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1

Venous leg ulcers  

PubMed Central

Introduction Leg ulcers usually occur secondary to venous reflux or obstruction, but 20% of people with leg ulcers have arterial disease, with or without venous disorders. Between 1.5 and 3.0/1000 people have active leg ulcers. Prevalence increases with age to about 20/1000 in people aged over 80 years. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of standard treatments, adjuvant treatments, and organisational interventions for venous leg ulcers? What are the effects of interventions to prevent recurrence of venous leg ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 80 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: compression bandages and stockings, cultured allogenic (single or bilayer) skin replacement, debriding agents, dressings (cellulose, collagen, film, foam, hyaluronic acid-derived, semi-occlusive alginate), hydrocolloid (occlusive) dressings in the presence of compression, intermittent pneumatic compression, intravenous prostaglandin E1, larval therapy, laser treatment (low-level), leg ulcer clinics, multilayer elastic system, multilayer elastomeric (or non-elastomeric) high-compression regimens or bandages, oral treatments (aspirin, flavonoids, pentoxifylline, rutosides, stanozolol, sulodexide, thromboxane alpha2 antagonists, zinc), peri-ulcer injection of granulocyte-macrophage colony-stimulating factor, short-stretch bandages, single-layer non-elastic system, skin grafting, superficial vein surgery, systemic mesoglycan, therapeutic ultrasound, self-help (advice to elevate leg, advice to keep leg active, advice to modify diet, advice to stop smoking, advice to reduce weight), and topical treatments (antimicrobial agents, autologous platelet lysate, calcitonin gene-related peptide plus vasoactive intestinal polypeptide, freeze-dried keratinocyte lysate, mesoglycan, negative-pressure recombinant keratinocyte growth factor, platelet-derived growth factor). PMID:19445798

2008-01-01

2

Leg ulcers and lymphoedema  

Microsoft Academic Search

Leg ulcers are a common and costly problem that can be influenced by a number of medical conditions. It is imperative that the correct diagnosis is made and therefore a thorough medical history plus careful examination of the wound and the surrounding skin is required. At each visit the maximal longitudinal length should be recorded and the wound documented photographically.

Kate Short; Richard Bull

2009-01-01

3

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

PubMed

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

Spoljar, Sanja

2014-10-01

4

Chronic ulcer of the leg: clinical history  

Microsoft Academic Search

Six hundred patients with chronic leg ulcers were studied by detailed history and examination as part of a population survey. In 22% ulceration began before the age of 40, and in this group the sex incidence was equal. Over age 40 there was an increasing preponderance of women. Ulcers were significantly more common in the left leg in women but

M J Callam; D R Harper; J J Dale; C V Ruckley

1987-01-01

5

Causes, investigation and treatment of leg ulceration  

Microsoft Academic Search

Summary Chronic ulceration of the lower leg is a frequent condition, with a prevalence of 3-5% in the population over 65 years of age. The incidence of ulceration is rising as a result of the ageing population and increased risk factors for atherosclerotic occlusion such as smoking, obesity and diabetes. Ulcers can be defined as wounds with afull thickness depthand

J. R. Mekkes; M. A. M. Loots; Wal van der A. C; J. D. Bos

2003-01-01

6

Vascular leg ulcers: histopathologic study of 293 patients.  

PubMed

: Vascular leg ulcers remain a challenge for the modern health care, and a systematic pathological study on this kind of lesions has not been reported so far. A total of 293 consecutive white patients with chronic leg ulcers (present for a minimum of 6 months and up to several years) referred to the Wound Care Unit (Dermatology, University of Bologna) between March 2008 and June 2011. Thirty-four patients affected by other than vascular ulcers, neoplastic or inflammatory conditions, were excluded. The remaining 259 patients affected by vascular leg ulcers were enrolled in this study. Assessment of the patients general health, skin biopsy, and vascular Doppler of the lower limbs were performed to determine the etiology and to formulate an appropriate management plan, whereas 2 punch biopsies of 3 mm were performed on the border and on the bed of each ulcer. Doppler evaluation showed the presence of vascular hemodynamic impairment in 259 patients. Of these, 181 (69.9%) patients were affected by venous insufficiency, 58 (22.4%) by venous and arterial insufficiency, and 20 (7.7%) by arterial insufficiency. Histopathologic features revealed significant differences, thus, reflecting the clinicopathologic correlation with the underlying hemodynamic impairments. In conclusion, histopathologic and hemodynamic data correlation could provide the basis for future analysis of leg ulcers pathogenesis and may improve treatment protocols. We should underline that this observational study represents a single-institute experience and that larger series are needed to confirm our observations. PMID:25072681

Misciali, Cosimo; Dika, Emi; Baraldi, Carlotta; Fanti, Pier Alessandro; Mirelli, Michele; Stella, Andrea; Bertoncelli, Marco; Patrizi, Annalisa

2014-12-01

7

The etiology of venous ulceration  

Microsoft Academic Search

Venous ulceration is caused by the disorganization of the microcirculation that is induced by prolonged venous hypertension. The most common cause of calf pump inefficiency that permits superficial venous hypertension during exercise is deep vein thrombosis. Venous hypertension causes venular dilatation and an increased capillary permeability. Fibrin is deposited around the capillaries and not removed because of a vein wall

N. L. Browse

1986-01-01

8

Venous leg ulcer pain and its characteristics.  

PubMed

This study investigated the prevalence, severity and characteristics of pain associated with venous leg ulceration. Sixty-five patients suffering with venous leg ulceration were randomised to one of three treatment groups over a 12-week treatment period. All patients received short-stretch compression bandaging. Data were collected by use of a visual analogue scale and the McGill Pain Questionnaire. Seventy per cent of patients reported pain on entry to the study and within 2 weeks of effective treatment initial pain was dramatically reduced. Patients typically described their pain as throbbing, sharp, itchy, sore and tender. The affective nature of pain was often described as tiring and patients evaluated their pain as being annoying and nagging. This study highlights the importance of pain associated with venous leg ulceration. PMID:12476504

Charles, Hildegard

2002-10-01

9

Leg ulceration in venous disease.  

PubMed Central

We have given a brief summary of the scale of the problem caused by venous ulceration in the UK, and have then reviewed the various theories of causation, including a historical survey, and presented the evidence for and against the two main current theories of fibrin cuffs and white cell trapping. We also outline previous hypotheses of the aetiology of venous ulceration, including arteriovenous microanastomoses, stasis and oedema. The contribution of superficial venous incompetence in the pathogenesis of ulceration is also examined. PMID:1461849

Shami, S. K.; Shields, D. A.; Scurr, J. H.; Smith, P. D.

1992-01-01

10

Etiology and Incidence of Pressure Ulcers in Surgical Patients  

Microsoft Academic Search

This experimental study was designed to identify the etiology of pressure ulcers in a surgical sample and to evaluate a special OR mattress overlay in preventing pressure ulcer development. Surgical patients (N = 413) were randomized to receive “usual perioperative care” or the new mattress overlay. Over six postoperative days, 89 patients (21.5%) developed pressure ulcers, primarily stage I. Only

Alyce A. Schultz; Maureen Bien; Karen Dumond; Kathleen Brown; Amanda Myers

1999-01-01

11

The etiology of pressure ulcers: Skin deep or muscle bound?  

Microsoft Academic Search

Bouten CV, Oomens CW, Baaijens FP, Bader DL. The etiology of pressure ulcers: skin deep or muscle bound? Arch Phys Med Rehabil 2003;84:616-9. Pressure ulcers are areas of soft tissue breakdown that result from sustained mechanical loading of the skin and underlying tissues; they can affect the quality of life of many individuals. Despite considerable efforts to prevent pressure ulcers,

Carlijn V. Bouten; Cees W. Oomens; Frank P. Baaijens; Daniel L. Bader

2003-01-01

12

Klinefelter's syndrome presenting with leg ulcers.  

PubMed

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

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

2004-01-01

13

Prevalence and aetiology of leg ulcers in Ireland  

Microsoft Academic Search

Background  The prevalence of leg ulcer disease in Ireland has been poorly documented.\\u000a \\u000a \\u000a \\u000a Aims  This study aimed to investigate the aetiology and prevalence of leg ulcers in one health district.\\u000a \\u000a \\u000a \\u000a Methods  All patients receiving healthcare for an active leg ulcer in the Mid-Western Health Board (MWHB) region of Ireland (population:\\u000a 317,069) were identified in a defined two-month period. A cross-sectional survey of all

J. F. O’Brien; P. A. Grace; I. J. Perry; P. E. Burke

2000-01-01

14

[Comprehensive treatment of venous ulcer of the leg].  

PubMed

A comprehensive approach to the treatment of venous leg ulcer is described. Its main characteristics are: 1. Maximum debridement of wound area of the ulcer and suppressing of its microbial contamination 2. Wound conditioning and its preparation for autografting and especially 3. Simultaneous operation of varicose veins (stripping of vena saphena and ligature of venae perforates Cocketti) and application of dermoepidermal autograft to the ulcer. The procedure is presented as a case report. PMID:8948161

Brychta, P; Cerbák, P

1996-08-01

15

Secondary hyperparathyroidism: Uncommon cause of a leg ulcer  

PubMed Central

INTRODUCTION Most leg ulcers are vascular based. Only if vascular therapy fails other causes are considered. We report the case of a female with incapacitating leg ulcers caused by a rare condition which was only diagnosed after failing treatment. PRESENTATION OF CASE The female had an extensive previous history including diabetes, renal insufficiency and cardiovascular disease and presented with three large and painful ulcers on her left lower leg. Standard treatment with antibiotics, wound excision and additional treatment with hyperbaric oxygen were ineffective. One month post hospital-admission calciphylaxis cutis caused by renal failure induced secondary hyperparathyroidism was diagnosed. Surgical treatment by a parathyroidectomy induced rapid regeneration of the ulcers. DISCUSSION Our patient's vast comorbidity and previous history had expanded differential considerations causing a delay in diagnosis. Our patient's previous history led us to believe her ulcers were vascular based, however her chronic renal failure appeared responsible for her condition. CONCLUSION Although less probable than venous insufficiency and concomittant leg ulcers or other differential considerations, calciphylaxis cutis should be part of the differential diagnosis in any end stage renal disease-patient with unexplained ulcers as an effective therapy is readily available. PMID:22288037

van Rijssen, L.B.; Brenninkmeijer, E.E.A.; Nieveen van Dijkum, E.J.M.

2011-01-01

16

A systematic review of compression treatment for venous leg ulcers.  

PubMed Central

OBJECTIVE: To estimate the clinical and cost effectiveness of compression systems for treating venous leg ulcers. METHODS: Systematic review of research. Search of 19 electronic databases including Medline, CINAHL, and Embase. Relevant journals and conference proceedings were hand searched and experts were consulted. MAIN OUTCOME MEASURES: Rate of healing and proportion of ulcers healed within a time period. STUDY SELECTION: Randomised controlled trials, published or unpublished, with no restriction on date or language, that evaluated compression as a treatment for venous leg ulcers. RESULTS: 24 randomised controlled trials were included in the review. The research evidence was quite weak: many trials had inadequate sample size and generally poor methodology. Compression seems to increase healing rates. Various high compression regimens are more effective than low compression. Few trials have compared the effectiveness of different high compression systems. CONCLUSIONS: Compression systems improve the healing of venous leg ulcers and should be used routinely in uncomplicated venous ulcers. Insufficient reliable evidence exists to indicate which system is the most effective. More good quality randomised controlled trials in association with economic evaluations are needed, to ascertain the most cost effective system for treating venous leg ulcers. PMID:9302954

Fletcher, A.; Cullum, N.; Sheldon, T. A.

1997-01-01

17

Leg ulcers in the eighteenth and early nineteenth centuries  

PubMed Central

Compared to today, ulceration of the legs was much more common in the eighteenth and early nineteenth centuries and occurred in much younger people. The evidence for this, based mainly on the records of the hospitals, the dispensaries and medical records of the navy and army, is discussed. It is likely that the underlying pathology was much more varied in the past, with the possibility that ascorbic acid deficiency played a significant part in the high frequency of leg ulcers. Imagesp265-a PMID:7031237

Loudon, I. S. L.

1981-01-01

18

LEG ULCERS IN SICKLE CELL DISEASE: CURRENT PATTERNS AND PRACTICES  

PubMed Central

Leg ulcers are a debilitating complication of patients with sickle cell disease, and their frequency in North America was reported to be 2.5% by the Cooperative Study of Sickle Cell Disease more than 20 years ago. We sought to determine if the frequency of leg ulcers in sickle cell patients in the United States had declined and to assess which treatments providers use most commonly. We sent an e-mail survey to health professionals belonging to the national Sickle Cell Adult Provider Network. Responses were obtained from 31 of them (26.0%). Most of them (96.0%) reported having some patients with leg ulcers. Providers reported a total of 185 patients with active leg ulcers and 224 in the previous 5 years, for a total of 409 patients. Hb SS (homozygous sickle cell anemia) was the most common genotype of affected individuals, followed by Hb SC (double heterozygote for Hb S [?6(A3)Glu?Val, GAG>GTG; HBB: c.20A>T] and Hb C [?6(A3)Glu?Lys, GAG>AAG; HBB: c.19G>A]). Males showed a 2:1 predominance. Two-thirds of patients were treated with either hydroxyurea (HU) or transfusion therapy and most used compression stockings and topical therapies as directed by wound care services. We conclude that leg ulcers continue to be a debilitating complication of young adults with sickle cell disease, despite improved supportive care and the widespread use of disease modifying agents such HU and transfusion. While some providers offer office-based ulcer care, the majority prefer specialty consultation including podiatry, plastic surgery and dermatology. Despite their frequency, there is no clear consensus among providers as to the best treatment. PMID:23600469

Delaney, Kara-Marie H.; Axelrod, Karen C.; Buscetta, Ashley; Hassell, Kathryn L.; Adams-Graves, Patricia E.; Seamon, Catherine; Kato, Gregory J.; Minniti, Caterina P.

2013-01-01

19

Nonlinear modeling of venous leg ulcer healing rates  

Microsoft Academic Search

BACKGROUND: The purpose of this manuscript was to determine whether the change in wound surface area over time could be described through nonlinear mathematics. METHODS: We studied 3,588 serial wound tracings of 338 venous leg ulcers (VLUs) that had been followed during a controlled, prospective, randomized trial of two topical wound treatments. RESULTS: A majority (72%) of VLUs exhibited surface

Matthew Cardinal; Tania Phillips; David E Eisenbud; Keith Harding; Jonathan Mansbridge; David G Armstrong

2009-01-01

20

Older women's experience of living with chronic leg ulceration.  

PubMed

In this study the authors sought to gain insight into the lives of older women, to focus on the experience of living with leg ulcers and to explore women's views by talking to them about their experiences. Twelve English-speaking women aged over 70 years who had experienced leg ulceration for 3 years or more were interviewed. Analysis of the interview text revealed two overarching themes: (i) gaining and maintaining control over vulnerable limb(s); and (ii) lifestyle consequences of chronic leg ulceration and impaired mobility. These themes contained several subthemes including: (i) nagging pain; (ii) self-expertise and infection; (iii) leakage, smell and embarrassment; (iv) fighting for skin and limb integrity; (v) wearing non-preferred apparel; (vi) loneliness; and (vii) coping, determination and hope. The findings of this research show that elderly women who live with leg ulcers experience multiple consequences. While the everyday problems of living with an unhealed would are addressed by the community nurse, other more subtle consequences may be overlooked. Recognition of the complex and sometimes hidden concerns of these women could help to avert the sense of helplessness which currently exists. PMID:10839029

Hyde, C; Ward, B; Horsfall, J; Winder, G

1999-12-01

21

Venous leg ulcer care: How evidence-based is nursing practice?  

Microsoft Academic Search

Objectives: The objectives of this study were to (1) determine how congruent community-provided leg ulcer care was with best practice for venous leg ulcers and (2) identify organizational and clinical factors associated with the provision of best practice for venous leg ulcers. Design: The practice variation study group was an audit of nursing agency client records to determine the provision

Karen R. Lorimer; Margaret B. Harrison; Ian D. Graham; Elaine Friedberg; Barbara Davies

2003-01-01

22

Topical Treatment of Nonhealing Venous Leg Ulcer with Propolis Ointment  

PubMed Central

An investigation of effectiveness of topical treatment of nonhealing chronic venous leg ulcers with propolis ointment was conducted. 56 patients were included in the study and randomized into two groups. In group 1, there were 28 patients (ulceration area: 6.9–9.78?cm2) treated by means of topical propolis ointment application and short stretch bandage compression. In group 2, there were 29 patients (ulceration area: 7.2–9.4?cm2) treated by means of Unna boot leg compression without topical propolis treatment. In the study, the efficacy of both treatment methods in patients with resistive venous leg ulcers was compared. The ulceration of patients from group 1 healed completely after 6 weeks of therapy in all cases. In all patients from group 2, the process of healing was longer but successfully completed after 16 weeks of the therapy. We found that an adjunctive propolis ointment treatment increases the efficacy of the short stretch bandage compression stocking, and this combined treatment is more effective than Unna's boot compression alone. PMID:23662121

Kucharzewski, M.; Kozka, M.; Urbanek, T.

2013-01-01

23

Topical treatment of nonhealing venous leg ulcer with propolis ointment.  

PubMed

An investigation of effectiveness of topical treatment of nonhealing chronic venous leg ulcers with propolis ointment was conducted. 56 patients were included in the study and randomized into two groups. In group 1, there were 28 patients (ulceration area: 6.9-9.78?cm(2)) treated by means of topical propolis ointment application and short stretch bandage compression. In group 2, there were 29 patients (ulceration area: 7.2-9.4?cm(2)) treated by means of Unna boot leg compression without topical propolis treatment. In the study, the efficacy of both treatment methods in patients with resistive venous leg ulcers was compared. The ulceration of patients from group 1 healed completely after 6 weeks of therapy in all cases. In all patients from group 2, the process of healing was longer but successfully completed after 16 weeks of the therapy. We found that an adjunctive propolis ointment treatment increases the efficacy of the short stretch bandage compression stocking, and this combined treatment is more effective than Unna's boot compression alone. PMID:23662121

Kucharzewski, M; Kózka, M; Urbanek, T

2013-01-01

24

Leg ulcer plastic surgery descent by laser therapy  

NASA Astrophysics Data System (ADS)

Low energy laser therapy (LELT) was used to treat chronic leg ulcers. Seven patients, aged 59 to 96 years, with 11 leg ulcers were referred for laser therapy by plastic surgeons. They had a history of ulceration of 3 - 50 years and five of the patients had breakdown of previous skin grafts. Laser treatments were administered with a microprocessor-controlled device. A 22 red ((lambda) equals 660 nm) laser head was utilized to provide a dose of (4 - 6) J/cm2 and 7 infrared ((lambda) equals 880 nm) head to provide a dose of (4 - 8) J/cm2. The patients were treated three to five times per week, 25 - 30 treatments per course. Three patients underwent two courses of laser therapy with three weeks interval between them. All patients, after 5 - 10 laser treatments, have gotten relief of pain and decreased the amount of analgesics used. All ulcers in six patients were completely healed and two ulcers in the seventh patient decreased in size by 75%. One may conclude the developed laser methodology might be used as a preventative measure to avoid plastic surgery or improve its success.

Telfer, Jacqui; Filonenko, Natalia; Salansky, Norman M.

1994-02-01

25

Factors influencing community nurses' treatment of leg ulcers.  

PubMed

Clinical effectiveness and evidence-based practice are a central feature of the clinical governance framework. Few studies have examined factors that motivate nurses to change practice in line with evidence-based guidelines. The overall aim of this exploratory study was to examine community nurses' experience of taking part in a clinical effectiveness programme for the management of leg ulcers in the community and to identify factors most likely to ensure a change in practice. The implementation programme was conducted in the general practices within one district of a primary care audit group. Face-to-face interviews were conducted with all practice nurses and district nurses involved in the care of patients with leg ulcers from the participating practices. Nurses identified the presence of a credible facilitator, visible benefits for patients and a desire to carry out their work in an evidence-based way as factors likely to influence change. However, the degree of change achieved was not uniform across all participants and three typologies of nurses were identified according to their attitudes and level of involvement. PMID:11826316

Ruston, Annmarie

26

A systematic review on the impact of leg ulceration on patients' quality of life  

Microsoft Academic Search

BACKGROUND: A systematic review was conducted to analyse journal articles that describe or measure the impact of leg ulceration on patients' quality of life (QoL) in order to improve the content of an educational programme that aims to enhance self-care agency in leg ulcer patients. METHOD: Original articles published in English and German between 1990 and 2006 were included if

Oliver R Herber; Wilfried Schnepp; Monika A Rieger

2007-01-01

27

Association between venous leg ulcers and sex chromosome anomalies in men.  

PubMed

We report here two cases of men, aged 46 and 23 years, with refractory chronic venous leg ulcers in association with sex chromosome aberrations: one with a 47,XXY/48,XXXY karyotype (Klinefelter syndrome) and the other with a 47,XYY karyotype (Jacob syndrome). In both patients, the occurrence of leg ulcers was the reason for seeking medical care; their medical history was other-wise unremarkable. Chromosomal analyses were performed due to the unusually young age for development of venous leg ulcers. The pathophysiology behind the occurrence of venous leg ulcers in patients with numerical aberrations of the sex chromosomes is incompletely understood. Involvement of elevated plasminogen activator inhibitor-1 levels in the pathogenesis of venous leg ulcers has been reported in patients with Klinefelter syndrome. Notably, our patient with 47,XXY/48,XXXY presented with androgen deficiency but normal plasminogen activator inhibitor-1 activity. PMID:21057745

Gattringer, Cornelia; Scheurecker, Christine; Höpfl, Reinhard; Müller, Hansgeorg

2010-11-01

28

Larval therapy for leg ulcers (VenUS II): randomised controlled trial  

Microsoft Academic Search

Objective To compare the clinical effectiveness of larval therapy with a standard debridement technique (hydrogel) for sloughy or necrotic leg ulcers.Design Pragmatic, three armed randomised controlled trial.Setting Community nurse led services, hospital wards, and hospital outpatient leg ulcer clinics in urban and rural settings, United Kingdom.Participants 267 patients with at least one venous or mixed venous and arterial ulcer with

Jo C Dumville; Gill Worthy; J Martin Bland; Nicky Cullum; Christopher Dowson; Cynthia Iglesias; Joanne L Mitchell; E Andrea Nelson; Marta O Soares; David J Torgerson

2009-01-01

29

Gastrointestinal tract ulcers in pediatric intestinal transplantation patients: etiology and management.  

PubMed

One of the observed complications in patients after intestinal transplantation is the occurrence of ulcers in the native or transplanted gastrointestinal tract. Previous reports have described the appearance of ulcers but have not described any systemic approach to accurately diagnose the etiology of the ulcer. We evaluated 112 intestinal transplantation patients at our institution, in which endoscopic examination identified ulcer formation in 11 patients. No common or defining demographic or clinical variables were found in the patients with ulcers. Biopsies were obtained from the ulcer edge as well as the intervening mucosa. The most common changes in the ulcers were compatible with post-transplant lymphoproliferative disorder (PTLD), acute rejection, and viral infections. These changes could occur simultaneously and retrospective analysis showed that ulcers could have concomitant etiologies. Endoscopically directed biopsies of ulcer edges often displayed morphologic changes compatible with acute rejection of the graft. Some patients were treated for rejection based on the changes within the mucosa outside the ulcer bed, and they responded with resolution of the ulcers. Our findings demonstrate that PTLD and acute rejection are the most common causes of chronic ulcer formation and reinforce the concept that biopsy samples should be collected simultaneously from both the ulcer edge and intervening mucosa. PMID:16573601

Sarkar, Shampa; Selvaggi, Gennaro; Mittal, Naveen; Cenk Acar, B; Weppler, Debbie; Kato, Tomoaki; Tzakis, Andreas; Ruiz, Phillip

2006-03-01

30

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

PubMed Central

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

Lucas, Antoine; Pierard, Gerald E.; Hermanns-Le, Trinh; De Paepe, Anne; Dupuy, Alain

2013-01-01

31

Management of non-healing leg ulcers in Unani system of medicine.  

PubMed

Non-healing leg ulcers are becoming a major public health problem. The high prevalence of leg ulcer directly affects patients' quality of life because it produces psychological (anxiety, depression), social and physical (amputation) handicap. Most leg ulcers become unsightly and they hardly if ever, yield to conventional treatment. Healing of an amputated part may pose a problem, hence amputation cannot be recommended without extensive pre-operative investigations. Prevalence is high among the poor, for whom expenses of surgery are not affordable. Few surgeons try skin graft but unfavourable local condition of the ulcer leads to rejection and all efforts prove futile. Keeping all these factors in mind, we have tested a Unani formulation for its ulcer healing properties; early results were surprising and in some cases unbelievable. PMID:23116214

Zulkifle, Mohd; Ansari, Abdul H; Shakir, Mohd; Kamal, Zahid; Alam, M Tanwir

2014-08-01

32

Managing a venous leg ulcer in the 21st century, by improving self-care.  

PubMed

This paper examines the context of managing a long-term condition within the community environment using appropriate evidence-based literature. It is a case study that focuses upon concordance with compression bandaging in treating venous leg ulceration and preventing ulcer recurrence through a well leg clinic. The challenges of this episode of care and the interventions put in place to improve concordance and promote self-care will be explained and analysed. PMID:23124371

Yarwood-Ross, Lee; Haigh, Carol

2012-10-01

33

Nonlinear modeling of venous leg ulcer healing rates  

PubMed Central

Background The purpose of this manuscript was to determine whether the change in wound surface area over time could be described through nonlinear mathematics. Methods We studied 3,588 serial wound tracings of 338 venous leg ulcers (VLUs) that had been followed during a controlled, prospective, randomized trial of two topical wound treatments. Results A majority (72%) of VLUs exhibited surface area reduction via an exponential decay model, particularly during the early stages of healing. These results were consistent with the mechanics of wound contraction and epithelial cell proliferation, supported by the higher frequency at which exponential surface area reduction associated with full wound closure (35% of wounds that fit the exponential model healed vs. 21% of wounds that did not fit the exponential model completely healed during the study period, p = 0.018). Goodness-of-fit statistics suggested that much of the individual variation in healing could be described as nonlinear variation from the exponential model. Conclusion We believe that parameter estimates from a mathematical model may provide a more accurate quantification of wound healing rates, and that similar models may someday reach routine use in comparing the efficacy of various treatments in routine practice and in product registration trials. PMID:19335882

Cardinal, Matthew; Phillips, Tania; Eisenbud, David E; Harding, Keith; Mansbridge, Jonathan; Armstrong, David G

2009-01-01

34

Clinician's perspectives on the treatment of venous leg ulceration.  

PubMed

Treatment of venous leg ulcers (VLU) represents a considerable challenge to the health care professional and to the patient alike. Much of the current literature regarding VLU focuses on either wound pathophysiology and treatment of chronic venous insufficiency or the patients' experience of the condition. We present two studies that examine more closely the clinicians' experience of treating VLU and reflect upon how that understanding may further enhance better outcomes for patients in the future. The first of these studies is a qualitative investigation of 49 clinicians treating VLU in the UK and USA. The second is a quantitative, online survey of 304 clinicians' beliefs, attitudes and practices in the UK, Germany and USA. Findings show that the clinicians' experience of treating VLU is often accompanied by frustration and dissatisfaction with treatment challenges and uncertain outcomes. Practices and treatment choices were found to vary widely and differ by countries. We conclude that a key aspect in improving VLU treatment is in listening to the frustrations of the clinician when considering new approaches to therapy. PMID:19912394

Cullen, George H; Phillips, Tania J

2009-10-01

35

[Upper digestive tract bleeding from ulcer with unusual etiology].  

PubMed

Case report of 40 year old female, admitted in emergency because signs and symptoms of upper digestive tract bleeding. Reappearance of bleeding, during haemodynamic compensation and dramatic installation of a haemorrhagic shock determines the surgical intervention for haemostasis. During surgery we discovered a duodenal ulcer with hypertrophic vessels, penetrating the gallbladder, that in its clinical course eroded the cystic artery. We performed bipolar cholecystectomy; removed the duodenal ulcer with anterior pilorectomy, Burlui antro-duodenostomy with a favorable postoperative course. PMID:15675288

Calot?, F; M?nescu, P; Me?in?, C; Intorcaciu, M; Vasile, I

2004-01-01

36

Etiology and management of alimentary tract ulcers in pediatric intestinal transplantation patients.  

PubMed

Patients who undergo intestinal transplantation encounter several complications in the posttransplant period, one of them being ulcer formation in the alimentary tract. During postoperative endoscopic monitoring of 112 pediatric intestinal transplantation patients at our institution, we identified chronic ulcer formation in 11 patients. There were no common or defining demographic or clinical variables that were found in the patients with ulcers. The ulcers could be located within the allograft or in native tissue. Biopsies were obtained from the ulcer edge and the intervening mucosa as well as an evaluation of possible infectious agents. The most common changes in the ulcers were compatible with Epstein-Barr virus-associated posttransplant lymphoproliferative disorder (PTLD; seven cases), acute rejection (six cases), and less commonly, infectious causes (one case). These changes could occur concomitantly and retrospective analysis after therapy showed that the ulcers could have multiple etiologies. Directed biopsies of ulcer edges often displayed morphological changes compatible with acute rejection of the graft, although some biopsies of the intervening mucosa did not show similar changes. Some patients treated based on the changes within the intervening mucosa responded well and led to resolution of the ulcers. Our findings demonstrate that PTLD and acute rejection are the most common causes of chronic ulcer formation and that biopsy samples should be collected simultaneously from both the ulcer edge and intervening mucosa since pathological changes can vary depending on the underlying cause(s). Infectious agents were rarely present but could be seen superimposed with the underlying cause. PMID:16908276

Selvaggi, G; Sarkar, S; Mittal, N; Acar, B C; Weppler, D; Kato, T; Tryphonopoulos, P; Tzakis, A; Ruiz, P

2006-01-01

37

[Primary antiphospholipid syndrome: newly developed leg ulcer and history of stroke].  

PubMed

Antiphospholipid syndrome features not only deep vessel thrombosis but also may have cutaneous manifestations such as Raynaud phenomenon, acral necrosis, livedo reticularis, subcutaneous nodules, and leg ulcers. A 72-year-old man presented with a rapidly progressing leg ulcer. He was already on anticoagulation with warfarin due to atrial fibrillation and disclosed a history of stroke with temporary paresis of the left leg. Histopathology of a biopsy of the edge of the ulcer revealed occlusive arteriosclerosis of medium-sized arteries. Serology showed autoantibodies against cardiolipin, ?2- glycoprotein I, and phosphatidylserine which led to the diagnosis of antiphospholipid syndrome. Therapy with low molecular weight heparin, dexamethasone, and azathioprine in combination with stage-adjusted wound care led to complete healing of the ulcer within 5 months. PMID:23744031

Van Beek, N; Schumacher, N; Haase, O; Zillikens, D; Kahle, B; Schmidt, E

2013-09-01

38

Low Circulating Protein C Levels Are Associated with Lower Leg Ulcers in Patients with Diabetes  

PubMed Central

Activated protein C (APC) promotes angiogenesis and reepithelialisation and accelerates healing of diabetic ulcers. The aim of this study was to determine the relationship between the incidence of lower leg ulcers and plasma levels of APC's precursor, protein C (PC), in diabetic patients. Patients with diabetes who had a lower leg ulcer(s) for >6 months (n = 36) were compared with age-, type of diabetes-, and sex-matched subjects with diabetes but without an ulcer (n = 36, controls). Total PC was assessed using a routine PC colorimetric assay. There was a significantly (P < 0.001) lower level of plasma PC in patients with ulcers (103.3 ± 22.7, mean?±?SD) compared with control (127.1 ± 34.0) subjects, when corrected for age and matched for gender and type of diabetes. Ulcer type (neuropathic, ischaemic, or mixed) was not a significant covariate for plasma PC levels (P = 0.35). There was no correlation between PC levels and gender, type of diabetes, HbA1c, or C-reactive protein in either group. In summary, decreased circulating PC levels are associated with, and may predispose to, lower leg ulceration in patients with diabetes. PMID:23484147

Whitmont, K.; Fulcher, G.; Reid, I.; Xue, M.; McKelvey, K.; Xie, Y.; Aboud, M.; Ward, C.; Smith, M. M.; Cooper, A.; March, L.; Jackson, C. J.

2013-01-01

39

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

PubMed Central

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

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

40

The bacteriology of chronic venous leg ulcer examined by culture-independent molecular methods.  

PubMed

The bacterial microbiota plays an important role in the prolonged healing of chronic venous leg ulcers. The present study compared the bacterial diversity within ulcer material from 14 skin graft operations of chronic venous leg ulcers using culture-based methods and molecular biological methods, such as 16S rRNA gene sequencing, fingerprinting, quantitative polymerase chain reaction, and fluorescence in situ hybridization. Each wound contained an average of 5.4 species but the actual species varied between wounds. The diversity determined by culture-based methods and the molecular biological methods was different. All the wounds contained Staphylococcus aureus, whereas Pseudomonas aeruginosa was in six out of 14 wounds. Molecular methods detected anaerobic pathogens in four ulcers that were not detected with anaerobic culture methods. Quantitative polymerase chain reaction was used to compare the abundance of S. aureus and P. aeruginosa at different locations in the ulcers and their numbers varied greatly between samples taken at different locations in the same ulcer. This should be considered when ulcers are investigated in routine clinical care. The differences between the results obtained with culture-based and molecular-based approaches demonstrate that the use of one approach alone is not able to identify all of the bacteria present in the wounds. PMID:20082680

Thomsen, Trine R; Aasholm, Martin S; Rudkjøbing, Vibeke B; Saunders, Aaron M; Bjarnsholt, Thomas; Givskov, Michael; Kirketerp-Møller, Klaus; Nielsen, Per H

2010-01-01

41

Chronic venous leg ulcer treatment: future research needs.  

PubMed

The prevalence and costs of chronic venous ulcer care in the US are increasing. The Johns Hopkins University Evidence-Based Practice Center recently completed a systematic review of the comparative effectiveness of advanced wound dressings, antibiotics, and surgical management of chronic venous ulcers. Of 10,066 citations identified in the literature search, only 66 (0.06%) met our liberal inclusion criteria for providing evidence on the effectiveness of interventions for chronic venous ulcers. Based on review of those studies, members of our team and a panel of informed stakeholders identified important research gaps and methodological deficiencies and prioritized specific future research needs. Based on that review, we provide the results of our assessment of future research needs for chronic venous ulcer care. Advanced wound dressings were considered to have the highest priority for future research, followed by venous surgery and antibiotics. An imperative from our assessment is that future research evaluating interventions for chronic venous ulcers meet quality standards. In a time of increasing cost pressure, the wound care community needs to develop high-quality evidence to justify the use of present and future therapeutic modalities. PMID:24134795

Lazarus, Gerald; Valle, M Fran; Malas, Mahmoud; Qazi, Umair; Maruthur, Nisa M; Doggett, David; Fawole, Oluwakemi A; Bass, Eric B; Zenilman, Jonathan

2014-01-01

42

The application of negative pressure wound therapy in the treatment of chronic venous leg ulceration: authors experience.  

PubMed

The aim of the study was to use negative pressure wound therapy (NPWT) in patients with chronic venous leg ulceration. The authors present their experience in treatment of 15 patients whose average ulceration surface area was 62.6 cm(2). In 10 patients, the ulcers healed within 6 weeks and in the remaining patients within 20 weeks. Based on the results obtained, the authors imply that NPWT is an effective method in the treatment of chronic venous leg. PMID:24696847

Kucharzewski, Marek; Mieszcza?ski, Pawe?; Wilemska-Kucharzewska, Katarzyna; Taradaj, Jakub; Kuropatnicki, Andrzej; Sliwi?ski, Zbigniew

2014-01-01

43

The Application of Negative Pressure Wound Therapy in the Treatment of Chronic Venous Leg Ulceration: Authors Experience  

PubMed Central

The aim of the study was to use negative pressure wound therapy (NPWT) in patients with chronic venous leg ulceration. The authors present their experience in treatment of 15 patients whose average ulceration surface area was 62.6?cm2. In 10 patients, the ulcers healed within 6 weeks and in the remaining patients within 20 weeks. Based on the results obtained, the authors imply that NPWT is an effective method in the treatment of chronic venous leg. PMID:24696847

Mieszczanski, Pawel; Wilemska-Kucharzewska, Katarzyna; Taradaj, Jakub; Kuropatnicki, Andrzej; Sliwinski, Zbigniew

2014-01-01

44

From skin disorders to venous leg ulcers: pathophysiology and efficacy of Daflon 500 mg in ulcer healing.  

PubMed

The standard treatments for venous diseases of the lower limb include compression bandaging and stockings as well as surgical removal of varicose veins. There are a number of conditions in which these conventional treatments are ineffective, particularly in the management of leg ulceration. Drug treatments for healing venous leg ulcers have yet to be developed to the stage of good clinical efficacy, but these may assist in the management of patients. Flavonoid drugs have been widely used in the management of the symptoms of venous disease for many years and have recently been studied in some detail to assess their effects on the microcirculation. Work in animal models of ischemia-reperfusion show that MPFF (micronized purified flavonoid fraction) modulates leukocyte adhesion and prevents endothelial damage. Similar biochemical effects have been observed in patients with venous disease and may explain the efficacy of this drug in the management of edema and other symptoms of venous disease. There is clinical evidence that MPFF modifies venous leg ulcer healing. PMID:12934756

Coleridge Smith, Philip D

2003-01-01

45

Quality of life profile and correlated factors in chronic leg ulcer patients in the mid-west of S?o Paulo State, Brazil*  

PubMed Central

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

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

2014-01-01

46

Wound Fluid from Chronic Leg Ulcers Contains Elevated Levels of Metalloproteinases MMP-2 and MMP-9  

Microsoft Academic Search

The purpose of the present research was to determine if metalloproteinase levels were elevated in human chronic wound fluid. Samples of blood and wound fluid from acute (mastectomy) and chronic (leg ulcer) wounds were collected, and metalloproteinase profiles of the samples were determined by gelatin zymography. Compared to serum, acute wound fluid (mastectomy fluid) contained markedly increased levels (five- to

Annette B. Wysocki; Lisa Staiano-Coico; Frederick Grinnell

1993-01-01

47

Leg ulcer treatment outcomes with new ovine collagen extracellular matrix dressing: a retrospective case series.  

PubMed

The purpose of this study was to describe the rate of closure observed in venous leg ulcers during treatment with ovine collagen extracellular matrix dressings and compression. Fourteen patients with 23 wounds were retrospectively evaluated with respect to healing rates, time to closure, and weekly facility charge fees. PMID:25198432

Bohn, Gregory A; Gass, Kimberly

2014-10-01

48

Chronic ulceration of the leg: extent of the problem and provision of care  

Microsoft Academic Search

A postal survey in two health board areas in Scotland, encompassing a population of about one million, identified 1477 patients with chronic ulcers of the leg. Women outnumbered men by a ratio of 2.8:1. The median age of the women was 74 and of the men 67. Seventy two (5%) were hospital inpatients, 174 (12%) were managed jointly by the

M J Callam; C V Ruckley; D R Harper; J J Dale

1985-01-01

49

An overview of technologies related to care for venous leg ulcers  

Microsoft Academic Search

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

Meghan Sarah Hegarty; Edward Grant; Lawrence Reid Jr.

2010-01-01

50

A Comparative Clinical Study on Five Types of Compression Therapy in Patients with Venous Leg Ulcers  

PubMed Central

The aim of this study was to compare five types of compression therapy in venous leg ulcers (intermittent pneumatic vs. stockings vs. multi layer vs. two layer short stretch bandages vs. Unna boots). Primary study endpoints were analysis of changes of the total ulcer surface area, volume and linear dimensions inside observed groups. The secondary end points were comparisons between all groups the number of completely healed wounds (ulcer healing rates), Gilman index and percentage change of ulcer surface area. In total, 147 patients with unilateral venous leg ulcers were included to this study. Participants were randomly allocated to the groups: A, B, C, D and E. After two months the healing rate was the highest in group A (intermittent pneumatic compression) - 57.14%, 16/28 patients, B (ulcer stocking system) - 56.66%, 17/30 patients and C (multi layer short stretch bandage) - 58.62%, 17/29 patients. Significantly much worse rate found in group D (two layer short stretch bandages) - only 16.66%, 5/30 patients and E (Unna boots) - 20%, 6/30 patients. The analysis of changes of the percentage of Gilman index and wound total surface area confirmed that intermittent pneumatic compression, stockings and multi layer bandages are the most efficient. The two layer short - stretch bandages and Unna boots appeared again much less effective. PMID:24396284

Dolibog, Pawel; Franek, Andrzej; Taradaj, Jakub; Dolibog, Patrycja; Blaszczak, Edward; Polak, Anna; Brzezinska-Wcislo, Ligia; Hrycek, Antoni; Urbanek, Tomasz; Ziaja, Jacek; Kolanko, Magdalena

2014-01-01

51

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

PubMed Central

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

2014-01-01

52

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

PubMed Central

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

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

2013-01-01

53

Etiology and pathogenesis of skin ulcers in menhaden, Brevoortia tyrannis: does Pfiesteria piscicida play a role?  

USGS Publications Warehouse

The toxic dinoflagellate, Pfiesteria piscicida, is widely blamed for adverse human health effects, acute fish kills and skin lesion events in fishes, particularly menhaden, Brevoortia tyrannis, inhabiting coastal waters from Delaware to North Carolina, USA. In response, we initiated studies to clarify the etiology and pathogenesis of presumed 'Pfiesteria-specific' menhaden skin lesions. Histopathologically, all lesions (>150 fish examined) were associated with a highly invasive and pathogenic fungus eliciting severe tissue necrosis and intense granulomatous inflammation. Severity and extent of the host response indicates that ulcers were at least 1 week old or older. Maryland and Virginia currently use menhaden ulcers as one of several indicators of local Pfiesteria activity. However, their chronic nature, advanced age, and consistent fungal involvement suggest that their use for this purpose may not be valid. We recently isolated an Aphanomyces sp. from the menhaden lesions which by appearance in culture, temperature growth curves, pathogenicity studies in snakehead and positive immunohistochemical staining with polyclonal antibodies suggest the infectious agent is A. invadans (cause of epizootic ulcerative syndrome in Asia, Japan and Australia) or a very closely related species. Ongoing research will address pathogenicity of the fungus in menhaden, genetic comparisons of isolates, and the role of environmental stressors, including P. piscicida, in initiation of the infection. Copyright (C) 2000.

Blazer, V.; Vogelbein, W. K.; Densmore, C.; Kator, H.; Zwerner, D.; Lilley, J.

2000-01-01

54

Etiology of Genital Ulcer Disease in a Sexually Transmitted Infection Reference Center in Manaus, Brazilian Amazon  

PubMed Central

Objectives To determine the etiology and factors associated with genital ulcer disease (GUD) among patients presenting to a sexually transmitted infections clinic in Manaus, Brazil; and to compare a multiplex polymerase chain reaction (M-PCR) assay for the diagnosis of GUD with standard methods. Methods Ulcer swabs were collected and used for Tzanck test and processed in an M-PCR to detect herpes simplex virus (HSV-1/2), Treponema pallidum (T. pallidum), and Haemophilus ducreyi (H. ducreyi). Sera were tested for HIV and syphilis antibodies. Multivariable analysis was used to measure the association between clinical aspects and GUD. M-PCR results were compared with syphilis serology and Tzanck tests. Results Overall, 434 GUD samples were evaluated, 84.8% from men. DNA from HSV-2 was detected in 55.3% of GUD samples, T. pallidum in 8.3%, HSV-1 in 3.2%, and 32.5% of GUD specimens were negative for the DNA of all three pathogens. No cases of H. ducreyi were identified. HIV serology among GUD patients was 3.2%. Treponemal antibodies and Tzanck test positivity for genital herpes was detected in 25 (5.8%) and in 125 (30.3%) of GUD patients, respectively. In multivariable analysis genital herpes etiology by M-PCR was associated with the vesicular, multiple and recurrent lesions whereas T. pallidum with non-vesicular, non-recurrent lesions. Compared to M-PCR, syphilis serology was 27.8% sensitive and 96.2% specific whereas Tzanck test was 43.8% sensitive and 88.9% specific. Conclusions The predominance of genital herpes etiology suggests a revision of existing national syndromic treatment guidelines in Brazil to include antiherpetic treatment for all GUD patients. The use of M-PCR can significantly improve the diagnosis of GUD and provide a greater sensitivity than standard diagnostics. PMID:23704961

Gomes Naveca, Felipe; Sabido, Meritxell; Amaral Pires de Almeida, Tatiana; Araujo Veras, Elaine; Contreras Mejia, Matilde del Carmen; Galban, Enrique; Benzaken, Adele Schwartz

2013-01-01

55

Daflon 500 mg and venous leg ulcer: new results from a meta-analysis.  

PubMed

The objective of this study was to assess the effect of oral treatment with Daflon 500 mg (micronized purified flavonoid fraction [MPFF]) on leg ulcer healing. This study was conducted as a meta-analysis of randomized prospective studies using Daflon 500 mg as an adjunct to conventional treatment. Medical literature databases and the manufacturer's records were searched for relevant clinical trials. Five prospective, randomized, controlled studies in which 723 patients with venous ulcers were treated between 1996 and 2001 were identified. Conventional treatment (compression and local care) in addition to Daflon 500 mg 2 tablets daily was compared with conventional treatment plus placebo in two studies (n = 309), or with conventional treatment alone in three studies (n = 414). The primary end point was complete ulcer healing at 6 months. The results are expressed as a reduction in the relative risk (RRR) of healing with 95% confidence intervals (CI). Since, in the present case, the desired treatment effect is increased ulcer healing, RRR should be positive to indicate a benefit of adjunctive Daflon 500 mg over conventional therapy alone. Type 1 error was set at 5%. At 6 months, the chance of ulcer healing was 32% better in patients treated with adjunctive Daflon 500 mg than in those managed by conventional therapy alone (RRR, 32%; 95% CI, 3% to 70%). This difference was present from month 2 (RRR, 44%; 95% CI, 7% to 94%), and was associated with a shorter time to healing (16 weeks vs 21 weeks; p = 0.0034). The benefit of Daflon 500 mg was found in the subgroup of ulcers between 5 and 10 cm2 in area (RRR, 40%; 95% CI, 6% to 87%), as well as in patients with ulcers of 6 to 12 months' duration (RRR, 44%; 95% CI, 6% to 97%). These results confirm that venous ulcer healing is accelerated by Daflon 500 mg treatment. Daflon 500 mg might be a useful adjunct to conventional therapy in large and longstanding ulcers that might be expected to heal slowly. PMID:16193225

Smith, Philip Coleridge

2005-01-01

56

A topical haemoglobin spray for oxygenating chronic venous leg ulcers: a pilot study.  

PubMed

Acute wounds will generally heal independently of any interventions, whereas chronic wounds are chronic for a reason and are unlikely to successfully heal without intervention. In the treatment of venous leg ulcers, the gold standard will always be compression therapy. However, many wounds still do not heal despite best practice. Therefore, the use of adjunct therapies alongside standard care become the priority for healing. This article describes a small evaluation, involving 17 patients with chronic venous leg ulcers, that set out to determine the effect of a topical oxygen therapy on wound size. The therapy comprises a canister that sprays pure haemoglobin in a water solution into the wound. The haemoglobin spray needs to be used at least once every 3 days, and no training is required on its use. Results showed the device helped promote wound healing in 14 out of 17 wounds treated for more than 2 weeks. These patients had previously been shown to be non-healing during a 4-week run-in period where they received standard care, including compression therapy. PMID:25382133

Norris, Ray

2014-11-01

57

The social and economic burden of venous leg ulcers: focus on the role of micronized purified flavonoid fraction adjuvant therapy.  

PubMed

Chronic venous insufficiency (CVI) occurs in a relatively large proportion of the population and is associated with significant morbidity, high cost of healthcare, loss of productivity and reduced quality of life. Lower extremity ulcers related to CVI have been estimated to affect 0.2-1% of the population in developed countries. The prevalence of venous ulcers in the US is estimated at 500,000-600,000, and increases with age. Estimates of the annual incidence of leg ulcer in the UK and Switzerland are 3.5 and 0.2 per 1000 individuals, respectively. Treatment of venous ulcers can be expensive, leading to a large economic burden on health services in many countries. The annual cost of CVI is estimated to be more than 1 billion US dollars in the US and between pound 400-600 million in the UK. Current treatments for CVI include surgery, sclerotherapy, compressive therapy (conventional therapy) and adjuvant pharmacotherapy. Various pharmacological agents have been used as adjuvant therapy but in many cases there is no definitive evidence of their efficacy. Effective treatment programs for venous leg ulcers could substantially reduce the economic impact of CVI on health services. In controlled studies, micronized purified flavonoid fraction (MPFF) adjuvant therapy has been shown to increase significantly the number of healed venous leg ulcers and to reduce significantly the healing time of ulcers compared with conventional therapy alone, potentially leading to an improvement in patients' quality of life. The treatment of venous leg ulcers with MPFF was also found to reduce overall treatment costs compared with conventional therapy alone. In a retrospective cost-effectiveness analysis based on direct medical costs only, MPFF therapy improved the cost-effectiveness ratio by 45% compared with conventional therapy. If intangible costs, such as loss of quality of life were included, the difference in cost-effectiveness ratios is likely to be even greater in favor of MPFF. Sensitivity analyzes showed that even with a 20% increase in drug price the cost-effectiveness ratio for MPFF therapy was substantially better than that for conventional therapy (1061.8 US dollars vs 1871.9 US dollars per ulcer healed). Hence, the addition of MPFF adjuvant therapy to the treatment of venous leg ulcers would be effective and potentially cost saving. PMID:12862500

Simka, Marian; Majewski, Eugeniusz

2003-01-01

58

Clinical audit of leg ulceration prevalence in a community area: a case study of good practice.  

PubMed

This article presents the findings of an audit on venous leg ulceration prevalence in a community area as a framework for discussing the concept and importance of audit as a tool to inform practice and as a means to benchmark care against national or international standards. It is hoped that the discussed audit will practically demonstrate how such procedures can be implemented in practice for those who have not yet undertaken it, as well as highlighting the unexpected extra benefits of this type of qualitative data collection that can often unexpectedly inform practice and influence change. Audit can be used to measure, monitor and disseminate evidence-based practice across community localities, facilitating the identification of learning needs and the instigation of clinical change, thereby prioritising patient needs by ensuring safety through the benchmarking of clinical practice. PMID:25191861

Hindley, Jenny

2014-09-01

59

Carbohydrate Intake in the Etiology of Crohn's Disease and Ulcerative Colitis  

PubMed Central

Background: Diet may have a role in the etiology of inflammatory bowel disease. In previous studies, the associations between increased intakes of carbohydrates, sugar, starch, and inflammatory bowel disease are inconsistent. However, few prospective studies have investigated the associations between these macronutrients and incident Crohn's disease (CD) or ulcerative colitis (UC). Methods: A total of 401,326 men and women were recruited between 1991 and 1998. At recruitment, dietary intakes of carbohydrate, sugar, and starch were measured using validated food frequency questionnaires. The cohort was monitored identifying participants who developed incident CD or UC. Cases were matched with 4 controls, and odds ratios were calculated for quintiles of total carbohydrate, sugar, and starch intakes adjusted for total energy intake, body mass index, and smoking. Results: One hundred ten participants developed CD, and 244 participants developed UC during follow-up. The adjusted odds ratio for the highest versus the lowest quintiles of total carbohydrate intake for CD was 0.87, 95% CI = 0.24 to 3.12 and for UC 1.46, 95% CI = 0.62 to 3.46, with no significant trends across quintiles for either (CD, Ptrend = 0.70; UC, Ptrend = 0.41). Similarly, no associations were observed with intakes of total sugar (CD, Ptrend = 0.50; UC, Ptrend = 0.71) or starch (CD, Ptrend = 0.69; UC, Ptrend = 0.17). Conclusions: The lack of associations with these nutrients is in agreement with many case–control studies that have not identified associations with CD or UC. As there is biological plausibility for how specific carbohydrates could have an etiological role in inflammatory bowel disease, future epidemiological work should assess individual carbohydrates, although there does not seem to be a macronutrient effect. PMID:25265262

Luben, Robert; van Schaik, Fiona; Oldenburg, Bas; Bueno-de-Mesquita, H. Bas; Hallmans, Göran; Karling, Pontus; Lindgren, Stefan; Grip, Olof; Key, Timothy; Crowe, Francesca L.; Bergmann, Manuela M.; Overvad, Kim; Palli, Domenico; Masala, Giovanna; Khaw, Kay-Tee; Racine, Antoine; Carbonnel, Franck; Boutron-Ruault, Marie-Christine; Olsen, Anja; Tjonneland, Anne; Kaaks, Rudolf; Tumino, Rosario; Trichopoulou, Antonia; Hart, Andrew R.

2014-01-01

60

Etiology of ulcerative lesions of Atlantic menhaden ( Brevoortia tyrannus ) from James River, Virginia  

Microsoft Academic Search

We observed ulcerative lesions on live Atlantic menhaden, Brevoortia tyrannus, during ichthyofaunal sampling in the tidal James River in October 1999 (near Jamestown, VA, USA). Other synoptically collected fishes exhibited no signs of lesions or pre-ulcerative tissues. Live fish were classified as unremarkable (no dermal anomalies), pre-ulcerative (integument intact with boil-like swelling), and ulcerative (severe focal lesions). Specimens were analyzed

Stanley R. Webb; Gregory C. Garman; Stephen P. McIninch; Thomas A. Nerad; Michael T. Peglar; Patrick M. Gillevet; Bonnie L. Brown

2005-01-01

61

Stasis Ulcer  

MedlinePLUS

newsletter | contact Share | Stasis Ulcer Information for adults A A A This image displays a patient with chronic leg swelling with stasis dermatitis and a stasis ulcer. Overview A stasis ulcer is a breakdown of ...

62

Etiology of ulcerative lesions of Atlantic menhaden (Brevoortia tyrannus) from James River, Virginia.  

PubMed

We observed ulcerative lesions on live Atlantic menhaden, Brevoortia tyrannus, during ichthyofaunal sampling in the tidal James River in October 1999 (near Jamestown, VA, USA). Other synoptically collected fishes exhibited no signs of lesions or pre-ulcerative tissues. Live fish were classified as unremarkable (no dermal anomalies), pre-ulcerative (integument intact with boil-like swelling), and ulcerative (severe focal lesions). Specimens were analyzed for bacteria, fungi, and pathogenic protozoans including amphizoic amoebae, Pfiesteria piscicida, and Kudoa sp. No Pfiesteria were detected in any tissue specimen. All B. tyrannus examined, including tissues from unremarkable fish, tested positive for presence of the known fish parasite Kudoa. Only ulcerative lesions were also colonized by bacteria, fungi, and amphizoic amoebae. The absence of bacteria, fungi, and protozoans from unremarkable and pre-ulcerative fish suggests that association of other potential pathogens with B. tyrannus ulcers was due to secondary colonization following lesion formation as a result of Kudoa infection. PMID:16133297

Webb, Stanley R; Garman, Gregory C; McIninch, Stephen P; Nerad, Thomas A; Peglar, Michael T; Gillevet, Patrick M; Brown, Bonnie L

2005-11-01

63

Ulcers  

MedlinePLUS

An ulcer is a crater-like sore on the skin or mucous membrane . Ulcers form when the top layers of skin or ... Ulcers can be caused by inflammation or infection. Some ulcers may be caused by a cancer.

64

Developing a nurse-led education program to enhance self-care agency in leg ulcer patients.  

PubMed

Patients with leg ulceration face changing self-care demands associated with the consequences of the disease and treatment. Often patients can manage their self-care for some time, but new therapeutic self-care demands may emerge that require more complex self-care actions. The purpose of this article is to describe the development of a nurse-led education program in North-Rhine Westphalia, Germany, that aims to help patients with leg ulcers to meet their therapeutic self-care demands. Orem's self-care deficit nursing theory is used as a framework to provide the conceptual context for this supportive-educative nursing system that is being tested in a multi-site clinical trial. PMID:18378825

Herber, Oliver R; Schnepp, Wilfried; Rieger, Monika A

2008-04-01

65

State-of-the-art treatment of chronic leg ulcers: a randomized controlled trial comparing vacuum-assisted closure (V.A.C.) with modern wound dressings  

Microsoft Academic Search

Background: Current treatment modalities for chronic leg ulcers are time consuming, expensive, and only moderately successful. Recent data suggest that creating a subatmospheric pressure by vacuum-assisted closure (V.A.C., KCI Concepts, San Antonio, Texas) therapy supports the wound healing process. Methods: The efficacy of vacuum-assisted closure in the treatment of chronic leg ulcers was prospectively studied in a randomized controlled trial

Jeroen D. D. Vuerstaek; Tryfon Vainas; Jan Wuite; Patty Nelemans; Martino H. A. Neumann; Joep C. J. M. Veraart

66

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

PubMed Central

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

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

67

Decreased hematocrit-to-viscosity ratio and increased lactate dehydrogenase level in patients with sickle cell anemia and recurrent leg ulcers.  

PubMed

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+)--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

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

68

Etiology and Management of Alimentary Tract Ulcers in Pediatric Intestinal Transplantation Patients  

Microsoft Academic Search

Patients who undergo intestinal transplantation encounter several complications in the posttransplant period, one of them being ulcer formation in the alimentary tract. During postoperative endoscopic monitoring of 112 pediatric intestinal transplantation patients at our institution, we identified chronic ulcer formation in 11 patients. There were no common or defining demographic or clinical variables that were found in the patients with

G. Selvaggi; S. Sarkar; N. Mittal; B. C. Acar; D. Weppler; T. Kato; P. Tryphonopoulos; A. Tzakis; P. Ruiz

2006-01-01

69

Improved healing rates for chronic venous leg ulcers: pilot study results from a randomized controlled trial of a community nursing intervention.  

PubMed

Venous leg ulcers are a frequent source of chronic ill-health and a considerable cost to health-care systems. This paper reports pilot study results from a randomized controlled trial to determine the effectiveness of a community-based 'Leg Club' environment on improving healing rates of venous leg ulcers. Leg Clubs offer a setting where people with similar problems can socialize in a supportive, information-sharing environment. A sample of 33 clients with a below-knee venous leg ulcer were randomized to treatment, either in their own homes or in a community Leg Club. Treatment was provided to all participants, whether in the control group or intervention group, by a team of trained wound-care nurses following evidence-based assessment and treatment guidelines. Data were collected on admission to the study and at 12 weeks from admission. Results showed a significant improvement in healing in the intervention group compared to the control group, as measured by ulcer area size and Pressure Ulcer Scale for Healing scores. These results suggest that a community Leg Club environment provides benefits additional to wound care expertise and evidence-based care. Knowledge gained from this study provides evidence to guide service delivery and improve client outcomes. PMID:15985095

Edwards, Helen; Courtney, Mary; Finlayson, Kathleen; Lewis, Caroline; Lindsay, Ellie; Dumble, Jean

2005-08-01

70

Factors influencing the implementation of a lifestyle counseling program in patients with venous leg ulcers: a multiple case study  

PubMed Central

Background Implementation of lifestyle interventions in patient care is a major challenge. Understanding factors that influence implementation is a first step in programs to enhance uptake of these interventions. A lifestyle-counseling intervention, Lively Legs, delivered by trained nurses, can effectively improve the lifestyle in patients with venous leg ulcers. The aim of this study was to identify factors that hindered or facilitated implementation of this intervention in outpatient dermatology clinics and in home care. Methods A mixed-methods multiple case study in five purposefully selected healthcare settings in the Netherlands was conducted. Measurements to identify influencing factors before and after implementation of Lively Legs included interviews, focus groups, questionnaires, and nurses’ registration. Analyses focused on qualitative data as the main data source. All data were compared across multiple cases to draw conclusions from the study as a whole. Results A total of 53 patients enrolled in the Lively Legs program, which was delivered by 12 trained nurses. Barriers for implementation were mainly organizational. It was difficult to effectively organize reaching and recruiting patients for the program, especially in home care. Main barriers were a lack of a standardized healthcare delivery process, insufficient nursing time, and a lack of motivated nurses to deliver the program. Facilitating factors were nurse-driven coordination of care and a standardized care process to tie Lively Legs into, as this resulted in better patient recruitment and better program implementation. Conclusions This study identified a range of factors influencing the implementation of a lifestyle-counseling program, mainly related to the organization of healthcare. Using a case study method proved valuable in obtaining insight into influencing factors for implementation. This study also shed light on a more general issue, which is that leg ulcer care is often fragmented, indicating that quality improvement is needed. PMID:23101504

2012-01-01

71

Factors that influence healing of chronic venous leg ulcers: a retrospective cohort*  

PubMed Central

BACKGROUND Venous ulcers have a significant impact on patient quality of life, and constitute a worldwide public health problem. Treatment is complex, with high failure rates. OBJECTIVES To identify clinical and therapeutic factors that influence healing of venous ulcers. METHODS Retrospective cohort study of patients with venous ulcers. Ulcer area was measured at the first visit (T0) and after 6 months (T6) and 1 year (T12). A reduction in ulcer area of 50% or more at T6 and T12 was the outcome of interest, weighted by clinical, demographic and treatment aspects. RESULTS Ninety-four patients were included (137 ulcers). A reduction in ulcer area of 50% or more was seen in 40.1% of patients (95%CI 31.9 to 48.4%) at T6 and 49.6% (95%CI 41.2 to 58.1%) at T12. Complete healing occurred in 16.8% (95%CI 10.5 to 23.1%) at T6 and 27% (95%CI 19.5 to 39.5%) at T12. The lowest ulcer area reductions at T6 were associated with longstanding ulcer (RR=0.95; 95%CI 0.91 to 0.98), poor adherence to compression therapy (RR=4.04; 95%CI 1.31 to 12.41), and infection episodes (RR= 0.42; 95%CI 0.23 to 0.76). At T12, lower reductions were associated with longstanding ulcer (RR=0.95; 95%CI 0.92 to 0.98), longer topical antibiotic use (RR=0.93; 95%CI 0.87 to 0.99), and systemic antibiotic use (RR=0.63; 95%CI 0.40 to 0.99). CONCLUSIONS Longstanding ulcer, infection, poor adherence to compression therapy, and longer topical and systemic antibiotic use were independently correlated with worse healing rates. PMID:24937814

Scotton, Marilia Formentini; Miot, Helio Amante; Abbade, Luciana Patricia Fernandes

2014-01-01

72

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

PubMed Central

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

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

2014-01-01

73

The debridement of hard to heal leg ulcers by means of a new device based on Fluidjet technology.  

PubMed

Debridement plays an essential role in the wound-bed preparation of necrotic and sloughy ulcers, being a mandatory step to achieve a well-debrided bed, proceeding towards healing. This study reports our experience with Versajet [Versajet Hydrosurgery System (Smith & Nephew, Hull, UK)], a new device for the debridement of exudating ulcers, based on Fluidjet technology, which excises and aspirates the unwanted tissue by using the Venturi effect. In a 10-month time period, a total of 68 patients, out of a setting of 167 patients, hospitalised as affected by chronic, hard-to-heal leg ulcers, stuck in the inflammatory phase, were treated with Versajet. Based on ulcer characteristics and clinical conditions, the remaining 99 patients underwent traditional debridement with moist dressings (controls). In the majority of Versajet-treated cases (46), an adequately debrided wound bed was achieved with one operative procedure; two and three procedures were required in 17 and 5 patients, respectively. Almost all the procedures were performed in the ward at the patient's bedside. This procedure is quick (mean time per treatment is about 5 minutes); when compared with a traditional treatment with moist dressings, Versajet considerably shortens the in-hospital stay and promotes a quicker healing process. When used by an experienced surgeon, Versajet allows a selective debridement, as it makes it possible to remove only the tissue centred in the working end and spare the healthy tissue. Debriding with Versajet is highly effective in reducing the bacterial load of the ulcer bed. The pain caused by Versajet is well tolerated, especially when set for gentle debridement. If multiple treatments are required, the combined use with moist dressings is synergistic, as the dressings soften the necrotic tissue, thus facilitating the following Versajet debridement. The results indicate that Versajet offers more precision than standard mechanical debridement and, at high settings, offers an alternative to surgical debridement. PMID:16618317

Mosti, Giovanni; Iabichella, Maria Letizia; Picerni, Pietro; Magliaro, Antonio; Mattaliano, Vincenzo

2005-12-01

74

/sup 201/Tl perfusion study of ''ischemic'' ulcers of the leg: prognostic ability compared with Doppler ultrasound  

SciTech Connect

Thallium 201 perfusion analysis was compared with Doppler ultrasound as a means of determining the healing potential of an ischemic ulcer of the leg in 27 patients. The degree of hyperemia was determined by comparative point counting of the 201Tl distribution in and about the ulcer. Using established Doppler criteria and a hyperemia ratio greater than 1.5:1, ultrasound alone correctly predicted healing in 15 out of 23 cases and 201Tl in 20 out of 23. Ultrasound correctly predicted non-healing in 3 out of 6 cases, compared with 5 out of 6 for 201Tl. The positive predictive value of the 201Tl study was 63%, versus 27% for ultrasound, and the negative predictive value was 95% for 201Tl and 83% for ultrasound. The accuracy of 201Tl and ultrasound was 86% and 62%, respectively. This limited study suggests that 201Tl perfusion scanning is a useful noninvasive test of ulcer healing potential and may be more sensitive than Doppler ultrasound.

Siegel, M.E.; Stewart, C.A.; Kwong, P.; Sakimura, I.

1982-04-01

75

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

PubMed

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

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

2014-10-01

76

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

Microsoft Academic Search

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

Randall D Wolcott; Viktoria Gontcharova; Yan Sun; Scot E Dowd

2009-01-01

77

Targeting Cx43 and N-Cadherin, Which Are Abnormally Upregulated in Venous Leg Ulcers, Influences Migration, Adhesion and Activation of Rho GTPases  

PubMed Central

Background Venous leg ulcers can be very hard to heal and represent a significant medical need with no effective therapeutic treatment currently available. Principal Findings In wound edge biopsies from human venous leg ulcers we found a striking upregulation of dermal N-cadherin, Zonula Occludens-1 and the gap junction protein Connexin43 (Cx43) compared to intact skin, and in stark contrast to the down-regulation of Cx43 expression seen in acute, healing wounds. We targeted the expression of these proteins in 3T3 fibroblasts to evaluate their role in venous leg ulcers healing. Knockdown of Cx43 and N-cadherin, but not Zonula Occludens-1, accelerated cell migration in a scratch wound-healing assay. Reducing Cx43 increased Golgi reorientation, whilst decreasing cell adhesion and proliferation. Furthermore, Connexin43 and N-cadherin knockdown led to profound effects on fibroblast cytoskeletal dynamics after scratch-wounding. The cells exhibited longer lamelipodial protrusions lacking the F-actin belt seen at the leading edge in wounded control cells. This phenotype was accompanied by augmented activation of Rac-1 and RhoA GTPases, as revealed by Förster Resonance Energy Transfer and pull down experiments. Conclusions Cx43 and N-cadherin are potential therapeutic targets in the promotion of healing of venous leg ulcers, by acting at least in part through distinct contributions of cell adhesion, migration, proliferation and cytoskeletal dynamics. PMID:22615994

Mendoza-Naranjo, Ariadna; Cormie, Peter; Serrano, Antonio E.; Hu, Rebecca; O'Neill, Shay; Wang, Chiuhui Mary; Thrasivoulou, Christopher; Power, Kieran T.; White, Alexis; Serena, Thomas; Phillips, Anthony R. J.; Becker, David L.

2012-01-01

78

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

PubMed Central

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

2014-01-01

79

Efficacy of Daflon 500 mg in venous leg ulcer healing: a double-blind, randomized, controlled versus placebo trial in 107 patients.  

PubMed

The objective of this study was to evaluate the efficacy of Daflon 500 mg (Dios)* in venous ulcers. A multicenter, double-blind, randomized, controlled versus placebo (Plac) trial was conducted, with stratification according to the size of ulcer (< or = 10 cm and > 10 cm). The protocol called for a two-month treatment with Dios (one tablet = 450 mg micronized purified Diosmin) or a placebo, two tablets/day, in addition to compression therapy. Evaluations were performed every fifteen days, from D0 to D60. The primary endpoint, in accordance with Alexander House group requirements were: percentage of patients with complete ulcer healing, ie, comparison between Dios and Plac group at D60, and comparison of survival curves in each group between D0 and D60 (log rank test). Secondary endpoints included ulcer surface area assessed by computerized planimetric measurements, qualitative evaluation of ulcers, and symptoms. The patients were 105 men and women ranging in age from eighteen to eighty-five years, with standard compression stocking, who were undergoing standardized local care of ulcer and had no significant arterial disease (ankle/arm systolic pressure index > 0.8). Fifty-three patients received Dios, and 52 received Plac. The 2 groups were well matched for age (m +/- 1 SD = seventy-one +/- eleven years), gender, ulcer size, and associated disorders. Among patients with ulcer size < or = 10 cm (Dios = 44, Plac = 47) a significantly larger number of patients had a complete ulcer healing at two months in the Dios group (n = 14) in comparison with the Plac group (n = 6) (32% vs 13%, P = 0.028) with a significantly shorter time duration of healing (P = 0.037). No difference was shown for the secondary criteria, except for sensation of heavy legs (P = 0.039) and a less atonic aspect of ulcer (P = 0.030) in favor of Dios. Among the 14 patients with ulcer size > 10 cm (Dios = 9, Plac = 5), subjected to a descriptive analysis only, no ulcer healed. This study showed that a two-month course of Daflon 500 mg at a daily dose of two tablets, in addition to conventional treatment, is of benefit in patients with venous ulcer < or = 10 cm by accelerating complete healing. PMID:8995348

Guilhou, J J; Dereure, O; Marzin, L; Ouvry, P; Zuccarelli, F; Debure, C; Van Landuyt, H; Gillet-Terver, M N; Guillot, B; Levesque, H; Mignot, J; Pillion, G; Février, B; Dubeaux, D

1997-01-01

80

Recruitment Strategy Effectiveness for a Cryotherapy Intervention for a Venous Leg Ulcer Prevention Study  

PubMed Central

PURPOSE To describe the strategies and costs associated with recruiting African American and white adults into a randomized controlled pilot trial. DESIGN “Cryotherapy for Venous Disorders: A Pilot Study” is a randomized controlled trial designed to determine the effects of a cool gel wrap and leg elevation intervention versus a leg elevation alone intervention on skin temperature, skin microcirculation, quality of life, and pain in adults with stages 4 and 5 chronic venous disorders. We sought to recruit 60 participants (21 African Americans, 37 whites, and 2 Hispanic or Latino) to complete the study. These enrollment targets reflect the demographic distribution of the community in which the study was conducted (33% African American, 66% white, and 2% Latino). Proactive and reactive recruitment strategies were implemented to recruit subjects. RESULTS Seventy-three individuals (9 African American men, 29 African American women, 11 white men, 22 white women, 1 Asian woman, and 1 Hispanic woman) were screened, and of those, 67 were randomized (9 African American men, 25 African American women, 9 white men, 22 white women, 1 Asian woman, and 1 Hispanic women). Fifty-eight completed the study, yielding an overall 11% attrition rate. An additional 8 subjects canceled or did not show up for a first appointment. Reactive recruitment strategies were most successful for recruiting men, women, African American, and white participants. The 3 most successful reactive strategies were referrals from providers/clinics (34%), flyers posted in the hospital elevators (22%), and targeted mailings from a business (16%). Of the healthcare provider referrals (19), wound care nurses referred 12 completed participants. The amount budgeted for advertisement was $5,000 (2% of the total grant award). The amount spent on recruitment including labor was $5,978, which averaged $103 per participant who completed the study (N = 58). Reactive strategies per participant completer proved more cost-efficient than proactive strategies ($83 vs $215). However, the time spent by the principal investigator (approximately 100 hours or 2.5 hours per week × 40 weeks) on recruitment, particularly maintaining frequent face-to-face contact with providers, increased success in the area of healthcare provider referrals. CONCLUSION A variety of recruitment strategies are needed to ensure a diverse participant response to clinical research studies. As nurses become more involved in research activities, and particularly in recruitment, it is important to understand the most effective types of strategies and costs associated with these activities. PMID:20075691

Kelechi, Teresa J.; Watts, Ashlee; Wiseman, Jan

2010-01-01

81

Ischemic ulcers - self-care  

MedlinePLUS

Ischemic ulcers (wounds) can occur when there is poor blood flow in your legs . Poor blood flow causes cells to die and damages tissue. Most ischemic ulcers occur on the feet and legs. These types ...

82

Factors influencing the sporulation and cyst formation of Aphanomyces invadans, etiological agent of ulcerative mycosis in Atlantic menhaden, Brevoortia tyrannus  

Microsoft Academic Search

Oomycete infections caused by Aphano- myces invadans occur in freshwater and estuarine fishes around the world. Along the east coast of the USA, skin ulcers caused by A. invadans are prevalent in Atlantic menhaden, Brevoortia tyrannus. From lab- oratory observations low salinities appear crucial to transmission of the pathogen. To better understand aspects of transmission, we characterized sporulation and cyst

Yasunari Kiryu; Vicki S. Blazer; Wolfgang K. Vogelbein; Howard Kator; Jeffrey D. Shields

2005-01-01

83

Evaluation of apoptotic cells and immunohistochemical detection of FAS, FAS-L, Bcl-2, Bax, p53 and c-Myc in the skin of patients with chronic venous leg ulcers.  

PubMed

In the present study we were interested, if apoptosis plays a role in the surrounding skin of venous ulcers, where microcirculatory disorders were already observed. For this purpose laser Doppler flow and partial oxygen pressure were measured in 17 patients at the ulcer edge, the transitional area of the lower leg and the thigh. Subsequently biopsies were taken from the respective sites and subjected to terminal deoxynucleotidyl transferase labelling (TUNEL) and immunohistochemistry using antibodies to determine the protein expression of Fas, Fas-L, Bax, Bcl-2, p53 and c-Myc. Laser Doppler flow was increased and transcutaneous oxygen partial pressure was decreased, with significant differences at the ulcer edge and the lower leg compared to the thigh. The skin biopsies did not show any differences when labelling for apoptotic cells. Keratinocytes of basal and spinous layer stained with antibodies against Fas, Fas-L and Bax in all probes of the three sites. c-Myc and p53 were negative in all keratinocytes of the skin probes. However, staining with Bcl-2 was significantly decreased at the ulcer edge in comparison to the lower leg and the thigh (p=0.017). Our study revealed that a disturbed microcirculation does not increase the number of apoptotic cells at the ulcer edge in patients with venous disease. The reduced staining pattern with Bcl-2 at the ulcer edge seems not to result in higher susceptibility to apoptosis, but it remains to be proven whether it is involved in epidermal acanthosis. PMID:18813857

Heising, Susanna; Giebel, Jürgen; Ostrowitzki, Anna-Lena; Riedel, Franziska; Haase, Hermann; Sippel, Kirstin; Jünger, Michael

2008-10-01

84

???????Evidence-informed leg ulcer care: a cohort study comparing outcomes of individuals choosing nurse-led clinic or home care.  

PubMed

Clinicians are interested in options for delivering community-based wound care. Studies have largely focused on nurse clinics as an alternative to people receiving wound care at home. A prospective, two-arm, cohort study of individuals who requested and received their preference for community-based leg ulcer care delivered in either their home or in a nurse-led clinic was conducted to explore the relationship between choice of care location and health outcomes. Provision of care was similar-ie, care was guided by an evidence-informed protocol and a trained nursing team. Individual and system level outcomes were compared between the groups, including 3-month healing rates, 1-year ulcer recurrence rate, time free of ulcers, health-related quality of life (HRQL), satisfaction with care, and resource use. Following the baseline assessment, data were collected every 3 months until healing occurred plus a 1-year follow-up to monitor recurrence. Of the 104 participants (average age 67.5 years), 56 chose home and 48 chose clinic-based care. More than half (55%) of the participants were men, 53.8% had an ulcer <5 cm(2) and <6 months' duration, 84% were English-speaking, and 51.9% had a previous episode of ulceration. No significant sociodemographic, HRQL, or clinical characteristic differences were found between groups at baseline. A trend toward improved healing for those choosing clinic care was observed (3-month healing rates at home were 48.1% versus clinic care 66.7%, P = 0.07) but neither healing outcome nor other variables, including resource utilization, were significantly different and post-hoc analysis revealed only 48% power to detect a difference in healing. The results confirm previous research indicating that the organization rather than the location of care is most important; however, observed differences in healing rates pose an important question for future inquiry regarding the potential impact of choice and whether the quality of care is standardized and delivered by the same team. The concept of providing individuals/families with the choice of care location warrants further research. PMID:21904018

Harrison, Margaret B; VanDenKerkhof, Elizabeth; Hopman, Wilma M; Graham, Ian D; Lorimer, Karen; Carley, Meg

2011-08-01

85

The direct inhibition of MMP-2 and MMP-9 by an enzyme alginogel: a possible mechanism of healing support for venous leg ulcers.  

PubMed

Flaminal Forte is an enzyme alginogel,whose activity depends on the absorption and binding of matrix metalloproteinases (MMPs), which are known to play a crucial role in delayed wound healing. The aim of the study was to evaluate the influence of Flaminal on MMP-2/-9 activity in ulcer exudate, ex vivo. Eight patients with bilateral venous leg ulcers were treated for 4 weeks with Flaminal Forte covered by hydrocolloid ('F' wounds), or with hydrocolloid alone ('H' wounds) as a reference control. Clinical assessment did not reveal any differences between F and H wounds regarding surface reduction and general wound condition. Nevertheless, although non-significant, there was a visible difference in peri-wound skin appearance in F wounds, as compared to H wounds. The wound exudate contained high MMP-2/-9 levels, which gradually decreased as wounds healed. The attenuation of MMPs was stronger in F than in H exudate, however, in standard zymography this difference appeared non-significant. Real-time zymography revealed that Flaminal mediated a powerful direct inhibition of gelatinolytic activity of wound exudate and of recombinant MMP-2/-9 in vitro. PMID:24810313

Grzela, T; Niderla-Bielinska, J; Litwiniuk, M; White, R

2014-05-01

86

Expression of apoptosis- and cell cycle-related proteins in epidermis of venous leg and diabetic foot ulcers  

Microsoft Academic Search

Background. Epithelialization of cutaneous ulcers is a long-lasting process. To study the pathomechanism of impaired epithelialization, we evaluated the role of cell cycle- and apoptosis-related proteins in the regenerating epidermis. We characterized immunohistochemically the expression of cell cycle regulators p63, CD29, PCNA, p53, pro- and antiapoptotic proteins bcl2, bax, caspase 3 and DNA breaks, as well as keratin 10, 16

Hanna Galkowska; Waldemar L Olszewsk; Urszula Wojewodzka; Joanna Mijal; Ewa Filipiuk

2003-01-01

87

A Real World, Observational Registry of Chronic Wounds and Ulcers  

ClinicalTrials.gov

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

2014-10-29

88

Factors influencing the sporulation and cyst formation of Aphanomyces invadans, etiological agent of ulcerative mycosis in Atlantic menhaden, Brevoortia tyrannus.  

PubMed

Oomycete infections caused by Aphanomyces invadans occur in freshwater and estuarine fishes around the world. Along the east coast of the USA, skin ulcers caused by A. invadans are prevalent in Atlantic menhaden, Brevoortia tyrannus. From laboratory observations low salinities appear crucial to transmission of the pathogen. To better understand aspects of transmission, we characterized sporulation and cyst formation of secondary zoospores of two isolates of A. invadans at different salinities and temperatures. Sporulation occurred only at low salinities. At room temperature (ca. 20-22 C), using "pond water" augmented with artificial sea salts, the endemic strain WIC and the Thailand strain PA7 of A. invadans produced free-swimming secondary zoospores at salinities of 0, 1 and 2 psu (practical salinity unit = per thousand), but not at 4 psu or higher. Secondary zoospores of another species, ATCC-62427 (Aphanomyces sp.), were observed at 1, 2, 4 and 8 psu but not at 0 and 12 psu. Secondary zoospores of all three isolates, especially WIC, were abundant and motile 1-2 d postsporulation. Sporulation was temperature dependent and occurred over a relatively narrow range. No sporulation occurred at 4, 30 or 35 C for either WIC or PA7. For both strains zoospore production within 1-3 d after the initiation of sporulation was more prolific at 25 C than at 20 and 15 C. At 15 C production of zoospores was sustained over 11 d for WIC and 5 d for PA7. At room temperature single WIC secondary zoospores remained motile 12-18 h. Salinities exceeding 4 psu or vigorous shaking caused immediate cyst formation of WIC secondary zoospores. Exposure to menhaden tissue, but not tissues of other fishes to secondary zoospores (WIC), caused rapid (2 h) cyst formation. Cysts were capable of excysting when transferred to 1 psu water within 2-3 h of cyst formation. Cysts that had remained encysted in 6.5 psu for 24 h did not excyst when transferred to 1 psu water. Salinity and temperature requirements for sporulation indicate that juvenile menhaden must acquire infections during rain or in low salinity oligohaline waters. PMID:16392244

Kiryu, Yasunari; Blazer, Vicki S; Vogelbein, Wolfgang K; Kator, Howard; Shields, Jeffrey D

2005-01-01

89

Factors influencing the sporulation and cyst formation of Aphanomyces invadans, etiological agent of ulcerative mycosis in Atlantic menhaden, Brevoortia tyrannus  

USGS Publications Warehouse

Oomycete infections caused by Aphanomyces invadans occur in freshwater and estuarine fishes around the world. Along the east coast of the USA, skin ulcers caused by A. invadans are prevalent in Atlantic menhaden, Brevoortia tyrannus. From laboratory observations low salinities appear crucial to transmission of the pathogen. To better understand aspects of transmission, we characterized sporulation and cyst formation of secondary zoospores of two isolates of A. invadans at different salinities and temperatures. Sporulation occurred only at low salinities. At room temperature (ca. 20-22 C), using "pond water" augmented with artificial sea salts, the endemic strain WIC and the Thailand strain PA7 of A. invadans produced free-swimming secondary zoospores at salinities of 0, 1 and 2 psu (practical salinity unit = ???), but not at 4 psu or higher. Secondary zoospores of another species, ATCC-62427 (Aphanomyces sp.), were observed at 1, 2, 4 and 8 psu but not at 0 and 12 psu. Secondary zoospores of all three isolates, especially WIC, were abundant and motile 1-2 d post-sporulation. Sporulation was temperature dependent and occurred over a relatively narrow range. No sporulation occurred at 4, 30 or 35 C for either WIC or PA7. For both strains zoospore production within 1-3 d after the initiation of sporulation was more prolific at 25 C than at 20 and 15 C. At 15 C production of zoospores was sustained over 11 d for WIC and 5 d for PA7. At room temperature single WIC secondary zoospores remained motile 12-18 h. Salinities exceeding 4 psu or vigorous shaking caused immediate cyst formation of WIC secondary zoospores. Exposure to menhaden tissue, but not tissues of other fishes to secondary zoospores (WIC), caused rapid (2 h) cyst formation. Cysts were capable of excysting when transferred to 1 psu water within 2-3 h of cyst formation. Cysts that had remained encysted in 6.5 psu for 24 h did not excyst when transferred to 1 psu water. Salinity and temperature requirements for sporulation indicate that juvenile menhaden must acquire infections during rain or in low salinity oligohaline waters. ?? 2005 by The Mycological Society of America.

Kiryu, Y.; Blazer, V.S.; Vogelbein, W.K.; Kator, H.; Shields, J.D.

2005-01-01

90

The effectiveness of a four-layer compression bandage system in comparison with Class 3 compression hosiery on healing and quality of life in patients with venous leg ulcers: a randomised controlled trial.  

PubMed

An increasing number of compression systems available for treatment of venous leg ulcers and limited evidence on the relative effectiveness of these systems are available. The purpose of this study was to conduct a randomised controlled trial to compare the effectiveness of a four-layer compression bandage system and Class 3 compression hosiery on healing and quality of life (QL) in patients with venous leg ulcers. Data were collected from 103 participants on demographics, health, ulcer status, treatments, pain, depression and QL for 24 weeks. After 24 weeks, 86% of the four-layer bandage group and 77% of the hosiery group were healed (P = 0·24). Median time to healing for the bandage group was 10 weeks, in comparison with 14 weeks for the hosiery group (P = 0·018). The Cox proportional hazards regression found participants in the four-layer system were 2·1 times (95% CI 1·2-3·5) more likely to heal than those in hosiery, while longer ulcer duration, larger ulcer area and higher depression scores significantly delayed healing. No differences between groups were found in QL or pain measures. Findings indicate that these systems were equally effective in healing patients by 24 weeks; however, a four-layer system may produce a more rapid response. PMID:22716129

Finlayson, Kathleen J; Courtney, Mary D; Gibb, Michelle A; O'Brien, Jane A; Parker, Christina N; Edwards, Helen E

2014-02-01

91

Pain and quality of life for patients with venous leg ulcers: proof of concept of the efficacy of Biatain-Ibu, a new pain reducing wound dressing.  

PubMed

Wound pain is a serious problem for elderly patients suffering from chronic leg ulcers, and it may lead to reduced wound healing rates and reduced quality of life. Biatain-Ibu Non-adhesive (Coloplast A/S), a new pain-reducing moist wound healing dressing containing ibuprofen was tested for pain reduction, safety, and efficacy on 10+2 patients in a single-blinded crossover study against Biatain Non-adhesive (Coloplast A/S). Pain was measured with a Numeric Box Scale before, during, and after dressing change. Quality of life was measured using the World Health Organization-5 Well-Being Index. Dressing moist wound healing properties such as absorption capacity and leakage were tested together with assessment of wound exudate and blood plasma content of ibuprofen. Use of the Biatain-Ibu foam dressing correlated with a decrease in pain intensity scores from 7 in the run-in period to approximately 2.5 in the Biatain-Ibu treatment phase. Quality of life measures were improved which together with the reduced pain could contribute to faster wound healing. The moist wound healing properties of Biatain-Ibu were similar to that of the Biatain Non-adhesive and ulcer size was reduced by 24% during the treatment period. Neither side effects nor systemic plasma concentrations of ibuprofen were observed. These data indicate that Biatain-Ibu could reduce persistent and temporary wound pain, increase Quality of life, was found safe to use, and had excellent moist wound healing properties. PMID:16808800

Jørgensen, Bo; Friis, Gitte Juel; Gottrup, Finn

2006-01-01

92

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

PubMed

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

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

2014-02-01

93

Use of 16S Ribosomal DNA PCR and Denaturing Gradient Gel Electrophoresis for Analysis of the Microfloras of Healing and Nonhealing Chronic Venous Leg Ulcers  

PubMed Central

The bacterial microfloras of 8 healing and 10 nonhealing chronic venous leg ulcers were compared by using a combination of cultural analysis and denaturing gradient gel electrophoresis (DGGE) of PCR-amplified 16S rRNA gene products. Cultural analysis of the microflora revealed that the majority of both wound types carried the aerobes Staphylococcus and Pseudomonas spp. (89 and 80%, respectively). Sequencing of 16S ribosomal DNAs selected on the basis of DGGE profiling allowed the identification of strains not detected by cultural means. Of considerable interest was the finding that more than 40% of the sequences represented organisms not cultured from the wound from which they were amplified. DGGE profiles also revealed that all of the wounds possessed one apparently common band, identified by sequencing as Pseudomonas sp. The intensity of this PCR signal suggested that the bacterial load of nonhealing wounds was much higher for pseudomonads compared to healing wounds and that it may have been significantly underestimated by cultural analysis. Hence, the present study shows that DGGE could give valuable additional information about chronic wound microflora that is not apparent from cultural analysis alone. PMID:15297496

Davies, Charlotte E.; Hill, Katja E.; Wilson, Melanie J.; Stephens, Phil; Hill, C. Michael; Harding, Keith G.; Thomas, David W.

2004-01-01

94

UNUSUAL CAUSES OF CUTANEOUS ULCERATION  

PubMed Central

Synopsis Skin ulceration is a major source of morbidity and is often difficult to manage. Ulcers due to an inflammatory etiology or microvascular occlusion are particularly challenging in terms of diagnosis and treatment. The management of such ulcers requires careful assessment of associated systemic conditions and a thorough analysis of the ulcer's clinical and histologic findings. In this report, we discuss several examples of inflammatory ulcers and the approach to their diagnosis and treatment. PMID:21074034

Panuncialman, Jaymie; Falanga, Vincent

2010-01-01

95

Molecular Detection of Cellulosimicrobium cellulans as the Etiological Agent of a Chronic Tongue Ulcer in a Human Immunodeficiency Virus-Positive Patient  

PubMed Central

Ulcerations appeared on the tongue of a 48-year-old human immunodeficiency virus-positive man. Histological findings of the biopsy specimen and the fact that the patient had resided in Louisiana led us to suspect “American histoplasmosis.” A new ulcer appeared while the patient was being treated with itraconazole, and the gene for 16S rRNA of Cellulosimicrobium cellulans was amplified. The lesions healed during treatment with oral penicillin and azithromycin. PMID:16081997

Heym, Beate; Gehanno, Pierre; Friocourt, Veronique; Bougnoux, Marie-Elisabeth; Le Moal, Michele; Husson, Corinne; Leibowitch, Jacques; Nicolas-Chanoine, Marie-Helene

2005-01-01

96

Molecular detection of Cellulosimicrobium cellulans as the etiological agent of a chronic tongue ulcer in a human immunodeficiency virus-positive patient.  

PubMed

Ulcerations appeared on the tongue of a 48-year-old human immunodeficiency virus-positive man. Histological findings of the biopsy specimen and the fact that the patient had resided in Louisiana led us to suspect "American histoplasmosis". A new ulcer appeared while the patient was being treated with itraconazole, and the gene for 16S rRNA of Cellulosimicrobium cellulans was amplified. The lesions healed during treatment with oral penicillin and azithromycin. PMID:16081997

Heym, Beate; Gehanno, Pierre; Friocourt, Véronique; Bougnoux, Marie-Elisabeth; Le Moal, Michèle; Husson, Corinne; Leibowitch, Jacques; Nicolas-Chanoine, Marie-Hélène

2005-08-01

97

Improvement of wound healing by water-filtered infrared-A (wIRA) in patients with chronic venous stasis ulcers of the lower legs including evaluation using infrared thermography  

PubMed Central

Background: Water-filtered infrared-A (wIRA) is a special form of heat radiation with a high tissue-penetration and with a low thermal burden to the surface of the skin. wIRA is able to improve essential and energetically meaningful factors of wound healing by thermal and non-thermal effects. Aim of the study: prospective study (primarily planned randomised, controlled, blinded, de facto with one exception only one cohort possible) using wIRA in the treatment of patients with recalcitrant chronic venous stasis ulcers of the lower legs with thermographic follow-up. Methods: 10 patients (5 males, 5 females, median age 62 years) with 11 recalcitrant chronic venous stasis ulcers of the lower legs were treated with water-filtered infrared-A and visible light irradiation (wIRA(+VIS), Hydrosun® radiator type 501, 10 mm water cuvette, water-filtered spectrum 550–1400 nm) or visible light irradiation (VIS; only possible in one patient). The uncovered wounds of the patients were irradiated two to five times per week for 30 minutes at a standard distance of 25 cm (approximately 140 mW/cm2 wIRA and approximately 45 mW/cm2 VIS). Treatment continued for a period of up to 2 months (typically until closure or nearly closure of the ulcer). The main variable of interest was “percent change of ulcer size over time” including complete wound closure. Additional variables of interest were thermographic image analysis, patient’s feeling of pain in the wound, amount of pain medication, assessment of the effect of the irradiation (by patient and by clinical investigator), assessment of feeling of the wound area (by patient), assessment of wound healing (by clinical investigator) and assessment of the cosmetic state (by patient and by clinical investigator). For these assessments visual analogue scales (VAS) were used. Results: The study showed a complete or nearly complete healing of lower leg ulcers in 7 patients and a clear reduction of ulcer size in another 2 of 10 patients, a clear reduction of pain and pain medication consumption (e.g. from 15 to 0 pain tablets per day), and a normalization of the thermographic image (before the beginning of the therapy typically hyperthermic rim of the ulcer with relative hypothermic ulcer base, up to 4.5°C temperature difference). In one patient the therapy of an ulcer of one leg was performed with the fully active radiator (wIRA(+VIS)), while the therapy of an ulcer of the other leg was made with a control group radiator (only VIS without wIRA), showing a clear difference in favour of the wIRA treatment. All mentioned VAS ratings improved remarkably during the period of irradiation treatment, representing an increased quality of life. Failures of complete or nearly complete wound healing were seen only in patients with arterial insufficiency, in smokers or in patients who did not have venous compression garment therapy. Discussion and conclusions: wIRA can alleviate pain considerably (with an impressive decrease of the consumption of analgesics) and accelerate wound healing or improve a stagnating wound healing process and diminish an elevated wound exudation and inflammation both in acute and in chronic wounds (in this study shown in chronic venous stasis ulcers of the lower legs) and in problem wounds including infected wounds. In chronic recalcitrant wounds complete healing is achieved, which was not reached before. Other studies have shown that even without a disturbance of wound healing an acute wound healing process can be improved (e.g. reduced pain) by wIRA. wIRA is a contact-free, easily used and pleasantly felt procedure without consumption of material with a good penetration effect, which is similar to solar heat radiation on the surface of the earth in moderate climatic zones. Wound healing and infection defence (e.g. granulocyte function including antibacterial oxygen radical formation of the granulocytes) are critically dependent on a sufficient energy supply (and on sufficient oxygen). The good clinical effect of wIRA on wounds and also on problem woun

Mercer, James B.; Nielsen, Stig Pors; Hoffmann, Gerd

2008-01-01

98

Mouth ulcers  

MedlinePLUS

Oral ulcer; Stomatitis - ulcerative; Ulcer - mouth ... Mouth ulcers are caused by many disorders. These include: Canker sores Gingivostomatitis Herpes simplex ( fever blister ) Leukoplakia Oral cancer ...

99

Arterial disease ulcers, part 1: clinical diagnosis and investigation.  

PubMed

Arterial disease (peripheral vascular disease) is the result of narrowing of the blood vessel lumen. The classic clinical signs need to be recognized early before progression to arterial predominant disease and limb ischemia. Arterial ulcers or tissue breakdown can result from trauma, infection, or other etiologies with diabetes, smoking, increasing age, and hypertension the most important risk factors. Diagnostic testing starts with a palpable pulse with special investigation including handheld Doppler for ankle brachial pressure index ratios, segmental duplex leg Doppler waveforms, and more specialized procedures, including transcutaneous oxygen saturation. PMID:25133344

Weir, Gregory Ralph; Smart, Hiske; van Marle, Jacobus; Cronje, Frans Johannes

2014-09-01

100

Venous ulcers - self-care  

MedlinePLUS

... treat a venous ulcer, you want to improve blood flow to your legs. Wear compression stockings or bandages ... or exercise every day. Being active helps improve blood flow. Take medications as directed to help with healing. ...

101

A randomized, controlled clinical pilot study comparing three types of compression therapy to treat venous leg ulcers in patients with superficial and/or segmental deep venous reflux ?.  

PubMed

Compression therapy--including inelastic, elastic, and intermittent pneumatic compression--is the standard of care for venous ulcers (VLUs) and chronic venous insufficiency, but there is no consensus in the literature regarding the most effective type of compression therapy. A prospective, randomized, clinical pilot study was conducted among 70 patients with unilateral VLUs treated in a hospital dermatology department in Poland to compare three types of compression therapy (intermittent pneumatic compression, stockings, and short-stretch bandages) in persons with superficial deep venous reflux alone or combined with the segmental variety. Study endpoints were change in ulcer dimensions and proportions healed. Patients with superficial or combined superficial and deep vein insufficiency were randomly allocated to receive one of the three therapies (one of each vein type for each treatment option, six groups total). All patients received saline-soaked gauze dressings along with micronized purified flavonoid fraction, diosmin, hesperidin, and Daflon 500 once daily. Compression treatments were changed or pneumatic compression provided daily for 15 days. Wound size reduction and percentage of wounds healed were significantly higher in groups receiving intermittent pneumatic compression or stockings than in groups using short-stretch bandages (for percentage change of ulcer surface area, P = 0.02; for healing rates P = 0.01). These results warrant additional randomized controlled clinical studies with a larger sample size and longer patient follow-up. PMID:23934375

Dolibog, Pawel; Franek, Andrzej; Taradaj, Jakub; Polak, Anna; Dolibog, Patrycja; Blaszczak, Edward; Wcislo, Ligia; Hrycek, Antoni; Urbanek, Tomasz; Ziaja, Jacek; Kolanko, Magdalena

2013-08-01

102

Hunner's Ulcers  

MedlinePLUS

Hunner's Ulcers Hunner's ulcers, also called "Hunner’s lesions" or "Hunner's patches," are a subtype of interstitial cystitis (also called IC) and are not ulcers in the usual sense. They are distinctive areas ...

103

Corneal Ulcer  

MedlinePLUS

... Health News Consumer Alerts What Is a Corneal Ulcer? Tweet A corneal ulcer is an open sore on the cornea — the ... covers the face of a watch. A corneal ulcer usually results from an eye infection, though it ...

104

Ugh! Ulcers  

MedlinePLUS

... Works Main Page The Pink Locker Society Ugh! Ulcers KidsHealth > Kids > Health Problems of Grown-Ups > Diseases & ... real story? Let's find out. What Is an Ulcer? An ulcer (say: ul -sur) is a sore, ...

105

[Oral ulcers].  

PubMed

Ulcers commonly occur in the oral cavity, their main symptom being pain. There are different ways to classify oral ulcers. The most widely accepted form divides them into acute ulcers--sudden onset and short lasting--and chronic ulcers--insidious onset and long lasting. Commonest acute oral ulcers include traumatic ulcer, recurrent aphthous stomatitis, viral and bacterial infections and necrotizing sialometaplasia. On the other hand, oral lichen planus, oral cancer, benign mucous membrane pemphigoid, pemphigus and drug-induced ulcers belong to the group of chronic oral ulcers. It is very important to make a proper differential diagnosis in order to establish the appropriate treatment for each pathology. PMID:16277953

Bascones-Martínez, Antonio; Figuero-Ruiz, Elena; Esparza-Gómez, Germán Carlos

2005-10-29

106

Pterygotus legs  

NSDL National Science Digital Library

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).

2001-03-01

107

Causes of venous ulceration: a new hypothesis  

Microsoft Academic Search

Previous hypotheses about the causes of venous ulceration are inconsistent with recently published data. In patients with chronic venous insufficiency the number of functioning capillary loops visible in the skin on microscopy fell after the legs had been dependent for 30 minutes. Another study had shown that leucocytes became trapped in the circulation in dependent legs. A new hypothesis linking

P D Coleridge Smith; P Thomas; J H Scurr; J A Dormandy

1988-01-01

108

Exertional leg pain in the athlete.  

PubMed

Exertional leg pain is a common condition seen in athletes and the general population. Although the differential diagnosis of exertional leg pain is broad, this article focuses on the incidence, anatomy, pathophysiology, clinical presentation, diagnostic evaluation, management, and return-to-play guidelines of chronic exertional compartment syndrome and vascular and nerve entrapment etiologies. PMID:23245661

Rajasekaran, Sathish; Kvinlaug, Kylie; Finnoff, Jonathan T

2012-12-01

109

Pyoderma gangrenosum: skin grafting and hyperbaric oxygen as adjuvants in the treatment of a deep and extensive ulcer*  

PubMed Central

Pyoderma gangrenosum is a rare dermatosis of unknown etiology and variable clinical presentation. The disease is challenging for the medical staff, from the frequent diagnostic difficulties to the lack of scientific evidence with a good level to support the management of extensive and refractory cases. Our patient is a 50 year-old man with an extensive and deep ulcer on the left leg, which exemplifies the therapeutic difficulties inherent to the disease and who, fortunately, has progressed with excellent result after association of hyperbaric oxygen therapy and skin grafting to the immunosuppression therapy initially proposed. PMID:24346912

Araujo, Fernanda Mendes; Kondo, Rogerio Nabor; Minelli, Lorivaldo

2013-01-01

110

Stress ulcer disease in the burned patient  

Microsoft Academic Search

Stress-induced ulcers of the stomach and duodenum in massively burned patients, otherwise known as Curling's ulcers, result from a defect in the mucosal barrier to secreted acid. The etiology of this defect is related, at least in part, to mucosal ischemia, which is aggravated by hypotension, sepsis, and hypoxia. Early prophylactic administration of antacids and cimetidine, either singly or in

Basil A. Pruitt; Cleon W. Goodwin

1981-01-01

111

Peptic Ulcers  

MedlinePLUS

... ulcer. Also make sure that your child avoids coffee, tea, sodas, and foods that contain caffeine , which ... movements bloody vomit or vomit that looks like coffee grounds If your child has peptic ulcer disease, ...

112

Peptic Ulcer  

MedlinePLUS

A peptic ulcer is a sore in the lining of your stomach or your duodenum, the first part of your small ... and goes for several days or weeks Peptic ulcers happen when the acids that help you digest ...

113

Pressure ulcer  

MedlinePLUS

A pressure ulcer is an area of skin that breaks down when something keeps rubbing or pressing against the skin. ... form. You are more likely to get a pressure ulcer if you: Use a wheelchair or stay in ...

114

Leg Strain  

MedlinePLUS

... have come apart. Symptoms Symptoms of a strained leg muscle can include: Muscle pain and tenderness, especially after an activity that stretches or violently contracts the muscle. Pain usually increases when you move ...

115

Buruli ulcer  

Microsoft Academic Search

Buruli ulcer is an indolent necrotizing disease of the skin, subcutaneous tissue, and bone that is caused by Mycobacterium ulcerans. Buruli ulcer is presently the third most common mycobacterial disease of humans, after tuberculosis and leprosy, and the least understood of the three. The disease remained largely ignored by many national public health programs, but more recently, it has been

Françoise Portaels; Manuel T. Silva; Wayne M. Meyers

2009-01-01

116

Management of venous ulcers.  

PubMed

Chronic venous insufficiency (CVI) results from venous hypertension secondary to superficial or deep venous valvular reflux, as well as venous obstruction. The most severe clinical manifestation of CVI is venous leg ulceration that can result in significant morbidity, including venous gangrene and amputation, albeit rare. Treatment modalities are aimed at reducing venous hypertension. Diuretic therapy, although widely used, only provides short-term improvement of the edema but provides no long-term benefit. Compression therapy is the cornerstone in the management of CVI. Compression can be achieved using compression bandaging, compression pumps, or graduated compression stockings. Topical steroid creams may reduce inflammation, venous eczema, and pain in the short term, but they can be detrimental in the long run. Apligraf (a living, bilayered, cell-based product) in conjunction with compression therapy was noted to be more effective in healing venous leg ulcerations, when compared with treatment with compression therapy and zinc paste. Endovascular and surgical techniques that minimize valvular reflux and relieve venous obstruction improve venous hemodynamics, promoting wound healing. PMID:24840970

Kolluri, Raghu

2014-06-01

117

Diagnosis and management of genital ulcers.  

PubMed

Herpes simplex virus infection and syphilis are the most common causes of genital ulcers in the United States. Other infectious causes include chancroid, lymphogranuloma venereum, granuloma inguinale (donovanosis), secondary bacterial infections, and fungi. Noninfectious etiologies, including sexual trauma, psoriasis, Behçet syndrome, and fixed drug eruptions, can also lead to genital ulcers. Although initial treatment of genital ulcers is generally based on clinical presentation, the following tests should be considered in all patients: serologic tests for syphilis and darkfield microscopy or direct fluorescent antibody testing for Treponema pallidum, culture or polymerase chain reaction test for herpes simplex virus, and culture for Haemophilus ducreyi in settings with a high prevalence of chancroid. No pathogen is identified in up to 25 percent of patients with genital ulcers. The first episode of herpes simplex virus infection is usually treated with seven to 10 days of oral acyclovir (five days for recurrent episodes). Famciclovir and valacyclovir are alternative therapies. One dose of intramuscular penicillin G benzathine is recommended to treat genital ulcers caused by primary syphilis. Treatment options for chancroid include a single dose of intramuscular ceftriaxone or oral azithromycin, ciprofloxacin, or erythromycin. Lymphogranuloma venereum and donovanosis are treated with 21 days of oral doxycycline. Treatment of noninfectious causes of genital ulcers varies by etiology, and ranges from topical wound care for ulcers caused by sexual trauma to consideration of subcutaneous pegylated interferon alfa-2a for ulcers caused by Behçet syndrome. PMID:22335265

Roett, Michelle A; Mayor, Mejebi T; Uduhiri, Kelechi A

2012-02-01

118

Ulcerative Colitis  

MedlinePLUS Videos and Cool Tools

... food. The middle layer of the intestines is muscle that helps push food through. The outer layer ... with ulcerative colitis may also experience • fatigue • weight loss • loss of appetite • rectal bleeding • loss of body ...

119

Ulcerative colitis  

MedlinePLUS

... a condtion in which the lining of the large intestine (colon) and rectum become inflamed. Ulcerative colitis is ... the rectal area. It may involve the entire large intestine over time. It may also start in the ...

120

Ulcerative Colitis  

MedlinePLUS

... symptoms or condition despite treatment continued dependency on steroids side effects from medications that threaten their health Removal of the entire colon, including the rectum, "cures" ulcerative colitis. A surgeon performs the procedure at a hospital. ...

121

A Dynamic Compression System for Improving Ulcer Healing: Design of a Sensing Garment  

E-print Network

1 A Dynamic Compression System for Improving Ulcer Healing: Design of a Sensing Garment M. Hegarty1 Company, 3 School of Computing, University of Utah Abstract--Venous leg ulcers remain a major problem ulcers, auscul- tation, bio-impedance. I. INTRODUCTION Between 500,000-600,000 persons living

Henderson, Thomas C.

122

l1:Leg l2:Leg l3:Leg l4:Leg p1:Person n1:Number  

E-print Network

#12;#12;t1:Table leg3 leg4 leg2 leg1 l1:Leg l2:Leg l3:Leg l4:Leg color owner i1:Ident p1:Person n1:Number ssn #12;Leg color owner Ident Person Number ssn Table leg1 leg2 leg3 leg4 Owner Person Company Low-Orbit p Path Contract Country c country #12;Person Son ssn Number father mother Child name

Bergstein, Paul

123

Mechanisms of Disease: pathogenesis of Crohn's disease and ulcerative colitis  

Microsoft Academic Search

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

R Balfour Sartor

2006-01-01

124

The epidemiology of neuropathic foot ulcers in individuals with diabetes  

Microsoft Academic Search

There is now substantial evidence that diabetic neuropathy is a major etiologic factor for diabetic foot ulcers. Epidemiologic\\u000a data show a very strong association between foot ulcers and indicators of sensorimotor neuropathy. Additionally, a causal\\u000a pathway (sensorimotor neuropathy, which leads to increased pressures at foot surfaces, which then leads to foot ulcers) has\\u000a been postulated. Evidence suggests that other factors

Jay Sosenko

2002-01-01

125

The DEPA scoring system and its correlation with the healing rate of diabetic foot ulcers  

Microsoft Academic Search

The purpose of this study was to examine the validity of a new scoring system in predicting the outcome of diabetic foot ulcers. The scoring system (DEPA score) includes the depth of the ulcer (D), the extent of bacterial colonization (E), the phase of ulcer healing (P) and the associated underlying etiology (A). The scoring system was validated against the

Nidal A Younes; Abla M Albsoul

2004-01-01

126

Oral ulceration due to chronic use of Nicorette gum: case report.  

PubMed

Oral ulceration is a common presentation in a dental clinic. These ulcers may be acute or chronic, based on the duration of symptoms. The etiology of oral ulceration can range from trauma to squamous cell carcinoma. It is the responsibility of the dentist to differentiate the various etiologies of oral ulceration for proper management. This case report is presented to remind dentists that the long-term use of Nicorette gum should be considered in the differential diagnosis of chronic oral ulcers. PMID:20591780

Narayana, Nagamani; Meinberg, Trudy

2010-01-01

127

Si Legs  

NASA Astrophysics Data System (ADS)

We have fabricated several kinds of uni-leg thermoelectric (TE) modules using Sb-doped n-type Mg2Si. In order to evaluate the influence of the structure of the modules on their durability with respect to heat-cycling, modules of two different types were evaluated. One was a conventional-structured module, in which the upper and lower surfaces of the legs were each fixed to a ceramic substrate. The other was a `half skeleton' module, in which the `cold-side' substrate was removed and a thermal-conductive sheet was used instead of a ceramic plate for the cold-side insulator. From the result of this evaluation, it was confirmed that, although some variation in the output power was observed for the `half-skeleton' module, the power variation was markedly less than for the conventional-structured module. Additionally, to improve the output power of the module, we replaced the Al2O3 substrate with Si3N4, which has a higher thermal conductivity than the Al2O3 substrate. The observed output power of a module (25 mm × 24 mm × 8.3 mm) fabricated using the Si3N4 substrate was 1,293 mW at ?T = 500 K. The output value of the module using the Si3N4 plate was improved by 29 % compared with the output value of the module using the Al2O3 substrate. Moreover, based on the structures of these modules, a 36 mm × 41 mm × 8.3 mm module was fabricated. The expected value of the output power of the module was 1.9 W at ?T = 500 K.

Nemoto, Takashi; Iida, Tsutomu; Sato, Junichi; Suda, Hiroshi; Takanashi, Yoshifumi

2014-06-01

128

Ulcerative colitis  

Microsoft Academic Search

Summary and conclusions  In so far as can be judged, the features of ulcerative disease of the colon in the aforementioned three patients have many\\u000a points in common. However, the intensity and severity of the disease as it afflicted the three patients are different. If\\u000a the patient in Case 2 had been permitted to continue without treatment for several more weeks,

Charles J. Donald; Philip W. Brown

1940-01-01

129

Pressure ulcers  

PubMed Central

Introduction Unrelieved pressure or friction of the skin, particularly over bony prominences, can lead to pressure ulcers in up to one third of people in hospitals or community care, and one fifth of nursing home residents. Pressure ulcers are more likely in people with reduced mobility and poor skin condition, such as older people or those with vascular disease. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in people at risk of developing pressure ulcers? What are the effects of treatments in people with pressure ulcers? We searched: Medline, Embase, The Cochrane Library, and other important databases up to June 2010 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 64 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: air-filled vinyl boots, air-fluidised supports, alternating-pressure surfaces (including mattresses), alternative foam mattresses, constant low-pressure supports, debridement, electric profiling beds, electrotherapy, hydrocellular heel supports, low-air-loss beds (including hydrotherapy beds), low-level laser therapy, low-tech constant-low-pressure supports, medical sheepskin overlays, nutritional supplements, orthopaedic wool padding, pressure-relieving overlays on operating tables, pressure-relieving surfaces, repositioning (regular "turning"), seat cushions, standard beds, standard care, standard foam mattresses, standard tables, surgery, therapeutic ultrasound, topical lotions and dressings, topical negative pressure, and topical phenytoin. PMID:21524319

2011-01-01

130

Pressure ulcers  

PubMed Central

Introduction Unrelieved pressure or friction of the skin, particularly over bony prominences, can lead to pressure ulcers in up to a third of people in hospitals or community care, and a fifth of nursing home residents. Pressure ulcers are more likely in people with reduced mobility and poor skin condition, such as older people or those with vascular disease. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of preventive interventions in people at risk of developing pressure ulcers? What are the effects of treatments in people with pressure ulcers? We searched: Medline, Embase, The Cochrane Library and other important databases up to February 2007 (BMJ Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 60 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: air-filled vinyl boots, air-fluidised supports, alternating pressure surfaces (including mattresses), alternative foam mattresses, constant low-pressure supports, debridement, electric profiling beds, electrotherapy, hydrocellular heel supports, low-air-loss beds (including hydrotherapy beds), low-level laser therapy, low-tech constant low-pressure supports, medical sheepskin overlays, nutritional supplements, orthopaedic wool padding, pressure-relieving overlays on operating tables, pressure-relieving surfaces, repositioning (regular "turning"), seat cushions, standard beds, standard care, standard foam mattresses, standard tables, surgery, therapeutic ultrasound, topical lotions and dressings, topical negative pressure, and topical phenytoin. PMID:19450317

2008-01-01

131

Getting Your Sea Legs  

PubMed Central

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

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

2013-01-01

132

Canker Sore (Aphthous Ulcer)  

MedlinePLUS

newsletter | contact Share | Canker Sore (Aphthous Ulcer) Information for adults A A A This image displays white-to-yellow lesions typical of apthous ulcers. Overview Canker sores (aphthous ulcers), ...

133

Differential diagnosis of ulcerative lesions in fish.  

PubMed Central

Tissues such as skin and muscle have a limited repertoire of morphological response to injury. The two most important phenomena that determine the outcome of cell injury appear to be a) critical cell membrane damage, with associated fluid and ionic imbalances; and b) inability of mitochondria, the powerhouse of the cell, to restart ATP synthesis. In fish, skin ulcers can have many different etiologies, including infectious agents, toxins, physical causes, immunologic causes, and nutritional and metabolic perturbations. This article is concerned primarily with the possible pathways of disease involved in ulcerative lesions of fish. In particular, the high prevalence of ulcerative lesions in Atlantic menhaden found along the mid-Atlantic coast, especially in North Carolina estuarine waters, has received much recent attention. These ulcerative lesions are likely to be initiated by a series of factors that lead ultimately to a breach of the normal barrier function of the skin. Bioassays that attempt to define the role of individual etiologic agents such as fungi (oomycetes) or putative Pfiesteria toxin(s) should recognize this multiplicity of factors and should include appropriate quality control measures for water quality parameters (temperature, dissolved oxygen, nitrogenous wastes, etc.) as well as bacterial and other contaminants that may confound bioassay results and their interpretation. Consideration of these factors along with the whole animal in the context of its environment can only advance the science, perhaps provide clues to the causative pathways of skin ulcers in fish, and give us keener insight into the health of the aquatic environment. PMID:11677175

Law, M

2001-01-01

134

Leg Injuries and Disorders  

MedlinePLUS

... They are important for motion and standing. Playing sports, running, falling, or having an accident can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. ...

135

Leg lengthening - series (image)  

MedlinePLUS

... severe unequal leg lengths caused by: poliomyelitis and cerebral palsy small, weak (atrophied) muscles or short, tight (spastic) muscles may cause deformities and prevent normal leg growth hip diseases ...

136

Leg lengthening and shortening  

MedlinePLUS

... to severely unequal leg lengths. They include: Poliomyelitis Cerebral palsy Small, weak muscles or short, tight (spastic) muscles, which may cause problems and prevent normal leg growth Hip diseases ...

137

A simplified method of total contact casting for diabetic foot ulcers.  

PubMed

A simplified method of total contact casting for diabetic plantar ulcerations is described in which a standard, well-molded short-leg walking cast is applied. Weekly cast changes are performed initially, followed by longer cast change intervals. Either fiberglass or plaster casting tape appears equally efficacious. Healing of all ulcers was demonstrated in 12 patients treated with this technique. PMID:10148327

Huband, M S; Carr, J B

1993-02-01

138

n -3 Fatty acids in the treatment of ulcerative colitis  

Microsoft Academic Search

\\u000a Ulcerative colitis is a chronic inflammatory disease of the large bowel of unknown etiology. The inflammation is generally\\u000a confined to the mucosal layers, resulting in extensive superficial ulceration. Antiinflammatory drugs are helpful in treating\\u000a this condition, as are drugs that reduce the immune response such as azathioprine and 6-mercaptopurine. Fish oil n-3 polyunsaturated fatty acids (PUFAs), eicosapentaenoic (EPA) and docosahexaenoic

John B. Rodgers

139

A natural biomembrane as a new proposal for the treatment of pressure ulcers Biomembrana natural como uma nova proposta de tratamento para as úlceras de pressão  

Microsoft Academic Search

Summary Pressure ulcer is a common syndrome of diffi cult treatment among bedridden individuals, with clinical and socioeconomic repercussions. A recently developed natural biomembrane (NBM) as a therapeutic option for leg ulcers with debriding and neo-angiogenic properties encouraged us to apply it as a treatment for pressure ulcers. The authors report the results obtained with the NBM dressing on alternate

Marco Andrey Cipriani Fradea; Adriana Martinelli Salathiela; Eduardo Lopez Mazzucatoa; Joaquim Coutinho Nettob; Norma Tiraboschi Fossa

2006-01-01

140

JAMA Patient Page: Pressure Ulcers  

MedlinePLUS

... the American Medical Association JAMA PATIENT PAGE Pressure Ulcers A pressure ulcer is an injury to the skin as a ... 203/259-8724. PREVENTION AND TREATMENT OF PRESSURE ULCERS Prevention of pressure ulcers is key because treatment ...

141

Skin zinc concentrations in patients with varicose ulcers  

SciTech Connect

The concentration of zinc in the skin has been determined noninvasively in patients with varicose vein ulcers. The examinations were performed with the use of diagnostic x-ray spectrometry, a method based on x-ray fluorescence for in vivo noninvasive evaluation of trace elements. Four skin foci were examined: at the periphery of the ulcer and control areas in a nonulcerated area in the diseased leg, in the noninvolved leg, and in the proximal inner surface of the arm. Zinc levels around the ulcer (mean +/- SD, 9.8 +/- 4.0 micrograms of zinc in 1 g of wet tissue) were higher than those in the nonulcerated skin in the diseased leg (6.9 +/- 3.0 micrograms/g, p greater than 0.05) and those in the noninvolved leg (5.4 +/- 2.0 micrograms/g, p less than 0.01). The concentration of zinc in the inner proximal surface of the arm (9.8 +/- 2.8 micrograms/g) was significantly higher than those of a control group (5.3 +/- 1.9 micrograms/g, p less than 0.01). These results suggest a defect of zinc distribution in patients with varicose vein ulcers.

Ackerman, Z.; Loewenthal, E.; Seidenbaum, M.; Rubinow, A.; Gorodetsky, R. (Hadassah Univ. Hospital, Jerusalem (Israel))

1990-06-01

142

Segmentation and analysis of the tissue composition of dermatological ulcers  

Microsoft Academic Search

Ulcered lesions on the legs and feet caused by venous insufficiency and other conditions require long-term clinical treatment and follow-up. To facilitate the analysis of the tissue composition of a lesion, we propose color imaging and image processing methods. Methods considering the bottom tissues are proposed for the segmentation of a given image into regions corresponding to red granulation, yellow

E. A. G. Dorileo; Marco A. C. Frade; Rangaraj M. Rangayyan; Paulo M. Azevedo-Marques

2010-01-01

143

A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule  

PubMed Central

Pyoderma gangrenosum is a phenomenon of cutaneous ulceration where etiology is not well understood. About half of the cases have an associated extracutanoeus manifestation or associated systemic diseases. Most commonly associated systemic disorders include inflammatory bowel disease, hematologic malignancies, autoimmune arthritis, and vasculitis. We are reporting a case where pyoderma gangrenosum has presenting features for ulcerative colitis. PMID:24596646

Li, Xin; Chandra, Subhash

2014-01-01

144

Bedsores (Pressure Ulcers)  

MedlinePLUS

... for adults A A A A well-defined superficial pressure ulcer. Overview Bedsores (pressure ulcers), also known ... wash the area with a mild soap and water. Clean open sores on the skin with salt ...

145

Corneal ulcers and infections  

MedlinePLUS

... at the front of the eye. A corneal ulcer is an erosion or open sore in the ... Corneal ulcers are most commonly caused by an infection with bacteria, viruses, fungi, or a parasite. Acanthamoeba keratitis occurs ...

146

Preventing pressure ulcers  

MedlinePLUS

Decubitus ulcer prevention; Bedsore prevention; Pressure sores prevention ... care protocol: Skin safety protocol: Risk assessment and prevention of pressure ulcers . Institute for Clinical Systems Improvement. 2nd ed. 2007 ...

147

ANEUPLOIDY: ETIOLOGY AND MECHANISMS  

EPA Science Inventory

The 'Symposium on Aneuploidy: Etiology and Mechanisms' was held from March 25-29, 1985. This Symposium developed as a consequence of the concern of the Environmental Protection Agency with the support of the National Institute of Environmental Health Sciences about human exposure...

148

Foot, leg, and ankle swelling  

MedlinePLUS

Swelling of the ankles - feet - legs; Ankle swelling; Foot swelling; Leg swelling; Edema - peripheral; Peripheral edema ... Foot, leg, and ankle swelling is common with the following situations: Being overweight Blood clot in the ...

149

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

PubMed

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

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

2014-10-01

150

Yellow Legged Frog  

USGS Multimedia Gallery

USGS scientists found this adult mountain yellow-legged frog on June 10 in Tahquitz Creek, a rediscovered population of the endangered frog in the San Jacinto Wilderness, San Bernardino National Forest, California....

2009-07-23

151

Legs of Mesolimulus  

NSDL National Science Digital Library

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).

2001-03-01

152

[Duplexsonography investigation in patients with venous ulcer].  

PubMed

Venous hypertension due to venous insufficiency causes venous ulcers. Duplexsonography is a widely accepted non invasive method to assess venous insufficiency with venous reflux measurements. Retrograde venous flow is defined as venous reflux. The testing of venous reflux is reliable if transvalvular pressure is sufficiently high and transvalvular flow velocity exceeds 30 cm/s. Reflux testing in the proximal leg veins (V. femoralis communis, V. femoralis, V. saphena magna) is done using a standardised Valsalva Manoeuvre (exspiration into a tube up to a pressure of 30 mmHg, pressure established within 0.5 seconds, pressure hold for 3 seconds). Distal leg vein testing (V. poplitea, V. tibialis posterior, V. saphena parva) is recommended with a two handed - compression distally to the tested veins. The most important parameter is venous reflux time, a cut off of > 2 seconds is recommended. PMID:21360458

Jeanneret-Gris, Christina

2011-03-01

153

Robot and Robot Leg Mechanism.  

National Technical Information Service (NTIS)

A robot with a body, at least one leg on each side of the body, and a hip connecting the leg to the body. The hip is configured to abduct and adduct the leg. A linkage is configured to rotate the leg along a predetermined path.

A. Saunders, M. Buehler

2004-01-01

154

Science Nation: Ulcer Answers  

NSDL National Science Digital Library

Every year, nearly four million people in the United States are afflicted with stomach ulcers. The explanation of how you contract an ulcer has evolved from what seemed like an educated guess 50 years ago to something based more in scientific fact today. In 1982, two Australian scientists were able to link a specific bacteria to most stomach ulcers. They eventually went on to win the 2005 Nobel Prize in Medicine for their work.

155

Etiology of melanoma.  

PubMed

Although the precise etiology of melanoma remains unknown, much data link sunlight to melanoma. The imperfect evidence associating sun exposure (particularly UVB radiation) with melanoma emerges from human data, obviating problems inherent in extrapolation from animal and other models. However, the mechanism by which sunlight might possibly initiate or promote melanoma remains obscure. Some clarification should emerge from the potential isolation of genes that carry susceptibility to melanoma in families prone to the disease; such work could serve as a basis to distinguish genetic and environmental influences in melanoma [167]. Continued studies of faulty DNA repair in XP patients may elucidate the steps in mutagenesis and carcinogenesis. Future case-control studies must address the limits on the accuracy of recall and the limits on statistical methods to separate the cluster of phenotypic risk needed in determining biologically effective dose. Animal and in vitro studies must contribute more insight. Further research in the South American opossum models appears promising [72]. Although ozone depletion has been documented, there has been little definitive evidence of subsequent increase of UVB at the Earth's surface. Nevertheless, the threat posed by ozone depletion deserves continued environmental action and public education. The role of precursor lesions, particularly dysplastic nevi/atypical moles, must be clarified with future research. The distribution of melanoma among various work forces suggests that occupational risk factors may play an important role in the etiology of this disease [168-170]. The consistent reports of excess melanoma among accountants, clerical workers, professional workers, and teachers deserve further study. Furthermore, evidence of excesses in printing and press, petrochemical, and the telecommunications industries require follow-up. Carefully planned studies that account for nonoccupational risk factors are recommended. Research over the last four decades has brought much information about melanoma etiology. More work is needed to learn the precise cause and ultimately to prevent avoidable mortality from malignant melanoma. PMID:8104018

Koh, H K; Sinks, T H; Geller, A C; Miller, D R; Lew, R A

1993-01-01

156

Acute duodenal ulcer.  

PubMed Central

A series of 31 infants and children with acute duodenal ulcer verified by endoscopy was studied over an eight year period. Eighteen (58%) of them were under 2 years of age. The most common symptom was upper gastrointestinal bleeding (n = 27, 87%). Twenty nine patients (94%) had a preceding illness characterised by diarrhoea, upper respiratory tract infection, or fever, which was not necessarily treated with antipyretic drugs. Initial endoscopy showed that ulcer lesions were solitary in 14 patients and present on the anterior wall (n = 11), posterior wall (n = 2), or both (n = 1). Multiple ulcers were found in 17 patients, and present in the bulb with (n = 6) or without (n = 11) extension into the second part of duodenum. The most conspicuous finding was the irregularly shaped ulcers seen in eight young children with similar clinical and endoscopic features. Sixteen patients were re-endoscoped one to two weeks after the initial examination; the ulcers had entirely disappeared in 13, and there were only small residual ulcers in three. Thirty patients were treated medically and only one (with uncontrollable haemorrhage) required operation. Most patients were symptom free two to six years after the initial diagnosis. Our results suggest that young children may develop acute duodenal ulcers after viral illnesses whether or not they are treated with drugs, mainly antipyretics. This kind of acute duodenal ulcer usually heals quickly irrespective of the morphology, site, and number of ulcers. Images Figure PMID:2774612

Hsu, H Y; Chang, M H; Wang, T H; Hsu, J Y; Wang, C Y; Lin, M I; Wu, M H

1989-01-01

157

[NUG--necrotizing ulcerative gingivitis: a review].  

PubMed

Necrotizing Ulcerative Gingivitis (NUG) is an acute and rare (0.5-11% of the population) infectious disease of the gum tissue, which is characterized by ulceration and inflammation of the inter-dental gum tissue. NUG was documented by historians since the fourth century BC, most of the reports from the ancient world were in the context of illness among fighting troops, present studies of NUG in the modern world are still common among soldiers. NUG is associated with poor oral hygiene and weakening of the host, especially in immunocompromised patients, malnutrition and poor living conditions, as well as in the context of mental stress. NUG is more common in young adults, but reports of morbidity in young children with malnutrition in the background are not uncommon. NUG diagnosis is based on three essential symptoms: sore gums, bleeding gums and the most diagnostic characteristic, ulceration and necrosis of the interdental papillae. The disease is considered to have a clear initial infectious etiology, when the main bacteria, associated with the disease, include: Bacteroides intermedius and Fusobacterium sp. The infection involves anaerobic \\ aerobic bacteria with a majority of Gram-negative bacteria. The treatment of NUG is based on combining mechanical removal of tartar with local and systemic delivery of antimicrobial agents. Adequate treatment usually prevent the progression of the disease and ulcer healing is expected in a few days. Nevertheless, lack of treatment can lead to deterioration in the form NUP to Noma. PMID:25219100

Mizrahi, Y

2014-07-01

158

The difficult venous ulcer: case series of 177 ulcers referred for vascular surgical opinion following failure of conservative management.  

PubMed

Venous leg ulcers are common, chronic, debilitating, and expensive. Evidence supports use of compression bandaging, with superficial venous surgery in selected cases, but these interventions frequently fail to achieve healing. We describe a series of 152 consecutive referrals from a nurse-led specialist dermatology clinic to a vascular surgical service; a group posing particularly challenging problems. This observational study, with median follow-up of 18 months, describes outcomes in a number of important clinically identifiable subgroups. Its findings may assist service planning and discussion of the surgical role within multidisciplinary ulcer management. PMID:19398420

Neequaye, S K; Douglas, A D; Hofman, D; Wolz, M; Sharma, R; Cummings, R; Hands, L

2009-01-01

159

Squamous Cell Carcinoma (Marjolin's Ulcer) Arising in a Sacral Decubitus Ulcer Resulting in Humoral Hypercalcemia of Malignancy.  

PubMed

Long-standing burns, fissures, and ulcers that undergo malignant transformation into a variety of malignancies, including squamous cell carcinoma, is commonly referred to as a Marjolin's ulcer. It is well recognized that squamous cell carcinomas of the lung and esophagus can cause humoral hypercalcemia of malignancy secondary to paraneoplastic secretion of parathyroid hormone-related peptide. However, it is extremely rare for a squamous cell carcinoma developing in a sacral decubitus ulcer to cause humoral hypercalcemia of malignancy. We describe the first case of a patient found to have elevated serum levels of parathyroid hormone related peptide related to his Marjolin's ulcer. A 45-year-old African American man with T6 paraplegia and a sacral decubitus ulcer present for 20 years was admitted for hypercalcemia of unclear etiology. He was subsequently found to have elevated parathyroid hormone related peptide and an excisional biopsy from the ulcer showed invasive squamous cell carcinoma suggestive of humoral hypercalcemia of malignancy. The patient ultimately succumbed to sepsis while receiving chemotherapy for his metastatic squamous cell carcinoma. Humoral hypercalcemia of malignancy is a rare and likely underrecognized complication that can occur in a Marjolin's ulcer. PMID:25197285

O'Malley, John T; Schoppe, Candace; Husain, Sameera; Grossman, Marc E

2014-01-01

160

Squamous Cell Carcinoma (Marjolin's Ulcer) Arising in a Sacral Decubitus Ulcer Resulting in Humoral Hypercalcemia of Malignancy  

PubMed Central

Long-standing burns, fissures, and ulcers that undergo malignant transformation into a variety of malignancies, including squamous cell carcinoma, is commonly referred to as a Marjolin's ulcer. It is well recognized that squamous cell carcinomas of the lung and esophagus can cause humoral hypercalcemia of malignancy secondary to paraneoplastic secretion of parathyroid hormone-related peptide. However, it is extremely rare for a squamous cell carcinoma developing in a sacral decubitus ulcer to cause humoral hypercalcemia of malignancy. We describe the first case of a patient found to have elevated serum levels of parathyroid hormone related peptide related to his Marjolin's ulcer. A 45-year-old African American man with T6 paraplegia and a sacral decubitus ulcer present for 20 years was admitted for hypercalcemia of unclear etiology. He was subsequently found to have elevated parathyroid hormone related peptide and an excisional biopsy from the ulcer showed invasive squamous cell carcinoma suggestive of humoral hypercalcemia of malignancy. The patient ultimately succumbed to sepsis while receiving chemotherapy for his metastatic squamous cell carcinoma. Humoral hypercalcemia of malignancy is a rare and likely underrecognized complication that can occur in a Marjolin's ulcer.

O'Malley, John T.; Schoppe, Candace; Husain, Sameera; Grossman, Marc E.

2014-01-01

161

Buruli Ulcer Recurrence, Benin  

Microsoft Academic Search

Buruli ulcer is a recognized public health problem in West Africa. In Benin, from 1989 to 2001, the Centre Sanitaire et Nutritionnel Gbemoten (CSNG) treated >2,500 Buruli ulcer patients. From March 2000 to February 2001, field trips were conducted in the Zou and Atlantique regions. The choice of the 2 regions was based on the dis- tance from CSNG and

Martine Debacker; Julia Aguiar; Christian Steunou; Claude Zinsou; Wayne M. Meyers; Françoise Portaels

162

Giant marginal ulcer  

Microsoft Academic Search

Marginal ulcer is a well-known complication of gastroenterostomy. It occurs in 3% of patients post-Billroth II subtotal gastrectomy; it occurs in less than 1% if truncal vagotomy is included but in up to 30% of patients with gastroenterostomy without vagotomy [10, 11, 14, 16]. These ulcers occur at the anastomosis, but always on the jejunal side, and are known to

G. F. Gowen; R. E. Campbell; M. M. McFarland; B. A. Alman

1994-01-01

163

Venous ulceration contaminated by multi-resistant organisms: larval therapy and debridement.  

PubMed

A 72-year-old female with venous insufficiency presented to a hospital-based multidisciplinary wound clinic after 20 years of recurrent episodes of venous leg ulcers. Examination showed bilateral leg ulcers with no evidence of arterial insufficiency, but complicated by considerable devitalised tissue, abnormally high bacterial load and the presence of multi-resistant organisms. The ulcers were initially treated with larvae to aid debridement and reduce the bacterial load, prior to skin grafting. Although ulcer free for a period of 4 months, further debridement was required when the skin condition deteriorated. Surgical intervention was chosen as the preferred method by the surgeons for a second acute care admission using hydrosugery, along with supplementary skin grafts and compression. Ongoing management, consisting of regular debridement, skin care and compression therapy, continues. PMID:24142139

McInnes, W; Ruzehaji, N; Wright, N; Cowin, A J; Fitridge, R

2013-10-01

164

Pressure Ulcer Prevention  

PubMed Central

Executive Summary In April 2008, the Medical Advisory Secretariat began an evidence-based review of the literature concerning pressure ulcers. Please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/tech/tech_mn.html to review these titles that are currently available within the Pressure Ulcers series. Pressure ulcer prevention: an evidence based analysis The cost-effectiveness of prevention strategies for pressure ulcers in long-term care homes in Ontario: projections of the Ontario Pressure Ulcer Model (field evaluation) Management of chronic pressure ulcers: an evidence-based analysis (anticipated pubicstion date - mid-2009) Purpose A pressure ulcer, also known as a pressure sore, decubitus ulcer, or bedsore, is defined as a localized injury to the skin/and or underlying tissue occurring most often over a bony prominence and caused by pressure, shear, or friction, alone or in combination. (1) Those at risk for developing pressure ulcers include the elderly and critically ill as well as persons with neurological impairments and those who suffer conditions associated with immobility. Pressure ulcers are graded or staged with a 4-point classification system denoting severity. Stage I represents the beginnings of a pressure ulcer and stage IV, the severest grade, consists of full thickness tissue loss with exposed bone, tendon, and or muscle. (1) In a 2004 survey of Canadian health care settings, Woodbury and Houghton (2) estimated that the prevalence of pressure ulcers at a stage 1 or greater in Ontario ranged between 13.1% and 53% with nonacute health care settings having the highest prevalence rate (Table 1). Executive Summary Table 1: Prevalence of Pressure Ulcers* Setting Canadian Prevalence,% (95% CI) Ontario Prevalence,Range % (n) Acute care 25 (23.8–26.3) 23.9–29.7 (3418) Nonacute care† 30 (29.3–31.4) 30.0–53.3 (1165) Community care 15 (13.4–16.8) 13.2 (91) Mixed health care‡ 22 (20.9–23.4) 13.1–25.7 (3100) All health care settings 26 (25.2–26.8) 13.1–53.3 (7774) * CI indicates confidence interval. † Nonacute care included sub-acute care, chronic care, complex continuing care, long-term care, and nursing home care. ‡ Mixed health care includes a mixture of acute, nonacute, and/or community care health care delivery settings. Pressure ulcers have a considerable economic impact on health care systems. In Australia, the cost of treating a single stage IV ulcer has been estimated to be greater than $61,000 (AUD) (approximately $54,000 CDN), (3) while in the United Kingdom the total cost of pressure ulcers has been estimated at £1.4–£2.1 billion annually or 4% of the National Health Service expenditure. (4) Because of the high physical and economic burden of pressure ulcers, this review was undertaken to determine which interventions are effective at preventing the development of pressure ulcers in an at-risk population. Review Strategy The main objective of this systematic review is to determine the effectiveness of pressure ulcer preventive interventions including Risk Assessment, Distribution Devices, Nutritional Supplementation, Repositioning, and Incontinence Management. A comprehensive literature search was completed for each of the above 5 preventive interventions. The electronic databases searched included MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. As well, the bibliographic references of selected studies were searched. All studies meeting explicit inclusion and exclusion criteria for each systematic review section were retained and the quality of the body of evidence was determined using the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) system. (5) Where appropriate, a meta-analysis was undertaken to determine the overall estimate of effect of the preventive intervention under review. Summary of Findings Ris

2009-01-01

165

20. DETAIL, TYPICAL LEG CONNECTION, CROSS BRACING AT LEG, WITH ...  

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

20. DETAIL, TYPICAL LEG CONNECTION, CROSS BRACING AT LEG, WITH CROSSED BRACE BLOCK, GROUND WIRES AND GUIDE WIRE. - Hat Point Fire Lookout Tower, Forest Service Road #4340, 24 miles from Imnaha, Imnaha, Wallowa County, OR

166

Connective tissue ulcers.  

PubMed

Connective tissue disorders (CTD), which are often also termed collagen vascular diseases, include a number of related inflammatory conditions. Some of these diseases include rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), localized scleroderma (morphea variants localized to the skin), Sjogren's syndrome, dermatomyositis, polymyositis, and mixed connective tissue disease. In addition to the systemic manifestations of these diseases, there are a number of cutaneous features that make these conditions recognizable on physical exam. Lower extremity ulcers and digital ulcers are an infrequent but disabling complication of long-standing connective tissue disease. The exact frequency with which these ulcers occur is not known, and the cause of the ulcerations is often multifactorial. Moreover, a challenging component of CTD ulcerations is that there are still no established guidelines for their diagnosis and treatment. The morbidity associated with these ulcerations and their underlying conditions is very substantial. Indeed, these less common but intractable ulcers represent a major medical and economic problem for patients, physicians and nurses, and even well organized multidisciplinary wound healing centers. PMID:23756459

Dabiri, Ganary; Falanga, Vincent

2013-11-01

167

Connective Tissue Ulcers  

PubMed Central

Connective tissue disorders (CTD), which are often also termed collagen vascular diseases, include a number of related inflammatory conditions. Some of these diseases include rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (scleroderma), localized scleroderma (morphea variants localized to the skin), Sjogren’s syndrome, dermatomyositis, polymyositis, and mixed connective tissue disease. In addition to the systemic manifestations of these diseases, there are a number of cutaneous features that make these conditions recognizable on physical exam. Lower extremity ulcers and digital ulcers are an infrequent but disabling complication of long-standing connective tissue disease. The exact frequency with which these ulcers occur is not known, and the cause of the ulcerations is often multifactorial. Moreover, a challenging component of CTD ulcerations is that there are still no established guidelines for their diagnosis and treatment. The morbidity associated with these ulcerations and their underlying conditions is very substantial. Indeed, these less common but intractable ulcers represent a major medical and economic problem for patients, physicians and nurses, and even well organized multidisciplinary wound healing centers. PMID:23756459

Dabiri, Ganary; Falanga, Vincent

2013-01-01

168

Athletes' leg pains  

Microsoft Academic Search

The frequency and nature of exertion pains of the leg in athletes were studied in 2,750 cases of overuse injuries treated at the Sports Clinic of the Deaconess Institute of Oulu, Finland, during the years 1972-1977. 465 cases of exertion pain (18%) were located in the shin. The medial tibial syndrome was the most common overuse injury among these athletes,

S. Orava; J. Puranen

1979-01-01

169

Restless legs syndrome  

Microsoft Academic Search

Group A ?-hemolytic streptococcal infections have been reported to cause neuropsychiatric symptoms, such as chorea, tics, and obsessive-compulsive disorder, presumably through autoimmune damage to basal ganglia. Mycoplasma pneumoniae infections have also been reported to cause damage to the basal ganglia. Restless legs syndrome is a movement disorder with focal restlessness, an irresistible desire to move, and exacerbation by long periods

Muneaki Matsuo; Katsunori Tsuchiya; Yuhei Hamasaki; Harvey S. Singer

2004-01-01

170

Metastable legged-robot locomotion  

E-print Network

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 ...

Byl, Katie

2008-01-01

171

Other Causes of Leg Pain  

MedlinePLUS

... Home Current Issue Past Issues Special Section Other Causes of Leg Pain Past Issues / Summer 2008 Table ... Leg pain can come from a variety of causes. Your health care professional has specific ways to ...

172

Nonspecific genital ulcers.  

PubMed

Recent intervention of nonspecific genital ulcers has added refreshing dimensions to genital ulcer disease. It was considered pertinent to dwell on diverse clinical presentation and diagnostic strategies. It seems to possess spectrum. It includes infective causes, Epstein Bar Virus, tuberculosis, Leishmaniasis, HIV/AIDS related ulcers and amoebiasis. Noninfective causes are immunobullous disorders, aphthosis, Behcet's disease (BD), inflammatory bowel disease, lichen planus and lichen sclerosis et atrophicus, drug reactions, premalignant and malignant conditions, pyoderma gangrenosum, and hidradenitis suppurativa. The diagnostic features and treatment option of each disorder are succinctly outlined for ready reference. PMID:24559562

Sehgal, Virendra N; Pandhi, Deepika; Khurana, Ananta

2014-01-01

173

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

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

Oien, Rut F; Forssell, Henrik W

2013-01-01

174

Etiology and Early Marker Studies  

Cancer.gov

The Etiology and Early Marker Studies (EEMS) is a component of the PLCO Trial. By collecting biologic materials and risk factor information from trial participants before the diagnosis of disease, PLCO EEMS adds substantial value to the trial, providing a resource for cancer research, focused, in particular, on cancer etiology and early markers.

175

Peptic ulcer disease - discharge  

MedlinePLUS

... better manage stress. Avoid drugs such as aspirin, ibuprofen (Advil, Motrin), or naproxen (Aleve, Naprosyn). Take acetaminophen ( ... choices if your ulcer was caused by aspirin, ibuprofen, or other NSAIDs. You may be able to ...

176

Living with Ulcerative Colitis  

MedlinePLUS

... treatment of people with mild-to-moderately active ulcerative colitis. Also useful in maintaining remission. Oral or rectal Corticosteroids prednisone (Deltasone®) budesonide (UCERIS™) prednisolone (Pediapred Oral Liquid®, Medrol®) ...

177

Biomechanical risk factors associated with neuropathic ulceration of the hallux in people with diabetes mellitus.  

PubMed

In this study of people with diabetes mellitus and peripheral neuropathy, it was found that the feet of patients with a history of hallux ulceration were more pronated and less able to complete a single-leg heel rise compared with the feet of patients with a history of ulceration elsewhere on the foot. The range of active first metatarsophalangeal joint dorsiflexion was found to be significantly lower in the affected foot. Ankle dorsiflexion, subtalar joint range of motion, and angle of gait differed from normal values but were similar to those found in other studies involving diabetic subjects and were not important factors in the occurrence of hallux ulceration. These data indicate that a more pronated foot type is associated with hallux ulceration in diabetic feet. Further studies are required to evaluate the efficacy of footwear and orthoses in altering foot posture to manage hallux ulceration. PMID:16707629

Nubé, Vanessa L; Molyneaux, Lynda; Yue, Dennis K

2006-01-01

178

Joint Leg Walking and Hybrid Robot Demonstrators  

Microsoft Academic Search

\\u000a Design of two and multi-legged robots like four legged, six legged, and eight legged robots shows a practical usefulness of\\u000a Bionics for the domain of robotics. Depending on the number of legs, such robotic platforms can be inspired from body constitution,\\u000a walking mechanics, and behavior of humans, animals (four legged), insects (six legged), or spiders (eight legged). There is\\u000a also

Bojan Jakimovski

179

HLA and Mooren's ulceration  

PubMed Central

BACKGROUND—Mooren's ulcer is a progressive intractable destructive peripheral ulceration of the cornea, probably of autoimmune aetiology. The disease is rare in the northern hemisphere but is more common in southern and central Africa and the Indian subcontinent. Although rare, its predominance in certain racial groups and their second generation migrants worldwide indicates a genetic as well as a geographic predisposition. The highly polymorphic human leucocyte antigens (HLA) confer genetic susceptibility to several autoimmune disorders. Therefore, a possible link between Mooren's ulcer and HLA type was investigated.?METHODS—Patients (n=22) with non-infective destructive peripheral corneal inflammatory disease were recruited worldwide. Differential diagnosis confirmed Mooren's ulceration in 12 cases. HLA typing (HLA-A, B, C, DRB, DQB) was performed by serology and PCR using sequence specific primers. The patients came from varied ethnic backgrounds and their HLA typing results were compared with published data from ethnically matched control populations.?RESULTS—Of the 12 patients with Mooren's ulcer, 10 (83%) were HLA-DR17(3) positive (including all nine patients of Asian, Indonesian, and black African origin), and 10 (83%) were HLA-DQ2 positive. The frequency of HLA-DR17(3) and DQ2 was higher in the Mooren's ulcer group compared to published data from ethnically matched control populations, where the expected antigen frequencies range between 5% and 40%.?CONCLUSION—These results suggest a possible association between HLA-DR17(3) and/or DQ2 and susceptibility to Mooren's ulcer.?? PMID:10611103

Taylor, C.; Smith, S.; Morgan, C.; Stephenson, S.; Key, T.; Srinivasan, M; Cunningham, E.; Watson, P.

2000-01-01

180

JAMA Patient Page: Diabetic Foot Ulcers  

MedlinePLUS

... American Medical Association JAMA PATIENT PAGE Diabetic Foot Ulcers D iabetic foot ulcers are sores or wounds on the feet that ... preventing diabetic foot ulcers. WHAT CAUSES DIABETIC FOOT ULCERS? FOR MORE INFORMATION • National Diabetes Information Clearinghouse 1- ...

181

Peptic Ulcer Disease and H. pylori  

MedlinePLUS

... Digestive Diseases Information Clearinghouse What is a peptic ulcer? A peptic ulcer is a sore on the ... the mouth to the stomach. What causes peptic ulcer disease? Causes of peptic ulcer disease include • an ...

182

Leg size and muscle functions associated with leg compliance  

NASA Technical Reports Server (NTRS)

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.

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

1988-01-01

183

Pathogenesis of skin ulcers: lessons from the Mycobacterium ulcerans and Leishmania spp. pathogens.  

PubMed

Skin ulcers are most commonly due to circulatory or metabolic disorders and are a major public health concern. In developed countries, chronic wounds affect more than 1 % of the population and their incidence is expected to follow those observed for diabetes and obesity. In tropical and subtropical countries, an additional issue is the occurrence of ulcers of infectious origins with diverse etiologies. While the severity of cutaneous Leishmaniasis correlates with protective immune responses, Buruli ulcers caused by Mycobacterium ulcerans develop in the absence of major inflammation. Based on these two examples, this review aims to demonstrate how studies on microorganism-provoked wounds can provide insight into the molecular mechanisms controlling skin integrity. We highlight the potential interest of a mouse model of non-inflammatory skin ulceration caused by intradermal injection of mycolactone, an original lipid toxin with ulcerative and immunosuppressive properties produced by M. ulcerans. PMID:24445815

Guenin-Macé, Laure; Oldenburg, Reid; Chrétien, Fabrice; Demangel, Caroline

2014-07-01

184

Microstructural and mechanical characterization of human tissue at and adjacent to pressure ulcers  

Microsoft Academic Search

This investigation evaluated the microstructural and mechanical properties of human skin at and adjacent to pressure ulcers (PUs). Healthy breast and leg tissue served as control tissue . The tissue was characterized through uniaxial tensile testing and histomorphometric analysis . The PU tissue had significantly fewer straight and wavy fibers, but the fibers present were significantly wider and longer than

Laura E. Edsberg; Renee Cutway; Shirley Anain; Joseph R. Natiella

185

Raised Leg Exercises for Leg Edema in the Elderly  

Microsoft Academic Search

Leg edema is a common problem in the elderly and requires further evaluation and management. Method: From October 1990 to July 1992, 245 patients presented to the Cleveland Clinic Florida with leg edema. All patients were counseled about the benefits of twenty-minute, three-times-a-day raised-leg exercises. Fifty seven (57) of the 245 patients were not compliant with this regimen (nonexercise group).

Jerry O. Ciocon; Daisy Galindo-Ciocon; Diana J. Galindo

1995-01-01

186

The etiology of loin disease  

E-print Network

THE ETIOLOGY OF LOIN DISEASE A Thesis By RALPH GORDON GREELEY Submitted to the Graduate College of the Texas ARM University in partial fulfillment of the requirements for the degree of MASTER OF SCIENCE May 1966 Major Subject: Veterinary... Microbiology THE ETIOLOGY OF LOIN DISEASE A Thesis By RALPH GORDON GREELEY Approved as to style and content by: (Chairma of Committee) (Member) ( mber) (Member) May 1966 ACKNOWLEDGMENTS Sincere appreciation is expressed to Drs. L. C. Grumbles, T. E...

Greeley, Ralph Gordon

2012-06-07

187

Pressure ulcer prevention knowledge among Jordanian nurses: a cross- sectional study  

PubMed Central

Background Pressure ulcer remains a significant problem in the healthcare system. In addition to the suffering it causes patients, it bears a growing financial burden. Although pressure ulcer prevention and care have improved in recent years, pressure ulcer still exists and occurs in both hospital and community settings. In Jordan, there are a handful of studies on pressure ulcer. This study aims to explore levels of knowledge and knowledge sources about pressure ulcer prevention, as well as barriers to implementing pressure ulcer prevention guidelines among Jordanian nurses. Methods Using a cross-sectional study design and a self-administered questionnaire, data was collected from 194 baccalaureate and master’s level staff nurses working in eight Jordanian hospitals. From September to October of 2011, their knowledge levels about pressure ulcer prevention and the sources of this knowledge were assessed, along with the barriers which reduce successful pressure ulcer care and prevention. ANOVA and t-test analysis were used to test the differences in nurses’ knowledge according to participants’ characteristics. Means, standard deviation, and frequencies were used to describe nurses’ knowledge levels, knowledge sources, and barriers to pressure ulcer prevention. Results The majority (73%, n = 141) of nurses had inadequate knowledge about pressure ulcer prevention. The mean scores of the test for all participants was 10.84 out of 26 (SD = 2.3, range = 5–17), with the lowest score in themes related to PU etiology, preventive measures to reduce amount of pressure/shear, and risk assessment. In-service training was the second source of education on pressure ulcer, coming after university training. Shortage of staff and lack of time were the most frequently cited barriers to carrying out pressure ulcer risk assessment, documentation, and prevention. Conclusions This study highlights concerns about Jordanian nurses’ knowledge of pressure ulcer prevention. The results of the current study showed inadequate knowledge among Jordanian nurses about pressure ulcer prevention based on National Pressure Ulcer Advisory Panel guidelines. Also, the low level of nurses’ pressure ulcer knowledge suggests poor dissemination of pressure ulcer knowledge in Jordan, a suggestion supported by the lack of relationship between years of experience and pressure ulcer knowledge. PMID:24565372

2014-01-01

188

Genetics Home Reference: Ulcerative colitis  

MedlinePLUS

... make up most of the length of the large intestine. The inflammation usually causes open sores (ulcers) to develop in the large intestine. Ulcerative colitis usually appears between ages 15 and ...

189

Ulcer disease of trout  

USGS Publications Warehouse

During the summer of 1933, lesions of a disease were noted among some fingerling brook, rainbow, blackspotted, and lake trout at the Cortland (New York) trout hatchery. Although these lesions bore a marked superficial resemblance to those of furunculosis, they were sufficiently atypical to warrant further investigation. A more detailed examination of the lesions proved them to be of a distinct disease, which for lack of a better name is herein called "ulcer disease," for the lesions closely resemble those described by Calkins (1899) under this name. Because of the marked resemblance to furunculosis, ulcer disease has not been generally recognized by trout culturists, and any ulcer appearing on fish has been ascribed by them to furunculosis without further question.

Fish, F. F.

1934-01-01

190

Understanding non ulcer dyspepsia.  

PubMed

Non ulcer dyspepsia is one of the most common problems encountered in primary care practice. The underlying pathophysiology of non ulcer dyspepsia is not fully understood, but it is known that this condition is associated with H. pylori infection and motility disorder. The presenting abdominal symptoms are non specific: they include bloating, belching, flatulence, excessive fullness after eating and nausea. Psychological condition such as anxiety, depression and stress do play a role in the recurrence of symptoms. Upper GI endoscopy is necessary in patients who presents with alarm symptoms suggestive of possible underlying organic condition before one makes the diagnosis of non ulcer dyspepsia. Pharmacological therapy using H2 receptor antagonist and proton pump inhibitors are effective for symptom relief. Patient's education and supportive care should be part of the management strategy in recurrent chronic dyspepsia. PMID:18942314

Loh, K Y; Siang, T K

2008-06-01

191

Evaluation of technetium-99m phosphate imaging for predicting skin ulcer healing  

SciTech Connect

We have developed criteria for radionuclide angiography to assess skin ulcer perfusion as an indicator of healing capacity. Twenty-six studies were performed on 21 consecutive patients with nonhealing ulcers of the lower leg; 20 mCi of technetium-99m phosphate was injected intravenously with immediate sequential scintillation camera imaging of the ulcer and surrounding area at 2 second intervals, followed by blood pool and delayed static images. Two radiologists without clinical bias graded the perfusion to the ulcer on the images as normal, increased, or reduced with respect to the opposite limb. Patients were either followed as outpatients for more than 10 days, as inpatients for at least 10 days, or both to determine whether ulcers showed clinical evidence of wound healing with optimal outpatient and in-hospital care. Of the 17 patients whose ulcers healed, imaging with technetium-99m phosphate predicted the outcome in 16. In nine patients the ulcers did not heal. This was correctly predicted by technetium-99m phosphate in eight of the patients. Overall, the sensitivity was 94 percent and the specificity was 89 percent. This technique appears to be a simple, reliable way to predict the microcirculatory adequacy for ulcer healing.

Lawrence, P.F.; Syverud, J.B.; Disbro, M.A.; Alazraki, N.

1983-12-01

192

Measurement of body fat using leg to leg bioimpedance  

Microsoft Academic Search

AIMS(1) To validate a leg to leg bioimpedance analysis (BIA) device in the measurement of body composition in children by assessment of its agreement with dual energyx ray absorptiometry (DXA) and its repeatability. (2) To establish a reference range of percentage body fat in Hong Kong Chinese children.METHODSSequential BIA and DXA methods were used to determine body composition in 49

R Y T Sung; P Lau; C W Yu; P K W Lam; E A S Nelson

2001-01-01

193

An Etiological Model of Perfectionism  

PubMed Central

Objective Perfectionism has been recognized as a transdiagnostic factor that is relevant to anxiety disorders, eating disorders and depression. Despite the importance of perfectionism in psychopathology to date there has been no empirical test of an etiological model of perfectionism. Method The present study aimed to address the paucity of research on the etiology of perfectionism by developing and testing an etiological model using a sample of 311 clients seeking treatment. Results Structural equation modeling showed a direct relationship between high Parental Expectations and Criticism, and Perfectionism. There was also an indirect relationship between Parental Bonding and Perfectionism that was mediated by core schemas of disconnection and rejection. Finally, it was found that Neuroticism had both an indirect relationship, which was mediated by core schemas, and a direct relationship with perfectionism. Conclusions The study provided the first direct test of an etiological model of perfectionism to date. Clinical implications include investigating whether the inclusion of etiological factors in the understanding and treatment of perfectionism is effective. PMID:24787357

Maloney, Gayle K.; Egan, Sarah J.; Kane, Robert T.; Rees, Clare S.

2014-01-01

194

Differentiating nocturnal leg cramps and restless legs syndrome.  

PubMed

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

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

2014-07-01

195

Inclined leg jack-up platform with flexible leg guides  

SciTech Connect

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.

Goldman, J.; Bennett, R.M.

1992-03-17

196

Prosthetic Leg Lesson Plan Biomedical Engineering  

E-print Network

prosthetic leg design include: leg structure, cushioning system, attachments, stabilizing system, and connections throughout the prosthetic device. Leg Structure: The lower leg structure should be an average child will need a smaller design. Students can also make their leg adjustable just like the lower

Provancher, William

197

Chronic idiopathic ulcerative colitis  

Microsoft Academic Search

Many frequently cited studies of the interaction of chronic idiopathic ulcerative colitis (CIUC) and pregnancy were performed in the 1950s before pharmacotherapy for this disease was common. We retrospectively reviewed obstetrical records at a large maternity facility to determine the effects of CIUC on pregnancy and on fetal outcome. We observed that the prevalence of CIUC in pregnant women was

Robert R. Schade; David H. Van Thiel; Judith S. Gavaler

1984-01-01

198

Glutathione Content of Colonic Mucosa (Evidence for Oxidative Damage in Active Ulcerative Colitis)  

Microsoft Academic Search

Oxidative stress appears to play a role in thetissue damage of active ulcerative colitis, and it hasbeen suggested that a defect in mucosal antioxidantdefenses is a etiological factor in the disease. This study was undertaken to investigate themucosal content and oxidation state of glutathione inulcerative colitis in the active and inactive states andto examine the relationship between glutathione content and

E. W. Holmes; S. L. Yong; D. Eiznhamer; A. Keshavarzian

1998-01-01

199

The comorbid occurrence of other diagnoses in patients with ulcerative colitis and Crohn's disease  

Microsoft Academic Search

OBJECTIVES:The comorbidity between inflammatory bowel disease (IBD) and other diagnoses may help to shed light on the etiology and pathophysiology of IBD. The US Vital Statistics offer the opportunity to study causes of death broken down by comorbid disease associations. The aim of this study was to analyze the presence of comorbid conditions in persons who died from ulcerative colitis

Claudia Cucino; Amnon Sonnenberg

2001-01-01

200

The red hearing: swollen ear in a patient with ulcerative colitis  

PubMed Central

Relapsing polychondritis is a rare connective tissue disease of unknown etiology characterized by recurrent inflammation, degeneration and deformity of auricular cartilage. The autoimmune inflammation may also affect cartilage at other sites including nose, larynx, trachea and bronchi. Here, we present a case of relapsing polychondritis in a patient with ulcerative colitis. We also review the presentation, diagnosis and management of this condition. PMID:25147631

Karmacharya, Paras; Pathak, Ranjan; Shrestha, Pragya; Alweis, Richard

2014-01-01

201

Steroid-refractory ulcerative colitis treated with corticosteroids, metronidazole and vancomycin: a case report  

Microsoft Academic Search

BACKGROUND: Increasing evidence elucidating the pathogenic mechanisms of ulcerative colitis (UC) has accumulated and the disease is widely assumed to be the consequence of genetic susceptibility and an abnormal immune response to commensal bacteria. However evidence regarding an infectious etiology in UC remains elusive. CASE PRESENTATION: We report a provocative case of UC with profound rheumatologic involvement directly preceded by

Jonathan Miner; M Monem Gillan; Philip Alex; Michael Centola

2005-01-01

202

The etiology of anorectal infections in homosexual men.  

PubMed

The infectious etiology of symptomatic anorectal disease was studied in 52 homosexual men who did not have gonococci on initial Gram stain of anorectal exudate. Herpes simplex virus (HSV) was isolated from the anal canal or rectum in 15 of the 52 (29 percent) men and characteristically caused severe anorectal pain and focal ulcerations visible on sigmoidoscopy. Despite negative initial Gram stains, seven men (14 percent) had anorectal gonococcal infection. Six (12 percent) had syphilis, including two with dark-field positive anal lesions. Four were infected with enteric pathogens, including Giardia lamblia, Entamoeba histolytica or Campylobacter fetus ssp. jejuni. Chlamydia trachomatis (LGV 2 strain) was isolated from one patient with severe granulomatous proctitis. One or more etiologic pathogens were identified in 28 (67 percent) of 42 men who had anorectal leukocytic exudate and in two of 10 who did not (p = 0.01). A review of the prominent features of different etiologic forms of anorectal infection in homosexuals is presented. PMID:7025620

Quinn, T C; Corey, L; Chaffee, R G; Schuffler, M D; Brancato, F P; Holmes, K K

1981-09-01

203

Common sports injuries to the foot and leg.  

PubMed

Running related injuries to the leg and foot account for approximately 45 per cent of the total injuries to the lower extremity. The incidence of running injuries has increased significantly in the past decade, thus, creating a demand for increased proficiency in treating runners. Specifically, overuse injuries account for most of the runner's complaints. The goal of sports medicine as mentioned previously is to keep the athlete active and injury free. To achieve this goal the etiologies of the injuries must be recognized and treated. Common, preventable causes of overuse injuries would include training errors and biomechanical factors. The biomechanical factors as they relate to foot and leg have been addressed within this article. Early recognition and biomechanical treatment will decrease the vast majority of the lower limb injuries. PMID:2899452

Rzonca, E C; Baylis, W J

1988-07-01

204

Perforated peptic ulcer associated with abdominal compartment syndrome.  

PubMed

Abdominal compartment syndrome (ACS) is defined as an increased intra-abdominal pressure with adverse physiologic consequences. Abdominal compartment syndrome caused by perforated peptic ulcer is rare owing to early diagnosis and management. Delayed recognition of perforated peptic ulcer with pneumoperitoneum, bowel distension, and decreased abdominal wall compliance can make up a vicious circle and lead to ACS. We report a case of perforated peptic ulcer associated with ACS. A 74-year-old man with old stroke and dementia history was found to have distended abdomen, edema of bilateral legs, and cyanosis. Laboratory tests revealed deterioration of liver and kidney function. Abdominal compartment syndrome was suspected, and image study was arranged to find the cause. The study showed pneumoperitoneum, contrast stasis in heart with decreased caliber of vessels below the abdominal aortic level, and diffuse lymphedema at the abdominal walls. Emergent laparotomy was performed. Perforated peptic ulcer was noted and the gastrorrhaphy was done. The symptoms, and liver and kidney function improved right after emergent operation. PMID:19091294

Lynn, Jiun-Jen; Weng, Yi-Ming; Weng, Chia-Sui

2008-11-01

205

Ulcerative colitis and pregnancy  

Microsoft Academic Search

A survey has been made of pregnancy occurring in patients who were attending the Ulcerative Colitis Clinic at Oxford during the 20-year period, 1960-79 inclusive. There were 256 married women of child-bearing age who attended during this period. Of these, 100 were excluded from the survey for various reasons, such as that they had completed their family before the onset

C P Willoughby; S C Truelove

1980-01-01

206

Severe ulcerative colitis  

Microsoft Academic Search

Opinion statement  Patients with severe ulcerative colitis should be hospitalized and treated with intravenous corticosteroids for 7 to 10 days.\\u000a Patients who fail to respond may be offered colectomy or rescue therapy with intravenous cyclosporine. Risks of cyclosporine\\u000a therapy, including a 1% to 2% risk of death from opportunistic infection and a 50% failure rate after 6 months of follow-up,\\u000a should

William J. Sandborn

1999-01-01

207

Management of radiation ulcers  

SciTech Connect

Despite more efficient and safer technics of radiation therapy, the problem of radiation-induced injury to the skin and soft tissue persists. The problem of adequate coverage of these painful, ischemic, and fibrotic ulcers remains challenging. Split-thickness skin grafts are seldom sufficient coverage, as the graft almost always has areas that do not take. Although these areas may eventually heal by epithelialization, the result is never ideal. Most often flap coverage is required, but elevation of local flaps is jeopardized because the tissue surrounding the ulcer crater frequently has been sufficiently compromised to cause loss of at least part of the flap. In the past, this necessitated use of pedicled flaps, tubed and transposed from a distance. With the development of axial-pattern musculocutaneous and muscle flaps, as well as microvascular free flaps, the difficulty in dealing with these ulcers has been decreased. Surgeons can now recommend earlier use of adequate debridement, many times of the entire irradiated area, and immediate coverage with a well vascularized axial-pattern musculocutaneous flap or revascularized free flap.

Shack, R.B.

1982-12-01

208

Athermal laser treatment of the diabetic leg  

NASA Astrophysics Data System (ADS)

This work shows the result obtained in the medical clinic of the `Dr. I. Cantacuzino Hospital' on a lot of 43 diabetic patients using the `LASSIS' devices composed of a He-Ne laser and 4 semiconductor lasers. The 43 patients showed various clinic pictures of a diabetic leg (diabetic arteriopathy and neuropathy) 16 of the lot showed an arteriopathy with claudication and a decrease of pulses oscillometrically measurements, 15 had ulceration and a beginning of gangrene and the other 12 showed a plantary boring ill. There has been achieved an amelioration of the oscillometric index of the claudication while walking the amelioration of local circulation, together with the limitation of the necrosis. For the boring ill, there has been achieved the acceleration of the granulating and epithelization process avoiding surgeries, suppuration and cutaneous plasties. The response to the laser treatment was compared to the response to the classic treatment (vasodilatation surgery unstrapping, antibiotherapy) on a proving lot. We appreciated that the cicatrization and local vasodilatation with athermal laser treatment should be a hope for the treatment of patients suffering of diabetic arteriopathy and neuropathy.

Ignat, P.; Suteanu, S.; Brojbeanu, Gabriela; Vasiliu, Virgil V.

1995-03-01

209

A patient with foot ulcer and severe metabolic alkalosis.  

PubMed

We report a case of triple acid-base disorder with metabolic alkalosis as the primary disorder in a 65-year-old man due to ingestion and application to leg ulcers of baking soda (calcium bicarbonate). The blood pH was 7.65 with hypochloremia, hypokalemia, and prerenal azotemia. He was treated with isotonic saline with K replacement, and the patient improved without any adverse clinical consequences. We discuss the causes, mechanisms, and management of Cl-responsive (depletion) metabolic alkalosis. PMID:21185672

John, Ruby Samuel; Simoes, Sonia; Reddi, Alluru S

2012-01-01

210

Diagnosis, Treatment, and Outcome in Patients with Bleeding Peptic Ulcers and Helicobacter pylori Infections  

PubMed Central

Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp) infection and nonsteroidal anti-inflammatory drug (NSAID) administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT), with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed 13C-urea breath test (UBT) or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity. PMID:25101293

2014-01-01

211

A metabolically efficient leg brace  

E-print Network

Locomotion assistive devices can be broadly classified as either being passive or powered. Both have been created to aid in the leg's generation of a ground reaction force which supports the torso during locomotion, yet ...

Carvey, Andrew W. (Andrew Williams), 1980-

2006-01-01

212

Design of robotic quadruped legs  

E-print Network

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 ...

McKenzie, Jacob Elijah

2012-01-01

213

Treatment for diabetic foot ulcers.  

PubMed

People with diabetes develop foot ulcers because of neuropathy (sensory, motor, and autonomic deficits), ischaemia, or both. The initiating injury may be from acute mechanical or thermal trauma or from repetitively or continuously applied mechanical stress. Patients with clinically significant limb ischaemia should be assessed by a vascular surgeon to determine the need for angioplasty, stenting, or femorodistal bypass. When infection complicates a foot ulcer, the combination can be limb or life-threatening. Infection is defined clinically, but wound cultures reveal the causative pathogens. Tissue specimens are strongly preferred to wound swabs for wound cultures. Antimicrobial therapy should be guided by culture results, and should aim to cure the infection, not to heal the wound. Alleviation of the mechanical load on ulcers (off-loading) should always be a part of treatment. Neuropathic ulcers typically heal in 6 weeks with total contact casting, because it effectively relieves pressure at the ulcer site and enforces patient compliance. The success of other approaches to off-loading similarly depends on the patients' adherence to the effectiveness of pressure relief. Surgery to heal ulcers and prevent recurrence can include tenotomy, tendon lengthening, reconstruction, or removal of bony prominences. However, these procedures may result in secondary ulceration and other complications. Ulcer recurrence rates are high, but appropriate education for patients, the provision of posthealing footwear, and regular foot care can reduce rates of re-ulceration. PMID:16291067

Cavanagh, Peter R; Lipsky, Benjamin A; Bradbury, Andrew W; Botek, Georgeanne

2005-11-12

214

[Ulcer therapy without acid inhibition].  

PubMed

The mechanism of action of ulcer drugs without acid inhibition appears to involve improvement of defensive factors of the gastroduodenal mucosa. The concept of ulcer healing without acid inhibition is attractive for theoretical reasons, because doubts have arisen about the safety of elevation of intragastric pH, especially in long-term treatment of peptic ulcer disease. Ulcer drugs that do not affect gastric acidity may therefore be preferred, provided they compare favorably to the best acid inhibitors available in terms of efficacy, adverse effects and other requirements. Among these drugs, sucralfate fulfills these criteria to a large extent. PMID:6547542

Koelz, H R

1984-05-19

215

THE ETIOLOGY OF BACTERIAL VAGINOSIS  

PubMed Central

Bacterial vaginosis (BV) is the most common vaginal infection among women of childbearing age. This condition is notorious for causing severe complications related to the reproductive health of women. Five decades of intense research established many risk factors for acquisition of BV, however due to the complexity of BV and due to lack of a reliable animal model for this condition, its exact etiology remains elusive. In this manuscript we use a historical perspective to critically review the development of major theories on the etiology of BV, ultimately implicating BV-related pathogens, healthy vaginal microbiota, bacteriophages and the immune response of the host. None of these theories on their own can reliably explain the epidemiological data. Instead, BV is caused by a complex interaction of multiple factors, which include the numerous components of the vaginal microbial ecosystem and their human host. Many of these factors are yet to be characterized because a clear understanding of their relative contribution to the etiology of BV is pivotal to formulation of an effective treatment for and prophylaxis of this condition. PMID:21332897

Turovskiy, Yevgeniy; Noll, Katia Sutyak; Chikindas, Michael L.

2011-01-01

216

Etiology, pathophysiology and classifications of the diabetic Charcot foot  

PubMed Central

In people with diabetes mellitus, the Charcot foot is a specific manifestation of peripheral neuropathy that may involve autonomic neuropathy with high blood flow to the foot, leading to increased bone resorption. It may also involve peripheral somatic polyneuropathy with loss of protective sensation and high risk of unrecognized acute or chronic minor trauma. In both cases, there is excess local inflammatory response to foot injury, resulting in local osteoporosis. In the Charcot foot, the acute and chronic phases have been described. The former is characterized by local erythema, edema, and marked temperature elevation, while pain is not a prominent symptom. In the latter, signs of inflammation gradually recede and deformities may develop, increasing the risk of foot ulceration. The most common anatomical classification describes five patterns, according to the localization of bone and joint pathology. This review article aims to provide a brief overview of the diabetic Charcot foot in terms of etiology, pathophysiology, and classification. PMID:23705058

Papanas, Nikolaos; Maltezos, Efstratios

2013-01-01

217

38 CFR 4.110 - Ulcers.  

Code of Federal Regulations, 2010 CFR

...2010-07-01 2010-07-01 false Ulcers. 4.110 Section 4.110 Pensions...Ratings The Digestive System § 4.110 Ulcers. Experience has shown that the term “peptic ulcer” is not sufficiently specific for...

2010-07-01

218

38 CFR 4.110 - Ulcers.  

Code of Federal Regulations, 2011 CFR

...2011-07-01 2011-07-01 false Ulcers. 4.110 Section 4.110 Pensions...Ratings The Digestive System § 4.110 Ulcers. Experience has shown that the term “peptic ulcer” is not sufficiently specific for...

2011-07-01

219

38 CFR 4.110 - Ulcers.  

Code of Federal Regulations, 2013 CFR

...2013-07-01 2013-07-01 false Ulcers. 4.110 Section 4.110 Pensions...Ratings The Digestive System § 4.110 Ulcers. Experience has shown that the term “peptic ulcer” is not sufficiently specific for...

2013-07-01

220

38 CFR 4.110 - Ulcers.  

Code of Federal Regulations, 2012 CFR

...2012-07-01 2012-07-01 false Ulcers. 4.110 Section 4.110 Pensions...Ratings The Digestive System § 4.110 Ulcers. Experience has shown that the term “peptic ulcer” is not sufficiently specific for...

2012-07-01

221

The patient with recurrent oral ulceration.  

PubMed

This paper discusses the range of recurrent oral ulceration which affects the oral mucosa. Types of ulceration covered in this paper include traumatic, infective, aphthous, ulceration related to the oral dermatoses, drug-induced, ulceration as a manifestation of systemic disease and ulceration indicating malignancy. Aspects of the aetiology, diagnosis and management of common oral recurrent ulcerative conditions are reviewed from a clinical perspective as an aid to practising dentists. PMID:20553241

Talacko, A A; Gordon, A K; Aldred, M J

2010-06-01

222

An approach to the management of refractory ulcerative colitis.  

PubMed

Ulcerative colitis (UC) is a chronic inflammatory bowel disease of unknown etiology associated with dysregulation of the gastrointestinal mucosal immune system. It is characterized by a waxing and waning course and approximately 15% of UC patients will experience a severe episode. The first line treatment for severe colitis includes IV corticosteroids, however, 40% of patients are non-responsive to corticosteroid therapy and may require either colectomy, intravenous infliximab or intravenous cyclosporine within 3-5 days of presentation. This review focuses on the management and treatment approaches to refractory UC. PMID:20485258

Sonu, I; Blonski, W; Lin, M V; Lichtenstein, G R

2010-06-01

223

Genetic correlations between claw health and feet and leg conformation in Norwegian Red cows.  

PubMed

The aim of this study was to estimate genetic correlations between claw disorders and feet and leg conformation traits in Norwegian Red cows. A total of 188,928 cows with claw health status recorded at claw trimming from 2004 to September 2013 and 210,789 first-lactation cows with feet and leg conformation scores from 2001 to September 2013 were included in the analyses. Traits describing claw health were corkscrew claw, infectious claw disorders (dermatitis, heel horn erosion, and interdigital phlegmon), and laminitis-related claw disorders (sole ulcer, white line disorder, and hemorrhage of sole and white line). The feet and leg conformation traits were rear leg rear view (new and old definition), rear leg side view, foot angle, and hoof quality. Feet and leg conformation traits were scored linearly from 1 to 9, with optimum scores depending on the trait. Claw disorders were defined as binary (0/1) traits for each lactation. Threshold sire models were used to model claw disorders, whereas the feet and leg conformation traits were described by linear sire models. Three multivariate analyses were performed, each including the 5 feet and leg conformation traits and 1 of the 3 claw disorders at a time. Posterior means of heritability of liability of claw disorders ranged from 0.10 to 0.20 and heritabilities of feet and leg conformation traits ranged from 0.04 to 0.11. Posterior standard deviation of heritability was ?0.01 for all traits. Genetic correlations between claw disorders and feet and leg conformation traits were all low or moderate, except between corkscrew claw and hoof quality (-0.86), which are supposed to measure the same trait. The genetic correlations between rear leg rear view (new) and infectious claw disorders (-0.20) and laminitis-related claw disorders (0.26), and between hoof quality and laminitis-related claw disorders (-0.33) were moderate. Eight of the 15 genetic correlations between claw disorders and feet and leg conformation traits had 0 included in the 95% highest posterior density interval. These results imply that selection for feet and leg conformation is not an efficient approach to genetically improve claw health in Norwegian Red cattle. PMID:24767887

Ødegård, C; Svendsen, M; Heringstad, B

2014-07-01

224

Solitary ulcer of the rectum  

PubMed Central

Solitary ulcer of the rectum is usually a disease of young adults of either sex which has a characteristic appearance on sigmoidoscopy. Distinctive changes may also be seen in biopsies taken from mucosa adjacent to the ulcer. The name `solitary ulcer' is misleading because more than one ulcer may be present. Moreover, there is a preulcerative phase which is clinically and histologically recognizable. The condition is essentially benign and may persist for many years unchanged. It has not responded satisfactorily to medical or surgical methods of treatment. The cause of solitary ulcer is unknown. Different views on the pathogenesis are discussed. ImagesFIG. 1FIG. 2FIGS. 3 and 4FIG. 5FIG. 6FIG. 7FIG. 8FIG. 9FIG. 10FIG. 11FIG. 12FIG. 13FIG. 14FIG. 15FIG. 16 PMID:5358578

Madigan, M. R.; Morson, B. C.

1969-01-01

225

[Genetic etiology of eating disorders].  

PubMed

Most twin studies suggest a heritability of SO to 80% for liability to eating disorders. At least moderate heritability is further supported by family and adoption studies. Polymorphisms of the 5-HT2A and BDNF genes appear robust candidates for anorexia nervosa and bulimia nervosa, while linkage studies suggest loci for anorexia nervosa in chromosome 1 and a locus in chromosome 10 for bulimia nervosa. Contemporary Western culture has a salient role in the rising incidence of eating disorders, and epigenetic mechanisms are suggested to be involved. In the near future, GWAS will likely provide compelling new data of genetic etiology and mechanisms of eating disorders. PMID:24340712

Raevuori, Anu

2013-01-01

226

Intrathoracic neoplasia: Epidemiology and etiology  

SciTech Connect

Neoplasms of the thorax encompass those derived from the thoracic wall, trachea, mediastinum, lungs and pleura. They represent a wide variety of lesions including benign and malignant tumors arising from many tissues. The large surface area, 60 to 90 m{sup 2} in man, represented by the respiratory epithelium and associated thoracic structures are ideal targets for carcinogens carried by inspired air. The topic of discussion in this report is the epidemiology, etiology, and mechanisms of spontaneous intrathoracic neoplasia in animals and man. Much of what we know or suspect about thoracic neoplasia in animals has been extrapolated from experimentally-induced neoplasms.

Weller, R.E.

1992-05-01

227

Pipe crawler with extendable legs  

DOEpatents

A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler.

Zollinger, William T. (3927 Almon Dr., Martinez, GA 30907)

1992-01-01

228

Pipe crawler with extendable legs  

DOEpatents

A pipe crawler for moving through a pipe in inchworm fashion having front and rear leg assemblies separated by air cylinders to increase and decrease the spacing between assemblies. Each leg of the four legs of an assembly is moved between a wall-engaging, extended position and a retracted position by a separate air cylinder. The air cylinders of the leg assemblies are preferably arranged in pairs of oppositely directed cylinders with no pair lying in the same axial plane as another pair. Therefore, the cylinders can be as long as a leg assembly is wide and the crawler can crawl through sections of pipes where the diameter is twice that of other sections. The crawler carries a valving system, a manifold to distribute air supplied by a single umbilical air hose to the various air cylinders in a sequence controlled electrically by a controller. The crawler also utilizes a rolling mechanism, casters in this case, to reduce friction between the crawler and pipe wall thereby further extending the range of the pipe crawler. 8 figs.

Zollinger, W.T.

1992-06-16

229

[Pedophilia: etiology, diagnostics and therapy].  

PubMed

Child sexual abuse is one of the most destructive events for healthy child development. Following psychiatric classification systems, pedophilia must be distinguished from child sexual abuse. Approximately only one half of all child abusers fulfill the diagnostic criteria for pedophilia which is defined as a persistent or dominating sexual preference for prepubescent children characterized by persistent thoughts, fantasies, urges, sexual arousal or behavior. This article describes the diagnostic criteria and potential differential diagnoses as well as epidemiological and etiological findings. From an etiological point of view multifactorial mechanisms are currently considered to be responsible especially genetic factors, learning theoretical and neurobiological factors. Psychotherapeutic and pharmaceutical treatment options will be discussed. According to the current state of knowledge cognitive-behavioral psychotherapy is the method of choice in the treatment of pedophilia and has demonstrated positive treatment effects in meta-analyses regarding relapse prevention. Medicinal treatment of pedophilia is only indicated for severe forms of pedophilia. Important aspects of risk management in the treatment of pedophilia and aspects which must be considered in the forensic psychiatric assessment are presented. PMID:23793393

Fromberger, P; Jordan, K; Müller, J L

2013-09-01

230

Prometheus Hot Leg Piping Concept  

NASA Astrophysics Data System (ADS)

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.

Gribik, Anastasia M.; DiLorenzo, Peter A.

2007-01-01

231

Intramuscular pressures beneath elastic and inelastic leggings  

NASA Technical Reports Server (NTRS)

Leg compression devices have been used extensively by patients to combat chronic venous insufficiency and by astronauts to counteract orthostatic intolerance following spaceflight. However, the effects of elastic and inelastic leggings on the calf muscle pump have not been compared. The purpose of this study was to compare in normal subjects the effects of elastic and inelastic compression on leg intramuscular pressure (IMP), an objective index of calf muscle pump function. IMP in soleus and tibialis anterior muscles was measured with transducer-tipped catheters. Surface compression between each legging and the skin was recorded with an air bladder. Subjects were studied under three conditions: (1) control (no legging), (2) elastic legging, and (3) inelastic legging. Pressure data were recorded for each condition during recumbency, sitting, standing, walking, and running. Elastic leggings applied significantly greater surface compression during recumbency (20 +/- 1 mm Hg, mean +/- SE) than inelastic leggings (13 +/- 2 mm Hg). During recumbency, elastic leggings produced significantly higher soleus IMP of 25 +/- 1 mm Hg and tibialis anterior IMP of 28 +/- 1 mm Hg compared to 17 +/- 1 mm Hg and 20 +/- 2 mm Hg, respectively, generated by inelastic leggings and 8 +/- 1 mm Hg and 11 +/- 1 mm Hg, respectively, without leggings. During sitting, walking, and running, however, peak IMPs generated in the muscular compartments by elastic and inelastic leggings were similar. Our results suggest that elastic leg compression applied over a long period in the recumbent posture may impede microcirculation and jeopardize tissue viability.(ABSTRACT TRUNCATED AT 250 WORDS).

Murthy, G.; Ballard, R. E.; Breit, G. A.; Watenpaugh, D. E.; Hargens, A. R.

1994-01-01

232

Diagnostic imaging in the evaluation of leg pain in athletes.  

PubMed

The causes of leg pain in the athlete are diverse. Pain can relate to more common etiologies, such as musculotendinous injury to the hamstrings and Achilles tendon as well as stress injury to bone, with tibial stress injuries comprising the most common cause for lower leg pain in athletes. Less-common causes include chronic exertional compartment syndrome and popliteal artery entrapment syndrome, both of which cause pain as a result of muscle ischemia. Radiologic evaluation plays an important role in differentiating among the many possible causes of leg pain and is often essential in determining degree of injury as well as in documenting healing before patient return to athletic activity. With PAES and hamstring and Achilles injuries, imaging may be helpful in surgical planning as well as in determining an underlying anatomic cause for injury. Several of these conditions can be evaluated with multiple different imaging modalities. The imaging modality of choice should be selected based on the sensitivity and specificity of the imaging examination but should also be tailored to each individual patient after determining comorbidities that may preclude certain types of imaging as well as assessing the patient's ability to undergo such testing. PMID:22341013

Bresler, Michael; Mar, Winnie; Toman, Jordan

2012-04-01

233

Disseminated Cryptococcosis-Induced Skin Ulcers in a Patient with Autoimmune Hepatitis  

PubMed Central

We report the case of a 68-year-old woman with autoimmune hepatitis (AIH) who had leg ulcers induced by disseminated cryptococcosis. She had received prednisolone for her AIH at 20 mg/day for maintenance. On the initial visit, she complained of a painful ulcer that had round, shallow pockets with erythema and erythematous subcutaneous indurations on the right thigh. Several metacarpophalangeal joints and wrist joints were swollen, with tenderness and stiffness in the morning for over 3 h. Her serum rheumatoid factor was high. Since other autoimmune disorders such as rheumatoid arthritis can present with AIH, it was necessary to distinguish it from ulcers due to rheumatoid arthritis, although the characteristic features of these ulcers seemed to be different. A biopsy specimen from the erythematous skin showed globe-shaped organisms in the dermis and subcutaneous tissues; vasculitis and phlebostasis were not observed. The results from computed tomography scans and sputum culture led to the diagnosis of disseminated cryptococcosis. The administration of fluconazole, fosfluconazole, and voriconazole for about 2 months improved the cryptococcal pneumonia, but the size of the skin ulcer enlarged. The administration was changed to itraconazole, which reduced the size. Cryptococcal infections occur more commonly in immunocompromised hosts, including patients under immunosuppressive therapies such as corticosteroids. The possibility that the skin ulcers in immunocompromised hosts may be caused by cryptococcosis should be considered. PMID:24761142

Ikeda, Takaharu; Kaminaka, Chikako; Yamamoto, Yuki; Furukawa, Fukumi

2014-01-01

234

[Traveler's thrombosis: incidence, etiology, prevention].  

PubMed

The number of persons traveling by airplane, railway or bus is on the increase. Recently, there has been a growing number of reports on travel-related disorders after long journeys, especially long-haul flights (i.e. deep venous thrombosis (DVT) and pulmonary thromboembolism (VTE), also known as "economy class syndrome" or "traveler's thrombosis"). The exact incidence of travel related thrombosis is not known. Contributing factors for DVT and VTE are sitting in a cramped position for hours, low humidity and lowered oxygen pressure in the aircraft cabin, reduced fluid intake and dehydration, as well as individual risk factors. In this review article definitions for risk groups (low, moderate and high risk for DVT and VTE) and recommendations for prevention (leg exercise, fluid intake, compression stockings and application of low molecular weight heparins) of travel related thrombosis, based on the outcome of a recent expert meeting, are presented. PMID:12407930

Schobersberger, Wolfgang; Hauer, Beatrix; Sumann, Günther; Gunga, Hanns-Christian; Partsch, Hugo

2002-01-15

235

Pressure ulcer prevention and management.  

PubMed

This chapter reviews 218 published and unpublished research reports of pressure ulcer prevention and management by nurse researchers and researchers from other disciplines. The electronic databases MEDLINE (1966-July 2001), CINAHL (1982-June 2001), AMED (1985-July 2001), and EI Compedex Plus (1980-June 2001) were selected for the searches because of their focus on health and applied research. Moreover, evaluations of previous review articles and seminal studies that were published before 1966 are also included. Research conducted worldwide and published in English between 1930 and 2001 was included for review. Studies using descriptive, correlational, longitudinal, and randomized control trials were included. This review found that numerous gaps remain in our understanding of effective pressure ulcer prevention and management. Moreover, the majority of pressure ulcer care is derived from expert opinion rather than empirical evidence. Thus, additional research is needed to investigate pressure ulcer risk factors of ethnic minorities. Further studies are needed that examine the impact of specific preventive interventions (e.g., turning intervals based on risk stratification) and the cost-effectiveness of comprehensive prevention programs to prevent pressure ulcers. Finally, an evaluation is needed of various aspects of pressure ulcer management (e.g., use of support surfaces, use of adjunctive therapies) and healing of pressure ulcers. PMID:12092517

Lyder, Courtney H

2002-01-01

236

Pathogenicity Studies with the Fungi Aphanomyces invadans, Achlya bisexualis, and Phialemonium dimorphosporum: Induction of Skin Ulcers in Striped Mullet  

Microsoft Academic Search

Based on isolations from naturally infected fish in Florida, we investigated the role of the fungi Aphanomyces invadans, Achlya bisexualis, and Phialemonium dimorphosporum in the etiology of ulcerative mycosis (UM) in striped mullet Mugil cephalus. We injected healthy striped mullet subcutaneously with secondary zoospores of four oomycete isolates: two concentrations (50 and 115 zoospores\\/mL) of SJR (an endemic isolate of

Emilio R. Sosa; Jan H. Landsberg; Yasunari Kiryu; Christy M. Stephenson; Theresa T. Cody; Angela K. Dukeman; Heather P. Wolfe; Mark W. Vandersea; R. Wayne Litaker

2007-01-01

237

Clinical management of pressure ulcers.  

PubMed

Pressure ulcers are chronic and difficult to heal. Pressure-reducing devices are clearly superior to a standard hospital mattress in preventing pressure ulcers, but only limited evidence and clinical intuition supports pressure-reducing devices in improving the healing rate of pressure ulcers. Local wound treatment should aim at maintaining a moist wound environment. The choice of a particular dressing depends on wound characteristics, such as the amount of exudate, dead space, or wound location. Nutritional status should be addressed as a process of good care. Debridement may improve time to a clean wound bed, but no clearly superior approach has been demonstrated. PMID:23571035

Thomas, David R

2013-05-01

238

Etiological characteristics of abusive husbands.  

PubMed

This study compared abusive husbands with nonabusive, marital discordant husbands using six measures to ascertain certain etiological characteristics of abusers. Both groups completed the Jenkins Activity Survey for measuring type A behavior, the Short Michigan Alcoholism Screening Test, the Index of Self-Esteem, the Spence-Helmrich Attitudes Toward Women Scale, the Index of Marital Satisfaction, and a simple rating scale to access their perceptions of their wives' physical attractiveness. As predicted, abusers evidence significantly higher type A behaviors, higher problem drinking behaviors, more rigid attitudes toward women, lower marital satisfaction, and rated their wives as less attractive than did nonabusers. Inconsistent with the literature, however, no significant differences were discovered between the self-esteem of abusers and nonabusers. PMID:1780068

Hurlbert, D F; Whittaker, K E; Munoz, C J

1991-12-01

239

Noise Injury: Etiology and Prevention  

PubMed Central

Exposure to noise might be responsible for a wide and varied spectrum of physical and mental morbidity, although many of the claims of cause and effect relationship are controversial and unproven. The etiological relationship between noise and high frequency hearing loss is, however, well documented. While noise-induced hearing loss is considered to be primarily an occupational problem, current leisure time activities have created the potential for it to become more common in the community at large. Once developed, this hearing loss is permanent and cannot be influenced by therapy. Noise-induced hearing loss is almost completely preventable and the family physician has an important responsibility for primary and secondary prevention, whether the noise source is in the workplace or in some other location. PMID:21286519

Lees, R. E. M.

1982-01-01

240

[The daily life of men who lives with chronic venous ulcer: phenomenological study].  

PubMed

The chronic venous leg ulcer is the major therapeutic problem of lower limb injuries, which can trigger changes in the daily life of the person affected by it. This study aimed to understand the daily life of men who lives with chronic venous ulcers. A phenomenological study was conducted with eight men, who were interviewed during June and July of 2001. The study asked questions related to: "Restrictions in social life" and "Recovering the skin integrity and restart the activities affected by the wound". The answers revealed that men with these ulcers have social implications in the areas of productivity and sexuality. This leads to restrictions in everyday life with loss in performance of socially established roles for men, leading to anxiety for his return at full performance of his social role. The findings suggest significant experiential aspects that may guide professionals in the planning and implementation of health actions aimed to treat these patients. PMID:24344590

da Silva, Marcelo Henrique; de Jesus, Maria Cristina Pinto; Merighi, Miriam Aparecida Barbosa; de Oliveira, Deise Moura; Biscotto, Priscilla Ribeiro; Silva, Greyce Pollyne Santos

2013-09-01

241

Evaluation of MAFbx expression as a marker for congenital splay leg in piglets.  

PubMed

Splay leg is a hereditary syndrome observed in highly varying frequency in newborn piglets. Although the phenotype indicates a muscular weakness, the etiology is still poorly understood. Only recently, the gene expression of muscle atrophy F-box (MAFbx; FBXO32) was proposed as being of diagnostic value for splay leg in piglet. In this study, total RNA from three healthy and three affected male piglets was isolated. Samples were collected from M. gracilis, Mm. adductores, and M. sartorius. Further samples were taken for histological and biochemical analyses. Expression of MAFbx was analysed by real-time RT-PCR and with the GeneChip" Porcine Genome Array (Affymetrix). No significant differences (p>0.05) were observed in relative MAFbx expression, either between the three muscles or between splay leg and healthy piglets for each muscle. The expression of further atrophy-related genes was unchanged, indicating that splay leg is not characterized by general muscular atrophy in the affected hind limbs. This is supported by histological and biochemical data that does not demonstrate signs of atrophy in splay leg muscles. We conclude that the diagnostic value of MAFbx expression for congenital splay leg in piglets is doubtful and that the disease is characterized by heterogeneous alterations in skeletal muscle. PMID:18817317

Boettcher, D; Schmidt, R; Rehfeldt, C; Thaller, G; Swalve, H H; Maak, S

2008-01-01

242

Why Dont Whales Have Legs?  

NSDL National Science Digital Library

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.

Bedell, S.

243

Rotational joint for prosthetic leg  

NASA Technical Reports Server (NTRS)

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.

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

1977-01-01

244

Colonic motility in ulcerative colitis  

PubMed Central

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.

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

2014-01-01

245

H. pylori and Peptic Ulcers  

MedlinePLUS

... in place of—antibiotics in some treatment regimens. Antacids Although an antacid may make the pain from a peptic ulcer ... check with their health care provider before taking antacids. Some of the antibiotics that health care providers ...

246

A Leg (or Three) to Stand On  

NSDL National Science Digital Library

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.

Weinburgh, Molly

2003-03-01

247

OCEAN DRILLING PROGRAM LEG 132 ENGINEERING PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 132 ENGINEERING PROSPECTUS WESTERN AND CENTRAL PACIFIC Mr. Michael A Institutions, Inc., under contract with the National Science Foundation. Funding for the program is provided, or Texas A & M Research Foundation. #12;Leg 132 Engineering Prospectus page 3 INTRODUCTION Leg 132

248

Static Stability of Tension Leg Platforms  

E-print Network

tendon system, 2) a partially damaged tendon system, and 3) a completely damaged tendon system. The four different types of TLP chosen for this study are 1) a conventional four-leg TLP, 2) three-leg mini TLP, 3) extended four-leg TLP and 4) mini four...

Xu, Ning

2010-07-14

249

Measurement of body fat using leg to leg bioimpedance  

PubMed Central

AIMS—(1) To validate a leg to leg bioimpedance analysis (BIA) device in the measurement of body composition in children by assessment of its agreement with dual energy x ray absorptiometry (DXA) and its repeatability. (2) To establish a reference range of percentage body fat in Hong Kong Chinese children.?METHODS—Sequential BIA and DXA methods were used to determine body composition in 49 children aged 7-18 years; agreement between the two methods was calculated. Repeatability for the BIA method was established from duplicate measurements. Body composition was then determined by BIA in 1139 girls and 1243 boys aged 7-16 years, who were randomly sampled in eight local primary and secondary schools to establish reference ranges.?RESULTS—The 95% limits of agreement between BIA and DXA methods were considered acceptable (?3.3 kg to ?0.5 kg fat mass and ?3.9 to 0.6% body fat). The percentage body fat increased with increasing age. Compared to the 1993 Hong Kong growth survey, these children had higher body mass index. Mean (SD) percentage body fat at 7years of age was 17.2% (4.4%) and 14.0% (3.4%) respectively for boys and girls, which increased to 19.3% (4.8%) and 27.8% (6.3%) at age 16.?CONCLUSION—Leg to leg BIA is a valid alternative method to DXA for the measurement of body fat. Provisional reference ranges for percentage body fat for Hong Kong Chinese children aged 7-16 years are provided.?? PMID:11517118

Sung, R; Lau, P; Yu, C; Lam, P; Nelson, E

2001-01-01

250

Red blood cell folate is associated with the development of dysplasia and cancer in ulcerative colitis  

Microsoft Academic Search

Patients with extensive ulcerative colitis have a high risk of developing colon cancer. The etiology of mucosal dysplasia, a premalignant lesion that is used as a screening test in surveillance programs, is unknown. Previously, a case-control study [Lashner et al. (1989) Gastroenterology 97:255–259] suggested that folate supplementation was associated with a 62% reduction in the risk of developing dysplasia or

Bret A. Lashner

1993-01-01

251

Diet as a risk factor for the development of ulcerative colitis  

Microsoft Academic Search

OBJECTIVE:Dietary factors have been considered as a possible risk factor for ulcerative colitis (UC). However, available data are inconsistent. The aim of the present study was to evaluate the etiological role of dietary factors in the development of UC.METHODS:Recently diagnosed (RESULTS:High intakes of monounsaturated fat (OR: 33.9 [95% CI 2.6–443.1]), polyunsaturated fat (OR: 5.1 [95% CI 1.0–26.7]), and vitamin B6

B. J Geerling; P. C Dagnelie; A Badart-Smook; M. G Russel; R. W Stockbrügger; R.-J. M Brummer

2000-01-01

252

Diet as a risk factor for the development of ulcerative colitis  

Microsoft Academic Search

OBJECTIVE:Dietary factors have been considered as a possible risk factor for ulcerative colitis (UC). However, available data are inconsistent. The aim of the present study was to evaluate the etiological role of dietary factors in the development of UC.METHODS:Recently diagnosed (<6 Months) UC patients (n = 43) and age- and gender-matched population controls (n = 43) were studied in a

B. J. Geerling; P. C. Dagnelie; A. Badart-Smook; M. G. Russel; R. W. Stockbrugger; R.-J. M. Brummer

2000-01-01

253

Fecal bacteriology and reservoir ileitis in patients operated on for ulcerative colitis  

Microsoft Academic Search

To investigate the etiology of ileal reservoir inflammation, fecal bacteriology and ileal wall morphology were compared in\\u000a three groups of 15 patients operated on four ulcerative colitis: 1) conventional ileostomy, 2) Kock ileostomy; and 3) pelvic\\u000a ileal pouch. Total bacterial counts showed overgrowth of fecal bacteria in each group, but the anaerobic bacterial counts\\u000a were significantly higher (P<.05) in the

P. Luukkonen; V. Valtonen; A. Sivonen; P. Sipponen; H. Järvinen

1988-01-01

254

Randomised controlled trial comparing European standard class 1 to class 2 compression stockings for ulcer recurrence and patient compliance.  

PubMed

The aim of this study was to determine the rate of venous ulcer recurrence and the level of compliance in patients wearing European class 1 or class 2 compression stockings. A total of 100 patients with healed venous leg ulcers were recruited, and were randomised to either class 1 (n = 50) or class 2 (n = 50) compression stockings. Follow-up was at 1 week, 3, 6, 9 and 12 months to monitor ulcer recurrence and compliance. Patients had a duplex scan to identify the source of venous incompetence. The rate of ulcer recurrence after 12 months was 16·1%, and the difference in recurrence rate between classes was not statistically significant (P = 0·287) although greater numbers in class 1 developed a recurrence. Participants (88·9%) were compliant; non-compliant patients were at a significantly greater risk of recurrence (P? 0·0001). Thirteen patients had both superficial and deep incompetence; those randomised to class 1 stockings (n = 4) developed ulcer recurrence. Patients with a history of multiple episodes of ulceration were more likely to develop a recurrence (P = 0·001). The lowest venous ulcer recurrence rates were seen in patients who were compliant with hosiery regardless of the compression level. Patients with both superficial and deep incompetence had a lower rate of recurrence with class 2 compression. PMID:23078587

Clarke-Moloney, Mary; Keane, Niamh; O'Connor, Veronica; Ryan, Mary Anna; Meagher, Helen; Grace, Pierce A; Kavanagh, Eamon; Walsh, Stewart R; Burke, Paul E

2014-08-01

255

The first leg video endoscopic groin lymphadenectomy in vulvar cancer: A case report  

PubMed Central

INTRODUCTION The current management of vulvar cancer depends on the extension of disease, and includes primary tumor resection with safety margin as well as inguinofemoral lymph node staging. We report the case of the first leg videoendoscopic inguinal lymphadenectomy performed in a woman with a squamous cell vulvar carcinoma. PRESENTATION OF CASE A 74 years old female referred to our institution complaining of vulvar mass associated with bleeding and swelling from external genitals, vaginal burning sensation and dysuria for 5 months. A vulvar–vaginal examination under narcosis reported a right major labium lesion of 5 cm with an irregular and ulcerated surface, easily bleeding on palpation, involving anteriorly the clitoral region and with a histological finding of a poorly differentiated squamous cell invasive carcinoma of the vulva ulcerating the surface epithelium. We performed, after adequate informed consent, a radical vulvectomy with a standard right inguinofemoral lymphadenectomy and a contralateral simultaneous video endoscopic inguinal lymphadenectomy-Leg procedure. DISCUSSION Our minimally invasive VEIL-Leg approach, performed for the first time in literature in a woman with vulvar cancer, could reduce the presence of high risk factors represented by surgical incision and by procedure-related complications, including wound infection and breakdown, hematoma, cellulitis and hernia formation. CONCLUSION A multicenter prospective randomized study will be helpful to clarify how this procedure could replace the standard laparotomic approach to inguinal lymphadenectomy in the vulvar cancer treatment and staging. PMID:24973526

Naldini, Angelica; Rossitto, Cristiano; Morciano, Andrea; Panico, Giovanni; Campagna, Giuseppe; Paparella, Pierluigi; Scambia, Giovanni

2014-01-01

256

Restless legs syndrome in multiple system atrophy.  

PubMed

The purpose of the study was to evaluate the frequency of restless legs syndrome in 30 patients with multiple system atrophy. Eight patients complained from restless legs syndrome, their severity score was 19.4 ± 4.1. Pittsburgh Sleep Quality Index scores were significantly higher in patients with restless legs syndrome than those without (9.3 ± 3.7 vs. 4.8 ± 2.9, p = 0.00165). Periodic limb movements were found in 75 % of patients with restless legs syndrome. Restless legs syndrome is more prevalent in multiple system atrophy as compared to the acknowledged prevalence in the general population. PMID:24818598

Ghorayeb, Imad; Dupouy, Sandrine; Tison, François; Meissner, Wassilios G

2014-12-01

257

The etiology and treatment of tennis elbow  

Microsoft Academic Search

The primary etiological factor in tennis elbow is a mechanical predisposition of the human elbow associated with force overload Additional etiological factors in clude lack of forearm strength and endur ance, age, and a tendency toward mus culo-tendinous inflammatory abnormali tiesTreatment includes relief of inflamma tion, improvement of tissue quality by exercise, decrease in the moments of force to which

Robert P. Nirschl

1974-01-01

258

Aetiopathogenesis of restless legs syndrome  

Microsoft Academic Search

The pathogenesis of restless legs syndrome (RLS) is not yet completely understood. However, recent research addressed the\\u000a hypothesis that dopaminergic pathways are involved in the mechanisms responsible for the syndrome both for sensory and motor\\u000a symptoms. Different aspects of RLS physiopathogenesis are discussed: the genetic components indicating different chromosomes\\u000a are responsible for the heterogeneity in the phenotypic expression of the

M. Zucconi; M. Manconi; L. Ferini Strambi

2007-01-01

259

Trends in peptic ulcer related diseases from 1972 to 1980  

Microsoft Academic Search

Between 1972 and 1980 Hospital Activity Analysis from 5 Northern Ireland Hospitals demonstrated a gradual increase in the number of patients discharged for all diagnoses whilst there was a decline in discharges for peptic ulcer related disease, (duodenal ulcer, gastric ulcer, gastrojejunal ulcer, peptic ulcer site unspecified and hiatal hernia). The mean number of peptic ulcer related disease discharges per

P. C. O'Connor; K. Griffiths; R. G. Shanks

1983-01-01

260

Pressure ulcers - what to ask your doctor  

MedlinePLUS

Pressure ulcers are also called bedsores, or pressure sores. They can form when your skin and soft tissue press ... damaged or die. When this happens, a pressure ulcer may form. Below are some questions you may ...

261

Peptic Ulcer - Multiple Languages: MedlinePlus  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Peptic Ulcer - Multiple Languages Chinese - Simplified (????) Chinese - Traditional (????) ... Simplified (????) Heartburn, Gastrointestinal Reflux Disease (GERD), and Peptic Ulcer English ???, ??????????? - ???? (Chinese - Simplified) PDF Chinese ...

262

[Surgical treatment of duodenal ulcer].  

PubMed

The medical and endoscopic treatment of duodenal ulcer are decreasing the frequency of surgical treatment in this disease. The authors study the operations performed for duodenal ulcer within the period 1989-1999 in the County Hospital Baia Mare. The decrease of the rate of surgical interventions is the pure effect of the medical treatment, as long as the endoscopic treatment is not yet available in our service. The rate of ulcer--induced perforations remained, however, unmodified (48% of total operatory indications), as well as the postoperative morbidity and--mortality (18% respectively 9%). The last category seems not to be influenced by the type of chosen surgical procedure, but by the patient's age, duration of the disease, and associated pathology. PMID:12731191

Lese, M; Naghi, I; Pop, C

2001-01-01

263

Ulcerative colitis — an allergic phenomenon  

Microsoft Academic Search

Summary  \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a Ulcerative colitis is frequently due to food allergy—in at least sixty-six per cent of cases.\\u000a \\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a The resemblance between the mucosal lesions of ulcerative colitis and allergic reactions in the skin is quite obvious.\\u000a \\u000a \\u000a \\u000a \\u000a 3. \\u000a \\u000a The pathological findings in early ulcerative colitis are identical with those demonstrated in allergy experiments in humans\\u000a and animals. Their progression would produce

Albert P. R Andresen

1942-01-01

264

Kayexalate-induced colonic ulcer.  

PubMed

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

Albeldawi, Mazen; Gaur, Varun; Weber, Luke

2014-08-01

265

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

PubMed Central

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

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

2013-01-01

266

Raynaud, digital ulcers and calcinosis in scleroderma.  

PubMed

Raynaud, digital ulcers and calcinosis are frequent manifestations of patients with systemic sclerosis. Digital ulcers are seen in more than half of the patients with scleroderma. Hospitalizations, ischemic complications and impairment of hand function are frequently observed in patients with digital ulcers, especially if treatment is delayed. Rapid and intensive treatment escalation in patients with scleroderma and refractory Raynaud's phenomenon is one of the most effective preventive action available in order to avoid the development of digital ulcers and tissue loss. PMID:22835924

Nitsche, Alejandro

2012-01-01

267

Computed tomographic findings in penetrating peptic ulcer  

SciTech Connect

Four cases of peptic ulcer penetrating the head of the pancreas were diagnosed by computed tomography (CT). Findings common to 3 cases included (a) an ulcer crater, (b) a sinus tract, and (c) enlargement of the head of the pancreas. Unlike other modalities, the inherent spatial resolution of CT allows a convenient diagnosis of this important complication of peptic ulcer disease.

Madrazo, B.L.; Halpert, R.D.; Sandler, M.A.; Pearlberg, J.L.

1984-12-01

268

Practice Recommendations for Preventing Heel Pressure Ulcers  

Microsoft Academic Search

Heels are the second most common anatomical location for pressure ulcers. A combination of risk factors, including pressure, may cause ulceration. Heel pressure ulcers are a particular concern for surgical patients. A review of the literature, including poster presentations, shows that controlled clinical studies to assess the effectiveness and cost-effectiveness of available interventions are not available. Case series (with or

Evonne Fowler; Suzy Scott-Williams; James B. McGuire

269

Refractory Restless Legs Syndrome Likely Caused by Olanzapine  

PubMed Central

We report a case of severe restless legs syndrome (RLS) that occurred as a side effect of olanzapine therapy. It was refractory to treatment with 2 mg of clonazepam and 3 mg ropinirole. There was partial relief with propoxyphene, however, it was stopped because of side effects. The symptoms disappeared once olanzapine was switched to another antipsychotic medication. Only two prior published reports associate olanzapine usage with development of RLS. In one report, low-dose benzodiazepines and ropinirole were associated with resolution of RLS symptoms stating dopamine depletion as the likely etiology. In our patient, however, RLS due to olanzapine was refractory to the trial of both high-dose benzodiazepine and ropinirole. This suggests that RLS occurring as a side effect of olanzapine therapy may have additional causative mechanisms beyond simple dopamine depletion as postulated before. High-dose narcotics, if tolerated, may be an alternative in such refractory cases. Citation: Khalid I; Rana L; Khalid TJ; Roehrs T. Refractory Restless Legs Syndrome Likely Caused by Olanzapine. J Clin Sleep Med 2009;5(1):68-69. PMID:19317385

Khalid, Imran; Rana, Lopa; Khalid, Tabindeh J; Roehrs, Timothy

2009-01-01

270

Molecular Assays for Detecting Aphanomyces invadans in Ulcerative Mycotic Fish Lesions  

PubMed Central

The pathogenic oomycete Aphanomyces invadans is the primary etiological agent in ulcerative mycosis, an ulcerative skin disease caused by a fungus-like agent of wild and cultured fish. We developed sensitive PCR and fluorescent peptide nucleic acid in situ hybridization (FISH) assays to detect A. invadans. Laboratory-challenged killifish (Fundulus heteroclitus) were first tested to optimize and validate the assays. Skin ulcers of Atlantic menhaden (Brevoortia tyrannus) from populations found in the Pamlico and Neuse River estuaries in North Carolina were then surveyed. Results from both assays indicated that all of the lesioned menhaden (n = 50) collected in September 2004 were positive for A. invadans. Neither the FISH assay nor the PCR assay cross-reacted with other closely related oomycetes. These results provided strong evidence that A. invadans is the primary oomycete pathogen in ulcerative mycosis and demonstrated the utility of the assays. The FISH assay is the first molecular assay to provide unambiguous visual confirmation that hyphae in the ulcerated lesions were exclusively A. invadans. PMID:16461710

Vandersea, Mark W.; Litaker, R. Wayne; Yonnish, Bryan; Sosa, Emilio; Landsberg, Jan H.; Pullinger, Chris; Moon-Butzin, Paula; Green, Jason; Morris, James A.; Kator, Howard; Noga, Edward J.; Tester, Patricia A.

2006-01-01

271

Molecular assays for detecting Aphanomyces invadans in ulcerative mycotic fish lesions.  

PubMed

The pathogenic oomycete Aphanomyces invadans is the primary etiological agent in ulcerative mycosis, an ulcerative skin disease caused by a fungus-like agent of wild and cultured fish. We developed sensitive PCR and fluorescent peptide nucleic acid in situ hybridization (FISH) assays to detect A. invadans. Laboratory-challenged killifish (Fundulus heteroclitus) were first tested to optimize and validate the assays. Skin ulcers of Atlantic menhaden (Brevoortia tyrannus) from populations found in the Pamlico and Neuse River estuaries in North Carolina were then surveyed. Results from both assays indicated that all of the lesioned menhaden (n = 50) collected in September 2004 were positive for A. invadans. Neither the FISH assay nor the PCR assay cross-reacted with other closely related oomycetes. These results provided strong evidence that A. invadans is the primary oomycete pathogen in ulcerative mycosis and demonstrated the utility of the assays. The FISH assay is the first molecular assay to provide unambiguous visual confirmation that hyphae in the ulcerated lesions were exclusively A. invadans. PMID:16461710

Vandersea, Mark W; Litaker, R Wayne; Yonnish, Bryan; Sosa, Emilio; Landsberg, Jan H; Pullinger, Chris; Moon-Butzin, Paula; Green, Jason; Morris, James A; Kator, Howard; Noga, Edward J; Tester, Patricia A

2006-02-01

272

Treatment of chronic ulcerative colitis  

Microsoft Academic Search

Summary  A treatment of Chronic Ulcerative Colitis in which diet, rest and treatment with Anayodin (iodoxyquinoline sulfonic acid)\\u000a has been described. Anayodin was administered orally and by enema with good results.\\u000a \\u000a Three case histories, one acute, one chronic and one recurrent have been related.

Charles J. Drueck

1944-01-01

273

10 Nutrition and ulcerative colitis  

Microsoft Academic Search

The role of diet in the aetiology and pathogenesis of ulcerative colitis (UC) remains uncertain. Impaired utilization by colonocytes of butyrate, a product of bacterial fermentation of dietary carbohydrates escaping digestion, may be important. Sulphur-fermenting bacteria may be involved in this impaired utilization. Oxidative stress probably mediates tissue injury but is probably not of causative importance. Patients with UC are

John L. Rombeau; Gary R. Lichtenstein

1997-01-01

274

Oesophageal ulcer caused by warfarin.  

PubMed Central

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

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

1989-01-01

275

Drug therapy for ulcerative colitis  

Microsoft Academic Search

Ulcerative colitis (UC) is an inflammatory destructive disease of the large intestine occurred usually in the rectum and lower part of the colon as well as the entire colon. Drug therapy is not the only choice for UC treatment and medical management should be as a comprehensive whole. Azulfidine, Asacol, Pentasa, Dipentum, and Rowasa all contain 5-aminosalicylic acid (5-ASA), which

Chang-Tai Xu; Shu-Yong Meng; Bo-Rong Pan

276

Gastric Ulcer Study Update from  

Microsoft Academic Search

2 different over-the-counter medications for the prevention of exercise-induced stomach ulcers in racing sled dogs. The two medications (famotidine - trade name Pepcid, given at a dose of 40 mg twice daily; and omeprazole - trade name Prilosec, given at a dose of 20 mg once daily on an empty stomach and approximately 30 min before a meal) were tested

Karen Ramstead; Jane Fuerstenau; Jolene Giese; Donna Quante; Thomas Swan; TC Wait; Jackie Wepruk; Ben Woodard

277

In vitro inhibition of Citrobacter freundii, a red-leg syndrome associated pathogen in raniculture, by indigenous Lactococcus lactis CRL 1584  

Microsoft Academic Search

Red-leg syndrome (RLS) is one of the main infectious diseases that cause economic losses in Lithobates catesbeianus hatcheries, Citrobacter freundii being an etiological agent. Treatment or prevention with therapeutics or chemicals results in modifications of the indigenous microbiota, development of antibiotic resistance, presence of their residues in food and enhancement of production costs. Thus, probiotics could be used as an

Sergio E. Pasteris; Marcos G. Guidoli; María C. Otero; Marta I. Bühler; María E. Nader-Macías

2011-01-01

278

Glycoaminoglycan (GAG) deficiency in protective barrier as an underlying, primary cause of ulcerative colitis, Crohn's disease interstitial cystitis and possibly Reiter's syndrome  

Microsoft Academic Search

Summary Ulcerative colitis, Crohn's disease and interstitial cystitis share many common features, the most important of which is a defect in the glycoaminoglycan (GAG) defensive barrier. This defect allows penetration of toxins causing localized inflammatory response, followed by fibrosis and distant pathological changes, together with a myriad of biochemical and immunological changes. The latter has caused confusion as to etiology

A. L. Russell

1999-01-01

279

Pediatric ulcerative colitis: a practical guide to management.  

PubMed

Ulcerative colitis (UC) is a chronic inflammatory disorder of the gastrointestinal tract of unknown etiology that frequently presents in the pediatric population. The evaluation of pediatric UC involves excluding infection, and a colonoscopy that documents the clinical and histologic features of chronic colitis. Initial management of mild UC is typically with mesalamine therapy for induction and maintenance. Moderate UC is often initially treated with oral prednisone. Depending on disease severity and response to prednisone, maintenance options include mesalamine, mercaptopurine, azathioprine, infliximab, or adalimumab. Severe UC is typically treated with intravenous corticosteroids. Corticosteroid nonresponders should either undergo a colectomy or be treated with second-line medical rescue therapy (infliximab or calcineurin inhibitors). The severe UC patients who respond to medical rescue therapy can be maintained on infliximab or thiopurine, but 1-year remission rates for such patients are under 50 %. These medications are discussed in detail along with the initial work-up and a treatment algorithm. PMID:24723200

Regan, Brian P; Bousvaros, Athos

2014-06-01

280

OCEAN DRILLING PROGRAM LEG 202 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 202 SCIENTIFIC PROSPECTUS SOUTHEAST PACIFIC PALEOCEANOGRAPHIC TRANSECTS 1000 Discovery Drive College Station TX 77845-9547 USA _____________________ Dr. Peter Blum Leg Project the international Ocean Drilling Program, which is managed by Joint Oceanographic Institutions, Inc., under contract

281

OCEAN DRILLING PROGRAM LEG 201 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 201 SCIENTIFIC PROSPECTUS CONTROLS ON MICROBIAL COMMUNITIES IN DEEPLY Discovery Drive College Station TX 77845-9547 USA _____________________ Dr. D. Jay Miller Leg Project the international Ocean Drilling Program, which is managed by Joint Oceanographic Institutions, Inc., under contract

282

OCEAN DRILLING PROGRAM LEG 111 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 111 SCIENTIFIC PROSPECTUS DSDP HOLE 504B REVISITED Keir Becker Japan Russell B. Merrill Staff Scientist, Leg 111 Ocean Drilling Program Texas ASM University College., under contract with the National Science Foundation. Funding for the program is provided

283

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 -------------------------------- Dr. Gary D. Acton Leg Project Manager and Staff Scientist Ocean Drilling Program Texas A&M University the international Ocean Drilling Program, which is managed by Joint Oceanographic Institutions, Inc., under contract

284

OCEAN DRILLING PROGRAM LEG 196 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 196 SCIENTIFIC PROSPECTUS LOGGING WHILE DRILLING AND ADVANCED CORKS College Station TX 77845-9547 USA _____________________ Dr. Adam Klaus Leg Project Manager and Staff Program, which is managed by Joint Oceanographic Institutions, Inc., under contract with the National

285

OCEAN DRILLING PROGRAM LEG 178 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 178 SCIENTIFIC PROSPECTUS ANTARCTIC PENINSULA Antarctic Glacial History and Sea-level Change Dr. Peter Barker Co-Chief Scientist, Leg 178 British Antarctic Survey High Cross of the University of Tokyo (Japan) National Science Foundation (United States) Natural Environment Research Council

286

The Reflex Mechanism of the Insect Leg  

Microsoft Academic Search

1. Variations in the frequency of the motor discharges to the leg muscles of Periplaneta americana are followed in the intact animal under different types of sensory stimulation by electrical recording from the muscles.2. Two main reflexes are described: the depressor reflex, evoked by stimulation of the campaniform sensilla on the legs, and a levator response to touch on the

J. W. S. Pringle

1940-01-01

287

OCEAN DRILLING PROGRAM LEG 118 PRELIMINARY REPORT  

E-print Network

RIDGE Paul T. Robinson Co-Chief Scientist, Leg 118 Centre for Marine Geology Dalhousie University Program consisted of: Paul T. Robinson, Co-Chief Scientist (Centre for Marine Geology, Dalhousie Halifax, Nova Scotia B3H 3J5 Canada Richard P. Von Herzen Co-Chief Scientist, Leg 118 Woods Hole

288

Two-leg longwall shield mechanics  

Microsoft Academic Search

This report investigates shield mechanics by describing the elastic response and interaction of shield components to applied vertical and horizontal displacements for various canopy and base contact configurations. This research provides information on generalized shield mechanics, which is applicable in describing the behavior of all two-leg shield supports. Utilizing mechanics of materials concepts and known kinematic relationships for two-leg shield

T. M. Barczak; D. E. Schwemmer

1989-01-01

289

INTENSIVE TREATMENT OF LEG LYMPHEDEMA  

PubMed Central

Background: Despite of all the problems caused by lymphedema, this disease continues to affect millions of people worldwide. Thus, the identification of the most efficacious forms of treatment is necessary. Aim: The aim of this study was to evaluate a novel intensive outpatient treatment for leg lymphedema. Methods: Twenty-three legs of 19 patients were evaluated in a prospective randomized study. The inclusion criteria were patients with Grade II and III lymphedema, where the difference, measured by volumetry, between the affected limb below the knee and the healthy limb was greater than 1.5 kg. Intensive treatment was carried out for 6- to 8-h sessions in the outpatient clinic. Analysis of variance was utilized for statistical analysis with an alpha error of 5% (P-value <0.05) being considered significant. Results: All limbs had significant reductions in size with the final mean loss being 81.1% of the volume of edema. The greatest losses occurred in the first week (P-value <0.001). Losses of more than 90% of the lymphedema occurred in 9 (39.13%) patients; losses of more than 80% in 13 (56.52%), losses of more than 70% in 17 (73.91%) and losses of more than 50% were recorded for 95.65% of the patients; only 1 patient lost less than 50% (37.9%) of the edema. Conclusion: The intensive treatment of lymphedema in the outpatient clinic can produce significant reductions in the volume of edema over a short period of time and can be recommended for any grade of lymphedema, in particular the more advanced degrees. PMID:20606882

Pereira de Godoy, Jose Maria; Azoubel, Lina M O; de Fatima Guerreiro de Godoy, Maria

2010-01-01

290

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

PubMed Central

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

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

2014-01-01

291

[Sexual-affective trajectories of people with chronic leg ulcers: aspects of therapeutic listening].  

PubMed

This is a qualitative study that aims to discuss the trajectories of people with chronic sores on the lower limbs,focusing on their affective and sexual experiences. Fifty-one adult outpatients participated and they received care at the infirmary of a public hospital in Salvador-Bahia, between 2008 and 2009. Data was collected through techniques that included themed-story drawings and in-depth interviews, during therapeutic listening sessions,followed by an analysis of the content and an analysis of the drawing contents. Three categories emerged solitary sexual-affective trajectory, fragmented sexual-affective trajectory, and continuous or linear sexual-affective trajectory. It was concluded that the limitations imposed by sores influence the subjectivity of these people, leading them to processes of loss of self-confidence, self-deprecation and fear of sexual- affective demands. It becomes clear, therefore, for the need to promote, not only curative interventions for the body, but also to include therapeutic listening and psychological support in the assistance offered to these people. PMID:24344599

Carvalho, Evanilda Souza de Santana; Paiva, Mirian Santos; Aparício, Elena Casado; Rodrigues, Gilmara Ribeiro Santos

2013-09-01

292

Skin grafting of a chronic leg ulcer with combined Versajet-V.A.C. therapy.  

PubMed

A new method for surgical wound debridement is the Versajet hydrosurgery technique. This technique uses a high velocity jet of sterile saline with a speed up to 1,078 km/h (670 miles/h). By using the Venturi effect (fluid speeds up in a restriction, reducing its pressure and producing a partial vacuum), a simultaneous vacuum is created across the operating window of the handpiece. The application of this high velocity fluid jet to a chronic wound enables precise debridement without collateral tissue damage. The vacuum-assisted closure (V.A.C.) therapy is used for chronic wounds to induce faster wound healing. This system creates a vacuum-induced negative pressure to a specific wound area resulting in an accelerated formation of granulation tissue in the wound bed. We present a patient who experienced rapid wound healing when both of these techniques were combined to clean the wound. After split-thickness skin grafting, V.A.C. therapy was continued. The result was excellent graft acceptance with complete wound healing. This case is unique in that a combination of both therapies resulted in complete wound healing. PMID:16928242

Stetter, Christoph; Plaza, Tobias; von den Driesch, Peter

2006-09-01

293

Cancer morbidity in ulcerative colitis  

Microsoft Academic Search

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

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

1982-01-01

294

Medical Management of Ulcerative Colitis  

Microsoft Academic Search

Ulcerative colitis (UC) is a chronic and relapsing inflammation limited to the colonic mucosa and always involving the rectum with variable extension towards the cecum. The aim of medical treatment is to induce and maintain clinical remission. In contrast to Crohn’s disease for which a ‘top-down’ or ‘early aggressive’ therapy is discussed, in UC the concept of a step-up treatment

Gerhard Rogler

2009-01-01

295

Corneal ulceration, measles, and childhood blindness in Tanzania  

Microsoft Academic Search

One hundred and thirty Tanzanian children with corneal ulceration were clinically examined to determine the cause of the ulceration. 37% of the ulcers were associated with recent measles infection and 38% of the children had bilateral ulceration. Herpes simplex virus infection was the commonest cause of ulceration in the series, but vitamin A deficiency was the major cause of bilateral

A Foster; A Sommer

1987-01-01

296

Erythema multiforme on the leg (image)  

MedlinePLUS

... person's back appear where blisters (bullae) caused by Erythema multiforme have ruptured and the overlying skin removed ( ... The resulting lesions are yellow-crusted ulcers (erosions). Erythema multiforme may be associated with herpes simplex infection, ...

297

[Exceptional etiologies in upper digestive tract bleeding ].  

PubMed

7 cases, considered as being true etiological exceptions selected from 756 upper gastrointestinal bleeding, are presented. The causes of bleeding were: pancreatic pseudocyst with intracystic hemorrhage broken into duodenum (2 cases), the nonepithelial gastroduodenal tumor (3 cases), the aneurysm of gastroduodenal artery broken into duodenum (1 case) and the aortoduodenal fistula in one patient with a bilateral aorto-iliac by-pass (1 case). The etiological diagnosis could not be established in any cases before the operations. All the cases were operated on, the operation being imposed by the severity of bleeding and having the haemostasis as a main purpose. PMID:12731169

Vilcea, V; Neme?, R; Georgescu, I; Rotaru, A; Surlin, V; Martin, L; T?nase, T; Ghelase, F

2001-01-01

298

[An uncommon etiology of anemia: copper deficiency].  

PubMed

A 58-year-old patient, without any notable medical history, except for alcoholism and treated hypertension, developed anemia and leukopenia with macrocytosis. Folate deficiency was diagnosed and subsequently treated. Despite folate supplementation, the hematological parameters did not normalize. Further diagnosis investigations were led to search for uncommon etiologies of anemia and leukoneutropenia. We diagnosed severe copper deficiency on the basis of decreased plasma levels of copper and ceruloplasmin. Copper supplementation improved blood counts within three months. This case illustrates hematological disorders due to copper deficiency, initially masked by an associated folate deficiency. The copper deficiency etiology was not identified in this case. PMID:23906580

Kouamou, Edwige; Stépanian, Alain; Khadra, Fadi; de Prost, Dominique; Teillet, France

2013-01-01

299

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

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

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

2013-02-01

300

The Most Common Detected Risk and Etiologic Factors of Pulmonary Thromboembolism  

PubMed Central

Introduction: Pulmonary thromboembolism (PTE) is the most serious manifestation of thromboembolic disease. Objective: To determine the most common risk and etiologic factors of pulmonary tromboembolism in patients treated in Intensive care unit of Clinic for Pulmonary Diseases and TB “Podhrastovi” in three-year- period from 2008. to 2010. Material and methods: We retrospectively analysed patients with PTE treated in Intensive care unit of Clinic for Pulmonary Diseases and TB “Podhrastovi” in three-year period from 2008. to 2010. PTE was diagnosed by high resolute computed tomography, in most of them ventilatory /perfusion scintigraphy (V/P SPECT) was made, with proper laboratory analyses (D-dimmer, platelets , fibrinogen, and if it was needed protein C, S and AT III factor were examined). In all of them echosonography of abdomen and pelvis was done, also the examination by angiologist, and in patients with indications echosonography of the heart and Color Doppler of leg veins was made. We analysed risk and etiologic factors for PTE in each patient. Results: In 222 treated patients with PTE risk factors were found in 124 or 55.86% patients, etiologic factors were found in 31 or 13.96%, and both risk and etiologic factors in one patient were found in 18 or 8.11% patients. Conclusion: PTE is very serious disease that very often has fatal prognosis, and can develop with previously entirely healthy people, and as soon as we become suspicious of its presence we have to made appropriate diagnostic procedures and include appropriate therapy. We can after look for risk and etiologic factors and try to influence them. PMID:23922531

Cukic, Vesna; Baljic, Rusmir

2012-01-01

301

Multiple cutaneous neutropenic ulcers associated with azathioprine  

PubMed Central

We report a case of neutropenic ulceration in a 42-year-old woman receiving azathioprine for pemphigus vulgaris. She developed multiple indolent ulcers involving the nose, neck, and back, after about 6–8 weeks following commencement of azathioprine 50 mg daily. The ulcers were large, disfiguring, dry, and with basal necrotic slough. They were painless and did not discharge pus. The absolute neutrophil count was severely depressed initially, but normalized following azathioprine withdrawal. Swab culture revealed colonization with Klebsiella pneumoniae and the ulcers healed with local debridement, treatment with imipenem, and topical application of mupirocin. However, nasal disfigurement persisted. Neutropenic ulceration is known to be associated with azathioprine therapy but we report this case because of the unusual presentation—indolent cutaneous ulcers. Early recognition of the problem and drug withdrawal can prevent complications like disfigurement. PMID:23112431

Laha, Baisakhi; Guha, Rajib; Hazra, Avijit

2012-01-01

302

Traumatic ulcerative granuloma with stromal eosinophilia.  

PubMed

Chronic ulcers of the oral mucosa are the lesions which a physician comes across frequently. "Eosinophilic Ulcer" is a rare variety of that. Eosinophilic ulcer or traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is a chronic benign lesion of the oral mucosa and is a relatively recent delineated entity. Its etiopathogenesis is still uncertain but trauma seems to play a fundamental role. Clinically the lesion manifests as an isolated ulcer, showing a raised and indurated border in addition to a white or yellowish bed. Microscopically, it is characterized by diffuse polymorphic inflammatory infiltrate, rich in eosinophils, involving the superficial mucosa and the deeper muscle layer with epitheliod cells. Hereby, reporting a case of a 60-year-old female patient who presented with a chief complaint of non-healing painful ulcer on the tongue. PMID:24444070

Chandra, Sunira; Raju, Srinivasa; Sah, Kunal; Anand, Prachi

2014-01-01

303

Iron for restless legs syndrome  

PubMed Central

Background Restless legs syndrome (RLS) is a common neurologic syndrome and is associated with iron deficiency in many patients. It is unclear whether iron therapy is effective treatment for RLS. Objectives The objective of this review was to assess the effects of iron supplementation (oral or intravenous) for patients with RLS. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Jan 1995 to April 2011); EMBASE (Jan 1995 to April 2011); PsycINFO (Jan 1995 to April 2011); and CINAHL (Jan 1995 to April 2011). Corresponding authors of included trials and additional members of the International Restless Legs Syndrome Study Group were contacted to locate additional published or unpublished trials. Selection criteria Controlled trials comparing any formulation of iron with placebo, other medications, or no treatment in adults diagnosed with RLS according to expert clinical interview or explicit diagnostic criteria. Data collection and analysis Two review authors extracted data and at least two authors assessed trial quality. We contacted trial authors for missing data. Main results Six studies (192 total subjects) were identified and included in this analysis. The quality of trials was variable. Our primary outcome was restlessness or uncomfortable leg sensations, which was quantified using the IRLS severity scale in four trials and another RLS symptom scale in a fifth trial. Combining data from the four trials using the IRLS severity scale, there was no clear benefit from iron therapy (mean difference in IRLS severity scores of -3.79, 95% CI: -7.68 to 0.10, p = 0.06). However, the fifth trial did find iron therapy to be beneficial (median decrease of 3 points in the iron group and no change in the placebo group on a 10 point scale of RLS symptoms, p = 0.01). Quality of life was improved in the iron group relative to placebo in some studies but not others. Changes in periodic limb movements were not different between groups (measured in two studies). Objective sleep quality, subjective sleep quality and daytime functioning were not different between treatment groups in the studies that assessed them. The single study of subjects with end stage renal disease did show a benefit of therapy. Most trials did not require subjects to have co-morbid iron deficiency and several excluded patients with severe anemia. The single study that was limited to iron deficient subjects did not show clear benefit of iron supplementation on RLS symptoms. There was no clear superiority of oral or intravenous delivery of iron. Iron therapy did not result in significantly more side effects than placebo (RR 1.39, 95% CI 0.85 to 2.27). Authors' conclusions There is insufficient evidence to determine whether iron therapy is beneficial for the treatment of RLS. Further research to determine whether some or all types of RLS patients may benefit from iron therapy, as well as the best route of iron administration, is needed. PMID:22592724

Trotti, Lynn M; Bhadriraju, Srinivas; Becker, Lorne A

2014-01-01

304

Effect of leg length on ROM, VJ and leg dexterity in dance.  

PubMed

We investigated the associations between leg length and specific ballet movements in different skill groups. Volunteers were from an undergraduate dance programme (n=18), a pre-professional school (n=43) and from an elite classical ballet company (n=45). Individual data were collected for anthropometry, vertical jump, leg dexterity, and leg active and passive ROM. ANCOVA identified both main effects as significant with regard to vertical jump (gender P<0.001 and skill P=0.017); leg length was also identified as a significant covariate (P=0.023). Analysis of leg dexterity identified no significant effects with gender, skill or leg length. Active and passive range of motion noted gender (P=0.001) and skill (P<0.001) differences. Leg length was found to be negatively associated with both active and passive ROM (P=0.002). In conclusion, the present data highlight the diverse and conflicting effects of leg length on fundamental ballet skills. The longer legs that benefit vertical jump have a negative influence on range of motion and leg dexterity except for highly skilled dancers, who through skill, seem to have overcome the effects of some of these dichotomies. PMID:20589589

Wyon, M A; Nevill, A M; Dekker, K; Brown, D D; Clarke, F; Pelly, J; Koutedakis, Y

2010-09-01

305

Does a crouched leg posture enhance running stability and robustness?  

PubMed

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

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

2011-07-21

306

Hemodynamic studies of the legs under weightlessness  

NASA Technical Reports Server (NTRS)

Significant among the medical findings following prolonged space flight are reduced orthostatic tolerance and ergometric work capacity. Changes in hemodynamics of the legs with increased blood pooling and reduction in cardiac output must be considered one of the most probable causes of these effects. Concern for the above plus the observed marked tissue changes occurring in the legs during flight prompted the addition of several procedures to evaluate hemodynamic changes in the leg; resting arterial blood flow, venous compliance and muscle pumping were investigated. In so far as possible, the initial reaction to pressure in the smallest possible vein segment was examined.

Thornton, W. E.; Hoffler, G. W.

1977-01-01

307

Gastric emptying abnormal in duodenal ulcer  

SciTech Connect

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.

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

1986-07-01

308

Cushing's ulcer: the eponym and his own.  

PubMed

One of the least remembered eponyms associated with Harvey Cushing is "Cushing's ulcer." The basis of this credit is a paper published in 1932 in which Cushing describes patients who postoperatively and unexpectedly died of perforated peptic ulcers. It is one of the first descriptions of a stress ulcer and a treatise on the brain-stomach connection. Harvey Cushing was puzzled by the pathogenesis of these peptic ulcerations and perforations and advanced several theories. The least plausible included the bile-vomiting theory suggesting that hemorrhagic ulceration could be produced by a combination of bile and acid in a patient recovering from the anesthetic. Other theories were stimulation of a parasympathetic center in the diencephalon or a disturbance of vagal centers in the brainstem. Quite surprisingly to Cushing, the Boston Herald implicitly insinuated that Cushing found the cause of ulcers and this claim upset him greatly. It is ironic that Harvey Cushing, in his later years with failing health, developed an ulcer himself. Cushing noted in his correspondence that he felt the agitation over this newspaper clipping caused his later ulcer. The first description of a neurogenic ulcer remains an important medical observation and is a testament to Cushing's broad accomplishments. PMID:21346647

Wijdicks, Eelco F M

2011-06-01

309

Practice recommendations for preventing heel pressure ulcers.  

PubMed

Heels are the second most common anatomical location for pressure ulcers. A combination of risk factors, including pressure, may cause ulceration. Heel pressure ulcers are a particular concern for surgical patients. A review of the literature, including poster presentations, shows that controlled clinical studies to assess the effectiveness and cost-effectiveness of available interventions are not available. Case series (with or without historical controls) as well as pressure ulcer guideline recommendations suggest the most important aspect of heel ulcer prevention is pressure relief (offloading). It also has been documented that the incidence of heel ulcers can be reduced using a total-patient care approach and heel offloading devices. Guidelines, observational studies, and expert opinion intimate that reducing heel ulceration rates can be expected to improve patient outcomes, decrease costs associated with their care, and avoid costs related to hospital-acquired pressure ulcers. The heel pressure ulcer prevention strategies reviewed should be implemented until the results of prospective, randomized controlled studies to compare the effectiveness and cost-effectiveness of these strategies are available. PMID:18927483

Fowler, Evonne; Scott-Williams, Suzy; McGuire, James B

2008-10-01

310

Post-bulbar and coexisting ulceration: unique features of peptic ulcer in Hyderabad  

Microsoft Academic Search

Post-bulbar ulceration is uncommon, but a pilot study in Hyderabad showed a high incidence. We therefore carried out a prospective endoscopic study of the distribution of peptic ulceration and its relation to symptoms and demography. Of the 360 consecutive patients referred for endoscopy, 113 (92 men, 21 women) had peptic ulceration. Median age 35 years, median duration one year. Five

S S Rao; K V Murthy

1993-01-01

311

Risk factors for healing of duodenal ulcer under antacid treatment: do ulcer patients need individual treatment?  

Microsoft Academic Search

In order to identify the risk factors affecting the healing of duodenal ulcer, a clinical trial with effective dose of antacid was carried out in 53 patients. Duration of ulcer history, number of relapses, duration of the last and present relapse, number, duration and severity of pain attacks in the present ulcer relapse, pain radiation to back, vomiting, appetite, smoking

S Massarrat; H G Müller; P Schmitz-Moormann

1988-01-01

312

Accelerated Ulcer Healing and Resistance to Ulcer Recurrence with Gastroprotectants in Rat Model of Acetic Acid-induced Gastric Ulcer  

PubMed Central

Quality of ulcer healing (QOUH) is defined as ideal ulcer healing featuring with the fine granular ulcer scar, high functional restoration and the resistance to recurrence. This study was designed to compare the rates of QOUH achievement in rat gastric ulcer model between acid suppressant treated group and gastroprotectant treated group accompanied with elucidations of molecular mechanisms. Serosal injection of acetic acids for generating gastric ulcer and intraperitoneal (ip) injection of recombinant interleukin 1-beta (IL-1?) for recurring healed ulcer was done in SD rats. The 72 rats were divided into three groups according to treatment as follows; Group I, no further treatment, Group II, 8 weeks treatment of omeprazole, and Group III, 8 weeks of gastroprotectant treatment. IL-1? was administered for ulcer recurrence after 28 weeks of acetic acid injection. At four weeks after gastric ulcerogenesis, 58.3% (7/12) of active gastric ulcer were converted to healing stage in Group III, but 16.7% (2/12) in Group II and none in Group I, for which significant levels of epidermal growth factor, mucin, and pS2/trefoil peptide1 were contributive to these accelerated healings of Group III. ip injections of rIL-1? (200 µg/kg) at 28 weeks after acetic acid injection led to 100% of ulcer recurrence in Group I and 75.0% in Group II, but only 16.7% of Group III rats showed ulcer recurrence. Significantly attenuated levels of inflammatory cytokines including IL-2, transforming growth factor-alpha (TNF-?), cyclooxygenase-2 (COX-2), nitrotyrosine were responsible for the resistance to ulcer recurrence in Group III. Conclusively, gastroprotectant might be prerequisite in order to achieve ideal QOUH through significant inductions of remodeling. PMID:18545642

Young Oh, Tae; Ok Ahn, Byung; Jung Jang, Eun; Sang Park, Joo; Jong Park, Sang; Wook Baik, Hyun; Hahm, Ki-Baik

2008-01-01

313

Etiology and treatment of homosexuality: A review  

Microsoft Academic Search

The major causal theories of and treatment approaches to male and female homosexuality are critically reviewed. Neither biological, psychoanalytic, nor learning and social-learning theories are found to provide convincing evidence for the etiology of homosexuality. All of these accounts, however, are viewed as providing mixed empirical support for their predictions, with social-learning research presenting the most consistent evidence. It is

Frank X. Acosta

1975-01-01

314

Pyogenic psoas abscess: Worldwide variations in etiology  

Microsoft Academic Search

Pyogenic abscess of the psoas muscle results from primary suppuration or direct extension of intraabdominal infection. The etiology varies with the country of origin. Our experience with 9 cases prompted a review of 367 cases from the world literature. A total of 286 primary abscesses occurred mainly in developing nations (200 cases), although 74 were reported from the United States.

Michael A. Ricci; Frederick B. Rose; Kenneth K. Meyer

1986-01-01

315

The Etiology Mystery in Primary Biliary Cirrhosis  

Microsoft Academic Search

The etiology of primary biliary cirrhosis remains largely unknown despite numerous lines of evidence that have been recently proposed or supported. Primary biliary cirrhosis is a chronic cholestatic liver disease for which an autoimmune pathogenesis is widely accepted, mostly based on the presence of autoantibodies and autoreactive T cells. Cumulatively, association and twin studies suggest that both a susceptible genetic

Carlo Selmi; M. Eric Gershwin

2010-01-01

316

Etiology and management of fecal incontinence  

Microsoft Academic Search

Fecal incontinence is a challenging condition of diverse etiology and devastating psychosocial impact. Multiple mechanisms may be involved in its pathophysiology, such as altered stool consistency and delivery of contents to the rectum, abnormal rectal capacity or compliance, decreased anorectal sensation, and pelvic floor or anal sphincter dysfunction. A detailed clinical history and physical examination are essential. Anorectal manometry, pudendal

J. Marcio N. Jorge; Steven D. Wexner

1993-01-01

317

Pulmonary fibrosis: pathogenesis, etiology and regulation  

Microsoft Academic Search

Pulmonary fibrosis and architectural remodeling of tissues can severely disrupt lung function, often with fatal consequences. The etiology of pulmonary fibrotic diseases is varied, with an array of triggers including allergens, chemicals, radiation and environmental particles. However, the cause of one of the most common pulmonary fibrotic conditions, idiopathic pulmonary fibrosis (IPF), is still unclear. This review examines common mechanisms

M S Wilson; T A Wynn

2009-01-01

318

Schizophrenia and Autoimmunity – A Possible Etiological Mechanism?  

Microsoft Academic Search

Schizophrenia is a chronic disease which begins during early adulthood and persists throughout life. It may appear in two main clinical patterns: chronic progressive and relapsing-remitting. The diagnosis is based entirely on clinical data, as no auxiliary laboratory tests are available. Schizophrenia has a heterogeneous clinical expression which may reflect different etiological factors, such as genetic susceptibility, dysfunction of different

S. Noy; A. Achiron; N. Laor

1994-01-01

319

On the Etiology of Sexual Dysfunction  

ERIC Educational Resources Information Center

Lack of consideration of the sexually functional population has led to misconceptions about causes of sexual dysfunction functioning. Automatic functioning can mask effects of pathogenic influences on sexuality, making these effects appear random, confounding etiological issues and creating the belief that causes of sexual dysfunction and disorder…

Apfelbaum, Bernard

1977-01-01

320

Definitions and terminology in cancer (tumour) etiology  

PubMed Central

In an attempt to overcome the confusion that exists in the terminology of cancer (tumour) etiology, the author has analysed the current situation and proposed terms which, he hopes, will stimulate international discussion and lead eventually to an agreed standard terminology. PMID:1087583

Hecker, Erich

1976-01-01

321

Attention Deficit Disorder: Diagnosis, Etiology and Treatment.  

ERIC Educational Resources Information Center

Provides most recent information on attention deficit disorder including: (1) diagnostic considerations according to the latest behavioral criteria and breakthroughs using neurometric EEG assessment; (2) prevalence; (3) etiologies; (4) neurological basis; and (5) treatments. Evaluates alternatives to medication, behavior modification, cognitive…

Barabasz, Marianne; Barabasz, Arreed

1996-01-01

322

Hot Leg Piping Materials Issues  

SciTech Connect

With Naval Reactors (NR) approval of the Naval Reactors Prime Contractor Team (NRPCT) recommendation to develop a gas cooled reactor directly coupled to a Brayton power conversion system as the space nuclear power plant (SNPP) for Project Prometheus (References a and b) the reactor outlet piping was recognized to require a design that utilizes internal insulation (Reference c). The initial pipe design suggested ceramic fiber blanket as the insulation material based on requirements associated with service temperature capability within the expected range, very low thermal conductivity, and low density. Nevertheless, it was not considered to be well suited for internal insulation use because its very high surface area and proclivity for holding adsorbed gases, especially water, would make outgassing a source of contaminant gases in the He-Xe working fluid. Additionally, ceramic fiber blanket insulating materials become very friable after relatively short service periods at working temperatures and small pieces of fiber could be dislodged and contaminate the system. Consequently, alternative insulation materials were sought that would have comparable thermal properties and density but superior structural integrity and greatly reduced outgassing. This letter provides technical information regarding insulation and materials issues for the Hot Leg Piping preconceptual design developed for the Project Prometheus space nuclear power plant (SNPP).

V. Munne

2006-07-19

323

Chronic ulcerative stomatitis: Clinical, histopathologic, and immunopathologic findings  

E-print Network

Chronic ulcerative stomatitis: Clinical, histopathologic, and immunopathologic findings Lynn W, Ky STATE UNIVERSITY OF NEW YORK, UNIVERSITY OF KENTUCKY, AND IMMCO DIAGNOSTICS INC Chronic ulcerative involve the skin. Clinically, CUS patients exhibit erosive or ulcerative lesions of the oral mucosa

Dennett, Daniel

324

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems  

E-print Network

Automated Pressure Ulcer Lesion Diagnosis for Telemedicine Systems Dimitrios I. Kosmopoulos dkosmo Force Hospital 11525 Athens, Greece Abstract The timely diagnosis and treatment of pressure ulcers for automated pressure ulcer stage classification can be integrated into an asynchronous telemedicine system

Kosmopoulos, Dimitrios I.

325

Preventing and Caring for Pressure Ulcers (Pressure Sores, Bedsores)  

MedlinePLUS

... new ulcers (see “How do you prevent pressure ulcers? ”). In addition, the doctor or nurse may suggest ... recommendations: Relieve pressure on the area near the ulcer • Do not allow the person to lie or ...

326

Laser Therapy of Recurrent Aphthous Ulcer in Patient with HIV Infection  

PubMed Central

The recurrent aphthous ulcer (RAU) is a pathological change found in the oral mucosa, characterized by painful single or multiple ulcers. The etiologic aspect of RAU is not well understood; however it is known that due to lower CD4 cell counts patients had higher prevalence of these oral lesions, and immunosuppressed patients with HIV are predisposed. Patient FC is African descent, 26 years old, male, HIV?+?CD4 67 cells/mm3, with minor RAU in the upper and lower right side lip, measuring about 4?mm, and major RAU in tongue and the tonsillar pillar measuring 2?cm. The patient was treated with laser therapy with the objective to help reverse the damage and decrease the symptoms. After one week there was remission of the lesions. The laser showed to be an important alternative therapy that promoted analgesic, healing effects and improving the quality of life of patients. PMID:23346114

Caputo, Bruno Vieira; Noro Filho, Gilberto Araujo; dos Santos, Camila Correia; Okida, Yugo; Giovani, Elcio Magdalena

2012-01-01

327

Assessing Sites for Yellow Legged Frog  

USGS Multimedia Gallery

Assessing suitable sites in southern California for reintroducing endangered southern mountain yellow-legged frogs, USGS scientists rediscovered a population in the San Jacinto Wilderness, 50 years since this frog was last seen there....

2009-07-23

328

Passive zero-gravity leg restraint  

NASA Technical Reports Server (NTRS)

A passive zero or microgravity leg restraint is described which includes a central support post with a top and a bottom. Extending from the central support post are a calf pad tab, to which calf pad is attached, and a foot pad tab, to which foot tab is attached. Also extending from central support post are knee pads. When the restraint is in use the user's legs are forced between pads by a user imposed scissors action of the legs. The user's body is then supported in a zero or microgravity neutral body posture by the leg restraint. The calf pad has semi-ridig elastic padding material covering structural stiffener. The foot pad has padding material and a structural stiffener. Knee pads have s structural tube stiffener at their core.

Miller, Christopher R. (inventor)

1989-01-01

329

Dynamic Computer Control of a Robot Leg  

Microsoft Academic Search

A dynamic control scheme for a three degree-of-freedom robot leg, which has been interfaced to a PDP-11\\/70 minicomputer, is developed and implemented. A CSMP (Continuous System Modeling Program) simulation is also used to study the dynamic characteristics of the leg off-line. The results of the work show that the dynamic equations of motion are valuable in robotic systems to develop

David E. Orin; Chi-Keng Tsai; Fan-Tien Cheng

1985-01-01

330

Stable and robust walking with compliant legs  

Microsoft Academic Search

Bipedal walking could be implemented into a robot by mimicking spring-like leg behaviour. The fundamental model, describing human-like leg function in walking is the bipedal spring-mass model which was investigated in this study. We identified several types of walking patterns, e.g. symmetric and asymmetric walking, that accounts for high variability of gait. The aim of this study is the identification

Juergen Rummel; Yvonne Blum; Horst Moritz Maus; Christian Rode; André Seyfarth

2010-01-01

331

Colonoscopic evaluation in ulcerative colitis  

PubMed Central

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

Paine, Elizabeth R.

2014-01-01

332

The prevention and treatment of pressure ulcers.  

PubMed

Pressure ulcers remain a significant secondary complication for many individuals with spinal cord injury (SCI). Technological advances have the potential to affect both the prevention and treatment of pressure ulcers. The focus of this article is hi-tech devices and methodologies. The current state-of-the-art methods are discussed and conceptual approaches are presented. PMID:17543771

Ho, Chester H; Bogie, Kath

2007-05-01

333

Importance of mucosal healing in ulcerative colitis  

Microsoft Academic Search

Treatment of patients with ulcerative colitis (UC) has tra- ditionally focused on improving symptoms, with the mainobjective of inducing and maintaining symptomatic remission. However, new evi- dence suggests that concentrating exclusively on clinical outcome measuresmay notbeadequatetoachievelong-termtreatmentsuccess. Indeed, physicians should also be assessing the reduction of endo- scopicactivity,withtheintentionofachievingcompletemucosal heal- ing (defined as the absence of all mucosal ulceration, both microscopic and

Gary R. Lichtenstein; Paul Rutgeerts

2009-01-01

334

Portable Gage for Pressure Ulcer Detection  

Microsoft Academic Search

Pressure ulcers are widely considered to be a critical problem in rehabilitation since they result in severe discomfort and high healthcare cost. The prevention of pressure ulcers is a constant preoccupation for every nursing team. This paper introduces a novel handheld instrument that can detect subtle changes in the skin biomechanical properties by measuring its biomechanical response. This could be

Qi Wang; Linghua Kong; Stephen Sprigle; Vincent Hayward

2006-01-01

335

Corneal ulceration following measles in Nigerian children  

Microsoft Academic Search

Acute corneal ulceration in malnourished children is the commonest cause of childhood blindness in Northern Nigeria and usually develops after measles. Other severe diseases in malnourished children rarely precipitate corneal ulceration. A survey in a school for blind children showed that 69% of the children were blind from corneal disease, and a survey of children with corneal scars showed that

J H Sandford-Smith; H C Whittle

1979-01-01

336

Pressure ulcers: Back to the basics  

PubMed Central

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of “prevention is better than cure” suits this condition the most. PMID:23162223

Agrawal, Karoon; Chauhan, Neha

2012-01-01

337

Changing demographics of peptic ulcer disease  

Microsoft Academic Search

The demography of peptic ulcer changed greatly and uniformly in western countries until the middle of this century. The demographic pattern reversed at about the turn of the century, duodenal ulcer becoming the predominant lesion, males the most often affected, and age-distribution shifting towards senior citizens. These changes have not continued beyond the 1950s, in fact a decline in the

O. Bonnevie

1985-01-01

338

Topical Therapy for Neuropathic Diabetic Foot Ulcers  

Microsoft Academic Search

Healing is slow in neuropathic diabetic foot ulcers, using conventional medical treatment. This delayed wound healing is caused mainly by the pressure damages of weight bearing, and sometimes by a tight dressing, on the painless ulcer. In our study, we used the dehydrating action of ethyl alcohol to reduce the oedema in the tissue compartments of the foot. This, in

Aziz Fatima; Faisal Masud

339

Pressure ulcers: Back to the basics.  

PubMed

Pressure ulcer in an otherwise sick patient is a matter of concern for the care givers as well as the medical personnel. A lot has been done to understand the disease process. So much so that USA and European countries have established advisory panels in their respective continents. Since the establishment of these organizations, the understanding of the pressure ulcer has improved significantly. The authors feel that the well documented and well publicized definition of pressure ulcer is somewhat lacking in the correct description of the disease process. Hence, a modified definition has been presented. This disease is here to stay. In the process of managing these ulcers the basic pathology needs to be understood well. Pressure ischemia is the main reason behind the occurrence of ulceration. Different extrinsic and intrinsic factors have been described in detail with review of literature. There are a large number of risk factors causing ulceration. The risk assessment scales have eluded the surgical literature and mostly remained in nursing books and websites. These scales have been reproduced for completion of the basics on decubitus ulcer. The classification of the pressure sores has been given in a comparative form to elucidate that most of the classifications are the same except for minor variations. The management of these ulcers is ever evolving but the age old saying of "prevention is better than cure" suits this condition the most. PMID:23162223

Agrawal, Karoon; Chauhan, Neha

2012-05-01

340

BURULI ULCER DISEASE IN CAMEROON REDISCOVERED  

Microsoft Academic Search

To assess the magnitude of the Buruli ulcer (BU) problem in Cameroon, we conducted a cross-sectional survey in the Nyong River basin and identified on clinical grounds a total of 436 cases of active or inactive BU (202 and 234, respectively). Swab specimens were taken from 162 active cases with ulcerative lesions and in 135 of these (83.3%) the clinical

JURGEN NOESKE; CHRISTOPHER KUABAN; SIMONA RONDINI; PHILIPPE SORLIN; LAURA CIAFFI; JOSEPHINE MBUAGBAW; FRANCOISE PORTAELS; GERD PLUSCHKE

341

Responses to drug therapy in ulcerative colitis  

Microsoft Academic Search

Rectal biopsies of active untreated ulcerative colitis and treated cases with positive or negative sigmoidoscopic findings were analyzed to evaluate responses to medical therapy. Effects of the administration of salicylazosulfapyridine, prednisone, and 6-mercaptopurine, singly and in combinations, were investigated by mucosal cell counts, comparing ulcerative colitis and noncolitis control groups statistically. Active disease was associated with decreased epithelial goblet cells

B. I. Korelitz; S. C. Sommers

1976-01-01

342

Facial Dysostoses: Etiology, Pathogenesis and Management  

PubMed Central

Approximately 1% of all live births exhibit a minor or major congenital anomaly. Of these approximately one-third display craniofacial abnormalities which are a significant cause of infant mortality and dramatically affect national health care budgets. To date, more than 700 distinct craniofacial syndromes have been described and in this review, we discuss the etiology, pathogenesis and management of facial dysostoses with a particular emphasis on Treacher Collins, Nager and Miller syndromes. As we continue to develop and improve medical and surgical care for the management of individual conditions, it is essential at the same time to better characterize their etiology and pathogenesis. Here we describe recent advances in our understanding of the development of facial dysostosis with a view towards early in-utero identification and intervention which could minimize the manifestation of anomalies prior to birth. The ultimate management for any craniofacial anomaly however, would be prevention and we discuss this possibility in relation to facial dysostosis. PMID:24123981

Trainor, Paul A.; Andrews, Brian T.

2013-01-01

343

Facial dysostoses: Etiology, pathogenesis and management.  

PubMed

Approximately 1% of all live births exhibit a minor or major congenital anomaly. Of these approximately one-third display craniofacial abnormalities which are a significant cause of infant mortality and dramatically affect national health care budgets. To date, more than 700 distinct craniofacial syndromes have been described and in this review, we discuss the etiology, pathogenesis and management of facial dysostoses with a particular emphasis on Treacher Collins, Nager and Miller syndromes. As we continue to develop and improve medical and surgical care for the management of individual conditions, it is essential at the same time to better characterize their etiology and pathogenesis. Here we describe recent advances in our understanding of the development of facial dysostosis with a view towards early in utero identification and intervention which could minimize the manifestation of anomalies prior to birth. The ultimate management for any craniofacial anomaly however, would be prevention and we discuss this possibility in relation to facial dysostosis. PMID:24123981

Trainor, Paul A; Andrews, Brian T

2013-11-01

344

Etiology, diagnosis, and treatment of nonepileptic seizures  

Microsoft Academic Search

Psychogenic nonepileptic seizures (NES) can be classified into five categories. This review focuses on NES associated with\\u000a emotional conflict, by far the most common and important group. Etiology is speculative, but the background histories of these\\u000a patients are often similar. The presence of a trauma history, depression, post-traumatic stress symptoms, and the use of dissociation\\u000a plus cognitive dysfunction possibly point

John J. Barry; Katherine Sanborn

2001-01-01

345

Skin ulcers in estuarine fishes: a comparative pathological evaluation of wild and laboratory-exposed fish.  

PubMed Central

The toxic dinoflagellate Pfiesteria piscicida Steidinger & Burkholder has recently been implicated as the etiologic agent of acute mass mortalities and skin ulcers in menhaden, Brevoortia tyrannus, and other fishes from mid-Atlantic U.S. estuaries. However, evidence for this association is largely circumstantial and controversial. We exposed tilapia (Oreochromis spp.) to Pfiesteria shumwayae Glasgow & Burkholder (identification based on scanning electron microscopy and molecular analyses) and compared the resulting pathology to the so-called Pfiesteria-specific lesions occurring in wild menhaden. The tilapia challenged by high concentrations (2,000-12,000 cells/mL) of P. shumwayaeexhibited loss of mucus coat and scales plus mild petecchial hemorrhage, but no deeply penetrating chronic ulcers like those in wild menhaden. Histologically, fish exhibited epidermal erosion with bacterial colonization but minimal associated inflammation. In moribund fish, loss of epidermis was widespread over large portions of the body. Similar erosion occurred in the mucosa lining the oral and branchial cavities. Gills exhibited epithelial lifting, loss of secondary lamellar structure, and infiltration by lymphoid cells. Epithelial lining of the lateral line canal (LLC) and olfactory organs exhibited severe necrosis. Visceral organs, kidney, and neural tissues (brain, spinal cord, ganglia, peripheral nerves) were histologically normal. An unexpected finding was the numerous P. shumwayae cells adhering to damaged skin, skin folds, scale pockets, LLC, and olfactory tissues. In contrast, histologic evaluation of skin ulcers in over 200 wild menhaden from Virginia and Maryland portions of the Chesapeake Bay and the Pamlico Estuary, North Carolina, revealed that all ulcers harbored a deeply invasive, highly pathogenic fungus now known to be Aphanomyces invadans. In menhaden the infection always elicited severe myonecrosis and intense granulomatous myositis. The consistent occurrence of this fungus and the nature and severity of the resulting inflammatory response indicate that these ulcers are chronic (age >1 week) and of an infectious etiology, not the direct result of an acute toxicosis initiated by Pfiesteria toxin(s) as recently hypothesized. The disease therefore is best called ulcerative mycosis (UM). This study indicates that the pathology of Pfiesteria laboratory exposure is fundamentally different from that of UM in menhaden; however, we cannot rule out Pfiesteria as one of many possible early initiators predisposing wild fishes to fungal infection in some circumstances. PMID:11677176

Vogelbein, W K; Shields, J D; Haas, L W; Reece, K S; Zwerner, D E

2001-01-01

346

Skin ulcers in estuarine fishes: a comparative pathological evaluation of wild and laboratory-exposed fish.  

PubMed

The toxic dinoflagellate Pfiesteria piscicida Steidinger & Burkholder has recently been implicated as the etiologic agent of acute mass mortalities and skin ulcers in menhaden, Brevoortia tyrannus, and other fishes from mid-Atlantic U.S. estuaries. However, evidence for this association is largely circumstantial and controversial. We exposed tilapia (Oreochromis spp.) to Pfiesteria shumwayae Glasgow & Burkholder (identification based on scanning electron microscopy and molecular analyses) and compared the resulting pathology to the so-called Pfiesteria-specific lesions occurring in wild menhaden. The tilapia challenged by high concentrations (2,000-12,000 cells/mL) of P. shumwayaeexhibited loss of mucus coat and scales plus mild petecchial hemorrhage, but no deeply penetrating chronic ulcers like those in wild menhaden. Histologically, fish exhibited epidermal erosion with bacterial colonization but minimal associated inflammation. In moribund fish, loss of epidermis was widespread over large portions of the body. Similar erosion occurred in the mucosa lining the oral and branchial cavities. Gills exhibited epithelial lifting, loss of secondary lamellar structure, and infiltration by lymphoid cells. Epithelial lining of the lateral line canal (LLC) and olfactory organs exhibited severe necrosis. Visceral organs, kidney, and neural tissues (brain, spinal cord, ganglia, peripheral nerves) were histologically normal. An unexpected finding was the numerous P. shumwayae cells adhering to damaged skin, skin folds, scale pockets, LLC, and olfactory tissues. In contrast, histologic evaluation of skin ulcers in over 200 wild menhaden from Virginia and Maryland portions of the Chesapeake Bay and the Pamlico Estuary, North Carolina, revealed that all ulcers harbored a deeply invasive, highly pathogenic fungus now known to be Aphanomyces invadans. In menhaden the infection always elicited severe myonecrosis and intense granulomatous myositis. The consistent occurrence of this fungus and the nature and severity of the resulting inflammatory response indicate that these ulcers are chronic (age >1 week) and of an infectious etiology, not the direct result of an acute toxicosis initiated by Pfiesteria toxin(s) as recently hypothesized. The disease therefore is best called ulcerative mycosis (UM). This study indicates that the pathology of Pfiesteria laboratory exposure is fundamentally different from that of UM in menhaden; however, we cannot rule out Pfiesteria as one of many possible early initiators predisposing wild fishes to fungal infection in some circumstances. PMID:11677176

Vogelbein, W K; Shields, J D; Haas, L W; Reece, K S; Zwerner, D E

2001-10-01

347

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

PubMed Central

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

Maeng, Jin Hee; Lee, Eunhye

2013-01-01

348

Ulcers  

MedlinePLUS

... antibiotics and bismuth subsalicylate (one brand name: Pepto-Bismol). Other combinations may also be effective. This treatment ... people start to feel better within 3 days. Antacids neutralize acid that the stomach makes. A medicine ...

349

Ulcers  

MedlinePLUS

... stomach is empty. Eating something or taking an antacid medication sometimes makes the pain go away for ... are taken every day for about 2 weeks. Antacids — acid blockers or proton pump inhibitors — are given ...

350

38 CFR 3.380 - Diseases of allergic etiology.  

...Relative to Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial asthma and urticaria, may not be disposed of routinely for compensation purposes as constitutional or developmental...

2014-07-01

351

38 CFR 3.380 - Diseases of allergic etiology.  

Code of Federal Regulations, 2011 CFR

...Relative to Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial asthma and urticaria, may not be disposed of routinely for compensation purposes as constitutional or developmental...

2011-07-01

352

38 CFR 3.380 - Diseases of allergic etiology.  

Code of Federal Regulations, 2013 CFR

...Relative to Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial asthma and urticaria, may not be disposed of routinely for compensation purposes as constitutional or developmental...

2013-07-01

353

38 CFR 3.380 - Diseases of allergic etiology.  

Code of Federal Regulations, 2010 CFR

...Relative to Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial asthma and urticaria, may not be disposed of routinely for compensation purposes as constitutional or developmental...

2010-07-01

354

38 CFR 3.380 - Diseases of allergic etiology.  

Code of Federal Regulations, 2012 CFR

...Relative to Specific Diseases § 3.380 Diseases of allergic etiology. Diseases of allergic etiology, including bronchial asthma and urticaria, may not be disposed of routinely for compensation purposes as constitutional or developmental...

2012-07-01

355

The Class II/1 anomaly of hereditary etiology vs. Thumb-sucking etiology  

PubMed Central

Rationale: The etiology of class II division 1 Angle anomaly comprises many entities, including heredity and the vicious habit of sucking the finger. A close connection between the etiology and the clinical features needs to be outlined, in order to have a more appropriate treatment approach. Aim: This study aims to find common clinical features for two groups of Class II division 1 etiological factors (heredity and the vicious habit of sucking the finger), outlining a characteristic dento-facial pattern for each etiological factor. Materials and methods: 160 orthodontic cases were studied, taken randomly from the Department of Orthodontics in "Carol Davila" University of Medicine and Pharmacy, between 2005 and 2011. From a total of 46 diagnosed with Class II/1, the following data were noted for each subject in a table: age, sex, etiology, facial symmetry, profile, size of the lower face, stage lip, labiomentonier ditch, menton, form of arches, palate, occlusion in the three plans, Spee curve, other dental anomalies. Discussions: The facial asymmetry was found in a greater proportion within the finger-sucking group. Subjects in the finger sucking group have 100% pronounced convex profile, with pronounced lip stage and sharp curve of Spee, being known that the thumb-sucking stops the mandible growth and stimulates the upper jaw protrusion. Conclusions: The predominant etiological factor is heredity and the clinical features obvious for II/1 Angle anomaly are present in the highest proportion in the thumb-sucking group, but no significant differences were observed between the groups studied according to etiology. PMID:22802900

Padure, H; Negru, AR; Stanciu, D

2012-01-01

356

Effect of one-legged exercise on the strength, power and endurance of the contralateral leg  

Microsoft Academic Search

Summary  The purpose of this investigation was to study the effect of one-legged exercise on the strength, power and endurance of the contralateral leg. The performance of the knee extensor and flexor muscle of 20 healthy young adults (10 men and 10 women) was first tested by Cybex II+ and 340 dynamometers. Then 10 subjects were chosen at random to train

P. Kannus; D. Alosa; L. Cook; R. J. Johnson; P. Renström; M. Pope; B. Beynnon; K. Yasuda; C. Nichols; M. Kaplan

1992-01-01

357

Larval Legs of Mulberry Silkworm Bombyx mori Are Prototypes for the Adult Legs  

E-print Network

LETTER Larval Legs of Mulberry Silkworm Bombyx mori Are Prototypes for the Adult Legs Amit Singh,1; silkworm; limb development; lepidoptera; imaginal disc; drosophila INTRODUCTION During evolution there has during pupal metamorphosis to give rise to adult derivatives (Cohen, 1993). The mulberry silkworm Bombyx

Singh, Amit

358

Omeprazole maintenance therapy prevents recurrent ulcer bleeding after surgery for duodenal ulcer  

PubMed Central

AIM: To evaluate the omeprazole maintenance therapy in patients with recurrent ulcer bleeding after surgery for duodenal ulcer. METHODS: We studied 15 consecutive patients with recurrent ulcer bleeding after surgery for duodenal ulcer. Omeprazole (20 mg/d) maintenance therapy was given after ulcer healing. In addition to clinical follow-up, ambulatory 24-h gastric pH assay was performed before and during omeprazole therapy in those patients and controls with previous duodenal ulcer surgery but no ulcer recurrence. RESULTS: All the 15 ulcers were healed after being treated with omeprazole (40 mg/d) for 2 mo. Eleven patients with two (1-9) episodes of recurrent ulcer bleeding completed the follow-up (43, 12-72 mo). None of them had a bleeding episode while on omeprazole. One patient discontinued the therapy and had recurrent bleeding. The median 24-h fraction time of gastric pH <4 in patients was 80, 46-95%, and was reduced to 32, 13-70% by omeprazole (P?=?0.002). CONCLUSION: Long-term maintenance therapy with omeprazole (20 mg/day) is effective in preventing recurrent ulcer bleeding. PMID:16521197

Demertzis, Konstantinos; Polymeros, Dimitrios; Emmanuel, Theodoros; Triantafyllou, Konstantinos; Tassios, Pericles; Ladas, Spiros D

2006-01-01

359

Diabetic foot ulcers. Pathophysiology, assessment, and therapy.  

PubMed Central

OBJECTIVE: To review underlying causes of diabetic foot ulceration, provide a practical assessment of patients at risk, and outline an evidence-based approach to therapy for diabetic patients with foot ulcers. QUALITY OF EVIDENCE: A MEDLINE search was conducted for the period from 1979 to 1999 for articles relating to diabetic foot ulcers. Most studies found were case series or small controlled trials. MAIN MESSAGE: Foot ulcers in diabetic patients are common and frequently lead to lower limb amputation unless a prompt, rational, multidisciplinary approach to therapy is taken. Factors that affect development and healing of diabetic patients' foot ulcers include the degree of metabolic control, the presence of ischemia or infection, and continuing trauma to feet from excessive plantar pressure or poorly fitting shoes. Appropriate wound care for diabetic patients addresses these issues and provides optimal local ulcer therapy with débridement of necrotic tissue and provision of a moist wound-healing environment. Therapies that have no known therapeutic value, such as foot soaking and topical antiseptics, can actually be harmful and should be avoided. CONCLUSION: Family physicians are often primary medical contacts for patients with diabetes. Patients should be screened regularly for diabetic foot complications, and preventive measures should be initiated for those at risk of ulceration. PMID:11398715

Bowering, C. K.

2001-01-01

360

Diabetic Heel Ulcer in the Sudan: Determinants of Outcome  

Microsoft Academic Search

Heel ulceration, on average, costs 1.5 times more than metatarsal ulceration. The aim of this study was to analyze the determinant factors of healing in diabetic patients with heel ulcers and the late outcomes at Jabir Abu Eliz Diabetic Centre Khartoum, Khartoum, Sudan. Data were collected prospectively for 96 of 100 diabetic patients presenting with heel ulcers at the Jabir Abu

Haseeb E. Bakheit; Mohamed F. Mohamed; Seif ElDin I. Mahadi; Abu Bakr H. Widatalla; Mohamed A. Shawer; Amar H. Khamis; Mohamed E. Ahmed

361

Radiographical evaluation of ulcerative colitis  

PubMed Central

Radiographical modalities have become important diagnostic tools in cases of ulcerative colitis (UC). Imaging can be used non-invasively to determine the extent of involvement, severity of disease and to detect disease-related complications and extra-intestinal inflammatory bowel disease (IBD) manifestations. While abdominal X-rays and barium enemas still retain their relevance in specific clinical settings, the use of computed tomography enterography (CTE) or magnetic resonance enterography (MRE) are now used as first-line investigations to exclude active small bowel disease in IBD patients and can be utilized to detect active colonic inflammation. Additionally, CT colonography and MR colonography are emerging techniques with potential applications in UC. Ultrasonography, leukocyte scintigraphy and positron emission tomography are novel abdominal imaging modalities currently being explored for IBD interrogations. This plethora of radiological imaging options has become a vital component of UC assessments. PMID:24843072

Deepak, Parakkal; Bruining, David H.

2014-01-01

362

The treatment of ulcerative colitis  

Microsoft Academic Search

Summary  \\u000a \\u000a \\u000a \\u000a 1. \\u000a \\u000a The intestinal tract in ulcerative colitis patients is more sensitive to carbon dioxide gas than that in normal individuals.\\u000a \\u000a \\u000a \\u000a \\u000a 2. \\u000a \\u000a Carbon dioxide producing carbohydrate foods are markedly restricted in the acute stage.\\u000a \\u000a \\u000a \\u000a \\u000a 3. \\u000a \\u000a Carbon dioxide producing foods are added to the diet in the order described, always within the tolerance of the patient, as\\u000a clinical experience has dictated.

M. B. Levin; B. A. Gwynn

1953-01-01

363

Probabilistic Mechanical Reliability Prediction of Thermoelectric Legs  

SciTech Connect

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.

Jadaan, Osama M. [University of Wisconsin, Platteville; Wereszczak, Andrew A [ORNL

2009-05-01

364

Conjoined legs: Sirenomelia or caudal regression syndrome?  

PubMed Central

Presence of single umbilical persistent vitelline artery distinguishes sirenomelia from caudal regression syndrome. We report a case of a12-year-old boy who had bilateral umbilical arteries presented with fusion of both legs in the lower one third of leg. Both feet were rudimentary. The right foot had a valgus rocker-bottom deformity. All toes were present but rudimentary. The left foot showed absence of all toes. Physical examination showed left tibia vara. The chest evaluation in sitting revealed pigeon chest and elevated right shoulder. Posterior examination of the trunk showed thoracic scoliosis with convexity to right. The patient was operated and at 1 year followup the boy had two separate legs with a good aesthetic and functional results. PMID:23960288

Das, Sakti Prasad; Ojha, Niranjan; Ganesh, G Shankar; Mohanty, Ram Narayan

2013-01-01

365

Ulcerated infantile hemangioma treated with imiquimod.  

PubMed

A 5-month-old boy was observed in our department presenting with an ulcerated infantile hemangioma on the right buttock. This lesion appeared during the first week of life and had been growing progressively, showing ulceration for 3 weeks. We started treatment with corticosteroids, first with the association of betametasone and fusidic acid topically, and then systemically. After 6 weeks of oral treatment as there was no significant improvement, corticosteroid therapy was slowly tapered and local application of imiquimod 5 percent cream, on alternate days, was started. After 12 weeks of therapy with imiquimod there was complete resolution of the ulceration. There were no side effects. PMID:21971278

Mascarenhas, Rosa; Guiote, V; Agro, J; Henrique, M

2011-01-01

366

Poor late prognosis of bleeding peptic ulcer  

Microsoft Academic Search

Background and aims  Long-term course of peptic ulcer bleeding is unclear. Because of a more aged and more diseased ulcer population, the long-term\\u000a prognosis may be expected as poor.\\u000a \\u000a \\u000a \\u000a Materials and methods  In a prospective study, all patients with peptic ulcer bleeding treated at the Department of Surgery of the Heinrich-Heine-University\\u000a in Düsseldorf were included between 1986 and 1995. Follow-up covered hospital

M. Imhof; S. Epstein; C. Ohmann; H.-D. Röher

2007-01-01

367

Duration of Survival after Peptic Ulcer Perforation  

Microsoft Academic Search

Background  The long-term course after peptic ulcer perforation is unclear, but because the ulcer population is generally older and has\\u000a concomitant disease, the long-term prognosis may be expected to be poor.\\u000a \\u000a \\u000a \\u000a Methods  In a study based on prospective data collection, all patients with peptic ulcer perforation treated at the Department of Surgery\\u000a at the Heinrich-Heine-University in Dusseldorf, Germany, were documented between 1986

Michael Imhof; Stefan Epstein; Christian Ohmann; Hans-Dietrich Röher

2008-01-01

368

Use of endoscopy in peptic ulcer disease.  

PubMed

The diagnosis and treatment of acute bleeding caused by peptic ulcer disease has been greatly facilitated by fiberoptic endoscopy. The basic differentiation between malignant and benign gastric ulcer requires endoscopic confirmation with biopsy. The management of bleeding from peptic ulceration can be enhanced by endoscopic examination as can the prediction of risk for recurrent bleeding or need for surgical intervention. Various therapeutic maneuvers can be performed endoscopically, including monopolar and multipolar cautery, laser and heater probe therapy, and injection of vasoconstrictors to control bleeding. Endoscopic balloon dilation for the management of gastric outlet obstruction is often effective. PMID:2072790

Mamel, J J

1991-07-01

369

Diabetic foot ulcers: Part II. Management.  

PubMed

The management of diabetic foot ulcers can be optimized by using an interdisciplinary team approach addressing the correctable risk factors (ie, poor vascular supply, infection control and treatment, and plantar pressure redistribution) along with optimizing local wound care. Dermatologists can initiate diabetic foot care. The first step is recognizing that a loss of skin integrity (ie, a callus, blister, or ulcer) considerably increases the risk of preventable amputations. A holistic approach to wound assessment is required. Early detection and effective management of these ulcers can reduce complications, including preventable amputations and possible mortality. PMID:24355276

Alavi, Afsaneh; Sibbald, R Gary; Mayer, Dieter; Goodman, Laurie; Botros, Mariam; Armstrong, David G; Woo, Kevin; Boeni, Thomas; Ayello, Elizabeth A; Kirsner, Robert S

2014-01-01

370

Contrasting host immuno-inflammatory responses to bacterial challenge within venous and diabetic ulcers.  

PubMed

Within chronic wounds, the relationship between the clinical diagnosis of infection and bacterial/immuno-inflammatory responses is imprecise. This study prospectively examined the interrelationship between clinical, microbiological, and proinflammatory biomarker levels between chronic venous leg ulcers (CVLUs) and diabetic foot ulcers (DFUs). Wound swabs and fluids were collected from CVLUs (n?=?18) and DFUs (n?=?15) and diagnosed clinically as noninfected or infected; and qualitative/quantitative microbiology was performed. CVLU and DFU fluids were also analyzed for cytokine, growth factor, receptor, proteinase/proteinase inhibitor; and oxidative stress biomarker (protein carbonyl, malondialdehyde, and antioxidant capacity) levels. While no correlations existed between clinical diagnosis, microbiology, or biomarker profiles, increasing bacterial bioburden (?10(7) colony-forming unit/mL) was associated with significant alterations in cytokine, growth factor, and receptor levels. These responses contrasted between ulcer type, with elevated and decreased cytokine, growth factor, and receptor levels in CVLUs and DFUs with increasing bioburden, respectively. Despite proteinase biomarkers exhibiting few differences between CVLUs and DFUs, significant elevations in antioxidant capacities correlated with increased bioburden in CVLU fluids, but not in DFUs. Furthermore, oxidative stress biomarker levels were significantly elevated in all DFU fluids compared with CVLUs. This study provides further insight into the contrasting disease-specific host responses to bacterial challenge within infected CVLUs and DFUs. PMID:24354589

McInnes, Rachael L; Cullen, Breda M; Hill, Katja E; Price, Patricia E; Harding, Keith G; Thomas, David W; Stephens, Phil; Moseley, Ryan

2014-01-01

371

Kaposi's sarcoma: an opportunistic infection by human herpesvirus-8 in ulcerative colitis.  

PubMed

Kaposi's sarcoma is a vascular tumor caused by human herpesvirus-8 infection. Iatrogenic Kaposi's sarcoma often occurs in patients receiving immunosuppressive therapy. To date, a few cases of colonic Kaposi's sarcoma have been reported in ulcerative colitis patients treated with immunomodulators. We describe a 65-year-old male diagnosed with left-sided ulcerative colitis who was treated with methotrexate and low-dose steroids for greater than 6 years. He presented with several papular, violet lesions on both legs. Colonoscopy revealed the presence of multiple reddish, elevated lesions in the sigmoid colon and rectum. Histological evaluation of skin and colonic biopsies showed findings suggestive of Kaposi's sarcoma; immunohistochemistry for human herpesvirus-8 was positive in the colonic lesions. To avoid the need for further immunosuppressive treatment, the patient underwent a colectomy. Following immunomodulator discontinuation, the patient experienced spontaneous regression of his skin lesions. With the present case, we wish to stress the important interaction of immunosuppressive therapy (mainly corticosteroids) used in ulcerative colitis patients in relation to the development of colonic Kaposi's sarcoma. Human herpesvirus-8 infection should be recognized as a possible opportunistic infection in patients with inflammatory bowel disease. PMID:21122564

Rodríguez-Peláez, María; Fernández-García, María Soledad; Gutiérrez-Corral, Natalia; de Francisco, Ruth; Riestra, Sabino; García-Pravia, Carmen; Rodríguez, José Ignacio; Rodrigo, Luis

2010-11-01

372

Leg Spasticity and Ambulation in Multiple Sclerosis  

PubMed Central

Background. Spasticity of the legs is common in multiple sclerosis (MS), but there has been limited research examining its association with ambulatory outcomes. Objective. This study examined spasticity of the legs and its association with multiple measures of ambulation in persons with MS. Methods. The sample included 84 patients with MS. Spasticity of the legs was measured using a 5-point rating scale ranging between 0 (normal) and 4 (contracted). Patients completed the 6-minute walk (6?MW), timed 25 foot walk (T25FW), and timed up-and-go (TUG), and O2 cost of walking was measured during the 6?MW. The patients undertook two walking trials on a GAITRite (CIR systems, Inc.) for measuring spatial and temporal parameters of gait. The patients completed the Multiple Sclerosis Walking Scale-12 (MSWS-12) and wore an accelerometer over a seven-day period. Results. 52% (n = 44) of the sample presented with spasticity of the legs. Those with leg spasticity had significantly worse ambulation as measured by 6?MW (P = 0.0001, d = ?0.86), T25FW (P = 0.003, d = 0.72), TUG (P = 0.001, d = 0.84), MSWS-12 (P = 0.0001, d = 1.09), O2 cost of walking (P = 0.001, d = 0.75), average steps/day (P < 0.05, d = ?0.45), and walking velocity (P < 0.05, d = ?0.53) and cadence (P < 0.05, d = ?0.46). Conclusion. Leg spasticity was associated with impairments in ambulation, including alterations in spatiotemporal parameters and free-living walking. PMID:24999434

Balantrapu, Swathi; Sosnoff, Jacob J.; Pula, John H.; Sandroff, Brian M.; Motl, Robert W.

2014-01-01

373

[Overview of the biological etiology of transsexualism].  

PubMed

Gender identity disorder, or transsexualism as it is more commonly known, is a highly complex clinical entity. The general belief among behavioural scientists and physicians is that transsexualism is an identifiable and incapacitating disease which can be diagnosed and successfully treated by reassignment surgery. Although the exact etiology of gender identity disorder is unknown, several environmental, genetic and anatomical theories have been described. The reviewers draw attention to the possible genetic, hormonal, immunological and anatomical causes. An attempt is made to point out the future trends in research, highlighting their progressive features. PMID:18687574

Kórász, Krisztián; Simon, Lajos

2008-08-17

374

Mycobacterium avium subspecies paratuberculosis in the etiology of Crohn's disease, cause or epiphenomenon?  

PubMed Central

The origin of inflammatory bowel disease is unknown. Attempts have been made to isolate a microorganism that could explain the onset of inflammation, but no pathological agent has ever been identified. Johne’s disease is a granulomatous chronic enteritis of cattle and sheep caused by Mycobacterium avium subspecies paratuberculosis (MAP) and shows some analogies with Crohn’s disease (CD). Several studies have tried to clarify if MAP has a role in the etiology of CD. The present article provides an overview of the evidence in favor and against the “MAP-hypothesis”, analyzing the methods commonly adopted to detect MAP and the role of antimycobacterial therapy in patients with inflammatory bowel disease. Studies were identified through the electronic database, MEDLINE, and were selected based on their relevance to the objective of the review. The presence of MAP was investigated using multiple diagnostic methods for MAP detection and in different tissue samples from patients affected by CD or ulcerative colitis and in healthy controls. On the basis of their studies, several authors support a close relationship between MAP and CD. Although increasing evidence of MAP detection in CD patients is unquestionable, a clear etiological link still needs to be proven.

Liverani, Elisa; Scaioli, Eleonora; Cardamone, Carla; Dal Monte, Paola; Belluzzi, Andrea

2014-01-01

375

Helicobacter pylori and Ulcers: A Paradigm Revised  

NSDL National Science Digital Library

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.

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

2010-07-12

376

Updated guidance on pressure ulcer prevention issued.  

PubMed

PATIENTS 'AT risk' of developing pressure ulcers should be repositioned at least every six hours and those 'at high risk' should have their position changed at least every four hours, according to new guidance. PMID:24874616

2014-06-01

377

Circulating and tissue eosinophils in ulcerative colitis  

Microsoft Academic Search

During a controlled clinical trial of various diets in ulcerative colitis the levels of circulating eosinophils in the peripheral blood and infiltration of rectal biopsy specimens with eosinophils were studied.

Ralph Wright; Sidney C. Truelove

1966-01-01

378

Crohn's Disease and Ulcerative Colitis: Emotional Factors  

MedlinePLUS

... ERIES About Crohn’s Disease About Ulcerative Colitis Medications Maintenance Therapy Diet and Nutrition Emotional Factors Complications Understanding Colorectal Cancer Surgery Women's Issues A Parent’s Guide A Teacher’s Guide ...

379

Tannins, Peptic Ulcers and Related Mechanisms  

PubMed Central

This review of the current literature aims to study correlations between the chemical structure and gastric anti-ulcer activity of tannins. Tannins are used in medicine primarily because of their astringent properties. These properties are due to the fact that tannins react with the tissue proteins with which they come into contact. In gastric ulcers, this tannin-protein complex layer protects the stomach by promoting greater resistance to chemical and mechanical injury or irritation. Moreover, in several experimental models of gastric ulcer, tannins have been shown to present antioxidant activity, promote tissue repair, exhibit anti Helicobacter pylori effects, and they are involved in gastrointestinal tract anti-inflammatory processes. The presence of tannins explains the anti-ulcer effects of many natural products. PMID:22489149

de Jesus, Neyres Zinia Taveira; de Souza Falcao, Heloina; Gomes, Isis Fernandes; de Almeida Leite, Thiago Jose; de Morais Lima, Gedson Rodrigues; Barbosa-Filho, Jose Maria; Tavares, Josean Fechine; da Silva, Marcelo Sobral; de Athayde-Filho, Petronio Filgueiras; Batista, Leonia Maria

2012-01-01

380

Prevention and treatment of pressure ulcers.  

PubMed

Pressure ulcers are complex chronic wounds for which no gold standard for prevention or treatment has yet been established. Several attempts at developing guidelines has been undertaken by different organizations. Pressure ulcers are devastating comorbidities for patients and difficult to prevent or manage. Whether or not pressure ulcers are preventable remains controversial. The strategy for prevention includes recognizing the risk, decreasing the effects of pressure, assessing nutritional status, avoiding excessive bed rest and prolonged sitting, and preserving the integrity of the skin. The principles of treatment of pressure ulcers include assessing severity, reducing pressure, friction and shear forces, optimizing local wound care, removing necrotic debris, managing bacterial contamination, and correcting nutritional deficits. PMID:16413435

Thomas, David R

2006-01-01

381

Restoring Psychology's Role in Peptic Ulcer  

PubMed Central

This paper reviews the history of the transition from the belief that gastrointestinal ulcers are caused primarily by psychological factors to the current state of belief that they are caused primarily by infection and argues that neither is fully accurate. We argue that psychological factors play a significant role as predisposing to vulnerability, modulating of precipitation, and sustaining of gastric ulceration. We review data that challenge the assumption of a simple infectious disease model and adduce recent preclinical data that confirm the predisposing, modulatory, and sustaining roles for psychological factors. We note that others, too, are now challenging the adequacy of the contemporary simple bacterial infection model. We hope to replace the competition between psychology and medicine with cooperation in understanding and treating patients suffering gastric ulceration and ulcer. PMID:23457084

Overmier, J Bruce; Murison, Robert

2013-01-01

382

Etiology, diagnosis, and clinical management of vulvodynia.  

PubMed

Chronic vulvar pain or discomfort for which no obvious etiology can be found, ie, vulvodynia, can affect up to 16% of women. It may affect girls and women across all age groups and ethnicities. Vulvodynia is a significant burden to society, the health care system, the affected woman, and her intimate partner. The etiology is multifactorial and may involve local injury or inflammation, and peripheral and or central sensitization of the nervous system. An approach to the diagnosis and management of a woman presenting with chronic vulvar pain should address the biological, psychological, and social/interpersonal factors that contribute to her illness. The gynecologist has a key role in excluding other causes for vulvar pain, screening for psychosexual and pelvic floor dysfunction, and collaborating with other health care providers to manage a woman's pain. An important component of treatment is patient education regarding the pathogenesis of the pain and the negative impact of experiencing pain on a woman's overall quality of life. An individualized, holistic, and often multidisciplinary approach is needed to effectively manage the woman's pain and pain-related distress. PMID:24833921

Sadownik, Leslie A

2014-01-01

383

Multifactorial Etiology of Cervical Cancer: A Hypothesis  

PubMed Central

Cancer of the cervix is the second most common life-threatening cancer among women worldwide, with incidence rates ranging from 4.8 per 100,000 women per year in the Middle East to 44.3 per 100,000 in East Africa. Epidemiologic and clinical data demonstrate that human papillomaviruses (HPV), especially HPV-16 and HPV-18, play at least a major if not a necessary role in the etiology of cervical cancer. However, many investigators acknowledge that HPV is not sufficient to induce cervical cancer and that a multifactorial etiology is likely. HPV can be found in a growing proportion of patients with cervical cancer, approaching 100%, but is not yet found in every patient with disease. Other factors, such as herpes simplex virus type 2 infections, cigarette smoking, vaginal douching, nutrition, and use of oral contraceptives, have been proposed as contributing factors. In the first half of the 20th century, Peyton Rous and colleagues demonstrated the joint action of tars and Shope papillomavirus to consistently induce squamous cell carcinomas in rabbits. Using the Rous model as a prototype, one might hypothesize that some cases of cervical cancer arise from an interaction between oncogenic viruses and cervical tar exposures. Cervical tar exposures include cigarette smoking, use of tar-based vaginal douches, and long years of inhaling smoke from wood- and coal-burning stoves in poorly ventilated kitchens. PMID:16614679

Haverkos, Harry W.

2005-01-01

384

Etiology and therapeutic approach to elevated lactate  

PubMed Central

Lactate levels are commonly evaluated in acutely ill patients. Although most commonly used in the context of evaluating shock, lactate can be elevated for many reasons. While tissue hypoperfusion is probably the most common cause of elevation, many other etiologies or contributing factors exist. Clinicians need to be aware of the many potential causes of lactate elevation as the clinical and prognostic importance of an elevated lactate varies widely by disease state. Moreover, specific therapy may need to be tailored to the underlying cause of elevation. The current review is based on a comprehensive PubMed search and contains an overview of the pathophysiology of lactate elevation followed by an in-depth look at the varied etiologies, including medication-related causes. The strengths and weaknesses of lactate as a diagnostic/prognostic tool and its potential use as a clinical endpoint of resuscitation will be discussed. The review ends with some general recommendations on management of patients with elevated lactate. PMID:24079682

Andersen, Lars W.; Mackenhauer, Julie; Roberts, Jonathan C.; Berg, Katherine M.; Cocchi, Michael N.; Donnino, Michael W.

2014-01-01

385

Muscle dynamics differences between legs in healthy adults.  

PubMed

Differences in muscle dynamics between the preferred and nonpreferred jumping legs of subjects in maximal, explosive exercise were examined. Eight subjects performed nonfatiguing bouts of single-legged drop jumps and rebound jumps on a force sledge apparatus. Measures of flight time, reactive strength index, peak vertical force, and vertical leg-spring stiffness were obtained for 3 drop jumps and 3 rebound jumps on both legs. Subjects utilized a stiffer leg spring and a more explosive jumping action in the nonpreferred leg when performing a cyclical rebound jumping task in comparison to a single drop jump task (observed through differences in vertical leg-spring stiffness, peak vertical force, and reactive strength index, p < 0.05). The preferred leg performed equally well in both tasks. Between-leg analysis showed no differences in dependent variables between the preferred and the nonpreferred leg in the rebound jumping protocol. However, the drop jump protocol showed significant performance differences, with flight time and reactive strength index greater in the preferred leg than the nonpreferred leg (p < 0.05). We hypothesize that, throughout the lifespan, both legs are equally trained in cyclical rebound jumping tasks through running. However, because a preferred leg must be selected when performing any one-off, single-legged jump, imbalances in this specific task develop over time with consistent selection of a preferred jumping leg. The data demonstrate that the rebound jump protocol is representative of the symmetrical mechanics of forward running and that leg-spring stiffness is modulated depending on the demands of the specific task involved. Strength and conditioning practitioners should give careful consideration to appropriate jump protocol selection and should exercise caution when comparing laboratory results to data gathered in field testing. PMID:17313262

Flanagan, Eamonn P; Harrison, Andrew J

2007-02-01

386

Painful anal ulceration in homosexual men.  

PubMed

Forty homosexual men with painful anal ulceration were studied. Two patients had primary syphilis; sixteen men had primary anal herpes and twenty-two men had traumatic ulceration of the anal canal. The clinical features of the men with primary herpes were compared with those of the group with traumatic anal fissures. Fever, paraesthesiae in the buttocks and lower limbs, and difficulty in initiating micturition were found significantly more frequently in the former group of patients. PMID:6697127

McMillan, A; Smith, I W

1984-03-01

387

Gastric heterotopia causing jejunal ulceration and obstruction.  

PubMed

A young woman with persistent postprandial vomiting was found to have a high-grade proximal jejunal stricture. The stricture was surgically excised, and histopathological examination showed gastric heterotopia with localised ulceration and fibrosis. Symptomatic gastric heterotopia in the small bowel is rare, and to our knowledge this is the first report of jejunal gastric heterotopia resulting in ulceration with subsequent stricturing and obstruction. PMID:24209701

Chinnery, Galya E; Bernon, Marc M; Banderker, M Asief; Roberts, Riyaad; Krige, Jake E J

2013-11-01

388

Intolerance to milk in ulcerative colitis  

Microsoft Academic Search

Fifty-nine per cent of a series of patients with ulcerative colitis were found to have lactose intolerance by a lactose-tolerance test. It appears likely that the inflamed, irritated bowel of patients with ulcerative colitis cannot handle the osmotic-acid load and that lactose intolerance imposes an extra burden upon the inflamed bowel. Therefore, a lactose-free diet is advisable in patients with

Henry J. Binder; Joyce D. Gryboski; Walter R. Thayer; Howard M. Spiro

1966-01-01

389

Bleeding esophageal ulcers caused by NSAIDs  

Microsoft Academic Search

.   This report describes four patients with NSAID-induced esophageal ulcers documented by endoscopy. The cause of injury was\\u000a ibuprofen alone in two patients, aspirin in one patient, and a combination of aspirin and ibuprofen in one patient. The most\\u000a common findings were anemia, retrosternal pain, and dysphagia. Three patients had bleeding esophageal ulcers requiring blood\\u000a transfusions. One patient had massive

C. Sugawa; Y. Takekuma; C. E. Lucas; H. Amamoto

1997-01-01

390

Pathogenesis and therapy of peptic ulcer disease.  

PubMed

The epithelial cells of the stomach and duodenum are normally protected from the damaging effects of acid and pepsin by a balancing mechanism of mucosal resistance. If an imbalance occurs, peptic ulcer may result. Traditional teaching has emphasized the importance of acid (and pepsin) as the cause of this imbalance; however, it is clear that acid and pepsin are not the only important factors in the pathogenesis of peptic ulcer. More recent investigative efforts have been directed at what constitutes mucosal resistance and how it can be disrupted to produce, in the presence of gastric acid, a peptic ulcer. Depletion of endogenous prostaglandins and Helicobacter pylori gastritis have emerged as prominent theories. As evidence exists both to support and refute these theories in humans, any definitive conclusions cannot be made at this time. The acute management of peptic ulcer disease is directed at relieving pain, accelerating ulcer healing, and preventing complications. Peptic ulcers can be healed with antisecretory agents (i.e., H2-receptor antagonists, omeprazole), antacids, prostaglandins, and sucralfate. Because they are effective, safe, and convenient, the H2-receptor antagonists are the most widely used agents for the management of peptic ulcer disease. Because the H2-receptor antagonist agents are equally effective in their indicated uses and are equally safe based on scientifically valid data, selection should be based primarily on cost. Omeprazole is the newest antisecretory agent: a single morning dose of 20 mg suppresses acid secretion for 24 h. The agent offers little advantage over H2-receptor antagonists for the majority of patients with peptic ulcer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1978840

Peterson, W L

1990-01-01

391

Protein kinase LegK2 is a type IV secretion system effector involved in endoplasmic reticulum recruitment and intracellular replication of Legionella pneumophila.  

PubMed

Legionella pneumophila is the etiological agent of Legionnaires' disease. Crucial to the pathogenesis of this intracellular pathogen is its ability to subvert host cell defenses, permitting intracellular replication in specialized vacuoles within host cells. The Dot/Icm type IV secretion system (T4SS), which translocates a large number of bacterial effectors into host cell, is absolutely required for rerouting the Legionella phagosome. Many Legionella effectors display distinctive eukaryotic domains, among which are protein kinase domains. In silico analysis and in vitro phosphorylation assays identified five functional protein kinases, LegK1 to LegK5, encoded by the epidemic L. pneumophila Lens strain. Except for LegK5, the Legionella protein kinases are all T4SS effectors. LegK2 plays a key role in bacterial virulence, as demonstrated by gene inactivation. The legK2 mutant containing vacuoles displays less-efficient recruitment of endoplasmic reticulum markers, which results in delayed intracellular replication. Considering that a kinase-dead substitution mutant of legK2 exhibits the same virulence defects, we highlight here a new molecular mechanism, namely, protein phosphorylation, developed by L. pneumophila to establish a replicative niche and evade host cell defenses. PMID:21321072

Hervet, Eva; Charpentier, Xavier; Vianney, Anne; Lazzaroni, Jean-Claude; Gilbert, Christophe; Atlan, Danièle; Doublet, Patricia

2011-05-01

392

Acute Marjolin's ulcers: a nebulous diagnosis.  

PubMed

Marjolin's ulcers are rare cutaneous malignancies that most commonly present as squamous cell carcinomas in previously injured, chronically inflamed, or scarred skin. Acute and chronic types have been distinguished by the length of latency; by definition, the acute type occurs within 12 months of injury whereas the chronic type appears over 12 months after injury. In this report, 3 cases of acute Marjolin's ulcers are described and questions are raised about the diagnosis of acute Marjolin's ulcer. Other than a discrepancy in lag time, it is unclear if there is any difference in clinical or histological characteristics or even prognosis between acute and chronic Marjolin's ulcers. In fact, the acute type may simply be a preemptive diagnosis that conveniently describes a carcinoma associated with a nonhealing wound and discovered within a short time span. Moreover, the rarity of the diagnosis and the relatively rapid rate of malignant degeneration from the inciting injury lead one to question whether the injury may have simply revealed or accelerated a previously existing occult cutaneous malignancy. With no definitive clinical, histological, or prognostic distinction between acute and chronic Marjolin's ulcers, the use of such terminology may not benefit a clinician's understanding or practice. In fact, it merely supports the clinical guideline that any nonhealing wound, acute or chronic, should be biopsied and sent for pathologic examination to ensure that it does not represent a Marjolin's ulcer. PMID:24691319

Chang, Jessica B; Kung, Theodore A; Cederna, Paul S

2014-05-01

393

OCEAN DRILLING PROGRAM LEG 181 SCIENTIFIC PROSPECTUS  

E-print Network

of this publication may be obtained from the ODP Publications Home Page on the World Wide Web at http K. Graber #12;Leg 181 Scientific Prospectus Page 3 ABSTRACT The circulation of cold, deep Antarctic the world ocean through the Southwest Pacific Gateway as a thermohaline drive Deep Western Boundary Current

394

Chronic Lower Leg Pain in Athletes  

PubMed Central

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

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

2012-01-01

395

OCEAN DRILLING PROGRAM LEG 178 PRELIMINARY REPORT  

E-print Network

OCEAN DRILLING PROGRAM LEG 178 PRELIMINARY REPORT ANTARCTIC GLACIAL HISTORY AND SEA-LEVEL CHANGE Dr Antarctic Survey Osservatorio Geofisico Sperimentale High Cross, Madingley Road P.O. Box 2011 Cambridge CB3 States) Natural Environment Research Council (United Kingdom) European Science Foundation Consortium

396

Testing Static Equilibrium for Legged Robots  

Microsoft Academic Search

Consider a legged robot at fixed foot placements. Where can the robot move its center of mass (CM) while remaining in static equilibrium? If the terrain is flat, the CM must lie above the convex hull of the robot's feet. If the terrain is not flat, this often-used approximation can be arbitrarily bad. Instead, the CM must lie above the

Timothy Bretl; Sanjay Lall

2008-01-01

397

OCEAN DRILLING PROGRAM LEG 105 PRELIMINARY REPORT  

E-print Network

-1197 Surat (Shiri) Srivastava Co-Chief Scientist, Leg 105 Atlantic Geoscience Centre Bedford Institute (Shiri), Co-Chief Scientist (Bedford Institute of Oceanography, Dartmouth, Nova Scotia, Canada) Aksu, Ali-Palaontologisches Institut, Kiel, FRG) Busch, William (University of New Orleans, New Orleans, LA) Cederberg, Tommy

398

OCEAN DRILLING PROGRAM LEG 195 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 195 SCIENTIFIC PROSPECTUS MARIANA CONVERGENT MARGIN/ WEST PHILIPPINE SEA Publications homepage on the World Wide Web at: http://www-odp.tamu.edu/publications This publication mud volcano on the forearc of the Mariana subduction system. The second segment is devoted to coring

399

Acupuncture for back and leg pain  

Microsoft Academic Search

SummaryBack pain and back-related leg pain respond surprisingly often to simple acupuncture even if there has been no benefit from standard, conventional treatment. Three case histories are discussed, with the acupuncture points used in each case. Often painful conditions are associated with psychological “stress” states. It may be that some of the benefit derived from acupuncture treatment is through altering

Mary Nesbitt

2000-01-01

400

PAW: a Hybrid Wheeled-leg Robot  

Microsoft Academic Search

Abstract—This paper discusses current wheeled mobility work on a hybrid wheeled-leg robot called PAW. In addition to providing design details, controllers are proposed for inclined turning and sprawled braking which take advantage of the hybrid nature of the platform and improve stability. Power consumption values for a number of its basic behaviours are given, as is the range of the

James Andrew Smith; Inna Sharf; Michael Trentini

2006-01-01

401

OCEAN DRILLING PROGRAM LEG 133 SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 133 SCIENTIFIC PROSPECTUS NORTHEAST AUSTRALIAN MARGIN Dr. Peter J Australia: the platforms of the Great Barrier Reef and the Queensland and Marionplateaus, and the basins of carbonate platforms, particularly the Great Barrier Reef. This information will have a substantial impact

402

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

PubMed Central

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

Graham, David Y

2014-01-01

403

Histological evaluation in ulcerative colitis  

PubMed Central

This review summarizes diagnostic problems, challenges and advances in ulcerative colitis (UC). It emphasizes that, although histopathological examination plays a major role in the diagnosis and management of UC, it should always be interpreted in the context of clinical, endoscopic, and radiological findings. Accurate diagnosis requires knowledge of the classic morphological features of UC, as well as a number of atypical pathological presentations that may cause mis-classification of the disease process, either in resection or biopsy specimens. These atypical pathological presentations include rectal sparing and patchiness of disease at initial presentation of UC in pediatric patients or in the setting of medically treated UC, cecal or ascending colon inflammation in left-sided UC, and backwash ileitis in patients with severe ulcerative pancolitis. Loosely formed microgranulomas, with pale foamy histiocytes adjacent to a damaged crypt or eroded surface, should not be interpreted as evidence of Crohn’s disease. Indeterminate colitis should only be used in colectomy specimens as a provisional pathological diagnosis. Patients with UC are at risk for the development of dysplasia and carcinoma; optimal outcomes in UC surveillance programs require familiarity with the diagnostic criteria and challenges relating to UC-associated dysplasia and malignancy. Colon biopsy from UC patients should always be evaluated for dysplasia based on cytological and architectural abnormalities. Accurate interpretation and classification of dysplasia in colon biopsy from UC patients as sporadic adenoma or UC-related dysplasia [flat, adenoma-like, or dysplasia-associated lesion or mass (DALM)] requires clinical and endoscopic correlation. Isolated polypoid dysplastic lesions are considered to be sporadic adenoma if occurring outside areas of histologically proven colitis, or adenoma-like dysplasia if occurring in the diseased segment. Recent data suggest that such lesions may be treated adequately by polypectomy in the absence of flat dysplasia in the patient. UC patients with DALM or flat high-grade dysplasia should be treated by colectomy because of the high probability of adenocarcinoma. The natural history of low-grade dysplasia (LGD) is more controversial: while multifocal LGD, particularly if detected at the time of initial endoscopic examination, is treated with colectomy, unifocal flat LGD detected during surveillance may be managed by close follow-up with increased surveillance. The surveillance interval and treatment options for UC patients with dysplasia are reviewed in detail. PMID:24942757

DeRoche, Tom C.; Xiao, Shu-Yuan; Liu, Xiuli

2014-01-01

404

A colored leg banding technique for Amazona parrots  

USGS Publications Warehouse

A technique for individual identification of Amazona was developed using plastic leg bands. Bands were made from 5- and 7-mm-wide strips of laminated PVC coiled 2.5 times with an inside diameter 4-5 mm gt the maximum diameter of the parrot's leg. Seventeen parrots were captured in Puerto Rico, marked with individual plastic leg bands, and observed for 204-658 d with only one lost or damaged plastic band. Plastic leg bands did not cause injury to or calluses on parrots' legs. The plastic material used for making leg bands was available in 18 colors in 1994, which would allow unique marking of 306 individuals using one plastic leg band on each leg.

Meyers, J.M.

1995-01-01

405

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

406

Restless Legs Syndrome -- Self-Tests and Diagnosis  

MedlinePLUS

... legs syndrome Diagnosis Talk to a board certified sleep medicine physician if you think you have restless legs ... He or she can refer you to a sleep medicine physician if necessary. The sleep physician may ask ...

407

Acute leg volume changes in weightlessness and its simulation  

NASA Technical Reports Server (NTRS)

Leg volume changes were studied in six subjects during 150 min of horizontal, 6 deg headdown tilt and supine immersion. Results were compared to previously obtained space flight data. It is found that, at equivalent study times, the magnitude of the leg volume changes during the simulations was less than one half that seen during space flight. Relative and absolute losses from the upper leg were greater during space flight, while relative losses were greater from the lower leg during simulations.

Thornton, William E.; Uri, John J.; Hedge, Vickie; Coleman, Eugen; Moore, Thomas P.

1992-01-01

408

Interaction of leg stiffness and surface stiffness during human hopping  

Microsoft Academic Search

Ferris, Daniel P., and Claire T. Farley. Interaction of leg stiffness and surface stiffness during human hopping. J. Appl. Physiol. 82(1): 15±22, 1997.DWhen mammals run, the overall musculoskeletal system behaves as a single linear ``leg spring.''We used force platform and kinematic measurements to determine whether leg spring stiffness (kleg) is adjusted to accommodate changes in surface stiffness (ksurf) when hu-mans

DANIEL P. FERRIS; CLAIRE T. FARLEY

1997-01-01

409

Periodic leg movements during sleep in narcoleptic patients with or without restless legs syndrome.  

PubMed

We compared periodic and non-periodic leg movements during sleep and polysomnography in patients with narcolepsy with cataplexy (NC) with or without restless legs syndrome (RLS) with matched idiopathic RLS (iRLS) and control subjects. We enrolled 100 patients with NC: 17 having RLS were compared with 34 sex- and age-matched patients without RLS and with 17 normal controls and 17 iRLS subjects. Periodic leg movements were highest in iRLS and lowest in controls, with those in NC with RLS very close to iRLS, but higher than those in NC without RLS. The periodicity indexes showed the highest value in iRLS followed by NC with or without RLS and, finally, by controls. The inter-leg movement intervals peaked between 10 and 50?s in NC with RLS and in iRLS, the former did not display the nocturnal gradual decrease of periodic leg movements typical of iRLS. Periodic leg movements during sleep and polysomnography displayed specific features in RLS and NC, respectively, with NC with RLS showing an intermediate pattern. Even if RLS is only detected by targeted interview in NC, its frequency and impact on night-time sleep architecture and continuity suggest that this condition should be routinely searched for in NC. PMID:21827556

Plazzi, Giuseppe; Ferri, Raffaele; Franceschini, Christian; Vandi, Stefano; Detto, Stefania; Pizza, Fabio; Poli, Francesca; De Cock, Valérie C; Bayard, Sophie; Dauvilliers, Yves

2012-04-01

410

Vertical root fracture: prevalence, etiology, and diagnosis.  

PubMed

A vertical root fracture (VRF) is a frustrating complication that may occur following root canal treatment, and in almost every case leads to the extraction of the affected tooth. This type of fracture is usually diagnosed by secondary symptoms that develop some time after primary treatment, often when prosthodontic restoration has already been completed. The fracture line itself is often not directly visible, and therefore clinical and radiographic signs and symptoms indicate the diagnosis indirectly. Knowledge of the condition and pathogenesis of VRF is required in order to avoid hopeless trials of periodontal and/or endodontic therapy. Several etiologic factors are discussed that make teeth susceptible to VRF, such as the loss of substance due to restorative and endodontic therapy and stress factors associated with root canal debridement, and filling. PMID:23757466

Haueisen, Helga; Gärtner, Kathrin; Kaiser, Lea; Trohorsch, Dominik; Heidemann, Detlef

2013-07-01

411

[Breast feeding in the etiology of diarrhea].  

PubMed

Information derived from different anthropological studies carried out in Guatemala as part of the activities of the maternal and child health and nutrition project reveal that, according to popular beliefs, maternal milk plays a definite role in the etiology of diarrheal diseases in the lactating child. This paper presents information on popular classification of diarrheal diseases that differ from biomedical definitions of same. Different factors that may alter the quality of mothers' breast milk and that may cause gastrointestinal diseases in the lactating child are given in detail. The possibilities and limitations of the popular concept frame of "hot-cold", so common in the popular medical beliefs in Latin American populations, are also pointed out as an explanatory model. Lastly, implications of findings in this study are suggested for public health programs, especially for the communication and education programs on breast feeding, and for the application of the high-risk focus. PMID:2490882

Hurtado, E

1989-09-01

412

Bilateral Breast Masses with a Rare Etiology  

PubMed Central

Breast masses have a variety of benign and malignant etiologies. We present the case of a 28-year-old woman with bilateral large painful breast masses that developed rapidly in the three weeks before first presentation. Further investigation revealed bilateral ovarian masses. Biopsies of both ovarian masses were taken, and the pathology reported Burkitt's lymphoma. Additional staging with a PET scan was suggestive of bone marrow involvement, but bone marrow biopsy was negative. Examination of the cerebrospinal fluid did not identify malignant cells. The patient underwent CODOX-M/IVAC chemotherapy, and a complete response was demonstrated after one cycle of treatment. Six months after finishing chemotherapy the patient remained in complete remission. To our knowledge this is the first case reporting simultaneous involvement of breast, ovaries, and bones in Burkitt's lymphoma. Gynecologists and oncologists should be aware of this pattern. Polychemotherapy treatment must be initiated rapidly with curative intent. PMID:24066248

Sartorius, Gideon; Kalf, Katrin; Heinzelmann, Viola

2013-01-01

413

Identification of candidate genes for congenital splay leg in piglets by alternative analysis of DNA microarray data.  

PubMed

The congenital splay leg syndrome in piglets is characterized by a temporarily impaired functionality of the hind leg muscles immediately after birth. Etiology and pathogenetic mechanisms for the disease are still not well understood. We compared genome wide gene expression of three hind leg muscles (M. adductores, M. gracilis and M. sartorius) between affected piglets and their healthy littermates with the GeneChip Porcine Genome Array (Affymetrix) in order to identify candidate genes for the disease. Data analysis with standard algorithms revealed no significant differences between both groups. By application of an alternative approach, we identified 63 transcripts with differences in two muscles and 5 genes differing between the groups in three muscles. The expression of six selected genes (SQSTM1, SSRP1, DDIT4, ENAH, MAF, and PDK4) was investigated with SYBRGreen RT-Real time PCR. The differences obtained with the microarray analysis could be confirmed and demonstrate the validity of the alternative approach to microarray data analysis. Four genes with different expression levels in at least two muscles (SQSTM1, SSRP1, DDIT4, and MAF) are assigned to transcriptional cascades related to cell death and may thus indicate pathways for further investigations on congenital splay leg in piglets. PMID:19421343

Maak, Steffen; Boettcher, Diana; Tetens, Jens; Wensch-Dorendorf, Monika; Nürnberg, Gerd; Wimmers, Klaus; Swalve, Hermann H; Thaller, Georg

2009-01-01

414

FSW (feasible solution of wrench) for multi-legged robots  

Microsoft Academic Search

In this paper, we focus on a problem of how to confirm a feasible condition of applied force to a multi-legged robot on rough terrain. The problem often appeals as a subject of walking stability criterion for a legged robot. ZMP (zero moment point) is one of the well-known criteria. It shows the condition as footprints of a legged robot,

Takao Saida; Yasuyoshi Yokokohji; Tsuneo Yoshikawa

2003-01-01

415

OCEAN DRILLING PROGRAM LEG 142 ENGINEERING AND SCIENTIFIC PROSPECTUS  

E-print Network

OCEAN DRILLING PROGRAM LEG 142 ENGINEERING AND SCIENTIFIC PROSPECTUS EAST PACIFIC RISE Mr. Michael Institutions, Inc., under contract with the National Science Foundation. Funding for the program is provided AT THE EAST PACIFIC RISE Leg 142 (Engineering Leg III) is the third of a series of cruises designed to support

416

Spider diffraction: a comparison of curved and straight legs  

SciTech Connect

It has been known for some time that, if curved legs rather than the usual straight ones are used in the spider that supports the secondary optics in certain telescopes, the visible diffraction effect is reduced. Fraunhofer theory is used to calculate the diffraction effects due to the curved leg spider. Calculated and photographic diffraction patterns are compared for straight and curved leg spiders.

Richter, J.L.

1984-06-15

417

The common inhibitory neuron innervates every leg muscle in crabs  

Microsoft Academic Search

The muscles proximal to the autotomy plane in the walking legs of two crab species,Eriphia spinifrons andCarcinus maenas, are innervated by the common inhibitory neuron (CI). Thus, CI is truly common to all 11 leg muscles. It is suggested that CI has the essential function in all leg muscles of preventing the tonic muscle fibers from participating in rapid contraction

W. Rathmayer; M. Bevengut

1986-01-01

418

Optimizing Robust Limit Cycles for Legged Locomotion on Unknown Terrain  

E-print Network

challenging task for a legged robot to negotiate unknown terrain. Control systems for legged robots nominal periodic trajectories for legged robots that maximize a measure of robustness against uncertainty compass gait walker, resulting in a dramatic increase in the number of steps taken over moderate terrain

Tedrake, Russ

419

Validation of a leg-to-leg bioimpedance analysis system in assessing body composition in postmenopausal women  

Microsoft Academic Search

OBJECTIVES: To evaluate the validity of a leg-to-leg bioimpedance analysis (BIA) system in predicting body composition as measured by dual-energy X-ray absorptiometry (DXA) in postmenopausal women.SUBJECTS AND METHODS: Body fat mass (FM), %Fat and fat free mass (FFM) were measured in 124 postmenopausal women (age: 51–63 y, body mass index (BMI): 17–38 kg\\/m2) first by the leg-to-leg BIA system, and

X Xie; N Kolthoff; O Bärenholt; SP Nielsen

1999-01-01

420

Microcrystalline cellulose membrane for re-epithelisation of chronic leg wounds: a prospective open study.  

PubMed

Treatment of chronic leg ulcers remains a major health care issue. Although many reports have examined different topical dressings, none have specifically looked at microcrystalline cellulose (MCC). We aimed to evaluate in a prospective, open study the safety and performance of a MCC membrane (Veloderm) in a series of chronic leg wounds of different aetiology. Fifty-five patients participated in this study. The membrane was applied every 5-10 days for 1 month, immediately after surgical debridement. The wound bed was assessed on days 7, 15 and 30 for erythema, pain, exudate level and infection. The wound size change at 30 days was the primary efficacy parameter and any adverse events were collected and analysed. A wound size change of 55% was achieved at the end of follow-up, with an improvement in all the collected parameters, but the erythema, which showed a mild increase. To date, this is the largest experience with a MCC product in chronic wounds. Our study suggests that this treatment may be safe and useful and deserves further investigation. PMID:20659185

Ricci, Elia B; Cassino, Roberto; Di Campli, Cristiana

2010-12-01

421

Prevention and management of pressure ulcers.  

PubMed

Pressure ulcers represent a major health problem causing a considerable amount of suffering for patients and a high financial burden for healthcare systems. The geriatric population with an increased risk of pressure ulcer development is rising constantly as a result of chronic degenerative diseases that can lead to prolonged immobilization and poor nutrition. Evidence clearly indicates that preventive measures are essential to reduce the prevalence rates of pressure ulcers; therefore healthcare professionals must be able to identify the appropriate strategies to adopt, in order to meet the individual patient's requirements. Important advances have taken place in the world of pressure ulcer treatment during the past decade. These advances are reflected in the high rate of cures being obtained. This, together with the implementation of prevention guidelines, the excellent cost/effectiveness relationship of the techniques described, and other factors, means that the field of pressure ulcers management is no more an isolated and self-administered issue in medical practice. The areas discussed here are those in which there will be linear or, in some cases, exponential growth in the decades to come. PMID:17199678

Dini, Valentina; Bertone, MariaStefania; Romanelli, Marco

2006-01-01

422

Protocol for treatment of diabetic foot ulcers.  

PubMed

Each year, 82,000 limb amputations are performed in patients with diabetes mellitus. The majority of these amputations could be avoided by following strict protocols. The collective experience treating patients with neuropathic diabetic foot ulcers of 4 major diabetic foot programs in the United States and Europe were analyzed. The following protocol has been developed for patients with diabetic foot ulcers: (1) measurement of the wound by planimetry; (2) optimal glucose control; (3) surgical debridement of all hyperkeratotic, infected, and nonviable tissue; (4) systemic antibiotics for deep infection, drainage, and cellulitis; (5) offloading; (6) moist-wound environment; and (7) treatment with growth factors and/or cellular therapy if the wound is not healing after 2 weeks with this protocol and a new epithelial layer is not forming. In addition, the pathogenesis of diabetic foot ulcers is discussed, as well as the associated costs and complications, including amputation. Debridement, wound-bed preparation, antibiotics, various types of dressings, biological therapies, growth factors, and offloading are described as treatment modalities for patients with diabetic foot ulcers. In diabetic foot ulcers, availability of the above modalities, in combination with early recognition and comprehensive treatment, ensure rapid healing and minimize morbidity, mortality, and costs, as well as eliminate amputation in the absence of ischemia and osteomyelitis. PMID:15147985

Brem, Harold; Sheehan, Peter; Boulton, Andrew J M

2004-05-01

423

[Infected pressure ulcers: evaluation and management].  

PubMed

Pressure ulcers in elderly individuals can cause significant morbidity and mortality and are a major economic burden to the health care system. Prevention should be the ultimate objective of pressure ulcer care, and it requires an understanding of the pathophysiology leading to pressure ulcers and the means of reducing both intrinsic and extrinsic risk factors. Clinical examination often underestimates the degree of deep-tissue involvement, and its findings are inadequate for the detection of associated osteomyelitis. Microbiological data, if obtained from deep-tissue biopsy, are useful for directing antimicrobial therapy, but they are insufficient as the sole criterion for the diagnosis of infection. Imaging studies, such as computed tomography and magnetic resonance imaging, are useful, but bone biopsy and histopathological evaluation remain the "gold standard" for the detection of osteomyelitis. The goals of treatment of pressure ulcers should be resolution of infection and promotion of wound healing. A combination of surgical debridement and medical interventions may be required. Systemic antimicrobial therapy should be used for patients with serious pressure ulcers infections, including those with spreading cellulitis, bacteremia or osteomyelitis. PMID:20428024

Iori, Ido; Pizzini, Attilia Maria; Arioli, Dimitriy; Favali, Davide; Leone, Maria Cristina

2009-09-01

424

Hydroxyurea and colonic ulcers: a case report  

PubMed Central

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

2014-01-01

425

Legging orthosis for venous and lymphatic insufficiency.  

PubMed

Presented are the description and advantages of a unique compression device in the form of a legging for the treatment of venous and lymphatic insufficiency. It consists of a number of pliable, unyielding, adjustable compression bands, from the knee to the instep. The bands are easily closed, tightened, and opened, which is particularly useful for the physically handicapped patient for whom the commonly prescribed elastic stocking is inappropriate because of the difficulty in putting it on and removing it. The effectiveness of the legging is enhanced by its nonelasticity, as has been long proven by the Unna boot, and its ability to maintain an unreduced compression level throughout its lifetime, regardless of edema changes. PMID:3606372

Vernick, S H; Shapiro, D; Shaw, F D

1987-07-01

426

Description and Drawings of the Human Leg  

E-print Network

Desoription and drawings of the human l e g . Description and Drawings of The Human Leg. John Bigger 1909. The Human Leg. The purpose of t h i s work i s to enable one to o b t a i n a more v i v i d and l a s t i n g idea of the r e l a t i o n... of the hones, muscles, "blood v e s s e l s , and nerves of the human l e g . To accomplish t h i s we took the r i g h t l e g of a-negro man and made twenty t h r u cross s e c t i o n s c o u n t i n g those of the f o o t . The l e g had "been p i c k l...

Bigger, John Dinsmore

1909-01-01

427

Multi-leg heat pipe evaporator  

NASA Technical Reports Server (NTRS)

A multileg heat pipe evaporator facilitates the use and application of a monogroove heat pipe by providing an evaporation section which is compact in area and structurally more compatible with certain heat exchangers or heat input apparatus. The evaporation section of a monogroove heat pipe is formed by a series of parallel legs having a liquid and a vapor channel and a communicating capillary slot therebetween. The liquid and vapor channels and interconnecting capillary slots of the evaporating section are connected to the condensing section of the heat pipe by a manifold connecting liquid and vapor channels of the parallel evaporation section legs with the corresponding liquid and vapor channels of the condensing section.

Alario, J. P.; Haslett, R. A. (inventors)

1986-01-01

428

Pathology Case Study: Leg Weakness and Numbness  

NSDL National Science Digital Library

The University of Pittsburgh School of Medicine's Department of Pathology has compiled a series of case studies to help both students and instructors. In this particular study, a 48 year-old man is admitted to the hospital with âÂÂa three week history of back pain, progressive right leg weakness and bilateral lower leg numbness.â A detailed patient history and account of the attending doctorâÂÂs examination is provided in the âÂÂPatient Historyâ section. MRI and CT images of the patient, as well as gross and microscopic descriptions of the condition are included as well. Clicking on the âÂÂFinal Diagnosisâ provides a thorough explanation of the diagnosis and treatment.

Goldberg, Herbert; Lavi, Ehud; Mourelatos, Zissimos; Quan, Dianna; Sinson, Grant

2009-08-28

429

Restless Legs Syndrome and Erectile Dysfunction  

PubMed Central

Study Objectives: Dopaminergic hypofunction in the central nervous system may contribute to restless legs syndrome (RLS) and erectile dysfunction (ED). We therefore examined whether men with RLS have higher prevalences of ED. Design: RLS was assessed using a set of standardized questions. Men were considered to have RLS if they met 4 RLS diagnostic criteria recommended by the International RLS Study Group, and had restless legs ? 5 times/month. Erectile function was assessed by a questionnaire. Setting: Community-based. Participants: 23,119 men who participated in the Health Professional Follow-up Study free of diabetes and arthritis. Results Multivariate-adjusted odds ratios for ED were 1.16 and 1.78 (95% confidence interval: 1.4, 2.3; P trend < 0.0001) for men with RLS symptoms 5–14 times/mo, and 15+ times/mo, respectively, relative to those without RLS, after adjusting for age, smoking, BMI, antidepressant use, and other covariates. The associations between RLS and ED persisted in subgroup analysis according to age, obesity, and smoking status. Conclusions: Men with RLS had a higher likelihood of concurrent ED, and the magnitude of the observed association was increased with a higher frequency of RLS symptoms. These results suggest that ED and RLS share common determinants. Citation: Gao X; Schwarzschild MA; O'Reilly EJ; Wang H; Ascherio A. Restless legs syndrome and erectile dysfunction. SLEEP 2010;33(1):75-79. PMID:20120623

Gao, Xiang; Schwarzschild, Michael A.; O'Reilly, Eilis J.; Wang, Hao; Ascherio, Alberto

2010-01-01

430

Sleep Duration Linked to Ulcerative Colitis Risk in Study  

MedlinePLUS

... sharing features on this page, please enable JavaScript. Sleep Duration Linked to Ulcerative Colitis Risk in Study ... Dallas Friday, October 24, 2014 Related MedlinePlus Pages Sleep Disorders Ulcerative Colitis FRIDAY, Oct. 24, 2014 (HealthDay ...

431

Peptic Ulcer: Questions to Discuss with Your Doctor  

MedlinePLUS

... Men’s Health Heart & Circulatory Health contact us Peptic Ulcer Disease Questions to Discuss with Your Doctor: Do ... Do you have a family history of peptic ulcer disease? Your Doctor Might Examine the Following Body ...

432

Vedolizumab for the treatment of ulcerative colitis.  

PubMed

Ulcerative colitis is a chronic inflammatory disease of the large intestine that often develops in the young. A few new treatment options have become available in the past decade, but management of a large proportion of patients still remains challenging because of side effects, unresponsiveness and cost. A novel strategy targeting trafficking of immune cells to the sites of inflammation involves reducing expression or binding of adhesion molecules to integrins. Natalizumab was the first therapeutic antibody blocking infiltration of leukocytes, but because of lack of selectivity to the gut and associated risk of progressive multifocal leukoencephalopathy, it will probably never be tested in ulcerative colitis. In this article we discuss molecules that block leukocyte trafficking to inflamed bowel that have been tested in ulcerative colitis. Because of favourable efficacy and safety data, we will review the development, pharmacology and clinical data of vedolizumab, a gut-selective ?4?7 antibody, in depth. PMID:24802046

Rietdijk, Svend T; D'Haens, Geert R

2014-07-01

433

Endoscopic hemostasis of bleeding peptic ulcers.  

PubMed

Developments in therapeutic endoscopy over the last decade have made it possible to perform endoscopic hemostasis for bleeding peptic ulcers. This review traces the developments in this field in the Department of Surgery of the National University of Singapore. A recently conducted prospective randomized controlled trial using intralesional adrenaline and heater probe demonstrated that initial hemostasis could be achieved in 100% of patients with actively bleeding ulcers or stigmata of recent hemorrhage. The rebleed rate was 6.6% compared with 20.3% in a well-matched control group. The recent advent of laparoscopic vagotomy and laparoscopic Billroth II gastrectomy offers a low-morbidity surgical option to long-term medical treatment for the follow-up management of patients with bleeding ulcers. PMID:8222304

Goh, P; Tekant, Y

1993-01-01

434

Versajet hydroscalpel: treatment of diabetic foot ulceration.  

PubMed

Treatment of diabetic foot ulceration continues to be a challenge to healthcare professionals. Wound healing can be affected in a number of ways, and it is of paramount importance that wound healing is achieved as quickly as possible to minimize the risk of amputation. One key aspect of management is wound debridement. A number of techniques can be employed, including, in severe cases, surgical debridement. These case histories illustrate where the novel Versajet hydroscalpel (Smith & Nephew) would be a useful tool for debriding a foot ulcer effectively without the patient undergoing orthopaedic surgery. The Versajet debrides quickly and efficiently, and a pink and granulating wound base was achieved in all cases. It should be considered for use in specialist centres where complex diabetic foot ulcers are treated and the expertise is available to use it. PMID:16936595

McCardle, Joanne E

435

Long-term Prognosis after Partial Gastrectomy for Gastroduodenal Ulcer  

Microsoft Academic Search

.   The decline in duodenal ulcer disease and the established relation of peptic ulcer to Helicobacter pylori have virtually abolished the need for elective ulcer surgery. However, a substantial proportion of the population around\\u000a retirement age has previously been subjected to partial gastric resection due to peptic ulcer, and the long-term outcome of\\u000a these patients is of continuing relevance. Patients

Christer Staël von Holstein

2000-01-01

436

Molar Incisor Hypomineralization, Prevalence, and Etiology  

PubMed Central

Aim. To evaluate the prevalence and possible etiological factors associated with molar incisor hypomineralization (MIH) among a group of children in Jeddah, Saudi Arabia. Methods. A group of 8-12-year-old children were recruited (n = 267) from the Pediatric Dental Clinics at the Faculty of Dentistry, King Abdulaziz University. Children had at least one first permanent molar (FPM), erupted or partially erupted. Demographic information, children's medical history, and pregnancy-related data were obtained. The crowns of the FPM and permanent incisors were examined for demarcated opacities, posteruptive breakdown (PEB), atypical restorations, and extracted FPMs. Children were considered to have MIH if one or more FPM with or without involvement of incisors met the diagnostic criteria. Results. MIH showed a prevalence of 8.6%. Demarcated opacities were the most common form. Maxillary central incisors were more affected than mandibular (P = 0.01). The condition was more prevalent in children with history of illnesses during the first four years of life including tonsillitis (P = 0.001), adenoiditis (P = 0.001), asthma (P = 0.001), fever (P = 0.014), and antibiotics intake (P = 0.001). Conclusions. The prevalence of MIH is significantly associated with childhood illnesses during the first four years of life including asthma, adenoid infections, tonsillitis, fever, and antibiotics intake. PMID:24949012

Allazzam, Sulaiman Mohammed; Alaki, Sumer Madani; El Meligy, Omar Abdel Sadek

2014-01-01

437

The Etiology of Osteoarthritis of the Hip  

PubMed Central

The etiology of osteoarthritis of the hip has long been considered secondary (eg, to congenital or developmental deformities) or primary (presuming some underlying abnormality of articular cartilage). Recent information supports a hypothesis that so-called primary osteoarthritis is also secondary to subtle developmental abnormalities and the mechanism in these cases is femoroacetabular impingement rather than excessive contact stress. The most frequent location for femoroacetabular impingement is the anterosuperior rim area and the most critical motion is internal rotation of the hip in 90° flexion. Two types of femoroacetabular impingement have been identified. Cam-type femoroacetabular impingement, more prevalent in young male patients, is caused by an offset pathomorphology between head and neck and produces an outside-in delamination of the acetabulum. Pincer-type femoroacetabular impingement, more prevalent in middle-aged women, is produced by a more linear impact between a local (retroversion of the acetabulum) or general overcoverage (coxa profunda/protrusio) of the acetabulum. The damage pattern is more restricted to the rim and the process of joint degeneration is slower. Most hips, however, show a mixed femoroacetabular impingement pattern with cam predominance. Surgical attempts to restore normal anatomy to avoid femoroacetabular impingement should be performed in the early stage before major cartilage damage is present. Level of Evidence: Level V, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18196405

Ganz, Reinhold; Leunig-Ganz, Katharina; Harris, William H.

2008-01-01

438

Biological therapy for ulcerative colitis: An update  

PubMed Central

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

Seo, Geom Seog; Chae, Soo-Cheon

2014-01-01

439

Early Family Influences in the Etiology of Homosexuality.  

ERIC Educational Resources Information Center

The etiology of homosexuality is probably best explained from a multidimensional framework which takes into account socialization, family background, and individual developmental factors. A research review was conducted to examine the influence of parental characteristics in the etiology of homosexuality. The findings of the review support the…

Neill, Stephanie Anne

440

Migraine headache: Review of parameters, etiology, and intervention  

Microsoft Academic Search

Reviews research on various characteristics of migraine headaches, the factors contributing to their etiology, and treatment techniques. Emphasis is placed on psychological intervention. Theoretical issues involving biological and psychological factors in migraine etiology are discussed, and a psychobiological model for the migraine disorder is proposed. Areas requiring further basic and clinical research are identified. Major conclusions include the following: (a)

Henry E. Adams; Michael Feuerstein; Joanne L. Fowler

1980-01-01

441

Severe acute pancreatitis in the elderly: Etiology and clinical characteristics  

Microsoft Academic Search

AIM: To investigate the etiology and clinical characteristics of severe acute pancreatitis (SAP) in elderly patients (? 60 years of age). METHODS: We reviewed retrospectively all the SAP cases treated in Xuanwu Hospital in Beijing between 2000 and 2007. RESULTS: In 169 patients with SAP, 94 were elderly and 16 died. Biliary and idiopathic etiologies were the first two causes

Ming-Jun Xin; Jia-Bang Sun; Changchun Jie; Chris E Forsmark

2008-01-01

442

Psychoanalytic Concepts of the Etiology of Severe Mental Illness  

Microsoft Academic Search

In this paper I challenge some prevalent psychoanalytic concepts of the etiology and pathogenesis of severe mental illness which I believe to be in need of revision. There is insufficient evidence to conclude that the etiology of the two major adult psychoses, schizophrenia and manic-depressive illness, can be attributed to failures in development or fixations during the earliest years of

Martin S. Willick

1990-01-01

443

Autism: Etiology, differential diagnosis, and behavioral assessment update  

Microsoft Academic Search

Significant advances in neurophysiological and psychopharmacological research necessitates updating professionals in the etiology, differential diagnosis, and general assessment considerations of autism. A review of the DSM-III-R diagnostic criteria is followed by an extensive description of etiological theories based on recent advances in neurobiological research. The article describes components of making a differential diagnosis of autism from mental retardation, schizophrenia, and

LeAdelle Phelps; Jo-Anne Grabowski

1991-01-01

444

!SOPHAGOGASTRIC ULCERS IN THE PIG ; PROPHYLAXIS After having expressed the hypothesis that esophagogastric ulcers are the consequence of  

E-print Network

SUMMARY !SOPHAGOGASTRIC ULCERS IN THE PIG ; PROPHYLAXIS After having expressed the hypothesis that esophagogastric ulcers are the consequence of troubles in the gastric secretion and that the ulcerogenic factors

Paris-Sud XI, Université de

445

Clinical study Deep tissue injury rat model for pressure ulcer  

E-print Network

Clinical study Deep tissue injury rat model for pressure ulcer research on spinal cord injury Fang model; Implant; Histology Abstract Many rat/mouse pressure ulcer (PU) models have been developed to test for pressure ulcer research on spinal cord injury, Journal of Tissue Viability (2009), doi:10.1016/j.jtv.2009

Makhsous, Mohsen

446

Dynamic biomechanical modeling for foot ulcer prevention *, A. Perrier,,  

E-print Network

Dynamic biomechanical modeling for foot ulcer prevention V. Luboz *, A. Perrier,, , M. Bucki , F AGIM, France; # IDS; $ IUF, France Keywords: foot ulcer prevention; biomechanical model; dynamic analysis 1. Introduction Most foot ulcers are the consequence of a trauma (repetitive high stress, ill

Boyer, Edmond

447

Haemophilus ducreyi Associated with Skin Ulcers among Children, Solomon Islands  

PubMed Central

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

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

2014-01-01

448

Patient Risk Factors for Pressure Ulcers During Cardiac Surgery  

Microsoft Academic Search

Patients undergoing cardiac surgery have increased risks for developing pressure ulcers. The researchers conducted this study to identify preoperative, intraoperative, and postoperative factors associated with the development of pressure ulcers among patients undergoing cardiac surgery at the Cleveland Clinic Foundation. The significant factors associated with pressure ulcer development in the study patients were presence of diabetes mellitus and other significant

Linda J. Lewicki; Lorraine Mion; Karen G. Splane; Doris Samstag; Michelle Secic

1997-01-01

449

Catastrophic Bleeding From a Marginal Ulcer After Gastric Bypass  

PubMed Central

Marginal ulceration at the gastrojejunal anastomosis is a common complication following Roux-Y gastric bypass (RYGB). Hemodynamically significant hemorrhagic marginal ulcers are usually treated either endoscopically or surgically. We describe a unique case of life-threatening hemorrhagic marginal ulcer eroding into the main splenic artery. This condition was initially managed with angiographic embolization, followed by surgical intervention. PMID:23743389

Sidani, Shafik; Akkary, Ehab

2013-01-01

450

Evidence-Based Protocol for Diabetic Foot Ulcers  

Microsoft Academic Search

Background: Diabetic foot ulcers are the single biggest risk factor for nontrau- matic foot amputations in persons with diabetes. Foot ulcers occur in 12 to 25 percent of persons with diabetes and precede 84 percent of all nontraumatic amputations in this growing population. Because of the high incidence of foot ulcers, amputations remain a source of morbidity and mortality in

Harold Brem; Peter Sheehan; Harvey J. Rosenberg; Jillian S. Schneider; Andrew J. M. Boulton

2006-01-01

451

Leg Muscle Activation and Distance Setting of the Leg Cycle Ergometer for Use by the Elderly  

PubMed Central

[Purpose] This study verified the leg muscle activities of elderly subjects performing leg cycle ergometer exercise. [Subjects] Forty-one elderly persons were the subjects of this study. [Methods] For the three distances corresponding to knee flexion angles of 15, 45, and 70, the muscle activities of the rectus femoris, biceps femoris, tibialis anterior and lateral gastrocnemius were measured while the subjects exercised on a cycle ergometer. [Results] The rectus femoris and biceps femoris showed statistically significant increases as the distance between the cycle ergometer and the body increased, and the lateral gastrocnemius muscle activation showed a statistically significant increase as the distance from the body to the cycle ergometer decreased. [Conclusion] When the elderly have limb muscle weakness, leg cycle ergometer distances should be adjusted. PMID:25364121

Kim, Seon-Chill; Lee, Sang-Yeol; Lee, Young-Ik

2014-01-01

452

Etiology of Lower Gastrointestinal Bleeding in Children:A Single Center Experience from Southern Iran  

PubMed Central

BACKGROUND This study aimed to determine the common etiologies and characteristics of lower gastrointestinal (GI) bleeding in children from Southern Iran. METHODS This five-year prospective cross-sectional study was performed from March 2006 to March 2011 in Nemazee Hospital. All pediatric patients (<18 years of age) who referred to our center with gross lower GI bleeding or two consecutive positive occult blood tests with at least a one-week interval were included in the study. Patients were categorized as neonates, infants, children and adolescents and the findings were reported separately in each group. Each patient underwent a colonoscopy and several mucosal biopsies were taken. Demographic and clinical information as well as colonoscopy and pathology findings were reported. RESULTS Overall, we included 363 pediatric patients with a mean age of 71.9±58.4 months (range: 1-216 months). There were 215 (59.2%) boys and 148 (40.8%) girls. The most common colonoscopy findings were sigmoid colon polyp in 91 (25.1%) patients followed by descending colon petechia in 78 (21.5%) patients, whitish rectal lesions in 45 (12.4%) patients, and sigmoid and rectal ulcers in 37 (10.2%) patients. Biopsy samples were non-specific in 96 (26.4%) patients. The most common pathological findings were juvenile polyp in 84 (23.1%) followed by lymphoid nodular hyperplasia in 55 (15.2%) and solitary rectal ulcers in 25 (6.9%) patients. CONCLUSION We found that lower GI bleeding was more common among 2-10 year-old children and was rarely encountered in neonates. Hematochezia was the most common form of presentation followed by bloody diarrhea and occult blood. The most common colonoscopy finding was sigmoid colon polyp and the most common pathological finding was juvenile polyp. PMID:24829660

Zahmatkeshan, Mozhgan; Fallahzadeh, Ebrahim; Najib, Khadijesadat; Geramizadeh, Bita; Haghighat, Mahmood; Imanieh, Mohammad Hadi

2012-01-01

453

On the Biomimetic Design of Agile-Robot Legs  

PubMed Central

The development of functional legged robots has encountered its limits in human-made actuation technology. This paper describes research on the biomimetic design of legs for agile quadrupeds. A biomimetic leg concept that extracts key principles from horse legs which are responsible for the agile and powerful locomotion of these animals is presented. The proposed biomimetic leg model defines the effective leg length, leg kinematics, limb mass distribution, actuator power, and elastic energy recovery as determinants of agile locomotion, and values for these five key elements are given. The transfer of the extracted principles to technological instantiations is analyzed in detail, considering the availability of current materials, structures and actuators. A real leg prototype has been developed following the biomimetic leg concept proposed. The actuation system is based on the hybrid use of series elasticity and magneto-rheological dampers which provides variable compliance for natural motion. From the experimental evaluation of this prototype, conclusions on the current technological barriers to achieve real functional legged robots to walk dynamically in agile locomotion are presented. PMID:22247667

Garcia, Elena; Arevalo, Juan Carlos; Munoz, Gustavo; Gonzalez-de-Santos, Pablo

2011-01-01

454

Human hopping on damped surfaces: strategies for adjusting leg mechanics.  

PubMed Central

Fast-moving legged animals bounce along the ground with spring-like legs and agilely traverse variable terrain. Previous research has shown that hopping and running humans maintain the same bouncing movement of the body's centre of mass on a range of elastic surfaces by adjusting their spring-like legs to exactly offset changes in surface stiffness. This study investigated human hopping on damped surfaces that dissipated up to 72% of the hopper's mechanical energy. On these surfaces, the legs did not act like pure springs. Leg muscles performed up to 24-fold more net work to replace the energy lost by the damped surface. However, considering the leg and surface together, the combination appeared to behave like a constant stiffness spring on all damped surfaces. By conserving the mechanics of the leg-surface combination regardless of surface damping, hoppers also conserved centre-of-mass motions. Thus, the normal bouncing movements of the centre of mass in hopping are not always a direct result of spring-like leg behaviour. Conserving the trajectory of the centre of mass by maintaining spring-like mechanics of the leg-surface combination may be an important control strategy for fast-legged locomotion on variable terrain. PMID:12965003

Moritz, Chet T; Farley, Claire T

2003-01-01

455

An Instrument to Measure Healing in Pressure Ulcers: Development and Validation of the Pressure Ulcer Scale for Healing (PUSH)  

Microsoft Academic Search

Background. Currently, there is no instrument that provides an accurate and simple method of monitoring pressure ulcer healing in clinical practice. This article reports the two studies that were conducted to assess the validity of the Pressure Ulcer Scale for Healing (PUSH) as a tool to monitor healing of stage II-IV pressure ulcers. Methods. Subjects in both studies ( N

Nancy A. Stotts; George T. Rodeheaver; David R. Thomas; Rita A. Frantz; Alfred A. Bartolucci; Carrie Sussman; Bruce A. Ferrell; Janet Cuddigan

456

[Definition, etiology, classification and presentation forms].  

PubMed

Osteoarthritis is defined as a degenerative process affecting the joints as a result of mechanical and biological disorders that destabilize the balance between the synthesis and degradation of joint cartilage, stimulating the growth of subchondral bone; chronic synovitis is also present. Currently, the joint is considered as a functional unit that includes distinct tissues, mainly cartilage, the synovial membrane, and subchondral bone, all of which are involved in the pathogenesis of the disease. Distinct risk factors for the development of osteoarthritis have been described: general, unmodifiable risk factors (age, sex, and genetic makeup), general, modifiable risk factors (obesity and hormonal factors) and local risk factors (prior joint anomalies and joint overload). Notable among the main factors related to disease progression are joint alignment defects and generalized osteoarthritis. Several classifications of osteoarthritis have been proposed but none is particularly important for the primary care management of the disease. These classifications include etiological (primary or idiopathic forms and secondary forms) and topographical (typical and atypical localizations) classifications, the Kellgren and Lawrence classification (radiological repercussions) and that of the American College of Rheumatology for osteoarthritis of the hand, hip and knee. The prevalence of knee osteoarthritis is 10.2% in Spain and shows a marked discrepancy between clinical and radiological findings. Hand osteoarthritis, with a prevalence of symptomatic involvement of around 6.2%, has several forms of presentation (nodal osteoarthritis, generalized osteoarthritis, rhizarthrosis, and erosive osteoarthritis). Symptomatic osteoarthritis of the hip affects between 3.5% and 5.6% of persons older than 50 years and has different radiological patterns depending on femoral head migration. PMID:24467954

Mas Garriga, Xavier

2014-01-01

457

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

Microsoft Academic Search

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

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

2011-01-01

458

Predicting outcome in severe ulcerative colitis  

Microsoft Academic Search

BACKGROUND: Simple criteria are needed to predict which patients with severe ulcerative colitis will respond poorly to intensive medical treatment and require colectomy. AIMS: To find out if the early pattern of change in inflammatory markers or other variables could predict the need for surgery and to evaluate the outcome of medical treatment during one year follow up. PATIENTS: 51

S P Travis; J M Farrant; C Ricketts; D J Nolan; N M Mortensen; M G Kettlewell; D P Jewell

1996-01-01

459

Proctocolectomy without ileostomy for ulcerative colitis  

Microsoft Academic Search

An operation has been developed that permits total removal of all disease-prone mucosa in ulcerative colitis but avoids the need for a permanent ileostomy. The colon and upper half of the rectum are excised and the remaining inflamed mucosa is stripped from the rectal stump down to the dentate line of the anal canal. A pouch is fashioned from a

A G Parks; R J Nicholls

1978-01-01

460

Treatment of Ulcerative Colitis in the Elderly  

Microsoft Academic Search

Ulcerative colitis (UC) has a bimodal age distribution, with the majority of patients being diagnosed between the second and fourth decades of life. However, a second peak in diagnosis occurs in older patients and an estimated 15% of patients present after age 65. Caring for older UC patients who have either presented later in life or who have carried an

Ashwin N. Ananthakrishnan; David G. Binion

2009-01-01