Management of incontinence-associated dermatitis with topical antibiotics and antifungal medication

2021 ◽  
Vol 30 (Sup4) ◽  
pp. S24-S27
Author(s):  
Chin-Min Wang ◽  
Yu-Ju Chien ◽  
Chiao-Yi Huang ◽  
Na-Chi Su ◽  
Hsing Long Lin ◽  
...  

Objective: The primary goals of managing incontinence-associated dermatitis (IAD) are to control the incontinence and to stop the progress of dermatitis. This study evaluated the effectiveness of using a combination of topical antibiotic and topical antifungal medication to manage IAD. Method: Patients with grade 2 IAD treated with a combination of topical antibiotic Biomycin (CBC Biotechnological and Pharmaceutical, Taiwan) and antifungal clotrimazole (Sinphar Group, Taiwan) between January 2017 and January 2019 were included in this retrospective study. Data collected included patients' age, sex, diagnosis, body mass index, comorbidities and surface area involved. Patients were reviewed fortnightly until the wounds had healed, the patient was discharged or had died. Results: A total of 76 patients were included. There were 39 men and 37 women with a mean age of 74 years. In 58 (76%) patients, the surface area involved was >50cm2, in 13 (17%) patients the involved area was 20–50cm2 and in five (7%) patients the area involved was <20cm2. The mean number of days treated was 10.3 (range: 1–53). A total of 46 (61%) patients showed total healing of their IAD, 17 (22%) patients showed improvement of >50% of the involved area, seven (9%) patients showed improvement of 0–50%, five (7%) patients showed no improvement and one (1%) patient showed an increase in the area involved. Conclusion: This combination of treatment was effective in the management of IAD. It was cheap, easy to apply, easy to remove and easily accessible. It could be used efficiently by the hospital staff and the patient's family.

2021 ◽  
Author(s):  
Solomon Demissie ◽  
Prasad Mergu ◽  
Teshale Fikadu ◽  
Tadios Hailu ◽  
Getachew Abebe ◽  
...  

Abstract Introduction: The spleen is a vital lymphoid soft organ that demands constant attention from the clinical point of view. It is multi-dimensional organs that enlarge in all dimensions in disease conditions. The detection of the spleen by palpation on physical examination is not an approval of an enlarged spleen because an unenlarged spleen may palpable. Therefore, this study aimed to assess the Morphometry of spleen dimensions and its correlates among individuals living in Arba Minch Town by sonographic examinations.Methods and Materials: Community-based cross-sectional study was conducted in Arba Minch town from February 1 to March 30, 2020. A multi-stage systematic and simple random sampling technique was applied to select study participants. Data was entered into Epi-Data version 3.1software and exported to SPSS version 20 software for analysis.Result: A total of 708 individuals, 390 (55.1%) males and 318 (44.9 %) females were included in the current study. The mean splenic length, width, thickness and volume were 10.24 cm, 4.79 cm, 3.93 cm, and 109.34 cm³, respectively. The mean spleen length, width, thickness and volumes among males were 10.64 cm, 4.92 cm, 4.05 cm and 119.81 cm³ and among females were 9.75 cm, 4.63 cm, 3.78 cm and 96.50 cm³ respectively. Significant negative correlations were found between age and spleen dimensions. Significant positive correlations were observed between spleen dimensions and height, weight, Body Mass Index, and Body Surface area. But, the correlation between width and body mass index was non-significant (p-value > 0.05).Conclusion and Recommendations: The spleen dimensions were higher in males than females and have a significant positive correlation with height, weight, Body Mass Index and Body Surface Area except for the width. Further studies in different parts of the country have to be done to have normative data on the dimension of Spleen in Ethiopia.


2021 ◽  
pp. 000313482199198
Author(s):  
Imad El Moussaoui ◽  
Etienne Van Vyve ◽  
Hubert Johanet ◽  
André Dabrowski ◽  
Arnaud Piquard ◽  
...  

Background Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in the world. Our purpose was to evaluate the percentage of excess weight loss (%EWL), resolution of obesity-related comorbidities after SG, and identify predictive factors of weight loss failure. Methods A prospective cohort study of adults who underwent SG during 2014 in 7 Belgian-French centers. Their demographic, preoperative, and postoperative data were prospectively collected and analyzed statistically. Results Overall, 529 patients underwent SG, with a mean preoperative weight and body mass index (BMI) of 118.9 ± 19.9 kg and 42.9 ± 5.5 kg/m2, respectively. Body mass index significantly decreased to 32.2 kg/m2 at 5 years ( P < .001). The mean %EWL was 63.6% at 5 years. A significant reduction in dyslipidemia (28.0%-18.2%), obstructive sleep apnea (OSAS) (34.6%-25.1%), and arterial hypertension (HTN) (30.4%-21.5%) was observed after 5 years, but not for diabetes and gastroesophageal reflux disease (GERD). At multivariate analysis, age >50 years old, BMI >50 kg/m2, and previous laparoscopic adjustable gastric banding (LAGB) remained independent predictors of weight loss failure. Conclusions Five years after SG, weight loss was satisfactory; the reduction of comorbidities was significant for dyslipidemia, OSAS, and HTN, but not diabetes and GERD. Age >50 years old, BMI >50 kg/m2, and previous LAGB were independent predictors of weight loss failure.


2021 ◽  
Vol 9 (7_suppl4) ◽  
pp. 2325967121S0024
Author(s):  
Michael Kucharik ◽  
Paul Abraham ◽  
Mark Nazal ◽  
Nathan Varady ◽  
Wendy Meek ◽  
...  

Objectives: Acetabular labral tears distort the architecture of the hip and result in accelerated osteoarthritis and increases in femoroacetabular stress. Uncomplicated tears with preserved, native fibers can be fixed to acetabular bone using labral repair techniques, which have shown improved outcomes when compared to the previous gold standard, labral debridement and resection. If the tear is complex or the labrum is hypoplastic, labral reconstruction techniques can be utilized to add grafted tissue to existing, structurally intact tissue or completely replace a deficient labrum. The ultimate goal is to reconstruct the labrum to restore the labral seal and hip biomechanics. Clinical outcomes using autografts and allografts from multiple sources for segmental and whole labral reconstruction have been reported as successful. However, reconstruction using autografts has been associated with substantial donor-site morbidity. More recently, all-arthroscopic capsular autograft labral reconstruction has been proposed as a way to repair complex or irreparable tears without the downside of donor-site morbidity. Since all-arthroscopic capsular autograft labral reconstruction is a novel technique, there is limited data in the literature on patient outcomes. The purpose of this study is to report outcomes in patients who have undergone this procedure at a minimum 2-year follow-up. Methods: This is a retrospective case series of prospectively collected data on patients who underwent arthroscopic acetabular labral repair by a senior surgeon between December 2013 and May 2017. Patients who failed at least 3 months of conservative therapy and had a symptomatic labral tear on magnetic resonance angiography (MRA) were designated for hip arthroscopy. The inclusion criteria for this study were adult patients age 18 or older who underwent arthroscopic labral repair with capsular autograft labral reconstruction and completion of a minimum 2-year follow-up. Intraoperatively, these patients were found to have a labrum with hypoplastic tissue (width < 5 mm), complex tearing, or frank degeneration of native tissue. Patients with lateral center edge angle (LCEA) ≤ 20° were excluded from analysis. Using the patients’ clinical visit notes with detailed history and physical exam findings, demographic and descriptive data were collected, including age, sex, laterality, body mass index (BMI), and Tönnis grade to evaluate osteoarthritis. Patients completed patient-reported outcome measures and postoperatively at 3 months, 6 months, 12 months, and annually thereafter. Results: A total of 72 hips (69 patients) met inclusion criteria. No patients were excluded. The cohort consisted of 37 (51.4%) male and 35 (48.6%) female patients. The minimum follow-up was 24 months, with an average follow-up of 30.3 ± 13.2 months (range, 24-60). The mean patient age was 44.0 ± 10.4 years (range 21-64), with mean body mass index of 26.3 ± 4.3. The cohort consisted of 6 (8.3%) Tönnis grade 0, 48 (66.7%) Tönnis grade 1, and 18 (25.0%) Tönnis grade 2. Two (2.8%) progressed to total hip arthroplasty. Intraoperatively, 5 (6.9%) patients were classified as Outerbridge I, 14 (19.4%) Outerbridge II, 45 (62.5%) Outerbridge III, and 8 (11.1%) Outerbridge IV. Seventy-two (100.0%) patients had a confirmed labral tear, 34 (47.2%) isolated pincer lesion, 4 (5.6%) isolated CAM lesion, and 27 (37.5%) had both a pincer and CAM lesion. The mean of differences between preoperative and 24-month postoperative follow-up PROMs was 22.5 for mHHS, 17.4 for HOS-ADL, 32.7 for HOS-Sport, 22.9 for NAHS, 33.9 for iHOT-33. (Figure 1) The mean of differences between preoperative and final post-operative follow-up PROMs was 22.1 for mHHS, 17.6 for HOS-ADL, 33.2 for HOS-Sport, 23.3 for NAHS, and 34.2 for iHOT-33. (Table 1) Patient age and presence of femoroacetabular impingement were independently predictive of higher postoperative PROM improvements at final follow-up, whereas Tönnis grade was not. (Table 2) The proportion of patients to achieve the minimally clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) thresholds were also calculated. (Table 3) Conclusions: In this study of 72 hips undergoing arthroscopic labral repair with capsular autograft labral reconstruction, we found excellent outcomes that exceeded the MCID thresholds in the majority of patients at an average 30.3 months follow-up. When compared to capsular reconstruction from autografts and allografts, this technique offers the potential advantages of minimized donor-site morbidity and fewer complications, respectively. [Table: see text][Table: see text][Table: see text]


Children ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 110
Author(s):  
Sun-Jin Lee ◽  
Sun-Young Kim ◽  
Minsun Kim

Gonadotropin-releasing hormone agonist (GnRHa) therapy is used to control puberty progression and it preserves height potential in patients with idiopathic central precocious puberty (ICPP). This study evaluated the correlation between weight and height gain at menarche following GnRHa treatment among girls with ICPP and relatively central early puberty (EP). We investigated height/weight trends and changes in height from diagnosis to menarche in girls with ICPP and EP treated with GnRHa. The mean difference in height (Δheight) from treatment cessation to menarche was 9.79 ± 3.53 cm. Girls were divided into girls with Δheight ≥ 9.79 cm (Group 1) and girls with Δheight < 9.79 cm (Group 2). Although near adult height was significantly higher in Group 1, the mean body mass index (BMI) and weight were significantly lower at diagnosis, treatment discontinuation, and menarche. The BMI and weight at the three time points were negatively correlated with height. Girls with higher BMI at all three time points had slower growth rates during the study period. Considering that BMI and body weight were closely related to Δheight, proper management of BMI and body weight of girls receiving early puberty treatment might contribute to growth during and after GnRHa treatment.


Author(s):  
V. V. Kucheryavchenko

In recent years, the concept of "metabolic syndrome" has become more spreading, and in parallel with disorders of carbohydrate and lipid metabolism, endothelial dysfunction is no less significant. The aim of our work was to analyze changes in homocysteine (HC) as a marker of metabolic syndrome in patients with an increased body mass index (IBMI) in polytrauma. The study involved 224 patients with polytrauma, who had different initial values of body mass index (BMI) and were treated at the polytrauma department and the intensive care unit for patients with combined injuries for a period from 1 day to 1 year since the moment of injury. All the patients were subjected to identifying the level of serum HC. The patients had the same severity according to the APACHE II scale, 14 ± 5.8, at the admission to the hospital, and were divided into 3 stratified clinical groups depending on the initial values of anthropometric parameters and BMI. The study was conducted on the 1, 3, 7, 14, 30 and 360 days from the date of polytrauma. Assessment of blood serum HC was performed by ELISA. It was found that the overweight patients with BMI ≤ 29.9 demonstrated an increase in the mean values of blood HC on the 7th and 14th days of the treatment, with a further decrease on the 15th day since the date of injury. For the patients with BMI within the range of 30.0 - 39.9, the persistence of the HC index during the first month of the treatment at baseline with an increase on the 360th day was found out. The patients with BMI ˃ 40.0 showed an increase in the level of blood HC through the year since the date of polytrauma. It was revealed that the level of HС directly affects the course of traumatic disease in patients with increased BMI, its severity in terms of uniformity of injuries received and the same range of severity according to the APACHE II scale depends on BMI at the admission to the hospital.


2015 ◽  
Vol 9 (1) ◽  
pp. 46-51 ◽  
Author(s):  
J Minov ◽  
J Karadzinska-Bislimovska ◽  
K Vasilevska ◽  
S Stoleski ◽  
D Mijakoski

Introduction : Non-cystic fibrosis bronchiectasis (NCFB) is a multidimensional disease, and no single isolated parameter is proved to have sufficient power for any overall determination of its severity and prognosis. Objective : To compare the results of the assessment of the NCFB severity with respect to its prognosis in the same patients by two different validated scores, i.e. the FACED score and the Bronchiectasis Severity Index (BSI). Methods : An observational study including 37 patients with NCFB (16 males and 21 female aged 46 to 76 years) was performed. All patients underwent evaluation of the variables incorporated in the FACED score (FEV1 % predicted, age, chronic colonization by Pseudomaonas aeruginosa, radiological extent of the disease, and dyspnea) and in the BSI (age, body mass index, FEV1 % predicted, hospitalization and exacerbations in previous year, dyspnea, chronic colonization by Pseudomaonas aeruginosa and other microrganisms, and radiological extent of the disease). Results : According to the value of the derived overall FACED score we found 17 patients (45.9%) with mild bronchiectasis, 14 patients (37.8%) with moderate bronchiectasis and 6 patients (16.2%) with severe bronchiectasis. The mean derived FACED score was 3.4 ± 1.3. In addition, according to the value of the derived overall BSI score, the frequency of patients with low, intermediate and high BSI score was 16 patients (43,2%), 14 patients (37.8%) and 7 patients (18.9%), respectively. The mean derived BSI score was 6.4 ± 2.5. Conclusion : We found similar results by the assessment of the NCFB severity in regard to its prognosis by both the FACED score and the BSI. Further studies determining how these scores may impact clinical practice are needed.


2019 ◽  
Vol 26 (5) ◽  
pp. 43-52
Author(s):  
V. I. Tseluyko ◽  
L. M. Yakovleva ◽  
D. A. Korchagina

The aim – to study the features of structural and functional remodeling of the left ventricle in patients suffering from arterial hypertension with concomitant hypothyroidism and to determine clinical and past medical history and laboratory factors associated with their development. Materials and methods. 50 patients suffering from hypertension with concomitant hypothyroidism were enrolled into the study. Depending on the level of thyroid stimulating hormone in the serum the examined patients were distributed into two groups of 25 patients with the compensated and 25 with decompensated course of hypothyroidism. The control group consisted of 30 patients with hypertension in which the pathology of the thyroid gland was excluded. The comparison of the main parameters of the echocardiography study of the myocardium has been performed depending on hypothyroidism compensation. Assessment of parameters of transmitral diastolic blood flow has been performed. A regression analysis has been conducted to detect the relation of clinical and past medical history factors and echocardiographic parameters with the development of diastolic dysfunction by E/A ratio. The values of central hemodynamics have been studied for evaluation of the contractile function of the myocardium. Results and discussion. According to the results of the echocardiography of both examined groups it has been found that the final systolic and stroke volume exceeded the parameters of the control group. The mean value of the left ventricle ejection fraction was statistically significantly lower than in the control group (p=0.004). The left ventricle myocardial mass in patients with hypothyroidism was statistically significantly greater than in the control group. It was proved that in patients, who were diagnosed with decompensated hypothyroidism, the mean value of the left atrium size to growth by the degree of 2.7 was statistically significantly higher than in the control group (p=0.01), whereas the average value of the ratio of the size of the left atrium to the surface area of the body had no statistically significant differences between the groups. It has been found that in both groups the proportion of patients with diastolic dysfunction in which the E/A ratio was less than 1.0 was higher than in the control group (р=0.01 and p=0.03, respectively). The independent factors of diastolic dysfunction of the left ventricle in patients with hypertension in the presence of hypothyroidism have been found. Conclusions. In the presence of decompensated hypothyroidism in patients with arterial hypertension, both with obesity and with normal body mass index, left ventricular mass indexes were significantly higher in comparison with a control group. Regardless of the compensation of the thyroid state in patients with arterial hypertension, the ejection fraction was significantly lower. According to regression analysis, independent factors for the development of diastolic dysfunction in patients with arterial hypertension and hypothyroidism with a body mass index ≥ 30 kg/m2 is the index of mass of the left ventricular myocardium, determined by the degree of 2.7, the level of total cholesterol to statistical significance – the level of office systolic blood pressure and the duration of hormone replacement therapy for hypothyroidism; with body mass index < 30 kg/m2 – age and left atrial index, determined by body surface area. For patients with arterial hypertension and reduced thyroid gland function, violation of the left ventricular myocardial relaxation is typical as evidenced by a higher proportion of patients with a decrease in E/A to less than 0.8 in these patients.


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