Current Advances in Hypertrophic Scar and Keloid Management

2021 ◽  
Author(s):  
Natasha Barone ◽  
Tyler Safran ◽  
Joshua Vorstenbosch ◽  
Peter Davison ◽  
Sabrina Cugno ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Wound Healing ◽  
Psychological Health ◽  
Hypertrophic Scar ◽  
Tissue Response ◽  
Fibroblast Proliferation ◽  
Hypertrophic Scars ◽  
Physical Status ◽  
Management Options

AbstractHypertrophic scars and keloids are caused by excessive tissue response to dermal injury due to local fibroblast proliferation and collagen overproduction. This response occurs because of pathologic wound healing due to dysregulation in the inflammatory, proliferative, and/or remodeling phase. Patients with hypertrophic scars or keloids report reduced quality of life, physical status, and psychological health. Hypertrophic scars or keloids will develop in 30 to 90% of individuals, and despite their prevalence, treatment remains a challenge. Of the treatments currently available for hypertrophic scars and keloids few have been adequately supported by studies with appropriate experimental design. Here, we aim to review the available literature to provide up-to-date information on the etiology, epidemiology, histology, pathophysiology, prevention, and management options available for the treatment of hypertrophic scars and keloids and highlight areas where further research is required.

721 Treatment of Hypertrophic Burn and Wound Scars Using a Novel Cold Laser System

2020 ◽  
Vol 41 (Supplement_1) ◽  
pp. S191-S192
Author(s):  
Jenn Tsai ◽  
Samy Bendjemil ◽  
Colin Dowling ◽  
Stathis Poulakidas
Keyword(s):  
Quality Of Life ◽  
High Intensity ◽  
Hypertrophic Scar ◽  
Case Series ◽  
Hypertrophic Scars ◽  
Non Invasive ◽  
High Intensity Laser ◽  
Intensity Laser ◽  
Scar Reduction

Abstract Introduction Hypertrophic scars are seen in 70% of individuals after a burn. Survival from acute burns have psychosocial and functional challenges. Hypertrophic scars contain disorganized whorls of collagen, an increase in occluded blood vessels resulting in raised discoloration, inflamed dermis/epidermis and painful sequelae. Management of such scars have been limited to invasive and non-invasive management. One innovative technology is a non-invasive high-intensity laser operating at 1275 nm and 74 Watts, optimizing increased depth of penetration into the tissue utilizing photomechanical effects to biostimulate tissue to heal and regenerate. We present a series of 10 patients. Methods 10 patients were enrolled with hypertrophic scarring secondary to deep partial or full thickness burns. Hypertrophic areas were identified and numerical pain scale, Vancouver Scar Scale and the World Health Organization Quality of Life score were recorded. The non-contact, high-intensity laser was passed over the hypertrophic scars, continuously moving the laser over the entirety of the scar. Each area of hypertrophic scar tissue was lasered for progressively longer sessions, reaching a therapeutic time of 10 min in each section. Results Patients were utilizing previously known non-invasive therapies for scar reduction, such as, compression garments, scar treatment ointments, as well as steroid injection and non-medical therapies such as acupuncture. In our series, 90% of the patients reported decrease in scar pain, inflammation, pigmentation and improved pliability by the second treatment. Decreased scar height was identified by the eighth session, where conventional protocols could require months to years before any changes were observed. Changes in the scars were even identified after the normal time period identified for maximal improvement using conventional burn therapies. In a survey presented to patient, even pain was improved, identified with reduction in narcotic/NSAID use in patients undergoing the therapies. Conclusions Non-invasive high-intensity laser therapies are useful adjuncts for reduction of hypertrophic burn scars. Our case series presents a treatment option in patients that have functional, physical and cosmetic challenges. We anticipate broader applications for hypertrophic burn scar reduction utilizing adjunctive non-invasive laser therapy, reducing the need for invasive scar revision and limiting psychosocial strain. Applicability of Research to Practice In this case series, non-invasive high-intensity laser therapy provided timely decrease in hypertrophic scar characteristics in an outpatient setting. Thus, leading to decrease in invasive operative therapy and overall improvement in quality of life. Further studies are needed to elucidate other benefits and utility of the laser and possible evaluation of keloid scars.

Critical issues of the biopsychosocial treatment of Parkinson’s disease

2015 ◽  
Vol 156 (12) ◽  
pp. 472-478 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
János Kállai
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Health ◽  
Interdisciplinary Approach ◽  
Cognitive Status ◽  
Psychological Burden ◽  
Her Family ◽  
Critical Issues

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson’s disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient’s quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family. Orv. Hetil., 2015, 156(12), 472–478.

scholarly journals Psychological risk factors that characterize the trajectories of quality of life after a physical trauma: a longitudinal study using latent class analysis

2021 ◽  
Author(s):  
Eva Visser ◽  
Brenda Leontine Den Oudsten ◽  
Taco Gosens ◽  
Paul Lodder ◽  
Jolanda De Vries
Keyword(s):  
Quality Of Life ◽  
Latent Class Analysis ◽  
Health Care Providers ◽  
Psychological Health ◽  
Latent Class ◽  
Stress Disorder ◽  
Class Analysis ◽  
Care Providers ◽  
Physical Trauma

Abstract Background The course and corresponding characteristics of quality of life (QOL) domains in trauma population are unclear. Our aim was to identify longitudinal QOL trajectories and determine and predict the sociodemographic, clinical, and psychological characteristics of trajectory membership in physical trauma patients using a biopsychosocial approach. Methods Patients completed a questionnaire set after inclusion, and at 3, 6, 9, and 12 months follow-up. Trajectories were identified using repeated-measures latent class analysis. The trajectory characteristics were ranked using Cohen’s d effect size or phi coefficient. Results Altogether, 267 patients were included. The mean age was 54.1 (SD = 16.1), 62% were male, and the median injury severity score was 5.0 [2.0—9.0]. Four latent trajectories were found for psychological health and environment, five for physical health and social relationships, and seven trajectories were found for overall QOL and general health. The trajectories seemed to remain stable over time. For each QOL domain, the identified trajectories differed significantly in terms of anxiety, depressive symptoms, acute stress disorder, post-traumatic stress disorder, Neuroticism, trait anxiety, Extraversion, and Conscientiousness. Discussion Psychological factors characterized the trajectories during 12 months after trauma. Health care providers can use these findings to identify patients at risk for impaired QOL and offer patient-centered care to improve QOL.

scholarly journals Molecular Mechanisms Associated with ROS-Dependent Angiogenesis in Lower Extremity Artery Disease

Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 735
Author(s):  
Greg Hutchings ◽  
Łukasz Kruszyna ◽  
Mariusz J. Nawrocki ◽  
Ewa Strauss ◽  
Rut Bryl ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Vessel ◽  
Lower Extremity ◽  
Molecular Mechanisms ◽  
Lower Extremities ◽  
Tissue Response ◽  
Peripheral Arteries ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Currently, atherosclerosis, which affects the vascular bed of all vital organs and tissues, is considered as a leading cause of death. Most commonly, atherosclerosis involves coronary and peripheral arteries, which results in acute (e.g., myocardial infarction, lower extremities ischemia) or chronic (persistent ischemia leading to severe heart failure) consequences. All of them have a marked unfavorable impact on the quality of life and are associated with increased mortality and morbidity in human populations. Lower extremity artery disease (LEAD, also defined as peripheral artery disease, PAD) refers to atherosclerotic occlusive disease of the lower extremities, where partial or complete obstruction of peripheral arteries is observed. Decreased perfusion can result in ischemic pain, non-healing wounds, and ischemic ulcers, and significantly reduce the quality of life. However, the progressive atherosclerotic changes cause stimulation of tissue response processes, like vessel wall remodeling and neovascularization. These mechanisms of adapting the vascular network to pathological conditions seem to play a key role in reducing the impact of the changes limiting the flow of blood. Neovascularization as a response to ischemia induces sprouting and expansion of the endothelium to repair and grow the vessels of the circulatory system. Neovascularization consists of three different biological processes: vasculogenesis, angiogenesis, and arteriogenesis. Both molecular and environmental factors that may affect the process of development and growth of blood vessels were analyzed. Particular attention was paid to the changes taking place during LEAD. It is important to consider the molecular mechanisms underpinning vessel growth. These mechanisms will also be examined in the context of diseases commonly affecting blood vessel function, or those treatable in part by manipulation of angiogenesis. Furthermore, it may be possible to induce the process of blood vessel development and growth to treat peripheral vascular disease and wound healing. Reactive oxygen species (ROS) play an important role in regulation of essential cellular signaling pathways such as cell differentiation, proliferation, migration and apoptosis. With regard to the repair processes taking place during diseases such as LEAD, prospective therapeutic methods have been described that could significantly improve the treatment of vessel diseases in the future. Summarizing, regenerative medicine holds the potential to transform the therapeutic methods in heart and vessel diseases treatment.

scholarly journals Quality of Life Prior and in the Course of the COVID-19 Pandemic: A Nationwide Cross-Sectional Study with Brazilian Dietitians

2021 ◽  
Vol 18 (5) ◽  
pp. 2712
Author(s):  
Raquel Adjafre da Costa Matos ◽  
Rita de Cassia Coelho de Almeida Akutsu ◽  
Renata Puppin Zandonadi ◽  
Raquel Braz Assunção Botelho
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
Social Relationship ◽  
Healthcare Professionals ◽  
Life Quality ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Chi Squared

Dietitians as healthcare professionals could decrease their quality of life during the SARS-COV-2 pandemic period; therefore, this study aimed to compare Brazilian dietitians’ perceptions of quality of life before and during the pandemic. This nationwide cross-sectional research aimed to evaluate Brazilian dietitians’ quality of life before and in the course of the COVID-19 pandemic, using a previously validated self-administered instrument WHO-QOL-BREF in Brazilian-Portuguese. The questionnaire was composed of 26 items (four domains) to evaluate life quality (physical, psychological, social relationship, and environment). The questionnaire also presented some sociodemographic variables and three questions about the COVID-19 pandemic. It was applied using GoogleForms® platform (Google LLC, Mountain View, CA, USA). For the statistical analysis of data, Paired T-test, Chi-squared test, and Analysis of Variance were used. A total of 1290 Brazilian dietitians replied to the instrument. Comparing quality of life (QoL) before SARS-COV-2 (3.83 ± 0.59) and during the pandemic (3.36 ± 0.66), data was statistically different. Comparing prior and in the course of the COVID-19 pandemic, all variables and domains presented statistical differences (better before the pandemic period). Among Brazilian dietitians, the psychological health domain was the most affected. The Sars-Cov-2 pandemic negatively impacted the QoL of Brazilian dietitians since health professionals face changes in their lives because of work.

scholarly journals Can biomarkers of extracellular matrix remodelling and wound healing be used to identify high risk patients infected with SARS-CoV-2?: lessons learned from pulmonary fibrosis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
D. J. Leeming ◽  
F. Genovese ◽  
J. M. B. Sand ◽  
D. G. K. Rasmussen ◽  
C. Christiansen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Extracellular Matrix ◽  
Wound Healing ◽  
Lung Function ◽  
Pulmonary Fibrosis ◽  
Interstitial Lung Diseases ◽  
Lessons Learned ◽  
Lung Function Decline ◽  
Tissue Remodelling

AbstractPulmonary fibrosis has been identified as a main factor leading to pulmonary dysfunction and poor quality of life in post-recovery Severe Acute Respiratory Syndrome (SARS) survivor’s consequent to SARS-Cov-2 infection. Thus there is an urgent medical need for identification of readily available biomarkers that in patients with SARS-Cov-2 infection are able to; (1) identify patients in most need of medical care prior to admittance to an intensive care unit (ICU), and; (2) identify patients post-infection at risk of developing persistent fibrosis of lungs with subsequent impaired quality of life and increased morbidity and mortality. An intense amount of research have focused on wound healing and Extracellular Matrix (ECM) remodelling of the lungs related to lung function decline in pulmonary fibrosis (PF). A range of non-invasive serological biomarkers, reflecting tissue remodelling, and fibrosis have been shown to predict risk of acute exacerbations, lung function decline and mortality in PF and other interstitial lung diseases (Sand et al. in Respir Res 19:82, 2018). We suggest that lessons learned from such PF studies of the pathological processes leading to lung function decline could be used to better identify patients infected with SARS-Co-V2 at most risk of acute deterioration or persistent fibrotic damage of the lung and could consequently be used to guide treatment decisions.

Psychological Well-being and Active Ageing: Maintaining Quality of Life in Older Age

2009 ◽  
Vol 24 (S1) ◽  
pp. 1-1 ◽  
Author(s):  
T. McFarquhar ◽  
A. Bowling
Keyword(s):  
Quality Of Life ◽  
Psychological Health ◽  
General Health Questionnaire ◽  
Well Being ◽  
Poor Mental Health ◽  
Postal Survey ◽  
Active Ageing ◽  
Psychological Well Being ◽  
British Sample

Aims:To investigate the relationship between psychological well-being and measures of active ageing in a British sample of older people. Active ageing is the process of optimising opportunities for health, participation and security to embrace quality of life as people age.Methods:A national survey of quality of life and psychological well-being including 999 people aged ≥65 years living in private households in Britain commenced in 1999. in the most recent follow up of 2007, 323 survivors aged ≥72 years completed a postal survey regarding their quality of life and specifically the process of active ageing. A subset of 42 participants was also interviewed qualitatively in 2008 about their perceptions of active ageing. Psychological well-being at baseline was measured using the 12 item General Health Questionnaire (GHQ12) and correlated with measures of active ageing at baseline and in subsequent follow ups. Measures of active ageing included number and frequency of leisure and social activities, physical ability and access to support networks.Results:A significant positive relationship between psychological well being and measures of active ageing was found at baseline (p< 0.05). Measure of active ageing in 2007 were also correlated with psychological well-being at baseline (p< 0.05). Qualitative interviews in 2008 provided additional insights into this relationship.Conclusions:Results suggesting a strong relationship between psychological health and ageing actively. Good psychological health may allow the elderly to maintain an active and fulfilling lifestyle and reduce isolation and dependence, which in turn may protect against some aspects of poor mental health.

scholarly journals Quality of life of patients with obsessive compulsive disorder

2017 ◽  
Vol 29 (1) ◽  
pp. 18-22
Author(s):  
Fahmida Ahmed ◽  
Meherunnessa Begum ◽  
Md Abdul Wahab ◽  
Sayed Kamaluddin Ahmed
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
Psychological Health ◽  
World Health ◽  
Obsessive Compulsive ◽  
World Health Organization Quality ◽  
Compulsive Disorder ◽  
Health Domain ◽  
Quality Of Life Scale

Obsessive-Compulsive Disorder (OCD) is a severe and debilitating anxiety disorder which causes severely impaired quality of life. The objective of the study was to assess the quality of life of the patients suffering from OCD. It was a cross-sectional study conducted from January 2011 to June 2011 among 46 patients who attended the out-patient department of the National Institute of Mental Health Sher-E-Bangla Nagar, Dhaka, Bangladesh and Holy Family Red Crescent Medical College and Hospital, Dhaka, Bangladesh by using purposive sampling technique. A Semi-structured questionnaire, Dhaka University Obsessive Compulsive Scale (DUOCS), World Health Organization Quality of Life-Scale Brief Version (WHOQOL-BREF), Diagnostic and Statistical Manual for Mental Disorder, 4th edition (DSM-IV) were used in each case for this assessment. Results showed that mean age of the patients was (29.07±6.11) years, majority of the respondents (71.7%) were male, 63.0% were unmarried and 34.8% were students. Patients were least satisfied with social domain and patients having only obsession had lower mean score (23.54±1.80) in environmental domain than in patients having both obsession and compulsion (25.15±3.70). OCD patients having major conflict (52.2%) were least satisfied with environmental health domain and patients suffering from OCD for more than ten years (78.3%) had low score than those suffering for less than ten years (21.7%) in overall quality of life domain. Patients having strained family relationship (34.8%) were less satisfied to psychological health domain and patients getting medication (91.3%) had better quality of life in all domains than those getting no medication (8.7%).Bang J Psychiatry June 2015; 29(1): 18-22

scholarly journals Variables associated with health-related quality of life in a Brazilian sample of patients from a tertiary outpatient clinic for depression and anxiety disorders

2015 ◽  
Vol 37 (4) ◽  
pp. 202-208 ◽  
Author(s):  
Bianca Schwab ◽  
Heloisa Silveira Daniel ◽  
Carine Lutkemeyer ◽  
João Arthur Lange Lins Neves ◽  
Louise Nassif Zilli ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Social Relationships ◽  
Psychological Health ◽  
Linear Regression Analysis ◽  
Multiple Linear Regression Analysis ◽  
Depression And Anxiety ◽  
Brazilian Sample ◽  
Related Quality ◽  
Health Related

Introduction: Health-related quality of life (HRQOL) assessment tools have been broadly used in the medical context. These tools are used to measure the subjective impact of the disease on patients. The objective of this study was to evaluate the variables associated with HRQOL in a Brazilian sample of patients followed up in a tertiary outpatient clinic for depression and anxiety disorders. Method: Cross-sectional study. Independent variables were those included in a sociodemographic questionnaire and the Hospital Anxiety and Depression Scale (HADS) scores. Dependent variables were those included in the short version of the World Health Organization Quality of Life (WHOQOL-BREF) and the scores for its subdomains (overall quality of life and general health, physical health, psychological health, social relationships, and environment). A multiple linear regression analysis was used to find the variables independently associated with each outcome. Results: Seventy-five adult patients were evaluated. After multiple linear regression analysis, the HADS scores were associated with all outcomes, except social relationships (p = 0.08). Female gender was associated with poor total scores, as well as psychological health and environment. Unemployment was associated with poor physical health. Conclusion: Identifying the factors associated with HRQOL and recognizing that depression and anxiety are major factors are essential to improve the care of patients.

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