scholarly journals Towards User-Oriented Recommendations for Local Therapy of Leg and Foot Ulcers—An Update of a S3-German Guideline

2021 ◽  
Vol 9 (3) ◽  
pp. 54
Author(s):  
Marion Burckhardt ◽  
Brigitte Nink-Grebe ◽  
Andreas Maier-Hasselmann
Keyword(s):  
Wound Care ◽  
Local Therapy ◽  
Foot Ulcers ◽  
Inclusion Criteria ◽  
S3 Guideline ◽  
Guideline Panel ◽  
The Right ◽  
Dynamic Updating ◽  
Stakeholder Requirements ◽  
Key Questions

Background: The German S3- guideline on local therapy of leg ulcers and diabetic foot ulcers is in the process of being updated. Major goals are to improve the guidelines’ applicability and to take steps towards a living guideline according to current methodological standards. The aim of this article is to describe the main measures to achieve these goals. Methods: The context of the guideline in the field of local wound care and the stakeholder requirements are briefly described. Based on a derived framework, the project team adjusted the methods for the guideline. Results: Main adjustments are more specific inclusion criteria, online consensus meetings and the use of an authoring and publication platform to provide information in a multi-layered format. A new set of practice-oriented key questions were defined by the guideline panel to foster the formulation of action-oriented recommendations. Conclusions: The set of new key questions addressing practical problems and patients’ preferences as well as the adjustments made to improve not only the guidelines’ applicability, but also the feasibility of the further dynamic updating processes in the sense of a living guideline, should be steps in the right direction.

Emotion Recognition Deficits in Psychiatric Disorders as a Target of Non-invasive Neuromodulation: A Systematic Review

2021 ◽  
pp. 155005942199168
Author(s):  
Yuji Yamada ◽  
Takuma Inagawa ◽  
Naotsugu Hirabayashi ◽  
Tomiki Sumiyoshi
Keyword(s):  
Systematic Review ◽  
Social Cognition ◽  
Emotion Recognition ◽  
Psychiatric Disorders ◽  
Parietal Lobe ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Inclusion Criteria ◽  
Cognitive Benefits ◽  
The Right ◽  
English Articles

Background. Social cognition deficits are a core feature of psychiatric disorders, such as schizophrenia and mood disorder, and deteriorate the functionality of patients. However, no definite strategy has been established to treat social cognition (eg, emotion recognition) impairments in these illnesses. Here, we provide a systematic review of the literature regarding transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS) for the treatment of social cognition deficits in individuals with psychiatric disorders. Methods. A literature search was conducted on English articles identified by PubMed, PsycINFO, and Web of Science databases, according to the guidelines of the PRISMA statement. We defined the inclusion criteria as follows: (1) randomized controlled trials (RCTs), (2) targeting patients with psychiatric disorders (included in F20-F39 of the 10th revision of the International Statistical Classification of Diseases and Related Health Problems [ICD-10]), (3) evaluating the effect of tDCS or rTMS, (4) reporting at least one standardized social cognition test. Results. Five papers (3 articles on tDCS and 2 articles on rTMS) met the inclusion criteria which deal with schizophrenia or depression. The significant effects of tDCS or rTMS targeting the left dorsolateral prefrontal cortex on the emotion recognition domain were reported in patients with schizophrenia or depression. In addition, rTMS on the right inferior parietal lobe was shown to ameliorate social perception impairments of schizophrenia. Conclusions. tDCS and rTMS may enhance some domains of social cognition in patients with psychiatric disorders. Further research is warranted to identify optimal parameters to maximize the cognitive benefits of these neuromodulation methods.

Hyperbaric oxygen treatment for University of Texas grade 3 diabetic foot ulcers: a retrospective cohort study

2021 ◽  
Vol 30 (9) ◽  
pp. 722-728
Author(s):  
Rutger C Lalieu ◽  
Willem Mulder ◽  
René D Bol Raap ◽  
Saskia Stolk ◽  
Casper Smit ◽  
...  
Keyword(s):  
Wound Healing ◽  
Cohort Study ◽  
Retrospective Cohort ◽  
Wound Care ◽  
Complete Healing ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
University Of Texas ◽  
Complete Wound Healing ◽  
Grade 3

Aim: Hard-to-heal diabetic foot ulcers (DFUs) may increase the risk of amputation. This study reports the positive influence of hyperbaric oxygen therapy (HBOT) on hard-to-heal DFUs involving underlying bone. Method: A single-centre, retrospective cohort study reporting the results of HBOT and wound care on hard-to-heal University of Texas grade 3 DFUs (i.e., involving underlying bone) between 2013 and 2019. Outcome measures were primarily (near-) complete wound healing (i.e., ≥80% ulcer surface area reduction) and amputation rate (minor or major), and secondarily the number of hyperbaric sessions and improvement in quality of life (QoL) and pain score. Results: The study included 206 patients, of whom 74 (36%) achieved complete wound healing, and 75 (36%) near-complete healing. Amputations were performed in 27 patients (13%): 12 (6%) minor and 15 (7%) major. The median number of HBOT sessions was 42. Participants who achieved complete healing received a median of 43 sessions, compared with 10 for those who required major amputation. Patients with at least 30 sessions were less likely to undergo amputation (odds ratio: 0.08; 95% confidence interval (CI): 0.03–0.21). Mean QoL increased by 7.6 points (95%CI: 3.9–11.3; p<0.01) and median pain score fell from 3 to 1 (0–3) (p<0.01). Conclusions: The addition of HBOT to standard wound care may lead to a decreased amputation risk, improved wound healing and increased QoL for people with a University of Texas grade 3 DFU. An adequate number of HBOT sessions is required to achieve optimal clinical results. Objective selection criteria and shared decision-making are suggested to improve dropout rates.

What are the most effective wound care measures for diabetic foot ulcers?

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Jillian Trieff Waller ◽  
Karen Borchert
Keyword(s):  
Diabetic Foot ◽  
Wound Care ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers

scholarly journals Transnational Feminisms, Nonideal Theory, and “Other” Women’s Power

2017 ◽  
Vol 3 (1) ◽  
Author(s):  
Serene J Khader
Keyword(s):  
Amartya Sen ◽  
Gender Justice ◽  
Nonideal Theory ◽  
Epistemic Practices ◽  
Just Culture ◽  
Multiple Strategies ◽  
Women's Power ◽  
Women's Oppression ◽  
The Right ◽  
Key Questions

Postcolonial and transnational feminists’ calls to recognize “other” women’s agency have seemed to some Western feminists to entail moral quietism about women’s oppression. Here, I offer an antirelativist framing of the transnational feminist critiques, one rooted in a conception of transnational feminisms as a nonideal theoretical enterprise. The Western feminist problem is not simple ethnocentrism, but rather a failure to ask the right types of normative questions, questions relevant to the nonideal context in which transnational feminist praxis occurs. Instead of asking which forms of power are gender-justice-enhancing, Western feminists are fixated on contrasting “other” cultures to an idealized Western culture. A focus on ideal theorizing works together with colonial epistemic practices to divert Western feminist attention from key questions about what will reduce “other” women’s oppression under conditions of gender injustice and ongoing imperialism. Western feminists need to ask whether “other” women’s power is resistant, and answering this question requires a focus on what Amartya Sen would call “justice enhancement” rather than an ideal of the gender-just culture. I show how a focus on resistance, accompanied by a colonialism-visibilizing hypothesis and a normative vision that allows multiple strategies for transitioning out of injustice, can guide Western feminists toward more appropriate questions about “other” women’s power.

scholarly journals Restorative minimally invasive interventions in patients with colostomy

2018 ◽  
Vol 99 (6) ◽  
pp. 1004-1008
Author(s):  
F Sh Akhmetzyanov ◽  
N A Valiev ◽  
A N Daminov ◽  
B Sh Bikbov
Keyword(s):  
Surgical Intervention ◽  
Surgical Trauma ◽  
Distal Stump ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Intestinal Continuity ◽  
Intestinal Stoma ◽  
The Right ◽  
Medical Indications ◽  
Oncology Center

Aim. To show the benefits of performing mini-access restorative phase on the colon in patients with colostomy. Methods. A retrospective analysis of the results of closure stomy operations in 2011-2017 in two emergency cancer departments of Republican Clinical Oncology Center MH RT was conducted. The inclusion criteria of the study were: 1) surgical intervention for acute intestinal obstruction in colorectal cancer performed in RCOC; 2) mandatory removal of the primary tumor during the first surgery; 3) the presence of a functioning intestinal stoma formed during the first surgery; 4) fixation of both stumps in one stoma. The exclusion criteria were refusal to restore the continuity of the colon for medical indications and the patient's refusal to undergo the surgery. Results. The study included 11 males (44 %) and 14 females (56 %). The age interval was 49 to 81 years, of which 12 patients were over 70 years old (48 %), the average age was 67.7 ± 5.4 years. The tumor removed at the first stage was localized in the right parts of the colon in 5 patients (20 %), and in the left in 20 patients (80 %). By the stages of the malignant process, the patients were distributed as follows: stage B - 14 cases (56 %), stage C - 10 (40 %), stage D - 1 (4 %). The average duration of the surgery was 53 ± 14.38 minutes (40 to 123). The postoperative period was 10.8 ± 1.92 days on average (5 to 18). Conclusion. Restoration of intestinal continuity through mini-paracolostomy access is technically rational, as due to the mini-access the patient undergoes minor surgical trauma; the anatomical proximity of the anastomosed bowel stumps excludes the difficulties associated with the search for the distal stump in the traditional method of recovery; the duration of the postoperative hospital stay decreases significantly.

INTERDISCIPLINARY APPROACH TO THE TREATMENT OF INFANT HEMANGIOMA

2021 ◽  
Vol 100 (3) ◽  
pp. 174-182
Author(s):  
N.P. Kotlukova ◽  
◽  
T.S. Belysheva ◽  
T.T. Valiev ◽  
N.K. Konstantinova ◽  
...  
Keyword(s):  
Laser Therapy ◽  
Soft Tissues ◽  
Treatment Algorithm ◽  
Clinical Manifestations ◽  
Local Therapy ◽  
Interdisciplinary Approach ◽  
Premature Baby ◽  
Maximum Effect ◽  
Ultrasound Diagnostics ◽  
The Right

The aim of the study is to find the best approaches to the treatment of infantile hemangiomas (IH). Materials and methods of research: the experience of treatment of pediatric patients with IH of various localization is presented, which was carried out according to the protocol elaborated by the authors. Systemic therapy with propranolol, local therapy, laser therapy were used in the complex of treatment. The age of patients at the beginning of therapy ranged from 1 month up to 4,5 years. Results: in all cases, patients with propranolol treatment showed a quick and stable effect. Even at the time of the selection of the dose of the drug, IH patients began to involute, became paler, less tense. The thickness of the soft tissues in the IH area decreased by 65% compared to the baseline, the number of functioning vessels decreased by 86%. The maximum effect was achieved within the first 6 months from the start of therapy. Clinical case report – a 2,5-year-old child with extensive hemangioma of the right buttock. There was a complex treatment with propranolol, local therapy, laser therapy. The general course of treatment with propranolol was 2 years 8 months. The total number of laser interventions was 6 with the overall effect in the form of maximum regression of residual clinical manifestations of IH. A positive clinical and ultrasound picture was noted, indicating a pronounced involution of IH, and a gradual withdrawal of propranolol was started. Conclusion: the effectiveness of a comprehensive interdisciplinary approach to the treatment of extensive complicated IH was demonstrated with the participation of specialists of various disciplines: pediatricians, cardiologists, surgeons, specialists in functional and ultrasound diagnostics, specialists in laser therapy, endocrinologists in a severe premature baby with a large number of somatic problems. The clinical treatment algorithm developed and implemented for patients with IH makes it possible to avoid more aggressive methods of treatment of this pathology and to improve the quality of life of this category of patients. On the basis on the results obtained, indications for laser therapy with a selective pulsed laser were formulated.

Conclusion

2018 ◽  
pp. 246-256
Author(s):  
Steven Hurst
Keyword(s):  
Nuclear Weapons ◽  
Islamic Republic ◽  
Political Factions ◽  
The Usa ◽  
The Right ◽  
Made In ◽  
Key Questions

The conclusion summarizes the arguments made in the previous chapters and returns to the key questions raised in the introduction. It concludes that the available evidence suggest that the Islamic Republic was not bent on the development of nuclear weapons and that key political factions within Iran were happy to forego them in return for reciprocal concessions from the USA. It further follows from that conclusion that claims that the JCPOA represented a successful coercion of Iran through sanctions are wide of the mark. Iranian leaders had been prepared to offer a compromise before effective sanctions were imposed and a deal was only reached when Obama conceded Iran the right to continue enriching uranium. Finally, the chapter argues, based on these conclusions, that Donald Trump's decision to abandon the agreement and re-impose sanctions is unlikely to produce the concessions from Iran that he desires

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