. For example, infliximab and adalimumab, which are anti-TNF agents, are being used for treating ulcerative colitis. Recently, golimumab, another anti-TNF agent, and vedolizumab, an anti-adhesion therapy, have been approved for ulcerative colitis by the U.S. Food and Drug Administration. In addition, new medications such as tofacitinib, a Janus kinase inhibitor, and etrolizumab, another anti-adhesion therapy, are emerging as therapeutic agents. Therefore, there is a need for further studies to select appropriate patient groups for these biologics and to improve the outcomes of ulcerative colitis treatment through appropriate medical usage. PMID:25547087

  19. Factors precipitating acute ulcerative colitis.

    PubMed

    Puri, A S; Chaubal, C C; Midha, Vandana

    2014-08-01

    Ulcerative colitis is characterized by mucosal inflammation of a variable length of the colon starting from the rectum. The precise etiopathogenesis is unknown but it occurs in genetically susceptible individuals who manifest an abnormal immunological response against gut commensal bacteria. The disease course is-characterized by multiple spontaneous relapses and remissions. Two pathogens namely CMV and C. difficile have been associated with disease exacerbation in specific clinical situations. Whereas C. difficile may produce worsening of the disease in those exposed to broad spectrum antibiotics, CMV reactivation is seen only in patients with moderate to severe steroid refractory disease. The importance of these two super-infections can be gauged by the fact that both the ACG and the ECCO recommend testing for these two pathogens in appropriate clinical situations. The applicability of these guidelines in the Indian scenario has yet to be determined in view of the bacterial and parasitic infections endemic in tropical countries. The guidelines for diagnosis and management of these two super-infections in the presence of ulcerative colitis are discussed in this review. PMID:25735121

  20. Large B-cell lymphoma of the leg in a patient with multiple malignant tumours.

    PubMed

    Eros, Nora; Karolyi, Zsuzsanna; Kovács, Anikó; Matolcsy, András; Barna, Tibor; Kelényi, Gábor

    2003-01-01

    A patient who had primary gastric B-cell non-Hodgkin's lymphoma, invasive ductal breast cancer and a basocellular carcinoma of the forehead in her medical history was studied. Three years after polychemotherapy and irradiation of the breast cancer, a rapidly enlarging, ulcerated violaceous tumour developed on the patient's left leg. The tumour was identified by the histopathological, immunohistochemical and immunoglobulin gene rearrangement analyses as a cutaneous large B-cell lymphoma. No signs of extracutaneous involvement were detectable. Despite surgical excision, interferon-alpha2b treatment and chlorambucil + prednisone chemotherapy, a relapse occurred in the previously affected site, whereafter the patient received radiotherapy. She was lost to follow-up, and died approximately 14 months after the surgical intervention without autopsy. We discuss the clinical and histologic features and outcome of the large B-cell lymphoma of the leg, its coincidence with other diseases, and the uncommon occurrence of primary multiple malignant tumours. PMID:14609103

  1. Genetic aspects of restless legs syndrome.

    PubMed

    Dhawan, V; Ali, M; Chaudhuri, K R

    2006-10-01

    Restless legs syndrome (RLS), also known as Ekbom syndrome, is a common movement disorder with sensorimotor symptoms occurring during sleep and quiet wakefulness. The underlying cause for RLS is unknown but genetic influences play a strong part in the pathogenesis of RLS, particularly when the condition starts at a young age. This review explores the genetic basis of RLS and related phenotypic variations. Recently, three loci showing vulnerability to RLS have been described in French-Canadian and Italian families in chromosomes 12q, 14q and 9q, emphasising on an autosomal dominant mode of inheritance. These have been labelled RLS1, RLS2 and RLS3, respectively. However, specific causative mutations remain elusive and no linkage analysis has been identified so far in the candidate genes investigated in RLS. PMID:17068272

  2. Rabbit gastric ulcer models: comparison and evaluation of acetic acid-induced ulcer and mucosectomy-induced ulcer

    PubMed Central

    Maeng, Jin Hee; Lee, Eunhye

    2013-01-01

    In this study, we examined rabbit gastric ulcer models that can serve as more clinically relevant models. Two types of ulcer model were studied: acetic acid-induced ulcers (AAU) and mucosal resection-induced ulcers (MRU). For AAU, rabbit gastric mucosa was exposed by median laparotomy and treated with bottled acetic acid. MRU was examined as a model for endoscopic mucosal resection (EMR). Normal saline was injected into the submucosal layer and the swollen mucosa was resected with scissors. Endoscopic mucosal resection (EMR) is frequently performed for treatment of early gastric cancers. This procedure inevitably leads to ulcers and bleeding. Bleeding control is the major concern in endoscopic mucosectomy, and some endoscopic hemostatic agents are currently under clinical and preclinical studies. MRU was developed as a model for these induced ulcers and the evaluation of the healing process. The clinical relevancy of those models was compared with that of rat models. Progressive healing was observed for 7 days based on histology. Rabbit models demonstrate round, deep ulcers with clear margins and well-defined healing stages that were difficult to define in rat models. PMID:23825482

  3. Targeted interventions required against genital ulcers in African countries worst affected by HIV infection.

    PubMed Central

    O'Farrell, N.

    2001-01-01

    It remains unclear why there is such marked variation in the severity of the human immunodeficiency virus (HIV) epidemic between African countries. The prevalence of HIV infection has reached high levels in many parts of southern Africa but in most countries of West Africa the levels are much lower. Although there is good evidence that sexually transmitted infections (STIs) and genital ulcers in particular facilitate heterosexual transmission of HIV, there is little comparative STI data from the African countries worst affected by HIV infection. A MEDLINE search covering the period 1966 to August 2000 using the keywords "sexually transmitted diseases", "genital ulcers" and "Africa" was performed to identify factors that might be relevant to the spread of HIV infection in countries with the highest prevalences of the virus. In the countries worst affected by HIV infection, the proportions of men and women with STI who had genital ulcers lay in the ranges 45-68% and 13-68%, respectively. The proportions were much lower in countries of West Africa than in those of southern Africa. The African countries worst affected by HIV infection should adopt a more specialized approach to STI control than hitherto and specifically target the high incidence of genital ulceration. Locally, technical STI committees should draw up country-specific guidelines taking into account the prevalence of the various causes of genital ulceration. In these countries, national AIDS control programmes and donor agencies should develop a specific focus for decreasing the incidence of genital ulcer disease. PMID:11436480

  4. Haemophilus ducreyi Cutaneous Ulcer Strains Are Nearly Identical to Class I Genital Ulcer Strains

    PubMed Central

    Gangaiah, Dharanesh; Webb, Kristen M.; Humphreys, Tricia L.; Fortney, Kate R.; Toh, Evelyn; Tai, Albert; Katz, Samantha S.; Pillay, Allan; Chen, Cheng-Yen; Roberts, Sally A.; Munson, Robert S.; Spinola, Stanley M.

    2015-01-01

    Background Although cutaneous ulcers (CU) in the tropics is frequently attributed to Treponema pallidum subspecies pertenue, the causative agent of yaws, Haemophilus ducreyi has emerged as a major cause of CU in yaws-endemic regions of the South Pacific islands and Africa. H. ducreyi is generally susceptible to macrolides, but CU strains persist after mass drug administration of azithromycin for yaws or trachoma. H. ducreyi also causes genital ulcers (GU) and was thought to be exclusively transmitted by microabrasions that occur during sex. In human volunteers, the GU strain 35000HP does not infect intact skin; wounds are required to initiate infection. These data led to several questions: Are CU strains a new variant of H. ducreyi or did they evolve from GU strains? Do CU strains contain additional genes that could allow them to infect intact skin? Are CU strains susceptible to azithromycin? Methodology/Principal Findings To address these questions, we performed whole-genome sequencing and antibiotic susceptibility testing of 5 CU strains obtained from Samoa and Vanuatu and 9 archived class I and class II GU strains. Except for single nucleotide polymorphisms, the CU strains were genetically almost identical to the class I strain 35000HP and had no additional genetic content. Phylogenetic analysis showed that class I and class II strains formed two separate clusters and CU strains evolved from class I strains. Class I strains diverged from class II strains ~1.95 million years ago (mya) and CU strains diverged from the class I strain 35000HP ~0.18 mya. CU and GU strains evolved under similar selection pressures. Like 35000HP, the CU strains were highly susceptible to antibiotics, including azithromycin. Conclusions/Significance These data suggest that CU strains are derivatives of class I strains that were not recognized until recently. These findings require confirmation by analysis of CU strains from other regions. PMID:26147869

  5. Analysis of lymphatic drainage in various forms of leg edema using two compartment lymphoscintigraphy.

    PubMed

    Bräutigam, P; Földi, E; Schaiper, I; Krause, T; Vanscheidt, W; Moser, E

    1998-06-01

    The anatomical and functional status of the epifascial and subfascial lymphatic compartments was analyzed using two compartment lymphoscintigraphy in five groups of patients (total 55) with various forms of edema of the lower extremities. Digital whole body scintigraphy enabled semiquantitative estimation of radiotracer transport with comparison of lymphatic drainage between those individuals without (normal) and those with leg edema by calculating the uptake of the radiopharmaceutical transported to regional lymph nodes. A visual assessment of the lymphatic drainage pathways of the legs was also performed. In patients with cyclic idiopathic edema, an accelerated rate of lymphatic transport was detected (high lymph volume overload or dynamic insufficiency). In those with venous (phlebo) edemas, high volume lymphatic overload (dynamic insufficiency) of the epifascial compartment was scintigraphically detected by increased tracer uptake in regional nodes. In patients with deep femoral venous occlusion (post-thrombotic syndrome). subfascial lymphatic transport was uniformly markedly reduced (safety valve lymphatic insufficiency). On the other hand, in the epifascial compartment, lymph transport was accelerated. In those patients with recurrent or extensive skin ulceration, lymph transport was reduced. Patients with lipedema (obesity) scintigraphically showed no alteration in lymphatic transport. This study demonstrates that lymphatic drainage is notably affected (except in obesity termed lipedema) in various edemas of the leg. Lymphatic drainage varied depending on the specific compartment and the pathophysiologic mechanism accounting for the edema. Two compartment lymphoscintigraphy is a valuable diagnostic tool for accurate assessment of leg edema of known and unknown origin. PMID:9664268

  6. Biological therapy for ulcerative colitis.

    PubMed

    Arora, Zubin; Shen, Bo

    2015-05-01

    Ulcerative colitis (UC) is a major form of inflammatory bowel disease (IBD) worldwide. Better understanding of the pathogenesis of UC has led to the development of novel therapeutic agents that target specific mediators of the inflammatory cascade. A number of biological agents have been approved by the U.S. Food and Drug Administration (FDA) for the treatment of UC and several more are currently in various phases of drug development. The commonly used agents include TNF? antagonists (e.g. infliximab, adalimumab, and golimumab) and anti-integrin agents (vedolizumab). These biological agents have profoundly influenced the management of UC patients, especially those with refractory disease. This paper reviews the currently available knowledge and evidence for the use of various biological agents in the treatment of UC. PMID:25344680

  7. Positioning Therapy for Ulcerative Colitis.

    PubMed

    Grinspan, Ari; Kornbluth, Asher

    2015-08-01

    Ulcerative colitis (UC) is a chronic inflammatory condition of the colon, characterized by diffuse mucosal inflammation, bloody diarrhea, and urgency. The mainstay of treatment has been mesalamine agents, steroids, thiopurines, and anti-tumor necrosis factor alpha (TNF-?) antibodies. Over the past several years, new therapies have emerged which have provided clinicians new treatment options as well as new challenges in deciding which treatment is best for their patient at given points in their disease course. These agents include budesonide-Multi-Matrix System (MMX), adalimumab, golimumab, and vedolizumab. In addition, randomized controlled trials have investigated a combination therapy of infliximab and azathioprine and a controlled trial of infliximab versus cyclosporine for intravenous steroid refractory UC. This review will focus on where these agents may be optimally positioned in treatment algorithms for UC. PMID:26143627

  8. Characterization of running with compliant curved legs.

    PubMed

    Jun, Jae-Yun; Clark, Jonathan E

    2015-01-01

    Running with compliant curved legs involves the progression of the center of pressure, the changes of both the leg's stiffness and effective rest length, and the shift of the location of the maximum stress point along the leg. These phenomena are product of the geometric and material properties of these legs, and the rolling motion produced during stance. We examine these aspects with several reduced-order dynamical models to relate the leg's design parameters (such as normalized foot radius, leg's effective stiffness, location of the maximum stress point and leg shape) to running performance (such as robustness and efficiency). By using these models, we show that running with compliant curved legs can be more efficient, robust with fast recovery behavior from perturbations than running with compliant straight legs. Moreover, the running performance can be further improved by tuning these design parameters in the context of running with rolling. The results shown in this work may serve as potential guidance for future compliant curved leg designs that may further improve the running performance. PMID:26151098

  9. Risk of plantar ulceration in diabetic patients with single-leg amputation

    Microsoft Academic Search

    R. V. Kanade; R. W. M. van Deursen; Patricia Price; Keith Harding

    2006-01-01

    BackgroundThere is a disconcerting rate of bilateral limb loss in patients with diabetes. Therefore, this study aimed to explore plantar loading of the surviving foot following unilateral trans-tibial amputation within a wider context of daily walking activity to investigate the precise risk to the surviving limb.

  10. Acid inhibition and peptic ulcer bleeding.

    PubMed

    Štimac, D; Franji?, N; Krznari?, Ž

    2011-01-01

    Peptic ulcer bleeding is one of the most common emergency situations in medicine. Combined pharmacological and endoscopic therapy together with emerging interventional radiological procedures are successfully treating peptic ulcer disease, reserving surgical procedures for only a small portion of patients unresponsive to 'conventional' therapy. Technological advancement has seen a great improvement in the field of endoscopic treatment in the form of various methods of hemostasis. However, pharmacological therapy with proton pump inhibitors still plays the central role in the peptic ulcer bleeding treatment algorithm. PMID:22095017

  11. Peripheral ulcerative keratitis in association with sarcoidosis.

    PubMed

    Harthan, Jennifer S; Reeder, Renée E

    2013-12-01

    Peripheral ulcerative keratitis (PUK) is a sight-threatening condition characterized by an epithelial defect, crescent-shaped stromal inflammation, and progressive stromal thinning. Peripheral ulcerative keratitis as a purely inflammatory entity is most commonly associated with collagen vascular diseases, including rheumatoid arthritis, polyarteritis nodosa, Wegener granulomatosis, systemic lupus erythematosus, and relapsing polychondritis. PUK can also be associated with infectious and inflammatory conditions such as hepatitis, syphilis, herpes simplex keratitis, fungal keratitis, Mooren ulcer, and marginal keratitis. We describe a case report of PUK associated with the inflammatory condition of sarcoidosis. PMID:23993305

  12. Inner / Outer Leg Symmetry Of the Cornell Ranger

    E-print Network

    Ruina, Andy L.

    of the walking `cycle' of the Ranger is as follows ­ First, say, the inner leg is the pivot or stance leg, while the outer leg is swung forward, by the hip-motor and a push-off mechanism on the outer leg (actuated by the foot motor on the outer leg). After the foot on the outer leg lands, it is now the stance leg

  13. [Squamous cell carcinoma in neuropathic plantar ulcers in leprosy: another example of Marjolin's ulcer].

    PubMed

    Schoeman, B J

    1996-08-01

    Seven cases of squamous cell carcinoma (SCC) arising in chronic neuropathic plantar ulcers of leprosy are described. These patients (average age 59 years) presented over a 5-year period. The mean duration of neuropathic ulceration until diagnosis of SCC was 24.5 years. Six patients required limb amputations and 3 underwent lymphadenectomy for involved nodes. One patient died of disseminated disease. The history of the eponym "Marjolin's ulcer' is traced and a case put forward for recognition of malignant change in neuropathic ulcers as yet another example of Marjolin's ulcer. A plea is made for an increased awareness of the possibility of malignant transformation in chronic neuropathic ulcers in order to effect an early diagnosis of a potentially aggressive cancer. This is the first report of its kind in South Africa. Similar cases, however, have been reported from other parts of the world where leprosy is endemic. PMID:8966648

  14. Asenapine-induced restless legs syndrome: differentiation from akathisia.

    PubMed

    McCall, W Vaughn; Riley, Mary Anne; Hodges, Chelsea; McCloud, Laryssa; Phillips, Marjorie; Rosenquist, Peter B

    2014-01-01

    Akathisia and restless legs syndrome (RLS) share some common clinical features and a common relationship with dopamine dysfunction. However, the underlying causes and appropriate treatments for akathisia and RLS are different. Herein we describe a case of RLS that was precipitated by a single dose of asenapine, which is an atypical antipsychotic, and dissect the features that support the contention that this was indeed a case of RLS and not akathisia. PMID:25325577

  15. Treponema infection associated with genital ulceration in wild baboons.

    PubMed

    Knauf, S; Batamuzi, E K; Mlengeya, T; Kilewo, M; Lejora, I A V; Nordhoff, M; Ehlers, B; Harper, K N; Fyumagwa, R; Hoare, R; Failing, K; Wehrend, A; Kaup, F J; Leendertz, F H; Mätz-Rensing, K

    2012-03-01

    The authors describe genital alterations and detailed histologic findings in baboons naturally infected with Treponema pallidum. The disease causes moderate to severe genital ulcerations in a population of olive baboons (Papio hamadryas anubis) at Lake Manyara National Park in Tanzania. In a field survey in 2007, 63 individuals of all age classes, both sexes, and different grades of infection were chemically immobilized and sampled. Histology and molecular biological tests were used to detect and identify the organism responsible: a strain similar to T pallidum ssp pertenue, the cause of yaws in humans. Although treponemal infections are not a new phenomenon in nonhuman primates, the infection described here appears to be strictly associated with the anogenital region and results in tissue alterations matching those found in human syphilis infections (caused by T pallidum ssp pallidum), despite the causative pathogen's greater genetic similarity to human yaws-causing strains. PMID:21411621

  16. A fundamental mechanism of legged locomotion with hip torque and leg damping.

    PubMed

    Shen, Z H; Seipel, J E

    2012-12-01

    New models and theories of legged locomotion are needed to better explain and predict the robustly stable legged locomotion of animals and some bio-inspired robots. In this paper we observe that a hip-torque and leg-damping mechanism is fundamental to many legged robots and some animals and determine its affect on locomotion dynamics. We discuss why this hip-torque-and-leg-damping mechanism is not so easily understood. We investigate how hip-torque and leg-damping affect the stability and robustness of locomotion using a mathematical model: First, we extend the canonical spring-loaded-inverted-pendulum model to include constant hip torque and leg damping proportional to leg length speed. Then, we calculate the stability and robustness of locomotion as a function of increasing levels of torque and damping, starting from zero-the energy conserving and marginally stable special case-to high levels of torque and damping. We find that the stabilizing effects of hip-torque and leg-damping occur in the context of the piecewise-continuous dynamics of legged locomotion, and so linear intuition does not apply. We discover that adding hip torque and leg damping changes the stability of legged locomotion in an unexpected way. When a small amount of torque and damping are added, legged locomotion is initially destabilized. As more torque and damping are added, legged locomotion turns stable and becomes increasingly more stable and more robust the more torque and damping are added. Also, stable locomotion becomes more probable over the biologically-relevant region of the parameter space, indicating greater prediction and explanatory capabilities of the model. These results provide a more clear understanding of the hip-torque-and-leg-damping mechanism of legged locomotion, and extend existing theory of legged locomotion towards a greater understanding of robustly stable locomotion. PMID:22989956

  17. Small bowel ulcerative lesions are common in elderly NSAIDs users with peptic ulcer bleeding

    PubMed Central

    Tsibouris, Panagiotis; Kalantzis, Chissostomos; Apostolopoulos, Periklis; Zalonis, Antonios; Isaacs, Peter Edward Thomas; Hendrickse, Mark; Alexandrakis, Georgios

    2014-01-01

    AIM: To determine the frequency of small bowel ulcerative lesions in patients with peptic ulcer and define the significance of those lesions. METHODS: In our prospective study, 60 consecutive elderly patients with upper gastrointestinal bleeding from a peptic ulceration (cases) and 60 matched patients with a non-bleeding peptic ulcer (controls) underwent small bowel capsule endoscopy, after a negative colonoscopy (compulsory in our institution). Controls were evaluated for non-bleeding indications. Known or suspected chronic inflammatory conditions and medication that could harm the gut were excluded. During capsule endoscopy, small bowel ulcerative lesions were counted thoroughly and classified according to Graham classification. Other small bowel lesions were also recorded. Peptic ulcer bleeding was controlled endoscopically, when adequate, proton pump inhibitors were started in both cases and controls, and Helicobacter pylori eradicated whenever present. Both cases and controls were followed up for a year. In case of bleeding recurrence upper gastrointestinal endoscopy was repeated and whenever it remained unexplained it was followed by repeat colonoscopy and capsule endoscopy. RESULTS: Forty (67%) cases and 18 (30%) controls presented small bowel erosions (P = 0.0001), while 22 (37%) cases and 4 (8%) controls presented small bowel ulcers (P < 0.0001). Among non-steroidal anti-inflammatory drug (NSAID) consumers, 39 (95%) cases and 17 (33%) controls presented small bowel erosions (P < 0.0001), while 22 (55%) cases and 4 (10%) controls presented small bowel ulcers (P < 0.0001). Small bowel ulcerative lesions were infrequent among patients not consuming NSAIDs. Mean entry hemoglobin was 9.3 (SD = 1.4) g/dL in cases with small bowel ulcerative lesions and 10.5 (SD = 1.3) g/dL in those without (P = 0.002). Cases with small bowel ulcers necessitate more units of packed red blood cells. During their hospitalization, 6 (27%) cases with small bowel ulcers presented bleeding recurrence most possibly attributed to small bowel ulcers, nevertheless 30-d mortality was zero. Presence of chronic obstructive lung disease and diabetes was related with unexplained recurrence of hemorrhage in logistic regression analysis, while absence of small bowel ulcers was protective (relative risk 0.13, P = 0.05). CONCLUSION: Among NSAID consumers, more bleeders than non-bleeders with peptic ulcers present small bowel ulcers; lesions related to more severe bleeding and unexplained episodes of bleeding recurrence. PMID:25512771

  18. Short report: Clinical and molecular evidence for a case of Buruli ulcer (Mycobacterium ulcerans infection) in Kenya.

    PubMed

    Walsh, Douglas S; Eyase, Fredrick; Onyango, David; Odindo, Alfred; Otieno, Walter; Waitumbi, John N; Bulimo, Wallace D; Schnabel, David C; Meyers, Wayne M; Portaels, Françoise

    2009-12-01

    Mycobacterium ulcerans infection is an emerging disease that causes indolent, necrotizing skin lesions known as Buruli ulcer (BU) and occasional contiguous or metastatic bone lesions. Buruli ulcer is named after Buruli County in Uganda (east Africa), where an epidemic occurred in the 1960s. Today, BU is most common in central and west Africa. We describe clinical and molecular evidence for a case of BU in Kenya. PMID:19996445

  19. Abductor Hallucis Muscle Flap and Staged Medial Column Arthrodesis for the Chronic Ulcerated Charcot Foot With Concomitant Osteomyelitis

    Microsoft Academic Search

    Claire M. Capobianco; Thomas Zgonis

    2010-01-01

    Midfoot ulceration is a common sequela of the diabetic Charcot rocker-bottom deformity. Because redundant soft tissue from a non— weight-bearing area is often scarce in this area of the foot, soft-tissue coverage may be challenging. Wound closure may be difficult to achieve with local wound care and off-loading techniques if the predisposing deformity that caused the ulceration is not addressed.

  20. EXERCISE PERFORMANCE IN PATIENTS WITH PERIPHERAL ARTERIAL DISEASE WHO HAVE DIFFERENT TYPES OF EXERTIONAL LEG PAIN

    PubMed Central

    Gardner, Andrew W.; Montgomery, Polly S.; Afaq, Azhar

    2009-01-01

    Purpose To compare the exercise performance of patients with peripheral arterial disease (PAD) who have different types of exertional leg pain. Methods Patients with PAD were classified into one of the following four groups according to the San Diego claudication questionnaire: intermittent claudication (n = 406), atypical exertional leg pain causing patients to stop (n = 125), atypical exertional leg pain in which patients were able to continue walking (n = 81), and leg pain on exertion and rest (n = 103). Patients were assessed on the following primary outcome measures: ankle/brachial index (ABI), treadmill exercise measures, and ischemic window Results All patients experienced leg pain consistent with intermittent claudication during a standardized treadmill test. Initial claudication distance (ICD) was similar (p = 0.642) among patients with intermittent claudication (168 ± 160 m; mean ± SD), atypical exertional leg pain causing patients to stop (157 ± 130 m), atypical exertional leg pain in which patients were able to continue walking (180 ± 149 m), and leg pain on exertion and rest (151 ± 136 m). The absolute claudication distance (ACD) was similar (p = 0.648) in the four respective groups (382 ± 232 m, 378 ± 237 m, 400 ± 245 m, 369 ± 236 m). Similarly, the ischemic window, expressed as the area under the curve (AUC) following treadmill exercise, was similar (p = 0.863) in these groups (189 ± 137 AUC, 208 ± 183 AUC, 193 ± 143 AUC, 199 ± 119 AUC). Conclusion PAD patients with different types of exertional leg pain, all limited by intermittent claudication during a standardized treadmill test, were remarkably similar in ICD, ACD, and ischemic window. Thus, the presence of ambulatory symptoms should be of primary clinical concern in evaluating PAD patients regardless of whether they are consistent with classic intermittent claudication. PMID:17540534

  1. Sunitinib induced pyoderma gangrenosum-like ulcerations

    PubMed Central

    2011-01-01

    Pyoderma gangrenosum is a non-infectious neutrophilic skin disease commonly associated with underlying systemic diseases. Histopathological and laboratory diagnostics are unspecific in the majority of the cases and the diagnosis is made in accordance with the clinical picture. Here, we report the case of a 69-year old man with progredient pyoderma gangrenosum-like ulcerations under treatment with sunitinib due to hepatocellular carcinoma. A conventional ulcer therapy did not lead to a regression of the lesions. Solely cessation of sunitinib therapy resulted in an improvement of the ulcerations. Sunitinib is a multikinase inhibitor that targets the PDGF-? - and -?-, VEGF-1-3-, KIT-, FLT3-, CSF-1- and RET-receptor, thereby impairing tumour proliferation, pathological angiogenesis and metastasation. Here, we demonstrate that pyoderma gangrenosum-like ulcers may represent a serious side effect of sunitinib-based anti-cancer treatment. PMID:22027642

  2. Buruli Ulcer Surveillance, Benin, 2003–2005

    PubMed Central

    Johnson, Roch Christian; Chauty, Annick; Dossou, Ange Dodji; Aguiar, Julia; Salmon, Olivier; Portaels, Françoise; Asiedu, Kingsley

    2007-01-01

    We reviewed Buruli ulcer (BU) surveillance in Benin, using the World Health Organization BU02 form. We report results of reliable routine data collected on 2,598 new and recurrent cases from 2003 through 2005. PMID:18252113

  3. Helicobacter pylori and Ulcers: A Paradigm Revised

    NSDL National Science Digital Library

    PhD Nancy A. Lynch (University of Iowa College of Medicine)

    2010-07-12

    FASEB Breakthroughs in Bioscience article. The story of the serendipitous discovery of the link between Helicobacter pylori and stomach ulcers. This story includes how this finding was applied to epidemiology, cancer research, and drug development.

  4. Cutaneous leishmaniasis "chiclero's ulcer" in subtropical Ecuador.

    PubMed

    Calvopiña, Manuel; Martinez, Leonardo; Hashiguchi, Yoshihisa

    2013-08-01

    An 18-year-old female presented with a severe ulcerative lesion on her right ear of 6 weeks duration. Her right ear was edematous and erythematous with a large, painless ulcerative lesion covering a third of the pinna and satellite papular lesions on the posterior. She was diagnosed with chiclero's ulcer. A skin smear stained with Diff-quik showed abundant Leishmania parasites. Chiclero's ulcer is a rare clinical presentation and is typically severe and difficult to treat. Physicians in Ecuador recommend administering prolonged intramuscular Glucantime. Side effects are common and can be severe resulting in low patient compliance. Because of preferences of the patient and the large volume needed for her weight, we recommended topical treatment with a lotion of Glucantime mixed half and half with white Merthiolate. After applying this lotion to the lesion 3 to 4 times a day for 6 weeks, the lesion healed. PMID:23926136

  5. Cutaneous Leishmaniasis “Chiclero's Ulcer” in Subtropical Ecuador

    PubMed Central

    Calvopiña, Manuel; Martinez, Leonardo; Hashiguchi, Yoshihisa

    2013-01-01

    An 18-year-old female presented with a severe ulcerative lesion on her right ear of 6 weeks duration. Her right ear was edematous and erythematous with a large, painless ulcerative lesion covering a third of the pinna and satellite papular lesions on the posterior. She was diagnosed with chiclero's ulcer. A skin smear stained with Diff-quik showed abundant Leishmania parasites. Chiclero's ulcer is a rare clinical presentation and is typically severe and difficult to treat. Physicians in Ecuador recommend administering prolonged intramuscular Glucantime. Side effects are common and can be severe resulting in low patient compliance. Because of preferences of the patient and the large volume needed for her weight, we recommended topical treatment with a lotion of Glucantime mixed half and half with white Merthiolate. After applying this lotion to the lesion 3 to 4 times a day for 6 weeks, the lesion healed. PMID:23926136

  6. [Mycobacterium chelonae and solitary rectal ulcer].

    PubMed

    Rodríguez, J C; Reyes, D M; Royo, G; Andrada, E; Sillero, C

    2000-12-01

    Solitary rectal ulcer is of varied etiology and the appearance of this syndrome due to Mycobacterium chelonae is exceptional. We present a case of a solitary rectal ulcer associated with Mycobacterium chelonae subspecies chelonae in an immunocompetent individual. This microorganism is involved in cutaneous, ocular, pulmonary and soft tissue infections. Treatment of infections has traditionally been surgical, although various antibiotic treatments have been used depending on the sensitivity of the microorganism, the severity of the infection and the surgical possibilities. PMID:11149222

  7. Fingertip and palmar patterns in duodenal ulcer.

    PubMed

    Habibullah, C M; Mujahid Ali, M; Shivaprakash, M; Iqbal, M A; Ishaq, M

    1982-01-01

    Dermatoglyphic studies were carried out on 90 adult males suffering from duodenal ulcer. Fingertip and palmar patterns were analysed to see if there was an association between duodenal ulcer and any of the dermatoglyphic traits. The patterns which were significantly different are: (1) increased frequency of whorls; (2) reduced frequency of loops on fingertips, and (3) increased frequency of patterns in the thenar I and IV interdigital area. PMID:7152533

  8. Surgical and reconstructive management of pressure ulcers

    Microsoft Academic Search

    Valentina Lefemine; Stuart Enoch; Dean Edward Boyce

    2009-01-01

    Despite significant advances in therapeutic options, pressure ulcers continue to pose a challenge to physicians and surgeons\\u000a and frequently require multidisciplinary input. In addition, they place huge financial burdens on health care providers. Generally\\u000a classified as grades I to IV depending on the extent and severity of the ulcer, grades I and II are usually amenable to conservative\\u000a management. Grades

  9. Bending of floating flexible legs

    NASA Astrophysics Data System (ADS)

    Park, Kun Joong; Kim, Ho-Young

    When long thin flexible solid objects, such as the legs of water striders, disposable spoons and human hairs, are pressed against a liquid surface, they bend due to interfacial and hydrostatic forces. To understand the phenomenon, we study the bending of a sheet touching the liquid surface at an angle while clamped at the other end, to find its deflection and the load that the sheet can support before sinking. The theoretically predicted shapes of the sheet and the meniscus match well with experiments. Our theory shows that flexible sheets can support more load than rigid ones before sinking when the sheets are highly hydrophobic.

  10. MAXIMUM SINGLE LEG FORCE PRODUCTION: COCKROACHES RIGHTING ON PHOTOELASTIC GELATIN

    Microsoft Academic Search

    R. J. FULL; A. YAMAUCHI; D. L. JINDRICH

    1995-01-01

    Integrating studies of mechanics, neural control and isolated muscle function are possible using arthropod legs. To evaluate leg performance, we measured the ground reaction forces generated by individual legs of the six- legged cockroach Blaberus discoidalis (3.1 g), during an emergency behavior, righting or over-turning. We used a photoelastic method to measure the forces generated by individual legs simultaneously. A

  11. Compliant leg behaviour explains basic dynamics of walking and running

    Microsoft Academic Search

    Hartmut Geyer; Andre Seyfarth; Reinhard Blickhan

    2006-01-01

    The basic mechanics of human locomotion are associated with vaulting over stiff legs in walking and rebounding on compliant legs in running. However, while rebounding legs well explain the stance dynamics of running, stiff legs cannot reproduce that of walking. With a simple bipedal spring-mass model, we show that not stiff but compliant legs are essential to obtain the basic

  12. Diabetic foot ulcers--a comprehensive review.

    PubMed

    Leung, P C

    2007-08-01

    As the incidence of diabetes mellitus is increasing globally, complications related to this endocrine disorder are also mounting. Because of the large number of patients, foot ulcers developing in the feet of diabetics have become a public health problem. The predisposing factors include abnormal plantar pressure points, foot deformities, and minor trauma. Vulnerable feet usually already have vascular insufficiency and peripheral neuropathy. The complex nature of these ulcers deserves special care. The most useful prognostic feature for healing remains the ulcer depth, ulcers heal poorly if they clearly involve underlying tendons, ligament or joints and, particularly, when gangrenous tissue is seen. Local treatment of the ulcer consists of repeated debridement and dressing. No 'miraculous' outcome is expected, even with innovative agents like skin cover synthetics, growth factors and stem cells. Simple surgery like split skin grafting or minor toe amputations may be necessary. Sophisticated surgery like flap coverages are indicated for younger patients. The merits of an intact lower limb with an abnormal foot have to be weighed against amputation and prosthesis in the overall planning of limb salvage or sacrifice. If limb salvage is the decision, additional means like oxygen therapy, and other alternative medicines, might have benefits. The off-loading of footwear should always be a major consideration as a prevention of ulcer formation. PMID:17849958

  13. History of Helicobacter pylori, duodenal ulcer, gastric ulcer and gastric cancer.

    PubMed

    Graham, David Y

    2014-05-14

    Helicobacter pylori (H. pylori) infection underlies gastric ulcer disease, gastric cancer and duodenal ulcer disease. The disease expression reflects the pattern and extent of gastritis/gastric atrophy (i.e., duodenal ulcer with non-atrophic and gastric ulcer and gastric cancer with atrophic gastritis). Gastric and duodenal ulcers and gastric cancer have been known for thousands of years. Ulcers are generally non-fatal and until the 20th century were difficult to diagnose. However, the presence and pattern of gastritis in past civilizations can be deduced based on the diseases present. It has been suggested that gastric ulcer and duodenal ulcer both arose or became more frequent in Europe in the 19th century. Here, we show that gastric cancer and gastric ulcer were present throughout the 17th to 19th centuries consistent with atrophic gastritis being the predominant pattern, as it proved to be when it could be examined directly in the late 19th century. The environment before the 20th century favored acquisition of H. pylori infection and atrophic gastritis (e.g., poor sanitation and standards of living, seasonal diets poor in fresh fruits and vegetables, especially in winter, vitamin deficiencies, and frequent febrile infections in childhood). The latter part of the 19th century saw improvements in standards of living, sanitation, and diets with a corresponding decrease in rate of development of atrophic gastritis allowing duodenal ulcers to become more prominent. In the early 20th century physician's believed they could diagnose ulcers clinically and that the diagnosis required hospitalization for "surgical disease" or for "Sippy" diets. We show that while H. pylori remained common and virulent in Europe and the United States, environmental changes resulted in changes of the pattern of gastritis producing a change in the manifestations of H. pylori infections and subsequently to a rapid decline in transmission and a rapid decline in all H. pylori-related diseases. PMID:24833849

  14. Pathophysiology of Helicobacter pylori-induced Gastritis and Peptic Ulcer Disease

    Microsoft Academic Search

    Richard M Peek

    1997-01-01

    Helicobacter pylori causes persistent infection and inflammation in the human stomach, yet only a small fraction of persons harboring this organism develop peptic ulcer disease. An important question is why this variation in infection outcome exists. Recent studies have demonstrated that H pylori isolates possess substantial phenotypic and genotypic diversity that may engender differential host inflammatory responses that influence clinical

  15. The skin ulceration disease in cultivated juveniles of Holothuria scabra (Holothuroidea, Echinodermata)

    Microsoft Academic Search

    P. Becker; D. Gillan; D. Lanterbecq; M. Jangoux; R. Rasolofonirina; J. Rakotovao; I. Eeckhaut

    2004-01-01

    It is frequently reported that cultivated holothuroids can suffer from a disease affecting their integument. We report here on a disease of juvenile Holothuria scabra, the widely marketed edible sea cucumber, reared in the Aqua-Lab hatchery of Toliara, Madagascar. This disease, which has been called skin ulceration disease, is very contagious and results from a severe bacterial infection that causes

  16. Ninja Legs: Amphibious One Degree of Freedom Robotic Legs Bir Bikram Dey, Sandeep Manjanna and Gregory Dudek

    E-print Network

    Ninja Legs: Amphibious One Degree of Freedom Robotic Legs Bir Bikram Dey, Sandeep Manjanna as "Ninja legs") that enable amphibious operation, both walking and swimming, for use on a class of hexapod in this paper. We refer to these amphibious legs as Ninja legs as the design resembles a spinning ninja star

  17. Golimumab in unresponsive ulcerative colitis.

    PubMed

    Lippert, Elisabeth; Müller, Martina; Ott, Claudia

    2014-01-01

    Ulcerative colitis (UC) is a chronic inflammation mainly affecting the colon mucosa. It predominantly occurs in younger patients. Until recently, the main goals in the treatment of UC were to temper the symptoms, such as diarrhea, pain, and weight loss, by using mesalazine and steroids. With newer medications, such as immunomodulators (thiopurines) and the biologics providing blockade of tumor necrosis factor (TNF), the goals of the therapy in UC have changed to long-term remission and mucosal healing. The first available anti-TNF therapy in UC included infusion therapy with infliximab every few weeks. In 2012, subcutaneously administered adalimumab gained approval for the treatment of UC in Germany. In patients with a mild disease, therapy with mesalazine, orally or topically, can be sufficient. In patients with moderate to severe disease, therapy with azathioprine or anti-TNF is often required to reach disease control; however, this is only efficient in about two-thirds of patients. Some patients either show no response or a lost response while on treatment. So, further medical options are warranted in the treatment of UC. With golimumab, a new approach in the treatment of mild to moderate UC recently became available in Germany and is a promising new option in the therapy regimen for patients with UC. PMID:24904202

  18. Golimumab in unresponsive ulcerative colitis

    PubMed Central

    Lippert, Elisabeth; Müller, Martina; Ott, Claudia

    2014-01-01

    Ulcerative colitis (UC) is a chronic inflammation mainly affecting the colon mucosa. It predominantly occurs in younger patients. Until recently, the main goals in the treatment of UC were to temper the symptoms, such as diarrhea, pain, and weight loss, by using mesalazine and steroids. With newer medications, such as immunomodulators (thiopurines) and the biologics providing blockade of tumor necrosis factor (TNF), the goals of the therapy in UC have changed to long-term remission and mucosal healing. The first available anti-TNF therapy in UC included infusion therapy with infliximab every few weeks. In 2012, subcutaneously administered adalimumab gained approval for the treatment of UC in Germany. In patients with a mild disease, therapy with mesalazine, orally or topically, can be sufficient. In patients with moderate to severe disease, therapy with azathioprine or anti-TNF is often required to reach disease control; however, this is only efficient in about two-thirds of patients. Some patients either show no response or a lost response while on treatment. So, further medical options are warranted in the treatment of UC. With golimumab, a new approach in the treatment of mild to moderate UC recently became available in Germany and is a promising new option in the therapy regimen for patients with UC. PMID:24904202

  19. RELAP5 Analyses of OECD/NEA ROSA-2 Project Experiments on Intermediate-Break LOCAs at Hot Leg or Cold Leg

    NASA Astrophysics Data System (ADS)

    Takeda, Takeshi; Maruyama, Yu; Watanabe, Tadashi; Nakamura, Hideo

    Experiments simulating PWR intermediate-break loss-of-coolant accidents (IBLOCAs) with 17% break at hot leg or cold leg were conducted in OECD/NEA ROSA-2 Project using the Large Scale Test Facility (LSTF). In the hot leg IBLOCA test, core uncovery started simultaneously with liquid level drop in crossover leg downflow-side before loop seal clearing (LSC) induced by steam condensation on accumulator coolant injected into cold leg. Water remained on upper core plate in upper plenum due to counter-current flow limiting (CCFL) because of significant upward steam flow from the core. In the cold leg IBLOCA test, core dryout took place due to rapid liquid level drop in the core before LSC. Liquid was accumulated in upper plenum, steam generator (SG) U-tube upflow-side and SG inlet plenum before the LSC due to CCFL by high velocity vapor flow, causing enhanced decrease in the core liquid level. The RELAP5/MOD3.2.1.2 post-test analyses of the two LSTF experiments were performed employing critical flow model in the code with a discharge coefficient of 1.0. In the hot leg IBLOCA case, cladding surface temperature of simulated fuel rods was underpredicted due to overprediction of core liquid level after the core uncovery. In the cold leg IBLOCA case, the cladding surface temperature was underpredicted too due to later core uncovery than in the experiment. These may suggest that the code has remaining problems in proper prediction of primary coolant distribution.

  20. Why person affected by leprosy did not look after their plantar ulcer? Experience from Pakokku zone, Myanmar.

    PubMed

    Win, Le Le; Shwe, San; Maw, Win; Ishida, Yutaka; Myint, Kyaw; Mar, Kyi Kyi; Min, Thandar; Oo, Phyo Min; Khine, Aye Win

    2010-09-01

    A cross-sectional study was carried out to identify methods of caring plantar ulcers in leprosy patients and the underlying causes of poor plantar ulcer care during January and February 2008. This was conducted in Pakokku zone as it was one of the "9 selected townships of the Disabilities survey, i.e., Basic Health Staff project 2003/4", which was funded by Japan International Cooperation Agency. After getting consent, all available leprosy cases, i.e., 101 cases with foot disability grade 2 were interviewed with the pre-tested questionnaire. Among 101 cases, 13 cases who took care of their ulcer poorly and 20 who did none of the recommended measures were recruited for in-depth interview (IDI). The subjects were largely old people, males and people with no marriage partner. The majority had earned money by doing sedentary job. Prolongation of ulcers was observed in 78 cases. Most had been suffering from ulcers for years. When asking face-to-face interview, all the recommended care measures were not reported. Among these recommended measures, a large number of respondents reported about soaking measure. However, these reported measures were contradicted to the preventive methods which they disclosed in IDI. Plantar ulcer care seemed to be an individualised practice. The individual ways of performing were related to their view of ulcer, the environment, and occupation, and custom, communication with family and health staff. The findings identified the actual practice of plantar ulcer care in study areas. It is suggested that the current performance of planar ulcer care is inadequate and more attention should be given to achieve the target set by the programme as a recommendation. PMID:20857653

  1. Bonded center leg for TEXT iron yoke

    Microsoft Academic Search

    R. L. Deblois; T. S. Latham; D. J. McFarlin; D. H. Polk; D. F. Brower; G. L. Cardwell; P. Wildi

    1979-01-01

    The paper presents the bond test program which was realized to select the adhesives and coating process for the laminations of the center leg of the TEXT (Texas EXperimental Tokamak) iron yoke and the test program conducted to select the urethane casing used as the nose-bearing material for the TF coils. Plans for the fabrication of the bonded center leg

  2. OCEAN DRILLING PROGRAM LEG 112 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 112 PRELIMINARY REPORT PERU CONTINENTAL MARGIN Roland von Huene Co Staff Scientist, Leg 112 Ocean Drilling Program Texas A&M University College Station, TX 77843 be obtained from the Director, Ocean Drilling Program, Texas A&M University, College Station, Texas 77843

  3. OCEAN DRILLING PROGRAM LEG 176 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 176 SCIENTIFIC PROSPECTUS RETURN TO HOLE 735B Dr. Henry Dick Co.S.A. Dr. Jay Miller Staff Scientist, Leg 176 Ocean Drilling Program Texas A&M University Research Park portion requires the written consent of the Director, Ocean Drilling Program, Texas A&M University

  4. OCEAN DRILLING PROGRAM LEG 145 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 145 SCIENTIFIC PROSPECTUS NORTH PACIFIC TRANSECT Dr. Ivan A. Basov Dr 48109-1063 Dr. Thomas Janecek Staff Scientist, Leg 145 Ocean Drilling Program Texas A&M University requires the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park

  5. OCEAN DRILLING PROGRAM LEG 159 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 159 SCIENTIFIC PROSPECTUS THE COTE D'IVOIRE - GHANA TRANSFORM MARGIN, Leg 159 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station requires the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park

  6. OCEAN DRILLING PROGRAM LEG 156 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 156 SCIENTIFIC PROSPECTUS NORTHERN BARBADOS RIDGE Dr. Tom Shipley Dr Austin, Texas 78579 Japan U.S.A. Dr. Peter Blum Staff Scientist, Leg 156 Ocean Drilling Program Texas A of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000 Discovery Drive, College Station

  7. OCEAN DRILLING PROGRAM LEG 146 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 146 SCIENTIFIC PROSPECTUS CASCADIA MARGIN Dr. Graham K. Westbrook Dr, Pennsylvania Dr. Robert Musgrave Staff Scientist, Leg 146 Ocean Drilling Program Texas A&M University Research of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000 Discovery Drive, College Station

  8. OCEAN DRILLING PROGRAM LEG 149 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 149 SCIENTIFIC PROSPECTUS OCEAN-CONTINENT TRANSITION IN THE IBERIA " United Kingdom Dr. Andy Fisher Staff Scientist, Leg 149 Ocean Drilling Program Texas A&M University purposes; however, republication of any portion requires the written consent of the Director, Ocean

  9. OCEAN DRILLING PROGRAM LEG 147 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 147 SCIENTIFIC PROSPECTUS HESS DEEP RIFT VALLEY Dr. Kathryn Gillis, E3 75252 Paris cedex 05, France Co-Chief Scientist Dr. James Allan Staff Scientist, Leg 147 Ocean portionrequiresthe written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  10. OCEAN DRILLING PROGRAM LEG 163 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 163 SCIENTIFIC PROSPECTUS SOUTHEAST GREENLAND MARGIN Dr. Hans Corvallis, OR 97331-5503 U.S.A. Dr. James F. Allan Staff Scientist, Leg 163 Ocean Drilling Program Texas A the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  11. OCEAN DRILLING PROGRAM LEG 207 SCIENTIFIC PROSPECTUS

    E-print Network

    June 2002 OCEAN DRILLING PROGRAM LEG 207 SCIENTIFIC PROSPECTUS DEMERARA RISE: EQUATORIAL CRETACEOUS Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA -------------------------------- Dr. Mitchell Malone Staff Scientist and Leg Project Manager Ocean Drilling Program Texas A

  12. OCEAN DRILLING PROGRAM LEG 136 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 136 SCIENTIFIC PROSPECTUS Ocean Seismographic Network Pilot Hole Scientist, Leg 136 Ocean Drilling Program Texas A&M University College Station, Texas 77845-9547 Philip D

  13. OCEAN DRILLING PROGRAM LEG 139 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 139 SCIENTIFIC PROSPECTUS Sedimented Ridges I Dr. Earl Davis Co of Hawaii 1000 Pope Road Honolulu, Hawaii 96822 Dr. Andrew Fisher Staff Scientist, Leg 139 Ocean Drilling the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  14. OCEAN DRILLING PROGRAM LEG 152 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 152 SCIENTIFIC PROSPECTUS EAST GREENLAND MARGIN Dr. Hans Christian Denmark Leicester LE1 7RH United Kingdom Dr. Peter Clift Staff Scientist, Leg 152 Ocean Drilling Program purposes; however, republication of any portion requires the written consent of the Director, Ocean

  15. OCEAN DRILLING PROGRAM LEG 151 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 151 SCIENTIFIC PROSPECTUS NORTH ATLANTIC ARCTIC GATEWAYS 1 Dr. Annik M Scientist, Leg 151 Ocean Drilling Program Texas A&M University Research Park College Station, Texas 77845

  16. OCEAN DRILLING PROGRAM LEG 168 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 168 SCIENTIFIC PROSPECTUS HYDROTHERMAL CIRCULATION IN THE OCEANIC CRUST Building Santa Cruz, CA 95064 U.S.A. Dr. John Firth Staff Scientist, Leg 168 Ocean Drilling Program Texas A purposes; however, republication of any portion requires the written consent of the Director, Ocean

  17. OCEAN DRILLING PROGRAM LEG 180 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 180 SCIENTIFIC PROSPECTUS WOODLARK BASIN Dr. Philippe Huchon Co France Dr. Brian Taylor Co-Chief Scientist, Leg 180 School of Ocean & Earth Science & Technology 180 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station

  18. OCEAN DRILLING PROGRAM LEG 173 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 173 SCIENTIFIC PROSPECTUS RETURN TO IBERIA Dr. R.B. Whitmarsh Co Geosciences Azur B.P. 48 06230 Villefranche-Sur-Mer France Dr. Paul Wallace Staff Scientist, Leg 173 Ocean requires the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park

  19. OCEAN DRILLING PROGRAM LEG 160 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 160 SCIENTIFIC PROSPECTUS MEDITERRANEAN I Dr. Kay-Christian Emeis Co of Edinburgh West Mains Road Edinburgh EH9 3JW United Kingdom Dr. Carl Richter Staff Scientist, Leg 160 Ocean

  20. OCEAN DRILLING PROGRAM LEG 138 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution Prevention· OCEAN DRILLING PROGRAM LEG 138 SCIENTIFIC PROSPECTUS Eastern Equatorial Pacific Dr. Larry Mayer Corvallis, Oregon 97331-5503 Canada Dr. Tom Janecek Staff Scientist, Leg 138 Ocean Drilling Program Texas A

  1. OCEAN DRILLING PROGRAM LEG 158 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 158 SCIENTIFIC PROSPECTUS TAG: DRILLING AN ACTIVE HYDROTHERMAL SYSTEM Federal Republic of Germany Dr. Laura Stokking Staff Scientist, Leg 158 Ocean Drilling Program Texas A the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  2. OCEAN DRILLING PROGRAM LEG 192 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 192 SCIENTIFIC PROSPECTUS BASEMENT DRILLING OF THE ONTONG JAVA PLATEAU of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station, TX 77845-9547 U.S.A. _____________________ Dr. Paul Wallace Leg Project Manager and Staff Scientist Ocean

  3. OCEAN DRILLING PROGRAM LEG 141 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 141 SCIENTIFIC PROSPECTUS CHILE TRIPLE JUNCTION Dr. Jan Behrmann Dr Staff Scientist, Leg 141 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive purposes; however, republication of any portion requires the written consent of the Director, Ocean

  4. OCEAN DRILLING PROGRAM LEG 150 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 150 SCIENTIFIC PROSPECTUS THE NEW JERSEY CONTINENTAL SLOPE AND RISE Dr/TAMU Dr. Peter Blum Staff Scientist, Leg 150 Ocean Drilling Program Texas A&M University Research Park

  5. OCEAN DRILLING PROGRAM LEG 165 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 165 SCIENTIFIC PROSPECTUS CARIBBEAN OCEAN HISTORY AND THE CRETACEOUS Scientist, Leg 165 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College

  6. OCEAN DRILLING PROGRAM LEG 170 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 170 PRELIMINARY REPORT COSTA RICA ACCRETIONARY WEDGE Dr. Gaku Kimura Co, Leg 170 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station, republication of any portion requires the written consent of the Director, Ocean Drilling Program, Texas A

  7. OCEAN DRILLING PROGRAM LEG 164 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 164 SCIENTIFIC PROSPECTUS GAS HYDRATE SAMPLING ON THE BLAKE RIDGE Wallace Staff Scientist, Leg 164 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery

  8. OCEAN DRILLING PROGRAM LEG 178 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 178 SCIENTIFIC PROSPECTUS ANTARCTIC PENINSULA Antarctic Glacial History Scientist, Leg 178 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000 Discovery Drive, College Station

  9. OCEAN DRILLING PROGRAM LEG 175 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 175 SCIENTIFIC PROSPECTUS BENGUELA CURRENT Dr. Wolfgang Berger Co Universität Bremen Postfach 33 04 40 D-28334 Bremen Germany Dr. Carl Richter Staff Scientist, Leg 175 Ocean of any portion requires the written consent of the Director, Ocean Drilling Program, Texas A&M University

  10. OCEAN DRILLING PROGRAM LEG 162 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 162 SCIENTIFIC PROSPECTUS NORTH ATLANTIC ARCTIC GATEWAYS II Dr. Maureen Scientist, Leg 162 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College

  11. OCEAN DRILLING PROGRAM LEG 166 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 166 SCIENTIFIC PROSPECTUS THE BAHAMAS TRANSECT Dr. Gregor Eberli Co.S.A. Dr. Mitchell Malone Staff Scientist, Leg 166 Ocean Drilling Program Texas A&M University Research

  12. OCEAN DRILLING PROGRAM LEG 105 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 105 SCIENTIFIC PROSPECTUS LABRADOR SEA - BAFFIN BAY Dr. Michael A. Bradford Clement Staff Science Representative, Leg 105 Ocean Drilling Program Texas A & M University College Station, TX 77843-3469" Philip Director Ocean Drilling Program Robert B. Kidd Manager of Science

  13. LEG 142 PRELIMINARY REPORT OCEAN DRILLING PROGRAM

    E-print Network

    LEG 142 PRELIMINARY REPORT OCEAN DRILLING PROGRAM ENGINEERING PRELIMINARY REPORT NO. 3 EAST PACIFIC RISE 1992 #12;OCEAN DRILLING PROGRAM LEG 142 PRELIMINARY REPORT East Pacific Rise Dr. Rodey Batiza Co 96822 Mr. Michael A. Storms Operations Superintendent/ Assistant Manager of Engineering and Drilling

  14. Reconfigurable Planar Three-Legged Parallel Manipulators

    E-print Network

    Hayes, John

    Reconfigurable Planar Three-Legged Parallel Manipulators M. John D. Hayes Department of Mechanical of reconfigurable planar three legged plat- forms is introduced. Kinematic mapping techniques are applied to solve Introduction There has been great interest in reconfigurable mechanisms in recent years (see Yim et al., March

  15. Swing leg retraction helps biped walking stability

    Microsoft Academic Search

    M. Wisse; C. G. Atkeson; D. K. Kloimwieder

    2005-01-01

    In human walking, the swing leg moves backward just prior to ground contact, i.e. the relative angle between the thighs is decreasing. We hypothesized that this swing leg retraction may have a positive effect on gait stability, because similar effects have been reported in passive dynamic walking models, in running models, and in robot juggling. For this study, we use

  16. OCEAN DRILLING PROGRAM LEG 133 SCIENTIFIC PROSPECTUS

    E-print Network

    . #12;Leg 133 Prospectus Page 3 ABSTRACT Five physiographic regions define offshore northeastern Australia: the platforms of the Great Barrier Reef and the Queensland and Marionplateaus, and the basins of the evolution of these carbonate platforms and adjacent basins. Leg 133 will sample Oligocene to Holocene

  17. [Metastatic small intestine carcinoma--delayed diagnosis due to misinterpretation of diagnostic imaging and symptom confusion due to Bechterew disease and duodenal ulcer].

    PubMed

    Zinsser, E; Oelzner, P; Bartunek, R; Adam, G

    2000-06-01

    Misinterpretations of sonographic and computed tomography scans and reduced sensitivity to pain of a patient suffering from Bechterew's disease and duodenal ulcer caused delayed diagnosis of metastasized carcinoma of the small intestine. PMID:10923361

  18. Gait Planning Research for Biped Robot with Heterogeneous Legs

    Microsoft Academic Search

    Jun Xiao; Xing Song; Jie Su; Xinhe Xu

    2010-01-01

    \\u000a Biped Robot with Heterogeneous Legs (BRHL) is a novel robot model, which consists of an artificial leg and an intelligent\\u000a bionic leg. The artificial leg is used to simulate the amputee’s healthy leg and the intelligent bionic leg works as the intelligent\\u000a artificial limb. This paper discusses how a BRHL robot imitates a person’s walking from the points of gait

  19. Muscle hernias of the leg: A case report and comprehensive review of the literature

    PubMed Central

    Nguyen, Jesse T; Nguyen, Jenny L; Wheatley, Michael J; Nguyen, Tuan A

    2013-01-01

    A case involving a retired, elderly male war veteran with a symptomatic peroneus brevis muscle hernia causing superficial peroneal nerve compression with chosen surgical management is presented. Symptomatic muscle hernias of the extremities occur most commonly in the leg and are a rare cause of chronic leg pain. Historically, treating military surgeons pioneered the early documentation of leg hernias observed in active military recruits. A focal fascial defect can cause a muscle to herniate, forming a variable palpable subcutaneous mass, and causing pain and potentially neuropathic symptoms with nerve involvement. While the true incidence is not known, the etiology has been classified as secondary to a congenital (or constitutional) fascial weakness, or acquired fascial defect, usually secondary to direct or indirect trauma. The highest occurrence is believed to be in young, physically active males. Involvement of the tibialis anterior is most common, although other muscles have been reported. Dynamic ultrasonography or magnetic resonance imaging is often used to confirm diagnosis and guide treatment. Most symptomatic cases respond successfully to conservative treatment, with surgery reserved for refractory cases. A variety of surgical techniques have been described, ranging from fasciotomy to anatomical repair of the fascial defect, with no consensus on optimal treatment. Clinicians must remember to consider muscle hernias in their repertoire of differential diagnoses for chronic leg pain or neuropathy. A comprehensive review of muscle hernias of the leg is presented to highlight their history, occurrence, presentation, diagnosis and treatment. PMID:24497767

  20. Fournier's gangrene complicating ulcerative pancolitis.

    PubMed

    Katsanos, Konstantinos H; Ignatiadou, Eleftheria; Sarandi, Maria; Godevenos, Dimitrios; Asproudis, Ioannis; Fatouros, Michael; Tsianos, Epameinondas V

    2010-06-01

    Fournier gangrene is a very rare and a rapidly progressing, polymicrobial necrotizing faciitis or myonecrosis of the perineal, perianal and genital regions, with a high mortality rate. Infection is associated with superficial traum, urological and colorectal diseases and operations. The most commonly found bacteria are Escherichia coli followed by Bacteroides and streptococcal species. Diabetes mellitus, alcoholism, and immunosuppression are perpetuating co-factors. Fournier's gangrene complicating inflammatory bowel disease has been reported in three patients so far, two with Crohn's disease. A 78-year-old man diagnosed with ulcerative pancolitis was referred for fever, and painful perianal and scrotal swelling after perianal surgery for a horseshoe-type perianal abscess. Since bowel disease diagnosis, patient was on mesalazine and achieved long-term remission. Perianal abscess occurred suddenly one week before perianal surgery without any evidence of pre-existing fistula or other abnormalities. Physical examination showed extensive edema and crepitus of perineum and genitalia and patient had symptoms of significant toxicity. The diagnosis of Fournier's gangrene was made and patient underwent emergency surgery with extensive surgical debridement of the scrotal and perianal area and Hartman procedure with a diverting colostomy. In addition, patient started on therapy with mesalazine 3gr, methylprednisolone 16 mg, parenteral nutrition and broad spectrum of antibiotics. Two days after the first operation the patient needed a second operation for perianal debridement. On the fourth day, blood cultures showed E. coli. Patient had an uneventful recovery and was discharged after 34 days of hospitalization. On follow up, disease review is scheduled and colostomy closure is planned. PMID:21122507

  1. Hydroxyurea and colonic ulcers: a case report

    PubMed Central

    2014-01-01

    Background Hydroxyurea at a relatively low dose is frequently prescribed to induce hemoglobin F production in patients with sickle cell and ?-thalassemia diseases because of its good efficacy and safety profiles. However, a potentially fatal gastrointestinal ulceration was recently found and herein reported. Case presentation A thirty-seven-year-old man with transfusion dependent hemoglobin E/?-thalassemia disease was treated with hydroxyurea to induce hemoglobin F production since 2007 without incident. From 2008 to April 2010, episodes of hematochezia, mucous diarrhea and epigastric pain intermittently manifested. Four colonoscopies done during the period repeatedly showed ulcerative lesions from the terminal ileum to the ascending colon with a non-specific histo-pathologic finding. Subsequently, ulcerative lesions also developed at the pharynx, histo-pathologic findings of which were not different from those in the colon. These ulcerative lesions resolved within a month after discontinuing hydroxyurea in April 2010 and have not recurred since. Conclusion The findings suggested role of hydroxyurea in the pathogenesis of these ulcers, and that it must be immediately discontinued to prevent further damage to the digestive mucosa. PMID:25082414

  2. Reducing avoidable pressure ulcers in the community.

    PubMed

    Parnham, Alison; Pankhurst, Sarah; Dabell, Wendy

    2015-02-27

    The elimination of avoidable pressure ulcers remains a challenge in healthcare provision, represents an increasing financial burden on resources and continues to affect patients' quality of life. Many pressure ulcers are deemed to be avoidable and there are several factors that can influence this, including the development of a care delivery system and a service delivery strategy that incorporate a comprehensive structure, a meticulous process and measurable outcomes. Nottingham CityCare developed a strategy to reduce avoidable pressure ulcers. The implementation of the strategy in an inner city community setting is discussed. The importance of eliminating pressure ulcers is explored, and the barriers to care delivery are reviewed, demonstrating how a new culture in clinical practice can ensure the elimination of avoidable pressure ulcers. The challenges within the implementation process are reflected on and the implementation of the SSKIN (Surface, Skin inspection, Keep your patient moving, Incontinence and moisture, Nutrition and hydration) phenomenon is reviewed in relation to care delivery, record-keeping and evaluation. PMID:25711596

  3. Salivary enzymes in peptic ulcer disease

    PubMed Central

    Motamedi, Mojdeh; Mansour-Ghanaei, Fariborz; Sariri, Reyhaneh; Vesal, Mahmoud

    2013-01-01

    Aim Peptic ulcer, the common disease of the upper gastro-intestinal tract, occurs in about 5–10% of the world's population. Therefore, diagnosis of trace disease progression with a noninvasive method is of prime importance in the field of healthcare research. The aim of this study was to evaluate the validity of salivary enzymes as noninvasive biomarkers for peptic ulcer. Materials and methods In practice, 34 peptic ulcer patients and 30 healthy subjects donated their un-stimulated saliva samples after 8 h of fasting. The activity of some selected enzymes was measured using appropriate enzymatic assay methods. Results The results indicated an overall alternation in enzymatic activity of saliva in patients suffering from peptic ulcer. Biological activity of a-amylase, peroxidase and lactate dehydrogenase, showed significantly higher values in almost all patients as compared to control subjects. Conclusions Based on the results of salivary enzyme activity, it was concluded that besides the influence of their peptic ulcer on enzyme activity of saliva, the considerably higher activity of a-amylase could also be related to the major role of the enzyme on physiological oxidative stress. PMID:25737890

  4. Does a crouched leg posture enhance running stability and robustness?

    PubMed

    Blum, Yvonne; Birn-Jeffery, Aleksandra; Daley, Monica A; Seyfarth, Andre

    2011-07-21

    Humans and birds both walk and run bipedally on compliant legs. However, differences in leg architecture may result in species-specific leg control strategies as indicated by the observed gait patterns. In this work, control strategies for stable running are derived based on a conceptual model and compared with experimental data on running humans and pheasants (Phasianus colchicus). From a model perspective, running with compliant legs can be represented by the planar spring mass model and stabilized by applying swing leg control. Here, linear adaptations of the three leg parameters, leg angle, leg length and leg stiffness during late swing phase are assumed. Experimentally observed kinematic control parameters (leg rotation and leg length change) of human and avian running are compared, and interpreted within the context of this model, with specific focus on stability and robustness characteristics. The results suggest differences in stability characteristics and applied control strategies of human and avian running, which may relate to differences in leg posture (straight leg posture in humans, and crouched leg posture in birds). It has been suggested that crouched leg postures may improve stability. However, as the system of control strategies is overdetermined, our model findings suggest that a crouched leg posture does not necessarily enhance running stability. The model also predicts different leg stiffness adaptation rates for human and avian running, and suggests that a crouched avian leg posture, which is capable of both leg shortening and lengthening, allows for stable running without adjusting leg stiffness. In contrast, in straight-legged human running, the preparation of the ground contact seems to be more critical, requiring leg stiffness adjustment to remain stable. Finally, analysis of a simple robustness measure, the normalized maximum drop, suggests that the crouched leg posture may provide greater robustness to changes in terrain height. PMID:21569779

  5. Research on gait planning of artificial leg based on central pattern generator

    Microsoft Academic Search

    Jun Xiao; Jie Su; Yu Cheng; Fei Wang; Xinhe Xu

    2008-01-01

    Biped robot with heterogeneous legs (BRHL) is a novel robot model, which consists of an artificial leg and an intelligent bionic leg. The artificial leg is used to simulate the amputeepsilas healthy leg and the bionic leg works as the intelligent artificial limb. To describe the present gait of the healthy leg and make intelligent bionic leg follow the walking

  6. Postoperative management of ulcerative colitis and crohn’s disease

    Microsoft Academic Search

    Rajesh N. Keswani; Russell D. Cohen

    2005-01-01

    Approximately 10% to 30% of patients with ulcerative colitis and up to 70% of patients with Crohn’s disease will undergo surgery\\u000a at some point during their lifetime. Although patients with ulcerative colitis are considered \\

  7. Pressure Ulcers Among Nursing Home Residents: United States, 2004

    MedlinePLUS

    ... Brief Number 14, February 2009 Pressure Ulcers Among Nursing Home Residents: United States, 2004 On this Page ... quality of care More than 1 in 10 nursing home residents had a pressure ulcer. Of the ...

  8. An index to measure the healing potential of ischaemic ulcers using Thallium 201

    Microsoft Academic Search

    M. E. SIEGEL; C. A. STEWART; F. W. WAGNER; I. SAKIMURA

    Prediction of healing of ulcers in ischaemic limbs can preclude unnecessary treatment for ulcers that cannot heal. Non-invasive methods are of marked value as the ischaemic limb is susceptible to further ulceration from local skin penetration. Relative hyperemia of the ulcer was measured by scintillation count over the ulcer and at points 2.5 cm from the edge of the ulcer.

  9. Restless legs syndrome and pregnancy: A review

    PubMed Central

    Srivanitchapoom, Prachaya; Pandey, Sanjay; Hallett, Mark

    2014-01-01

    Restless legs syndrome (RLS) is a common sensorimotor neurological disorder that is diagnosed according to the revised criteria of the International RLS Study Group (IRLSSG). The pathophysiology of RLS is still unknown and its prevalence is influenced by ethnicity, age, and gender. RLS is divided into two types by etiology: primary or idiopathic and secondary. Primary RLS is strongly influenced by a genetic component while secondary RLS is caused by other associated conditions such as end-stage renal disease or peripheral neuropathy. Another common condition associated with RLS is pregnancy. The prevalence of RLS during pregnancy is two to three times higher than in the normal population and is influenced by the trimester and the number of parity. The main mechanisms that may contribute to the pathophysiology of RLS during pregnancy are hormonal changes and iron and folate status. Standard medications for treating RLS during pregnancy are not established. Most medications have been used according to the evidence from non-pregnant patients. Therefore, consideration of the medical treatment for treating RLS during pregnancy should be balanced between the benefit of relieving the symptoms and maternal and fetal risk. In general, the prognosis of RLS during pregnancy is good and symptoms are usually relieved after delivery. PMID:24768121

  10. Management of patients with ulcer bleeding.

    PubMed

    Laine, Loren; Jensen, Dennis M

    2012-03-01

    This guideline presents recommendations for the step-wise management of patients with overt upper gastrointestinal bleeding. Hemodynamic status is first assessed, and resuscitation initiated as needed. Patients are risk-stratified based on features such as hemodynamic status, comorbidities, age, and laboratory tests. Pre-endoscopic erythromycin is considered to increase diagnostic yield at first endoscopy. Pre-endoscopic proton pump inhibitor (PPI) may be considered to decrease the need for endoscopic therapy but does not improve clinical outcomes. Upper endoscopy is generally performed within 24h. The endoscopic features of ulcers direct further management. Patients with active bleeding or non-bleeding visible vessels receive endoscopic therapy (e.g., bipolar electrocoagulation, heater probe, sclerosant, clips) and those with an adherent clot may receive endoscopic therapy; these patients then receive intravenous PPI with a bolus followed by continuous infusion. Patients with flat spots or clean-based ulcers do not require endoscopic therapy or intensive PPI therapy. Recurrent bleeding after endoscopic therapy is treated with a second endoscopic treatment; if bleeding persists or recurs, treatment with surgery or interventional radiology is undertaken. Prevention of recurrent bleeding is based on the etiology of the bleeding ulcer. H. pylori is eradicated and after cure is documented anti-ulcer therapy is generally not given. Nonsteroidal anti-inflammatory drugs (NSAIDs) are stopped; if they must be resumed low-dose COX-2-selective NSAID plus PPI is used. Patients with established cardiovascular disease who require aspirin should start PPI and generally re-institute aspirin soon after bleeding ceases (within 7 days and ideally 1-3 days). Patients with idiopathic ulcers receive long-term anti-ulcer therapy. PMID:22310222

  11. Genome-wide association identifies multiple ulcerative colitis susceptibility loci

    Microsoft Academic Search

    Agnès Gardet; Leif Törkvist; Philippe Goyette; Jonah Essers; Kent D Taylor; Benjamin M Neale; Rick T H Ong; Caroline Lagacé; Chun Li; Todd Green; Christine R Stevens; Claudine Beauchamp; Phillip R Fleshner; Marie Carlson; Mauro D'Amato; Jonas Halfvarson; Martin L Hibberd; Mikael Lördal; Leonid Padyukov; Angelo Andriulli; Elisabetta Colombo; Anna Latiano; Orazio Palmieri; Edmond-Jean Bernard; Colette Deslandres; Daan W Hommes; Dirk J de Jong; Pieter C Stokkers; Rinse K Weersma; Yashoda Sharma; Mark S Silverberg; Judy H Cho; Jing Wu; Kathryn Roeder; Steven R Brant; L Phillip Schumm; Richard H Duerr; Marla C Dubinsky; Nicole L Glazer; Talin Haritunians; Andy Ippoliti; Gil Y Melmed; David S Siscovick; Eric A Vasiliauskas; Stephan R Targan; Vito Annese; Cisca Wijmenga; Sven Pettersson; Jerome I Rotter; Ramnik J Xavier; Mark J Daly; Dermot P B McGovern; John D Rioux; Mark Seielstad

    2010-01-01

    Ulcerative colitis is a chronic, relapsing inflammatory condition of the gastrointestinal tract with a complex genetic and environmental etiology. In an effort to identify genetic variation underlying ulcerative colitis risk, we present two distinct genome-wide association studies of ulcerative colitis and their joint analysis with a previously published scan, comprising, in aggregate, 2,693 individuals with ulcerative colitis and 6,791 control

  12. The Mycotic Ulcer Treatment Trial

    PubMed Central

    Prajna, N. Venkatesh; Krishnan, Tiruvengada; Mascarenhas, Jeena; Rajaraman, Revathi; Prajna, Lalitha; Srinivasan, Muthiah; Raghavan, Anita; Oldenburg, Catherine E.; Ray, Kathryn J.; Zegans, Michael E.; McLeod, Stephen D.; Porco, Travis C.; Acharya, Nisha R.; Lietman, Thomas M.

    2013-01-01

    Objective To compare topical natamycin vs voriconazole in the treatment of filamentous fungal keratitis. Methods This phase 3, double-masked, multicenter trial was designed to randomize 368 patients to voriconazole (1%) or natamycin (5%), applied topically every hour while awake until reepithelialization, then 4 times daily for at least 3 weeks. Eligibility included smear-positive filamentous fungal ulcer and visual acuity of 20/40 to 20/400. Main Outcome Measures The primary outcome was best spectacle-corrected visual acuity at 3 months; secondary outcomes included corneal perforation and/or therapeutic penetrating keratoplasty. Results A total of 940 patients were screened and 323 were enrolled. Causative organisms included Fusarium (128 patients [40%]), Aspergillus (54 patients [17%]), and other filamentous fungi (141 patients [43%]). Natamycin-treated cases had significantly better 3-month best spectacle-corrected visual acuity than voriconazole-treated cases (regression coefficient=?0.18 logMAR; 95% CI, ?0.30 to ?0.05; P=.006). Natamycin-treated cases were less likely to have perforation or require therapeutic penetrating keratoplasty (odds ratio=0.42; 95% CI, 0.22 to 0.80; P=.009). Fusarium cases fared better with natamycin than with voriconazole (regression coefficient=?0.41 logMAR; 95% CI, ?0.61 to ?0.20; P<.001; odds ratio for perforation=0.06; 95% CI, 0.01 to 0.28; P<.001), while non-Fusarium cases fared similarly (regression coefficient=?0.02 logMAR; 95% CI, ?0.17 to 0.13; P=.81; odds ratio for perforation=1.08; 95% CI, 0.48 to 2.43; P=.86). Conclusions Natamycin treatment was associated with significantly better clinical and microbiological outcomes than voriconazole treatment for smear-positive filamentous fungal keratitis, with much of the difference attributable to improved results in Fusarium cases. Application to Clinical Practice Voriconazole should not be used as monotherapy in filamentous keratitis. Trial Registration clinicaltrials.gov Identifier: NCT00996736 PMID:23710492

  13. Ropinirole for the treatment of restless legs syndrome

    PubMed Central

    Kushida, Clete A

    2006-01-01

    Dopaminergic agents, anticonvulsants, benzodiazepines, opiates, and iron supplementation comprise the classes of medications commonly used to treat restless legs syndrome (RLS), which is a disorder that is estimated to affect about 1 in 10 individuals worldwide and impacts an affected patient’s sleep, mood, daytime function, and quality of life. RLS is characterized by an urge to move the legs that is worse at bedtime and at rest; the symptoms are temporarily relieved by leg movement. It is frequently accompanied by periodic limb movements during sleep (PLMS), which may independently disrupt sleep and may cause daytime drowsiness. Dopaminergic agents are considered to be first-line therapy in the management of RLS as well as PLMS. Ropinirole (Requip®, GlaxoSmithKline) is a dopamine agonist that was the first medication approved by the US Food and Drug Administration (FDA) for the treatment of moderate-to-severe primary RLS. Based on several large-scale clinical trials and open-label clinical series, this medication has been demonstrated to be effective and safe in treating the motor symptoms of RLS and improving sleep quality. PMID:19412490

  14. Biological therapy for ulcerative colitis: an update.

    PubMed

    Seo, Geom Seog; Chae, Soo-Cheon

    2014-10-01

    Of the diverse biological agents used for patients with ulcerative colitis, the anti-tumor necrosis factor-? agents infliximab and adalimumab have been used in large-scale clinical trials and are currently widely used in the treatment of inflammatory bowel disease patients. Recent studies have indicated that golimumab, oral tofacitinib and vedolizumab reportedly achieved good clinical response and remission rates in ulcerative colitis patients. Thus, we believe that the detailed investigation of various studies on clinical trials may provide important information for the selection of appropriate biological agents, and therefore, we have extensively reviewed such trials in the present study. PMID:25309060

  15. Biological therapy for ulcerative colitis: An update

    PubMed Central

    Seo, Geom Seog; Chae, Soo-Cheon

    2014-01-01

    Of the diverse biological agents used for patients with ulcerative colitis, the anti-tumor necrosis factor-? agents infliximab and adalimumab have been used in large-scale clinical trials and are currently widely used in the treatment of inflammatory bowel disease patients. Recent studies have indicated that golimumab, oral tofacitinib and vedolizumab reportedly achieved good clinical response and remission rates in ulcerative colitis patients. Thus, we believe that the detailed investigation of various studies on clinical trials may provide important information for the selection of appropriate biological agents, and therefore, we have extensively reviewed such trials in the present study. PMID:25309060

  16. Hybrid treatment of penetrating aortic ulcer*

    PubMed Central

    Lara, Juan Antonio Herrero; Martins-Romêo, Daniela de Araújo; Escudero, Carlos Caparrós; Vázquez, Rosa María Lepe; Falcón, María del Carmen Prieto; Batista, Vinicius Bianchi

    2015-01-01

    Penetrating atherosclerotic aortic ulcer is a rare entity with poor prognosis in the setting of acute aortic syndrome. In the literature, cases like the present one, located in the aortic arch, starting with chest pain and evolving with dysphonia, are even rarer. The present report emphasizes the role played by computed tomography in the diagnosis of penetrating atherosclerotic ulcer as well as in the differentiation of this condition from other acute aortic syndromes. Additionally, the authors describe a new therapeutic approach represented by a hybrid endovascular surgical procedure for treatment of the disease. PMID:26185346

  17. Biomechanical implications of mild leg length inequality.

    PubMed Central

    McCaw, S T; Bates, B T

    1991-01-01

    The effect of mild leg length inequality (lower extremity length difference less than 3 cm) on posture and gait has been the source of much controversy. Many opinions have been expressed both for and against the need for intervention to reduce the magnitude of the discrepancy. This paper emphasizes the need for accurate and reliable assessment of leg length differences using a clinically functional radiographic technique, and reviews the biomechanical implications of leg length inequality as related to the development of stress fractures, low back pain and osteoarthritis. PMID:1913023

  18. Exploratory clinical trial of combination wound therapy with a gelatin sheet and platelet-rich plasma in patients with chronic skin ulcers: study protocol

    PubMed Central

    Morimoto, Naoki; Kakudo, Natsuko; Matsui, Makoto; Ogura, Tsunetaka; Hara, Tomoya; Suzuki, Kenji; Yamamoto, Masaya; Tabata, Yasuhiko; Kusumoto, Kenji

    2015-01-01

    Introduction Chronic skin ulcers, such as diabetic ulcers, venous leg ulcers and pressure ulcers, are intractable and increasing in prevalence, representing a costly problem in healthcare. We developed a combination therapy with a gelatin sheet, capable of providing sustained release of platelet-rich plasma (PRP). The objective of this study is to investigate the safety and efficacy of autologous PRP covered with a hydrocolloid dressing and PRP covered with a gelatin sheet in the treatment of chronic skin ulcers. Methods and analysis Thirty patients with chronic skin ulcers who have not healed with conventional therapy for at least 1?month are being recruited. The patients will receive PRP after debridement, and the wounds will be covered with a hydrocolloid dressing or gelatin sheet. The efficacy will be evaluated according to the time from the beginning of PRP application to secondary healing or the day on which wound closure is achieved with a relatively simple surgical procedure, such as skin grafting or suturing. All patients will be followed up until 6?weeks after application to observe adverse events related to the application of PRP and the dressings. This study was designed to address and compare the safety and efficacy of PRP covered with a hydrocolloid dressing versus a gelatin sheet. If successful, this combination therapy may be an alternative to bioengineered skin substitutes containing living cells and lead to substantial progress in the management of chronic skin ulcers. Ethics and dissemination The study protocol was approved by the Institutional Review Board of Kansai Medical University (KMU Number 0649-1, 4 August 2014: V.1.0). The findings of this trial will be disseminated through peer-reviewed journals, and national and international scientific meetings as well as to the patients. Trial registration number UMIN000015689. PMID:25968005

  19. Leg venous hemodynamics and leg volumes during a 42-day-6 ° head-down bedrest

    NASA Astrophysics Data System (ADS)

    Louisy, F.; Schroiff, P.; Guezennec, C.-Y.; Güell, A.

    Seven healthy subjects were submitted to a 42-day head down bedrest, where leg venous compliance (venous distensibity index VDI) and leg volumes were assessed by mercury strain gauge plethysmography with venous occlusion and optoelectronic plethysmography, respectively. Plethysmographic and volometric measurements were made, before, during (at days 1, 4, 7, 14, 21, 26, 34 and 41), and after bedrest (days 1, 4, 7, 11 and 30 of the recovery period). Results showed a continuous decrease in leg volumes throughout bedrest, when VDI increased until day 26 of bedrest, and then decreased afterwards. The recovery period was characterized by a rapid return of VDI to prebedrest levels while leg volumes progressively normalised. These results showed that leg venous compliance changes are not always dependant upon skeletal muscle changes, and that factors other than size of muscle compartment are able to determine increases in leg venous compliance during long-term bedrest.

  20. Rectal ulcers and massive bleeding after hemorrhoidal band ligation while on aspirin

    PubMed Central

    Patel, Shruti; Shahzad, Ghulamullah; Rizvon, Kaleem; Subramani, Krishnaiyer; Viswanathan, Prakash; Mustacchia, Paul

    2014-01-01

    Endoscopic hemorrhoidal band ligation is a well-established nonoperative method for treatment of bleeding internal hemorrhoids (grade 1 to 3). It is a safe and effective technique with a high success rate. Complications with this procedure are uncommon. Although rectal ulceration due to band ligation is a rare complication, it can cause life-threatening hemorrhage especially when patients are on medications which impair hemostasis like aspirin or non steroidal anti-inflammatory drugs. We present 2 cases of massive lower gastro-intestinal bleeding in patients who had a band ligation procedure performed 2 wk prior to the presentation and were on aspirin at home. Both the patients were hemodynamically unstable requiring resuscitation. They required platelet and blood transfusions and were found to have rectal ulcers on colonoscopy done subsequently. The rectal ulcers corresponded to the site of band ligation. The use of aspirin by these patients would have caused defects in the hemostasis and may have predisposed them to massive bleeding in the presence of rectal ulcers occurring after the band ligation procedure. Managing aspirin before and after the ligation may be difficult especially since adequate guidelines are unavailable. Stopping aspirin in all the cases might not be safe and the decision should be individualized. PMID:24749117

  1. [The value of radial shock wave therapy in the management of extended crural ulceration. Case report].

    PubMed

    Fekete, László; Nagy, György Ádám; Diamant, Péter Kamilló; Halmy, Csaba; Zentai, Agnes

    2014-11-01

    The authors present the history of a 36-year-old woman who had crural ulceration in the ventral side of the left lower limb due to venous circulatory failure for 5 years. In addition to the application of dressing adapted to the actual status of the wound, the authors applied an extracorporal shock wave therapy two times per week. After this treatment the size of the ulcer significantly decreased and it became suitable for mesh-graft cover. The patient is currently asymptomatic. The authors draw attention to the fact that the number of patients having crural ulcer is increasing in developed countries including Hungary. Lower limb ulcers occur in 1-5% of the adult population. Predisposing factors include older age and civilization hazards such as obesity, diabetes and sedentary lifestyle. The main cause of the disease is circulatory failure; venous insufficiency occurs in about two-thirds of the patients, arterial ischemia in 15% and diabetic angiopathy in 15% of the cases. Infections, metabolic diseases and immunological disorders may be also an underlying cause in a small number of patients. In several patients the causative factors occur simultaneously making difficult to find and effective treatment. Despite the use of numerous preventive and therapeutic protocols, treatment is usually long and does not always match expectations of the patients. PMID:25362642

  2. Duodenal ulcers induced by diethyldithiocarbamate, a superoxide dismutase inhibitor, in the rat: role of antioxidative system in the pathogenesis.

    PubMed

    Takeuchi, K; Nishiwaki, H; Niida, H; Ueshima, K; Okabe, S

    1991-11-01

    Pathogenesis of duodenal ulcers induced by diethyldithiocarbamate (DDC), a superoxide dismutase (SOD) inhibitor, was investigated in the rat. Repeated s.c. administration of DDC (750 mg/kg) every 12 hr induced duodenal ulcers in the fed rats, and the severity of the ulcers reached the maximum after three injections. DDC not only reduced basal acid output but also impaired duodenal alkaline secretion. These ulcers were significantly prevented by antioxidative agents such as SOD (50000 units/kg, s.c.), allopurinol (50 mg/kg, s.c.) or glutathione (200 mg/kg, s.c.) as well as the antisecretory agent cimetidine (100 mg/kg, s.c.). The impaired HCO3- response caused by DDC was partially but significantly reversed by either SOD (15000 units/kg/hr, i.v.), allopurinol or glutathione; and SOD by itself significantly elevated the rate of basal alkaline secretion. 16,16-Dimethyl prostaglandin E2 (10 micrograms/kg, s.c.) increased duodenal HCO3- output in the presence of DDC and significantly prevented the development of duodenal ulcers in response to DDC. These results suggest that the mucosal antioxidative system including SOD may play a role in the regulatory process of alkaline secretion and contribute to the mucosal defensive ability in the duodenum. The insufficiency of this system may be involved in the pathogenesis of DDC-induced duodenal ulcers. PMID:1667532

  3. A RESISTIVE FORCE MODEL FOR LEGGED LOCOMOTION ON GRANULAR MEDIA*

    E-print Network

    Goodisman, Michael

    the net forces on both an L-leg and a reversed L-leg rotated through granular media with better accuracy1 A RESISTIVE FORCE MODEL FOR LEGGED LOCOMOTION ON GRANULAR MEDIA* CHEN LI, TINGNAN ZHANG on granular surfaces like sand and gravel. Understanding the mechanics of legged locomotion on granular media

  4. Compliant leg behaviour explains basic dynamics of walking and running

    E-print Network

    Compliant leg behaviour explains basic dynamics of walking and running Hartmut Geyer1,*, Andre in walking and rebounding on compliant legs in running. However, while rebounding legs well explain­mass model, we show that not stiff but compliant legs are essential to obtain the basic walking mechanics

  5. Static Stability of Tension Leg Platforms 

    E-print Network

    Xu, Ning

    2010-07-14

    The static stability of a Tension Leg Platform (TLP) with an intact tendon system is principally provided by its tendons and hence quite different from those of a conventional ship or even a floating structure positioned by its mooring system...

  6. OCEAN DRILLING PROGRAM LEG 113 PRELIMINARY REPORT

    E-print Network

    James P Kennett Co-Chief Scientist, Leg 113 Graduate School of Oceanography University of Rhode Island, University of Rhode Island, Narraganett, Rhode Island 02882-1197) Suzanne 0'Connell, ODP Staff Scientist

  7. OCEAN DRILLING PROGRAM LEG 161 PRELIMINARY REPORT

    E-print Network

    , Universidad de Granada Campus Fuentenueva 18002 Granada Spain Dr. Rainer Zahn Co-Chief Scientist, Leg 161; E-mail: mcomas@ goliat.ugr.es) Rainer Zahn, Co-Chief Scientist (GEOMAR, Wischhofstraße 1-3, D-24148

  8. Prosthetic Leg Design Biomedical Technology Exploration

    E-print Network

    Provancher, William

    .00 Large Sponge = $2.00 Duct Tape = $7.00 (share with others?) #12;Assignment Draw prosthetic leg design & detail materials (Next Monday) Proposal (Next Wednesday) Document that engineers must write before

  9. Pepsinogen C gene polymorphisms associated with gastric body ulcer.

    PubMed Central

    Azuma, T; Teramae, N; Hayakumo, T; Yasuda, K; Nakajima, M; Kodama, T; Inokuchi, H; Hayashi, K; Taggart, R T; Kawai, K

    1993-01-01

    This study was aimed to investigate the association of restriction fragment length polymorphisms (RFLPs) for pepsinogen genes with peptic ulcer disease. Eighty unrelated controls, 61 patients with gastric ulcer, and 57 patients with duodenal ulcer were studied. No genetic polymorphisms for pepsinogen A were detected by EcoRI digestion in Japanese subjects but a 100 base pairs insertion-deletion RFLP for the pepsinogen C gene was observed. The allele frequencies of the large (3.6 kilobase EcoRI fragment) and the small fragment (3.5 kilobase EcoRI fragment) were 80.6% and 19.4% respectively in controls, 55.4% and 44.6% in patients with gastric body ulcer, 79.4% and 20.6% in patients with gastric angular ulcer, 71.4% and 28.6% in patients with gastric antral ulcer, and 75.4% and 24.6% in patients with duodenal ulcer. The allele frequency of the small fragment was significantly higher in patients with gastric body ulcer than in controls and in patients with gastric angular or antral ulcer. The genotypes which possessed the small fragment were significantly more frequent in patients with gastric body ulcer (78.4%) than in controls (33.8%) and in patients with gastric angular or antral ulcer (37.5%). These results suggest that there is a significant association between the genetic polymorphism at the pepsinogen C gene locus and gastric body ulcer, and that the pepsinogen C RFLP is a useful marker of the genetic predisposition to this disorder. These results also indicate genetic heterogeneity of gastric ulcer disease, and suggest that the pepsinogen C RFLP may be a useful subclinical marker to explain the differences in genetic aetiologies of gastric body ulcer and gastric angular or antral ulcer. Images Figure 1 Figure 2 PMID:8098309

  10. Pressure ulcers: effectiveness of risk-assessment tools. A randomised controlled trial (the ULCER trial)

    Microsoft Academic Search

    Joan Webster; Kerrie Coleman; Alison Mudge; Louise Marquart; Glenn Gardner; Monica Stankiewicz; Julie Kirby; Catherine Vellacott; Margaret Horton-Breshears; Alice McClymont

    2011-01-01

    ObjectiveTo evaluate the effectiveness of two pressure-ulcer screening tools against clinical judgement in preventing pressure ulcers.DesignA single blind randomised controlled trial.SettingA large metropolitan tertiary hospital.Participants1231 patients admitted to internal medicine or oncology wards. Patients were excluded if their hospital stay was expected to be 2 days or less.InterventionsParticipants allocated to either a Waterlow (n=410) or Ramstadius (n=411) screening tool group

  11. [Anti-aging. The pretty leg].

    PubMed

    Stege, H

    2005-04-01

    The leg is a very important aesthetic unit along with the face, neck, décolleté and hands. In addition to individual and inherited factors, which define the appearance and shape of the legs, multiple changes may occur during life which are cosmetically disturbing and may influence individual attractiveness. These changes offer dermato-phlebologists a wide spectrum of possibilities to intervene. Sclerotherapy, laser procedures, surgical approaches such as liposuction, conventional and endovasal phlebosurgery and physical therapy can all be beneficial. PMID:15761695

  12. Rotational joint assembly for the prosthetic leg

    NASA Technical Reports Server (NTRS)

    Owens, L. J.; Jones, W. C. (inventors)

    1977-01-01

    A rotational joint assembly for a prosthetic leg has been devised, which enables an artificial foot to rotate slightly when a person is walking, running or turning. The prosthetic leg includes upper and lower tubular members with the rotational joint assembly interposed between them. The assembly includes a restrainer mechanism which consists of a pivotably mounted paddle element. This device applies limiting force to control the rotation of the foot and also restores torque to return the foot back to its initial position.

  13. On the stability of legged locomotion

    Microsoft Academic Search

    Zhuohua Shen

    2011-01-01

    Spring-Loaded Inverted Pendulum(SLIP) is a canonical model legged locomotion, but it fails to predict dynamical stability of real world legged locomotion. Recently there are some actuated models with greater stability than SLIP developed and analyzed. But the reason behind the improved stability is still unknown. Here, we introduce a new model called Forced-Damped Spring-Loaded Inverted Pendulum(FD-SLIP) capable of achieving fully

  14. Failure of colonoscopic surveillance in ulcerative colitis

    Microsoft Academic Search

    D A Lynch; A J Lobo; G M Sobala; M F Dixon; A T Axon

    1993-01-01

    A prospective surveillance programme for patients with longstanding (> = 8 years), extensive (> = splenic flexure) ulcerative colitis was undertaken between 1978 and 1990. It comprised annual colonoscopy with pancolonic biopsy. One hundred and sixty patients were entered into the programme and had 739 colonoscopies (4.6 colonoscopies per patient; 709 patient years follow up). Eight eight per cent of

  15. Cytokines in the pathogenesis of ulcerative colitis.

    PubMed

    Bamias, Giorgos; Kaltsa, Garyfallia; Ladas, Spiros D

    2011-05-01

    Ulcerative colitis is a chronic inflammatory condition of the large intestine whose etiology remains largely unknown. Its pathogenesis involves the breakdown of intestinal mucosal homeostasis due to a genetically determined miscommunication between commensal flora and the gut associated immune system. Cytokines are central components of the inflammatory pathways that take place during the active and chronic phases of ulcerative colitis. Recent research has identified several novel cytokine systems that are upregulated at the mucosa of patients with ulcerative colitis and started to unveil their functional importance for disease pathogenesis. The significance of interleukin-13 (IL-13), TNF-like cytokine 1A (TL1A), IL-33, and their receptors in ulcerative colitis is strongly supported by converging expression and functional data. These molecular systems may define subgroups of patients with uniform immunological profiles. Within these subpopulations such novel cytokine systems may serve as markers of biological activity of the disease. More importantly, they may offer unique therapeutic opportunities through the development of drugs that specifically target and neutralize well-defined inflammatory pathways. PMID:21616044

  16. Chemoprevention of colorectal cancer in ulcerative colitis

    Microsoft Academic Search

    Victoria J. Croog; Thomas A. Ullman; Steven H. Itzkowitz

    2003-01-01

    Background Patients with ulcerative colitis (UC) are at greater risk of developing colorectal cancer (CRC) than the general population. Both duration and extent of UC are important risk factors for CRC, as is the presence of primary sclerosing cholangitis, family history of CRC, and (in some studies) early age at diagnosis of UC. Efforts to reduce this risk have focused

  17. Healing of chronic gastroduodenal ulcerations by antacids

    Microsoft Academic Search

    STANISILAW J. KONTUREK; Tomasz Brzozowski; Danuta Drozdowicz; Artur Dembi?ski; Christian Nauert

    1990-01-01

    Antacids show gastroprotective action against various irritants in experimental animals and enhance the healing of chronic gastroduodenal ulcers in humans but the mechanisms of these effects are unknown. The present study was designed to determine whether prostaglandin (PG) and epidermal growth factor (EGF), which also have protective and antiulcer properties, contribute to the action of antacids on rat's stomach. It

  18. The gastric acid conundrum in peptic ulcer.

    PubMed

    Dobrilla, G; Steele, A; Comberlato, M; Amplatz, S

    1990-06-01

    According to the traditional view, gastric acid and pepsin are a sine qua non for ulcer development. Acid suppression, however, is far from being the only successful therapeutic approach, and similar healing rates are achieved by drugs with substantially different mechanism of action antacids, H2-antagonists, antimuscarinics, cytoprotective and site-protective agents-thus denoting a multifactorial pathogenesis. Even with the antisecretory compounds, the relationship between gastric acid and ulcer healing gives rise to perplexity: antacids prove effective at widely varying doses; pirenzipine and H2-blockers, which are clinically equieffective, differ considerably in antisecretory efficacy; H2-antagonist studies on early vs late postprandial dosing, yield contradictory clinical results; morning and bedtime single administration of H2-antagonists prove equiactive on ulcer healing, leading to a appraisal of the alleged importance of nocturnal acidity. Ulcer sealants such as colloidal bismuth and sucralfate prove as effective as H2-antagonists despite their total lack of antisecretory activity, thereby reapparently under-mining the primary pathogenetic role of acid. However, with the spectacular 100% healing rates achieved by the proton-pump blocker, omeprazole, the wheel has come full circle, and gastric acid appears to re-emerge as a primary element in pathogenesis. Specific therapy, based on the predominant pathogenetic factor involved, is likely to be a feasible proposition, but, at present, remains little more than a remote possibility. PMID:2131944

  19. Stomach Ulcers and the Endurance Horse

    Microsoft Academic Search

    David Marlin

    The results of numerous surveys, conducted from the 1980s to present day suggest that gastric (stomach) ulcers are an ongoing and widespread problem for adult horses. Thoroughbreds in active race training were quickly identified as being a 'high risk' group, with the results of several published studies citing a prevalence of 80-90% within horses in training. Following on from these

  20. When Is Surgery Indicated in Ulcerative Colitis?

    Microsoft Academic Search

    Qin Ouyang; Yan Pan

    2011-01-01

    Background: Surgery continues to play an important role in ulcerative colitis (UC) therapy, with the operation rate for severe UC (SUC) cases varying between 25 and 30% in western countries. The indication and timing for surgery are not clearly defined, and there are some differences between the West and the East. By analyzing present data from different levels, the evidence

  1. High prevalence of buccal ulcerations in largemouth bass, Micropterus salmoides (Centrarchidae) from Michigan inland lakes associated with Myzobdella lugubris Leidy 1851 (Annelida: Hirudinea)

    PubMed Central

    Faisal, M.; Schulz, C.; Eissa, A.; Whelan, G.

    2011-01-01

    Widespread mouth ulcerations were observed in largemouth bass collected from eight inland lakes in the Lower Peninsula of Michigan during the summer months of 2002 and 2003. These ulcerations were associated with, and most likely caused by, leech parasitism. Through the use of morphological dichotomous keys, it was determined that all leeches collected are of one species: Myzobdella lugubris. Among the eight lakes examined, Lake Orion and Devils Lake had the highest prevalence of leech parasitism (34% and 29%, respectively) and mouth ulcerations (53% and 68%, respectively). Statistical analyses demonstrated that leech and ulcer prevalence varied significantly from one lake to the other. Additionally, it was determined that the relationship between the prevalence of ulcers and the prevalence of leech attachment is significant, indicating that leech parasitism is most likely the cause of ulceration. The ulcers exhibited deep hemorrhagic centers and raised irregular edges. Affected areas lost their epithelial lining and submucosa, with masses of bacteria colonizing the damaged tissues. Since largemouth bass is a popular global sportfish and critical to the food web of inland lakes, there are concerns that the presence of leeches, damaged buccal mucosa, and general unsightliness may negatively affect this important sportfishery. PMID:21395209

  2. Ulcer healing activity of Mumijo aqueous extract against acetic acid induced gastric ulcer in rats

    PubMed Central

    Shahrokhi, Nader; Keshavarzi, Zakieh; Khaksari, Mohammad

    2015-01-01

    Objective: Gastric ulcer is an important clinical problem, chiefly due to extensive use of some drugs. The aim was to assess the activity of Mumijo extract (which is used in traditional medicine) against acetic acid induced gastric ulcer in rats. Materials and Methods: The aqueous extract of Mumijo was prepared. Animals were randomly (n = 10) divided into four groups: Control, sham-operated group (received 0.2 ml of acetic acid to induce gastric ulcer), Mumijo (100 mg/kg/daily) were given for 4 days postacetic acid administration, and ranitidine group (20 mg/kg). The assessed parameters were pH and pepsin levels (by Anson method) of gastric contents and gastric histopathology. Ranitidine was used as reference anti-ulcer drug. Results: The extract (100 mg/kg/daily, p.o.) inhibited acid acetic-induced gastric ulceration by elevating its pH versus sham group (P < 0.01) and decreasing the pepsin levels compared to standard drug, ranitidine (P < 0.05). The histopathology data showed that the treatment with Mumijo extract had a significant protection against all mucosal damages. Conclusion: Mumijo extract has potent antiulcer activity. Its anti-ulcer property probably acts via a reduction in gastric acid secretion and pepsin levels. The obtained results support the use of this herbal material in folk medicine. PMID:25709338

  3. Fasting and postprandial gastrointestinal motility in ulcer and non-ulcer dyspepsia.

    PubMed Central

    Stanghellini, V; Ghidini, C; Maccarini, M R; Paparo, G F; Corinaldesi, R; Barbara, L

    1992-01-01

    This study aimed to compare fasting and postprandial gastrointestinal motor patterns in patients with ulcer and non-ulcer dyspepsia. Forty five subjects were studied: 10 with uncomplicated gastric ulcer, eight with uncomplicated duodenal ulcer, 18 with chronic idiopathic dyspepsia, and nine healthy asymptomatic controls. Gastrointestinal fasting and postprandial motor patterns were recorded using a low compliance perfusion technique. The interdigestive antral cumulative motility index, computed for 30 minutes before the appearance of duodenal activity fronts, and the number of activity fronts with an antral component were significantly less in patients with ulcers and those with non-ulcer dyspepsia compared with asymptomatic controls. The patient groups also had a reduced antral motor response to a solid-liquid test meal compared with healthy controls. Intestinal motor abnormalities (bursts of non-propagated phasic pressure activity and discrete clustered contractions) were recorded in a minority of patients, all with associated irritable bowel symptoms. In conclusion, antral hypomotility is a frequent but nonspecific motor abnormality in dyspepsia; abnormal motor patterns of the small bowel are less frequent and seem to be confined to patients with concomitant irritable bowel syndrome. PMID:1541413

  4. Usefulness of the Computed Tomography Venography for Evaluation of Leg Edema Including Deep Vein Thrombosis in Rehabilitation Patients

    PubMed Central

    Chang, Ji Hea; Kwon, Jae Hyun; Ryu, Gi Hyeong; Moon, Heebong; Kim, Changjae; Nam, Ki Yeon; Kwon, Bum Sun

    2014-01-01

    Objective To investigate the usefulness of computed tomography venography (CTV) for evaluation of leg swelling, especially deep vein thrombosis (DVT), in rehabilitation patients. Methods A hundred twenty-three patients, who had performed CTV performed because of suspected DVT in our clinic, were enrolled. We performed chart reviews retrospectively and categorized CTV findings as follows: DVT distal to inguinal ligament and no compression lesion; DVT proximal to inguinal ligament and no compression lesion; DVT distal to inguinal ligament and anatomical variant (for example, May-Thurner syndrome); DVT due to compression of mass (cancer or cyst); DVT and other incidental abnormal finding; and no DVT and other possible causes of leg swelling. Results DVTs were found in 65 (53%) patients. DVTs were found at distal level (thigh or lower leg) to inguinal ligament in 47 patients. DVTs were found at proximal to inguinal ligament, usually undetectable with duplex ultrasonography, in 6 patients. DVTs caused by external compression, such as femoral vein and cancer mass, were found in 12 patients (10%), which are also not easily detected with duplex ultrasonography. Other various causes of leg edema without DVT were found in 22 (18%) patients. Conclusion CTV can evaluate more extensively venous problems in the pelvis and abdomen and detect other possible causes of leg swelling. Therefore, CTV can be a useful tool not only for easy detection of DVT but also for evaluating differential diagnosis of leg edema in rehabilitation patients. PMID:25566481

  5. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper.

    PubMed

    Posthauer, Mary Ellen; Banks, Merrilyn; Dorner, Becky; Schols, Jos M G A

    2015-04-01

    Nutrition and hydration play an important role in preserving skin and tissue viability and in supporting tissue repair for pressure ulcer (PrU) healing. The majority of research investigating the relationship between nutrition and wounds focuses on PrUs. This white paper reviews the 2014 National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Nutrition Guidelines and discusses nutrition strategies for PrU management. PMID:25775201

  6. Become the PPUPET Master: Mastering Pressure Ulcer Risk Assessment With the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET).

    PubMed

    Sterken, David J; Mooney, JoAnn; Ropele, Diana; Kett, Alysha; Vander Laan, Karen J

    2015-01-01

    Hospital acquired pressure ulcers (HAPU) are serious, debilitating, and preventable complications in all inpatient populations. Despite evidence of the development of pressure ulcers in the pediatric population, minimal research has been done. Based on observations gathered during quarterly HAPU audits, bedside nursing staff recognized trends in pressure ulcer locations that were not captured using current pressure ulcer risk assessment tools. Together, bedside nurses and nursing leadership created and conducted multiple research studies to investigate the validity and reliability of the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET). PMID:25450444

  7. Stable control of a simulated one-legged running robot with hip and leg compliance

    Microsoft Academic Search

    Mojtaba Ahmadi; Martin Buehler

    1997-01-01

    We present a control strategy for a simplified model of a one-legged running robot which features compliant elements in series with hip and leg actuators. For this model, proper spring selection and initial conditions result in “passive dynamic” operation close to the desired motion, without any actuation. However, this motion is not stable. Our controller is based on online calculations

  8. Liver transplantation in a patient with cholangiocarcinoma and ulcerative colitis.

    PubMed Central

    Abouna, G. M.; Preshaw, R. M.; Silva, J. L.; Hollingsworth, W. J.; Hershfield, N. B.; Novak, W.; Shaw, D. T.; Vetters, J. M.

    1976-01-01

    A 39 year-old patient with cholangiocarcinoma and pre-existing ulcerative colitis was successfully treated by orthotopic liver transplantation. He was given low doses of prednisone and azathioprine and survived for more than 9 months, dying with tumour metastases, thrombosis of the inferior vena cava and an intra-abdominal abscess. At autopsy the homograft showed little evidence of rejection. Preoperatively the patient had septicemia. Removal of his liver was difficult. The discrepancy between donor and recipient in size of blood vessels and the presence of two hepatic arteries in the donor caused problems during the vascular anastomoses. During the operation cardiac arrest occurred. Postoperatively there were several medical and surgical problems, including intraperitoneal and gastrointestinal hemorrhage, paralysis of the right dome of the diaphragm, sinus bradycardia, massive diuresis, peroneal nerve palsy, and one major and three minor episodes of rejection, which were reversed by giving pulse doses of methylprednisolone intravenously. Images FIG. 1 FIG. 2 FIG. 5 PMID:184908

  9. Ulcerated Radiodermatitis Induced after Fluoroscopically Guided Stent Implantation Angioplasty

    PubMed Central

    Herz-Ruelas, Maira Elizabeth; Gómez-Flores, Minerva; Moxica-del Angel, Joaquín; Miranda-Maldonado, Ivett; Gutiérrez-Villarreal, Ilse Marilú; Villarreal-Rodríguez, Adriana Orelia

    2014-01-01

    Cases of radiation-induced skin injury after fluoroscopically guided procedures have been reported since 1996, though the majority of them have been published in Radiology and Cardiology literature, less frequently in Dermatology journals. Chronic radiation dermatitis induced by fluoroscopy can be difficult to diagnose; a high grade of suspicion is required. We report a case of an obese 46-year-old man with hypertension, dyslipidemia, and severe coronary artery disease. He developed a pruritic and painful atrophic ulcerated skin plaque over his left scapula, six months after fluoroscopically guided stent implantation angioplasty. The diagnosis of radiodermatitis was confirmed histologically. We report this case to emphasize the importance of recognizing fluoroscopy as a cause of radiation dermatitis. A good clinical follow-up at regular intervals is important after long and complicated procedures, since the most prevalent factor for injury is long exposure time. PMID:25276441

  10. Investigation on lower leg muscles activity and discomfort on prolonged standing task

    Microsoft Academic Search

    Sari Julia Sartika; Siti Zawiah Dawal

    2009-01-01

    Prolonged static standing caused less freedom to move around and rest the muscles. This lack of flexibility in choosing body position contributes to health problems. It will accelerate fatigue besides discomfort, aching feet and swelling on leg. The aim of this study is to investigate the muscle activity and body discomfort while standing. Twelve subjects (seven females and five males)

  11. A novel method to produce extensive gastric antral ulcer in rats: pharmacological factors involved in the etiology of antral ulceration.

    PubMed

    Uchida, M; Takayama, M; Kato, Y; Tsuchiya, S; Horie, S; Watanabe, K

    1999-11-01

    Gastric antral area is the most susceptible region to gastric ulceration in man. However, only limited information is available on animal models. In the present paper, we have developed an improved method for inducing gastric antral ulcers by the administration of 1.0 M HCl after refeeding for 1 h in rats. On day 4, the severe ulcer was found covering extensively the whole area of the antrum, and penetrated through the muscularis mucosae. The incidence of ulceration was 100% and the mean ulcer index was 37.1 +/- 16.6 mm2. In contrast, none of the erosive lesions were observed in the corpus area. Before 24 h, only slight hyperemia was observed in the antral region, suggesting that some submucosal mechanisms are involved in the ulceration processes other than the direct erosive action of HCl on the mucosal surface. Additional treatment with diethyldithiocarbamate (125 mg x kg(-1), s.c.), superoxide dismutase inhibitor, significantly aggravated this antral ulcer, and the ulcer index was 66.0 +/- 13.6 mm2. Allopurinol (50 mg x kg(-1), p.o.) significantly prevented ulcer formation induced by HCl plus DDC. GSH (150 mg x kg(-1), i.p.) also markedly prevented the ulceration. However, DMSO (0.5%, 5 mL x kg(-1), p.o.) was found not to affect ulcer formation. Famotidine (20 mg x kg(-1), p.o.) almost completely inhibited ulcer formation. From the above results, it was concluded that gastric antral ulcer can be induced by the simple treatment of 1.0 M HCl in refed rats, and the antrum has a different defensive mechanism from that in the corpus area. In addition. oxygen derived radicals, especially superoxide anion and endogenous acid secretion were found to be involved in the etiology of the aggravation of the gastric antral ulcer induced by DDC. PMID:10674922

  12. Biologics in the management of ulcerative colitis - comparative safety and efficacy of TNF-? antagonists.

    PubMed

    Fausel, Rebecca; Afzali, Anita

    2015-01-01

    Ulcerative colitis can cause debilitating symptoms and complications such as colonic strictures, colonic dysplasia, colorectal cancer, and toxic megacolon or perforation. Goals of treatment in ulcerative colitis include resolution of gastrointestinal symptoms, healing of colonic mucosa, and prevention of disease complications. Our treatment armamentarium has expanded dramatically over the past 10 years, and we now have multiple biologic agents approved for the treatment of moderate-severe disease, in addition to conventional therapies such as 5-aminosalicylates, thiopurines, and corticosteroids. In this review, we will provide a detailed discussion of the three tumor necrosis factor-alpha (TNF-?) inhibitors currently approved for treatment of ulcerative colitis: infliximab, adalimumab, and golimumab. All three agents are effective for inducing and maintaining clinical response and remission in patients with ulcerative colitis, and they have comparable safety profiles. There are no head-to-head trials comparing their efficacy, and the choice of agent is most often based on insurance coverage, route of administration, and patient preference. Combination therapy with an immunomodulator is proven to be more effective than anti-TNF monotherapy, and patients who lose response to an anti-TNF agent should undergo dose intensification in order to regain clinical response. Despite therapeutic optimization, a significant percentage of patients will not achieve clinical remission with anti-TNF agents, and so newer therapies are on the horizon. PMID:25609972

  13. Methods used in preclinical assessment of anti-Buruli ulcer agents: A global perspective.

    PubMed

    Tsouh, Patrick Valere Fokou; Addo, Phyllis; Yeboah-Manu, Dorothy; Boyom, Fabrice Fekam

    2015-01-01

    Buruli ulcer (BU) caused by Mycobacterium ulcerans is the third most common chronic mycobacterial infection in humans. Approximately 5000 cases are reported annually from at least 33 countries around the globe, especially in rural African communities. Even though anti-mycobacterial therapy is often effective for early nodular or ulcerative lesions, surgery is sometimes employed for aiding wound healing and correction of deformities. The usefulness of the antibiotherapy nonetheless is challenged by huge restrictive factors such as high cost, surgical scars and loss of income due to loss of man-hours, and in some instances employment. For these reasons, more effective and safer drugs are urgently needed, and research programs into alternative therapeutics including investigation of natural products should be encouraged. There is the need for appropriate susceptibility testing methods for the evaluation of potency. A number of biological assay methodologies are in current use, ranging from the classical agar and broth dilution assay formats, to radiorespirometric, dye-based, and fluorescent/luminescence reporter assays. Mice, rats, armadillo, guinea pigs, monkeys, grass cutters and lizards have been suggested as animal models for Buruli ulcer. This review presents an overview of in vitro and in vivo susceptibility testing methods developed so far for the determination of anti-Buruli ulcer activity of natural products and derivatives. PMID:25792087

  14. Protective effects of escin against indomethacin-induced gastric ulcer in mice.

    PubMed

    Wang, Tian; Zhao, Shanshan; Wang, Yucun; Yang, Yujiao; Yao, Le; Chu, Liuxiang; Du, Hanhan; Fu, Fenghua

    2014-12-01

    Escin, a natural mixture of triterpenoid saponin isolated from the seed of the horse chestnut, is reported to have a potent antiulcer activity against ethanol-induced gastric mucosal lesions. This study investigated the possible mechanisms underlying the gastroprotective effect of escin against indomethacin-induced gastric ulcer in mice. Gastric ulceration was induced by a single intragastric administration of indomethacin (18?mg/kg). The mice underwent intragastric treatment with escin at doses of 0.45, 0.9 or 1.8?mg/kg. Gastric lesion was estimated morphometrically and histopathologically 6?h after the indomethacin administration. The antioxidative parameters in gastric mucosa were measured. Moreover, the activity of myeloperoxidase and the contents of TNF-?, P-selectin and VCAM-1 in gastric tissues were determined. The results showed that escin protected gastric tissues against indomethacin-induced gastropathy as demonstrated from a reduction in the ulcer index and an attenuation of histopathologic changes. Escin caused significant reductions of the contents of malondialdehyde, TNF-?, P-selectin, VCAM-1 and myeloperoxidase activity. The altered activities of superoxide dismutase, catalase and glutathione peroxidase in the stomach tissues were also ameliorated by escin treatment. The present study demonstrated that escin had a protective effect against indomethacin-induced gastric ulcer in mice, not only by virtue of its antioxidant potential, but also due to its anti-inflammatory effect. PMID:25137224

  15. Biologics in the management of ulcerative colitis – comparative safety and efficacy of TNF-? antagonists

    PubMed Central

    Fausel, Rebecca; Afzali, Anita

    2015-01-01

    Ulcerative colitis can cause debilitating symptoms and complications such as colonic strictures, colonic dysplasia, colorectal cancer, and toxic megacolon or perforation. Goals of treatment in ulcerative colitis include resolution of gastrointestinal symptoms, healing of colonic mucosa, and prevention of disease complications. Our treatment armamentarium has expanded dramatically over the past 10 years, and we now have multiple biologic agents approved for the treatment of moderate-severe disease, in addition to conventional therapies such as 5-aminosalicylates, thiopurines, and corticosteroids. In this review, we will provide a detailed discussion of the three tumor necrosis factor-alpha (TNF-?) inhibitors currently approved for treatment of ulcerative colitis: infliximab, adalimumab, and golimumab. All three agents are effective for inducing and maintaining clinical response and remission in patients with ulcerative colitis, and they have comparable safety profiles. There are no head-to-head trials comparing their efficacy, and the choice of agent is most often based on insurance coverage, route of administration, and patient preference. Combination therapy with an immunomodulator is proven to be more effective than anti-TNF monotherapy, and patients who lose response to an anti-TNF agent should undergo dose intensification in order to regain clinical response. Despite therapeutic optimization, a significant percentage of patients will not achieve clinical remission with anti-TNF agents, and so newer therapies are on the horizon. PMID:25609972

  16. Steering by transient destabilization in piecewise-holonomic models of legged locomotion

    NASA Astrophysics Data System (ADS)

    Proctor, J.; Holmes, P.

    2008-08-01

    We study turning strategies in low-dimensional models of legged locomotion in the horizontal plane. Since the constraints due to foot placement switch from stride to stride, these models are piecewise-holonomic, and this can cause stride-to-stride changes in angular momentum and in the ratio of rotational to translational kinetic energy. Using phase plane analyses and parameter studies based on experimental observations of insects, we investigate how these changes can be harnessed to produce rapid turns, and compare the results with dynamical cockroach data. Qualitative similarities between the model and insect data suggest general strategies that could be implemented in legged robots.

  17. Leucocytoclastic vasculitis in severe ulcerative colitis.

    PubMed

    Martin, Donald; Handler, Tristan; McDermott, Joseph

    2011-05-01

    Ulcerative colitis may be associated with a number of extraintestinal skin manifestations including erythema nodosum and pyoderma gangrenosum. We describe an unusual case of a 26-year-old military pilot with ulcerative colitis and skin lesions diagnosed as leucocytoclastic vasculitis. The skin lesions occurred twice during the severe flare. The first occurrence was treated successfully with corticosteroids. When the lesions recurred several weeks later, concomitant with the ongoing flare, treatment with mesalamine and infliximab resolved the lesions. Ultimately, the patient required total colectomy for flare unresponsive to maximum medical therapy. The leucocytoclastic vasculitis did not recur after colectomy. We propose a potential immunopathophysiologic mechanism linking the 2 conditions based on recent biochemical and clinical research. PMID:21634306

  18. Primer: managing NSAID-induced ulcer complications—balancing gastrointestinal and cardiovascular risks

    Microsoft Academic Search

    Francis KL Chan

    2006-01-01

    Ulcer complications associated with the use of NSAIDs, in high-risk patients, are often caused by a failure to identify patients' risk factors, concomitant use of aspirin or multiple NSAIDs, and underutilization of gastroprotective agents. Current data suggest that cyclo-oxygenase 2 (COX2) inhibitors and some nonselective NSAIDs increase the risk of myocardial infarction. Physicians must, therefore, take into account both the

  19. Prognosis of carcinoma in ulcerative colitis.

    PubMed Central

    Ritchie, J K; Hawley, P R; Lennard-Jones, J E

    1981-01-01

    Between 1947 and 1980, 67 patients with carcinoma complicating ulcerative colitis were treated at St Mark's Hospital. The tumours in these patients were compared with those in 4817 patients without colitis seen over the same period. There was a higher proportion of inoperable and high grade tumours in the colitic group but the prognosis was found to be very similar in patients with and without colitis. PMID:7297924

  20. Rectal ulcers induced by systemic lupus erythematosus.

    PubMed

    Yau, Alan Hoi Lun; Chu, Karen; Yang, Hui Min; Ko, Hin Hin

    2014-01-01

    A 28-year-old woman presented with diarrhoea, haematochezia, tenesmus and rectal pain for 2?months. She was diagnosed with systemic lupus erythematosus (SLE) 8?years ago and remained on prednisone, azathioprine and hydroxychloroquine. Blood work revealed a positive ANA (antinuclear antibody test), anti-dsDNA 749?IU/mL (0-300?IU/mL), C3 0.22?g/L (0.65-1.65?g/L) and C4 0.05?g/L (0.16-0.60?g/L). Stool studies were unremarkable. MRI of the pelvis showed a rectum with eccentric wall thickening. Flexible sigmoidoscopy showed severe proctitis with multiple deep ulcers and diffuse submucosal haemorrhage. Rectal biopsy revealed crypt architectural distortion and reactive fibrosis in the lamina propria. The patient was given mesalamine suppository for 2?weeks with minimal improvement. Repeat flexible sigmoidoscopy showed a coalesced 3×4?cm full-thickness rectal ulcer. Therefore, the patient was given intravenous methylprednisolone for 3?days, followed by intravenous cyclophosphamide for 2?weeks. Her symptoms resolved and repeat flexible sigmoidoscopy showed fibrotic healing of the rectal ulcers. PMID:25150239

  1. Effects of Antiulcer Agents on Healing of Mepirizole-induced Duodenal Ulcers in Rats

    Microsoft Academic Search

    Y. Ishihara; S. Okabe

    1983-01-01

    Healing processes of duodenal ulcers induced by mepirizole and effects of several drugs on the ulcer healing were studied in rats. Mepirizole-induced duodenal ulcers, except for the perforated ones within 3 days after ulceration, gradually diminished in size and depth by the 15th day. Several ulcers persisted for up to 40 days, but complete healing in all rats occurred by

  2. Probabilistic Mechanical Reliability Prediction of Thermoelectric Legs

    SciTech Connect

    Jadaan, Osama M. [University of Wisconsin, Platteville; Wereszczak, Andrew A [ORNL

    2009-05-01

    The probability of failure, Pf, for various square-arrayed thermoelectric device designs using bismuth telluride, lead telluride, or skutterudite thermoelectric materials were estimated. Only volume- or bulk-based Pf analysis was considered in this study. The effects of the choice of the thermoelectric material, the size of the leg array, the height of the thermoelectric legs, and the boundary conditions on the Pf of thermoelectric devices were investigated. Yielding of the solder contacts and mounting layer was taken into account. The modeling results showed that the use of longer legs, using skutterudites, allowing the thermoelectric device to freely deform while under a thermal gradient, and using smaller arrays promoted higher probabilities of survival.

  3. Coeliac disease: Oral ulcer prevalence, assessment of risk and association with gluten-free diet in children

    Microsoft Academic Search

    G. Campisi; C. Di Liberto; A. Carroccio; D. Compilato; G. Iacono; M. Procaccini; G. Di Fede; L. Lo Muzio; A. Craxi; C. Catassi; C. Scully

    2008-01-01

    AimsOral mucosal lesions may be markers of chronic gastrointestinal disorders, such as those causing malabsorption. Our objectives were to assess the prevalence of recurrent oral aphthous-like ulcers in coeliac disease patients living in the Mediterranean area, and to evaluate the impact of a gluten-free diet.

  4. Pressure ulceration and palliative care: prevention, treatment, policy and outcomes.

    PubMed

    Stephen-Haynes, Jackie

    2012-01-01

    Pressure ulcer development and management have particular significance in palliative and end-of-life care owing to the prevalence of mobility issues and the skin changes that can occur with ageing, chronic illness, and at the end of life. Hence, it is important for nurses working in palliative care to be vigilant for pressure ulcer development and to possess knowledge relating to the prevention and management of pressure ulceration. This article considers current UK policy regarding pressure ulcers, highlighting contradictions of relevance to patients requiring palliative care. It then provides a brief overview of pressure ulcer prevention, prescription, preservation, and palliation, highlighting areas of specific consideration to pressure ulcer care within palliative care. PMID:22306714

  5. Ulcerative enteritis-like disease associated with Clostridium perfringens type A in bobwhite quail (Colinus virginianus).

    PubMed

    Shivaprasad, H L; Uzal, Francisco; Kokka, Randy; Fisher, Derek J; McClane, Bruce A; Songer, A Glenn

    2008-12-01

    Ulcerative enteritis-like disease due to Clostridium perfringens type A was attributed as the cause of mortality in excess of 50% in a flock of 1000, 10-to-16-wk-old bobwhite quail (Colinus virginianus). Clinical signs in these birds ranged from sudden death to listlessness, depression, watery white droppings, ruffled feathers, loss of weight, and death in a few days. Necropsy of 30 birds revealed multiple deep ulcers of the mucosa throughout the small intestine and ceca, some with perforation and subsequent coelomitis (peritonitis). The livers in some birds contained white foci of necrosis, and many birds had enlarged and congested spleens. Microscopic lesions included multifocal severe fibrinosuppurative ulcerative enteritis associated with large numbers of rod-shaped gram-positive bacteria, and necrotizing hepatitis with or without rod-shaped bacteria. Anaerobic culturing of the intestine and liver yielded pure cultures of C. perfringens. The C perfringens isolates were of genotype A and were polymerase chain reaction-positive for alpha toxin and for cpb2, the structural gene for beta2 toxin. Repeated attempts to isolate C colinum by using a specialized medium containing 8% horse plasma were not fruitful, suggesting that the enteritis and hepatitis in these birds were produced by C pefringens. Retrospective examination of records of quail submissions to the California Animal Health and Food Safety Laboratory System over 16 yr revealed at least nine quail submissions in which isolation of C. perfringens from the liver, intestine, or both was associated with ulcerative enteritis and hepatitis in quail. This is the first description of ulcerative enteritis-like disease in quail associated with C perfringens. Final conclusions await experimental reproduction of the disease. PMID:19166055

  6. Protective effect of Acer mono Max. sap on water immersion restraint stress-induced gastric ulceration

    PubMed Central

    PARK, CHUL-HONG; SON, HYUNG-U; SON, MINSIK; LEE, SANG-HAN

    2011-01-01

    Acer mono Max. sap (AmMs) is called ‘Gol-Li-Su’ or ‘Go-Lo-Soe’ in Korean, which means ‘water beneficial to the bones’. It is reported that the sap contains several types of minerals and sugars. In particular, the calcium concentration of the sap is 36.5 times higher than that of commercial mineral water. Apart from its anti-osteoporosis effect, no reports have addressed the biological activities of AmMs against degenerative diseases. In the present study, we investigated whether AmMs alleviates gastric ulcer-related symptoms in a stress-induced mouse model. To assess the effect of AmMs on gastric ulcer-like symptoms, we carried out a water immersion restraint (WIRE) test and found that AmMs has potential in alleviating gastric ulcers in a concentration-dependent manner. These results indicate that the nutritional factors of the sap mitigate the gastric ulcer-related symptoms caused by stress-induced gastric lesions in mice. AmMs-treated mice exhibited a significant decrease in the ulcer index as compared to those treated with omeprazole or L-arginine. To examine one potential mechanism underlying this effect, we performed reverse transcription-polymerase chain reaction to ascertain whether molecular markers were associated with the mitigation of the gastric lesions. Epithelial and/or tissue nitric oxide synthase (NOS) was assessed to determine whether or not the genes were down-regulated dose-dependently by the sap. The levels of these enzymes were found to be lower in the tissue samples treated with AmMs compared with the levels in the control samples. These findings collectively suggest that AmMs significantly protects the gastric mucosa against WIRE stress-induced gastric lesions, at least in part, by alleviating inducible NOS and/or neuronal NOS expression. PMID:22977586

  7. Design and validation of a periodic leg movement detector.

    PubMed

    Moore, Hyatt; Leary, Eileen; Lee, Seo-Young; Carrillo, Oscar; Stubbs, Robin; Peppard, Paul; Young, Terry; Widrow, Bernard; Mignot, Emmanuel

    2014-01-01

    Periodic Limb Movements (PLMs) are episodic, involuntary movements caused by fairly specific muscle contractions that occur during sleep and can be scored during nocturnal polysomnography (NPSG). Because leg movements (LM) may be accompanied by an arousal or sleep fragmentation, a high PLM index (i.e. average number of PLMs per hour) may have an effect on an individual's overall health and wellbeing. This study presents the design and validation of the Stanford PLM automatic detector (S-PLMAD), a robust, automated leg movement detector to score PLM. NPSG studies from adult participants of the Wisconsin Sleep Cohort (WSC, n?=?1,073, 2000-2004) and successive Stanford Sleep Cohort (SSC) patients (n?=?760, 1999-2007) undergoing baseline NPSG were used in the design and validation of this study. The scoring algorithm of the S-PLMAD was initially based on the 2007 American Association of Sleep Medicine clinical scoring rules. It was first tested against other published algorithms using manually scored LM in the WSC. Rules were then modified to accommodate baseline noise and electrocardiography interference and to better exclude LM adjacent to respiratory events. The S-PLMAD incorporates adaptive noise cancelling of cardiac interference and noise-floor adjustable detection thresholds, removes LM secondary to sleep disordered breathing within 5 sec of respiratory events, and is robust to transient artifacts. Furthermore, it provides PLM indices for sleep (PLMS) and wake plus periodicity index and other metrics. To validate the final S-PLMAD, experts visually scored 78 studies in normal sleepers and patients with restless legs syndrome, sleep disordered breathing, rapid eye movement sleep behavior disorder, narcolepsy-cataplexy, insomnia, and delayed sleep phase syndrome. PLM indices were highly correlated between expert, visually scored PLMS and automatic scorings (r²?=?0.94 in WSC and r²?=?0.94 in SSC). In conclusion, The S-PLMAD is a robust and high throughput PLM detector that functions well in controls and sleep disorder patients. PMID:25489744

  8. Remission of severe restless legs syndrome and periodic limb movements in sleep after bilateral excision of multiple foot neuromas: a case report

    PubMed Central

    2010-01-01

    Introduction Restless legs syndrome is a sensorimotor neurological disorder characterized by an urge to move the legs in response to uncomfortable leg sensations. While asleep, 70 to 90 percent of patients with restless legs syndrome have periodic limb movements in sleep. Frequent periodic limb movements in sleep and related brain arousals as documented by polysomnography are associated with poorer quality of sleep and daytime fatigue. Restless legs syndrome in middle age is sometimes associated with neuropathic foot dysesthesias. The causes of restless legs syndrome and periodic limb movements in sleep are unknown, but the sensorimotor symptoms are hypothesized to originate in the central nervous system. We have previously determined that bilateral forefoot digital nerve impingement masses (neuromas) may be a cause of both neuropathic foot dysesthesias and the leg restlessness of restless legs syndrome. To the best of our knowledge, this case is the first report of bilateral foot neuromas as a cause of periodic limb movements in sleep. Case presentation A 42-year-old Caucasian woman with severe restless legs syndrome and periodic limb movements in sleep and bilateral neuropathic foot dysesthesias was diagnosed as having neuromas in the second, third, and fourth metatarsal head interspaces of both feet. The third interspace neuromas represented regrowth (or 'stump') neuromas that had developed since bilateral third interspace neuroma excision five years earlier. Because intensive conservative treatments including repeated neuroma injections and various restless legs syndrome medications had failed, radical surgery was recommended. All six neuromas were excised. Leg restlessness, foot dysesthesias and subjective sleep quality improved immediately. Assessment after 18 days showed an 84 to 100 percent reduction of visual analog scale scores for specific dysesthesias and marked reductions of pre-operative scores of the Pittsburgh sleep quality index, fatigue severity scale, and the international restless legs syndrome rating scale (36 to 4). Polysomnography six weeks post-operatively showed improved sleep efficiency, a marked increase in rapid eye movement sleep, and marked reductions in hourly rates of both periodic limb movements in sleep with arousal (135.3 to 3.3) and spontaneous arousals (17.3 to 0). Conclusion The immediate and near complete remission of symptoms, the histopathology of the excised tissues, and the marked improvement in polysomnographic parameters documented six weeks after surgery together indicate that this patient's severe restless legs syndrome and periodic limb movements in sleep was of peripheral nerve (foot neuroma) origin. Further study of foot neuromas as a source of periodic limb movements in sleep and as a cause of sleep dysfunction in patients with or without concomitant restless legs syndrome, is warranted. PMID:20849622

  9. Cutaneous ulcerative lichen planus exhibiting pathergy, response to acitretin.

    PubMed

    Henderson, Robert L; Williford, Phillip M; Molnar, Joseph A

    2004-01-01

    While ulcerative lichen planus is a common diagnosis when involving the mucosa, it is uncommonly found on the cutaneous surface. Cutaneous ulcerative lichen planus is usually found on the palmar or plantar surfaces and has only rarely been described elsewhere. We describe a case of cutaneous ulcerative lichen planus involving the pretibia and exhibiting pathergy, which to our knowledge has not been previously reported. We also describe successful treatment with oral acitretin in conjunction with topical and intralesional corticosteroids. PMID:15098977

  10. A quality improvement programme to reduce pressure ulcers.

    PubMed

    Heywood, Nicola; Brown, Lisa; Arrowsmith, Michaela; Poppleston, Alexa

    2015-07-15

    This article outlines an innovative way of preventing pressure ulcers in the acute hospital setting. A programme using Rapid Spread Methodology was undertaken to reduce hospital-acquired pressure ulcers over a short period of time. Results demonstrated a reduction to zero in the prevalence of hospital-acquired pressure ulcers and an 80% reduction in their incidence, in a six-month period. PMID:26174287

  11. Ulcerated necrobiosis lipoidica to a teenager with diabetes mellitus and obesity.

    PubMed

    P?tra?cu, Virgil; Giurc?, Claudia; Ciurea, Raluca Niculina; Georgescu, Corneliu Cristian; Ciurea, Marius Eugen

    2014-01-01

    Many skin lesions are associated with diabetes mellitus (DM) type 1 or 2, due to the use of antidiabetics or to metabolic and endocrine disorders caused by this disease. Necrobiosis lipoidica (NL) occurs more frequently in patients with DM. Painful ulcerations may occur on NL areas in about 20-25% of the cases and usually they are related to trauma. We present the case of a teenager, male, 17-year-old, having NL with multiple plaques, some of them spontaneously ulcerated after about 33 months of onset. He is known with type 1 DM from 2.5 years and the NL preceding the diagnosis of diabetes mellitus with about six months, presented erythematous-infiltrative skin plaques, some ulcerated for about three months, interesting both shins. Based on clinical, histopathological and paraclinical examinations, we established the following diagnoses: ulcerated NL, type 1 DM, moderate mixed dyslipidemia, class I obesity; commissural candidiasis, juvenile acne. Under treatment with Pentoxifyllinum, Sulodexidum, Ketotifenum and topical therapy with 0.2% Hyaluronic acid two months later, we have managed to heal two of the three ulcerated plaques and of the third has become superficial. We applied 0.5% Fluocortolonum on non-ulcerated plaques recording an improvement after two weeks of treatment. NL is a skin disease with a predilection for the shins, more frequent in patients with diabetes and is a part of palisading granulomatous dermatitis, which leads to skin atrophy. NL is found in the 0.3-1.2% of diabetic patients and is rare in children with diabetes (0.006%). It is more common in the patients with type 1 DM. The onset is in the third decade in diabetic patients and in the fourth decade in non-diabetics. There is no consensus concerning the treatment of NL, and the results are often modest. Antiplatelet agents, corticosteroids (local and general), immunomodulatory drugs, cyclins, wide synthetic antipaludics, heparin, Thalidomide are used. NL treatment is very difficult, especially in the ulcerated forms. Many of the drugs listed have proven efficacy only in isolated cases. Studies are necessary on large series of patients to determine the optimal therapy of NL. PMID:24715184

  12. [Vascular diseases in lipedema of the legs. Special symptoms, common therapeutic results, viewpoint on vascular surgery].

    PubMed

    Brunner, U

    1982-08-14

    Lipedema of the legs is a symmetrical thickening of upper and lower leg and topically accentuated fat pads. The back of the foot is usually free of swelling. Pathogenetically it is a disturbance of the distribution pattern of subcutaneous fat tissue. Epidemiologically, the subjects affected are women, starting from puberty. Weight reduction programs do not influence the real deformations. If this abnormal fat tissue is infiltrated by angiological diseases, these manifest themselves in modified form. In particular, all the symptoms are more painful. In arterial ischemic syndromes that taut skin is susceptible to necrosis at atypical locations. For reconstruction of trunk arteries it is advisable to bypass larger bulges for better wound nealing. Venous strips should be peeled out away from fat pads and venous-bridges very carefully to protect the tissue. Acute and chronic phlebothrombosis lead to unusual and asymmetrical forms of swelling. The venous ulcer lies directly beneath a fat-muff in the gaiter region. Since they are hard to compress, free skin transplants should be considered early in the course of development. Surgery of varicose veins calls for most careful technique to ensure wound healing. From the lymphological viewpoint there are clinically and lymphographically mixed forms of lymphedema with lipedema. PMID:7134941

  13. Optimal management of digital ulcers in systemic sclerosis

    PubMed Central

    Abraham, Shawn; Steen, Virginia

    2015-01-01

    Raynaud’s phenomenon and digital ulcerations are two common clinical features seen in patients with systemic sclerosis. They are painful and lead to significant morbidity and altered hand function within this patient population. While currently there are no US Food and Drug Administration (FDA)-approved medications for the treatment of digital ulcerations in the United States, clinical trials have supported the use of pharmacologic and nonpharmacologic modalities in facilitating healing of existing digital ulcers and preventing formation of new ulcers. This article reviews the published data on these therapeutic options. PMID:26109864

  14. The prevention of foot ulceration in diabetic patients.

    PubMed

    Howard, Ileana M

    2009-11-01

    Diabetic foot ulcerations are a costly and common public health challenge. Although several organizations have emphasized the need to increase awareness of this problem and called health care providers to action to decrease the incidence of ulceration and amputation, there is limited evidence regarding what interventions are best suited to accomplish this goal. This article reviews the pathogenesis, risk factors, and current interventions that have been studied for the prevention of foot ulceration. Preventive measures with evidence for decreasing incidence of ulceration include patient education, offloading abnormal pressures with foot orthotics, and thermal monitoring. PMID:19781501

  15. [Gastroduodenal ulcers during the period of acute economical crisis].

    PubMed

    Pomakov, P; Guéorgiéva, S; Stantchéva, J; Ténev, T; Rizov, A

    1993-05-01

    The occurrence and development of acute ulcers in Sofia during the period of heavy economical recession--January trough February 1991--is analyzed. There is a clear cut increase in the total number and rate of acute duodenal ulcers from 2 to 14%. No gastric ulcer cases are recorded. The young age group--up to 40 years of age--is mainly affected (79% of cases). The incidence among the female population shows a noticeable rise. Difficult living, working and social conditions, associated with inadequate feeding regimen with diets, poor in meat and vitamins, are taken to be the underlying factors of acute ulcers development during the period in question. PMID:8320659

  16. Potential application of in vivo imaging of impaired lymphatic duct to evaluate the severity of pressure ulcer in mouse model

    PubMed Central

    Kasuya, Akira; Sakabe, Jun-ichi; Tokura, Yoshiki

    2014-01-01

    Ischemia-reperfusion (IR) injury is a cause of pressure ulcer. However, a mechanism underlying the IR injury-induced lymphatic vessel damage remains unclear. We investigated the alterations of structure and function of lymphatic ducts in a mouse cutaneous IR model. And we suggested a new method for evaluating the severity of pressure ulcer. Immunohistochemistry showed that lymphatic ducts were totally vanished by IR injury, while blood vessels were relatively preserved. The production of harmful reactive oxygen species (ROS) was increased in injured tissue. In vitro study showed a high vulnerability of lymphatic endothelial cells to ROS. Then we evaluated the impaired lymphatic drainage using an in vivo imaging system for intradermally injected indocyanine green (ICG). The dysfunction of ICG drainage positively correlated with the severity of subsequent cutaneous changes. Quantification of the lymphatic duct dysfunction by this imaging system could be a useful strategy to estimate the severity of pressure ulcer. PMID:24566895

  17. 11. NORTH VIEW OF INNER FACING OF SOUTHEASTERN LEG OF ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    11. NORTH VIEW OF INNER FACING OF SOUTHEASTERN LEG OF SEA WALL. SOUTHERN END OF NORTHEASTERN LEG OF SEA WALL IN BACKGROUND. - Fort Delaware, Sea Wall, Pea Patch Island, Delaware City, New Castle County, DE

  18. Genetic and expression analysis of enabled in Drosophila leg segmentation

    E-print Network

    Ramel, Marie-Christine

    2001-01-01

    Drosophila leg segmentation is a process which is beginning to be understood. The Notch (N) signaling pathway has been identified as a key regulator of joint formation and segmental growth in Drosophila legs. In this context, four-jointed (fj...

  19. Tandem wheel drop-legs for standard truck trailer

    NASA Technical Reports Server (NTRS)

    Cantwell, W.; Selstad, R.

    1970-01-01

    Tandem wheel drop-leg device provides a semitrailer with fore and aft mobility that allows it to be moved without a prime mover. The modified drop-legs have trunnion dual wheels and an adjustable brace.

  20. Factors predicts skin ulcer following coronary artery bypass.

    PubMed

    Sabzi, F; Faraji, R

    2014-01-01

    The number of off-pump coronary artery surgery procedures in high-risk patients such as renal failure, hepatic failure and in anticoagulant drug using patients is increasing. The associated co morbidity and repeated use of electrocautery in postoperative bleeding, caused a susceptibility of patients to pressure or electrocautery ulcers. During a period of three years, 1400 off-pump coronary artery bypass surgery were performed in our center. Of these patients, 20 (A group) suffered from electrocautery sore (ES) and 40 (B group) had pressure sore (PS). These patients were compared with respect to variables such as age, hypertension, hypercholesterolemia, operating time, smoking, opium using, diabetes, weight, sex, respiratory failure, renal failure, and cerebrovascular accident, intra aortic balloon pump using, inotropic drug using by x2 or t test, according to categorical or continuous variables consequently. Electrocautery sore and pressure ulcer as dependence variables and others variables with p value less than 0.1 entered a multivariable logistic regression model and odd ratio of significant variables were obtained. These two groups of patients were different with respect to variables such as age, sex, respiratory failure and cerebrovascular accident and, in the logistic regression model, two factors predicted pressure sore, respiratory failure and cerebrovascular accident, but the only factor that was significant in predicting electrocautery sore in multiple logistic regression analysis was postoperative bleeding. Results of this study revealed that pressure sore is a patient dependent complication in contrast with the electrocautery sore, which is related to technical or device faults and to experience and care of operating room staff. PMID:25870669

  1. Get Your Legs Ready For Summer!

    E-print Network

    Leistikow, Bruce N.

    Get Your Legs Ready For Summer! Free seminars: Treatments for spider veins The vascular program at UC Davis Health System is the most comprehensive in the Sacramento area for the treatment of varicose and spider veins. The UC Davis Vascular Center's vein program offers advanced cosmetic and therapeutic

  2. OCEAN DRILLING PROGRAM LEG 199 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 199 SCIENTIFIC PROSPECTUS PALEOGENE EQUATORIAL TRANSECT Dr. Mitchell Oceanography Centre School of Ocean and Earth Science European Way Southampton SO14 3ZH UK __________________ Dr. Jack Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University

  3. OCEAN DRILLING PROGRAM LEG 201 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 201 SCIENTIFIC PROSPECTUS CONTROLS ON MICROBIAL COMMUNITIES IN DEEPLY. Jack Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Manager and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College

  4. OCEAN DRILLING PROGRAM LEG 184 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 184 SCIENTIFIC PROSPECTUS SOUTH CHINA SEA Dr. Warren L. Prell Co's Republic of China Dr. Peter Blum Staff Scientist Ocean Drilling Program Texas A&M University Research Park the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  5. OCEAN DRILLING PROGRAM LEG 182 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 182 SCIENTIFIC PROSPECTUS GREAT AUSTRALIAN BIGHT Cenozoic Cool Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station, Texas purposes; however, republication of any portion requires the written consent of the Director, Ocean

  6. OCEAN DRILLING PROGRAM LEG 195 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 195 SCIENTIFIC PROSPECTUS MARIANA CONVERGENT MARGIN/ WEST PHILIPPINE SEA Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX

  7. OCEAN DRILLING PROGRAM LEG 190 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 190 SCIENTIFIC PROSPECTUS DEFORMATION AND FLUID FLOW PROCESSES Taira Co-Chief Scientist Ocean Research Institute University of Tokyo 1-15-1 Minamidai Nakano-ku Tokyo 164 Japan __________________ Dr. Jack Baldauf Deputy Director of Science Operations Ocean Drilling

  8. OCEAN DRILLING PROGRAM LEG 177 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 177 SCIENTIFIC PROSPECTUS SOUTHERN OCEAN PALEOCEANOGRAPHY Dr. David 177 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000 Discovery Drive, College Station

  9. OCEAN DRILLING PROGRAM LEG 172 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 172 SCIENTIFIC PROSPECTUS NW ATLANTIC SEDIMENT DRIFTS Dr. Lloyd D Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station, Texas portion requires the written consent of the Director, Ocean Drilling Program, Texas A&M University

  10. OCEAN DRILLING PROGRAM LEG 188 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 188 SCIENTIFIC PROSPECTUS PRYDZ BAY-COOPERATION SEA, ANTARCTICA: GLACIAL Stanford University Stanford, CA 94305-2115 Dr. Carl Richter Staff Scientist Ocean Drilling Program Texas A portion requires the written consent of the Director, Ocean Drilling Program, Texas A&M University

  11. OCEAN DRILLING PROGRAM LEG 200 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 200 SCIENTIFIC PROSPECTUS DRILLING AT THE H2O LONG-TERM SEAFLOOR Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA

  12. OCEAN DRILLING PROGRAM LEG 187 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 187 SCIENTIFIC PROSPECTUS MANTLE RESERVOIRS AND MIGRATION ASSOCIATED WITH AUSTRALIAN-ANTARCTIC RIFTING Dr. David M. Christie Co-Chief Scientist College of Oceanic and Atmospheric 5007 Bergen, Norway Dr. Jay Miller Staff Scientist Ocean Drilling Program Texas A&M University 1000

  13. OCEAN DRILLING PROGRAM LEG 206 SCIENTIFIC PROSPECTUS

    E-print Network

    July 2002 OCEAN DRILLING PROGRAM LEG 206 SCIENTIFIC PROSPECTUS AN IN SITU SECTION OF UPPER OCEANIC 93106-9630 USA Dr. Damon A.H. Teagle Co-Chief Scientist School of Ocean and Earth Science Southampton Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA

  14. OCEAN DRILLING PROGRAM LEG 161 SCIENTIFIC PROSPECTUS

    E-print Network

    of the Ocean Drilling Program in consultation with the Planning Committee and the Pollution PreventionOCEAN DRILLING PROGRAM LEG 161 SCIENTIFIC PROSPECTUS MEDITERRANEAN SEA II - THE WESTERN Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station, Texas

  15. OCEAN DRILLING PROGRAM LEG 169 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 169 SCIENTIFIC PROSPECTUS SEDIMENTARY RIDGES II Dr. Yves Fouquet Dr the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000://www-odp.tamu.edu/publications. D I S C L A I M E R This publication was prepared by the Ocean Drilling Program, Texas A

  16. OCEAN DRILLING PROGRAM LEG 135 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 135 SCIENTIFIC PROSPECTUS Lau Basin Dr. James Hawkins Co-Chief Scientist Road, Wormley Godalming, Surrey GU8 5UB United Kingdom Dr. James Allan StaffScientist,Legl35 Ocean of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000 Discovery Drive, College Station

  17. OCEAN DRILLING PROGRAM LEG 191 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 191 SCIENTIFIC PROSPECTUS NORTHWEST PACIFIC SEISMIC OBSERVATORY Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA

  18. OCEAN DRILLING PROGRAM LEG 202 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 202 SCIENTIFIC PROSPECTUS SOUTHEAST PACIFIC PALEOCEANOGRAPHIC TRANSECTS Dr. Alan C. Mix Co-Chief Scientist College of Oceanic and Atmospheric Sciences Oregon State University 104 Ocean Administration Building Corvallis OR 97331-5503 USA Dr. Ralf Tiedemann Co

  19. OCEAN DRILLING PROGRAM LEG 196 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 196 SCIENTIFIC PROSPECTUS LOGGING WHILE DRILLING AND ADVANCED CORKS Deputy Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA

  20. OCEAN DRILLING PROGRAM LEG 197 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 197 SCIENTIFIC PROSPECTUS MOTION OF THE HAWAIIAN HOTSPOT: A PALEOMAGNETIC TEST Dr. Robert A. Duncan Co-Chief Scientist Oregon State University College of Oceanic and Atmospheric Sciences 104 Ocean Administration Building Corvallis OR 97331-5503 USA Dr. John A. Tarduno Co

  1. OCEAN DRILLING PROGRAM LEG 183 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 183 SCIENTIFIC PROSPECTUS KERGUELEN PLATEAU-BROKEN RIDGE: A Large of Technology Cambridge, Massachusetts 02139 Dr. Paul Wallace Staff Scientist Ocean Drilling Program Texas A of any portion requires the written consent of the Director, Ocean Drilling Program, Texas A&M University

  2. OCEAN DRILLING PROGRAM LEG 186 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 186 SCIENTIFIC PROSPECTUS WESTERN PACIFIC GEOPHYSICAL OBSERVATORIES Dr-Chief Scientist Ocean Research Institute The University of Tokyo 1-15-1 Minamidai Tokyo 164-8639, Japan Dr. Gary D. Acton Staff Scientist Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive

  3. OCEAN DRILLING PROGRAM LEG 205 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 205 SCIENTIFIC PROSPECTUS FLUID FLOW AND SUBDUCTION FLUXES ACROSS __________________ Dr. Jack Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University Manager and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College

  4. OCEAN DRILLING PROGRAM LEG 189 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 189 SCIENTIFIC PROSPECTUS THE TASMANIAN SEAWAY BETWEEN AUSTRALIA J. Malone Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  5. OCEAN DRILLING PROGRAM LEG 194 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 194 SCIENTIFIC PROSPECTUS MARION PLATEAU Dr. Alexandra Isern Co-Chief Scientist Ocean Studies Board National Research Council 2101 Constitution Avenue, NW Washington, DC 20418 of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station, TX

  6. OCEAN DRILLING PROGRAM LEG 165 PRELIMINARY REPORT

    E-print Network

    , Leg 165 Graduate School of Oceanography Department of Geosciences University of Rhode Island University of Massachusetts Narragansett, Rhode Island 02828 Amherst, Massachusetts 01003 U.S.A. U.S.A. Dr of Rhode Island, Narragansett, Rhode Island 02882-1197, USA, E-mail: haraldur@gsosun1.gso.uri.edu) Mark

  7. Three Uses for Springs in Legged Locomotion

    Microsoft Academic Search

    R. Mcn. Alexander

    1990-01-01

    Running animals and robots can save energy and reduce unwanted heat production by bouncing along on springs, using the principle of the pogo stick. (The principal springs in animals are tendons.) They can make further energy savings by using return springs to halt the legs at the end of each foward or backward swing and start them swinging the other

  8. OCEAN DRILLING PROGRAM LEG 104 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 104 SCIENTIFIC PROSPECTUS NORWEGIAN SEA Olav Eldholm Co-Chief Scientist Ocean Drilling Program Texas A & M University College Station, Texas 77843-3469 Pni±ip o Rabinowitz Director Ocean Drilling Program Robert B Kidd Manager of Science Operations Ocean Drilling Program Louis E

  9. OCEAN DRILLING PROGRAM LEG 106 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 106 PRELIMINARY REPORT BARE ROCK DRILLING IN THE MID-ATLANTIC RIDGE RIFT 106 Ocean Drilling Program Texas A & M University College Station, TX 77843-3469 ±nuwiLZ" ector ODP Drilling Program, Texas A & M University, College Station, Texas 77843-3469. In some cases, orders

  10. OCEAN DRILLING PROGRAM LEG 132 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 132 PRELIMINARY REPORT ENGINEERING II: WESTERN AND CENTRAL PACIFIC Mr. Michael A. Storms Supervisor of Development Engineering Ocean Drilling Program Texas A&M University and Drilling Operations ODP/TAMU Timothy J.G. Francis Deputy Director ODP/TAMU September 1990 #12;This informal

  11. OCEAN DRILLING PROGRAM LEG 109 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 109 PRELIMINARY REPORT BARE ROCK DRILLING IN THE MID-ATLANTIC RIDGE RIFT 109 Ocean Drilling Program Texas A & M University College Station, TX 77843-3469 Philip D. Rabinowitz Director Ocean Drilling Program Robert B. Kidd Manager of Science Operations Ocean Drilling Program Louis E

  12. Force and motion management in legged locomotion

    Microsoft Academic Search

    Kenneth J. Waldron; Nordholt Nordholt

    1985-01-01

    The control of a legged locomotion system over uneven terrain requires a new approach to coordination. The system has a high degree of static indeterminacy and, because of the stiffness of the structural and actuation systems, has stability problems if position-velocity control is used. The problem has many similarities to that of grasping and manipulating an object in a multi-fingered

  13. Force and motion management in legged locomotion

    Microsoft Academic Search

    Kenneth J. Waldron

    1986-01-01

    The control of a legged locomotion system over uneven terrain requires a new approach to coordination. The system has a high degree of static indeterminacy and, because of the stiffness of the structural and actuation systems, has stability problems if position-velocity control is used. The problem has many similarities to that of grasping and manipulating an object in a multi-fingered

  14. OCEAN DRILLING PROGRAM LEG 101 PRELIMINARY REPORT

    E-print Network

    Brunswick, New Jersey) Arthur Moore (Marathon Oil Company, Littleton, Colorado) Henry Mullins (Syracuse Unversity, Syracuse, New York) Amanda Palmer (Ocean Drilling Program, Texas A&M University, College StationOCEAN DRILLING PROGRAM LEG 101 PRELIMINARY REPORT BAHAMAS James A. Austin, Jr. Co-Chief Scientist

  15. Gait pattern estimation for intelligent bionic leg

    Microsoft Academic Search

    Fei Wang; Shiguang Wen; Chengdong Wu

    2008-01-01

    Intelligent bionic leg (IBL) can restitute walking function for above-knee amputees. To realize symmetrical stable walking, IBL must be able to perceive the movement intention of amputee so as to actuate its knee joint accordingly when walking on various terrains with different cadences and stride length. Gait pattern estimation schemes using thigh kinematic data based on two classical pattern recognition

  16. OCEAN DRILLING PROGRAM LEG 108 SCIENTIFIC PROSPECTUS

    E-print Network

    . These sites will provide a latitudinal transect allowing integration of records of surface and deep-water Federal Republic of Germany Dr. Jack G. Baldauf Staff Scientist, Leg 108 Ocean Drilling Program Texas A & M University College Station, Texas 77843-3469 Philip W Rabin Direct Ocean Drilling Program

  17. SLIP running with an articulated robotic leg

    Microsoft Academic Search

    Marco Hutter; C. David Remy; Mark A. Höpflinger; Roland Siegwart

    2010-01-01

    SLIP models are generally known as one of the best and simplest abstractions describing the spring-like leg behavior found in human and animal running, and have thus been subject to exhaustive investigation. To exploit these findings in real robots, we utilize an operational space controller that projects the behavior of the SLIP model onto the dynamics of an actual segmented

  18. A Leg Exoskeleton Utilizing a Magnetorheological Actuator

    Microsoft Academic Search

    Jinzhou Chen; Wei-hsin Liao

    2006-01-01

    Exoskeleton systems that can enhance people's performance or assist disabled people have been investigated in recent years. However, most exoskeletons utilize DC motors with batteries as the driving source. While the motors require a lot of power, the working time of the exoskeletons is a limiting factor for the implementation of mobile exoskeletons. This paper proposes a new leg exoskeleton

  19. Neuropathy in a cohort of restless leg syndrome patients.

    PubMed

    Bastia, Jogendra K; Bhoi, Sanjeev K; Kalita, Jayantee; Misra, Usha K

    2015-08-01

    This study aims to evaluate the types of neuropathy in a cohort of restless leg syndrome (RLS) patients and compare them with primary RLS. RLS symptoms can occur in peripheral neuropathy and may cause diagnostic confusion, and there is a paucity of studies comparing neuropathic RLS and primary RLS. Patients with RLS diagnosed according to the international restless legs syndrome study group criteria were categorized as primary RLS or secondary. Those with evidence of peripheral neuropathy were categorized as neuropathic RLS. The demographic, clinical, laboratory profile and therapeutic response to dopamine agonists at 6months and 1year of neuropathic RLS patients were compared between primary and secondary RLS patients. There were 82 patients with RLS of whom 22 had peripheral neuropathy and 28 had primary RLS. The etiology of neuropathic RLS was diabetes mellitus in 13, renal failure in six, hypothyroidism in five, demyelinating in two, nutritional deficiency in three, leprosy in one, and miscellaneous etiologies in four patients. The neuropathic RLS patients were older (46.0±14.1 versus 35.8±15.4years), had shorter duration of illness (1.4±1.4 versus 6.2±6.2years) and were more frequently symptomatic. RLS symptoms were asymmetric in primary RLS patients compared to neuropathic RLS (25% versus 0%). The therapeutic response was similar in both groups. PMID:26094177

  20. OCEAN DRILLING PROGRAM LEGS 143 AND 144 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEGS 143 AND 144 SCIENTIFIC PROSPECTUS NORTHWEST PACIFIC ATOLLS AND GUYOTS-Milano 20113, Italy Dr. John Firth Staff Scientist, Leg 143 Ocean Drilling Program Texas A&M University Scientist, Leg 144 Ocean Drilling Program Texas A&M University Research Park 1000 Discovery Drive College

  1. The Significance of Leg Mass in Modeling Quadrupedal Running Gaits

    Microsoft Academic Search

    James Schmiedeler; Robert Siston; Kenneth Waldron

    In modeling running gaits of biological and robotic quadrupeds, leg mass is often neglected. Analysis of the system angular momentum in a biological model and a robot model indicates that including leg mass is significant in capturing the roll motion in trotting and pacing. Leg mass has a more significant effect on the pitch motion in bounding and is most

  2. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology

    Microsoft Academic Search

    Richard P Allen; Daniel Picchietti; Wayne A Hening; Claudia Trenkwalder; Arthur S Walters; Jacques Montplaisi

    2003-01-01

    Background: Restless legs syndrome is a common yet frequently undiagnosed sensorimotor disorder. In 1995, the International Restless Legs Syndrome Study Group developed standardized criteria for the diagnosis of restless legs syndrome. Since that time, additional scientific scrutiny and clinical experience have led to a better understanding of the condition. Modification of the criteria is now necessary to better reflect that

  3. The Bow Leg Hopping Robot Ben Brown and Garth Zeglin

    E-print Network

    Zeglin, Garth

    with a highly resilient leg that resembles an archer's bow. During flight, a ``thrust'' actuator adds elastic energy to the leg, which is automatically released during stance to control hopping height. LateralThe Bow Leg Hopping Robot Ben Brown and Garth Zeglin The Robotics Institute Carnegie Mellon

  4. Optimal motion planning of a one-legged hopping robot

    Microsoft Academic Search

    Guang-Ping He; Zhi-Yong Geng

    2007-01-01

    The optimal motion planning and stable jumping control for a new one-legged hopping robot are investigated. The new robot has one passive telescopic leg and two actuated arms, therefore an underactuated mechanical system of which the motion can only be controlled by the internal dynamic coupling. The features of the dynamic coupling between the passive leg and the actuated arms

  5. The Bow Leg Hopping Robot Ben Brown and Garth Zeglin

    E-print Network

    Zeglin, Garth

    with a highly resilient leg that resembles an archer's bow. During flight, a "thrust" actuator adds elastic energy to the leg, which is automatically released during stance to control hopping height. LateralThe Bow Leg Hopping Robot Ben Brown and Garth Zeglin The Robotics Institute Carnegie Mellon

  6. Athletic Footwear, Leg Stiffness, and Running Kinematics

    PubMed Central

    Bishop, Mark; Fiolkowski, Paul; Conrad, Bryan; Brunt, Denis; Horodyski, MaryBeth

    2006-01-01

    Context: The leg acts as a linear spring during running and hopping and adapts to the stiffness of the surface, maintaining constant total stiffness of the leg-surface system. Introducing a substance (eg, footwear) may affect the stiffness of the leg in response to changes in surface stiffness. Objective: To determine if the type of athletic footwear affects the regulation of leg stiffness in dynamic activities. Design: Repeated-measures design. Setting: Motion analysis laboratory. Patients or Other Participants: Nine healthy adults (age = 28 ± 6.8 years, mass = 71.6 ± 12.9 kg) free from lower extremity injuries. Intervention(s): Subjects hopped at 2.2 Hz on a forceplate under 3 footwear conditions (barefoot, low-cost footwear, high-cost footwear). Subjects ran on a treadmill at 2 speeds (2.23 m/s, 3.58 m/s) under the same footwear conditions. Main Outcome Measure(s): Limb stiffness was calculated from forceplate data. Kinematic data (knee and ankle angles at initial contact and peak joint excursion after contact) were collected during running. We calculated 1-way repeated-measures (stiffness) and 2-way (speed by footwear) repeated-measures analyses of variance (running kinematics) to test the dependent variables. Results: A significant increase in leg stiffness from the barefoot to the “cushioned” shoe condition was noted during hopping. When running shod, runners landed in more dorsiflexion but had less ankle motion than when running barefoot. No differences were seen between the types of shoes. The primary kinematic difference was identified as running speed increased: runners landed in more knee flexion. At the ankle, barefoot runners increased ankle motion to a significantly greater extent than did shod runners as speed increased. Conclusions: Footwear influences the maintenance of stiffness in the lower extremity during hopping and joint excursion at the ankle in running. Differences in cushioning properties of the shoes tested did not appear to be significant. PMID:17273463

  7. Water-soluble vitamin deficiencies in complicated peptic ulcer patients soon after ulcer onset in Japan.

    PubMed

    Miyake, Kazumasa; Akimoto, Teppei; Kusakabe, Makoto; Sato, Wataru; Yamada, Akiyoshi; Yamawaki, Hiroshi; Kodaka, Yasuhiro; Shinpuku, Mayumi; Nagoya, Hiroyuki; Shindo, Tomotaka; Ueki, Nobue; Kusunoki, Masafumi; Kawagoe, Tetsuro; Futagami, Seiji; Tsukui, Taku; Sakamoto, Choitsu

    2013-01-01

    We investigated over time whether contemporary Japanese patients with complicated peptic ulcers have any water-soluble vitamin deficiencies soon after the onset of the complicated peptic ulcers. In this prospective cohort study, fasting serum levels of water-soluble vitamins (vitamins B1, B2, B6, B12, C, and folic acid) and homocysteine were measured at 3 time points (at admission, hospital discharge, and 3 mo after hospital discharge). Among the 20 patients who were enrolled in the study, 10 consecutive patients who completed measurements at all 3 time points were analyzed. The proportion of patients in whom any of the serum water-soluble vitamins that we examined were deficient was as high as 80% at admission, and remained at 70% at discharge. The proportion of patients with vitamin B6 deficiency was significantly higher at admission and discharge (50% and 60%, respectively, p<0.05) than at 3 mo after discharge (10%). In conclusion, most patients with complicated peptic ulcers may have a deficiency of one or more water-soluble vitamins in the early phase of the disease after the onset of ulcer complications, even in a contemporary Japanese population. PMID:24477246

  8. [A multi-disciplinary approach to diabetic foot patients--an organizational model for the treatment of leg complications in diabetic patients].

    PubMed

    Zandman-Goddard, Gisele; Feldbrin, Zeev; Ovadia, Shmuel; Zubkov, Tatiana; Lipkin, Alexander; Wainstein, Julio; Vainstein, Hulio

    2011-07-01

    Diabetes mellitus is the major cause of non-traumatic limb amputations in the Western world. In the diabetic foot patient, 85% have developed a leg ulcer prior to limb amputation. Due to the complicated nature of therapy in such patients, a multi-disciplinary approach is warranted. In this review, we describe an organizational model which provides an immediate solution to the factors involved in the evolution of a diabetic foot. At the end of 2002, The Wolfson Medical Center administration decided to centralize the diabetic foot patients into one unit situated in the Department of Medicine C. Ten beds were allocated for this purpose and situated at the far end of the department reducing the potential spread of infections to the rest of the ward. With the opening of the unit, a multi-disciplinary team was established that included internists, orthopedists, vascular surgeons, diabeticians, infectious disease specialists, and a specialized nursing staff that acquired their expertise while working with the medical staff and consultants including plastic surgeons and orthotists as required. With the initiation of the Diabetic Foot Unit, there was a reduction of 50% in major amputations in the unit when compared to the preceding years. During the years 2003-2004, the major amputation rate dropped to Less than 8%. Treatment of the diabetic foot patient is complex. In order to reduce the morbidity of limb amputation, a Diabetic Foot Unit is justified. In addition, specialized staff working in concert enable a synergistic effort that cannot be acquired individually. Most importantly, the amputation rate can be significantly reduced by utilizing the Diabetic Foot Unit model. PMID:21874770

  9. Severe Ulcerative Esophagitis Induced by Crizotinib Therapy

    PubMed Central

    Craig, Jamie; Bajaj, Rajesh; Spurling, Timothy

    2014-01-01

    Crizotinib is an oral tyrosine-kinase inhibitor that inhibits anaplastic lymphoma kinase (ALK) in gene-rearranged non-small cell lung cancer (NSCLC). In 2011, the Food and Drug Administration approved crizotinib for treatment of locally advanced or metastatic ALK-positive NSCLC. The crizotinib adverse events profile included esophageal disorders in 11% of patients treated during trial phases I, II, and III, but none of them had severe events. We describe the development of severe ulcerative esophagitis secondary to crizotinib therapy and the re-introduction of therapy at a lower dose without recurrence of esophageal symptoms.

  10. Perforated marginal ulcers after laparoscopic gastric bypass

    Microsoft Academic Search

    Edward L. Felix; John Kettelle; Elijah Mobley; Daniel Swartz

    2008-01-01

    Background  Perforated marginal ulcer (PMU) after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a serious complication, but its incidence\\u000a and etiology have rarely been investigated. Therefore, a retrospective review of all patients undergoing LRYGB at the authors’\\u000a center was conducted to determine the incidence of PMU and whether any causative factors were present.\\u000a \\u000a \\u000a \\u000a Methods  A prospectively kept database of all patients at the

  11. Epithelial Cell Apoptosis in Recurrent Aphthous Ulcers.

    PubMed

    Al-Samadi, A; Drozd, A; Salem, A; Hietanen, J; Häyrinen-Immonen, R; Konttinen, Y T

    2015-07-01

    A recurrent aphthous ulcer (RAU) is a common inflammatory ulcerative lesion affecting oral mucosa. We studied the eventual apoptosis of epithelial cells from the point of view of ulcer and inflammation. RAU lesions and healthy mucosa samples were immunostained for caspase-3 and high-mobility group box 1 (HMGB1). DNA nicks were identified using TUNEL staining. We studied the effects of tumor necrosis factor ? (TNF?) and interferon ? (IFN?) on the toll-like receptor 2 and 4 (TLR2 and TLR4) expression of human oral SCC-25 keratinocytes. We also studied the effects of self-DNA, all-thiol-HMGB1, and disulfide-HMGB1 on epithelial cells, with or without IFN?. At the edge of RAU lesions, all epithelial cell layers were caspase-3(+), TUNEL(+), and HMGB-1(+) and had widened intercellular spaces. In contrast, healthy epithelial cells were negative for caspase-3 and TUNEL staining. HMGB1 was seen in only the basal cell layers, and the cells retained close cell-to-cell contacts. Self-DNA increased TNF-? mRNA (P = 0.02) in SCC-25 cells. Both TNF? and IFN? (P = 0.01) increased TLR2. Upon TNF? stimulation, SCC-25 cells lost their nuclear HMGB1 staining. HMGB1 did not increase IL-8, IL-6, or TNF-? mRNA in SCC-25 cells, which was unaffected by the presence of IFN?. We conclude that in healthy epithelium, the most superficial cells at the end of their life cycle are simply desquamated. In contrast, RAU is characterized by top-to-bottom apoptosis such that dead cells may slough off, leading to an ulcer. Because of a lack of scavenging anti-inflammatory macrophages, apoptotic cells probably undergo secondary necrosis releasing proinflammatory danger signals, which may contribute to the peripheral inflammatory halo. This is supported by self-DNA-induced TNF? synthesis. In contrast to TLR4- and TLR2-binding lipopolysaccharide used as a positive control, disulfide-HMGB1 did not stimulate proinflammatory cytokines. PMID:25861801

  12. Mechanisms of Disease: pathogenesis of Crohn's disease and ulcerative colitis

    Microsoft Academic Search

    R Balfour Sartor

    2006-01-01

    Crohn's disease and ulcerative colitis are idiopathic, chronic, relapsing, inflammatory conditions that are immunologically mediated. Although their exact etiologies remain uncertain, results from research in animal models, human genetics, basic science and clinical trials have provided important new insights into the pathogenesis of chronic, immune-mediated, intestinal inflammation. These studies indicate that Crohn's disease and ulcerative colitis are heterogeneous diseases characterized

  13. Current misunderstandings in the management of ulcerative colitis

    Microsoft Academic Search

    Thomas Ochsenkühn; Geert DHaens

    2011-01-01

    Past and ongoing therapeutic concepts for ulcerative colitis have only been moderately successful. A significant proportion of patients with ulcerative colitis will still have to undergo colectomy and overall half of the patients do not achieve sustained remission, leading to impairment of physical and mental health, social life, employment issues and sexual activity. Reluctance to treat patients early on with

  14. Anaerobic bacteria and herpes simplex virus in genital ulceration.

    PubMed Central

    Masfari, A N; Kinghorn, G R; Hafiz, S; Barton, I G; Duerden, B I

    1985-01-01

    Of 91 patients with genital ulceration, herpes simplex virus was isolated from 52 (57%) and Haemophilus ducreyi from 12 (13%); none had syphilis. The difference in incidence of other aerobes in patients and controls was not significant. Anaerobes, predominantly Bacteroides spp, were isolated from a large proportion (77%) of men and women patients with ulcers but from few control men. The most common anaerobic species were B asaccharolyticus and B ureolyticus, with fewer isolates of the melaninogenicus/oralis group. The bacterial flora of herpetic and non-herpetic ulcers were similar, but Candida albicans was isolated significantly more often from non-herpetic ulcers. Anaerobic bacteria may contribute to the pathogenesis of genital ulcers. PMID:2984108

  15. Tracheobronchitis with dyspnea in a patient with ulcerative colitis.

    PubMed

    Hiyoshi, Masaya; Kawai, Kazushige; Shibuya, Mihoko; Ozawa, Tsuyoshi; Kishikawa, Junko; Nirei, Takako; Tanaka, Toshiaki; Tanaka, Junichiro; Kiyomatsu, Tomomichi; Tada, Tomohiro; Kanazawa, Takamitsu; Kazama, Shinsuke; Shoda, Hirofumi; Sumitomo, Shuji; Kubo, Kanae; Yamaguchi, Hironori; Ishihara, Soichiro; Sunami, Eiji; Kitayama, Joji; Yamamoto, Kazuhiko; Watanabe, Toshiaki

    2015-01-01

    We herein report the case of a 42-year-old man with a one-year history of ulcerative colitis who presented with exacerbated bloody diarrhea, a productive cough and increasing breathing difficulties. Colonoscopy revealed typical deep ulcers in the rectosigmoid colon and atypical multiple sucker-like ulcers in the transverse colon, and computed tomography of the chest demonstrated wall thickening of the trachea and bronchi. In addition, bronchoscopy showed ulcers in the trachea, and histopathology disclosed findings of necrosis and inflammation of the subepithelial tissue of the trachea. Based on these findings, the patient's respiratory symptoms were strongly suspected to be due to ulcerative colitis-related tracheobronchitis. Treatment with systemic corticosteroids subsequently resulted in a rapid clinical improvement. PMID:25832936

  16. Ulcerative colitis: epidemiology, diagnosis, and management.

    PubMed

    Feuerstein, Joseph D; Cheifetz, Adam S

    2014-11-01

    Ulcerative colitis is a chronic idiopathic inflammatory bowel disease characterized by continuous mucosal inflammation that starts in the rectum and extends proximally. Typical presenting symptoms include bloody diarrhea, abdominal pain, urgency, and tenesmus. In some cases, extraintestinal manifestations may be present as well. In the right clinical setting, the diagnosis of ulcerative colitis is based primarily on endoscopy, which typically reveals evidence of continuous colonic inflammation, with confirmatory biopsy specimens having signs of chronic colitis. The goals of therapy are to induce and maintain remission, decrease the risk of complications, and improve quality of life. Treatment is determined on the basis of the severity of symptoms and is classically a step-up approach. 5-Aminosalycilates are the mainstay of treatment for mild to moderate disease. Patients with failed 5-aminosalycilate therapy or who present with more moderate to severe disease are typically treated with corticosteroids followed by transition to a steroid-sparing agent with a thiopurine, anti-tumor necrosis factor agent, or adhesion molecule inhibitor. Despite medical therapies, approximately 15% of patients still require proctocolectomy. In addition, given the potential risks of complications from the disease itself and the medications used to treat the disease, primary care physicians play a key role in optimizing the preventive care to reduce the risk of complications. PMID:25199861

  17. Augmentation in Restless Legs Syndrome: Treatment with Gradual Medication Modification

    PubMed Central

    Rosenstein, Adam; Rabin, Marcie; Kurlan, Roger

    2015-01-01

    Dopaminergic drugs can cause augmentation during the treatment of restless legs syndrome (RLS). We previously reported that sudden withdrawal of dopaminergic treatment was poorly tolerated. We now report our experience with gradual withdrawal of the dopaminergic drug during the drug substitution process using a retrospective chart review with comparison to previous data. Seven patients with RLS and dopaminergic drug-induced augmentation were treated with a gradual withdrawal of the offending drug and replacement with an alternative medication. Compared to sudden withdrawal, measured outcomes were similar but gradual tapering was better tolerated. We conclude that for augmentation in RLS, gradual tapering of the augmentation-inducing dopaminergic drug is better tolerated than sudden withdrawal. The optimal approach to treating augmentation has not been established and may differ between patients. Further study with direct comparison of strategies and a larger patient population is needed to confirm our preliminary observations. PMID:26106453

  18. Restless legs syndrome: diagnosis and review of management options

    PubMed Central

    Byrne, Ruth; Sinha, Smita; Chaudhuri, K Ray

    2006-01-01

    Restless legs syndrome (RLS) is one of the commonest movement disorders affecting sleep and also daytime functioning. The prevalence may be 8%–10% of the white Caucasian population. The diagnosis is simple and is based on a well-validated clinical questionnaire, yet misdiagnosis is common and the condition remains underdiagnosed and consequently inappropriately treated, often causing great distress to the sufferers. In spite of robust evidence for effective treatment of RLS, patients may often be told to “put up with the symptoms” and suffer the consequence of years of poor sleep which may lead to major lifestyle changes. This review addresses the diagnostic issues, the differential diagnosis, and the evidence base for treatment of the common condition. PMID:19412460

  19. Evaluation of lower leg function in patients with Achilles tendinopathy.

    PubMed

    Silbernagel, Karin Grävare; Gustavsson, Alexander; Thomeé, Roland; Karlsson, Jon

    2006-11-01

    Achilles tendinopathy is considered to be one of the most common overuse injuries in elite and recreational athletes. However, the effect that the Achilles tendinopathy has on patients' physical performance is still unclear. The purpose of this study was to evaluate if Achilles tendinopathy caused functional deficits on the injured side compared with the non-injured side in patients. A test battery comprised of tests for different aspects of muscle-tendon function of the gastrocnemius, soleus and Achilles tendon complex was developed to evaluate lower leg function. The test battery's test-retest reliability and sensitivity (the percent probability that the tests would demonstrate abnormal lower limb symmetry index in patients) were also evaluated. The test battery consisted of three jump tests, a counter movements jump (CMJ), a drop counter movement jump (drop CMJ) and hopping, and two strength tests, concentric toe-raises, eccentric-concentric toe-raises and toe-raises for endurance. The reliability was evaluated through a test-retest design on 15 healthy subjects. The test battery's sensitivity and possible functional deficits in patients with Achilles tendinopathy were evaluated on 42 patients (19 women and 23 men). An excellent reliability was found between test days 1-2 and 2-3 for all tests (ICC = 0.76-0.94) except for concentric toe-raise, test 2-3, which had fair reliability (ICC = 0.73). The methodological error ranged from 8 to 17%. There were significant differences (P = 0.001-0.049) between the non-injured (or least symptomatic) side and injured (most symptomatic) side for hopping, drop CMJ, concentric and eccentric-concentric toe-raises, and significant differences (P = 0.000-0.012) in the level of pain during CMJ, hopping, and drop CMJ. The sensitivity of the test battery at a 90% capacity was 88. Achilles tendinopathy causes not only pain and symptoms in patients but also apparent impairments in various aspects of lower leg muscle-tendon function as measured with the test battery. This test battery is reliable and able to detect differences in lower leg function between the injured or "most symptomatic" and non-injured or "least symptomatic" side in patients with Achilles tendinopathy. The test battery has higher demand on patients' function compared with each individual test. PMID:16858560

  20. Leg regeneration in the cockroach, Blattella germanica

    Microsoft Academic Search

    Vernon French

    1976-01-01

    The interactions occuring between graft and host leg epidermis at a congruent junction (non-rotated, homopleural combination of components cut perpendicular to the proximal-distal axis) were studied at the tibia level in the cockroach,Blattella germanica. Grafts were made between dark (Bl) and light (br) cuticle colour mutants.1)Precise boundaries could not usually be drawn between Bl and br tissue over areas of