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Sample records for leg ulcer

  1. Hemoglobinopathies and Leg Ulcers.

    PubMed

    Alavi, Afsaneh; Kirsner, Robert S

    2015-09-01

    Major hemoglobinopathies, including sickle cell anemia, are becoming a global health issue. Leg ulcers are the most common cutaneous manifestation of sickle cell disease and an important contributor to morbidity burden in this population. Leg ulcers following sickling disorders are extremely painful, and hard to heal. The clinical evidence for the optimal management of these ulcers is limited. Treating the cause and the strategies to prevent sickling are the mainstay of treatment. The basic principles of wound bed preparation and compression therapy is beneficial in these patients. PMID:26293989

  2. FAQs on leg ulcer care.

    PubMed

    Anderson, Irene; King, Brenda; Knight, Susan; Keynes, Milton

    In a webchat on leg ulcer management issues, hosted by Nursing Times, participants raised three key areas of care: the role of healthcare assistants in compression bandaging; reporting and investigating damage caused by compression therapy; and recommendations for dressings to be used under compression. This article discusses each of these in turn. PMID:23495505

  3. Venous Leg Ulcer in a Sarcoidosis Patient: A Case Report

    PubMed Central

    Ohn, Jungyoon; Byun, Sang Young; Kim, In Su

    2015-01-01

    Venous leg ulcers, the most common form of leg ulcers, are relevant to the pathogenicity of pericapillary fibrin cuff. Sarcoidosis, a multiorgan granulomatous disease, causes fibrin deposition in tissues. We report a case of a 50-year-old man with venous leg ulcers coexisting with sarcoidosis. On the basis of the histologic findings, we propose the hypothesis that sarcoidosis patients are prone to the development of venous leg ulcers. PMID:26719645

  4. Venous Leg Ulcer in a Sarcoidosis Patient: A Case Report.

    PubMed

    Ohn, Jungyoon; Byun, Sang Young; Kim, In Su; Park, Kyoung Chan

    2015-12-01

    Venous leg ulcers, the most common form of leg ulcers, are relevant to the pathogenicity of pericapillary fibrin cuff. Sarcoidosis, a multiorgan granulomatous disease, causes fibrin deposition in tissues. We report a case of a 50-year-old man with venous leg ulcers coexisting with sarcoidosis. On the basis of the histologic findings, we propose the hypothesis that sarcoidosis patients are prone to the development of venous leg ulcers. PMID:26719645

  5. [List of diagnostic tests and procedures in leg ulcer].

    PubMed

    Spoljar, Sanja

    2013-10-01

    Many factors contribute to the pathogenesis of leg ulcer. Most patients have venous leg ulcer due to chronic venous insufficiency. Less often, patients have arterial leg ulcer resulting from peripheral arterial occlusive disease, the most common cause of which is arteriosclerosis. Leg ulcer may be of a mixed arteriovenous origin. In diabetic patients, distal symmetric neuropathy and peripheral vascular disease are probably the most important etiologic factors in the development of diabetic leg ulcer. Other causes of chronic leg ulcers are hematologic diseases, autoimmune diseases, genetic defects, infectious diseases, primary skin diseases, cutaneous malignant diseases, use of some medications and therapeutic procedures, and numerous exogenous factors. Diagnosis of leg ulcer is based on medical history, inspection, palpation of skin temperature, palpation of arteries, fascia holes, presence and degree of edema, firm painful cords, and functional testing to assess peripheral occlusive arterial disease or identify superficial and deep venous reflux of the legs. Knowledge of differential diagnosis is essential for ensuring treatment success in patients with leg ulcer. There are many possible etiologic factors of leg ulcers and sometimes, clinical findings are similar. Additional testing should be performed, e.g., serologic testing such as blood count, C-reactive protein, HBA1c, erythrocyte sedimentation rate, differential blood count, total proteins, electrolytes, coagulation parameters, circulating immune complex, cryoglobulins, homocysteins, AT, PAI-1, APC resistance, proteins C and S, paraproteins, ANA, ENA, ANCA, dsDNA, antiphospholipid antibodies, urea, creatinine, blood lipids, vitamins and trace elements. Also, biopsy of the lesion for histopathology, direct immunofluorescence, bacteriology and mycology should be included. Other tests are Raynaud (cold stimulation) test and pathergy test. Device-based diagnostic testing should be performed for future clarification. Ankle brachial pressure index, color duplex sonography, plethysmography, MSCT and MR angiography, digital subtraction angiography, phlebography, angiography, x-ray, and capillaroscopy in lupus erythematosus are indicated. Except for bacteriologic analyses of wound biopsies, there is no test to provide specific information on the wound condition. PMID:24371972

  6. [Innovative therapy for leg ulcers: Electrostimulation].

    PubMed

    Maillard, H

    2015-01-01

    Chronic wounds can take a long time to heal despite appropriate therapy based upon aetiology and use of suitable dressings. The success of electrostimulation is based upon the existence within the skin of the endogenous currents involved in the wound healing process. Where skin continuity is broken by a wound, these electrical potentials are short-circuited, resulting in leakage of electrical current. Woundel(®) therapy is the only such treatment currently available in France and is based on the use of continuous pulsed current that generates an electrical field near the endogenous electrical fields. It utilises a console to deliver the electrical impulses, a dressing electrode and a dispersion electrode. The electrode dressing is left on the wound for 3 days, and venous compression bandaging may be applied to the leg, taking care to leave the connector free. Negative polarity stimulates migration of fibroblasts, resulting in elimination of fibrin. Positive polarity causes keratinocyte migration, which in turn leads to epidermisation. Electrostimulation is of recognised utility in the healing of chronic wounds: it has been assigned a high-level recommendation in the European and American guidelines for the treatment of venous ulcers and bedsores with proof level of A. Further, the analgesic effect of electrostimulation has been demonstrated in several studies. Electrostimulation is already well developed in France among wound specialists, but prospective studies are planned so that it may be used at patients' homes. PMID:26188964

  7. Managing venous leg ulcers using compression therapy and dressings.

    PubMed

    Powell, Gail; Wicks, Gill; Will, Katrin

    Patient comfort and satisfaction with both compression therapy and wound care are critical to the success of venous leg ulcer treatment. This study observed 22 patients with venous leg ulcers treated over 12 weeks with two-layer compression hosiery and a range of wound dressings. The mean duration of the ulcers was 10.5 months and 48% had a history of recurrent ulcers. Half the ulcers healed within 12 weeks; there was an increase in the proportion of patients reporting 'no impairment' to their mobility, but it was not significant. The ease of donning the two-layer hosiery was rated as excellent or good at 86% of control visits and the ease of doffing at 78%. In 95% of cases the clinicians said they would use the same combination of products again and 73% of patients were satisfied with it. PMID:26266566

  8. Healing rate and bacterial necrotizing vasculitis in venous leg ulcers.

    PubMed

    Piérard-Franchimont, C; Paquet, P; Arrese, J E; Piérard, G E

    1997-01-01

    Morbidity associated with venous leg ulcers is important in the elderly. The biological processes involved during attempts at healing are much more complex than in most models of experimental wounds. In addition, there is still controversy on deleterious effects elicited by both microorganisms and antiseptics on cells involved in the healing process. Using histology, immunohistochemistry and iterative computerized planimetry, we evaluated the bacterial load, the inflammatory aspects and the healing rate of leg ulcers present in 15 eligible women aged from 57 to 73 years. Each patient had at least 2 chronic ulcers treated with hydrocolloid dressing alone or in combination with daily applications of povidone-iodine solution (PVP-I). The weekly reduction in wound area was superior for hydrocolloid+PVP-I treatment than in hydrocolloid-treated ulcers. After a 4-week treatment, hydrocolloid-treated ulcers contained clumps of microorganisms and showed massive infiltration by phagocytes including Mac 387+ and factor XIIIa+ cells. Leukocytoclastic vasculitis was present as well. These features were less pronounced in ulcers treated with hydrocolloid+PVP-I. In sum, a broad-spectrum antimicrobial such as PVP-I may be beneficial in reducing deleterious bacteria-related inflammation. As a result, the healing rate leg ulcers is enhanced. PMID:9252771

  9. The Limerick Leg-Ulcer Project: early results.

    PubMed

    Castineira, F; Fisher, H; Coleman, D; Grace, P A; Burke, P

    1999-01-01

    Nurse led clinics in joint hospital and community settings are now being advocated as the most effective and economic way of dealing with leg ulcers. However, little information exists on the profile and outcome of patients with venous ulcers treated either in the community or in the hospital setting. Over a 2 yr period we assessed 134 patients with leg ulcers of whom 122 were deemed suitable for compression bandaging therapy. Thirty-four patients (28 per cent) were treated by the newly developed community service and 88 (72 per cent) were treated at the hospital clinic. Our overall healing rate for venous ulcers was 50 per cent @ 40 weeks. This probably reflects the long duration (48 per cent > 2 yr) and large size (0.5-600 cm2) of ulcer prior to treatment. There were no differences in outcome between hospital (50 per cent @ 40 weeks) and community (35 per cent @ 40 weeks) based treatment (p > 0.05). We conclude that most venous ulcers can be effectively treated in the community and resources should be provided to achieve this goal. PMID:10098337

  10. Leg ulcer plastic surgery descent by laser therapy

    NASA Astrophysics Data System (ADS)

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

    1994-02-01

    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.

  11. [Leg ulcer due to hydroxyurea. A case report].

    PubMed

    Gning, S B; Debonne, J M; Diagne-Guèye, N M; Ndiaye, B; Fall, F; Mbaye, P S

    2006-01-01

    Hydroxyurea is an antineoplasic agent usually used in myeloproliferative syndromes, but also in other benign pathological circumstances. Several dermatological manifestations have been recognized as being secondary to its prolonged use, of which the leg ulcer. We report an observation. Mrs. L.D, 47 years, were hospitalized on July 14, 2004 for an ulcer of left ankle in a feverish context. She was followed since 2001 for a chronic myelogenous leukaemia, and took hydroxyurea at a rate of 1500 mg per day, with a good clinical and hematologic answer. She presented a painful ulcer compared to the left external malleolus, with purulent bottom, without signs of vascular attack. The hemogram showed a hyperleucocytosis with 24.000 white elements/mm3 with neutrophilic polynucleosis. Pus sample on the ulcer showed Pseudomonas aeruginosa, and the blood culture was negative. The cure was obtained two months after stopping hydroxyurea. The ulcer of leg related to hydroxyurea is a seldom described pathology. Its occurrence imposes the final stop of the treatment. PMID:17632983

  12. Disturbed blood flow regulation in venous leg ulcers.

    PubMed

    Jünger, M; Klyscz, T; Hahn, M; Rassner, G

    1996-01-01

    Microangiopathy of the skin has been recognized as an important factor in the development of skin diseases connected with chronic venous insufficiency (CVI). Here the relationship between postcapillary transmural pressure and precapillary vaso-constriction - we call it the postural feedback system - was examined in venous ulcers (n = 12) and compared to blood flow regulation in the inner ankle area of healthy controls (n = 12). Blood flow changes were measured by laser Doppler fluxmetry. Changes in the laser Doppler flux (LDF) minus the biological zero value were measured after 3 min of arterial occlusion, during 3 min of venous occlusion, while the leg was elevated and while it was lowered and expressed relative to the pretest resting value. In venous ulcers the LDF remained nearly unchanged after arterial occlusion (3 vs. 190%, p < 0.001), leg elevation caused an LDF decrease contrary to what was seen in the controls (-17 vs. +80%, p < 0.001), in the lowered leg an LDF decrease was found (-51 vs. -65%) and venous occlusion led to a profound reduction of flux (-78 vs. -84%). In severe CVI the precapillary arterioles seem to be dilated even with the leg at heart level. This finding means that the postural feedback system under resting conditions is upregulated, and 'luxus' hyperperfusion results. The upregulated postural feedback system contributes to the cutaneous microangiopathy due to chronic venous congestion. PMID:8951524

  13. Leg ulcer in Werner syndrome (adult progeria): a case report.

    PubMed

    Fumo, Giuseppe; Pau, Monica; Patta, Federico; Aste, Nicola; Atzori, Laura

    2013-01-01

    Werner syndrome (WS; MIM#277700) or adult progeria, is a rare disease, associated with mutations of a single gene (RECQL2 or WRN), located on chromosome 8 (8p12). It codes a DNA-helicase, whose defects cause genomic instability. The highest incidences are reported in Japan and Sardinia (Italy). On this major island of the Mediterranean Basin, the WS cases have been observed in the northern areas. The authors describe the apparently first case reported in southern Sardinia, a 51-year-old woman, who was born in and resides in the province of Cagliari. She presented with a 9-year history of an intractable leg ulcer and other characteristic symptoms, including "bird-like" face, high-pitched voice, premature greying, short stature, abdominal obesity in contrast with thin body type, scleroderma-like legs, decreased muscle mass, diabetes, atherosclerosis, and premature menopause. A specialized genetic Institute of Research (IRCCS-IDI, Rome) confirmed the clinical diagnosis. There is no cure or specific treatment and patients must be periodically screened for an increased risk of cardiovascular and cerebrovascular disease and malignancies. Among the many findings, leg ulcers significantly affect the patient's quality of life. This problem may send the patient to the dermatologist, who finally suspects the diagnosis. Poor response to medical treatment may require aggressive repeated surgery, with poor or temporary results. PMID:23552003

  14. Successful Management of a Chronic Refractory Leg Ulcer in an Adolescent with Sickle Cell Anemia.

    PubMed

    Paolino, Giovanni; Santopietro, Michelina; Palumbo, Giovanna; Onesti, Maria Giuseppina; Micozzi, Alessandra; Venosi, Salvatore; Laurino, Marica; Ferrazza, Giancarlo; Fino, Pasquale; Foà, Robin; Giona, Fiorina

    2015-09-01

    Sickle cell disease (SCD) is an inherited hemoglobinopathy characterized by a wide range of clinical manifestations. Chronic leg ulcers are a disabling complication with repercussions on the quality of life. We report the case of a 14-year-old girl with a diagnosis of SCD who developed a chronic leg ulcer that was successfully treated with a multi-disciplinary approach, including local and systemic therapies. The role of different treatments, in particular low molecular weight heparin, in the refractory chronic leg ulcer healing process will be discussed. PMID:26476907

  15. Therapy-resistant skin ulcers on hypoplastic leg associated with neurofibromatosis type 1.

    PubMed

    Fujimura, Taku; Okuyama, Ryuhei; Aiba, Setsuya

    2008-02-01

    We describe a case of therapy-resistant skin ulcers in sporadic neurofibromatosis type 1. A 40-year-old woman had suffered from neurofibromata on her trunk and extremities since 30 years prior. She suffered from hypoplasia of her right leg from a young age and had a 1-year history of therapy-resistant skin ulcers on the leg and inguinal region. Magnetic resonance angiography disclosed a narrowed femoral artery at the level of the upper thigh with poor root in the inner side corresponding to the ulcerated lesions. The vascular changes were thought to be the cause of the skin ulcers. PMID:18271810

  16. [The individual with leg ulcer and structured nursing care intervention: a systematic literature review].

    PubMed

    Fonseca, César; Franco, Tiago; Ramos, Ana; Silva, Cláudia

    2012-04-01

    The objective of this study is to identify the nursing interventions for people with venous, arterial or mixed leg ulcers. This study was performed using the EBSCO search engine: CINAHL and MEDLINE yielded results, based on full-text articles published between 2000 and 2010, using the following descriptors: Leg* Ulcer* AND Nurs* AND Intervention*, filtered using a starting question using PICO. At the same time, a search was performed on the National Guideline Clearinghouse, using the same search guidelines. A person-centered intervention increased positive health outcomes, with a range of direct wound care in agreement with the etiology. The following interventions associated with the healing of leg ulcers of any etiology were highlighted: nurse/client treatment relationship, individualization of care and pain monitoring. PMID:22576555

  17. Phase I Study of H5.020CMV.PDGF-? to Treat Venous Leg Ulcer Disease

    PubMed Central

    Margolis, David J; Morris, Lee M; Papadopoulos, Maryte; Weinberg, Linda; Filip, Jennifer C; Lang, Stephanie A; Vaikunth, Sachin S; Crombleholme, Timothy M

    2009-01-01

    Venous leg ulcers are a prevalent nonhealing wound of the lower extremity. Although topically applied growth factors successfully improve wound repair in animal studies, similar studies on humans with venous leg ulcers have not been successful. This study was designed to evaluate the acute safety and biologic feasibility of peri-ulcer injection of a replication-incompetent adenoviral construct expressing platelet-derived growth factor-? (PDGF-?). In this phase I study, we demonstrate the initial safety, feasibility, and biologic plausibility of using H5.020CMV.PDGF-? to treat venous leg ulcer disease. PMID:19638959

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

    PubMed Central

    Mieszcza?ski, Pawe?; Wilemska-Kucharzewska, Katarzyna; Taradaj, Jakub; Kuropatnicki, Andrzej; ?liwi?ski, Zbigniew

    2014-01-01

    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

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

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

    PubMed

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

    2014-04-01

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

  2. Behaviour of the plasma concentration of gelatinases and their tissue inhibitors in subjects with venous leg ulcers.

    PubMed

    Caimi, G; Ferrara, F; Montana, M; Muratori, I; Amato, C; Canino, B; Lo Presti, R; Hopps, E

    2015-07-27

    Venous leg ulcers are common in subjects with chronic venous insufficiency. The increased intraluminal pressure causes alteration of the skin microcirculation, leukocyte activation and release of proteolytic enzymes leading to ulceration. An impaired expression and activity of matrix metalloproteases (MMPs) and their tissue inhibitors (TIMPs) might influence extracellular matrix degradation and deposition in chronic venous ulcers with the failure of the healing process. Our aim was to evaluate plasma concentration of gelatinases (MMP-2 and MMP-9) and their inhibitors (TIMP-1 and TIMP-2) in subjects with venous leg ulcers before and after the compression therapy. We enrolled 36 subjects (12 men and 24 women, mean age 67.38 ± 12.7?yrs) with non-infected venous leg ulcers (CEAP C6), which underwent a color Duplex scan examination of the veins and arteries of the inferior limbs and were treated with a multi-layer bandaging system. The ulcer healing was obtained in 23 subjects only (9 men and 14 women). We evaluated, on fasting venous blood, the plasma levels of MMP-2, MMP-9, TIMP-1 and TIMP-2 using ELISA kit, before and after the treatment. We observed a significant increase in plasma concentration of gelatinases and their inhibitors and in MMP-2/TIMP-2 ratio in subjects with leg ulcers in comparison with normal controls. In subjects with healed ulcers we found a decrease in MMP-9 and TIMP-1 levels and in MMP-2/TIMP-2 ratio compared to the baseline values, although higher levels of all the examined parameters in comparison with normal controls. In conclusion, plasma MMPs profile is impaired in subjects with venous leg ulcers and it improves after the healing, persisting anyway altered in respect to healthy controls. PMID:25159491

  3. Management of leg and pressure ulcer in hospitalized patients: direct costs are lower than expected

    PubMed Central

    Assadian, Ojan; Oswald, Joseph S.; Leisten, Rainer; Hinz, Peter; Daeschlein, Georg; Kramer, Axel

    2011-01-01

    Background: In Germany, cost calculations on the financial burden of wound treatment are scarce. Studies for attributable costs in hospitalized patients estimate for pressure ulcer additional costs of € 6,135.50 per patient, a calculation based on the assumption that pressure ulcers will lead to prolonged hospitalization averaging 2 months. The scant data available in this field prompted us to conduct a prospective economical study assessing the direct costs of treatment of chronic ulcers in hospitalized patients. Study design: The study was designed and conducted as an observational, prospective, multi-centre economical study over a period of 8 months in three community hospitals in Germany. Patients: Direct treatment costs for leg ulcer (n=77) and pressure ulcer (n=35) were determined observing 67 patients (average age: 75±12 years). 109 treatments representing 111 in-ward admissions and 62 outpatient visits were observed. During a total of 3,331 hospitalized and 867 outpatient wound therapies, 4,198 wound dressing changes were documented. Main outcome measure: Costs of material were calculated on a per item base. Direct costs of care and treatment, including materials used, surgical interventions, and personnel costs were determined. Results: An average of € 1,342 per patient (€ 48/d) was spent for treatment of leg ulcer (staff costs € 581, consumables € 458, surgical procedures € 189, and diagnostic procedures € 114). On average, each wound dressing change caused additional costs of € 15. For pressure ulcer, € 991 per patient (€ 52/d) was spent on average (staff costs € 313, consumables € 618, and for surgical procedures € 60). Each wound dressing change resulted in additional costs of € 20 on average. Conclusion: When direct costs of chronic wounds are calculated on a prospective case-by-case basis for a treatment period over 3 months, these costs are lower than estimated to date. While reduction in prevalence of chronic wounds along with optimised patient care will result in substantial cost saving, this saving might be lower than expected. Our results, however, do not serve as basis for making any conclusions on cost-benefit analysis for both, the affected individual, as well as for the society. PMID:22242088

  4. A new option for endovascular treatment of leg ulcers caused by venous insufficiency with fluoroscopically guided sclerotherapy

    PubMed Central

    Garcarek, Jerzy; Falkowski, Aleksander; Rybak, Zbigniew; Jargiello, Tomasz; ?okaj, Marek; Czapla, Norbert

    2015-01-01

    Introduction Ulcers of lower legs are the most bothersome complication of chronic venous insufficiency (CVI). Aim To assess the effectiveness of endovascular fluoroscopically guided sclerotherapy for the treatment of venous ulcers. Material and methods Thirty-eight limbs in 35 patients with crural venous ulcers were treated with guided sclerotherapy under the control of fluoroscopy. Patients with non-healing ulcers in the course of chronic venous insufficiency, with and without features of past deep vein thrombosis, were qualified for the study. Doppler ultrasound and dynamic venography with mapping of venous flow were performed. Ambulatory venous pressure measurements, leg circumference and varicography were performed just before and following the procedure. Results In 84% of cases, ulcers were treated successfully and healed. Patients with post-thrombotic syndrome (n = 17) healed in 13 (76.5%) cases, whereas patients without post-thrombotic syndrome (n = 21) healed in 19 (90.5%) cases. The mean time of healing of an ulcer for all patients was 83 days (in the first group it was 121 days and in the second group 67 days). Recurrence of an ulcer was observed in 10 limbs: 6 cases in the first group and 4 cases in the second group. Occurrence of deep vein thrombosis associated with the procedure was not observed. Temporary complications were reported but none giving a serious clinical outcome. Conclusions Endovascular fluoroscopically guided sclerotherapy can be an alternative method of treatment of venous ulcers, especially in situations when surgical procedures or other options of treatment are impossible. PMID:26649090

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

    PubMed Central

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

    2015-01-01

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

  6. Diagnosing and managing venous leg ulcers in patients in the community.

    PubMed

    Day, Julie

    2015-12-01

    Venous leg ulcers (VLUs) are a chronic condition affecting between 0.1% and 0.3% of the population in the UK. Healing rates are variable and recurrence rates are high. The diagnosis, assessment, and management of this patient group is primarily carried out in the community. Assessment of this patient group requires skill and competence to ensure a correct diagnosis is made. When carrying out the assessment, it is important to consider the patient's past medical history, medication, and allergies, as well as to record the ankle brachial pressure index (ABPI), pain level, palpation of pulses, and ankle joint movement, among other aspects of the assessment. VLUs heal with compression therapy, and practitioners should be knowledgeable about the various compression systems available in order to offer patients the most suitable and informed choices. PMID:26639070

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

    PubMed Central

    Hussain, Syed M. Asim

    2015-01-01

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

  8. The Effect of a Connexin43-Based Peptide on the Healing of Chronic Venous Leg Ulcers: A Multicenter, Randomized Trial

    PubMed Central

    Ghatnekar, Gautam S; Grek, Christina L; Armstrong, David G; Desai, Sanjay C; Gourdie, Robert G

    2015-01-01

    The gap junction protein, connexin43 (Cx43), has critical roles in the inflammatory, edematous, and fibrotic processes following dermal injury and during wound healing, and is abnormally upregulated at the epidermal wound margins of venous leg ulcers (VLUs). Targeting Cx43 with ACT1, a peptide mimetic of the carboxyl-terminus of Cx43, accelerates fibroblast migration and proliferation, and wound reepithelialization. In a prospective, multicenter clinical trial conducted in India, adults with chronic VLUs were randomized to treatment with an ACT1 gel formulation plus conventional standard-of-care (SOC) protocols, involving maintaining wound moisture and four-layer compression bandage therapy, or SOC protocols alone. The primary end point was mean percent ulcer reepithelialization from baseline to 12 weeks. A significantly greater reduction in mean percent ulcer area from baseline to 12 weeks was associated with the incorporation of ACT1 therapy (79% (SD 50.4)) as compared with compression bandage therapy alone (36% (SD 179.8); P=0.02). Evaluation of secondary efficacy end points indicated a reduced median time to 50 and 100% ulcer reepithelialization for ACT1-treated ulcers. Incorporation of ACT1 in SOC protocols may represent a well-tolerated, highly effective therapeutic strategy that expedites chronic venous ulcer healing by treating the underlying ulcer pathophysiology through Cx43-mediated pathways. PMID:25072595

  9. A chronic leg ulcer presenting with Charcot-Marie-Tooth disease and type 2 diabetes: a case report.

    PubMed

    Ren, Haitao; You, Chuangang; Han, Chunmao

    2013-03-01

    Charcot-Marie-Tooth (CMT) disease is characterized by hereditary sensorimotor polyneuropathy with foot deformity, sensorineural hearing loss, moderate developmental delay, and gait disturbance. CMT presenting with type 2 diabetes and an ulcer has not been reported. This article reports a man who presented with the symptoms mentioned above and also with a leg ulcer and type 2 diabetes. He was diagnosed with CMT disease based on family history and genetic testing. A skin defect in the left leg had manifested for more than 1 year, and results of initial fasting plasma glucose revealed type 2 diabetes. The evolution of these manifestations, coupled with a slowly progressive weakness, numbness, muscular wasting, and sensory impairment, strongly suggested the co-occurrence of 3 different diseases in the same individual. PMID:23446367

  10. Nurse clinic versus home delivery of evidence-based community leg ulcer care: A randomized health services trial

    PubMed Central

    Harrison, Margaret B; Graham, Ian D; Lorimer, Karen; VandenKerkhof, Elizabeth; Buchanan, Maureen; Wells, Phil S; Brandys, Tim; Pierscianowski, Tadeusz

    2008-01-01

    Background International studies report that nurse clinics improve healing rates for the leg ulcer population. However, these studies did not necessarily deliver similar standards of care based on evidence in the treatment venues (home and clinic). A rigorous evaluation of home versus clinic care is required to determine healing rates with equivalent care and establish the acceptability of clinic-delivered care. Methods Health Services RCT was conducted where mobile individuals were allocated to either home or nurse clinic for leg ulcer management. In both arms, care was delivered by specially trained nurses, following an evidence protocol. Primary outcome: 3-month healing rates. Secondary outcomes: durability of healing (recurrence), time free of ulcers, HRQL, satisfaction, resource use. Data were collected at base-line, every 3 months until healing occurred, with 1 year follow-up. Analysis was by intention to treat. Results 126 participants, 65 randomized to receive care in their homes, 61 to nurse-run clinics. No differences found between groups at baseline on socio-demographic, HRQL or clinical characteristics. mean age 69 years, 68% females, 84% English-speaking, half with previous episode of ulceration, 60% ulcers at inclusion < 5 cm2 for < 6 months. No differences in 3-month healing rates: clinic 58.3% compared to home care at 56.7% (p = 0.5) or in secondary outcomes. Conclusion Our findings indicate that organization of care not the setting where care is delivered influences healing rates. Key factors are a system that supports delivery of evidence-based recommendations with care being provided by a trained nursing team resulting in equivalent healing rates, HRQL whether care is delivered in the home or in a community nurse-led clinic. Trial registration ClinicalTrials.gov Protocol Registration System: NCT00656383 PMID:19036149

  11. [Nutrition and chronic wound healing. A clinical case of a patient with a hard to heal venous leg ulcers].

    PubMed

    Lozano, Sandra Alexandre; Bonet, Carme Marquilles; Bou, Joan-Enric Torra I; Llobet Burgués, Marta

    2014-05-01

    The cronicity of a wound can be produced by the alteration of several factors. One of the agents that can produce a delay in the wound healing process is malnutrition. According with the evidence, nutrition is an important factor in chronic wound prevention and treatment. The prevalence of low extremity wounds increases in population aged 65 or more. As we became older, malnutrition risk is more relevant due to physiological changes related to ageing. We describe a clinical case of a torpid venous leg ulcer in an elder patient centering on nutrition assessment and management. PMID:24984303

  12. Ulcers

    MedlinePLUS

    ... name for these bacteria is Helicobacter pylori (or H. pylori , for short). Today doctors know that most peptic ulcers are caused by an infection from H. pylori . Experts believe that 90% of all people ...

  13. Self-monitoring of lower leg skin temperature: accuracy of self-reported data and adherence to a cooling protocol for the prevention of venous leg ulcers

    PubMed Central

    Kelechi, Teresa J; Madisetti, Mohan; Mueller, Martina; Dooley, Mary; Prentice, Margaret

    2015-01-01

    Background For intervention studies that require the use of participant self-reports, the quality and accuracy of recorded data and variability in participant adherence rates to the treatment can cause significant outcome bias. Purpose To assess the quality and accuracy of participant documentation of daily self-monitoring of leg skin temperature, adherence to a graduated cooling treatment protocol to prevent venous leg ulcers, and the potential for bias in treatment effect in a randomized controlled trial that included a population with chronic venous disease. Methods Individuals were randomized to a leg cooling intervention or placebo treatment group to daily self-monitor and record lower leg skin temperature over a 9-month period on monthly paper study logs. Returned study logs for the first 100 completed participants (n=54 cooling intervention, n=46 control) were reviewed for quality and accuracy. Adherence was determined from evaluating the accuracy of participant documentation. To examine potential outcome bias in treatment effect, mean between group and within group comparisons of the before and after treatment differences were conducted using an intention-to-treat (ITT) versus a modified intention-to-treat (mITT) analysis approach with an 85% accuracy cut-off rate. Data were collected in 2011–2014. Results Of the expected 900 study logs, 91.8% (826/900) were returned and 8.2% (74/900) were not. Non-mutually exclusive main error types in returned documentation included: 59.2% (489/826) white-outs, cross-off and/or overwrites, 34.9% (288/826) entries omitted, 29.4% (243/826) no performance of daily self-monitoring, 28.7% (237/826) no performance of the treatment intervention per the prescribed protocol regime, 26.8% (221/826) extraneous data, 8.6% (71/826) suspected fabrication, and 7.6% (63/826) questionable validity. Under ITT analysis, 38.4% (346/900) of all returned logs were <85% accurate, 25.0% (225/900) were 85%–99% accurate, and 36.6% (329/900) were 100% accurate. Mean overall participant adherence rates were: 22.0% at <85% accuracy, 53.0% at 85%–99% accuracy, and 25.0% at 100% accuracy. Under the mITT analysis, 54.0% (483/900) of returned logs were deemed adherent with ?85% accuracy. Conclusion This study found good rates of adherence. Under ITT analysis, 78.0% of participants were deemed adherent to the study protocol with ?85% accuracy in documenting daily self-monitoring of skin temperatures in response to a topically applied experimental cooling cuff intervention for the prevention of venous leg ulcers. PMID:26719678

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

    PubMed Central

    2014-01-01

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

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

    PubMed Central

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

    2014-01-01

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

  16. Low-grade elastic compression regimen for venous leg ulcers - an effective compromise for patients requiring daily dressing changes.

    PubMed

    Dabiri, Ganary; Hammerman, Scott; Carson, Polly; Falanga, Vincent

    2015-12-01

    Venous leg ulcers (VLUs) affect millions of patients worldwide and are a tremendous financial burden on our health care system. The hallmark of venous disease of the lower extremities is venous hypertension, and compression is the current mainstay of treatment. However, many patients are non-compliant, partly because of the complexity of the dressings and the difficulties with application and removal. The aim of our study was to test an effective compression dressing regimen for patients with VLUs who require changing the ulcer primary dressing twice daily. We used two layers of a latex-free tubular elastic bandage for compression. The primary endpoint of our study was increased wound-healing rate and our secondary endpoint was complete wound closure. All active study subjects had positive healing rates at week 4 and week 8. Two subjects achieved complete wound closure by week 8. We conclude that compression with a latex-free tubular elastic bandage can be safely used in patients with VLUs requiring frequent dressing changes. This type of compression allows for daily inspection of wounds, dressing changes at home, flexibility in the context of clinical trials, and is a compromise for patients who are intolerant to compression dressings. PMID:24267477

  17. Efficacy and safety of a gauze pad containing hyaluronic acid in treatment of leg ulcers of venous or mixed origin: a double-blind, randomised, controlled trial.

    PubMed

    Humbert, Philippe; Mikosinki, Jacek; Benchikhi, Hakima; Allaert, François-André

    2013-04-01

    Topical hyaluronic acid (HA) is routinely used in the local treatment of chronic wounds, but few data have been reported to date. A 60-day double-blind, randomised, controlled superiority trial was designed to investigate the efficacy and safety of a gauze pad containing HA in local treatment of venous leg ulcers, compared with its neutral vehicle. The primary endpoint was the percentage of wound size reduction after 45 days. Totally 89 patients were included. At day 45, the percentage of ulcer surface reduction was significantly greater in the HA group (73 ± 4·6%) versus neutral vehicle group (46 ± 9·6%) (P = 0·011). The number of healed ulcers was significantly higher in the HA group at day 45 (31·1% versus 9·3% respectively) and day 60 (37·8% versus 16·3% respectively; P < 0·05). At day 30, pain intensity based on visual analogue scale was significantly lower in the HA group (12·4 mm ± 2·6 versus 22·8 mm ± 3·8; P = 0·026). Tolerance of both treatments was comparable in the two groups. HA gauze pad, in local treatment of venous leg ulcers, was significantly more effective than the neutral vehicle on wound size reduction, healed ulcers rate and pain management with a good safety profile. PMID:22405094

  18. Systematic review of economic evaluations of human cell-derived wound care products for the treatment of venous leg and diabetic foot ulcers

    PubMed Central

    Langer, Astrid; Rogowski, Wolf

    2009-01-01

    Background Tissue engineering is an emerging field. Novel bioengineered skin substitutes and genetically derived growth factors offer innovative approaches to reduce the burden of diabetic foot and venous leg ulcers for both patients and health care systems. However, they frequently are very costly. Based on a systematic review of the literature, this study assesses the cost-effectiveness of these growth factors and tissue-engineered artificial skin for treating chronic wounds. Methods On the basis of an extensive explorative search, an appropriate algorithm for a systematic database search was developed. The following databases were searched: BIOSIS Previews, CRD databases, Cochrane Library, EconLit, Embase, Medline, and Web of Science. Only completed and published trial- or model-based studies which contained a full economic evaluation of growth factors and bioengineered skin substitutes for the treatment of chronic wounds were included. Two reviewers independently undertook the assessment of study quality. The relevant studies were assessed by a modified version of the Consensus on Health Economic Criteria (CHEC) list and a published checklist for evaluating model-based economic evaluations. Results Eleven health economic evaluations were included. Three biotechnology products were identified for which topical growth factors or bioengineered skin substitutes for the treatment of chronic leg ulceration were economically assessed: (1) Apligraf®, a bilayered living human skin equivalent indicated for the treatment of diabetic foot and venous leg ulcers (five studies); (2) Dermagraft®, a human fibroblast-derived dermal substitute, which is indicated only for use in the treatment of full-thickness diabetic foot ulcers (one study); (3) REGRANEX® Gel, a human platelet-derived growth factor for the treatment of deep neuropathic diabetic foot ulcers (five studies). The studies considered in this review were of varying and partly low methodological quality. They calculated that due to shorter treatment periods, fewer complications and fewer inpatient episodes the initial cost of the novel biotechnology products may be offset, making the treatment cost-effective or even cost-saving. The results of most studies were sensitive to initial costs of the products and the evidence of effectiveness. Conclusion The study results suggest that some growth factors and tissue-engineered artificial skin products feature favourable cost-effectiveness ratios in selected patient groups with chronic wounds. Despite the limitations of the studies considered, it is evident that health care providers and coverage decision makers should take not only the high cost of the biotechnology product but the total cost of care into account when deciding about the appropriate allocation of their financial resources. However, not only the cost-effectiveness but first of all the effectiveness of these novel biotechnology products deserve further research. PMID:19591680

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

    PubMed

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

    2015-03-01

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

  20. [Ulcer + ulcer].

    PubMed

    Stocker, D N; Christ, A D; Speich, R

    1998-09-01

    We report on an elderly woman suffering from an acutely bleeding duodenal ulcer. Apart from old age and a history of gastrointestinal ulcer there were no risk factors detectable. However, clinical examination revealed that the patient had put a diclofenac hydroxyethylpyrrolidine plaster, which had been prescribed for lower back pain, inadvertently on a large ulcus cruris. The diclofenac serum concentration was 80 mu/l corresponding to a therapeutic serum level. This case demonstrates that false application of new pharmaceutical formulation may lead to inadvertent side-effects. PMID:9789473

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

    ClinicalTrials.gov

    2014-10-29

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

  2. Interleukin-8 production by polymorphonuclear leukocytes from patients with chronic infected leg ulcers treated with Lactobacillus plantarum.

    PubMed

    Peral, M C; Rachid, M M; Gobbato, N M; Huaman Martinez, M A; Valdez, J C

    2010-03-01

    Bacterial infection impairs the healing process, promoting the chronicity of inflammation and wounds. Because antibiotics fail to eradicate bacteria, especially in biofilm form, new therapeutic modalities may be required. In the present study, the effectiveness of bacteriotherapy with Lactobacillus plantarum on infected chronic venous ulcers was investigated and its effects on interleukin (IL)-8 production by cells from the ulcer bed and neutrophils isolated from peripheral blood that were previously challenged in vitro with Pseudomonas aeruginosa and L. plantarum were studied. Topical application of L. plantarum culture to lesions (25-60 cm(2)) of 14 diabetic and 20 non-diabetic patients induced debridement, granulation tissue formation and total healing after 30 days in 43% diabetics and in 50% non-diabetics. No significant differences between the groups were observed. The cells from ulcer beds collected after treatment with L. plantarum for 10 days showed a decrease in the percentage of polymorphonuclear, apoptotic and necrotic cells and an enhancement of IL-8 production. IL-8 production by isolated neutrophils from these patients was compared with that in diabetics without ulcers, as well as normal subjects under basal conditions, and after infection of polymorphonuclear cells with P. aeruginosa preincubated either with or without L. plantarum. The basal values in diabetic and ulcer patients were higher than normal (p <0.001) and were increased by P. aeruginosa infection in normal, diabetics (p <0.001) and non-diabetics with ulcers (p <0.01). Preincubation with L. plantarum decreased IL-8 production in patients with ulcers non-diabetic and diabetic (p <0.001). Lactobacillus plantarum treatment reduced wound bacterial load, neutrophils, apoptotic and necrotic cells, modified IL-8 production and induced wound healing. PMID:19519855

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

    PubMed Central

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

    2015-01-01

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

  4. A randomized controlled trial of larval therapy for the debridement of leg ulcers: results of a multicenter, randomized, controlled, open, observer blind, parallel group study.

    PubMed

    Mudge, Elizabeth; Price, Patricia; Walkley, Neal; Neal, Walkley; Harding, Keith G

    2014-01-01

    It has been known for centuries that the application of larvae is useful to heal certain wounds by facilitating debridement of necrotic tissue,(1) yet the efficacy of larval therapy continues to be debatable. This study compared the clinical effectiveness of a larval therapy dressing (BioFOAM) with a standard debridement technique (Purilon gel; hydrogel) in terms of time to debridement of venous (VLU) or mixed arterial/venous (MLU) leg ulcers. Data analyses were conducted on 88 subjects. Sixty-four subjects completed the full study. Of these, 31 of the 32 (96.9%) patients who completed treatment in the larvae arm debrided fully, compared with 11 of the 32 (34.4%) patients who completed the hydrogel arm. In addition, 42 (48%) ulcers fully debrided within the 21-day intervention phase, 31 (67.4%) from the larvae arm (n?=?46), and 11 (26.2%) from the hydrogel arm (n?=?42), which was statistically significant (p?=?0.001) in support of larvae. A statistically significant difference was also observed between treatment arms with regard to numbers of dressing changes during the intervention phase of the study (p?ulcer-related pain or discomfort than subjects in the hydrogel arm (p?

  5. Evaluation of CD4(+)CD25(+)FoxP3(+) T cell populations, IL-10 production, and their correlation with clinical and biochemical parameters in sickle cell anemia patients with leg ulcers.

    PubMed

    Rêgo, Moacyr Jesus Barreto Melo; da Silva, Rafael Ramos; Pereira, Michelly Cristiny; da Silva Araújo, Aderson; Pitta, Ivan da Rocha; Falcão, Diego Arruda; Bezerra, Marcos André Cavalcanti; Pitta, Maira Galdino da Rocha

    2015-10-01

    Leg ulcers (LUs) are a debilitating complication of sickle cell anemia (SCA), with inflammation known to play a crucial role in their pathogenesis. Many studies have described the roles of T helper type 1 (Th1) and Th2 pathways in SCA; however, defects in anti-inflammatory responses are poorly understood. We evaluated interleukin (IL)-10 levels in serum and peripheral blood mononuclear cells (PBMCs) in SCA patients with leg ulcers (SCALU) and without leg ulcers (SCAWH) in addition to CD4(+) CD25(+)FoxP3(+) T cell populations and their its IL-10 expression. In stimulated and unstimulated PBMC cultures, SCALU patients produced higher levels of IL-10 than those in the SCAWH group. Higher levels of IL-10 in SCALU patients correlated with a history of osteonecrosis in stimulated and unstimulated cultures when compared with those in SCAWH. Immunophenotyping revealed that SCALU patients had a higher proportion of CD4(+)CD25(+)FoxP3(+), Tr1 and CD4(+)CD25(+)FoxP3(+)IL-10(+) T cells than other groups. Our findings revealed that IL-10 levels were increased in unstimulated cells from the SCALU group, and that this group also presented with a predominant CD4(+) CD25(+)FoxP3(+) cell population despite many of those cells being IL-10 negative. PMID:26210477

  6. Venous Ulcers

    PubMed Central

    Caprini, J.A.; Partsch, H.; Simman, R.

    2013-01-01

    Venous leg ulcers are the most frequent form of wounds seen in patients. This article presents an overview on some practical aspects concerning diagnosis, differential diagnosis and treatment. Duplex ultrasound investigations are essential to ascertain the diagnosis of the underlying venous pathology and to treat venous refluxes. Differential diagnosis includes mainly other vascular lesions (arterial, microcirculatory causes), hematologic and metabolic diseases, trauma, infection, malignancies. Patients with superficial venous incompetence may benefit from endovenous or surgical reflux abolition diagnosed by Duplex ultrasound. The most important basic component of the management is compression therapy, for which we prefer materials with low elasticity applied with high initial pressure (short-stretch bandages and Velcro-strap devices). Local treatment should be simple, absorbing and not sticky dressings keeping adequate moisture balance after debridement of necrotic tissue and biofilms are preferred. After the ulcer is healed compression therapy should be continued in order to prevent recurrence. PMID:26236636

  7. Restless Legs

    MedlinePLUS

    Restless legs syndrome (RLS) causes a powerful urge to move your legs. Your legs become uncomfortable when you are lying down or sitting. ... your legs feel better, but not for long. RLS can make it hard to fall asleep and ...

  8. Ulcerative colitis

    MedlinePLUS

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

  9. Person Number leg1 leg2 leg3 leg4

    E-print Network

    Bergstein, Paul

    #12;#12;Leg color owner Ident Person Number ssn Table leg1 leg2 leg3 leg4 Owner Person Company:Leg l3:Leg l4:Leg color owner i1:Ident p1:Person n1:Number ssn #12;#12;Basket OneOrMore Several-related Numberweight Brick width length height Coin radius Weight-related Number mass gravity #12;#12;Occupation ssn

  10. Durability of healing from spray-applied cell therapy with human allogeneic fibroblasts and keratinocytes for the treatment of chronic venous leg ulcers: a 6-month follow-up.

    PubMed

    Kirsner, Robert S; Marston, William A; Snyder, Robert J; Lee, Tommy D; Cargill, D Innes; Zhang, Yuxin; Dickerson, Jaime E; Slade, Herbert B

    2013-01-01

    Patients who participated in a Phase 2 trial of HP802-247 for venous leg ulcers were invited to participate in this 24-week follow-up study to assess the durability of healing, document additional ulcer closures, and evaluate posttreatment safety. Consent was given by 90% (206/228), with 80% (183/228) completing all visits. Blinding was retained from the previous trial in which subjects had been randomized to vehicle or one of four cell therapy regimens. Visits were every 8 weeks. Among the 183 subjects, 43% (21/49) previously treated with cells and entering follow-up with an open wound achieved closure, compared with 35% (7/20) previously treated with vehicle, while 10% (11/106) and 17% (3/18), respectively, experienced reopening of a previously closed wound. Subjects previously treated with cells closed more open wounds than those previously treated with vehicle (OR 1.39, 95% CI 0.47-4.10; p = 0.739), and less subjects with a previously closed wound reopened (OR 0.65, CI 0.16-2.60; p = 0.821); however, these findings were not statistically significant. At the final visit, the difference in proportion of subjects with wounds closed continued to favor the best dose from the prior trial (83% closed vs. 58%, delta 25%). Follow-up beyond 12 weeks is necessary to evaluate the full benefit of this therapy, as treatment with cells may provide stimulus toward healing that persists for up to several weeks following the last application. The results show that the greater proportional benefit achieved by HP802-247 relative to standard care after 12 weeks of treatment persists over a meaningful timeframe. PMID:23927847

  11. Peptic Ulcers

    MedlinePLUS

    ... truth is that bacteria called Helicobacter pylori (or H. pylori ) are the main culprit. And while many ... gastric ulcer and a duodenal ulcer happen when H. pylori or a drug weakens the protective mucous ...

  12. Peptic ulcer

    MedlinePLUS

    ... patients with ulcer bleeding. Am J Gastroenterol . 2012 Mar;107(3):345-60. PMID: 22310222 www.ncbi. ... NSAID-related ulcer complications. Am J Gastroenterol . 2009 Mar;104(3):728-38. McColl KEL. Helicobacter pylori ...

  13. 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 ...

  14. Ulcerative Colitis

    MedlinePLUS

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

  15. Oral Ulcerations

    E-print Network

    Fetterolf, Brandon; Zabella, Alexandra; Strote, Jared

    2015-01-01

    of Emergency Medicine Fetterolf et al. Oral UlcerationsOral Ulcerations Brandon Fetterolf, DO* Alexandra Zaballa, BS † Jared Strote, MD, MS ‡ * Madigan Army Medical Center, Department of Emergency Medicine,

  16. Cutaneous ulcer as leading symptom of systemic cytomegalovirus infection.

    PubMed

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

    2015-01-01

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

  17. Stomach ulcer

    MedlinePLUS Videos and Cool Tools

    ... are absorbed in the small intestine. It produces acid and various enzymes that break down food into ... wall of the stomach is protected from the acid and enzymes by a mucous lining. Ulcers are ...

  18. Ugh! Ulcers

    MedlinePLUS

    ... sores, or ulcers, are caused. Continue Who Has H. Pylori Infection? By testing someone's blood or bowel ... she has been exposed to and might have H. pylori . When tested, lots of people have H. ...

  19. Bedsores (Pressure Ulcers)

    MedlinePLUS

    ... ulcer. Overview Bedsores (pressure ulcers), also known as pressure sores or decubitus ulcers, result from prolonged pressure that ... down. The skin is especially likely to develop pressure sores if it is exposed to rubbing (friction) and ...

  20. Leg Problems

    MedlinePLUS

    ... See your doctor or go to the emergency room right away. A blood clot in the legs could break away and block an artery in the lungs, causing pulmonary embolism. No 7. Do you have twisted dark blue or purple veins near the surface of ...

  1. Leg Injuries and Disorders

    MedlinePLUS

    ... can damage your legs. Common leg injuries include sprains and strains, joint dislocations, and fractures. These injuries can affect the entire leg, or just the foot, ankle, knee, or hip. Certain diseases also lead to leg ...

  2. Restless Legs Syndrome

    MedlinePLUS

    ... Legs Syndrome Overview What is restless legs syndrome (RLS)? Restless legs syndrome (also called RLS) is a condition in which your legs feel ... age and becomes a problem for older adults. RLS can make sleeping and traveling difficult and uncomfortable. ...

  3. Stasis dermatitis and ulcers

    MedlinePLUS

    ... the leg At first, the skin of the ankles and lower legs may look thin or tissue- ... hardening of the skin on the legs and ankles (lipodermatosclerosis) A bumpy or cobblestone appearance of the ...

  4. Leg MRI scan

    MedlinePLUS

    ... imaging - leg; Magnetic resonance imaging - lower extremity; MRI - ankle; Magnetic resonance imaging - ankle; MRI - femur; MRI - leg ... or bone scan Birth defects of the leg, ankle, or foot Bone pain and fever Broken bone ...

  5. Preventing pressure ulcers

    MedlinePLUS

    Pressure ulcers are also called bedsores, or pressure sores. They can form when your skin and soft tissue ... become damaged or die. When this happens, a pressure ulcer may form. You have a risk of developing ...

  6. Peptic Ulcer Disease

    MedlinePLUS

    ... stomach and duodenum to diagnose or treat disease. Erosion – a very shallow sore, similar to an abrasion ... Ulcer – an open sore. Ulcers are deeper than erosions. Author(s) and Publication Date(s) Sean P. Caufield, MD, ...

  7. Acute genital ulcers.

    PubMed

    Delgado-García, Silvia; Palacios-Marqués, Ana; Martínez-Escoriza, Juan Carlos; Martín-Bayón, Tina-Aurora

    2014-01-01

    Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers. PMID:24473429

  8. Peripheral Ulcerative Keratitis

    MedlinePLUS

    ... This Article Medical Dictionary Also of Interest (Quiz) Pupils, Unequal (Video) Macular Degeneration Additional Content Medical News Peripheral Ulcerative Keratitis (Marginal Keratolysis; Peripheral ...

  9. Restless legs syndrome

    MedlinePLUS

    ... restless legs syndrome: a systematic review and meta-analysis. Eur J Neurol. 2013;20:605-615. Wilt ... restless legs syndrome: a systematic review and meta-analysis. JAMA Internal Med. 2013;173:496-505.

  10. Leg Cramps during Pregnancy

    MedlinePLUS

    ... Global Map Premature birth report card Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... months of pregnancy. Causes of leg cramps during pregnancy Leg cramps are a sudden tightening of muscles, ...

  11. Leg lengthening - series (image)

    MedlinePLUS

    ... as Legg-Perthes disease previous injuries or bone fractures that may stimulate excessive bone growth abnormal spinal ... lengthened; usually the lower leg bone (tibia) or upper leg bone (femur). Metal pins or screws are ...

  12. Leg or foot amputation

    MedlinePLUS

    Leg or foot amputation is the removal of a leg, foot or toes from the body. These body parts are called extremities. Amputations are done either by surgery or they occur by accident or trauma to the body.

  13. Restless Legs Syndrome

    MedlinePLUS

    ... What Is Restless Legs Syndrome? Restless legs syndrome (RLS) is a disorder that causes a strong urge ... urge and the unpleasant feelings. People who have RLS describe the unpleasant feelings as creeping, crawling, pulling, ...

  14. Restless Legs Syndrome

    MedlinePLUS

    ... What is Restless Legs Syndrome? Restless legs syndrome (RLS) is a neurological disorder characterized by unpleasant sensations ... may suggest a variety of medications to treat RLS, including dopaminergics, benzodiazepines (central nervous system depressants), opioids, ...

  15. 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 when the person also: Is overweight Has a blood clot in the leg Is older Has ...

  16. Ulcerative Lupus Vulgaris Over Nose, Leading to Cosmetic Deformity

    PubMed Central

    Nair, Pragya A; Mehta, Malay J; Patel, Bhumi B

    2015-01-01

    Lupus vulgaris (LV), is a chronic and progressive form of secondary cutaneous tuberculosis. In India, it is commonly seen over buttocks, thighs, and legs whereas involvement of nose is quite rare. Ulcerative variant particularly over nose causes destruction of cartilage, leading to irreversible deformities and contracture. High-index of suspicion is required for early diagnosis and prevention of cosmetic deformity. A case of LV over nose in a young male with ulceration is reported who responded well to anti-tubercular therapy, but left with scarring of nose, which could have been prevented if adequate awareness regarding extra-pulmonary cases would have been practiced. PMID:25657427

  17. PEPTIC ULCER DISEASE

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Peptic ulcer disease (PUD) is an ulcerative condition of the stomach or duodenum that may be accompanied by mucosal inflammation. PUD is classified as primary when it occurs in healthy children and as secondary when underlying disorders associated with injury, illness, or drug therapy co-exists. Pri...

  18. Pressure Ulcer Prevention

    PubMed Central

    2009-01-01

    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

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

    PubMed

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

    2013-10-01

    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

  20. Connective Tissue Ulcers

    PubMed Central

    Dabiri, Ganary; Falanga, Vincent

    2013-01-01

    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

  1. Connective tissue ulcers.

    PubMed

    Dabiri, Ganary; Falanga, Vincent

    2013-11-01

    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

  2. UNUSUAL CAUSES OF CUTANEOUS ULCERATION

    PubMed Central

    Panuncialman, Jaymie; Falanga, Vincent

    2010-01-01

    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

  3. Leg Length Inequality

    PubMed Central

    Sharpe, Colin R.

    1983-01-01

    Leg length inequality, a common abnormality, can cause musculoskeletal pain, scoliosis, and osteoarthritis of the hip. Seven percent of the asymptomatic population has a leg length inequality greater than 12 mm; the incidence is considerably higher (13%-22%) in individuals complaining of low back pain. Correction can usually be accomplished by shoe modification, and can result in dramatic relief of pain. Leg length inequality of more than half an inch is considered clinically significant. Leg length measurement should be routine in all patients complaining of low back pain, hip pain, and atypical flank and lower quadrant pain. Correction might prove very cost-effective. PMID:21283327

  4. Cushing's ulcer: Further reflections

    PubMed Central

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

    2015-01-01

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

  5. Pressure ulcer prevention.

    PubMed

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

    2004-01-01

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

  6. A case of HIV ulcer

    PubMed Central

    2015-01-01

    HIV-associated ulcers must be distinguished from idiopathic anal fissures in HIV-positive patients and from other sexually transmitted diseases that cause anogenital ulcers as the treatments differ. PMID:26266040

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

    E-print Network

    Henderson, Thomas C.

    variables. A sensing system capable of monitoring both blood flow velocity and the extent of edema variables [4]. With respect to venous leg ulcers, blood flow velocity and the extent of edema likelihood for clot formation. The extent of edema/swelling is also closely tied to healing time because

  8. Influence of healing on the disturbed blood flow regulation in venous ulcers.

    PubMed

    Jünger, M; Hahn, M; Klyscz, T; Rassner, G

    1996-01-01

    Cutaneous blood flow regulation is disturbed in severe chronic venous insufficiency (CVI). The feedback system between the transmural pressure in the postcapillary venules and the precapillary resistance regulating arterioles has gone awry. The upregulated control system causes "luxus"-hyperperfusion. In this study laser Doppler fluxmetry was performed in 6 patients' florid venous ulcers (U) and later in the former ulcer area after healing (H) and in the inner ankle area of 12 healthy volunteers (C). Laser Doppler flux (LDF) changes were measured with the leg elevated and lowered as well as after arterial and during venous occlusion. The results proved a diminished (p < 0.01) flux increase with the leg elevated (U: LDF = -9%, H: LDF = 3.1%, C: LDF = 80%) and after arterial occlusion (U: LDF = 1.3%, H: LDF = 0%; C: 189.6%) in severe CVI both in florid ulcers and after healing. The ability to reduce flux when transmural pressures were increased remained. Leg lowering reduced flux by 46.4% in ulcers and by 36.8% after healing. This postural response to high transmural pressures, however, seemed weakened compared to controls, where LDF decreased by 65.8%. Our findings suggest that the postural feedback system remains disturbed and upregulated even after a venous ulcer has healed. PMID:8956551

  9. 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....

  10. Limits and possibilities experienced by nurses in the treatment of women with chronic venous ulcers.

    PubMed

    Silva, Marcelo Henrique da; Jesus, Maria Cristina Pinto de; Merighi, Miriam Aparecida Barbosa; Oliveira, Deíse Moura de

    2014-08-01

    Objective To understand the experiences and expectations of nurses in the treatment of women with chronic venous ulcers. Method Phenomenological research was based on Alfred Schütz, whose statements were obtained in January, 2012, through semi-structured interviews with seven nurses. Results The nurse reveals the difficulties presented by the woman in performing self-care, the perceived limitations in the treatment anchored in motivation, and the values and beliefs of women. It showed professional frustration because venous leg ulcer recurrence, lack of inputs, interdisciplinary work and training of nursing staff. There was an expected adherence to the treatment of women, and it emphasized the need for ongoing care, supported self-care and standard practices in treatment. Conclusion That treatment of chronic venous leg ulcers constitutes a challenge that requires collective investment, involving women, professionals, managers and health institutions. PMID:25517835

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

    SciTech Connect

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

    1983-12-01

    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.

  12. Actuator device for artificial leg

    NASA Technical Reports Server (NTRS)

    Burch, J. L. (inventor)

    1976-01-01

    An actuator device is described for moving an artificial leg of a person having a prosthesis replacing an entire leg and hip joint. The device includes a first articulated hip joint assembly carried by the natural leg and a second articulated hip joint assembly carried by the prosthesis whereby energy from the movement of the natural leg is transferred by a compressible fluid from the first hip joint assembly to the second hip joint assembly for moving the artificial leg.

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

    E-print Network

    Bergstein, Paul

    :Number ssn #12;Leg color owner Ident Person Number ssn Table leg1 leg2 leg3 leg4 Owner Person Company Owner Person Company Number String expense address #12;#12;a1:Adm_assistant course_assigned ssn n1:Number Economics Comp_Sci salary r1:Real p1:Professor ssn n1:Number salary r1:Real c1:Course major u1

  14. Management of Chronic Pressure Ulcers

    PubMed Central

    2009-01-01

    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 Objective The Medical Advisory Secretariat (MAS) conducted a systematic review on interventions used to treat pressure ulcers in order to answer the following questions: Do currently available interventions for the treatment of pressure ulcers increase the healing rate of pressure ulcers compared with standard care, a placebo, or other similar interventions? Within each category of intervention, which one is most effective in promoting the healing of existing pressure ulcers? Background A pressure ulcer is a localized injury to the skin and/or underlying tissue usually over a bony prominence, as a result of pressure, or pressure in conjunction with shear and/or friction. Many areas of the body, especially the sacrum and the heel, are prone to the development of pressure ulcers. People with impaired mobility (e.g., stroke or spinal cord injury patients) are most vulnerable to pressure ulcers. Other factors that predispose people to pressure ulcer formation are poor nutrition, poor sensation, urinary and fecal incontinence, and poor overall physical and mental health. The prevalence of pressure ulcers in Ontario has been estimated to range from a median of 22.1% in community settings to a median of 29.9% in nonacute care facilities. Pressure ulcers have been shown to increase the risk of mortality among geriatric patients by as much as 400%, to increase the frequency and duration of hospitalization, and to decrease the quality of life of affected patients. The cost of treating pressure ulcers has been estimated at approximately $9,000 (Cdn) per patient per month in the community setting. Considering the high prevalence of pressure ulcers in the Ontario health care system, the total cost of treating pressure ulcers is substantial. Technology Wounds normally heal in 3 phases (inflammatory phase, a proliferative phase of new tissue and matrix formation, and a remodelling phase). However, pressure ulcers often fail to progress past the inflammatory stage. Current practice for treating pressure ulcers includes treating the underlying causes, debridement to remove necrotic tissues and contaminated tissues, dressings to provide a moist wound environment and to manage exudates, devices and frequent turning of patients to provide pressure relief, topical applications of biologic agents, and nutritional support to correct nutritional deficiencies. A variety of adjunctive physical therapies are also in use. Method Health technology assessment databases and medical databases were searched from 1996 (Medline), 1980 (EMBASE), and 1982 (CINAHL) systematically up to March 2008 to identify randomized controlled trials (RCTs) on the following treatments of pressure ulcers: cleansing, debridement, dressings, biological therapies, pressure-relieving devices, physical therapies, nutritional therapies, and multidisciplinary wound care teams. Full literature search strategies are reported in appendix 1. English-language studies in previous systematic reviews and studies published since the last systematic review were included if they had more than 10 subjects, were randomized, and provided objective outcome measures on the healing of pressure ulcers. In the absence of RCTs, studies of the highest level of evidence available were included. Studies on wounds other than pressure ulcers and on surgical treatment of pressure ulcers were excluded. A total of 18 systematic reviews, 104 RCTs, and 4 observational

  15. Inflammation, acid and ulcers.

    PubMed Central

    Muller, M. J.; Hunt, R. H.

    1994-01-01

    Chronic active type B gastritis is invariably the result of Helicobacter pylori infection and is an important factor in duodenal ulcer disease. The actions of mediators produced (a protein factor, a lipid soluble "pore-forming factor" and urease) or induced (immune/inflammatory cell mediators) by this bacterium on the control of gastric acid secretion are currently being investigated. These studies are reviewed in light of our current knowledge of the physiological control of gastric acid secretion. PMID:7502522

  16. Persistent nicorandil induced oral ulceration

    PubMed Central

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

    2004-01-01

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

  17. [Neuropathy and diabetic foot ulcers].

    PubMed

    Lobmann, R

    2015-05-01

    Diabetic foot ulceration is a serious complication of diabetes mellitus worldwide and the most common cause of hospitalization in diabetic patients. The etiology of diabetic foot ulcerations is complex due to their multifactorial nature. Polyneuropathy plays an important role in the pathophysiology of diabetic foot ulceration. Proper adherence to standard treatment strategies and interdisciplinary cooperation can reduce the high rates of major amputations. PMID:25903093

  18. Metastable legged-robot locomotion

    E-print Network

    Byl, Katie

    2008-01-01

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

  19. Myxoma of the upper leg originating from an appendiceal mucinous neoplasm: A case report

    PubMed Central

    LI, JUN; ZHANG, XUE-YAN; WANG, BIN; CAO, QING-YONG

    2015-01-01

    Myxoma is rare in the upper leg. The current study presents the case of a large tumor in the right upper leg. The tumor extended to pelvic cavity and was found to be connected with a cystic and solid neoplasm that was adjacent to the ascending colon in the right lower quadrant. The large tumor of the upper leg had existed for 15 years and had ulcerated through the skin 4 days prior to admittance. Palliative surgery was performed, with histological findings of a myxoma. Since appendiceal mucinous neoplasms may invade organizations outside of the mucous layer of the appendix and cause secondary peritoneal myxoma, this myxoma of the upper leg probably originated from an appendiceal mucinous neoplasm.

  20. ORTHOPEDIC LEG BRACE

    NASA Technical Reports Server (NTRS)

    Myers, William Neil (Inventor)

    2005-01-01

    Knee braces generally have been rigid in both the knee bending direction and in the knee straightening direction unless a manually operated release is incorporated in them to allow the knee to bend. Desirably a braced knee joint should effectively duplicate the compound, complex, actions of a normal knee. The key to knee braces is the knee joint housing. The housing herein carries a number of cam action pawls. with teeth adapted to engage the internal teeth of a ratchet ring mounted in the housing. Cam action return springs and the shape of the cam action pawl teeth allow rotation of the ratchet ring in a leg straightening direction while still supporting a load. The leg can then be extended during walking while at the same time being prevented by the cam action pawls from buckling in the knee bending direction.

  1. Revisiting Buruli ulcer.

    PubMed

    Yotsu, Rie R; Murase, Chiaki; Sugawara, Mariko; Suzuki, Koichi; Nakanaga, Kazue; Ishii, Norihisa; Asiedu, Kingsley

    2015-11-01

    Buruli ulcer (BU), or Mycobacterium ulcerans infection, is a new emerging infectious disease which has been reported in over 33 countries worldwide. It has been noted not only in tropical areas, such as West Africa where it is most endemic, but also in moderate non-tropical climate areas, including Australia and Japan. Clinical presentation starts with a papule, nodule, plaque or edematous form which eventually leads to extensive skin ulceration. It can affect all age groups, but especially children aged between 5 and 15 years in West Africa. Multiple-antibiotic treatment has proven effective, and with surgical intervention at times of severity, it is curable. However, if diagnosis and treatment is delayed, those affected may be left with life-long disabilities. The disease is not yet fully understood, including its route of transmission and pathogenesis. However, due to recent research, several important features of the disease are now being elucidated. Notably, there may be undiagnosed cases in other parts of the world where BU has not yet been reported. Japan exemplifies the finding that awareness among dermatologists plays a key role in BU case detection. So, what about in other countries where a case of BU has never been diagnosed and there is no awareness of the disease among the population or, more importantly, among health professionals? This article will revisit BU, reviewing clinical features as well as the most recent epidemiological and scientific findings of the disease, to raise awareness of BU among dermatologists worldwide. PMID:26332541

  2. Leg size and muscle functions associated with leg compliance

    NASA Technical Reports Server (NTRS)

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

    1988-01-01

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

  3. Influence of the calcaneus shape on the risk of posterior heel ulcer using 3D patient-specific biomechanical modeling.

    PubMed

    Luboz, V; Perrier, A; Bucki, M; Diot, B; Cannard, F; Vuillerme, N; Payan, Y

    2015-02-01

    Most posterior heel ulcers are the consequence of inactivity and prolonged time lying down on the back. They appear when pressures applied on the heel create high internal strains and the soft tissues are compressed by the calcaneus. It is therefore important to monitor those strains to prevent heel pressure ulcers. Using a biomechanical lower leg model, we propose to estimate the influence of the patient-specific calcaneus shape on the strains within the foot and to determine if the risk of pressure ulceration is related to the variability of this shape. The biomechanical model is discretized using a 3D Finite Element mesh representing the soft tissues, separated into four domains implementing Neo Hookean materials with different elasticities: skin, fat, Achilles' tendon, and muscles. Bones are modelled as rigid bodies attached to the tissues. Simulations show that the shape of the calcaneus has an influence on the formation of pressure ulcers with a mean variation of the maximum strain over 6.0 percentage points over 18 distinct morphologies. Furthermore, the models confirm the influence of the cushion on which the leg is resting: a softer cushion leading to lower strains, it has less chances of creating a pressure ulcer. The methodology used for patient-specific strain estimation could be used for the prevention of heel ulcer when coupled with a pressure sensor. PMID:25384835

  4. Common Questions About Pressure Ulcers.

    PubMed

    Raetz, Jaqueline G M; Wick, Keren H

    2015-11-15

    Patients with limited mobility due to physical or cognitive impairment are at risk of pressure ulcers. Primary care physicians should examine at-risk patients because pressure ulcers are often missed in inpatient, outpatient, and long-term care settings. High-risk patients should use advanced static support surfaces to prevent pressure ulcers and air-fluidized beds to treat pressure ulcers. Physicians should document the size and clinical features of ulcers. Cleansing should be done with saline or tap water, while avoiding caustic agents, such as hydrogen peroxide. Dressings should promote a moist, but not wet, wound healing environment. The presence of infection is determined through clinical judgment; if uncertain, a tissue biopsy should be performed. New or worsening pain may indicate infection of a pressure ulcer. When treating patients with pressure ulcers, it is important to keep in mind the patient's psychological, behavioral, and cognitive status. The patient's social, financial, and caregiver resources, as well as goals and long-term prognosis, should also be considered in the treatment plan. PMID:26554282

  5. Exertional Leg Pain.

    PubMed

    Rajasekaran, Sathish; Finnoff, Jonathan T

    2016-02-01

    Exertional leg pain is a common condition seen in runners and the general population. Given the broad differential diagnosis of this complaint, this article focuses on the incidence, anatomy, pathophysiology, clinical presentation, diagnostic evaluation, and management of common causes that include medial tibial stress syndrome, tibial bone stress injury, chronic exertional compartment syndrome, arterial endofibrosis, popliteal artery entrapment syndrome, and entrapment of the common peroneal, superficial peroneal, and saphenous nerves. Successful diagnosis of these conditions hinges on performing a thorough history and physical examination followed by proper diagnostic testing and appropriate management. PMID:26616179

  6. Pressure ulcer good practice published.

    PubMed

    2015-06-17

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

  7. Differentiating nocturnal leg cramps and restless legs syndrome.

    PubMed

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

    2014-07-01

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

  8. Endoscopic Obliteration for Bleeding Peptic Ulcer

    PubMed Central

    Zawadzki, J.J. J.; Gajda, A.G. G.; Kami?ski, P. ?.; Lembas, L.; Bielecki, K.

    1997-01-01

    A group of 133 patients treated for bleeding peptic ulcer in our Department, is reviewed. Within several hours of admission, all patients underwent upper gastrointestinal tract gastroscopy and obliteration of the bleeding ulcer. Bleeding gastric ulcers were found in 41 patients, and duodenal ulcers in 92 patients. Patients were classified according to the Forrest scale: IA – 11 patients, IB – 49 patients, IIA – 35 patients, lIB – 40 patients. In 126 (94.7%) patients the bleeding was stopped, and 7 required urgent surgery: 3 patients with gastric ulcer underwent gastrectomy, and 4 with duodenal ulcer – truncal vagotomy with pyloroplasty and had the bleeding site underpinned. Fifty-five patients underwent elective surgery: gastrectomy and vagotomy (18 patients with gastric ulcer), highly selective vagotomy (25 patients with duodenal ulcer) and truncal vagotomy and pyloroplasty (12 patients with duodenal ulcer). None of the patients was observed to have recurrent bleeding. PMID:18493453

  9. [Restless-legs syndrome].

    PubMed

    Karroum, E; Konofal, E; Arnulf, I

    2008-01-01

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

  10. 38 CFR 4.110 - Ulcers.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ...specific for rating purposes. Manifest differences in ulcers of the stomach or duodenum in comparison with those at an anastomotic stoma are sufficiently recognized as to warrant two separate graduated descriptions. In evaluating the ulcer, care should be taken...

  11. 38 CFR 4.110 - Ulcers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ...specific for rating purposes. Manifest differences in ulcers of the stomach or duodenum in comparison with those at an anastomotic stoma are sufficiently recognized as to warrant two separate graduated descriptions. In evaluating the ulcer, care should be taken...

  12. 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 ... become damaged or die. When this happens, a pressure ulcer may form. Below are some questions you may ...

  13. 38 CFR 4.110 - Ulcers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...shown that the term “peptic ulcer” is not sufficiently specific for rating purposes. Manifest differences in ulcers of the stomach or duodenum in comparison with those at an anastomotic stoma are sufficiently recognized as to warrant two separate graduated...

  14. 38 CFR 4.110 - Ulcers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...shown that the term “peptic ulcer” is not sufficiently specific for rating purposes. Manifest differences in ulcers of the stomach or duodenum in comparison with those at an anastomotic stoma are sufficiently recognized as to warrant two separate graduated...

  15. Pradaxa-induced esophageal ulcer.

    PubMed

    Wood, Michele; Shaw, Paul

    2015-01-01

    Pradaxa (dabigatran) is a direct thrombin inhibitor approved for prevention of stroke and systemic embolism in patients with non-valvular atrial fibrillation. We describe a case of esophageal ulceration associated with Pradaxa administration in a 75-year-old man. The patient reported difficulty swallowing and a burning sensation after taking his first dose of Pradaxa. An esophagogastroduodenoscopy (EGD) revealed linear ulcerations in the mid-esophagus. Pradaxa was held beginning the day before the EGD. The patient reported that his pain and difficulty swallowing resolved on stopping Pradaxa. Pradaxa is formulated with a tartaric acid excipient to reduce variability in absorption. We hypothesise that the capsule lodged in the patient's esophagus and the tartaric acid may have caused local damage resulting in an esophageal ulcer. It is important to educate patients on proper administration of Pradaxa, to decrease the risk of this rare, but potentially serious adverse event. PMID:26452739

  16. Intra-arterial intervention chemotherapy for sarcoma and cancerous ulcer via an implanted pump.

    PubMed

    Liu, Cheng; Cui, Qiu; Guo, Jun; Li, Dingfeng; Zeng, Yanjun

    2014-04-01

    To observe the efficacy of intra-arterial chemotherapy with subcutaneously implanted pump for soft tissue sarcoma in extremities and cancerous ulcer. 31 patients with ulcerative skin squamous cell carcinoma or sarcoma in extremities who received treatment during the period from July 2003 to November 2011 at our hospital were recruited, including 15 male and 16 female patients, aging between 14 and 83 with average age of 49 years old. 10 patients had tumor in upper extremities and 21 patients in lower extremities. The pathological types of studied cases include 9 cases with skin squamous cell carcinoma, 6 cases with synovial sarcoma, 5 cases with malignant fibrous histiocytoma, 3 cases with liposarcoma, 3 cases with osteosarcoma, 2 cases with malignant melanoma, 2 cases with epidermoid sarcoma, and 1 case with protuberans. The main symptoms of cancerous ulcer were pain, infection and hemorrhage; All the studied patients were administrated with cisplatin and doxorubicin by intra-arterial chemotherapy pump, and the patients with squamous cell carcinoma were additionally applied with bleomycin and patients with malignant melanoma were additionally applied with dacarbazine. The chemotherapy efficiency was observed after at 3 cycles of intra-arterial chemotherapy. The total remission rate of pain (RR) was 87 %, and total remission rate of ulcer cicatrization (RR) was 71 %, with ulcer cicatrizing spontaneously in 9 cases and obvious homeostasis in 5 cases with bleeding ulcers. 19 patients underwent surgery after chemotherapy, in which 16 cases had limb-salvage surgery and 3 cases underwent lower leg amputation after chemotherapy, and 3 patients out of 16 cases had local recurrence (19 %). The subcutaneous intra-arterial targeting chemotherapy could be applied to treat refractory sarcoma and cancerous ulcer in extremities to significantly increase the chemotherapeutic concentration at tumor area so as to effectively constrain the tumor rupture induced main symptoms including pain, infection and bleeding, which would help to make a decreased blood supplied and well defined tumor boundary to finally decrease the recurrence rate. PMID:24446082

  17. Preventing Decubitus Ulcers with Cotton Sheeting Systems

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Decubitus pressure ulcers are a worldwide health crisis and their prevention and treatment has become a national priority. The National Pressure Ulcer Advisory Board estimates that as many as three million people in the United States have pressure ulcers. The causes of the ailment include both extr...

  18. Computed tomographic findings in penetrating peptic ulcer

    SciTech Connect

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

    1984-12-01

    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.

  19. Getting Your Sea Legs

    PubMed Central

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

    2013-01-01

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

  20. A metabolically efficient leg brace

    E-print Network

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

    2006-01-01

    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 ...

  1. Design of robotic quadruped legs

    E-print Network

    McKenzie, Jacob Elijah

    2012-01-01

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

  2. Recording pressure ulcer risk assessment and incidence.

    PubMed

    Plaskitt, Anne; Heywood, Nicola; Arrowsmith, Michaela

    2015-07-15

    This article reports on the introduction of an innovative computer-based system developed to record and report pressure ulcer risk and incidence at an acute NHS trust. The system was introduced to ensure that all patients have an early pressure ulcer risk assessment, which prompts staff to initiate appropriate management if a pressure ulcer is detected, thereby preventing further patient harm. Initial findings suggest that this electronic process has helped to improve the timeliness and accuracy of data on pressure ulcer risk and incidence. In addition, it has resulted in a reduced number of reported hospital-acquired pressure ulcers. PMID:26174286

  3. Challenges in pressure ulcer prevention.

    PubMed

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

    2015-06-01

    Although this article is a stand-alone article, it sets the scene for later articles in this issue. Pressure ulcers are considered to be a largely preventable problem, and yet despite extensive training and the expenditure of a large amount of resources, they persist. This article reviews the current understanding of pressure ulcer aetiology: pressure, shear and microclimate. Individual risk factors for pressure ulceration also need to be understood in order to determine the level of risk of an individual. Such an assessment is essential to determine appropriate prevention strategies. The main prevention strategies in terms of reducing pressure and shear and managing microclimate are studied in this article. The problem of pressure ulceration related to medical devices is also considered as most of the standard prevention strategies are not effective in preventing this type of damage. Finally, the possibility of using dressings as an additional preventive strategy is raised along with the question: is there enough evidence to support their use? PMID:23786251

  4. Restless Legs Syndrome and Leg Motor Restlessness in Parkinson's Disease

    PubMed Central

    Suzuki, Keisuke; Miyamoto, Masayuki; Miyamoto, Tomoyuki; Hirata, Koichi

    2015-01-01

    Sleep disturbances are important nonmotor symptoms in Parkinson's disease (PD) that are associated with a negative impact on quality of life. Restless legs syndrome (RLS), which is characterized by an urge to move the legs accompanied by abnormal leg sensations, can coexist with PD, although the pathophysiology of these disorders appears to be different. RLS and PD both respond favorably to dopaminergic treatment, and several investigators have reported a significant relationship between RLS and PD. Sensory symptoms, pain, motor restlessness, akathisia, and the wearing-off phenomenon observed in PD should be differentiated from RLS. RLS in PD may be confounded by chronic dopaminergic treatment; thus, more studies are needed to investigate RLS in drug-naïve patients with PD. Recently, leg motor restlessness (LMR), which is characterized by an urge to move the legs that does not fulfill the diagnostic criteria for RLS, has been reported to be observed more frequently in de novo patients with PD than in age-matched healthy controls, suggesting that LMR may be a part of sensorimotor symptoms intrinsic to PD. In this paper, we provide an overview of RLS, LMR, and PD and of the relationships among these disorders. PMID:26504610

  5. Helicobacter pylori and peptic ulcer disease.

    PubMed Central

    Feldman, M; Peterson, W L

    1993-01-01

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

  6. Larval therapy applied to a large arterial ulcer: an effective outcome.

    PubMed

    Rafter, Linda

    This article is a review of larval therapy and includes a case study that uses larval therapy in the treatment of complex leg ulcer wounds. Complex wounds require careful management from the multidisciplinary team and present clinicians with intricate challenges to save the limb. Wound-bed preparation and debridement needs to be as effective and non-traumatic as possible for the patient. Larval therapy removes the devitalised tissue effectively with minimal tissue trauma. This case study reports on a patient with a non-progressing, full-thickness wound with exposed tendon following reconstructive surgery at a local vascular unit. The patient was left with very limited treatment options, as traditional dressings for the arterial ulcer nearly resulted in amputation due to the deterioration in the wound. As part of the patient's management, she was treated with larval therapy in an attempt to salvage her limb. This article follows the progress of complex leg ulcer wounds employing BioFoam® dressing (BioMonde, Bridgend) for larvae debridement therapy over a 4-week period and incorporating five applications of three BioFoam dressing bags. This care pathway ensured the patient's safety by promoting effective wound healing with the larval therapy leading to excellent clinical patient outcomes. PMID:23587971

  7. Cancer complicating chronic ulcerative and scarifying mucocutaneous disorders

    SciTech Connect

    Kaplan, R.P. )

    1987-01-01

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

  8. Pipe crawler with extendable legs

    DOEpatents

    Zollinger, W.T.

    1992-06-16

    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.

  9. Pipe crawler with extendable legs

    DOEpatents

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

    1992-01-01

    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.

  10. Intramuscular pressures beneath elastic and inelastic leggings

    NASA Technical Reports Server (NTRS)

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

    1994-01-01

    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).

  11. Promethus Hot Leg Piping Concept

    SciTech Connect

    AM Girbik; PA Dilorenzo

    2006-01-24

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

  12. Prometheus Hot Leg Piping Concept

    SciTech Connect

    Gribik, Anastasia M.; DiLorenzo, Peter A.

    2007-01-30

    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.

  13. Intestinal microbiota and ulcerative colitis.

    PubMed

    Ohkusa, Toshifumi; Koido, Shigeo

    2015-11-01

    There is a close relationship between the human host and the intestinal microbiota, which is an assortment of microorganisms, protecting the intestine against colonization by exogenous pathogens. Moreover, the intestinal microbiota play a critical role in providing nutrition and the modulation of host immune homeostasis. Recent reports indicate that some strains of intestinal bacteria are responsible for intestinal ulceration and chronic inflammation in inflammatory bowel diseases (IBD) such as ulcerative colitis (UC) and Crohn's disease (CD). Understanding the interaction of the intestinal microbiota with pathogens and the human host might provide new strategies treating patients with IBD. This review focuses on the important role that the intestinal microbiota plays in maintaining innate immunity in the pathogenesis and etiology of UC and discusses new antibiotic therapies targeting the intestinal microbiota. PMID:26346678

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

    NASA Astrophysics Data System (ADS)

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

    2015-03-01

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

  15. Engaging patients in pressure ulcer prevention.

    PubMed

    Hudgell, Lynne; Dalphinis, Julie; Blunt, Chris; Zonouzi, Maryam; Procter, Susan

    2015-05-01

    As patients increasingly care for themselves at home, they require accessible information to enable informed self-care. This article describes the development of an educational electronic application (app) designed for use by patients at risk of pressure ulcers, and their carers. The app can be downloaded to Windows, Android or Apple smartphones or tablets. The app is based on the current pressure ulcer prevention and management guidelines from the National Pressure Ulcer Advisory Panel and the National Institute for Health and Care Excellence, and is designed to educate patients and carers about how to prevent a pressure ulcer, how to recognise a pressure ulcer, and what to do if they suspect they are developing a pressure ulcer. We hope the app will be used to help with educational conversations among patients, carers and healthcare professionals. PMID:25942988

  16. X-Ray Exam: Femur (Upper Leg)

    MedlinePLUS

    ... Sports: Keeping Kids Safe Concussions: What to Know X-Ray Exam: Femur (Upper Leg) KidsHealth > Parents > Doctors & Hospitals > Medical Tests & Exams > X-Ray Exam: Femur (Upper Leg) Print A A A ...

  17. Venous dynamics in leg lymphedema.

    PubMed

    Kim, D I; Huh, S; Hwang, J H; Kim, Y I; Lee, B B

    1999-03-01

    To determine whether there is anatomical and/or functional impairment to venous return in patients with lymphedema, we examined venous dynamics in 41 patients with unilateral leg lymphedema. A Volometer was used for computer analysis of leg volume, a color Duplex Doppler scanner was used to determine deep vein patency and skin thickness, and Air-plethysmography was used to assess ambulatory venous pressure, venous volume, venous filling index and the ejection fraction. In the lymphedematous leg, volume and skin thickness were uniformly increased (126.4 +/- 21.3% and 156.9 +/- 44.5%) (mean +/- S.D.), respectively. The ambulatory venous pressure was also increased (134 +/- 60.7%) as was the venous volume (124.5 +/- 37.5%), and the venous filling index (134.5 +/- 50.5%). The ejection fraction was decreased (94.9 +/- 26.1%). Greater leg volume correlated with increased venous volume and venous filling index (values = 0.327, 0.241, respectively) and decreased ejection fraction (r = -0.133). Increased subcutaneous thickness correlated with increased venous filling index and venous volume (r = 0.307, 0.126, respectively) and decreased ejection fraction (r = -0.202). These findings suggest that soft tissue edema from lymphatic stasis gradually impedes venous return which in turn aggravates the underlying lymphedema. PMID:10197322

  18. Other Causes of Leg Pain

    MedlinePLUS

    ... can come from a variety of causes. Your health care professional has specific ways to discover if the cause is P.A.D. Other non-P.A.D. common causes of leg pain may include: A muscle cramp (also called a charley horse), frequently caused by the following: Dehydration or low ...

  19. Rotational joint for prosthetic leg

    NASA Technical Reports Server (NTRS)

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

    1977-01-01

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

  20. Pressure ulcer prevention in frail older people.

    PubMed

    Barry, Maree; Nugent, Linda

    2015-12-16

    Pressure ulcers are painful and cause discomfort, have a negative effect on quality of life, and are costly to treat. The incidence and severity of preventable pressure ulcers is an important indicator of quality of care; it is essential that healthcare providers monitor prevalence and incidence rates to ensure that care strategies implemented are effective. Frail older people are at increased risk of developing pressure ulcers. This article discusses the complexities of preventing pressure ulcers in frail older people and emphasises the importance of structured educational programmes that incorporate effective clinical leadership and multidisciplinary teamwork. PMID:26669407

  1. OCEAN DRILLING PROGRAM LEG 132 ENGINEERING PROSPECTUS

    E-print Network

    technology. LEG 124E ENGINEERING TEST RESULTS During the first dedicated engineering leg (Leg 124E to be feasible. State-of-the-art "high-tech" sensor technology, coupled with a microprocessor unit, was used extreme weather conditions. A 3- 1/2-in. outer diameter (OD) tubing string, with Hydril series 500 wedge-lock

  2. OCEAN DRILLING PROGRAM LEG 107 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 107 PRELIMINARY REPORT TYRRHENIAN SEA Kim A. Kastens Co-Chief Scientist University, Kyoto, Japan). #12;Scientific Report, Leg 107 Page 1 INTRODUCTION The Tyrrhenian Sea is the small for Leg 107 of the Ocean Drilling Program considered the Tyrrhenian Sea from three different perspectives

  3. OCEAN DRILLING PROGRAM LEG 126 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 126 PRELIMINARY REPORT BONIN ARC-TRENCH SYSTEM Dr. Kantaro Fujioka Co-Chief Scientist, Leg 126 Ocean Research Institute University of Tokyo 1-15-1 Minamidai, Nakano-ku Tokyo 164, Japan at Manoa 2525 Correa Road Honolulu, Hawaii 96822 Dr. Thomas Janecek Staff Scientist, Leg 126 Ocean Drilling

  4. OCEAN DRILLING PROGRAM LEG 100 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 100 SCIENTIFIC PROSPECTUS SHAKEDOWN AND SEA TRIALS CRUISE Philip D. Rabinowitz Co-Chief Scientist, Leg 100 Ocean Drilling Program Texas A&M University College Station, TX 77843 William J. Merrell Co-Chief Scientist, Leg 100 Ocean Drilling Program Texas A&M University College Station

  5. OCEAN DRILLING PROGRAM LEG 100 REPORT

    E-print Network

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

  6. Ulcerative colitis flare with splenic ven thrombosis

    PubMed Central

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

    2015-01-01

    Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events. Here, we present a 28-year-old man with active ulcerative pancolitis presenting via splenic vein thrombosis and left renal superior infarct that was not associated with a surgical procedure. PMID:26064409

  7. Ulcerative colitis flare with splenic ven thrombosis.

    PubMed

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

    2015-01-01

    Patients with ulcerative colitis (UC) have an increased risk of thromboembolic events. Here, we present a 28-year-old man with active ulcerative pancolitis presenting via splenic vein thrombosis and left renal superior infarct that was not associated with a surgical procedure. PMID:26064409

  8. Vulvar Ulcers and Erosions: A Clinical Approach.

    PubMed

    Bohl, Tanja G

    2015-09-01

    Vulvar ulcers have a plethora of potential causes and variable clinical presentations that can prove to be a challenge to any clinician. The terminology of these causes can further add to the difficulty of diagnosis. A clinical approach to diagnosis and management is presented with classification tables and a discussion of the terminology of aphthosis, a common cause of vulvar ulceration. PMID:26176786

  9. Urine-drainage leg bags: an overview.

    PubMed

    Wilson, Mary

    This article looks at leg bags from the perspective of the clinical guidance available, published research, review papers, the diverse nature of products available, and their use with catheters, sheaths or urinals. The part that leg bags play in catheter-associated urinary tract infection control is addressed. Other aspects of catheter safety are discussed, including the avoidance of catheter traction. Variations in leg-bag structure including bag size, inlet tubing, tap, connector and backing, along with the reasons for selecting a particular leg bag are considered, along with the choice of either leg-bag straps or sleeves. The article concludes that, as a result of the variation of leg bags available, patients may require assistance and support from health professionals in finding the right leg bag for them. PMID:26450819

  10. Assessing Children's Legs and Feet

    PubMed Central

    Wedge, John H.

    1985-01-01

    Shoes are necessary for protection and warmth. Normal children do not require shoes for support. There is no scientific evidence that shoes—‘orthopedic’ or otherwise—influence or alter the growth or shape of the normal child's foot except, perhaps, adversely if they fit poorly. Family physicians must understand common variations of normal foot and leg development if they are to effectively advise and reassure parents about appropriate footwear. Flat feet, knock knees, bow legs, in-toeing, and out-toeing in otherwise normal children can easily be distinguished from similar but more serious deformities associated with disease or congenital anomaly. ImagesFig. 1AFig. 1BFig. 2AFig. 2B PMID:21274231

  11. [Advances in the research of Marjolin's ulcer].

    PubMed

    Long, Zhongheng; Xie, Weiguo

    2014-12-01

    Marjolin's ulcer is a rare malignancy arising from various forms of scars, mainly an old scar resulted from burn. The second most common origin is malignant degeneration arising from tissue within osteomyelitis fistulae. Not uncommonly, the lesions may arise secondary to ulcers due to venous insufficiency or pressure sores. The pathology of the majority of Marjolin's ulcer is a well-differentiated squamous cell carcinoma. The exact reason for an ulcer which undergoes a malignant transformation is unknown. The pathologic diagnosis is the gold standard. Surgery remains the preferred treatment after diagnosis is reached. Wide surgical excision with margins up to 2-3 cm has been suggested. The necessity of whether lymphatic dissection should be executed, or radiotherapy and chemotherapy following surgery is still in dispute. This article deals with the etiology of Marjolin's ulcer and its pathological grading, diagnosis, treatment, prognosis, and prevention, with a hope to provide some useful clinical information. PMID:25608786

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

    PubMed

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

    2015-07-01

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

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

    PubMed Central

    Maeng, Jin Hee; Lee, Eunhye

    2013-01-01

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

  14. Anti-ulcer and ulcer healing potentials of Musa sapientum peel extract in the laboratory rodents

    PubMed Central

    Onasanwo, Samuel Adetunji; Emikpe, Benjamin Obukowho; Ajah, Austin Azubuike; Elufioye, Taiwo Olayemi

    2013-01-01

    Background: This study investigated the anti-ulcer and ulcer healing potentials of the methanol extract of Musa sapientum peel in the laboratory rats. Materials and Methods: Methanol extract of the peels on Musa sapientum (MEMS) was evaluated for its anti-ulcer using alcohol-induced, aspirin-induced, and pyloric ligation-induced models, and for its ulcer healing employing acetic acid-induced ulcer models in rats. Results: The findings from this experiment showed that MEMS (50, 100 and 200 mg/kg, b.w.) anti-ulcer and ulcer healing activity (P ? 0.05) is dose-dependent. Also, MEMS exhibited healing of the ulcer base in all the treated groups when compared with the control group. Conclusion: The outcomes of this experiment revealed that the anti-ulcer effect of MEMS may be due to its anti-secretory and cyto-protective activity. The healing of the ulcer base might not be unconnected with basic fibroblast growth factors responsible for epithelial regeneration. PMID:23900937

  15. Diabetic foot ulcers. Pathophysiology, assessment, and therapy.

    PubMed Central

    Bowering, C. K.

    2001-01-01

    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

  16. Pressure ulcer incidence on a spinal cord injury unit.

    PubMed

    Hammond, M C; Bozzacco, V A; Stiens, S A; Buhrer, R; Lyman, P

    1994-11-01

    Because of the high risk for pressure ulcers among hospitalized, spinal cord injured patients, one quality improvement measure is to monitor incidence of pressure ulcers. A retrospective chart review of each patient who developed an ulcer during an 18-month period revealed patient characteristics associated with pressure ulcer risk. Of 468 inpatient admissions, 35 patients developed 81 pressure ulcers. Patient variables associated with an incidence rate of 7.5% were an admission diagnosis of pressure ulcer, surgical repair of pressure ulcers, length of stay, new spinal cord injury, longstanding injury (> 10 years), and the use of condom catheters. PMID:7795866

  17. Biological therapy for ulcerative colitis

    PubMed Central

    Arora, Zubin; Shen, Bo

    2015-01-01

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

  18. Data driven models of legged locomotion

    NASA Astrophysics Data System (ADS)

    Revzen, Shai; Kvalheim, Matthew

    2015-05-01

    Legged locomotion is a challenging regime both for experimental analysis and for robot design. From biology, we know that legged animals can perform spectacular feats which our machines can only surpass on some specially controlled surfaces such as roads. We present a concise review of the theoretical underpinnings of Data Driven Floquet Analysis (DDFA), an approach for empirical modeling of rhythmic dynamical systems. We provide a review of recent and classical results which justify its use in the analysis of legged systems.

  19. Endoscopic application of EGF-chitosan hydrogel for precipitated healing of GI peptic ulcers and mucosectomy-induced ulcers.

    PubMed

    Maeng, Jin Hee; Bang, Byoung Wook; Lee, Eunhye; Kim, Jungju; Kim, Hyung Gil; Lee, Don Haeng; Yang, Su-Geun

    2014-02-01

    The gastrointestinal (GI) endoscopy has become a standard diagnostic tool for GI ulcers and cancer. In this study we studied endoscopic application of epidermal growth factor-containing chitosan hydrogel (EGF-CS gel) for treatment of GI ulcer. We hypothesized that directional ulcer-coating using EGF-CS gel via endoscope would precipitate ulcer-healing. EGF-CS gel was directly introduced to the ulcer-region after ulceration in acetic acid-induced gastric ulcer (AAU) and mucosal resection-induced gastric ulcer (MRU) rabbit and pig models. The ulcer dimensions and mucosal thicknesses were estimated and compared with those in the control group. Healing efficacy was more closely evaluated by microscopic observation of the ulcer after histological assays. In the AAU model, the normalized ulcer size of the gel-treated group was 2.3 times smaller than that in the non-treated control group on day 3 after ulceration (P < 0.01). In the MRU model, the normalized ulcer size of the gel-treated group was 5.4 times smaller compared to that in the non-treated control group on day 1 after ulceration (P < 0.05). Histological analysis supported the ability of EGF-CS gel to heal ulcers. The present study suggests that EGF-CS gel is a promising candidate for treating gastric bleeding and ulcers. PMID:24338378

  20. A reproducible animal model of acute bleeding ulcer-the "ulcer maker".

    PubMed

    Protell, R L; Silverstein, F E; Piercey, J; Dennis, M; Sprake, W; Rubin, C E

    1976-12-01

    An instrument has been developed which creates an experimental model of an acute bleeding gastric ulcer. The diameter and depth of these gastric ulcers are reproducible. The instrument can be used endoscopically or at laparotomy. Using this ulcer model nonsurgical modalities for the treatment of upper gastrointestinal bleeding can be compared in a controlled manner. This standard experimental model may also facilitate comparison of results among different research groups. PMID:992279

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

    PubMed Central

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

    2014-01-01

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

  2. Tannins, Peptic Ulcers and Related Mechanisms

    PubMed Central

    de Jesus, Neyres Zinia Taveira; de Souza Falcão, 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, Petrônio Filgueiras; Batista, Leonia Maria

    2012-01-01

    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

  3. Peripheral Ulcerative Keratitis with Pyoderma Gangrenosum

    PubMed Central

    Imbernón-Moya, Adrián; Vargas-Laguna, Elena; Aguilar, Antonio; Gallego, Miguel Ángel; Vergara, Claudia; Nistal, María Fernanda

    2015-01-01

    Pyoderma gangrenosum is an unusual necrotizing noninfective and ulcerative skin disease whose cause is unknown. Ophthalmic involvement in pyoderma gangrenosum is an unusual event. Only a few cases have been reported, from which we can highlight scleral, corneal, and orbital cases. Peripheral ulcerative keratitis is a process which destroys the peripheral cornea. Its cause is still unknown although it is often associated with autoimmune conditions. Pyoderma gangrenosum should be included in the differential diagnosis of peripheral ulcerative keratitis. Early recognition of these manifestations can vary the prognosis by applying the appropriate treatment. We introduce a 70-year-old woman who suffered pyoderma gangrenosum associated with peripheral ulcerative keratitis in her left eye. The patient's skin lesions and peripheral keratitis responded successfully to systemic steroids and cyclosporine A. PMID:26527531

  4. Ulcerative Colitis - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... List of All Topics All Ulcerative Colitis - Multiple Languages To use the sharing features on this page, please enable JavaScript. Arabic (???????) Chinese - Traditional (????) French (français) Hindi (??????) Japanese (???) Korean (???) Russian (???????) Somali (af Soomaali) Spanish (español) ...

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

    PubMed

    Calvopiña, Manuel; Martinez, Leonardo; Hashiguchi, Yoshihisa

    2013-08-01

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

  6. Space Elevator Base Leg Architecture

    NASA Astrophysics Data System (ADS)

    Swan, C.; Swan, P. A.

    While the Space Elevator stretches for 104,000 kilometers, the region of most concern, from the survival perspective, is 2,500 kms and below. The threats inside this dangerous arena include debris, spacecraft, meteorites, lightening, winds, rogue waves, aircraft, and intentional human acts. Two major questions will be addressed that will influence the overall systems architecture of a Space Elevator. While the deployment phase of the development of the Space Elevator will only have a single ribbon from the surface of the Earth to well beyond the Geosynchronous altitude, a mature Space Elevator must never allow a complete sever of the system. Design approaches, materials selections, international policy development and assembly must ensure that the integrity of the Space Elevator be maintained. The trade space analysis will address the probability of an individual ribbon being severed, the length of time to repair, and the potential for a catastrophic Space Elevator cut. The architecture proposed for the base leg portion will address two questions: Shall there be multiple base legs to 2,500 kms altitude? And Should the anchor be based on land or at sea?

  7. Running with a load increases leg stiffness.

    PubMed

    Silder, Amy; Besier, Thor; Delp, Scott L

    2015-04-13

    Spring-mass models have been used to characterize running mechanics and leg stiffness in a variety of conditions, yet it remains unknown how running while carrying a load affects running mechanics and leg stiffness. The purpose of this study was to test the hypothesis that running with a load increases leg stiffness. Twenty-seven subjects ran at a constant speed on a force-measuring treadmill while carrying no load, and while wearing weight vests loaded with 10%, 20%, and 30% of body weight. We measured lower extremity motion and created a scaled musculoskeletal model of each subject, which we used to estimate lower extremity joint angles and leg length. We estimated dimensionless leg stiffness as the ratio of the peak vertical ground reaction force (normalized to body weight) and the change in stance phase leg length (normalized to leg length at initial foot contact). Leg length was calculated as the distance from the center of the pelvis to the center-of-pressure under the foot. We found that dimensionless leg stiffness increased when running with load (p=0.001); this resulted from an increase in the peak vertical ground reaction force (p<0.001) and a smaller change in stance phase leg length (p=0.025). When running with load, subjects had longer ground contact times (p<0.020), greater hip (p<0.001) and knee flexion (p=0.048) at the time of initial foot contact, and greater peak stance phase hip, knee, and ankle flexion (p<0.05). Our results reveal that subjects run in a more crouched posture and with higher leg stiffness to accommodate an added load. PMID:25728581

  8. Decubitus ulcers: a review of the literature.

    PubMed

    Bansal, Cheryl; Scott, Ron; Stewart, David; Cockerell, Clay J

    2005-10-01

    Decubitus ulcers are a worldwide health care concern affecting tens of thousands of patients and costing over a billion dollars a year. Susceptibility to pressure ulcers comes from a combination of external factors (pressure, friction, shear force, and moisture), and internal factors (e.g. fever, malnutrition, anaemia, and endothelial dysfunction). Often, enough damage is done to create the basis for a decubitus ulcer after as little as 2 h of immobility, a situation which may be difficult to avoid if the patient must undergo prolonged surgery or remain bedridden. Damage owing to pressure may also occur hours before the patient receives medical attention, especially if the patient falls or becomes immobilized owing to a vascular event. Several classification systems for decubitus ulcers have been described, based on where injury first occurs. The histologic progression of decubitus ulcers is a dynamic process involving several stages, each having characteristic histologic features. A team-focused approach integrating all aspects of care, including pressure relief, infection control, nutrition, and surgery, may improve healing rates. With accurate risk assessment and preventative care, we can hope to minimize complications and mortality owing to decubitus ulcers. PMID:16207179

  9. Acute Marjolin's ulcers: a nebulous diagnosis.

    PubMed

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

    2014-05-01

    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

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

    PubMed Central

    Graham, David Y

    2014-01-01

    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

  11. OCEAN DRILLING PROGRAM LEG 179 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 179 PRELIMINARY REPORT HAMMER DRILLING and NERO Dr. John F. Casey Thomas the ODP Publications Homepage on the World Wide Web at http://www-odp.tamu.edu/publications. D I S C L A I were aboard JOIDES Resolution for Leg 179 of the Ocean Drilling Program: Chief Scientist John F. Casey

  12. OCEAN DRILLING PROGRAM LEG 175 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 175 PRELIMINARY REPORT BENGUELA CURRENT Dr. Wolfgang Berger Co, Texas 77845-9547 U.S.A. __________________ Paul J. Fox Director of Science Operations ODP The following scientists were aboard the JOIDES Resolution for Leg 175 of the Ocean Drilling Program: Wolfgang

  13. OCEAN DRILLING PROGRAM LEG 128 PRELIMINARY REPORT

    E-print Network

    , Argyll P434 4AD, United Kingdom) Peter DeMenocal (Lamont-Doherty Geological Observatory, ColumbiaOCEAN DRILLING PROGRAM LEG 128 PRELIMINARY REPORT JAPAN SEA Dr. James C. Ingle, Jr. Co party aboard JOIDES Resolution for Leg 128 of the Ocean Drilling Program consisted of: James C. Ingle

  14. OCEAN DRILLING PROGRAM LEG 149 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 149 SCIENTIFIC PROSPECTUS OCEAN-CONTINENT TRANSITION IN THE IBERIA western Iberia to determine the changes in the physical and petrological nature of the acoustic basement for the Iberia Abyssal Plain sites and will only be drilled if the leg objectives can not be achieved

  15. OCEAN DRILLING PROGRAM LEG 105 SCIENTIFIC PROSPECTUS

    E-print Network

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

  16. OCEAN DRILLING PROGRAM LEG 140 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 140 PRELIMINARY REPORT HOLE 504B Dr. Henry Dick Dr. Jörg Erzinger Co Giessen Federal Republic of Germany Dr. Laura Stokking Staff Scientist, Leg 140 Ocean Drilling Program Copies of this publication may be obtained from the Director, Ocean Drilling Program, Texas A

  17. LEG 142 PRELIMINARY REPORT OCEAN DRILLING PROGRAM

    E-print Network

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

  18. OCEAN DRILLING PROGRAM LEG 108 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 108 SCIENTIFIC PROSPECTUS NORTHWEST AFRICA Dr. William Ruddiman Co Federal Republic of Germany Dr. Jack G. Baldauf Staff Scientist, Leg 108 Ocean Drilling Program Texas A & M University College Station, Texas 77843-3469 Philip W Rabin Direct Ocean Drilling Program

  19. OCEAN DRILLING PROGRAM LEG 159 SCIENTIFIC PROSPECTUS

    E-print Network

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

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

    PubMed

    Thompson, Trish Morris; Marks-Maran, Di

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

  1. Body Mass Index and Pressure Ulcers: Improved Predictability of Pressure Ulcers in Intensive Care Patients

    PubMed Central

    Hyun, Sookyung; Li, Xiaobai; Vermillion, Brenda; Newton, Cheryl; Fall, Monica; Kaewprag, Pacharmon; Moffatt-Bruce, Susan; Lenz, Elizabeth R.

    2015-01-01

    Background Obesity contributes to immobility and subsequent pressure on skin surfaces. Knowledge of the relationship between obesity and development of pressure ulcers in intensive care patients will provide better understanding of which patients are at high risk for pressure ulcers and allow more efficient prevention. Objectives To examine the incidence of pressure ulcers in patients who differ in body mass index and to determine whether inclusion of body mass index enhanced use of the Braden scale in the prediction of pressure ulcers. Methods In this retrospective cohort study, data were collected from the medical records of 4 groups of patients with different body mass index values: underweight, normal weight, obese, and extremely obese. Data included patients’ demographics, body weight, score on the Braden scale, and occurrence of pressure ulcers. Results The incidence of pressure ulcers in the underweight, normal weight, obese, and extremely obese groups was 8.6%, 5.5%, 2.8%, and 9.9%, respectively. When both the score on the Braden scale and the body mass index were predictive of pressure ulcers, extremely obese patients were about 2 times more likely to experience an ulcer than were normal weight patients. In the final model, the area under the curve was 0.71. The baseline area under the curve for the Braden scale was 0.68. Conclusions Body mass index and incidence of pressure ulcers were related in intensive care patients. Addition of body mass index did not appreciably improve the accuracy of the Braden scale for predicting pressure ulcers. PMID:25362673

  2. Steerable Hopping Six-Legged Robot

    NASA Technical Reports Server (NTRS)

    Younse, Paulo; Aghazarian, Hrand

    2010-01-01

    The figure depicts selected aspects of a six-legged robot that moves by hopping and that can be steered in the sense that it can be launched into a hop in a controllable direction. This is a prototype of hopping robots being developed for use in scientific exploration of rough terrain on remote planets that have surface gravitation less than that of Earth. Hopping robots could also be used on Earth, albeit at diminished hopping distances associated with the greater Earth gravitation. The upper end of each leg is connected through two universal joints to an upper and a lower hexagonal frame, such that the tilt of the leg depends on the relative position of the two frames. Two non-back-driveable worm-gear motor drives are used to control the relative position of the two frames along two axes 120 apart, thereby controlling the common tilt of all six legs and thereby, further, controlling the direction of hopping. Each leg includes an upper and a lower aluminum frame segment with a joint between them. A fiberglass spring, connected via hinges to both segments, is used to store hopping energy prior to launch into a hop and to cushion the landing at the end of the hop. A cable for loading the spring is run into each leg through the center of the universal joints and then down along the center lines of the segments to the lower end of the leg. A central spool actuated by a motor with a harmonic drive and an electromagnetic clutch winds in all six cables to compress all six springs (thereby also flexing all six legs) simultaneously. To ensure that all the legs push off and land in the same direction, timing- belt pulley drives are attached to the leg segments, restricting the flexing and extension of all six legs to a common linear motion. In preparation for a hop, the spool can be driven to load the spring legs by an amount corresponding to a desired hop distance within range. The amount of compression can be computed from the reading of a shaft-angle encoder that indicates the amount by which the spool has been turned. When the robot is ready to hop, the electromagnetic clutch disengages the motor from the spool, thus releasing the cable restraints on the springs and allowing the springs to extend all six legs simultaneously.

  3. Differences and correlations in knee and hip mechanics during single-leg landing, single-leg squat, double-leg landing, and double-leg squat tasks.

    PubMed

    Donohue, Michael R; Ellis, Samantha M; Heinbaugh, Erika M; Stephenson, Mitchell L; Zhu, Qin; Dai, Boyi

    2015-01-01

    Landing and squat tasks have been utilized to assess lower extremity biomechanics associated with anterior cruciate ligament loading and injury risks. The purpose of this study was to identify the differences and correlations in knee and hip mechanics during a single-leg landing, a single-leg squat, a double-leg landing, and a double-leg squat. Seventeen male and 17 female recreational athletes performed landings and squats when kinematic and kinetic data were collected. ANOVAs showed significant differences (p < 0.00001) for maximum knee flexion angles, maximum hip flexion angles, maximum knee abduction angles, maximum hip adduction angles, and maximum external knee abduction moments among squats and landings. For maximum knee and hip flexion angles, significant correlations (r ? 0.5, p ? 0.003) were observed between the two landings and between the two squats. For maximum knee abduction and hip adduction angles and maximum external knee abduction moments, significant correlations were mostly found between the two landings, and between the single-leg squat and landings (r ? 0.54, p ? 0.001). Individuals are likely to demonstrate different profiles of injury risks when screened using different tasks. While a double-leg landing should be considered as a priority in screening, a single-leg squat may be used as a surrogate to assess frontal plane motion and loading. PMID:26275102

  4. Expansion Compression Contacts for Thermoelectric Legs

    NASA Technical Reports Server (NTRS)

    Sakamoto, Jeffrey

    2009-01-01

    In a proposed alternative to previous approaches to making hot-shoe contacts to the legs of thermoelectric devices, one relies on differential thermal expansion to increase contact pressures for the purpose of reducing the electrical resistances of contacts as temperatures increase. The proposed approach is particularly applicable to thermoelectric devices containing p-type (positive-charge-carrier) legs made of a Zintl compound (specifically, Yb14MnSb11) and n-type (negative charge-carrier) legs made of SiGe. This combination of thermoelectric materials has been selected for further development, primarily on the basis of projected thermoelectric performance. However, it is problematic to integrate, into a practical thermoelectric device, legs made of these materials along with a metal or semiconductor hot shoe that is required to be in thermal and electrical contact with the legs. This is partly because of the thermal-expansion mismatch of these materials: The coefficient of thermal expansion (CTE) of SiGe is 4.5 x 10(exp -6) C (exp -1), while the CTE of Yb14MnSb11 is 20 x 10(exp -6) C(exp -1). Simply joining a Yb14MnSb11 and a SiGe leg to a common hot shoe could be expected to result in significant thermal stresses in either or both legs during operation. Heretofore, such thermal stresses have been regarded as disadvantageous. In the proposed approach, stresses resulting from the CTE mismatch would be turned to advantage.

  5. Hemodynamic studies of the legs under weightlessness

    NASA Technical Reports Server (NTRS)

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

    1977-01-01

    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.

  6. Biomechanical implications of mild leg length inequality.

    PubMed Central

    McCaw, S T; Bates, B T

    1991-01-01

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

  7. Childhood Abuse Linked to Ulcerative Colitis Later in Life

    MedlinePLUS

    ... Childhood Abuse Linked to Ulcerative Colitis Later in Life But study finds no association with another inflammatory ... between childhood abuse and ulcerative colitis later in life. The study was published online recently in the ...

  8. Psychological correlates of gastric and duodenal ulcer disease.

    PubMed

    Tennant, C; Goulston, K; Langeluddecke, P

    1986-05-01

    Psychological correlates of gastric and duodenal ulcer disease were assessed in a group of somewhat older patients with ulcer disease identified by endoscopy. Associations between both ulcer types and symptom measures (anxiety and depression) seemed only to reflect severity or chronicity of gastrointestinal symptoms or the impending endoscopy procedure. Associations with 'trait' psychological indices may be of causal significance. Duodenal ulcer patients had higher 'introversion' and 'psychoticism' scores (on the EPQ) than controls, while gastric ulcer patients had higher psychoticism scores and 'trait anxiety' scores. These findings could not be attributed to confounding variables. When the two ulcer groups were compared, the gastric ulcer group had significantly higher neuroticism, psychoticism and hostility scores which were not attributable to confounding variables. The higher depression scores in gastric ulcer patients, however, simply reflected the greater chronicity of their physical symptoms. The groups did not differ significantly on measures of trait anxiety, tension, introversion or Type A behaviour. PMID:3726009

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

    MedlinePLUS

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

  10. Extracorporeal shockwave therapy in diabetic foot ulcers.

    PubMed

    Wang, Ching-Jen; Cheng, Jai-Hong; Kuo, Yur-Ren; Schaden, Wolfgang; Mittermayr, Rainer

    2015-12-01

    Diabetic foot ulcers (DFUs) are among the most common foot disorders with ulceration, infection, and gangrene that may ultimately lead to lower extremity amputation. The goals of treatment include the control of diabetes and proper shoe wear. An effective therapy and appropriate foot care are important in wound healing in DFUs. Recently, extracorporeal shockwave therapy (ESWT) was reported to significantly promote and accelerate the healing of complex soft tissue wounds as compared to the standard methods of treatment in DFUs. ESWT showed positive results in short-term and long-term outcomes in diabetic patients suffering from foot ulcers. In this article, we review the clinical results of ESWT in DFUs. PMID:26079500

  11. [Surgical policy in nonspecific ulcerative colitis].

    PubMed

    Navruzov, S N; Iusupbekov, A A; Khudaiarov, A A; Rustamov, A E; Sapaev, D A; Turaev, G Kh; Rakfmonov, S T

    2003-01-01

    Results of surgical treatment of 101 patients with nonspecific ulcerative colitis are analyzed. In 73 (72.3%) patients variants of abdomino-anal coloproctectomy were performed, 22 of them underwent total coloproctectomy with terminal ileo- or colostoma creation. In 21 (20.8%) patients who had no inflammatory-ulcerative process in the rectum resection of the affected part of the colon with ileo--or colorectal anastomosis was performed, in 8 cases suturing device AKA-2 was used. In 7 (6.9%) patients who had undergone total coloproctectomy S-type intestinal reservoir and reservoir-anal anastomosis were created. Rate of postoperative complications was 16.8%, lethality--3.0%. 6 months after creation of reservoir-anal anastomosis nearly complete recovery of anal sphincter function was seen that permits to regard this surgery as a method of choice in the treatment of patients with total ulcerative colitis. PMID:12744131

  12. [Buruli ulcer--Africa's latest mycobacterial scourge].

    PubMed

    Roupe, Gösta

    2003-11-01

    Buruliulcer is an extensive ulceration usually on the extremities. The ulcer can spread to subcutaneous fat, muscle and even bone causing osteomyelitis and death. It is the the third most common mycobacterial disease in humans after tuberculosis and leprosy. The bacterium grows in still standing water and infects children through small ulcerations in their skin. Mycobacterium ulcerans may also be transmitted by the bite of aquatic bugs (Naucordiae), which harbor the bacterium in their salivary glands. The disease affects poor people in rural, tropical areas where deforestation has led to flooding rivers, stagnant bodies of water and marsh. Benin, Cote d'Ivoire and Ghana in West Africa are seriously hit. Skin transplantation is the treatment of choice. Treatment with antibiotics has been disappointing. PMID:14650033

  13. A new pressure ulcer conceptual framework

    PubMed Central

    Coleman, Susanne; Nixon, Jane; Keen, Justin; Wilson, Lyn; McGinnis, Elizabeth; Dealey, Carol; Stubbs, Nikki; Farrin, Amanda; Dowding, Dawn; Schols, Jos MGA; Cuddigan, Janet; Berlowitz, Dan; Jude, Edward; Vowden, Peter; Schoonhoven, Lisette; Bader, Dan L; Gefen, Amit; Oomens, Cees WJ; Nelson, E Andrea

    2014-01-01

    Aim This paper discusses the critical determinants of pressure ulcer development and proposes a new pressure ulcer conceptual framework. Background Recent work to develop and validate a new evidence-based pressure ulcer risk assessment framework was undertaken. This formed part of a Pressure UlceR Programme Of reSEarch (RP-PG-0407-10056), funded by the National Institute for Health Research. The foundation for the risk assessment component incorporated a systematic review and a consensus study that highlighted the need to propose a new conceptual framework. Design Discussion Paper. Data Sources The new conceptual framework links evidence from biomechanical, physiological and epidemiological evidence, through use of data from a systematic review (search conducted March 2010), a consensus study (conducted December 2010–2011) and an international expert group meeting (conducted December 2011). Implications for Nursing A new pressure ulcer conceptual framework incorporating key physiological and biomechanical components and their impact on internal strains, stresses and damage thresholds is proposed. Direct and key indirect causal factors suggested in a theoretical causal pathway are mapped to the physiological and biomechanical components of the framework. The new proposed conceptual framework provides the basis for understanding the critical determinants of pressure ulcer development and has the potential to influence risk assessment guidance and practice. It could also be used to underpin future research to explore the role of individual risk factors conceptually and operationally. Conclusion By integrating existing knowledge from epidemiological, physiological and biomechanical evidence, a theoretical causal pathway and new conceptual framework are proposed with potential implications for practice and research. PMID:24684197

  14. Hot Leg Piping Materials Issues

    SciTech Connect

    V. Munne

    2006-07-19

    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).

  15. Perforated Duodenal Ulcer in a Cow

    PubMed Central

    Fatimah, I.; Butler, D. G.; Physick-Sheard, P. W.

    1982-01-01

    A case report of perforated duodenal ulcer in a ten year old Holstein cow is presented. On three occasions, sudden anorexia and rapidly progressing abdominal fluid distension were associated with metabolic alkalosis, hypochloremia and hypokalemia. Rumen fluid at the time of the second episode was acidic and contained an excessive amount of chloride ion. An abdominal mass dorsal to the abomasum involving the pylorus and several loops of small bowel was identified but not corrected at surgery. Necropsy confirmed a 1.5 cm diameter duodenal ulcer 6 cm distal to the pylorus. PMID:17422146

  16. Biological therapy for ulcerative colitis: An update

    PubMed Central

    Seo, Geom Seog; Chae, Soo-Cheon

    2014-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  18. Static Stability of Tension Leg Platforms 

    E-print Network

    Xu, Ning

    2010-07-14

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

  19. OCEAN DRILLING PROGRAM LEG 179 SCIENTIFIC PROSPECTUS

    E-print Network

    .S.A. Tom Pettigrew Chief Engineer, Leg 179 Ocean Drilling Program Texas A&M University Research Park 1000 of the cruise, actual site operations may indicate to the Co-Chief Scientists and the Operations Manager

  20. OCEAN DRILLING PROGRAM LEG 130 PRELIMINARY REPORT

    E-print Network

    Honolulu, HI 96822 D-2800 Bremen 33 Federal Republic of Germany Dr. Tom Janecek Staff Scientist, Leg 130 in the cruise. Thereportwas assembled under time constraints and is not considered to be a formal publication

  1. Passive zero-gravity leg restraint

    NASA Technical Reports Server (NTRS)

    Miller, Christopher R. (inventor)

    1989-01-01

    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.

  2. An Endangered Yellow-Legged Frog

    USGS Multimedia Gallery

    USGS biologists are leading the monitoring and reintroduction effort of the Southern California mountain yellow-legged frog -- federally listed as endangered with only 200 wild adults remaining in the mountains surrounding Los Angeles County....

  3. 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....

  4. Attitudes of Nurses Toward Pressure Ulcer Prevention: A Literature Review.

    PubMed

    Waugh, Shirley M

    2014-01-01

    Despite the existence of accepted guidelines to prevent pressure ulcers, interventions are not performed consistently. Many variables, including nurses' attitudes, contribute to the development of pressure ulcers. A review of the literature on nurses' attitudes toward pressure ulcer prevention is provided. PMID:26292449

  5. Catastrophic Bleeding From a Marginal Ulcer After Gastric Bypass

    PubMed Central

    Sidani, Shafik; Akkary, Ehab

    2013-01-01

    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

  6. Standard treatment of ulcerative colitis.

    PubMed

    Gionchetti, Paolo; Rizzello, Fernando; Habal, Flavio; Morselli, Claudia; Amadini, Cristina; Romagnoli, Rossella; Campieri, Massimo

    2003-01-01

    Ulcerative colitis (UC) is an idiopathic, chronic inflammation of the colon which may present with a range of mild to severe symptoms. The disease may be localized to the rectum or can be more extensive and involve the left side of the colon or the whole colon. Treatment in UC is directed towards inducing and maintaining remission of symptoms and mucosal inflammation. The key parameters to be assessed for the most appropriate treatment are the severity and extent of the inflammation. Meta-analyses of published trials have shown that topical treatment with 5-aminosalicylic acid (5-ASA) is the treatment of choice in active distal mild-to-moderate UC. Oral aminosalicylates are effective in both distal and extensive mild-to-moderate disease, but in distal disease, the rates of remission are lower than those obtained with topical 5-ASA. New steroids, such as budesonide and beclomethasone dipropionate (BDP), administered as enemas, constitute an alternative to 5-ASA therapy. In some studies, these have been shown to be as effective as conventional steroids but with significantly lower inhibition of plasma cortisol levels. Patients with unresponsive disease or those with more severe presentation will require oral corticosteroids and sometimes intravenous therapy. Approximately 10% of patients with unresponsive UC have severe attacks requiring hospitalization. Patients with severe disease should be managed jointly by a medical and surgical team, and intensive intravenous treatment should be started with high-dose steroids. Early recognition of failure of therapy will allow the introduction of immunosuppressive therapy with intravenous cyclosporine. Patients who respond are shifted to oral cyclosporine associated with azathioprine/6-mercaptopurine, whereas those who fail will require proctocolectomy. Oral aminosalicylates are the first-line therapy in maintenance of remission. Topical 5-ASA may play a role in distal disease. Patients who are steroid dependent can be started on azathioprine or 6-mercaptopurine although it may take up to 3 months for the treatment to become effective. They may have reversible immediate side effects, such as pancreatitis or bone marrow suppression, which disappear upon discontinuation of therapy. Close monitoring of these hematologic and biochemical parameters will improve safety. The use of biologic therapy with infliximab in more severe disease has not been established. PMID:14571113

  7. Thyrza Jagt 1509489 (TU Delft) Modeling the risk at pressure ulcers June 11, 2014 1 / 25 Modeling the risk at pressure ulcers

    E-print Network

    Vuik, Kees

    Ulcers (or bedsores or pressure sores) European Pressure Ulcer Advisory Panel: EPUAP "A pressure ulcerThyrza Jagt 1509489 (TU Delft) Modeling the risk at pressure ulcers June 11, 2014 1 / 25 Modeling the risk at pressure ulcers During patient repositioning in bed Delft University of Technology Thyrza Jagt

  8. Painful leg and moving toes syndrome

    PubMed Central

    Pandey, Sanjay

    2015-01-01

    Painful leg and moving toes (PLMT) syndrome is a distinct clinical entity and in majority of the patients there are some underlying causes related to spinal cord, cauda equina, or peripheral neuropathy. However, some cases are cryptogenic with no identifiable underlying cause. Response to treatment is disappointing in most of the cases. We report a 60-year-old lady who presented with very severe type of painful legs and moving toes (PLMT) with no underlying cause. PMID:26713024

  9. Microgravity, Mesh-Crawling Legged Robots

    NASA Technical Reports Server (NTRS)

    Behar, Alberto; Marzwell, Neville; Matthews, Jaret; Richardson, Krandalyn; Wall, Jonathan; Poole, Michael; Foor, David; Rodgers, Damian

    2008-01-01

    The design, fabrication, and microgravity flight-testing are part of a continuing development of palm-sized mobile robots that resemble spiders (except that they have six legs apiece, whereas a spider has eight legs). Denoted SpiderBots (see figure), they are prototypes of proposed product line of relatively inexpensive walking robots that could be deployed in large numbers to function cooperatively in construction, repair, exploration, search, and rescue activities in connection with exploration of outer space and remote planets.

  10. Rotational joint assembly for the prosthetic leg

    NASA Technical Reports Server (NTRS)

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

    1977-01-01

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

  11. The VCU Pressure Ulcer Summit: Collaboration to Operationalize Hospital-Acquired Pressure Ulcer Prevention Best Practice Recommendations.

    PubMed

    Brindle, C Tod; Creehan, Sue; Black, Joyce; Zimmermann, Deb

    2015-01-01

    This executive summary reports outcomes of an interprofessional collaboration between experts in pressure ulcer prevention, bedside clinicians, regulatory agencies, quality improvement, informatics experts, and professional nursing organizations. The goal of the collaboration was to develop a framework to assist facilities to operationalize best practice recommendations to sustain organizational culture change in hospital-acquired pressure ulcer prevention, to develop a hospital-acquired pressure ulcer severity score, and to address topics related to the unavoidable pressure ulcer. PMID:26010220

  12. Foot and leg conformation traits have a small effect on genomic predictions of claw disorders in Norwegian Red cows.

    PubMed

    Ødegård, C; Svendsen, M; Heringstad, B

    2015-06-01

    The aim of this study was to evaluate whether the predictive correlation of genomic breeding values (GEBV) for claw disorders increased by including genetically correlated traits as additional information in the analyses. Predictive correlations of GEBV for claw disorders were calculated based on claw disorders only and by analyzing claw disorders together with genetically correlated foot and leg conformation traits. The claw disorders analyzed were corkscrew claw (CSC); infectious claw disorder, including dermatitis, heel horn erosion, and interdigital phlegmon; and laminitis-related claw disorder, including sole ulcer, white line disorder, and hemorrhage of sole and white line. The foot and leg conformation traits included were hoof quality, foot angle, rear leg rear view new, and rear leg rear view old. The data consisted of 183,728 daughters with claw health records and 421,319 daughters with foot and leg conformation scores. A 25K/54K single nucleotide polymorphism (SNP) data set containing 48,249 SNP was available for the analyses. The number of genotyped sires with daughter information in the analyses was 1,093 including claw disorders and 3,111 including claw disorders and foot and leg conformation traits. Predictive correlations of GEBV for CSC, infectious claw disorder, and laminitis-related claw disorder were calculated from a 10-fold cross-validation and from an additional validation set including the youngest sires. Only sires having daughters with claw health records were in the validation sets, thus increasing the reference population when adding foot and leg conformation traits. The results showed marginal improvement in the predictive correlation of GEBV for CSC when including hoof quality and foot angle, both in 10-fold cross-validation (from 0.35 to 0.37) and in the validation including the youngest sires (from 0.38 to 0.49). For infectious claw disorder and laminitis-related claw disorder, including foot and leg conformation traits had no effect on the predictive correlation of GEBV. Claw disorders are novel traits with a limited amount of historical data and, therefore, a small reference population. Increasing the reference population by including sires with daughter information on foot and leg conformation traits had small effect on the predictive correlation of GEBV. However, the small increase in predictive correlation of GEBV for CSC shows a possible gain when including moderate to high genetically correlated traits. PMID:25828662

  13. Prevention and management of superficial pressure ulcers.

    PubMed

    Butcher, Martyn

    2005-06-01

    Superficial pressure ulcers--those involving the upper layers of skin--are currently the object of academic controversy, in particular regarding the influence of moisture in their formation. This article aims to steer nurses round these debates with a practical approach to preventing pressure damage, placing a strong emphasis on skin care and reduction of friction. PMID:15944501

  14. Pressure ulcers: prevention, evaluation, and management.

    PubMed

    Bluestein, Daniel; Javaheri, Ashkan

    2008-11-15

    A pressure ulcer is a localized injury to the skin or underlying tissue, usually over a bony prominence, as a result of unrelieved pressure. Predisposing factors are classified as intrinsic (e.g., limited mobility, poor nutrition, comorbidities, aging skin) or extrinsic (e.g., pressure, friction, shear, moisture). Prevention includes identifying at-risk persons and implementing specific prevention measures, such as following a patient repositioning schedule; keeping the head of the bed at the lowest safe elevation to prevent shear; using pressure-reducing surfaces; and assessing nutrition and providing supplementation, if needed. When an ulcer occurs, documentation of each ulcer (i.e., size, location, eschar and granulation tissue, exudate, odor, sinus tracts, undermining, and infection) and appropriate staging (I through IV) are essential to the wound assessment. Treatment involves management of local and distant infections, removal of necrotic tissue, maintenance of a moist environment for wound healing, and possibly surgery. Debridement is indicated when necrotic tissue is present. Urgent sharp debridement should be performed if advancing cellulitis or sepsis occurs. Mechanical, enzymatic, and autolytic debridement methods are nonurgent treatments. Wound cleansing, preferably with normal saline and appropriate dressings, is a mainstay of treatment for clean ulcers and after debridement. Bacterial load can be managed with cleansing. Topical antibiotics should be considered if there is no improvement in healing after 14 days. Systemic antibiotics are used in patients with advancing cellulitis, osteomyelitis, or systemic infection. PMID:19035067

  15. Genital Ulcers: Their Diagnosis and Management

    PubMed Central

    Sacks, Stephen L.

    1987-01-01

    This article offers some background information on diagnosis and treatment of three major causes of genital ulcers: syphilis, herpes simplex virus (HSV), and chancroid. The author also discusses differential diagnoses and suggests an approach to treatment. ImagesFigure 1Figure 2Figure 3Figure 4Figure 6Figure 7 PMID:21263799

  16. Ulcer healing activity of Mumijo aqueous extract against acetic acid induced gastric ulcer in rats

    PubMed Central

    Shahrokhi, Nader; Keshavarzi, Zakieh; Khaksari, Mohammad

    2015-01-01

    Objective: Gastric ulcer is an important clinical problem, chiefly due to extensive use of some drugs. The aim was to assess the activity of Mumijo extract (which is used in traditional medicine) against acetic acid induced gastric ulcer in rats. Materials and Methods: The aqueous extract of Mumijo was prepared. Animals were randomly (n = 10) divided into four groups: Control, sham-operated group (received 0.2 ml of acetic acid to induce gastric ulcer), Mumijo (100 mg/kg/daily) were given for 4 days postacetic acid administration, and ranitidine group (20 mg/kg). The assessed parameters were pH and pepsin levels (by Anson method) of gastric contents and gastric histopathology. Ranitidine was used as reference anti-ulcer drug. Results: The extract (100 mg/kg/daily, p.o.) inhibited acid acetic-induced gastric ulceration by elevating its pH versus sham group (P < 0.01) and decreasing the pepsin levels compared to standard drug, ranitidine (P < 0.05). The histopathology data showed that the treatment with Mumijo extract had a significant protection against all mucosal damages. Conclusion: Mumijo extract has potent antiulcer activity. Its anti-ulcer property probably acts via a reduction in gastric acid secretion and pepsin levels. The obtained results support the use of this herbal material in folk medicine. PMID:25709338

  17. Malnutrition as a Precursor of Pressure Ulcers

    PubMed Central

    Litchford, Mary D.; Dorner, Becky; Posthauer, Mary Ellen

    2014-01-01

    Significance: Numerous studies have reported associations between declining nutrition status and risk for pressure ulcers. Oral eating problems, weight loss, low body weight, undernutrition, and malnutrition are associated with an increased risk for pressure ulcers. Moreover, inadequate nutrient intake and low body weight are associated with slow and nonhealing wounds. However, the biologic significance of deterioration in nutrition status and consistent methodologies to quantify malnutrition and diminished micronutrient stores as predictors of skin breakdown remains controversial. Recent Advances: The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (ASPEN) Consensus Statement: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition provide a standardized and measureable set of criterion for all health professionals to use to identify malnutrition. The Agency for Healthcare Research and Quality identified malnutrition as one of the common geriatric syndromes associated with increased risk for institutionalization and mortality that may be impacted by primary and secondary preventions. Critical Issues: The purpose of this article is to examine the Academy/ASPEN consensus statement on characteristics of adult malnutrition in the context of the National Pressure Ulcer Advisory Panel (NPUAP)/European Pressure Ulcer Advisory Panel (EPUAP) Guidelines on the Prevention and Treatment of Pressure Ulcers. Future Directions: Moreover, clinicians, and in particular, registered dietitians have the opportunity to integrate the Characteristics of Malnutrition with the NPUAP/EPUAP 2009 Prevention and Treatment Clinical Practice Guidelines, into clinical assessment and documentation using the Nutrition Care Process. Consensus guidelines will provide consistent research criteria yielding more useful data than presently available. PMID:24761345

  18. Abomasal ulcers in captive white-tailed deer (Odocoileus virginianus).

    PubMed

    Palmer, M V; Waters, W R; Whipple, D L

    2001-01-01

    Abomasal ulceration was noted in 32 of 200 white-tailed deer. Ulceration was most common in the abomasal pylorus and at the abomasal-duodenal junction. Abomasal ulceration was characterized by focal to multifocal, sharply demarcated areas of coagulation necrosis and haemorrhage extending through the mucosa, with fibrin thrombi in mucosal blood vessels of small diameter. Ulcerated areas were often covered by a mixture of mucus, debris and neutrophils. Visible bacteria were not associated with ulcerative lesions. All deer with abomasal ulceration had intercurrent disease, including bacterial pneumonia, enterocolitis, intussusception, chronic diarrhoea, capture myopathy, or experimentally induced tuberculosis. The anatomical distribution of abomasal ulcers in this population of captive white-tailed deer resembled that seen in veal calves. PMID:11578141

  19. The role of nutrition for pressure ulcer management: national pressure ulcer advisory panel, European pressure ulcer advisory panel, and pan pacific pressure injury alliance white paper.

    PubMed

    Posthauer, Mary Ellen; Banks, Merrilyn; Dorner, Becky; Schols, Jos M G A

    2015-04-01

    Nutrition and hydration play an important role in preserving skin and tissue viability and in supporting tissue repair for pressure ulcer (PrU) healing. The majority of research investigating the relationship between nutrition and wounds focuses on PrUs. This white paper reviews the 2014 National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, and Pan Pacific Pressure Injury Alliance Nutrition Guidelines and discusses nutrition strategies for PrU management. PMID:25775201

  20. Become the PPUPET Master: Mastering Pressure Ulcer Risk Assessment With the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET).

    PubMed

    Sterken, David J; Mooney, JoAnn; Ropele, Diana; Kett, Alysha; Vander Laan, Karen J

    2015-01-01

    Hospital acquired pressure ulcers (HAPU) are serious, debilitating, and preventable complications in all inpatient populations. Despite evidence of the development of pressure ulcers in the pediatric population, minimal research has been done. Based on observations gathered during quarterly HAPU audits, bedside nursing staff recognized trends in pressure ulcer locations that were not captured using current pressure ulcer risk assessment tools. Together, bedside nurses and nursing leadership created and conducted multiple research studies to investigate the validity and reliability of the Pediatric Pressure Ulcer Prediction and Evaluation Tool (PPUPET). PMID:25450444

  1. Changes in leg volume during microgravity simulation

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

    Little published information exists regarding the magnitude and time course of cephalad fluid shift resulting from microgravity simulations. Six subjects were exposed to 150 min each at horizontal bed rest, 6-deg head-down tilt, and horizontal water immersion. Fluid shift was estimated by calculating leg volumes from eight serial girth measurements from groin to ankle before, during, and after exposure. Results were compared with data from the first 3 h of spacecraft. By the end of exposure, total leg volume for the six subjects decreased by 2.6 +/- 0.8 percent, 1.7 +/- 1.2 percent, and 4.0 +/- 1.6 percent for horizontal, head-down, and immersion, respectively. Changes had plateaued for horizontal and head-down and had slowed for immersion. Relatively more fluid was lost from the lower leg than the thigh for all three conditions, particularly head-down. During the first 3 h of spaceflight, total leg volume decreased by 8.6 percent, and relatively more fluid was lost from the thigh than the lower leg. The difference in volume changes in microgravity and simulated microgravity may be caused by the small transverse pressures still present in ground-based simulations and the extremely nonlinear compliance of tissue.

  2. Illness meanings and experiences for pre-ulcer and ulcer conditions of Buruli ulcer in the Ga-West and Ga-South Municipalities of Ghana

    PubMed Central

    2012-01-01

    Background Ghana is a Buruli ulcer (BU) endemic country yet there is paucity of socio-cultural research on BU. Examining distinctive experiences and meanings for pre-ulcers and ulcers of BU may clarify the disease burden, illness experience and local perceptions of causes and spread, and environmental features of BU, which are useful to guide public health programmes and future research. This study aimed to explain local meanings and experiences of BU for persons with pre-ulcers and ulcers in the Ga-West and Ga-South municipalities in Accra. Methods Semi-structured interviews based on the Explanatory Model Interview Catalogue framework were administered to 181 respondents comprising 15 respondents with pre-ulcers and 166 respondents with ulcers. The Wilcoxon rank-sum test was used to compare categories of illness experiences (PD) and perceived causes (PC) among respondents with pre-ulcer and ulcer conditions. The Fisher’s exact test was used to compare the most troubling PD and the most important PC variables. Qualitative phenomenological analysis of respondents’ narratives clarified illness experiences and meanings with reference to PC and PD variables. Results Families of respondents with pre-ulcers and the respondents themselves were often anxious about disease progression, while families of respondents with ulcers, who had to give care, worried about income loss and disruption of school attendance. Respondents with pre-ulcers frequently reported swimming in ponds and rivers as a perceived cause and considered it as the most important PC (53.3%). Respondents with ulcers frequently attributed their BU illness to witchcraft (64.5%) and respondents who claimed they had no water contact, questioned the credibility of health messages Conclusions Affected persons with pre-ulcers are likely to delay treatment because of social and financial constraints and the absence of pain. Scepticism on the role of water in disease contagion and prolonged healing is perceived to make ideas of witchcraft as a PC more credible, among respondents with ulcers. Health messages should address issues of locally perceived risk and vulnerability. Guided by study findings, further research on the role of environmental, socio-cultural and genetic factors in BU contagion, is also needed to clarify and formulate health messages and strengthen public health initiatives. PMID:22471884

  3. Probabilistic Mechanical Reliability Prediction of Thermoelectric Legs

    SciTech Connect

    Jadaan, Osama M.; Wereszczak, Andrew A

    2009-05-01

    The probability of failure, Pf, for various square-arrayed thermoelectric device designs using bismuth telluride, lead telluride, or skutterudite thermoelectric materials were estimated. Only volume- or bulk-based Pf analysis was considered in this study. The effects of the choice of the thermoelectric material, the size of the leg array, the height of the thermoelectric legs, and the boundary conditions on the Pf of thermoelectric devices were investigated. Yielding of the solder contacts and mounting layer was taken into account. The modeling results showed that the use of longer legs, using skutterudites, allowing the thermoelectric device to freely deform while under a thermal gradient, and using smaller arrays promoted higher probabilities of survival.

  4. Plantar Pressure in Diabetic Peripheral Neuropathy Patients with Active Foot Ulceration, Previous Ulceration and No History of Ulceration: A Meta-Analysis of Observational Studies

    PubMed Central

    Fernando, Malindu Eranga; Crowther, Robert George; Pappas, Elise; Lazzarini, Peter Anthony; Cunningham, Margaret; Sangla, Kunwarjit Singh; Buttner, Petra; Golledge, Jonathan

    2014-01-01

    Aims Elevated dynamic plantar pressures are a consistent finding in diabetes patients with peripheral neuropathy with implications for plantar foot ulceration. This meta-analysis aimed to compare the plantar pressures of diabetes patients that had peripheral neuropathy and those with neuropathy with active or previous foot ulcers. Methods Published articles were identified from Medline via OVID, CINAHL, SCOPUS, INFORMIT, Cochrane Central EMBASE via OVID and Web of Science via ISI Web of Knowledge bibliographic databases. Observational studies reporting barefoot dynamic plantar pressure in adults with diabetic peripheral neuropathy, where at least one group had a history of plantar foot ulcers were included. Interventional studies, shod plantar pressure studies and studies not published in English were excluded. Overall mean peak plantar pressure (MPP) and pressure time integral (PTI) were primary outcomes. The six secondary outcomes were MPP and PTI at the rear foot, mid foot and fore foot. The protocol of the meta-analysis was published with PROPSERO, (registration number CRD42013004310). Results Eight observational studies were included. Overall MPP and PTI were greater in diabetic peripheral neuropathy patients with foot ulceration compared to those without ulceration (standardised mean difference 0.551, 95% CI 0.290–0.811, p<0.001; and 0.762, 95% CI 0.303–1.221, p?=?0.001, respectively). Sub-group analyses demonstrated no significant difference in MPP for those with neuropathy with active ulceration compared to those without ulcers. A significant difference in MPP was found for those with neuropathy with a past history of ulceration compared to those without ulcers; (0.467, 95% CI 0.181– 0.753, p?=?0.001). Statistical heterogeneity between studies was moderate. Conclusions Plantar pressures appear to be significantly higher in patients with diabetic peripheral neuropathy with a history of foot ulceration compared to those with diabetic neuropathy without a history of ulceration. More homogenous data is needed to confirm these findings. PMID:24915443

  5. Sympathetic adaptations to one-legged training

    NASA Technical Reports Server (NTRS)

    Ray, C. A.

    1999-01-01

    The purpose of the present study was to determine the effect of leg exercise training on sympathetic nerve responses at rest and during dynamic exercise. Six men were trained by using high-intensity interval and prolonged continuous one-legged cycling 4 day/wk, 40 min/day, for 6 wk. Heart rate, mean arterial pressure (MAP), and muscle sympathetic nerve activity (MSNA; peroneal nerve) were measured during 3 min of upright dynamic one-legged knee extensions at 40 W before and after training. After training, peak oxygen uptake in the trained leg increased 19 +/- 2% (P < 0.01). At rest, heart rate decreased from 77 +/- 3 to 71 +/- 6 beats/min (P < 0.01) with no significant changes in MAP (91 +/- 7 to 91 +/- 11 mmHg) and MSNA (29 +/- 3 to 28 +/- 1 bursts/min). During exercise, both heart rate and MAP were lower after training (108 +/- 5 to 96 +/- 5 beats/min and 132 +/- 8 to 119 +/- 4 mmHg, respectively, during the third minute of exercise; P < 0.01). MSNA decreased similarly from rest during the first 2 min of exercise both before and after training. However, MSNA was significantly less during the third minute of exercise after training (32 +/- 2 to 22 +/- 3 bursts/min; P < 0.01). This training effect on MSNA remained when MSNA was expressed as bursts per 100 heartbeats. Responses to exercise in five untrained control subjects were not different at 0 and 6 wk. These results demonstrate that exercise training prolongs the decrease in MSNA during upright leg exercise and indicates that attenuation of MSNA to exercise reported with forearm training also occurs with leg training.

  6. Leg Spasticity and Ambulation in Multiple Sclerosis

    PubMed Central

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

    2014-01-01

    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

  7. [The influence of the leg load and the support mobility under leg on the anticipatory postural adjustment].

    PubMed

    Kazennikov, O V; Kireeva, T B; Shlykov, V Iu

    2015-01-01

    Anticipatory postural adjustment is an essential part of equilibrium maintainance during standing in human. So changes in stance condition could affect both control of equilibrium and anticipatory adjustment. Anticipatory changes in the stabilogram of each leg were studied in standing subject during the early stage of quick right arm lifting while legs were on two separated supports. The center of pressure (CP) movement was analyzed in three variants of experiment: both legs on immovable support, with only right leg on the movable support and with only left leg on the moveable support. In each standing condition subject stood with symmetrical load on two legs or with the load voluntary transferred to one leg. The anticipatory CP shift depended on the mobility of the support under the leg and on loading of the leg. While standing on unmovable supports with symmetrical load on the legs before lifting of the right arm CP of right leg shifted backward and CP of left leg--forward. While standing with one leg on movable support the anticipatory CP shift of this leg was small and did not depend on the load on the leg. However the shift of CP of the leg that was placed on the unmovable support depended on the load in the same way as in the case when both legs were on unmovable supports. Results suggested that since on movable support the support and proprioceptive afferent flow from distal part of the leg that was did not supply unambiguous information about body position, the role of distal joints in posture control is reduced. PMID:25857178

  8. Treatment of ulcers with ablative fractional lasers.

    PubMed

    Morton, Laurel M; Dover, Jeffrey S; Phillips, Tania J; Krakowski, Andrew C; Uebelhoer, Nathan S

    2015-03-01

    Chronic, nonhealing ulcers are a frustrating therapeutic challenge and investigation of innovative therapies continues to be an important research pursuit. One unique and newly applied intervention is the use of ablative fractional lasers. This technology has recently been employed for the treatment of hypertrophic, disfiguring and function-limiting scars, and was first shown to induce healing of chronic wounds in patients with persistent ulcers and erosions within traumatic scars. Recent reports suggest it may be applicable for other types of chronic wounds as well. The mechanism of action for this modality remains to be elucidated but possible factors include laser-induced collagen remodeling, photomicrodebridement and disruption of biofilms, and induction of a proper wound healing cascade. PMID:25922956

  9. Respiratory-Related Leg Movements and Their Relationship with Periodic Leg Movements During Sleep

    PubMed Central

    Manconi, Mauro; Zavalko, Irina; Bassetti, Claudio L.; Colamartino, Elisabetta; Pons, Marco; Ferri, Raffaele

    2014-01-01

    Study Objectives: To describe the time structure of leg movements (LM) in obstructive sleep apnea (OSA) syndrome, in order to advance understanding of their clinical significance. Location: Sleep Research Centre, Oasi Institute (IRCCS), Troina, Italy. Setting: Sleep laboratory. Patients: Eighty-four patients (16 females, 68 males, mean age 55.1 y, range 29-74 y). Methods: Respiratory-related leg movements (RRLM) and those unrelated to respiratory events (NRLM) were examined within diagnostic polysomnograms alone and together for their distributions within the sleep period and for their periodicity. Measurements and Results: Patients with OSA and RRLM exhibited more periodic leg movements in sleep (PLMS), particularly in NREM sleep. A gradual decrease in number of NRLM across the sleep period was observed in patients with RRLM. This pattern was less clear for RRLM. Frequency histograms of intermovement intervals of all LMs in patients with RRLM showed a prominent first peak at 4 sec, and a second peak at approximately 24 sec coincident with that of PLMS occurring in the absence of OSA. A third peak of lowest amplitude was the broadest with a maximum at approximately 42 sec. In patients lacking RRLM, NRLM were evident with a single peak at 2-4 sec. A stepwise linear regression analysis showed that, after controlling for a diagnosis of restless legs syndrome and apnea-hypopnea index, PLMS remained significantly associated with RRLM. Conclusion: The time structure of leg movements occurring in conjunction with respiratory events exhibit features of periodic leg movements in sleep occurring alone, only with a different and longer period. This brings into question the validity, both biologic and clinical, of scoring conventions with their a priori exclusion from consideration as periodic leg movements in sleep. Citation: Manconi M; Zavalko I; Bassetti CL; Colamartino E; Pons M; Ferri R. Respiratory-related leg movements and their relationship with periodic leg movements during sleep. SLEEP 2014;37(3):497-504. PMID:24587572

  10. Guidelines for evaluating decubitus ulcer research.

    PubMed

    Abruzzese, R S

    1989-02-01

    The classic critique of research is applied to a systematic evaluation of the components of research reports and company literature related to pressure ulcer products and devices. Emphasis is on the need to control variables that influence the findings; some of these are: relief of pressure, nutrition and hydration, comparability of subjects, the Hawthorne Effect and the Pygmalion Effect. Replication of research before adopting products/devices for protocol use is advocated. PMID:2751832

  11. [Zantac (ranitidine) in treating duodenal ulcers].

    PubMed

    Vasil'ev, Iu V

    2002-01-01

    There are the results of the examination and treatment of 68 patients with duodenal ulcers, 52 of them having the Helicobacter pylori (HP) semination of the mucous coat of stomach revealed by the histologic method and/or fast urease test before the treatment. The healing of the duodenal bulb ulcer was recorded in 82.7% of cases in this group of patients after the four-week treatment (ranitidine, 150 mg b.i.d. for four weeks in combination with amoxicillin, 500 mg q.i.d., and metronidazole, 500 mg b.i.d. for the initial ten-day period); the healing of ulcers was recorded in 81.3% of cases in the second group of patients who had no HP revealed and were treated only with ranitidine, 150 mg b.i.d. for four weeks. The eradication of HP in the first group of patients was recorded in 86.5% of cases after 28-42 days following the termination of the treatment. PMID:12353395

  12. Effect of Helicobacter pylori eradication on peptic ulcer healing.

    PubMed Central

    O'Connor, H. J.; Kanduru, C.; Bhutta, A. S.; Meehan, J. M.; Feeley, K. M.; Cunnane, K.

    1995-01-01

    In a prospective study designed to assess the effect of Helicobacter pylori eradication on peptic ulcer healing, 85 consecutive patients with H. pylori-positive peptic ulcer disease were treated with a triple therapy regimen consisting of colloidal bismuth subcitrate 120 mg four times daily for 28 days, with metronidazole 400 mg three times daily and tetracycline 500 mg three times daily for the first seven days of treatment. H. pylori status was assessed by CLO test and histology at least four weeks after completing therapy. Of 75 patients (88%) H. pylori-negative after therapy, 69 (92%) had healed ulcers compared with only five of 10 patients (50%) who remained H. pylori-positive (p = 0.003). Cigarette smoking had no significant effect on ulcer healing. Our results suggest that H. pylori eradication may accelerate ulcer healing and provide further evidence that an effective helicobactericidal regimen is the treatment of choice in H. pylori-positive peptic ulcer. PMID:7724441

  13. A colored leg banding technique for Amazona parrots

    USGS Publications Warehouse

    Meyers, J.M.

    1995-01-01

    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.

  14. Leg Injuries and Disorders - Multiple Languages: MedlinePlus

    MedlinePLUS

    ... Exercises: Lying (Arabic) ??????? Bilingual PDF Health Information Translations Active Leg Range of Motion Exercises: Sitting (Arabic) ??????? Bilingual PDF Health Information Translations French (français) Active Leg Range of Motion Exercises: ...

  15. OCEAN DRILLING PROGRAM LEGS 143 AND 144 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEGS 143 AND 144 SCIENTIFIC PROSPECTUS NORTHWEST PACIFIC ATOLLS AND GUYOTS Abstract Legs 143 and 144 constitute an integrated campaign of drilling Cretaceous reef-bearing guyots

  16. Tandem wheel drop-legs for standard truck trailer

    NASA Technical Reports Server (NTRS)

    Cantwell, W.; Selstad, R.

    1970-01-01

    Tandem wheel drop-leg device provides a semitrailer with fore and aft mobility that allows it to be moved without a prime mover. The modified drop-legs have trunnion dual wheels and an adjustable brace.

  17. 11. NORTH VIEW OF INNER FACING OF SOUTHEASTERN LEG OF ...

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

    11. NORTH VIEW OF INNER FACING OF SOUTHEASTERN LEG OF SEA WALL. SOUTHERN END OF NORTHEASTERN LEG OF SEA WALL IN BACKGROUND. - Fort Delaware, Sea Wall, Pea Patch Island, Delaware City, New Castle County, DE

  18. X-Ray Exam: Lower Leg (Tibia and Fibula)

    MedlinePLUS

    ... Deal With Bullies Pregnant? What to Expect X-Ray Exam: Lower Leg (Tibia and Fibula) KidsHealth > Parents > Doctors & Hospitals > Medical Tests & Exams > X-Ray Exam: Lower Leg (Tibia and Fibula) Print A ...

  19. A quality improvement programme to reduce pressure ulcers.

    PubMed

    Heywood, Nicola; Brown, Lisa; Arrowsmith, Michaela; Poppleston, Alexa

    2015-07-15

    This article outlines an innovative way of preventing pressure ulcers in the acute hospital setting. A programme using Rapid Spread Methodology was undertaken to reduce hospital-acquired pressure ulcers over a short period of time. Results demonstrated a reduction to zero in the prevalence of hospital-acquired pressure ulcers and an 80% reduction in their incidence, in a six-month period. PMID:26174287

  20. Anti-ulcer activity of essential oil constituents.

    PubMed

    Oliveira, Francisco de Assis; Andrade, Luciana Nalone; de Sousa, Elida Batista Vieira; de Sousa, Damião Pergentino

    2014-01-01

    Essential oils have attracted considerable worldwide attention over the last few decades. These natural products have wide-ranging pharmacological activities and biotechnological applications. Faced with the need to find new anti-ulcer agents and the great effort on the development of drugs for the treatment of ulcers, in this review, the anti-ulcer activities of 21 bioactive compounds found in essential oils are discussed. PMID:24802985

  1. Options for Treating Restless Legs Syndrome

    MedlinePLUS

    ... pump to squeeze your legs during the night Near-infrared light therapy: treatments with a device that uses near-infrared ... Pneumatic compression devices work to lessen RLS symptoms. Near-infrared light therapy may help lessen RLS symptoms, but more research ...

  2. Integrated system for single leg walking

    NASA Astrophysics Data System (ADS)

    Simmons, Reid; Krotkov, Eric; Roston, Gerry

    1990-07-01

    The Carnegie Mellon University Planetary Rover project is developing a six-legged walking robot capable of autonomously navigating, exploring, and acquiring samples in rugged, unknown environments. This report describes an integrated software system capable of navigating a single leg of the robot over rugged terrain. The leg, based on an early design of the Ambler Planetary Rover, is suspended below a carriage that slides along rails. To walk, the system creates an elevation map of the terrain from laser scanner images, plans an appropriate foothold based on terrain and geometric constraints, weaves the leg through the terrain to position it above the foothold, contacts the terrain with the foot, and applies force enough to advance the carriage along the rails. Walking both forward and backward, the system has traversed hundreds of meters of rugged terrain including obstacles too tall to step over, trenches too deep to step in, closely spaced obstacles, and sand hills. The implemented system consists of a number of task-specific processes (two for planning, two for perception, one for real-time control) and a central control process that directs the flow of communication between processes.

  3. OCEAN DRILLING PROGRAM LEG 140 SCIENTIFIC PROSPECTUS

    E-print Network

    , through the dike/gabbro and/or layer 2/3 transition. Located in 5.9-m.y.-old crust, Hole 504B is perhaps and the underlying gabbros in the context of a complete crustal section. Leg 140 is scheduled for 16 September to 12

  4. OCEAN DRILLING PROGRAM LEG 137 SCIENTIFIC PROSPECTUS

    E-print Network

    deepening through the dike/gabbro and/or Layer 2/3 transition(s). Located in 5.9-m.y.-old crust, Hole 504B and underlying gabbros in the context of a complete crustal section. The leg is scheduled for 21 March to 1 May

  5. OCEAN DRILLING PROGRAM LEG 138 SCIENTIFIC PROSPECTUS

    E-print Network

    Corvallis, Oregon 97331-5503 Canada Dr. Tom Janecek Staff Scientist, Leg 138 Ocean Drilling Program Texas A. This Scientific Prospectus is based on pre-cruise site-survey information and JOIDES panel discussions of the cruise, actual site operations may indicate to the Co-Chief Scientists and the Operations Superintendent

  6. OCEAN DRILLING PROGRAM LEG 156 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 156 SCIENTIFIC PROSPECTUS NORTHERN BARBADOS RIDGE Dr. Tom Shipley Dr, or Texas A&M Research Foundation. This Scientific Prospectus is based on pre-cruise JOIDES panel. During the course of the cruise, actual site operations may indicate to the Co-Chief Scientists

  7. OCEAN DRILLING PROGRAM LEG 127 PRELIMINARY REPORT

    E-print Network

    Tamaki Co-Chief Scientist, Ixg 127 Co-Chief Scientist, Leg 127 7547 Terrace Drive Ocean Research (7547 Terrace Drive, El Cerrito, California 94530) Kensaku Tamaki, Co-Chief Scientist (Ocean Research (Center for Marine Science, University of Southern Mississippi, Stennis Space Center, Mississippi 39529

  8. OCEAN DRILLING PROGRAM LEG 180 PRELIMINARY REPORT

    E-print Network

    24 rue Lhomond 75231 Paris Cedex 05 France Dr. Brian Taylor School of Ocean and Earth Science Taylor School of Ocean and Earth Science and Technology University of Hawaii at Manoa 2525 Correa RoadOCEAN DRILLING PROGRAM LEG 180 PRELIMINARY REPORT ACTIVE CONTINENTAL EXTENSION IN THE WESTERN

  9. A biological screw in a beetle's leg.

    PubMed

    van de Kamp, Thomas; Vagovi?, Patrik; Baumbach, Tilo; Riedel, Alexander

    2011-07-01

    The coxa-trochanteral joints on the legs of the weevil Trigonopterus oblongus (Pascoe) work as a biological screw-and-nut system. The apical portions of the coxae closely resemble nuts with well-defined inner threads covering 345°. The corresponding trochanters have perfectly compatible external spiral threads of 410°. PMID:21719669

  10. OCEAN DRILLING PROGRAM LEG 101 PRELIMINARY REPORT

    E-print Network

    Wolfgang Schlager Co-Chief Scientist, Leg 101 Rosenstiel School of Marine and Atmospheric Sciences 4600, Jr. (University of Texas Institute for Geophysics, Austin, Texas) Co-Chief Scientist Wolfgang Schlager (Rosenstiel School of Marine and Atmospheric Sciences, Miami, Florida) Co-Chief Scientist Paul

  11. Leg Pain in a Manual Laborer.

    PubMed

    Atluri, Prashanthi; Glancy, D Luke

    2015-12-01

    A man admitted for deep vein thrombosis of his leg is found to have an important unrelated electrocardiographic abnormality. In the second paragraph, either reinsert the comma after V1 in the fifth line or remove the comma after enlargement in the fourth line. PMID:26428024

  12. OCEAN DRILLING PROGRAM LEG 150 PRELIMINARY REPORT

    E-print Network

    -Pierre Aubry (LGQ, C.N.R.S. Lummy-Case 907, 13288 Marseille Cedex 9, France) Lloyd H. Burckle (Lamont-Doherty S. Mountain Co-Chief Scientist, Leg 150 Lamont-Doherty Earth Observatory Columbia University Sciences Rutgers, The State University New Brunswick, New Jersey 08903 U.S.A. Dr. Peter Blum Staff

  13. OCEAN DRILLING PROGRAM LEG 165 SCIENTIFIC PROSPECTUS

    E-print Network

    502, the Caribbean has not been targeted by the Ocean Drilling Program or Deep Sea Drilling ProjectOCEAN DRILLING PROGRAM LEG 165 SCIENTIFIC PROSPECTUS CARIBBEAN OCEAN HISTORY AND THE CRETACEOUS and Safety Panel. #12;ABSTRACT The Caribbean region presents a wide array of geologic problems related to its

  14. OCEAN DRILLING PROGRAM LEG 173 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 173 SCIENTIFIC PROSPECTUS RETURN TO IBERIA Dr. R.B. Whitmarsh Co The Galicia Bank and Iberia Abyssal Plain segments of the west Iberia margin were drilled during Ocean landward and oceanward limits to the ocean- continent transition (OCT) of the crust off western Iberia

  15. OCEAN DRILLING PROGRAM LEG 115 PRELIMINARY REPORT

    E-print Network

    of Geology, Durham, NC 27708) Alistair Baxter (City of London Polytechnic Geology Department, Bigland Street Dr. Jan Backman Co-Chief Scientist, Leg 115 Department of Geology University of Stockholm S-106 91 State College Department of Geological Sciences, Salem, MA 01970) Andre Droxler (Rice University

  16. OCEAN DRILLING PROGRAM LEG 132 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 132 PRELIMINARY REPORT ENGINEERING II: WESTERN AND CENTRAL PACIFIC Mr. Michael A. Storms Supervisor of Development Engineering Ocean Drilling Program Texas A&M University and Drilling Operations ODP/TAMU Timothy J.G. Francis Deputy Director ODP/TAMU September 1990 #12;This informal

  17. OCEAN DRILLING PROGRAM LEG 199 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 199 SCIENTIFIC PROSPECTUS PALEOGENE EQUATORIAL TRANSECT Dr. Mitchell __________________ Dr. Jack Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University Project Manager and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive

  18. OCEAN DRILLING PROGRAM LEG 104 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 104 SCIENTIFIC PROSPECTUS NORWEGIAN SEA Olav Eldholm Co-Chief Scientist Ocean Drilling Program Texas A & M University College Station, Texas 77843-3469 Pni±ip o Rabinowitz Director Ocean Drilling Program Robert B Kidd Manager of Science Operations Ocean Drilling Program Louis E

  19. OCEAN DRILLING PROGRAM LEG 195 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 195 SCIENTIFIC PROSPECTUS MARIANA CONVERGENT MARGIN/ WEST PHILIPPINE SEA Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX

  20. OCEAN DRILLING PROGRAM LEG 202 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 202 SCIENTIFIC PROSPECTUS SOUTHEAST PACIFIC PALEOCEANOGRAPHIC TRANSECTS __________________ Dr. Jack Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University Manager and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College

  1. OCEAN DRILLING PROGRAM LEG 109 PRELIMINARY REPORT

    E-print Network

    OCEAN DRILLING PROGRAM LEG 109 PRELIMINARY REPORT BARE ROCK DRILLING IN THE MID-ATLANTIC RIDGE RIFT 109 Ocean Drilling Program Texas A & M University College Station, TX 77843-3469 Philip D. Rabinowitz Director Ocean Drilling Program Robert B. Kidd Manager of Science Operations Ocean Drilling Program Louis E

  2. OCEAN DRILLING PROGRAM LEG 120 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 120 SCIENTIFIC PROSPECTUS CENTRAL KERGUELEN PLATEAU Dr. Roland Schlich Drilling Program Texas A&M University College Station, TX 77841 Philip D.VRabinowitz Director ^^~-- ODP of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000 Discovery Drive, College Station

  3. OCEAN DRILLING PROGRAM LEG 185 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 185 SCIENTIFIC PROSPECTUS IZU-MARIANA MARGIN Dr. Terry Plank Co France Dr. Carlota Escutia Staff Scientist Ocean Drilling Program Texas A&M University Research Park 1000 the written consent of the Director, Ocean Drilling Program, Texas A&M University Research Park, 1000

  4. OCEAN DRILLING PROGRAM LEG 200 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 200 SCIENTIFIC PROSPECTUS DRILLING AT THE H2O LONG-TERM SEAFLOOR Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA

  5. OCEAN DRILLING PROGRAM LEG 196 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 196 SCIENTIFIC PROSPECTUS LOGGING WHILE DRILLING AND ADVANCED CORKS Deputy Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station TX 77845-9547 USA

  6. OCEAN DRILLING PROGRAM LEG 192 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 192 SCIENTIFIC PROSPECTUS BASEMENT DRILLING OF THE ONTONG JAVA PLATEAU of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College Station, TX Drilling Program Texas A&M University 1000 Discovery Drive College Station, TX 77845-9547 U.S.A. May 2000

  7. OCEAN DRILLING PROGRAM LEG 205 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 205 SCIENTIFIC PROSPECTUS FLUID FLOW AND SUBDUCTION FLUXES ACROSS __________________ Dr. Jack Baldauf Deputy Director of Science Operations Ocean Drilling Program Texas A&M University Manager and Staff Scientist Ocean Drilling Program Texas A&M University 1000 Discovery Drive College

  8. OCEAN DRILLING PROGRAM LEG 191 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 191 SCIENTIFIC PROSPECTUS NORTHWEST PACIFIC SEISMIC OBSERVATORY AND HAMMER DRILL ENGINEERING TESTS Dr. Toshihiko Kanazawa Co-Chief Scientist Earthquake Research Institute Director of Science Operations Ocean Drilling Program Texas A&M University 1000 Discovery Drive College

  9. [Secondary leg edema--experimental study].

    PubMed

    Gregl, A

    1988-12-01

    Peripheral lymphedema can be induced experimentally by obliteration or destruction of the veins and/or lymphatics, extirpation of the lymph nodes and occlusion of lymphatics, circular incision of the soft tissues, experimentally induced thrombophlebitis and by simultaneous traumatization of the veins and lymphatics. Our own animal experiments were designed to provoke leg edema after ligation of the femoral vein and/or accompanying lymphatics below the inguinal ligament. In 23 animals, only one ligature of the femoral vein was applied, below the inguinal ligament and in 12 animals all accompanying lymphatics were ligated in addition. In all animals, the leg circumferences were measured in three precisely fixed positions before the experiments and daily for 22 days during the experiment. The greatest increase in circumference was found in the lower leg irrespective of the time of measurement. The peak increase of circumference was between the third and sixth day after the operation. Permanent lymph edema has not developed in any of the animals. At the latest after three weeks, the leg circumference has normalized. Additional ligation of the lymphatics merely led to a nonsignificant increase in circumference and to displacement of the maximum point by two to three days. Immediately after the operation, phlebographic and lymphographic control investigations were carried out in all animals. PMID:3245261

  10. Navigation Planning for Legged Robots Thesis Proposal

    E-print Network

    just flat, obstacle-free floors, they grow closer to fulfilling the potential of legged locomotion. Furthermore, when a robot must spend a significant amount of time supported by a single foot, the contact that foot makes with the ground is very important for stability, requiring that the robot properly as- sess

  11. Acute leg volume changes in weightlessness and its simulation

    NASA Technical Reports Server (NTRS)

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

    1992-01-01

    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.

  12. [Guided growth in children and adolescents. Correction of leg length discrepancies and leg axis deformities].

    PubMed

    Vogt, B; Schiedel, F; Rödl, R

    2014-03-01

    The treatment of crooked legs and unequal leg length is one of the key tasks of orthopedic surgery. While mature patients usually require complex and invasive surgical interventions, the growth potential of the physes can be used to advantage for correction of these leg length discrepancies and axis deformities of the legs in growing children and adolescents. This guided growth is induced by temporary or permanent and partial or complete arrest of the growth plate, depending on the indications. This technique is called epiphysiodesis. Although these procedures are principally less invasive with few complications, accurate preoperative indications and planning, precise surgical techniques and careful postoperative follow-up examinations are mandatory prerequisites to achieve the desired therapeutic target. PMID:24627039

  13. Device-related atypical pressure ulcer after cardiac surgery.

    PubMed

    Glasgow, D; Millen, I S; Nzewi, O C; Varadarajaran, B

    2014-08-01

    Medical devices must be closely monitored to prevent harm to patients. Pressure ulcers secondary to medical devices present a significant health burden in terms of length of stay in hospital and cost. Intensivists, anaesthetists and other professionals involved in managing critically ill patients following cardiac surgery need to be aware that pressure ulcers may develop in atypical sites and present at a later stage of the hospital stay. This case report highlights the important issue of device-related pressure ulcers in the cardiac surgical intensive care setting, particularly when the clinical status of the patient may preclude routine assessment and prophylaxis. An algorithm for preventing such pressure ulcers is suggested. PMID:25139595

  14. Incidence and clinical features of endoscopic ulcers developing after gastrectomy

    PubMed Central

    Chung, Woo Chul; Jeon, Eun Jung; Lee, Kang-Moon; Paik, Chang Nyol; Jung, Sung Hoon; Oh, Jung Hwan; Kim, Ji Hyun; Jun, Kyong-Hwa; Chin, Hyung Min

    2012-01-01

    AIM: To determine the precise incidence and clinical features of endoscopic ulcers following gastrectomy. METHODS: A consecutive series of patients who underwent endoscopic examination following gastrectomy between 2005 and 2010 was retrospectively analyzed. A total of 78 patients with endoscopic ulcers and 759 without ulcers following gastrectomy were enrolled. We analyzed differences in patient age, sex, size of the lesions, method of operation, indications for gastric resection, and infection rates of Helicobacter pylori (H. pylori) between the nonulcer and ulcer groups. RESULTS: The incidence of endoscopic ulcers after gastrectomy was 9.3% and that of marginal ulcers was 8.6%. Ulcers were more common in patients with Billroth II anastomosis and pre-existing conditions for peptic ulcer disease (PUD). Infection rates of H. pyloridid not differ significantly between the two groups. The patients who underwent operations to treat PUD had lower initial levels of hemoglobin and higher rates of hospital admission. CONCLUSION: H. pylori was not an important factor in ulcerogenesis following gastrectomy. For patients who underwent surgery for PUD, clinical course of marginal ulcers was more severe. PMID:22783050

  15. Optimal management of digital ulcers in systemic sclerosis

    PubMed Central

    Abraham, Shawn; Steen, Virginia

    2015-01-01

    Raynaud’s phenomenon and digital ulcerations are two common clinical features seen in patients with systemic sclerosis. They are painful and lead to significant morbidity and altered hand function within this patient population. While currently there are no US Food and Drug Administration (FDA)-approved medications for the treatment of digital ulcerations in the United States, clinical trials have supported the use of pharmacologic and nonpharmacologic modalities in facilitating healing of existing digital ulcers and preventing formation of new ulcers. This article reviews the published data on these therapeutic options. PMID:26109864

  16. Athletic Footwear, Leg Stiffness, and Running Kinematics

    PubMed Central

    Bishop, Mark; Fiolkowski, Paul; Conrad, Bryan; Brunt, Denis; Horodyski, MaryBeth

    2006-01-01

    Context: The leg acts as a linear spring during running and hopping and adapts to the stiffness of the surface, maintaining constant total stiffness of the leg-surface system. Introducing a substance (eg, footwear) may affect the stiffness of the leg in response to changes in surface stiffness. Objective: To determine if the type of athletic footwear affects the regulation of leg stiffness in dynamic activities. Design: Repeated-measures design. Setting: Motion analysis laboratory. Patients or Other Participants: Nine healthy adults (age = 28 ± 6.8 years, mass = 71.6 ± 12.9 kg) free from lower extremity injuries. Intervention(s): Subjects hopped at 2.2 Hz on a forceplate under 3 footwear conditions (barefoot, low-cost footwear, high-cost footwear). Subjects ran on a treadmill at 2 speeds (2.23 m/s, 3.58 m/s) under the same footwear conditions. Main Outcome Measure(s): Limb stiffness was calculated from forceplate data. Kinematic data (knee and ankle angles at initial contact and peak joint excursion after contact) were collected during running. We calculated 1-way repeated-measures (stiffness) and 2-way (speed by footwear) repeated-measures analyses of variance (running kinematics) to test the dependent variables. Results: A significant increase in leg stiffness from the barefoot to the “cushioned” shoe condition was noted during hopping. When running shod, runners landed in more dorsiflexion but had less ankle motion than when running barefoot. No differences were seen between the types of shoes. The primary kinematic difference was identified as running speed increased: runners landed in more knee flexion. At the ankle, barefoot runners increased ankle motion to a significantly greater extent than did shod runners as speed increased. Conclusions: Footwear influences the maintenance of stiffness in the lower extremity during hopping and joint excursion at the ankle in running. Differences in cushioning properties of the shoes tested did not appear to be significant. PMID:17273463

  17. Spider diffraction: a comparison of curved and straight legs

    SciTech Connect

    Richter, J.L.

    1984-06-15

    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.

  18. Helicobacter pylori and gastritis in patients with peptic ulcer and non-ulcer dyspepsia: ethnic differences in Singapore.

    PubMed Central

    Kang, J Y; Wee, A; Math, M V; Guan, R; Tay, H H; Yap, I; Sutherland, I H

    1990-01-01

    Peptic ulcer occurs with different frequencies in the three main racial groups in Singapore. This study aimed firstly to determine the prevalence of Helicobacter pylori in peptic ulcer and non-ulcer dyspepsia patients of the different races and secondly, to assess the relation between H pylori, histological gastritis, patient diagnosis, and race. Gastric antral biopsy specimens from 1502 patients undergoing gastroduodenoscopy were studied and 892 (59%) were positive for H pylori. H pylori was strongly associated with gastritis: 873 of 1197 (73%) patients with gastritis were positive compared with 19 of 305 (6%) without gastritis (p less than 0.0001). The prevalences of H pylori and gastritis were similar in peptic ulcer patients of different races. Malay patients with non-ulcer dyspepsia, however, were less likely to be positive for H pylori (10 of 46 (22%] or to have antral gastritis (17 of 46 (37%] than Chinese (292 of 605 (48%) were positive for H pylori and 421 of 605 (70%) had gastritis) and Indians (35 of 61 (57%) were H pylori positive and 42 of 61 (69%) had gastritis). Patients with duodenal ulcer were more likely to be positive for H pylori than those with non-ulcer dyspepsia, even when subjects with gastritis were considered separately. While our results do not help to explain the observed racial differences in peptic ulcer frequency it may be that the pathophysiology of non-ulcer dyspepsia is different in the different races in Singapore. PMID:2387503

  19. Influence of Soft or Hard Floors before and after First Calving on Dairy Heifer Locomotion, Claw and Leg Health

    PubMed Central

    Bergsten, Christer; Telezhenko, Evgenij; Ventorp, Michael

    2015-01-01

    Simple Summary In this study the effect of different flooring systems on locomotion, claw conformation, loading, claw- and leg disorders was assessed in heifers from one year before to one year after calving. After calving, heifers kept on alleys covered with rubber flooring were found to develop less lameness, fewer claw disorders of the sole horn and fewer leg lesions than those kept on concrete alleys. Recruitment heifers reared on soft deep straw bedding had fewer sole horn lesions and more overgrown claws before calving, but were more prone to severe sole horn lesions after calving, than those reared in cubicles with hard concrete floors. Abstract Claw health, an important dairy cow welfare parameter, may be affected by early-life foot/leg stresses. To investigate this, groups of pregnant heifers were allocated to deep straw bedding (Soft) or cubicles (Hard), both with scraped concrete feeding alleys. After the grazing season, they were re-housed in cubicle systems, half on slatted concrete (Hard) and half on slatted rubber (Soft) alleys. Claw measurements, contact area and pressure distribution claw/flooring, claw disorders and leg lesions were recorded at the start and end of each housing season. Locomotion and leg lesions were also scored monthly after calving. Prevalence of sole haemorrhages was higher among pregnant heifers in cubicles than in deep straw. After calving, first-calvers on Hard floors had higher odds for lameness (OR = 3.6; p < 0.01), sole haemorrhages/ulcers (OR = 2.2; p < 0.05), white-line haemorrhages (OR = 2.8; p < 0.01) and leg lesions (OR = 2.6; p < 0.02) than those on Soft floors. Lowest prevalence and severity of sole and white-line haemorrhages (non-significant) in first-calvers was found in those on Soft floors and reared on Hard floors and the highest prevalence and severity on those on Hard floors reared on Soft floors. Soft flooring after calving is of most importance for healthy feet and legs. PMID:26479380

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

    E-print Network

    Dudek, Gregory

    flippers for swimming. But the walking legs have extremely poor thrust for swimming and the flippers by measuring the thrust generated by newly designed legs and comparing the same with the thrust generated) Aqua swimming in the sea water with the Ninja legs. uses a RHex-based body design [2] to walk on land

  1. Impact of Facial Conformation on Canine Health: Corneal Ulceration

    PubMed Central

    Packer, Rowena M. A.; Hendricks, Anke; Burn, Charlotte C.

    2015-01-01

    Concern has arisen in recent years that selection for extreme facial morphology in the domestic dog may be leading to an increased frequency of eye disorders. Corneal ulcers are a common and painful eye problem in domestic dogs that can lead to scarring and/or perforation of the cornea, potentially causing blindness. Exaggerated juvenile-like craniofacial conformations and wide eyes have been suspected as risk factors for corneal ulceration. This study aimed to quantify the relationship between corneal ulceration risk and conformational factors including relative eyelid aperture width, brachycephalic (short-muzzled) skull shape, the presence of a nasal fold (wrinkle), and exposed eye-white. A 14 month cross-sectional study of dogs entering a large UK based small animal referral hospital for both corneal ulcers and unrelated disorders was carried out. Dogs were classed as affected if they were diagnosed with a corneal ulcer using fluorescein dye while at the hospital (whether referred for this disorder or not), or if a previous diagnosis of corneal ulcer(s) was documented in the dogs’ histories. Of 700 dogs recruited, measured and clinically examined, 31 were affected by corneal ulcers. Most cases were male (71%), small breed dogs (mean± SE weight: 11.4±1.1 kg), with the most commonly diagnosed breed being the Pug. Dogs with nasal folds were nearly five times more likely to be affected by corneal ulcers than those without, and brachycephalic dogs (craniofacial ratio <0.5) were twenty times more likely to be affected than non-brachycephalic dogs. A 10% increase in relative eyelid aperture width more than tripled the ulcer risk. Exposed eye-white was associated with a nearly three times increased risk. The results demonstrate that artificially selecting for these facial characteristics greatly heightens the risk of corneal ulcers, and such selection should thus be discouraged to improve canine welfare. PMID:25969983

  2. Spinal cord injury pressure ulcer treatment: an experience-based approach.

    PubMed

    Sunn, Gabriel

    2014-08-01

    Pressure ulcers continue to impact the lives of spinal cord injury patients severely. Pressure ulcers must be accurately staged according to National Pressure Ulcer Advisory recommendations before treatment design. The first priority in treatment of pressure ulcers is offloading. Intact skin ulcers may be treated with noncontact nonthermal low-frequency ultrasound. Superficial pressure ulcers may be treated with a combination of collagenase and foam dressings. Deeper pressure ulcers warrant negative-pressure wound therapy dressings along with biologic adjuncts to fill in wound depth. Discovery and treatment of osteomyelitis is a high priority when initially evaluating pressure ulcers. Surgical intervention must always be considered. PMID:25064794

  3. Maximum single leg force production: cockroaches righting on photoelastic gelatin

    PubMed

    Full; Yamauchi; Jindrich

    1995-01-01

    Integrating studies of mechanics, neural control and isolated muscle function are possible using arthropod legs. To evaluate leg performance, we measured the ground reaction forces generated by individual legs of the six-legged cockroach Blaberus discoidalis (3.1 g), during an emergency behavior, righting or over-turning. We used a photoelastic method to measure the forces generated by individual legs simultaneously. A gelatin track placed between crossed polarizing filters was illuminated from below, and a high-speed video camera recorded the stress-induced optical signals from above. The size and skew of the optical patterns were found to be related to the magnitude and direction of the force. We discovered that the ground reaction forces generated during the righting behavior of the death-head cockroach were eight times greater than those observed during high-speed running, supporting the possibility that relative leg forces (leg force per unit body weight) during running and maximal leg activity differ more in small arthropods than in larger vertebrates. Non-geometric scaling of relative leg force (i.e. scaling to less than body mass-0.33), along with the reduced force-generating ability of a single leg in animals with many legs, may help to explain why the maximum relative leg force production by six-legged cockroaches, as well as by some other small insects, can be similar to the relative single leg forces produced by two- and four-legged vertebrates that are almost 1000 times more massive. Leg number and body mass alone, however, appear to be insufficient to explain the variation observed in relative leg force production at a given body mass, because enormous diversity in musculo-skeletal parameters exists. The maximal relative leg force of the cockroach B. discoidalis during righting was at the low end of a 100-fold variation observed for smaller insects wedging (pushing through a small crevice) and pulling loads. Thus, this cockroach can be characterized as a moderately strong insect with the capacity for relatively high speed. Results from the present study question the predictive strength of the simple geometric scaling arguments involving a strength:weight ratio as they are applied to small arthropods and encourage further consideration of the importance of leg number, muscle force production and mechanical advantage in the derivation of general principles of leg performance. PMID:9320366

  4. Peripheral corneal ulceration associated with rheumatoid arthritis

    PubMed Central

    Karampatakis, Vasileios; Konidaris, Vasileios; Michailidou, Maria; Gerofotis, Antonios; Daniilidis, Michail

    2013-01-01

    Patient: Female, 60 Final Diagnosis: Corneal ulceration Symptoms: Blurred vision Medication: Abatacept Clinical Procedure: — Specialty: Ophthalmology Objective: Management of emergency care Background: To report a case of a patient with rheumatoid arthritis (RA) and associated peripheral corneal ulceration. Case Report: A 60-year-old woman with RA diagnosed 15 years ago, under immunosuppressive therapy (IV abatacept 250 mg/month), demonstrated blurring of vision in her RE (right eye). Visual acuity was 6/10 in the RE and 10/10 in the LE. Slit lamp examination revealed a paracentral superior corneal melt in the RE. Anterior chamber reaction was 2+. Laboratory investigations revealed positive anti-Ro and anti-La, anti-Extractable Nuclear Antigens (anti-ENA, ELISA), while anti-Sm, anti-Rnp, anti-Jo1 and anti-Scl70 were found negative. IgG and IgA serum immunoglobulins were found elevated, but IgE and IgM were within normal levels. Further evaluation for the underlying disease revealed highly elevated rheumatoid factor and C-reactive protein. The patient, who had been receiving anti-TNF during the last 6 months, underwent treatment with topical tobramycin and lubricants and oral prednisone 60 mg/day with tapering doses, to which methotrexate p.os. 15 mg/week was added. The condition improved within a few days after the initiation of prednisone treatment. Re-epithelization occurred 1 week after the onset of the immunosuppressive treatment. Only punctate fluorescein dye uptake was detected in the margins of the lesion. Conclusions: The effective control of the underlying disease and early diagnosis of the dry eye syndrome in RA patients may prevent serious corneal complications such as corneal ulceration. The initiation of treatment with steroids and immunosuppresants was found to halt the progression of keratolysis, and assisted re-epithelization. PMID:23986797

  5. [The surgical treatment of pressure ulcers].

    PubMed

    Gaucher, Sonia; Rochet, Jean-Michel

    2013-01-01

    The whole context of the treatment must be taken into account. The aim is to treat the patient and avoid a recurrence. Not all pressure ulcers are suitable for surgery and patients must be rigorously assessed, which requires a coherent approach by all the medical and allied health care teams in order to harmonise practices. This coordination must lead to the acceptance of the surgical procedure and the implementation of a care approach which will ensure its success both with regard to the preoperative preparation and the immediate post-operative period as well as the long-term. PMID:23785861

  6. Pressure ulcers and endothelial dysfunction: is there a link?

    PubMed

    Struck, Bryan D; Wright, Jonelle E

    2007-01-01

    Pressure ulcers were first described in the medical literature in the mid-16th century. Today, in the 21st century, pressure ulcers continue to cause pain and suffering to patients and increase the cost of medical care. Researchers and clinicians have used significant time and money to develop prevention and treatment strategies for pressure ulcers. Accepted risk factors for pressure ulcer development include pressure, shear force, friction, moisture and malnutrition. Yet despite procedures to help minimize these risk factors, pressure ulcers are still problematic. Endothelial dysfunction, which is a well-documented cardiovascular risk factor, has been proposed as another risk factor for pressure ulcers. Yet little is known about how pressure ulcers and endothelial dysfunction are linked. In this article we explore the literature to build an argument that research into the role of endothelial function is a plausible line of translational investigation that would contribute greatly to the knowledge base that guides present-day practices in the prevention and treatment of pressure ulcers. PMID:18285294

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

    E-print Network

    Payan, Yohan

    analysis 1. Introduction Most foot ulcers are the consequence of a trauma (repetitive high stress, ill perceive the pain announcing deep tissue injury and their natural defense is thus altered. Today done to prevent ulcer creations, especially because they stem from high stresses and strains inside

  8. Acute necrotizing ulcerative gingivitis-periodontitis: a literature review.

    PubMed

    Wade, D N; Kerns, D G

    1998-05-01

    Acute necrotizing ulcerative gingivitis-periodontitis (ANUG/NUP) is a relatively uncommon periodontal disease characterized by gingival necrosis and ulceration, pain, and bleeding. The purpose of this paper is to provide a review of current knowledge on ANUG/NUP. Current literature on the epidemiology, pathogenesis, immunology, predisposing factors, and treatment of ANUG/NUP is reviewed. PMID:9597852

  9. Cimetidine for peptic ulcer in patients with arthritis.

    PubMed Central

    Croker, J R; Cotton, P B; Boyle, A C; Kinsella, P

    1980-01-01

    Patients taking anti-inflammatory drugs for arthritis are prone to dyspepsia, and management of peptic ulcer is difficult because surgery is poorly tolerated. In this open study cimetidine treatment was associated with ulcer healing in 17 out of 21 patients with arthritis even when anti-inflammatory treatment was continued. Remission was maintained for 1 year by continued cimetidine therapy. PMID:7416819

  10. Mindfulness May Be Helpful for People with Ulcerative Colitis

    MedlinePLUS

    ... homework. This was compared to a “time/attention” control—a course on mind and body medicine that was similar in format but did not include coping skills, practice, or any information on ulcerative ... the MBSR and control groups in the course of ulcerative colitis disease, ...

  11. Effect of Concentrate Form on Gastric Ulcer Syndrome in Horses 

    E-print Network

    Huth, Lindsey

    2012-02-14

    EGUS score on a scale of 0 to 4 (0= no ulceration or hyperkeratosis, 4= extensive, deep ulceration) and sex, and utilized in a 77-d cross-over design with two 28-d periods separated by a 21-d washout period. During the first 28-d period, horses were...

  12. Acute necrotising ulcerative gingivitis in an immunocompromised young adult.

    PubMed

    Hu, Jessie; Kent, Paul; Lennon, Joshua M; Logan, Latania K

    2015-01-01

    Acute necrotising ulcerative gingivitis is an acute onset disease characterised by ulceration, necrosis, pain and bleeding in gingival surfaces. It is predominantly seen in severely malnourished children and young adults with advanced HIV infection. We present a unique presentation in a young adult with high-grade osteogenic sarcoma. PMID:26376700

  13. Multi-leg heat pipe evaporator

    NASA Technical Reports Server (NTRS)

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

    1986-01-01

    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.

  14. Dynamic legged locomotion in robots and animals

    NASA Astrophysics Data System (ADS)

    Raibert, Marc; Playter, Robert; Ringrose, Robert; Bailey, Dave; Leeser, Karl

    1995-01-01

    This report documents our study of active legged systems that balance actively and move dynamically. The purpose of this research is to build a foundation of knowledge that can lead both to the construction of useful legged vehicles and to a better understanding of how animal locomotion works. In this report we provide an update on progress during the past year. Here are the topics covered in this report: (1) Is cockroach locomotion dynamic? To address this question we created three models of cockroaches, each abstracted at a different level. We provided each model with a control system and computer simulation. One set of results suggests that 'Groucho Running,' a type of dynamic walking, seems feasible at cockroach scale. (2) How do bipeds shift weight between the legs? We built a simple planar biped robot specifically to explore this question. It shifts its weight from one curved foot to the other, using a toe-off and toe-on strategy, in conjunction with dynamic tipping. (3) 3D biped gymnastics: The 3D biped robot has done front somersaults in the laboratory. The robot changes its leg length in flight to control rotation rate. This in turn provides a mechanism for controlling the landing attitude of the robot once airborne. (4) Passively stabilized layout somersault: We have found that the passive structure of a gymnast, the configuration of masses and compliances, can stabilize inherently unstable maneuvers. This means that body biomechanics could play a larger role in controlling behavior than is generally thought. We used a physical 'doll' model and computer simulation to illustrate the point. (5) Twisting: Some gymnastic maneuvers require twisting. We are studying how to couple the biomechanics of the system to its control to produce efficient, stable twisting maneuvers.

  15. Energy Efficient Legged Robotics at Sandia Labs

    SciTech Connect

    Buerger, Steve

    2014-12-16

    Sandia is developing energy efficient actuation and drive train technologies to dramatically improve the charge life of legged robots. The work is supported by DARPA, and Sandia will demonstrate an energy efficient bipedal robot at the technology exposition section of the DARPA Robotics Challenge Finals in June, 2015. This video, the first in a series, describes early development and initial integration of the Sandia Transmission Efficient Prototype Promoting Research (STEPPR) robot.

  16. [Indications for surgical treatment of hard scarring gastric ulcers].

    PubMed

    Durleshter, V M; Korochanskaia, N V; Serikova, S N

    2014-01-01

    It was done the comparative analysis of the morphofunctional state of the upper gastrointestinal tract between 350 patients with effective conservative treatment and 104 patients with hard scarring gastric ulcers. The analysis identified the predictors of ineffective medical treatment and led to deliver the indications for timely surgical treatment. It was identified the next indications for planned organ-preserving surgical treatment of patients with hard scarring gastric ulcers: penetrating and non-healing ulcers with large or gigantic size in case of the adequate medical therapy, high-grade dysplasia and colonic metaplasia of the gastric epithelium in the borders or fundus of the ulcer,ulcers combination with fixed cardio-fundal or fundo-corporal hiatal hernias; hypotonic-hypokinetic type of the gastric and duodenal activity with the development of gastrostasis and pronounced duodenogastric reflux. PMID:24781063

  17. Preventing pressure ulcers in patients in intensive care.

    PubMed

    Gage, William

    2015-02-27

    This article discusses the prevention and management of pressure ulcers in intensive care. It outlines a service improvement project conducted in the intensive care units at Imperial College Healthcare NHS Trust with the aim of reducing the incidence of hospital-acquired pressure ulcers. The project introduced a set of 'essential standards' and an audit tool to monitor compliance. Implementation of the essential standards resulted in a reduction in the total number of pressure ulcers acquired in the four intensive care units, with an absence of any category 3 or 4 pressure ulcers (the most severe categories of pressure ulcer). The article describes the measures taken to ensure the sustainability and spread of the initiative within the NHS trust. PMID:25711595

  18. Physical activity at work and duodenal ulcer risk.

    PubMed Central

    Katschinski, B D; Logan, R F; Edmond, M; Langman, M J

    1991-01-01

    To determine whether the social class differences in duodenal ulcer frequency may be explained by differences in physical activity at work, the energy expenditure during work, smoking habits, and social class were compared in 76 recently diagnosed duodenal ulcer patients and in age and sex matched community controls. As anticipated, the relative risk of duodenal ulcer showed significant associations with smoking and social class. Social class and physical activity at work were associated with one another. After adjusting for age, sex, smoking, and social class, physically active work was still associated with duodenal ulcer, with relative risks for moderate and high activity compared with sedentary work being 1.3 (0.6-3.0) and 3.6 (1.3-7.8) respectively. Within each social class stratum, the relative risk of having a duodenal ulcer was greater in those with a high level of occupational activity than in those undertaking sedentary work. PMID:1916502

  19. Do pressure ulcer risk assessment scales improve clinical practice?

    PubMed Central

    Kottner, Jan; Balzer, Katrin

    2010-01-01

    Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU) risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed. PMID:21197359

  20. Eosinophilic ulcer of the tongue--Case report.

    PubMed

    Didona, Dario; Paolino, Giovanni; Donati, Michele; Didona, Biagio; Calvieri, Stefano

    2015-01-01

    Eosinophilic ulcer of the oral mucosa is a rare, self-limiting, chronic and benign lesion of unknown pathogenesis that affects the oral mucosa. We present the case of a 65 year-old Caucasian female with a five month history of a painful ulcer on the lateral side of her tongue. The ulcer was not adhered to the underlying structures and there was no evidence of regional lymph node involvement. Laboratory examinations and X-rays revealed no abnormalities. Topical treatments had been performed without any improvement. Histopathological examination showed an ulcerated surface and mixed inflammatory infiltrate with several eosinophils extending into the mucosa and submucosa. No cellular atypia was observed. Based on the patient-s history and mucosal biopsy, a final diagnosis of eosinophilic ulcer of the oral mucosa was made. PMID:26312683

  1. Ulcerating Ileocolitis in Severe Amatoxin Poisoning.

    PubMed

    Hilty, Matthias Peter; Halama, Marcel; Zimmermann, Anne-Katrin; Maggiorini, Marco; Geier, Andreas

    2015-01-01

    Amatoxin poisoning is still associated with a great potential for complications and a high mortality. While the occurrence of acute gastroenteritis within the first 24 hours after amatoxin ingestion is well described, only very few descriptions of late gastrointestinal complications of amatoxin poisoning exist worldwide. We present the case of a 57-year-old female patient with severe amatoxin poisoning causing fulminant but reversible hepatic failure that on day 8 after mushroom ingestion developed severe abdominal pain and watery diarrhea. Ulcerating ileocolitis was identified by computed tomography identifying a thickening of the bowel wall of the entire ileum and biopsies taken from the ileum and large bowel revealing distinct ileitis and proximally accentuated colitis. The absence of discernible alternative etiologies such as infectious agents makes a causal relationship between the ulcerating ileocolitis and the amatoxin poisoning likely. Diarrhea and varying abdominal pain persisted over several weeks and clinical follow-up after six months showed a completely symptom-free patient. The case presented highlights the importance to consider the possibility of rare complications of Amanita intoxication in order to be able to respond to them early and adequately. PMID:26357578

  2. Pressure ulcer grading and appropriate equipment selection.

    PubMed

    Charlton, Sarah

    2014-08-12

    This article explores the process and rationale for designing a poster to support community nurses in selecting appropriate pressure-relieving equipment based on accurate risk assessment and correct pressure ulcer grading. The project was prompted by the requirement to update community nurses' knowledge and ensure pressure-relieving equipment selection was evidence-based and not reliant on personal preference. The 2012 NHS Midlands and East 'Stop the pressure' campaign provided community nurses with a framework for pressure ulcer prevention and management. The attention to support surfaces highlighted the need for appropriate equipment. However the tissue viability team found that the introduction of this pathway alone did not help with the practical issues of appropriate equipment selection. The poster was designed with consideration as to how adults learn, and by looking to the Plan, Do, Study, Act (PDSA) cycle. This provided the framework for enabling new ideas and changes to practice to be tested on a small scale before full implementation. PMID:25117600

  3. Ulcerating Ileocolitis in Severe Amatoxin Poisoning

    PubMed Central

    Hilty, Matthias Peter; Halama, Marcel; Zimmermann, Anne-Katrin; Maggiorini, Marco; Geier, Andreas

    2015-01-01

    Amatoxin poisoning is still associated with a great potential for complications and a high mortality. While the occurrence of acute gastroenteritis within the first 24 hours after amatoxin ingestion is well described, only very few descriptions of late gastrointestinal complications of amatoxin poisoning exist worldwide. We present the case of a 57-year-old female patient with severe amatoxin poisoning causing fulminant but reversible hepatic failure that on day 8 after mushroom ingestion developed severe abdominal pain and watery diarrhea. Ulcerating ileocolitis was identified by computed tomography identifying a thickening of the bowel wall of the entire ileum and biopsies taken from the ileum and large bowel revealing distinct ileitis and proximally accentuated colitis. The absence of discernible alternative etiologies such as infectious agents makes a causal relationship between the ulcerating ileocolitis and the amatoxin poisoning likely. Diarrhea and varying abdominal pain persisted over several weeks and clinical follow-up after six months showed a completely symptom-free patient. The case presented highlights the importance to consider the possibility of rare complications of Amanita intoxication in order to be able to respond to them early and adequately. PMID:26357578

  4. Cohort study of atypical pressure ulcers development.

    PubMed

    Jaul, Efraim

    2014-12-01

    Atypical pressure ulcers (APU) are distinguished from common pressure ulcers (PU) with both unusual location and different aetiology. The occurrence and attempts to characterise APU remain unrecognised. The purpose of this cohort study was to analyse the occurrence of atypical location and the circumstances of the causation, and draw attention to the prevention and treatment by a multidisciplinary team. The cohort study spanned three and a half years totalling 174 patients. The unit incorporates two weekly combined staff meetings. One concentrates on wound assessment with treatment decisions made by the physician and nurse, and the other, a multidisciplinary team reviewing all patients and coordinating treatment. The main finding of this study identified APU occurrence rate of 21% within acquired PU over a three and a half year period. Severe spasticity constituted the largest group in this study and the most difficult to cure wounds, located in medial aspects of knees, elbows and palms. Medical devices caused the second largest occurrence of atypical wounds, located in the nape of the neck, penis and nostrils. Bony deformities were the third recognisable atypical wound group located in shoulder blades and upper spine. These three categories are definable and time observable. APU are important to be recognisable, and can be healed as well as being prevented. The prominent role of the multidisciplinary team is primary in identification, prevention and treatment. PMID:23374746

  5. [Long-term prognosis of ulcerative colitis].

    PubMed

    Kaminaga, N; Satake, Y

    1999-11-01

    Despite its intermittent course of activity and remission, the good response to salazopyridine and steroids makes the long-term prognosis of ulcerative colitis favorable. The number of non-active type ulcerative colitis is increasing and consequently, the rate of active disease and relapse is decreasing every year. More than 90% of the patients even with disease of 10 or more years are able to work almost with no limits for the daily living. The colectomy rate in Japan is 4.1% after one year of the onset of the disease and 6.8% after 2 years. Thereafter approximately 1% of the patients undergo surgery yearly. The most common reasons of surgery are complications such as massive bleeding, perforation or toxic megacolon. Other indications are chronic continuous disease and cases with frequent relapses. Considering the extension of the disease, about one-third of the total colitis type and 10% of the left-sided type undergo surgery. The risk of colonic cancer is higher in patients with total colitis type and when has had the disease for more than 10 years. Most of the them are flat type poor-differentiated adenocarcinomas. Therefore patients with total colitis type for more than 10 years should undergo colonoscopic surveillance. PMID:10572407

  6. Radical induction theory of ulcerative colitis

    PubMed Central

    Pravda, Jay

    2005-01-01

    To propose a new pathogenesis called Radical Induction to explain the genesis and progression of ulcerative colitis (UC). UC is an inflammatory bowel disease. Colonic inflammation in UC is mediated by a buildup of white blood cells (WBCs) within the colonic mucosal lining; however, to date there is no answer for why WBCs initially enter the colonic mucosa to begin with. A new pathogenesis termed “Radical Induction Theory” is proposed to explain this and states that excess un-neutralized hydrogen peroxide, produced within colonic epithelial cells as a result of aberrant cellular metabolism, diffuses through cell membranes to the extracellular space where it is converted to the highly damaging hydroxyl radical resulting in oxidative damage to structures comprising the colonic epithelial barrier. Once damaged, the barrier is unable to exclude highly immunogenic fecal bacterial antigens from invading the normally sterile submucosa. This antigenic exposure provokes an initial immune response of WBC infiltration into the colonic mucosa. Once present in the mucosa, WBCs are stimulated to secrete toxins by direct exposure to fecal bacteria leading to mucosal ulceration and bloody diarrhea characteristic of this disease. PMID:15832404

  7. Pressure ulcer related pain in community populations: a prevalence survey

    PubMed Central

    2014-01-01

    Background Pressure ulcers are costly to the healthcare provider and can have a major impact on patient’s quality of life. One of the most distressing symptoms reported is pain. There is very little published data on the prevalence and details of pain experienced by patients with pressure ulcers, particularly in community populations. The study was conducted in two community NHS sites in the North of England. Methods The aim was to estimate the prevalence of pressure area related pain within a community population. We also explored the type and severity of the pain and its association with pressure ulcer classification. A cross-sectional survey was performed of community nurses caseloads to identify adult patients with pressure ulcers and associated pain. Consenting patients then had a full pain assessment and verification of pressure ulcer grade. Results A total of 287 patients were identified with pressure ulcers (0.51 per 1000 adult population). Of the 176 patients who were asked, 133 (75.6%) reported pain. 37 patients consented to a detailed pain assessment. Painful pressure ulcers of all grades and on nearly all body sites were identified. Pain intensity was not related to number or severity of pressure ulcer. Both inflammatory and neuropathic pain were reported at all body sites however the proportion of neuropathic pain was greater in pressure ulcers on lower limbs. Conclusions This study has identified the extent and type of pain suffered by community patients with pressure ulcers and indicates the need for systematic and regular pain assessment and treatment. PMID:25024642

  8. On the Biomimetic Design of Agile-Robot Legs

    PubMed Central

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

    2011-01-01

    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

  9. Locomotion via paralyzed leg muscles: feasibility study for a leg-propelled vehicle.

    PubMed

    Glaser, R M; Gruner, J A; Feinberg, S D; Collins, S R

    1983-07-01

    Functional electrical stimulation has been used to restore some degree of controllable movement to paralyzed muscle. The purpose of this study was to demonstrate the feasibility of using electrically stimulated paralyzed leg muscles to propel a wheelchair-type vehicle. For this, a conventional manual wheelchair was modified by the addition of a drive system which permits forward propulsion by reciprocating movements of the legs. A battery-powered electrical stimulator using surface electrodes over the quadriceps muscles controls locomotive characteristics. This vehicle has been successfully operated by paraplegic and quadriplegic test subjects. Advantages of using paralyzed leg muscles for locomotion may include improvement in locomotive capability, circulation in the lower extremities, cardiovascular and respiratory fitness, strength and size of the exercised muscles and bones, and self-image. PMID:6101225

  10. [QOL and the older people with peptic ulcer].

    PubMed

    Fu, Hing Ying; Murata, Hiroaki; Kawano, Sunao

    2002-08-01

    The population older than 65 years old in Japan is now increasing in the recent years. The peptic ulcer, especially complicated peptic ulcers such as bleeding ulcer or perforating ulcer may disturb the quality of life in the older people because of long term hospitalization or death. To evaluate the characteristics of gastric mucosa in the older people, we investigated the mucosal blood volume using reflectance spectrophotometry and measured adenine nucleotides in biopsy samples from gastric mucosa using high-performance liquid chromatography. In the elderly, the mucosal blood volume significantly decreased according to aging and energy metabolism in human gastric mucosa was impaired. This may weaken their defensive mechanism. The combination therapy cimetidine and ecabet sodium compared with cimetidine alone showed a significant higher ulcer healing rate and symptom relief rate. Thus, the combination therapy with mucoprotective agents and acid suppressant accelerates ulcer healing and symptom relief and may maintain QOL in the old people with peptic ulcers. However, in the recent studies, Helicobacter pylori infection may affect these factors in the elderly. Therefore, we should reinvestigate the changes of mucosal defensive factors by aging. PMID:12187763

  11. Enhanced gastric nitric oxide synthase activity in duodenal ulcer patients.

    PubMed Central

    Rachmilewitz, D; Karmeli, F; Eliakim, R; Stalnikowicz, R; Ackerman, Z; Amir, G; Stamler, J S

    1994-01-01

    Nitric oxide, the product of nitric oxide synthase in inflammatory cells, may have a role in tissue injury through its oxidative metabolism. Nitric oxide may have a role in the pathogenesis of duodenal ulcer and may be one of the mechanisms responsible for the association between gastric infection with Helicobacter pylori and peptic disease. In this study, calcium independent nitric oxide synthase activity was detected in human gastric mucosa suggesting expression of the inducible isoform. In 17 duodenal ulcer patients gastric antral and fundic nitric oxide synthase activity was found to be two and 1.5-fold respectively higher than its activity in the antrum and fundus of 14 normal subjects (p < 0.05). H pylori was detected in the antrum of 15 of 17 duodenal ulcer patients and only in 7 of 14 of the control subjects. Antral nitric oxide synthase activity in H pylori positive duodenal ulcer patients was twofold higher than in H pylori positive normal subjects (p < 0.05). In duodenal ulcer patients antral and fundic nitric oxide synthase activity resumed normal values after induction of ulcer healing with ranitidine. Eradication of H pylori did not further affect gastric nitric oxide synthase activity. These findings suggest that in duodenal ulcer patients stimulated gastric mucosal nitric oxide synthase activity, though independent of the H pylori state, may contribute to the pathogenesis of the disease. PMID:7525417

  12. Pressure-ulcer reduction using low-friction fabric bootees.

    PubMed

    Gleeson, Deborah

    At St Helens and Knowsley Teaching Hospitals NHS Trust, implementation of pressure management measures has reduced the incidence of hospital-acquired pressure ulcers. There is now a focus on those pressure ulcers still occurring despite these measures, particularly grade 2 ulcers on the heel, which are often attributed to friction and shear. During 2012 and 2013 low friction fabric bootees (Parafricta®) were used on at-risk patients (where possible) to attempt to address this issue. The bootees were first introduced in 2012. There was a decline in heel ulcers of 78% in the 2 years, which accounted for a sizeable portion of the overall decline in all grade 2 pressure ulcers. There was also a substantial change in the ratio of heel to all other grade 2 pressure ulcers, which fell from 0.67 to 0.24. On the basis of heel pressure ulcers avoided, there is an implied net saving to the NHS. The trust concluded that routine use of low-friction fabric bootees made a significant further contribution towards achieving zero harm targets and had done so while providing substantial cost benefits. PMID:25815999

  13. A critical Evaluation of Surgical Treatment of Perforated Ulcer

    PubMed Central

    Rigopoulos, A.; Ramboiu, S.; Georgescu, I.

    2011-01-01

    The treatment of perforated ulcer disease continues to evolve because of recent advances in pharmacology, bacteriology, and operative techniques. Despite antisecretory medication and Helicobacter pylori eradication, it is still the most common indication for emergency gastric surgery associated with high morbidity and mortality. A clinical study was carried out on patients with perforated gastric or duodenal ulcer, admitted in the 1st Surgery Department between 2002 and 2008. During the 7 years of study there were admitted 256 patients with perforated ulcer - 212 cases of duodenal and 44 cases of gastric perforated ulcer. The main surgical treatment option was simple closure with Graham patch, followed by ulcer excision and vagotomy with pyloroplasty. The second major objective was the topical treatment of peritonitis and consisted in the lavage of the peritoneal cavity and drainage. Distal gastric resection has now very limited indications. We recorded no complications postoperatively. In the modern treatment of ulcer, surgery is reserved for the acute (perforation and bleeding) and chronic complications (stenosis / penetration) and exceptionally or the patients with a prolonged history of uncomplicated ulcers with lack of response to conservative therapy. PMID:24778834

  14. Microclimate and development of pressure ulcers and superficial skin changes.

    PubMed

    Yusuf, Saldy; Okuwa, Mayumi; Shigeta, Yoshie; Dai, Misako; Iuchi, Terumi; Rahman, Sulaiman; Usman, Awaluddin; Kasim, Sukmawati; Sugama, Junko; Nakatani, Toshio; Sanada, Hiromi

    2015-02-01

    This study aims to evaluate the microclimate and development of pressure ulcers and superficial skin changes. A prospective cohort study was conducted in an acute care ward in Indonesia. Risk factors for pressure ulcers and superficial skin changes were identified based on the Bergstrom Braden conceptual model. Microclimate data were collected every 3 days for 15 days while the development of pressure ulcers and superficial skin changes was observed every day. Pressure ulcers and superficial skin changes were developed in 20 of the 71 participants. Total mean difference in skin temperature was higher for patients with pressure ulcers and superficial skin changes (0·9 ± 0·6°C) compared with controls (0·6 ± 0·8°C) (P = 0·071). Binary logistic regression predictor values for pressure ulcers and superficial skin changes were 0·111 for type of sheet and 0·347 for Braden Scale results. In conclusion, difference in skin temperature seems to be a predictor for pressure ulcer development and superficial skin changes, while synthetic fibre sheets are able to maintain a beneficial microclimate. PMID:23490303

  15. Gastric ulcer localization: Potential use of in vivo labeling

    SciTech Connect

    Pera, A.; Rose, H.; Seavers, R.; Bekerman, C.; Pinsky, S.

    1984-01-01

    A previous work suggests that sucralfate labeled by binding to Tc-99m HSA permits the visualization of gastric ulcers. Potential problems with this technique are: 1) decreased binding of sucralfate to ulcer sites due to the labeling method of binding to exogenous protein (HSA); 2) overlying activity that may obscure identification of the ulcer. Because of these problems we have examined the possibility of direct in vivo Tc-99m labeling of sucralfate after it has already bound to the ulcer. In vitro studies were done to determine the binding of Tc-99m pertechnetate to sucralfate in the presence of tin in HCl solution at pHs comparable to those found in the stomach. Rapid and efficient labeling was achieved with 75-95% of the label bound to sucralfate at 30 minutes. In vivo studies were performed in rabbits with aspirin induced ulcers and in ulcer free human volunteers. The animal studies confirm that orally administered Tc-99m pertechnetate will bind to previously ingested sucralfate and that the labeled material will bind to the ulcers. Tc-99m pertechnetate was also shown to bind well to previously ingested sucralfate in humans. The results suggest that it is possible to label sucralfate in vivo. This method would offer the following advantages: 1) a simpler labeling procedure; 2) the potential of increased sensitivity by delaying the labeling until much of the sucralfate not bound to ulcer has passed, and thus decreasing the activity that remains in the stomach; and also by leaving the protein binding sites of the sucralfate free to interact with the ulcer since no exogenous protein is involved in labeling.

  16. One week's anti-Helicobacter pylori treatment for duodenal ulcer.

    PubMed Central

    Logan, R P; Gummett, P A; Misiewicz, J J; Karim, Q N; Walker, M M; Baron, J H

    1994-01-01

    This open study tested whether eradication of Helicobacter pylori (H pylori) heals duodenal ulcers as well as decreasing recurrence. H pylori was detected in patients with endoscopic duodenal ulcers by histology, CLO-test, culture, and 13C-urea breath test (13C-UBT). Tripotassium dicitrato bismuthate (120 mg) and amoxycillin (500 mg) each four times daily, were given for seven days, with 400 mg metronidazole five times a day on days 5-7. The 13C-UBT was repeated immediately after treatment and endoscopy repeated within 21 days. After treatment unhealed ulcers were reinspected one month later and healed ulcers followed up by 13C-UBT alone for 12 months. Of 45 patients, 44 were available for follow up. Mean pretreatment excess delta 13CO2 excretion was 25.6 per mil, which fell to 2.4 per mil immediately after finishing treatment, indicating clearance of H pylori in every patient. At the second endoscopy (median interval 20 days from start of treatment) 33 of 44 (75%) duodenal ulcers had healed. Ten of the remaining 11 duodenal ulcers were smaller and those 10 healed in the next two weeks with no further treatment. Two patients' ulcers that initially healed with clearance of H pylori recurred three weeks later (both had metronidazole resistant H pylori). H pylori was eradicated in 28 of 44 (64%) patients (13C-UBT negative for median follow up 10.2 months). Overall 41 of 43 (93%, 95% confidence intervals 81%-99%) duodenal ulcers were healed at one month. This study suggests that one week of anti-H pylori triple treatment is effective in healing duodenal ulcers. PMID:8307442

  17. Role of dietary polyphenols in the management of peptic ulcer

    PubMed Central

    Farzaei, Mohammad Hosein; Abdollahi, Mohammad; Rahimi, Roja

    2015-01-01

    Peptic ulcer disease is a multifactorial and complex disease involving gastric and duodenal ulcers. Despite medical advances, the management of peptic ulcer and its complications remains a challenge, with high morbidity and death rates for the disease. An accumulating body of evidence suggests that, among a broad reach of natural molecules, dietary polyphenols with multiple biological mechanisms of action play a pivotal part in the management of gastric and duodenal ulcers. The current review confirmed that dietary polyphenols possess protective and therapeutic potential in peptic ulcer mediated by: improving cytoprotection, re-epithelialization, neovascularization, and angiogenesis; up-regulating tissue growth factors and prostaglandins; down-regulating anti-angiogenic factors; enhancing endothelial nitric oxide synthase-derived NO; suppressing oxidative mucosal damage; amplifying antioxidant performance, antacid, and anti-secretory activity; increasing endogenous mucosal defensive agents; and blocking Helicobacter pylori colonization associated gastric morphological changes and gastroduodenal inflammation and ulceration. In addition, anti-inflammatory activity due to down-regulation of proin?ammatory cytokines and cellular and intercellular adhesion agents, suppressing leukocyte-endothelium interaction, inhibiting nuclear signaling pathways of inflammatory process, and modulating intracellular transduction and transcription pathways have key roles in the anti-ulcer action of dietary polyphenols. In conclusion, administration of a signi?cant amount of dietary polyphenols in the human diet or as part of dietary supplementation along with conventional treatment can result in perfect security and treatment of peptic ulcer. Further well-designed preclinical and clinical tests are recommended in order to recognize higher levels of evidence for the confirmation of bioefficacy and safety of dietary polyphenols in the management of peptic ulcer. PMID:26074689

  18. Probiotics in the Management of Ulcerative Colitis.

    PubMed

    Chibbar, Richa; Dieleman, Levinus A

    2015-01-01

    Rapid progress has been made to understand the pathophysiology of inflammatory bowel diseases and to identify new treatments. Interaction of the gut microbiota on the host inflammatory response has suggested that alternative therapies, such as probiotics, might have a complementary role in treating and preventing disease flares. Multiple probiotics and their formulations have been studied for both the induction and maintenance of remission of ulcerative colitis (UC); however, mainly Escherichia coli Nissle 1917 and VSL#3 have been shown to provide significant benefits for the prevention and treatment of mild to moderate UC. Although these data are promising, there is still a paucity of robust, randomized-controlled trials to suggest that probiotics be utilized as part of a standard treatment regimen. With continued research and a movement toward carefully selected, individualized management based on an individual's specific microbiota composition and function, probiotics may become an integral part of tailored therapy for UC. PMID:26447965

  19. Isolated ulcerative skin lesion caused by Salmonella Weltevreden.

    PubMed

    Desikan, Prabha; Kumar, Yashwant; Pande, Hemant K; Jain, Aruna; Panwalkar, Nikita; Verma, Mayanka; Bramhne, Hemant G; Yadav, Anand; Mohapatra, Srikant

    2009-01-01

    Salmonella enterica serovar Weltevreden is not a commonly isolated serotype in India. We report isolation of Salmonella Weltevreden, from an unusual site--an ulcer on the gluteal region of a patient who had undergone coronary artery bypass surgery. To our knowledge, Salmonellae have never been reported to cause isolated ulcerative lesions on the skin. This is the first report of an isolated ulcerative lesion on the skin caused by Salmonella Weltevreden. Our findings indicate that there may be modes of pathogenesis of Salmonella infections that we are yet unaware of. Further work and extensive reporting of all Salmonella infections are necessary to elucidate these mechanisms. PMID:19762977

  20. Factors associated with ulceration and amputation in the neuropathic foot.

    PubMed

    Birke, J A; Patout, C A; Foto, J G

    2000-02-01

    The purpose of this paper is to review selected literature on the relationship of neuropathy and other related factors in foot ulceration and lower extremity amputation. There is strong evidence that sensory loss and mechanical stress are the primary cause of foot ulceration and common factors in the pathway to lower extremity amputation. Foot stress results from extrinsic factors such as footwear and intrinsic factors such as deformity and limited joint mobility. Understanding the interplay of these factors is valuable in identifying persons whose feet are at risk, effectively preventing and treating foot ulcerations and ultimately preventing lower extremity amputation. PMID:10693087

  1. Fabric-based Pressure Sensor Array for Decubitus Ulcer Monitoring

    PubMed Central

    Chung, Philip; Rowe, Allison; Etemadi, Mozziyar; Lee, Hanmin; Roy, Shuvo

    2015-01-01

    Decubitus ulcers occur in an estimated 2.5 million Americans each year at an annual cost of $11 billion to the U.S. health system. Current screening and prevention techniques for assessing risk for decubitus ulcer formation and repositioning patients every 1–2 hours are labor-intensive and can be subjective. We propose use of a Bluetooth-enabled fabric-based pressure sensor array as a simple tool to objectively assess and continuously monitor decubitus ulcer risk. PMID:24111232

  2. Histamine H2 receptor - Involvement in gastric ulceration

    NASA Technical Reports Server (NTRS)

    Brown, P. A.; Vernikos-Danellis, J.; Brown, T. H.

    1976-01-01

    The involvement of the H1 and H2 receptors for histamine in the pathogenesis of gastric ulcers was investigated in rats. Metiamide, an H2 receptor antagonist, reliably reduced ulceration produced by stress alone or by a combination of stress and aspirin. In contrast, pyrilamine, which blocks only the H1 receptor, was without effect under these same conditions. The results support the hypothesis that histamine mediates both stress and stress plus aspirin induced ulceration by a mechanism involving the H2 receptor.

  3. Restless Leg Syndrome: A Neglected Diagnosis

    PubMed Central

    Einollahi, Behzad; Izadianmehr, Neda

    2014-01-01

    Context: Restless legs syndrome (RLS) is an irresistible urge to move legs that usually occur during inactivity and at night. This neurologic condition is associated with increased risk of nocturnal hypertension as well as cardiovascular events and affects patient’s sleep, which leads to anxiety, depression, and decreases quality of life. Presence of RLS in patients on hemodialysis is associated with higher mortality rate. Most of the times, patients have indescribable symptoms. The aim of this review was to provide physicians with information to be aware and turn their attention to the patient’s symptoms, which are the most important clue to diagnosis of RLS. Evidence Acquisition: For data extraction, we reviewed PubMed, Scopus, Google scholar, the Cochrane collaboration, and Up to Date databases with the keywords of restless legs syndrome, sleep disorders, and end-stage renal disease (ESRD). The most recent review articles, clinical trials, and cross-sectional studies with large sample sizes that had used International RLS Study Group criteria (IRLSSG) and had focused on demographic characteristics and renal function were included. This situation has described in primary and secondary forms. The former usually occurs in younger patients and seems to have genetic tendencies and the latter is due to the iron deficiency state, pregnancy, and ESRD. Results: Two major theories are developed regarding the pathophysiology of RLS. The first one concerns central nervous system dopamine imbalance and the second one concerns intracellular iron dysregulation. The most common used pharmacologic agents in treatment of RLS are dopamine agonists. Other used therapeutic agents include levodopa, Alpha-2-delta calcium channel ligands, opioids, anticonvulsants, benzodiazepines, clonidine, iron therapy in low levels of serum ferritin, and nonpharmacologic therapies. Conclusions: The most important factor in diagnosis is physician’s attention and clinical experience with this condition and using IRLSSG. PMID:25695039

  4. Is leg compression beneficial for alpine skiers?

    PubMed Central

    2013-01-01

    Background This study examined the effects of different levels of compression (0, 20 and 40 mmHg) produced by leg garments on selected psycho-physiological measures of performance while exposed to passive vibration (60 Hz, amplitude 4-6 mm) and performing 3-min of alpine skiing tuck position. Methods Prior to, during and following the experiment the electromygraphic (EMG) activity of different muscles, cardio-respiratory data, changes in total hemoglobin, tissue oxygenation and oscillatory movement of m. vastus lateralis, blood lactate and perceptual data of 12 highly trained alpine skiers were recorded. Maximal isometric knee extension and flexion strength, balance, and jumping performance were assessed before and after the experiment. Results The knee angle (?10°) and oscillatory movement (?20-25.5%) were lower with compression (P?leg compression, alpine skiers could maintain a deeper tuck position with less perceived exertion and greater deoxygenation of the vastus lateralis muscle, with no differences in whole-body oxygen consumption or blood lactate concentration. These changes occurred without compromising maximal leg strength, jumping performance or balance. Accordingly, our results indicate that the use of lower leg compression in the range of 20-40 mmHg may improve alpine skiing performance by allowing a deeper tuck position and lowering perceived exertion. PMID:24004479

  5. Transcutaneous laser treatment of leg veins.

    PubMed

    Meesters, Arne A; Pitassi, Luiza H U; Campos, Valeria; Wolkerstorfer, Albert; Dierickx, Christine C

    2014-03-01

    Leg telangiectasias and reticular veins are a common complaint affecting more than 80% of the population to some extent. To date, the gold standard remains sclerotherapy for most patients. However, there may be some specific situations, where sclerotherapy is contraindicated such as needle phobia, allergy to certain sclerosing agents, and the presence of vessels smaller than the diameter of a 30-gauge needle (including telangiectatic matting). In these cases, transcutaneous laser therapy is a valuable alternative. Currently, different laser modalities have been proposed for the management of leg veins. The aim of this article is to present an overview of the basic principles of transcutaneous laser therapy of leg veins and to review the existing literature on this subject, including the most recent developments. The 532-nm potassium titanyl phosphate (KTP) laser, the 585-600-nm pulsed dye laser, the 755-nm alexandrite laser, various 800-983-nm diode lasers, and the 1,064-nm neodymium yttrium-aluminum-garnet (Nd:YAG) laser and various intense pulsed light sources have been investigated for this indication. The KTP and pulsed dye laser are an effective treatment option for small vessels (<1 mm). The side effect profile is usually favorable to that of longer wavelength modalities. For larger veins, the use of a longer wavelength is required. According to the scarce evidence available, the Nd:YAG laser produces better clinical results than the alexandrite and diode laser. Penetration depth is high, whereas absorption by melanin is low, making the Nd:YAG laser suitable for the treatment of larger and deeply located veins and for the treatment of patients with dark skin types. Clinical outcome of Nd:YAG laser therapy approximates that of sclerotherapy, although the latter is associated with less pain. New developments include (1) the use of a nonuniform pulse sequence or a dual-wavelength modality, inducing methemoglobin formation and enhancing the optical absorption properties of the target structure, (2) pulse stacking and multiple pass laser treatment, (3) combination of laser therapy with sclerotherapy or radiofrequency, and (4) indocyanin green enhanced laser therapy. Future studies will have to confirm the role of these developments in the treatment of leg veins. The literature still lacks double-blind controlled clinical trials comparing the different laser modalities with each other and with sclerotherapy. Such trials should be the focus of future research. PMID:24220848

  6. Towards active capsular endoscopy: preliminary results on a legged platform.

    PubMed

    Menciassi, Arianna; Stefanini, Cesare; Orlandi, Giovanni; Quirini, Marco; Dario, Paolo

    2006-01-01

    This paper illustrates the problem of active locomotion in the gastrointestinal tract for endoscopic capsules. Authors analyze the problem of locomotion in unstructured, flexible and tubular environments and explain the reasons leading to the selection of a legged system. They present a theoretical simulation of legged capsule locomotion, which is used to define the optimal parameters for capsule design and gait selection. Finally, a legged capsule--about 3 cm3 in volume--is presented; it consists of 4 back legs whose actuation is achieved thanks to a miniaturized DC brushless motor. In vitro tests demonstrate good performance in terms of achievable speed (92 mm/min). PMID:17946504

  7. Cutaneous Ulcers as Initial Presentation of Localized Granulomatosis with Polyangiitis: A Case Report and Review of the Literature

    PubMed Central

    Nasir, Noreen; Ali, Syed Ahsan; Mehmood Riaz, Hafiz Mohammed

    2015-01-01

    Background. Granulomatosis with polyangiitis (GPA) is an ANCA associated small vessel vasculitis characterized by necrotizing granulomatous inflammation involving the upper and the lower respiratory tract and the kidneys. The disease has a broad clinical spectrum that ranges from limited/localized involvement of a single organ system to a generalized systemic vasculitis that affects several organs with evidence of end organ damage. Atypical forms of the disease have been recognized with or without respiratory tract involvement with a long protracted course before manifesting as generalized disease. Case Presentation. We describe a 57-year-old woman who presented with recurrent fever and cutaneous ulcers on her legs who was diagnosed to have granulomatosis with polyangiitis (GPA) after an extensive evaluation which excluded infectious, other vasculitides, connective tissue disease and malignant etiologies. Conclusion. In the absence of typical manifestations, granulomatosis with polyangiitis (GPA) is indeed a diagnostic challenge to the physician. Atypical manifestations like unexplained recurrent fever and cutaneous ulcers nevertheless call for keeping a low threshold for the diagnosis of GPA as the disease can initially present in localized form before heralding into a generalized disease. PMID:26664797

  8. The role of surgical off-loading to prevent recurrent ulcerations.

    PubMed

    La Fontaine, Javier; Lavery, Lawrence A; Hunt, Nathan A; Murdoch, Douglas P

    2014-12-01

    Foot ulcerations in patients with diabetes are common. Most ulcers heal with conservative treatment, but recurrence is common. The pathway of ulcer development includes neuropathy, deformity, and trauma. The first attempt to avoid recurrence is by the use of shoes and insoles. When shoes and insoles fail, surgical correction of deformity leading to the ulcer can be attempted. This article reviews the most common procedures performed to heal ulcers or avoid recurrence. PMID:25384915

  9. Hard to heal pressure ulcers (stage III-IV): efficacy of injected activated macrophage suspension (AMS) as compared with standard of care (SOC) treatment controlled trial.

    PubMed

    Zuloff-Shani, Adi; Adunsky, Abraham; Even-Zahav, Aviva; Semo, Haim; Orenstein, Arie; Tamir, Jeremy; Regev, Eli; Shinar, Eilat; Danon, David

    2010-01-01

    The objective of this study was to compare local injections of AMS with SOC treatments for stage III and IV pressure ulcers in elderly patients. It was designed as historically prospective 2-arms non-parallel open controlled trial, and conducted in a department of geriatric medicine and rehabilitation of a university affiliated tertiary hospital. We studied 100 consecutive elderly patients with a total of 216 stage III or IV pressure ulcers, 66 patients were assigned to the AMS group and had their wounds injected, while 38 patients were assigned to the SOC group. Primary outcome was rate of complete wound closure. Time to complete wound closure and 1-year mortality served as secondary outcomes. Statistical analyses were performed at both patient and wound levels. Percentage of completely closed wounds (wound level and patient level) were significantly better (p<0.001/p<0.001, respectively) in all patients in favor of AMS, as well as in the subset of diabetic patients (p<0.001/p<0.001). Similarly, AMS proved significantly better for the subset of those with leg ulcers and with baseline wounds ?15 cm(2), compared with SOC. There were no statistically significant differences with regard to time to complete closure or 1-year mortality rates in the two groups. It is concluded that there is a significant difference in favor of stage III and IV wound closure rates by AMS, as compared with SOC treatments. PMID:20034682

  10. Pramipexole Alters Thermoregulation in Restless Legs Syndrome

    PubMed Central

    Salminen, Aaro V.; Rimpilä, Ville; Polo, Olli

    2014-01-01

    Study Objectives: Previous studies have associated restless legs syndrome (RLS) with peripheral hypoxia and impaired thermoregulation in the lower extremities. We performed long-term monitoring of skin temperatures in order to investigate whether these findings could be explained by reduced blood flow to the peripheral tissues. Methods: 96-hour continuous measurements of skin temperature were performed both in the distal and proximal parts of the body of 15 patients with RLS and 14 healthy controls. During the recording, the patients participated in suggested immobilization tests both with and without pramipexole medication. Results: We found no baseline differences in distal or proximal skin temperature between patients and controls in daytime or during immobilization. However, pramipexole significantly increased distal skin temperature in the patient group during immobilization (31.1°C vs. 32.9°C, p < 0.05). Daytime temperatures were not affected by therapy or disease status. Conclusions: The data suggest that patients with RLS and healthy controls have similar blood flow to the peripheral skin tissue. Pramipexole, however, alters thermoregulation and the previous studies might have been biased by medication. Dopaminergic medication is a major confounding factor when assessing peripheral phenomena in RLS and should be controlled for in the future studies. Citation: Salminen AV, Rimpilä V, Polo O. Pramipexole alters thermoregulation in restless legs syndrome. J Clin Sleep Med 2014;10(12):1325-1329. PMID:25325594

  11. A flexible pressure monitoring system for pressure ulcer prevention

    E-print Network

    Yip, Marcus

    Pressure ulcers are painful sores that arise from prolonged exposure to high pressure points, which restricts blood flow and leads to tissue necrosis. This is a common occurrence among patients with impaired mobility, ...

  12. Faecal mucus degrading glycosidases in ulcerative colitis and Crohn's disease.

    PubMed

    Rhodes, J M; Gallimore, R; Elias, E; Allan, R N; Kennedy, J F

    1985-08-01

    Because the normal faecal flora includes bacteria which can produce mucus-digesting glycosidases, it follows that increased digestion of colonic mucus by these bacterial enzymes could be important in the pathogenesis of ulcerative colitis. Faecal activities of potential mucus-degrading glycosidases have therefore been assayed in samples from patients with inflammatory bowel disease and normal controls. The enzymes alpha-D-galactosidase, beta-D-galactosidase, beta-NAc-D-glucosaminidase alpha-L-fucosidase and neuraminidase were assayed. Considerable glycosidase activity was present in most faecal samples. Similar activities of all the enzymes assayed were found in faeces from patients with ulcerative colitis, Crohn's disease and normal controls and there was no significant correlation with disease activity. These results imply that relapse of ulcerative colitis is not initiated by increased degradation of colonic mucus by faecal glycosidases but do not exclude a role for bacterial mucus degradation in the pathogenesis of ulcerative colitis. PMID:2991089

  13. Improving the ability to eliminate wounds and pressure ulcers.

    PubMed

    Kuffler, Damien P

    2015-01-01

    Pressure ulcers can be initiated by as little as 2 hours of constant pressure on the ski, that blocks blood circulation causing the skin and underlying tissues to die, leading to an open wound that never heals, but continues to grow in diameter and depth, and frequently jeopardizes patients' lives. Despite the application of many diverse techniques, pressure ulcers remain exceptionally difficult to heal because many ulcer elimination techniques have minimal effects, and although other techniques may appear to be effective, the evidence supporting their efficacy is weak. However, increasing evidence indicates that other techniques, such as the application of platelet-rich plasma, vacuum assisted closure, electrical stimulation, and hyperbaric oxygen therapy are effective and should be substituted for the older techniques. This review describes different standard and novel techniques that have been tested for eliminating pressure ulcers and discusses the relative efficacy of these techniques. PMID:25801293

  14. Reducing hospital acquired pressure ulcers in intensive care

    PubMed Central

    Cullen Gill, Emma

    2015-01-01

    Pressure ulcers are a definite problem in our health care system and are growing in numbers. Unfortunately, it is usually the most weak and vulnerable of our culture that faces these complications, causing the patient and their families discomfort, anguish, and economic hardship due to their expensive treatment. Data collected by the tissue viability department showed high incidence of hospital acquire pressure ulcers in the intensive care unit in March 2013. An action plan was initiated and implemented by the tissue viability team, senior nursing management, pressure ulcer prevention (PUP) team and respiratory therapists (RT's) within the ICU. Our objective was to reduce hospital acquired pressure ulcers in the intensive care unit using the plan, do, check, act quality improvement process.

  15. Stable operation of an elastic three-segment leg.

    PubMed

    Seyfarth, A; Günther, M; Blickhan, R

    2001-05-01

    Quasi-elastic operation of joints in multi-segmented systems as they occur in the legs of humans, animals, and robots requires a careful tuning of leg properties and geometry if catastrophic counteracting operation of the joints is to be avoided. A simple three-segment model has been used to investigate the segmental organization of the leg during repulsive tasks like human running and jumping. The effective operation of the muscles crossing the knee and ankle joints is described in terms of rotational springs. The following issues were addressed in this study: (1) how can the joint torques be controlled to result in a spring-like leg operation? (2) how can rotational stiffnesses be adjusted to leg-segment geometry? and (3) to what extend can unequal segment lengths and orientations be advantageous? It was found that: (1) the three-segment leg tends to become unstable at a certain amount of bending expressed by a counterrotation of the joints; (2) homogeneous bending requires adaptation of the rotational stiffnesses to the outer segment lengths; (3) nonlinear joint torque-displacement behaviour extends the range of stable leg bending and may result in an almost constant leg stiffness; (4) biarticular structures (like human gastrocnemius muscle) and geometrical constraints (like heel strike) support homogeneous bending in both joints; (5) unequal segment lengths enable homogeneous bending if asymmetric nominal angles meet the asymmetry in leg geometry; and (6) a short foot supports the elastic control of almost stretched knee positions. Furthermore, general leg design strategies for animals and robots are discussed with respect to the range of safe leg operation. PMID:11357549

  16. [Peptic ulcer among workers in the engineering and chemical industries].

    PubMed

    Schabowski, J

    1995-01-01

    Incidence of peptic ulcer among workers employed in the engineering and chemical industries is presented in view of selected environmental factors. The study covered 157 workers with peptic ulcer who reported themselves to outpatient clinics at the Nitrogenous Fertilizers Plant in Pulawy and the Automobile Works in Lublin (5000 and 3252 employees, respectively). The study was conducted over a period of one year. It included: medical examinations, supplementary tests and a questionnaire survey. The questionnaire asked, among others, about working conditions, type of occupation performed and lifestyle. Peptic ulcer was diagnosed in 2.03% of workers engaged in the engineering industry and 1.82% of those working at the chemical plant. The incidence of peptic ulcer was higher among manual workers (2.18%) than in office workers (1.16%). The patients had been exposed to the following environmental factors: excessive noise--21%, vibration--17.2%, commuting--11.5%, extra work--14.5%, conflicts at work--13.5%, conflicts at home--15.3%, irregular meals--21.6%, alcohol intake--22.4%, cigarette smoking--62.4%. The study indicates that peptic ulcer is more often diagnosed in manual than in office workers and its incidence can be associated with working conditions and lifestyle. However, no significant variation in annual morbidity caused by peptic ulcer was observed among workers of the plants under study. PMID:9732844

  17. Assessing diabetic foot ulcer development risk with hyperspectral tissue oximetry

    NASA Astrophysics Data System (ADS)

    Yudovsky, Dmitry; Nouvong, Aksone; Schomacker, Kevin; Pilon, Laurent

    2011-02-01

    Foot ulceration remains a serious health concern for diabetic patients and has a major impact on the cost of diabetes treatment. Early detection and preventive care, such as offloading or improved hygiene, can greatly reduce the risk of further complications. We aim to assess the use of hyperspectral tissue oximetry in predicting the risk of diabetic foot ulcer formation. Tissue oximetry measurements are performed during several visits with hyperspectral imaging of the feet in type 1 and 2 diabetes mellitus subjects that are at risk for foot ulceration. The data are retrospectively analyzed at 21 sites that ulcerated during the course of our study and an ulceration prediction index is developed. Then, an image processing algorithm based on this index is implemented. This algorithm is able to predict tissue at risk of ulceration with a sensitivity and specificity of 95 and 80%, respectively, for images taken, on average, 58 days before tissue damage is apparent to the naked eye. Receiver operating characteristic analysis is also performed to give a range of sensitivity/specificity values resulting in a Q-value of 89%.

  18. Validity of pressure ulcer diagnosis using digital photography

    PubMed Central

    Baumgarten, Mona; Margolis, David J.; Selekof, Joan L.; Moye, Nancy; Jones, Patricia S.; Shardell, Michelle

    2010-01-01

    The purpose of this study was to evaluate the validity of digital photographs for the assessment of the presence of pressure ulcers stage 2 or higher. Participants were 48 patients (28 white and 20 black) with pressure ulcers identified in the course of a wound specialist’s routine clinical practice at the University of Maryland Medical Center. One pressure ulcer and one unaffected skin area were photographed on each participating patient. The gold standard diagnosis (stage 2 pressure ulcer vs. stage 1 or no pressure ulcer) was recorded by the wound specialist based on bedside examination. The photographs were reviewed blindly by another wound expert. The sensitivity of the blinded assessment was 97% (95% confidence interval [CI] 91–100%). The specificity was 97% (95% CI 92–100%). The sensitivity and specificity were both 100% in the white patients. In black patients, the sensitivity and specificity were 92% (95% CI 75–100%) and 93% (95% CI 82–100%), respectively. These results suggest that the use of photographic images to assess the presence or absence of a pressure ulcer stage 2 or higher has a high degree of validity. Since blinded outcome assessment is one of the cornerstones of good clinical trial design, photography offers the potential to strengthen future studies. PMID:19320898

  19. Diagnostic and Treatment Approaches for Refractory Peptic Ulcers

    PubMed Central

    2015-01-01

    Refractory peptic ulcers are defined as ulcers that do not heal completely after 8 to 12 weeks of standard anti-secretory drug treatment. The most common causes of refractory ulcers are persistent Helicobacter pylori infection and use of nonsteroidal anti-inflammatory drugs (NSAIDs). Simultaneous use of two or more H. pylori diagnostic methods are recommended for increased sensitivity. Serologic tests may be useful for patients currently taking proton pump inhibitors (PPIs) or for suspected false negative results, as they are not affected by PPI use. NSAID use should be discontinued when possible. Platelet cyclooxygenase activity tests can confirm surreptitious use of NSAIDs or aspirin. Cigarette smoking can delay ulcer healing. Therefore, patients who smoke should be encouraged to quit. Zollinger-Ellison syndrome (ZES) is a rare but important cause of refractory gastroduodenal ulcers. Fasting plasma gastrin levels should be checked if ZES is suspected. If an ulcer is refractory despite a full course of standard PPI treatment, the dose should be doubled and administration of another type of PPI considered. PMID:26240800

  20. Efficacy of Collagen Particles in Chronic Non Healing Ulcers

    PubMed Central

    Kumar, Yogesh; Kini, U Anand

    2015-01-01

    Introduction Chronic foot ulcers will lead to a significant and prolonged stress to the patients. Pain and discomfort that may be acute or continuous is the usual complaint in chronic non healing ulcers that may even exacerbate with change of the dressings. The end process in any wound healing is wound contracture and scar formation. Collagen plays an important role in this stage of wound healing. Collagen particles were used in chronic non healing ulcer management to prove their efficacy when compared with conventional dressing in a study conducted by us. Objective To compare the healing process in non healing ulcers using collagen particles with those of conventional method of dressing (betadine). Materials and Methods It was a non randomized, prospective study conducted for a period of October 2012 to October 2014 in hospitals belonging to Kasturba medical college. Non concurrent pre and post comparative study; between collagen group and conventional dressing group. A total of 110 patients with chronic ulcers were included; each group comprising 55 patients. Results There was a significant decrease in wound size with a mean difference of 37.29 in experimental group when compared to 14.29 in control group. Conclusion Collagen dressing is effective in management of chronic non healing ulcers when compared to conventional betadine dressing. It heals by forming an early granulation tissue and thus reducing the length of hospital stay. PMID:26266157

  1. Behçet's ulcerations in the lower extremity: A case report.

    PubMed

    Clark, Seth N; Hronek, Anna L; Hodge, Nan E; Soloman, Nehad; Vaughn, Teri L

    2015-09-01

    Behçet's Disease is a syndrome characterized by recurrent, painful oral aphthous ulcers, in conjunction with 2 or more systemic manifestations - a common systemic manifestation of the disease being cutaneous lesions, which often present as papules that ulcerate to form ulcerations which exhibit the same pathergy phenomenon as pyoderma gangrenosum and are thus difficult to heal. We present a case of a type 2 diabetic male with previously undiagnosed Behçet's Disease who presented to clinic with an atypical lower extremity wound. Due to the atypical nature of the patient's wound, combined with information from the patient regarding the history of the wound and other illnesses he had, the wound was biopsied and the results from the biopsy combined with clinical suspicion yielded a diagnosis of Behçet's Disease. After understanding the nature of the wound, management of the ulceration was adjusted appropriately so as to properly treat the patient with both local wound care and medical management for the disease. Patient was referred to rheumatology for further workup and long-term management of Behçet's Disease. Correct identification and treatment of the systemic disease, as well as the lower extremity ulcerations, in patients with Behçet's Disease are critical to avoid organ and limb-threatening complications. Had the diagnosis of Behçet's not been made in this case, the patient's wound would have been at increased risk of disease-related complications - ranging from non-healing ulceration leading to amputation to renal failure to loss of eyesight. PMID:25802130

  2. Swinging of the leg is an important part of human locomotion. The back-and-forth motion of the legs has been

    E-print Network

    by the cost of moving the legs. Here we test whether fast leg swinging is metabolically costly. The metabolic cost of active leg motion has previously been considered mostly in running animals. Taylor et al. (1980 with frequency of motion. Swinging the leg at high frequencies might therefore cost metabolic energy

  3. ODYSSEUS autonomous walking robot: The leg/arm design

    NASA Technical Reports Server (NTRS)

    Bourbakis, N. G.; Maas, M.; Tascillo, A.; Vandewinckel, C.

    1994-01-01

    ODYSSEUS is an autonomous walking robot, which makes use of three wheels and three legs for its movement in the free navigation space. More specifically, it makes use of its autonomous wheels to move around in an environment where the surface is smooth and not uneven. However, in the case that there are small height obstacles, stairs, or small height unevenness in the navigation environment, the robot makes use of both wheels and legs to travel efficiently. In this paper we present the detailed hardware design and the simulated behavior of the extended leg/arm part of the robot, since it plays a very significant role in the robot actions (movements, selection of objects, etc.). In particular, the leg/arm consists of three major parts: The first part is a pipe attached to the robot base with a flexible 3-D joint. This pipe has a rotated bar as an extended part, which terminates in a 3-D flexible joint. The second part of the leg/arm is also a pipe similar to the first. The extended bar of the second part ends at a 2-D joint. The last part of the leg/arm is a clip-hand. It is used for selecting several small weight and size objects, and when it is in a 'closed' mode, it is used as a supporting part of the robot leg. The entire leg/arm part is controlled and synchronized by a microcontroller (68CH11) attached to the robot base.

  4. EVOLVING SENSOR MORPHOLOGY ON A LEGGED ROBOT IN NICHE ENVIRONMENTS

    E-print Network

    Parker, Gary B.

    EVOLVING SENSOR MORPHOLOGY ON A LEGGED ROBOT IN NICHE ENVIRONMENTS GARY B. PARKER, CONNECTICUT This paper discusses the issue of evolution of morphology and automatic design, specifically evolving sensor morphology on a legged hexapod robot in niche environments. The evolution of sensor morphology in different

  5. OCEAN DRILLING PROGRAM LEG 124E ENGINEERING PROSPECTUS

    E-print Network

    , the concept of a dedicated engineering leg has been discussed for many years both within the Ocean Drilling test programs. It is hoped that the concept of dedicated ship time for engineering tOCEAN DRILLING PROGRAM LEG 124E ENGINEERING PROSPECTUS PHILIPPINE SEA Michael A. Storms Supr

  6. The Bow Leg Hopping Robot Ben Brown and Garth Zeglin

    E-print Network

    Zeglin, Garth

    the configuration of a planar hopping machine that we have developed based on the above The Bow Leg Hopping Robot Ben Brown and Garth Zeglin The Robotics Institute Carnegie Mellon energy to the leg, which is automatically released during stance to control hopping height. Lateral

  7. OCEAN DRILLING PROGRAM LEG 171A SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEG 171A SCIENTIFIC PROSPECTUS BARBADOS ACCRETIONARY PRISM LOGGING WHILE DRILLING (LWD) Dr. J. Casey Moore Co-Chief Scientist, Leg 171A University of California, Santa Cruz Earth Drilling Program Texas A&M University Research Park 1000 Discovery Drive College Station, Texas 77845

  8. 33 CFR 147.809 - Mars Tension Leg Platform safety zone.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ...2012-07-01 2012-07-01 false Mars Tension Leg Platform safety zone. 147...ACTIVITIES SAFETY ZONES § 147.809 Mars Tension Leg Platform safety zone. (a) Description. The Mars Tension Leg Platform (Mars TLP) is located...

  9. 33 CFR 147.809 - Mars Tension Leg Platform safety zone.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ...2014-07-01 2014-07-01 false Mars Tension Leg Platform safety zone. 147...ACTIVITIES SAFETY ZONES § 147.809 Mars Tension Leg Platform safety zone. (a) Description. The Mars Tension Leg Platform (Mars TLP) is located...

  10. 33 CFR 147.809 - Mars Tension Leg Platform safety zone.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ...2013-07-01 2013-07-01 false Mars Tension Leg Platform safety zone. 147...ACTIVITIES SAFETY ZONES § 147.809 Mars Tension Leg Platform safety zone. (a) Description. The Mars Tension Leg Platform (Mars TLP) is located...

  11. 78 FR 68909 - Agency Information Collection (Knee and Lower Leg Conditions Disability Benefits Questionnaire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ...NEW] Agency Information Collection (Knee and Lower Leg Conditions Disability Benefits...to ``OMB Control No. 2900-- NEW (Knee and Lower Leg Conditions Disability Benefits...refer to ``OMB Control No. 2900-NEW (Knee and Lower Leg Conditions Disability...

  12. 78 FR 38098 - Proposed Information Collection (Knee and Lower Leg Disability Benefits Questionnaire) Activity...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ...2900-NEW] Proposed Information Collection (Knee and Lower Leg Disability Benefits Questionnaire...related to a claimant's diagnosis of knee and lower leg conditions. DATES: Written...refer to ``OMB Control No. 2900-NEW (Knee and Lower Leg Conditions Disability...

  13. A Terradynamics of Legged Locomotion on Granular Media

    E-print Network

    Chen Li; Tingnan Zhang; Daniel I. Goldman

    2013-03-28

    The theories of aero- and hydrodynamics predict animal movement and device design in air and water through the computation of lift, drag, and thrust forces. Although models of terrestrial legged locomotion have focused on interactions with solid ground, many animals move on substrates that flow in response to intrusion. However, locomotor-ground interaction models on such flowable ground are often unavailable. We developed a force model for arbitrarily-shaped legs and bodies moving freely in granular media, and used this "terradynamics" to predict a small legged robot's locomotion on granular media using various leg shapes and stride frequencies. Our study reveals a complex but generic dependence of stresses in granular media on intruder depth, orientation, and movement direction and gives insight into the effects of leg morphology and kinematics on movement.

  14. Adaptive leg coordination with a biologically inspired neurocontroller

    NASA Astrophysics Data System (ADS)

    Braught, Grant; Thomopoulos, Stelios C.

    1996-10-01

    Natural selection is responsible for the creation of robust and adaptive control systems. Nature's control systems are created only from primitive building blocks. Using insect neurophysiology as a guide, a neural architecture for leg coordination in a hexapod robot has been developed. Reflex chains and sensory feedback mechanisms from various insects and crustacea form the basis of a pattern generator for intra-leg coordination. The pattern generator contains neural oscillators which learn from sensory feedback to produce stepping patterns. Using sensory feedback as the source of learning information allows the pattern generator to adapt to changes in the leg dynamics due to internal or external causes. A coupling between six of the single leg pattern generators is used to produce the inter-leg coordination necessary to establish stable gaits.

  15. A Terradynamics of Legged Locomotion on Granular Media

    E-print Network

    Li, Chen; Goldman, Daniel I; 10.1126/science.1229163

    2013-01-01

    The theories of aero- and hydrodynamics predict animal movement and device design in air and water through the computation of lift, drag, and thrust forces. Although models of terrestrial legged locomotion have focused on interactions with solid ground, many animals move on substrates that flow in response to intrusion. However, locomotor-ground interaction models on such flowable ground are often unavailable. We developed a force model for arbitrarily-shaped legs and bodies moving freely in granular media, and used this "terradynamics" to predict a small legged robot's locomotion on granular media using various leg shapes and stride frequencies. Our study reveals a complex but generic dependence of stresses in granular media on intruder depth, orientation, and movement direction and gives insight into the effects of leg morphology and kinematics on movement.

  16. A terradynamics of legged locomotion on granular media.

    PubMed

    Li, Chen; Zhang, Tingnan; Goldman, Daniel I

    2013-03-22

    The theories of aero- and hydrodynamics predict animal movement and device design in air and water through the computation of lift, drag, and thrust forces. Although models of terrestrial legged locomotion have focused on interactions with solid ground, many animals move on substrates that flow in response to intrusion. However, locomotor-ground interaction models on such flowable ground are often unavailable. We developed a force model for arbitrarily-shaped legs and bodies moving freely in granular media, and used this "terradynamics" to predict a small legged robot's locomotion on granular media using various leg shapes and stride frequencies. Our study reveals a complex but generic dependence of stresses in granular media on intruder depth, orientation, and movement direction and gives insight into the effects of leg morphology and kinematics on movement. PMID:23520106

  17. Protection against high intravascular pressure in giraffe legs.

    PubMed

    Petersen, Karin K; Hørlyck, Arne; Ostergaard, Kristine H; Andresen, Joergen; Broegger, Torbjoern; Skovgaard, Nini; Telinius, Niklas; Laher, Ismael; Bertelsen, Mads F; Grøndahl, Carsten; Smerup, Morten; Secher, Niels H; Brøndum, Emil; Hasenkam, John M; Wang, Tobias; Baandrup, Ulrik; Aalkjaer, Christian

    2013-11-01

    The high blood pressure in giraffe leg arteries renders giraffes vulnerable to edema. We investigated in 11 giraffes whether large and small arteries in the legs and the tight fascia protect leg capillaries. Ultrasound imaging of foreleg arteries in anesthetized giraffes and ex vivo examination revealed abrupt thickening of the arterial wall and a reduction of its internal diameter just below the elbow. At and distal to this narrowing, the artery constricted spontaneously and in response to norepinephrine and intravascular pressure recordings revealed a dynamic, viscous pressure drop along the artery. Histology of the isolated median artery confirmed dense sympathetic innervation at the narrowing. Structure and contractility of small arteries from muscular beds in the leg and neck were compared. The arteries from the legs demonstrated an increased media thickness-to-lumen diameter ratio, increased media volume, and increased numbers of smooth muscle cells per segment length and furthermore, they contracted more strongly than arteries from the neck (500 ± 49 vs. 318 ± 43 mmHg; n = 6 legs and neck, respectively). Finally, the transient increase in interstitial fluid pressure following injection of saline was 5.5 ± 1.7 times larger (n = 8) in the leg than in the neck. We conclude that 1) tissue compliance in the legs is low; 2) large arteries of the legs function as resistance arteries; and 3) structural adaptation of small muscle arteries allows them to develop an extraordinary tension. All three findings can contribute to protection of the capillaries in giraffe legs from a high arterial pressure. PMID:24005251

  18. Adult Sacrococcygeal Teratoma: The third leg

    PubMed Central

    Yekula, M.S. Kiran Kumar; Yekula, Anudeep

    2015-01-01

    Introduction Sacrococcygeal Teratoma (SCT) is a rare benign neoplasm comprised of mixed elements derived from two or more germ cell layers. They are extremely rare in adults. They attract attention because of their gross appearance and bizarre histology. Presentation of case A 25 year old male presented to Surgical OPD, Government General Hospital, Guntur Medical College, Guntur with a large mass comprising a partially developed 3rd leg and rudimentary external genitalia in the lower back. He complained of cosmetic blemish, difficulty in sitting, sleeping and walking. Discussion He was diagnosed mature Sacrococcygeal Teratoma Altman Type II based on history, clinical examination, ultrasound, MRI. Histopathology confirmed the diagnosis. He had complete surgical excision with primary wound closure and a good postoperative recovery. A 3-year follow-up using clinical, biochemical and radiological assessment revealed no evidence of recurrence. Conclusion Mature SCT, though very rare in adults, are usually benign. Complete surgical excision remains the mainstay of treatment. PMID:26275739

  19. Management of acute severe ulcerative colitis

    PubMed Central

    Kedia, Saurabh; Ahuja, Vineet; Tandon, Rakesh

    2014-01-01

    The management strategy of acute severe ulcerative colitis has evolved over the past decade from being entirely restricted to twin choices of intravenous steroids or colectomy to include colon rescue therapies like cyclosporin as well as infliximab. However it still remains a medical emergency requiring hospitalization and requires care from a multidisciplinary team comprising of a gastroenterologist and a colorectal surgeon. The frame shift in management has been the emphasis on time bound decision making with an attempt to curtail the mortality rate to below 1%. Intravenous corticosteroids are the mainstay of therapy. Response to steroids should be assessed at day 3 of admission and partial/non-responders should be considered for alternative medical therapy/surgery. Medical rescue therapies include intravenous cyclosporin and infliximab. Cyclosporin is administered in a dose of 2 mg/kg per day and infliximab is administered as a single dose intravenous infusion of 5 mg/kg. Approximately 75% patients have short term and 50% patients have long term response to cyclosporin. Long term response to cyclosporin is improved in patients who are thiopurine naïve and are started on thiopurines on day 7. Infliximab also has a response rate of approximately 70% in short term and 50% in long term. Both cyclosporin and infliximab are equally efficacious medical rescue therapies as demonstrated in a recent randomized control trial. Patients not responding to infliximab or cyclosporin should be considered for colectomy. PMID:25401001

  20. Pancreatic cancer after remote peptic ulcer surgery

    PubMed Central

    Tascilar, M; van Rees, B P; Sturm, P D J; Tytgat, G N J; Hruban, R H; Goodman, S N; Giardiello, F M; Offerhaus, G J A; Tersmette, A C

    2002-01-01

    Background: Peptic ulcer surgery may carry an increased risk for pancreatic cancer development. Molecular analysis of K-ras codon 12, frequently mutated in conventional pancreatic cancers, might provide insight into the aetiological mechanisms. Methods: The relative risk of pancreatic cancer was computed by multivariate and person–year analysis in a cohort of 2633 patients who had undergone gastrectomy. Lung cancer risk was analysed as an indirect means of assessing smoking behaviour. K-ras codon 12 mutational analysis was performed on 15 postgastrectomy pancreatic cancers. Results: There was an overall increased risk of pancreatic carcinoma of 1.8 (95% confidence interval, 1.3 to 2.6) five to 59 years postoperatively, which gradually increased to 3.6 at 35 years or more after surgery (?2 test for trend, p < 0.05). Multivariate analysis indicated that parameters other than postoperative interval did not influence the risk. Lung cancer risk was significantly increased after surgery, but no time trend was observed. The spectrum and prevalence of K-ras codon 12 mutations were comparable to conventional pancreatic cancer. Conclusions: Remote partial gastrectomy is associated with an increased risk of pancreatic cancer. Postgastrectomy and non-postgastrectomy pancreatic cancers may share similar aetiological factors, such as smoking. However, the neoplastic process in patients who have undergone gastrectomy appears to be accelerated by factors related to the surgery itself. PMID:11986336

  1. Tacrolimus for the Treatment of Ulcerative Colitis

    PubMed Central

    Matsuoka, Katsuyoshi; Saito, Eiko; Fujii, Toshimitsu; Takenaka, Kento; Kimura, Maiko; Nagahori, Masakazu; Ohtsuka, Kazuo

    2015-01-01

    Tacrolimus is a calcineurin inhibitor used for the treatment of corticosteroid-refractory ulcerative colitis (UC). Two randomized controlled trials and a number of retrospective studies have assessed the therapeutic effect of tacrolimus in UC patients. These studies showed that tacrolimus has excellent short-term efficacy in corticosteroid-refractory patients, with the rates of clinical response ranging from 61% to 96%. However, the long-term prognosis of patients treated with tacrolimus is disappointing, and almost 50% of patients eventually underwent colectomy in long-term follow-up. Tacrolimus can achieve mucosal healing in 40-50% of patients, and this is associated with a favorable long-term prognosis. Anti-tumor necrosis factor (TNF)-? antibodies are another therapeutic option in corticosteroid-refractory patients. A prospective head-to-head comparative study of tacrolimus and infliximab is currently being performed to determine which treatment is more effective in corticosteroid-refractory patients. Several retrospective studies have demonstrated that switching between tacrolimus and anti-TNF-? antibody therapy was effective in patients who were refractory to one of the treatments. Most adverse events of tacrolimus are mild; however, opportunistic infections, especially pneumocystis pneumonia, are the most important adverse events, and these should be carefully considered during treatment. Several issues on tacrolimus treatment in UC patients remain unsolved (e.g., use of tacrolimus as remission maintenance therapy). Further controlled studies are needed to optimize the use of tacrolimus for the treatment of UC. PMID:26130996

  2. [Detection of lymph vessel changes in venous diseases of the leg using imaging procedures].

    PubMed

    Tiedjen, K U

    1989-12-01

    Chronic venous insufficiency reveals both functional correlations with the lymphatic system of the limbs as well as pathological-anatomical. The functional correlation initially consists in an enhancement of function as a manifestation of a compensation mechanism of lymphatic drainage in relation to the insufficient venous system. Finally, if the lymphatics are themselves damaged in their further course, a safety valve insufficiency occurs with resulting lymphostasis. Apart from this participation, regional damages to the lymphatic fascicles play a role in chronic venous insufficiency in trophic disorders, as for example leg ulcer and atrophy. However, these are far less significant for the overall function of lymphatic drainage. As a role, they show a pronounced collateralization, and thus good possibilities of functional compensation. In particular indirect lymphography with water-soluble contrast medium is suitable as imaging technique in diagnostics with regard to the morphology. Isotope lymphography is suitable with regard to investigating the function of lymphatic drainage and for circumscribed local disorders. As native techniques, xeroradiography and computed tomography are very suitable to analyse tissue damage of the cutis and subcutis resulting from chronic venous insufficiency and from lymphostasis and to make indirect inferences from this with regard to the chronicity of this disease process. PMID:2699137

  3. Restless legs syndrome: pathophysiology and modern management.

    PubMed

    Nagandla, Kavitha; De, Somsubhra

    2013-07-01

    Restless legs syndrome (RLS) is a common sensory motor neurological disorder that is characterised by an irresistible urge to move the legs that significantly affects the quality of life of the patient. Prevalence in the general population is 5-25% and it is twice as prevalent in women as in men. RLS is the most common movement disorder in pregnancy with a fourfold increased risk of developing this disorder later in life. The pathophysiology of RLS is centred on dopaminergic dysfunction, reduced central nervous system iron, genetic linkages, or alteration in neurotransmitters such as hypocretins, endorphins levels and immune dysfunction and inflammatory mechanisms. With the emergence of new evidence, there are changes to the previous treatment recommendations for RLS. There is sufficient evidence to conclude that dopamine agonists such as rotigotine transdermal patch, pramipexole, ropinirole, gabapentin enacarbil, pregabalin and gabapentin are effective in the short-term treatment of RLS and rotigotine, followed by gabapentin enacarbil, ropinirole, pramipexole and gabapentin for long-term treatment. Based on expert consensus, the recommendation for daily RLS is dopamine agonists or gabapentin or low-potency opioids. Levodopa is less preferred for treating daily RLS due to its high risk of augmentation. For intermittent RLS, it is levodopa or dopamine agonists or low-potency opioids or benzodiazepines. For refractory RLS, the choice is to change to gabapentin or a different dopamine agonist, addition of a second agent like gabapentin or benzodiazepine to the existing drug or changing to a high-potency opioid or tramadol. Medications with safety record in pregnancy include opioids and antiepileptics such as carbamazepine and gabapentin. There are concerns that patients with RLS are at risk for metabolic deregulation, autonomic dysfunction and cardiovascular morbidity. However, a recent study concluded that RLS is not associated with increased risk of cardiovascular complications. PMID:23524988

  4. STROBE—Radiation Ulcer: An Overlooked Complication of Fluoroscopic Intervention

    PubMed Central

    Wei, Kai-Che; Yang, Kuo-Chung; Mar, Guang-Yuan; Chen, Lee-Wei; Wu, Chieh-Shan; Lai, Chi-Cheng; Wang, Wen-Hua; Lai, Ping-Chin

    2015-01-01

    Abstract With increasing numbers of percutaneous coronary intervention (PCI) and complex cardiac procedures, higher accumulated radiation dose in patient has been observed. We speculate cardiac catheter intervention induced radiation skin damage is no longer rare. To study the incidence of cardiac fluoroscopic intervention induced radiation ulcer. We retrospectively reviewed medical records of those who received cardiac fluoroscopic intervention in our hospital during 2012 to 2013 for any events of radiation ulcer. Only patients, whose clinical photos were available for reviewing, would be included for further evaluation. The diagnosis of radiation ulcers were made when there is a history of PCI with pictures proven skin ulcers, which presented typical characteristics of radiation injury. Nine patients with radiation ulcer were identified and the incidence was 0.34% (9/2570) per practice and 0.42% (9/2124) per patient. Prolonged procedure time, cumulative multiple procedures, right coronary artery occlusion with chronic total occlusion, obesity, and diabetes are frequent characteristics. The onset interval between the first skin manifestation and the latest radiation exposure varied from 3 weeks to 3 months. The histopathology studies failed to make diagnosis correctly in 5 out of 6 patients. To make thing worse, skin biopsy exacerbated the preexisting radiation dermatitis. Notably, all radiation ulcers were refractory to conventional wound care. Surgical intervention was necessary to heal the wound. Diagnosis of cardiac fluoroscopy intervention induced radiation skin damage is challenging and needs high index of clinical suspicion. Minimizing the radiation exposure by using new approaches is the most important way to prevent this complication. Patient education and a routine postprocedure dermatology follow up are mandatory in high-risk groups for both radiation skin damage and malignancies. This is a retrospective study, thus the true incidence of radiation ulcer caused by cardiac fluoroscopic intervention could be higher. PMID:26632903

  5. Corneal cross-linking in 9 horses with ulcerative keratitis

    PubMed Central

    2013-01-01

    Background Corneal ulcers are one of the most common eye problems in the horse and can cause varying degrees of visual impairment. Secondary infection and protease activity causing melting of the corneal stroma are always concerns in patients with corneal ulcers. Corneal collagen cross-linking (CXL), induced by illumination of the corneal stroma with ultraviolet light (UVA) after instillation of riboflavin (vitamin B2) eye drops, introduces crosslinks which stabilize melting corneas, and has been used to successfully treat infectious ulcerative keratitis in human patients. Therefore we decided to study if CXL can be performed in sedated, standing horses with ulcerative keratitis with or without stromal melting. Results Nine horses, aged 1 month to 16 years (median 5 years) were treated with a combination of CXL and medical therapy. Two horses were diagnosed with mycotic, 5 with bacterial and 2 with aseptic ulcerative keratitis. A modified Dresden-protocol for CXL could readily be performed in all 9 horses after sedation. Stromal melting, diagnosed in 4 horses, stopped within 24 h. Eight of nine eyes became fluorescein negative in 13.5 days (median time; range 4–26 days) days after CXL. One horse developed a bacterial conjunctivitis the day after CXL, which was successfully treated with topical antibiotics. One horse with fungal ulcerative keratitis and severe uveitis was enucleated 4 days after treatment due to panophthalmitis. Conclusions CXL can be performed in standing, sedated horses. We did not observe any deleterious effects attributed to riboflavin or UVA irradiation per se during the follow-up, neither in horses with infectious nor aseptic ulcerative keratitis. These data support that CXL can be performed in the standing horse, but further studies are required to compare CXL to conventional medical treatment in equine keratitis and to optimize the CXL protocol in this species. PMID:23803176

  6. Interleukin-17 expression in murine pressure ulcer tissues

    PubMed Central

    CUI, WEI; YANG, LEI-FANG; WEI, WEN-HONG; ZHU, YA-QIN; WU, XIAO; MU, PEI-XIA; GUO, SHU-PING

    2013-01-01

    To explore the process of pressure ulcer formation, interleukin (IL)-17 expression levels were observed in a mouse model of pressure ulcers. Twenty mice were divided into experimental and control groups (10 mice per group). A mouse model of pressure ulcers was established by inducing ischemia-reperfusion injury on local tissue in the experimental group. Pressure ulcer tissues in the experimental group and normal mouse tissue in the control group were stained using hematoxylin and eosin (H&E) and observed using light microscopy. The protein and mRNA expression levels of IL-17, in mouse pressure ulcer tissues from the experimental group and in the normal tissue from the control group, were determined using real-time PCR and western blot analysis, respectively. The mRNA and protein expression levels of IL-17 were compared between the two groups. H&E staining indicated that striated muscle was arranged orderly and cellular structure was intact in the control group, whilst inflammatory cell infiltration was observed in the muscle tissue of the experimental group. The expression levels of IL-17 mRNA were 0.307±0.058 ng in the experimental group and 0.112±0.042 ng in the control group (P<0.05). The expression levels of the IL-17 protein were 0.434±0.097 ng in the experimental group and 0.181±0.040 ng in the control group (P<0.05). IL-17 expression levels were increased in pressure ulcers, which suggests that IL-17 may be associated with pressure ulcers. PMID:23403648

  7. Don't break a leg: running birds from quail to ostrich prioritise leg safety and economy on uneven terrain

    PubMed Central

    Birn-Jeffery, Aleksandra V.; Hubicki, Christian M.; Blum, Yvonne; Renjewski, Daniel; Hurst, Jonathan W.; Daley, Monica A.

    2014-01-01

    Cursorial ground birds are paragons of bipedal running that span a 500-fold mass range from quail to ostrich. Here we investigate the task-level control priorities of cursorial birds by analysing how they negotiate single-step obstacles that create a conflict between body stability (attenuating deviations in body motion) and consistent leg force–length dynamics (for economy and leg safety). We also test the hypothesis that control priorities shift between body stability and leg safety with increasing body size, reflecting use of active control to overcome size-related challenges. Weight-support demands lead to a shift towards straighter legs and stiffer steady gait with increasing body size, but it remains unknown whether non-steady locomotor priorities diverge with size. We found that all measured species used a consistent obstacle negotiation strategy, involving unsteady body dynamics to minimise fluctuations in leg posture and loading across multiple steps, not directly prioritising body stability. Peak leg forces remained remarkably consistent across obstacle terrain, within 0.35 body weights of level running for obstacle heights from 0.1 to 0.5 times leg length. All species used similar stance leg actuation patterns, involving asymmetric force–length trajectories and posture-dependent actuation to add or remove energy depending on landing conditions. We present a simple stance leg model that explains key features of avian bipedal locomotion, and suggests economy as a key priority on both level and uneven terrain. We suggest that running ground birds target the closely coupled priorities of economy and leg safety as the direct imperatives of control, with adequate stability achieved through appropriately tuned intrinsic dynamics. PMID:25355848

  8. Don't break a leg: running birds from quail to ostrich prioritise leg safety and economy on uneven terrain.

    PubMed

    Birn-Jeffery, Aleksandra V; Hubicki, Christian M; Blum, Yvonne; Renjewski, Daniel; Hurst, Jonathan W; Daley, Monica A

    2014-11-01

    Cursorial ground birds are paragons of bipedal running that span a 500-fold mass range from quail to ostrich. Here we investigate the task-level control priorities of cursorial birds by analysing how they negotiate single-step obstacles that create a conflict between body stability (attenuating deviations in body motion) and consistent leg force-length dynamics (for economy and leg safety). We also test the hypothesis that control priorities shift between body stability and leg safety with increasing body size, reflecting use of active control to overcome size-related challenges. Weight-support demands lead to a shift towards straighter legs and stiffer steady gait with increasing body size, but it remains unknown whether non-steady locomotor priorities diverge with size. We found that all measured species used a consistent obstacle negotiation strategy, involving unsteady body dynamics to minimise fluctuations in leg posture and loading across multiple steps, not directly prioritising body stability. Peak leg forces remained remarkably consistent across obstacle terrain, within 0.35 body weights of level running for obstacle heights from 0.1 to 0.5 times leg length. All species used similar stance leg actuation patterns, involving asymmetric force-length trajectories and posture-dependent actuation to add or remove energy depending on landing conditions. We present a simple stance leg model that explains key features of avian bipedal locomotion, and suggests economy as a key priority on both level and uneven terrain. We suggest that running ground birds target the closely coupled priorities of economy and leg safety as the direct imperatives of control, with adequate stability achieved through appropriately tuned intrinsic dynamics. PMID:25355848

  9. Dynamics of the support leg in soccer instep kicking.

    PubMed

    Inoue, Koichiro; Nunome, Hiroyuki; Sterzing, Thorsten; Shinkai, Hironari; Ikegami, Yasuo

    2014-01-01

    We aimed to illustrate support leg dynamics during instep kicking to evaluate the role of the support leg action in performance. Twelve male soccer players performed maximal instep kicks. Their motions and ground reaction forces were recorded by a motion capture system and a force platform. Moments and angular velocities of the support leg and pelvis were computed using inverse dynamics. In most joints of the support leg, the moments were not associated with or counteracting the joint motions except for the knee joint. It can be interpreted that the initial knee flexion motion counteracting the extension joint moment has a role to attenuate the shock of landing and the following knee extension motion associated with the extension joint moment indirectly contributes to accelerate the swing of kicking leg. Also, appreciable horizontal rotation of the pelvis coincided with increase of the interaction moment due to the hip joint reaction force on the support leg side. It can be assumed that the interaction moment was the main factor causing the pelvis counter-clockwise rotation within the horizontal plane from the overhead view that precedes a proximal-to-distal sequence of segmental action of the swing leg. PMID:24575753

  10. Managing osteoporosis in ulcerative colitis: Something new?

    PubMed Central

    Piodi, Luca Petruccio; Poloni, Alessandro; Ulivieri, Fabio Massimo

    2014-01-01

    The authors revise the latest evidence in the literature regarding managing of osteoporosis in ulcerative colitis (UC), paying particular attention to the latest tendency of the research concerning the management of bone damage in the patient affected by UC. It is wise to assess vitamin D status in ulcerative colitis patients to recognize who is predisposed to low levels of vitamin D, whose deficiency has to be treated with oral or parenteral vitamin D supplementation. An adequate dietary calcium intake or supplementation and physical activity, if possible, should be guaranteed. Osteoporotic risk factors, such as smoking and excessive alcohol intake, must be avoided. Steroid has to be prescribed at the lowest possible dosage and for the shortest possible time. Moreover, conditions favoring falling have to been minimized, like carpets, low illumination, sedatives assumption, vitamin D deficiency. It is advisable to assess the fracture risk in all UC patient by the fracture assessment risk tool (FRAX® tool), that calculates the ten years risk of fracture for the population aged from 40 to 90 years in many countries of the world. A high risk value could indicate the necessity of treatment, whereas a low risk value suggests a follow-up only. An intermediate risk supports the decision to prescribe bone mineral density (BMD) assessment and a subsequent patient revaluation for treatment. Dual energy X-ray absorptiometry bone densitometry can be used not only for BMD measurement, but also to collect data about bone quality by the means of trabecular bone score and hip structural analysis assessment. These two indices could represent a method of interesting perspectives in evaluating bone status in patients affected by diseases like UC, which may present an impairment of bone quality as well as of bone quantity. In literature there is no strong evidence for instituting pharmacological therapy of bone impairment in UC patients for clinical indications other than those that are also applied to the patients with osteoporosis. Therefore, a reasonable advice is to consider pharmacological treatment for osteoporosis in those UC patients who already present fragility fractures, which bring a high risk of subsequent fractures. Therapy has also to be considered in patients with a high risk of fracture even if it did not yet happen, and particularly when they had long periods of corticosteroid therapy or cumulative high dosages. In patients without fragility fractures or steroid treatment, a medical decision about treatment could be guided by the FRAX tool to determine the intervention threshold. Among drugs for osteoporosis treatment, the bisphosphonates are the most studied ones, with the best and longest evidence of efficacy and safety. Despite this, several questions are still open, such as the duration of treatment, the necessity to discontinue it, the indication of therapy in young patients, particularly in those without previous fractures. Further, it has to be mentioned that a long-term bisphosphonates use in primary osteoporosis has been associated with an increased incidence of dramatic side-effects, even if uncommon, like osteonecrosis of the jaw and atypical sub-trochanteric and diaphyseal femoral fractures. UC is a long-lasting disease and the majority of patients is relatively young. In this scenario primary prevention of fragility fracture is the best cost-effective strategy. Vitamin D supplementation, adequate calcium intake, suitable physical activity (when possible), removing of risk factors for osteoporosis like smoking, and avoiding falling are the best medical acts. PMID:25339798

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

    PubMed

    Bhattacharya, Surajit; Mishra, R K

    2015-01-01

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

  12. Developing eLearning for pressure ulcer prevention and management.

    PubMed

    Cameron, Rosie; Rodgers, Angela; Welsh, Lynn; McGown, Katrina

    2014-08-12

    The impact of pressure ulcers is psychologically, physically and clinically challenging for both patients and NHS staff. NHS Greater Glasgow and Clyde (NHS GGC), in line with the Scottish Best Practice Statement for the Prevention and Management of Pressure Ulcers ( Quality Improvement Scotland, 2009 ), and the NHS Health Improvement Scotland (2011) Preventing Pressure Ulcers Change Package, launched an awareness campaign throughout the organisation in April 2012 and has more recently adopted a 'zero-tolerance' approach to pressure damage. The tissue viability service in NHS GGC recognised that in order to achieve this aim, education of front-line staff is essential. An educational framework for pressure ulcer prevention was developed for all levels of healthcare staff involved in the delivery of patient care. As a means to support the framework, an initiative to develop web-based eLearning modules has been taken forward. This has resulted in the creation of an accessible, cost-effective, stimulating, relevant, and evidence-based education programme designed around the educational needs of all healthcare staff. In conjunction with the organisation's 'top ten tools' for pressure ulcer prevention and management, the modular online education programme addresses the aims of quality improvement and zero tolerance by supporting the provision of safe and effective person-centered care. PMID:25117595

  13. Transdermal deferoxamine prevents pressure-induced diabetic ulcers.

    PubMed

    Duscher, Dominik; Neofytou, Evgenios; Wong, Victor W; Maan, Zeshaan N; Rennert, Robert C; Inayathullah, Mohammed; Januszyk, Michael; Rodrigues, Melanie; Malkovskiy, Andrey V; Whitmore, Arnetha J; Walmsley, Graham G; Galvez, Michael G; Whittam, Alexander J; Brownlee, Michael; Rajadas, Jayakumar; Gurtner, Geoffrey C

    2015-01-01

    There is a high mortality in patients with diabetes and severe pressure ulcers. For example, chronic pressure sores of the heels often lead to limb loss in diabetic patients. A major factor underlying this is reduced neovascularization caused by impaired activity of the transcription factor hypoxia inducible factor-1 alpha (HIF-1?). In diabetes, HIF-1? function is compromised by a high glucose-induced and reactive oxygen species-mediated modification of its coactivator p300, leading to impaired HIF-1? transactivation. We examined whether local enhancement of HIF-1? activity would improve diabetic wound healing and minimize the severity of diabetic ulcers. To improve HIF-1? activity we designed a transdermal drug delivery system (TDDS) containing the FDA-approved small molecule deferoxamine (DFO), an iron chelator that increases HIF-1? transactivation in diabetes by preventing iron-catalyzed reactive oxygen stress. Applying this TDDS to a pressure-induced ulcer model in diabetic mice, we found that transdermal delivery of DFO significantly improved wound healing. Unexpectedly, prophylactic application of this transdermal delivery system also prevented diabetic ulcer formation. DFO-treated wounds demonstrated increased collagen density, improved neovascularization, and reduction of free radical formation, leading to decreased cell death. These findings suggest that transdermal delivery of DFO provides a targeted means to both prevent ulcer formation and accelerate diabetic wound healing with the potential for rapid clinical translation. PMID:25535360

  14. Wound Bed Preparation for Chronic Diabetic Foot Ulcers

    PubMed Central

    Mat Saad, Arman Zaharil; Khoo, Teng Lye; Halim, Ahmad Sukari

    2013-01-01

    The escalating incidence of diabetic mellitus has given rise to the increasing problems of chronic diabetic ulcers that confront the practice of medicine. Peripheral vascular disease, neuropathy, and infection contribute to the multifactorial pathogenesis of diabetic ulcers. Approaches to the management of diabetic ulcers should start with an assessment and optimization of the patient's general conditions, followed by considerations of the local and regional factors. This paper aims to address the management strategies for wound bed preparation in chronic diabetic foot ulcers and also emphasizes the importance of preventive measures and future directions. The “TIME” framework in wound bed preparation encompasses tissue management, inflammation and infection control, moisture balance, and epithelial (edge) advancement. Tissue management aims to remove the necrotic tissue burden via various methods of debridement. Infection and inflammation control restores bacterial balance with the reduction of bacterial biofilms. Achieving a moist wound healing environment without excessive wound moisture or dryness will result in moisture balance. Epithelial advancement is promoted via removing the physical and biochemical barriers for migration of epithelium from wound edges. These systematic and holistic approaches will potentiate the healing abilities of the chronic diabetic ulcers, including those that are recalcitrant. PMID:23476800

  15. Clinical experience of esophageal ulcers and esophagitis in AIDS patients.

    PubMed

    Yang, M T; Ko, F T; Cheng, N Y; Lin, K Y; Wang, C S; Siauw, C P; Shih, L S; Liao, S T

    1996-11-01

    In Taiwan, numbers of patients with the acquired immunodeficiency syndrome (AIDS) have been increasing in recent years. We present esophageal disease of different causes in 5(16%) heterosexual men among 31 AIDS patients over a 5-year period. Major symptoms included mild dysphagia in 4 (80%) patients and odynophagia in 3 (60%) patients. The duration of symptoms varied from 3 days to 6 months. The symptoms occurred before the diagnosis of AIDS in 3 patients. At esophagogastroduodenoscopy (endoscopy), all 5 patients had esophagitis and/or esophageal ulcers proved by histopathologic evaluation. Four had Candida esophagitis, 3 had cytomegalovirus esophagitis/ulcers and 2 had idiopathic esophageal ulcerations (IEU). Three patients had different esophagitis/ulcers at the same time or during follow-up. The median CD4 lymphocyte count at the time of diagnosis of esophageal disease was 12.2 cells/mm3 (range, 3 to 35 cells/mm3). The endoscopic pictures of the different causes of esophagitis/ ulcers lack uniformity in number, size and appearance. These observations make a conclusion that all AIDS patients with an esophageal disease should undergo endoscopy with biopsy to obtain a definitive diagnosis. PMID:8953856

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

    PubMed Central

    Bhattacharya, Surajit; Mishra, R. K.

    2015-01-01

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

  17. Clinical trials in ulcerative colitis: a historical perspective.

    PubMed

    Hindryckx, Pieter; Baert, Filip; Hart, Ailsa; Magro, Fernando; Armuzzi, Alessandro; Peyrin-Biroulet, Laurent

    2015-07-01

    The clinical trial landscape in ulcerative colitis has evolved significantly in recent decades. Study endpoints have been shifting from mere clinical response to mucosal healing. It has become clear that the choice of combined clinical and endoscopic outcome criteria leads to a reduction in placebo responses, especially when central reading of the endoscopic images is performed. Accumulating evidence suggests that histological remission yields better long-term outcomes for ulcerative colitis patients than mucosal healing alone, and clinical trials with prolonged follow-up will have to address whether histological remission should be the ultimate treatment goal in ulcerative colitis. In recent years there has also been increasing interest in the implementation of patient-reported outcomes in clinical practice and research, and the regulatory authorities have set up guidelines for the development of such outcomes. This paper aims to provide a comprehensive review of historical aspects of clinical trials in ulcerative colitis and to discuss challenges and perspectives for clinical trials in the near future. A thorough analysis of all available landmark literature (both original papers and reviews) on clinical trials in ulcerative colitis was performed. PMID:25913641

  18. Transdermal deferoxamine prevents pressure-induced diabetic ulcers

    PubMed Central

    Duscher, Dominik; Neofytou, Evgenios; Wong, Victor W.; Maan, Zeshaan N.; Rennert, Robert C.; Januszyk, Michael; Rodrigues, Melanie; Malkovskiy, Andrey V.; Whitmore, Arnetha J.; Galvez, Michael G.; Whittam, Alexander J.; Brownlee, Michael; Rajadas, Jayakumar; Gurtner, Geoffrey C.

    2015-01-01

    There is a high mortality in patients with diabetes and severe pressure ulcers. For example, chronic pressure sores of the heels often lead to limb loss in diabetic patients. A major factor underlying this is reduced neovascularization caused by impaired activity of the transcription factor hypoxia inducible factor-1 alpha (HIF-1?). In diabetes, HIF-1? function is compromised by a high glucose-induced and reactive oxygen species-mediated modification of its coactivator p300, leading to impaired HIF-1? transactivation. We examined whether local enhancement of HIF-1? activity would improve diabetic wound healing and minimize the severity of diabetic ulcers. To improve HIF-1? activity we designed a transdermal drug delivery system (TDDS) containing the FDA-approved small molecule deferoxamine (DFO), an iron chelator that increases HIF-1? transactivation in diabetes by preventing iron-catalyzed reactive oxygen stress. Applying this TDDS to a pressure-induced ulcer model in diabetic mice, we found that transdermal delivery of DFO significantly improved wound healing. Unexpectedly, prophylactic application of this transdermal delivery system also prevented diabetic ulcer formation. DFO-treated wounds demonstrated increased collagen density, improved neovascularization, and reduction of free radical formation, leading to decreased cell death. These findings suggest that transdermal delivery of DFO provides a targeted means to both prevent ulcer formation and accelerate diabetic wound healing with the potential for rapid clinical translation. PMID:25535360

  19. Laparoscopic rectopexy in solitary rectal ulcer.

    PubMed

    Kargar, Saeed; Salmanroughani, Hassan; Binesh, Fariba; Taghipoor, Shokoh; Kargar, Shady

    2011-01-01

    Patients with Solitary Rectal Ulcer Syndrome (SRUS) come to a physician with passage of mucus and bloody liquid within defecation. The treatment for SRUS is depended to the severity of symptoms and the existance of rectal prolapse. This study is a report of the assessing of rectopexy as surgical modalities for 62 medical treatment resistant SRUS patients who were referred to the gastrointestinal department of Shahid Sadoughi Medical University and Mojibian hospital. The present non-randomized clinical trial was carried out in 62 SRUS patients from 1991 till 2005. In these patients SRUS was confirmed by histology. They were symptomatic after conservative therapy and referred for surgical intervention. All of them had been undergone abdominal rectopexy by two laparoscopic surgeons. In our study, rectal bleeding and history of digitalization had the highest and lowest frequency of symptoms and signs in our cases respectively. Abdominal rectopexy was done in 39 cases and complete recovery in our cases was 69.23%. Complete recovery rate in cases with dysplasia (63.8%) was significantly higher than cases without that (P=0.04). Complete recovery rate in cases that had finger defecation (85%) was significantly higher than cases without that (50%) (P=0.03). Laparoscopic rectopexy is one of the main surgical techniques for treatment of SRUS. This technique can present complete recovery for SRUS patients. Some of them include topical medications, behavior modification supplemented by fiber and biofeedback and surgery were more available and studied. But it seems that education of SRUS patient conservative treatment remain cornerstone in the SRUS management. PMID:22174170

  20. 76 FR 74789 - Scientific Information Request on Pressure Ulcer Treatment Medical Devices

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ...Scientific Information Request on Pressure Ulcer Treatment Medical Devices AGENCY...HHS. ACTION: Request for Scientific Information...public information requests, including via the...on pressure ulcer treatment strategies,...

  1. 77 FR 24718 - Scientific Information Request on Chronic Venous Ulcers Treatments

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-25

    ...Scientific Information Request on Chronic Venous Ulcers Treatments AGENCY: Agency for...HHS. ACTION: Request for Scientific Information...public information requests, including via the...chronic venous ulcer treatments, including...

  2. Acid, motility, and ulcers: a comparison of cisapride with placebo in the prevention of duodenal ulcer relapse.

    PubMed Central

    Kerrigan, D D; Taylor, M E; Read, N W; Johnson, A G

    1993-01-01

    In a single centre double blind study of 66 patients, the value of cisapride (10 mg twice daily) was compared with placebo in the prevention of duodenal ulcer relapse. Patients who remained ulcer free attended for clinical review every two months and had a mandatory endoscopy at 0, 4, 8, and 12 months or if symptoms suggestive of ulcer recurrence developed. The 12 month crude relapse rates (that underestimate the probability of ulcer recurrence) showed that cisapride was superior to placebo (34% (11/32) relapsed on cisapride v 68% (23/34) on placebo, p = 0.007). This finding was confirmed using lifetable analysis, with a 35% reduction (95% confidence intervals 10-59%, p < 0.05) in the proportion of ulcer relapses in patients who had received cisapride compared with those treated with placebo. These results are similar to those reported in maintenance trials of H2 receptor antagonists analysed by the same method. Drug related adverse clinical events were mainly trivial, but led to three patients on cisapride and one on placebo withdrawing from the trial. PMID:8174950

  3. Esophageal ulcer due to ingestion of melted copper.

    PubMed

    Shibuya, S; Takase, Y; Sharma, N

    1992-11-01

    We report a patient with esophageal stricture as a result of the accidental swallowing of melted copper by a 49-year-old male. As a result, esophagogastric ulcers developed and left a cicatrical stricture. The patient could only manage to swallow liquid food. Radiology of the upper gastrointestinal tract showed marked stricture of the esophagus from the middle thoracic portion to the esophagogastric junction and shortening of the lesser curvature of the stomach. The patient underwent a single-session total gastrectomy, and excision of the thoracic esophagus and construction of anterior thoracic esophagocolic and duodenocolic anastomoses were performed by right thoracotomy and laparotomy, respectively. Macroscopic findings of the surgical specimens showed extensive circular ulcers at the esophagus, and microscopic findings showed deep ulcers extending to the muscle layer with marked fibrosis. The postoperative course was uneventful. PMID:1425082

  4. [New methods of vagotomy in the treatment of duodenal ulcer].

    PubMed

    Za?tsev, V T; Lagoda, A E; Dudenko, G I; Molotiagin, G E; Lagoda, O G; Bo?ko, V V

    1993-01-01

    The experience to use in the treatment of duodenal ulcer disease the new methods of vagotomy: selective distal antral cellular vagotomy (SDAV) and selective distal vagotomy with pyloroplasty (SDV) is substantiated. By means of these operations, the suppression of phase II of gastric secretion is achieved due to denervation of gastrin-producing antral portion of the stomach. The results of experimental studies in 15 dogs, and the results of treatment of 37 patients with duodenal ulcer disease caused by the increased production at phase II of alimentation are presented. SDAV was performed in 20 patients, SDV--in 17. A result of treatment was studied in 34 patients at the period of up to 3 years. A pronounced acid inhibiting effect of the new methods of vagotomy was noted. No ulcer recurrence was revealed. PMID:8158916

  5. Diagnosis and management of long-standing benign oral ulceration.

    PubMed

    Birt, D; From, L; Main, J

    1980-05-01

    The authors formed a Mouth Clinic at Sunnybrook Hospital in 1973 since when there have been 3025 patient visits. Those patients with chronic ulceration present a challenge, the diagnosis sometimes being difficult and therapy not rapidly effective. The differential diagnosis includes lichen planus, pemphigus vulgaris, benign mucous membrane pemphigoid, discoid lupus erythematosus, erythema multiforme, aphthous ulcers, Behcets disease, periadenitis mucosa necrotica recurrens, specific infections and iatrogenic causes. It is possible to reach a definite diagnosis in virtually every case by means of a good history and careful clinical examination supplemented by biopsies and in some cases direct and indirect immunofluorescent studies. Treatment emphasizes scrupulous attention to oral hygiene with baking soda mouthwashes and careful teeth cleaning to minimize the accumulation of dental plaque. Specific therapy includes topical steroids in lichen planus, intra muscular gold in benign mucous membrane pemphigoid, a previously unreported treatment which considerably improved seven out of ten patients, and tetracycline mouthwashes in aphthous ulcers. PMID:6990140

  6. SAPPIRE: a Prototype Mobile Tool for Pressure Ulcer Risk Assessment

    PubMed Central

    Kim, Hyeoneui; Chung, Heejoon; Wang, Shuang; Jiang, Xiaoqian; Choi, Jeeyae

    2015-01-01

    Accurate assessment and documentation of skin conditions facilitate communication among care providers and are critical to effective prevention and mitigation of pressure ulcer. We report developing a prototype mobile system called SAPPIRE (Skin Assessment for Pressure Ulcer Prevention, an Integrated Recording Environment) for an android device to assist nurses with skin assessment and documentation at bedside. SAPPIRE demonstrates (1) data documentation conforming to the relevant terminology standards, (2) data exchange using Continuity of Care Records (CCR) standard and (3) smart display of patient data relevant to risk parameters to promote accurate pressure ulcer risk assessment with the Braden scale. Challenges associated standardizing assessment data faced during this development and the approaches that SAPPIRE took to overcome them are described. PMID:24943578

  7. Fungal corneal ulcers of onion harvesters in southern Taiwan

    PubMed Central

    Lin, S. H.; Lin, C. P.; Wang, H. Z.; Tsai, R. K.; Ho, C. K.

    1999-01-01

    Fungal corneal ulcers related to agriculture has been reported throughout the world, especially in tropical areas. Most of them were sporadic and had histories of ocular trauma or use of topical corticosteroids and topical antibiotics. Five onion harvesters had fungal corneal ulcers during the same harvest period in Southern Taiwan. The authors think that this is the first report of a group occurrence relating to agricultural workers. Although all of the patients improved after medical and surgical management, their vision was greatly decreased. It is suggested that the tropical climate, the harvest procedure, the characteristic monsoon, and lack of eye protection were involved. Therefore, the importance of the eye protection, hygiene education, and improving medical care to reduce the occurrence of fungal corneal ulcer in agriculture workers must be emphasised.   PMID:10474540

  8. Seasonal variations in the onset of ulcerative colitis.

    PubMed Central

    Moum, B; Aadland, E; Ekbom, A; Vatn, M H

    1996-01-01

    Several retrospective studies have reported seasonal variations in the relapse of ulcerative colitis, and two studies have found seasonality in the onset of ulcerative colitis, with a peak from August to January. This study was designed to investigate possible seasonal variations of onset of ulcerative colitis (UC) and Crohn's disease (CD). Patients with symptoms of one year or less were recruited from a prospective study of the incidence of inflammatory bowel disease, and the onset of symptoms was recorded month by month for four consecutive years. A total of 420 patients with UC and 142 patients with CD were included. There was monthly seasonality (p = 0.028) in symptomatic onset in December and January for UC but not for CD. It was found that environmental agents with known seasonality can be of importance for the seasonal variations of disease onset in UC. PMID:8675089

  9. Assessment of some Herbal Drugs for Prophylaxis of Peptic Ulcer.

    PubMed

    Gohar, Ahmed A; Zaki, Ahmed A

    2014-01-01

    Aqueous (hydrophilic) and chloroform (Lipophilic) extracts of nine medicinal plants currently used in Egyptian traditional medicine to treat some gastrointestinal tract (GIT) disorders were tested for their gastro-protective effect against the incidence of peptic ulcer. Indomethacin-induced ulcer in a rat model was used for this testing. Mentha microphylla, Brassica oleracea Capitata (Cabbage), B. oleracea Botrytis (cauliflower) aqueous fraction, Portolaca oleracea polysaccharide fraction, Oreganum marjoranum, Matricaria recutita, Solanum nigrum hydrophilic and lipophilic fractions, in addition to the chloroform fraction of Portolaca oleracea and Cicorium intybus afforded high protection against the incidence of gastric ulcer (~95%). O. syriacum hydrophilic and lipophilic fractions and gum arabic afforded moderate prophylactic effect. L. sicerarea, C. intybus hydrophilic fractions and M. microphylla lipophilic fraction were inactive. Herbs represent excellent resources for cost-effective and readily available gastro-protective remedies without side effects. PMID:25276211

  10. [The role of anti-TNF therapy in ulcerative colitis].

    PubMed

    Cukovi?-Cavka, Silvija; Vuceli?, Boris; Urek, Marija Crncevi?; Brinar, Marko; Turk, Niksa

    2013-04-01

    Anti-TNF-alfa molecules are currently being used to treat ulcerative colitis regarding to the fact that TNF-alpha has an important role in the pathogenesis of IBD. Although these drugs improved the therapy of patients, immunogenicity limits their potential for clinical use. Infliximab and adalimumab are effective for induction and maintenance of remission in outpatients with moderate to severe steroid-refractory ulcerative colitis. Biologics can be a drug of choice for patients with refractory proctitis and refractory pouchitis. In hospitalized patients with steroid-resistant severe ulcerative colitis who are candidates for colectomy, infliximab may be second-line option. Adequate long-term maintenance therapy with anti-TNF is required after rescue therapy for a sustained benefit. Regarding to the known risk for side-effects of anti-TNF drugs especially in patients concomitantly treated with thiopurines it is urgent future research. PMID:24471300

  11. Gastroprotective effect of kefir on ulcer induced in irradiated rats.

    PubMed

    Fahmy, Hanan A; Ismail, Amel F M

    2015-03-01

    The current study was designed to investigate the protective effect of kefir milk on ethanol-induced gastric ulcers in ?-irradiated rats. The results of the present study revealed that treatment with ?-irradiation and/or ethanol showed a significant increase in ulcers number, total acidity, peptic, H(+)K(+)ATPase, MMP-2 and MMP-9 activities and MDA level, which were accompanied by a significant decrease in the mucus content, the stomach GSH level, the GSH-Px activity and DNA damage. Pre-treatment with kefir milk exert significant improvement in all the tested parameters. Kefir milk exerts comparable effect to that of the antiulcer drug ranitidine. In conclusion, the present study revealed that oral administration of kefir milk prevents ethanol-induced gastric ulcer in ?-irradiated rats that could attribute to its antioxidant, anti-apoptotic and radio-protective activities. PMID:25728227

  12. Becaplermin gel in the treatment of diabetic neuropathic foot ulcers

    PubMed Central

    Papanas, Nikolaos; Maltezos, Efstratios

    2008-01-01

    Diabetic foot ulcers remain a major cause of morbidity. Significant progress has been accomplished in ulcer healing by improved management of both ischemia and neuropathy in the diabetic foot. Nevertheless, there is a vital need for further improvement. Becaplermin gel represents an important therapeutic advance for diabetic neuropathic foot ulcers with adequate blood supply. Randomized controlled trials have shown that it is effective in increasing healing rates. However, this efficacy has not translated to positive clinical experience, and the drug is not widely used. Moreover, becaplermin is an expensive medication. Even though it has repeatedly been estimated as cost-effective, its high cost may be prohibitive for some clinicians, especially in developing countries. Clearly, further work is needed to clarify whether use of becaplermin is justified in everyday clinical practice. Future research also needs to assess the potential room for improvement with becaplermin, for instance by combination with other growth factors or by exploring alternative modes of drug delivery. PMID:18686746

  13. [Importance of the morphofunctional status of APUD cells in the prognosis of duodenal ulcer hemorrhage].

    PubMed

    Seidov, V D; Alekberzade, A V

    2000-01-01

    In 24 patients with uncomplicated duodenal ulcer and 40 patients with acute bleeding duodenal ulcer morphofunctional status of the local paraendocrine adjusting system of the duodenal mucous membrane in the periulcer, ulcer and remote zones was studied with histochemical and electron-microscopic techniques. It is established, that ECL- and G-apudocytes hyperplasia and hyperfunction and vice versa D-cells reduction of the number and suppression of the secretory activity are reliable prognostic criteria of duodenal ulcer bleeding. PMID:11026195

  14. An outbreak of chromium ulcer in a manufacturing plant.

    PubMed

    Deng, J F; Fleeger, A K; Sinks, T

    1990-04-01

    On May 23, 1989, managers of a manufacturing plant requested an investigation of an outbreak of hand ulceration and skin discoloration among workers. The plant has manufactured kitchen ranges for 30 years and employs approximately 633 hourly workers. The affected employees worked in the enamel department, where metallic range tops are coated with a "ground coat" or sprayed with an enamel coloring, and then baked in ovens at 1200F. Our evaluation included physical examinations, environmental sampling, and a questionnaire eliciting information concerning skin ulceration job history, demographics, and use of protective practices. We identified 10 enamel department workers (13.5%) who developed chromium ulcers between January 1st and June 30th, 1988. Ulcers were found on hands, forearms, periumbilical area and/or axillae. Within the enamel department, workers who handled conveyer hooks used to suspend range tops as they passed through the oven were at greatest risk (rate ratio (RR) = 12.44, 95% confidence interval (CI) = 2.90-53.35). Workers who wore gloves were protected from developing ulcers (RR = 0.08, 95% CI = 0.01-0.60). Normally, trivalent chromium (Cr+3) does not cause skin ulcers unless it is oxidized to hezavalent chromium Cr+6). The enamel used contained only Cr+3, not Cr+6, but analysis of hooks that had passed through the oven revealed Cr+6 on their surface. A mechanical failure of the oven resulted in the formation of sharp edges of the parts and consequently causing the abrasion of exposed skin. We believe Cr+3 was converted to Cr+6 during the baking process which associated with the mechanical failure of the oven causing this outbreak. PMID:2139265

  15. Foot ulcers in the diabetic patient, prevention and treatment

    PubMed Central

    Wu, Stephanie C; Driver, Vickie R; Wrobel, James S; Armstrong, David G

    2007-01-01

    Lower extremity complications in persons with diabetes have become an increasingly significant public health concern in both the developed and developing world. These complications, beginning with neuropathy and subsequent diabetic foot wounds frequently lead to infection and lower extremity amputation even in the absence of critical limb ischemia. In order to diminish the detrimental consequences associated with diabetic foot ulcers, a com-mon-sense-based treatment approach must be implemented. Many of the etiological factors contributing to the formation of diabetic foot ulceration may be identified using simple, inexpensive equipment in a clinical setting. Prevention of diabetic foot ulcers can be accomplished in a primary care setting with a brief history and screening for loss of protective sensation via the Semmes-Weinstein monofilament. Specialist clinics may quantify neuropathy, plantar foot pressure, and assess vascular status with Doppler ultrasound and ankle-brachial blood pressure indices. These measurements, in conjunction with other findings from the history and physical examination, may enable clinicians to stratify patients based on risk and help determine the type of intervention. Other effective clinical interventions may include patient education, optimizing glycemic control, smoking cessation, and diligent foot care. Recent technological advanced combined with better understanding of the wound healing process have resulted in a myriad of advanced wound healing modalities in the treatment of diabetic foot ulcers. However, it is imperative to remember the fundamental basics in the healing of diabetic foot ulcers: adequate perfusion, debridement, infection control, and pressure mitigation. Early recognition of the etiological factors along with prompt management of diabetic foot ulcers is essential for successful outcome. PMID:17583176

  16. Restless legs syndrome and pregnancy: A review

    PubMed Central

    Srivanitchapoom, Prachaya; Pandey, Sanjay; Hallett, Mark

    2014-01-01

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

  17. Why Do Alcoholic Beverages Have "Legs"?

    NASA Astrophysics Data System (ADS)

    Silverstein, Todd P.

    1998-06-01

    After a sip of wine, "legs" of liquid typically run up and down the inside of the glass for many minutes. This phenomenon stems from the dipole-dipole intermolecular forces that are so important in understanding the physical behavior of aqueous solutions. The combination of cohesive forces within the liquid and adhesive forces between the liquid and a solid surface can explain physical phenomena such as viscosity, surface tension, capillary action, and the shape of the meniscus. Aqueous ethanol solutions tend to have cohesive forces that are weaker than those of pure water, while their adhesive forces toward polar glass surfaces are roughly equivalent to those of water. Because adhesive forces are stronger than cohesive forces, wine may cling to the glass surface, hovering high above the remainder of the wine in the bottom of the glass. As ethanol evaporates, however, cohesive forces increase until the wine falls in a thin stream. Upon touching the surface of the wine in the bottom of the glass, ethanol concentration is restored, cohesive forces weaken, and the thin stream of wine rises back to the top of the glass.

  18. Progress on the Legs Polarized HD Target

    NASA Astrophysics Data System (ADS)

    Lowry, M. M.; Lincoln, F.; Miceli, L.; Saitoh, T.; Sandorfi, A. M.; Wei, X.; Whisnant, C. S.

    2002-04-01

    A deuterium-hydride ice target with frozen spin polarization is under development for use at LEGS, TJNAF, and elsewhere. This target features favorable dilution factors and an open geometry. HD gas is isotopically purified by distillation, doped with a small amount of ortho-H2 and frozen into a mesh of aluminum wires which conducts away the heat from the ortho to para conversion of the H2. The wires constitute only about 20% of the target by mass and their contribution is readily determined by empty target measurements. The 2.5 cm diameter by 5 cm long cylinder of ice is created inside a dilution refrigerator-superconducting magnet system, where it is subsequently cooled to 15 mK in a 17 T magnetic field. The H reaches its equilibrium polarization of 80% in a few days. Transfers of spin from the H to the D, and subsequent re-polarizations of the H, allow a D polarization of 50% to be reached. After 6 to 8 weeks of aging, the ortho-H2 decays sufficiently to allow removal of the target and storage in a separate dewar. The target is transferred into an inbeam dewar for bombardment. After an NMR calibration, the target is vaporized, ready to begin a new cycle. The current status and future program are discussed.

  19. Hybrid Equation/Agent-Based Model of Ischemia-Induced Hyperemia and Pressure Ulcer Formation Predicts Greater Propensity to Ulcerate in Subjects with Spinal Cord Injury

    PubMed Central

    Solovyev, Alexey; Mi, Qi; Tzen, Yi-Ting; Brienza, David; Vodovotz, Yoram

    2013-01-01

    Pressure ulcers are costly and life-threatening complications for people with spinal cord injury (SCI). People with SCI also exhibit differential blood flow properties in non-ulcerated skin. We hypothesized that a computer simulation of the pressure ulcer formation process, informed by data regarding skin blood flow and reactive hyperemia in response to pressure, could provide insights into the pathogenesis and effective treatment of post-SCI pressure ulcers. Agent-Based Models (ABM) are useful in settings such as pressure ulcers, in which spatial realism is important. Ordinary Differential Equation-based (ODE) models are useful when modeling physiological phenomena such as reactive hyperemia. Accordingly, we constructed a hybrid model that combines ODEs related to blood flow along with an ABM of skin injury, inflammation, and ulcer formation. The relationship between pressure and the course of ulcer formation, as well as several other important characteristic patterns of pressure ulcer formation, was demonstrated in this model. The ODE portion of this model was calibrated to data related to blood flow following experimental pressure responses in non-injured human subjects or to data from people with SCI. This model predicted a higher propensity to form ulcers in response to pressure in people with SCI vs. non-injured control subjects, and thus may serve as novel diagnostic platform for post-SCI ulcer formation. PMID:23696726

  20. Deployable Landing Leg Concept for Crew Exploration Vehicle

    NASA Technical Reports Server (NTRS)

    Lawrence, Charles; Solano, Paul; Bartos, Karen

    2007-01-01

    The NASA Exploration program is investigating the merits of land landing concepts for the Crew Exploration Vehicle (CEV). Four options are under investigation: retro-rockets which fire and slow the vehicle before contact with the landing surface, deployable crushable material which deploys just before landing and crushes during land contact, airbags which deploy just before landing and deflate during land contact, and deployable legs which deploy before landing and contain material that absorbs energy during land contact. The purpose of the present work is to determine the effectiveness of the deployable leg concept. To accomplish this goal, structural models of the deployable leg concept are integrated with the Crew Model (CM) and computational simulations are performed to determine vehicle and component loadings and acceleration levels. Details of the modeling approach, deployable leg design, and resulting accelerations are provided.

  1. Eyelash Transplantation Using Leg Hair by Follicular Unit Extraction

    PubMed Central

    2015-01-01

    Summary: Fine hairs of the head and nape areas have been used as donor sources in eyelash transplantation but are straight, coarse, and grow rapidly, requiring frequent eyelash maintenance. This is the first reported case of eyelash transplantation by follicular unit extraction using leg hair as a donor source; findings were compared with that of another patient who underwent a similar procedure with donor hairs from the nape area. Although both patients reported marked improvement in fullness of eyelashes within 3 months postsurgery, the transplanted leg hair eyelashes required less frequent trimming (every 5–6 weeks) compared with nape hair eyelashes (every 2–3 weeks). Additionally, in leg hair eyelashes, the need for perming to sustain a natural looking eyelash curl was eliminated. Eyelash transplantation using leg donor hair in hirsute women may result in good cosmetic outcomes and require less maintenance compared with nape donor hair. PMID:25878935

  2. Using learning algorithms to develop dynamic gaits for legged robots

    E-print Network

    Schaaf, Brian

    2006-01-01

    As more legged robots have begun to be developed for their obvious advantages in overall maneuverability and mobility over rough terrain and difficult obstacles, their shortcomings over flat terrain have become more apparent. ...

  3. Dynamic Leg Exercise Improves Tolerance to Lower Body Negative Pressure

    NASA Technical Reports Server (NTRS)

    Watenpaugh, D. E.; Ballard, R. E.; Stout, M. S.; Murthy, G.; Whalen, R. T.; Hargens, A. R.

    1994-01-01

    These results clearly demonstrate that dynamic leg exercise against the footward force produced by LBNP substantially improves tolerance to LBNP, and that even cyclic ankle flexion without load bearing also increases tolerance. This exercise-induced increase of tolerance was actually an underestimate, because subjects who completed the tolerance test while exercising could have continued for longer periods. Exercise probably increases LBNP tolerance by multiple mechanisms. Tolerance was increased in part by skeletal muscle pumping venous blood from the legs. Rosenhamer and Linnarsson and Rosenhamer also deduced this for subjects cycling during centrifugation, although no measurements of leg volume were made in those studies: they found that male subjects cycling at 98 W could endure 3 Gz centrifugation longer than when they remained relaxed during centrifugation. Skeletal muscle pumping helps maintain cardiac filling pressure by opposing gravity-, centrifugation-, or LBNP-induced accumulation of blood and extravascular fluid in the legs.

  4. Swimming with stiff legs at low Reynolds number

    NASA Astrophysics Data System (ADS)

    Takagi, Daisuke

    2015-08-01

    Locomotion at low Reynolds number is not possible with cycles of reciprocal motion, an example being the oscillation of a single pair of rigid paddles or legs. Here, I demonstrate the possibility of swimming with two or more pairs of legs. They are assumed to oscillate collectively in a metachronal wave pattern in a minimal model based on slender-body theory for Stokes flow. The model predicts locomotion in the direction of the traveling wave, as commonly observed along the body of free-swimming crustaceans. The displacement of the body and the swimming efficiency depend on the number of legs, the amplitude, and the phase of oscillations. This study shows that paddling legs with distinct orientations and phases offers a simple mechanism for driving flow.

  5. Swimming with stiff legs at low Reynolds number.

    PubMed

    Takagi, Daisuke

    2015-08-01

    Locomotion at low Reynolds number is not possible with cycles of reciprocal motion, an example being the oscillation of a single pair of rigid paddles or legs. Here, I demonstrate the possibility of swimming with two or more pairs of legs. They are assumed to oscillate collectively in a metachronal wave pattern in a minimal model based on slender-body theory for Stokes flow. The model predicts locomotion in the direction of the traveling wave, as commonly observed along the body of free-swimming crustaceans. The displacement of the body and the swimming efficiency depend on the number of legs, the amplitude, and the phase of oscillations. This study shows that paddling legs with distinct orientations and phases offers a simple mechanism for driving flow. PMID:26382516

  6. Restless Legs Syndrome -- Self-Tests and Diagnosis

    MedlinePLUS

    ... Benefits Side Effects Variations Tips Healthy Sleep Habits Sleep Disorders by Category Insomnias Insomnia Child Insomnia Short Sleeper ... and Facts Restless legs syndrome is a neurological sleep disorder that make you have an overwhelming urge to ...

  7. Dynamically Stable Legged Locomotion (September 1985-Septembers1989)

    E-print Network

    Raibert, Marc H.

    1989-09-01

    This report documents our work in exploring active balance for dynamic legged systems for the period from September 1985 through September 1989. The purpose of this research is to build a foundation of knowledge that ...

  8. Applied optimal control for dynamically stable legged locomotion

    E-print Network

    Tedrake, Russell L., 1977-

    2004-01-01

    Online learning and controller adaptation will be an essential component for legged robots in the next few years as they begin to leave the laboratory setting and join our world. I present the first example of a learning ...

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

    PubMed Central

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

    2015-01-01

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

  10. Driving hospital-acquired pressure ulcers to zero.

    PubMed

    Morehead, Donna; Blain, Brenda

    2014-12-01

    The prevention of hospital-acquired pressure ulcers remains a top priority for health care facilities worldwide. This article discusses a process improvement in an intensive care unit where the unit-acquired pressure ulcer rate was dropped from 30% to 0% by front-line staff nurses. The key areas addressed by the staff were education, creating a process for turning patients during bedside report, and the creation of a documentation tool for accurate skin/wound assessment. Involving front-line staff in the prevention methodology creates a process that is quickly adopted by staff, peer-to-peer accountability in accurate skin/wound assessment, and positive outcomes. PMID:25438897

  11. Idiopathic ulcerative laryngitis causing midmembranous vocal fold granuloma.

    PubMed

    Sinclair, Catherine F; Sulica, Lucian

    2013-02-01

    Idiopathic ulcerative laryngitis (IUL) is characterized by bilateral midmembranous vocal fold ulceration, which follows upper respiratory infection with cough. In contrast, granuloma of the membranous vocal fold can occur rarely following microlaryngoscopy, presumably secondary to surgical violation of deep tissue planes. We report a novel case of noniatrogenic membranous vocal fold granulation developing in a patient with IUL. Although the presence of granulation implied injury to the entire microstructure of the vibratory portion of the vocal fold, the lesion resolved with conservative management without adverse sequelae. PMID:22990885

  12. Clustering-based limb identification for pressure ulcer risk assessment.

    PubMed

    Baran Pouyan, M; Nourani, M; Pompeo, M

    2015-08-01

    Bedridden patients have a high risk of developing pressure ulcers. Risk assessment for pressure ulceration is critical for preventive care. For a reliable assessment, we need to identify and track the limbs continuously and accurately. In this paper, we propose a method to identify body limbs using a pressure mat. Three prevalent sleep postures (supine, left and right postures) are considered. Then, predefined number of limbs (body parts) are identified by applying Fuzzy C-Means (FCM) clustering on key attributes. We collected data from 10 adult subjects and achieved average accuracy of 93.2% for 10 limbs in supine and 7 limbs in left/right postures. PMID:26737228

  13. Ethical issues and accountability in pressure ulcer prevention.

    PubMed

    Welsh, Lynn

    2014-10-28

    Pressure ulcers represent a considerable cost, both in terms of healthcare spending and quality of life. They are increasingly viewed in terms of patient harm. For clinicians involved in pressure ulcer prevention, ethical issues surrounding accountability may arise from both policy and practice perspectives. It may be useful for clinicians to refer to ethical theories and principles to create frameworks when addressing ethical dilemmas. However, such theories and principles have been criticised for their simplicity and over-generalisation. Alternative theories, for example, virtue ethics and experiential learning, can provide more comprehensive guidance and promote a pluralistic approach to tackling ethical dilemmas. PMID:25335632

  14. Recurrence of Diabetic Pedal Ulcerations Following Tendo-Achilles Lengthening

    PubMed Central

    Weiner, Richard D.; Hlad, Lee M.; McKenna, Danielle R.

    2011-01-01

    Foot and ankle surgeons are frequently challenged by the devastating systemic consequences of diabetes mellitus manifested through neuropathy, integumentary and joint breakdown, delayed healing, decreased ability to fight infection, and fragile tendon/ligaments. Diabetic neuropathic pedal ulcerations lead to amputations at an alarming rate and also carry a high mortality rate. This article will discuss causes of diabetic pedal ulcerations that persist or recur after tendo-Achilles lengthening and will highlight areas that need to be addressed by the practitioner such as infection, vascular and nutritional status, glucose control, off-loading, biomechanics, and patient compliance. PMID:22396818

  15. Incidence and prevalence of ulcerative colitis in Punjab, North India

    PubMed Central

    Sood, A; Midha, V; Sood, N; Bhatia, A S; Avasthi, G

    2003-01-01

    Introduction: Ulcerative colitis occurs worldwide. It is considered common in most of Europe and North America and uncommon in most of the developing Asian countries. The incidence/prevalence of ulcerative colitis varies not only according to geographical region but also with race and ethnicity. There are no reported data from India on the incidence of the disease and its prevalence. Material and methods: A house to house survey was conducted by questionnaire, formulated to enquire about symptoms that are suggestive of ulcerative colitis. Those with prolonged diarrhoea with or without rectal bleeding were considered as suspected cases. These suspected cases were subjected to video sigmoidoscopy/colonoscopy and rectal biopsy. In addition, patients already diagnosed and receiving treatment for ulcerative colitis, encountered during the survey, were reviewed. Resurvey of the same areas was conducted after a one year interval to detect new cases. Using direct methods, standardised rates were calculated using world standard population weights 22, 18, 16, 12, 12, 9, 7, 3, and 1 for each 10 year age group. Standardised rates were also obtained separately for males, females, and combined populations, using the Punjab state 1991 population census data. Rates were also estimated according to UK 2000 population data. Ninety five per cent confidence intervals (95% CI) of prevalence and incidence rates of ulcerative colitis were estimated under the assumption that the distribution of cases followed a Poisson probability model. Results: A total population of 51 910 were screened from January to March 1999. We identified 147 suspected cases and of these 23 were finally established as ulcerative colitis cases, giving a crude prevalence rate of 44.3 per 100 000 inhabitants (95% CI 29.4–66.6). A second visit to the same areas after one year identified 10 suspected cases in a population of 49 834. Of these, three were confirmed as “definite” ulcerative colitis giving a crude incidence rate of 6.02 cases per 100 000 inhabitants (95% CI 1.2–17.6). Conclusions: This is the first population based study from India reporting on the incidence and prevalence of ulcerative colitis. The disease frequency is not much less than that reported from Europe and North America. PMID:14570727

  16. Foot Ulcer Prevention Using Biomechanical Modeling UJF-Grenoble 1/CNRS/TIMC-

    E-print Network

    Payan, Yohan

    Foot Ulcer Prevention Using Biomechanical Modeling V. Luboz UJF-Grenoble 1/CNRS/TIMC- IMAG UMR 5525-Grenoble 1/CNRS/TIMC-IMAG UMR 5525 38041La Tronche, France ypayan@imag.fr Abstract Foot ulcers are a common in persons with diabetes. Ulcers appear internally when pressures applied on the foot create high internal

  17. Microarray analysis of potential genes in the pathogenesis of recurrent oral ulcer

    PubMed Central

    Han, Jingying; He, Zhiwei; Li, Kun; Hou, Lu

    2015-01-01

    Recurrent oral ulcer seriously threatens patients’ daily life and health. This study investigated potential genes and pathways that participate in the pathogenesis of recurrent oral ulcer by high throughput bioinformatic analysis. RT-PCR and Western blot were applied to further verify screened interleukins effect. Recurrent oral ulcer related genes were collected from websites and papers, and further found out from Human Genome 280 6.0 microarray data. Each pathway of recurrent oral ulcer related genes were got through chip hybridization. RT-PCR was applied to test four recurrent oral ulcer related genes to verify the microarray data. Data transformation, scatter plot, clustering analysis, and expression pattern analysis were used to analyze recurrent oral ulcer related gene expression changes. Recurrent oral ulcer gene microarray was successfully established. Microarray showed that 551 genes involved in recurrent oral ulcer activity and 196 genes were recurrent oral ulcer related genes. Of them, 76 genes up-regulated, 62 genes down-regulated, and 58 genes up-/down-regulated. Total expression level up-regulated 752 times (60%) and down-regulated 485 times (40%). IL-2 plays an important role in the occurrence, development and recurrence of recurrent oral ulcer on the mRNA and protein levels. Gene microarray can be used to analyze potential genes and pathways in recurrent oral ulcer. IL-2 may be involved in the pathogenesis of recurrent oral ulcer. PMID:26722428

  18. Fatal pox infection in a rough-legged hawk

    USGS Publications Warehouse

    Pearson, G.L.; Pass, D.A.; Beggs, E.C.

    1975-01-01

    Natural pox infection occurred in a free-living rough-legged hawk (Buteo lagopus) in northeastern North Dakota. Gross, histological and electron microscopic findings were typical of pox infection, and characteristic lesions developed in red-tailed hawks (Buteo jamaicensis) but not in great horned owls (Bubo virginianus) following inoculation with case material. Death of the rough-legged hawk was attributed to starvation resulting from inability to capture prey and to blood loss from foot lesions.

  19. Fatal pox infection in a rough-legged hawk.

    PubMed

    Pearson, G L; Pass, D A; Beggs, E C

    1975-04-01

    Natural pox infection occurred in a free-living rough-legged hawk (Buteo lagopus) in northeastern North Dakota. Gross, histological and electron microscopic findings were typical of pox infection, and characteristic lesions developed in red-tailed hawks (Buteo jamaicensis) but not in great horned owls (Bubo virginianus) following inoculation with case material. Death of the rough-legged hawk was attributed to starvation rsulting from inability to capture prey and to blood loss from foot lesions. PMID:167207

  20. Heuristic exploration of how leg checking procedures may lead to inappropriate sacroiliac clinical interventions

    PubMed Central

    Cooperstein, Robert

    2010-01-01

    Several primary studies have shown that an anatomical short leg predicts anterior rotation of the ipsilateral ilium, whereas anatomical long leg predicts posterior rotation of the ilium on the long leg side. At the same time, in chiropractic and other manual therapy professions, it is widely believed that the leg check finding of a short leg is associated with posterior ilium rotation, and a long leg with anterior ilium rotation. The purpose of this commentary is to explore the consequences of this paradox for the manual therapy professions, insofar as leg checking procedures are commonly used to derive appropriate vectors for chiropractic manipulation/adjustive procedures. PMID:22027038

  1. Force feedback reinforces muscle synergies in insect legs.

    PubMed

    Zill, Sasha N; Chaudhry, Sumaiya; Büschges, Ansgar; Schmitz, Josef

    2015-11-01

    The nervous system solves complex biomechanical problems by activating muscles in modular, synergist groups. We have studied how force feedback in substrate grip is integrated with effects of sense organs that monitor support and propulsion in insects. Campaniform sensilla are mechanoreceptors that encode forces as cuticular strains. We tested the hypothesis that integration of force feedback from receptors of different leg segments during grip occurs through activation of specific muscle synergies. We characterized the effects of campaniform sensilla of the feet (tarsi) and proximal segments (trochanter and femur) on activities of leg muscles in stick insects and cockroaches. In both species, mechanical stimulation of tarsal sensilla activated the leg muscle that generates substrate grip (retractor unguis), as well as proximal leg muscles that produce inward pull (tibial flexor) and support/propulsion (trochanteral depressor). Stimulation of campaniform sensilla on proximal leg segments activated the same synergistic group of muscles. In stick insects, the effects of proximal receptors on distal leg muscles changed and were greatly enhanced when animals made active searching movements. In insects, the task-specific reinforcement of muscle synergies can ensure that substrate adhesion is rapidly established after substrate contact to provide a stable point for force generation. PMID:26193626

  2. A terradynamics of legged locomotion on granular media

    NASA Astrophysics Data System (ADS)

    Li, Chen; Zhang, Tingnan; Goldman, Daniel

    2013-03-01

    The theories of aero and hydrodynamics form the bases for prediction of animal movement and device design in air and water, and allow computation of lift, drag, and thrust forces on wings and fins. While models of terrestrial legged locomotion have focused on interactions with solid ground, many legged animals (and increasingly robots) move on substrates such as sand, gravel, soil, mud, snow, grass, and leaf litter that flow in response to intrusion. However, locomotor-ground interaction models on such flowable ground are often unavailable. Here we develop a resistive force model that predicts forces on arbitrary-shaped legs and bodies moving freely in granular media in the vertical plane. Our resistive force measurements reveal a complex but generic dependence of stresses on an intruder on its depth, orientation, and movement direction in granular media of different particle size, density, friction, and compaction. Our resistive force model and a multi-body simulation predict a small legged robot's locomotion on granular media using various leg shapes and stride frequencies, and give insight into the effects of leg morphology and kinematics on movement on granular media. Our study is an initial but important step in creation of ``terradynamics'' of locomotion on flowable ground.

  3. Marjolin's Ulcer Presenting with In-Transit Metastases: A Case Report and Literature Review

    PubMed Central

    Altunay, Ilknur; Sakiz, Damlanur; Ates, Bilge

    2015-01-01

    Marjolin's ulcer is an aggressive cutaneous malignancy common in previously traumatized or chronically inflamed skin. It has high regional metastasis and fatality rates. Our patient presented with subcutaneous nodules and ulcerations on the right limb. He had a history of osteomyelitis of the fifth toe. Histopathological examination of the nodule and ulceration demonstrated squamous cell carcinoma. The nodules and ulcerations were in-transit metastases of Marjolin's ulcer. Here, we present a case of squamous cell carcinoma arising at a site of a chronic osteomyelitis with resultant in-transit metastases. PMID:26273163

  4. [Effects of composite xueliting on four gastric ulcer models in rats and mice].

    PubMed

    Yang, J R; Chen, G X; Li, W M

    1995-07-01

    Composite Xueliting (CXLT) was found to be an effective anti-ulcer agent in four experimental models in rats and mice, namely, the stress restraint-induced, histamin-induced, salicylic acid-induced and reserpine-induced ulcers. In above-mentioned models, CXLT (0.214-0.856 g/kg, 1/d x 5, per os) could inhibit gastric ulcer by 40%-63%, 48%-85%, 68%-87% and 27%-65% respectively. Among these, the salicylic acid-induced ulcer was more markedly inhibited. The result suggested that CXLT had the protective function against the gastric ulcer. PMID:7580064

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

    PubMed

    Narayana, Nagamani; Meinberg, Trudy

    2010-01-01

    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

  6. Evidence-based guidelines for pressure ulcer management at the end of life.

    PubMed

    Langemo, Diane; Haesler, Emily; Naylor, Wayne; Tippett, Aletha; Young, Trudie

    2015-05-01

    It is important to develop an individualised plan of care for people at the end of life to prevent pressure ulcers, and to treat them if they do occur. This article discusses patient and risk assessment, prevention and care for pressure ulcers for the palliative care patient and the recommendations given in the palliative care section of the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline (National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel and Pan Pacific Pressure Injury Alliance, 2014). PMID:26107544

  7. Quadruple therapy for symptomatic spontaneous duodenal ulcer disease

    PubMed Central

    Bateson, M

    2001-01-01

    AIM—To investigate Helicobacter pylori eradication in duodenal ulcer patients with a new regimen, lansoprazole 30 mg daily for one or four weeks plus twice daily tetracycline 500 mg, clarithromycin 250 mg, and metronidazole 400 mg.?BACKGROUND—Spontaneous duodenal ulcer is regularly associated with H pylori, and permanent cure follows eradication of this bacterium. Numerous treatments have been proposed and none is ideal, possibly because of primary or acquired antibiotic resistance. Quadruple regimens with proton pump inhibitor therapy and three antibiotics offer promise as the most effective therapy.?METHODS—From November 1995 all patients with spontaneous duodenal ulcer were offered quadruple therapy. A month after completion a carbon 14 urea breath test (UBT) was performed. Sensitivity of H pylori to the antibiotics used was tested in 1992-3, 1996, and 1999.?RESULTS—A total of 331 patients were treated; 313 attended for a UBT, of which 299 were negative (95.5%). Of those patients who had an endoscopy with positive urease test immediately before treatment, 95/101 (94.0%) on lansoprazole for one week and 116/121 (95.8%) on lansoprazole for four weeks had a negative UBT. H pylori antibiotic sensitivity did not change.?CONCLUSION—This regimen produced some of the best results yet seen and may be generally recommended as first line therapy.???Keywords: Helicobacter pylori; duodenal ulcer PMID:11423595

  8. Documentation and record-keeping in pressure ulcer management.

    PubMed

    Chamanga, Edwin; Ward, Renee

    2015-05-01

    National and international guidelines recommend the use of clinical assessments and interventions to prevent pressure-related skin damage. This includes the categorisation of pressure ulcers as avoidable or unavoidable, which is challenging in clinical practice, mainly because of poor documentation and record-keeping for care delivered. Documentation and record-keeping are influenced by the individual's employing organisation, maintenance procedures for documentation and record-keeping, and local auditing processes. A transfer sticker to enable patient assessment and promote pressure ulcer documentation was designed and implemented. The transfer sticker captures the date, time and location of a pressure ulcer preventive risk assessment and the plan of care to be implemented. The increased clarity of record of care achieved by using the transfer sticker has enabled the number of avoidable hospital-acquired pressure ulcers resulting from poor documentation on admission or ward transfers to be reduced. The transfer sticker helps staff identify patients at risk and allows interventions to be implemented in a timely manner. PMID:25942987

  9. CCR9 Antagonists in the Treatment of Ulcerative Colitis

    PubMed Central

    Bekker, Pirow; Ebsworth, Karen; Walters, Matthew J.; Berahovich, Robert D.; Ertl, Linda S.; Charvat, Trevor T.; Punna, Sreenivas; Powers, Jay P.; Campbell, James J.; Sullivan, Timothy J.; Jaen, Juan C.; Schall, Thomas J.

    2015-01-01

    While it has long been established that the chemokine receptor CCR9 and its ligand CCL25 are essential for the movement of leukocytes into the small intestine and the development of small-intestinal inflammation, the role of this chemokine-receptor pair in colonic inflammation is not clear. Toward this end, we compared colonic CCL25 protein levels in healthy individuals to those in patients with ulcerative colitis. In addition, we determined the effect of CCR9 pharmacological inhibition in the mdr1a?/? mouse model of ulcerative colitis. Colon samples from patients with ulcerative colitis had significantly higher levels of CCL25 protein compared to healthy controls, a finding mirrored in the mdr1a?/? mice. In the mdr1a?/? mice, CCR9 antagonists significantly decreased the extent of wasting and colonic remodeling and reduced the levels of inflammatory cytokines in the colon. These findings indicate that the CCR9:CCL25 pair plays a causative role in ulcerative colitis and suggest that CCR9 antagonists will provide a therapeutic benefit in patients with colonic inflammation. PMID:26457007

  10. Risk factors of recurrent aphthous ulceration among university students

    PubMed Central

    Shi, Liuxia; Wan, Kuan; Tan, Mengmeng; Yin, Guifang; Ge, Mengkai; Rao, Xiaoqian; He, Lianping; Jin, Yuelong; Yao, Yingshui

    2015-01-01

    Recurrent aphthous ulceration (RAU) is a common oral mucosal disease. The etiological involves in genetics, vitamin deficiencies, trauma, immune dysfunction and stress. This study was to explore the related risk factors of recurrent aphthous ulceration (RAU) among college students, and provide basis for further research. We conducted a questionnaire survey among students from three colleges in Wuhu by stratified cluster sampling. The information collected includes general demographic characteristics, dietary habits and so on. The overall prevalence of RAU is 23.30% among college students (23.23% in male and 23.39% in female). There are statistical significance in prevalence of RAU between subjects with RAU and without RAU (P<0.05) the prevalence of RAU in different grade, age, adequate brushing time, good brushing habits, wear dentures or braces, other oral disease, eat barbecue, adequate exercise time is statistic difference. According to the result of multinomial logistic regression analysis, the risk of recurrent aphthous ulceration factors including grade, inadequate brushing time. Tempering was a protective factor of RAU. Some measure should be taken to control dental ulcer, which consist of promoting a correct way of living habits, paying attention to the health conscious diet, strengthen physical exercise, self-decompression and keeping good mentality. PMID:26131228

  11. Prophylactic aspirin and risk of peptic ulcer bleeding.

    PubMed Central

    Weil, J.; Colin-Jones, D.; Langman, M.; Lawson, D.; Logan, R.; Murphy, M.; Rawlins, M.; Vessey, M.; Wainwright, P.

    1995-01-01

    OBJECTIVE--To determine the risks of hospitalisation for bleeding peptic ulcer with the current prophylactic aspirin regimens of 300 mg daily or less. DESIGN--A case-control study with hospital and community controls. SETTING--Hospitals in Glasgow, Newcastle, Nottingham, Oxford, and Portsmouth. SUBJECTS--1121 patients with gastric or duodenal ulcer bleeding matched with hospital and community controls. RESULTS--144 (12.8%) cases had been regular users of aspirin (taken at least five days a week for at least the previous month) compared with 101 (9.0%) hospital and 77 (7.8%) community controls. Odds ratios were raised for all doses of aspirin taken, whether compared with hospital or community controls (compared with combined controls: 75 mg, 2.3 (95% confidence interval 1.2 to 4.4); 150 mg, 3.2 (1.7 to 6.5); 300 mg, 3.9 (2.5 to 6.3)). Results were not explained by confounding influences of age, sex, prior ulcer history or dyspepsia, or concurrent non-aspirin non-steroidal anti-inflammatory drug use. Risks seemed particularly high in patients who took non-aspirin non-steroidal anti-inflammatory drugs concurrently. CONCLUSION--No conventionally used prophylactic aspirin regimen seems free of the risk of peptic ulcer complications. PMID:7711618

  12. Perforated duodenal ulcer: An unusual manifestation of allergic eosinophilic gastroenteritis

    PubMed Central

    Riggle, Kevin M; Wahbeh, Ghassan; Williams, Elizabeth M; Riehle, Kimberly J

    2015-01-01

    Spontaneous perforation of a duodenal ulcer secondary to allergic eosinophilic gastroenteritis (EGE) has not been previously reported. We present such a case in a teenager who presented with peritonitis. After exploration and operative repair of his ulcer, he continued to experience intermittent abdominal pain, and further evaluation revealed eosinophilic gastroenteritis in the setting of multiple food allergies. His EGE resolved after adhering to a restrictive diet. Both duodenal ulcers and EGE are very rarely seen in pediatric patients. EGE has a variable presentation depending on the layer(s) of bowel wall affected and the segment of the gastrointestinal tract that is involved. Once diagnosed, it may respond to dietary changes in patients with recognized food allergies, or to steroids in patients in whom an underlying cause is not identified. Our case highlights the need to keep EGE in the differential diagnosis when treating pediatric patients with duodenal ulcers. The epidemiology, pathophysiology, and treatment of EGE are also discussed, along with a review of the current literature. PMID:26640348

  13. Ulcerative umbrellar lesions in captive moon jelly (Aurelia aurita) medusae.

    PubMed

    LaDouceur, E E B; Garner, M M; Wynne, J; Fish, S; Adams, L

    2013-05-01

    Over a period of 6 months, dozens of moon jelly (Aurelia aurita) medusae from a single-species exhibit at the California Science Center (CSC) developed exumbrellar ulcers. Ulcers were progressive, causing umbrellar creases that expanded radially to the bell rim and occasional adoral erosions that extended into gastrovascular cavities. Husbandry interventions, including addition of ultraviolet light sterilizers, repopulation with fresh cultures, and enclosure disinfection, did not arrest the recurrence of lesions. Biopsies or whole specimens representing 17 medusae (15 affected and 2 grossly unaffected) from CSC and 2 control medusae from Aquarium of the Pacific were submitted to a private diagnostic laboratory and processed for light and electron microscopy. Microscopic lesions were present in all CSC medusae and were not observed or negligible in control medusae. Lesions included ulceration, necrosis, and hyperplasia in all umbrellar layers, with most severe lesions in the exumbrella and amoebocyte infiltration in the underlying mesoglea. Special stains, electron microscopy, and fungal culture did not associate microorganisms with the lesions. Bacterial cultures from the CSC population consistently grew Shewanella and Vibrio spp, both of which were considered commensal. Trauma and environmental stress are proposed as possible causes for the ulcers. PMID:23024139

  14. Mucosal injury and. gamma. -irradiation produce persistent gastric ulcers in the rabbit. Evaluation of antiulcer drug binding to experimental ulcer sites

    SciTech Connect

    Yokel, R.A.; Dickey, K.M. )

    1991-05-01

    A method producing persistent gastric ulcers in the rhesus monkey by combined mucosal injury and {gamma}-irradiation was modified and evaluated in the rabbit. {gamma}-Irradiation (800-1000 cGy) immediately after removal of 2-mm-diameter sections of antral mucosa resulted in ulcer craters 5-7 days later. Ulcer sites were characterized by loss of the mucosa, muscularis mucosa, and much of the submucosa. The exposed submucosa was coated with fibrin and necrotic debris infiltrated with heterophils, the rabbit equivalent of neutrophils. These ulcers strongly resemble human chronic gastric ulcers. Binding of Carafate (sucralfate; Marion Laboratories, Inc., Kansas City, MO) and Maalox (magnesia-alumina oral suspension; Wm. H. Rorer, Inc., Ft. Washington, PA) to ulcer and nearby nonulcer sites in the antrum was assessed 1 hour after drug dosing. Drug binding was determined by aluminum quantitation of stomach wall punch biopsies at necropsy. Both drugs significantly increased aluminum bound to the stomach wall compared with vehicle treatment. Significantly more antiulcer drug was bound to ulcer sites than to nearby nonulcer sites only after sucralfate administration. This model of persistent gastric ulcer should be useful to further study gastric ulcer pathogenesis and treatment.

  15. Role of Helicobacter pylori in ulcer healing and recurrence of gastric and duodenal ulcers in longterm NSAID users. Response to omeprazole dual therapy.

    PubMed Central

    Bianchi Porro, G; Parente, F; Imbesi, V; Montrone, F; Caruso, I

    1996-01-01

    BACKGROUND: The relation between Helicobacter pylori infection and non-steroidal anti-inflammatory drug (NSAID)-associated peptic ulcers remains unclear; in particular, it is not known whether H pylori plays a part in the healing and recurrence of these ulcers. AIMS: To evaluate prospectively in a consecutive series of arthritis patients receiving longterm NSAID treatment the prevalence of peptic ulcer as well as the effect of H pylori eradication on the healing and recurrence of gastric and duodenal ulcer found. PATIENTS: Some 278 consecutive patients underwent gastroscopy with multiple biopsies of the gastric antrum and corpus for histological examination and rapid urease test. One hundred peptic ulcers (59 gastric ulcers, 39 duodenal ulcers, and two gastric ulcers concomitant with a duodenal ulcer) were found. Seventy per cent of these ulcers were H pylori positive. METHODS: According to their H pylori status, ulcer patients were randomised to one of the following treatments: H pylori negative ulcers received omeprazole 20 mg twice daily for four to eight weeks, whereas H pylori positive lesions were treated with omeprazole 20 mg twice daily plus amoxycillin 1 g twice daily (the second of these for the first two weeks) or omeprazole alone for four to eight weeks while continuing NSAID therapy. Patients with healed ulcers were endoscopically followed up for six months after stopping antiulcer therapy while continuing NSAIDs. RESULTS: Endoscopic healing rates for gastric and duodenal ulcers in the three different groups were similar both at four and eight weeks. H pylori eradication did not influence healing, which occurred in 14 of 20 (70%) of patients in whom H pylori was eradicated, compared with 14 of 17 (82%) of patients with persistent infection. Cumulative recurrence rates at six months did not statistically differ among the three different groups (27% in H pylori negative, 46% in H pylori positive, and 31% in those where H pylori was eradicated during the healing phase), although a numerical trend in favour of a higher recurrence rate in infected patients was evident. CONCLUSIONS: H pylori eradication does not confer any significant advantage on the healing of gastric and duodenal ulcers associated with longterm NSAID use. It remains to be established with certainty whether eradication may be helpful in the reduction of recurrence in a specific subset of NSAID associated ulcer. PMID:8881802

  16. Cruise No.: TN-179, Leg 1 and Leg 3 April 8, 2005 FOCI No.: 1TT05 and 2TT05

    E-print Network

    , Alaskan Ocean Observatory System, Steller Sea Lion Research Programs, and PMEL/FOCI base. Leg 1.4.2 Cruise TN-179 Leg 2 ­ Gulf of Alaska. 1.4.3 Cruise TN-179 Leg 3 ­ Eastern Bering Sea shelf. 2.0 CRUISE of the North Pacific Ocean and Bering Sea in order to discern the physical and biological processes

  17. Abstract This paper presents a six-legged, sprawl-tuned autonomous robot (STAR). This novel robot has a variable leg

    E-print Network

    Fearing, Ron

    Abstract² This paper presents a six-legged, sprawl-tuned autonomous robot (STAR). This novel robot has a variable leg sprawl angle in the transverse plane to adapt its stiffness, height, and leg, enabling the robot to run in a planar configuration, upright, or inverted (see movie). STAR is fitted

  18. Local blockage of EMMPRIN impedes pressure ulcers healing in a rat model

    PubMed Central

    Zhao, Xi-Lan; Luo, Xiao; Wang, Ze-Xin; Yang, Guo-Li; Liu, Ji-Zhong; Liu, Ya-Qiong; Li, Ming; Chen, Min; Xia, Yong-Mei; Liu, Jun-Jie; Qiu, Shu-Ping; Gong, Xiao-Qing

    2015-01-01

    Excessive extracellular matrix degradation caused by the hyperfunction of matrix metalloproteinases (MMPs) has been implicated in the failure of pressure ulcers healing. EMMPRIN, as a widely expressed protein, has emerged as an important regulator of MMP activity. We hypothesize that EMMPRIN affects the process of pressure ulcer healing by modulating MMP activity. In the rat pressure ulcer model, the expression of EMMPRIN in ulcers detected by Western blot was elevated compared with that observed in normal tissue. To investigate the role of EMMPRIN in regulating ulcer healing, specific antibodies against EMMPRIN were used via direct administration on the pressure ulcer. Local blockage of EMMPRIN resulted in a poor ulcer healing process compared with control ulcers, which was the opposite of our expectation. Furthermore, inhibiting EMMPRIN minimally impacted MMP activity. However, the collagen content in the pressure ulcer was reduced in the EMMPRIN treated group. Angiogenesis and the expression of angiogenic factors in pressure ulcers were also reduced by EMMPRIN local blockage. The results in the present study indicate a novel effect of EMMPRIN in the regulation of pressure ulcer healing by controlling the collagen contents and angiogenesis rather than MMPs activity. PMID:26261551

  19. Quality of healing of gastric ulcers: Natural products beyond acid suppression

    PubMed Central

    Kangwan, Napapan; Park, Jong-Min; Kim, Eun-Hee; Hahm, Ki Baik

    2014-01-01

    Gastric ulcer is a chronic disease featured with unexpected complications, including bleeding, stenosis and perforation, as well as a high incidence of recurrence. Clinical treatments for gastric ulcer have allowed the rapid development of potent anti-ulcer drugs during the last several decades. Gastric ulcer healing is successful with conventional treatments including H2-receptor antagonists, and proton pump inhibitors (PPIs) have been essential for ulcer healing and prevention of complications. Additionally, Helicobacter pylori eradication therapy is effective in reducing ulcer recurrence and leads to physiological changes in the gastric mucosa which affect the ulcer healing process. However, in spite of these advancements, some patients have suffered from recurrence or intractability in spite of continuous anti-ulcer therapy. A new concept of the quality of ulcer healing (QOUH) was initiated that considers the reconstruction of the mucosal structure and its function for preventing ulcer recurrence. Although several gastroprotection provided these achievements of the QOUH, which PPI or other acid suppressants did not accomplish, we found that gastroprotection that originated from natural products, such as a newer formulation from either Artemisia or S-allyl cysteine from garlic, were very effective in the QOUH, as well as improving clinical symptoms with fewer side effects. In this review, we will introduce the importance of the QOUH in ulcer healing and the achievements from natural products. PMID:24891974

  20. Environmental transmission of Mycobacterium ulcerans drives dynamics of Buruli ulcer in endemic regions of Cameroon.

    PubMed

    Garchitorena, Andrés; Ngonghala, Calistus N; Texier, Gaëtan; Landier, Jordi; Eyangoh, Sara; Bonds, Matthew H; Guégan, Jean-François; Roche, Benjamin

    2015-01-01

    Buruli Ulcer is a devastating skin disease caused by the pathogen Mycobacterium ulcerans. Emergence and distribution of Buruli ulcer cases is clearly linked to aquatic ecosystems, but the specific route of transmission of M. ulcerans to humans remains unclear. Relying on the most detailed field data in space and time on M. ulcerans and Buruli ulcer available today, we assess the relative contribution of two potential transmission routes -environmental and water bug transmission- to the dynamics of Buruli ulcer in two endemic regions of Cameroon. The temporal dynamics of Buruli ulcer incidence are explained by estimating rates of different routes of transmission in mathematical models. Independently, we also estimate statistical models of the different transmission pathways on the spatial distribution of Buruli ulcer. The results of these two independent approaches are corroborative and suggest that environmental transmission pathways explain the temporal and spatial patterns of Buruli ulcer in our endemic areas better than the water bug transmission. PMID:26658922

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

    PubMed

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

    2015-01-01

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

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

    PubMed Central

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

    2015-01-01

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

  3. Environmental transmission of Mycobacterium ulcerans drives dynamics of Buruli ulcer in endemic regions of Cameroon

    PubMed Central

    Garchitorena, Andrés; Ngonghala, Calistus N.; Texier, Gaëtan; Landier, Jordi; Eyangoh, Sara; Bonds, Matthew H.; Guégan, Jean-François; Roche, Benjamin

    2015-01-01

    Buruli Ulcer is a devastating skin disease caused by the pathogen Mycobacterium ulcerans. Emergence and distribution of Buruli ulcer cases is clearly linked to aquatic ecosystems, but the specific route of transmission of M. ulcerans to humans remains unclear. Relying on the most detailed field data in space and time on M. ulcerans and Buruli ulcer available today, we assess the relative contribution of two potential transmission routes –environmental and water bug transmission– to the dynamics of Buruli ulcer in two endemic regions of Cameroon. The temporal dynamics of Buruli ulcer incidence are explained by estimating rates of different routes of transmission in mathematical models. Independently, we also estimate statistical models of the different transmission pathways on the spatial distribution of Buruli ulcer. The results of these two independent approaches are corroborative and suggest that environmental transmission pathways explain the temporal and spatial patterns of Buruli ulcer in our endemic areas better than the water bug transmission. PMID:26658922

  4. Tuning of human vestibulospinal reflexes by leg rotation.

    PubMed

    Grasso, C; Barresi, M; Scattina, E; Orsini, P; Vignali, E; Bruschini, L; Manzoni, D

    2011-04-01

    Changing the foot position modifies the mechanical action exerted by the ankle extensor and flexor muscles over the body. We verified, in two groups of healthy subjects standing with the heels touching or apart, whether a 90° external rotation of the right leg and foot also changes the pattern of vestibulospinal reflexes elicited by electrical stimulation of the labyrinth. With the head oriented forward, leg rotation did not modify the labyrinthine-driven displacements of the center of pressure (CoP). When the head was rotated in the horizontal plane, either to the right or to the left, the CoP displacement increased along the y axis in all subjects. Changes in the x component in most instances appropriate to preserve unmodified the direction of body sway elicited by the stimulus were observed. Right leg rotation increased the basal EMG activity of ankle extensors and flexors on the left side, while the right side activity was unaffected. The EMG responses to labyrinthine stimulation were modified only on the left side, in a way appropriate to correct the effects of the altered torque pattern exerted on the body by right leg muscles. It appears, therefore, that somatosensory signals related to leg rotation and/or copy of the corresponding voluntary motor commands modify the pattern of vestibulospinal reflexes and maintain the postural response appropriate to counteract a body sway in the direction inferred by labyrinthine signals. PMID:20813417

  5. Injury due to leg bands in willow flycatchers

    USGS Publications Warehouse

    Sedgwick, J.A.; Klus, R.J.

    1997-01-01

    We report an apparently unusually high incidence of leg injury in Willow Flycatchers (Empidonax traillii) as a result of banding and color banding. Color bands and U.S. Fish and Wildlife Service (USFWS) bands applied to Willow Flycatchers from 1988-1995 resulted in an overall leg injury rate of 9.6% to birds returning to our study areas in subsequent years. Most injuries occurred on legs with only color band(s) (58.3%) or on legs with both a USFWS band and a color band (35%); only 6.7% of injuries (4/60) were due to USFWS bands alone, yielding an overall USFWS band injury rate of only 0.6%. Injuries ranged from severe (swollen, bleeding legs; a missing foot) to relatively minor (irritations on the tarsus). Amputation of the foot occurred in 33.9% of the cases. Return rates of adult injured birds in the year(s) following injury were significantly lower than for the population at large.

  6. Prosthetic leg powered by MR brake and SMA wires

    NASA Astrophysics Data System (ADS)

    Nguyen, The; Munguia, Vicente; Calderon, Jose

    2014-04-01

    Current knee designs for prosthetic legs rely on electric motors for both moving and stationary states. The electric motors draw an especially high level of current to sustain a fixed position. The advantage of using magnetorheological (MR) fluid is that it requires less current and can have a variable braking torque. Besides, the proposed prosthetic leg is actuated by NiTinol wire, a popular shape memory alloy (SMA). The incorporation of NiTinol gives the leg more realistic weight distribution with appropriate arrangement of the batteries and wires. The prosthesis in this research was designed with MR brake as stopping component and SMA wire network as actuating component at the knee. The MR brake was designed with novel non-circular shape for the rotor that improved the braking torque while minimizing the power consumption. The design also helped simplify the control of braking process. The SMA wire network was design so that the knee motion was actively rotated in both directions. The SMA wires were arranged and played very similar role as the leg's muscles. The study started with the overall solid design of the knee including both MR and SMA parts. Theoretical models were derived and programmed in Simulink for both components. The simulation was capable of predicting the power required for moving the leg or hold it in a fixed position for a certain amount of time. Subsequently, the design was prototyped and tested to validate the theoretical prediction. The theoretical models were updated accordingly to correlate with the experimental data.

  7. Actigraph Evaluation of Acupuncture for Treating Restless Legs Syndrome

    PubMed Central

    Wang, Mingzhe; Li, Mao; Wang, Qiudong; Kwak, Shin; Jiang, Wenfei; Yamamoto, Yoshiharu

    2015-01-01

    We evaluated the effects of acupuncture in patients with restless legs syndrome (RLS) by actigraph recordings. Among the 38 patients with RLS enrolled, 31 (M = 12, F = 19; mean age, 47.2 ± 9.7 years old) completed the study. Patients were treated with either standard acupuncture (n = 15) or randomized acupuncture (n = 16) in a single-blind manner for 6 weeks. Changes in nocturnal activity (NA) and early sleep activity (ESA) between week 0 (baseline), week 2, week 4, and week 6 were assessed using leg actigraph recordings, the International Restless Legs Syndrome Rating Scale (IRLSRS), and Epworth Sleepiness Scale (ESS). Standard but not randomized acupuncture reduced the abnormal leg activity of NA and ESA significantly in week 2, week 4, and week 6 based on the changes in the clinical scores for IRLSRS and ESS in week 4 and week 6 compared with the baseline. No side effects were observed. The results indicate that standard acupuncture might improve the abnormal leg activity in RLS patients and thus is a potentially suitable integrative treatment for long-term use. PMID:25763089

  8. Dynamic behaviors for a hybrid leg-wheel mobile platform

    NASA Astrophysics Data System (ADS)

    Steeves, Carl; Buehler, Martin G.; Penzes, Steven G.

    2002-07-01

    A hybrid platform for an Unmanned Ground Vehicle (UGV), one with legs and wheels, was initially considered to yield a design that possessed a high degree of intrinsic mobility. Integrating a high level of mobility reduces the UGV's perception and computational requirements for successful semi-autonomous or autonomous terrain negotiation. An investigation into the dynamic capabilities of the hybrid design revealed a large amount of otherwise impossible behaviors. The widened scope of maneuvers enabled the simulated robot to negotiate higher obstacles, clear larger ditches and generally improved its rough terrain mobility. A scalability study was also undertaken to predict dynamic potential of various platform sizes and to aid in the selection of design specifications such as motor torque-speed curves. The hybrid design of the platform (legs with active wheels) proved invaluable in achieving these dynamic behaviors and revealed that the leg-wheel design was as fundamental to dynamic capabilities, as it was to intrinsic mobility.

  9. Microelectronic neural bridging of toad nerves to restore leg function.

    PubMed

    Shen, Xiaoyan; Wang, Zhigong; Lv, Xiaoying; Huang, Zonghao

    2013-02-25

    The present study used a microelectronic neural bridge comprised of electrode arrays for neural signal detection, functional electrical stimulation, and a microelectronic circuit including signal amplifying, processing, and functional electrical stimulation to bridge two separate nerves, and to restore the lost function of one nerve. The left leg of one spinal toad was subjected to external mechanical stimulation and functional electrical stimulation driving. The function of the left leg of one spinal toad was regenerated to the corresponding leg of another spinal toad using a microelectronic neural bridge. Oscilloscope tracings showed that the electromyographic signals from controlled spinal toads were generated by neural signals that controlled the spinal toad, and there was a delay between signals. This study demonstrates that microelectronic neural bridging can be used to restore neural function between different injured nerves. PMID:25206698

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

    PubMed Central

    2014-01-01

    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

  11. Ulcerative disease outbreak in crayfish Orconectes propinquus linked to Saprolegnia australis in big Muskellunge Lake, Wisconsin.

    PubMed

    Krugner-Higby, Lisa; Haak, Danielle; Johnson, Pieter T J; Shields, Jeffery D; Jones, William M; Reece, Kimberly S; Meinke, Tim; Gendron, Annette; Rusak, James A

    2010-07-26

    Crayfish populations in the area of the North Temperate Lakes Long Term Ecological Research (LTER) project, Wisconsin, USA, have been monitored for >25 yr. In 2005, native crayfish Orconectes propinquus from Big Muskellunge Lake were found with ulcerated lesions in the cuticle. In 2006, lesions occurred in 9.5% of sampled crayfish from the lake (n=3146). Ulcers generally occurred on the appendages of affected individuals but varied in location and severity. The prevalence of ulcers varied widely among sites, sample depths, and sampling dates, ranging from < 2% to >20%. The prevalence of ulcers in crayfish increased from a minimum in early June to a maximum in late July and August. In aquarium trials, healthy crayfish representing either O. propinquus or O. rusticus co-housed with ulcerated crayfish did not develop ulcers within 4 wk of exposure. Gross and histopathologic analyses of ulcerated crayfish revealed the presence of filamentous hyphae in the lesions while hemocytic infiltrates, melanotic reactions and silver-stained sections indicated that the ulcers had an oomycete etiology. Excised samples of ulcerated crayfish cuticle grown in culture developed an oomycete that was identified as Saprolegnia australis by PCR amplification and sequence analysis of 2 different DNA fragments. This is the first report of the occurrence of ulcers in wild crayfish associated with S. australis infection in the U.S.A. The advent of the outbreak and its underlying ecological causes are still under investigation. PMID:20853742

  12. Restraint ulcers in the rat. 1: Influence on ulcer frequency of fasting and of environmental temperature associated with immobilization of varying durations

    NASA Technical Reports Server (NTRS)

    Buchel, L.; Gallaire, D.

    1980-01-01

    The results of the production of experimental ulcers in rats are described. Two experimental conditions were found to regularly provoke the appearance of gastric ulcers in a high percentage of rats: (1) two-and-a-half hour restraint, proceeded by a 24 hour fast; and (2) one-and-a-half hour restraint with lowering of the environmental temperature while fasting.

  13. Pressure Ulcer Preventive Device Use Among Elderly Patients Early in the Hospital Stay

    PubMed Central

    Rich, Shayna E.; Shardell, Michelle; Margolis, David; Baumgarten, Mona

    2010-01-01

    Background Clinical guidelines for the prevention of pressure ulcers advise that pressure-reducing devices should be used for all patients at risk of or with pressure ulcers and that all pressure ulcers should be documented in the patient record. Adherence to these guidelines among elderly hospital patients early in the hospital stay has not been examined in prior studies. Objective The objective of this study was to examine adherence to guidelines by determining the frequency and correlates of use of preventive devices early in the hospital stay of elderly patients and by determining the frequency and correlates of recording pressure ulcers in the patient record. Methods This was a cross-sectional study of 792 patients aged 65 years or older admitted through the emergency department to the inpatient medical service at two teaching hospitals in Philadelphia, Pennsylvania, between 1998 and 2001. Patients were examined by a research nurse on Hospital Day 3 (median of 48 hours after admission) to determine the use of preventive devices, presence of pressure ulcers, and risk of pressure ulcers (by Norton scale). Data on additional risk factors were obtained from the admission nursing assessment in the patient record. Data on documentation of pressure ulcers were obtained by chart abstraction. Results Only 15% of patients had any preventive devices in use at the time of the examination. Among patients considered at risk of pressure ulcers (Norton score ?14), only 51% had a preventive device. In multivariable analyses, high risk of pressure ulcers was associated with use of preventive devices (odds ratio = 41.8, 95% confidence interval = 14.0–124.6), whereas the type and stage of pressure ulcer were not. Documentation of a pressure ulcer was present for only 68% of patients who had a pressure ulcer according to the research examination. Discussion Use of preventive devices and documentation of pressure ulcers are suboptimal even among patients at high risk. PMID:19289930

  14. Leg hammock for closed reduction of tibial shaft fractures.

    PubMed

    Watkins, Colyn; Todd, Dane; Jamieson, Sarah; Mansour, Ashton

    2015-02-01

    Tibial shaft fractures are common injuries in emergency departments (EDs). Although many of these fractures require surgery, nearly all are stabilized in the ED with a long leg splint or bivalved cast. Long leg splinting is often challenging for a single health care provider. Further, even with assistance or previously described techniques for fracture reduction and stabilization, fracture angulation may occur, potentially leading to pain for the patient, fracture displacement, or further soft tissue injury. The authors propose a method for splinting tibial fractures that avoids fracture angulation, is cost-effective and quick, and can be easily performed by a single health care provider. PMID:25665109

  15. Erosive pustular dermatosis of the leg mimicking lower limb cellulitis.

    PubMed

    Zhou, Z; Zhang, Z K; Liu, T H

    2015-12-01

    Erosive pustular dermatosis (EPD) of the leg is an unusual form of amicrobial pustulosis, which typically affects elderly patients with chronic venous insufficiency. We report a patient who presented with painful erythema, crusted erosions and pustules on her right lower leg. Histology showed a dermal infiltration made up predominantly of neutrophils. Bacteria were isolated from the lesions. The condition was initially diagnosed as cellulitis, but antibiotic treatment was unsuccessful. After the correct diagnosis was made, complete resolution was obtained with betamethasone 0.05%. PMID:25476720

  16. Differentiating between red legs and cellulitis and reviewing treatment options.

    PubMed

    Salmon, Michelle

    2015-10-01

    Red legs (RL) is a chronic inflammatory condition often misdiagnosed as cellulitis. Antibiotic therapy is not required and does not resolve the symptoms. The main causes of RL are chronic dermatological and venous disease, including chronic oedema. Raising awareness of this condition among health professionals could prevent misdiagnosis and unnecessary costly and potentially harmful antibiotic therapy. The aim of this paper is to highlight the differential diagnoses and management of red legs, and the author also includes an example through a case history. PMID:26418399

  17. Outcome measurement in clinical trials for Ulcerative Colitis: towards standardisation

    PubMed Central

    Cooney, Rachel M; Warren, Bryan F; Altman, Douglas G; Abreu, Maria T; Travis, Simon PL

    2007-01-01

    Clinical trials on novel drug therapies require clear criteria for patient selection and agreed definitions of disease remission. This principle has been successfully applied in the field of rheumatology where agreed disease scoring systems have allowed multi-centre collaborations and facilitated audit across treatment centres. Unfortunately in ulcerative colitis this consensus is lacking. Thirteen scoring systems have been developed but none have been properly validated. Most trials choose different endpoints and activity indices, making comparison of results from different trials extremely difficult. International consensus on endoscopic, clinical and histological scoring systems is essential as these are the key components used to determine entry criteria and outcome measurements in clinical trials on ulcerative colitis. With multiple new therapies under development, there is a pressing need for consensus to be reached. PMID:17592647

  18. Ulcers in restrained rats: Study of protective substances

    NASA Technical Reports Server (NTRS)

    Buche, L.; Gallaire, D.

    1980-01-01

    The genesis of ulcers in restrained rats is discussed through an investigation of the relationship between the protective effects of nervous system effectual substances examined vis-a-vis ulcers in restrained rats and their elective or secondary pharmacologic effects. The substances used were capable of either peripheral parasympatholytic, sympatholytic, ganglioplegic, spasmolytic effects or central, hypnotic, tranquilizing, neuroleptic, analgesic effects. The regular and considerable protection observed with parasympatholytics (atropine sulfate, benzylonium bromide, dihexyverine, J.L. 1344) and a ganglioplegic (pentamethonium) is a function of their anticholinergic properties. It is of less importance with dibenamine, a sympatholytic action on the adrenergic receptors. Among the central depressive substances tested (hypnotics, tranquilizers, neuroleptics, analgesic), phenobarbital at a nonhypnotic dose, and dextromoramide at a nonanalgesic dose, show antiulcerous effects, which are found with chlorpromazine only at cataleptogenic doses.

  19. Topical Metronidazole for Odor Control in Pressure Ulcers.

    PubMed

    Lyvers, Elizabeth; Elliott, David P

    2015-09-01

    There are many remedies that have been recommended for the treatment of foul odor associated with pressure ulcers. This article seeks to review the literature surrounding the use of metronidazole as a safe and effective solution to an oftentimes stubborn and frustrating problem. Other tools used to control odor include bleach-based solutions and charcoal dressings. Metronidazole, with its antianaerobic properties, appears to have a useful role in therapy when applied topically to a pressure ulcer. Commercially available products include 0.75% and 1% creams, gels, lotions, and intravenous solutions. Of the 59 cases viewed throughout several publications, 56 reported nearly complete odor resolution in two to seven days when metronidazole was applied to the wound two or three times daily. Virtually no systemic adverse events have been reported in the literature, despite the risk for systemic absorption. A need remains to monitor for toxicities such as nausea, gastrointestinal distress, and neural toxicities from long-term use. PMID:26350892

  20. Compression therapy for ulcers: The science and the art

    PubMed Central

    Gogia, Shashi B.; Gogia, Arun R.

    2012-01-01

    Introduction: Chronic ulcers are characterized by being resistant to all forms of treatment. Recent improvement in compression techniques, notably use of multilayer bandaging has created a need for a re-look into it's use. Materials and Methods: The authors present two case reports of successful management of chronic ulcers using compression through bandaging where all other forms of treatment had failed. This is followed by a review of literature based on previous articles as well as more recent ones found through Pubmed. Conclusion: It is suggested that, at least in India, compression through proper multilayer bandaging, should be a choice far higher in the treatment ladder than so previously. However, if the technique is improper, it may be harmful so the option is to be exercised with care and only by those who have received adequate training. The need of a team approach, and alongside, wider introduction of more and better training facilities for therapists and nurses is underlined. PMID:23162227

  1. Nurse Assistant Communication Strategies About Pressure Ulcers in Nursing Homes.

    PubMed

    Alexander, Gregory L

    2015-07-01

    There is growing recognition of benefits of sophisticated information technology (IT) in nursing homes (NHs). In this research, we explore strategies nursing assistants (NAs) use to communicate pressure ulcer prevention practices in NHs with variable IT sophistication measures. Primary qualitative data were collected during focus groups with NAs in 16 NHs located across Missouri. NAs (n = 213) participated in 31 focus groups. Three major themes referencing communication strategies for pressure ulcer prevention were identified, including Passing on Information, Keeping Track of Needs and Information Access. NAs use a variety of strategies to prioritize care, and strategies are different based on IT sophistication level. NA work is an important part of patient care. However, little information about their work is included in communication, leaving patient records incomplete. NAs' communication is becoming increasingly important in the care of the millions of chronically ill elders in NHs. PMID:25331206

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

    PubMed Central

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

    2014-01-01

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

  3. Ulcerative colitis associated with the herbal weight loss supplement Hydroxycut.

    PubMed

    Sivarajah, Vernon; Abdul, Quddus; Pardoe, Helen; Lunniss, Peter

    2013-01-01

    A 25-year-old Iranian gentleman was admitted to hospital with severe bloody diarrhoea and abdominal pain. He had similar episodes in the past. On each occasion his symptoms developed following the consumption of the herbal weight loss supplement Hydroxycut Hardcore X. On this admission, a (CT) scan demonstrated bowel wall thickening and peri-colonic fat stranding in the sigmoid colon. On flexible sigmoidoscopy, a continuous length of congested mucosa with multiple small ulcers was seen extending up to the mid-transverse colon, in keeping with ulcerative colitis. Histological analysis of biopsies was taken at the time and confirmed this. He was started on steroids early during his admission but this only provided a transient clinical improvement. The addition of cyclosporine, which was later changed to azathioprine, did not improve his condition either. He therefore underwent an open subtotal colectomy with end ileostomy. He made a slow but steady recovery and was discharged 3 weeks later. PMID:23291814

  4. [Cytological changes in patients with diabetes mellitus and corneal ulcer].

    PubMed

    Raica, D; Turlea, M; Ciocm?reanu, M; Haidar, A; Demian, C; Jinga, F

    1999-01-01

    There were studied 11 diabetic patients, insulin dependents, from 4 were with juvenile diabetes mellitus. These were hospitalized in the Dept. Ophthalm. of the City Hospital of Arad, during 1996-1998, admitted with the diagnosis of corneal ulcer. There were made samples of the gathered secretion from the level of conjunctiva and of the grataj material, gathered at the level of the edges of the corneal ulcer. All samples were stained with the BPT-Dr?gan method. There are described cytologic alterations, insisting on details that indicate the severity of the corneal disease. There are taken into consideration cytologic aspects in relationship with the clinical outcome of the disease, pointing out the cellular alterations which announce a nonfavourable prognosis. Cytologic results can improve the diagnosis and they are involved in therapeutic schedule. PMID:10641114

  5. Adult dermatomyositis with bleeding ulcer in the pharynx.

    PubMed

    Kusano, Junko; Takahashi, Yuka; Misaki, Yoshikata; Murai, Norihiko

    2014-01-01

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

  6. Chronic gastritis, alcohol, and non-ulcer dyspepsia 1

    PubMed Central

    Roberts, D. M.

    1972-01-01

    An investigation of 102 men comprising alcoholics, patients with non-ulcer dyspepsia, and healthy controls is reported. It demonstrates that alcohol is a cause of chronic gastritis and the severity of the mucosal lesion is directly related to the duration of excess drinking. Contrary to popular belief, chronic gastritis does not give rise to symptoms. The effect of alcohol on the gastric mucosa is a direct one and is not mediated by malnutrition, hepatic damage, intestinal malabsorption, anaemia, ascorbic acid deficiency, or any disturbance in immune tolerance. The natural history of chronic gastritis is described, involving an initial hypertrophy and hyperfunction of the gastric mucosa, followed by atrophy and hypofunction. Cigarette smoking is confirmed as another cause of chronic gastritis. The non-ulcer dyspepsia syndrome is unrelated to chronic gastritis. ImagesFig. 1Fig. 2Fig. 3Fig. 4Fig. 5Fig. 6 PMID:5087067

  7. A Case of Cerebral Vasculitis Associated with Ulcerative Colitis

    PubMed Central

    Raj, Naveen; Arkebauer, Matthew; Waters, Barry; Dickinson, Brucha

    2015-01-01

    Ulcerative colitis (UC) is a chronic, debilitating condition characterized by inflammation of the colonic mucosa. It is regarded as a systemic inflammatory disorder that can affect a number of organ systems. Central nervous system disease associated with UC is a rare sequela of inflammatory bowel disease, occurring in less than 5% of cases. These manifestations include arterial and venous thrombosis, leukoencephalitis, seizures, and vasculitis. We present a case of a 61-year-old female with a two-year history of well-controlled ulcerative colitis, who developed altered mental status and weakness. On brain imaging, she was found to have cerebral lesions which were biopsied. Histopathology subsequently revealed coagulative necrosis and inflammation characteristic of vasculitis. Rheumatology serologies were negative, and the patient was started on steroids that dramatically improved her neurological function, with no residual deficits, and led to resolution of the brain lesions. PMID:26557402

  8. Adult Dermatomyositis with Bleeding Ulcer in the Pharynx

    PubMed Central

    Kusano, Junko; Takahashi, Yuka

    2014-01-01

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

  9. An oral ulceration associated with Morgellons disease: a case report.

    PubMed

    Grosskopf, Courtney; Desai, Bhavik; Stoopler, Eric T

    2011-08-01

    Morgellons disease is a psycho-dermatologic condition in which patients report fibers or filaments "growing" out of their skin. This case report highlights an oral ulceration in a young woman associated with Morgellons disease, a condition that has not been previously described in the dental literature. An increasing number of individuals are self-reporting this condition and oral health care providers must be familiar with this disorder. PMID:21749875

  10. Pressure Ulcer-Related Pelvic Osteomyelitis: A Neglected Disease?

    PubMed

    Bodavula, Phani; Liang, Stephen Y; Wu, Jiami; VanTassell, Paige; Marschall, Jonas

    2015-09-01

    Background. ?Decubitus ulcers can become complicated by pelvic osteomyelitis. Little is known about the epidemiology of pressure ulcer-related pelvic osteomyelitis. Methods. ?We performed a retrospective cohort study of adult patients with pressure ulcer and pelvic osteomyelitis admitted to an academic center from 2006 to 2011. Data on clinical presentation, diagnostic evaluation, and treatment during the index admission were collected. Outcome measures included length of hospital stay and number of readmissions in the subsequent year. Results. ?Two hundred twenty patients were included: 163 (74%) were para/quadriplegic and 148 (67%) were male (148; 67%). Mean age was 50 (±18) years. Pelvic osteomyelitis was the primary admission diagnosis for 117 (53%). Fifty-six (26%) patients had concurrent febrile urinary tract infection. Wound cultures collected for 113 patients (51%) were notable for methicillin-resistant Staphylococcus aureus (37; 33%), Streptococci (19; 17%), and Pseudomonas spp (20; 18%). Plain films were obtained in 89 (40%) patients, computed tomography scans were obtained for 81 (37%) patients, and magnetic resonance images were obtained for 40 (18%) patients. Most patients received osteomyelitis-directed antibiotics (153; 70%), 134 of 153 (88%) of which were scheduled to receive ?6 weeks of treatment. Fifty-five (25%) patients underwent surgery during the index admission; 48 (22%) patients received a combined medical-surgical approach. One third of patients had ?2 readmissions during the subsequent year. Patients treated with a combined approach were less likely to be readmitted than those who received antibiotics alone (0 [range, 0-4] vs 1 [0-7] readmissions; P = .04). Conclusions. ?This is one of the largest cohort studies of pressure ulcer-related pelvic osteomyelitis to date. Significant variations existed in diagnostic approach. Most patients received antibiotics; those treated with a combined medical-surgical approach had fewer hospital readmissions. PMID:26322317

  11. Pressure Ulcer-Related Pelvic Osteomyelitis: A Neglected Disease?

    PubMed Central

    Bodavula, Phani; Liang, Stephen Y.; Wu, Jiami; VanTassell, Paige; Marschall, Jonas

    2015-01-01

    Background.?Decubitus ulcers can become complicated by pelvic osteomyelitis. Little is known about the epidemiology of pressure ulcer-related pelvic osteomyelitis. Methods.?We performed a retrospective cohort study of adult patients with pressure ulcer and pelvic osteomyelitis admitted to an academic center from 2006 to 2011. Data on clinical presentation, diagnostic evaluation, and treatment during the index admission were collected. Outcome measures included length of hospital stay and number of readmissions in the subsequent year. Results.?Two hundred twenty patients were included: 163 (74%) were para/quadriplegic and 148 (67%) were male (148; 67%). Mean age was 50 (±18) years. Pelvic osteomyelitis was the primary admission diagnosis for 117 (53%). Fifty-six (26%) patients had concurrent febrile urinary tract infection. Wound cultures collected for 113 patients (51%) were notable for methicillin-resistant Staphylococcus aureus (37; 33%), Streptococci (19; 17%), and Pseudomonas spp (20; 18%). Plain films were obtained in 89 (40%) patients, computed tomography scans were obtained for 81 (37%) patients, and magnetic resonance images were obtained for 40 (18%) patients. Most patients received osteomyelitis-directed antibiotics (153; 70%), 134 of 153 (88%) of which were scheduled to receive ?6 weeks of treatment. Fifty-five (25%) patients underwent surgery during the index admission; 48 (22%) patients received a combined medical-surgical approach. One third of patients had ?2 readmissions during the subsequent year. Patients treated with a combined approach were less likely to be readmitted than those who received antibiotics alone (0 [range, 0–4] vs 1 [0–7] readmissions; P = .04). Conclusions.?This is one of the largest cohort studies of pressure ulcer-related pelvic osteomyelitis to date. Significant variations existed in diagnostic approach. Most patients received antibiotics; those treated with a combined medical-surgical approach had fewer hospital readmissions. PMID:26322317

  12. Five-year Survey of the Treatment of Varicose Ulcers

    PubMed Central

    Henry, Mary E. F.; Fegan, W. G.; Pegum, J. M.

    1971-01-01

    Eighty-two consecutive women with varicose ulcers were treated by compression sclerotherapy; 73 (89%) of them were reviewed 46 to 69 months after treatment. The cure rate at follow-up for the whole group was 82%. In obese patients the cure rate was 76%, while in non-obese patients it was 89%. These results compare favourably with those of surgery. PMID:5579490

  13. Factors predicts skin ulcer following coronary artery bypass

    PubMed Central

    Sabzi, F; Faraji, R

    2014-01-01

    The number of off-pump coronary artery surgery procedures in high-risk patients such as renal failure, hepatic failure and in anticoagulant drug using patients is increasing. The associated co morbidity and repeated use of electrocautery in postoperative bleeding, caused a susceptibility of patients to pressure or electrocautery ulcers. During a period of three years, 1400 off-pump coronary artery bypass surgery were performed in our center. Of these patients, 20 (A group) suffered from electrocautery sore (ES) and 40 (B group) had pressure sore (PS). These patients were compared with respect to variables such as age, hypertension, hypercholesterolemia, operating time, smoking, opium using, diabetes, weight, sex, respiratory failure, renal failure, and cerebrovascular accident, intra aortic balloon pump using, inotropic drug using by x2 or t test, according to categorical or continuous variables consequently. Electrocautery sore and pressure ulcer as dependence variables and others variables with p value less than 0.1 entered a multivariable logistic regression model and odd ratio of significant variables were obtained. These two groups of patients were different with respect to variables such as age, sex, respiratory failure and cerebrovascular accident and, in the logistic regression model, two factors predicted pressure sore, respiratory failure and cerebrovascular accident, but the only factor that was significant in predicting electrocautery sore in multiple logistic regression analysis was postoperative bleeding. Results of this study revealed that pressure sore is a patient dependent complication in contrast with the electrocautery sore, which is related to technical or device faults and to experience and care of operating room staff. Abbreviations: electrocautery sore = ES, pressure sore = PS, electrocautery ulcer = EU, pressure ulcer = PU, activated clotting time = ACT PMID:25870669

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

    SciTech Connect

    Lam, Marnix G. E. H.; Banerjee, Subhas; Louie, John D.; Abdelmaksoud, Mohamed H. K.; Iagaru, Andrei H.; Ennen, Rebecca E.; Sze, Daniel Y.

    2013-12-15

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

  15. 76 FR 55413 - Proposed Safe Harbor Agreement for California Red-legged Frog, California Tiger Salamander, Smith...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-07

    ...Harbor Agreement for California Red-legged Frog, California Tiger Salamander, Smith's...federally threatened California red-legged frog (Rana draytonii) and California tiger...conservation of the California red-legged frog, California tiger salamander,...

  16. Examination of the Accuracy of Coding Hospital-Acquired Pressure Ulcer Stages

    PubMed Central

    Coomer, Nicole M; McCall, Nancy T

    2013-01-01

    Objective Pressure ulcers (PU) are considered harmful conditions that are reasonably prevented if accepted standards of care are followed. They became subject to the payment adjustment for hospitalacquired conditions (HACs) beginning October 1, 2008. We examined several aspects of the accuracy of coding for pressure ulcers under the Medicare Hospital-Acquired Condition Present on Admission (HAC–POA) Program. We used the “4010” claim format as a basis of reference to show some of the issues of the old format, such as the underreporting of pressure ulcer stages on pressure ulcer claims and how the underreporting varied by hospital characteristics. We then used the rate of Stage III and IV pressure ulcer HACs reported in the Hospital Cost and Utilization Project State Inpatient Databases data to look at the sensitivity of PU HAC–POA coding to the number of diagnosis fields. Methods We examined Medicare claims data for FYs 2009 and 2010 to examine the degree that the presence of stage codes were underreported on pressure ulcer claims. We selected all claims with a secondary diagnosis code of pressure ulcer site (ICD-9 diagnosis codes 707.00–707.09) that were not reported as POA (POA of “N” or “U”). We then created a binary indicator for the presence of any pressure ulcer stage diagnosis code. We examine the percentage of claims with a diagnosis of a pressure ulcer site code with no accompanying pressure ulcer stage code. Results Our results point to underreporting of PU stages under the “4010” format and that the reporting of stage codes varied across hospital type and location. Further, our results indicate that under the “5010” format, a higher number of pressure ulcer HACs can be expected to be reported and we should expect to encounter a larger percentage of pressure ulcers incorrectly coded as POA under the new format. Conclusions The combination of the capture of 25 diagnosis codes under the new “5010” format and the change from ICD-9 to ICD-10 will likely alleviate the observed underreporting of pressure ulcer HACs. However, as long as coding guidelines direct that Stage III and IV pressure ulcers be coded as POA, if a lower stage pressure ulcer was POA and progressed to a higher stage pressure ulcer during the admission, the acquisition of Stage III and IV pressure ulcers in the hospital will be underreported. PMID:24834362

  17. Evaluation of dairy allergy among ulcerative colitis patients.

    PubMed

    Judaki, Arezo; Hafeziahmadi, Mohamadreza; Yousefi, Atefe; Havasian, Mohamad Reza; Panahi, Jafar; Sayehmiri, Koroush; Alizadeh, Sajjad

    2014-01-01

    The intestine is the largest mucosal organ of the body and also the first line immune homeostasis. Inflammatory bowel disease or IBD is divided into ulcerative colitis and Crohn's disease. One of the problems that can occur with UC is dietary allergy to some foods. This study aimed to evaluated the dairy allergy among patients with ulcerative colitis. This study is a Case - control study, that studied 72 patients with Ulcerative Colitis, after recording history of the disease, colonoscopy and confirmed by biopsy and 72 person without history of colitis. In this study, in order to investigate of food allergy, used of the EUROMMUM kit with an international code number DP3420-1601-11E. We used chi-square and Monte Carlo method for analysis of data. Among UC patients, 30.6% mild, 52.8% moderate and 16.6% of cases were in sever stage. 9.7% of them reported a history of abdominal surgery due to disease. According to the chi-square and Monte Carlo methods, dairy allergy (including: cow milk, cow milk UHT and casein) in UC group was significant (P=0.00). This study indicated that there is significant relationship between UC and cow milk, cow milk UHT and casein. UC patients who are allergic to dairy products and the use of dairy products can increase the severity of UC. PMID:25512686

  18. [Prevalence of peptic ulcer in patients with various hepatopathies].

    PubMed

    Andriulli, A; Arrigoni, A; Gindro, T; Verme, G

    1986-10-13

    Aim of this study was to re-evaluate the overall prevalence of a peptic disease in 350 patients with liver diseases of different etiology and severity. A normal endoscopic picture was found in 82% of cases. Peptic lesions were found in 18% of total cases and were located in the duodenal (10.9%) and gastric (7.1%) wall. On the basis of the 15-20% rate, which most Authors think to be a reasonable estimate of the overall ulcer prevalence in normal population, the prevalence rate in this survey would suggest that there is no association between ulcer and liver disease. Ulcers were more commonly present in cirrhotic than in noncirrhotic patients. Both alcohol intake and cigarette smoking were identified as two ulcerogenic events in these patients while portal hypertension and etiology of liver disease were irrelevant factors. The contemporary occurrence of the three ulcerogenic factors (cirrhosis, smoking, and alcohol intake) in a given patient seems to potentiate each others as ulcerogenic event. It is concluded that patients with liver diseases share the same risk of developing a peptic disease as the general population. PMID:3774200

  19. Traumatic ulcerative granuloma with stromal eosinophilia - Mystery of pathogenesis revisited.

    PubMed

    Sarangarajan, R; Vaishnavi Vedam, V K; Sivadas, G; Sarangarajan, Anuradha; Meera, S

    2015-08-01

    Oral ulcers are a common symptom in clinical practice. Among various causative factors, different types of ulcers in oral cavity exist. Among this, traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) appears to be quite neglected by the clinicians due to the limited knowledge and awareness. On reviewing with a detailed approach to titles and abstracts of articles eliminating duplicates, 40 relevant articles were considered. Randomized studies, review articles, case reports and abstracts were included while conference papers and posters were excluded. Of importance, TUGSE cases been reported only to a minimal extent in the literature. Lack of its awareness tends to lead clinicians to a misconception of cancer. Thus, this particular lesion needs to be differentiated from other malignant lesions to provide a proper mode of treatment. The present article reviews various aspects of the TUGSE with emphasis on the clinical manifestation, pathogenesis, histological, and immunohistochemical study. This study provides the clinician contemporaries, a humble expansion to their knowledge of the disease, based on the searched literature, enabling a more comprehensive management of this rare occurrence. PMID:26538890

  20. Traumatic ulcerative granuloma with stromal eosinophilia – Mystery of pathogenesis revisited

    PubMed Central

    Sarangarajan, R.; Vaishnavi Vedam, V. K.; Sivadas, G.; Sarangarajan, Anuradha; Meera, S.

    2015-01-01

    Oral ulcers are a common symptom in clinical practice. Among various causative factors, different types of ulcers in oral cavity exist. Among this, traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) appears to be quite neglected by the clinicians due to the limited knowledge and awareness. On reviewing with a detailed approach to titles and abstracts of articles eliminating duplicates, 40 relevant articles were considered. Randomized studies, review articles, case reports and abstracts were included while conference papers and posters were excluded. Of importance, TUGSE cases been reported only to a minimal extent in the literature. Lack of its awareness tends to lead clinicians to a misconception of cancer. Thus, this particular lesion needs to be differentiated from other malignant lesions to provide a proper mode of treatment. The present article reviews various aspects of the TUGSE with emphasis on the clinical manifestation, pathogenesis, histological, and immunohistochemical study. This study provides the clinician contemporaries, a humble expansion to their knowledge of the disease, based on the searched literature, enabling a more comprehensive management of this rare occurrence. PMID:26538890

  1. Differential expression patterns of the hox gene are associated with differential growth of insect hind legs

    E-print Network

    Popadic', Aleksandar

    enlarged T3 leg, such as crickets and grasshoppers, and species that exhibit more moderate enlarge- ment legs of orthopteran insects such as crickets and grasshoppers, which originate from the T3 segment

  2. Dynamically Diverse Legged Locomotion for Rough Terrain Katie Byl and Russ Tedrake

    E-print Network

    Tedrake, Russ

    -impedance quadruped to operate across a variety of rough terrain. At one extreme, the robot can achieve precise comparable to that legged creatures in nature: ideally, legged locomotion should exploit both careful foot

  3. 33 CFR 147.809 - Mars Tension Leg Platform safety zone.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Mars Tension Leg Platform safety... Navigation and Navigable Waters COAST GUARD, DEPARTMENT...SAFETY ZONES § 147.809 Mars Tension Leg Platform...

  4. 33 CFR 147.809 - Mars Tension Leg Platform safety zone.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... Navigation and Navigable Waters 2 2011-07-01 2011-07-01 false Mars Tension Leg Platform safety... Navigation and Navigable Waters COAST GUARD, DEPARTMENT...SAFETY ZONES § 147.809 Mars Tension Leg Platform...

  5. Protection Agency led the fourth leg, investigating the effects of ocean dump-

    E-print Network

    Protection Agency led the fourth leg, investigating the effects of ocean dump- ing off the coasts by the dumping. Jack Hathaway of the USGS Woods Hole laboratory was principal inves- tigator for the fifth leg

  6. Gait Control for Redundant Legged Biped Robot at Constant Velocity and Constant Height of the Waist

    NASA Astrophysics Data System (ADS)

    Shima, Ryoichi; Haishi, Masahiko; Shibata, Masaaki

    In this paper, we propose a gait control method for redundant legged biped robot based on leg center of mass (COM) position control at constant velocity and constant height of the waist. The developed biped robot has redundant legs, which have 4 degree-of-freedoms (DOFs) on each in the saggital plane. The redundant DOF enables to move its leg tip position and its leg COM position independently. Therefore proposed robot has structural capability to control the leg COM position for keeping the projection of the total COM inside the support polygon without upper body motion. Such capability enables the stable static walk in the arbitrarily desired velocity and height of the waist motion. The validity of the proposed method for the static walk at constant velocity and constant height of the waist in the leg COM position control for redundant legged biped robot is confirmed by several results of simulation and experiment.

  7. Design of a quasi-passive parallel leg exoskeleton to augment load carrying for walking

    E-print Network

    Valiente, Andrew (Andrew J.)

    2005-01-01

    Biomechanical experiments suggest that it may be possible to build a leg exoskeleton to reduce the metabolic cost of walking while carrying a load. A quasi-passive, leg exoskeleton is presented that is designed to assist ...

  8. Modeling of the Supporting Legs for Designing Biomimetic Water Strider Robots

    E-print Network

    Sitti, Metin

    ] to underwater fish- like robots [2]. Many robots adapt designs inspired by insects, such as the 6-legged robots similar to cockroaches [3]-[5], 8- legged robot [6], and the micromechanical flying robot [7]. Recently

  9. Cigarette smoking and risk of pressure ulcer in adult intensive care unit patients.

    PubMed

    Nassaji, Mohammad; Askari, Zahra; Ghorbani, Raheb

    2014-08-01

    The objective of this study was to assess relationship between smoking, some other risk factors and ulcers development in intensive care unit. This prospective cohort study was performed in two university-affiliated hospitals. The sample consisted of adult male patients who were admitted to medical-surgical intensive care units. All eligible patients were grouped according to their cigarette smoking status as smoker and non-smoker. The final sample included 160 smokers and 192 non-smokers. Pressure ulcer occurred in 62 smoker patients and 28 of non-smoker who showed significant difference. Also number of pack-year of cigarettes smoking showed significant association with ulcer development. Ulcer stage was significantly different between the two groups. Besides of smoking, age, length of stay, faecal incontinency, diabetes mellitus, anaemia and trauma were significantly associated with pressure ulcers. Our study showed significant association between smoking and development of pressure ulcers. PMID:25157943

  10. Laser therapy in pressure ulcers: evaluation by the Pressure Ulcer Scale for Healing and Nursing Outcomes Classification.

    PubMed

    Palagi, Sofia; Severo, Isis Marques; Menegon, Dóris Baratz; Lucena, Amália de Fátima

    2015-10-01

    OBJECTIVETo describe the pressure ulcer healing process in critically ill patients treated with conventional dressing therapy plus low-intensity laser therapy evaluated by the Pressure Ulcer Scale for Healing (PUSH) and the result of Wound Healing: Secondary Intention, according to the Nursing Outcomes Classification (NOC).METHODCase report study according to nursing process conducted with an Intensive Care Unit patient. Data were collected with an instrument containing the PUSH and the result of the NOC. In the analysis we used descriptive statistics, considering the scores obtained on the instrument.RESULTSA reduction in the size of lesions of 7cm to 1.5cm of length and 6cm to 1.1cm width, in addition to the increase of epithelial tissue and granulation, decreased secretion and odor.CONCLUSIONThere was improvement in the healing process of the lesion treated with adjuvant therapy and the use of NOC allowed a more detailed and accurate assessment than the PUSH. PMID:26516754

  11. Measurement and simulation of thermoelectric efficiency for single leg.

    PubMed

    Hu, Xiaokai; Yamamoto, Atsushi; Ohta, Michihiro; Nishiate, Hirotaka

    2015-04-01

    Thermoelectric efficiency measurements were carried out on n-type bismuth telluride legs with the hot-side temperature at 100 and 150°C. The electric power and heat flow were measured individually. Water coolant was utilized to maintain the cold-side temperature and to measure heat flow out of the cold side. Leg length and vacuum pressure were studied in terms of temperature difference across the leg, open-circuit voltage, internal resistance, and heat flow. Finite-element simulation on thermoelectric generation was performed in COMSOL Multiphysics, by inputting two-side temperatures and thermoelectric material properties. The open-circuit voltage and resistance were in good agreement between the measurement and simulation. Much larger heat flows were found in measurements, since they were comprised of conductive, convective, and radiative contributions. Parasitic heat flow was measured in the absence of bismuth telluride leg, and the conductive heat flow was then available. Finally, the maximum thermoelectric efficiency was derived in accordance with the electric power and the conductive heat flow. PMID:25933893

  12. Measurement and simulation of thermoelectric efficiency for single leg

    NASA Astrophysics Data System (ADS)

    Hu, Xiaokai; Yamamoto, Atsushi; Ohta, Michihiro; Nishiate, Hirotaka

    2015-04-01

    Thermoelectric efficiency measurements were carried out on n-type bismuth telluride legs with the hot-side temperature at 100 and 150 °C. The electric power and heat flow were measured individually. Water coolant was utilized to maintain the cold-side temperature and to measure heat flow out of the cold side. Leg length and vacuum pressure were studied in terms of temperature difference across the leg, open-circuit voltage, internal resistance, and heat flow. Finite-element simulation on thermoelectric generation was performed in COMSOL Multiphysics, by inputting two-side temperatures and thermoelectric material properties. The open-circuit voltage and resistance were in good agreement between the measurement and simulation. Much larger heat flows were found in measurements, since they were comprised of conductive, convective, and radiative contributions. Parasitic heat flow was measured in the absence of bismuth telluride leg, and the conductive heat flow was then available. Finally, the maximum thermoelectric efficiency was derived in accordance with the electric power and the conductive heat flow.

  13. Monocoque structure for the SKITTER three-legged walker

    NASA Technical Reports Server (NTRS)

    Bansek, Robert N.; Booth, Andrew J.; Daneman, Steven A.; Dresser, James A.; Haney, Todd G.; Johnson, Gregory R.; Lindzen, Eric C.; Montgomery, Robert C.; Warren, Andrew L.

    1988-01-01

    The SKITTER 2 design is a monocoque version of the proposed lunar three-legged walker. By the definition of monocoque, the body and legs are a shell with no internal ribbing or supports added for absorbing stresses. The purpose of the monocoque is to encase the elements used for power transmission, power supply, and control of the motion. The material for the structure is a vinyl ester resin, Derakane 8084. This material is easily formable and locally obtainable. The body consists of a hexagonally shaped cylinder with truncated hexagonal pyramids on the top and botton. The legs are eight inch diameter cylinders. The legs are comprised of a tibia section and a femur section. The SKITTER 2 is powered by six actuators which provide linear forces that are transformed into rotary torques by a series of chains and sprockets. The joints connect the femur to the body and the tibia to the femur. Surrounding the joints are flexible rubber hoses that fully encase the chains and sprockets. The SKITTER 2 is capable of walking upside down, righting itself after being overturned, and has the ability to perform in many environments. Applications for this walker include lunar transport or drilling, undersea exploration, and operation in severe surroundings such as arctic temperatures or high radiation.

  14. Measurement and simulation of thermoelectric efficiency for single leg

    SciTech Connect

    Hu, Xiaokai; Yamamoto, Atsushi Ohta, Michihiro; Nishiate, Hirotaka

    2015-04-15

    Thermoelectric efficiency measurements were carried out on n-type bismuth telluride legs with the hot-side temperature at 100 and 150°C. The electric power and heat flow were measured individually. Water coolant was utilized to maintain the cold-side temperature and to measure heat flow out of the cold side. Leg length and vacuum pressure were studied in terms of temperature difference across the leg, open-circuit voltage, internal resistance, and heat flow. Finite-element simulation on thermoelectric generation was performed in COMSOL Multiphysics, by inputting two-side temperatures and thermoelectric material properties. The open-circuit voltage and resistance were in good agreement between the measurement and simulation. Much larger heat flows were found in measurements, since they were comprised of conductive, convective, and radiative contributions. Parasitic heat flow was measured in the absence of bismuth telluride leg, and the conductive heat flow was then available. Finally, the maximum thermoelectric efficiency was derived in accordance with the electric power and the conductive heat flow.

  15. Dynamic postural stability for double-leg drop landing.

    PubMed

    Niu, Wenxin; Zhang, Ming; Fan, Yubo; Zhao, Qinping

    2013-01-01

    Dynamic postural stability has been widely studied for single-leg landing, but seldom considered for double-leg landing. This study aimed to evaluate the dynamic postural stability and the influence mechanism of muscle activities during double-leg drop landing. Eight recreationally active males and eight recreationally active females participated in this study and dropped individually from three heights (0.32?m, 0.52?m, and 0.72?m). Ground reaction force was recorded to calculate the time to stabilisation. Electromyographic activities were recorded for selected lower-extremity muscles. A multivariate analysis of variance was carried out and no significant influence was found in time to stabilisation between genders or limb laterals (P?>?0.05). With increasing drop height, time to stabilisation decreased significantly in two horizontal directions and the lower-extremity muscle activities were enhanced. Vertical time to stabilisation was not significantly influenced by drop height. Dynamic postural stability improved by neuromuscular change more than that required due to the increase of drop height. Double-leg landing on level ground is a stable movement, and the body would often be injured before dynamic postural stability is impaired. It is understandable to protect tissues from mechanical injuries by the sacrifice of certain dynamic postural stability in the design of protective devices or athlete training. PMID:23351015

  16. Muscle strategies for leg extensions on a "Reformer" apparatus.

    PubMed

    Cantergi, Débora; Loss, Jefferson Fagundes; Jinha, Azim; Brodt, Guilherme Auler; Herzog, Walter

    2015-04-01

    Considering the kinematics of leg extensions performed on a Reformer apparatus, one would expect high activation of hip and knee extensor muscle groups. However, because of the bi-articular nature of some lower limb muscles, and the possibility to vary the direction of force application on the Reformer bar, muscles can be coordinated theoretically in a variety of ways and still achieve the desired outcome. Hence, the aim of this study was to determine the knee and hip moments during leg extensions performed on the Reformer apparatus and to estimate the forces in individual muscles crossing these joints using static optimization. Fifteen subjects performed leg extensions exercises on the Reformer apparatus using an individually chosen resistance. To our big surprise, we found that subjects performed the exercise using two conceptually different strategies (i) the first group used simultaneous hip and knee extension moments, (ii) while the second group used simultaneous hip flexion and knee extension moments to perform the exercise. These different strategies were achieved by changing the direction of the resultant force applied by the subject's feet on the Reformer bar. While leg extensions on the Reformer apparatus have been thought to strengthen the hip and knee extensors muscles, our results demonstrate that patients can perform the exercise in a different and unexpected way. In order to control the hip and knee moments and achieve the desired outcome of the exercise, the direction of force application on the Reformer bar must be controlled carefully. PMID:25262161

  17. Finite Wave Vector Pairing in Doped Two-leg Ladders

    SciTech Connect

    Robinson N. J.; Tsvelik A.; Essler, F.H.L.; Jeckelmann, E.

    2012-05-02

    We consider the effects of umklapp processes in doped two-leg fermionic ladders. These may emerge either at special band fillings or as a result of the presence of external periodic potentials. We show that such umklapp processes can lead to profound changes of physical properties and in particular stabilize pair-density wave phases.

  18. Insect senses: how to hear with your legs

    E-print Network

    Moczek, Armin P.

    Insect senses: how to hear with your legs and taste with your feet (yum!) #12;INSECT SENSES PART I revisited #12;INSECT VISION INSECT VISION Ocelli ·simple lense eyes, ·good for contrasts ·not image forming ·many insects have lost them Compoundeyes(=sumof100s-1000sofommatidia) Insects see with their eyes

  19. OCEAN DRILLING PROGRAM LEGS 127 AND 128 SCIENTIFIC PROSPECTUS

    E-print Network

    OCEAN DRILLING PROGRAM LEGS 127 AND 128 SCIENTIFIC PROSPECTUS JAPAN SEA Dr. Kenneth Pisciotto Co, or Texas A&M Research Foundation. #12;ABSTRACT The Japan Sea is one of the best known backarc basins constraints on the age of rifting of the Japan Sea and help to better understand the kinematics of the entire

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

    E-print Network

    Goldman, Daniel I.

    and performance tests of large, off-road, wheeled and tracked vehicles * This work was supported by The Burroughs, USA Compared to agile legged animals, wheeled and tracked vehicles often suffer large performance loss than using simple one-dimensional penetration and drag force models. A multi- body dynamic simulation