Maggot Therapy in Wound Management in Modern Era and a Review of Published Literature

2010 ◽  
Vol 24 (1) ◽  
pp. 89-93 ◽  
Author(s):  
Liya Davydov
Keyword(s):  
United States ◽  
American Medical Association ◽  
Wound Care ◽  
Cost Effective ◽  
Mechanisms Of Action ◽  
Wound Management ◽  
Maggot Therapy ◽  
Coding Guidelines ◽  
Near Future ◽  
Modern Era

Maggot therapy is an old remedy, which is being looked into with renewed interest. The use of medicinal maggots was approved by Food and Drug Administration (FDA) as a medical device in 2004. Maggot therapy appears to be efficacious, well tolerated, and cost-effective. Because American Medical Association (AMA) and Centers for Medicare and Medicaid (CMS) released reimbursement coding guidelines with regards to maggot therapy, there is a potential for a wider use of maggot therapy in United States in the near future. Several mechanisms of action suggested for maggots in debriding wounds are discussed. While maggot therapy demonstrated effectiveness in necrotic wounds, not all wound types respond well to maggot therapy. Future large, randomized, well-designed studies would help better delineate the place of maggot therapy among other options for wound care, and determine whether maggot therapy should be initiated earlier in the course of treatment, or continued to be used as a last resort.

scholarly journals Telemedicine for wound management

2012 ◽  
Vol 45 (02) ◽  
pp. 412-417 ◽  
Author(s):  
Ravi K. Chittoria
Keyword(s):  
Health Care ◽  
Chronic Wounds ◽  
Wound Care ◽  
Cost Effective ◽  
Skin Lesions ◽  
Wound Management ◽  
Care Practice ◽  
Telemedicine Technology ◽  
Store And Forward ◽  
Financial Burdens

ABSTRACTThe escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer) and real-time transmission (synchronous transfer, e.g. video conference), are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

scholarly journals Study of hydrocellular functional material as microbicidal wound dressing for diabetic wound healing

2021 ◽  
Vol 19 ◽  
pp. 228080002110549
Author(s):  
Michael Rodrigues ◽  
Thilagavati Govindharajan
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Wound Care ◽  
Cost Effective ◽  
Wound Dressings ◽  
Wound Management ◽  
Histopathological Analysis ◽  
Diabetic Wound ◽  
Functional Material ◽  
Diabetic Wound Healing

A hydrocellular functional material as a wound dressing is developed and it is found to be superior in its efficacy as compared to some of the comparator controls in diabetic wound healing studies. A study on wound contraction and Histopathological analysis is done in rats. The efficacy of the dressing is comparable to the established wound dressings like Carboxymethyl cellulose alginate dressings and autolytic enzyme based hydrogel. It is found to be superior to Polyhexamethylene biguanide dressing used as reference controls in this study. The reason for good wound healing performance of the dressing can be attributed to a combined property of effective exudates management and broad spectrum antimicrobial effect. The concept of functional hydro cellular material has shown good results due to the excellent balance of exudates pickup and drying it out. This ensures moist wound healing conditions on the wound. Because of its porous nature it allows good air flow and gaseous exchange in the structure. The cationic sites created on the surface of the dressing ensure a good antimicrobial action on the exudates in the dressing. It reduces the infection load on the wound. The nonleaching property of the dressing also helps in preventing the generation of more resistant and mutant strains of the microbes. The developed dressing can be used as a relatively durable long lasting dressing for wound management in diabetic wounds. The need of repetitive wound dressing changes can be brought down with this concept of dressing. It is not only cost effective in terms of its material cost but also is a cost effective solution when entire wound management cost is considered. Such novel wound dressing material can change the quality of life of diabetic wound patients especially in developing world, where access to functional advanced wound care dressings is limited.

scholarly journals ArcGIS Urban: an application for plan assessment

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Ellen Soward ◽  
Jianling Li
Keyword(s):  
United States ◽  
The United States ◽  
Spatial Context ◽  
Future Studies ◽  
Planning Profession ◽  
Gis Tools ◽  
Comprehensive Plans ◽  
Near Future ◽  
The City

AbstractMost cities in the United States rely on zoning to address important planning-related issues within their jurisdictions. Planners often use GIS tools to analyze these issues in a spatial context. ESRI’s ArcGIS Urban software seeks to provide the planning profession with a GIS-based solution for various challenges, including zoning’s impacts on the built environment and housing capacity.This research explores the use of ArcGIS Urban for assessing the existing zoning and comprehensive plans in meeting the projected residential growth in the near future using the City of Arlington, Texas as a case study. The exploration provides examples and lessons for how ArcGIS Urban might be used by planners to accomplish their tasks and highlights the capabilities and limitations of ArcGIS Urban in its current stand. The paper is concluded with some suggestions for future studies.

scholarly journals Decline in Marriage Associated with the COVID-19 Pandemic in the United States

2020 ◽  
Vol 6 ◽  
pp. 237802312098032
Author(s):  
Brandon G. Wagner ◽  
Kate H. Choi ◽  
Philip N. Cohen
Keyword(s):  
United States ◽  
The United States ◽  
Cumulative Number ◽  
Short Term ◽  
Know How ◽  
The Social ◽  
Reporting Delays ◽  
Social Upheaval ◽  
Near Future ◽  
Do So

In the social upheaval arising from the coronavirus disease 2019 (COVID-19) pandemic, we do not yet know how union formation, particularly marriage, has been affected. Using administration records—marriage certificates and applications—gathered from settings representing a variety of COVID-19 experiences in the United States, the authors compare counts of recorded marriages in 2020 against those from the same period in 2019. There is a dramatic decrease in year-to-date cumulative marriages in 2020 compared with 2019 in each case. Similar patterns are observed for the Seattle metropolitan area when analyzing the cumulative number of marriage applications, a leading indicator of marriages in the near future. Year-to-date declines in marriage are unlikely to be due solely to closure of government agencies that administer marriage certification or reporting delays. Together, these findings suggest that marriage has declined during the COVID-19 outbreak and may continue to do so, at least in the short term.

You’re Fired! Donald Trump and the 2020 Congressional Elections

The Forum ◽  
2020 ◽  
Vol 18 (4) ◽  
pp. 627-650
Author(s):  
Jamie L. Carson ◽  
Spencer Hardin ◽  
Aaron A. Hitefield
Keyword(s):  
United States ◽  
Presidential Election ◽  
Descriptive Analysis ◽  
Vice President ◽  
The United States ◽  
Congressional Elections ◽  
General Election ◽  
Donald Trump ◽  
Modern Era

Abstract The 2020 elections brought to an end one of the most divisive and historic campaigns in the modern era. Former Vice President Joe Biden was elected the 46th President of the United States with the largest number of votes ever cast in a presidential election, defeating incumbent President Donald Trump in the process. The record turnout was especially remarkable in light of the ongoing pandemic surrounding COVID-19 and the roughly 236,000 Americans who had died of the virus prior to the election. This article examines the electoral context of the 2020 elections focusing on elections in both the House and Senate. More specifically, this article examines the candidates, electoral conditions, trends, and outcomes in the primaries as well as the general election. In doing so, we provide a comprehensive descriptive analysis of the climate and outcome of the 2020 congressional elections. Finally, the article closes with a discussion of the broader implications of the election outcomes on both the incoming 117th Congress as well as the upcoming 2022 midterm election.

scholarly journals Antidiabetic Effects of Resveratrol: The Way Forward in Its Clinical Utility

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Omolola R. Oyenihi ◽  
Ayodeji B. Oyenihi ◽  
Anne A. Adeyanju ◽  
Oluwafemi O. Oguntibeju
Keyword(s):  
Diabetes Mellitus ◽  
Clinical Utility ◽  
Therapeutic Agent ◽  
Molecular Targets ◽  
Therapeutic Agents ◽  
Mechanisms Of Action ◽  
Antidiabetic Drug ◽  
Near Future ◽  
Antidiabetic Effects ◽  
The Way

Despite recent advances in the understanding and management ofdiabetes mellitus, the prevalence of the disease is increasing unabatedly with resulting disabling and life-reducing consequences to the global human population. The limitations and side effects associated with current antidiabetic therapies have necessitated the search for novel therapeutic agents. Due to the multipathogenicity ofdiabetes mellitus,plant-derived compounds with proven multiple pharmacological actions have been postulated to “hold the key” in the search for an affordable, efficacious, and safer therapeutic agent in the treatment of the disease and associated complications. Resveratrol, a phytoalexin present in few plant species, has demonstrated beneficial antidiabetic effects in animals and humans through diverse mechanisms and multiple molecular targets. However, despite the enthusiasm and widespread successes achieved with the use of resveratrol in animal models ofdiabetes mellitus, there are extremely limited clinical data to confirm the antidiabetic qualities of resveratrol. This review presents an update on the mechanisms of action and protection of resveratrol indiabetes mellitus, highlights challenges in its clinical utility, and suggests the way forward in translating the promising preclinical data to a possible antidiabetic drug in the near future.

scholarly journals Safety, Efficacy, and Patient Acceptability of the Copper T-380A Intrauterine Contraceptive Device

2011 ◽  
Vol 4 ◽  
pp. CMWH.S5332
Author(s):  
Anita L. Nelson
Keyword(s):  
Intrauterine Device ◽  
Cost Effective ◽  
Mechanisms Of Action ◽  
Contraceptive Device ◽  
Menstrual Blood Loss ◽  
First Line ◽  
Medical Problems ◽  
Patient Acceptability ◽  
Cost Effective Method ◽  
Intrauterine Contraceptive

The ParaGard Copper T 380A intrauterine device (CuT380A) provides reversible contraception that is as effective as sterilization for up to 20 years. The CuT380A is a mainstream, first-line contraceptive option for most healthy women, including nulligravid women, as well as many women who have serious medical problems. Because it is the most cost-effective method of birth control, the CuT380A is the preferred IUD, except for women who desire lighter or no menstrual blood loss. Surveys reveal that 95% of US CuT380A users are “very” or “somewhat” satisfied with their method. This article describes current candidates for IUD use, discusses the mechanisms of action of the CuT380A, provides guidance to reduce barriers to IUD access, suggests counseling points for patients, and outlines techniques to reduce the risks and side effects that can be associated with use of the CuT380A.

SI Units

PEDIATRICS ◽  
1989 ◽  
Vol 83 (1) ◽  
pp. 129-131
Author(s):  
Keyword(s):  
United States ◽  
American Medical Association ◽  
Scientific Communication ◽  
The United States ◽  
Coherent System ◽  
Common Language ◽  
Si Units ◽  
Drug Concentrations ◽  
Significant Figures ◽  
Base Units

Le Systeme International d'Unites or SI units is a system of measure that is an outgrowth of the metric system, widely used in countries other than the United States. This system comprises seven base units from which all other measurements are made (Table). The aim of SI units is to (1) provide a coherent system of measure, (2) ensure that quantities and units are uniform in concept and style, and (3) minimize the number of multiples and submultiples in common use. A more complete review of metrification and SI units has been published in this journal. The conversion to SI units was mandated in December 1984 by the American Medical Association House of Delegates to "provide physicians and other scientists in the United States with an improved common language for fluent scientific communication between nations as well as between sciences." In several published articles there have been suggestions that the United States should, during the next year, begin uniformly reporting laboratory test data in SI units, including drug concentrations in molar units. Although drugs would continue to be prescribed in mass units, the desirability of prescribing and dispensing drugs in molar units has been suggested. The focus of this commentary is to summarize the problems and inconsistencies of expressing drug concentrations in molar units, assuming that prescribing and dispensing would continue in mass units. PHARMACOKINETIC CALCULATIONS In a recent study tenfold dosing errors were demonstrated, resulting from mathematical miscalculations while using traditional units. The introduction of additional calculations for conversion to SI units, and the fact that SI units involve decimal places with several significant figures, will likely magnify this type of error.

Addressing the Scottish burden of wounds through the Lens of Profound Knowledge

2021 ◽  
Vol 30 (Sup20) ◽  
pp. S34-S40
Author(s):  
Jenni MacDonald
Keyword(s):  
Patient Outcomes ◽  
Wound Care ◽  
Cost Effective ◽  
Theory Of Knowledge ◽  
Care Needs ◽  
Profound Knowledge ◽  
The Cost ◽  
Improve Patient ◽  
Growing Population

The prevalence of wounds and the cost of treating them are increasing year on year. Improving the quality of wound care will improve patient outcomes and is a financial necessity. The Lens of Profound Knowledge is a tool that can be used to support quality improvement and identify where action is needed. It allows exploration of an organisation through four aspects—appreciate the system, understanding variation, psychology, and theory of knowledge—and working on all four aspects simultaneously is believed to increase the likelihood of achieving improvement. Improvements at and between all levels—microsystem (such as frontline services), mesosystem (health boards) and macrosystem (NHS Scotland)—would reduce variation in practice and prove to be both clinically and cost-effective. Given the rapidly growing population of people with unhealed wounds, wound care needs to be valued at all system levels and be adequately resourced.

scholarly journals Surgical instrumentation: the true cost of instrument trays and a potential strategy for optimization

2015 ◽  
Vol 4 (6) ◽  
pp. 82 ◽  
Author(s):  
Julie M. Mhlaba ◽  
Emily W. Stockert ◽  
Martin Coronel ◽  
Alexander J. Langerman
Keyword(s):  
United States ◽  
Cost Savings ◽  
Cost Effective ◽  
The United States ◽  
Waste Reduction ◽  
Significant Cost ◽  
Instrument Type ◽  
Hospital Revenue ◽  
Potential Strategy ◽  
The Cost

Objective: Operating rooms (OR) generate a large portion of hospital revenue and waste. Consequently, improving efficiency and reducing waste is a high priority. Our objective was to quantify waste associated with opened but unused instruments from trays and to compare this with the cost of individually wrapping instruments.Methods: Data was collected from June to November of 2013 in a 550-bed hospital in the United States. We recorded the instrument usage of two commonly-used trays for ten cases each. The time to decontaminate and reassemble instrument trays and peel packs was measured, and the cost to reprocess one instrument was calculated.Results: Average utilization was 14% for the Plastic Soft Tissue Tray and 29% for the Major Laparotomy Tray. Of 98 instruments in the Plastics tray (n = 10), 0% was used in all cases observed and 59% were used in no observed cases. Of 110 instruments in the Major Tray (n = 10), 0% was used in all cases observed and 25% were used in no observed cases. Average cost to reprocess one instrument was $0.34-$0.47 in a tray and $0.81-$0.84 in a peel pack, or individually-wrapped instrument.Conclusions: We estimate that the cost of peel packing an instrument is roughly two times the cost of tray packing. Therefore, it becomes more cost effective from a processing standpoint to package an instrument in a peel pack when there is less than a 42%-56% probability of use depending on instrument type. This study demonstrates an opportunity for reorganization of instrument delivery that could result in a significant cost-savings and waste reduction.

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