scholarly journals Therapy of patients with congenital epidermolysis bullosa using modern non-adherent wound dressings

2019 ◽  
Vol 95 (1) ◽  
pp. 30-40
Author(s):  
A. A. Kubanov ◽  
A. E. Karamova ◽  
V. I. Albanova ◽  
E. S. Monchakovskaya
Keyword(s):  
Clinical Efficacy ◽  
Epidermolysis Bullosa ◽  
Data Reduction ◽  
Objective Assessment ◽  
Complete Healing ◽  
Baseline Data ◽  
Wound Dressings ◽  
Slight Reduction ◽  
Reduction Of Pain ◽  
Inflammation Signs

Aim. To evaluate the clinical efficacy of modern atraumatic non-adherent wound dressings in patients with congenital epidermolysis bullosa. Materials and methods. The study involved 9 patients diagnosed with congenital epidermolysis bullosa (EB), including 7 women and 2 men aged 21–50 years. All the patients underwent immunofluorescent antigenic mapping of skin biopsies to confirm the clinical diagnosis. External therapy using modern atraumatic non-adherent wound dressings was performed in all the patients. The evaluation of the clinical efficacy of the applied therapy was carried out on the 14th and 30th day in accordance with the following criteria: complete healing of erosions or ulcers; significant improvement (reduction of erosions/ulceration by at least 75 % compared with the baseline data, reduction of exudate, the presence of granulations, reduction of inflammation signs, reduction of pain); improvement (reduction of erosions/ulceration area by less than 75 %, but more than 25 % compared with the baseline data, reduction of exudate, presence of granulations, reduction of inflammation signs, reduction of pain); without change (reduction of erosions/ulceration by less than 25 % or no change compared with the baseline data, a slight decrease in the amount of exudate, no granulations, a slight decrease in inflammation signs, a slight reduction of pain); deterioration (increase in the area of erosions/ulceration, increase in the amount of exudate, the level of inflammation and subjective estimation either increases or remains the same). Results. On the 14th day, 22 out of 58 (37.9 %) erosions were epithelized. The area of 15 erosions was reduced by more than 75 %. The area of 12 erosions (20.6 %) was reduced by more than 25 %, but less than 75 %. The area of 7 (12.25 %) erosions decreased by less than 25 %. The area of 2 erosions in patients with severe generalised recessive dystrophic epidermolysis bullosa (RDEB) increased (3.45 %). Out of 36 erosions that had not been epithelized by the 14th day, 20 (55.5 %) achieved complete healing by the 30th day. The dimensions and characteristics of 5 (13.8 %) nonhealing erosive-ulcerative defects had remained unchanged by the 30th day. The share of reduction in the area of these defects did not exceed 30 %. Conclusion. The obtained results demonstrate the clinical efficacy of external therapy using modern atraumatic nonadherent wound dressings. The dynamic observation of erosive-ulcerative defects, regular documentation of changes in the parameters of erosive and ulcerative defects allows the development of standardised approaches of efficient external therapy in such conditions, including the selection of non-adherent dressings. Objective assessment of the dynamics of erosive-ulcerative skin defects contributes to the development of individualized plans for treating EB patients.

scholarly journals Clinical Efficacy of Combination of Rifampin and Streptomycin for Treatment of Mycobacterium ulcerans Disease

2010 ◽  
Vol 54 (9) ◽  
pp. 3678-3685 ◽  
Author(s):  
Fred Stephen Sarfo ◽  
Richard Phillips ◽  
Kingsley Asiedu ◽  
Edwin Ampadu ◽  
Nana Bobi ◽  
...  
Keyword(s):  
Body Weight ◽  
Clinical Efficacy ◽  
Healing Rate ◽  
Average Rate ◽  
Community Setting ◽  
Skin Grafting ◽  
Complete Healing ◽  
Mycobacterium Ulcerans ◽  
The Times

ABSTRACT We have evaluated the clinical efficacy of the combination of oral rifampin at 10 mg/kg of body weight and intramuscular streptomycin at 15 mg/kg for 8 weeks (RS8), as recommended by the WHO, in 160 PCR-confirmed cases of Mycobacterium ulcerans disease. In 152 patients (95%) with all forms of disease from early nodules to large ulcers, with or without edema, the lesions healed without recourse to surgery. Eight patients whose ulcers were healing poorly had skin grafting after completion of antibiotics. There were no recurrences among 158 patients reviewed at the 1-year follow-up. The times to complete healing ranged from 2 to 48 weeks, according to the type and size of the lesion, but the average rate of healing (rate of reduction in ulcer diameter) varied widely. Thirteen subjects had positive cultures for M. ulcerans during or after treatment, but all the lesions healed without further antibiotic treatment. Adverse events were rare. These results confirm the efficacy of RS8 delivered in a community setting.

scholarly journals New protocol treatment of pseudo-syndactyly in the Epidermolysis Bullosa hand using the dermal regeneration template glove

2020 ◽  
Author(s):  
Fedele Lembo ◽  
Domenico Parisi ◽  
Liberato Roberto Cecchino ◽  
Francesco Ciancio ◽  
Alessandro Innocenti ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Epidermolysis Bullosa ◽  
Hand Surgery ◽  
Complete Healing ◽  
Long Term Results ◽  
Minimal Trauma ◽  
Stay Time ◽  
Dermal Regeneration Template ◽  
Microsurgical Approach ◽  
Dermal Regeneration

Abstract BACKGROUNDː The Epidermolysis Bullosa (EB) is a rare congenital disease associated with blistering skin caused by minimal trauma. Because of its exposed position and its continued use in daily activities, the hand is constantly at risk of microtrauma and is therefore one of the organs most affected by the disease with highly disabling deformities that represents a challenging field in hand surgery practice.METHODSː The Authors present their experience in the microsurgical treatment of pseudosyndactylies comparing the classic dressing with vaseline gauze with our innovative “glove protocol” using a Dermal Regeneration Template. The endpoints analyzed were: healing times, hospital stay time, discomfort for the patient, free-recurrence interval, follow-up range and major complications.RESULTSː A total of 34 procedures were performed on 24 EB patients with hand deformities according to the proposed treatment strategy. We observed reduction of: hospital stay time, complete healing times, discomfort after dressings and average time to free recurrence.CONCLUSIONSː The microsurgical approach followed by our new protocol described in the study has been beneficial in providing consistent and successful long-term results for these patients.

The Treatment of Long-Standing Venous Ulcers with an Extract of Early Placenta – a Pilot Study

1991 ◽  
Vol 6 (3) ◽  
pp. 153-158 ◽  
Author(s):  
Tina Beaconsfield ◽  
Olga Genbačev ◽  
R.S. Taylor
Keyword(s):  
Pilot Study ◽  
Physiological Activity ◽  
Healing Process ◽  
Complete Healing ◽  
Wound Dressings ◽  
Cytosol Fraction ◽  
Venous Ulcers ◽  
Surgical Wounds ◽  
Early Placenta

The human placenta and its membranes have been used intermittently as wound dressings for more than 70 years. Term placenta is known to contain a number of growth factors essential to the healing process. The intense physiological activity of early placenta suggested that it should have similar attributes and we tested this hypothesis on one of the most refractory of all wounds – ulcers caused by chronic venous insufficiency. The cytosol fraction of 6–8 week placenta was incorporated under sterile conditions into an inactive cream vehicle and applied daily to the ulcer. The preparation and quality control of this extract are described. Eighteen patients were treated in this pilot study. The chronicity of the ulcers varied from 12 weeks to 30 years, and all had previously received conventional therapy. Ten patients with bilateral ulcers had treatment with the test preparation on one side only thereby serving as their own controls. Granulation tissue appeared between the 7th and 17th day after starting treatment, and epithelialization began within 2 weeks thereafter. The preparation produced complete healing in all cases and took 12 to 24 weeks, depending on ulcer size. None of the untreated ulcers were closed at the end of the trial. No breakdown has been seen so far on follow-up. The healing effect suggests that trophoblast might supply the missing factor(s) normally operative in surgical wounds and uninfected traumatic wounds.

Effects of Colchicine on NSAID-Induced Severe Small Intestinal Damage: A Pilot Study

Digestion ◽  
2020 ◽  
pp. 1-6
Author(s):  
Koji Otani ◽  
Toshio Watanabe ◽  
Akira Higashimori ◽  
Yuji Nadatani ◽  
Yasuaki Nagami ◽  
...  
Keyword(s):  
Pilot Study ◽  
Clinical Efficacy ◽  
Nlrp3 Inflammasome ◽  
Colchicine Treatment ◽  
Complete Healing ◽  
Inflammasome Activation ◽  
Intestinal Damage ◽  
Blood Tests ◽  
Elevated Liver Enzymes ◽  
Small Intestinal

<b><i>Background:</i></b> We previously reported that nonsteroidal anti-inflammatory drugs (NSAIDs) induced small intestinal damage through nucleotide-binding oligomerization domain-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome-dependent interleukin-1β secretion in mice. Our further study demonstrated that colchicine, a therapeutic agent for gout, significantly suppressed NSAID-induced small intestinal damage by inhibiting NLRP3 inflammasome activation in mice. However, clinical efficacy of colchicine for NSAID-induced small intestinal damage has not been established. <b><i>Objectives:</i></b> We examined the clinical efficacy of colchicine in patients with NSAID-induced severe small intestinal damage as an animal-to-human translational research. <b><i>Methods:</i></b> This is a single-center, single-arm, prospective pilot study. From February 2017 to March 2019, we performed video capsule endoscopy (VCE) to screen 10 patients who took NSAIDs continuously for more than 3 months, and 7 of those with severe small intestinal damage were enrolled. Participants were treated with oral colchicine 0.5 mg twice daily for 8 weeks and thereafter followed up with blood tests and VCE. <b><i>Results:</i></b> After 8 weeks of colchicine treatment, complete healing was achieved in 4 patients (57.1%), and the median number of small erosions decreased significantly from 7.0 (range, 5.0–10.5) to 0.0 (range, 0.0–2.3) (<i>p</i> = 0.031). One patient withdrew due to diarrhea, and 5 patients revealed slightly elevated liver enzymes during the study. No other adverse events including changes in blood tests and clinical symptoms were observed. <b><i>Conclusions:</i></b> Colchicine treatment achieved a high rate of complete healing in patients with NSAID-induced severe small intestinal damage.

scholarly journals Clinical Efficacy of Minimally Invasive Transpedicular Stabilization for Thoracic and Lumbar Vertebrae Fractures

2016 ◽  
Vol 23 (1) ◽  
pp. 15-20
Author(s):  
V. A Byval’tsev ◽  
A. A Kalinin ◽  
A. E Budaev
Keyword(s):  
Blood Loss ◽  
Clinical Efficacy ◽  
Lumbar Vertebrae ◽  
Pain Syndrome ◽  
Female Ratio ◽  
Duration Of Surgery ◽  
Male Female Ratio ◽  
Reduction Of Pain ◽  
Transpedicular Stabilization ◽  
Lumbar Fractures

Clinical efficacy of percutaneous transpedicular stabilization for the treatment of patients with A2 and A3 traumatic compression thoracic and lumbar fractures was performed. The study included 25 patients with mean age 34 (29-42) years. The male-female ratio was 2:1. Severity of pain syndrome by analog visual scale (VAS), quality of life by Oswestry Disability Index (ODI), duration of surgery and blood loss, patient outcome satisfaction by MacNab's criteria and rate of complications were assessed. Mean duration of surgery made up 120 (90-140) min, median blood loss - 50 (30-80) ml. Marked postoperative reduction of pain syndrome (p

Comparison of the Clinical Efficacy of 2.5% Non-Heated Sodium Hypochlorite and 2.5% Heated Sodium Hypochlorite as Irrigation to Control Postoperative Pain in Single Visit Root Canal Treatment

2021 ◽  
Vol 15 (8) ◽  
pp. 2220-2223
Author(s):  
Muhammad Waleed ◽  
Farah Tasleem ◽  
Sarwanand . ◽  
Noorullah Jagirani ◽  
Fozia Rajput ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Clinical Efficacy ◽  
Sodium Hypochlorite ◽  
Root Canal ◽  
Root Canal Treatment ◽  
Sodium Hypochlorite Solution ◽  
Hypochlorite Solution ◽  
Single Visit ◽  
Significant Difference ◽  
Reduction Of Pain

Objective: To compare the clinical efficacy of 2.5% non-heated sodium hypochlorite and 2.5% heated sodium hypochlorite as irrigation to control postoperative pain in single visit root canal treatment. Study Design: Comparative analytical study Place and Duration: Operative dentistry department of Liaquat University of Medical and Health Sciences, Jamshoro for 6 months duration from March 2017 to September 2017. Material and Methods: A total of 60 patients with single rooted maxillary and mandibular permanent teeth were randomly allocated into two groups. 30 patients were in group A and treated with non heated sodium hypochlorite solution and 30 patients in group B were treated with 2.5% heated sodium hypochlorite solution. In both groups, the level of pain was measured postoperatively after 48 hours by using Heft Parker visual Analog Scale of 10 and information was collected on Performa. Results: The average age of the patients was 28.62±6.06 years. There were 40(66.7%) male and 20(33.3%) female. Pain was reduced in both groups but there were no significant difference in reduction of pain between groups (p=0.640). Conclusion: Severity of pain was not statistically significant between groups. At 48 hours, Pain was reduced in both groups but there were no significant difference in reduction of pain between groups. Heated sodium hypochlorite to relieve postoperative pain, it should be new trend for recommendation for treatment of irreversible pulpitis in single visit root canal treatment. Key Words: Root canal, Heated sodium hypochlorite, Postoperative pain.

scholarly journals Cells from discarded dressings differentiate chronic from acute wounds in patients with Epidermolysis Bullosa

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ignacia Fuentes ◽  
Christina Guttmann-Gruber ◽  
Birgit Tockner ◽  
Anja Diem ◽  
Alfred Klausegger ◽  
...  
Keyword(s):  
Epidermolysis Bullosa ◽  
Chronic Wounds ◽  
Cost Effective ◽  
Wound Dressings ◽  
Impaired Wound Healing ◽  
Adaptive Immune Cells ◽  
Large Numbers ◽  
Wide Range ◽  
Invasive Method ◽  
Single Cell Profiling

Abstract Impaired wound healing complicates a wide range of diseases and represents a major cost to healthcare systems. Here we describe the use of discarded wound dressings as a novel, cost effective, accessible, and non-invasive method of isolating viable human cells present at the site of skin wounds. By analyzing 133 discarded wound dressings from 51 patients with the inherited skin-blistering disease epidermolysis bullosa (EB), we show that large numbers of cells, often in excess of 100 million per day, continually infiltrate wound dressings. We show, that the method is able to differentiate chronic from acute wounds, identifying significant increases in granulocytes in chronic wounds, and we show that patients with the junctional form of EB have significantly more cells infiltrating their wounds compared with patients with recessive dystrophic EB. Finally, we identify subsets of granulocytes and T lymphocytes present in all wounds paving the way for single cell profiling of innate and adaptive immune cells with relevance to wound pathologies. In summary, our study delineates findings in EB that have potential relevance for all chronic wounds, and presents a method of cellular isolation that has wide reaching clinical application.

scholarly journals Tolperisone in the combination treatment of muscular tonic syndrome in individuals with a high level of physical activity

2021 ◽  
pp. 49-58
Author(s):  
O. G. Gutianskii ◽  
A. N. Zarubin
Keyword(s):  
Physical Activity ◽  
Treatment Group ◽  
Combination Therapy ◽  
Clinical Efficacy ◽  
Muscle Soreness ◽  
Comparison Group ◽  
Objective Assessment ◽  
Pain Syndrome ◽  
Before And After ◽  
Acting Muscle

Introduction. Dorsalgia is one of the most common diseases in individuals practising regular physical training and sports Rationale. Because of the growth of the number of physically active individuals expected to rise by 2024, the improvement of drug and physical rehabilitation methods comes into sharp focus.The objective of the study is to evaluate the clinical efficacy of the use of a centrally acting muscle tolperisone-containing relaxant in the combined treatment of dorsalgia accompanied by a muscular tonic syndrome.Materials and methods. In the study, two groups of patients (30 people each) with muscular tonic syndrome received therapy that included NSAIDs and a neurotropic vitamin complex (in the comparison group), and additionally a centrally acting muscle relaxant (in the treatment group).The treatment outcome was assessed by changes in complaints and the objective neurological status of patients, the degree of muscle soreness upon palpation, and the evaluation of pain syndrome using a visual analogue scale.The shear wave elastography (SWE) of defunct muscles was used as an objective assessment method.Earlier in clinical practice, muscle tension in patients was usually assessed using manual palpation, i.e., only qualitatively and subjectively. SWE is an operator-independent, relatively reproducible, and quantitative method for assessing tendons and muscles. SWE was used in this study to obtain more objective assessment and comparison of the elasticity of “affected” and “healthy” symmetrical back muscles before and after the use of drugs.Results. The study showed a high clinical efficacy of tolperisone in the combination therapy of the lower back pain accompanied by muscular tonic syndrome, which was confirmed by a more significant decreased muscle-tonic syndrome based on the evaluation of complaints and the degree of muscle soreness upon palpation, a more pronounced regression of pain syndrome according to VAS in the treatment group of patients vs the comparison group. According to the elastography findings before and after treatment, the group receiving tolperisone showed a more significant decrease in muscular tonic syndrome.Сonclusion. The study confirmed the clinical efficacy of tolperisone manufactured by Sotex pharmaceutical company. On these grounds we recommend that the drug is used in combination therapy for dorsalgias (dorsopathies) accompanied by a muscular tonic (myofascial) syndrome both in patients without a proper level of physical activity, and in those practising regular physical training and sports. 

scholarly journals Clinical Effect of Day-case Arthroscopic Surgery of Tibial Eminence Fracture using the Button Plates for Treatment in Adults

2021 ◽  
Author(s):  
Xiaohui XU ◽  
Huayi WANG ◽  
Feng GUO ◽  
Fengguo CUI
Keyword(s):  
Knee Joint ◽  
Clinical Efficacy ◽  
Subjective Evaluation ◽  
Objective Assessment ◽  
Arthroscopic Surgery ◽  
X Rays ◽  
Lachman Test ◽  
Tibial Eminence Fracture ◽  
Tibial Eminence

Abstract Background: The aim of this paper is to evaluate the early clinical efficacy and complications of arthroscopic treatment of tibial eminence fracture (TEF) with button plates.Methods: Retrospective analysis of patients with TEF fracture treated by arthroscopic surgery was performed. Clinical subjective evaluation included the International Knee Documentation Committee (IKDC) scores, Lysholm knee score, and visual analog scale (VAS). The knee joint scores were evaluated according to the Lysholm score. Clinical objective assessment included the Lachman test, anterior drawer test (ADT), IKDC, and the range of motion. The patient's quality of life was measured using a life summary table. Assessment of fracture healing and internal fixation was performed on lateral X-rays of the knee joint. The patients’ satisfaction was measured and evaluated at the last follow-up in accordance with Marsh criteria. RESULTS: There were 22 patients (22 knees) with a mean age of 33.64 ± 8.60 years. The mean follow-up was 28.36 ± 2.79 months. The difference in Lachman test and ADT before and after the operation was statistically significant. According to the IKDC classification, there were 11 cases with type A, 9 cases with type B, and 2 cases with type C. According to the intra-articular button position classification, the rate of ideal position was 100%. The satisfaction rate was 81.8%.CONCLUSIONS: Day surgery using double-button plates to treat TEF can achieve anatomical reduction, power and stability, and good clinical efficacy.

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