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Skin Ulcer

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121. A Woman with a Skin Ulcer

A Woman with a Skin Ulcer Rotation Prep | NEJM Resident 360 Social Login Email Login Log in via Email Create Your Account We will not share your email with anyone. Password must be at least 8 characters. Show or Hide the password you are typing. Request to Join has invited you to join this group Your browser does not support video tags Welcome! NEJM Resident 360 helps you prepare for your next rotation quickly and efficiently, provides support for coping with the pressures of resident life

2016 Now@NEJM

122. The venous ulcer continues to be a clinical challenge: an update Full Text available with Trip Pro

. The pathogenesis of venous ulcers is unrelieved or ambulatory venous hypertension resulting mostly from deep venous thrombosis leading to venous incompetence, lipodermatosclerosis, leucocyte plugging of the capillaries, tissue hypoxia and microvascular dysfunction. It is not known what initiates venous ulcers. Triggers vary from trauma of the lower extremity to scratching to relieve itchy skin over the ankle region. Venous ulcers can be painful, and this condition presents an increasing burden of care (...) The venous ulcer continues to be a clinical challenge: an update Venous ulcers are a common chronic problem in many countries especially in Northern Europe and USA. The overall prevalence of this condition is 1% rising to 3% in the over 65 years of age. Over the last 25 years, there have been many developments applicable to its diagnosis and treatment. These advances, notwithstanding healing response and recurrence, are variable, and the venous ulcer continues to be a clinical challenge

2018 Burns & trauma

123. Physician-initiated clinical study of limb ulcers treated with a functional peptide, SR-0379: from discovery to a randomized, double-blind, placebo-controlled trial Full Text available with Trip Pro

, double-blind, randomized clinical study was conducted from October 2015 to September 2016. The inclusion criteria for leg ulcers were (1) diabetes or critical limb ischemia and (2) wound size <6 cm in diameter. Twelve patients were randomized into four groups and administered 0.02%, 0.1%, or 0.5% SR-0379 or placebo treatment on skin ulcers once per day for 28 days. Efficiency was evaluated by determining the rate of wound size reduction as a primary endpoint at 4 weeks after the first treatment (...) compared with the pre-treatment wound size. As a secondary endpoint, the DESIGN-R score index, time to wound closure, and the 50% wound size reduction ratio were also evaluated. The safety of SR-0379 was evaluated during the study period. In the evaluation of efficiency, the skin ulcer reduction rates at the last evaluation were 44.73% for the 0.02% SR-0379 group, 68.25% for the 0.1% group, and 71.61% for the 0.5% group, compared with 9.95% for the placebo group. Six adverse events were reported

2018 NPJ aging and mechanisms of disease Controlled trial quality: predicted high

124. Emerging Technologies for the Prevention of Pressure Ulcers in Acute Care Settings: A Review of Clinical and Cost-Effectiveness and Guidelines

that prophylactic polyurethane film dressings may be effective in preventing pressures sores in individuals without existing skin or tissue damage. One evidence-based guideline was identified relating to emerging technologies for the prevention of pressure ulcers in acute care settings; recommended practices include microclimate manipulation, prophylactic dressings, silk-like fabrics designed to reduce shear and friction, and electrical stimulation of the muscles in individuals with spinal cord injury (...) . No published literature was identified relating to the cost-effectiveness of emerging interventions for the prevention of pressure ulcers in acute care setting or regarding the clinical effectiveness of emerging preventive strategies in the operating room. Tags dermatology, hydrogels, microclimate, pressure ulcer, silk, bed sore, bed sores, skin lesion, skin lesions, decubitis, decubitus, Prevention, preventing, preventive Files Rapid Response Summary with Critical Appraisal Published : September 12, 2016

2016 Canadian Agency for Drugs and Technologies in Health - Rapid Review

125. Evidence for infliximab dose intensification (5mg/kg every 4-6 weeks) for the maintenance treatment of Ulcerative Colitis in patients who have lost response

Evidence for infliximab dose intensification (5mg/kg every 4-6 weeks) for the maintenance treatment of Ulcerative Colitis in patients who have lost response 1 This LMEN review is produced by the NHS for the NHS and is not to be used for commercial and marketing purposes. London Medicines Evaluation Network Review Evidence for infliximab dose intensification (5mg/kg every 4-6 weeks) for the maintenance treatment of Ulcerative Colitis in patients who have lost response December 2016 Background (...) The National Institute for Health and Care Excellence (NICE) guidance on the treatment of moderately to severely active ulcerative colitis (UC) after the failure of conventional therapy (TA329) 3 recommend infliximab 5mg/kg given as an intravenous infusion followed by additional 5mg/kg infusion doses at 2 and 6 weeks after the first infusion, then every 8 weeks thereafter. Commissioning groups are being asked to fund requests for infliximab dose intensification (i.e. reducing intervals to 4-6 weeks

2017 Specialist Pharmacy Services

126. Flixabi (infliximab) - rheumatoid arthritis, Crohn?s disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis or psoriasis

Flixabi (infliximab) - rheumatoid arthritis, Crohn?s disease, ulcerative colitis, ankylosing spondylitis, psoriatic arthritis or psoriasis 30 Churchill Place ? Canary Wharf ? London E14 5EU ? United Kingdom An agency of the European Union Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5520 Send a question via our website www.ema.europa.eu/contact 1 April 2016 EMA/CHMP/272283/2016 Committee for Medicinal Products for Human Use (CHMP) CHMP assessment report Flixabi International non (...) to conventional therapy including a corticosteroid, an immunomodulator and primary nutrition therapy; or who are intolerant to or have contraindications for such therapies. Infliximab has been studied only in combination with conventional immunosuppressive therapy. Ulcerative colitis Flixabi is indicated for treatment of moderately to severely active ulcerative colitis in adult patients who have had an inadequate response to conventional therapy including corticosteroids and 6-mercaptopurine (6-MP

2016 European Medicines Agency - EPARs

127. Handcrafted Vacuum-Assisted Device for Skin Ulcers Treatment Versus Traditional Therapy, Randomized Controlled Trial. (Abstract)

Handcrafted Vacuum-Assisted Device for Skin Ulcers Treatment Versus Traditional Therapy, Randomized Controlled Trial. Chronic lower limb ulcers constitute a public health problem, with important socioeconomic implications and high attention cost. This trial evaluates handcrafted vacuum-assisted therapy versus traditional treatment effectiveness for lower limbs ulcers.It was a prospective randomized clinical trial conducted over 144 patients with lower limbs ulcers. Patients were randomized (...) into two groups of 72 patients: Experimental group were treated with debridement, cure and a handcrafted vacuum-assisted device that was changed every 72 h. Control group was treated with debridement and cure with soap every 24 h. Ulcers were evaluated every 72 h and on 10th day. The presence of systemic inflammatory response, pain, granulation tissue and viability for discharge was registered and analyzed .After exclusion of 18 patients, 126 were included, 65.1% were men with an average of 58 years

2016 World Journal of Surgery Controlled trial quality: uncertain

128. An ex vivo porcine skin model to evaluate pressure-reducing devices of different mechanical properties used for pressure ulcer prevention. Full Text available with Trip Pro

An ex vivo porcine skin model to evaluate pressure-reducing devices of different mechanical properties used for pressure ulcer prevention. Pressure ulcers are complex wounds caused by pressure- and shear-induced trauma to skin and underlying tissues. Pressure-reducing devices, such as dressings, have been shown to successfully reduce pressure ulcer incidence, when used in adjunct to pressure ulcer preventative care. While pressure-reducing devices are available in a range of materials (...) in compressive creep tests. To evaluate biological efficacy we employed a new ex vivo porcine skin model, with a confirmed elastic moduli closely matching that of human skin (113 vs. 119 kPa, respectively). Static loads up to 20 kPa were applied to porcine skin ex vivo with subsequent evaluation of pressure-induced cell death and cytokine release. Pressure application alone increased the percentage of epidermal apoptotic cells from less than 2% to over 40%, and increased cellular secretion of the pro

2016 Wound Repair and Regeneration

129. Delayed Healing of Sickle Cell Ulcers Is due to Impaired Angiogenesis and CXCL12 Secretion in Skin Wounds. Full Text available with Trip Pro

Delayed Healing of Sickle Cell Ulcers Is due to Impaired Angiogenesis and CXCL12 Secretion in Skin Wounds. Leg ulcers are a major complication of sickle cell disease that occur in 2.5-40% of patients. Leg ulcers are responsible for frequent complications because they are often long-lasting and are highly resistant to therapy. Although their occurrence is associated with hyperhemolysis, the mechanisms underlying sickle cell ulcers remain poorly understood. In this study, we show that skin wound (...) and rescued the healing defect together with mobilization of circulating endothelial progenitor cells. To our knowledge, this is a previously unreported study of the cellular and molecular mechanisms of sickle cell ulcers in a murine model that provides promising therapeutic perspectives for clinical trials. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

2016 Journal of Investigative Dermatology

130. Composite Skin Grafting with Human Acellular Dermal Matrix Scaffold for Treatment of Diabetic Foot Ulcers: A Randomized Controlled Trial. (Abstract)

Composite Skin Grafting with Human Acellular Dermal Matrix Scaffold for Treatment of Diabetic Foot Ulcers: A Randomized Controlled Trial. Composite split-thickness skin grafting (STSG) with acellular dermal matrix (ADM) has been used successfully in burn injuries and trauma, but its use in treating diabetic foot ulcers (DFUs) has not been reported to date. This study investigated the efficacy and safety of composite STSG with ADM in the treatment of DFUs.Fifty-two patients with DFUs were

2016 Journal of the American College of Surgeons Controlled trial quality: uncertain

131. Adipose-derived Stem Cells Added to Platelet-rich Plasma for Chronic Skin Ulcer Therapy. (Abstract)

Adipose-derived Stem Cells Added to Platelet-rich Plasma for Chronic Skin Ulcer Therapy. Adipose-derived stem cells (ASCs) hold great promise for regenerative medicine applications due to their ability to promote the healing process through in situ differentiation and secretion of paracrine factor. The aim of this paper is to present a clinical adjunct for chronic skin wound therapy based on ASCs added to platelet-rich plasma (PRP), to obtain an enhanced PRP (e-PRP).For 18 months, 24 control (...) -group patients with 31 chronic skin ulcers were treated with standard wound care, while 16 experimental-group patients with 21 chronic skin ulcers were treated with standard wound care and 1 e-PRP injection. The patients were randomly assigned to the control or experimental group. Outpatients had weekly follow-up visits where they were subjected to standard treatment and the wound healing process was assessed.At the end of the study, the control and experimental groups had similar healing rates

2016 Wounds : a compendium of clinical research and practice Controlled trial quality: uncertain

132. Post-transplant lymphoproliferative disorder presenting with skin ulceration in a renal transplant recipient who achieved sustained remission with rituximab therapy: A case report Full Text available with Trip Pro

Post-transplant lymphoproliferative disorder presenting with skin ulceration in a renal transplant recipient who achieved sustained remission with rituximab therapy: A case report Post-transplant lymphoproliferative disorder (PTLD) is associated with a variety of clinical presentations, but rarely involves the skin. We herein report a case of PTLD presenting with skin ulceration in a renal transplant recipient. A biopsy of the ulcer confirmed the diagnosis of diffuse large B-cell lymphoma (...) . The patient was initially treated with immunosuppression reduction, but the skin ulcer persisted. He was then treated with two courses of chemotherapy, but his condition was complicated with cryptococcal infection. Antifungal agents were administered to control the fungal infection. The patient later developed lymphoma recurrence and was successfully treated with single-agent rituximab. The patient remains well 6 years after treatment, with no evidence of disease relapse. Therefore, PTLD may manifest

2016 Molecular and clinical oncology

133. CD56− extranodal natural killer (NK)/T-cell lymphoma, nasal type presenting as skin ulcers in a white man Full Text available with Trip Pro

CD56− extranodal natural killer (NK)/T-cell lymphoma, nasal type presenting as skin ulcers in a white man 27752533 2019 02 26 2352-5126 2 5 2016 Sep JAAD case reports JAAD Case Rep CD56 - extranodal natural killer (NK)/T-cell lymphoma, nasal type presenting as skin ulcers in a white man. 390-396 Vainder Charles C Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania. Ho Jonhan J Department of Dermatology, University of Pittsburgh, Pittsburgh, Pennsylvania. Swerdlow

2016 JAAD Case Reports

134. Treatment of a Refractory Skin Ulcer Using Punch Graft and Autologous Platelet-Rich Plasma Full Text available with Trip Pro

Treatment of a Refractory Skin Ulcer Using Punch Graft and Autologous Platelet-Rich Plasma Background. Chronic ulceration of the lower legs is a relatively common condition amongst adults: one that causes pain and social distress and results in considerable healthcare and personal costs. The technique of punch grafting offers an alternative approach to the treatment of ulcers of the lower limbs. Objective. Combining platelet-rich plasma and skin graft enhances the efficacy of treating chronic (...) diabetic wounds by enhancing healing rate and decreasing recurrence rate. Platelet-rich plasma could, by stimulating dermal regeneration, increase the take rate after skin grafting or speed up reepithelialization. Methods and Materials. The ulcer was prepared by removing fibrin with a curette and the edges of the ulcer were freshened. The platelet-rich plasma has been infiltrated on the bottom and edges of the ulcer. The punch grafts were placed in 5 mm holes arranged. The ulcer was medicated

2016 Case reports in dermatological medicine

135. ANA Negative Systemic Lupus Erythematosus Leading to CTEPH, TTP-Like Thrombocytopenia, and Skin Ulcers Full Text available with Trip Pro

ANA Negative Systemic Lupus Erythematosus Leading to CTEPH, TTP-Like Thrombocytopenia, and Skin Ulcers SLE affects almost every organ system, with differing degrees of severity. During its clinical course periods of flares may alternate with periods of remission culminating in disease and therapy related damage. We describe a case of ANA negative SLE with severe thrombocytopenia, cutaneous vasculitis, antiphospholipid antibody syndrome, and pulmonary artery hypertension

2016 Case reports in rheumatology

136. The “Buruli Score”: Development of a Multivariable Prediction Model for Diagnosis of Mycobacterium ulcerans Infection in Individuals with Ulcerative Skin Lesions, Akonolinga, Cameroon Full Text available with Trip Pro

The “Buruli Score”: Development of a Multivariable Prediction Model for Diagnosis of Mycobacterium ulcerans Infection in Individuals with Ulcerative Skin Lesions, Akonolinga, Cameroon Access to laboratory diagnosis can be a challenge for individuals suspected of Buruli Ulcer (BU). Our objective was to develop a clinical score to assist clinicians working in resource-limited settings for BU diagnosis.Between 2011 and 2013, individuals presenting at Akonolinga District Hospital, Cameroon (...) , were enrolled consecutively. Clinical data were collected prospectively. Based on a latent class model using laboratory test results (ZN, PCR, culture), patients were categorized into high, or low BU likelihood. Variables associated with a high BU likelihood in a multivariate logistic model were included in the Buruli score. Score cut-offs were chosen based on calculated predictive values. Of 325 patients with an ulcerative lesion, 51 (15.7%) had a high BU likelihood. The variables identified

2016 PLoS neglected tropical diseases

137. Differential Diagnosis of Skin Ulcers in a Mycobacterium ulcerans Endemic Area: Data from a Prospective Study in Cameroon Full Text available with Trip Pro

Differential Diagnosis of Skin Ulcers in a Mycobacterium ulcerans Endemic Area: Data from a Prospective Study in Cameroon Clinical diagnosis of Buruli ulcer (BU) due to Mycobacterium ulcerans can be challenging. We aimed to specify the differential diagnosis of skin lesions in a BU endemic area.We conducted a prospective diagnostic study in Akonolinga, Cameroon. Patients presenting with a skin ulcer suspect of BU were included. M. ulcerans was detected using swabs for Ziehl-Neelsen staining (...) , PCR and culture. Skin punch biopsies were taken and reviewed by two histopathologists. Photographs of the lesions were taken and independently reviewed by two dermatologists. Final diagnosis was based on consensus, combining the results of laboratory tests and expert opinion.Between October 2011 and December 2013, 327 patients with ulcerative lesions were included. Median age was 37 years (0 to 87), 65% were males, and 19% HIV-positive. BU was considered the final diagnosis for 27% of the lesions

2016 PLoS neglected tropical diseases

138. Use of Munsell Color Charts to Measure Skin Tone Objectively in Nursing Home Residents at Risk for Pressure Ulcer Development Full Text available with Trip Pro

Use of Munsell Color Charts to Measure Skin Tone Objectively in Nursing Home Residents at Risk for Pressure Ulcer Development To assess the feasibility of classifying skin tone using Munsell color chart values and to compare Munsell-based skin tone categories to ethnicity/race to predict pressure ulcer risk.Pressure ulcer classification uses level of visible tissue damage, including skin discoloration over bony prominences. Prevention begins with early detection of damage. Skin discoloration (...) values and skin tone. Mean Munsell buttocks values differed significantly by ethnicity/race. Across ethnicity/race, Munsell value ranges overlapped, with the greatest range among African Americans. Trunk pressure ulcer incidence varied by skin tone, regardless of ethnicity/race. In multinomial regression, skin tone was more predictive of skin damage than ethnicity/race for trunk locations but ethnicity/race was more predictive for heels.Given the overlap of Munsell values across ethnicity/race, color

2016 Journal of advanced nursing

139. Ulcers as a Sign of Skin Infection with Mycobacterium wolinskyi: Report of a Case and Review of the Literature Full Text available with Trip Pro

Ulcers as a Sign of Skin Infection with Mycobacterium wolinskyi: Report of a Case and Review of the Literature Infection with Mycobacterium wolinskyi, if not detected, may cause severe skin and soft tissue infection with prolonged healing process and is therefore associated with high morbidity. Only about 20 cases of M. wolinskyi infections in humans have been described in the literature until now, none of them in Switzerland. We report a case of an infection in a 72-year-old male patient (...) with recurrent subcutaneous abdominal wall abscesses and ulcer formation after insulin injection in the underbelly. A culture of skin biopsy tissue showed rapid growth of non-tuberculous mycobacteria (NTM), which were identified by 16S rRNA gene sequencing as M. wolinskyi. Surgical excision and primary closure of all abdominal ulcers in combination with antibiotic therapy, based on the antimicrobiotic susceptibility test results, were performed and resulted in complete resolution of the clinical symptoms

2016 Case reports in dermatology

140. Large Morel-Lavallée lesion presenting as fungating mass with skin ulceration Full Text available with Trip Pro

Large Morel-Lavallée lesion presenting as fungating mass with skin ulceration A Morel-Lavallée lesion, a type of soft tissue degloving injury that has also been referred to as a chronic expanding hematoma, is a relatively rare condition that usually develops following traumatic injury. Here, we present a case of a 60-year-old male with a Morel-Lavallée lesion diagnosed over 5 years after a traumatic injury of the hip. He presented with a large fungating mass and overlying skin ulceration

2016 Journal of clinical orthopaedics and trauma

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