New Perspectives in the Treatment of Decubitus Ulcers

1992 ◽  
Vol 8 (2) ◽  
pp. 5-10 ◽  
Author(s):  
Elisabeth Guggisberg ◽  
Kistnensamy Terumalai ◽  
Jean-Marie Carron ◽  
Charles-Henri Rapin
Keyword(s):  
Early Detection ◽  
Preventive Measures ◽  
Decubitus Ulcer ◽  
Pathological Process ◽  
Careful Examination ◽  
Pressure Sores ◽  
Decubitus Ulcers ◽  
Human Race ◽  
Adequate Knowledge ◽  
Lying Down

Although the consequences of prolonged lying on a hard surface are as old as the human race, publications on this subject are scarce. This is due to the fact that a decubitus ulcer never occurs in isolation but is nearly always a complication of some other condition. The term “decubitus” was already used by Hildnaus in 1590 and is derived from the Latin word decumbere which means “lying down” (1). The most important fact to keep in mind is that pressure sores can be prevented. This is the reason why this article not only discusses the management of pressure sores but also the importance of preventive measures. The basis of effective treatment is early detection and an adequate knowledge of the fundamental pathological process. Only adequate preventive measures, careful examination of the lesions, and a thorough knowledge of the products used can avoid unnecessary suffering by patients.

scholarly journals PENCEGAHAN DAN TATALAKSANA DEKUBITUS PADA GERIATRI

Biomedika ◽  
2019 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Iin Novita Nurhidayati Mahmuda
Keyword(s):  
Health Care ◽  
Geriatric Patients ◽  
Body Movement ◽  
Cost Effective ◽  
Decubitus Ulcer ◽  
Pressure Sore ◽  
Pressure Sores ◽  
Decubitus Ulcers ◽  
Adequate Nutrition ◽  
Aged People

Decubitus ulcer or pressure sore is a serious morbidity in elderly patients. The incidence of pressure sores in geriatric patients is 11%. Population at 70-75 of their aged had a two-fold risk higher for suffering decubitus ulcers compared with 55-69 years of aged people. The highest incidence is in group of 80-84 years old peole. Studies has found 95% of cases are preventable. Prevention efforts have already proven to be more effective and cost effective than treatment. Prevention efforts include mobilization, skin care, fulfillment of fluids and adequate nutrition, the use of tools / aids for body movement, environmental regulation of health care and education. Treatment of decubitus ulcers by administering topical material, systemic drugs or surgery should be done as early as possible. Keyword: decubitus ulcer, geriatric patients, prevention, treatment 

scholarly journals Knowledge and behavior of Indonesian general practitioners on cervical cancer early detection

2020 ◽  
Vol 28 (1) ◽  
pp. 20
Author(s):  
Laila Nuranna ◽  
Nessyah Fatahan ◽  
Alfu Nikmatul Laily ◽  
Gatot Purwoto
Keyword(s):  
Cervical Cancer ◽  
Early Detection ◽  
General Practitioners ◽  
Cross Sectional ◽  
Hpv Dna ◽  
Adequate Knowledge ◽  
Cancer Early Detection ◽  
High Knowledge ◽  
Cross Sectional Design ◽  
And Behavior

Objective: Outline the correlation between cervical cancer-related knowledge and voluntary enrollment on early detection of cervical cancer.Material and Methods: Cross sectional design was performed. The inclusion is general practitioner women which currently married. Knowledge and behavior were assessed using questionnaire.Results: Among 367 respondents who filled the questionnaire, 77.4% of them (284) satisfy the inclusion criteria. 56% has high knowledge, and 42.3% has adequate knowledge. Moreover, 62.7% subjects ever performed cervical cancer early detection to themselves; 39.8% with VIA (visual inspection with acetic acid) and 46.5% with Papsmear and/or HPV DNA. Proportion of no early detection history with low and adequate knowledge 1.9 and 1.5 times simultaneously higher than proportion of no early detection with high knowledge. There is no significant correlation between level of knowledge and early detection history.Conclusion: There was no significant correlation between the level of knowlegde and voluntary enrollment for early detection of cervical cancer for general practitioners in Indonesia.

scholarly journals Previous Long-Term Care Facility Admission as a Risk Factor For Scabies in a Medical Facility

2021 ◽  
Author(s):  
Eunyoung Lee ◽  
Se Yoon Park ◽  
Eunjung Lee ◽  
Tae Hyong Kim
Keyword(s):  
Early Detection ◽  
Long Term Care ◽  
Care Facility ◽  
Careful Examination ◽  
Control Group ◽  
Term Care ◽  
Indwelling Catheters ◽  
Term Care Facility ◽  
Long Term Care Facility

Abstract The aim of study was to elucidate simple and effective risk factors for scabies infection in medical environment for early detection and prevention of exposure to other patients and medical staffs. We conducted a case-control study of patients who were diagnosed with scabies among hospitalized patients between 2008 and 2019 in an acute-care teaching hospital. Each case was matched sex and age with two randomly selected controls without scabies during hospitalization. Clinical characteristics of cases at the time of hospital admission were compared to those of control group. Scabies group included 34 patients and 68 patients were included in control group. Scabies group was admitted more via emergency department and had more history of long-term care facility admission. Scabies group had more indwelling catheters, was more in severe medical status, incommunicable, in a bed ridden condition. Scabies patients also had higher C-reactive protein and lower albumin levels. After adjustment, previous long-term care facility admission alone was associated with scabies (risk ratio 12.74, 95% confidence interval 1.42-114.31, P = 0.023). Careful examination particularly patients with previous long-term care facility admission might useful for early detection of scabies infection.

Neonatal and Pediatric Pressure Injuries Secondary to Limb Splinting for Intravascular Access: Case Series and Literature Review

2018 ◽  
Vol 23 (2) ◽  
pp. 108-116 ◽  
Author(s):  
Kyrie A. Sweeney ◽  
Kate Cogill ◽  
Katrina Davis ◽  
Jacqueline I. Jauncey-Cooke
Keyword(s):  
Literature Review ◽  
Case Series ◽  
Decubitus Ulcer ◽  
Evidence Base ◽  
Infants And Children ◽  
Cochrane Library ◽  
Decubitus Ulcers ◽  
Paediatric Hospital ◽  
Pressure Injury ◽  
The Cochrane Library

Abstract Aim: This review aims to present a case series on pressure injury (PI) formation secondary to limb-splinting for preservation of peripheral intravascular catheter (PIVC) access in neonatal and pediatric patients. A literature review was undertaken to analyze the existing knowledge base on this phenomenon. Background: Medical devices and attachments are considered a risk factor for PI development in neonates, infants, and children. Three cases of PI formation caused by contact with limb boards used to preserve PIVC access were identified in an Australian tertiary pediatric facility during 2016. Methods: A literature search was conducted during December 2017 using the Cumulative Index of Nursing and Allied Health, Excerpta Medica database, MEDLINE, PubMed, and the Cochrane Library. Keywords used were pressure injury(ies), pressure ulcer, pressure ulcers, decubitus ulcer, and decubitus ulcers. Articles were excluded if published before 2006, patients were adolescents or adults, and if injuries were not caused by PIVC-associated limb-splinting. Patients included in the case series were identified through screening of admissions in one ward of a tertiary paediatric hospital. Results: Five low-quality studies were included in the literature review. Three children were included in the case series. Each child acquired a PI subsequent to limb-splinting and taping adjacent to a PIVC. Hydration, nutritional state, and oxygenation did not appear to contribute to PI development in these cases. Conclusions: There is a gap in the evidence base pertaining to PIVC splinting and its involvement with PI formation in neonates, infants, and children. The existing literature provides low-quality evidence this problem exists; thus, further research is recommended.

scholarly journals Knowledge, Awareness, and Perception of Genetic Testing for Hereditary Disorders Among Malaysians in Klang Valley

2020 ◽  
Vol 11 ◽  
Author(s):  
Jia-Jia Chin ◽  
Hong-Wai Tham
Keyword(s):  
Genetic Testing ◽  
Early Detection ◽  
Educational Level ◽  
Field Of Study ◽  
The Public ◽  
Adequate Knowledge ◽  
Hereditary Disorders ◽  
Local Residents ◽  
Klang Valley ◽  
Self Administered Questionnaire

Genetic testing aids patients in making important decisions in the prevention, treatment, or early detection of hereditary disorders. Low awareness of the importance of genetic testing contributes to the increase in the incidence of hereditary disorders. This study aims to explore the knowledge, awareness, and perception of genetic testing for hereditary disorders among local residents of the Klang Valley, Malaysia, and the potential variables that influence their understanding of genetic testing. A survey was conducted in different municipalities of the Klang Valley through self-administered questionnaire assessing the public's knowledge, awareness, and perception of genetic testing. Overall, the results revealed adequate knowledge and positive awareness of genetic testing, in which both were influenced by the respondent's educational level (P < 0.001), field of study (P < 0.001), and status of heard or unheard of genetic testing (P < 0.001). The perception of genetic testing was generally positive and influenced by the respondent's differences in age (P < 0.016), educational level (P < 0.001), field of study (P < 0.001), and status of heard or unheard of genetic testing (P < 0.001). Although positive responses were obtained, ~20.2% of the respondents had never heard of genetic testing. Of the respondents, 24.5% were unwilling to undergo genetic testing, with 25.1% believing that genetic testing tampers with nature and 18% believing that it opposes religion and their beliefs. Such attitude calls for the need to conduct programs to eliminate any misconception, as well as to educate the public to lessen any perceived misunderstanding of the concepts of genetic testing.

scholarly journals 1423. Antibiotic Utilization and Outcomes in Patients with Sacral Osteomyelitis and Decubitus Ulcers

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S518-S519
Author(s):  
Kelly Carpenter Byrge ◽  
Amanda Bailey ◽  
Bryan Harris ◽  
Thomas Talbot ◽  
Patty Wright ◽  
...  
Keyword(s):  
Tissue Culture ◽  
Bone Biopsy ◽  
Antibiotic Use ◽  
Decubitus Ulcer ◽  
Advanced Stage ◽  
Tissue Cultures ◽  
Decubitus Ulcers ◽  
Clinical Concern ◽  
Antibiotic Utilization ◽  
Sacral Osteomyelitis

Abstract Background Osteomyelitis is a common complication of advanced stage pressure ulcers and known to be associated with increased mortality, length of stay (LOS), and treatment costs. However, limited data and lack of guidelines regarding appropriate diagnosis and treatment result in variability in management. We sought to investigate whether microbiology data are associated with reduced antibiotic utilization in patients with osteomyelitis secondary to decubitus ulcers. Methods This retrospective cohort study included hospitalized patients from 2007 to 2015 with an advanced stage (IV or unstageable) sacral decubitus ulcer and clinical concern for osteomyelitis. The exposure group was those who underwent tissue culture (superficial swab, deep bedside or surgical tissue, or bone biopsy). The primary outcome was antibiotic days of therapy (DOT). Additional secondary outcomes including clinical characteristics at presentation, LOS, readmission rates, and antibiotic-related complications were evaluated using Fisher’s exact or Wilcoxon-Mann–Whitney test for continuous variables. Results A total of 220 cases of advanced-stage decubitus ulcer with clinical concern for osteomyelitis were identified. Data abstracted from 40 cases show that tissue cultures were obtained in 22 (55%). Bacterial growth was identified from 100% of samples sent for culture. Antibiotic use prior to admission was the most significant predictor of failure to obtain tissue cultures (P = 0.0002). MRI was performed in 15% of abstracted cases, with radiographic evidence of osteomyelitis noted in 100%. Bone biopsy was performed in 4 cases; bone pathology was not sent in any of these instances. Median antibiotic DOT was 84 days in both groups. Conclusion In cases of sacral osteomyelitis secondary to decubitus ulcers, antibiotic use prior to admission was inversely related to the likelihood of obtaining a tissue culture. When tissue cultures were obtained, they were uniformly positive; however, in our preliminary analysis of 40 cases, this did not appear to influence antibiotic utilization as determined by DOT. Bone biopsy was rarely performed, and when done, was not sent for pathology despite this being recognized as the gold standard in the diagnosis of osteomyelitis. Disclosures All authors: No reported disclosures.

scholarly journals The Story of Equine Atypical Myopathy: A Review from the Beginning to a Possible End

2012 ◽  
Vol 2012 ◽  
pp. 1-14 ◽  
Author(s):  
Dominique-Marie Votion
Keyword(s):  
Dehydrogenase Deficiency ◽  
Preventive Measures ◽  
Clinical Signs ◽  
Pathological Process ◽  
Scientific Data ◽  
Practical Support ◽  
Main Emphasis ◽  
History Of ◽  
Treatment Plans ◽  
Great Step

Atypical myopathy (AM) is a frequently fatal seasonal pasture myopathy that emerges in Europe. Outbreaks are of an acute and unexpected nature and practitioners should be prepared to handle these critically ill patients. This review retraces the history of AM and describes results of epidemiological investigations that were conducted to raise hypotheses concerning the etiology of this devastating disease as well as to be able to suggest potential preventive measures. Also, clinical studies have contributed to a better definition and recognition of the syndrome, whereas elucidation of the pathological process, identified as a multiple acyl-CoA dehydrogenase deficiency (MADD), was a great step forward improving medical management of AM and guiding the search for the etiological agent towards toxins that reproduce the identified defect. Treatment plans can be extrapolated from the described clinical signs and metabolic problems, but they remain limited to supportive care until the causative agent has been identified with certainty. Since treatment is still unsuccessful in the majority of cases, the main emphasis is currently still on prevention. This paper aims at being a practical support for equine clinicians dealing with AM and is based on discussion and comparison of the currently available scientific data.

scholarly journals A Survey About Awareness of Oral Cancer Among The Undergraduate Dental Students

2020 ◽  
Vol 11 (SPL3) ◽  
pp. 1565-1573
Author(s):  
Anushya P ◽  
Keerthi Sasanka L ◽  
Jothi Priya A
Keyword(s):  
Oral Cancer ◽  
Early Detection ◽  
Preventive Measures ◽  
Dental Students ◽  
Oral Diseases ◽  
Prevention Measures ◽  
Teaching Program ◽  
Study Population ◽  
School Of Dentistry ◽  
General Dentist

Dentists have a crucial role within the best prevention measures, controlling etiological factors and early detection. Lack of general dentist carcinoma knowledge has been shown to be a serious factor to delays in referral and treatment. Dentists’ competence and confidence in detecting carcinoma could also be strongly influenced by their school of dentistry training. Hence, it's the responsibility of the school of dentistry to make sure the formation of a generalist with solid technical, scientific, ethical knowledge, promoting good oral hygiene and prevention of oral diseases. Therefore, the aim of this study was to assess dental student’s awareness, role in preventing and early detection of oral cancer. The study population included 100 dental students. The data was collected and statistically analysed. In this present study, 48% male and 52% female participated. Here, 76% of scholars are conscious of carcinoma whereas 24% of scholars are unaware of oral cancer. The risk factors for carcinoma mainly described by the scholars were 44% for smoking and 8% for alcohol consumption. Most of the scholars considered that labial/ buccal mucosa was the commonest site in diagnosis of oral cancer. The early detection of carcinoma improves survival, which was suggested by 46% of scholars. About 59% of scholars reported that they need sufficient knowledge regarding prevention and management of carcinoma. In this present study, out of 100 Dental students who participated in awareness of carcinoma, majority of the dental students were aware and had better knowledge on preventive measures of oral cancer. This study also highlights the necessity for an improvement of the teaching program regarding oral examination.

Autopsy-Based Assessment of Extent and Type of Osteomyelitis in Advanced-Grade Sacral Decubitus Ulcers: A Histopathologic Study

2003 ◽  
Vol 127 (12) ◽  
pp. 1599-1602
Author(s):  
Elizabeth E. Türk ◽  
Michael Tsokos ◽  
G. Delling
Keyword(s):  
Soft Tissue ◽  
Chronic Osteomyelitis ◽  
Imaging Techniques ◽  
Decubitus Ulcer ◽  
Medical Problem ◽  
Considerable Proportion ◽  
Decubitus Ulcers ◽  
Source Of Infection ◽  
Bone Biopsies ◽  
Life Threatening

Abstract Context.—Decubitus ulcers constitute a serious medical problem, often encountered in association with hospitalization or institutionalization in senior citizens' or nursing homes. Potentially life-threatening sepsis has been reported to originate not only from soft tissue infection, but also from osteomyelitis as a complication of involvement of bone tissue in decubitus ulcers. Objective.—To assess the histopathology of osseous structures involved in grade IV decubitus ulcers. Design.—Autopsy-based histopathologic assessment of the presence and extent of osteomyelitis on os sacrum specimens from 28 deceased individuals with grade IV sacral decubitus ulcers using an undecalcified preparation following plastic embedding (staining with Goldner, Kossa modification, toluidine blue, and Giemsa). Results.—The histologic findings were classified in 4 types of pathomorphologic changes: type 1, decubitus ulcer confined to soft tissue, no inflammation (n = 7); type 2, decubitus ulcer involving bone, no inflammation (n = 7); type 3, decubitus ulcer involving bone, inflammation of soft tissue, no osteomyelitis (n = 1); and type 4, decubitus ulcer involving bone, presence of osteomyelitis (n = 13). Type 4 changes are further described as follows: type 4a, chronic osteomyelitis alone (n = 6); and type 4b, chronic and acute osteomyelitic changes (n = 7). More than half of the cases (n = 15) showed no inflammatory reaction within the medullary cavity (types 1–3). In all cases with osteomyelitis, inflammation was exclusively confined to the superficial parts of the os sacrum. Chronic osteomyelitis was seen in all cases in which osteomyelitis was present. In addition, mild acute osteomyelitic changes were observed in 7 cases. Severe liquefying osteomyelitis affecting deeper layers of the os sacrum was not found. Sepsis was present in 2 cases; in one of these cases, the decubitus ulcer was considered a possible source of infection. Conclusions.—Our results provide evidence that in cases of grade IV decubitus ulcers, the macroscopic aspect and clinical imaging techniques may lead to an overestimation of the extent of osseous involvement. We suggest that the investigation of bone biopsies is not necessary in a considerable proportion of cases of grade IV decubitus ulcers in patients without sepsis, as the minor osseous alterations are of little consequence when establishing a therapeutic approach.

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